A timeline showing the latest swine flu news and content from the BBC website, the Guardian and Health Service Journal
Created by Mike_Berry_ on 09/07/2009
Last updated: 18/10/10 at 11:06
Tags: swine flu BBC Guardian Health Service Journal
The hysteria over swine flu made me sickIt's probable that you are not reading this wearing a "swine flu" surgical mask, but if you are, please take it off for two reasons. The first is that the "swine flu pandemic" (which cost Britain an estimated £1bn, with fewer fatalities worldwide than regular flu) is now deemed semi-officially "over", with the UK's 24-hour helpline closing this week.The second reason to take the masks off is that people who wore them, even when they weren't at international airports, bound for far-flung destinations, who were merely strolling down ordinary British streets, nipping into Boots or Argos, tended to look rather silly.Other people who looked silly during the swine flu scare were those who kept anointing their hands with sterile gel, pumping away on their overpriced mini-dispensers, as if obsessive compulsive disorder was no longer a psychological issue affecting the unfortunate few, but a tic signalling the self-indulgence of the many.And let's not even get into hunching wild-eyed over the internet trying to "score" Tamiflu, or queuing for it when nobody was even ill yet, but – hey! – that slight snuffle could turn dangerous. Or it could just be a slight snuffle, but then where was the fun – the suspense, the hysteria – in that?In the end, swine flu didn't destroy the world, but it did expose us as a nation of hypochondriac drama queens. It was all very well ensuring that the most vulnerable (elderly, young, sick) would be safe, but what about the rest of the perfectly fit adults, putting on masks, gel-ing hands, screaming for Tamiflu like babes in arms wailing for mother's milk?All the while, the rationale was: "Better to be on the safe side, it's so scary, we're all going to die!" The way certain people were acting anyone would have thought the doodlebugs were still falling. So from Blitz spirit in real adversity to headless chickens when not much is going on. Never mind what happened to swine flu, what happened to us?Admittedly, retrospect is a wonderful thing. What if swine flu had erupted into a genuine pandemic? Indeed, people did die (411 in the UK, with over 100 people still hospitalised), and no one is underestimating their suffering.However, let's talk about overestimating. Chief medical officer Liam Donaldson said at worst swine flu could claim 65,000 lives. Health secretary, Andy Burnham estimated 100,000 new cases a day (figures now say 5,000 cases a week, far below the average for regular flu). Meanwhile, drug companies enjoyed an estimated £4bn pandemic bonanza. That's rather a lot of time, money, and angst expended on what was for the majority a bit of a heavy cold.Even at the time, some of us had our suspicions (the new Black Death or just the new bird flu?), but we found ourselves screamed down by not just the powers that be but also the Tamiflu-crazed masses. Indeed, isn't it the case that, while diseases are said to be forever changing, the climate of public reaction in Britain has changed too – to over-reaction?Most people eventually came to the conclusion that while there was an element of over-reaction to Princess Diana's death, what we don't seem to realise is that it didn't end there. It would seem that the same strain, the same bubble of hysteria and melodrama, is present in public reaction to other things too.All of which must have contributed to the public hysteria over swine flu, when relatively few deaths (well, 64,589 fewer than Donaldson predicted) were reported. All of which was embarrassing to behold. Hypochondria is bad enough in individuals, but intolerable when it seizes an entire nation. Next time, let us hope that some of us will pause before donning our masks, or squirting our gel, and think: "Hang on, last time this cost us a billion."Gisele, if you didn't feel pain, I sure didExactly how much does beauteous Brazilian supermodel, Gisele Bundchen want to be hated by other women? She recently opined that giving birth "wasn't painful, not even a little bit". Oh really. Pray explain how forcing another living being out of your body doesn't hurt "not even a little bit". Does what happens to John Hurt's chest in Alien look painless?In some ways, it doesn't matter what Gisele says – she looks tithe type who would refuse an epidural because she's scared of the extra calories. Nevertheless, the very fact of her saying it is an appalling betrayal of her sex. Women be aware: even, if by some miracle, it genuinely doesn't hurt, if you are blessed with the strength of Zeus, and nether regions of Sheffield steel, don't be going on about it, there's a duck.The pain of childbirth is the one arena where women can claim eternal bragging rights, where men can't hog centre stage – they just have to put up with us, nature's life-givers, whingeing about our terrible sacrifice, how we might never be the same again physically (be brief but pointed with this bit), but it was all worth it in the end, despite the hell we went through. ("For them" is insinuated.)Now here is Gisele saying that childbirth was pain-free and easy. Shut up, you're spoiling everything. Indeed, Gisele – you're a supermodel who once dated Leonardo DiCaprio – women already have enough reasons to resent you. You really don't need to provide more.Jews aren't paranoid – they are still victims of hateAttacks on Jewish people were at a record high in 2009, according to data collected by the Community Security Trust, a Jewish organisation monitoring "hate" attacks, which recorded 924 incidents – 55% more than the previous peak of 598 incidents in 2006.Incidents include verbal abuse and violence, bullying of schoolchildren and bacon strips hung on the doors of synagogues and the CST reports a direct link to events in Gaza. Gordon Brown called the findings "deeply troubling" and they are. So is the fact that it took a Jewish organisation to compile these figures.Now that we have them, are we going to start taking this seriously? Obviously Jewish people are far from alone in being targeted for "hate crimes"; recently Exeter University called upon Muslims to start their own CST system of monitoring. However, had black or Asian communities been targeted, wouldn't a 55% increase in incidents be a cause for national concern; wouldn't we be seeing heaving editorials about the rise of the BNP?Indeed, while there have been several reports about increased attacks on Jewish communities, with some Jewish people I know saying they feel "unsafe" like never before, this always seems to be met with a kind of shrugging-off or apathy. It's almost as if people are saying, well, yeah, it does appear to be antisemitism, but that's not as bad as real racism is it? One doesn't want to make excuses for the British, but, while not prejudiced per se, it's almost as if some people are unaware of how easy it is to slip into antisemitic stereotypes. There's just this jumble of alleged Israel/Jewish paranoia ("They're constantly harping on about being victimised"), as well the spurious feeling that: "They can look after themselves – aren't they all rich and powerful and best mates with Stephen Spielberg?"That 55% rise in antisemitic hate crime is nothing to shrug off. Nor is the prevailing feeling that what happens to Jewish people, and their places of worship, is "no biggie". Perhaps the CST figures will help prove that, aggravated by Israel or not, this is becoming a huge problem, and British Jews are not paranoid. The fact they were moved to compile their own figures is shocking.Swine fluBarbara Ellenguardian.co.uk © Guardian News & Media Limited 2010 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/commentisfree/2010/feb/07/barabara-ellen-swine-flu
There was no conspiracy or panic. Scientists were right to prepare us for a major crisisSimon Jenkins's distaste for scientists leads him to declare that they deliberately overstate risks, and make panic predictions (Swine flu was as elusive as WMD. The real threat is mad scientist syndrome, 15 January). In reality, scientists worked calmly – not "frantically" as Jenkins asserts – to predict the progress of the disease and to understand risk.Jenkins says of the initial predictions about the spread of swine flu: "The chief medical officer, Sir Liam Donaldson, bandied about any figure that came into his head, settling on '65,000 could die', peaking at 350 corpses a day."Worst-case predictions are not figures plucked out the air "to convey plausibility", but result from well-researched computer simulations. Margins of error are high; no one pretends otherwise. Yet Jenkins is delighted when a worst-case scenario isn't met, as though he were right and everyone else wrong.There is a genuine debate which we must not overlook. What should the government response be? Does the risk justify the expense of stockpiling vaccine? Is it right to divert funds away from other health matters? But Jenkins doesn't ask such questions – instead he dismisses it all as "hysteria". Reasonable advice – alerting morgues, identifying vital key workers – is denounced as "drivel".You could argue that media coverage of H1N1 was excessive and that editors think the biggest numbers make the best headlines. But the scientific process has been evidence-based and transparent throughout. At the Science Media Centre we have tried to ensure that responsible journalists have had access to the best scientists. We've seen lots of co-operation and very little hysteria.Science moves by small steps, and as we learn more the picture becomes clearer. This is how official advice on Tamiflu for children was revised. Each time a risk comes along we are better prepared to characterise the next one. But decisions still need to be made early. Picture a beleaguered Simon Jenkins in the middle of a deadly pandemic, decrying the government's woefully inadequate response and failure to order enough vaccine.It's embarrassingly straightforward. Viruses usually don't mutate into major killers; that's why there are still people left on the planet. But it has happened before and will happen again. We can't predict when – that's what risk is – but we can perform the analyses, educate ourselves and be prepared, all underpinned by evidence drawn from virology and epidemiology. Or we could shrug and say it's all hype, and most of the time we'd be right. Similarly, most of the times I put on a seatbelt I don't crash my car.Jenkins's logic goes as follows. Once there was a boy who cried wolf, but there wasn't a wolf. Therefore not only do wolves not exist, but there must be a conspiracy between wolf experts, the lupine risk assessment board and the manufacturers of bite-proof trousers to convince the rest of us that they do.With swine flu there wasn't conspiracy and hype; just scientists, patiently performing the analyses, and explaining the possibilities.Swine fluHealthHealth policyNHSFluHealth & wellbeingFlu pandemicTom Sheldonguardian.co.uk © Guardian News & Media Limited 2010 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/commentisfree/2010/jan/21/swine-flu-panic-health-tamiflu
Simon Jenkins may scoff about swine flu estimates, but HIV/Aids has taught us not to wait to see how deep a pile of bodies getsIt is disappointing to see Simon Jenkins continue his attacks on scientists attempting to explain complex concepts of risk about a new strain of virus to an ignorant public whose main source of information is an often hysterical media. From his opening paragraph Jenkins presents a unique interpretation of the dangers of swine flu based on his understanding of comments from public scientists. He accuses Sir Liam Donaldson of bandying "about any figure that came into his head, settling on '65,000 could die'". This figure was in fact a worst case scenario, as the article linked to in Jenkins' piece clearly indicates.Jenkins cites BSE/CJD as a previous example of scare story about science that came to nought, claiming that "it would 'lead to 136,000 deaths' – a spurious exactitude used to convey plausibility". Again the cited article makes clear that this is an estimated upper limit in a worst case scenario. One might also be curious about where Jenkins came across the phrase "the absence of evidence is not the evidence of absence," which he calls a classic Rumsfeld-ism. In fact it is a misquote from Carl Sagan's Demon Haunted World, where it is used to illustrate the dangers of arguing from ignorance.But this isn't about Jenkins' lack of scholarship, this is about a reflexive, unthinking attitude to science and risk assessment that can go drastically, horribly wrong. In the early 1990s, when Jenkins was editor of the Times, he supported the then Sunday Times science correspondent, Neville Hodgkinson, who advocated the arguments of Peter Duesberg, a now notorious individual, who doubted the links between HIV and Aids. At this point in time Duesberg's theories were already considered wrong by the scientific community, yet this did not stop the Sunday Times from lending its support. In December 1993 Jenkins wrote an article in which he claimed that fears over Aids were simple scaremongering, predictions of fatalities were wrong, and drug company funding was distorting the public debate, thus, the link between HIV and Aids should be questioned. This position was untenable given the current state of the literature. Interestingly the arguments in that piece are almost identical to those Jenkins wields today against the dangers of swine flu.What Jenkins fails to understand is that scientific arguments are not constructed by rhetoric, but by the tedious and often slow process of evidence-gathering and interpretation. Sometimes, especially so in the case of a rapidly spreading disease, an official response is required before the scientific picture is clear. This response is based on a risk assessment from the contemporaneous evidence and can often seem to be wrong given hindsight benefiting from up-to-date evidence. Even so, governments are not responding in the firm belief that the worst is happening, they will be prepared for a wide range of possibilities, from slight to serious. The impact of the epidemic will become more apparent as the state of knowledge improves and the response modified accordingly. However, it is undesirable for governments to sit back and wait and see how deep the pile of bodies becomes before a serious response begins.Perhaps the best example of sitting back and waiting for disaster comes from the way in which South Africa dealt with Aids under Thabo Mbeki. Influenced by Duesberg and Hodgkinson, among others, Mbeki doubted the link between HIV and Aids and declined to make anti-retroviral drugs publicly available. It has been estimated that more than 300,000 deaths occurred because of this in South Africa alone.Being wrong about an epidemic can be lethal. Jenkins might be right in assuming that the dangers of swine flu and BSE/CJD were overestimated, but he was wrong about Aids. Being right two out of three times might be a winning strategy in games of poker, but when being wrong results in hundreds of thousands of deaths it is hard to argue that the game is worth playing given the stakes.• This article was amended on 19 January 2010. In its original form it wrongly referred to Neville Hodgkinson as "the then Times science correspondent". He in fact worked for its sister title, the Sunday Times. This has been corrected.Swine fluHealthBSEHIV infectionAlexander Holmesguardian.co.uk © Guardian News & Media Limited 2010 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/commentisfree/2010/jan/18/anti-science-lethal-simon-jenkins
Remember the warnings of 65,000 dead? Health chiefs should admit they were wrong – yet again – about a global pandemicLet me recap. Six months ago I reviewed the latest bit of terrorism to emerge from the government's Cobra bunker, courtesy of Alan Johnson, home secretary. Swine flu was allegedly ravaging the nation. The BBC was intoning nightly statistics on what "could" happen as "the deadly virus" took hold. The chief medical officer, Sir Liam Donaldson, bandied about any figure that came into his head, settling on "65,000 could die", peaking at 350 corpses a day.Donaldson knew exactly what would happen. The media went berserk. The World Health Organisation declared a "six-level alert" so as to "prepare the world for an imminent attack". The happy-go-lucky virologist, John Oxford, said half the population could be infected, and that his lowest estimate was 6,000 dead.The "Andromeda strain" was stalking the earth, and its first victims were clearly scientists. Drugs were frantically stockpiled and key workers identified as vital to be saved for humanity's future. Cobra alerted the army. Morgues were told to stand ready. The Green party blamed intensive pig farming. The Guardian listed "the top 10 plague books".If anyone dared question this drivel, they were dismissed by Donaldson as "extremists". When people started reporting swine flu to be even milder than ordinary flu, he accused them of complacency and told them to "wait for next winter". He was already buying 32m masks and spending more than £1bn on Tamiflu and vaccines. Surgeries refused entry to those with flu symptoms, referring them to a government "hotline" where prescription drugs were ordered to be made available without examination or doctor's note. Who knows how many died of undiagnosed illness as a result? Lines were instantly jammed. It was pure, systematic government-induced panic – in which I accept that the media played its joyful part.This week the authorities admitted that, far from a winter upturn in swine flu, there has been a slump. From 100,000 a week at the peak, there were just 12,000 last week. After the coldest winter for decades, when deaths might be expected to rise, the rate is below that of seasonal flu. In the UK, 360 people have died under its influence, most with prior "non-flu" conditions. Swine flu is not nice – I have had it – but bears no relation to the government hysteria.I accept that anyone can make a mistake, and authority has some duty to err on the side of caution. As Alastair Campbell implied on Tuesday, Iraq might have had weapons of mass destruction, so Blair was right to go to war just in case. But it is reasonable to ask, as the Chilcot inquiry is doing, why precaution on such a colossal and potentially destructive scale was justified when those who questioned the need for it have since been proved right. Is anyone asking about flu?Swine flu is not the first time we have suffered this nonsense. I have a stack of predictions by senior scientists on BSE/CJD in 1995. It would "lead to 136,000 deaths" – a spurious exactitude used to convey plausibility – and "could infect up to 10 million Britons". This led to an obscene £5bn campaign of cattle destruction and compensation. When the prediction proved wildly wrong, the government excused itself with a classic Rumsfeld-ism: "The absence of evidence is not the evidence of absence."This was followed by Sars 2003, a "panic