Pregnant women and young children most at risk as swine flu cases hit 100,000

Under-fives and pregnant women are emerging as key swine flu risk groups, according to hospital figures and the age profiles of those who have already died.

The Health Protection Agency (HPA) altered its advice this week to include the youngest age range – the under-fives – in the category of those "predominantly affected" while the Royal College of Midwives gave fresh advice todayon giving expectant women anti-viral drugs.

The shift in emphasis by health officials is a reminder that even if the final death rates from the pandemic are the same as normal seasonal flu, the social impact will be significantly different, with the disease apparently targeting the young more than elderly people. In normal seasonal flu it is the elderly who usually succumb through developing pneumonia.

Altogether, 29 people have died from swine flu in the UK. A patient from Swindon and a female tourist who died in Scotland after being admitted to hospital three weeks ago are among recent deaths. Figures from the West Midlands show that at one stage this month 23 of the 79 patients receiving treatment in hospital for swine flu were less than five years old.

On Thursday the chief medical officer, Sir Liam Donaldson, produced statistics showing that under-fives were three times more likely to need inpatient care than those in other age groups.

At least five of those who died are known to have been young children or babies. The NHS in London today confirmed that a baby less than six months old was among the fatalities. Some, like nine-year-old Asmaa Hussain, from Dewsbury, who suffered from epilepsy, had other prior conditions.

The Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists issued joint advice on prescribing anti-virals, suggesting that pregnant women with flu symptoms be given a course of Relenza, using an inhaler.

"It is recommended for pregnant women because it easily reaches the throat and lungs, where it is needed, and does not reach significant levels in the blood or placenta," the advice said. "This has the theoretical advantage of not affecting the pregnancy or the growing baby." It added: "A few cases of severe illnesses among pregnant women and infants have been reported in the UK and from other countries. These have mostly affected women with pre-existing health problems. In previous pandemics, and in reports from some countries in this pandemic, there is evidence that pregnancy can increase the risk for influenza complications for the mother and the foetus."

As many as 100,000 people may now have contracted swine flu in the UK, according to estimates by the Health Protection Agency.

Fears that meningitis could be confused with swine flu were raised today after news that Gemma Drury, 17, of Brimington, Chesterfield, was first diagnosed with swine flu but then rushed to hospital with meningitis days later.

The Department for Children, Schools and Families said today that some schools and nurseries might not open as usual at the start of the autumn term.

The Department of Health dismissed fears that the threat of high death rates could endanger the international supply of vaccines. The UK has ordered 132m doses of vaccine, sufficient for all the UK population. The first doses could be ready as early as August.

Italy yesterday advised its citizens to take extra precautions when travelling to Britain. Italy's health ministry said travellers should first visit their doctor to see if they have any conditions that put them at risk, and should avoid crowded places.