Swine flu deaths in England reach highest level

Deaths from the swine flu pandemic in England rose to their highest peak yet last week, new figures have shown.

The number of confirmed deaths for the week ended November 26 were 21, three higher than the week before and two higher than the previous high a fortnight ago.

However at the same time the overall number of people catching swine flu in England fell to an estimated 46,000 new cases in the last week, 7,000 less than the week before.

There has also been a drop in the number of people in hospital, from 783 to 753.

A total of 154 of those being cared for are in intensive care.

The figures are dropping so low that the government said that it was reviewing its online and telephone flu service with a view to withdrawing it after Christmas.

Sir Liam Donaldson, the chief medical officer for England, said that the number of people who have had swine flu or died means the current pandemic is comparable with a normal winter flu season.

But he said: "If you look at the levels you would say they are comparable with a winter flu outbreak but a winter flu outbreak does not kill young people and does not take under-fives into hospital and intensive care on this scale."

Meanwhile more than a million people at high risk from swine flu have been vaccinated, according to Government estimates.

About a million people in England and thousands more in Scotland, Wales and Northern Ireland have received their jab in the first month of the programme.

GPs are currently vaccinating people at risk – such as those with asthma, heart disease and diabetes – before moving on to the under-fives.

The number of deaths in England now stands at 163 and the UK total stands at 242, up from 214 last week.

Sir Liam said the one million figure did not include health care workers, who have also been having the vaccine.

One million is about one in 10 of all the people in at-risk groups who are being offered the vaccine.

So far, 10 million doses of the jab have been sent out to GP surgeries, primary care trusts and acute hospitals in England.

A total of 14 million doses of the vaccine Pandemrix have been delivered to the Government, with another 2.3 million doses of Celvapan also delivered.

From:

http://www.telegraph.co.uk/health/swine-flu/Swine-flu-deaths-in-England-reach-highest-level

Swine flu- strain resistant to Tamiflu spreads between UK hospital patients

A strain of Tamiflu resistant swine flu has spread between patients in a hospital as five patients on a unit for people with severe underlying health conditions at the University Hospital of Wales, in Cardiff, were diagnosed with swine flu that is resistant to the drug.

Three appear to have acquired the infection in hospital, the National Public Health Service for Wales (NPHS) said.

Two of the five have recovered and have been discharged from hospital, one is in critical care and two are being treated on the ward.

The service said the resistant strain does not appear to be more severe than the swine flu virus circulating since the spring.

All patients on the unit have been tested and patients diagnosed with Tamiflu-resistant swine flu have been given other antivirals.

Patients have been isolated or are being cared for in a designated area for influenza cases.

Cardiff and Vale University Health Board has put appropriate infection control measures in place on the unit, the NPHS added.

Staff and patients have been offered swine flu vaccinations, and patients due to come into the unit for treatment are being warned to get the jab from their GP.

Close contacts of the patients are being warned to make sure they are treated quickly if they show any symptoms.

Dr Roland Salmon, director of the NPHS 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.”

It comes after it was announced that more than 3million healthy children under five across the UK are to be offered the swine flu jab.

Parents will be invited by their GPs to bring their children into surgeries, with vaccinations expected to start in December.

Health ministers across the UK agreed children aged six months to five years should be included in the next phase of the vaccination programme after GPs have finished vaccinating at-risk groups, including people aged six months to 65 with conditions like asthma, diabetes and heart disease. Pregnant women and frontline health workers are also currently being given the jab.

Figures released on Thursday showed an estimated 53,000 new cases of swine flu in England in the last week, down from 64,000 in the week before. In Scotland, the figure was 21,200, down from about 21,500 in the previous seven days.

The rate of flu-like illnesses diagnosed by GPs in Wales dropped to 36 cases for every 100,000 people from 65.8 the previous week.

Seven swine flu-related deaths were recorded in Wales in the previous week, taking the total to 21.

Wales’s Chief Medical Officer Dr Tony Jewell said people with suppressed immune systems were designated as a priority group for vaccination because they were known to be more susceptible to the virus.

“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,” he said.

“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.”

Meanwhile, Norwegian health authorities said they had discovered a potentially significant H1N1 mutation that could be responsible for causing the severest symptoms.

The mutated virus was found in the bodies of two people who died of the virus, although medics do not believe it has been transmitted between humans.

From:

http://www.telegraph.co.uk/Swine-flu-Strain-resistant-to-Tamiflu-spreads-between-UK-hospital-patients

Sharp rise in England swine flu deaths

The latest weekly bulletin showed a sharp rise in patient deaths and the number of children being admitted to hospital.

The overall number of new cases showed a second successive weekly fall. Health officials estimate there were 55,000 new cases this week in England compared with 64,000 last week. There was a slight drop in Scotland.

The number of people who have died from swine flu in the UK has reached 214. There were 18 deaths in England last week. The figures since the start of the outbreak in May are 142 fatalities in England, 21 in Wales, 38 in Scotland and 13 in Northern Ireland.

The number of people needing hospital care for the virus is 783, down slightly from 785, in the previous week. Of those in hospital, 180 were in intensive care, up from 173 in the previous week.

The Conservative party has been pressing the government to give vaccinations to healthy children because those under the age of 16 are in one of the more vulnerable groups.

About 21% of all H1N1 deaths in the UK have been among under 14s.

So far the priority groups have included those with pre-existing medical conditions, their carers and pregnant women. Children with asthma or diabetes are already being vaccinated. Now, children aged six months to five years are to be offered the vaccination from next month.

From:

http://www.guardian.co.uk/world/2009/nov/19/swine-flu-vaccines-healthy-children

Swine flu jab to be given to healthy children under five

Healthy children aged under five are to be given the swine flu jab, the Government has confirmed.

Currently people in priority groups - including young children with asthma or diabetes - are being vaccinated.

But the programme will now be rolled out to children with no underlying health issues, aged over six months and under five .

The UK-wide policy was officially confirmed by the Scottish Government today ahead of a similar announcement in England, expected later.

Nicola Sturgeon, the Scottish Health Secretary, said: "I am able to announce today that the next group in the population that will be vaccinated, or offered vaccination, is children aged over six months and under five years."

The announcement came as it emerged that an 11-year-old girl from Berkshire who had tested positive for the H1N1 virus died on November 11.

NHS figures show that children under 16 are the age group most likely to be admitted to hospital with swine flu, and 21 per cent of deaths in England are among under-14s.

Last week, the death toll in the UK stood at 182, with 124 deaths in England, 33 in Scotland, 11 in Northern Ireland and 14 in Wales.

Currently nine million people in priority groups are being vaccinated against swine flu including those with long-term illnesses and pregnant women. Frontline health and social care workers are also being offered the vaccine.

Britain has ordered enough vaccine for everyone to have two doses, but data from clinical trials has shown that one dose is effective.

Children have been hardest hit by swine flu and are the under fives are the most likely age group to be admitted to hospital with the virus.

Researchers warned that intensive care beds for children could run out in Britain this winter due to swine flu.

All of Britain's 303 intensive care beds for children could be filled with swine flu patients this winter and this would leave no beds available for children suffering other illness, recovering from surgery or accidents, according to a study conducted by Dr Art Ercole, of Cambridge University and colleagues.

The research was published online ahead of the print edition of the journal Archives of Disease in Childhood.

