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More needs to be done to guard against avian flu pandemic - Ó Caoláin

13 October, 2005

News that the avian flu virus has reached Turkey should prompt accelerated action by the Irish Government, according to Sinn Féin Health and Children spokesperson Caoimhghin Ó Caoláin. He stated:

"News that the avian flu virus H5N1 has reached Turkey should prompt the Irish Government to accelerate the measures being undertaken to address the threat of a pandemic if this virus is transferred to humans. I put down a Dáil Question to the Tánaiste and Minister for Health and Children Mary Harney TD on this issue to which she replied on 28 September.

"The Minister stated that treatment packs of antiviral drugs had been ordered but that packs to cover only 15% of the population would be delivered by the end of 2005. The remaining supplies, bringing the total cover to 25% of the population, are not due to arrive until an unspecified date next year.

"Given the proximity of avian flu to Europe the Minister needs to mandate the Health Protection Surveillance Centre and the Influenza Pandemic Expert Group to accelerate their efforts, with an additional allocation of resources coming from the Department as necessary." ENDS

Dáil Question and reply

* To ask the Tánaiste and Minister for Health and Children the action she has taken since Dáil Éireann rose for the 2005 summer recess to address the threatened avian flu pandemic; if further stocks of medicines to combat the threat have been ordered; when stocks already ordered will come on stream; and if she will make a statement on the matter.

- Caoimhghín Ó Caoláin

For WRITTEN answer on Wednesday, 28th September, 2005. Pandemic influenza is a type of influenza that can be expected to occur, on average, three or four times each century when new virus subtypes emerge and are readily transmitted from person to person. Influenza experts agree that another influenza pandemic will occur; however, it is impossible to predict when it will occur. The ongoing outbreaks of avian influenza in Asia highlight the need for vigilance and preparedness.

The greatest concern for human health is that the avian influenza (H5N1) virus will remain endemic in Asia and that continued transmission of the virus to humans and other animals will provide opportunities for human and avian viruses to exchange genes (reassortment) to produce a virus that can replicate in humans, is highly pathogenic and is easily transmissible between humans. In a human population with no pre-existing immunity, such a virus could trigger a global influenza pandemic. However, there is currently no evidence of sustained person-to-person transmission of avian influenza.

The Health Protection Surveillance Centre (HPSC) plays a key role in relation to the prevention and management of infectious diseases, including influenza, in this country. The Irish approach to infectious diseases outbreaks is based on sound internationally accepted principles such as:

  • preventative measures
  • early identification of cases
  • effective clinical care including good hospital infection control
  • appropriate surveillance
  • contact tracing and management of contacts.

The HPSC monitors the avian influenza situation in Asia on an ongoing basis through the World Health Organisation. There are no restrictions on travel to any country currently experiencing outbreaks of H5N1 avian infection in poultry flocks, including countries which have also reported cases in humans. However, in line with advice from WHO, it is recommended that Irish travellers to areas experiencing outbreaks of H5N1 avian influenza infection should avoid contact with live animal markets and poultry farms.

In addition, the following actions have been undertaken:

  • Interim Irish Guidelines on the Investigation and Management of Suspected Human Cases of Avian Influenza (Influenza A/H5) have been circulated to all healthcare professionals and are also posted on the HPSC website.
  • A clinical management algorithm has been circulated to hospitals and clinicians on the appropriate management of travellers returning from countries affected by avian influenza presenting with fever and respiratory symptoms. This will assist in early detection of any influenza A/H5 cases.

The overall aims of pandemic influenza preparedness planning are to reduce morbidity and mortality, and to minimise the resulting disruption to society. However, the consequences of a global pandemic are still likely to be serious. Pandemic planning can only mitigate the effects.

Ireland's first influenza pandemic preparedness plan was finalised in 2002. The Influenza Pandemic Expert Group is currently reviewing and updating the expert guidance on pandemic preparedness and response. A generic public health emergency plan was prepared in 2004 to facilitate health service providers in developing and reviewing their plans for public health emergencies. The Health Service Executive is now developing and implementing a National Operational Plan for the Health Services in the event of an influenza pandemic.

The main treatment for pandemic influenza is antiviral drugs. Antivirals can shorten the duration of the disease and alleviate symptoms. Arrangements have already been made to purchase 1 million treatment packs of antivirals (Tamiflu). This quantity is sufficient to treat 25% of the population and is in line with international trends. 600,000 packs will be delivered by the end of this year - this is sufficient to treat 15% of the population. The remaining 400,000 packs will be delivered next year.

Vaccination is the principal measure for preventing influenza and reducing the impact of epidemics. It will be the primary public health intervention in the event of an influenza pandemic. However, the production of a vaccine tailored to a pandemic influenza strain could take six to nine months.

Developments are taking place at international level seeking to expedite the pandemic vaccine production process. A vaccine is in development which could offer some protection against an H5N1 flu strain. International experts consider that a stockpile of H5N1 vaccine could be used as a first line of defence for priority groups, such as healthcare staff, while a vaccine against the exact pandemic influenza strain is manufactured.

In August I accepted a recommendation from the Influenza Pandemic Expert Group that a limited amount of H5N1 vaccine should be purchased. This stockpile will be reserved for key workers in essential services. My Department is actively pursuing this matter.

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