Pandemic Update: Keep your distance

Pandemic Update

13th June 2006

Keep your distance

When it comes to avoiding the spread of influenza in New Zealand, pigs and birds are of no concern – it’s people you need to be aware of.

“Influenza is highly infectious,” says Bay of Plenty and Lakes Medical Officer of Health Dr Phil Shoemack. “To help control and reduce the spread of infection, it’s important to keep at least one metre away from people who are sick, or if you have influenza – keep your distance.”

He says we can all do our bit to help stop the spread of infection.

“If you have influenza, avoid other people as much as possible until you are well,” he says. “Whether you are at work or socializing, ask yourself “do I have to be here?” and if it’s not imperative - stay home.”

Public gatherings are likely to be a means of transmission during the early stages of a pandemic.

“The spread of disease is more likely in crowded situations such as sports events, schools, bars or an institution such as prison or a rest home. Gatherings with large numbers of people in confined spaces, such as concerts, are more likely to contribute to disease transmission than, for example, local rugby club matches in the open air,” says Dr Phil Shoemack. “During a pandemic people will probably avoid these sort of situations and in some cases public gatherings may be cancelled.”

If you can’t avoid being around people when you are sick, or you are well and want to help avoid the spread of infection, there are two things to remember - hand washing and cough etiquette.

“The hand washing message may be starting to sound like a broken record, but it’s amazing how many people say they wash their hands thoroughly – yet don’t,” says Dr Phil Shoemack. “Sing Happy Birthday to yourself twice while you wash your hands, then dry them, preferably with paper towels.”

He says the term cough etiquette basically means – cover your cough, so carry tissues if you are sick and dispose of used ones in a lined bin.

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Background information as detailed on the Ministry of Health website (last updated 3 November)
What is Influenza?
Influenza (the flu) is a highly infectious illness caused by a virus.

It is much more serious than a common cold and will leave you ill for up to 10 days.

Symptoms of the flu start suddenly and include:

- a high fever

- headache

- muscle aches and pains

- fatigue

- cough

- sore throat, or

- a runny nose.
Influenza can be a mild or severe illness depending on the type of influenza virus causing it, and the age and general health of the person affected. It may take up to three days to show symptoms when you catch the flu.

Anyone can get influenza — being fit, active and healthy does not protect you from getting this virus.

Anyone can die from influenza — it kills at least 100 New Zealanders every year, including some young, fit people.

Can I do anything to prevent myself getting it?
Every year you can ask your doctor to vaccinate you against the flu. As the influenza virus changes frequently, new vaccine against the new virus is made every year. To get your immunity to the new virus you will need to get the new vaccine.

The flu is very easily spread by sick people who cough and sneeze. To reduce the chances of getting the flu there are also things you can do, such as ensuring good health hygiene habits.

If you have the flu, you should stay home from work, avoid public places and close contact with others. If you have the flu, you should always cough and sneeze into a disposable tissue and wash your hands afterwards.

What is Avian Influenza (Bird Flu)?
There are many types of influenza virus, some of which infect other animals including birds. The viruses that infect birds are avian influenza viruses. Very rarely, an avian influenza virus can also infect people. One of these viruses - H5N1- has infected some people who have caught it from having close contact with infected birds .

Avian influenza can cause severe flu-like symptoms in people and may result in death. It has not been shown for sure that
anyone has caught avian influenza from another person. If this has happened it has been very rare.

There are currently no commercially available vaccines that will protect people against disease caused by H5N1.

Is Avian Influenza transmissible to humans?
Yes, very rarely, an avian influenza virus can also infect people. The current avian influenza virus – H5N1 – has infected some people who have caught it from having close contact with infected birds.

Since December 2003, widespread outbreaks of H5N1 in birds in Asian countries have been associated with human cases and deaths in Asia.

For more information on avian influenza and the significance of its transmission to humans, see the World Health Organization website (www.who.int).

