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11th December

Swine flu "less lethal" than feared

The swine flu pandemic has been "considerably less lethal" than originally feared, Chief Medical Officer Sir Liam Donaldson has said.

By November 8 this year, 26 people have died out of every 100,000 infected with the swine flu virus, a study led by Sir Liam revealed.

"The first influenza pandemic of the 21st century is considerably less lethal than was feared in advance," the study said.

With a death rate of 0.026%, the UK has appears to have got off lightly compared with past flu pandemics.

The two most recent flu pandemics in 1957 and 1967 had death rates of around 0.2 %, and the notorious Spanish flu pandemic of 1918 had a rate of 2-3%, eventually killing around 50 million people worldwide.

The analysis of swine flu deaths also found that around two thirds of deaths could have been prevented by vaccination as the people were in the high risk groups.

But a sizeable minority (38%) of deaths occurred in people outside the high risk groups.

"Given that a substantial minority minority of deaths occur in previously healthy people, there is a case for extending the vaccination programme and for continuing to make anti-viral treatment widely available," Sir Liam stated.

Although 5-14 year olds have consistently been most at risk of being infected, the study shows they had one of the lowest rates with around 11 deaths per 100,000 people.

In contrast to this, death rates were found to be highest in the over 65s age group at 980 per 100,000, despite being less likely to be infected.

The results, reported online in the British Medical Journal, came as the number of new cases of swine flu in the UK continues to fall.

Last week, 11,000 people were infected in England compared with 22,000 the week before.

Infection rates are down in most age groups except for those under the age of one year old. To date, 283 deaths in the UK have been linked to the swine flu virus.

The study concluded that modern medicine may have also helped influence the death rates seen in flu pandemics.

"Since the most recent pandemics, there have been major advance in intensive care medicine.

"Many more patients may have died in England without the ready availability of critical care support, including mechanical ventilation.”

20th November 2009

Tamiflu resistant swine flu arrives in UK/ Person to person spread confirmed

A strain of swine flu which is resistant to the anti-viral drug Tamiflu has spread between patients in a South Wales hospital.

Five patients on a unit treating patients with severe underlying health conditions at the University Hospital of Wales, Cardiff, have been infected.

Three patients appear to have been infected in hospital.

Although transmission between people of a drug resistant strain of the virus has been suspected in other parts of the world, this is believed to be the first time the spread has been confirmed.

All of the patients diagnosed with Tamiflu-resistant swine flu on the unit have been treated with an alternative antiviral drug, and all staff are being offered the swine flu vaccination.

Dr Roland Salmon, Director of the National Public Health Service for Wales Communicable Disease Surveillance Centre, said: “The emergence of influenza A viruses that are resistant to Tamiflu is not unexpected in patients with serious underlying conditions and suppressed immune systems, who still test positive for the virus despite treatment.

“In this case, the resistant strain of swine flu does not appear to be any more severe than the swine flu virus that has been circulating since April.

“For the vast majority of people, Tamiflu has proved effective in reducing the severity of illness. Vaccination remains the most effective tool we have in preventing swine flu so I urge people identified as being at risk to look out for their invitation to be vaccinated by their GP surgery.”

Chief Medical Officer for Wales, Dr Tony Jewell, said: “We know that people with suppressed immune systems are more susceptible to the swine flu virus, which is why they are a priority group under the first phase of the vaccination programme in Wales which is progressing at pace.

“We have stringent processes in place for monitoring for antiviral resistance in the UK so that we can spot resistance early and the causes can be investigated and the cases managed.

"Identifying these cases shows that our systems are working so patients should be reassured.

“Treatment with Tamiflu is still appropriate for swine flu and people should continue to take Tamiflu when they are prescribed it.

“It’s also important that good hygiene practices are followed to further prevent the spread of the virus.”

Two of the patients with Tamiflu-resistant swine flu have recovered and been discharged from the hospital. One patient remains in critical care and two others are being treated on the ward.

20th Novemberv 2009

Healthy under-fives to get swine flu jab/ Group most at risk of being hospitalised

Healthy children between the ages of 6 months and 5 years will be vaccinated against swine flu starting from next month, the Department of Health has announced.

The vaccine is currently available only to children who are already in the high risk groups.

The news came as the number of new swine flu cases fell for the second week running. Last week an estimated 55,000 people were infected with the H1N1 virus in England compared with 64,000 the week before.

The number of people visiting their doctor with flu-like illness also dipped slightly to 36 per 100,000 people compared with 37.7 in the previous week, but still above baseline threshold levels for England.

To date, the number of deaths linked to the virus now stands at 215 - 142 in England, 39 in Scotland, 21 in Wales and 13 in N. Ireland. A total of 783 were admitted to hospital last week due to the virus, with 180 in intensive care.

The latest figures to be released by the Health Protection Agency (HPA) show that young people in the 1-4 and 5-14 age groups continue to be the most affected by swine flu.

Approximately 21% of all swine flu deaths in the UK have occurred in the under-14s. Ominously, 80% of children in the under-5 age group who have needed hospital treatment had no underlying health problems.

Commenting on the plans to extend the vaccination programme to the under-5s, Chief Medical Officer, Professor Liam Donaldson, said: “Our first priority is to ensure that people with clinical risk factors, and frontline health and social care staff are vaccinated.

“Protecting those most at risk from the disease will reduce the levels of serious illness, and deaths. That’s why we will shortly offer the vaccine to young children.

“Vaccination remains a personal choice, but I urge everyone who is offered the vaccine to accept it and protect themselves. While the risks of serious complications from ‘flu may be small, the impact on those affected can be devastating.”

Professor Steve Field, Chairman of the Royal College of General Practitioners, also added:

“We shouldn’t underestimate swine flu – it is a nasty infection and its effects can be devastating.

"I know that some parents have concerns about immunisation but the swine flu vaccine is our most effective protection against the virus. This is obviously a personal choice but I would advise all parents whose children are offered the vaccine to take it up.

"If you are worried, please talk to your GP and get all the information so that you can make an informed choice.”

An estimated 715,000 people in the UK have been infected with the virus. Most illness caused by the virus is mild, but can be severe in a small minority of cases.

TheFamilyGP guide to swine flu

Action plan

For tips on how to be prepared for swine flu, and important contact numbers and sources of information.

Swine flu background

Risk groups

Progress of the disease

This article was published on Mon 20 July 2009

Image © CDC C. S. Goldsmith and A. Balish

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