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Swine flu plan to ditch doctors’ notes

Government says contingency plan to extend self-certification for limited period will only be implemented ‘if absolutely needed’

Anyone infected with swine flu could stay off work for 14 days without a doctor’s note, under government plans to deal with the pandemic.

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.

Professor Sayeed Khan, chief medical adviser at the manufacturers’ body EEF, said: “We are going to have GPs – quite rightly – dealing with more serious cases. The advice is not to visit your GP if you get swine flu.

“Being realistic, there will be some people who think ‘I’ve got a bit of a cold’ or ‘I’m not that bad’ and will stay off work. There’s nothing you can do to fix that. Employers can rely on the good morals of their employees and say ‘don’t abuse it’. They can say they will take tough measures against anyone found abusing it, but that’s about all they can do.”

The move follows the government’s chief medical officer announcement yesterday that the number of deaths from swine flu had risen to 14, with the infection reaching epidemic levels in the worst-hit parts of the country, such as London and the west Midlands.

The Health Protection Agency revealed a snapshot of the numbers going to hospital in a serious condition. Yesterday, 335 people were being treated, 43 of whom were in critical care. Sixty of those in hospital were under five years old, 47 were aged five to 15, 189 were 16-64 and only 39 were over 65.

Exact figures for the numbers of people diagnosed as having swine flu are no longer being given, because of the large numbers infected. Sir Liam Donaldson, the chief medical officer, said about 27,000 people had consulted a GP with symptoms in the last week, but the HPA said its sampling showed that only about 28% – 8,000 or so people – of those had a flu-like illness.

The government’s national framework for dealing with a flu pandemic estimates that up to 50% of the workforce may require time off at some stage, “with individuals absent for a period of seven to 10 working days”. Staff may also need time off to care for family members with swine flu and some may suffer “other psychosocial impacts, fear of infection and/or practical difficulties in getting to work,” the plan says.

Small firms, with five to 15 staff, or small teams within a larger organisation are likely to suffer more, with a higher proportion of staff absence. This could mean up to 35% of their workforce off over a two or three-week period at the peak of a pandemic.

Neil Carberry, head of employment policy at the CBI, said it was likely that temporary changes to sick leave policy would have to be taken.

“Employers need to be thinking through their business resilience plans in the face of threat of pandemic. The impact of a pandemic outbreak is going to be the significant threat to employers, not necessarily some of the temporary measures,” he said.

The plans were revealed as it emerged that some senior NHS managers had criticised the government’s pandemic flu strategy as muddled and contradictory. Health trust chiefs also claimed that the introduction of vouchers for Tamiflu would hamper the rapid distribution of antiviral drugs, according to the Times.

A memo obtained by the paper sent by an NHS trust executive responsible for emergency planning to other senior NHS staff described some measures to distribute drugs and relieve pressure on hospitals and GPs as “a complete waste of time”.

Ian Dalton, the government’s national director of flu resilience, said the NHS was “coping very well with the challenges” posed by swine flu.

“However, now that we have moved into the treatment phase, further clear guidance has been provided to the NHS on its roles and responsibilities,” he said. “Although this is being centrally led, the local NHS clearly must ensure that these plans are implemented in a way that meets local needs.”

The UK’s swine flu case total is the third highest in the world after Mexico, where the bug was first identified, and the US. There are 9,718 confirmed cases of swine flu in the UK. Mexico has 10,262 cases of the disease, with 33,902 in the US.

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Swine flu tally: 37

37 cases of the H1N1 virus, otherwise known as swine flu, have been registered in Serbia to date. 28 cases arrived in Serbia from a country where the outbreak had already been registered.

Swine flu death toll rises amid epidemic fears

The Health Protection Agency reveals numbers hospitalised as London and West Midlands show epidemic levels of infection

The number of deaths from swine flu has risen to 14, the government’s chief medical officer has disclosed today, as the infection reached epidemic levels in the worst-hit parts of the country.

For the first time, the Health Protection Agency revealed a snapshot of the numbers going to hospital in a serious condition. Today, 335 people were being treated, 43 of whom were in critical care.

Sixty of those in hospital were under five years old, 47 were aged five to 15, 189 were 16-64 and only 39 were over 65.

But exact figures for the numbers of people with a diagnosis of swine flu were no longer being given, because of the large numbers infected.

Sir Liam Donaldson, the chief medical offcier, said that about 27,000 people had consulted a GP with symptoms in the last week, but the HPA said its sampling showed that only about 28% – 8,000 or so people – of those had a flu-like illness.

Worst hit are London and the West Midlands, both showing epidemic levels of infection (defined as 200 cases per 100,000 population).

Donaldson said:”Even with seasonal flu, you start to see different parts of the country affected in sequence. I’m convinced when we do start to see a big surge it will sweep around the country.”

The government’s scientific advisory group has suggested there could be 100,000 new cases a day by the end of August. As of today , there were 9,718 laboratory-confirmed cases in the UK. Other countries with lower numbers are seeing more deaths, however: Argentina with 2,485 cases has had 60, Canada with 7,983 cases has had 25. Those who have died had underlying health problems.

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British swine flu death toll rises to 14

The Health Protection Agency reveals numbers hospitalised as London and West Midlands show epidemic levels of infection

The number of deaths from swine flu has risen to 14, the government’s chief medical officer has disclosed today, as the infection reached epidemic levels in the worst-hit parts of the country.

For the first time, the Health Protection Agency revealed a snapshot of the numbers going to hospital in a serious condition. Today, 335 people were being treated, 43 of whom were in critical care.

