A leading doctor has warned that the deadly swine flu could become resistant to Tamiflu, the only drug that can treat the virus.
Dr Holden, the British Medical Association’’s lead authority on pandemic flu, cites over-prescription as the reason, reports The Telegraph.
The expert, based in Matlock, Derbyshire, said that he thought the thresholds for issuing Tamiflu [...]
Posts Tagged ‘Sir Liam Donaldson’
Over-prescription turning swine flu resistant to Tamiflu
July 28th, 2009 |
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New swine flu cases double in a week
July 24th, 2009 |
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About 100,000 people caught swine flu in England last week, the chief medical officer revealed today, as the government’s online diagnosis service crashed within minutes of launch when thousands of people tried to log on at the same time.
The rapid spread of the virus was confirmed as the National Pandemic Flu Service – dispensing advice and anti-viral prescriptions over the telephone and online – went live to relieve pressure on GPs.
The world’s first government-run swine flu diagnosis website could not cope with the volume of traffic when it opened for business at 3pm today. Designed to handle 1,200 hits a second, the service was suspended just four minutes later when 2,600 people tried to access it every second.
The service’s inauspicious launch came as new official figures on consultation rates with GPs showed that:
• the infection has spread broadly across the country from the hotspots where it was initially concentrated;
• under-14s are the most affected;
• 840 patients in England are receiving hospital treatment for illnesses associated with the H1N1 virus, of whom 63 are in intensive care. Comparable figures for the previous week were: 652 in hospital and 53 in intensive care.
In another development, a pregnant woman critically ill with swine flu was transferred to Sweden for specialised treatment after suffering a rare complication.
The 26-year-old Scot was flown out because all five beds were occupied at the national unit in Leicester that provides the highly specialised procedure known as extracorporeal membrane oxygenation (ECMO), which involves circulating the patient’s blood outside the body and adding oxygen to it artificially.
Nationally, the Department of Health said there were hopeful signs, producing a revised death rate that showed lower than anticipated fatalities and suggesting there could be a lull in infections over the summer.
Following a rigorous investigation of reported fatalities, Sir Liam Donaldson, the chief medical officer, said there had been 26 “provisionally validated” swine flu deaths in England since the beginning of the outbreak. Combined with four deaths reported in Scotland, the UK total stood at 30.
Unlike normal seasonal flu, which is a threat primarily to the pneumonia-prone elderly, the H1N1 virus appears to affect the young more severely. Of those who have died in England, a third were under the age of 15 while only 17% of fatalities have been among pensioners.
Within the same sample of 26 deaths, two-thirds of the victims had what were described as pre-existing “severe conditions” such as leukaemia, and only 16% were described as fully “healthy”.
The infection rate has almost doubled from an estimated 55,000 new cases in the previous week to 100,000 fresh cases. A slight dip in daily consultation rates with GPs within the last few days has given some health officials hope that the first wave of infections may have peaked in Britain, Donaldson said. “You will see a suggestion of a downturn but I don’t think you can read too much into it at this stage,” he added.
A scenario anticipated by Department of Health officials and those from other departments who meet regularly in the Cabinet Office’s emergency planning committee, Cobra, is for a slowdown in the infection rate during the summer when schools are closed. The outbreak may pick up pace again in the autumn.
Donaldson said there was no evidence of the virus becoming more virulent and stressed that for most people it would be relatively mild. He denied there was a danger of a shortage of respirators for children in intensive care beds. “We can expand capacity somewhat in the event of an emergency by cancelling some routine operations,” he added.
The fact that rates of influenza-like illness are running at a far higher level than those normally observed during high summer remains a puzzle for scientists. In previously severe outbreaks activity dipped.
“This level in July and August is highly unusual,” Donaldson said.
Tower Hamlets in east London continues to be the primary care trust with the highest number of GP consultations for people with flu-like illness. It is seeing 792 consultations for every 100,000 people, followed by Islington in north London with 488 consultations for every 100,000 people.
Other parts of England that are severly affected include Greenwich, south-east London, Leicester, and Telford and Wrekin, Shropshire. In Wales, 3,075 people contacted their GPs in the past week with symptoms of the H1N1 virus.
Swine flu infection rates in Scotland appear to have reached record levels, with the virus spreading uniformly across the country, despite hopes the outbreak may have peaked.
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840 people being treated for swine flu in hospitals
July 23rd, 2009 |
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• Latest figures show 100,000 cases recorded in past week
• National Flu Pandemic Service can take 1m calls a week
The website for the new national pandemic flu service in England crashed on launch today as the government announced that the number of new swine flu cases had doubled in a week and that 840 people were seriously ill in hospital.
People trying to access the site, which was officially launched at 3pm, were told it is “currently very busy and cannot deal with your request at this time”.
Viewers were told to try again “in a little time”. The website crash is potentially extremely embarrassing for the government, which promised it would be launched only when it had been proved capable of coping with the expected traffic.
The service is designed to take pressure off GPs, help patients diagnose themselves and gain access to antiviral drugs without formal prescriptions, although callers are issued with identification numbers.
Liberal Democrats said the website crash raised serious questions about the robustness of the system. “The government claims the reason for the delay in setting up this service was because they needed to thoroughly test it to ensure this wouldn’t happen,” said health spokesman Norman Lamb. ” It is absolutely vital that the public has access to a reliable source of information on swine flu to provide reassurance and take the pressure of GP surgeries.”
Meanwhile the government’s chief medical officer said in the UK as a whole, 840 people were seriously ill in hospital with swine flu and 100,000 new cases had been recorded in the last week. The number of people in hospital included 63 in intensive care.
The figures were given by Sir Liam Donaldson during a press conference at the Department of Health, to provide a weekly update on the progress of the disease throughout Britain.
The number of deaths associated with the swine flu outbreak has risen to 30. Last week the government announced there had been 29 deaths in total and 55,000 new cases in the previous week.
The National Flu Pandemic Service for England, which started today, will be capable of answering more than a million calls a week, it was confirmed today. It will be staffed by more than 1,500 people, with the option of recruiting 500 more.
They will, it is hoped, be capable of answering more than 200,000 calls a day. There will be an alternative internet service where people answer a questionnaire to receive a diagnosis of swine flu and are given a unique code authorising the release of antiviral drugs.
The details emerged as scientists suggested the outbreak may have peaked for in Scotland, implying that the surge in cases in England could also subside within weeks. One of the planning scenarios used by the DoH assumes the figures will fall during the summer, when schools are on holiday, and then surge again once term starts in the autumn.
People whose holiday plans have been wrecked by swine flu, because of a diagnosis through the pandemic flu service in England, will have to keep the label from the anti-flu drugs they collect if they are to claim from insurers, the Association of British Insurers (ABI) said last night.
Insurers usually require a medical certificate from a GP or other medically qualified staff, and had raised concerns that people would be given diagnoses and access to drugs by people who were not medically qualified.
