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A presentation by Australia's Chief Medical Officer, Professor Jim Bishop AO, to the MISMS Oceania Influenza Meeting. 16 March 2010
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Overview of the current situation for H1N1 Influenza in
Australia amp Internationally
MISMS Oceania Influenza Meeting
MELBOURNE -
16 March 2010
Professor Jim Bishop AO Chief Medical Officer
The Australian Health Management Plan for Pandemic Influenza (AHMPPI)
bull
The AHMPPI (2008) third edition of the national health management plan
bull
Revised as a result of Exercise Cumpston 06ndash
Addressing policy gaps
ndash
Streamlined decision makingndash
More flexible policy
Australian Health Protection Committee (AHPC) Aileen Plant National Incident Room
bull
The key decision-making body for health emergenciesndash
Chaired by DoHA Deputy Secretary
ndash
Commonwealth CMO ST Chief Health Officers
ndash
Experts in mental health emergency medicine communicable diseases
bull
Preparedness role
bull
Response role in health emergencies
4
WHO announces health emergency24 Apr
WHO moves to Pandemic phase 427 Apr
Australia moves to
Pandemic DELAY28 Apr
WHO moves to Pandemic
phase 529 Apr
Australia moves to Pandemic
CONTAIN22 May
Victoria moves to MODIFIED
SUSTAIN3 Jun
WHO moves to Pandemic
phase 611 Jun
Australia moves to Pandemic
PROTECT17 Jun
TGA Approves pandemic (H1N1) vaccine WHO Donation18 Sept
30 Sept Adult Vaccination Program commences
TGA Approves and registers pandemic vaccine
for children5 Dec
PANDEMIC (H1N1) 2009 TIMELINE
DELAY PHASE
CONTAIN PHASE
bull
Contact tracing and home quarantinebull
Anti-virals for contacts
bull
Increased public messaging bull
Some school closures
bull
Continuation of the measures commenced in DELAY
Actions taken during CONTAIN included
H1N1 Influenza 09 Pandemic Phases
ALERT (pre 24 April 09)
DELAY (24 April 09)
CONTAIN (22 May 09)
SUSTAIN
Victoria moved to a MODIFIED SUSTAIN on 3 June 2009
CONTROL
RECOVER
PROTECT
17 June 2009
Evidence supports focusing efforts on protecting the lsquovulnerablersquo
Australias response is continual informed by the emerging evidence around the virus and effectiveness of control measures
H1N1 Influenza 09 mild in most and severe in
some (the vulnerable)
Key Elements of PROTECT
bull Re-focus of testing and treatmentbull Identification and early treatment for those at risk bull
Voluntary home isolation no treatment mild disease
bull Controlling outbreaks in special settingsbull Limited school closures early in the Pandemicbull Communicationsbull Re-focus surveillance
Office of Health Protection Surveillance Branch Department of Health and Ageing
PANDEMIC (H1N1) 2009 SURVEILLANCE AUSTRALIA
0
200
400
600
800
1000
1200
1400
1600
805
200
9
220
520
09
506
200
9
190
620
09
307
200
9
170
720
09
310
720
09
140
820
09
280
820
09
110
920
09
250
920
09
910
200
9
231
020
09
611
200
9
201
120
09
412
200
9
181
220
09
101
201
0
150
120
10
290
120
10
120
220
10
260
220
10
Date of onset notification
Num
ber o
f con
firm
ed c
ases
of p
ande
mic
(H1N
1) 2
009
ACT NSW NT Qld
SA Tas Vic WA
VIC moved to modified SUSTAIN phase
AUS phase PROTECT
Vaccination commenced
Source NetEPI database
Source NetEPI
database
Laboratory Confirmed CasesOf Pandemic (H1N1) in Australia
to 26 February 2010
0
10
20
30
40
50
60
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53Week
Rat
e of
ILI p
er 1
000
con
sulta
tions
ASPREN 2007ASPREN 2008ASPREN + NT + VIDRL 2009ASPREN + NT 2010
First case of Pandemic
(H1N1) 2009 reported in Australia
bullDelays in the reporting of data may cause data to change retrospectively As data from the NT surveillance system is combined with ASPREN data for 2010 rates may not be directly comparable across 2007 2008 and 2009 SOURCE ASPREN and NT GP surveillance system
Sentinel General Practice Surveillance1 January 2007 to 21 February 2010
0
200
400
600
800
1000
1200
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51Week
Num
ber o
f Em
erge
ncy
Dep
artm
ent I
LI
Pre
sent
atio
ns in
WA
2007 Presentations2008 Presentations2009 Presentations2010 Presentations
Child deaths associated with
influenza infection in 2007
Source WA lsquoVirus Watchrsquo Report
WA Emergency Departments1 January 2007 to 14 February 2010
Source NSW lsquoInfluenza Monthly Epidemiology Reportrsquo
Deaths Associated with Influenza and Pneumonia 2005 - 2010
Rates of absenteeism (greater than 3 days absent) national employerfrom 28 January 2007 to 17 February 2010 by week
0
02
04
06
08
1
12
14
16
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53
Week
Per
cent
of S
taff
Abs
ent
2007 Absenteeism2008 Absenteeism2009 Absenteeism2010 Absenteeism
SOURCE Absenteeism data
ABSENTEEISM28 Jan 2007 to 17 Feb 2010
Overview of pandemic (H1N1) 2009 severity ndash to 26 February 2010
2009 2010Pandemic (H1N1) 2009 Confirmed
casesHospitalised
casesICU cases Deaths Confirmed
casesHospitalised
casesICU
casesDeaths
Total number 37636 13 ofConfirmed
cases
14 ofHospitalised
cases
191 44 +186
InfluenzaType A
11 1 0
Crude rate per100000 population
1721 228 31 09 02
Median age (years) 21 31 44 53 30
Females 51 51 53 44 29
Vulnerable groups na 58 74 67
Indigenous people 11 20 19 13
Pregnant women na 27 Hospitalisedfemales aged15-44 years
16 Hospitalised
Pregnantwomen
4
Cases with at least 1co-morbidity
na 46 67 62
Severe Pandemic (H1N1) 2009
Hospitalisations-
Respiratory diabetes immuno compromised obesity chronic cardiac renal pregnancy rapid deteriorating flu patient
Higher proportion of Indigenous Australians
Over 50 admitted within 48 hours of onset
Higher ICU Admissions than expected
Hospitalisations of pandemic (H1N1) 2009 5 June ndash
23 October 2009 by week
17
0
100
200
300
400
500
600
700
21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43
Week of report
Num
ber o
f hos
pita
lista
tions
ass
ocia
ted
with
pan
dem
ic (H
1N1)
200
9
Australia
Age specific rates of hospitalised confirmed cases of pandemic (H1N1) 2009 to 3 October 2009 compared with average annual age specific rates of
hospitalisations from seasonal influenza 2004-05 to 2006-07 Australia
18
00
100
200
300
400
500
600
700
800
0-4
5-9
10-1
415
-19
20-2
425
-29
30-3
435
-39
40-4
445
-49
50-5
455
-59
60-6
465
-69
70-7
475
-79
80-8
485
+
Age group (5 Years)
Age
spec
ific
rate
(per
100
000
pop
ulat
ion) Males pandemic (H1N1) 2009
Females pandemic (H1N1) 2009
2004-07 seasonal influenza
Comparison of hospitalisations ICU admissions and deaths by age group to 2 October 2009
0
200
400
600
800
1000
1200
1400
0-9 10-19 20-29 30-39 40-49 50-59 60+
Age groups (10 years)
Tota
l num
ber
of h
ospi
talis
atio
ns
and
ICU
adm
issi
ons
of
conf
irmed
cas
es
0
10
20
30
40
50
60
Num
bers
of d
eath
s of
con
firm
ed
case
s
HospICUDeaths
Notification rates for pandemic (H1N1) 2009 in a selection of affected countries
Country Population Confirmed cases Crude rate per 100000
population
Hospitalisation rate per 100000 population
Deaths Trends
Southern Hemisphere
Australia 21262641 37636 1721 228 191 Low influenza activity
New Zealand 4319932 3233 730 227 18 Low levels of ILI decreasing trend
Argentina 40482000 11234 278 337 613 Low ILI activity decreasing trend
Chile 16454143 12276 746 98 150 Low ILI activity decreasing trend
Northern Hemisphere
Canada 33212696 NA 235 44 336 Low influenza activity
UK 60943912 26110 428 NA 265 Decreasing influenza activity
Mexico 109955400 66070 601 na 671 na
USA 304059724 50768 165 103 1336 Low influenza activity
Pandemic (H1N1) 2009 Vaccine
bull
Safety profile as with seasonal flu
bull
One injection 15μg protects adults
bull
FDA licenceTGA registration
bull
Emphasis on priority groups but available to ALL
Source New England Journal of Medicine 2009 361 September 10
Clinical Trials of Pandemic (H1N1) 2009 Vaccine
Systemic Side effects
Headache
Fever
Myalgia
Malaise
Immune Response15mcg
97
30mcg 93
Source New England Journal of Medicine 2009 361 September 10
VACCINE ROLL OUT
bull
Around 76 million doses distributed (35
population)
bull
Available for this Influenza season
bull
Trivalent vaccine for seasonal influenza available
to targeted groups
Key lessons so far
1
Value of detailed planning2
Leadership and co-ordination
bull
AHPCbull
NPEC
3
Flexibility4
Medical innovation
5
Communication
NEJM on line publication ndash
Dec 2009
Current Situation ndash
2010
bull
Influenza activity low in Australia but showing some signs of increasing earlier than usualndash
lt2 respiratory tests positive for influenza
ndash
55 confirmed cases influenza per week
bull
Pandemic strain predominant in Australiandash
35 pandemic (H1N1) 2009
bull
Pandemic (H1N1) 2009 predominant in most countries
bull
Type B predominant in China (83) and Hong Kong (56)
Laboratory confirmed cases of influenza (pandemic (H1N1) 2009 and seasonal) in Australia 2010 to 26 February by week and type
0
10
20
30
40
50
60
2012010 9012010 16012010 23012010 30012010 6022010 13022010 20022010
Week of onsetnotification - start date
Num
ber o
f con
firm
ed in
fluen
za c
ases
AMexico2232009(H1N1) AH1N1 strain unknownA not subtyped AH1N1Brisbane592007AH3N2 AH3n2Brisbane102007 BUntyped AampB
Current Situation -
2010
KEY INDIVIDUALS FOR PANDEMIC RESPONSE
NIRMs Mary MurnaneMs Jenny BryantDr Gary LumMs Fay GardnerDr Bernie TowlerDr Andrew SingerDr Andrea FordeMs Kay McNieceDr Jenean Spencer
Prof Terry Nolan ATAGIDr Chris Mitchell RACGPDr Vicki Krause CDNA
NSW
Dr Kerry Chant
Dr Jeremy McAnulty
VIC
Dr John Carnie
Dr Rosemary Lester
QLD
Dr Jeanette Young
Dr Christine Selvey
TAS
Dr Chrissie Pickin
WA
Dr Tarun Weeramanthri
Dr Andy Robertson
SA
Dr Stephen Christley
ACT
Dr Charles Guest
NT
Dr Barbara Paterson
The Australian Health Management Plan for Pandemic Influenza (AHMPPI)
bull
The AHMPPI (2008) third edition of the national health management plan
bull
Revised as a result of Exercise Cumpston 06ndash
Addressing policy gaps
ndash
Streamlined decision makingndash
More flexible policy
Australian Health Protection Committee (AHPC) Aileen Plant National Incident Room
bull
The key decision-making body for health emergenciesndash
Chaired by DoHA Deputy Secretary
ndash
Commonwealth CMO ST Chief Health Officers
ndash
Experts in mental health emergency medicine communicable diseases
bull
Preparedness role
bull
Response role in health emergencies
4
WHO announces health emergency24 Apr
WHO moves to Pandemic phase 427 Apr
Australia moves to
Pandemic DELAY28 Apr
WHO moves to Pandemic
phase 529 Apr
Australia moves to Pandemic
CONTAIN22 May
Victoria moves to MODIFIED
SUSTAIN3 Jun
WHO moves to Pandemic
phase 611 Jun
Australia moves to Pandemic
PROTECT17 Jun
TGA Approves pandemic (H1N1) vaccine WHO Donation18 Sept
30 Sept Adult Vaccination Program commences
TGA Approves and registers pandemic vaccine
for children5 Dec
PANDEMIC (H1N1) 2009 TIMELINE
DELAY PHASE
CONTAIN PHASE
bull
Contact tracing and home quarantinebull
Anti-virals for contacts
bull
Increased public messaging bull
Some school closures
bull
Continuation of the measures commenced in DELAY
Actions taken during CONTAIN included
H1N1 Influenza 09 Pandemic Phases
ALERT (pre 24 April 09)
DELAY (24 April 09)
CONTAIN (22 May 09)
SUSTAIN
Victoria moved to a MODIFIED SUSTAIN on 3 June 2009
CONTROL
RECOVER
PROTECT
17 June 2009
Evidence supports focusing efforts on protecting the lsquovulnerablersquo
Australias response is continual informed by the emerging evidence around the virus and effectiveness of control measures
H1N1 Influenza 09 mild in most and severe in
some (the vulnerable)
Key Elements of PROTECT
bull Re-focus of testing and treatmentbull Identification and early treatment for those at risk bull
Voluntary home isolation no treatment mild disease
bull Controlling outbreaks in special settingsbull Limited school closures early in the Pandemicbull Communicationsbull Re-focus surveillance
Office of Health Protection Surveillance Branch Department of Health and Ageing
PANDEMIC (H1N1) 2009 SURVEILLANCE AUSTRALIA
0
200
400
600
800
1000
1200
1400
1600
805
200
9
220
520
09
506
200
9
190
620
09
307
200
9
170
720
09
310
720
09
140
820
09
280
820
09
110
920
09
250
920
09
910
200
9
231
020
09
611
200
9
201
120
09
412
200
9
181
220
09
101
201
0
150
120
10
290
120
10
120
220
10
260
220
10
Date of onset notification
Num
ber o
f con
firm
ed c
ases
of p
ande
mic
(H1N
1) 2
009
ACT NSW NT Qld
SA Tas Vic WA
VIC moved to modified SUSTAIN phase
AUS phase PROTECT
Vaccination commenced
Source NetEPI database
Source NetEPI
database
Laboratory Confirmed CasesOf Pandemic (H1N1) in Australia
to 26 February 2010
0
10
20
30
40
50
60
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53Week
Rat
e of
ILI p
er 1
000
con
sulta
tions
ASPREN 2007ASPREN 2008ASPREN + NT + VIDRL 2009ASPREN + NT 2010
First case of Pandemic
(H1N1) 2009 reported in Australia
bullDelays in the reporting of data may cause data to change retrospectively As data from the NT surveillance system is combined with ASPREN data for 2010 rates may not be directly comparable across 2007 2008 and 2009 SOURCE ASPREN and NT GP surveillance system
Sentinel General Practice Surveillance1 January 2007 to 21 February 2010
0
200
400
600
800
1000
1200
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51Week
Num
ber o
f Em
erge
ncy
Dep
artm
ent I
LI
Pre
sent
atio
ns in
WA
2007 Presentations2008 Presentations2009 Presentations2010 Presentations
Child deaths associated with
influenza infection in 2007
Source WA lsquoVirus Watchrsquo Report
WA Emergency Departments1 January 2007 to 14 February 2010
Source NSW lsquoInfluenza Monthly Epidemiology Reportrsquo
Deaths Associated with Influenza and Pneumonia 2005 - 2010
Rates of absenteeism (greater than 3 days absent) national employerfrom 28 January 2007 to 17 February 2010 by week
0
02
04
06
08
1
12
14
16
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53
Week
Per
cent
of S
taff
Abs
ent
2007 Absenteeism2008 Absenteeism2009 Absenteeism2010 Absenteeism
SOURCE Absenteeism data
ABSENTEEISM28 Jan 2007 to 17 Feb 2010
Overview of pandemic (H1N1) 2009 severity ndash to 26 February 2010
2009 2010Pandemic (H1N1) 2009 Confirmed
casesHospitalised
casesICU cases Deaths Confirmed
casesHospitalised
casesICU
casesDeaths
Total number 37636 13 ofConfirmed
cases
14 ofHospitalised
cases
191 44 +186
InfluenzaType A
11 1 0
Crude rate per100000 population
1721 228 31 09 02
Median age (years) 21 31 44 53 30
Females 51 51 53 44 29
Vulnerable groups na 58 74 67
Indigenous people 11 20 19 13
Pregnant women na 27 Hospitalisedfemales aged15-44 years
16 Hospitalised
Pregnantwomen
4
Cases with at least 1co-morbidity
na 46 67 62
Severe Pandemic (H1N1) 2009
Hospitalisations-
Respiratory diabetes immuno compromised obesity chronic cardiac renal pregnancy rapid deteriorating flu patient
Higher proportion of Indigenous Australians
Over 50 admitted within 48 hours of onset
Higher ICU Admissions than expected
Hospitalisations of pandemic (H1N1) 2009 5 June ndash
23 October 2009 by week
17
0
100
200
300
400
500
600
700
21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43
Week of report
Num
ber o
f hos
pita
lista
tions
ass
ocia
ted
with
pan
dem
ic (H
1N1)
200
9
Australia
Age specific rates of hospitalised confirmed cases of pandemic (H1N1) 2009 to 3 October 2009 compared with average annual age specific rates of
hospitalisations from seasonal influenza 2004-05 to 2006-07 Australia
18
00
100
200
300
400
500
600
700
800
0-4
5-9
10-1
415
-19
20-2
425
-29
30-3
435
-39
40-4
445
-49
50-5
455
-59
60-6
465
-69
70-7
475
-79
80-8
485
+
Age group (5 Years)
Age
spec
ific
rate
(per
100
000
pop
ulat
ion) Males pandemic (H1N1) 2009
Females pandemic (H1N1) 2009
2004-07 seasonal influenza
Comparison of hospitalisations ICU admissions and deaths by age group to 2 October 2009
0
200
400
600
800
1000
1200
1400
0-9 10-19 20-29 30-39 40-49 50-59 60+
Age groups (10 years)
Tota
l num
ber
of h
ospi
talis
atio
ns
and
ICU
adm
issi
ons
of
conf
irmed
cas
es
0
10
20
30
40
50
60
Num
bers
of d
eath
s of
con
firm
ed
case
s
HospICUDeaths
Notification rates for pandemic (H1N1) 2009 in a selection of affected countries
Country Population Confirmed cases Crude rate per 100000
population
Hospitalisation rate per 100000 population
Deaths Trends
Southern Hemisphere
Australia 21262641 37636 1721 228 191 Low influenza activity
New Zealand 4319932 3233 730 227 18 Low levels of ILI decreasing trend
Argentina 40482000 11234 278 337 613 Low ILI activity decreasing trend
Chile 16454143 12276 746 98 150 Low ILI activity decreasing trend
Northern Hemisphere
Canada 33212696 NA 235 44 336 Low influenza activity
UK 60943912 26110 428 NA 265 Decreasing influenza activity
Mexico 109955400 66070 601 na 671 na
USA 304059724 50768 165 103 1336 Low influenza activity
Pandemic (H1N1) 2009 Vaccine
bull
Safety profile as with seasonal flu
bull
One injection 15μg protects adults
bull
FDA licenceTGA registration
bull
Emphasis on priority groups but available to ALL
Source New England Journal of Medicine 2009 361 September 10
Clinical Trials of Pandemic (H1N1) 2009 Vaccine
Systemic Side effects
Headache
Fever
Myalgia
Malaise
Immune Response15mcg
97
30mcg 93
Source New England Journal of Medicine 2009 361 September 10
VACCINE ROLL OUT
bull
Around 76 million doses distributed (35
