UK: 607 confirmed fatalities due to influenza

NS1 · Jan 1, 2011

HA 158E in Cameroon Pair with Additional HA Changes Correlated to Anti-Viral Resistance

HA 158E in Cameroon Pair with Additional HA Changes Correlated to Anti-Viral Resistance

HA 158E in Cameroon Pair with Additional HA Changes Correlated to Anti-Viral Resistance

The UK National Institute for Medical Research published a group of sequences on 2010-12-30 at GISAID. One group originated from the Centre Pasteur du Cameroun.

HA 158E, a polymorphism associated with Vaccine Escape, appears in two Cameroon sequences upon a highly plastic background that is demonstrated worldwide, including multiple non-adjacent, coastal areas of the United States and in Australia on a background that may be permissive to HA 230I.

This Cameroon background has additionally been conserved in domestic poultry Pandemic H1N1 from Canada.

The most recent sequence taken in April 2010, Cameroon10v_1090_2010_04_08, also carries HA syn223V just upstream of the 225 amino acid position that is so often tracked. HA syn223V has been co-located with 454N in Texas45131774_2009_09_13. 454N and other changes at 454 are highly correlated to the most recent UK sequences on file and to a chain of sequences spanning Australia before the UK and Iran after the UKWhiteChapel4880374_2M_2010_11_28 <a href="http://www.flutrackers.com/forum/showpost.php?p=384242&postcount=139" target="_blank">sample</a>. The related hypermorphic Australian sequence, OzVictoria508_9F_2010_07_24, shares <a href="http://pf11.blogspot.com/2010/09/australia-shows-novel-ha-238d-in-august.html" target="_blank">8 changes </a>with Cameroon.

Notice that the syn254P is has been found on a Japanese TamiFlu Resistant sequence. 523A, which is found at various points on Vaccine Escape and TamiFlu Resistant sequences, is also contained within the potential UK donation reservoir from Australia.

Based on these updates from NIMR, potential exists for a 158E emergence in the UK.

GeneWurx has prepared an <a href="http://genewurx.com/data/GeneWurx_UK_December_Emerging_Genetics_v2.xls" target="_blank">Excel spreadsheet</a> investigating potential genetic acquisition in the currently <a href="http://www.flutrackers.com/forum/showthread.php?t=156569" target="_blank">uncharted severe</a> Pandemic H1N1 wave in the UK. In Version 2 of this spreadsheet, the Cameroon 158E sequence takes Column W and provides homology with potential predecessors to one UK White Chapel <a href="http://www.flutrackers.com/forum/showpost.php?p=384072&postcount=119" target="_blank">sequence</a> of interest.

<a href="http://genewurx.com/data/GeneWurx_UK_December_Emerging_Genetics_v2.xls" target="_blank">GeneWurx_UK_December_Emerging_Genetics_v2.xls</a>

. . . . Cameroon10v_1090_2010_04_08 (
. . . . . . . . 35I,
. . . . . . . . 114L,
. . . . . . . . syn152I,
. . . . . . . . 158E,
. . . . . . . . syn219I,
. . . . . . . . syn223V [Thailand34_9913_2010_07_14,
. . . . . . . . . . . . . . Texas45131774_2009_09_13],
. . . . . . . . syn254P [Kumamoto2_2010_01_14_TmX],
. . . . . . . . syn276H,
. . . . . . . . syn402H,
. . . . . . . . syn419L,
. . . . . . . . syn456L,
. . . . . . . . 463V,
. . . . . . . . 523A [OzSydney217_2010_09_19 with 188T,
. . . . . . . . . . . . . OzVictoria508_9F_2010_07_24,
. . . . . . . . . . . . . Montana02_2010_04_07_VxX,
. . . . . . . . . . . . . Shizuoka_C21_2010_01_20_TmX])

. . . . Cameroon10v_813_2010_03_23 (
. . . . . . . . 35I,
. . . . . . . . syn152I,
. . . . . . . . 158E mix wt,
. . . . . . . . syn219I,
. . . . . . . . syn254P,
. . . . . . . . syn276H,
. . . . . . . . HA truncated after aa396)

