Swine flu tracker

22 Dec 09

The very latest on the swine flu outbreak. Scroll to the bottom of the page to see a live map of reported incidents. This page will be updated regularly. To tell us what's going on in your area, leave a comment, email snowottny@cmpmedica.com or give us a call on 0207 921 8104

Tuesday 22 December

18.16 56% of GPs believe that vaccinating healthy children under the age of five is not a good use of NHS resources, a Pulse survey has found. See the full poll results here.

Monday 7 December

10.33 European regulators warn that young children may experience fever after their second dose of the pandemic influenza vaccine Pandemrix. The EMEA say the second dose does increase the immune response, but they advise GPs to monitor the temperature of the vaccinated child and, if necessary, lower the fever by giving an antipyretic such as paracetamol.

Thursday 3 December

15.27 The Health Protection Agency has reported a 'significant decrease' in the number of new swine flu cases, giving an estimate of 22,000 over the past week.

The consultation rate for flu-like illness in England recorded by the RCGP scheme has decreased slightly to 38.6 per 100,000, down from 39.2 per 100,000 the previous week.

Thursday 26 November

15.16 The consultation rate for flu-like illness in England has increased slightly to 39.2 per 100,000 last week, compared to 35.9 in the week before. But swine flu cases have fallen from 53,000 to 46,000, the HPA estimates.

Wednesday 25 November

14.58 A statement from NHS Milton Keynes confirms that a five year old boy who died at Milton Keynes hospital on Sunday did have swine flu, but the virus was not the cause of his death.

Dr Diane Gray, deputy director of public health, said: 'This is a very sad event and until we know why this boy died it would be wise not to speculate as to the cause.'

Tuesday 24 November

12.15pm The Health Protection Agency announces research findings which suggest that one in five children will already have had the H1N1 strain of flu this year, with about half developing no symptoms.

Monday 23 November

16.20 Emberton school in Olney, Buckinghamshire, has temporarily closed pending the investigation of the death of a five-year-old boy with suspected swine flu.

Dr Diane Gray, deputy director of public health for NHS Milton Keynes, said: 'My sympathies go out to his parents, family and friends. We don't yet know the cause of this boy's death.

'At this stage, there is no need to change normal behaviour ‑ you should continue to go to school, work and any social activities.

Friday 20 November

17.10 The BBC reports that health officials in Wales are investigating a possible case of human to human transmission of a Tamiflu resistant strain of the H1N1 swine flu virus.

The strain has infected a small number of patients at the University Hospital Wales, in Cardiff, who had serious underlying health conditions.

11.50 GP leaders in Northern Ireland have reacted angrily to the Government's announcement that the swine flu vaccination campaign is to be extended to the under-fives, insisting 'there has been no agreement with GPs.'

Dr Tom Black, deputy chair of GPC Northern Ireland and a GP in Derry, said: 'We certainly welcome the extension of the H1N1 vaccination programme to children aged up to five years old. However, GPs are extremely disappointed that Minister McGimpsey did not consult with us before this announcement.'

'There has been no agreement with GPs to deliver the second phase of the vaccination programme.This programme needs to move forward on a four-country negotiation basis to ensure that H1N1 vaccinations are delivered safely to patients.'

Thursday 19 November

16.35 The estimated number of people diagnosed with swine flu fell to 53,000 from 64,000 cases last week, according to the latest Health Protection Agency figures.

The GP consultation rate for flu-like illness in England decreased slightly to 35.9 per 100,000 in the last week, compared to 37.8 in week 45.

13.43 The swine flu vaccination programme is to be extended to cover children under the age of five, according to reports.

Wednesday 18 November

17.59 Dr Chris Cooper, a GP in Archway, north London, says patients in priority groups at his practice have shown plenty of interest in the vaccine.

'Swine flu clinics are proving popular, getting fully booked and over booked - but we’re still nowhere near using our first 500 doses,' he says.

09.56 The Department of Health has issued a statement in response to Pulse's swine flu exclusive this morning, revealing widespread resistance from patients to taking up the vaccine, which has been covered widely in the national press.

A DH spokesperson told the Telegraph: 'We have not set a target for vaccination – there is no target.'

'We recommend that people in the at-risk groups accept the offer of vaccination.'

'This is because people in the risk groups are more likely to be severely ill if they catch swine flu, and the vaccine provides the best protection against the disease.'

'It is too early to speculate on uptake rates. GPs are working as quickly as they can to reach as many patients as possible with their initial supplies – some of which were still being delivered last week.'

Friday 13 November

13.14 Swine flu has now killed almost 4,000 people in the US, including 540 children, officials say.

The BBC reports that the latest figure from the Centers for Disease Control and Prevention (CDC) is based on a new system for calculating the estimated death toll, which has been signficantly revised upwards from a previous estimate of 672.

Thursday 12 November

15.18 The estimated number of new swine flu cases in England fell by almost a quarter last week, according to the Health Protection Agency.

The latest figures published by the HPA show there were an estimated 64,000 new cases in England last week.

The consultation rate for flu-like illness in England, recorded by the RCGP, also fell, from 37.7 per 100,000 in week 44 to 36.0 per 100,000 in week 45.

However the HPA warns: 'The recent half-term school holidays may have continued to influence the figures this week, and so it is difficult to predict future trends.'

12.30 The distribution strategy for the swine flu vaccine has come under fire amid reports that a supply shortage has forced larger GP practices to put their vaccination campaigns on hold.

Wednesday 11 November

10.38 Dr James Larcombe, a GP in Sedgefield, County Durham, says his practices has been recruiting volunteers to help run concurrent seasonal and swine flu vaccination campaigns.

'We are relatively well prepared and are trying to run the flu campaign and the swine flu campaign together where possible,' he says. 'But I suspect the different availabilities, indications and schedules of the vaccines means that they will often have to be given separately.'

'The potential workload is causing our nurses, in particular, some concerns; we have been asking volunteers for extra time and using a retired nurse to help.'

Monday 9 November

13.12 A bowel cancer screening programme in Northern Ireland has been delayed because funding for it has been diverted to tackle swine flu.

The BBC reports that the cost of swine flu 'is now impacting on other services', and the screening programme - which had been due to start next month - has now been delayed until April 2010.

Thursday 5 November

16.00 Latest figures from the Health Protection Agency show there were an estimated 84,000 new swine flu cases in England last week, up 8%.

But the rise is less than in previous weeks, and the flu-like illness rate in England recorded through the RCGP scheme fell to 37.7 per 100,000, comparedt to 42,8 per 100,000 in the previous week.

13.40 Conservative health spokesperson Andrew Lansley has called for the Government to roll out a swine flu vaccination programme for school children and college students.

He said: 'For weeks now, behind the scenes, I have urged the Government to go further: they should extend the vaccination programme to school children and college students.'

'Last week in America, I met swine flu experts at the Health and Human Services Department. Their epidemiological data shows that the incidence and severity of swine flu is significantly greater in the under 24 age group, compared to the rest of the healthy population. They have called all young people for vaccination, including a school-located vaccination programme. I think we should follow their lead.'

'A school-based programme needs preparation and needs to be coordinated with vaccine availability. I urge the Government to make the decision and put the plan in place.'

12.00 NHS Medway has begun vaccinating frontline healthcare workers against swine flu.

More than 50 Medway Community Healthcare staff were vaccinated at St Bartholemew's Hospital in Rochester on Tuesday.

Wednesday 4 November

18.20 The total number of deaths in Scotland related to swine flu has risen to 31.

The Scottish Government said the latest person with the virus to die was from the Ayrshire and Arran region.

09.42 - A US study has found that swine flu kills more than one in 10 of those it affects severely enough to put in hospital.

Researchers from the California Department of Public Health found that up to 20% of older patients who were hospitalised with the virus died, according to findings published in the Journal of the American Medical Association.

Treatment in intensive care was required in almost a third of cases, and deaths were observed in all age groups.

Tuesday 3 November

14.54 Londonwide LMCs have issued their latest swine flu update, with advice on the vaccination of pregnant women.

'It is clear that that a few recent media stories have caused anxiety and apprehension in some pregnant women about receiving the swine flu vaccine, and an understandable paucity of evidence uncertainty among some clinicians in our practices,' the update reads. Read the whole thing here.

10.10 Dr Lawrence Addlestone, a GP in Salford in Manchester, one of the re-emerging hotspots, is already halfway through the seasonal flu vaccination campaign.

His practice - which has seen lots of extra cases - is now gearing up for swine flu vaccination. 'We hope we are ready but we are really busy without this additional burden,' he says.

Monday 2 November

17.20 A 31-year-old woman in Salford who contracted swine flu while pregnant has died after giving birth, it was announced today.

The BBC reports that the woman, who has not been named, died in the early hours of Saturday. The coroner has yet to rule on the cause of the woman's death.

12.57 The Joint Committee on Vaccination and Immunisation is 'expected to recommend that the vaccination of 10 to 18-year-olds begins by the end of the year', according to a report in the Sunday Times.

Friday 30 October

13.25 GP practices will be expected to vaccinate at least half of all patients in the priority at-risk group against swine flu.

The target was revealed in details of the swine flu DES published by the Government today.

12.04 'Extremists' are targeting hospitals in Birmingham and handing out leaflets to patients to dissuade them from taking part in the swine flu vaccination campaign, the Times reports.

