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Epidemiological report of pandemic (H1N1) 2009 in the UK: April 2009 - May 2010

Ronan Kelly

Retired 2020
This is the UK final report on the pandemic for the 2009-2010 season. Some exerpts;


P36: SEVERITY INDICATORS
HOSPITALISATION
The number of people reported to be hospitalised in NHS trusts in England with suspected pandemic (H1N1) 2009 showed two peaks similar to the other surveillance indicators. The highest hospitalisation rate was consistently in children aged less than 5 years. Between July 2009 and February 2010, when this surveillance system was operational, an overall cumulative rate of 221.7 per 100,000 population (95% CI 216.4 – 227.1) was observed in children under 5 years, which was 6 times higher than in the 16-64 year group (rate ratio 5.9, 95% CI 5.7 – 6.1). The rate in the under 5 year group peaked at 17.8 (95% CI 16.3 – 19.4) per 100,000 population in week 49 when it was 10 times higher (95% CI 8.9 – 11.2) than the rate in the 16-64 year age group.

A total of 2,831 patients were reported as hospitalised with confirmed pandemic (H1N1) 2009 infection in England from the beginning of the pandemic to April 2010 through the HPA/CMO reporting system in 129 acute hospital trusts (figure 26). Thirty-eight per cent of the cases were admitted in the summer pandemic wave. In total, 55.5% of hospitalised cases with available information were reported to have an underlying risk factor for severe disease including pregnancy and obesity[32].

In Northern Ireland there were 580 hospital admissions of confirmed pandemic (H1N1) 2009 of which 51 (8.8%) occurred during the first wave (weeks 21 – 35) (figure 25), with four admissions to ICU (3.9%) The proportion of admissions of confirmed cases to ICU in the second wave was 9.1%. While the weekly hospitalisation trend closely corresponded to sentinel consultation rates in the second wave this was less so during the first wave when there were comparatively few hospitalisations. Admission rates were highest in the 0-4 year age group (109.5 per 100,000) followed by the 5-14 age group (admission rate 51.5 per 100,000)[33].

In Scotland a total of 1542 patients were hospitalised with confirmed pandemic (H1N1) 2009 infection over the period of the pandemic. The peak week for admission was week 43 (ending 25 October 2009) (figure 26).
In Wales 423 patients were hospitalised with virologically confirmed pandemic (H1N1) 2009. Similar to Northern Ireland, there were few hospitalisations during the first pandemic wave; the peak of hospital admissions in Wales (by week of test) was week 44 (ending 1 November 2009) when there were 83 hospitalisations (figure 26).

....

MORTALITY
The first death due to pandemic (H1N1) 2009 in the UK occurred on 14 June 2009. A total of 474 deaths with confirmed pandemic (H1N1) 2009 (either laboratory confirmed or with mention on the death certificate) were reported in the UK up to 15 April 2010 (359 in England, 69 in Scotland, 18 in Northern Ireland and 28 in Wales). A number of deaths occurred in the spring/summer of 2009 but the majority (83%) occurred over the autumn/winter (figure 28). Seventy-two per cent of fatal cases were reported to have an underlying risk factor for severe disease[34].


....

RISK GROUPS
Data from the FF100 surveillance project showed that people with underlying medical conditions, such as chronic respiratory, neurological or heart disease were not at significantly greater risk of clinical infection in the early stages of the pandemic[21]. In England, people aged between 6 months and less than 65 years with an underlying condition were 10 times more likely to be hospitalised with confirmed pandemic (H1N1) 2009 infection compared to people of the same age without an underlying condition, and 18
times more likely to die from the infection[32;34].
The underlying conditions with the highest risk of hospitalisation with pandemic (H1N1) 2009 infection were immunosuppression, chronic renal disease and chronic neurological disease (including stroke)[32]. For death, the risks were highest for chronic neurological disease (excluding stroke), chronic liver disease and immunosuppression[34]. Pregnant women were not at an elevated risk of becoming cases, but were 5 times more likely to be hospitalised and seven times more likely to die, once infected, compared to females of child-bearing age (15-44 years) with no underlying condition (table 4)[34].

full report (2.7 MB) at; http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1284475321350
 
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