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Scotland and Australia: What's really happening

Fergus Walsh | 23:02 PM, Wednesday, 10 June 2009

Swine flu warning in MelbourneHours before the World Health Organization is expected to declare a pandemic of H1N1 swine flu, I've been seeking expert comment from two of the worst affected countries outside North America - Scotland and Australia.

Along with Chile and Japan, these are the countries which are forcing the move to Phase 6, a global epidemic or pandemic.

Dr Ian Barr is the Deputy Director of the WHO Influenza Centre in Australia.

He's based in Melbourne, which is the centre of the flu outbreak there.

The state of Victoria has had more than 1,000 confirmed cases of swine flu and Dr Barr said that the government was now changing the way it managed the outbreak.

"If someone is ill then we will continue to ask that they stay at home and don't go out and risk infecting anyone. But there won't be a recommendation for quarantining whole families as has happened.
"Unless someone falls quite ill they won't be given antiviral treatment like Tamiflu and we won't trace their contacts. We won't close schools if there's a single case, so it's a much more relaxed approach than we've had prior to this phase."

But Dr Barr said that the virus was not causing serious problems:

"We've had just a handful of cases admitted to hospital and no deaths.
"There've been very mild symptoms among the 1,000 laboratory confirmed cases and probably thousands more that have not been tested."

With the southern hemisphere moving into its peak winter flu season, it will be vital to keep a close watch on what happens there in the months ahead.

Dr Harry BurnsScotland, by contrast, is heading into summer. That did not stop 47 new cases being confirmed there today, the highest number for a single day. It takes the total to 311.

Ten people are in hospital. Dr Harry Burns, the Chief Medical Officer for Scotland, said that there was no doubt that they were seeing community transmission well beyond the confirmed cases.

"The last figures I saw there were between 30 and 40 cases where there was no known source for the infection - it did not seem to be travel-related or connected to a particular outbreak. But sometimes people don't always remember their contacts".

Dr Burns said that there was also no doubt that there were plenty of cases going untested and unmeasured, just as was happening in other countries.

I asked him whether it was time for a change in approach as is happening in Australia, with fewer school closures and so on.

"We are getting close to a change in strategy, but quite how and when it is rolled out we can't say yet. We will continue to take scientific advice.
"If you have a new travel-related case in a rural part of Scotland where there have been no cases, then you may look for contacts. That might be less so in other areas where there have been lots of cases."

He has no doubt that the virus is here to stay and he hoped that it would remain a largely mild infection.

"But it's worth preparing for the worst. The nightmare scenario a few years ago was that H5N1 avian flu would reassort with a human flu virus in pigs.
"If H1N1 reassorted with H5N1, it would be important to have some initial protection against the H1N1 strain. That's why it's worth creating a vaccine."

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  • 1. At 08:12am on 11 Jun 2009, sensiblegrannie wrote:

    What do ordinary people do in Australia at the moment? How does the average Australian get on with the ordinary daily grind of life with flu everywhere?

    Closing schools is daft and is an overreaction.

    Yes there are some people who may be compromised, but mostly kids and families will get the flu and get over it, as they have done with all other flu viruses. Those children and adults with special exceptions could stay away from school and work during peak virus transmission, working and learning from home.

    The only time that schools should close is if H5N1 is in the country. Egypt should take more precautions. There is supposed to be a rapid test available to test for H1N1 and hopefully it can distinguish between the two viruses.

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  • 2. At 08:59am on 11 Jun 2009, jpwrighty wrote:

    Thanks again Fergus for bringing us further insights into this Flu Pandemic as it is/will be classified from today. In the Northern Hemisphere so much more populated than the Southern Hempishere we are able to 'see' a Flu Season of H1N1 in progress, a lucky break for us so to speak. I am very pleased to see the reaction taken by the Australian Authourities. I was lucky enough to visit some of the Health Departments in Australia 2 years ago and I thought they were excellent representatives of Public Health then, now I am even more pleased to see the cautious, but not over reacted stance they have taken.

    We of course need to be concerned about H5N1, as this seems to attack much lower down the respitory tract and is therefore so much more dangerous (I believe that the smaller the changes from Bird to Human form, means it will generally be that more deadly). The chances of H5N1 and H1N1 combiing to form a new strain are I believe, and please correct me if i'm wrong, very very low 'at present'. Still we have to be wary as this combination could lead to a less virulent strain in comparison to H1N1 but it would produce much more deadly symptoms, in correspondance to the H5N1 strain.

    I continue to look forward to both your reports Fergus, and the great comments on this blog.

    JP


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  • 3. At 4:01pm on 11 Jun 2009, Innocent Monya-Tambi wrote:

    As I read this, the news flash is that WHO has declared a pandemic. It seems most developed countries are capable to some extent to deal with the current situation. However my real concern, is for developing (especially African) countries with poor health infrastructure and resources and public health awareness/education media in place to begin with. With responsibility on individual governments to take specific measures, we may likely see very large variations in approaches depending on resources availability/allocation. And given the large scale global travel in today's world, how this would compromise the overall global effort in dealing with this pandemic is yet to be seen. Do you have any information on what is being done at the moment for vulnerable people in these countries at the intergovernmental or WHO level to mitigate this threat posed?

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