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HPA reports 10 deaths in UK from H1N1 flu in past six weeks
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All who died were adults aged younger than 65 years. Most had underlying health conditions, although a few were healthy, said John Watson, head of the agency’s respiratory diseases department. No pregnant women were among those who died; this group showed an excess number of deaths in the 2009 H1N1 pandemic.
In the five fatal cases for which vaccination information was available, none of the people had received the 2010-11 seasonal flu vaccine or the 2009 monovalent pandemic flu vaccine.
“Over the last few weeks we have seen a rise in the number of cases of seasonal flu, including both H1N1 (2009) and flu B, in the community,” Professor Watson reported. “We have also received reports of patients with serious illness requiring hospitalisation and outbreaks of flu in schools across the country.”
He added, “At present we are not seeing any hint of an overall excess of deaths due to influenza.
“But when young people become ill and require hospital treatment it is expected that we try to figure out what’s going on.”
From now on figures for flu will be reported on a weekly basis, as in any flu season.
Commenting on the deaths David Salisbury, director of immunisation at the Department of Health for England, said, “These figures demonstrate that the effects of flu are not to be underestimated. It is not the same as getting a cold and can seriously affect health.”
Most people infected with the currently circulating flu strains, including H1N1 (2009), develop mild, self limiting illness that typically lasts 7-10 days, Professor Watson said. “However, it can be far more dangerous for those in at-risk groups, such as the elderly, pregnant women, and patients with heart problems, diabetes, or lung, liver, or renal diseases or those who have weak immune systems who are at risk of developing complications.”
In response to the recent deaths of younger adults from flu the health department has issued a reminder to people in groups at risk that they should have the seasonal flu vaccination.
The seasonal vaccine for 2010-11 protects against the three commonest flu viruses currently circulating around the world, including H1N1 (2009). Pandemic flu strains often become the most common seasonal strain in the next flu season, so it is not surprising that H1N1 is circulating this winter.
The health department has reported slightly fewer people receiving the seasonal flu vaccine this year than last. Figures to the end of November showed that 66% of people aged over 65 had received the vaccination, down slightly from 68% at the same time last year; 40% of under 65s in at-risk groups had been vaccinated, down from 45% last year.
A statement from the department in response to lower than usual flu vaccination rates in October said that the slight drop may be due to “people being unnecessarily concerned about the jab containing swine flu vaccine.”
Professor Watson explained that the seasonal vaccine differs from the pandemic H1N1 vaccine. The pandemic vaccine was a monovalent vaccine containing H1N1 and an adjuvant. The adjuvant may have made the vaccine more reactogenic, which may explain the reports of adverse reactions, he said. “The seasonal vaccine is a non-adjuvanted vaccine, prepared in the same way as the last 20 years, simply being updated with the latest circulating flu strains.”
The department wrote to GPs on 10 December advising on the use of antivirals for people at higher risk of complications from flu infection. The letter notes, “The most recent surveillance data from the Health Protection Agency indicate that there is now a substantial likelihood that people presenting with an influenza-like illness are infected with influenza virus.” On that basis, it says, oseltamivir or zanamivir are recommended for the prophylaxis and treatment of flu in people “at clinical risk” from seasonal flu, a group that now includes pregnant women.
Notes
Cite this as: BMJ 2010;341:c7206
Footnotes
- The latest weekly national influenza report is atwww.hpa.org.uk/web/HPAwebFile/HPAweb_C/1287146267647. The health department’s letter to GPs on use of antivirals is atwww.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalass
Please note: The bold and italics is my emphasis - please ensure you get the flu and any other vaccine needed and that should you get the flu, to ask your doctor about these vaccines and anti-virals. There is no need to feel more anxious about the winter flu, but merely to point out the importance of getting all the vaccines, including pneumovax and how important they are if you are taking corticosteroids or immunosuppressants and have a compromised immune system.
