2009 flu pandemic in the United Kingdom
Encyclopedia
The 2009 flu pandemic
is a global outbreak
of a new strain of influenza A virus subtype H1N1, first identified in April 2009, termed Pandemic H1N1/09 virus
by the World Health Organization
(WHO) and colloquially called swine flu. The outbreak was first observed in Mexico, and quickly spread globally. On the 11 June 2009, the WHO declared the outbreak to be a pandemic. The overwhelming majority of patients experience mild symptoms", but some persons are in higher risk groups, such as those with asthma
, diabetes, obesity
, heart disease
, or who are pregnant or have a weakened immune system
. In the rare severe cases, around 3–5 days after symptoms manifest, the sufferer's condition declines quickly, often to the point of respiratory failure
.
The virus reached the United Kingdom in April 2009. The first cases were confirmed on 27 April 2009 in passengers returning from Mexico. The first case of person to person transmission within the UK was announced on 1 May 2009. In the UK, 5–14 year olds are the age group predominantly affected. Laboratory tests have demonstrated that older people have some immunity.
After a slow start, the virus spread rapidly in the UK in July 2009, with new cases peaking at 110,000 in the last week of that month, according to The Health Protection Agency's modelling estimate, but declining sharply in the first week of August 2009. Cases fell progressively down to 3,000 in the first week of September 2009, then began to rise again. The decline in cases during the summer had been predicted, but a large surge was expected in the autumn to coincide with the normal flu season. Cases rose to 84,000 by the end of October, well below the summer's peak and then declined during November.
Deaths are often reported as occurring "after contracting the swine flu virus" without flu being necessarily the cause of death of people with underlying health problems.
Researchers at Imperial College London said in July 2009 that the best estimate was that about 0.5% of those who get swine flu bad enough to seek medical help die from it, a figure very similar to the estimate for seasonal influenza.
cabin crew was taken to Northwick Park Hospital
in Harrow
and quarantined after falling ill with flu-like symptoms on a flight from Mexico City though he was later found not to have swine flu.
On 26 April, two people were admitted to Monklands Hospital
in Airdrie
, North Lanarkshire
, with mild flu-like symptoms after returning from Mexico. The next day, the Cabinet Secretary for Health and Wellbeing
, Nicola Sturgeon
, confirmed that these were cases of the swine influenza A (H1N1) virus. Authorities in both Scotland and England stated that there were no plans to trace the fellow airline passengers who may have travelled alongside the couple, since the authorities do not classify them as "close contacts". These cases along with one in Spain are the first confirmed cases in Europe.
At noon on 29 April the government reported three more confirmed cases in the UK, including the first cases in England. All three had recently returned from Mexico. The secondary school, Paignton Community and Sports College, closed for seven days.
By 26 May the number of people who had contracted the disease in-country increased to 125, the highest in Europe and triple the second highest, Spain.
On 28 May, sixty four people connected with a primary school in Birmingham were diagnosed with swine flu .
On 8 June the HPA issued a report stating that the majority of cases are in school age children and young adults, which has not been the case in most pandemics with the notable exception of 1918.
On 25 June the chief medical officer Sir Liam Donaldson said certain areas were seeing rapid community spread which meant that it was no longer practical to attempt in those areas (initially parts of London, the west Midlands and east Berkshire) to put a ring around the outbreaks by tracing the people with whom confirmed cases have come into contact and giving them drugs to try to prevent flu developing. In these areas, anti-viral drugs may in the future only be given to people showing symptoms, and tracing of contacts will stop. The contingency plans always envisaged the containment phase would not last indefinitely. The start of the treatment (as against containment) approach was announced on 2 July 2009.
Every year in late June and early July the Wimbledon
tennis championships are held in London, attracting worldwide interest and with many hours of UK television coverage every day. On 1 July 2009 it was reported that 28 Wimbledon staff had been asked to stay at home with flu-like symptoms. Two named players are reported to have caught the virus.
A study published in the August 2009 issue of The Lancet
(available on 20 July) suggests that prolonging the school holidays could reduce the spread of the virus by up to 17%. This would be disruptive, and would not reduce the overall number of infections, but could delay the spread and buy time for preparation of a vaccine. The government's advice is that schools should not be closed, but that the evidence will be reviewed in August as school summer holidays end.
announced that television and radio advice would also be broadcast starting on 30 April. On 30 April 2009, a swine flu information line was launched with advice on setting up "flu friends" (this is not the National Flu Line service mentioned below).
The Department of Health Pandemic Plan (revised November 2007) states "UK health departments (directorate in Scotland) will run a national door drop and advertising campaign in Phase 5, alerting the public to the heightened risk, emphasising the need for personal preparation and socially responsible behaviour. A public information film will demonstrate how to slow the spread of the virus, and the National Flu Line service will be available. Information materials will also be available through primary care, pharmacies and on the Department of Health website." After criticism of the lateness of its launch, it was announced in late July that the National Flu Line service was to be launched on 24 July 2009.
There are government websites with general information and the latest updates on human swine flu in England, Northern Ireland,Northern Ireland Department of Health, Social Services and Public Safety update on confirmed swine flu cases: 29 June 2009 (this link will be updated to reference the latest update) Scotland, and Wales.
The HPA website includes frequently updated advice for the public, advice on exclusion from schools and workplaces (and a document specifically for schools), and information for health professionals.
During the initial containment phase of the swine flue outbreak the HPA published detailed information in daily and weekly reports linked from its Epidemiological data page on its website. On 2 July, when the policy of containment was dropped in favour of treatment of presumed cases, the daily updates of laboratory confirmed cases were stopped. A weekly epidemiological update and pandemic flu update are published each Tuesday, with much detailed information including regional information and breakdown by age.
considered that H1N1 swine flu was spreading fast enough to justify the preparations for a pandemic. It was showing "sustained human-to-human transmission", thereby justifying the WHO's pandemic phase 5 rating. It is estimated that on average each person who contracts flu passes it on to between 1.4 and 1.6 other people, no worse than the three influenza pandemic
s of the twentieth century. Early analysis suggested that the spread was likely to be similar to the earlier pandemics. Up to the date of the study, clinical severity was similar to 1957
and less than 1918 flu pandemic. However, the clinical severity of the outbreak and how the virus will evolve cannot yet be predicted.
in Mexico... "may wish to consider whether they should remain in Mexico at this time". On 28 April the Mexican Tourist Board estimated that there were "a few thousand" British tourists in Mexico.
Holiday companies Thomas Cook
and Airtours said that between them they had about "3,000 holidaymakers in Mexico" as of 28 April 2009. The first British tourists being brought back early from Mexico on 28 April 2009 told reporters that they had received little or no information about health precautions, either from the Mexican authorities, hotels, or from local tour guides.
