Why is the UK a swine flu hotspot?
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AP Photo/Centers for Disease Control and Prevention, C. S. Goldsmith and A. Balish
This 2009 file microscope image originally provided by the Centers for Disease Control and Prevention, shows a negative-stained image of the swine flu virus
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As the global swine flu pandemic gathers pace, one question is puzzling scientists. Why is a small country on the eastern seaboard of the north Atlantic so badly affected?
Britain is among the top half dozen global hot spots for swine flu. Along with Mexico, where the disease orginated, the US, Canada, Chile, Argentina and Australia, we are leading the way in the battle against the bug. We have more cases, and more deaths, than any other country in Europe and the pandemic is growing exponentially here, with 55,000 new cases last week, while it is subsiding elsewhere, notably in Mexico. And because we are in the front line, we are having to learn as we go.
This is not what was expected. Britain is an island nation, accustomed to the security that living within sea borders brings. But when it comes to highly pathogenic viruses, even the English channel cannot protect us.
When the pandemic emerged in Mexico last April, spreading first to the US and then across the Atlantic to Britain and Europe, it was thought that, as we were entering our summer, the virus might spread only slowly, giving us a few months grace to prepare for a winter surge.
It has not turned out that way. The expected winter surge, which may still occur, has been preceded by a summer one. In the early weeks of the pandemic, last May, Britain and Spain had roughly equivalent numbers of cases. But as the weeks have passed, Britain has been much harder hit. By 16 July, we had 9,718 confirmed cases and 14 deaths, nine times more than Spain with 1099 cases and two deaths. In Germany, France and Italy, the number of cases is still in the hundreds and there have been no recorded deaths.
Confronted with these puzzles, experts respond with a single phrase: the behaviour of the flu virus is very difficult to predict. Flu repeatedly confounds efforts to understand, and forecast, its course - it behaves in mysterious ways. Nevertheless, Sir Liam Donaldson, the Government’s chief medical officer, offered two possible explanations for Britain’s high rate of swine flu sickness this week.
Our close links with the US, with large numbers of visitors coming and going, made Britain an ideal staging post for the virus to break out from north America. Heathrow is one of the world’s busiest international transport hubs and as such is one of the key routes for global viral transmission.
In addition, Sir Liam said, disease surveillance in the UK is exceptionally good. It may be that we are picking up more cases which in other countries are going undetected.
A further reason, cited by some experts, is that schools close earlier for the summer holidays on the continent and this may have slowed the spread.
The upshot is that the pandemic in Britain may simply be more advanced than in other countries, and they will eventually catch up.
The unpredictability of the virus is re-inforced by its behaviour in the southern hemisphere, which was expected to face the first wave of the pandemic. But while there are significant epidemics in Australia, Chile and Argentina, there is little evidence of swine flu in South Africa, with just 18 confirmed cases at 6 July.
At the same date, Chile had 7,376 cases and 14 deaths while Argentina had 2,485 cases and 60 deaths.
Some parts of Australia have experienced significant outbreaks, but the overall total (5,298 cases at 6 July and 10 deaths) is still below that in the UK. And it is mid-winter there.
What will happen next? "It is very difficult to predict," said Allan Hay, the man in the best position to do so - were it possible - as director of the World Health Organisation’s Influenza Monitoring Centre in mill Hill, north London.
"In Mexico it peaked in late April, and it is supposedly turning down in the US. It certainly hasn’t been escalating in those countries, but nor has it disappeared."
"In the UK, we anticipate it might peak in a week or two - the closure of schools for the summer holidays may have an impact. Then we will expect to have a normal flu season in the winter and all the indications are that it will be caused by the pandemic H1N1 virus."
"We don’t know if it will replace the seasonal flu virus [or circulate in parallel with it]. In Australia, we have seen most infections caused by the pandemic virus. That is the usual experience - one virus tends to dominate. But we are monitoring the situation closely. Other seasonal viruses may return in the coming years."
It may be Britain’s misfortune to be hit first and hit hardest by the world’s first flu pandemic for 40 years. On the other hand, if it causes only mild illness this winter, we may be counting our blessings by the following one should the virus mutate to something nastier. What doesn’t kill us, makes us stronger.
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Comments
At the end of the day, the only thing to fear is fear itself.
And NHS wards are filthy, based on my father's stay 2 years ago, and from several reports from friends and relatives.
I can't say whether this is causing higher levels of swine flu, but it can't help !
Standards of Hygiene in some NHS hospitals are appalling though. My partner had a hysterectomy a few years ago and had a private room with shower. she had to clean the shower when she went in as it was filthy, had the previous user's hairs in it.
She said the Nurses and doctors were great, but the nurses said cleaning rooms was contracted out and there was a lack of overall accountability.
