Wednesday, 08 July 2009 11:28
The Government has announced that the UK is moving to a treatment phase to manage the current pandemic flu outbreak.
As a result GPs will now diagnose cases on the basis of clinical observation rather than laboratory testing. Everyone who has flu-like symptoms will be assessed by a doctor and may be given antivirals to manage their illness. Routine swabbing of suspected cases will now stop, and the Health Protection Agency will no longer trace close contacts and provide antivirals to limit spread.
The announcement, made by the Secretary of State for Health, Andy Burnham, earlier today, has been made as we are now seeing further clusters around the country where the disease is spreading within the community. As a result the public health interventions to reduce spread are no longer appropriate and the focus must move to the treatment of individual patients.
Since the first cases were seen in the UK the policy has been to contain the spread of the virus using a number of public health interventions. This included giving antivirals both to those who were symptomatic as a treatment as well as to their close contacts to prevent them from developing the disease. This was successful in containing the spread but could not have been used indefinitely.
Antivirals used in the treatment of flu are not a 'cure'. They reduce the virus spreading in the body, help the patient to recover more quickly and reduce the risk of complications. They also reduce shedding of the virus by infected people so that its spread may be delayed. However they do not offer longer term protection.
Once the virus is widespread within the community, the value of antivirals in terms of slowing the spread of the disease or offering individual protection is greatly reduced. This is because people are likely to be repeatedly exposed to the disease and extensive use of prophylaxis would no longer be appropriate as it would mean people having to take repeated courses of medicine. It is not possible to eliminate the virus using antivirals.
The move to using antivirals for treatment only is consistent with the approach being taken in other countries across the world including the USA, Canada, Australia, New Zealand, Chile and Mexico.
The Health Protection Agency's role in this treatment phase will continue to be that of providing scientific advice to Government and using the established surveillance systems to monitor the spread and incidence of the virus.
HPA has internationally respected surveillance systems for monitoring incidence and assessing the impact of flu, which it has operated through the normal 'flu season' over the last few years. These systems have effectively informed policy and planning, and evaluation of interventions (particularly the uptake of seasonal flu vaccine), and have been identified in pandemic preparedness plans as central to surveillance activities in the pandemic situation.
These systems will, however, be augmented by additional surveillance activities that are relevant to the pandemic situation e.g. continuing assessment of the severity of disease associated with this novel virus, and monitoring for changes in the characteristics of the virus.
It is still important to be aware that if people are diagnosed with swine flu they should stay at home while they have symptoms, to avoid spreading the infection as much as possible.
There are various measures that people can use to reducethe spread of infection. General infection control practices and good respiratory hand hygiene can help to reduce transmission of all viruses, including the pandemic flu. This includes:
Covering your nose and mouth when coughing or sneezing, using a tissue when possible.
- 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.
- Disposing of dirty tissues promptly and carefully.
- Cleaning hard surfaces (e.g. door handles) frequently using a normal cleaning product.
- Making sure your children follow this advice.
People who think they have swine flu should first go online and check their symptoms on http://www.nhs.uk, or call the Swine Flu information line on 0800 1 513 513. They can then call their local GP who will be able to provide a clinical diagnosis and appropriate advice on treatment over the phone.
For people belonging to a high-risk group it is particularly important that they start taking antivirals as soon as possible. High-risk groups include people with long-term conditions, those over 65, children under five and pregnant women.
Health Protection Agency