11.00 Apologies for posting being somewhat intermittent lately - we'll now be updating the tracker much more frequently so please check back for the latest updates.

Wednesday 21 October

09.35 Canada annouces it's first case of H1N1 in Turkeys believed to be passed on by human handlers. This follows just days after the recent US announcement of it's first outbreaks of swine flu in pigs.

08.00 The Swine flu Vaccination campaign starts in the UK today. Australia, China and the U.S have alreday begun their campaigns.

Friday 16 October

14.30 The British swine flu death toll has exceed 100 report many of the national newspapers as they announce the plans for the nationwide vaccination campaign to begin nextc week. A Department of Health spokesperson confirmed that one vaccine - being developed by GlaxoSmithKline, will be delivered in one dose. The Baxter vaccine will be delivered in two doses three weeks apart.

A Department of Health spokesperson confirmed that the vaccine being developed by GlaxoSmithKline will be delivered in one dose, while the Baxter vaccine will be delivered in two doses three weeks apart.

Friday 25 September

11.35 The European Medicines Agency has given the go-ahead for the swine flu vaccination to be granted European-wide authorisation.

The recommendation to the European Commission means the UK's vaccination programme is a step closer to being rolled out.

09.00The battle against swine flu has led to an unexpected health hazard for convicts and prison officers.

Dispensers at a category-C prison in Portland, Dorset, had to be removed after prisoners got drunk on the hand gel and started a brawl, report several of today’s papers.

08.00 At least 66 schools in England have reported outbreaks of swine flu in the past week, according to the Department of Health.

The news comes as an increase in the number of cases was reported to have risen from 5,200 cases in the previous week to 9,000 last week, appearing to show the start of the long-predicted second wave of infections.

Thursday 17 September

15.30 Rates of flu-like illness in England are starting to rise again, according to the Health Protection Agency.

In the week ending 13 September GP consultation rates for flu-like illness in England were 12.9 per 100,000 - up from 8.6 per 100,000 in the previous week.

Tuesday 15 September

10.36 GlaxoSmithKline is refusing to disclose what the UK Government paid for up to 132 million doses of the H1N1 swine flu vaccine, the Independent reports.

Wednesday 9 September

16.40 The Queen has had to cancel a visit to Gordonstoun School in Scotland planned for next week after a suspected outbreak of swine flu among pupils, according to reports.

Tuesday 1 September

10.45 More than 100 people in India have now died of swine flu.

The BBC says there have been nearly 4,000 cases of H1N1 reported across the country, with deaths reported in at least eight Indian cities.

Friday 28 August

11.09 The latest estimates from the Department of Health show a further reduction in GP consultation rates for influenza-like illness, from 21.1 to 16.5 per 100,000 people in England in the week ending 23 August.

5,000 new cases were reported last week in England, and deaths in the UK rose to 66, seven more than last week.

Thursday 27 August

11.04 Calls to NHS 24 in Scotland increased by 60 percent during the peak of the first wave of the swine flu pandemic.

Dr George Crooks, medical director of NHS 24, told the Scotsman: 'From April through to early summer, we saw an increase in calls to NHS 24 on an order of magnitude of 25 to 30 per cent from predicted volumes, rising at times to 60 per cent increase in call volume directly related and indirectly related to the H1N1 influenza pandemic.'

'The pandemic situation has been a very significant challenge for NHS 24, in terms of managing this in partnership with others, we have played not just an important role, but played it very well.'

Wednesday 26 August

18.10 The NHS has spent almost £40 million on responding to the swine flu pandemic so far, Pulse reveals.

Full story here

Tuesday 25 August

11.49 A teenage girl from Lancashire who had swine flu has died, according to reports.

The Gazette reports that the girl, from the Preston area, died on Sunday. A spokesperson for NHS North West said that the death was being investigated.

Monday 24 August

11.48 The Department of Health has allocated £2.25million for 'urgent swine flu research'.

Results are expected by the end of the year, and will bolster the body of evidence available to the Government's expert advisors experts when making policy decisions.

The work will be led by research centres in Leicester, Nottingham, Newcastle, Edinburgh, Sheffield, Manchester and London.

10.58 The first person with swine flu to die in Northern Ireland was buried yesterday in the village of Ahoghill, north Antrim, the Belfast Telegraph reports.

Friday 21 August

17.35 Healthy patients who catch swine flu do not need to be treated with antivirals, the World Health Organisation has said.

Thursday 20 August

13.17 The number of GP-consultation for influenza-like illness has fallen from 30.9 per 100,000 of the population last week to 21.1 per 100,000 of the population, according to the HPA's latest weekly swine flu report.

10.33 The Medicines and Healthcare products Regulatory Agency (MHRA) has issued a statement on a suspected interaction between Tamiflu and warfarin, after receiving several reports that blood clotting time could be prolonged due to interactions between the two drugs.

A spokesperson said: 'The available evidence is insufficient to establish whether such cases are a true drug interaction or whether blood clotting control in these patients may have been affected by illness.

'Therefore there is no change to the product information for Tamiflu and patients should continue to take Tamiflu as advised by their healthcare provider.

'Doctors and healthcare professionals are encouraged to be vigilant and report any sign of INR fluctuation to the MHRA so that we can continue to monitor this issue and keep it under close review.'

Wednesday 19 August

13.36 NHS Lincolnshire has closed its Antiviral Collection Points as the number of patients contracting swine flu begins to drop

The PCT said that antiviral collection has been relocated to seven local pharmacies.

Tuesday 18 August

09.38 Up to a third of nurses will refuse to be vaccinated against swine flu because of safety concerns, according to a new poll.

The survey of 1,500 nurses, released by Nursing Times and covered in the national press today, found just 37 percent definitely plan to have the jab. 30 percent said they would not be vaccinated, while 33 percent they were unsure.

Monday 17 August

15:10 GPs have been warned to look out for cases of nerve disease Guillian-Barre syndrome when the swine flu vaccine is introduced next month. The HPA says the risk of developing the nerve disease is increased after a flu-like illness.

13:55 The Government’s own expert panel on swine flu has claimed that ministers ignored their advice on the use of tamiflu because they feared a public backlash if antivirals were withheld. Committee member Professor Robert Dingwall told the Guardian that the Committee advised it that there was no need for the widespread use of Tamiflu.

Thursday 13 August

17:11 Department of Health announces priority groups for swine flu vaccination programme. As Pulse revealed earlier this month, first in line will be pregnant women, under-65s with a chronic illness and healthcare professionals. These groups are expected to all receive their vaccinations by the end of December.

13.09 The MHRA has received more than 400 reports of suspected adverse reactions to Tamiflu - including 125 in the past week - new figures show. More follows.

Tuesday 11 August

16.06 West Midlands GPs have 'seamlessly accomodated' the additional swine flu workload in their area - one of the country's major hotspots - according to the GPC.

Dr Grant Ingrams, secretary of GPC West Midlands, said: 'We recently reviewed the role that general practice has taken in the swine flu pandemic and were pleased to find that general practice arose to the challenge. Both normal and out of hours general practice seamlessly accommodated the significant increases in work load that have been associated with the swine flu. General practices have coped with additional appointments, telephone consultations and home visits with no additional resources.'

'Every practice and out of hours service has seen an increase in workload, with some areas reporting increases of three to four hundred percent at times.'

11.10 GMTV presenter Andrew Castle has told how his daughter 'almost died' after taking Tamiflu, following an outbreak of swine flu in South London.

Monday 10 August

11.06 The country's first swine flu vaccine trial is being carried out. 175 people have enrolled in the trial at the Leicester Royal Infirmary, and a statement from the University Hospitals of Leicester NHS Trust says results of the trial, which is testing different doses of the vaccine, may be available in four to six weeks time.

10.55 The actor who appears in the Department of Health adverts teaching people how to prevent the spread of swine flu has ad the virus himself.

Press reports say David McCusker, 30, was quarantined two weeks ago but has since recovered.

10.50 Healthy patients are lying to call centre operators at the National Pandemic Flu Service in order to obtain Tamiflu, RCGP chair Professor Steve Field has warned.

Professor Field told the Observer: 'Some people are deceiving the national flu line in order to get Tamiflu. Doctors tell me that some patients are undoubtedly misusing the service.'

Friday 7 August

10.42 Ministers are drawing up plans to carry out swine flu vaccination for the UK's 8.5 million pupils at immunisation posts in every school, the Guardian has claimed.

The newspaper quotes a 'senior source involved in Whitehall planning' as saying: 'The general principle of schools being the ideal, logical place to do this is well establish. They have captive audiences.'

However the Department of Health insist that the exact form of the immunisation strategy has not yet been agreed. 'The chief medical officer has said that he expects GPs to be the bedrock of the programme,' a spokesperson said.

Thursday 6 August

17.34 There have now been a total of 36 swine flu-related deaths in the UK, the Department of Health has confirmed.

14.55 The number of UK swine flu cases has ''decreased significantly', according to the Health Protection Agency.

New figures show the rate of GP appointments for influenza-like illness fell sharply from 138 to 42 per 100,000 of the population in the week ending 2 August.

14.36 The first swine flu vaccines are likely to be licensed for use in the general population by September, according to the World Health Organisation.

The global health body has published two briefings today - one a statement reassuring the public that licensing procedures are 'rigorous and do not compromise safety or quality controls', and the other a likely timeline for the pandemic influenza vaccine manufacturing process.

