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Swine flu 'less lethal than was feared'

Fergus Walsh | 15:01 UK time, Thursday, 10 December 2009

New research has estimated that there have been 26 deaths out of every 100,000 cases of swine flu in England.

Swine flu information leafletThe authors say this makes the first pandemic of the 21st Century "considerably less lethal than was feared in advance". No surprises there, but it is the first time we've had a figure for death rates in this country.

The study, published online in the British Medical Journal
was carried out by a research team at the Department of Health.

It concludes that swine flu has a fatality rate of 0.026% or put another away, about one death in every 3,800 people infected.

That would make it 10 times less lethal than flu pandemics in the 50s and 60s and 100 times less dangerous than the pandemic of 1918-19. So-called Spanish flu is thought to have killed at least 50 million people, more than died in the World War I.

It's worth pointing out that all estimates of deaths from flu pandemics are subject to very wide variation. Increases in fatality are usually worked out more than a year later by analysing trends in death rates and calculating the likely proportion due to flu.

This is the first time that individual deaths from a pandemic flu virus have been counted. The Centers for Disease Control and Prevention estimate for deaths in the United States is similar at 0.018%.

The Chief Medical Officer, Sir Liam Donaldson said improvements in nutrition, housing and health care might explain some of the apparent decrease in fatality from one pandemic to the next.

But even the comparatively low death rate of 0.026% may itself be a huge overestimate. That's because huge numbers of those infected have probably had swine flu without knowing it.

Recently the Health Protection Agency estimated that up to one in five schoolchildren have had the virus, half of them without showing symptoms.

Two thirds of those who died from swine flu would have been eligible for vaccination and the authors say this demonstrates the importance of immunising those at high risk of complications.

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  • 1. At 3:52pm on 10 Dec 2009, Peter Galbavy wrote:

    Still, with GPs getting a nice healthy bonus to force jabs on people the whole circus will continue...

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  • 2. At 4:07pm on 10 Dec 2009, MrRanter wrote:

    Nice to see the hype didn't cost us much!!

    Even now I read that Sir Liam Donaldson worries that it might mutate. Note to Sir Liam it might not. Find another way to try and justify your existance.

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  • 3. At 4:13pm on 10 Dec 2009, chipshopshippers wrote:

    Hold the front page:

    Government in overhyped threat of death shock.

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  • 4. At 4:19pm on 10 Dec 2009, maria07 wrote:

    What are the estimated number of new cases for this week in UK?

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  • 5. At 4:24pm on 10 Dec 2009, John Bristol wrote:

    This focus on Swine-flu is going to start causing deaths if the NHS don’t calm down.

    My Daughter is ill, symptoms are very high temperature, chest pains and a cough as per NHS instruction we called NHS direct to be told it was Swine flu and would send a proscription.

    Not convinced by this we ignored instructions to avoid the doctors and booked an appointment.

    It turns out that her left lung is not working correctly and we were lucky to have caught it when we did. She was given antibiotics and advised that if the temperature did not drop within 24 hours she would need to go to hospital.

    I think advising sick people to avoid the doctor is very dangerous, is this not why they are there in the first place?

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  • 6. At 4:26pm on 10 Dec 2009, kentspur wrote:

    Got to say fergus, even back when a lot of people were saying this was apocalypse now, you were erring on the side of cautious optimism and I, for one, found your reports and blogs informative and, crucially, reassuring. My son was off school with a temperature of 102, sustained for three days, and a dreadful post viral 'urgh' feeling, but we didn't go to the GP or contact NHS Direct. Chances are he had it, but the official stats will never know...

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  • 7. At 4:35pm on 10 Dec 2009, yorkshireshaz wrote:

    The last paragraph says :-

    "Two thirds of those who died from swine flu would have been eligible for vaccination and the authors say this demonstrates the importance of immunising those at high risk of complications."

    As we have not yet done all the at risk lists maybe the anti vacination lobby should get back into their boxes.