A leaflet is being distributed at all ports of entry into the UK providing passengers arriving in the UK with information on swine flu.
Until 21 May HPA staff met travellers arriving from Mexico. This was discontinued on 22 May, but advice remained that travellers from affected areas who become unwell within seven days of arrival, and contacts with symptoms of a confirmed or probable case, should stay at home and contact their GP or NHS Direct
. Contact tracing of passengers deemed to be at risk of swine flu will be carried out on the basis of risk, as for other communicable diseases.
Information, advice, and guidance both general and for specific cases (schools, workplaces) is being made available and updated by the HPA (see Public information campaign section above).
As of 13 June 2009 the government estimated that the UK has enough anti-viral drugs for 50% of the population but has plans to raise that figure to 80%.
There is a pandemic plan covering topics from distributing the drugs and setting up helplines to closing schools and banning public events which was tested in a large exercise in 2007. There is also a specific response plan for London. Oseltamivir
(Tamiflu) and zanamivir (Relenza), the two anti-virals known to be effective, must be taken within 48 hours of onset of symptoms or earlier to be effective; the positive effects are greatest if treatment is started within six hours.
The HPA reported in its 24 June 2009 weekly epidemiological report that all 17 samples of the virus laboratory tested for resistance that week were found to be sensitive
to oseltamivir and zanamivir, but resistant to amantadine
. The first case of resistance of the virus to oseltamivir, in Denmark, was reported on 29 June 2009.
On 5 May 2009 plans were announced for pupils unable to sit examinations at schools affected by flu to be assessed in other ways to ensure that children are not disadvantaged.
The Department of Health has listed all the pandemic flu guidance that it had published as of 8 June 2008.
in London, which is also examining samples of the U.S. strain of the disease.
By 8 May 2009 the US Centres for Disease Control and Prevention had made genetic information on the swine flu virus available, and the virus from European samples had been isolated and its full genetic fingerprint determined by UK researchers. The genetics and effects of the virus in general are discussed in the article on the 2009 swine flu outbreak.
method, described as a real-time method. According to the World Health Organization there are four laboratories in the UK able to perform PCR to diagnose influenza A (H1N1) virus infection in humans: Regional Virus Laboratory, Royal Victoria Hospital, Belfast
, NI; Regional Virus Laboratory, Gartnavel General Hospital
, Glasgow, Scotland; Health Protection Agency, Centre for Infections, Enteric, Respiratory, & Neurological Virus Laboratory
, London; WHO Collaborating Centre for Reference and Research on Influenza
, National Institute for Medical Research, London.
Another laboratory confirmation is a fourfold increase in virus-specific antibodies 10 to 14 days later.
From 2 July 2009 when a treatment, rather than containment, approach was adopted, the official clinical diagnostic criteria became: "fever (pyrexia ≥38 °C) or a history of fever, and also influenza-like illness (two or more of the following symptoms: cough; sore throat; rhinorrhoea; limb or joint pain; headache; vomiting or diarrhoea) or severe and/or life-threatening illness suggestive of an infectious process".
"Laboratory confirmed" cases
Professor Neil Ferguson, an epidemiologist at Imperial College London, who advises the Government and the World Health Organisation, said on 8 June 2009 that HPA statistics were at best accounting for half of cases.
In the USA
mathematical modelling based on surveys estimated that there were about 1 million cases of H1N1 flu on 25 June 2009, compared to 28,000 reported officially. Such a study has not been carried out in the UK.
As of 2 July 2009 GPs will diagnose based on clinical observation and routine swabbing will stop, and the HPA will "no longer be providing a daily update of the numbers of cases confirmed through laboratory tests"
When the issue of touching your eyes, nose or mouth is combined with other infection control
practices and good hygiene measures as recommended by the Health Protection Agency's website, the following recommendations emerge as important ways to help reduce the spread of swine flu and other viruses:
For people belonging to a high-risk group it is particularly important that they start taking anti-virals as soon as possible after infection. High-risk groups include people with long-term conditions, those over 65, children under five and pregnant women.
published in May 2009 found that children had no pre-existing immunity
to the new strain but that adults, particularly those over 60, had some degree of immunity. Children showed no cross-reactive antibody
reaction to the new strain, adults aged 18 to 64 had 6–9%, and older adults 33%. The large proportion of cases in the UK affecting children and young adults is consistent with this pattern of resistance.
vaccine
s give little or no immunity against the new strain of flu. There is an international program to produce a vaccine which will be effective against the new H1N1 strain. The chief medical officer Sir Liam Donaldson said on 25 June that it seemed likely that the UK would receive the first batches of vaccines slightly earlier than expected, possibly from August rather than the autumn as first expected, although some industry sources do not expect supplies to be available so soon. The government has contracts for 132 million doses. There are risks involved in shifting resources to the new vaccine: it will not be possible to produce the seasonal flu vaccine, and it is possible that the virus will mutate
to make a vaccine developed before the mutation ineffective.
The then Health Secretary
Alan Johnson told MPs on 27 April that "Although we are aware that face-masks are being given out to the public in Mexico, the available scientific evidence
does not support the general wearing of face-masks by those who are not ill, whilst going about their normal activities."
Professor Steve Field, chairman of the Royal College of General Practitioners, said people in the UK were "perfectly safe at the moment", and did not need to start wearing face-masks or stop eating pork.
The Head of Pandemic Planning at the Royal College of General Practitioners
, Dr Maureen Baker, stated on 27 April that "Masks become ineffective when they become damp or after a few hours. There has been a lot of debate on the use of face-masks and some authorities say that, in the community, the most effective use is to give to patients who may have symptoms when they present in the surgery – that should help reduce the infectivity of that patient to surgery staff and other patients. I expect the Department of Health will issue guidance on use of face-masks if we move into a pandemic phase." Masks may not protect the wearer from inhalation of the virus, but might protect other people from picking up the virus from the wearer.
Professor John Oxford, a virologist at leading London hospital, The Barts and the London
, said: "Really, there is very little evidence that masks actually offer much protection against flu."
It is reported that the UK government is urgently seeking to acquire more face-masks.
The advice given by authorities in several countries on the use of face masks has been summarised in an article, with many references, published on 4 June 2009.
