No need for 'epidemic notice' in flu outbreak

Health officials say they have no plans for Prime Minister John Key to issue an "epidemic notice" - a key legal step to trigger special powers for regional medical officers of health.

"The illness that this pandemic is causing is not severe enough to warrant the use of the powers that issuing the notice would permit," Fran McGrath, deputy director of public health told NZPA.

A total of 127 cases has been confirmed in New Zealand, up 18 from 109 yesterday, and 105 of them are current cases.

There are also 20 probable cases.

The cumulative total of confirmed cases by region are: Auckland 42, Waikato 4, Bay of Plenty/Lakes 3, Hawke's Bay 1, Wanganui/Palmerston North 1, Wellington 27, Nelson/Marlborough 1 and Canterbury 30.

Under an epidemic notice, authorised by the prime minister, regional medical officers of health have the power to:

* 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;
* Call on police to use reasonable force if they need that to carry out their duties.

Dr McGrath said the current priority was containment of the virus, which was estimated to have a "reproductive value" of 1.4, which meant that every two people who fell ill were expected to transmit the disease to three other people.

"Increased spread of the virus could overwhelm the health services during the already busy winter season," she said.

"While the virus in the main causes moderate illness in most people, there is an increased risk for some groups such as those with a chronic disease and pregnancy."

The country was still in a "containment phase", she said.

Containment involved both border management and stamping out clusters of the virus spread. Doctors were telling arriving travellers that only people with flu-like symptoms within four days of overseas travel were now considered to be at risk of having the swine flu form of the A(H1N1) virus.

But as more cases were confirmed in the community the focus would shift to boosting the way care was provided in the community, Dr McGrath said.

Planning for this "manage it" phase provided for community-based health services to manage large numbers of people with influenza as well as maintain services for patients with other illnesses.

As much as 30 percent of the population was expected to contract the swine flu, but the symptoms, which included fever, coughing, a sore throat and often diarrhoea, disappeared after about five days.

In this "manage it" phase, many people would be sent home to look after themselves - in the same way they would with seasonal flu. They would be told to stay home for seven days after the start of symptoms or until they have been symptom-free for 24 hours - whichever was longer.

Health officials expected most ill New Zealanders would be able to nurse themselves at home, though an Australian expert has warned asthma and A(H1N1) flu were a potentially deadly mix.

Dr Matthew Peters, head of respiratory medicine at a Sydney Hospital, said chronic heart or lung disease and diabetes were common ailments that could dramatically escalate the risk posed by the virus.

"Around 40 percent of admissions to hospital with swine flu-related illnesses in the US have been in people with asthma," he said.

Asked to what extent the ministry was looking to the two-week school holidays due to start on July 3 as a potential "firebreak" in reducing the rate of community transmission, Dr McGrath said the school holidays "may be very useful as a break".