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As at 28 April 2009




Swine Influenza
 -   What is the swine influenza?
 -   What are the symptoms?
 -   How is it spread?
 -   What medications are available?
 -   Which countries are affected?
 -   What is the current situation in Australia?
 -   How to stay up to date?
 -   How to reduce the risk of spreading the virus in the workplace?
 -   We have a pandemic plan. What should we do now?
 -   We do not have a pandemic plan. What should we do now?
Pandemic Risk Update: Swine Influenza



 What is the       Swine influenza (swine flu) is a respiratory disease affecting pigs caused by type A
                   influenza. Outbreaks of swine flu are regular amongst pigs.
 swine
 influenza?        The risk of swine flu virus in humans is rare because it does not normally infect
                   humans. However, human infections can occur - the virus which has infected people
                   in Mexico, seems to be a hybrid form of human, bird and swine flu.
                   Like the seasonal flu, swine flu in humans can vary in severity from mild to severe to
                   fatal.
                   Swine flu is supposedly related to the Spanish flu - an influenza pandemic that in 1918
                   spread to nearly every part of the world, affected up to one billion people (half the
                   world's population at the time) and killed around 70 million people. Like the swine flu,
                   most of the Spanish flu victims were healthy young adults, in contrast to most
                   influenza outbreaks which predominantly affect juvenile, elderly, or otherwise
                   weakened patients.



 What are the      The symptoms of swine flu in people are similar to the symptoms of regular human
                   seasonal influenza and include fever, lethargy, body aches, headache, chills, lack of
 symptoms?
                   appetite and coughing.
                   Some people with the swine flu also report runny nose, sore throat, nausea, vomiting
                   and diarrhoea.



 How is it         Human-to-human transmission of swine flu occurs in the same way as seasonal flu
                   occurs in people, which is mainly person-to-person transmission through coughing or
 spread?
                   sneezing of people infected with the influenza virus.
                   People may also become infected by touching something with a flu virus on it and
                   then touching their mouth or nose.
                   Infected people may be able to infect others from 1 day before symptoms develop
                   and up to 7 or more days after becoming sick. This means that people can pass on the
                   flu to other before they know they are sick.
                   Swine influenza viruses are not spread by food. Eating properly handled and cooked
                   pork products is safe.



 What              The Australian seasonal influenza vaccine will not provide protection against this new
                   strain of influenza virus.
 medications
 are available?    In Australia, current information suggests that the antiviral drugs (Tamiflu and
                   Relenza) are useful against the swine influenza virus. These drugs are readily available
                   through pharmacists and can be prescribed by GPs.
                   Antiviral drugs are prescription medicines (pills, liquid or an inhaler) that fight against
                   the flu by keeping flu viruses from reproducing in your body. If people are sick,
                   antiviral drugs can make the illness milder and make them feel better faster. They may
                   also prevent serious flu complications.
                   For treatment, antiviral drugs work best if started soon after getting sick (within 2 days
                   of symptoms).



© InConsult 2009                                                                                        Page 1
Pandemic Risk Update: Swine Influenza



 Which             The World Health Organisation (WHO) has confirmed the quot;pandemic potentialquot;.
 countries are     The current WHO phase of the alert is Phase 4 - this indicates a significant increase in
 affected?         risk of a pandemic but does not necessarily mean that a pandemic is a forgone
                   conclusion. The next alert level, Phases 5-6 are Pandemic Phases.
                   Reported deaths (confirmed) as at 28 April 2009
                               MEXICO - 152 (26)
                   Major reported cases and (laboratory confirmed cases) at 28 April 2009:
                               MEXICO - 1,995 (172)
                               USA - 266 (50)
                               CANADA - 28 (6)
                               UK - 21 (2)
                               SPAIN - 32 (2)
                               NEW ZEALAND – 43 (3)
                               AUSTRALIA - 40




                   H1N1 Swine flu in 2009 as at 28 April 2009.
                   These numbers are constantly changing.
                   Source: Google Map.




