The number of people with symptoms of swine flu has fallen dramatically in the past week, with growing signs that the recent outbreak may have peaked ahead of an expected second wave of infections later this year.

Official figures showed that the weekly consultation rate between doctors and patients suffering from flu-like infections had fallen almost to normal levels, but government scientists warned this is likely to be a temporary lull before a second outbreak occurs after schools re-open in September.

The Health Protection Agency estimated that there were about 30,000 new cases of swine flu last week, compared with more than 110,000 cases a week at the peak of the summer outbreak. But it emphasised that there were uncertainties in the estimates — the true figure for last week could lie anywhere between 15,000 and 85,000 new cases.

Last week also saw a sharp decline in the number of people with flu symptoms who sought consultations with GPs. The weekly average was 42 consultations per 100,000 people, just above the normal ‘base line’ of 30.

The decline in consultations occurred in all age groups and in all NHS primary care trusts in all regions of the country. No primary care trust reported an increase in the weekly rate of people seeing their GPs because of flu-like symptoms.

The confirmed number of people with swine flu who have died in England has risen from 27 to 36. Sir Liam Donaldson, the Government's Chief Medical Officer, said not all of the extra deaths occurred last week because of delays in reporting the figures, and that nothing significant could be read into the extra nine reported deaths.

“All the trends are indicating a further downward movement in the number of people infected with the H1N1 swine flu virus, and there are no signs that the virus is evolving into a more severe disease or becoming resistant to the anti-viral drugs being distributed to combat the infection,” Sir Liam said.

However, experts believe that a second wave of infections is highly likely later in the year, probably after children return to school, when the virus will have the opportunity to spread again. “We are pretty certain a second wave will come, but we're not clear when this will be,” Sir Liam said.

The Government will continue to plan for a mass vaccination campaign when such a vaccine becomes available, despite signs that the infection is relatively mild in the vast majority of people who are infected. “If you abandon this [mass vaccination] then you take the view that it's acceptable that a substantial number of people will die,” Sir Liam said.

Scientists at the Health Protection Agency's Respiratory Virus Unit in north London have now analysed 607 samples of the H1N1 virus for signs of drug resistance and none was found to be positive. A further 110 specimens were all found to be susceptible to Tamiflu and Relenza, the two anti-virals stockpiled by the Government.

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