About Fergus On Flu
I've been reporting for the BBC since 1984 and for the past few years, I've been the medical correspondent for BBC News.
I reported from Vietnam and Turkey on the threat posed by H5N1 avian flu. I have also reported on HIV/Aids, malaria and TB - which together claim millions of lives each year. These pose a far more immediate and deadly threat to the world than swine flu.
Given that the virus has caused very few deaths in comparison, it may seem odd to start blogging now. But it's the potential of swine flu to create a global health emergency which has prompted the blog.
I'll try to chart the progress of the virus around the world, to assess the threat it poses, and to let you know what various governments and health bodies are doing to prepare for a pandemic.
I'll do my best to answer your questions and respond to your comments. Bear in mind that I'm not a qualified scientist, but a journalist. So I'll try not to blind you with complex data. If you have a complicated scientific question, please try to put it as simply and clearly as possible.
I certainly don't have all the answers, but I can try to get them for you. I guess that everyone's hope is that the likely pandemic of H1N1 flu doesn't happen. If that's the case, then at some point, I can wind up this blog. For the time being, though, it pays to be prepared. Welcome to Fergus On Flu.
I'm 
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Fergus:
Thanks for the excellent profile and background....
~Dennis Junior~
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Fergus: Although there's a pretty scary swine flu TV commercial in the UK aimed at prevention, don't you think that something targetted at infants and children would be also useful? I work with a team of writers creating educational songs and stories for 2 - 6 year olds and we have written a very charming song specifically for swine flu encouraging young children - in a fun way - to use a tissue when they sneeze and to wash their hands. The song lends itself naturally to be animated perhaps as a TV and Cinema commercial and a DVD for nurseries and schools. Because the song is in English it could be useful - not only in the UK but other English-speaking countries. I have made enquiries at DirectGov, the NHS and WHO but haven't been able to actually speak with anyone. Do you have any ideas? Thank you. Neal Fullerton.
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Hi, I'm a Medical resident in internal medicine in valparaiso, chile. Our country has a very efficient surveillance program but the cases of swine flu are increasing rapidly. In 10 days we have reach from 0 to 393 cases, 1 fatal an 7 are severe, with the need of advanced ICU support. The most interesting thing is that 6 of the seven severe cases are from Puerto Montt, a city in the south of chile. Is there a mutation of the virus at that community?, certainly that our public health institute is reserching about that. And for the worst, we are just entering in the flu period of the year... Well, i really thing that this epidemic is going to strike hard in Chile, but it should be harder in less prepared countries in southern hemisphere. Thanks for your interesting Blog. Mario Verdugo
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Fergus, as far as I can see you have not mentioned the figures from Canada.
We have a number of young people ill in Manitoba, some needing respirators. Several have died in Alberta and Manitoba. The concern is who and why. Are we seeing a genetic link to the early deaths in Mexico or is it due to socioeconomic factors?
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Fergus, if the virus can be dangerous to certain groups why in Birmingham closing schools is left to the Headteacher's criteria? Demographic distancing proved to be efficient in Mexico. Does that mean that some countries are not prepared to put their people above the econimic effects of closing down institutions?
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I am really glad tht you decided to write this blog as I have been trying to find a sensible forum in which to express my concern at the UK's inability to control the spread of swine flu.
I do not feel that it is being taken seriously enough either by the powers that be or the public.
How is it that the UK is now the 5th or 6th worst affectd country in the world and the worst BY FAR in Europe? At one point Spain had more cases than we did and yet now we have several times more cases than they do and many times more cases than the rest of Europe, who by the BBC's figures, have less than 100 cases each.
I share the concerns of slpslp who commented this morning, regarding whether the UK government has the backbone to take more drastic measures such as closing things down to slow the spread? Unfortunately I have my doubts that they do. Whilst some may critisize countries like Mexico for not being as advanced as others, at least they had the courage to close areas down to try to gain control.
The same can be said for air travel - a lot of the new cases I am reading about come about after travel to America - can we imagine the government or airlines stopping flights out there? I hope they would be brave enough.
I think some responsibility also rests with the UK public - I for one would not be travelling to badly affected areas and yet people selfishly still are. What is more important - people's lives or a holiday?
And I know the stock answer that is trotted out (when there is anything about swine flu on the news or in the papers - which is suspiciously not as often as I would have expected. But that's another subject) - that in most cases it is mild and some cases had underlying health issues.
