The South's low population and a smaller volume of international air travel may be the reasons why there are no confirmed cases of swine flu in Otago and Southland, deputy director of public health Dr Darren Hunt said yesterday.
However, this did not mean there would not be cases in the future.
Otago, Southland, Northland and Tairawhiti (Gisborne) districts are the only areas where there have been no confirmed cases as health authorities nationally are moving to manage rather than contain swine flu outbreaks.
The change announced yesterday was about how the outbreak was managed, Health Minister Tony Ryall said.
"We're remaining in code yellow; we are not moving to code red. This is a reflection of the spread, not the severity, of the flu," he said.
Yesterday, there were 643 suspected cases across the country.
The total number of confirmed cases was 216, with most in the Wellington (80), Canterbury (77) and Auckland (46) areas.
No deaths have been recorded in New Zealand.
However, a Lower Hutt woman last night remained in critical condition with swine flu in Wellington Hospital's intensive care unit.
The 30-year-old morbidly obese woman, with respiratory problems as well as swine flu, was believed to be a unique case.
Wellington, too, become the first region to place restrictions on who gets the antiviral drug Tamiflu.
"Only those with severe symptoms or serious health conditions will be given Tamiflu," Wellington regional public health medical officer Stephen Palmer Palmer said.
Estimates show a sharp increase in the number of people visiting their doctors in the past week from about 30 per 100,000 people to almost 60.
Some primary health organisations and other health services contacted by the Otago Daily Times yesterday reported no particular difficulties in dealing with increased numbers of people concerned about swine flu.
Student Health Services director Dr Kim Maiai said the amount of people with flu symptoms being seen was normal - " quite low".
The situation could change and the service was prepared for that.
Well Dunedin primary health organisation co-ordinator Jo-Anne Skinner said a meeting of representatives of the 29 practices in the PHO had reported a slightly increased workload dealing with flu inquiries, but this did not seem to be causing difficulties.
Practices were well aware of the need for planning should the situation escalate and the district health board had " absolutely fabulous" processes and contingencies.
• Parents who defy new regulations providing for children exposed to swine flu to be excluded from school are liable to fines of up to $500.
The Health (Infectious and Notifiable Diseases) Amendment Regulations 2009 that took effect on June 8 allow children and teachers to be sent home for up to seven days.
But schools can close altogether in the case of an epidemic or other emergency.
• Managing the outbreak
Containment focus
> Identifying possible cases.
> Quarantining or isolating suspected cases and people in close contact with them.
> Providing Tamiflu medication for that group.
This approach meant closure of a business as well as school classrooms, and vetting of people entering New Zealand.
Management focus
> Continued identification of likely cases.
> Isolation only for confirmed cases.
> Those with symptoms would get treatment.
This approach means people with the flu staying home and treating themselves. Advice is available on health lines or by calling GPs.
Only seriously ill people would be treated with Tamiflu. Containment would continue in areas where swine flu had not spread or strategically; for example, a class may be sent home to reduce spread across the whole school.
