Just one in three nurses in London have been vaccinated against swine flu, the NHS has admitted.
A BBC London Freedom of Information request has shown the majority of medical staff remain unprotected against the virus.
Although swine flu rarely kills healthy adults, it is dangerous to many patients in hospitals.
NHS London insisted the vaccine take-up was "encouraging" and rising, with more than 60,000 staff having had the jab.
But figures, seen by BBC London, reveal the take-up has hit a plateau, with a limited increase in the numbers of staff to have been vaccinated over the last month.
In mid-December, a total of 33% of frontline staff - including dentists, paramedics and so on - had been vaccinated.
By 18 January that figure was 40% - a rise of 7%.
The vaccine has been available to some sections of the public, such as asthmatics, since October.
Swine flu cases remain below normal seasonal flu levels in England and Wales, new figures show
The consultation rate for flu-like illness last week was:
19.9 per 100,000 in England
17.2 per 100,000 in Wales
Both rates are below the ‘baseline' level of 30 per 100,000 for seasonal flu activity in England.
The latest figures for cases per 100,000 in Scotland and Northern Ireland remain slightly higher:
112.8 in Scotland
55.5 in Northern Ireland
Reduced levels of swine flu activity has led the Health Protection Agency (HPA) to decide to cease producing weekly figures for flu-like illness levels in England. Such figures have been issued in a weekly pandemic flu media update.
As the biggest gainer from the H1N1 swine flu pandemic, GlaxoSmithKline now has most to lose as countries cut back their orders.
While supplies already shipped in 2009 look safe, the British drugmaker will make less money than expected from its Pandemrix shot in 2010. It also faces weaker demand for flu treatment Relenza as swine flu concerns wane.
At the same time, sales of herpes drug Valtrex are plunging after its US patent expired last month, spelling a tough year ahead for Glaxo, which is trying to reduce its traditional reliance on sales of prescription products in Western markets.
Consensus forecasts point to a meagre 1 percent uptick in earnings per share this year, following impressive growth of 14 percent forecast for 2009, according to Thomson Reuters.
The swine flu pandemic is "considerably less lethal" than feared, with a death rate lower than 0.1 per cent, research by England's chief medical officer showed today.
Twenty-six people have died for every 100,000 cases in England, an analysis of deaths to November 8 revealed.
About 1per cent of the population in England has had swine flu with symptoms, of which 0.026 per cent died, the research added.
Sir Liam Donaldson, the Government's chief medical officer for England, led the study, published online in the British Medical Journal (BMJ), which described the low death rates as "fortunate".
His study concluded: "The first influenza pandemic of the 21st century is considerably less lethal than was feared in advance."
Sir Liam wrote, however, that a lower impact than feared was not justification for "inaction".
It was right to vaccinate people at risk - such as those with asthma, diabetes, heart disease and pregnant women - and to extend the programme, he went on.
"Viewed statistically, mortality in this pandemic compares favourably with 20th century influenza pandemics," he said.
"A lower population impact than previous pandemics, however, is not a justification for public health inaction.
"Our data support the priority vaccination of high risk groups.
"Given that a substantial minority of deaths occur in previously healthy people, there is a case for extending the vaccination programme and for continuing to make early anti-viral treatment widely available."
The paper showed the estimated death rate was lowest among children aged five to 14, with around 11 deaths per 100,000 population.
It was highest for those aged over 65, with 980 per 100,000.
In the 138 people in whom the confirmed cause of death was pandemic flu, the typical age at death was 39.
The analysis showed many of the patients who died were high risk and would have been eligible for vaccination.
"Two thirds of patients who died (92 or 67%) would now be eligible for the first phase of vaccination in England.
"Fifty (36%) had no, or only mild, pre-existing illness.
"Most patients (108, 78%) had been prescribed anti-viral drugs, but of these, 82 (76%) did not receive them within the first 48 hours of illness."
Sir Liam compares the pandemic with previous ones, saying "improvements in nutritional status, housing and health care availability might explain some of the apparent decrease in case fatality from one pandemic to the next".
He added: "Since the most recent pandemic there have been major advances in intensive care medicine.
"Many more patients may have died in England without the ready availability of critical care support, including mechanical ventilation."
Sharon Boor warned other parents not to be complacent following the death of her daughter Brittany Eastland, who was not in an at-risk group for swine flu, and urged them to accept the swine flu vaccine if it is offered.
Brittany, a Year 5 pupil at Three Bridges Junior School in Crawley, West Sussex, died in October at East Surrey Hospital in Redhill, Surrey.
Tests were carried out and it was confirmed that the ''fit and healthy'' youngster died from pneumonia as a result of H1N1 influenza, a spokesman for NHS West Sussex said today.
Miss Boor said in a statement: ''Brittany didn't have any underlying conditions and wasn't in an at-risk group for swine flu, so people can't be complacent.
''Don't think being fit and healthy will protect you. My daughter was fit and healthy too.
''Everyone should accept the swine flu vaccine if you are offered it. It doesn't just protect you, it protects your loved ones around you.
Tests were being carried out to determine how much the H1N1 virus contributed to his death.
The boy, who has not been named, was admitted to Milton Keynes Hospital, where he died in the early hours of Sunday.
Emberton School, near Olney, Buckinghamshire, a village school for children between the ages of four and seven, placed a message on its website this morning informing parents of the temporary closure.
Dr Diane Gray, deputy director of public health for Milton Keynes, said: "My sympathies go out to his parents, family and friends. We don't yet know the cause of this boy's death.
"At this stage, there is no need to change normal behaviour – you should continue to go to school, work and any social activities."
Steve Dunning, head teacher of Emberton School, told the BBC the boy's death had come as a great shock.
Since the swine flu outbreak began in April, 214 people in the UK with swine flu have died including 15 under the age of five.
Last week it was announced that all healthy children between the ages of six months and five years will be given the swine flu vaccine.
Their parents will be sent letters once GPs have finished vaccinating people in the priority groups including those with long-term conditions and pregnant women.
They boy would not have been offered the vaccine unless he other illnesses such as severe asthma and was included in the priority groups.
Children aged between six months and five years were supposed to be offered the vaccine from the middle of December.
However, that is now in doubt after negotiations between the Government and GPs over how the scheme would be administered broke down.
The sticking point in the talks was over how GPs and clinics would have the time for the extra appointments without losing out financially.
The Daily Telegraph understands ministers would not agree to relax the target that GPs must see patients within 48 hours in order to free-up time for the vaccination programme.
GP practices lose substantial amounts of income if they miss the 48-hour target.
However sources at the Department of Health claimed GPs wanted more money for administering each vaccine than the £5.25 that was agreed early in the discussions - an allegation the British Medical Association denies.
Local arrangements will now have to be made with the NHS in each area negotiating separately with their GP representatives over what tasks practices can drop in order to free up time.
Children under five are the group most likely to be admitted to hospital with complications from swine flu. Admission rates are still rising in young children even though overall, new cases of the virus are dropping.
GPs are already offering the swine flu vaccine to nine million people in the priority groups, including pregnant women and people with long-term illnesses.
Adding three million healthy children to the vaccination programme at the same time would have put greater time pressures on surgeries at their busiest time of year, family doctors argued.
Andy Burnham, Health Secretary, said vaccinations for children would begin before Christmas but Dr Laurence Buckman, chairman of the British Medical Association's GPs Committee said this would now be 'extremely difficult' for most practices.
A DAMNING review of the antiviral drug Tamiflu has cast doubts on its usefulness in preventing serious illness, and led to accusations that manufacturer Roche withheld trial data from researchers.
And experts say the review raises questions about the entire system by which drugs are evaluated, regulated and promoted, because it relies on data created and held by drug companies.
But Roche yesterday stood by Tamiflu, which was widely used during this year's swine flu pandemic, saying its safety and efficacy had been well established.
The Cochrane review, published in the British Medical Journal yesterday and led by Professor Chris Del Mar from Bond University in Queensland, looked at all evidence on the effectiveness of antiviral drugs.
It concluded Tamiflu had a ''modest'' effect on flu symptoms, reducing the length of illness by one day. ''We believe [antivirals] should not be used in routine control of seasonal influenza,'' it said, and it was unable to give a confident recommendation about use in a pandemic.
There was no reliable evidence that the drug could ward off hospital admission or complications such as pneumonia or bronchitis - counter to previous claims.
The review agreed with Japanese researcher Keiji Hayashi, who strongly criticised a previous review in 2005 for using unreliable data. The previous review had relied on 10 trials of Tamiflu that looked at its effectiveness in preventing complications. All were funded by Roche and written by Roche employees or paid academic consultants. Only two were published in peer-reviewed journals.
The authors of the new review said these factors left the trials ''at risk of bias'', and they had been unable to independently confirm their conclusions because Roche had not provided the raw data.
''Governments around the world have spent billions of pounds on a drug that the scientific community now finds itself unable to judge,'' said Dr Fiona Godlee, editor of the British Medical Journal.
