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The latest on Swine Flu

THE DEPARTMENT of Health says it will follow a “safety first” approach of offering antiviral medicine to everyone with swine flu. The announcement comes after the publication of research that says antivirals are of “small benefit” for treating children with seasonal flu. It says the benefit must be weighed against a risk of side effects. The research did not specifically look at the swine flu virus or current pandemic.

A Department of Health spokesman said “Whilst there is doubt about how swine flu affects children, we believe a safety-first approach of offering antivirals 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.”

Vaccine progress
The World Health Organization (WHO) confirmed last week that the first swine flu vaccines are likely to be licensed for use in the general population in September. Initial batches of an H1N1 vaccine have already been produced, and clinical trials are underway. “The quality controls on today’s vaccine are much better than they were 30 years ago,” said the WHO, which also oversees the safety checks on the seasonal flu jab.

Although a decision has not yet been finalised on which groups of the UK population will receive the vaccine first, it is likely to be people who are most vulnerable, such as those with underlying (existing) health conditions, frontline health workers (staff in contact with the public) and young children.

Swine flu dips
The number of new cases of swine flu in England dropped sharply in the first week of August, with an estimated 30,000 new cases reported. This compares to an estimated 110,000 cases the week before. However, the virus is not expected to go away. Experts still expect an increase in the autumn when schools reopen and the traditional flu season begins in the UK.

Other key points made at a briefing by the chief medical officer (CMO) included:

There is still no sign of the virus mutating into a more dangerous form, or developing resistance to drugs.The number of swine flurelated deaths in England is now 36. In total, 530 patients were admitted to hospital in England in the first week of August, down on the previous week’s total of 793.In Australia, about a quarter of hospital patients are in intensive care. There has been a relatively high number of deaths, and it is not known why. The position in Latin America is worsening. In Argentina, the number of deaths has doubled in a fortnight.

National Pandemic Flu Service
The National Pandemic Flu Service was launched in July. This new online service assesses patients for swine flu and, if required, gives them an authorisation number that can be used to collect antiviral medication.The system, which can also be accessed by telephone, will take the strain off GPs as swine flu spreads. For the moment, it is only being used in England. “The National Pandemic Flu Service is a new self-care service which will give people with pandemic swine flu symptoms fast access to information and antivirals,” said a Department of Health spokesman.

“This new service will free up GPs, enabling them to deal with other illnesses that need their urgent attention.”

The launch of the new system means important changes to the official advice that is given to people who think they may have swine flu. That advice, and the new system itself, is supported by the Royal College of General Practitioners.

Latest advice
If you have flu-like symptoms and are concerned that you may have swine flu, the advice is to stay at home and check your symptoms at the National Pandemic Flu Service.

Call your GP if:
*you have a serious underlying (existing) illness,
*you’re pregnant, *you have a sick child under one year old,
*your condition suddenly gets much worse, or
*your condition is still getting worse after seven days (five for a child).

Telephone: 0800 1 513 100

Minicom:0800 1 513 200

For more information on the National Pandemic Flu Service, go to Flu Service: questions and answers.

People in Scotland, Wales and Northern Ireland can visit
www.direct.gov.uk/pand emicflu

Planning assumptions
The government released a Planning Assumptions paper in July outlining possible scenarios for how the pandemic might develop in the UK. It says that if the current growth in cases is sustained, a substantial wave of cases with up to 30% of the population experiencing symptoms could peak in early September. A smaller but earlier peak is also possible. Alternatively, seasonal effects might substantially slow the epidemic in July and August, perhaps to the extent of leading to a decline in weekly cases in August, before a resurgence in the autumn, for example when schools reopen. If so, the overall peak of the pandemic might be delayed to October or even later.

These forecasts and others in the report are based on a “reasonable worst case” value and should therefore not be taken as a prediction of how the pandemic will develop. Planning against the reasonable worst-case scenario will ensure, however, that plans for all likely scenarios are robust.

Mortality planning assumptions range from 3,100 deaths in the UK to 65,000 deaths in a reasonable worst case scenario.

How dangerous is swine flu?

The vast majority of cases reported so far in this country have been mild. Only a small number have led to serious illness, and these have frequently been where patients have had underlying health problems.

There has been an argument put forward that the government should restrict antivirals to those groups who are most at risk of developing serious complications from swine flu. In other words, if people are otherwise healthy, then the NHS should let the virus run its course, treating it with paracetamol and bed rest, as for normal flu.

However, the government’s Scientific Advisory Group for Emergencies (SAGE) believes there is still some uncertainty about the risk profile of the virus. For instance, there are reports of some cases in Argentina where young, healthy adults have apparently become extremely ill from swine flu.While there is still this doubt, the government has decided to continue offering Tamiflu to everyone with swine flu at their doctor’s discretion.

“We will keep this matter under review, with advice from SAGE,” said health minister Andy Burnham.

Which groups are at greatest risk?

Some people are more at risk than others of serious illness if they catch swine flu. They will need to start taking antivirals as soon as they are confirmed with the illness. On occasion, doctors may advise some high risk patients to take antivirals before they have symptoms if someone close to them has swine flu.

The risk profile of the virus is still being studied but it is already known that certain groups of people are particularly vulnerable.

These include:
*Patients who have had drug treatment for asthma in the past three years
*Pregnant women
*People aged 65 years and older
*Children under five years old
*People with chronic lung disease
*People with chronic heart disease
*People with chronic kidney disease
*People with chronic liver disease
*People with chronic neurological disease
*People with i m m u n o s u p p r e s s i o n (whether caused by disease or treatment)
*People with diabetes mellitus

What about a vaccine?

A vaccine to protect against swine flu is being developed and is not yet available.

The first batches of vaccine are expected to arrive in September, and 30 million double doses, enough for half the population, are expected to be available by the end of the year.

The government has ordered enough vaccine for the whole population and, when it becomes available, will focus on those at the greatest risk first.

What is the global situation?

As of August 5, there were more than 193,000 laboratory confirmed cases, though the actual number of infections is probably much higher. Global swine flu deaths have passed 1,300.

Catch it, Bin it, Kill it
Although the UK has moved to a treatment phase for swine flu, it’s important that people continue to do everything they can to stop the virus from spreading.The most important way to stop it spreading is to have good respiratory hygiene (i.e. sneezing and coughing into a tissue) and hand hygiene (keeping your hands clean).
(Culled from NHS website).

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