A second wave of swine flu could be on its way, scientists warned last night after the number of new cases rose for the first time since July.
The jump, from an estimated 3,000 to 5,000, comes a fortnight after children – key spreaders of the disease – returned to school.
There have been outbreaks at six schools in England, but health chiefs repeated that there are no plans to close schools as it would do little to contain the disease.
In another development, two sufferers are believed to have developed resistance to Tamiflu, the anti-viral drug which is the only line of defence to the disease before a vaccine is ready.
Chief medical officer Sir Liam Donaldson however said the two cases were not of significance as there was no evidence these resistant viruses had been transmitted from person to person.
Experts have been predicting a second wave of swine flu will hit in the winter months following a lull over the summer break, when children were not mixing as freely.
Sir Liam said the figures ‘begin to suggest swine flu is coming back’. And he admitted: ‘We would naturally have hoped for a bit more breathing space before it started again.
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October 12th, 2009 at 4:50 am
The Department of Health has ordered NHS bosses across England to ensure that frontline staff get immunised against swine flu amid growing signs that many doctors and nurses intend to shun the vaccine.
Chief executives and boards who run hospitals, primary care trusts and strategic health authorities have been told to urgently maximise the number of workers having the jab. Leading DH figures including Sir Liam Donaldson, the chief medical officer, have written to them six times in the last five weeks stressing the need for action before the second wave of the pandemic causes major problems.
Ian Dalton, the NHS’s national director of flu resilience, last week warned that vaccination of nurses, doctors and other frontline staff was “absolutely critical” and that widespread take-up of the jabs “will help us to save lives”.
The DH’s letters stress that patients’ health could be put at risk and the NHS left seriously short-staffed through virus-related absenteeism if senior managers do not overcome “perceived obstacles” to the vaccination of workers. Swine flu’s threat is so great that the NHS must avoid only small numbers of personnel getting immunised, as usually happens with seasonal flu every winter, the letters add.
They stress that vulnerable patients could be endangered if staff decide not to heed repeated urgings from Donaldson and other senior figures to have the vaccine. There are growing signs that large numbers of workers will shun the jabs because they see them as unnecessary and potentially unsafe.
Dalton wrote to the chief executives of local NHS organisations in England on 10 September telling them: “We all know that uptake of the seasonal flu vaccine among NHS staff is traditionally low. It is an NHS board responsibility that we do not find ourselves in this position with the swine flu vaccine.”
October 20th, 2009 at 7:58 pm
The first vaccinations in the UK-wide programme aimed at combating the spread of swine flu are to take place later.
Seriously ill hospital patients and the health staff caring for them will be the first of 14m people in the “priority group” to be given the jab.
From next week GPs will begin inviting people with health problems, damaged immune systems and pregnant women to come forward for immunisation.
Medical chiefs urged everyone in the priority group to have the vaccine.
The government has yet to decide whether the rest of population will be immunised, although enough doses have been ordered.
So far just over 100 people with swine flu have died in the UK out of the 500,000 who have been infected.
The spread of the virus peaked during the summer but in recent weeks the number of cases has started climbing again.
Sir Liam Donaldson, the government’s chief medical officer, said the vaccination programme was starting just in time.
“This is the first pandemic for which we have had vaccine to protect people. I urge everyone in the priority groups to have the vaccine,” he said.
He also stressed it was essential for NHS and social care staff to come forward.
Uptake-up of the seasonal flu jab among such workers in England has been low traditionally – often below 20%.
Sir Liam said: “It will help prevent them and their families getting the virus from patients, it will stop them passing the virus on to their patients, it will potentially protect them from mutated strains and it will reduce the disruption to NHS services caused by people being absent due to illness.”
The vaccination programme represents a huge logistical challenge for the health service and is likely to take at least two months to complete.
It is being run at the same time as the seasonal flu campaign and has forced many GP surgeries to take on extra staff to cope with the workload.
But Professor Steve Field, president of the Royal College of GPs, said despite the scale of the programme, doctors were ready to immunise the priority groups.
“We have been planning for this for a while and everything is in place. We will be contacting patients in the coming weeks and they should wait for that.”
There are two vaccines which will be used – one manufactured by GlaxoSmithKline and the other by Baxter.
The GSK one will be offered to most patients, while the Baxter vaccine is being generally reserved for people with egg allergies as the GSK jab was made using chicken eggs.
Most patients will require only one dose of the vaccine, although children and those receiving the Baxter version will need two doses, three weeks apart.
Under the system drawn up for GPs by the government, the priority groups have been ordered into four groups.
