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Thursday, 30 July 2009

Swine Flu, pregnancy and young children

The Department of Health are clarifying their guidelines on how pregnant mothers and parents with children under five can deal with the outbreak of Swine Flu. This is because expectant mothers and young children have proven to be particularly vulnerable to the disease. So far the government advice is:

For pregnant mums:
The Royal College of Midwives have issued a statement that expectant mothers should 'avoid crowded places and unnecessary travel'. Obviously for some pregnant mums this will be unavoidable, but if you can't avoid crowded places you should always follow good hygiene rules such as washing your hands and using an antiseptic gel after using public transport. Using tissues to cover the mouth and nose when coughing and sneezing and disposing of tissues promptly has also been suggested.

The reason pregnant women are at risk, is because when you are pregnant your immune system is lowered slightly so that your body doesn't reject your growing baby. For this reason pregnant women are more susceptible to any type of flu and therefore swine flu. At present the Government are under pressure to reveal whether pregnant women will be vaccinated against swine flu when the flu vaccine batch is expected in the autumn. This is because pregnant women are normally advised NOT to have vaccinations.

In short, if you are pregnant and can avoid being in crowded places and public transport - do so. If you are pregnant and have the any of the Swine Flu symptoms:

- sudden fever (a high body temperature of over 38C or 100.4F), and
- sudden cough

Other symptoms include:

- headache
- tiredness
- chills
- aching muscles
- limb or joint pain
- diarrhoea or stomach upset
- sore throat
- runny nose
- sneezing, and
- loss of appetite

Can pregnant women take antivirals?
Anti virals are safe for pregnant women to take but you should always talk to your GP first before taking them. The Department of health has purchased Relenza, an inhaled antiviral drug that can treat swine flu without reaching your developing baby. Relenza should not affect your pregnancy or growing baby. Don't forget that talking Paracetamol when pregnant is safe and can also be used to counter the effects of any type of flu symptoms.

Most people who have contracted Swine Flu recover within a week and do not suffer complications, even without being given antiviral medicine. If you are pregnant and worried about Swine Flu or have any of the symptoms listed above, call NHS direct on 0845 4647

For young children:
Call your GP immediately if your child has any of the following symptoms AND a temperature of 38C and above or feels hot.

- tiredness
- headache
- runny nose and sneezing
- sore throat
- shortness of breath
- loss of appetite
- vomiting and diarrhoea
aching muscles, limb and joint pain

If you are worried about your child or your child has any of the symptoms above, call your GP for more advice. You can also get more information by calling the Swine Flu Information Line on 0800 1 513 513.

If your child has Swine Flu:
If your GP confirms your child has Swine Flu (normally by a telephone assesment where you will be asked to describe your child's symptoms), they should stay at home and you should treat their symptoms like any other cold or flu. So, plenty of liquids, plenty of rest and medicine to bring their fever down. Your GP will advise you on whether your child needs an antiviral drug such as Tamiflu. However, antiviral drugs are only effective if taken within 48 hours of symptoms appearing so if you are worried about your child, call your GP immediately.

Are antivirals safe for children to take?
Antivirals are safe for infants aged one and over at a reduced dose, but again it is always best to talk to your GP first to explain your child's symptoms and to tell your GP the age of your child. Relenza (an inhaler) can be used by children aged five and over under the supervision of an adult. Tamiflu and Relenza are not licensed for use in babies under the age of one, although under medical supervision (i.e probably in a hospital) they may be used.

How do I get antiviral drugs for my child?
Your GP will give you an authorization code which one of your flu friends ( a friend or relative who does not have any symptoms or swine flu) takes to the antiviral collection point in your area - your GP can tell you where these are.


What is Swine Flu?
Swine flu is a respiratory disease which has some elements of a virus often found in pigs. At present time, swine flu has been confirmed in a number of countries (mostly Mexico and the US) and is spreading from human to human. This quick spreading of a virus is referred to as a pandemic flu outbreak. Because it is a virus, no one has immunity to it, which means it can affect the old, the young, healthy adults and those who are sick already.

How does swine flu spread?
Like normal flu that we are used to, swine flu spreads when you cough or sneeze without covering your mouth or nose, releasing tiny droplets into the air. They are then inhaled by other people or can be spread on everyday items such as computer keyboards, door handles and surfaces that the droplets may have settles on.