Parents of children at Christ's Hospital near Horsham, West Sussex, were told by letter that the number infected was anticipated to double by Monday.
In a letter to parents which was published on the school's website, headmaster John Franklin said the school would be shut from midday on Saturday, November 15, until Sunday, November 22.
"We have around 100 pupils at school with swine 'flu and the School Medical Officer anticipates that this figure will have doubled by Monday. Just as importantly, there is an increasing number of house parents and teaching staff who are unwell," Mr Franklyn said.
"I regret to inform you that as a result, the school will have to close."
It said pupils too ill to travel home would be cared for in the boarding school's health centre until they were well enough to do so.
"Teachers will be setting pupils work for the coming week and will be available for consultation on academic matters by email if necessary," Mr Franklyn added.
"As long as pupils are healthy, they should return to school on the afternoon of Sunday, 22nd November.
"Any pupils who are displaying ‘flu-like symptoms at that time should remain at home and not be sent back to school until they are fully recovered."
The school's history stretches back more than 450 years.
The number of people contracting swine flu in England dropped to 64,000 this week, from 84,000 last week, according to Department of Health figures. The number in hospital with the condition fell to 785, from 848.
The fall may only be temporary, due to the school half-term break. In Scotland, the number of new cases rose to 21,500. Across the UK a total of 182 people have died.
Sir Liam Donaldson, the government's chief medical officer, said he was making a "strong recommendation" to pregnant women to be vaccinated as they were at higher risk of complications.
EXPERTS last night admitted they did not know whether the second wave of swine flu has peaked.
The latest figures suggest that the number of people infected by the virus is falling.
It is not yet clear whether this is the end of the second wave or a temporary lull in the numbers, caused by the school half-term.
Dr Roland Salmon, who is director of the communicable disease surveillance centre for the National Public Health Service for Wales, has predicted that swine flu may be over by the end of the Christmas holidays.
He added: “What’s not clear is whether we will have a brief upswing to see us out or whether it will continue to decline.”
But Dr Tony Jewell, Wales’ chief medical officer, was last night more cautious, warning that swine flu could continue to cause illnesses, especially in young children and teenagers throughout the winter months.
“We mustn’t relax too much,” he said. “We must get the vaccine out to the high-risk groups because this is still causing severe illness in some people. There is still a long way to go until the end of March.”
The latest figures suggest that just over 1,700 people have swine flu in Wales, down from an autumnal high of 2,650 last month.
This is significantly lower than the number of people affected in July when the first wave of the H1N1 virus peaked in Wales.
A total of nine people have died after contracting swine flu in Wales and 75 people are being treated in hospital.
GPs have said they have been busier than they would normally expect at this time of year with patients seeking help for flu-like symptoms.
And the swine flu vaccination campaign has now begun in earnest, with the bulk of supplies of the jab arriving at GP surgeries.
It is expected that the vast majority of the 750,000 people classed as a priority for the jab will be vaccinated in the next month.
Mum-of-two Saffron Herbert, from Caerphilly, had her swine flu and seasonal flu jab yesterday after being invited by her GP.
The 34-year-old needs the jab because she has low immunity following the removal of her spleen as a teenager.
“I know that I need it because I have low immunity – it’s a safety precaution for me,” Mrs Herbert said.
Dr David Bailey, a GP in Trethomas and chairman of the Welsh GP committee, said: “People are aware that people have died from swine flu and they are also aware that if it does take hold, like it did during the first wave in July, it will come on very quickly.
“Most of us expect that there will be a second peak but we could be wrong. Certainly there is no evidence at the moment that we will see another peak but that could change in the matter of a week.”
Mothers with young children and pregnant women are being turned away from swine flu vaccination clinics in the United States, some in tears, many utterly frustrated by the shortage of vaccine.
But it could have been much worse. The new strain of H1N1 flu could have been much more virulent, and it could have been bird flu, which, due to the way the United States produces flu vaccine, could wreak havoc.
Months back, when a swine flu vaccine was still just a glimmer in scientists' eyes, US health officials were driving home the message that children, and especially those with underlying health conditions like asthma, and pregnant women were at greater risk of dying from H1N1 influenza and should be first in line for inoculation.
DES MOINES, Iowa — A 13-year-old Iowa cat has been infected with swine flu, veterinary and federal officials said Wednesday, and it is believed to be the first case of the H1N1 virus in a feline.
The domestic shorthaired cat was treated last week at Iowa State University College of Veterinary Medicine in Ames and has recovered, officials said. The virus also has been confirmed in two ferrets – one in Oregon and the other in Nebraska – but they died.
A young mum suffering from swine flu has died 18 days after an op to save her baby.
Susan Ford, 31, was 35 weeks pregnant when admitted to hospital with severe flu-like symptoms.
She had an emergency caesarean section and daughter Poppy was born healthy - but Susan was put on a ventilator in intensive care.
Doctors confirmed she had swine flu and gave her Tamiflu, but she developed severe pneumonia. She died in Salford Royal Hospital, Greater Manchester, at 4.30am on Saturday.
Yesterday, mum Wynne said: "The staff did everything they could. I can't fault them." But the family called for more specialist machines in hospitals to help swine flu victims.
Extra-Corporeal Membrane Oxygenation units, which circulate blood outside the body and add oxygen, have already saved lives.
Swine flu kills more than one in 10 of those it affects severely enough to put in hospital, a US study has shown.
Up to 20% of older patients taken to hospital with the virus ended up dead, researchers in California found.
Almost a third of cases required intensive care treatment, and deaths occurred among all age groups.
The findings, published in the Journal of the American Medical Association (Jama), suggest that H1N1 swine flu is potentially more dangerous than many people believe, according to the authors.
Dr Janice Louie, from the California Department of Public Health, led the study of 1,088 swine flu cases resulting in being taken to hospital or death in the state between April 23 and August 11 this year. Of these, 32% were children under the age of 18, with infants having the highest rates of hospitalisation. The midpoint age of patients was 27. In total, 340 patients (31%) were admitted to hospital intensive care units. Of the 297 intensive care cases for whom information was available, 65% required mechanical ventilation
Nurses and doctors have been urged to set an example to patients by having themselves vaccinated against swine flu.
The pleas come following concerns that many NHS staff plan to turn down the chance of a free jab over safety worries and the belief that the virus is so mild.
GPs across the country will receive their first batches of the jab in the coming days, after the first jabs were carried out in hospitals last week, in preparation for the nationwide vaccination of 12 million people deemed at risk.
Pregnant women will receive the vaccine first, along with those with suppressed immune systems and underlying health conditions.
But because the vaccine is still being manufactured, it could take until the beginning of December for all at-risk people to be offered their jab.
And NHS are concerned that threatened postal strikes could delay letters inviting people to come in for their immunisation - potentially putting patients at risk.
Swine flu has killed more than a 100 people in the UK so far, although initial estimates that it could kill up to 65,000 people have been downgraded.
All healthcare workers are being offered the swine flu jab for free, to protect patients.
But a poll by Pulse magazine showed that 49 per cent of GPs would reject the jab; and earlier this month a Nursing Times survey showed that 47 per cent of nurses were definitely not going to have the jab, while just 23 per cent said they definitely were.
NHS bosses say their reluctance could lead to needless deaths during the expected second wave of the disease as staff pass the virus on to frail patients and those with compromised immune systems.
And they say that if staff are unprotected from another onslaught of the bug, there could be massive sickness rates which would lead to cancelled operations.
Last month the Department of Health was forced to write to all NHS organisations to order them to ensure that frontline staff get immunised against the disease.
Ian Dalton, the NHS's national director of flu resilience, told chief executives and boards or NHS trusts to maximise the number of workers having the jab.
He wrote in a letter: 'We all know that uptake of the seasonal flu vaccine among NHS staff is traditionally low. It is an NHS board responsibility that we do not find ourselves in this position with the swine flu vaccine.'
Professor Steve Field, president of the Royal College of General Practitioners, said: 'It is a good, safe vaccine and I would urge patients - and doctors - to have it, as it is well-researched.
'We want the Health Service to run effectively so we can treat our patients as best as we can. We would urge healthcare staff to have the vaccination as soon as it becomes available to them.
'Critical care facilities in hospitals are already under pressure: another reason why I would urge doctors to have it.'
Professor Ian Gilmore, president of the Royal College of Physicians, said: 'It is clearly important to maintain a healthy workforce that is as fit as possible during a pandemic, and we hope that consultants will take a lead in encouraging other healthcare workers to be immunised. They are well-placed to set an example.'
A hard-hitting advertising campaign about how easily swine flu can spread was launched today.
Health secretary Andy Burnham said: 'Vaccination of at-risk groups is well under way - a crucial defence against swine flu. But we can't vaccinate everyone straight away.
'Helping to stop the spread of flu is easy, simply by covering your nose and mouth with tissues when you cough and sneeze, throwing the tissue away and washing your hands really cuts the chances of spreading the virus.
'This campaign is a reminder of how easily germs are passed around.'
The swine flu vaccination programme has begun, with at-risk groups the first to be offered the immunisation.
