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Experts fear swine flu could be the one -

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Experts fear swine flu could be the one

The World Today - Monday, 27 April , 2009 12:10:00

Reporter: Peter Cave

PETER CAVE: Well, as you've just heard, one of Australia's leading experts on the spread of
diseases believes the current outbreak of swine flu could be the pandemic that the world has been
getting ready for and dreading since a SARS pandemic failed to eventuate six years ago.

Bird flu had the potential, but so far it's largely only afflicted those with direct contact with
infected birds.

Now, a worrying new form of influenza from pigs may have jumped the species barrier in Mexico. More
than 80 people have died there and it's suspected that the disease may have spread to the United
States and perhaps half a dozen other countries.

Ten New Zealand students who recently visited Mexico have been quarantined, after developing
flu-like symptoms. Tests are being carried out in Melbourne to confirm if they do indeed have swine
flu.

In a moment we'll take a look at what the Australian authorities are doing here.

Professor Paul Kelly is an infectious diseases expert from the National Centre for Epidemiology and
Population Health at the ANU.

He was on a teaching trip to New Zealand he was drafted in to help local authorities.

I asked him if the New Zealand students definitely had the disease.

PAUL KELLY: They have tested positive for flu, but the actual definitive diagnosis is pending at
this stage.

PETER CAVE: How long will that take?

PAUL KELLY: At least another couple of days before, before the the actual result will be available.

PETER CAVE: How serious a situation is it for New Zealand and, I guess, for Australia?

PAUL KELLY: This issue of swine flu - it appears to be a new virus.

Influenza, of course, we have influenza seasons, usually in the winter months in the northern and
southern hemispheres. So at the moment, it's the flu season in the northern hemisphere.

There's various types of flu; A and B are the two major components there. And within the A strain
there is a number of sub strains, if you like, of influenza.

Now, this appears to be a new strain which appears to also be circulating from, spreading from
human to human, and that is a very concerning thing.

And certainly in Mexico, there have been a number of deaths. The last report I saw was 82 deaths
and over 1000 people have been made sick by this particular strain.

PETER CAVE: Is what we're seeing in the United States and what we're seeing in Mexico the same
thing?

PAUL KELLY: It appears that way, yes. There's been a number of cases - as of yesterday, 20 cases
have been confirmed by the laboratory testing in the United States in several states.

There's also possibly reports from other countries, including these 10 possible cases - I should
say possible cases at the moment - in Auckland.

PETER CAVE: What do you think has happened? Do you think that this swine flu from pigs has combined
with a human strain?

Or is that taking it too far at this stage?

PAUL KELLY: That appears to be the case. Of course it's all very early state - it's an early state
in this potential epidemic at the moment.

What appears to have happened though is what we've been concerned about for a number of years, of
different strains of flu from different animals combining, and causing, and transferring into a flu
strain that is transmissible between humans.

PETER CAVE: Is this as serious as the avian influenza threat?

PAUL KELLY: Well, avian influenza we've been concerned about for about 12 years, as the first cases
came on, and we've been very much in preparation mode for that particular strain transferring into
humans.

And there has been limited - to a limited extent that has happened in Indonesia and other places.
But it's never been on the sort of scale as this. And this is actually really more worrying.

PETER CAVE: Why exactly is it more worrying?

PAUL KELLY: Well, it doesn't seem to have as much, as high a fatality rate as the avian influenza,
but it does seem to be able to more easily spread, and rather rapidly.

PETER CAVE: Why is it a bad thing that it doesn't have the same fatality rate?

PAUL KELLY: Well, of course for people that die of it, that's a terrible thing.

But in terms of an epidemic, for the virus to be able to spread, it's actually better for the virus
for humans to remain alive, because they can actually spread it more quickly and more, to a greater
extent geographically.

PETER CAVE: Swine flu has been regarded as a fairly mild disease in the past. Has it changed?

PAUL KELLY: That remains to be seen for this particular strain.

The death rate is rather high in Mexico; at the moment there's been no deaths, as far as I know,
anywhere else.

PETER CAVE: A couple of years ago, when there were deep concerns about avian influenza, there
wasn't enough Tamiflu, there wasn't enough Relenza.

Are stocks sufficient to deal with this? And does it indeed - are Tamiflu and Relenza the drugs of
choice to treat swine flu?

PAUL KELLY: Well, so far the information out of the United States says that this particular strain
is sensitive to Tamiflu or Relenza; both of them in fact. So that's good news.

Vaccination is another plank in our response and preparedness for this sort of event. As far as we
know, the vaccine that is currently available is not suitable for protection against this strain.

PETER CAVE: So is the advice for people to go and get the flu shot as normal?

PAUL KELLY: Absolutely. Coming up to our influenza season which will be starting soon, in our
winter months in Australia and New Zealand, definitely vaccination is recommended, particularly
people with underlying illness.

PETER CAVE: Vaccination was also recommended in the case of bird flu, because there was the
possibility of the bird flu combining with another flu, and therefore it was a good idea to have
more people vaccinated. Is that still the case for swine flu?

PAUL KELLY: Yes. I mean, we would expect that we will have influenza in Australia this flu season
as normal. Whether that happens to be some of those cases being this new strain or not, it's too
early to tell.

But for the moment yes, vaccination is still recommended.

PETER CAVE: Who is at the greatest risk?

PAUL KELLY: Well, that's an interesting thing. So far, out of what we have from other parts of the
world, it's not the typical people that are at greatest risk during a normal flu season.

So, a lot of the people that have been, that have died from this illness in Mexico, for example,
have been young, otherwise fit people.

PETER CAVE: Why is that? It was much the same with bird flu, I seem to remember.

PAUL KELLY: That's right, and it's one of the typical things one looks for when a new strain hits
the human population.

And so, when we look back to the major pandemics of the 20th century, particularly the 1918-19 flu,
that was the case. It was predominantly young people that were badly affected, and many of them
died.

PETER CAVE: Young healthy people.

PAUL KELLY: Yes.

PETER CAVE: What works to protect yourself against influenza? Masks, washing your hands, staying
away from crowded areas? What are the best things to do?

PAUL KELLY: Well, all of those things have been enacted and are helpful. But at this stage I think,
you know, within Australia, there's no need to panic or to consider major public health messages
like that - at the moment.

But the normal thing would be reducing your role in spreading respiratory infections, which as you
said, washing your hands, staying at home if you're ill, seeking medical advice if you're required,
staying away from other people that are sick, and so on.

And that's the sort of thing that's happening in New Zealand at the moment in relation to those
cases in Auckland.

PETER CAVE: Infectious diseases expert, Professor Paul Kelly, speaking to me earlier.