'Snowballing' of cases in intensive care
It is curious that although the overall number of H1N1 swine flu cases has been fairly static over the past week, intensive care units continue to come under increasing pressure. The Chief Medical Officer for England, Sir Liam Donaldson, gave his weekly update to journalists via video link from Washington, where he's attending health meetings.
Sir Liam said: "there has been a snowballing of cases in intensive care units in recent weeks which is giving us real concern". He stressed that there was no evidence that the H1N1 virus was mutating. "It is unexplained," he said, adding that he'd met the chief medical officer for New Zealand in recent days who had pointed out that his country had seen a similar phenomenon over their winter. Half-way through their recent flu season there had been a fall in the severity of most cases in the community but an increase in severity in a minority of cases with complications.
My thanks to the Department of Health, as always, for providing this data for the blog. Never before has a pandemic been so closely monitored, in real time. This chart shows that as of 0800 on 4 November there were 848 people of all ages in hospital in England with suspected swine flu. Of these, 172 were in critical care. Last week there were 751 in hospital of whom 157 were in intensive care.
That seems surprising when you look at what's happening to swine flu from weekly consultations with GPs.
This is a key graph for understanding what the H1N1 virus is doing. As always, look at the solid red line. You'll see that it actually dipped a bit in the week up to 1 November. Health officials think this is probably the result of children being on half-term, rather than the start of a downward trend.
The Health Protection Agency estimates there was a slight increase in cases of swine flu in England this week, to 84,000 cases, up from 78,000 the week before. Remember though there is a huge margin for error because very few people are tested for the virus and we still don't know the proportion of those who get infected yet have such a mild illness that they either don't know they've had swine flu, or they cope without bothering the health service.
This is a useful chart because it shows, by age group, the ratio of people in the community who have been hospitalised. Children under five represent the biggest group needing hospital treatment. If you look at the five to 15 age range, this is the only group where there was a fall in the ratio hospitalised over the past week (probably due to half-term).
Vaccine
I promised to update you on how the distribution of swine flu is going. Health officials confirmed that 6.4 million doses of the GSK vaccine Pandemrix were now in the UK and of these, 4.4 million had been distributed. Sir Liam said that by the end of next week virtually all GPs would have received their first delivery of swine flu vaccine. The warehousing and distribution of the vaccine is being handled by Movianto, which on its website says that it delivers 40% of all domestic pharmaceutical products in the UK.
Movianto also has 1.43 million doses of Celvapan, the swine flu vaccine made by Baxter. This is being reserved for the tiny proportion of people who have a severe egg allergy as (unlike Pandemrix) it is not grown in eggs. The potential downside of Celvapan is that two doses are required to confer immunity compared to one dose of Pandemrix, which explains why the GSK vaccine is the one primarily recommended by the Department of Health.
A reminder that vaccination against the H1N1 pandemic strain is being limited, initially, to people considered most at risk of complications of flu (such as those with asthma, heart disease or immune disorders).
In addition, front-line health workers are being immunised. There are no figures yet on uptake of the jab among NHS staff, but Ian Dalton, the NHS flu resilience director, said that anecdotal evidence was looking good: "It's very positive," he said. "There's a sense that staff recognise it will protect them, their families and patients."
Extending vaccination
As I've said before, it's just a question of time before the swine flu immunisation programme is extended beyond at-risk groups, with healthy children being the next priority.
The Conservative health spokesman Andrew Lansley has formally called on the government to extend vaccination to all school children and college students. Mr Lansley says he's been pressing for this "behind the scenes" for weeks. Sir Liam says it's not a question of whether but when the programme is extended, but they are looking at the best way of doing it. He said an announcement would be made "within a couple of weeks".
Swine flu across the UK
My apologies to those who live outside England. This summary must appear rather England-centric. It's an inescapable fact that I can't get to the swine flu briefings outside London, but I do my best to reflect what's happening UK-wide. It would be great if the four health departments could get together and publish UK data as well as that representing their individual statistics.
To summarise, there have been slight falls in the number of suspected swine flu cases in Scotland and Wales, with a big decrease in Northern Ireland.
In Scotland 17,487 people are thought to have contracted swine flu over the last week, compared with 19,200 cases reported in the previous week.
In Northern Ireland, 215 laboratory-confirmed new cases have been reported in the last week, compared with 142 in the previous week - the department there does not seem to publish an estimated total of those infected, making comparisons difficult. Nonetheless, it does report GP consultations for flu and flu-like illness, which have decreased from the very high level of 280 per 100,000 to 222 in week 44 (21% decrease). Contrast that with the rate of 37.7 in England.
In Wales, 1,971 people contacted their GP in the last week with flu-like symptoms, compared with 2,626 the week before.
Justin McCracken, chief executive of the Health Protection Agency told journalists that in England, around 50% of patients who were being swabbed for suspected swine flu actually tested positive for the H1N1 virus. In Scotland and Wales, the rate is around 40%, while in Northern Ireland it is 80%.
Deaths
The overall number of deaths linked to swine flu now stands at 154 for the United Kingdom - 105 in England, 31 in Scotland, eight in Wales and 10 in Northern Ireland. The average age of those who've died is 44. Four out of five of those who've died have had some underlying health problem.
Useful resources:
Detailed UK weekly epidemiology update
I'm 
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Comments
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Great post Fergus. Looking Positive at the moment. Good to read we are having a similar experience to the Southern Hemisphere, where they experienced their mildest influenza season on record across the board.
Good news.
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It seems half term week is being seen as the reason for the lessening numbers last week. I have an alternative take on this:
Firstly the increase in numbers also halved the previous week and were up 50% rather than the doubling we saw the week before. This seems to hint at a possible decrease in acceleration of numbers even before this weeks figures.
Secondly, many people who were in school the previous week would have come down with SF during half term week so the numbers of GP consultations would not necessarily have been so low.