© InConsult 2009                                                                                     Page 2
Pandemic Risk Update: Swine Influenza




 What is the       There are no ‘confirmed’ swine flu cases in Australia to date. The pandemic threat
                   level is still ‘MILD’ at this stage, but it is quickly evolving.
 current
 situation in      Virologist say the disease could be in Australia already and cases are expected.
 Australia?        If it’s not here already, there is a risk it may arrive soon. A delegation of Australian
                   politicians is currently in Mexico on trade talks.
                   Queensland is now ‘officially’ on pandemic alert. The two Queenslanders feared to
                   have picked up swine flu have been given the all-clear. More cases are being
                   investigated now.
                   Five people in NSW are now being tested for swine flu.
                   The key message from the Commonwealth Chief Medical Officer (CMO) is to “be alert,
                   but not be alarmed”.
                   The CMO has proposed tighter quarantine measures.
                   Medical staff are now on standby at all international airports.
                   Australia has thermal imaging technology that can detect high body temperatures
                   (indicating risk of flu), but the technology has not been installed and activated yet.
                   Australian hospital emergency departments and GP’s have been alerted.
                   Australia has a “surveillance system” in place.
                   Australia has a stock pile of 9 million doses of anti-viral medicines.
                   The Australian health department has been consulting with border agencies and
                   reviewing their preparedness.
                   Airports are on official alert and are aware of the situation.
                   Airlines are now required to report passengers or crew with flu-like symptoms for all
                   flights coming in from the Americas.



 How to stay       The Australian Government, Department of Health and Ageing (DoHA), is responsible
                   for managing an influenza pandemic in Australia. Their main strategy for a pandemic is
 up to date?
                   to contain the virus in the first instance and thereafter, maintenance of critical
                   infrastructure to support community services such as water, electricity, transport and
                   communications.
                   Swine Influenza Hotline 180 2007
                   Department of Health and Ageing           www.health.gov.au
                   Department of Foreign Affairs & Trade     www.smartraveller.gov.au
                   World Health Organisation (WHO)           www.who.int
                   Avian Influenza resource                  www.avianinfluenza.com.au
                   NSW State Health Department               www.health.nsw.gov.au
                   Centres for Disease Control               www.cdc.gov




© InConsult 2009                                                                                      Page 3
Pandemic Risk Update: Swine Influenza




 How to            It is important that employers start to communicate some simple practices to all staff
                   to help reduce the risk of catching and spreading the swine flu. The messages
 reduce the
                   communicated and actions implemented should be appropriate to the severity of the
 risk of           risk and phase/pandemic level declared at the time. Strategies could include:
 spreading the
                      Staying in good general health.
 virus in the
                      Getting plenty of sleep, more physical activity, managing stress, drinking plenty of
 workplace?
                      fluids and eating nutritious food. Vitamin supplements may help.
                      Keeping all surfaces regularly cleaned.
                      Avoid sharing phone handsets & mobiles.
                      When the risk increases, wear Personal Protective Equipment (PPE) e.g. gloves,
                      masks.
                      Avoiding contact with ill persons e.g. hand shakes, kissing.
                      Require ill persons to stay at home.
                      Covering your nose and mouth with a tissue when people cough or sneeze.
                      Throwing used tissues in the bin.
                      Washing your hands with soap and water, or using an alcohol-based hand gel after
                      coughing or sneezing.
                      Minimising international and interstate travel – especially to Mexico and USA.
                      Avoiding crowds and travel on mass transport systems whilst ill.
                      Seeking immediate medical care if people are severely ill (such as having trouble
                      breathing).
                      Taking prescribed antiviral medications for prevention and treatment.



 We have a            Review your current pandemic plan and ensure all response strategies and
                      appendices are updated.
 pandemic
 plan. What           Review procedures relating to:
 should we do              Communication
                           Infection Control
 now?
                           Social Distancing
                           Critical Business Functions
                           Alternate Workplace Arrangements
                      Ensure the various severity phases/scenarios and responses for each pandemic
                      phase are updated and remain appropriate.
                      Check the ‘use by’ dates on flu supplies and PPE.
                      Convene a meeting of the pandemic committee or equivalent to conduct a risk
                      assessment of the situation assessing likelihood and consequences.
                      Review planned controls and assess the need to put additional treatment
                      strategies in place.




