Alert: Important information about swine flu

Important changes have been announced today to the way in which the NHS is managing the growing swine flu pandemic in England. Read the latest advice to help protect yourself, your family and others.

 

Last updated: 16.45 BST

The secretary of state for health today announced the groups that will be given priority for vaccination once a swine flu vaccine becomes available. The government has placed orders for enough vaccine for the entire population, but as it will take time to produce enough vaccine, the most vulnerable groups need to be given priority.

Andy Burnham said that the vaccine, with the first batches expected to be available in October, would initially be given to the following groups, in this order:

• People aged between six months and 65 years in current seasonal flu vaccine clinical at-risk groups
• All pregnant women (subject to licensing)
• Household contacts of people with compromised immune systems
• People aged 65 and over in the current seasonal flu vaccine clinical at-risk groups

He said that frontline health and social care workers will also begin to be vaccinated at the same time as the first at-risk group.

At-risk groups

At-risk groups will be the same as for seasonal flu vaccination, and include people with serious heart disease, diabetes, and those with weakened immune systems due to cancer treatment.

The health secretary 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 list has been drawn up according to advice from the Joint Committee on Vaccination and Immunisation. The group of independent experts reviewed the evidence and advised the Department of Health on the crucial risk groups to be offered vaccination to reduce the rate or possibility of serious illness.

A vaccination programme for the rest of the population will be based on the evolution of the pandemic as well as new clinical data on the use of the vaccine.

People in the priority groups outlined above do not need to take any action yet. Further announcements will be made when the vaccination strategy is ready, and those who need a vaccine will be contacted.

 

Weekly pandemic flu update

Other key points made at this week’s briefing by the chief medical officer (CMO) included:

• There has been a further reduction in the rates of flu-like illness and related activity this week. There were an estimated 25,000 new cases last week compared to 110,000 new cases two weeks before.
• Weekly GP consultation rates decreased over the last week in England.
• There are 371 patients in hospital with swine flu, 39 of whom are in critical care.
• There have been 44 confirmed deaths in England, bringing the UK total to 49.
• There is still no sign of the virus mutating into a more dangerous form, or developing resistance to drugs.

 

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. 

 

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).

For people who do not have internet access, the National Pandemic Flu Service can be accessed by phone on:

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/pandemicflu

 

Swine flu latest from the NHS

The government today launched the National Pandemic Flu Service, a new online service that will assess patients for swine flu and, if required, provide an authorisation number that can be used to collect antiviral medication.

 

 

 

If you have flu-like symptoms find out what should you do

• If you have flu-like symptoms and are concerned that you may have swine flu:

  • Stay at home and check your symptoms at the National Pandemic Flu Service
  • You should call your GP directly if: 

              - you have a serious underlying illness

              - you are pregnant

              - you have a sick child under one year old

              - your condition suddenly gets much worse

              - your condition is still getting worse after seven days (or five days for a child)

  Note: The National Pandemic Flu Service is a self-care service that will asses your symptoms and, if required, provide an authorisation number which can be used to collect antiviral medication from a local collection point. For those who do not have internet access, the same service can be accessed by telephone on:

  • Telephone: 0800 1 513 100
  • Minicom: 0800 1 513 200

  For more information on the National Pandemic Flu Service go to Flu Service – Q&A

  Key actions

  Swine flu is spreading fast in the UK. Prepare now by:

  • Learning to recognise the symptoms of swine flu
  • Establishing ‘flu friends’ - friends and relatives who can help if you fall ill
  • Keeping  paracetamol-based cold remedies in the house
  • Having a thermometer available so you can check your temperature if needed

  Note: If you have elderly or vulnerable neighbours please check on them. They may need your help but be reluctant to ask for it. It is important you do what you can.

  Note: To order a Braille copy of the swine flu information leaflet, call the swine flu information line on 0800 1 513 513

   

  Good hygiene

  Preventing the spread of germs is the single most effective way to slow the spread of diseases such as swine flu. You should always:

  • Ensure everyone washes their hands regularly with soap and water
  • Clean surfaces regularly to get rid of germs
  • Use tissues to cover your mouth and nose when you cough or sneeze
  • Place used tissues in a bin as soon as possible

  What is swine flu (influenza A H1N1)?

  

  Although symptoms of swine flu have generally been mild, a small number of patients will develop more serious illness. Certain groups of people, and people with other health conditions, such as heart or lung disease, are at increased risk.
  

  Find out more about the cause of swine flu and how it differs from ordinary flu.

  Scotland, Wales and Northern Ireland

  If you live in Scotland, Wales or Northern Ireland go to this pandemic flu information page.  It will direct you to swine flu information and treatment advice in your area.

• Swine flu is the common name that has been given to a new strain of influenza. It is called swine flu because it is thought to have originated in pigs, but this is not known for certain.

  The most common symptoms are fever, sore throat, diarrhoea, headache, feeling generally unwell and a dry cough – in other words, symptoms very similar to seasonal influenza. Most people recover within a week, even without special treatment.

  Pandemic

  The virus was first identified in Mexico in April and has since become a pandemic, which means it has spread around the globe. It has spread quickly because it is a new type of influenza virus that few, if any, people have full resistance to.

  Flu pandemics are a natural event that occur from time to time. Last century, there were flu pandemics in 1918, 1957 and 1968, when millions of people died across the world.

  So far the new virus is known to have infected more than 119,000 people worldwide. However, this figure is almost certainly a large underestimate because it reflects only those cases which have been confirmed by laboratory tests.