Sixty of those in hospital were under five years old, 47 were aged five to 15, 189 were 16-64 and only 39 were over 65.

But exact figures for the numbers of people with a diagnosis of swine flu were no longer being given, because of the large numbers infected.

Sir Liam Donaldson, the chief medical offcier, said that about 27,000 people had consulted a GP with symptoms in the last week, but the HPA said its sampling showed that only about 28% – 8,000 or so people – of those had a flu-like illness.

Worst hit are London and the West Midlands, both showing epidemic levels of infection (defined as 200 cases per 100,000 population).

Donaldson said:”Even with seasonal flu, you start to see different parts of the country affected in sequence. I’m convinced when we do start to see a big surge it will sweep around the country.”

The government’s scientific advisory group has suggested there could be 100,000 new cases a day by the end of August. As of today , there were 9,718 laboratory-confirmed cases in the UK. Other countries with lower numbers are seeing more deaths, however: Argentina with 2,485 cases has had 60, Canada with 7,983 cases has had 25. Those who have died had underlying health problems.

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Three more die as UK swine flu cases pass 7,500

• Two children are among the latest fatalities
• All victims had serious underlying health issues

Three more people have died of swine flu it was announced today, taking the death toll in the UK to seven.

All three victims, two of them children, had serious underlying health problems, according to NHS officials. One of the children, a nine-year-old from south London, died at the weekend. The family asked for their privacy to be respected.

The other two were Abdullah Patel, in his 40s, and a nine-year-old girl, Asmaa Hussain, both from Dewsbury, West Yorkshire. Asmaa, who suffered from epilepsy and attended a special school, died on Thursday. Patel, a teacher who was said to have worked at the Institute of Islamic Education in Savile Town, Dewsbury, died on Sunday.

Three children have now died. The first, Sameerah Ahmad in Birmingham, was six and had a rare, life-threatening disease that impaired her immune system. Only one victim has been elderly – a 73-year-old man in Scotland. The others were a 19-year-old man and a woman, aged 38. All had serious underlying health problems.

The virus is more likely to affect younger people than older. The chief medical officer, Sir Liam Donaldson, has said that the flu strain is part animal, part bird and part human, and that the human element had been in circulation in the past, with the result that the immune systems of older people may offer protection.

So far more than 7,500 people have been diagnosed with swine flu in the UK, although the numbers are now rising so rapidly that the Health Protection Agency is no longer providing them on a daily basis. London, the West Midlands and Scotland have been worst hit.

World Health Organisation figures show there have been 94,512 cases and 429 deaths. Many more people will have been infected but will not have been listed, because they did not see a doctor.

The vulnerability of younger people could mean they will be prioritised when a vaccine becomes available in August. The government has made provision for enough doses for the entire population, but they will arrive in batches. “We will have to debate what would be a sensible vaccine programme according to the delivery schedule,” Donaldson has said .

When the order was placed, it was assumed two doses of vaccine would be needed for each person. If it turns out that one dose is enough, it will go further. The first priority is likely to be people with underlying diseases or compromised immune systems, such as those undergoing cancer treatment. “Firstly it will be at-risk groups, then possibly age groups,” said Donaldson.

Most cases of swine flu have been and continue to be mild, except in those children and adults with existing serious health problems. However, there have been cases of severe illness involving hospitalisation, and even death, in some apparently previously healthy people in other countries. For that reason, everybody who is diagnosed with the virus in the UK will continue to be given antiviral drugs, the government said last week.

As of last week, however, when the authorities abandoned their containment strategy, people who fall ill are urged not to go to their doctor or to hospital, but to check their symptoms online at nhs.uk, or call the swine flu information line, on 0800 1 513 513. If they need drugs, a prescription will be issued for a healthy friend to collect.

Last week, the health secretary, Andy Burnham, said contingency planners had estimated the number of new cases could hit 100,000 a day by the end of August. The public health strategy is now to treat those affected rather than attempt to stop the spread. Schools, for instance, will only be closed if too many teachers are off sick to keep classes going, or if they cater for children who are particularly vulnerable.

The disease seems to be spreading faster in the UK than elsewhere. Donaldson said this was possibly because of the traditionally strong travel links between the UK and the US, where the virus has been spreading unchecked for some time.

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Children dead as swine flu toll rises

• Man and child from Yorkshire, child from London killed
• All victims had serious underlying health problems

Three more people, two of them children, have died of swine flu, it was announced today, taking the death toll in the UK to seven.

One of the children, a nine year-old from south London, died at the weekend. The family asked for their privacy to be respected and would not allow any information about the child’s health problems to be divulged.

The other two were a man and a child from the Kirklees area of West Yorkshire. All three victims had serious underlying health problems, according to local NHS officials.

Three children have now died. The first, Sameerah Ahmad in Birmingham, was six and suffered from a rare life-threatening disease which impaired her immune system and made her vulnerable to infections. Only one victim so far has been elderly – a 73-year-old man in Scotland. The others were a 19-year-old and a 38-year-old woman, who had recently given birth. All five had serious underlying health problems, according to NHS officials.

The virus is more likely to affect younger people than older. The chief medical officer, Sir Liam Donaldson, has said that the flu strain was part animal, part bird and part human and that the human element had been in circulation in the past, with the result that the immune systems of some of the older generation have some protective “memory” of it.

So far, more than 7,500 people have been diagnosed with swine flu in the UK, although the numbers are now rising so rapidly that the Health Protection Agency is no longer providing them on a daily basis. London, the West Midlands and Scotland have been worst hit so far.