Dr Ercole said over half of admissions to paediatric intensive care units (PICUS) are unplanned and respiratory illness is the second largest cause of admission, accounting for around one in four cases.

From

http://www.telegraph.co.uk/health/swine-flu/6606561/Healthy-children-below-age-of-five-to-get-swine-flu-jab.html

Half term helps curb swine flu infections

Half term holidays may have temporarily eased the rise in the number of cases of swine flu, the government's chief medical officer said yesterday.

Unveiling the latest data showing a decline to an estimated 64,000 new infections this week, compared with 84,000 last week, Sir Liam Donaldson said it could be explained by the school holidays.

The reversal caused some surprise, with the trend in recent weeks suggesting the UK was experiencing an escalating "second wave" of the H1N1 virus in the build-up to winter. "We don't know whether this is the start of a downturn or not," Sir Liam said.

Officials said the decline could also reflect fewer cases of children reporting to doctors during the holidays even if they did develop symptoms.

The school summer holidays were seen as helping suppress the first pandemic wave, since the virus spreads most easily among children. Since the start of the autumn term there have been 241 school outbreaks recorded, with the highest number of 92 in Yorkshire and Humberside.

There was also a drop over the past week in hospitalisations in England from 848 to 785. An estimated 670,000 people have been infected to date. Vaccination programmes are now under way, with 6.6m doses sent to doctors and 3m new doses arriving each week.

From:

http://www.ft.com/cms/s/0/55aecc3a-cff4-11de-a36d-00144feabdc0.html?nclick_check=1

WHO says that otherwise healthy people should not be given Tamiflu

Healthy people who catch swine flu should not be given antiviral drugs, the World Health Organisation (WHO) has said, as most people will recover from symptoms within a week.

The drugs are currently offered to anyone in England with flu like symptoms but the WHO’s guidance contradicts this policy, suggesting that the side effects may outweigh the benefits for otherwise healthy people.

But Tamiflu (oseltamivir) or Relenza (zanamivir) should still be used as “soon as possible” if people present with severe illness or whose condition was deteriorating, the UN’s health agency said.

Those in at-risk groups — such as pregnant women or people with an underlying medical condition such as diabetes — should also receive treatment promptly.

The latest WHO advice, from a panel of international experts, comes as new figures show that 45,986 courses of antivirals were given to patients in England last week.

In the previous week, 90,363 had been given out after people contacted the National Pandemic Flu Service, the telephone and internet service which allows people to obtain medication without seeing a doctor.

There have been fears that mass use of Tamiflu will encourage the H1N1 swine flu strain to become resistant to the antiviral.

Researchers have also expressed concern over the side-effects of the drug, including sickness, nightmares and insomnia in children.

A team from the University of Oxford said earlier this month that children with mild symptoms should not be given the antiviral to combat swine flu and urged the Department of Health to urgently rethink its policy.

The advice, published on the WHO website, said that most patients were experiencing typical flu symptoms and would get better within a week.

A statement said that the new guidelines “represent the consensus reached by an international panel of experts who reviewed all available studies on the safety and effectiveness of these drugs.

“Emphasis was placed on the use of oseltamivir and zanamivir to prevent severe illness and deaths, reduce the need for hospitalisation, and reduce the duration of hospital stays.

From:
http://www.timesonline.co.uk/tol/news/uk/health/Swine_flu/article6805254.ece

Swine flu shirkers cost firms more than virus, say employers

Staff using the swine flu pandemic as an excuse to take time off work are causing more disruption to businesses than the virus itself, according to employers.

Thousands of healthy workers are thought to have taken advantage of official guidelines on the pandemic to extend their summer holidays.

By simply phoning the NHS swine flu hot line or visiting its website, unscrupulous workers can get themselves a course of antiviral medicine and do not need a sick note from their GP for the first seven days’ absence.

The labour Government is considering doubling this period to a fortnight, which companies fear could make the situation worse and cost them millions of pounds in lost productivity at a time when they are struggling with the effects of the recession.

There are predictions that more healthy workers will be tempted to call in sick as the weather improves over the next week, after the wettest July on record.

The Employment Law Advisory Service, which provides legal advice to companies on personnel problems, disclosed yesterday that it had begun receiving calls from concerned managers as soon as the self-diagnosis website was set up last month.

It has since heard from more than 1,000 companies that believe staff have exploited concern about the spread of the H1N1 virus to take an extra week off. It believes that the Department of Health’s guidance risks creating a “skiver’s charter”.

Peter Mooney, the service’s head of consultancy, said: “Managers feel that some staff are simply taking advantage of concerns about the transmission of swine flu to take an extra few days off work. Because the emphasis has been on not going to your local GP but using websites to assess the infection and the risk to others, those who stay at home are not going to need a doctor’s note or have too many people calling on them to see how they feel.

“Based on the volume, and the nature, of calls we have been taking, the number of deliberate false cases of the condition is having a significant impact on workplaces across the country — something bosses are keen to tackle.”

The Department of Health’s own planning assumptions state that nine per cent of the workforce could be absent at any one time during August, rising to 12 per cent in the winter. Ministers set up emergency measures to reduce the pressure on the NHS and slow the transmission of the virus amid predictions of a worst-case scenario in which one in three of the population falls ill and 65,000 people die.

Those who believe they have symptoms are advised to contact the National Pandemic Flu Service over the phone or online, rather than visit a family doctor.

If they are diagnosed with swine flu, they are given a number to allow them to collect a course of antiviral drugs and told to stay at home for a minimum of seven days in order to prevent further spread of the virus.

The flu service website and phone line handed out over 150,000 doses of Tamiflu in its first week. However, there is evidence that only about one in four recipients actually has the H1N1 virus.

GPs have said that they are being inundated with calls from patients claiming to have swine flu and requesting a note to sign them off work for longer than a week. Many are concerned that they are being asked to certify that people are ill without having seen them, meaning shirkers could take advantage.

Recent figures suggest the average worker takes 7.4 days off sick a year at a total cost of £17.3?billion to the economy, so the impact of staff taking another fortnight off for self-diagnosed swine flu could cripple some small businesses.


Ben Willmott, a senior public policy adviser at the Chartered Institute of Personnel and Development, said: “Obviously some employers are concerned that employees could take advantage of that.”

He urged managers to make sure they have contingency plans in place so they can cope if staff are genuinely ill with swine flu, and also to ensure that workers know that absence levels are monitored in order to catch those “swinging the lead”.

Meanwhile, GPs have been warned that a Tamiflu solution designed for babies will run out if it continues to be given to people who do not like to swallow capsules.

The Royal College of General Practitioners has told doctors not to prescribe the antiviral liquid to older children or adults. In a bulletin to members, the college said this was happening “across the country” and was “causing an unprecedented demand for the solution”.

Those who cannot swallow capsules should instead open the capsule and dissolve the powder in a sweet drink, it recommended.

http://www.telegraph.co.uk/Swine-flu-skivers-cost-firms-more-than-virus-say-employers

Tamiflu side effects linked to children reports find

More than half of children taking Tamiflu to combat swine flu suffer side effects such as nausea, insomnia and nightmares, new research claims.

The antiviral drug, which is being handed out to hundreds of thousands of Britons, can also produce stomach pains, vomiting and diarrhoea, research suggests.