The under-65s with health problems and damaged immune systems, such as chemotherapy patients, will get the vaccine first.
They will be followed by pregnant women, then people who live with individuals who have compromised immune systems and, finally, those over 65 with health problems.
October 22nd, 2009 at 4:05 pm
A TEENAGE boy has become the fourth person suffering with swine flu to have died in the last 24 hours.
The news came as Department of Health figures showed cases of the killer virus in England have shot up 96 per cent in the past week from 27,000 to 53,000.
Increases were seen across all age groups with the largest rise – of 40 per cent – in 5 to 14-year-old children.
The four deaths – all in Scotland – were of a 16-year-old boy, a 77-year-old man, a woman, 54, from Glasgow and a 47-year-old woman from Fife.
Health officials said all four had underlying health problems.
The deaths bring the total in Scotland to 21 since the outbreak of the pandemic began in spring.
Figures showed the number of people with swine flu in Scotland increased to 14,650 last week. There were 75 people in hospital today with the H1N1 virus, 15 of them in intensive care.
Scottish Health Secretary Nicola Sturgeon said 108 people were hospitalised last week – up from 64 the previous week.
“The NHS continues to cope and continues to cope well. Obviously, that kind of increase in hospitalised cases does put pressure on the National Health Service,” she said.
News of the deaths come a day after the launch of a mass vaccination programme in the UK.
November 22nd, 2009 at 8:10 pm
Health officials say a Tamiflu-resistant strain of swine flu has spread between hospital patients.
Five patients on a unit treating people with severe underlying health conditions at the University Hospital of Wales, Cardiff, were infected.
Three appear to have acquired the infection in hospital.
They are thought to be the first confirmed cases of person-to-person transmission of a Tamiflu-resistant strain in the world.
There have been several dozen reports around the world of people developing resistance to Tamiflu while taking the drug – but they have not passed on the strain to others.
Just one possible cases of person-to-person transmission of a resistant strain has been recorded – between two people at a US summer camp – and this has never been confirmed.
Two of the University Hospital Wales patients have recovered and have been discharged from hospital, one is in critical care and two are being treated on the ward.
The health officials stressed there was no risk to anyone else.
They said tests were being carried out to confirm exactly what happened.
August 25th, 2010 at 2:36 am
The vaccination of children and adolescents in Finland with swine flu vaccine – Pandemrix – has been suspended until a link to narcolepsy has either been ruled out or detected, the Finnish National Institute for Health and Wefare (THL – Terveyden ja Hyvinvoinin Laitos) announced today. THL said this is a precautionary measure until the issue has been adequately examined and explained.
The seasonal flu vaccine recommendations in Finland are to include the swine flu vaccination. In other words, Finland hasn’t halted swine flu jabs per se, but rather the stand-alone version with adjuvants.
As there is no current epidemic in Finland, hence there is no immediate need for vaccination, THL added. Discretionary vaccinations will be allowed if the individual plans to travel to an infected area.
THL says the reported cases of narcolepsy could be due to:
* The H1N1 (swine) flu infection itself
* The vaccination
* The vaccination interacting with some other factor
September 8th, 2010 at 7:21 am
Infection from the 2009 A(H1N1) pandemic virus presented a lower risk of serious complications than other recent strains of the flu, according to US research presented Tuesday.
Analysis of influenza cases in the midwestern US state of Wisconsin showed infected individuals were younger than in earlier strains, but complications were not as likely as with the H3N1 virus that arose in the 2007-2008 flu season, said researchers at Wisconsin’s Marshfield Clinic Research Foundation.
“The pandemic 2009 influenza A(H1N1) virus caused widespread transmission in the United States and other countries,” noted lead author Edward Belongia and colleagues in the September 8 issue of the Journal of the American Medical Association (JAMA).
According to Centers for Disease Control and Prevention (CDC) estimates, the United States saw 43 million to 89 million infections from April 2009 to April 2010, “with mid-range estimates of 274,000 H1N1-related hospitalizations and 12,470 deaths,” including seasonal and pandemic strains, said the study.
September 17th, 2010 at 3:12 pm
A swine flu vaccine given to millions of Britons is under review over a possible link to the sleeping disorder narcolepsy, it was announced today.
The European Medicines Agency is looking into Pandemrix, made by GlaxoSmithKline, after a number of cases were reported, mostly in Sweden and Finland.
Pandemrix was the main vaccine used in the UK at the height of last year’s flu pandemic, and was given to millions of people in high-risk groups, including children and those with conditions such as diabetes, heart disease and asthma.