Is there protection against swine flu?
The government have been stockpiling antiviral drugs (including Tamiflu and Relenza) so there is enough to treat 33 million people (roughly half of the population). They are planning to increase this. At present there is no vaccination against swine flu, as it can only be developed when a specific strain has been identified. After this it will take a few months to produce a suitable vaccine.

Here are answers to questions that I asked the Department of Health earlier today:

Are antivirals safe to use on children?
All medicines that are licensed have to go through checks on their safety, quality and efficacy before they are licensed. Licensed doses of Tamiflu are available for all children over one in lower dose capsules. The size of the capsules depends on the age of the child. As licensed medicines there is good evidence about their safety and efficacy.

Relenza is only licensed for treatment of influenza of children over five years old except in very limited circumstances.

Will we be issuing antivirals prophylactically to children?
No, our aim is just to provide treatment for flu cases. We are not considering prophylaxis in adults or children.

Are antivirals safe for babies?
Tamiflu is not licensed for under one's. However, we have evidence from clinical trials in Japan that it is safe for children under one to take in small doses. We have plans to manufacture Tamiflu solution in designated hospital pharmacies from stocks which we have stockpiled. This process is now underway. The royal college of Paediatrics and Child Health has developed a consensus statement which supports the use of oseltamivir in babies under one.



Is one of the antivirals more appropriate for pregnant women and people with certain kidney conditions?
Relenza is an inhaled drug that will be used for pregnant women and people with certain kidney conditions who are unable to take Tamiflu.




Is it safe to eat pig meat?


Yes. The WHO says there is no evidence that swine flu can be transmitted through eating meat from infected animals. However, it is essential to cook meat properly. A temperature of 70°C (158°F) would be sure to kill the virus. Pig meat includes pork, bacon, ham and pork products.


So, what can you do to protect yourself and your family from swine flu?

Always carry tissues on you to use if you sneeze or cough (or if your kids sneeze or cough)
Always try to cover your mouth and nose when you sneeze or cough
Throw the tissue away after you have used it on yourself or your kids
Wash your hands often with soap and hot water and encourage your children to do the same

Do I need a facemask?
Apparently, there is no scientific evidence to say basic face masks can protect you from swine flu - it's better to follow the steps above in order to help prevent the spread of disease.

What are the symptoms of swine flu?
Symptoms of swine flu include:

a sudden onset of fever
a cough

shortness of breath

headache and sore throat

tiredness
aching muscles

chills
sneezing
runny nose
loss of appetite

If you are worried about swine flu or need information about it, call the government's Swine Flu Information Line on: 0800 1 513 513

If you are suffering from any of the symptoms above, the advice is NOT to go to your GP surgery or A&E department, but phone your surgery and describe your symptoms or phone NHS Direct: 0845 46 47

If you have recently returned from Mexico or the US and are experiencing any of the symptoms mentioned above, call the Swine Flu Information Line on: 0800 1 513 513

The information in this feature is intended for educational purposes only. If you have any concerns about your health, the health of your child or the health of someone you know, please consult with a doctor or other healthcare professional.

Thanks to NHS direct

www.medisave.co.uk

The number of new cases of swine flu in England

The number of new cases of swine flu in England appears to be levelling off, with an estimated 110,000 new cases reported last week. This compares to an estimated 100,000 cases the week before.

Sir Liam Donaldson, the Chief Medical Officer, noted that the change coincided with the break up of schools for the summer and the introduction of the National Pandemic Flu Service last week.