Typical Flu waves are 12 weeks long we are told. We are in week 8 of this wave and so approx when a peak might occur. The US is also peaking in some states we hear.
I remain optimistic!
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Good point questions. And the increased ICU and hospital admission rate is easy. Super spreaders are generally fit and healthy, they have all had it now, so the older people, the sicker people etc... Are the ones catching it now. As i said. Good news all round
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Full report finally up on the HPA site:
http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1257260344728
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Skyline, I think that goes with what happened in the late 50's with the asian flu, the young and healthy got sick first, then later in the 2nd/3rd waves in the Jan, it was the elderly who all caught it.
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Exactly Tinkerdellbobby2. The so called "super spreaders" are the ones who catch it first, the school and college kids, the frontline shop workers etc... you know what i mean. These people are generally the healthiest and least prone to complications. Now the main wave has passed, i.e the superspreaders are all now immune due to catching it in the previous months. The next people to get infected are going to be the older generation, the weaker, the sick etc....
Swine flu is less likely to infect an older person, but if they get infected they are the most likely to die. Just like seasonal flu. Thats why the deaths have been so small. And will continue to be so long as we can get the older people immunized quick enough.
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And isn't it that bacterial infections are around more in the autumn/winter so we're more likely to see secondary infections, particularly in those who are vulnerable to them anyway?
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Good point. Hence the statistics being pretty positive overall. I cant see any cause for concern. We just have to grin and bear it for this winter. We will have a very similar situation to australia and NZ during their winters. Similar infastructure etc....
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Okay, just caught up with the posts on the last topic. Skyline, no offence taken, I knew exactly what you meant in your post, I've learned that even health professionals who happen to be very good at their jobs don't know everything which is probably a good thing.
Tinkerdell, one of your posts has been referred to the mods. Everything okay with you? Do you want to be known with a d or a b? :-) Good to see you anyway. FWIW I agree with Skyline, you are feeding your anxiety. I know you have to face your fears, but not feed them.
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Skyline the 'no offence' was for the previous topic re my nurse friend. She was one of the people up for a sf party, she was so sure it would have mutated by now. Oh well.
Glad things are looking positive. :-)
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Thats rather sad that a nurse thinks like that. Especially when a immunity to a virus doesnt mean you will be immune to any significant mutation. Not that this will happen with swine flu. Have to watch my words here!
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Thanks Angel, no all is fine, dont know why a post I have made has been reffered to mods - the one still awaiting moderation was just some comments on a link that Skyline posted, nothing I wrote I think. It was an article regarding the situation in India. Dont know why they havent posted it, you can see it by going through Skylines link.
Hope you are all well. I read that your sons pre-school teacher has been ill with SF Angel, if I could advise you to look out for anything, it would be the dreaded cough, thats one major sign its going around I think. I agree with you too, its better to try and hope its out the way by Xmas. X
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Angel, I had problems signing back in when they changed the format as my old e mail address had expired, so I had to re-register with a different name but close to the one i had. I dont mind what I am called on here. lol
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Lol, Skyline. Actually I really do think that is what she was being told by her superiors, that there was going to be significant mutation this autumn.
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Thats incredibly stupid if thats the case angel. Id love to know who they were getting their info from. Because it certainly wasnt British Virologists....
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Tinkerbell, I thought you might have been caught up in the floods. I had huge problems signing in earlier this week, I had to get e-mail support to get back in again. There is definitely something doing the rounds here, but it seems quite mild and my boy's teacher is fully recovered. My younger daughter has been coughing for over a week with a dry cough but is otherwise 100% normal, not a lot of coughing elsewhere although my daughter says there is a lot of sneezing at school. Not particularly high absence either, although I gather that quite a few families were laid up last week - so no, I don't think half term will have affected the figures, unless it is that parents were off work anyway and so didn't need a med certificate for their kids to show their employer. It's good in a way that it's not here too badly, but worrying too as I don't want this to hit us late at Xmas! But then it's obviously here already, so hopefully will be done and dusted by then, one way or another.
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Skyline, I've no idea, although this was in the early days. Maybe it's NHS policy to expect the worse until things prove otherwise. I didn't tell her but she scared me witless.
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My 14 year old tells me there are fewer kids off sick at the moment at his school than a couple of weeks ago.
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"There's a sense that staff recognise it will protect them, their families and patients."
Can I find out which GPs in my health centre have had the vaccine? I wouldn't want to visit the other ones, and the anecdotal evidence I've collected from colleagues and friends with NHS connections is that vaccine uptake among GPs in the North East has been far from enthusiastic.
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My GP definitely had a bunged up nose the other day!
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Thanks Fergus, useful info.
Is there any reason why your graphs (which refer to England & Wales only) are superimposed on an image of the globe? It adds nothing to the presentation of the data and makes it look like they are referring to global figures.
And the first table of hospitalised patients would greatly benefit from percentages of patients in critical care so we don't have to work it out in our heads.
Cheers.
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Good point, Bri. And I really don't find lumping 16-64 yr olds together helpful or accurate. I'm nearly forty and have had three kids and major surgery and in no way can I be compared to my twenty year old self.
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We have had it. Or, it is supposed that is what we have had. Without tests taken to verify this, we have no sure way of knowing. We have just spent two weeks under self imposed quarantine, but in truth no one wanted to go out anyway. I have written at length over how frightened I was at my children and I getting this on here over the past few months. I cant say it has been better than I thought, but I can say, we got through it, asthmatics all.Our daughter we took to the out of hours because of a high temp , an horrendous headache and delusional. We didn't realise she had a high temp, the thermometer didn't register it. If you have an electronic one, check its range.The Out of hours said she had a virus but didn't say where it would go, wait and see. Later I rang the swine flu helpline as a growing suspicion dawned on me. They were very thorough and very helpful, and prescribed Tamiflu, which we had to get from the next town.
