More swine flu deaths last winter than during pandemic

More people died after contracting swine flu in Britain last winter than during the previous year’s pandemic.
More swine flu deaths last winter than during pandemicOfficial figures show there were at least 562 deaths linked to the H1N1 virus during the most recent “season” compared with 474 in the global outbreak of 2009.

The young and the middle aged bore the burnt of the cases with 50 children and nine pregnant women dying across the country, according to the Health Protection Agency.

It came after GPs in some areas struggled to access sufficient vaccines, prompting the Government to raid a stockpile from the previous year while hospitals were forced to cancel planned operations in order to care for critically ill flu patients.

In an attempt to avoid a repeat of the recent problems, the Department of Health now hopes to vaccinate far more people including frontline doctors and nurses as well as at-risk groups such as pregnant women and those with long-term diseases. It will also hold a central reserve of jabs and may centralise supply in future years.

Prof John Watson, head of the watchdog’s respiratory diseases department, said: “The information published in our annual flu report confirms that seasonal flu activity in 2010/11 was higher than last winter and that H1N1 ‘swine’ flu was the dominant strain. Sadly, a small proportion of flu cases resulted in serious illness and death, predominantly in young and middle aged adults.

“Each year hundreds of thousands of people catch flu and the majority will make a full recovery. Traditionally the elderly have been more seriously affected by winter flu but the picture is beginning to change as we are now seeing a higher proportion of young and middle aged people taken seriously ill.”

The pandemic outbreak of the H1N1 swine flu virus, thought to have originated in Mexico, led to the deaths of 474 people in Britain between June 2009 and April 2010. Most of those who died had underlying health problems.

The HPA’s report on the most recent season – between September 1st, 2010, and May 4th, 2011 – shows there were 602 fatal influenza cases across Britain while a further 91 probable cases are still under investigation to confirm the cause of death.

The highest regional concentrations of deaths were in the north west of England (96), Yorkshire and the Humber (83) and Scotland (63).

More than 90 per cent of the fatalities, according to data obtained from death certificates, were linked to the H1N1strain but 40 were among those who had the Influenza B infection, leaving at least 562 deaths in those who had swine flu.

Only about one in five deaths were in pensioners and three quarters of those who died had not been vaccinated.

Nine babies died before their first birthday, along with 16 pre-schoolers and 25 children aged between five and 14.

During last winter’s outbreak the Government tried to vaccinate vulnerable groups such as pregnant women against flu but there was neither a programme to protect all children nor a campaign to publicise the jabs, despite public outcry.

Prof Watson said: “We are very concerned that only half of adults eligible for the jab last winter took up the offer of vaccination, and particularly that just over a third of healthy pregnant women received it.

“For the majority of people with these conditions, flu is a preventable illness and ahead of the next flu season, a concerted effort must be made by healthcare professionals – including GPs and midwifes – to encourage those at risk to take up the offer vaccination. It is the best way to protect against flu.”

But stocks of the flu jab ran short in some areas and the “worried well” were accused of using up supplies.

In the first seasonal flu plan, published by the Department of Health on Wednesday, Andrew Lansley, the Health Secretary, claims the system “coped well” last winter but admits: “The consequences of the surge in demand for vaccine as well as the number of patients requiring treatment in hospital were felt across the primary and secondary care systems; there were also issues for the vaccine industry.”

The report sets a goal of increasing uptake of the vaccine from 50 per cent to 75 per cent as well as buying a “central strategic reserve” of the jab in case of shortages.

Ministers are also considering introducing a “central purchase system” for the vaccine – rather than letting individual GPs order it directly from manufacturers – on the grounds that it may make the system “more robust” as well as increasing uptake.


Swine flu- labour’s spin led to sensationalised reporting say MPs

It is “absolutely essential” that the coalition government improves how it communicates risk and uncertainty to the public and the media, say MPs, reporting on Ministers’ handling of the H1N1 (swine flu) pandemic.
Swine flu- labour's spin led to sensationalised reporting say MPsOn July 16, 2009, when Chief Medical Officer Sir Liam Donaldson held a press briefing that led to media reports suggesting that in a “worst-case scenario” 65,000 people in the UK could die from swine flu, the number of deaths at that time actually stood at around 30 and, by the time the pandemic was over in April 2010, had reached 460 in total, says a report published today by the House of Commons Science and Technology Committee on the use of scientific advice and evidence in emergencies.