A study found that almost one in five youngsters experience neuropsychiatric side effects, such as poor concentration, confusion, and sleeping problems.

Thousands of schoolchildren were given the drug as a preventive measure during the early stages of the swine flu pandemic in Britain.

The findings are likely to lead to concern among parents that their children's performance at school has been jeopardised by taking the drug.

Only people with suspected or confirmed swine flu are now being prescribed Tamiflu, and around 150,000 packs have been distributed by the newly launched National Pandemic Flu Service in the past week alone.

Two studies from experts at the Health Protection Agency (HPA) showed a "high proportion" of British schoolchildren reporting problems after taking Tamiflu.

Data was gathered from children at three schools in London and one in south west England who were given Tamiflu earlier this year after classmates became infected.

One study, of 248 children aged 11 and 12 at a school in south west England, which was closed after a pupil contracted the virus, found that more than half suffered side effects from taking Tamiflu.

The report said: "Fifty-one per cent experienced symptoms, such as feeling sick (31.2 per cent), headaches (24.3 per cent) and stomach ache (21.1 per cent).

"Although some children were ill with flu-like symptoms, those tested did not have A (H1N1) v (swine flu) infection."

The researchers said "likely side effects were common" and the "burden of side effects needs to be considered" when deciding on giving Tamiflu to children prophylactically.

Another study of 103 schoolchildren found 45 suffered side-effects such as nausea, stomach pain, problems sleeping, vomiting and diarrhoea.

Almost one in five (18 per cent) reported a neuropsychiatric side effect, such as poor concentration, inability to think clearly, problems sleeping, feeling dazed or confused and nightmares.

The report concluded: "This may be of particular concern to exam year students (and their parents)."

The studies were carried out in the early stages of the pandemic, when everyone sharing a classroom with a child who developed swine flu was given the drug, even if they showed no symptoms.

The findings were disclosed as it emerged that Japanese authorities are advising doctors not to prescribe Tamiflu to youngsters aged 10 to 19 over fears of neuropsychiatric side effects.

A statement from Roche, which manufactures Tamiflu, said the contribution of Tamiflu to neuropsychiatric effects "has not been established".

Tamiflu-linked-to-side-effects-among-children-reports-find

Labour Ministers unprepared for swine flu second wave Lords warn

The labour Government appears to be unprepared for an expected second wave of swine flu in the autumn, according to a report by peers published this week.

The House of Lords Science and Technology Committee said that ministers had failed to offer reassurances that NHS services could deal with the predicted surge, when several million people may become ill.

It called for clarity on how intensive and critical care departments will cope with high patient numbers. It expressed concerns about NHS staff providing services outside their usual expertise if they are transferred around the country to the areas experiencing most demand.

The committee also criticised ministers for not setting up the National Pandemic Flu Service for England earlier in the year.

An interim service is now in operation to diagnose cases over the phone or internet and distribute drugs at pharmacies and health centres. But this was beset by problems when it launched last week, with the website crashing in the first few minutes.

The committee praised the Government’s actions in stockpiling antiviral drugs such as Tamiflu and entering into advance purchase agreements for a vaccine for the H1N1 flu strain, but said ministers needed to offer better guidance over who could have access to these treatments.

Swine flu is affecting about 100,000 people a week, and hundreds are being treated in hospital.

Lord Sutherland, the chairman of the committee, said that he was disappointed that tests to examine how the full range of health services would respond in a pandemic had not been carried our earlier.

“While the Government have got some things right in preparing for a flu pandemic, such as the stockpiling of antivirals, there are other areas where we appear to be under-prepared,” he said.

“We were surprised and disappointed that the Government had not undertaken ‘whole system’ testing of health services preparations for a flu pandemic before swine flu emerged.”

The peers said that the national swine flu helpline in England should also have been set up sooner and asked for assurances that it will cope with high demand this autumn.

Lord Jenkin of Roding, a former health secretary, who was asked to sit on the committee’s flu pandemic inquiry, told The Times earlier this year that ministers had said the hotline would be ready by April or May.

From:
http://www.timesonline.co.uk/tol/news/uk/health/Swine_flu/article6730118.ece

Pregnant women up to four times more likely to become seriously ill with swine flu

Pregnant women are up to four times more likely to be seriously ill and require hospitalisation when they have swine flu than the general population, new research from the United States suggests.

They are also more likely to die of swine flu or even seasonal flu, meaning they should be prioritised for the flu vaccine as soon as it is available, a study by the US Centers for Disease Control and Prevention (CDC) concluded.

So far, at least two pregnant women are known to have died in Britain after contracting the H1N1 flu strain, while a third had to be flown to Sweden for emergency treatment.

The researchers said that pregnant women with flu symptoms should start taking antiviral treatment as soon as possible, while all expectant mothers should receive a vaccine once one becomes available in coming months.

Little is known about the possible ill-effects of the drugs on the foetus but scientists say their benefits are likely to be greater than the risks.

Data collected by the CDC showed there were 34 confirmed cases of swine flu among pregnant women in the United States between mid-April and mid-May, the first month of the outbreak that has since been declared a global pandemic by the World Health Organisation.

Eleven of the pregnant women, or about a third, were admitted to hospital. The hospitalisation rate for members of the general public infected with swine flu was around eight per cent, or a quarter of the rate among pregnant women, the study showed.

One of the women who became ill in that first month died, but five more pregnant women died of swine flu in the United States during the following month of the outbreak, the report said.

None of the women who died had been given antiviral drugs promptly, within the first 48 hours of symptoms occurring. All of them had developed pneumonia and “acute respiratory distress syndrome” which required them to go on a ventilator, it said.

Denise Jamieson, the CDC’s lead author of the study, which is to be published next month in the Lancet medical journal, said: “We know that in seasonal influenza as well as in pandemic influenza, situations that pregnant women have an increased risk of severe disease and of dying.”

The increased risk is likely to be due to the changes that take place in a woman’s body during pregnancy, she said.

“There are mechanical and hormonal changes in pregnancy, there are changes in the cardiovascular and respiratory systems, there are immunologic changes.

“Lung capacity decreases because as the uterus grows it moves the diaphragm up and there’s basically less room for the lungs. All these changes make pregnant women more susceptible to and more severely affected by certain viruses, including influenza."

Once a vaccine is available, pregnant women will be a high priority, Dr Jamieson suggests. However, she said she was concerned that women may not come forward to be vaccinated because of fear of any effect on their baby.

The babies of five of the six pregnant women who died during the study period were delivered by Caesarean section.

None had any evidence of influenza infection and all but one, who was born 13 weeks before term, have been discharged in good health, the study said.

Boon Lim, Pandemic Flu Planning spokesman for the Royal College of Obstetricians and Gynaecologists (RCOG) said today: “The World Health Organization (WHO) have stated that pregnant women should be prioritised to receive the swine flu vaccines when these are available. Currently, in the UK, pregnant women are advised to be immunised against the seasonal flu. The recommendation by the CDC to immunise pregnant women from swine flu is an extension of this principle and one which we support.

“The RCOG is working closely with the Department of Health to examine the evidence around safety of vaccination against the swine flu virus. Further guidance on vaccination will be issued in the near future.”

Sir Liam Donaldson, the Chief Medical Officer for England, said that most pregnant women with swine flu would only get mild symptoms but pregnancy brought a higher risk of complications.

