March 8, 2018

March 8, 2018

Announcements – L.J Tan (IAC)

L.J opened the call by mentioning several upcoming deadlines:

  • March 13 – Deadline to provide comments on the two new proposed HEDIS immunization measures. The web page that includes the instructions, materials, and submission platform is available online.
  • March 15 – Deadline to sign onto the Summit letter to CMS about the importance of advancing immunization measures for End Stage Renal Disease (ESRD) patients. For additional information and to join other Summit partners who have signed the letter, contact L.J Tan.
  • March 15 – Deadline to submit an abstract for the poster session to be held at the annual Summit in-person meeting.
  • Ongoing – Be sure to register to attend the 2018 NAIIS meeting to be held in Atlanta Georgia on May 17-18. Persons needing the password to register for the meeting should contact L.J Tan.

Influenza Surveillance and ACIP Influenza Update – Alicia Budd (CDC)

Alicia provided highlights of the influenza surveillance report from week 8, ending February 24, 2018. Although influenza levels are still high, all of our national metrics are beginning to show signs of a decline in activity. The percentage of respiratory specimens testing positive for influenza in clinical laboratories was 21.6%, a decline for the second week in a row. The percentage of specimens testing positive for influenza A (51.6%) has continued to trend downward, while the percentage of influenza B specimens (48.4%) is on the rise. All 10 public health regions now appear to be past their peak in terms of reported positives.

For the season as a whole, data from public health laboratories indicates 20% of viruses have been influenza B. H1 viruses also are increasing, but at a much lower level than influenza B. Of the B viruses for which lineage information was available, approximately 90% were B Yamagata and 10% were B Victoria. Specimens characterized since May continue to be antigenically and genetically similar to the reference virus for this season’s vaccine. As of early February, the antigenic similarity is lower for egg-grown virus than cell-grown virus. Of the several hundred viruses that have been tested, only 5 have shown any antiviral resistance. All of these virus samples were H1N1, which is not the predominant strain this season.

Nationwide, influenza-like illness (ILI) activity was at 5.0%, well above the baseline of 2.2% However, this was below the 6.4% reported in the previous week. All 10 HHS regions are now appearing to be past their peak ILI activity. Alicia noted that over the last 5 years, the average duration of time above baseline is 16 weeks (range 11-20 weeks). We are at 14 weeks for this season. ILI information also is available on a state level, with activity summarized as high, moderate, low, or minimal. Last week, 32 states, New York City, and the District of Columbia reported high ILI activity, 9 states and Puerto Rico reported moderate ILI activity, 6 states reported low ILI activity, and 3 states reported minimal ILI activity.

Information from the Influenza Hospitalization Surveillance Network (FluSurv-NET) indicates an overall hospitalization rate of 82 per 100,000 population. The highest rate (351 per 100,000) was among adults aged >65 years, followed by adults aged 50–64 (89 per 100,000 population). Overall, the all ages combined rate and all adult rates are at the highest levels ever reported into the system. Pediatric rates have not reached these high levels at this time.

Based on reports from the National Center for Health Statistics (NCHS) surveillance system available for the week ending February 10, 9.0% of deaths were due to pneumonia and influenza (P&I). Although this is still above epidemic threshold levels, this is the third week in which we have seen a decline in the percentage of deaths attributed to P&I.

Seventeen (17) influenza-associated pediatric deaths were reported during week 8. For the 2017–2018 season, the total number of reported pediatric deaths is 114. Approximately one-third of these deaths were associated with influenza B viruses. Of the deaths associated with influenza A viruses, about ½ were associated with H1.

In terms of geographic spread of influenza within a state (characterized as widespread, regional, local, sporadic, or no activity) as reported by state and territorial epidemiologists, 45 states and Puerto Rico reported widespread activity, 2 states (Minnesota and Texas) and Guam reported regional activity, 3 states (Oregon, Hawaii, and Vermont) and the District of Columbia reported local activity, and 0 states and the U.S. Virgin Islands reported no influenza activity.

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