A father and his young son from Kaiapoi have become the South Island's first swine flu victims and take New Zealand's total number of confirmed cases to 15.
But authorities fear there is worse to come, as the number of cases surge across the Tasman.
In a message titled "Pigs can't fly but flu can", public health boss Mark Jacobs has warned family doctors that community transmission here is a matter of "when rather than if".
In Australia the tally of confirmed cases has passed 600, including 521 in Victoria.
Tiaki Maindonald, seven, from Kaiapoi, just north of Christchurch, was confirmed to have swine flu at about 5pm last night. His father Ash had earlier been confirmed with the H1N1 virus after returning from a two-week business trip to America's west coast on Sunday, May 31.
After seven days in isolation, Mr Maindonald, 50, is due to return to work tomorrow at Kaiapoi Borough School, The Press reported.
Meanwhile, thirty-seven children from a South Auckland childcare centre are in quarantine and taking anti-viral treatment after a child tested positive for swine flu.
The 1-year-old boy from the Tama Ale Eleele A'oga Amata childcare centre in Papatoetoe tested positive to Influenza A (H1N1), swine flu on Friday.
His contacts who displayed flu-like symptoms were tested for the disease and all of their results were yesterday confirmed as negative.
Dr Richard Hoskins, medical officer of health at Auckland Regional Public Health, said the 37 children and 13 adults would be in quarantine while they took a course of Tamiflu.
The positive case returned from Australia on May 26 and attended the centre for one and a half days before his parents decided he was too sick and kept him home.
The latest edition of the College of GPs newsletter, ePulse, carries a message from Dr Jacobs, the Health Ministry's director of public health.
"The recent rapid increase in cases in Australia in particular emphasises that community transmission in New Zealand is a matter of when rather than if.
"In the event of sustained community transmission, hospitals already entering the seasonal influenza period would soon be overwhelmed, most people will need to be cared for at home supported by telephone triage, probably through Healthline."
A Health Ministry public-awareness campaign began on radio on Saturday and will be extended to newspapers and international airports today.
Dr Jacobs wrote to schools telling them they must prepare how they would cope when the virus - readily spread by children - started circulating freely.
"If a school or early childhood service was directed to close it could happen very fast - students would be sent home at the end of the day and told not to return. Your communication with parents needs to be thought through and prepared. Consideration also needs to be given to remote learning and lessons by schools, not just for a week, but potentially several weeks."
Secondary Principals' Association of New Zealand vice-president Paul Daley said closing schools for this long would disrupt learning, but if it was needed there could be no objection.
"If we get to that, everybody's health is what's important."
Some education could continue through email, the internet and by hand-delivering materials, but this had limitations. If some schools were closed for much longer than others, this would have to be taken into account in NCEA results.
Dr Jacobs also suggested students be kept home from school for a week if they had recently returned from Australia, even without flu symptoms.
This suggestion has caused confusion. The Ministry of Education told principals it was "background information for families and not a directive. Schools and early childhood education services are not expected to act on this suggestion".
Dr Jacobs' suggestion reflects a controversial move by New South Wales state to impose a seven-day quarantine period on children returning there from neighbouring Victoria. They cannot attend school for a week, which the Victorian Government called bizarre.
Mr Daley said the Ministry of Education's email had "clarified" Dr Jacobs' letter.
What action to take regarding asymptomatic pupils returning from Australia was up to each school, Mr Daley said. He advised principals to prevent such children from simply returning to school. He suggested they first be questioned by a school nurse about potential contact with flu patients before deciding the appropriate action.
- With NZPA
South Island swine flu cases take total to 15
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