- guardian.co.uk, Friday January 14 2000 03.48 GMT
The latest figures collected by the Birmingham research unit of the Royal College of General Practitioners rose to 203 per 100,000 of the population from last week's level of 144. The nationwide averages are extrapolated from figures submitted from 70 GP practices in England and Wales.
The unit's director, Douglas Fleming, called the new level "not particularly exceptional". The public health laboratory service considers a rate of between 50 and 200 per 100,000 is usual when a flu virus is circulating. Levels above 400 are considered an epidemic.
Dr Fleming acknowledged that the elderly had been particularly badly hit by the Sydney strain of flu that has affected the country this winter, but suggested that the acute bronchitis many had gone down with was caused by other viruses as well as flu.
"The high incidence in the elderly, coupled with particularly high rates of acute bronchitis in this age group (the highest for those over 65 for 15 years), is the reason that hospitals are pressured by this particular outbreak. Acute bronchitis in the elderly is caused by several viruses including influenza," he said.
In a normal year, doctors expect to see 600 to 800 elderly people per 100,000 over the age of 65, with acute bronchitis. In the last week, they were dealing with 943 per 100,000.
The flu outbreak is worst in the north, where the official figures record 259 per 100,000 as visiting their GP with flu-like symptoms. In the central region, the numbers drop to 198 and in the south to 174 per 100,000.
A spokesman for the public health laboratory service said: "The virus is always unpredictable but we now think we are seeing the peak and the numbers will begin to tail off in the next few weeks."
Thousands of people have had their operations cancelled this week as beds were commandeered for those with complications resulting from flu. Ministers have insisted that the NHS difficulties have been caused by an exceptionally severe outbreak of flu, which the chief medical officer, Liam Donaldson, termed an epidemic. They argued that many people would not be recorded in the official statistics because they had contacted NHS Direct, the telephone help service, rather than visiting their GP.
Most flu casualties are the frail and elderly, who are recommended by the department of health to have a flu vaccination in October or November. But take-up of the flu jab has not been high. "We would like to be able to have better take-up of the vaccination programme in the coming year. We are going to have to look at how we can improve take-up," said a spokesman for the prime minister.
There have been some young flu casualties. Mandy Nicholson, 26, from east London, was found dead in her bed by her husband, Daniel, two days after Christmas, just five weeks after giving birth to their daughter, Susan. She had flu which triggered a fatal bout of pneumonia.
Mr Nicholson said: "My wife had the baby five weeks before Christmas, then the flu, so when she started feeling ill again we just thought it had come back.
"She had the usual high temperature and there was no sign of her fighting for breath. We had no idea it might be pneumonia. She did not have the strength to fight."
