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

Abstract

SUMMARYThe 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.

Influenza- and respiratory syncytial virus-associated mortality and hospitalisations

“…Co-circulation of other respiratory viruses during influenza season, in particular the respiratory syncytial virus (RSV) [13], makes it challenging to estimate the influenza-associated burden indirectly. Several studies suggested that RSV is responsible for considerable morbidity and even mortality not only in children but also among older adults [2,[14][15][16]. Over the last 10 yrs the development of vaccines against RSV has progressed [17], and although a vaccine is not expected in the very near future, insight into the RSV-associated healthcare burden would be valuable.…”

Molecular Investigations of an Outbreak of Parainfluenza Virus Type 3 and Respiratory Syncytial Virus Infections in a Hematology Unit

“…RSV and PIV-3 infections recur throughout life despite the presence of specific neutralizing antibodies. There are annual epidemics of these virus infections in the community; in England and Wales, PIV-3 infections occur between May and September each year (16) and RSV infections occur every winter (23).…”

Short report: seasonal pattern of respiratory syncytial virus in a region with a tropical climate in southeastern Brazil.

“…In countries with a temperate climate, epidemics occur mainly in the winter, although they can begin in the fall and extend into early spring. [4][5][6][7][8][9] In southern Brazil, which has a predominantly temperate climate, RSV also produces epidemics in the winter months (June, July, and August) (Straliotto SM, unpublished data). However, the seasonality of RSV in the city of Rio de Janeiro, located in southeastern Brazil, occurs in the fall and early winter, thus preceding the outbreak in southern Brazil.…”