population)
bull
Available for this Influenza season
bull
Trivalent vaccine for seasonal influenza available
to targeted groups
Key lessons so far
1
Value of detailed planning2
Leadership and co-ordination
bull
AHPCbull
NPEC
3
Flexibility4
Medical innovation
5
Communication
NEJM on line publication ndash
Dec 2009
Current Situation ndash
2010
bull
Influenza activity low in Australia but showing some signs of increasing earlier than usualndash
lt2 respiratory tests positive for influenza
ndash
55 confirmed cases influenza per week
bull
Pandemic strain predominant in Australiandash
35 pandemic (H1N1) 2009
bull
Pandemic (H1N1) 2009 predominant in most countries
bull
Type B predominant in China (83) and Hong Kong (56)
Laboratory confirmed cases of influenza (pandemic (H1N1) 2009 and seasonal) in Australia 2010 to 26 February by week and type
0
10
20
30
40
50
60
2012010 9012010 16012010 23012010 30012010 6022010 13022010 20022010
Week of onsetnotification - start date
Num
ber o
f con
firm
ed in
fluen
za c
ases
AMexico2232009(H1N1) AH1N1 strain unknownA not subtyped AH1N1Brisbane592007AH3N2 AH3n2Brisbane102007 BUntyped AampB
Current Situation -
2010
KEY INDIVIDUALS FOR PANDEMIC RESPONSE
NIRMs Mary MurnaneMs Jenny BryantDr Gary LumMs Fay GardnerDr Bernie TowlerDr Andrew SingerDr Andrea FordeMs Kay McNieceDr Jenean Spencer
Prof Terry Nolan ATAGIDr Chris Mitchell RACGPDr Vicki Krause CDNA
NSW
Dr Kerry Chant
Dr Jeremy McAnulty
VIC
Dr John Carnie
Dr Rosemary Lester
QLD
Dr Jeanette Young
Dr Christine Selvey
TAS
Dr Chrissie Pickin
WA
Dr Tarun Weeramanthri
Dr Andy Robertson
SA
Dr Stephen Christley
ACT
Dr Charles Guest
NT
Dr Barbara Paterson
Australian Health Protection Committee (AHPC) Aileen Plant National Incident Room
bull
The key decision-making body for health emergenciesndash
Chaired by DoHA Deputy Secretary
ndash
Commonwealth CMO ST Chief Health Officers
ndash
Experts in mental health emergency medicine communicable diseases
bull
Preparedness role
bull
Response role in health emergencies
4
WHO announces health emergency24 Apr
WHO moves to Pandemic phase 427 Apr
Australia moves to
Pandemic DELAY28 Apr
WHO moves to Pandemic
phase 529 Apr
Australia moves to Pandemic
CONTAIN22 May
Victoria moves to MODIFIED
SUSTAIN3 Jun
WHO moves to Pandemic
phase 611 Jun
Australia moves to Pandemic
PROTECT17 Jun
TGA Approves pandemic (H1N1) vaccine WHO Donation18 Sept
30 Sept Adult Vaccination Program commences
TGA Approves and registers pandemic vaccine
for children5 Dec
PANDEMIC (H1N1) 2009 TIMELINE
DELAY PHASE
CONTAIN PHASE
bull
Contact tracing and home quarantinebull
Anti-virals for contacts
bull
Increased public messaging bull
Some school closures
bull
Continuation of the measures commenced in DELAY
Actions taken during CONTAIN included
H1N1 Influenza 09 Pandemic Phases
ALERT (pre 24 April 09)
DELAY (24 April 09)
CONTAIN (22 May 09)
SUSTAIN
Victoria moved to a MODIFIED SUSTAIN on 3 June 2009
CONTROL
RECOVER
PROTECT
17 June 2009
Evidence supports focusing efforts on protecting the lsquovulnerablersquo
Australias response is continual informed by the emerging evidence around the virus and effectiveness of control measures
H1N1 Influenza 09 mild in most and severe in
some (the vulnerable)
Key Elements of PROTECT
bull Re-focus of testing and treatmentbull Identification and early treatment for those at risk bull
Voluntary home isolation no treatment mild disease
bull Controlling outbreaks in special settingsbull Limited school closures early in the Pandemicbull Communicationsbull Re-focus surveillance
Office of Health Protection Surveillance Branch Department of Health and Ageing
PANDEMIC (H1N1) 2009 SURVEILLANCE AUSTRALIA
0
200
400
600
800
1000
1200
1400
1600
805
200
9
220
520
09
506
200
9
190
620
09
307
200
9
170
720
09
310
720
09
140
820
09
280
820
09
110
920
09
250
920
09
910
200
9
231
020
09
611
200
9
201
120
09
412
200
9
181
220
09
101
201
0
150
120
10
290
120
10
120
220
10
260
220
10
Date of onset notification
Num
ber o
f con
firm
ed c
ases
of p
ande
mic
(H1N
1) 2
009
ACT NSW NT Qld
SA Tas Vic WA
VIC moved to modified SUSTAIN phase
AUS phase PROTECT
Vaccination commenced
Source NetEPI database
Source NetEPI
database
Laboratory Confirmed CasesOf Pandemic (H1N1) in Australia
to 26 February 2010
0
10
20
30
40
50
60
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53Week
Rat
e of
ILI p
er 1
000
con
sulta
tions
ASPREN 2007ASPREN 2008ASPREN + NT + VIDRL 2009ASPREN + NT 2010
First case of Pandemic
(H1N1) 2009 reported in Australia
bullDelays in the reporting of data may cause data to change retrospectively As data from the NT surveillance system is combined with ASPREN data for 2010 rates may not be directly comparable across 2007 2008 and 2009 SOURCE ASPREN and NT GP surveillance system
Sentinel General Practice Surveillance1 January 2007 to 21 February 2010
0
200
400
600
800
1000
1200
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51Week
Num
ber o
f Em
erge
ncy
Dep
artm
ent I
LI
Pre
sent
atio
ns in
WA
2007 Presentations2008 Presentations2009 Presentations2010 Presentations
Child deaths associated with
influenza infection in 2007
Source WA lsquoVirus Watchrsquo Report
WA Emergency Departments1 January 2007 to 14 February 2010
Source NSW lsquoInfluenza Monthly Epidemiology Reportrsquo
Deaths Associated with Influenza and Pneumonia 2005 - 2010
Rates of absenteeism (greater than 3 days absent) national employerfrom 28 January 2007 to 17 February 2010 by week
0
02
04
06
08
1
12
14
16
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53
Week
Per
cent
of S
taff
Abs
ent
2007 Absenteeism2008 Absenteeism2009 Absenteeism2010 Absenteeism
SOURCE Absenteeism data
ABSENTEEISM28 Jan 2007 to 17 Feb 2010
Overview of pandemic (H1N1) 2009 severity ndash to 26 February 2010
2009 2010Pandemic (H1N1) 2009 Confirmed
casesHospitalised
casesICU cases Deaths Confirmed
casesHospitalised
casesICU
casesDeaths
Total number 37636 13 ofConfirmed
cases
14 ofHospitalised
cases
191 44 +186
InfluenzaType A
11 1 0
Crude rate per100000 population
1721 228 31 09 02
Median age (years) 21 31 44 53 30
Females 51 51 53 44 29
Vulnerable groups na 58 74 67
Indigenous people 11 20 19 13
Pregnant women na 27 Hospitalisedfemales aged15-44 years
16 Hospitalised
Pregnantwomen
4
Cases with at least 1co-morbidity
na 46 67 62
Severe Pandemic (H1N1) 2009
Hospitalisations-
Respiratory diabetes immuno compromised obesity chronic cardiac renal pregnancy rapid deteriorating flu patient
Higher proportion of Indigenous Australians
Over 50 admitted within 48 hours of onset
Higher ICU Admissions than expected
Hospitalisations of pandemic (H1N1) 2009 5 June ndash
23 October 2009 by week
17
0
100
200
300
400
500
600
700
21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43
Week of report
Num
ber o
f hos
pita
lista
tions
ass
ocia
ted
with
pan
dem
ic (H
1N1)
200
9
Australia
Age specific rates of hospitalised confirmed cases of pandemic (H1N1) 2009 to 3 October 2009 compared with average annual age specific rates of
hospitalisations from seasonal influenza 2004-05 to 2006-07 Australia
18
00
100
200
300
400
500
600
700
800
0-4
5-9
10-1
415
-19
20-2
425
-29
30-3
435
-39
40-4
445
-49
50-5
455
-59
60-6
465
-69
70-7
475
-79
80-8
485
+
Age group (5 Years)
Age
spec
ific
rate
(per
100
000
pop
ulat
ion) Males pandemic (H1N1) 2009
Females pandemic (H1N1) 2009
2004-07 seasonal influenza
Comparison of hospitalisations ICU admissions and deaths by age group to 2 October 2009
0
200
400
600
800
1000
1200
1400
0-9 10-19 20-29 30-39 40-49 50-59 60+
Age groups (10 years)
Tota
l num
ber
of h
ospi
talis
atio
ns
and
ICU
adm
issi
ons
of
conf
irmed
cas
es
0
10
20
30
40
50
60
Num
bers
of d
eath
s of
con
firm
ed
case
s
HospICUDeaths
Notification rates for pandemic (H1N1) 2009 in a selection of affected countries
Country Population Confirmed cases Crude rate per 100000
population
Hospitalisation rate per 100000 population
Deaths Trends
Southern Hemisphere
Australia 21262641 37636 1721 228 191 Low influenza activity
New Zealand 4319932 3233 730 227 18 Low levels of ILI decreasing trend
Argentina 40482000 11234 278 337 613 Low ILI activity decreasing trend
Chile 16454143 12276 746 98 150 Low ILI activity decreasing trend
Northern Hemisphere
Canada 33212696 NA 235 44 336 Low influenza activity
UK 60943912 26110 428 NA 265 Decreasing influenza activity
Mexico 109955400 66070 601 na 671 na
USA 304059724 50768 165 103 1336 Low influenza activity
Pandemic (H1N1) 2009 Vaccine
bull
Safety profile as with seasonal flu
bull
One injection 15μg protects adults
bull
FDA licenceTGA registration
bull
Emphasis on priority groups but available to ALL
Source New England Journal of Medicine 2009 361 September 10
Clinical Trials of Pandemic (H1N1) 2009 Vaccine
Systemic Side effects
Headache
Fever
Myalgia
Malaise
Immune Response15mcg
97
30mcg 93
Source New England Journal of Medicine 2009 361 September 10
VACCINE ROLL OUT
bull
Around 76 million doses distributed (35
population)
bull
Available for this Influenza season
bull
Trivalent vaccine for seasonal influenza available
to targeted groups
Key lessons so far
1
Value of detailed planning2
Leadership and co-ordination
bull
AHPCbull
NPEC
3
Flexibility4
Medical innovation
5
Communication
NEJM on line publication ndash
Dec 2009
Current Situation ndash
2010
bull
Influenza activity low in Australia but showing some signs of increasing earlier than usualndash
lt2 respiratory tests positive for influenza
ndash
55 confirmed cases influenza per week
bull
Pandemic strain predominant in Australiandash
35 pandemic (H1N1) 2009
bull
Pandemic (H1N1) 2009 predominant in most countries
bull
Type B predominant in China (83) and Hong Kong (56)
Laboratory confirmed cases of influenza (pandemic (H1N1) 2009 and seasonal) in Australia 2010 to 26 February by week and type
0
10
20
30
40
50
60
2012010 9012010 16012010 23012010 30012010 6022010 13022010 20022010
Week of onsetnotification - start date
Num
ber o
f con
firm
ed in
fluen
za c
ases
AMexico2232009(H1N1) AH1N1 strain unknownA not subtyped AH1N1Brisbane592007AH3N2 AH3n2Brisbane102007 BUntyped AampB
Current Situation -
2010
KEY INDIVIDUALS FOR PANDEMIC RESPONSE
NIRMs Mary MurnaneMs Jenny BryantDr Gary LumMs Fay GardnerDr Bernie TowlerDr Andrew SingerDr Andrea FordeMs Kay McNieceDr Jenean Spencer
Prof Terry Nolan ATAGIDr Chris Mitchell RACGPDr Vicki Krause CDNA
NSW
Dr Kerry Chant
Dr Jeremy McAnulty
VIC
Dr John Carnie
Dr Rosemary Lester
QLD
Dr Jeanette Young
Dr Christine Selvey
TAS
Dr Chrissie Pickin
WA
Dr Tarun Weeramanthri
Dr Andy Robertson
SA
Dr Stephen Christley
ACT
Dr Charles Guest
NT
Dr Barbara Paterson
4
WHO announces health emergency24 Apr
WHO moves to Pandemic phase 427 Apr
Australia moves to
Pandemic DELAY28 Apr
WHO moves to Pandemic
phase 529 Apr
Australia moves to Pandemic
CONTAIN22 May
Victoria moves to MODIFIED
SUSTAIN3 Jun
WHO moves to Pandemic
phase 611 Jun
Australia moves to Pandemic
PROTECT17 Jun
TGA Approves pandemic (H1N1) vaccine WHO Donation18 Sept
30 Sept Adult Vaccination Program commences
TGA Approves and registers pandemic vaccine
for children5 Dec
PANDEMIC (H1N1) 2009 TIMELINE
DELAY PHASE
CONTAIN PHASE
bull
Contact tracing and home quarantinebull
Anti-virals for contacts
bull
Increased public messaging bull
Some school closures
bull
Continuation of the measures commenced in DELAY
Actions taken during CONTAIN included
H1N1 Influenza 09 Pandemic Phases
ALERT (pre 24 April 09)
DELAY (24 April 09)
CONTAIN (22 May 09)
SUSTAIN
Victoria moved to a MODIFIED SUSTAIN on 3 June 2009
CONTROL
RECOVER
PROTECT
17 June 2009
Evidence supports focusing efforts on protecting the lsquovulnerablersquo
Australias response is continual informed by the emerging evidence around the virus and effectiveness of control measures
H1N1 Influenza 09 mild in most and severe in
some (the vulnerable)
Key Elements of PROTECT
bull Re-focus of testing and treatmentbull Identification and early treatment for those at risk bull
Voluntary home isolation no treatment mild disease
bull Controlling outbreaks in special settingsbull Limited school closures early in the Pandemicbull Communicationsbull Re-focus surveillance
Office of Health Protection Surveillance Branch Department of Health and Ageing
PANDEMIC (H1N1) 2009 SURVEILLANCE AUSTRALIA
0
200
400
600
800
1000
1200
1400
1600
805
200
9
220
520
09
506
200
9
190
620
09
307
200
9
170
720
09
310
720
09
140
820
09
280
820
09
110
920
09
250
920
09
910
200
9
231
020
09
611
200
9
201
120
09
412
200
9
181
220
09
101
201
0
150
120
10
290
120
10
120
220
10
260
220
10
Date of onset notification
Num
ber o
f con
firm
ed c
ases
of p
ande
mic
(H1N
1) 2
009
ACT NSW NT Qld
SA Tas Vic WA
VIC moved to modified SUSTAIN phase
AUS phase PROTECT
Vaccination commenced
Source NetEPI database
Source NetEPI
database
Laboratory Confirmed CasesOf Pandemic (H1N1) in Australia
to 26 February 2010
0
10
20
30
40
50
60
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53Week
Rat
e of
ILI p
er 1
000
con
sulta
tions
ASPREN 2007ASPREN 2008ASPREN + NT + VIDRL 2009ASPREN + NT 2010
First case of Pandemic
(H1N1) 2009 reported in Australia
bullDelays in the reporting of data may cause data to change retrospectively As data from the NT surveillance system is combined with ASPREN data for 2010 rates may not be directly comparable across 2007 2008 and 2009 SOURCE ASPREN and NT GP surveillance system
Sentinel General Practice Surveillance1 January 2007 to 21 February 2010
0
200
400
600
800
1000
1200
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51Week
Num
ber o
f Em
erge
ncy
Dep
artm
ent I
LI
Pre
sent
atio
ns in
WA
2007 Presentations2008 Presentations2009 Presentations2010 Presentations
Child deaths associated with
influenza infection in 2007
Source WA lsquoVirus Watchrsquo Report
WA Emergency Departments1 January 2007 to 14 February 2010
Source NSW lsquoInfluenza Monthly Epidemiology Reportrsquo
Deaths Associated with Influenza and Pneumonia 2005 - 2010
Rates of absenteeism (greater than 3 days absent) national employerfrom 28 January 2007 to 17 February 2010 by week
0
02
04
06
08
1
12
14
16
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53
Week
Per
cent
of S
taff
Abs
ent
2007 Absenteeism2008 Absenteeism2009 Absenteeism2010 Absenteeism
SOURCE Absenteeism data
ABSENTEEISM28 Jan 2007 to 17 Feb 2010
Overview of pandemic (H1N1) 2009 severity ndash to 26 February 2010
2009 2010Pandemic (H1N1) 2009 Confirmed
casesHospitalised
casesICU cases Deaths Confirmed
casesHospitalised
casesICU
casesDeaths
Total number 37636 13 ofConfirmed
cases
14 ofHospitalised
cases
191 44 +186
InfluenzaType A
11 1 0
Crude rate per100000 population
1721 228 31 09 02
Median age (years) 21 31 44 53 30
Females 51 51 53 44 29
Vulnerable groups na 58 74 67
Indigenous people 11 20 19 13
Pregnant women na 27 Hospitalisedfemales aged15-44 years
16 Hospitalised
Pregnantwomen
4
Cases with at least 1co-morbidity
na 46 67 62
Severe Pandemic (H1N1) 2009
Hospitalisations-
Respiratory diabetes immuno compromised obesity chronic cardiac renal pregnancy rapid deteriorating flu patient
Higher proportion of Indigenous Australians
Over 50 admitted within 48 hours of onset
Higher ICU Admissions than expected
Hospitalisations of pandemic (H1N1) 2009 5 June ndash
23 October 2009 by week
17
0
100
200
300
400
500
600
700
21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43
Week of report
Num
ber o
f hos
pita
lista
tions
ass
ocia
ted
with
pan
dem
ic (H
1N1)
200
9
Australia
Age specific rates of hospitalised confirmed cases of pandemic (H1N1) 2009 to 3 October 2009 compared with average annual age specific rates of
hospitalisations from seasonal influenza 2004-05 to 2006-07 Australia
18
00
100
200
300
400
500
600
700
800
0-4
5-9
10-1
415
-19
20-2
425
-29
30-3
435
-39
40-4
445
-49
50-5
455
-59
60-6
465
-69
70-7
475
-79
80-8
485
+
Age group (5 Years)
Age
spec
ific
rate
(per
100
000
pop
ulat
ion) Males pandemic (H1N1) 2009
Females pandemic (H1N1) 2009
2004-07 seasonal influenza
Comparison of hospitalisations ICU admissions and deaths by age group to 2 October 2009
0
200
400
600
800
1000
1200
1400
0-9 10-19 20-29 30-39 40-49 50-59 60+
Age groups (10 years)
Tota
l num
ber
of h
ospi
talis
atio
ns
and
ICU
adm
issi
ons
of
conf
irmed
cas
es
0
10
20
30
40
50
60
Num
bers
of d
eath
s of
con
firm
ed
case
s
HospICUDeaths
Notification rates for pandemic (H1N1) 2009 in a selection of affected countries
Country Population Confirmed cases Crude rate per 100000
population
Hospitalisation rate per 100000 population
Deaths Trends
Southern Hemisphere
Australia 21262641 37636 1721 228 191 Low influenza activity
New Zealand 4319932 3233 730 227 18 Low levels of ILI decreasing trend
Argentina 40482000 11234 278 337 613 Low ILI activity decreasing trend
Chile 16454143 12276 746 98 150 Low ILI activity decreasing trend
Northern Hemisphere
Canada 33212696 NA 235 44 336 Low influenza activity
UK 60943912 26110 428 NA 265 Decreasing influenza activity
Mexico 109955400 66070 601 na 671 na
USA 304059724 50768 165 103 1336 Low influenza activity
Pandemic (H1N1) 2009 Vaccine
bull
Safety profile as with seasonal flu
bull
One injection 15μg protects adults
bull
FDA licenceTGA registration
bull
Emphasis on priority groups but available to ALL