Nick Starling, the ABI’s director of general insurance and health, said it had been told by the government the service would authorise an anti-flu prescription only to those genuinely displaying signs of flu.
“On that basis, travel insurers will accept an individual’s unique ID number generated by the national flu service together with the label on their anti-flu drugs which states their name and date of issue, as proof of diagnosis to validate a travel insurance cancellation claim.”
The archbishops of Canterbury and York have recommended the suspension of the sharing of the chalice at communion as the spread of swine flu continues, it was announced today.
The archbishops have written to bishops in the Church of England setting out the new measures following DoH advice not to share “common vessels” for food or drink.
The letter said it aimed to offer guidance at a national level about how church worship could “best take into account the interests of public health during the current phase of the swine flu pandemic”.
Some bishops have already taken the step to limit the spread of the virus.
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840 people treated in UK hospitals due to swine flu
July 23rd, 2009 |
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• Latest figures show 100,000 cases recorded in past week
• National Flu Pandemic Service can take 1m calls a week
There are 840 people seriously ill in hospital with swine flu and 100,000 new cases have been recorded in the past week, according to the government’s chief medical officer.
The number of people in hospital includes 63 in intensive care.
The figures were given by Sir Liam Donaldson during an early afternoon press conference at the Department of Health, providing a weekly update on the progress of the disease throughout Britain.
The number of deaths associated with the swine flu outbreak has risen to 30. Last week the government announced there had been 29 deaths in total and 55,000 new cases in the previous week.
The National Flu Pandemic Service for England, which started today, will be capable of answering more than a million calls a week, it was confirmed today. It will be staffed by more than 1,500 people, with the option of recruiting 500 more.
They will, it is hoped, be capable of answering more than 200,000 calls a day. There will be an alternative internet service where people answer a questionnaire to receive a diagnosis of swine flu and are given a unique code authorising the release of anti-viral drugs.
The details emerged as scientists suggested that the outbreak may have peaked for now in Scotland, implying that the surge in cases in England could also subside within weeks. One of the planning scenarios used by the DoH assumes that the figures will fall back during the summer, when schools are on holiday, and then surge again once term starts in the autumn.
One of the UK’s leading bacteriologists, Professor Hugh Pennington, said this morning that Scotland was “possibly through the worst of this phase of the virus”.
Cases in the worst Scottish hotspots – Glasgow and Paisley – began to tail off earlier this month. That is one of the reasons why Scottish health ministers are not following moves in England to set up a national flu pandemic helpline – existing NHS services are able to cope with the current rate of cases.
The H1N1 virus caught hold in Scotland more quickly, after the first cases in the UK emerged in the small town of Polmont near Falkirk in April, and the first death of a swine flu patient outside the Americas.
To the surprise of experts, the virus was confined largely to three clusters, in southern Glasgow, Paisley and Dunoon, which erupted in May and June. The outbreak in Dunoon subsided quickly. Reported flu cases in the greater Glasgow area – which saw the first swine flu deaths in the UK – have also declined.
Last week the Scottish health secretary, Nicola Sturgeon, said the overall rate of people reporting flu-like symptoms was not significantly higher than normal for this time of year. She said there were “encouraging signs” that cases were declining in the Glasgow area.
Prof Pennington, speaking on BBC Radio Scotland this morning, also cautioned against the rush to set up mass vaccinations of the population before the vaccine had been fully tested – a move being considered by ministers.
He said proposals to bypass normal testing procedures were laid out in the flu pandemic plan, but this virus was not proving as fatal or virulent as predicted in the plans. Pennington suggested it may be wiser to wait until the vaccine had been fully tested and if necessary altered before rushing it out.
The Archbishops of Canterbury and York have recommended the suspension of the sharing of the chalice at communion as the spread of swine flu continues, it was announced today.
The archbishops have written to bishops in the Church of England setting out the new measures following DoH advice not to share “common vessels” for food or drink.
The letter said it aimed to offer guidance at a national level about how church worship could “best take into account the interests of public health during the current phase of the swine flu pandemic”.
Some bishops have already taken the step in a bid to limit the spread of the virus.
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Could ‘virtual schools’ curb the spread of swine flu?
July 23rd, 2009 |
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By Angela Harrison
BBC News education reporter
Emergency plans for virtual schools and "homework by post" have been drafted to set children work if a decision is taken to close schools over swine flu.
Officials have been considering whether to extend the school summer holidays to try to limit the spread of the virus before a vaccine is widely available.
Head teachers want schools to stay open but say they will do all they can to continue lessons if they do close.
Officials say it is "very unlikely" the holidays will be extended.
However, Schools Secretary Ed Balls has said the government will monitor the situation closely over the holidays and review the evidence in late August.
Scientists at Imperial College London have asked the government to consider closing schools this autumn to curb the spread of swine flu cases, while outlining the costs in terms of disruption and impact on business and essential services.
The Chief Medical Officer, Sir Liam Donaldson, said yesterday that "it would take a lot for us to move in that direction; it would be extremely disruptive to society".
But officials do have to plan for eventualities and both head teachers and Becta, the body charged with promoting the best use of technology in England’s schools, have been involved in talks with government officials on the issue.
Contingency plans
Becta confirms contingency plans are in place. Its officials have been liaising with the government and are working on revising government guidance to schools about how they can help children’s education continue using technology.
Guidance released by the government in December last year details plans schools and local authorities should make in case schools are closed for extended periods, which include provision for long-distance learning using email, the internet and the post.
Martin Ward, deputy general secretary of the Association of School and College Leaders (ASCL) told BBC News: "They (the government) do speak to us about the long term and ask our views on this.
"The view of the government until the last few days has been to work on business as normal. They are telling schools to stay open even if they have cases.
"If they decide that closing schools would save a lot of lives, then schools would do their best to send work home, to use technology, put work on the internet or send it by email"
Martin Ward, Assoc School and College Leaders
"We are not anxious to see schools being closed. Obviously, keeping schools closed would have a deleterious effect on children’s education.
"They would not be able to work as if they were at school."
If a decision were taken to close schools, however, Mr Ward said schools would do all they could to continue children’s education.
"It’s not a decision for us to take; it’s for the government and if they decide that closing schools would save a lot of lives, then schools would do their best to send work home, to use technology, put work on the internet or send it by email," he said.
Updating guidance
Becta officials have been liaising with the government and are revising government guidance to schools about how they can help children’s education continue using technology.
Neil McClean, Becta’s executive director of institutional development, said: "We are looking to update the existing guidance on how schools can maintain a continuity of services, should the school have to close or children be off with long-term illness.
"We will not be setting an alternative to schools. The key relationship is between schools, parents and children and the issue is how to use technology to maintain the relationships. We will not be issuing work sheets."
"We saw in the snow that many schools recognised that their school website was a good communication channel"
Neil McClean, Becta technology agency
Becta’s advice would include that schools make sure they have email addresses for parents and that teachers have access to the schools’ websites from outside school, so they can set work.