What are Avian Influenza symptoms in humans?
The exact symptoms, incubation period and duration of avian influenza in people are not known, because there have not been enough cases.

Generally the symptoms are similar to those for people infected with human influenza virus, although the severity of the illness may differ. Symptoms generally appear three to seven days after exposure and can last up to seven days.

Why are health authorities concerned about Avian Influenza?
The World Health Organization is worried that an avian influenza virus might change so that it has the ability to easily spread from person to person, or mix with a human influenza virus resulting in a new strain of influenza virus that can do this. This could trigger an influenza pandemic.

What is an influenza pandemic?
An influenza pandemic occurs when a new strain of influenza virus emerges, spreading around the world and infecting many people in a very short time.

An influenza virus capable of causing a pandemic is one that people have no natural immunity to and can easily spread from person to person. It may cause severe disease. An influenza pandemic could cause many deaths and could occur at any time. It could happen at any time of the year, not just winter.

What are the symptoms of an influenza pandemic?
The symptoms of pandemic influenza are the same as seasonal influenza.

This includes: The sudden start of a high fever, headache, muscle aches and pains, fatigue, cough, sore throat, or a runny nose.

The virus can cause a mild or severe illness depending on the type of influenza virus and the age and general health of the person affected. It may take up to three days to show symptoms.

How likely is an influenza pandemic?
It is certain an influenza pandemic will happen one day.

There are many bird flu viruses circulating in some countries at present. One of these, the H5N1, could become a pandemic influenza virus at any time if it changes so it can be easily spread from human to human.

How often do pandemics occur?
There were three influenza pandemics last century, in 1918, 1956-57 and 1968.

What caused them?
All three pandemics last century were caused by different types of bird flu viruses.

Could migratory birds "import" avian influenza virus to New Zealand?
Migratory waterfowl (such as ducks and geese) are carriers of the avian influenza virus. It generally does not make them sick, but they excrete the virus. The virus they leave in fields or water can then infect domestic birds.

Fortunately New Zealand is not on the regular migratory pathways of any waterfowl. The small number which do reach New Zealand mostly originate from southern Australia.

Other migratory birds such as shorebirds including the bar-tailed godwit, lesser knot, ruddy turnstone, Pacific golden plover etc, visit estuaries along the Asian coastline, Philippines and Australia on their annual migrations south from arctic Russia . They are not "waterfowl" and are not regarded as a high risk for introducing avian viruses into New Zealand.

The Ministry of Agriculture and Forestry (MAF) is currently undertaking surveillance in wild birds to assess the influenza status of waterfowl and shore birds.

It is not known why some strains of influenza become virulent in some species under certain circumstances while others do not, but it is thought that inter-species mixing (i.e. quails, geese, ducks and chickens) and high population densities, such as occur in intensive poultry farming and bird markets in China and other Asian countries, may favour interspecies transmission of the viruses.

Avian influenza in New Zealand is notifiable.

For general information on Avian Influenza infection in birds visit the Biosecurity New Zealand web site.

To report suspected cases of avian influenza in birds or exotic diseases call 0800 809 966.

How can avian influenza be controlled in birds?
The most important control measures are surveillance, identification and rapid destruction (culling) of all infected or exposed birds, proper disposal of carcasses, and the quarantining and rigorous disinfection of farms.

Restrictions on the movement of live poultry, both within and between countries, are another important control measure.

I have chickens. How will I know if my flock has got avian influenza?
The disease can be variable, depending on species, age, virus type and other factors like concurrent bacterial infections. The main symptoms to look for in poultry are:

- Sudden and unexplained deaths

- Rapid spread of disease throughout the flock

- Depression and loss of appetite

- Drop in egg production

- Nervous signs

- Swelling and blue combs and wattles

- Coughing, sneezing and diarrhoea.

For general information on Avian Influenza infection in birds visit the Biosecurity New Zealand web site.

To report suspected cases of avian influenza in birds or exotic diseases call 0800 809 966.

ENDS

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