Source New England Journal of Medicine 2009 361 September 10
Clinical Trials of Pandemic (H1N1) 2009 Vaccine
Systemic Side effects
Headache
Fever
Myalgia
Malaise
Immune Response15mcg
97
30mcg 93
Source New England Journal of Medicine 2009 361 September 10
VACCINE ROLL OUT
bull
Around 76 million doses distributed (35
population)
bull
Available for this Influenza season
bull
Trivalent vaccine for seasonal influenza available
to targeted groups
Key lessons so far
1
Value of detailed planning2
Leadership and co-ordination
bull
AHPCbull
NPEC
3
Flexibility4
Medical innovation
5
Communication
NEJM on line publication ndash
Dec 2009
Current Situation ndash
2010
bull
Influenza activity low in Australia but showing some signs of increasing earlier than usualndash
lt2 respiratory tests positive for influenza
ndash
55 confirmed cases influenza per week
bull
Pandemic strain predominant in Australiandash
35 pandemic (H1N1) 2009
bull
Pandemic (H1N1) 2009 predominant in most countries
bull
Type B predominant in China (83) and Hong Kong (56)
Laboratory confirmed cases of influenza (pandemic (H1N1) 2009 and seasonal) in Australia 2010 to 26 February by week and type
0
10
20
30
40
50
60
2012010 9012010 16012010 23012010 30012010 6022010 13022010 20022010
Week of onsetnotification - start date
Num
ber o
f con
firm
ed in
fluen
za c
ases
AMexico2232009(H1N1) AH1N1 strain unknownA not subtyped AH1N1Brisbane592007AH3N2 AH3n2Brisbane102007 BUntyped AampB
Current Situation -
2010
KEY INDIVIDUALS FOR PANDEMIC RESPONSE
NIRMs Mary MurnaneMs Jenny BryantDr Gary LumMs Fay GardnerDr Bernie TowlerDr Andrew SingerDr Andrea FordeMs Kay McNieceDr Jenean Spencer
Prof Terry Nolan ATAGIDr Chris Mitchell RACGPDr Vicki Krause CDNA
NSW
Dr Kerry Chant
Dr Jeremy McAnulty
VIC
Dr John Carnie
Dr Rosemary Lester
QLD
Dr Jeanette Young
Dr Christine Selvey
TAS
Dr Chrissie Pickin
WA
Dr Tarun Weeramanthri
Dr Andy Robertson
SA
Dr Stephen Christley
ACT
Dr Charles Guest
NT
Dr Barbara Paterson
DELAY PHASE
CONTAIN PHASE
bull
Contact tracing and home quarantinebull
Anti-virals for contacts
bull
Increased public messaging bull
Some school closures
bull
Continuation of the measures commenced in DELAY
Actions taken during CONTAIN included
H1N1 Influenza 09 Pandemic Phases
ALERT (pre 24 April 09)
DELAY (24 April 09)
CONTAIN (22 May 09)
SUSTAIN
Victoria moved to a MODIFIED SUSTAIN on 3 June 2009
CONTROL
RECOVER
PROTECT
17 June 2009
Evidence supports focusing efforts on protecting the lsquovulnerablersquo
Australias response is continual informed by the emerging evidence around the virus and effectiveness of control measures
H1N1 Influenza 09 mild in most and severe in
some (the vulnerable)
Key Elements of PROTECT
bull Re-focus of testing and treatmentbull Identification and early treatment for those at risk bull
Voluntary home isolation no treatment mild disease
bull Controlling outbreaks in special settingsbull Limited school closures early in the Pandemicbull Communicationsbull Re-focus surveillance
Office of Health Protection Surveillance Branch Department of Health and Ageing
PANDEMIC (H1N1) 2009 SURVEILLANCE AUSTRALIA
0
200
400
600
800
1000
1200
1400
1600
805
200
9
220
520
09
506
200
9
190
620
09
307
200
9
170
720
09
310
720
09
140
820
09
280
820
09
110
920
09
250
920
09
910
200
9
231
020
09
611
200
9
201
120
09
412
200
9
181
220
09
101
201
0
150
120
10
290
120
10
120
220
10
260
220
10
Date of onset notification
Num
ber o
f con
firm
ed c
ases
of p
ande
mic
(H1N
1) 2
009
ACT NSW NT Qld
SA Tas Vic WA
VIC moved to modified SUSTAIN phase
AUS phase PROTECT
Vaccination commenced
Source NetEPI database
Source NetEPI
database
Laboratory Confirmed CasesOf Pandemic (H1N1) in Australia
to 26 February 2010
0
10
20
30
40
50
60
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53Week
Rat
e of
ILI p
er 1
000
con
sulta
tions
ASPREN 2007ASPREN 2008ASPREN + NT + VIDRL 2009ASPREN + NT 2010
First case of Pandemic
(H1N1) 2009 reported in Australia
bullDelays in the reporting of data may cause data to change retrospectively As data from the NT surveillance system is combined with ASPREN data for 2010 rates may not be directly comparable across 2007 2008 and 2009 SOURCE ASPREN and NT GP surveillance system
Sentinel General Practice Surveillance1 January 2007 to 21 February 2010
0
200
400
600
800
1000
1200
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51Week
Num
ber o
f Em
erge
ncy
Dep
artm
ent I
LI
Pre
sent
atio
ns in
WA
2007 Presentations2008 Presentations2009 Presentations2010 Presentations
Child deaths associated with
influenza infection in 2007
Source WA lsquoVirus Watchrsquo Report
WA Emergency Departments1 January 2007 to 14 February 2010
Source NSW lsquoInfluenza Monthly Epidemiology Reportrsquo
Deaths Associated with Influenza and Pneumonia 2005 - 2010
Rates of absenteeism (greater than 3 days absent) national employerfrom 28 January 2007 to 17 February 2010 by week
0
02
04
06
08
1
12
14
16
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53
Week
Per
cent
of S
taff
Abs
ent
2007 Absenteeism2008 Absenteeism2009 Absenteeism2010 Absenteeism
SOURCE Absenteeism data
ABSENTEEISM28 Jan 2007 to 17 Feb 2010
Overview of pandemic (H1N1) 2009 severity ndash to 26 February 2010
2009 2010Pandemic (H1N1) 2009 Confirmed
casesHospitalised
casesICU cases Deaths Confirmed
casesHospitalised
casesICU
casesDeaths
Total number 37636 13 ofConfirmed
cases
14 ofHospitalised
cases
191 44 +186
InfluenzaType A
11 1 0
Crude rate per100000 population
1721 228 31 09 02
Median age (years) 21 31 44 53 30
Females 51 51 53 44 29
Vulnerable groups na 58 74 67
Indigenous people 11 20 19 13
Pregnant women na 27 Hospitalisedfemales aged15-44 years
16 Hospitalised
Pregnantwomen
4
Cases with at least 1co-morbidity
na 46 67 62
Severe Pandemic (H1N1) 2009
Hospitalisations-
Respiratory diabetes immuno compromised obesity chronic cardiac renal pregnancy rapid deteriorating flu patient
Higher proportion of Indigenous Australians
Over 50 admitted within 48 hours of onset
Higher ICU Admissions than expected
Hospitalisations of pandemic (H1N1) 2009 5 June ndash
23 October 2009 by week
17
0
100
200
300
400
500
600
700
21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43
Week of report
Num
ber o
f hos
pita
lista
tions
ass
ocia
ted
with
pan
dem
ic (H
1N1)
200
9
Australia
Age specific rates of hospitalised confirmed cases of pandemic (H1N1) 2009 to 3 October 2009 compared with average annual age specific rates of
hospitalisations from seasonal influenza 2004-05 to 2006-07 Australia
18
00
100
200
300
400
500
600
700
800
0-4
5-9
10-1
415
-19
20-2
425
-29
30-3
435
-39
40-4
445
-49
50-5
455
-59
60-6
465
-69
70-7
475
-79
80-8
485
+
Age group (5 Years)
Age
spec
ific
rate
(per
100
000
pop
ulat
ion) Males pandemic (H1N1) 2009
Females pandemic (H1N1) 2009
2004-07 seasonal influenza
Comparison of hospitalisations ICU admissions and deaths by age group to 2 October 2009
0
200
400
600
800
1000
1200
1400
0-9 10-19 20-29 30-39 40-49 50-59 60+
Age groups (10 years)
Tota
l num
ber
of h
ospi
talis
atio
ns
and
ICU
adm
issi
ons
of
conf
irmed
cas
es
0
10
20
30
40
50
60
Num
bers
of d
eath
s of
con
firm
ed
case
s
HospICUDeaths
Notification rates for pandemic (H1N1) 2009 in a selection of affected countries
Country Population Confirmed cases Crude rate per 100000
population
Hospitalisation rate per 100000 population
Deaths Trends
Southern Hemisphere
Australia 21262641 37636 1721 228 191 Low influenza activity
New Zealand 4319932 3233 730 227 18 Low levels of ILI decreasing trend
Argentina 40482000 11234 278 337 613 Low ILI activity decreasing trend
Chile 16454143 12276 746 98 150 Low ILI activity decreasing trend
Northern Hemisphere
Canada 33212696 NA 235 44 336 Low influenza activity
UK 60943912 26110 428 NA 265 Decreasing influenza activity
Mexico 109955400 66070 601 na 671 na
USA 304059724 50768 165 103 1336 Low influenza activity
Pandemic (H1N1) 2009 Vaccine
bull
Safety profile as with seasonal flu
bull
One injection 15μg protects adults
bull
FDA licenceTGA registration
bull
Emphasis on priority groups but available to ALL
Source New England Journal of Medicine 2009 361 September 10
Clinical Trials of Pandemic (H1N1) 2009 Vaccine
Systemic Side effects
Headache
Fever
Myalgia
Malaise
Immune Response15mcg
97
30mcg 93
Source New England Journal of Medicine 2009 361 September 10
VACCINE ROLL OUT
bull
Around 76 million doses distributed (35
population)
bull
Available for this Influenza season
bull
Trivalent vaccine for seasonal influenza available
to targeted groups
Key lessons so far
1
Value of detailed planning2
Leadership and co-ordination
bull
AHPCbull
NPEC
3
Flexibility4
Medical innovation
5
Communication
NEJM on line publication ndash
Dec 2009
Current Situation ndash
2010
bull
Influenza activity low in Australia but showing some signs of increasing earlier than usualndash
lt2 respiratory tests positive for influenza
ndash
55 confirmed cases influenza per week
bull
Pandemic strain predominant in Australiandash
35 pandemic (H1N1) 2009
bull
Pandemic (H1N1) 2009 predominant in most countries
bull
Type B predominant in China (83) and Hong Kong (56)
Laboratory confirmed cases of influenza (pandemic (H1N1) 2009 and seasonal) in Australia 2010 to 26 February by week and type
0
10
20
30
40
50
60
2012010 9012010 16012010 23012010 30012010 6022010 13022010 20022010
Week of onsetnotification - start date
Num
ber o
f con
firm
ed in
fluen
za c
ases
AMexico2232009(H1N1) AH1N1 strain unknownA not subtyped AH1N1Brisbane592007AH3N2 AH3n2Brisbane102007 BUntyped AampB
Current Situation -
2010
KEY INDIVIDUALS FOR PANDEMIC RESPONSE
NIRMs Mary MurnaneMs Jenny BryantDr Gary LumMs Fay GardnerDr Bernie TowlerDr Andrew SingerDr Andrea FordeMs Kay McNieceDr Jenean Spencer
Prof Terry Nolan ATAGIDr Chris Mitchell RACGPDr Vicki Krause CDNA
NSW
Dr Kerry Chant
Dr Jeremy McAnulty
VIC
Dr John Carnie
Dr Rosemary Lester
QLD
Dr Jeanette Young
Dr Christine Selvey
TAS
Dr Chrissie Pickin
WA
Dr Tarun Weeramanthri
Dr Andy Robertson
SA
Dr Stephen Christley
ACT
Dr Charles Guest
NT
Dr Barbara Paterson
CONTAIN PHASE
bull
Contact tracing and home quarantinebull
Anti-virals for contacts
bull
Increased public messaging bull
Some school closures
bull
Continuation of the measures commenced in DELAY
Actions taken during CONTAIN included
H1N1 Influenza 09 Pandemic Phases
ALERT (pre 24 April 09)
DELAY (24 April 09)
CONTAIN (22 May 09)
SUSTAIN
Victoria moved to a MODIFIED SUSTAIN on 3 June 2009
CONTROL
RECOVER
PROTECT
17 June 2009
Evidence supports focusing efforts on protecting the lsquovulnerablersquo
Australias response is continual informed by the emerging evidence around the virus and effectiveness of control measures
H1N1 Influenza 09 mild in most and severe in
some (the vulnerable)
Key Elements of PROTECT
bull Re-focus of testing and treatmentbull Identification and early treatment for those at risk bull
Voluntary home isolation no treatment mild disease
bull Controlling outbreaks in special settingsbull Limited school closures early in the Pandemicbull Communicationsbull Re-focus surveillance
Office of Health Protection Surveillance Branch Department of Health and Ageing
PANDEMIC (H1N1) 2009 SURVEILLANCE AUSTRALIA
0
200
400
600
800
1000
1200
1400
1600
805
200
9
220
520
09
506
200
9
190
620
09
307
200
9
170
720
09
310
720
09
140
820
09
280
820
09
110
920
09
250
920
09
910
200
9
231
020
09
611
200
9
201
120
09
412
200
9
181
220
09
101
201
0
150
120
10
290
120
10
120
220
10
260
220
10
Date of onset notification
Num
ber o
f con
firm
ed c
ases
of p
ande
mic
(H1N
1) 2
009
ACT NSW NT Qld
SA Tas Vic WA
VIC moved to modified SUSTAIN phase
AUS phase PROTECT
Vaccination commenced
Source NetEPI database
Source NetEPI
database
Laboratory Confirmed CasesOf Pandemic (H1N1) in Australia
to 26 February 2010
0
10
20
30
40
50
60
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53Week
Rat
e of
ILI p
er 1
000
con
sulta
tions
ASPREN 2007ASPREN 2008ASPREN + NT + VIDRL 2009ASPREN + NT 2010
First case of Pandemic
(H1N1) 2009 reported in Australia
bullDelays in the reporting of data may cause data to change retrospectively As data from the NT surveillance system is combined with ASPREN data for 2010 rates may not be directly comparable across 2007 2008 and 2009 SOURCE ASPREN and NT GP surveillance system
Sentinel General Practice Surveillance1 January 2007 to 21 February 2010
0
200
400
600
800
1000
1200
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51Week
Num
ber o
f Em
erge
ncy
Dep
artm
ent I
LI
Pre
sent
atio
ns in
WA
2007 Presentations2008 Presentations2009 Presentations2010 Presentations
Child deaths associated with
influenza infection in 2007
Source WA lsquoVirus Watchrsquo Report
WA Emergency Departments1 January 2007 to 14 February 2010
Source NSW lsquoInfluenza Monthly Epidemiology Reportrsquo
Deaths Associated with Influenza and Pneumonia 2005 - 2010
Rates of absenteeism (greater than 3 days absent) national employerfrom 28 January 2007 to 17 February 2010 by week
0
02
04
06
08
1
12
14
16
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53
Week
Per
cent
of S
taff
Abs
ent
2007 Absenteeism2008 Absenteeism2009 Absenteeism2010 Absenteeism
SOURCE Absenteeism data
ABSENTEEISM28 Jan 2007 to 17 Feb 2010
Overview of pandemic (H1N1) 2009 severity ndash to 26 February 2010
2009 2010Pandemic (H1N1) 2009 Confirmed
casesHospitalised
casesICU cases Deaths Confirmed
casesHospitalised
casesICU
casesDeaths
Total number 37636 13 ofConfirmed
cases
14 ofHospitalised
cases
191 44 +186
InfluenzaType A
11 1 0
Crude rate per100000 population
1721 228 31 09 02
Median age (years) 21 31 44 53 30
Females 51 51 53 44 29
Vulnerable groups na 58 74 67
Indigenous people 11 20 19 13
Pregnant women na 27 Hospitalisedfemales aged15-44 years
16 Hospitalised
Pregnantwomen
4
Cases with at least 1co-morbidity
na 46 67 62
Severe Pandemic (H1N1) 2009
Hospitalisations-
Respiratory diabetes immuno compromised obesity chronic cardiac renal pregnancy rapid deteriorating flu patient
Higher proportion of Indigenous Australians
Over 50 admitted within 48 hours of onset
Higher ICU Admissions than expected
Hospitalisations of pandemic (H1N1) 2009 5 June ndash
23 October 2009 by week
17
0
100
200
300
400
500
600
700
21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43
Week of report
Num
ber o
f hos
pita
lista
tions
ass
ocia
ted
with
pan
dem
ic (H
1N1)
200
9
Australia
Age specific rates of hospitalised confirmed cases of pandemic (H1N1) 2009 to 3 October 2009 compared with average annual age specific rates of
hospitalisations from seasonal influenza 2004-05 to 2006-07 Australia
18
00
100
200
300
400
500
600
700
800
0-4
5-9
10-1
415
-19
20-2
425
-29
30-3
435
-39
40-4
445
-49
50-5
455
-59
60-6
465
-69
70-7
475
-79
80-8
485
+
Age group (5 Years)
Age
spec
ific
rate
(per
100
000
pop
ulat
ion) Males pandemic (H1N1) 2009
Females pandemic (H1N1) 2009
2004-07 seasonal influenza
Comparison of hospitalisations ICU admissions and deaths by age group to 2 October 2009
0
200
400
600
800
1000
1200
1400
0-9 10-19 20-29 30-39 40-49 50-59 60+
Age groups (10 years)
Tota
l num
ber
of h
ospi
talis
atio
ns
and
ICU
adm
issi
ons
of
conf
irmed
cas
es
0
10
20
30
40
50
60
Num
bers
of d
eath
s of
con
firm
ed
case
s
HospICUDeaths
Notification rates for pandemic (H1N1) 2009 in a selection of affected countries
Country Population Confirmed cases Crude rate per 100000
population
Hospitalisation rate per 100000 population
Deaths Trends
Southern Hemisphere
Australia 21262641 37636 1721 228 191 Low influenza activity
New Zealand 4319932 3233 730 227 18 Low levels of ILI decreasing trend
Argentina 40482000 11234 278 337 613 Low ILI activity decreasing trend
Chile 16454143 12276 746 98 150 Low ILI activity decreasing trend
Northern Hemisphere
Canada 33212696 NA 235 44 336 Low influenza activity
UK 60943912 26110 428 NA 265 Decreasing influenza activity
Mexico 109955400 66070 601 na 671 na
USA 304059724 50768 165 103 1336 Low influenza activity
Pandemic (H1N1) 2009 Vaccine
bull
Safety profile as with seasonal flu
bull
One injection 15μg protects adults
bull
FDA licenceTGA registration
bull
Emphasis on priority groups but available to ALL
Source New England Journal of Medicine 2009 361 September 10
Clinical Trials of Pandemic (H1N1) 2009 Vaccine
Systemic Side effects
Headache
Fever
Myalgia
Malaise
Immune Response15mcg
97
30mcg 93
Source New England Journal of Medicine 2009 361 September 10
VACCINE ROLL OUT
bull
Around 76 million doses distributed (35
population)
bull
Available for this Influenza season
bull
Trivalent vaccine for seasonal influenza available
to targeted groups
Key lessons so far
1
Value of detailed planning2
Leadership and co-ordination
bull
AHPCbull
NPEC
3
Flexibility4
Medical innovation
5
Communication
NEJM on line publication ndash
Dec 2009
Current Situation ndash
2010
bull
Influenza activity low in Australia but showing some signs of increasing earlier than usualndash
lt2 respiratory tests positive for influenza
ndash
55 confirmed cases influenza per week
bull
Pandemic strain predominant in Australiandash
35 pandemic (H1N1) 2009
bull
Pandemic (H1N1) 2009 predominant in most countries
bull
Type B predominant in China (83) and Hong Kong (56)
