Swine Flu Statement
Health Secretary Nicola Sturgeon
Scottish Parliament
April 29, 2009
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I am grateful for this - the first opportunity available to me - to update Parliament on the current situation arising from the AH1N1 swine flu virus.
I have endeavoured to update opposition spokespeople as regularly as possible over the last few days and I will continue to do so.
Today, I want to update the chamber on the global situation, on the up to date position here in Scotland and on the extensive and wide-ranging actions we are taking in response.
Members will be aware that on Sunday the World Health Organisation declared the situation a public health emergency of international concern and, on Monday evening, raised its pandemic alert level to four. I want to reassure members that this does not mean that we are in a pandemic situation, nor does it mean that a pandemic is inevitable. However, it does mean that the risk has increased and that our actions have to step up in response.
Members will be aware that this outbreak began in Mexico, as far as we know in March. There are an unknown number of cases in Mexico although estimates put it at around 2,500. There have also been an estimated 159 deaths. It is worth stressing, however, that only 26 of the cases in Mexico have been confirmed as being caused by the AH1N1 virus. It is therefore possible that other causes of infection are also circulating in Mexico and causing illness to people there.
Beyond Mexico, and in addition to the 2 confirmed cases here in Scotland, there are now more than 60 cases that have been confirmed in a number of states in the USA, 13 have been confirmed in Canada, 4 in Spain, 3 in Germany, 3 in New Zealand, 1 in Israel and 1 in Austria.
Members will also be aware that, in the last couple of hours, three cases have been confirmed in England. One of these is a child whose school has now been closed as a result.
Suspected cases have also been reported and are being investigated in a number of other countries and governments across the world are monitoring the situation very closely.
The most disturbing development today is, of course, the tragic news from the US that a 23 month old child has died as a result of this virus.
Presiding Officer,
Let me now turn to the up to date position in Scotland.
Member are aware that two individuals who had returned from Mexico on 21 April and presented with symptoms to the NHS on Saturday were confirmed to be positive for swine flu on Monday.
I am pleased to report that they are continuing to recover in hospital. A short while ago, I spoke to Iain Askham on the telephone. I passed on what, I am sure, are the very best wishes of this parliament and the whole country to both him and his wife Dawn.
As soon as Iain and Dawn Askham presented with symptoms on Saturday and were admitted to Monklands hospital, action was taken quickly to identify and contact all those who had been in close contact with these individuals since their return from Mexico. All of the contact group were given prophylactic antivirals and appropriate advice and are being monitored daily. I reported yesterday that 9 people from within the contact group were displaying mild symptoms. At the onset of their symptoms they were treated with antivirals and advised to stay at home.
Presiding Officer, I am able to confirm today that 8 of these people have tested negative for influenza A. As swine flu is a strain of influenza A, that means they do not have swine flu. 1 test result remains outstanding. The test results therefore suggest that to date, as far as we know, we have managed to prevent the spread of infection within Scotland. That is, at this stage, encouraging.
I also reported yesterday that there were 14 further cases under investigation in a number of health board areas across Scotland. I should now clarify that one of these was a contact of the two confirmed cases, not a new travel related case as I indicated yesterday. The rest were all people who had travelled from Mexico or other affected areas.
I can confirm today that 5 of these cases have also tested negative for influenza. A further 2 have been declassified - that means they are no longer suspect cases. The results from the remaining 7 people remain outstanding - that includes the one that was a contact of the confirmed cases.
However, I also have to report that, as of 10.00 am today, a further 24 cases across Scotland are now under investigation. These are in the following health board areas: Ayrshire & Arran, Greater Glasgow & Clyde, Grampian, Lanarkshire, Highland and Lothian. All of these cases are people with travel connections to Mexico or other affected areas.
Presiding Officer, that means that between cases outstanding from yesterday and new cases today, we have 32 cases now under investigation. That still includes 2 of the 10 contacts of the confirmed cases that have shown symptoms.
Let me stress that these are cases being treated and investigated on a precautionary basis. They are not confirmed swine flu cases
I would now like to outline the action the Scottish Government has been and is taking to respond to this situation.
At this stage, our top priority is to disrupt the spread of infection.
