Research and analysis

Winter health watch summary: 16 March 2017

Published 30 March 2017

1. Summary

1.1 Cold Weather Alert

All regions are at level 1 (winter preparedness and alert). Temperatures and weather conditions are not expected to exceed cold weather alert threshold criteria in any region until further notice.

Prior cold weather alerts have been in place this season from:

  • 8 to 9 November
  • 18 to 21 November
  • 24 to 26 November
  • 28 November to 6 December
  • 27 December to 31 January
  • 5 to 13 February
  • 23 to 25 February
  • 27 February to 4 March

1.2 Flu

During week 10 (ending 12 March 2017), influenza continues to circulate with further decreases noted in most indicators. The Department of Health has issued an alert on the prescription of antiviral medicines by GPs.

1.3 Syndromic Surveillance

There were further increases in GP consultations for scarlet fever during week 10, particularly in the 5 to 14 years age group.

1.4 Norovirus

Reports of suspected and confirmed outbreaks of norovirus in hospitals continue to be reported at lower levels than in previous years.

The number of laboratory reports of norovirus in this season* (since week 27 in 2016) is 4381. This is 7% lower than the average number for the same period in the 5 seasons from season 2011 and 2012 to season 2015 and 2016 (4690), and 36% higher than the same weeks last season. Norovirus activity varies from season-to-season, and the level of norovirus activity was lower than average during the 2015 and 2016 season. Therefore, it is more appropriate to use the 5 season average for comparison. Due to this variability between norovirus seasons, it is not possible to predict how the current season will progress.

The most commonly detected norovirus strains in circulation this season belong to the Sydney2012 cluster of GII.4 noroviruses. This group of GII.4 norovirus strains have been circulating worldwide since 2012.

1.5 Rotavirus

The number of laboratory reports of rotavirus in this season* (since week 27 in 2016) is 2377. This is 54% lower than the 10 season average for the same period in the seasons 2003 and 2004 to 2012 and 2013 (5136)** and 50% higher than the 3 season average for the same period in the post-vaccine seasons 2013 and 2014 to 2015 and 2016.

In the first season following the introduction of the rotavirus vaccine in July 2013, a 77% decline in laboratory-confirmed rotavirus infections in infants was observed (Atchison et al, 2016). The total number of laboratory-confirmed rotavirus infections each season has since remained low compared to the pre-vaccine period.

There may be some fluctuation in activity due to low numbers of infections in the early part of the season when compared to the same period prior to use of the vaccine. Furthermore, most laboratory tests in use do not distinguish vaccine from wild-type rotavirus. In the post-vaccine period, further characterisation of laboratory-confirmed rotavirus infections should be considered. Broader testing of cases among eligible infants for other enteric pathogens should also be considered to avoid over-attributing rotavirus as a cause of infectious intestinal disease in young children.

1.6 All-Cause Mortality

During week 10 in 2017, no statistically significant excess all-cause mortality by week of death was seen through the EuroMOMO algorithm in England overall or by age group.

*In order to capture the winter peak of activity in one season, for reporting purposes, the norovirus and rotavirus season runs from week 27 in year 1 to week 26 in year 2, for example week 27 in 2009 to week 26 in 2010, July to June. Data for 2009 and 2015 exclude week 53.

**Comparison is made with this 10 season period as it is prior to the vaccine introduction.

2. Surveillance reports updated weekly

PHE syndromic surveillance page

PHE national seasonal influenza report

PHE norovirus and rotavirus: summary of surveillance

PHE weekly all-cause mortality surveillance

3. Further information

NHS Choices winter website

Met Office Get Ready for Winter

Keep warm keep well: information for over 60s, low income families and people living with a disability

4. Planning resources

Cold weather plan for England

Annual flu programme