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Continuing HIV care during swine flu epidemic

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Matt Williams
Member
Posts: 312
Continuing HIV care during swine flu epidemic
Posted on: July 30 2009, 11:44 am

This is the text of a leaflet designed for people using London HIV clinics, but many of the points apply regardless.

Continuing HIV care during swine flu epidemic

The number of people with swine flu is increasing in the UK.  It is predicted that there will be a significant increase in the number of people with swine flu during autumn or winter.  If this does occur then there may be disruption to routine NHS services and transport around London.
There are some easy steps that you can take to ensure that your HIV care is not affected during the potential disruption to HIV services.

If you do develop symptoms suggestive of swine flu then please do not attend HIV outpatient services.  Instead, you should stay at home and call NHS direct 0845 4647 or the flu hotline on 0800 1 513 100. You should mention your HIV status when asking for advice.

If you do not have a GP then register with one now.   It is important to have a GP as flu vaccine and Tamiflu (a treatment for swine flu) will be available from your GP.  HIV services will not provide flu vaccine or Tamiflu. A vaccine is being developed against swine flu and it is likely that this will be available from your GP. You can find details of GPs in your area by calling 0845 4647 or by visiting this website www.nhs.uk

Don’t let your HIV treatment supply get very low before you ask for more.   A disruption to services may mean that there is a delay in getting further medication.  It is therefore advisable to contact your clinic earlier than usual to ensure that your medication does not run out.  Never have less than four weeks supply.

Know what medication you are taking.  When you next see your doctor, ask for a copy of your prescription. If there are difficulties getting in to clinic this will help provide another doctor with information on what medication you are taking and may make it easier to obtain supplies from another clinic in an emergency situation.

Ensure that your clinic has up to date contact details e.g. mobile phone number.  In an emergency situation routine appointments may be suspended.  In this situation your clinic will need your phone number to contact you to rearrange your appointment and ensure you have enough medication.

In an emergency additional information about HIV clinics in North Central London will be available at www.camden.nhs.uk

The following are useful numbers and websites:

www.direct.gov.uk/swineflu
www.nhs.uk
www.nhsdirect.nhs.uk
www.hpa.org.uk

If you have moved address or changed your telephone number recently then please ensure reception [at your clinic] have the correct details.
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Christophe Palaggi
Member
Posts: 22
Re: Continuing HIV care during swine flu epidemic
Reply #1 on: July 31 2009, 09:10 am


In the same spirit: This is what Option E service users received from 56, Dean street, the new flagship Soho clinic from the Chelsea and Westminster Group. Please note advice for patients with underlying conditions, regardless of CD4 count.
 

 

28th July 2009                                  Apologies if this does not concern you.

 

Dear xxxxxxxxxx

Please find important swine flu information for your attention. If you have any related queries or need further clarification on any issue, please call the Telephone Clinic on 020 3315 9500 on Monday, Tuesday and Thursday 9-11am.

 

Lastly, if any of your contact details have changed, please send changes to 56deanstreet@chelwest.nhs.uk

 

The 56 Dean Street team

 

Swine Flu Q&A for HIV positive individuals

 

What is swine flu?

Swine flu is a respiratory illness caused by the type A flu (H1N1) virus. The current influenza pandemic (commonly known as swine flu) in countries around the world has been caused by a new version (strain) of the virus named as Pandemic (H1N1) 2009 by World Health Organization (WHO). Swine flu is spread in the same way as ordinary colds and flu. The virus is spread through the droplets that come out of the nose or mouth when someone coughs or sneezes.

 

How can I prevent infection?

General infection control practices and good respiratory hygiene can help to reduce the transmission, of all viruses including influenza:

• Cover your nose and mouth when coughing or sneezing, using a tissue if possible

• Dispose of used tissues promptly and carefully

• Maintain good basic hygiene by, for example, washing your hands frequently with soap and water

• Clean hard surfaces (eg light switches, door handles) frequently using your normal cleaning product

• Make sure that your children follow this advice

 

What should I do if I feel unwell?
It is likely that you have swine flu IF your temperature is above 38ºC or have a history of fever AND two or more of the following: cough, sore throat, runny nose, limb or joint pain, diarrhoea or headache.
 
If you meet this criteria then call your GP or the National Pandemic Flu Service by telephone on 0800 1 513 100 from 8am to 12 midnight or online at www.direct.gov.uk/pandemicflu for further assessment and possible treatment. At this point do not attend the clinic or hospital unless you begin to deteriorate or there is no improvement. It is important at this point that we reduce the likelihood of spreading the virus amongst patients as much as possible.
 
If you have any of the following symptoms:

·        Significant breathlessness or unable to complete sentences

·        Increased rate of breathing

·        Unable to tolerate oral fluids or has significant vomiting

·        Confusion, agitation, visual disturbance, limb weakness or seizures

·        Irregular heart beat/palpitations or chest pain

·        Blood-stained sputum

Then you should attend your nearest Accident and Emergency department immediately

 
Am I more likely to suffer complications if I have HIV?

If you have a low CD4 count (under 200), you may be more likely to suffer complications from any type of flu, including swine flu. If your CD4 is below 200 and you have likely symptoms of swine flu it is important that you are assessed by a clinician. Please call the Kobler Clinic at 0208 746 5607.

 

What if I have other underlying conditions

If you have any of the following as well as HIV, regardless of your CD4 count:

·        Are pregnant

·        Asthma

·        Chronic lung disease, chronic heart disease, chronic renal disease, chronic liver disease or chronic neurological disease

·        Cancers currently being treated, or having been recently treated with chemotherapy

·        Other immunosuppressant conditions

and are suffering with the symptoms of swine flu then it important that you are assessed by a clinician. Please call the Kobler Clinic at Chelsea & Westminster Hospital on 0208 746 5607.

 

Is there treatment for swine flu?

Testing has showed that human swine influenza H1 N1 can be treated with antivirals Tamiflu and Relenza. As flu is a virus antibiotics will not work. They will only be given if a secondary bacterial infection develops. A vaccine is not currently available for the H1 N1 strain of influenza but one is expected later in the year. This will need to be done via your GP as the vaccine will not be available through the clinic or your HIV doctor.

 

What should I do if I come into contact with someone who has Swine Flu?

You only need antiviral treatment if you have been diagnosed with swine flu and your doctor decides it is necessary, or if a doctor decides that you are at serious risk of developing severe illness.

 

In most cases antivirals won’t be given to people without symptoms. The government is no longer trying to contain the virus because it is now widespread in the UK. It is not effective to give antivirals to people who are not ill, as they will be repeatedly exposed to the virus in the community. 

 

Is there anything else I can do?

Yes. In order to minimize the likelihood of you running short of medication as more of the population become ill, including clinic staff and manufacturers, it is advisable to discuss having an extra month of medication with your clinic doctor or nurse.

 

Further information

• NHS Direct offers health information and advice from a specially trained nurse over the phone 24 hours a day on 0845 4647—the NHS Direct website also has health information at www.nhsdirect.nhs.uk

• The Health Protection Agency works alongside the NHS providing specialist support in communicable disease and infection control, and emergency planning—the HPA website has information at www.hpa.org.uk
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Ben Cromarty
Member
Posts: 451
Re: Continuing HIV care during swine flu epidemic
Reply #2 on: August 4 2009, 09:39 am

Thanks for this...the "take-home" point for me was the one about having a buffer of HIV drugs - I would urge members to ensure that their local organisations are up to speed with this, and are making their service users aware of this point. Having a buffer supply of say 4 weeks worth of drugs sounds like a reasonable idea.
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