Laboratory confirmed cases of influenza (pandemic (H1N1) 2009 and seasonal) in Australia 2010 to 26 February by week and type
0
10
20
30
40
50
60
2012010 9012010 16012010 23012010 30012010 6022010 13022010 20022010
Week of onsetnotification - start date
Num
ber o
f con
firm
ed in
fluen
za c
ases
AMexico2232009(H1N1) AH1N1 strain unknownA not subtyped AH1N1Brisbane592007AH3N2 AH3n2Brisbane102007 BUntyped AampB
Current Situation -
2010
KEY INDIVIDUALS FOR PANDEMIC RESPONSE
NIRMs Mary MurnaneMs Jenny BryantDr Gary LumMs Fay GardnerDr Bernie TowlerDr Andrew SingerDr Andrea FordeMs Kay McNieceDr Jenean Spencer
Prof Terry Nolan ATAGIDr Chris Mitchell RACGPDr Vicki Krause CDNA
NSW
Dr Kerry Chant
Dr Jeremy McAnulty
VIC
Dr John Carnie
Dr Rosemary Lester
QLD
Dr Jeanette Young
Dr Christine Selvey
TAS
Dr Chrissie Pickin
WA
Dr Tarun Weeramanthri
Dr Andy Robertson
SA
Dr Stephen Christley
ACT
Dr Charles Guest
NT
Dr Barbara Paterson
H1N1 Influenza 09 Pandemic Phases
ALERT (pre 24 April 09)
DELAY (24 April 09)
CONTAIN (22 May 09)
SUSTAIN
Victoria moved to a MODIFIED SUSTAIN on 3 June 2009
CONTROL
RECOVER
PROTECT
17 June 2009
Evidence supports focusing efforts on protecting the lsquovulnerablersquo
Australias response is continual informed by the emerging evidence around the virus and effectiveness of control measures
H1N1 Influenza 09 mild in most and severe in
some (the vulnerable)
Key Elements of PROTECT
bull Re-focus of testing and treatmentbull Identification and early treatment for those at risk bull
Voluntary home isolation no treatment mild disease
bull Controlling outbreaks in special settingsbull Limited school closures early in the Pandemicbull Communicationsbull Re-focus surveillance
Office of Health Protection Surveillance Branch Department of Health and Ageing
PANDEMIC (H1N1) 2009 SURVEILLANCE AUSTRALIA
0
200
400
600
800
1000
1200
1400
1600
805
200
9
220
520
09
506
200
9
190
620
09
307
200
9
170
720
09
310
720
09
140
820
09
280
820
09
110
920
09
250
920
09
910
200
9
231
020
09
611
200
9
201
120
09
412
200
9
181
220
09
101
201
0
150
120
10
290
120
10
120
220
10
260
220
10
Date of onset notification
Num
ber o
f con
firm
ed c
ases
of p
ande
mic
(H1N
1) 2
009
ACT NSW NT Qld
SA Tas Vic WA
VIC moved to modified SUSTAIN phase
AUS phase PROTECT
Vaccination commenced
Source NetEPI database
Source NetEPI
database
Laboratory Confirmed CasesOf Pandemic (H1N1) in Australia
to 26 February 2010
0
10
20
30
40
50
60
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53Week
Rat
e of
ILI p
er 1
000
con
sulta
tions
ASPREN 2007ASPREN 2008ASPREN + NT + VIDRL 2009ASPREN + NT 2010
First case of Pandemic
(H1N1) 2009 reported in Australia
bullDelays in the reporting of data may cause data to change retrospectively As data from the NT surveillance system is combined with ASPREN data for 2010 rates may not be directly comparable across 2007 2008 and 2009 SOURCE ASPREN and NT GP surveillance system
Sentinel General Practice Surveillance1 January 2007 to 21 February 2010
0
200
400
600
800
1000
1200
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51Week
Num
ber o
f Em
erge
ncy
Dep
artm
ent I
LI
Pre
sent
atio
ns in
WA
2007 Presentations2008 Presentations2009 Presentations2010 Presentations
Child deaths associated with
influenza infection in 2007
Source WA lsquoVirus Watchrsquo Report
WA Emergency Departments1 January 2007 to 14 February 2010
Source NSW lsquoInfluenza Monthly Epidemiology Reportrsquo
Deaths Associated with Influenza and Pneumonia 2005 - 2010
Rates of absenteeism (greater than 3 days absent) national employerfrom 28 January 2007 to 17 February 2010 by week
0
02
04
06
08
1
12
14
16
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53
Week
Per
cent
of S
taff
Abs
ent
2007 Absenteeism2008 Absenteeism2009 Absenteeism2010 Absenteeism
SOURCE Absenteeism data
ABSENTEEISM28 Jan 2007 to 17 Feb 2010
Overview of pandemic (H1N1) 2009 severity ndash to 26 February 2010
2009 2010Pandemic (H1N1) 2009 Confirmed
casesHospitalised
casesICU cases Deaths Confirmed
casesHospitalised
casesICU
casesDeaths
Total number 37636 13 ofConfirmed
cases
14 ofHospitalised
cases
191 44 +186
InfluenzaType A
11 1 0
Crude rate per100000 population
1721 228 31 09 02
Median age (years) 21 31 44 53 30
Females 51 51 53 44 29
Vulnerable groups na 58 74 67
Indigenous people 11 20 19 13
Pregnant women na 27 Hospitalisedfemales aged15-44 years
16 Hospitalised
Pregnantwomen
4
Cases with at least 1co-morbidity
na 46 67 62
Severe Pandemic (H1N1) 2009
Hospitalisations-
Respiratory diabetes immuno compromised obesity chronic cardiac renal pregnancy rapid deteriorating flu patient
Higher proportion of Indigenous Australians
Over 50 admitted within 48 hours of onset
Higher ICU Admissions than expected
Hospitalisations of pandemic (H1N1) 2009 5 June ndash
23 October 2009 by week
17
0
100
200
300
400
500
600
700
21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43
Week of report
Num
ber o
f hos
pita
lista
tions
ass
ocia
ted
with
pan
dem
ic (H
1N1)
200
9
Australia
Age specific rates of hospitalised confirmed cases of pandemic (H1N1) 2009 to 3 October 2009 compared with average annual age specific rates of
hospitalisations from seasonal influenza 2004-05 to 2006-07 Australia
18
00
100
200
300
400
500
600
700
800
0-4
5-9
10-1
415
-19
20-2
425
-29
30-3
435
-39
40-4
445
-49
50-5
455
-59
60-6
465
-69
70-7
475
-79
80-8
485
+
Age group (5 Years)
Age
spec
ific
rate
(per
100
000
pop
ulat
ion) Males pandemic (H1N1) 2009
Females pandemic (H1N1) 2009
2004-07 seasonal influenza
Comparison of hospitalisations ICU admissions and deaths by age group to 2 October 2009
0
200
400
600
800
1000
1200
1400
0-9 10-19 20-29 30-39 40-49 50-59 60+
Age groups (10 years)
Tota
l num
ber
of h
ospi
talis
atio
ns
and
ICU
adm
issi
ons
of
conf
irmed
cas
es
0
10
20
30
40
50
60
Num
bers
of d
eath
s of
con
firm
ed
case
s
HospICUDeaths
Notification rates for pandemic (H1N1) 2009 in a selection of affected countries
Country Population Confirmed cases Crude rate per 100000
population
Hospitalisation rate per 100000 population
Deaths Trends
Southern Hemisphere
Australia 21262641 37636 1721 228 191 Low influenza activity
New Zealand 4319932 3233 730 227 18 Low levels of ILI decreasing trend
Argentina 40482000 11234 278 337 613 Low ILI activity decreasing trend
Chile 16454143 12276 746 98 150 Low ILI activity decreasing trend
Northern Hemisphere
Canada 33212696 NA 235 44 336 Low influenza activity
UK 60943912 26110 428 NA 265 Decreasing influenza activity
Mexico 109955400 66070 601 na 671 na
USA 304059724 50768 165 103 1336 Low influenza activity
Pandemic (H1N1) 2009 Vaccine
bull
Safety profile as with seasonal flu
bull
One injection 15μg protects adults
bull
FDA licenceTGA registration
bull
Emphasis on priority groups but available to ALL
Source New England Journal of Medicine 2009 361 September 10
Clinical Trials of Pandemic (H1N1) 2009 Vaccine
Systemic Side effects
Headache
Fever
Myalgia
Malaise
Immune Response15mcg
97
30mcg 93
Source New England Journal of Medicine 2009 361 September 10
VACCINE ROLL OUT
bull
Around 76 million doses distributed (35
population)
bull
Available for this Influenza season
bull
Trivalent vaccine for seasonal influenza available
to targeted groups
Key lessons so far
1
Value of detailed planning2
Leadership and co-ordination
bull
AHPCbull
NPEC
3
Flexibility4
Medical innovation
5
Communication
NEJM on line publication ndash
Dec 2009
Current Situation ndash
2010
bull
Influenza activity low in Australia but showing some signs of increasing earlier than usualndash
lt2 respiratory tests positive for influenza
ndash
55 confirmed cases influenza per week
bull
Pandemic strain predominant in Australiandash
35 pandemic (H1N1) 2009
bull
Pandemic (H1N1) 2009 predominant in most countries
bull
Type B predominant in China (83) and Hong Kong (56)
Laboratory confirmed cases of influenza (pandemic (H1N1) 2009 and seasonal) in Australia 2010 to 26 February by week and type
0
10
20
30
40
50
60
2012010 9012010 16012010 23012010 30012010 6022010 13022010 20022010
Week of onsetnotification - start date
Num
ber o
f con
firm
ed in
fluen
za c
ases
AMexico2232009(H1N1) AH1N1 strain unknownA not subtyped AH1N1Brisbane592007AH3N2 AH3n2Brisbane102007 BUntyped AampB
Current Situation -
2010
KEY INDIVIDUALS FOR PANDEMIC RESPONSE
NIRMs Mary MurnaneMs Jenny BryantDr Gary LumMs Fay GardnerDr Bernie TowlerDr Andrew SingerDr Andrea FordeMs Kay McNieceDr Jenean Spencer
Prof Terry Nolan ATAGIDr Chris Mitchell RACGPDr Vicki Krause CDNA
NSW
Dr Kerry Chant
Dr Jeremy McAnulty
VIC
Dr John Carnie
Dr Rosemary Lester
QLD
Dr Jeanette Young
Dr Christine Selvey
TAS
Dr Chrissie Pickin
WA
Dr Tarun Weeramanthri
Dr Andy Robertson
SA
Dr Stephen Christley
ACT
Dr Charles Guest
NT
Dr Barbara Paterson
Key Elements of PROTECT
bull Re-focus of testing and treatmentbull Identification and early treatment for those at risk bull
Voluntary home isolation no treatment mild disease
bull Controlling outbreaks in special settingsbull Limited school closures early in the Pandemicbull Communicationsbull Re-focus surveillance
Office of Health Protection Surveillance Branch Department of Health and Ageing
PANDEMIC (H1N1) 2009 SURVEILLANCE AUSTRALIA
0
200
400
600
800
1000
1200
1400
1600
805
200
9
220
520
09
506
200
9
190
620
09
307
200
9
170
720
09
310
720
09
140
820
09
280
820
09
110
920
09
250
920
09
910
200
9
231
020
09
611
200
9
201
120
09
412
200
9
181
220
09
101
201
0
150
120
10
290
120
10
120
220
10
260
220
10
Date of onset notification
Num
ber o
f con
firm
ed c
ases
of p
ande
mic
(H1N
1) 2
009
ACT NSW NT Qld
SA Tas Vic WA
VIC moved to modified SUSTAIN phase
AUS phase PROTECT
Vaccination commenced
Source NetEPI database
Source NetEPI
database
Laboratory Confirmed CasesOf Pandemic (H1N1) in Australia
to 26 February 2010
0
10
20
30
40
50
60
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53Week
Rat
e of
ILI p
er 1
000
con
sulta
tions
ASPREN 2007ASPREN 2008ASPREN + NT + VIDRL 2009ASPREN + NT 2010
First case of Pandemic
(H1N1) 2009 reported in Australia
bullDelays in the reporting of data may cause data to change retrospectively As data from the NT surveillance system is combined with ASPREN data for 2010 rates may not be directly comparable across 2007 2008 and 2009 SOURCE ASPREN and NT GP surveillance system
Sentinel General Practice Surveillance1 January 2007 to 21 February 2010
0
200
400
600
800
1000
1200
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51Week
Num
ber o
f Em
erge
ncy
Dep
artm
ent I
LI
Pre
sent
atio
ns in
WA
2007 Presentations2008 Presentations2009 Presentations2010 Presentations
Child deaths associated with
influenza infection in 2007
Source WA lsquoVirus Watchrsquo Report
WA Emergency Departments1 January 2007 to 14 February 2010
Source NSW lsquoInfluenza Monthly Epidemiology Reportrsquo
Deaths Associated with Influenza and Pneumonia 2005 - 2010
Rates of absenteeism (greater than 3 days absent) national employerfrom 28 January 2007 to 17 February 2010 by week
0
02
04
06
08
1
12
14
16
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53
Week
Per
cent
of S
taff
Abs
ent
2007 Absenteeism2008 Absenteeism2009 Absenteeism2010 Absenteeism
SOURCE Absenteeism data
ABSENTEEISM28 Jan 2007 to 17 Feb 2010
Overview of pandemic (H1N1) 2009 severity ndash to 26 February 2010
2009 2010Pandemic (H1N1) 2009 Confirmed
casesHospitalised
casesICU cases Deaths Confirmed
casesHospitalised
casesICU
casesDeaths
Total number 37636 13 ofConfirmed
cases
14 ofHospitalised
cases
191 44 +186
InfluenzaType A
11 1 0
Crude rate per100000 population
1721 228 31 09 02
Median age (years) 21 31 44 53 30
Females 51 51 53 44 29
Vulnerable groups na 58 74 67
Indigenous people 11 20 19 13
Pregnant women na 27 Hospitalisedfemales aged15-44 years
16 Hospitalised
Pregnantwomen
4
Cases with at least 1co-morbidity
na 46 67 62
Severe Pandemic (H1N1) 2009
Hospitalisations-
Respiratory diabetes immuno compromised obesity chronic cardiac renal pregnancy rapid deteriorating flu patient
Higher proportion of Indigenous Australians
Over 50 admitted within 48 hours of onset
Higher ICU Admissions than expected
Hospitalisations of pandemic (H1N1) 2009 5 June ndash
23 October 2009 by week
17
0
100
200
300
400
500
600
700
21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43
Week of report
Num
ber o
f hos
pita
lista
tions
ass
ocia
ted
with
pan
dem
ic (H
1N1)
200
9
Australia
Age specific rates of hospitalised confirmed cases of pandemic (H1N1) 2009 to 3 October 2009 compared with average annual age specific rates of
hospitalisations from seasonal influenza 2004-05 to 2006-07 Australia
18
00
100
200
300
400
500
600
700
800
0-4
5-9
10-1
415
-19
20-2
425
-29
30-3
435
-39
40-4
445
-49
50-5
455
-59
60-6
465
-69
70-7
475
-79
80-8
485
+
Age group (5 Years)
Age
spec
ific
rate
(per
100
000
pop
ulat
ion) Males pandemic (H1N1) 2009
Females pandemic (H1N1) 2009
2004-07 seasonal influenza
Comparison of hospitalisations ICU admissions and deaths by age group to 2 October 2009
0
200
400
600
800
1000
1200
1400
0-9 10-19 20-29 30-39 40-49 50-59 60+
Age groups (10 years)
Tota
l num
ber
of h
ospi
talis
atio
ns
and
ICU
adm
issi
ons
of
conf
irmed
cas
es
0
10
20
30
40
50
60
Num
bers
of d
eath
s of
con
firm
ed
case
s
HospICUDeaths
Notification rates for pandemic (H1N1) 2009 in a selection of affected countries
Country Population Confirmed cases Crude rate per 100000
population
Hospitalisation rate per 100000 population
Deaths Trends
Southern Hemisphere
Australia 21262641 37636 1721 228 191 Low influenza activity
New Zealand 4319932 3233 730 227 18 Low levels of ILI decreasing trend
Argentina 40482000 11234 278 337 613 Low ILI activity decreasing trend
Chile 16454143 12276 746 98 150 Low ILI activity decreasing trend
Northern Hemisphere
Canada 33212696 NA 235 44 336 Low influenza activity
UK 60943912 26110 428 NA 265 Decreasing influenza activity
Mexico 109955400 66070 601 na 671 na
USA 304059724 50768 165 103 1336 Low influenza activity
Pandemic (H1N1) 2009 Vaccine
bull
Safety profile as with seasonal flu
bull
One injection 15μg protects adults
bull
FDA licenceTGA registration
bull
Emphasis on priority groups but available to ALL
Source New England Journal of Medicine 2009 361 September 10
Clinical Trials of Pandemic (H1N1) 2009 Vaccine
Systemic Side effects
Headache
Fever
Myalgia
Malaise
Immune Response15mcg
97
30mcg 93
Source New England Journal of Medicine 2009 361 September 10
VACCINE ROLL OUT
bull
Around 76 million doses distributed (35
population)
bull
Available for this Influenza season
bull
Trivalent vaccine for seasonal influenza available
to targeted groups
Key lessons so far
1
Value of detailed planning2
Leadership and co-ordination
bull
AHPCbull
NPEC
3
Flexibility4
Medical innovation
5
Communication
NEJM on line publication ndash
Dec 2009
Current Situation ndash
2010
bull
Influenza activity low in Australia but showing some signs of increasing earlier than usualndash
lt2 respiratory tests positive for influenza
ndash
55 confirmed cases influenza per week
bull
Pandemic strain predominant in Australiandash
35 pandemic (H1N1) 2009
bull
Pandemic (H1N1) 2009 predominant in most countries
bull
Type B predominant in China (83) and Hong Kong (56)
Laboratory confirmed cases of influenza (pandemic (H1N1) 2009 and seasonal) in Australia 2010 to 26 February by week and type
0
10
20
30
40
50
60
2012010 9012010 16012010 23012010 30012010 6022010 13022010 20022010
Week of onsetnotification - start date
Num
ber o
f con
firm
ed in
fluen
za c
ases
AMexico2232009(H1N1) AH1N1 strain unknownA not subtyped AH1N1Brisbane592007AH3N2 AH3n2Brisbane102007 BUntyped AampB
Current Situation -
2010
KEY INDIVIDUALS FOR PANDEMIC RESPONSE
NIRMs Mary MurnaneMs Jenny BryantDr Gary LumMs Fay GardnerDr Bernie TowlerDr Andrew SingerDr Andrea FordeMs Kay McNieceDr Jenean Spencer
Prof Terry Nolan ATAGIDr Chris Mitchell RACGPDr Vicki Krause CDNA
NSW
Dr Kerry Chant
Dr Jeremy McAnulty
VIC
Dr John Carnie
Dr Rosemary Lester
QLD
Dr Jeanette Young
Dr Christine Selvey
TAS
Dr Chrissie Pickin
WA
Dr Tarun Weeramanthri
Dr Andy Robertson
SA
Dr Stephen Christley
ACT
Dr Charles Guest
NT
Dr Barbara Paterson
Office of Health Protection Surveillance Branch Department of Health and Ageing
PANDEMIC (H1N1) 2009 SURVEILLANCE AUSTRALIA
0
200
400
600
800
1000
1200
1400
1600
805
200
9
220
520
09
506
200
9
190
620
09
307
200
9
170
720
09
310
720
09
140
820
09
280
820
09
110
920
09
250
920
09
910
200
9
231
020
09
611
200
9
201
120
09
412
200
9
181
220
09
101
201
0
150
120
10
290
120
10
120
220
10
260
220
10
Date of onset notification
Num
ber o
f con
firm
ed c
ases
of p
ande
mic
(H1N
1) 2
009
ACT NSW NT Qld
SA Tas Vic WA
VIC moved to modified SUSTAIN phase
AUS phase PROTECT
Vaccination commenced
Source NetEPI database
Source NetEPI
database
Laboratory Confirmed CasesOf Pandemic (H1N1) in Australia
to 26 February 2010
0
10
20
30
40
50
60
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53Week
Rat
e of
ILI p
er 1
000
con
sulta
tions
ASPREN 2007ASPREN 2008ASPREN + NT + VIDRL 2009ASPREN + NT 2010
First case of Pandemic
(H1N1) 2009 reported in Australia
bullDelays in the reporting of data may cause data to change retrospectively As data from the NT surveillance system is combined with ASPREN data for 2010 rates may not be directly comparable across 2007 2008 and 2009 SOURCE ASPREN and NT GP surveillance system
