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UK. HPA - Weekly pandemic flu media update (August 20, 2009, edited)
UK. HPA - Weekly pandemic flu media update (August 20, 2009, edited)
Weekly pandemic flu media update 20 August 2009
KEY POINTS
Following the move from laboratory testing for confirmation of swine flu (H1N1v) to clinical diagnosis of cases, the level of flu in the community is being monitored using a range of surveillance mechanisms, including the RCGP consultation rates, QSurveillance?, and the National Pandemic Flu Service.
A more detailed UK weekly epidemiology update can be accessed at:https://www.hpa.org.uk/swineflu/surv...e&epidemiology
CLINICAL INDICATORS
Clinical data are obtained from GP surgeries that report the weekly and daily consultations for flu-like illness and other acute respiratory illness.
Current estimated weekly Royal College of General Practitioners (RCGP) consultation rates of flu-like illness
From a network of approximately 100 general practices covering a population of approximately 900,000 with an equal distribution within each of three defined reporting regions; North, Central and South.
In week 33 (ending 16 August) GP consultation rates for flu-like illness in England decreased compared to the previous week (30.9 per 100,000 to 21.1 per 100,000). The rate declined in all three RCGP regions (North 25 per 100,000, Central 29 per 100,000 and South 14 per 100,000) and in age groups.
Figure 1: Current estimated weekly RCGP consultation rates of flu-like illness
QSurveillance?
Set up by the University of Nottingham and EMIS (the main supplier of general practice computer systems within the UK) in collaboration with the Health Protection Agency. QSurveillance? is a not-for-profit network over 3,300 general practices covering a total population of almost 22 million patients (> 25% of the UK population).
The weekly QSurveillance? flu-like illness consultation rate decreased from 48.3 per 100,000 to 30.8 per 100,000 in week 33. The daily rate for flu-like illness for the last few days remained low for all regions.
NB: QSurveillance? is based on data from 43% of England's population (about 3000 practices), 10% of the population in Wales, 17% in Northern Ireland, and 0% in Scotland.
Figure 2: QSurveillance? - weekly consultation rate for flu-like illness in England, Wales and Northern Ireland (all ages
Figure 3: QSurveillance? - daily consultation rate for influenza-like illness by English SHA (all ages)
Figure 4: QSurveillance influenza-like illness rate by age band in week 33 (ending 16 August)
The latest rates were reduced in all age groups. This coincided with the introduction of the National Pandemic Flu Service and school closures. The highest flu-like illness consultation rates were in the <1 year group (who are not considered by the National Pandemic Flu Service and always referred to a GP) and 1-4 year age groups.
SYNDROMIC SURVEILLANCE
NHS Direct
On 23 July the National Pandemic Flu Service was implemented. This had an impact on the number of 'cold/flu' calls received through the routine NHS Direct service. For this reason, data from NHS Direct do not reflect the true pattern of cold/ flu callers and so are not currently an accurate surveillance tool.
VIRAL CHARACTERISTICS
Viral characteristics (including antiviral susceptibility (as at 19/08/09):
Testing for antiviral susceptibility is carried out by the Agency's Respiratory Virus Unit, Centre for Infections, in Colindale. 719 viruses have been analysed for the marker commonly associated with resistance to oseltamivir in seasonal influenza (H274Y); none were found to carry this marker. In addition, 186 specimens have been fully tested for susceptibility; all were found to be sensitive to oseltamivir and zanamivir.
SEVERITY
Disease severity continues to be monitored. The disease is generally mild in most people so far, but is proving severe in a small minority of cases.
Swine flu hospitalisations in England: 263 patients (currently hospitalised as of 8am on 19 August).
Deaths - the number of deaths related to swine flu in England is 54. (This figure represents the number of deaths in individuals with swine flu but does not represent the number of deaths that can be attributed to swine flu).
INTERNATIONAL SUMMARY
Confirmed cases and deaths reported by ECDC (Update 17:00 CEST 18 August 2009)
Grand total of cases confirmed (*) 237,129
Total deaths reported 2,144
(*) This figure represents the number of laboratory confirmed cases and is therefore not representative of the actual number of cases worldwide.
In the last 7 days, cases reported globally have increased by 10% and the number of deaths by 24%.
Americas
WHO reports an overall decline in the Americas. Where available, virological information shows pandemic (H1N1) 2009 is the predominant virus.
Latest information from Argentinean Ministry of health website (to 05/08):
Notified cases= 762,111 (from all parts of the country), represents an intensity of activity that is atypical for the time of year.
Cases confirmed by PCR: 5,710;
Hospitalised: 6,384 (mainly less than 5 years and between 15 and 24 years);
Deaths: 337 (47% with underlying illness).
Overall tendency is of decreasing case numbers in most parts of the country. Moderate impact on health services but they have the capacity to cope.
Latest information from Chilean Ministry of health website (to 12/08):
Cases compatible with case definition = 352,742 (from all parts of the country), represents an intensity of activity that is atypical for the time of year.
Cases confirmed by PCR: 12,104;
Hospitalised: 1,212 (median age 32, 46% with underlying morbidity).
