We previously wrote about the H7N9 virus that had been detected in China , which was important but not alarming. Back then the research suggested that early detection was key to successfully treat the illness with oseltamivir. This has now been confirmed by a study, which was recently published in the Lancet.

In the study, the researchers analysed results from all patients that had presented to their hospital with flu-like symptoms. Of those, 14 were confirmed to have bird-flu with two being immune to treatment. In order to obtain a full picture of the infected participants’ symptoms, the researchers analysed a wide range of data including haematological results, radiological data, and biochemical and microbiological investigations. The key findings indicated that all of the participants had gotten their infection via cross-species infection, and that treatment within two days of onset was associated with better outcomes than treatment started late. Based on this, the researchers maintained the importance of treating suspected or confirmed cases as soon as possible. In addition to that, the team urged more research to be carried out to look into the pathogenesis of H7N9.

The current study is a step forward in the research of this topic. However, the fact that two participants were immune to the treatment also highlights an important gap in current knowledge that warrants further research. Given that there are many on-going studies that are yet to be published, we have no doubt that there soon will be more information to provide a fuller picture of the H7N9 virus.

The outbreak of a new type of bird-flu , the so-called H7N9 virus, has forced Chinese authorities to close down markets in Shanghai and Nanjing. In this article we provide you with an update of what we know so far and discuss whether there is reason to be alarmed.

To date, 43 cases have been identified, of which 11 have died. The effects of the virus are not fully known, but severe pneumonia with bouts of fever and shortness of breath appear to be the most commonly reported symptoms. The virus was initially detected in Shanghai, Anhuji and Zhejiang provinces and we are not aware of any reports of the virus spreading to other areas. Therefore, it appears that the closure of markets in Nanjing is a pre-cautionary action. In addition to closing down markets in China, it is also estimated that 20,000 or more poultry have been culled and a ban on import on poultry to China has been implemented.

According to the World Health Organisation there is no evidence to indicate human-to-human transmission of the virus. Although there is not vaccination for the H7N9 virus, there are early studies that have indicated that treatment with drugs that contain oseltamivir and zanamivir are effective in early detection of the virus. However, this has not been tested outside of a research environment. In addition to treatment, there is also ongoing epidemiological research to ensure that we are aware of whether there are any more cases and to establish whether this virus is spreading globally.

Based on all this information, it appears that the spread of this virus is very low and that there is no reason to be alarmed. It is clear that both precautionary and reactionary actions are being carried out in many separate areas. As we have previously written, the shelf-life of bird-flu vaccines is quite long, and it is promising that neuraminidase inhibitors (ie oseltamivir and zanamivir) appear to be useful in the treatment of the virus. Lastly, it is worth remembering that the field of researching vaccinations for H7 strains of bird flu is far from stagnant. If the virus mutates to such an extent that it can spread from human to human, then it is also likely that appropriate vaccinations will have been developed by the time this occurs. Further information is here.

Within research, there is no lack of creative solutions for studying complex problems. One recent example of that comes from a study seeking to find out whether using face-shields would be effective protection for clinical staff during flu season by keeping its participants “locked in” for observation for a total of 14 days.

The study, which is yet to be published, is a part of four trials that are due to be conducted on UK, Canada, Australia and the US. So far only the UK version has been completed, where a total of 41 participants took part. After being given various tests, half of the participants were intentionally infected with a mild type of influenza. The remainder of the participants were split into two groups. One group consisted of eleven participants that were given face-shields, while the other group consisted of ten participants that were not given any kind of protection. Following this, all the participants were guided to a common room, where they had to spend 60 hours together combined over the course of four days. Lastly, all participants got put under observation until the end of the study.

Although the results are not out yet, the researchers are hoping that their findings will show whether droplets or aerosols play a crucial role in transmission of influenza. The implication is that if droplets are key to the spread of influenza, then the use of face-shields in clinical settings could help to minimise the spread of the virus. If this was to be confirmed, then getting face-shields for hospital staff could be a realistic solution to a common problem as face-shields are rather cost-effective.

While this study is intriguing and has clear clinical implications, there are several factors worth considering. Perhaps the most obvious one being that the researchers only used one type of virus, which limits the generalizability of the findings. Similarly, it is worth asking to what extent this environment reflects the real world. While the study is being conducted in an isolated, clinical environment, the participants are too healthy for it to mimic hospital conditions. On the other hand, it could be argued that the healthy participants could be useful to explain how influenza spreads without considering co-morbidities. Unfortunately, healthy individuals rarely stay in clinical or controlled environments. Despite these weaknesses, we are keen to see the combined outcome of all the studies once they are published and will keep you updated once it happens.

Although the most notable outbreak of the swine-flu peaked in 2009, the reports regarding the virus and its treatment have continued to make headlines in mainstream media. A few days ago, researchers in Australia presented findings that indicated that a cluster of virus samples showed that it was resistant to oseltamivir in around 10% of cases in New South Wales. Oseltamivir is the active ingredient in Tamiflu.