Sentinel General Practice Surveillance1 January 2007 to 21 February 2010
0
200
400
600
800
1000
1200
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51Week
Num
ber o
f Em
erge
ncy
Dep
artm
ent I
LI
Pre
sent
atio
ns in
WA
2007 Presentations2008 Presentations2009 Presentations2010 Presentations
Child deaths associated with
influenza infection in 2007
Source WA lsquoVirus Watchrsquo Report
WA Emergency Departments1 January 2007 to 14 February 2010
Source NSW lsquoInfluenza Monthly Epidemiology Reportrsquo
Deaths Associated with Influenza and Pneumonia 2005 - 2010
Rates of absenteeism (greater than 3 days absent) national employerfrom 28 January 2007 to 17 February 2010 by week
0
02
04
06
08
1
12
14
16
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53
Week
Per
cent
of S
taff
Abs
ent
2007 Absenteeism2008 Absenteeism2009 Absenteeism2010 Absenteeism
SOURCE Absenteeism data
ABSENTEEISM28 Jan 2007 to 17 Feb 2010
Overview of pandemic (H1N1) 2009 severity ndash to 26 February 2010
2009 2010Pandemic (H1N1) 2009 Confirmed
casesHospitalised
casesICU cases Deaths Confirmed
casesHospitalised
casesICU
casesDeaths
Total number 37636 13 ofConfirmed
cases
14 ofHospitalised
cases
191 44 +186
InfluenzaType A
11 1 0
Crude rate per100000 population
1721 228 31 09 02
Median age (years) 21 31 44 53 30
Females 51 51 53 44 29
Vulnerable groups na 58 74 67
Indigenous people 11 20 19 13
Pregnant women na 27 Hospitalisedfemales aged15-44 years
16 Hospitalised
Pregnantwomen
4
Cases with at least 1co-morbidity
na 46 67 62
Severe Pandemic (H1N1) 2009
Hospitalisations-
Respiratory diabetes immuno compromised obesity chronic cardiac renal pregnancy rapid deteriorating flu patient
Higher proportion of Indigenous Australians
Over 50 admitted within 48 hours of onset
Higher ICU Admissions than expected
Hospitalisations of pandemic (H1N1) 2009 5 June ndash
23 October 2009 by week
17
0
100
200
300
400
500
600
700
21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43
Week of report
Num
ber o
f hos
pita
lista
tions
ass
ocia
ted
with
pan
dem
ic (H
1N1)
200
9
Australia
Age specific rates of hospitalised confirmed cases of pandemic (H1N1) 2009 to 3 October 2009 compared with average annual age specific rates of
hospitalisations from seasonal influenza 2004-05 to 2006-07 Australia
18
00
100
200
300
400
500
600
700
800
0-4
5-9
10-1
415
-19
20-2
425
-29
30-3
435
-39
40-4
445
-49
50-5
455
-59
60-6
465
-69
70-7
475
-79
80-8
485
+
Age group (5 Years)
Age
spec
ific
rate
(per
100
000
pop
ulat
ion) Males pandemic (H1N1) 2009
Females pandemic (H1N1) 2009
2004-07 seasonal influenza
Comparison of hospitalisations ICU admissions and deaths by age group to 2 October 2009
0
200
400
600
800
1000
1200
1400
0-9 10-19 20-29 30-39 40-49 50-59 60+
Age groups (10 years)
Tota
l num
ber
of h
ospi
talis
atio
ns
and
ICU
adm
issi
ons
of
conf
irmed
cas
es
0
10
20
30
40
50
60
Num
bers
of d
eath
s of
con
firm
ed
case
s
HospICUDeaths
Notification rates for pandemic (H1N1) 2009 in a selection of affected countries
Country Population Confirmed cases Crude rate per 100000
population
Hospitalisation rate per 100000 population
Deaths Trends
Southern Hemisphere
Australia 21262641 37636 1721 228 191 Low influenza activity
New Zealand 4319932 3233 730 227 18 Low levels of ILI decreasing trend
Argentina 40482000 11234 278 337 613 Low ILI activity decreasing trend
Chile 16454143 12276 746 98 150 Low ILI activity decreasing trend
Northern Hemisphere
Canada 33212696 NA 235 44 336 Low influenza activity
UK 60943912 26110 428 NA 265 Decreasing influenza activity
Mexico 109955400 66070 601 na 671 na
USA 304059724 50768 165 103 1336 Low influenza activity
Pandemic (H1N1) 2009 Vaccine
bull
Safety profile as with seasonal flu
bull
One injection 15μg protects adults
bull
FDA licenceTGA registration
bull
Emphasis on priority groups but available to ALL
Source New England Journal of Medicine 2009 361 September 10
Clinical Trials of Pandemic (H1N1) 2009 Vaccine
Systemic Side effects
Headache
Fever
Myalgia
Malaise
Immune Response15mcg
97
30mcg 93
Source New England Journal of Medicine 2009 361 September 10
VACCINE ROLL OUT
bull
Around 76 million doses distributed (35
population)
bull
Available for this Influenza season
bull
Trivalent vaccine for seasonal influenza available
to targeted groups
Key lessons so far
1
Value of detailed planning2
Leadership and co-ordination
bull
AHPCbull
NPEC
3
Flexibility4
Medical innovation
5
Communication
NEJM on line publication ndash
Dec 2009
Current Situation ndash
2010
bull
Influenza activity low in Australia but showing some signs of increasing earlier than usualndash
lt2 respiratory tests positive for influenza
ndash
55 confirmed cases influenza per week
bull
Pandemic strain predominant in Australiandash
35 pandemic (H1N1) 2009
bull
Pandemic (H1N1) 2009 predominant in most countries
bull
Type B predominant in China (83) and Hong Kong (56)
Laboratory confirmed cases of influenza (pandemic (H1N1) 2009 and seasonal) in Australia 2010 to 26 February by week and type
0
10
20
30
40
50
60
2012010 9012010 16012010 23012010 30012010 6022010 13022010 20022010
Week of onsetnotification - start date
Num
ber o
f con
firm
ed in
fluen
za c
ases
AMexico2232009(H1N1) AH1N1 strain unknownA not subtyped AH1N1Brisbane592007AH3N2 AH3n2Brisbane102007 BUntyped AampB
Current Situation -
2010
KEY INDIVIDUALS FOR PANDEMIC RESPONSE
NIRMs Mary MurnaneMs Jenny BryantDr Gary LumMs Fay GardnerDr Bernie TowlerDr Andrew SingerDr Andrea FordeMs Kay McNieceDr Jenean Spencer
Prof Terry Nolan ATAGIDr Chris Mitchell RACGPDr Vicki Krause CDNA
NSW
Dr Kerry Chant
Dr Jeremy McAnulty
VIC
Dr John Carnie
Dr Rosemary Lester
QLD
Dr Jeanette Young
Dr Christine Selvey
TAS
Dr Chrissie Pickin
WA
Dr Tarun Weeramanthri
Dr Andy Robertson
SA
Dr Stephen Christley
ACT
Dr Charles Guest
NT
Dr Barbara Paterson
0
200
400
600
800
1000
1200
1400
1600
805
200
9
220
520
09
506
200
9
190
620
09
307
200
9
170
720
09
310
720
09
140
820
09
280
820
09
110
920
09
250
920
09
910
200
9
231
020
09
611
200
9
201
120
09
412
200
9
181
220
09
101
201
0
150
120
10
290
120
10
120
220
10
260
220
10
Date of onset notification
Num
ber o
f con
firm
ed c
ases
of p
ande
mic
(H1N
1) 2
009
ACT NSW NT Qld
SA Tas Vic WA
VIC moved to modified SUSTAIN phase
AUS phase PROTECT
Vaccination commenced
Source NetEPI database
Source NetEPI
database
Laboratory Confirmed CasesOf Pandemic (H1N1) in Australia
to 26 February 2010
0
10
20
30
40
50
60
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53Week
Rat
e of
ILI p
er 1
000
con
sulta
tions
ASPREN 2007ASPREN 2008ASPREN + NT + VIDRL 2009ASPREN + NT 2010
First case of Pandemic
(H1N1) 2009 reported in Australia
bullDelays in the reporting of data may cause data to change retrospectively As data from the NT surveillance system is combined with ASPREN data for 2010 rates may not be directly comparable across 2007 2008 and 2009 SOURCE ASPREN and NT GP surveillance system
Sentinel General Practice Surveillance1 January 2007 to 21 February 2010
0
200
400
600
800
1000
1200
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51Week
Num
ber o
f Em
erge
ncy
Dep
artm
ent I
LI
Pre
sent
atio
ns in
WA
2007 Presentations2008 Presentations2009 Presentations2010 Presentations
Child deaths associated with
influenza infection in 2007
Source WA lsquoVirus Watchrsquo Report
WA Emergency Departments1 January 2007 to 14 February 2010
Source NSW lsquoInfluenza Monthly Epidemiology Reportrsquo
Deaths Associated with Influenza and Pneumonia 2005 - 2010
Rates of absenteeism (greater than 3 days absent) national employerfrom 28 January 2007 to 17 February 2010 by week
0
02
04
06
08
1
12
14
16
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53
Week
Per
cent
of S
taff
Abs
ent
2007 Absenteeism2008 Absenteeism2009 Absenteeism2010 Absenteeism
SOURCE Absenteeism data
ABSENTEEISM28 Jan 2007 to 17 Feb 2010
Overview of pandemic (H1N1) 2009 severity ndash to 26 February 2010
2009 2010Pandemic (H1N1) 2009 Confirmed
casesHospitalised
casesICU cases Deaths Confirmed
casesHospitalised
casesICU
casesDeaths
Total number 37636 13 ofConfirmed
cases
14 ofHospitalised
cases
191 44 +186
InfluenzaType A
11 1 0
Crude rate per100000 population
1721 228 31 09 02
Median age (years) 21 31 44 53 30
Females 51 51 53 44 29
Vulnerable groups na 58 74 67
Indigenous people 11 20 19 13
Pregnant women na 27 Hospitalisedfemales aged15-44 years
16 Hospitalised
Pregnantwomen
4
Cases with at least 1co-morbidity
na 46 67 62
Severe Pandemic (H1N1) 2009
Hospitalisations-
Respiratory diabetes immuno compromised obesity chronic cardiac renal pregnancy rapid deteriorating flu patient
Higher proportion of Indigenous Australians
Over 50 admitted within 48 hours of onset
Higher ICU Admissions than expected
Hospitalisations of pandemic (H1N1) 2009 5 June ndash
23 October 2009 by week
17
0
100
200
300
400
500
600
700
21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43
Week of report
Num
ber o
f hos
pita
lista
tions
ass
ocia
ted
with
pan
dem
ic (H
1N1)
200
9
Australia
Age specific rates of hospitalised confirmed cases of pandemic (H1N1) 2009 to 3 October 2009 compared with average annual age specific rates of
hospitalisations from seasonal influenza 2004-05 to 2006-07 Australia
18
00
100
200
300
400
500
600
700
800
0-4
5-9
10-1
415
-19
20-2
425
-29
30-3
435
-39
40-4
445
-49
50-5
455
-59
60-6
465
-69
70-7
475
-79
80-8
485
+
Age group (5 Years)
Age
spec
ific
rate
(per
100
000
pop
ulat
ion) Males pandemic (H1N1) 2009
Females pandemic (H1N1) 2009
2004-07 seasonal influenza
Comparison of hospitalisations ICU admissions and deaths by age group to 2 October 2009
0
200
400
600
800
1000
1200
1400
0-9 10-19 20-29 30-39 40-49 50-59 60+
Age groups (10 years)
Tota
l num
ber
of h
ospi
talis
atio
ns
and
ICU
adm
issi
ons
of
conf
irmed
cas
es
0
10
20
30
40
50
60
Num
bers
of d
eath
s of
con
firm
ed
case
s
HospICUDeaths
Notification rates for pandemic (H1N1) 2009 in a selection of affected countries
Country Population Confirmed cases Crude rate per 100000
population
Hospitalisation rate per 100000 population
Deaths Trends
Southern Hemisphere
Australia 21262641 37636 1721 228 191 Low influenza activity
New Zealand 4319932 3233 730 227 18 Low levels of ILI decreasing trend
Argentina 40482000 11234 278 337 613 Low ILI activity decreasing trend
Chile 16454143 12276 746 98 150 Low ILI activity decreasing trend
Northern Hemisphere
Canada 33212696 NA 235 44 336 Low influenza activity
UK 60943912 26110 428 NA 265 Decreasing influenza activity
Mexico 109955400 66070 601 na 671 na
USA 304059724 50768 165 103 1336 Low influenza activity
Pandemic (H1N1) 2009 Vaccine
bull
Safety profile as with seasonal flu
bull
One injection 15μg protects adults
bull
FDA licenceTGA registration
bull
Emphasis on priority groups but available to ALL
Source New England Journal of Medicine 2009 361 September 10
Clinical Trials of Pandemic (H1N1) 2009 Vaccine
Systemic Side effects
Headache
Fever
Myalgia
Malaise
Immune Response15mcg
97
30mcg 93
Source New England Journal of Medicine 2009 361 September 10
VACCINE ROLL OUT
bull
Around 76 million doses distributed (35
population)
bull
Available for this Influenza season
bull
Trivalent vaccine for seasonal influenza available
to targeted groups
Key lessons so far
1
Value of detailed planning2
Leadership and co-ordination
bull
AHPCbull
NPEC
3
Flexibility4
Medical innovation
5
Communication
NEJM on line publication ndash
Dec 2009
Current Situation ndash
2010
bull
Influenza activity low in Australia but showing some signs of increasing earlier than usualndash
lt2 respiratory tests positive for influenza
ndash
55 confirmed cases influenza per week
bull
Pandemic strain predominant in Australiandash
35 pandemic (H1N1) 2009
bull
Pandemic (H1N1) 2009 predominant in most countries
bull
Type B predominant in China (83) and Hong Kong (56)
Laboratory confirmed cases of influenza (pandemic (H1N1) 2009 and seasonal) in Australia 2010 to 26 February by week and type
0
10
20
30
40
50
60
2012010 9012010 16012010 23012010 30012010 6022010 13022010 20022010
Week of onsetnotification - start date
Num
ber o
f con
firm
ed in
fluen
za c
ases
AMexico2232009(H1N1) AH1N1 strain unknownA not subtyped AH1N1Brisbane592007AH3N2 AH3n2Brisbane102007 BUntyped AampB
Current Situation -
2010
KEY INDIVIDUALS FOR PANDEMIC RESPONSE
NIRMs Mary MurnaneMs Jenny BryantDr Gary LumMs Fay GardnerDr Bernie TowlerDr Andrew SingerDr Andrea FordeMs Kay McNieceDr Jenean Spencer
Prof Terry Nolan ATAGIDr Chris Mitchell RACGPDr Vicki Krause CDNA
NSW
Dr Kerry Chant
Dr Jeremy McAnulty
VIC
Dr John Carnie
Dr Rosemary Lester
QLD
Dr Jeanette Young
Dr Christine Selvey
TAS
Dr Chrissie Pickin
WA
Dr Tarun Weeramanthri
Dr Andy Robertson
SA
Dr Stephen Christley
ACT
Dr Charles Guest
NT
Dr Barbara Paterson
0
10
20
30
40
50
60
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53Week
Rat
e of
ILI p
er 1
000
con
sulta
tions
ASPREN 2007ASPREN 2008ASPREN + NT + VIDRL 2009ASPREN + NT 2010
First case of Pandemic
(H1N1) 2009 reported in Australia
bullDelays in the reporting of data may cause data to change retrospectively As data from the NT surveillance system is combined with ASPREN data for 2010 rates may not be directly comparable across 2007 2008 and 2009 SOURCE ASPREN and NT GP surveillance system
Sentinel General Practice Surveillance1 January 2007 to 21 February 2010
0
200
400
600
800
1000
1200
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51Week
Num
ber o
f Em
erge
ncy
Dep
artm
ent I
LI
Pre
sent
atio
ns in
WA
2007 Presentations2008 Presentations2009 Presentations2010 Presentations
Child deaths associated with
influenza infection in 2007
Source WA lsquoVirus Watchrsquo Report
WA Emergency Departments1 January 2007 to 14 February 2010
Source NSW lsquoInfluenza Monthly Epidemiology Reportrsquo
Deaths Associated with Influenza and Pneumonia 2005 - 2010
Rates of absenteeism (greater than 3 days absent) national employerfrom 28 January 2007 to 17 February 2010 by week
0
02
04
06
08
1
12
14
16
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53
Week
Per
cent
of S
taff
Abs
ent
2007 Absenteeism2008 Absenteeism2009 Absenteeism2010 Absenteeism
SOURCE Absenteeism data
ABSENTEEISM28 Jan 2007 to 17 Feb 2010
Overview of pandemic (H1N1) 2009 severity ndash to 26 February 2010
2009 2010Pandemic (H1N1) 2009 Confirmed
casesHospitalised
casesICU cases Deaths Confirmed
casesHospitalised
casesICU
casesDeaths
Total number 37636 13 ofConfirmed
cases
14 ofHospitalised
cases
191 44 +186
InfluenzaType A
11 1 0
Crude rate per100000 population
1721 228 31 09 02
Median age (years) 21 31 44 53 30
Females 51 51 53 44 29
Vulnerable groups na 58 74 67
Indigenous people 11 20 19 13
Pregnant women na 27 Hospitalisedfemales aged15-44 years
16 Hospitalised
Pregnantwomen
4
Cases with at least 1co-morbidity
na 46 67 62
Severe Pandemic (H1N1) 2009
Hospitalisations-
Respiratory diabetes immuno compromised obesity chronic cardiac renal pregnancy rapid deteriorating flu patient
Higher proportion of Indigenous Australians
Over 50 admitted within 48 hours of onset
Higher ICU Admissions than expected
Hospitalisations of pandemic (H1N1) 2009 5 June ndash
23 October 2009 by week
17
0
100
200
300
400
500
600
700
21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43
Week of report
Num
ber o
f hos
pita
lista
tions
ass
ocia
ted
with
pan
dem
ic (H
1N1)
200
9
Australia
Age specific rates of hospitalised confirmed cases of pandemic (H1N1) 2009 to 3 October 2009 compared with average annual age specific rates of
hospitalisations from seasonal influenza 2004-05 to 2006-07 Australia
18
00
100
200
300
400
500
600
700
800
0-4
5-9
10-1
415
-19
20-2
425
-29
30-3
435
-39
40-4
445
-49
50-5
455
-59
60-6
465
-69
70-7
475
-79
80-8
485
+
Age group (5 Years)
Age
spec
ific
rate
(per
100
000
pop
ulat
ion) Males pandemic (H1N1) 2009
Females pandemic (H1N1) 2009
2004-07 seasonal influenza
Comparison of hospitalisations ICU admissions and deaths by age group to 2 October 2009
0
200
400
600
800
1000
1200
1400
0-9 10-19 20-29 30-39 40-49 50-59 60+
Age groups (10 years)
Tota
l num
ber
of h
ospi
talis
atio
ns
and
ICU
adm
issi
ons
of
conf
irmed
cas
es
0
10
20
30
40
50
60
Num
bers
of d
eath
s of
con
firm
ed
case
s
HospICUDeaths
Notification rates for pandemic (H1N1) 2009 in a selection of affected countries
Country Population Confirmed cases Crude rate per 100000
population
Hospitalisation rate per 100000 population
Deaths Trends
Southern Hemisphere
Australia 21262641 37636 1721 228 191 Low influenza activity
New Zealand 4319932 3233 730 227 18 Low levels of ILI decreasing trend
Argentina 40482000 11234 278 337 613 Low ILI activity decreasing trend
Chile 16454143 12276 746 98 150 Low ILI activity decreasing trend
Northern Hemisphere
Canada 33212696 NA 235 44 336 Low influenza activity
UK 60943912 26110 428 NA 265 Decreasing influenza activity
Mexico 109955400 66070 601 na 671 na
USA 304059724 50768 165 103 1336 Low influenza activity
Pandemic (H1N1) 2009 Vaccine
bull
Safety profile as with seasonal flu
bull
One injection 15μg protects adults
bull
FDA licenceTGA registration
bull
