Be well. Practice big medicine.

1105 Slight rise in the number of people seeing GP with ILI [New Zealand]--During the week ending 30 October there was a slight rise in the number of New Zealanders seeing their doctor in relation to influenza-like illnesses (ILI). Most people were seeking advice for sick babies and children aged under four. As at midday today there is one person in intensive care with confirmed H1N1 pandemic influenza.

The total number of deaths attributed to swine flu remains at 19. Please note that this number is likely to change as Coroners complete investigations into a number of influenza-related deaths that have occurred over the last few months.

The Ministry of Health is closely monitoring the situation and remains vigilant in case a second wave of pandemic influenza starts to spread in New Zealand.

The international picture

Pandemic influenza cases are continuing to increase in many northern hemisphere countries. In America, the CDC (Centres for Disease Control and Prevention) have reported steep increases in all indicators of influenza activity. Visits to doctors, hospitalisations, and deaths due to influenza or pneumonia are all higher than expected for this time of year. The number of people seeking medical advice is now at a rate higher than during a regular flu season.

The World Health Organization's (WHO) latest update states that Mexico has reported more confirmed cases of pandemic influenza since September, than during the springtime epidemic. In Europe, high rates of influenza illness have been observed in Iceland, Ireland, the UK, Belgium, the Netherlands and Ukraine. Many other countries in Europe and Western and Central Asia are showing evidence of early influenza transmission including Spain, Austria, parts of Northern Europe, Russia and Turkey. In Japan, influenza activity has increased sharply - this is around ten weeks ahead of the usual winter influenza season.

There is little influenza activity being reported in temperate regions of the southern hemisphere (which includes New Zealand and Australia)

Vaccine update - seasonal influenza vaccination to be free for more people at risk of developing complications

Next year's seasonal influenza vaccine will contain the pandemic (swine flu) strain and be free to extra groups who are at particular risk from swine flu. Health Minister Tony Ryall announced yesterday that free vaccines will be available next year to people over 65, but also to pregnant women, people who are morbidly obese and children aged six months to four years who are enrolled in particular high deprivation General Practices.

Seasonal flu immunisation is already free (paid for by the Government) for all people over 65 and to those aged 6 months to 64 years with certain pre-existing health conditions. Those conditions include people with chronic respiratory disease and diabetes, who were particularly susceptible to more severe outcomes from swine flu.

Remain alert to signs and symptoms and ways to reduce spread

People should still remain vigilant to the signs and symptoms of the disease and seek medical advice if the person who is sick is pregnant or obese, or has underlying medical conditions such as respiratory disease, heart disease, liver disease, blood disorders, is immuno-suppressed or has a neurological condition.

If someone has flu-like symptoms and their condition worsens, you should phone for medical advice straight away. Healthline provides free advice 24 hours a day, seven days a week. Healthline 0800 611 116.

We should all continue to follow the same tried and true public health advice- regularly wash and dry hands, stay home if sick with flu symptoms, and cover your coughs and sneezes.

Study to test pandemic influenza immunity

A study investigating the level of immunity New Zealanders have to pandemic influenza (H1N1) will get underway this month. Blood samples will be taken from 2500 people to see how many have been exposed to pandemic influenza and developed immunity to it. This information will be used to establish how many people are still at risk of contracting the illness.

The study is being undertaken by Environmental Science and Research (ESR) on behalf of the Ministry of Health. The results of the survey will be useful for the Ministry of Health so it can plan for a possible second wave.

A two week pilot study is expected to begin within the next few days at a single practice in the Hutt Valley. It will be followed by a nationwide study that will run from later in November until March next year. People randomly selected from participating general practices throughout the country will be asked to take part. The final report is expected in May.

Healthline Calls

The number of ILI calls to HealthLine over the past week remains stable, but overall levels are still above those at the same time last year. Over the past week, around 16% of all calls to HealthLine were ILI-related calls.

1105 Health warning continues on semi-dried tomatoes - Another 23 Hep C cases in the past week [Melbourne, VIC]--Health authorities in Victoria have renewed their advice that people buying loose semi-dried tomatoes should not eat them unless they are thoroughly cooked.

The advice follows the notification of a further 23 Victorians diagnosed with hepatitis A in the past week and the completion today of the preliminary analysis of a case control study into a recent increase of cases.

Victoria’s Chief Health Officer Dr John Carnie said that so far this year there had been 200 notifications of hepatitis A. This compares with 74 cases to the same time last year.

“The food history evidence indicates that over two thirds of the latest cases recall eating semi-dried tomatoes,” Dr Carnie said.

“And the preliminary results of the case control study of 50 of the notified cases reported to us over the past few months supports this strong association between illness and consumption of semi-dried tomatoes.

“Because the incubation period for hepatitis A could be as long as two months, trying to get people who fell ill to accurately pin down what and where they actually ate this product can be difficult.

“We still are unclear as to why there has been a recent spike in cases in Victoria. However, we are continuing to work with the manufacturers and suppliers of semi-dried tomatoes to try and identify the source.

“The department has been given an undertaking by all local producers that they have instituted steps to reduce the risk from hepatitis A virus in their products.

“We have also been in contact with importers of these products to ensure that they have appropriate quality control measures in place to minimise transmission of the virus,” Dr Carnie said.

Semi-dried tomatoes are widely available in supermarkets, independent delis and cafes throughout Victoria. They are also used by restaurants and cafes in many foods, including salads and sandwiches.

“The outbreak seems to be confined mainly to Victoria which appears to rule out produce sold through major supermarket chains which is distributed nationwide.

“Bottled semi-dried tomatoes available at supermarkets are pasteurised and have not been implicated in this outbreak,” Dr Carnie said.

“People who may have semi-dried tomatoes at home and are unsure of where they were bought should not eat them unless they are thoroughly cooked - such as in pizza and quiche. Restaurants and cafes should also follow this advice.”

Hepatitis A is spread when traces of faecal matter containing the virus contaminates hands, objects, water or food and is then taken in by mouth.

Symptoms of hepatitis A include abdominal pain, nausea, fever and chills and jaundice. Anyone experiencing these symptoms should contact their GP or Nurse On Call on 1300 60 60 24.

1105 Free vaccine extended to swine flu at risk groups [New Zealand]--Next winter's seasonal influenza vaccine will contain the pandemic (swine flu) strain and be free to extra groups who are at particular risk from swine flu.

Health Minister Tony Ryall says free vaccines will be available from next March to people over 65, but also to pregnant women, people who are morbidly obese and children aged six months to four years who are enrolled in particular high deprivation General Practices.

Seasonal flu immunisation is already free (paid for by the Government) for all people over 65 and to those aged 6 months to 64 years with certain pre-existing health conditions.

Those conditions include people with chronic respiratory disease and diabetes, who were particularly susceptible to more severe outcomes from swine flu.

The annual flu immunisation programme usually runs from March to June. Vaccination is by choice.

People who want the vaccine will be able to get it by going to their General Practice or health provider, although some will have to pay for it. Some employers pay for flu immunisations for their staff.

The World Health Organisation has recommended next year's seasonal flu vaccine includes the three main flu strains currently circulating.

"It is most likely we will have an upsurge in swine flu cases next Autumn." says Mr Ryall. "The northern hemisphere is currently experiencing extraordinary levels of influenza, ahead of its normal influenza season, so it is possible that another wave will occur in New Zealand before next winter."

Mr Ryall says if the pandemic becomes more severe before the seasonal flu vaccine becomes available, the Government has a contingency plan to immunise front-line workers who would be most at risk or who provide critical emergency services. Emergency pandemic immunisation would only be offered once the vaccine has been approved for use in New Zealand.

The extension in subsidised vaccination will cost around $2 million on top of the usual cost of $14 million per year.

Background:

In 2010, the Government will subsidise flu immunisations for:

* People aged 65 years or over
* People aged 6 months to 64 years with the following conditions:

o Cardiovascular disease - ischaemic heart disease, congestive heart disease, rheumatic heart disease, congenital heart disease, cerebrovascular disease.
o Chronic respiratory disease - asthma (if on regular preventive therapy), and other chronic respiratory disease with impaired lung function.
o Diabetes.
o Chronic renal disease.
o Cancer (patient currently has cancer), excluding basal and squamous skin cancer if not invasive.
o Other conditions - autoimmune disease, immune suppression, human immunodeficiency virus (HIV), transplant recipients, neuromuscular and central nervous system diseases, haemoglobinopathies and children on long term aspirin.
o Pregnant women
o People with morbid obesity
o Children 6 months to 4 years old who are enrolled in Access Primary Health Practices

Influenza vaccines have been used widely for many years now and their safety is well-known. Like any medicine side effects do occur. Most are minor and temporary such as pain at the injection site, general discomfort, headache, or a raised temperature. In rare cases they can cause more serious adverse reactions (approximately 1 to 10 per million doses administered).

