A recurring series of infectious-like events leading to excess deaths, emer-gency department attendances, and medical admissions in Scotland

A series of infectious-like events are characterised within the geographical area of the Scottish NHS Health Boards. Each event leads to a relatively sudden 3% increase in total deaths (around 3,500 extra deaths for Scotland) which lasts for around two to three years. The onset and shape of the time trend is slightly different in each Health Board area and it is this which suggests an infectious spread. There is a general north to south movement in each outbreak with initiation always occurring in Scotland before England. The number of medical admissions and emergency department attendances also rise at roughly the same time as the onset of these events. A similar phenomena has been documented in Australia, Canada and the USA and the effects appear to extend to general practitioner (GP) referrals, occupied beds in hospitals, the trajectory of incidence for specific cancers and a cycle in the gender ratio at birth. The possibility that the ubiquitous immune modifying herpes virus, cytomegalovirus, may be involved in these events is discussed.