One by one the rest of us fell poorly with varying symptoms of the same theme. The good thing is we all recovered,my daughter a week, almost exactly, the baby, 4 days. My other child,didnt get it,having already been on antibiotics for a chest infection I was very concerned, but maybe that is why she didn't get it. My husband and I did with various responses. This bug appears to pick on the weak spot of its victims. My husbands throat and glands, my chest. I am nearly finished a course of antibiotics for a chest infection. It isn't the flu, it is the after effects. It is easy to understand why it spreads because just when you think you are better, and can go out and about you get hit with the secondary bit
The spread of it may be less this past week because we have just had a school break. That might be worth remembering.
Meanwhile, because it has been undiagnosed formally as H1N1 in this family, I have to decide whether to let those of us who are eligible have the vaccine or not... was it swine flu? what if it wasn't? How do I find out? or shall we just vaccinate anyway?
Whatever it was, it wasn't very nice and I have no wish to see it again or the effect of it on my children, so when in doubt, vaccinate.
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I think that with regard to swine flu it is all over bar the shouting, this plateau is I think the second peak, cases will probably start to fall from now on. I also think that it is highly likely that we will see a smaller amount of seasonal flu this year due to sf crowding it out.
Obviously the vaccination program is still hugely important, just because most people have had sf doesn't mean that the vulnerable groups are any less susceptible to complications should they catch it.
Lessons learned -
A virus with a high transmission rate can appear suddenly and pass around the world in a very short time (less than 7 months)
It takes about 7 months from identifying a possible pandemic agent at large to mass vaccination capability. (which is too long in my opinion)
I'm no scientist and these are just my personal views.
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I have the following suggestions as to why more of those hospitalised with swine flu are ending up in intensive care this winter:
1. Perhaps physicians are becoming more complacent about treating and diagnosing those with swine flu and so there is a significant delay in starting treatment once people enter hospital compared with earlier in the year. Remember Tamiflu is very effective if given early, but hours matter.
2. Perhaps the general public are being more confident with the way they handle swine flu, not least because they can get swift access to tamiflu without seeing a doctor or attending hospital and so as compared with earlier in the year, it is only the more severe patients that are ending up in hospital, hence a larger proportion go on to need intensive care.
3. Finally, and this is more of a stretch, perhaps vitamin D has a positive effect in fighting swine flu and the lack of sunlight exposure is taking its toll.
It will be interesting to see if the medics can pin down why this is happening.
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Evening all - Thanks for the info again Fergus - for some reason the link at the bottom of your article to the HPA (England) report doesn't work so I went the long way around! Did anyone else spot the error in Figure 7 on the HPA weekly report? 10 colours on the graph, but only 8 on the key. Missing were light green and light purple - one must be Yorks and Humber, the other West Midlands. I have emailed it and asked them to correct it, but I doubt they will......!
I agree with you Angel - at 47 I am so definitely not in the same health and fitness as my daughter aged 21! Neither am I nearly as frail as my mother at 66, despite all my extra weird immune system goings-on!
I was speaking with a couple of friends who work in a local school - they said that although they had a few staff and children off, it wasn't a significant level of absence in either group. They also said that they have usual colds, coughs, sneezes, and sick bugs going around. Nothing unexpected for the autumn term. It is the longest one and the most tiring - everyone is exhausted by Christmas!
I also asked them about any special instructions they may have received from the Health Authority - apparently, just the usual instructions - send any visibly sick child home if parents/carers can be reached, ask parents to keep sick children off of school, reinforce hand washing protocols. That's it really. Perhaps schools can make their own individual arrangements with approval of governors? Who knows.
Re the cough - this was dreadful with my hubbie and Mum - mucky and frankly disgusting! Both also had significantly raised temperatures, Mum felt sick (Tamiflu made her sick), but she did take it on an empty stomach the silly thing), Hubbie had watery diarrhea. The cough was my biggest concern - especially after the warning on the Tamiflu authorisation that they may be suffering a complication. All the stuff I have read over the last few months suggested that lung complications could strike pretty suddenly, and this worried me very much, hence being firmly insistent that I spoke with a doctor. I remain convinced that the Tamiflu and antibiotics enabled my hubbie to recover much more quickly than my Mum, who just took her antibiotics in the end.
Just in case anyone missed my earlier postings re the recommended antibiotics for Pneumonia complicationson the HPA reports they are 'Co-Amoxiclavs and Tetracyclines', although hubbie had a sort of '...mycine' - can't quite remember all the name, and Mum Amoxycillin and both seemed to have worked alright, though personally I have no faith in Amoxycillin!
Hope all are ok - Tinkerbell - I thought I was having a funny brain moment and was seeing things with your new sign on! So relieved that I wasn't!
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Looking at the figures for hospitalisations - the high number of under 5's suggests to me that doctors are not taking any chances with a young child who has a cough and temperature. Bronchiolitis is pretty common I believe in such young children so are we sure that these hospitalisation figures are definitely due to Swine Flu?
I've probably missed something obvious there on that one! However, if these figures are Swine Flu statistics only, I agree with others on here - it would suggest that:
1. They are taking no chances with the under 5's and hospitalising them just in case they get worse.
2. The ICU figures being in a different age group could be broken down more - it covers too many decades in my opinion, and it would also be informative to know percentages for pregnant women. Why not do a sex split too for good measure? I have no idea what proportion of Male/Female suffer seasonal flu, nor what proportions are suffering Swine Flu.
3. The ICU figures for the 16-64 group looks alarming, but if the split suggested at item 2 happened, then would it really show the same vulnerable people as with seasonal flu? This bracket includes the 16-24 next highest risk group, so I'm not entirely sure we can assume that older and more susceptible people are now falling foul of SF complications. Also, in this bracket are pregnant women, parents and students. Pregnant women are already acknowledged as vulnerable, students tend not to eat properly (unless they live at home) and get a lot less sleep than they should, and parents will worry more about their offspring than themselves. All these groups get very tired so it's no surprise they may be at risk and some not having time to see a doctor when they should.
