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Swine flu: New advice to pregnant women

Fergus Walsh | 11:27 UK time, Friday, 13 November 2009

I've had a lot of questions from pregnant women and their partners about the swine flu vaccine.

Swine flu and pregnancy: how to protect yourself and your babySo it is timely that the Department of Health is issuing a new leaflet for pregnant women. It should be available in GP surgeries from next week, but you can read it online now.

We don't yet know what the uptake of the vaccine has been among pregnant women.

The Chief Medical Officer for England, Sir Liam Donaldson, recognises that many women will be agonising over what to do:

"It's obvious that pregnant women worry about catching flu and having a vaccine... it is a difficult time for them and a difficult decision. It is their choice, but the information we have given out will help people to take that decision. The best way for them to protect themselves and their baby is to have the vaccine."

Vaccine distribution

Have you had your swine flu jab yet? The Department of Health says that 6.6 million doses of Pandemrix have been distributed so far and that, by the end of this week, "virtually all GPs" will have received their first delivery of vaccine. Officials say the campaign is "on track".

Healthy children next?

I have said several times that an announcement extending immunisation to all children is inevitable.

The Department of Health continues to insist that no decision has been made and it won't confirm that healthy children will be the next group. A decision is expected within two weeks.

But rather like the plot of a thriller where you guess the ending long before you get to it, it is abundantly clear that children will be the next in line for the jab, once at-risk groups have been immunised.

There is no rush to make an announcement, as there are millions of people with asthma, heart disease and other conditions to immunise before children can be targeted.

Cases down but deaths up

Meanwhile, the H1N1 virus continues its unpredictable course. The number of cases is falling in much of the UK, but there has been a significant increase in the number of deaths.

There were an estimated 64,000 new cases of swine flu in England in the past week, a fall of 20,000.

There were decreases in Northern Ireland and cases seem to have stalled in Wales (on one measure in Wales cases rose, and on another they fell).

Only Scotland showed an definite increase. Health officials think the dip in cases may be due to the recent half-term school holidays.

At the same time, there has been a big jump in the number of deaths, up by 28 to 182 across the UK.

But there is no evidence that the virus is becoming more virulent. Sir Liam Donaldson said:

"[T]he lab scientists continue to watch the virus and it's not changing, but it looks like now the virus is out of the summer it has a more serious spectrum about it."
Graph showing weekly consultations with GPs related to swine flu This gives a good snapshot of flu trends over time. The rate of 37.7 consultations per 100,000 population is not terribly relevant because it doesn't tell us how many people actually have the flu.

You can see that the red line is showing a bit of a dip. This is good news, as it gives GPs a breathing space to get people immunised.

It's reckoned that 620,000 people in England have now had swine flu - but that is a very rough estimate and the true total may be much higher.

The vast majority have had a mild illness, but of concern is the small minority who need hospital treatment.

Hospitalisation ratios by week

This demonstrates the ugly side of swine flu. As of 0800 on Wednesday, there were 785 people in hospital in England with swine-flu-related illness, 173 of those in intensive care. There were 109 people in hospital in Scotland.

The overall number of deaths linked to swine flu now stands at 154 for the UK: 105 in England; 31 in Scotland; eight in Wales and 10 in Northern Ireland.

That represents a rise of 28 deaths from the previous week. The average age of those who have died is 44.

Hospitalisations due to flu

I've included this data because it illustrates the difference between pandemic and seasonal flu. You can see that, whereas those over the age of 60 make up the peak group hospitalised by seasonal flu, it is children who are most affected by swine flu.

Age distribution of deaths: seasonal v swine flu

This graph shows that whereas 94% of deaths from seasonal flu are in the 65+ age group, with swine flu the fatalities are much more evenly spread.

Indeed, 60% of the deaths so far have been of people under the age of 45. 20% of those who have died had no underlying health conditions.

Useful resources

Health Protection Agency data for the UK
Swine flu figures for England
Swine flu figures for Northern Ireland
Swine flu figures for Scotland
Swine flu figures for Wales

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