Seasonal Flu 2008 - 2009

[Giuseppe]

Re: Seasonal Flu 2008 - 2009

From Shiloh's post no. 28:

''Eastern Bay of Plenty had experienced epidemic levels of the bug that week with more than 550 in every 100,000 people seeing doctors, while south Canterbury had the second-highest rates.''

Here below the graph of epi-curve in Italy during 2007/08 influenza season with co-circulation of H1N1/Brisbane - H3N2 and B strains. To note the highest incidence of ILI for 0-4 class age. (Source http://www.iss.it/binary/iflu/cont/I...1209724991.pdf)

[HenryN]

Re: Seasonal Flu 2008 - 2009

Source: http://www.nzherald.co.nz/section/st...ectid=10528682

New Zealand: Flu woes worsen
5:00AM Sunday August 24, 2008
By Michelle Coursey

Flu figures have hit a three-year high as wet weather extends the virus season.

Schoolchildren have been particularly hard hit as rain forces them to stay indoors. Schools in Marlborough and Porirua have been blitzed by the virus, with large numbers of children absent.

Further north, Auckland Regional Public Health Service medical officer Craig Thornley said his office was aware of above-average levels of sickness, some schools reporting a 100 per cent rise in students off sick.

"It's likely that kids are spending more time inside, so there's more chance of transmission between them, and just some seasonal change in the types of viruses that seem to be going around," said Thornley.

Latest flu figures from Environmental Science and Research show type B influenza as the most common strain from August 11-15.

Eastern Bay of Plenty had experienced epidemic levels of the bug that week with more than 550 in every 100,000 people seeing doctors, while south Canterbury had the second-highest rates.

Auckland Public Health advises parents and pupils to stay home if sick, cover their coughs and wash their hands often to help stop the transmission of viruses. Parents should take children to a GP if they had difficulty breathing, chest pain, or severe vomiting.

The latest bulletin was published on 14th August, covering weeks 30?32. It recorded that in the southern hemisphere, the regular winter epidemics had started with a considerable increase in both influenza activity and detection of influenza viruses. Influenza A (H1), A(H3) and influenza B were circulating. Widespread outbreaks were reported in New Zealand. To date there is no information on whether any of the A(H1) viruses are resistant to oseltamivir.

http://ecdc.europa.eu/Health_topics/influenza/news/news_Influenza_080821.html

[Shiloh]

Re: Seasonal Flu 2008 - 2009

Source: http://www.stuff.co.nz/stuff/4667440a11.html

NZ: Tamiflu-resistant viruses spreading rapidly
NZPA | Monday, 25 August 2008

Tamiflu retroviral drugs being stockpiled by the Government may not be an effective weapon against the next flu pandemic.

Tamiflu-resistant forms of the "ordinary" seasonal influenza are rapidly spreading and the drug may be ineffective in fighting the dominant flu strain in South Africa this winter.

World Health Organisation data show tests on 107 people in South Africa with the H1N1 strain one of the three most common flu viruses in humans found all had a mutant bug resistant to Tamiflu, the WHO said. Only one patient was taking Tamiflu at the time.

Tests on 788 samples taken from H1N1 flu patients in 12 countries, mostly in the southern hemisphere, from April 1 to August 20 found that 242, or 31 per cent, had the so-called H274Y mutation associated with Tamiflu resistance, the WHO said.

Southern hemisphere incidence of the mutation in tests on the H1N1 virus ranged from 100% in South Africa to 13% in Chile, compared with a resistance rate of 16% found in 7528 samples tested from the last quarter of 2007 to March 31 in 34 countries, mostly in the northern hemisphere.

"What we're seeing is the evolution of the resistance gene and the distribution of it throughout the world," said Lance Jennings, a clinical virologist with the Canterbury District Health Board, who is chairman of the Asia-Pacific Advisory Committee on Influenza. "We have a lot to learn about the molecular epidemiology of influenza viruses."

The Tamiflu-resistant form of flu has been reported in 40 countries in Europe, North and South America, Africa, Asia and Australia since widespread resistance to the pill was first reported to the WHO by Norway in January.

Until birdflu vaccines are developed for the specific pandemic influenza virus once it evolves and starts spreading work likely to take three months or more Tamiflu and another retroviral treatment, Relenza, are the main medical weapons to battle pandemic flu.

