Seasonal respiratory illnesses present a major burden on primary care services. We assessed the
burden of respiratory illness on a national telehealth system in England and investigated the
potential for providing early warning of respiratory infection. We compared weekly laboratory
reports for respiratory pathogens with telehealth calls (NHS 111) between week 40 in 2013 and
week 29 in 2015. Multiple linear regression was used to identify which pathogens had a
significant association with respiratory calls. Children aged <5 and 5–14 years, and adults over
65 years were modelled separately as were time lags of up to 4 weeks between calls and
laboratory specimen dates. Associations with respiratory pathogens explained over 83% of the
variation in cold/flu, cough and difficulty breathing calls. Based on the first two seasons
available, the greatest burden was associated with respiratory syncytial virus (RSV) and
influenza, with associations found in all age bands. The most sensitive signal for influenza was
calls for ‘cold/flu’, whilst for RSV it was calls for cough. The best-fitting models showed calls
increasing a week before laboratory specimen dates. Daily surveillance of these calls can provide
early warning of seasonal rises in influenza and RSV, contributing to the national respiratory
surveillance programme.