A total of 1.3 million people in Scotland are in priority groups with the first access to the H1N1 vaccine.
They include social care and health workers, pregnant women, people with asthma, diabetes and those having cancer treatment.
Other people prioritised for the first round of vaccinations will be contacted by their GP over coming weeks.
The launch of the vaccine programme comes the day after the death of a Fife woman who was suffering from the virus.
The 59-year-old, who suffered from underlying health conditions, is the 16th person in Scotland to die since the outbreak of the pandemic last year.
The vaccine will start to be distributed to GP practices from the beginning of next week
Nicola Sturgeon Health Secretary
Two people without any underlying health problems have died from the virus - including a 17-year-old pregnant woman from the Borders - although a suppressed immune system can make pregnant women more vulnerable.
In the majority of cases, the vaccine will be administered in a single dose, but children under the age of 10 and in the at-risk group will need two doses.
Health Secretary Nicola Sturgeon told the BBC's Good Morning Scotland programme the vaccine was safe.
She said: "It has gone through extensive safety checks and the European Medicines Agency has given it a licence, so people can have confidence in this vaccine.
"I would simply say to people whatever concerns you have about vaccines, remember swine flu is a virus that, for some people, can lead to very serious complications, and in some cases, to death and that is what makes vaccination so important."
Ms Sturgeon said the first supplies would be available in hospitals for frontline staff and patients with conditions which make them vulnerable to the virus.
"The vaccine will start to be distributed to GP practices from the beginning of next week and it will take perhaps two or three weeks to get it to every GP practice across the country," Ms Sturgeon said.
'Personal choice'
She said people in priority groups would get a letter from their GP in the next few weeks advising them to get the vaccine.
The health secretary added that eligible groups should also be vaccinated against seasonal flu.
Public sector union Unison has also urged its members working in the NHS to take the vaccine.
John Gallacher, secretary to the union's health care group, said: "There should be no shortcuts to safety when it comes to getting the vaccine up and running, and we are glad it has now had its EC license granted.
"Ultimately, having the injection is down to personal choice, but we recommend that members - especially those dealing directly with patients - get the protection."
BERLIN — A row in Germany over a "two-tier" swine flu vaccination programme has prompted Chancellor Angela Merkel to say she'll get the jab meant for the public rather than one reserved for "essential workers".
Criticism over "government-only" flu jabs, reserved for soldiers, policemen, and essential workers, comes against the backdrop of a nationwide immunisation campaign due to start next week.
The H1N1 virus has so far affected just 23,000 people in Germany, but the government is keen on vaccinating as many people as possible to avoid a possible large-scale outbreak at the start of the winter season.
But revelations in the press that top officials and other essential workers will get the Celvapan vaccine, manufactured by Baxter, which has fewer side effects than the mass Pandemrix vaccine manufactured by GlaxoSmithKline has caused a public outcry.
Government spokesman Ulrich Wilhelm has rejected accusations of a "two-tier medical system", saying both vaccines have equal worth
With demand far outstripping supply, state cancels clinics
Swine flu vaccine shipments to Massachusetts are running three weeks behind schedule, forcing the state to direct local health departments to cancel vaccine clinics scheduled for next month.
At the same time, shortages of the vaccine against seasonal flu strains are also being reported, as unusually high demand is outpacing the supply. Communities from Scituate to Somerville and Cambridge said they were postponing vaccine clinics aimed at protecting the public against both types of the flu.
The problems seen in Massachusetts reflect a nationwide shortage, as production facilities - pressed to make two types of vaccine at once - have been unable to churn out adequate amounts of either one.
The number of new swine flu cases in England has again risen, with an estimated 27,000 in the week to October 15, up from 18,000 the week before. Read the latest official advice to help protect yourself, your family and others.
Health chiefs will attend an emergency meeting later after it emerged that the family of a girl who died from swine flu was only told she had the virus on Friday, a week after her funeral.
The health minister has asked the chief medical officer to convene the meeting following the death of Orla O'Kane, 14, from Londonderry.
The Western Trust has said it will prevent similar delays in future.
It said it "regretted" distress caused to the O'Kane family by the delay.
Chief Medical Officer Dr Michael McBride said he will convene a meeting bringing together representatives from the trust, the Department of Health and the Public Health Agency.
He said he wished to pass on his sympathy to the O'Kane family.
"It is extremely regrettable that there was a delay in the family receiving the confirmation of swine flu, particularly at a time when they were already going through such a personal tragedy," Dr McBride said.
"Our first priority must be to find out the exact details of what happened and how the delay occurred, and to make sure that this does not happen again.
"We must ensure that we learn lessons from what happened here."
Swine flu vaccinations begin locally this week, but it might be a while before everyone who wants to be vaccinated can get the shot (or mist). Here are some common questions and answers about vaccinations.
Florida's Flu Safety website: www.myflusafety.com, includes a list of swine flu vaccination sites.
Florida's toll-free flu information telephone line: 1-877-352-3581.
U.S. Centers for Disease Control and Prevention H1N1 site: www.cdc.gov/H1N1FLU
As H1N1 swine flu vaccinations get under way in South Florida, health officials are urging people to be patient and wait their turns, respecting priority lists that reserve first doses for children, young adults, older adults with health problems and healthcare workers who might come in contact with flu victims.
``The next couple of weeks will be challenging, but more vaccine is coming,'' said Dr. Anne Schuchat, immunization expert of the U.S. Centers for Disease Control and Prevention. ``But we will have enough that eventually anyone who wants can be vaccinated.''
The H1N1 swine flu, which started in April, is spreading rapidly across the country, doing its worst damage among young children and pregnant women. Big drug companies are struggling to produce enough vaccine against both H1N1 swine flu and regular seasonal flu, falling behind on both fronts.
Here are some common questions and answers:
Q: Is H1N1 swine flu still spreading?
A: The H1N1 influenza is widespread in 41 states now, including Florida -- up from 37 a week ago. Visits to doctors, hospitalizations and deaths from flu all are higher than expected for this time of year, according to the U.S. Centers for Disease Control and Prevention. Florida has had 121 flu deaths this year, including 12 in the past week.
The World Health Organization estimates that a worldwide production capacity of 3 billion doses of pandemic H1N1 vaccines will be used to prevent the outbreak and spread of the 2009 H1N1 flu, or "swine flu," as it is better known. This ambitious plan for widespread vaccine use, albeit inadequate for a total population of 6.8 billion people, has drawn criticism regarding the vaccine's safety, and the use and potential use of vaccine adjuvants.
In the alternative health community, chiropractor Ginger Mills, DC, of Redwood City, is concerned that adjuvants, especially squalene, will be added to vaccines used in the U.S., should the number of cases rise. "Squalene is an oil that is found in olives and in certain other foods, and is perfectly healthy when you ingest it — but when injected into the bloodstream, it can have adverse effects."
Adjuvants enhance or "supercharge" the immune response, reduce the number of vaccines needed, and allow supplies to last longer. Currently, aluminum salts are the only approved vaccine adjuvants for use in the United States. The use of adjuvants has been suspected, but not confirmed, in the development of illnesses in Gulf War veterans who may have received squalene-containing anthrax vaccines.
However, the current stock of U.S. swine flu vaccines does not contain adjuvants, according to Anne Schuchat, MD, in an informational video produced by the Centers for Disease Control and Prevention (CDC).
Schuchat does acknowledge that there is an emergency provision to use them — should the pandemic accelerate.
Adjuvants are being used in swine flu vaccines in countries outside of the United States, including Canada, Europe and Australia. However, even though Canada is using an adjuvanted vaccine, it has also ordered 1.8 million doses of the unadjuvanted vaccine for use in pregnant women and children under the age of 3.
Peta's poster campaign stating 'Meat Kills' could cause undue fear, rules advertising watchdog
The advertising watchdog has banned an ad campaign by animal rights group Peta for misleading consumers that swine flu could be contracted by eating meat.
Peta's poster campaign stated "Meat kills" in large letters. In the background smaller text listed a range of superbugs including E.Coli, mad cow disease, swine flu and MRSA. The words "swine flu" were more prominent than the surrounding text. A line at the bottom of the ad said: "Go Vegetarian. Peta".
The Advertising Standards Authority received a complaint that the poster misleadingly implied that swine flu could be caught be eating meat and that it might cause "undue fear" about how it could be contracted.
Peta said it did not intend to suggest that eating meat caused swine flu but wanted to highlight the role that livestock production played in the incubation, development and spreading of fatal infectious diseases.
Patients could be put at risk because as few as 10 per cent of NHS staff may volunteer to have the swine flu vaccine, managers warn.
Doctors and nurses are shunning the jab because they believe the virus is mild and there is only a slim chance they will get the disease.
But NHS bosses say their reluctance could lead to needless deaths during the expected second wave of the disease as staff pass the virus on to frail patients and those with compromised immune systems.
And if staff are unprotected from another onslaught of the bug, sickness rates could lead to cancelled operations.
The situation has forced the Department of Health to order all NHS organisations to ensure frontline staff get immunised against the disease.
