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Swine Flu Daily Update Issued At: 11am Tuesday 7 July 2009, Wales

-- 58 laboratory confirmed cases in Wales, with eight new cases: - 23-year-old male from Rhondda Cynon Taf - 28-year-old female from Torfaen County Borough - 26-year-old male from Newport - 53-year-old male from Newport - 21-year-old female from Merthyr Tydfil County Borough - 18-year-old female from Newport - 20-year-old male in Conwy - 51-year-old male from Torfaen County Borough -- With diagnosis now being made by GPs without the need to test for swine flu, the number of laboratory confirmed cases will only be part of the total number of cases in Wales. -- 28 clinically presumed cases in Wales. Clinically presumed cases are no longer notified to the NPHS. They are household contacts of cases of swine flu who, because of their symptoms, are presumed to have swine flu but who have not been laboratory tested. In such cases, there is enough evidence that the patient has contracted swine flu for their doctor to treat them. Testing is unnecessary to reach a diagnosis. -- 280 people have been under investigation in Wales. Of these, swine flu has been confirmed in 58 cases, clinically presumed in 28 cases and ruled out in 187 cases, leaving 7 still under investigation. All of these are displaying, or have displayed, mild symptoms. -- Of the 7 people under investigation, all were well when first identified, but reported recent flu-like symptoms following travel to affected areas. Blood tests are being undertaken on these individuals to see if they had the flu and to help the NPHS understand the pattern of the disease from the past. Their symptoms may or may not have been due to swine flu. Testing will be conducted in a number of weeks to check whether these people did have swine flu - scientifically it won"t work before that. Investigations have shown that people they had close contact with did not catch flu from them when they were ill. -- Two people with swine flu have been hospitalised in Wales and have been discharged. -- GPs are no longer being asked to swab people they suspect may have swine flu. Microbiology laboratories will therefore no longer be testing most people suspected of having swine flu. The NPHS is monitoring the spread of swine flu using a surveillance scheme which records reports of GPs" diagnoses of flu from more than 300 GP practices across Wales. This will change the way cases are reported each day. -- The NPHS influenza surveillance report for Wales shows low levels of influenza activity in all parts of Wales. Further detail can be found here. -- The latest surveillance information (from 2 July) estimates there are 4.4 cases of an influenza like illness in every 100,000 people in Wales - the equivalent of 132 people with flu in Wales. Not all of these will be swine flu. It is expected that the proportion that are due to swine flu will increase as the virus spreads in Wales. -- No further details will be confirmed or denied about cases in order to protect their right to confidentiality. -- There are now 7,642 laboratory confirmed cases in the UK - 58 cases in Wales, 1,377 cases in Scotland, 6,162 cases in England and 45 in Northern Ireland. -- Seven people in the UK with swine flu have died. All had underlying health conditions. -- Swine flu cases have been confirmed in 135 countries. For the latest international figures for the spread of swine flu, visit the website of the World Health Organization at http://www.who.int Comment from Welsh Assembly Government and National Public Health Service for Wales -- Chief Medical Officer for Wales, Dr Tony Jewell, said: "We knew that there would be an increase in the number of cases and we have robust plans in place to deal with it. "Scientific advice now is that there will continue to be a rise in the number of cases across the UK and, knowing the infection is circulating we have moved to treatment rather than trying to slow the spread of disease. "We are now relying on clinical symptoms for diagnosing the illness rather than laboratory tests. Some patients will still be tested as part of our monitoring to get more information about the virus. "We are also stopping giving preventative medicine to people the patient has been in contact with, unless clinicians determine it is appropriate due to their medical conditions. The focus for antivirals is for at-risk groups, those with chronic conditions, or pregnant women or those under 5, and getting antivirals to these groups within 48 hours to maximise their effectiveness. "Healthy people with flu-like symptoms should stay at home, check their symptoms on the NHS Direct Wales website and, if they are still concerned, phone their GP - not go to their local surgery or A&E in case they spread the virus to others, especially at-risk groups. The Swine Flu Information Line - 0800 1 513 513 - has also been updated with the latest information. "Evidence so far suggests that the majority of patients have had relatively mild symptoms and with rest recover