Influenza: Don’t get it, don’t give it

Influenza is caused by different strains of influenza viruses. Around one in four New Zealanders are infected with influenza or ‘flu’ each year. Influenza can be anywhere, and is highly contagious.

Influenza is more than just a ‘bad cold’ – it is a serious illness that can put anyone in hospital or even kill them, including young and healthy people. Symptoms may vary with age, immune status and health of the individual and include fever, sore throat, muscle aches, headache, cough, fatigue and generally feeling miserable. The fever and body aches can last for up to 5 days, and the cough and fatigue may last for two or more weeks.

You may have influenza and not feel unwell – but you can still pass it on and make other people very sick. It is important you do not pass the flu onto those who are particularly vulnerable.You can reduce the spread of influenza by:

• covering your mouth and nose when you sneeze or cough; and
• washing and drying your hands often.

Stay at home from work, school or preschool if you have the flu so that you don’t spread it to others. Even a mild case of influenza can disrupt your everyday activities with family, friends, community and work.

Pregnant women and their babies can suffer serious consequences as a result of influenza.

Older people and those with certain medical conditions are also more likely to be affected by the flu. This is because influenza can make an existing medical condition worse (including asthma and diabetes), or increase the risk of complications such as pneumonia heart failure, and worsening asthma.

Influenza vaccination is FREE for those who need it most

Immunisation is the best protection against influenza. Your symptoms are less likely to be severe if you still catch influenza after being immunised.

Get immunised to stop the spread of influenza around your community. Even if you don’t feel sick, you could still be infected with influenza and pass it on to others.

Getting immunised each year as early as possible before winter hits gives the best protection, and protection can last until the next year.

You need to get the flu vaccine each year as protection from the previous vaccination lessens over time, and the flu strains in the vaccine often change each year. Over a million New Zealanders get the annual immunisation against influenza.

The influenza vaccine is safe, effective and cannot give you “the flu”.

The seasonal influenza vaccine is FREE for the following eligible people from Monday 1st April 2019:

1. Pregnant women – at any stage or trimester in the pregnancy
2. Anyone aged 65 years or over
3. Children aged from 6 months to four years who have had a stay in hospital for asthma or other breathing problems or have a history of significant respiratory illness.
4. Anyone under 65 years with one or more of the following medical conditions:
   • Cardiovascular or cerebrovascular disease
   • Chronic respiratory diseases
   • Diabetes
   • Cancer, excluding basal and squamous skin cancers if not invasive
   • Other conditions (such as chronic renal disease, autoimmune diseases, transplant recipients, neuromuscular and central nervous systems diseases, and haemoglobinopathies).

You can still get the influenza vaccine from your general practice or local pharmacy for a small cost if you are not eligible for a free vaccine.

• Visit the Fight the Flu website for more information.

Resources to help after the Christchurch incident

Here are some messages from the All Right? campaign after the distressing and shocking events in Christchurch last week.

Normalising our reactions

• A lot of us are feeling on edge and upset right now – this is a completely normal reaction.
• Disasters and big shocks take a toll on all of us and coping is not always easy.
• During scary or surprising events, our brains react by releasing adrenaline. This response is our natural alarm system – our body telling us to be alert and ready for action. It’s there to help us, but afterwards we can feel shaky, queasy or on-edge, and that’s totally normal.

Looking after ourselves and each other

There are small things we can do to look after ourselves and others, even when times are tough:

• Be kind to one another. Kindness is contagious, and boosts endorphins.
• Take a digital detox, and focus on an activity you love. Reading, games with the kids, or a short walk.
• Spend time with people you love – we all need each other. Talk about how your feeling.
• Focus on the things you can control.

Supporting our kids and whānau

• Children take their cues of parents — so if you’re okay, they’ll be okay too.
• Be mindful how much ‘worry’ you’re displaying, just be as cool as you can!
• Keep children away from the media.
• Answer their questions pretty matter of factly and in very ‘general’ terms. Drama it down. You don’t have to get the answers exactly right here. Ensure you talk too about the police and how they did a really good job of keeping us safe. Keep the reassurance low key too — over-reassuring can make us think we need to be worrying more than we are!
• Let them talk about it, but don’t let it ‘take over’ – use distraction to keep their mind off it – we’ve got the board games out!
• Stick to your normal routines as much as you can.

For parents of teens…

• Try and keep them off or away from the social media as much as you can, but it’s okay if they need to have it on tap right now – it can be a great way for them to be checking in with friends and supporting each other.
• Let them know there’s a lot of hype out there.
• Say that you’re sticking with credible sources of information as they report only the things released by the police and people actually ‘in the know’. If they are really affected by this ‘hype’ tell them it’s time to put the phone down or away. Keep the reassurance low key too.

Support is available

• Traumatic events affect each of us differently, and we all need a bit of support from time-to-time.
• There is free help available if you or someone you know is struggling. Free call or text 1737 any time, 24 hours a day. You can also call Lifeline on 0800 543354 or text HELP to 4357.
• The Ministry of Health website also has resources to assist those experiencing mental distress.

Information for schools

• Sparklers has wellbeing activities promote kindness, friendships and strengths in a classroom setting.
• The Sparklers website also has activities that focus on understanding emotions and managing worries.

Source: All Right campaign messages (16th March 2019) and Ministry of Health media release (17th March 2019).

Cases of measles confirmed in the Canterbury region

Cases of measles have been confirmed in Canterbury.

• Download a frequently asked questions sheet on measles [158KB] – updated 29 March 2019
• Download an information sheet on measles for Canterbury mums and babies [116KB] – updated 29  March 2019
• Download an information sheet on measles for Canterbury schools and early childhood centres [90KB] – updated 29 March 2019
• Download an information sheet on measles for Canterbury workplaces [79KB] – updated 29th March 2019

Investigations by Community and Public Health are ongoing, including contact tracing in relation to new cases and prophylactic treatment and/or isolation for anyone thought to have been exposed, but not fully immune.