© InConsult 2009                                                                                    Page 4
Pandemic Risk Update: Swine Influenza




 We do not         The response strategy and priorities will vary depending on the nature of your
                   industry, business activities, location, dependencies and stakeholders. Here are some
 have a
                   suggestions.
 Pandemic
                      Do not panic and do not try to put a pandemic response plan together in a week.
 plan. What
                      Assign additional resources to assess the situation and key impacts and
 should we do
                      dependencies on service levels, staffing, suppliers, building services, clients,
 now?
                      reputation, legal obligations, contract obligations, market share, economic impact,
                      revenue and cash flow.
                      Raise the pandemic issue at a senior management meeting to assess the potential
                      impact on critical business function of your business.
                      Establish your maximum tolerable service levels with a reduced workforce.
                      Consider how you will run your business with 30-50% less staff.
                      Convene the OH&S committee or equivalent for a situation assessment.
                      Conduct a risk assessment of the situation assessing likelihood and consequences.
                      Assess the need to put additional treatment strategies in place.
                      Assess the need to assign a dedicated co-ordinator.
                      Assess the need for specialist external support.
                      If deemed a “high risk”, consider convening a crisis committee meeting.
                      Take measures to reduce the risk of spreading the flu in the workplace.
                      Consider purchasing adequate supplies of tissues, masks, gloves, cleaning
                      products and anti-viral medication.
                      Prepare and distribute workplace pandemic handouts and install signage.
                      Review the succession plan. Ensure alternates are identified for key positions.
                      Assess the need to cross-train staff in key service areas and activities.
                      Assign a person/co-ordinator to continually monitor the situation.
                      Communicate the situation to staff and key stakeholders regularly. Suggested
                      topics:
                          The pandemic status.
                          The organisations preparations for staff should the influenza pandemic spread
                          including identified priority work arrangements.
                          Changes to work requirements.
                          How to protect themselves and family (hygiene, social distancing).
                          Recommend staff stay up to date with the latest news.
                          Limiting travel.
                          Counselling and other available support.




© InConsult 2009                                                                                    Page 5
Pandemic Risk Update: Swine Influenza




About InConsult
InConsult is a specialist risk management consulting firm that provides a comprehensive range of risk
management and business continuity solutions including pandemic preparedness assessment, training,
testing and planning.

Contact: Tony Harb
Address: L9, 255 George St
         SYDNEY NSW 2000
Tel:     +61 2 9241 1344
Email:   info@inconsult.com.au
Website: www.inconsult.com.au




Sources and references used
The New Killer Germs, Pete Moore BSc, PhD
World Health Organisation
Department of Health and Aging
Centers for Disease Control and Prevention
Google Map
The Australian
www.livenews.com.au
www.news.com.au
smh.com.au




© InConsult Pty Ltd 2009. All rights reserved. No part of this report can be reproduced without permission.

The information in this report is provided for general information purposes only and must not be relied upon as a
substitute for independent professional advice. Organisations should seek specialist medical advice in relation to the
virus and its symptoms. We have summarised critical information to make it easier for our clients to understand the
situation. Specialist professional advice should be sought in relation to any of the issues contained in this report. No
liability will be accepted for any losses incurred by any person relying on this document.




© InConsult 2009                                                                                                 Page 6

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Pandemic Risk Update Swine Influenza 28 April 2009

