Swine Flu Update: 28/08/2009

Despite a continued fall in the number of new cases for last week – with 5,000 new cases reported, compared to a peak of 100,000 at the start of the month - and a consecutive decline in the number of GP consultations, – the UK’s Chief Medical Officer, Sir Liam Donaldson, once again warned Britons against complacency in the fight against the virus - adding that whilst "It is normally a mild illness…for some it continues to be very serious”. An additional 7 deaths were recorded for the week and over 200 people continue to be hospitalized with the illness. HPA figures continue to be questioned for their reliability since the transition to the National Pandemic Flu Service (NPFS) earlier in the month. Moreover, on the issue of anti-virals such as Roche’s Tamiflu and GlaxoSmithKline’s Relenza, and in the context of the World Health Organization’s refreshed guidelines on the administration of the drugs, the Department for Health has continued to support its existing philosophy (at least in the meantime) with a spokesperson for the authority saying: “We believe a safety-first approach of offering antivirals, when required, to everyone remains a sensible and responsible way forward. However, we will keep this policy under review as we learn more about the virus and its effects”. Yet for all the positive news of the past week or so, there is absolutely no cause for complacency. To a certain degree, the most recent fall – however substantial – was somewhat to be expected, with officials fully aware that initial fluctuations were possible – leading up to an eventual zenith during the course of the winter months. The worst may be yet to come.


“In the southern hemisphere, most countries (represented by Chile, Argentina, New Zealand, and Australia) appear to have passed their peak of influenza activity and have either returned to baseline levels or are experiencing focal activity in later affect areas; while a few others (represented by South Africa and Bolivia) continue to experience high levels of influenza activity. Many countries in tropical regions (represented by Central America and tropical regions of Asia), continue to see increasing or sustained high levels of influenza activity with some countries reporting moderate strains on the healthcare system. In temperate areas of the northern hemisphere (represented by North America, Europe, and Central Asia), influenza and respiratory disease activity remains low overall, with some countries experiencing localized outbreaks. In Japan, the level of influenza activity has passed the seasonal epidemic threshold, signaling a very early beginning to the annual influenza season. Pandemic H1N1 influenza virus continues to be the predominant circulating strain of influenza, both in the northern and southern hemisphere. Antiviral susceptibility testing has increased in several countries, confirming that pandemic H1N1 influenza virus remains sensitive to the antiviral oseltamivir, except for sporadic reports of oseltamivir resistant pandemic H1N1 virus detailed in the previous web update (No. 62)”.
*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.
• The majority of cases continue to be mild. There is no sign that the virus is changing. It is not becoming more severe or developing resistance to anti-virals • A second wave of infections in the UK is still expected later in the year • There were 218 people with swine flu hospitalised in England (as of 8am on 26 August), • There have been over 2,500 deaths worldwide • In the past seven days, cases reported globally have increased by 8% and the number of deaths by 21%.
This week also witnessed the confirmation of which priority groups will be the first to be given the vaccine in the UK. In making the announcement, Health Secretary, Andy Burnham, said: “Although the virus has so far proved to be mild in most people, for others it has been more serious. By vaccinating high-risk groups first, we aim to protect those most vulnerable to this virus”. The first stocks of the vaccine will be distributed to groups in the following order: • People aged between six months and 65 years in the clinically at-risk groups for seasonal flu. • Pregnant women, subject to licensing by the European Medicines Agency, which will indicate whether it can be given throughout pregnancy or only at certain stages of pregnancy. • Household contacts of people with compromised immune systems. • People aged 65 and over in the current seasonal flu vaccine clinical at-risk groups. *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.