Overall, it has been given to at least 30.8 million Europeans.
Narcolepsy is a rare sleep disorder which causes a person to fall asleep suddenly and unexpectedly.
In a statement, the European Agency said: “Although the cases of narcolepsy have been reported in temporal association with the use of Pandemrix, it is at present not known if the vaccine caused the disorder.
“The Agency’s Committee for Medicinal Products for Human Use (CHMP) will look carefully at all of the available data to determine whether there is evidence for a causal association.”
On Tuesday, Finland’s National Institute for Health and Welfare recommended that vaccination with Pandemrix be stopped until the suspected link with narcolepsy had been thoroughly evaluated.
In December, the European Medicines Agency expressed concerns that children having their second dose of Pandemrix may develop a high fever.
September 20th, 2010 at 1:16 pm
The swine flu vaccine is to be included in the winter flu jab for the first time in a bid to stop the virus from returning.
Combining immunisation against the flu with the swine flu vaccine would prevent people from being able to turn down the swine flu jab without also missing out on the usual protection against winter flu viruses.
However, concerns have been raised about the swine flu vaccine after possible side-effects from the vaccine were reported in several European countries. The Department of Health said it intended to reassure patients that the vaccine was safe.
The government has more than 30 million swine flu vaccines left over after responding to the outbreak of the swine flu pandemic last year.
The World Health Organisation has advised governments to keep issuing the vaccine during the “post pandemic” period to protect against a possible resurgence of the H1N1 strain.
The Department for Health has decided to implement the advice immediately.
September 26th, 2010 at 5:08 pm
The flu season may feel far away but new research show that a flu jab can prevent heart attacks. DR ELLIE CANNON says now is the time to book a jab
Why should I have it?
Anybody can have a flu jab but there are certain high-risks groups who are offered them as a priority on the NHS. This includes all those over 65
and anyone with chronic heart, lung or kidney disease, as well
as diabetics. Anyone else must pay for a vaccine privately.
What’s in it?
The vaccine contains deactivated particles of the flu virus. This tricks your immune system into thinking the virus is in the body and so it creates protective antibodies that prevent you falling ill when presented with flu. Each year the flu vaccine is refined to help protect against current strains..
Can a child with diabetes have a jab?
Yes. All children with chronic diseases and weaker immune systems should have the vaccine.
When should you have it?
Now. The earlier in the winter you can get it the better to protect you for the season. GP surgeries will have their vaccines in stock already and most will offer flu clinics throughout the week.
September 29th, 2010 at 11:10 pm
All pregnant women will be offered the seasonal flu jab for the first time, under plans unveiled by the government.
The one-off move has been sanctioned as the swine flu virus – which is more risky for pregnant women than others – is likely to be still circulating.
The vaccine will offer protection against that and two other flu strains.
As well as pregnant women, it will be offered to the normal target groups – the over 65s, people with conditions such as diabetes and health workers.
This amounts to more than 14 million people, of which pregnant women account for about 500,000.
The Department of Health said GPs will have already started getting the vaccine and should complete the £100m programme by December.
Officials urged all the at-risk groups to come forward – take-up traditionally varies between about 75% for the elderly and 50% for those with health conditions, to just over 10% for health staff.
While it is a temporary move because of the swine flu risk, experts are currently reviewing evidence which could lead the government to keep pregnant women in the eligible group in future years.
Other countries, including the US, already offer it to pregnant women and they were included in the UK swine flu vaccination programme.
Some pregnant women in the UK will also have had the seasonal vaccine in the past, as a number would have fallen into the group targeted because of underlying health conditions.
It had long-been anticipated that this winter’s flu jab would include protection against swine flu.
October 1st, 2010 at 5:29 am
Multiple definitions of pandemic caused “confusion” and muddled the response, the head of a World Health Organisation probe into the international handling of the swine flu pandemic has said.
“This multiplicity has led to confusion and at least produced very different understandings of what the meaning of the field reality is,” said Harvey Fineberg, chairman of the review committee of external experts formed in April.
Fineberg said after the third round of hearings by the panel in Geneva that it would consider recommendations seeking “at the minimum” clarity and consistency on the issue.
However, he told journalists that a system with several definitions that could be applied to different situations might be warranted.
The WHO declared the first flu pandemic of the 21st century in June 2009 as the new A(H1N1) influenza strain spread swiftly around the world less about six weeks after it was first uncovered in the United States and Mexico.
It triggered a rash of costly emergency measures to guard against infection and a rush on doctors in some countries, but public concern about swine flu fizzled out later in the year as it proved to be less severe than feared.
