April 04, 2016

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Summit Call Recap – March 31, 2016
Summit Call Recap – March 17, 2016
Special Announcements
Information From CDC
Other News

SUMMIT CALL RECAP – MARCH 31, 2016


Influenza Surveillance Update – Sophie Smith (CDC)

Today’s report provides a summary of published reports for week 11, ending March 19, 2016. Influenza activity in the U.S. decreased slightly during this week, but remains elevated.

CDC is now reporting separately on influenza specimens received from U.S. clinical laboratories and U.S. public health laboratories. For week 11, 20.1% of specimens submitted to clinical laboratories were positive for influenza. Of these, 73.9% were influenza A and 26.1% were influenza B. For public health laboratories, 1,086/1,848 (58.8%) specimens were positive, with 839 (77.3%) influenza A and 247 (22.7%) influenza B.

One thousand two hundred twenty-nine (1,229) influenza virus specimens have been characterized as of October 1. Of these, 507 were A(H1N1), 324 were A(H3N2), and 398 were influenza B. All 507 A(H1N1) viruses and all 324 A(H3N2) viruses were similar to their respective components of the 2015–2016 Northern Hemisphere vaccine. A subset of 139 H3N2 viruses also were antigenically characterized, with 131/139 (94.2%) being A/Switzerland/9715923/2013-like. Two hundred thirty-nine (239) of the B viruses were of the B/Yamagata lineage, and the remaining 159 were B/Victoria.

Since October 1, 1,772 influenza viruses have been tested for antiviral resistance, including 922 influenza A(H1N1), 387 influenza A(H3N2), and 463 influenza B. Of these, 5 influenza A(H1N1) were resistant to oseltamivir and peramivir. All the remaining samples tested were sensitive to oseltamivir, zanamivir, and peramivir.

Based on National Center for Health Statistics (NCHS) data available on March 24, 2016, 7.4% of deaths occurring during the week ending March 5 (week 9) were due to pneumonia and influenza (P&I.) (NCHS data has an approximate 2-week lag time for reporting.) This is below the epidemic threshold of 7.7% for week 9. Similarly, data from the 122 Cities Mortality Reporting System for week 11 indicate 7.3% of deaths were due to P&I. This is above the epidemic threshold of 7.2% for week 11.

Two influenza-associated pediatric deaths were reported to CDC during week 11. A total of 30 influenza-associated pediatric deaths have been reported during the 2015–2016 season. Of these 30 deaths, 6 had no vaccination history available, 1 was not eligible for vaccination due to age, 1 was fully vaccinated, and 22 were unvaccinated.

For week 11, the cumulative hospitalization rate was 18.2 laboratory-confirmed influenza-associated hospitalizations per 100,000 population. The highest rate of hospitalization was among adults aged >65 years (46.1 per 100,000 population), followed by children aged 0–4 years (25.6 per 100,000 population). Among all hospitalizations, 79.8% were associated with influenza A, the majority of which were influenza A(H1N1). Hospitalizations also were associated with influenza A(H3), B, and A/B co-infections.

During week 11, influenza-like Illness (ILI) activity levels, which are based on the percent of outpatient visits due to ILI, were at 3.2%, which is lower than the previous week, but above the baseline of 2.1% for the week.

On a regional level, outpatient visits for ILI ranged from 11.0% to 29.6% during week 11. All 10 public health regions reported outpatient visits for ILI to be at or above region-specific baseline levels. The geographic spread of influenza as assessed by state and territorial epidemiologists indicates the following levels of influenza activity during week 9:

  • Widespread – 39 states and Puerto Rico
  • Regional – 10 states and Guam
  • Local – 1 state and the District of Columbia
  • Sporadic – 0 states
  • No report – Virgin Islands

Several Summit partners provided observations following Sophie’s report. One Summit member noted that this season’s influenza activity appears to be very similar to what was observed during the 2011–2012 season. L.J Tan commented that, although 30 pediatric deaths this year is a regrettable total, it nonetheless is considerably below the number reported during the previous season. When he asked whether any methodology is available to connect the reduction in pediatric deaths with a better vaccine this year and/or improved vaccine uptake, Carolyn Bridges replied that we may get some inkling about this when Brendan Flannery provides a preliminary report on this season’s vaccine effectiveness during the 2016 NAIIS.


