The latest GP consultation rates in Wales for flu-like illness have decreased and are now steady, although still a little above the usual rates for the time of year. On the 26th November, 77 people were in hospital with swine flu, 14 of those in critical care.
We must all continue to be vigilant as swine flu still poses a serious threat and is affecting groups of the population such as young children and pregnant women who are not usually particularly at risk with seasonal flu. We must also remember that our traditional flu season does not normally arrive until January and February.
Advice I have received suggests that the second wave of the pandemic in the UK may be nearly at an end and in the vast majority of cases, people are recovering well. However, we are likely to continue to see people experiencing severe complications, admission to critical care facilities and more deaths. There have now been 23 deaths in Wales. Even with a reducing incidence of swine flu, it is inevitable that this will continue to increase over time.
Turning now to vaccination, the first phase of delivery of the vaccination programme has been progressing well and I would like to thank all primary care and NHS staff for their efforts in planning and mobilising the programme quickly and effectively.
We are expecting to have swine flu vaccine uptake figures shortly. Indications are that there has been a positive response from those invited to have their vaccination as a priority.
Optimising the vaccination of the clinical at risk groups remains our highest priority, but we will be extending the programme to offer the vaccine to all healthy children over six months and under five years of age – a decision supported by advice from the Joint Committee on Vaccination and Immunisation (JCVI).
Evidence shows that young children are currently suffering the greatest overall impact from the disease. They are particularly vulnerable to complications and more likely to become seriously ill and need hospital treatment than other groups. The clinical attack rate is also higher, meaning a greater proportion of children will become ill. Vaccinating as many children in this age group as possible will give them the best possible protection against swine flu.
The Chief Medical Officer and the Chief Executive of NHS Wales recently wrote to the Health Service in Wales outlining details of phase 2 of the vaccination programme. While we are still to finalise the logistics of how the vaccine will be delivered to children over six months and under five, we expect that general practitioners will want to continue be a key component in the delivery of vaccines to young children. Along with the other UK health departments, we are currently working with the General Practitioner Committee (GPC) and NHS organisations to agree exactly how this will take place.
We have also taken note of the JCVI advice that the vaccination of main carers of older and disabled people, whose welfare may be at risk if their carer falls ill, should be an important next step. Carers have considerable ongoing responsibilities towards the health and welfare of others and are looking after vulnerable people who need to be protected from the risk of infection. We are therefore discussing how best to implement this advice with carers’ organisations to establish a sensible approach before communicating further detail on how the programme will work.
Members will have seen the media coverage around the safety of the vaccine for pregnant women. The CMO advises that it is very important that when a pregnant woman is invited to receive her vaccination that she does so, in order to protect herself and her unborn child. Pregnant women who contract swine flu are four times more likely to suffer from serious complications than women of the same age who are not pregnant. The Royal College of Obstetricians and Gynaecologists has looked at the evidence on the safety of flu vaccines in pregnancy and supports pregnant women receiving the vaccination. Women who delay their vaccination until the baby is delivered are putting themselves at increased risk. Advice for pregnant women on swine flu is available from the Welsh Assembly Government website.
Members will be aware that person-to-person spread of a strain of swine flu resistant to Tamiflu has been found in Wales. The CMO has advised that the emergence of influenza A viruses that are resistant to Tamiflu is not unexpected in patients with serious underlying conditions and suppressed immune systems. There have been more than 70 reports of Tamiflu-resistant strains worldwide.
Eight patients on a unit treating patients with severe underlying health conditions at the University Hospital of Wales, Cardiff, have been diagnosed with swine flu resistant to Tamiflu. Three appear to have acquired the infection in hospital. All patients diagnosed with Tamiflu-resistant swine flu on the unit have been treated with an alternative antiviral. All other patients on the unit have been tested for swine flu. Three of the patients remain in hospital, with one in critical care and the others being treated in isolation on the unit. All patients are responding well to treatment. There is no evidence of spread of the Tamiflu-resistant strain of swine flu outside the unit.
Patients have been isolated or are being cared for in a designated area for influenza cases, and Cardiff and Vale University Health Board has ensured that all appropriate infection control measures are in place on the unit. Patients and staff at the unit have been offered swine flu vaccination, while patients due to come into the unit for treatment are being advised to have the vaccination from their GP in advance of coming to the hospital.
Advice I have received suggests that the resistant strain of swine flu does not appear to be any more severe than the swine flu virus that has been circulating since April. We know that people with suppressed immune systems are more susceptible to the swine flu virus, which is why they are a priority group under the first phase of the vaccination programme in Wales. Treatment with Tamiflu is still appropriate for swine flu and people should continue to take Tamiflu when they are prescribed it.
It remains vital at this time to continue to stress the importance of key public health messages such as good hand hygiene and the importance of vaccination in our fight against swine flu. To this end, a further communications campaign to promote the uptake of swine flu vaccination began in Wales on November 9th. The campaign includes targeted communication to various audiences through radio, press and public relations activity.
The CMO and I continue to meet representatives of the professional groups on a monthly basis. We are reassured that primary and secondary care services are coping with the demands of the pandemic and that professional bodies support our approach. We see additional pressures on NHS services each winter and we are well placed to manage them.
I will continue to report regularly to the Assembly on these matters, and will keep Members informed over the recess if there are significant changes to the current situation.