Supporting Sequences

. . . . OzVictoria508_9F_2010_07_24 (
. . . . . . . . 35I [H5N1],
. . . . . . . . 88P [H2N3, H5N1, H11],
. . . . . . . . . . . [HunanHechengSWL1616_2009-11-23,
. . . . . . . . . . . KoreaAF2376_2009_10_27
. . . . . . . . . . . . . . . with 280A and 290K
. . . . . . . . . . . Nevada15_9F_2009_09_10
. . . . . . . . . . . . . . . with 22I, 225E, 256F, 299Y,
. . . . . . . . . . . . . . . . . . 299Y, 300S, syn384S,
. . . . . . . . . . . GermanyCologne13_2009_06_29
. . . . . . . . . . . . . . . with 35I, 38V, syn108L,
. . . . . . . . . . . . . . . . . . syn205G, 206s, syn276H],
. . . . . . . . syn102E [SingON2407_2009_12_13,
. . . . . . . . . . . . . . . Singapore544_2009_12_10,
. . . . . . . . . . . . . . . Brussels243_2009_11_09
. . . . . . . . . . . . . . . . . . . . with syn44L and 89G],
. . . . . . . . syn152I [CalifVRDL115_2009_12_04,
. . . . . . . . . . . . . . . NY6939_2009_12_11,
. . . . . . . . . . . . . . . tkOntarioFAV117_1C_2009_12_07
. . . . . . . . . . . . . . . . . . . . with 35I, syn219I, syn276H,
. . . . . . . . . . . . . . . . . . . . . . . syn456L, 463V, 523A,
. . . . . . . . . . . . . . . England1050_2009_12,
. . . . . . . . . . . . . . . Scotland103_2009_12,
. . . . . . . . . . . . . . . England1051_2009_12,
. . . . . . . . . . . . . . . ItalyAncona451_2009_11_27_f,
. . . . . . . . . . . . . . . NY6607_2009_11_24,
. . . . . . . . . . . . . . . CalifVRDL107_2009_11_15,
. . . . . . . . . . . . . . . CalifVRDL101_2009_11_05,
. . . . . . . . . . . . . . . DC_114_2009_11_04,
. . . . . . . . . . . . . . . England94800096_2009_11,
. . . . . . . . . . . . . . . Calif_SD35_2009_10_26,
. . . . . . . . . . . . . . . NY5447_2009_10_23,
. . . . . . . . . . . . . . . CalifVRDL84_2009_10_09,
. . . . . . . . . . . . . . . CalifVRDL87_2009_10_09,
. . . . . . . . . . . . . . . IndiaPune6196_2009_08,
. . . . . . . . . . . . . . . IndiaDhule9433_2009_08,
. . . . . . . . . . . . . . . SantoDomingoWR1057N_2009_07_02,
. . . . . . . . . . . . . . . SantoDomingoWR1058N_2009_07_02,
. . . . . . . . . . . . . . . SantoDomingoWR1059N_2009_06_30],
. . . . . . . . 206S,
. . . . . . . . syn219I [CalifVRDL115_2009_12_04
. . . . . . . . . . . . . . . . . with 35I, syn152I, syn276H,
. . . . . . . . . . . . . . . . . . . . syn456L, 463V, 523A,
. . . . . . . . . . . . . . FL_Pen213_2009_11_17
. . . . . . . . . . . . . . . . . . . . with 35I, syn152I, 273A,
. . . . . . . . . . . . . . . . . . . . syn456L, 463V, 523A,
. . . . . . . . . . . . . . CalifVRDL107_2009_11_15
. . . . . . . . . . . . . . . . . . . . with 35I, syn152I, syn276H,
. . . . . . . . . . . . . . . . . . . . syn456L, 463V, 523A,
. . . . . . . . 238D (GAc) [H2N3, H7N3, H7N7],
. . . . . . . . . . . . . . . . . . [Belgorod2_2010-03-15 (GAt),
. . . . . . . . . . . . . . . . . . Kaliningrad01_2009_11_02 (GAt)
. . . . . . . . . . . . . . . . . . . . . . . . with 225E and 226R,
. . . . . . . . . . . . . . . . . . AthensINS398_2010-01-24 GAt),
. . . . . . . . . . . . . . . . . . KaliningradCRIE_DA_2009-09-26 (GAt),
. . . . . . . . . . . . . . . . . . KaliningradCRIE_KG_2009-09-25 (GAt),
. . . . . . . . . . . . . . . . . . KaliningradCRIE_MA_2009-09-25 (GAt),
. . . . . . . . . . . . . . . . . . KaliningradCRIE_SHD_2009-09-25 (GAt),
. . . . . . . . . . . . . . . . . . KaliningradCRIE_ZD_2009-09-25 (GAt)],
. . . . . . . . syn247A [Belize8756_2009_10_08,
. . . . . . . . . . . . . . . Singapore93_2009_06_22]
. . . . . . . . syn254P,
. . . . . . . . 272G [Niigata19_2009_12_31,
. . . . . . . . . . . . GuangdongSWL36_2009_11_29],
. . . . . . . . syn276H [1918, S5],
. . . . . . . . syn388K [H5N1],
. . . . . . . . . . . . . . . [NagasakiHA_10_28_2010_03_23
. . . . . . . . . . . . . . . . . . . . . with 22I,
. . . . . . . . . . . . . . . NagasakiHA_10_26_2010_03_15
. . . . . . . . . . . . . . . . . . . . . with 22I, syn103E,
. . . . . . . . . . . . . . . NagasakiHA_10_24_2010_03_08
. . . . . . . . . . . . . . . . . . . . . with syn103E,
. . . . . . . . . . . . . . . GuangxiLonganSWL1990_2010_02_08
. . . . . . . . . . . . . . . . . . . . . with 453K, syn462E,
. . . . . . . . . . . . . . . JiangxiDonghuSWL15_2010_01_04
. . . . . . . . . . . . . . . . . . . . . with syn106E, 149R, syn456L (TTg),
. . . . . . . . . . . . . . . ViennaINS142_2009_11_26
. . . . . . . . . . . . . . . . . . . . . with syn97D, 99T,
. . . . . . . . . . . . . . . CzechUsti208_2009_11_25
. . . . . . . . . . . . . . . . . . . . . with 268T,
. . . . . . . . . . . . . . . GhanaFS_1921_2009_11_11,
. . . . . . . . . . . . . . . Alaska44_2009_11_17
. . . . . . . . . . . . . . . . . . . . . with syn275V, 276N,
. . . . . . . . . . . . . . . CalifVRDL76_2009_09_21
. . . . . . . . . . . . . . . . . . . . . with syn283Q,
. . . . . . . . . . . . . . . Taiwan206_2009_09_18,
. . . . . . . . . . . . . . . Taiwan177_2009_09_18,
. . . . . . . . . . . . . . . Taiwan167_2009_09_18,
. . . . . . . . . . . . . . . Taiwan156_2009_09_18,
. . . . . . . . . . . . . . . Taiwan143_2009_09_15
. . . . . . . . . . . . . . . . . . . . . with 205E mix,
. . . . . . . . . . . . . . . Utah20_C2_2_2009_07_25_VxX
. . . . . . . . . . . . . . . . . . . . . with 159D, 206S, 227G
. . . . . . . . . . . . . . . Slovenia2687_2009_07_01
. . . . . . . . . . . . . . . . . . . . . with 35I, 206S],
. . . . . . . . syn456L [H5N1],
. . . . . . . . 463V,
. . . . . . . . 523A [Nebraska02_2010_03_11,
. . . . . . . . . . . . NagasakiHA1022_2010_03_01_syn413K,
. . . . . . . . . . . . DomRepublic3768_2009_12_15,
. . . . . . . . . . . . NY6939_2009_12_11,
. . . . . . . . . . . . CalifVRDL115_2009_12_04,
. . . . . . . . . . . . NY6607_2009_11_24,
. . . . . . . . . . . . RheinlandPfalz81_2009_11_23,
. . . . . . . . . . . . Berlin210_2009_11_16,
. . . . . . . . . . . . BadenWurttemberg511_2009_11_16,
. . . . . . . . . . . . CalifVRDL107_2009_11_15,
. . . . . . . . . . . . FL_Pensacola40_2009_11_09,
. . . . . . . . . . . . CalifVRDL101_2009_11_05,
. . . . . . . . . . . . DC114_2009_11_04,
. . . . . . . . . . . . Calif_SD35_2009_10_26,
. . . . . . . . . . . . NY5447_2009_10_23,
. . . . . . . . . . . . CalifVRDL84_2009_10_09,
. . . . . . . . . . . . CalifVRDL87_2009_10_09,
. . . . . . . . . . . . KuwaitN13013_2009_08_31_syn413K])