Mothers to be were currently advised to continue “normal activities” such as going to work, travelling on public transport and attending events and family gatherings.

“We are not advising pregnant women to cut down on their normal daily activity - some might choose to be very precautionary and not want to go into crowded places, but that is not the advice,” Sir Liam said.

From:
http://www.timesonline.co.uk/tol/news/uk/health/Swine_flu/article6731659.ece

Swine flu could become resistant to Tamiflu because of over prescribing

Swine flu could become resistant to Tamiflu, the only drug that can treat the virus, because it is being over prescribed, a leading doctor has warned.

Dr Holden, the British Medical Association's lead authority on pandemic flu, said he thought the thresholds for issuing Tamiflu had been set too low, a policy which he fears will come back to haunt the Department of Health if the H1N1 virus becomes resistant to Tamiflu.

The GP, based in Matlock, Derbyshire, helped draft the clinical algorithm used by operators on the National Pandemic Flu Service telephone line, but said doctors are being encouraged to dish out a "pill for every ill".

Writing in Pulse mageazine, he also accused Andy Burnham, the Health Secretary, and Sir Liam Donaldson, the Chief Medical Officer, of giving different advice to GPs and the public.

"Both ... have contradicted themselves by telling the public they can have Tamiflu if and when they want it, but at the same time telling GPs to use their clinical judgement.

"They are running with the hares and hunting with the hounds.

"People are finding it a bit hard to swallow that we are getting beaten up by the DH for antibiotics prescribing but that the same principle doesn't seem to apply to the judicious use of Tamiflu.

"Personally I feel the flu line will help to relieve pressure on GPs but my concern is that the threshold for giving out Tamiflu will be set too low. For most people, given that is a mild illness the amount of medication being given out is overkill."

As more courses of Tamiflu are distributed, GPs are seeing an increase in the number of patients who have experienced side-effects caused by the antiviral, including nausea, vomiting, diarrhoea and headaches.

"Every day GPs are saying they are seeing people with side effects from Tamiflu," said Dr Holden. People are going for second and third consultations with their GP. It's putting even more strain on the NHS."

Swine-flu-could-become-resistant-to-Tamiflu-because-of-over-prescribing

Swine flu- labour ministers blamed for chaos

The labour Government will be criticised over its handling of the swine flu crisis by a powerful parliamentary committee this week.

The report will attack the labour Government's failure to keep its promise to set up a flu telephone helpline by April.

Labour Ministers will be held to account for the delay in setting up the national flu helpline and for giving confusing advice to vulnerable groups and NHS staff.

The report will be published as senior doctors hold an urgent meeting with Andy Burnham, the Health Secretary, in a last ditch attempt to persuade him to drop controversial European rules limiting the hours doctors can work, which are due to come into force on Saturday.

One doctor gave warning that the NHS was facing a “triple whammy” as it struggled with swine flu, the introduction of the European Union Working Time Directive and– four days later – the movement of more than 30,000 junior doctors between hospitals as part of the annual rotation of specialities.

Further concerns over Britain’s swine flu response are raised today by a Sunday Telegraph investigation, which has exposed major security lapses in the national flu pandemic service.

The flaws would allow fraudsters to obtain dozens of doses of Tamiflu – the main drug being issued to swine flu victims.

The Sunday Telegraph has also discovered that maternity units are planning to cancel home births and planned caesarean sections if the outbreak turns into a major epidemic.

Andrew Lansley, the shadow health secretary, said government planning failures had created a response to the pandemic that already appeared to be “riddled with problems”. He accused ministers of taking “an ad hoc approach” to a situation which needed careful planning.

This week’s report by the House of Lords science and technology select committee is the first to look into the Government’s preparedness for pandemic flu. It will attack its failure to keep its promise to set up a flu telephone helpline by April when the world was on the brink of a pandemic.

This newspaper disclosed in May that the delay was caused by the Treasury, which took seven months to sign off on the deal.

The hold-up meant the Government had to introduce a stopgap flu phoneline, introduced last week, manned by staff given just one day of training.

In the meantime, NHS Direct, which should have been running the service, has made hundreds of its highly trained staff redundant.

The Lords report will also question the adequacy of advice being issued to the public, in particular that offered to vulnerable groups such as expectant mothers. In evidence sessions, committee members described the lack of public advice for pregnant women as “extraordinary”.

The advice was only publicised last week, leading to further confusion when ministers appeared to distance themselves from recommendations they had previously endorsed.

Last night senior doctors said ministers must take urgent action to avert an impending crisis.

From Saturday, doctors will not be allowed to work more than 48 hours a week, under EU rules. The change has been fiercely resisted by many senior doctors who say it will put lives at risk.

It could mean that the NHS is short of doctors just as pressure on hospitals caused by the swine flu outbreak intensifies.

Britain’s top surgeon has urged ministers to suspend changes to working hours. John Black, the president of the Royal College of Surgeons, accused ministers of “having their heads in the sand”.

He said: “The courageous thing to do would be to step in and suspend the 48-hour limit for the whole of the NHS, once we come under pressure, but that would require political leadership. I don’t expect it to happen.”

Mr Black said despite warnings the Government had made no useful concessions over the rules which he says will put lives at risk, and “devastate” the training of health professionals. He will restate his plea for concessions over doctors’ hours in a meeting with Mr Burnham on Wednesday.

The weekly 48-hour limit for doctors is measured over a sixth-month period, allowing doctors to work extra hours some weeks, if they then cut back on others.

Doctors can opt out of the directive on a voluntary basis, but only individually, throwing rota planning into “chaos”, according to senior doctors. They want whole departments or specialities to be allowed to suspend the rules.

Both Mr Black, and John Heyworth, the president of the College of Emergency Medicine, said they did not expect the introduction of the working directive to have an immediate impact, but they fear it could cause shortages of doctors by September, when flu cases may soar. Mr Heyworth, an A&E consultant at Southhampton General Hospital, said: “There is a triple whammy heading inexorably our way – the directive, doctor rotations, and swine flu, and the impact of all of this happening at once is unknown.”

He said doctors had explained their concerns to ministers about the changes to working hours “at great length”. Last night the Government defended the operation of its Pandemic Flu Service. It said that on the first day of the service, Thursday, it carried out more than 58,000 assessments, and almost 6,000 courses of antiviral drugs were collected in England.

From:
http://www.telegraph.co.uk/health/swine-flu/Swine-flu-ministers-blamed-for-chaos

Swine flu helpline hit by problems

The launch of the national pandemic flu service for England yesterday was marred by some early hiccups as the number of the country’s swine flu cases was estimated to have almost doubled in a week from 55,000 to 100,000.

Despite the steep rise in cases, there was a smaller increase in the numbers in hospital with the disease – up to 840 against 652 last week – and a rise of just 10 in the number in intensive care to 63. All strategic health auth­ority areas are classified as suffering from “exceptional influenza activity”. Some areas, including eastern districts of London, are hot spots.

But at 150 consultations per 100,000 population, the number of patients visiting the GP nationally remains below the rates seen in the last sizeable outbreak of flu like illness in 1999-2000 and the number of actual cases is far below the peak of the last flu pandemic in 1969-70.

Sir Liam Donaldson, the chief medical officer, said more detailed investigation of the deaths that have to date been attributed to swine flu had resulted in some new cases being counted in and others discounted, leaving the provisional total at 26.

