Abermed video | Swine Flu Update |
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The numbers of people reporting flu-like illness is now starting to drop throughout the UK, suggesting that the first wave of swine flu is coming to an end. Despite everyone’s fears the illness has not turned out to be as virulent as expected – the vast majority of people have had mild symptoms which have resolved within a week. To date there is no evidence that the virus is mutating and virologists are now saying that a second wave of H1N1 in the Winter is unlikely to be worse. The virus has not spread as easily as anticipated and there appears to be a level of pre-existing immunity in the general population which has built up due to previous exposure to flu viruses in the past. All the evidence suggests that this pandemic should be milder than those in the past, and result in fewer deaths. It may even be that the death rate will be lower than that of usual seasonal flu. The development of resistance to antiviral drugs remains a concern. 4 resistant strains of virus have been identified worldwide, but none in UK as yet. Although the WHO advised against the widespread use of antivirals the UK Government adopted a policy of distributing antivirals to individuals based on self diagnosis and on the recommendation of non medically trained telephone advisers. In the early stages of the pandemic antivirals were also given to healthy contacts of cases as prophylaxis. This policy of indiscriminate use may yet result in reduced efficacy of the drugs at a later date.
How safe are antivirals?
The effectiveness and tolerability of antivirals such as Tamiflu and Relenza has also been questioned. Tamiflu has only been shown to reduce the duration of illness by 1 day, but has a significant risk of side effects, particularly vomiting. It has also been associated with hallucinations. Neither drug is particularly effective for children. It has been suggested that the use of these drugs should be restricted to people in high risk groups in the future.
When is the Vaccine due?
Vaccine trials are currently underway and mass vaccination programmes are expected in October. Priority will be given to groups in the following order
1. Those aged 6 months to 65 years with medical conditions which could be exacerbated by flu. At the same time frontline health and social care staff will be vaccinated.
2. Pregnant women
3. Household contacts of people with compromised immune systems, and people aged over 65.
It is anticipated that it will take 3 weeks to vaccinate the priority groups and this will be carried out by Primary Care Trusts and GPs.
The usual seasonal flu vaccine programme will also be starting soon. This does not give any additional protection against H1N1.
Guidelines for Mobilising Offshore
Offshore the policy continues to be one of “localised containment”, with isolation of suspected cases and treatment of close contacts. A supply of antivirals has been made available by the Government for treating offshore workers and this is currently being distributed to installations, where the medic will be responsible for prescribing treatment as appropriate following medical advice.
OGUK advise that the following people SHOULD NOT MOBILISE OFFSHORE
The following people CAN MOBILISE
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