. . . . CalifVRDL115_2009_12_04 (
. . . . . . . . . . . . 35I [H5N1],
. . . . . . . . . . . . 77N,
. . . . . . . . . . . . syn152I,
. . . . . . . . . . . . syn219I,
. . . . . . . . . . . . syn276H [1918, S5],
. . . . . . . . . . . . syn456L [H5N1],
. . . . . . . . . . . . 463V,
. . . . . . . . . . . . 523A)

. . . . FL_Pen213_2009_11_17 (
. . . . . . . . . . . . 35I [H5N1],
. . . . . . . . . . . . syn152I,
. . . . . . . . . . . . syn219I,
. . . . . . . . . . . . 273A,
. . . . . . . . . . . . syn276H [1918, S5],
. . . . . . . . . . . . syn456L [H5N1],
. . . . . . . . . . . . 463V,
. . . . . . . . . . . . 523A)

. . . . CalifVRDL107_2009_11_15 (
. . . . . . . . . . . . 35I [H5N1],
. . . . . . . . . . . . 39N,
. . . . . . . . . . . . syn152I,
. . . . . . . . . . . . syn219I,
. . . . . . . . . . . . syn276H [1918, S5],
. . . . . . . . . . . . syn456L [H5N1],
. . . . . . . . . . . . 463V,
. . . . . . . . . . . . 523A)

. . . . KoreaAF2376_2009_10_27 (
. . . . . . . . 88P [H2N3, H5N1, H11],
. . . . . . . . . . . . [Victoria508_2010_07_24 with ext changes,
. . . . . . . . . . . HunanHechengSWL1616_2009-11-23,
. . . . . . . . . . . Nevada15_9F_2009_09_10,
. . . . . . . . . . . GermanyCologne13_2009_06_29],
. . . . . . . . 131P,
. . . . . . . . 280A,
. . . . . . . . 290K [HunanHechengSWL1617_2009_11_23],
. . . . . . . . HA truncated after aa386)

. . . . Nevada15_9F_2009_09_10 (
. . . . . . . . 22I,
. . . . . . . . 88P,
. . . . . . . . 225E,
. . . . . . . . 256F,
. . . . . . . . 299Y,
. . . . . . . . 300S,
. . . . . . . . syn384S)

. . . . GermanyCologne13_2009_06_29 (
. . . . . . . . HA truncated until aa28,
. . . . . . . . 35I,
. . . . . . . . 38V,
. . . . . . . . 88P,
. . . . . . . . syn108L,
. . . . . . . . syn205G,
. . . . . . . . 206S,
. . . . . . . . syn276H,
. . . . . . . . HA truncated after aa321)

. . . . Texas45131774_2009_09_13 (
. . . . . . . . syn223V [H5N1, H6N1],
. . . . . . . . 454N [H7N3, H7N7, H9N2]
. . . . . . . . . . . . . . [IndiaPune9355_2009_08 with 225G,
. . . . . . . . . . . . . . IndiaBlore236_2009_06 with 226R,
. . . . . . . . . . . . . . SouthCarolina18_2009_09_16_VxX,
. . . . . . . . . . . . . . FL_Pen210_2009_11_10 with 225E]),

. . . . Shizuoka_C21_2010_01_20_TmX (
. . . . . . . . 22I,
. . . . . . . . syn149K,
. . . . . . . . syn413K,
. . . . . . . . 523A [Extensive US 2010 April & May (10),
. . . . . . . . . . . . on entirely different background,
. . . . . . . . . . . . including Montana02_2010_04_07_VxX]),