Influenza vaccines typically provide protection from the types of influenza they target for at least six months to around 70% of people who receive them.

1105 Chief Health Officer encourages Pandemic (H1N1) 2009 influenza vaccination [Sydney NSW]--NSW Chief Health Officer Dr Kerry Chant today made a renewed call for people to obtain the Pandemic (H1N1) 2009 influenza vaccination as NSW distributed its 1.5 millionth dose of the vaccine.

Dr Chant particularly encouraged people who are heading overseas or receiving guests from other countries during the forthcoming holiday season, in addition to at-risk groups, to take the free shot. The Northern Hemisphere is entering winter and reports indicate that H1N1 pandemic activity is high in many countries.

Across NSW, approximately 30,000 doses of the vaccine are being distributed every day, with the state today receiving its 1.5 millionth dose from Australian biopharmaceutical company CSL.

Dr Chant said: "With the holidays approaching, many people will be travelling abroad or having overseas guests. It is important to think about getting vaccinated now to protect yourself and your family.

"It does take time for the vaccine to work so it is best not to leave it to the last minute."

Dr Chant said it was particularly important that pregnant women, who are susceptible to the illness, get immunised.

"Pregnant women remain at risk and are strongly encouraged to get the vaccine as there is no vaccine for children less than six months old. Women in this category can help protect their baby by being vaccinated and also by encouraging people who will be helping to care for their baby to be vaccinated," Dr Chant said.

"Some of the vaccines available overseas are not recommended for pregnant women, however the vaccine in Australia has been recommended by the Australian Technical Advisory Group on Immunisation.

"The vaccine is the best defence against pandemic flu," she added.

"We are still seeing a few cases of pandemic flu in the community."

Dr Chant reminded pregnant women as well as Aboriginal people and anyone with underlying chronic medical conditions such as diabetes, lung, heart and kidney disease, who have symptoms of the flu to consult their doctor immediately.

Those considered more vulnerable to the pandemic include:
o People with underlying chronic medical conditions, ie. heart and lung disease, cancers, HIV, asthma, diabetes;
o People who are morbidly obese;
o Indigenous people;
o Pregnant women

1105 Historic agreement for Trauma Response Centre and Princess Alexandra Hospital in Brisbane [Darwin NT]--The National Critical Care and Trauma Response Centre (NCCTRC) and Royal Darwin Hospital's ability to respond to disasters has been boosted with the signing of an agreement with Princess Alexandra Hospital in Brisbane.

Minister for Health Kon Vatskalis helped launch the Agreement in Brisbane today, made possible through Federal Government funding. The Commonwealth Government has committed $120 million until 2013 to maintain and enhance disaster response preparedness.

The agreement will provide $3.2 million over four years to the National Critical Care and Trauma Response Centre and Royal Darwin Hospital and offer education and training opportunities for medical and nursing staff.

“RDH is recognised nationally for its disaster response preparedness as well as having the capacity to treat victims with critical injuries and to rapidly deploy trained staff to disaster sites,” Mr Vatskalis said.

“The National Critical Care and Trauma Response Centre and Princess Alexandra Hospital in Brisbane will work collaboratively in the event that RDH is required to respond to a national incident.”

Mr Vatskalis said the agreement will provide the National Critical Care and Trauma Response Centre and Royal Darwin Hospital with improved disaster response and emergency management plans.

“Queensland has a strong history of providing assistance to the Territory in times of need,” Mr Vatskalis said.

“This new formal agreement will allow RDH to supplement its medical response capacity through access to a pool of medical staff, as well providing RDH staff with opportunities to enhance their skills and education.”

The National Critical Care and Trauma Response Centre, now headed by Executive Director Dr Len Notaras, was established 2005.

It has responded to disaster emergencies many times and most recently the National Critical Care and Trauma Response Centre medical team, headed by Royal Darwin Hospital's Dr Ian Norton, led the field team in the retrieval of the most urgent and critical cases following the boat blast off Ashmore Reef.

The Centre has also developed a trauma nursing service and burns nursing service, upgrade of burns facilities and spent $15 million on equipment and critical infrastructure.

1105 Road safety campaign targets residential streets [Canberra ACT]--A new road safety campaign which uses TV, radio and print advertising to encourage drivers to slow down in Canberra's residential streets was launched today by Chief Minister and Minister for Transport Jon Stanhope.

Mr Stanhope said the ACT Government campaign was locally produced and would run until late December 2009.

"Speeding through residential areas is highly dangerous," Mr Stanhope said. "Drivers travelling at 60 km/h take at least 10 metres longer to stop than those travelling at 50 km/h.

"The Government's new road safety campaign aims to remind Canberrans to slow down in residential streets and to obey the 50 km/h default speed limit.

"Drivers should not to exceed 50km/h unless a higher speed limit is signposted and should be on the look-out for lower speed limits around schools.

"By promoting safe driving through residential streets we hope to reduce crashes, save lives and help to make our suburbs more liveable," Mr Stanhope said.

The road safety campaign is part of a suite of ACT Government initiatives aimed at reducing road fatalities, including variable message boards, tougher child restraint laws to be introduced next year, a stronger police presence and infrastructure improvements to ACT roads.

The Government has also convened two road safety roundtables in partnership with NRMA Motoring and Servicesto consider whether the ACT could adopt a "Vision Zero" approach to road safety. Further community consultation on the policy will be held in the coming months.

Further Government advertising covering the dangers of speeding, drink driving and driver distraction is planned for 2010.

To find out more visit http://www.tams.act.gov.au/move/roads/road_safety

1105 Mandatory car restraints to protect children [Canberra ACT]--The ACT Government will introduce mandatory car restraints for children up to the age of seven as part of its commitment to new national road safety guidelines.

Under the guidelines, babies up to six months must be secured in a rear-facing capsule, children between six months and four years must travel in a child restraint with an inbuilt harness, and children aged between four and seven must use a child restraint with an in-built harness or abooster seat.

Currently, only children up to 12 months must be restrained in an approved child seat in the ACT.

Mr Stanhope said the laws would provide greater protection for children in cars.

"The ACT Government has signed on to nationally-agreed rules on mandatory child restraints in cars," Mr Stanhope said. "From early 2010, ACT drivers will be encouraged to ensure all children under seven are secured in a capsule, child restraint or a booster seat depending on their age.

"The new laws will become mandatory after a 12 month phase-in period. The phase-in will give drivers enough time to purchase the restraints. The Government is working with Kidsafe to prepare a guide to help drivers choose the correct restraint based on their child's age and size.

"Properly fitted restraints can improve a child's chance of surviving a serious crash.

"Details of the phase-in period and appropriate child restraints will be released later this year."

Mr Stanhope said failure to comply with the new laws after the phase-in period would attract a similar penalty to other seatbelt offences.

The ACT will introduce all nationally-agreed reforms to the Australian Road Rules, which were determined by a national advisory group and representatives from all states and territories.

The reforms also restrict children from sitting in the front seat of a car where rear seating is available.

"While this pandemic influenza is mild in most cases, it has been severe in some people and has caused a number of deaths in Australia," Ms Gallagher said.

Ms Gallagher said the Panvax® H1N1 vaccine was available free to all Australians and would help protect against future waves of the virus. The Minister set an example by receiving her H1N1 influenza vaccination today.

"Now that the priority groups have had sufficient time to obtain the vaccine, it's time for all Canberrans to take action to protect themselves from H1N1 disease," she said. "The vaccine has been registered by the Therapeutic Goods Administration and is readily available through your GP or specific Community Clinics.

"Some workplaces are being proactive and organising vaccination through corporate medical services and hospital occupational medical units are providing the vaccine to their staff."

Ms Gallagher said she would also like to encourage anyone in the priority groups who had not yet been vaccinated to discuss vaccination with their GP. These groups include pregnant women, people with chronic medical conditions, individuals with obesity, health care workers, Aboriginal and Torres Strait Islander People, children over 10 year old attending special schools and parents or guardians of children aged less than six months.

"These people are the most likely to become seriously ill if infected, or to infect those who may become very ill," she said. "I urge everyone to obtain their free vaccine soon. This strain is the common circulating flu virus this year and the vaccine will help stop the spread within the community."

