The situation regarding swine flu is changing constantly, the government has set up a new website giving guidance and information, please check it for the latest news.
The situation is evolving quite quickly, so up-to-date information should be accessed from the contacts listed below.
On 11 June, the World Health Organisation (WHO) declared that the H1N1 ‘swine flu’ virus (actually a strain with a mix of components from swine, human and avian flu viruses) had reached pandemic status after more than 27,000 cases were confirmed across several continents.
Swine flu is the common name for a new strain of influenza, which first emerged in Mexico, and is different from what is seen in the annual seasonal flu epidemics. By 22 July there were 134,503 laboratory-confirmed cases reported to the World Health Organisation in over 100 countries around the world, with many more cases not reported.
According to the NHS website, www.nhs.uk, it has spread quickly because it is a new type of influenza virus to which few people in young to middle age have any resistance (ie. from previous exposure to similar flu viruses).
So far, in the majority of cases, the virus has proved relatively mild. Of more than 100,000 cases reported in the UK by 19 July, only a small number led to serious illness. A very small fraction have died as a result of complications associated with swine flu, but the great majority of these have had other significant health problems, which meant that the impact of the flu virus on them was different. Globally, at time of writing, just over 0.4% of the laboratory-confirmed cases reported to WHO have died, which is consistent with the rate normally observed with seasonal influenza.
The UK moved from a ‘containment’ phase to a ‘treatment’ phase for swine flu on 2 July. So efforts to contain the spread, through automatic school closures for example, shifted to a focus on managing and treating the increasing numbers of people who contract it.
Although there is a lot of public concern, preparation and speculation about swine flu, the impact so far on individuals seems similar to seasonal flu – so don’t get caught up in any hype – just be sensible!
Symptoms
The typical main symptoms (in ‘normal’ people) are sudden fever, cough and sore throat. Other symptoms may include: headache, tiredness, chills, aching muscles, limb or joint pain, diarrhoea or stomach upset, runny nose, sneezing and loss of appetite. Although this sounds a bit like M.E. symptoms or other infections, it is typically quite a different feeling from many other flu-like illnesses.
Most people who contract swine flu recover within a week and do not suffer complications, even without antiviral medication.
Where complications do occur, they are often caused by the virus affecting the lungs, and leading to serious secondary bacterial infections. This is more likely in people who are already vulnerable to such infections, or who have structural lung disease, and these people will be an especial focus for early recognition and treatment. M.E./CFS does not normally make people more vulnerable to bacterial infection, nor does it affect lung structure or function.
At the time of writing, antiviral medication is being given to many of those with swine flu in the UK. However, the situation is changing rapidly and up-to-date information should be sought from the pandemic information line (see below).
We don’t have enough experience of large-scale use of anti-flu antivirals in people with M.E., but at present there are no indications of significant difference in their potential for causing adverse effects in M.E. generally.
High-risk groups
At present, there is no clinical or biological reason to think that M.E. would itself increase vulnerability to swine flu or its complications.
The people who are likely to be more vulnerable are those who are pregnant, aged over 65 years or under 5, if they have chronic lung disease (including asthma on treatment), heart, kidney or liver disease, some chronic neurological diseases, diabetes mellitus or immunosuppression (caused by disease or treatment).
People at higher risk of serious complications if they catch swine flu will need to start taking antivirals as soon as they are provisionally diagnosed and, in some, if someone close to them has swine flu.
Obviously, like seasonal flu and other infections, swine flu could trigger a setback in people with M.E., so it is still worth avoiding it if you can by any reasonable means. If you are especially vulnerable to the effect of a setback, it is worth discussing the use of anti-flu medication with your GP, if you have definite close contact with a case, or if you show early symptoms.
Vaccination
At time of writing, the first batches of vaccine were expected to arrive this autumn and 30 million double doses – enough for half the population – are expected to be available by the end of the year. When it becomes available, use will focus on those at the greatest risk first.
Professor Pinching says: “The advice on the balance of risk and benefit of flu vaccination that we normally give to people with M.E. does shift a bit more in favour of vaccination, because of the limited previous immunity of this general flu virus type, and because of the likelihood of more rapid spread. But prompt antiviral treatment is a reasonable alternative.
“If you have especial reason or concern you should discuss the overall balance of these possibilities in advance with your GP or specialist.”
If you have symptoms
Who to contact for advice is different, depending on whether you live in England, Northern Ireland, Scotland or Wales. If you have new flu-like symptoms and are concerned that you may have swine flu, contact your regional NHS service listed opposite.
As well as a pen and paper to write down the information they give you, be ready to give your (or the patient’s) date of birth, current symptoms, history of any serious medical conditions and home address including postcode.
The Pandemic Flu Service in England says people who have symptoms of swine flu should contact their doctor (rather than their service) if they: have a serious underlying illness, are pregnant, have a sick child under one year old, if their condition suddenly gets much worse or their condition is still getting worse after 7 days (5 for a child).
Be prepared
Swine flu is spreading fast in the UK with several hundred new cases being confirmed daily. The NHS says you should:
● establish a network of ‘flu friends’ – friends, relatives or carers - who can help if you fall ill. They could, for example, collect medicines and food for you
● make sure that you have an adequate amount of paracetamol-based cold remedies in the house in case you become ill.
Useful contacts
England
Pandemic Flu Service Tel: 0800 1 513 513 www.pandemicflu.direct.gov.uk
Scotland
Tel: 0845 4 24 24 24 www.nhs24.com
Wales
Tel: 0845 46 47 www.nhsdirect.wales.nhs.uk/swineflu www.wales.gov.uk/health
Northern Ireland
N Ireland Swine Flu Helpline 0800 0514 142 www.dhsspsni.gov.uk www.publichealth.hscni.net
Travelling abroad?
Foreign and Commonwealth Office Tel: 0845 850 2829 www.fco.gov.uk/travel
Unless otherwise specified, the content of this article has been adapted from the NHS Choices website, www.nhs.uk