. . . . Kumamoto2_2010_01_14_TmX (
. . . . . . . . syn10Y [China22811_2009_12
. . . . . . . . . . . . . . . . . . . with 14 HA changes],
. . . . . . . . 252L [Maryland03_2010_01_13,
. . . . . . . . . . . . Guangdong2361_2009_11_25],
. . . . . . . . syn254P [1918, tn, H5N1]),
. . . . . . . . . . . . . . [Ancona451_2009_11_27_f,
. . . . . . . . . . . . . . Iran15583_2009_11_21
. . . . . . . . . . . . . . . . . . with 16 HA (226R) + 3 NA changes,
. . . . . . . . . . . . . . Iran16677_2009_11_24],
. . . . . . . . syn320G [H5N1],
. . . . . . . . . . . . . . [Yamagata307_2009_09_24
. . . . . . . . . . . . . . . . . . . with 123T, syn134G,
. . . . . . . . . . . . . . Moscow_ION_2009_07_16,
. . . . . . . . . . . . . . Bolivia1263_2009_07_14 with syn107Q,
. . . . . . . . . . . . . . Mie41_2009_07_11 with syn107Q]
. . . . . . . . syn366A (GCa) [H5N1],
. . . . . . . . . . . . . . [Unique to PF11 Asia,
. . . . . . . . . . . . . . Netherlands2143_2009_11_16,
. . . . . . . . . . . . . . Maryland31_2009_11_09,
. . . . . . . . . . . . . . Calif_SD35_2009_10_26,
. . . . . . . . . . . . . . NY5297_2009_10_22,
. . . . . . . . . . . . . . NorthCarolina53_2009_10_18,
. . . . . . . . . . . . . . Stockholm67_2009_07_17,
. . . . . . . . . . . . . . MauritusMPn_2009_07_01,
. . . . . . . . . . . . . . MauritusMPt_2009_07_01,
. . . . . . . . . . . . . . ENG92860032_2009_07,
. . . . . . . . . . . . . . ENG520_2009_06,
. . . . . . . . . . . . . . ENG507_2009_06,
. . . . . . . . . . . . . . WiscS1416_2009_10_26_xL (GCt),
. . . . . . . . . . . . . . TexasJMS385_2009_12_04 (GCt)],
. . . . . . . . syn390N [H2, H3N8, H5, H6, H7N3, H7N7, H9N2, H11],
. . . . . . . . . . . . . . [Calif09_2010_05_11,
. . . . . . . . . . . . . . NY7480_2010_03_01,
. . . . . . . . . . . . . . NY03_2010_02_09,
. . . . . . . . . . . . . . Texas01_2010_01_13,
. . . . . . . . . . . . . . TexasJMS400_2009_12_31,
. . . . . . . . . . . . . . TexasJMS399_2009_12_31,
. . . . . . . . . . . . . . TexasJMS398_2009_12_30,
. . . . . . . . . . . . . . TexasJMS397_2009_12_30,
. . . . . . . . . . . . . . Washington73_2009_12_14,
. . . . . . . . . . . . . . NY6937_2009_12_11,
. . . . . . . . . . . . . . Bishkek03_2009_11_28
. . . . . . . . . . . . . .. . . . . . . . . . with syn131S, 175D,
. . . . . . . . . . . . . . Tomsk06_2009_11_22,
. . . . . . . . . . . . . . Russia200_2009_11_01
. . . . . . . . . . . . . .. . . . . . . . . . with syn131S, 175D,
. . . . . . . . . . . . . . NY5196_2009_10_20,
. . . . . . . . . . . . . . NY5141_2009_10_16
. . . . . . . . . . . . . .. . . . . . . . . . with syn131S,
. . . . . . . . . . . . . . ENG94280034_2009_10_06,
. . . . . . . . . . . . . . Texas45093846_2009,
. . . . . . . . . . . . . . Texas45024243_2009,
. . . . . . . . . . . . . . AfghanistanN10786_2009_09_07
. . . . . . . . . . . . . .. . . . . . . . . . with syn131S,
. . . . . . . . . . . . . . AfghanistanN10760_2009_09
. . . . . . . . . . . . . .. . . . . . . . . . with syn131S,
. . . . . . . . . . . . . . AfghanistanN09787_2009_08
. . . . . . . . . . . . . .. . . . . . . . . . with syn131S,
. . . . . . . . . . . . . . Nepal (Nov)
. . . . . . . . . . . . . . NeimengguHuimin11560_2009_12_30,
. . . . . . . . . . . . . . Kentucky16_2009_07_30],
. . . . . . . . syn466G [H5N1, tn],
. . . . . . . . . . . . . . [Unique to PF11 Japan,
. . . . . . . . . . . . . . ChongqingYuzhong11307_2009_12_15
. . . . . . . . . . . . . .. . . . . . . . . . with 219V,
. . . . . . . . . . . . . . NY6864_2009_12_02
. . . . . . . . . . . . . .. . . . . . . . . . with 530I,
. . . . . . . . . . . . . . NY6909_2009_11_29
. . . . . . . . . . . . . .. . . . . . . . . . with 530I,
. . . . . . . . . . . . . . GuangdongHaizhu1644_2009_11_25,
. . . . . . . . . . . . . . NY6675_2009_11_24
. . . . . . . . . . . . . .. . . . . . . . . . with 530I,
. . . . . . . . . . . . . . DC46_2009_11_03
. . . . . . . . . . . . . .. . . . . . . . . . with 530I,
. . . . . . . . . . . . . . NY4995_2009_10_04
. . . . . . . . . . . . . .. . . . . . . . . . with 530I,
. . . . . . . . . . . . . . CalifVRDL75_2009_09_19
. . . . . . . . . . . . . .. . . . . . . . . . with 119M,
. . . . . . . . . . . . . . Texas45130742_2009_09_13,
. . . . . . . . . . . . . .. . . . . . . . . . with syn227E,
. . . . . . . . . . . . . . Texas45132788_2009_09_13,
. . . . . . . . . . . . . . Texas45120922_2009_09_12,
. . . . . . . . . . . . . . Texas45122282_2009_09_12,
. . . . . . . . . . . . . . Texas45113882_2009_09_11],
. . . . . . . . syn548C [H5N1, 1918, tn]
. . . . . . . . . . . . . . [Unique to PF11 Asia,
. . . . . . . . . . . . . . Bishkek03_2009_11_28
. . . . . . . . . . . . . .. . . . . . . . . . with syn131S, 175D,
. . . . . . . . . . . . . . Russia200_2009_11_01
. . . . . . . . . . . . . .. . . . . . . . . . with syn131S, 175D,
. . . . . . . . . . . . . . NY5141_2009_10_16
. . . . . . . . . . . . . .. . . . . . . . . . with syn131S,
. . . . . . . . . . . . . . AfghanistanN10786_2009_09_07
. . . . . . . . . . . . . .. . . . . . . . . . with syn131S,
. . . . . . . . . . . . . . AfghanistanN10760_2009_09
. . . . . . . . . . . . . .. . . . . . . . . . with syn131S,
. . . . . . . . . . . . . . AfghanistanN09787_2009_08
. . . . . . . . . . . . . .. . . . . . . . . . with syn131S])

Ronan Kelly · Jan 1, 2011

Re: UK: Reports of Approximately 39 Deaths and 700+ Patients in intensive care (39 deaths confirmed by HPA as for Dec. 30 2010) due to influenza

Re: UK: Reports of Approximately 39 Deaths and 700+ Patients in intensive care (39 deaths confirmed by HPA as for Dec. 30 2010) due to influenza

Saturday, January 01, 2011, 07:002
warning as flu hits city
By liz perkins health reporter

TWO people have died of suspected swine flu in Swansea and 14 patients with flu-like symptoms are being treated in intensive care.

The woman, in her 50s, and a man in his 20s died after becoming ill last week.

It is not known if the pair, whose identities have not been released, had underlying health conditions.

Health bosses have confirmed they are treating 10 patients in Morriston Hospital with flu-like symptoms, along with two in Singleton and two in Neath Port Talbot Hospital.

...

continues at; http://www.thisissouthwales.co.uk/news/warning-flu-hits-city/article-3055473-detail/article.html

Ronan Kelly · Jan 1, 2011

Re: UK: Reports of Approximately 39 Deaths and 700+ Patients in intensive care (39 deaths confirmed by HPA as for Dec. 30 2010) due to influenza

Re: UK: Reports of Approximately 39 Deaths and 700+ Patients in intensive care (39 deaths confirmed by HPA as for Dec. 30 2010) due to influenza

It should be noted that the figure of 738 patients in intensive care is the number for England only. The article above indicates 14 ICU patients in Swansea (Wales) alone. Figures for the rest of Wales [edit: are in post 190 below].
Scotland reports 23 cumulative ITU cases of which 12 were newly admitted in the week ending Dec 30. Northern Ireland does not report hospitalizations in its weekly report.

NS1 · Jan 1, 2011

Re: UK: Reports of Approximately 39 Deaths and 700+ Patients in intensive care (39 deaths confirmed by HPA as for Dec. 30 2010) due to influenza

Re: UK: Reports of Approximately 39 Deaths and 700+ Patients in intensive care (39 deaths confirmed by HPA as for Dec. 30 2010) due to influenza

RoRo said:
Saturday, January 01, 2011, 07:002
warning as flu hits city
By liz perkins health reporter

TWO people have died of suspected swine flu in Swansea and 14 patients with flu-like symptoms are being treated in intensive care.