Tamiflu is being stockpiled by the WHO and governments around the world for use in the event of a pandemic, and to treat the H5N1 avian flu strain that has infected humans in 15 of the 60 countries to which it has spread.

Last year, Swedish researchers warned that sewage systems do not break down Tamiflu, and that the drug was being discharged in rivers and streams used by the waterfowl thought to be the main carriers of avian flu.

They urged doctors not to overprescribe Tamiflu to avoid creating resistance in avian flu carried by ducks. If those viruses combined with other viruses that made humans sick they could mutate into strains resistant to Tamiflu, they said early in 2007.

Health Minister David Cunliffe said this year that 103 of the 1229 treatment courses of Tamiflu the Government had bought at a cost of $300,000 had reached their expiry dates.

[Giuseppe]

Re: Seasonal Flu 2008 - 2009

Source: http://www.stuff.co.nz/stuff/4667440a11.html

NZ: Tamiflu-resistant viruses spreading rapidly
NZPA | Monday, 25 August 2008

Tamiflu retroviral drugs being stockpiled by the Government may not be an effective weapon against the next flu pandemic.

Tamiflu-resistant forms of the "ordinary" seasonal influenza are rapidly spreading and the drug may be ineffective in fighting the dominant flu strain in South Africa this winter.

World Health Organisation data show tests on 107 people in South Africa with the H1N1 strain one of the three most common flu viruses in humans found all had a mutant bug resistant to Tamiflu, the WHO said. Only one patient was taking Tamiflu at the time.

Tests on 788 samples taken from H1N1 flu patients in 12 countries, mostly in the southern hemisphere, from April 1 to August 20 found that 242, or 31 per cent, had the so-called H274Y mutation associated with Tamiflu resistance, the WHO said.

Southern hemisphere incidence of the mutation in tests on the H1N1 virus ranged from 100% in South Africa to 13% in Chile, compared with a resistance rate of 16% found in 7528 samples tested from the last quarter of 2007 to March 31 in 34 countries, mostly in the northern hemisphere.

"What we're seeing is the evolution of the resistance gene and the distribution of it throughout the world," said Lance Jennings, a clinical virologist with the Canterbury District Health Board, who is chairman of the Asia-Pacific Advisory Committee on Influenza. "We have a lot to learn about the molecular epidemiology of influenza viruses."

The Tamiflu-resistant form of flu has been reported in 40 countries in Europe, North and South America, Africa, Asia and Australia since widespread resistance to the pill was first reported to the WHO by Norway in January.

Until birdflu vaccines are developed for the specific pandemic influenza virus once it evolves and starts spreading work likely to take three months or more Tamiflu and another retroviral treatment, Relenza, are the main medical weapons to battle pandemic flu.

Tamiflu is being stockpiled by the WHO and governments around the world for use in the event of a pandemic, and to treat the H5N1 avian flu strain that has infected humans in 15 of the 60 countries to which it has spread.

Last year, Swedish researchers warned that sewage systems do not break down Tamiflu, and that the drug was being discharged in rivers and streams used by the waterfowl thought to be the main carriers of avian flu.

They urged doctors not to overprescribe Tamiflu to avoid creating resistance in avian flu carried by ducks. If those viruses combined with other viruses that made humans sick they could mutate into strains resistant to Tamiflu, they said early in 2007.

Health Minister David Cunliffe said this year that 103 of the 1229 treatment courses of Tamiflu the Government had bought at a cost of $300,000 had reached their expiry dates.

SIC 1) ''Tamiflu retroviral drugs being stockpiled by the Government may not be an effective weapon against the next flu pandemic.'' NOT retroviral. Oseltamivir is a Neuraminidase-Inhibitor. Anti-retroviral drugs are employed in treatment of HIV/AIDS (AZT, 3TC, DDI, other protease-inbibitors, fusion-inhibitors, etc.).

SIC 2) ''They urged doctors not to overprescribe Tamiflu to avoid creating resistance in avian flu carried by ducks'' Use of oseltamivir for treatment of influenza isn't - to date - proven to cause emersion of this kind of strain of seasonal human influenza subtype A/H1N1 with specific mutation H274Y.

SIC 3) '' another retroviral treatment, Relenza, are the main medical weapons to battle pandemic flu'', zanamvir is also a NA-inhibitor and there are also amantadine/rimantadine M2-inhibitors and ribavirin also worth to be further investigated.

