Published 6 October 2009, doi:10.1136/bmj.b4103
Cite this as: BMJ 2009;339:b4103

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People with asthma are most at risk of complications from swine flu, study shows

¹ BMJ

The government has released further information on the underlying conditions that can cause swine flu to become more dangerous, showing that asthma is the most common comorbidity found in those who are admitted to hospital.

The figures come from a study conducted by the Flu Clinical Information Network (FLU-CIN) and funded by the Department of Health, which looked at a sample of 192 patients in England who had been hospitalised with the H1N1 virus. It found that lung disease was the most common underlying condition, with more than 25% of those admitted having asthma. Cardiac disease was present in 15% of patients admitted to hospital.

England’s chief medical officer, Liam Donaldson, noted that pregnant women made up 5% of hospitalised patients who had a diagnosis of swine flu, a "small but significant proportion."

The figures also underline the dangers of swine flu to previously healthy young people. Although older people with complications resulting from swine flu often had underlying conditions, half of the 80 people aged 16-44 years and 35 of the 40 children aged under 5 years who needed hospital treatment had no known comorbidities.

Andrew Shennan, professor of obstetrics for the charity Tommy’s, which funds research into babies’ health, said that pregnant women have about a fivefold increased risk of serious complications. "It’s therefore important to think of pregnant women as a high risk group," he said. "The current recommendation is for women to be vaccinated during pregnancy. As this is a dead vaccine, the vaccination itself is quite safe."

The British Heart Foundation said that people with heart conditions are more likely to have complications. Those with heart failure or complex congenital heart disease should be encouraged to seek medical advice at the first signs of flu, said Judy O’Sullivan, a cardiac nurse at the foundation. Because heart attacks are more common in association with inflammatory events, such as flu, the number of patients admitted with heart attacks could rise during a flu epidemic, she said.

Cher Piddock, lead asthma nurse at Asthma UK, said that advice to people with asthma was to be vaccinated against swine vaccine as soon as possible and to keep their condition under control. She said, "They can do this by using their preventer inhaler as prescribed, seeing their doctor or asthma nurse for an asthma review, and getting a personal asthma action plan."

Schools in the Yorkshire and Humber region have been the hardest hit in England by the pandemic since the autumn term started. Figures show a total of 39 outbreaks there, almost twice as many as the West Midlands, the next highest region. A spokesperson for the Department for Children, Schools and Families said that any decision to close schools would be made in conjunction with the Health Protection Agency.

Cite this as: BMJ 2009;339:b4103

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