Flu and freezing weather may be driving up winter death rates

Behind the Headlines

Wednesday February 4 2015

You should check to see if you need the winter flu jab

The flu can be dangerous for vulnerable people

"The current death rate in England and Wales is running about one-third higher than its normal rate for this time of year," BBC News reports. A combination of flu and very cold weather may be responsible.

The BBC's story comes from the latest official statistics on deaths in England and Wales. They show that in the last three weeks of January, death rates were significantly higher than predicted for the time of year.

In addition, over the last six weeks a significantly higher than predicted death rate was reported in people aged 65 and above living in England. 

Although the cause of these spikes is uncertain, experts point out they coincide with both seasonal increases in respiratory problems – in particular the flu – and the recent cold snap.

The number of deaths always rises in winter, especially among elderly people. This is because of the colder weather and increases in respiratory problems.

While flu is a viral infection, it can make the lungs vulnerable to bacterial infections, such as pneumonia, which can be fatal in the elderly.

Who should have the seasonal flu jab?

Flu is not a serious threat for most fit and healthy adults, but the elderly and those with other illnesses, such as diabetes and asthma, are at risk of developing serious complications, including pneumonia.

See your GP about the flu jab if you're 65 or over, or if you have any of the following problems (however old you are):

Your GP may advise you to have a flu jab if you have serious liver disease, multiple sclerosis (MS), or other diseases of the nervous system.

Read more about who should have the flu jab.

Pregnancy

If you're pregnant, you should have the flu jab, regardless of the stage of pregnancy you've reached.

Pregnant women are more prone to complications from flu that can cause serious illness for both mother and baby.

If you are pregnant and catch flu, talk to your GP urgently as you may need treatment with antiviral medicine.

Read more about the flu jab in pregnancy.

Children

The flu vaccine is recommended for:

  • children over the age of six months with a long-term health condition
  • healthy children aged two, three and four

Children aged between six months and two years of age who are eligible for the flu vaccine should have the flu jab.

Children eligible for the flu vaccine aged between two and 18 will usually have the flu vaccine nasal spray.

Read about who should have the children's flu vaccine.

Where did the story come from?

The figures used in the BBC story come from the Office for National Statistics (ONS), which produces figures on issues of public importance.

It is also based on an analysis of mortality figures from Public Health England (PHE), the body responsible for maintaining the nation's health. These are both government bodies.

The BBC also included an interview with Professor John Newton, chief knowledge officer at PHE. One explanation for the higher than usual death rates is the prevalence of the H3N2 sub-type, a flu virus.

Professor Newton reportedly said that while PHE tries to anticipate which subtypes of the virus may be circulating in any year so the virus can be vaccinated against, the type this year may have mutated and might not be as well matched to vaccines at the end of the flu season as at the beginning.

What were the figures?

The ONS has published weekly figures on deaths registered in England and Wales from December 5 2014.

This shows that in the week beginning January 9 2015, there was a total of 16,237 deaths, followed by a total of 14,866 deaths in the week beginning January 16 2015, and 13,934 deaths in the week beginning January 23 2015. 

This rate is about one-third higher in the last two weeks compared with deaths over the same period in the previous five years.

The majority of these deaths were in those aged 65 or over. For example, in the week starting January 16 2015, 13,083 of the deaths were in those aged 65 and over.

According to the ONS, in the week beginning January 9 2015 and January 23 2015, 3,515 and 3,215 of all deaths were registered as caused by respiratory disease. 

The PHE surveillance report points out the estimated 16,237 deaths in week two and the 14,866 deaths in week three of January was above the upper limit predicted for the time of year.

In England, PHE says there have been excess deaths from week 50 in 2014 up to week four in 2015 among those over the age of 65 in England. They point out the excess deaths coincide with circulating influenza and recent cold snaps.

Significant excess deaths were also seen in children under five and in 15- to 64-year-olds in the first week of this year.

Similar excess deaths were seen in Scotland and Wales during this period, but not in Northern Ireland.

How did the researchers interpret the results?

PHE says there are always a higher number of deaths in winter months compared with the summer, and that some peaks in mortality above the expected level typically occur in winter.

This is most commonly the result of factors such as cold snaps and the increase in respiratory viruses, particularly the flu.

However, PHE also says "acute" weekly excess mortality rates "triggers further investigations of spikes and informs any public health responses".

Conclusion

There are always more deaths in winter than other seasons, particularly among elderly people. But why these fairly dramatic spikes in the death rate have occurred is still not understood.

It should be noted these figures are provisional, as there can be a delay in the ONS receiving the data.

Although the media has focused on the likely cause being flu, the numbers provided are for all respiratory conditions. Cold weather can exacerbate many of these conditions, such as asthma and chronic obstructive pulmonary disease.

For most fit and healthy people, flu is not a serious threat, but the elderly and those with other illnesses, such as diabetes and asthma, are at risk of developing serious complications, including pneumonia.

It's important to stay healthy in winter and protect yourself against illness.

Analysis by Bazian. Edited by NHS Choices. Follow Behind the Headlines on Twitter. Join the Healthy Evidence forum.

Analysis by Bazian

Edited by NHS Choices

Links to the headlines

Death rate up by a third in January. BBC News, February 4 2015

Death rate rises as cold snap grips UK. The Guardian, February 4 2015

Further reading

Office for National Statistics. Weekly Provisional Figures on Deaths Registered in England and Wales, Week Ending 23/01/2015. February 2015

Public Health England. Weekly All-cause Mortality Surveillance 29 January 2015 – Week 5 report (PDF, 342kb). February 2015

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