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What we know
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| What we know | |||||||||||||||||
| Influenza (flu) can be very serious particularly for those with underlying diseases and the elderly. It is caused by flu viruses, of which there are three subtypes – A, B and C. In the UK flu is generally a winter disease with a peak in the first quarter of each year. The number of cases of flu varies considerably from year to year. The virus that causes influenza A changes frequently, most often in small ways. If it changes to a greater extent epidemics may result because people have little immunity and if there is a very major change a large pandemic may result. In the 2003/04 flu season, a new strain was seen in Northern Ireland - Fujian Strain of Influenza A H3N2. Cases of this new strain occurred from the first week of October 2003 – several months earlier than normal. Rates of illness were highest in children under 4 years of age. The Fujian Strain predominated across the UK, Ireland and Europe during 2003/2004. Flu vaccine is an effective measure to reduce the risk of catching flu and importantly the risk of serious complications following flu. Each year the World Health Organisation recommends the flu vaccination which should be used in the following season according to the strains which are circulating. The strains of influenza virus recommended by WHO to be included in the 2004/05 vaccine are:
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| What information do we have about the Eastern Board area? | |||||||||||||||||
| Flu vaccine is given in October/November each year in campaigns run in general practices. The Eastern Health and Social Services Board is very successful at meeting or nearly meeting the regional targets each year. During the 2003/04 flu season 112,589 flu
vaccines were administered in the Eastern Board area. In Northern
Ireland a total of 270,161 vaccines were administered in the same
period. The mean uptake rate as a percentage of the 65+ population
in the Eastern Board was 73%, comparable to the Northern Ireland
mean of 73.4%. |
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| What is the result of this on our health locally? | |||||||||||||||||
| In Northern Ireland eight or nine people die directly of flu infection in an average year. Many more die each year of the complications of flu. In an epidemic year the number of deaths is much higher, and in a pandemic might be over 1000 and may be many thousands. Admissions to hospital increase markedly in a flu epidemic mainly due to complications in the elderly. Flu vaccine is 70-80% effective in preventing
flu if the vaccine strain is a good match to the circulating strain.
Flu vaccination also decreases severity of disease in those who
do catch it. |
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| Policies | |||||||||||||||||
| Each year, in conjunction with the Department of Health in London, the Department of Health and Social Services and Public Safety Northern Ireland issues regional guidance on the people who should be offered flu vaccination. National policy for 2004/05 is that influenza immunisation should be offered to:
Flu vaccination is also recommended for healthcare workers, as there is evidence that healthcare workers can spread influenza virus to patients in their care in settings such as GP practices, hospitals, long-term and residential care facilities and other healthcare settings. Responsibility for occupational influenza immunisation rests with the employer and it should be provided through an occupational health service. It is up to individual trusts/employers to determine their own programme and fund the immunisation of their staff. From 2004, under the terms of the new General Medical Services contract, the influenza and pneumococcal programmes will be delivered as a Directed Enhanced Service (DES), commissioned by HSS Boards from primary medical services Uptake of flu vaccine is reported by GPs.
Surveillance of cases of flu and flu-like illness in the community
is carried out by the Communicable Disease Surveillance Centre (CDSCNI)
in conjunction with the Department of General Practice, Queens University
Belfast. This surveillance system relies on a number of practices,
across Northern Ireland, (spotter practices) reporting numbers of
patients who present to them with flu-like illness, and sending
samples to the Regional Virology Laboratory for testing. This information
is compiled on a weekly basis and compared to previous years with
the information fed back to public health and clinicians. When influenza
A is circulating in the community, the DHSSPS
will authorise the use of antivirals. |
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| What is happening in the Eastern Board area? | |||||||||||||||||
| Flu
vaccination In 2002/03 a significant project was undertaken to examine the organisational reasons for good and poorer uptakes in GP practices. This project identified that having an identified flu co-ordinator and a good flu register were key to success. Flu Pandemic Planning The risk of a flu pandemic is heightened at present because of outbreaks of highly pathogenic avian flu, particularly in the Far East. There have been a number of human cases with a high mortality rate, but to date no evidence of efficient human-to-human transmission. Work is ongoing on an international, national and local level to update and improve planning for a potential pandemic. Pneumonoccal Immunisation
Programme
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For further information on this topic please contact us at publichealth@ehssb.n-i.nhs.uk Eastern Health and Social Services Board Champion
House, 12-22 Linenhall Street, Belfast BT2 8BS Telephone: (028)
9032 1313 Fax: (028) 9055 3681 Text Phone:(028) 9032 4980 Website:
www.ehssb.org
E-mail: pr@ehssb.n-i.nhs.uk |
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