The woman, in her 50s, and a man in his 20s died after becoming ill last week.

It is not known if the pair, whose identities have not been released, had underlying health conditions.

Health bosses have confirmed they are treating 10 patients in Morriston Hospital with flu-like symptoms, along with two in Singleton and two in Neath Port Talbot Hospital.

...

continues at; http://www.thisissouthwales.co.uk/news/warning-flu-hits-city/article-3055473-detail/article.html

RoRo,

Do we have a cumulative fatality count (official plus media)?

Ronan Kelly · Jan 1, 2011

Re: UK: Reports of Approximately 39 Deaths and 700+ Patients in intensive care (39 deaths confirmed by HPA as for Dec. 30 2010) due to influenza

Re: UK: Reports of Approximately 39 Deaths and 700+ Patients in intensive care (39 deaths confirmed by HPA as for Dec. 30 2010) due to influenza

CopitoSP was keeping a list for a while, but I don't know how updated that is. I suspect the best way to tally fatalities would be to go through this thread.

Ronan Kelly · Jan 1, 2011

Re: UK: Reports of Approximately 39 Deaths and 700+ Patients in intensive care (39 deaths confirmed by HPA as for Dec. 30 2010) due to influenza

Re: UK: Reports of Approximately 39 Deaths and 700+ Patients in intensive care (39 deaths confirmed by HPA as for Dec. 30 2010) due to influenza

More information from Wales;

Vaccine call as flu cases rise across Wales
Jan 1 2011 by Kate Forrester, Daily Post

Swine flu hits North Wales
VULNERABLE patients are being urged to get vaccinated against flu as new figures show an increase in cases across Wales last week.

Public Health Wales is reporting 92.1 cases per 100,000 of the population, compared with 85.5 per 100,000 the week before. The highest rate was in the the 25-34 age group at 171.8 cases per 100,000.

Eight patients are currently being treated in North Wales for swine flu ? the H1N1 virus ? one at Glan Clwyd, five at Wrexham Maelor and two at Ysbyty Gwynedd.

...

continues at; http://www.dailypost.co.uk/news/nor...s-flu-cases-rise-across-wales-55578-27916151/

Ronan Kelly · Jan 1, 2011

Re: UK: Reports of Approximately 39 Deaths and 700+ Patients in intensive care (39 deaths confirmed by HPA as for Dec. 30 2010) due to influenza

Re: UK: Reports of Approximately 39 Deaths and 700+ Patients in intensive care (39 deaths confirmed by HPA as for Dec. 30 2010) due to influenza

Man dies of swine flu after wedding
(UKPA) ? 1 hour ago

A father has died of suspected swine flu just 10 days after his wedding.

Martin Clorley married the love of his life, Nicola Bartley, 39, on December 16.

But the 37-year-old, from Wrexham, North Wales, fell ill before Christmas and was eventually taken to hospital on Boxing Day.

The father of two young children, Imogen and Ella, and stepdaughter Darryl, 18, died a short time later.

...

continues at; http://www.google.com/hostednews/uk...OjK2OF44mLJjMSEpQ?docId=N0413511293881204078A

Ronan Kelly · Jan 1, 2011

Re: UK: Reports of Approximately 39 Deaths and 700+ Patients in intensive care (39 deaths confirmed by HPA as for Dec. 30 2010) due to influenza

Re: UK: Reports of Approximately 39 Deaths and 700+ Patients in intensive care (39 deaths confirmed by HPA as for Dec. 30 2010) due to influenza

This puts the UK ICU total above 800 patients - England 738, Wales 58, Scotland 12+, N. Ireland unknown.

Frustration as ?at risk? group fail to get flu jab
Dec 31 2010 by Clare Hutchinson, Western Mail

Swine flu jab
ALMOST 60 patients in Wales are critically ill with flu, according to latest figures from the Assembly Government.

A spokesman said 58 patients with flu-like symptoms were in critical care beds as of Wednesday, but said the illness was still within seasonal flu activity.
....

Read More http://www.walesonline.co.uk/news/w...-to-get-flu-jab-91466-27911004/#ixzz19mvb30mh

Ronan Kelly · Jan 1, 2011

Re: UK: Reports of Approximately 39 Deaths and 800+ Patients in intensive care (39 deaths confirmed by HPA as for Dec. 30 2010) due to influenza

Re: UK: Reports of Approximately 39 Deaths and 800+ Patients in intensive care (39 deaths confirmed by HPA as for Dec. 30 2010) due to influenza

Hospitals struggling to cope with swine flu
Saturday 1st January 2011, 11:30AM GMT

...

Walsall Hospitals NHS Trust director of nursing and governance Sue Hartley said there were plans to increase critical care capacity at Walsall Manor Hospital.

?The beds on critical care units are designed to flex up and down according to demand which can change daily.?

In Wolverhampton, New Cross Hospital said today there had been between 10 and 15 confirmed cases of swine flu overnight, with 32 yesterday.

...

Read more: http://www.expressandstar.com/news/...uggling-to-cope-with-swine-flu/#ixzz19n1UEt7e

NS1 · Jan 1, 2011

UK Homology on Cameroon Pair Carrying 230I Permissive SNPs

UK Homology on Cameroon Pair Carrying 230I Permissive SNPs

UK Homology on Cameroon Pair Carrying 230I Permissive SNPs

The UK National Institute for Medical Research published a group of sequences on 2010-12-30 at GISAID. One group originated from the Centre Pasteur du Cameroun.

Two young boys, ages 10 and 7, are part of a transmission chain extended over 13 days. Cameroon10v_00812_7M_2010_03_23 is an exact HA match with Cameroon10v_00751_10M_2010_03_10.

These two sequences carry genetics common to the most recent October and November 2010 UK sequences while combining polymorphisms associated with RBD changes including 230I. Using domaining produces a clear relationship between Cameroon and the 230I carrier and 230I permissive sequences. Simple scrolling of the provided spreadsheet demonstrates the relationships.

GeneWurx has prepared an <a href="http://genewurx.com/data/GeneWurx_UK_December_Emerging_Genetics_v3.xls" target="_blank">Excel spreadsheet</a> investigating potential genetic acquisition in the currently <a href="http://www.flutrackers.com/forum/showthread.php?t=156569" target="_blank">uncharted severe</a> Pandemic H1N1 wave in the UK. In Version 3 of this spreadsheet, this Cameroon representative sequence, Cameroon10v_00812_7M_2010_03_23, takes Column U and provides homology with UK <a href="http://www.flutrackers.com/forum/showpost.php?p=384072&postcount=119" target="_blank">sequences</a> of recent interest.

