Background to XFG

The following situation reports detail the hypothetical global pandemic influenza spread in the days leading up to Exercise Forrest Gump in the Hunter New England Health region. Please note, these situation reports are for exercise purposes only and are not real.

Pandemic Influenza Situation Report 1
As at 14h00 on 20 September 2008
Global Pandemic Alert Phase 5
Australian Pandemic Phase Overseas 5
WHO reports 15 further confirmed H5N1 cases in Jenesia, including an intensive care nurse and emergency department doctor, working at President Cobala Nemesis Hospital in Helix, the capital of Jenesia. H5N1 confirmed in specimens from poultry in the affected Jenesian village. Further genetic characterisation of human and avian H5N1 virus is currently being conducted by the CDC Atlanta and Tokyo WHO Influenza Reference Laboratories.
WHO is also investigating 8 cases of influenza-like illness amongst “fly-in/fly-out” technical mining staff in Gumpland, a country close to Jenesia. These staff work at the Jenesian mine where H5N1 influenza has been confirmed in humans.
Japanese (1 tourist), French (1 tourist) and German (2 mining contractors) health authorities have confirmed H5N1 to WHO in returning nationals from Jenesia.
Two Australian mine workers that returned to Perth early morning on 20 September 2008 on a flight from Jenesia have been confirmed positive for H5N1 and have been admitted in isolation in a Perth Hospital. Victorian health authorities are awaiting H5N1 PCR results for an Australian tourist who
returned from Jenesia with influenza-like illness and who is currently admitted, in isolation, in a Melbourne hospital.
State and Territory Health Departments are assisting the Commonwealth in contacting passengers that were in close contact on-board the two flights.
No evidence of local transmission in Australia. However, all Divisions of General Practice have been faxed at 12h00 today to urgently contact their GPs to alert them to the change in Pandemic Phase, and to inform them to:
- heighten awareness for influenza like illness in travellers returning from overseas (updates of affected areas will be posted on the Commonwealth website below),
- ensure that appropriate infection control precautions are in place for all patients presenting with influenza-like illness,
- contact local Public Health units if patients meeting the case definition present to practices.

Avian Influenza Situation Report 782
As at 18h00 on 19 September 2008
NOTE CHANGE IN AUSTRALIAN PHASE
Global Pandemic Alert Phase 5
Australian Pandemic Phase Overseas 5
The Chief Medical Officer confirms that the Expert Advisory Group (NIPAC and CDNA) review of available data, provides convincing evidence of a large cluster of human-to-human transmission in Jenesia. He has declared a change in Phase to Overseas Phase 5. An urgent meeting of the Australian Health Disaster Management Policy Committee was convened to recommend actions to the Prime Minister and Cabinet.

Measures to be implemented by DFAT, AQIS, State and Territory Chief Health Officers within 12 hours i.e. by 06h00 on 20 September 2008:

• No travel to Australia from Jenesia, with the exception of Australians returning home.
• Positive ‘pratique’ on all inbound flights.
• Health declaration cards for travellers, asking whether they have been in contact with people with influenza or have symptoms of influenza.
• Border thermal screening to determine whether a disembarking passenger from Jenesia has a fever; and deploy nurses to assess and assist people who have flu-like symptoms.
• Transfer of arriving travellers from Jenesia with flu-like symptoms to a hospital or other health-care service for further assessment.
• Effective infection control for border screening nurses, assisting AQIS officers and any other at risk border workers, including the use of personal protective equipment.
• Antiviral medicines will be provided for people exposed to the virus or at continuous high risk of exposure at international borders.
The Chief Medical Officer confirms that Australia is well prepared for this emergency.

Avian Influenza Situation Report 781
As at 14h00 on 19 September 2008
NOTE CHANGE IN WHO PHASE
Global Pandemic Alert Phase 5
Australian Pandemic Phase Overseas 3
WHO Reference Laboratory in Gumpland has confirmed Influenza A H5N1 in specimens from deceased Canadian Engineer and four indigenous Jenesian miners.
Epidemiological investigations provide evidence of human-to-human transmission amongst miners, many of whom report no contact with sick or dead chickens. Also evidence of transmission between individuals with close social but non-household contact. Further epidemiological investigations are underway; 120 human cases meeting case definition in mining compound and adjoining village.
General alert to all member countries – pandemic containment plans activated. Australia remains on Australia Pandemic Phase Overseas 3.
Chief Medical Officer advises Expert Advisory Group (NIPAC and CDNA) currently reviewing available WHO data to determine implications for Australia.

Avian Influenza Situation Report 780
As at 1400h on 18 September 2008
Global Pandemic Alert Phase 3
Australian Pandemic Phase Overseas 3
No new confirmed cases of avian influenza. Last reported human case confirmed from Inkinesio on 16 July 2008.
WHO reports: A WHO field team has been mobilised to Jenesia. Report influenza-like illness widespread in mining compound and a neighbouring village. A small number of villagers (numbers to be confirmed) have succumbed and there have been admissions of a number of individuals with influenza-like illness to President Cobala Nemesis Hospital in Helix, the capital of Jenesia.
Large-scale poultry deaths in affected village, but there have been unusually high summer temperatures. There are reports amongst ill miners of no contact with dead or ill poultry. Human and poultry specimens have been shipped to Regional Influenza Reference Laboratory in Gumpland. No results yet available.

Avian Influenza Situation Report 779
As at 1400h on 17 September 2008
Global Pandemic Alert Phase 3
Australian Pandemic Phase Overseas 3
No new confirmed cases of avian influenza.
Last reported human case confirmed from Inkinesio on 16 July 2008.
WHO reports: GOARN surveillance partner, International SOS, in Jenesia (small Asian country) reports suspicious death in an expatriate previously healthy 50yr old Canadian Engineer working on a mine in Jenesia. Rapid Ag test - influenza A positive.
International SOS reports widespread respiratory illness amongst the mining workforce, local and expatriate. Respiratory specimens have been sent to the Regional Influenza Reference Laboratory in nearby Gumpland.