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H3N2 Flu Strains British Health Care System

hawkeye

Well-known member
KILLER FLU HITS BRITAIN



BRITAIN’S flu crisis is expected to get even worse within weeks as a deadly Australian strain of the virus spreads across the country, health officials warned yesterday.

The strain that caused a severe epidemic in Australia, killing six children, has arrived here as the UK struggles with its worst flu outbreak for eight years.

Experts have warned that infections in Britain and Ireland will increase from January to March.

A sharp rise in the number of flu-like illnesses has already been reported by the Health Protection Agency.

Soaring infections have caused havoc at A&E departments in NHS hospitals in the past two weeks as thousands of GPs’ surgeries have been closed over the Christmas holiday period.

The flu season began a month earlier than last year and coincided with widespread outbreaks of the norovirus “winter vomiting bug”.

Now the arrival of the H3N2 Brisbane 10 strain will put further pressure on the health service.Latest figures show that among the over-65s, 45 in every 100,000 people now have flu, up from 18 just a week ago.

Though the 15 to 44 age group are most likely to report cases – with a rate of infections of 80 per 100,000 people – it is older people who are most likely to die from flu.

This year’s outbreak is well on course to be the worst since 1999/2000, when 22,000 people died.

Officially, an outbreak does not become an epidemic until the rate is higher than 200 per 100,000 people.

Tory health spokesman Andrew Lansley last night blasted the Government’s broken promises after the last killer outbreak.
He said: “In recent years it has rather complacently assumed winter crises don’t happen any more.

“I know the NHS will respond well – but I regret that ministers have let bed numbers fall.”

Following the 1999/2000 crisis, the Government pledged to increase the number of hospital beds by 7,000. In fact, the number has fallen by 13,000.

Last week Health Secretary Alan Johnson insisted that the increase in sickness was “pressure we can cope with”, but Professor Steve Field, chairman of the Royal College of GPs, warned last night that problems were stacking up.

He said: “Older age groups are now showing increases.

“They have the most serious consequences, with extra load on the lungs, possible viral pneumonia and the increased risk of a second bacterial infection.

“The NHS is coping remarkably well, although there are desperate problems in the West Midlands.”

Calls to ambulance services there have risen by 30 per cent, compared with last December. Prof Field said: “The outbreak is affecting young adults, many of whom are health service workers.

“On top of norovirus, which is causing ward closures, there is a lot of pressure on the NHS.

“The influenza vaccination programme has been good in some areas but patchy in others. In these areas the NHS will take a big hit.”

John Heyworth, incoming president of the College of Emergency Medicine, said most people with symptoms would be fine within two or three days.

But he stressed: “The bottom line is that if people can’t access care in the community and need to see someone, they should come to A&E because we don’t want bad things to happen.

“If there is any doubt, we are happy to help.”

The Health Protection Agency said the current flu vaccine protects against the Australian strain. And a Department of Health spokesman urged those in “at risk” groups not to delay in getting their free jabs.

Vulnerable groups include the elderly, stroke victims, heart patients, those with diabetes or asthma, people with high blood pressure, or suffering kidney failure or liver disease, and anyone taking immunosuppressive drugs.

The spokesman said: “If you are over 65 or in one of the ‘at risk’ groups and have not had the jab, contact your surgery to check if they still have supplies and make an appointment. It is not too late, even after Christmas.”

Anyone over 65 is entitled to the flu vaccine on the NHS, and around 70 per cent have taken it up.

Others only get the jab free if they are deemed at risk.

Other European countries in the grip of a H3N2 Brisbane 10 outbreak include Spain and Bulgaria.
 
