Last updated at 14:56, Thursday, 15 October 2009

Professor John Ashton, director of public health for Cumbria, answers readers' questions about swine flu...

director: Prof John Ashton

How many people are currently in hospital in Cumbria with swine flu?

This number will vary but less than 10 people will be in hospital with swine flu across Cumbria and most will have underlying health conditions. It is very unusual for perfectly well people to need hospital admission.

Is the trend increasing or decreasing?

As predicted the number of people with suspected swine flu is increasing as we approach what is traditionally known as the flu season (autumn to winter). Though it does fluctuate weekly The only reliable figures which we are have are for the number of people who have collected antivirals from an antiviral collection point. However as people with suspected swine flu are no longer being swabbed, anyone with cold or flu like symptoms who contacts the National Pandemic Flu Service will be treated as having swine flu, so those with antivirals may have a cold or normal flu rather than swine flu.

From Mon 28 Sept to Sun 4 October, 470 antivirals were collected across Cumbria. This is in comparison to 384 From Mon 5 Oct to Sun 11 Oct.

Which age group is most at risk (ie has the most in hospital)?

At the moment the attack rate for swine flu is higher in under 15s. However if you get swine flu as an elderly person the complication rate is higher, therefore you’re more likely to be admitted to hospital.

Has anyone died from swine flu in Cumbria?

Ten people across the North West have so far have died either directly from contracting the swine flu virus, or as a result of secondary complications, since the outbreak of the virus in April. The majority have had underlying health conditions.

These figures are so low that they are not being broken down further by county as it could lead to identification.

What's Cumbria's strategy for dealing with swine flu?

Stay at home
Use flu friends
Maintain good hand and respiratory hygiene
Antivirals
Vaccine

Cumbria’s strategy for swine flu follows the national Department of Health guidance, asking people to stay calm and stay at home if they have suspected swine flu and use flu friends to pick up their medication and essentials. Ask the general public to maintain basic hygiene; Catch It, Kill It, Bin It. Appropriate use of antivirals to reduce the length of time people have the virus and reduce its shedding, which could infect other people and finally a vaccine to protect those most at risk of developing complications if they catch swine flu first.

I would like to know, that if my baby who was vaccinated with the pneumococcal conjugate vaccine (7-valent) – ‘PCV', mean that he is protected against the secondary infections associated with swine flu, so there is no need for me to worry about him, and in turn there will not be a need for me to vaccinate him against swine flu, as it should only be a case of flu for him, obviously we need to look out for the febrile convulsions, but he would be less likely to need critical care? Could someone clarify as I’m not happy for any of us to have a swine flu vaccine? If this is not the case, why was there a need to have the PCV, as the likelihood of having pneumonia outside of a flu scenario would be very slim, this is what vaccines are made for? Isn’t it?!

The PCV protects against pneumococcal pneumonia which is an infection on its own which is why we protect babies against it. Pneumococcal can be a complication of flu but it can also be the cause of pneumococcal meningitis or blood poisoning.

Meanwhile the swine flu vaccine protects against the H1N1 strain of flu alone. It has not been included amongst the 10 strains in the seasonal flu vaccine simply because it began circulating too late for the World Health Organisation (WHO) to include it in this year’s batch.

In the first instance the swine flu vaccine will only be offered to at risk groups, which include:

• People between six months and 65 years old who usually get the seasonal flu jab;
• Pregnant women, The medicines license will indicate whether the vaccine can be given to all pregnant women or whether it should only be offered at certain stages of pregnancy;
• People who live with those whose immune systems are compromised, such as cancer patients or people with HIV/AIDS;
• People aged 65 and over who have certain underlying health conditions;
• Front line health and social care workers will also be offered the vaccine. They are both at an increased risk of catching swine flu and of spreading it to other at-risk patients;

Is the vaccine safe?

Yes the vaccine has been licensed for use by the European Medicine Agency and has passed stringent tests.

As with most vaccines, the most common adverse reactions are injection site reactions (such as redness and swelling), mild fever, general aches and pains, rash and fatigue. These are non-serious and usually resolve within a couple of days. Vaccines may very rarely cause a serious allergic reaction. However, the health professionals who administer vaccines are trained to manage this situation, even though it is very rare.

Is the risk of the vaccine as great as having the H1N1 flu?

No the risks of complications caused by catching swine flu far outweigh any minor risks connected with the vaccine.

How much safety is there in getting the vaccine?

See previous answer

Why is this flu greater risk than other flu?

Swine flu is not anymore dangerous than normal seasonal flu which circulates every year. The only issue is that it is a pandemic therefore there is a greater risk of catching it as it is more widespread across the world.

If you are allergic to eggs, what is the advice?

There are two brands of swine flu vaccine. One version is totally egg free, for people who’ve had a severe anaphylactic reaction to eggs in the past.

What is in this new vaccine that we should be aware of being allergic to?

See above

Risk to children? and elderly ? adult parents?

The peak attack rate for swine flu so far appears to be under 15s, whilst over 40s seems to be the age range with the lowest number of suspected cases. Again though if you are elderly and you have suspected swine flu there is a chance that it could cause complications as your immune system is naturally weaker.

If you have no underlying conditions but do not have a mild case yet not severe enough for the emergency room, at what point should your Dr prescribe Tamiflu or other Rx????

Tamiflu should be handled through the National Pandemic Flu Service to people who contact it with suspected swine flu symptoms. The benefits of antivirals are seen if taken early enough during the first 48 hours of the symptoms appearing. They work by reducing the length you are ill by and also reducing the shed of the virus which can it spread to other people.

If someone has received the swine flu mist, are they carriers to those around them? My husband is active AF, we are currently trying to get pregnant, and we have an asthmatic 5 yr old at home. Being in the AF, it is likely mandatory that my husband get the vaccine, and seeing as the mist has been the usual method of reg flu vaccination, I am assuming that will be the case with the swine flu vaccine, as well. This is further proved by the fact that the injections are not available yet. My concern? If he is given the mist, which I understand contains a live virus, is he going to bring it home and infect my son and I, who have not been vaccinated yet?

The H1N1 vaccine being used for the general public across the UK is a killed injectable vaccine, not an inhaled mist.
However if you receive the live virus through a mist you are not contagious to others. For example if you get the MMR vaccine, then you are not at risk of infecting others with measles after having it.

By the way, I am still on the fence about getting the vaccine, though probably will if I can get it before I get pregnant. Not sure if I would take the risk that might be associated with the vaccine itself, after I were already pregnant. As for my son, he has recently (just last week) been cleared of having asthma, and since his asthma hasn't been severe in 3 yrs, I am not sure I would have him get the vaccine. Many concerns about a med that is in new testing right now. Sadly, the risk of him getting the flu is frightening as well. What is a mother to do?

It is your decision at the end of the day whether to have the vaccine or whether to allow your children to have it. However children with mild asthma may not be called for a swine flu vaccine early on as part of a priority group, unless their asthma is more severe.

The swine flu vaccine is licensed for use on pregnant women. This is because any infection can slightly increase the risk of miscarriage early on in pregnancy. Also pregnant women have reduced immunity and have a higher risk of complications if they contract any type of flu, swine flu or other. But again it is personal choice.

First published at 14:55, Thursday, 15 October 2009
Published by http://www.whitehavennews.co.uk