29 October 2009
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:
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 43 (ending 25 October) GP consultation rates for flu-like illness in England increased compared to the previous week (39.1 per 100,000 in week 42 to 42.8 per 100,000 in week 43). This is now above the baseline threshold of 30/100,000.
Figure 1: Current estimated weekly RCGP consultation rates of flu-like illness
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 continued to show a gradual rise from 37.4 per 100,000 in week 42 to 49.2 per 100,000 in week 43. The weekly rate for flu-like illness in all SHA regions and all age groups also showed a continuing rise.
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® - weekly consultation rate for influenza-like illness by English SHA (all ages)
Figure 4: QSurveillance influenza-like illness rate by age band in week 43 (ending 25 October)
The latest weekly flu-like illness rates show that the highest flu-like illness consultation rates were in the 1-4 and 5-14 year-old age groups. Compared with week 42 this week (week 43) rates have increased in all age groups, particularly in the <1 (40.0="(40.0" 67.3="67.3" 100,000)="100,000)" and="and" 1-4="1-4" year="year" olds="olds" (54.2="(54.2" to="to" 89.4="89.4" per="per" 100,000)</p="100,000)</p" />
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.
To date (as of 28 October 2009) 2,050 viruses have been analysed by the Centre for Infections for the genetic marker commonly associated with resistance to oseltamivir in seasonal H1N1 flu (H274Y). Three viruses have been found to carry this marker in the UK. In addition, 292 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.
There have been no significant changes in the virus.
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: 751 patients (currently hospitalised as of 8am on 28 October).
Deaths - the number of deaths related to swine flu in England is 97 (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).
Confirmed global deaths reported by ECDC (Update 17:00 CEST 28 October 2009)Total deaths reported: 5,938
In the last 7 days, the total number of deaths reported globally has increased by 12% - similar to the 13% increase reported last week.
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 23 October that for:
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/
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: 19 May 2010