As at 17:00 on August 11th over 215,000 cases have been reported worldwide, with 1,735 associated deaths, a mortality rate of 0.8%, remaining significantly below the mortality rate associated with seasonal flu.

As well as a widely reported decline in cases in the UK, case numbers are receding in the USA, Canada, Mexico, Chile and Argentina.  The National Pandemic Flu Service in the UK appears to be functioning well, with the authorisation and distribution of anti-virals experiencing no major difficulties.

There are early suggestions that case numbers are falling in New Zealand, although Australia is still experiencing an increasing number of cases, as well as an increase in seasonal flu cases.

There have been no signs that the virus is mutating and the virus has not developed resistance to anti-virals.  The majority of cases continue to be mild, with nearly all patients experiencing uncomplicated, self-limited illness.

South Africa has reported initial influenza activity attributed to seasonal A/H3N2, although A/H1N1 is increasing as proportion of cases.  Significant increasing activity is also being reported from China and Thailand.

In Europe, Germany has experienced the second highest number of cases in Europe (after the UK).  In Scandinavia, Norway is reporting widespread influenza activity.

The Joint Committee on Vaccination and Immunisation, which advises the Department of Health, has suggested that initial A/H1N1 vaccination be provided for those in existing 'at risk' (chronic illnesses, etc.) groups (the same 'at risk' groups as for seasonal flu) initially, followed by pregnant women (subject to licensing conditions), frontline care workers, household contacts of those with compromised immune systems.  Frontline care workers will be vaccinated alongside the first 'at risk' groups.

Whilst children are disproportionately affected by swine flu in terms of case numbers, the vast majority make a full recovery.  The Joint Committee on Vaccination and Immunisation have advised that children are not vaccinated initially, other than those in at-risk groups.

Although there are a widely reported figures in the media, such as 11 million people being initially vaccinated in the UK from September, there are a number of factors that Blossoms suggest should still be considered in the context of the media reports.

Supplies of the vaccine will undoubtedly be delivered as soon as the become available, however, due to natural limitations in vaccine production, replication rates (and therefore production volumes) are yet to be confirmed.

The BBC reports that Baxter Healthcare have experienced difficulty with replicating the virus and that 300,000 doses of the vaccine will be delivered this month by the tow manufacturers (GSK and Baxter) contracted by the government.  Blossoms has so far been unable to verify the reports from clinical sources of information.

Although a small number of stocks may be delivered in the coming weeks, which attracts significant media attention, they cannot be used until the vaccines receive licensing approval from the European Medicines Agency (EMEA).  Blossoms anticipate that licences may be granted in late September or October and that the earliest date for a vaccination programme to commence will be mid-October.

Guidance from the Joint Committee on Vaccination and Immunisation on vaccinating the wider healthy population will depend on the evolution of the pandemic in the coming months, as well as clinical data on the use and effectiveness of the vaccine, which Blossoms will continue to monitor.

Blossoms continues to suggest that caution is exercised in the purchase or endorsement of any A/H1N1 vaccines until more clinical evidence is available regarding safety and efficacy.

Please do contact our occupational health team at any time for any further advice or guidance.