The medical profession must do more to prevent and manage infections in elderly people as the current methods are “hit and miss”, the chief medical officer for England has said.
Writing in his annual report for 2025, Prof Chris Whitty said preventing and treating infections had led to “extraordinary improvements in life expectancy over the last 150 years”.
But he stressed there had not been enough research into infections in elderly people, a growing segment of society.
“Whilst we are very systematic about reducing infections and preventing infections in children and in young adults, in older adults it’s often a lot more hit and miss,” he said at a briefing to the press.
Data for England from 2023 reveals that the vast majority of deaths from infectious diseases were among older adults, and in this group most were caused by respiratory infections or Covid.
Dr Thomas Waite, the deputy chief medical officer, defended the raising of the age at which older people are eligible for a Covid booster, and Whitty said the current priority was encouraging older people to take up other vaccinations, including the new jab against RSV.
Whitty said the issue of infections among elderly people did not only relate to hospitalisation and severe disease. “Even quite apparently moderately important diseases like cellulitis can lead to very significant quality of life issues for older people,” he said, noting that such infections could lead to people becoming trapped in their homes and unable to socialise.
In addition, he said, older people could face an increased risk of stroke after bacterial or viral infections, while some evidence suggested infections could also increase the risk of heart attack or other heart problems.
Infections can also lead to delirium, and there is an association between severe infections and dementia – although Whitty noted it was not yet clear if this was causal or whether infections accelerated the onset.
Whitty said hand-washing, careful preparation of food, vaccination and encouraging people who had recently got an infection not to visit until they were well were among the actions individuals could take to protect themselves from infections.
He said while it was important to maintain a “firm grip” on the prescribing of antibiotics to help tackle the threat of antimicrobial resistance, there should be a lower threshold for prescribing such medications in older people as the risks of an infection turning into sepsis were much higher.
Prof Arne Akbar, of UCL, the chair of the British Society for Immunology’s immune ageing network, said preventing and better managing infections into older age had huge potential to enable people to enjoy a better quality of life for longer and alleviate pressure on health and social care systems.
“We welcome the focus of the chief medical officer’s report on infections in older age and hope it will catalyse a renewed focus on researching how we can prevent disease and improve health outcomes from infection in this age group,” he said.
The report does not focus only on elderly people. Among other areas, it warns that the potential to achieve near elimination of cervical cancer could be threatened if HPV vaccination rates are not maintained.
The report also highlights a decline in vaccine uptake among pregnant women and a drop in coverage of routine vaccinations in children, with the latter particularly pronounced in London and more deprived areas.
“Some of the people who are keen to spread disinformation like to give the impression that the UK is becoming a vaccine-sceptical nation. Absolutely that is not true,” Whitty said, adding that much of the downward drift in childhood vaccinations was down to the practicality of getting hold of a vaccine.
The report also reveals a rise in imported infections such as malaria over the past decade, something Whitty said highlighted the importance of maintaining the UK’s expertise in such areas. And it looks to the future, noting situations such as pandemics are “entirely predictable”, even if their timing is not.
“We need to keep our capacity to prevent and respond to infections up between events rather than wring our hands and wish we had done so when they occur,” Whitty wrote.
