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

Weekly pandemic flu media update

12 November 2009

KEY POINTS

  • The consultation rate for flu-like illness in England from the Royal College of General Practitioners (RCGP) scheme decreased to 36.0 per 100,000 in week 45 compared to 37.7 in week 44.
  • The main burden of flu-like illness nationally in week 45 is in the <1 and="and" 1-4="1-4" years="years" age="age" groups.</li="groups.</li" />
  • This week, the antiviral collection numbers in the National Pandemic Flu Service decreased in all age groups.
  • The recent half-term school holidays may have continued to influence the figures this week, and so it is difficult to predict future trends.
  • 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 64,000 new cases in England last week (range 32,000 to 140,000). This represents an 24% decrease on the previous week.    
    This estimate incorporates data from National Pandemic Flu Service and GP consultations.
  • The HPA estimates a cumulative total number of cases of 668,000 (with a range 313,000 to 1,382,000 since the pandemic began.

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 45 (ending 8 November) GP consultation rates for flu-like illness in England have shown a small decrease compared to the previous week (37.7 per 100,000 in week 44 to 36.0 per 100,000 in week 45) which is still above the English baseline threshold of 30/100,000.

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).

The weekly QSurveillance® flu-like illness consultation rate showed a slight decrease from 48.5 per 100,000 in week 44.to 47.2 per 100,000 in week 45. The weekly rate for flu-like illness in all SHA regions and all age groups showed a mixed picture with some increasing and others decreasing.

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 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 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 45 (ending 8 November)

Figure 4: QSurveillance influenza-like illness rate by age band in week 45 (ending 8 November)

The latest weekly flu-like illness rates show that the highest flu-like illness consultation rates were in the <1 1-4="1-4" year-old="year-old" groups.="groups." Compared="Compared" with="with" 44="44" this="this" week="week" (week="(week" 45)="45)" rates="rates" have="have" increased="increased" the="the" 15-24="15-24" and="and" 45+="45+" bands="bands" but="but" decreased="decreased" in="in" all="all" <15="<15" years="years" age="age" bands.="bands." </p="</p" />

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 11 November 2009) 2,834 viruses have been analysed by the Centre for Infections for the genetic marker commonly associated with resistance to oseltamivir in seasonal H1N1 flu (H274Y). Six viruses have been found to carry this marker in the UK. In addition, 293 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.

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: 785 patients (currently hospitalised as of 8am on 11 November). 

Deaths - the number of deaths related to swine flu in England is 124 (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 11 November 2009)

Total deaths reported: 6,592

In the last 7 days, the total number of deaths reported globally has increased by 5% - the same increase as 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 6 November that for:

  • Tropical regions: active influenza transmission and increasing levels of respiratory disease continue to be reported in parts of the Caribbean, with most other countries in the tropical region of Central and South America reporting declining activity. Transmission continues to decline in most parts of tropical South and Southeast Asia. Unconfirmed media reports suggest increased disease activity in sub-Saharan Africa.
  • Temperate northern hemisphere regions: intense and persistent influenza activity continues be reported in North America without evidence of a peak in activity.  Rates of influenza like illness, proportions of samples positive for influenza, and numbers of outbreaks in educational settings continue to increase in Canada with activity spreading eastward.  Significantly more cases of pandemic H1N1 have been reported in Mexico since September than were observed during the initial springtime epidemic.
  • In Europe and Central and Western Asia: influenza activity continues to increase signalling an unusually early start to the winter influenza season.  Active circulation of the pandemic virus was reported in Belgium, Ireland, the Netherlands, Norway, Spain, Sweden and Germany.  Increasing transmission was also reported across Northern and Eastern Europe, and Eastern Russia.  In Western Asia and the Eastern Mediterranean Region increasing activity has been reported in Oman and Afghanistan.
  • In East Asia: intense and increasing influenza activity continues to be reported in Mongolia.  Sharp increases in pandemic influenza activity continue to be reported throughout Japan.
    More information on the latest global situation can be found on the WHO website at: http://www.who.int/csr/don/2009_11_06/en/index.html

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: 19 May 2010