Emphasis on priority groups but available to ALL
Source New England Journal of Medicine 2009 361 September 10
Clinical Trials of Pandemic (H1N1) 2009 Vaccine
Systemic Side effects
Headache
Fever
Myalgia
Malaise
Immune Response15mcg
97
30mcg 93
Source New England Journal of Medicine 2009 361 September 10
VACCINE ROLL OUT
bull
Around 76 million doses distributed (35
population)
bull
Available for this Influenza season
bull
Trivalent vaccine for seasonal influenza available
to targeted groups
Key lessons so far
1
Value of detailed planning2
Leadership and co-ordination
bull
AHPCbull
NPEC
3
Flexibility4
Medical innovation
5
Communication
NEJM on line publication ndash
Dec 2009
Current Situation ndash
2010
bull
Influenza activity low in Australia but showing some signs of increasing earlier than usualndash
lt2 respiratory tests positive for influenza
ndash
55 confirmed cases influenza per week
bull
Pandemic strain predominant in Australiandash
35 pandemic (H1N1) 2009
bull
Pandemic (H1N1) 2009 predominant in most countries
bull
Type B predominant in China (83) and Hong Kong (56)
Laboratory confirmed cases of influenza (pandemic (H1N1) 2009 and seasonal) in Australia 2010 to 26 February by week and type
0
10
20
30
40
50
60
2012010 9012010 16012010 23012010 30012010 6022010 13022010 20022010
Week of onsetnotification - start date
Num
ber o
f con
firm
ed in
fluen
za c
ases
AMexico2232009(H1N1) AH1N1 strain unknownA not subtyped AH1N1Brisbane592007AH3N2 AH3n2Brisbane102007 BUntyped AampB
Current Situation -
2010
KEY INDIVIDUALS FOR PANDEMIC RESPONSE
NIRMs Mary MurnaneMs Jenny BryantDr Gary LumMs Fay GardnerDr Bernie TowlerDr Andrew SingerDr Andrea FordeMs Kay McNieceDr Jenean Spencer
Prof Terry Nolan ATAGIDr Chris Mitchell RACGPDr Vicki Krause CDNA
NSW
Dr Kerry Chant
Dr Jeremy McAnulty
VIC
Dr John Carnie
Dr Rosemary Lester
QLD
Dr Jeanette Young
Dr Christine Selvey
TAS
Dr Chrissie Pickin
WA
Dr Tarun Weeramanthri
Dr Andy Robertson
SA
Dr Stephen Christley
ACT
Dr Charles Guest
NT
Dr Barbara Paterson
0
200
400
600
800
1000
1200
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51Week
Num
ber o
f Em
erge
ncy
Dep
artm
ent I
LI
Pre
sent
atio
ns in
WA
2007 Presentations2008 Presentations2009 Presentations2010 Presentations
Child deaths associated with
influenza infection in 2007
Source WA lsquoVirus Watchrsquo Report
WA Emergency Departments1 January 2007 to 14 February 2010
Source NSW lsquoInfluenza Monthly Epidemiology Reportrsquo
Deaths Associated with Influenza and Pneumonia 2005 - 2010
Rates of absenteeism (greater than 3 days absent) national employerfrom 28 January 2007 to 17 February 2010 by week
0
02
04
06
08
1
12
14
16
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53
Week
Per
cent
of S
taff
Abs
ent
2007 Absenteeism2008 Absenteeism2009 Absenteeism2010 Absenteeism
SOURCE Absenteeism data
ABSENTEEISM28 Jan 2007 to 17 Feb 2010
Overview of pandemic (H1N1) 2009 severity ndash to 26 February 2010
2009 2010Pandemic (H1N1) 2009 Confirmed
casesHospitalised
casesICU cases Deaths Confirmed
casesHospitalised
casesICU
casesDeaths
Total number 37636 13 ofConfirmed
cases
14 ofHospitalised
cases
191 44 +186
InfluenzaType A
11 1 0
Crude rate per100000 population
1721 228 31 09 02
Median age (years) 21 31 44 53 30
Females 51 51 53 44 29
Vulnerable groups na 58 74 67
Indigenous people 11 20 19 13
Pregnant women na 27 Hospitalisedfemales aged15-44 years
16 Hospitalised
Pregnantwomen
4
Cases with at least 1co-morbidity
na 46 67 62
Severe Pandemic (H1N1) 2009
Hospitalisations-
Respiratory diabetes immuno compromised obesity chronic cardiac renal pregnancy rapid deteriorating flu patient
Higher proportion of Indigenous Australians
Over 50 admitted within 48 hours of onset
Higher ICU Admissions than expected
Hospitalisations of pandemic (H1N1) 2009 5 June ndash
23 October 2009 by week
17
0
100
200
300
400
500
600
700
21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43
Week of report
Num
ber o
f hos
pita
lista
tions
ass
ocia
ted
with
pan
dem
ic (H
1N1)
200
9
Australia
Age specific rates of hospitalised confirmed cases of pandemic (H1N1) 2009 to 3 October 2009 compared with average annual age specific rates of
hospitalisations from seasonal influenza 2004-05 to 2006-07 Australia
18
00
100
200
300
400
500
600
700
800
0-4
5-9
10-1
415
-19
20-2
425
-29
30-3
435
-39
40-4
445
-49
50-5
455
-59
60-6
465
-69
70-7
475
-79
80-8
485
+
Age group (5 Years)
Age
spec
ific
rate
(per
100
000
pop
ulat
ion) Males pandemic (H1N1) 2009
Females pandemic (H1N1) 2009
2004-07 seasonal influenza
Comparison of hospitalisations ICU admissions and deaths by age group to 2 October 2009
0
200
400
600
800
1000
1200
1400
0-9 10-19 20-29 30-39 40-49 50-59 60+
Age groups (10 years)
Tota
l num
ber
of h
ospi
talis
atio
ns
and
ICU
adm
issi
ons
of
conf
irmed
cas
es
0
10
20
30
40
50
60
Num
bers
of d
eath
s of
con
firm
ed
case
s
HospICUDeaths
Notification rates for pandemic (H1N1) 2009 in a selection of affected countries
Country Population Confirmed cases Crude rate per 100000
population
Hospitalisation rate per 100000 population
Deaths Trends
Southern Hemisphere
Australia 21262641 37636 1721 228 191 Low influenza activity
New Zealand 4319932 3233 730 227 18 Low levels of ILI decreasing trend
Argentina 40482000 11234 278 337 613 Low ILI activity decreasing trend
Chile 16454143 12276 746 98 150 Low ILI activity decreasing trend
Northern Hemisphere
Canada 33212696 NA 235 44 336 Low influenza activity
UK 60943912 26110 428 NA 265 Decreasing influenza activity
Mexico 109955400 66070 601 na 671 na
USA 304059724 50768 165 103 1336 Low influenza activity
Pandemic (H1N1) 2009 Vaccine
bull
Safety profile as with seasonal flu
bull
One injection 15μg protects adults
bull
FDA licenceTGA registration
bull
Emphasis on priority groups but available to ALL
Source New England Journal of Medicine 2009 361 September 10
Clinical Trials of Pandemic (H1N1) 2009 Vaccine
Systemic Side effects
Headache
Fever
Myalgia
Malaise
Immune Response15mcg
97
30mcg 93
Source New England Journal of Medicine 2009 361 September 10
VACCINE ROLL OUT
bull
Around 76 million doses distributed (35
population)
bull
Available for this Influenza season
bull
Trivalent vaccine for seasonal influenza available
to targeted groups
Key lessons so far
1
Value of detailed planning2
Leadership and co-ordination
bull
AHPCbull
NPEC
3
Flexibility4
Medical innovation
5
Communication
NEJM on line publication ndash
Dec 2009
Current Situation ndash
2010
bull
Influenza activity low in Australia but showing some signs of increasing earlier than usualndash
lt2 respiratory tests positive for influenza
ndash
55 confirmed cases influenza per week
bull
Pandemic strain predominant in Australiandash
35 pandemic (H1N1) 2009
bull
Pandemic (H1N1) 2009 predominant in most countries
bull
Type B predominant in China (83) and Hong Kong (56)
Laboratory confirmed cases of influenza (pandemic (H1N1) 2009 and seasonal) in Australia 2010 to 26 February by week and type
0
10
20
30
40
50
60
2012010 9012010 16012010 23012010 30012010 6022010 13022010 20022010
Week of onsetnotification - start date
Num
ber o
f con
firm
ed in
fluen
za c
ases
AMexico2232009(H1N1) AH1N1 strain unknownA not subtyped AH1N1Brisbane592007AH3N2 AH3n2Brisbane102007 BUntyped AampB
Current Situation -
2010
KEY INDIVIDUALS FOR PANDEMIC RESPONSE
NIRMs Mary MurnaneMs Jenny BryantDr Gary LumMs Fay GardnerDr Bernie TowlerDr Andrew SingerDr Andrea FordeMs Kay McNieceDr Jenean Spencer
Prof Terry Nolan ATAGIDr Chris Mitchell RACGPDr Vicki Krause CDNA
NSW
Dr Kerry Chant
Dr Jeremy McAnulty
VIC
Dr John Carnie
Dr Rosemary Lester
QLD
Dr Jeanette Young
Dr Christine Selvey
TAS
Dr Chrissie Pickin
WA
Dr Tarun Weeramanthri
Dr Andy Robertson
SA
Dr Stephen Christley
ACT
Dr Charles Guest
NT
Dr Barbara Paterson
Source NSW lsquoInfluenza Monthly Epidemiology Reportrsquo
Deaths Associated with Influenza and Pneumonia 2005 - 2010
Rates of absenteeism (greater than 3 days absent) national employerfrom 28 January 2007 to 17 February 2010 by week
0
02
04
06
08
1
12
14
16
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53
Week
Per
cent
of S
taff
Abs
ent
2007 Absenteeism2008 Absenteeism2009 Absenteeism2010 Absenteeism
SOURCE Absenteeism data
ABSENTEEISM28 Jan 2007 to 17 Feb 2010
Overview of pandemic (H1N1) 2009 severity ndash to 26 February 2010
2009 2010Pandemic (H1N1) 2009 Confirmed
casesHospitalised
casesICU cases Deaths Confirmed
casesHospitalised
casesICU
casesDeaths
Total number 37636 13 ofConfirmed
cases
14 ofHospitalised
cases
191 44 +186
InfluenzaType A
11 1 0
Crude rate per100000 population
1721 228 31 09 02
Median age (years) 21 31 44 53 30
Females 51 51 53 44 29
Vulnerable groups na 58 74 67
Indigenous people 11 20 19 13
Pregnant women na 27 Hospitalisedfemales aged15-44 years
16 Hospitalised
Pregnantwomen
4
Cases with at least 1co-morbidity
na 46 67 62
Severe Pandemic (H1N1) 2009
Hospitalisations-
Respiratory diabetes immuno compromised obesity chronic cardiac renal pregnancy rapid deteriorating flu patient
Higher proportion of Indigenous Australians
Over 50 admitted within 48 hours of onset
Higher ICU Admissions than expected
Hospitalisations of pandemic (H1N1) 2009 5 June ndash
23 October 2009 by week
17
0
100
200
300
400
500
600
700
21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43
Week of report
Num
ber o
f hos
pita
lista
tions
ass
ocia
ted
with
pan
dem
ic (H
1N1)
200
9
Australia
Age specific rates of hospitalised confirmed cases of pandemic (H1N1) 2009 to 3 October 2009 compared with average annual age specific rates of
hospitalisations from seasonal influenza 2004-05 to 2006-07 Australia
18
00
100
200
300
400
500
600
700
800
0-4
5-9
10-1
415
-19
20-2
425
-29
30-3
435
-39
40-4
445
-49
50-5
455
-59
60-6
465
-69
70-7
475
-79
80-8
485
+
Age group (5 Years)
Age
spec
ific
rate
(per
100
000
pop
ulat
ion) Males pandemic (H1N1) 2009
Females pandemic (H1N1) 2009
2004-07 seasonal influenza
Comparison of hospitalisations ICU admissions and deaths by age group to 2 October 2009
0
200
400
600
800
1000
1200
1400
0-9 10-19 20-29 30-39 40-49 50-59 60+
Age groups (10 years)
Tota
l num
ber
of h
ospi
talis
atio
ns
and
ICU
adm
issi
ons
of
conf
irmed
cas
es
0
10
20
30
40
50
60
Num
bers
of d
eath
s of
con
firm
ed
case
s
HospICUDeaths
Notification rates for pandemic (H1N1) 2009 in a selection of affected countries
Country Population Confirmed cases Crude rate per 100000
population
Hospitalisation rate per 100000 population
Deaths Trends
Southern Hemisphere
Australia 21262641 37636 1721 228 191 Low influenza activity
New Zealand 4319932 3233 730 227 18 Low levels of ILI decreasing trend
Argentina 40482000 11234 278 337 613 Low ILI activity decreasing trend
Chile 16454143 12276 746 98 150 Low ILI activity decreasing trend
Northern Hemisphere
Canada 33212696 NA 235 44 336 Low influenza activity
UK 60943912 26110 428 NA 265 Decreasing influenza activity
Mexico 109955400 66070 601 na 671 na
USA 304059724 50768 165 103 1336 Low influenza activity
Pandemic (H1N1) 2009 Vaccine
bull
Safety profile as with seasonal flu
bull
One injection 15μg protects adults
bull
FDA licenceTGA registration
bull
Emphasis on priority groups but available to ALL
Source New England Journal of Medicine 2009 361 September 10
Clinical Trials of Pandemic (H1N1) 2009 Vaccine
Systemic Side effects
Headache
Fever
Myalgia
Malaise
Immune Response15mcg
97
30mcg 93
Source New England Journal of Medicine 2009 361 September 10
VACCINE ROLL OUT
bull
Around 76 million doses distributed (35
population)
bull
Available for this Influenza season
bull
Trivalent vaccine for seasonal influenza available
to targeted groups
Key lessons so far
1
Value of detailed planning2
Leadership and co-ordination
bull
AHPCbull
NPEC
3
Flexibility4
Medical innovation
5
Communication
NEJM on line publication ndash
Dec 2009
Current Situation ndash
2010
bull
Influenza activity low in Australia but showing some signs of increasing earlier than usualndash
lt2 respiratory tests positive for influenza
ndash
55 confirmed cases influenza per week
bull
Pandemic strain predominant in Australiandash
35 pandemic (H1N1) 2009
bull
Pandemic (H1N1) 2009 predominant in most countries
bull
Type B predominant in China (83) and Hong Kong (56)
Laboratory confirmed cases of influenza (pandemic (H1N1) 2009 and seasonal) in Australia 2010 to 26 February by week and type
0
10
20
30
40
50
60
2012010 9012010 16012010 23012010 30012010 6022010 13022010 20022010
Week of onsetnotification - start date
Num
ber o
f con
firm
ed in
fluen
za c
ases
AMexico2232009(H1N1) AH1N1 strain unknownA not subtyped AH1N1Brisbane592007AH3N2 AH3n2Brisbane102007 BUntyped AampB
Current Situation -
2010
KEY INDIVIDUALS FOR PANDEMIC RESPONSE
NIRMs Mary MurnaneMs Jenny BryantDr Gary LumMs Fay GardnerDr Bernie TowlerDr Andrew SingerDr Andrea FordeMs Kay McNieceDr Jenean Spencer
Prof Terry Nolan ATAGIDr Chris Mitchell RACGPDr Vicki Krause CDNA
NSW
Dr Kerry Chant
Dr Jeremy McAnulty
VIC
Dr John Carnie
Dr Rosemary Lester
QLD
Dr Jeanette Young
Dr Christine Selvey
TAS
Dr Chrissie Pickin
WA
Dr Tarun Weeramanthri
Dr Andy Robertson
SA
Dr Stephen Christley
ACT
Dr Charles Guest
NT
Dr Barbara Paterson
Rates of absenteeism (greater than 3 days absent) national employerfrom 28 January 2007 to 17 February 2010 by week
0
02
04
06
08
1
12
14
16
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53
Week
Per
cent
of S
taff
Abs
ent
2007 Absenteeism2008 Absenteeism2009 Absenteeism2010 Absenteeism
SOURCE Absenteeism data
ABSENTEEISM28 Jan 2007 to 17 Feb 2010
Overview of pandemic (H1N1) 2009 severity ndash to 26 February 2010
2009 2010Pandemic (H1N1) 2009 Confirmed
casesHospitalised
casesICU cases Deaths Confirmed
casesHospitalised
casesICU
casesDeaths
Total number 37636 13 ofConfirmed
cases
14 ofHospitalised
cases
191 44 +186
InfluenzaType A
11 1 0
Crude rate per100000 population
1721 228 31 09 02
Median age (years) 21 31 44 53 30
Females 51 51 53 44 29
Vulnerable groups na 58 74 67
Indigenous people 11 20 19 13
Pregnant women na 27 Hospitalisedfemales aged15-44 years
16 Hospitalised
Pregnantwomen
4
Cases with at least 1co-morbidity
na 46 67 62
Severe Pandemic (H1N1) 2009
Hospitalisations-
Respiratory diabetes immuno compromised obesity chronic cardiac renal pregnancy rapid deteriorating flu patient
Higher proportion of Indigenous Australians
Over 50 admitted within 48 hours of onset
Higher ICU Admissions than expected
Hospitalisations of pandemic (H1N1) 2009 5 June ndash
23 October 2009 by week
17
0
100
200
300
400
500
600
700
21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43
Week of report
Num
ber o
f hos
pita
lista
tions
ass
ocia
ted
with
pan
dem
ic (H
1N1)
200
9
Australia
Age specific rates of hospitalised confirmed cases of pandemic (H1N1) 2009 to 3 October 2009 compared with average annual age specific rates of
hospitalisations from seasonal influenza 2004-05 to 2006-07 Australia
18
00
100
200
300
400
500
600
700
800
0-4
5-9
10-1
415
-19
20-2
425
-29
30-3
435
-39
40-4
445
-49
50-5
455
-59
60-6
465
-69
70-7
475
-79
80-8
485
+
Age group (5 Years)
Age
spec
ific
rate
(per
100
000
pop
ulat
ion) Males pandemic (H1N1) 2009
Females pandemic (H1N1) 2009
2004-07 seasonal influenza
Comparison of hospitalisations ICU admissions and deaths by age group to 2 October 2009
0
200
400
600
800
1000
1200
1400
0-9 10-19 20-29 30-39 40-49 50-59 60+
Age groups (10 years)
Tota
l num
ber
of h
ospi
talis
atio
ns
and
ICU
adm
issi
ons
of
conf
irmed
cas
es
0
10
20
30
40
50
60
Num
bers
of d
eath
s of
con
firm
ed
case
s
HospICUDeaths
Notification rates for pandemic (H1N1) 2009 in a selection of affected countries
Country Population Confirmed cases Crude rate per 100000
population
Hospitalisation rate per 100000 population
Deaths Trends
Southern Hemisphere
Australia 21262641 37636 1721 228 191 Low influenza activity
New Zealand 4319932 3233 730 227 18 Low levels of ILI decreasing trend
Argentina 40482000 11234 278 337 613 Low ILI activity decreasing trend
Chile 16454143 12276 746 98 150 Low ILI activity decreasing trend
Northern Hemisphere
Canada 33212696 NA 235 44 336 Low influenza activity
UK 60943912 26110 428 NA 265 Decreasing influenza activity
Mexico 109955400 66070 601 na 671 na
USA 304059724 50768 165 103 1336 Low influenza activity
Pandemic (H1N1) 2009 Vaccine
bull
Safety profile as with seasonal flu
bull
One injection 15μg protects adults
bull
FDA licenceTGA registration
bull
Emphasis on priority groups but available to ALL
Source New England Journal of Medicine 2009 361 September 10
Clinical Trials of Pandemic (H1N1) 2009 Vaccine
Systemic Side effects
Headache
Fever
Myalgia
Malaise
Immune Response15mcg
97
30mcg 93
Source New England Journal of Medicine 2009 361 September 10
VACCINE ROLL OUT
bull
Around 76 million doses distributed (35
population)
bull
Available for this Influenza season
bull
Trivalent vaccine for seasonal influenza available
to targeted groups
Key lessons so far
1
Value of detailed planning2
Leadership and co-ordination
bull
AHPCbull
NPEC
3
Flexibility4
Medical innovation
5
Communication
NEJM on line publication ndash
Dec 2009
Current Situation ndash
2010
bull
Influenza activity low in Australia but showing some signs of increasing earlier than usualndash