gripping the world". The World Health Organisation declared that "One in four Britons could die". The medical doom-monger, Dr Patrick Dixon, said that Sars had "a 25% chance of killing tens of millions", whatever that meant. The madcap Tory health spokesman, Liam Fox, demanded the arrest and quarantining of all recent travellers from Asia, including 30,000 Asian students.In the event, some 800 people died with Sars worldwide, against 21,000 who died in Britain in the seasonal flu epidemic of 1999/2000.Undaunted, within a year the same alarmists were at work on avian flu. With now habitual hyperbole, Donaldson predicted 50,000 deaths, with "an upper limit", graciously conceded, of 750,000. When one dead swan slumped on a beach in Scotland, BBC reporters went crazy as inspectors stumbled through the seaweed, clad in anti-nuclear armour. Within a year the horror had passed. The global mortality was put at 262, with not one death in Britain. Another fiasco was brushed under the carpet.The Blair government, and now Brown's, have proved adept at using scare politics to divert attention from other troubles. During foot-and-mouth Blair was quick to don a yellow jumpsuit for photographers and intone as if he alone stood between an illness (that is in fact harmless to humans) and armageddon. This time the swine flu coincided with two other "mystery diseases", MRSA and C-difficile, which killed 10,000 Britons in 2007 alone. But those deaths lay squarely at the doors of unclean NHS hospitals. Hence there were no scary stories or predictions about them from Donaldson.Donaldson and his eager virologists will doubtless stick loyally to their predictions since it is "too early to be complacent". His allies at the BBC did their bit on Wednesday with a Horizon programme that turned a serious study of virology into grotesque scaremongering, with solemn music and voices crying, "there's no escape", "this could take a devilish turn", and "we don't even know how many viruses there are!" Children writhed in agony from smallpox.Mad scientist syndrome is rampant. Had these scares been disseminated by a private firm, a local authority or a newspaper (as was anti-MMR), they would be damned from on high with demands that heads roll. As it is, the government's Scientific Advisory Group for Emergencies sails gaily on, still graced by the presence of Sir Roy Anderson, who happens also to draw a six-figure salary as a non-executive director of GlaxoSmithKline, which made hundreds of millions from the government's panic. Anderson, and GSK, vigorously deny any conflict of interest.The Council of Europe's head of health, Wolfgang Wodarg, is one of the few who have dared blow the whistle on the links between "Big Pharma" and national and supranational agencies. He this week persuaded the council to stage a debate on the "enormous gains" made by GSK and others from the swine flu pandemic. He seeks details of relations between the companies and the WHO, given that stockpile contracts kick in the moment that organisation uses the word "pandemic". It did so for the first time last year, with reckless alacrity.I am not aware of the WHO or the General Medical Council or any of the medical colleges investigating these matters, or any check on conflicts of interest of government doctors who work for drugs companies. I am not aware of any Whitehall or Commons committee, any National Audit Office or competition inquiry into the supply of these drugs. All I know is that a huge amount of health money, time and effort was last year diverted from possibly critical therapies into what looked from the start to be yet more terror virology.This is why people are ever more sceptical of scientists. Why should they believe what "experts" say when they can be so wrong and with such impunity? Weapons of mass destruction, lethal viruses, nuclear radiation, global warming … why should we believe a word of it? And it is a short step from don't believe to don't care.Swine fluBSESarsBird fluMRSA and superbugsNHSSimon Jenkinsguardian.co.uk © Guardian News & Media Limited 2010 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/commentisfree/2010/jan/14/swine-flu-elusive-as-wmd
Council of Europe to discuss whether pharmaceutical firms spread alarm over pandemic to boost orders of medicinesEuropean health chiefs are to hold emergency talks about whether pharmaceutical giants have unduly influenced governments into squandering public money on vast stockpiles of unnecessary swine flu drugs.The Council of Europe will debate a resolution that accuses drug companies of leaning on public health officials to alarm governments about the risks of H1N1 flu.The talks, due to be held later this month, come as British ministers decide what to do with a surplus of as many as 20m doses of vaccine ordered at the height of the swine flu outbreak."The governments have sealed contracts with vaccine producers where they secure orders in advance and take upon themselves almost all the responsibility."In this way, the producers of vaccines are sure of enormous gains without having any financial risks. So they just wait, until WHO says 'pandemic' and activate the contracts," Wolfgang Wodarg, head of health at the Council of Europe, told the Daily Mail.Wodarg, who proposed the resolution, added that H1N1 virus was "a mild flu and a false pandemic".Last week, Germany and France announced they would scale back orders or sell excess H1N1 drug supplies. Shares in the manufacturer GlaxoSmithKline (GSK) have fallen as orders are cancelled. The drugmaker had previously estimated total sales of its pandemic flu vaccine across more than 70 countries at £2bn, over 2009 and 2010.The impact of the H1N1 virus has been less severe than anticipated. At the height of the pandemic scare, around 65,000 deaths were expected in Britain; the current, downgraded estimate is for 1,000 fatalities. The latest death toll for the whole of the UK stands at 360.The Department of Health confirmed last week that a total of 28.9m doses had already been delivered to the UK – 23.9m from GSK and 5m from another firm, Baxter.A break clause in the Baxter contract has been exercised by the UK but more orders were due to arrive from GSK. Health officials were negotiating with the firm to suspend further deliveries.Professor David Salisbury, the Department of Health's director of immunisation, confirmed that discussions about what to do with Britain's surplus vaccine were under way.But Salisbury stressed: "We have to keep a stockpile for ourselves because we simply don't know what is going to happen over 2010, and we know that there are proportions even within the risk group who have not been vaccinated."If there were a UK resurgence during 2010, we would look very foolish if we had disposed of a valuable stockpile."The options being reviewed include selling it, giving it away, or possibly even keeping one of its component parts – known as an "adjuvant" – to use as the basis of a vaccine for a different virus pandemic in the future.The text of the resolution prosed by Wodarg calling for an inquiry states that "in order to promote their patented drugs and vaccines against flu, pharmaceutical companies influenced scientists and official agencies responsible for public health standards to alarm governments worldwide and make them squander tight health resources for inefficient vaccine strategies, and needlessly expose millions of healthy people to the risk of an unknown amount of side-effects of insufficiently-tested vaccines."The total bill for fighting swine flu in the UK was put at £1bn in a parliamentary question back in September. It is expected to have risen since then.Swine fluHealthWorld Health OrganisationVaccines and immunisationJames SturckeOwen Bowcottguardian.co.uk © Guardian News & Media Limited 2010 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/world/2010/jan/11/swine-flu-h1n1-vaccine-europe
John Oxford, professor of virology at Barts, on why the danger isn't over yetI first heard about swine flu in April, sitting having a coffee in St Pancras station, near my office. I read a small item in a specialist newsletter I get by email, called Daily Virology News, headlined "Two cases of swine flu in Orange County, California." The two main vaccines in use now are named after them, because they were the first two cases that were picked up.Initially I didn't think swine flu was serious. The real problem would have been, and still is, a bird flu pandemic. An H5N1 outbreak would have been a huge global health emergency and would have shaken the planet, and cost who knows how many lives.Swine flu has been relatively mild, but it has killed about 9,000 people worldwide, including several hundred in the UK, and left others seriously ill. It's a relatively mild virus, but has a nasty sting in its tail – one that's being stuck into pregnant women, children under four and obese people. The number of deaths of children has caught people's attention and made them anxious. But remember that 25,000 people in the UK died of seasonal flu in the winter of 1999-2000, mainly the elderly, and nobody seemed to care about that.I took Tamiflu as a preventative measure in Cairo in the summer, when I woke up feeling unwell after visiting a chicken market the day before. The Tamiflu didn't affect me at all, perhaps because I took it with a biscuit, as you're meant to. Taking Tamiflu is like taking an aspirin for a headache; it's a safe drug.I haven't had the swine flu jab yet because I'm not in a risk group; but as soon as I can get it, I will. About 80m people worldwide have been vaccinated with it so far and no one has died as a result. People shouldn't worry about taking it, including pregnant women.Air travel means that modern societies are more vulnerable to pandemics than before, because it has made the world so small. as John Donne said, "No man is an island." So problems in Mexico soon became problems in America, then Scotland, England and Spain.My greatest fear is that the virus will mutate next year, to enable it to infect older people. If it does, then the death rate next year will be much worse than this, perhaps even as high as the winter of 1999-2000. Remember that between a third and a half of all people who have ended up in intensive care with swine flu were previously completely well; they weren't asthmatics or on chemotherapy. While the pandemic has been fairly mild here, I think it will kill off for ever the notion (among doctors and the public alike) around influenza that "Oh, it's only flu". I hope that will be swine flu's lasting legacy.Swine fluDenis Campbellguardian.co.uk © Guardian News & Media Limited 2010 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/world/2009/dec/27/swine-flu-vaccine-mutating
Figures show 25 people died of the virus last week, though number of new cases has dropped by halfThe number of new swine flu cases has fallen for the fourth successive week, suggesting that – despite more deaths – the outbreak may be on the wane.Figures released by the Department of Health today show that 25 people died from the H1N1 virus in the past week, bringing the total number of fatalities in the UK since May to 270.Sir Liam Donaldson, the chief medical officer in England, said there had been "a striking reduction" in the incidence of swine flu in young children, but cautioned that it was too early to claim victory.The biggest fear was that the virus could mutate, he said, although there had been no evidence of that so far. "We're not sitting here claiming a victory as there's still too many things to worry about." Another peak in reported cases could occur after Christmas, he added.In England, around 22,000 new cases emerged this week, a fall in the rate of infection of more than half compared with the previous week's record of 46,000. But calls to the National Pandemic Flu Service from parents worried about their young children rose.Their anxiety may reflect the fact that proportionately more young people have died in the second wave of the outbreak this autumn than during the initial surge of infections in the summer.The unusual pattern of fewer infections but more critical cases continues. There are 161 patients with swine flu being treated in intensive care beds, a slight increase. Around a quarter of those currently receiving hospital treatment are under the age of five.As many as 275,000 frontline health workers have been vaccinated against swine flu over the past four weeks, the department has revealed. Eighteen million doses of swine flu vaccine have so far arrived in the UK.In terms of swine flu deaths, there have been 178 England, 54 in Scotland, 25 in Wales and 13 in Northern Ireland.Dr Roland Salmon, director of the communicable disease surveillance centre of the National Public Health Service for Wales, said: "The number of people who test positive for swine flu, as a proportion of all those being tested, is falling. There are other illnesses circulating in the community, with symptoms very similar to swine flu."At the moment, about one in every 10 people tested for swine flu actually has swine flu. Nine out of ten people tested do not have swine flu, but often have another infection such as the common cold or seasonal flu virus."The pandemic is also declining in other parts of the world. "In North America and a limited number of European countries there are signs that disease activity has peaked," the Health Protection Agency said.According to a comparative survey of public figures who have talked about swine flu, Gordon Brown is the "least effective communicator" on the pandemic. The study was carried out by Insignia Communications together with the University of Wolverhampton. To be fair to the prime minister, he was only non-health official rated – the findings suggest a medical expert provides a welcome voice of reassurance.Swine fluHealthNHSOwen Bowcottguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/world/2009/dec/03/swine-flu-rate-falls
Sixth patient tests positive for Tamiflu-resistant strain of swine flu in CardiffThe number of people catching swine flu in England is falling, figures out today show.There were an estimated 46,000 new cases in the last week, down from 53,000 in the week before. The number of people in hospital has also dropped, from 783 to 753. Of those, 154 are in intensive care.The number of deaths linked to the virus rose to 163 from 142.Experts confirmed today that a sixth person has tested positive for Tamiflu-resistant swine flu at the University Hospital of Wales in Cardiff. Five patients were diagnosed in the same hospital last week, in what could be the world's first cases of person-to-person transmission of the strain.The National Public Health Service for Wales said the new patient was linked to the five people found to be resistant to Tamiflu last week and was tested as part of routine screening arrangements."Test results are still awaited on one other direct contact of the six patients with swine flu resistant to Tamiflu," it said. "All other patients on the unit have now tested negative for the virus."Three of the patients remain in hospital, with one in critical care.All patients diagnosed with Tamiflu-resistant swine flu have been treated with an alternative antiviral.Swine fluHealthNHSguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/world/2009/nov/26/swine-flu-cases-fall-england
Most people get better from swine flu in about a week. But some people have had longer-lasting illness, and some people have had serious complications. For the majority of people, swine flu is a minor illness. Many people will have had swine flu and recovered without even seeing a doctor, or taking medicines. And many will have recovered well after treatment with an antiviral drug. Treatment with an antiviral drug may help people recover faster, and avoid the risk of complications.You'll be at your most infectious in the early stages of your illness. You might still be spreading the virus five to seven days after you first get symptoms. When you've been free of symptoms for more than 24 hours, you're unlikely to be infectious any more.[2] However, some people with swine flu get more severe illness. In many cases, these have been people with certain risk factors. Risk factors don't mean you will definitely have more severe illness from swine flu. But they mean you are more likely to be seriously ill. Risk factors include:[3] [4] Being pregnant, especially during the last three months of pregnancy Being a child under five years of age Having heart or vascular disease Having lung disease (including asthma) Having diabetes Having kidney, liver, or nervous system disease Having a suppressed immune system (from illness or drug treatment) Having cancer Being very overweight (obese). More seriously ill people may need to be treated in hospital. They may need higher doses of antiviral drugs, or support with their breathing. One study showed that pregnant women in the US were more likely to be admitted to hospital with swine flu than other people. That could be because they've been more seriously affected. Or it might be because doctors are more cautious with pregnant women. They might be more willing to admit pregnant women, to be on the safe side.[5] Some people who've been treated in hospital had severe pneumonia caused by the swine flu virus.[6] Pneumonia is when an infection causes part of your lungs to clog up with fluid and stop working properly.Some people have died from swine flu. It's very hard while the outbreak is still growing to tell how many people are likely to die from it.[7] One estimate is that it could be anywhere between four deaths for every million cases and 600 deaths for every million cases. So the experts are still very unsure.[8] For comparison, about 300 to 400 people die from seasonal flu in the UK every year. Seasonal flu is much more likely to be fatal for older people (over 65). But in Mexico, where swine flu first became common in March and April 2009, young people aged 20 to 45 were much more likely to be seriously affected than people over 65.[1] Call your GP for advice if you are being treated for swine flu and: Your condition suddenly gets worse You are still getting worse after seven days (five days for children). If you or someone you are caring for has bad breathing problems such as severe breathlessness or very fast breathing (not just breathing problems from a stuffy nose), call 999 for an ambulance.[9] References Chowell G, Bertozzi SM, Colchero MA, et al. Severe respiratory disease concurrent with the circulation of H1N1 influenza. June 2009. Available at http://content.nejm.org/cgi/content/short/NEJMoa0904023v1 (accessed on 8 September 2009). Health Protection Agency. Swine flu: frequently asked questions. July 2009. Available at http://www.hpa.org.uk (accessed on 8 August 2009). World Health Organization. Preliminary information important for understanding the evolving situation: Pandemic (H1N1) 2009 briefing note 4. Available at http://www.who.int (accessed on 8 August 2009). Health Protection Agency. Human swine influenza: information for health professionals. August 2009. Available at http://www.hpa.org.uk (accessed on 8 August 2009). Jamieson DJ, Honein MA, Rasmussen SA, et al. H1N1 2009 influenza virus infection during pregnancy in the USA. August 2009. Available at http://www.thelancet.com (accessed on 8 September 2009). Centers for Disease Control and Prevention. Intensive-care patients with severe novel influenza A (H1N1) virus infection - Michigan, June 2009. Morbidity and Mortality Weekly Report. 2009; 58: 749-752. Garske T, Legrand J, Donnelly CA, et al. Assessing the severity of the novel influenza A/H1N1 pandemic. BMJ. 2009; 339: 2840. Wilson N, Baker MG. The emerging influenza pandemic: estimating the case fatality ratio. July 2009. Available at http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19255 (accessed on 8 August 2009). Department of Health. NHS swine flu adult community assessment tool. Available at http://www.dh.gov.uk (accessed on 8 August 2009). Glossary pneumonia Pneumonia is an infection in your lungs. Anything that causes infections (bacteria, viruses or fungi, for example) can give you pneumonia. asthma Asthma is a disease of the lungs. It makes you wheeze, cough and feel short of breath. Asthma attacks are caused by inflammation and narrowing of your airways, which makes it hard for air to pass in and out of your lungs. kidney disease Your kidneys are the organs in your body that make urine. Kidney diseases are diseases in which your kidneys have been damaged. Kidney disease can be caused by several things, including high blood pressure (hypertension). immune system Your immune system is made up of the parts of your body that fight infection. When bacteria or viruses get into your body, it's your immune system that kills them. Antibodies and white blood cells are part of your immune system. They travel in your blood and attack bacteria, viruses and other things that could damage your body. © BMJ Publishing Group Limited ("BMJ Group") 2009Health & wellbeingSwine fluguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/lifeandstyle/besttreatments/swine-flu-prognosis