Ms Gallagher said that while at the moment the vaccine was only available to those aged 10 and over, the Government was currently waiting on the completion of clinical trials in the under 10s before recommending vaccination for this age group.

The incidence of H1N1 has slowed since the end of the traditional influenza season with over 940 confirmed cases and 2 associated deaths in the ACT since May 2009. ACT Health continues to monitor the incidence of this disease in the community.

To make an appointment at a Community Health clinic phone 6207 9977. For more information visit http://www.health.act.gov.au/

1101 53-year-old male fatal meningococcal case [Adelaide, South Australia]--A 53 year-old male from metropolitan Adelaide was admitted to hospital today in a critical condition with invasive meningococcal disease and has died.

The Department of Health has identified more than thirty contacts.

Of these, three people have been directed to receive medical assessment and antibiotic chemoprophylaxis.

Meningococcal health information is being distributed to all contacts in accordance with the Guidelines for the Early Clinical and Public Health Management for Meningococcal Disease in Australia.

This is the 22nd case of invasive meningococcal disease reported in South Australia during 2009, and compares to 16 cases recorded at the same time last year; 19 cases were reported in 2008.

Ms Singh congratulated Ms Taylor on her tireless dedication towards improving safety on farms in Tasmania.

“Anne Taylor received the Award for developing and being the driving force behind the formation of Proactive Agricultural Safety and Support,” Ms Singh said. “PASS is a voluntary, grass roots organisation that provides resources and support to the agricultural community of Tasmania.

“As direct result of the number of fatalities on farms in northern Tasmania, Anne Taylor decided to form PASS to raise the profile of farm safety and provide safety information and support to farmers.

“The voluntary efforts of Anne in being the major contributor and motivator of PASS have made an outstanding contribution towards raising the profile of safety management in the Tasmanian rural industry.”

Ms Singh said all of the award winners demonstrated the wide variety of organisations making safety a priority in their workplaces.

“Winners come from businesses and voluntary organisations around the State, indicating that safe business equals good business in the 21st century,” she said.

“Collaboration and consultation between employers and workers were strong elements of all the successful entries in the Awards.”

There were seven categories in this year’s Awards, including four that feed into the national Safe Work Australia Awards.

The presentation of the WorkCover Safety Awards, now in their 14th year, are the finale of Safe Work Tasmania Week and are a positive opportunity to recognise Tasmanian businesses that have made workplace health and safety a priority.

1101 Volunteers prepare to rescue Wellington [New Zealand]--Who said civil defence was boring? Come along to the waterfront next Saturday (7 November) at 1.20pm to watch volunteer firefighters practise for a civil emergency in Wellington. They will rappel out of an airborne helicopter while volunteer rescuers simulate a second-storey rescue.

It's all part of Exercise Phoenix, organised by Wellington City Council's Emergency Management Office, testing how well our volunteer civil defence network would cope with a large-scale disaster like an earthquake or flood.

The Council's Emergency Preparedness Manager, Fred Mecoy, says about 80 of the city's civil defence volunteers will be involved in the exercise.

"We have a number of volunteer civil defence centres set up in suburbs around Wellington and eight of these centres will be involved in the exercise. It's a great way to see what's working well for us and where we can improve before we need to respond to a real emergency."

The Council's Social Portfolio Leader, Councillor Ngaire Best, says in the event of an emergency, these volunteers will be the eyes and ears of the community, informing the Council's Emergency Management Office of the local situation and passing critical information back to the community.

"Volunteers are a vital part of our emergency response - and we're always looking for more. If you're over 16 and want to make a difference in your community, we'd love to hear from you."

The civil defence volunteer exercise will run in the morning and the Mayor will speak to the volunteers over lunch. The volunteer firefighters' helicopter exercise will run from 1.20pm to 2.00pm on the lawn adjacent to the City to Sea Bridge on the waterfront (in front of St John's Bar and behind the rowing club) and Jack Illot Green. The public and media are invited to attend. Council staff will be on hand to talk to anyone interested in volunteering to work in civil defence, rural fire fighting or rescue.

Exercise Phoenix is a regional emergency preparedness exercise but only Wellington City Council volunteers are involved in this part of the exercise.

1101 New parents to receive free whooping cough vax [Victoria, Australia]--New parents will continue to be provided with free pertussis vaccine until the end of the year under Brumby Labor Government moves to curb an increase in cases of whooping cough.

Health Minister Daniel Andrews said Victoria was experiencing a continued increase in pertussis or whooping cough notifications in recent months, which is part of a nationwide outbreak.

“The Brumby Labor Government is offering the vaccine to parents for free as soon as possible after the birth of their child,” Mr Andrews said. “This is a strategy recommended by immunisation experts as the best way to offer protection to very young babies.

“It is anticipated 42,000 new Victorian parents will have received the free vaccines between June and the end of the year, when the impact of pertussis cases will be evaluated.

“Vaccinations will continue to be made available through maternity hospitals and general practitioners.

“Local government and maternal and child health nurses have also been informed of the extension so that they can bring it to the attention of their new parent clients.”

Mr Andrews said babies were at risk from pertussis because no protection was passed from the mother to the newborn infant.

“Infants do not develop sufficient pertussis protection until the three dose course of pertussis containing vaccine is completed,” he said. “Pertussis is most serious in babies less than six months of age and around one in every 200 infants aged under six months who catches pertussis will die.”

There were 2,818 confirmed cases of pertussis in Victoria up until October 23 this year. To the same period last year there were 1,129 notified cases. In 2008, 1,647 cases were notified, compared to 1,053 in 2007.

Victoria’s Chief Health officer, Dr John Carnie, said all immunisation providers are encouraged to remind parents of the importance of timely vaccination for their children.

“Increased notifications of whooping cough have been reported across the country,” Dr Carnie said. “Whooping cough is often a distressing illness causing bouts of coughing lasting a few months. It is a highly-contagious disease spread by droplets from coughing and sneezing. Initial symptoms can be similar to the common cold, but it progresses to a severe cough.

“In children a whooping sound may be made at the end of a bout of coughing,” Dr Carnie said.

1101 Next year's seasonal flu vax will contain pandemic flu strain [New Zealand]--The international picture: Pandemic influenza cases are increasing in many northern hemisphere countries. According to the World Health Organization's (WHO) latest update USA is reporting high rates of pandemic H1N1 and influenza-like illness (ILI).

Canada too reports increased ILI rates for the fourth week in a row, and Mexico reports influenza in some areas. Influenza activity is low but showing a small increase in Europe and Northern Asia.

Pandemic influenza (H1N1) 2009 is decreasing in New Zealand, however, it is still circulating and people with influenza-like illness are being treated by their GPs. The tried and true protections are covering coughs and sneezes, washing and drying hands regularly, and staying home while unwell.

With influenza cases increasing in the northern hemisphere, and with international travel we expect that we may see further clusters of cases here over the coming months. While a significant upsurge in cases may occur at any time, autumn next year seems the most likely time. The Ministry of Health continues to monitor the situation and remains vigilant in case of a second wave of pandemic influenza.

Vaccine update

Next year's seasonal influenza vaccine will contain the pandemic influenza strain and will be available in New Zealand in autumn. Immunisation from pandemic influenza will be available as part of the seasonal influenza programme. For some people it will be free of charge - the Government subsidises seasonal influenza immunisation for people aged 65 years or over and people aged 6 months to 64 years with a range of chronic conditions.

The numbers

The total number of deaths attributed to swine flu remains at 19. Please note that this number is likely to change as Coroners complete investigations into a number of influenza-related deaths that have occurred over the last few months.

As at midday today there was noone in hospital with confirmed pandemic influenza (H1N1) 2009 or its complications. This is the second consecutive week with no one in hospital.

Remain alert to signs and symptoms and ways to reduce spread

People should still remain vigilant to the signs and symptoms of the disease and seek medical advice if the person who is sick is pregnant or obese, or has underlying medical conditions such as respiratory disease, heart disease, liver disease, blood disorders, is immuno-suppressed or has a neurological condition.

If someone has flu-like symptoms and their condition worsens, you should phone for medical advice straight away. Healthline provides free advice 24 hours a day, seven days a week. Healthline 0800 611 116.

We should all continue to follow the same tried and true public health advice- regularly wash and dry hands, stay home if sick with flu symptoms, and cover your coughs and sneezes.

Healthline Calls

The number of ILI calls to HealthLine over the past week remains stable, but overall levels are still a little above those at the same time last year. Over the past week, around 17% of all calls to HealthLine were ILI-related calls.