The English figures were disclosed as Professor Hugh Pennington, a leading virologist at the University of Aberdeen, said that Scotland was “possibly through the worst” of the first phase of the virus as latest figures showed far lower GP consultation rates than in ­England.

The relatively small rise in those being admitted to hospital in England and an apparent drop in the GP consultation rate in some parts of the country provided a possible first hint that the initial wave of the infection might also be peaking in England, as it has in the US.

But Sir Liam warned against “reading too much” into those figures. If the data held for another week or so they might indicate a lull in the pandemic, “but I don’t think so yet”.

The infection remains mild in most people and continues disproportionately to affect children. Two thirds of those who have died had other severe underlying medical conditions, Sir Liam said, with only 16 per cent of the small number of deaths in otherwise healthy people.

“The bad thing would be if 100 per cent of the deaths were healthy people,” he said. With the current state of the virus, “the vast majority, even with an underlying condition, will get flu and recover well”.

The Federation of Small Businesses wrote on Thursday to Andy Burnham, the health secretary, calling for measures to help its members through the pandemic.

It wants routine inspections of businesses suspended in areas with high levels of infection and a simpler system for the smallest companies to reclaim statutory sick pay.

“A small firm employing only three people could expect to have all of its workforce off for up to two weeks this autumn,” John Wright, the federation’s national chairman, said.

Sir Liam said that school closures had not been ruled out for the autumn, but “it would be a huge step to close schools across the country”, with a considerable economic impact.

The pandemic flu service is intended to lift the burden from GPs and give swift access to anti virals. Patients whose replies to a list of questions indicate they may have swine flu will be given an access number and told where a relative or friend can, with suitable ID, collect their Tamiflu.

The Association of British Insurers said its members would accept the number as the equivalent of a medical diagnosis of flu for travel insurance claims.

Early callers to the swine flu hotline on Thursday afternoon were greeted with the slightly disconcerting question asking whether they were “conscious”, write FT reporters.

More worrying was the fact that the online version had already crashed after being swamped, though the telephone service seemed to be working well and call centre staff were responding promptly.

One potential sufferer with flu-type symptoms said the person taking his call appeared to be reading from a similar list of “do you have swine flu?” questions as seen online. The questions ranged from “do you have trouble speaking?” to “do you have a patch of purple dots underneath your skin?” and “can you bring your chin down to your chest?”

Callers are also told that if they misused the service they would be prosecuted.

No questions were asked of the caller whether he was part of an “at risk” group, such as asthmatics.

He described the process as similar to “ringing a bank or an insurance company”, with the call-centre worker “clearly not a medical professional”. The 2,000 operators will liaise with GPs to report problems. So far, the hotline is available only in England.

From:
http://www.ft.com/cms/s/0/909e04e0-7794-11de-9713-00144feabdc0,dwp_uuid=819fc44c-33e2-11de-9eea-00144feabdc0.html

Swine flu- travellers abroad face hostile reception

Long viewed with suspicion for bringing drunken rowdiness to foreign cities, the British face a new reason for hostility as they head abroad for summer holidays: the risk that they bring swine flu with them from the country with one of the world’s highest infection rates.

While the pandemic has spread to nearly 200 countries, the UK has intrigued public health specialists by reporting to date the most cases outside Mexico and the US, with 100,000 new suspected infections in recent days and rising fast.

After recent incidents when British citizens have been detained in China, Brunei and Romania, the Foreign Office is warning visitors to its website that they could be screened on entry to a foreign country and even placed in quarantine if found to have swine flu like symptoms.

But with many countries across Europe and elsewhere yet to be significantly affected by the flu, and often with modest stockpiles of the medicine Tamiflu, those who do fall ill while abroad may face greater hurdles than normal in gaining swift access to treatment.

Some countries are simply putting up posters at ports of entry advising travellers to seek medical help if they have flu symptoms, but it says Romania is among those now specifically asking those arriving from the UK to fill in a medical questionnaire and placing those with symptoms in isolation in hospital for treatment.

The Association of British Travel Agents has also criticised overzealous imposition of screening of British travellers by foreign countries including Egypt and Turkey despite advice that it serves no purpose from the World Health Organisation.

Official advice warns those who have already fallen ill to defer their trips, while the airlines BA and Virgin have already indicated that they may prevent people from travelling if they have the symptoms.

After concerns that two travel insurers had said they would not cover cancellation costs for people contracting swine flu, the Association of British Insurers stressed this week that all would be reimbursed provided their condition had been recognised by the government’s new Pandemic Flu Service.

To date, at least 52 British students have been quarantined in China, 200 soldiers in Brunei and eight school children in Romania.

The Foreign and Commonwealth Office said that it was providing consular assistance to at least 160 British nationals in swine-flu quarantine in four countries: China, Singapore, India and Egypt.

“We are paying close attention to the welfare of Brits in quarantine. We are keeping in touch by phone with those in quarantine to check on their welfare; ensure they understand the procedures; and to pass messages to and from parents and relatives in the UK.”

From:
http://www.ft.com/cms/s/0/019983e0-7876-11de-bb06-00144feabdc0,dwp_uuid=819fc44c-33e2-11de-9eea-00144feabdc0.html

Companies in swine flu fight over staff and profits

Most businesses were trying to avoid being swept up in the panic this week. But with the number of cases doubling to 100,000, companies were testing business continuity plans to make sure they could cope with large numbers of sick workers.

“With companies already hit by recession, the threat from swine flu is the last thing firms need,” said David Frost, director-general of the British Chambers of Commerce.

One research group, FirstCare, estimates the number of people off work because of colds, coughs and flu is three times higher than normal for the time of year.

The caution shown by companies such as Britvic could help explain part of the jump. The drinks maker said it was taking the “sensible approach” of asking staff to work from home if friends, family or anyone else they meet has swine flu.

However, BT, one of the country’s biggest employers, said it was not seeing “significant absentee rates at this stage”. Nevertheless, the telecommunications group is sending out regular bulletins to staff about the threat and has given “hygiene packs” to engineers, including alcohol wipes and face masks.

Ocado, the Waitrose owned online grocer, is issuing delivery drivers with hand sanitisers and wipes to reassure customers. Domino’s Pizza said in the event of a more serious outbreak it could leave orders at a customer’s front door to avoid contact. J. Sainsbury has bought masks for workers in case of a serious outbreak.

The BBC was criticised this week for buying 4,000 doses of the anti viral drug Tamiflu, and there is sensitivity among companies anxious not to be seen to hoard stocks, though several banks including Nomura and HSBC have supplies if needed.

Centrica, owner of British Gas, said: “Tamiflu is being provided for our employees who work in critical roles, for example those working on offshore platforms and service engineers who provide essential maintenance support in customers’ homes, to be taken only if they begin to display symptoms.”

Some companies– such as Google, Nomura and Goldman Sachs– are installing extra hand cleaning facilities, including alcohol wipes outside lifts and in staff canteens. Inter­Continental Hotels Group, owner of the Holiday Inn chain, has gone further by installing hand sanitisers for customers in hotel bathrooms and restaurants.

Honda, the carmaker, has introduced “enhanced cleaning” for all solid surfaces, including door handles, and issued staff with antiseptic handwash. BBH, a large advertising agency in London’s Soho, has “deep cleaned” the desks of infected staff.

