UK: 2012-2013: HPA / PHE Weekly National Influenza Reports.

[Ronan Kelly]

PHE Weekly National Influenza Report
Summary of UK surveillance of influenza and other seasonal
respiratory illnesses
11 April 2013 – Week 15 report (up to week 14 data)

Influenza is continuing to circulate in England and outbreaks continue to be reported, particularly in care
homes. GPs may still prescribe antiviral medicines for the prophylaxis and treatment of influenza in
accordance with NICE guidance.
...
Virological surveillance
 In week 14 2013, 92 (12.4%) of the 743 respiratory specimens
reported to the English Respiratory Data Mart system were
positive for influenza (75 A unsubtyped, 41 A(H3), 10
A(H1N1)pdm09 and 10 B) compared to 16.0% in week 13
...
Severe disease surveillance
 In week 14 2013, 21 new admissions of confirmed influenza cases to ICU/HDU (13 A unknown subtype, four
A(H3N2), 3 B and one A(H1N1)pdm09) and two confirmed influenza deaths in ICU/HDU have been reported through
the national USISS mandatory ICU scheme across the UK (133 Trusts in England) (Figure 4). Twenty-seven new
hospitalised confirmed influenza cases have been reported through the USISS sentinel hospital network across
England (18 Trusts) (10 A(H3N2),seven B, six A(H1N1)pdm09, four A(unknown subtype).
 In week 13 2013 (which had one bank holiday), an estimated 9,280 all-cause deaths were registered in England and
Wales (source: Office for National Statistics). This is less than the 11,075 estimated death registrations in week 12
and below the 95% upper limit of expected death registrations for this time of year as calculated by the HPA.
 In week 14 2013, significant excess mortality above threshold was seen in 65+ year olds in England after correcting
ONS disaggregate data for reporting delay with the standardised EuroMOMO algorithm (Table 1). By region this
excess was localised to the North West. This excess coincides with continued circulating influenza and low
temperatures. This data is provisional due to the time delay in registration and the Easter bank holidays and so
numbers may vary from week to week.
...
http://www.hpa.org.uk/webc/HPAwebFil.../1317138680595

[Ronan Kelly]

PHE Weekly National Influenza Report
Summary of UK surveillance of influenza and other seasonal respiratory illnesses
18 April 2013 – Week 16 report (up to week 15 data)

Summary
Influenza is continuing to circulate in England and outbreaks continue to be reported, particularly in care homes. GPs may still prescribe antiviral medicines for the prophylaxis and treatment of influenza in accordance with NICE guidance.

 Overall weekly influenza GP consultation rates across the UK o In week 15 (ending 14 April 2013), overall weekly influenza GP consultations remained stable in England (5.4 per 100,000), Scotland (5.6 per 100,000) and Wales (7.0 per 100,000) and increased in Northern Ireland (41.6 per 100,000).
o In week 15 2013, the weekly proportion of NHS Direct calls for cold/flu and fever (5-14yrs) remained below their respective influenza thresholds of 1.6% and 11.7%.
o 19 new acute respiratory disease outbreaks have been reported in the past seven days. Eight had a virological result available (four influenza A (unsubtyped), one A(H3), one B, one A(H1N1)pdm09 and one hMPV).

 Virology
o 129 influenza positive detections (62 A(H3), 30 A subtype not known, 20 B and 17 A(H1N1)pdm09) were recorded through the DataMart scheme (overall positivity of 15.8% compared to 13.7% the previous week).
o The proportion of samples positive in DataMart (England) decreased for rhinovirus and remained stable for adenovirus, parainfluenza, RSV and hMPV.
o No influenza positive detections were recorded through the two English GP-based sentinel schemes in week 15.

 Disease severity and mortality
o 22 new admissions to ICU/HDU with confirmed influenza (10 A(subtype not known), nine A(H1N1)pdm09, two B and one A(H3N2) were reported through the USISS mandatory ICU surveillance scheme across the UK (140 Trusts in England) in week 15. 30 new hospitalised confirmed influenza cases have been reported through the USISS sentinel hospital network across England (21 Trusts).
o In week 15 2013, excess all-cause mortality was seen in England in 65+ year olds through the EuroMOMO algorithm. This data is provisional due to the time delay in death registration.

