Two further patients under investigation in England and one patient in Scotland have today been confirmed with swine flu, bringing the current total number of confirmed UK cases to 18.

Confirmed UK Cases as at 03 May 2009	Cases currently under laboratory investigation as at 17:00 02 May 2009
18	716*

* Cases currently under laboratory investigation change on a daily basis on account of some of those under assessment being discounted and new ones being introduced. The figure quoted above is correct at the time stated

Both cases in England are of school age, from the London region. The first case is a close contact of a person who had recently returned from Mexico. The second case had recently returned from the United States, where there is evidence of sustained human to human transmission.

In the first case - linked to a returned traveller from Mexico - school contacts (the same year group) are already receiving antivirals as a precautionary measure. According to guidance from the Health Protection Agency, the school has also been advised to close temporarily as a precautionary measure, initially for a period of seven days.

In the second case - the patient who had recently returned from the US - a thorough risk assessment has established no wider public health action is deemed to be required. No school closure is necessary as the patient did not attend school while symptomatic.

The Health Protection Agency is working to ensure that any close contacts of all patients who test positive for swine flu are offered antivirals as a precautionary measure. Close contacts are defined as those individuals who have been exposed to a probable or confirmed case within the previous seven days for longer than one hour and within a distance of one metre or less.

At this stage, with only a small number of cases of human to human transmission in the UK, this does not yet represent sustained human to human transmission. The cases of human to human transmission in the UK all had contact with individuals with illness and travel history to an affected area. The risk to the general public remains very low.

Outside of Mexico, the majority of cases have been mild and cases have responded positively to antiviral treatment.

Advice remains that individuals returning from affected areas who become unwell within seven days of their return should stay at home and contact their GP or NHS Direct on 0845 4647. Individuals will be assessed and, if necessary, testing and treatment will be provided.

The Health Protection Agency is providing expert advice and support to the UK government, NHS and other organisations. This includes:

Enhancing the Agency's presence at airports in England to provide all passengers arriving from Mexico with information and advice on swine flu.

A leaflet produced by the Health Protection Agency, the Department of Health and the UK Borders Agency is being made available at all ports of entry into the UK providing passengers arriving in the UK with information on swine flu.

Specialist liaison to the UK Embassy in Mexico to aid the UK effort to tackle swine flu.

In association with the College of General Practitioners (RCGP), the HPA has produced standard practical advice for healthcare professionals investigating individuals with possible swine influenza infection, including contact details of local health protection units.

Advice has been issued for schools. Measures including deciding to close temporarily or offer antivirals as a precautionary measure are only advised when a case is strongly suspected or confirmed within a school community. These decisions are a matter for local determination on a case by case basis by schools, working with the Health Protection Agency, NHS Primary Care Trusts and local authorities.

The World Health Organization (WHO) has raised its pandemic alert level to Phase 5. 'This is characterised by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that pandemic is imminent and that the time to finalise the organisation, communication and implementation of the planned mitigation measures is short'. The Agency is well prepared to meet the requirements of phase 5.

Anyone returning from affected areas who becomes unwell with flu-like symptoms within seven days of their return should stay at home and contact their GP by phone or ring NHS Direct on 0845 4647. Individuals will be assessed and, if necessary, testing and treatment will be provided. The Health Protection Agency will identify any close contacts as part of the assessment, and they will be given advice and, if necessary, antiviral drugs.

General infection control practices and good respiratory and hand hygiene can help to reduce transmission of all viruses, including human swine flu. This includes:

Covering your nose and mouth when coughing or sneezing, preferably with a tissue;

Disposing of dirty tissues promptly and carefully;

Maintaining good basic hygiene - washing hands frequently with soap and water to reduce the spread of the virus from your hands to face or to other people;

Cleaning hard surfaces (e.g. door handles) frequently using a normal cleaning product;

Making sure children follow this advice.

Ends

The Department of Health has set up a swine flu information line for the public on 0800 1 513 513.

Further information on swine flu is available on the Health Protection Agency's website atwww.hpa.org.uk.

The Department of Health has set up a swine flu information line for the public on 0800 1 513 513.

Copies of the leaflet being distributed at all ports of entry into the UK providing passengers arriving in the UK with information on swine flu are available at http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1240986139568.

For further information on this statement please contact the Health Protection Agency's Centre for Infections press office on:

Head of Press Office 020 8327 6647

Alexandra Baker 020 8327 7098

Louise Brown 020 8327 7080

Kate Swan 020 8327 7097