Suspected swine flu cases in Scotland rise to 23

The news came as the country's chief scientist warned Scotland faced a battle against the outbreak.

Health secretary Nicola Sturgeon revealed 23 possible cases of swine flu were being investigated in Scotland, in addition to the two confirmed cases. The number is expected to rise.

Swine flu latest: Second Scottish honeymoon couple tested for virus

She said infected honeymoon couple Dawn and Iain Askham, from Polmont, near Falkirk, were continuing to improve in Monklands Hospital in Airdrie.

The nine showing mild flu symptoms, from a group of 22 who had been in contact with the Askhams, were being tested, Ms Sturgeon said.

She added that, across Scotland, a further 14 cases were under investigation last night.

Health officials are also investigating an undisclosed number of suspected cases in England and Wales.

Last night, the Department of Health (DH) confirmed leaflets would be distributed to households across the UK giving information on the swine flu virus.

A DH spokeswoman said: "The leaflet will be sent out next week, cover the whole of the UK, and will contain information about this flu outbreak and preventative messages."

The DH also confirmed it was in talks with a number of companies who produce surgical face masks. However, it would not confirm reports that millions of the masks had been ordered.

It is intended that the extra masks will be used by health workers.

There were reports of 11 cases in New Zealand and two in Israel yesterday, plus up to 89 suspected cases in Australia and other possible outbreaks in Denmark, Switzerland and Ireland.

Seven people were in hospital in the US, where a senior health official, Richard Besser, said: "I fully expect we will see deaths from this infection."

The Australian government has introduced powers to detain and disinfect people suspected of having swine flu.

Tour companies in the UK cancelled flights to Mexico for the next week after advice from the Foreign Office to avoid non-essential travel to affected areas.

Professor Sir John Savill, Scotland's chief scientist, said it was still too soon to gauge the full impact of swine flu in Scotland.

He added: "There's clearly going to be an epidemic. It's going to go across the world."

He told a conference on the future of Scottish medical research at the University of Glasgow: "It's difficult to be sure how it will play out.

We have to be optimistic in our own public health system. It is like the start of an Old Firm match. We know there'll be a battle, but we don't know to what extent as yet."

The additional suspected cases were being investigated in the Greater Glasgow and Clyde, Lothian, Forth Valley, Grampian, Tayside and Lanarkshire health board areas.

A couple from Edinburgh, Peter and Jennifer Marshall, from Gorgie, Edinburgh, who returned from their honeymoon in the Cancun area of Mexico last Tuesday, said they had quarantined themselves at home while awaiting test results.

Mr Marshall, 37, said: "I'm not too worried. Any cases I've seen in Britain have been mild cases. I feel absolutely fine. To be honest, I don't think it is swine flu, but it's better to be safe than sorry."

Ms Sturgeon said the cases had travel connections with the affected parts of Mexico and the United States. "I would anticipate absolutely that we will have more cases under investigation over the next number of days and weeks," she said.

People in Scotland who have had contact with suspected and confirmed flu cases were asked to stay in their homes even if they showed no symptoms.

Dr George Crooks, medical director of NHS 24 – Scotland's 24-hour health service phone line – said it was receiving about 20 per cent more calls than it would expect at this time of year. He added: "NHS 24 has increased its staffing to cope with the anticipated increase in demand."

Worldwide, between 500,000 and a million people die from seasonal flu every year. The number infected during a normal winter in the UK varies, but each year several thousand deaths are linked to flu. Seasonal flu levels in Scotland and elsewhere in Europe are currently low.

Ms Sturgeon insisted people should not panic as cases of swine flu continued to increase.

"People are concerned," she said. "It is understandable given what people are seeing and reading at the moment. But there is no cause for alarm. The public health threat in Scotland remains low."

Dr Harry Burns, Scotland's chief medical officer, said it was reassuring that, outside Mexico – the only country to suffer swine flu deaths – the infection continued to be mild.

He said one explanation for the difference could be that cases of milder disease had not been picked up in Mexico, which did not have the same surveillance measures as Scotland.

Dr Burns suggested that, as in Mexico, the cases being investigated in Scotland were among the younger age group – those between 25 and 40. "That would broadly be in keeping with the people involved (in Mexico]."

He stressed that people were most at risk if they had spent an hour or more in close contact with someone infected.

Those on the plane with the Scottish couple were not seen as at high risk, because they did not have symptoms at that time. However, it is thought that another passenger on the flight is being investigated for swine flu in England.

