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.

Achoo! Do you have a cold or flu?

The winter season for the majority of the Northern Hemisphere is not a pleasant time. Temperatures often plunge into the minuses as snow makes a regular appearance, as does ice, resulting in inevitable pandemonium for vehicle drivers and walking pedestrians.

Also prevalent at this time of the year are a huge number of colds, cases of flu, and various respiratory illnesses. Contagious viruses are of course active throughout the year, but winter is when we are most vulnerable. When it is cold, many people understandably choose to stay indoors, meaning a virus can spread rapidly through households.

Flu is transmitted between people when the infected individual then sneezes or coughs, releasing droplets into the air. Even touching a surface where the virus has been deposited can you put at risk of developing said virus.

It is worth noting there is a difference between a ‘cold’ and the flu, although they have some of the same symptoms and thus, are often mistakenly self-diagnosed. It is thought that around a third of Brits assume they just have a ‘bad cold’, when it is in fact the flu. This is a worrying statistic as thousands die each year from complications arising from flu.

A runny nose, coughing, a sore throat and sneezing are characteristics most common in colds, and usually develop over one or two days, lasting no more than a few days. However, some colds may last for as long as two weeks.

Flu usually strikes more suddenly than a common cold, symptoms are more serious and it lasts for a longer period of time. Flu symptoms include: sudden fever of 38-40°C (100-104°F), aches and pains in muscles and joints, sweats, a dry cough, headache and a feeling of exhaustion/needing to lie down.

One to three days following infection is the time when flu symptoms rear their ugly head, but many find they recover within one week, but a feeling of tiredness lingers for slightly longer than this. Severe colds may cause muscle aches and fever, which explains why many people struggle to differentiate the two.

Regardless of if it is a cold or flu you have, you must seek medical help if you also have chronic health condition such as asthma, diabetes, or heart disease, or are experiencing a high fever, a severe headache, or abdominal or chest pain.

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 straight away.
. Washing hands as soon as possible.
. Get an annual flu jab if you are in one of high-risk groups.
. Throwing a used tissue away as soon as possible.
. Washing your hands as soon as possible.
. Having a flu jab every year if you’re in an at-risk group (i.e. children under the age of 5, adults over the age of 65, pregnant women).

Painkillers, such as paracetamol, ibuprofen and aspirin, can help to ease your symptoms if you just have a cold – although aspirin should not be given to anyone under the age of 16. You should also rest, drink plenty of fluids, and eat healthily (a low-fat, high-fibre diet is generally advised).

You can usually treat yourself in the comfort of your own home if you have the flu. Make sure to get plenty of rest (most people know when they feel fit enough to carry on with their normal activities), keep yourself warm, and drink plenty of fluids.

Paracetamol or anti-inflammatory medicines such as ibuprofen can help to lower your high temperature and relieve aches if you are unwell with a fever.

Prescription antiviral medications such as Tamiflu (oseltamivir) are also widely used for both flu prevention and treatment.

Tamiflu stops the chemical neuraminidase – made by the influenzavirus – from having an impact that is. The virus relies on neuraminidase to spread in the airways, but because Tamiflu blocks neuraminidase from having an effect, the spread of the influenzavirus in the airways is reduced and the body’s immune system is more easily able clear-up the infection.

GPs can prescribe Tamiflu to fight influenza

The Health Protection Agency’s (HPA) recently released health data show that GP consultations for influenza have risen – particularly amongst children and young people.

The HPA figures show that for the week prior to Christmas, weekly primary care consultation rates across England had increased to 27.4 per 100,000 people. Encouragingly, other countries in the UK had witness similar increases for the same period, with a rate of 18.9 per 100,000 in Wales, 19.7 per 100,000 in Scotland and 25.5 per 100,000 in Northern Ireland.

Flu-like symptoms were predominantly reported in the 5-14 year olds – double those of overall levels. Other HPA information show that also in the week before Christmas, 45 acute respiratory disease outbreaks had occurred; 43 within schools and the other 2 in care homes.

Influenza or ‘flu’ as it is commonly known as is a respiratory illness associated with infection by influenza virus. Common symptoms usually make an appearance roughly 2 days after infection and include fever, headache, cough, sore throat, aching muscles and joints. The condition was first identified in 1933, and there are main three types determined: Influenza A, B, and C.

Dr Richard Pebody, head of seasonal flu surveillance at the HPA commented that the latest flu figures were ‘encouraging’, saying: “The latest vaccine uptake figures for one of the ‘at risk’ groups – the over 65 age group – are encouraging, with more than 70 percent taking up the offer of the flu vaccine. Among those in an ‘at risk’ group under 65 years of age, uptake is just under 50 percent and around 40 percent of pregnant women and healthcare workers have accepted the offer of vaccination this season.”

The HPA stats come in the same week that it emerged The Department of Health (DoH) have informed GPs they  can prescribe antivirals such as Tamiflu for influenza to the groups of people who are most at risk of developing complications from contracting flu. High-risk people include pregnant women and those over the age of 65.

However, according to The DoH, there is a ‘substantial likelihood’ that schoolchildren across the UK showing with influenza-like symptoms had the disease.  NHS chief medical officer Dame Sally Davies said: “The most recent surveillance data indicate that there is now a substantial likelihood that people, including children in schools, presenting with an influenza-like illness are infected with an influenza virus.”

This follows action from The U.S. Food and Drug Administration, who last Friday extended the use of Tamiflu to children as young as 2 weeks old who have shown flu symptoms for no more than two days. The U.S. approval means that Tamiflu is the only prescription oral antiviral medication approved to treat patients of all ages; infants two weeks of age all the way to the elderly
Roche’s Tamiflu works at lessening the duration and severity of influenza by blocking the virus from replicating within the body. It 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. Tamiflu was first given FDA approval in the United States back in 1999, so its existence is not a new revelation. However, the drug came to worldwide prominence a decade later in 2009 due to the deadly H1N1 swine flu epidemic, hitting peak sales of an incredible $3 billion because of the epidemic.

Tamiflu is available today through Medical Specialists Pharmacy from as little as £21.98 per pack after we dramatically lowered the price of Tamiflu earlier in the year to help out new and existing patients during this difficult recession.