in those aged over 65, and lowest in those aged 5 to 14. the average age at death was 39. of the patients who died, 67% were in the "high risk" vaccination priority group and were eligible to get vaccinated, 36% had either no or only mild pre-existing illnesses. sir liam again urged people to come forward for immunisation, commenting that a lower impact than previously feared "is not a justification for public health inaction. our data supports the priority vaccination of high risk groups. given that a substantial minority of deaths occur in previously healthy people, there is a case for extending the vaccination programme". 17 december new swine flu cases again fell with 9000 people infected in last week. total deaths in the uk increased to 299 (203 in england). the number of currently hospitalised patients fell to 523 patients of which more than 100 were in intensive care. 3 million people out of the 9 million in the 1st vaccination priority groups have now been vaccinated including 100,000 pregnant women. in addition to that, 343,000 front line health workers have also been vaccinated. it appears that the second wave of swine flu is coming to an end but experts warn cases could rise again in the future in a "third wave" of swine flu. 24 december new cases of swine flu fell by a third to 6,000 cases this week. the total death figures will be updated by the hpa on thursday 7 january. the number of hospitalised patients declined to 454 currently in hospital (as of 8 am on 23 december). 31 december the hpa did not release estimate numbers this week, instead saying that flu activity is continuing to decrease across the uk but some caution must be exercised as this may be influenced by the holiday period. 496 patients were currently hospitalised in england as of 8 am on 30 december (an increase from last week). a more detailed update will be released next week. 8 january swine flu cases continued to decrease, down to less than 5,000 new cases in the preceding week. total uk deaths increased to 360 (251 in england, 64 in scotland, 28 in wales and 17 in northern ireland). hospitalised patients in england (as of 8 am on 6 january) numbered 393, of whom 103 were in critical care. only 3.2 million people had been vaccinated (out of 9 million in the priority groups), including 113,000 pregnant women (out of roughly 600,000), 86,000 under-5s (out of more than 3 million) and an additional 373,000 front-line health workers (out of more than a million). the head of immunisation at the department of health, professor david salisbury urged all those in the at-risk priority groups to get immunised, especially children under five and those with underlying health conditions, because while cases were currently down, it was not clear what would happen with swine flu over the year ahead. reported cases until 2 july 2009 the hpa published daily reports of laboratory-confirmed cases with breakdown by region, by age, and by source of infection (travel, community, etc.). from that date routine laboratory testing of all suspected cases and reporting of figures was discontinued. as of 8 july 2009 figures shown in this article are laboratory confirmed cases reported on 2 july. deaths are often reported as occurring "after contracting the swine flu virus" without flu being necessarily the cause of death of people with underlying health problems. researchers at imperial college london said in july 2009 that the best estimate was that about 0.5% of those who get swine flu bad enough to seek medical help die from it, a figure very similar to the estimate for seasonal influenza. cases by region figures for laboratory confirmed cases in england and scotland are as of 2 july 2009, after which routine testing was discontinued. deaths are of people with swine flu, not necessarily caused by swine flu. region cases laboratory confirmed† confirmeddeaths totals 28,456 392 england 19,995 279 northern ireland 1,355 18 scotland 6,450 67 wales 656 28 † the cumulative total number of cases, including patients who have recovered. laboratory-confirmed cases of ah1n1 influenza in the united kingdom up to 2 july 2009 health protection agency update bulletins uk weekly gp consultations for influenza-like illness. qresearch data from health protection agency detailed reports on 25 april 2009, a member of british airways cabin crew was taken to northwick park hospital in harrow and quarantined after falling ill with flu-like symptoms on a flight from mexico city though he was later found not to have swine flu. on 26 april, two people were admitted to monklands hospital in airdrie, north lanarkshire, with mild flu-like symptoms after returning from mexico. the next day, the cabinet secretary for health and wellbeing, nicola sturgeon, confirmed that these were cases of the swine influenza a (h1n1) virus. authorities in both scotland and england stated that there were no plans to trace the fellow airline passengers who may have travelled alongside the couple, since the authorities do not classify them as "close contacts". these cases along with one in spain are the first confirmed cases in europe. at noon on 29 april the government reported three more confirmed cases in the uk, including the first cases in england. all three had recently returned from mexico. the secondary school, paignton community and sports college, closed for seven days. by 26 may the number of people who had contracted the disease in-country increased to 125, the highest in europe and triple the second highest, spain. on 28 may, sixty four people connected with a primary school in birmingham were diagnosed with swine flu . on 8 june the hpa issued a report stating that the majority of cases are in school age children and young adults, which has not been the case in most pandemics with the notable exception of the 1918 flu pandemic. on 25 june the chief medical officer sir liam donaldson said certain areas were seeing rapid community spread which meant that it was no longer practical to attempt in those areas (initially parts of london, the west midlands and east berkshire) to put a ring around the outbreaks by tracing the people with whom confirmed