When avian influenza virus will be isolated in wild avifauna and tested properly for subtyping and genetic presence of NA-inhibitors motifs we also know if oseltamivir sporadic use is enough to drive mutations via sewage system.

We expect the results of ongoing surveillance in wild avifauna

[Shiloh]

Re: Seasonal Flu 2008 - 2009

Source: http://www.wanganuichronicle.co.nz/l...ondsubsection=

New Zealand: Monday influx swamps emergency department

27.08.2008
By LIN FERGUSON

Wanganui Hospital's emergency department was stretched almost beyond its limits on Monday night by a huge, unexplained influx of sick people.

Emergency department director Athol Steward said yesterday 80 people were seen and 30 of those had to be admitted.

"It was very, very hectic for the staff."

Dr Steward said Monday night's phenomenon had staff running until the early hours of Tuesday morning. And it hadn't helped that the department was short-staffed, he said.

"But not only did the staff do an incredible job, the public waiting were all wonderful as well."

The triage nurse and the receptionist had constantly updated and told people there was going to be a long wait, but no one had complained, he said.


Patients on Monday night had ranged from small babies to elderly people, with many of them suffering from respiratory complications from the flu that has swept through Wanganui over the past month.

"There was also a few accidents and other medical problems."
[B]
The mad rush into the emergency department had started about 4pm on Monday and steadily built up through the night, he said.

"It was just exceptional."

One man told the Chronicle he had taken his wife in at 8.30pm and it was 1.30am before she was seen.

Dr Steward said the average patient number through emergency was usually between 50-55 a day and that Monday had been the busiest, with the greatest number of patients through for more than three years. He attributed the increase in patient numbers over the past year to people now preferring to go to the emergency department rather than their GP.

"It's a choice people in Wanganui are making.

"It's the time of the year as well, with the winter weather."

Fortunately, though, with higher numbers of patients coming through, the new facility, which opened in April, had helped enormously.

"It's so much easier to work."

Though Mondays numbers were beyond anything the staff would have envisaged a bed was found for everyone, he said.

"No one was left waiting in a corridor, and that is remarkable a real achievement."

However, things will pick up by the end of this week, when four new junior doctors will have started, he said.

"Even though patient numbers can't be predicted, the four new doctors will make a huge difference. Were a very busy hospital for a small place."

Even though Wanganui was geographically small, with a small population, the health problems were enormous, he said.

"It's an older population, and it's a sickly population. Wanganui is not the healthiest town. There are a lot of health problems here."

[Shiloh]

Re: Seasonal Flu 2008 - 2009

Source: http://www.news.com.au/mercury/story...6-3462,00.html

AU: Flu hits school's 270 students
Article from: The Mercury

SALLY GLAETZER

August 28, 2008 10:10am

ALMOST half of the students at Lauderdale Primary School are off sick today as the school grapples with a severe flu outbreak.

Principal Mike Woods of Lauderdale Primary School said up to four children have spent a night in hospital and one staff member has spent three nights in hospital.

"We have had over the last almost two weeks now varying reports of the illness," Mr Woods said.

He said an average of 80 out of the 590 students were away each day last week, but the epidemic has worsened in more recent days.

Today 270 students, 11 teachers and 5 support staff are off sick.
Mr Woods said the symptoms are vomiting, diarrhoea, severe upper body aches and difficulty breathing.

"We're still waiting on pathology results to see if it is Influenza A," Mr Woods said.

He said the remaining 38 teachers are handling two classes each and education department staff have been made available to help out.

"Even doubling up we barely have 20 students in a class," Mr Woods said.

[Commonground]

Re: Seasonal Flu 2008 - 2009

Flu outbreak: 291 off school

August 28, 2008 - 12:05PM

Several primary school students and a teacher in Tasmania have been hospitalised by a flu outbreak that has affected almost 300 children and staff from the one school.

The Lauderdale Primary School near Hobart is dealing with a suspected Influenza A epidemic with 271 students and 20 staff off sick today - almost half the school's population.

School principal Mike Woods today said several children and one teacher had been treated in hospital for suspected Influenza A.

"Most alarmingly it seems to be affecting young children's breathing and several children have been hospitalised, usually overnight, over the last week, as a precaution," Mr Woods said.

"We did have a staff member admitted to hospital for a couple of nights as well but she's home now.

"Today we have 271 students absent and 20 staff, including 11 classroom teachers."