Swine flu cases across the UK with data showing swine flu rates in England, Scotland and WalesWe know there are still a lot of swine flu cases across the country right now - rates are starting to rise again with the onset of the flu season. But where are the concentrations? Which areas have the highest rates? Now we know.Produced by Nottingham University's Division of Primary Care the figures show the rate of infections recorded in GPs' surgeries across England, Wales, Scotland and Northern Ireland. You can see from this exactly how bad Tower Hamlets is - and which areas have the lowest rates. Nottingham only really gets us England and Northern Ireland rates, so we have gone to the regional government sites for Scotland and Wales data.Can you visualise it for us?Download the data• DATA: download the full list as a spreadsheetCan you do something with this data? Flickr Please post your visualisations and mash-ups on our Flickr group or mail us at datastore@guardian.co.uk• Get the A-Z of data• More at the Datastore directory• Follow us on TwitterSummary table Swine fluHealthHealth & wellbeingFluSimon Rogersguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/world/datablog/2009/sep/18/uk-swine-flu-cases-data
All healthy schoolchildren may be vaccinated against swine flu, the Department of Health revealed today, as it issued guidance on how to help pregnant women who catch the infection.Confirmation that the government is considering extending the vaccination programme came as the Conservatives called for all pupils to be immunised against the H1N1 virus.Cases of the disease in England increased only marginally this week to 84,000, according to official estimates. The latest figures show 154 people have died from swine flu – 105 in England, eight in Wales, 31 in Scotland and 10 in Northern Ireland. Seventeen people have died in the UK in the past week.The chief medical officer, Sir Liam Donaldson, confirmed the government's Joint Committee on Vaccination and Immunisation is examining whether to extend the vaccination programme.Healthy children are not among the priority groups in the first round of vaccinations. "We would hope to take a decision on [inoculating them] in the next few weeks," he said. "We are looking very hard at the next steps. We will have to work out whether any groups in the healthy population will have to be prioritised."The Tory health spokesman, Andrew Lansley, proposed a universal schools vaccination programme. "For weeks now, behind the scenes," he said, "I have urged the government to go further: they should extend the vaccination programme to schoolchildren and college students."Last week in America I met swine flu experts at the Health and Human Services Department. Their data shows the incidence and severity of swine flu is significantly greater in the under-24 age group, compared to the rest of the healthy population. They have called all young people for vaccination, including a school-located vaccination programme. I think we should follow their lead."The Department of Health said the US had so far left it up to individual states to determine what they believed were the priority groups deserving protection.Its new advice to help doctors recognise serious symptoms in pregnant women has been released, suggesting those with high heart rates or shortness of breath when first infected are most at risk of serious illness or death.The guidance notes that: "Pregnant women have been noted to have a four times higher risk of being hospitalised for complications compared to the non-pregnant population."The new guidance also notes that: "The mortality rate for all hospitalised adults is approximately 6%" – a stark figure suggesting that a significant proportion of those admitted for treatment will die.A Department of Health spokesman added: "The chief medical officer has already announced that the vaccine programme will be extended – we will announce details shortly."Swine fluFluHealth & wellbeingHealthSchoolsOwen Bowcottguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/world/2009/nov/05/swine-flu-vaccine-for-schoolchildren
• World No4 wants best possible preparation for Australian Open• ATP monitors spread of swine flu as leading player falls illAndy Murray has revealed that he is so determined to get everything right in an effort to do well at the Australian Open in January that he is to forego his traditional Christmas at home in favour of staying at his training base in Miami.For the past two years, Murray, the world No4, has trained in Florida in December but returned to Scotland for a family Christmas before flying to a tournament in Doha and then on to Australia. Last year, although he managed to win in Doha he picked up a virus that affected him at the Australian Open, where he lost to Fernando Verdasco in the fourth round.This year, the family will have to fly out to see him for he has decided to change plans and go straight from Miami to Australia, where he will begin his preparations for the year's first grand slam tournament in the mixed team event at the Hopman Cup in Perth, where he will represent Britain alongside 15-year-old Laura Robson, last year's junior Wimbledon champion.The fact that swine flu is becoming ever more prevalent in Scotland, with more than 30 people having died of the virus there, was probably not uppermost in Murray's mind when he decided to change his plans but the 22-year-old admitted that it is a concern for all the players after the news that Tommy Haas, the world No17, had fallen ill. "It's tough," he said. "I think quite a few of the players have had it, but none of them as high profile as Tommy."Murray said he was sure Haas would recover quickly but with tennis players as much at risk as any other sportsmen and women – a number of Premier League teams last week admitted that some of their players have been affected – the ATP said it is closely monitoring the situation, having issued the players with general guidelines when swine flu first hit in the spring. Any player affected, who is worried whether the medication they are taking might cause a positive drugs test, is advised to call a 24-hour anti-doping hotline."I am looking forward to going to Australia early and making sure I'm over the jet lag and fully ready," Murray said. "I was coming back from Miami and going to Scotland for a few days over Christmas so it was three, four weeks of training [in Miami], then back to Scotland, [where] it's cold, go to Doha, it's cold. It's like two weeks of bad weather and you go to Australia and you've got basically four or five days to get used to the heat again. I think doing it this way will work much better. I am going to spend Christmas in the States and then go straight over to Australia from there."Andy MurrayAustralian OpenSwine fluTennisSimon Cambersguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/sport/2009/nov/05/andy-murray-australian-open-swine-flu
Department of Health examines whether to broaden vaccination programme as figures show small rise in new casesThe Department of Health today revealed that all healthy schoolchildren could be inoculated against swine flu.The news came as the department issued fresh guidance on how to help pregnant women who become infected with the virus.Cases of swine flu appear to have increased only marginally in the past week, according to official estimates, but unseasonably warm weather and the half-term break could have impeded its spread.There were an estimated 84,000 new cases of swine flu during the past week, up 6,000 from the week before.The latest figures reveal that 154 people have died from the H1N1 virus – 105 in England, eight in Wales, 31 in Scotland and 10 in Northern Ireland.Seventeen people died in the UK last week, while the number of patients in critical care due to swine flu has increased.The number of critically ill patients in hospital continues to rise, adding to the pressure on intensive care beds.There are 172 people in critical care, and 848 are currently receiving hospital treatment for the condition.Speaking via satellite from Washington, where he is attending a medical conference, the chief medical officer, Sir Liam Donaldson, confirmed that the government's joint committee on vaccination and immunisation was examining whether to extend the planned vaccination programme.Healthy children are not included in the priority groups who will be inoculated in the first round of vaccinations."We would hope to take a decision on this in the next few weeks," Donaldson said. "We are looking very hard at what might be the next steps."We will have to work out whether any groups in the healthy population will have to be prioritised."New advice for doctors about how to recognise serious symptoms in pregnant women is also being released. The guidelines suggest that those whose heart rates rise rapidly when first infected could be at serious risk from swine flu.Swine fluSchoolsHealthChildrenOwen Bowcottguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/world/2009/nov/05/swine-flu-schoolchildren-vaccination
Fever, shivers, delirium: being sick makes you a rock'n'roll animal, if only for a week or so"Everybody's got the fever," murmured Elvis, and Peggy Lee before him. They didn't seem to think it was a bad thing; in fact, it was "a lovely way to burn". Later, when the Bee Gees caught Night Fever, they didn't want it to go away. They were "prayin' for this moment to last". They even started "glowin' in the dark" it was so good.The Nation of Ulysses' Ian Svenonius positively celebrated his poorly state in 50,000 Watts of Goodwill: "I promise you that I'll never get well! I'm throwing out all my vitamin pills, yeah yeah yeah!" "Burnin' up can feel so right," was Bad Company's diagnosis, and in a song also called Fever, Kylie just wanted to know when she could remove her clothes.This year, swine flu has proved to be a media and pharmaceutical bonanza, with a major side effect of public fear. But as many of us have now experienced, when the body turns up the heat to fight off invading forces, maybe it isn't end of the world – it may even be the start of something interesting. Fever sends your mind wild with delirium, while your body stays in the same position for a long time. You then have no choice but to stay home, eat junk food, read comics and mutter crazed messages from the Other Side.To be sick is to fail to conform – it makes you a creature of rock'n'roll. By skiving school and avoiding work, you unintentionally become a rebel. Your body, at once taking control and going on strike, breaks all the rules that you, and everyone else, have set for it. This visceral quality is at the root of rock'n'roll; previously suppressed feral urges come to the fore and dictate the action. Rock'n'roll has always celebrated the sick, twisted and weird. It's never been about winning, arranging a mortgage or being promoted at work. What's really cool is to be an outsider. Being laid low by the flu gives you a brief taste of outsider culture, if only for a week or so.Your choice: run off for a vaccine that could be as Toxic as Britney, or accept, like Beastie Boys, that it's Time to Get Ill. Pop and rockSwine fluguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/music/musicblog/2009/nov/02/flu-new-rock-and-roll
Halloween 2009 may see a lull in trick-or-treating as Denver health experts encourage children to stay at home so as not to spread swine fluEven the undead become ill, so vampires and zombies, along with pirates, ghosts and princesses, who are ill for Halloween 2009 should stay home, health experts in the US are warning.They might miss the treats, but they'll avoid the nasty trick of spreading swine flu.Public health experts in America are busy dispensing tips for a flu-free Halloween. "All the little vampires need to come with their own dentures this year," said Jim Rettew, spokesman for the Denver office of the American Red Cross. "Don't trade fangs."Little Jimmy may be tired of his Frankenstein mask and want to put on someone's Sponge Bob mask," he said. "But all those germs accumulate in the mask and then they share it with all their friends."Parents should remind kids to keep their hands away from their eyes, nose and mouth to keep germs away.And forget those big bowls of sweets."We love our kids to death, but they're little germ factories," he said. "Now the flu has the chance to walk itself door to door."People on both ends of the treats giving and receiving should not spare the hand gels.And some old traditions are now out of bounds. "Bobbing for apples is out this year," said Rettew. "We don't want open mouths in a communal tub of water, with everyone drinking the same witches brew."And don't forget the obvious."If you see a scary looking pig with the flu on his chest," he said, "turn and run away."HalloweenSwine fluUnited Statesguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/lifeandstyle/2009/oct/31/halloween-2009-google-doodle
The number of swine flu patients being treated on intensive care wards rose by more than 50% in the past week, according to the Department of Health. More than 750 people – 102 of them children – are currently in hospital in England owing to illnesses associated with the H1N1 virus. There are 157 patients in critical care.The total number of deaths across the UK rose this week to 137, up from 128 at the end of the previous week. The estimated infection rate rose from 53,000 new cases last week to 78,000 this week – still well below the peak infection rate recorded in July.The government's chief medical officer, Sir Liam Donaldson, warned that there has been a "very substantial increase in the numbers in intensive care" despite the lower prevalence."We are seeing a level of activity in the community which has not yet reached anywhere near the levels we were seeing in July," Sir Liam said. "But we are seeing a level of ... serious illness in hospitals which has easily surpassed the level we saw in July."In England, there have been 97 swine flu-related deaths since the outbreak began, in Scotland 25, in Northern Ireland eight and in Wales seven.Many of those outside hospital considered to be at high risk from swine flu may not receive their pandemic vaccinations until mid-December, the department confirmed yesterday.People suffering from conditions such as heart disease, cancer, asthma and diabetes are due to be first in line for the innoculations, alongside pregnant women and frontline NHS staff.Boxes of GlaxoSmithKline's vaccine, Pandemrix, have begun arriving in GP surgeries this week, although the government admits few will have received them yet. Ian Dalton, national director for flu resilience, said all GPs in England should have their first box of 500 doses in the next three to four weeks. "It's the nature of running a vaccination programme of this type," he explained.A civil disobedience group opposed to the vaccines – TPUC – has put up posters in Birmingham hospitals warning against having the jab and claiming there are safety fears. The slogans declare: "Swine flu is not the biggest danger. It's the vaccine."A report in the online Lancet medical journal suggests that allowing children to fall ill with seasonal flu may protect them against more dangerous pandemic strains. Vaccinating children aged six months to five years against seasonal flu might not be in their best interests, say the three Dutch doctors, led by Dr Guus Rimmelzwaan, from Erasmus Medical Centre in Rotterdam.They said their research showed that infection with "seasonal" influenza A viruses could induce immunity against unrelated sub-strains.Flu jabs for healthy children are recommended in the US and some European countries, but not currently in the UK.Swine fluFluHealth & wellbeingHealthOwen Bowcottguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/world/2009/oct/30/swine-flu-intensive-care
Carlo Ancelotti says his grandmother's concoction will sort out a dose of H1N1. Which homemade remedies work miracles?Chelsea manager Carlo Ancelotti says that he is unconcerned by the prospect of a swine flu outbreak, even after the revelation that three players from Blackburn Rovers, who faced Chelsea last Saturday, have been struck down by the illness. Rather than stock up with Tamiflu, Ancelotti is putting his faith in a remedy passed down through his Italian family:It is my grandmother's prescription. It's hot milk with red wine. Fantastic. I'm not worried [about swine flu]. My players will shake hands and swap shirts with their opponents as normal, absolutely.We might leave it up to Ancelotti to road-test this particular beverage, but perhaps you'd like to tell us about your own homemade cures for common afflictions. Hot cider with lemon and honey for a bad cough? Mint infusions for a cold? Marmite on toast for a hangover? What are the best – or most outlandish – homespun remedies you've come across?Carlo AncelottiWineHealthSwine fluguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/commentisfree/2009/oct/29/wine-milk-homemade-remedies
