Australia’s response and activities

Rhonda Owen

August 2009

PANDEMIC (H1N1) 2009

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Australian Epicurve to 7 August

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VIC moved to modified SUSTAIN phase

AUS phase PROTECT

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DELAY & CONTAIN PHASES• Amended quarantine legislation to cover the new

virus• Strengthened border measures

– Incoming flight messages, universal pratique for arriving flights, and health declaration cards,

– Passenger fever screening with thermal imaging cameras, border nurses for screening and testing of suspect cases,

– Arriving passenger information informing about symptoms that might develop later and how to report for assessment.

– Travel advisories for those intending to travel to affected areas.

• Communications – public and Health Professionals• School exclusion policy

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DELAY & CONTAIN SURVEILLANCE• Enhanced surveillance

– Intensive investigations of suspect cases and their close contacts

– Voluntary case isolation and contact quarantine– Antivirals for treatment and prophylaxis

• Collected all suspected, probable and confirmed cases via web-bases data base

• Monitored ILI– Sentinel GP and ED systems– Hotline– Absenteeism

• Conducted sentinel laboratory surveillance – Proportion of respiratory tests positive for influenza– Proportion of pandemic H1N1 compared to seasonal influenza– Systematic testing of ILI patients through sentinel GPs

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21/04/23

Australian Epicurve to 25 June 2009

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9 WA

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Vic moved to modif ied sustain phase, 3rd June

Move to contain

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PROTECT phase • A re-focus of testing

– cases with moderate to severe disease– vulnerable groups (more susceptible to severe outcome)– outbreaks in institutional settings

• Early treatment of those identified as vulnerable – and those with moderate or severe disease

• Voluntary home isolation for those who are sick • Controlling outbreaks,

– including diagnostic testing, in institutional settings, such as special schools

• School exclusion – emphasis on excluding students with ILI from school

• Communications– Emphasising the importance of personal hygiene and social distancing

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Surveillance During PROTECT• Is the Situation Changing?

– ILI from sentinel GP & ED,– Absenteeism– Laboratory surveillance – proportion positive, ratio pandemic to

seasonal

• How severe is the disease?– Hospitalisations and ICU data– Deaths

• Is the virus changing?– Stability – Resistance monitoring

• What is ahead– Analysis and Modelling to predict path and impact of pandemic

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21/04/23

Australian Epicurve to 7 August

0

200

400

600

800

1000

1200

1400

Date of onset, notification or detection

Co

nfi

rmed

cas

es o

f p

and

emic

(H

1N1)

200

9

WA

VIC

TAS

SA

QLD

NT

NSW

ACT

VIC moved to modified SUSTAIN phase

AUS phase PROTECT

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21/04/23

Pandemic A(H1N1) in Australia• >25,000 confirmed cases• >3,000 hospitalisations• 104 deaths• Past peak in some states, still increasing in others• ILI similar to 2007 for sentinel GPs, higher in for sentinelEDs• >80% influenza is A(H1N1) range 70%-97% • Rate of fever lower than many countries• Hospitalisation

– Highest rate in <5 years & 50-60 years– 14% of hospitalisations admitted to ICU – Indigenous 5x more likely to be hospitalised– 4% hospitalised pregnant; July: 35% hospitalised women 25-35

years• Deaths

– Most had co-morbidities; cancer, diabetes, morbid obesity– Median age 56 years (cf 83 years for seasonal)

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Thanks for your attention.

More information: www.healthemergency.gov.au