"We saw in the snow that many schools recognised that their school website was a good communication channel, for letting people know when it would re-open but also for setting work sheets too," said Mr McClean.
Many schools now have what are known as "learning platforms" – virtual classrooms where children can log in from home and do work set and marked by teachers.
These could be expanded to set work generally and to enable teachers and pupils to communicate live.
Guidance on closures- Aim is to provide reasonable degree of teaching and learning
- Overall planning responsibility lies with local authority
- Schools to review students’ home access to IT
- Need to consider non-IT systems to get work to and from pupils
Some schools work in partnership with others to share learning platforms.
The government advice says if schools are closed for an extended period in a flu pandemic "students should be provided with a reasonable degree of teaching and learning".
The overall planning responsibility "lies with the local authority, working with schools on planning and delivery".
It calls on local authorities to discuss plans with schools now and for schools to review "the proportion of students with IT facilities at home" and the extent to which students with such facilities could access school IT systems from home.
Local authorities should also consider posting work or making it available at central points such as libraries or town halls, for children without access to online systems.
It adds: "A severe pandemic would cause major disruption to all aspects of life, including what is reasonable to expect of schools and local authorities – but that is not a reason to neglect planning".</p
This article is from the BBC News website. © British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.
World swine flu death toll tops 700
July 21st, 2009 |
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Pregnant women may be advised to stay home if outbreak worsens in autumn, chief medical officer says
More than 700 people have died from the swine flu virus worldwide since H1N1 emerged in April, the World Health Organisation (WHO) said.
Twenty-nine of those deaths have been in the UK but the WHO is no longer giving country-by-country breakdowns.
The global death toll is about 300 up on the 429 reported two weeks ago but since then countries have been told there is no longer any need to report infections.
The figure compares with 262 confirmed deaths from bird flu in 15 countries since 2003.
The WHO report of deaths came as Britain’s chief medical officer, Sir Liam Donaldson, said pregnant women, cancer patients on chemotherapy and others with weakened immune systems may be advised to stay away from crowds for “a few weeks” when the swine flu pandemic reaches its height, probably this autumn.
Mothers-to-be are at present not being recommended to cut back on normal activities such as going to work, using public transport or attending events and family gatherings, but that could change if swine flu reached a level of, for example, one in three of the population.
But Donaldson also said some pregnant women may wish to exercise their choice now “on a highly precautionary basis, to avoid large, densely populated gatherings where they have little control over personal contact”.
Donaldson has been attempting to clarify official advice since confusion emerged at the weekend over exactly what it meant.
Guidance was posted on the Department of Health website yesterday and this morning the chief medical officer returned to the subject on GMTV.
“We are not advising pregnant women to cut down on their normal daily activity – some might choose to be very precautionary and not want to go into crowded places, but that is not the advice,” he said.
“But we will look at it again when it comes to the autumn when we get possibly big numbers of cases.
“If we got, for example, one in three of the population affected by flu, which is one of the estimates, at that point I may advise pregnant women and people for example on cancer treatment who have weakened immune systems to avoid crowded places for a period of a few weeks when it is at its peak.”
His remarks came as ministers were urged to rethink their policy of keeping schools open through the pandemic after research showed that a shutdown would curb the spread of infection and limit the number of deaths.
Two infectious disease experts said school closures should be considered to reduce the number of cases and buy time until a vaccine is available.
Schools across Britain have broken up for summer holidays and experts hope this will help to slow the spread of the virus. But there are fears that when classes resume in the autumn the number of cases will increase rapidly.
School closures would cause serious difficulties for working parents, lead to a 1% loss in GDP through absenteeism and see as many as 30% of NHS staff taking time off just when they are needed to treat patients.
In a study published in the Lancet Infectious Diseases, government adviser Prof Neil Ferguson and Dr Simon Cauchemez, both of the department of infectious disease epidemiology, Imperial College London, said “prolonged” closures could reduce the scale of the outbreak by 13-17% and at the pandemic’s peak the shutting of schools could bring down the number of cases by 38-45%.
“It is therefore hoped that closure of schools during the pandemic might break the chains of transmission, with the following potential benefits: reducing the total number of cases; slowing the epidemic to give more time for vaccine production; and reducing the incidence of cases at the peak of the epidemic, limiting both the stress on healthcare systems and peak absenteeism in the general population, and thus increasing community-wide resilience,” the researchers said.
Such a move would also raise the question of what should be done with millions of schoolchildren during a prolonged shutdown, they added. The authors said that governments in Europe and America might have to take such a step after they studied the impact of school closures during flu epidemics in other countries stretching back to 1918.
They say that study of the 1918 flu outbreak in America and Australia indicates that shutting schools, in tandem with closing churches and improved hygiene, could have reduced the death toll by between 10% and 30%, and as much as 50% in some cities at the height of the outbreak.
About 100 schools closed after the start of the outbreak in May but soon reopened when official advice changed because swine flu was becoming so prevalent.
Donaldson responded coolly to the idea during his GMTV appearance. “I think it would take a lot for us to move in that direction. It would be extremely disruptive to society. When would you open them again, given that flu might be around for several months?
“If we look at what we did in the west Midlands for example, where we did very aggressively initially close schools and treat people with Tamiflu who didn’t have symptoms but were contacts of cases, eventually it broke out of the box and spread more widely.”
He added: “I think we will obviously keep all of these things under review as we do with any scientific advice, but at the moment I think it is unlikely.”
The WHO said “it is really up to individual countries to consider what mitigation measures suit them in regard to the situation in individual countries”.
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Experts urge swine flu school closures
July 21st, 2009 |
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Infectious disease experts say closures could reduce number of swine flu cases and buy time until vaccine is available
Ministers have been urged to rethink their policy of keeping schools open through the swine flu pandemic after research showed that a shutdown would curb the spread of infection and limit the number of deaths.
As Andy Burnham, the health secretary, announced that a flu helpline to take the pressure off GPs’ surgeries would go live this week, two infectious disease experts said school closures should be considered to reduce the number of cases and buy time until a vaccine is available.
Schools across Britain have now broken up for summer holidays and experts hope this will help to slow the spread of the virus. But there are fears that when classes resume in the autumn the number of cases will increase rapidly.
School closures would cause serious difficulties for working parents, lead to a 1% loss in GDP through absenteeism and see as many as 30% of NHS staff taking time off just when they are needed to treat patients.
In a study published in the Lancet, government adviser Prof Neil Ferguson and Dr Simon Cauchemez, both of the department of infectious disease epidemiology, Imperial College London, said “prolonged” closures could reduce the scale of the outbreak by 13-17% and at the pandemic’s peak the shutting of schools could bring down the number of cases by 38-45%.
“It is therefore hoped that closure of schools during the pandemic might break the chains of transmission, with the following potential benefits: reducing the total number of cases; slowing the epidemic to give more time for vaccine production; and reducing the incidence of cases at the peak of the epidemic, limiting both the stress on healthcare systems and peak absenteeism in the general population, and thus increasing community-wide resilience,” the researchers said.