Announcements – L.J Tan (CDC)
  • The 2016 National Adult and Influenza Immunization Summit is scheduled for May 10–12, 2016 in Atlanta, GA. The password-protected registration site is now available online. Persons needing the password for this invitation only event may contact L.J Tan or LaDora Woods. Persons needing a hotel room are asked to go through the Summit website when making hotel reservations and to request a room soon, as the rooming block is filling up quickly.

SUMMIT CALL RECAP – MARCH 17, 2016


Influenza Surveillance Update – Sophie Smith (CDC)

Today’s report provides a summary of published reports for week 9, ending March 5, 2016. Influenza activity in the U.S. remained elevated during this week.

CDC is now reporting separately on influenza specimens received from U.S. clinical laboratories and U.S. public health laboratories. For week 9, 20.6% of specimens submitted to clinical laboratories were positive for influenza. Of these, 77.6% were influenza A and 22.4% were influenza B. For public health laboratories, 1,074/1,880 (57.1%) specimens were positive, with 810 (75.4%) influenza A and 264 (24.6%) influenza B.

Nine hundred seventy (970) influenza virus specimens have been characterized as of October 1. Of these, 385 were A(H1N1), 275 were A(H3N2), and 310 were influenza B. All 385 A(H1N1) viruses and all 275 A(H3N2) viruses were similar to their respective components of the 2015–2016 Northern Hemisphere vaccine. A subset of 113 H3N2 viruses also were antigenically characterized, with 106/113 (93.8%) being A/Switzerland/9715923/2013-like. Two hundred five (205) of the B viruses were of the B/Yamagata lineage, and the remaining 105 were B/Victoria.

Since October 1, 1,322 influenza viruses have been tested for antiviral resistance, including 596 influenza A(H1N1), 350 influenza A(H3N2), and 376 influenza B. Of these, 2 influenza A(H1N1) were resistant to oseltamivir and peramivir. All the remaining samples tested were sensitive to oseltamivir, zanamivir, and peramivir.

Based on National Center for Health Statistics (NCHS) data available on March 10, 2016, 6.9% of deaths occurring during the week ending February 20 (week 7) were due to pneumonia and influenza (P&I.) (NCHS data has an approximate 2-week lag time for reporting.) This is below the epidemic threshold of 7.7% for week 7. Similarly, data from the 122 Cities Mortality Reporting System for week 9 indicate 7.0% of deaths were due to P&I. This is below the epidemic threshold of 7.2% for week 9.

Two influenza-associated pediatric deaths were reported to CDC during week 9. A total of 20 influenza-associated pediatric deaths have been reported during the 2015–2016 season. Of these 20 deaths, 3 had no vaccination history available, 1 was not eligible for vaccination due to age, 1 was fully vaccinated, and 15 were unvaccinated.

For week 9, the cumulative hospitalization rate was 10.4 laboratory-confirmed influenza-associated hospitalizations per 100,000 population. The highest rate of hospitalization was among adults aged >65 years (27.6 per 100,000 population), followed by children aged 0–4 years (15.8 per 100,000 population). Among all hospitalizations, 76.5% were associated with influenza A, the majority of which were influenza A(H1N1). Hospitalizations also were associated with influenza A(H3), B, and A/B co-infections.

During week 9, influenza-like Illness (ILI) activity levels, which are based on the percent of outpatient visits due to ILI, were at 3.5%, above the baseline of 2.1% for the week.

On a regional level, outpatient visits for ILI ranged from 1.6% to 4.8% during week 9. All 10 public health regions reported outpatient visits for ILI to be at or above region-specific baseline levels. The geographic spread of influenza as assessed by state and territorial epidemiologists indicates the following levels of influenza activity during week 9:

  • Widespread – 37 states and Puerto Rico
  • Regional – 13 states and Guam
  • Local – District of Columbia
  • Sporadic – Virgin Islands

Troy Knighton noted that so far this season the Veteran’s Administration (VA) has reported eleven influenza deaths in adults. In general, the VA data parallels the national data for testing and the number of positive specimens.


Announcements – L.J Tan (CDC)
  • Guidelines for the Summit’s Adult Vaccine Video Contest are available online. Please be sure to share information about this unique opportunity. The deadline for submissions is March 15.

