Swine Flu
Malmesbury Surgery Update
In view of all the media attention given to the outbreak of swine flu worldwide, we thought you might appreciate a ‘bulletin’ from your local surgery.
Historical Background
A lot of you may know what follows already, as some of the media have covered the issues of swine flu very responsibly, and the leaflet which was distributed by the Department of Health a few months ago, is most informative.
Influenza A, H1N1, the new flu virus which causes swine flu (so called because it originated in pigs) is related to the viruses which caused the pandemics last century, most recently Hong Kong flu in 1968/69, and Asian flu in 1957. In much the same way that family resemblances can be apparent in even rather distant relatives, H1N1 shares features of the previous viruses, which is presumably why very few people over the age of 60 have been affected by swine flu so far, as they already have some immunity. However, it is a new virus, and therefore we do not yet know quite what to expect, which is why there has been so much emphasis on ‘pandemic flu planning’
The term ‘pandemic’ is because the virus has spread world-wide, and is NOT an indication of the severity of the illness. We have been ‘expecting’ a pandemic around this time because of the fact that historically, this is what happens, and mathematical modelling had indicated that it must be ‘due’ around now.
It had been thought that the Avian/bird flu a few years ago would become pandemic, but it did not: this was fortunate as it was a much nastier infection. So far, in the vast majority of cases, swine flu seems to be an even milder version of the ‘ordinary’ seasonal flu, with which we are all so familiar. But we now know that in a tiny minority of cases (1 or 2 per 1000, most of whom have other health problems), it can be more serious.
However, the pandemic flu planning which began at the time of the Avian flu outbreak has been invaluable, because it means that we have had a chance to think about a lot of the issues before we have been faced with them. Certainly, we have accumulated a lot of information and guidance over the last few months, which we are now putting into action.
General Information
· Flu – of any sort – is not infectious until you develop symptoms (unlike, for instance, some childhood illnesses).
· A sneeze or a cough can spread virus-laden droplets around for up to 1 metre – but not more. That is why there is so much emphasis on ‘catch it’ – in a hanky etc. - and ‘bin it’. But, more significantly, the virus lives on our skin, particularly on our hands, and can then be transferred to any surfaces we touch – a lot of infection spreads this way. That is why there is so much emphasis on hand-washing, and why you will see antiseptic gel dispensers appearing in our building, and why we have had to remove magazines etc from the waiting areas. You may also notice more cleaning activity around the building at unusual times, particularly of the stand-alone toy units, which we would like to leave in place to entertain our young patients.
· If you do NOT HAVE A TEMPERATURE of more than 38°C (100.4°F) you DO NOT have flu, of any sort, regardless of whether you have a cough/sore throat etc.
· Incubation period – this is the interval between being exposed to the virus and developing symptoms. It’s usually about 3-5 days, but we tend to say 7 days to be on the safe side. So, if you are concerned that you have been in contact with someone who has symptoms of swine flu, but are still well 7 days later, you are very unlikely to start to develop the illness after that contact.
· Tamiflu – if taken early in the illness – may help to shorten the flu illness by a day or two, and lessen the symptoms – but it is NOT a cure. So you will not notice any dramatic change when you take it (unlike antibiotics for some acute infections, when the benefits are felt within 24–48 hours). Its particular role is that it reduces the chances of serious complications, such as pneumonia. That is why we are so keen for patients who have other health problems to have a course as soon as they develop symptoms.
What’s Happening in Malmesbury?
· We have an ‘assessment room’ specially designated to see patients who have symptoms of possible swine flu, and whom we have assessed over the phone, and asked to come in for examination. It is immediately accessible from the staff car-park at the front of our building, facing the main road, which means that the risk of other patients being exposed is reduced, and that our reception staff are not so much ‘in the firing line’ We are very fortunate that our splendid new building provides us with the flexibility to do this.
· As we hope most of you know, we have a very dedicated and efficient team of both clinicians and support staff, and we also work very closely with the flu response unit at NHS Wiltshire (which used to be called the PCT) in Devizes. We are in e-mail contact at least once a day, and recently more often than that! We are well informed and as well prepared as one can be for a slightly unknown and evolving situation.
· Both the on-site and the High Street Boots, together with Lloyds Chemist are our local centres for supplying Tamiflu for patients who need it. The on-site Boots does have extended opening hours from 6.30am-10.30pm Monday-Friday, 6.30am-8.30pm Saturday and 10am-4pm Sunday.
· We are sorry about the lack of reading material in the waiting areas – as described above – so please feel free to bring your own, then take them home again!
· We will try to keep our surgery web-site updated as frequently as possible – but you will appreciate that our priority is looking after the medical needs of our patients – both those who have swine flu and the vast majority who don’t!
· As soon as the vaccine is available, we will very speedily organise a programme to vaccinate those most in need first. We will be issued with guidance from the Department of Health and will follow it closely. Unlike Tamiflu, which is a treatment by mouth for those who already have swine flu, the vaccine is an injection (two in fact, 3 weeks apart) which will immunise those who haven’t had swine flu and prevent them from catching it.
What you can do
· Please try not to worry too much, keep up to date with information and advice from the NHS web-site (www.nhs.uk), the flu advice line – 0800 1 513513 and the surgery web-site www.malmesburypcc.nhs.uk. If you have no symptoms, go about your daily life in the normal way.
· Make sure you have a thermometer in the house – a digital one is just as good as an in-ear one, and much cheaper. It will probably be the first question you will be asked if you ring for advice – ‘What is your temperature?’ – because, if it’s normal, you have no cause for concern.
· Follow the rules about ‘catch it, bin it, kill it’ - leaflets and posters around our building.
· Look out for neighbours in your community who may not have family close by, and offer to do errands/collect prescriptions etc for them if they become ill.
· Try to keep as well as you can, with plenty of nourishing food, and a good night’s sleep. This will give your immune system the best possible chance of fighting infection – of any sort.
· Please bear with us over the next few weeks and months, as we may have to re-order our priorities and please make allowances if some non-urgent tasks take rather longer than usual (eg. forms/queries etc)! Rest assured, we will be doing our very best to look after you all, whatever your medical problems.