PROTECT Swine Flu Outbreak Top Lines Briefing No 84

Updates are sidelined As 1/10/09

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BACKGROUND

The World Health Organization has declared Phase 6 of its pandemic alert system, which means that swine flu is now spreading in communities in several countries. The National Pandemic Flu Service was launched in England on 23rd July 2009.

THE NATIONAL PANDEMIC FLU SERVICE

To Log on go to www.direct.gov.uk/p andemicflu or call 0800 1 513 100 or Textphone 0800 1 513 200

TOP LINES
Rates of flu-like illness and related activity have shown further increases in England This week, the antiviral collection numbers in the National Pandemic Flu Service in England have continued to increase and this has been seen in all age groups. The largest increase was in the 25-44 year olds (8,796 in week 38 to 12,055 in week 39). HPA modelling gives an estimate of 14,000 new cases in England last week (range 7,000 to 30,000). This is a 50 per cent rise since the previous week. However, interpretation of data to produce estimates on the number of new cases continues to be subject to a considerable amount of uncertainty. In Scotland, this week's figures consist of data from 732 GP practices for the first time, compared to 58 practices last week, to allow a more comprehensive picture of consultation rates. Using this data Health Protection Scotland have estimated that the total number of people in Scotland who have contracted H1N1 over the last week is 13,800, approximately double compared to last week. It was announce today that UK Health Ministers have agreed to double ECMO facilities at the UK centre in Leicester. In addition there has been confirmation from the EU Commission that the GSK vaccine is now officially licensed. Globally, activity is generally increasing in the northern hemisphere, is variable in the tropical regions and has largely returned to baseline in the southern hemisphere. The majority of cases continue to be mild, although there continue to be a low, if tragic, number of deaths and some hospitalisations. People can still speak to their GP if they are concerned. In fact - it is important to stress that people with underlying health conditions, pregnant women, and parents with children under the age of one should speak to their GP if they have symptoms. Scotland and Wales do not yet need to switch on their National Pandemic Flu Service. This situation is being kept under constant review and the Service can be opted into if needed. People in Northern Ireland who are worried about flu-like symptoms should stay at home and continue to contact their GP or the Northern Ireland helpline which operates daily from 8am-8pm
FOR

UK SWINE FLU LINKED DEATHS* AS AT 17/9/09

Scotland 9 Northern Ireland 2 Wales 1 England 72 TOTAL 84
*Deaths associated with Swine Flu: This figure represents deaths where A//H1N1 [Swine Flu] is recorded in either part 1 or 2 of the death certificate, or where a positive laboratory test for A/H1N1 has been returned.

KEY CONTACT INFO

The Swine Flu Information Line is available within GB on: 0800 1 513 513 In Northern Ireland call: 0800 0 514 142. If calling from overseas call: 00 44 207 928 1010. The Swine Flu Information booklet can be downloaded from the web addresses at the end of page 2. Before travelling, check the FCOs website country specific information on: www.fco.gov.uk. Those without internet access can call the FCO's 24-hour advice line on 0845 850 2829. NHS Direct 0845 4647 In Scotland call NHS Scotland on 08454 242424

PRIORITY GROUPS

VACCINATION

On 13/8/09 Ministers from all four nations accepted the advice of the Joint Committee on Vaccination and Immunisation on priority groups for H1N1 vaccination.' This advice was also scrutinised and endorsed by the Scientific Advisory Group for Emergencies (SAGE). Vaccination of frontline health and social care workers will begin at the same time as the first at-risk group, and will continue for as long as necessary. The following groups will be prioritised in this order are: People aged over six months and under 65 years in current seasonal flu vaccine clinical at-risk groups. All pregnant women, subject to licensing conditions on trimesters. TLB No 84 Updates to nccinformation@cabinet-office.x.gsi.gov.uk or on 020 7276 5104 PROTECT

PROTECT Swine Flu Outbreak Top Lines Briefing No 84

Updates are sidelined As 1/10/09

Household contacts of people with compromised immune systems e.g. people in regular close contact with patients on treatment for cancer. People aged 65 and over in the current seasonal flu vaccine clinical at-risk groups. This does not include otherwise healthy over 65s, since they appear to have some natural immunity to the virus.
WITH

VACCINATION AGREEMENT

GPS

The upcoming swine flu vaccination programme will be administered by GPs following successful negotiations between the Department of Health, General Practitioners Committee (GPC) of the British Medical Association (BMA) and NHS Employers., The vaccination programme, which is expected to begin in the autumn, subject to the vaccine being licensed, will target the nine million people most at risk from complications. The new deal will mean that GP surgeries will receive 5.25 per dose of vaccine given. The additional money will come from the Department of Health budget and will help surgeries to contact patients, administer the vaccine and, if necessary, take on extra staff. It is currently expected that patients will receive two doses of the vaccine. This advice may change following clinical trials.