SPECIAL ANNOUNCEMENTS


Vote for your Favorite Adult Vaccine Video: Voting Closes April 12, 2016

The National Adult and Influenza Immunization Summit (NAIIS) recently asked the public to make short, creative videos to help educate adults about the importance of adult vaccines. Video makers were asked to incorporate at least one of the following important adult vaccine messages:

  • Vaccines aren’t just for kids. Adults need vaccines, too.
  • Adults can’t afford to risk getting sick
  • Adults can protect their health and the health of those around them by getting the recommended vaccines
  • Adults should talk to their healthcare professional to make sure they are up to date with the vaccines recommended for them

The Adult Vaccine Video Contest Review Board received multiple fantastic entries! Now you can vote for your favorite by watching the videos on YouTube and “liking” your favorite. (Note: You must have a YouTube account and be signed in for your vote to count.) See the Summit website for information on how to vote and links to the seven finalists. The first and second-place videos will be announced during the NAIIS meeting being held in Atlanta on May 10–12. Voting closes at 5 p.m. (ET) on April 12, so be sure to vote for your favorite now!


United States Department of State Seeks Public Comment on WHO Pandemic Influenza Preparedness Framework

The U.S. Department of State is soliciting comments from the public and relevant industries on influenza surveillance and response, related to the implementation of the World Health Organization (WHO) Pandemic Influenza Preparedness Framework (PIP-FW). Comments are specifically requested on the PIP-FW Review areas of virus sharing and benefits sharing, and on governance and linkages with other international programs or instruments. The Federal Register announcement is available online.


Help IAC Promote Florida and Georgia Workshops to Improve Implementation of Standing Orders for Adult Vaccines

Please help IAC get the word out to Florida and Georgia medical practices on the availability of workshops to help them implement standing orders for adult vaccinations. These workshops are part of a national initiative to put standing orders into action. IAC is also delighted to announce that immunization thought leaders Drs. Vincent Hsu, Naresh Pathak, and Carolyn Bridges will be presenting at the workshops.

Florida workshops are being held in Orlando (April 12) and Fort Lauderdale (April 13), and the Georgia workshop is in Atlanta (April 15).

As part of the initiative, IAC is offering a full year of free follow up support to medical practices that participate in the workshop and implement standing orders for adult vaccines.

Check the standing orders website to register for the workshops or to learn more about the initiative and see other workshop locations.


INFORMATION FROM CDC


CDC/Influenza Division Weekly Influenza Surveillance Report and CDC Key Points

The CDC weekly influenza surveillance report for week 12, 2016 (ending March 26, 2016) and region specific data are now available.

NCHS mortality surveillance data for week 10 (ending March 12, 2016, but available March 31, 2016) indicate 7.3% of deaths were due to pneumonia and influenza (P&I). This percentage is below the epidemic threshold of 7.6% for week 10. Region and state-specific NCHS data are available online. During week 12, 7.7% of all deaths reported through the 122 Cities Mortality Reporting System were due to P&I. This percentage was above the epidemic threshold of 7.2% for week 12.

CDC characterized 1,341 influenza viruses [550 A (H1N1)pdm09, 336 A (H3N2), and 455 influenza B viruses] collected by U.S. laboratories since October 1, 2015. All 336 A (H3N2) viruses were genetically sequenced, and all viruses belonged to genetic groups for which a majority of viruses antigenically characterized were similar to A/Switzerland/9715293/2013, the influenza A (H3N2) component of the 2015–2016 Northern Hemisphere vaccine. A subset of 151 H3N2 viruses also were antigenically characterized; 143 of 151 (94.7%) H3N2 viruses were A/Switzerland/9715293/2013-like by HI testing or neutralization testing.

All 550 (100%) influenza A (H1N1)pdm09 viruses were antigenically characterized as A/California/7/2009-like, the influenza A (H1N1) component of the 2015-2016 Northern Hemisphere vaccine. All 296 (100%) B/Yamagata-lineage viruses were antigenically characterized as B/Phuket/3073/2013-like, which is included as an influenza B component of the 2015–2016 Northern Hemisphere trivalent and quadrivalent influenza vaccines. One hundred fifty-five of 159 (97.5%) B/Victoria-lineage viruses were antigenically characterized as B/Brisbane/60/2008-like, which is included as an influenza B component of the 2015–2016 Northern Hemisphere quadrivalent influenza vaccines.

