Swine flu: keep perspective over death

Europe's first death from H1N1 swine flu was a horrible tragedy for the family of the pregnant woman who died. But it does need to be kept in perspective.

By Prof Angela McLean, director of the Institute for Emerging Infectious Diseases at Oxford University.

Published: 7:00AM BST 16 Jun 2009

As of yesterday there have been 1,320 confirmed cases in the UK. In the United States, as of Friday, there had been 17,855 confirmed cases and 45 deaths – amounting to one death for each 400 confirmed cases.

By that count, one death in the UK is not unexpected. Nor is it a surprise that pregnant women should be at particularly high risk – that pattern occurs in seasonal influenza and in previous influenza pandemics.

In America, where the outbreak is several weeks ahead of ours, they have seen relatively few infections in the elderly with half of known cases in people between five and 24 years of age. The highest rates of admission to hospital are in children under the age of five, followed by people aged five to 24.

Seven in ten of those in admitted to hospital had an underlying health condition, like asthma, cardiovascular disease, diabetes or, indeed, pregnancy.

So far swine flu has been compared with seasonal flu and in the last twenty years there have been three flu seasons when the estimated number of deaths in England and Wales has exceeded 20,000.

There are around 42m people under the age of 60 in England and Wales.

If a quarter contract swine flu, as has been predicted, and one in 400 of those were to die the arithmetic says there would be around 26,000 deaths from swine flu – as bad as the 1989/90 season which was the worst in the last twenty years.

Sunday's tragic death reminds us that all flu can be serious. But we have time to learn from how swine flu behaves during a winter flu season in the southern hemisphere. We can learn from the risk groups, how many people fall ill, and fatalities in Australia over the coming months to understand who in our communities will be at highest risk, and just how large those risks will be.