These findings were presented at the Annual Scientific Meeting of the Australasian Society for Infectious Diseases. The emergence of this resistant strain of this virus, which is called H1N1pdm09, gave rise to several concerns among public health experts. The first concern came from the fact that this virus was found in the community, rather than with sick patients who had pre-existing conditions, which resulted in a weak immune system. This implied that the concern for the spread of the virus would not only be for particularly vulnerable patients, but also for healthy individuals. The second concern came from the fact that the H1N1pdm09 had spread to individuals who had never been treated with Tamiflu. This indicated that the virus could spread quite effectively from one person to another even if there is an oseltamivir intervention. The final concern, which was never stated by researchers, but has been noted in mainstream media, was the controversy regarding the efficacy of Tamiflu that had been reported in the last 12 months.

We were not surprised to read about a treatment resistant virus developing, as it has happened in the past with other diseases and treatments. Adamanatane was used to treat influenza but this is now largely obsolete for this purpose following a development of resistance. However, we were surprised to see that not all the reports had put the findings into context. The Australian researchers reported that they had found this to affect two per cent of their study sample, and a total of eight resistant cases were confirmed in the UK to date. Naturally it could be argued that these numbers are concerning, however they are far from alarming. Similarly, while it is important not to underestimate a new resistant strain of the virus, this strain is just one of many viruses that are circulating. This is in stark contrast to how it was when the swine flu was the dominant virus in 2009. Perhaps the most encouraging news was the fact that although H1N1pdm09 appears to be resistant to oseltamivir, other reports suggested that the same virus might be sensitive to zanamivir (which is the active ingredient in Relenza). Relenza operates in a different way from Tamiflu (even although it also disables the influenza virus through neuraminidase inhibition).

We feel that once these findings have been put into context, they show a more realistic version of the implications of this new virus. The importance of monitoring the spread of new viruses and strains of viruses is understandable, but our interpretation of the findings to date suggests that it is too early to be alarmed by these reports. The really scary flu virus is H5N1. If that started to pass from human to human in meaningful numbers then we may have a very serious problem.

The research of bird flu has been controversial for a long time, and nine months ago new findings prompted scientists to place a voluntary moratorium on research.  As two unrelated teams managed to produce a version of the bird flu virus which could successfully pass from one ferret to the next, concerns were raised about what would happen if the virus or information about the virus got into the wrong hands.

Therefore, the moratorium was put in place in order for the scientist to get some time to examine the most optimal way to proceed. However, as it has now been nine months since the moratorium started, it appears timely that the ban be re-examined.

This has been the topic for a series of publications in the current issue of mBO, which is a journal published by American Society for Microbiology. Overall, there appears to be a consensus that there is a need for both strict regulations on the research and the researchers conducting it but that the moratorium ought to end in order for research to continue. To date, the moratorium has not been lifted.

The implications of these studies are significant as ferrets’ response to flu is similar to human responses. Given that the passing of bird flu between humans has been rare in the past, the release of an often deadly virus that can pass between humans would cause a pandemic. As such, it is understandable that precautions are taken. However, knowledge is always valuable and it is better that humans examine the potential risks of this development than to halt research.

It can be argued that when it comes to creating public policy to reduce the spread of influenza, one size does not fit all. A recent large-scale study in the Lancet supports this argument.

The five countries considered for the study were Argentina, Japan, Mexico, UK and the US and 900 individuals from each country were interviewed over the phone regarding what measures they would take to reduce the risk of influenza during the H1N1 pandemic in 2009. The primary aim was to investigate whether behaviours such as hand washing and social distancing deter vaccinations.

Remarkably, despite the cross national differences in behaviours, this did not appear to affect the participants’ tendencies towards vaccinations. For instance in the UK only ten per cent of the asked participants avoided shaking hands with family, friends or distant acquaintances. In contrast to that, the other countries this was the case for 30-56% of the participants. However, this question was not applicable to the participants in Japan, potentially due to the fact that handshaking is not as customary in Japan. This further highlights the strength of the study to be sensitive to cultural differences. In terms of vaccinations, the range of participants varied from 16-33 % between countries.

There are a few issues worth considering when interpreting the study’s findings. Given that the main way of interviewing participants included calling individuals who owned a phone, it cannot be assumed that these findings would apply to individuals with lower socio economic status. Moreover, the self-reported results of retrospective events may be subject to recall bias and answering questions in a socially desirable way. A replication of this type of study next time an influenza pandemic of the H1N1 scale occurs would be suitable to further substantiate the findings and see whether individual behaviours have changed. Nevertheless, the implication that protective behaviours and vaccinations are complementary to each other offers a holistic view of the precautions individuals take to protect themselves in this type of situation.

At The Online Clinic we believe that it is important to tailor public policy to ensure a desirable outcome, without asking individuals to make unrealistic changes to their lives. Using hand sanitizer and getting vaccinated may sound obvious to some, but as this study suggests this may not always be the case.

The World Health Organization has confirmed that a 6 year old Cambodian girl has died of bird flu. She is the 18^th person in Cambodia to contract the H5N1 form of the flu virus that is proving deadly to humans, even although it is not yet being passed from human to human. Of the 18 people in Cambodia to have contracted this form of flu, 16 of them have died.