Background information
2009 flu pandemic
The 2009 flu pandemic was an influenza pandemic, and the second of the two pandemics involving H1N1 influenza virus , albeit in a new version...
is a global outbreak
Pandemic
A pandemic is an epidemic of infectious disease that is spreading through human populations across a large region; for instance multiple continents, or even worldwide. A widespread endemic disease that is stable in terms of how many people are getting sick from it is not a pandemic...
of a new strain of influenza A virus subtype H1N1, first identified in April 2009, termed Pandemic H1N1/09 virus
Pandemic H1N1/09 virus
The Pandemic H1N1/09 virus is a swine origin Influenza A virus subtype H1N1 virus strain responsible for the 2009 flu pandemic. For other names see the Nomenclature section below.-Virus characteristics:...
by the World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
(WHO) and colloquially called swine flu. The outbreak was first observed in Mexico, and quickly spread globally. On the 11 June 2009, the WHO declared the outbreak to be a pandemic. The overwhelming majority of patients experience mild symptoms", but some persons are in higher risk groups, such as those with asthma
Asthma
Asthma is the common chronic inflammatory disease of the airways characterized by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm. Symptoms include wheezing, coughing, chest tightness, and shortness of breath...
, diabetes, obesity
Obesity
Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems...
, heart disease
Heart disease
Heart disease, cardiac disease or cardiopathy is an umbrella term for a variety of diseases affecting the heart. , it is the leading cause of death in the United States, England, Canada and Wales, accounting for 25.4% of the total deaths in the United States.-Types:-Coronary heart disease:Coronary...
, or who are pregnant or have a weakened immune system
Immune system
An immune system is a system of biological structures and processes within an organism that protects against disease by identifying and killing pathogens and tumor cells. It detects a wide variety of agents, from viruses to parasitic worms, and needs to distinguish them from the organism's own...
. In the rare severe cases, around 3–5 days after symptoms manifest, the sufferer's condition declines quickly, often to the point of respiratory failure
Respiratory failure
The term respiratory failure, in medicine, is used to describe inadequate gas exchange by the respiratory system, with the result that arterial oxygen and/or carbon dioxide levels cannot be maintained within their normal ranges. A drop in blood oxygenation is known as hypoxemia; a rise in arterial...
.
The virus reached the United Kingdom in April 2009. The first cases were confirmed on 27 April 2009 in passengers returning from Mexico. The first case of person to person transmission within the UK was announced on 1 May 2009. In the UK, 5–14 year olds are the age group predominantly affected. Laboratory tests have demonstrated that older people have some immunity.
After a slow start, the virus spread rapidly in the UK in July 2009, with new cases peaking at 110,000 in the last week of that month, according to The Health Protection Agency's modelling estimate, but declining sharply in the first week of August 2009. Cases fell progressively down to 3,000 in the first week of September 2009, then began to rise again. The decline in cases during the summer had been predicted, but a large surge was expected in the autumn to coincide with the normal flu season. Cases rose to 84,000 by the end of October, well below the summer's peak and then declined during November.
Outbreak timeline
| 2009 | UK swine flu outbreak, milestone |
|---|---|
| 27 Apr | First two UK H1N1 cases confirmed in Scotland Scotland Scotland is a country that is part of the United Kingdom. Occupying the northern third of the island of Great Britain, it shares a border with England to the south and is bounded by the North Sea to the east, the Atlantic Ocean to the north and west, and the North Channel and Irish Sea to the... after a flight from Mexico. |
| 29 Apr | Paignton Community and Sports College closes for about a week in first school closure. |
| 1 May | First two UK person to person transmissions confirmed. |
| 2 May | Further schools are temporarily closed from this date. |
| 7 May | HPA issues advice on exclusion from schools and workplaces. |
| 8 May | HPA issues "advice on actions to be taken in a school in the event of a probable or confirmed case of "swine flu" being identified in a school pupil", in which closure for 7 days is advised when appropriate. |
| The virus from European samples isolated and its full genetic fingerprint determined by UK researchers, following similar work in the US on the virus in the American continent. | |
| 17 May | One hundredth confirmed case. |
| 22 May | HPA staff no longer routinely meet flights from Mexico. Contact tracing of passengers deemed to be at risk of swine flu carried out on the basis of risk, as for other communicable diseases. |
| 26 May | The largest single outbreak so far, with 50 confirmed cases identified at a Birmingham primary school (later increased to 74). |
| 13 Jun | Over 1,000 cases of swine flu confirmed in the UK. |
| 14 Jun | First death, of patient with underlying health problems, reported at the Royal Alexandra Hospital Royal Alexandra Hospital (Paisley) The Royal Alexandra Hospital is the main hospital in Paisley serving a large catchment area as much as 200 000 from Renfrewshire, stretching all the way to Oban and Argyll The hospital is owned and run by NHS Greater Glasgow and Clyde, previously NHS Argyll & Clyde... in Paisley Paisley Paisley is the largest town in the historic county of Renfrewshire in the west central Lowlands of Scotland and serves as the administrative centre for the Renfrewshire council area... , Glasgow, Scotland. |
| 26 Jun | Second death, of patient with underlying health problems, of a six-year-old girl at Birmingham Children's Hospital Birmingham Children's Hospital The Birmingham Children's Hospital is a children's hospital located in Birmingham, England.It provides general and emergency health care services to children in Birmingham, the West Midlands and beyond. It specialises in liver transplantation, cardiac, and neonatal surgery... in the West Midlands region West Midlands (region) The West Midlands is an official region of England, covering the western half of the area traditionally known as the Midlands. It contains the second most populous British city, Birmingham, and the larger West Midlands conurbation, which includes the city of Wolverhampton and large towns of Dudley,... . Her death was reported on 29 June. |
| 30 Jun | 6,000 cases of swine flu confirmed in the UK. |
| 2 Jul | The HPA announced that the containment approach to reduce spread was no longer appropriate given the clusters of cases around the UK, and would be replaced by a treatment phase in which everybody presenting symptoms would be treated if necessary without laboratory confirmation, but contacts would not be traced. Daily reports of confirmed cases are no longer being published. |
| 6 Jul | Three deaths in the UK bringing the total to seven. The new victims include two 9-year-old girls. NHS stated all three had "serious underlying health problems". The victims are from South London and Dewsbury in West Yorkshire. |
| 9 Jul | The government announced that there are now over 9,000 cases of Swine flu in the UK and 14 patients have died, 2 in Scotland, 5 in London, and the remainder elsewhere in England. |
| 10 Jul | A 15th person has died from swine flu in Essex. Unlike previous cases, they had no underlying health conditions. |
| 13 Jul | 2 more people die with swine flu in England. One, a 6-year-old girl, who died of septacemia, and a middle-aged doctor. Initial reports that he died of Pulmonary Embolism were disproved on his final Post Mortem, which concluded that Swine Flu was a contributing factor in his death. |
