A Presumed Infectious Event in England and Wales during 2014 and 2015 Leading to Higher Deaths in those with Neurological and Other Disorders

Abstract

A recurring series of periods of unexplained higher deaths in those suffering from neurological conditions (Alzheimer’s, Dementia, Parkinson’s etc.) has been previously identified, and the effect of the 2012 event was investigated in some detail. Since that time, a seemingly similar event occurred in 2014, which exhibited all the characteristics of the previous events, namely, spatial spread of both deaths and medical admissions throughout the UK, deaths and admissions limited to a particular range of conditions, all of which endure for approximately 12 months before abating, and a parallel increase in NHS staff sickness absence - all of which are suggestive of an infectious aetiology. The trend observed at national level is greatly attenuated due to the unique kinetics of sub-national spread and duration of the event; however, despite this limitation a specific increase in neurological and other deaths can likewise be seen during the 2014 event. The 2014 event mainly initiated during the last half of 2014, and as such, the increased deaths only reflected half of the potential increase, although they were highly statistically significant. As before, the increase in deaths is condition, gender and age specific. In addition to those with existing neurological deaths, increased deaths were observed in those with cancer, congenital and perinatal conditions. A potential interaction between this agent and an influenza outbreak in January of 2015 appears to have led to additional effects against those with Alzheimer’s and dementia and a period of higher deaths inconsistent with the effects of influenza alone. The pattern of conditions most affected shows some evidence for common immune function aetiology, and the immune modifying virus cytomegalovirus may be in some way involved in these events, either as cause or via opportunistic reactivation.