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24 Nov 10
GP and flu expert Dr Douglas Fleming answers GP Dr Pam Brown’s questions on vaccinating children, distinguishing flu from other infections and spotting complications
Excerpt:
13. In which returning travellers with fever and URTI symptoms should we consider avian flu and how should we investigate and manage them?
For avian flu (H5N1 virus), we remain in Pandemic Alert Period phase 3. This can be summarised as: ‘No, or very limited, human-to-human transmission of a new flu virus’.
The H5N1 virus has been around for more than 10 years and fortunately has shown no signs of mutating to a readily transmissible variant. But we need to acknowledge this possibility, which has not changed because of the emergence of the recent H1N1 pandemic virus, and plan accordingly.
Also, we cannot be sure about the risks from other strains. Reliable surveillance and eternal vigilance are key to flu protection.
It is important for both clinicians and virologists to recognise the unusual. Guidance on the management of respiratory infections in travellers from abroad is available from the Health Protection Agency.5
People with high fever of uncertain origin who have recently arrived in this country need to be investigated promptly and thoroughly, especially if they have travelled from countries known to have cases of H5N1 avian flu (such as Indonesia, Vietnam, Cambodia and Egypt).
It is equally important to consider the possibility of malaria. The local infectious disease specialist at the HPA is always available to offer help and advice.
Dr Douglas Fleming is director of the RCGP Research and Surveillance Centre. Any opinions expressed here are exclusively his.
Competing interests Dr Fleming has served on advisory committees to pharmaceutical and vaccine manufacturers. He has been reimbursed by them to attend international meetings and to present lectures on flu-related matters.
Dr Pam Brown is a GP in Swansea
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