December 13, 2018

December 13, 2018

Amy Parker Fiebelkorn facilitated today’s call.

Influenza Surveillance Update – Alicia Budd (CDC)

Alicia provided an update on influenza activity reported for week 48, ending December 1, 2018. Influenza activity remains at low levels, although we are seeing slight increases in activity across the country.

For the week, 4.2% of specimens sent to clinical laboratories tested positive for influenza. H1 is the predominant virus to date. At public health labs, 91% of the viruses tested have been influenza A, and 81% of these were H1 viruses. Small amounts of H3 and influenza B have been seen. Of the B specimens which have been tested, 74% belonged to the Yamagata lineage.

During this season, 163 viruses have received antigenic and genetic characterization. This data indicates the majority of viruses are similar to this season’s vaccine components. The only difference has been for B Victoria, but only 7 viruses of this lineage have been received. Of these, 2 were in the same genetic group as the vaccine virus. Of the 3 viruses have been antigenically characterized, none was similar to the B Victoria vaccine virus. Last season we began seeing a newly emerging B Victoria group with an amino acid deletion, and we are still seeing some circulation of this group. The three viruses antigenically characterized so far did not have this deletion, but this season’s vaccine was modified to include B Victoria viruses with this deletion. Although this is concerning, Alicia reminded the group that this was based on very small numbers tested and very small numbers of B Victoria circulating as a whole. None of the 158 viruses tested for antiviral resistance has been found to be resistant to oseltamivir, peramivir, and zanamivir.

For the last 2 weeks, outpatient visits for influenza-like illness (ILI) have been at the national baseline of 2.2%. During the current week, 4 regions have been at or slightly above their region-specific baselines. On a state level, 2 states experienced high ILI levels, 2 reported moderate activity, and the remaining 46 states, New York City, and Puerto Rico all were at minimal or low activity levels.

There were 383 lab-confirmed influenza hospitalizations reported to the FluSurv-NET system for the week, for a rate of 1.3/100,000. Highest hospitalization rates were in persons >65 years and the 0–4 age group, both of which had a rate of 3.3/100,000.

The percent of deaths reported due to pneumonia and influenza (P&I) remained below the epidemic threshold, with 5.7% of deaths due to P&I. The threshold rate is 6.5%.

Two additional pediatric deaths have been reported to CDC, brining the season total to 5. All 5 have been associated with influenza A; 3 were H1, 1 was H3, and 1 was an A that was not subtyped.

For the geographic spread of influenza during the week, 1 state reported widespread activity, 9 states reported regional activity, 18 reported local activity, and 22 states reported sporadic activity. Geographic spread and intensity are still relatively low in most locations.

Finally, Alicia noted that a brief report on this season’s influenza activity (see next report for link) was released in this week’s MMWR. She also reminded partners of the importance of continuing to stress the need for vaccination. As of November 30, almost 164 million doses of vaccine have been distributed in the U.S.

CDC Influenza Releases Update – Erin Connelly (CDC)

Erin reported on three recent releases from CDC:

  • Early Season Flu Vaccination Coverage –United States, November 2018 – This report was published on December 14. It indicates that, at this point in the season, more people have been vaccinated than in the past 4 seasons. For children age 6 months – 17 years, flu vaccination rates were at 45.6%, an increase of 6.8% compared to the same time period last season. Adult coverage was at 44.9%, up 6.9% compared to the previous season. Both of these rates were the highest we’ve seen since the 2014–2015 season. This is possibly a reaction to the severe season we experienced in the 2017–2018 season. In terms of place of vaccination, 67.6% of children were vaccinated at a doctor’s office and 13.5% were vaccinated at a clinic, health center, or other medical place. For adults, 34.3% were vaccinated at a doctor’s office, 34.2% were vaccinated at a pharmacy or retail location, and 14.9% were vaccinated at their workplace.

National Influenza Vaccination Week Summary – John Donovan (CDC)

John provided a presentation on this season’s NIVW, which occurred December 2–8, 2018.  The goals of NIVW are to highlight the continuing importance of flu vaccination and to communicate the intense burden of flu. The principal target this year was health care providers (HCPs). Flu Fighters highlights profiles of HCPs working to fight flu.

CDC had planned a webinar for December 5, but this was postponed until December 12 due to the National Day of Mourning for President Bush. Over 2,700 people were registered for the webinar. CDC will post the webinar recording and issue a report on the webinar metrics in the near future. A wide variety of resources were discussed during the call, and these are available on CDC’s NIVW website. Web tools such as the Flu Vaccine Finder and badges, banners, social media messages, posters, and animated graphics also are available on the site.

CDC would love to hear about your successful NIVW activities and events. Share your story by submitting information to CDC. Past success stories are available for viewing online.

Persons with questions about NIVW may contact John Donovan.

Partner Updates

California’s Shot by Shot program is now partnering with the American Lung Association’s My Shot campaign. Anyone is interested in increasing social media coverage of the campaign may contact Tammy Pilisuk.

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