The worldwide figures as of yesterday were 94,512 cases and 429 deaths, according to the World Health Organisation. Many more people will have been infected but will not be reported, because they have not seen a doctor.

The increased vulnerability of younger people could mean that they will be prioritised when the vaccine against swine flu becomes available, which should be by the end of August. Although the government has signed a contract for enough doses for the entire population, they will arrive in batches.

Most cases of swine flu have been and continue to be mild, except in those children and adults with existing serious health problems. However, there have been cases of severe illness involving hospitalisation and even death in some apparently previously healthy people in other countries. For that reason, everybody who falls ill and is diagnosed with swine flu in the UK will continue to be given antiviral drugs, the government said last week, rather than allowing the illness to take its course.

As of last week, however, when the government abandoned its containment strategy; people who fall ill are urged not to go to their doctor or to hospital accident and emergency departments. Instead, they are asked to check their symptoms online at www.nhs.uk or call the swine flu information line, on 0800 1 513 513. If they need drugs, a prescription will be issued for a healthy friend to collect.

Last week the health secretary, Andy Burnham, said contingency planners had estimated the number of new cases could hit 100,000 a day by the end of August. The public health strategy is now to treat those affected rather than attempt to stop the spread. Schools, for instance, will only be closed if too many teachers are off sick to keep classes going.

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Nine-year-old dies of swine flu

• All victims had serious underlying health problems
• Virus more likely to affect younger people

A second child has died from swine flu, it was announced today, bringing the death toll so far to five.

The latest victim, from south London, was nine years old. The other child to die, Sameerah Ahmad in Birmingham, was reportedly six. Only one victim has been elderly so far – a 73-year-old man in Scotland. The others were a 19-year-old teenager and a 38-year-old woman. All five had serious underlying health problems, according to NHS officials.

The virus is more likely to affect younger people than older. Chief medical officer Sir Liam Donaldson has said that one element of the strain had been in circulation in the past, with the result that the immune systems of the older generation have some protective “memory” of it.

There are almost 2,000 cases of swine flu in London, the second most affected area in the UK after the West Midlands. Last week there were warnings that the number of cases of swine flu could soar to 100,000 a day by the end of next month. Health chiefs said the UK had moved past the stage of containing the outbreak and into the “treatment phase”.

A spokesman for NHS London said the latest fatality happened over the weekend, and said the family did not wish more details to be be released.

He added: “Once again we wish to take this opportunity to remind the public that for most people this is a minor illness and that they should start to feel better after a few days without needing to go to their GP or A&E.

“However, some people may be more susceptible to the virus. If you have flu-like symptoms it’s important that you talk to your doctor if you are pregnant, very young, over-65 or have long-term conditions such as asthma or diabetes.”

He said NHS London was running a series of newspaper and radio adverts to provide advice about swine flu.

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Man is fourth in UK to die from swine flu

A 19-year-old man has become the fourth person in the UK to die of swine flu and the first in London.

The teenager, from south London, who has not been identified, had serious underlying health problems, as had all those who have died in the UK so far. He tested positive for the H1N1 virus after his death at Lewisham hospital on Wednesday.

So far there have been four deaths among the nearly 7,500 lab-confirmed cases. On Thursday the health secretary Andy Burnham said projections showed that if cases continued to rise at the current rate there would be 100,000 new cases a day by the end of August.

The number of deaths will inevitably also rise, but extrapolation from the four deaths so far would not be statistically valid because the numbers are too few. A Department of Health spokesman said suggestions that there could be 40 deaths a day by the end of the summer were wrong.

“Scientific and clinical experts can use sophisticated modelling techniques to help us understand how the virus may behave, but that is all they can do – be a guide, not a prediction,” he said.

Those whose immune systems are compromised, for instance through cancer treatment, or who have breathing problems, like asthmatics, or who are otherwise frail are at greatest risk from the virus. The south London teenager is the second youngest victim, after nine year-old Sameerah Ahmad, who was born with a rare life-threatening disease. The first victim was 38-year-old Jacqui Fleming, who died in hospital in Glasgow where she had been in intensive care since giving birth three months prematurely. The baby also later died, but not from swine flu.

The Department of Health said that it was possible to catch swine flu in hospital, where many people might be at risk because of their poor state of health. “Like any other place where there are lots of people, you could get it in hospital,” said a spokesman. “But we’re making sure that people with swine flu are isolated away from other patients and staff are very meticulous in their cleanliness.”

Another death is likely to add to the alarm created by the soaring numbers of cases, but chief medical officer Sir Liam Donaldson warned that people should not attempt to buy antiviral drugs such as Tamiflu over the internet.

Donaldson pointed out that the UK has one of the biggest stockpiles of the drug in the world and certainly enough to treat all cases of the disease here. He warned on Thursday against buying antiviral drugs on the internet.

All those who fall ill will receive Tamiflu, even though some experts think treatment is warranted only for those with other health problems. However, some of those who have become seriously ill and at least one who died elsewhere were apparently healthy before their infection.

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Public warned off web swine flu drugs

Fourth death in UK as chief medical officer says Britain has enough Tamiflu and online pills may be counterfeit

The government’s chief medical officer has warned the public against panic-buying swine flu drugs online after it was revealed that the number of new cases of the virus could reach 100,000 per day.

Professor Sir Liam Donaldson said Britain had a large stockpile of Tamiflu, the antiviral drug used to combat infection with the H1N1 virus, and there was no need for people to buy what were likely to be counterfeit medicines on the internet.