The first human death from bird flu was observed in 2003 and since then there have been 565 recorded cases and 331 deaths. Clearly if this avian flu virus were to mutate in a way that enabled its transmission from human to human, this could prove to be the deadly pandemic that we managed to avoid with swine flu.

The latest in mobile phone applications introduces the FluPhone app and has been invented by researchers at the University of Cambridge Computer Laboratory in order to observe the spread of flu among users and hopefully reduce the spread of such infectious diseases. The app allows phones to communicate with one another and record the number of people the phone user comes into contact with via a Bluetooth connection.

The impact of the app was observed over a 3 month pilot study in 2010 and the data proved insightful. Epidemiologists always ask patients to keep a diary of their social interactions so that they can better understand the spread of such infections and disease. The phone app will give medics a greater understanding of how flu spreads in different community structures and at what pace the spread accelerates.

Daiichi Sankyo, a Tokyo based pharmaceutical company, has received approval to market and manufacture Inavir, a single dose flu treatment. Biota, a Melbourne based pharmaceutical company, is to share the royalties and their shares surged by 17 percent after the news.

Biota is also the research company behind Relenza, another flu antiviral. Biota has apparently seen a collapse in royalties from Relenza following the swine flu pandemic last year but we wonder if there have been manufacturing problems with this drug as we have not been able to source Relenza for over a year now.

The two pharmaceutical companies merged their respective ideas seven years ago when they realised that they were working on comparable 2^nd generation flu compounds. Inavir is considered a breakthrough drug; a neuraminidase inhibitor that is inhaled in powder form like Relenza but only needs a one off dosing. The company states that just one dose is as powerful as a five day course of Tamiflu.

Biota is looking for alternative partners to take the compound forward for licensing in Europe and North America.

New Zealand is still facing swine flu deaths as the number of infections climb. 15 deaths have now been recorded and have been linked to the pandemic H1N1 virus.  Director of public health, Marc Jacobs said that effects of H1N1 were continuing and that numbers affected were dependent on geographic region.

The New Zealand Ministry of Health today confirmed that 11 of the deaths were due to swine flu. 5 deaths were reported since Monday in the Auckland and Waitemata health regions. 3 more patients died with confirmed H1N1. Waitemata confirmed the death of 2 males with the H1N1 virus. Both men had underlying health conditions.

The numbers affected do however seem to be declining in certain regions for example the North Island where most of the infections had been occurring. This year so far there have been 583 patients hospitalized in New Zealand with confirmed pandemic influenza type H1N1 and 13 people are in hospital presently with confirmed H1N1.

Like the UK, whilst there have been deaths in New Zealand related to Swine Flu, the overall number are really not significant when compared with the normal death rete associated with seasonal flu.

An MP has slammed the World Health Organisation, saying that they made a ‘terrible mistake’ and caused panic.

Paul Flynn, MP for Newport West, has compiled a report on the handling of the H1N1 virus for the Council of Europe. He told the BBC’s Dragons Eye program that he believed the WHO frightened the world into believing that a major plague was going to happen.

He was particularly critical of the amount of money that governments worldwide were encouraged to spend on antiviral drugs like Tamiflu and vaccines that were developed to protect against the pandemic.

He has claimed that the World Health Organisation’s decision to declare a pandemic was influenced by the pharmaceutical companies, saying that the ‘firewall’ which should exist between them, commercial interests and scientists was breached.

The Chief Medical Officer for Wales Dr. Tony Jewell has responded by saying that after the event, it is easy to look back with hindsight and identify what should have been done differently.  The WHO have said that they did not exaggerate the dangers of the pandemic and consistently reminded the public that most people who contracted the virus experienced mild symptoms and made a rapid recovery.

The Council of Europe, which has a particular focus on human rights, is set to debate Mr. Flynn’s report late r in the month.

Anyone who has ever accused their husband, father or boyfriend of malingering when they come down with the sniffles may be feeling a bit guilty right now - because apparently, man-flu is no myth.

A team from the University of Cambridge have released research which suggests that men tend to catch more infectious diseases than women and that when they do, they suffer worse and for longer.

By applying a mathematical model to the different factors that charecterise men and women, the team say that they predict that as men tend to be more adventurous this exposes them to more diseases but their immune systems are more vulnerable.

While ill, men’s bodies invest more energy in ensuring that while ill they are still able to reproduce, but allow them to be reinfected quickly, as they do not need as strong immune systems as women. The scientists said that men are programmed to compete more with each other than women, working on the principle of ‘live hard, die young’, meaning that their bodies are less concerned about strengthening their immune systems.

The team also theorised that male hormones interfere with their ability to fight off infections like influenza.

Published in the Proceedings of the Royal Society Biological Sciences, the study, lead by Dr. Oliver Restif and Dr. William Amos, used theories of evolution to see how male and female defence systems lead to a difference between the sexes in coping with illness.

They concluded that across the species, the male tends to be the weaker in terms of immunity and that even if they have strong immune systems they are liable to frequent reinfection.

So, I would like to take this chance to issue an apology to my father (though it must be said that the riskiest and most adventurous activity he engages in is his daily constitutional to the newsagents.) You weren’t faking it and I will ply you with Lemsip and daughterly affection next time you’re feeling sneezy.

