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Rapid rise in flu consultations putting strain on GPs

Worst flu season for seven years for GPs – but hospital figures suggest outbreak less severe

Louise Prime

Friday, 19 January 2018

GPs are under yet more strain with a 152.9% rise in consultations for influenza-like illness (ILI) since the start of the year and a 42% rise in just a week, making this the most significant flu season since 2010 to 2011 in terms of GP activity, show official figures from Public Health England. Hospital indicators suggest, however, that in other terms the outbreak is not as severe at this stage as it was seven years ago; and mortality levels have not yet reached the levels seen in 2014-15 and 2016-17.

The Royal College of GPs’ Research and Surveillance Centre (RSC) has reported that an estimated 31,300 patients in England attended their GP practice with ILI between 8-14 January – a rise of over 9,000 on the previous week. This is based on data collected from 1,701,482 patients, the RSC’s biggest ever sample.

The worst-affected region was the Midlands and East England (which includes Birmingham, Norwich and Nottingham) where 57.9% patients per 100,000 population presented with ILI – an increase from 35.5% per 100,000 the previous week. North England (including Manchester, York and Newcastle) had 57.3% patients per 100,000 population presenting with ILI – up from 34.5%. South England (which includes Bristol, Portsmouth and Canterbury) saw a rise from 45.3% to 54.3% patients per 100,000. And in London, ILI presentation rates rose from 30.3% to 42.1% patients per 100,000.

Professor Simon de Lusignan, RSC medical director, said: “Unsurprisingly, given what we’ve been hearing anecdotally from GPs, rates of influenza-like illness have risen again. Whilst flu rates in primary care are still within what we term the ‘medium threshold’, the virus does seem to be affecting patients aged over 65 most, with rates moving into the ‘very high threshold’.”

PHE said England is currently seeing a mix of flu types, including the A(H3N2) strain that circulated last winter in the UK and then in Australia, and that particularly affects older, more vulnerable age groups. The main strains circulating continue to be flu A(H3N2), A(H1N1) and Flu B.

Its report also shows that in weeks 50 of 2017 to week 2 of 2018, statistically significant excess mortality from all causes is now being observed in over 65s in England although this currently remains lower than the excess mortality observed last season and in 2014 to 2015. It said these excess deaths cannot with certainty be attributed to specific causes, but flu and the very cold weather some areas have seen since Christmas are likely to be contributing factors.

PHE medical director Professor Paul Cosford said: “In terms of hospital admission, this is the most significant flu season since the winter of 2010/11 and the preceding pandemic year of 2009, although it is not an epidemic.”

PHE is reminding people that the best protection from flu is to get vaccinated if eligible – only 71.7% of adults over 65, 47.5% of adults with a long-term health condition, 46% of pregnant women, 41.4% of 3-year-olds and 42.7% of 2-year-olds have received the vaccine – and to practise good respiratory and hand hygiene.

RCGP chair Professor Helen Stokes-Lampard said: “General practice continues to face huge winter pressures with a significant increase in patients presenting with influenza, and high numbers of patients continuing to present with other common winter illnesses.”

She urged patients to take measures to keep themselves well, and self-care where possible, avoiding going to their general practice unless they really need too – not just to reduce pressure on the NHS, but also to avoid passing on infection to those in at-risk groups. She said: “The College’s ‘3 before GP’ advice asks patients whether self-care is an option in the first instance; whether advice from a reputable online UK source, such as NHS Choices, could help; or whether they could seek advice from a pharmacist, before booking an appointment with their GP.”

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