I'm very relieved that so far neither my daugher or myself has caught it, despite having it in the house and looking after my Mum too. We are both in the priority group, but haven't had letters inviting us to a vaccination session yet. We wait with bated breath!
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Still knocking out the tractor-production figures then Fergus,on your non-stop "swine-flu" merry-go-round blog?
http://www.youtube.com/watch?v=nZOXJt6KZm4&feature=related
http://www.youtube.com/watch?v=ONlWVpQl1Ik&feature=related
http://www.youtube.com/watch?v=yepxUWc14Ko&feature=related
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I see it`s the same posters,day-in,day-out.
"Just get your damn vaccine!"
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So anyway!
Ignore the troll guys, only way it'l go away.
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27. At 01:15am on 06 Nov 2009, Tigerjayj
"We are both in the priority group, but haven't had letters inviting us to a vaccination session yet. We wait with bated breath!"
I can tell.
24. At 11:31pm on 05 Nov 2009, BobRocket wrote:
"Obviously the vaccination program is still hugely important."
To the manufacturers and their shills and toadies,maybe.
I live in Southern Hampshire.I have not heard of a single case of "swine flu" amongst friends and extended family.
23. At 11:22pm on 05 Nov 2009, twistywillow
"Meanwhile, because it has been undiagnosed formally as H1N1 in this family, I have to decide whether to let those of us who are eligible have the vaccine or not... was it swine flu? what if it wasn't? How do I find out? or shall we just vaccinate anyway?
Whatever it was, it wasn't very nice and I have no wish to see it again or the effect of it on my children, so when in doubt, vaccinate."
Yes,because scientists know best.Just like they did with DDT,500 atmospheric nuclear detonations,de-natured food,"treated" water,"depleted" uranium etc,etc.
It`s all good clean "harmless" fun.
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Rather than just a split in the 16-64 group, I would actually like to see a true age breakdown of cases. I have seen mention elsewhere that it is worse in the under 45s, well I am 45 exactly, so am I suddenly at less risk? Mind you I've also see "average age" from the 16-64 group stated as 44 as well!
A couple of weeks back I did find a list detailing each fatality, wondering if I can find it again...
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OK found it - may help to see how many of exactly what age actually died from this:
http://www.whitehaven-news.co.uk/news/list_of_swine_flu_deaths_in_the_uk_updated_1_608462?referrerPath=1.453403
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Would any swine-flu enthusiasts like to try and explain away this:
"Less than 0.1% of French population has taken "swine flu" jab so far, admits French Health Minister"
http://www.theflucase.com/index.php?option=com_content&view=article&id=1620%3Aless-than-01-of-french-population-has-taken-qswine-fluq-jab-so-far-admits-french-health-minister&catid=1%3Alatest-news&Itemid=64&lang=en
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Does anyone else find it really unhelpful that the age, sex & health status is sometimes held back by an authority? It does not impose upon a family's privacy at all to provide this - we don't want the sufferer's name or even location - it just helps build up the picture better of who are worse affected.
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"CFR admits false scarcity tactic to get people to take the H1N1 vaccine"
http://www.youtube.com/watch?v=Ly5DR_3D_mA&feature=player_embedded
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Twisty, what a horrid time you've had. We've had similar viruses in the past and it is so hard to know what causes which bugs, but it is probably likely that you've had sf. Interesting about the antibiotics, we had a virus in the house once that lasted nearly ten days', my eldest, who was 6, had a temp over 39 for six days and then her baby brother, who was two, got it, as did me and my husband. Yet my middle daughter, who'd just been hospitalised with tonsilitis, escaped with just a snotty nose, and the only possible reason that she was okay was that she was on a daily dose of antibiotic and it had acted as a prophylactic.
Just got back from pre-school, only 5 out of 9 kids in although one is on holiday and one has chicken pox so not necessarily swine flu. My boy had very mild chicken pox as a newborn so I'm hoping that will give him enough immunity to escape it this winter.
Tiger - sounds like your dh had erythromicin. I believe that co-amoxiclav is less likely to have side effects than the tetracyclines. Personally I find amoxil works as a one-off but if you need repeated doses, like my children have for tonsilitis and middle ear infections, then it loses its oomph.
TechSing - as far as the general public are concerned there is not the hysteria around sf so far fewer go to hospital. There are targets that the A&E depts. have to make on waiting times, which results in unnecessary admissions of people who don't need to be there to get them off the A&E figures, who are then almost immediately discharged. It seems likely that the vast numbers of 'worried well' at A&Es back in July would have had an impact on the figures for 'admissions for swine flu'. Add to that the fact that respiratory problems and associated bacterial infections are always worse in the winter and it really doesn't seem that strange to me.
Questions, I agree with you about the lack of info given out about people who've died from swine flu, one of the most sensible people in this whole situation was the coroner very early on who gave out details of the little girl who'd died's profound underlying health conditions. I thought that the family were terribly brave too, and everyone showed an awareness of the alarm that too little information would cause parents. I know that some information can be very sensitive, but not to release some details can also lead to speculation which is equally unfair. That said, I'm more concerned about the possibilty of getting secondary complications and a clearer idea of which age groups are ending up with those would be helpful.
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I was just speaking to a nurse (fellow Mum) up at the school who told me that she and her colleagues have all had the SF vaccination. I aksed if she or anyone else had suffered from it, she said no, that they had all just had soreness around the point of vaccination, trouble raising their arms etc, but that was all. She did say though that they did put a lot of pressure on the staff to have it done, but most of them wanted to take it up anyway as a lot of them have children of their own and didnt want to bring anything home. No fuss, no bother, most of them had it.
