Mutating flu viruses linked to havoc at A&E departments

Flu rates have now reached their highest level than at any time in the previous three years, and doctors are blaming mutated forms of the flu virus that are not being protected against with the seasonal winter flu jab.

Strains of flu virus commonly naturally mutate, with changes being witnessed this year already within the US and Australia.

The primary flu virus rife this winter has been found to be influenza A type H3N2, appearing to disproportionately impacting the elderly.

On Wednesday David Cameron was speaking in Manchester and highlighted an increasing number of elderly patients as one of the main causes of pressure on hospital A&E departments, with one hospital even drafting in help from the Red Cross, as NHS capacity is pushed to its limits.

The prime minister noted how it was “particularly striking” that over a million more over-65s were seeking help at A&E in comparison to just four years ago, blaming a lack of “clarity” regarding GP access.

Cameron’s comments came as the latest GP Patient Survey for England show that almost 15% of patients could not get an appointment with their GP at the previous time of trying, though 78% of people who completed the survey still claimed they would recommend their GP surgery.

The US Centres of Disease Control has released a warning that half of the H3N2 viruses they have analysed were discovered to be “drifted strains” from the one covered by the winter flu jab. Public Health England (PHE) have tested 24 samples so far, with five found to be drifted strains. This means the flu type has mutated, resulting in the vaccines becoming less effective.

PHE say that more hospitals and GP surgeries are reporting a larger number of flu cases in comparison to that of the peak periods of the last three winters. It is this massive spike which is probably responsible for the severe pressures felt by hospitals up and down the country this week, but health officials believe the problems could continue to worsen for another eight weeks yet.

Dr Richard Pebody, head of seasonal flu surveillance at Public Health England, commented: “Overall, levels are now higher than the peak of flu activity observed in the last three seasons, but have not reached the levels seen in the last notable seasons of 2010/11 and 2008/09.”

Dr Ben Marshall, a specialist in respiratory medicine at Southampton General Hospital, says the number of patients admitted into hospital with respiratory illnesses has now doubled.
Asthma and COPD are two respiratory problems which can be significantly worsened by flu, sometimes resulting in serious complications that need hospital treatment.

The injected flu vaccine is available free of cost on NHS to those deemed to be high risk. This is to protect them against flu and the serious complications that can arise from it.
Those that qualify for a free flu jab include:

. People 65 years of age or over.
. Pregnant women.
. People with certain medical conditions.
. People living in a long-stay residential care home or other long-stay care facility.
. Those receiving a carer’s allowance, or the main carer for an elderly or disabled person who could. be at further risk if the carer was to become ill.
. Healthcare workers with direct patient contact or a social care worker.

Dr Tristan Clark, a specialist in infectious diseases and respiratory viruses at Southampton General Hospital, said: “We can sometimes predict what a flu season is going to be like based on the activity in the southern hemisphere before it reaches north of the equator and we know countries like Australia had a bad year.

“Unfortunately, since the vaccine was prepared, the influenza A H3 strain has changed significantly, making the vaccine less effective at protecting against the virus – something we occasionally see.”
People are still being advised to get vaccinated to offer some degree of protection, especially those with chronic illnesses who have yet to get the jab. Moreover, antiviral treatment Tamiflu is still active against all strains of the flu and works to lessen the severity of symptoms, particularly when taken early at an early stage of the condition.

Winter Wellness: Protect yourself against flu and other illness

Certain health conditions are triggered or exuberated by cold weather, and considering recent years has seen the winter season in the United Kingdom become increasingly chilly with sub-zero temperatures, this can cause chaos for the majority of the UK’s 63.23 million people.

However, there are practical steps and self-help measures you can take during the winter to stay warm, reduce your risk of developing illness, and sufficiently equip your body to deal with an ailment should you unfortunately become unwell.

Flu

One of the most common winter illnesses, and one not to be confused with a cold. Colds usually start gradually with a runny or stuffy nose and sore throat. Flu symptoms begin much suddenly and it is more serious than a cold.

For many of us, flu is not life-threatening and a full recovery can usually be made after a week. However, flu can prove deadly for vulnerable people and lead to complications such as bronchitis and pneumonia.

