Weekly pandemic flu media update
29 October 2009
KEY POINTS
The flu-like illness rate in England from the Royal College of General Practitioners (RCGP) scheme increased to 42.8 per 100,000 in week 43 compared to 39.1 in week 42. An increase was seen in all age groups.
The main burden of flu-like illness nationally is in the 1-4 and 5-14 years age groups.
This week, the antiviral collection numbers in the National Pandemic Flu Service have continued to increase and this has been seen in all age groups. The largest increase (49%) in week 43, compared with week 42, was seen in the 1-4 year olds.
Interpretation of data to produce estimates on the number of new cases continues to be subject to a considerable amount of uncertainty. HPA modelling gives an estimate of 78,000 new cases in England last week (range 39,000 to 169,000). This represents a 56% increase on the previous week.
This estimate incorporates data from National Pandemic Flu Service and GP consultations.
The HPA estimates a cumulative total number of cases of 521,000 since the pandemic began.
A more detailed UK weekly epidemiology update can be accessed at:
CLINICAL INDICATORS
Clinical data are obtained from GP surgeries that report the weekly and daily consultations for flu-like illness and other acute respiratory illness.
Current estimated weekly Royal College of General Practitioners (RCGP) consultation rates of flu-like illness
From a network of approximately 100 general practices covering a population of approximately 900,000 with an equal distribution within each of three defined reporting regions; North, Central and South.
In week 43 (ending 25 October) GP consultation rates for flu-like illness in England increased compared to the previous week (39.1 per 100,000 in week 42 to 42.8 per 100,000 in week 43). This is now above the baseline threshold of 30/100,000.
Figure 1: Current estimated weekly RCGP consultation rates of flu-like illness

QSurveillance?
Set up by the University of Nottingham and EMIS (the main supplier of general practice computer systems within the UK) in collaboration with the Health Protection Agency. QSurveillance? is a not-for-profit network over 3,300 general practices covering a total population of almost 22 million patients (> 25% of the UK population).
The weekly QSurveillance? flu-like illness consultation rate continued to show a gradual rise from 37.4 per 100,000 in week 42 to 49.2 per 100,000 in week 43. The weekly rate for flu-like illness in all SHA regions and all age groups also showed a continuing rise.
NB: QSurveillance? is based on data from 43% of England's population (about 3000 practices), 10% of the population in Wales, 17% in Northern Ireland, and 0% in Scotland.
Figure 2: QSurveillance? - weekly consultation rate for flu-like illness in England, Wales and Northern Ireland (all ages)

Figure 3: QSurveillance? - weekly consultation rate for influenza-like illness by English SHA (all ages)

Figure 4: QSurveillance influenza-like illness rate by age band in week 43 (ending 25 October)