As for travellers from other hotspots, such as the US, we should have done what Japan, for instance, did, and used remote temperature sensing. This involves checking the temperature of every passenger arriving using remote sensing equipment, and anyone who has an eleveted temperature could either have been sent back (if foreign) or given suitable medication and advice (if British).
Foreigners have no right to enter Britain. It is a privilege, and one which can be denied to anyone who is infected and likely to spread disease.
The Mexicans virtually shut down thir country and had a good deal of success. This simple yet effective response has proved invaluable to the Mexican nation. A pity our so called experts didnt have the same fore thought!
I see the BNP are out in force again.
If anyone has carried this disease into Britain it is likely to be white American visitors or wealthy white Britains on yet another holiday. And we don't impose on them do we?
We really would be a better country if we deport the BNP and their supporters.
This is hardly an area famous for its wealthy white population!! There is obviously an issue here worth investigating.
I do agree that wealthy whites who travelled to Mexico on holiday were partly responsible, and there were early outbreaks of swine flu in wealthy private schools. On the other hand, we need to be open minded about ALL the aggravating factors. I did not myself suggest that immigrants are a problem, but I am open-minded when others suggest this.
You are obviously one of those extreme left-wing cretins who believes that immigrants must never be criticised, that immigrants are all wonderful, that immigration is an unalloyed benefit and that there should be no ceiling on the number of immigrants in Britain.
If anyone should be deported - along with all those here illegally - it is people like you. You don't really love this country or its history or its native people. Why don't you have the honesty and integrity to go and live in Africa or Asia where you would obviously feel so much more at home.
The rest of us can then look at this problem with an open mind. Maybe immigration is an aggravating factor, or maybe its not. The hotspots in immigrant areas are certainly a valid issue which need explaining. So let's talk about this rationally and honestly.
http://www.medicalnewstoday.com/article
Although I resent being called "filthy" (see first comment) I agree that the state of public loos leaves an awful lot to be desired. I've known for some years now that frequent hand washing reduces the number of viruses I catch so I've resorted to carrying one of those waterless hand sanitisers around with me (but hope I'm not going to end up as an OCD sufferer).
I'll be one of the last in the queue for vaccination because I'm middle-aged and healthy, and I'd rather put my trust in good nutrition and frequent hand washing.
I too carry an anti-bacterial gel, I greatly recommended it and it has nothing to do with OCD. This is what I mean: what on the continent is standard hygiene (bidet, soap, etc.) in the UK is considered OCD.
Dinner is served.
The Government (Alan Johnsons last pronouncement "Immigration doesn't keep me awake at night"), may have encouraged conditions that led to the current crisis. This strain isn't particularly dangerous, but if it mutates (as many in the scientific community expect), then the UK is in a particularly perilous position.
timonsays is entirely correct to question why the hotspots are predominately in immigrant areas. Absurd posturing as practicised by fluke (the immigrant love-in junkie), are pathetic.
New immigrants tend to live in areas of high population density because they are poorer on average than the indigenous population.
Higher density of population/housing correlates with poorer health.
If there was a UK Mexican expatriate housing block you would be likely to find a much higher incidence of swine flu there.
I wonder what the Mexican for "there's nowt sa queer as racists" is?
So a number of points here. Infections such as flu, scarlet fever and other nasties which should be dealt with in our community - end up being taken into out of hours, or the walk in or reluctantly into overused casualty.
Also due to nobody being allowed to sign on anywhere else - the PCT allow a situation to run where nobody can approach another GP surgery - this leaves patients with no diagnosis forced to take infections into work - as no sick note, and jobs very vulnerable out here and scarce. Also the local primary school is run by a highly unprofessional individual who has hounded some families over genuine absence, preferring to have a section 2 disease sitting in school putting other children at risk, in order for the correct box to be ticked. So nasty infections sit in school, as there is no medical diagnosis for some. The culture is dreadful, writing to the PCT or the Education Department triggers carefully worded sanitized responses putting the blame at the door of the parent - in other words whole families being caught between two institutions both behaving badly whilst drawing their public wages.
The last letter my family had, in response to our very legitimate worries, ie our child not being believed to have had pneumonia, despite the correct paperwork provided, we felt for a small child to be interviewed by a punative head on his first day back after a long illness as if he had been naughty was wrong.
The result a letter stating that all illness must be taken to the GP whatever it is or it will be recorded as unauthorised absence - I am led to believe from successful NHS public announcements that vomiting bugs and swine flu are not supposed to be taken into a GP surgery.
I fully blame my PCT and the council for aiding and abetting the uncessary spread of nasty germs. The government really needs to scrutinize our area, however most of us would prefer a hard hitting article in the newspaper or a document made