Blossoms continues to monitor the 'Swine flu' situation and provide updates for clients.  This week's note also contains the latest guidance Blossoms can provide about the forthcoming UK vaccination programme.

In the last week rates of flu-like illness have started to increase in England.  The increase was mainly seen in school age children, although increases have been noted in all age groups.

Health Protection Agency (HPA) modelling gives an estimate of 5,000 new cases in England last week (with a modelling range of 3,000 to 11,000).  Hospitalisations of people with suspected pandemic flu in England have levelled overall (143 patients currently hospitalised as of 16th September) and the vast majority of cases continue to be mild.  The number of deaths related to swine flu in England is 67.

The Health Protection Agency has reported to the World Health Organization (WHO) that two UK cases of resistance to the antiviral Oseltamivir ("Tamiflu") have been found.  In both cases the resistance was identified in immuno-compromised patients and remained susceptible to the antiviral Zanamivir ("Relenza").

There is no evidence of onward transmission of the resistant viruses or widespread resistance and the emergence of isolated cases of resistance is not unexpected.  Over 10,000 virus specimens have been tested for resistance worldwide and 23 have shown resistance.

Testing carried out by the HPA indicates that both patients were initially infected with an oseltamivir-susceptible virus, with resistance to the drug developing during their treatment, which is common amongst immuno-compromised patients.

Moving beyond the UK, although increasing cases of respiratory disease are noted in many parts of Asia (particularly India and Cambodia) and South America, most countries in Central America, the Caribbean, Australasia and South Africa are reporting declining activity, with flu cases moving towards baseline levels for the time of year.  Activity is varied across the Northern Hemisphere, with increased cases reported in the USA and Eastern Europe.

Blossoms understands from the Independent Doctor's Forum, which works closely with the Department of Health, that the European Medicines Agency (EMEA) is likely to licence the UK vaccines from GSK and Baxter Healthcare this week, which means the UK's vaccination programme (for high risk patients) will probably start in the second week of October.

Both vaccine manufacturers have confirmed that all production is reserved for the government and it is therefore unlikely the vaccine will be available to be purchased privately on prescription for some time.  Blossoms suggests extreme caution is exercised if any private stocks of vaccines are offered for sale in the coming weeks.