UK swine flu cases have fallen for the first time since August, down to 64,000 new infections in the past week. It is thought the half-term break may be behind the drop of 20,000 from the previous week.
Despite a fall in cases the number of people needing hospital treatment for the virus has remained high, with 785 patients in hospital. Of these patients 173 are receiving critical care.
The UK has also seen 28 further deaths related to swine flu, raising the total to 182: 124 in England, 33 in Scotland 14 in Wales and 11 in Northern Ireland.
Virtually all GPs have now received their first supplies of the swine flu vaccine. The 6.6 million doses delivered in the past month are now being used to protect those most susceptible to swine flu, including pregnant women and people with long-term conditions.
The government is also launching an advertising campaign that will explain the importance of receiving the vaccine, which is expected to offer several years of protection against swine flu.
In other swine flu news:
- Use of the National Pandemic Flu Service has levelled off.
- Priority groups continue to be vaccinated, and virtually all GPs have received their first delivery of swine flu vaccine.
- The Department of Health has published new guidelines for the treatment of swine flu in pregnancy. The new guidance contains detailed advice for clinicians caring for pregnant women.
The National Vaccination Programme
NHS hospitals are now vaccinating patients facing the greatest risk of complications. Healthcare staff dealing with the public are also being vaccinated to help keep medical services running smoothly and to prevent them from passing the virus to patients.
Virtually all GPs have received their first supplies of the vaccine. Patients will be contacted by their GPs if they fall into one of the at-risk categories.
The order of priority will be:
- People aged from six months to 65 years in current seasonal flu risk groups
- All pregnant women
- Those living with people with compromised immune systems, for example those recieving cancer treatment
- People aged over 65 in the current seasonal flu risk groups.
The government has produced a swine flu vaccination leaflet with more information. The chief medical officer, Sir Liam Donaldson, said: “I urge everyone in the priority groups to have the vaccine – it will help prevent people in clinical risk groups from getting swine flu and the complications that may arise from it.”
Who is a priority for vaccination with the H1N1 swine flu vaccine?
People who are most at risk from swine flu need to be vaccinated first. These groups are, in order of priority:
- People aged between six months and 65 years in the seasonal flu vaccine at-risk groups.
- All pregnant women, subject to licensing. The European Medicines Agency, who license the vaccine, will indicate whether it can be given to all pregnant women or whether it should only be offered at certain stages of pregnancy.
- People who live with those whose immune systems are compromised, such as cancer patients or people with HIV/AIDS.
- People aged 65 and over in the seasonal flu vaccine at-risk groups.
Frontline health and social care workers will also be offered the vaccine at the same time as the first clinical at-risk groups. Health and social care workers are both at an increased risk of catching swine flu and of spreading it to other at-risk patients.
What are the seasonal flu vaccine at-risk groups?
These are people with:
- chronic respiratory disease, such as chronic obstructive pulmonary disease (COPD),
- chronic heart disease, such as heart failure,
- chronic kidney disease, such as kidney failure,
- chronic liver disease, such as chronic hepatitis,
- chronic neurological disease, such as Parkinson’s disease,
- diabetes requiring insulin or oral hypoglycaemic drugs, and
- immunosuppression (a suppressed immune system), due to disease or treatment.
Why are healthy people over 65 and children not a priority for the swine flu vaccine?
Healthy people aged over 65 appear to have some natural immunity to the swine flu virus. And while children are disproportionately affected by swine flu, the vast majority make a full recovery – therefore the experts do not advise that children (other than those in at-risk groups) should be vaccinated initially.
Who is at greatest risk of serious complications from swine flu?
Some people are more at risk of complications if they catch swine flu, and need to start taking antivirals as soon as it is confirmed that they have the illness. Doctors may advise some high-risk patients to take antivirals before they have symptoms, if someone close to them has swine flu.
It is already known that people are particularly vulnerable if they have:
- chronic (long-term) lung disease,
- chronic heart disease,
- chronic kidney disease,
- chronic liver disease,
- chronic neurological disease (neurological disorders include motor neurone disease, multiple sclerosis and Parkinson’s disease),
- immunosuppression (whether caused by disease or treatment), or
- diabetes mellitus.
Also at risk are:
- patients who have had drug treatment for asthma in the past three years,
- pregnant women,
- people aged 65 and over, and
- children under five.
National Pandemic Flu Service
The National Pandemic Flu Service was launched in July. This 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 phone, will take the strain off GPs as swine flu spreads. For the moment, it is being used only 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 system brought important changes to the official advice that is given to people who think they may have swine flu. That advice – and the new system – is supported by the Royal College of General Practitioners.
Advice for antivirals
Several newspapers reported that the World Health Organization (WHO) had changed its advice regarding use of antivirals for swine flu. Its advice suggests that while antivirals should always be given in serious cases, they may not always be necessary for otherwise healthy people.
The papers pointed out that this appeared to differ from the approach taken in the UK, where Tamiflu is being widely used.
However, the Department of Health said:
“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.
“The WHO recommendations are in fact in line with UK policy on antivirals. We have consistently said that many people with swine flu only get mild symptoms, and they may find bed rest and over-the-counter flu remedies work for them.”