Young people are at a greater risk from swine flu than the over-60s but are more reluctant to get vaccinated, an expert has warned.
Professor John Oxford, from Queen Mary, University of London, said pensioners would have been exposed to the virus in the 1940s and 1950s.

He explained older people are usually more vulnerable to flu in general but they have a tolerance to the swine flu strain.

Prof Oxford said: “That’s the paradoxical thing. There were fewer deaths across those age groups compared to younger people last year. The only thing is, younger people can’t be persuaded to have the vaccine.”

Asked why fewer young people are getting inoculated, he said: “The problem is that on websites like Twitter people are saying we’re all going to die from the vaccine, but that is utter nonsense.”

The virologist said people should listen to expert advice, rather than rumours from unqualified sources on the internet.

An estimated 67.2% of over-65s and 41.5% of under-65s in at-risk groups have had the flu jab in England.

At-risk groups from the flu virus include people over 65, those suffering from a chronic heart or chest complaint, people with asthma, chronic kidney disease, diabetes, and those with lowered immunity due to cancer.

Prof Oxford said: “It’s not a great start to the season, but it’s a tricky virus to deal with. It’s certainly not a walkover for people. I do expect trouble with it, but what came out from last year is that the vaccine was 95% effective.”

Urging people to take preventative steps, he said: “The message here is, at this stage, we have to be very careful with it, but people can take action.  We can’t guarantee it’s going to be 95% effective like last year, but certainly vulnerable people should get it now.”

Amid fears a major flu crisis is brewing in the UK, the professor said: “We’re quite well set in the UK.”

As well as having enough flu vaccine to go round, he said there are “plentiful stocks of Tamiflu” which is taken shortly after symptoms of the virus start to take hold.

He said: “We’re on full alert. People know what they’re up to and what they are up against. I’d rather be here if anything goes wrong.”

People should also take other precautions to avoid catching the virus, such as improving personal hygiene and avoid coming into contact with people suffering from flu.

From: http://www.independent.co.uk/young-not-taking-swine-flu-vaccine

HS Direct is struggling to cope as the number of people using the helpline dramatically increases due to freezing weather and the swine flu outbreak.Amid claims some patients had waited for two days to speak to a nurse, officials urged patients to use a new online health information service.

Senior nurses suggested the helpline was struggling to cope with the overload of calls as figures show the number of people calling the helpline had dramatically increased over the past few days.

An NHS Direct spokeswoman admitted the telephone advice service was “experiencing extremely high demand as a result of the severe weather”. She said the service had received 50 per cent more calls than forecast.

Up to 46,000 people called the service last weekend, the equivalent of almost 960 an hour.

It was also disclosed that there had been 5,700 more calls made to NHS Direct last week compared with the same week last year.

The online “symptom checker” system was used 160,000 times while the colds and flu symptom system was the most used service with almost 59,000 checks.

NHS Direct management apologised to patients who had been forced to wait longer than expected.

It came as doctors were told they could prescribe Tamiflu to otherwise healthy people suffering from flu as the illness prompts a surge in hospital admissions.

The move is an indication of the authorities’ concern about the risks from swine flu, which has become the predominant strain of the virus this winter and is striking younger age groups than usual.

Cases of flu have risen more than six fold in three weeks, the latest figures show.

Normally antiviral drugs, such as Tamiflu and Relenza, are only prescribed to people with flu who have other conditions such as heart disease and severe asthma because of the extra risk that influenza poses to them.

But officials are so concerned at the number of otherwise healthy people who have been admitted to hospital that they are taking special measures to lift these restrictions.

Doctors will be able to use their discretion and prescribe the drugs, which shorten the length of the illness by about one day and reduce spread, to anyone they think will benefit.

The drugs are most effective if taken within 48-hours of symptoms first appearing.

Prof Dame Sally Davies, interim Chief Medical Officer, has written to all GPs with the new instructions as figures were released showing there are more than 300 people in intensive care with flu, higher than during any point in last year’s pandemic. Last week there were 180 people in intensive care.

Nine of the 17 deaths, that have so far been linked to flu this winter, were in otherwise healthy people. None of those victims had been vaccinated with this year’s seasonal flu jab or the pandemic vaccine against just swine flu that was administered last year.

Figures released by the Royal College of GPs disclosed that the number of people going to their GP with flu-like symptoms has more than doubled in a week. There were 87 consultations per 100,000 people in the week up until December 19th compared with 34 the week before.

In the week ending December 5th just 13 consultations per 100,000 people were about fly symptoms. Illness was most common in children aged between five and 14, followed by children under four, and those aged between 15 and 44.

It is not known how many of those people have had swine flu but the H1N1 virus is the most common this winter.

The letter to GPs said: “Antiviral treatments for influenza are currently only available from GPs for NHS patients who are in a designated “at clinical risk” category.

“The most recent surveillance data indicate that higher than normal numbers of patients, who are not in one of the “at clinical risk” groups, are becoming seriously ill with flu – requiring hospitalisation.

“Regulations currently say that prescribers should not order oseltamivir and zanamivir [Tamiflu and Relenza] for patients who are not in the target risk groups.”

It added: “However, the Chief Medical Officer has recommended that the current restrictions should be amended to allow general practitioners (and other prescribers) to exercise their clinical discretion so that any patient who their GP feels is at serious risk of developing complications from influenza may receive these treatments on the NHS.

