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Is Austrailia an "at risk" area for swine flu
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04-06-2009 8:52am#1
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BTW thisis what the latest daily update from the RGCP suggest all GP's should keep up to date with !
Update 17
Dear RCGP members,
The Health Protection Agency (HPA) reports that 12 further patients under investigation in England have today been confirmed with A (H1N1) flu, bringing the current total number of confirmed UK cases to 215. The newly confirmed cases are ten children from the West Midlands region, all linked to the outbreak at the Welford Primary School. The additional newly confirmed cases are a child in London linked to a previously confirmed case and an adult in the North West region whose source of infection remains under investigation.
We understand that a 37-year-old man with underlying health problems remains critically ill in a hospital in Glasgow with a suspected case of A (H1N1) flu. Two further probable cases of A (H1N1) flu have been detected among pupils at a Glasgow primary school. Two of the five pupils affected at the Annette Street Primary school are children of the man who is critically ill in hospital.
We are monitoring these events closely, and the comments, queries and suggestions which you send you to flu@rcgp.org.uk continue to inform our discussions with the HPA, the Department of Health and organisations in the devolved countries. It is therefore important that you continue to contact us at our flu mailbox.
Our next update will be on Wednesday next week. We may, however, release an update sooner depending on how the situation develops.
SURVEILLANCE
The HPA has provided the following information about measures being taken to detect cases of A (H1N1) in the community:
The surveillance strategy to detect the potential onset of community transmission of swine flu (i.e. cases in those without risk factors such as travel or contact with a known case) in the UK has two main components:
1. Virological sampling of potential cases. This includes:
- Continuing and enhancing the sampling protocol in the RCGP Spotter Practice scheme. This scheme collects nose and throat samples from patients with influenza-like illness in 52 practices across the country, covering a population of about 400,000 people.
- Re-instatement of the HPA scheme which collects virological samples from patients with influenza-like illness in 65 practices across the country, also covering a population of about 400,000 people. This scheme is being enhanced by the addition of practices in areas where there have already been travel or school associated cases.
- Testing samples from hospital patients with compatible clinical illness: all hospital laboratories have been asked to submit specimens to the HPA for testing.
- GPs in areas where cases of swine flu have been identified in the community can discuss sampling of cases with compatible clinical illness (see algorithm on HPA website http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1240732819361 ).
2. Surveillance of clinical influenza and other respiratory illness in the community, including:
- The RCGP spotter practice scheme, which has been reporting high-quality information for decades in England and Wales.
- Q-surveillance, which collects information on cases seen in 3,300 GP practices, covering about 40% of the UK's population. This information is updated daily.
- NHS Direct (or equivalents across UK), which provide rates for calls in relation to syndromes such as cold/flu, fever and cough, covering the whole of the country. This is also updated daily.
- Information on outbreaks from the HPA's formal and informal surveillance networks, e.g. with the Medical Officers for Schools Association.
- Mortality surveillance using routine death registrations from the Office for National Statistics covering the population of England and Wales
VACCINATION
A crucial step towards large scale production of a vaccine against swine flu has been completed in the UK by the National Institute for Biological Standards and Control (NIBSC), part of the Health Protection Agency. A strain of virus suitable for vaccine manufacture has now been produced and is being made available to the pharmaceutical industry and other flu laboratories.
INFORMATION LEAFLET FOR RECEPTIONISTS
An information leaflet for receptionists is currently being developed by the HPA. We hope to provide a link to this document in our update next week.