His comments came as a 19-year-old man was confirmed today as the fourth person with swine flu to die in the UK. The teenager from south London, who had other serious health problems, tested positive for the virus after his death on Wednesday.

The health secretary, Andy Burnham, yesterday told MPs the spread of swine flu in the UK could no longer be contained.

He said predictions showed the figure of up to 100,000 new cases diagnosed every day could be reached by the end of next month.

In a Commons statement yesterday, Burnham said the country had moved into the “treatment phase” of its response to the flu pandemic.

No more schools will be closed unless forced to by a lack of staff or if pupils are especially vulnerable.

Families and others in contact with infected people will not be given preventative antiviral drugs – a move some doctors predict could push people to go to internet pharmacies.

Donaldson told GMTV there was considerable concern that people might buy counterfeit drugs.

“People shouldn’t buy Tamiflu from the internet,” he said. “We have got a massive stockpile in this country, and everybody can have access to it through the National Health Service.”

The Royal Pharmaceutical Society’s director of policy, David Pruce, said most Tamiflu for sale online was probably fake because no legitimate online pharmacy would sell it.

“These sites could be based anywhere in the world,” he told BBC Radio 4′s Today programme. “They could be selling anything from sugar to rat poison.

“Counterfeiters are very good at producing goods that look like the genuine article. When it’s counterfeit medicines and you’ve got really no idea what’s in the tablet or the capsule, you’re taking your life in your hands.”

Pruce added that while people could get a private prescription for Tamiflu from their GP, there was no point in taking the drug unless they had symptoms.

There are now 7,447 diagnosed cases in the UK, but the number is doubling every week.

People who think they may have flu are advised to go online and check their symptoms on the NHS website or call the swine flu information line on 0800 1 513 513.

Anyone still concerned after that should phone their GP, who can provide a diagnosis over the phone.

If swine flu is confirmed, they will be issued with an authorisation voucher, which a “flu friend” can take to an antiviral drug collection point, which may be a pharmacy or a health centre.

The first doses of swine flu vaccine will arrive in the UK in August. Although the government has ordered enough for the entire population, it will arrive in batches.

At-risk groups – especially those vulnerable because of diseases which have compromised their immune systems or affect their breathing, such as asthma – would get it first.

The shift in the government’s swine flu strategy came as the World Health Organisation warned that the spread of swine flu was now “unstoppable”, with a total of 112 countries reporting nearly 77,201 infected people and 332 deaths since April.

Dr Margaret Chan, the WHO director general, told an international conference on swine flu in Mexico: “With well over 100 countries reporting cases, once a fully fit pandemic virus emerges its further international spread is unstoppable.”

Chan said there was “good reason to believe” the swine flu pandemic would be “of moderate severity, at least in its early days”.

But she said that while most deaths had so far occurred in people with serious underlying medical conditions, there were a few exceptions that raised alarm.

“For reasons that are poorly understood, some deaths are occurring in perfectly healthy young people,” she said.

“Moreover, some patients experience a very rapid clinical deterioration, leading to severe, life-threatening viral pneumonia that requires mechanical ventilation.”

So far, the fatality rate appears to be low. In the UK only four people have died. All had significant underlying health problems.

Jacqui Fleming, 38, of Glasgow, was the first person in the UK to die after contracting the virus. Fleming died last month, two weeks after her son, Jack, was born 11 weeks prematurely. The boy died later but had not contracted the virus.

The second victim was a 73-year-old man from the Inverclyde area of Scotland. Then a week ago today six-year-old Sameerah Ahmad, who was born with a rare life-threatening disease, became the youngest UK victim to date.

Health experts believe more people have caught swine flu but have shown no symptoms.

In the US the official figures show 27,725 Americans have contracted H1N1, with 127 deaths.

The Centres for Disease Control and Prevention, in Atlanta, estimate that one million Americans may have caught swine flu but not been to a doctor, suggesting fatality rates are as low as 0.012%, Burns said.

The European Centre for Disease Prevention and Control reported on Thursday that of 69,177 cases which had been detected worldwide only 328 people had died – a fatality rate of 0.47%.

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Swine flu ‘can no longer be contained’

More than 100,000 people could be diagnosed with swine flu every day by the end of August, the government said, announcing that the disease can no longer be contained in the UK.

A Commons statement by the health secretary, Andy Burnham, marks a watershed in the spread of the flu. No more schools will be closed, unless forced to by the lack of staff or if the pupils are especially vulnerable. Families and people in contact with those with flu will not be given preventative antiviral drugs.

The new policy of treatment for those with diagnosed illness, rather than containment, has already begun in the hotspots – chiefly London, Birmingham and Scotland.

The change of tactic is the predicted response to the swelling number of people infected. There are now 7,447 diagnosed cases in the UK, but the number is doubling every week. If they continue in this way, said Burnham in his statement, “we could see over 100,000 cases per day by the end of August”. He later stressed that the figure “is a projection. It is not a fact. This is how the disease could develop and we don’t know.”

Those sorts of numbers would put a heavy burden on the NHS, which is already feeling the strain in some areas. The new strategy will help keep those with possible symptoms out of GP surgeries.

People who think they may have flu are now being advised to go online and check their symptoms on the NHS website or call the swine flu information line, on 0800 1 513 513. Anyone still concerned after that should phone their GP, who can provide a diagnosis over the phone. If swine flu is confirmed, they will be issued with an authorisation voucher, which a “flu friend” can take to an antiviral drug collection point, which may be a pharmacy or a health centre.

