1. Australia’s response and activities Rhonda Owen August 2009 PANDEMIC (H1N1) 2009

2. 8/12/2015 2 Australian Epicurve to 7 August

3. 8/12/2015 3 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

4. 8/12/2015 4 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

5. 8/12/2015 5 Australian Epicurve to 25 June 2009 Move to contain

6. 8/12/2015 6 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

7. 8/12/2015 7 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

8. 8/12/2015 8 Australian Epicurve to 7 August

9. 8/12/2015 9 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)

10. 8/12/2015 10 Thanks for your attention. More information:www.healthemergency.gov.auwww.healthemergency.gov.au