# 5135
Over the weekend the British press has carried a number of stories about an `unexpected’ spate of flu deaths in the UK, presumably from the H1N1 virus.
A few of the headlines include:
Swine flu alert after 10 deaths revealed in UK Wales Online
Swine flu: Ten deaths raise fears of a new epidemic Daily Mail
Swine flu on march again: 10 die in new bug outbreak Daily Star
The Independent gave us a headline that read:
But when you read the actual story, the `shock’ mentioned in the headline is watered down to `a little surprised’, based on this quote from Dr. John Watson, head of respiratory diseases at the Health Protection Agency.
"I am a little surprised to see as much activity as we seem to be seeing – both in terms of its spread in the community and its severity. I don't see it as being extraordinary but it is more than I would have expected."
My nominee for the Creative Headline Award comes from this side of the pond, however, with this entry from New York’s Daily News (complete with an undated photo of high school students in Spain wearing face masks).
Swine flu kills 10 in Britain; sparks fear of another pandemic in 2011
Just for the record . . . nowhere in this article does any official express concern over H1N1 sparking another pandemic in 2011.
All of this sound and fury has emanated from the latest influenza report from the UK’s HPA Weekly National Influenza Report Week 49 (9 December, 2010).
The actual contents of this report – save a single paragraph briefly reporting 10 deaths over the past 6 weeks – describes an increasing – but relatively low level - of influenza activity across the UK and the globe.
A few excerpts from the Summary, and then a look at the 10 fatalities that have caused a stir in the media.
Summary
- Influenza activity is increasing across the UK. Although GP consultation rates remain low, several outbreaks and severe, hospitalised cases have been reported.
- In week 48 (ending 5 December), the weekly influenza/influenza-like illness (ILI) consultation rates increased slightly in England (13.3 per 100,000) and Wales (10.5 per 100,000), while decreasing in Scotland (28.8 per 100,000) and Northern Ireland (21.0 per 100,000). All GP consultation rates are within baseline levels. Consultation rates for acute bronchitis and pneumonia slightly increased.
<SNIP>
- Worldwide, influenza activity remains low, except in areas of South Asia and central and western Africa, which have seen recent surges in influenza H1N1 (2009) virus detections. Most countries in the temperate zone of the northern hemisphere continued to report low activity levels. Except for a few countries in Southeast Asia, most countries in the tropics of the Americas and Asia have recently reported low levels of influenza activity. Globally, there continued to be co-circulation of influenza H1N1 (2009), A(H3N2), B viruses, with the latter two being predominant.
If there is an operative word in this summary, it is surely `Low’, referring to the level of influenza generally being reported around the world.
When you compare the ILI consultation rates of this year against last year, you can see a considerable difference.
Buried well down the report, we get a report on mortality rates in the UK, which seems to have sparked this renewed interest in swine flu.
Disease severity and mortality data
HPA receives weekly death registrations from the Office for National Statistics. In week 47, an estimated 9,473 all-cause deaths were registered, which was increased slightly from 9,437 in week 46. This remains within expected levels for the time of year (figure 8).
Several severe cases of influenza have been reported in the last two weeks resulting in an increase in ITU-bed occupancy and in the provision of beds used for Extra-Corporeal Membrane Oxygenation (ECMO). The majority of these patients are aged under 65 years. Since week 36, ten deaths associated with influenza infection have been reported in the UK. None of the five fatal cases with information available had received the 2010/11 seasonal influenza, or the 2009 monovalent pandemic influenza vaccine.
Some newspapers have erroneously interpreted the above as saying that half of the fatal cases had been vaccinated. The vaccination status of only 5 are known, and of those, none had received the vaccine.
While 10 influenza deaths is certainly regrettable, in a country of 60 million people, it is hardly unexpected.
The H1N1 pandemic has ended, but the virus continues pretty much unchanged. And that means the H1N1 virus still has a predilection for those under the age of 65.
What has changed is that over the past 18 months, much of the world has been either exposed to the virus, or has received a vaccination, leading to a certain level of community or `herd’ immunity.
Therefore the new H1N1 virus is expected to act (actually, spread) more like a seasonal flu than a pandemic virus.
But it is important to remember that seasonal flu kills hundreds of thousands of people every year around the globe.
The ending of the pandemic wasn’t an all-clear signal, that the threat was gone. Only that the incidence of H1N1 outbreaks is expected be more in line with what is seen during a non-pandemic season.
This year, however, we have three strains of flu to contend with. The remnants of the H1N1 pandemic, the newly emerging H3N2 virus, and a nasty B virus as well.
So while somewhat hyperbolic, with the height of the flu season presumably still ahead, hopefully these news headlines will inspire more people to get vaccinated.
