Swine Flu Pandemic Weekly Report, Wales

Main Category: Swine Flu
Also Included In: Flu / Cold / SARS;  Public Health;  Respiratory / Asthma
Article Date: 24 Nov 2009 - 0:00 PDT

email to a friend   printer friendly   opinions  

Key points:

- The clinical consultation rate for influenza - not necessarily swine flu - in Wales during the week ending 15 November decreased to 36.0 cases of flu-like illness diagnosed by GPs out of every 100,000 people in Wales. This was 65.8 per 100,000 in the previous week. Current levels of flu in Wales remain higher than usual for this time of year.

- According to the NPHS daily GP surveillance scheme, as at 17 November, the influenza consultation rate in Wales as a whole was 45.0 cases of flu-like illness diagnosed by GPs in the previous seven days out of every 100,000 people in Wales. This is the equivalent of 1,350 people contacting their GPs in the last seven days with flu-like symptoms.

- Consultation rates for flu-like illness are highest in people aged between 1 and 4 years.

- 580 laboratory confirmed cases of swine flu have been reported by NPHS Health Protection Teams in Wales since the start of the outbreak (as at midday on 18 November).

- A total of 377 people confirmed with swine flu in Wales have been admitted to hospital since the start of the outbreak. 46 of these cases were still in hospital as at 17 November.

- The Welsh Assembly Government has been notified formally of seven further swine flu-related deaths in Wales since the last report. This brings the total number of swine flu-related deaths in Wales to 21. We are also aware of a swine flu-related death of a person from Wales abroad. No further details will be released.

- Two immunosuppressed patients being treated for H1N1v Influenza virus (swine flu) at a South Wales hospital have been found to have developed resistance to oseltamivir (Tamiflu). The emergence of influenza A viruses that are resistant to oseltamivir (Tamiflu) is not unexpected in patients with serious underlying conditions and suppressed immune systems, who still test positive for the virus despite treatment.

Initial investigations suggest that the resistance developed during treatment and that the resistant virus has not spread from patient to patient. This is in line with findings throughout the world.

The patients have been given alternative antiviral treatment, and one has made a full recovery while the other continues to be monitored.

- Latest figures show that the percentage of total calls to NHS Direct Wales which were flu-related decreased to 23.1 per cent. This was 23.6 per cent in the previous week.

- The figure below shows the daily consultation rate of influenza across Wales since 1 May 2009 using the Audit+ system.

- The figure below shows the weekly influenza consultation rate in Wales (per 100,000 practice population per week), from week 1 1987 to week 46 2009 [using the weekly GP sentinel report].

The full NPHS Weekly Influenza Surveillance Report for week 45 of 2009 (week ending 4 November) is available to view online.

Comment from the Chief Medical Officer for Wales, Dr Tony Jewell:

The Chief Medical Officer for Wales, Dr Tony Jewell, said: "The four UK Health Ministers have agreed that the second phase of the swine flu vaccination programme should focus on all children aged six months and over and under five years. "Evidence shows that young children are suffering the greatest overall impact from the disease. They are particularly vulnerable to complications and more likely to become seriously ill and need hospital treatment than other groups. Young children are effective spreaders of the disease and the clinical attack rate is also higher, meaning a greater proportion of children will become ill. Vaccination will mean that fewer children in this age group will become seriously ill and need hospital treatment.

"Vaccination is the simplest, safest and most effective way of protecting people's health and will help in our efforts to minimise its impact on individuals and communities. "We expect vaccination to be through GPs, and are exploring with the GPC how best to do this. The programme will begin very shortly once phase one of the vaccination programme targeting the original priority groups is coming to an end. Parents will be contacted by their GP surgery inviting them to have their eligible children vaccinated.

"The approach has been agreed by the Joint Committee on Vaccination and Immunisation and Scientific Advisory Group on Emergencies.
"In addition, advice from the JCVI has suggested that main carers for elderly or disabled people should be an important next group. We will discuss this advice with carers' organisations, including a number of practical questions, including how to identify and verify the carers involved.
"While the vast majority of people, who contract swine flu, get over it within five to seven days, with rest, plenty of fluids and paracetamol, some people experience severe complications and even die.
"Sadly, this week, we have seen a further increase in swine flu-related deaths. However, we are aware that a number of these people had been seriously ill for some time. This is a tragedy for the families and friends of the individuals but unfortunately, we have been expecting to see an increase in the number of deaths. This is the same for seasonal flu in the winter.

"Whilst reported cases of swine flu have recently started declining, it is too early to draw any conclusions about the number of future cases."

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

"The number of people contacting their GP with flu symptoms has stalled and started to decline slightly over Wales as a whole. Nevertheless, flu is still circulating and we therefore continue to emphasise the importance of being aware of the symptoms of swine flu and of the steps that can be taken to prevent its spread.

"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 stay at home, observe good respiratory and hand hygiene and stay away from GP surgeries, Accident and Emergency departments and pharmacies unless advised to do so, which will also help to limit the infection's spread.

"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. Most people make a full recovery from swine flu 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."

The Chief Medical Officer for Wales, Dr Tony Jewell, has stressed the important of pregnant women taking up their invitation to receive the swine flu vaccination.

"The vaccine is safe. Prior to it being used across the UK, the swine flu vaccination underwent clinical tests to ensure its safety and effectiveness. This was the same process that the annual seasonal flu vaccination undergoes, which in successive years has been proved to be safe and effective. The Royal College of Obstetricians and Gynaecologists has looked at the evidence on the safety of flu vaccines in pregnancy and supports pregnant women be offered the vaccine.

"Evidence suggests that pregnant women who contract swine flu are four times more likely to suffer from serious complications than women their age who are not pregnant. Therefore it is very important that when a pregnant woman is invited to receive her free vaccination she does so in order to protect herself and her unborn child.

"Whilst reported cases of swine flu have recently started declining it is too early to draw any conclusions about the number of future cases."

A leaflet is available online on our website, giving pregnant women important information about how to protect themselves and their baby from swine flu. The link is here.

Source
Welsh Assembly Government

• Additional
• References
• Citations