  • 1. As at 28 April 2009 Swine Influenza - What is the swine influenza? - What are the symptoms? - How is it spread? - What medications are available? - Which countries are affected? - What is the current situation in Australia? - How to stay up to date? - How to reduce the risk of spreading the virus in the workplace? - We have a pandemic plan. What should we do now? - We do not have a pandemic plan. What should we do now?
  • 2. Pandemic Risk Update: Swine Influenza What is the Swine influenza (swine flu) is a respiratory disease affecting pigs caused by type A influenza. Outbreaks of swine flu are regular amongst pigs. swine influenza? The risk of swine flu virus in humans is rare because it does not normally infect humans. However, human infections can occur - the virus which has infected people in Mexico, seems to be a hybrid form of human, bird and swine flu. Like the seasonal flu, swine flu in humans can vary in severity from mild to severe to fatal. Swine flu is supposedly related to the Spanish flu - an influenza pandemic that in 1918 spread to nearly every part of the world, affected up to one billion people (half the world's population at the time) and killed around 70 million people. Like the swine flu, most of the Spanish flu victims were healthy young adults, in contrast to most influenza outbreaks which predominantly affect juvenile, elderly, or otherwise weakened patients. What are the The symptoms of swine flu in people are similar to the symptoms of regular human seasonal influenza and include fever, lethargy, body aches, headache, chills, lack of symptoms? appetite and coughing. Some people with the swine flu also report runny nose, sore throat, nausea, vomiting and diarrhoea. How is it Human-to-human transmission of swine flu occurs in the same way as seasonal flu occurs in people, which is mainly person-to-person transmission through coughing or spread? sneezing of people infected with the influenza virus. People may also become infected by touching something with a flu virus on it and then touching their mouth or nose. Infected people may be able to infect others from 1 day before symptoms develop and up to 7 or more days after becoming sick. This means that people can pass on the flu to other before they know they are sick. Swine influenza viruses are not spread by food. Eating properly handled and cooked pork products is safe. What The Australian seasonal influenza vaccine will not provide protection against this new strain of influenza virus. medications are available? In Australia, current information suggests that the antiviral drugs (Tamiflu and Relenza) are useful against the swine influenza virus. These drugs are readily available through pharmacists and can be prescribed by GPs. Antiviral drugs are prescription medicines (pills, liquid or an inhaler) that fight against the flu by keeping flu viruses from reproducing in your body. If people are sick, antiviral drugs can make the illness milder and make them feel better faster. They may also prevent serious flu complications. For treatment, antiviral drugs work best if started soon after getting sick (within 2 days of symptoms). © InConsult 2009 Page 1
  • 3. Pandemic Risk Update: Swine Influenza Which The World Health Organisation (WHO) has confirmed the quot;pandemic potentialquot;. countries are The current WHO phase of the alert is Phase 4 - this indicates a significant increase in affected? risk of a pandemic but does not necessarily mean that a pandemic is a forgone conclusion. The next alert level, Phases 5-6 are Pandemic Phases. Reported deaths (confirmed) as at 28 April 2009 MEXICO - 152 (26) Major reported cases and (laboratory confirmed cases) at 28 April 2009: MEXICO - 1,995 (172) USA - 266 (50) CANADA - 28 (6) UK - 21 (2) SPAIN - 32 (2) NEW ZEALAND – 43 (3) AUSTRALIA - 40 H1N1 Swine flu in 2009 as at 28 April 2009. These numbers are constantly changing. Source: Google Map. © InConsult 2009 Page 2
  • 4. Pandemic Risk Update: Swine Influenza What is the There are no ‘confirmed’ swine flu cases in Australia to date. The pandemic threat level is still ‘MILD’ at this stage, but it is quickly evolving. current situation in Virologist say the disease could be in Australia already and cases are expected. Australia? If it’s not here already, there is a risk it may arrive soon. A delegation of Australian politicians is currently in Mexico on trade talks. Queensland is now ‘officially’ on pandemic alert. The two Queenslanders feared to have picked up swine flu have been given the all-clear. More cases are being investigated now. Five people in NSW are now being tested for swine flu. The key message from the Commonwealth Chief Medical Officer (CMO) is to “be alert, but not be alarmed”. The CMO has proposed tighter quarantine measures. Medical staff are now on standby at all international airports. Australia has thermal imaging technology that can detect high body temperatures (indicating risk of flu), but the technology has not been installed and activated yet. Australian hospital emergency departments and GP’s have been alerted. Australia has a “surveillance system” in place. Australia has a stock pile of 9 million doses of anti-viral medicines. The Australian health department has been consulting with border agencies and reviewing their preparedness. Airports are on official alert and are aware of the situation. Airlines are now required to report passengers or crew with flu-like symptoms for all flights coming in from the Americas. How to stay The Australian Government, Department of Health and Ageing (DoHA), is responsible for managing an influenza pandemic in Australia. Their main strategy for a pandemic is up to date? to contain the virus in the first instance and thereafter, maintenance of critical infrastructure to support community services such as water, electricity, transport and communications. Swine Influenza Hotline 180 2007 Department of Health and Ageing www.health.gov.au Department of Foreign Affairs & Trade www.smartraveller.gov.au World Health Organisation (WHO) www.who.int Avian Influenza resource www.avianinfluenza.com.au NSW State Health Department www.health.nsw.gov.au Centres for Disease Control www.cdc.gov © InConsult 2009 Page 3
