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Influenza A (H1N1) virus
14/05/2009
Scotland is planning to have supplies of vaccine for the A (H1N1) virus ready in anticipation of any vaccination programme that may be necessary later this year, the Scottish Parliament was told today.
Health Secretary Nicola Sturgeon updated MSPs on the latest situation, saying the Government's strategy remained one of containment but that 'at some stage over the coming weeks we may require to move from containment to a mitigation strategy'.
Read the full statement
Later, it was announced that one new probable case of Influenza A (H1N1) is currently under investigation in Scotland, taking the total number of probable cases to five, all in Greater Glasgow and Clyde.
In addition there are 16 possible cases undergoing testing in the Fife, Forth Valley, Greater Glasgow and Clyde, Highland, Lothian and Tayside health board areas.
The total number of confirmed cases remains at five.
Health Secretary Nicola Sturgeon said:
"We continue to monitor this situation and the figures today show us that we must remain vigilant as we focus on disrupting the spread of the virus.
"In Scotland, we have five confirmed cases. A further five cases are being considered probable and there are also 16 possible cases currently under investigation.
"Our strategy on containing the virus and minimising further spread has so far been successful and we intend to continue with it for as long as we believe it will be effective.
"Scotland, and the UK as a whole, is well prepared for a pandemic and I would urge the public to remain calm and continue taking sensible hygiene precautions."
The local health board breakdown for possible cases is as follows:
Fife - 2
Forth Valley - 1
Greater Glasgow and Clyde - 7
Highland - 1
Lothian - 4
Tayside - 1
In the Scottish Parliament this morning Ms Sturgeon said:
"As of this morning, the World Health Organisation reports that 5251 cases of A/H1N1 have been officially reported across 33 countries. There have been 56 reported deaths in Mexico, 3 in the US and 1 in each of Canada and Costa Rica.
"The WHO's pandemic alert remains at level 5, which means that we need to be ready to implement our pandemic plans should they be needed.
"A total of 71 cases have been confirmed across the UK.
"In Scotland, we have 5 confirmed cases. A further 4 cases are being considered probable - this means they have tested positive for influenza A, but further testing is required to confirm the strain.
"There are also 12 possible cases currently undergoing testing in 4 NHS Boards, 7 of which are travel related. All these cases are being treated and investigated on a precautionary basis. They are not confirmed as positive for Influenza A, let alone the specific H1N1 strain.
"Presiding Officer, much of the focus in the last few days, since a 19 year old man in Greenock with family connections to Mexico was confirmed as positive, has been on further cases in the Greenock area.
"All four probable, and many of the possible cases, are in or connected to Greenock. The 4 probables are as I reported yesterday - a 3 year old child, a five year old child, the five year old's mother and a 16 year old girl who, as far as we know at this stage, is not connected to any of the other confirmed or probable cases. Final test results are still awaited in all 4 cases.
"Members are aware that the cases of the five year old and three year old children have resulted in the closure of Ravenscraig Primary School and Ladybird Nursery School in Greenock.
"The decisions to close the school and the nursery, in both cases for a period of 7 days, were not taken lightly. They were precautionary decisions, taken on the basis of expert advice from Health Protection Scotland and Greater Glasgow & Clyde Health Board, with input from the Health Protection Agency.
"The close contacts of these two children - at both the nursery and the school - have also been given Tamiflu and parents have been offered appropriate advice and reassurance.
"The five year old child also attended an after school club around the time he became symptomatic. The 17 children who attended with him - and the staff who were there at the time - have also been given Tamiflu. Parents of these children have been asked to keep them off school and away from the after school club for 7 days.
"Presiding Officer, I know how concerning and, indeed, inconvenient school and nursery closures are for parents. However, I know parents will understand the reasons for these actions and I would like to thank them for their patience and understanding. I would also like to thank Inverclyde Council and Greater Glasgow & Clyde NHS for their sterling efforts in communicating with all concerned and offering the appropriate advice and reassurance.
