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Speaking last week in central London at the launch of the DoH's national pandemic framework, CMO Sir Liam Donaldson, said that 'adding a strain of H5N1 into the seasonal flu vaccine is something that should be explored'.

Dr George Kassianos, RCGP immunisation spokesman and Berkshire GP, said that a UK-wide programme of immunisation was needed to protect against a pandemic.

'A lot of work has already been done into assessing whether a strain of H5N1 could be incorporated into the flu vaccination. It would be a very good move if the DoH could do this,' he said.

'Three flu strains go into the flu jab so you'd lose the strain with the lowest prevalence and replace it with the H5N1 strain.'

Losing the strain with the lowest prevalence means that people should still be protected from flu, said Dr Kassianos.

Dr Nigel Higson, a Brighton GP and virologist, agreed that H5N1 should be incorporated into the flu jab, but also stressed that it would not guarantee protection against a pandemic.

'H5N1 causes pandemic flu in birds but not in humans, although it has the potential to.

'We must not focus on the H5N1 strain as other strains have the ability to cause a pandemic,' he said.

'It is very important that every practice thinks about how it will respond to the threat and how it can maintain access to care.'

It is also vital that the DoH provides GPs with information that is rapid, trustworthy and appropriate, said Dr Higson.

It is good news that a pandemic framework has been launched by the DoH because it shows that it takes the issue seriously, he added.

The framework calls for a doubling of the stockpile of the antiviral drug Tamiflu to cover at least half of the UK population.

An order has also been made for 14.7 million cases of antibiotics to cover at-risk groups and to treat complications of flu such as pneumonia.

Dr Higson said that the antibiotics would be needed if a pandemic started.

A flu hotline will also be set up to help ease GP workload. If diagnosed with flu over the phone, patients would be given access to antiviral drugs.

Each patient would then receive a unique code to show that they had been prescribed the drugs. Only patients who are experiencing complications should consult their GP.

The framework acknowledges that GPs will be focused on dealing with the most seriously ill patients and recommends that community pharmacists be given wider powers to supply prescription-only medicines to ensure patients can continue to access their routine medications.

sanjay.tanday@haymarket.com

DoH National Framework for Influenza Pandemic 2007

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