The latest weekly flu-like illness rates show that the highest flu-like illness consultation rates were in the 1-4 and 5-14 year-old age groups. Compared with week 42 this week (week 43) rates have increased in all age groups, particularly in the <1 (40.0 to 67.3 per 100,000) and 1-4 year olds (54.2 to 89.4 per 100,000)
VIRAL CHARACTERISTICS
To date (as of 28 October 2009) 2,050 viruses have been analysed by the Centre for Infections for the genetic marker commonly associated with resistance to oseltamivir in seasonal H1N1 flu (H274Y). Three viruses have been found to carry this marker in the UK. In addition, 292 specimens have been fully tested for susceptibility.
The Agency is continually assessing its advice to government on health protection policies such as antiviral use. Currently there is no requirement to change existing guidance.
There have been no significant changes in the virus.
SEVERITY
Disease severity continues to be monitored. The disease is generally mild in most people so far, but is proving severe in a small minority of cases.
Swine flu hospitalisations in England: 751 patients (currently hospitalised as of 8am on 28 October).
Deaths - the number of deaths related to swine flu in England is 97 (This figure represents the number of deaths in individuals with swine flu but does not represent the number of deaths that can be attributed to swine flu).
Confirmed global deaths reported by ECDC (Update 17:00 CEST 28 October 2009) - 5,938
29 October 2009
KEY POINTS
The flu-like illness rate in England from the Royal College of General Practitioners (RCGP) scheme increased to 42.8 per 100,000 in week 43 compared to 39.1 in week 42. An increase was seen in all age groups.
The main burden of flu-like illness nationally is in the 1-4 and 5-14 years age groups.
This week, the antiviral collection numbers in the National Pandemic Flu Service have continued to increase and this has been seen in all age groups. The largest increase (49%) in week 43, compared with week 42, was seen in the 1-4 year olds.
Interpretation of data to produce estimates on the number of new cases continues to be subject to a considerable amount of uncertainty. HPA modelling gives an estimate of 78,000 new cases in England last week (range 39,000 to 169,000). This represents a 56% increase on the previous week.
This estimate incorporates data from National Pandemic Flu Service and GP consultations.
The HPA estimates a cumulative total number of cases of 521,000 since the pandemic began.
A more detailed UK weekly epidemiology update can be accessed at:
CLINICAL INDICATORS
Clinical data are obtained from GP surgeries that report the weekly and daily consultations for flu-like illness and other acute respiratory illness.
Current estimated weekly Royal College of General Practitioners (RCGP) consultation rates of flu-like illness
From a network of approximately 100 general practices covering a population of approximately 900,000 with an equal distribution within each of three defined reporting regions; North, Central and South.
In week 43 (ending 25 October) GP consultation rates for flu-like illness in England increased compared to the previous week (39.1 per 100,000 in week 42 to 42.8 per 100,000 in week 43). This is now above the baseline threshold of 30/100,000.
Figure 1: Current estimated weekly RCGP consultation rates of flu-like illness

QSurveillance?
Set up by the University of Nottingham and EMIS (the main supplier of general practice computer systems within the UK) in collaboration with the Health Protection Agency. QSurveillance? is a not-for-profit network over 3,300 general practices covering a total population of almost 22 million patients (> 25% of the UK population).
The weekly QSurveillance? flu-like illness consultation rate continued to show a gradual rise from 37.4 per 100,000 in week 42 to 49.2 per 100,000 in week 43. The weekly rate for flu-like illness in all SHA regions and all age groups also showed a continuing rise.
NB: QSurveillance? is based on data from 43% of England's population (about 3000 practices), 10% of the population in Wales, 17% in Northern Ireland, and 0% in Scotland.
Figure 2: QSurveillance? - weekly consultation rate for flu-like illness in England, Wales and Northern Ireland (all ages)

Figure 3: QSurveillance? - weekly consultation rate for influenza-like illness by English SHA (all ages)

Figure 4: QSurveillance influenza-like illness rate by age band in week 43 (ending 25 October)

The latest weekly flu-like illness rates show that the highest flu-like illness consultation rates were in the 1-4 and 5-14 year-old age groups. Compared with week 42 this week (week 43) rates have increased in all age groups, particularly in the <1 (40.0 to 67.3 per 100,000) and 1-4 year olds (54.2 to 89.4 per 100,000)
VIRAL CHARACTERISTICS
To date (as of 28 October 2009) 2,050 viruses have been analysed by the Centre for Infections for the genetic marker commonly associated with resistance to oseltamivir in seasonal H1N1 flu (H274Y). Three viruses have been found to carry this marker in the UK. In addition, 292 specimens have been fully tested for susceptibility.
The Agency is continually assessing its advice to government on health protection policies such as antiviral use. Currently there is no requirement to change existing guidance.
There have been no significant changes in the virus.
SEVERITY
Disease severity continues to be monitored. The disease is generally mild in most people so far, but is proving severe in a small minority of cases.
Swine flu hospitalisations in England: 751 patients (currently hospitalised as of 8am on 28 October).
Deaths - the number of deaths related to swine flu in England is 97 (This figure represents the number of deaths in individuals with swine flu but does not represent the number of deaths that can be attributed to swine flu).
Confirmed global deaths reported by ECDC (Update 17:00 CEST 28 October 2009) - 5,938