Swine flu - moving from a containment phase to a treatment phase Statement by Dr Carol Davidson, Director of Public Health Scotland, along with the rest of the UK, is now moving to the treatment phase for dealing with pandemic flu. The decision has been taken jointly by all four UK health ministers, as a result of the number of cases, and widespread community transmission.

There will also be an end to routine testing and a move to surveillance with numbers reported regionally on a weekly basis, similar to the current seasonal flu reporting.

Surveillance reports will include: The number per 100,000 of the population with a flu-like illness (regionally) The percentage of them with swine flu - based on sampling The number currently in hospital with swine flu The number of deaths to date.

This change in strategy does not mean that the virus is getting more severe or that there is any cause for alarm. It simply means that we are seeing a rise in the number of cases and are adapting our approach to dealing with these.

What are the symptoms of Influenza A (H1N1) and how serious is it?

The most common symptoms of Influenza A (H1N1) or swine flu are fever, sore throat, diarrhoea, headache, feeling generally unwell and a dry cough - in other words, symptoms very similar to seasonal influenza. Most people recover within a week, even without antiviral treatment.

Although symptoms have generally proved mild, a small number of patients will develop more serious illness. Many of these people have other underlying health conditions, such as heart or lung disease, putting them at increased risk.

What measures have we taken to contain the virus?

As little was known about the new flu virus when the outbreak started, it was sensible to take all necessary precautions to try and slow its spread while we learned more about it. To do this, we: tested patients suspected of having swine flu to confirm the infection offered antiviral drugs to all patients suspected of or confirmed as having swine flu collected detailed information about these patients to learn more about how the virus affects people traced people who had close contact with patients and gave them antiviral drugs to try to prevent the flu from spreading more widely.

During the containment phase, we have been able to study the characteristics of the new virus, to build up medical supplies and to make significant progress towards developing a vaccine.

Why are we now moving to the treatment phase and what does this mean in practice?

There are now signs that the spread of the virus is accelerating. The number of new cases in the UK is doubling every seven days, and we have recently seen the development of hotspot areas, where swine flu is particularly prevalent.

As more people catch the virus in their communities rather than from abroad, it becomes less effective to carry on the intensive work to contain swine flu, especially when we need to devote more time and energy to treat the increasing numbers who have the virus.

We have always been clear that, at some point, we will need to take the decision to move from containment to treatment across the UK. This will mean the NHS taking the lead as we establish national systems to deal with high numbers of cases.

We have drawn on advice from leading scientists and health experts to inform our decision, and on 2 July all four UK administrations confirmed the decision to move to the treatment phase.

In Ayrshire and Arran, this will mean: GPs will be able to diagnose cases on the basis of symptoms rather than waiting for laboratory testing.

All contact tracing will now cease, and we will stop giving antiviral drugs to people who may have been exposed to the virus.

GPs and hospital doctors will use clinical judgement in deciding who should receive antivirals and will focus their efforts on those for whom swine flu presents a significant risk of, or is already causing, severe illness.

Which groups are at greatest risk from swine flu?

Some groups of people are more at risk of serious illness if they catch swine flu, and will need to start taking antivirals as soon as they are confirmed with the illness.

We are still learning more about the risk profile of the virus, but we already know that the following people are particularly susceptible: People with: Chronic lung disease Chronic heart disease Chronic kidney disease Chronic liver disease Chronic neurological disease Immunosuppression (whether caused by disease or treatment) Diabetes mellitus Patients who have had drug treatment for asthma within the past three years Pregnant women People aged 65 years and older Young children under five years old It is vital that people in these higher risk groups get antivirals and start taking them as soon as possible - within 48 hours of the onset of symptoms. We have issued clear guidance to GPs on this.

What should you do if you think you have swine flu?

For most people, the advice given for normal seasonal flu is the same as for swine flu: bed rest, drink plenty of fluids, take paracetamol to reduce temperature and ease aches and pains, and maintain good respiratory and hand hygiene. Catch it, bin it, kill it - catch your sneeze in a tissue, place the tissue in a bin, and wash your hands and surfaces regularly to kill the virus.

If you have flu-like symptoms - that is, a temperature of 38°C or more and a flu-like illness such as a cough, sore throat, runny nose, limb / joint pain, or headache - contact your own GP or NHS24 (0845 4242424) for advice.

What about a vaccine?

As swine flu is a new virus, experts have had to develop a new vaccine to deal with it. We expect to have the supplies of the new vaccine in August and will begin vaccinating people in the at risk groups from then.