Australian Health Management Plan for Pandemic Influenza

3.2 What is new in the AHMPPI (2008)

There are five major changes to the AHMPPI in the 2008 edition.

1. The plan does not cover the inter-pandemic period.

At the time of publication, Australia is in the Pandemic Alert Period (OS3). Given the continued reporting of human cases of influenza A/H5N1, as well as sporadic reports of human cases caused by H7 and H9 viruses, it is unlikely that we will return to the inter-pandemic period (Phases 1–2) in the foreseeable future.

2. We assume that the next pandemic will emerge overseas.

It is considered unlikely that the pandemic will emerge in Australia. These phases are therefore dealt with in Appendix D as the actions that would be taken if AUS3, AUS4 or AUS5 were to occur are markedly different from those that are taken in the equivalent overseas phases OS3, OS4 and OS5.

3. New phases have been added—SUSTAIN and CONTROL.

Since 2006, the following developments have occurred that have altered our thinking about the phases. We have:

• greater understanding of how effective different combinations of control measures could be
• increased availability of antiviral medication for both treatment and prophylaxis (prevention)
• increased confidence in vaccine technology and availability of a pandemic vaccine
• inclusion of H5N1 candidate vaccines in the NMS.

The major amendment in the phasing system since the AHMPPI (2006) is the addition of the SUSTAIN phase, where the aim is to sustain the response while we wait for a customised pandemic vaccine to become available. The emphasis of this phase will be on sustaining transmission reduction in order to keep case numbers at a manageable level as well as sustaining health systems until the customised pandemic vaccine becomes available in sufficient quantities to help bring the pandemic under control in Australia. This phase is followed by the CONTROL phase, where the pandemic is brought under control.

4. We anticipate only one wave of the pandemic in Australia.

We expect that a pandemic specific vaccine could be available in Australia in time to prevent subsequent waves, however, they could occur if the virus changes its genetic material (i.e. drifts).

5. The Maintenance phase is seen as an exception.

In the AHMPPI (2006), the arrival of the AUS 6B phase signalled the start of the maintenance phase whereby the use of antivirals would focus on maintaining functioning. This is now seen as an exceptional situation.

If at any point during the pandemic, sustaining both the health system and critical infrastructure becomes unmanageable, then Australia would move to a maintenance strategy (see Appendix F).

In this exceptional circumstance, when our ability to keep the number of cases at a manageable level is not successful or that the pandemic vaccine is not effective, it will be necessary to shift the focus to maintaining critical services until the pandemic becomes under control. The Australian Government’s policy on the distribution of antiviral medicines will focus on sustaining society and the economy.

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This information is current for 03 September, 2010
This information was issued on 05 December, 2008