Mr Woods said symptoms of the virus which started spreading at the school 10 days ago included vomiting, diarrhoea, aches and pains, and headaches.

Health authorities have decided against closing the school unless the situation deteriorates.

http://www.smh.com.au/news/national/flu-outbreak-291-off-school/2008/08/28/1219516630225.html

[Commonground]

Re: Seasonal Flu 2008 - 2009

Rice bowled over by pneumonia
28th August 2008, 13:45 WST

Olympian Stephanie Rice says she has mild pneumonia and has been ordered to rest, putting an end to a planned trip to Perth.
Rice and fellow Olympic medallist Eamon Sullivan today appeared at the Myer store in Brisbane’s CBD to promote Davenport underwear.

The triple gold medallist swimmer said she started to feel sick towards the end of the Beijing games.

“I haven’t been well since Beijing and it’s gotten a lot worse since coming home,” the former Brisbane schoolgirl told the crowd of several hundred autograph hunters.

“Perth is not what I should be doing right now. I really want to go to Perth but I can’t until I get better.

“(The doctors said) I have the early stages of pneumonia, which a lot people probably have.”

http://www.thewest.com.au/default.aspx?MenuId=77&ContentID=94737

[Commonground]

Re: Seasonal Flu 2008 - 2009

Qld govt under pressure over health

27th August 2008, 14:22 WST
The Queensland government has come under renewed pressure over its troubled health system after being hit with a barrage of fresh complaints in state parliament on Wednesday.
Opposition Leader Lawrence Springborg said a major north Queensland hospital was on Tuesday unable to find beds for 24 people.

Townsville Hospital reportedly declared a "code yellow", using ambulances as makeshift beds and cancelling elective surgery for Wednesday and Thursday.

The crisis came on the same day as the government extended its Health Action Plan, designed to improve the health system, with the five-point Advancing Health Action plan, Mr Springborg said.

"How long do you have to masterplan before you actually do anything?" he said.

Opposition health spokesman Mark McArdle said central Queensland health services were also in crisis, with Aramac Hospital's 22 staff on Tuesday told the facility would be downgraded to a health centre.

In addition, problems on the Sunshine Coast, where Nambour Hospital was on bypass on Tuesday with 24 emergency patients waiting, and in Cairns, where patients have complained about golden staph, also emerged in parliament.

Mr McArdle said it was "incredible hypocrisy" for the government to shed a rural hospital on the same day it was lauding a new health plan.

"Aramac is again a symptom of the larger malaise that is impacting across Queensland Health," Mr McArdle told reporters in Brisbane on Wednesday.

"Add all these issues together you still find that 10 years after being in government the health crisis continues to roll out, unfortunately, day in, day out."

Barcaldine mayor Robert Chandler said the decision would "gut" Aramac - removing 22 families that support the town's school and businesses.

"I'm not much of a politician, but I do know that the government of the day has a ... community service obligation, to look after all Queenslanders, and that goes for the little places like Aramac with 300 people," Mr Chandler said.

But Health Minister Stephen Robertson said the 10-bed facility had only 12 overnight admissions over the past 12 months.

"It's hardly a hospital now when we haven't had a full-time doctor there for the last four years because we can't attract a full-time doctor there," Mr Robertson told reporters.

"What we want to do is find a new model of care that will deliver health services for the people of Aramac and stop this charade about pretending that they have a fully functioning hospital, because they clearly don't."

Mr Robertson said Townsville's problems were caused by 22 nurses calling in sick with the flu and additional staff were being sought.

"Winter always is our busiest time, but staff sickness hasn't helped on this occasion, along with an increase in the number of elderly patients presenting to the hospital," he said.

Mr Robertson denied the health system was still failing, despite the government's efforts.

"People carry on calling it a third-world health system, that it's in crisis - that's nonsense," he said.

"If it was in crisis, we wouldn't be able to treat record numbers of patients, we'd be going backwards, and that is not the case on every indices."

AAP

http://www.thewest.com.au/aapstory.aspx?StoryName=509872

[Shiloh]

Re: Seasonal Flu 2008 - 2009

Source: http://www.media.tas.gov.au/release.php?id=24621

FLU IN TASMANIA

Public health authorities are waiting on test results to show the reason for a spike in flu-like illness affecting Lauderdale Primary School in Southern Tasmania.

Senior Medical Advisor, Dr Avner Misrachi, said it was not clear yet what is causing the illness.

