Is there anything new about swine flu?

The Department of Health update revealed an interesting finding this week. The Guardian reports;

“One of the odder aspects of the latest data is that only 10% of those who sought help from a GP or the National Pandemic Flu helpline and subsequently took a swab test actually showed signs of infection.”

Other incidence figures from the report appear reassuringly low for the UK and other European countries. The lull might give the northern hemisphere a chance to learn from the southern hemisphere – the south emerging from their winter flu season.

Top tips from experts working down under add practical advice to a BMJ feature, pandemic lessons from Australia.

Tips from Australia

“Encourage primary healthcare sector to assess respiratory rate and where possible to do pulse oximetry in patients with typical influenza symptoms, to check for potential severe disease,” said Paul Torzillo, a respiratory and intensive care physician from Sydney.

For hospital planning he added; “increase intensive care capacity to cope with increased numbers of patients with overwhelming respiratory failure.”

The themes of Australia and intensive care cropped up during UK discussions of the flu figures this week too. The Guardian reported some of numbers from Australia;

“The development of the pandemic in Australia has been worrying health officials,” it writes, “with as many as 30% of those admitted to hospital being treated in intensive care.”

UK officials should already be thinking about flu intensive care plans. It hit the UK headlines after a Scottish woman was flown to Sweden for extracorporeal membrane oxygenation because there was no room for her in the UK. Days later, intensive care also emerged as a concern in the third report on Pandemic flu from The House of Lords Science and Technology Committee, July 2009.

In pandemic lessons from Australia, intensive care physician Paul Torzillo continued;

“I’ve never seen anything like this in my professional life, and I’ve been a respiratory intensivist for 30 years. There may well be fewer people who are old with comorbidities who die, but there is no question that the overwhelming respiratory failure you see in young people is something you rarely ever see with normal influenza.”

Meantime, Paul Collingnon, an infectious diseases physician has a different view and thinks response to the virus has been excessive.

“One of the lessons we need to learn is not to over-react. The problem with influenza experts is that they’re to a large degree fixated on what happened in 1918-9 and think that’s going to happen again. Over 95% of deaths then were due to bacterial pneumonia. We now have effective antibiotics.”

The great flu game

Now it seems anyone can try out planning for the pandemic. The Australian Sydney Morning Herald reports on the success of a computer game based on stopping a pandemic virus.

“The clock is ticking, people are dying and a flu virus is sweeping the globe,” according to the opening scenario of The Great flu game. Players can choose to stockpile drugs or deploy research teams, and using limited funds they must purchase their choices.

The game was developed as an educational resource for Dutch teenagers, and launched at the start of the year, before the pandemic struck. At its peak it has attracted 40,000 users a day, according the article.
Albert Osterhaus, head of virology at Rotterdam’s Erasmus Medical Centre and the games scientific editor said;

“If the money is well invested, the pandemic can be stopped.”