1024 Hep C update: None of those screened have contracted the disease [Adelaide SA]--SA Health says the precautionary screening of patients who came into contact with a health care worker with Hepatitis C have shown none of those tested have contracted the disease.

Chief Medical Officer Professor Paddy Phillips says thirty patients from the Royal Adelaide Hospital were identified as having been in close enough contact to warrant screening.

“The risk of any transmission from a health care worker to a patient is extremely low and we’re pleased to say none of the patients who were tested have contracted Hepatitis C.”

Of the thirty people, there were 24 who agreed to be tested and they have been contacted and informed of their negative results.

Two people declined testing altogether, two people from remote Australia will get tested at a convenient time in the future. Two other people have died from completely unrelated illnesses.

“I would like to thank the health care worker for coming forward so soon after diagnosis, which meant our infection control procedures got underway very quickly,” Professor Phillips said.

The health care worker became aware of the positive test result on 18 September and notified hospital management immediately.

SA Health’s experts in the Communicable Disease Control Branch and at the hospital used national and international guidelines to determine which thirty patients at the RAH should have been offered precautionary screening and counselling.

Hepatitis C affects around one percent of South Australians, with around 16,000 cases recorded in SA since 1995.

1024 Health Update: New Zealand health response in Samoa winds down [NZ]--New Zealand's emergency medical response to help tsunami victims in Samoa is winding down.

Health Minister Tony Ryall says he is advised there have been no new tsunami related medical cases seen in Apia hospital in the past two weeks and care is now largely being handed over to Samoan health services and aid agencies.

A small kiwi presence of a GP, two wound care nurses and a small number of trauma counsellors will stay on in Samoa until next week.

"At the peak New Zealand had more than 30 health professionals in Samoa providing wound care, infection control, routine surgical follow-ups, with some counselling for trauma and grief" says Mr Ryall.

"I would like to thank New Zealand health services and individual kiwis for the prompt and generous way they have stepped up to help our neighbours in Samoa.".

The Health Minister says 815 Kiwi health professionals had volunteered to go to Samoa to help tsunami victims.

New Zealand's health services will continue to support ongoing tsunami related aid by providing visiting specialists. In the next few weeks and months this will include respiratory physicians - to assist with the after effects of wet lung (from breathing in seawater); microbiologists to assist with sampling and testing services; and psychiatric professionals to assist with grief counselling services.

Routine care will now be provided by local medical professionals with ongoing support from visiting NZ medical personnel under existing aid programmes.

This will be facilitated by the Government's aid agency NZAID and its Australian counterpart AusAid, as the recovery phase of the health response continues in Samoa. Through NZAID, the New Zealand Government is providing significant long term support to improve the provision of healthcare in Samoa. Additional needs arising from the tsunami will be integrated into this ongoing assistance from NZAID and other donors.

Most medical equipment and supplies brought to Samoa during the emergency response have been donated by the Government and companies in New Zealand and will remain in Samoa to assist with medical care.

1024 Morning round up and latest fire activity as at 9am [Queensland]--Fire weather warning: The Queensland Fire and Rescue Service is urging people to remain vigilant with the Bureau of Meteorology issuing a fire weather warning for the Northern Goldfields and Upper Flinders district.

Around 5am the Bureau of Meteorology predicted severe grassland fire danger 50-74, temperatures up to 36 degrees, relative humidity down to 10% and winds to 35
km/h for these districts.

The Queensland Fire and Rescue Service, Rural Operations Branch advises that fires will be uncontrollable and fast-moving.

Find information on potential fire behaviour and impact at http://www.ruralfire.qld.gov.au.

Seek advice and monitor fire and weather situations on radio and through http://www.ruralfire.qld.gov.au and http://www.bom.gov.au, or phone 1800-020-440.

Fire bans
Fire bans will remain in place for the following Local Government areas: Richmond; North Burnett; Sunshine Coast; Fraser Coast; South Burnett; Gympie; Cherbourg; Bundaberg; Somerset; Lockyer Valley; Ipswich City; Scenic Rim; Logan City; Gold Coast; Brisbane City; Redland City; Moreton Bay; Toowoomba; Western Downs; Southern Downs; Paroo; Balonne; Goondiwindi; Maranoa; Murweh; Palm Island; Banana; Gladstone; Rockhampton; Central Highlands; Woorabinda; Isaac; Mackay; Hinchinbrook; Townsville; Whitsunday; Charters Towers; Flinders; Richmond; and Burdekin. Fire bans have been extended until midnight Monday, 26 October and may be extended again if dangerous fire conditions continue across the State.

The Rural Fire Service has put a ban on the lighting of all fires in these areas, including permit fires as a precaution with high, and at times extreme, conditions expected to continue. The following exemptions apply under fire ban conditions:
• The use of gas and electric barbecues are permitted provided they are not left unattended. The use of wood fire barbecues is prohibited;
• Fires for the purpose of disposal of animal carcasses are permitted, subject to the issue of a Permit to Light Fire by the local Fire Warden;
• Fires of commercial necessity are permitted subject to the issue of a Permit to Light Fire by the Area Director Rural Operations;
• Fires for the purpose of burning standing sugar cane for harvest in accordance with the established practice of the industry; and
• Fires for the purpose of burning sugar cane tops and trash on cane production land between the hours of 1800 (6.00 pm) and 0900 (9.00 am).

Regular updated information will be provided on the QFRS Rural Operations website at www.ruralfire.qld.gov.au or at www.fire.qld.gov.au or by listening to your local radio station.

Mt Archer

Fire crews continue to monitor a fire burning near Norman Gardens in the Mt Archer area. The fire is contained and continues to burn within containment lines. Crews will remain on scene today to monitor the perimeter of the fire and attend to hot spots. There is no threat to structures.

Kalpowar Road, Gaeta

Multiple fire crews remain on scene at a fire burning off Kalpowar Road, Gaeta. Fire crews will continue blackening out within the area and strengthening containment lines throughout the day. There are approximately 100 emergency services personnel at the scene including urban and rural fire crews, Queensland Ambulance Service personnel and State Emergency Services volunteers. Emergency services personnel from New South Wales also continue to assist Queensland crews on the fire ground. This fire is currently burning within containment lines. There is no threat to property.

Townsville – two car crash

Emergency crews responded after two cars collided on the corner of Ingham Road and Mather Street, Mt Louisa around 5.45am. Fire crews freed one patient trapped within the wreckage. The patient was transported to Townsville Hospital with a suspected leg fracture.

Mt Isa – single vehicle rollover

Two patients were airlifted to Townsville Hospital after their motor vehicle rolled on the Barkly Highway between Mt Isa and Camooweal just before midnight. Paramedics treated one patient at the scene for head injuries and the other for chest injuries. Another patient was transported by road to Mt Isa Hospital for a suspected back injury.

Ayr – house fire

A house on Elizabeth Street, Ayr was completely destroyed after a fire broke out around 4.50am. Three fire crews arrived to find the home well involved. A 14-year-old boy was treated at the scene by paramedics for burns to his hands and was transported to Ayr Hospital. It is believed all occupants had evacuated the home before crews arrived. Fire Investigators will attend the scene today.

1024 H1N1-related death of 35-year-old woman with underlying medical conditions [Waikato NZ]--The total number of deaths attributed to swine flu is now 19 following investigation of the death of a 35 year old woman who died in Waikato on 21 September – she had underlying medical conditions. Please note that this number is likely to change as the Coroner completes investigations into a number of influenza-related deaths that have occurred over the last few months.

The virus is still circulating in New Zealand, although the recorded rate of Pandemic Influenza infection has declined.

As at midday today there is no one in hospital with confirmed pandemic influenza (H1N1) 2009 or its complications. There was one person at this time last week.

The cumulative total of people in New Zealand who have returned a positive laboratory test for pandemic influenza (H1N1) 2009 is 3175, no change from last week.

Isolated outbreak in Christchurch serves as timely reminder

Last weekend, some students among a group visiting from Japan developed influenza. Four students tested positive for pandemic influenza H1N1, and a number of others had influenza like symptoms. It appears that their illness originated in Japan where they are experiencing higher than seasonal rates of influenza, predominantly pandemic H1N1. Following treatment the group were all declared safe to travel and left New Zealand yesterday.

Levels of influenza activity are increasing in the northern hemisphere, and with international travel it is likely that we will see further clusters of cases here over the coming months.

Remain alert to signs and symptoms and ways to reduce spread

While Pandemic Influenza case numbers are decreasing, people should still remain vigilant to the signs and symptoms of the disease and seek medical advice if the person who is sick is pregnant or obese or has underlying medical conditions such as respiratory disease, heart disease, liver disease, blood disorders, is immuno-suppressed or has a neurological condition.

