Swine Flu Daily Update Issued At: 11am Tuesday 30 June 2009, Wales

Main Category: Swine Flu
Also Included In: Flu / Cold / SARS;  Public Health;  Respiratory / Asthma
Article Date: 02 Jul 2009 - 1:00 PST

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-- 26 confirmed cases in Wales, with 9 new cases:

- A 25-year-old male from Cardiff who is a healthcare worker at the University Hospital of Wales, Cardiff. The infection is related to travel and not to another case of swine flu in a healthcare worker at the same hospital. Close contacts, including patients and staff, are being identified and will be offered antiviral medicine. The case is no longer in work and there is no further risk to patients or staff at the hospital. He has been offered antiviral medicine and is recovering well.

- A 21-year-old male from Cardiff who is a direct contact of a confirmed case in Leicester. Close contacts have been identified. He has been offered antiviral medicine and is recovering well.

- A 19-year-old female from Swansea who is a direct contact of a confirmed case in Exeter. Close contacts have been identified. She has been offered antiviral medicine and is recovering well.

- A 20-year-old female from Swansea who is a direct contact of a confirmed case in Exeter. Close contacts have been identified. She has been offered antiviral medicine and is recovering well.

- A 20-year-old female from Cardiff who is a direct contact of a confirmed case in Exeter. Close contacts have been identified. She has been offered antiviral medicine and is recovering well.

- A 19-year-old female from Cardiff who is a direct contact of a confirmed case in Exeter. Close contacts have been identified. She has been offered antiviral medicine and is recovering well.

- A 19-year-old female from Cardiff who is a direct contact of a confirmed case in Warwick. Close contacts have been identified. She has been offered antiviral medicine and is recovering well.

- A 19-year-old female from Bridgend County Borough who is a direct contact of a confirmed case in Exeter. Close contacts have been identified. She has been offered antiviral medicine and is recovering well.

- A 22-year-old female from Caerphilly who is a contact of a confirmed case in Oxford. Close contacts have been identified. She has been offered antiviral medicine and is recovering well.

There are 5 clinically presumed cases in Wales with 0 new cases.

Up until now, the NPHS has been testing everyone who has potentially come into contact with swine flu and who has symptoms. We are moving to the position where swine flu is circulating so freely in the community that we will test very few people as patient's doctors will assume that anyone with flu-like symptoms has contracted swine flu. As part of the transition towards this phase, we are now reporting clinically presumed cases. They are household contacts of confirmed cases of swine flu, who have symptoms of swine flu and are presumed to have swine flu but will not be laboratory tested. In such cases, there is enough evidence that the patient has contracted swine flu for their doctor to treat them and testing is unnecessary to reach a diagnosis.

-- 201 people have been under investigation in Wales. Of these, swine flu has been confirmed in 26 cases, clinically presumed in 5 cases and ruled out in 154 cases, leaving 16 still under investigation. All of these are displaying, or have displayed, mild symptoms.

-- Of the 16 people under investigation, 7 were well when first identified, but reported recent flu-like symptoms following travel to affected areas. Blood tests are being undertaken on these individuals to see if they had the flu and to help the NPHS understand the pattern of the disease from the past. Their symptoms may or may not have been due to swine flu. Testing will be conducted in a number of weeks to check whether these people did have swine flu - scientifically it won't work before that. Investigations have shown that people they had close contact with did not catch flu from them when they were ill.

-- One person with swine flu has been hospitalised in Wales and has been discharged.

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

-- There are now 5,946 laboratory confirmed cases in the UK - 26 cases in Wales, 922 cases in Scotland, 4,968 cases in England and 30 in Northern Ireland.

-- A third person in the UK with swine flu has died. The patient was from Birmingham and had underlying health conditions. The earlier deaths were in Scotland, also in patients with underlying health conditions.

-- Swine flu cases have been confirmed in 112 countries. 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 Welsh Assembly Government and National Public Health Service for Wales

-- Chief Medical Officer for Wales, Dr Tony Jewell, said:

"The number of cases is continuing to increase in Wales. This is to be expected given the increase in other parts of the UK.

"People should not be alarmed by this increase, but it is natural for people to be apprehensive.

"So far, in the UK and other countries where the virus is circulating, in the majority of cases, it remains mild, but proving more severe in a small number of people, and three people have died.