Away from business but reflecting the general caution, students graduating at Sussex university were given alcohol gel on Friday before they went on stage to receive their certificate and shake hands with Sanjeev Bhaskar, the comedian and university chancellor.

“It seems like a good idea– he’s going to be shaking hands with 400 students,” said Tom Wills, president of the university’s student union.

From:
http://www.ft.com/cms/s/0/417576fa-7884-11de-bb06-00144feabdc0,dwp_uuid=819fc44c-33e2-11de-9eea-00144feabdc0.html?nclick_check=1

Cherie Blair suffering from swine flu

News that the former prime minister's wife had become Britain's most high profile victim of the virus came as figures emerged showing that the number of swine flu cases jumped by nearly 50 per cent in a week.

Mrs Blair started feeling unwell at the start of the week and received a diagnosis of swine flu on last week.

She was given a course of the antiviral Tamiflu and told to cancel all engagements until she recovers. Mrs Blair had been due today to pick up an honorary degree from Liverpool's Hope University in recognition of her work as a human rights lawyer. A staff barbecue has also been cancelled as a precaution.

Data from a sample of GPs’ surgeries, seen by The Times, shows that up to 40,000 people complained to their doctor last week of "flu-like illness" in England and Wales, with a huge rise in the number of young children being affected.

The report shows that the highest rates of reported illness are in children aged five to 14, with 160 of every 100,000 in this age group reporting symptoms, followed by 114 per 100,000 in those aged up to four years old.

Overall, the rate of people complaining of symptoms increased to 73.4 cases for every 100,000 people in the week to Sunday, compared to 50.3 cases per 100,000 the week before.

This is a rise of 46 per cent and is equivalent to about 39,150 people across the country reporting symptoms compared to about 27,000 people who did so the previous week.

The figures, from the Royal College of GPs (RCGP), are based on a sample of 84 doctors’ surgeries across the country. Although they do not provide a total of confirmed cases of the H1N1 virus they are used by the Government as an official measure of how the outbreak is spreading.

The figures show the current outbreak is already worse than the seasonal flu experienced over Christmas and the New Year which was the worst for eight years. The winter flu outbreak hit a peak of 69 cases per 100,000 people across England and Wales. Doctors would normally expect to see fewer than 30 cases per 100,000 during the summer.

Separately, however, the RCGP criticised the Government's response to the flu pandemic, accusing it of providing conflicting advice to both doctors and patients.

From:
http://www.timesonline.co.uk/tol/news/uk/health/article6716158.ece

GPs criticise labour response to swine flu pandemic

GPs have criticised the labour Government's response to the flu pandemic, accusing it of providing conflicting advice to both doctors and patients.

The Royal College of GPs is collecting feedback from family doctors on issues arising from the current outbreak, which has been linked to 17 deaths in the UK so far.

GPs have complained of poor out-of-hours planning, confusion over prescribing the antiviral drug Tamiflu and a lack of knowledge over how long patients should stay at home if they have the virus.

It comes after GPs saw a leap of almost 50 per cent in the last week in the numbers of people contacting them with fears they have swine flu.

Around 40,000 people a week in England and Wales are now complaining to their doctor of "flu-like illness", with a huge rise in the number of young children being affected.

The figures, from the Royal College of GPs' monitoring system, showed 50.3 people per 100,000 were reporting flu-like illness between June 29 and July 5.

But this leapt 46 per cent to 73.4 people per 100,000 between July 6 and 12.

In a submission to the House of Lords Science and Technology Committee, the College said it had an "excellent working relationship" with the Government's chief flu adviser, Ian Dalton, and was "very pleased" with the responsiveness of health officials.

But it said issues were arising via feedback from GPs, including a "lack of information and conflicting advice" from both the Government and primary care trusts (PCTs).

Changes to the procedure for obtaining Tamiflu - such as patients obtaining the drugs from a flu centre rather than a GP surgery - "were not cascaded down to PCTs/GPs".

The written evidence said: "Family doctors also noted that conflicting advice was being provided by different agencies.

"Some GPs raised concerns about the lack of support provided by their PCTs, such as no action plan to help primary care respond to the outbreak."

Some out of hours doctors have complained that they are not being seen as the "major player in the flu plan operationally in their area".

"They reported that they had received poor and inconsistent communication, including lengthy and verbose documents that were unworkable operationally."

There was also anxiety among GPs about a lack of protective clothing and whether they should take Tamiflu preventatively with the aim of trying to protect their own families.

"Concerned family doctors have also been in contact seeking the latest recommendations on the protection of pregnant healthcare workers that might come into contact with possible swine flu patients. It appears guidance on this issue is not very clear.

"Family doctors have also informed the RCGP that they do not know when they should advise their patients to come out of isolation following an episode of H1N1 flu. In addition, there seems to be confusion around how long health workers need to stay off work following a presumed flu diagnosis."

The weekly flu report from the College said flu was evident in all age groups "but remains highest in five to 14 age groups."

The study said the highest number of cases was being seen in central England but the North had seen "a marked increase compared to previous weeks".

There has been a small decrease in the number of cases being seen in London although the capital remains a major hot spot for the virus.

The rate of influenza-like illness is highest among those aged five to 14, at 159.57 per 100,000 population.

The next most affected group is youngsters and babies aged up to four, at 114.12 per 100,00 population.

This is followed by people aged 15 to 44, those aged 45 to 64 and then people aged 65 and over.

From:
http://www.independent.co.uk/gps-criticise-response-to-flu-pandemic

Swine flu virus has mutated in London, scientists warn

London has already developed its own mutated strain of swine flu, scientists warned yesterday.

They say the sheer number of infections in the capital has led to the virus mutating into a unique form.

According to the Royal College of GPs, about 12,500 new infections are being reported to London GPs each week.

Wendy Barclay, professor of influenza virology at Imperial College, warned that authorities needed to keep a close eye on London's infections as the virus could mutate into a faster-spreading or more harmful version.

"It is very important to keep a careful look for clusters of severe cases that might indicate that a mutated virus has arisen, which could be more virulent," she said.

However, researchers admit they do not know when this could happen.

Dr Oliver Pybus, an evolutionary biologist at the University of Oxford, said: "Predicting how the virus will mutate is rather like trying to predict the weather in several months' time - virtually impossible.

"The mutation rate of the flu virus is a million times faster than in animals, so it can change very quickly. London will have already developed its own strain of swine flu, even though at the moment it may not act any differently from the rest of the UK strains.

“However, the worry is that it could change, or that should a new, more dangerous version appear anywhere in the world, it will hit London first because of the number of travellers passing through.”

The warning comes as new research shows swine flu penetrates deeper into the lungs and can inflict more damage than ordinary seasonal flu.

Tests on animals showed that swine flu thrives all over the respiratory system, including the lungs, and causes lesions instead of staying in the head, as seasonal flu does.

Experts also believe swine flu is closely related to the 1918 pandemic strain, which killed up to 40 million. Blood tests show many survivors seem to have immunity to swine flu.

Commenting on the research, Professor Ian Jones from the University of Reading said: “It shows that the new virus is about five times more pathogenic than seasonal H1N1 but that, nonetheless, the major outcome is recovery.”