Health chiefs across the UK are still investigating an undisclosed number of suspected cases. NHS Wiltshire confirmed seven people were being tested. Eight suspected cases were being investigated in Wales.

A passenger on a flight from Mexico was treated by medics at Manchester Airport yesterday morning, but later sent home, the Health Protection Agency said.

A spokeswoman for NHS Direct – England's health service phone line – said it had had more than 1,300 swine flu-related calls on Monday.

Sir Liam Donaldson, England's chief medical officer, said there were "simple steps" everyone could take to help prevent the spread of the virus.

"Most importantly, if you have come back from Mexico or one of the affected countries and have flu-like symptoms, stay at home and call your GP or NHS Direct," he said.

The government's Cobra emergencies committee met to discuss the issue yesterday.

Prime Minister Gordon Brown said Britain was "among the best prepared countries" to handle an outbreak.

FOUR IN TEN COULD CATCH THE VIRUS, WARN WORLD HEALTH OFFICIALS

FOUR in ten Britons could catch the deadly swine flu virus in the next six months, leading health officials warned yesterday.

The World Health Organisation (WHO) also warned that it was no longer possible to contain the spread of swine flu, and that travel bans would not work.

Commenting on the raising of the WHO's alert level to four on a six-point scale, WHO assistant director-general Keiji Fukuda said: "

At this time we think we have taken a step in that direction, but a pandemic is not considered inevitable."

Neil Ferguson, a professor at London's Imperial College and a member of the WHO taskforce, said 40 per cent of people in the UK could be infected if the country were hit by a pandemic.

The EC also warned of the situation worsening. Health commissioner Androulla Vasiliou said:

"No one should under-estimate the situation but there is no need to panic either."

Isolated Scots newlyweds 'making good progress'

THE newlywed couple who have become Scotland's first swine flu victims were yesterday said to be "shocked" at testing positive, as concern grew that the virus could be spreading among their friends, relatives and colleagues.

Iain and Dawn Askham contracted the virus on honeymoon in Mexico. The couple, from Polmont, near Falkirk, are being treated in isolation in Monklands Hospital, Lanarkshire, after falling ill on their return from Cancun.

Yesterday their parents, Ian and Pauline Askham and Linda and Brian Colston, said they had been given antiviral treatment as a precaution.

In a statement issued by NHS Lanarkshire, the families said: "We are delighted that they continue to make good progress and remain in good spirits. They were both quite shocked that the result was positive for swine flu but are relieved that their symptoms have been very mild. We have received precautionary antiviral treatment as we have been in close contact with Dawn and Iain.

"We are aware that some close friends have displayed some mild symptoms, having been in close contact with Dawn and Iain, and we understand they are receiving treatment and are being closing monitored."

Earlier, Mrs Askham's father said his daughter's condition was improving. Mr Colston said: "She's doing OK, she's getting better."

Mrs Askham works as a dispenser at Boots in Falkirk, where a number of staff have been sent home and are undergoing tests.

The couple were married on 4 April at the Three Kings hotel, near Falkirk. Mr Askham is employed by ScottishPower.

If you think you are at risk, here are key tips on what to do

ALTHOUGH the spread of swine flu is still fairly limited, patients can be reassured that the NHS and the medical profession have plans in place to manage a pandemic situation, writes Dr Dean Marshall.

So far it seems the public is heeding the advice issued by health authorities and government as they attempt to inform and reassure people about the potential spread of swine flu.

It is inevitable that the longer this goes on, and the number of those infected continues to rise, people will become more and more anxious and contact their GPs for advice.

Most of the advice they need at this stage is available online and in the media; but if people are concerned and genuinely think they are at risk, they need to speak to their doctor.

To minimise the spread of infection to other people, we would advise patients who think they might be at risk to telephone the surgery rather than visit in person.

At the moment, people are at risk if they have been on holiday to the infected regions or have been in contact with someone who has swine flu. If these people do start to suffer flu-like symptoms, they should give NHS 24 or their GP a call.

Obviously it may be difficult for people to know if they have unwittingly been in contact with someone who has been exposed to those infected with swine flu, but if they contact us we can help them assess the level of their risk and any appropriate action.

Those who have the condition will be prescribed an antiviral, but the vast majority will probably only have a cold and will be given advice on how to manage that themselves.

People should be reassured that in Scotland and the UK, we have done a lot of planning to prepare for a potential flu pandemic and are among the best prepared in the world.

But no matter how much planning is done, you do not know how it will work until a pandemic actually happens.

Dr Dean Marshall is a GP in Dalkeith and chair of the British Medical Association's Scottish GPs committee.