WIREDGOV

Young and middle aged adults bore the brunt of influenza this winter with more than 70 per cent of fatal cases hitting this age group, according to figures published by the Health Protection Agency (HPA) in their annual flu report yesterday.

Compared with other age groups, those aged between 15 and 64 years were also more likely to have visited their GPs with flu-like illness and their rates of admission to hospital were higher.

Across all age groups, 602 people in the UK were reported to the HPA as having died with a confirmed influenza infection during the 2010/11 season.

More than 70 per cent of those fatal cases - 415 - were in young and middle aged people aged 15-64 years. Around 20 per cent of confirmed deaths - 122 - were in the over 64s.

Across all age groups, almost 70 per cent (373 out of 555) of those who died this season were in a clinical 'at risk' group for vaccination. Information on vaccination history was available for just over half of the fatal cases and almost 75 per cent (229 out of 307) had not received the flu vaccine this year.

Among children, there were 25 reported deaths in those aged five to 14 years, 16 in children aged between one and four and nine in children less than a year old.

To date, nine pregnant women are reported to have died from flu this season.

Professor John Watson, head of the respiratory diseases department at the HPA, said: "The information published in our annual flu report confirms that seasonal flu activity in 2010/11 was higher than last winter and that H1N1 'swine' flu was the dominant strain. Sadly, a small proportion of flu cases resulted in serious illness and death, predominantly in young and middle aged adults.

"Each year hundreds of thousands of people catch flu and the majority will make a full recovery. Traditionally the elderly have been more seriously affected by winter flu but the picture is beginning to change as we are now seeing a higher proportion of young and middle aged people taken seriously ill."

Differences in the numbers of reported deaths are seen by country and region. This reflects not only the differing population sizes and profiles, but also variation in voluntary reporting systems.

Where information was available on the strain of infection, more than 90 per cent of these deaths (535 out of 582) were influenza A H1N1 'swine' flu. Influenza B infection was associated with 40 deaths.

A further 91 probable cases are still under investigation to confirm flu as the cause of death.

In England, just 50 per cent of adults under 65 who were in an 'at risk' group and eligible for flu vaccination last season received the vaccine, down slightly from the 2009/10 season. Among over 65s in England - all of whom are offered vaccination - 73 per cent accepted - up slightly from the previous year.

For the first time in 2010/11, flu vaccination was routinely offered to all pregnant women as they were disproportionally affected by the H1N1 strain during the pandemic and are more at risk of serious complications. Just 37 per cent of healthy pregnant women in England were vaccinated. Among pregnant women with underlying conditions, the figure was 57 per cent.

Professor Watson added: "We are very concerned that only half of adults eligible for the jab last winter took up the offer of vaccination, and particularly that just over a third of healthy pregnant women received it.

"For the majority of people with these conditions, flu is a preventable illness and ahead of the next flu season, a concerted effort must be made by healthcare professionals - including GPs and midwifes - to encourage those at risk to take up the offer vaccination. It is the best way to protect against flu."
Justin McCracken, HPA's chief executive, said: "Throughout the flu season, the HPA publishes a weekly flu report which provides 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.
"This national report of the 2010/11 season will help public health experts target and refine their plans for next winter, ultimately helping to prevent serious illness and deaths, particularly among those in 'at risk' groups. It's clear from this report that a focus on increasing vaccine uptake is a priority for the year ahead."

Notes to editors:

• The Health Protection Agency Annual Influenza Report 2010/11 is available from the press office under embargo and will be published on our website at 9am on Wednesday 25 May, 2011.  View report.
• Number of reported confirmed fatal influenza cases by region in the UK during  2010/11 influenza season, 1 September 2010 – 4 May 2011

• The mortality figures presented in this report represent only a proportion of those who may have died from flu or complications from flu, such as pneumonia, over the 2010/11 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. The excess all cause mortality figures for the 2010/11 season were 3,757 (95% confidence interval 3,340–4291), up from 2,963 (95% CI 2,696–3,230) in 2009/10 but less than 9,904 (95% CI) 9,637–10,171) in the 2008/09 season.
• During the pandemic H1N1 (2009) outbreak, 474 deaths were reported as being associated with the H1N1 ‘swine’ flu between June 2009 and April 2010 – 359 in England, 69 in Scotland, 28 in Wales and 18 in Northern Ireland. A number of deaths occurred in the spring/summer of 2009 but the majority (83%) occurred over the autumn/winter. Seventy-two per cent of fatal cases were reported to have an underlying risk factor for severe disease.
• The H1N1 (2009) virus 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 was not surprising to see H1N1 (2009) circulating in the 2010/11 winter season.
• This year's seasonal flu vaccine included a H1N1 (2009) component so that people who were vulnerable were protected against all the circulating strains. For the first time the seasonal vaccine was 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. 
• 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 longstay residential care homes, health care workers and carers.
• 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. 
• 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.
• Anyone suffering from flu can use NHS Direct colds and flu symptom checker available at www.nhs.uk/nhsdirect or call 0845 4647. For further information on flu go to:
  http://www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/SeasonalInfluenza/
• The Health Protection Agency is an independent UK organisation that was set up by the government in 2003 to protect the public from threats to their health from infectious diseases and environmental hazards.  It does this by providing advice and information to the general public, to health professionals such as doctors and nurses, and to national and local government. The Department of Health has announced its intention to transfer the functions of the HPA to Public Health England in 2012. To find out more, visit our website: www.hpa.org.uk
• For media enquiries please contact the national HPA press office at Colindale on 020 8327 7901 or email cfipressoffice@hpa.org.uk. Out of hours the duty press office can be contacted on 020 8200 4400.