Home > Media Centre > Departmental media releases and speeches > Departmental Speeches

Departmental Speeches

Australia’s Winter with Pandemic (H1N1) 2009

Professor Jim Bishop AO, Chief Medical Officer,Department of Health and Ageing, addresses the 5th Australian Influenza Symposium 2009

PDF printable version of Australia’s Winter with Pandemic (H1N1) 2009 (PDF 777 KB)

24 September 2009

Slide 1 - Australia’s Winter with Pandemic (H1N1) 2009

Professor Jim Bishop AO
Chief Medical Officer
Department of Health and Ageing
Australian Influenza Symposium 2009

Slide 2 - The Australian Health Management Plan for Pandemic Influenza (AHMPPI)

• The AHMPPI (2008): third edition of the national health management plan
• Revised as a result of Exercise Cumpston 06

- Addressing policy gaps
- Streamlined decision making
- More flexible policy

Slide 3 - AHMPPI Phases

• ALERT – preparation
• DELAY – prevent entry
• CONTAIN – limiting spread
• SUSTAIN – waiting for vacc
• CONTROL – using vaccine
• RECOVER – returning to normal

Slide 4 - Australian Health Protection Committee (AHPC) Aileen Plant National Incident Room

• The key decision-making body for health emergencies

– Chaired by DoHA Deputy Secretary
– Commonwealth CMO, S/T Chief Health Officers
– Experts in mental health, emergency medicine, communicable diseases

• Preparedness role
• Response role in health emergencies

Slide 5 - National Resources

• Antivirals and antibiotics
• Personal protective equipment (PPE)
• Thermal imaging scanners
• Vaccination packs
• ICU ventilators
• Vaccine

Slide 6 - Pandemic (H1N1) 2009 Timeline

24 Apr	WHO announces health emergency
27 Apr	WHO moves to Pandemic phase 4
28 Apr	Australia moves to Pandemic DELAY
29 Apr	WHO moves to Pandemic phase 5
22 May	Australia moves to Pandemic CONTAIN
3 Jun	Victoria moves to MODIFIED SUSTAIN
11 Jun	WHO moves to Pandemic phase 6
17 Jun	Australia moves to Pandemic PROTECT
18 Sept	TGA Approves pandemic (H1N1) vaccine: WHO Donation

Slide 7 - Delay Phase

Slide 8 - CONTAIN Phase

• Contact tracing and home quarantine
• Anti-virals for contacts
• Increased public messaging
• Some school closures
• Continuation of the measures commenced in DELAY
• Actions taken during CONTAIN included:

Slide 9 - H1N1 Influenza 09 Pandemic phases

Slide 10 - PROTECT Assumptions

• Highest attack rates in younger age groups
• Overall of moderate severity
• 1 - 2% hospitalization and 10% ICU rate
• Severe illness more likely in vulnerable groups
• Geographic variation

Slide 11 - Key Elements of PROTECT

• Re-focus of testing and treatment
• Identification and early treatment for those at risk
• Voluntary home isolation, no treatment, mild disease
• Controlling outbreaks in special settings
• Limited school closures early in the Pandemic
• Communications
• Re-focus surveillance

Slide 12 - PANDEMIC (H1N1) 2009 SURVEILLANCE, AUSTRALIA

Slide 13 - Laboratory confirmed cases of pandemic (H1N1) 2009 in Australia to 11 September 2009 by jurisdiction, by week

Slide 14 - Rate of ILI reported from GP ILI surveillance systems from 2007 to 6 September 2009 by week

Slide 15 - Number of Presentations to ED for ILI in WA, 1 Jan 2007 – 6 September 2009

Rate of Diagnoses of ILI in EDs in NSW, 1 Jan 2005 – 4 September 2009

Slide 16 - Rates of absenteeism of greater than 3 days, National employer, 1 Jan 2007 – 2 September 2009, by week

Slide 17 - Proportion of Influenza A positive for pandemic (H1N1) 2009

Slide 18 - Summary of severity indicators of pandemic (H1N1) in Australia

Slide 19 - Severe Pandemic (H1N1) 2009

• Hospitalisations
• Respiratory, diabetes, immuno compromised obesity, chronic cardiac, renal, pregnancy rapid deteriorating flu patient
• Higher proportion of Indigenous Australians
• Over 50% admitted within 48 hours of onset
• Higher ICU Admissions than expected

Slide 20 - Hospitalisations of pandemic (H1N1) 2009, 5 June – 11 September 2009, by week

Slide 21 - Age specific rates of hospitalised confirmed cases of pandemic (H1N1) 2009 to 11 September 2009, compared with average annual age specific rates of hospitalisations from seasonal influenza 2004-05 to 2006-07*, Australia

Slide 22 - Hospitalised confirmed cases of pandemic (H1N1) 2009 in pregnant women by weeks of gestation, to 11 September 2009

Source: NETEPI database

Slide 23 - Comparison of hospitalisations, ICU admissions and deaths, by age group, to 11 September 2009

Slide 24 - Key Statistics

As of 23 September 2009:

• 36, 454 Confirmed Cases
• 4,759 Hospitalisations (Total)
• 177 Deaths

Slide 25 - Notification rates for pandemic (H1N1) 2009 in a selection of affected countries

Slide 26 - Pandemic (H1N1) 2009 – Four possible scenarios for coming year

Slide 27 - Clinical Trials of Pandemic (H1N1) 2009 Vaccine

Systemic Side effects:

• Headache
• Fever
• Myalgia
• Malaise

Immune Response:

• 15mcg - 97 %
• 30mcg - 93 %

^{Source: New England Journal of Medicine: 2009: 361, September 10}

Slide 28 - Pandemic (H1N1) 2009 Vaccine

• Safety profile as with seasonal flu
• One injection 15μg protects adults
• FDA licence/TGA registration
• Emphasis on priority groups but available to ALL

^{Source: New England Journal of Medicine: 2009: 361, September 10}

Slide 29 - Key lessons so far

1. Value of detailed planning
2. Leadership and co-ordination
- AHPC
- NPEC
3. Flexibility
4. Medical innovation
5. Communication

Slide 30 - Key Individuals for Pandemic Response

NIR
Ms Mary Murnane
Ms Jenny Bryant
Dr Gary Lum
Ms Fay Gardner
Dr Bernie Towler
Dr Andrew Singer
Dr Andrea Forde
Ms Kay McNiece
Dr Jenean Spencer

ATAGI - Prof Terry Nolan
RACGP - Dr Chris Mitchell
CDNA - Dr Vicki Krause

NSW - Dr Kerry Chant
Dr Jeremy McAnulty

VIC - Dr John Carnie
Dr Rosemary Lester

QLD - Dr Jeanette Young
Dr Christine Selvey

TAS - Dr Chrissie Pickin

WA - Dr Tarun Weeramanthri
Dr Andy Robertson

SA - Dr Stephen Christley

ACT - Dr Charles Guest

NT - Dr Barbara Paterson