| 16 Jul | It emerges that 12 more people have died. The total now stands at 29. 85,000 people are estimated to be affected by swine flu as of 16 July, with 55,000 new infections in the preceding week according to HPA modelling. |
| 23 Jul | The National Pandemic Flu Service goes live in England for the first time. Shortly after it goes live, the Service gets over 2,000 hits per second. Scotland, Wales and Northern Ireland can opt in for the service if the rate of infection increases. |
| 21 Aug | The first swine flu related death in Wales has been confirmed after a 55 year old women died. |
| 15 Oct | Its announced that there were 27,000 new swine flu cases in the past week, up from 18,000 the week before, and new cases were rising more slowly than expected, but the number requiring treatment in intensive care had increased from 47 out of 290 hospitalised last week to 74 out of 364 hospitalised this week. The number of deaths in the UK rose to 106. |
| 21 Oct | Swine Flu Vaccine 2009 flu pandemic vaccine The 2009 flu pandemic vaccines are the set of influenza vaccines that have been developed to protect against the pandemic H1N1/09 virus. These vaccines either contain inactivated influenza virus, or weakened live virus that cannot cause influenza. The killed vaccine is injected, while the live... became available across the UK and mass immunisation programme gets under way. |
| 22 Oct | It's announced that Swine flu cases in the UK almost doubled from the previous week to 53,000. The number of patients needing hospital care has risen to 506 in England with 99 in critical care – the highest since the pandemic began. Deaths increased to 128. The total number of cases is now estimated to be 435,000. |
| 29 Oct | Swine Flu cases rose by almost 50% to 78,000 new cases. Deaths increased to 137. Hospitalised patients increased to 751, of which 157 are in intensive care including nine people on ECMO (extracorporeal membrane oxygenation) machines. It is now estimated that there have been 521,000 cases in England since the pandemic began. It is also reported that one in three deaths are not in the "priority vaccination group" as currently defined by the government. |
| 5 Nov | New Swine Flu cases increased to 84,000. Deaths increased to 154. 848 people are hospitalised, 172 of which are in intensive care. It is thought that the rise in new cases was smaller this week due to school children being on their "half term" holidays. Andrew Lansley Andrew Lansley Andrew David Lansley, CBE, MP is the UK Secretary of State for Health, who has been the Conservative Member of Parliament for South Cambridgeshire since the 1997 general election, and was Shadow Secretary of State for Health from June 2004 until becoming Secretary of State for Health in May 2010... , the Shadow Health Secretary, called on the Government to commit to vaccinating all schoolchildren in the country, as well as university students. |
| 12 Nov | The number of new swine flu cases in the past week fell by nearly a quarter to 64,000 in England. Deaths increased to 182 (124 deaths in England, 33 in Scotland, 11 in Northern Ireland and 14 in Wales). Hospitalised patients fell to 785, of whom 173 are in intensive care. The Chief Medical Officer, Sir Liam Donaldson Liam Donaldson Sir Liam Joseph Donaldson was the Chief Medical Officer for England, the 15th occupant of the post since it was established in 1855... , said that the drop in new cases could be due to school children's half term break, the impact of which could last two weeks and that next week's figures should give a clearer picture of how the virus is developing. Shadow health secretary Andrew Lansley said the latest figures again illustrated the importance of vaccinating children. "This is further evidence that we need to begin planning a school and college-based vaccination programme immediately." |
| 19 Nov | New Swine Flu cases decreased again from the previous week, down to 53,000 new cases in England in the last week. 783 patients were hospitalised. The number of deaths related to swine flu in the UK increased to 214 (142 in England). The HPA estimates that there have now been a total of 715,000 cases of swine flu since the pandemic began. The government has announced that all children under the age of five are to get the swine flu vaccine. Chief Medical Officer Sir Liam Donaldson said there had been a rise in serious illnesses recently among young children that was "causing concern". "We consider them to be seriously at risk". Latest figures showed that 81% of under-5s hospitalised with swine flu had no underlying health issues. The Conservative Party says that all under-25s should get the vaccine next. |
| 20 Nov | The first officially confirmed cases of person-to-person transmission of a Tamiflu-resistant strain of swine flu in the world are reported to have happened between 5 patients at the University Hospital of Wales University Hospital of Wales University Hospital of Wales , opened in November 1971, is a major 1000-bed hospital situated in the inner city district of Heath in Cardiff, Wales... in Cardiff Cardiff Cardiff is the capital, largest city and most populous county of Wales and the 10th largest city in the United Kingdom. The city is Wales' chief commercial centre, the base for most national cultural and sporting institutions, the Welsh national media, and the seat of the National Assembly for... . |
| 26 Nov | The number of new swine flu cases continue to fall, with 46,000 new cases in the last week, 7,000 less than the week before. However Swine flu deaths in England in a single week reached their highest level with a record 21 deaths, bringing the total deaths to 245 in the UK (163 in England). There were 753 hospitalised patients, 154 of those being in intensive care. The Government estimates more than a million people have now been vaccinated, roughly a month after the vaccination program started (that figure excludes health care workers, who are also being offered the vaccine). That means only about 1 in 10 of the 11 million people in the "at risk" priority groups have so far been vaccinated. Professor David Salisbury, head of immunisation at the Department of Health Department of Health (United Kingdom) The Department of Health is a department of the United Kingdom government with responsibility for government policy for health and social care matters and for the National Health Service in England along with a few elements of the same matters which are not otherwise devolved to the Scottish,... was disappointed, saying "Clearly I would have liked a bigger number...I would like to see an acceleration now". |
| 3 Dec | New Swine Flu cases more than halved from the previous week, dropping to 22,000 new cases in England in the last week. Total deaths increased to 270 (178 deaths in England). There are 747 hospitalised patients – 161 of which are in critical care. A further 600,000 people were vaccinated in the last week, bringing total to 1.6 million people. In addition to that, 275,000 healthcare workers have been vaccinated out of nearly 2 million. Chief Medical Officer Sir Liam Donaldson said it was still "too early" to know whether the downward trend in new cases would continue and that his biggest worry was the virus mutating or mixing with other viruses and creating a new, more dangerous virus. Prof David Salisbury, head of immunisation at the Department of Health, said the vaccines with adjuvants Immunologic adjuvant In immunology, an adjuvant is an agent that may stimulate the immune system and increase the response to a vaccine, without having any specific antigenic effect in itself. The word “adjuvant” comes from the Latin word adiuvare, meaning to help or aid... , substances which boost the immune system and allow less active ingredient to be used in each dose, offer good protection even if the virus does change; "One of the advantages with adjuvanted vaccines is their ability to protect against drifted (mutated) strains. It opens the door for a whole new strategy in dealing with flu." The GlaxoSmithKline GlaxoSmithKline GlaxoSmithKline plc is a global pharmaceutical, biologics, vaccines and consumer healthcare company headquartered in London, United Kingdom... vaccine, Pandemrix Pandemrix Pandemrix is an influenza vaccine for influenza pandemics, such as the H1N1 2009 flu pandemic colloquially called the swine flu. The vaccine was developed by GlaxoSmithKline and patented in September 2006.... , which forms the bulk of the governments mass vaccination programme with 11.2 million doses delivered so far to health services, contains an adjuvant. |