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  • 8. At 4:36pm on 10 Dec 2009, Lurkingmumoftwo wrote:

    Maria, the summary is there now but I can't see the detailed summary; down by half to 11,000 new cases.
    http://www.hpa.org.uk/webw/HPAweb&HPAwebStandard/HPAweb_C/1259152211290?p=1231252394302

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  • 9. At 4:42pm on 10 Dec 2009, Ryan wrote:

    Maybe theses statments should be said after a pandemic, not in between waves. Stuff like this will make people more complacent. Atm I think this pandemic is mild, but to say this half way through is nuts. Swine flu is going to be around for a while.

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  • 10. At 4:43pm on 10 Dec 2009, Spiny Norman wrote:

    OK, so what will be the next scare to panic us into obeying those set in authority over us?

    We've had terrorism, paedophilia, global warming and swine flu - how about little green men from the Planet Tharg?


    Curiously, the only newspaper to talk sense about swine flu was the Sun. How frightening is that?

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  • 11. At 4:46pm on 10 Dec 2009, Nada wrote:

    So if swine flu is less lethal than was feared, why are we rushing to vaccinate healthy children? I have 2 boys (1Y & 3Y) and I'm not too confident that enough research have been done to give it to them.

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  • 12. At 4:59pm on 10 Dec 2009, RisainCanada wrote:

    Interesting. I agree that SF has not been (and continues to be unlikely to develop into) the killer that was feared. If about 1 in 38000 cases die, and if this stat can be extrapolated to my area (its the same illness the world over, right?) that would mean about 2/3rds of the population of my province has had the virus. I am really not sure how likely that is--I hope it is as it would make a third wave unlikely here.

    I did find this bit of the study Fergus linked above interesting, especially in light of the recent cumulative review study saying there's not enough evidence to support the wide-spread use of antivirals:

    "We observed delayed antiviral use in most fatal cases, which suggests an opportunity to reduce deaths by making timely antiviral treatment available, although the lack of a control group limits the ability to extrapolate from this observation."

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  • 13. At 5:05pm on 10 Dec 2009, RisainCanada wrote:

    Oops! That should be 1 in 3800 cases are fatal, which makes more sense. Fergus, you've got an extra zero in your article (in the 3,8000 number).

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  • 14. At 5:12pm on 10 Dec 2009, Ryan wrote:

    What I don't get is didn't they say yesterday, that only 1 in 5 who rang up the swine flu hotline, actually had it ?

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  • 15. At 5:16pm on 10 Dec 2009, SkylineOnFire wrote:

    Ryan, that was in the daily mail correct? Yeah... Best not to take them so seriously.

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  • 16. At 5:30pm on 10 Dec 2009, Lurkingmumoftwo wrote:

    Hi Skyline just wanted to say, whilst you are around, that your input on this blog has had a very positive effect on how I personally have coped with a very worrying time. It is great how all of your predictions and reassurances have actually come true and I can't thank you enough.

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  • 17. At 5:41pm on 10 Dec 2009, Questionsaplenty2 wrote:

    Lurking - those are wonderful figures - down 50% woohoo!

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  • 18. At 5:44pm on 10 Dec 2009, Questionsaplenty2 wrote:

    Ryan/ sky - i agree on the Daily Mail usually but the quote in that article was from the HPA and i think it was in the Telegraph also.

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  • 19. At 5:44pm on 10 Dec 2009, Little_swan wrote:

    Hi Skyline - hope your still around as I would like to echo Luking's sentiments. Thank you very much.

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  • 20. At 5:47pm on 10 Dec 2009, Lurkingmumoftwo wrote:

    Questions, I know! Brilliant news and just in time for Christmas! I might even give myself permission to stop worrying for a while!! :)

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  • 21. At 5:49pm on 10 Dec 2009, Little_swan wrote:

    Ooops! sorry that s/b Lurking's

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  • 22. At 6:00pm on 10 Dec 2009, SkylineOnFire wrote:

    There is no way of knowing how many people who phoned truly had swine flu. But 1 in 5 is absolute garbage. Its far higher than that. A very large percentage of the population has had swine flu. Thats just indisputable.

