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Globe Medical in Adelaide provides a comprehensive service for travellers whether outbound, inbound or just passing through. Call us or book online to arrange an appointment. Important Information on Swine Flu June 27th Update: Australia now with 4 Swine Flu-related deaths. Australia has one of the highest per capita attacks rates in the world with more than 3,520 cases now reported. Victoria continues to lead the way with notifications 1,560 followed by NSW (653), QLD (527), SA (262), WA (190), ACT (131), NT (125). There are currently 50 people hospitalised with 18 in intensive care units. The disease profile is broad with most individuals experiencing a mild upper respiratory tract illness. However, it can cause serious illness in some individuals and it is important these people be identified and exposure limited as much as possible. If exposure does occur in those "at risk" then early treatment becomes very important. Unfortunately, as with all new influenza A viruses in a virtually non immune population, it is expected that majority of the population will ultimately be exposed. Vaccination of the non- immune population may be available in due course. In the last week Health authorities have changed the national response to H1N1 to a PROTECT phase. It sits alongside CONTAIN AND SUSTAIN but has a greater focus on protecting and caring for people in whom the disease may be severe. It is important that travellers be aware that WHO is clear in its recommendation that there should be NO BORDER CLOSURES or TRAVEL RESTRICTIONS. It is also clear at this time that providing care becomes more important than containment. Over the next few weeks it will become increasingly difficult to determine the source of an outbreak. This does not mean a failure of containment. Containment is about limiting the number of infections with attention to good public health measures. Many measures must be instituted at an INDIVIDUAL level and INDIVIDUAL responsibility to the wider community. Such measures involve self quarantine when unwell with a flu-like illness and attention to hand washing and covering the mouth and nose when coughing or sneezing. The southern hemisphere countries are most at risk. We have to expect many more cases given the nature of international travel in 2009. It is highly unlikely any country will pose restriction on travel. According to WHO (World Health Organisation) as of June 27th, almost 60,000 cases have been confirmed. It is impossible to know the real number of cases as many in the “mild” group will go unreported. There have been at least 263 deaths. COUNTRIES OF CONCERN TO TRAVELLERS
The lightening off of case reports in Europe is a seasonal influence rather than exceptional public health containment measures. This would be expected to continue as the summer months start. Asia still remains a major concern but strict quarantine arrangements are well in place. It is important to note there is no seasonal preference in tropical regions with an all year round presence. China and Thailand have now reported over 500 cases. An interactive map can be viewed from WHO at: According to researchers in the UK the virus may be more virulent than seasonal influenza with a case fatality rate similar to the Asian influenza which caused between 2 and 3 million deaths globally in the 1950s. On the good side is a report out of CDC in Atlanta stating that this virus may be less virulent than the H1N1 human influenza which wreaked havoc on the world in 1918/19. This is a very important finding however it does not diminish the concern that this virus will circulate the world widely causing considerable ill health. People will get sick, miss work, school or sport but they are unlikely to die. This does not mean that authorities shouldn't try to contain spread as much as possible. If 20% of the population were to be unwell at the same time the effect on the community would be massive. A small percentage would need hospitalisation and some (the very young, elderly and those with serious pre-existing diseases) might die. We are fortunate that the currently available antiviral agents are useful in the treatment of this influenza. However, these medications must be administered early and hence early presentation and diagnosis becomes vitally important. At this point in time everything possible must be done to slow up the spread and hopefully a vaccine will be available within 6 months. It is still likely that WHO will move to phase 6 in coming weeks. This states nothing about virulence rather spread. It has implications for governments and pharmaceutical companies regarding vaccine development. More Information on the virulence of this still virus remains critical but we can be encouraged by the downgrading in the number of deaths directly attributed to the virus. At this stage individuals would be well advised to defer non essential travel to areas where sustained person to person transmission is occurring (Mexico). This upgraded warning can be found at: www.dfat.gov.au People who are ill are advised to defer travel and those unwell ( in particular, fever > 37.8, chills, sore throat, cough, nasal congestion and fatigue) after or during travel to seek medical attention as soon as possible. It is advisable that you do not front up at an airport until you have been given clearance. The current global health alert is different to the SARS and Avian Influenza alerts experienced in 2003 and 2005. While the current strain is a new influenza A, it is well known that an H1N1 has the potential to become a pandemic. This virus has already demonstrated it's ability to go from person to person unlike H5N1. On the other hand the SARS and Avian Influenza outbreaks have helped global health authorities in better planning for future pandemics. What is unknown at the moment is it's virulence. Certainly the attack rate (person to person) will be high but the expected number of deaths is confusing given the discrepancy in deaths between Mexico and other affected regions. In the case of a swine flu pandemic it is likely public health measures will be put in place to slow up transmission in affected areas (closure of schools, cinemas, public places) while a vaccine is developed. This is likely to take some months but the outlook would be good. Details on case notifications for Europe and the USA can be found at:
Dr Bob Kass Latest Travel News Vaccinations for Travel  Swine Flu  |
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