Epidemic fear as flu outbreak gains momentum

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The Independent Online

Health Editor

Cases of flu and flu-like illness are sweeping the country in an outbreak that some doctors still fear could be the prelude to a Christmas epidemic.

The latest figures show that there were139 cases per 100,000 of the population to the end of last week, up from 90 per 100,000 a week earlier. This time last year, there were 30 cases per 100,000.

Central and southern England appear to be bearing the brunt of the illness which is being caused predominantly by the A/Johannesburg strain of the influenza virus.

A regional breakdown of the figures showed an increase from 120 to 161 cases per 100,000 in central England, and 82 to 131 per 100,000 in the South. In the North, the number of cases has more than doubled to 120 per 100,000 population from 58 in the previous week.

Dr Douglas Fleming, director of the Royal College of General Practitioners' flu monitoring bureau in Birmingham, dismissed claims of a flu epidemic, for which the official threshold is about 250 per 100,000. A major epidemic would be 400 cases per 100,000 of the population and above.

"Today's figures are certainly below what we would regard as a national epidemic," Dr Fleming said.

The bureau collates reports from 93 GP practices throughout England and Wales, covering about 700,000 patients. In total, there have been 77,000 new cases of flu and flu-like illness.

The Department of Health is urging the frail and elderly, those suffering from chronic diseases such as diabetes, bronchitis, asthma, kidney failure, and people with suppressed or weakened immune systems due to disease or drug treatment, to get vaccinated.

Residents of nursing homes and other long-stay facilities are also regarded as at high risk. It is estimated that only 50 per cent of those who need the vaccine actually receive it.

Around 6 million units of vaccine are available, and health officials say it will confer 70 to 80 per cent protection against the A/Johannesburg, A/Singapore and B/Beijing strains that are known to be in circulation.

A/Johannesburg, first isolated in the South African city towards the end of last year, is the newest and most problematic strain of this year's viruses. The other strains have been circulating for some time - or are closely related to previous strains - and many people will have some residual immunity.

Major influenza epidemics occur when there are fundamental changes in the genetic structure of the virus producing a strain to which few people have immunity and vaccines cannot protect against.

Previous epidemics occurred in 1957 (Asian), 1968 (Hong Kong), and 1976- 1977, which was due to Australian and English strains. The last significant epidemic in Britain was in 1989, when flu-like illness was believed to have been responsible for 19,000 to 25,000 deaths.