H1N1 Flu (Swine Flu)
CDC Advisors Make Recommendations for Use of Vaccine Against Novel H1N1 (07/29/2009, Centers for Disease Control and Prevention)
Prioritize Pregnant Women to Get Swine Flu Shot, Experts Say (07/29/2009, HealthDay)
Save Swine Flu Drugs for Younger Patients (07/28/2009, HealthDay)
Drugs Work Best When Swine Flu Found Early (07/27/2009, Reuters Health)
FDA Authorizes Emergency Use of Another Test for 2009 H1N1 Influenza Virus (07/24/2009, Food and Drug Administration)
First Defense Against Swine Flu - Seasonal Vaccine (07/24/2009, Reuters Health)
Swine Flu Could Eventually Affect 40% of Americans (07/24/2009, HealthDay)
Swine Flu Spreads; Health Officials Plan Vaccines (07/24/2009, Reuters Health)
U.S. Expects 160 Million Doses Of Swine Flu Vaccine By October (07/23/2009, HealthDay)
Guard Against Swine Flu at Summer Camp (07/18/2009, HealthDay)
CDC Fears More Swine Flu Cases in Fall (07/17/2009, Reuters Health)
Swine Flu Vaccine on Track for Fall (07/17/2009, HealthDay)
H1N1 Pandemic Spreading Too Fast to Count (07/16/2009, Reuters Health)
Swine Flu Vaccine Taking Longer Than Expected (07/13/2009, HealthDay)
Obesity Emerges as Risk Factor in Severe Flu (07/11/2009, Reuters Health)
Swine Flu Summit Focuses on Preparedness (07/09/2009, HealthDay)
Experts Keep Wary Eye on Tamiflu-Resistant Swine Flu (07/08/2009, HealthDay)
U.S. Health Department Response to H1N1 Mixed (07/07/2009, Reuters Health)
U.S. Parents Think Twice About Sending Kids to Camp (07/03/2009, Reuters Health)
New Flu May Not Spread Like Regular Flu (07/02/2009, Reuters Health)
WHO Chief Identifies "Warning Signs" of Severe Flu (07/02/2009, Reuters Health)
WHO Says Tamiflu-Resistant H1N1 "Isolated Case" (06/30/2009, Reuters Health)
Air Traffic Patterns Predict Swine Flu Spread (06/29/2009, HealthDay)
Younger People Appear More at Risk from New Swine Flu (06/29/2009, HealthDay)
New H1N1 Flu Not Going Away (06/26/2009, Reuters Health)
1 Million Americans Likely Stricken by Swine Flu (06/25/2009, HealthDay)
CDC Sees "Something Different" with New Flu (06/19/2009, Reuters Health)
Swine Flu Continues to Flare Up, CDC Says (06/19/2009, HealthDay)
New Swine Flu Strain Found in Brazil (06/17/2009, HealthDay)
First Batch of Swine Flu Vaccine Already Here (06/12/2009, HealthDay)
Swine Flu Now a Pandemic (06/11/2009, HealthDay)
WHO Declaration Of Swine Flu Pandemic Looks Imminent (06/10/2009, HealthDay)
Global Testing Shows No Variation in Swine Flu Virus (06/04/2009, HealthDay)
WHO Close to Declaring Swine Flu Pandemic (06/03/2009, HealthDay)
WHO Official Says World Edging Towards Pandemic (06/02/2009, Reuters Health)
Swine Flu Now Reported in All 50 States (06/01/2009, HealthDay)
FDA, FTC Warn Public of Fraudulent 2009 H1N1 Influenza Products (05/30/2009, Food and Drug Administration)
Swine Flu Vaccine Won't Be Ready Until October: CDC (05/29/2009, HealthDay)
Swine Flu Vaccine Won't Be Ready Until October (05/28/2009, HealthDay)
U.S. Considering Emergency Use of Booster in H1N1 Vaccine (05/28/2009, Reuters Health)
Possible Return of Swine Flu in Fall Has U.S. Health Officials on Alert (05/27/2009, HealthDay)
U.S. Prepares for Possible Return of Swine Flu in Fall (05/26/2009, HealthDay)
Viable Swine Flu Shot Closer to Reality (05/25/2009, HealthDay)
WHO Chief Says World Should Prepare for Severe Flu (05/24/2009, Reuters Health)
Regular Flu Vaccine Little Help against New Strain (05/21/2009, Reuters Health)
Swine Flu Outbreak May Be Subsiding, CDC Says (05/21/2009, HealthDay)
Older Adults May Have Some Immunity to Swine Flu (05/20/2009, HealthDay)
U.S. Officials Consider Bumping Up Flu Shot Season (05/20/2009, Reuters Health)
Could H1N1 Start to Resist Drugs? (05/19/2009, Reuters Health)
Sicker People More Vulnerable to Swine Flu (05/19/2009, HealthDay)
Adequate Supply of Swine Flu Vaccine Uncertain (05/18/2009, HealthDay)
New Methods Could Speed Production of Flu Vaccines (05/18/2009, HealthDay)
Swine Flu Fatality Rate a 'Little Bit' Higher Than That of Seasonal Flu (05/18/2009, HealthDay)
Swine Flu May Have Infected More Than 100,000 Americans (05/17/2009, HealthDay)
Focus On Children Best Way to Stop Flu Bugs (05/14/2009, Reuters Health)
Fewer Than a Third in U.S. Would Get Swine Flu Jab (05/13/2009, Reuters Health)
Pregnant Women Should Take Flu Drugs Promptly (05/13/2009, HealthDay)
Study Supports Swine Flu's Pandemic Potential (05/12/2009, HealthDay)
Swine Flu May Pose Problems for Pregnant Women (05/12/2009, HealthDay)
CDC Shifts Swine Flu Focus to Likely Impact in the Fall (05/11/2009, HealthDay)
Third U.S. Swine Flu Death Reported (05/10/2009, HealthDay)
Scientists Still Baffled About Origins of Swine Flu (05/08/2009, HealthDay)
Flu Spreads in U.S., World, Winds Down in Mexico (05/07/2009, Reuters Health)
U.S. Swine Flu Count Nears 1,900; Person-to-Person Transmission Now Common (05/07/2009, HealthDay)
FDA Approves New Influenza Vaccine Production Facility (05/06/2009, Food and Drug Administration)
Swine Flu Likely to Return to U.S. Next Winter (05/06/2009, HealthDay)
Younger Age of More Severe Swine Flu Cases Worries Experts (05/06/2009, HealthDay)
Swine Flu Kills Second Person in U.S. (05/05/2009, Reuters Health)
1976 Swine Flu Outbreak Offers Echoes, Lessons Today (05/04/2009, HealthDay)
Swine Flu Cases Still Up, but U.S. Officials Are Guardedly Optimistic (05/04/2009, HealthDay)
Swine Flu Outbreak Not a Pandemic at This Point (05/03/2009, HealthDay)
Swine Flu: A Primer (05/03/2009, HealthDay www.medisave.co.uk

