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Swine Influenza Daily Update: 02 November 2009, Wales

Main Category: Swine Flu
Also Included In: Public Health | Flu / Cold / SARS
Article Date: 03 Nov 2009

The NPHS influenza surveillance scheme, which records reports of diagnoses of flu from more than 300 GP practices across Wales, shows levels of influenza continue to increase across Wales and are normal for the time of year. Further detail can be found on the NPHS website.

The report from 29 October estimates there were 82.8 cases of a flu-like illness diagnosed by GPs out of every 100,000 people in Wales - this is the equivalent of 2,484 people in Wales contacting their GPs in the last seven days with flu like symptoms. Not all of these people will have swine flu and not everyone with flu like symptoms will contact their GP. It is expected that the proportion of influenza cases diagnosed that are due to swine flu will increase as the virus spreads in Wales.

The report also shows levels of influenza activity in each county of Wales. On 29 October, the rate of diagnosis of flu-like illness at a local level ranged from 35.4 per 100,000 people in Monmouthshire to 138.7 per 100,000 people in Carmarthenshire.

Ps are no longer being asked to swab people they suspect may have swine flu. Microbiology laboratories are therefore no longer testing mostpeople suspected of having swine flu.

As at midday on 28 October, there have been a total of 341 laboratory confirmed cases of swine flu in Wales since the start of the outbreak.

As at midday on 28 October, of the laboratory confirmed cases, a total of 192 had been admitted to hospital since the start of the outbreak with 31 still in hospital.

On 28 October, there were 58 clinically diagnosed patients in hospital in connection with swine flu, 13 of whom were in critical care.

On 28 October, the Welsh Assembly Government reported that it had been formally notified that seven people with swine flu in Wales have died. The Welsh Assembly Government is also aware of a swine flu-related death of a person from Wales abroad.

No further details will be confirmed or denied about cases in order to protect their right to confidentiality.

The rates of GP consultations for flu-like illness across the UK, which are taken from different surveillance schemes and are not directly comparable, are:

60.18 cases of flu like illness diagnosed by GPs in the previous seven days out of every 100,000 people in Wales (as of 25 October).

42.8 cases of flu like illness diagnosed by GPs in the previous seven days out of every 100,000 people in England (for the week ending 25 October)

111.4 cases of flu like illness diagnosed by GPs out of every 100,000 people in Scotland (for the week ending 26 October)

280.6 cases of flu like illness diagnosed by GPs out of every 100,000 people in Northern Ireland (for the week ending 23 October)

138 people in the UK with swine flu have died - 7 in Wales, 97 in England 26 in Scotland and 8 in Northern Ireland. The majority had underlying health conditions.

For the latest international figures for the spread of swine flu, visit the website of the World Health Organization at http://www.who.int
Comment from the National Public Health Service for Wales
Dr Roland Salmon, Director of the Communicable Disease Surveillance Centre, National Public Health Service for Wales, said:

"The number of people contacting their GP with flu like symptoms is increasing. It seems that the winter wave is getting underway.

"Not everyone who has contacted their GP with flu like symptoms will have swine flu. It's also true that not everyone with flu like symptoms will contact their GP.

"The vaccine against swine flu has been tested and approved. It is now being offered to people at most risk of complications from the virus as well as front line health and social care workers. Vaccination is 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.

"People with flu like symptoms should check their symptoms on http://www.nhsdirect.wales.nhs.uk or by calling the Swine Flu Information Line on 0800 1 513 513.

"Most people will get better at home with rest, plenty of fluids, and medication such as paracetamol.

"Antiviral medications are available for individuals who are at particular risk from flu, or for people who become very ill.

"If symptoms worsen or people have underlying health problems they should call their GP. People should not go to Accident and Emergency Departments, a pharmacy or to their GP surgery unless advised to do so as this may risk spreading the infection. It also places undue pressure on the emergency services.

"Over the last six months, the symptoms of swine flu have generally been like those of seasonal flu. Most people recover from the infection without needing to be admitted to hospital or to call a doctor. However, a few people go on to develop complications and as the pandemic continues we are seeing deaths from swine flu in Wales, just as we do most years from seasonal flu.

"Sadly, the number of deaths in Wales has increased. However, the great majority of people make a full recovery. By following public health advice if they become ill, and taking up the swine flu vaccine now it is available to those in at-risk groups, people can help prevent the spread of the virus and by the same token help prevent death and serious disease.

"It is still important that people practice good respiratory and hand hygiene to reduce the chance of catching or spreading viruses."