  In the majority of cases the virus has proved relatively mild. However, more than 700 people have died globally and its 'risk profile' is still not fully understood. For this reason, and because all viruses can mutate to become more potent, scientists are advising caution.

  The situation in the UK

  There have been an estimated 55,000 cases in the UK since the outbreak started here on 27 April. Of these, over 600 have involved hospitalisation, and 31 people have died.

  The UK formally moved from a 'containment' to a 'treatment' phase for swine flu on 2 July. This meant that intensive efforts to contain swine flu, via automatic school closures, for example, ended in order to free up capacity to treat the increasing numbers of people who are contracting swine flu daily.

  As in other countries, the majority of cases reported so far in the UK 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 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 you would normal flu.

  However, the government's Scientific Advisory Group on Emergencies (SAGE) believes that there is still some doubt 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 offer the antiviral medicines Tamiflu or Relenza to everyone confirmed with swine flu.

  High-risk groups

  Some people are more at risk of serious illness if they catch swine flu, and 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 the following people are particularly vulnerable:

  • people with:
    - chronic 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), and
    - diabetes mellitus,
  • patients who have had drug treatment for asthma in the past three years,
  • pregnant women,
  • people aged 65 years and older, and
  • children under five years old.

  Swine flu vaccine

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

  The first batches of vaccine are expected to arrive in the autumn, 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.

  Catch it, bin it, kill it

  Although the UK has moved to a treatment phase for swine flu, it is important that people continue to do everything they can to stop the virus from spreading.

  The key is to practise good respiratory and hand hygiene. In other words, remember to Catch it, Bin It, Kill It. Catch your sneeze in a tissue, place it quickly in a bin and wash your hands and surfaces regularly to kill the virus.

   

• Advice for pregnant women

If you are pregnant, you are in one of the high-risk groups for swine flu, so it is important you read this page carefully and follow the advice to protect yourself and your baby.

This page explains why pregnant women are at greater risk from swine flu, what those risks are, the special precautions you should take and the safety information for swine flu treatments.

Why pregnant women are more at risk

In pregnancy, the immune system is naturally suppressed. This means that pregnant women are more likely to catch swine flu, and if they do catch it, they are more likely to develop complications (see below).

However, it is important not to panic: your immune system still functions and the risk of complications is still very small. The majority of pregnant women will only suffer mild symptoms.

Symptoms and risks

If you are pregnant and you catch swine flu, the symptoms are expected to be similar to those of regular human seasonal flu. Typical symptoms are fever and a cough, and sometimes also tiredness, headache, aching muscles, runny nose, sore throat, nausea or diarrhoea.

Most pregnant women will have only mild symptoms and recover within a week. However, there is evidence from previous flu pandemics that pregnant women are more likely to develop complications from flu.

Possible complications are pneumonia (an infection of the lungs), difficulty breathing and dehydration. In pregnant women, these are more likely to happen in the second and third trimester.

If a pregnant woman develops a complication of swine flu, such as pneumonia, there is a small chance this will lead to premature labour or miscarriage. There is not yet enough information to know precisely how likely these birth risks are.

It is therefore important to be well prepared and to take precautions against swine flu.

Special precautions

If you are pregnant, you can reduce your risk of infection by avoiding unnecessary travel and avoiding crowds where possible.

Pregnant women should also follow the general advice outlined in the box, top right. Good hygiene is essential.

If a family member or other close contact has swine flu, your doctor may prescribe you antiviral medication (usually Relenza) as a preventative (prophylactic) measure.

If you think that you may have swine flu, call your doctor for an assessment immediately. If your doctor confirms swine flu over the phone, you will be prescribed antiviral medication to take as soon as possible (see box, left).

Unless you have swine flu symptoms, carry on attending your antenatal appointments so you can monitor the progress of your pregnancy.

Swine flu treatment

Antivirals

If you are pregnant and diagnosed with swine flu, you will usually be given a course of the antiviral drug Relenza, which is inhaled using a disk-shaped inhaler. It is recommended for pregnant women because it easily reaches the throat and lungs, where it is needed, and does not reach significant levels in the blood or placenta. Relenza should not affect your pregnancy or your growing baby.

However, if your doctor or midwifery specialist thinks that a different medicine is needed (for instance, if you have unusually severe flu), you will be given Tamiflu instead.

An expert group reviewed the risk of antiviral treatment in pregnancy, which is extremely small - much smaller than the risk posed by the symptoms of swine flu.

Some people have had wheezing or serious breathing problems when they have used Relenza. Relenza is therefore not recommended for people with asthma or COPD. Other possible side effects include headaches, diarrhoea, nausea and vomiting.

Nausea is a known side effect of Tamiflu, in a small number of cases.

If you take an antiviral and have side effects, see your healthcare professional to check that you are ok. Then report your suspected drug reaction to the Medicines and Healthcare products Regulatory Agency (MHRA) via their new new online system.

Painkillers

You can also take paracetamol-base cold remedies to reduce fever and other symptoms. Paracetamol is safe to take in pregnancy.

However, pregnant women should not take non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Nurofen).

Vaccine

It will be in the autumn before a swine flu vaccine becomes available. When it is available, there will be guidelines on which groups of people are a greater priority for vaccination.

You should take up the swine flu vaccine as soon as it is offered - it will not harm you or your unborn baby.

 

 

SWINE FLUE ACROSS THE BRITAIN