Such a move would also raise the question of what should be done with millions of schoolchildren during a prolonged shutdown, they added. The authors said that governments in Europe and North America might have to take such a step after they studied the impact of school closures during flu epidemics in other countries stretching back to 1918.
They say that study of the 1918 flu outbreak in America and Australia indicates that shutting schools, in tandem with closing churches and improved hygiene, could have reduced the death toll by between 10% and 30%, and as much as 50% in some cities at the height of the outbreak.
About 100 schools closed after the start of the outbreak in May but soon reopened when official advice changed because swine flu was becoming so prevalent.
The chief medical officer, Sir Liam Donaldson, today responded coolly to the idea, when hew appeared on GMTV. “I think it would take a lot for us to move in that direction. It would be extremely disruptive to society. When would you open them again, given that flu might be around several months?
“If we look at what we did in the west Midlands for example, where we did very aggressively initially close schools, and treat people with Tamiflu who didn’t have symptoms but were contacts of cases, eventually it broke out of the box and spread more widely.”
Sir Liam said: “I think we will obviously keep all of these things under review as we do with any scientific advice, but at the moment I think it is unlikely.”
Ed Balls, schools secretary, said last night: “Now that the virus is established in the community, expert advice is that there is no longer a strong case for closing schools to contain the spread of infection. We will be monitoring the situation closely over the school holidays and will review the evidence in late August.”
The department’s emergency planning group, Cerg, is now solely concerned with orchestrating schools’ response to the spread of swine flu and updating ministers daily on the situation.
Prof Steve Field, chairman of the Royal College of General Practitioners, said ministers should keep open the possibility of school closures. “It’s something that shouldn’t be discounted if it’s the height of the pandemic,” he said. “It would depend on how the pandemic has developed. The Lancet study demonstrates that it would slow down the transmission of the virus and might cut the number of people who get serious illness and who die.”
Martin Ward, deputy general secretary of the Association of School and College Leaders, said schools could set up internet-based classrooms if there were long-term school closures. “But with the best will in the world they are not going to make the progress they would have if they had been in school,” he said.
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Shut schools to save lives, ministers told
July 21st, 2009 |
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Slowing spread of virus would give more time to develop vaccine
Ministers were urged tonight to rethink their policy of keeping schools open through the swine flu pandemic after research showed that a shutdown would curb the spread of infection and limit the number of deaths.
As Andy Burnham, the health secretary, announced that a flu helpline to take the pressure off GPs’ surgeries would go live this week, two infectious disease experts said school closures should be considered to reduce the number of cases and buy time until a vaccine is available.
Schools across Britain have now broken up for summer holidays, and experts hope this will help to slow the spread of the virus. But there are fears that when classes resume in the autumn the number of cases will increase rapidly.
School closures would cause serious difficulties for working parents, lead to a 1% loss in GDP through absenteeism and see as many as 30% of NHS staff having to take time off just when they are needed to treat growing numbers of patients.
In a study published in the today Lancet , Government adviser Professor Neil Ferguson and Dr Simon Cauchemez, both of the department of infectious disease epidemiology, Imperial College London, said “prolonged” closures could reduce the scale of the outbreak by 13-17% and at the pandemic’s peak shutting schools could bring down the number of cases by 38-45%.
“It is therefore hoped that closure of schools during the pandemic might break the chains of transmission, with the following potential benefits: reducing the total number of cases; slowing the epidemic to give more time for vaccine production; and reducing the incidence of cases at the peak of the epidemic, limiting both the stress on healthcare systems and peak absenteeism in the general population, and thus increasing community-wide resilience,” the researchers said.
Such a move would also raise the question of what should be done with millions of schoolchildren during a prolonged shutdown, they added. The authors said that governments in Europe and North America might have to take such a step after they studied the impact of school closures during flu epidemics in other countries stretching back to 1918.
They say that study of the 1918 flu outbreak in America and Australia indicates that shutting schools, in tandem with closing churches and improved hygiene, could have reduced the death toll by between 10% and 30%, and as much as 50% in some cities at the height of the outbreak.
About 100 schools closed after the start of the outbreak in May, but soon reopened when official advice changed because swine flu was becoming so prevalent.
Last night the schools department said it was sticking with the current guidance, which is not to close schools. Ed Balls, schools secretary, said: “Now that the virus is established in the community, expert advice is that there is no longer a strong case for closing schools to contain the spread of infection. We will be monitoring the situation closely over the school holidays and will review the evidence in late August.”
The department’s emergency planning group, Cerg, is now solely concerned with orchestrating schools’ response to the spread of swine flu and updating ministers daily on the situation.
Professor Steve Field, chairman of the Royal College of General Practitioners, said ministers should keep open the possibility of school closures. “It’s something that shouldn’t be discounted if it’s the height of the pandemic,” he said. “It would depend on how the pandemic has developed. The Lancet study demonstrates that it would slow down the transmission of the virus and might cut down the number of people who get serious illness and who die.”
Mick Brookes, general secretary of the National Association of Headteachers, called for a balanced view of the risks. “Even one person dying is a tragedy but if the mortality rate is the same of any other flu that needs to be kept in perspective,” he said. “If more and more people become infected closures may well become inevitable. Younger children are more at risk so it might be right to close early years centres and nurseries first.”
Martin Ward, deputy general secretary of the Association of School and College Leaders, said schools could set up internet-based classrooms if there were long-term school closures. “But with the best will in the world they are not going to make the progress they would have if they had been in school,” he said.
Pregnant women may want to steer clear of crowded places in order to reduce their chances of catching the virus, the government’s chief medical officer, Sir Liam Donaldson, said yesterday. The swine flu virus’s current known level of risk meant that expectant mothers should not stop using public transport, going to work or attending events and family gatherings, he said. But he added: “Some mothers-to-be may wish to continue their day-to-day activities but exercise their choice now, on a highly precautionary basis, to avoid large densely populated gatherings where they have little control over personal contact.”
He was trying to end the confusion over what steps pregnant women should take to avoid catching the virus after conflicting advice from medical organisations .
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Swine flu school closures urged
July 20th, 2009 |
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Slowing spread of virus would give more time to develop vaccine
Ministers were urged tonight to rethink their policy of keeping schools open through the swine flu pandemic after research showed that a shutdown would curb the spread of infection and limit the number of deaths.
As Andy Burnham, the health secretary, announced that a flu helpline to take the pressure off GPs’ surgeries would go live this week, two infectious disease experts said school closures should be considered to reduce the number of cases and buy time until a vaccine is available.
Schools across Britain have now broken up for summer holidays, and experts hope this will help to slow the spread of the virus. But there are fears that when classes resume in the autumn the number of cases will increase rapidly.
School closures would cause serious difficulties for working parents, lead to a 1% loss in GDP through absenteeism and see as many as 30% of NHS staff having to take time off just when they are needed to treat growing numbers of patients.
