Respiratory diseases, including flu, claimed thousands of lives of elderly people last winter as "excess winter deaths" reached the second highest level in eight years, new figures show.
There were more than 34,000 "excess deaths" across England and Wales over the last winter period, according to figures from the Office for National Statistics (ONS).
The ONS said the rise "is likely due to the predominant strain of flu prevalent during the 2016 to 2017 winter which had greater impact on the elderly than the young".
It is the second highest number of excess winter deaths since 2008/09 when there were 36,450 additional deaths observed over the winter period.
The highest number of winter deaths since then was seen in 2014/15 when the winter death toll reached almost 44,000 with the peak being attributed to a less effective flu vaccination.
Last winter, 12,500 excess deaths were caused by respiratory diseases.
There were 61.9% more respiratory deaths in the winter months of 2016/17 compared with non-winter months, ONS figures show.
Four-fifths (80.8%) of respiratory deaths were amongst those aged 75 and older. Women were more likely than men to be affected.
The ONS said that of the estimated 34,300 excess winter deaths in the winter of 2016/17, 57.6% of these were among women.
Every year there is a seasonal fluctuation in deaths, with more people dying in the winter than in the summer.
The ONS measures excess winter deaths by comparing the number of deaths in the period December to March with the average number of deaths in the four month periods before and after.
January this year saw the highest number of deaths each day.
In August 2016 where the average temperature across England and Wales was 16.7C (62F), the average number of daily deaths was 1,294. But by January, when the mercury dipped to 3.9C (39F), 1,830 adults were dying every day.
The ONS said that research has shown that as the temperature gets colder mortality increases, but temperature is only able to explain a part of the variance in excess winter mortality.
Commenting on the figures, Jodie Withers, health analysis and life events at the ONS, said: "While there has been an increase in excess winter deaths making the total the second highest over the last five winter periods, the number does not exceed the peak that was observed in the 2014 to 2015 winter period.
"The increase is likely due to the predominant strain of flu prevalent during the 2016 to 2017 winter which had greater impact on the elderly than the young."
During the 2016/17 flu season the vaccine was not found to be significantly effective in protecting against influenza among over-65s, Public Health England has previously said.
Janet Morrison, chief executive of the charity Independent Age, said: "These statistics highlight the impact flu can have, particularly on the oldest people in society.
"Despite this, it is extremely concerning that almost a third of older people who are entitled to a free flu jab still does not get it.
"The Government must do more to ensure there is greater uptake of the flu vaccine amongst older people if we are to effectively reduce the impact of illness on the most vulnerable people this winter."