Top level messages updated to 6 Jul 09

Swine flu is here for quite some time and it is continuing to spread throughout the community,
but there is no cause for alarm."

There is no need to change our management approach at this stage but we remain vigilant.
For most New Zealanders, swine flu will be a mild illness, but in some instances, the infection
can cause more severe illness and in a few tragic instances, death.

1.Warning from overseas

We were increasing concerned about the situation overseas

During March and early April 2009 Mexican public health authorities reported test results
confirming cases of Influenza A (H1NI) strain
NZ has a pandemic plan that outlines the national response at all stages of a pandemic
The first community transmission was recorded in Wellington on 14 June 2009 and on 19
June, after further cases of community transmission the MOH moved to the manage it phase

2. Events over the Auckland first cases weekend

ARPHS was notified at approximately midday on Saturday 25 April by calls from a general
practitioner from the North Shore Hospital who the GP had called for advice

3. What actions taken

Preliminary tests to determine the cause of illness and to exclude or confirm

Contact tracing process

Students and teachers put in home isolation
Implemented containment measures at international borders and requesting that people
suspected of Influenza A (H1N1) stay in isolation and take anti-viral medication

4. Work load for for ARPH

Increased pressure on primary health care
Also have to carry on with BAU
Very grateful to the support of our staff who have worked additional shifts and long hours

5. What have the particular challenges been

Dr Julia Peters Key messages Radio NZ doc updated 5July 09 by Courtney Lambert
Because this virus is new, people have no immunity to it so it will spread more quickly and
widely than the seasonal flu.
The pandemic situation could mean lots of people become sick at the same time and this
could have a big impact on our day-to-day lives, and place considerable pressure on the
health services.

Winter gives the influenza viruses an opportunity to intermingle and possible exchange
genetic material in unpredictable ways

6. Health response

Public health is a priority

Strain on health care services
Even conservative estimates by MoH based on an attack rate of 60% of Nzers predicts there
would be 14 000 to 35 000 extra hospitalisations in total and about 850 to 2100 extra
intensive care admissions

Illness mild for most but fatal for few.

We continue to take the disease seriously as there have been deaths both here and overseas

Even a mild disease with a low death rate will affect a lot of people if large numbers of people
are infected

7. Precautions

An important part of the Manage it approach includes individuals with mild to moderate flu

Dr Julia Peters Key messages Radio NZ doc updated 5July 09 by Courtney Lambert
symptoms looking after themselves at home in the same way they would with ordinary winter
flu. This is to ensure hospitals and medical services can look after those who develop a more
severe illness, or have existing conditions that may lead to complications.

Public health messages through communications staff and a public health campaign

There are ads on the television explaining the importance of cough and sneeze etiquette and
hand hygiene

Public health workers in the community with groups

8. Pandemic planning
Following a national pandemic plan
Regular contact with the World Health Organization to ensure we are well informed about
international developments and acting in concert with global initiatives to limit the spread of
the disease
monitoring the spread of the disease and getting good information about individual cases in
New Zealand

Latest Numbers

The cumulative total of confirmed cases in New Zealand is 945, up from 912 yesterday. The
number of probable cases remains unchanged at 61 since yesterday.

The cumulative total of confirmed cases by region at 5 July 09 are:

Northland (20), Auckland (202), Waikato (45), Bay of Plenty/Lakes (29), Gisborne (2), Hawkes
Bay (75), Taranaki (3), Wanganui/Palmerston North (14), Wellington (292),
Nelson/Marlborough (19), Canterbury (230), Otago/Southland (14).

International Update from the World Health Organization

WHO figures were last updated on 3 July 2009 at 09:00 GMT, where 89,921 cases of Novel
Influenza A (H1N1) 09 infection have been reported internationally, including 382 deaths.

The WHO figures include a breakdown of the number of laboratory-confirmed cases by

country (www.who.int).

Dr Julia Peters Key messages Radio NZ doc updated 5July 09 by Courtney Lambert