The Ministry of Health provides updated information on its website daily at midday http://www.arphs.health.nz/public-health-topics/disease-and-illness/novel-coronavirus-2019-ncov/

The spread of the novel coronavirus, originating in Wuhan City, China, is being closely monitored by Auckland Regional Public Health Service and the Ministry of Health.

The virus can cause acute respiratory infection ranging from mild to severe. Most of the infected people have had mild to moderate illness.

Anyone with fever or difficulty breathing, and who, in the last two weeks has been –

• to mainland China
• in close contact with someone diagnosed with the novel coronavirus,

should not present unannounced to any medical facility but call the dedicated number 0800 358 5453 (Interpreters are available).

Travelers who have been to mainland China in the last 14 days should read the Ministry of Health’s advice on self-isolation.

You can find further advice on the Ministry of Health website.

Based on interim advice from Ministry of Health

There are no confirmed cases of coronavirus in NZ at time of uploading 2 Feb 2020.

We will update as new information becomes available.

If you’ve travelled from China and have symptoms …..

If you have and symptoms of a fever/ cough/ shortness of breath / cold or unwell and have travelled from China in past 14 days please ring reception and we will arrange a nurse or doctor to talk to you so we can organise the most appropriate medical assistance and avoid risk of infecting others in case you have coronavirus rather than some other viral illness.

If you’ve travelled from anywhere else and have symptoms….

All patients with respiratory and recent overseas travel (in the past 14 days)  or exposure to someone else who travelled in that time- you should put on a surgical mask at the door to our waiting room (these are available by the door).

Necessary precautions if you have travelled from China (from Ministry of Health)

As of 2 February 2020, all travellers arriving in New Zealand out of mainland China, or any travellers who have had exposure to a confirmed case of novel coronavirus (2019-nCoV) will be expected to self-isolate for a period of 14 days from the time they leave mainland China or were exposed to novel coronavirus.

Existing travellers already in New Zealand who arrived or transited from mainland China after 19 January should refer to previous advice. Self-isolation for people who arrived before 2 February only applies if they have been in Wuhan City or Hubei Province.

Minimum precautions to reduce the general risk of transmission of acute respiratory infections

• Avoid close contact with people suffering from any acute respiratory infections.
• Frequent hand-washing, especially after direct contact with ill people or their environment.
• People with symptoms of acute respiratory infection should practice cough etiquette (maintain distance, cover coughs and sneezes with disposable tissues or clothing and wash hands) and stay home if unwell.
• Adhere to standard infection prevention and control practices in primary care. All patients with respiratory infection and recent overseas travel history should be provided with a surgical mask upon entry to the facility.

Close contact definition

A case is considered as potentially infectious 48 hours prior to developing symptoms, while symptomatic and until symptom-free for 24 hours.

• Living in the same household or household-like setting (e.g. in a hostel) as a 2019-nCoV case
• Having spent two hours or longer in the same room (such as a general practice or ED waiting room) as a 2019-nCoV case
• Having been seated within 2 rows either side of a 2019-nCoV case on a flight, bus or train for two hours or longer
• Having been face-to-face within one meter or less of the case for more than 15 minutes in any other setting not listed above

More information, which is updated daily, please use the link below:- 

http://www.arphs.health.nz/public-health-topics/disease-and-illness/novel-coronavirus-2019-ncov/

Measles is still a concern:

• Babies can be vaccinated from 6 months in Auckland or if travelling to the Pacific Islands and/or Philippines.
• Adults under 50 years old travelling to the Pacific Islands and/or Philippines are recommended to have had 2 documented doses or MMR (Measles/Mumps/Rubella) vaccine.
• Adults under 30 years old with no recorded MMR should have at least 1 dose of the MMR vaccine.
  Please check the Ministry of Health website for the latest updates:
  https://www.health.govt.nz/your-health/conditions-and-treatments/diseases-and-illnesses/measles/2019-measles-outbreak-information
  

Gardasil (HPV vaccine) – while your teens or Uni students are home over the holidays, ask them to come in to complete their Gardasil (HPV vaccine) course if not already completed (3 doses of the vaccine).

Zostavax (Shingles) vaccine – current funding for the 66-80 year olds runs out on 31 March 2020 – if you are in the 66-80 year age bracket and have NOT had a funded shingles vaccine, please phone for a Nurse Appointment well before the end date.

One dose of Zostavax^® is indicated for the prevention of shingles. It can be given to patients who have previously had shingles. 