| 10 Dec | New Swine Flu cases halved from the previous week, to 11,000 new cases in England. Deaths increased to 283 (191 in England) and there were currently 636 hospitalised patients. The number of people vaccinated increased to 2.3 million. The estimated total number of cases is 795,000. The Chief Medical Officer Sir Liam Donaldson revealed that the swine flu pandemic is "considerably less lethal" than feared. An analysis of deaths to 8 November showed that 26 people have died for every 100,000 cases in England, meaning a death rate of 0.026% in those infected with Swine Flu. The highest death rate was in those aged over 65, and lowest in those aged 5 to 14. The average age at death was 39. Of the patients who died, 67% were in the "high risk" vaccination priority group and were eligible to get vaccinated, 36% had either no or only mild pre-existing illnesses. Sir Liam again urged people to come forward for immunisation, commenting that a lower impact than previously feared "is not a justification for public health inaction. Our data supports the priority vaccination of high risk groups. Given that a substantial minority of deaths occur in previously healthy people, there is a case for extending the vaccination programme". |
| 17 Dec | New Swine Flu cases again fell with 9000 people infected in last week. Total deaths in the UK increased to 299 (203 in England). The number of currently hospitalised patients fell to 523 patients of which more than 100 were in intensive care. 3 million people out of the 9 million in the 1st vaccination priority groups have now been vaccinated including 100,000 pregnant women. In addition to that, 343,000 front line health workers have also been vaccinated. It appears that the second wave of Swine Flu is coming to an end but experts warn cases could rise again in the future in a "third wave" of swine flu. |
| 24 Dec | New cases of Swine Flu fell by a third to 6,000 cases this week. The total death figures will be updated by the HPA on Thursday 7 January. The number of hospitalised patients declined to 454 currently in hospital (as of 8 am on 23 December). |
| 31 Dec | The HPA did not release estimate numbers this week, instead saying that flu activity is continuing to decrease across the UK but some caution must be exercised as this may be influenced by the holiday period. 496 patients were currently hospitalised in England as of 8 am on 30 December (an increase from last week). A more detailed update will be released next week. |
| 8 Jan | Swine Flu cases have continued to decrease, down to less than 5,000 new cases in the last week. Total UK deaths have increased to 360 (251 in England, 64 in Scotland, 28 in Wales and 17 in Northern Ireland). Currently hospitalised patients in England (as of 8 am on 6 January) were 393, of which 103 were in critical care. So far, only 3.2 million people have been vaccinated (out of 9 million in the priority groups), including 113,000 pregnant women (out of roughly 600,000), 86,000 under-5s (out of more than 3 million) and an additional 373,000 front-line health workers (out of more than a million). The Head of Immunisation at the Department of Health Department of Health (United Kingdom) The Department of Health is a department of the United Kingdom government with responsibility for government policy for health and social care matters and for the National Health Service in England along with a few elements of the same matters which are not otherwise devolved to the Scottish,... , Professor David Salisbury urged all those in the at-risk priority groups to get immunised, especially children under five and those with underlying health conditions, because while cases are currently down, it was not clear what would happen with swine flu over the year ahead. |
Reported cases
Until 2 July 2009 the HPA published daily reports of laboratory-confirmed cases with breakdown by region, by age, and by source of infection (travel, community, etc.). From that date routine laboratory testing of all suspected cases and reporting of figures was discontinued. figures shown in this article are laboratory confirmed cases reported on 2 July.Deaths are often reported as occurring "after contracting the swine flu virus" without flu being necessarily the cause of death of people with underlying health problems.
Researchers at Imperial College London said in July 2009 that the best estimate was that about 0.5% of those who get swine flu bad enough to seek medical help die from it, a figure very similar to the estimate for seasonal influenza.
Cases by region |
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Detailed reports
On 25 April 2009, a member of British AirwaysBritish Airways
British Airways is the flag carrier airline of the United Kingdom, based in Waterside, near its main hub at London Heathrow Airport. British Airways is the largest airline in the UK based on fleet size, international flights and international destinations...
cabin crew was taken to Northwick Park Hospital
Northwick Park Hospital
Northwick Park Hospital is a large hospital in the northwest corner of the London Borough of Brent in Greater London, England.-Hospital role:...
in Harrow
Harrow, London
Harrow is an area in the London Borough of Harrow, northwest London, United Kingdom. It is a suburban area and is situated 12.2 miles northwest of Charing Cross...
and quarantined after falling ill with flu-like symptoms on a flight from Mexico City though he was later found not to have swine flu.
On 26 April, two people were admitted to Monklands Hospital
Monklands Hospital
Monklands District General Hospital, is a district general hospital in Airdrie, North Lanarkshire, Scotland. Administered by NHS Lanarkshire, it serves a population of approximately 260,000 people of North and South Lanarkshire council areas...
in Airdrie
Airdrie, North Lanarkshire
Airdrie is a town within North Lanarkshire, Scotland. It lies on a plateau roughly 400 ft above sea level, and is approximately 12 miles east of Glasgow city centre. Airdrie forms part of a conurbation with its neighbour Coatbridge, in the former district known as the Monklands. As of 2006,...
, North Lanarkshire
North Lanarkshire
North Lanarkshire is one of 32 council areas in Scotland. It borders onto the northeast of the City of Glasgow and contains much of Glasgow's suburbs and commuter towns and villages. It also borders Stirling, Falkirk, East Dunbartonshire, West Lothian and South Lanarkshire...
, with mild flu-like symptoms after returning from Mexico. The next day, the Cabinet Secretary for Health and Wellbeing
Cabinet Secretary for Health and Wellbeing
The Cabinet Secretary for Health, Wellbeing and Cities Strategy, commonly referred to as the Health Secretary, is a cabinet position in the Scottish Government...
, Nicola Sturgeon
Nicola Sturgeon
Nicola Sturgeon is the Deputy First Minister of Scotland, Cabinet Secretary for Health, Wellbeing and Cities Strategy, Deputy Leader of the Scottish National Party and Member for Glasgow Southside....
, confirmed that these were cases of the swine influenza A (H1N1) virus. Authorities in both Scotland and England stated that there were no plans to trace the fellow airline passengers who may have travelled alongside the couple, since the authorities do not classify them as "close contacts". These cases along with one in Spain are the first confirmed cases in Europe.
