Wednesday, June 17, 2009

Scotland and Australia: What's really happening

Fergus Walsh (BBC News)Jun 10, 2009 23:02:37 GMT

Swine flu warning in Melbourne
Hours before the World Health Organization is expected to declare a pandemic of H1N1 swine flu, I've been seeking expert comment from two of the worst affected countries outside North America - Scotland and Australia.
Along with Chile and Japan, these are the countries which are forcing the move to Phase 6, a global epidemic or pandemic.
Dr Ian Barr is the Deputy Director of the WHO Influenza Centre in Australia.
He's based in Melbourne, which is the centre of the flu outbreak there.
The state of Victoria has had more than 1,000 confirmed cases of swine flu and Dr Barr said that the government was now changing the way it managed the outbreak.
"If someone is ill then we will continue to ask that they stay at home and don't go out and risk infecting anyone. But there won't be a recommendation for quarantining whole families as has happened.
"Unless someone falls quite ill they won't be given antiviral treatment like Tamiflu and we won't trace their contacts. We won't close schools if there's a single case, so it's a much more relaxed approach than we've had prior to this phase."
But Dr Barr said that the virus was not causing serious problems:
"We've had just a handful of cases admitted to hospital and no deaths.
"There've been very mild symptoms among the 1,000 laboratory confirmed cases and probably thousands more that have not been tested."
With the southern hemisphere moving into its peak winter flu season, it will be vital to keep a close watch on what happens there in the months ahead.
Scotland, by contrast, is heading into summer. That did not stop 47 new cases being confirmed there today, the highest number for a single day. It takes the total to 311.
Ten people are in hospital. Dr Harry Burns, the Chief Medical Officer for Scotland, said that there was no doubt that they were seeing community transmission well beyond the confirmed cases.
"The last figures I saw there were between 30 and 40 cases where there was no known source for the infection - it did not seem to be travel-related or connected to a particular outbreak. But sometimes people don't always remember their contacts".
Dr Burns said that there was also no doubt that there were plenty of cases going untested and unmeasured, just as was happening in other countries.
I asked him whether it was time for a change in approach as is happening in Australia, with fewer school closures and so on.
"We are getting close to a change in strategy, but quite how and when it is rolled out we can't say yet. We will continue to take scientific advice.
"If you have a new travel-related case in a rural part of Scotland where there have been no cases, then you may look for contacts. That might be less so in other areas where there have been lots of cases."
He has no doubt that the virus is here to stay and he hoped that it would remain a largely mild infection.
"But it's worth preparing for the worst. The nightmare scenario a few years ago was that H5N1 avian flu would reassort with a human flu virus in pigs.
"If H1N1 reassorted with H5N1, it would be important to have some initial protection against the H1N1 strain. That's why it's worth creating a vaccine."

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