cases have come into contact and giving them drugs to try to prevent flu developing. in these areas, anti-viral drugs may in the future only be given to people showing symptoms, and tracing of contacts will stop. the contingency plans always envisaged the containment phase would not last indefinitely. the start of the treatment (as against containment) approach was announced on 2 july 2009. every year in late june and early july the wimbledon tennis championships are held in london, attracting worldwide interest and with many hours of uk television coverage every day. on 1 july 2009 it was reported that 28 wimbledon staff had been asked to stay at home with flu-like symptoms. two named players are reported to have caught the virus. a study published in the august 2009 issue of the lancet (available on 20 july) suggests that prolonging the school holidays could reduce the spread of the virus by up to 17%. this would be disruptive, and would not reduce the overall number of infections, but could delay the spread and buy time for preparation of a vaccine. the government's advice is that schools should not be closed, but that the evidence will be reviewed in august as school summer holidays end. public information the department of health announced on 29 april 2009 that they intended to send an information leaflet on swine flu to every household in the uk. the information leaflets were distributed at the beginning of may. on 29 april, alan johnson announced that television and radio advice would also be broadcast starting on 30 april. the slogan "catch it, bin it, kill it" was used to encourage good hand and respiratory hygiene. on 30 april 2009, a swine flu information line was launched with advice on setting up "flu friends" (this is not the national flu line service mentioned below). the department of health pandemic plan (revised november 2007) states "uk health departments (directorate in scotland) will run a national door drop and advertising campaign in phase 5, alerting the public to the heightened risk, emphasising the need for personal preparation and socially responsible behaviour. a public information film will demonstrate how to slow the spread of the virus, and the national flu line service will be available. information materials will also be available through primary care, pharmacies and on the department of health website." after criticism of the lateness of its launch, it was announced in late july that the national flu line service was to be launched on 24 july 2009. there are government websites with general information and the latest updates on human swine flu in england, northern ireland, scotland, and wales. the hpa website includes frequently updated advice for the public, advice on exclusion from schools and workplaces (and a document specifically for schools), and information for health professionals. during the initial containment phase of the swine flu outbreak the hpa published detailed information in daily and weekly reports linked from its epidemiological data page on its website. on 2 july, when the policy of containment was dropped in favour of treatment of presumed cases, the daily updates of laboratory confirmed cases were stopped. a weekly epidemiological update and pandemic flu update are published each tuesday, with much detailed information including regional information and breakdown by age. control measures main article: prevention and treatment for the 2009 swine flu pandemic on 11 may 2009 uk epidemiologists at imperial college london considered that h1n1 swine flu was spreading fast enough to justify the preparations for a pandemic. it was showing "sustained human-to-human transmission", thereby justifying the who's pandemic phase 5 rating. it is estimated that on average each person who contracts flu passes it on to between 1.4 and 1.6 other people, no worse than the three influenza pandemics of the twentieth century. early analysis suggested that the spread was likely to be similar to the earlier pandemics. up to the date of the study, clinical severity was similar to 1957 and less than 1918 flu pandemic. however, the clinical severity of the outbreak and how the virus will evolve cannot yet be predicted. travel to and from affected areas on 27 april, the foreign & commonwealth office advised against all but essential travel to mexico and stated that british citizens in mexico... "may wish to consider whether they should remain in mexico at this time". on 28 april the mexican tourist board estimated that there were "a few thousand" british tourists in mexico. holiday companies thomas cook and airtours said that between them they had about "3,000 holidaymakers in mexico" as of 28 april 2009. the first british tourists being brought back early from mexico on 28 april 2009 told reporters that they had received little or no information about health precautions, either from the mexican authorities, hotels, or from local tour guides. a leaflet was being distributed at all ports of entry into the uk providing passengers arriving in the uk with information on swine flu. until 21 may hpa staff met travellers arriving from mexico. this was discontinued on 22 may, but advice remained that travellers from affected areas who become unwell within seven days of arrival, and contacts with symptoms of a confirmed or probable case, should stay at home and contact their gp or nhs direct. contact tracing of passengers deemed to be at risk of swine flu will be carried out on the basis of risk, as for other communicable diseases. preparations tamiflu, influenza anti-viral drug information, advice, and guidance both general and for specific cases (schools, workplaces) is being made available and updated by the hpa (see public information campaign section above). as of 13 june 2009 the government estimated that the uk has enough anti-viral drugs for 50% of the population but has plans to raise that figure to 80%. there is a pandemic plan covering topics from distributing the drugs and setting up helplines to closing schools and banning public events which was tested in a large exercise in 2007. there is also a specific response plan for london.