Jeremy Laurance: Ignore all those scare stories: flu is in steady decline

Medical Life

Are we a nation of wimps? I only ask because of the outbreak of whingeing about the sickness that is said to be sweeping the land. "Happy Flu Year" was the front-page effort of the 'Daily Mail' on 1 January. "Flu and sickness bug overwhelms schools" shrieked 'The Observer' on Sunday. And "999 crisis" claimed 'The Daily Telegraph' on New Year's Eve.

An unsuspecting visitor to these shores would conclude that we are engaged in a life-or-death battle with battalions of bugs and viruses, all threatening to lay us low. But a glance at the figures would suggest that memories are short. We are, in fact, living in the best of times, healthwise, not the worst of times, and yet the belief that things are worse may itself be making us ill.

The misunderstanding started (and I admit, I was myself a victim) with the report just before Christmas that Britain was facing its worst flu outbreak for eight years – or was it nine? The prediction was made by no less an authority than Douglas Fleming, the distinguished doctor who has for decades overseen the Royal College of General Practitioners' monitoring unit that collects flu data from practices around the country.

But the distinction between eight and nine years was crucial. Dr Fleming was referring to the winter of 2000-2001, eight years ago, when flu peaked at 81 cases per 100,000 population. The previous year, nine years ago, and the last serious outbreak in England, it reached 233 cases per 100,000. In fact, in each of the last three years of the 20th century, flu easily exceeded 200 cases per 100,000, the official benchmark for an epidemic.

So, even if this year, cases rise above 81 – and on current trends, that is by no means certain – they will still be extremely low by historic standards. Latest figures show a decline in cases from 69 before Christmas to 41 in the week after, but these are not reliable because GP surgeries were closed for at least two days that week. In 1989-90, cases peaked at 580 per 100,000, and in the last flu pandemic, in 1969, they reached 1,250 cases per 100,000, more than 20 times above the current levels.

How lucky we are. But do you feel lucky? No, I thought not. So let me brighten your day. Flu has been in steady decline for at least three decades, punctuated by the occasional epidemic. For most of this century, it has barely risen above the baseline level of 50 cases per 100,000 population.

The reasons are not wholly clear – less crowding, less pollution and wider vaccination for the elderly have all played their part. But a key reason, according to Dr Fleming, is that as a population we have gradually acquired some immunity to the H3N2 virus that has been the principal cause of outbreaks for the past 40 years.

Until the next major genetic shift triggers another pandemic, we can therefore rest easy that ordinary winter flu is not as nasty – or as widespread – as it used to be. Even if you happen to be reading this while shivering in bed, I hope that helps you to feel better.