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We have had pts ringing up today saying NHSD is telling them they are "no longer handling swine flu advice, they are too busy dealing with emergencies and to ring their GP!" I am sure the patient is mistaken... -----Original Message----- From: Julian Bradley [mailto:[log in to unmask]] Sent: 15 July 2009 10:19 To: [log in to unmask] Subject: Re: Flu and asplenics? At 22:41 14/07/2009, you wrote: I think, at least this was believed a long time ago and is probably still the case, that asplenics are particularly susceptible to bacteria with capsules of some kind. But I can't remember all the types although pneumococcal seems to be the most important one. On a slightly different note, off tops of your heads, is there much evidence that Tamiflu reduces mortality or risk of serious complication? I caught a bit on the news about poor old NHS Direct having to field 6000 or maybe it was 9000 calls a day on swine flu and that segued to someone doing a Q n A. Only bit that hit me about using Tamiflu was that it knocks about one day off illness duration. Declan NHSD is what it always has been. They can go through the whole flu protocol (if people are willing to wait up to 10 hours) but can't issue Tamiflu. There are claims by journalists and perhaps government that Tamiflu reduces the incidence of complications and I think some claims that it reduces the period during which people are infectious. While this is may be based on general information about Tamiflu and seasonal flu, I've not seen any detailed science on these issues in respect of Pandemic H1N1 2009 (the new official WHO name AFAIR). There may be arguments against buying more Tamiflu, but there are probably fewer arguments against using stock that will otherwise simply go out of date. We have also had the following from the HPA today: "We are writing to inform you that the incidence of invasive group A streptococcal (iGAS) infections in the South East region remains high. We have had three deaths due to iGAS in the last two weeks, in Thames Valley." "Most cases of iGAS are sporadic (not clustered) and arise in the community. Cases occur in all age groups, although older people are at the highest risk. Other risk factors include"....."recent viral respiratory tract infection." They ask us to retain a "high index of suspicion". Can anyone tell me how to do this in the middle of a flu pandemic? Our OOH service has 3 times its normal seasonal workload (a 200% increase). A significant number of people do fit the criteria for the issue of Tamiflu. Julian