The Health Protection Agency (HPA) estimates that there were 55,000 new cases of swine flu in the UK last week.  The under-5's and 5-14 year olds are the age groups most affected.  30 cases have proven fatal so far, nearly all with underlying medical conditions.

Ongoing containment of A/H1N1 has become impractical and most countries have now moved from containment to treatment of the virus, although it's important to keep the severity of the virus in context: seasonal flu related deaths in the UK during average winters normally number between 6,000 to 8,000 (Source: Office for National Statistics).  The World Health Organistation (WHO) is no longer tracking numbers of cases and tracing of people who have been in contact with a sufferer by the Health Protection Agency has also now ceased.

Whilst the situation is still evolving, further spread of the pandemic is considered inevitable.  GP's are now able to diagnose swine flu on the basis of symptoms, rather than waiting for laboratory testing.  People who may have been exposed to the virus are no longer being given anti-viral drugs as a preventative measure (except people in higher risk groups).  Anyone diagnosed with swine flu will continue to be offered anti-virals.

Nearly all patients have experienced uncomplicated, self-limited illness and usually recover quickly, even without medical treatment, within a week of the onset of symptoms.  Some groups, such as pregnant women, persons with asthma and other chronic conditions such as morbid obesity appear to be at increased risk.  Although in past influenza pandemics viruses have needed more than six months to spread as widely as A/H1N1 has spread in recent weeks, it is important to recall that the situation has been charaterized, to date, by the mildness of symptoms in the overwhelming majority of patients.

The National Flu Line (telephone 0800 1 513 513) is planned to be launched on Thursday 23rd July, which will act as a national triage point for all flu-related presenting conditions.  The service is designed to authorise the prescription of anti-virals, with the intention of a 'flu-friend' subsequently collecting the drugs from a local collection point.  It is challenging to predict how well the service will work, although the current intensive media focus is likely to place significant demand on the service as it launches.  However, it is reassuring that the national distribution of anti-virals has worked well to date.  Supplies of anti-virals are also becoming more readily avaliable once more.

All informed medical advice (from WHO, Health Protection Agency, Department of Health etc) continues to be that people who may have been exposed, but are not showing symptoms, do not need to be quarantined or excluded from the workplace.

Extensive references have also been made in the media to vaccines being avaliable 'within a few weeks', however, although a vaccine has been developed, it is unlikely significant volumes of an effective vaccine will be avaliable for many months.  Most vaccines strains are grown and replicated in eggs, which results in long manufacturing times (4-6 months).  One manufacturer is currently producing a vaccine which may be avaliable in a few weeks using cell culture technology, which has shortened the production process significantly, although has not yet been extensively evaluated for safety in certain population groups.

Despite the potential benefits of a much shorter production time, any vaccine publicised as being avaliable in a few weeks will still need to complete extensive clinical trials and is unlikely to be fully licensed for use for some time (further information about the licensing process is avaliable from The Lancet).  National governments have ordered vaccines which are being prodcued using traditional methods (from GSK in the UK and SanofiAventis in France, for example).  GSK anticipates the first doses of the A/H1N1 vaccine antigen are expected to be avaliable in four to six months time, subject to regularity approval.

Blossoms suggests that caution is exercised in the purchase of any A/H1N1 vaccines until more clinical evidence is avaliable regarding safety and efficacy.  Once licensed, any initial vaccine supply for the A/H1N1 will be targeted to key areas, such as health-care workers, the police, fire brigades etc.  After key areas have been vaccinated, a subsequent phased approach to vaccination is also highly likely, for example, for pregnant women; those with one of several chronic medical conditions; healthy young adults of 15-49 years of age; healthy children; healthy adults of 50-64 years of age; and healthy adults of 65 years of age and above.

For businesses with employees overseas, the distribution of A/H1N1 vaccines will be dependant on individual national policies, although Blossoms will be pleased to provide whatever help and support is possible to help mitigate the health risks of overseas colleagues.  Most of the production of the seasonal vaccine for the 2009-2010 influenza season in the Norhern Hemisphere is almost complete and is therefore unlikely to be greatly affected by the production of pandemic A/H1N1 vaccine.  Blossoms anticipates delivery of seasonal flu vaccines towards the end of September 2009.

As the situation continues to develop, Blossoms believe the most prudent advice is to exercise discretion when supporting employees who may have (or believe they have been exposed to) swine flu, for example, particular sensitvity may be required for those who are pregnant or have chronic health conditions.  Remote working could be considered (as far as practical) and plans should be considered for an increase in short-term absences, although basic hygiene steps are still the most effective way to mitigate the risk of commuting to or working in an office environment.

Please don't hesitate to contact our team at any time if there is any further information or advice we can provide.