Swine Flu LatestJul 17, 02:59 PM

What is swine flu?

Swine flu is a respiratory illness caused by a virus that usually infects pigs. People do not normally get swine flu but human infection can happen. People have some natural immunity to flu strains that are in common circulation, but not to strains that circulate in other animals. Sometimes, humans and animals can pass strains of flu back and forth to one another, such as when people become ill with bird or swine flu. This usually occurs after a human has direct and close contact with animals that are ill. Mixing of human and animal flu viruses can lead to the development of new, changed viruses, to which people may have little or no immunity. Infection can develop and then spread quickly.

What are the symptoms?

The symptoms of this swine flu are similar to the symptoms of regular seasonal flu and include fever, fatigue, lack of appetite, coughing, sore throat, pain in muscles and joints, headache and chills. Some people with swine flu have also reported vomiting and diarrhoea. So far however, the illness has been generally mild in most people. Most people will get better simply with self-help treatment that includes rest, paracetamol and plenty of fluids, as with regular flu.

I think I have swine flu! What do I do?

If you develop flu-like symptoms, you should stay at home and phone NHS Direct on 0845 4647, or the Flu Helpline on 0800 1513 513 or check your symptoms and get advice on www.nhs.uk or www.nhsdirect.nhs.uk.

>>> PLEASE DO NOT COME TO SURGERY IF YOU THINK YOU MAY HAVE SWINE FLU <<<

If, after seeking advice as above, you remain concerned, please stay at home and ring the surgery 01773 514130 for
further advice. If you need to be assessed face to face, we will make the necessary arrangements for you to be seen. If
you think you may have swine flu, you should not go to school or work, and you should stay at home and self-treat.

Do I need antiviral treatment? [PLEASE SEE BELOW FOR MORE DETAILS]
Antiviral treatment is currently being recommended to all those confirmed as having swine flu and particularly those at risk
of developing complications from flu – for instance, those with chronic heart or chest disease, diabetes, the elderly, pregnant women and very young children. The issuing of antiviral treatment is being coordinated centrally by government.
If your doctor confirms swine flu (either on the telephone or after face to face assessment), you will be given a voucher
entitling you to treatment. This is not an NHS prescription and cannot be dispensed by a chemist. You will be given instructions on how a healthy friend or relative can fetch the treatment for you from a designated local collection centre.
Please note antiviral treatment is not a cure for swine flu. It shortens the duration of the illness by about a day or two, but
only works if given within 48 hours of the onset of symptoms, and may also cause severe side effects. If your condition is
mild and you are not in an at-risk group, you may choose not to take antiviral treatment at all and decide to self-treat.

I’ve been in contact with someone with swine flu! Do I stay off work or school?
If you are well, there is no need to avoid school, nursery, place of study or work or social gatherings. Being in contact with
persons who are well, but who themselves have had contact with a swine flu case, does not carry any significant increased risk of you developing swine flu. Antiviral treatment is no longer being recommended for people who have been in contact with cases of swine flu. Workplaces and schools do not need to be closed even if there has been a confirmed swine flu case. Your workplace or school can get additional information from www.hpa.org.uk/swineflu/public.

How can I avoid catching swine flu?
Swine flu is highly contagious and spread person to person by coughing or sneezing and transmitted on objects like door
handles. To prevent spread, cover your nose and mouth with a tissue when coughing or sneezing and bin the tissue. Wash hands regularly with soap and water and clean hard surfaces frequently with normal household cleaner.

ANTIVIRAL TREATMENT (TAMIFLU) – INFORMATION LEAFLET

THIS LEAFLET WAS LAST UPDATED ON July 16, 2009

What is tamiflu?

Tamiflu is the more well-known antiviral treatment for swine flu. The other antiviral treatment is called Relenza. Antiviral
treatments are currently being offered to all people who have been clinically diagnosed with swine flu, but especially those who are in the at-risk groups. You are entitled to one course of treatment within 7 days of symptoms starting.

Am I in an at-risk group?
You are in an at-risk group if you are considered to be at increased chance of developing complications if you got flu. Examples of at-risk groups are: children aged 5 years and under, those aged 65 years or over, those with chronic lung or heart disease (eg, asthma, chronic bronchitis, heart failure, angina, stroke), those with liver or kidney disease, those with neurological disorders (eg, MS, parkinson’s), those with suppressed immune systems (eg, on steroids, cancer drugs),
those with diabetes and pregnant women.

What are the complications of flu?
The complications of flu include chest infections, pneumonia, worsening of existing heart disease, and rarely, meningitis, encephalitis (inflammation of the brain) and acute inflammation of nerves. Most people recover without complications.

I have been diagnosed with swine flu – do I need antiviral treatment?
In answering this question, you may wish to consider the following information about antiviral treatment:

GOOD POINTS ABOUT ANTIVIRAL TREATMENT BAD POINTS ABOUT ANTIVIRAL TREATMENT
• It can reduce the duration of symptoms by a day or two
• It can reduce the severity of symptoms
• It can reduce the chance of transmitting the virus to another
person
• It may reduce the chance of serious complications from flu

BAD POINTS ABOUT ANTIVIRAL TREATMENT
• It is not a cure for swine flu or any other flu-like illness
• You still need to self-treat your flu illness with paracetamol,
rest and fluids
• If more than 48 hours have passed since your symptoms
started, antiviral treatment is unlikely to be of any benefit
• Serious side effects can occur (see below)
• Swine flu is generally mild compared to normal seasonal flu so
you may consider it is not worth treating
• It cannot stop you getting another dose of flu at a later date

What are the side effects of antiviral treatment?
Tamiflu is a relatively new drug. This means that its safety outside of clinical trials is still being carefully monitored. The side effects of tamiflu include nausea, vomiting, abdominal pain, diarrhoea, headache, conjunctivitis and rash. Less commonly, hepatitis (inflammation of the liver), irregular heart rhythms, neuropsychiatric disorders in children and adolescents (fits and delirium, altered level of consciousness, confusion, abnormal behaviour, delusions, hallucinations, agitation, anxiety, nightmares and in a very few cases accidental injury and death), visual disturbances and severe skin reactions have been reported. Relenza can cause chest tightness, respiratory problems, acute allergic reactions, rashes and also neuropsychiatric disorders as described above.

OK, so I take the antiviral treatment. What if I get flu again? What if I didn’t have swine flu the first time?
Swine flu may mutate into a more virulent (dangerous) strain of flu or it may combine with normal seasonal flu to form a new strain. So you could catch flu again. Unfortunately, you are only allowed to have one course of treatment.

So should I take antiviral treatment or not?
Unfortunately, the case for antiviral treatment is not as clear cut as both the government or the media would make out. As doctors we have a duty to always balance the potential risk of doing harm to patients against the benefits of the treatment, rather than make blanket recommendations or blindly follow guidance and regulations to issue medications and expect our patients to take them, regardless of the consequences. Your doctor will discuss these issues with you, but ultimately the decision for your doctor to issue antiviral treatment and for you to take it will have to be a shared one  based on your individual circumstances and opinion and the information we have on swine flu at the current time.

July 16, 2009

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