Weekly pandemic flu media update
8 October 2009
KEY POINTS
- The flu-like illness rate in England from the Royal College of General Practitioners (RCGP) scheme increased to 26.3 per 100,000 in week 40. An increase was seen in most age groups.
- The main burden of flu-like illness nationally is in the 5-14 and 15-24 years age groups.
- This week, the antiviral collection numbers in the National Pandemic Flu Service have continued to increase and this has been seen in all age groups. From week 37 to week 38 there was a 24% increase, 39% between week 38 to 39 and 12% from week 39 to 40. The antivirals were most collected by the 25-44 year olds but the largest increase was in the 15-24 year olds. (7,935 in week 39 to 9,675 in week 40).
- 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 18,000 new cases in England last week (range 9,000 to 38,000) compared with 14,000 in week 39.
This estimate incorporates data from National Pandemic Flu Service and GP consultations. - Globally, activity is generally increasing in the northern hemisphere, is variable in the tropical regions and has largely returned to baseline in the southern hemisphere.
Following the move from laboratory testing for confirmation of swine flu 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 40 (ending 4 October) GP consultation rates for flu-like illness in England increased compared to the previous week (22.2 per 100,000 in week 39 to 26.3 per 100,000 in week 40).
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 increased from 25.0 per 100,000 in week 39 to 29.6 per 100,000 in week 40. The daily rate for flu-like illness have showed an increased level of flu-like illness activity. The daily rates in all age groups in the last week showed a small rise though the rates in the 65-74 and over 75s have remained low.
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 40 (ending 4 October)
The latest weekly flu-like illness rates show that the highest flu-like illness consultation rates were in the 5-14 and 15-24 year-old age groups. Compared with week 39 this week (week 40) rates have increased in all age groups, particularly in the 1-4 (29.2 to 36.1) and 15-24 year-olds (33.1 to 39.8 per 100,000).
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
To date (as of 7 October 2009) 1,359 viruses have been analysed by the Centre for Infections for the genetic marker commonly associated with resistance to oseltamivir in seasonal H1N1 flu (H274Y). Two viruses have been found to carry this marker in the UK. In addition, 285 specimens have been fully tested for susceptibility.
The Agency is continually assessing its advice to government on health protection policies such as antiviral use. Currently there is no requirement to change existing guidance.
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: 290 patients (currently hospitalised as of 8am on 07 October). These figures show little change from the previous week.
Deaths - the number of deaths related to swine flu in England is 76 (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 global deaths reported by ECDC (Update 17:00 CEST 7 October 2009)
| Total deaths reported | 4,524 |
NB: Laboratory confirmed case numbers are no longer being reported for most countries as they do not give a representative view of the actual number of cases worldwide.
The World Health Organization (WHO) reported on 2 October that for:
- Tropical regions: influenza activity remains variable. Regional to widespread activity has been reported throughout the Americas; however, many countries have reported a declining trend (Bolivia, Brazil, Costa Rica, El Salvador, Panama, Paraguay, Venezuela), while others recently reported an increasing trend (Columbia and Cuba). There continues to be an increasing trend in respiratory diseases in parts of India and in Cambodia, while other countries in the Southeast Asia have recently reported declining transmission.
- Temperate southern hemisphere regions: influenza transmission has largely returned to baseline (Chile, Argentina, and New Zealand) or has declined substantially (Australia and South Africa).
- Temperate northern hemisphere regions: In the United States, influenza activity has continued to increase and remains above the seasonal baseline in most regions. In Mexico, a high intensity of respiratory diseases has been reported for two consecutive weeks (week 37 - 38), with large increases in cases being reported in the north and northwest of the country. Overall, influenza activity remains low in Europe and central and western Asia; however rates of flu-like illness remain above baseline levels in Ireland, Israel, and France and more than 10 countries in the region have reported geographically localised spread of influenza. In Japan, influenza activity has continued to increase above the seasonal epidemic threshold since week 33. These increases in flu-like illness have been accompanied by increases in laboratory isolations of pandemic influenza H1N1 2009 in most of these areas.
This update summarises information published by WHO about the latest global situation and is also published on the HPA website at http://www.hpa.org.uk/HPA/Topics/InfectiousDiseases/InfectionsAZ/1251473469008/
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: 8 October 2009