Three influenza-associated pediatric deaths were reported to CDC during week 12. One death was associated with an influenza A (H1N1)pdm09 virus and occurred during week 11 (week ending March 19, 2016). One death was associated with an influenza A virus for which no subtyping was performed and occurred during week 11 (week ending February 27, 2016), and one death was associated with an influenza A virus for which no subtyping was performed and occurred during week 11. One death was associated with an influenza B virus and occurred during week 8 (the week ending February 27, 2016).

A total of 33 influenza-associated pediatric deaths have been reported during the 2015-2016 season from Puerto Rico [1], Chicago [1], and 15 states (Arizona [3], California [6], Florida [6], Illinois [1], Indiana [2], Louisiana [1], Michigan [1], Minnesota [3], Mississippi [1], Nebraska [1], Nevada [2], New York [1], Tennessee [1], Texas [1], and Washington [1]). More detail is available on CDC’s Influenza-Associated Pediatric Mortality webpage.

The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts population-based surveillance for laboratory-confirmed influenza-related hospitalizations in children younger than 18 years of age (since the 2003–2004 influenza season) and adults (since the 2005–2006 influenza season) in select counties in the Emerging Infections Program (EIP) states and Influenza Hospitalization Surveillance Project (IHSP) states.

Between October 1, 2015 and March 26, 2016, 5,915 laboratory-confirmed influenza-associated hospitalizations were reported. The overall hospitalization rate was 21.4 per 100,000 population. The highest rate of hospitalization was among adults aged ≥65 years (54.5 per 100,000 population), followed adults aged 50–64 (31.4 per 100,000 population) and children aged 0–4 years (29.3 per 100,000 population). Among all hospitalizations, 4,711 (79.6%) were associated with influenza A, 1,143 (19.3%) with influenza B, 33 (0.6%) with influenza A and B co-infection, and 28 (0.5%) had no virus type information. Among those with influenza A subtype information, 1,390 (90.1%) were A(H1N1)pdm09 and 153 (9.9%) were A(H3N2) virus.

Clinical findings are preliminary and based on 1,094 (18.8%) cases with complete medical chart abstraction. The majority (91.4%) of hospitalized adults had at least one reported underlying medical condition; the most commonly reported were obesity, cardiovascular disease, metabolic disorders and chronic lung disease. There were 159 hospitalized children with complete medical chart abstraction; 89 (55.9%) had at least one underlying medical condition. The most commonly reported underlying medical conditions among pediatric patients were asthma and neurologic disorders. Among the 114 hospitalized women of childbearing age (15-44 years), 25 (21.9%) were pregnant.

Nationwide during week 12, 2.9% of patient visits reported through the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) were due to influenza-like illness (ILI). This percentage is above the national baseline of 2.1%. ILI is defined as fever (temperature of 100°F [37.8°C] or greater), and cough and/or sore throat.

An Influenza Summary Update of the influenza activity reported by state and territorial epidemiologists, which indicates geographic spread of influenza viruses but does not measure the intensity of influenza activity, is available. This currently reflects data from March 26, 2016. Currently 31 states are reporting widespread activity, 18 states are reporting regional activity, and the remaining states are reporting local or sporadic activity.

CDC Influenza Division seasonal influenza key points for April 1 are now available, as is the FluView report for week 12, ending March 26. Archives of previous FluViews also may be found online.


Global Role and Burden of Influenza in Pediatric Respiratory Hospitalizations, 1982-2012: A Systematic Analysis

On March 24, 2016, the manuscript, “Global Role and Burden of Influenza in Pediatric Respiratory Hospitalizations, 1982-2012: A Systematic Analysis,” was published in PLOS Medicine. The study is a collaboration between CDC and global partners looking at data from 350 sites in 60 countries. The main finding is that influenza is responsible for about 10% of respiratory hospitalizations in all children younger than 18 years worldwide, with the highest proportion of flu respiratory hospitalizations occurring among children 5 years to 17 years of age.