That can not be comfort for those seriously ill or who may fall ill or their families.
And why risk anyone's health - there must be millions with underlying health issues and anyway a large portion of serious cases have been in healthy people.
The public should be reminded that it is not something to be casual about and I think better quarantining of infected households not just individuals should be put in place. I hope to goodness that people who are told to stay at home for the requisite number of days are not disobeying that. Could it be a criminal offence if they are?
I just feel that there should be more concern as to why the UK is so badly hit and better attempts to get it under control.
Surely the more people who have it going into Autumn/Winter and flu season the more worrying the potential for it to mix with seasonal flu to create something different?
I urge anyone who reads this and agrees to comment and maybe try to get the message that we want more to be done to the authorities.
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Glad to see your flu blog here, have been reading it with interest.
Have you found out anything about what percentage of people with some of these 'underlying conditions' need hospitalisation - as opposed to what percentage of people needing hospitalisation had a particular condition?
For instance, rather than knowing only that 40% or so of people needing hospitalisation had asthma, it would be good to know what percentage of people with asthma (and having a confirmed new H1N1 infection) needed hospitalisation. That would help to make the risk clearer.
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Dear Fegus ,
This is typical from a lying , cheating government .
First they create the problem them give you the soloution.
I believe, and there are sources to back this up that this so called flu has been purposefully engineered to create fear and panic and death.
I have read many articles about how many vaccines contain carciogenic substances and other harmful ingriedients and there is also evidence for this too.
Also this means there are massive profits to be made out of this whole senario by the big Pharma's.
I feel we as human beings are having our freedoms gradually eroded and we now have to make a stand for our rights as human beings and say no to this tyranny.
Paul.
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Fergus,
A key element of this story which does not seem to have been covered in any depth is the manner by which the virus is transmitted. A significant risk here is from the airborne transmission of tiny droplets from coughing and sneezing. At the moment, the Government and the HPA seem to be in a state of denial about the risk of swine flu spreading through the atmosphere; particularly indoors where high numbers of people create a high 'bio-load'. The truth is that the risk of airborne transmission is significant, but because it cannot easily be assessed or contained it is largely being ignored even though the technology exists to greatly reduce the risks.
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My daughter (16 mths) got a head cold last sat. By monday she had high temp, runny nose etc...so i ran GP as she has a history of febrile convulsions. They immediately suspected Swine flu, as we had a friend who was already on tamiflu and decided that my baby should be put on it also - on capsules i hasten to add!!
On wednesday the inevitable happened and she had a fit. I rang the GP who rang the hospital. They said to take her straight in and to bring in the tamiflu.
When we arrived i told them she was being treated for swine flu yet we were still told to wait in the waiting area full of people for 20 minutes. When we were taken in and she was assessed it was only after her assessment that staff put on apron, masks and gloves.
They then insisted i hold a mask over my little girl while walking through the waiting area past the people we had just been sitting with. She was then put on antibiotics for tonsillitis for 14 days but we were told to also continue with the tamiflu and keep her quarrantined!
My questions are - Is this standard procedure in all hospitals? How can they say dont come to A & E if you have flu like symptoms and then put a known case in a crowded waiting room? Also if is it possible that she had tonsillitis and not swine flu, has having tamiflu helped her at all if she does indeed come into contact with the virus in the future?
Many thanks - sorry for such a drawn out message.
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Anti-viral drugs - you'll be lucky to get any!
My husband developed flu like symptoms on Monday and was pretty poorly on Tuesday. I read up all about it on NHS Direct website and the Direct.gov website which specifically advised that you should contact your local GP surgery who, after assessing the symptoms and diagnosing flu, would issue instructions for the collection of Tamiflu. When I contacted the surgery however, they insisted that I contact NHS Direct. When I did this they were obviously so overwhelmed with calls that they would only take calls regarding severely ill people - Catch 22 or what?
As aniti-viral drugs need to be taken with 2 days of the onset of symptoms I gave up.
Why do surgeries not know what the Government recommendations are?
As there must be tens of thousands of people around the country like my husband lying ill in their beds but no one has them as a statistic, why does the Government continue to quote meaningless patient figures?
