Swine Flu: How Serious A Threat?

With the UK confirming two cases of swine flu and the World Health Organization raising its alert level from three to four, how serious a threat does the disease pose to us all?

WHO says the virus, which has killed more than 150 people in Mexico, is showing a “sustained ability” to pass from human to human and is able to cause community-level outbreaks.

The UK’s leading experts on flu give their views on what the future threat might be.

Clearly we are on track for a pandemic in the coming months.

The good news is that we were all worried about so-called bird flu H5N1 which was a much more dangerous virus. Here, we are not in the same ball park.

We might expect up to 30-40% of the population to become ill in the next six months if this truly turns into a pandemic  Professor Ferguson

But we can’t at the moment answer the question is it comparable to 1918 Spanish flu which killed a lot of people – or is it much more like Hong Kong flu.

We are coming out of the normal time of year when we have flu circulating in the UK so we don’t really know what size of epidemic there may be in the next couple of months.

It is almost certain that even if it does fade away in the next few weeks which it might we will get a sizable epidemic in the autumn.

We might expect up to 30-40% of the population to become ill in the next six months if this truly turns into a pandemic.

We could get substantial numbers infected in the next few weeks. If I was to be a betting man I would say it would be a slightly longer period of time just because we are heading into the summer months.

A new strain of flu is something to which we do not have natural immunity, and we have not been vaccinated against, because there is not a vaccine, so it does mean that many more people are vulnerable and so it spreads more easily and affects more people.

But we don’t know enough about this virus yet. It is being studied by the top laboratories in the world.

When we know more about it we will be able to give better predictions about who is at greater risk, and who is at risk of developing serious complications.

At this point the picture coming out of Mexico is rather confused, and we can’t make any firm statements about what is likely to happen, but we have to prepare for all eventualities.

If the avian flu H5N1 virus had spread from human to human like this then I would be extremely worried. It would be top of my Richter scale.

But this swine flu worries me less because as a population we have a basic immunity to H1N1. Outside of Mexico there have been no deaths, so it doesn’t seem so aggressive.

And not only are we coming up to the summer, which makes it less likely for these viruses to spread as well, but Britain has enough antiviral drugs for half of the population.

So we should not panic in any way. This does not look as though it is going to be a virus that sweeps the world and causes huge mortality.

I still think we are a day or so away from knowing what the threat is. WHO has gone to stage four, so we know there will be an epidemic stemming from direct contact with these cases in Mexico. We will see more cases.

But we will have to wait to see how it spreads to know if there will be a pandemic that sweeps nations.

The key thing is how lethal a virus is it. Outside of Mexico it has not caused any deaths, which is good news. And we are prepared for it.

We should have a complete picture in the next five to seven days to answer these questions.

There is no evidence of pandemic in Europe at this point in time but should the threat increase, the UK has a wealth of scientific and engineering expertise which can be deployed to ramp up the countermeasures necessary to protect the population at large.

Let’s keep things in perspective. This is not 1918; and with over 30 million doses of antiviral treatments, effective against H1N1 available in the UK right now we are well placed to combat any outbreak.

We should also bear in mind that there are two flu-vaccine manufacturers in the UK (Novartis and Medimmune) and whilst there may be capacity issues, both companies are technically capable of producing appropriate vaccines.

It’s a new virus – we’ve never before seen this combination of swine virus and human virus genes.

It’s very difficult to make any predictions when it’s not like any flu virus before.

If there are no more cases in the next couple of weeks then we can maybe say with reasonable confidence that we’re out of the woods.

But the flu virus is a pretty awkward customer and you have to be very circumspect.

I don’t think the public health authorities will be giving the all-clear for some time yet.

We have a very confusing picture coming out of Mexico.

We are not aware of how many people there are with mild infections out of Mexico. It may be that those few deaths represent just the tip of an iceberg which is a lot more much milder infections.

Therefore we feel that one should not be looking at Mexico and saying that is the pattern we will necessarily be following in Europe.

We do know from previous influenza viruses and previous pandemics that what you see at the start is not necessarily what you see six months, a year or two years later. Sometimes you get a second or third wave which is more vicious than the first.

As a region, Europe – and particularly the European Union – is better prepared than any other part of the world.

Unfortunately you can never prepare well enough. We are beyond the stage of being able to contain the virus, we can only mitigate it and there is still more work to be done – and a cool summer would give us time to do some additional work.

UK Homes To Get Swine Flu Advice

Leaflets about the swine flu outbreak and how to prevent its spread are to be delivered to every UK household.

The Department of Health is also “urgently looking” at increasing stockpiles of facemasks, most likely for issue to health professionals.

The results of swine flu tests on 23 people in Scotland are expected later. A Falkirk couple, who recently returned from Mexico, are the UK’s first cases.

The virus is thought to have killed nearly 160 people in Mexico.

The number of swine flu cases globally is rising, though no-one outside Mexico has died.

