Influenza A (H1N1) Swine Flu – Update Fifteen

Influenza A (H1N1) Swine Flu – Update Fifteen

1pm Friday 1 May 2009

Please attribute to Dr Mark Jacobs, Director of Public Health

The WHO now refers to the new influenza virus as Influenza A (H1N1).

New Zealand numbers
This morning's situation report shows there are 13 probable cases and 3 confirmed cases of Influenza A (H1N1) Swine Flu.

In addition there are 136 suspected cases. These are people who have developed symptoms of influenza within seven days of having been in the areas of concern or are close contacts of cases and have symptoms.

In total there are 401 people in isolation and being treated with Tamiflu. This includes suspected cases and people without symptoms who are being isolated as a precaution because they are in close contact with a suspected case.

These numbers will fluctuate as a result of more suspected cases being found, or suspected cases being ruled out.

International situation http://www.who.int/en/
As at 9am Friday 1 May 11 countries have officially reported 257 cases of Influenza A (H1N1) Swine Flu infection.
The United States Government has reported 109 laboratory confirmed human cases, including one death. Mexico has reported 97 confirmed human cases of infection, including seven deaths.
The following countries have reported laboratory confirmed cases with no deaths - Austria (1), Canada (19), Germany (3), Israel (2), Netherlands (1), New Zealand (3), Spain (13), Switzerland (1) and the United Kingdom (8).

Tamiflu for normal seasonal influenza
The current stock of Tamiflu is sufficient to provide cover for 30 percent of the population. An additional 125,000 doses of the antivral drug Relenza have been ordered. Once filled, this will increase the national stock of antiviral drugs by 10 per cent.

No changes to the controls allowing access to Tamiflu are likely in the short term. The Medicines Classification Committee (MCC) which in 2006 recommended that pharmacists be allowed to sell Tamiflu, required direct consultation in order to ensure the product was only being supplied to patients with influenza.

The controls on supply were placed in order to minimise the risk of inappropriate use to treat other viral infections, reduce the risk of development of resistance to Tamiflu and ensure the product was not being sold for use in children under 12 years of age. In addition, the MCC were concerned that unless sale to a patient in the pharmacy was required, the risk of the NZ product being purchased from pharmacists by overseas consumers via the internet, thereby depriving NZ of supplies of Tamiflu, would be unacceptably high. This risk of diversion of supply is especially high during times when there’s heightened public concern about influenza.

The MCC further considered the requirement for face-to-face consultation to obtain Tamiflu at its meeting in June 2008 and confirmed its earlier position that until more data was available on use in pharmacy and the factors leading to resistance became clearer, the requirement will remain in place.

Seasonal influenza vaccine
There has been a significant increase in demand for the seasonal influenza vaccine in New Zealand in the past three days. We are increasing the national stock of seasonal influenza vaccine by 125,000 doses. This is in addition to the 800,000 doses already in stock. Last year the country used 760,000 doses of seasonal influenza vaccine. The influenza vaccine season runs until the end of June.

•60,000 doses left (from 120,000 available last week).
•Demand usually slows down this time as ‘all at risk’ are usually vaccinated.
•Pharmac cannot predict demand which should be dying off now but last
week demand was twice normal.

Alert levels
The World Health Organisation current level of influenza pandemic alert remains at five.

Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short.

New Zealand's status is Code Yellow. We are currently in Phase 5.1. New Zealand is not escalating its plan at the moment. Our actions are to limit any spread of Influenza A (H1N1) Swine Flu that has come to New Zealand. We have taken a precautionary approach from the start.

More information on New Zealand's pandemic plan can be accessed on the Ministry of Health website www.moh.govt.nz

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Definitions
Suspected is all people who display flu symptoms AND have travelled through areas of concern, or are close contacts of cases.
Probable are all suspected cases that test positive for Influenza A – all these cases are being treated as confirmed for the purposes of treatment.
Isolation includes all cases and contacts in isolation or quarantine (do not include hospital isolation). This includes many people without symptoms who are being isolated as a precaution because they are in close contact with a suspected case.

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