December 22, 2014


Summit Call Recap – December 18, 2014
Information from CDC


Influenza Surveillance Update – shared by L.J Tan (IAC)

Sophie Smith, who usually provides the influenza surveillance update from CDC, was unable to be on today’s call. However, CDC staff provided a written summary to L.J for sharing with the Summit.

Influenza is continuing to increase. For week 49, ending December 6, approximately 21.2% of the 16,093 specimens submitted to collaborating laboratories for testing were positive. The vast majority of the subtyped influenza A viruses were influenza A (H3).

Of the deaths reported through the 122 Cities Mortality Reporting System during week 49, 6.0% were attributed to pneumonia and influenza (P&I), below the 6.6% epidemic threshold for the week. Reports indicated there were 3.8 laboratory-confirmed influenza-associated hospitalizations per 100,000 population. The highest rate of hospitalization was among adults age >65 years (13.4 per 100,000 population), followed by children age 0–4 years (6.2 per 100,000 population).

The ILI-Net national data indicated 2.5% of total patient visits were for ILI, which is above the national baseline level of 2.0% for this week. Eight of 10 regions reported ILI at or above region-specific baseline levels.

Two new influenza-associated pediatric deaths were reported during the week. One death was associated with influenza A (H3) virus, while the other was associated with an influenza A for which subtyping was not performed. A total of 7 pediatric deaths have been reported so far during the 2014–2015 season.

As shown in CDC’s weekly influenza summary map, the geographic spread for influenza for week 49 is:

  • Widespread – 14 states
  • Regional – 25 states, Guam, Puerto Rico
  • Local – 7 states, Virgin Islands
  • Sporadic – 4 states, District of Columbia
  • No activity – no states

Since October 1, CDC has antigenically characterized 236 influenza viruses, including 10 influenza A (H1N1) viruses, 197 influenza A (H3N2) viruses, and 29 influenza B viruses. All 10 influenza A (H1N1) viruses tested were characterized as A/California/7/2009-like, the influenza A (H1N1) component of the 2014–2015 Northern Hemisphere influenza vaccine. Of the 197 influenza A (H3N2) viruses tested, 64 were characterized as A/Texas/50/2012-like, which also is included in this season’s Northern Hemisphere vaccine. The remaining 133 viruses tested showed either reduced titers with antiserum produced against A/Texas/50/2012 or belonged to a genetic group that typically shows reduced titers to A/Texas/50/2012. The majority of these 133 were antigenically similar to A/Switzerland/9715293/2013, the H3N2 virus selected for the 2015 Southern Hemisphere influenza vaccine. Both B/Victoria and B/Yamagata-lineage viruses are circulating in the U.S. Twenty of the 29 influenza B viruses tested belonged to the B/Yamagata/16/88 lineage and were characterized as B/Massachusetts/2/2012-like, a component of both the trivalent and quadrivalent vaccines for the Northern Hemisphere. Seven of the 9 other influenza B viruses belonged to the B/Victoria lineage and were characterized as B/Brisbane/0/2008-like, a component of the 2014–2015 Northern Hemisphere quadrivalent influenza vaccine. Two of the B/Victoria-lineage viruses tested showed reduced titers to B/Brisbane/60/2008.

None of the specimens tested this season has shown resistance to oseltamivir or zanamivir.

A Summit member asked whether reports that this year’s drifted strain is not a component of this season’s vaccine are having an impact on vaccine coverage. Carolyn Bridges replied that we won’t have specific data on this until next September. The early season coverage reports (through November) indicated vaccine coverage is on par with this time last year, but this was before general information about the drifted strain was available. In response to questions about perceived severity of illness this year, Carolyn stated that we appear to be having similar impact of illness compared to last year at this time. However, she also pointed out that that we often see great variation from community to community during every influenza season. In years in which H1N1 is the predominant strain, we typically see greater impact in children. When H3N2 predominates, we typically see more illness in the elderly, so we should anticipate a greater impact in the elderly population this year. Carolyn reminded Summit members about the importance of early use of antiviral medications when influenza is suspected, particularly in long term care settings with many elderly patients.