"We expect that with large numbers of people contracting swine flu, there will be deaths, particularly in patients with underlying health conditions. Even with the seasonal flu, we do see deaths occurring.

"I would reasure the public that we have been planning and working to prepare for the arrival of the virus for many years and have robust procedures in place. We have the added benefit of learning from the experience of other countries who have been dealing with significantly more cases than us.

"While we are prepared for this, we are not complacent and people must be vigilant. Our advice to the public remains the same, people should follow good respiratory and hand hygiene to help prevent the spread of influenza - always using a tissue to catch sneezes, throwing away used tissues where germs can linger and killing germs by regularly washing your hands, or cleaning them with a sanitising gel. In short, catch it, bin it, kill it."

-- Dr Roland Salmon, Director of the Communicable Disease Surveillance Centre, National Public Health Service for Wales, said:

"Because this particular type of swine flu is new, people have little or no immunity to it. For this reason, we know it will spread across the country eventually.

"The pandemic will reach different countries at different times. While the outbreak is dying away in Mexico it is still growing here.

"Whereas we are currently investigating and responding to individual cases and prescribing antivirals to all close contacts to prevent the quick spread of the disease, there will come a time when it is sensible to change this approach so that our focus moves to treating people who are ill and preventing illness in people who are most at risk. There will be a greater emphasis on local risk assessments by public health professionals.

"The World Health Organization considers the overall severity of the pandemic to be moderate. This means that most people recover from infection without the need for hospitalisation or medical care. Levels of clinically severe or fatal cases appear similar to levels seen with seasonal influenza.

"Nevertheless, the death of a third patient in the UK shows we must not be complacent about the effects of the virus in those with pre-existing health conditions.

"Seasonal flu can be severe, particularly for elderly and vulnerable people, so there is still good reason for us all to take action to reduce its effects. Flu is often confused with a bad cold but is in fact far more serious and leads to many deaths each year in Wales.

"We continue to advise that anyone who has flu-like symptoms and has returned from an area where swine flu is circulating, or who has been in close contact with a confirmed case, should stay at home and phone their GP or NHS Direct Wales on 0845 46 47.

"People should not go to Accident and Emergency Departments or to their GP surgery without ringing first, as this may risk spreading the infection. It also places undue pressure on the emergency services.

"The National Public Health Service for Wales will continue to assess any person with flu-like symptoms."

Public health advice and messages

-- If you have flu-like symptoms and have returned from an area where swine flu is circulating or have been in close contact with a confirmed case, stay at home, phone your GP or NHS Direct Wales and you will be assessed and receive treatment if necessary. 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, 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

-- Agreements have been signed between the UK Government and vaccine manufacturers to secure supplies of up to 90 million doses of H1N1 vaccine by the autumn. This will not affect the usual seasonal flu vaccination and will be made available to frontline healthcare workers and vulnerable people. Advance purchase arrangements are also in place to buy enough vaccine for the whole population.

-- The Welsh Assembly Government's Health Emergency Preparedness Unit has issued guidance to Local Health Boards on anti-viral distribution. The unit is co-ordinating work on identifying appropriate collection points and the necessary arrangements to support this process.

-- People who have flu-like symptoms and have returned from an area where swine flu is circulating or who have been in close contact with a confirmed case have been advised to stay at home and call NHS Direct Wales on 0845 4647 or phone their GP for health advice.

-- The national Swine Flu Information line - 0800 1 513 513 - provides recorded information. People requiring health advice should contact NHS Direct Wales on 0845 4647.

-- The National Public Health Service for Wales has provided advice to port health authorities on arrangements for returning travellers.

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.

-- A change to phase six means that vaccine manufacturers will need to meet the contractual obligations of advance purchase agreements for vaccines that countries, including the UK, have already agreed in the event of phase six being declared.

-- A crucial step towards large scale production of a vaccine against swine flu has been completed in the UK by the National Institute for Biological Standards and Control, part of the Health Protection Agency.

-- A strain of virus suitable for vaccine manufacture has now been produced and is being made available to the pharmaceutical industry and other flu laboratories.

-- Testing has shown that the human swine influenza H1N1 can be treated with the antiviral oseltamavir (Tamiflu®) and zanamivir (Relenza®).

-- Further 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
Welsh Assembly Government

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