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Is it not the case that swine flu is no different in clinical effect to any of the recent years' seasonal flu in terms of death rate? it is described as "mild". The biggest fuss in recent years has been GPs not achieving vaccination targets. The Government has whipped up the public fears by frenetic planning and news coverage because it is risk averse, as is the public. Next, we plan to vaccinate the public with a medicine which is as yet untested in clinical trials.
Swine flu is a scientifically interesting organism full stop.
Just think what is going to happen when the predicted highly virulent, easily transmissable virus does arise as statistically, it must. Here we (will be) going again! And potentially resistant to all the Tamiflu that's in the system.
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Hi Fergus
Here is a question that I think needs answering.
Health workers are being issued with FFP3 filtration masks.
FFP3 is a particulate arrestment down to 300nano in size and yet the H1N1 virus is between 80/120 nano in size. So is it similar in trying to stop a golf ball getting through a football goalmouth net? Or does the filter actually trap all of the virus in someway?
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I have just recovered from "suspected" (note) swine flu at the age of 66.
But it was a hard slog, both physical and mental.
Being cooped up alone in one's first floor flat is hard.
And the after effects certainly continue as my stamina remains weak.
But I do wonder whether I did have swine flu as no lab tests were carried out - just a cursory couple of phone questions from my GP before being given TamiFlu. And I doubt whether all this media coverage and government warnings have helped. I more than suspect not.
I also feel a bit of a pariah among my elderly neighbours...
One of my daughters has however had the real thing, in her late 20s. Two weeks on, she has managed to go back to work but does remain worryingly poorly. And there seem to be no follow up checks.
I really do not feel the NHS is handling this at all well, getting its facts wrong (or at least changing them day to day), failing to deliver enough antivirals and certainly vaccines in time for what it claims will be the big surge. NHS Direct is a semi-disaster if you read the actual performances. And as for GPs, well their advice seems to veer wildly region to region.
Luke, Worcester
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Fergus
Any reason why the amazing Austrian court case against Baxter International for suspicious behaviour in regard to swine flu is not being reported on by the BBC and other mainstream media? The silence is too deafening for comfort.
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Hi Fergus,
All the news talks about how many people the swine flu, but there is no news about how many people get well and no more have the flu.
I think if the news tells us about how many people is well now, we will be more confident.
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Hi Fergus
As the mother of an active 2 year old with special educational needs who attends regular nursery and hospital sessions I am really concerned about the anticipated treatment of the 'under threes' with regard to swine flu. The virus now appears to be predominant in one to four year olds and this category also shares the highest predicted mortality rates. Despite this reality, Professor Salisbury's June letter to pandemic coordinators fails to place 'under threes' in any priority grouping at all for the swine flu vaccination program. I completely fail to comprehend the reason for this!! In Salisbury's priority breakdown younger infants come in last place amongst the general population, after the over 65's, whilst children over three come somewhere near the top of this list. Can you clarify for me whether this continues to be the position given the latest confirmation that 'under fives' and pregnant women officially rank amongst the highest risk groups for this disease?
On a personal level, I am obviously concerned first and foremost about the health of my child but also the effect on children, their parents and the economy if nurseries have to close as young children get sick while the vaccine is available but appropriated elsewhere. Are parents with young children really expected to quarantine themselves away at home indefinitely until the middle of next year.
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Mr. Walsh,
Thanks to you (and the BBC) for this excellent blog. I'm definitely going to add this to the BBC blogs I visit.
Two questions. First, will you be covering the H1N1 outbreak and its effects outside the UK?
Second (and this is somewhat of a plug), I'm taking part in a pandemic flu awareness/simulation game run by the Hawaii Research Center for Futures Studies. There are several people from the UK who are taking part in this game as well. Find out more at http://www.coralcrossthegame.org .