A poll by Pulse magazine showed that 49 per cent of GPs would reject the jab; and last week a Nursing Times survey showed that 47 per cent of nurses were definitely not going to have the jab, while just 23 per cent said they definitely were.
Ian Dalton, the NHS's national director of flu resilience, has told chief executives and boards to maximise the number of workers having the jab.
He wrote in a letter: 'We all know that uptake of the seasonal flu vaccine among NHS staff is traditionally low.
'It is an NHS board responsibility that we do not find ourselves in this position with the swine flu vaccine.'
SCOTLAND'S swine flu death toll hit 14 last night - as two more victims were revealed.
The latest to die were a 48-year-old man from Glasgow and a Fife woman aged 81 - making it four fatalities in the last two days alone.
Government chiefs said the male patient had "significant" underlying health problems, while the H1N1 virus was a "contributory factor" in the pensioner's death.
Last night Health Secretary Nicola Sturgeon said: "Our thoughts are with the families and friends of both patients, and I express my sincere condolences to everyone who knew them."
It comes just 24 hours after the deaths of two men - one aged 42 from Glasgow and a 75-year-old from Grampian.
Ms Sturgeon added: "In the vast majority of cases, most people have fairly mild symptoms and make a full recovery within a week.
"Vaccination is the best defence we have against the H1N1 virus and Scotland is preparing very well for the first phase of the vaccination programme which is due to start later this month."
It is estimated around 6,800 people caught the bug last week.
Health chiefs predict up to 30 per cent of Scots could eventually contract the virus - with one per cent ending up in hospital.
GPs across the nation are set to give the anti-swine flu jab to patients deemed to be "at risk".
Around 1.4 million people in Scotland will receive the vaccination by the end of the year.
The number of UK deaths linked to swine flu now stands at 94 - including the two latest cases.
In Scotland alone, 36 people were admitted to hospital with the H1N1 bug last week - the largest weekly increase since the outbreak began.
The figure takes the number of people being hospitalised in Scotland since the start of the outbreak to 208.
Over 100 prescriptions for antiviral medication are being handed out in Northern Ireland each day — with health experts warning the worst of the swine flu pandemic is yet to come.
Latest government figures on the spread of swine flu throughout Northern Ireland are to be released today and are expected to show a further sharp hike in the number of laboratory confirmed cases, GP consultations and hospitalisations across the province due to swine flu.
Government statistics relating to the four-week period between the weeks ending September 4 and September 25 have already reinforced warnings by health officials of an explosion in swine flu cases, while the death on Tuesday of a young child with the virus has raised further fears among parents across Northern Ireland.
At the beginning of September there were an average of two new laboratory confirmed cases each day but this had risen to eight every day by the end of the month.
Another child with swine flu has died in Northern Ireland - the second in less than 48 hours.
The 12-year-old boy died in the Ulster Hospital at Dundonald on the eastern outskirts of Belfast.
The Department of Health in Belfast said the boy had a "serious underlying medical condition" but would not elaborate.
Health Minister Michael McGimpsey, who conceded there was now a high level of swine flu in Northern Ireland, said: "It is very sad when a child dies and my thoughts and sympathies are with the family. I would ask everyone to respect the privacy of the family at this very sad time."
He warned: "Incidents of swine flu in Northern Ireland remain high and we must expect further increases in cases in the weeks ahead.
"Swine flu remains a major public health threat but we are well prepared and have been planning for a pandemic for some time."
Hugh McCaughey, chief executive of the South Eastern HSC Trust, which runs the Ulster Hospital, said: "Our thoughts at this time are with the boy's family. We should also not forget our staff who have cared for him on a regular basis during his many hospital visits."
The boy's death was the fourth related to swine flu in Northern Ireland. On Wednesday it was announced a toddler under the age of three had died in the south east of the province on Tuesday.
A baby died last month but a pre-existing heart condition was determined as the cause of death. In August the mother of two young children died. She had been fighting cancer for five years.
A soldier from Co Londonderry, who was based in the south of England, also contracted the virus and died in Surrey at the end of July.
The first swine flu vaccine doses have arrived in two North Florida counties. More vaccine will be flooding into Florida soon
The first swine flu vaccine arrived in Florida on Thursday, in Jefferson and St. Johns counties -- two northern Florida counties that together have had only one flu death since the H1N1 influenza began its spread in April.
Chief medical officer now optimistic about the scale of the epidemic
Britain's swine flu outbreak is slowing down, possibly as the result of a "lucky break" in the way the virus has behaved, the chief medical officer said today.
Sir Liam Donaldson, who has been generally cautious in his weekly predictions on the likely course of the epidemic, was more optimistic as he suggested during a news conference that the peak number of cases may be lower than previously thought.
The rate of increase looks to be nothing like the weekly doubling of cases that experts had predicted. Last week, there were 18,000 new cases of swine flu, rising from 14,000 the previous week and 9,000 the week before that.
"We are well into the second wave of pandemic flu, having had the first wave in July, but it's proving so far to be a slow burner," Donaldson said. "It's possible that it might peak at a lower level – and an earlier level – than expected which would be incredibly positive news.
"It means we could get the vaccine programme well under way. If this virus has another peak up its sleeve, as in 1968, we might be able to avert that completely."
The news did not look as good in Northern Ireland, however, where a 12-year-old boy died in the Ulster hospital at Dundonald on the eastern outskirts of Belfast – the second death in less than 48 hours.
The Department of Health in Belfast said the boy had a "serious underlying medical condition" but would not elaborate.
The health minister, Michael McGimpsey, who conceded there was now a high level of swine flu in Northern Ireland, said: "It is very sad when a child dies and my thoughts and sympathies are with the family. I would ask everyone to respect the privacy of the family at this very sad time."
He warned: "Incidents of swine flu in Northern Ireland remain high and we must expect further increases in cases in the weeks ahead. Swine flu remains a major public health threat, but we are well prepared and have been planning for a pandemic for some time."
Four people from Northern Ireland have now died from the complications of swine flu. The last death, on Tuesday, was of a three-year-old in the south-east. The two previous victims were a mother of two young children, who died in August, and a soldier from Co Londonderry who was serving in the south of England and died in July.
There have been 76 deaths in England, one in Wales and two in Scotland. There are 290 people in hospital in England with diagnosed swine flu, of which 47 are in intensive care. Sir Liam said the number of people in intensive care was the highest figure for the last two months. He said this was a "bit of a concern".
Half a million doses of one of the two swine flu vaccines ordered by the government, made by Baxter, are now in stock in the UK, but deliveries from GlaxoSmithKline are still awaited. The government hopes to start vaccinating frontline health workers and priority groups by the end of this month.
"We may have got a lucky break in how the virus has behaved at the start of our flu season and we may be able to get the vaccine out there before our flu season really gets under way," said Donaldson. "I'm looking at it very optimistically."
A large clinical trial to compare two UK swine flu vaccines in children was launched at the weekend. It will assess which vaccine will be most suitable for children to have during the national vaccination programme.
The vaccines, which last week received positive recommendations from the European Medicines Agency health watchdog, will be given to 1,000 children aged six months to 12 years. Following two doses of either vaccine, blood tests will confirm which vaccine stimulates the greatest immune response to the swine flu virus. The testing will also check for potential side effects, although the trial leaders believe any will be mild.
The news comes as the chief medical officer (CMO) announced that the second wave of swine flu has now begun, with the latest official figures showing that swine flu infections are steadily mounting. In the past week there were 14,000 new cases, a 45% increase over the previous week. Schoolchildren were the group most affected.
During his weekly update the CMO, Sir Liam Donaldson, said he expected the vaccine to be available to at-risk patients later this month.
He said, “The good news is, we’ve got the green light to approval of the vaccine at European level and we’re expecting to be able to start administering it in the second part of October."
Weekly update
Other news from the weekly update:
There are 286 people in hospital with swine flu, 36 of whom are in critical condition. This is a substantial rise.
To date, 84 people with swine flu have died in the UK. There have been 72 deaths in England, nine in Scotland, two in Northern Ireland, and one in Wales.
A swine flu vaccine has now received licensing approval, meaning the first doses of the vaccine should be administered in the second half of October.
There have been 79 school outbreaks (defined as at least 15% absenteeism or a marked increase in cases) since the pandemic began.
While concern over the spread of the H1N1 virus sweeps the country, epidemiologists in New York and a few other cities that were awash in swine flu last spring are detecting very little evidence of a resurgence.
Although flu season will not peak until the weather gets cold, in New York, which was the nation’s hardest-hit city, officials say that flu activity is no higher than it normally is at this time of year and that school attendance is normal.
Last week, Dr. Anne Schuchat, the director of immunization at the federal Centers for Disease Control and Prevention, said, “Most states do have quite a lot of disease right now, and that’s unusual for this time of year.”
But public health officials say there appears to be a pattern of areas that had big outbreaks in the spring, like New York, Boston and Philadelphia, seeing less swine flu now.
