Blossoms continues to monitor the 'Swine flu' situation and provide updates for clients.  This week's note contains a further update about the forthcoming UK vaccination programme and confirmation of the likely number of vaccine doses required.

Rates of flu-like illness have increased again this week and Margaret Chan, Director-General of the World Health Organisation (WHO), this week confirmed that the predicted 'second wave' of infection has now started (source: WHO).

Health Protection Agency (HPA) modelling gives an estimate of 9,000 new cases in England last week (with a modelling range of 5,000 to 20,000), a near doubling of cases in the last week.  Hospitalisations of people with suspected pandemic flu in England have also increased (218 patients currently hospitalised as of 23rd September) and the vast majority of cases continue to be mild.  The number of deaths related (but not necessarily attributed) to swine flu in England is 70.

In the light of the increase in flu activity, Blossoms suggests that businesses plan for an increase in short-term absence in the coming weeks, perhaps by taking steps to job-share, facilitate remote working or considering cover arrangements.  Health or absence policy regarding attendance at work for those presenting symptoms should be considered.  All professional health advice suggests remaining isolated until 24-hours after symptoms have passed (usually around 5 days).

Up to 23rd September nearly 1,000 viruses have been analysed by the Centre for Infections for resistance to oseltamivir ("Tamiflu").  Two viruses have been found to carry to a mark of resistance, although still retained susceptibility to zanamivir ("Relenza").

Moving beyond the UK, the USA reports a significant increase in flu-related activity, particularly amongst school children.  Increasing activity has also been reported in a number of European countries, particularly France.

Widespread influenza activity continues to be reported throughout much of South and Sout East Asia, with increasing trends in respiratory diseases being reported in India and Bangladesh.  Widespread influenza activity also continues to be reported for tropical regions of Central and South America.

Southern hemisphere regions (Chile, Argentina, Australia, New Zealand, and South Africa) all report influenza activity continuing to decrease or return to baseline.

Blossoms reported last week that the European Medicines Agency (EMEA) was likely to licence UK pandemic influenza vaccines this week and GSK has this morning announced that the European Committee for Medicinal Products for Human Use (CHMP) has issued a "positive opinion" and recommends approval of GSK's candidate pandemic "Pandemrix".

The "positive opinion" means the vaccine will be immediately reviewed for approval by the European Commission, which is an important step closer to a licence being awarded.  Blossoms anticipates this process to take around a week.

Of most relevance for businesses was the determination from the CHMP that the GSK vaccine should be administered as two single doses at least 3 week apart.

Although the vaccines are progressing towards approval for use the WHO have also called for post-delivery surveillance of the 'highest possible quality' to ensure extensive safety evaluation of all pandemic vaccines.

Blossoms re-iterates current guidance that all vaccine 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.

Although most considered guidance with regard to personal protective items has indicated that face masks are generally ineffective in preventing viral transmission, a recent study published in the BMJ indicates that measures such as hand washing and wearing personal protective equipment (such as masks, gloves and gowns) can be individually beneficial in reducing spread of respiratory viruses.  However, the study did not indicate which method of protection was most effective and called for further research.  (Source: BMJ).

In the meantime, all considered health advice remains focussed on maintaining good basic hygiene, cleaning hard surfaces (e.g. door handles) frequently using a normal cleaning product, covering your nose and mouth when coughing or sneezing, using a tissue when possible and disposing of dirty tissues promptly and carefully.

Blossoms will continue to monitor developments and update clients accordingly.  Please don't hesitate to contact our team at any time if we can be of any assistance.