Last edited by a moderator:
Re: H3N2 Flu Strains British Health Care System

31 December 2008
Flu activity is still circulating at 'normal seasonal levels', according to latest figures.


Surveillance from the Royal College of General Practitioners for week 52 of 2008 (December 22 to December 28 2008) reports an incidence rate for flu-like illness of 41 per 100,000 population, down from 68.5 per 100,000 in week 51. However, owing to the two bank holidays over the Christmas period the results for this week need to be interpreted with caution. In addition, over the flu season rates will fluctuate each week.
As in previous weeks the Agency's advice is to be alert to symptoms of flu.
  • Anyone over the age of 65, or under 65 who falls into an "at risk" group, should ensure they receive their flu vaccination.
  • Health care workers involved in the delivery of care and/or support to patients should see their occupational health department for their flu jab. Care workers should speak to their GP to establish if they meet the criteria for flu vaccination.
  • If you do get flu this year, our advice is to stay at home, rest, drink plenty of fluids and use over-the-counter remedies if they make you feel more comfortable.
Professor Nick Phin, a flu expert at the Health Protection Agency said: "Flu is still circulating in the population and our advice is for anyone who thinks they have flu is to rest, take plenty of fluids and to self-medicate to ease their symptoms.
"For most people flu is an unpleasant experience but they will recover. Some people, such as the elderly, are more at risk and flu can lead to complications such as pneumonia and that is why we would encourage everyone in this group to get their free flu jab at their GP surgery. The current vaccine is well matched to the circulating flu strains and should offer good protection."
Professor Nick Phin added: "We can all do our bit to stop flu spreading by having good hand and respiratory hygiene. When sneezing and coughing it is important to use tissues to cover the mouth and nose and then to dispose of these correctly - Catch it, bin it, kill it. Washing the hands with soap and water will also destroy the virus and help to stop it spreading."
-ends-
Notes to Editors:

1. Latest flu data from the Health Protection Agency can be found at:
http://www.hpa.org.uk/webw/HPAweb&HPAwebStandard/HPAweb_C/1222154877315?p=1191942171484
2. Further information on seasonal flu can be found at:
http://www.hpa.org.uk/infections/topics_az/influenza/seasonal/default.htm
3. The flu jab is well matched to the flu strains that are circulating this year and should offer good protection to those who are 65 or over and other people who are in an at risk group.
The flu vaccine for this winter includes the following viruses:
- A/Brisbane/59/2007 (H1N1)-like virus
- A/Brisbane/10/2007 (H3N2)-like virus
- B/Florida/4/2006-like virus.
Advice on flu is available from NHS Direct on 0845 4647 or www.nhsdirect.nhs.uk
4. The Health Protection Agency is using a variety of clinical, virological and epidemiological indicators to monitor flu activity in the UK. These include:
  • Royal College of General Practitioners
    The overall incidence rate of flu-like illness remains within normal seasonal activity levels. Rates decreased from 68.5 per 100,000 population in week 51 to 41.3 per 100,000 in week 52. However, owing to the two bank holidays during week 52 when GP surgeries would normally be closed, rates should be interpreted with caution.
NB: Thresholds used to define the level of flu activity are:
'baseline activity' ( 'normal seasonal activity' (30 - 200 consultations per week per 100,000 population)
'epidemicactivity'(>200 consultations per week per 100,000 population).

5. The Department of Health's flu immunisation programme for this winter recommends that all those aged 65 and over and other at-risk groups should be vaccinated. In addition it is recommended that health care workers be vaccinated. For further details see their website: http://www.dh.gov.uk/en/Publicationsandstatistics/Lettersandcirculars/Professionalletters/Chiefmedicalofficerletters/DH_083812

6. For media enquires only, please contact the Health Protection Agency's Centre for Infections press office on
Alex Baker 020 8327 7098
David Daley 020 8327 6647
Louise Brown 020 8327 7080
Kate Swan 020 8327 7097

Last reviewed: 31 December 2008

http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPAweb_C/1230713153123
 
Re: H3N2 Flu Strains British Health Care System

Source: http://news.bbc.co.uk/2/hi/uk_news/northern_ireland/7806476.stm

Northern Ireland: Flu level 'higher than expected'

Northern Ireland is experiencing a higher than expected level of flu cases, the deputy chief medical officer has said.