Experts have predicted half the UK population could contract swine flu this year and 150,000 could die — based on figures which suggest the H1N1 virus kills about 0.5 per cent of humans who catch it.

Virologist Nigel Dimmock, emeritus professor at the Department of Biological Sciences at Warwick University, said millions would fall ill.

He said: “It would be reasonable to assume that half the population will get flu this year. If that's all swine flu, then that would be a hugely significant number of deaths.”

“The percentage of people killed who contract the virus is believed to be around 0.5 per cent. If half the population catch swine flu then that could mean 30 million times that percentage as a number of deaths — it's an awful lot of people.

“Things are certainly not going to get any better by the end of the year. At the minute everyone is susceptible.”

The news comes after the recent deaths of the first victims of swine flu who were otherwise healthy.

Schoolgirl Chloe Buckley, six, from West Drayton, died on Thursday. She is believed to be the first child in Britain without underlying health problems to be killed by the virus, while
Dr Michael Day, 64, from Bedfordshire, was taken to hospital on Saturday and died the same day.

An unnamed patient from Essex was the other victim. The co-ordinated national response to the virus is now in the “treatment” phase, as opposed to “containment”, meaning experts believe the spread of the virus is unstoppable.

Health chiefs are now working to implement a plan to vaccinate at least 30 million people by the end of the year to minimise disruption to public services and industry with people taking time off work.

From:
www.thisislondon.co.uk/swine+flu+virus+has+mutated+in+London%2C+scientists+warn

Swine flu cases in Britain could top 100,000 a day

The number of swine flu cases could reach more than 100,000 per day by the end of August, Andy Burnham, the Health Secretary, told the Commons.

The UK has moved past the stage of containing the swine flu outbreak and into the "treatment phase", he said.

"The national focus will be on treating the increasing numbers affected by swine flu. We will move to this treatment phase across the UK with immediate effect."

There are now 7,447 laboratory-confirmed cases in the UK, he said.

London and the West Midlands have already had sufficiently high numbers to move towards a policy of outbreak management, which saw people with swine flu clinically diagnosed rather than being confirmed by laboratory reports.

Mr Burnham said that last week saw a "considerable rise" in swine flu cases.

"There are now on average several hundred new cases every day," he said.

"Our efforts during the containment phase have given us precious time to learn more about the virus. We have always known it would be impossible to contain the virus indefinitely and at some point we would need to move away from containment to treatment."

He added: "We have now signed contracts to secure enough vaccine for the whole population."

The first will become available next month, with 60 million doses available by the end of the year.

From:
http://www.telegraph.co.uk/Swine-flu-cases-in-Britain-could-top-100000-a-day.html

Swine flu- nanny state launches mass advertising campaign as ministers step up fight

Labour ministers will blow more taxpayers' money as a mass advertising campaign will be mounted to try to contain the growing swine flu outbreak in the UK.

Every household in the country will have a leaflet through the door from next Tuesday onwards

As five cases of swine flu were confirmed in the UK – including a 12-year-old girl – and 78 further people are being tested, labour ministers mounted a major offensive to contain the problem.

Adverts will run in newspapers, on radio and on TV from today giving information about swine flu and advising people that basic hygiene measures such as covering your nose and mouth with a tissue and washing your hands are the best ways to protect against the disease.

Every household in the country will have a leaflet through the door from next Tuesday onwards also giving information on the disease and what to do in the event of someone showing symptoms.


Health Secretary Mr Johnson said: "We are following the philosophy to hope for the best but absolutely prepare for the worst. It is inevitable there will be more cases. What is reassuring is that if you take Tamiflu early you make a full recovery. It is just like a dose of flu. It could get much worse but we are prepared."

Sir Liam Donaldson, chief medical officer, said the last bad seasonal flu year was in the winter of 1999/2000 when 22,000 people died – ten times the norm – and he warned that a pandemic could be similar to that situation but 'multiplied several times over'.

Mr Johnson announced a raft of new measures including boosting the stock of antiviral drugs, Tamiflu and Relenza, which reduce symptoms and severity of flu from 33m courses to 50m courses and extra antibiotics are being purchased to treat people who may develop secondary complications such as pneumonia.

Extra face masks with inbuilt filters are being bought for NHS staff and all front line health workers will receive their own course of anti-virals to take if they treat someone found to be infected with swine flu.

Health Protection Agency staff will be at all airports where flights come in from infected areas and all passengers on flights from affected areas to be given a leaflet with advice about seeking medical attention if display symptoms within seven days.

Airlines are being asked to keep passenger manifests for seven days instead of usual 24 hours to aid in contact tracing if necessary.

The public are being advised not to buy face masks as there is no evidence they prevent the spread.

Sir Liam, said: "So far all the cases in the UK have been imported cases from the main affected areas and we have not seen any ongoing transmission."

He said the positive side of this situation is that the virus is so far not spreading easily between people and no onward transmission has been yet seen outside Mexico and the US with the only confirmed cases having caught the disease in Mexico.

He said: "The virus is giving us a bit of time. It may become fast and furious at a later stage."

He warned that in past epidemics and pandemics children have been the 'supercarriers' so the school holidays, going back to school have been key factors in the spread.

This may be why health experts acted quickly to advise that the Paignton Community College be closed for a week after a 12-year-old girl there was confirmed as having contracted swine flu.

Ed Balls, the Schools Secretary egotist said: "We will put the health of children first."

From:
http://www.telegraph.co.uk/health/swine-flu/5244796/Swine-flu-Mass-advertising-campaign-as-ministers-step-up-fight.html

Swine flu confirmed in Britain

Swine flu has reached Britain it was disclosed last night, as officials confirmed that two people were being treated in a hospital isolation unit after contracting the disease on holiday in Mexico.

Cases have also been confirmed in Spain, Canada, and several states in the USA.

They were named in the Scottish press as honeymooners Iain and Dawn Askham, of Polmont, near Falkirk.

The World Health Organisation upgraded its pandemic alert level to 4 - two stages below the most serious threat - while the Foreign Office advised against all but essential travel to Mexico.

"British nationals resident in or visiting Mexico may wish to consider whether they should remain in Mexico at this time," a statement on the Foreign Office website added.

It comes as WHO Assistant Director General Keiji Fukuda said it was "too late" to contain swine flu and countries should now focus on mitigating the effects of the virus.

Describing the significance of the level four threat, Mr Fukuda said: "What this can really be interpreted as is a significant step towards pandemic influenza. But also, it is a phase that says we are not there yet."

It is believed twenty two other people who have been in close contact with the Scottish couple since their return who are receiving anti-viral drugs as a precaution. Seven of them are showing mild symptoms of influenza.

The seven with symptoms have been told to stay at home and will be tested to see if they have swine flu.

Fears were growing that the virus could cause a flu pandemic as a series of countries confirmed cases.

Officials in Mexico – the centre of the outbreak – said there were 1,455 probable cases and 149 confirmed deaths.

Cases have also been confirmed in Spain, Canada, and several states in the USA. More are suspected in New Zealand, Israel and Colombia. Four people in the Irish Republic were being tested for the virus.

The two British patients, from the Falkirk area of Scotland, returned from holiday last Tuesday and on Saturday developed symptoms and contacted doctors.

They are being kept in isolation at a hospital in Airdrie. They are being treated with anti-viral drugs and are said to be ‘‘recovering well’’.

