An Auckland nurse and her child who returned to New Zealand from a family holiday in the UK, on 6 June on flight NZ1, have both tested positive for Influenza A (H1N1).

Both cases have a number of contacts who are being traced and managed. The nurse worked one shift at Auckland City Hospital's Renal Medicine & Transplant Ward (Ward 71) on 8 June, and the child attended ABC Childcare Centre in Meadowbank the same day.

Dr David Sage - Auckland District Health Board Chief Medical Advisor, said the nurse was asymptomatic when returning to work for a 12 hour shift on 8 June. However, that evening the nurse's child began to show flu-like symptoms and immediate medical advice was sought. Later that night the nurse began to develop symptoms.

On Tuesday 9 June nurses from the Auckland Regional Public Health Service visited the mother and child at home, appropriate measures were put in place and swabs were taken. Last night both swabs returned positive results for H1N1. Dr Sage said as soon as the alert was raised at Auckland City Hospital, staff acted swiftly to identify, isolate and treat all those potentially affected. This includes staff and patients who were on Ward 71 at Auckland City Hospital on Monday 8 June.

"At this time, none of these people are showing flu-like symptoms," he said. "I would like to commend all the staff who worked tirelessly last night and this morning to help us contain the potential spread of this virus."

Ward 71 remains operational, with strict infection-control procedures in place, although as a precautionary measure, is closed to new admissions. Five patients are being cared for in isolation, there is a limit on visitors to all patients and the number of staff coming to the ward has been reduced. In the community, the child attended ABC Childcare Centre in Meadowbank has closed its doors and staff are working with Auckland Regional Public Health (ARPHS) to identify children who were at the centre on Monday 8 June. It's likely to remain closed at least until next Tuesday, 16 June.

ARPHS clinical director, Dr Julia Peters says public health staff are working closely with Auckland City Hospital to manage the public health aspects of the situation and are also working with parents and staff from the childcare centre. Dr Peters said "We are working closely with the childcare centre to identify all attendees and ensure children and staff are in quarantine and have been offered Tamiflu." She expressed thanks to the staff and parents of the centre for their co-operation.

Although the mother and child arrived in New Zealand from the UK on flight NZ1 on 6 June, as neither developed symptoms until more than 48 hours after arrival, contact tracing for those on the flight will not be necessary.

The Ministry of Health's chief public health advisor, Dr Ashley Bloomfield, said as more people tested postive for influenza A (H1N1) "swine flu" there would be more instances where workplaces, schools, and child care centres would be affected.

"People have been highly cooperative to date. This has undoubtedly contributed to New Zealand's relatively low number of confirmed cases.

"As has been demonstrated this week, each case can have a large number of contacts, and already, this virus is causing significant disruption to the regular routines and lives of those affected.

"Our assessment is that our actions to "Keep it out" and "stamp it out" are still appropriate and worthwhile. There are real benefits to delaying wipespread community transmission of the virus for as long as possible," Dr Bloomfield said.