The human influenza A (H1N1) outbreak is evolving rapidly. As of 12 May 2009, 30 countries have officially reported 5251 cases of the infection. Three countries on the rim of the Pacific Islands have reported laboratory confirmed cases with no deaths – New Zealand (7), Australia (1) and Hawaii (6) – increasing the likelihood that the infection could spread to Pacific Island countries and territories (PICTs)*.
‘We have asked all PICTs to immediately notify WHO if they identify any suspected cases of the swine flu as requested by the International Health Regulations.’’ says Dr Jacob Kool, Communicable Disease Surveillance and Response, World Health Organization Office for the South Pacific. ‘They are also asked to report to us twice a week on the total number of influenza cases’.
The World Health Organization (WHO) and the Secretariat of the Pacific Community (SPC) are working to support PICTs in responding quickly and efficiently to this public health threat. The priority is to ensure that countries’ surveillance systems are working, as well as their laboratory testing procedures to detect any suspected cases.
Health authorities in all PICTs were initially alerted about the situation last Saturday (25 April). Since then, updates on how it is evolving and technical advice on public health measures and precautions that need to be implemented urgently have been provided regularly.
‘We started working intensively with PICTs on pandemic preparedness four years ago when we designed the Pacific Regional Influenza Pandemic Preparedness Project (PRIPPP) in collaboration with WHO, the World Animal Health Organisation (OIE) and the Food and Agriculture Organisation (FAO),’ says Dr Tom Kiedrzynski, Epidemiologist at SPC.
PICTs are encouraged to activate their pandemic preparedness plans according to the WHO Influenza Pandemic Phases. The preparedness strategies developed and tested in recent years under PRIPPP will assist countries in dealing with this potentially alarming situation.
For more information, please contact: Christelle Lepers, Surveillance Information Officer at SPC – Tel. +687 26 01 81 or WHO South Pacific: +679-3234100
INFORMATION ON INFLUENZA A (H1N1)
Mode of transmission
The mode of transmission of influenza viruses explains why the standard precautions below are recommended. Influenza viruses can survive for days or weeks in the environment, especially in cold conditions. They are generally transmitted by contact with surfaces contaminated by respiratory secretions and through respiratory droplets (from coughing and sneezing). Airborne transmission is rarer but can also happen.
An infected person is considered to spread the virus through respiratory secretions from 1 day before the onset of symptoms until 7 days after, sometimes longer for young children.
Symptoms and outcomes of the new flu A (H1N1) infection
Similar to the usual flu, i.e. acute onset of fever (≥38°C/100.4°F) or chills with cough or sore throat, and possibly other symptoms such as body aches, runny nose, fatigue, vomiting and diarrhea.
As with the usual flu, severe illness, including death, may affect a low proportion of people. The following are at risk of severe illness:
• those with certain chronic medical conditions, such as asthma, diabetes, renal or heart disease, or immune-compromising disorders;
• those who are 65 years-old or more;
• children younger than 2 years.
Protect yourself from getting the new influenza H1N1 from infected people
• Avoid close contact (1) with people who appear unwell and who have fever and cough.
• Wash your hands with soap and water frequently and thoroughly. Don’t use reusable towels in public facilities. If soap and water is not available, please use an alcohol-based hand-rub.
• Avoid touching your face (especially mouth, nose and eyes).
• Make sure that common contact surfaces, i.e. touched by many people such as door knobs, hand rails, tap handles, bathroom bench tops, are frequently cleaned and/or disinfected.
• Improve airflow in your living space by opening windows as much as possible.
• Practice good health habits including getting adequate sleep, eating nutritious food, and keeping physically active.
• In times of outbreak, as the virus may be transmitted by infected people before they have any symptoms, avoid unnecessary close contact with people (e.g. hugging or kissing) as well as crowded situations and reduce the time spent in crowded settings. Apply the standard precautions above with extra vigour. In crowded situations, a mask (medical or surgical) may give additional protection. Nevertheless, it is much more important that whoever has symptoms of influenza wears a mask to avoid spreading the disease through coughing and sneezing (see below).
If you are sick with a respiratory disease
• Stay at home or at your hotel if you are unwell. If you have to move elsewhere, take care to cover your nose and mouth, i.e. use a medical or surgical mask if you are with other people. Masks are normally available from pharmacies.
• Cough and sneeze etiquette:
- Cover your mouth and nose with disposable tissues and dispose of the used tissues in a rubbish bin, or
- Cough/sneeze in your sleeve or in the inside of your shirt/blouse.
• Wash your hands with soap and water frequently and thoroughly, especially after coughing and sneezing.
• Rest and take plenty of fluids.
• Inform others that you’re sick and seek help for chores that require contact with other people (e.g. shopping).
• Please contact or see a local doctor. Also, provide the doctor with your travel history. This is especially important if you are at risk of severe illness.
In general, pork meat is safe to eat as long as it is handled appropriately and cooked thoroughly. Although this new influenza A (H1N1) virus was called swine flu virus initially, you cannot get it from eating pork products.
*American Samoa, Cook Islands, Federated States of Micronesia (FSM), Fiji Islands, French Polynesia, Guam, Kiribati, Marshall Islands, Nauru, New Caledonia, Niue, Northern Mariana Islands (CNMI), Palau, Papua New Guinea (PNG), Pitcairn Islands, Samoa, Solomon Islands, Tokelau, Tonga, Tuvalu, Vanuatu, and Wallis and Futuna.
(1) Some sources define the close contact distance as within approximately 1 meter (3 feet). “Three feet has often been used by infection control professionals to define close contact and is based on studies of respiratory infections; however, for practical purposes, this distance may range up to 6 feet. The World Health Organization uses "approximately 1 meter"; the U.S. Occupational Safety and Health Administration uses "within 6 feet."
The World Health Organization is coordinating the global response to the swine influenza A (H1N1) outbreak and is monitoring the corresponding threat of an influenza pandemic.
The Pacific Regional Influenza Pandemic Preparedness Project (PRIPPP) has been designed to build the capacity of PICTs to deal with the potential threat of emerging infectious diseases, in particular avian influenza and pandemic influenza. Swine influenza is one such threat. The project is implemented by SPC in collaboration with WHO, the World Animal Health Organisation (OIE) and the Food and Agriculture Organisation (FAO), and with financial assistance from AusAID and NZAID. It covers 22 Pacific Island countries and territories*. PRIPPP is completed by a project funded by the Centers for Disease Control and Prevention on strengthening influenza surveillance in PICTs.