In a study published in the today Lancet , Government adviser Professor Neil Ferguson and Dr Simon Cauchemez, both of the department of infectious disease epidemiology, Imperial College London, said “prolonged” closures could reduce the scale of the outbreak by 13-17% and at the pandemic’s peak shutting schools could bring down the number of cases by 38-45%.
“It is therefore hoped that closure of schools during the pandemic might break the chains of transmission, with the following potential benefits: reducing the total number of cases; slowing the epidemic to give more time for vaccine production; and reducing the incidence of cases at the peak of the epidemic, limiting both the stress on healthcare systems and peak absenteeism in the general population, and thus increasing community-wide resilience,” the researchers said.
Such a move would also raise the question of what should be done with millions of schoolchildren during a prolonged shutdown, they added. The authors said that governments in Europe and North America might have to take such a step after they studied the impact of school closures during flu epidemics in other countries stretching back to 1918.
They say that study of the 1918 flu outbreak in America and Australia indicates that shutting schools, in tandem with closing churches and improved hygiene, could have reduced the death toll by between 10% and 30%, and as much as 50% in some cities at the height of the outbreak.
About 100 schools closed after the start of the outbreak in May, but soon reopened when official advice changed because swine flu was becoming so prevalent.
Last night the schools department said it was sticking with the current guidance, which is not to close schools. Ed Balls, schools secretary, said: “Now that the virus is established in the community, expert advice is that there is no longer a strong case for closing schools to contain the spread of infection. We will be monitoring the situation closely over the school holidays and will review the evidence in late August.”
The department’s emergency planning group, Cerg, is now solely concerned with orchestrating schools’ response to the spread of swine flu and updating ministers daily on the situation.
Professor Steve Field, chairman of the Royal College of General Practitioners, said ministers should keep open the possibility of school closures. “It’s something that shouldn’t be discounted if it’s the height of the pandemic,” he said. “It would depend on how the pandemic has developed. The Lancet study demonstrates that it would slow down the transmission of the virus and might cut down the number of people who get serious illness and who die.”
Mick Brookes, general secretary of the National Association of Headteachers, called for a balanced view of the risks. “Even one person dying is a tragedy but if the mortality rate is the same of any other flu that needs to be kept in perspective,” he said. “If more and more people become infected closures may well become inevitable. Younger children are more at risk so it might be right to close early years centres and nurseries first.”
Martin Ward, deputy general secretary of the Association of School and College Leaders, said schools could set up internet-based classrooms if there were long-term school closures. “But with the best will in the world they are not going to make the progress they would have if they had been in school,” he said.
Pregnant women may want to steer clear of crowded places in order to reduce their chances of catching the virus, the government’s chief medical officer, Sir Liam Donaldson, said yesterday. The swine flu virus’s current known level of risk meant that expectant mothers should not stop using public transport, going to work or attending events and family gatherings, he said. But he added: “Some mothers-to-be may wish to continue their day-to-day activities but exercise their choice now, on a highly precautionary basis, to avoid large densely populated gatherings where they have little control over personal contact.”
He was trying to end the confusion over what steps pregnant women should take to avoid catching the virus after conflicting advice from medical organisations .
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Swine flu cases hit 100,000
July 17th, 2009 |
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• Under fives three times more likely to need hospital
• Warning that schools may not reopen in autumn
Under-fives and pregnant women are emerging as key swine flu risk groups, according to hospital figures and the age profiles of those who have already died.
The Health Protection Agency (HPA) altered its advice this week to include the youngest age range – the under-fives – in the category of those “predominantly affected” while the Royal College of Midwives issued fresh advice todayon giving expectant women anti-viral drugs.
The shift in emphasis by health officials is a reminder that even if the final death rates from the pandemic are the same as normal seasonal flu, the social impact will be significantly different, with the disease apparently targeting the young more than elderly people. In normal seasonal flu it is the elderly who usually succumb through developing pneumonia.
Altogether, 29 people have died from swine flu in the UK. A patient from Swindon and a female tourist who died in Scotland, after being admitted to hospital in Inverness three weeks ago, are among recent deaths. Figures from the NHS in the West Midlands show that at one stage this month 23 out of the 79 patients receiving treatment in hospital for swine flu were less than five years old.
On Thursday the chief medical officer, Sir Liam Donaldson, produced statistics, based on the current outbreak, showing that under-fives were three times more likely to need inpatient care than those in other age groups.
At least five of those who died are known to have been young children or babies. The NHS in London today confirmed that a baby less than six months old was among the fatalities. Some, like nine-year-old Asmaa Hussain, from Dewsbury, who suffered from epilepsy, had other prior conditions.
The Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists issued joint advice on prescribing anti-virals, suggesting that pregnant women with flu symptoms be given a course of Relenza, using an inhaler.
“It is recommended for pregnant women because it easily reaches the throat and lungs, where it is needed, and does not reach significant levels in the blood or placenta,” the advice said. “This has the theoretical advantage of not affecting the pregnancy or the growing baby.”
It added: “A few cases of severe illnesses among pregnant women and infants have been reported in the UK and from other countries. These have mostly affected women with pre-existing health problems. In previous pandemics, and in reports from some countries in this pandemic, there is evidence that pregnancy can increase the risk for influenza complications for the mother and the foetus.”
As many as 100,000 people may now have contracted swine flu in the UK, if estimates released by the Health Protection Agency are correct.
Fears the potentially fatal illness meningitis could be confused with swine flu were raised today after Gemma Drury, 17, of Brimington, Chesterfield, was first diagnosed with swine flu but then rushed to hospital with meningitis days later.
The Department for Children, Schools and Families (DCSF) suggested today that some schools and nurseries might not open as usual at the start of the autumn term due to swine flu.
The Department of Health yesterday dismissed fears that the threat of high death rates could endanger the international supply of vaccines. The UK has ordered 132m doses of vaccine, sufficient for all the UK population. The first doses could be ready as early as August.
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Swine flu may keep schools shut
July 17th, 2009 |
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Uncertainty over spread of pandemic could keep pupils away for start of autumn term
Some schools in England could remain closed in September if the swine flu pandemic escalates over the summer, the government has admitted.
The Department for Children, Schools and Families (DCSF) said that, while it was expected schools and nurseries would open as usual at the start of the academic year, it could not be “certain what the situation will be” in the autumn.
Decisions on closures would be taken shortly before the start of the autumn term, a message to schools across the country from the department said.
The DCSF guidance, issued as many schools broke up for the summer today, said it was monitoring the spread of the H1N1 virus on a day-by-day basis. A message will be sent to schools in the last week of August telling them what to do at the start of term, it added.
The DCSF said: “As the summer term is drawing to an end, it is important to ensure that everyone will be in a position to know what will happen at the start of the autumn term.
“We expect that schools and early-years and childcare settings will reopen as usual but at this time we cannot be certain what the situation will be then; we will need to monitor developments over the summer, and take decisions based on the best advice available shortly before the start of term.”
