26/07/09
Originally identified in Mexico, this illness has quickly spread around the planet leading to many deaths (over 700 so far). Flu Pandemics have occurred in the past in 1918, 1957 and 1968 leading to millions of deaths. These tend to occur when a new virus appears that people around the world have little resistance to, leading to mass spread of the virus. As the agent is a new virus there would be no effective vaccine available immediately and due to the method of transmission would lead to global spread over a short period of time.
In the UK there are so far 55,000 cases since April 2009 with 600 hospitalisations and 31 deaths. The UK has moved from "containment" to "treatment" phase - swabs originally taken to diagnose the illness in the "containment" phase have now been abandoned due to the numbers involved and diagnosis is purely on clinical grounds. Although "Flu" does not usually occur at this time of the year, coughs and colds can be present and with clinical judgements becoming the main diagnostic tool in establishing Swine Flu there is a variety of thresholds being exercised nationally in diagnosing the illness and prescribing "Tamiflu", at present there is no plans to confirm whether an individual has "Swine Flu" or a "cold" in the community due to the scale of the problem.
Caused by a virus (H1N1), the illness is named due to the fact that this virus usually causes swine influenza in pigs. At present it is not thought that this virus is currently present in pigs in the UK and the origins of the illness is uncertain but the H1N1 virus has changed in properties to allow it to now infect humans and transmit itself between humans.
The virus is spread from human to human by droplet contact via the nose and mouth ie through sneezing and coughing. A normal sneeze may spread the virus up to 3 feet away leading to the possibility of anyone in the vicinity breathing in the virus and developing the illness. If individuals sneeze into their hands they can transfer the virus by contact to other people (shaking hands, touching your face) or to other objects (door handles, keyboards, telephones, tables and so on), if you touch these surfaces and then touch your face you could get infected.
The virus can survive on hard surfaces for up to 24hours and on soft surfaces for up to 20minutes. From infection to developing symptoms may take 2-5days but at present the exact characteristics of the virus are unknown. This virus is very contagious. Number of new Swine Flu cases in the UK is doubling every 7 days. Individuals are infectious to others soon after developing symptoms and can shed the virus for 5-7days after. Generally they are not infectious when the symptoms have fully resolved.
Originally thought to manifest as a minor illness in the healthy population with complications in those with other existing health problems (see below), it is not certain now whether the healthy populations is safe with the government planning to vaccinate the whole population not just those with existing health problems.
Currently the following are classified as being part of the High Risk category and most vulnerable to the complications of Swine Flu
Any one with flu like illness who have any of the above symptoms should consult their GP for advise and assessment on the first signs of any flu like symptoms (see below).
These may develop 5-7 days after infection, individuals are infectious to others from the development of the symptoms until full resolution of all symptoms. Sufferers of Swine Flu will have any of the following with a temperature of 38C or more / feeling hot :
Although the above is a general guide any symptoms with a high temperature should be discussed with a health care professional.
The following need to be considered in this section :
This is not the time to neglect your body and health. The body responds to a viral infection by activating the immune system which leads to the formation of antibodies that find and kill the virus in the body. Formation of antibodies leads to future protection against the same virus by the remaining antibodies circulating in the body. If there has been no previous exposure to a virus (as in the case of H1N1) the body needs to be in the best possible state of health to expedite the formation to the new antibodies and undertake "seek and destroy" function. Any weakness of the body (physical or mental) will delay the bodies reaction to the formation of these antibodies and thereby allowing the multiplication of the virus in the body and the possible development of complications. General measures should include :
If you have any pre-existing illnesses, check with your GP to ensure that the above do not exacerbate any illnesses.
If you are unfortunate enough to be infected by H1N1 virus (Swine Flu) the most effective way to avoid spreading the virus is as follows:
Currently the guidelines suggest remaining indoors until full resolution of symptoms (up to 7 days) to minimise spread spread to other individuals. Within the household it is difficult to avoid other family members but ensure the above (Catch it, Bin it, Kill it) is adhered to and avoid close contact (within 1 metre) if possible.
Whilst you are infected you must remain off work and school until all symptoms resolve. For work you can submit a "self certification" certificate from your GP or local post office following which you will need a sick note from your GP (med3 or med5). If the school needs proof your GP may provide a letter (this is not an NHS service and therefore your GP may charge you for the letter).