Think of swine flu and you might think runny nose, cough, the horrors of a temperature. If you’re riddled with flu then social etiquette is probably not too high on your agenda – but for the posh people at Debretts, social etiquette should always be on the agenda.

So to help navigate our tricky Christmas social calendars in the best of health, the social mores rulebook has usefully provided guidelines on how to get through the potential minefield that is mistletoe swine-flu free.

For those planning tongue sandwiches at the office party this year its bad news, as apparently kissing on the lips is off the menu. Equally, there should be no wandering hands and it’s not the done thing to ‘leave a saliva trace’. Nonetheless, Ab-Fab style air kissers should also beware, as the practice is forbidden, along with making loud ‘mwah’ noises to up the authenticity.

The polite way to do it is apparently to briefly touch your cheek to the other person’s. Raunchy. Even if you are repulsed by your kisser, you should still allow them to make their move, but only if neither party are masticating some devils on horseback at the time. Drunks are also advised to avoid the mistletoe as their ‘social skills might be impaired’.

Debrett’s social etiquette advisor Jo Bryant said the cheek-bump was a far more hygienic way of greeting, as it has been medically proven to allow fewer germs to be passed on. Hands contain thousands of germs whereas cheeks are less contaminated.

She added that as people are more aware of the spread of germs this year, there is a set of manners relating to hygiene and health. Those feeling unwell should stay at home while those instigating the snog should ask first and then avoid overly close contact during the kiss itself.

Hmm. Swine flu is definitely to be avoided, but any sensible person goes to a Christmas party with the clear intention of imparing their social skills and then entwining tongues with some equally inebriated party flotsam under a bit of twig. I would take it as a grave social slight were someone instead to try and bump cheeks with me and would probably storm off in a drunken hissyfit were this to happen.

Is that what you want, Debretts posh people?? A ruined Christmas for the nation? Is it???

There has been criticism over Egypt’s handing of a group of tourists who saw their children taken to makeshift hospitals after passport officials suspected them of having swine flu.

Up to 40 children were taken out of the airport and kept in the hospital for days when they were believed to be carrying the influenza strain. Newspaper reports that some children were kept apart from their parents for up to five days.

Parents reported how policemen grabbed their children ‘without warning’, saying that as their temperature was 38C they needed to be taken to hospital. The officials at Sharm El Sheik airport used hidden thermal imaging cameras to scan the children’s body temperature as they came through customs.

Sarah and Chris Kemp said that their passports were taken at gunpoint, and the policemen refused to return the passport of their daughter, Ellie, eight. They complained that the ‘hospital’ that their children were confined to was filthy and filled with mosquitos, while they were forced to sleep on urine-stained mattresses with about 30 other families.

Another family, the Plants, said that they were told they would be arrested if they took their son Zachariah out of the hospital, which they claimed was infected with rats.

While some of the children kept in hospital tested positive for the swine flu strain of influenza , others didn’t, though their parents were afraid they would pick up an infection in the hospital. Those who were treated were prescribed Tamiflu and are recovering well.

The Foreign Office said that there was little they could do about the situation as the ‘measures have been put in place by the Egyptian authorities.”

The animal rights charity Peta have had their latest advertising campaign pulled after complaints were received that it mislead consumers about the link between eating meat and swine flu.

The advertising watchdog the Advertising Standards Agency launched an investigation after the poster campaign was drawn to their attention. It contained large block text saying ‘meat kills’, with smaller text in the background listing a variety of superbugs such as mad cow disease, E-Coli and swine flu, which was more prominent than the other diseases. Beneath this was the tag line, ‘Go Vegetarian. Peta’.

Peta said that the poster was intended to highlight the role livestock played in the incubation, development and spread of infectious diseases rather than imply that meat-eating caused swine flu. They added that it highlighted how reducing meat consumption was one of the best ways to prevent diseases like swine flu developing and spreading.

The ASA found that though the intention was to highlight livestock and meat production, the message that came across was ‘at best, ambiguous.’ In a statement they said that readers might infer from the poster that eating meat caused swine flu, making the poster likely to mislead.

They concluded therefore that it had the potential to cause ‘undue fear and distress’ to some people and ordered the posters be taken down.

Two of the swine flu centres opened to cope with the pandemic are to close this week after demand for the service fell. The Department of Health say that the decision was made after infection rates fell back quickly.

The two centres scheduled to close are in Watford and Farnborough.

1,200 posts will go but the spokesperson from the Department of Health said that as the service was flexible it could be scaled back up if infection rates rose. They have warned that they expect a second wave of infection in Autumn as the schools start their new term and in Winter, the traditional flu season.

The swine flu centres opened to take the strain of GPs and NHS staff when they were swamped with cases and patients afraid that they might have contracted the strain of Influenza. The staff in the centres, some of which remain open, are able to authorise prescriptions of the anti-viral Tamiflu, which designated ‘flu friends’ can pick up for the patient.

The service is run by NHS Professionals and a private company, Teleperformance. NHS Professionals said the move was due to “much lower than expected call volumes”.

