Update on H1N1 Swine Flu In Highland

23rd November 2009

There is evidence that cases of Influenza A H1N1v (swine flu) have increased in Highland over the past 7-10 days. The levels of illness seen in the central belt some weeks ago are now being reported in our area. Some schools are reporting higher than usual pupil absence levels, many with flu like illness. More cases have been seen at NHS Highland Out of Hours services especially in the Inverness area. More cases of confirmed swine flu have been hospitalised at Raigmore in the last week than any week previously. So far all NHS services are coping well.

Surveillance systems across Scottish General Practices are used to give an indication of the trends in illness. Across the whole of Scotland (for week 46, 9 -16 Nov) the rate of consultation of GPs by people with symptoms of a flu like illness are 119.4 per 100,000. The comparable figure for Highland is 113.9, much higher than the previous week (77.1). This figure is based on electronic reporting from 90% of NHS Highland GP practices. There has also been an increase in the number of calls for colds/flu to NHS24, along with an increased rate of GP prescribing of anti-viral (Tamiflu) medication.

Viruses other than swine flu are also contributing to the cases of flu like illness and this is the time of year we would expect to see various causes of coughs, colds, sore throats, etc. However, swine flu is undoubtedly one of the contributing factors. Routine diagnosis is now made on the basis of symptoms, but seven Highland GP practices participate in an additional surveillance scheme in which patients with symptoms of flu are tested by taking swabs. In the last week reported, 41% of samples were positive for H1N1, up from 33% the previous week. The comparable figure for the whole of Scotland is 43%. So around 4 in every 10 patients with a flu like illness has swine flu. Levels of seasonal flu (flu caused by other types of flu viruses) remain very low across the whole country including Highland.

Reporting by the Education Department of Highland Council demonstrates that a significant number of pupils are absent with flu symptoms, although some schools appear to be relatively unaffected.

Despite these indications of a rise in H1N1 activity, which also includes a rise in hospital admissions, it remains the case that for the majority of people swine flu remains a relatively mild illness that can be treated at home.

The vaccination programme in Highland and Argyll started at the beginning of November. By the end of this week (20th November) all frontline health and social care workers will have had the opportunity to be immunised.

General practices have also begun offering the vaccine to those in priority groups:

People aged over six months and under 65 years in current seasonal flu vaccine clinical at-risk groups.
All pregnant women,
Household contacts of people with compromised immune systems e.g. people in regular close contact with patients on treatment for cancer
People aged 65 and over in the current seasonal flu vaccine clinical at-risk groups. This does not include otherwise healthy over 65s, since they appear to have some natural immunity to the virus.
As the initial vaccine supply was relatively small, GPs were asked to start by focusing upon children in clinical risk groups and pregnant women. However, more vaccine is now available so this has now been extended to cover all those in the above groups, and it is anticipated that by early December, sufficient vaccine will have been received to immunise 90% of those eligible with all being offered by Christmas.

The most important advice to the public is that if they have symptoms of flu-like illness they should stay at home until fully recovered. If they are concerned they should phone their GP or NHS 24 on 0845 4 24 24 24. Information about the vaccine can be obtained by phoning the Scottish Swine Flu Vaccination Helpline on 08000 28 28 16. People can also be directed to the following websites for information:

www.nhs24.com