Swine flu concerns spread nationwide

Otago, Nelson, Waikato, Auckland outbreak fears

At least four district health boards are battling a suspected swine flu outbreak, as the Prime Minister warns Kiwis to think very carefully before travelling to Mexico.

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Health Minister Tony Ryall said this afternoon that Otago District Health Board was also dealing with suspected cases of swine flu - adding to two possible cases reported in Waikato and further cases in the Nelson-Tasman region.

Cases of Influenza A were confirmed in Auckland yesterday in 10 Rangitoto College pupils who had been staying in Mexico. Officials say it is "likely" they have contracted swine flu.

The college group had originally thought they might be having a bad reaction to Mexican food, Rangitoto College principal David Hodge said.

At least three students from a second school group, Northcote College - which also returned from Mexico on Saturday - have also exhibited flu-like symptoms. Officials are likely to find out today if those pupils have also contracted Influenza A.

Mr Ryall said officials were treating all cases as if they had swine flu and administering Tamiflu. There are currently 1.25 million Tamiflu treatment courses in New Zealand, though some of the stock would expire later this year.

Prime Minister John Key said this afternoon that while there was not a travel ban in place for Mexico "people should think very cautiously about visiting."

He said there was some suggestion that if visitors became unwell they may be stopped from leaving Mexico.

It has emerged this afternoon that a number of passengers on board Air New Zealand Los Angeles flight NZ1 - carrying the 10 influenza-infected Rangitoto College students - are now in isolation.

Mr Ryall said this afternoon that two thirds of the passengers on NZ1 had been contacted by health officials for follow-up checks.

A team of 25 was making contact with the passengers. Once completed passengers on board NZ5 - the flight carrying the Northcote College pupils - would also be contacted, Mr Ryall said.

Mexican officials today put the death toll from the new swine flu strain at over 100, with about 1600 sick, while cases have also been reported in the United States, Canada, Spain and France.

Nelson Marlborough Public Health Service said this evening they were following up 10 people from flight NZ1 as well as eight people from flight NZ5. 

District manager Peter Bassett said 20 people had so far been identified across the Nelson-Marlborough district "and are in home quarantine until further notice."

Waikato District Health Board said this afternoon it was investigating two possible cases of swine flu. In both cases the patients had been isolated within their homes until test results for Influenza A come back within the next 24 hours.

PASSENGER DISAPPOINTED AT RESPONSE

A Christchurch father onboard NZ1 from Los Angeles, who did not want to be named, said he was disappointed with the response from health officials. "I'm a bit hacked off with the Department of Health."

Since visiting an emergency 24-hour doctor surgery he had had no contact with health officials.
 
He had purchased two courses of Tamiflu at a cost of $160, which he planned to take as a precaution.

"I just want to eliminate any risks," he told Stuff.co.nz this afternoon.

He believed Tamiflu treatment for the 360-odd passengers on board NZ1 should be mandatory, particularly as there was a stockpile of 1.2 million Tamiflu treatments following the 2003 Sars outbreak.
 
"They could stamp it out for the [nearly] 400 people onboard. But potentially by now they could have tens-of-thousands of people exposed to it."

He had not been sitting near the 22 Rangitoto College pupils and three teachers on flight NZ1, but had checked-in alongside the sombrero-wearing group, returning from a language trip to Mexico.

HEALTH OFFICIALS RESPOND:

Director of Public Health Dr Mark Jacobs said it was possible the virus could be spread through toilet contamination on board the flight if the affected party members had not washed their hands, but overall the risk of infection spread was relatively low.

Testing on the Influenza A-positive results from Rangitoto pupils will begin in Melbourne today with officials poised to upgrade infection control measures, if needed. "We're going to continue dealing with it as if it's swine flu until we're told it's not," Dr Jacobs said.

"Additional measures may involve greater surveillance," Mr Ryall said.

Influenza A-positive tests results were being sent to Melbourne as that was where laboratories that meet World Health Organisation testing standards were based.

He stressed however that New Zealand was heading into the flu season and the great majority of Kiwis who may have flu symptoms "have just got a cold".

"This [advice] is specifically about people who have been in Mexico and the US in the past couple of weeks and they've developed symptoms."

Dr Jacobs said the situation was very different in Mexico compared with the US. "We still don't know if the deaths in Mexico are related to this particularly type of infection [swine flu] or not." He said only 19 tests had been carried out on the many suspected cases of swine flu in Mexico.

The situation in the US was encouraging with patients mainly suffering "a mild flu-like illness," Dr Jacobs said.

Director-General of Health Stephen McKernan said New Zealand was one of the first to identify the potential swine flu outbreak and he predicted other countries would also discover such cases in the coming days.

Dr Jacobs said there were two main factors that lead health officials to believe swine flu was "likely". "Firstly, the fact that it's Influenza A... The second is the link to Mexico and the fact they are coming out of their influenza season." If the flu had been contracted while the pupils were visiting in winter - Mexico is currently moving into summer - it would be of less concern, he said.

'FREAKY' SITUATION

One of the sick Rangitoto high school students, who has tested negative for the deadly flu, spoke with Radio New Zealand this morning.

The unnamed girl - who is currently in quarantine at her home – told how the group were in homestays for the last few days of their trip to Mexico.

"We were at the school with them and living with them for about three or four days of the trip but we were out and about basically every minute of the day."

"Some of us were getting coughs and stuff within the last few days of our trip," she said. 

The student said while she had been suffering a cough and the occasional headache the flu was "not really bothering" her.

The Department of Health had told her she could be in quarantine for up to a week.

"It is pretty surreal. It's sort of movie like, but it's alright. My mum is with me so we'll be all good amusing ourselves."

The situation didn’t really feel real, she said.

"I think that it's pretty freaky... some people might be freaking out about who they've been in contact with and whether their kid has it or not and it's a fair worry."

Rangitoto College principal David Hodge said the positive tests were a shock. "Naturally we are very anxious for the students and staff affected and their families.

"But our fears are tempered by the fact they are getting the best medical care possible. The response from the health authorities has been amazing. From the start, we erred on the side of caution."

Mr Hodge told Radio New Zealand this morning the school was open today after being given the all clear by health authorities.

The 22 students and three teachers affected were being closely monitored, he said.

AIRPORT SURVEILLANCE

Health authorities have instituted a "Code Yellow", with district health boards on alert and airport surveillance beefed up.

Travellers arriving into Auckland Airport from North America this morning were issued with a public health warning.

If the situation deteriorated, the ministry would "ramp up" its response, moving into the code red phase.

This would involve far more intensive work at border entry points, ring-fencing outbreaks within New Zealand, and continuing to treat patients with Tamiflu.

The Foreign Affairs and Trade Ministry has also issued a travel notice for people returning from Mexico, California and Texas.

STOP THE SPREAD:

- Stay at home and away from others if you are sick

- Cover coughs and sneezes with a tissue and put used tissues in the bin

- Wash and dry hands frequently, even when you start to feel better

* Anyone who has travelled to Mexico or North America in the last fortnight should contact Healthline (0800 611 116) for information. They should seek medical advice if they are displaying flu-like symptoms.

- By ANNA CHALMERS, CLIO FRANCIS and MICHAEL FIELD with NZPA