CDC Zika Resources

For Clinicians Caring for Pregnant Women and Women of Reproductive Age

US Zika Pregnancy Registry
To understand more about Zika virus infection during pregnancy and congenital Zika virus infection, CDC established the US Zika Pregnancy Registry and is collaborating with state, tribal, local, and territorial health departments. The data collected through this registry will be used to update recommendations for clinical care, to plan for services for pregnant women and families affected by Zika virus, and to improve prevention of Zika virus infection during pregnancy.

MMWR: Interim Guidance for Health-Care Providers Caring for Women of Reproductive Age with Possible Zika Virus Exposure — United States, 2016
CDC has updated its interim guidance for U.S. health-care providers caring for women of reproductive age with possible Zika virus exposure  to include recommendations for counseling women and men with possible Zika virus exposure who are interested in conceiving. The updated guidelines also include recommendations for Zika virus testing and guidance for women residing along the US-Mexico Border.

Tools for Health-Care Providers
View printable and easy to use CDC testing algorithms for Zika virus infection.

Clinical Consultation Service for Health-Care Providers Caring for Pregnant Women with Possible Zika Virus Infection
CDC maintains a 24/7 consultation service for health-care providers caring for pregnant women with possible Zika virus infection. This consultation service is NOT for patients or the general public. To contact the service, call CDC-INFO at 800-232-4636 or email.

MMWR: Estimating Contraceptive Needs and Increasing Access to Contraception in Response to the Zika Virus Disease Outbreak — Puerto Rico, 2016
Approximately two thirds of pregnancies in Puerto Rico are unintended. An estimated 138,000 women of reproductive age (15–44 years) in Puerto Rico do not desire pregnancy and are not using an effective contraceptive method. Access to contraception is constrained by limited availability, especially of highly effective long-acting reversible contraceptives, high cost, incomplete insurance coverage, and lack of trained providers.

MMWR: Preventing Transmission of Zika Virus in Labor and Delivery Settings Through Implementation of Standard Precautions — United States, 2016
CDC recommends Standard Precautions in all health-care settings to protect both health-care personnel and patients from infection with Zika virus as well as from blood-borne pathogens (e.g., human immunodeficiency virus [HIV] and hepatitis C virus [HCV]).

Questions and Answers For Health-Care Providers Caring for Pregnant Women and Women of Reproductive Age with Possible Zika Virus Exposure

Interim Guidelines for Health-Care Providers Caring for Pregnant Women and Women of Reproductive Age with Possible Zika Virus Exposure — United States, 2016Updated guidelines include a new recommendation to offer serologic testing to asymptomatic pregnant women (women who do not report clinical illness consistent with Zika virus disease) who have traveled to areas with ongoing Zika virus transmission.  This update also expands guidance to women who reside in areas with ongoing Zika virus transmission. Local health officials should determine when to implement testing of asymptomatic pregnant women on the basis of information about levels of Zika virus transmission and laboratory capacity.
Clinicians Caring for Infants and Children

Questions and Answers For Health-Care Providers Caring for Infants and Children with Possible Zika Virus Infectionhttp://www.cdc.gov/zika/hc-providers/qa-pediatrician.html

MMWR: Increase in Reported Prevalence of Microcephaly in Infants Born to Women Living in Areas with Confirmed Zika Virus Transmission During the First Trimester of Pregnancy — Brazil, 2015

Interim Guidelines for Health-Care Providers Caring for Infants and Children with Possible Zika Virus Infection — United States, February 2016
CDC has updated its interim guidelines for U.S. health-care providers caring for infants born to mothers who traveled to or resided in areas with Zika virus transmission during pregnancy and expanded guidelines to include infants and children with possible acute Zika virus disease.

Sexual Transmission

MMWR: Interim Guidance for Prevention of Sexual Transmission of Zika Virus — United States, 2016
The following recommendations apply to men who have traveled to or reside in areas with active Zika virus transmission and their female or male sex partners. These recommendations replace the previously issued recommendations and are updated to include time intervals after travel to areas with active Zika virus transmission or after Zika virus infection for taking precautions to reduce the risk for sexual transmission.

