Official swine flu figures are just 'tip of the iceberg', warn health experts

Pregnant women and young people most at risk as recorded cases rise to 185

Swine flu is far more widespread than official figures suggest and is causing the severest illness in children, young adults and pregnant women, international evidence shows.

The worrying developments emerged as a 37-year-old man critically ill in hospital in Glasgow was yesterday confirmed as having swine flu, and five members of his family are being viewed as possible cases.

The man, who has not been named, was admitted to intensive care last week and has a serious underlying illness. He is not known to have had contact with any swine flu cases or travelled recently.

The total number of confirmed cases in the UK leapt on Tuesday after an outbreak at Welford Primary School in Handsworth, Birmingham infected 50 children. One further case was reported in the East Midlands yesterday taking the UK total to 185 cases.

In the US, where the official number of cases stands at 6,764, including 10 deaths, experts at the Centres for Disease Control and Prevention say the true total is likely to be 20 times higher, at over 100,000. The official total is the "tip of the iceberg", they said.

National surveillance systems in the US and Europe depend on family doctors taking swabs from patients who consult them with flu-like symptoms and sending them to the laboratory for analysis, but most patients with flu never see a doctor.

A spokesman for the UK Health Protection Agency (HPA) said the size of the outbreak at Welford Primary School was "not unexpected" and there was "no evidence of sustained transmission in the community at the moment".

He added: "It is the largest school outbreak so far. But if we get a case in a school we know it will spread. Seasonal flu is no different. We fully expect more cases in the same school."

Officials accept that if the novel H1N1 virus starts to spread rapidly, the government will be forced to abandon its containment strategy, which involves offering anti-viral drugs prophylactically to close contacts of those infected.

The HPA spokesman said: "We are using [the containment strategy] at the moment. It buys you time to develop a vaccine by delaying the spread. I don't think anyone assumes you can go on with this indefinitely, but we have not reached that point yet."

A spokesman for the European Centre for Disease Prevention and Control (ECDC) in Stockholm, which monitors the spread of swine flu across Europe, said: "With any surveillance system there will be cases that are not picked up. The number of laboratory confirmed cases is likely to be lower than the total in the real world."

"The strategy of containment is being pursued by all countries in Europe but, at some point, that will change. You could paint a very rosy scenario of the whole thing burning out but that is unlikely."

Over 50 countries have confirmed cases of swine flu totalling 13,394 people, including 95 deaths. Although most of these have suffered mild flu, the virus is putting a number of children, young adults and pregnant women in hospital.

Among 30 patients hospitalised with swine flu in California – with an average age of 27 – half had signs of pneumonia, six were treated in intensive care and four required ventilation. Five were pregnant, two of whom developed complications and spontaneously aborted. Almost two-thirds (19) had an underlying medical condition that may have lowered their immunity.

Experts from the ECDC said although the evidence was preliminary, it showed older people may have some protection against swine flu, which could include elements from flu viruses circulating in the 1960s, to which they may have developed immunity. Younger people, especially those with chronic illnesses or pregnant, may by more susceptible and need priority treatment with anti-virals and vaccination, they said.

Will a more dangerous strain return in autumn? Are we really ready?

Why has swine flu not spread further?

Fewer than 200 people have been identified with the virus in the UK in more than a month; normal flu outbreaks cut a swathe through populations in days or weeks. However, more may have been infected but not felt ill enough to bother their GP – in the US health officials reckon the true total is 20 times the recorded number.

Is it about to take off in the UK?

Unlikely during the warmer summer months. Flu viruses spread more readily in damp, humid conditions and swine flu is expected to return – and spread more widely – in the autumn.

Is it as mild as it looks?

Yes – but this could be deceptive. We know it is a mixture of pig, bird and human viruses in a combination never seen before. It has jumped the species barrier and is spreading from human to human – that alone is disturbing. Even "mild" seasonal flu infects 10 per cent of the population and kills around 4,000 people in the UK per year.

Could it become more dangerous?

Yes – this is what keeps Government chief medical officers awake at nights. The virus is constantly evolving and could mutate into a more aggressive form. This is what happened in the 1918 pandemic and scientists are looking carefully to detect any changes.

Is a pandemic inevitable?

Most experts agree – it is only a matter of time. The critical unanswered question is how bad it will be – both in the number of cases and the severity. A "pandemic" does not automatically imply severe disease. If the virus evades the current strategy of containment, as is likely, and starts to spread, the Government will face a tough challenge explaining why it is withdrawing prophylactic treatment with anti-viral drugs for contacts of infected people.