<a href="http://genewurx.com/data/GeneWurx_UK_December_Emerging_Genetics_v3.xls" target="_blank">GeneWurx_UK_December_Emerging_Genetics_v3.xls</a>

. . . . Cameroon10v_00812_7M_2010_03_23 (
. . . . . . . . 100N [UKWhiteChapel4780352_2010_10_26
. . . . . . . . . . . . . . . . with 128D, syn131S, syn210S, 377K],
. . . . . . . . syn137A [UKCambridge118_2010_11_19
. . . . . . . . . . . . . . . . . . . . with syn363G, syn455Q, syn474C,
. . . . . . . . . . . . . . . . NorthCarolina56_2009_12_07
. . . . . . . . . . . . . . . . . . . . with 100N, 377K],
. . . . . . . . 218V [Minnesota04_18M_2010_03_22
. . . . . . . . . . . . . . . . with 165N, 230I, syn346G,
. . . . . . . . . . . . . Pennsylvania14_20M_2009_06_07
. . . . . . . . . . . . . . . . with 158E, 523I],
. . . . . . . . syn270I,
. . . . . . . . syn343G,
. . . . . . . . syn350G [IranShiraz1_2010_02
. . . . . . . . . . . . . . . . . . . . with 218A, 228R,
. . . . . . . . . . . . . . . . swThaiCURA4_2009_11
. . . . . . . . . . . . . . . . . . . . with 226R, syn484N],
. . . . . . . . 377K,
. . . . . . . . 457R [swJapanOkinawa2_2005
. . . . . . . . . . . . . . . . with 225G],
. . . . . . . . syn461K [Iran16273_2009_11_22
. . . . . . . . . . . . . . . . . . . . with syn55L, 226R],
. . . . . . . . syn466G [cheetahCA30954_2009_11_17
. . . . . . . . . . . . . . . . . . . . with syn169I, 200S])

. . . . Cameroon10v_00751_10M_2010_03_10 (
. . . . . . . . 100N,
. . . . . . . . syn137A,
. . . . . . . . 218V,
. . . . . . . . syn270I,
. . . . . . . . syn343G,
. . . . . . . . syn350G,
. . . . . . . . 377K,
. . . . . . . . 457R,
. . . . . . . . syn461K,
. . . . . . . . syn466G)

Shiloh · Jan 1, 2011

Re: UK: Reports of Approximately 51 Deaths and 800+ Patients in intensive care (39 deaths confirmed by HPA as for Dec. 30 2010) due to influenza

Re: UK: Reports of Approximately 51 Deaths and 800+ Patients in intensive care (39 deaths confirmed by HPA as for Dec. 30 2010) due to influenza

Source: http://www.thisishampshire.net/news/8765954.Deadly_swine_flu_outbreak/

Swine flu leaves six in intensive care
3:56pm Saturday 1st January 2011

* By Melanie Adams ? Health Reporter

THE deadly swine flu virus has swept through Hampshire leaving six people starting the new year in intensive care.

Four of those struck down by the potentially fatal H1N1 bug are adults who are ?critical but stable? and two are children who are in a ?serious? condition.

All six are being treated at Southampton General Hospital, with the youngsters on the paediatric intensive care unit. There are two further suspected cases of adults having the illness.

Staff at the hospital are battling against an ?unprecedented? number of flu cases, with more than 50 per cent of patients being admitted through the emergency unit suffering from flu-like symptoms...

mixin · Jan 1, 2011

Re: UK: Reports of Approximately 51 Deaths and 800+ Patients in intensive care (39 deaths confirmed by HPA as for Dec. 30 2010) due to influenza

Re: UK: Reports of Approximately 51 Deaths and 800+ Patients in intensive care (39 deaths confirmed by HPA as for Dec. 30 2010) due to influenza

As NS1 notes antiviral resistance, 2 sequences recently released at GISAID: A/CHIBA/12/2010 and A/SAITAMA-C/174/2009 both are noted to be resistant to oseltamivir and peramivir but sensitive to zanamivir.

tetano · Jan 1, 2011

Re: UK: Reports of Approximately 51 Deaths and 800+ Patients in intensive care (39 deaths confirmed by HPA as for Dec. 30 2010) due to influenza

Re: UK: Reports of Approximately 51 Deaths and 800+ Patients in intensive care (39 deaths confirmed by HPA as for Dec. 30 2010) due to influenza

Emergency operation to save Scots swine flu mum's baby

DOCTORS were forced to carry out an emergency operation to save the baby of a swine flu mum.

The woman was rushed to hospital after falling ill with complications linked to the virus.

Doctors immediately recognised she needed an emergency Caesarean section to save her baby's life.

As a result of their swift treatment, both mum and baby are understood to have recovered enough to be transferred out of the intensive care unit.

The patient is the fourth pregnant woman to have been treated for swine flu at Crosshouse Hospital near Kilmarnock, Ayrshire, in recent weeks.

...

http://www.dailyrecord.co.uk/2011/0...ve-scots-swine-flu-mum-s-baby-86908-22819176/

Ronan Kelly · Jan 1, 2011

Re: UK: Reports of Approximately 51 Deaths and 800+ Patients in intensive care (39 deaths confirmed by HPA as for Dec. 30 2010) due to influenza

Re: UK: Reports of Approximately 51 Deaths and 800+ Patients in intensive care (39 deaths confirmed by HPA as for Dec. 30 2010) due to influenza

Swine flu surge causes critical shortage in intensive care beds for children
By Susie Boniface 2/01/2011

Doctors last night warned of a critical *shortage of intensive care beds for children ? *because of the surge in swine flu.

Dr Kevin Morris, of the *Paediatric Intensive Care Society, said: ?We are virtually in a situation where there isn?t a single paediatric *intensive care bed left in the *country. This is the worst crisis within living memory.?

...

Dr Morris added: ?We have a situation where a sick child can?t get an intensive care bed in large parts of the country ? which means children are having to travel some distance to find a bed.

...

About one in five of the 305 child intensive care hospital beds is now taken up with critically ill youngsters with suspected swine flu. Last night there were just 15 left.

....