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  • 23. At 6:15pm on 10 Dec 2009, Questionsaplenty2 wrote:

    skyline - I think they were saying it was based on the results of HPA swabs sent out in a sample of those that called in. But don't shoot me please - I know nothing - just the messenger!

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  • 24. At 6:17pm on 10 Dec 2009, Questionsaplenty2 wrote:

    Lurking - I am DEFINITELY having Christmas off worrying...lets see...at this rate we should be down to 2500 by Christmas Day if the decrease continues at the same speed (probably won't but I like to dream!)

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  • 25. At 6:18pm on 10 Dec 2009, Questionsaplenty2 wrote:

    skyline - thinking about it - they are saying 1 in 5 of those that called in to the helpline so that doesn't include those that were not so sick or unsymptomatic so still fits with your theory. :)

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  • 26. At 6:31pm on 10 Dec 2009, Jon wrote:

    Well... Good job you guys didn't spend the last 9 months wasting your time on internet discussion boards - just think, you could have had a baby in that time...

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  • 27. At 6:31pm on 10 Dec 2009, Questionsaplenty2 wrote:

    skyline - someone from another website pointed to this CDC document declaring the swab test inaccuracy so perhaps the HPA declaration also bears some level of inaccuracy?

    http://www.cdc.gov/eid/content/15/10/1662.htm#figure

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  • 28. At 6:48pm on 10 Dec 2009, SkylineOnFire wrote:

    Honestly. All we know is a few million have had swine flu. Thats it. There is no way of comprehensively knowing anything else without blood tests for the entire nation. Its on its way down, and that wouldnt be happening if there were still plenty of people for it to infect. Hence the herd immunity only given when a certain percentage of the active population have had the virus or the vaccine. Hence the fact we know a few million have had swine flu at the least. Anyone saying otherwise is defying science, logic, virology and common sense.

    Hope everyone is good!

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  • 29. At 8:06pm on 10 Dec 2009, angelscomeinthrees wrote:

    As I understand it the swab test needs to be done within 24 hrs - 48 absolute max - and returns a lot of false negatives. I should think it very difficult to get people swabbed in the first 24 hrs of showing symptoms - the most reliable way would be for households to have kits at home but that would be very costly. I really don't understand why the HPA have sent young Hugo a swab test because he'd been symptomatic long before. The only way to really know is to carry out a large-scale blood screening.

    1 in 3800 still sounds high to me. However, if we assume that half of sf cases aren't recorded then 1 in 7600 sounds a bit better.

    Thanks as ever, Skyline. You've kept many of us sane over the past few months. Perhaps you should take over from Donaldson, yo've been way more accurate than he has.

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  • 30. At 8:11pm on 10 Dec 2009, SkylineOnFire wrote:

    Id love to! I could really do with the money!

    My paypal is... Haha no im not that mercenary that id charge for explanations and comfort!

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  • 31. At 8:13pm on 10 Dec 2009, SkylineOnFire wrote:

    Also, http://www.myfoxphilly.com/dpp/news/dpg-flu-One-Six-Americans-H1N1-10000-Have-Died-fc-200912101260473926059

    One in six Americans has had SF according to the CDC. Pretty crazy.

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  • 32. At 8:15pm on 10 Dec 2009, dmcblue wrote:

    so most people who get swine flu don't die?

    and some of the posters above think that its all OK then

    most people who play russian roulette don't get a bullet, most people who smoke don't get lung cancer - does that mean its safe to play russian roulette or smoke?

    is the low death rate any consolation to the parents of the children that have died? just because most people are lucky doesn't mean all are

    283 dead from swine flu, 0 from the vaccine you do the maths

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  • 33. At 8:54pm on 10 Dec 2009, Questionsaplenty2 wrote:

    Here's the detailed update for today - had to google it as they are late putting the link in from the HPA site... AGAIN! (Don't they know how many of us want to read it!)

    http://www.hpa.org.uk/webw/HPAweb&HPAwebStandard/HPAweb_C/1259152211290?p=1231252394302

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  • 34. At 8:56pm on 10 Dec 2009, Questionsaplenty2 wrote:

    Sorry - that was the summary as lurking posted above :(

    Still waiting then!