These vulnerable, high-risk groups of people are entitled to a free flu jab on the NHS to protect themselves developing flu and serious complications from it. Those eligible for the jab include the over-65s, pregnant women, if you have a medical condition such as diabetes or asthma (your GP will advise you), are a healthcare or social care worker with direct patient contact, or reside in either a long-stay residential care home or other long-stay care facility. There may be other situations where you are entitled to the flu jab, with your GP or practice nurse being able to offer more information.

You can take preventative steps though to try and protect yourself and those around you by: coughing or sneezing into a tissue, disposing of used tissues immediately and washing hands straight away. You should also rest, drink plenty of fluids, and eat healthily (a low-fat, high-fibre diet is generally advised).

Flu FAQ

I am pregnant, do I need a flu jab this year?

Yes. The flu vaccine can be safely administered at any stage of pregnancy following conception to protect both you and your unborn baby. It will help to protect against serious complications in the latter stages of pregnancy, such as pneumonia, and will       even offer protection for the baby in the first few months of their life after birth. The vaccine also means there is a lesser risk of premature birth or the baby having a low birth weight.

I am pregnant but I think I have flu. What should I do?

See your doctor as soon as flu symptoms first appear as there is prescription medicine that can be taken to reduce the chance of complications arising, but the treatment needs to be taken soon after the initial symptoms start to show.

I have already had flu. Do I need the vaccine?

Yes. You will not know which virus caused your flu and the vaccine is essential to protect you against other flu viruses after yours has passed.

I received a flu vaccination last year. Do I need one this year?

Yes. The vaccine will offer protection against different strains than the previous years. Even if you were vaccinated last year, it is strongly advised you receive another this year. Health experts identify the flu viruses way in advance that are most likely to be predominant and appropriate vaccines are made.

Which flu viruses will the 2013/14 vaccine protect against?

. H1N1 – the strain of flu responsible for the 2009 swine flu pandemic.
. H3N2 – a strain of flu prominent in birds and mammals that was notoriously active in 2011.
. B/Massachusetts/2 – a strain of flu that was active in 2012.

Why is flu dangerous for older and chronically ill people?

Those over 65 and/or suffering with a chronic illness will have difficulty fighting influenza as their body’s system for getting rid of infection has usually become much weaker. Older people who have flu are at risk of pneumonia, bronchitis, and even death.

Who should not have the flu vaccine?

There are not many people who should avoid the flu vaccine. If you have had a serious allergic reaction to a previous jab then it is generally advised to avoid having another. Because some flu jabs are created using eggs, people with an allergy to eggs may be at risk of experiencing a reaction with that type of vaccine. Therefore, it is best to check with your doctor who may be able to provide a flu vaccine with low egg content if an egg-free version isn’t available. If you have a fever, you should wait until you have fully recovered before considering the flu vaccine.

What is the flu nasal spray vaccination?

The NHS childhood vaccination programme means that all children aged 2 to 3 years of age are eligible to receive an annual flu nasal spray vaccine. As the initiative rolls out, all children between the ages of 2 and 16 will be vaccinated against flu with the nasal spray. It is administered as a single dose of spray in each nostril and has the major advantage of there being no needles involved and also less side effects.

What is Tamiflu and do I need it?

Tamiflu is a prescription only antiviral medicine for the treatment or prevention of various types of influenza such as swine flu. Tamiflu belongs to a group of medicines named ‘neuraminidase inhibitors’. These medicines prevent the influenza virus from spreading inside the body and so help to ease or prevent the symptoms arising from the influenza virus infection. A doctor will determine if you need Tamiflu and prescribe it as necessary.

Asthma

The 5.4 million people in the UK need to take extra care and precautions during the winter months as cold air and flu viruses are major triggers for asthma symptoms, which include: a shortness of breath, wheezing (accompanied by a whistling sound), chest tightness/pain/pressure, coughing (especially at night or early in the morning).

Before stepping outside on cold, dry days, always make sure to take your usual dose of reliever inhaler (normally a blue inhaler) and keep this inhaler on you at all times. Wrap up well and ideally you should wear a scarf that covers your nose and mouth. Doing this will help to warm up the air before you breathe it in. Exercise is another trigger for asthma attacks and you need to be cautious of exercising during the winter. Warm up for 10–15 minutes prior to exercise and take one or two puffs of your blue reliever inhaler before you begin.