Since 1 April 2018, one dose of Zostavax is funded for adults aged 65 years. A ‘catch-up’ programme is available for people aged from 66–80 years inclusively until 31 March 2020. Funded vaccine doses are only available through general practice. 

As of 21 October, Ministry of Health have recommended for Auckland region vaccination of 6 months to 11 months.  This is a summary of current MOH recommendations. We are in the process of recalling the 6 months to 1-year olds – this age group is most likely to be hospitalised in the current outbreak and are a priority for protection (60% of cases of measles in babies younger than 12 months have been hospitalised).

1. Active recall of 6-11 month olds (MMR0) prioritising Pacific and Māori and opportunistic vaccination of this age group (these babies will still need two further immunisations and nurses will discuss the timing of this when baby is here for vaccination.

2. Continue scheduled 12 month and 4-year-old vaccine

3. One dose of MMR to people aged under 30 years with no recorded MMR1, with particular focus on:

• Pacific and Māori people
• Students including both school and tertiary students
• Postpartum women and family members of new-born babies (0-6 months).
• Teachers and early childhood educators.

4. Based on clinical judgement: we may give one dose of MMR to people aged 30-49 years:

• Who work in higher risk environments such as institutions (e.g. prisons)
• Who are in one of priority groups in point 3 (e.g. teachers or new mothers aged 30-49 years)

It is with sadness that we say a fond farewell to Mikaela who has been one of our Nursing team for almost 4 years, she will be greatly missed.

Mikaela is moving back to Hawkes Bay with her husband where both their families are living.  We wish them an exciting future and best wishes for their new start.

We do have a new Nurse starting in a couple of weeks, but until then Annette will be working solo.

A big thank you for your patience with all the disruptions caused by the Measles outbreak, we have been extremely busy ensuring all our children from 12 months to 4 years are up to date with their scheduled vaccines.

Looking ahead, as new information comes to hand about when extra MMR supplies are available for the under 50 year olds, we will advise via our website when we can take bookings again to ensure all people under the age of 50 years old have 2 documented doses of the MMR vaccine.

MMR vaccine management advice to General Practice from MoH, ADHB, and PHO

MMR Vaccine Stock: Ongoing Advice for Auckland Region

Current MMR stock in Auckland remains limited and stocks continue to be required to be reserved for priority groups only as listed below:

1. Scheduled immunisations at 12 months and 4 years
2. In special circumstances, based on clinical judgement, one dose MMR can be given to:
   • People under 30 years of age with no recorded MMR1 with a particular focus on Pacific and Maori.
   • Babies 6 to 12 months.
3. MMR may not be given to anyone 30 years or older

♦ Adults aged 50 years or older (born in New Zealand or overseas before 1969)

• Not recommended to receive MMR vaccination. They are considered to be immune to measles.
• No measles vaccine was available in New Zealand until 1969 and measles is so infectious that people born before this were highly likely to be exposed.
• For those born overseas, it is fairly similar as most countries introduced a measles vaccine in the late 1960s, 1970s or later.

Meadowbank General Practice is following the recommendations for Auckland and will be reserving our very limited MMR stock for:

• First priority: 1-4 year olds scheduled immunisations, 2^nd dose MMR will be given at 4 years of age as per schedule, unless more stock become readily available
• Second priority: unimmunised Pacific and Maori people aged under 30 years

Information received today from Auckland, Counties and Waitemata DHB’s advises there are current vaccine distribution issues.

They have directed Primary care practices that the aim is to protect those children most at risk from measles, and have advised us to focus on childhood immunisations and on Pacific people aged between 15 and 29 years.

We will continue to update and appreciate your understanding. This measles outbreak began back in February and we have tried to accommodate as many requests for MMR vaccines as possible up until now, as such this has left us with very limited stocks and therefore we will be cancelling appointments of those not considered high risk.

We are unable to order any vaccines today and there are no stocks available at MGP until further notice (hopefully next week).

We have enough for the vulnerable people who are already booked here for vaccinations this week.

We will update the website as soon as this situation changes, so please watch here and we will advise when further vaccines available.

The advice in entry from 1st September below is still current.

We will have to prioritise immunisations so :-

• If you need MMR immunisation for an unimmunised child enrolled at this practice, who is over 6 months and attends school or daycare, please contact reception who will pass the message to our nurses to contact you.

• If you were born from 1969 onward and have no idea if you are immune see our previous web post which details how you can go to Labtests and have your immunity tested for approximately $50-$55 – you do not need a form from us – but you can ask them to copy your doctor in so it is in your records.