Other Items – L.J Tan (IAC)
  • Summit Calls – L.J reminded Summit members that our regular call will not take place for the next two Thursdays (December 25 and January 1). However, updated information will continue to be available in The Summit Buzz throughout the holidays. Our next regularly scheduled Summit call will take place on January 8, 2015.
  • Surveillance Reports – CDC’s weekly surveillance reports, which usually are posted on Friday of each week, will be delayed until the following Mondays (December 28 and January 5) during the holidays.


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

The CDC weekly influenza surveillance report for week 50 (ending December 13, 2014) and region specific data are now available. During week 50, 6.0% of all deaths reported through the 122 Cities Mortality Reporting System were due to pneumonia and influenza (P&I). This percentage was below the epidemic threshold of 6.7% for week 50.

For the 2014–2015 influenza season, the CDC/Influenza Division and the National Center for Health Statistics (NCHS) are collaborating on a pilot project to use NCHS mortality surveillance data for the rapid assessment of pneumonia and influenza (P&I) mortality.

Four influenza-associated pediatric deaths were reported to CDC during week 50. Two deaths were associated with an influenza A (H3) virus and occurred during week 49 (week ending December 6, 2014). One death was associated with an influenza A virus for which no subtyping was performed and occurred during week 50 (week ending December 13, 2014), and one death was associated with an influenza B virus and occurred during week 49. A total of 11 influenza-associated deaths have been reported during the 2014-2015 season from six states (Florida [2], Minnesota [2], North Carolina [2], Nevada [1], Ohio [2], and Texas [2]).

Between October 1, 2014 and December 13, 2014, 1,702 laboratory-confirmed influenza-associated hospitalizations were reported. The overall hospitalization rate was 6.2 per 100,000 population. The highest rate of hospitalization was among adults aged ≥65 years (23.6 per 100,000 population), followed by children aged 0-4 years (9.3 per 100,000 population). Among all hospitalizations, 1,611 (94.7%) were associated with influenza A, 81 (4.7%) with influenza B, five (0.3%) with influenza A and B co-infection, and five (0.3%) had no virus type information. Among those with influenza A subtype information, 463 (100%) were H3N2 virus. Additional virus characterization is available on FluView.

Nationwide during week 50, 3.7% 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 2.0%. 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 the December 13, 2014. At this time, 30 states are reporting widespread influenza activity.

The FluView report for week 50 and archives of previous FluViews are available from CDC. CDC also has released seasonal influenza key points for December 19, 2014.

Updated Key Points on EV-D68 Infections and Disease

The United States has been experiencing a nationwide outbreak of enterovirus D68 (EV-D68) associated with severe respiratory illness. Updated EV-D68 key points, current as of December 18, 2014, include the weekly update of EV-D68-like illness activity in states and specimens that tested positive for EV-D68 from patients who died.

Updated Information on Acute Flaccid Myelitis

Up-to-date key points from December 18, 2014 are now available about the investigation of acute flaccid myelitis in children, including the weekly update of CDC-verified neurologic illness cases reported by states that meet the case definition.

Updated CDC Social Messaging on Influenza

CDC’s Influenza Division has developed the following social media messages that your organization may use to help communicate about influenza and flu activity. These can be tweeted using your organization’s Twitter handle or adapted for use on other social media platforms. CDC will share suggested social media messages every other week.

  • The percentage of ppl in the U.S. visiting the doctor for ‎#flu showed a large increase last week. Learn more:
  • Get serious about the #flu. It can lead to hospitalization and even death. Learn more abt #flu #getafluvax
  • #Fluvax offers the best protection against flu, even if some circulating viruses are different from vax virus.
  • Take #flu antivirals if your dr. prescribes them. They’re especially important if you’re at high risk for flu complications
  • A manufacturer of #flu antivirals @Genentech says this season’s flu antiviral supply is ample. More in:
  • Upcoming and Recent CDC COCA Calls

None upcoming.


AOHP Announces Supportive Position Statement on Standards for Adult Immunization Practice

As the national leader for occupational health in healthcare, the Executive Board of Directors for the Association of Occupational Health Professionals in Healthcare (AOHP) recently adopted a new position statement on Standards for Adult Immunization Practice.