Christmas asthma triggers should also be taken into account and precautions need to be taken to avoid them where best possible. Pets, Christmas trees and Christmas decorations can cause havoc if you have asthma or other allergies.

Norovirus

The virus may also be more commonly known as the winter vomiting bug. As the name suggests, it is particularly rife during the winter months, but can be caught at any time during the year. In recent years norovirus has made headlines after spreading rapidly amongst the passengers on cruise ships and it is quite often spread within schools and hotels. The first symptom is suddenly feeling nauseous, followed by forceful vomiting and diarrhoea. Sufferers may also experience stomach cramps, aching limbs, frequent headaches, and a high temperature (over 38C/100.4F).

The virus is difficult to try and deal with, but should pass after a few days. If you are vomiting and have diarrhoea, you must drink plenty of fluid to prevent dehydration, with this being more dangerous with the very young and elderly.

Each year approximately 600,000 to 1 million people in the UK become ill with the norovirus, but there are things you can do to prevent getting the virus or try to prevent it spreading. For example, avoid sharing towels and flannels, wash your hands thoroughly with soap and water after using the toilet as well as prior to preparing meals, use a bleach-based household cleaner to disinfect any surfaces or areas that may be contaminated and wash all clothing and bedding at risk separately from other items.

Warnings issued after ‘high risk’ patients are not going for their flu jab

We are fast approaching the winter season in the UK as autumn is coming to a close. You may have already noticed this though by the rapidly dropping temperatures, the need to use the ice scraper on your car windscreen and it is now getting darker much earlier in the evenings. The wintery chill will unfortunately also bring with it a high number of colds and flu outbreaks across Britain. The common cold can be dealt with simple enough and will be gone within a week usually but the flu can be more serious and even prove fatal at times.

However many of the population who are deemed as ‘high risk’ are not receiving the flu jab despite many the warnings that health officials give around this time each year.  Department of Health (DOH) figures worryingly show that many people who are at risk of becoming seriously ill from flu complications, have yet to receive the flu vaccination.

The vaccine is available without charge to those deemed at risk to provide protection against catching flu and developing serious complication such as bronchitis and pneumonia. Some of the eligible groups of people include anyone over 65 years of age or over, if you have a certain medical condition such as asthma or diabetes, are pregnant or if you are the carer for somebody who may be at risk if you yourself fall ill.

Information released by the DOH though shows that an increasing number of pensioners and those with medical conditions are not bothering to get the vaccine. In England alone there are approximately 4,700 deaths every year that are attributed to flu and those who are in the ‘high risk’ groups are shockingly around 11 times more likely to die from it in comparison to somebody not deemed at risk.

Figures show that at the end of last week 48.9% of patients aged 65 or over in England had received the flu jab. However, in the same week in 2011, the take-up for the vaccine was 54.8%. A similar trend has been seen in patients with health conditions such as asthma, whereby 28.7% of patients had received the vaccine by 28 October and at the same point last year the figure stood at 32.2%.

Health officials are now urging those at high risk to get themselves to their GP for a vaccination and there has been a website set-up called ‘Winterwatch’, which will go live in the next few weeks and will aim to provide up-to-date winter-related health information.

The health secretary, Jeremy Hunt, warned: “Cold weather can be hazardous for our health – particularly for older people and those with respiratory illnesses. Each year, the cold weather is responsible for an increase in deaths and thousands of cases of flu, falls, heart attacks and strokes. In past years, these extra pressures have cost the NHS £42 million in emergency admissions alone. As winter approaches, we should all be on our guard against health problems – by taking simple steps and looking after our older friends and family we can keep warm and well.”

Adding to Mr Hunt’s comments was public health minister Anna Soubry, who said: “We have taken the decision this year to run a flu campaign because too many people in at-risk groups have not come forward for the jab yet, although local campaigns have been running for the past month. Our campaign aims to encourage people who are most at risk from flu, who have put it off or who don’t think it is important, to get the vaccine.”

People should bear in mind that it can take around ten days for the vaccine to provide protection against flu following the jab. If you are unsure whether you need the vaccine or wondering if you are able to receive a free vaccine, you can contact NHS Inform on 0800 22 44 88 for more information.