Pandemic Influenza H1N1 2009 (swine flu) - Update 183

Pandemic Influenza H1N1 2009 (swine flu) - Update 183
Overall influenza activity in New Zealand continues to be low although we are starting to see small increases, as we would expect at this time of year. There has been a small increase in the number of people visiting a GP with influenza-like illness however, the numbers remain below baseline levels.

The number of people calling Healthline (0800 611 116) for advice is slightly higher than at this time last year. Many people are seeking advice about caring for babies and young children with symptoms of influenza-like illness.

Autumn is when colds and other viruses start to circulate in the community so it's timely to remember that we can all help reduce the spread of these by washing and drying hands frequently, covering coughs and sneezes, and staying home from work or school when you have a cold or influenza.

It's also timely to remind those who are at greatest risk of complications for pandemic influenza, to seek medical advice as soon as they develop influenza-like symptoms. Young children are at higher risk of complications of pandemic influenza, as are women who are pregnant or recently pregnant, severely overweight people and those with serious underlying medical conditions.


Provisional findings from coroner takes death toll to 35

The Ministry of Health has previously reported 20 deaths due to pandemic influenza. This week we are including provisional findings from Coroners' offices of an additional 15 deaths attributable to or associated with pandemic influenza. These deaths occurred between June and August 2009.

Most of the additional 15 people had underlying health conditions that put them at higher risk of complications from influenza. Five died while in hospital and ten died in the community. The 15 cases were located in Auckland, Counties Manukau, Canterbury, Otago, South Canterbury, Southland, Taranaki and Waikato DHB areas.

Confirmed decisions on these cases are expected from Coroners over the coming months. In addition to the coronial review process, the Ministry of Health has a pandemic influenza mortality group reviewing the number of deaths that may be attributed to pandemic influenza. Findings from this group are expected to be released in the coming months, once clinical review is complete.


Vaccine Supply

New Zealand's seasonal flu vaccine stockpile became depleted over the past fortnight, due to the recent widespread closure of European airports. This affected our ability to restock, as our current supplier of seasonal flu vaccine ships from France.

On Tuesday 27 April the first new stock arrived in New Zealand and was cleared for delivery. 47,000 doses arrived, which is less than our usual order - however a second shipment of equivalent size is expected before the end of this week

Larger shipments are due next week, and once the first of those arrives we should be back to 'business as usual' with flu vaccinations.


Vaccination of children under the age of five

Australian health authorities continue to investigate what they have described as a "spike" in the number of under-fives admitted to hospital in that country with fever, and in some cases febrile convulsions, within 24 hours of having received a seasonal flu vaccine.

As a precautionary measure, last Friday (23 April 2010) the New Zealand Ministry of Health recommended that health professionals do not use the Fluvax brand of seasonal flu vaccine when vaccinating children under the age of five. That recommendation remains in place at this time.

The Ministry is liaising with Australian health authorities as they investigate this situation, however the data available for New Zealand do not suggest that we are seeing an increase in high fevers or febrile convulsions in young children after flu vaccination. More than 800,000 doses of seasonal flu vaccine have been delivered across New Zealand so far in 2010, many of those to children under the age of five. According to the Centre for Adverse Reactions Monitoring (CARM) data the total number of reported cases of febrile convulsions within 24 hours of seasonal flu vaccination in New Zealand stood at five in the 2010 year up to Friday April 23.

The Ministry is reminding health professionals and parents to report any adverse reactions to vaccines to the Centre for Adverse Reactions Monitoring. Given this, and extensive media coverage of the Australian situation, we anticipate that the number of cases reported will increase.


Weekly consultation rates for influenza-like illness in New Zealand, 2008-2010

Week 16: 21 - 28 April

*A weekly rate of less than 50 ILI consultations per 100,000 patient population is considered baseline activity. A rate of 50-249 is considered indicative of normal seasonal influenza activity, and a rate of 250-399 indicative of higher than expected influenza activity. A rate of over 400 ILI consultations per 100,000 patient population indicates an epidemic level of influenza activity.

Source: Institute of Environmental Science and Research, Influenza Weekly Update 2010/16


The international picture

As at 23 April 2010, WHO reports it is continuing to actively monitor the progress of the pandemic. The most active areas of pandemic virus transmission currently are in parts of West and Central Africa, but transmission is also occurring in South East Asia and Central America.

Pandemic influenza activity remains low in much of the temperate zone of both the northern and southern hemispheres. Since the pandemic began in April 2009, almost all countries have experienced outbreaks of pandemic influenza and over 17,853 laboratory-confirmed deaths have been reported worldwide.

For the WHO's latest updates on the global pandemic, check their website: