Statement by Minister for Health and Social Services re Swine flu with questions

7.  Statement by the Minister for Health and Social Services regarding swine flu

7.1   Deputy A.E. Pryke of Trinity (The Minister for Health and Social Services):

I am grateful for this opportunity to provide Members with an update on swine flu. As Members will be aware, cases are increasing rapidly in Jersey. In the week leading up to 15th November, 119 cases were confirmed compared with 34 cases the previous week. 50 per cent of swabs taken from swine flu are now being confirmed as positive and 80 per cent of these are children. To put this into context, swine flu cases are now higher than the number of seasonal flu cases my department would expect to see at this time of year. We are also seeing clusters of swine flu occurrence in schools and it is for these reasons that a swine flu outbreak has been declared. The control of this outbreak will be led by the Consultant in Communicable Diseases, Dr. Ivan Muscat. With increased levels of swine flu activity in schools, it is our intention to move to a heightened phase of containment. By this Wednesday - tomorrow - all schools and nursery children will have been offered the vaccine. I am delighted to confirm that over 6,400 primary school pupils - that is approximately 80 per cent of the cohort - have already been vaccinated and that a further 1,000 children in nurseries would have been vaccinated as well. If the take-up is similar among secondary schools, it will mean that at least 80 per cent of all school children - that is nearly 13,000 of them - will have immunity to this virus by the first week of December. As it takes 14 days for immunity to develop, we have to do all we can to contain the virus until the vaccine takes effect. This means that, instead of waiting for the laboratory results as it happens now, my department will assume that everyone who has a clinical diagnosis of swine flu has the virus and, as a result, they and their contacts will be offered the antiviral drug Tamiflu. My department has written to all G.P.s (general practitioners) in the Island to notify them of this change and I want to take this opportunity of thanking them for all their co-operation and support. The school vaccination programme has been an incredible achievement; it has been a huge logistical exercise involving a great deal of work in a very short space of time. Members should know that this has been only possible because of excellent teamwork that I have observed in the past few months. I would like to take this opportunity to thank the public health team, hospital staff, Family Home Care as well as the Department of Education, Sport and Culture and especially the schools for all their hard work and co-operation. This has been a real community effort and we would not have been able to do so so quickly without all their help. Finally, I would like to remind everyone of the importance of continuing with the public health message: "Catch it, bin it, kill it."

1. The Deputy of St. John :

It is only a brief one. Tamiflu, is this taken orally or is it by way of an injection? If by way of an injection, does it mean that you will have to go through all the schools yet again?

The Deputy of Trinity :

No. Tamiflu is an antiviral drug which is in tablet form and is dispensed by the G.P.s. It is only given if you have signs or there has been a clinical diagnosis by your G.P. or consultant. If they have had Tamiflu they still can have the actual vaccine injection.

2. Deputy K.C. Lewis :

While I congratulate the Minister for the inoculation programme so far, I am sure the Minister is aware that there are quite a few parents who choose not to have their children inoculated against this swine flu. Is the Minister aware of any encumbrance involved whereby children are barred from nurseries or schools, et cetera, should the parents choose not to have the vaccine?

The Deputy of Trinity :

Yes. The Deputy is quite right; the vaccine is offered to any school child and the parents have to sign a consent form whether they want their child to be vaccinated or not vaccinated, the choice is theirs. A very positive campaign was put into place before we started the vaccinations in schools where a team - the Medical Officer of Health, Dr. Muscat and the Clinical Immuniser as well as a consultant from the hospital - went round to 6 public evenings to raise the awareness of the importance of vaccine and to answer parents' questions and concerns, which is quite understandable. I know of no incident that the Deputy was talking about.

3. Deputy I.J. Gorst :

I wonder if the Minister could just reconfirm that during this containment phase any members of the public who feel that they or a family member have flu-like symptoms which might be swine flu should phone their G.P. and ask them to do a home visit and that they will continue to be covered by the special regulations that this Assembly approved whereby they are only expected to meet the costs of a normal surgery visit. I wonder if she could just confirm that will continue to be in place during this extended containment phase. Thank you.