About 1,000 schools have already recorded cases of swine flu, although most have remained open, according to the DCSF.
The message to schools follows a warning from the government’s chief medical officer, Sir Liam Donaldson, that up to 65,000 people could die from swine flu in the UK in a worst-case scenario.
A planning document published by the Department of Health yesterday suggested that if the current growth in cases was sustained, the number of cases could peak in early September, with up to 30% of the population suffering illness.
There are also suggestions the spread of the virus could begin to slow over July and August before a resurgence in the autumn when schools reopen.
Margaret Morrissey, of the lobby group Parents Outloud, said ministers should have closed schools across the country early for the summer.
“I do think the government has had a major event of mismanagement here. They should have shut down schools and public places, not for ever, but to stop the virus spreading,” she said.
In swine flu hotspots, schools should remain closed until children had been vaccinated, Morrissey suggested. “We might have to, in some schools, keep them closed until the vaccine is in place,” she said.
The campaigner also called for the government to hand money to employers so that their staff can stay at home with their children if they are affected by swine flu.
“We helped the banks out, how about helping parents?” she said.
“There could be a decision that schools have got to say to parents, ‘If your finances can be supported, do you agree with having the school closed until the children are vaccinated?’”
But she added that if it was possible to open schools in September then that should happen.
At the start of the outbreak, affected schools were closed, but the Health Protection Agency is no longer recommending that approach because swine flu is now widespread within communities.
HPA guidance says: “People are likely to be repeatedly exposed to the virus in their everyday lives. Closing a school will no longer be effective in slowing the spread of the virus as people could still be exposed outside the school.
“In some special circumstances – for example, a school with children who are particularly vulnerable to infection – then school closures might still be recommended.”
Parents expressed concern yesterday about the now rapid spread of the virus, and some admitted they were scared and unsure how to respond to the situation.
Gloria Newell, 49, a housing officer, who was picking up her nine-year-old daughter, Natasha, from St Mary’s Church of England school in Islington, north London, said: “I am just astonished. The figures are quite shocking. There seems to be nothing really in place to cope with this. We have heard about a national vaccination scheme but we do not know when it might be in place.”
In north London, another mother, Amal Khaireddine, 30, was concerned about her sons Joseph, five, Shamus, six, and Ryan, eight, all pupils at Hugh Myddelton school in Islington, where there had been several cases of swine flu. “They had sore throats and temperatures and I did what you should do and called the GP. They said … not to worry. But I think they should have been tested, some swabs should have been taken … all you are told is check the NHS website, but that is not 100% safe.”
In nearby Culpepper Gardens, Richard O’Connell, 63, said he had taken his two-year-old grandson, Alfie, to the doctor because of a high temperature and had been told not to worry. “But you do worry because you don’t know what to do … it’s all very well telling people to look at the NHS website but what of those of us who do not have a computer?”
Anne Alexander, 62, a retired playschool worker from Highbury, north London, believed the publicity was causing “mass panic”. Collecting her nine-year-old granddaughter, Niamh Stepto, from school, she said: “The reality is that it may only be as serious as normal seasonal flu.”
Paola Domizio, a pathologist and mother of year-old twins Aron and Susha, said : “I’m undecided whether to panic or not. Certainly it is alarming that so many young children may be susceptible. But what can you do? Even if you keep them in all day there are no guarantees. If a vaccine is developed I suppose children will be vaccinated, but until then all you can do is follow the guidelines. So I can’t say that I’m particularly panicking, although the figures do sound alarming.”
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Swine flu may claim 65,000 lives in Britain
July 17th, 2009 |
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Medical experts have warned that swine flu could claim 65,000 lives in Britain unless the epidemic is stopped.
It would be the worst case scenario based on 30 per cent of the population catching the virus, The Mirror quoted Chief Medical Officer Sir Liam Donaldson, as saying.
Donaldson spoke as it was announced the number [...]
UK swine flu deaths hit 29 – and could rise to 65,000
July 16th, 2009 |
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Minimum of 3,100 deaths expected, says Britain’s chief medical officer, as official toll reaches 29
Up to 65,000 people in the UK could die from swine flu if the pandemic achieves it worst possible potential, the government warned today.
The chief medical officer, Professor Sir Liam Donaldson, said that in the worst case scenario 30% of the UK population could be infected by the H1N1 virus, with 65,000 killed.
The best case scenario is that 5% of the population contract the virus, with 3,100 deaths.
The estimates were released as the government confirmed that 29 people had died in the UK after contracting swine flu.
The flu is spreading fast across much of Britain, with 55,000 new cases in England last week, according to the Health Protection Agency.
The death toll was released by the Department of Health as the Scottish health secretary, Nicola Sturgeon, announced that a female tourist who had the H1N1 virus died in hospital yesterday.
The woman, who had other serious health problems, died at Raigmore hospital in Inverness last night. It is unclear whether her death has been included in the official toll.
Donaldson warned against panic about the projected death toll from a swine flu pandemic, noting that there had been 21,000 extra deaths over the winter of 1999-2000 due to seasonal flu and this had raised little public concern.
Among new suspected swine flu cases is Cherie Blair. The barrister and wife of the former prime minister pulled out of an honorary ceremony at Liverpool Hope University after falling ill and is reported to have been given a course of Tamiflu. Tony Blair and their children have shown no signs of infection.
Health ministers from across the UK – including those from Scotland, Wales and Northern Ireland – are attending weekly meetings of the government’s civil contingencies committee, Cobra, to assess the impact of the disease.
Information collected by the Royal College of General Practitioners’ research and surveillance centre in Birmingham, which monitors communicable and respiratory diseases, shows that the total of those affected by the H1N1 virus rose by 46% in the seven days up to last Sunday.
The rate of people diagnosed with influenza-like illness in the north of England rose from 6.6 per 100,000 of population between 29 June and 6 July to 37.2 per 100,000 between 6 and 16 July – almost six times as many.
It more than doubled in central England from 42.8 to 93.9 per 100,000 but only rose slightly in the south from 72.1 to 74.9 per 100,000. However, cases in London – a swine flu “hotspot” along with the West Midlands – declined from about 180 to 140 per 100,000. Across England, the incidence increased from 50.3 to 73.42 during that week, a rise of 46%.
Professor Steve Field, the chairman of the Royal College, said: “Swine flu is spreading rapidly across the whole of the country now. GPs are saying that they are coming under a lot of pressure from patients who have it and many GPs say that the publicity surrounding the death of six-year-old London schoolgirl Chloe Buckley has increased demand and made people more anxious, although there is no reason for them to be so.”
Children between five and 14 remain the worst affected, with an incidence rate of 160 per 100,000. The rate among under-fives is 114 per 100,000 and 89.4 among those aged 15-44.