Twistywillow - glad you are all feeling better, I think back to the WHO who said that this was a sneaky virus and now we know what they meant. Just when you think the kids are getting better, the secondary infection sets in. When I had to take my daughter to the out of hours Dr, he was great and instantly knew what to look for as he said he had seen 10 kids the week before with secondary infections. Seems this is a common trait.
Saying that though, with the antibiotics my daughter bouncd straight back. I did notice though, (It reminded me what you were saying about the temperature) that when my eldest daughter got a temp, she felt as cool as a cucumber to touch, but registered as 38.5 when we used the thermometer. So just to say, always use a thermometer and never assume that because they feel cool there is no temp. (I dont know if this is common, but had never happened to us before)
Tiger, Im so glad your family are feeling better. Do you think you may have had it too? The under 5's are being watched v carefully, when I rang the Dr's with my three year old, they told me to bring her straight down as she was under 5.
Bob - I agree, by the time the peak is over the vaccine will only just start being rolled out to the masses. Just goes to show that if this is a conspiracy, its a rubbish one. If they knew what the virus was because they put it out there, then they are a bit slow at following up with the jabs. It just goes to show that in 50 years (since the asian flu) we havent really advanced that much, as I am sure the timescale to get the vaccines out isnt that different. Although, there are many more people needing it now than back then I guess.
Brown - you are a regular poster here also now, so whats your point? Are you saying we are all paid Govt posters trying to drum home the vaccine message????
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That figure re France is misleading though isnt it? They havent started trying to vaccinate the general public yet, that starts on Nov 12th. They are currently only vaccinating a certain group of people.
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Tinkerbell, a good place to check a temp with a child who feels cool is under the arm. Cold hands and feet are especially a sign that a child needs to be seen, along with a headache and dislike of light.
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It was strange Angel, she was cool on the forehead, her cheeks, under the arm and round the back of neck, it was only by chance that we took her temp. Id never seen that before.
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My younger son gets hot hands when he has a temperature, my older one gets a hot neck. All wired up differently i think!
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All that French article shows is a nervousness out there. It just means information hasn't been spread so well.
I haven't a clue what BrownbankruptsBrits is getting at either - he just seems to be attacking everybody and everything with negative comments.
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To madness112
Sorry it took a while to answer. I answered on post 190 underneath you but I'm not sure if anyone looks at those once Fergus has done a new blog - not very technologically-literate, sadly - so I'll repeat what I said, sorry to be boring!
The kids were totally healthy after their jabs. My 6yr old has had 2 jabs and has had no side-effects after either. My 22mth old has had 1 and is due the 2nd next week. He has been completely well too. As far as immunity between the jabs is concerned, I don't know. I assume it takes a while to build since no checks are made until three weeks after 2nd shot. By that stage GSK (on their site) promise 100%. But I haven't been feeling well this week, have been - hmhm - fluey! But my 22mth old has only had a mild cough, no temperature or anything. He always gets ill with me since obviously we are always so physically close. I find that a bit wierd. Mavbe I'm reading too much into it.
Anyway, despite my rambling, hope that helps.
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What I mean in post 43 is that it is the no news that there are nervous people in every country re the vaccines. Some countries are able to put across the benefits more positively than others. Ideally I'm sure nobody on the planet wants to have to have any vaccine but there are times when such things may be necessary.
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I know it would be difficult, but I still think, to halt the pressure on the NHS over the Winter/Xmas it would be wise to close the schools a little earlier for Xmas and return a little later in the New Year. If this means that the NHS can deal with the numbers a little easier and more space in the ICU's wouldnt that be a better option?
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Hot hands with a temp is normal. When hands go cold can be a sign that the blood is leaving the extremities and going to the vital organs. It's okay to pop on some socks or even trousers with kids with even the highest temps, so long as the torso is stripped off. Tinkerbell, weird about under the arm not being hot, I've known my kids to be cool on the forehead and the tummy but always the underarm seems to register the temp. As we've said before though, it is how yoru child is that counts - I've had my kids with temps over 39 still be up and about playing, and temps of barely 38 (and their 'normal' is around 37.3) and yet they've been really wiped out. When my daughter had her most severe episode of tonsilitis I knew she was really unwell even though her temp was just over 38 and she wasn't showing any major signs, I just knew because she'd come in and laid down in my room and said her throat hurt, and she was too wiped out to lift her head up. Within 12 hrs her temp was over 40 and within 24 hrs she was on a drip and IV antibiotics. Yet when I initially took her to the GP, clinically there was no cause for concern and to be fair the GP couldn't have forseen what was coming, but I just knew there was something wrong. The point of all this is that parents shoudl trust their instincts, we all know our children best and if something seems wrong then act, regardless of what a thermometer says.
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Questions - thats interesting, I guess everyone is different.
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i have been reading these blogs for some time and generally reassured, but a post a few days ago, nov 2nd has reall worried me. I work in an nhs hospital and have signed up to have sf vaccine should be round 16th nov, I am also currently trying for a baby, with incresed risks of sf during pregnancy i thought it best to protect myself and planned baby now while i have the opportunity. Then i read that squalene is being used in a sterilization vaccine and that novartis product information states could cause harm when administered to pregant women, and the poster added or affect reproduction capacity. I am already concerned about fertility, i am 33 and my husband just over 40 and dont feel i can take any chances where this is concerned.I now dont know ehether to have the vacccine as the implications are very worrying.
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Just read about funds in N.I. being diverted from a bowel cancer screening programme to pay for sf (doesn't say what exactly). In my naivety I'd assumed that the NHS had some kind of contingency fund set aside for this, but it seems not. Given the state of the economy means cuts across the board, what state is the NHS going to be left in when this is over - the general opinion being that this particular is the tip of the iceberg. So how much money was it we've spent on publicising the flu line, let alone running it? And free tamiflu to everyone regardless of income on the grounds of a phone call?
Oh, and apparently bowel cancer kills 400 people a year in N.I.