The Deputy of Trinity :

Yes. I can confirm that and also say if people are concerned that they have swine flu, with a high temperature or sore throat or whatever, that they do contact their G.P. first. Some G.P.s are arranging a flu clinic at the end of their normal clinic days, otherwise they will be doing a home visit and, if it is a home visit, as the Minister has said, it will be the same price as a visit to the surgery. I stress that people do make that phone call rather than turning up at our A. and E. (accident and emergency) department, please.

4. Deputy M. Tadier :

The question does follow on quite nicely from that of Deputy Lewis . I would like to say this question does not represent my own view but, because I have had quite a lot of representations from members of the public, I think it would be negligent if I did not at least raise it. There are concerns with the public that the vaccinations may not be safe, that the side effects for children, in extreme cases, may not be worth the while of their children getting it, on balance. There is also a general opinion in some areas that there is an element of overkill in the whole vaccination process. So the question I would ask the Minister is what steps have she and her department taken to make the public aware of the risks so that they can make a fully informed decision as to whether to inoculate their children?

The Deputy of Trinity :

As I said, this is important and we have been in containment and I think the Island should be congratulated for maintaining this containment phase. We are ahead of the game. As I say, there are 119 confirmed cases last week from Wednesday to Friday and 80 per cent of those were children so we know it was in their schools. But I understand the parents' concerns and the parents' evenings I have mentioned before, and that were arranged prior to the vaccination programme, have been very well attended and that panel answered everyone's concerns. But also, in the Education Department, the pandemic hub is set up and a variety of staff have manned it every day answering questions which have come in by phone or by email, not only from parents but concerned other Islanders as well as G.P.s. I stress if anybody does have any concerns to use one of those 3 methods.

5. Deputy J.A. Hilton of St. Helier :

I believe the question from Deputy Lewis was asking whether children who had not had the vaccination had to stay away from school and I am not sure that the Minister answered that question. I have just been notified, and I do not know whether the Minister can confirm this or not, that children who have not had the vaccination do have to stay away from school.

The Deputy of Trinity :

I am not aware, but I can give the Deputy that information. There have been at schools ... and also some parents are concerned, too, that they might have changed their minds because there have been some clusters, in 4 schools especially, and they now come back asking for that vaccination, of which we hope to do by the end of this week, go back and vaccinate. But the specific question I will check rather than give the advice, and come back to you.

6. Senator S.C. Ferguson:

In order to clear the air, has the Minister had any notification - has she in fact made it a notifiable requirement - that any side effects on either the vaccine or Tamiflu should be notified to the department and can she supply the statistics on these if they exist?

The Deputy of Trinity :

A lot of research is being done all over the world regarding Tamiflu, as well as the vaccine, ranging from Australia, U.S.A. (United States of America), too, and they were all fed into, as I understand, the W.H.O. (World Health Organisation). But the actual specific answers I do not have, but I can get back to the Senator with that.

7. Deputy D.J. De Sousa:

Can the Minister inform the House what the department is doing to inform parents of students that are away at university in the U.K. as to where they will be in the vaccine programme?

The Deputy of Trinity :

That is a very important cohort which we did identify and our aim is that when they come back from university they will be offered the vaccine.

8. Deputy J.M. Maçon of St. Saviour :

How will that message be communicated to families and Islanders? The Deputy of Trinity :

It will be communicated in the usual way. There is a set priority of whom to vaccinate first and our first priority was to vaccinate all healthcare workers because in fact they will be providing the care. Then it went on to Islanders who have got underlying medical conditions; I think that speaks for itself. Then research did show that children and pregnant mothers were in a high-risk area, too. So the pregnant mothers have been vaccinated or have been offered the vaccination and we are now coming to the end of the school programme, which has been a major exercise considering that over 16,000 children have been offered that vaccination within a week. I think we just need to understand that it has been a big exercise which has been done effectively and smoothly with the help of the schools. The next cohort we are looking at is the children that do not attend nursery or similar groups and so they are our next priority. Then we will be going on with that. It is assessed on a day-by-day basis because it is a very fast-moving situation. I would like to assure everyone that there is enough vaccine for everyone to be offered it and our hope is that we can vaccinate at least half of the population before Christmas.