Sky News understands that the first batch of flu vaccine is expected at hospitals on October 14.
This will be given to front-line health workers and the most vulnerable patients first.
Family doctors will get their first batches on October 19.
Around 4.7m batches of the vaccine were due to be delivered by end of September but only 300,000 were delivered.
The government's chief medical officer Professor Sir Liam Donaldson told Sky News: "We've not quite seen a doubling (in cases), which is better news.
Normally at this point in the second wave of a pandemic we would be starting to see explosive increases in numbers. We're seeing it steadily mounting.
"On vaccination, the good news is that we've got approval of the vaccine at European level and we're expecting to be able to start administering in the second part of October."
Asked if there was enough vaccine available, he replied: "We'll actually have enough to treat the priority groups to begin with.
"Ultimately, the virus is going to be around for quite a time, so everybody will have the chance to be protected, even though some people probably get the disease before the vaccine's available.
"But we can only produce a vaccine as quickly as modern technology will allow."
The first children in Britain have started receiving a swine flu vaccine as part of a major new trial.
Researchers are hoping to use around 1,000 youngsters over the next fortnight to see which of two different drugs perform the best.
The children, aged between six months and 12 years, are being recruited at five test venues in Oxford, Bristol, Southampton, Exeter and London.
One vaccine being used - Pandremix, made by GlaxoSmithKline (GSK) - has been approved by European regulators.
Another made by Baxter is still being considered by the European Medicines Agency but could get approval this week.
Head researcher Professor Andrew Pollard, from the University of Oxford, said: "We are doing this trial to compare head-to-head the two vaccines which are going to be used in the UK against swine flu to see which one works best in children and which one is best tolerated.
"We are sort of in a race against time because we know the flu season is already started. We hope to immunise the children over the next 10 days or so."
The most recent data from the Government showed the number of swine flu cases across the country almost doubled in a week, from an estimated 5,000 to 9,000, prompting speculation a second wave of infections could be on its way.
The Government is hoping to start vaccinating millions of people in high-risk groups, such as those with asthma and diabetes, and health workers, next month.
Across the UK, 82 deaths have been linked to the virus, with 70 in England, nine in Scotland, one in Wales and two in Northern Ireland.
WASHINGTON - After months of warnings and frantic preparations, the second wave of the swine flu pandemic is starting to be felt around the country. Doctors, health clinics, hospitals, and schools are reporting rapidly increasing numbers of patients experiencing flu symptoms.
While most cases so far are mild, and the health care system is handling the load, officials say the number of people seeking treatment for the flu is unprecedented for this time of year.
In Austin, so many parents are rushing their children to Dell Children’s Medical Center of Central Texas with swine flu symptoms that the hospital had to set up tents in the parking lot to cope with the onslaught.
In Memphis, the Le Bonheur Children’s Medical Center emergency room got so crowded with feverish, miserable youngsters that it had to do the same thing.
And in Manning, S.C., a private school where an 11-year-old girl died shut down after the number of pupils who were out sick with similar symptoms reached nearly a third of the student body.
“It just kind of snowballed,’’ said Kim Jordan, a teacher at Laurence Manning Academy, which closed Wednesday after Ashlie Pipkin died and the number of ill students hit 287. “We had several teachers out also.’’
“H1N1 is spreading widely throughout the US,’’ said Thomas Frieden, director of the federal Centers for Disease Control and Prevention in Atlanta. The CDC reported last week that at least 26 states are now reporting widespread flu activity, up from 21 a week earlier.
Even though some parts of the Southeast that started seeing a surge of cases first now seem to be showing a decline, that could be a temporary reprieve, Frieden said. And other parts of the country are probably just starting to feel the second wave.
“Influenza is perhaps the most unpredictable of all infectious diseases,’’ Frieden said.
The pandemic has prompted scattered school closings around the country in recent weeks, including 42 schools that closed in eight states Friday, affecting more than 16,000 students.
Many colleges and universities have been hit particularly hard, forcing some to open separate dorms for sick students. Ninety-one percent of the 267 colleges and universities being surveyed by the American College Health Association are now reporting cases.
The government is starting an unprecedented system to track possible side effects as mass flu vaccinations begin next month. The idea is to detect any rare but real problems quickly, and explain the inevitable coincidences that are sure to cause some false alarms.
In just a few months, health authorities hope to vaccinate well over half the population against swine flu, which doctors call the 2009 H1N1 strain. No more than 100 million Americans usually get vaccinated against regular winter flu, and never in such a short period.
The last mass inoculations against a different swine flu, in 1976, were marred by reports of a rare paralyzing condition, Guillain-Barré syndrome, a sometimes fatal paralysis. Other possible side effects could potentially include heart attacks, strokes, seizures, and miscarriages.
Swine flu cases in England almost doubled last week with at least 66 schools reporting outbreaks, according to the Department of Health.
The increase – from 5,200 cases in the previous week to 9,000 last week – appears to be the beginning of a second wave of infections. So far there have been 82 deaths in the UK. The number of patients in hospital has also begun to climb again.
The race to licence and distribute the anti-pandemic flu vaccine before the next peak of cases may be close, the government's chief medical officer, Sir Liam Donaldson, implied today, at the weekly swine flu briefing. "Our suspicion is that we will start to see a speedier increase."
The first swine flu vaccines are expected to be given out in October to vulnerable risk groups and key health workers.
The government is waiting for European regulators to license the swine flu vaccine before it can be given out. One dose per person may be sufficient to deliver immunity, Donaldson said, although vulnerable groups, such as children, may need two.
Infection rates are rising, even though the flu season has not yet started. France, which had few cases earlier in the summer, is now suffering a major outbreak.
In Geneva, the World Health Organisation warned today that not enough of the anti-pandemic flu vaccine will be produced this year to safeguard the planet. It has downgraded its estimate of the number of doses that will be manufactured globally from 5 billion to 3 billion. The problem, said Dr Marie-Paule Kieny, director of WHO's initiative for vaccine research, was a poor yield from viruses grown in hen's eggs. It had been half or a third the amount of virus that is normally produced for seasonal flu vaccines. Inevitably, rich countries will get the quantities of vaccine they want, because they already have contracts with manufacturers. Countries with their own production capacity, such as China and possibly Russia, will also get good supplies, she said.
The WHO's supplies will go to the most needy countries' health workers first.
For the first time, the Department of Health released numbers of schools reporting outbreaks. There are 27 schools with swine flu cases in Yorkshire and the Humber, 12 in the West Midlands, eight in the east Midlands, six in London and 13 in other parts of the country. In Yorkshire and the Humber, two schools reported infected pupils last Thursday, six by the following day, 10 by Monday, 16 on Tuesday and by Wednesday this week 27 schools reported cases.
Across England the number of people being treated in hospital has risen by more than 50%, from 143 last week to 218 this week. Of those, 25 are in intensive care.
In Scotland about 7,000 people are thought to have the virus – a slight increase on last week. Of the deaths in the UK, 70 have been in England (up three in the last week), nine in Scotland, one in Wales and two in Northern Ireland.
Prof Sir Liam Donaldson, the Chief Medical Officer, admitted that he would have liked “more breathing space” before infections, always predicted to increase in the autumn, started to rise again.
He also announced that Britain has seen its first cases of the flu resistant to Tamiflu, the main anti-viral drug used to reduce the severity of symptoms.
However, in neither of the two cases reported did the resistant strain of the virus spread
Over a third of GP surgeries have seen patients suffering complications after being misdiagnosed with swine flu including at least three deaths, a survey suggests.
Family doctors have reported effects ranging from mild adverse reactions to the antiviral drug Tamiflu to severe case of tonsillitis, meningitis and pneumonia.
Three out of 205 family doctors and practice managers surveyed by the health magazine Pulse reported a patient dying after being misdiagnosed.
Ninety one per cent of those polled called on the Government to review its policy of offering Tamiflu to all patients with swine flu symptoms.
The findings have been published within days of Government figures showing a jump in the number of swine flu cases in the last week.
Experts have been predicting a second wave of the disease will hit the UK in the winter months after a lull during the summer break.
There have been 67 deaths linked to the virus in England, nine in Scotland, two in Northern Ireland and one in Wales.
More than 1.3 million people have been assed via the National Pandemic Flu Service for England with 522,890 collecting anti-viral drugs.
The Government is currently waiting for European regulators to license a swine flu vaccine before issuing it to health workers and at-risk groups across the UK.
Earlier this month prescribing experts called for the NHS to urgently review the use of Tamiflu, with concerns that the public has been misled about the effectiveness of the drug.
One GP, who did not want to be identified, told Pulse that a patient had died from meningitis after being wrongly diagnosed over the telephone.
Two other practices, in Dorset and Wiltshire, also reported that one of their patients had died. There has been a range of lesser side-effect to anti-viral treatment including, diarrhoea, vomiting and lethargy.
Dr Ellen Wright, a GP in Greenwich, south London, whose son contracted swine flu early in the first wave, said mild adverse reactions to anti-viral drugs had been widely reported.