Prime Minister Gordon Brown is to be briefed on the latest developments on Wednesday by the chief medical officer for England, Sir Liam Donaldson, and Health Secretary Alan Johnson.

Information campaign

Delivery of the government leaflets is due to start within the next few days.

“Guidelines for doctors issued a few months ago anticipated this kind of public information campaign as an important part of the current phase four alert,” said BBC health correspondent Branwen Jeffreys.

Available scientific evidence does not support the general wearing of facemasks by those who are not ill whilst going about their normal activities  Department of Health spokesman

The World Health Organization (WHO) raised its pandemic alert status to level four on Monday – two levels from a full pandemic – after concluding there had been sustained transmission between humans.

But a national pandemic flu helpline set out in the government plans is not expected to be operational before the autumn.

The prime minister has said Britain is “among the best prepared countries in the world” to deal with the outbreak.

“We have been preparing for this kind of scenario for many years,” he said, insisting that Britain was now taking “all the urgent action that is necessary”.

A Department of Health spokesman said: “We are urgently looking into how we can increase our current stockpiles of facemasks for healthcare workers who would come into close contact with symptomatic individuals during an influenza pandemic.”

The spokesman said that “available scientific evidence does not support the general wearing of facemasks by those who are not ill whilst going about their normal activities”.

Chief medical officer for Scotland, Dr Harry Burns, is hoping for the results of tests on 23 people displaying swine flu symptoms.

Fourteen have been screened after returning from Mexico or the US, while nine had been in contact with the British couple confirmed as having swine flu.

Iain and Dawn Askham, of Polmont, near Falkirk, are continuing to improve at Monklands Hospital in Airdrie, Lanarkshire.

It has emerged they were mixing with people at home and work for five days after their return from honeymoon in Cancun, before feeling ill and being admitted to hospital.

If any of the Askhams’ friends or workmates test positive, “it will mean the infection was transmitted here in Scotland”, says Scotland correspondent Colin Blane.

CONFIRMED & SUSPECTED CASES Mexico: 159 suspected deaths – 20 confirmed cases US: 64 confirmed cases Canada: 13 confirmed cases New Zealand: 3 confirmed cases UK, Spain, Israel: 2 confirmed cases each Countries with suspected cases: Brazil, Guatemala, Peru, Australia, and South Korea, and seven EU states

The chief medical officer for Wales, Tony Jewell, said there were eight suspected cases under investigation in the nation – all linked to travel in Mexico.

The Health Protection Agency said it was not releasing details about any suspected cases in England until swine flu was confirmed.

Wiltshire Primary Care Trust has said that seven people are being tested, while two cases are under investigation in Derbyshire.

Tests carried out on a female patient at West Middlesex hospital in west London have proved negative.

In Northern Ireland the chief medical officer, Dr Liz Mitchell, said it was likely that there would be cases, although there was none currently under investigation.

The health secretary has said a stockpile of anti-viral drugs will be used to treat patients showing symptoms of the disease, should the virus start spreading in the UK.

Sir Liam Donaldson said: “If a new pandemic does start as a result of this outbreak in Mexico and the United States, we can’t make it go away, but what we can do through our plans, particularly our stockpiles of anti-virals, is mitigate its effect.”

But the Conservatives have criticised the government over the national flu helpline, which was supposed to be ready in early 2009.

Shadow health minister Stephen O’Brien said: “The national flu line will be crucial if a pandemic were to happen in Britain, by allowing people to get the information and the anti-virals they will need to fight the flu without having to go to GP surgeries or hospitals.”

Cancelled holidays

NHS Direct has stopped call centre staff from booking any new periods of time off until further notice in response to the expected high demand for the service.

There were 57% more visits to the NHS Direct website on Monday afternoon and Tuesday morning compared with the same period last week.

Official UK guidance is that anyone with flu-like symptoms who might have been in contact with the virus – such as those living or travelling in the affected areas of Mexico – should seek medical advice.

SWINE FLU Swine flu is a respiratory disease thought to spread through coughing and sneezing Symptoms mimic those of normal flu. In Mexico more than 150 people are thought to have died from the virus Good hygiene like using a tissue and washing hands thoroughly can help reduce transmission

But patients are being asked not to go into GP surgeries in order to minimise the risk of spreading the disease to others. Instead, they should stay at home and call their healthcare provider for advice.

Swine flu is usually found in pigs and contracted only by people in contact with the animals.

The Foreign Office is advising against all but essential travel to Mexico, also urging travellers to “consult a doctor immediately if they show signs of flu-like symptoms”.

The department has suspended routine consular and visa services at the Mexico City embassy.

On Tuesday, Thomas Cook cancelled all Thomas Cook and Airtours holidays to the resort of Cancun for the next seven days.

Holiday firms Thomson and First Choice have cancelled all outbound flights to Cancun and Cozumel, up to and including 8 May, and are starting repatriation flights for British holidaymakers already in Mexico.

British Airways, which has four flights a week to Mexico City, said it would not be cancelling any flights.