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  • 35. At 9:18pm on 10 Dec 2009, angelscomeinthrees wrote:

    Dmc, it's absolutely not okay, not by a mile. I will get my kids vaccinated asap, just as I have against measles because that too is a killer, although it kills in small numbers. And unlike some I won't be relaxing until either sf has long gone or we have access to a reliable vaccine as and when we need it.

    For me it's not just about death rates but avoiding the need to go to hospital, the possibility of deafness as my boy has ear problems, just avoiding the whole trauma. Why go through it if you don't need to? I freely admit I am a wimp, I don't want to get sf, I want the vaccine!

    That said, I live in a small community and when the 64,000 death rate was announced I sat down and worked out how many people in my village woudl die, then how many children from the school, and how many from the local comp. Now it looks like the odds are in favour of my community not losing anyone, and for that I am truly and profoundly grateful.

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  • 36. At 9:20pm on 10 Dec 2009, angelscomeinthrees wrote:

    Lol, Skyline :-)

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  • 37. At 9:22pm on 10 Dec 2009, Tinkerdellbobby2 wrote:

    John at post 5 - I agree. The same happened with my daughter, luckily here in Wales we dont have the advice line and so had to see a Dr anyway, especially as she is under 5 years old. How old is your daughter? Hope she is better soon, if its any consulatiopn, my three year old started getting better not too long after she had the antibiotics, and 24 hours later they checked her again to see she had enough oxygen in her blood and she was back to normal. After three-four days fit as a fiddle. Take care.

    26# lol.

    Skyline - I would like to echo what the others have said. Thanks for your excellent posts. You have kept me sane also. Your figures have been spot on.

    Questions, made me smile reading your posts. Good to see the worrying is dying down. ;-)

    Anyone heard from enlightened?

    There is a terrible bug doing the rounds at the moment, v similar to the symptoms of SF. More blasted coughing. I dont know how they can tell who has what quite frankly.

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  • 38. At 9:26pm on 10 Dec 2009, angelscomeinthrees wrote:

    Questions, I agree with Tinkerbell, I am very glad for you that your worry is receeding now. It was infection rates that you were so worried about, wasn't it? Only good news for you. :-)

    Tinkerbell, that sounds awful. How are your girls now? My eldest has a headache/vomiting bug. Am crossing everything that no-one else gets it and she's better soon. I hate anything sicky, the last norovirus we had was the bug from hell, we even had to dump a matress. Urgh.

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  • 39. At 9:40pm on 10 Dec 2009, Tinkerdellbobby2 wrote:

    Angel, yes i think its the same thing, headache sickness etc only she had a fever, runny nose, cough aswell. Although we've all had it so we know its not the SF. Lol, yes the norovirus, we had to bin a carpet!! lol

    Hope your eldest is better soon AngelsXXX

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  • 40. At 9:53pm on 10 Dec 2009, angelscomeinthrees wrote:

    Thanks, Tinkerbell. Your poor girls have really been through it, haven't they? :-( My eldest has the runny nose but no cough and, mercifully, no temp. She's not been sick since this morning so fingers crossed - I have heard that the bug going around here is a 24hr max one and it doesn't sound hugely contagious in the sense that people are saying only one child in the house is getting it. I thought my boy was sick on Monday because he had an ear infection but I'm now wondering if he had this bug too. I was also very off-colour on Tuesday so maybe that was my brush with it. I'm a bit emetaphobic, not as full on as some but enough for d&v bugs to make me quite jittery. And I absolutely hate having anything like it myself, I'd rather have another section.

