Swine flu cases hit 25,000 mark in Northern Ireland
Thursday, 15 October 2009
The number of suspected swine cases in Northern Ireland has hit the 25,000 mark, with the infection rate now at its highest ever level.
Chief medical officer Dr Michael McBride today warned there is a great risk of complacency about the public health risk.
Vaccinations will begin on October 21 for frontline workers with jabs for at-risk groups soon afterwards.
Dr McBride said: “We have never seen levels of transmission like this before. This represents a very significant increase as compared to last week but I think we need to keep a sense of proportion and not create a sense of panic.”
There have been over 13,000 courses of anti-virals prescribed.
The past week saw an almost 60% rise in lab confirmed diagnoses of the virus, with 119 detected in the last seven days, according to the Department of Health. This accounts for more than a fifth of the 565 positive samples detected in the region since the outbreak began.
With only a proportion of those with symptoms undergoing the tests, the actual number who have contracted flu is much higher.
GP consultations for flu and flu-like illness have jumped by 37% over the past seven days - which represents 222 per 100,000 head of population. The age category with the highest incidence is the 5-14 bracket.
Four deaths have been linked to the virus in Northern Ireland and 280 people have been hospitalised.
Two other people from the region have died in England and Spain.
The first 11,000 doses of the vaccine arrived in the region earlier this week.
Chief Medical Officer Dr McBride said while the number being admitted to hospital had actually dropped in the last week (from 61 to 34) he expected it to rise again in the coming seven days as a consequence of the increased number of diagnoses.
“I think that there is a tremendous risk of complacency in relation to the significant public health risk that this virus still poses,” he added.
“We need to ensure that we communicate that message clearly and consistently to the public to ensure that we protect the public for whatever lies ahead.”
He stressed that most of those who catch swine flu will experience mild symptoms.
“I want to reassure the public however that for the vast majority of people swine flu remains a relatively mild illness from which you will make a full recovery,” he said.
“If you think you have swine flu stay at home, please do not visit your GP practice, pharmacy or A&E in person.”
However he urged anyone with an underlying health condition or who is in one of the high risk categories - such as pregnant women, young children and older people - to contact their GP.
“For otherwise fit and healthy people, there is usually no need to take antivirals,” he said.
“Most people will recover at home by taking simple measures to alleviate symptoms such as resting, taking paracetamol and drinking plenty of fluids.
“If, however, your condition suddenly deteriorates or is getting worse after seven days (five for a child) then you should contact your GP or out-of-hours service.”
PE risk highlighted in severely ill swine flu patientsBy Lynda Williams15 October 2009Am J Roentgenol 2009; Advance online publicationMedWire News: Computed tomography (CT) scanning should be performed in patients severely affected by the swine-origin influenza A (H1N1) virus, say US researchers, who found such patients have an increased risk for pulmonary embolism (PE).
“CT scans proved valuable in identifying those patients at risk of developing more serious complications as a possible result of the H1N1 virus, and for identifying a greater extent of disease than is appreciated on chest radiographs,” said lead author Prachi Agarwal (University of Michigan Health Service, Ann Arbor).
Agarwal and co-workers examined chest radiographs of 66 patients with a confirmed diagnosis of the disease between May and July 2009.
Fourteen of the patients were admitted to the intensive care unit (ICU) and required mechanical ventilation while the remaining 52 patients did not. ICU patients were more likely to be male and were older (43.5 vs 22.1 years) than those who did not require ICU admission.
Overall, 42% of patients had abnormalities in their initial chest radiograph. The most common finding was patchy consolidation (50%), usually in the lower (71%) and central (71%) lung zones.
All ICU patients had abnormal initial radiographs and 13 (93%) had extensive disease, defined as affecting three or more lung zones, compared with just 9.6% of non-ICU patients. Furthermore, 13 (93%) of ICU patients had more than 20% of their lungs affected compared with none of the non-ICU patients.
Chest CT was performed in 10 ICU and five non-ICU patients using intravenous contrast. PE was diagnosed in five (36%) of the ICU group. One patient developed a saddle embolus at the bifurcation of the main pulmonary artery, and another had lobular emboli, while two were diagnosed with segmental and one with subsegmental PE. A further two patients were diagnosed with deep vein thrombosis.
“Although sepsis and acute respiratory distress syndrome are known to represent hypercoagulable states, acute PE is not a common complication of influenza infection,” Agarwal et al Nevertheless, they write: “Knowledge of this complication, which presumably is secondary to a hypercoagulable state in these patients, is important not only for the clinicians taking care of the patient but also for the radiologist so as to avoid missing emboli on contrast-enhanced CTs performed for other reasons.”
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2009
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