WHAT IS SWINE FLU Fever

Swine flu was declared a global pandemic by the World Health Organisation on June 11, 2009. The initial outbreak of the new strain of the swine flu, or H1N1, virus was in Mexico before spreading to the rest of the world. On July 21, the WHO reported the global death toll had reached more than 700; the agency has now stopped counting laboratory-confirmed cases as it is a waste of resources.

In Britain, Prof Nigel Dimmock, a virologist at Warwick University, has claimed that half the UK population could come down with swine flu this year. His worst case scenario is that 150,000 people could die in Britain.

WHAT IS SWINE FLU?
It is a flu virus that affects pigs, often hitting farms in autumn and winter. It rarely spreads to humans. But when it does, the outbreak begins with someone being in contact with an infected pig.

Flu viruses have the ability to mutate quickly, and pigs provide an excellent host for this. The new version has developed the ability to spread among humans, who then infect each other through coughing and sneezing. It cannot be spread by eating pork or pork products.

This outbreak has been caused by a version of the H1N1 strain of influenza type A. It is the same strain as causes flu outbreaks in humans, however the new version contains genetic material from strains of the virus that affect humans, birds and swine.

Fresh research from the University of Winsconsin suggests the new strain is related to the 'Spanish flu' virus of 1918 that killed millions. The study suggests it penetrates deeper into the respiratory tissues - making it more likely to cause pneumonia. Blood tests show that people who lived through the 1918 flu pandemic are immune to swine flu, but not to the seasonal flu that hits every year.

On the plus side, the H1N1 strain is far less dangerous than H5N1, or bird flu, and despite the similiarities it is not (yet) as severe as the 1918 version.

WHAT ARE THE SYMPTOMS?
The symptoms are the same as with normal seasonal flu: fever (a body temperature of over 38C or 100.4F), coughing, sore throat, aching muscles, limb or joint pain, runny nose, lack of appetite and nausea. Some patients have also reported diarrhoea and vomiting.

Several of those diagnosed with swine flu after trips to Mexico mistook the first signs as the effects of jetlag. Those who have died suffered from pneumonia and respiratory failure.

WHO IS CATCHING IT?
The illness has spread rapidly, with 'hotspots' developing in urban areas. In Britain, these are London, Glasgow and the West Midlands. In July the Government warned that cases could reach 100,000 a day in August.

