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Commentary
H1N1
Immunological Escape Signals Wave 3
Recombinomics
Commentary 17:50
January 5, 2011
Critical care beds across Greater Manchester are near breaking point as hospitals battle to cope with a surge in swine flu victims.
The region has around 119 intensive care beds – but at one point yesterday all but three were full.
Dozens of patients have ops postponed at Leicester's hospitals as beds are full
The beds are being used for swine flu patients needing specialist Ecmo (extra corporeal membrane oxygenation) treatment.
ALMOST half of Britain’s 3,000 intensive care beds are occupied by swine flu victims.
That is the warning from experts who last night said the pandemic – the worst in two decades – shows no sign of easing.
If new cases continue to rise as people return to work and school, hospitals may turn operating theatres into intensive care units.
The above comments are from various media reports describing the pressure on intensive care units at hospitals throughout the UK. The vast majority of these cases are due to H1N1 infections, indicating that the H1N1 circulating in the UK has largely escaped the immunological reponse generated by infection or vaccination with the H1N1 circulating in the UK last season.
The vaccine breakthrough was initially cited in Australia over the summer, and related sequences have become dominant in the UK and other northern hemisphere countries where vaccine breakthroughs and dramatic increases in severe H1N1 cases is becoming increasingly common.
These new infections are creating additional problems because vaccine uptake was low, and preparedness was relaxed because of the WHO declaration of the end of the H1N1 pandemic phase. This declaration was based on widespread immunity due to infections in 2009 as well as a re-emergence of H3N2. However, in many European countries, including the UK, H1N1 dominates and continues to target those under 65. Moreover the frequency of severe cases in patients without underlying conditions is higher, leading to more hospital admissions and an associated increase in admissions requiring ICU beds and ECMO machines.
Recent reports from other northern hemisphere countries, including the United States, have raised concerns that these spikes in H1N1 cases represents the start of a third wave of H1N1 that will sweep through the region and produce greater numbers of severe and fatal cases, leading to a serious strain on health care delivery.
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