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i am very concerned to discover that in Wiltshire and probably the rest of the country, there are no enforcements in place by Central Government to ensure that schools have pump dispenser soap. Considering children are vulnerable to the virus and one of the main pieces of advice to reduce the spread of the swine flu virus is hand washing then this is deeply worrying. For example, my kid's school only has bars of soap and the head teacher deemed it unnecessary to install pump dispensers during the school hols to protect his pupils on their return. Fergus Walsh said in his report today that it would be impractical to close schools in the Autumn, so at least give the kids a fighting chance of protecting themselves. I spoke to local governemnt and was informed that they have no power to do anything about this and have to wait for the say so from Central Government! The person I spoke to even said, "maybe something will happen in September when things get worse". This seems crazy - why no make use of the school holidays to prepare each and every school with soap pump dispensers, as the most basic hygiene requirement. It seems schools are either apathetic or confused about the situation and they are responsible for the health of hundreds of children! I also have established that the general ruling by the Public Health Protection Agency on soap dispensers versus bars of soap (which my kid's school have) is that soap dispensers are more hygienic. To me, this is common sense. Who would be happy with a bar of soap these days in a public place such as a hospital, airport or restaurant. These days children are accustomed to using soap dispensers in most places, including their own homes, anyway. Action needs to be taken by Central Government immediately to prepare schools for September by providing all schools with soap dispensers and informing all head teachers of uniform guidelines to end the confusion and apathy. This would never happen in another country such as China or U.S.A. Considering, we are dealing with a Pandemic, this situation beggars belief and is a very fundamental problem that must be solved immediately.
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I am 69 years old and I gather I probably have partial H1N1 immunity since I've had all the major flu infections including those in the 1950s.
I've read on the internet that this virus is isolate CA04 strain, and that neutralising antibodies have been found in older people. My questions are:
1. Can I be presumed to have these antibodies - and if so, how effective are they?
2. Would it be an idea to test people over 65 who are vulnerable for this antibody?
3. Importantly, might there be a conflict between the anitbodies we're presumed to and a possible vaccine? And would be the consequences of such a conflict? Minor or serious?
Many thanks
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I watched last night's Panorama with interest. I was intrigued by Liam Donaldson's assertion that in a 'worst case' scenario the DoH had plans to double critical care bed provision within a matter of weeks. This is clearly impossible and it is a shame that this point wasn't pressed.
Most of the UK's critical care provision consists of level 2 or High-Dependency beds, which offer support for single organ system failure. Only level 3 or Intensive Care beds can offer full or multisystem critical care.
The reality is that existing anaesthetic rooms, operating theatres and recovery wards will be turned into temporary critical care spaces - most already have the equipment to deliver rudimentary critical care. This is fine in the very short term, but there are two major problems with this solution:
1. There simply won't be nearly enough skilled staff to look after these extra critical care beds on a 24/7 basis, and
2. Routing operations will almost certainly have to be cancelled.
Can extracorporeal membrane oxygenation (ECMO) be provided outside of Leicester? The answer is, of course, yes! Every time a cardiac patient is placed on a heart-lung machine for surgery they are, in effect, undergoing ECMO. Therefore each and every cardiothoracic centre in the UK can provide ECMO.
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I wonder whether the Ministry of Health policy regarding vaccination is likely to be influenced by the findings in an article published this week in the peer-reviewed literature. Researchers focusing on a series of seriously ill pandemic influenza patients from Australia and New Zealand 'reaffirmed that infants under the age of 1 year have the highest risk of developing severe illness'. This is taken from the WHO website: http://www.who.int/csr/don/2009_10_16/en/index.html
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This comment was removed because the moderators found it broke the House Rules.
Hi Fergus, I see that you have just done an article on Muscular dystrophy trial to start, and the reason i am contacting you is that we are doing a charity event called "Fighting for Sam"
We are White Collar Boxing in London and this is done every year and its CAMBRIDGE v LONDON and there will be 12 local lads (Cambridgeshire) fighting on the 30th of October 2009 at the home of boxing YORK HALL (Bethnal Green). All money raised will be for a young lad called Sam with Duchenne muscular Dystrophy (DMD).
Would this be something you could do a story on??
Sam Jerred of Somersham is 4 years old and was last year diagnosed with Duchenne muscular Dystrophy (DMD). DMD affects 1 in every 3500 boys born. It can also affect girls, although this is very rare. Children with DMD cannot produce Dystropin, a protein necessary for muscle strength and function. As a result, every skeletal muscle in the body deteriorates, there is NO CURE. DMD has a 1--% fatality rate; on average DMD boys die in their late teens or early twenties. Most boys with DMD are in a wheelchair from the age of 10-12 years old. DMD is associated with respiratory failure, heart failure and debilitating orthopaedic complications.
FIGHTING FOR SAM aims to raise money to send Sam and his family on a trip of a lifetime to Disneyland. this money will also be used to purchase a stair lift to fit in Sam's family home which he will need in the near future. This will in turn raise awareness and money for the charity action Duchenne which is working hard to fund research for a much needed cure for this cruel disease.