This week the WHO gave the advice that healthy patients whose illness was uncomplicated did not need to be prescribed anti-viral drugs like Tamiflu. There has been growing controversy about the prescription of Tamiflu in the UK, especially regarding its being given to children.

Last night the upcoming World Cup match between Wales and Russia became a little bit dirtier after Russian health chiefs offended the Welsh with warnings to fans not to travel to Cardiff  - to avoid catching swine flu.

The head of Russia’s state health agency even suggested that the match, scheduled for September 9^th, be cancelled, describing the game as “extremely unnecessary and inappropriate.” Gennady Onishchenko is so alarmed by the prospect of a truckload of swiney fans returning back to the motherland that he vowed to “persuade our compatriots not to go to this match in Britain.”

So far Russia has only reported 55 cases of swine flu. Britain by contrast has hit the 11,000 mark, though only 30 people have died. However Onishchenko, who may well have a glittering future as a diplomat ahead of him, implied that we possibly were concealing the true extent of the outbreak, warning, “Our sources indicate that these figures are inaccurate” and postulating that the real number of those infected was tens or hundreds of times higher.

The Football Association of Wales have insisted that they have had no indication from their Russian colleagues that the match may be cancelled and expressed the hope that fans would be not put off coming.

They then added that they believed the advice was a case of someone trying to make a name for themselves and promised to welcome the Russians with “open arms”.

Smooth-tongued Mr. Onishchenko concluded rather alarmingly that the Russians “will be dissuading... countrymen” who express “willingness” to travel, conjuring up vivid images of thumbscrews and football fans rotting in cells, brokenly muttering, “I just vanted to see zee footie...”

A British schoolgirl is fighting for her life after being admitted to hospital in Greece with complications caused by swine flu. Natasha Newman, 16, is being treated in the intensive care unit of Penteli Children’s Hospital in Athens and is described as being in a “very serious” condition.

Natasha was on holiday on the island of Cephalonia when her illness started to give concern. It is believed she first contracted the flu in the UK but did not seek medical attention until her symptoms became critical, trying first to just carry on with her holiday. The schoolgirl had just finished her GCSEs at the prestigious Scottish boarding school Gordonstoun.

Greek doctors have said that she is receiving Tamiflu and antibiotics, as well as other treatments. She is believed to have contracted the virus ten days ago but did not seek medical help until the 8th day. She was airlifted from Cephalonia on Monday with a dangerously high temperature.

Meanwhile, Sir Liam Donaldson, the chief medical officer, has said that he is hopeful that the rate of infection has reached a “plateau”. He said that the number of new cases is no longer rising as rapidly and there has also been a fall in the number of 5 -14 year old children contracting swine flu, believed to be due to the start of the school holidays.

However there has been a rise in the number of cases reported amongst other age groups and in the North of England. Health experts believe that the full extent of the infection will not be felt until Autumn, when schools start again and workers return from the holidays.

A House of Lords report to be released tomorrow is widely expected to criticise the government for being slow in setting up the swine flu helpline that was eventually launched on Thursday. The Lords report attacks ministers for not following the set timetable for setting up the phone line, after a variety of newspaper reports suggested that the delay was caused in ministerial and inter-departmental infighting.

The Science and Technology paper will say that ministers failed to still to the timetable they set fir themselves for informing and advising the public. In 2005 the committee recommended that te government needed to make it a priority to ensure that they prioritised access to information uin the event of a pandemic.

The Hotline was launched so patients can get advice, diagnosis and treatment without going to their GP’s surgery. Within an hour of the website going online, it was receiving 2.600 hits per second. The website has proved more popular than the phoneline, with 80% of the 58,000 assessment completed in first day being done online.

When patients are diagnosed with the virus, they are given a unique reference code that their ‘flu buddy’ can use to go and pick up a prescription from the dispatch centre.

Ministers have hit back at claims that they took too long to get the information services up and running, with Gillian Merron, health minister, saying that the service could only be launched when the infection had moved past local outbreaks to significant levels of infection across the country.

After prospective mothers were issued with alarming advice to consider putting off getting pregnant until the swine flu pandemic has passed, Andy Burnham, the health secretary, today urged the British public to have confidence in how the NHS was handling the crisis.

The weekend saw a spate of worrying headlines hit the newspapers, from conflicting advice about what pregnant women should do to protect themselves to criticism of the handling of the pandemic hotline.

The NHS Website had advised pregnant women to reduce their chances of getting infected by avoiding public transport and crowded spaces. The Royal College of Midwives went further and suggested expectant mothers might want to leave earlier or later to avoid rush hour tubes. It is believed pregnant women are particularly at risk from swine flu, as their immune systems work less well to prevent the baby being rejected.

However the website was then changed on Sunday and later the department of heath released a statement saying that they “might consider” avoiding crowds but that it was important to carry on with their routine.

The National Childbirth Trust advised women to consider postponing pregnancy, but the chairman of the Royal College of GPs dismissed the advice as ‘scaremongering.”

Meanwhile, the Observer newspaper carried a story claiming that the national pandemic hotline, providing advice to patients and helping distribute anti-viral drugs, was severely delayed by infighting between different Whitehall departments.

