June 02, 2015


Summit Call Recap – May 21, 2015
Information from CDC


Influenza Surveillance Update – Sophie Smith (CDC)

Sophie provided a summary of the published reports for week 18, ending May 9, 2015. Influenza activity in the U.S. continues to decrease.

The ILI-Net national data indicated 1.2% of total outpatient visits were for influenza-like illness (ILI), which is below the national baseline of 2.0%. Approximately 4.9% of specimens submitted for testing were positive. Of the deaths reported through the 122 Cities Mortality Reporting System during week 18, 6.5% were attributed to pneumonia and influenza (P&I), below the 6.7% epidemic threshold for the week. Reports indicated there were 65.4 laboratory-confirmed influenza-associated hospitalizations per 100,000 population.

Two influenza-associated pediatric deaths were reported to CDC during the week 18. One death was associated with an influenza A (H3) virus, while the other was associated with an influenza A virus for which subtyping was not performed. A total of 138 pediatric deaths have been reported during the 2014–2015 season. Of the 118 for whom vaccination status was known, 13 were ineligible for vaccination, and only 14 were fully vaccinated. (Note: In response to questions, Sophie stated that “fully vaccinated” means children have received both doses, if recommended for their age. She did not have data on the number of children who might have had only 1 of 2 recommended doses.) Information on the estimated vaccine effectiveness against pediatric death as an outcome is being analyzed now for future publication.

As shown in CDC’s weekly influenza summary map, the geographic spread for influenza for week 18 is:

  • Widespread – 3 states
  • Regional – 2 states and Guam
  • Local – 12 states and Puerto Rico
  • Sporadic – 27 states and the District of Columbia
  • No activity – 6 states and the U.S. Virgin Islands

Since October 1, CDC has antigenically characterized 1,950 influenza viruses; 50 2009 A (H1N1) viruses, 1,267 influenza A (H3N2) viruses, and 633 influenza B viruses. All 50 of the 2009 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 1,267 influenza A (H3N2) viruses tested, 244 (19.3%) were characterized as A/Texas/50/2012-like, which also is included in this season’s Northern Hemisphere vaccine. One thousand twenty-three (80.7%) of viruses tested were different from A/Texas/50/2012. The majority of these were antigenically similar to A/Switzerland/9715293/2013, the influenza A (H3N2) component of the 2015 Southern Hemisphere influenza vaccine. Both B/Victoria and B/Yamagata-lineage viruses are circulating in the U.S. Four hundred forty-three (70.0%) of the influenza B viruses tested belonged to the B/Yamagata/16/88 lineage, and the remaining 190 (30.5%) influenza B viruses tested belonged to the B/Victoria/91/87 lineage. Four hundred thirty-two (97.5%) of the 443 B/Yamagata-lineage viruses were characterized as B/Massachusetts/2/2012-like, a component of both the trivalent and quadrivalent vaccines for the Northern Hemisphere, while 11 (2.5%) of the 443 B/Yamagata-lineage viruses showed reduced titers to B/Massachusetts/2/2012. One hundred eighty-five (97.4%) of the 190 B/Victoria viruses were characterized as B/Brisbane/60/2008-like, a component of the 2014–2015 Northern Hemisphere quadrivalent influenza vaccine. Five (2.6%) of the B/Victoria lineage viruses tested showed reduced titers to B/Brisbane/60/2008.

One of the 55 influenza A (H1N1) specimens tested was found to be resistant to oseltamivir, and 1 was resistant to peramivir. None of the 3,133 influenza A (H3N2) or 729 influenza B samples tested showed resistance to oseltamivir, zanamivir, or peramivir.

Sophie reported that influenza surveillance will continue throughout the summer, with the exception of hospitalization data and reports from state and territorial epidemiologists related to geographic spread. These 2 surveillance methods will be reinstated in the fall.

Avian Influenza Update – Fiona Havers (CDC)

Fiona reported that CDC is working closely with the U.S. Department of Agriculture (USDA) to monitor the human health implications of the current outbreak of highly pathogenic avian influenza (HPAI) H5 viruses in both domestic and wild birds in the U.S. There have been more than 200 outbreaks affecting millions of birds. HPAI H5 viruses were first detected in British Columbia before being reported in Washington State and other Western states. Subsequent outbreaks were reported in other migratory bird flyways in the US. As of May 21, twenty states had reported outbreaks in both commercial poultry and wild birds, and the number of affected states continues to increase in spite of control efforts.

