Provisional counts of the number of death occurrences in England and Wales due to coronavirus (COVID-19) and influenza and pneumonia, by age, sex and place of death.

BackgroundTo evaluate the risk of foetal loss associated with pandemic influenza vaccination in pregnancy. Retrospective cohort study. UK General Practice Research Database Pregnancies ending in delivery or spontaneous foetal death after 21 October 2009 and starting before 01 January 2010. Methodology/Principal FindingsHazard ratios of foetal death for vaccinated compared to unvaccinated pregnancies were estimated for gestational weeks 9 to 12, 13 to 24 and 25 to 43 using discrete-time survival analysis. Separate models were specified to evaluate whether the potential effect of vaccination on foetal loss might be transient (for ∼4 weeks post vaccination only) or more permanent (for the duration of the pregnancy). 39,863 pregnancies meeting our inclusion criteria contributed a total of 969,322 gestational weeks during the study period. 9,445 of the women were vaccinated before or during pregnancy. When the potential effect of vaccination was assumed to be transient, the hazard of foetal death during gestational weeks 9 through 12 (HRunadj 0.56; CI95 0.43 to 0.73) and 13 through 24 (HRunadj 0.45; CI95 0.28 to 0.73) was lower in the 4 weeks after vaccination than in other weeks. Where the more permanent exposure definition was specified, vaccinated pregnancies also had a lower hazard of foetal loss than unvaccinated pregnancies in gestational weeks 9 through 12 (HRunadj 0.74; CI95 0.62 to 0.88) and 13 through 24 (HRunadj 0.59; CI95 0.45 to 0.77). There was no difference in the hazard of foetal loss during weeks 25 to 43 in either model. Sensitivity analyses suggest the strong protective associations observed may be due in part to unmeasured confounding. Conclusions/SignificanceInfluenza vaccination during pregnancy does not appear to increase the risk of foetal death. This study therefore supports the continued recommendation of influenza vaccination of pregnant women.

Between October 2021 and September 2023, over 100,000 carcasses of wild birds, primarily waterbirds and seabirds, were reported from the UK and Crown Dependencies during a high pathogenicity H5N1 avian influenza (HPAI) outbreak. To document the spatial and temporal mortality in wild birds in the UK, Isle of Man and the Channel Islands during an outbreak of HPAI. Counts of dead birds (mortality data) were collated from UK statutory animal health and nature conservation bodies, online bird recording platforms and conservation organizations, and compared with national avian influenza surveillance data and subsequent population counts at seabird colonies. A total of 103,497 dead individuals (90,062 full grown and 13,435 chicks) of 155 species, plus another 3,976 individuals where the species could not be ascertained, were contained within 11,453 reports of dead birds received during the two-year period. Scotland and England accounted for most of the deaths, with the Northern Gannet Morus bassanus, Black-headed Gull Chroicocephalus ridibundus and Barnacle Goose Branta leucopsis among the most affected species. Over 7,500 bird carcasses were tested for HPAI, with 80 species testing positive. Mortality data closely matched the species testing positive, and there was a positive correlation between the seabird carcasses recorded and population changes observed in 2023. The study demonstrates that mortality data can estimate disease impact, aid in real-time outbreak assessments and support better coordination during future events. Standardizing data collection and linking to disease surveillance systems is recommended for an improved understanding of wild bird health.