“This is consistent with guidance from NICE which informs the existing statutory restrictions but which envisages that prescribers may exercise their clinical discretion in individual cases.

“Whilst antiviral manufacturers and wholesalers should have sufficient supply to meet demand, prescribers and pharmacists are asked to consider carefully the need to order sensibly and not to stockpile. Stockpiling and over-ordering could cause shortages.”

It comes as doctors in some parts of the country are preparing to open their surgeries on Christmas Day to deal with large localised outbreaks of flu.

Doctors in Leicester have said the outbreak there is the worst for ten years.

Some GP practices will open on Christmas Day and Boxing Day as well as the Monday and Tuesday bank holidays – although doctors will only see patients registered at the practice.

Ivan Brown, a public health consultant with NHS Leicester City, said: “As things stand at the moment, we are confident we are managing well but we must do anything we can to avoid unnecessary admissions to hospital.

“At the moment, we do have enough hospital beds. There aren’t a huge number to play with but there are enough.

“I understand people are going to have a good deal of anxiety but, for the vast majority of individuals, the raft of winter-related illnesses around are self-limiting and patients will recover.”

Dr Brian Gaffney, NHS Direct’s Medical Director, urged people to use the online system.

“Patients can be assured that they will receive the same quality of advice that they have come to expect from the telephone service when they access our services online,” he said.

Meanwhile sales of over-the-counter medicine have increased dramatically as patients try to keep themselves well at home.

Tesco has reported a surge in demand for cold relieving powders and drinks, cough syrup, lozenges for sore throats and other related pain relievers and is selling around half a million of these products a day.

Tesco pharmacy buyer Joy Wickham said: “As if the Arctic temperatures and horrendous travelling conditions aren’t bad enough the UK is suffering a higher than normal incidence of colds and flu illness.

“We are selling nearly half a million cold and flu remedies plus pain relievers a day while our flu jab service uptake has more than trebled.

“Since the recent heavy snowfall we are also seeing far higher than normal demand in our high street Express stores which suggests that shoppers are finding it easier to buy their essentials in urban areas.”

From: http://www.telegraph.co.uk/NHS-Direct-under-growing-strain-as-doctors-told-to-give-Tamiflu-to-low-risk-patients

Three scientists who drew up the key World Health Organisation guidelines advising governments to stockpile drugs in the event of a flu pandemic had previously been paid by drug companies which stood to profit.
An investigation by the British Medical Journal and the Bureau of Investigative Journalism, the not-for-profit reporting unit, shows that WHO guidance issued in 2004 was authored by three scientists who had previously received payment for other work from Roche, which makes Tamiflu, and GlaxoSmithKline (GSK), manufacturer of Relenza.

City analysts say that pharmaceutical companies banked more than $7bn (£4.8bn) as governments stockpiled drugs. The issue of transparency has risen to the forefront of public health debate after dramatic predictions last year about a swine flu pandemic did not come true.

The UK, which warned that 65,000 could die as a result of the virus, spent an estimated £1bn stockpiling drugs and vaccines; officials are now attempting to unpick expensive drug contracts.

The cabinet office has launched an inquiry into the cost to the taxpayer of the panic-buying of drugs.

Although the experts consulted made no secret of industry ties in other settings, declaring them in research papers and at universities, the WHO itself did not publicly disclose any of these in its seminal 2004 guidance. In its note, the WHO advised: “Countries that are considering the use of antivirals as part of their pandemic response will need to stockpile in advance.”

Many nations would adopt this guidance, including Britain. In 2005, the government said it had begun bulk-buying the drug Tamiflu, initially ordering 14.6m doses after bird flu killed 40 in Asia.

The specific guidance on antivirals was written by Professor Fred Hayden. He has confirmed in an email that he was being paid by Roche for lectures and consultancy work at the time the guidance was produced and published. He received payments from GSK for consultancy and lecturing until 2002. He said “[declaration of interest] forms were filled out for the 2002 consultation”.

The previous year Hayden was also one of the main authors of a Roche-sponsored study that asserted what was to become a main Tamiflu selling point – its claim of a 60% reduction in flu hospitalisations.

Dr Arnold Monto was the author of the WHO annex dealing with vaccine usage in pandemics. Between 2000 and 2004, and at the time of writing the annex, Monto had openly declared consultancy fees and research support from Roche and GSK. No conflict of interest statement was included in the annex published by the WHO.

When asked if he had signed a declaration of interest form for WHO, Dr Monto said “conflict of interest forms are requested before participation in any WHO meeting”.

The third scientist, Professor Karl Nicholson, is credited with the WHO’s influential work Pandemic Influenza. According to declarations he made in the BMJ and Lancet in 2003, he had received sponsorship from GSK and Roche.

Even though the previous year these declarations had been openly made, no conflict of interest statement was included in the annex. Nicholson said he last had “financial relations” with Roche in 2001.

When asked if he had signed a declaration of interest form for WHO, he replied: “The WHO does require attendees of meetings, such as those held in 2002 and 2004, to complete declarations of interest.”

A WHO official told the BMJ it had to balance an individual’s privacy with the robustness of guidelines, which were subject to a wide external review process.

From: http://www.guardian.co.uk/business/2010/jun/04/swine-flu-experts-big-pharmaceutical