Public health advice and messages

If you have flu-like symptoms, stay at home. You can check your symptoms by calling the Swine Flu Information Line on 0800 1 513 513 or visiting http://www.nhsdirect.wales.nhs.uk. If you are still concerned, phone your GP. Do not go into your GP surgery or Accident and Emergency department unless you are advised to do so or are seriously ill, as you may spread the illness to others.

It is always good practice to follow respiratory and hand hygiene such as:

Covering your nose and mouth when coughing or sneezing, always carrying tissues, using a tissue when possible.
Disposing of dirty tissues promptly and carefully.
Maintaining good basic hygiene, for example washing hands frequently with soap and water to reduce the spread of the virus from your hands to face or to other people.
Cleaning hard surfaces (e.g. door handles) frequently using a normal cleaning product.
Helping your children follow this advice.

Facemasks

Although we are aware that facemasks were being given out to the public in Mexico, the available scientific evidence does not support the general wearing of facemasks by those who are not ill whilst going about their normal activities. We are, however, reviewing NHS supplies and stockpiles of facemasks for healthcare workers who are likely to come into regular contact with people who may have symptoms. The UK will receive an additional 227 million surgical facemasks and 34 million respirators. Wales will receive its proportionate share.

Control measures

The European Medicines Agency has granted marketing authorisation to Celvapan (Baxter), Focetria (Novartis) and Pandemrix (GlaxoSmithKline) H1N1 swine flu vaccines.

The European Medicines Agency has strict processes in place for licensing pandemic vaccines. In preparing for a pandemic, appropriate trials to assess the safety and the immune responses have been carried out on vaccines very similar to the swine flu vaccine.

Supplies of the vaccine have arrived in Wales and the vaccination programme has started to protect those at most risk of complications of the virus and front line health and social care workers.

The four UK nations have accepted the advice of the Joint Committee on Vaccination and Immunisation on priority groups for swine flu vaccination:

People aged over six months and under 65 years in current seasonal flu vaccine clinical at-risk groups

All pregnant women, subject to licensing conditions on trimesters
Household contacts of people with compromised immune systems e.g. people in regular close contact with patients on treatment for cancer

People aged 65 and over in the current seasonal flu vaccine clinical at-risk groups. This does not include otherwise healthy over 65s, since they appear to have some natural immunity to the virus.

Vaccination of frontline health and social care workers began at the same time as the first at-risk group, and will continue for as long as necessary. This group is at increased risk of infection and of transmitting that infection to susceptible patients. Protecting these people will help the NHS workforce to remain resilient and able to treat sick patients.

GPs are administering the vaccination programme following agreement between the Department of Health, the devolved Administrations, the General Practitioners Committee and NHS employers.

Around 60 million doses of vaccine are expected by the end of the year - enough for 30 million people to be vaccinated - with more following after that.

The Foreign and Commonwealth Office has produced a webpage providing information for British citizens planning to attend the Hajj. The page is available at http://www.fco.gov.uk/en/travelling-and-living-overseas/ta-relevant-to-you/hajj-pilgrims

A leaflet providing advice for British Hajjis is available at: http://www.fco.gov.uk/resources/en/pdf/pdf1/hajj-advice

Key advice included in the leaflet is that the elderly, pregnant women, people with chronic diseases and children should postpone the Hajj and Umrah pilgrimages this year due to the high likelihood of transmission of flu in the course of the pilgrimage. Although health care facilities for the Hajj are generally of a high standard, due to the large number of pilgrims, it might be less than would normally be expected in the UK for people who are vulnerable to complications.

Features of the outbreak

Based on assessment of all available information and following several expert consultations, the World Health Organization (WHO) declared the level of influenza pandemic alert at phase six on 11 June 2009.

Phase six indicates there is human-to-human spread of the virus in at least two countries in one World Health Organization region, with community level outbreaks in at least one other country in a different WHO region.

On 2 July the four UK nations agreed to move to the treatment phase in their response to the pandemic - treating people most at risk. Contact tracing and the use of antivirals preventively were ended. GPs are providing clinical diagnosis of swine flu cases rather than awaiting laboratory test results.

Further health information for the public on swine flu is available bilingually from http://www.nhsdirect.wales.nhs.uk

Further public health information on swine flu and Pandemic Flu is available bilingually from http://www.nphs.wales.nhs.uk

Further information from the Welsh Assembly Government response is available bilingually at http://www.wales.gov.uk

Source
National Public Health Service for Wales

Original article posted on Medical News Today.
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Swine Influenza Daily Update: 02 November 2009, Wales

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