At noon on 29 April the government reported three more confirmed cases in the UK, including the first cases in England. All three had recently returned from Mexico. The secondary school, Paignton Community and Sports College, closed for seven days.
By 26 May the number of people who had contracted the disease in-country increased to 125, the highest in Europe and triple the second highest, Spain.
On 28 May, sixty four people connected with a primary school in Birmingham were diagnosed with swine flu .
On 8 June the HPA issued a report stating that the majority of cases are in school age children and young adults, which has not been the case in most pandemics with the notable exception of 1918.
On 25 June the chief medical officer Sir Liam Donaldson said certain areas were seeing rapid community spread which meant that it was no longer practical to attempt in those areas (initially parts of London, the west Midlands and east Berkshire) to put a ring around the outbreaks by tracing the people with whom confirmed cases have come into contact and giving them drugs to try to prevent flu developing. In these areas, anti-viral drugs may in the future only be given to people showing symptoms, and tracing of contacts will stop. The contingency plans always envisaged the containment phase would not last indefinitely. The start of the treatment (as against containment) approach was announced on 2 July 2009.
Every year in late June and early July the Wimbledon
The Championships, Wimbledon
The Championships, Wimbledon, or simply Wimbledon , is the oldest tennis tournament in the world, considered by many to be the most prestigious. It has been held at the All England Club in Wimbledon, London since 1877. It is one of the four Grand Slam tennis tournaments, the other three Majors...
tennis championships are held in London, attracting worldwide interest and with many hours of UK television coverage every day. On 1 July 2009 it was reported that 28 Wimbledon staff had been asked to stay at home with flu-like symptoms. Two named players are reported to have caught the virus.
A study published in the August 2009 issue of The Lancet
The Lancet
The Lancet is a weekly peer-reviewed general medical journal. It is one of the world's best known, oldest, and most respected general medical journals...
(available on 20 July) suggests that prolonging the school holidays could reduce the spread of the virus by up to 17%. This would be disruptive, and would not reduce the overall number of infections, but could delay the spread and buy time for preparation of a vaccine. The government's advice is that schools should not be closed, but that the evidence will be reviewed in August as school summer holidays end.
Public information
The Department of Health announced on 29 April 2009 that they intended to send an information leaflet on swine flu to every household in the UK. The information leaflets were distributed at the beginning of May. On 29 April, Alan JohnsonAlan Johnson
Alan Arthur Johnson is a British Labour Party politician who served as Home Secretary from June 2009 to May 2010. Before that, he filled a wide variety of cabinet positions in both the Blair and Brown governments, including Health Secretary and Education Secretary. Until 20 January 2011 he was...
announced that television and radio advice would also be broadcast starting on 30 April. On 30 April 2009, a swine flu information line was launched with advice on setting up "flu friends" (this is not the National Flu Line service mentioned below).
The Department of Health Pandemic Plan (revised November 2007) states "UK health departments (directorate in Scotland) will run a national door drop and advertising campaign in Phase 5, alerting the public to the heightened risk, emphasising the need for personal preparation and socially responsible behaviour. A public information film will demonstrate how to slow the spread of the virus, and the National Flu Line service will be available. Information materials will also be available through primary care, pharmacies and on the Department of Health website." After criticism of the lateness of its launch, it was announced in late July that the National Flu Line service was to be launched on 24 July 2009.
There are government websites with general information and the latest updates on human swine flu in England, Northern Ireland,Northern Ireland Department of Health, Social Services and Public Safety update on confirmed swine flu cases: 29 June 2009 (this link will be updated to reference the latest update) Scotland, and Wales.
The HPA website includes frequently updated advice for the public, advice on exclusion from schools and workplaces (and a document specifically for schools), and information for health professionals.
During the initial containment phase of the swine flue outbreak the HPA published detailed information in daily and weekly reports linked from its Epidemiological data page on its website. On 2 July, when the policy of containment was dropped in favour of treatment of presumed cases, the daily updates of laboratory confirmed cases were stopped. A weekly epidemiological update and pandemic flu update are published each Tuesday, with much detailed information including regional information and breakdown by age.
Control measures
On 11 May 2009 UK epidemiologists at Imperial College LondonImperial College London
Imperial College London is a public research university located in London, United Kingdom, specialising in science, engineering, business and medicine...
considered that H1N1 swine flu was spreading fast enough to justify the preparations for a pandemic. It was showing "sustained human-to-human transmission", thereby justifying the WHO's pandemic phase 5 rating. It is estimated that on average each person who contracts flu passes it on to between 1.4 and 1.6 other people, no worse than the three influenza pandemic
Influenza pandemic
An influenza pandemic is an epidemic of an influenza virus that spreads on a worldwide scale and infects a large proportion of the human population. In contrast to the regular seasonal epidemics of influenza, these pandemics occur irregularly, with the 1918 Spanish flu the most serious pandemic in...
s of the twentieth century. Early analysis suggested that the spread was likely to be similar to the earlier pandemics. Up to the date of the study, clinical severity was similar to 1957
Asian flu
Asian Flu may refer to:* The Asian Financial Crisis of 1997, or* Asian Flu, the H2N2 virus...
and less than 1918 flu pandemic. However, the clinical severity of the outbreak and how the virus will evolve cannot yet be predicted.
Travel to and from affected areas
On 27 April, the Foreign & Commonwealth Office advised against all but essential travel to Mexico and stated that British citizensBritish nationality law
British nationality law is the law of the United Kingdom that concerns citizenship and other categories of British nationality. The law is complex because of the United Kingdom's former status as an imperial power.-History:...
in Mexico... "may wish to consider whether they should remain in Mexico at this time". On 28 April the Mexican Tourist Board estimated that there were "a few thousand" British tourists in Mexico.
Holiday companies Thomas Cook
Thomas Cook
Thomas Cook of Melbourne, Derbyshire, England founded the travel agency that is now Thomas Cook Group.- Early days :...
and Airtours said that between them they had about "3,000 holidaymakers in Mexico" as of 28 April 2009. The first British tourists being brought back early from Mexico on 28 April 2009 told reporters that they had received little or no information about health precautions, either from the Mexican authorities, hotels, or from local tour guides.
A leaflet is being distributed at all ports of entry into the UK providing passengers arriving in the UK with information on swine flu.
Until 21 May HPA staff met travellers arriving from Mexico. This was discontinued on 22 May, but advice remained that travellers from affected areas who become unwell within seven days of arrival, and contacts with symptoms of a confirmed or probable case, should stay at home and contact their GP or NHS Direct
NHS Direct
NHS Direct is the health advice and information service provided by the National Health Service for residents and visitors in England, with advice offered 24 hours a day, every day of the year through telephone contact on the national 0845 46 47 number, web based symptom checkers at and via...