Dr Elizabeth Mitchell said people who are ill with the cold or flu should not visit patients in hospital.

She said the number of cases this December was the "highest since the millennium".


She said people who were already ill in hospital could experience serious complications if they caught the flu.

"The flu is a highly contagious infection and you will only put others at risk," she said.

She said in one week just before the Christmas holiday 196 people per 100,000 of population had attended GP surgeries with flu or flu-like symptoms.

Dr Mitchell said in December 2006 the numbers "were more like 100 per 100,000".


She said the winter flu was an unpleasant experience "but for more vulnerable groups, it can lead to complications that are more serious".

"This is certainly the case for patients who are already ill in hospital," she said.

"Although I fully understand that relatives and friends want to visit their loved ones during the festive and new year period, I would ask that if you are ill, please stay at home and only visit hospital once you have made a full recovery."

She said the flu was caused by a virus and ordinary antibiotics will not be effective in treating the infection.

"Medical advice should only be sought if symptoms become severe or last more than about a week," she said.

"However those who already have a chronic or long standing illness may need medical attention earlier..."
 
Re: H3N2 Flu Strains British Health Care System

In addition to the UK links provided in Niman's post the UK is a participant in the European Influenza Surveillance Scheme (EISS) who have a good site with maps for each week of the flu season with serotype incidence levels by region.
http://www.eiss.org/index.cgi

click on the small map to expand and use it interactively.
 
Re: H3N2 Flu Strains British Health Care System

[At this point, it could be useful to know whether family doctors in UK may have found more severe influenza-like syndrome in response to this high influx of patients. Because, I suspect that the bloody headlines of some media sources could have spark panic among population. It wouldn't be the first time it happens. Conversely, if a more serious clinical pattern of influenza-like illness with bacterial superinfections or other complications then the people's reactions could be better understood. IOH]

UK: Family doctors 'inundated with patients' - Telegraph

Family doctors 'inundated with patients'

Family doctors have been flooded with patients over the festive season, new figures suggest, thanks to a combination of the flu outbreak and other winter bugs.


By Kate Devlin Medical Correspondent
Last Updated: 7:57AM GMT 01 Jan 2009

Some areas have seen an increase of 60 per cent in patients going to visit their GP.

Across England demand for GP out-of-hour services was 25 per cent higher between the 19 th and the 21st of December than during the same period in November.

The NHS Alliance, which compiled the figures from a survey of its members, said that most of the calls were about flu.

Earlier this week experts warned of a deadly "Australian" strain of influenza hitting the country.

Separate figures from the Royal College of GPs show that the flu outbreak could be on the wane.

The college's weekly report of members' consultations found that the number of flu cases they were seeing had decreased by almost 45 per cent on the previous week.
-
<cite cite="http://www.telegraph.co.uk/health/4059367/Family-doctors-inundated-with-patients.html">Family doctors 'inundated with patients' - Telegraph</cite>
 
Re: H3N2 Flu Strains British Health Care System

Source: http://www.southwalesargus.co.uk/news/gwentnews/4013148.GPs_say_Gwent_flu_calls_are_up/

(Wales) GPs say Gwent flu calls are up
12:20pm Thursday 1st January 2009
By South Wales Argus Newsdesk ?


OUT-of-hours GPs in Gwent have been reporting increased levels of flu-related calls from patients.

Surveillance from the out-of-hours service, which provides family doctor and nursing cover for hundreds of thousands of patients outside of normal surgery hours, showed that in the week before Christmas there were 301 flu-related calls in Gwent, against 273 the previous week.

The figures come against the backdrop of a UK-wide increase in flu-related consultations, and though Wales is not yet seeing the same sort of rise as England, Scotland and Northern Ireland, the NHS here is already feeling the effects.

The latest flu surveillance report from the National Public Health Service for Wales, for the penultimate week of the year, indicates that there were 15.6 flu-like illness consultations per 100,000, an increase on previous weeks.

