Winter Pressure on Intensive Care Units as Flu Rates Rise

Peter Russell

January 21, 2019

Moderate increases of flu this winter are having a high impact on hospital intensive care unit and high dependency unit admissions, latest figures showed.

GPs reported increases in consultations with patients reporting flu-like symptoms in the second week of January, while admission rates for suspected flu were having a medium impact on hospitals overall.

This season's flu vaccine appears to be well-matched to strains circulating in the community, health officials said.

Flu Surveillance Report

The latest weekly figure from Public Health England (PHE) showed that compared with the previous week:

  • GP consultations with flu-like illness increased from 14.8 to 19.2 per 100,000

  • Hospital admission rates rose from 3.54 to 4.75 per 100,000

  • Intensive care admission rates increased from 0.42 to 0.50 per 100,000

Rates of influenza-like illness remained below the baseline threshold in Scotland, were at low intensity levels for Northern Ireland, and at medium intensity levels in Wales.

GP consultation rates for flu-like symptoms per 100,000 were 25.6 in Scotland, 20.4 in Wales, and 18.9 in Northern Ireland.

The surveillance report also showed no statistically significant excess all-cause mortality either in the community overall or within any age group.

Subtype A Viruses Predominant

Influenza A(H1N1)pdm09 was the dominant circulating subtype, microbiological surveillance showed.

Among 640 patient samples in secondary care, 41.9% tested positive for influenza A(H1N1)pdm09, 17% for influenza A(H3), 40.1% for influenza A (not subtyped), and 0.5% for influenza B.

Richard Pebody, head of flu at PHE said: "In the last week, there have been small increases to both hospital and intensive care admission rates, meaning flu is starting to have a greater impact. These rises are typical for this time of year.

"We are currently seeing mainly A(H1N1)pdm09 circulating, which is well matched to the strains in this year's flu vaccines."
 

Flu Vaccine Uptake

Provisional figures showed that the proportion of people in targeted groups in England who had received the influenza vaccine was 45.7% in under 65 year olds in a clinical risk group, 44.2% in pregnant women, and 70.5% in people aged 65 and over.

This year, for the first time, people in the 65+ age group were offered the newly available adjuvanted trivalent influenza vaccine to increase immune response, although pharmacists reported supply difficulties in the early part of the season.

People in the younger at-risk groups were offered a quadrivalent influenza vaccine.

For children of school years reception to year 5, uptake ranged between 43.7% and 49.6%, provisional figures for the month ending 30th November 2018 showed.

The Royal College of GPs (RCGP) said it was not too late for people with underlying conditions to be vaccinated. Prof Helen Stokes-Lampard, RCGP chair, said: "It’s encouraging to see confirmation that this year's vaccine is well-matched to the circulating strains of flu, so we're confident that those eligible for the jab are getting the protection they need, but there are still at-risk patients who haven't had it, and flu can sometimes spread until early spring."

Vaccination Among Frontline Health Workers

PHE figures showed that 61% of eligible frontline healthcare workers had received the flu vaccine by the end of November 2018, an increase of 1.7% (or 36,992 staff) compared to the same period the previous year.

Although coverage was significantly below the national target of 75% uptake among frontline health workers, this season's overall figure marks a significant improvement on the 50.6% coverage seen in 2015-16.

Last month, NHS Employers said that 36 trusts in England had achieved the national target. It said more up-to-date figures would be released on Thursday.

In a response earlier this month to the Commons Science and Technology Committee Report on Flu Vaccination in England, the Department of Health and Social Care (DHSC) agreed that the current variation between trusts in vaccinating healthcare workers for flu was "unacceptable".

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