 International situation
o During week 14 2013, influenza activity in Europe continued to decline or had already returned to baseline levels; after more than three months of active transmission, the 2012/13 influenza season is waning and getting closer to its end.
o Influenza activity in North America continues to decrease.
o Low levels of influenza activity were reported across the tropical regions of the world and activity in countries of the southern hemisphere remains at inter-seasonal levels.
o Up to 15 April 2013, 60 cases of human infection with influenza A(H7N9) in China have been reported by ECDC. 13 of the cases have died, 44 are severe cases and three are mild cases.
...
-In week 15, 22 new admissions to ICU/HDU with confirmed influenza infection (10 A unknown subtype, nine
A(H1N1)pdm09, two B and one A(H3N2)) were reported across the UK (140/163 Trusts in England) through
the USISS mandatory ICU scheme (Figures 12 and 13). A total of 893 admissions (296 B, 267 A unknown
subtype, 168 A(H1N1)pdm09 and 162 A(H3N2)) have been reported since week 40 2012. One new
confirmed influenza death was reported in week 15 2013. One hundred and five confirmed influenza deaths
(34 A(H3N2), 31 B, 25 A(H1N1)pdm09 and 15 A unknown subtype) have been reported across the UK in
ICU/HDU since week 40 (Figure 12).
...
http://www.hpa.org.uk/webc/HPAwebFil.../1317138732188

[Ronan Kelly]

PHE Weekly National Influenza Report
Summary of UK surveillance of influenza and other seasonal
respiratory illnesses
25 April 2013 – Week 17 report (up to week 16 data)
...
Influenza is continuing to circulate in England and outbreaks continue to be reported. GPs may still
prescribe antiviral medicines for the prophylaxis and treatment of influenza in accordance with NICE
guidance.

...
Community surveillance
 GP consultation rates for influenza-like illness remain low in all schemes in the UK
...
Virological surveillance
 In week 16 2013, 65 (8.5%) of the 761 respiratory specimens
reported to the English Respiratory Data Mart system were
positive for influenza (30 A(H3), 16 A unsubtyped, 12 B and 7
A(H1N1)pdm09) compared to 15.5% in week 15 (Figure 3).
 Positivity remained stable for rhinovirus (10.0%), parainfluenza
(7.7%), hMPV (6.5%), adenovirus (4.2%) and RSV (1.2%).
...
Outbreak Reporting
 9 new acute respiratory outbreaks have been reported in the past week across the UK (seven in care homes
and two in hospitals). Six had a virological result available (five influenza A(unsubtyped) and one B).
...
Severe disease surveillance
 In week 16, 22 new admissions of confirmed influenza cases to ICU/HDU (13 A unknown subtype, six A(H3N2), two
A(H1N1)pdm09) and one B and one confirmed influenza death in ICU/HDU have been reported through the national
USISS mandatory ICU scheme across the UK (145 Trusts in England) (Figure 4). Fifteen new hospitalised confirmed
influenza cases have been reported through the USISS sentinel hospital network across England (23 Trusts) (five
A(H3N2), four B, three A(H1N1)pdm09, three A(unknown subtype).

In week 15 2013, an estimated 12,147 all-cause deaths were registered in England and Wales (source: Office for
National Statistics). This is more than the 10,890 estimated death registrations in week 14 (which had one bank
holiday) and above the 95% upper limit of expected death registrations for this time of year as calculated by PHE.

 In week 16 2013, significant excess mortality above threshold was seen in 65+ year olds in England after correcting
ONS disaggregate data for reporting delay with the standardised EuroMOMO algorithm in most regions (Table 1).
This excess coincides with continued circulating influenza. This data is provisional due to the time delay in registration
and so numbers may vary from week to week.
...
http://www.hpa.org.uk/webc/HPAwebFil.../1317138804852

[Ronan Kelly]

PHE Weekly National Influenza Report
Summary of UK surveillance of influenza and other seasonal respiratory illnesses
02 May 2013 – Week 18 report (up to week 17 data)

Summary
Indicators of influenza activity have remained stable or decreased compared to the previous week. GPs may still prescribe antiviral medicines for the prophylaxis and treatment of influenza in accordance with NICE guidance.

 Overall weekly influenza GP consultation rates across the UK o In week 17 (ending 28 April 2013), overall weekly influenza GP consultations remained stable in England (5.2 per 100,000) and Wales (5.8 per 100,000) and decreased in Scotland (11.4 per 100,000) and Northern Ireland (19.4 per 100,000).
o In week 17 2013, the weekly proportion of NHS Direct calls for cold/flu and fever (5-14yrs) remained below their respective influenza thresholds of 1.6% and 11.7%.
o Eight new acute respiratory disease outbreaks have been reported in the past seven days. Four had a virological result available (four influenza A (unsubtyped)).