ESSENTIAL DOCUMENTS FOR GPs
GPs should consult the following websites for updates on a regular basis:
- Health Protection Agency (www.hpa.org.uk)
- Health Protection Scotland (www.hps.scot.nhs.uk)
- National Public Health Service for Wales (www.wales.nhs.uk)
- Department of Health, Social Services and Public Safety (http://www.dhsspsni.gov.uk/)
- Royal College of General Practitioners (www.rcgp.org.uk/pandemic)
We suggest that GPs familiarise themselves with the following documents:
- Standard practical advice for investigating individuals with possible swine influenza (http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1241048770758)
Scottish equivalent document: Influenza [A(H1N1)] Scottish Management of Cases and Contacts [Influenza (SMOCC)] (http://www.hps.scot.nhs.uk/resp/publicationsdetail.aspx?id=41230)
- WHO Pandemic Alert Phase 5: Algorithm for the management of suspected cases of swine influenza (http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1240732819361)
Scottish equivalent document: S5/HPS - WHO Pandemic Alert Phase 5: Algorithm for the management of possible cases of Influenza A/H1N1swl (http://www.hps.scot.nhs.uk/resp/publicationsdetail.aspx?id=41240)
- WHO Pandemic Alert Phase 5: Actions and post exposure prophylaxis for close contacts of probable or confirmed human cases of swine influenza (http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1240986160584)
Scottish equivalent document: P5 - WHO Pandemic Alert Phase 5: Algorithm for the management including Post-exposure prophylaxis (PEP) for contacts of confirmed and probable human cases of swine influenza (A/H1N1) in the UK (http://www.hps.scot.nhs.uk/resp/publicationsdetail.aspx?id=41241)
There are also a number of useful documents accessible in the Information for Healthcare Professionals section of the HPA website (http://www.hpa.org.uk/web/HPAweb&Page&HPAwebAutoListName/Page/1240812234677) including:
- Recommendations on the use of antiviral medicines for pregnant women, women who are breastfeeding and children under the age of one year
http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1242371196158
Scottish equivalent document: Antiviral Prescribing: Summary of prescribing guidance for Health Protection Teams (http://www.hps.scot.nhs.uk/resp/publicationsdetail.aspx?id=41331)
- The use of personal protective equipment (PPE) by healthcare workers in close contact with possible, probable and confirmed cases of swine flu during the pre and pandemic phases
http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1242371195903
Scottish equivalent document: Influenza [A(H1N1)] Scottish Management of Cases and Contacts [Influenza (SMOCC)] (http://www.hps.scot.nhs.uk/resp/publicationsdetail.aspx?id=41230)
- HPA interim advice on the lifespan of facemasks and respirators
http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1242371195983
No Scottish equivalent document
- Guidance on packaging samples for suspected A/H1N1 ("swine flu") (Category
: guidance for healthcare professionals http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1242371171250
No Scottish equivalent document
A (H1N1 FLU UPDATES:
The WHO reports (as of May 29, 2009, 06:00 GMT) 53 countries have officially reported 15,510 cases of influenza A (H1N1) infection, including 99 deaths.
The European Centre for Disease Prevention and Control reported (as of May 28, 2009, 17:00 CEST) 34 new cases confirmed in EU and EFTA countries in the previous 24 hours. A total of 456 confirmed cases were reported from 21 EU and EFTA countries.
The Centers for Disease Control and Prevention (CDC) report (as of May 29, 2009, 11:00am ET) that there have been a total of 8,975 confirmed or probable cases and 15 deaths in a total of 49 states in the US.
The HPA reports a total of 215 cases in the UK, including 200 in England, 14 in Scotland and 1 in Northern Ireland.
INFORMATION RELATING SPECIFICALLY TO NOTHERN IRELAND, WALES AND SCOTLAND:
SCOTLAND:
Two Greek students confirmed as having swine flu are now believed to have contracted the disease in Edinburgh. Health officials are currently trying to track down all the people who were in contact with the two students from Heriot-Watt University, who are being treated for the H1N1 virus in Greece.
As of yesterday, there were 14 confirmed cases of A (H1N1) flu in Scotland. These are residents of the following NHS boards: Ayrshire & Arran (1); Forth Valley (6) and Greater Glasgow & Clyde (7). There were 6 probable cases under investigation in Scotland today in the Greater Glasgow & Clyde (5) and Lothian (1) NHS board areas. One is travel related and five are non travel related. There were 11 possible cases under investigation in Scotland yesterday, from the following NHS board areas: Fife (2); Forth Valley (1); Lothian (7) and Tayside (1). Six are travel related and five are non travel related.
NORTHERN IRELAND:
There is currently on case under investigation. There has been one confirmed case to date and 82 cases have been found to be negative.