lt2 respiratory tests positive for influenza
ndash
55 confirmed cases influenza per week
bull
Pandemic strain predominant in Australiandash
35 pandemic (H1N1) 2009
bull
Pandemic (H1N1) 2009 predominant in most countries
bull
Type B predominant in China (83) and Hong Kong (56)
Laboratory confirmed cases of influenza (pandemic (H1N1) 2009 and seasonal) in Australia 2010 to 26 February by week and type
0
10
20
30
40
50
60
2012010 9012010 16012010 23012010 30012010 6022010 13022010 20022010
Week of onsetnotification - start date
Num
ber o
f con
firm
ed in
fluen
za c
ases
AMexico2232009(H1N1) AH1N1 strain unknownA not subtyped AH1N1Brisbane592007AH3N2 AH3n2Brisbane102007 BUntyped AampB
Current Situation -
2010
KEY INDIVIDUALS FOR PANDEMIC RESPONSE
NIRMs Mary MurnaneMs Jenny BryantDr Gary LumMs Fay GardnerDr Bernie TowlerDr Andrew SingerDr Andrea FordeMs Kay McNieceDr Jenean Spencer
Prof Terry Nolan ATAGIDr Chris Mitchell RACGPDr Vicki Krause CDNA
NSW
Dr Kerry Chant
Dr Jeremy McAnulty
VIC
Dr John Carnie
Dr Rosemary Lester
QLD
Dr Jeanette Young
Dr Christine Selvey
TAS
Dr Chrissie Pickin
WA
Dr Tarun Weeramanthri
Dr Andy Robertson
SA
Dr Stephen Christley
ACT
Dr Charles Guest
NT
Dr Barbara Paterson
Overview of pandemic (H1N1) 2009 severity ndash to 26 February 2010
2009 2010Pandemic (H1N1) 2009 Confirmed
casesHospitalised
casesICU cases Deaths Confirmed
casesHospitalised
casesICU
casesDeaths
Total number 37636 13 ofConfirmed
cases
14 ofHospitalised
cases
191 44 +186
InfluenzaType A
11 1 0
Crude rate per100000 population
1721 228 31 09 02
Median age (years) 21 31 44 53 30
Females 51 51 53 44 29
Vulnerable groups na 58 74 67
Indigenous people 11 20 19 13
Pregnant women na 27 Hospitalisedfemales aged15-44 years
16 Hospitalised
Pregnantwomen
4
Cases with at least 1co-morbidity
na 46 67 62
Severe Pandemic (H1N1) 2009
Hospitalisations-
Respiratory diabetes immuno compromised obesity chronic cardiac renal pregnancy rapid deteriorating flu patient
Higher proportion of Indigenous Australians
Over 50 admitted within 48 hours of onset
Higher ICU Admissions than expected
Hospitalisations of pandemic (H1N1) 2009 5 June ndash
23 October 2009 by week
17
0
100
200
300
400
500
600
700
21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43
Week of report
Num
ber o
f hos
pita
lista
tions
ass
ocia
ted
with
pan
dem
ic (H
1N1)
200
9
Australia
Age specific rates of hospitalised confirmed cases of pandemic (H1N1) 2009 to 3 October 2009 compared with average annual age specific rates of
hospitalisations from seasonal influenza 2004-05 to 2006-07 Australia
18
00
100
200
300
400
500
600
700
800
0-4
5-9
10-1
415
-19
20-2
425
-29
30-3
435
-39
40-4
445
-49
50-5
455
-59
60-6
465
-69
70-7
475
-79
80-8
485
+
Age group (5 Years)
Age
spec
ific
rate
(per
100
000
pop
ulat
ion) Males pandemic (H1N1) 2009
Females pandemic (H1N1) 2009
2004-07 seasonal influenza
Comparison of hospitalisations ICU admissions and deaths by age group to 2 October 2009
0
200
400
600
800
1000
1200
1400
0-9 10-19 20-29 30-39 40-49 50-59 60+
Age groups (10 years)
Tota
l num
ber
of h
ospi
talis
atio
ns
and
ICU
adm
issi
ons
of
conf
irmed
cas
es
0
10
20
30
40
50
60
Num
bers
of d
eath
s of
con
firm
ed
case
s
HospICUDeaths
Notification rates for pandemic (H1N1) 2009 in a selection of affected countries
Country Population Confirmed cases Crude rate per 100000
population
Hospitalisation rate per 100000 population
Deaths Trends
Southern Hemisphere
Australia 21262641 37636 1721 228 191 Low influenza activity
New Zealand 4319932 3233 730 227 18 Low levels of ILI decreasing trend
Argentina 40482000 11234 278 337 613 Low ILI activity decreasing trend
Chile 16454143 12276 746 98 150 Low ILI activity decreasing trend
Northern Hemisphere
Canada 33212696 NA 235 44 336 Low influenza activity
UK 60943912 26110 428 NA 265 Decreasing influenza activity
Mexico 109955400 66070 601 na 671 na
USA 304059724 50768 165 103 1336 Low influenza activity
Pandemic (H1N1) 2009 Vaccine
bull
Safety profile as with seasonal flu
bull
One injection 15μg protects adults
bull
FDA licenceTGA registration
bull
Emphasis on priority groups but available to ALL
Source New England Journal of Medicine 2009 361 September 10
Clinical Trials of Pandemic (H1N1) 2009 Vaccine
Systemic Side effects
Headache
Fever
Myalgia
Malaise
Immune Response15mcg
97
30mcg 93
Source New England Journal of Medicine 2009 361 September 10
VACCINE ROLL OUT
bull
Around 76 million doses distributed (35
population)
bull
Available for this Influenza season
bull
Trivalent vaccine for seasonal influenza available
to targeted groups
Key lessons so far
1
Value of detailed planning2
Leadership and co-ordination
bull
AHPCbull
NPEC
3
Flexibility4
Medical innovation
5
Communication
NEJM on line publication ndash
Dec 2009
Current Situation ndash
2010
bull
Influenza activity low in Australia but showing some signs of increasing earlier than usualndash
lt2 respiratory tests positive for influenza
ndash
55 confirmed cases influenza per week
bull
Pandemic strain predominant in Australiandash
35 pandemic (H1N1) 2009
bull
Pandemic (H1N1) 2009 predominant in most countries
bull
Type B predominant in China (83) and Hong Kong (56)
Laboratory confirmed cases of influenza (pandemic (H1N1) 2009 and seasonal) in Australia 2010 to 26 February by week and type
0
10
20
30
40
50
60
2012010 9012010 16012010 23012010 30012010 6022010 13022010 20022010
Week of onsetnotification - start date
Num
ber o
f con
firm
ed in
fluen
za c
ases
AMexico2232009(H1N1) AH1N1 strain unknownA not subtyped AH1N1Brisbane592007AH3N2 AH3n2Brisbane102007 BUntyped AampB
Current Situation -
2010
KEY INDIVIDUALS FOR PANDEMIC RESPONSE
NIRMs Mary MurnaneMs Jenny BryantDr Gary LumMs Fay GardnerDr Bernie TowlerDr Andrew SingerDr Andrea FordeMs Kay McNieceDr Jenean Spencer
Prof Terry Nolan ATAGIDr Chris Mitchell RACGPDr Vicki Krause CDNA
NSW
Dr Kerry Chant
Dr Jeremy McAnulty
VIC
Dr John Carnie
Dr Rosemary Lester
QLD
Dr Jeanette Young
Dr Christine Selvey
TAS
Dr Chrissie Pickin
WA
Dr Tarun Weeramanthri
Dr Andy Robertson
SA
Dr Stephen Christley
ACT
Dr Charles Guest
NT
Dr Barbara Paterson
Severe Pandemic (H1N1) 2009
Hospitalisations-
Respiratory diabetes immuno compromised obesity chronic cardiac renal pregnancy rapid deteriorating flu patient
Higher proportion of Indigenous Australians
Over 50 admitted within 48 hours of onset
Higher ICU Admissions than expected
Hospitalisations of pandemic (H1N1) 2009 5 June ndash
23 October 2009 by week
17
0
100
200
300
400
500
600
700
21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43
Week of report
Num
ber o
f hos
pita
lista
tions
ass
ocia
ted
with
pan
dem
ic (H
1N1)
200
9
Australia
Age specific rates of hospitalised confirmed cases of pandemic (H1N1) 2009 to 3 October 2009 compared with average annual age specific rates of
hospitalisations from seasonal influenza 2004-05 to 2006-07 Australia
18
00
100
200
300
400
500
600
700
800
0-4
5-9
10-1
415
-19
20-2
425
-29
30-3
435
-39
40-4
445
-49
50-5
455
-59
60-6
465
-69
70-7
475
-79
80-8
485
+
Age group (5 Years)
Age
spec
ific
rate
(per
100
000
pop
ulat
ion) Males pandemic (H1N1) 2009
Females pandemic (H1N1) 2009
2004-07 seasonal influenza
Comparison of hospitalisations ICU admissions and deaths by age group to 2 October 2009
0
200
400
600
800
1000
1200
1400
0-9 10-19 20-29 30-39 40-49 50-59 60+
Age groups (10 years)
Tota
l num
ber
of h
ospi
talis
atio
ns
and
ICU
adm
issi
ons
of
conf
irmed
cas
es
0
10
20
30
40
50
60
Num
bers
of d
eath
s of
con
firm
ed
case
s
HospICUDeaths
Notification rates for pandemic (H1N1) 2009 in a selection of affected countries
Country Population Confirmed cases Crude rate per 100000
population
Hospitalisation rate per 100000 population
Deaths Trends
Southern Hemisphere
Australia 21262641 37636 1721 228 191 Low influenza activity
New Zealand 4319932 3233 730 227 18 Low levels of ILI decreasing trend
Argentina 40482000 11234 278 337 613 Low ILI activity decreasing trend
Chile 16454143 12276 746 98 150 Low ILI activity decreasing trend
Northern Hemisphere
Canada 33212696 NA 235 44 336 Low influenza activity
UK 60943912 26110 428 NA 265 Decreasing influenza activity
Mexico 109955400 66070 601 na 671 na
USA 304059724 50768 165 103 1336 Low influenza activity
Pandemic (H1N1) 2009 Vaccine
bull
Safety profile as with seasonal flu
bull
One injection 15μg protects adults
bull
FDA licenceTGA registration
bull
Emphasis on priority groups but available to ALL
Source New England Journal of Medicine 2009 361 September 10
Clinical Trials of Pandemic (H1N1) 2009 Vaccine
Systemic Side effects
Headache
Fever
Myalgia
Malaise
Immune Response15mcg
97
30mcg 93
Source New England Journal of Medicine 2009 361 September 10
VACCINE ROLL OUT
bull
Around 76 million doses distributed (35
population)
bull
Available for this Influenza season
bull
Trivalent vaccine for seasonal influenza available
to targeted groups
Key lessons so far
1
Value of detailed planning2
Leadership and co-ordination
bull
AHPCbull
NPEC
3
Flexibility4
Medical innovation
5
Communication
NEJM on line publication ndash
Dec 2009
Current Situation ndash
2010
bull
Influenza activity low in Australia but showing some signs of increasing earlier than usualndash
lt2 respiratory tests positive for influenza
ndash
55 confirmed cases influenza per week
bull
Pandemic strain predominant in Australiandash
35 pandemic (H1N1) 2009
bull
Pandemic (H1N1) 2009 predominant in most countries
bull
Type B predominant in China (83) and Hong Kong (56)
Laboratory confirmed cases of influenza (pandemic (H1N1) 2009 and seasonal) in Australia 2010 to 26 February by week and type
0
10
20
30
40
50
60
2012010 9012010 16012010 23012010 30012010 6022010 13022010 20022010
Week of onsetnotification - start date
Num
ber o
f con
firm
ed in
fluen
za c
ases
AMexico2232009(H1N1) AH1N1 strain unknownA not subtyped AH1N1Brisbane592007AH3N2 AH3n2Brisbane102007 BUntyped AampB
Current Situation -
2010
KEY INDIVIDUALS FOR PANDEMIC RESPONSE
NIRMs Mary MurnaneMs Jenny BryantDr Gary LumMs Fay GardnerDr Bernie TowlerDr Andrew SingerDr Andrea FordeMs Kay McNieceDr Jenean Spencer
Prof Terry Nolan ATAGIDr Chris Mitchell RACGPDr Vicki Krause CDNA
NSW
Dr Kerry Chant
Dr Jeremy McAnulty
VIC
Dr John Carnie
Dr Rosemary Lester
QLD
Dr Jeanette Young
Dr Christine Selvey
TAS
Dr Chrissie Pickin
WA
Dr Tarun Weeramanthri
Dr Andy Robertson
SA
Dr Stephen Christley
ACT
Dr Charles Guest
NT
Dr Barbara Paterson
Hospitalisations of pandemic (H1N1) 2009 5 June ndash
23 October 2009 by week
17
0
100
200
300
400
500
600
700
21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43
Week of report
Num
ber o
f hos
pita
lista
tions
ass
ocia
ted
with
pan
dem
ic (H
1N1)
200
9
Australia
Age specific rates of hospitalised confirmed cases of pandemic (H1N1) 2009 to 3 October 2009 compared with average annual age specific rates of
hospitalisations from seasonal influenza 2004-05 to 2006-07 Australia
18
00
100
200
300
400
500
600
700
800
0-4
5-9
10-1
415
-19
20-2
425
-29
30-3
435
-39
40-4
445
-49
50-5
455
-59
60-6
465
-69
70-7
475
-79
80-8
485
+
Age group (5 Years)
Age
spec
ific
rate
(per
100
000
pop
ulat
ion) Males pandemic (H1N1) 2009
Females pandemic (H1N1) 2009
2004-07 seasonal influenza
Comparison of hospitalisations ICU admissions and deaths by age group to 2 October 2009
0
200
400
600
800
1000
1200
1400
0-9 10-19 20-29 30-39 40-49 50-59 60+
Age groups (10 years)
Tota
l num
ber
of h
ospi
talis
atio
ns
and
ICU
adm
issi
ons
of
conf
irmed
cas
es
0
10
20
30
40
50
60
Num
bers
of d
eath
s of
con
firm
ed
case
s
HospICUDeaths
Notification rates for pandemic (H1N1) 2009 in a selection of affected countries
Country Population Confirmed cases Crude rate per 100000
population
Hospitalisation rate per 100000 population
Deaths Trends
Southern Hemisphere
Australia 21262641 37636 1721 228 191 Low influenza activity
New Zealand 4319932 3233 730 227 18 Low levels of ILI decreasing trend
Argentina 40482000 11234 278 337 613 Low ILI activity decreasing trend
Chile 16454143 12276 746 98 150 Low ILI activity decreasing trend
Northern Hemisphere
Canada 33212696 NA 235 44 336 Low influenza activity
UK 60943912 26110 428 NA 265 Decreasing influenza activity
Mexico 109955400 66070 601 na 671 na
USA 304059724 50768 165 103 1336 Low influenza activity
Pandemic (H1N1) 2009 Vaccine
bull
Safety profile as with seasonal flu
bull
One injection 15μg protects adults
bull
FDA licenceTGA registration
bull
Emphasis on priority groups but available to ALL
Source New England Journal of Medicine 2009 361 September 10
Clinical Trials of Pandemic (H1N1) 2009 Vaccine
Systemic Side effects
Headache
Fever
Myalgia
Malaise
Immune Response15mcg
97
30mcg 93
Source New England Journal of Medicine 2009 361 September 10
VACCINE ROLL OUT
bull
Around 76 million doses distributed (35
population)
bull
Available for this Influenza season
bull
Trivalent vaccine for seasonal influenza available
to targeted groups
Key lessons so far
1
Value of detailed planning2
Leadership and co-ordination
bull
AHPCbull
NPEC
3
Flexibility4
Medical innovation
5
Communication
NEJM on line publication ndash
Dec 2009
Current Situation ndash
2010
bull
Influenza activity low in Australia but showing some signs of increasing earlier than usualndash
lt2 respiratory tests positive for influenza
ndash
55 confirmed cases influenza per week
bull
Pandemic strain predominant in Australiandash
35 pandemic (H1N1) 2009
bull
Pandemic (H1N1) 2009 predominant in most countries
bull
Type B predominant in China (83) and Hong Kong (56)
Laboratory confirmed cases of influenza (pandemic (H1N1) 2009 and seasonal) in Australia 2010 to 26 February by week and type
0
10
20
30
40
50
60
2012010 9012010 16012010 23012010 30012010 6022010 13022010 20022010
Week of onsetnotification - start date
Num
ber o
f con
firm
ed in
fluen
za c
ases
AMexico2232009(H1N1) AH1N1 strain unknownA not subtyped AH1N1Brisbane592007AH3N2 AH3n2Brisbane102007 BUntyped AampB
Current Situation -
2010
KEY INDIVIDUALS FOR PANDEMIC RESPONSE
NIRMs Mary MurnaneMs Jenny BryantDr Gary LumMs Fay GardnerDr Bernie TowlerDr Andrew SingerDr Andrea FordeMs Kay McNieceDr Jenean Spencer
Prof Terry Nolan ATAGIDr Chris Mitchell RACGPDr Vicki Krause CDNA
NSW
Dr Kerry Chant
Dr Jeremy McAnulty
VIC
Dr John Carnie
Dr Rosemary Lester
QLD
Dr Jeanette Young
Dr Christine Selvey
TAS
Dr Chrissie Pickin
WA
Dr Tarun Weeramanthri
Dr Andy Robertson
SA
Dr Stephen Christley
ACT
Dr Charles Guest
NT
Dr Barbara Paterson
Age specific rates of hospitalised confirmed cases of pandemic (H1N1) 2009 to 3 October 2009 compared with average annual age specific rates of
hospitalisations from seasonal influenza 2004-05 to 2006-07 Australia
18
00
100
200
300
400
500
600
700
800
0-4
5-9
10-1
415
-19
20-2
425
-29
30-3
435
-39
40-4
445
-49
50-5
455
-59
60-6
465
-69
70-7
475
-79
80-8
485
+
Age group (5 Years)
Age
spec
ific
rate
(per
100
000
pop
ulat
ion) Males pandemic (H1N1) 2009
Females pandemic (H1N1) 2009
2004-07 seasonal influenza
Comparison of hospitalisations ICU admissions and deaths by age group to 2 October 2009
0
200
400
600
800
1000
1200
1400
0-9 10-19 20-29 30-39 40-49 50-59 60+
Age groups (10 years)
Tota
l num
ber
of h
ospi
talis
atio
ns
and
ICU
adm
issi
ons
of
conf
irmed
cas
es
0
10
20
30
40
50
60
Num
bers
of d
eath
s of
con
firm
ed
case
s
HospICUDeaths
Notification rates for pandemic (H1N1) 2009 in a selection of affected countries
Country Population Confirmed cases Crude rate per 100000
population
Hospitalisation rate per 100000 population
Deaths Trends
Southern Hemisphere
Australia 21262641 37636 1721 228 191 Low influenza activity
New Zealand 4319932 3233 730 227 18 Low levels of ILI decreasing trend
Argentina 40482000 11234 278 337 613 Low ILI activity decreasing trend
Chile 16454143 12276 746 98 150 Low ILI activity decreasing trend
Northern Hemisphere
Canada 33212696 NA 235 44 336 Low influenza activity
UK 60943912 26110 428 NA 265 Decreasing influenza activity
Mexico 109955400 66070 601 na 671 na
USA 304059724 50768 165 103 1336 Low influenza activity
Pandemic (H1N1) 2009 Vaccine
bull
Safety profile as with seasonal flu
bull
One injection 15μg protects adults
bull
FDA licenceTGA registration
bull
Emphasis on priority groups but available to ALL
Source New England Journal of Medicine 2009 361 September 10
Clinical Trials of Pandemic (H1N1) 2009 Vaccine
Systemic Side effects
Headache
Fever
Myalgia
Malaise
Immune Response15mcg
97
30mcg 93
Source New England Journal of Medicine 2009 361 September 10
VACCINE ROLL OUT
bull
Around 76 million doses distributed (35
population)
bull
Available for this Influenza season
bull
Trivalent vaccine for seasonal influenza available
to targeted groups
Key lessons so far
1
Value of detailed planning2
Leadership and co-ordination
bull
AHPCbull
NPEC
3
Flexibility4
Medical innovation
5
Communication
NEJM on line publication ndash
Dec 2009
Current Situation ndash
2010
bull
Influenza activity low in Australia but showing some signs of increasing earlier than usualndash
lt2 respiratory tests positive for influenza
ndash
55 confirmed cases influenza per week
bull
Pandemic strain predominant in Australiandash
35 pandemic (H1N1) 2009
bull
Pandemic (H1N1) 2009 predominant in most countries
bull
Type B predominant in China (83) and Hong Kong (56)
