Update 69 - Influenza A (H1N1) Swine Flu

Media Release
2:00pm, Thursday 11 June 2009

Update 69 - Influenza A (H1N1) Swine Flu

New Zealand situation

The cumulative total of confirmed cases in New Zealand is now 27, up from 23 yesterday. The cumulative total of probable cases remains at 10.

Of the confirmed cases, 10 are still in isolation at home while they are being treated with Tamiflu. The rest of the confirmed cases and all probable cases have been treated and have fully recovered.

Two of the new confirmed cases were reported in Waikato. One is a factory worker whose travel history or link to someone who has traveled recently has yet to be confirmed. The second case is a New Zealander who arrived from Melbourne on 5 June.

Auckland cases

The two other new confirmed cases are an Auckland nurse and her child who returned from a family holiday in the United Kingdom on Air NZ flight NZ1 on 6 June. The nurse worked one shift at Auckland City Hospital’s Renal Medicine and Transplant Ward (Ward 71) on 8 June and the child attended ABC Childcare Centre in Meadowbank the same day. The contacts of both cases are currently being contact-traced.

Dr David Sage, chief medical officer at Auckland City Hospital, said the nurse did not have flu symptoms when she was at work on 8 June. However, her child began to show flu-like symptoms that day and immediate medical treatment was sought. The nurse returned home after completing her shift. The family voluntarily isolated themselves at home while awaiting the test results for their child at which time the nurse began exhibiting flu symptoms. Last night, both swabs returned positive results for Influenza A (H1N1).

Dr Sage said staff at Auckland City Hospital acted swiftly to identify, isolate and treat all those potentially affected as soon as the alert was raised. This includes staff, patients and visitors who were on Ward 71 at Auckland City Hospital on 8 June.

"At this time, none of these people are showing flu-like symptoms," he said. "I would like to commend all the staff who worked tirelessly last night and this morning to help us contain the potential spread of this virus," Dr Sage said.

Ward 71 remains open but is closed to new admissions and has strict infection-control procedures in place. Five patients are being cared for in isolation and there is a limit on visitors to patients and the number of staff working in the ward has been reduced.

The ABC Childcare Centre has closed temporarily and will likely remain so until 16 June. The childcare centre’s staff are currently working with Auckland Regional Public Health (ARPH) staff to identify children who were at the centre on 8 June.

ARPH's clinical director Dr Julia Peters said staff were working closely with the childcare centre. The 29 children enrolled at the Centre and seven staff are being offered Tamiflu and are in isolation at home. Dr Peters expressed thanks to the staff and parents of the centre for their cooperation to date.

Passengers off flight NZ1 will not be contact-traced as the child did not develop symptoms until 48 hours after arriving home in New Zealand, and would not have been infectious while on the flight.

The Ministry of Health's chief advisor on public health, Dr Ashley Bloomfield, said as more people tested positive for influenza A (H1N1) "swine flu" there would be more instances where workplaces, schools, and child care centres would be affected.

"People have been highly cooperative to date. This has undoubtedly contributed to New Zealand's relatively low number of confirmed cases.

"As has been demonstrated this week, each case can have a large number of contacts, and already, this virus is causing significant disruption to the regular routines and lives of those affected.

"Our assessment is that our actions to "keep it out" and "stamp it out" are still appro
priate and worthwhile. There are real benefits to delaying widespread community transmission of the virus for as long as possible," Dr Bloomfield said.

In summary:

* Five patients in Ward 71 are being treated in isolation. Access to the ward is restricted.

* Two former patients who had been cared for by the nurse during the 12-hour shift on 8 June have been visited by medical staff and care plans are in place.

* 19 ADHB staff who were in close contact with the nurse are also at home in quarantine and taking Tamiflu.

* Importantly, none of the close contacts have flu symptoms at present.

* 29 children and seven staff from the ABC Childcare Centre are being given Tamiflu and isolated at home.

Gisborne Boys High School

All the swab results for the Gisborne Boys High School students are negative for Influenza A (H1N1). Medical Officer of Health Dr Geoff Cramp said the 16 students, two teachers and one parent who were previously classified as suspected cases are now free to return to work or school if they are well.

The group of 19 had been asked to remain in isolation at home as a precautionary measure. The students were part of a group who returned on 7 June from a class trip to Brisbane.

Dr Cramp said the other students, the community and those who have had contact with the students can be reassured that there is no risk of catching the Influenza A (H1N1) virus.

How to protect yourself and others

Anyone who has recently travelled overseas and is ill with influenza symptoms is advised to phone their GP or Healthline (0800 611 116) for medical advice. Do not turn up at a hospital or medical centre before doing this as you can spread germs to other people.

Signs and symptoms of influenza include fever, cough, sore throat, stuffy nose, body aches, headache, chills and fatigue. Some people also experience diarrhea and vomiting.

Hand hygiene is still the single most effective measure in protecting yourself. Wash your hands with soap and water and dry them thoroughly.

Alcohol-based cleaners are also effective. Avoid touching your eyes, nose or mouth as germs spread this way.

Practise good cough and sneeze etiquette. This means covering your nose and mouth with a tissue when you cough or sneeze, and disposing of the tissue in a lined rubbish bin with a lid or plastic bag.

Sick people should stay home until they are well, rather than going to school or work. Try to avoid contact with sick people and reduce time spent in crowded settings. If you become sick, stay home for seven days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer. This is to keep you from infecting others.

International Update from the World Health Organization

As of 06:00 GMT, 10 June 2009, 74 countries have officially reported 27,737 cases of influenza A (H1N1) infection, including 141 deaths. WHO remains in pandemic influenza Phase 5 but continues to monitor the situation closely in all countries reporting cases of new influenza A (H1N1).

As at 5am today, Australia reported 1263 cases of Influenza A (H1N1) infection.

The breakdown of the number of laboratory-confirmed cases by country is given in the following table and map. (http://www.who.int/csr/don/Map_20090610_0800.png)

Updates on the Influenza A (H1N1) outbreak are available on the WHO website on a regular basis (http://www.who.int).

This information can be attributed to Dr Ashley Bloomfield, Chief Advisor, Public Health.

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