Hostname: page-component-8448b6f56d-t5pn6 Total loading time: 0 Render date: 2024-04-19T08:16:41.061Z Has data issue: false hasContentIssue false

Impact of influenza and respiratory syncytial virus on mortality in England and Wales from January 1975 to December 1990

Published online by Cambridge University Press:  15 May 2009

K. G. Nicholson
Affiliation:
Department of Microbiology and Immunology, Leicester University, Leicester LEI 9HN, and Leicester Royal Infirmary, Leicester LE1 5WW
Rights & Permissions [Opens in a new window]

Summary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The effects of influenza A and B and RSV on mortality in England and Wales were assessed by regression analysis for the period 1975–90. Morbidity data from sentinel practices were used to calculate 4-weekly rates of aggregated upper respiratory tract infections (URTI); PHLS laboratory reports were used as indices of infection, and 4-weekly death rates from all causes, excluding childbirths, were used to study relationships with mortality. Deaths correlated strongly with influenza A and B reports, temperature, and interactions between aggregated URTI and temperature, and RSV outbreaks and temperature. Estimates of ‘seasonal’ 4-weekly mortality associated with URTI were made by substituting into primary regression models the mean of annual trough consultation rates for aggregated URTI and baseline values for RSV and influenza. Peak 4-weekly mortality associated with URTIs was estimated at c. 24000 and c. 28000 during combined influenza and RSV epidemics of 1975–6 and 1989–90 respectively. Secondary regression analysis was carried out with the estimated ‘seasonal’ 4-weekly deaths associated with URTI as dependant variable and laboratory data as regressors. Estimated excess mortality associated with influenza was considerable even during years without major epidemics. Overall during the 15 winters the estimated mortality associated with RSV was 60–80 % more than that associated with influenza. The modelling permits only a crude estimate of RSV associated mortality. None the less it suggests that RSV is an important cause of winter mortality.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1996