She added: “There have been a lot of complications, especially in children given it in schools at the beginning of the outbreak, and I suspect that is what a lot of GPs have been seeing.”
A family doctor in Derbyshire reported the case a three year old girl who was diagnosed with swine flu and prescribed Tamiflu by the National Pandemic Flu Service.
She was later found to have bacterial pneumonia and admitted to hospital a few days later.
The GP said: “It was unlikely she ever had swine flu. It is near-impossible to diagnose a febrile illness over the phone, and I am afraid one could miss meningitis or other serious illnesses by presuming it is wine flu.”
Another GP in Tyne and Wear reported that one of her patients who was initially thought to have swine flu was later diagnosed with salmonella.
The patient was later admitted to hospital after extreme dehydration as a result of the food poisoning.
A deal has been struck with GPs in the UK, who will receive £5.25 for each dose of the swine flu vaccine they give to patients.
It is hoped that at-risk groups, such as those with diabetes or asthma, will be able to get their normal seasonal flu jab at the same time.
However, GPs are being told not to hold off starting the seasonal flu vaccine programme until the swine flu vaccine arrives.
A total of 132 million doses have been ordered by the UK Government - enough for the entire population with two doses each.
WALES is on the cusp of a second wave of swine flu, health officials have warned.
Figures for the past two weeks show there were 510 cases of swine flu in Wales, up almost 50% on the start of September.
They come as research will today show that flu can trigger heart attacks and cause cardiovascular disease.
An article in The Lancet Infectious Diseases said the influenza vaccine may offer protection for heart patients.
The review’s author, Dr Andrew Hayward, of University College London, said more efforts were needed to encourage people with heart disease and diabetes – which increase the risk of heart attacks – to have the flu jab.
He said this could be especially important with the looming double blow of the H1N1 influenza pandemic and a seasonal flu outbreak, when many more people are expected to catch the flu.
Dr Roland Salmon, director of the communicable disease surveillance centre for the National Public Health Service for Wales, said there were already “a few pointers” that a second wave of swine flu will emerge before Christmas.
“We are starting to see the number of cases drift up in Scotland and parts of England and I expect Wales to follow suit,” he said.
“Although the number of cases being reported fell from the high rates in July and August it has never actually gone away, it was always still out there.”
The latest figures show that in the past week 510 people across Wales reported swine flu symptoms, rising from 300 a week at the beginning of the month.
The highest levels are still along the M4 corridor and in Wrexham.
Dr Salmon added: “I’m expecting to see a build-up in the number of new cases but whether that is in four, eight or 10 weeks I don’t know.
“If it’s towards the end of October and beginning of November then this would coincide well with the new vaccine once trials have been completed and it is licensed for use.
“When this comes on stream it will give us a good opportunity to reduce the second wave.”
At his weekly briefing, the chief medical officer for England, Sir Liam Donaldson, said:
"We might be seeing the start of an upturn. There are straws in the wind, from the increase in consultations with GPs and a small increase in hospitalisations. It suggests swine flu is coming back."
The estimated number of cases in England rose last week from 3,000 to 5,000. In Scotland, cases also rose sharply to around 6,000. There were small rises in Northern Ireland and Wales.
So swine flu is back. It never, of course went away. It's worth remembering that in one week in July, there were more than 100,000 cases. It seems likely that we are at the start of the next upturn. There have been outbreaks in several schools, but it's unlikely that schools will close because the virus is so entrenched in the community.
It bears repeating that the vast majority of people who get infected will get a mild illness. Very few people die from H1N1 swine flu, although it does cause complications in a minority. On the morning of 16 September, there were 143 people in hospital in England with swine flu, of whom 23 are in critical care.
So far, 79 people have died after contracting the virus, far lower than the number of those who die from seasonal flu (anything from 4,000-12,000 in a normal year). The difference is that swine flu is targeting younger age groups whereas seasonal flu usually kills the frail elderly. About one in five of the deaths from swine flu has been in previously entirely healthy people.
Routine operations being cancelled to free up staff as traditional flu season approaches.
The NHS is preparing to double its intensive care capacity to cope with the predicted surge in swine flu cases in the autumn, the chief medical officer said today.
Routine operations will be cancelled so theatre staff and equipment can be redeployed on flu patients, and new ventilators will be bought, Sir Liam Donaldson said. He also launched a consultation on allowing one doctor rather than two to section a mentally ill person and send them to hospital, in the event that the second wave of swine flu drastically reduces numbers of NHS staff able to work.
The announcements came as the government's chief scientist, Professor John Beddington, said it was "virtually impossible" that Britain would be spared an autumn outbreak coinciding with the traditional flu season. It could be with us in less than a month, he said.
"It's hard to imagine there won't be a second wave, in fact it's virtually impossible, but whether it comes early in October at a high level, or in more moderate waves late in the year is not possible to predict," said Beddington at the British Science Association festival in Guildford.
At the Department of Health in London, Ian Dalton, national director of NHS flu resilience, said it had been decided to carry on with contingency plans originally devised to cope with bird flu, even though the government's expert advisory committee now believes that only 1% of patients, instead of 2%, will be hospitalised. "But that's still the basis on which we are planning – which we think is the prudent place to be," said Dalton.
Donaldson denied that doubling critical care beds was a political decision. Last week the Tories claimed the NHS might not have enough intensive care beds to cope with a second wave.
"I don't think it is political," said Donaldson. "I think we're tantalisingly close to being able to win the battle against this pandemic virus. In the past we have had to take whatever it throws at us and chalk up the extra deaths.
"Albeit it is mild, it can still kill … We are closer and closer to having a vaccine available. Every patient counts."
Neither Donaldson nor Dalton were able to put figures on the amount of money that scaling up critical care will cost.
The plans are to double intensive care beds from the current 1,982 for adults in England and 363 for children. Scotland, Wales and northern Ireland will make similar arrangements.
Beddington also defended the decision to make Tamiflu available to all through GPs. Some scientists are concerned that the move would increase the chances of the virus becoming resistant before a vaccine was ready. So far, only a dozen or so cases of drug-resistant swine flu have been confirmed worldwide.
The NHS may not have enough intensive care beds to cope if a second wave of swine flu hits the country, the Conservative party claims today. Hospitals are already at "breaking point" and having to close critical care beds to new admissions for large parts of the year, shadow health secretary Andrew Lansley says. The allegation comes amid intensifying party exchanges over the NHS. According to FOI requests returned to the Tories, almost 2,000 people in England had to be discharged early from intensive care last year while 20,000 were discharged belatedly because of shortages of other beds.
Most companies in Britain have not been affected by the outbreak of swine flu, research has found, compounding fears that the virus could derail the country's fledgling economic recovery.
But the survey of 450 companies by the British Chambers of Commerce (BCC) found that fewer than half of firms had contingency plans in place to cope if the swine flu outbreak gets worse, despite warnings of a second wave in the autumn.
The report, the first of its kind, said 83.7% of businesses had not been affected by the spread of swine flu and only a third believed the disease could threaten the UK's recovery from recession.
As a result, many have failed to draw up contingency plans for dealing with large numbers of workers taking time off if they contract the H1N1 virus.
There had been fears that businesses, shops and distribution centres could be forced to shut if the virus spread rapidly. Airlines and other transport services could also be disrupted.
The BCC's findings refute claims that workers are using the virus as an excuse to take sick days. Anecdotal evidence shows employers are more likely to tell staff to stay away if they have symptoms.
The TUC general secretary, Brendan Barber, said: "This shows that, contrary to what some have been claiming, workers are not using swine flu as an excuse to take time off work."
He called on employers not to become complacent about the threat to their staff simply because infection levels had declined in recent weeks. The government's chief medical officer, Sir Liam Donaldson, has repeatedly warned of a second wave of swine flu in the autumn.
Barber said: "Employers should be using this time to work with their staff to ensure they have contingency plans in place to deal with any possible resurgence of the virus in the autumn."
A BCC spokesman said: "We haven't seen any evidence of employees skiving en masse because of swine flu." But he said the government needed to exercise caution in its plans to allow employees infected with swine flu to stay off work for 14 days without a doctor's note, rather than seven days.
GPs have been seeing a high number of patients at the start of the week and Donaldson said the National Pandemic Flu Service for England received most calls from patients on Mondays.
But he shrugged off the idea that workers were faking sickness: "I think people traditionally hold on to their illnesses over the weekend, then see their GP on Monday."
As schools reopen, health authorities are bracing themselves for another rise in swine flu. The UK and the US governments say they will not close schools except under exceptional circumstances after experts claimed closures did not reduce the number of cases, but spread them over a longer period.
Several studies suggest up to 60% of GPs would oppose being immunised because they are concerned the safety trials will be rushed.
Many GPs, as well as their patients, may be reluctant to be immunised against swine flu once a vaccine is developed, surveys suggest today.
A survey of GPs published on Healthcare Republic, the website of GP magazine, found that up to 60% of GPs may decline vaccination. Although the numbers who responded were small – 216 GPs – they are in line with a much bigger survey of nurses published a week ago by Nursing Times, which found that a third of 1,500 nurses would refuse vaccination.