Laboratory confirmed cases of influenza (pandemic (H1N1) 2009 and seasonal) in Australia 2010 to 26 February by week and type
0
10
20
30
40
50
60
2012010 9012010 16012010 23012010 30012010 6022010 13022010 20022010
Week of onsetnotification - start date
Num
ber o
f con
firm
ed in
fluen
za c
ases
AMexico2232009(H1N1) AH1N1 strain unknownA not subtyped AH1N1Brisbane592007AH3N2 AH3n2Brisbane102007 BUntyped AampB
Current Situation -
2010
KEY INDIVIDUALS FOR PANDEMIC RESPONSE
NIRMs Mary MurnaneMs Jenny BryantDr Gary LumMs Fay GardnerDr Bernie TowlerDr Andrew SingerDr Andrea FordeMs Kay McNieceDr Jenean Spencer
Prof Terry Nolan ATAGIDr Chris Mitchell RACGPDr Vicki Krause CDNA
NSW
Dr Kerry Chant
Dr Jeremy McAnulty
VIC
Dr John Carnie
Dr Rosemary Lester
QLD
Dr Jeanette Young
Dr Christine Selvey
TAS
Dr Chrissie Pickin
WA
Dr Tarun Weeramanthri
Dr Andy Robertson
SA
Dr Stephen Christley
ACT
Dr Charles Guest
NT
Dr Barbara Paterson
Comparison of hospitalisations ICU admissions and deaths by age group to 2 October 2009
0
200
400
600
800
1000
1200
1400
0-9 10-19 20-29 30-39 40-49 50-59 60+
Age groups (10 years)
Tota
l num
ber
of h
ospi
talis
atio
ns
and
ICU
adm
issi
ons
of
conf
irmed
cas
es
0
10
20
30
40
50
60
Num
bers
of d
eath
s of
con
firm
ed
case
s
HospICUDeaths
Notification rates for pandemic (H1N1) 2009 in a selection of affected countries
Country Population Confirmed cases Crude rate per 100000
population
Hospitalisation rate per 100000 population
Deaths Trends
Southern Hemisphere
Australia 21262641 37636 1721 228 191 Low influenza activity
New Zealand 4319932 3233 730 227 18 Low levels of ILI decreasing trend
Argentina 40482000 11234 278 337 613 Low ILI activity decreasing trend
Chile 16454143 12276 746 98 150 Low ILI activity decreasing trend
Northern Hemisphere
Canada 33212696 NA 235 44 336 Low influenza activity
UK 60943912 26110 428 NA 265 Decreasing influenza activity
Mexico 109955400 66070 601 na 671 na
USA 304059724 50768 165 103 1336 Low influenza activity
Pandemic (H1N1) 2009 Vaccine
bull
Safety profile as with seasonal flu
bull
One injection 15μg protects adults
bull
FDA licenceTGA registration
bull
Emphasis on priority groups but available to ALL
Source New England Journal of Medicine 2009 361 September 10
Clinical Trials of Pandemic (H1N1) 2009 Vaccine
Systemic Side effects
Headache
Fever
Myalgia
Malaise
Immune Response15mcg
97
30mcg 93
Source New England Journal of Medicine 2009 361 September 10
VACCINE ROLL OUT
bull
Around 76 million doses distributed (35
population)
bull
Available for this Influenza season
bull
Trivalent vaccine for seasonal influenza available
to targeted groups
Key lessons so far
1
Value of detailed planning2
Leadership and co-ordination
bull
AHPCbull
NPEC
3
Flexibility4
Medical innovation
5
Communication
NEJM on line publication ndash
Dec 2009
Current Situation ndash
2010
bull
Influenza activity low in Australia but showing some signs of increasing earlier than usualndash
lt2 respiratory tests positive for influenza
ndash
55 confirmed cases influenza per week
bull
Pandemic strain predominant in Australiandash
35 pandemic (H1N1) 2009
bull
Pandemic (H1N1) 2009 predominant in most countries
bull
Type B predominant in China (83) and Hong Kong (56)
Laboratory confirmed cases of influenza (pandemic (H1N1) 2009 and seasonal) in Australia 2010 to 26 February by week and type
0
10
20
30
40
50
60
2012010 9012010 16012010 23012010 30012010 6022010 13022010 20022010
Week of onsetnotification - start date
Num
ber o
f con
firm
ed in
fluen
za c
ases
AMexico2232009(H1N1) AH1N1 strain unknownA not subtyped AH1N1Brisbane592007AH3N2 AH3n2Brisbane102007 BUntyped AampB
Current Situation -
2010
KEY INDIVIDUALS FOR PANDEMIC RESPONSE
NIRMs Mary MurnaneMs Jenny BryantDr Gary LumMs Fay GardnerDr Bernie TowlerDr Andrew SingerDr Andrea FordeMs Kay McNieceDr Jenean Spencer
Prof Terry Nolan ATAGIDr Chris Mitchell RACGPDr Vicki Krause CDNA
NSW
Dr Kerry Chant
Dr Jeremy McAnulty
VIC
Dr John Carnie
Dr Rosemary Lester
QLD
Dr Jeanette Young
Dr Christine Selvey
TAS
Dr Chrissie Pickin
WA
Dr Tarun Weeramanthri
Dr Andy Robertson
SA
Dr Stephen Christley
ACT
Dr Charles Guest
NT
Dr Barbara Paterson
Notification rates for pandemic (H1N1) 2009 in a selection of affected countries
Country Population Confirmed cases Crude rate per 100000
population
Hospitalisation rate per 100000 population
Deaths Trends
Southern Hemisphere
Australia 21262641 37636 1721 228 191 Low influenza activity
New Zealand 4319932 3233 730 227 18 Low levels of ILI decreasing trend
Argentina 40482000 11234 278 337 613 Low ILI activity decreasing trend
Chile 16454143 12276 746 98 150 Low ILI activity decreasing trend
Northern Hemisphere
Canada 33212696 NA 235 44 336 Low influenza activity
UK 60943912 26110 428 NA 265 Decreasing influenza activity
Mexico 109955400 66070 601 na 671 na
USA 304059724 50768 165 103 1336 Low influenza activity
Pandemic (H1N1) 2009 Vaccine
bull
Safety profile as with seasonal flu
bull
One injection 15μg protects adults
bull
FDA licenceTGA registration
bull
Emphasis on priority groups but available to ALL
Source New England Journal of Medicine 2009 361 September 10
Clinical Trials of Pandemic (H1N1) 2009 Vaccine
Systemic Side effects
Headache
Fever
Myalgia
Malaise
Immune Response15mcg
97
30mcg 93
Source New England Journal of Medicine 2009 361 September 10
VACCINE ROLL OUT
bull
Around 76 million doses distributed (35
population)
bull
Available for this Influenza season
bull
Trivalent vaccine for seasonal influenza available
to targeted groups
Key lessons so far
1
Value of detailed planning2
Leadership and co-ordination
bull
AHPCbull
NPEC
3
Flexibility4
Medical innovation
5
Communication
NEJM on line publication ndash
Dec 2009
Current Situation ndash
2010
bull
Influenza activity low in Australia but showing some signs of increasing earlier than usualndash
lt2 respiratory tests positive for influenza
ndash
55 confirmed cases influenza per week
bull
Pandemic strain predominant in Australiandash
35 pandemic (H1N1) 2009
bull
Pandemic (H1N1) 2009 predominant in most countries
bull
Type B predominant in China (83) and Hong Kong (56)
Laboratory confirmed cases of influenza (pandemic (H1N1) 2009 and seasonal) in Australia 2010 to 26 February by week and type
0
10
20
30
40
50
60
2012010 9012010 16012010 23012010 30012010 6022010 13022010 20022010
Week of onsetnotification - start date
Num
ber o
f con
firm
ed in
fluen
za c
ases
AMexico2232009(H1N1) AH1N1 strain unknownA not subtyped AH1N1Brisbane592007AH3N2 AH3n2Brisbane102007 BUntyped AampB
Current Situation -
2010
KEY INDIVIDUALS FOR PANDEMIC RESPONSE
NIRMs Mary MurnaneMs Jenny BryantDr Gary LumMs Fay GardnerDr Bernie TowlerDr Andrew SingerDr Andrea FordeMs Kay McNieceDr Jenean Spencer
Prof Terry Nolan ATAGIDr Chris Mitchell RACGPDr Vicki Krause CDNA
NSW
Dr Kerry Chant
Dr Jeremy McAnulty
VIC
Dr John Carnie
Dr Rosemary Lester
QLD
Dr Jeanette Young
Dr Christine Selvey
TAS
Dr Chrissie Pickin
WA
Dr Tarun Weeramanthri
Dr Andy Robertson
SA
Dr Stephen Christley
ACT
Dr Charles Guest
NT
Dr Barbara Paterson
Pandemic (H1N1) 2009 Vaccine
bull
Safety profile as with seasonal flu
bull
One injection 15μg protects adults
bull
FDA licenceTGA registration
bull
Emphasis on priority groups but available to ALL
Source New England Journal of Medicine 2009 361 September 10
Clinical Trials of Pandemic (H1N1) 2009 Vaccine
Systemic Side effects
Headache
Fever
Myalgia
Malaise
Immune Response15mcg
97
30mcg 93
Source New England Journal of Medicine 2009 361 September 10
VACCINE ROLL OUT
bull
Around 76 million doses distributed (35
population)
bull
Available for this Influenza season
bull
Trivalent vaccine for seasonal influenza available
to targeted groups
Key lessons so far
1
Value of detailed planning2
Leadership and co-ordination
bull
AHPCbull
NPEC
3
Flexibility4
Medical innovation
5
Communication
NEJM on line publication ndash
Dec 2009
Current Situation ndash
2010
bull
Influenza activity low in Australia but showing some signs of increasing earlier than usualndash
lt2 respiratory tests positive for influenza
ndash
55 confirmed cases influenza per week
bull
Pandemic strain predominant in Australiandash
35 pandemic (H1N1) 2009
bull
Pandemic (H1N1) 2009 predominant in most countries
bull
Type B predominant in China (83) and Hong Kong (56)
Laboratory confirmed cases of influenza (pandemic (H1N1) 2009 and seasonal) in Australia 2010 to 26 February by week and type
0
10
20
30
40
50
60
2012010 9012010 16012010 23012010 30012010 6022010 13022010 20022010
Week of onsetnotification - start date
Num
ber o
f con
firm
ed in
fluen
za c
ases
AMexico2232009(H1N1) AH1N1 strain unknownA not subtyped AH1N1Brisbane592007AH3N2 AH3n2Brisbane102007 BUntyped AampB
Current Situation -
2010
KEY INDIVIDUALS FOR PANDEMIC RESPONSE
NIRMs Mary MurnaneMs Jenny BryantDr Gary LumMs Fay GardnerDr Bernie TowlerDr Andrew SingerDr Andrea FordeMs Kay McNieceDr Jenean Spencer
Prof Terry Nolan ATAGIDr Chris Mitchell RACGPDr Vicki Krause CDNA
NSW
Dr Kerry Chant
Dr Jeremy McAnulty
VIC
Dr John Carnie
Dr Rosemary Lester
QLD
Dr Jeanette Young
Dr Christine Selvey
TAS
Dr Chrissie Pickin
WA
Dr Tarun Weeramanthri
Dr Andy Robertson
SA
Dr Stephen Christley
ACT
Dr Charles Guest
NT
Dr Barbara Paterson
Clinical Trials of Pandemic (H1N1) 2009 Vaccine
Systemic Side effects
Headache
Fever
Myalgia
Malaise
Immune Response15mcg
97
30mcg 93
Source New England Journal of Medicine 2009 361 September 10
VACCINE ROLL OUT
bull
Around 76 million doses distributed (35
population)
bull
Available for this Influenza season
bull
Trivalent vaccine for seasonal influenza available
to targeted groups
Key lessons so far
1
Value of detailed planning2
Leadership and co-ordination
bull
AHPCbull
NPEC
3
Flexibility4
Medical innovation
5
Communication
NEJM on line publication ndash
Dec 2009
Current Situation ndash
2010
bull
Influenza activity low in Australia but showing some signs of increasing earlier than usualndash
lt2 respiratory tests positive for influenza
ndash
55 confirmed cases influenza per week
bull
Pandemic strain predominant in Australiandash
35 pandemic (H1N1) 2009
bull
Pandemic (H1N1) 2009 predominant in most countries
bull
Type B predominant in China (83) and Hong Kong (56)
Laboratory confirmed cases of influenza (pandemic (H1N1) 2009 and seasonal) in Australia 2010 to 26 February by week and type
0
10
20
30
40
50
60
2012010 9012010 16012010 23012010 30012010 6022010 13022010 20022010
Week of onsetnotification - start date
Num
ber o
f con
firm
ed in
fluen
za c
ases
AMexico2232009(H1N1) AH1N1 strain unknownA not subtyped AH1N1Brisbane592007AH3N2 AH3n2Brisbane102007 BUntyped AampB
Current Situation -
2010
KEY INDIVIDUALS FOR PANDEMIC RESPONSE
NIRMs Mary MurnaneMs Jenny BryantDr Gary LumMs Fay GardnerDr Bernie TowlerDr Andrew SingerDr Andrea FordeMs Kay McNieceDr Jenean Spencer
Prof Terry Nolan ATAGIDr Chris Mitchell RACGPDr Vicki Krause CDNA
NSW
Dr Kerry Chant
Dr Jeremy McAnulty
VIC
Dr John Carnie
Dr Rosemary Lester
QLD
Dr Jeanette Young
Dr Christine Selvey
TAS
Dr Chrissie Pickin
WA
Dr Tarun Weeramanthri
Dr Andy Robertson
SA
Dr Stephen Christley
ACT
Dr Charles Guest
NT
Dr Barbara Paterson
VACCINE ROLL OUT
bull
Around 76 million doses distributed (35
population)
bull
Available for this Influenza season
bull
Trivalent vaccine for seasonal influenza available
to targeted groups
Key lessons so far
1
Value of detailed planning2
Leadership and co-ordination
bull
AHPCbull
NPEC
3
Flexibility4
Medical innovation
5
Communication
NEJM on line publication ndash
Dec 2009
Current Situation ndash
2010
bull
Influenza activity low in Australia but showing some signs of increasing earlier than usualndash
lt2 respiratory tests positive for influenza
ndash
55 confirmed cases influenza per week
bull
Pandemic strain predominant in Australiandash
35 pandemic (H1N1) 2009
bull
Pandemic (H1N1) 2009 predominant in most countries
bull
Type B predominant in China (83) and Hong Kong (56)
Laboratory confirmed cases of influenza (pandemic (H1N1) 2009 and seasonal) in Australia 2010 to 26 February by week and type
0
10
20
30
40
50
60
2012010 9012010 16012010 23012010 30012010 6022010 13022010 20022010
Week of onsetnotification - start date
Num
ber o
f con
firm
ed in
fluen
za c
ases
AMexico2232009(H1N1) AH1N1 strain unknownA not subtyped AH1N1Brisbane592007AH3N2 AH3n2Brisbane102007 BUntyped AampB
Current Situation -
2010
KEY INDIVIDUALS FOR PANDEMIC RESPONSE
NIRMs Mary MurnaneMs Jenny BryantDr Gary LumMs Fay GardnerDr Bernie TowlerDr Andrew SingerDr Andrea FordeMs Kay McNieceDr Jenean Spencer
Prof Terry Nolan ATAGIDr Chris Mitchell RACGPDr Vicki Krause CDNA
NSW
Dr Kerry Chant
Dr Jeremy McAnulty
VIC
Dr John Carnie
Dr Rosemary Lester
QLD
Dr Jeanette Young
Dr Christine Selvey
TAS
Dr Chrissie Pickin
WA
Dr Tarun Weeramanthri
Dr Andy Robertson
SA
Dr Stephen Christley
ACT
Dr Charles Guest
NT
Dr Barbara Paterson
Key lessons so far
1
Value of detailed planning2
Leadership and co-ordination
bull
AHPCbull
NPEC
3
Flexibility4
Medical innovation
5
Communication
NEJM on line publication ndash
Dec 2009
Current Situation ndash
2010
bull
Influenza activity low in Australia but showing some signs of increasing earlier than usualndash
lt2 respiratory tests positive for influenza
ndash
55 confirmed cases influenza per week
bull
Pandemic strain predominant in Australiandash
35 pandemic (H1N1) 2009
bull
Pandemic (H1N1) 2009 predominant in most countries
bull
Type B predominant in China (83) and Hong Kong (56)
Laboratory confirmed cases of influenza (pandemic (H1N1) 2009 and seasonal) in Australia 2010 to 26 February by week and type
0
10
20
30
40
50
60
2012010 9012010 16012010 23012010 30012010 6022010 13022010 20022010
Week of onsetnotification - start date
Num
ber o
f con
firm
ed in
fluen
za c
ases
AMexico2232009(H1N1) AH1N1 strain unknownA not subtyped AH1N1Brisbane592007AH3N2 AH3n2Brisbane102007 BUntyped AampB
Current Situation -
2010
KEY INDIVIDUALS FOR PANDEMIC RESPONSE
NIRMs Mary MurnaneMs Jenny BryantDr Gary LumMs Fay GardnerDr Bernie TowlerDr Andrew SingerDr Andrea FordeMs Kay McNieceDr Jenean Spencer
Prof Terry Nolan ATAGIDr Chris Mitchell RACGPDr Vicki Krause CDNA
NSW
Dr Kerry Chant
Dr Jeremy McAnulty
VIC
Dr John Carnie
Dr Rosemary Lester
QLD
Dr Jeanette Young
Dr Christine Selvey
TAS
Dr Chrissie Pickin
WA
Dr Tarun Weeramanthri
Dr Andy Robertson
SA
Dr Stephen Christley
ACT
Dr Charles Guest
NT
Dr Barbara Paterson
Current Situation ndash
2010
bull
Influenza activity low in Australia but showing some signs of increasing earlier than usualndash
lt2 respiratory tests positive for influenza
ndash
55 confirmed cases influenza per week
bull
Pandemic strain predominant in Australiandash
35 pandemic (H1N1) 2009
bull
Pandemic (H1N1) 2009 predominant in most countries
bull
Type B predominant in China (83) and Hong Kong (56)
Laboratory confirmed cases of influenza (pandemic (H1N1) 2009 and seasonal) in Australia 2010 to 26 February by week and type
0
10
20
30
40
50
60
2012010 9012010 16012010 23012010 30012010 6022010 13022010 20022010
Week of onsetnotification - start date
Num
ber o
f con
firm
ed in
fluen
za c
ases
AMexico2232009(H1N1) AH1N1 strain unknownA not subtyped AH1N1Brisbane592007AH3N2 AH3n2Brisbane102007 BUntyped AampB
Current Situation -
2010
KEY INDIVIDUALS FOR PANDEMIC RESPONSE
NIRMs Mary MurnaneMs Jenny BryantDr Gary LumMs Fay GardnerDr Bernie TowlerDr Andrew SingerDr Andrea FordeMs Kay McNieceDr Jenean Spencer
Prof Terry Nolan ATAGIDr Chris Mitchell RACGPDr Vicki Krause CDNA
NSW
Dr Kerry Chant
Dr Jeremy McAnulty
VIC
Dr John Carnie
Dr Rosemary Lester
QLD
Dr Jeanette Young
Dr Christine Selvey
TAS
Dr Chrissie Pickin
WA
Dr Tarun Weeramanthri
Dr Andy Robertson
SA
Dr Stephen Christley
ACT
Dr Charles Guest
NT
Dr Barbara Paterson
Laboratory confirmed cases of influenza (pandemic (H1N1) 2009 and seasonal) in Australia 2010 to 26 February by week and type
0
10
20
30
40
50
60
2012010 9012010 16012010 23012010 30012010 6022010 13022010 20022010
Week of onsetnotification - start date
Num
ber o
f con
firm
ed in
fluen
za c
ases
AMexico2232009(H1N1) AH1N1 strain unknownA not subtyped AH1N1Brisbane592007AH3N2 AH3n2Brisbane102007 BUntyped AampB
Current Situation -
2010
KEY INDIVIDUALS FOR PANDEMIC RESPONSE
NIRMs Mary MurnaneMs Jenny BryantDr Gary LumMs Fay GardnerDr Bernie TowlerDr Andrew SingerDr Andrea FordeMs Kay McNieceDr Jenean Spencer
Prof Terry Nolan ATAGIDr Chris Mitchell RACGPDr Vicki Krause CDNA
NSW
Dr Kerry Chant
Dr Jeremy McAnulty
VIC
Dr John Carnie
Dr Rosemary Lester
QLD
Dr Jeanette Young
Dr Christine Selvey
TAS
Dr Chrissie Pickin
WA
Dr Tarun Weeramanthri
Dr Andy Robertson
SA
Dr Stephen Christley
ACT
Dr Charles Guest
NT
Dr Barbara Paterson
KEY INDIVIDUALS FOR PANDEMIC RESPONSE
NIRMs Mary MurnaneMs Jenny BryantDr Gary LumMs Fay GardnerDr Bernie TowlerDr Andrew SingerDr Andrea FordeMs Kay McNieceDr Jenean Spencer
Prof Terry Nolan ATAGIDr Chris Mitchell RACGPDr Vicki Krause CDNA
NSW
Dr Kerry Chant
Dr Jeremy McAnulty
VIC
Dr John Carnie
Dr Rosemary Lester
QLD
Dr Jeanette Young
Dr Christine Selvey
TAS
Dr Chrissie Pickin
WA
Dr Tarun Weeramanthri
Dr Andy Robertson
SA
Dr Stephen Christley
ACT
Dr Charles Guest
NT
Dr Barbara Paterson