But health officials in Scotland doubt the virus will spread dramatically across the UK, as it seems to have peaked in Scotland, which saw the first big outbreaks, and the first two deaths in Europe.

The rapid spread of the virus has slowed down in Paisley, which suffered the second largest outbreak, and it has disappeared in Dunoon, where a coachload of football fans were infected. In Glasgow, until recently the worst affected area of the UK, infection rates have stabilised. After infection rates peaked at 111 confirmed cases on 25 June, the rate in Scotland has remained steady at an average of about 60 new cases a day over the last week. There is no evidence that infection rates in Scotland, where the virus first arrived in late April, were doubling.

Dr Harry Burns, Scotland’s chief medical officer, said he was “now optimistic that sometime over the next few weeks, the rate of transmission will begin to slow down” [in Scotland].

It was entirely possible, he added, that the outbreaks elsewhere in the UK would also slow down in a matter of weeks.

The fatality rate also appears to be low. In the UK, only three people – all with significant underlying health problems – have died out of 7,447 confirmed cases. Health experts believe more people have caught swine flu but shown no symptoms.

In the United States, the official figures show 27,725 Americans have contracted H1N1, with 127 deaths. The Centres for Disease Control and Prevention, in Atlanta, estimates that a million Americans may have caught swine flu but not been to a doctor, suggesting that fatality rates are as low as 0.012%, Burns said.

The European Centre for Disease Prevention and Control reported on Thursday that of 69,177 cases which had been detected worldwide, only 328 people had died – a fatality rate of 0.47%.

However, Sir Liam Donaldson, the chief medical officer, said that it was not yet possible to work out the death rate from the virus, “given the unreliability of the data”, but that it would become clearer in the coming months.

The first batches of vaccine will arrive in August.

Although the UK has ordered enough for the entire population, it will arrive in batches. At-risk groups would get it first, said Donaldson: those especially vulnerable because of diseases which have compromised their immune systems or affect their breathing, such as asthma.

New flu strains cannot be eradicated. They simply become part of the seasonal flu mix. Donaldson said that swine flu could continue to cause extra deaths for five years. “We will need the vaccine in years to come,” he said.

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Swine flu ‘can no longer be contained’

More than 100,000 people could be diagnosed with swine flu every day by the end of August, the government said, announcing that the disease can no longer be contained in the UK.

A Commons statement by the health secretary, Andy Burnham, marks a watershed in the spread of the flu. No more schools will be closed, unless forced to by the lack of staff or if the pupils are especially vulnerable. Families and people in contact with those with flu will not be given preventative antiviral drugs.

The new policy of treatment for those with diagnosed illness, rather than containment, has already begun in the hotspots – chiefly London, Birmingham and Scotland.

The change of tactic is the predicted response to the swelling number of people infected. There are now 7,447 diagnosed cases in the UK, but the number is doubling every week. If they continue in this way, said Burnham in his statement, “we could see over 100,000 cases per day by the end of August”. He later stressed that the figure “is a projection. It is not a fact. This is how the disease could develop and we don’t know.”

Those sorts of numbers would put a heavy burden on the NHS, which is already feeling the strain in some areas. The new strategy will help keep those with possible symptoms out of GP surgeries.

People who think they may have flu are now being advised to go online and check their symptoms on the NHS website or call the swine flu information line, on 0800 1 513 513. Anyone still concerned after that should phone their GP, who can provide a diagnosis over the phone. If swine flu is confirmed, they will be issued with an authorisation voucher, which a “flu friend” can take to an antiviral drug collection point, which may be a pharmacy or a health centre.

But health officials in Scotland doubt the virus will spread dramatically across the UK, as it seems to have peaked in Scotland, which saw the first big outbreaks, and the first two deaths in Europe.

The rapid spread of the virus has slowed down in Paisley, which suffered the second largest outbreak, and it has disappeared in Dunoon, where a coachload of football fans were infected. In Glasgow, until recently the worst affected area of the UK, infection rates have stabilised. After infection rates peaked at 111 confirmed cases on 25 June, the rate in Scotland has remained steady at an average of about 60 new cases a day over the last week. There is no evidence that infection rates in Scotland, where the virus first arrived in late April, were doubling.

Dr Harry Burns, Scotland’s chief medical officer, said he was “now optimistic that sometime over the next few weeks, the rate of transmission will begin to slow down” [in Scotland].

It was entirely possible, he added, that the outbreaks elsewhere in the UK would also slow down in a matter of weeks.

The fatality rate also appears to be low. In the UK, only three people – all with significant underlying health problems – have died out of 7,447 confirmed cases. Health experts believe more people have caught swine flu but shown no symptoms.

In the United States, the official figures show 27,725 Americans have contracted H1N1, with 127 deaths. The Centres for Disease Control and Prevention, in Atlanta, estimates that a million Americans may have caught swine flu but not been to a doctor, suggesting that fatality rates are as low as 0.012%, Burns said.

The European Centre for Disease Prevention and Control reported on Thursday that of 69,177 cases which had been detected worldwide, only 328 people had died – a fatality rate of 0.47%.

However, Sir Liam Donaldson, the chief medical officer, said that it was not yet possible to work out the death rate from the virus, “given the unreliability of the data”, but that it would become clearer in the coming months.

The first batches of vaccine will arrive in August.

Although the UK has ordered enough for the entire population, it will arrive in batches. At-risk groups would get it first, said Donaldson: those especially vulnerable because of diseases which have compromised their immune systems or affect their breathing, such as asthma.

