GPs Told How To Prepare For Flu Pandemic
Featured ArticleMain Category: Flu / Cold / SARS
Also Included In: Public Health; Primary Care / General Practice
Article Date: 08 Jan 2009 - 11:00 PDT
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GPs in England were told yesterday how to prepare for and operate during a flu pandemic: similar instructions for practitioners in the rest of the UK will follow shortly.
The new guidance was issued jointly by the British Medical Association (BMA) and the Royal College of General Practitioners (RCGP), with the support of the Department of Health in England, on Wednesday. A full copy of the 61-page guide, which is described as a "live" document (ie GPs should keep returning for updates) can be downloaded from the BMA website.
Many health experts believe we are overdue for another pandemic; there have been three in the last hundred years, but it's not possible to say exactly when the next one will arrive.
The new guide is intended as a practical document for practitioners and practice managers. It recommends general practices take sensible steps and prepare now, to ensure that a maximum number of lives are saved instead of trying to struggle with a "getting through" approach. It warns that a pandemic would put the NHS under "unprecedented pressure" and general practice would be "stretched beyond its current limits".
The document says that the average GP surgery is likely to see an average of 186 extra cases a week when the current flu outbreak reaches its peak.
The guide explains how GP surgeries should operate during a pandemic, for instance they will be expected to:
- Respond robustly by following "command and control" arrangements co-ordinated and monitored through Primary Care Trusts.
- "Buddy up" with neighbouring practices to share resources and swap staff, as necessary. These fallback arrangement should be in place by the end of March.
- Minimize the spread of infection by doing things like putting patients with flu in a separate waiting area.
- Retired doctors will be called upon to ease pressure on local services, for example for signing off death certificates.
- Flu patients will have direct access to antiviral medicine via a new National Pandemic Flu Line Service, and not via their GP surgery.
- Health service capacity will be freed up by re-prioritizing services and patients, systematically and ethically.
"Family doctors need to be prepared for this and this guidance has been produced to help them with their planning," said Buckman in a press statement.
"During a pandemic many people will get flu and a few will be very poorly, but there will still be people suffering from other illnesses and they will also need our full attention," he explained, adding that "plans are being put in place now to make sure general practice and the health service not only copes during the crisis, but does the best it can do to minimise the spread and impact of a flu pandemic in the UK."
Dr Maureen Baker, Honorary Secretary at the RCGP said:
"General Practice is a critically important service which needs to be able to function as well as possible during a flu pandemic."
"This guidance provides practices with clear instructions on the steps they need to take now and during the pandemic, so that they can look after people with flu, and other emergencies, as well as can be done in very difficult circumstances," she added.
Though it is not possible to predict the timing or the severity of a pandemic, experts suggest that up to half of the population of the UK (about 30 million people) could catch flu during one. Most people would be expected to treat themselves at home, but up to one third of those may need to be assessed and treated by their GP and about 4 per cent are expected to be admitted to hospital, usually because of bronchitis that could turn into pneumonia.
"Preparing for pandemic influenza. Guidance for GP practices. What to do now and in a pandemic."
Royal College of General Practitioners and British Medical Association's General Practitioners Committee.
Produced by COI, December 2008.
Click here for more information and to download the full guide (PDF).
Sources: BMA.
Written by: Catharine Paddock, PhD
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today
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13 Feb. 2012. <http://www.medicalnewstoday.com/articles/134834.php>
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Flu
posted by Dan on 8 Jan 2009 at 1:48 pmHistorical Facts Associated With Influenza:
The last influenza pandemic that occurred in the United States was nearly 100 years ago, and this deadly outbreak resulted in about 50 million deaths worldwide. Influenza is caused by a virus, which is a parasite that needs a host to survive and reproduce.
It was called the Spanish Flu because the first human case was identified there. The pandemic ended up killing more than those that died during WWI. Understandably there was panic among people worldwide, as influenza was not discovered until 1933, so the mystery was rather frightening of what was happening.
Those who survived have allowed others to obtain antibodies from them to develop other antibodies for future viral outbreaks that may occur with this type of virus. This last influenza pandemic also allowed others to obtain this virus from those who died as a result to facilitate effective treatments and vaccines for viral outbreaks that may happen in the future as well.
The virus responsible for the 1918 pandemic was an avian influenza. Nearly 700,000 people in the U.S. died as the result of the Spanish Flu- and those that did die was due often to a bacterial pneumonia that followed the viral invasion and damage. Ultimately, this pandemic killed nearly 3 percent of humans infected. Normally, an influenza strain may kill less than one percent of those infected. The Spanish Flu caused an unusually severe immune response in the human host which made it very deadly due to overkill of the cells of this host.
The influenza viruses are categorized as A, B, and C. The Influenza A virus is the one that historically has caused pandemics that have developed-, such as the Spanish Flu Pandemic. The other influenza pandemics primarily have occurred in countries in Asia.