The “reasonable worst-case scenario” of around 65,000 deaths communicated by the government was useful for emergency responders such as the NHS but led to sensationalised media reporting, say the MPs, who suggest that it would be better for the government to establish a “most probable scenario” with the public. Improvements in how risk and uncertainty are presented to the public and media are “absolutely essential for allaying fears,” they add.

It is equally – if not more – important for central government to communicate effectively with emergency responders, say the Committee members, who had been told by the British Medical Association (BMA) that doctors had felt “overwhelmed” by the volume of information about the swine flu pandemic issued by various bodies, including government, and that key advice had been lost within the large quantity of emails received, which often duplicated information.

The Committee suggests instead that a single portal of information should be set up for every emergency along the lines of in the US, for use by the public as well as emergency responders. This should be the primary source of all information, linking to other websites as necessary.

The swine flu pandemic was also the first emergency in the UK for which a Scientific Advisory Group for Emergencies (SAGE) was convened to advise the government, and the MPs have concerns about the operations of such groups. Their report finds that SAGEs  “tended towards an unnecessarily secretive way of working, thus closing doors to the wider scientific community, and did not appear to adhere to any published guidance or code of conduct.”

A SAGE “should not be given carte blanche to operate however it pleases simply because an emergency is occurring,” say the MPs, and they call on the government to provide greater clarification as to the codes, principles and guidance which cover the operations of such groups. “The Government Office for Science should take responsibility for ensuring that all future SAGEs operate in a more organised, transparent and accessible manner and adhere to a published code – existing or new,” they add.

Experience with the swine flu pandemic also points to the need for a better international mechanism for data-sharing, particularly for raw epidemiological data, say the MPs, and they suggest that the UK should propose the formation of an international working group within the World Health Organisation (WHO) to discuss how epidemiological data can be shared effectively between countries in the run-up to a new pandemic.

As well as the H1N1 pandemic, the Committee also examined the role played by scientific advice and evidence in the government’s handling of the April 2010 volcanic ash disruption, space weather and cyber attacks. The experience has, they say, left them with the impression that “while science is used effectively to aid the response to emergencies, the government’s attitude to scientific advice is that it is something to reach for once an emergency happens, not a key factor for consideration from the start of the planning process.”

“This is not trivial,” the MPs stress, concluding: “we urge the government to do better at embedding scientific advice and an evidence-based approach in risk assessment and policy processes before emergencies occur.”


MRSA Action UK’s fears for government’s continued failings over hygiene

MRSA Action UK’s dismay at the government’s continued failings to inform the public of the need to protect themselves from Swine Flu and other infectious illnesses that have become a modern day plague.
MRSA Action UK's fears for government's continued failings over hygieneWith H1N1 (Swine Flu), norovirus and the continuing threat from MRSA and Clostridium difficile in the community setting MRSA Action UK is dismayed that their calls for a public information campaign on both hand and respiratory hygiene have not been forthcoming.

Whilst there has been considerable efforts put into preventing avoidable infections in hospitals, the public are still largely unaware of the simple actions that can be taken to reduce the burden of avoidable infections in the wider community.

Resistant pathogens continue to concern many in the field of microbiology, but not all healthcare professionals are in tune with the need to inform their patients on the sensible use of antibiotics. Posters in surgeries are few and far between, workplaces, supermarket notice boards, schools and public transport could all help spread the word.

There are some NHS Hospital Trusts and Strategic Health Authorities that have taken the initiative to raise awareness, but with cuts in budgets for many this has been a lower priority, despite the fact that preventing infections is far more cost effective than trying to manage the consequences of contracting them in the first place, which can often be fatal.

The Swine Flu epidemic has served to heighten the need for information and more needs to be done to raise awareness not only of the need for those at higher risk to come forward for vaccination, but also to take the necessary precautions to help prevent and fight infections like the Swine Flu.

With cases of flu in England and Wales soaring by 45% in a week, Swine Flu reaching epidemic proportions in under-fives and 39 dead from flu, 36 from the H1N1 virus, it’s time for the government to put promised resources into a public information campaign.

The previous administration was criticised by the present Health Secretary Andrew Lansley for making promises it didn’t keep, the Labour government stepped down the resources that were earmarked for raising awareness by curtailing the “cleanyourhands” campaign and ignored the research findings that they themselves commissioned proving the need for a public information campaign. We had hoped the new administration would heed our warnings, but to date little has changed as the campaign has not come to fruition.