A pandemic denotes global geographical spread, according to the WHO, but its flu alert system is also influenced by concerns about the potential severity of a virus, while some national definitions also differ.
Fineberg, who heads of the Institute of Medicine at the US National Academy of Sciences, said after several months of gathering testimony from a wide range of those involved in the swine flu crisis that many gaps in detail still had to be filled.
The experts, who will hold another public hearing in early November, are aiming to have a draft report ready for the WHO Director General in early January 2011, with the final version released in May, he said.
October 1st, 2010 at 5:44 am
Some two-thirds of Americans may already be immune to H1N1 swine flu, making an explosive new wave unlikely.
High vaccination rates this flu season, especially among children and young adults, might even drive the pandemic bug to extinction, speculate top researchers at the National Institutes of Health.
“Clearly, a large percentage of the U.S. population must already be immune to pandemic H1N1, reducing opportunities for explosive pandemic spread in the future,” write David M. Morens, MD; Jeffery K. Taubenberger, MD, PhD; and Anthony S. Fauci, MD.
“History suggests that pandemic H1N1 likely faces extinction unless it mutates,” they add.
Fauci is director of the National Institutes of Health. Morens is his senior advisor, and Taubenberger is a flu expert and senior investigator at the National Institute of Allergy and Infectious Diseases.
However, the H1N1 swine flu bug isn’t yet gone, and the most likely scenario is that it will continue to haunt us for a few years, even if it can’t reignite the pandemic.
“It is noteworthy that other post-pandemic [flu] viruses have continued to cause various rates of excess mortality among younger persons for years after pandemic appearance,” Morens, Taubenberger, and Fauci warn.
H1N1 Swine Flu Immunity High in U.S.
The National Institutes of Health researchers calculate that more people may be immune to H1N1 swine flu than previously appreciated:
* Even before H1N1 swine flu appeared, some 19% of the population had pre-existing immunity, likely due to some combination of exposure to related viruses and related vaccines.
* About 20% of the U.S. population received the H1N1 swine flu vaccine.
* About 20% of the U.S. population got swine flu.
* It’s possible that the 1976 swine flu vaccine offered some protection against H1N1 swine flu, even though it did not raise protective antibodies. If so, 8.3% more of the population is protected.
* People without the usual kind of antibodies that protect against flu may have other kinds of protective antibodies or other kinds of immune protection against the pandemic flu bug.
This means that at least 59% of Americans can’t get H1N1 swine flu unless it mutates. Over 67% of the population may have some kind of protection.
The 2010-2011 seasonal flu vaccine protects against H1N1 swine flu. If vaccination rates are high in the most vulnerable population — children and young adults — we may be able to say good-bye to the pandemic virus once and for all, the researchers say.
All bets are off if the H1N1 swine flu bug mutates, which it can do by a number of different mechanisms. But it hasn’t done this so far, suggesting that it may have limited ability to change.
Indeed, previous H1N1 viruses have not mutated very rapidly. On the other hand, they’ve managed to hang on and even come back despite very high levels of immunity all around the globe.
And it’s frustratingly unclear why, despite their limited ability to mutate, H1N1 viruses have hung on, even though they face competition from the seasonal H3N2 virus, which has been mutating very quickly since it appeared in 1968.
The Morens report appears in the online journal mBio.
October 17th, 2010 at 1:53 pm
Health chiefs have for the first time acknowledged that the swine flu jab may be linked to an increased risk of developing a deadly nerve condition.
Experts are examining a possible association between the controversial jab and Guillain-Barre Syndrome, according to a report from official watchdog the Medicines and Healthcare products Regulatory Agency (MHRA).
Previously, the Government has always stressed there is no evidence to link the paralysing condition to the H1N1 vaccine.
After The Mail on Sunday revealed in August 2009 that doctors were being asked to monitor cases of GBS during the swine flu pandemic, a letter from the Health Protection Agency’s chief executive Justin McCracken stated: ‘There is no evidence to suggest an increased risk of GBS from the vaccines being developed to fight the current pandemic.’
Now the MHRA’s newly published report suggests the Government’s position has changed.
It says: ‘Given the uncertainties in the available information and as with seasonal flu vaccines, a slightly elevated risk of GBS following H1N1 vaccines cannot be ruled out. Epidemiological studies are ongoing to further assess this possible association.’
It is not known precisely what causes GBS but the condition attacks the lining of the nerves, leaving them unable to transmit signals to muscles effectively.
It can cause partial paralysis and mostly affects the hands and feet – but it can be fatal.