The current viruses being seen in the U.S. are different than the avian influenza H5N1 HPAI viruses that have caused outbreaks in poultry and human cases in other parts of the world outside of North and South America. . Although the presence of HPAI H5 viruses has been confirmed in both domestic and wild birds in the U.S., no human infections with these viruses have been detected the U.S., Canada, or internationally. While it is possible that human infections with these viruses may occur, human infection with avian influenza viruses in general are rare, and, when they occur, these viruses have not spread easily from person to person. So far, genetic markers do not show changes associated with increased likelihood of human infection. CDC has developed interim guidance on testing and prophylaxis among exposed persons who develop illness and CDC is working closely with state and local health departments and the USDA to help minimize any potential risk to exposed persons.

One Summit partner stated a recent ProMED article had reported 33 million birds in the U.S. had either died from HPAI infection or had been killed as part of control measures and asked about the impact on vaccine production. Fiona noted that while the outbreak in poultry may have an impact on the price of commercial poultry and eggs, but it is not anticipated there will be a negative impact on the availability of eggs to make seasonal influenza vaccine.

Fiona noted an inherent difficulty in containing HPAIV H5 virus outbreaks given their potential for spread by migratory birds, water fowl, and fomites. She noted that unlike domesticated poultry, wild waterfowl have limited to no illness from HPAI infections, but can spread viruses.

Current information on this evolving public health issue is available on the CDC and USDA websites.

Other Items – Carolyn Bridges (CDC)

Summit UpdateCarolyn thanked the many people who helped make the recent National Adult and Influenza Immunization Summit (NAIIS) a success. She noted that the majority of presentations given at the meeting are now available on the Summit website.

Next meeting – There will be no Summit call on May 28. The next call is scheduled to take place on June 4.


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

The CDC weekly influenza surveillance report for week 20, 2015 (ending May 23, 2015) and region specific data are now available. During week 20, 6.4% 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 6.6% for week 20.

For the 2014–2015 influenza season, 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 P&I mortality.

Two thousand one hundred ninety-three influenza viruses [59 A(H1N1)pdm09, 1,324 A(H3N2), and 810 influenza B viruses] have been collected by U.S. laboratories since October 1, 2014.

Two hundred forty-six (18.6%) of the 1,324 H3N2 viruses tested have been characterized as A/Texas/50/2012-like, the influenza A (H3N2) component of the 2014–2015 Northern Hemisphere influenza vaccine. One thousand and seventy-eight (81.4%) of the 1,324 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. Among viruses that showed reduced titers with antiserum raised against A/Texas/50/2012, most were antigenically similar to A/Switzerland/9715293/2013, the H3N2 virus selected for the 2015 Southern Hemisphere influenza vaccine. A/Switzerland/9715293/2013 is related to, but antigenically and genetically distinguishable from, the A/Texas/50/2012 vaccine virus. A/Switzerland-like H3N2 viruses were first detected in the United States in small numbers in March of 2014 and began to increase through the spring and summer.

For week 20, five hundred eighty-two (71.9%) of the influenza B viruses tested belong to B/Yamagata/16/88 lineage and the remaining 228 (28.1%) influenza B viruses tested belong to B/Victoria/02/87 lineage. Five hundred seventy-one (98.1%) of the 582 B/Yamagata-lineage viruses were characterized as B/Massachusetts/2/2012-like, which is included as an influenza B component of the 2014–2015 Northern Hemisphere trivalent and quadrivalent influenza vaccines. Eleven (1.9%) of the B/Yamagata-lineage viruses tested showed reduced titers to B/Massachusetts/2/2012. Two hundred twenty-three (97.8%) of the 228 B/Victoria-lineage viruses were characterized as B/Brisbane/60/2008-like, the virus that is included as an influenza B component of the 2014–2015 Northern Hemisphere quadrivalent influenza vaccine. Five (2.2%) of the B/Victoria-lineage viruses tested showed reduced titers to B/Brisbane/60/2008.

Two influenza-associated pediatric deaths were reported to CDC during week 20. Both deaths were associated with an influenza B virus and occurred during week 19 (the week ending May 16, 2015). One influenza-associated pediatric death that was reported during week 19 and occurred during the 2013–14 season was later reclassified by the reporting jurisdiction as not due to influenza. This brings the total number of reported pediatric deaths occurring during that season to 111.

A total of 141 influenza-associated pediatric deaths have been reported during the 2014–2015 season from New York City [3] and 40 states (Alaska [1], Arizona [3], Arkansas [4], California [7], Colorado [6], Florida [3], Georgia [1], Illinois [3], Indiana [2], Iowa [3], Kansas [2], Kentucky [3], Louisiana [2], Maryland [1], Massachusetts [1], Michigan [3], Minnesota [10], Mississippi [1], Missouri [1], Nebraska [1], Nevada [8], New Jersey [1], New Mexico [1], New York [3], North Carolina [2], Ohio [6], Oklahoma [7], Oregon [1], Pennsylvania [3], Rhode Island [2], South Carolina [3], South Dakota [2], Tennessee [9], Texas [16], Utah [2], Virginia [5], Washington [1], Wisconsin [6], West Virginia [1], and Wyoming [1]). More detail is available on the FluView website.

