Swine flu gathers pace

[Posted: Tue 27/10/2009 by Niall Hunter, Editor]

The swine flu outbreak is intensifying in Ireland, with the number of cases almost doubling since last week and an increase also reported in deaths and hospitalisations.

Hospitals are now on alert to prepare to deal with an upsurge of swine flu cases.

In the meantime, the vaccination programme, for at-risk groups first, will officially begin shorly, and some GPs are already starting to administer the vaccine to under 65s with chronic illness, as they receive sufficient batches.

Five more people have now died of swine flu in recent days in the Republic, it has been announced, bringing to nine the number of people who have died of the virus. The latest death was of a 14-year-old boy.

All the people who died recently had underlying medical conditions.

We are likely to see a further escalation in swine flu cases in the coming weeks, in addition to more hospitalisations, and unfortunately, more deaths.

The current surge in H1N1 incidence was expected. Flu pandemics usually come in waves, and this is likely to be the first of a number of waves in this particular pandemic.

While we are still far away from and indeed may never reach, the "worst case scenario" of 25% of the population being infected, and the health authorities are reassuring us that the vast majority of swine flu cases are mild, public concern is understandably starting to increase.

The new deaths have occurred as the number of cases reported by GPs has risen dramatically, and there has been an especially dramatic increase among children.

The overall infection rate is now 158.8 per 100,000, up by 61 per 100,000 on last week's reported rate. However, in children under five, the rate is now 239 per 100,000, compared to only 86.1 per 100,000 previously reported.

In children five to 14, the rate is higher, at 448.5 per 100,000, compared to the previous rate of 170.

Announcing the figures, Dr Colette Bonner, Deputy Chief Medical Officer at the Department of Health, said as it was still only October, the rate of swine flu infection was likely to increase further.

However, she said the latest figures should be kept in perspective, as H1N1 infection was a mild illness in the vast majority of cases.

Signs that the expected significant increase in swine flu cases was starting became evident yesterday, when two children's hospitals in Dublin announced they were curtailing admissions and restricting visiting as a result of the large number of suspected cases presenting to them.

It is now expected that an increasing number of hospitals will start to cut back on non-emergency admissions, as the rate of infection accelerates.

Dr Paul Kavanagh of the HSE told a press briefing that plans for dealing with a pandemic had been in place for a number of years and it was in fact a relief to the authorities that to date, the H1N1 virus had led to mainly mild to moderate illness.

He said hospitals were now preparing to manage a surge on their services from patients with suspected swine flu and they were prioritising services and identifying where there could be be temporary pauses in services of lower priority.

He said some hospitals had already begun to curtail services, but to put this in context, every year, particularly in winter, hospitals did this when there were spikes in seasonal flu or the winter vomiting bug.

Dr Kavanagh stressed that although there had been an upturn in swine flu cases, the current situation would eventually pass, and "normal service will resume in due course."

He said he would urge the public to take up the call to be vaccinated.

Dr Darina O' Flanagan of the Health Protection Surveillance Centre told the briefing that the best way to reduce the impact of swine flu was for people to avail of the vaccine when offered it.

It was stressed that the swine flu vaccine is arriving in small amounts so it was not possible to vaccinate all of the initial at-risk group at once.

However, Dr O' Flanagan stressed that Ireland was better supplied with vaccines to date than other countries, some of which did not have any vaccines yet.

Supplies of the pandemic vaccine are now being distributed to GPs in the Republic and the official vaccine programme is due to commence on November 2, starting with chronically-ill people under the age of 65 and women over 14 weeks pregnant.

By October 30, GPs should have enough vaccine supplies to start a national campaign of vaccination in the initial at-risk patients.

Following this, all children, over 65s and healthcare workers are expected to be vaccinated before the campaign moves onto the rest of the population.

Dr Kevin Kelleher of the HSE told the briefing that at-risk groups can be vaccinated by their GP, and in addition, the HSE is setting up 32 vaccination clinics to administer the swine flu vaccine.

He stressed that if people have got the flu they should stay at home and not go into work and he also stressed the importance of people adhering to the "catch it, bin it, kill it" hygiene policy.

There have been 81 new hospital admissions in the past week, including seven admissions to hospital ICUs - 71 people remain in hospital.

The health authorities say the new upsurge upsurge in infection rates underlines the need for people in at-risk groups to get vaccinated as quickly as possible.

Dr Joan Gilvarry of the Irish Medicines Board told the briefing that any side effects of the H1N1 vaccine were mild and would pass.

She said the National Immunisations Advisory Committee had recommended that women over 14 weeks pregnant should get the vaccine, as should those under 14 weeks pregnant with chronic conditions.

This advice is also being endorsed by the Institute of Obstetricians, which says the vaccine is safe for pregnant women.

Of the four swine flu deaths over the past week in the Republic, two were adult females from the east of the country and the other two were adult males, one from the east and one from the south. All four had underlying conditions.

Forty-three per cent of hospitalised patients have underlying medical conditions.

Labour Party health spokesperson Jan O' Sullivan has called on the HSE to bring forward from November 2 the vaccination programme for at-risk groups. She said it was also essential that the vaccination campaign for healthcare workers should start as soon as possible.

While it is unlikely that the vaccine campaign can officially be launched earlier, some GPs who have got the vaccine have already begun to administer it, believing that there is no real reason to delay giving it if they have sufficient supplies at this stage.

Ms O' Sullivan said we now face one of the most serious threats to public health for some time.

Ten people from Northern Ireland have died from the swine flu virus; eight of those lived in the North, and two were from the North but lived elsewhere.

For more information on swine flu see www.swineflu.ie