Pandemic Flu

1
Pandemic Flu

• Update to NHS Bolton
• 24.06.09
• Jan Hutchinson, DPH

2
Background

• A pandemic has been forecast for some time last
  world wide pandemic was in 1968
• Concern had centred on Avian Flu (H5N1) but we
  are now dealing with swine flu H1N1(described
  as 2 parts pig, one part bird and one part human)
• Cases can be traced back over recent years to
  outbreaks in N Carolina associated with pig
  farms, and more recently to Mexico
• WHO announced alert level 6, 2 weeks ago
  sustained outbreaks in 2 or more countries
• UK alert levels are not being used as the spread
  across the UK is so variable

3
Latest Situation

• 52160 laboratory confirmed cases worldwide, since
  the outbreak began
• 231 deaths (113 in Mexico)
• 21449 cases in USA, 7624 in Mexico, 5710 in
  Canada, 4315 in Chile, 2436 in Australia
• 2905 cases in UK, with 1 death
• Most cases in Scotland, W Midlands and London
• 43 cases in NW, of which 11 are in GM and 1 in
  Bolton

4
What do we know about the virus?

• Appears to affect children and young adults under
  30 far more than other age groups (few cases in
  over 50s and very few in over 65s)
• Seems to be a highly transmissible infection, but
  in most people, causes only a mild illness, very
  similar to seasonal flu high temperature, cough
  and cold symptoms
• Viruses behave very unpredictably this one
  could mutate and become more serious
• Particular concern about H1N1 mixing with
  seasonal flu in the autumn (so great interest in
  monitoring what happens in the southern
  hemisphere during their winter flu season)

5
What are we doing to prepare?

• We have been preparing for a flu pandemic for the
  past 5 years, via a multi-agency borough planning
  group.
• This has now become the boroughs Pandemic
  Influenza Coordination group, which has met three
  times in the past 6 weeks
• Tactical plan in place, constantly under review
• Sub groups include health and social care group,
  communications, anti-viral distribution / flu
  line, vulnerable people, and bereavement
• Links in place with the resilience forum and SCG
  (Strategic Command Group) at Greater Manchester
  level
• Reporting arrangements in place to SCG and on to
  COBR (cabinet office) and NHS NW through to
  Department of Health.
• NHS and Council have their own pandemic flu
  planning and response groups in place, and
  meeting regularly.
• NHS Bolton has an outbreak team, which has met at
  least weekly since the outbreak began.

6
Action taken so far.

• In containment phase emphasis on slowing the
  spread. Swabbing potential cases, prescribing
  anti-virals to confirmed cases and household
  contacts.
• May very soon move to next phase mitigation
  in which anti-virals will be given to people with
  symptoms of flu, and testing for H1N1 will cease
  (NB anti virals may be given to high risk groups
  only this is the strategy in Scotland, USA)
• Plans for 4 x Assessment and Collection points
  across Bolton, one of which could be opened at 24
  hours notice, and could operate 24/7 if required
• Good stock of anti-virals and PPE (masks etc) are
  available in Bolton and more being delivered
• Local Flu line plans in place (may be required if
  national flu line is not operational)

7
Action so far..

• Testing plans eg Anti-viral collection point,
  local flu line
• Multi-agency exercise on June 12 used a worst
  case scenario very useful learning
• Business continuity plans reviewed and revised
• Ensuring synergy between plans especially NHS
  Bolton, hospital, and social care
• Plans for support to vulnerable individuals (eg
  flu friends, home delivery of anti-virals) via
  CVS
• Preparation for mass vaccination
• Communications very important messages about
  infection control (Catch it, Bin it, Kill it)
  and self care

8
What will happen next?

• The big question we dont know.
• We need to take this very seriously even if
  its only a mild illness, the impact on the NHS
  would be a concern (particularly primary care)
• We need to continue to plan carefully so that we
  are ready to deal with whatever challenges come
  along