In England in the same week, there were 39.6 such consultations per 100,000, in Scotland 65 per 100,000 and in Northern Ireland 196.5 per 100,000.


Baseline activity for flu is different in each country, but while this minimal rate has been passed in England and Scotland, and there is no baseline measurement in Northern Ireland, it has not yet been passed in Wales.

However, NPHD Wales figures show that flu-related activity is above what was experienced last year, and the NHS is bracing itself for what may be the heaviest rate of flu cases in almost a decade.

January, February and early March are likely to be the busiest months, if such a scenario continues to develop, and Gwent Healthcare Trust, along with others across Wales, are urging people with flu or other seasonal illnesses to stay away from hospitals if possible.

However, with hospitals already busy due to increasing demand, there is a possibility that the complications caused by flu, such as pneumonia, particularly in the elderly, could cause big problems in the early months of 2009.
 
Re: H3N2 Flu Strains British Health Care System

Decade?s Worst Flu Marches on Europe After Virus Hits Ireland
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By Jason Gale
Jan. 15 (Bloomberg) -- Dublin?s Wexford Street pharmacy can?t keep shelves stocked with fever remedies and cough drops this week as snuffling customers seek relief from Ireland?s worst flu season in almost a decade.
The virus, which hit Ireland and Portugal a month ago, is on an eastward march across Europe, leaving a wake of crowded emergency rooms and absent workers. In Ireland, the rate of flu- like illness is the highest since 2001, and the season is only midway. In Lisbon, Health Minister Ana Jorge asked the military last week to provide additional beds for flu patients.
The epidemic is now hitting France, Germany and Scandinavia, according to the European Centre for Disease Prevention and Control in Stockholm. Laboratories reported a 10- fold jump in flu cases in Sweden since the end of 2008 and a government agency says it may be one of the worst seasons of this century. It is being driven by a variant of a strain known as H3N2 that surfaced in Brisbane, Australia in 2007.
?Our alarm detection system said that influenza had a grip on the whole country? by mid-December, said Annika Linde, head of epidemiology at the Swedish Institute for Infectious Disease Control in Solna. In the first week of 2009, ?we had an explosion.?
At a time when scientists can tailor drugs to match a patient?s genetic profile and people live longer than ever, the flu, first described by Hippocrates 2,400 years ago, still has the power to make millions bed-bound for a week and kill the very young, the elderly and those weakened by chronic disease.
Hong Kong Flu
The H3N2 strain first appeared in 1968 with the Hong Kong flu that killed an estimated 1 million people. Four decades later, H3N2 reigns as ?the major and most troublesome? influenza in humans, New York Medical College researcher Edwin D. Kilbourne wrote in a 2006 study of pandemics.
For many Europeans, it will be their first encounter with the new Brisbane variant, so they will have no natural immunity, said Angus Nicoll, ECDC influenza coordinator in Stockholm. While those who get a flu shot will be protected, Europe?s typically low inoculation rates will increase the amount of illness.
?This will be an important season to watch,? Nicoll said.
Ross Ardill, a general practitioner in Dublin?s financial district, said he and his five colleagues are treating about 20 flu patients a day, up from two or three in a normal season.
More patients are showing up at hospitals with respiratory problems such as pneumonia, said Gerard Sheehan, an infectious diseases specialist at Dublin?s Mater Misericordiae University Hospital. The Irish Nurses Organisation said there were 435 patients on trolleys in hospital emergency departments across the country on Jan. 13, the most in almost three years.
Rising Rates
The Health Protection Surveillance Centre in Dublin says the rate of influenza-like illness in Ireland climbed to 120.5 cases per 100,000 people in the second week of the year, from 72.8 per 100,000 at the end of December.
?We?re only seeing the tip of the iceberg,? said Ronan Boland, 45, a doctor in Cork, Ireland?s second-largest city, and chairman of the Irish Medical Organisation?s general practitioner group.
