Mary Harney (Dublin Mid West, Progressive Democrats)

I welcome the opportunity to speak to the Seanad on the ongoing situation in relation to the current outbreak of influenza and the measures being taken in response to the outbreak

On Friday, 24 April 2009, a public health alert was received from the World Health Organisation indicating that human cases of influenza type A(H1 N1) virus infection had been identified in the US and Mexico. On 26 April, the WHO upgraded the pandemic alert level from phase 3 to phase 4 and on 28 April to phase 5. Phase 5 is defined by the WHO as clusters of the virus with human to human spread. These upgrades were anticipated in the context of our national influenza preparedness.

There is one confirmed case of A(H1 N1) influenza in Ireland. It was confirmed on 2 May 2009. The case involves a young male in the east who recently returned from travel to Mexico. The man, who is relatively well, is currently receiving antiviral medication in his home. Close contacts have been contacted and are also receiving appropriate treatment. There are no further probable or confirmed cases in Ireland.

In order to ensure people who may have influenza will come forward for investigation and, if necessary, treatment, it is proposed to maintain absolute confidentiality in relation to the identity and precise location of probable and confirmed cases. It is not proposed to report on numbers of people under investigation but rather to limit reporting to probable or confirmed cases, which provides important information for planning purposes and is similar to how this information is reported in other countries.

As of 8 a.m., there were 125 confirmed cases of the influenza in Europe, including the wider European Economic Area and European Free Trade Association countries, with 15 probable cases and evidence of community transmission in three countries. Outside Europe, there are 1,527 confirmed cases and 22 probable cases. The bulk of the confirmed cases relate to three countries. Mexico has 942 cases, the USA has 403 and Canada has 165. While there is no change to the current level of influenza pandemic alert, it is likely that the numbers of cases worldwide will continue to increase.

In the event that the WHO changes its pandemic alert level to phase 6, our national preparedness will allow Ireland to respond appropriately to this. Phase 6 would indicate sustained community spread in a second WHO region other than the Americas. It should be noted that some community transmission has been seen in the UK, Spain and Germany but it is not yet the sustained high level of transmission seen in Mexico and the USA.

It is too early to draw definite conclusions on the severity of illness caused by influenza A(H1 N1). However, cases that have occurred outside Mexico appear to be of mild illness. This is a cause for hope but not for complacency. We hope for the best but we need to plan for the worst. Influenza A(H1 N1) is a new virus against which there is no pre-existing immunity in the population and for which there is no vaccine. This means that, even if illness caused by influenza A(H1 N1) proves to be milder than initially suspected, levels of infection in the population might still be high.

On receipt of the alert, my Department activated our national plan for the health service response to pandemic influenza which was finalised in January 2007. The plan is accompanied by detailed expert guidance developed by the pandemic expert guidance group. In line with the plan, we have put appropriate governance structures in place to deal with the outbreak. This involves the HSE's crisis management team, the pandemic expert guidance group, chaired by Professor Bill Hall, and the EU co-ordination group, feeding into a national public health emergency team, NPHET, which is chaired by the Secretary General of my Department. This national group manages the interface between my Department and the HSE and is the main decision making forum for the health system response. We have also maintained close contact with the World Health Organisation on the matter.

To date the following measures have been put in place. Enhanced surveillance in the community and hospitals across the country to enable the detection and reporting of cases has been instituted. Improved viral diagnostic services and enhanced laboratory capacity, including out-of-hours arrangements, are currently in place, which strengthens our ability for early detection. Provision has been made for antiviral stockpiles to cover 47% of the population, which is amongst the highest levels worldwide. Some of these supplies have been distributed through public health departments to facilitate the treatment of initial cases. An advance purchase agreement with the vaccine companies is being put in place to secure the necessary supplies of a pandemic vaccine when these become available. Communication to professionals outlining their role in managing cases of influenza is updated on a frequent basis. Contact tracing arrangements have been established. Posters and leaflets have been placed in air and sea ports. The HSE has established a flu information helpline, freefone 1800 94 11 00, for the public which is available 24 hours a day. Up to yesterday it had received over 1,000 calls. A public information leaflet containing practical information for the public on what to do in the event of a pandemic has been printed and is currently being distributed to every household in the country. The leaflet is currently available on the HSE website. Supplies of personal protective equipment and other medications that are required for management of influenza have been issued. Frequently asked questions have been compiled and are updated daily on my Department's website and a travel advisory has been prepared and is updated daily on my Department's website and that of the Department of Foreign Affairs.

I am satisfied fully with our levels of preparedness and our capacity to deal with a possible flu pandemic. I compliment all those involved in developing our plans for a pandemic and pay special tribute to those throughout the health services who, since the current outbreak, have worked tirelessly to ensure our health system is geared up and ready to meet the challenge.