Unimmunised people who come within 2 metres of an infectious person – however briefly – have a 90 percent chance of contracting measles.

Measles is a serious, highly infectious, potentially life-threatening disease. It is spread easily through tiny droplets in a cough or sneeze. One in ten people who get measles will need treatment in hospital. Up to 30 percent will develop complications – usually children under 5 and adults over the age of 20. Measles during pregnancy increases the risk of miscarriage, premature labour and low birth-weight in babies.

Unimmunised people exposed to measles first develop a respiratory type illness with dry cough, runny nose, temperature over 38.5°C and feel very unwell. The rash starts on day 4 or 5 of the illness – usually on the face and then it moves down to the chest and arms.

Some of the confirmed cases are children under 5 years. Canterbury Medical Officer of Health Dr Ramon Pink says this highlights the need for younger members of our community to have their scheduled vaccinations on time, and their whānau need to be fully immunised as well. “The measles, mumps, rubella (MMR) vaccine protects against measles, and should be received at 15 months and four years of age according to the Ministry of Health’s national immunisation schedule” says Dr Pink.

Babies whose mother is immune will have some protection if they are currently being breastfed. The best way to protect children who are too young to have had both MMRs or who cannot be immunised for other reasons is to ensure everyone around them has been vaccinated – if you can’t get it, you can’t pass it on.

“Immunisation is the only sure way to avoid getting measles as there is no cure,” says Dr Pink “This is why it’s vital that you protect yourself and those around you by making sure you have had two doses of the MMR vaccine, without delay.”

People are considered fully protected against measles if they:

• have received two doses of measles, mumps, rubella (MMR) vaccine; or
• were born before 1969.

“Those aged between 29 and 50 will only have had one measles vaccination and are not considered immune.” says Dr Pink.

People born overseas who are unsure which vaccinations they might have had, should contact their general practice team for advice. The measles vaccine and the appointment to have it is free to all those who are eligible for funded healthcare in New Zealand.

For more information on measles please go to www.immune.org.nz

What you need to know if you think you may have measles

Canterbury DHB Medical Officer of Health Dr Ramon Pink advises that people are infectious from five days before the onset of the rash until five days after the rash appears.

People should stay in isolation from the time that they may have become infected until five days after the rash first appears. “This means staying home from school or work and having no contact with unimmunised people. Others in your household who are unimmunised also need to stay in isolation too.”

Anyone who thinks they have been exposed to measles or are exhibiting symptoms should not go to the Emergency Department, after hours’ clinic or their general practice. Instead call your GP any time 24/7 for free health advice – to limit further exposure to other people. A nurse will answer a call to your general practice team after hours and will advise you on what to do and where to go if you need to be seen.

• Get more information about measles on the Ministry of Health website.
• Find out more about the MMR vaccination on the Immunisation Advisory Centre website.
• Download an information sheet if you are a contact of a person infected with measles.

Key information about measles including signs and symptoms

• Measles is a highly infectious viral illness spread by contact with respiratory secretions through coughing and sneezing.
• Symptoms of measles include:
  • A respiratory type of illness with dry cough, runny nose, and headache;
  • Temperature over 38.5ºC and feeling very unwell; and
  • A red blotchy rash starts on day 4 or 5 of the illness usually on the face and moves to the chest and arms.
• People are infectious from five days before the onset of the rash to five days after the rash starts.
• Infected persons should stay in isolation – staying home from school or work – during this time.
• The best protection from measles is to have two MMR vaccinations. MMR is available from your family practice and is free to eligible persons.
• People are considered immune if they have received two doses of MMR vaccine, have had a measles illness previously, or were born before 1969.
• Anyone believing they have been exposed to measles or exhibiting symptoms should not go to the Emergency Department, after hours’ clinic or general practitioner. Instead call your GP any time 24/7 for free health advice.

Source: Canterbury District Health Board media releases (26th February to 19th March 2019).

Check for health warnings before going near waterways

Recreational water users are being reminded to avoid contact with some Canterbury and South Canterbury waterways.

“Many of these waterways have been in bloom for some time now and will continue to be so with the warm weather we have been experiencing” says Canterbury Medical Officer of Health Dr Alistair Humphrey.

• Find out about current potentially toxic algae warnings in Canterbury and South Canterbury.
• Visit the Environment Canterbury website for more information on swimming quality in the region.
• Contact your local Community and Public Health office for more information on current health warnings.

Harmful effects of toxic algae on humans and animals

Algal blooms can produce toxins harmful to humans and animals. People should avoid contact with the water where algal blooms are present until further notice.

Dr Humphrey. says people who come into contact with toxic algae can also experience unpleasant symptoms. “Exposure may cause skin rashes, nausea, stomach cramps, tingling and numbness around the mouth and fingertips. Visit your doctor immediately if you experience any of these symptoms and please let your doctor know if you have had contact with these waterways,” says Dr Humphrey.

Animals that show signs of illness after coming into contact with toxic algae should be taken to a vet immediately. “Symptoms of cyanobacteria poisoning in dogs include panting, lethargy, muscle tremors, twitching and convulsions – which usually occur within 30 minutes of exposure.”

People should never drink water from a waterway where a health warning is in place and they should also avoid eating fish and shellfish taken from areas where warnings are in place. “Boiling the water does not remove the toxin. If fish are eaten, remove the gut and liver and wash in clean water” says Dr Humphrey.

Source: Canterbury District Health Board media release (21st February 2019).