Recurring Outbreaks of an Infection Apparently Targeting Immune Function, and Consequent Unprecedented Growth in Medical Admission and Costs in the United Kingdom: A Review.

ABSTRACT

Background: The National Health Service (NHS) in the UK has been beset by unprecedented growth in emergency admissions to hospital which are specifically medical in nature, while surgical and trauma admissions are only showing the level of low growth expected from demographic change, or what is called the ageing population. There has never been an adequate explanation for this dichotomy. An Infectious Basis The proposed infectious basis rests upon the observation that growth in medical admissions occurs in spurts which occur approximately five years apart, albeit three years between spurts have also been observed during the 1990’s. It is these spurts which are driving the long-term growth, rather than the relatively minor growth which occurs in the interval between the spurts. These periods of high growth are characterized by spikes in all-cause mortality, and typically result in a 15% increases in admissions to the medical group of specialties. However much higher growth is seen for particular conditions/diagnoses which appear to have a common immune function basis via infection, inflammation and autoimmunity. These outbreaks can be seen across Europe, and the last three outbreaks commenced around Mar-02, Mar-05 and Mar-10 with subsequent spread over the next two years. The middle of these three outbreaks had the lowest increase in deaths and medical admissions. Implications There is now an overwhelming body of evidence pointing to a recurring series of infectious-like events. In the UK, the 2012/2013 outbreak led to 45,000 extra deaths while across the 27 EU countries, each outbreak appears to result in somewhere in excess of 467,000 deaths. In Europe, the outbreaks tend to occur earlier in Denmark, Romania, Bulgaria and Slovakia, while they tend to occur later in the UK, Belgium, Greece and Slovenia. Emphasis now needs to switch toward clinical studies which screen the population for changes in the levels of specific IgM and IgG antibodies against a range of potential candidate organisms, and post mortem examination of the tissues of persons who die from a particular range of conditions such as neurological disorders including dementia and Alzheimer’s; respiratory and gastrointestinal tract diseases, and cardio/vascular conditions. Conclusion: This new disease has the potential to be a highly disruptive discovery involving changes in fundamental health care policy, and our understanding of the role of immune function in the exacerbation of a range of common medical conditions.