Alan Johnson, UK Secretary of State for Health said yesterday that while the public response to the flu threat has been good, there is now a “danger of complacency”.

Johnson and Chief Medical Officer Sir Liam Donaldson gave a press briefing where according to a report in the Guardian, they defended their handling of the flu outbreak in the wake of criticism that they should be treating it like a mild seasonal flu outbreak without the need to close schools or take other precautions like giving antivirals to people who have been in contact with flu victims.

Donaldson said we don’t know enough about the virus and how it affects people yet, although it was reassuring that cases so far were not severe. He said he was being very cautious, especially where children were concerned:

“We don’t want a situation where a child is admitted to hospital because of the complications of flu,” he told the press. Donaldson also said just letting people get exposed to the virus and develop antibodies was not the right approach.

Donaldson and Johnson said the best laboratories in the world were still analysing the H1N1 strain that is now thought to have killed 42 people in Mexico, where the confirmed cases has reached 1,112. They said it will be several weeks before we have a “characterisation of the virus”.

Johnson said he would rather be accused of over-hyping and over-exaggerating than fail to protect citizens: he would rather have egg on his face than deaths on his hands, he said.

Closing schools is necessary to contain the spread, and as to the strategy for who gets “precious antiviral drugs”, Johnson said that could change if the infections became more widespread and severe, with fewer people being given them as a preventive measure.

Donaldson said the virus could be more infectious than first thought, and it appears that the World Health Organization agrees, saying yesterday that if it is not contained, this new H1N1 strain could infect as many as 2 billion people or one third of the world’s population, according to a report from the Associated Press.

Dr Keiji Fukuda, WHO Assistant Director-General ad Interim for Health Security and Environment said that the history of flu pandemics shows that about one third of the world’s population gets infected.

“If we do move into a pandemic, then our expectation is that we will see a large number of people infected worldwide,” said Fukuda said.

“If you look at past pandemics, it would be a reasonable estimate to say perhaps a third of the world’s population would get infected with this virus.”

While some experts agree with the general figure, they pointed out that many people may not show any symptoms.

In a briefing on Tuesday however, Fukuda warned that:

“When a new influenza virus enters into the human population, and people do not have immunity to this virus, then the levels of serious illness and the levels of death can be higher than we see with regular seasonal influenza.”

Also, the infections can be mild in the spring and then become more severe when the winter sets in, he said.

Donaldson said that although the reaction to the strain, which now affects 23 countries, only appears to be mild at the moment, the rate of of attack is around 25 to 30 per cent.

He also said people over the age of 50 may have some immunity to the virus, which, because it is an H1N1, is descended from a sub-type of the Spanish flu, and is also a relative of strains used to develop our current seasonal flu vaccine.

“The optimistic interpretation is that the immune systems of the over-50s might have some memory of the H1N1 of this kind,” said Donaldson, according to the Guardian report.

The Health Protection Agency said that in the UK it appears that only people who have been within one metre of an infected person for more than an hour are thought to be at risk, although Donaldson said that might change if the virus becomes more transmissible “when it gets going”.

According to the latest update on 7 May from the Health Protection Agency, two more people in England who were being tested have now been confirmed with swine flu, bringing the current UK total number of confirmed cases to 34. Another 464 cases were reported to be under investigation.

The first new case is an adult in the East of England who returned from trip to the United States recently, and the second is a schoolchild from South West London, where health officials are working with the school, where two other pupils were confirmed to have contracted swine flu last week. Both those pupils have been treated with antivirals and are recovering at home. People close to them are also receiving antivirals.

All children and staff at the school are being given antivirals and the school will remain shut until Monday 11 May, said the Health Protection Agency announcement.

Travellers returning from affected areas who feel ill within seven days of their return who get symptoms should stay at home and contact either their GP or NHS Direct on 0845 4647 said the Health Protection Agency. This also goes for anyone who has been in contact with someone who is a confirmed case of swine flu.

Measures you can take to reduce your risk of infection include:

  • Cover your nose and mouth when you cough or sneeze and use a tissue if you can.
  • Carefully throw dirty tissues away immediately.
  • Wash your hands frequently with soap and water.
  • Make sure your children do these things too.
  • Clean frequently touched surfaces (like door handles) often.

— Health Protection Agency

Main sources: Guardian, BBC, Associated Press, HPA.

Written by: Catharine Paddock, PhD