. Contact tracing of passengers deemed to be at risk of swine flu will be carried out on the basis of risk, as for other communicable diseases.
Preparations
As of 13 June 2009 the government estimated that the UK has enough anti-viral drugs for 50% of the population but has plans to raise that figure to 80%.
There is a pandemic plan covering topics from distributing the drugs and setting up helplines to closing schools and banning public events which was tested in a large exercise in 2007. There is also a specific response plan for London. Oseltamivir
Oseltamivir
Oseltamivir INN , an antiviral drug, slows the spread of influenza virus between cells in the body by stopping the virus from chemically cutting ties with its host cell; median time to symptom alleviation is reduced by 0.5–1 day. The drug is sold under the trade name Tamiflu, and is taken orally...
(Tamiflu) and zanamivir (Relenza), the two anti-virals known to be effective, must be taken within 48 hours of onset of symptoms or earlier to be effective; the positive effects are greatest if treatment is started within six hours.
The HPA reported in its 24 June 2009 weekly epidemiological report that all 17 samples of the virus laboratory tested for resistance that week were found to be sensitive
Drug resistance
Drug resistance is the reduction in effectiveness of a drug such as an antimicrobial or an antineoplastic in curing a disease or condition. When the drug is not intended to kill or inhibit a pathogen, then the term is equivalent to dosage failure or drug tolerance. More commonly, the term is used...
to oseltamivir and zanamivir, but resistant to amantadine
Amantadine
Amantadine is the organic compound known formally as 1-adamantylamine or 1-aminoadamantane. The molecule consists of adamantane backbone that has an amino group substituted at one of the four methyne positions. This pharmaceutical is sold under the name Symmetrel for use both as an antiviral and an...
. The first case of resistance of the virus to oseltamivir, in Denmark, was reported on 29 June 2009.
On 5 May 2009 plans were announced for pupils unable to sit examinations at schools affected by flu to be assessed in other ways to ensure that children are not disadvantaged.
The Department of Health has listed all the pandemic flu guidance that it had published as of 8 June 2008.
Genetic analysis
Samples from suspected cases have been analysed by the National Institute for Medical ResearchNational Institute for Medical Research
The National Institute for Medical Research, commonly abbreviated to NIMR, is a medical research facility situated in Mill Hill, on the outskirts of London, England. It is mainly funded by the Medical Research Council, or MRC, and is its largest establishment and the only one designated as an...
in London, which is also examining samples of the U.S. strain of the disease.
By 8 May 2009 the US Centres for Disease Control and Prevention had made genetic information on the swine flu virus available, and the virus from European samples had been isolated and its full genetic fingerprint determined by UK researchers. The genetics and effects of the virus in general are discussed in the article on the 2009 swine flu outbreak.
Diagnosis
The fastest way for laboratory confirmation of swine flu is by the PCRPolymerase chain reaction
The polymerase chain reaction is a scientific technique in molecular biology to amplify a single or a few copies of a piece of DNA across several orders of magnitude, generating thousands to millions of copies of a particular DNA sequence....
method, described as a real-time method. According to the World Health Organization there are four laboratories in the UK able to perform PCR to diagnose influenza A (H1N1) virus infection in humans: Regional Virus Laboratory, Royal Victoria Hospital, Belfast
Royal Victoria Hospital, Belfast
The Royal Victoria Hospital is a hospital in Belfast, Northern Ireland....
, NI; Regional Virus Laboratory, Gartnavel General Hospital
Gartnavel General Hospital
Gartnavel General Hospital is a teaching hospital in the West End of Glasgow, Scotland. The hospital is located next to the Great Western Road, between Hyndland, Anniesland and Kelvindale. Hyndland railway station is adjacent to the hospital. The name Gartnavel is derived from the Gaelic Gart ...
, Glasgow, Scotland; Health Protection Agency, Centre for Infections, Enteric, Respiratory, & Neurological Virus Laboratory
UK statutory notification system
The UK statutory notification system for infectious diseases is a system whereby doctors are required to notify a "Proper Officer" of the local authority if they are presented with a case of a serious infectious disease such as diphtheria or measles...
, London; WHO Collaborating Centre for Reference and Research on Influenza
National Influenza Centers
National Influenza Centers are institutions which are formally recognized as such by the World Health Organization ."The WHO Global Influenza Surveillance Network was established in 1952...
, National Institute for Medical Research, London.
Another laboratory confirmation is a fourfold increase in virus-specific antibodies 10 to 14 days later.
From 2 July 2009 when a treatment, rather than containment, approach was adopted, the official clinical diagnostic criteria became: "fever (pyrexia ≥38 °C) or a history of fever, and also influenza-like illness (two or more of the following symptoms: cough; sore throat; rhinorrhoea; limb or joint pain; headache; vomiting or diarrhoea) or severe and/or life-threatening illness suggestive of an infectious process".
"Laboratory confirmed" cases
Professor Neil Ferguson, an epidemiologist at Imperial College London, who advises the Government and the World Health Organisation, said on 8 June 2009 that HPA statistics were at best accounting for half of cases.
In the USA
2009 flu pandemic in the United States
The 2009 flu pandemic in the United States was a pandemic experienced in the United States of a novel strain of the Influenza A/H1N1 virus, commonly referred to as 'swine flu', that began in the spring of 2009. The virus had spread to the US from an outbreak in Mexico.As of mid-March 2010, the U.S...
mathematical modelling based on surveys estimated that there were about 1 million cases of H1N1 flu on 25 June 2009, compared to 28,000 reported officially. Such a study has not been carried out in the UK.
As of 2 July 2009 GPs will diagnose based on clinical observation and routine swabbing will stop, and the HPA will "no longer be providing a daily update of the numbers of cases confirmed through laboratory tests"
Hygiene recommendations
According to the Health Protection Agency's "Swine flu: frequently asked questions" web page, transmission of this new virus is thought to occur in the same way as seasonal flu:- large droplets from coughing and/or sneezing by an infected person within a short distance (usually 1 metre or less) of someone;
- touching or shaking the hand of an infected person, and then touching your eyes, nose or mouth without first washing your hands;
- touching surfaces or objects (eg door handles) that have become contaminated with the flu virus, and then touching your eyes, nose or mouth without first washing your hands.