Wednesday 5 August

11.08 A swine flu call centre worker has been sacked - after contracting swine flu.

The Daily Mail reports that Emily Morgan, 21, from Plymouth, Devon, was told by a security guard she was on a list of leavers who were not allowed in the building, after attempting to return to work.

Ms Morgan was diagnosed with swine flu via the internet-based Pandemic Flu Service after just one day at work in the £6-an-hour role.

Tuesday 4 August

12.31 There has been a significant increase in the number of people in Northern Ireland contacting their GPs about swine flu, the Department of Health has said.

Figures from the department show that the number increased to 134 per 100,000 of the population last week from 42.1 per 100,000 the week before - an increase of 219%.

10.07 Patients are well aware of the symptoms to describe if they wish to obtain Tamiflu from the National Pandemic Flu Service, a GP has warned.

Dr Shan Whitear, GP in Westcliff-on-Sea, Essex, said: ‘People know what symptoms to say they have. There was one case of one of my patients being prescribed Tamiflu by the out-of-hours service who subsequently had lobar pneumonia. Since the call line calls have been less, but there are still a lot of patients being directed back at us.’

Monday 3 August

18.30 GPs swamped with extra swine flu work have been forced to halt medical reports relating to insurance claims.

Matt Rann, head of underwriting at Aegon, told the Scotland on Sunday: 'We've had letters from doctors' surgeries saying all paperwork is being put to one side to allow GPs to care for their patients.'

'We are concerned that if the epidemic worsens in the autumn, as predicted, this will lead to an admin gridlock, with consumers unable to get the cover they require.'

16.14 Dr Saj Azfar, a GP in Rochdale in Lancashire, believes the Government's swine flu helpline has definitely reduced workload.

'It has definitely had an effect,' he said. 'I think people who are criticising the Government for being slow at setting it up are a little unfair as it is a massive undertaking, but I feel it could be publicised better.'

'We have just about managed to maintain normal service as well as pulling one GP off surgeries to do swine flu, but those of us with outside interests such as PBC have had to put those meetings on hold.'

09.48 Dr Caroline Davies-Wragg, a GP in Farningham, Kent, says that many non-flu patients are staying away from the surgery where possible.

'We are getting more [swine flu] enquiries, but also I think people with no flu don't want to come to the surgery in case they catch something - so the workload is the same,' she says.

'Personally, I don't think patients need Tamiflu if not at particular risk until they have been ill for more than 48 hours, as most people are getting over it by then and it makes you feel sick.'

Friday 31 July

16.02 Suspected cases of swine flu are occurring more frequently even in remote areas, according to one GP.

Dr Rob Colebrook, a GP on the Ardnamurchan peninsula near Fort William in Scotland, reports that he has diagnosed four people with flu over the telephone in the past seven days.

12.59 GPs in the West Midlands have seen swine flu calls double in the past week despite an overall plateau of cases.

The Birmingham Post reports that rates of GP consultations in the West Midlands have risen from 105 per 100,000 of the population last week to 213 per 100,000 this week.

11.36 GPs and other healthcare professionals will be vaccinated first in the Government's swine flu vaccination campaign, Pulse has learned from a senior Government adviser.

Read the full exclusive story here.

09.41 Lloyds Pharmacy is to supply Tamiflu through its online pharmacy.

Thursday 30 July

17.05 GPC deputy chair Dr Richard Vautrey has hit back at the Daily Mail's claim that the BMA have demanded a £27000 'bonus' to run a swine flu vaccination campaign.

He told Pulse the £7.51 figure quoted in the story was 'completely inappropriate'. 'We're not seeking to make any money from the vaccination campaign. The Daily Mail has conflated certain figures for its own politicial agenda.

16.20 The Chief Medical Officer confirms there have been 27 deaths confirmed to have been caused by swine flu in England, including 4 with no underlying health conditions.

15.30 The rate of GP consultations for swine flu has begun to plateau, the latest figures for England show.

The Health Protection Agency's weekly report shows the rate of consultations for influenza-like-illness, which includes those with suspected and true swine flu, fell to 138 per 100,000 of the population in the week ending July 26th, down from 155 per 100,000 of the population the week before.

08.56 The Daily Mail report that GPs are demanding a £27000 'bonus' to vaccinate the public against swine flu, calculated by multiplying the £7.51 paid for the annual seasonal flu jab by the 'average' 1,800 patients on a GP's list. They also can't help but remind the reader the average GP pockets an annual salary of £107,000.

Wednesday 29 July

3.45pm The equivalent of 4,593 people in Wales have contacted their GPs in the last seven days with flu like symptoms. There have been 85 laboratory confirmed cases in Wales with no new cases. Of the confirmed cases, 23 people with swine flu have been hospitalised and all have been discharged.

1.00pm The global death toll from swine flu has risen to more than a thousand. The latest figures from the European Centre for Disease Prevention and Control (ECDC) in Stockholm show 1,012 deaths have been reported.

The figure is almost 200 higher than reported by the World Health Organisation. A spokesman for the ECDC said the organisation collects figures from ministry of health websites, which are more up to dat than the WHO's system of counting death notifications.

Tuesday 28 July

12:59pm House of Lord's report slams Government for the delayed launch of the national flu-line and calls for 'reassurance' the extra support promised for later on in the year will be ready to meet the challenge of an expected second wave of flu in the autumn

Monday 27 July

1.37pm There is 'huge regional variation' in the number of antivrial collection points available around the country, according to figures released by the Conservatives. Eight trusts have no collection points in place as yet, 47 trusts have just one collection point, whereas ten have more than 30.

There is also little correlation between the prevalence of swine flu in an area and the number of antiviral collection points.

Shadow health minister Stephen O'Brien said: 'These figures are a genuine concern and raise further questions about the Government’s handling of swine flu.

'The number of collection points available in many areas still seems surprisingly low. If there are areas with too few collection points, then the Government must take urgent action to open more so that people suffering from swine flu can get the antivirals they need.'

9.15am The House of Lords science and technology committee is expected to be highly critical of the Government's response to the swine flu pandemic when the committee's report is published today.

Friday 24 July

2.45pm Experts are warning that a dire lack of intensive care beds could leave NHS hospitals struggling to cope if the swine flu outbreak worsens over the coming months. A study published in the journal Anaesthesia predicts demand for critical care beds could outstrip supply by 130%.

07.45am The Conservatives have criticised the National Pandemic Flu Service, claiming the system is "too little, too late".

The flu advice website, covering England, crashed on Thursday after it was overwhelmed with 9.3m hits an hour.

Thursday 23 July

15.00 The national pandemic flu service goes live in England, but pregnant women, children under one year old, people with chronic illnesses and those whose symptoms have persisted for several days will be referred back to their GP.

14.38 100,000 people caught swine flu in the last week, up from 55,000 the week before. The latest Department of Health figures also show 804 people are in hospital in England with swine flu, and 63 are in intensive care.

11.08am The Guardian reports that experts believe the number of cases of swine flu in Scotland may have already peaked - and that cases may begin to subside in England over the next few weeks.

Professor Hugh Pennington, professor of bacteriology at the University of Aberdeen, told BBC radio Scotland that was 'possibly through the worst of this phase of the virus.'

8.09am The Department of Health confirm that the National Pandemic Flu Service will go live today. The service will feature a telephone line and a website from which patients diagnosed with swine flu can obtain a code, which a 'flu friend' can use to collect Tamiflu at a local antiviral collection point.

Wednesday 22 July

4.05pm A person from the West Midlands has died after contracting swine flu. The death of the person, who tested positive for the H1N1 virus, is under investigation by NHS Walsall. It is the third confirmed death connected to the virus in the West Midlands and the 31st in the UK.

1.04pm Human trials of a vaccine to protect against the H1N1 swine flu virus have begun in Australia, with initial results due in six weeks.

12.31pm Prime Minister Gordon Brown moves to calm any public panic by telling the House of Commons the NHS has 'robust' plans in place to cope with the pressure.

'I would like the public to be reassured that we have been preparing for a pandemic for a number of years.

'The NHS is continuing to cope well, but as swine flu cases have started to increase we have needed to give anti-virals more quickly.

'From the end of this week the National Flu Service will be up and running. This will free up GP and NHS time.'

10.04am A 15-year-old girl who had underlying medical conditions is the 30th British victim of swine flu after she died in the Royal Hospital for Sick Children in Glasgow.

A 51-year-old woman, from Lea, Wiltshire, is also reported to have died after getting the virus, but the Department of Health is yet to confirm her death.

9.57am Chloe Buckley, the six-year-old girl thought to have died of swine flu, had a serious bacterial infection caused by streptococcus A, which led to tonsillitis and blood poisoning, according to post-mortem results.

Dr Laurence Buckman said: 'The development of secondary infections is always worrying but doctors will be on the lookout for signs as the number of swine flu cases increases. This is part of our planning and we have good systems in place.'

Tuesday 21 July

5.30pm

GP leaders demand PCTs in hotspot areas allow GPs to put non-urgent work on hold as GPs tell Pulse they are finding it impossible to cope with the workload generated by the outbreak. Some practices have already suspended routine appointments but have begun attracting complaints from patients who do not accept swine flu as an excuse. GP leaders fear practices could now lose out on funding because they will get worse scores on the patient access survey and are calling for it to be suspended.

12 noon The World Health Organisation announces there have been more than 700 deaths from swine flu worldwide since the start of the outbreak, an increase of 300 since the start of the month.

