Swine flu at-risk patient groups could expand

GPs may need to be alert for 'de novo' cases

GPs across the UK may have to test a growing number of patients for swine flu after the CMO hinted at expanding the at-risk groups.

Currently, GPs are advised to follow the Health Protection Agency (HPA) algorithm which recommends taking swabs from patients who present with flu-like symptoms and have recently travelled to Mexico and the US and those they have come into contact with.

But at a briefing in central London last week, Sir Liam Donaldson said that GPs may need to take note of more cases of flu.

An alert was sent out to GPs by the DoH which stated: 'Any patient who contacts or consults you unwell, with flu like symptoms (especially given that we are outside of the normal flu season) and who has no history of overseas travel, nor any apparent contact with swine flu cases, is very important for surveillance purposes. Such apparent "de novo" cases could be a sign of wider transmission.'

A DoH spokeswoman told GP that GPs should use their clinical judgment to assess any patient who presents with flu symptoms and diarrhoea, a recognised symptom of swine flu.

Dr Maureen Baker, honorary secretary at the RCGP, said that 'I can understand the rationale behind looking for symptoms in more patients. People may have symptoms but not have travelled to Mexico and the US.

'Flu-like symptoms and diarrhoea is not a particularly common combination, so patients presenting with theses symptoms may well have swine flu.'

Sir Liam also warned that swine flu may be more infectious than first thought, with hot temperatures in Mexico hindering the spread of the virus.

'Most of the experts that I have talked to believe this is the start of a classic pandemic,' he said.

'It is very important to watch what happens with the spread of the virus in the southern hemisphere as it enters its flu season.'

sanjay.tanday@haymarket.com

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