When the issue of touching your eyes, nose or mouth is combined with other infection control
Infection control
Infection control is the discipline concerned with preventing nosocomial or healthcare-associated infection, a practical sub-discipline of epidemiology. It is an essential, though often under-recognized and under-supported, part of the infrastructure of health care...
practices and good hygiene measures as recommended by the Health Protection Agency's website, the following recommendations emerge as important ways to help reduce the spread of swine flu and other viruses:
- Don't touch your eyes, nose or mouth without first washing your hands.
- Cover your nose and mouth when coughing or sneezing, and use a tissue when possible.
- Dispose of dirty tissues promptly and carefully.
- Maintain good basic hygiene, for example washing handsHand washingHand washing for hand hygiene is the act of cleaning the hands with or without the use of water or another liquid, or with the use of soap, for the purpose of removing soil, dirt, and/or microorganisms....
frequently with soap and water to reduce the spread of the virus from your hands to your face, or to other people. - Clean hard surfaces, such as door handles, frequently using a normal cleaning product.
- Make sure children follow this advice.
- Anyone with swine flu or being investigated as a possible case will be given anti-virals and asked to stay at home and limit their contact with other people.
- Where anti-virals are prescribed the course of treatment must be followed and completed, although it may sometimes cause nausea.
For people belonging to a high-risk group it is particularly important that they start taking anti-virals as soon as possible after infection. High-risk groups include people with long-term conditions, those over 65, children under five and pregnant women.
Immunity
A study at the U.S. Centers for Disease Control and PreventionCenters for Disease Control and Prevention
The Centers for Disease Control and Prevention are a United States federal agency under the Department of Health and Human Services headquartered in Druid Hills, unincorporated DeKalb County, Georgia, in Greater Atlanta...
published in May 2009 found that children had no pre-existing immunity
Immunity (medical)
Immunity is a biological term that describes a state of having sufficient biological defenses to avoid infection, disease, or other unwanted biological invasion. Immunity involves both specific and non-specific components. The non-specific components act either as barriers or as eliminators of wide...
to the new strain but that adults, particularly those over 60, had some degree of immunity. Children showed no cross-reactive antibody
Antibody
An antibody, also known as an immunoglobulin, is a large Y-shaped protein used by the immune system to identify and neutralize foreign objects such as bacteria and viruses. The antibody recognizes a unique part of the foreign target, termed an antigen...
reaction to the new strain, adults aged 18 to 64 had 6–9%, and older adults 33%. The large proportion of cases in the UK affecting children and young adults is consistent with this pattern of resistance.
Vaccine
The usual seasonal fluFlu season
Flu season is a annually-recurring time period characterized by the prevalence of outbreaks of influenza . The season occurs during the cold half of the year in each hemisphere. Influenza activity can sometimes be predicted and even tracked geographically...
vaccine
Vaccine
A vaccine is a biological preparation that improves immunity to a particular disease. A vaccine typically contains an agent that resembles a disease-causing microorganism, and is often made from weakened or killed forms of the microbe or its toxins...
s give little or no immunity against the new strain of flu. There is an international program to produce a vaccine which will be effective against the new H1N1 strain. The chief medical officer Sir Liam Donaldson said on 25 June that it seemed likely that the UK would receive the first batches of vaccines slightly earlier than expected, possibly from August rather than the autumn as first expected, although some industry sources do not expect supplies to be available so soon. The government has contracts for 132 million doses. There are risks involved in shifting resources to the new vaccine: it will not be possible to produce the seasonal flu vaccine, and it is possible that the virus will mutate
Mutation
In molecular biology and genetics, mutations are changes in a genomic sequence: the DNA sequence of a cell's genome or the DNA or RNA sequence of a virus. They can be defined as sudden and spontaneous changes in the cell. Mutations are caused by radiation, viruses, transposons and mutagenic...
to make a vaccine developed before the mutation ineffective.
Possible use of face-masks
Secretary of State for Health
Secretary of State for Health is a UK cabinet position responsible for the Department of Health.The first Boards of Health were created by Orders in Council dated 21 June, 14 November, and 21 November 1831. In 1848 a General Board of Health was created with the First Commissioner of Woods and...
Alan Johnson told MPs on 27 April that "Although we are aware that face-masks are being given out to the public in Mexico, the available scientific evidence
Scientific evidence
Scientific evidence has no universally accepted definition but generally refers to evidence which serves to either support or counter a scientific theory or hypothesis. Such evidence is generally expected to be empirical and properly documented in accordance with scientific method such as is...
does not support the general wearing of face-masks by those who are not ill, whilst going about their normal activities."
Professor Steve Field, chairman of the Royal College of General Practitioners, said people in the UK were "perfectly safe at the moment", and did not need to start wearing face-masks or stop eating pork.
The Head of Pandemic Planning at the Royal College of General Practitioners
Royal College of General Practitioners
The Royal College of General Practitioners is the professional body for general practitioners in the United Kingdom. The RCGP represents and supports GPs on key issues including licensing, education, training, research and clinical standards. It is the largest of the medical royal colleges, with...
, Dr Maureen Baker, stated on 27 April that "Masks become ineffective when they become damp or after a few hours. There has been a lot of debate on the use of face-masks and some authorities say that, in the community, the most effective use is to give to patients who may have symptoms when they present in the surgery – that should help reduce the infectivity of that patient to surgery staff and other patients. I expect the Department of Health will issue guidance on use of face-masks if we move into a pandemic phase." Masks may not protect the wearer from inhalation of the virus, but might protect other people from picking up the virus from the wearer.
Professor John Oxford, a virologist at leading London hospital, The Barts and the London
Barts and The London NHS Trust
Barts and The London NHS Trust is an NHS Trust operating in the City of London and east London.It runs three hospitals:* The Royal London Hospital in Whitechapel* St Bartholomew's Hospital in Smithfield in the City...
, said: "Really, there is very little evidence that masks actually offer much protection against flu."
It is reported that the UK government is urgently seeking to acquire more face-masks.
The advice given by authorities in several countries on the use of face masks has been summarised in an article, with many references, published on 4 June 2009.
See also
- GISAIDGISAIDThe Global Initiative on Sharing All Influenza Data , is a global consortium of scientists who actively promote the international sharing of all influenza type virus sequences, related clinical and epidemiological data associated with human isolates, and geographic and species-specific data...
the Global Initiative on Sharing Avian Influenza Data (also covers novel A/H1N1 swine flu)
External links
Official status reports- H1N1 outbreak status report, at the European CDC
- Swine influenza updates, at the World Health Organisation
Background information
- WHO's Pandemic Influenza Phases
- Influenza Research Database – Database of influenza genomic sequences and related information.
- Medical Encyclopedia Medline Plus: Swine Flu
- Medical Encyclopedia WebMD: Swine Flu Centre
- Swine flu information line—freephone number 0800 1 513 513.