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Eurosurveillance, Volume 7, Issue 45, 06 November 2003
Articles

Citation style for this article: Crofts J. Current influenza activity in the United Kingdom: A/Fujian/411/2002 (H3N2)-like strains circulating in the community, week 44. Euro Surveill. 2003;7(45):pii=2320. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2320

Current influenza activity in the United Kingdom: A/Fujian/411/2002 (H3N2)-like strains circulating in the community, week 44

Jonathan Crofts (jonathan.crofts@hpa.org.uk), Health Protection Agency Communicable Disease Surveillance Centre, London, England

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.

References:
  1. Health Protection Agency. Current influenza activity in the UK. Commun Dis Rep CDR Wkly 2003; 13 (45): news. (http://www.hpa.org.uk/cdr/PDFfiles/2003/cdr4503.pdf)
  2. Chief Medical Officer, Department of Health. Influenza is now circulating in the community. Reference: CEM/CMO/2003/16 (gateway ref 2235). Public Health Link cascade, 5 November 2003. (http://www.info.doh.gov.uk/doh/embroadcast.nsf/vwDiscussionAll/4DA0D6CB5CCD831F80256DD500526ACE) [accessed 6 November 2003]

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