New NZ research into the swine flu underway

New NZ research into the swine flu pandemic underway

The Ministry of Health (MoH) and the Health Research Council of New Zealand (HRC) have awarded more than $700,000 following a call for research into the Influenza A (H1N1) 09 virus.

These funds will support five leading scientific teams to engage in research that will shed light on the Influenza A (H1N1) 09 pandemic.

Global studies suggest that a second wave of the H1N1 influenza pandemic is likely to reach the Southern Hemisphere in autumn 2010.

The commissioned work will utilise experience from last year’s wave of influenza and help prepare the New Zealand health sector for future waves.

HRC Chief Executive, Dr Robin Olds, said: “The need for urgent research into how to handle both the current pandemic, and influenza outbreaks in general has been recognised by the HRC and the MoH. This research will inform the health sector in anticipation of future pandemic influenza activity.”

Details of funding offered to the five research teams are as follows:

Australia and New Zealand influenza intensive care patient registry

Principal Investigator: Dr Colin McArthur

Host institution: Auckland DHB Charitable Trust

12 months, $59,500

Project summary: Current reporting of hospitalisations from H1N1 influenza includes little patient-level clinical data. An anonymised registry based at Monash University, Melbourne for patients admitted to intensive care in New Zealand and Australia with influenza was established in June 2009. Important insights into the clinical characteristics of critical illness due to H1N1 influenza infection have been identified and published. More detailed analysis of patients requiring extra-corporeal membrane oxygenation and cases associated with pregnancy have been undertaken. Specific data from the New Zealand cohort has also been made available to the Ministry of Health and the World Health Organisation. This proposal is to support the continued NZ contribution to the registry at least until the end of winter 2010, to enable reporting and analysis of intensive care patient characteristics during any further re-emergence of pandemic influenza. This will be particularly valuable in characterising the pattern of critical illness in a vaccinated population.

Models Of Primary Care For Responding To Pandemic Influenza

Principal Investigator: Dr Tom Love

Host institution: University of Otago

12 months, $249,800

Project summary: Our objectives are to understand the capacity of routine general practice to respond to the high demand for care during an influenza pandemic and to compare the model of using routine general practice with the model of using a centralised Community Based Assessment Centre (CBAC) for responding to a pandemic. We will use routinely collected data from general practices and emergency departments across the lower North Island in the winters of 2008 and 2009, and data collected from the CBAC used in Christchurch during the pandemic influenza wave of winter 2009. The impact of this work will be to inform decisions about whether and/or up to what point to rely upon routine general practice, or to implement a CBAC model in the event of future waves of pandemic disease. We will define the utilisation threshold at which point a CBAC would be effective from a workload and resource perspective.

Does seasonal influenza vaccination protect against pandemic influenza?

Principal Investigator: Professor Richard Beasley

Host institution: Medical Research Institute of New Zealand

3 months, $83,300

Project summary: This case-control study of healthcare workers at Capital & Coast District Health Board will investigate whether seasonal influenza vaccination has any protective effect against pandemic influenza A H1N1 infection. The vaccination status of 111 cases who presented with an influenza-like illness and in whom influenza A H1N1 infection was virologically confirmed (positive PCR on nasopharyngeal swabs) will be compared with 467 controls who presented with an influenza-like illness and were virologically negative for influenza A H1N1. The analysis will be controlled for confounding variables including age, sex, deprivation index, domiciliary isolation, ethnicity, occupation including patient contact, overseas travel, comorbidity and pregnancy. The data will be obtained from information prospectively recorded within the CCDHB Occupational Health Service and the CCDHB and Hutt Valley Health Board IBA Patient System databases. The study findings will be relevant to the development of future influenza vaccination strategies for both pandemic and seasonal influenza infection.

Ethnic and socioeconomic differences in pandemic influenza infection in NZ Principal Investigator: Associate Professor Michael Baker

Host institution: University of Otago

12 months, (budget tbc)

Project summary: The H1N1 influenza pandemic caused more severe health impacts for Māori and Pacific peoples, with markedly higher hospitalisation and intensive care unit (ICU) admission rates for these ethnic groups compared with Europeans and others. This project will investigate whether infection rates (seroprevalence) showed the same differences as disease rates, and the contribution of chronic illnesses (such as asthma and diabetes) to the risk of infection and to poor outcome (ICU admission and/or death). It will also analyse the contribution, to health impacts, of environmental factors (including household crowding, housing conditions, and environmental tobacco smoke exposure) and differences in how groups responded to influenza (including measures to avoid infection, recognition of illness, health-seeking behaviour, and attitudes to vaccination). The goal is to identify opportunities for reducing these inequalities. Such measures could help protect vulnerable populations during future waves of this pandemic as well as reduce rates of infectious disease more generally.

Early estimation of epidemic parameters.

Principal Investigator: Professor Mick Roberts

Host institution: Massey University

12 months, $96,059

Project summary: The first questions asked at the beginning of an epidemic are: “What is the infection reproduction number?”, and “What is the case fatality ratio?”. By linking rigorous mathematical models with the estimation procedure, it is possible to provide estimates of these statistics adjusted for the most serious sources of bias: which are the inclusion of imported cases in the data; the so-called truncation error; and the effects of age structure. We will develop a scheme whereby these statistics can be estimated at an early stage of an epidemic, and revised as more data become available. A model will then by used to assess the performance of control strategies against influenza. The scheme will be demonstrated with regard to the 2009 epidemic of H1N1, and will be used for any future wave of H1N1 or epidemic of an emerging virus. Results will be used to make recommendations for strategic epidemic planning.

ENDS

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