If someone has flu-like symptoms and their condition worsens, you should seek medical advice straight away. Healthline provides free advice 24 hours a day, seven days a week. Healthline 0800 611 116.

We should all continue to follow the same basic public health advice- regularly wash and dry hands, stay home if sick with flu symptoms, and cover your coughs and sneezes.

Working group established to review H1N1 deaths

A working group has been set up to review all death or severe illness resulting from pandemic influenza H1N1 for all New Zealanders. Cindy Farquhar, an obstetrician and gynaecologist and chair of the Perinatal and Maternal Mortality Review Committee has been appointed as chair of the working group. She said it was important to learn as much as possible about the impact of this virus on New Zealanders. "We want to look at each case, particularly those who had severe illness to see what we can learn that will be helpful and assist with the health response to the anticipated second wave," Dr Farquhar said. The group's first report is expected to be released in the first quarter of 2010.

Healthline Calls

The percentage of callers to Healthline with influenza-like symptoms slightly increased over the past week, and is slightly above last year’s rate at the same time. Call numbers have been decreasing over recent weeks.

The number of deaths associated with pandemic (H1N1) 2009 continues to increase. As of 23 October, 186 people have died. Of these deaths, four were pregnant women and 24 (12.9%) were Indigenous.

There have been 2 confirmed deaths in the ACT, 51 in NSW, 6 in the NT, 41 in Qld, 28 in SA, 7 in Tas, 24 in Victoria and 27 in WA.

The reporting of current hospitalisations has been replaced by weekly reporting of new hospitalisations, as States and Territories have moved from reporting data daily to reporting weekly.

There have been 11 new hospitalisations for the past week around Australia with pandemic (H1N1) 2009. Of these, 3 people in hospital are Indigenous Australians.

There has been 4 people hospitalised in NSW , 1 in the NT, 4 in SA, and 2 in WA, in the past week.

ICU admissions: 1 person in SA has been admitted to an Intensive Care Unit this week.

The total number of hospitalisations in Australia since pandemic (H1N1) 2009 is identified at 4,904.

1014 Health response in Samoa moves to recovery phase [New Zealand]--The New Zealand Government's health response to the tsunami in Samoa is now moving to the recovery phase. Plans are in place to determine the on-going help that will be required to support the health system in Samoa as they gradually return to "business as usual".

"We are continuing to rotate staff up to Samoa, and this will carry on for some weeks yet. A relief liaison manager and logistics person left for Samoa yesterday, and today two GPs and a general surgeon will join the roster in Samoa," said Minister of Health, Tony Ryall.

"While the demand for acute and emergency surgery has decreased, our staff report that around 100-130 people are still being seen each day by health teams working in field clinics. On-going wound care and plastic surgery continue to keep hospital staff busy."

"Our psychologists and psychiatrists are involved in coordinating psycho-social support. Our role is to help increase the local capacity and capability as the demand for psychosocial services will be ongoing."

New Zealand mental health staff have played a role in establishing ‘train the trainer' courses for school teachers in Samoa to ensure they are equipped to support young people through their grief.

Since September 29 a total of 43 NZ medical personnel have been deployed through DHBs and the Ministry of Health. At present 28 New Zealand health personnel are currently deployed to Samoa. This number will reduce to 20 as demand for services reduces and Samoan health providers are able to cope.

"In addition to personnel, New Zealand has dispatched well over three tonnes of medical equipment, supplies and medications."

New Zealand has an existing arrangement with Samoa to support their health system by providing access to specialist care. "This has been managed through Counties Manukau DHB for many years. We are currently reassessing this arrangement to see how best to provide visiting specialist support to Samoa over the next 12 months," Tony Ryall said.

1014 Precautionary Hep C screening [South Australia]--Thirty patients from the Royal Adelaide Hospital have been offered precautionary screening for hepatitis C after a hospital employee tested positive for the virus.

SA Health Chief Medical Officer Professor Paddy Phillips said that the risk of
transmission to any patient was extremely low.

“The health care worker became aware of the positive test result on 18 September
and notified hospital management straight away,” said Professor Phillips. “The hospital immediately began an investigation to determine which patients may
have been at any risk of transmission.

“Using national and international guidelines, 30 patients at the RAH were identified
and offered precautionary screening and counselling.”

All 30 patients have been contacted by letter over recent days and today, and will also
be contacted by phone. All of the patients’ GPs have been notified.

Hepatitis C virus is spread by blood to blood contact. Most people do not display any
symptoms when they are first infected by the virus. Treatment can cure hepatitis C in more than 50 percent of cases. Around seven percent of all people chronically infected with hepatitis C will develop liver cirrhosis after 20 years of infection.

Hepatitis C affects around one percent of South Australians, with around 16,000
cases recorded in SA since 1995. In May 2009, SA Health launched the SA Hepatitis C Action Plan 2009-2012 to improve access to treatment and care for people who are living with hepatitis C.

For more information, contact the dedicated RAH hotline on 1800 228 902, or the
Hepatitis C Council on 08 8362 8443.

While some GPs may charge to administer the vaccination, most of this will be refunded through Medicare.

For further details people can contact the Pandemic Flu Hotline on 180 2007 or visit the Department of Health website at: http://www.health.wa.gov.au

Photos taken by NZ 5 Squadron P3-k Orion of areas of Samoa after the tsunami. WN-09-0118-002

1004 Operation Niuatoputapu [Tonga]--From the Prime Minister's Office, Nuku'alofa, Tongatapu, October 1, 2009. At 6:50am, Wednesday 30th September 2009, the island of Niuatoputapu was struck by a 8.3 magnitude earthquake which lasted 20 minutes.

Five minutes after the earthquake the island of Niuatoputapu was hit by the first of 3 large tidal waves at 3 minute intervals measuring at about 6 meters.

The waves moved inland about 600 meters. The largest and the strongest was the last wave.

90% of the houses on the island have been destroyed with the villages of Hihifo and Falehau being the worst affected. The third village of Vaipoa was relatively unharmed.

There are 7 persons confirmed dead with 3 missing. The majority of the survivors have sustained minor injuries with 4 who are in a critical condition. The survivors have requested as a matter of urgency water, food, medical supplies, clothing, shelter and bedding.

They also requested government radio programmes of comfort and reassurance last night because many were afraid and in state of shock. They were still sheltering in the hills above the villages.

All of the island's water storage tanks have been either rendered unusable or destroyed completely.

All government schools were cancelled yesterday (30 Sept 09). A special Cabinet meeting was convened at 10:00am to work on the immediate government response to the natural disaster. Cabinet also met again this morning.

A plane was chartered to fly to Niutoputapu to carry out an aerial assessment at 3:30pm yesterday. They have reported considerable damage to the island particularly the administrative centre and most populated village of Hihifo.

The Hon. Acting Prime Minister, Lord Tuita made a public announcement last night on television and radio informing the nation of the natural disaster and the actions taken by government.

The patrol boat VOEA Neiafu departed last night at 7:00pm for Niuatoputapu with emergency supplies, equipment and personnel. This includes a team a medical team capable of carrying out emergency surgery and qualified trauma counselors. It is scheduled to arrive at Niuatoputapu at 6.00pm this evening.

Pending the condition of the runway at Niuatoputapu a special flight will depart Vava'u this morning at 9:00am to evacuate the 4 persons who are in a critical condition. (It has been reported that the aircraft landed safely on Niuatoputapu at around 12:00 noon today)

A French frigate is expected to arrive in Nuku'alofa on Friday (2 Oct 09) on a goodwill visit. Arequest has been made to the French authorities in New Caledonia to allow the ship to sail to Niuatoputapu with further emergency supplies. If that request is approved the French frigate will depart Nuku'alofa for Niuatoputapu on Saturday (3 Oct 09.

A radio fund-raising appeal is currently being carried out in Nuku'alofa today to raise funds and supplies for the people of Niuatoputapu. Vehicles have also been arranged to travel to all the villages of Tongatapu to collect food, clothing, bedding and other supplies that the public are willing to donate.

A daily media briefing will be held at 11:00am at the office of the National Disaster Management Office, from today onwards. Operation Niuatoputapu is being coordinated by Col. Siamelie Latu of the Tonga Defence Service.

1001 Qld disaster experts deploy for Sumatra quake effort [Queensland]--A 40-strong contingent of Queensland disaster response experts will fly out of Brisbane tomorrow morning (Friday 2 October) for earthquake-ravaged Sumatra.

