Swine flu pandemic declared

FLU ZONE: School children and parents wear face masks as they leave the Japanese International School in Germany. Authorities have confirmed 30 cases of the H1N1 flu at the school.
FLU ZONE: School children and parents wear face masks as they leave the Japanese International School in Germany. Authorities have confirmed 30 cases of the H1N1 flu at the school.

The World Health Organisation has told its member nations it is declaring a swine flu pandemic - the first global flu pandemic in 41 years.

In a statement sent to member countries, WHO said it decided to raise the pandemic alert level from phase 5 to 6, meaning that a global outbreak of swine flu has begun.

The decision was made after the UN health agency held an emergency meeting on swine flu with its experts.

Countries were preparing for tighter swine flu controls as some nations said they had received advance notice of the declaration from the WHO.

Moving to phase 6, the highest level, means a pandemic has begun. It triggers drugmakers to speed up production of a swine flu vaccine and prompt governments to devote more money to containing the virus.

The last pandemic - the Hong Kong flu of 1968 - killed about 1 million people. Ordinary flu kills about 250,000 to 500,000 people each year.

On Wednesday, the WHO reported that the virus has infected at least 27,737 people in 74 countries and caused 141 deaths. Most cases have been in North America, but Europe and Australia have seen a sharp increase in recent days.

Four patients with swine flu were fighting for their lives in Melbourne hospitals, while Thailand's Public Health Ministry said the country's case load had nearly tripled to 46, including 17 infected at a disco in the resort town of Pattaya.

Earlier there had been speculation that a  jump in infections in Australia could push WHO to finally announce a pandemic. Australia's cases reached 1275 by late Wednesday.

NEW ZEALAND'S SITUATION

An Auckland daycare centre has been closed and part of Auckland hospital put on lock-down as the number of confirmed cases of swine flu rises to 27.

An Auckland nurse and her child who returned from a family holiday in the United Kingdom on Air NZ flight NZ1 on June 6 have both tested positive for Influenza A (H1N1).

The Ministry of Health said the nurse worked one shift at Auckland City Hospital's Renal Medicine and Transplant Ward (Ward 71) on June 8 and the child attended ABC Childcare Centre in Meadowbank the same day. Contacts of both cases are currently being traced.

Two former patients who had been cared for by the nurse during the 12-hour shift on June 8 have been visited by medical staff and care plans are in place.

Nineteen ADHB staff who were in close contact with the nurse are also at home in quarantine and taking Tamiflu.

The Ministry of Health said none of the close contacts have flu symptoms at present.

Auckland City Hospital chief medical officer Dr David Sage said the nurse did not have flu symptoms when she was at work on June 8.

However, her child began to show flu-like symptoms that day and immediate medical treatment was sought.

Health Minister Tony Ryall said the growing number of confirmed Swine Flu cases were "anticipated" and are "no cause for alarm".

"It is inevitable we will get much wider spread through the community at some stage and New Zealanders should not be worried by this. We have longstanding plans to deal with the situation," said Mr Ryall.

In the meantime the Health Minister says it is important people continue to hide sneezes and coughs in a tissue, then wash and dry their hands thoroughly. If they think they have flu symptoms they should, in the first instance, call their doctor or Healthline (0800 611 116).

NEW POWERS GIVEN TO HEALTH OFFICIALS

The declaration of a full-blown global influenza pandemic places the nation's regional health officials in the limelight.

New health regulations which took effect on April 29 added non-seasonal flu – such as A/H1N1 swine flu – to other quarantinable diseases such as avian influenza, cholera, plague and yellow fever.

And a ministerial authorisation, an epidemic notice issued under the Epidemic Preparedness Act 2006, or declaration of a state of emergency can give extra powers to regional medical officers of health.

These officials are public health specialists the director-general of health makes responsible for specific health districts.

According to Iris Reuvecamp, a senior associate at Buddle Findlay law firm, issue of epidemic notice for non-seasonal flu – a quarantinable disease under the Health Act – will mean health authorities can:

* Require people to submit to medical examination or testing at specified times and places;

* Require persons, places, buildings, ships, vehicles, aircraft, animals or things to be tested, isolated, quarantined or disinfected as they think fit;

* Restrict the movement of people and vehicles;

* Set up emergency hospitals;

* Restrict public gatherings;

* Close any premises, except for Parliament and private homes;

The Health Act also allows the officials to call on police to use reasonable force if they need that to carry out their duties.

The Epidemic Preparedness Act 2006 says that the prime minister may issue an epidemic notice if they are satisfied that the effects of an outbreak of a quarantinable disease are likely to significantly disrupt or to continue to disrupt essential government and business activity.

And while such a notice is in force, the Government has significant powers to make regulations which temporarily modify other statutes.

There are no appeal provisions specified in the Health Act for exercise of powers of the medical officers of health – they can require people to undergo counselling and to refrain from carrying out specified activities, going to specified places, associating with specified persons or specified classes of persons, staying at a specified residence and accepting the supervision of a named person.

But more restrictive powers, such as detention or compulsory medical examination, are likely to only be exercised under a "health risk order" issued by a court, though a medical officer of health could issue an interim order for detention of up to 72 hours with immediate effect.

The regional health officials already have extensive powers: under section 79 of the Health Act, they can order a person suspected of spreading an infectious disease to be isolated, an order that can executed by force if necessary.

Where a person is suspected of suffering from non-seasonal influenza, they can be forced to provide bodily samples, and to be detained under surveillance doctors are satisfied that he or she is not contagious.

Detention can be up to a maximum of 28 days, and may only be more than 14 days if the medical officer of health considers the person is still contagious.

SWINE FLU SPREAD IN ASIA

Several Asian governments took fresh measures to contain the virus. The Chinese territory of Hong Kong ordered all kindergartens and primary schools closed for two weeks after 12 students were infected. A school in Bangkok will be shut for a week after four students were infected.

Hong Kong, which has counted swine flu cases separately from the mainland, reported 61 cases as of Thursday.

In Beijing, China's health minister said the swine flu virus was under control on the mainland, despite a rise in new infections to more than 110. Those include about 10 cases where people caught it from others within the country.

China has been quarantining people exposed to the virus, including New Orleans Mayor Ray Nagin, who was released after a three-day quarantine in a Shanghai hotel.

New infection cases were also reported in the Philippines, South Korea, New Zealand, Vietnam and Malaysia.

The Philippine Health Secretary Francisco Duque confirmed 15 new cases, bringing its total to 92 - the highest number in Southeast Asia.

South Korea reported one new case to bring its total to 56, and Vietnam confirmed one new case to bring its total to 20.

Malaysia's Health Ministry said two more people had tested positive for swine flu, bringing the country's total to 11.

The virus has proven relatively mild in Asia, and most patients have recovered. Australian officials tried to assure the public that the fact four people there were in critical condition did not mean the virus was becoming more dangerous.

"We don't have any evidence or suggestion that the disease itself is mutating in any way," Health Minister Nicole Roxon said. "Those who are hospitalised generally have ... had other existing conditions and complications, such as morbid obesity or respiratory conditions."

Australian authorities on Thursday defended their handling of H1N1, saying the high number of cases, the overwhelming majority in the southern state of Victoria, was a result of widespread testing and a normal winter flu season.

"We have tested 5500 people in the last two weeks, that is more people than we test in our whole influenza season," said Victorian state premier John Brumby. "If you test that many people you will find something.

The other two new cases were reported in the Waikato, where a factory worker and a New Zealander recently returned from Melbourne have tested positive to the virus.

- By CLIO FRANCIS, AP and Reuters