Senior civil servants met in an emergency session in Whitehall to discuss the threat posed by the disease.

Nicola Sturgeon, the Scottish Health Minister, said every precaution was being taken to prevent further spread of the virus.

She said: “The seven displaying, and I stress, very mild symptoms will now be given anti-virals as treatment. The 22 that are not symptomatic will be given very extensive advice about minimising the spread.

“The focus is on the immediate contacts. Effectively, what we are trying to do is put a ring around this. We are trying to contain this as effectively as we can.”

Sir Liam Donaldson, the Government’s Chief Medical Officer, had earlier said that it was “inevitable” that the infection would reach Britain. “Hopefully, if we identify those early and treat people and their contacts, we might be able to reduce the spread,” he said.

Alan Johnson, the Health Secretary, told MPs there had been 25 suspected cases so far in Britain. Eight of them had subsequently tested negative for the disease.

A Canadian woman was taken to hospital in Manchester showing symptoms of flu, but officials said it was highly unlikely she had swine flu.

Mr Johnson added that Britain was – with France – one of the two best-prepared countries in the world to deal with a potential flu pandemic.

The Government had imposed “enhanced” port health checks in an attempt to identify passengers arriving in Britain with symptoms of the illness, he said, and measures were in place to allow the swift nationwide distribution of the drug Tamiflu, which can reduce the severity and length of flu illnesses.

In the Government’s pandemic plan the worst case scenario suggests that if half the population contracted pandemic flu there could be around 709,000 deaths.

Schools, sports events and concerts could be shut down to limit the spread of the illness. Doctors who come into contact with suspected cases should wear face masks, gloves and aprons, under protocols issued by the Health Protection Agency.

The World Health Organisation (WHO) has said the disease has ‘‘pandemic potential’’ and work has already begun on a vaccine against the potentially lethal virus – a variation of H1N1 swine flu – although this is likely to take months before it is ready for use.

Mr Johnson said: “Everywhere outside Mexico the symptoms have been mild and all the victims have made a full recovery.”

People who suspect they may have been infected should stay at home and seek medical advice over the telephone, he added.

The WHO increased the pandemic alert level from level three, where experts have identified little or no human to human transmission to level four indicating that it was spreading much more easily between people across large areas. A pandemic is declared at level six.

Since the alerts were introduced in 2005 it has never been higher than level three.

The Department of Health pandemic plan says that a likely scenario during a pandemic is that businesses should expect repeated waves of one in four employees being off work.

Stephen Alambritis, of the Federation of Small Businesses, said that this could be disastrous during a recession.

From:
http://www.telegraph.co.uk/health/swine-flu/5232846/Swine-flu-confirmed-in-Britain.html

Bird flu- health officials finally propose big rise in antiviral drugs for pandemic

Health officials are proposing up to a sixfold increase in the UK's stockpile of antiviral drugs as they reinforce preparations against a possible flu pandemic in the coming months. Based on computer simulations of the likely spread of the virus, experts believe it may be worth increasing stocks of the drug Tamiflu, made by Roche, the Swiss based pharmaceutical group, from the current 14.5m courses to 60m 90m, or up to one and a half packets for every UK resident.

The purchases would form a central part of a package of extra pandemic health preparation measures to be debated in the next comprehensive spending review this summer, which could cost more than £2bn.

The case for greater investment comes as the UK suffers its first significant outbreak in poultry of the H5N1 flu strain, which experts fear could form the basis for a mutation into a lethal human form.

Tamiflu, which the World Health Organisation has cited as a first line treatment for pandemic flu in spite of a still limited evidence base, is seen as pivotal to preparations, particularly since with current technology there are no effective vaccines that would be ready fast to protect against a pandemic flu strain.

Roche sells Tamiflu to governments for stockpiles at €15 (£9.90) per packet, so the additional purchases could be worth €700m-€1.1bn.

The larger stockpile would allow greater efforts to use the drug as a prophylactic, based on computer modelling conducted by Prof Neil Ferguson at Imperial College, London. This shows that there may be the possibility of diminishing the impact of a pandemic if those at risk of infection are treated before symptoms appear.

Currently, just 0.1 per cent of the 14.5m-strong stockpile is earmarked for such post-exposure prophylaxis.

Separately, purchases of more than £1bn have been proposed for face masks to limit the spread of infection, and antibiotics to treat the secondary infections likely to arise.

A year ago the government also paid £33m for sufficient "pre-pandemic" vaccine to protect 1.3m frontline health workers and key staff.

From
http://www.ft.com/cms/s/c6d178da-b586-11db-a5a5-0000779e2340.html

Health Direct has long warned that the govt's efforts so far to protect the UK populace have been pathetic. On Nov 02, 2005 in The Chief Medical Officer labels N5H1 bird flu as 'Public Enemy No1' when the Chief Medical Officer- Sir Liam Donaldson, called on NHS managers to 'react as well' to a flu pandemic as they did to the London bombings.

'The NHS has got to take the pandemic seriously,' he said. 'We regard pandemic flu as public health enemy number one and we are on the march against it. The NHS needs to react as well to this pandemic as it did to the July bombings.'

He added: 'I hope the urgency of the pandemic will make even the most uninterested managers make the move to develop a plan. With good planning and preparation we can reduce the impact of pandemic flu on the health of our population.'

Primary care trusts are being warned that they should expect to see at least 1,000 new flu patients a week during any pandemic and this figure could rise to over 5,000 at the virus's peak.

Hospital admissions for acute respiratory and related conditions could increase by at least 50 per cent, with around 20,000 new patients a week at the height of the pandemic.

PCTs have been asked to draw up plans detailing how they would respond to a pandemic, which would be checked by the Department of Health to insure they were appropriate.

Sir Liam warned that the vaccine might not be available in time for the pandemic reaching the UK, but said the government was stockpiling 15 million anti-viral treatment courses to treat flu victims in the event of an outbreak.

Health Direct questioned what extra money was being allocated by the Labour govt to combat the flu epidemic when it does break- or is this yet another case of spin before truth?

The above was at least a better action that Labour's "efforts" on Aug 19, 2005 when in Bird flu- Labour gives Doctors leaflets not vaccines it was announced that every doctor's surgery in Britain will be sent official instructions on how to handle an outbreak of bird flu as ministers step up their preparations for a global pandemic that, if the worst fears are borne out, could kill up to 50m people.

The UK's 10,465 surgeries will receive a package of information from the government to help tackle a flu pandemic, which scientists warn is now inevitable. Ministers and officials have privately expressed the view that a bird flu pandemic poses a greater threat than terrorism.

Each surgery will also be given 50 copies of a leaflet for patients. How very useful.

The Department of Health says up to 50m people could die worldwide, of whom between 50,000 and 650,000 would be in the UK.

Ministers are anxious to be able to demonstrate, if the virus strikes, that they have done everything possible to limit its impact.

Labour has been accused of failing to stockpile enough vaccines to combat the virus but officials say they cannot develop a jab until they know the exact strain.

Roche, the Swiss pharmaceutical group, is close to agreeing a donation of up to 3m doses of its antiviral drug, Tamiflu, to the World Health Organisation in an effort to limit the effects of a bird flu pandemic.

For a government obsessed with lies and spin over reality and improvement, this crass exercise is pathetic.