4 November 2009

Pandemic Influenza (H1N1) 09 Swine Flu - Update 158

During the week ending 30 October there was a slight rise in the number of New Zealanders seeing their doctor in relation to influenza-like illnesses (ILI). Most people were seeking advice for sick babies and children aged under four. As at midday today there is one person in intensive care with confirmed H1N1 pandemic influenza.

The total number of deaths attributed to swine flu remains at 19. Please note that this number is likely to change as Coroners complete investigations into a number of influenza-related deaths that have occurred over the last few months.

The Ministry of Health is closely monitoring the situation and remains vigilant in case a second wave of pandemic influenza starts to spread in New Zealand.

The international picture

Pandemic influenza cases are continuing to increase in many northern hemisphere countries. In America, the CDC (Centres for Disease Control and Prevention) have reported steep increases in all indicators of influenza activity. Visits to doctors, hospitalisations, and deaths due to influenza or pneumonia are all higher than expected for this time of year. The number of people seeking medical advice is now at a rate higher than during a regular flu season.

The World Health Organization's (WHO) latest update states that Mexico has reported more confirmed cases of pandemic influenza since September, than during the springtime epidemic. In Europe, high rates of influenza illness have been observed in Iceland, Ireland, the UK, Belgium, the Netherlands and Ukraine. Many other countries in Europe and Western and Central Asia are showing evidence of early influenza transmission including Spain, Austria, parts of Northern Europe, Russia and Turkey. In Japan, influenza activity has increased sharply - this is around ten weeks ahead of the usual winter influenza season.

There is little influenza activity being reported in temperate regions of the southern hemisphere (which includes New Zealand and Australia)

Futher information is available on the WHO's website http://www.who.int/en/

Vaccine update - seasonal influenza vaccination to be free for more people at risk of developing complications

Next year's seasonal influenza vaccine will contain the pandemic (swine flu) strain and be free to extra groups who are at particular risk from swine flu. Health Minister Tony Ryall announced yesterday that free vaccines will be available next year to people over 65, but also to pregnant women, people who are morbidly obese and children aged six months to four years who are enrolled in particular high deprivation General Practices.

Seasonal flu immunisation is already free (paid for by the Government) for all people over 65 and to those aged 6 months to 64 years with certain pre-existing health conditions. Those conditions include people with chronic respiratory disease and diabetes, who were particularly susceptible to more severe outcomes from swine flu.

Remain alert to signs and symptoms and ways to reduce spread

People should still remain vigilant to the signs and symptoms of the disease and seek medical advice if the person who is sick is pregnant or obese, or has underlying medical conditions such as respiratory disease, heart disease, liver disease, blood disorders, is immuno-suppressed or has a neurological condition.

If someone has flu-like symptoms and their condition worsens, you should phone for medical advice straight away. Healthline provides free advice 24 hours a day, seven days a week. Healthline 0800 611 116.

We should all continue to follow the same tried and true public health advice- regularly wash and dry hands, stay home if sick with flu symptoms, and cover your coughs and sneezes.

Study to test pandemic influenza immunity

A study investigating the level of immunity New Zealanders have to pandemic influenza (H1N1) will get underway this month. Blood samples will be taken from 2500 people to see how many have been exposed to pandemic influenza and developed immunity to it. This information will be used to establish how many people are still at risk of contracting the illness.

The study is being undertaken by Environmental Science and Research (ESR) on behalf of the Ministry of Health. The results of the survey will be useful for the Ministry of Health so it can plan for a possible second wave.

A two week pilot study is expected to begin within the next few days at a single practice in the Hutt Valley. It will be followed by a nationwide study that will run from later in November until March next year. People randomly selected from participating general practices throughout the country will be asked to take part. The final report is expected in May.

Healthline Calls

The number of ILI calls to HealthLine over the past week remains stable, but overall levels are still above those at the same time last year. Over the past week, around 16% of all calls to HealthLine were ILI-related calls. `

GP Consultations

Figure 1: ESR Sentinel Surveillance of GP consultations for ILI by week during 2007, 2008 and 2009 (Reporting to week 43 for 2009 which ended at 2400hrs on Sunday, 25/10/09)

The number of GP consultations based on a sample of sentinel practices has been generally decreasing and is only slightly higher than at the same time in the last two years.

The data are from the Institute of Environmental Science and Research's (ESR) sentinel general practice surveillance system.

Australian Situation

For the number of confirmed cases in Australia, go to the Australian Government's Department of Health and Ageing website at: http://www.healthemergency.gov.au/internet/healthemergency/publishing.nsf/Content/updates

International Update from the World Health Organization

As at 25 October 2009, worldwide there have been more than 440000 laboratory-confirmed cases of pandemic influenza 2009 and at over 5700 deaths reported to the World Health Organisation. For more information check: http://www.who.int/en/

ENDS

Please attribute comment in this update to Dr Mark Jacobs, Director of Public Health

For health information and advice, the public should call Healthline 0800 611 116

For latest updates on Influenza A (H1N1) Swine Flu, visit http://www.moh.govt.nz

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