New flu strains cannot be eradicated. They simply become part of the seasonal flu mix. Donaldson said that swine flu could continue to cause extra deaths for five years. “We will need the vaccine in years to come,” he said.

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Swine flu ‘can no longer be contained’

Government moves to ‘treatment phase’ as health secretary says infection rate could reach 100,000 a day by end of August

Swine flu is spreading so rapidly across Britain that there could be 100,000 new cases a day by the end of next month, the health secretary, Andy Burnham, said today.

The UK would immediately move to the “treatment phase” of its plan to combat swine flu, meaning doctors would no longer test for the H1N1 virus and urge anyone with symptoms to stay at home, Burnham told the House of Commons.

The first swine flu vaccine would be made available from August, with 60m doses available by the end of the year, he added.

“We have reached the next stage in management of the disease,” Burnham said. “The national focus will be on treating the increasing numbers affected by swine flu. We will move to this treatment phase across the UK with immediate effect.”

The move does not mean the H1N1 virus, which was declared a pandemic by the World Health Organisation last month, is becoming more deadly, just that it can no longer be contained.

Burnham said there was a “considerable rise” in swine flu cases last week.

“We have always known it would be impossible to contain the virus indefinitely and at some point we would need to move away from containment to treatment.

“Cases are doubling every week and on this trend we could see over 100,000 cases per day by the end of August.

“The pressure on the system is such that it is the right time to take this step. Scientists can expect to see rapid rises in the number of cases.”

Burnham added that the public should be reassured by the steps being taken to tackle the virus. He said: “We are the only country in the world to be able to offer anti-virals to everyone as well as those at greater risk.”

The government’s chief medical officer, Professor Sir Liam Donaldson, said the production of a vaccine was “at an advanced stage” and denied that the outbreak was out of control.

Speaking at a special briefing at the Department of Health, he said: “We are continuing to take a very firm grip on this situation. We have a big stockpile of anti-virals, the biggest probably in the world. We have vaccine at an advance stage of production.”

Donaldson added that despite its rapid spread, the virus outbreak was “following a predictable path”.

The Health Protection Agency said a further 458 patients in England had been confirmed with swine flu, while the figure for the UK as a whole rose to 7,447.

Efforts to trace people who had been in contact with swine flu cases would now stop and schools no longer needed to close when hit by the virus, unless particular circumstances made it necessary.

The government has said that not everybody with swine flu would receive anti-viral drugs, which may be reserved for at-risk groups.

The daily collation of swine flu cases would also end because it was proving time-consuming. Instead, “more general” estimates of numbers would be given. Other affected countries already update their swine flu numbers less frequently, such as weekly or every other day.

The Scottish health secretary, Nicola Sturgeon, announced a similar shift in swine flu policy at a simultaneous briefing in Edinburgh.

She said: “We’ve always said it would be impossible to limit the spread of what is a contagious virus indefinitely.

“We’ve always said that, when it did start to spread more widely within communities, we would require to make a judgment about when to shift efforts from intense containment to treatment, or mitigation.”

Sturgeon, who is also the deputy first minister of Scotland, said “high-risk” groups such as children under five, pregnant women and the elderly would get priority access to medication.

Scotland’s chief medical officer, Harry Burns, said the country could expect to have a tenth of the UK cases of swine flu. He predicted there would be about 10,000 new cases a day in Scotland by August.

He said: “It could be a bit less, it could be a bit more. It also presupposes that there isn’t a downturn, if it continues to rise at this rate, and it’s doubling approximately every week, you can do the sums yourself.”

However, Scottish health officials said the swine flu infection rate may have already peaked, as the number of new cases in three hotspots in the greater Glasgow area appears to be in decline.

After infection rates peaked at 111 confirmed cases on 25 June, with Scotland experiencing the first two swine flu deaths in Europe, the rate has remained steady at about 60 new cases a day over the last week.

The rapid spread in two of the major hotspots – Dunoon in Argyll and Paisley south of Glasgow – now appears to have stopped and cases have begun to decline sharply.

The official statistics on the virus were likely to underestimate the true scale of infection in the UK because now only a sample of patients in the hotspots had a diagnosis of swine flu confirmed by lab tests. Many people were thought to have such mild symptoms that they were not bothering to contact their doctors while others were being treated in surgeries without being regarded as suspected swine flu cases.

In swine flu hotspots such as London, the West Midlands and parts of Scotland diagnosis of the virus was already being done by doctors rather than laboratory testing, and tracing the contacts of people with swine flu and the use of preventative anti-viral drugs had stopped. Anti-viral drugs were still being offered to all people with symptoms.

Although a bout of swine flu was currently causing less serious illness than traditional seasonal flu, three people with other serious health conditions in the UK have died after catching the virus and there are concerns it could mutate into a more virulent form.

The chief medical officer, Sir Liam Donaldson, has warned that there may be tens of thousands of cases each week this autumn, because the virus is more likely to thrive in a colder climate.

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Burnham to alter swine flu approach

Health secretary Andy Burnham to make Commons statement on changes to way outbreaks are managed

The government is due to announce a major change in its handling of swine flu outbreaks today, with the daily recording and reporting of cases expected to be abandoned because of the increasingly rapid spread of the virus.

The health secretary, Andy Burnham, is due to make a statement on swine flu in the House of Commons just after midday. With the number of cases confirmed by laboratory tests set to exceed 7,000 today, it is likely that the policy of trying to contain the H1N1 virus may be abandoned in favour of “outbreak management”.