18/08/09
The number of cases of swine flu in England continued to fall last week (week ending 9 August). The Health Protection Agency (HPA) estimates there were 25,000 new cases of swine flu in England last week, compared with 30,000 the week before and 100,000 the week before that. Cases of swine flu have fallen in all regions and among all age groups.
The disease is generally mild in most people so far, but is proving severe in a small minority of cases. So far 371 people have been hospitalised in England, while 44 people have died.
Swine flu vaccine
The government has announced that priority for the swine flu vaccine will be given to at-risk groups. These include pregnant women and people with serious underlying health conditions.
Vaccinations for these groups are expected to begin in the autumn. Steps are being taken to extend the vaccination programme to other people once this stage has been completed.
Children should not be given Tamiflu, Oxford researchers
Children should not be given the antiviral drug Tamiflu for swine flu because its harms outweigh any benefits and the Government should review its policy on dealing with the pandemic, researchers have said.
Anti-viral drugs Tamiflu and Relenza, reduce the length of time children are ill with flu by about one day and can cause vomiting as a common side effect, Oxford researchers found.
Vomiting is more dangerous in children than in adults as it can rapidly lead to dehydration and admission to hospital, they said.
Also the drugs had little or no effect on asthma flare-ups, ear infections or the likelihood of a child needing antibiotics meaning on balance the medicine does more harm than good in otherwise healthy children, the authors said.
It comes after research last week showed that Tamiflu reduced the length of flu in adults by just half a day.
Together the findings will question whether the Government's policy of stockpiling enough antiviral drugs for 80 per cent of the population was a waste of money. The exact cost of the stockpile has been kept secret for 'commercial reasons' but is expected to run to tens of millions of pounds.
Countries around the world have stockpiled around 50m doses of Tamiflu, made by Roche, for use during a flu pandemic.
Tamiflu has also been linked to side effects such as insomnia and nightmares in children.
Dr Matthew Thompson, a GP and senior clinical scientist at Oxford University and Dr Carl Heneghan, a clinical lecturer at Oxford University, said the findings review of seven research studies should prompt the Department of Health to reconsider its policy.
The study, published online in the British Medical Journal, reviewed trials where children aged between one and 12 were either given Relenza or Tamiflu to treat seasonal flu or where one of their family had flu and they were given medicine to stop them becoming ill.
The researchers said although the studies were carried out on seasonal flu the findings are relevant to the current swine flu outbreak.
The drugs may still be of some benefit for children who have underlying conditions such as cystic fibrosis or whose immune system is compromised because they are being treated for leukaemia, for example, but there was not enough evidence to be conclusive about this, the researchers said.
Dr Thompson said the Government's current policy of giving Tamiflu to all symptomatic people was 'inappropriate'.
GPs are using their clinical judgement and providing anti-virals to severe cases of flu but the National Pandemic Flu Service is handing out the drugs to anyone who fits the criteria for having a flu-like illness. Data from the Health Protection Agency has suggested only one in four of those with symptoms will actually have swine flu.
The Flu Service handed out 150,000 doses of Tamiflu in its first week as cases peaked at around 110,000 in seven days.
Dr Thompson said: "Reserving these antiviral drugs for children who are more likely to have complications may be a more sensible strategy and would take some of the pressure off the current public demand for anti-virals."
Dr Heneghan warned that prescribing the drugs so widely will encourage flu to become resistant to the medicine.
He said: "Going forward we have a treatment which is ineffective because we've given it to everybody."
He also warned that people were relying on Tamiflu, 'like a magic bullet', and this meant that serious complications of swine flu could be dismissed in those on the drug.
Parents should treat flu in children with paracetamol and rest but watch carefully for complications and contact their GP if they are worried, the authors said.
The research trials which were reviewed have been available for over a year and the Government could have carried out its own study in this before the outbreak of swine flu began, they said.
The findings also showed that when using antiviral drugs in children who have been exposed to flu but do not yet have symptoms, as preventive treatment, they were of limited use. They found 13 children need to be treated to prevent one case, meaning onward transmission was only reduced by eight per cent.
Government data released on July 30th suggested that by then one in 77 children aged between one and four had already had swine flu along with one in 95 of those aged between four and 14.
Norman Lamb, Liberal Democrat health spokesman said: "An urgent review must be carried out into whether the benefits of prescribing certain antiviral drugs are worth the risks when it comes to our children’s health.
“Parents will now need urgent guidance and reassurance about what exactly they should be doing to look after their children. This is even more crucial given that health experts are predicting a surge in swine flu cases this autumn.”
A Department of Health spokesman said: "The BMJ review is based on seasonal flu and not swine flu. As the authors note, the extent to which the findings can be applied to the current pandemic is questionable - after all, we already know that swine flu behaves differently to seasonal flu, and past pandemics have hit younger people hardest.
"Whilst there is doubt about how swine flu affects children, we believe a safety-first approach of offering antivirals to everyone remains a sensible and responsible way forward. However, we will keep this policy under review as we learn more about the virus and its effects.
"For those who experience severe symptoms, the best scientific advice tells us that Tamiflu should still be taken as soon as possible - and to suggest otherwise is potentially dangerous.
"If people are in any doubt about whether to take Tamiflu, they should contact their GP."
The latest figures have suggested the first wave of the swine flu outbreak has peaked with officials saying around 30,000 new cases were diagnosed in the week ending August 1st but a second wave it still expected later in the autumn.
The Chief Medical Officer Sir Liam Donaldson said he remained "cautious" about the current fall in the number of new swine flu cases
The number of new cases of H1N1 swine flu in England and Scotland has fallen significantly, latest figures show.
England recorded an estimated 30,000 cases last week, compared with 110,000 the week before. In Scotland estimated numbers fell from 1,500 to 1,050.
The Health Protection Agency said there was no sign that the virus was mutating into a more lethal form, or developing resistance to drugs.
The total of swine flu-related deaths in England and Scotland stands at 40.
In all, 530 patients were admitted to hospital in England last week, down on the previous week's total of 793.
Wales is also reporting falling but widespread levels of "influenza like illness" with an estimated 2,670 new cases compared with 4,410 last week.
Cases in Northern Ireland seem to have risen with 83 new cases compared with 10 the week before.
HIGHEST FLU RATES IN ENGLAND
Wakefield District 188 GP consultations per 100,000
Tower Hamlets 163
Gateshead 161
Greenwich 137
Southwark 130
Hackney 129
Islington 126
Milton Keynes 123
North Tyneside 119
South Birmingham 117
Officials have always predicted rates of infection would fall away in the summer before a large surge in the autumn to coincide with the normal flu season.
England's Chief Medical Officer, Professor Sir Liam Donaldson, said it was very difficult to predict when a second wave would hit.
"It's guesswork really - we would anticipate that when the schools go back, at some point after that it would rise.
"We can't be complacent about this, we have to continue planning, we have to be ready for what happens in the autumn."
He added that the national pandemic flu service, launched two weeks ago to take the pressure off GPs, was "flexible enough" to scale up or down dependent on levels of swine flu.
Figures from the Department of Health suggest three-quarters of the general public are not very or not at all worried about swine flu.
Awareness is high, with 37% saying they heard a great deal about swine flu in the media in the past week.
Experts are currently looking at what is happening in the southern hemisphere to help predict what could happen in the UK over the winter months.
In the past week deaths in Argentina from swine flu have risen sharply and currently stand at 337.
There are also indications that Mexico may be now seeing a second wave of cases.
Vaccine
Meanwhile, the World Health Organization has announced that the first swine flu vaccines are likely to be licensed for use in the general population in September.
Several manufacturers have produced initial batches of a H1N1 vaccine and some clinical trials are already underway.
WHO director of vaccine research Dr Marie-Paule Kieny also sought to calm fears about safety of new vaccines.
She said the vaccines were based on "old and proven technology".
We can't be complacent about this, we have to continue planning, we have to be ready for what happens in the autumn
Professor Sir Liam Donaldson
Although it has not yet been clarified who would be first in line for a vaccine, it is likely to be those who are most vulnerable, such as pregnant women and young children.
Some experts have raised concerns about the lack of safety data on flu vaccines in these groups.
In particular a very rare neurological condition called Guillain-Barre syndrome, which affected 500 people during a US vaccine programme against swine flu in 1976.
Dr Kieny said much was known about flu vaccines in these groups from seasonal vaccines given every winter and added that regulatory agencies would be monitoring for any signs of adverse reaction.
"The quality controls on today's vaccine are much better than they were 30 years ago," she added.
Regulators in the US and Europe have special plans in place to fast-track swine flu vaccines, some of which are based on conventional seasonal flu vaccines and some which use newer technology.
It comes as drug company, Baxter, has announced the production of the first commercial batches of its swine flu vaccine Celvapan.
The vaccine has been grown using cell culture, a much faster method than the traditional way of growing it in eggs.