Zika and Sexual Transmission

MMWR: Transmission of Zika Virus Through Sexual Contact with Travelers to Areas of Ongoing Transmission — Continental United States, 2016

Zika Travel Information

MMWR: Travel-Associated Zika Virus Disease Cases Among U.S. Residents — United States, January 2015–February 2016
During January 1, 2015–February 26, 2016, a total of 116 residents of U.S. states and the District of Columbia had laboratory evidence of recent Zika virus infection based on testing performed at CDC, including one congenital infection and 115 persons who reported recent travel to areas with active Zika virus transmission (n = 110) or sexual contact with such a traveler (n = 5).

MMWR: Revision to CDC’s Zika Travel Notices: Minimal Likelihood for Mosquito-Borne Zika Virus Transmission at Elevations Above 2,000 Meters

Zika Virus Infection Among U.S. Pregnant Travelers — August 2015–February 2016

CDC Issues Advice for Travel to the 2016 Summer Olympic Games

Zika Travel Notices

Conferences and Meetings

A CDC Update for Clinicians on Zika Virus Disease with Platform Q Health
Date: Wednesday, April 6, 2016
Time: 1:00 – 2:00 pm (Eastern Time)
Join us for this educational activity to learn the latest information about Zika and to gain a better understanding of the role of clinicians in early recognition and reporting of suspected cases.

Zika Action Plan Summit
CDC is hosting a one-day Zika Action Plan Summit as the nation faces likely local mosquito-borne transmission of Zika virus in some places in the continental United States. Register to watch the Summit live.

Clinical Evaluation and Testing

Biosafety Guidance for Transportation of Specimens and for Work with Zika Virus in the Laboratory

CDC Laboratory Test for Zika Virus Authorized for Emergency Use by FDA
In response to a request from the Centers for Disease Control and Prevention, the U.S. Food and Drug Administration issued an Emergency Use Authorization for the Trioplex Real-time RT-PCR Assay, a diagnostic tool for Zika virus that will be distributed to qualified laboratories.

Clinical Evaluation & Disease
Zika virus is transmitted to humans primarily through the bite of an infected Aedes species mosquito. Most people infected with Zika virus are asymptomatic. Characteristic clinical findings are acute onset of fever with maculopapular rash, arthralgia, or conjunctivitis. Other commonly reported symptoms include myalgia and headache.

Diagnostic Testing
Contact your state or local health department to facilitate testing.

Collection and Submission of Body Fluids for Zika Virus Testing

State and Local Health Department Resources

Top 10 Zika Response Planning Tips: Brief Information for State, Tribal, Local, and Territorial Health Officials

Zika Virus Risk-Based Preparedness and Response Guidance for States

Zika Virus Microsite
CDC has developed an easily embeddable collection of Zika virus information for partner and stakeholder websites. This collection, called a microsite, can supplement partner web sites with CDC’s up-to-date, evidence-based content. The content is automatically updated when CDC’s website is updated.


CDC Measles Update

CDC has new measles information and resources available for you to share with your membership, including key points that can be obtained upon request. These key points are meant to be a resource for increasing awareness of measles activity, other pertinent information, and communicating measles-related messages.

Contact Jill Woodard at the CDC if you have any questions or additional requests for information.  Also, CDC would like to know what you are doing to promote MMR vaccination and measles education to your membership.


CDC Clinician Outreach and Communication Activity (COCA) Information

CDC Science Clips: Volume 7, Issue: 49 – (CDC)
Each week select science clips are shared with the public health community to enhance awareness of emerging scientific knowledge. The focus is applied public health research and prevention science that has the capacity to improve health now.

Seasonal Influenza Information for Healthcare Professionals
The CDC’s Long Term Care toolkit is also available at his website.

Upcoming and Recent COCA Webinars/Calls

Update on Interim Zika Virus Clinical Guidance and Recommendations
During this COCA Call, participants learned why CDC has updated the clinical guidelines and how they can use the guidelines for Zika virus evaluation and testing.

2015­–2016 Influenza Activity and Clinical Recommendations
During this COCA Call, clinicians learned about 2015–2016 influenza activity, heard an overview of CDC’s current recommendations for vaccination and antiviral medications, and gained insight into data supporting the recommendations.


OTHER NEWS


Summit Announces Winners of Its Immunization Excellence Awards

Recognizing the value and extraordinary contributions of individuals and organizations towards improved vaccination rates within their communities during the past year, the National Adult and Influenza Immunization Summit is pleased to announce the recipients of the 2016 Immunization Excellence Awards. The awards will be presented during the National Adult and Influenza Immunization Summit in Atlanta, Georgia, May 11, 2016.