Early fears that it was most lethal to people aged 25 to 45 have subsided. In the UK symptoms exhibited by victims have not been severe. People with long term health conditions are deemed most at risk by the NHS and so far there have been very few deaths among who did not have underlying health issues.

IS THERE A VACCINE?
Large quantities will be manufactured after human trials which began in Australia on July 20. The first batch of vaccine is not expected in Britain until August or September. Despite a claim by the Government that it could be 'fast-tracked', the WHO announced that trials taking several weeks would be necessary.

However, it is not plain sailing. Scientists have told the WHO that the 'seed strains' grown to produce the vaccine are giving poor yields of antigen. The yield is a quarter to a half of that vaccine makers typically get for seasonal flu vaccine production.

The good news is that Tamiflu and other antiviral drugs are also effective against swine flu viruses, although they may not work against new strains if they emerge.

HOW IS BRITAIN DEALING WITH THE OUTBREAK?
When the new vaccine arrives there are plans to vaccinate the entire population, with high risk groups and medical workers first on the list.

Because of the recent bird flu scare, Britain also has a stockpile of the antiviral drugs Tamiflu and Relenza, enough to treat half the population. These drugs do not completely cure swine flu, but they can reduce its severity and help limit its spread.

New cases are now being diagnosed by phone and sufferers being asked to quarantine themselves for up to two weeks.

On July 23, the Government is due to launch the National Pandemic Flu Service which will allow people to self-diagnose online or by phone and order Tamiflu without visiting doctors' surgeries.

SHOULD WE BE WEARING FACEMASKS?
It is unnecessary. The Department of Health advises that "available scientific evidence does not support the general wearing of facemasks by those who are not ill whilst going about their normal activities". However, the Department is making efforts to increase its stock of facemasks for use by hospital staff in the event of a pandemic being declared.
www.medisave.co.uk

Swine flu is spreading unexpectedly fast in Germany

Swine flu is spreading unexpectedly fast in Germany, doubling in less than a week, according to the country's infectious disease center. Most new cases have resulted from people returning from vacation.
More cases of H1N1 swine flu are to be expected in Germany, according to the Robert Koch Institute (RKI), Germany's center for infectious diseases.



There were 2,455 confirmed cases of swine flu in Germany on Wednesday, 637 more were reported on Tuesday. The current number of infections represents an increase of nearly 30 percent in two days. On July 15, there were just 834 cases, officials from the institute told reporters on Thursday.



"We see it this way: the increase is worrisome for us, but not a reason to panic," RKI head Joerg Hacker told the dpa news agency.



Most of the cases in Germany were mild but "serious cases could arise, as they have in other countries," RKI Vice President Reinhard Burger told German public broadcaster SWR.



The increase in infections is largely due to people returning from vacation with the virus, Hacker said, adding that about 20 percent of Germans diagnosed with the virus caught it in Germany.



"The general rule applies that when a lot of people gather in a small area there's a chance of infection," Hacker added.



Burger called on people to follow simple personal hygiene procedures, including washing their hands often with soap and warm water, to slow the virus' spread.



"The virus can be spread through contact, so measures like regular hand washing and, particularly, avoiding touching the eyes, nose and mouth, are very important," he said.



Pharmaceutical sales up



Bildunterschrift: Großansicht des Bildes mit der Bildunterschrift: Simple hygienic practices might help slow the virus' spread
Anticipating that the virus will continue to spread around the globe, the Swiss pharmaceutical giant Roche said Thursday it would sell another 658 million euros worth of anti-flu drug Tamiflu by the end of 2009, having already sold a similar amount this year.



"Additional government stockpiling orders and increased demand in the retail pharmacy market contributed to the particularly strong sales recorded in the second quarter," the company said in a statement.



The group expected to sell "around 1 billion (Swiss) francs" more of the drug, one of two recommended by the World Health Organization to treat swine flu, Roche chief executive Severin Schwan told journalists.



GlaxoSmithKline said sales of Relenza, the other drug approved for use in swine flu cases, had also increased.



"GSK now expects to increase its annual production capacity of Relenza to 190 million treatment courses by the end of 2009. This represents a threefold increase to GSK's previous maximum capacity of 60 million treatment courses," the company said in a statement.





sms/AFP/dpa/Reuters

www.medisave.co.uk
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