Who spokeswoman Aphaluck Bhatiasevi says school closures could be among recommendations but that it was up to each country to consider appropriate steps to try to slow the spread of the illness.

11.30 Liberal Democrat shadow schools secretary, David Laws says decisions on whether to close schools for extended summer holidays to help slow the spread of swine flu must be taken by medical professionals not politicians.

'Given that swine flu is already in many areas, it is not clear whether closing schools would be necessary or effective,' he says.

'It’s important that the decision on this issue is driven by the considered advice of medical experts and not by the gut instincts of politicians.
Early and prolonged school closures can substantially ease the burden on the NHS by reducing the number of swine flu cases at the peak of the pandemic, a paper in the August edition of The Lancet Infectious Diseases argues.

Monday 20 July

16.30 Andy Burnham, the secretary of state for health, confirms in his statetment to the House of Commons that the national pandemic flu service will be up and running by the end of the week 'subject to testing'.

16.00 Health Secretary Andy Burnham is briefing the House of Commons on the new national pandemic flu service. More follows...

11.38 Dr Patrick Clarke, a GP in Buckinghamshire, says his local OOH service has been 'overwhelmed' with calls.

'One of our problems is getting access to tamiflu in those patients who have likely swine flu,' he says. 'This is generating some extra unnecessary anxieties for patients.'

'Our current out of hours provider was providing support via a phone line but the number of calls have overwhelmed them each day so the calls end up being passed back. It has therefore been easier to provide the service ourselves which our practice is more than happy to. I worry that the national service will have similar problems.'

08.59 Health Secretary Andy Burnham is to unveil plans on how the National Pandemic Flu Service will work later today.

He will give a statement to MPs setting how details of the service, which is due to go live this week.

Friday 17 July

13.33 PCTs offering locum cover to some practices but not others is impacting on morale, one GP tells Pulse. Shropshire GP Dr Louise Warburton says: ' What a nightmare. I'm just trying to fight my way through the advice calls at the moment and deal with all the other emergencies. But in our area the PCT is helping some practices with locums and not others, which isn't helping morale. And of course we keep asking: when will QOF be suspended?'

11.34 NHS London has confirmed the death of a baby under six months old from swine flu, who died at the Royal Free hospital in north west London on July 8. The baby is amongst four people to have died from swine flu in London in the past week, bringing the total in the captial to ten. A further three fatatlities are still being investigated.

Dr Simon Tanner, regional director of public health at NHS London, said: 'It is also important that these deaths be kept in perspective. All four had underlying health conditions and these upsetting cases should be kept in context with the many people who have had swine flu and recovered just a few days after experiencing a mild illness.'

10.15 A GP in the North-West of England warns of a 'desperate need' for help giving support to patients and families with swine flu. Dr Vijay Bansal, a GP in Warrington, called for PCTs to set up emergency service action teams (ESAT) to deal with the outbreak.

'There is a desperate need for support to patients and families. ESATs must do home visits around the clock 24/7. All hands on deck. Sorry those in charge have been very slow to react and act and that national general guideline from the HPA has overridden local patients needs,' he said.

09.44 Swine flu could cause as many as 65,000 deaths in the UK over the next few months, according to the Chief Medical Officer.

Thursday 16 July

18.07 Cherie Blair is the latest high-profile celebrity to catch swine flu. The former Prime Minister's wife has had to cancel a string of public engagements and is reportedly being treated with Tamiflu.

15.51 26 people in England suffering from the swine flu virus have now died, and there were an estimated 55,000 new cases of swine flu last week, the Health Protection Agency says.

15.31 A female tourist who had contracted the swine flu virus has died in hospital in Inverness, according to reports.

11.15 The chief medical officer has insisted that the first supplies of the swine flu vaccine will be available in the UK in five weeks' time. Sir Liam Donaldson sought to quell panic after Dr Margaret Chan, director general of the WHO, said yesterday that a vaccine was 'still months away'.

Sir Liam said: 'She may have been commenting from a global perspective, but as far as the UK is concerned, we are still expecting 60 million doses by the end of the calendar year.'

09.44 Calls to GPs about swine flu have jumped 50% in the last week, with more than 73 people per 100,000 now reporting influenza-like illness.

RCGP figures show that more than 40,000 potential swine flu patients contacted their GP in the last week.

Wednesday 15 July

11.08 Scientists from Imperial College London say the government must map the spread of swine flu more accurately in order to predict the number of people who are likely to die from it. Their modelling study, published in the BMJ, suggests the swine flu will have a case fatality ration of around 0.5% - similar to the upper range seen for normal seasonal influenza.

10.52 The Guardian reports that the Department of Health have been 'a bit optimistic' in their estimates of when a swine flu vaccine will be available, according to Dr Alan Hay, director of the WHO world influenza centre. Dr Margaret Chan, director general of the WHO, has also said the vaccine 'will not be available for another two or three months' - contrary to Andy Burnhams assertions it will be ready by August.

Tuesday 14 July

17.55 The death of a GP who was confirmed as having swine flu is not being treated as suspicious, the NHS has said. Reports suggest Dr Day did suffer from swine flu, but died from natural causes with the major factor being a blood clot to the lungs. As a result, an inquest will not be held.

10.19 The RCGP has submitted a damning dossier to a House of Lords investigation into how the Government has managed swine flu, claiming GPs across the country have been left exposed to chaos.

Issues raised include poor communication, an 'unsustainable workload' for out-of-hours providers, and anxiety among pregnant doctors over whether to continue working. Read the full story here.

Monday 13 July

17.20 RCGP and GPC leaders have paid tribute to 'well-respected' GP Dr Michael Day, who was suffering from swine flu and died on Saturday.

15.10 A GP with swine flu who died has been named as Dr Michael Day, a GP at the Priory Gardens Health Centre in Dunstable.

14.00 A six-year old girl has become the UK's 16th swine flu fatality.

The Press Association is reporting that Chloe Buckley, from north west London, died at St Mary's Hospital in Paddington on Thursday.

09.34 Swine flu has hit Downing Street, after a senior member of the Prime Minister's staff was diagnosed with the illness.

Senior climate change adviser Michael Jacobs contracted the virus while at climate change talks in Mexico, according to reports.

Friday 10 July

17.49 The Government is considering measures to allow patients with swine flu to stay off work for 14 days without a note from their GP.

According to reports, the Department of Work and Pensions is drawing up plans to extend self-certification to 14 days for a limited period, in a bid to reduce workload on GPs - although the final decision will be taken by the Civil Contingencies Committee.

09.58 A document from a senior executive for emergency planning has criticised the Government's 'muddled thinking' over the 'treatment phase'.

According to The Times, the leaked memo raises a number of concerns - notably that the scheduled national flu line is still not in place, that many trusts will have to set up local call centres to cope with the demand for Tamiflu and in order to distribute it, and that the use of Tamiflu vouchers could be 'a complete waste of time'.

Thursday 9 July

17.38 The UK death toll from swine flu has risen sharply to 14, it was announced today. 12 of the deaths have occurred in England and 2 in Scotland, the Government said - although not all deaths were as a direct result of the virus.

In England, 335 people have been admitted to hospital with swine flu, of whom 43 are in critical care.

15.20 Surveillance figures published by the Health Protection Agency show that GP consultation rates for flu-like illness are now above the threshold level for normal seasonal flu activity.

Wednesday 8 July

14.04 GPs in Leicester say they are 'under siege' from dozens of patients with suspected swine flu.

The Leicester Mercury reports that one surgery has had to pull a GP away from routine work to handle patients with flu symptoms, while a practice in Highfields is reporting that demand for appointments is up by a third.

Dr Vijay Rawal, city secretary of Leicestershire and Rutland LMC, said: 'Emergency planning has been good until now, but we need immediate help.'

'We have felt under siege since Thursday afternoon when the Government announced it was changing its policy and that people would no longer be swabbed. We are expecting even more of a surge in cases – both because schools have started telling pupils to stay at home if they are unwell and because we are seeing more cases.'

13.56 Two of the latest swine flu fatalities have been named today in various reports. The Press Association said that nine-year-old Asmaa Hussain and a man in his 40s, understood to be teacher Abdullah Patel, both from the West Yorkshire town of Dewsbury, died after contracting the virus

Tuesday 7 July

16.46 The GPC renews calls on the Government to suspend QOF in areas hardest hit by swine flu, as it reveals it is holding urgent talks to prevent practices being swamped

14.29 The MHRA has set up a new online reporting system to monitor suspected adverse reactions to antiviral use as the swine flu pandemic spreads.

10.05 Latest WHO figures show there have now been 94,512 laboratory-confirmed cases globally, and 429 deaths.

Monday 6 July

17.15 The Press Association reports that a man and a child from West Yorkshire, who both had underlying health issues, have died after contracting swine flu, according to a spokeswoman for NHS Yorkshire and Humber.

15.25 A nine-year-old girl from south London has become the UK's fifth swine flu fatality.

The BBC reports that NHS London are saying the child had 'serious underlying health problems' and 'died over the weekend'. NHS London does not plan to release any further details.

09.54 A number of celebrities have fallen ill with suspected cases of swine flu as the virus spreads, according to media reports.

Among those reportedly affected are Harry Potter star Rupert Grint, former Big Brother housemate Imogen Thomas - and footballer David Beckham's 11-year-old niece.

