Swine Flu Update: 02/10/2009

""It is steadily mounting, we are not seeing the sort of explosive increase, doubling week on week, that we've seen in some previous pandemics, but it is the start of the second peak, we are pretty confident of that now”. These were the words of the UK’s Chief Medical Officer, Sir. Liam Donaldson, as he predicted the emergence of a second-wave of the virus in the UK. Today, the numbers verify the assumptions: with a 50% increase in the number of new cases in England for the week ending the 25th of September, the country is now bracing itself for a second, more widespread, wave of H1N1. Last week witnessed 14,000 new cases of the virus in England – up from 9,000 in the previous week - with 286 people hospitalized and 36 in critical care. 84 people have now died from H1N1 in the UK since the start of the outbreak in April. In Scotland, figures more than doubled, as the number of new cases skyrocketed to over 13,000. According to the Health Protection Agency (HPA), the most substantial rises in the number of new cases in England were seen in the North-West and Yorkshire. For Sir. Liam, then, having operated in the predictions business for the past several months, there is now a considerable degree of certainty that the country is in the early phases of a second wave of the virus. “There is a steady rate of increase, but there is no sign of the explosive surge you can see in a pandemic”, he said, while cautioning that "There is still time for that to happen”. Yet, in the face of burgeoning figures, the UK’s Chief Medical Officer also left some room for optimism. "Normally at this point in the second wave of a pandemic we would be starting to see explosive increases in numbers. We're seeing it steadily mounting”. This is promising, then, but the next few weeks will tell us a lot more about the extent of this second wave – for good or for worse. Now is the time for collective vigilance. On the topic of the impending H1N1 vaccines, the news continues to prove heartening, as the world’s healthcare authorities brace themselves for the first stage of mass immunization in the weeks to come. Critically, the world’s regulatory bodies have now begun to authorize the treatments for public use and vaccines have already been licensed in Australia, China and the United States. Many more countries, including the UK, are due to follow suit in the next few weeks. In addition, over 1,000 children between the ages of six months to 12 years are now taking part in the very first round of immunization in England, as officials seek to test the comparative efficacy of the two H1N1 vaccines currently being considered for universal public use. The clinical trials are taking place at five key sites across England, in Oxford, Bristol, Southampton, Exeter and London.

“As of 20 September 2009, there have been more than 300,000 laboratory confirmed cases of pandemic influenza H1N1, 3917 deaths, in 191 countries and territories reported to WHO. As more and more countries have stopped counting individual cases, particularly of milder illness, the case count is significantly lower than the actually number of cases that have occurred. While the case counts no longer reflect actual disease activity, WHO is actively monitoring the progress of the pandemic through frequent consultations with the WHO Regional Offices and member states and through monitoring of multiple sources of data. In the temperate regions of the northern hemisphere, influenza-like-illness (ILI) activity continues to increase in many areas. In North America, the United States has reported continued increases in activity above the seasonal baseline for the last 2 to 3 weeks, primarily in the southeast but now also appearing in the upper midwest and the northeast. In Europe and Central and Western Asia, the United Kingdom is reporting regional increases in ILI activity in Northern Ireland and Scotland and the Netherlands, France, Ireland, and Israel are reporting rates above the seasonal baseline. In In Japan, influenza activity continues to be slightly above the seasonal epidemic threshold. The increases in ILI activity have been accompanied by increases in laboratory isolations of pandemic influenza H1N1 2009 in most of these areas. In the tropical regions of the Americas and Asia, influenza activity remains variable. In parts of India, Bangladesh and Cambodia, influenza transmission continues to be active, while other countries in the Southeast Asia have been recently reporting declining transmission (Indonesia, Singapore and Thailand). Although most countries in the tropical regions of the Americas are still reporting regional to widespread geographic spread of influenza activity, there is no consistent pattern in the trend of respiratory diseases. Peru and Mexico have reported an increasing trend in some areas, while most others are reporting an unchanged or decreasing trend (most notably Bolivia, Venezuela and Brazil). In the temperate regions of the southern hemisphere, influenza transmission has largely returned to baseline (Chile, Argentina, and New Zealand) or is continuing to decline (Australia and South Africa). All pandemic H1N1 2009 influenza viruses analyzed to date have been antigenically and genetically similar to A/California/7/2009-like pandemic H1N1 2009 virus.”
*The information above is a copy of the latest WHO regulations and guidelines for Swine Flu and can be found in more detail at the WHO Website, here.
• There are 286 people in hospital with swine flu, 36 of whom are in critical condition. This represents a substantial rise. • To date, 84 people with swine flu have died in the UK. There have been 72 deaths in England, nine in Scotland, two in Northern Ireland, and one in Wales. • A swine flu vaccine has now received licensing approval, meaning the first doses of the vaccine should be administered in the second half of October. • There have been 79 school outbreaks (defined as at least 15% absenteeism or a marked increase in cases) since the pandemic began • Internationally, there have been 3,491 deaths related to swine flu.
*The information above is a copy of the latest NHS key updates for Swine Flu and can be found in more detail at the NHS Swine Flu Website, here.
• WHO Twitter – ‘WHO's official Twitter channel. Who is the directing and coordinating authority within the UN system for public health’. • NHS Swine Flu Overview – ‘This page brings together the latest science and developments on the swine flu pandemic into a single accessible resource for both health professionals and the general public’. • NHS Swine Flu Vaccine – Detailed information on the development of the H1N1 vaccine, along with logistical updates on clinical trials in the U.S. and Australia, efficacy and WHO recommendations. • The Lancet H1N1 Flu Resource Centre – With over 40 journals, Lancet is one of the leading scholarly resources on the topic of Swine Flu – if not any healthcare issue. With free, unlimited access for all, this is one powerful research resource. • Nature – A number of interesting feature articles and blogs pertaining to the topic of Swine Flu. • Fergus on flu – Great Swine Flu blog from the BBC’s Chief Medical Correspondent. • Microsoft Bing Swine Flu Tracker – ‘Map of 2009 Swine Flu H1N1 outbreaks and migration paths reported from news and government agencies. The map lists reported dates and paths of infected persons traveling’. • Facebook Group for H1N1 – With over 3,500 members – and literally hundreds of personal accounts on the current outbreak, this Facebook Group provides an interesting view into the potential future impact of Social Media on healthcare related issues.