Swine flu won't be as dangerous as we thought, official says

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 feared

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• Severin Carrell, Scotland correspondent
• guardian.co.uk, Thursday 3 September 2009 14.52 BST
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Scottish health secretary Nicola Sturgeon has revised downwards the official predictions for the swine flu death toll this winter. Photograph: CS Goldsmith/AP

The 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."

Latest Science Summary - NHS

Swine Flu latest http://www.nhs.uk/news/2009/04April/Pages/Swineflulatest.aspx - see latest Science from NHS.

"Almost nine out of 10 of those suspected of having swine flu had some other viral illness"

Dr James Le Fanu: swine flu

Swine flu? Pigs may fly

By Dr James Le Fanu
Published: 7:00AM BST 02 Sep 2009

Dr James Le Fanu Photo: MARTIN POPE

There is nothing like a fortnight’s holiday for putting things in perspective. I flew to Greece, leaving Britain in the grip of the swine flu epidemic with an estimated 100,000 new cases per week – only to discover on my return that this major threat to the nation’s health seems to have evaporated.

Or perhaps, as the British Medical Journal suggests, there never was an epidemic. After considerable difficulty, Edinburgh doctor Wilfrid Treasure tracked down confirmed cases in his area – just 13 per cent of those in whom it was originally diagnosed. Almost nine out of 10 of those suspected of having swine flu had some other viral illness. It was a similar story at Middlesbrough’s University Hospital, which set aside a special swine flu ward. In July, 28 patients were admitted but the diagnosis was confirmed in just two. It will be interesting to see if a more realistic assessment of the scale of the “epidemic” will influence plans for a mass immunisation campaign this autumn. I doubt it

My son has got Swine Flu

3am 2 September: Dominic (18) wakes with a high temperature (100.4F (4.30am) -101.3F (5.30am). He has a throbbing headache and vomitting (6 times in 2 hours). The National Pandemic online website advises he has Swine flu and prescribes Tamiflu - an antiviral treatment course and issues prescription number and tells us to phone GP because he may have complications. The authorisation number for this patient is: R10-123xx123-B

We give him a capsule of Tamiflu (prescribe via www.pimsreg.com) but he vomits within 10 minutes. He vomits with paracetemol tablets - which come up.

We phone our GP and then the west Hampshire Out of hours service 0844 811 3060. Catherine Trusson, a call handler for the antivirus service advises that Mike (nurse) will phone in <1 hour which he does.

Mike, the nurse reviews his symptons (5.30-5.45am) and says that this is probably a "simple viral illness" probably not "swine flu" or "meningitis".

At 5.55am Dominic has diarrhoea.

I take a Tamiflu capsule but wife refuses to do so (I've been taking a Tamiflu capsule every other day since early August, as a preventative measure). We both wash hands since we've touched the glass that Dominic was holding.
9.05am: Dominic has a rash around shoulders, temperature 100.3F, he says he is 'confused'. I phone GP, Dr Nigel Savage will call before 9.35am.

10.30am: Nigel says rash is not meningites/meningococal. 38.2C= 101F. His 'symptoms tick all the Swine flu boxes'. After some obfuscation (government has made a mess of it..) he agrees with me for Dominic to take Tamiflu. Will be in bed for a few days, take fluids and anti-vomiting tablets.

Dr Savage after mentioning economics / health tradeoff, agrees that other members of my family should take Tamiflu once a day as paliative (prevention) measure.

Parents and GPs warned not to mistake meningitis for swine flu

The two illnesses have many symptoms in common – but a wrong diagnosis could be fatal

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• guardian.co.uk, Tuesday 1 September 2009 12.25 BST
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As the school year begins, parents are warned to look out for symptoms of meningitis. Photograph: Peter Dazeley/Getty Images

Parents 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.