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  • 41. At 9:57pm on 10 Dec 2009, Questionsaplenty2 wrote:

    Norovirus is going round here tinker/ angel...48 hr thing...20/29 kids off sick in sons class last week on the same day but all back now. Hope all of yours get better soon.

    Angels - yes I was worried about infection rates as I kind of focussed on that as a measure of the extent of the danger. I am concerned about the other issues too of course. Still undecided on whether my healthy boys would have the jab if they ever get offered it... guess it depends on how things play out in the next few months as it is currently only likely to protect for 12 months. I it goes away & then if a mutation appears in a couple of years everyone will need revaccinating anyway probably as their immunity from the initial jab will have worn off.

    angels - I remember doing the same calcs as you when SF first broke out - working out from %, how many kids at sons schools might statistically die - it was indescribebly horrible. Thankfully none have here that I am aware of but sadly there are some families out there who will be having terrible Christmases this year.

    On a general note, as someone mentioned above, I really hope the WHO/ HPA are learning a lot of lessons from this outbreak as to how to handle a similar or even worse epidemic should we ever be so unlucky. Need to speed up vaccine production methods at the very least. Am hopeful from what skyline says about in 20 yrs it won't be a worry though. :)

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  • 42. At 10:15pm on 10 Dec 2009, Lurkingmumoftwo wrote:

    Yes I do find the reducing figures less worrying although I am very aware that this isn't over yet. My eldest sister and her grown up daughter are both on Tamiflu with suspected SF. Thankfully they seem to be recovering well although my sister has a secondary sinus infection. They both live in Yorkshire so it's obviously still doing the rounds up there.
    It was very scary in summer when we had ten times as many people supposedly catching it and I am grateful that there is a downwood trend. The odds of catching it are less now and I take comfort in that.
    dmcblue (#32), no I don't think everything is ok and I am not anti-vaccine. My daughters are 12 and 14 and I suspect they will not be offered the vaccine in time to make much difference and my hubby and I will be right at the end of the line. That's how it should be and I think the priorty list is about right. So forgive me for looking for some comfort from a general reduction in figures.

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  • 43. At 10:44pm on 10 Dec 2009, angelscomeinthrees wrote:

    Lurkingmum, I think that by February the country should have most of its vaccine. The question will be how to get it out to those older children and healthy adults who want it. Mass clinics really do make sense for healthy school-age (esp. teenage) children and adults. You are right, the odds of catching it are far less now which has to be good news.

    Thank you, Questions :-) Really, 20 out of 29 off should have closed the school if that was across the board.

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  • 44. At 10:47pm on 10 Dec 2009, angelscomeinthrees wrote:

    On a slightly different subject, is it my imagination or is norovirus far more rife than when I was at school? I never got sick when I was a teenager (well, not unless I'd been at the Snakebite) and very rarely once I was over the age of five or so, in fact in junior school I can only remember one very full-on stomach bug. Now we seem to expect at least one lot a winter and through all age groups.

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  • 45. At 11:02pm on 10 Dec 2009, Lurkingmumoftwo wrote:

    Thanks Angels lets hope so.

    Did anyone see Fergus on News at 10? Came accross very well! One of the figures he quoted quite shocked me; that only 1 in 4 of the initial priority patients were coming forward to be vaccinated. That seems really low to me.

    Re norovirus, you're right there does seem to be more of it about now. Luckily my two don't seem to catch it; they had a couple of bad sickness bugs when they were in infant school but nothing really since. I hope all your family are better soon Angels; at least it should be over for Christmas.

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  • 46. At 11:11pm on 10 Dec 2009, dmcblue wrote:

    apology if any of the posters above thought i was having a go at them personally as i didn't mean it like that, but i get the feeling some posters will try to use the fact the death rate is lower than feared as a reason to dismiss the health service work and vaccine programme as unnecessary when imo it clearly was and still is, swine flu is, for the majority a not very nice but mild illness, but, in the majority it can be fatal and just because most don't die doesn't mean we shouldn't try and stop the few that may die from that fate

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  • 47. At 00:13am on 11 Dec 2009, angelscomeinthrees wrote:

    Dmc, I suspect that those who dismiss it come from the anti-vaccine group anyway. Those of us who'd decided on the vaccine won't be changing our minds in a hurry.