Premier Anna Bligh said the deployment had been requested by the Indonesian Government.

“We have been notified formally tonight by Emergency Management Australia that our team is needed as part of an emergency response effort,” Ms Bligh said. “The team was placed on standby earlier today until the extent of the earthquake devastation became clearer.

“The Queensland contingent consists of highly-trained paramedics, a doctor, Queensland Fire and Rescue Service urban search and rescue experts, an engineer, hazmat officer, mechanic and support officers.

“The team has expertise in difficult technical search and rescue operations in structure collapse incidents, such as those experienced in earthquakes.

“It also has the capability for full management, structural assessment, hazmat assessment, search and rescue, canine search, command and control, communications, medical support, and logistics.

“We understand our team and another from New South Wales will fly to Sumatra to provide what help we can to this devastated region. This is a tragedy of enormous proportions – the number of dead and the injury toll continues to rise. There are fears many people are buried under rubble.”

Ms Bligh said Queensland was playing a key role in the Australian response to the dual tragedies of the Samoa tsunami and Sumatra quake.

“Overnight, teams of special operations paramedics, health practitioners, and search and rescue personnel flew to Samoa, where they went immediately to work,” she said.
“More medical and rescue equipment will be flown from Brisbane to Samoa early tomorrow (Friday) morning.

“Queensland remains ready and able to offer more assistance, if requested by federal government authorities.”

1001 NSW deploys doctors to assist in Samoa [New South Wales]--NSW Minister for Health, Carmel Tebbutt, has confirmed two NSW Health medical officers will be deployed to Samoa immediately to assist following the tsunami in Samoa.

Ms Tebbutt said the two doctors flew to Samoa last night on an Australian reconnaissance mission with AusAID.

“Two of our doctors have been urgently deployed to Samoa in response to today’s devastating tsunami, leaving on a chartered flight tonight via Brisbane with representatives of AusAID,” Minister Tebbutt said.

“The doctors will assess the medical needs of the communities affected and determine what additional resources are required. In the meantime, we arranged for a number of medical supplies to be flown to Samoa from Richmond Air Base last night,” added Ms Tebbutt.

The two doctors urgently leaving Australia are Dr Michael Novey, Deputy Medical Director, Ambulance Helicopter Base Bankstown and public health expert, Dr Mitchell Smith.

“I am grateful to Drs Novey and Smith who have agreed to drop everything and leave at short notice in order to help those in need. I also want to thank their families for their valued support at this time,” Minister Tebbutt said.

“Today, it is anticipated that a larger deployment of emergency and medical personnel will be dispatched from NSW and other states. NSW will be ready to support any additional national efforts that are being proposed in the days and weeks that follow,” the Minister added.

1001 H1N1 : Pandemic vax commences [New South Wales]--Deputy Premier and Minister for Health, Carmel Tebbutt, today joined NSW Acting Chief Health Officer, Dr Greg Stewart, as the first doses of the Pandemic (H1N1) 2009 Influenza vaccine were administered.

Ms Tebbutt said people now have the opportunity to protect themselves and their families against pandemic flu by getting vaccinated.

“Anyone who would like to be vaccinated against the pandemic will be eligible to get the vaccine through their GP,” Ms Tebbutt said. “The vaccine is the best defence against pandemic flu.”

Acting Chief Health Officer, Dr Greg Stewart, said NSW Health has been facilitating vaccine rollout across the state, and to date, more than 2,000 orders from practices, private hospitals, aged care facilities and public health facilities have been dispatched by the State Vaccine Centre.

“In the past week over 600,000 doses of the vaccine have been delivered across the state – from Broken Hill to Eden and the Tweed Valley,” Dr Stewart said.

“It is important that people call ahead and make an appointment with their GP.”

Dr Stewart strongly urged any GPs who have not yet placed orders for the vaccination to do so, to assist in getting the vaccine to their patients. GPs will provide the vaccine, using their normal billing arrangements.

“Although the vaccine will be available for everyone aged 10 and over, I encourage the most vulnerable in our communities to access this vaccination in order to protect themselves and/or those they care for,” he added.

Those considered more vulnerable to the pandemic include:
• Front line health care and community care workers;
• People with underlying chronic medical conditions, ie. heart and lung disease, cancers,
HIV, asthma, diabetes;
• People who are morbidly obese;
• Indigenous people;
• Pregnant women; and
• Parents and guardians of children aged 0-6 months.

Dr Stewart, said NSW Health was working with GP groups and Aboriginal Medical Services to ensure that the vaccine was provided in areas where there are difficulties accessing primary care services.
“Our priority is to make sure all people living in NSW have access to the vaccination, and outreach services will be established – including, in some areas, mobile clinics with Aboriginal health workers – to encourage take-up of the vaccine.

“We are anticipating that a vaccine for children nine years and under will be available soon once further information is obtained from clinical trials,” he added.

Dr Stewart said while the number of patients affected by the pandemic strain continues to decrease, it is possible that higher levels of flu will occur this summer than would normally be seen.

“It’s still important for people to get vaccinated,” he said.

More information is available from the Pandemic (H1N1) 2009 Hotline 180 2007 and at the NSW Health website www.emergency.health.nsw.gov.au/swineflu/index.asp.

1001 Minister praises Kiwis' readiness for tsunami [New Zealand]--Civil Defence Minister John Carter has congratulated regional civil defence operations and coastal communities for their organisation and response to the tsunami warning issued for New Zealand yesterday morning.

An earthquake measuring 8.3 on the Richter scale caused widespread damage in Samoa yesterday morning, and triggered a tsunami which reports suggest has wiped out buildings and claimed lives.

Warnings of a tsunami of up to 1 metre in height were subsequently issued for the East Coast of New Zealand, with suggestions that other coastal areas would be affected as the wave moved down the country.

"While the initial tsunami hasn't caused damage in New Zealand, our preparedness for such events is vital. Civil Defence remains on alert following reports of second wave near Raoul Island, and for any waves caused by aftershocks.

"But I can't emphasise enough the need to act on Civil Defence warnings. Areas throughout the country swung into action quickly today - and I congratulate local civil defence controllers for their considered and prompt responses.

"Reports suggest the damage caused by the earthquake and tsunami in Samoa is significant. I know this must be a particularly worrying time for all those with family and friends there."

The Ministry of Foreign Affairs and Trade is co-ordinating New Zealand's response to the situation in Samoa, and has issued emergency telephone numbers for those who require more information about family and/or friends in Samoa. It is expected further information will be released by MFAT later today.

Mr Carter says as soon as the Wellington-based Civil Defence National Crisis Management Team received alerts, regional Civil Defence, Police, emergency services and other core groups were warned about the possibility of a tsunami.

"Each region acted immediately to put into place the plan for their area, depending on the anticipated severity of the tsunami. In Gisborne, for example, Civil Defence volunteers drove to low-lying beach areas to alert residents.

"It's that kind of attention to detail which helps New Zealand's emergency planning save lives, property and communities."

Mr Carter said it was important New Zealanders paid attention to official reports in such situations.

"In order to avoid panic and unnecessary worry, New Zealanders should heed only those reports from Civil Defence national headquarters and their local council's Civil Defence team."

Residents in coastal areas are still being urged to be mindful of sudden tidal surges and currents in the wake of the tsunami.

1001 Orion heads to Samoa, Hercules on stand-by [New Zealand]--An Airforce P3 Orion is enroute to Samoa, and before dark may be able to join the coastal search for survivors of this morning's earthquake and tsunami, Foreign Minister Murray McCully said today.

"The Orion will join the search along the coast of Upolu, Savaii, and other islands, and also help assess damage to villages, roads and infrastructure," Mr McCully said.

"A C130 Hercules is also on standby to carry emergency supplies to Samoa if needed.

"The full extent of the disaster is not yet clear but reports suggest there has been significant damage around the southern coast of Upolu, and it seems likely that many people have been injured or killed.

"New Zealand's diplomatic missions around the Pacific are in contact with local governments over what damage has been suffered, and how we might be able to assist.

"Reports from Tonga suggest the northern island of Niuatoputapu has been affected, but no firm details are yet available.

"The Cook Islands has reported limited wave activity and no serious damage, however communications with the northern Cooks is limited. Other countries around the Pacific are reporting no significant damage or casualties.

"The New Zealand High Commission in Apia is working to contact New Zealanders in Samoa to check on their well-being.

"New Zealanders in Samoa are advised to follow instructions issued by the local authorities. They should stay tuned to local radio, and stay away from the sea. We are also encouraging people to make contact with friends and family at home to allay any concerns," Mr McCully said.