within five to seven days. For some, the symptoms have been more severe, and seven people with underlying health conditions have died. "While we are prepared for this, we are not complacent and people must be vigilant. Our advice to the public remains the same and that is to follow good respiratory and hand hygiene - in short, catch it, bin it, kill it - to help prevent the spread of influenza." -- Dr Roland Salmon, Director of the Communicable Disease Surveillance Centre, National Public Health Service for Wales, said: "Because this particular type of swine flu is new, people have little or no immunity to it. For this reason, we know it will spread across the country eventually. "Until last week, we have been investigating and responding to individual cases. This has allowed us to learn about the virus, how it spreads and how it affects people. We have learnt that, in the majority of cases it is mild although proving severe for a small minority. Most people recover from infection without the need for hospitalisation or medical care. "As the disease becomes more widespread in the UK we are changing our approach to focus on treatment, emphasising those people most at risk - people more likely to develop serious illness or complications. These are, particularly, the groups that we encourage to get vaccinated each winter, because they are at risk from seasonal influenza, together with pregnant women and children under 5. "We advise people to practise good respiratory and hand hygiene to reduce the chance of catching or spreading the virus. If people think they may have flu and want to check their symptoms they can call the Swine Flu Information Line on 0800 1 513 513. If they are still concerned they should contact NHS Direct Wales on 0845 4647. "People should not go to Accident and Emergency Departments or to their GP surgery as this may risk spreading the infection. It also places undue pressure on the emergency services." Public health advice and messages -- If you have flu-like symptoms stay at home. You can check your symptoms by calling the Swine Flu Information Line on 0800 1 513 513. If you are still concerned contact NHS Direct Wales on 0845 4647. Do not go into your GP surgery or Accident and Emergency department unless you are advised to do so or are seriously ill, as you may spread the illness to others. -- It is always good practice to follow respiratory and hand hygiene such as: - Covering your nose and mouth when coughing or sneezing, using a tissue when possible. - Disposing of dirty tissues promptly and carefully. - Maintaining good basic hygiene, for example washing hands frequently with soap and water to reduce the spread of the virus from your hands to face or to other people. - Cleaning hard surfaces (e.g. door handles) frequently using a normal cleaning product. - Helping your children follow this advice. Facemasks -- Although we are aware that facemasks were being given out to the public in Mexico, the available scientific evidence does not support the general wearing of facemasks by those who are not ill whilst going about their normal activities. We are, however, reviewing NHS supplies and stockpiles of facemasks for healthcare workers who are likely to come into regular contact with people who may have symptoms. The UK will receive an additional 227 million surgical facemasks and 34 million respirators. Wales will receive its proportionate share. Control measures -- Agreements have been signed between the UK Government and vaccine manufacturers to secure enough vaccine for the whole population. The first batches are expected in August with around 60 million doses by the end of the year - enough for 30 million people to be vaccinated - with more following after that. -- The Welsh Assembly Government"s Health Emergency Preparedness Unit has issued guidance to Local Health Boards on anti-viral distribution. The unit is co-ordinating work on identifying appropriate collection points and the necessary arrangements to support this process. Features of the outbreak -- Based on assessment of all available information and following several expert consultations, the World Health Organization (WHO) declared the level of influenza pandemic alert at phase six on 11 June 2009. -- Phase six indicates there is human-to-human spread of the virus in at least two countries in one World Health Organization region, with community level outbreaks in at least one other country in a different WHO region. -- On 2 July the four UK nations agreed to move to the treatment phase in their response to the pandemic - treating people most at risk. Contact tracing and the use of antivirals preventively have been ended. GPs will now provide clinical diagnosis of swine flu cases rather than awaiting laboratory test results. -- Further information on swine flu and Pandemic Flu is available bilingually from http://www.nphs.wales.nhs.uk -- Further information from the Welsh Assembly Government response is available bilingually

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