WALES:
A probable case of A (H1N1) flu in Wales has been identified in Wales. The patient is a 31 year old male from the Caerphilly local authority area who has recently returned from the USA. He has had mild flu symptoms, has been offered antivirals and is recovering at home. Confirmation is expected from further microbiology testing on Monday. Chief Medical Officer for Wales, Dr Tony Jewell, said, "We have made it clear all along that there would be cases in Wales and everyone must continue to be vigilant and try to reduce the spread of the virus. Dr Roland Salmon, Director of the Communicable Disease Surveillance Centre, National Public Health Service for Wales, said, "We continue to advise that anyone who has flu-like symptoms and has travelled to one of the affected areas should stay at home and phone their GP or NHS Direct Wales on 0845 46 47.
There have been no confirmed cases of A (H1N1) flu in Wales to date.
USEFUL INFORMATION FOR GPs in ENGLAND, WALES, SCOTLAND AND NORTHERN IRELAND:
Preparing for Pandemic Influenza: guidance for GP practices (http://www.rcgp.org.uk/PDF/GP_Guidance.pdf)
Pandemic Influenza - Preparation Checklist for Practices
(http://www.rcgp.org.uk/Docs/Preparation%20Checklist%20for%20Practices.doc)
The Lancet H1N1 Flu Resource Centre
http://www.TheLancet.com/H1N1-flu
International Journal of Clinical Skills http://www.ijocs.org/swineflu.aspx
ENGLAND:
Local Health Protection Units:
http://www.hpa.org.uk/webw/HPAweb&Page&HPAwebAutoListName/Page/1158945066055?p=1158945066055
Contact telephone numbers for Health Protection Agency / National Health Service Flu Response Centres
http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1243150121676
WALES:
National Public Health Service for Wales:
http://www.wales.nhs.uk/sites3/home.cfm?orgid=719
NHS Wales: http://www.wales.nhs.uk/
Investigation kits are available at out-of-hours centres across Wales and through local Health Protection teams. Kits are to be used only after discussion with local Communicable Disease Control Centres (CCDC) / Out-of-hours Public Health Service
Between 9:00am and 5:00pm call:
- South East (including Gwent) 029 20402478
- South West (including Dyfed Powys) 01792 607387
- North Wales 01352 803234
After 5:00pm ring and ask for an on call consultant in communicable disease control:
- South East (inc Gwent) 01633 293272 (
- South west (inc Dyfed Powys) 01267 222555
- North Wales 01248 689123
SCOTLAND:
NHS 24 Swine Flu Information: http://www.nhs24.com/content/default.asp?page=s3_12
Health Protection Scotland: http://www.hps.scot.nhs.uk/resp/swineinfluenza.aspx
The Scottish Government - Health and Community Care: http://www.scotland.gov.uk/Topics/Health/health/AvianInfluenza/mexicanswiuneflu
Health Protection Scotland (www.hps.scot.nhs.uk)
NORTHERN IRELAND:
Department of Health, Social Services and Public Safety: http://www.dhsspsni.gov.uk/
SOURCES OF INFORMATION FOR PATIENTS:
England:
NHS Direct: 0845 4647 / www.nhsdirect.nhs.uk
Wales:
NHS Direct Wales: 0845 4647 / http://www.nhsdirect.wales.nhs.uk
Scotland:
NHS 24: 08454 242424 / www.nhs24.com
Northern Ireland:
Swine Flu helpline: 0800 0514 142 / http://www.nidirect.gov.uk/index/health-and-well-being/swine-flu.htm
RCGP in the media:
Since the outbreak began, the RCGP has provided interviews for:
- BBC News Channel
- BBC Breakfast
- ITN
- Sky News
- CNN
- Radio 4's Today Programme
- World At OneRadio 5 Live
- ITV's GMTV
- This Morning
- All national papers
- Several regional BBC radio and TV stations
- Al Jazeera TV
- CNBC
- Health Services Journal
- Pulse Magazine
- BBC Online
- BMJ
Please look out for our update on Wednesday!
Yours sincerely,
Dr Maureen Baker
Honorary Secretary of Council
Web: http://www.rcgp.org.uk/pandemic
Email: flu@rcgp.org.uk
RCGP Annual National Primary Care Conference Excellence in Practice: winning ways for primary care
5 - 7 November 2009, Glasgow
www.rcgpannualconference.org.uk http://www.rcgpannualconference.org.uk
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