There are five categories of recognition: overall influenza season activities, “immunization neighborhood” champion, corporate campaign, adult immunization champion, and adult immunization publication award. Nominees were evaluated based on the areas of impact, originality, challenges, opportunities, collaboration, coordination, and communication with partners and stakeholders.

Many exciting and innovative programs were nominated this year. The Summit applauds all nominees who are working towards improving the health of their communities.

Complete descriptions of the award winners will be within the Summit Awards booklet available on May 11th at the Summit website.


Veterans Health Administration (VHA) Influenza Report

Veteran Patient Data
VHA patient summary data is presented below.  For details (and “by facility” reports) visit the IDPIO SharePoint site.  This report is compiled by the Public Health Surveillance and Research Group, Office of Quality, Safety and Value.

Since August 1, 2015:

  • Over 1.69 million flu vaccinations have been administered in outpatient settings within VHA facilities.
  • 9.7% (165,163) were coded as being the high-dose vaccine formulation.
  • These vaccination figures do not include inpatients or patients who may have been vaccinated outside of VHA, such as at a Walgreen’s Pharmacy. (Walgreen’s has provided over 42,000 immunizations to VA patients since Aug 1, 2015.)
  • 10.4% (3,955/37,961) of patients tested have been confirmed for influenza by VA laboratories.
  • 76.8% of positive tests were Influenza A, 22% were Influenza B, and 1.2% unspecified.
  • 974 individuals had an influenza-coded hospitalization for 2015–16 season.
  • Overall for the season, 13% (127/974) required an critical care/ICU stay.
  • 19 deaths have been recorded.

During week 11 (Mar 13 – Mar 19, 2016):

  • Over 8,000 patient flu vaccinations were administered in VHA facilities.
  • 20.8% (578/2,777) lab specimens tested positive for influenza.
  • The highest number of lab-confirmed flu tests were seen in California (58), Florida (57), Illinois, (29), Texas (27) and Ohio (26).
  • The proportion of primary/urgent care outpatient visits for ILI was 2.0%.


NACCHO Assessment of Local Health Department Use of Immunization Information Systems

In the fall of 2015, NACCHO conducted an assessment of local health department use of Immunization Information Systems (IIS). NACCHO would like partners to know that it has recently created a one-pager highlighting key findings from the assessment, and that one-pager is now posted on its blog here.  Please feel free to disseminate and share it with your network and members.


School-based Influenza Vaccination Clinics Reduce Absenteeism

School-based clinics providing influenza vaccinations to school-aged children reduced the rate of influenza-related absenteeism from schools in Arkansas, according to recent study findings.

“School-aged children are an important target for influenza prevention as children experience high rates of influenza infection, and due to insufficient hygienic practices, are likely to amplify disease transmission in communal settings, such as schools,” Rachel E. Gicquelais, MPH, of the CDC and Council of State and Territorial Epidemiologists, and colleagues wrote in the Journal of School Health. “Therefore, the CDC recommends that authorities consider providing influenza vaccine in schools.”

A related news story is available online.


Flu Shot During Pregnancy May Cut Stillbirth Risk by Half

Getting a flu shot during pregnancy may do more than protect against the flu, researchers reported. In a retrospective cohort analysis covering some 60,000 births, influenza immunization was associated with a more than 50% reduction in stillbirths.

The study findings support the safety of seasonal influenza immunization during pregnancy, and suggest a protective benefit, researcher Annette Regan, MPH, of Western Australia Department of Health, and colleagues, wrote online in Clinical Infectious Diseases.


You Call the Shots Modules from CDC

You Call the Shots is a web-based training course developed through the Project to Enhance Immunization Content in Nursing Education and Training. Several updated modules are now available, including Hepatitis B, Pneumococcal, and Meningococcal. Please visit the You Call the Shots web page for additional information and other modules. Continuing Education (CE) credit is available for viewing a module and completing an evaluation.


Kansas Court of Appeals: Vaccine Objector Can Be Denied Unemployment Benefits

The Kansas Court of Appeals ruled Friday that a former hospital employee who conscientiously objected to receiving a flu vaccine can be denied unemployment benefits.