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Tinkerbell - yes everyone seems to be fine now. My daughter and I definitely did not have SF - we all had a cold, then hubbie and Mum both went out to different locations on the Sunday catching SF from the places they went.
It's my muscles and joints which get extraordinarily painful if I catch something more serious than a cold - the pain caused by the autoimmune reaction is often worse than the symptoms of the bug. Colds just make me incredibly tired for a couple of weeks.
I have been fortunate and only had flu once - I had a secondary lung infection from it and was very poorly. Hence why I dread catching SF, but I don't worry too much about it. I was sure I would catch it after nursing hubbie and Mum, but I was lucky I guess although my manic cleaning probably had something to do with it! I don't go out a great deal, so I usually only catch what comes into the house, if at all. I don't seem to be especially susceptible to infections, just suffer a lot of pain if I do catch something nasty. Not entirely sure why this should be, but I'm sure the Immunologist I am seeing will work it out!
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Angel - I read that too - very worrying. I really think that in a pandemic situation, drug companies should provide the vaccines for nothing, or at the very least a very low minimal charge. I find it appalling that money should decide whether a country has a vaccine or not - in a more serious pandemic illness hundreds of thousands could die, just for want of money. It's not at all good enough that some really poor countries have to rely on donated vaccine from richer countries.
If free vaccine were provided, the countries would be able to fund extraordinary requirements and not have to move funding from elsewhere. I'm not sure how the funding has been achieved for all this SF intervention and treatment in England, but it seems that Ireland, Wales and Scotland all have to fund their own services.
I know that we have been advised that if things get severe, there will be cancelling of routine surgery etc, and I remember reading something about this already happening in some hospitals.
I really can't understand why so much has to be paid out. Doctors charging for vaccinations, drug companies charging for vaccines etc. If the NHS has been expected to find the monies by suspending scans for serious illnesses etc, what other cuts may we see if things get worse?
Like you, I would have thought contingency funds would have been set aside. Although this SF pandemic is going to put a strain on our NHS if it worsens, it is surely not as bad as the bird flu would have been.
Maybe this is another lesson learned from a pandemic of a relatively mild illness. There will be a lot of meetings in a lot of places after all this is over, I'm sure!
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Ellamed, I know little about squalene but I do know we aren't using novartis vaccines. It might be useful to know that in the US seasonal flu vaccines are given routinely to pregnant women, and given that the make-up is pretty much the same, there doesn't seem to be loads of problems, I think someone would have started a lawsuit by now if there were. I hear you on fertility - I got pregnant at 30, 32 and 34, and most of my friends with kids the same ages as mine are older than me, if it is just age you are worried about - but maybe if you are that concerned you might want to postpone trying until after Xmas when it looks like things will have died down?
How rotten for you to have your peace of mind taken like that, FWIW there has been a hell of a lot of scaremongering on this blog. With regards to your job, I guess it depends on whether you have contact with vulnerable people and whether your dept. could cope without you if you had a prolonged absence due to sickness.
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Ellamed - It is so worrying when you are trying for a baby or expecting - what you can take, what you can do, what you should take, what you should do. It may have been a very long time since I was in your situation, but I can still recall the deep worry I felt over my diet, painkillers, and so on.
I was very lucky then - I had a terrific doctor and midwife and they were always so reassuring to talk to. Maybe it would be best to speak to your GP about this if you can - I find the amount of information out there for pre-conception health very bewildering, and I sometimes wonder how on earth people like me or older managed to have a healthy pregnancy and baby!
In your shoes I would definitely discuss any worries I had with my GP or similar professional - this blog is brilliant, but for something as important as this I would 'go to the horses mouth' - nothing else will be as good as that.
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Tiger, cancelling surgery makes sense - there is a need for more bed capacity, more ICU beds especially, plus more staff to look after the extra patients. I can see why it isn't useful to have nurses tied up with looking after people who've had their varicose veins done. Also I would think that post-operative patients are more at risk from sf, so again postponing surgery makes sense - we've already told our boy's consultant that he's not having grommets this year.
But as for the rest of it...the GP's contract was of the Govt.'s own making, although the BMA coudl have waived it, and there is absolutely no reason why most people can't pay for tamiflu.
Maybe this is a wake-up to the fact that a) we've squandered an unthinkable amount of money and b) we're not a 'rich' country any more, we can afford to buy the vaccines and the tamiflu and that's about it, and only then if we let something else go.
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ellamed... I don't have a strong stance either way on the vaccine - I've had my concerns & been reassured by people on here to a point but I think in your position, I would delay trying for a baby for 6 months or so until you feel happier with what to do. Just a thought :)
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skyline - re ellamed & angels discussion above - can you clarify whether the US use adjuvants in their vaccines or not please? I heard they don't (or not for the SF anyway) but then read American posters elsewhere who were concerned that they were adding them in.
It would really help to know where exactly adjuvants have been used before - was it one particular year they put it in the UK flu vaccine but not other years. Why was that? The info out there is so confusing!
Much appreciated
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Looks like half term did have effect then. However, I am not as optimistic as others that this is a levelling off of cases. The first time the school holidays had an effect in the summer it cut the number of cases by about a third. This time it has still actually increased, albeit slowly. Generally we've mirrored the USA, so I would expect another sharpish rise next week. I will be VERY happy to discover I'm wrong though!
Comparing us to other countries in Europe at the moment, it looks like us being hit much harder than anywhere else in the summer was a blessing in disguise, as it allowed us to build up some immunity. I think Italy has over 300 cases per 100,000 at the moment, THREE TIMES what it was at our peak. Apparently the figure for Belgians of school age is a mind boggling 2500 per 100,000. So every week 2.5% of Belgian kids will catch flu.
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Ellamed, I agree that the only advice you should really take is from your GP.