New Zealanders concerned about family members in Samoa should try to make contact with them in the first instance. Those with ongoing concerns can call the Ministry of Foreign Affairs and Trade on 04 439 8000. Anyone worried about the safety of non-New Zealand relatives in Samoa should contact the Samoan High Commission on 04 472 0953.

The Pacific Cooperation Foundation has set up a Tsunami Relief Fund, and deposits can be made at any Westpac branch. The funds will go to the Samoan government.

1001 Minister calls for Civil Defence review [New Zealand]--Civil Defence Minister John Carter has asked for a review into how the Civil Defence and Emergency Management ministry deals with tsunami alerts.

"Generally, the response to yesterday's tsunami warning was pretty good, but there are concerning reports about the ways in which some information was communicated to the public. Frankly, that is not good enough," says Mr Carter.

"Public confidence in Civil Defence is critical. There are always lessons we can learn from events such as these and I am determined to ensure we do learn from them."

Mr Carter says co-ordination between the national Civil Defence headquarters and regional operations went largely to plan, and it is usual for regional civil defence controllers to manage warnings in their own areas, because what works in one area may not work in another.

"For example, some places have cell phone coverage and some don't. That's why it's important regional controllers are able to make their own calls on their own patch.

"However, I think Civil Defence weren't as helpful as they could have been in communicating with the media in the early stages and I am also concerned about reports saying places like Wellington Airport didn't get timely information. We have to sort that out," Mr Carter says.

1001 Samoa quake and tsunami response [New Zealand]--The response of Wellingtonians to yesterday's Pacific earthquake and tsunami alert was highly satisfactory - but their thoughts should now be with the region's Samoan community, says Wellington's Acting Mayor, Ian McKinnon.

"The quake and tsunami has caused terrible devastation in parts of Samoa and American Samoa. I am aware there is understandable distress in the local Samoan community because of the obvious strong family ties binding New Zealand and Samoa.

"The City Council will liaise with the Government and the local Pasifika community to help offer assistance to the Samoan nations and to the local Samoan community if necessary."

Cr McKinnon says the response of national and local emergency management systems - coupled with a generally responsible approach by Wellingtonians - meant yesterday's tsunami alert passed with no major problems.

The Council's emergency management staff were on alert as soon as word came through and monitored reports closely from then on. Patrols were sent to the south coast and harbour approaches in vehicles to advise people, some being fishermen, to vacate those areas.

A helicopter also flew the area from Sinclair Head to the harbour and used the Council's emergency public-address system to alert a number of people. "The high-volume system worked well - the helicopter flew at a height of about 300 feet and the messages were well-received from the ground. I'm told the crew got a lot of thumbs-up responses."

The Council's Customer Contact Centre received about 70 calls during the morning from Wellingtonians trying to get more information about the emergency.

"The advice from this morning is that people must listen to the radio at such times - and keep a radio at hand during such alerts. It really does appear to be the best way to keep up with developments."

Cr McKinnon says it appears a small number of people were seen to be walking and driving to the beaches this morning - probably out of curiosity. "It's not a wise decision - if a tsunami of any significant size arrives then by the time you see it, it'll be too late to escape to safety."

He says yesterday morning's alert was a "decent wake-up call" for Wellingtonians to be prepared for a very large quake or other big emergency.

It is also a reminder to residents living on or near the South Coast and around the region's coastline that they are at risk of being overwhelmed by a quake-generated tsunami.

"If people are by the sea or in low-lying areas like Kilbirnie, Seatoun or Island Bay, and they feel a very strong quake, then they should immediately head inland or to higher ground once the shaking stops. If a quake sets off a tsunami in Cook Strait then there'll be only a matter of minutes for people to get to safety before the wave hits."

People should think and plan on how they will get themselves, their families and their neighbours to safety as quickly and easily as possible, says Cr McKinnon.

1001 PM to assess Samoan tsunami damage firsthand [New Zealand]--Prime Minister John Key will return to New Zealand earlier than expected in order to fly to tsunami-hit Samoa.

Mr Key, who has been holidaying in the United States, will return to Auckland on Saturday and then fly out to Samoa a few hours later.

"While officials have kept me regularly informed, it is important I see the extent of the damage myself.

"I made good friends with the Samoan people on my visit in July and I was shocked to see the devastation on the south coast of the island. The villagers of Poutasi were particularly kind and it is heartbreaking to hear the village was destroyed by the waters.

"It is important that I reassure Samoan leaders face to face that New Zealand stands ready to assist - not just with short-term disaster relief but with long-term reconstruction.

"I have purposefully made my visit very brief. I am mindful that essential life-saving work is going on on the ground, and I do not want my visit in any way to distract from that."

The Prime Minister will return to New Zealand on Sunday.

1001 Health sector rallies to support Samoa [New Zealand]--The Health Minister Tony Ryall says New Zealand's health sector is mobilising to support recovery efforts in Samoa.

Mr Ryall expressed his sympathy to all those affected - both in Samoa, and here in New Zealand.

He says requests have been received from the Samoan government for orthopaedic surgeons, general surgeons, theatre nurses, anaesthetists and post-operative staff.

The Ministry of Health's National Health Coordination Centre is currently working with District Health Boards to compile a register of New Zealand health professionals who are coming forward to volunteer.

Any health professional, including those working in primary care, who wants to offer support should contact the emergency controller at their local DHB or phone 09 263 1381 or fax 09 261 3396 or email Incident.Controller@middlemore.co.nz outlining relevant qualifications, experience, availability and contact details.

New Zealand's response is coordinated nationally by NZAID, and yesterday the Ministry of Health contacted them to offer personnel, medical supplies and equipment which are available immediately for disaster relief.

The Ministry has offered staff who are qualified to provide on-site medical needs assessments in Samoa to support the wider New Zealand response.

One staff member is in Samoa working with the disaster recovery team, already.

Ron Dunham, chief operating officer at Counties Manukau DHB will be working with Samoan health officials to identify the specific resources they will be needing and discussing other practical assistance New Zealand can provide.

Counties-Manukau DHB has longstanding relationships with hospitals in Samoa and Tonga.

Mr Whan said dust build-up in smoke alarms could cause false alarms or prevent the devices from working properly.

"During last week's dust storms, firefighters attended more than 600 fire alarm calls, many of which were triggered by dust particles, Mr Whan said.

"While these calls were mostly to high rise and industrial fire alarm systems, household smoke alarms were just as likely to be affected.

"Now that the dust has settled, you should take a few minutes over the long weekend to use a vacuum cleaner to remove dust which may have built up in your smoke alarm. Then just press the 'test' button to make sure it is working.

"A dust clogged smoke alarm can't do its job properly - only a working smoke alarm will help save your life. If you live near an elderly or less mobile person, you may like to do the neighbourly thing and offer to clean their smoke alarm for them as well, Mr Whan said.

All residential accommodation in NSW is required by law to have at least one working smoke alarm per floor.

NSW Fire Brigades Acting Commissioner John Benson said smoke alarms provided an early warning in case of fire.

"If you're asleep at the time of a fire, the smoke may numb your senses and put you into a deeper sleep. The sound of a smoke alarm is designed to wake you so you can put your fire escape plan into action before you are overcome by smoke.

"Time is everything in a fire. It can take only a few minutes for a flame to spread and engulf your home so an early warning can be the difference between life and death."

The Fire Brigades recommends three steps to maintain a working smoke alarm:

* clean your smoke alarms regularly with a vacuum cleaner to keep them free from dust;
* test them every month by pressing the button with a broom handle to ensure they are working, and;
* once a year, replace the batteries.

1001 H1N1/ILI : Pandemic flu vax available for all Victorians [Victoria]--Victorians wanting to protect themselves from the 2009 H1N1 influenza strain will be able to obtain vaccine from their General Practitioner or local health service from tomorrow.

Victoria’s Chief Health Officer, Dr John Carnie, has urged Victorians who are in a priority group for vaccination and front line health and community care workers to take advantage of the free vaccine.

“Although the number of Victorians with influenza like illness has decreased significantly, it is not possible to predict when there maybe a resurgence of the H1N1 virus,” Dr Carnie said.

“The roll out of the vaccine in Victoria through GPs and hospitals follows the registration of the CSL pandemic influenza vaccine by the Therapeutic Goods Administration.

“Adult trials indicate that the vaccine is similar to that of seasonal influenza vaccine and that only one dose is required for adults and children aged 10 years and over. A decision on whether the vaccine is suitable for children aged under 10 will be made in the near future.