  • 5. Pandemic Risk Update: Swine Influenza How to It is important that employers start to communicate some simple practices to all staff to help reduce the risk of catching and spreading the swine flu. The messages reduce the communicated and actions implemented should be appropriate to the severity of the risk of risk and phase/pandemic level declared at the time. Strategies could include: spreading the Staying in good general health. virus in the Getting plenty of sleep, more physical activity, managing stress, drinking plenty of workplace? fluids and eating nutritious food. Vitamin supplements may help. Keeping all surfaces regularly cleaned. Avoid sharing phone handsets & mobiles. When the risk increases, wear Personal Protective Equipment (PPE) e.g. gloves, masks. Avoiding contact with ill persons e.g. hand shakes, kissing. Require ill persons to stay at home. Covering your nose and mouth with a tissue when people cough or sneeze. Throwing used tissues in the bin. Washing your hands with soap and water, or using an alcohol-based hand gel after coughing or sneezing. Minimising international and interstate travel – especially to Mexico and USA. Avoiding crowds and travel on mass transport systems whilst ill. Seeking immediate medical care if people are severely ill (such as having trouble breathing). Taking prescribed antiviral medications for prevention and treatment. We have a Review your current pandemic plan and ensure all response strategies and appendices are updated. pandemic plan. What Review procedures relating to: should we do Communication Infection Control now? Social Distancing Critical Business Functions Alternate Workplace Arrangements Ensure the various severity phases/scenarios and responses for each pandemic phase are updated and remain appropriate. Check the ‘use by’ dates on flu supplies and PPE. Convene a meeting of the pandemic committee or equivalent to conduct a risk assessment of the situation assessing likelihood and consequences. Review planned controls and assess the need to put additional treatment strategies in place. © InConsult 2009 Page 4
  • 6. Pandemic Risk Update: Swine Influenza We do not The response strategy and priorities will vary depending on the nature of your industry, business activities, location, dependencies and stakeholders. Here are some have a suggestions. Pandemic Do not panic and do not try to put a pandemic response plan together in a week. plan. What Assign additional resources to assess the situation and key impacts and should we do dependencies on service levels, staffing, suppliers, building services, clients, now? reputation, legal obligations, contract obligations, market share, economic impact, revenue and cash flow. Raise the pandemic issue at a senior management meeting to assess the potential impact on critical business function of your business. Establish your maximum tolerable service levels with a reduced workforce. Consider how you will run your business with 30-50% less staff. Convene the OH&S committee or equivalent for a situation assessment. Conduct a risk assessment of the situation assessing likelihood and consequences. Assess the need to put additional treatment strategies in place. Assess the need to assign a dedicated co-ordinator. Assess the need for specialist external support. If deemed a “high risk”, consider convening a crisis committee meeting. Take measures to reduce the risk of spreading the flu in the workplace. Consider purchasing adequate supplies of tissues, masks, gloves, cleaning products and anti-viral medication. Prepare and distribute workplace pandemic handouts and install signage. Review the succession plan. Ensure alternates are identified for key positions. Assess the need to cross-train staff in key service areas and activities. Assign a person/co-ordinator to continually monitor the situation. Communicate the situation to staff and key stakeholders regularly. Suggested topics: The pandemic status. The organisations preparations for staff should the influenza pandemic spread including identified priority work arrangements. Changes to work requirements. How to protect themselves and family (hygiene, social distancing). Recommend staff stay up to date with the latest news. Limiting travel. Counselling and other available support. © InConsult 2009 Page 5
  • 7. Pandemic Risk Update: Swine Influenza About InConsult InConsult is a specialist risk management consulting firm that provides a comprehensive range of risk management and business continuity solutions including pandemic preparedness assessment, training, testing and planning. Contact: Tony Harb Address: L9, 255 George St SYDNEY NSW 2000 Tel: +61 2 9241 1344 Email: info@inconsult.com.au Website: www.inconsult.com.au Sources and references used The New Killer Germs, Pete Moore BSc, PhD World Health Organisation Department of Health and Aging Centers for Disease Control and Prevention Google Map The Australian www.livenews.com.au www.news.com.au smh.com.au © InConsult Pty Ltd 2009. All rights reserved. No part of this report can be reproduced without permission. The information in this report is provided for general information purposes only and must not be relied upon as a substitute for independent professional advice. Organisations should seek specialist medical advice in relation to the virus and its symptoms. We have summarised critical information to make it easier for our clients to understand the situation. Specialist professional advice should be sought in relation to any of the issues contained in this report. No liability will be accepted for any losses incurred by any person relying on this document. © InConsult 2009 Page 6