Andy Burnham went on to GMTV (he seems to like it there – he’s made a couple of “don’t panic” type statements from the comfort of their squishy sofas) to deny that there had been any conflicting advice issued.

He said that Britain had the best preparations in place to cope with the pandemic and was dealing with it “fantastically well.” There have, however, been reports of chaos at the first distribution centre for anti-virals in London and we have noticed a deluge of new enquiries from members of the public who do not trust the Government's system of distribution to get Tamiflu to them in time.  There has also been concern that the new Swine Flu hotline will be staffed by people without any medical training.

A memo leaked to The Times has revealed that senior healthcare officials are concerned that the NHS is not well enough prepared to deal with the expected swine flu explosion over the next few months.

In correspondence between the officials, they seemed to express views that plans to hand out medication and relieve the strain on GP and hospital services are a “complete waste” of time. A memo leaked from the health service indicated that current emergency plans are contradictory and confused.

The memo accused the government of “muddled” thought processes. Its author suggested that the creation of Tamiflu vouchers, where someone diagnosed over the phone with swine flu can send a representative to pick up their prescription, could actually hamper efforts to distribute medication. He argued that existing prescription forms would work just as well.

Sir Liam Donaldson, the chief medical officer, has admitted that they can not be sure of how many people in the UK have contracted swine flu as many people, as the symptoms are mild, will have chosen to stay at home and not contract their doctor.

The chief medical officer for the government, Sir Liam Donaldson, has warned the public not to panic-buy anti-viral drugs to treat swine flu on the internet. As well as reminding the population that the NHS has stockpiled large amounts of the drug Tamiflu, he warned that many companies were selling counterfeit versions of the medication.

The instructions come as the government admitted that the virus was no longer containable. It is now expected that within a month as many as 100,000 new cases could be diagnosed each day. Andy Burnham, the health secretary, said the NHS had now moved to ‘treatment phase’ in dealing with the pandemic. This means that schools will no longer close as a matter of course when a case is diagnosed and anti-viral medications will not routinely be given as a preventative measure when someone comes into contact with the virus.

Some experts have predicted that this will lead people to seek the medication from online pharmacies. The Royal Pharmaceutical Society’s Director of Policy David Pruce warned that internet sites could be based anywhere in the world and added that counterfeiters had become so good at copying the medication it was impossible to tell the fakes from the real thing.

As a guideline, Tamiflu and Relenza are both prescription-only medications. You should only be able to buy the drugs with a prescription, and if online clinics claim that they can provide you with this, check the registration details of the prescribing doctor. Then check that the pharmacy is registered with the Royal Pharmaceutical Society.

We have not received confirmation that the World Health Organization has raised its flu virus alert level to Level 6.  This indicates that we have a flu pandemic for the first time in 41 years. As we said earlier, the raised alert level is not connect to the virulence of the virus; it simply relates to how fast it is spreading from human to human.

There have been around 27,000 reported cases in 74 countries although the actual incidence of infections will be much higher as not all cases are reported.  So far there have been 141 deaths related to the swine flu virus. There have been 822 cases in the UK but no fatalities. The virus appears to cause symptoms that are relatively mild in nature although this may change as the virus develops.  A few cases have resulted in complications. The Chief Medical Officer has said that there should be no cause for alarm and he has stated that the Government has a plan in place in the event of a large outbreak of the virus in the community.

We have heard that the World Health Organisation is meeting in Geneva today to discuss raising the alert of Swine Flu from Level 5 to Level 6. A Level 6 alert means that the speard of the swine flu virus has reached pandemic levels. This should not be interpreted as meaning that the severity of the virus has increased, it merely relates to the spread of the infection.

We have seen a number of people approach us today for a prescription for Tamiflu and Relenza.  We have Tamiflu in stock but we are still out of Relenza unfortunately.

People should not panic if the WHO raises the alert level as the Government has made substantial provisions to deal with any threat from the swine flu virus.

A leading flu expert has warned that it is very likely Britain will be hit by a swine flu pandemic as autumn arrives. An expert of virology, Professor John Oxford from the Queen Mary School of Medicine has said that the re-opening of schools and universities after the summer break and the return of workers from their summer holidays will create the ideal environment for swine flu to spread.

He has suggested that there may already be cases in the UK that have gone undetected, pointing to sporadic cases that have appeared without links to people who have been travelling. He believes this shows the flu is ‘silently’ spreading. So far, there are 244 confirmed cases in the UK. Ireland has recently announced their second patient, a school boy believed to be a pupil at Eton College, where there has been an outbreak.

Scientists will be keenly studying the spread of the flu virus in the Southern Hemisphere, where countries such as Australia and South Africa have already entered their winter season, traditionally the peak flu season. The spread of the virus there will give a good indication of what the UK may expect when summer ends.

Professor Oxford said that it was crucial that if a pandemic does arrive in the UK, then people continue as far as possible to continue with their normal routines. He warned that otherwise, an economic crisis could be the result, but with social distancing and some protective measures, such as shielding the mouth with the crook of the arm when coughing, there would be no need for people to avoid work or school.

The World Health Organisation has just raised the alert level to 5 - only one away from pandemic level. We will keep you posted once we hear any further information.

