AUSTRALIA H1N1 CASES CONTINUE TO RAMP UP

UNCLAS SECTION 01 OF 02 CANBERRA 000531 SENSITIVE SIPDIS STATE FOR OES/IHB, AIAG FOR WINN E.O. 12958: N/A TAGS: TBIO KFLU AS SUBJECT: AUSTRALIA H1N1 CASES CONTINUE TO RAMP UP REF: CANBERRA 518 AND PREVIOUS ¶1. (U) This is an action request, see para 5. ¶2. (SBU) Summary: In per capita terms, Australia surpassed the U.S. for confirmed H1N1 infections on June 4-5. The rapid internal spread of the disease following a lengthy period with only a few, foreign-connected cases highlights the difficulty any country - even an island like Australia - faces in preventing an infectious disease from entering the country. The H1N1 outbreak has tested Australia's emerging infectious disease and pandemic response plans, and coordination between federal and state authorities has functioned but not prevented inter-state friction. Preparations to assess border measures and other steps taken initially to prevent transmission into Australia are underway, and a process identifying key gaps in federal and state capabilities is being set up. End Summary. CASE NUMBERS TAKE OFF -------------- ¶3. (SBU) Confirmed cases of H1N1 in Australia exploded between May 19 and June 5, going from ONE case in May to nearly 900 as of the latest reports. Australia's per capita infection rate now surpasses that of the U.S. The government of Victoria, which has 85% of Australia's confirmed cases so far, moved its response phase from "contain" to "modified sustain" on June 3, an admission that containing infections through quarantine and social distancing was no longer effective. Morbidity of the H1N1 strain in Australia has been mild, with no deaths reported to date and only five hospitalizations required. Australia is in the midst of the normal seasonal flu season, has expanded its testing and confirmation capacity, and has lost containment of flu clusters in several locations, all of which are contributing to the rapid growth in case numbers. A major vector in Victoria has been schools, where despite closing more than a dozen schools following detection of cases there, 62 percent of confirmed cases have emerged among school age children. Under their new modified sustain posture, all Victoria schools are reopening on June 5. ¶4. (SBU) According to Gary Lum, head of the HEALTH Emergency Management and Biosecurity Branch at the Department of HEALTH and Ageing (DOHA),and ONE of the leaders of DOHA's National Incident Room for H1N1, the government response to H1N1 is being modified as several jurisdictions currently at moderate levels of response move to a "sustain" level over the next several days. The massive expansion in case numbers, along with the low severity of the infections in Australia, means that quarantines, surveillance, and social distancing measures were being reassessed. The activation of border measures, detailed reporting, and surveillance had been largely successful in detecting the disease but voluntary and home quarantine measures undertaken by various states and territory HEALTH officials has not prevented the virus from breaking out. The federal and state governments have maintained a relatively soft touch throughout, with home quarantining and voluntary social distancing, which would change if the disease had proved to be more dangerous. COORDINATING A ROLLERCOASTER -------------- ¶5. (SBU) Lum said that the Federal Government, which has a coordinating role but few direct HEALTH assets,, has worked Qcoordinating role but few direct HEALTH assets,, has worked generally well with the state authorities who have the medical capacity to respond to an outbreak. Medicines and supplies to bolster state stockpiles were in place early on in the outbreak, and the national HEALTH coordinating bodies meet daily to coordinate actions. The imposition of quarantine and distancing measures has varied widely over different states and territories as they have experienced very different attack rates. Lum said that Australia's response is struggling around three different response levels simultaneously, which has complicated coordination efforts. In Victoria, schools are being reopened and quarantine measures lifted. At the same time, the Australian Capital Territory government ordered on June 5 that any school child returning from Victoria wait seven days before returning to school; now all Australian jurisdictions states have adopted CANBERRA 00000531 002 OF 002 that requirement. Federal authorities are currently examining whether to maintain existing border surveillance practices, Lum said, and there will be a face-to-face after action review process between federal and state authorities in the near future. DOHA's ongoing response posture remains unchanged, as there are considerations that "go beyond epidemiology" in maintaining a federal role in confronting the disease, Lum said. He expressed concern that there would likely be a next wave of outbreaks in the region, as new cases were still turning up in places like Singapore. NEED INFO ON U.S. TESTING GUIDANCE -------------- ¶6. (SBU) Action Request: Lum asked for detailed information on current USG guidance and policy on surveillance and testing for Novel H1N1 Influenza A. He said the perception in Australia was that HHS, CDC and states were rolling back their efforts on testing and surveillance as the specter of a very dangerous outbreak recedes. U.S. thinking on those issues would be very valuable, Lum said. We ask that OES/IHB pass on any information or details on changes to HHS/CDC domestic testing and surveillance recommendations over the past seven days. ¶7. (SBU) Comment: Australia failed to prevent the establishment of H1N1 on its shores, but has been spared fatalities and expensive hospitalizations so far. The value of many of the elements of the GOA's pandemic planning will be examined as the country adjusts to having H1N1 in its population and prepares for follow-on or new emerging disease outbreaks. End Comment. CLUNE