Friday 3 July

15.20 Katrina McCormick, joint interim director of public health for NHS Lewisham, confirms the swine flu death reported earlier this afternoon. She said: 'We are extremely saddened to confirm the death of a 19 year old man. He died at Lewisham Hospital on Wednesday 1 July 2009. The young man has tested positive for swine flu.

13.39 The fourth swine flu death in the UK has been reported.

The Times reports that an unnamed 19-year-old man from south London with underlying health problems tested positive for the virus after his death on Wednesday. NHS London are expected to release more details shortly.

09.47 WHO chief Margaret Chan has warned that the spread of the swine flu virus worldwide is now 'unstoppable'.

The BBC reports that a WHO summit, symbolically held in Cancun, Mexico, heard that while the vast majority of patients are experiencing mild symptoms and making a full recovery within a week, pregnant women and 'people with underlying health problems' are at a higher risk of complications.

Thursday 2 July

17.36: Latest figures from the HPA show a further 458 cases of swine flu have been laboratory-confirmed in England today, bringing the UK cumulative total to 7,447.

England has also recorded a cumulative total of 1,130 clinically presumed cases.

14.30: Trying to contain the swine flu virus is no longer an option, health minister Andy Burnham says, predicting that within weeks there may be 100,000 new cases a day.

He announces a move to a new ‘treatment’ phase across the UK, meaning anti-flu drugs will no longer be given to the close contacts of those infected and the abandonment of lab testing, which has revealed just a mere fraction of the real number of cases.

Mr Burnham says: ‘The national focus will be on treating the increasing numbers affected by swine flu.

‘Cases are doubling every week and on this trend we could see over 100,000 cases per day by the end of August.’

10.00 The inquest into a six-year-old girl from Birmingham who died after contracting swine flu, was told yesterday that she had suffered from a life –threatening illness since she was born.

Sameerah Ahmad died at Birmingham's Children's Hospital on Friday evening.

It is believed she suffered from a condition which weakened her bone marrow and her immune system, making it difficult for her body to fight infection.

Yesterday the Department of Health announced there had been another 342 further patients confirmed through laboratory testing, taking the total to 6,929.

Wednesday 1 July

11.53 Dr Alan Campion, a GP in London who worked at two different out-of-hours providers last weekend, says: 'I have never seen such a mess.'

'NHS London were meant last weekend to be issuing an e-mail to stop swabbing but this arrived only this weekend. Members of the public then started phoning the HPU and were told that we would after all have to swab them if for example they were teachers in a school without a confirmed case.'

'No assessment was really made of many patients, to the annoyance of parents who felt that swabbing should continue. We had no clue which schools were affected, parents were confused between treatment and prophylaxis and by 18.00 [on Sunday] calls were mounting with flu like symptoms of three to four hours.'

Tuesday 30 June

15.00 394 further patients in England are confirmed through laboratory testing with swine flu, bringing the total number of laboratory confirmed UK cases identified to 6,538.

A Department of Health spokesperson says: 'The cases of swine flu found in the UK have so far been generally mild in most people, but are proving to be severe in a small minority of cases,' adding: 'We are continuing to work to slow the spread of the disease in the majority of the UK, but we are allowing a more flexible outbreak management approach in areas where more community transmission has taken place. Here, it makes sense to move beyond extensive swabbing and all contact tracing. Instead, we are asking the local NHS to focus on individuals who have symptoms.
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09.46 The BMA has warned parents against holding 'swine flu parties'. Dr Richard Jarvis, chair of the BMA's Public Health Committee, told the Today programme: 'I think parents would want to take into account that the flu - although this particular strain is relatively mild for the most part - is something that will knock people off their feet for a few days and we are seeing appreciable morbidity, severe side-effects and sadly the occasional death.'

'My advice to parents would be to take this into account before taking any child along to a flu party.'

Monday 29 June

17.15 Roche, the manufacturer of Tamiflu, says it has received the first report of resistance of the H1N1 virus to the antiviral drug in a patient in Denmark. But David Reddy, chief executive of Roche Holding AG, stresses that there are still no signs of a tamiflu-resistant strain of H1N1 circulating in the community.

17.12 Responding to the third swine-flu related UK death, Health Secretary Andy Burnham says: 'I would like to express my condolences to the patient’s family. Tragic as today’s death is I would like to emphasise that, across England, the majority of swine flu cases have not been severe. I would reiterate that the risk to the general public remains low.'

15.33 A nine-year-old girl with existing health problems dies at Birmingham Children's Hospital after contracting swine flu, the BBC reports. It has not yet been established whether her death was directly caused by the virus.

15.20 Laboratory testing has confirmed a further 1,604 swine flu cases in England, bringing the UK cumulative total to 5,937. The steep rise over the weekend includes more than 500 new confirmed cases in both London and the West Midlands.

England has also reported a cumalative total of 817 clinically presumed cases.

09.54 A 73-year-old man from Inverclyde has become the second person in the UK to die of swine flu.

The Scottish Daily Record reports that the elderly man, who was being treated in the Royal Alexandra Hospital in Paisley, had underlying health problems.

Friday 26 June

17.30 The Health Protection Agency has reported a further 535 laboratory-confirmed cases of swine flu in England today, bringing the UK cumalative total to 4,250. A further 442 clinically presumed cases in England and 1,440 in Scotland have also been recorded.

10.12 Contact tracing and the prophylactic use of antivirals is to stop in outbreak areas as part of the Government's change in tactics in swine flu 'hotspots'.

Cases in these hotspots may now be determined by clinical diagnosis as opposed to laboratory testing, and swabbing will now only be conducted on a small sample of cases to support the HPA's surveillance work. However treatment will continue to be offered to all symptomatic cases.

Thursday 25 June

15.10 A total of 3,597 swine flu cases have now been confirmed in the UK, as the Chief Medical Officer warns a 'surge' of cases may be on the way.

Sir Liam Donaldson said that while a national policy of containment will continue, in hotspot areas (London, Birmingham and Glasgow) antivirals will now only be given to symptomatic patients and the tracing of contacts will stop.

Dr Maureen Baker, pandemic planning lead at the RCGP, welcomed the move. 'We feel they are sensible and very practical for the GPs and practices in the affected area.'

Wednesday 24 June

15.06 The number of lab-confirmed swine flu cases in the UK has topped 3,000, with the biggest rise in cases in a single day. New Health Protection Figures reveal there have been a further 306 cases confirmed today, bringing the UK total to 3,254.

In addition, 201 'clinically presumed' cases have now been reported in England, as GPs in London and parts of Birmingham move to clinical diagnosis. 1,440 clinically presumed cases have been reported in Scotland, although GPs there have been told to revert to swabbing every case.

14.52 The WHO reports there have now been 55,867 laboratory-confirmed cases of swine flu globally, with 238 deaths.

10.45 Patients who think they may have a mild case of swine flu should 'stay at home and take paracetamol', Dr Rosemary Leonard, a GP in Dulwich, south London and board member of the Health Protection Agency has said.

Tuesday 23 June

17.06 109 further patients in England have been confirmed to have swine flu through laboratory testing, bringing the total number of confirmed cases in the UK to 2,905. There have also been a further 1,481 'clinically presumed' cases.

15.46 Dr David Shurmer, a GP in Sheffield, has had some potential swine flu cases at his practice, but is phlegmatic. 'I don't think it's necessary to suspend the QOF at the moment,' he says. 'I have three thousand patients and last week I had to swab two, so we're not so busy that we need to suspend QOF work. At the moment it's probably not necessary to suspend it, so the DH's is a reasonable decision. Come the autumn the situation may be different, and it may be warranted if it becomes more prevalent. But it would have to be significantly more prevalent.'

09.45 231 people around the world have now been confirmed to have died from swine flu. The World Health Organisation reports that, as of yesterday, there have now been a total of 52,160 laboratory-confirmed swine flu cases globally.

Monday 22 June

17.50 GPs in London and some parts of Birmingham have been told to switch to clinical assessment of swine flu patients. An HPA London spokesperson said: 'London has moved to that approach now, so GPs are able to use clinical assessment to determine who needs to be treated, and give a prescription to those people. GPs will also be swabbing patients but it’s likely not everyone will be swabbed.'

This is also the case in some parts of Birmingham, although a national HPA spokesperson says 'the changes in treatment are not widespread across the county'.

Meanwhile GPs in Scotland have - after a brief flirtation with clinical assessment - been told to revert to swabbing all cases.

17.40 Despite Sheffield being named as one of the latest swine flu hotspots, local GP Dr Trefor Roscoe doesn't see the suspension of the QOF as necessary.

'I don't think it will make any difference if the QOF is suspended or not,' he says. 'My understanding was that suspension would come into place if there were serious problems with staffing. Therefore you would not be able to do normal work or care for routine patients because you would not have enough people to do it. But with careful hygiene measures and so on it looks like hardly any healthcare professionals have got it.'

'At my practice we are by no means doing anything over and above our normal workload. I don't think we're at a situation that will require suspension of normal day to day work. It's more of a nuisance than anything.'

15.52 204 more patients in England have today been confirmed through laboratory testing to have swine flu, the Health Protection Agency says. This includes 89 cases in the West Midlands and 78 cases in London.

The UK total is now 2,773 laboratory-confirmed cases, with a further 1,481 'clinically presumed' cases.

10.09 Latest figures from the Health Protection Agency show there have now been 2,506 laboratory-confirmed cases of swine flu in the UK. There have also been 41 clinically presumed cases in England and 1,440 clinically presumed cases in Scotland.

