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.

Elsewhere around the globe swine flu levels fluctuated. In Europe, Norway reported a rising number of cases. Further afield, Australasia has a mixed picture – the number of cases in Australasia is rising and preliminary reports suggest they are falling in New Zealand. In South Africa and Asia rates have increased. And in the Americas they saw fewer cases.

With a dwindling number of cases, much UK media coverage has turned to vaccination priority groups. The headlines vary.

Priorities

“Healthy children and over 65s are not a swine flu vaccine priority,” said the Telegraph. “Pregnant women to get vaccine,” the BBC reported. “First Swine flu vaccinations on the way for more than 13m Britons,” wrote the Guardian.

Vaccinations will start in October. Although there are enough vaccinations on order for the whole UK population, they will not all be available by October – this is one factor that means priority groups are needed.

At risk people (aged six months to 65 years) who get the seasonal flu jab will be first. Pregnant women will be next, subject to licensing and clearer information on timing. People living with immunosupressed individuals or those who are over 65 with co-morbidities will follow. Next will be front line health and social care workers. After that, officials will consider how best to manage risk in the wider population.

Sir Liam Donaldson said:

“We are looking at the prospect of extending the vaccination programme and the timing of that. We have to protect the most vulnerable and I think people will understand that we don’t want to see people who have underlying illnesses, particularly children, getting into a situation where they get serious complications from this flu.”

Discrepancies

The UK’s priority groups differ from the US’s, according to The Telegraph. In the US, healthy six month to 24 year olds will be a priority; some had expected schools and children to be a priority in the UK. Apparently, the discrepancy reflects a difference in the strategy of the two countries. The US is concentrating on reducing transmission, but the UK aims to prevent severe illness and death – most infections in healthy children and adults are mild.

Rolling it out

0.3 million jabs are ready. There are 11 million in the target groups above. Trials of the swine flu vaccine are underway, but there are concerns that one of the companies developing the vaccine, Baxter pharmaceuticals, is behind schedule. Sir Liam Donaldson said that the company has had difficulties growing the virus. However, GlaxoSmithKline, the other supplier, is contracted to deliver the majority of the UK’s order.

The government and leading doctors are now planning how to deliver the vaccine. For example, the jab could be given with the seasonal flu jab, if an individual needs both, according to the BBC.

Sewage

“Catch it, bin it, kill it” is the advice for preventing flu. But according to a story in The Telegraph some people are flushing it, and that may be causing problems. Anglian water think Swine flu could be behind “significant increase in blocked sewers and pumps”. They blame wipes.

“Wipes should not be flushed down the toilet, despite what the packaging may say, as unlike toilet paper, wipes do not break up – they can accumulate in the drains,” explained a spokesman for Anglia water, which supplies 5 million domestic and commercial customers.