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. 2018 Jul;146(9):1106-1113.
doi: 10.1017/S0950268818001152. Epub 2018 May 10.

Significant spike in excess mortality in England in winter 2014/15 - influenza the likely culprit

R G Pebody  1 , H K Green  1 , F Warburton  1 , M Sinnathamby  1 , J Ellis  1 , K Mølbak  2 , J Nielsen  2 , S de Lusignan  3 , N Andrews  1
Affiliations

Significant spike in excess mortality in England in winter 2014/15 - influenza the likely culprit

R G Pebody et al. Epidemiol Infect. 2018 Jul.

Abstract

Significant increases in excess all-cause mortality, particularly in the elderly, were observed during the winter of 2014/15 in England. With influenza A(H3N2) the dominant circulating influenza A subtype, this paper determines the contribution of influenza to this excess controlling for weather. A standardised multivariable Poisson regression model was employed with weekly all-cause deaths the dependent variable for the period 2008-2015. Adjusting for extreme temperature, a total of 26 542 (95% CI 25 301-27 804) deaths in 65+ and 1942 (95% CI 1834-2052) in 15-64-year-olds were associated with influenza from week 40, 2014 to week 20, 2015. This is compatible with the circulation of influenza A(H3N2). It is the largest estimated number of influenza-related deaths in England since prior to 2008/09. The findings highlight the potential health impact of influenza and the important role of the annual influenza vaccination programme that is required to protect the population including the elderly, who are vulnerable to a severe outcome.

Keywords: Influenza A; vaccination (immunization).

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Conflict of interest statement

None.

Figures

Fig. 1.
Fig. 1.
FluMOMO influenza (a), positivity (b), activity (c), temperature (d) and mortality (e) variables, 2008/09 week 40 to 2014/15 week 20. 1RCGP ILI consultation rate per 100 000 population multiplied by the proportion of samples positive for influenza through RCGP and PHE-SMN sentinel swabbing schemes. 2Temperature data from National Oceanic and Atmospheric Administration (http://www.noaa.gov/). 3Definitions: temp, weekly mean temperature; ptemp, predicted weekly-mean temperature; ptmin, predicted weekly-mean minimum temperature; ptmax, predicted weekly-mean maximum temperature; ptlow, the minimum predicted mean temperature across the time series; pthigh, the maximum predicted mean temperature across the time series.
Fig. 2.
Fig. 2.
Weekly number of deaths and attribution to influenza (red line) and extreme temperature (green line), England, 2008/09 to 2014/15.
Fig. 3.
Fig. 3.
Schema to illustrate defined terms.
See this image and copyright information in PMC

References

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