Swine flu to infect 100,000 a day by autumn

SWINE flu is spreading so rapidly across Britain that there could be 100,000 new cases a day by the end of next month.

The virus can no longer be contained, UK Health Secretary Andy Burnham said as he issued the alarming projection.

The Scottish Government, which is co-ordinating strategy with Westminster, said 10,000 people a day north of the Border were expected to contract the virus by next month.

Scotland's chief medical officer, Harry Burns, said: "It could be a bit less, it could be a bit more. It also presupposes that there isn't a downturn. It's doubling approximately every week – you can do the sums yourself."

In a statement to MPs yesterday, Mr Burnham said the government would now move on to a new "treatment phase". This means doctors will no longer routinely test for the H1N1 virus; instead, anyone with symptoms will be urged to stay at home.

It also emerged the virus could take five years to stamp out and that healthy young people could eventually die from swine flu.

There was now a "race against time" to get 60 million doses of a new vaccine rolled out before the end of the year, England's chief medical officer, Sir Liam Donaldson, said.

Of the 7,447 laboratory-confirmed cases in the UK, 1,263 are in Scotland. A further 46 were confirmed north of the Border yesterday.

Mr Burnham laid bare the extent of the disease projections for the whole of the UK.

His warning came days after Sameerah Ahmad, six, became the third person in the country to die after contracting the virus – the others were in Scotland.

"Cases are doubling every week, and on this trend we could see over 100,000 cases per day by the end of August," he said.

"We have always known it would be impossible to contain the virus indefinitely and that at some point we would have to move away from containment to treating the increasing numbers falling ill."

But his projection was challenged by a professor of virology at St Bart's and Royal London Hospital. Prof John Oxford said: "It seems like a lot of mathematical modelling and not too much common sense." He predicted swine flu would taper off with the warm summer weather.

The UK is to focus on treating those who have the H1N1 strain with anti-viral drugs, rather than trying to contain the disease. Patients will be asked to stay at home and GPs, rather than hospitals, will take the lead on diagnosing the flu.

Britain will be one of the first countries to obtain a new vaccine, with 60 million doses available by Christmas. Sir Liam said it was expected people would need two doses.

He also said swine flu was expected to follow the pattern of other flu pandemics, killing more young than old people.

While all three UK swine flu fatalities are believed to have had other health problems, Sir Liam said "not all the people who have died around the world so far have been young people with underlying health problems".

He went on: "When the GP sits down with the patient who is a young, healthy adult, who has the symptoms of swine flu, that doctor is not going to know whether the patient … is someone who will have a mild course or whether they are someone who will have a very serious course."

At a briefing in Edinburgh, Scottish health secretary Nicola Sturgeon announced similar changes to the flu strategy.

She said: "We've always said it would be impossible to limit the spread of what is a contagious virus indefinitely.

"We've always said that, when it did start to spread more widely within communities, we would require to make a judgment about when to shift efforts from intense containment to treatment, or mitigation."

She said this did not mean that the virus was getting more severe, adding that there was no cause for alarm.

"It simply means that we are seeing a rise in the number of cases and are adapting our approach to dealing with these.

"I would again reiterate that the risk to the general public remains low. Fortunately, the vast majority of people who get the virus experience only mild symptoms."

Of the 46 Scottish cases confirmed yesterday, 33 were in the Greater Glasgow and Clyde health board area, six in Lanarkshire, five in Tayside, and one each in Forth Valley and Grampian. Forty of the cases were not travel related.

Six people are in hospital in Scotland receiving treatment for swine flu.

Glasgow is one of the UK's swine flu hotspots, but the worst affected areas are believed to be London and the West Midlands. Mr Burnham suggested Birmingham had been hit particularly badly as there was more inter-generational contact among its large Asian community. People with circulation problems or who were obese were more likely to contract swine flu, he said.

Britain has had the most cases of any European country. The government had been trying to contain the disease by giving the drug Tamiflu to all suspected cases and their contacts. This has drawn criticism from some experts who warned that it wasted resources, drugs and could promote antiviral resistance.

The World Health Organisation last night warned people to look out for more severe symptoms. Although the vast majority of people would have a mild dose, experts said adults with a high fever that lasted for more than three days should seek help, and children who had difficulty waking up, or were lethargic or no longer alert might also need extra care.

New flu resistant to main drug

JAPAN has confirmed its first case of a genetic mutation of the new H1N1 influenza that shows resistance to Tamiflu, the main antiviral flu drug, a health ministry official said.

The patient, who was confirmed in May with the H1N1 strain of the flu in the Osaka province, has recovered since then and no cases of the new flu have been confirmed around the patient, Takeshi Enami, an official at the health ministry said.

The first case of H1N1 that did not respond to Tamiflu was a patient in Denmark.

Earlier this week, the World Health Organisation (Who) said that case was an isolated one and did not amplify the severity of the virus.

Who director-general Dr Margaret Chan said the virus was now "unstoppable".

She warned that officials are concerned about the virus mutating. She said: "Like all influenza viruses, H1N1 has the advantage of surprise on its side."

Sufferers are told to stay at home as focus switches to treatment

A NEW strategy to treat, rather than contain, H1N1 was revealed yesterday as the numbers infected spiral.

Anyone who suspects they may have swine flu will no longer be routinely tested.

Instead, they will be effectively quarantined at home, urged to stay away from work or any large gathering.

Sufferers will be urged to appoint a "flu friend" or someone who can bring them food and medication.

Anti-virals will no longer be given to everyone who has come into contact with a swine flu sufferer. However, they will be made available to those who contract H1N1 and GPs will use clinical discretion in individual cases on whether anti-virals should be used.

Eventually, anti-viral Tamiflu collection points will be established around the country.

Figures will be reported on a regional and weekly, rather than daily, basis.

The vaccine will initially be given to vulnerable groups, including patients undergoing other treatment, pregnant women and the elderly.

Britain has previously handed out Tamiflu to anyone suspected of having the disease and all their contacts – a strategy that had been criticised by some because of the risk of the treatment becoming resistant to the virus.

Other countries, including Australia, Japan and the United States, initially tried the same strategy but changed it within weeks. But England's chief medical officer, Sir Liam Donaldson, defined the approach. "We've been fighting this pandemic very aggressively," he said. "We're unapologetic about that."

Westminster Health Secretary Andy Burnham also said this effort to contain the virus had allowed the government time to study it more closely. As part of the new strategy, schools will no longer be routinely closed.

Most people who have caught the infection have only suffered mild symptoms, but in a small minority it has proved more severe, with three deaths in Britain so far.

For more information on swine flu call 0800 1 513 513 or visit www.nhs.uk.

Sixty million vaccine doses available to all by Christmas

THE UK is expected to be one of the first countries to have a swine flu vaccine available for most of the population, writes Gerri Peev.

About 60 million doses of the vaccines have been ordered but most patients are expected to need at least two doses to become resistant to the H1N1 strain. These will not be available until Christmas.

Two different companies will be providing vaccines to Britain.

One of them, GSK, accounts for the bulk of the order and its vaccine has been created using the traditional egg-growing method. The rest will come from Baxter, using a rapid cell-culture method.

That same pioneering method has been developed by German firm Novartis, which yesterday claimed that it had produced the first swine flu vaccine. So far it has orders from 35 governments for its H1N1 pandemic flu vaccine.

None of the vaccines has undergone medical trials, however. These will take at least two months to undertake before they can be rolled out around the world.