Government estimate of 78,000 newly infected up from 53,000 the week before, but figures still below virus's summer peakThe number of new swine flu cases has risen by almost 50% in the past week, government figures showed today, although the level remains below that seen at the peak of the virus's spread in the summer.There were an estimated 78,000 new cases of swine flu in England in the past week, up from 53,000 in the week before – which in turn was double the number in the previous week, meaning the rate of increase has declined.The weekly tally is also still below the 100,000 weekly cases at the peak of swine flu in July.There are currently 751 people in hospital with the virus, of whom 157 are in intensive care. The number of swine flu deaths in England now stands at 97.While the number of cases in the summer outbreak declined steeply, there was a widespread presumption that the H1N1 virus would again spread rapidly with the onset of winter, when seasonal flu outbreaks tend to peak.During the lull, plans were rushed through for a mass vaccination programme against swine flu, which was launched eight days ago, targeting 11 million priority patients and frontline health workers in its initial phase.The US president, Barack Obama, last week declared a national emergency in America over swine flu, although health officials described this as mainly a precautionary measure.Swine fluHealthHealth policyPeter Walkerguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/world/2009/oct/29/swine-flu-cases-rise-in-week
Get all the cases, suspected and confirmed, in our up-to-date spreadsheet• Swine flu cases where you liveThe World Health Organisation has declared a swine flu pandemic, and the British government now expects the flu to hit 100,000 cases a day in August.Well, we have been tracking swine flu, day by day and the best figures out there are below. We're listing every case, as it's reported, either by country health agencies or the mainstream press wires and reports. The WHO is no longer updating its figures. Now it looks like the US CDC might be doing the same thing. But we will continue to get you the most reliable data we can, making this one of the few up-to-date swine flu sources on the web.There are some caveats: not all of these cases have been confirmed as swine flu in the lab; the dates in the spread sheet are mostly the dates they have been reported in the media, not the dates reported to the medical authorities. We've also left off a lot of the suspected cases, just because we're not sure about the source. But as this progresses, we will try to do more with this and get more info - and any ideas, let us know. The data here is being updated at a faster rate than the interactive graphic - so keep refreshing the page for latest figures. We've cross-referenced these figures repeatedly - let us know if you would like to see anything else. Swivel has already started visualising our data, as has Visioko (although you need to download their app to see it. What can you do?Download the dataDATA: swine flu cases, country by countryDATA: swine flu cases, country by country (use this if you already have a GoogleDocs account)VISUALISATION: how this data looksResearch by Holly Bentley and Lauren GoodchildCan you do something with this data? Flickr Please post your visualisations and mash-ups on our Flickr group or mail us at datastore@guardian.co.uk• Get the A-Z of data• More at the Datastore directory• Follow us on TwitterSummary tableSwine fluFluMexicoHealthHealth & wellbeingSimon Rogersguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/news/datablog/2009/apr/27/flu-flu-pandemic
Agriculture secretary emphasised that flu could not be contracted by consuming pork productsAt least one pig in the US has tested positive for the H1N1 virus, the US department of agriculture said today, the country's first case of a pig contracting the virus.US agriculture secretary Tom Vilsack said in a statement that USDA officials have begun to reach out to US trade partners and international organisations to emphasise that H1N1, also known as swine flu, cannot be contracted by eating pork products."We have fully engaged our trading partners to remind them ... that there is no scientific basis to restrict trade in pork and pork products," Vilsack said. "People cannot get this flu from eating pork or pork products. Pork is safe to eat."The USDA's National Veterinary Services Laboratories confirmed the presence of H1N1 after an initial test suggested that as many as three pigs may have had the virus. The USDA is continuing to conduct tests to confirm other potential positive tests from the pig samples. The original samples were taken as a part of a university research project from pigs shown at the Minnesota state fair between 26 August and 1 September.USDA officials have said that the pigs did not show signs of sickness, and officials suggested they likely contracted the virus from some of the nearly 1.8 million people who visited the fair in the mid-western state.Officials also said the infection of a so-called show pig doesn't indicate an infection of commercial herds because show pigs are in separate segments of agriculture than the swine industry.Agriculture officials have expected H1N1 to find its way to domestic pigs this year. Herd infections were already reported in Canada, Australia, Argentina, Ireland, Britain and Norway. A hog vaccine for the virus is being developed but isn't yet available.Swine fluAnimalsUnited StatesObama administrationguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/world/2009/oct/19/swine-flu-h1n1-minnesota
Patrick Blower: livedraw: This week we have seen the return of old favourites, from Damien Hirst to swine fluPatrick Blower
http://www.guardian.co.uk/commentisfree/video/2009/oct/16/damienhirst-banking
The majority of doctors and nurses are bypassing the swine flu jab. Health Department officials fear that the vaccine's low take-up could have dire consequences when the second wave of the pandemic hits. Should immunity be mandatory for all health staff?
http://www.guardian.co.uk/commentisfree/poll/2009/oct/12/nhs-swine-flu
• Health department urges frontline staff to get jab• Inoculation vital in efforts to contain pandemic 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."But hospital chief executives have told the Guardian that they expect as few as 10%-20% of their staff to get vaccinated and cannot fulfil the DH's demands because the jabs, which are due to begin within days, are entirely voluntary.One chief executive of a busy urban hospital in one of the swine flu "hotspots" said: "At the moment in my hospital if nothing changes then it could be that 10%-20% of staff have the swine flu jab … Staff could have the virus and pass it on to patients, a proportion of whom will die, albeit a very small proportion."He added: "The other consequence is that if loads of staff go off with swine flu that will leave us short-staffed, which is dangerous to patients. That's a bigger danger than transmission."Another hospital chief executive said: "Ideally it should be 100% of frontline staff having the swine flu vaccine. But it obviously isn't going to be. I hope we'll get at least the 50% we usually get for seasonal flu. This is important because although this strain of swine flu is mild in most people, if it's contracted by someone with an underlying health condition that can be serious."One medical director at another hospital added: "The word on the street in NHS staff circles is that the vaccine is no good and you shouldn't bother with it. Nurses in particular worry that there may be side-effects, that corners have been cut in producing the vaccine and that the generally mild nature of the virus means they don't need to take it. As few as 10%-15% of doctors may have it because we doctors believe ourselves to be above such trivial things as infections."A poll by Nursing Times magazine last week showed that the proportion of nurses who do not intend to get vaccinated has risen from 31% in August to 47%, while those who definitely will has fallen from 35% to 23%.Dame Christine Beasley, the chief nursing officer for England, responded by stressing that the vaccine is "as safe as a vaccine can be" and adding: "Nothing in life is risk-free. I can well understand people being worried. I can well understand people thinking it's only a mild illness and why should I bother? I do understand all that, I think you wouldn't be human if you didn't think that." Beasley wants directors of nursing to act as role models to allay concerns among frontline nurses.Hospital chief executives say privately that Donaldson's repeated reminders of the mild nature of swine flu's effects in those who contract it, and recent claim that the UK is "tantalisingly close" to beating the virus, may be leading staff to believe that vaccination is not important.The health department said: "Frontline healthcare workers will be absolutely crucial in the height of a pandemic – without them, patient care will suffer, and the NHS will be stretched. Getting the swine flu vaccine will protect them and their patients."It added: "All NHS organisations will be working hard to ensure that all eligible staff have the choice to protect themselves and their patients from swine flu by having the vaccine."Swine fluFluFlu pandemicNHSHealthDoctorsNursingDenis Campbellguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/world/2009/oct/11/swine-flu-pandemic-vaccine-nhs
Chief medical officer now optimistic about the scale of the epidemicBritain's swine flu outbreak is slowing down, possibly as the result of a "lucky break" in the way the virus has behaved, the chief medical officer said today.Sir Liam Donaldson, who has been generally cautious in his weekly predictions on the likely course of the epidemic, was more optimistic as he suggested during a news conference that the peak number of cases may be lower than previously thought.The rate of increase looks to be nothing like the weekly doubling of cases that experts had predicted. Last week, there were 18,000 new cases of swine flu, rising from 14,000 the previous week and 9,000 the week before that."We are well into the second wave of pandemic flu, having had the first wave in July, but it's proving so far to be a slow burner," Donaldson said. "It's possible that it might peak at a lower level – and an earlier level – than expected which would be incredibly positive news."It means we could get the vaccine programme well under way. If this virus has another peak up its sleeve, as in 1968, we might be able to avert that completely."The news did not look as good in Northern Ireland, however, where a 12-year-old boy died in the Ulster hospital at Dundonald on the eastern outskirts of Belfast – the second death in less than 48 hours.The Department of Health in Belfast said the boy had a "serious underlying medical condition" but would not elaborate.The health minister, Michael McGimpsey, who conceded there was now a high level of swine flu in Northern Ireland, said: "It is very sad when a child dies and my thoughts and sympathies are with the family. I would ask everyone to respect the privacy of the family at this very sad time."He warned: "Incidents of swine flu in Northern Ireland remain high and we must expect further increases in cases in the weeks ahead. Swine flu remains a major public health threat, but we are well prepared and have been planning for a pandemic for some time."Four people from Northern Ireland have now died from the complications of swine flu. The last death, on Tuesday, was of a three-year-old in the south-east. The two previous victims were a mother of two young children, who died in August, and a soldier from Co Londonderry who was serving in the south of England and died in July.There have been 76 deaths in England, one in Wales and two in Scotland. There are 290 people in hospital in England with diagnosed swine flu, of which 47 are in intensive care. Sir Liam said the number of people in intensive care was the highest figure for the last two months. He said this was a "bit of a concern".Half a million doses of one of the two swine flu vaccines ordered by the government, made by Baxter, are now in stock in the UK, but deliveries from GlaxoSmithKline are still awaited. The government hopes to start vaccinating frontline health workers and priority groups by the end of this month."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," said Donaldson. "I'm looking at it very optimistically."Swine fluHealthNHSSchoolsSarah Boseleyguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/world/2009/oct/08/lucky-break-slows-swine-flu
• Demand for H1N1 vaccine up by 50% since August to 440m doses• GSK on course for £3bn boost as governments stockpile for winterBritain's biggest pharmaceutical company today disclosed a big boost in orders for its swine flu vaccine as governments around the world build stockpiles ahead of the winter.GlaxoSmithKline, headed by chief executive Andrew Witty, revealed that the number of orders for its H1N1 vaccine had jumped by 50% to more than 400m since August, putting the company on course for a windfall worth about £3bn by the end of the year, according to City analysts.Witty has said that each vaccine will sell for close to £5 a shot, although the boost to GSK's top line ignores production and research and development costs, so profits will be lower. But Kevin Wilson at Citigroup said that "pandemic sales should lead to potential earnings surprises through the fourth quarter of 2009 to the second quarter of 2010 when overlaid with the rest of the business".GSK has received 22 government contracts since the summer, with a total of 440m doses ordered. The company makes the vaccine in Dresden and Quebec but the demand is so great – about 60% higher than for usual seasonal vaccines – that it is also outsourcing production to third-party manufacturers.The vaccine has been approved by European officials and the US is expected to follow suit soon. GSK said talks were under way with governments around the world over further supplies.Authorities are also stockpiling large supplies of GSK's anti-viral treatment Relenza, which can relieve swine flu symptoms, providing another lift for revenue.British health officials are worried that there could be a marked increase in swine flu cases as the northern hemisphere moves into colder weather over the next couple of months.In the UK, there are plans to vaccinate the entire population, if necessary, and the government has already given the go-ahead for vulnerable people and frontline health workers to receive jabs over the next four to six weeks.Whether the rest of the population is then offered a jab will depend on the evolution of the pandemic in the coming months.Separately, GSK unveiled plans to expand in China by establishing a joint venture with a local biotech company to produce MMR vaccines ahead of "a significant expansion in the Chinese public vaccine market".The move is part of a plan by Witty to further diversify into the emerging economies of Asia and Latin America.Under the terms of the Chinese deal, the UK group will build a manufacturing facility, passing on its technology to enable local production within in a few years. Initially, about 65% of the venture will be controlled by GSK.GlaxoSmithKlinePharmaceuticals industryCitigroupSwine fluRichard Wachmanguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/business/2009/oct/06/glaxosmithkline-swine-flu-vaccine-orders
UN report says pandemic may result in anarchy unless western world pays for antiviral drugs and vaccinesThe swine flu pandemic could kill millions and cause anarchy in the world's poorest nations unless £900m can be raised from rich countries to pay for vaccines and antiviral medicines, says a UN report leaked to the Observer.The disclosure will provoke concerns that health officials will not be able to stem the growth of the worldwide H1N1 pandemic in developing countries. If the virus takes hold in the poorest nations, millions could die and the economies of fragile countries could be destroyed.Health ministers around the globe were sent the warning on Thursday in a report on the costs of averting a humanitarian disaster in the next few months. It comes as officials inside the World Health Organisation, the UN's public health body, said they feared they would not be able to raise half that amount because of the global downturn.Gregory Hartl of WHO said the report required an urgent response from rich nations. "There needs to be recognition that the whole world is affected by this pandemic and the chain is only as strong as its weakest link. We have seen how H1N1 has taken hold in richer nations and in the southern hemisphere. We have been given fair warning and must act soon," he said.The report was drawn up by UN officials over the last two months. It was commissioned in July after Ban ki-moon, the UN's secretary general, expressed concern that the H1NI virus could have a severe impact on the world's poorest countries.It paints a disastrous picture for the world's most vulnerable people unless there is immediate action. "There is a window in which it will be possible to help poor countries get as ready as they can for H1N1 and that window is closing rapidly," it says."Countries where health services are overburdened by diseases, such as HIV/Aids, tuberculosis and malaria, will have great difficulty managing the surge of cases. And if the electricity and water sectors are not able to maintain services, this will have serious implications for the ability of the health sector to function."If suppliers of fuel, food, telecommunications, finance or transport services have not developed plans as to how they would continue to deliver their services, the consequences could be significantly intensified," it adds.The 47-page report provides a detailed breakdown of the basic needs of 75 vulnerable countries with the weakest capacity to withstand an escalation of the virus. Six countries from Latin America, including Cuba and Bolivia, 21 countries from Asia and the Pacific such as North Korea and Bangladesh, and 40 countries from Africa such as Congo and Eritrea are included in the survey.UN officials say in the report that £700m should be spent on antiviral drugs and vaccines to protect health care workers and other essential personnel as well as cover those suffering from severe illness. They have identified 85 countries that do not have the ability to access vaccines from any other source and intend to cover 5-10% of each population.A further £147m should be put aside to organise vaccine campaigns, improve communications, monitor levels of illness and improve laboratory capacity in 61 countries, the report claims. The remainder should be used to pay for the WHO and other UN-related organisations to help in these countries as well as an emergency fund for additional antiviral medicines, it argues.The UN's efforts were boosted last week when nine countries, including Britain and the US, pledged to give the equivalent of a 10% share of their swine flu vaccine supply to help fight the deadly virus's global spread. In Britain, Douglas Alexander, the development secretary, pledged to give £23m.Some officials within WHO believe, however, that this will not be enough. One said that richer countries were reluctant to pay out all of the money that was needed. "The downturn means that governments countries are reluctant to give," he said.Another said: "The money is a trickle, not a flood. It is going to be a struggle. If we are not careful, the virus could destroy a burgeoning economy or democracy."The UN's request for the money comes as the virus begins to establish itself in some of the world's most vulnerable countries. On Wednesday, health officials told one website that the African continent had recorded 8,187 confirmed cases of swine flu and 41 deaths.Swine flu was declared a pandemic in June and has since been identified in 180 countries. Pandemic experts believe that the western world, including Britain, is facing a second wave of the virus.Swine fluUnited NationsWorld Health OrganisationGlobal economyRajeev Syalguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/world/2009/sep/20/swine-flu-costs-un-report