In that position I think I would keep trying for the baby, it could take up to a year anyway (though hopefully not) by which time, SF could be a thing of the past. I am not sure (someone correct me if I am wrong) but most of the complications from SF occur in the last trimester of the pregnancy, so you may be looking at a long way off yet - which will give you time to re-evaluate and look at the situation with other pregnant mothers who have had the vaccine. SF has been in every nook and cranny it seems, in the area in which I live. I know lots of pregnant women and new Mums to be and all have been fine.
Speak to your GP.
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sorry that should read New Mums, not new Mums to be.
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Luv those figures are staggering. I take it then that those places didnt get hit as hard in the Summer. It may have done us a favour then that the schools were open longer than elsewhere in the first wave as its made a lot of people immune for the winter.
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You know I keep reading with trepidation that word "snowballing" of cases above. It is a scary phrase, even when balanced by positive facts in the article. Looking forward to the next article so I don't keep reading the phrase! LOL
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Tinker - I was in France in the summer when our papers were full of all the hype. SF over there (La Grippe) barely got a mention.
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Questions, the use of emotive language along with scare stories by Donaldson (64,000 fatalities?) is one of the most shameful things about the way this pandemic has been handled by the authorities. I still maintain we were being spun into the hysteria of July because the Govt knew the situation wasn't so bad and wanted to be able to take the credit for 'saving' us, (hence the later statements about 'defeating' swine flu) but I don't get what is going on now at all. Unless he's enjoying the drama of the moment, who knows?
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To everyone advising Ellamed to get advice from her GP, do any of you seriously think a GP would not recommend a woman trying for a baby having the vaccine? I would suggest that they could be guilty of failure in patient care if they didn't, whatever their personal views about vaccination. I would think that a midwife would be better placed to discuss issues such as pain relief, vaccinations during pregnancy, side effects with flu etc. I don't know how you consult one if you aren't pregnant though. Maybe a private clinic? There is also the organisation Foresight, which deals with preconceptual care, they might be worth a look.
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Just checked out Foresight's website and they aren't exactly pro-vaccination.
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" 46. At 10:44am on 06 Nov 2009, Tinkerdellbobby2 wrote:
I know it would be difficult, but I still think, to halt the pressure on the NHS over the Winter/Xmas it would be wise to close the schools a little earlier for Xmas and return a little later in the New Year. If this means that the NHS can deal with the numbers a little easier and more space in the ICU's wouldnt that be a better option? "
Not really. The NHS staff would have to find emergency childcare (and its not just the docs/nurses either but the cleaning staff, the caterers etc) which would probably mean one adult looking after a load of kids at once anyway.
#57. Almost every vaccine has some sort of adjuvant added. If you don't use them the vaccination is inefficient and very hit & miss. In human vaccines its normally an oil or aluminium salt NOT mercury if thats what you're worried about (and contrary to popular lies MMR doesn't have mercury in it either). Alum in tiny doses is not harmful to humans. Swine flu on the other hand sometimes kills you.
If you're worried hunt down this paper:
Baylor N, Egan W, Richman P (2002). "Aluminum salts in vaccines--US perspective". Vaccine 20 Suppl 3: S18–23
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Angel, I think a GP would know more re that one particular case than anyone else. Generally, re any advice given re the medical profession would be to listen to it all, and then go with your instincts.
If that were me, I would avoid the vaccine and wait and see. But on here its our own personal opinions and advice cannot really be given. To be honest, I dont even think a midwife would be that qualified to advise on it, although it depends who you get. My midwives were like chocolate teapots..
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Questions - I dont know about the highly populated areas in France, but a lot of it is so remote, its barely a problem. My friend lives in France and she has about seven people near her house and thats it, although the school would still have the same problems, the communities are so spread out, its just not the same scale as here.
Or it could be that they are driving out the sick with bricks and fiery torches. lol
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http://news.bbc.co.uk/1/hi/entertainment/8346828.stm
Seems Elton John is over his flu/E.coli bout. Good to hear, i always loved Rocketman.
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#68 My mum was a midwife.... superb at delivering babies, not qualified in virology or vaccine technology at all. A GP in contrast spends most of their working lives sticking routine vaccines in people and telling them there's not much they can give them for whatever winter virus they've come in with.
My advice would be that there will be a very, very small group of people who will suffer serious side effects (or even death) from the vaccine, but they will be a fraction of 1% of the people who will suffer serious side effects from the swine flu. If you are one of the 'at risk' groups then its totally illogical to avoid the vaccine and chance the virus.
Its worth remembering that 10% of people taking penicillin suffer side effects (vomitting, diarhea etc) and 0.01% anaphalaxis. Aspirin can cause stomach bleeds etc. The only medicine with no side effects is a placebo.
Incidentally I'm not having the swine flu vaccine, but thats because I'm not eligible at present and don't want a sore arm for a day or two anyway. I haven't had influenza in over 20 years either so my immune system seems pretty good (which may explain why I get a very sore arm whenever I get a vaccine)
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Ellamed is concerned about fertility problems from the vaccine, so a virologist isn't going to be able to help there. Actually, rather than a midwife, some kind of fertility clinic would probably be the best people to talk to. In my three pregnancies I had a mix of good and bad midwives, but then I've found the same with GPs - and fertility definitely isn't their speciality. When I had flu it wasn't from my GP that I found out that I was in danger of going into early labour, it was from the midwife at the delivery unit that I phoned, having had no joy at all from my doctor.
If it were me I'd stop trying for a baby for a while (I did plan one of mine so I know it's not easy), which kind of takes the pressure off a bit over having the vaccine. But I know that is easy to say, and as Tinkerbell says, we're not experts. Ellamed, have you actually spoken to anyone about your fertility worries? Maybe that should be your next step. I am sure that whoever you see could research your concerns about the materials being used in the vaccines and their effects on fertlity.
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I think the issue for people like Ellamed is that at the moment, she isn't 'at risk' - she only is in this position because she gets offered a jab through her employment. The vast majority of women trying for babies won't be offered the jab until they are pregnant. Of course anyone who is 'at risk' should have the jab, but that isn't what is worrying Ellamed, as I understand it.