References

1.Fair, W. Tenth annual report of the Registrar General. London: HMSO, 1847: xii.Google Scholar
2.Stocks, P. The effect of influenza epidemics on the certified cause of death. Lancet 1935; ii: 386–95.CrossRefGoogle Scholar
3.Eickhoff, TC, Sherman, IL, Serfling, RE. Observations on excess mortality associated with epidemic influenza. JAMA 1961; 176: 776–82.CrossRefGoogle ScholarPubMed
4.Housworth, J, Langmuir, AD. Excess mortality from epidemic influenza. Am J Epidemiol 1974; 100: 40–8.CrossRefGoogle ScholarPubMed
5.Ashley, J, Smith, T, Dunnell, K. Deaths in Great Britain associated with the influenza epidemic of 1989/90. Pop Trends 1991; 65: 1620.Google Scholar
6.Garvie, DG, Gray, J. Outbreak of respiratory syncytial virus infection in the elderly. BMJ 1980; 281: 1253–4.CrossRefGoogle ScholarPubMed
7.Communicable Disease Surveillance Centre. Respiratory syncytial virus infection in the elderly, 1976–1982. BMJ 1983; 287: 1618–9.CrossRefGoogle Scholar
8.Hart, RJC. An outbreak of respiratory syncytial virus infection in an old peoples' home. J Infect 1984; 8: 259–61.CrossRefGoogle Scholar
9. Anonymous. Respiratory syncytial disease - Missouri. MMWR 1977; 26: 351.Google Scholar
10.Mathur, U, Bentley, DW, Hall, CB. Concurrent respiratory syncytial virus and influenza A infections in the institutionalized elderly and chronically ill. Ann Intern Med 1980; 93: 4952.CrossRefGoogle ScholarPubMed
11.Morales, F, Calder, MA, Inglis, JM, Murdoch, PS, Williamson, J. A study of respiratory infections in the elderly to assess the role of respiratory syncytial virus. J Infect 1983; 7: 236–47.CrossRefGoogle ScholarPubMed
12.Sorvillo, FJ, Huie, SF, Strassburg, MA, Butsumyo, A, Shandera, WX, Fannin, SL. An outbreak of respiratory syncytial virus pneumonia in a nursing home for the elderly. J Infect 1984; 9: 252–6.CrossRefGoogle Scholar
13.Nicholson, KG, Baker, DJ, Farquhar, A, Hurd, D, Kent, J, Smith, SH. Acute upper respiratory tract viral illness and influenza immunisation in homes for the elderly. Epidemiol Infect 1990; 105: 609–18.CrossRefGoogle ScholarPubMed
14.Falsey, AR, Walsh, EE, Betts, RF. Serologic evidence of respiratory syncytial virus infection in nursing home patients. J Inf Dis 1990; 162: 568–9.CrossRefGoogle ScholarPubMed
15.Monto, AD, Cavallaro, JJ. The Tecumseh study of respiratory illness. II Patterns of occurrence of infections with respiratory pathogens, 1965–69. Am J Epidemiol 1971; 94: 280–9.CrossRefGoogle Scholar
16.Curwen, M, Devis, T. Winter mortality, temperature and influenza: has the relationship changed in recent years? Pop Trends 1988; 54: 1720.Google Scholar
17.Clifford, RE, Smith, JWG, Tillett, HE, Wherry, PJ. Excess mortality associated with influenza in England and Wales. Int J Epidemiol 1977; 6: 115–28.CrossRefGoogle ScholarPubMed
18.Tillett, HE, Smith, JWG, Gooch, CD. Excess deaths attributable to influenza in England and Wales: age at death and certified cause. Int J Epidemiol 1983; 6: 115–28.Google Scholar
19.Fleming, DM, Cross, KW, Crombie, DL, Lancashire, RJ. Respiratory illness and mortality in England and Wales. Eur J Epidemiol 1993; 9: 571–6.CrossRefGoogle ScholarPubMed
20.Chakraverty, P, Cunningham, P, Shen, GZ, Pereira, MS. Influenza in the United Kingdom 1982–85. J Hyg 1986; 97: 347–58.CrossRefGoogle ScholarPubMed
21.Tillett, HE, Smith, JWG, Clifford, R. Excess morbidity and mortality associated with influenza in England and Wales. Lancet 1980; i: 793–5.CrossRefGoogle Scholar
22.Tillett, HE, Nicholas, S, Watson, JM. Unusual pattern of influenza mortality in 1989/90. Lancet 1991; 338: 1590–1.CrossRefGoogle ScholarPubMed
23.Ailing, DW, Blackwelder, WC, Stuart-Harris, CH. A study of excess mortality during influenza epidemics in the United States, 1968–1976. Am J Epidemiol 1981; 113: 3043.CrossRefGoogle Scholar
24.Sprenger, MJW, Mulder, PGHG, Beyer, WEP, Van Strik, R, Masurel, N. Impact of influenza on mortality in relation to age and underlying disease, 1967–1989. Int J Epidemiol 1993; 22: 334–40.CrossRefGoogle ScholarPubMed
25.Anderson, LJ, Parker, RA, Strikas, RL. Association between respiratory syncytial virus outbreaks and lower respiratory tract deaths of infants and young children. J Infect Dis 1990; 161: 640–6.CrossRefGoogle ScholarPubMed
26.Fleming, DM, Cross, KW. Respiratory syncytial virus or influenza? Lancet 1993; 342: 1507–10.CrossRefGoogle ScholarPubMed
27.Hall, CB. Respiratory syncytial virus. In: Zuckerman, AJ, Banatvala, JE, Pattison, JR, eds. Principles and practice of clinical virology, 2nd ed.Chichester: John Wiley, 1990; 253–66.Google Scholar
28.Bull, GM, Morton, J. Relationships of temperature with death rates from all causes and from certain respiratory and arteriosclerotic diseases in different age groups. Age and Ageing, 1975; 4: 232–46.CrossRefGoogle ScholarPubMed
29.Curwen, M. Excess winter mortality: a British phenomenon? Health Trends 1990/1991; 21: 169–75.Google Scholar