New guidelines on the management of pandemic H1N1 influenza were published recently by the Department of Health. They include guidelines on when to refer patients to hospital (see below) and an update on the epidemiology of the disease: fewer than 1% of cases are admitted to hospital; 12-15% of patients admitted to hospital go on to need high dependency or critical care; and mortality for hospitalised adults is around 6%. more…

One thing about the current swine flu pandemic is that it has brought with it a universal sense of fear. As with all fears, individuals respond differently, but we know what they are feeling because the sensation of fear, which varies from a mild anxiety to incapacitating panic, is so much part of our constitution that some see it as a normal component of the human condition. more…

England’s chief medical officer Sir Liam Donaldson can sound gloomy and pessimistic but he sounded very upbeat in this week’s swine flu update, saying: “We may have got a lucky break in how the virus has behaved at the start of our flu season and we may be able to get the vaccine out there before our flu season really gets under way. I’m looking at it very optimistically.” more…

The BBC trailed it as everything you need to know about swine flu. The title probably raised my expectations too high.

A street poll near the start of the programme showed that the public were a bit confused about who was at the most risk of swine flu, so it seemed the programme had some scope to educate viewers; and it did feel a bit like a government broadcast, or a school education film. Three presenters travelled the world to “expose the myths and the dangers of swine flu,” interviewing “swine flu survivors and the relatives of its young victims”. more…

Two swine flu call centres in England will close on Sunday with the loss of 1200 jobs reports The Guardian. Demand for Tamiflu has plummeted: it peaked on 27 July with nearly 39,000 authorisations for the use of Tamiflu while on 16 August there were only 3396. According to the HPA there were only 11,000 new cases of swine flu last week and the GP consultation rates have dropped from a peak of 35 consultations per 100,000 of the population to under 5 (similar to the rate in January this year for seasonal flu). 59 people in the UK are reported to have died from the virus so far. more…

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.” more…

I had the honor of being the first case reported officially from the United Arab Emirates (UAE). It was 3 am on Sunday, 17th May when I arrived at Dubai Airport, via Calgary and Heathrow, after spending a week with my family in Saskatoon, Canada. Later that day I returned to my department at the university where several colleagues passed by my office to welcome me back. That night l developed a sore throat, high fever, and cough. At 8 am the following day, feeling lethargic and generally unwell and fearing the worst, I went to the emergency department of our local hospital and presented myself to the on-duty infectious diseases consultant.

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The number of swine flu cases fell across the UK again, according to the weekly figures from the Health Protection Agency, although they caution their interpretation. Sir Liam Donaldson, England’s chief medical officer, announced plans to scale back the pandemic flu service now cases are falling. At the moment there are around 1600 call centres. He plans to reduce this to between 200 and 600 from 23rd August, according to the BBC. more…

Carl Heneghan

The last few days has been hectic since the publication of our systematic review in the BMJ on the use of  antivirals in children.  By now, you are probably aware of the findings given the media interest. Basically, our study raised questions about the usefulness of antiviral flu drugs in preventing and treating flu in children, indicating the harmful effects may not be justified by the limited benefits provided. This puts us in direct conflict with the DOH policy of antivirals for all. I think what is important in the present pandemic is to remember how we spent a number of years preventing a similar strategy with the use of antibiotics in sore throat; especially when the published research showed limited benefits in mild disease and the emergence of resistance became a real issue.    more…

Calm settled over swine flu coverage this week as the northern hemisphere headed into the summer holidays; but much remains uncertain.

Stories tracking the Health Protection Agency’s weekly flu figures fell from the front pages. But based on the agency’s numbers, the press report that cases, consultations, admissions and deaths from swine flu are far lower in the UK this week than last – as predicted for the summer. more…