Giuseppe
Emeritus
UK. HPA - Weekly pandemic flu media update (August 13, 2009, edited)
Weekly pandemic flu media update 13 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: www.hpa.org.uk/swineflu/surveillance&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 32 (ending 09 August) GP consultation rates for flu-like illness in England decreased compared to the previous week (42 per 100,000 to 30.9 per 100,000). The rate declined in all three RCGP regions (North 33 per 100,000, Central 38 per 100,000 and South 24 per 100,000) and 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 72.2 per 100,000 to 48.3 per 100,000 in week 32. 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 32 (ending 09 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 DirectOn 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 so these data do not reflect the true pattern of cold/ flu callers.
Figure 5: Daily NHS Direct/HPA Syndromic Surveillance System estimated total cold/flu calls 2009 compared to routine daily NHS Direct 'cold/flu' calls 2008-2009 shown as a percentage of all NHS Direct calls
VIRAL CHARACTERISTICS
Viral characteristics (including antiviral susceptibility (as at 12/08/09):
Testing for antiviral susceptibility is carried out by the Agency's Respiratory Virus Unit, Centre for Infections, in Colindale. 658 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, 132 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: 371patients (currently hospitalised as of 8am on 12 August)
Deaths - the number of deaths related to swine flu in England is 44.
(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
Total of Confirmed Cases reported by European Centre for Disease Prevention and Control (ECDC) (Update 17:00 CEST 11 August 2009)
In the last seven days, cases reported globally have increased by 11% and the number of deaths by 27%.
Americas
As well as a decline in USA, Canada, Mexico a downturn is occurring in several South American countries previously reporting high levels of activity (especially Chile and Argentina).
Australasia
Most of Australia is seeing increasing case numbers with a mixture of seasonal and pandemic influenza. Preliminary reports suggest New Zealand case numbers are starting to fall.
Africa
In South Africa initial influenza activity has been seasonal H3N2, but now pandemic H1N1 is increasing as proportion of isolates.
Asia
Significant increasing activity is currently being reported from China and Thailand.
Europe
Germany has the second highest number of cases in Europe (highest UK) occurring mostly in school outbreaks. Norway is reporting wide spread influenza activity. Some other countries are reporting mainly imported cases.
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: 13 August 2009
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<cite cite="http://www.hpa.org.uk/webw/HPAweb&HPAwebStandard/HPAweb_C/1250148894409?p=1231252394302">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 decreased 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 with the move from GP consultations to the National Pandemic Flu Service. HPA modelling gives an estimate of 25,000 new cases in England last week (range 15,000 to 60,000). 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: www.hpa.org.uk/swineflu/surveillance&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 32 (ending 09 August) GP consultation rates for flu-like illness in England decreased compared to the previous week (42 per 100,000 to 30.9 per 100,000). The rate declined in all three RCGP regions (North 33 per 100,000, Central 38 per 100,000 and South 24 per 100,000) and 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 72.2 per 100,000 to 48.3 per 100,000 in week 32. 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 32 (ending 09 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 DirectOn 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 so these data do not reflect the true pattern of cold/ flu callers.
Figure 5: Daily NHS Direct/HPA Syndromic Surveillance System estimated total cold/flu calls 2009 compared to routine daily NHS Direct 'cold/flu' calls 2008-2009 shown as a percentage of all NHS Direct calls
VIRAL CHARACTERISTICS
Viral characteristics (including antiviral susceptibility (as at 12/08/09):
Testing for antiviral susceptibility is carried out by the Agency's Respiratory Virus Unit, Centre for Infections, in Colindale. 658 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, 132 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: 371patients (currently hospitalised as of 8am on 12 August)
Deaths - the number of deaths related to swine flu in England is 44.
(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
Total of Confirmed Cases reported by European Centre for Disease Prevention and Control (ECDC) (Update 17:00 CEST 11 August 2009)
- Grand total of cases confirmed 215,090
- Total of deaths reported 1,735
In the last seven days, cases reported globally have increased by 11% and the number of deaths by 27%.
Americas
As well as a decline in USA, Canada, Mexico a downturn is occurring in several South American countries previously reporting high levels of activity (especially Chile and Argentina).
Australasia
Most of Australia is seeing increasing case numbers with a mixture of seasonal and pandemic influenza. Preliminary reports suggest New Zealand case numbers are starting to fall.
Africa
In South Africa initial influenza activity has been seasonal H3N2, but now pandemic H1N1 is increasing as proportion of isolates.
Asia
Significant increasing activity is currently being reported from China and Thailand.
Europe
Germany has the second highest number of cases in Europe (highest UK) occurring mostly in school outbreaks. Norway is reporting wide spread influenza activity. Some other countries are reporting mainly imported cases.
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: 13 August 2009
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