If diagnosed with Swine Flu you must NOT attend your GP surgery, hospital or other healthcare facility due to the risk of cross contamination of other individuals - ring NHSDirect, National Pandemic Flu Service helpline (see below) or your GP for advice on further management of your condition.
Coming into contact with individuals diagnosed with Swine Flu, somebody at work or school being diagnosed with Swine Flu is not a reason to abstain from school or work unless you develop the symptoms and are diagnosed as having Swine Flu in which case you would stay off as above.
The common treatment to manage high temperature should be paracetamol and/or Ibuprofen (check with a pharmacist or your GP there is no contraindications with any current/past illnesses or current medication taken). This should also help in the management of any aches/pains and any other symptoms could be discussed with NHSDirect, National Pandemic Flu Service or your GP to seek advice on other treatments to control your symptoms.
Tamiflu is the antiviral currently used in the National Health Service to manage cases of Swine Flu. Antivirals generally:
Tamiflu comes in a liquid and capsule form, it appears the liquid form is becoming difficult to obtain. Tamiflu comes in different strengths for the different age groups and the usual adult dose is 75mg capsule twice daily for 5 consecutive days (total of 10 capsules provided). The way to obtain Tamiflu if diagnosed with Swine Flu is as follows:
The Swine Flu vaccine to protect against Swine Flu is currently still being developed. The UK government is purchasing enough vaccine for the whole population. This will involve 2 vaccines at 3 week intervals and the question still remains how the government will secure the manpower resource required to provide 2 injections to every individual in the country.
Currently the following have been identified as a priority groups when the vaccine becomes available :
Currently it is unknown whether the "Seasonal Flu Vaccine" will provide any defence against this strain of H1N1 causing Swine Flu. Although the NHS provides "Seasonal Flu Vaccination" and "Pneumococcal" vaccination to anyone 65 years and over and those will chronic illnesses, it would now be advisable to obtain these vaccinations (privately if needed) to minimise the risk of complications of Swine Flu such as Pneumonia.
At present there is no indication that Swine Flu can be transmitted from Humans to pets.
Any meats cooked to 70C will kill the virus.
At present there seems to be a differing opinion on the effectiveness of face masks in the prevention of catching the virus. Although abroad certain countries advocate the use of face masks in the prevention of catching the virus and in the UK the government have provided face masks to front line clinicians to use in the event they need to consult face to face with a suspected case of Swine Flu there appears no need according to the government for the general public to use face masks. A common sense approach would be advisable, if you work in or travel in confined environments (e.g. London Underground or rush hour public transport) or intend on travelling abroad which brings you into close contact with people from other countries in close proximity (Pilgrimages to Mecca - ensure they do not violate your religious responsibilities) there would be no harm in adding a face mask to your itinerary.
As this is a Pandemic illness, it may be possible to catch the illness anywhere in the world. As it is unlikely that most people will stop travelling (and at present there is no national guidance to suggest you should not travel) it is imperative that all necessary precautions are taken :
IF YOU HAVE SWINE FLU THEN DO NOT TRAVEL UNTIL YOUR SYMPTOMS HAVE FULLY RESOLVED.
To access the Department of Health Swine Flu Information line from abroad call - 0044 207 9281010
There are a number of ways to obtain help :
The government has recently provided the National Pandemic Flu Service to assist in the management of cases of Swine Flu, this service is ONLY for those who suspect they have the infection and is handled by call handlers (experienced call handlers have been given 3 hours training and less experienced call handlers given 1days training). There are NO healthcare workers in these call centres.
Routine health services delivered by GPs may be abandoned in the near future if the scale of the emergency escalates. To manage illnesses and minimise the level of morbidity and mortality associated with this Pandemic illness the whole health service from GPs to Community services and Hospitals will need to redesign the way they function. At present there is concern amongst clinicians regarding the state of readiness of the Health Service to deal with the scale of the Pandemic flu.
There has been an extrapolation that there may be 65,000 deaths. Looking at past Pandemic outbreaks and the second wave of infection later this year which will be more virulent and potent there is no reason not to assume a significant number of deaths across the planet. Planning is the key to improving individual chances, ensure recording & access to your healthcare information (it may not be your GP that you consult), ensure you are aware of how and when to access the Swine Flu vaccine when available, maintain healthy body and mind, ensure you have both a legal Will and Living Will to record your wishes.
This page will provide information and guidance as it is released so visit this site regularly to ensure you are kept informed of the latest national guidance.