In its Standards for Adult Immunization Practice, AOHP strongly supports, through advocacy and education, safe administration of immunizations to adults in the healthcare workplace as recommended by the Advisory Committee on Immunization Practices (ACIP) to help prevent serious illnesses and transmission of diseases, and to minimize absenteeism associated with vaccine-preventable diseases. AOHP encourages its members and their organizations to adopt the Standards for Adult Immunization Practice and implement the following steps to ensure that adult patients are fully immunized:

  • Assess immunization status of all patients in every clinical encounter.
  • Share a strong recommendation for vaccines that patients need.
  • Administer needed vaccines, or refer to a provider who can vaccinate.
  • Document vaccines received by the patients in state vaccine registries.

In addition, AOHP advocates for mandates that all healthcare personnel be offered ACIP-recommended immunizations at no charge. AOHP respects the individual healthcare worker’s right to make an informed decision regarding vaccinations and supports healthcare institutions in developing their own policies and practices to immunize their workforce consistent with the ACIP recommendations. AOHP believes that immunization of healthcare personnel is essential to their health and the health of their patients, and the organization is committed to promoting ACIP-recommended immunizations for healthcare workers and the Standards for Adult Immunization Practice in healthcare institutions represented by AOHP members.

AOHP is recognized as the definitive resource for issues related to staff in the healthcare setting and holds the exclusive mission of addressing the needs and concerns of occupational health professionals in healthcare settings, which includes the development of position statements on a variety of other related issues, such as:

      • Confidentiality of Employee Health Records
      • Influenza Vaccination of Healthcare Workers
      • Injury and Illness Prevention Programs
      • Occupational Health Professionals in Healthcare Settings
      • Safe Patient Handling

AOHP is a national association representing thousands of healthcare personnel whose vision is to be the defining resource and leading advocate for occupational health, safety and well-being in healthcare. AOHP: advocates for employee health and safety; provides occupational health education and networking opportunities; promotes health and safety advancement through best practice and research; and partners with employers, regulatory agencies and related associations.

For more information, please call AOHP Headquarters at 800-362-4347, or e-mail AOHP’s position statements, including its new Standards for Adult Immunization Practice, are located on the AOHP web page.

NFID’s “Gift of Health” Campaign

The NFID “Gift of Health” campaign includes a series of entertaining visuals for sharing on social media during the holiday season. Using humor to convey a serious message, these visuals communicate that the worst gift you could give this holiday season is a vaccine-preventable disease, like the flu and pneumococcal disease. Join NFID as we continue to urge parents and healthcare professionals to protect children and families against influenza and other infectious diseases. Throughout the holiday season, you can follow NFID’s Twitter and Facebook pages and share these visuals to help spread the word.

Archive of AIM/NFID Webinar “Flu Care in Day Care” Available

NFID, in collaboration with the Association of Immunization Managers (AIM), hosted a webinar—Flu Care in Day Care—on November 18 that featured guest speakers from New Jersey, Connecticut, and New York City presenting on the impact of influenza vaccination requirements for day care and preschool in their respective jurisdictions. NFID will be issuing a brief summary report based on the webinar, which may serve as a helpful guide for others planning similar efforts. If your organization has resources specific to this topic, please share them by sending an email to Ellyn Terry.

Final Summary Report of the 2014 Influenza/Pneumococcal News Conference

The National Foundation for Infectious Diseases (NFID) has released a final summary report with the results from the 2014 NFID Influenza/Pneumococcal News Conference. The report includes an overview of the coverage, stories, and message penetration as well as ongoing efforts to communicate critical public health messages about influenza and pneumococcal disease prevention.

Thanks to your continued support, this year’s high-profile media event reached a national audience with critical public health messages in support of vaccine recommendations. The event resulted in a tremendous amount of quality media coverage and social media engagement.