In swine flu hotspots such as London, the West Midlands and parts of Scotland, which have already moved to the outbreak management phase, diagnosis of the virus is now being done by doctors rather than laboratory testing and tracing the contacts of people with swine flu and the preventative use of anti-viral drugs has stopped. Anti-viral drugs are still being offered to all people with symptoms.

Collating daily figures is proving time consuming but the government and other agencies recognise they still need other ways of regularly informing the public.

Other countries already update their swine flu numbers less frequently, for instance, weekly or every other day. Among the options being considered by the government is weekly updates on the spread of the disease, with cases reported as a number per 100,000 of the UK population. This is how traditional flu cases are reported each winter, and with the NHS preparing for tens of thousands of swine flu cases a week by the end of this year, a similar system would be understood by public health experts.

The Health Protection Agency yesterday announced another 342 patients in England have been confirmed with swine flu, while the figure for the UK as a whole rose to 6,929.

The official statistics on the virus are likely to underestimate the true scale of infection in the UK because only a sample of patients in the hotspots now have a diagnosis of swine flu confirmed by lab tests. Furthermore many people are thought to have such mild symptoms they are not even bothering to contact their doctors and others are being treated in surgeries without being regarded as suspected swine flu cases.

Although a bout of swine flu is currently causing less serious illness than traditional seasonal flu, three people with other serious health conditions in the UK have died after catching the virus and there are concerns that it could mutate into a more virulent form.

The chief medical officer, Sir Liam Donaldson, has already warned that there may be tens of thousands of cases each week this autumn, because the virus is more likely to thrive in a colder climate.

Meanwhile, senior doctors have warned parents not to take their children to “swine flu parties” in the hope that they catch the disease now and build up immunity.

Although no firm evidence has emerged that these are taking place, the family website mumsnet.com has seen discussions between parents on whether they should deliberately expose their offspring to the virus in the same way that chickenpox parties are sometimes arranged to allow friends to have the once-only disease at a convenient time.

Richard Jarvis, of the British Medical Association’s public health committee, said: “I think parents would want to take into account that the flu – although this strain is relatively mild for the most part – is something that will knock people off their feet for a few days and we are seeing appreciable morbidity, severe side-effects and sadly the occasional death.”

Scientists have found the first case of the new H1N1 influenza strain showing resistance to Tamiflu, the main anti-viral flu drug, Danish officials and the manufacturer said yesterday. It was expected that the strain would at some point show resistance to Tamiflu, Denmark’s State Serum Institute said. The patient is now well and no further infection with the resistant virus had been detected.

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Hajj officials confront swine flu threat

Saudi workshop discusses ways to minimise spread of swine flu during pilgrimage season

The elderly, young, infirm and pregnant should stay away from this year’s hajj to avoid catching swine flu, Saudi health officials said today.

Their recommendations followed a workshop aimed at minimising the spread of the disease during the pilgrimage season, which attracts about 4 million Muslims from around the world.

Other measures include vaccinating people at least a fortnight before their arrival in the country and encouraging international delegations to stock medication to prevent and treat the virus causing swine flu.

Participants in the workshop stressed the need to encourage pilgrims to cover their noses when sneezing, cough into tissues and wash their hands with soap. Face masks, another precaution, are already worn by pilgrims to protect against pollution in Mecca and Medina.

The Saudi health minister, Dr Abdullah Al-Rabeeah, said at a press conference in Jeddah that the World Health Organisation experts who took part in the workshop were satisfied with the safeguards in place.

Asked about the efficacy of vaccines against swine flu, he said: “The available vaccines are yet to be evaluated and assessed, a process that might take months.” He disagreed with claims that the media had exaggerated the threat posed by swine flu, saying: “The danger of the disease comes from the absence of immunity and vaccination against it.”

Fever-detecting cameras will be installed at King Abdulaziz airport in Jeddah, the main gateway for pilgrims entering Saudi Arabia. This week another six cases were announced in the country, raising the total to 81.

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Schoolgirl is England’s first swine flu death

Schoolgirl dies in Birmingham hospital after catching virus on top of existing health problems, becoming third UK victim

A young girl has become the third person to die in the UK after catching swine flu, as the total of confirmed cases in the country passed 6,000.

The girl, who had other significant health problems, died at Birmingham children’s hospital on Friday evening. Her death is the first in England associated with swine flu, although it is not yet known if it contributed to her death.

Two people, also with other significant health problems, died at a hospital in Paisley, Scotland. They were an unnamed 73-year-who died on Saturday night after 15 days in intensive care, and Jacqui Fleming, 38, who died after giving birth prematurely more than two weeks ago.

As details of the girl’s death emerged, the government’s Health Protection Agency announced a big jump of 1,604 in the number of patients in England confirmed with swine flu. The figure for the UK as a whole rose to 6,133. Changes in the way health officials are confirming cases in areas where the disease is most prevalent may complicate judgments about how fast the disease is spreading.

The chief medical officer, Sir Liam Donaldson, has already warned that there may be tens of thousands of cases each week this autumn, because the virus is more likely to thrive in a colder climate.

The family of the girl who died has asked for her identity to be kept private. Andy Burnham, the health secretary, said: “Tragic as today’s death is, I would like to emphasise that, across England, the majority of swine flu cases have not been severe.

“The risk to the public remains low and we can all play our part in slowing the spread of the virus by following simple hygiene procedures – like washing your hands and using tissues when coughing or sneezing. We are making sure arrangements are in place so that the UK remains well placed to deal with this pandemic.”