Dr Crippen may not have had all the facts to hand in his column (Just don't try giving me the swine flu vaccine, G2, 8 September). While he may have been happy to have smallpox vaccine on the basis that it was "tried, tested and proven", the smallpox vaccination programme in the UK was halted because the risks associated with the vaccine eventually outweighed the benefits. In the case of swine flu vaccination, his suggestion that it may not work if the virus mutates does not reflect the decision to use an adjuvanted, or whole-virus, H1N1 vaccine that offers cross-protection, should this occur. The UK has robust surveillance in place for early detection of any adverse events. So it is to be expected that the government should seek to raise awareness among clinicians.David SalisburyDirector of immunisation, Department of HealthSwine fluHealthguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/world/2009/sep/14/swine-flu-vaccine
A mass vaccination programme for swine flu in the US was cancelled amid controversy in 1976. What lessons can the UK learn?As the government prepares to roll out the swine flu vaccine campaign, few people are aware of a US vaccination programme more than 30 years ago that was abruptly stopped after reports of deaths and adverse reactions. In early February 1976, an 18-year-old soldier at Fort Dix, New Jersey, collapsed and died suddenly. Subsequent tests revealed that four men at the base, including the dead soldier, were suffering from a strain of swine flu. In total, 13 soldiers developed the disease.The possibility of a pandemic on the scale of the one in 1918, in which one million Americans had died, was soon being discussed in the press. Although many scientists expressed reservations, some officials at the Center for Disease Control (CDC) argued for a mass vaccination programme. Such an unprecedented undertaking required months of preparation, so President Gerald Ford's government was under pressure to act quickly, particularly as 1976 was an election year. In March, Ford announced that he was asking for $135m (£82.6m) for a vaccination programme. Congress agreed immediately.The National Swine Flu Immunization Program Act was passed on 12 August, and it made the US government liable for any damages, after the insurance industry refused to indemnify the vaccine manufacturers. The vaccination programme started on 1 October with the televised vaccination of the president and his family, but within days, the deaths had been reported of two elderly people. Weeks later, a Minnesota doctor reported that a patient had developed the neurological condition Guillain-Barré syndrome (GBS) after vaccination. Other similar cases followed in Minnesota, with one death. By December, the CDC announced that 30 people had developed GBS within a month of being vaccinated. The possibility of a link meant that the vaccination programme was immediately stopped. A subsequent CDC investigation found that vaccination increased the risk of developing GBS eightfold, and it was decided to compensate anyone who developed the syndrome within 10 weeks of vaccination. In all, 4,181 people successfully claimed damages, costing the American taxpayer nearly $93m (£57m). However, many argued that the supposed link between GBS and the vaccination was the result of reporting bias. For example, 80% of the US armed forces were vaccinated, twice, yet no increase of GBS was found in military personnel. In the Netherlands, the only other country that vaccinated against swine flu, studies revealed that there was no increase in the incidence of GBS, despite over 1.5m vaccinations.The context of the current UK swine flu vaccination programme is different from the US inasmuch as 1976 was an anticipated epidemic that never materialised; no other cases were found anywhere in the world. Liability is also not an issue. Britain has a government compensation scheme for damage caused by routine childhood vaccinations, and this will apply to swine flu. Yet, so far, the majority of swine flu cases continue to be mild, and there are no signs of the virus mutating. Given that the first people to be vaccinated will be those with underlying health conditions, such as diabetes, asthma and heart disease, it is a statistical certainty that there will be some deaths among these people soon after vaccination. Whether or not these are caused by the vaccination, some will argue that the vaccine is unsafe. Indeed, anti-vaccination websites are already recounting the alleged link between the 1976 vaccine and GBS as "proof" of the potential dangers of swine flu vaccination. And a survey published this month by the Lancet revealed that about half of pregnant women will refuse the vaccination. One positive message from 1976 is that it is possible to vaccinate large numbers of people, and that vaccination may save many lives. But safety concerns could derail any vaccination programme and dent confidence in vaccines and healthcare professionals. For the forthcoming vaccination campaign to be successful, lessons need to be learned from 1976. Healthcare professionals should be alert to any possible coincidental or vaccination-related adverse events. In the UK, this data is collected by the Medicines and Healthcare Products Regulatory Agency, which has set up the "swine influenza portal" for reporting adverse reactions to the antiviral drugs Tamiflu and Relenza, and it will be extended to include the vaccination. This system is also open to members of the public to report any adverse reaction to the vaccine they think they have had. Most importantly, there needs to be effective and balanced communication. The responsibility for this rests with politicians, the media and the Department of Health, as well as individual healthcare professionals.The government needs to heed criticisms of its failure to come clean about potential problems with Tamiflu. Without a balanced acknowledgment of the risks and benefits of vaccination against swine flu, the scene is set for a repeat of the MMR scandal, which has led to a resurgence of measles after a claim in 1998 that the vaccine was linked to autism resulted in many parents not getting their children vaccinated.• Peter Washer's book, Emerging Infectious Diseases and Society, will be published by Palgrave Macmillan next yearHealthSwine fluFluHealth & wellbeingInfectious diseasesUS domestic policyguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/society/2009/sep/09/swine-flu-mass-vaccination
The Conservative party says hospitals are at breaking point and claims that a second wave of swine flu could result in a bed shortageThe NHS may not have enough intensive care beds to cope if a second wave of swine flu hits the country, the Conservative party claimed today.Hospitals are already at "breaking point" and are having to close critical care beds to new admissions for large parts of the year, according to the shadow health secretary, Andrew Lansley.The allegation comes amid intensifying party exchanges over the future of the NHS. The Tories are attempting the novel political manoeuvre of outflanking Labour from the left, promising real-terms increases in spending during the recession.Concerns about the number of NHS intensive care beds available first surfaced during the initial midsummer outbreak of swine flu. At one stage, Australia reported that as many as 15% of patients admitted to hospital with the infection needed intensive care nursing.Such high rates were not experienced in the UK, but research published in the journal Anaesthesia at the time estimated that during the expected peak infection rate, demand for intensive care beds could outstrip supply by 130% in some regions, while the demand for ventilators could exceed supply by 20%.The latest figures, obtained through freedom of information (FOI) requests, reinforce those fears, the Conservatives claim, even though official projections of likely casualty rates have been downgraded. Past predictions by experts, the party maintains, did not take into account the existing shortage of beds.According to FOI requests returned to the Conservatives, almost 2,000 people in England had to be discharged early from intensive care last year, a further 1,000 patients had to be transferred to other hospitals in order to find an intensive care bed and 20,000 were belatedly discharged from intensive care because of shortages of other beds.On average, the Tories allege, hospitals had all their intensive care beds full for almost a third of the year during 2008. At least one intensive care bed per hospital was closed due to lack of staff for, on average, 25 days last year."The system is already stretched to breaking point," a party spokesman said. "Hospitals have to close their intensive care beds to new admissions for large parts of the year, seriously ill patients are being discharged early and there is a lack of beds in other wards to discharge them to."Lansley said: "In many areas, the UK is among the best prepared in the world [for a flu pandemic], but there are some issues on which the government has not taken action – and one of these is critical care capacity in the NHS."It is worrying that we have far fewer beds to treat the most critically ill patients than almost any other developed country. If the second wave of swine flu occurs when schools return, as is being predicted, this could cause real problems in the traditional flu season in the autumn."The government urgently needs to review its plans in order to help the NHS provide extra beds to deal with the pandemic and ease the pressure on intensive care units. It should look at how more staff can be trained in ventilatory support and the idea of rest centres to care for patients who can't look after themselves at home."The Conservative party says that the UK has fewer intensive care beds than any other western European or north American country.Swine fluNHSConservativesLabourHealthOwen Bowcottguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/world/2009/sep/08/swine-flu-hospital-bed-shortage
Primary school pupils in Brittany told to abandon traditional Gallic greeting to avoid catching virusFor 6.5 million children across France yesterday was the first day back at school after the long, hot summer holiday. But, for 166 of them, la rentrée scolaire was missing one crucial thing: kisses.Determined to meet the threat of the swine flu pandemic head-on, the formidable mayor of Guilvinec in south-western Brittany, Hélène Tanguy, has decreed that there be no kissing on the cheek for any child in the town.Instead of the traditional Gallic greeting, she has ordered pupils at Guilvinec's two primary schools to adopt what she claimed was a gesture beloved of native Americans and raise their hand in recognition of each other. In place of planting un petit bisou on each cheek, pupils are expected to keep their distance and say "ugh!" – supposedly a traditional greeting that is considered by many to be racially demeaning.Angelique Joncour, the headteacher of the Jean Lebrun primary school, said the measure was simply "a question of common sense" in the face of the contagious H1N1 virus. She added that if the pupils felt the need to show affection in the absence of kisses they could take a paper heart from one of the "bisous boxes" being made available by staff and give it to their friend.Unfortunately for the teachers of Guilvinec, their idea has been greeted with derision by many observers, who say the ban is pointless.The bisous ban has been condemned by one anonymous political blogger, who is also unhappy with another anti-swine flu measure in the north-western town of Coulaines, where spitting in the street has been outlawed. The blogger said the schemes were "perfectly idiotic"."If kissing and spitting are potentially dangerous … human beings are going to have to protect themselves from absolutely everything," the blogger wrote. "You would, for example, have to ban making love … you would have to ban talking to each other, or ask people to do it several metres apart."Undeterred by the criticism however, Tanguy is enforcing her ban – and leading by example. For the last few days she has been refusing to kiss anyone in the village, preferring instead to greet them with a "friendly" gesture."To begin with it made everyone laugh. But people quickly understood my attitude, which now seems obvious to them," she said. Meanwhile the World Health Organisation said yesterday that the H1N1 virus, which causes swine flu, had not mutated and nor was it causing more severe illness than previously."There is no sense that the virus has mutated or changed in any sense," WHO spokesman Gregory Hartl told a news briefing.But the Red Cross said even the most optimistic estimates had the virus causing several million deaths worldwide.Swine fluFranceInternational education newsHealth & wellbeingHealthLizzy Daviesguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/world/2009/sep/04/swine-flu-france
Luke JerramA trio of deadly diseases: smallpox, flu and HIV lined up
http://www.guardian.co.uk/artanddesign/gallery/2009/sep/02/swine-flu-sculpure-art-disease
Doctors saved the life of a 22-year-old woman critically ill with swine flu by experimentally giving her a high dose of an antiviral drug directly into her bloodstream, they report today.Relenza is licensed for use only through an inhaler, but attempts to treat the woman with the oral drug Tamiflu and Relenza in the usual way had little effect. In the case study, published online by the Lancet medical journal, Dr Michael Kidd and Dr Mervyn Singer from University College London Hospitals call for studies to find out whether Relenza given intravenously could save more lives.The patient, whose immune system had been compromised by chemotherapy to treat Hodgkin's disease, was taken into intensive care on 8 July. Tamiflu and antimicrobials failed to help her, and she was put on a ventilator. Eight days of Relenza through a nebuliser did not work so doctors were given permission by her relatives and the hospital to put the drug in an intravenous drip. They also gave her a corticosteroid to reduce lung inflammation.Within 48 hours she had improved, with no drug-related side-effects. Just over three weeks after her arrival in intensive care, she was discharged.NHS guidance has lowered the estimate of the number of swine flu deaths in the UK, putting the range from 3,000 deaths to a "worst-case scenario" of 19,000, down from 65,000 in July. There have been 70 deaths so far.Swine fluFluHealth & wellbeingHealthNHSSarah Boseleyguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/world/2009/sep/04/swine-flu-woman-saved-relenza
The estimate of the number of Britons who will die of swine flu this winter has fallen dramatically after health experts admitted the virus is less lethal then they fearedThe official estimate of the number of Britons who could die this winter from swine flu is to be reduced substantially to roughly 20,000 because health experts have decided the virus is far less lethal than first feared.Ministers and health officials predicted in July that up to 65,000 people could be killed across the UK by the H1N1 virus, as infection rates accelerated over the summer and deaths began to mount.But the Scottish health secretary, Nicola Sturgeon, said this morning that that official worst case scenario had been revised downwards, with experts now predicting a death rate of 0.1%, much lower than the initial estimate of 0.35%.Swine flu infections have continued over the summer and at least 66 people have died. Ministers still believe the number of cases will rise steeply this winter, causing a full-blown epidemic and putting public services and businesses under severe strain.The new estimate is expected to be confirmed by Sir Liam Donaldson, the chief medical officer for England and Wales, this afternoon.Sturgeon's statement to the Scottish parliament today confirms strong signals from government advisers, including the Scottish chief medical officer Harry Burns, that H1N1 is a relatively mild virus. Burns and other health experts noted that in the US, fatalities were rare.Even so, health services, council morgues and crematoria, and the economy could be put under severe strain. Sturgeon said that up to 30% of the population could fall ill. Millions of people may have the H1N1 at the same time.An official UK report published today warns: "It is possible that the virus may mutate, becoming more virulent, and it is important to remain prepared for the full range of possibilities."Sturgeon disclosed that the first swine flu vaccines are due to be given to key target groups, such as pregnant women, people with weak immune systems and their immediate families, and people over 65, from mid-October onwards.The European Medicines Agency is expected to license the vaccines later this month or in early October. The vaccination programme would be backed up by a UK-wide publicity and public information campaign, and 13 million people across the UK are expected to be vaccinated in the first phase.She said: "Estimates of delivery of vaccine from the manufacturers are subject to change, but the current assessment suggests over 54m vaccine doses will be delivered to the UK by the end of December. From this we estimate a potential delivery to Scotland in the region of 300-350,000 doses per week from the date when the vaccine is licensed."She said the revised death rates estimate did not take account of the vaccination programme, which could significantly cut the death rates by targeting some of the most vulnerable groups."Furthermore, they are not predictions; they are assumptions that allow us to plan for the worst, while continuing to hope for the best," she said. "And while having lower estimates for hospitalised cases and fatalities is positive, the assumptions will be kept under review."Swine fluHealthScotlandSeverin Carrellguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/world/2009/sep/03/swine-flu-predicted-death-toll
