OVER the last week there has been increased reporting on influenza as we experience a sharp rise in the number of reported cases in Scotland. Unfortunately, many of these reports have contained clinical inaccuracies. Given the importance of vaccination as a response to influenza, I thought it important to provide some clarity and correction to some of these misconceptions.

Each year, the World Health Organisation reviews evidence from previous years and determines the most likely flu viruses that should be covered by the vaccine programmes in the northern and southern hemispheres for the next influenza season. Manufacturers of the vaccines adopt these recommendations and these products are then incorporated into nations’ vaccine programmes.

At this time, the vaccine is a good match for the predominant strain in Scotland, a variety of influenza A (H3N2). The proportion of the population who have received their vaccine is the same as last year.

There has been discussion between the Scottish Government and public health experts about the experience of southern hemisphere countries such as Australia for several months. The predominant strain currently circulating in Scotland is not the same strain that was predominant in Australia. Indeed there are differences even across the UK with which influenza strain is predominant, and this may fluctuate and change over the course of a flu season. Remaining vigilant about patterns of influenza activity continues to be important.

A small rise in all-cause mortality in the final weeks of 2017 has been reported as being a rise in “flu-related deaths”. It is not possible to infer this from the data available and it is too simplistic to say this was due to flu, particularly as flu detections were at a low level until part of the final week of this reporting period, and other serious and complex clinical presentations were being seen by services.

It is important to be clear about the terminology. When epidemiologists talk about “excess deaths”, this is a statistical term reflecting a greater number of deaths than would normally be expected.

Vaccination offers the best defence for people against flu, and I would encourage those who are eligible but who have not received it to do so.

Gregor Smith
Deputy Chief Medical Officer for Scotland

I LISTENED with total astonishment to a report by a caller to the Kaye Adams BBC talk-in yesterday morning regarding a reference to an alleged incident where a person with “a broken arm in three places” was refused treatment at an A&E unit and told to “come back the following morning”. Frankly I do not accept the details reported, as no medic I know and have had to consult could possibly have acted in the manner described.

I have required to visit for treatment A&E departments at Stobhill and GUQE hospitals twice within the last six months. The units were extremely busy and the organisation of triage was obviously sensibly and expertly handled. Though in some pain I was advised to wait while others in more critical situations were dealt with. My treatment was available in both cases within acceptable time delay and was excellent in every way. Common sense was clearly in evidence.

It is contemptible that our NHS in Scotland is constantly denigrated and used as a mere football by opponents of the Scottish Government.

John Hamilton