The highest number of recorded flu cases at Christmas in almost a decade could put extra strain on hospitals, health officials have warned.

Rates of infection have reached levels not usually seen until January or February, with hospitals also feeling increasing pressure over the number of patients admitted with the winter vomiting bug, norovirus.

Recent figures suggest there are 40 flu cases per 100,000 people – the highest number since the winter of 2000-1, when they went on to reach epidemic proportions.

Jonathan Fielden, of the British Medical Association said: “We all know that this time of year has increased pressures, but this winter has been worse than many of the last few.

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“Hospitals are under intense pressure. The cold snap has brought, as predicted, an increase in the number of chest and cardiac problems. We have also seen intense pressure on our ambulance colleagues.”

The concerns come just days after Peter Bradley, the national director of ambulance services, said ambulance workers and A&E departments were “struggling to cope” with the winter illness season.

However, a Department of Health spokeswoman said: “Flu has started earlier this year than last year, but current levels are not unusually high. We will continue to monitor levels closely.”

She added: “People should always feel able to call an ambulance or attend A&E, but there are a range of services available where people can go for medical advice, such as NHS Direct and their own GPs.”

Professor Steve Field, chairman of the Royal College of General Practitioners, said surgeries and hospitals would be very stretched this winter but stressed that staff were dedicated to providing a good service.

Professor Field, who also works as a GP in Birmingham, said his surgery was receiving double the number of calls about flu than usual at this time of year. “We’re seeing more people with cold and flu symptoms, but we’re also seeing quite a few people with nasty chest infections," he said.

“We’re seeing twice as many people and some of the partners have been off as well. It’s really about asking the public to manage themselves and only call services when they need to.”

He added: “We’ve had an earlier peak of the flu than we normally get, and that peak is higher than usual.”

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