By Derek Butler Chair MRSA Action UK

Flu vaccination call for all children from doctors

The doctor parents of a three year old girl who died from swine flu have called for all children to be vaccinated against the virus.
Flu vaccination call for all children from doctorsLana Ameen, who had no underlying health problems, died in hospital on Boxing Day, two days after apparently catching a cold and developing a high temperature.

Her parents, a doctor and nurse, have described how they were “shocked” at losing their daughter and said it was wrong that not all children were given the swine flu jab this winter. During the 2009 swine flu outbreak, it was recommended that all under-fives be vaccinated.

In the past fortnight, the Government has come under fire for restricting use of the seasonal flu jab, which protects against swine flu and two other strains, to under-fives who suffer from health problems, such as neurological disorders or asthma.

Ministers insist they are legally bound to follow the recommendation of the Joint Committee on Vaccination and Immunisation, which last July decided against vaccinating all children against this winter’s flu strains, a position they reaffirmed over Christmas.

But Gemma and Zana Ameen from Quinton, Birmingham, said the “price was too high” not to vaccinate children against the potentially deadly swine flu (H1N1) virus.

Mrs Ameen, 28, who is 12 weeks pregnant, said: “I want to say to people, to parents, ‘If you can get the vaccine don’t hesitate’. The risk of not having it and the price you might pay is just too high.

“We have been so shocked by what has happened and we feel very strongly that everyone, particularly children, should have the vaccine. The Government has made the swine flu vaccine from last year available now — we should all be having it.

“Even financially, surely it makes sense. The swine flu vaccine is inexpensive and has already been bought — it cost £1,700 just to care for Lana in intensive care for one day.”

The Ameen family were visiting relatives in Stockport, Greater Manchester, when Lana became ill on Christmas Eve. At about 2am on Christmas Day, her parents took her to Stepping Hill Hospital, where they had formerly worked, where she was diagnosed with an infection and her temperature stabilised before being sent home.

When she woke she seemed slightly better, opening Christmas presents and eating a little lunch. But after falling asleep that afternoon, she started having fits and was taken in an ambulance back to the hospital. She was eventually transferred to Alder Hey Hospital in Liverpool and died the next day.

Since October, five of the 50 patients known to have died of flu have been under-fives.


Pregnant women denied flu jabs say midwives

Pregnant women were denied the seasonal flu jab in some parts of the UK, before swine flu began claiming more lives, because not all GPs were aware that mothers-to-be had been made a priority group to receive the jab this winter.
Pregnant women denied flu jabs say midwivesLouise Silverton, deputy general secretary of the Royal College of Midwives, told the Guardian that a number of pregnant women had been refused the vaccine by family doctors in autumn.

“In October, when GPs started telling patients to come for immunisation, some pregnant women got it and some didn’t. GPs sent some of them away because they thought they didn’t need it, because no one had told them that pregnant women had been added to the list of groups of people considered ‘at risk’,” she said.

Research shows pregnant women are four times more likely to develop serious complications if they catch H1N1 swine flu, which is the main strain of seasonal flu circulating this winter. There has been concern that takeup of the jab protecting against all three strains of flu has been low among pregnant women.

Silverton also criticised the decision by the health secretary, Andrew Lansley, to cancel the usual advertising campaign intended to prompt the 16 million Britons classed as vulnerable to have the jab.

“It was short-sighted of the Department of Health not to have the usual campaign, she said. “It was done to save money. I agree with the government’s overall aim of reducing government advertising, but they should have been more selective and kept the campaign for all at-risk groups.

“Usually there are posters on buses and all sorts, but this year there was nothing. It was a wasted opportunity not to have the awareness campaign stressing the importance of people in at-risk groups being vaccinated.”

A majority of the 50 people to die from flu so far this winter had not had the three-in-one jab at least two weeks before falling ill, the Health Protection Agency said.

The outbreak has so far claimed 50 lives and left 783 people in intensive care, amid vaccine shortages and low takeup rates of the seasonal flu jab.


Young not taking swine flu vaccine

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.
Young not taking swine flu vaccineProfessor 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.