Read more: http://www.mirror.co.uk/news/top-st...s-for-children-115875-22820630/#ixzz19pajVdW2

sharon sanders · Jan 1, 2011

Re: UK: Reports of Approximately 31 Deaths and 460 Patients in intensive care (27 deaths confirmed by HPA as for Dec. 23 2010) due to influenza

Re: UK: Reports of Approximately 31 Deaths and 460 Patients in intensive care (27 deaths confirmed by HPA as for Dec. 23 2010) due to influenza

sharon sanders said:
After re-reading this article and all of the posts on the thread, it appears that extending the Christmas vacation for a week so that the schools and daycare operations could remain closed to students, might positively affect the outcome of this flu wave.

"Young children have overtaken those aged five to 14 after rates dropped among older children because of the school holidays."

The teachers and administrators could use that week to administer some work at home project(s). While vaccines are 70% effective in the best case scenario, staying away from people who are sick with flu is 100% effective. Of course, the closure can be extended a week at a time pending the disease pattern.

I know the arguments against school closure: 1) It does not decrease disease, it only flattens the curve 2) The schools are an effective "baby sitting" operation and working parents will not go to work if the schools are closed.

As to #1 - Apparently the case load for the hospitals and health care workers is straining, a flattened curve will give an opportunity for better health care delivery

As to #2 - Parents are very resourceful. They can use sick time, vacation time, grandparents, and/or work from home.

The Population Chart for the UK appears to show that the range for children aged 3 - 15 years is low as a percentage of the total population.

Doesn't it make sense to protect this vulnerable age group?

I know this is not a popular idea amongst government planners, but at FluTrackers we operate this site as parents.

Fears of flu epidemic rise as schools start new term

With infection rates soaring, Labour says the Government has 'seriously misjudged' the crisis

By Emily Dugan, Nina Lakhani and Brian Brady

Sunday, 2 January 2011

Health experts are warning of a "surge" in flu cases this week as schools reopen and the UK returns to work in earnest after the Christmas and New Year break.

http://www.independent.co.uk/life-s...c-rise-as-schools-start-new-term-2174156.html

-------------------

I think at this point it is becoming apparent that the holiday vacations should be extended for a week in, at least, some parts of the UK.

NS1 · Jan 2, 2011

Cameroon 230I Permissive Sequences Carry H3N8 and H7N7 Zoonotic Matches

Cameroon 230I Permissive Sequences Carry H3N8 and H7N7 Zoonotic Matches

Cameroon 230I Permissive Sequences Carry H3N8 and H7N7 Zoonotic Matches

Recently published sequences from Cameroon show homology to backgrounds that have supported HA 230I. Several of these backgrounds carry homology to animal reservoirs and Cameroon follows suit. These two young boys, ages 10 and 7, who were part of a transmission chain extended over 13 days may or may not have had close contact with animals. Cameroon10v_00812_7M_2010_03_23 is an exact HA match with Cameroon10v_00751_10M_2010_03_10.

The sequences are potentially related to the severe wave in the UK that has filled hospitals and, more importantly, Intensive Care Units to capacity (edit S.S.). English elective surgeries are actively being cancelled. Families are being told not to attempt a hospital visit in the case of Influenza due to the infrastructure strain. Emergency departments are forced to place patients on gurneys due to no beds being available while operating theatres and lounges are being hastily converted to patient rooms. These and other escalation procedures are reported in the media to be underway in hospitals throughout the country with several institutions presently indicating "Red" or "Black" alert levels.

Animal influences on the genetics of human-infecting Influenza like the pH1N1 strain may generate extreme outcomes and variant clinical behaviour. In these cases from Cameroon, the syn350G, 457R, syn461K and syn466G, among others, share homology with animal reservoirs as noted on the sequence details. We have discussed widely the HA 188T found in the emerging sub-clade including Australia, the UK and Iran. HA 188T is also found in the H7N7 reservoir, as is the syn350G on these Cameroon sequences.

The 457R and syn466G appear together within the H3N8 reservoir and are paired on a particularly interesting set of related horse and dog sequences from Australia. These two changes fall into a domain band that is related to the emerging sub-clade from Australia to the UK.

canineSydney6525_2007_10_14
canineSydney6692_2007_10_15
equineSydney6085_2007_10_10

GeneWurx_UK_December_Emerging_Genetics_v3.xls

. . . . Cameroon10v_00812_7M_2010_03_23 (
. . . . . . . . 100N [UKWhiteChapel4780352_2010_10_26
. . . . . . . . . . . . . . . . with 128D, syn131S, syn210S, 377K],
. . . . . . . . syn137A [UKCambridge118_2010_11_19
. . . . . . . . . . . . . . . . . . . . with syn363G, syn455Q, syn474C,
. . . . . . . . . . . . . . . . NorthCarolina56_2009_12_07
. . . . . . . . . . . . . . . . . . . . with 100N, 377K],
. . . . . . . . 218V [Minnesota04_18M_2010_03_22
. . . . . . . . . . . . . . . . with 165N, 230I, syn346G,
. . . . . . . . . . . . . Pennsylvania14_20M_2009_06_07
. . . . . . . . . . . . . . . . with 158E, 523I],
. . . . . . . . syn270I,
. . . . . . . . syn343G,
. . . . . . . . syn350G [H7N3, H7N7],
. . . . . . . . . . . [IranShiraz1_2010_02
. . . . . . . . . . . . . . . with 218A, 228R,
. . . . . . . . . . . swThaiCURA4_2009_11
. . . . . . . . . . . . . . . with 226R, syn484N],
. . . . . . . . 377K,
. . . . . . . . 457R [H2N3, H3N8, H4, H5N1, H7N3],
. . . . . . . . . . . . . [swJapanOkinawa2_2005
. . . . . . . . . . . . . . . . . . . with 225G],
. . . . . . . . syn461K [H2N3, H5N1 Human, Civet & Avian, H6N1, H11],
. . . . . . . . . . . . . . . [Iran16273_2009_11_22
. . . . . . . . . . . . . . . . . . . . with syn55L, 226R],
. . . . . . . . syn466G [H2N3, H3N8, H4N8, H6N1, H7N3, H9N2, H10N7],
. . . . . . . . . . . . . . . [cheetahCA30954_2009_11_17
. . . . . . . . . . . . . . . . . . . . with syn169I, 200S])

