September 20, 2018

September 20, 2018

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

Alicia reported that all influenza indicators are showing very low levels of activity.

Both influenza A subtypes and influenza B lineages have been found among the small number of specimens currently being submitted. Overall, influenza A viruses have been predominant since mid-June, and the split has been fairly even between H1 and H3 viruses reported since August. For influenza B viruses, only B Yamagata lineage has been reported since mid-July.

Since the last Summit call, one additional influenza-associated pediatric death has been reported to CDC. This death occurred in January, but it has just now been confirmed and reported. This death was associated with influenza A virus infection. A total of 180 pediatric deaths have been reported for the 2017–2018 season.

A few outbreaks have been reported over the summer. Some were associated with returning international travelers, which were predominantly caused by H3 viruses. There also have been some outbreaks of domestic origin that were largely from H1 viruses. Fourteen (14) novel influenza A cases have been reported during the summer. All were variant virus infections. Of these cases, one was H3N2-v, and the remaining 13 were H1N2-v. Thirteen of the infections occurred in children <18 years of age. In addition, 13 reported contact with swine and/or attendance at an agricultural fair. All infected persons have recovered, and no ongoing human-to-human transmission was identified.

Internationally, the southern hemisphere is continuing to see influenza activity. Influenza H1 has been the predominant strain identified. Australia and New Zealand are seeing a particularly low level of activity during this season. Tropical area countries also are reporting low levels of activity.

The 2018–2019 season surveillance system will begin on September 30. The first report for the season will be published on October 12. This will be the first report which includes all of CDC’s surveillance components. The ACIP recommendations for the 2018–2019 season were published in the MMWR in August. The article provides updates for the vaccine strain composition, the return of LAIV as an option for vaccination, additional information supporting use of vaccine in persons with egg allergies, and age indication licensure changes for Afluria (now licensed for anyone >5 years of age) age and Fluarix Quadrivalent (now licensed for anyone >6 months of age.)

One Summit partner noted anecdotal reports of influenza in the area and asked how CDC receives reports. Alicia explained that CDC’s reporting methodology is somewhat complex. A group of clinical laboratories report influenza positive tests directly to the National Respiratory and Enteric Virus Surveillance System (NREVSS). In addition, another group of public health laboratories report to CDC, but the specimens they receive in their labs can vary as to their source, whether are not they are the result of active surveillance during an outbreak, etc. Therefore, if an individual notices influenza in patients, that information may or may not reach CDC.

Announcements – L.J Tan (IAC)
  • NFID Influenza Media Call – NFID’s annual Influenza/Pneumococcal News Conference will take place at the National Press Club in Washington, D.C. on September 27 at 10 a.m. Several speakers will provide comments, and updated influenza vaccine coverage data will be presented. On October 4, Marla Dalton will join the scheduled Summit call to provide a summary of the conference and a report on media hits resulting from the event.
  • Cold Cough Flu Conference – On October 15, which is Global Handwashing Day, Sickweather Inc. will hold its inaugural Cold Cough Flu Conference in Kansas City, MO. The conference will feature expert speakers and discuss how technology is changing our ability to connect with the population. The goal of the conference is to bring together partners to discuss what’s working now, what role data and technology can play in patient engagement and wellness, and what the future might look like to interact with and treat patients. The group is working with Kansas City Public Health to offer influenza vaccination at the conference. Persons with questions may contact Laurel Edelman.
  • Families Fighting Flu Influenza Toolkit – FFF recently updated its healthcare professional toolkit, Do You Know the Flu? Although the toolkit was developed for pediatric HCPs, but includes educational resources helpful for all providers, including PSAs, a conversation roadmap, infographics, and family stories.
  • NPHIC Webinar on Influenza Messaging – On September 17 the National Public Health Information Coalition (NPHIC) sponsored a helpful and timely webinar, 2018–2019 Seasonal Flu Recommendations and Communications Messaging. The archived presentation, slides, and resources are now available on the Virtual Immunization Communication network (VICNetwork).
  • Summit Call Schedule. – The Summit calls will resume a weekly schedule on October 11. All calls take place on Thursdays at 3 p.m. ET
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