Friday 19 June

16.46 224 further patients have been confirmed to have the swine flu virus through laboratory testing, bringing the UK confirmed total to 1,984, according to the latest HPA figures. A further 41 cases in England and 1,195 have been ‘clinically presumed’.

16.10 The GPC and RCGP are lobbying ministers to declare UK alert level 3 and allow the suspension of the QOF and other routine work in four of the UK's largest cities, Pulse can reveal. Full story here

14.27 Dr Robert Morley, executive secretary of Birmingham LMC, says local GPs are coping with one of the UK's biggest outbreaks - despite some 'confusion' over how to deal with patients meeting the HPA's second algorithm.

'Things are hotting up on a daily basis,' he says. 'It’s still manageable at the moment, but it is increasing – for this time of year it’s obviously an awful lot busier.'

12.40 Dr Chris Woods, a GP in Bolton, says practices in the town are prepared for a swine flu outbreak but have so far had little to do. 'We have our packs in reception for dealing with patients whho turn up with suspected swine flu,' he says. 'We have our local arrangements in place. There’s not very much activity really – we’re just watching and waiting.'

10.41The latest WHO figures - dating from 17 June - show there have now been 39,620 laboratory confirmed cases globally, and 167 deaths. As the pandemic spreads these figures may be less reliable, however.

Thursday 18 June

17.58 GPs in Birmingham will no longer use laboratory tests to confirm cases of swine flu, the BBC reports. Clinical diagnosis will be used instead, as trusts there move to what appears to effectively be a local mitigation strategy.

15.11 A further 145 patients in England have been diagnosed with swine flu bringing the total number of laboratory-confirmed cases in the UK to 1,752, according to the latest Health Protection Agency figures. The largest rise today was in London, with 94 new cases. Meanwhile Scotland now has 850 'clinically presumed' cases in addition to the 530 confirmed by laboratory testing.

13.05 The RCGP has published its latest H1N1 flu update, including an explanation of the current situation with containment/mitigation.

They say: 'In his statement to Parliament last week, the Secretary of State for Health in England, Andy Burnham, confirmed that we remain in the containment phase with respect to managing the swine flu outbreak. However, he did recognise that, in areas with significant outbreaks, this strategy can mean that many people may need to be contacted for swabbing and prophylactic treatment. Practices and Out-of-Hours providers in areas where there is evidence of sustained community transmission, such as Birmingham and areas in West Scotland, should therefore liaise closely with local health protection services to agree a practical and proportionate way of investigating and treating possible contacts. In other parts of the UK affected with only a few sporadic cases, the containment strategy remains in place for now, although this is constantly under review. The Department of Health’s objective is to slow the disease down as much as possible and the rationale for following a containment policy at present is that it allows time to better understand the effects and characteristics of the virus.'

10.04 Seven more deaths from swine flu have been reported in New York City, bringing the city's death toll to 23, the New York Times reports

Wednesday 17 June

15.09 Today's update from the Health Protection Agency reveals a further 110 patients in England, including 55 from the West Midlands, have been confirmed through laboratory testing to have swine flu. This brings the total number of labroratory confirmed cases in the UK to 1,582. However intriguingly, for the first time, a figure is also given for the number of 'clinically presumed' cases in Scotland - and it's high, at 550.

14.22 Dr Nigel Higson, a GP in Hove and chair of the primary care virology group in Sussex, warns the public to ensure they are registered with a GP before the pandemic develops further. He told the Brighton Argus: 'Distribution of the anti-viral agents will most likely be dependent on the patient being able to quote his or her NHS number. If you have not registered with a GP, not only may there be difficulty in obtaining medical advice, there may be problems obtaining effective treatments.'

10.09 Swine flu has hit Topshop, apparently - the BBC reports that two members of staff working in the Oxford Street branch of the high street chain have tested positive for the virus.

Tuesday 16 June

15.10 141 more cases of swine flu have been confirmed in England in the past 24 hours, according to the Health Protection Agency. The vast majority of these - 124 - are in the West Midlands. The UK total is now 1,461, with the latest Scottish figures expected later today.

12.29 GPC chair Dr Laurence Buckman has hit out at claims in the media - it was the Metro's splash this morning - that GPs could strike over indemnity fears and death-in-service payments for locums. He says: 'GPs are not considering and have never considered strike action over this issue and the BMA would not support such action. Media reports claiming this to be the case are wholly inaccurate.'

11.27 NHS Eastern and Coastal Kent has asked its local out-of-hours provider, South East Health, to handle swabbing suspected cases and issuing antivirals, and a PCT spokeperson reports that pandemic preparations are well in hand. '110 out of 115 practices are in 'buddying up' groups who have all identified working arrangments and attended training,' she says.

09.49 A total of ten children have now been diagnosed with swine flu at a primary school in Sheffield, the BBC reports. Lydgate Junior School has been closed on Health Protection Agency advice.

Monday 15 June

17.17 New figures from the HPA show there have been a further 59 confirmed cases in England today, bringing the UK total to 1,320. The World Health Organisation has officially declared a pandemic, and its latest figures show that 76 countries have reported 35,928 confirmed cases, including 163 deaths.

Wednesday 10 June

15.03 Confirmed cases in the UK have now hit 750. Today's HPA update reports 42 English patients have been confirmed with the virus in the past 24 hours, while there were 32 cases in Scotland announced yesterday.

10.57 Latest figures from the World Health Organisation - 73 countries have officially reported 25,288 cases, including 139 deaths. The BBC reports a sharp rise in cases in Australia - a four-fold increase in a week - may hasten the declaration of a pandemic.

Monday 8 June

15.28 Latest update from the HPA - 29 further patients in England have today been confirmed with swine flu, bringing the UK total to 621 confirmed cases.

Thursday 4 June

17.35 There have been 23 new cases in England and 31 new cases in Scotland today, bringing the the UK total to 459. Globally, 66 countries have reported 19,273 cases, including 117 deaths.

17.27 In Scotland, the swine flu testing criteria has been expanded, with GPs in some areas now told to consider patients presenting with flu-like illness as possible cases even if they are not a contact of a previous cases and have no history of foreign travel.

Tuesday 2 June

17.03 A further 23 new cases in Scotland today brings the UK total confirmed cases to 362. The BBC reports that three patients in Scotland are now 'critically ill' in hospital, with a 45-year old man from Paisley the first in the UK to become critically ill wholly because of swine flu.

15.20 The HPA reports another big leap in swine flu cases in the UK. 61 further patients in England have today been confirmed with swine flu, which combined with 23 additional cases in Scotland yesterday brings the current total number of cases in the UK to 339.

13.29 Latest WHO update - there have now been 17,410 cases of swine flu and 115 deaths reported across 62 countries.

Monday 1 June

17.29 The HPA have confirmed a further nine cases in England, bringing the UK total to 255. Testing will now be carried out regionally rather than centrally, after the Centre for Infections successfully developed a swine flu test which can be carried out in the HPA's regional laboratories.

Thursday 28 May

15.35 HPA confirms 17 more confirmed case on swine flu in the UK today - 14 of them in the West Midlands. There have now been a total of 203 confirmed UK cases.

Tuesday 26 May

16.32 A big rise in the number of swine flu cases today - the HPA has reported 47 new confirmed cases, mainly in the West Midlands.

Tuesday 19 May

17.16 HPA update: four further cases have been confirmed in London, bringing the total number of confirmed cases in the UK to 107.

10.03 The WHO - currently holding its annual meeting in Geneva - says that there have now been 8,480 confirmed cases across 40 countries.

Monday 18 May

17.34 The Health Protection Agency says that a patient under investigation in Scotland has today been confirmed with swine flu, bringing the total confirmed cases in the UK to 102. That's 92 in England, 9 in Scotland and one in Wales.

Thursday 14 May

17.28 Latest cases update. The HPA reports a further six confirmed cases in England, and one in Northern Ireland, bringing the total number of UK cases to 78. 314 potential cases are currently under laboratory investigation.

Meanwhile the latest figures from the WHO show that 33 countries have officially reported 6,497 confirmed H1N1 cases.

Wednesday 13 May

12.52 WHO update: now 5,728 cases reported across 33 countries.

10.01 No WHO update on cases across the globe as yet, but the BBC has a useful map of which regions the UK cases have occurred in so far. We'll be updating our map too, which you can see by scrolling down to the bottom of this page (the three latest cases, not included on the BBC's map, all occurred in London).

Tuesday 12 May

15.31 Latest World Health Organisation figures show that 30 countries have officially reported 5,251 cases.

15.11 The latest update from the Health Protection Agency states 'three further patients under investigation in England have today been confirmed with swine flu, bringing the current total number of confirmed UK cases to 68'. The three new cases are two children and one adult from the London area, all close contacts of previously confirmed cases.

07.12 Research published in the journal Science suggests that if a second wave of a swine flu pandemic develops, it could infect up to three times as many people as normal seasonal influenza. Lead researcher Professor Neil Ferguson says 'What we're seeing is not the same as seasonal flu and there is still cause for concern - we would expect this pandemic to at least double the burden on our healthcare systems.'

Monday 11 May

16.43 GPC chair Dr Laurence Buckman attacks the Government's decision to allow each PCT to develop its own policies on swabs, facemasks and access to antivirals as 'mad'.

