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Expert says that hospitals are missing true extent of swine flu infection

The extent of swine flu infection in the UK is being underestimated because hospitals are not testing patients with respiratory illnesses for the virus, according to one of the world’s leading experts on the disease.

Professor Neil Ferguson, an epidemiologist at Imperial College London, and adviser to the Government and the World Health Organisation, said that serious cases of swine flu were almost certainly being missed because hospital surveillance was “almost non-existent”.

He said that there was anecdotal evidence of “significant numbers” of cases of severe respiratory illness in London, which should be checked in case they were caused by swine flu. Surveillance strategies needed to be rethought with the H1N1 virus apparently spreading widely.

The UK needed to learn from the approach taken in America, where the epidemic was much more advanced, Professor Ferguson said. “In the US, they’ve stopped trying to do individual case surveillance and they’re focusing on testing healthy young adults hospitalised with respiratory disease. That’s the direction we need to follow.”

While 557 cases had been officially confirmed, the true figure was several times higher and there was a danger that serious cases were not being picked up.

At least a dozen people have been reported to have needed hospital treatment for H1N1, though the Health Protection Agency could not provide confirmed statistics.

British GPs identified six cases last month not linked to known infections. Extrapolations suggest that between 500 and 1,000 people with swine flu consulted a doctor last month but were not tested. As only a minority of patients with mild flu-like illnesses see a GP, even that is an underestimate, and two to three times as many people have probably had swine flu.

At present, swine flu surveillance has concentrated on tracing the contacts of people known to have the virus.

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