• Nearly half would refuse jab, survey shows • Results come as Tamiflu introduction is criticisedAlmost half of all pregnant women say they will refuse to be vaccinated against swine flu once the jab is available, suggesting there is widespread concern about its safety, a poll has revealed.Pregnant women are one of the target groups for vaccination identified by experts advising the government. In July, a study in the US showed they are more at risk of complications if they get the virus and more likely to end up in hospital than other people. Six pregnant women in the US died of swine flu complications between 15 April and 18 May.Yesterday's survey, published by the website mumsnet.com, confirms the fears of the authors of the US study, which was published online by the Lancet. It showed almost half – 48% – of pregnant women who responded said they probably or definitely would not have the jab if it is available. Only 6% said they definitely would and 22% said they probably would.The results were unveiled on the eve of publication today of serious criticism of the government's handling of another part of its flu strategy. The Drug and Therapeutics Bulletin (DTB), which is independent of pharmaceutical companies, says the government has failed to come clean with the public about potential problems with Tamiflu, the already available antiviral drug that can reduce the severity of a bout of illness. Those include the side-effects, the potential spread of resistance – which could make the drug ineffective – and black market resale of the drug.The women surveyed by mumsnet were not only reluctant to be immunised themselves but were also not happy to take their children to be vaccinated; 46% of those with children under five said they probably or definitely would not take their children for the jab. Just 5% said they definitely would, and 22% probably would. Some 1,458 people responded to the poll, 15% of whom said they had already had a case of swine flu in their family.The results may in part be a response to the mildness of the illness that swine flu has induced in most people, but they suggest also that the government will have a big task ahead persuading people that immunisation is a good idea."It's obvious from these results and from discussions about this on mumsnet that lots of mums and mums-to-be are questioning whether or not to have the swine flu vaccine or give the vaccine to their children. Some are worried about how well it's been tested, others about its effectiveness and side-effects," said one of the website's founders, Carrie Longton."Everyone wants to do the best for their child or unborn child but many parents seem from our poll to be more anxious about the safety of the vaccine than they do about catching swine flu."The editorial in the DTB, which is owned by the British Medical Journal, says the aims of the introduction of Tamiflu were to limit the transmission of swine flu, to reduce complications that could lead to death, to reduce the burden on society and the economy by shortening the length of a bout of flu, and to increase public confidence that a treatment was available.But, says the DTB editorial, because this is the first time that Tamiflu has been used in a pandemic, "none of these is underpinned by strong evidence, despite allusions to the contrary from health officials and politicians".The editorial, published online, goes on: "Defenders of the policy might argue that urgent situations sometimes require action despite incomplete evidence. But in such cases transparent risk assessment is crucial, as is honest communication with the public. So it is regrettable that obvious potential problems from widespread use of oseltamivir [Tamiflu] were not presented openly from the outset."The UK took delivery last week of 200,000 packs of the vaccine made by Baxter Healthcare, one of two drug companies with which the government has signed contracts.The vaccines were delivered – in contrast to the normal process for new drugs – ahead of approval for their use. The next step is for the European Medicines Agency to decide whether to license the Baxter vaccine and one made by GlaxoSmithKline. Both manufacturers hope to have their licence by early October. The Department of Health will give priority to those most at risk from the flu, including people with conditions that make them vulnerable – such as diabetes and HIV – as well as health workers.Swine fluFluHealth & wellbeingHealthPregnancyPharmaceuticals industrySarah Boseleyguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/world/2009/sep/02/swine-flu-vaccine-pregnant-women
• Results of poll suggest widespread concern about safety of vaccine• US study showed pregnant women more at risk of swine flu complicationsHalf of all pregnant women say they will refuse to be vaccinated once the swine flu jab is available, suggesting there is widespread concern about its safety, a new poll has revealed.Pregnant women are one of the target groups for vaccination identified by experts advising the government. In July, a study in the US showed they are more at risk of complications if they get it and more likely to end up in hospital than other people. Six pregnant women died of swine flu complications there between 15 April and 18 May.The authors of the US study, which was published online by the Lancet, said at the time that they were concerned pregnant women might not come forward for vaccination because of their fears for the baby. Today's survey, published by the website Mumsnet, showed that almost half – 48% – of pregnant women who responded probably or definitely would not have the jab once it is available. Only 6% said they definitely will and 22% said they probably will.The women were also reluctant to get their children immunised. Nearly the same proportion (46%) of those with children under five said they probably or definitely would not take their children for the jab. Just 5% again said they definitely would and 22% said they probably would.Some 1,458 people responded to the poll, 15% of whom said they had already experienced a case of swine flu in their family.The results may in part be a response to the mildness of the illness that swine flu has induced in most people, but they suggest also that the government will have a big task ahead persuading people that immunisation is a good idea."It's obvious from these results and from discussions about this on Mumsnet.com that lots of mums and mums-to be are questioning whether or not to have the swine flu vaccine or give the vaccine to their children. Some are worried about how well it's been tested, others about its effectiveness and side-effects," said one of the website's founders, Carrie Longton."Everyone wants to do the best for their child or unborn child, but many parents seem, from our poll, to be more anxious about the safety of the vaccine than they do about catching swine flu.""Pregnant women are a top priority for vaccination because they are more at risk of complications from swine flu," said the government's Chief Nursing Officer, Christine Beasley."Vaccination offers the best protection against swine flu and will be carefully assessed for safety. Strict processes are in place for licensing pandemic vaccines and it will not start to be used on anyone, including pregnant women, until a license has been granted."HealthSwine fluDrugsPregnancySarah Boseleyguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/society/2009/sep/01/swine-flu-vaccine-pregnant-pregnancy
The two illnesses have many symptoms in common – but a wrong diagnosis could be fatalParents and GPs were warned today not to mistake meningitis for swine flu as millions of children began the new school year.The two illnesses have similar symptoms, including aches and pains and cold hands and feet.Cases of meningitis typically rise in the autumn – the same time experts have predicted a surge in the number of cases of swine flu.Schools and universities going back means people are in close proximity, making it easy for illness to spread, and the flu virus tends to thrive in the cooler months.At least two people are already known to have died from meningitis after mistakenly being diagnosed with swine flu.Today, Steve Dayman, chief executive of the charity Meningitis UK, said parents should "trust their instincts" and watch out for the disease, which can kill in under four hours.He lost his son Spencer to meningitis in 1982, when the boy was just 14 months old.Dayman said: "Meningitis occurs throughout the year but very shortly we will see the number of cases going up."It's very difficult for GPs to identify meningitis in its early stages because it's very similar to flu – with symptoms such as cold hands and feet and aching limbs."He said a pin prick rash that can turn into purple bruising is a classic sign of a meningococcal meningitis and requires urgent attention.But he said parents should be on their guard even before this happens and seek medical attention if their child appears to deteriorate rapidly.Children under five are most at risk from meningitis, followed by teenagers and students."The issue with children is that there is a rapid deterioration in their condition – within a matter of hours," Dayman said."I think it's important for parents of children to contact their GP if they feel concerned – meningitis should be a consideration."This is about parents and GPs working together – it's better to be safe than sorry. If hospitals are inundated with young children, then that's just the way it's got to be."Pupils start to return to schools across the UK this week and experts have predicted there will be a rise in swine flu cases over the next few months.At present, there are about 5,000 people being newly diagnosed with the virus in England every week, down from a peak of around 100,000 some weeks ago.Research commissioned by Meningitis UK shows that nearly seven out of 10 adults are unaware there is no vaccine to protect against the most common form of the illness, meningitis B.The strain causes almost 90% of cases and can kill in under four hours.Dayman said: "We're urging [parents] to know the facts and be extra vigilant as their children return to the crowded environment of a school, where germs spread more easily due to close human contact."Meningitis and septicaemia can be hard to recognise in the early stages because the initial symptoms are similar to many mild childhood diseases."A child with bacterial meningitis or septicaemia will usually get ill quickly and get worse fast."Classic symptoms of meningitis include a headache, stiff neck and a dislike of bright light. Other symptoms are difficulty supporting own weight, fever, vomiting and diarrhoea, confusion and drowsiness.Septicaemia leads to aching limbs, cold hands and feet and a rash.In 2008, there were around 3,000 cases of meningitis in the UK. Every year, 300 people die and hundreds more are left with permanent disabilities.HealthChildrenMeningococcal diseaseSwine fluYoung peopleEarly years educationSchoolsHigher educationguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/society/2009/sep/01/swine-flu-meningitis-symptoms
Most companies in Britain have not been affected by the outbreak of swine flu, research has found, compounding fears that the virus could derail the country's fledgling economic recovery.But the survey of 450 companies by the British Chambers of Commerce (BCC) found that fewer than half of firms had contingency plans in place to cope if the swine flu outbreak gets worse, despite warnings of a second wave in the autumn.The report, the first of its kind, said 83.7% of businesses had not been affected by the spread of swine flu and only a third believed the disease could threaten the UK's recovery from recession.As a result, many have failed to draw up contingency plans for dealing with large numbers of workers taking time off if they contract the H1N1 virus.There had been fears that businesses, shops and distribution centres could be forced to shut if the virus spread rapidly. Airlines and other transport services could also be disrupted.The BCC's findings refute claims that workers are using the virus as an excuse to take sick days. Anecdotal evidence shows employers are more likely to tell staff to stay away if they have symptoms.The TUC general secretary, Brendan Barber, said: "This shows that, contrary to what some have been claiming, workers are not using swine flu as an excuse to take time off work."He called on employers not to become complacent about the threat to their staff simply because infection levels had declined in recent weeks. The government's chief medical officer, Sir Liam Donaldson, has repeatedly warned of a second wave of swine flu in the autumn.Barber said: "Employers should be using this time to work with their staff to ensure they have contingency plans in place to deal with any possible resurgence of the virus in the autumn."A BCC spokesman said: "We haven't seen any evidence of employees skiving en masse because of swine flu." But he said the government needed to exercise caution in its plans to allow employees infected with swine flu to stay off work for 14 days without a doctor's note, rather than seven days.GPs have been seeing a high number of patients at the start of the week and Donaldson said the National Pandemic Flu Service for England received most calls from patients on Mondays.But he shrugged off the idea that workers were faking sickness: "I think people traditionally hold on to their illnesses over the weekend, then see their GP on Monday."As schools reopen, health authorities are bracing themselves for another rise in swine flu. The UK and the US governments say they will not close schools except under exceptional circumstances after experts claimed closures did not reduce the number of cases, but spread them over a longer period.Swine fluFluHealth & wellbeingHealthRecessionTrade unionsJulia Kolleweguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/world/2009/aug/31/survey-uk-companies-swine-flu
Diagnosis prompts fears for health of Latin American leaders who met Uribe at regional summit last weekPresident Álvaro Uribe of Colombia has been diagnosed with swine flu, prompting urgent checks into the health of other South American leaders he met at a summit last week.The Colombian leader has been kept partly secluded in an office at the presidential palace in Bogotá, and has continued working by telephone and internet.Officials said Uribe was expected to make a full recovery. "This isn't something that has us scared," Diego Palacio, the social protection minister, told a news conference yesterday.The 57-year-old conservative leader showed symptoms soon after addressing a summit at the Argentine ski resort of Bariloche on Friday. The presidents of Argentina, Bolivia, Brazil, Chile, Ecuador, Paraguay, Peru, Uruguay and Venezuela all attended the regional meeting.Uribe returned to Colombia. During a public event on Saturday, he was sneezing and had a fever and aching muscle. On Sunday, doctors confirmed the cause was the H1N1 swine flu virus.Checks were being carried out on the 55 people who flew with him to the summit, including cabinet ministers, and Colombian authorities were using diplomatic channels to urge other South American governments "to adopt the necessary measures", said Uribe's spokesman, César Mauricio Velásquez.To date, neither the president's travelling companions nor the other heads of state with whom he came into contact have reported symptoms.Venezuela's president, Hugo Chávez, said yesterday his own health was fine, and wished his counterpart a speedy recovery. "I regret this and hope there are no repercussions for the president's health, and that nobody else has caught the disease," he said.The good wishes were a rare break in the war of words between two Andean neighbours who regularly trade insults, not least because the Venezuelan socialist sees Uribe as a supporter of what he calls US imperialism.The Union of South American Nations summit was called because Chávez and other regional leaders had expressed alarm over Bogotá's plan to expand US access to Colombia's military bases in a pact that has evoked bitter memories of US meddling in the region.Uribe, in a combative performance, defended the deal with Washington as a means of combating drug traffickers and leftist guerrillas. He said it would not be used to spy on or undermine neighbouring governments.It was not immediately clear whether he was infected with the virus in Colombia, which has 621 confirmed cases, or picked it up in Argentina, which is in the depths of the southern hemisphere winter and has tens of thousands of suspected cases.Alberto Cortez, an infectious disease specialist at Colombia's National University, told the Associated Press Uribe could have infected other leaders. The presidents shook hands, spent hours around a table and mingled during the joint photo session.Uribe is not the first Latin American leader to be infected. Earlier this month, Costa Rica's president, Óscar Arias, was diagnosed and placed under quarantine at his home. The 69-year-old Nobel laureate, who helped end central America's civil wars in the 80s, has recovered.The World Health Organisation declared a flu pandemic in June, warning that the new strain could infect hundreds of millions of people.As the northern hemisphere braces itself for a surge in winter flu cases, the good news from the southern hemisphere is that its winter outbreak was less fatal than feared. The virus has not mutated into a harsher strain, allowing most people to recover without treatment.ColombiaSwine fluHugo ChávezArgentinaVenezuelaBoliviaBrazilEcuadorChileParaguayUruguayCosta RicaPeruRory Carrollguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/world/2009/aug/31/uribe-alvaro-colombia-swine-flu