We are therefore treating all suspected cases in line with the precautionary principle. That means they are all assumed to be positive until they are shown to be negative.
We are contact tracing for all suspected cases and ensuring appropriate management of all contacts.
Based on the test results we have so far, we are cautiously optimistic that this approach is showing some signs of success. However, we are by no means complacent and remain focussed and vigilant.
Our second priority is to try to learn as much as we can to contribute to both our own and the international understanding of the epidemiology of the virus. Our extensive contact tracing of suspected cases, something that not all countries do as systematically as we do, puts us in a potentially strong position to learn more about the virus and how it behaves. That is, of course, vital in helping to shape our future response to it. I spoke yesterday to Dr Margaret Chan, DG of the World Health Organisation and she agreed that our work would be important in informing the international understanding of swine flu. Health Protection Scotland continues to work closely with the WHO.
Presiding officer, it stands to reason that our overarching priority is to ensure that as a country we are fully prepared for anything might that lie ahead.
Along with other parts of the UK, Scotland has been preparing for a flu pandemic for several years. Our Pandemic Flu framework has been in place since November 2007 and all NHS Boards have their own plans in place. According to the WHO, we are amongst the best prepared countries in the world.
As part of out wider planning, we have established a stockpile of antiviral drugs. We have sufficient doses available to us to treat half the population if necessary. As a result of the decision - which we are party to - to increase stocks across the UK, our stocks will increase significantly beyond that. The antivirals Tamiflu and Relenza are proving effective against the virus.
We are working with NHS Boards and NHS 24 to quickly develop a system that ensures patient access to antivirals where appropriate. Planning is well advanced to move antivirals from central stockpiles to local distribution points.
We also have a stockpile of 9 million surgical facemasks and almost half a million high fidelity respiratory facemasks for use by healthcare workers. Action is underway at UK level to increase stockpiles of facemasks.
We also have advance agreements in place with manufacturers should a vaccine be developed, although members will appreciate that may still be some time away.
We are involved in developing the UK-wide communications strategy to advise people on the actions they should take to minimise the risk to themselves and others. TV and radio ads will start to air in the next couple of days and the leaflet for door-to-door distribution is due to print tonight and will be available from Tuesday. Updated information is also available to the public on the Health Protection Scotland website and, of course, NHS 24 can provide information to anyone who may be concerned.
We have also been working with the UK authorities to provide appropriate information to travellers arriving in Scotland. Airport checks have been increased to identify people coming into the country with symptoms.
On that point, it is worth noting that the UK government is now advising against all but essential travel to Mexico.
Presiding officer,
I would also like to assure members that we are working closely and constructively with colleagues in the UK government and in the devolved administrations in Wales and Northern Ireland to ensure that our response is consistent, co-ordinated and effective.
I have spoken to Alan Johnson regularly since Sunday and have appreciated his co-operation on a number of issues.
The Minister for Public Health attended the UK Ministerial Civil Contingencies meeting by phone link on Monday and I did so yesterday and again this morning.
Within the Scottish Government we have activated our own emergency response procedures and have put in place the resources to ensure the situation is effectively managed. The Scottish Cabinet committee on civil contingencies has met at least once daily since Sunday.
Presiding Officer,
We are working hard with our partners to respond as effectively as possible to this situation.
Of course, there are also simple but very effective things that members of the public can do to help limit the spread and impact of this virus.
Washing hands frequently and using tissues to cover mouth and nose for coughs and sneezes will be the single most effective thing people can do to protect themselves and others.
To conclude, I know that people will be concerned by recent developments, but I would like to reassure parliament and the public that the risk to the public is, at this stage, low and we are working hard to keep it that way.
Obviously the death of a child in the US is a tragic and extremely concerning development that requires further investigation. However the fact remains that, outside Mexico, all other cases of this virus have been mild and not led to severe illness. That is and should be reassuring to the public.
Nevertheless we continue to be vigilant in monitoring the situation and we are taking the threat extremely seriously. The NHS in Scotland, in partnership with other organisations such as local authorities, is already dealing vigorously with this outbreak and we are activating our plans - developed over a number of years - to protect the public.
I will of course keep Parliament fully updated on what will continue to be a developing situation.