A campaign teaching children how to sneeze safely has started as schools across the country urge parents to keep youngsters with colds away from class.
Principals Federation national president Pat Newman said primary schools had been reporting up to one-fifth of students away sick with flu but the problem was the number turning up to school unwell.
"They are coughing and sneezing and passing it on to everyone else, which doesn't help," he said.
An attempt to combat that has begun in Auckland with a "sneeze safe" campaign run by tissue manufacturer Kimberly-Clark New Zealand.
The company is offering a poster and other written material to 4200 early childhood and Plunket centres.
At Strawberry Fields Childcare centre in Newmarket yesterday children were taught that just putting a hand over the mouth when sneezing was not enough, and tissues were needed.
The Health Ministry has strengthened its warnings on the risk of influenza in children and young people after three North Island youngsters died from complications of the B Hong Kong strain of influenza.
It has also asked GPs to refer children to hospitals if concerned about complications.
B Hong Kong is the dominant strain of flu in the outbreak and it is not in this year's flu vaccine, although it was in last year's.
Julien Le Sueur, president of the Auckland Primary Principals Association and principal of Pinehill School, said that last week up to a quarter of the school's 600 pupils were off sick and many were away for five or six days.
Absences appeared to have tapered off this week but sick children were still turning up to school.
"Sometimes within half an hour we have rung the parents to say their kid can't stay, they are out of it and need to go home."
Institute of Environmental Science and Research figures indicate the outbreak has hit the eastern Bay of Plenty particularly hard. Colleen MacGregor, the acting nurse manager of Whakatane Hospital's emergency department, said it had been caring for high numbers of patients with flu-like symptoms this month.
An Auckland medical officer of health, Dr Will Patterson, said the number of cases in the Auckland region had levelled off.
"We are probably more than half-way through the epidemic. We expect it to be tailing off in the next one to two weeks."
Virus specialist Dr Lance Jennings blamed bad luck for this winter's flu vaccine, made to World Health Organisation recommendations, not covering the B Hong Kong-like strain.
He said the re-emergence of the strain could not have been predicted.
Campaign to stop flu from spreading starts in schools
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