Key highlights include:

  • Leading by example: Keynote speaker CDC Director Tom Frieden, MD, led by example and posed for the cameras while getting his flu vaccine. This photo was picked up widely by national media and used on social media. Months later, it continues to be published by news outlets.
  • Widespread broadcast coverage: Nearly 60 press members attended the news conference either onsite or via webinar, including six television camera crews, generating a significant increase in media coverage compared to prior years. The event resulted in nearly 4,300 media placements and more than 906,219,919 impressions in print, online, TV, and radio outlets, including Associated Press, TIME, CNN, USA Today, and CBS This Morning.
  • Key messages conveyed: A comprehensive message analysis showed that virtually all coverage (99%) included the call to action for everyone six months and older to get vaccinated, and the majority of print and online coverage highlighted CDC/NFID priority message: the need to increase vaccination rates among young/middle-aged, healthy adults.
  • Significant social media activity: Attendees actively tweeted about the news conference, and the hashtag #FightFlu had more than 300 tweets reaching an estimated 778,323 Top media and medical personalities, such as Liz Szabo of USA Today, also tweeted about the event. The following month, ABC News Chief Health and Medical Editor Richard Besser, MD co-hosted a Twitter chat about flu, extending the news conference messages to an even wider consumer audience.

As influenza activity increases, NFID continues to promote vaccination as the first line of defense against flu, along with the complete CDC “Take 3” approach. In response to recent news about the drifted (H3N2) viruses, NFID experts have participated in national media interviews continuing to recommend flu vaccine as the single best way to prevent flu.

GSK Announces Results from Trial on New Investigational Herpes Zoster Vaccine

GSK Vaccines announced the first results of a phase 3 efficacy study to assess its investigational herpes zoster vaccine (HZ/su). HZ/su is a candidate vaccine that combines gE with an adjuvant system, AS01B.

These are the first results from the Zoster Efficacy study in adults aged 50 years and over (ZOE-50) – NCT01165177. The study, which started in August 2010, is ongoing in 18 countries and involves more than 16,000 individuals.

Analysis of the primary endpoint showed that HZ/su reduced the risk of shingles by 97.2% in adults aged 50 years and older compared to placebo.

Data from the ZOE-50 trial are expected to be presented at a forthcoming scientific conference and submitted for publication in a peer-reviewed journal. Additional trials to evaluate the ability of HZ/su to prevent shingles are underway in individuals aged 70 and older and in immunocompromised people.

NYC to Require Flu Shots in City Regulated Preschools and Child Care Centers

The New York City Health Department says it will now mandate flu shots for children in all city regulated preschools and child care centers. Beginning December 31, children aged 6–59 months will be required to receive the flu shot. The department says this new rule was designed to address the increased risk for flu facing children under age five in group settings such as licensed child care centers or preschools.

FDA Approves Rapivab to Treat Influenza Infection

On December 19, the U.S. Food and Drug Administration approved Rapivab (peramivir) to treat influenza infection in adults.

Rapivab is an inhibitor of influenza virus neuraminidase, an enzyme that releases viral particles from infected cells. Neuraminidase inhibitors are commonly used to treat flu infection. Rapivab is the first neuraminidase inhibitor approved for intravenous (IV) administration and is administered as a single IV dose. It is intended for patients 18 years and older who have acute uncomplicated influenza and have shown symptoms of flu for no more than two days.

Rapivab and other antiviral drugs used to treat flu are not substitutes for early, annual flu vaccination, as recommended by CDC’s Advisory Committee on Immunization Practices. CDC recommends all persons ages 6 months and older receive an annual flu vaccine.

Many Influenza Infections Aren’t Good Match for Vaccine: CDC

The flu is starting to tighten its grip on much of the United States, particularly in the South and Midwest, U.S. health officials reported Thursday. And more than half of the flu infections examined so far have been caused by the strain known as influenza A H3N2, which appears to have mutated from the H3N2 strain included in this year’s flu vaccine. That mutated strain has federal officials concerned because the vaccine may not offer the protection seen in seasons when the vaccine is a better match.

CDC and FDA Revising VAERS Form – Seeking Public Input Until January 23, 2015

As announced in the Federal Register, the US Centers for Disease Control and Prevention (CDC) and US Food and Drug Administration (FDA) are calling for comments on a new adverse event reporting form for vaccines meant to replace the current paper-based reporting form.

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.


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

Summit calls are cancelled for December 25, 2014, and January 1, 2015. Happy holidays and best wishes for a wonderful 2015!

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