We are now expecting some supplies of Tamiflu tomorrow morning and we will keep everyone updated.

The first case of swine flu was confirmed in the U.K today as the World Health Organisation upped its alert system to a 4 out of a possible 6: 6 meaning that a pandemic has been confirmed. Scottish newlyweds Iain and Dawn Askham , who had been in Mexico for their honeymoon, are reported to be recovering well in hospital and their friends and family are being monitored for the signs of the virus.

As it becomes more and more likely that we are going to see further U.K cases, however, experts are indicating that this strain of influenza is not as serious as others, such as avian flu. Part of the H1N1 strain, we already have some degree of immunity towards it. Others have also pointed out that the U.K, heading into summer, is in a better position than Latin America and other countries in the Southern Hemisphere, as they are moving into winter, naturally the season where influenza takes stronger hold. Alan Johnson, the health secretary, has said that the U.K is almost uniquely well-placed to deal with a pandemic and after 5 years of planning for this eventuality has stockpiled enough anti-viral medication to treat at least half the British population.

The European Union has announced that henceforth ‘swine flu’ will be known as ‘novel flu’ to avoid any damage being caused to the pig and pork industry.  Though the influenza is a cross between a strain found in humans and a strain found in pigs, it is not believed to be passed on through contact with pigs or pig products, but via human-to-human contact.

Thanks to years of ad campaigns warning of the dangers of drink-driving, none of us are ignorant about the risks of getting behind the wheel after even one or two drinks. However, research just published seems to indicate that driving while suffering from cold or flu can be almost as dangerous. The symptoms produced, such as stuffy head, wooziness and sneezing can cause a driver’s ability to be impaired to the same extent as those who have drunk enough to bring them close to or at the drink-driving level.

Lloyds TSB Insurers commissioned the research to see how drivers suffering from a range of illnesses and conditions performed. They found that flu or cold sufferers performed 11% worse than healthy drivers, the same performance as those who have downed a double whisky before getting into the car. Slowed reaction times would add 1 metre when driving at 30mph to a healthy driver’s stopping distance of 12 metres .Naturally enough, most drivers are unaware that driving when sick may be dangerous, with 38% of those surveyed saying they had driven when suffering from flu. The company have estimated that considering a YouGov poll where 22 drivers said they had crashed when driving ill, some 125,000 accidents could be caused each year by flu or cold-ridden motorists.

The insurers have warned that driving when unwell, especially if you are taking medication or are fatigued, could put you at significant risk. A spokesperson for them said, “Getting behind the wheel when ill causes thousands of accidents every year. Try to avoid driving if you’re suffering from cold or flu.”

The Royal Society for the Prevention of Accidents have recommended - unsurprisingly - that motorists use their judgement when weighing up whether they are in a fit condition to drive. “A common sense approach is needed as it is possible to drive safely when feeling 'slightly under the weather', but a point may be reached when it is unwise to drive. People need to be honest with themselves about their ability to drive safely."

Studies like this are always interesting, but what impact it will really have on motorists is questionable. Someone with flu would clearly rather be in bed than driving around, so the likelihood is that they are making what they consider to be a necessary journey. No one wants to drive when sick, so unless legislation was put in place, being aware it is a little risky is unlikely to put people off. And were there to be legislation, imagine how that would work. Perhaps points would be deducted according to redness of nose or the number of used tissues on the passenger seat

The NHS is bracing itself today as it emerged that the current flu epidemic, which is already set to be the worst Britain has experienced in eight years, is set to get worse as a deadly Australian strain of the virus spreads.

The European Influenza Surveillance Scheme has published a report warning that flu is going to reach epidemic levels across Europe over the coming weeks. They have drawn attention to the fact that the most common strain in circulation is Brisburn 10, which in 2007 killed 6 children and caused a three-fold rise in flu cases in Australia.

The situation is being worsened because we are reaching the traditional 'peak' flu season, the months between January and March. However, already the UK Health Protection Agency and the Royal College of GPs have noted a sharp increase in the number of cases with flu-like symptoms. The rise in flu cases has co-incided with outbreaks of the winter vomiting bug Norovirus, putting health services under even greater strain.

We have not yet reached epidemic proportions, classified as when the rate of cases exceeds 200 amongst every 100,000 consultations. The rate is currently at about 68 cases per 100,000 consultations.  Doctors are encouraging those groups at risk to have the flu vaccine, which provides protection against the strains in circulation and are authorised to prescribe anti-virals, which combat the flu symptoms. 

A Department of Health spokesperson has recommended the flu vaccine as the best protection against the illness. "The best protection against flu is to have the flu jab...its not too late." They added, "There are simple steps that everyone can take to help prevent catching colds and flu. Always use a tissue to catch your sneezes, throw away use tissues...and regularly wash your hands."

And if you were unlucky enough to catch it - drink lots of fluid, take medicines like paracetamol or aspirin and then retire to the sofa to watch Christmas telly, moan a lot and make your family run around after you.

