Current influenza activity in the United Kingdom: A/Fujian/411/2002
(H3N2)-like strains circulating in the community, week 44
Clinical indicators of influenza activity continue to rise
in England and Northern Ireland and are now above baseline levels in Scotland
(1). Rates in Wales remain stable and below the baseline level. Sporadic detections
of influenza A viruses continue to be reported from all countries in the United
Kingdom (UK). The rate for influenza like illness in England is highest in
the north and in the 0-4 year age group (information collected by the Royal
College General Practitioners*
). In England young
children make up the majority of infections reported from hospital sources,
while most detections from virological surveillance in GP practices are in
the 15-44 year age group. Current information suggests that the UK is moving
into the influenza season.
Three sudden deaths in young children aged between two and eight years
in central and southern Scotland have been attributed to influenza A since
early September. In England there were sudden deaths with confirmed influenza
A infection in two young children aged 18 months and 11 years, which were
reported from the same hospital in central England in October. Characterization
of the influenza A viruses from two of the deaths in Scotland and also the
two in England have confirmed the strain as A/Fujian/411/2002 (H3N2)-like.
No underlying risk factors have been identified so far for any of the reported
deaths in Scotland or England.
Young children are particularly susceptible to influenza because most have
little or no history of exposure to influenza viruses and have limited protective
immunity. The relatively low levels of influenza activity that have been
seen in the UK in recent years may also have contributed to this. In a small
percentage of children, particularly the very young, illness may be severe.
In the light of the increase in influenza activity, the chief medical officers
(CMOs) in England (2) and Scotland have written to all doctors to make them
aware of the current situation and remind them about:
||The current immunization programme including the immunisation of ‘at
risk’ groups of all ages over 6 months of age.
||The National Institute of Clinical excellence (NICE, http://www.nice.org.uk/)
guidance on the use of antivirals for influenza in ‘at risk’ groups
comes into effect now that influenza A is circulating in the community.
The Scottish Centre for Infection and Environmental Health (SCIEH, http://www.show.scot.nhs.uk/scieh/)
and England and Wales’ Health Protection Agency (HPA, http://hpa.org.uk)
have issued news and information concerning influenza vaccination, which
can be viewed at their websites.
* Royal College of General Practitioners (RCGP)
weekly returns service: A weekly reporting service from sentinel GP practices
distributed throughout England who record morbidity data from every consultation
as the working diagnosis made by the general practitioner. Unpublished diagnostic
guidelines for acute respiratory infections have been circulated to participants
in the RCGP scheme. Similar schemes are run in Northern Ireland, Scotland
and Wales. All rates are reported per 100 000 of the general population.
Rates for influenza-like illness, acute bronchitis and total respiratory
disease are of particular relevance.