Sorry, we're all talking about you, you must think we're very rude!
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Skyline, cool about Elton, that sounded really grim - I love Rocketman, too, and Blue Eyes.
I can only just about forgive him for Goodbye English Rose though.
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#64 Angel
the 64,000 figure was a worst case scenario figure that they have to plan for, in this worst case the medical infrastructure would be placed under a tremendous amount of strain and contingencies have to be planned for. When more and better data became apparent the numbers were downgraded (but still worst case based on the new data)
Donaldson could have placed more emphasis on the 'worst case' bit of the information he was giving out or he could have used 'most likely' numbers, either way he would have been accused of downplaying the possible seriousness of the outbreak or covering up the numbers. (rock/hard place)
They still have to plan for unknowns such as a scenario where those who didn't catch it in the first wave somehow have more serious complications than the first lot and how that might affect ICU places.
Unlikely but they still have to produce plans for that eventuality.
Re: French uptake - do they have to pay for it ? / is it actually available ?
(in the UK I know someone in a priority group who will have his vaccine tomorrow, the only person I know who has been offered it, I thought it was being rolled out a fortnight ago)
#49 ellamed
Have the vaccine and keep trying, (the trying is the best bit:)
don't worry about it, this vaccine is the same as any other seasonal flu jab.
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You're more generous than me, Bob. Poor old Donaldson, I want to throw things at the television whenever he's on. If Skyline knew that 64,000 was a ridiculous estimate then one would hope that Donaldson's people did too. I find it even harder to forgive him for making me sit down and work out how many people from my village and community we were going to lose based on his erroneous estimate.
As it happens I agree with you 100% about the vaccine, I think it is entirely the same as the seasonal flu one which pregnant women and people trying for babies have used for years. But poor Ellamed has doubts in her mind now.
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Tinkerbell, your idea about schools is a good one, they could keep a skeleton staff on for the children of key workers.
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#72 Thanks for clarifying that.
I've never heard of a fertility problem associated with a flu vaccine. I'd stand by my advice that getting swine flu will be a bigger risk. I'd be suprised if any professional would give an absolute answer either because there ALWAYS someone suffers a bad reaction to something. Being rational though driving to the fertility clinic is probably more dangerous than getting the vaccine.
Whats definately more dangerous is getting swine flu while pregnant or just after giving birth. Thats been the cause of a few UK deaths already and I wonder how many miscarriages.
I'm not medically qualified and fertility isn't my area (but making vaccines is) so consider that when considering my advice. Good luck whatever you choose to do.
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I think they should have kept Elton John in even longer, just to be on the safe side.
We dont want any more concerts now do we? lol
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Hi guys - angel & bob - I keep reading elsewhere that the SF vaccine IS different to the standard seasonal flu jab because they don't (usually) contain the squalene & mercury, though possibly one year the jab did? The US jab doesn't have these chemicals apparantly and so IS like our seasonal jab. It's all very confusing!
Does anyone (skyline perhaps) know which previous jabs had these adjuvants in. I know they are meant to be safe & I "get" the argument for the "at risk" people having the jab, but now we are about to be faced with the decision re our healthy kids having it, I'm after more info.
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My eldest is doing his GCSEs. I'd love for him to get a longer Xmas break but how might that impact on the necessary teaching that has to be covered? It's a nightmare just missing a day through sickness at the moment & he missed three already having possibly had the SF mildly.
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Absolutely, Peter, I remember my GP saying exactly the same thing to me about driving to the surgery being more dangerous than having a vaccine, and he's right. I wonder how many people freaking out about the vaccine got in cars today, or walked along the road?
So do you actually make flu vaccines of any kind?
And here's another question: if a pregnant woman has swine flu and recovers, does she pass any antibodies on to her newborn? Vaccine antibodies don't get passed on, but ones produced in response to illness do - that is why my boy is here, because I had varicella antibodies.
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Questions and Angel, I think it would be the ideal time to do it really, is there another half term in the Feb?
They have so much time off in a year anyway, I dont see another couple of weeks making too much difference, and by then they could evaluate if it would put any ease on the NHS. Although by then, the super spreaders may have done their job and it will be another group of people being affected.
I have seen posts elsewhere from people saying they have seen no SF anywhere, that nobody they know or from their imm area has been sick, so I guess there are still places untouched really, these are the places that may benefit from school closures later in the year.
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Sadly tinker it does make a difference at GCSE level - a big difference - they have a lot to cover. They would need to put in place some kind of home learning instead...and by Xmas this wave may all be over with anyway
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It might be, but it might not. I guess I dont understand as my kids arent doing their GCSE's, but I would rather a competent NHS with a safe running critical care unit, than a possible disruption in GCSE's. But again, thats easy for me to say I supposeXX
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Glad Elton is well again :)
Tinker - don't get me wrong - I'd love it to happen just they would need to make sure the kids taking exams/ relevant coursework don't miss out on teaching..and I'm trying to feel optomistic for once re the timescales of this wave!
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Again, if you are concerned about Adjuvants read my past posts on them. Let me just add, 40 million doses of Adjuvant flu vaccines have been used in Europe in the past few years. Yes, its safe. There isnt even a logical explanation as to why it wouldnt be. You are better off asking the Vaccine expert here, peter sym, rather than me about vaccines, he knows far more than me i assume, im more of a "virus itself" guy than a vaccine guy.
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thanks everyone for the advice, i will look at the sites and papers suggested, i do remember skyline saying before that the sf vaccine is the same as seasonal flu and there dont appear to be any andverse affects from that which is reassuring.
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Ellamed - please see my response to you on the next article.
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Some food for thought.For those still actually capable of it.
http://www.augustforecast.com/2009/11/03/swine-flu-bad-science-massive-cover-up/
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