Baxter is one of two companies contracted to provide pandemic flu vaccine to the UK, the other being GlaxoSmithKline, and both plan to start clinical trials this month.
One key part of the trials is to work out whether people need one or two doses of the vaccine.
Ministers have repeatedly said they expect to have enough doses for half the UK population by the end of the year.
Sir Liam said vaccine advisors were still finalising plans on who would get the first doses.
The number of deaths in England linked to swine flu has jumped by nine to 36 in the past week.
But the Health Protection Agency (HPA) says the overall number of cases "decreased significantly" in the past seven days and there is no evidence the virus is mutating.
At a briefing in London, the HPA said 530 patients had been admitted to hospital in England which is down on last week's total of 793.
Meanwhile, company bosses have reported a steep rise in the number of staff self-diagnosing themselves with swine flu and taking time off.
Employment Law Advisory Services says it has received many more calls than normal from managers who claim "swine flu skivers" are causing more disruption to the workplace than the virus itself.
Thousands of healthy workers are thought to have taken advantage of official guidelines on the pandemic to extend their summer holidays.
Health officials said they had found cases of Tamiflu-resistant swine flu along the US border with Mexico, as India and South Africa announced their first deaths from the A(H1N1) virus.
"We have found resistance to Tamiflu on the border. We have observed some cases, few to be sure, in El Paso and close to McAllen, Texas," said Maria Teresa Cerqueira, head of the Pan-American Health Organization office in La Jolla, California.
Cases of A(H1N1) that were resistant to the anti-viral medicine have now been found in the United States, Canada, Denmark, Hong Kong and Japan.
Experts had gathered in La Jolla on Monday to discuss the response to the outbreak, and warned that resistant strains were likely emerging because of overuse of antivirals like Tamiflu.
"In the United States Tamiflu is sold with a prescription, but in Mexico and Canada it is sold freely and taken at the first sneeze. Then, when it is really needed, it doesn't work," said Cerqueira.
The Tamiflu-resistant cases were reported as South Africa and India both announced their first fatalities from the A(H1N1) virus, which emerged in Mexico in April and has since spread worldwide, gaining pandemic status.
In South Africa, health authorities said Ruan Muller, a 22-year-old student at Stellenbosch University near Cape Town, had died after contracting the virus.
"He died on the 28th (of July), but there had to be some testing done to ensure the cause of death. It was the A(H1N1) influenza," said Fidel Hadebe, spokesman for South Africa's Department of Health.
With the world's highest number of HIV/AIDS-affected people -- nearly 19 percent of a 49-million-person population -- South Africa is considered particularly at risk because people with compromised immunity are more likely to fall prey to the disease.
South Africa's swine flu caseload has increased fourfold since the country's first case was reported on June 14. The government has said its stockpile of Tamiflu will only be used for the seriously ill, but that schools may also be closed on a case-by-case basis.
In India, authorities said a 14-year-old girl in the western city of Pune became the country's first fatality from the virus.
The teenager first felt unwell on July 21, complaining of a sore throat, runny nose and headaches. She returned to school the following day after the general symptoms improved, the Ministry of Health and Family Welfare said.
She then developed a fever again on July 25 and two days later was admitted to a private clinic for treatment. She was put on a ventilator in an intensive care unit and was treated with Oseltamivir, a generic brand of Tamiflu.
"Her condition deteriorated again with multi-system involvement and (she) expired on the evening of 03.08.09," the ministry said in a statement.
Meanwhile, the Russian state health agency warned the country's football fans to stay away from the national team's World Cup qualifying tie with Wales in Cardiff on September 9.
"This would be an extremely unnecessary and inappropriate undertaking at a time of a flu epidemic," the head of Russia's state health agency Gennady Onishchenko said, according to local news agencies.
Onishchenko expressed fear that "the expressions of emotion on the part of football fans involving intense shouting" could lead to the airborne transmission of the flu virus.
Russia has to-date been relatively spared by the swine flu pandemic, with just 55 confirmed cases in the country.
Experts remain puzzled as to why different countries have not always been affected to the same degree, with England and Scotland both heavily hit proportionately, yet neighboring France's tally appearing light by comparison.
Some have argued that gargantuan sums being spent by rich economies on a disease that is no more lethal than seasonal flu are grotesquely disproportionate when thousands die each day of diseases which receive less media coverage.
The death toll in the swine flu pandemic has passed the 1,000 mark, with 1,154 deaths since the outbreak was uncovered in April, data published Wednesday by the World Health Organisation showed.
Swine flu now reaches 168 countries and territories, the WHO said in its latest update on its website.
As of July 31, Azerbaijan, Gabon, Grenada, Kazakhstan, Moldova, Monaco, Nauru, Swaziland, and Suriname were added to the ranks of countries reporting laboratory confirmed cases of influenza A(H1N1).
Just over a week ago on July 27, the WHO reported 816 deaths around the world.
The total number of laboratory confirmed infections worldwide reached 162,380, but the figure understates the full number since individual cases no longer have to be tested or reported.
Most of the deaths -- 1,008 -- have occurred in the WHO's America's region, encompassing North and South America and including Mexico and the United States, the countries where the new A(H1N1) pandemic strain first appeared.
Sixty-five deaths were reported in the WHO's regional office for South East Asia and 39 in its Western Pacific region since the outbreak began. Forty-one were reported in Europe.
By comparison, seasonal flu causes about 250,000 to 500,000 deaths a year, and results in about three to five million cases of severe illness, according to the WHO.
The number of new cases of swine flu in England appears to be levelling off, with an estimated 110,000 new cases reported last week. This compares to an estimated 100,000 cases the week before. http://www.nhs.uk/news/2009/04April/Pages/Swineflulatest.aspx
Sir Liam Donaldson, the Chief Medical Officer, noted that the change coincided with the break up of schools for the summer and the introduction of the National Pandemic Flu Service last week.
It made the announcement after confirming that 29 people in the UK - 26 in England and three in Scotland - have already died after getting the virus.
The Health Protection Agency (HPA) estimates there were 55,000 new cases of swine flu in England in the last week, including people visiting GPs and those who are looking after themselves at home.
Up to 85,000 people could be currently affected, the HPA modelling shows.
The UK has moved from the 'containment' to the 'treatment' phase of swine flu as the number of people catching swine flu continues to rise.
Health Secretary Andy Burnham said that cases are doubling every week and if it continues at this rate there could be over 100,000 cases per day by the end of August.
To date, a total of 7,447 cases of swine flu have been confirmed in the UK.
2/07/09
The UK has moved from the 'containment' to the 'treatment' phase of swine flu as the number of people catching swine flu continues to rise.
The move from containment to treatment will apply in all four nations of the UK - England, Scotland, Wales and Northern Ireland.
To date, a total of 7,447 cases of swine flu have been confirmed in the UK.
A further 342 people in England were confirmed with swine flu on Wednesday.
Together with 44 cases in Scotland, one case in Northern Ireland and four cases in Wales, there have now been 6,929 cases of swine flu confirmed in the UK.
30/06/09
A further 394 people in England were confirmed with swine flu on Tuesday.
Together with 196 cases in Scotland, two cases in Northern Ireland and nine cases in Wales, there have now been 6,538 cases of swine flu confirmed in the UK.
29 /06/09
A further 1,604 people in England were confirmed with swine flu over the weekend.
Together with 72 cases in Scotland, six cases in Northern Ireland and five cases in Wales, there have now been 5,937 cases of swine flu confirmed in the UK.
Some areas with high numbers of swine flu cases have moved from the 'containment' phase to an 'outbreak management' phase. This gives affected areas more flexibility to deal with the outbreak.
26/06/09
A further 535 people in England were confirmed with swine flu on Friday. This follows 111 cases in Scotland and five cases in Northern Ireland confirmed on Thursday and three cases in Wales announced earlier on Friday.
To date there have been 4,250 confirmed cases of swine flu in the UK.
A further 306 people in England were confirmed with swine flu on Wednesday.
This follows a further 40 cases in Scotland and one case in Northern Ireland announced on Tuesday, and three cases in Wales confirmed earlier today.
There have now been 3,254 cases of swine flu confirmed in the UK.
24/06/09
A further 109 people in England were confirmed with swine flu on Tuesday.
Together with the 21 cases in Scotland, three cases in Northern Ireland and two cases in Wales confirmed on Monday, there have now been 2,905 cases of swine flu confirmed in the UK.
WHO has now raised the level of the swine flu alert from Phase 5 to Phase 6 – its highest alert level. By raising the alert level to phase 6 the WHO is indicating that "a global pandemic is under way".
Dr Margaret Chan, WHO's Director-General, also said that "pregnant women are at increased risk of complications". Follow the 'Pregnancy and swine flu' link below for more information.
IE Hygiene Services provide Office Cleaning and PC Cleaning services across the UK. Milton Keynes Based, covering Luton, Bedford, Northampton, Oxford, Hertfordshire, London and surrounds.
The vaccine will start to be distributed to GP practices from the beginning of next week 
We can't be complacent about this, we have to continue planning, we have to be ready for what happens in the autumn 
