EndocrinologySwine Influenza Daily Update: 16 July 2009, Wales
The NPHS influenza surveillance scheme, which records reports of diagnoses of flufrom more than 300 GP practices across Wales, shows low but increasing levels of influenza activity across Wales. Further detail can be found on the NPHS website.
The report from 14 July estimates there were 26.6 cases of a flu-like illness diagnosed by GPs out of every 100,000 people in Wales - this is the equivalent of 798 people in Wales contacting their GPs in the last seven days with flu like symptoms. Not all of these people will have swine flu and not everyone with flu like symptoms will contact their GP. It is expected that the proportion of influenza cases diagnosed that are due to swine flu will increase as the virus spreads in Wales.
The report also shows levels of influenza activity in each county of Wales. On 14 July, the rate of diagnosis of flu-like illness at a local level ranged from 9.3 per 100,000 people in Carmarthenshire, to 65.5 per 100,000 people in Newport.
GPs are no longer being asked to swab people they suspect may have swine flu. Microbiology laboratories are therefore no longer testing mostpeople suspected of having swine flu.
There have been 67 laboratory confirmed cases in Wales, with one new case:
A 20 year old female from Cardiff admitted to hospital, now discharged. She had recently visited a symptomatic relative in Birmingham.
A total of ten people with swine flu have been hospitalised in Wales, nine of whom have been discharged.
No further details will be confirmed or denied about cases in order to protect their right to confidentiality.
There have been 9,725 laboratory confirmed cases in the UK including the 67 cases in Wales.
The rate of GP consultations for flu-like illness across the UK are:
26.6 cases of flu like illness diagnosed by GPs out of every 100,000 people in Wales (as of 14 July) 23.6 cases of flu like illness diagnosed by GPs out of every 100,000 people in Scotland (for the week ending 8 July) 51.9 cases of flu like illness diagnosed by GPs out of every 100,000 people in England (for the week ending 5 July)
Seventeen people in the UK with swine flu have died - 15 in England and 2 in Scotland. The majority had underlying health conditions.
There has been a total of 385 people hospitalised with swine flu - 335 in England, 40 in Scotland and 10 in Wales.
Swine flu cases have been confirmed in 135countries. For the latest international figures for the spread of swine flu, visit the website of the World Health Organization at http://www.wales.nhs.uk/sites3/page.cfm?orgid=457&pid=38241
Comment from the National Public Health Service for Wales
Dr Roland Salmon, Director of the Communicable Disease Surveillance Centre, National Public Health Service for Wales, said:
"The rise in numbers of people contacting their GP with flu like symptoms illustrates the spread of the disease across Wales. Not everyone however who has contacted their GP with flu like symptoms will have swine flu and not everyone with swine flu contacts their GP so it is difficult to accurately record the spread of the virus across Wales.
"Previously, we have been investigating and responding to individual cases. This has allowed us to learn about the virus, how it spreads and how it affects people. We have learnt that, in the majority of cases it is mild although proving severe for a small minority. Most people recover from infection without the need for hospitalisation or medical care.
"As the disease becomes more widespread in the UK we have changed our approach to focus on treatment, emphasising those people most at risk - people more likely to develop serious illness or complications. These are, particularly, the groups that we encourage to get vaccinated each winter, because they areat risk from seasonal influenza, together with pregnant women and children under 5.
"As the virus seems to predominantly affect younger age groups, it is expected that we will see more cases in schools. As with any feverish illness, children who are displaying flu-like symptoms, particularly if their temperature is raised, should not attend school.
"If a child has had contact with someone diagnosed with swine flu and does not display any flu-like symptoms there is no reason for this child to be kept away from school.
"We advise people to practice good respiratory and hand hygiene to reduce the chance of catching or spreading the virus. If people think they may have flu and want to check their symptoms they can call the Swine Flu Information Line on 0800 1 513 513. If they are still concerned they should contact NHS Direct Wales on 0845 4647.
"People should not go to Accident and Emergency Departments or to their GP surgery as this may risk spreading the infection. It also places undue pressure on the emergency services."
Public health advice and messages
If you have flu-like symptoms stay at home. You can check your symptoms by calling the Swine Flu Information Line on 0800 1 513 513. If you are still concerned contact NHS Direct Wales on 0845 4647. Do not go into your GP surgery or Accident and Emergency department unless you are advised to do so or are seriously ill, as you may spread the illness to others.
Further information including health advice can be found at http://www.wales.gov.uk, http://www.nphs.wales.nhs.uk and http://www.hpa.org.uk. You can also call the Swine Flu Information line on 0800 1 513 513 for recorded information, or NHS Direct Wales on 0845 46 47 for health advice.
It is always good practice to follow respiratory and hand hygiene such as:
Covering your nose and mouth when coughing or sneezing, using a tissue when possible.
Disposing of dirty tissues promptly and carefully.
Maintaining good basic hygiene, for example washing hands frequently with soap and water to reduce the spread of the virus from your hands to face or to other people.
Cleaning hard surfaces (e.g. door handles) frequently using a normal cleaning product.
Helping your children follow this advice.
Facemasks
Although we are aware that facemasks were being given out to the public in Mexico, the available scientific evidence does not support the general wearing of facemasks by those who are not ill whilst going about their normal activities. We are, however, reviewing NHS supplies and stockpiles of facemasks for healthcare workers who are likely to come into regular contact with people who may have symptoms. The UK will receive an additional 227 million surgical facemasks and 34 million respirators. Wales will receive its proportionate share.
Control measures
Agreements have been signed between the UK Government and vaccine manufacturers to secure enough vaccine for the whole population. The first batches are expected in August with around 60 million doses by the end of the year - enough for 30 million people to be vaccinated - with more following after that.
The Welsh Assembly Government"s Health Emergency Preparedness Unit has issued guidance to Local Health Boards on anti-viral distribution. The unit is co-ordinating work on identifying appropriate collection points and the necessary arrangements to support this process.
Features of the outbreak.
Based on assessment of all available information and following several expert consultations, the World Health Organization (WHO) declared the level of influenza pandemic alert at phase six on 11 June 2009.
Phase six indicates there is human-to-human spread of the virus in at least two countries in one World Health Organization region, with community level outbreaks in at least one other country in a different WHO region.
On 2 July the four UK nations agreed to move to the treatment phase in their response to the pandemic - treating people most at risk. Contact tracing and the use of antivirals preventively have been ended. GPs will now provide clinical diagnosis of swine flu cases rather than awaiting laboratory test results.
Further information on swine flu and Pandemic Flu is available bilingually from http://www.nphs.wales.nhs.uk
Further information from the Welsh Assembly Government response is available bilingually at http://www.wales.gov.uk
Welsh Assembly Government