Can you please contact me to see if the BBC or any other people can help promote our event.
Regards.
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Very nice blog Fergus.
Nothing like this overseas.
Go on, so that we could find the right information.
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Swine flu can start as a bad bout of sickness, possibly the first sign before the temperature. Also, we have a work "private" medical membership which is extremely good, and the doc there advised us not to give Tamiflu to children.
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This comment was removed because the moderators found it broke the House Rules.
Fergus, great blog, we wanted to inform you that as a preventative measure to the swine flu, bird flu, SARS, Tuberculosis with EU and CE certified by Inspec EN 149 2001, Health Protection Agency, and Retroscreen Virology all in the UK, we have found the World's 1st 28 day reusable N99 and FFP3 respirator masks that kills all bacteria tested and inactivates all viruses tested including Swine Flu, Bird Flu, and even the common cold Rhinovirus. FYI
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I wanted to inform Fergus, since he still doesn't know, that 'Norwegian health authorities have discovered a potentially significant mutation in the H1N1 influenza strain that could be responsible for causing the severest symptoms among those infected.' (Reuters + top news around the world except UK)
Compliments on the bad blog and for misinforming the British readers.
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Thank you for all your hard work to date Fergus.I thought you might be interested in that seems to be a problem with the H1N1 vaccine supply in the Croydon PCT area.Not all people with underlying health problems can have one.I was to have one due to having a chronic neurological disorder and being immunosuppressed but I have been knocked off the list.My GP said she didn't even have enough for all asmatic patients.
Is this happeing elsewere?
Is there any other means of obtaining it?
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Fergus, could you cover why the classification of the pandemic was changed around may/2009.
The old text, pre-2009, that can be found in various sites of respected organizations and government agencies, including the WHO, states that:
"An influenza pandemic occurs with the appearance of a new influenza virus against which none of the population has any immunity. This results in several simultaneous epidemics worldwide with enormous numbers of cases and deaths. With the increase in global transport and communications, as well as urbanization and overcrowded conditions, epidemics resulting from a new influenza virus are likely to be established quickly around the world."
In the new definition, that appeared in May/2009, states that:
"A disease epidemic occurs when there are more cases of that disease than normal. A pandemic is a worldwide epidemic of a disease. An influenza pandemic may occur when a new influenza virus appears against which the human population has no immunity. With the increase in global transport, as well as urbanization and overcrowded conditions in some areas, epidemics due to a new influenza virus are likely to take hold around the world, and become a pandemic faster than before. Pandemics can be either mild or severe in the illness and death they cause, and the severity of a pandemic can change over the course of that pandemic."
As you may have noticed, the part that says "This results in several simultaneous epidemics worldwide with enormous numbers of cases and deaths." were removed in the new text, replacing it for the fuzzy and confused statement that "Pandemics can be either mild or severe in the illness and death they cause, and the severity of a pandemic can change over the course of that pandemic"
Where you can find the documents that prove this:
Old definition:
http://www.who.int/entity/csr/resources/publications/influenza/CDS_CSR_GIP_2004_1.pdf
New definition:
http://www.who.int/csr/disease/influenza/pandemic/en/
Check also the video of the epidemiologist Tom Jefferson tells a Swedish TV about this change and how it would enormously benefit pharmaceutical companies:
http://bigbrother-uk-1984.blogspot.com/2009/10/irrefutable-truth-oms-changed-pandemic.html
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A/H1N1 Update for Europe: 24 Fatal Cases in the Past 24 Hours, Death Toll Rises to 714
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France — more than two million cases H1N1
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D225G in Fatal H1N1 Lung Cases in Norway and Ukraine
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England — 21 deaths (Total Registered deaths 163) in the past week + 154 are in critical care.
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The Guardian: UK — 31 H1N1 deaths in a week
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Voice of America — Two die from mutated H1N1 virus in France
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WHO Studying Swine Flu Mutations
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The World Health Organisation said Thursday that it is investigating reports of mutations in the swine flu virus, after half-a-dozen countries recorded cases in which the virus was transforming.
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Swine flu virus mutations are spreading in Europe, French health officials said Friday
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France24 — Virus kills more than 1,000 in one week
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December 4th — 265 deaths (240 last week) in the UK
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