Swine flu vaccine must sit in storage for over a month while manufacturers wait to see whether it will be given a licenceThe first batch of swine flu vaccine has arrived in the UK, but it must sit in storage for more than a month while the manufacturers wait to see whether it will be given a licence, the chief medical officer said today.The news of the delivery of around 200,000 packs of the vaccine came as it was announced that the UK death toll from swine flu has risen to 66 after 11 fatalities in the past week.The vaccine packs made by Baxter Healthcare – one of two drug companies with whom the government has signed contracts – have been delivered ahead of the drugs being approved, in contrast to the normal process for new drugs and treatments.The European Medicines Agency will now decide whether to licence this vaccine and one made by GlaxoSmithKline. Both manufacturers hope to have their licence by early October, which will mean the roll-out can begin later that month. The Department of Health will prioritise distribution to those most at risk from the flu, including those with conditions that make them vulnerable, such as diabetes and HIV, as well as health workers.When the vaccine is available, many people may be reluctant to be immunised because of fears it has not been tested properly, recent surveys of health care workers and the public suggest.A Canadian study published on Monday indicated that a successful vaccination campaign would need to win over people who believe that alternative therapies and a good diet are a better option than vaccines.Today the chief medical officer, Sir Liam Donaldson, said the health professionals he had spoken to seemed to want the vaccine as soon as it became available. "It still remains the case that this disease is not a killer but it can kill," he said.While the vaccine sits in storage, the epidemic in the UK continues to abate.Donaldson, who repeated warnings of a second wave of swine flu in the autumn, said the number of cases was currently down to what would be normal levels of flu if this was winter – although clearly this was abnormal for summer.In the last week, the Health Protection Agency said there were an estimated 5,000 cases of swine flu - although the true figure could be anywhere between 3,000 and 12,000. There have been three swine flu deaths in England, seven in Scotland and one each in Wales and Northern Ireland over the last week. There were 218 people hospitalised with swine flu in the last week, which is a fall, but is high for the summer.The weekly consultation rates at GP surgeries have risen in 11 primary care trusts but decreased in 134, with no change in two. But even among those where the rates have risen – most markedly in Cornwall and the Isles of Scilly – the consultation rates were generally nowhere near as high as they were at the peak of the current outbreak. The highest rate of consultation in England was in Greenwich, London, at 45.2 swine flu consultations per 100,000. Tower Hamlets, which came second with 44.1 consultations per 100,000, hit 75 per 100,000 a few weeks ago.One thing that surprised him, Donaldson said, was the continuing high level of swine flu cases in the West Midlands.In contrast to most countries, only 22% of deaths in the UK have been among healthy people, said Donaldson. Figures from the World Health Organisation suggested 40% of those who had died were previously healthy. The proportion ending up in intensive care in the UK also appeared to be lower, he said.More than 460,000 packets of the antiviral Tamiflu have been given out via the government's National Pandemic Flu Service for England since it launched in July.Swine fluHealthHealth policySarah Boseleyguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/world/2009/aug/27/swine-flu-vaccine
Two of the emergency call centres established a month ago to cope with the alarm over swine flu will close this week with the loss of 1,200 posts.The decision to scale back the number of telephone advice lines at the National Pandemic Flu Service (NPFS) reflects a decline in demand, according to the Department of Health. Infection rates have fallen back rapidly.The announcement comes amid controversy over the advisability of routinely prescribing antiviral drugs, such as Tamiflu, to otherwise healthy adults who fall ill. Last week, the World Health Organisation issued advice stating that "healthy patients with uncomplicated illness need not be treated with antivirals".Staff at the NPFS call centres, operated by NHS Professionals and private companies such as Teleperformance, have been able to authorise prescriptions for antivirals. The drugs can be picked up at NHS-operated distribution centres.More than 500,000 packs of Tamiflu were dispensed in the two weeks after the call centres opened on 23 July. Calls to the service peaked in late July. The two call centres scheduled to close are in Watford and Farnborough, Hampshire. Their last shifts will be worked on Sunday; both are operated by NHS Professionals. Call centres run by Teleperformance in Bristol and Northern Ireland, which also form part of the NPFS network, are expected to remain open. As many as 2,000 operators, who were not medically trained, were recruited to answer calls.A spokesman for the Department of Health said: "As the chief medical officer announced recently, we are scaling back the National Pandemic Flu Service to reflect demand. This is a flexible service so we can scale it back up when necessary."The health service in Wales, Scotland and Northern Ireland never participated in the NPFS, advising their patients to contact local GP surgeries. The Department of Health has warned that it expects a second wave of H1N1 swine flu infections in the autumn or winter.NHS Professionals said: "As a result of much lower than expected call volume to the NPFS call centres, NPFS have decided to reduce capacity and as a result the call centres provided by NHS Professionals will be put on standby and will take no further calls until further notice."Research published in the British Medical Journal today shows that just over half of healthcare workers surveyed in Hong Kong say they would not be vaccinated against swine flu because of fears of side effects and doubts about efficacy.The Nursing Standard magazine today reports that specialist cancer nurses are being redeployed to help with swine flu work, in Northumberland and other places. A Northumberland Care Trust spokeswoman confirmed it draws staff from a wide range of services. She said: "We are required to include a nurse in the team at each antiviral collection point."Swine fluFluHealth & wellbeingNHSOwen Bowcottguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/world/2009/aug/26/swine-flu-call-centres-close
Two emergency swine flu call centres to close this week, due to fall in demandTwo of the emergency call centres established a month ago to cope with the alarm over swine flu will close this week with the loss of 1,200 posts.The decision to "scale back" the number of telephone advice lines at the National Pandemic Flu Service (NPFS) reflects decline in demand, according to the Department of Health. Infection rates have fallen back rapidly since the midsummer peak.The announcement comes amid mounting controversy over the advisability of routinely prescribing antiviral drugs, such as Tamiflu, to otherwise healthy adults who fall ill. Last week, the World Health Organisation (WHO) issued fresh advice stating that: "Healthy patients with uncomplicated illness need not be treated with antivirals."Staff at the NPFS call centres, operated by NHS Professionals and private companies such as Teleperformance, have been able to authorise prescriptions for callers requesting antivirals. The drugs can be picked up at NHS-operated distribution centres.More than 500,000 packs of Tamiflu were dispensed in the two weeks after the call centres opened on 23 July. Calls to the service peaked in late July but have been in decline ever since.The two call centres scheduled to close are in Farnborough, Hampshire, and Watford. Their last shifts will be worked on Sunday; both are operated by NHS Professionals.Teleperformance said that the three swine flu call centres it runs, in Bristol and Northern Ireland, are expected to remain open. As many as 2,000 operators, who were not medically trained, were initially recruited to answer calls.A spokesman for the Department of Health said: "As the chief medical officer announced recently, we are scaling back the National Pandemic Flu Service to reflect demand. This is a flexible service so we can scale it back up when necessary."The health service in Wales, Scotland and Northern Ireland never participated in the NPFS, advising their patients to contact local GP surgeries. The Department of Health has was warned that it expects a second wave of H1N1 swine flu infections in the autumn or winter.A statement from NHS Professionals said: "As a result of much lower than expected call volume to the NPFS call centres, NPFS have decided to reduce capacity and as a result the call centres provided by NHS Professionals will be put on standby and will take no further calls until further notice."We understand this is the case with a number of providers. However, our call centre facilities remain available should call demand increase during the autumn and winter flu season."Swine fluFluHealth & wellbeingFlu pandemicHealthOwen Bowcottguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/world/2009/aug/25/swine-flu-call-centres-close
The government's decision to make antiviral drugs to treat swine flu widely available goes against latest scientific advice. Is this a mistake, asks Vaishali BhardwajTo accept or reject the opinion of scientists? That is the question. Well that was the question facing the British government this week when ministers were warned by advisers, appointed by the Department of Health, that the mass prescription of the swine flu antiviral Tamiflu could speed up the virus' resistance to the drug.The government seemingly fears what the public's reaction will be should Tamiflu stocks be withheld and as suggested by scientific advisers, only prescribed to people in high-risk categories, such as people with underlying health conditions.No doubt the government is trying to show the public that it is actively trying to reduce the spread of the influenza A (H1N1) [swine flu] virus with such a move, but is this really the solution? Shouldn't the government instead aim to educate the public on the potential long-term risks of overuse of Tamiflu before the mass distribution of the drug to the wider public? Perhaps this should be the government's stance instead of taking one that so flatly rejects scientific advice, which history itself supports.Indeed, scientists are not new to the phenomenon of drug-resistant microbes developing as a result of the overuse of antimicrobial drugs. The resistance of the bacterium Staphylococcus aureus to penicillin in the 1950s is a classic example of how the overuse of an effective drug led to widespread penicillin resistance in the bacterial population by the late 1980s.Understandably the government needs to be seen to be providing a solution to the swine flu pandemic. And it seems on this occasion it has made a perhaps more politically driven decision rather than a medical one based on potential public reaction.To reject the advice of expert advisers on such an issue as the swine flu pandemic is risky business. The widespread use of a single drug such as Tamiflu will speed up the selection of resistant mutant strains. Should one of these mutant, more virulent flu strains emerge in the future (one which has the risk of spreading on a pandemic level) the drug will be prove to be ineffective.Of course this has not yet occurred. But if scientists have learned anything from the past 100 years of scientific discovery it is that microbes can and will develop resistance to drugs over time. So the government seems to have two options: treat all suspected cases of swine flu with Tamiflu and risk the rapid emergence of resistant viral strains (and please the uninformed public) or choose to heed the opinion of scientists and only prescribe the drug to high-risk category cases. Tough choice.• Vaishali Bhardwaj is a microbiology graduate from Imperial College London.HealthSwine fluFlu pandemicFluVaishali Bhardwajguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/society/joepublic/2009/aug/21/swine-flu-tough-choice-tamiflu
• Patients advised against taking antiviral drug if symptoms mild• First deaths of swine flu patients in Wales and Northern IrelandHealthy people who catch swine flu need not be given Tamiflu, the World Health Organisation (WHO) has announced. The advice appears to contradict the UK's policy of making the antiviral drug readily available to those who call the national pandemic helpline or approach their GPs.Hundreds of thousands of doses have been given to British patients although the majority have not been severely ill. Fears have been voiced that mass use of Tamiflu will make the virus resistant to it.The latest advice from the WHO said: "Worldwide, most patients infected with the pandemic virus continue to experience typical influenza symptoms and fully recover within a week, even without any form of medical treatment. Healthy patients with uncomplicated illness need not be treated with antivirals."Previously the WHO had said antivirals should be given to patients with "serious progressive illness". The new guidance is the first time it has specifically advised against otherwise healthy individuals being given the drug.The recommendation is based on the conclusion of an international panel of experts that includes representatives from the UK. The advice added that Tamiflu, also called oseltamivir, and the similar drug Relenza, also called zanamivir, should be given quickly to seriously ill or deteriorating patients.The WHO guidance said at-risk groups should receive the drugs. "For patients with underlying medical conditions that increase the risk of more severe disease, WHO recommends treatment with either oseltamivir or zanamivir."These patients should also receive treatment as soon as possible after symptom onset, without waiting for the results of laboratory tests. As pregnant women are included among groups at increased risk, WHO recommends that they receive antiviral treatment as soon as possible after symptom onset."Some medical researchers have expressed concern about the side-effects of Tamiflu, particularly sickness, nightmares and insomnia in children. A team from Oxford University said this month that children with mild symptoms should not be given Tamiflu and urged the Department of Health (DoH) to urgently rethink its policy.Figures released by the DoH show that 45,986 courses of antivirals were given to patients in England in the week ending 18 August. In the previous week 90,363 courses of antivirals were given out. The data relates to people collecting the drugs after an assessment via the National Pandemic Flu Service. Many more have collected antivirals via their GP.The DoH said the new WHO guidance was not too different from its own position that people with mild symptoms could recover without antiviral drugs.The new WHO statement said: "Worldwide, around 40% of severe cases are now occurring in previously healthy children and adults, usually under the age of 50 years. Some of these patients experience a sudden and very rapid deterioration in their clinical condition, usually on day five or six following the onset of symptoms."The first deaths of patients in Wales and Northern Ireland with swine flu has been announced, bringing the number of UK deaths to 61. In Wales, a 55-year-old woman was admitted to the Royal Gwent hospital in Newport on 2 August and given antiviral drugs. She developed cardiac problems and died on Saturday.In Northern Ireland, a female patient who was said to have had an underlying health condition died last night in hospital. No further details were released.The Department of Health has hinted that accumulating evidence about the degree of severity of the outbreak might lead to a change in policy. A spokesman said: "We believe a safety-first approach of offering antivirals, when required, to everyone remains a sensible and responsible way forward. However we will keep this policy under review as we learn more about the virus and its effects.""The WHO recommendations are in fact in line with UK policy on antivirals. We have consistently said that many people with swine flu only get mild symptoms and they may find bed rest and over-the-counter flu remedies work for them."WHO state that 40% of severe cases worldwide have been in previously healthy children and adults and that serious cases should be treated immediately. This emphasises the need not to become complacent about the mildness of the illness and the reasoning behind a precautionary policy."People with underlying health conditions, pregnant women and parents with children under the age of one should speak to their GP if they have symptoms. If people have any doubts about taking antivirals they should contact their GP."Swine fluFlu pandemicFluHealth & wellbeingHealthOwen Bowcottguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/world/2009/aug/21/tamiflu-swine-flu-healthy
Pandemic showing summer decline but health officials prepare for second wave in autumnThe number of deaths from swine flu in Britain has climbed to 59 but infection rates have continued to fall through the summer, according to the Department of Health.The latest figures released today show the disease on the wane during the holidays with about 260 people still being treated in hospital, fewer than last week. Of those, 30 were in intensive care.There were an estimated 11,000 people diagnosed with H1N1 flu in England last week, the cases spread uniformly across the country, and representing a sharp decline from the 25,000 cases recorded during the previous week.After an unusual mid-summer spike in infections, pandemic flu could now be conforming to the normal pattern of seasonal flu which traditionally delivers peak rates of illness during the winter.Health officials expect a second wave of infections to start building up again in the autumn, though when that will occur, and whether it will be chiefly due to the return of schools or the arrival of colder weather, remains unknown.Sir Liam Donaldson, the chief medical officer, confirmed that there were no national plans to keep schools closed at the start of term. But he added: "If we get a big surge during the autumn it may be that individual schools will close."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.Health experts said they were not surprised by the low proportion. The estimate of 11,000 new cases takes into account both the observation that not all those seeking medical help were ill and also that many who become infected never contact a doctor.The government's Scientific Advisory Group for Emergencies (Sage) is assessing the latest fatality and infection rates – which are far lower than initially feared – to develop planning for the severity of the outbreak.Commenting on the need for a revision, Justin McCracken, chief executive of the Health Protection Agency, said: "It's always best to plan for the worst, not the best."The number of deaths did show a significant increase last week, rising from 44 to 54 in England. Almost half of those, 25, died in London. With five additional deaths in Scotland, the UK total now stands at 59 deaths.Donaldson said he could not speculate on the timing of the second wave of swine flu but hoped it would follow the pattern of the 1968-70 pandemic which hit around Christmas time – a progession that would provide the UK with sufficient time to vaccinate as many people as possible, and possibly avoid a second peak altogether.The chief medical officer said the full picture on how swine flu had affected the UK, including the number of excess deaths, would not be known until after the pandemic had passed.The UK had taken a much more aggressive policy initially towards tackling the disease than many other countries, he said, enforcing school closures, providing antiviral drugs for contacts of swine flu victims, and checking flight lists to track down further potential contacts.The development of the pandemic in Australia has been worrying health officials, with as many as 30% of those admitted to hospital being treated in intensive care.Although infection in the UK appears to be subsiding in the warmer summer weather, Donaldson said it was "exceptional" to have so many flu victims in hospital at this time of year.Of the 54 people who have died in England, 15% were under 15, a third were aged between 16 and 44, and 29% were over 65.Of the same group of fatalities, 21% were recorded as having previously been healthy. More than half had severe prior conditions such as leukaemia.Swine fluFluHealth & wellbeingOwen Bowcottguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/world/2009/aug/20/swine-flu-deaths-britain