A Vaccine Scandal in China Causes an Outcry

Wang Sheng Sheng, a lawyer who lives in Guangzhou in southern China, is the mother of a newborn baby. The province’s health officials advised her, she says, to have her baby vaccinated not only against tuberculosis and hepatitis-B (which is mandatory) but also against chickenpox, hepatitis-A, meningitis and other diseases, which is not. She did so, and got a hepatitis-A vaccination herself. A few days later, China’s latest medical scandal erupted. The country, it turns out, has been using millions of doses of outdated or improperly stored vaccines for the diseases not covered by the mandatory programme.


Ebola Is Spreading Again in West Africa — But This Time There’s a Plan to Stop It

At least nine new cases of Ebola have been reported in West Africa in recent weeks, reviving fears of another deadly outbreak more than two years after the hemorrhagic fever began killing thousands in the region. The latest case was recorded in Liberia’s capital Monrovia. A sick woman was transported from a clinic in the nearby city of Paynesville to Monrovia’s Redemption Hospital, the epicenter of the 2014 outbreak in the country. Health officials announced on Friday that the woman, who was said to be in her early 30s, died the previous day.


H1N1 Dominates Mild 2015–2016 flu season

The 2015–2016 influenza season has been milder than the previous 3 seasons and appears to have peaked later than normal, according to the CDC.  “It looks like March will have been the peak for this season,” Lynnette Brammer, MPH, epidemiologist for the CDC’s domestic influenza surveillance team, told Infectious Disease News. However, because influenza viruses can circulate year-round in the United States, Brammer said people should continue to get vaccinated. According to the latest data, this season’s vaccine has been much more effective than the vaccine from last season, and several indicators of influenza activity are down.


Please Help the Summit, AIRA, and CDC Engage EHR Vendors in Immunization IT

The Summit has been active and interested in improving interoperability and utilization of EHRs and immunization information systems (IIS) for several years. Indeed, for the past two years, there has been a lot of prioritization of IIS and health information technology (HIT) activity within the Summit workgroups.

However, engagement by vendors of EHRs remains difficult. We hope that, with the Summit’s support, we can begin to change that in little steps. If you are connected with an EHR vendor, perhaps you can start by encouraging them to simply join in two activities in the IIS community that are not demanding on their time.

The first is the AIRA Standards & Interoperability Steering Committee (SISC). SISC provides technical support and guidance to interoperability efforts of AIRA members and the IIS community. They act as a liaison between national organizations involved with interoperability, such as the Office of the National Coordinator (ONC) and others, and serve as a technical resource for AIRA members and the IIS community.  SISC meets the 2nd Wednesday of every month from 1–2 pm ET. Participation of EHR, pharmacy, health information exchange (HIE), and other IIS partners trading perspectives is welcomed to help drive forward increased interoperability. For more information, please connect with Mary Beth Kurilo.

The second is the CDC Clinical Decision Support for Immunization (CDSi) project. This project provides a single, authoritative, implementation-neutral foundation for development and maintenance of CDS engines. It captures ACIP recommendations in an unambiguous manner and improves the uniform representation of vaccine decision guidelines, as well as the ability to automate vaccine evaluation and forecasting. Interested parties can reach out to Eric Larson.


Three Slide Decks Available to Support New Standards for Adult Immunization Practice

The Summit’s Access and Collaboration workgroup has developed three separate slide decks with talking notes to support partners and others who wish to present on the Standards to their peers and colleagues. The three audiences targeted by the decks are: healthcare providers; patients/public; and public health. These are now available, along with tips and tools on how to use them, at the Summit website.

Also do not forget that Medscape has produced two modules to support the implementation of the Standards:


Every Child By Two (ECBT) Compiles Media Information on Its Website

On a daily basis, ECBT assembles significant news media coverage on immunizations in their “Daily Clips.” Summit partners may find this effort useful.


Summit Website Offers Wonderful Resources on Influenza Vaccination

Remember to visit the Summit website for the latest on influenza immunization resources. You also can find archived copies of The Summit Buzz there.


Reminder

Summit calls are now scheduled every Thursday at 3 p.m. Eastern time, unless cancelled. Please email L.J Tan or LaDora Woods if you have any updates on activities to provide to the Summit.

 

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