Influenza A (H1N1) Swine Flu Information for health professionals Healthcare workers are the first line of response in an influenza pandemic, as the swiftly-spreading virus places unprecedented demands on New Zealand’s public health system. Frontline health workers should wear a surgical or procedure mask for close contact, in addition to standard precautions, when examining a patient with flu-like symptoms. Precautions should also be taken, with regards to eye protection, gowns, gloves and appropriate ventilation when performing high-risk aerosol-generating procedures such as bronchoscopy. More guidelines and resources for the health sector are provided below and in the boxes on the right: Case Definitions Poster for practices and infection control video Background information About Influenza A (H1N1) A/H1N1 influenza virus: the basics Guidance documents Clinical guideline for infants and children Ethical values for a pandemic, including guidance on health professionals’ responsibilities and prioritisation in situations of overwhelming demand. Guidance for clinicians on the management of pregnant women with suspected Pandemic Influenza A (H1N1) 09 in the ‘Manage it’ phase Guidance on the diagnosis and management of Pandemic (H1N1) 2009 in the Pandemic ‘Management’ phase Guidance for Public Health Services involved in managing influenza in residential institutions and day care centres Psychosocial impacts of quarantine Tamiflu Research papers Rationing of Resources: Ethical Issues in Disasters and Epidemic Situations Case Definitions Last updated: 19 June Widespread contact tracing will not be carried out as areas move from ‘containment’ to ‘management’. The purpose of the new case definitions below is to assist: with ongoing surveillance and international reporting obligations with clinical management decisions with public health or infection control responses. There is no longer a suspected case definition as there is community transmission in several places in New Zealand and a travel history is no longer a prerequisite for having suspected Novel Influenza A (H1N1). Confirmed case A confirmed case of novel influenza A H1N1 virus infection is defined as a person with laboratory confirmed novel influenza A H1N1 virus infection by one or more of the following tests: real-time RT-PCR viral culture four-fold rise in novel influenza A H1N1 virus specific neutralising antibodies. Probable case A probable case of novel influenza A H1N1 virus infection is defined as a person with an influenza like illness* who has a strong epidemiological link to a confirmed case or defined cluster. Close contact Close contact is defined as having cared for, lived with, or had direct contact with respiratory secretions or bodily fluids of a probable or confirmed case. * Influenza-like illness: (i) history of fever, chills, and sweating or clinically documented fever ≥38 °C, plus (ii) cough or sore throat. Back to top Poster for practices and infection control video Poster for your practice, department or clinic Important notice to all patients (PDF, 76 KB) Infection control for primary healthcare practices in the pandemic influenza setting This video has been made to demonstrate infection control recommendations for primary health care practices in the event of pandemic influenza. View this video in the Pandemic influenza resources section - Infection Control for Primary Healthcare practices in the Pandemic Influenza setting Back to top Background information About Influenza A (H1N1) Transmission, incubation period, clinical findings, testing and infection, complications, high risk groups, flu jab (Word, 37 KB) Pandemic flu - A/H1N1 influenza virus: the basics This article on the BMJ (British Medical Journal) website the explains the basic science of the influenza virus. A/H1N1 influenza virus: the basics (www.bmj.com) Back to top Guidance documents Clinical guideline for infants and children This guidance provides clinical guidance for diagnosis and management of influenza in infants and children. Influenza presents in infancy and childhood as a wide variety of clinical syndromes. The diagnosis needs to be considered and if any suspicion of influenza exists, appropriate precautions taken to prevent spread. Clinical guideline for infants and children (PDF, 93 KB) Ethical values for a pandemic This guidance from the National Ethics Advisory Committee considers ethical issues in a pandemic and identifies shared values on which to base the process and content of our decisions. Getting Through Together offers guidance on health professionals’ responsibilities and health service prioritisation in situations of overwhelming demand. Getting Through Together: Ethical values for a pandemic (NEAC 2007 - www.neac.health.govt.nz) Guidance for clinicians on the management of pregnant women with suspected Pandemic Influenza A (H1N1) 09 in the ‘Manage it’ phase Pregnant women have a higher risk of severe disease than other women following infection with influenza, whether seasonal or pandemic influenza A H1N1 09. These guidelines provide recommendations for managing pregnant women presenting with an influenza-like illness (ILI). Guidance for clinicians on the management of pregnant women with suspected Pandemic Influenza A (H1N1) 09 in the ‘Manage it’ phase (Word, 44 KB) Guidance on the diagnosis and management of Pandemic (H1N1) 2009 in the Pandemic ‘Management’ phase This guidance updates guidance provided on 30 June 2009 and includes procedures for collecting nasopharyngeal samples and the use of antiviral medications. The current case definitions are appended. Guidance on the diagnosis and management of Pandemic (H1N1) 2009 in the Pandemic ‘Management’ phase, Version 3 (Word, 124 KB) Guidance for Public Health Services involved in managing influenza in residential institutions and day care centres This guidance provides important considerations, action points and infection control procedures for public health services when assisting high-risk institutions. Related information on personal protection measures for workers who need to be in the workplace due to the nature of their role and associated risk level is also provided. Guidance for Public Health Services Involved in Managing Influenza in Residential Institutions and Day Centres (Word, 40 KB) Personal Protection Measures grid (Word, 74 KB) Psychosocial impacts of quarantine This guidance note summarises the psychosocial issues that may arise for affected persons, health care and other front-line workers when using quarantine controls. Psychosocial Impacts of Quarantine and Interventions that may Help to Relieve Strain - Guidance Notes (Word, 128 KB) Tamiflu Tamiflu: Preparation of a pharmacy-compounded suspension (PDF, 39 KB) Back to top Research papers Rationing of Resources: Ethical Issues in Disasters and Epidemic Situations (PDF, 473 KB) Back to top Website feedback We welcome your feedback on this page. Page last updated: 25 September 2009

New Zealand Resources Guidelines for the health sector - in the Pandemic influenza section Pandemic resources - in the Pandemic influenza section Tamiflu information leaflet (medsafe.govt.nz) New Zealand Influenza Pandemic Action Plan 2006 Pandemic resources - in the Pandemic influenza section International Resources World Health Organization Centers for Disease Control The Lancet The Society for Healthcare Epidemiology of America Statement (PDF)