Swine Flu Update: 02/11/2009

The past few weeks have been something of a medical paradox. Yes, the number of cases is increasing, but it is doing so somewhat more steadily than first anticipated. The full brunt of the highly anticipated ‘second wave’ is more likely to come towards the end of December and into the heat of the winter season. Conversely, while there hasn’t been a terrible spike in the number of cases, more people are being hospitalized with the virus. Hospitals too are beginning to feel the strain. Speaking on BBC 1’s the Andrew Marr Show, the UK’s Chief Medical Officer, Sir. Liam Donaldson said "What we are seeing is that while most people generally get a mild illness, a small proportion of people are getting very serious illnesses”. And while it doesn’t represent anything like the surge in numbers that some officials had expected by now, the number of new cases last week was still great enough. An estimated 78,000 new cases of the virus emerged – a 50% increase in the week before – and the number of patients requiring critical care shot up to a record 157. An additional 594 individuals needed less intensive hospital treatment. Worst of all by any metric, another 15 deaths were counted, bringing the UK total to 137. Approximately 50% of the new deaths have come as the result of pre-existing conditions. In the case of the H1N1 vaccine, the postal strikes too, are causing officials some sleepless nights. Over the next few weeks, GPs will be moving on from the vaccination of frontline NHS staff to the first of the ‘priority groups’ – such as pregnant women and people will long-standing conditions. As GPs begin to send out appointment letters, there is concern that post backlogs will lead to missed appointments and delayed vaccinations for those individuals most in need of immunity. Commenting on the concerns, Donaldson said: "We are a little bit worried about the postal strike because GPs send their letters out, letters of appointment, so we are working very hard to try and get around that, ensuring that people get their appointments in time." As we move further into the winter season, the concern over hospital resources is likely to intensify further, as critical care facilities come under increasing levels of strain. Already, several intensive care units are being tested under the pressure. The numbers are only likely to grow as the weeks and months pass. Notwithstanding Donaldson’s “plans to expand them [beds]” over the coming months, he also warned that "the intensive care beds are [already] under a lot of pressure”. Yet, as a pause in the surge of cases presents itself, medical officials will be presented with greater time to administer the vaccine in advance of the real ‘second wave’. “The good thing about the situation at the moment is we are getting a bit of breathing space”, said Donaldson. The challenge is to make the most of it.

“In the temperate zone of the northern hemisphere, influenza transmission continues to intensify marking an unusually early start to winter influenza season in some countries. In North America, the US, and parts of Western Canada continue to report high rates of influenza-like-illness (ILI) and numbers of pandemic H1N1 2009 virus detections; Mexico has reported more confirmed cases since September than during the springtime epidemic. In Western Europe, high rates of ILI and proportions of respiratory specimens testing positive for pandemic H1N1 2009 have been observed in at least five countries: Iceland, Ireland, the UK (N. Ireland), Belgium, and the Netherlands. Many other countries in Europe and Western and Central Asia are showing evidence of early influenza transmission, including in Spain, Austria, parts of Northern Europe, Russia, and Turkey. In Japan, influenza activity has also increased sharply, especially on the northern island, approximately 10 weeks ahead the usual start of the winter influenza season. Pandemic influenza transmission remains active in many parts of the tropical zone of the Americas, most notably in several Caribbean countries. Overall transmission continues to decline in most but not all parts of the tropical zone of South and Southeast Asia Little influenza activity has been reported in temperate region of the southern hemisphere since the last update.”
*The information above is a copy of the latest WHO regulations and guidelines for Swine Flu and can be found in more detail at the WHO Website, here.
• Rates have risen again, with an estimated 78,000 new swine flu cases in the past week, up from 53,000 the week before. • There has been an increase in deaths related to swine flu. To date, there have been 137 deaths in the UK; 97 in England, 25 in Scotland, eight in Northern Ireland and seven in Wales. • There has been a further rise in hospitalisations, with 751 patients with swine flu in hospital in England. This is the greatest number since July. • The number of people needing critical care is at its highest level yet, at 157 patients in England. • The disease is mild in most people so far, but is proving severe in a small minority of cases. • The swine flu vaccination programme is underway: it is expected that 12m high-risk patients will receive the vaccine by the end of November.
*The information above is a copy of the latest NHS key updates for Swine Flu and can be found in more detail at the NHS Swine Flu Website, here.
• WHO Twitter – ‘WHO's official Twitter channel. Who is the directing and coordinating authority within the UN system for public health’. • NHS Swine Flu Overview – ‘This page brings together the latest science and developments on the swine flu pandemic into a single accessible resource for both health professionals and the general public’. • NHS Swine Flu Vaccine – Detailed information on the development of the H1N1 vaccine, along with logistical updates on clinical trials in the U.S. and Australia, efficacy and WHO recommendations. • The Lancet H1N1 Flu Resource Centre – With over 40 journals, Lancet is one of the leading scholarly resources on the topic of Swine Flu – if not any healthcare issue. With free, unlimited access for all, this is one powerful research resource. • Nature – A number of interesting feature articles and blogs pertaining to the topic of Swine Flu. • Fergus on flu – Great Swine Flu blog from the BBC’s Chief Medical Correspondent. • Microsoft Bing Swine Flu Tracker – ‘Map of 2009 Swine Flu H1N1 outbreaks and migration paths reported from news and government agencies. The map lists reported dates and paths of infected persons traveling’. • Facebook Group for H1N1 – With over 3,500 members – and literally hundreds of personal accounts on the current outbreak, this Facebook Group provides an interesting view into the potential future impact of Social Media on healthcare related issues.