January 23, 2020

January 23, 2020

Influenza Surveillance Update – Alicia Budd (CDC)

Alicia provided an update on influenza activity for Week 2, ending January 11, 2020.  Flu activity remains high and widespread across the country. However, indicators of severity are not high.

Clinical labs reported 22.9% of submitted specimens were positive for influenza, a slight decrease from the previous week. It is too early to know if this is a course correction from the holiday elevation resulting from healthcare seeking behavior changes. It also may be due to a decrease in influenza because schools were closed, offering less opportunity for close transmission. This also could be the result of decreased circulation of the B Victoria strain. CDC will continue to monitor these trends closely.

Public health labs reported widespread influenza. Although B Victoria has been the predominant strain seen throughout this season, there is now an almost equal mixture of B Victoria and A(H3). Strain differences continue to be seen among different age groups. For persons 0–24 years of age, B Victoria is predominant, while H1 is reported more frequently in persons 25 and older.

Genetic characterization of influenza viruses continues to increase. Approximately 950 specimens have been submitted for testing. H1 and B Victoria specimens continue to be the same clade as the vaccine reference virus. The majority of characterized H3 viruses belonged to the 3C.2a clade. For B Victoria, 9% of specimens were double deletion viruses, while 91% were triple deletion viruses. Sixty percent (60%) of B viruses were similar to the cell-grown reference virus. No changes in antiviral susceptibility have were seen during the week. Of the more than 900 viruses tested, 99% were susceptible to the antiviral medications oseltamivir, zanamivir, peramivir, and baloxavir.

Outpatient influenza-like illness (ILI) activity decreased to 4.7%, down from the 5.7% reported the previous week. However, reported ILI levels are still above baseline in all 10 regions. Thirty-four (34) states reported high levels of influenza.

Although lots of influenza is circulating, severity indicators are not unusually high. Cumulative hospitalization rates were at 19.9 per 100,000 for the overall population. Highest rates are seen in age 65 and above (47.6 per 100,000), followed by the 0–4 year age group (34.4 per 100,000.) Fifty-six percent (56%) of hospitalizations are due to infection with influenza A. Rates of reported pneumonia and influenza (P&I) increased sharply during the week, but they are still below threshold levels for the season.

Seven (7) influenza-related pediatric deaths were reported during the week, bringing the 2019–2020 total for pediatric deaths to 39. Twenty-eight (28) of these deaths were associated with B Victoria, and 11 were influenza A. All of the A infections were subtyped as H1.

Fifty (50) states reported widespread or regional influenza activity. In-season burden of influenza estimates are 13 million persons infected, 120,000 hospitalizations, and 6,600 deaths.

HCP Survey on MMR and Measles – Holly Patrick, NCIRD

Holly provided preliminary results of a survey on Healthcare Providers’ Knowledge, Attitudes, and Behaviors Regarding MMR Vaccination and Measles in Adults. Before providing survey results, Holly reviewed the basics of measles transmission and MMR vaccine recommendations. She also discussed the prolonged measles outbreaks experienced in New York City and New York State during 2019–2019.

Of the 1,249 measles cases reported from January–September 2019, 29% were adults. The outbreaks prompted many questions from clinicians and the public about measles and MMR vaccination. The purpose of the survey was to assess healthcare providers’ (HCP) knowledge, attitudes, and behaviors regarding adult measles and MMR vaccination in order to support response to questions and concerns and, ultimately, to prevent measles cases and outbreaks in the U.S., as well as unnecessary vaccination and testing.

The survey was conducted from October 3–November 3, 2019, and included 1,250 HCPs. Highlights of the survey results include:

  • 51% of HCP reported an increase in adult patients asking questions about measles/MMR in the previous year.
  • Top MMR-related topics included the need for a booster dose or serologic testing, as well as general recommendations for adult vaccination.
  • HCPs noted their top reasons to check a patient’s vaccination status were for patients with immune system issues, those planning international travel or with a history of travel abroad, and pregnant women.
  • HCPs reported their most preferred materials for counseling patients were handouts/brochures and vaccine information statements (VIS).

Additional details on specific topics may be found in the presentation.

Other Items – Carolyn Bridges (IAC)
  • 2020 Summit Meeting – This year’s meeting will be held on May 18, the day prior to the opening of the National Immunization Conference. Information on registration and other pertinent details is available on the Summit website. Approaching deadlines of importance are: nominations are being accepted for the 2020 Immunization Excellence Awards through February 1, and the deadline for a poster submission is March 15.
  • Summit Call Schedule – Summit calls are held each Thursday at 3 pm ET unless otherwise cancelled via an email announcement.
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