?So far this winter the flu season has been mild compared to last year? Dr Misrachi said.

?52 adults and children from around Tasmania have been confirmed to have influenza so far this year, but there has been an increase in notifications in the last few weeks.

?We won?t know what is causing the flu-like illness affecting Lauderdale Primary School until we get test results back in the next 24 hours.?

The main symptoms of influenza are sudden onset of fever, chills, dry cough, extreme tiredness and body aches.

Dr Misrachi urged all parents to keep unwell children at home.

?Flu spreads easily and can cause serious illness and hospitalisation, especially for older people and people with chronic illnesses,? Dr Misrachi said.

?If you or your child has flu symptoms, keep them at home.

?Its important not to go back to work or school until you are fully recovered, so you don?t spread the disease to others.?

Dr Misrachi said influenza can cause severe illness but it is largely vaccine preventable.

?The flu vaccine is effective against influenza.

?Vaccine is still available but it takes around two weeks to be fully effective.?

Dr Misrachi said there are a number of simple steps people can take to protect themselves and others from flu.

?The flu is very contagious, and a person can infect others before they even realise they are sick.

?Wash your hands often with soap and water or alcohol rubs, especially before touching your face or anything that goes in your mouth. This is because the virus can be picked up unknowingly on your hands.

?Always cover your cough or sneeze with a tissue or your elbow if you don?t have a tissue.

?Throw dirty tissues in the bin straight away.

?And if you have a fever and other flu symptoms, stay home,? Dr Misrachi said.

[Commonground]

Re: Seasonal Flu 2008 - 2009

FLU IN TASMANIA

Public health authorities are waiting on test results to show the reason for a spike in flu-like illness affecting Lauderdale Primary School in Southern Tasmania.

A number of viruses to blame for flu outbreak


Tasmania's Health Department says a number of viruses have caused the high level of absenteesim at Lauderdale Primary School in the state's south.

Influenza A and B are among the viruses that have been identified.

More than half of Lauderdale Primary's students didn't make it to school yesterday - 300 all up, out of an enrolment of 530.

20 staff were also off sick, including one who was admitted to hospital.

The Health Department says test results showing the presence of the two influenza viruses confirm the outbreak is typical for this time of year.

But Dr Avner Misrachi says the number is relatively high, and has advised those struck down to stay home.

Those unaffected should follow basic hygiene guidelines, or be vaccinated.

The Department yesterday rejected requests from parents to temporarily close the Lauderdale school.

http://www.abc.net.au/news/stories/2008/08/29/2350589.htm

[HenryN]

Re: Seasonal Flu 2008 - 2009

<CENTER>LAUDERDALE FLU RESULTS
<HR class=text noShade SIZE=1></CENTER>
The Public and Environmental Health Service today said test results have shown that influenza B has been identified as affecting the Lauderdale Primary School and probably other viruses are also active at the school

Senior Medical Advisor, Dr Avner Misrachi, said results received by the Department indicated a range of different respiratory viruses have been circulating among the Hobart community and the Eastern shore and these included both influenza A and influenza B

?This confirms that, although the numbers of people who have become ill are relatively high, this outbreak is typical for this time of year.

?Seasonal influenza can affect between 10% and 30% of the community each winter and outbreaks are common.?

Dr Misrachi said the test results did not change the advice to the school and the wider community about the flu.

?The main symptoms are sudden onset of fever, chills, dry cough, extreme tiredness and body aches.

?Parents should keep unwell children at home and adults who become ill also should stay home.

?Flu spreads easily and can cause serious illness and hospitalisation, especially for older people and people with chronic illnesses.

?It?s important that people affected stay home until they are fully recovered, so they don?t spread the disease to others.?

Dr Misrachi said influenza was largely vaccine preventable and people who had not been vaccinated should see their doctor.

?The flu vaccine is still available but it takes around two weeks to be fully effective.

?There are also a number of other steps people can take to protect themselves and others from flu.

?Wash your hands often with soap and water or alcohol rubs, especially before touching your face or anything that goes in your mouth. This is because the virus can be picked up unknowingly on your hands.

?Always cover your cough or sneeze with a tissue or your elbow if you don?t have a tissue. Throw dirty tissues in the bin straight away.?

http://www.media.tas.gov.au/release.php?id=24649

[HenryN]

Re: Seasonal Flu 2008 - 2009

New H1N1 sequences from Guatamala look like Tamiflu resistant (only HA sequences released).

