Social Affairs Editor Niall Dickson: "The NHS is at full stretch"

The Association for Influenza Monitoring and Surveillance (AIMS) is advising people most at risk from the flu that it is not too late to get vaccinated.

The advice comes as health workers warn that emergency bed levels remain at critical levels and Health Secretary Frank Dobson sought to reassure the public.

AIMS says uptake of the flu vaccine has been low and drug companies have over a million doses of the vaccine in stock.

The Public Health Laboratory Service (PHLS) is also advising the most vulnerable and NHS staff that it is not too late to get vaccinated, although it predicts the current outbreak to peak by early next week.

The vaccine available is effective against the Sydney and Beijing flu strains that are sweeping the country.

People who are most at risk include the elderly, the very young, asthmatics, diabetics and those with a damaged immune system.

Slow uptake

The Department of Health issued its annual call for people over 75 to get vaccinated against the flu in October.

GPs say many did get vaccinated as a result, but others at risk may have been slower to demand the vaccine.

AIMS says general uptake appears to have been "very slow".

A spokeswoman said this could be due in part to environmental reasons.

"Last year was very mild and people may not have thought about getting vaccinated.

"Last year flu was probably at its lowest level in a decade and that may have made some people complacent."

She added: "People should not think it is too late now. If you have the vaccination now and avoid contact with people with the flu for seven to 10 days, you will be immunised."

Most deaths from flu occur in people over 65 and those with underlying medical problems, such as a history of respiratory illness, are particularly at risk.

Research shows that vaccination can reduce elderly people's risk of death and hospital admissions by as much as 50%.

Young children appear to be especially susceptible to the current Sydney strain of flu.

As of last week, there were 164 cases of flu per 100,000 people in children under four and 103 cases per 100,000 in those aged between five and 14.

This compares to 93 cases per 100,000 in the 15-64 age group and 67 cases per 100,000 in people over 65.

AIMS says schools and playgroups help spread the virus because children are in close proximity to each other.

But children usually shake off the illness better than the elderly.

Changing situation

The situation on the flu outbreak is changing from day to day, with this week seeing a huge surge in cases and the Emergency Bed Service issuing a warning about bed shortages.

On Wednesday night it said there were only 16 additional beds available in England for hospitals which had reached capacity levels.

By Thursday morning, there were 24.

Bob Platt on the flu crisis in the Midlands

According to BBC sources, the situation in the Midlands remains very tight with two hospitals having to use refridgerated lorries as mortuaries because of lack of space and some doctors working double shifts.

One crematorium in Nottingham has been using floodlights to fit in more services and another has been holding Saturday services.

Death rates over the last two weeks are at 520, compared with 200 for the same period last year.

However, health managers say they have seen worse flu outbreaks.

In London, which has seen problems over the last week or so - particularly in the east, the situation appears to be easing slightly.

In Portsmouth, relatives and friends of hospital patients have been asked to wash, shave and feed them to relieve pressure on staff.

And in Torbay, hospital managers have issued an urgent appeal for people with nursing qualifications to come forward because of a staff shortage.

In the North there has been a small drop in flu admissions. However, there are still pockets of problems.

Most routine surgery has been cancelled and the region's three big hospitals had no intensive care beds free on Wednesday.

But Scotland has escaped relatively unscathed.

Frank Dobson: the situation is changing from day to day

Frank Dobson has been trying to reassure the public, saying the situation is not extraordinary.

"This is what happens when there is a big surge in the number of people ill in winter, but the figures change very quickly," he said.

He added that he did not accept criticism from the Liberal Democrats and Conservatives that the latest NHS crisis was due to the government's preoccupation with waiting lists.

Figures released on Wednesday showed waiting lists had continued to fall in November.

Mr Dobson said: "We are not skewing priorities. In December, higher priority was given to emergency cases.

"It is ridiculous to suggest that people have not benefitted from reducing the waiting lists."