Deaths: 112 (classified as influenza as primary cause 35, and as secondary cause 70) and median age: 49, 67% with underlying conditions. Overall tendency is of decreasing case numbers. Low impact on health services.
Australasia
Activity is widespread in the general community in Australia. Areas such as Victoria, Queensland and New South Wales which were affected earlier are showing a decline in the number of cases, while other areas are still seeing an increasing number. The pandemic strain is the most common circulating influenza virus. Extensive pressure has been placed on intensive care units: plans had allowed for 10% of hospitalizations to be admitted to intensive care, but the actual figure is about 30%.
The number of people presenting to GPs with influenza like illness continues to fall in New Zealand, and along with fewer hospital admissions and reduced demand for intensive care beds indicates the pandemic is on a downward trend
Africa
In South Africa, all provinces are now affected, with community spread in Gauteng and Western Cape provinces.
Asia
India has seen a significant number of cases associated with local outbreaks in Pune, Mumbai, Bangalore, Delhi, Hyderabad city and Ahmadabad. Public reaction is strongly concerned.
Local transmission is occurring in Guangdong, Fuijian and Sichuan provinces in China, with widespread transmission in the general community in Hong Kong and Taiwan.
Thailand has community level spread in most provinces.
Europe
In the latest Euroflu bulletin, all countries reported low or moderate intensity indicating a normal or slightly increased proportion of their populations were affected by respiratory illness. Widespread activity was reported for Austria, Israel, the Netherlands, England and Wales http://www.euroflu.org/index.php. The majority of new confirmed cases are being reported from Germany (ECDC).
ENDS
Notes to editors
General infection control practices and good respiratory hand hygiene can help to reduce transmission of all viruses, including swine flu. This includes:
Further information on swine flu is available on the Health Protection Agency's website at www.hpa.org.uk/swineflu.
For media enquiries only please contact the Health Protection Agency's Centre for Infections press office on
020 8327 7080
020 8327 7097
020 8327 7098
020 8327 6690
020 8327 6647
Last reviewed: 20 August 2009
-
<cite cite="http://www.hpa.org.uk/servlet/Satellite?c=HPAweb_C&childpagename=HPAweb%2FHPAweb Standard&cid=1250755468708&p=1231252394302&pagenam e=HPAwebWrapper">HPA - Weekly pandemic flu media update</cite>
KEY POINTS
- This week there has been a further reduction in the rates of flu-like illness and related activity.
- Weekly GP consultation rates continued to decrease over the last week in England.
- The majority of cases continue to be mild. There is no sign that the virus is changing. It is not becoming more severe or developing resistance to anti-virals.
- Interpretation of data to produce estimates on the number of new cases continues to be subject to a considerable amount of uncertainty. HPA modelling gives an estimate of 11,000 new cases in England last week (range 6,000 to 25,000). There has been a decrease in estimated number of cases in all age groups and in all regions. This estimate incorporates data from National Pandemic Flu Service and GP consultations.
Following the move from laboratory testing for confirmation of swine flu (H1N1v) to clinical diagnosis of cases, the level of flu in the community is being monitored using a range of surveillance mechanisms, including the RCGP consultation rates, QSurveillance?, and the National Pandemic Flu Service.
A more detailed UK weekly epidemiology update can be accessed at:https://www.hpa.org.uk/swineflu/surv...e&epidemiology
CLINICAL INDICATORS
Clinical data are obtained from GP surgeries that report the weekly and daily consultations for flu-like illness and other acute respiratory illness.
Current estimated weekly Royal College of General Practitioners (RCGP) consultation rates of flu-like illness
From a network of approximately 100 general practices covering a population of approximately 900,000 with an equal distribution within each of three defined reporting regions; North, Central and South.
In week 33 (ending 16 August) GP consultation rates for flu-like illness in England decreased compared to the previous week (30.9 per 100,000 to 21.1 per 100,000). The rate declined in all three RCGP regions (North 25 per 100,000, Central 29 per 100,000 and South 14 per 100,000) and in age groups.
Figure 1: Current estimated weekly RCGP consultation rates of flu-like illness
QSurveillance?
Set up by the University of Nottingham and EMIS (the main supplier of general practice computer systems within the UK) in collaboration with the Health Protection Agency. QSurveillance? is a not-for-profit network over 3,300 general practices covering a total population of almost 22 million patients (> 25% of the UK population).
The weekly QSurveillance? flu-like illness consultation rate decreased from 48.3 per 100,000 to 30.8 per 100,000 in week 33. The daily rate for flu-like illness for the last few days remained low for all regions.
NB: QSurveillance? is based on data from 43% of England's population (about 3000 practices), 10% of the population in Wales, 17% in Northern Ireland, and 0% in Scotland.
Figure 2: QSurveillance? - weekly consultation rate for flu-like illness in England, Wales and Northern Ireland (all ages
Figure 3: QSurveillance? - daily consultation rate for influenza-like illness by English SHA (all ages)
Figure 4: QSurveillance influenza-like illness rate by age band in week 33 (ending 16 August)
The latest rates were reduced in all age groups. This coincided with the introduction of the National Pandemic Flu Service and school closures. The highest flu-like illness consultation rates were in the <1 year group (who are not considered by the National Pandemic Flu Service and always referred to a GP) and 1-4 year age groups.