“Public and private hospitals have been asked to participate and that they vaccinate their staff and patients in the priority groups.

“General Practitioners have been advised on all aspects of the program including ordering of vaccine. The distribution of vaccines by CSL to GPs and health services has commenced.

“The most vulnerable people in our community are encouraged to get the swine flu vaccine first,” Dr Carnie said.

These groups include:
· Pregnant women;
· People with chronic health conditions such as asthma, heart and lung disease, cancer, diabetes, kidney disease, neurological disease and people with suppressed immune systems;
· People with moderate to severe obesity; and
· Indigenous people.

Other priority groups who should have the vaccine are front line health and community care workers who have direct contact with patients and parents and guardians of children under six months.

“Both these groups should be vaccinated to reduce the transmission of influenza to other vulnerable members of the community.

“Victorians in the higher risk groups are encouraged to contact their doctor or local health service to be vaccinated as soon as possible.

“Anyone else who wishes to protect themselves from swine flu can get the vaccine for free, including healthy people. However, the health care provider may charge a service fee for administering the vaccine,” Dr Carnie said.

Further information about the vaccine can be obtained by calling 180 2007 or by visiting http://humanswineflu.health.vic.gov.au/

1001 H1N1/ILI : Free pandemic flu vax available for all [Australia]--Today Australia will embark on what is potentially the biggest vaccination program in its history, offering free pandemic (swine flu) vaccine to every person in the country.

From today all States and Territories began offering vaccine to adults and children 10 years and over. Once the vaccine is registered for younger children by the Therapeutic Goods Administration, children will also be eligible to be vaccinated.

A total of 5.5 million doses of the vaccine have been delivered around Australia for the start of this program. Thousands more vaccines are being produced each day by local pharmaceutical company CSL. The Rudd Government has placed an order for 21 million doses of the newly developed vaccine.

While the H1N1 09 influenza has remained a mild illness in most people, it is important that we don’t lose sight of the more devastating hard edge of this disease.

This influenza has led to more than 4700 people being hospitalised in Australia, with around 13% of these being admitted to ICU. Almost 1500 of those hospitalisations have been in children and teenagers. Sadly, since the pandemic began, there have been 180 associated deaths.

Unlike seasonal influenza which mainly impacts the elderly, the current pandemic influenza strain has affected younger people. The average age of Australian deaths from pandemic influenza is 51 years. Ten deaths have been recorded in children.

Australia's Chief Medical Officer, Professor Jim Bishop, has expressed concern that while the normal winter influenza season is on the wane, pandemic influenza may continue into summer as it has done in the northern hemisphere. There is also a chance of the pandemic flu returning as a more virulent disease.

Therefore, it is important that people take this disease seriously and protect themselves and their families by getting vaccinated.
Australia will be one of the first countries in the world to offer the vaccine to the general population and all people aged over ten are immediately eligible to receive the free vaccination.

Those people most vulnerable to the disease – such as those with chronic respiratory disease, diabetes, cancer, severe obesity and conditions that suppress the immune system, as well as pregnant women and Indigenous Australians – are encouraged to talk to their doctor about having this flu shot as soon as it is available in their local area.

State and Territory health authorities have a range of strategies in place to provide the vaccine to their populations including through GPs, influenza clinics, Aboriginal Medical Services and local government.

For information about how people can access the free vaccine, ring the National Pandemic Hotline on 180 2007 or visit www.healthemergency.gov.au

1001 H1N1/ILI : New flu testing equipment for all States and Territories [Australia]--The Australian Government will provide $1.4 million in funding to the National Influenza Centres and other public health laboratories to purchase automated influenza testing equipment. Every State and Territory will receive funding as part of this initiative.

This new equipment will enhance the capacity for pandemic influenza testing by Australia’s public health facilities and allow laboratories to handle increased influenza testing demand.

This funding is part of a package of measures provided by the Government as a result of the recent swine flu pandemic.

Pathologists and medical laboratory scientists reported that additional high throughput testing equipment was needed to enable them to process the large volumes of influenza testing required during the Pandemic (H1N1) 2009 outbreak.

Now laboratories in every state and territory will be able to purchase the equipment that is appropriate to the particular needs of their service.

The following hospitals and laboratories will receive funding for the purchase of the new influenza testing equipment:

* Institute of Clinical Pathology & Medical Research (ICPMR) – New South Wales
* South East Area Laboratory Service (SEALS) – New South Wales
* Victorian Infectious Diseases Reference Laboratory (VIDRL) – Victoria
* PathWest – Western Australia
* Queensland Health Forensic & Scientific Services (QHFSS) – Queensland
* Pathology Queensland – Queensland
* Institute of Medical & Veterinary Science (IMVS) – South Australia
* ACT Pathology – Australian Capital Territory
* Royal Darwin Hospital – Northern Territory
* Royal Hobart Hospital – Tasmania

While demand for influenza testing has started to decline in line with normal seasonal trends, this new equipment will ensure that public health laboratories are well prepared for any future pandemic threats or heightened seasonal influenza activity.

1001 Injury deaths twice as likely for men [Australia]--Men are twice as likely as women to suffer injury-related deaths according to a report released today by the Australian Institute of Health and Welfare.

The report, Injury deaths, Australia 2004-05, found a total of 9,775 deaths with the rate of injury-related deaths per 100,000 people being 63.9 for men and 30.3 for women.

Overall, the most common cause of injury-related deaths was unintentional falls, which accounted for 29% of all injury deaths that occurred in 2004–05. People aged 70 years and over accounted for almost 90% of all deaths in this group.

Unintentional falls were followed closely by suicide and transport injuries, which accounted for 24% and 18% of all injury deaths respectively.

‘Men were close to four times as likely as women to commit suicide’, said report author Geoff Henley.

‘Similarly for transport deaths, men were close to three times as likely as women to die as a result of a transport accident, with men aged 15 to 34 years accounting for almost 33% of all deaths in this group.’

‘Almost 87% of all transport-related deaths were as a result of a motor vehicle traffic accident and in 65% of these deaths the victim was an occupant of a motor vehicle.’

The report also found people living in remote areas were more likely to die from an injury, with the rate almost 2.5 times greater in very remote areas than in major cities.

Among the states and territories, the Northern Territory had the highest rate of injury deaths per 100,000 people, at 97.2, with Tasmania having the next highest rate, at 60.0.

The Australian Capital Territory had the lowest rate at 43.7, marginally lower than the national rate (46.7).

The report found just over 25% of all injury deaths involved some type of fracture, with just on two-thirds of fracture deaths involving a hip fracture.

Injuries to the head were also common, accounting for over 17% of all injury deaths. Of these, 40% were recorded as sustaining some form of intracranial injury.

1001 H1N1/ILI : Reported level of flu has declined [New Zealand]--As at midday today two people are reported to be in hospital with Pandemic Influenza (H1N1) 09 or its complications.

Since May 2009 the cumulative total of people in New Zealand who have returned a positive laboratory test for pandemic influenza (H1N1) 09 is 3163, compared with 3161 reported on Wednesday last week.

The number of deaths from Pandemic Influenza (H1N1) swine flu where swine flu was a primary cause is 18, following the death this week in Auckland of a 67 year old woman reportedly without the underlying health conditions that have been associated with more severe illness. Some deaths are still being investigated by the Coroner.

Border control

The Ministry of Health intends to today suspend in-flight cabin announcements around Swine flu, and return to the normal levels of health screening of flights in and out of New Zealand.

The reported level of influenza has declined to levels similar to the level at this time in the past two years. Influenza is still circulating, but this measure better reflects the reduced level of risk.

A public health presence will be maintained at international airports. Help is still available for passengers identified as potentially sick by aircrew or who self-identify. Anyone needing assistance will be assessed by a paramedic then transported to hospital or advised how to seek medical help.

Tamiflu

Medsafe - the Ministry of Health unit responsible for assessing medicines and vaccines - has approved a two year extension to expiry dates currently shown on boxes of Tamiflu in New Zealand.

This extension follows Medsafe's evaluation of data supplied by Roche, the manufacturer of Tamiflu, demonstrating that the product continues to meet its safety and quality specifications for two years beyond the original date. Medsafe reviewed this data and approved extending Tamiflu’s shelf life from five years to seven years, meaning two years can be added to the expiry date shown on packet and foil packs containing Tamiflu capsules.

The move follows a decision by regulatory authorities in Australia, Canada, Hong Kong, the US and the European Union which have also extended Tamiflu’s shelf life by two years.