NHS Direct under growing strain as doctors told to give Tamiflu to low risk patients

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.NHS Direct under growing strain as doctors told to give Tamiflu to low risk patientsAmid 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.”


Swine flu- half of worst afflicted were previously in good health

Fears of a major swine flu crisis are growing after a letter from the country’s top doctor warned that half of the most severe cases have involved people who were previously healthy.
Swine flu- half of worst afflicted were previously in good healthProfessor Dame Sally Davies, the Government’s chief medical officer, has written to all GPs and NHS hospitals warning of a “sharp increase” in the numbers of patients admitted to intensive care because swine flu has caused their lungs to fail.

The letter says pressures on critical care services are “significantly over and above” those expected at this time of year.

Crucially, the memo, says that while “half of patients requiring respiratory support have had recognised comorbidities [underlying health problems] which increase the risk for severe influenza, half have had no recognised comorbidities.”

A spokesman for the Department of Health (DoH) confirmed that the presence of so many previously healthy people among those worst affected by the virus was “unusual” and said anyone concerned about worsening flu-like symptoms should contact their GP.

While overall flu levels remain normal for this time of year, the rate of flu has more than doubled in just seven days, latest figures show.

The official death toll from flu this winter has now reached 17, including six children. Fourteen of the deaths were linked to swine flu, and none of those who died had been vaccinated against the virus.

In the same letter, the senior doctor says pregnant women, children, young adults, and those who are overweight are among the most severely ill.

Yesterday, Prof Davies criticised the Government’s decision to axe the annual publicity campaign urging people in at risk groups to have the seasonal flu jab, which protects against the main viruses in circulation, including swine flu.

Prof Davies said: “The Government took a decision not to use the marketing campaign this year. I would prefer to have done it because I believe in belt and braces. I am a doctor – I don’t like leaving things to chance.”

For the first time, the winter flu jab is being offered on the NHS to pregnant women, who were disproportionately affected by last year’s swine flu outbreak, as well as to elderly people and those with existing health problems.

Pregnant women are being advised to be immunised, no matter how far into their pregnancy they are, since they are thought to be more than four times more likely than others to develop serious complications if they contract swine flu.

The medical officer said the number of people seeing their GP because of flu was “bang in the range” for the season.

However, the sharp rise in all flu cases in seven days and the number of people below the age of 65 being admitted to hospital were reasons why the Government was examining the patterns carefully, she said.

GPs are worried that elderly people, who suffered less than younger people in last year’s swine flu pandemic, are failing to protect themselves against other strains of flu.

Vaccination rates among the elderly are down two per cent on last year, while among at risk groups, rates are down by 6 per cent.

In some parts of the country, pharmacists and hospitals are complaining of shortages of the drug used to treat the virus. Chemists and hospitals in Yorkshire were unable to track down supplies of Tamiflu, with NHS bosses describing “difficulties with the national supply chain”. The DoH said there was no national shortage of the drugs, and that any local delays “should be short-lived”.

At least four more pregnant women with swine flu in England have undergone intensive care treatment. In Scotland, a woman with swine flu has been placed in a coma after giving birth to a daughter by caesarean section.

A spokesman for the DoH said GPs would be contacting patients in “at risk” groups to invite them to have the vaccination. He said: “It is vital that those at greatest risk are vaccinated as soon as possible.”

Anyone who did not know if they were in such a group should contact their GP, he said.

Doctors shocked by spread of swine flu– and its severity

The Swine flu H1N1 virus that swept the world last year causing a global health emergency has returned to claim the lives of 10 adults in the UK in the past six weeks.Doctors shocked by spread of swine flu – and its severityThe 10 deaths were in younger adults under 65 and associated with H1N1 swine flu. Most had underlying conditions but “a small proportion” were healthy before being struck down by the virus, according to the Health Protection Agency (HPA).

Seasonal flu normally causes severe illness and death in the elderly. The H1N1 swine flu virus targets pregnant women, younger adults, and those with chronic conditions, making it a cause of particular alarm.

No other similar reports of deaths linked with swine flu have been received from elsewhere in Europe.

Official figures show GP consultations for flu-like illness in England were at 13.3 per 100,000 population last week, well below baseline levels.

Flu experts expressed surprise at the relatively high incidence of deaths and severe illness in the context of the low consultation rates. John Watson, head of respiratory diseases at the Health Protection Agency, said: “We seem to be in the vanguard on this. Other European countries are just beginning to see some H1N1 activity.”

