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Pandemic Influenza The Australian Response Business Council of Australia Friday 16 December 2005. Professor John Horvath Chief Medical Officer Australian Department of Health and Ageing. Pandemics have been documented since 1889, occurring in 10-40 year cycles
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Pandemic Influenza The Australian Response Business Council of Australia Friday 16 December 2005 Professor John Horvath Chief Medical Officer Australian Department of Health and Ageing
Pandemics have been documented since 1889, occurring in 10-40 year cycles Historical anecdotes date pandemic like events as far back as 1100’s, some catastrophic
Avian Influenza Epidemic - affected countries July 27 2005 - Now also Mongolia and Russia
Avian Influenza Epidemic • Human Cases • First human cases in 1997 in Hong Kong with 18 cases • and 6 deaths and again in 2002 with 3 deaths. • Widespread culling of poultry was carried out. • Widespread re emergence in 2003 • WHO notifications 133 cases with 63 deaths since 2003 • Drug Resistance • H5N1 is to one class of the two types of antiviral • medication
The most recent wave In Vietnam & Cambodia Changing epidemiological pattern - family clusters - wider age range - reduction in mortality Genetic changes occurring The risk of pandemic is considered by many to be increasing
IMPACT OF PANDEMIC STRAIN IN AUSTRALIA In Australia’s population with an attack rate of 25% we would expect over 6 – 8 weeks 13,000 deaths (2,000 children, 7,000 elderly) 57,900 hospitalisations 2.6 million outpatient visits (Meltzer CDC 2003)
Preparedness • 2003 2005 • Department of Health • The National Incident Room upgraded • Increased resources centrally development of response • plans and interagency roles • High level representation on peak committees • Scenario testing • Border (learning from SARS) • Training for border workers • Thermal scanners purchased • Development of border protocols • - positive pratique • - customs
Preparedness 2003 2005 • Surveillance • Development of rapid on line surveillance • and case management tools • Secure networks • Laboratory • Upgrading of public health laboratory capacity • Relocation and upgrading of the WHO • Collaborating Centre for influenza
Preparedness 2003 2005 • Stockpile • $150 M antivirals • Additional antibiotics • Infection Control Equipment (masks, gloves) • Vaccination Packs • Negative Pressure Units • Quarantine Caches
Preparedness 2003 2005 • Vaccines • Two contracts, on soil and overseas • Pandemic capacity plus research and development • Recent additional funding to CSL Ltd • - fast track clinical trials (finalise Sept 06) • - immediate and potential stockpile • pandemic vaccine capacity
Preparedness 2003 2005 • Communications package • Information to general practitioners • DVD on infection control • Communications forums commencing • Review of urgent research needs • NHMRC and DoHA Development of Australian Management Plan for Pandemic Influenza
Antiviral Recommendations The objective of the Australian antiviral stockpile is to reduce mortality and morbidity through containment of the pandemic and maintenance of essential services. The best use of the antivirals will differ dependent on the phases of the pandemic.
Communications • Phase specific during pandemic alert • Current educational materials • Information kit for general practitioners • DVD on infection control • Department of Health and Ageing’s website • Qualitative research underway to inform Communications strategy and materials • Informed Communications strategy by June 2006
Research • NHMRC pledged $7.5m to emergent infectious diseases research • $23.2m to upgrade the World Health Organisation collaborating influenza laboratory in Melbourne • Priorities for pandemic influenza • Rapid diagnostic tests • Modeling public health interventions • Social issues/communication • Transmission parameters • Antivirals/vaccine development • Antiviral resistance
Many policy challenges • Many health and social policy dilemmas • Degree of border control • School closures, banning of mass gatherings • International efforts to control disease • Quarantine of well contacts and areas of Australia • Communication approach • Level of social interaction at different phases • Priority groups of antivirals and then vaccines • Maintaining essential services versus caring for the sick