October 10, 2019

October 10, 2019

Influenza Surveillance Update – Alicia Budd (CDC)

Alicia provided an update on influenza activity for Week 39, through the week ending September 28, 2019. All flu indicators are still well below baseline levels, though we are beginning to see sporadic increases.

Just over 3% of specimens tested at clinical labs were positive for influenza. Over the past 3 weeks, public health labs have seen a mixture of all A and B viruses, with influenza A(H3N2) predominating.

Outpatient influenza-like illness (ILI) activity was at 1.4%, below the baseline of 2.2%. All regions remain below their baseline levels as well. Pneumonia and influenza (P&I) mortality remains below epidemic thresholds.

No new influenza-related pediatric deaths were reported during the week, leaving the season total at 136.

Today the MMWR contained Update: Influenza Activity — United States and Worldwide, May 19–September 28, 2019, and Composition of the 2020 Southern Hemisphere Influenza Vaccine. This update provides a summary of influenza activity during the summer. Of note, the virus characterization data summarized in the article states that ~850 viruses were collected over the summer in the U.S. and worldwide and were either genetically or antigenically characterized. Similar to last year, the H1 viruses belonged to the 61 genetic group, and 96% were similar to the cell-propogated reference virus for this season’s vaccine. All the B Yamagata viruses tested belonged to the Y3 genetic group and were antigenically similar to the vaccine virus. The H3 story continues to be more complex. We continue to have co-circulation of the 3.C.3a and 3.C.2a clades. with the 3.C.2a clades being predominant (80%). The majority of these belonged to the 3.C.2a1 subclade. Of the H3 viruses tested during this time, 70% were similar to the vaccine reference virus. For the B Victoria viruses, the same 3 genetic groups (V1A, V1A.1, and V1A-3Del) that at were circulating last season continue to be seen. All the double-deletion viruses tested were similar to the vaccine virus. Some cross-protection between double- and triple-deletion viruses has been seen in humans. In response to a question, Alicia said she will determine if talking points from CDC will be available. in the meantime, the main points are that it is too early in the season to determine the predominant strain and/or clade, and recent experience in Australia does not necessarily predict what will be seen in the Northern Hemisphere. All of this will continue to be closely monitored.

More than 800 viruses were tested for antiviral resistance. Only two viruses (one H1, one B) showed some level of reduced inhibition to both oseltamivir and peramivir. One H3 virus showed decreased susceptibility to baloxavir.

The first FluView of the 2019–2020 season will be published tomorrow (October 11). The format will be slightly changed from prior years in an effort to improve user access to important information.

At the end of the call, one questioner asked about the availability of comparative effectiveness studies between trivalent high-dose influenza vaccine and quadrivalent regular, quadrivalent recombinant, or trivalent adjuvanted formulations. Neither Alicia nor Carolyn Bridges were aware of any new studies in this area. Alicia will check with CDC SMEs and provide an update during a future call. In addition, Lisa Dunkle with Sanofi (formerly with Protein Sciences) noted that studies are currently underway comparing the high-dose vaccine with the adjuvanted vaccine. However, she was not clear when the study would be completed and published.

2019 NFID Influenza/Pneumococcal Disease News Conference – Marla Dalton (NFID)

Marla provided a presentation about the 2019 NFID Influenza/Penumococcal Disease News Conference that was held on September 26 at the National Press Club in Washington, DC. The conference, which is held in collaboration with CDC, serves as the official kickoff to the upcoming flu season and provides a forum to share public health messages for the coming season.

Panelists for this year’s conference were:

  • William Schaffner, MD, NFID Medical Director (moderator)
  • Alex M. Azar II, Secretary of Health and Human Services
  • Patricia Whitley-Williams, MD, President-Elect of NFID and Pediatrician at the Rutgers Robert Wood Johnson Medical School
  • William Borden, MD, Preventive Cardiologist and Associate Professor of Medicine at George Washington University

The panelists shared CDC’s final vaccination coverage rates from the 2018–2019 season, as well as the results from a new NFID survey, Attitudes about Influenza and Pneumococcal Disease Prevention. Although 60% of adults surveyed agreed that flu vaccination was the best preventive measure against flu-related deaths and hospitalizations, only 52% said they planned to be vaccinated. More than half of the individuals surveyed said they don’t think flu vaccines work very well. Marla noted that this gives added incentive for providers to discuss the partial protection message, i.e., even if vaccine doesn’t completely prevent disease, it goes a long way in helping reduce the complications associated with flu.

The conference was well-received by the media and offered a wonderful opportunity to highlight NFID’s “Leading by Example” program, where individuals are vaccinated on camera. One participant was former NFL and 2-time Super Bowl champion Mark May, NFID’s Fight Flu ambassador.

Marla expressed gratitude to the many partners involved in the event. Media placements in print, online, television, and radio outlets were provided by outlets including the Associated Press, ABC News, CNN, the New York Times. Overall this amounted to close to one billion impressions. Marla also reported two new Spanish language placements were made.

The key message in all coverage was a strong call to action that annual vaccination is the best way to prevent flu. The messaging also provided information about partial protection and the importance of vaccination in reducing severity of serious complications, particularly in patients with chronic health conditions. Digital screens behind the speakers provided images emphasizing these important messages.

Almost sixty vaccines were administered to news conference attendees by the MedStar Visiting Nurses Association.

Social media also helped expand the messaging. There were more than 2,000 tweets around the conference using the hashtags #FightFlu and #PreventPneumo.

A summary of the activities and a full video of the news conference are available online.

Marla noted that individuals and groups can join NFID’s efforts by:

  • joining the Leading by Example initiative and including photos of leaders being immunized;
  • using available #FightFlu Facebook frames to update your profile image;
  • downloading the #TravelingFluBug to use in your own social media posts and pictures.

Other Items – L.J Tan (IAC)
  • Timing of Influenza Vaccination Panel Discussion – The Summit’s Influenza Workgroup (WG) will be holding a panel discussion on Friday, Oct 11 from 12–1:30 pm ET. The panel will focus on the language contained in the recently released ACIP influenza recommendations. Specifically, the discussion will revolve around language recommending that persons (particularly the elderly) requiring only one dose of vaccine should not be vaccinated in July or August. The panel will include CDC subject matter expert Jill Ferdinands, who will discuss the rationale behind this new language. The group will try to determine how the Summit can best assist in communicating this new language during the 2020–2021 influenza season. The panel discussion will be archived on the Summit website in the future.
  • Summit Call Schedule – L.J reminded partners that the Summit calls have now returned to a weekly schedule, unless otherwise cancelled. Calls are held on Thursdays at 3 p.m. ET.


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