Big Medicine

London England--The consultation rate for flu-like illness in England from the Royal College of General Practitioners (RCGP) scheme has decreased slightly to 35.9 per 100,000 in week 46 compared to 37.8 in week 45. This is still above the English baseline threshold of 30/100,000.

The estimated cases self referring to the National Pandemic Flu Service have shown an overall decline. Antiviral collection numbers are variable across England with increases in some regions and decreases in others. Increases in collection rates were seen in the 1-4, 5-14 and 75+ age groups.

Interpretation of data to produce estimates on the number of new cases continues to be subject to a considerable amount of uncertainty. HPA modelling gives an estimate of 53,000 new cases in England last week (range 26,000 to 114,000) which represents a decrease from the previous week.

This estimate incorporates data from National Pandemic Flu Service and GP consultations.

The HPA estimates a cumulative total number of cases of 715,000 (with a range 336,000 to 1,483,000) since the pandemic began.

The latest weekly flu-like illness rates show that the highest flu-like illness consultation rates were in the 1-4 year-old age group. Compared with week 45 this week (week 46) rates have increased in all age bands except the 15-24 and 25-44 age bands where the rates have decreased. The largest increase (38%) was seen in the 5-14 year old age band.

SYNDROMIC SURVEILLANCE

NHS Direct
On 23 July the National Pandemic Flu Service was implemented. This had an impact on the number of 'cold/flu' calls received through the routine NHS Direct service. For this reason, data from NHS Direct do not reflect the true pattern of cold/ flu callers and so are not currently an accurate surveillance tool.

VIRAL CHARACTERISTICS

To date (as of 18 November 2009) 3,359 viruses have been analysed by the Centre for Infections for the genetic marker commonly associated with resistance to oseltamivir in seasonal H1N1 flu (H274Y). 12 viruses have been found to carry this marker in the UK with three of these, through additional testing, showing evidence of resistance when viral growth is tested in the presence of antivirals. In addition, 293 specimens have been fully tested for susceptibility.

The Agency is continually assessing its advice to government on health protection policies such as antiviral use. Currently there is no requirement to change existing guidance.

There have been no significant changes in the virus.

SEVERITY

Disease severity continues to be monitored. The disease is generally mild in most people so far, but is proving severe in a small minority of cases.

Swine flu hospitalisations in England: 783 patients (currently hospitalised as of 8am on 18 November).

Deaths - the number of deaths related to swine flu in England is 142 (This figure represents the number of deaths in individuals with swine flu but does not represent the number of deaths that can be attributed to swine flu).