THE

POSITION AROUND THE COUNTRY

England Scotland Wales

N. Ireland

The flu-like illness rate in England from the Royal College of General Practitioners (RCGP) scheme increased to 22.2 per 100,000 in week 39. Most age groups saw an increase. A rate of GP consultations for flu-like illnesses - not necessarily H1N1 - across Scotland of 103.7 per 100,000 Using the new methodology this represents a 7% increase from last week. The number of community samples that tested positive for H1N1 has almost doubled from 17.6 to 34.1 per cent. The report from 29 September estimates there were 35.0 cases of a flu-like illness diagnosed by GPs out of every 100,000 people in Wales this is the equivalent of 1,050 people in Wales contacting their GPs in the last seven days with flu like symptoms. Not all of these people will have swine flu and not everyone with flu like symptoms will contact their GP. It is expected that the proportion of influenza cases diagnosed that are due to swine flu will increase as the virus spreads in Wales. 1GP consultation rates for combined flu/ FLI have risen from 142.5 in Wk 38 to 208.3/100,000 population in Wk 39 (46% increase), reaching the highest rate since the start of the enhanced influenza surveillance program began. Rates highest in the 5-14 age group. OOH calls for flu/FLI have increased to 625 (43% increase) in Wk 39 and are highest in the 5-14 age group. Sixty-one swine influenza detections A/H1N1v in Wk 39 (highest weekly number reported to date).

VACCINE DONATION

The UK will provide up to 23 million to help the developing world tackle the H1N1 pandemic, Development Secretary Douglas Alexander has announced. The commitment is equivalent to 10 percent of domestic supply of vaccine. The UK will also make H1N1 vaccine available to the WHO on a rolling basis as vaccine supplies become available. This will enable the United Nations to provide the poorest countries with H1N1 vaccine and other pandemic response measures as required.

CRITICAL CARE CAPACITY

On 10th September, Ian Dalton wrote to Chief Executives in the NHS confirming that ventilated critical care capacity could be doubled in the NHS during the peak weeks of a potential second wave in the months ahead; and sustain this additional capacity for at least 8 weeks. The published full critical care strategy sets out how the NHS will collectively achieve this increase. Some examples of the measures include: creating additional Level 3 beds by upgrading Level 2 and post-operative surgical beds; specialist medical and nursing staff caring for more patients than usual; staff with experience of working in critical care redeployed to critical care units; redeploying ventilators and other essential equipment; temporary postponement of inpatient elective surgery and reduction in outpatient activity.

REVISED PLANNING ASSUMPTIONS

The original pandemic plan suggested that a single wave could infect up to half the population. Estimates published in July were much lower and gave a maximum clinical attack rate of less than a third of the population (30%). More data on the virus meant we could update the planning assumptions in September and the estimates for hospitalisation and fatality rates have been reduced. The updated planning assumptions indicate that: Up to 30 per cent of the population may become ill with flu at some point over the course of the pandemic 1 per cent of people who become ill with flu may require hospitalisation. 0.1 per cent of people who become ill may die from the virus.

TLB No 84 Updates to nccinformation@cabinet-office.x.gsi.gov.uk or on 020 7276 5104 PROTECT

PROTECT Swine Flu Outbreak Top Lines Briefing No 84

Updates are sidelined As 1/10/09

KEY WEBSITES

Directgov (www.direct.gov.uk/swineflu) the primary government website for essential cross-government swine flu messages; NHS Choices (www.nhs.uk) the primary public-facing health information and advice service; the Department of Health website (www.dh.gov.uk) the home of content relating to health and care professionals; and Business Link (www.businesslink.gov.uk/swineflu) the home of business-related information. The dedicated Swine Flu page on the FCO website is at: www.fco.gov.uk/en/travelling-and-living-overseas/swine-flu.

TLB No 84 Updates to nccinformation@cabinet-office.x.gsi.gov.uk or on 020 7276 5104 PROTECT