<TABLE cellPadding=0 width="100&#37;"><TBODY><TR><TD style="WHITE-SPACE: nowrap" vAlign=top width="20%">CY034621</TD><TD vAlign=top align=left>
Reports<SCRIPT language=JavaScript1.2><!--var PopUpMenu2_LocalConfig_Reports197323089 = [ ["TitleText","Reports"]];var Reports197323089 = [ ["UseLocalConfig","Reports197323089","",""], ["ASN.1","window.top.location='/entrez/viewer.fcgi?list_uids=197323089&db=nuccore&dopt=as n'","",""], ["XML","window.top.location='/entrez/viewer.fcgi?list_uids=197323089&db=nuccore&dopt=xm l'","",""], ["Summary","window.top.location='/entrez/viewer.fcgi?list_uids=197323089&db=nuccore&dopt=do csum'","",""], ["Brief","window.top.location='/entrez/viewer.fcgi?list_uids=197323089&db=nuccore&dopt=br ief'","",""], ["FASTA","window.top.location='/entrez/viewer.fcgi?list_uids=197323089&db=nuccore&dopt=fa sta'","",""], ["TinySeq XML","window.top.location='/entrez/viewer.fcgi?list_uids=197323089&db=nuccore&dopt=fa sta_xml'","",""], ["GenBank","window.top.location='/entrez/viewer.fcgi?list_uids=197323089&db=nuccore&dopt=gb '","",""], ["INSDSeq XML","window.top.location='/entrez/viewer.fcgi?list_uids=197323089&db=nuccore&dopt=gb c_xml'","",""], ["GenBank(Full)","window.top.location='/entrez/viewer.fcgi?list_uids=197323089&db=nuccore&dopt=gb withparts'","",""], ["GI List","window.top.location='/entrez/viewer.fcgi?list_uids=197323089&db=nuccore&dopt=gi '","",""], ["Graphic","window.top.location='?cmd=Show&doptcmdl =graph&db=nuccore&term=CY034621'","",""], ["Revision History","window.top.location='/entrez/sutils/girevhist.cgi?val=CY034621'","",""]]--></SCRIPT> </TD><TD vAlign=top align=right>
</TD></TR><TR><TD style="PADDING-LEFT: 2.8em" vAlign=top align=left colSpan=3>Influenza A virus (A/Guatemala/AF1995/2008(H1N1)) segment 4 sequence
gi|197323089|gb|CY034621.1|[197323089] </TD></TR></TBODY></TABLE>

[HenryN]

Re: Seasonal Flu 2008 - 2009

Guatemala and Honduras isolates do not have the South African cluster.

[Shiloh]

Re: Seasonal Flu 2008 - 2009

Source: http://warrnambool.yourguide.com.au/...k/1258133.aspx

AU: Flu epidemic alert Pneumonia hits 14 in past week
ANDREW THOMSON
30/08/2008 4:00:00 AM
SOUTH-WEST residents have been warned of a late influenza epidemic.

In the past week, 14 people under the age of 30 have been treated for pneumonia at South West Healthcare Warrnambool hospital's emergency department.

City council medical officer of health Dr John Philpot said yesterday a strain of flu, which had hit Melbourne, was ``coming this way''. ``I would not be surprised if the flu hit town soon,'' he said.

He said that although there had not been a flu outbreak around Warrnambool this winter, the district had been rife with colds, coughs and sore throats ``It's been a miserable winter with a lot of bugs going about, mostly colds and viruses,'' he said.

South West Healthcare spokeswoman Suzan Morey said although patient numbers with flu-like symptoms had not increased, the severity of cases was worse than normal.

``In the past week we have treated an average of two people a day with pneumonia (secondary bacterial infection). And each of these 14 patients was less than 30 years of age,'' she said.

The Department of Human Services told The Standard official numbers of flu this year were well down on last year. At this time last year there were 794 cases compared with 397 this year. Last year's total figures were boosted by a severe August-September flu outbreak with 1206 cases for the two months.

Dr Philpot said it was not too late to be vaccinated. He said those most at risk included the elderly and those with chronic medical illnesses.

Meanwhile, Dr Philpot said he had not heard reports of Warrnambool school-aged children being struck down with a stomach bug for weeks.

It has been reported that three children in one street have had the illness which includes headaches and a sore stomach. One child has been off school for seven weeks and another for five.