With influenza, it is understood that the disease influenza is a disease caused by a RNA virus that can infect both mammals and birds. In fact, this particular virus can mutate to where it can be shared between the two life forms and multiply within each one of them. Unlike coryza, influenza expresses symptoms more severely, and usually lasts two weeks until one recovers who has the flu. Influenza, however, poses a danger to some with compromised immune systems, such as the chronically ill, so the recommendation is greater in such populations, along with women who may be pregnant during the flu season, residents of nursing homes or chronic care facilities. Health care personnel are encouraged to get the flu vaccine as well. Such populations allow influenza to progress to deadly pneumonia.
Symptoms of influenza usually start to express themselves symptomatically 36 hours after being infected with the virus. Over 10 percent of the population is infected with this virus every year- resulting in about 200,000 hospitalizations and nearly 40,000 deaths. This season’s first influenza case was identified in Delaware in November of 2008, and it was a type B influenza strain.
The flu vaccination is trivalent- meaning it contains three viral strains of suspected viruses for flu outbreaks during a particular winter season, as determined by the World Health Organization, as well as the Centers for Disease Control, and other organizations. Unfortunately, the influenza vaccine administered last flu season was largely ineffective due to unsuspected strains of the virus infecting others, although about 140 million injections of this vaccine were administered.
After giving the vaccination dose to one, it takes about 10 days for that person to build up the immunity for the disease of influenza. The months of October to December are recommended to receive this vaccine. And the vaccine is about 50 percent effective in offering protection from influenza, according to others. Vaccines are a catalyst for antibody production in humans, which protect them against the virus. Influenza vaccines can be given by injection or nasally.
Anti-virals, on the other hand, decrease greatly the ability for viruses to reproduce once established in a human.
The Avian influenza that many have heard of is potentially the next flu pandemic- as humans have no immunity to what is called the H5N1 virus- on of about 1 strains of avian Influenza. For an Influenza pandemic to occur, which means a global disease existence, the virus must emerge from another species to humans without immunity, as well as the ability to make more humans ill than normal. Also, the virus must be highly contagious for a pandemic to occur. The H5N1 virus appears to replicate in the human GI tract and also has a longer incubation period in humans, one to two weeks, compared with other influenza strains. The H5N1 Avian influenza virus seems to have become progressively more pathogenic in the past decade, according to others.
With the Avian Influenza existing with the H5N1 strain, millions of birds have been slaughtered due to the danger and unpredictability of this strain. The first human case infected with this strain occurred in China in 1997. The first human avian flu case outside of China was identified in 2003 in the Netherlands. The first recorded incidence of human-to-human transmission of the H5N1 virus was in Thailand in 2004. In 2006, it was discovered that the H5N1 had split into two separate strains. There have been outbreaks of Avian flu in about 15 countries in the world so far- with Indonesia being the worst. Migratory birds spread this influenza virus between continents.
The pathogenic strength of the H5N1 strain varies due to constant re-assortment or switching of genetic material between the viruses- essentially creating a hybrid of what it was before this occurs. So far, about 300 people worldwide have been infected with this strain- and about half have died from the infection. Vaccinations are being developed and reformulated constantly at this time due to the pandemic threat of the H5N1 Influenza virus.
Yet, the normal flu season that is now occurring was supplied with 150 million vaccines in the United States. However, some studies have shown that this vaccine is rather ineffective based on incidences of the acquisition of the influenza virus by others anyway.
The influenza season peaks between the months of January and March. The vaccine for this influenza season is manufactured by 6 different companies. Yet the strains chosen are speculated influenza viruses, as this does not eliminate the chance of a new and dominant influenza viral strain that possibly could cause a pandemic. It takes manufacturers about 6 months to make and formulate the influenza vaccination. There is a vaccine for this illness that is produced every year according to which type of virus may be prevalent during a particular flu season. The presence of influenza can be widespread in certain states, yet not others. The vaccination is recommended to be administered to those who are at high risk, such as the chronically ill. Also, it is recommended that those under 18 years of age get the vaccine, as well as those people over the age of 50. Furthermore, those people who regularly take aspirin should receive the vaccine, as the influenza disease can become a catalyst for what is called Reye’s Syndrome. Pregnant women should receive the vaccine as well- as there are many other vaccines available to fortunately prevent other diseases, perhaps.
http://www.cdc.gov/flu/weekly/
Dan Abshear
Flu
posted by bird flu on 2 Feb 2009 at 5:13 amHi,
Until now, the spread of the virus from one person to another has been very rare and it is thought that it cannot spread beyond one person. However, some scientists are concerned that in the future the H5NI virus could easily spread from one person to another due to the fact a that all types of influenza viruses are known for the increased ability to mutate. If this happens, the consequences will be horrifying as the H5NI virus is foreign to humans and our bodies cannot begin to offer us a reliable immune protecion against it.
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