The British Medical Journal answers your questions about Tamiflu, the drug being used to treat swine fluWhat is it?Tamiflu is an antiviral drug. The scientific name is oseltamivir. It works by slowing down the speed at which the virus can reproduce in the body. It comes as a capsule, as well as in liquid form for children and adults who have problems swallowing.Who can take it?Tamiflu is licensed to treat all types of flu in adults and children over the age of one. It isn't used much for ordinary (seasonal) flu, but is being used widely for swine flu.Some doctors think it should be used only if people have severe symptoms, or are at risk of being seriously ill with swine flu (for example, people who have other health problems). But in practice, most people with symptoms of swine flu are being offered Tamiflu. Babies under one can take it if a doctor agrees it is necessary. They'll need the liquid formulation and a lower dose.People whose kidneys don't work properly, and pregnant women, are usually offered another antiviral drug called Relenza (zanamivir), instead.What does it do?Tamiflu isn't a cure for flu. Research has found that it may reduce the amount of time people have symptoms of flu, by about a day. And it may reduce the risk of people getting complications such as pneumonia. It may also protect you from getting flu symptoms, if you've come into contact with someone who has flu.Tamiflu doesn't work for everyone. It works best if you take it within 48 hours of getting flu symptoms. That's when the virus is reproducing fastest in the body, and when you're most infectious.All the research so far looks at how Tamiflu works against seasonal flu. There hasn't been time for any large-scale research into Tamiflu for swine flu. But laboratory trials show the swine flu virus is affected by antiviral drugs, including Tamiflu.What about side effects?The most common side effects from Tamiflu are nausea and vomiting. Other reported side effects are stomach pain, diarrhoea and headache. Some children and teenagers have reported unusual feelings, for example vivid nightmares and feeling delirious.If you get these symptoms while taking Tamiflu, it's hard to know whether they're caused by Tamiflu, or by the flu virus. Flu can cause most of these symptoms.A research study showed that nausea and vomiting were no more common in adults taking Tamiflu for flu, than people taking a dummy (placebo) drug for flu. But nausea and vomiting were more common in adults taking Tamiflu to prevent flu.What's the latest research?The latest research looked at Tamiflu for children. It re-examined studies in children, and questioned whether the harms outweighed the benefits. Taking all the research together, it's not clear whether Tamiflu can prevent complications in children, such as ear infections or asthma attacks.Children with flu are more likely to vomit if they take Tamiflu. Up to seven in 100 children with flu are likely to have vomiting without treatment. Researchers calculate that an additional one in every 20 children would get vomiting with Tamiflu treatment. Vomiting can cause children to become dehydrated, so it's good to ensure they have plenty of fluids.Can I take it if I'm pregnant?Yes, but you may be offered another type of antiviral drug instead. Research shows that Tamiflu is likely to be safe for pregnant women and their babies. But Relenza, an antiviral drug that is breathed into the lungs through an inhaler, is less likely to reach the growing fetus. Relenza works in much the same way as Tamiflu. It slows the speed at which the virus reproduces.Swine fluBMJ Group newsHealthHealth & wellbeingguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/world/2009/aug/17/tamiflu-questions-and-answers
What do we know?At present there is no good-quality research about how well antiviral drugs work against swine flu. All the research looks at how well the drugs work against normal, seasonal flu.Does Tamiflu work?Antiviral drugs do not cure flu, but can reduce the time people have it. The earlier they are taken, the better. Their effectiveness is reduced if taken more than two days after symptoms set in. When taken early, Tamiflu can reduce the severity of flu symptoms and shorten the time you are sick by one or two days. Research indicates that Tamiflu can reduce the risk of complications in adults with other health problems, such as asthma, and reduce flu spread by around 8%.What side effects are there?Tamiflu has been in use since 1999. Side effects are common in children, such as nausea, vomiting, and problems sleeping, including nightmares. Half of all children may get these side effects, although it is difficult to know how severe they might be. Vomiting (which can also be caused by flu itself) carries a risk of dehydration. Side effects in adults are less common.How can people avoid swine flu?Many experts say the most crucial advice is to follow good hygiene precautions, such as washing your hands regularly. There is good evidence that regular hand-washing (more than four times a day) cuts the spread of illnesses such as flu and common colds. Sensible hygiene measures that help prevent the spread of swine flu include:• Covering your nose and mouth when you cough or sneeze, using a tissue where possible.• Disposing of used tissues quickly and sensibly.• Washing your hands often, with hot water and soap.• Cleaning frequently-touched hard surfaces, such as door handles.Any other ways to treat swine flu?As with ordinary flu, rest, fluids and paracetamol-based cold remedies are effective in reducing body temperature and relieving symptoms.Swine fluFluFlu pandemicHealth & wellbeingJames Sturckeguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/world/2009/aug/16/swine-flu-facts-advice-tamiflu
The government rejected advice from its expert advisers on swine flu, who said there was no need for the widespread use of Tamiflu and suggested that the public should simply be told to take paracetamol.An independent panel set up by the Department of Health warned ministers that plans to make the stockpiled drug widely available could do more harm than good, by helping the flu virus to develop resistance to the drug.But ministers pressed ahead with a policy of mass prescription, fearing the public would not tolerate being told that the millions of doses of Tamiflu held by the state could not be used during a pandemic, one of the committee members has told the Guardian."It was felt ... it would simply be unacceptable to the UK population to tell them we had a huge stockpile of drugs but they were not going to be made available," Professor Robert Dingwall, a member of the Committee on Ethical Aspects of Pandemic Influenza, said.Today one of the country's foremost flu experts called for the national helpline to be shut down to stop hundreds of thousands of doses of Tamiflu going out in an unregulated way, which could render it useless when a more dominant strain returns in the autumn.As it became clear that the current outbreak only had mild symptoms, the committee recommended that antivirals should only be given to those in high risk categories, like pregnant women or people with existing respiratory illnesses. It suggested the government explain to people that they would not be given medicine they did not need and should use off-the- shelf flu treatments."There were discussions within the Health Protection Authority and the Department of Health, once it became clear that swine flu was a relatively mild infection, about whether to reserve antivirals for high-risk groups and to advise the general population to treat themselves with paracetamol or ibuprofen," said Dingwall, director of the Institute for Science and Society at Nottingham University."Some people wanted to take a long-term view of the risk of resistance developing and to seek to preserve the effectiveness of antivirals for the next pandemic, which may be more severe."Last month, the government launched the national pandemic flu service which authorised more than 511,000 courses of Tamiflu and Relenza treatment during its first fortnight in operation.Oxford University researchers have warned that antivirals are not a "magic bullet" against flu, and that resistance to the drug could develop, making it useless to fight any future and potentially more serious pandemic flu strain.The concern was seconded by flu expert Hugh Pennington, emeritus professor at Aberdeen University, who called for the national flu line to be shut down."I am concerned about the vast amount of Tamiflu that is going out almost unregulated," he told the Guardian. "We are increasing the possibility that the flu will become resistant sooner or later. At the moment there is no desperate need for Tamiflu. We should be reconsidering its issue, rather than encouraging its use."I think we should stop the national pandemic flu service. It was put there for an outbreak of far higher mortality than we have. If you get a resistant strain that becomes dominant in the autumn, Tamiflu will then be useless."A senior government adviser, Prof Peter Openshaw, said the government was told during the early stages of the current outbreak of the "significant side effects" that Tamiflu was causing in some people."I think there was, in some quarters, a slight over-optimism about the acceptability of prophylactic medication and its effectiveness," said Openshaw, a member of the Scientific Advisory Group for Emergencies. "Maybe some of the less clinical scientific advisers perhaps slightly over-inflated expectations of the ease and efficiency of antiviral treatment. Many of us who do clinical work and are clinically trained had a bit more of a jaundiced view of how things may turn out."Openshaw said antivirals were effective only if used within 36 to 48 hours of symptoms developing. "If the treatment is delayed they are relatively ineffective."On the other hand, we do have this large stockpile available and I think there is an advantage in trying to treat cases early, in order to reduce the severity and the number of patients who end up needing hospital care."Such a policy could "blunt" a spike of cases, reducing pressure on health resources, he said.The pandemic ethical committee was set up at the request of Sir Liam Donaldson, the chief medical officer, to assist planners and policy makers with ethical aspects of decisions they face in a pandemic, such as how to allocate scarce drugs when many people are sick.At its last meeting in May, when it was already becoming clear that the current H1N1 strain was causing a relatively mild disease in most people, the committee discussed the government's antiviral strategy.Members feared that the widespread use of antivirals in the current outbreak was incompatible with the principle of minimising harm, minutes from the meeting show. The current outbreak did not alter the risk of a more serious flu pandemic developing in the future. There would be ethical concerns if the blanket use of antivirals compromised their effectiveness in the future.Members said it was important to use antivirals in the most appropriate way, not just because the government had a stockpile of the drugs. The committee called on the government to explain to the public that they were no cure for flu.The committee concluded that it would be appropriate to offer antivirals as treatment only for those in risk groups, or with underlying conditions.In a statement, the Department of Health said: "Protecting the public is the prime concern of our strategy, which has been shaped by advice from the most eminent specialists from the beginning."There is still doubt about how swine flu affects people – a safety-first approach is the best approach. This means offering antivirals when required. However, we will keep this policy under review as we learn more about the virus and its effects. This is in line with the views of both the Committee on Ethical Aspects of Pandemic Influenza and of the Scientific Advisory Group for Emergencies.Swine fluHealth policyFlu pandemicHealthFluHealth & wellbeingJames Sturckeguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/world/2009/aug/16/swine-flu-tamiflu-helpline-paracetamol
Swine flu panic is sweeping India. But the biggest casualty of this media-manufactured hysteria is common senseSwine flu is strangling India. The government in Goa has advised against "non-essential" travel to other Indian states. The states of Tamil Nadu and Rajasthan have asked residents to stay away from Maharashtra. In Bombay, celebrations for Krishna Janmashtami, a popular festival honouring Hinduism's most adored deity, have been cancelled. The health ministry in Delhi has called for "social distancing measures".Schools, colleges, shopping malls and multiplexes across India's major cities have been shut down. Millions of Indians are going to mark the 62nd anniversary of India's freedom from colonial rule by locking themselves up. According to the headline splashed on the front page of the Times of India, there's "No stopping swine flu".One could be excused for thinking that human life on the Deccan plateau has, or is about to, become extinct. But the reality is that this "unstoppable" killer virus has so far claimed all of 24 lives. While each death is tragic, and the number will no doubt climb, two dozen fatalities, scattered across a country of 1.3bn people, do not amount to a pandemic.Dr Shobha Broor, a professor of microbiology at the All India Institute of Medical Sciences in New Delhi, estimates that seasonal flu kills up to 50,000 people annually in India. She told me that resources are being stretched to conduct tests on people who do not need them. Each testing kit costs up to $300 and, according to Broor, only those with existing conditions – mainly heart disease, diabetes or respiratory problems – should be tested.But the biggest fatality in this media-manufactured mass hysteria is common sense. Under intense pressure from a deeply irresponsible news media, the government is diverting precious resources to control the spread of a virus which, in 90% of cases, is cured without any medication at all. Roche, the Switzerland-based manufacturer of Tamiflu, has been the principal beneficiary of this panic. By July this year, it had made nearly $1bn on sales of Tamiflu. The Indian government alone has stocked up on more than a million Tamiflu capsules, spending between 35 and 200 rupees on each capsule.Roche has sold a licence to Hetero Drugs to manufacture generic Tamiflu for India and Africa. Local pharmaceutical giants want a share of the pie, and are pressing the government to let them manufacture the drug. By the time the drug is widely distributed, the virus will most probably have developed resistance. This is an extraordinary rip-off. But the government has to be seen to be doing something, and all it can do is spend money – money that is required elsewhere.There is a reason why the spread of H1N1 is getting the kind of attention in India that malaria and tuberculosis, which kill many thousands each year, never do. In a country that is so sharply divided along class lines, where everyday integration is limited to the street, H1N1 has emerged as the disease of the socially mobile, of the beneficiaries of globalisation. It is telling that the first confirmed case of H1N1 in India was a 23-year-old man returning from the US.For over a decade now, well-heeled Indians, and those joining their ranks, have built walls around themselves, excluding the poor – those most likely to suffer from malaria and TB, diseases all but extinct in first-world India's imagination – with a brutality unmatched in any part of the democratic world. The malls and multiplexes and schools and colleges that have been shut down define this class of Indians: apathetic, callous and, as we now know, cowardly. Remarkably, the virus that has shaken their world is named after swine.IndiaSwine fluFluFlu pandemicHealthKapil Komireddiguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/commentisfree/2009/aug/15/swine-flu-india
According to the Health Protection Agency, the number of cases in England has decreased significantly in the last week and the majority of cases continue to be mild.Paddy Allen
http://www.guardian.co.uk/uk/interactive/2009/may/05/swine-flu-cases-britain
People with health conditions will be first to receive swine flu vaccine in October, followed by pregnant womenPeople with health conditions such as diabetes, asthma and heart disease will be the first to receive the swine flu vaccine in October, the government said today.The vaccination programme, which will give priority to those aged between six months and 65 years old whose health problems could be aggravated by the flu, will begin two months later than the government previously stated.Next in line for the vaccine after at-risk groups will be all pregnant women, subject to licensing arrangements on the most suitable trimester to give the jab, people living in households with patients with suppressed immune systems, such as cancer patients receiving chemotherapy or those with HIV, and people over 65 with health problems aggravated by flu.At the same time, frontline health and social care workers will be vaccinated to keep essential services running, such as hospitals. The rest of the population will then be vaccinated.Three hundred thousand doses of the vaccine have been delivered by the manufacturers this month and 54.6m doses will have arrived by the end of the year, said the chief medical officer, Professor Sir Liam Donaldson.Trials on the vaccines are taking place in England and across Europe this month and the European Medicines Agency is expected to licence the drug in late September or early October.Details of the vaccination programme came as government figures showed the number of new swine flu cases has continued to fall, with an estimated 25,000 patients diagnosed in England in the last week.The number of deaths in England linked to the H1N1 virus jumped by eight to 44 in the past week, according to the health protection agency.The agency, which monitors infectious diseases, said 371 patients had been admitted to hospital in England – down on last week's total of 530.Experts have said the number of new cases should continue to fall while schools and universities are on their summer holidays.The majority of cases continue to be mild and there is no sign that the virus is mutating or developing resistance to antiviral drugs such as Tamiflu, said the agency.In the last seven days cases of swine flu reported worldwide have increased by 11% and the number of deaths by 27%, according to the European Centre for Disease Prevention and Control. Globally, there are now 215,090 reported cases, and 1,735 infected patients have died.Swine fluHealthNHSDavid Battyguardian.co.uk © Guardian News & Media Limited 2009 | Use of this content is subject to our Terms & Conditions | More Feeds
http://www.guardian.co.uk/world/2009/aug/13/uk-swine-flu-cases-fall
Update Sources