SYNDROMIC SURVEILLANCE
NHS Direct
On 23 July the National Pandemic Flu Service was implemented. This had an impact on the number of 'cold/flu' calls received through the routine NHS Direct service. For this reason, data from NHS Direct do not reflect the true pattern of cold/ flu callers and so are not currently an accurate surveillance tool.
VIRAL CHARACTERISTICS
Viral characteristics (including antiviral susceptibility (as at 19/08/09):
Testing for antiviral susceptibility is carried out by the Agency's Respiratory Virus Unit, Centre for Infections, in Colindale. 719 viruses have been analysed for the marker commonly associated with resistance to oseltamivir in seasonal influenza (H274Y); none were found to carry this marker. In addition, 186 specimens have been fully tested for susceptibility; all were found to be sensitive to oseltamivir and zanamivir.
SEVERITY
Disease severity continues to be monitored. The disease is generally mild in most people so far, but is proving severe in a small minority of cases.
Swine flu hospitalisations in England: 263 patients (currently hospitalised as of 8am on 19 August).
Deaths - the number of deaths related to swine flu in England is 54. (This figure represents the number of deaths in individuals with swine flu but does not represent the number of deaths that can be attributed to swine flu).
INTERNATIONAL SUMMARY
Confirmed cases and deaths reported by ECDC (Update 17:00 CEST 18 August 2009)
Grand total of cases confirmed (*) 237,129
Total deaths reported 2,144
(*) This figure represents the number of laboratory confirmed cases and is therefore not representative of the actual number of cases worldwide.
In the last 7 days, cases reported globally have increased by 10% and the number of deaths by 24%.
Americas
WHO reports an overall decline in the Americas. Where available, virological information shows pandemic (H1N1) 2009 is the predominant virus.
Latest information from Argentinean Ministry of health website (to 05/08):
Notified cases= 762,111 (from all parts of the country), represents an intensity of activity that is atypical for the time of year.
Cases confirmed by PCR: 5,710;
Hospitalised: 6,384 (mainly less than 5 years and between 15 and 24 years);
Deaths: 337 (47% with underlying illness).
Overall tendency is of decreasing case numbers in most parts of the country. Moderate impact on health services but they have the capacity to cope.
Latest information from Chilean Ministry of health website (to 12/08):
Cases compatible with case definition = 352,742 (from all parts of the country), represents an intensity of activity that is atypical for the time of year.
Cases confirmed by PCR: 12,104;
Hospitalised: 1,212 (median age 32, 46% with underlying morbidity).
Deaths: 112 (classified as influenza as primary cause 35, and as secondary cause 70) and median age: 49, 67% with underlying conditions. Overall tendency is of decreasing case numbers. Low impact on health services.
Australasia
Activity is widespread in the general community in Australia. Areas such as Victoria, Queensland and New South Wales which were affected earlier are showing a decline in the number of cases, while other areas are still seeing an increasing number. The pandemic strain is the most common circulating influenza virus. Extensive pressure has been placed on intensive care units: plans had allowed for 10% of hospitalizations to be admitted to intensive care, but the actual figure is about 30%.
The number of people presenting to GPs with influenza like illness continues to fall in New Zealand, and along with fewer hospital admissions and reduced demand for intensive care beds indicates the pandemic is on a downward trend
Africa
In South Africa, all provinces are now affected, with community spread in Gauteng and Western Cape provinces.
Asia
India has seen a significant number of cases associated with local outbreaks in Pune, Mumbai, Bangalore, Delhi, Hyderabad city and Ahmadabad. Public reaction is strongly concerned.
Local transmission is occurring in Guangdong, Fuijian and Sichuan provinces in China, with widespread transmission in the general community in Hong Kong and Taiwan.
Thailand has community level spread in most provinces.
Europe
In the latest Euroflu bulletin, all countries reported low or moderate intensity indicating a normal or slightly increased proportion of their populations were affected by respiratory illness. Widespread activity was reported for Austria, Israel, the Netherlands, England and Wales http://www.euroflu.org/index.php. The majority of new confirmed cases are being reported from Germany (ECDC).
ENDS
Notes to editors
General infection control practices and good respiratory hand hygiene can help to reduce transmission of all viruses, including swine flu. This includes:
- Maintaining good basic hygiene, for example washing hands frequently with soap and water to reduce the spread of virus from your hands to face or to other people.
- Cleaning hard surfaces (e.g. door handles) frequently using a normal cleaning product.
- Covering your nose and mouth when coughing or sneezing, using a tissue when possible.
- Disposing of dirty tissues promptly and carefully.
- Making sure your children follow this advice.
Further information on swine flu is available on the Health Protection Agency's website at www.hpa.org.uk/swineflu.
For media enquiries only please contact the Health Protection Agency's Centre for Infections press office on
020 8327 7080
020 8327 7097
020 8327 7098
020 8327 6690
020 8327 6647
Last reviewed: 20 August 2009
-