    Daughter number two is now vomiting. I don't remember signing up to this when they gave me that little bundle in the hospital!

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  • 48. At 00:31am on 11 Dec 2009, Spiny Norman wrote:

    I took the vaccine, and was glad to do so. That doesn't mean I go along with the panic.

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  • 49. At 06:53am on 11 Dec 2009, Questionsaplenty2 wrote:

    angels - I called the school up & asked but it was just his class that was so bad on that day. Big school, lots of classes in the year. The virus was def going around the rest but perhaps not so many at once , i don't know. Fortunately sickness bugs don't last too long.

    lurking - it's weird, mine don't get the norovirus/ sickness ones either...but they get the coughs & colds. Guess it's where a person's weaknesses lie! LOL

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  • 50. At 08:58am on 11 Dec 2009, robbo wrote:

    this is good news, good news indeed, but let's not forget the people who have lost thier loved ones through this virus, it's so easy for us to get wrapped up in statistics and we forget that each of those numbers is a life that has been lost,my sympathies go out to all those people who lost relatives through this.

    also, is it just me or does anyone else feel that the human race just dodged another bullet? this could have been so much worse, which is why it is important for the vacination to go full steam ahead, it's the first stage in completely destroying this virus, one strain at a time.

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  • 51. At 09:05am on 11 Dec 2009, littleworkingmum wrote:

    My 5 yr old daughter had her first Pandemrix jab a couple of weeks ago as she has asmtha and she was due for her second next week. Our GP had split the doses as she was so young. A nurse from the surgery has now rung me to tell me the dept of health told them that children don't need a full dose and they have cancelled next weeks appt. I wondered if anyone else has been told this?
    Part of me is really relieved I don't have to drag her in for another injection as she hates them and screams the place down, but on the other hand I'm worried as she's only had half a dose??
    I wondered if anyone can confirm this? Thks

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  • 52. At 09:23am on 11 Dec 2009, jon112dk wrote:

    First impressions - based on Mexico - had this looking like a serious thing. It turned out not be so. But I don't think we should criticise people for taking it seriously.

    For the public it has disclosed the NHS plans.

    Imagine a flu pandemic that was killing millions - like the 1918 flu. You personally know several people who are dead. You are terrified for yourself and your family.

    Imagine you get symptoms which might be the deadly flu. The NHS has closed the GP surgeries to you. You can phone up an asylum seeker on a help line but no NHS staff will come any where near you to help you. There is a vaccine that could save your family, but only NHS staff are allowed access to it.

    Personally I find the prospect of a lethal pandemic flu in the context of what I now know to be the NHS response absolutely terrifying.

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  • 53. At 09:32am on 11 Dec 2009, angelscomeinthrees wrote:

    Questions - we've had d&v bugs that have lasted well over a week and often they involve trips to A&E for dehydration. Looks like we've got off lightly this time as both girls are now drinking and free of pain. Can't say the same for dh though. I know our local comp was closed and fumigated once due to norovirus - it has 2,000 pupils so the number of kids off doesn't bear thinking about! Having said that, I suspect that teenagers would be quick off the mark in knowing what will get them sent home!

    Delta, I totally agree, and at this time of year in particular it isn't just those who've lost loved ones to sf that are having a tough time. I am glad that it isn't just me and mine who are less likely to get sf but all of us, hopefully the tragic stories will be far fewer, but even so, I'm just drawing breath, not celebrating. Roll on getting the jab to all who want it.

    Littleworkingmum, I did read a while ago that research showed the u-5s responded better to a single dose of the vaccine than expected and that only a single dose was necessary but I can't remember if that was for Baxter or Glaxo. I did think it odd that the DoH was carrying on vaccinating children with 2 shots but it sounds like they were awaiting the research to be confirmed.

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