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Home News centre National Press Releases 2009 Press Releases ›  Weekly pandemic flu update

Weekly pandemic flu update

16 July 2009

KEY POINTS

  • GP consultation rates in England for individuals presenting with flu-like illness show increased rates, above the threshold level for normal seasonal flu activity and higher than the peak activity in winter 08/09.
  • The under-5s and 5-14 year olds are the age groups predominantly affected.
  • The majority of cases continue to be mild with 26 deaths in England to date.
  • HPA estimates that there were 55,000 new cases of swine flu last week (range 30,000 - 85,000).

This estimate is based on latest weekly consultation rates for flu-like illness, taking into consideration positivity rates for swine flu H1N1 from HPA's virological sampling and a range of assumptions related to the numbers of people attending their GP.


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. These enable HPA to accurately estimate flu levels, monitor new and emerging viruses and identify trends in activity. Our experience over many flu seasons means we can confidently continue to monitor the incidence and distribution of this pandemic virus over the summer and beyond.

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 28 (ending 12 July), GP consultation rates for flu-like illness continue to increase in England. This rate (73.4 per 100,000) is now above the peak (68.5 per 100,000) reached in winter season 08/09. Rates in Central England are particularly high (93.9) and climbing in Northern England (37.2). In Southern England the rate is 74.9 per 100,000.
Figure 1: Current estimated weekly RCGP consultation rates of flu-like illness

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).

For QSurveillance® the flu-like illness weekly consultation rate reached 86.8 per 100,000 in week 28. This is higher than the peak activity in winter 08/09. 

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 for week 28 (week ending 12 July) in UK (all ages)
Figure 2: QSurveillance® – weekly consultation rate for flu-like illness for week 28 (week ending 12 July) in UK (all ages)

Figure 3: QSurveillance® - flu-like illness weekly consultation rate for week 28 (week ending 12 July) by age band

Figure 3: QSurveillance® - flu-like illness weekly consultation rate for week 28 (week ending 12 July) by age band

SYNDROMIC SURVEILLANCE

NHS Direct

NHS Direct has an existing algorithm for cold/flu calls. There is a significantly higher proportion of 'cold/flu' calls to NHS Direct across most of England and Wales compared with seasonal data from previous winters.

Figure 4: Daily NHS Direct/HPA Syndromic Surveillance System estimated total 'cold/flu' calls by SHA (comparative data provided*)

Figure 4: Daily NHS Direct/HPA Syndromic Surveillance System estimated total ‘cold/flu’ calls by SHA (comparative data provided)

* Based on between 8,000 and 30,000 calls each day to NHS Direct in April, May, June and July 2009.  In recent winter flu seasons, the maximum proportion of calls to NHS Direct for 'cold/flu' has been 2.8%.

VIRAL CHARACTERISTICS

Antiviral susceptibility (as at 15/07/09): 18 of the swine flu (H1N1v) isolates have been fully tested for susceptibility by the Health Protection Agency. All 18 were found to be sensitive to oseltamivir and zanamivir and resistant to amantadine. 368 positive specimens have been analysed for the marker commonly associated with resistance to oseltamivir in seasonal influenza (H274Y), all were found not to carry this marker.

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: 652 patients

26 deaths have been reported in England.

(Health warning: 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 14 July 2009)

Grand total of cases confirmed: 119,344
Total of deaths reported: 589
Table 1: Countries with more than 1000 laboratory-confirmed cases reported, as at 14 July (in addition to UK).

Country

Cumulative total number of cases reported

Cumulative total number of deaths reported

Argentina

2,928

94

Australia

9,050

19

Brazil

1,027

2

Canada

9,717

39

Chile

9,549

25

China (mainland)

1,362

0

China (Hong Kong)

1,327

0

Japan

2,919

0

Mexico

11,699

121

New Zealand

1,779

7

Peru

1,912

5

Philippines

2,668

3

Singapore

1,217

0

Spain

1,034

2

Thailand

2,428

9

USA

37,246

211

 

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. 

 

Figures A & B below are sample graphical representations to show how primary care surveillance of flu-like illness proves a good comparator to laboratory confirmations (daily reporting of laboratory confirmed cases alongside weekly and daily primary care surveillance reports for flu-like illness).

Figure A: Comparison of daily laboratory confirmed H1N1v case reports and weekly RCGP reports of flu-like illness, UK

Figure A: Comparison of daily laboratory confirmed H1N1v case reports and weekly RCGP reports of flu-like illness, UK
Figure B: Comparison of daily laboratory confirmed H1N1v case reports and daily QSurveillance® reports of influenza-like illness, UK

Figure B: Comparison of daily laboratory confirmed H1N1v case reports and daily QSurveillance® reports of influenza-like illness, UK

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 6647

020 8327 7098

020 8327 7097

020 8327 6690

Last reviewed: 3 June 2010