Vivienne Nathanson, head of science and ethics at the British Medical Association, said: “Flu can kill completely healthy people if they get pneumonia, but if they have got health problems they are more likely to get complications.

Nathanson said that as public health officials gathered more information on complications, doctors might start to be able to identify higher risk groups at higher risk. “That will help us in future to vaccinate the people at highest risk.”

Six people had suspected swine flu at the Glastonbury festival. Health officials said this was remarkably low, but the incubation period of three to four days means other cases may emerge.

A handful of ball boys and girls at Wimbledon, where attendance has reached 40,000 a day, have been advised to stay at home after suffering flu-like symptoms. Anyone with symptoms has been advised to ring NHS Direct or GP surgeries for advice, rather than going to surgeries and risking infecting more people.

Because of the outbreak’s scale, health officials in hotspots such as London, the West Midlands and parts of Scotland are no longer tracing people who have come into contact with confirmed cases. Doctors are now confirming cases on the spot, rather than through laboratory results. The official statistics at present include only cases confirmed in laboratories.

The jump reported in England covered new cases confirmed between Thursday lunchtime and Sunday lunchtime. But the figure for Scotland rose later in the day from 922 to more than 1,118, six of whom were being treated in hospital.

Scientists have found the first case of the new H1N1 influenza strain showing resistance to Tamiflu, the main antiviral flu drug, Danish officials and the manufacturer said yesterday. It was expected that the strain would at some point show resistance to Tamiflu, Denmark’s State Serum Institute said. The patient was now well and no further infection with the resistant virus had been detected.

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Pensioner second Briton to die from swine flu

An elderly man from the Glasgow area has become the second Briton to die from swine flu.

The 73-year-old, who had other very serious underlying health problems and has not yet been named, died at the Royal Alexandra hospital in Paisley on Saturday night. He had been in intensive care for 15 days, health officials said.

Nicola Sturgeon, the Scottish health secretary, said: “Our thoughts are with the family and friends of the patient at this tragic and very sad time. The family have asked for the patient’s identity to be kept private.

“Although it is concerning that the patient had swine flu, we are aware that the patient had very serious underlying health issues.”

A family spokesman said: “Our beloved relative was private in life and we would ask that his privacy continues to be respected.”

The first Briton to succumb to the H1N1 virus, Jacqui Fleming, also died at the Royal Alexandra after giving birth prematurely to her third child. She was the first person outside the Americas to die after contracting the virus.

Fleming also had significant underlying health problems and had been critically ill for several weeks before she died.

Officials have repeatedly stressed that the virus appears to be relatively mild.

The latest official figures show that 4,322 Britons have so far contracted the virus, with significant outbreaks now in Birmingham, London and the Glasgow area, but health experts believe the real figure will be much higher.

In the US, specialists at the Centers for Disease Control in Atlanta estimate that at least 1 million Americans may have had swine flu and not been diagnosed, although the official figures put confirmed US cases at 27,717, with 127 deaths.

However, the virus is now spreading quickly in the southern hemisphere, where it is winter – the traditional season for flu epidemics.

The last update of the World Health Organisation put total cases at 59,814 with 263 deaths.

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Scottish man dies from swine flu

73-year-old man from Glasgow, who had been in intensive care for 15 days, is second Briton to die from swine flu virus

An elderly man from the Glasgow area has become the second Briton to die from swine flu.

The 73-year-old, who had other very serious underlying health problems and has not yet been named, died at the Royal Alexandra hospital in Paisley late on Saturday night. He had been in intensive care for 15 days, health officials said.

Nicola Sturgeon, the Scottish health secretary, said: “Our thoughts are with the family and friends of the patient at this tragic and very sad time. The family have asked for the patient’s identity to be kept private.

“Although it is concerning that the patient had swine flu, we are aware that the patient had very serious underlying health issues.”

A family spokesman said: “Our beloved relative was private in life and we would ask that his privacy continues to be respected as we try to come to terms with our loss.”

The first Briton to succumb to the H1N1 virus, Jacqui Fleming, also died at the Royal Alexandra after giving birth prematurely to her third child. She was the first person outside the Americas to die with the virus.

Fleming also had significant underlying health problems, and had been critically ill for several weeks before she died. Her baby, named Jack by her partner, William McCann, died the following day.

Health officials have repeatedly stressed that the virus appears to be relatively mild, despite its rapid transmission around the world.

The latest official figures show that 4,322 Britons have so far contracted the virus, with significant outbreaks now in Birmingham, London and the Glasgow area, but health experts believe the real figure will be much higher.

In the United States, specialists at the Centers for Disease Control in Atlanta estimate that at least one million Americans may have had swine flu and not been diagnosed, although the official figures on Friday put confirmed US cases at 27,717, with 127 deaths.

However, the virus is now spreading quickly in the southern hemisphere, where it is winter – the traditional season for flu epidemics.

In Australia, where confirmed cases stood at 3,280, four people have now died, all with underlying health problems. There have been 21 deaths reported by the World Health Organisation in Argentina and seven in Chile. The last WHO update put total cases at 59,814 with 263 deaths.

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Collaboration can’t cure #swineflu, but it can fight filter failure

Perhaps you’ve noticed a bit of activity online the last few days related to a certain not-quite-pandemic bug that’s going around.
Swine Flu.
Or, to put it in microblogging terms, #swineflu.
The wonderful thing about the ease of communication online is that anyone can start a discussion, carry it on, pass along information, retweet it, forward an e-mail, [...]