Latest figures from the Health Protection Agency (HPA) indicate that levels of seasonal flu may be starting to peak in England, Wales and Scotland. This is to be interpreted with caution as the rate of consultations will have decreased owing to school and GP surgeries closing over the holiday period.

Influenza A H1N1 (2009) 'swine' flu and Influenza B remain the predominant strains circulating although sporadic cases of H3N2 have also been seen. A small proportion of flu cases are resulting in severe disease, particularly in people under the age of 65.

In the past week, the HPA has been notified of a further 11 people who have died with confirmed flu, bringing the total number since the flu season began in October this year to 50. 45 of these people died with the H1N1 (2009) strain and five with Influenza B. The majority were under 65 years of age - eight cases between 5-14, 33 cases aged between15-64 and four cases over 64. Since October there have been five deaths in children under the age of five.

This mortality data is presented to give a picture of the characteristics of those that have died and the number should not be interpreted as including all those who may have died from flu or complications from flu, such as pneumonia, over the season. Precise figures for flu related deaths each winter are not available but estimates based on excess all cause mortality figures are typically in the region of 0-5,000, predominantly in people over 65 years of age.

Where information is available on the fatal cases, 33 out of 48 (69 per cent) of those who have died were in a clinical 'at risk' group for vaccination. Where information on vaccine status was available for this season's trivalent vaccine, only three people out of 39 had received their jab. And only one person out of 34 had received last year's pandemic vaccine.

Professor John Watson, head of the respiratory diseases department at the HPA, said: "Our latest flu report suggests levels of people seeing their doctor for flu-like illness is peaking. We cannot say at present whether this is the peak as the figures are potentially skewed by the holiday period. We will have a better idea of the likely trend in the next couple of weeks.

"However flu is still circulating and we would urge those people in an at-risk group to have their seasonal flu vaccine as soon as possible as this is the best way to protect themselves from flu this winter.

"Although there were reports of many people during the pandemic only experiencing mild disease we can't stress enough that flu can be an extremely serious illness for people in 'at risk' groups, including pregnant women, the elderly and those with other underlying conditions such as heart problems, diabetes, lung, liver or renal diseases and those who have weakened immune systems.

"Most people with flu can 'self care' by taking plenty of rest, drinking lots of fluids and taking over the counter pain relievers such as paracetamol. But anyone displaying severe symptoms, particularly those in vulnerable groups should contact their GP or local out-of-hours service for medical advice.

Professor Watson continued: "It is important that people do all they can to reduce the spread of the virus and they can do this by maintaining good cough and hand hygiene, such as covering your nose and mouth with a tissue when you cough and sneeze, disposing of the tissue as soon as possible and cleaning your hands as soon you can. These are all important actions that can help prevent the spread of germs and reduce the risk of flu transmission."

Notes

1.Throughout the flu season the HPA publishes weekly figures on flu and flu-like illness on a Thursday afternoon via its weekly flu report. To view the latest report, visit the HPA website.

2.The Department of Health now publishes its Winterwatch report which reports on how well the NHS is coping with winter pressures and has practical advice. This can be found at the following link here.

3.The flu H1N1 (2009) virus, formerly known as 'swine flu', is now one of the group of seasonal flu viruses circulating around the world. Following a pandemic, it is often the case that the pandemic strain becomes the most common seasonal strain of influenza the next flu season, so it is not surprising to see H1N1 (2009) circulating this winter.

4.This year's seasonal flu vaccine includes a H1N1 2009 component so that people who are vulnerable are protected against all the circulating strains. For the first time the seasonal vaccine is being offered to pregnant women as they were disproportionally affected by the H1N1 (2009) strain during the pandemic and are more at risk of serious complications.

5.The seasonal flu vaccine is recommended for those aged 65 or over and those with the following conditions, regardless of age: chronic respiratory disease, heart disease, renal disease and chronic liver disease, diabetes requiring insulin or oral hypoglycaemic drugs, immunosuppression. Vaccination is also recommended for pregnant women, those living in long-stay residential care homes, health care workers and carers.

6.Symptoms of seasonal flu include sudden onset of fever, cough as well as sore throat, aching muscles and joints. The Department of Health has recently confirmed guidance on the use of antiviral drugs for the management of people who are displaying flu symptoms, this includes previously healthy people as well as those in 'at risk' groups.

7.Antivirals are drugs given to high risk patients who become ill with seasonal influenza. They are most effective if taken within 48 hours of onset and may help limit the impact of some symptoms and reduce the potential for serious complications. They are also used in some situations where it is important to help prevent people from getting influenza.

Source:
Health Protection Agency (HPA)