SWINE FLU: FROM CONTAINMENT TO TREATMENT

SWINE FLU: FROM
CONTAINMENT
TO TREATMENT

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SWINE FLU: FROM CONTAINMENT TO TREATMENT
INTRODUCTION
As Swine Flu spreads and more people start to catch it,
it makes sense to move from intensive efforts to contain
the virus to focusing efforts on treating the increasing
number of people who have the disease.
Following the agreement of ministers in all four
UK nations, and in line with our own Pandemic Flu
plans, we made the decision on 2 July to move from
containment and outbreak management policies to the
treatment phase.
This paper is intended to provide clear information
explaining why we have chosen to do this, what our
plans are from now on and how these developments
will affect the general public.
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WHAT IS SWINE FLU
AND HOW SERIOUS IS IT?
A new strain of Influenza A (H1N1), also known as
Swine Flu, was confirmed in the UK in April and has
spread to more than 100 countries around the world.
The most common symptoms are fever, sore throat,
diarrhoea, headache, feeling generally unwell and a
dry cough – in other words, symptoms very similar to
seasonal influenza. Most people recover within a week,
even without antiviral treatment.
Although symptoms have generally proved mild, a small
number of patients will develop more serious illness.
Many of these people have other underlying health
conditions, such as heart or lung disease, that put them
at increased risk.
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SWINE FLU: FROM CONTAINMENT TO TREATMENT
WHAT MEASURES HAVE WE
TAKEN TO CONTAIN THE VIRUS?
As little was known about the new flu virus when the
outbreak started, it was sensible to take all necessary
precautions to try and slow its spread while we learned
more about it. To do this we:

• Tested patients suspected of having Swine Flu
to confirm the infection;

• Offered antivirals to all patients suspected of
or confirmed as having Swine Flu;

• Collected detailed information about these patients
to learn more about how the virus affects people;

• Closed schools where medical advice deemed
it appropriate;

• Traced people who had close contact with
patients and gave them antivirals to try to
prevent the flu from spreading more widely;
a process known as prophylaxis.
During the containment phase we have had precious
time to understand the characteristics of the new virus,
to build up medical supplies and to make significant
progress towards developing a vaccine.
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WHY DID WE MOVE TO AN
OUTBREAK MANAGEMENT
APPROACH IN SOME AREAS?
There are now signs that the spread of the virus is
accelerating. The number of new cases in the UK is
doubling every seven days, and we have recently seen
the development of hotspot areas, where Swine Flu is
particularly prevalent.
As more people catch the virus in their communities
rather than from abroad, it becomes less effective
to carry on the intensive work to contain Swine Flu,
especially when health services need to devote more
time and energy to treat the increasing numbers who
have the virus.
So on 25 June we announced that these hotspot areas
would be able to relax their containment policies and
move to outbreak management.
In these areas, health officials could stop tracing and
offering antivirals to people who may have been
exposed to the virus, and GPs could begin to confirm
Swine Flu in patients by clinical observation.
This has provided local health services in the badly hit
areas more scope to focus their resources on dealing with
the increasing number of people catching the virus.
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SWINE FLU: FROM CONTAINMENT TO TREATMENT
WHY ARE WE MOVING TO THE
TREATMENT PHASE AND WHAT
DOES THIS MEAN IN PRACTICE?
We have always been clear that, at some point, we will
need to take the decision to move from containment to
treatment across the UK. This will mean the NHS taking
the lead as we establish national systems to deal with
high numbers of Swine Flu cases.
We have drawn on advice from leading scientists and
health experts to inform our decision, and on 2 July all
four UK administrations confirmed the decision to move
to the Treatment phase.
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In practical terms, this will mean that across
the country:

• GPs will be able to diagnose Swine Flu on the basis of
symptoms rather than waiting for laboratory testing.

• All contact tracing will now cease, and we will stop
giving antiviral drugs to people who may have been
exposed to the virus.

• Anyone who has contracted Swine Flu should
continue to be offered antivirals until further notice.

• It will remain a matter for clinical discretion to decide
whether antivirals should be prescribed in individual
cases, where doctors are contacted by patients with
coughs, colds and the worried well.
Local primary care trusts will also begin to establish
designated antiviral collection points in their local
communities. These may be at a pharmacy or a
community centre, depending on local need.
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SWINE FLU: FROM CONTAINMENT TO TREATMENT
WHAT SHOULD PEOPLE DO
IF THEY THINK THEY
HAVE SWINE FLU?
1. People should check their symptoms.
They can do this by:
– visiting www.nhs.uk or by
– calling the Swine Flu Information Line
on 0800 1 513 513;

2. If they still think they have Swine Flu, then people
should call their local GP, who will be able to provide
a clinical diagnosis over the phone.
3. If Swine Flu is confirmed, the GP will give the patient
an authorisation voucher which their Flu Friend can
then take to the designated local collection centre to
pick up antivirals.
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WHICH GROUPS ARE AT
GREATEST RISK OF
SWINE FLU?
Some groups of people are more at risk of serious
illness if they catch Swine Flu, and will need to start
taking antivirals as soon as they are confirmed with
the illness.
We are still learning more about the risk profile of the
virus, but we already know that the following people
are particularly susceptible:

• People with:
– Chronic lung disease
– Chronic heart disease
– Chronic kidney disease
– Chronic liver disease
– Chronic neurological disease
– Immunosuppression
(whether caused by disease or treatment)
– Diabetes mellitus

• Patients who have had drug treatment
for asthma within the past three years

• Pregnant women

• People aged 65 years and older

• Young children under five years old
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SWINE FLU: FROM CONTAINMENT TO TREATMENT
It is vital that people in these higher risk groups get
antivirals and start taking them as soon as possible –
within 48 hours of the onset of symptoms. We will
issue clear guidance to GPs on this.
WHEN IS THE NATIONAL
PANDEMIC FLU SERVICE GOING
TO BE UP AND RUNNING?
We appreciate that GPs surgeries and hospitals in the
worst affected areas are now under pressure as cases
are increasing in numbers.
The National Pandemic Flu Service will take pressure
off them by allowing people with suspected Swine
Flu to confirm (either online or via a dedicated call
centre service) that they have the virus and receive
an authorisation number for antivirals for collecting a
course of antivirals.
We are at an advanced stage in preparing the system,
and we expect the National Pandemic Flu Service to go
live when it is needed. People will then be directed to
use this service rather than contacting their GP if they
have Swine Flu symptoms.
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