"I also want to stress that these are not precedent setting cases. If similar situations occur in other schools in Scotland - which we are obviously hoping will not happen - they will all be risk assessed on a case by case basis. However, there is evidence from England to suggest that very early precautionary closure of this kind - as happened at the school in Paignton - can be effective in disrupting further spread of the virus.
"Presiding Officer, as I said last week, our focus at this stage is on containing the virus and minimising further spread. That strategy has been successful so far and we intend to continue with it for as long as we believe it will be effective in reducing the spread of the virus. However, as I also said last week, at some stage over the coming weeks we may require to move from a containment to a mitigation strategy. That is most likely to happen when there is sustained community transmission. We are not yet at that stage but we are monitoring the situation closely.
"Our scientific advisors also continue to examine emerging evidence from both the worldwide and UK cases of H1N1. While we still don't know enough about this virus to be able to draw any definite conclusions, the science is beginning - albeit very tentatively - to point in certain directions.
"For example, emerging evidence suggests that healthy young adults and children are being proportionately more affected than other groups.
"Early estimates also suggest an attack rate of around 20%. This compares to seasonal flu attack rates of between 5 and 15%, although in recent years seasonal flu attack rates have been even lower than this at around 2 to 4%.
"Early experience also points to this being an illness with relatively mild symptoms although, of course, we need to be quite clear that even mild flu can be unpleasant and debilitating and that, in exceptional cases, flu can cause deaths.
"All in all we have to be prepared for an illness that might affect large numbers of people with symptoms that, although mild, might see them bed-ridden for a few days. Members will appreciate that the impact of that on our NHS and our economy - should it come to pass - could be significant. Even in a normal flu season the demands on the NHS can put severe pressure on services.
"And, of course, there is also the risk that the virus might mutate and become more virulent during the autumn and winter months.
"That is why, in parallel to our efforts to contain the virus, we are also working hard with our colleagues across the UK to prepare for further developments in its spread and virulence and to seek to reduce and mitigate its impact on our population and our economy as much as we can.
"Discussions on a web and phone based system to facilitate the distribution of antivirals to large numbers of people are well advanced.
"One of the other key issues under discussion at the present time is that of a vaccine. An important development in recent days has been the identification by scientists of the genetic fingerprint of the European strain of the virus. That is a crucial first step in the production of a vaccine and obviously the concern of all four administrations in the UK is how best we can secure supplies of an effective vaccine as soon as it becomes available.
"Our clear and shared objective is to secure sufficient supplies to allow vaccination of the whole population. That is in line with the approach recommended by scientific advice, including that of the Scientific Advisory Group on Emergencies which has advised that universal vaccination is the preferred approach.
"As members are aware, the UK has advance supply contracts in place for a pandemic vaccine. While these contracts guarantee a supply of vaccine, they can only be triggered in certain circumstances - for example when the WHO declares a pandemic by moving to phase 6.
"Obviously we do not know when or if these triggers will be reached. We do know that if we simply wait until then we risk losing the capacity manufacturers have available now which would allow us to build up a stockpile and get a vaccination programme underway before the winter.
"I can therefore advise parliament that I have decided, in discussion with the Health Ministers in England, Wales and Northern Ireland, to secure and purchase early supplies of vaccine.
"Negotiations with manufacturers are ongoing and I would hope that agreement on a contract and delivery schedule will be reached very soon.
"Presiding Officer, it is important to understand that by the time a pandemic is declared, global demand for a vaccine will outstrip the capacity to supply it. Under any scenario and even after our sleeping contracts kick in, it will be a number of months before we get supplies sufficient for 100% of the population. The decision that we have taken now to utilise spare manufacturing capacity is therefore important in seeking to secure an early supply to allow a vaccination programme - focussed initially on priority groups - to get underway as quickly as possible.
"I hope I have assured members today that we remain focussed on containing the virus for as long as we can while also preparing for the possibility of its further spread. I will continue to keep parliament updated."