Editor,

Re: Exercise Paton: A simulation exercise to test New South Wales Emergency Departments’ Response to Pandemic Influenza

The short report on Exercise Paton clearly demonstrates Australian jurisdictions’ commitment to preparing for an influenza pandemic.1 The exercise focused on containment activities, which will form the critical first phase of any Australian response.2 In order for containment to be effective, public health staff need to be able to rapidly identify suspected cases of pandemic influenza, that is, people with a history of recent contact with pandemic influenza who have onset of fever within the previous 24 hours.3 Furthermore, successful home quarantine for contacts of pandemic influenza cases will depend on their ability to reliably monitor themselves for symptoms of influenza, including fever. The interim case definition for pandemic influenza includes a specific criterion for fever of ≥38ºC.4 It is assumed that most community contacts of pandemic influenza will have a thermometer at home to perform daily or twice daily temperature monitoring.2 However, there is scant information regarding the availability of thermometers in Australian households.

Following the June 2007 long-weekend natural disaster in the Hunter region of New South Wales, we conducted a random survey of 227 households in the local government areas of Newcastle and Lake Macquarie in New South Wales, to assess household disaster preparedness.5 Our response rate was 71% and households were representative of recent census demographics. We found that only 48% (95% confidence interval 41–54%) of households had a thermometer available at home. This finding indicates that many community contacts of pandemic influenza cases would have difficulty monitoring their temperature at home and be unable to accurately report the development of fever while under home quarantine.

In order to support essential public health activities, including screening, surveillance and home quarantine, Commonwealth and State Governments should include household thermometers in their medical stockpiles. Careful thought should also be given to other essential components of a ‘home quarantine starter pack’ containing basic supplies that will assist contacts to remain at home. Such preparations may prove vital for successful containment of pandemic influenza or other future infectious disease epidemics that Australia may face.

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References

1. Craig A, Armstrong P. Exercise Paton: A simulation exercise to test New South Wales emergency departments’ response to pandemic influenza. Commun Dis Intell 2007;31:310-313.

2. Australian Government Department of Health and Ageing. Australian Management Plan for Pandemic Influenza. Australian Government Department of Health and Ageing; Canberra; 2006. Available from: http://www1.health.gov.au/internet/wcms/publishing.nsf/Content/ohp-pandemic-ahmppi.htm/$file/AHMPPI.pdf

3. NSW Department of Health. Hospital Response to Pandemic Influenza: Part 1 Emergency Department Response. NSW Department of Health: Sydney; June 2007. Available from: http://www.health.nsw.gov.au/policies/pd/2007/pdf/PD2007_048.pdf

4. NSW Department of Health. Pandemic influenza (PI): interim response protocol for public health units. NSW Department of Health: Sydney; October 2006. Available from: http://www.health.nsw.gov.au/pandemic/docs/piresponse.pdf

5. Hunter New England Population Health. Hunter storm study 2007. Available from: http://www1.hnehealth.nsw.gov.au/hneph/HunterStorm2007/HunterStorm2007.html

Dr Michelle Cretikos
Keith Eastwood
Professor David Durrheim

Author details

Dr Michelle Cretikos, Public Health Officer¹

Keith Eastwood, Biopreparedness Epidemiologist¹

Professor David Durrheim, Service Director^1,2

1. Population Health Unit, Hunter New England Area Health Service, Newcastle, New South Wales

2. Hunter Medical Research Institute, Newcastle, New South Wales

Corresponding author: Dr Michelle Cretikos, Population Health Unit, Hunter New England Area Health Service, Wallsend Health Campus, Locked Bag 10, Wallsend NSW 2287. Telephone +61 2 4924 6339. Facsimile: +61 2 4924 6215. Email: mcretikos@optusnet.com.au