The Royal College of GPs today complained that a submission it made to a House of Lords committee had been taken out of context. It insisted that it was “very pleased” with the responsiveness of health officials to the emergency. It had been asked to provide feedback from GPs about swine flu. Among one of the comments was that: “Family doctors also noted that conflicting advice was being provided by different agencies.”
The comment was connected to an apparent discrepancy between a message on the NHS Direct website that appears to indicate all those with confirmed swine flu will receive Tamiflu or Relenza to help reduce the virus’s severity, and separate advice from the Royal College saying doctors should use their discretion.
Field agreed there appeared to be an “inconsistency” between the two lines of advice. “The last time [the advice] was changed was to give more discretion to GPs for dealing with those outside the at-risk groups and partly to send the message to patients that they don’t all need Tamiflu,” he said.
The decision about whether to prescribe should be reached in “partnership” between doctor and patient, he said. “I don’t think it’s the GP’s job not to give it.”
The Department of Health said it did not believe there was any difference in the advice being proffered. “There’s not going to be a case of people being refused Tamiflu,” a spokeswoman said.
A GP who contacted the Guardian said the differing advice being given to GPs and patients was placing an unnecessary burden on GPs and out-of-hours care “resulting in hysteria and patients in real need being put at risk” because people were being told they needed Tamiflu “when they don’t”.
Gloucestershire police today defended a decision to send three officers wearing face masks, gloves and overalls into a house containing a suspected swine flu victim. “It was a precaution at the time but won’t necessarily become standard practice,” said a spokeswoman.
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Swine flu cases up sixfold in a week
July 15th, 2009 |
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The number of people diagnosed with swine flu soared almost sixfold during the course of last week in some parts of England, NHS figures revealed today.
The virus is spreading fast across much of the country and the total of those affected rose by 42% in the seven days up to last Sunday, according to data provided by family doctors.
Information collected by the Royal College of General Practitioners’ research and surveillance centre in Birmingham, which monitors communicable and respiratory disease, shows that the rate of people diagnosed with influenza-like illness in the north of England leapt from 6.6 per 100,000 of population during 29 June to 6 July to 37.2 per 100,000 between 6 and 16 July.
It more than doubled in central England from 42.8 to 93.9 per 100,000 but only rose slightly in the south of England from 72.1 to 74.9 per 100,000. However, cases in London – the worst affected swine flu “hotspot” so far with the West Midlands – declined from about 180 to 140 per 100,000. Across England as a whole the incidence increased from 51.88 to 73.42 during that week, a rise of 42%.
Sir Liam Donaldson, the Government’s chief medical officer, will tomorrow afternoon release latest details of the numbers of people who have died or been hospitalised by or been diagnosed with the H1N1 bug. The death toll currently stands at 16.
Professor Steve Field, chairman of the Royal College, said: “Swine flu is spreading rapidly across the whole of the country now. GPs are saying that they are coming under a lot of pressure from patients who have it, and many GPs say that the publicity surrounding the death of six-year-old London schoolgirl Chloe Buckley has increased demand and made people more anxious, although there is no reason for them to be so.”
Children aged between five and 14 remain the worst affected, with an incidence rate of 160 per 100,000. The rate among under-fives is 114 per 100,000 and 89.4 among those aged 15-44.
There appeared to be an element of “inconsistency” in official advice over whether GPs are expected to prescribe anti-viral treatment to all those diagnosed with swine flu.
The NHS Direct website informs patients that: “If swine flu is confirmed, ask a healthy friend or relative to visit your GP to pick up a document entitling you to antiviral medication.” The statement raises the expectation that those diagnosed will automatically be given Tamiflu or Relenza to help relieve symptoms.
But advice circulated by the Royal College makes it clear that even if a diagnosis is confirmed, clinical discretion means it may not be necessary to prescribe anti-viral drugs to an infected, healthy patient. Doctors, the college insisted, should excercise clinical discretion in their decision on whether or not to give the drugs.
The advice given to GPs treating those diagnosed with swine flu who are not in a vulnerable medical category is to “consider authorisation of antivirals bearing in mind whether the patient has a strong preference for active treatment.”
Professor Steve Field, chairman of the Royal College of GPs, agreed that there appeared to be an “inconsistency” between the two lines of advice.
He said: “The last time [the advice] was changed was to give more discretion to GPs for dealing with those outside the at risk groups and partly to send the message to patients that they don’t all need Tamiflu.”
The decision whether to prescribe should be reached in “partnership” between doctor and patient, he added. “I don’t think it’s the GP’s job not to give it.”
The Department of Health said it did not believe there was any differnece in the advice being proffered. “There’s not going to be a case of people being refused Tamiflu,” a spokeswoman said.
A GP who contacted The Guardian said that the differing advice being given to GPs and patients was placing an unnecessary burden on GPs and out of hours care “resulting in hytteria and patients in real need being put at risk” because people were being told they needed Tamiflu “when they don’t”.
Gloucestershire police today defended the decision to send three officers wearing face masks, gloves and overalls into a house containing a suspected swine flu victim. “It was a precaution at the time. but won’t necessarily become standard practice”, said a spokeswoman.
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The girl who borrowed a heart
July 14th, 2009 |
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• Ten years with two hearts, then her own recovers
• 16-year-old leads full life after cancer and transplant
Her life used to consist of endless rounds of medicines, long stays in hospital and uncertainty about how much longer she would live for. Now 16-year-old Hannah Clark – the first person in Britain to receive someone else’s heart but later have it removed, only for her own to unexpectedly recover – relishes typical teenage pursuits such as running, shopping and walking her dog.
Born with a rare heart condition that could easily have killed her, Hannah, from Mountain Ash near Cardiff, was two when she joined an exclusive club by having a five-month-old girl’s heart grafted on to her own.
For 10 and a half years she had two hearts – “piggybacking”, doctors call it – although it was the donated heart that kept Hannah alive while her original organ took a long rest.
Complications meant the second heart had to be taken out when she was 12, and doctors were unsure what would happen. No one had survived such a procedure.
Now, three and a half years later, one of the most dramatic success stories in recent medical history has just done her GCSEs, started her first part-time job at a kennels and is preparing for a family holiday by the seaside – all powered by a heart which, for her first 12 years, doctors thought could not keep her alive.
Confirmation of Hannah’s highly unusual success in recovering from cardiomyopathy, which affects the heart’s muscle, comes today in the form of a long article in the Lancet medical journal.
In complicated medicalese, it tells an amazing story of survival. The authors, who include renowned heart surgeon Sir Magdi Yacoub, testify to the teenager’s feat.
Yesterday the girl who used to have two hearts negotiated another obstacle: a press conference to tell her story.
At times the constant whirring of cameras, barrage of questions and sheer number of people left her lost for words, or in tears.
How specially does she treasure life now, someone asked? “I can’t say,” replied Hannah. It took her mother, Liz, to answer: “She just loves life. She doesn’t think about tomorrow; she thinks about today, and lives life to the full. She gets up every morning smiling, and it’s very, very rare to see Hannah upset.
