Latest figures from the Health Protection Agency (HPA) indicate a mixed picture of flu activity across the UK. Some indicators are suggesting that the level of flu activity is beginning to plateau but this should be interpreted with caution as we are still monitoring data collected over the Christmas and New Year period when the rate of consultations will have been lower due to closure of school and GP surgeries.

Influenza A H1N1 (2009) 'swine' flu and Influenza B remain the predominant strains circulating although sporadic cases of H3N2 have also been reported. 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 confirmed a further 62 deaths from flu across the UK, bringing the total number since the flu season began in October this year to 112. Most of these deaths did not occur in the past week - a substantial number of these 62 deaths occurred in December but due to the backlog over the seasonal holiday period they have only been confirmed this week.

This mortality data is collected by the HPA in order to understand the key characteristics of the groups that have been affected by flu and provide vital information to front line clinicians and the Department of Health to enable them to make the best decisions on how to prevent, treat and manage flu over the course of a season.

These figures represent only a proportion of those who may have died from flu or complications from flu, such as pneumonia, over the current flu 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.

Of the 112 confirmed deaths, 95 had the H1N1 (2009) strain, five Influenza B and 12 remain untyped. The majority of those who died were under 65 years of age - nine were aged 5-14, 70 were 15-64 and 16 cases were in people aged 65 and over. Since October there have been six deaths in children under the age of five.

Where information is available on the fatal cases, 63 out of 81 (78 per cent) were in a clinical 'at risk' group for vaccination. Where information on vaccine status was available for this season's trivalent vaccine, 40 out of 47 had not received their jab this season.

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 beginning to plateau but this may be skewed by the recent holiday period.

"Flu is still circulating in the community and the message remains that those people in an at-risk group should have their seasonal flu vaccine as soon as possible as this is the best way to protect themselves from flu this winter.

"Flu is an unpleasant but self-limiting illness for most people but we can't stress enough how it 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.

"Ongoing HPA surveillance has this week indicated a modest increase in cases of some invasive bacterial infections such as pneumococcal and meningococcal disease and invasive Group A streptococcal Infection (iGAS) which may follow on from or be associated with influenza. Although we expect to see more cases of these bacterial infections during the winter months the HPA is monitoring the situation closely and currently investigating whether co-infection with flu is contributing to these increases.

"As a result of this surveillance, the Chief Medical Officer has this week reminded front line clinicians to be aware of the signs and symptoms of certain bacterial infections and remain vigilant for the possibility of severe illness due to possible co-infection with influenza. The severity of these conditions means that prompt identification and treatment are essential."

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 published 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.

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 in 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. 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.

8. If you are suffering from flu you can use NHS Direct colds and flu symptom checker available here.

Source:
Health Protection Agency