 Virology
o 31 influenza positive detections (16 A(H3), six B, six A(H1N1)pdm09 and three A subtype not known) were recorded through the DataMart scheme (overall positivity of 4.9% compared to 8.5% the previous week).
o The proportion of samples positive in DataMart (England) remained stable for rhinovirus, adenovirus, parainfluenza, RSV and hMPV.
o No samples were tested for influenza through the two English GP-based sentinel schemes in week 17.

 Disease severity and mortality
o 12 new admissions to ICU/HDU with confirmed influenza (five A(subtype not known), three B, two A(H1N1)pdm09 and two A(H3N2) were reported through the USISS mandatory ICU surveillance scheme across the UK (129 Trusts in England) in week 17. Ten new hospitalised confirmed influenza cases have been reported through the USISS sentinel hospital network across England (28 Trusts).
o In week 17 2013, excess all-cause mortality was seen in England in 65+ year olds through the EuroMOMO algorithm. This data is provisional due to the time delay in death registration.
...
-In week 17, 12 new admissions to ICU/HDU with confirmed influenza infection (five A unknown subtype, three B,
two A(H1N1)pdm09 and two A(H3N2)) were reported across the UK (129/163 Trusts in England) through the
USISS mandatory ICU scheme (Figures 12 and 13). A total of 934 admissions (303 B, 287 A unknown subtype,
173 A(H1N1)pdm09 and 171 A(H3N2)) have been reported since week 40 2012. One new confirmed influenza
death was reported in week 17 2013. One hundred and seven confirmed influenza deaths (35 A(H3N2), 31 B, 26
A(H1N1)pdm09 and 15 A unknown subtype) have been reported across the UK in ICU/HDU since week 40
(Figure 12).
...
http://www.hpa.org.uk/webc/HPAwebFil.../1317138867042

[Ronan Kelly]

PHE Weekly National Influenza Report
Summary of UK surveillance of influenza and other seasonal
respiratory illnesses
23 May 2013 – Week 21 report (up to week 20 data)

Indicators of influenza activity are low. GPs may no longer prescribe antiviral medicines for the
prophylaxis and treatment of influenza in accordance with NICE guidance.

Community surveillance
 GP consultation rates for influenza-like illness remain low in all schemes in the UK
...
Virological surveillance
 In week 20 2013, four (0.6%) of the 676 respiratory specimens
reported to the English Respiratory Data Mart system were
positive for influenza (2 B, 1 A(H3) and 1 A(H1N1)pdm09)
compared to 3.0% in week 19 (Figure 3).
 Positivity remained stable for rhinovirus (16.4%), parainfluenza
(9.7%), hMPV (5.3%), adenovirus (4.9%) and RSV (1.7%).
 0/10 samples tested through the English GP-based sentinel
schemes in week 20 were positive for influenza (compared to a
positivity of 17.6% in week 19). 0/13 samples from Scotland were
positive for influenza and no samples were received through the
Northern Ireland and Welsh schemes.
...
Outbreak Reporting
 Three new acute respiratory outbreaks have been reported in the past week from the West Midlands in care
homes. One had a virological result available (one A(unsubtyped).
...
Severe disease surveillance
 In week 20, one new admission of confirmed influenza cases to ICU/HDU (one A(H1N1)pdm09) and no confirmed
influenza deaths in ICU/HDU have been reported through the national USISS mandatory ICU scheme across the UK
(126 Trusts in England) (Figure 4). One new hospitalised confirmed influenza case has been reported through the
USISS sentinel hospital network across England (18 Trusts) (one A(unknown subtype)).
 In week 19 2013 (including one bank holiday), an estimated 8,814 all-cause deaths were registered in England and
Wales (source: Office for National Statistics). This is less than the 10,169 estimated death registrations in week 18
and is below the 95% upper limit of expected death registrations for this time of year as calculated by PHE.
 In week 20 2013, significant excess mortality just above threshold was seen in 65+ year olds in England after
correcting ONS disaggregate data for reporting delay with the standardised EuroMOMO algorithm in most regions
(Table 1). This data is provisional due to the time delay in registration and so numbers may vary from week to week.
...
http://www.hpa.org.uk/webc/HPAwebFil.../1317139048898