'They should have planned it all in one go,’ he says. ‘We said we wanted national guidance and instead they’ve done it PCO by PCO.'

15.09 Ten more swine flu cases confirmed in the UK. In the East of England, infection is confirmed in an adult and a child who are returning travellers, and two other adults. In London, cases have been confirmed in an adult and a child, both close contacts of previous cases. In the North West two adults who are returning travellers and one adult who is a close contact of a previous case have been confirmed to have swine flu. And in the South East a case has been confirmed in a child who is a returning traveller.

14.47 Dr Fiona Le Quesne, a GP in Newmarket, Suffolk, reports difficulties last week in accessing the suspension form of Tamiflu to give to a patient who had been in close contact with a confirmed case of swine flu. On enquiring, Dr Le Quesne says she was told there was only one bottle of suspension available in the whole county, at West Sussex Hospital.

‘I cannot believe that days into the swine flu crisis this was the only medication available,’ she tells Pulse. ‘The patient was given exactly 50 mls, leaving 25 mls should a case or contact need it at the hospital. I dread to think what will happen in the coming days if more people need medication and look to us for support when we are so underprepared.’

However Christine Bower, head of medicines management at NHS Suffolk, says she is unaware of the incident, and insists Dr Le Quesne must have been misinformed. ‘There were additional stocks of Tamiflu in the county,’ she says.
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09.46 Update on numbers from the weekend. There have now been a total of 55 confirmed cases of swine flu in the UK, with a further 384 cases currently under investigation. Worldwide, the WHO reports 4,379 cases across 29 countries.

Friday 8 May

17.05 Four more children and one adult from Alleyn's in Dulwich, south-east London, have been diagnosed with swine flu. Six pupils from the school were diagnosed with the H1N1 virus earlier this week. All 1,200 pupils as well as staff have already been given Tamiflu antiviral drugs and the school has been closed.

16.20 Pulse journalists discover that Labour MP Nia Griffith's suggestion that licking the roof of your mouth could prevent the onset of a sneeze-and that it could slow the spread of the outbreak- does not work

11.16 Health secretary Alan Johnson says the UK has made a 'significant step' towards producing a European prototype swine flu vaccine. Mr Johnson visited the HPA's national institute of biological standards and control, where researchers have sequenced the virus' genetic code.

'The speed with which vaccine prototypes can be created to combat potential pandemics is testimony to the dedication and world-class expertise of Health Protection Agency researchers' Mr Johnson said.

'We have been preparing for the possibility of a pandemic for some time. We now look to the vaccine industry to produce the required quantities of vaccine as quickly as possible.'

10.05 Latest WHO figures - 2,371 confirmed cases in a total of 24 countries. However Dr Margaret Chan, director-general of the WHO, says 'the world is better prepared for an influenza pandemic than at any time in history.'

Thursday 7 May

16.45 NHS Hampshire is not distributing facemasks and swabs to all practices, but has put together a pack for GPs to access if and when they encounter a suspected case. 'These packs are currently located in eight key points across Hampshire and the Isle of Wight. These points are accessible 24 hours a day, seven days a week,' a spokesperson says.

13.31 Two more confirmed cases of swine flu have been identified in England, the Health Protection Agency says, bringing the total number of confirmed cases in the UK to 34. The first new case is an adult in the East of England who recently returned from the United States, the second a child of school age from London. 464 possible cases are now under laboratory investigation.

10.03 Latest from the WHO - now 1893 cases reported across 23 countries.

Wednesday 6 May

16.52 The HPA now says there are 32 confirmed cases of swine flu in the UK, with 390 possible cases currently under laboratory investigation.

11.50 The GPC has criticised practices which have failed to draw up pandemic flu plans yet as 'foolish' - despite Pulse's survey finding a third of practices have yet to do so.

10.52 Latest update from the World Health Organisation reports 1,516 confirmed cases across 22 countries.

Tuesday 5 May

17.02 Practices in west Berkshire have been reporting shortages of viral swabs to test any patients suspected of having the swine flu virus. A spokesperson for NHS Berkshire West says the PCT are aware 'there is a shortage of viral media' and promises 'fresh deliveries are expected in the next day or two.'

Local practices were issued with facemasks two to three years ago, he says, adding: 'There are central stockpiles of masks which we understand will be distributed to local areas for onward distribution to clinicians.'

16.48 A statement from NHS Berkshire East, where a case of swine flu was confirmed in a man in his 20s earlier today, say his case is 'mild'.

'He was symptomatic while on a flight from Mexico, which landed back in the UK on 30 April. Since arriving home and reporting flu-like symptoms, he has been given ant-viral drugs. His symptoms have been mild and he has responded well to treatment. Close contacts of the man were identified and have also been given antivirals.'

Dr Angela Snowling, acting director of public health for NHS Berkshire East, said: 'We're glad to say that the person involved has not been affected any more than thousands of other people who get flu each year – it's not very nice, but neither is it very serious.'

16.46 Ian Dalton, Chief Executive of NHS North East, has been appointed to the newly created position of National Director for NHS Flu Resilience at the Department of Health. Health Secretary Alan Johnson says: 'The appointment of Ian Dalton will support the vital operational side of our plans by ensuring every NHS organisation in England is in the best possible position to protect the population.'

16.21 There are now 28 confirmed cases of swine flu in the UK, the Health Protection Agency announces. A spokeswoman for NHS South Central confirms the latest case of swine flu is in an adult in Slough, Berkshire.

16.05 Two patients in Derry are being tested for suspected swine flu, according to unconfirmed reports in the Derry Journal. A total of four cases are currently under investigation in Northern Ireland.

15.36 The US government says the swine flu virus may be milder than previously thought. 'We are cautiously optimisitic that what we are seeing right now is presenting itself as a much milder virus than the initial cases that presented themselves in Mexico,' says new US health secretary Kathleen Sebelius.

15.29 In Hull, NHS managers have collated a list of recently retired doctors who remain on the performers list and could be asked to help out in a pandemic, and a similar list of locum GPs. But despite the WHO declaring a Phase Five pandemic the trust has not yet, as guidelines recommend, contacted either.

'The PCT will ensure appropriate action is taken, when required, as part of implementing the pandemic flu plan,' a spokesperson tells Pulse.

15.17 GPs in Walsall are taking responsibility for swabbing patients who attend with flu-like symptoms, while a 'special Swab Team' has been set up to swab patients who ring in.

However NHS Walsall refuses to clarify whether viral swabs or facemasks have been issued to local GP practices, and how many. 'We are not commenting on movement of materials,' a spokesperson says - a stance he insists is 'in line with national policy'.

15.02 The Health Protection Agency confirms another case of swine flu has been confirmed in the UK, bringing the total to 28. The new case, associated with travel to Mexico, is an adult in the south east region. A statement from the HPA says it 'is working to ensure that any close contacts of this case are offered antivirals as a precautionary measure.'

14.56 Calderdale PCT report that 80% of GP practices in their area currently have pandemic flu plans in place. All practices have been issued with PPE, and swabbing is being done centrally, rather than at a practice-level.

13.42 Derbyshire County PCT has instructed practices to leave swabbing of any potential swine flu cases in its areas to the Health Protection Agency and the GP out-of-hours service, and the out-of-hours service has also been put in charge of drawing up a list of locum GPs who could help out in a pandemic.

However the PCT has decided against widespread distribution of facemasks to practices. 'These will be given out if there is a pandemic,' a spokesperson says. 'Very small numbers might be given out in advance.'

11.34 We've heard a lot from GPs about a shortage of face-masks, but in Bury at least there has been a plentiful supply. NHS Bury report that 48 facemasks have been distributed to each practice, and 90 sent to the out-of-hours service.

Local GP practices haven't drawn up specific pandemic flu plans, a PCT spokesperson says. 'However 28 out of 32 have business continuity plans which would cover untoward incidents,' she adds.

10.21 GPs in Wokingham have reported a marked increase in calls from patients and patients booking 'appointments for check-ups', the Wokingham Times reports.

09.55 Dr Trevor Stammers, a GP in Wimbledon, south London, says Sutton and Merton PCT has been handling the outbreak well. 'Guidance has been good and specific and the system is working well here,' he says, adding that advice has also been given as to what will happen in the event of a pandemic either now or in the winter.

09.29 There are now 27 confirmed cases of swine flu in the UK, with a further 331 cases still under laboratory investigation. Globally, 1,124 cases have been reported across 21 countries.

Friday 1 May

17.19 The number of confirmed cases suddenly seems to be rising. The BBC reports a Year 7 pupil at a school in Bristol has become the UK's 11th confirmed case.

17.17 The total number of confirmed cases in the UK is now 10, including the latest confirmed case from Scotland.

17.10 The latest confirmed case in England is in an adult from the North West. Meanwhile an NHS worker in Scotland has become the UK's first confirmed case of human-to-human transmission.

16.58 Now nine confirmed cases and 642 cases under laboratory investigation, the HPA says.

16.52 Half of GPs are unable to access swabs antivirals and face masks, a Pulse survey finds.

15.23 Newcastle LMC secretary Dr George Rae tells Pulse there is 'no sense of disarray' on Tyneside, with relations between LMC and the PCT 'very constructive'. However he warns that no one can afford complacency in tackling the outbreak.

14.43 Practices in Barnet - where one of the first cases of swine flu in England was confirmed on Wednesday - have been sent four viral swabs each so far. 'There will be additional deliveries which are expected throughout the week,' a PCT spokesperson tells Pulse.