Swine flu: Country by country

US – 6,764 cases

Mexico – 4,541 cases

Canada – 921 cases

Japan – 360 cases

UK – 185 cases

Spain – 138 cases

Chile – 86 cases

Panama – 76 cases

Australia – 39 cases

Costa Rica – 33 cases

Arts and Entertainment
Lou Reed distorted the truth about his upbringing, and since his death in 2013, biographers and memoirists have added to the myths
musicThe truth about Lou Reed's upbringing beyond the biographers' and memoirists' myths
News
people
News
Ed Miliband received a warm welcome in Chester
election 2015
Life and Style
Apple CEO Tim Cook announces the Apple Watch during an Apple special even
fashionIs the Apple Watch for you? Well, it depends if you want it for the fitness tech, or for the style
Life and Style
ebookNow available in paperback
ebooks
ebookPart of The Independent’s new eBook series The Great Composers
  • Get to the point
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Recruitment Genius: Project Implementation Executive

    £18000 - £23000 per annum: Recruitment Genius: They work with major vehicle ma...

    Recruitment Genius: Chiropractic Assistant

    £16500 per annum: Recruitment Genius: A Chiropractic Assistant is needed in a ...

    Recruitment Genius: Digital Account Executive - Midlands

    £18000 - £26000 per annum: Recruitment Genius: They work with major vehicle ma...

    Recruitment Genius: Web Developer

    £28000 - £30000 per annum: Recruitment Genius: This company provides coaching ...

    Day In a Page

    NHS struggling to monitor the safety and efficacy of its services outsourced to private providers

    Who's monitoring the outsourced NHS services?

    A report finds that private firms are not being properly assessed for their quality of care
    Zac Goldsmith: 'I'll trigger a by-election over Heathrow'

    Zac Goldsmith: 'I'll trigger a by-election over Heathrow'

    The Tory MP said he did not want to stand again unless his party's manifesto ruled out a third runway. But he's doing so. Watch this space
    How do Greek voters feel about Syriza's backtracking on its anti-austerity pledge?

    How do Greeks feel about Syriza?

    Five voters from different backgrounds tell us what they expect from Syriza's charismatic leader Alexis Tsipras
    From Iraq to Libya and Syria: The wars that come back to haunt us

    The wars that come back to haunt us

    David Cameron should not escape blame for his role in conflicts that are still raging, argues Patrick Cockburn
    Sam Baker and Lauren Laverne: Too busy to surf? Head to The Pool

    Too busy to surf? Head to The Pool

    A new website is trying to declutter the internet to help busy women. Holly Williams meets the founders
    Heston Blumenthal to cook up a spice odyssey for British astronaut manning the International Space Station

    UK's Major Tum to blast off on a spice odyssey

    Nothing but the best for British astronaut as chef Heston Blumenthal cooks up his rations
    John Harrison's 'longitude' clock sets new record - 300 years on

    ‘Longitude’ clock sets new record - 300 years on

    Greenwich horologists celebrate as it keeps to within a second of real time over a 100-day test
    Fears in the US of being outgunned in the vital propaganda wars by Russia, China - and even Isis - have prompted a rethink on overseas broadcasters

    Let the propaganda wars begin - again

    'Accurate, objective, comprehensive': that was Voice of America's creed, but now its masters want it to promote US policy, reports Rupert Cornwell
    Why Japan's incredible long-distance runners will never win the London Marathon

    Japan's incredible long-distance runners

    Every year, Japanese long-distance runners post some of the world's fastest times – yet, come next weekend, not a single elite competitor from the country will be at the London Marathon
    Why does Tom Drury remain the greatest writer you've never heard of?

    Tom Drury: The quiet American

    His debut was considered one of the finest novels of the past 50 years, and he is every bit the equal of his contemporaries, Jonathan Franzen, Dave Eggers and David Foster Wallace
    You should judge a person by how they peel a potato

    You should judge a person by how they peel a potato

    Dave Hax's domestic tips are reminiscent of George Orwell's tea routine. The world might need revolution, but we like to sweat the small stuff, says DJ Taylor
    Beige is back: The drab car colours of the 1970s are proving popular again

    Beige to the future

    Flares and flounce are back on catwalks but a revival in ’70s car paintjobs was a stack-heeled step too far – until now
    Bill Granger recipes: Our chef's dishes highlight the delicate essence of fresh cheeses

    Bill Granger cooks with fresh cheeses

    More delicate on the palate, milder, fresh cheeses can also be kinder to the waistline
    Aston Villa vs Liverpool: 'This FA Cup run has been wonderful,' says veteran Shay Given

    Shay Given: 'This FA Cup run has been wonderful'

    The Villa keeper has been overlooked for a long time and has unhappy memories of the national stadium – but he is savouring his chance to play at Wembley
    Timeless drama of Championship race in league of its own - Michael Calvin

    Michael Calvin's Last Word

    Timeless drama of Championship race in league of its own