“She doesn’t go to bed until three o’clock in the morning sometimes … that’s how much energy she’s got. She couldn’t have done that before.”
Yacoub, of the Harefield hospital in west London, said her recovery had given the many doctors involved in her care insights into many things, such as transplant surgery and the use of immunosuppressant drugs, which must be taken to minimise the chances of a patient’s body rejecting a new organ.
Before Hannah, no one’s own heart had ever recovered enough to keep them alive, although doctors did think it was a theoretical possibility that a weak heart could somehow become strong.
Among the lessons learned from Hannah, Yacoub said, was that “the possibility of recovery of the heart is just like magic. A heart that was not contracting at all, after a time we put the new heart to pump next to it, and do its work. Now it is functioning normally. That is going to be very fundamental in helping people in the future.”
Born in 1993, Hannah underwent what surgeons call heterotopic cardiac transplantation, or “piggybacking”, two years later. However, the immunosuppressant drugs led to her developing an incurable, rare cancer that kept returning despite repeated bouts of chemotherapy.
But the doctors’ strategy, to reduce the doses of immunosuppressants, led to Hannah’s second heart failing. In February 2006, they decided they had no choice but to take it out, or risk Hannah’s death. Three and a half years of constant improvement, and Hannah’s gloriously normal life, have proved enough for them to pronounce the reversal of her transplant an unqualified, if unexpected, success.
Her father, Paul, recalled how when she was being treated at London’s Great Ormond Street hospital the family was told that Hannah was about to die.
“They called us in and said that a tumour had affected her spinal cord and was putting pressure on her brain, and was going to kill her. A nurse told us that she only had 12 hours to live. I said, ‘Well, you believe what you believe and I’ll believe what I believe’. For some reason, the next day she was OK.”
Their experience has made the Clark family advocates of presumed consent, a policy – supported by Gordon Brown and chief medical officer Sir Liam Donaldson – that would see everyone in the UK presumed to be in favour of donating their organs after death. Supporters believe that, with 1,000 people dying every year due to shortages, the move would greatly increase the supply of organs. Yacoub said that, having previously been opposed to presumed consent, he now backed it.
Survival story
1 May 1993 Hannah Clark born in Wales.
July 1995 Aged two, Hannah undergoes “piggybacking”, in which a donor heart is joined with her own. She improves for four and a half years.
August 2001 Hannah is found to have a rare form of cancer caused by immunosuppressant drugs that stop her body rejecting the new organ.
2001-2006 Her cancer keeps recurring. Doctors deem it incurable.
February 2006 Doctors decide to remove the donor heart.
14 July 2009 Hannah’s story reported in the Lancet.
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Swine flu death of ‘healthy’ person
July 11th, 2009 |
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• Latest person to die was otherwise healthy – NHS
• Experts say virus has not necessarily mutated
The first death from swine flu of an otherwise healthy individual was announced last night by NHS authorities in Essex.
At the wishes of the family, no details were given of the patient who died at Basildon and Thurrock University hospital. But the case will cause widespread concern. Until now, every adult and child who has died has had serious underlying health problems that made them particularly vulnerable to infections.
But the chief medical officer, Sir Liam Donaldson, has warned that a few apparently healthy people have succumbed to swine flu and become seriously ill abroad. In one case last month, a healthy 15-year-old teenager called Matthew Davis from Buffalo in New York state, fell ill with swine flu and died, apparently because of co-infection with the superbug MRSA, which he may have contracted in the community rather than in hospital.
Speaking last night, Donaldson pointed to the sometimes apparently random behaviour of the infection: “This death underlines that, although the virus is proving generally mild in most people, it is more severe in some cases. As with all flu-like viruses, some people are at higher risk than others. Unfortunately, people who are otherwise healthy could also become seriously ill or, sadly, die.”
But the director of public health for NHS south-east Essex, Dr Andrea Atherton, said she wanted to reassure people that the risk of transmission still remains small.
“It is important to stress that the symptoms of swine flu are, relatively speaking, mild. Unless you have flu-like symptoms and are being tested for swine flu, there is absolutely no need to stop your normal everyday activities,” she said.
Another expert, Prof Robert Dingwall, director of the Institute for Science and Society at the University of Nottingham, also struck a reassuring note. “This is not at all unexpected – there have been a few deaths elsewhere in the world among people with no obvious underlying condition.
“However, it does not really affect the growing body of evidence that the first pandemic of the 21st century is a relatively mild one and that death rates are likely to be broadly comparable with the annual toll from seasonal flu. There certainly will be more deaths like this one – but most deaths will still occur among people who have some serious underlying condition, and are already likely to be under active medical management,” he said.
John Oxford, professor of virology at Queen Mary’s College of Medicine in London and scientific director of Retroscreen Virology Ltd, said the death was to be expected and did not give any extra cause for concern: “We’ve all been gritting our teeth, waiting for this to happen, and now it has. This doesn’t necessarily mean the virus has mutated. Whether more patients with no underlying health problems die … depends on what the virus does next.”
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Swine flu death of ‘healthy’ person
July 10th, 2009 |
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A hospital patient from Essex has become the first person without underlying health problems to die after contracting swine flu, it was announced today.
The patient died today at Basildon and Thurrock University Hospitals NHS Foundation Trust, NHS East of England said.
The patient’s family has asked that no details of their relative are released.
The trust said in a statement it “would like to extend their deepest sympathies to the family affected as they come to terms with their loss”.
News of the death comes as the number of people who had died while infected with the H1N1 virus has doubled in the last week.
It is thought that fifteen people with swine flu have now died since the virus was first identified in the UK in March.
Today’s death marks a new point in the outbreak as all of the previous victims were believed to have serious underlying health problems.
Yesterday Sir Liam Donaldson, the chief medical officer said that on top of the deaths, another 43 people were critically ill with the bug and a further 335 were being treated in hospital.
London and the West Midlands are on the verge of being classed as having epidemics because of the rate at which the virus is spreading.
There are 9,718 confirmed cases of swine flu in the UK but officials fear the real figure could be 10 times higher.
The US has the biggest outbreak, with 33,902 confirmed cases, followed by Mexico, with 10,262, and the UK third.
The World Health Organisation has said there have been 429 deaths from the virus worldwide and nearly 95,000 infections since it was first reported in Mexico.
Earlier today, the government said plans to deal with the pandemic could allow anyone infected with swine flu to stay off work for 14 days without a doctor’s note.
Employees can currently be off for seven days, including weekends and bank holidays, without needing a sick note from their GP.
A spokesman for the Department for Work and Pensions said: “The government is rightly considering possible measures to minimise the risk of further spread of swine-flu and protect public health.
“We don’t want people to feel obliged to leave the home or return to work when they are still unwell or put an unnecessary burden on GPs in a pandemic. Contingency plans therefore include the possibility of extending self-certification to 14 days for a limited period.”
He said the measures would “only be implemented if absolutely needed”, and the decision would be taken by the government’s civil contingencies committee.
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