14.34 GPs are being told they must buy their own face masks and protective clothing - reports from Birmingham and Sefton in Liverpool.

12.06 Dr Richard Fieldhouse, chief executive of the National Association of Sessional GPs, tells Pulse a poll of his members shows 85% have received no updates on swine flu from their PCT. 'This represents 13,000 GPs who are being left out of pandemic flu alerts.'

12.04 A quick reminder that we want to hear from you and know how your practice is coping with the swine flu crisis. Answer our quick survey and we'll enter you into a draw to win an iPod.

10.48 Health Protection Agency issues two new algorithms - actions and post exposure prophyllaxis for close contacts of probable or confirmed human case(s) of swine influenza AND algorithm for management of returning travellers and visitors from countries affected by swine influenza A/H1N1 presenting with febrile respiratory illness: recognition, investigation and initial management.

It also issues advice for investigating people with possible swine flu and a case definition for swine flu.

10.19 The Royal College of Physicians has just released new guidance for hospitals on preparing for a pandemic.

09.59 Dr Asad Mubarik, a GP in Halifax, reports that the information cascade to GPs in his area has been 'excellent', but says that calls from the worried well have been 'flooding' the practice.

However he warns: 'Unfortunately all suspected cases are meant to ring a telephone number so that the correct swabs can be sent to the practice by taxi on an individual basis. Obviously this will cause problems with isolating the patient at the practice over this time.'

'I suspect this implies that this area does not expect a large outbreak.'

Thursday 30 April

21.10 Canada confirms its first case of human to human transmission of swine flu, in Nova Scotia.

17.41 A GP in central Wales, who asks not to be named, tells Pulse: ‘We have access to face masks, swabs and Tamiflu - we can access them by phoning the Health Protection Team and requesting that they send us some. However, that is not really adequate access, since from the time of asking it will take a minimum of 2 hours for such items to arrive at the surgery even if dispatched immediately by special courier. Is it anticipated we should have these patients wait in the waiting room and infect us all while we are waiting?’

17.31 BMA has recruited 300 retired doctors to help with death certification in the event of a full-blown pandemic.

17.23 NHS Coventry has told GPs to visit suspected swine flu cases in patients' homes and then drive to the local hospital themselves to deliver the swabs for analysis. Local practices are also reporting a shortage of face masks.

17.10 The 230 possible swine flu cases currently being investigated across the UK include 28 in Scotland - 27 'possible' and one 'probable'.

16.45 EU health ministers are meeting in Luxembourg today to co-ordinate Europe's response to the outbreak.

16.30 A dedicated swine flu advice line goes live this afternoon in Scotland. Callers to NHS 24 - 08454 24 24 24 - will be given the additional option of being put through to a dedicated team who are dealing with swine flu.

Scottish Health Secretary Nicola Sturgeon said: ‘It's vital that members of the public can readily access reliable and trustworthy information about swine flu. Although we have had two confirmed cases in Scotland, I would like to reassure people that we are not in a pandemic situation and the level of threat to public health remains low.’

NHS 24 Medical Director George Crooks said it had been receiving around 18 per cent more calls than forecast. While around eight per cent of these calls are related to swine flu, only a small number relate to people with flu-like symptoms who have returned from affected areas.

15.50 The Department of Health says all three of the new UK cases confirmed today were in patients who had recently returned from Mexico.

15.24 The BBC reports that two further cases of swine flu have been confirmed in the UK, bringing the total to eight. The Department of Health confirm the sixth case in a student in Newcastle. The latest two cases are in London residents. The conditions of the patients in the latest three cases is unknown.

15.04 A person from Newcastle is reported to be the sixth in the UK to have contracted swine flu. The Guardian claims the latest victim lives with two students in the city, both of whom are now being tested for the virus and says the city's university is soon to issue a statement on the crisis.

It also claims chemists in Torbay, the site of an earlier confirmed case, have been selling out of face masks, nasal sprays and hand washes today, with one pharmacist claiming to have sold dozens of masks after news of the girl's condition spread.

The paper also reports Sir Liam Donaldson as saying he was 'concerned but not alarmed' after the World Health Organisation raised its swine flu global epidemic threat level to phase five, although he admits the UK will see 'many more cases'.

15.00 Dr Nigel Watson, chief executive of Wessex LMCs, has urged patients not to try and buy antivirals online, warning they could end up buying fake drugs.

'What is more important than Tamiflu is that people also use common sense,' Dr Watson told the Southern Daily Echo.

14.11 NHS Direct has banned call-centre staff from booking annual leave as it fields hundreds of swine flu calls, Personnel Today reports. On Sunday, NHS Direct received 88 calls on swine flu - by the end of Monday, there had been 1,300.

13.59 Dr Jane Lothian, secretary of Northumberland LMC, says GPs have received WHO guidance and a couple of brief letters from the PCT and SHA - but would welcome a more coordinated approach. She tells Pulse: 'I did personally speak to the public health director last night just to let him know that the information getting through to GPs was fairly sparse. We’re like everybody else, everybody’s had to ring up the hospital independently to get viral swabs. As far as we can see we’re not aware of any coordinated distriburtion of viral swabs or masks.

'We know there is a lot of activity going on at the PCO in terms of emergency planning, it just hasn’t got out to GPs yet,' she adds.

13.12 Quick update on the latest number of patients being tested for swine flu - more than 70 across the UK, including 32 in Scotland and 20 in Wales. None reported in Northern Ireland as yet.

12.35 Dr Martin Harris, a GP in Barnet, north London, where swine flu was confirmed in a 22 year old man yesterday, tells Pulse he has had an 'enormous' volume of phone calls all week, though he has not spoken to any patients who have travelled in affected areas. Barnet LMC, of which he is vice chair, will be meeting with NHS Barnet on Tuesday, and has sent out advice to GPs.

12.18 Dr Adrian Jeffries, a GP in Cramlington, Northumberland, says that while stringent surveillance is justified by the threat of a pandemic, the HPA's current algorithms could lead to a large number of false alarms. 'If anyone comes back from New York City, or California or Mexico with any cold symptoms they could end up with antivirals and be included as a suspected case,' he says. 'There could be an awful lot of suspected cases which come to absolutely nothing in the next two to three weeks.'

Facemasks may prove of limited use in the event of a pandemic, but one nearby practice at least is taking no chances. 'There's one GP who's been stockpiling masks for ages,' he says.

10.29 The RCGP has warned it's hearing lots of GP concern over access to swabs and Tamiflu.

10.13 In Northern Ireland a similar helpline has been set up for those concerned about swine flu. The number's 0800 0514 142, although at the moment it's ringing off the hook.

09.31The Department of Health has set up a swine flu information line providing recorded information for patients - it's 0800 151 3513.

09.22 Dr Philip Foster, chair of Retford Health in Retford, Nottinghamshire, says there are no reported cases of swine flu in Nottinghamshire so far.

09.14 Dr Peter Holden, the GPC's pandemic flu lead and a GP in Matlock, Derbyshire, has been fielding several queries from patients about swine flu, but urges calm. 'I would say the Government, in particular the Department of Health, has put a massive amount of work in to preparing for this, using the best brains in the land,' he says. Two people in Derbyshire are reportedly being tested for swine flu.

08.01 GPs in Hampshire, Portsmouth and Southampton have received public health guidance copied to Out of Hours Service providers warning that 'thorough surveillance is absolutely essential'. Viral nose and throat swabs should be carried out as far as possible 'at the patient's home or at the place of initial presentation'. GPs are warned 'transfer of the patient to any other clinical setting should be avoided unless mandated by the patient's clinical condition.'

Wednesday 29 April

21.20 WHO raises its pandemic flu status level to 5, one level below its definition of global pandemic. Level 5 indicates that there are systemic outbreaks in at least two countries within one WHO region.

18.09 Dr Fay Wilson, medical director of a practice in central Birmingham and chair of this year's LMCs conference, says there are insufficient swabs available locally. She has had about 30 swine-flu related queries from patients today.

17.05 Dr Ian Hume, a GP in Diss, Norfolk, says his practice has ordered its own face masks, and PCTs in his area are expecting delivery of face masks for primary care staff shortly. 'The PCT are making arrangements to field calls in the absence of a national patient line. I'm attending a meeting with them to discuss supply and distribution measures for Tamiflu.'

16.15 Somerset LMC chair Dr Barry Moyse tells Pulse his practice is investigating one suspected case of swine flu in a patient recently returned from Mexico.

16.09 More details from NHS South West on the case of a 12-year old girl in Torbay, Devon found to have a confirmed case of swine flu. 230 students in her year group at Paignton Community College have been found offered antivirals, and the college will be closed for seven days.

15.23 Lord Darzi tells the House of Lords that anviral stockpiles will be available in every PCTs for GPs to access. 'Stockpiles will be in every PCT and we have plans in which we will let every general practitioner know where the stockpile and the distribution sites are. That announcement will be made in due course.'

13.55 Dr Charlie Daniels, chair of Devon LMC and a GP in Torbay, where a case of swine flu has been confirmed in a 12-year old girl, speaks to Pulse and says there has been an 'appreciable' increase in the volume of calls. 'We are reasonably prepared, our PCT has plans in place and the local health protection unit has been faxing us updates every hour, so we have every reason to be confident and positive.'

12.10 - Three more cases confirmed in the UK. More to follow...