Calls to NHS Direct and other indicators show there is “quite a lot” of H1N1 swine flu about, despite the low GP consultation rate.

Around 30 per cent of those who fell ill, went to their GP and got tested for the virus, were coming up positive for H1N1, which was a high rate. Flu was very difficult to predict, Dr Watson added. “I am a little surprised to see as much activity as we seem to be seeing – both in terms of its spread in the community and its severity. I don’t see it as being extraordinary but it is more than I would have expected.”

All parts of the country are affected with deaths reported from each region, according to the HPA. There were nine flu outbreaks last week, eight in schools and one in an army barracks in Yorkshire.

Pressure has been building on intensive care in recent days with the worst affected patients treated on Extra-Corporeal Membrane Oxygenation (ECMO) machines which bypass the lungs to artificially oxygenate the blood. “A good many intensive care units are seeing severely ill cases including some using ECMO beds,” Dr Watson said.

Swine flu arrived last year from Mexico creating the first flu pandemic for 40 years. In the UK, the first wave of the pandemic struck in the summer – unusually for flu – followed by a second smaller wave before Christmas.

Dr Watson said: “A lot of people were infected through the two waves of the last pandemic. We estimate something like two-thirds of children and a half of adults are likely to have been infected even though they may have had no symptoms.

“We wouldn’t anticipate a big epidemic wave of flu activity due to H1N1 this year. “But there are still a substantial number of people who remain susceptible.”

Many who caught swine flu last year suffered only minor illness but a small number were severely ill. There were 494 deaths in the year to April 2010.

The fear among flu experts is that the virus could mutate to cause more severe illness or target a different section of the population such as the elderly who are more vulnerable.

But laboratory analysis has shown that the circulating strain of the virus is “very much the same” as last year and has not shown “any significant change”, according to the HPA.

Five of the 10 adults who died for whom information was available had not received the flu vaccine, the HPA said. National figures show vaccination rates are lower than in previous years covering 66 per cent of the over-65s and 40 per cent of younger adults at risk (pregnant women and those with chronic diseases such as asthma).

Professor David Salisbury, director of immunisation at the Department of Health said: “These figures demonstrate that the effects of flu are not to be underestimated. It is not the same as getting a cold and can seriously affect your health.

“The seasonal flu jab protects against the dominant strains – this year it protects against three types of flu, including the type known as swine flu. If you are in a risk group, then I would urge you to visit your GP surgery and get the vaccination as soon as possible. It is not too late to get vaccinated for your protection and that of your family.”

In addition to H1N1 swine flu, which has become the dominant Influenza A virus in Britain, about 40 per cent of virus strains isolated this winter are Influenza B, which is most common in children, causes mostly mild illness, and has been responsible for several outbreaks in schools in recent weeks.

The last year in which it caused widespread illness was 2005-6. “There is plenty of B about,” Dr Watson said.

Hong Kong diagnoses first bird flu case in seven years

A woman in Hong Kong is seriously ill in hospital with bird flu – the first human case of the disease to be diagnosed in the territory since 2003.
Hong Kong diagnoses first bird flu case in seven yearsOfficials said the 59-year-old fell ill shortly after returning from a visit to the Chinese mainland.

It is not yet clear whether she contracted the potentially fatal disease there or in Hong Kong.

The territory has raised its alert level to “serious”, meaning there is a risk of contracting the disease.

The last outbreak of the H5N1 bird flu virus in Hong Kong killed six people in 2003.

Health chief York Chow said there was no sign yet that the virus has been spread between humans and that investigations were focusing on poultry as being the source of the infection.

“But we will be concentrating on people who were in contact with her when she showed symptoms and also when she was in Hong Kong,” the AFP news agency quoted him as saying.

“The chances of her catching it is most likely on the mainland, but you cannot rule out Hong Kong,” he said.

The woman is reported to have travelled to the mainland with her husband and daughter, and to have visited Shanghai, Hangzhou and Nanjing.

Mr Chow said officials would meet on Thursday to decide what further precautions are needed.

The first time the virus crossed the species barrier between poultry and humans in 1997, every chicken in Hong Kong was culled.

The World Health Organization says more than 500 cases of bird flu have been diagnosed worldwide since 2003. Of those, 302 cases were fatal.