Perhaps the greatest misery of cold and flu season is the ability of the virus to attack just when it is least wanted. Its almost impressive - big date, loads of work on, family coming over and expecting to be fed? What could make such occasions better than a nose redder than Rudolf’s, a soaring temperature and skin the colour of mouldy yoghurt?

Being fairly irreligious, Christmas for me is one big exercise in vanity, as the prospect of meeting up with long-lost friends at a succession of parties sees me determined to stun them with my bouncy hair, glowing skin and killer heels. I plan this somewhat like a military campaign and have no doubt that my biggest enemy is that mild-mannered business man sneezing into my ear on the tube. I have developed a fine line in filthy, accusatory looks and have taken to trailing scarves in my wake whenever on public transport, as they are amazingly handy for use as impromptu face-shields. Granted, I look a little odd, but it will be worth it when I get through flu-free. I hope.

Turns out, my paranoia is justified. It has now been shown that Brits over their lifetime will spend an impressive three years and fifteen days reaching for the Beechams. Over one year, we will suffer from three colds, each lasting five days, and one bout of influenza. All told, that makes three weeks every year feeling rough. Its also bad for the economy, as 44% percent of us take time off work with a cold and 71% will stay home with flu. The research, done by antiseptic-spray manafacturers Dettol, unfortunately also showed that while the majority of workers feel resentful when their colleagues take time of work with a cold, they also get annoyed by their constant sniffling when they do come in.

For those of you who also intend only to be feeling sick as a result of too much champagne and mince pies, the best way to stay flu-free is to be manic about washing your hands and wipe the surfaces in your home and work down as much as possible. Treat everyone with beady-eyed suspicion, as the flu virus is contagious a day before symptoms start to appear. Finally, don’t be embarrassed to hide the entire lower part of your face with whatever materials are handy - scarves, jumpers, balaclavas…And remember, if people give you funny looks they are doubtless just jealous that you are both warm and have an attractive, personalised version of the white doctor’s mask.

Google is for many people an invaluable tool for gathering information. With millions upon millions of people searching for all manner of things every day, it is one of the most popular websites in the world. In 2006, its total entrenchment in our society was confirmed when ‘to google’, meaning ‘to use the Google search engine to gain information on the internet’ was added to the Oxford English Dictionary.

In recent years, the world has started to realise just how much information Google is gathering about us. Anyone who has ever cringed at the thought of their weird or embarrassing searches being made public will probably take a very personal interest in the debate over privacy raging within the company. However, it looks like Google’s ability to gather information on us could in fact be put to very good use. The search engine has developed something called “Google Flu Trends” which could help authorities work out where influenza epidemics are about to hit.

Currently only operational in the US, the tracker monitors where people are searching for key flu-related words, such as “cough” or “fever”. Having tested the program in nine US states, they say that the technology allows them to predict outbreaks between 7 and 14 days earlier than the federal authorities. Their findings have been published in a well-respected journal, Nature, and on their website the company said, “This is an exciting development, because early detection of a disease outbreak can reduce the number of people affected. If a new strain of influenza virus emerges under certain conditions, a pandemic could emerge and cause millions of deaths... Our up-to-date influenza estimates may enable public health officials and health professionals to better respond to seasonal epidemics and – though we hope never to find out – pandemics.”

If any of you have been watching the frankly terrifying BBC1 program Survivors, where we see the horrible result of a pandemic that is not caught early enough, you will doubtless find this new use of search technology extremely comforting. At the very least, an improved early-warning system allowing individuals to take measures early on to avoid a flu outbreak can only be a very good thing.

Just when it seemed that the panic over a flu pandemic had subsided, startling news has been announced this week which makes this threat a potent reality: that bird flu, which is rife in the Far East, can be transmitted from one human being to another.

This disturbing development in events has come to the attention of doctors in the case of a 24-year-old man who, having contracted the disease from a poultry market, passed on the disease to his 52-year-old father. The young man died as a result of the disease while his father survived. The fact that the H5N1 strain of bird flu has evolved, and now seems to be able to freely pass between humans could be the birth of a strain of the virus which could infect hundreds of millions of people.

The 24-year-old developed flu symptoms after visiting a poultry market in the Jiangsu Province in China. He suffered fever, chills, a headache, a sore throat and a cough. He was treated with antibiotics but with no success. He died in hospital, five days after he was admitted. His father who, importantly, lived six miles away and never visited the poultry market where his son was infected, fell ill a week after going to visit his son in hospital. He himself had to be admitted and spent over three weeks being treated. He was treated with antivirals and the blood plasma from a woman who had been infected with the same strain of avian flu. He narrowly pulled through.

There is a possibility that the father contracted the disease from another market where it was noted that poultry were being slaughtered. The man maintains, however, that he went nowhere near these birds, which strongly suggests that he caught the avian flu from his son. It is thought that this family may have had a genetic susceptibility to the disease though Wendy Barkley, from Imperial College, London, said that there was no firm evidence to suggest that the H5N1 strain has mutated to allow it to pass from one human being to another.

Cats have become infected with the H5N1 bird flu virus in Indonesia according to recently published research. A study of 500 stray cats from five sites where there have been outbreaks of the deadly virus found that one in five cats was infected. This raises fresh concerns about the disease jumping to human beings.