In Europe, flu typically starts in Ireland and Portugal and moves eastward, according to a 2007 study in the online journal BMC Infectious Diseases, which noted population, geographical and climate factors, including wind direction, may drive early epidemic activity.
Coughs and Sneezes
The virus travels in the fine spray of the coughs and sneezes of infected people. A single sneeze can eject thousands of flu particles. Once inside the airways, the virus attacks the cells that line the respiratory tract, potentially breaching the airway?s protective barrier and leading to complications such as pneumonia. The body reacts by raising its temperature and producing mucus to fight the infection.
The three main flu strains -- H3N2, H1N1 and type-B -- cause 250,000 to 500,000 deaths a year globally, according to the World Health Organization.
The Brisbane H3N2 virus set off the worst epidemic in a decade in northeastern Australia in 2007. Nationwide, flu cases were three times the average of the previous five years and seven children died, compared with a nine-year average of 2.6 deaths.
The virus reached the U.S. late year. There, it contributed to a threefold jump in flu-related hospitalization rates among children four years old and younger compared with the previous season, according to surveillance data of laboratory-confirmed cases by the Centers for Disease Control and Prevention in Atlanta.
?The symptoms of H3N2 are generally more severe than the symptoms with H1N1,? David Reddy, head of the influenza task force at Roche Holding AG, which makes the best-selling flu medicine Tamiflu, said in a telephone interview. Flu-related mortality is typically higher during epidemics in which H3N2 is the dominant strain, according to the WHO.
Off the Job
The most significant cost of the disease is lost productivity and absenteeism, according to the European Scientific Working Group on Influenza, which found flu caused 203 million days of lost productivity, $11.6 billion of medical and other direct costs and $25.4 billion of indirect costs, such as parents taking time off to care for sick children.
Tamiflu and Relenza, an inhaled powder made by London-based GlaxoSmithKline Plc, reduce the severity and duration of symptoms if the drugs are taken in the first 48 hours. Dublin doctor Ardill says most of his patients seek help too late to benefit from anti-flu medicines.
?A lot of people will feel so bad initially that they will spend the first three, four, five days in bed,? he said.
For patients who make it to the doctor?s room in time, there?s another problem: one strain at least has developed resistance to the Roche drug.
Tracking Resistance
Almost all the H1N1 viruses have now developed resistance, according to the Centers for Disease Control and Prevention. All flu viruses still can be treated with Relenza.
Basel, Switzerland-based Roche will follow 1,200 flu sufferers in seven countries during the next three winters to gauge resistance to Tamiflu and other drugs, Reddy said.
?The important thing is to immunize, immunize, immunize,? said the ECDC?s Nicoll.
A survey of 19 European nations found most countries failed to vaccinate at least half those ages 65 or older, especially where the shots weren?t free, researchers said in an October report in Eurosurveillance. In comparison, two-thirds of Americans in the same age group were immunized in 2007, according to the CDC. The U.S. government recommends 85 percent of the population should get a shot each year and covers the cost for those 65 and older.
Vaccines
The vaccine requires annual adjustments because the flu virus constantly mutates, giving rise to new strains not recognized by the immune system.
Last year, when the H3N2 flu hit the U.S., the vaccines manufactured by companies including Glaxo and Sanofi-Aventis SA, based in Paris, didn?t incorporate the Brisbane variant, so those most at risk weren?t fully protected. The vaccine sold in Europe and the U.S. this year has been adjusted for the newcomer.
?For such a simplistic virus, it?s also one of the most complicated,? says Michael Osterholm, director of the Center for Infectious Disease and Policy at the University of Minnesota in Minneapolis. ?As researchers learn more about influenza it is becoming increasingly clear how much we don?t know.?
To contact the reporters on this story: Jason Gale in Singapore at j.gale@bloomberg.net
Last Updated: January 14, 2009 19:01 EST

http://www.bloomberg.com/apps/news?pid=20601085&sid=a8cTy7tbUjhQ&refer=europe
 
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