. . . . Cameroon10v_00751_10M_2010_03_10 (
. . . . . . . . 100N,
. . . . . . . . syn137A,
. . . . . . . . 218V,
. . . . . . . . syn270I,
. . . . . . . . syn343G,
. . . . . . . . syn350G,
. . . . . . . . 377K,
. . . . . . . . 457R,
. . . . . . . . syn461K,
. . . . . . . . syn466G)

Ronan Kelly · Jan 2, 2011

Re: UK: Reports of Approximately 51 Deaths and 800+ Patients in intensive care (39 deaths confirmed by HPA as for Dec. 30 2010) due to influenza

Re: UK: Reports of Approximately 51 Deaths and 800+ Patients in intensive care (39 deaths confirmed by HPA as for Dec. 30 2010) due to influenza

James Paget hospital in Yarmouth, Norfolk was on black alert on Dec 30 as reported by several sources -
http://www.bbc.co.uk/news/uk-england-norfolk-12100135
http://www.telegraph.co.uk/health/s...ng-faster-in-Britain-than-rest-of-Europe.html

I think the origin of the "many" claim is this article in the Telegraph;
http://www.telegraph.co.uk/health/h...-almost-double-among-children-under-five.html

which states; "[On Dec 30]James Paget University Hospital in Great Yarmouth was among those forced to declare a "black alert" ? an NHS hospital's most severe status level. "
but I have been unable to find any other named hospital on "black" status.

The Telegraph repeated the claim on Jan 1 saying;
'It came as some hospitals were on "black alert" yesterday as figures showed the number of children under five seriously ill with the disease has doubled in a week. Black alert is an NHS hospital?s most severe status level.'
http://www.telegraph.co.uk/health/h...-from-GP-surgeries-amid-vaccine-shortage.html

On the same day, the Express was reporting only one Black alert - at James Paget Hospital.
"One hospital was on ?black alert? yesterday as a surge in patients forced it to cancel operations and ask those with minor injuries to go elsewhere."
http://www.express.co.uk/posts/view...ntFlu-hospitals-at-crisis-point#ixzz19sm2Ned6

While the "many hospitals on Black alert" claim has gained legs on the internet, I have not been able to find much evidence to support it.

Ronan Kelly · Jan 2, 2011

Re: UK: Reports of Approximately 51 Deaths and 800+ Patients in intensive care (39 deaths confirmed by HPA as for Dec. 30 2010) due to influenza

Re: UK: Reports of Approximately 51 Deaths and 800+ Patients in intensive care (39 deaths confirmed by HPA as for Dec. 30 2010) due to influenza

Comment: 7 of 20 hospitalized cases in ICU.

Swine Flu hits hard on Fylde
Premium Article By Elizabeth Broughton
SEVEN people are fighting for their lives at Blackpool Victoria Hospital after being hit by swine flu.

Almost half of the hospital's 16 intensive care beds are currently taken up by the seriously ill patients battling the killer virus.

Hospital bosses said they are dealing with a total of 16 confirmed swine flu cases while four more patients are suspected to have the H1N1 strain. One new case has been admitted in the last 24 hours as swine flu and seasonal influenza continues to sweep the country

...

continues at; http://www.blackpoolgazette.co.uk/blackpoolnews/Swine-Flu-hits-hard-on.6677385.jp

sharon sanders · Jan 2, 2011

Re: UK: Reports of Approximately 51 Deaths and 800+ Patients in intensive care (39 deaths confirmed by HPA as for Dec. 30 2010) due to influenza

Re: UK: Reports of Approximately 51 Deaths and 800+ Patients in intensive care (39 deaths confirmed by HPA as for Dec. 30 2010) due to influenza

RoRo said:
James Paget hospital in Yarmouth, Norfolk was on black alert on Dec 30 as reported by several sources -
http://www.bbc.co.uk/news/uk-england-norfolk-12100135
http://www.telegraph.co.uk/health/s...ng-faster-in-Britain-than-rest-of-Europe.html

I think the origin of the "many" claim is this article in the Telegraph;
http://www.telegraph.co.uk/health/h...-almost-double-among-children-under-five.html

which states; "[On Dec 30]James Paget University Hospital in Great Yarmouth was among those forced to declare a "black alert" ? an NHS hospital's most severe status level. "
but I have been unable to find any other named hospital on "black" status.

The Telegraph repeated the claim on Jan 1 saying;
'It came as some hospitals were on "black alert" yesterday as figures showed the number of children under five seriously ill with the disease has doubled in a week. Black alert is an NHS hospital?s most severe status level.'
http://www.telegraph.co.uk/health/h...-from-GP-surgeries-amid-vaccine-shortage.html

On the same day, the Express was reporting only one Black alert - at James Paget Hospital.
"One hospital was on ?black alert? yesterday as a surge in patients forced it to cancel operations and ask those with minor injuries to go elsewhere."
http://www.express.co.uk/posts/view...ntFlu-hospitals-at-crisis-point#ixzz19sm2Ned6

While the "many hospitals on Black alert" claim has gained legs on the internet, I have not been able to find much evidence to support it.

Thanks RoRo. I wonder how long the majority of the hospitals can stay below the highest alert if they are canceling surgeries and implementing other emergency management protocols.

Vibrant62 · Jan 2, 2011

Re: UK: Reports of Approximately 51 Deaths and 800+ Patients in intensive care (39 deaths confirmed by HPA as for Dec. 30 2010) due to influenza

Re: UK: Reports of Approximately 51 Deaths and 800+ Patients in intensive care (39 deaths confirmed by HPA as for Dec. 30 2010) due to influenza

ICUs and critical care unit capcities are generally allotted on a simple calculation: the past numbers of individuals within the catchment area requiring critical care as a result of acute illness with an assessment of annual peak requirements (surge capcity), plus the numbers required as a norm as part of surgical after care.

Most hospitals have flexible capacities in that operating theatres and recovery rooms can be converted to ICU beds in times of higher than average peak demands; with six or more operating suites with only one theatre and recovery unit remaining operational for accidents/ emergencies in extreme circumstances, - and this is how UK plans allow for a doubling of ICU capacity.

A status of 'Black Alert' is only achieved when all theatre/ recovery capacity has been converted, at which time the hospital will have cancelled all elective surgery and admissions. In the most extreme of cirucmstances, A&E admissions will be diverted to other hospitals.

Many hospitals in the UK are at various stages of the scale on this - i.e way above normal and Red Alert status, but not yet at a stage where they can accept no more patients = black alert. There are many local reports that have indicated cancellation of non-urgent ops, and I expect that this is where the 'many' may have come from.

UK: 607 confirmed fatalities due to influenza

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