Between October 1, 2014 and April 30, 2015, 17,911 laboratory-confirmed influenza-associated hospitalizations were reported. The overall hospitalization rate was 65.5 per 100,000 population. The highest rate of hospitalization was among adults aged ≥65 years (322.8 per 100,000 population), followed by children aged 0–4 years (57.2 per 100,000 population). Among all hospitalizations, 15,271 (85.3%) were associated with influenza A, 2,473 (13.8%) with influenza B, 112 (0.6%) with influenza A and B co-infection, and 55 (0.3%) had no virus type information. Among those with influenza A subtype information, 5,552 (99.7%) were A(H3N2) and 16 (0.3%) were A(H1N1)pdm09. Additional virus characterization is available on FluView.

Clinical findings are preliminary and based on 9,084 (50.7%) cases with complete medical chart abstraction. The majority (93.6%) of hospitalized adults had at least one reported underlying medical condition; the most commonly reported were cardiovascular disease, metabolic disorders, and obesity. There were 998 hospitalized children with complete medical chart abstraction, 432 (43.3%) had no identified underlying medical conditions. The most commonly reported underlying medical conditions among pediatric patients were asthma, neurologic disorders, and obesity. Among the 626 hospitalized women of childbearing age (15-44 years), 200 (31.9%) were pregnant.

Nationwide during week 20, 1.2% 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 below 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 May 23, 2015.

The May 17–23, 2015 FluView marks the final full influenza surveillance report for the 2014–2015 influenza season in the United States. Influenza surveillance in the U.S. will continue through the summer months with condensed reports available on CDC’s FluView website. Archives of previous FluViews also are available.

This season’s final issues of the seasonal influenza key points (dated May 29, 2015) and weekly FluView report (for week 20) have been released by CDC. After today, seasonal influenza key points will no longer be released on a fixed schedule, but will be issued as they are warranted, such as in conjunction with the release of important influenza-related publications or guidance or unexpected increases in flu activity. Full reporting for the 2015–2016 influenza season will begin in mid-October 2015, and will appear in the weekly influenza surveillance report, FluView.

CDC Health Alert Network (HAN) Health Advisory Message Issued on June 2, 2015

Please feel free to share this information with your members.

Distributed via the CDC Health Alert Network (HAN)
June 2, 2015, 13:00 ET (1:00 PM ET)

Bird Infections with Highly-Pathogenic Avian Influenza A (H5N2), (H5N8), and (H5N1) Viruses: Recommendations for Human Health Investigations and Response

Highly-pathogenic avian influenza A H5 viruses have been identified in birds in the United States since December 2014. The purpose of this HAN Advisory is to notify public health workers and clinicians of the potential for human infection with these viruses and to describe CDC recommendations for patient investigation and testing, infection control including the use personal protective equipment, and antiviral treatment and prophylaxis.

Between December 15, 2014, and May 29, 2015, the US Department of Agriculture (USDA) confirmed more than 200 findings of birds infected with highly-pathogenic avian influenza (HPAI) A (H5N2), (H5N8), and (H5N1)[1] viruses. The majority of these infections have occurred in poultry, including backyard and commercial flocks. USDA surveillance indicates that more than 40 million birds have been affected (either infected or exposed) in 20 states. These are the first reported infections with these viruses in US wild or domestic birds.

While these recently-identified HPAI H5 viruses are not known to have caused disease in humans, their appearance in North American birds may increase the likelihood of human infection in the United States. Human infection with other avian influenza viruses, including a different HPAI (H5N1) virus found in Asia, Africa, and other parts of the world; HPAI (H5N6) virus; and (H7N9) virus, has been associated with severe, sometimes fatal, disease. Previous human infections with other avian viruses have most often occurred after unprotected direct physical contact with infected birds or surfaces contaminated by avian influenza viruses, being in close proximity to infected birds, or visiting a live poultry market. Human infection with avian influenza viruses has not occurred from eating properly cooked poultry or poultry products. For more information on the origin of the recently-identified HPAI H5 viruses in the United States, their clinical presentation in birds, and their suspected clinical presentation in humans, please see http://www.cdc.gov/flu/avianflu/hpai/hpai-background-clinical-illness.htm.

CDC considers the risk to the general public from these newly-identified US HPAI H5 viruses to be low; however, people with close or prolonged unprotected contact with infected birds or contaminated environments may be at greater risk of infection. Until more is known about these newly-identified HPAI H5 viruses, public health recommendations are largely consistent with guidance for influenza viruses associated with severe disease in humans (e.g., HPAI H5N1 viruses that have caused human infections with high mortality in other countries). Currently, CDC considers these newly-identified HPAI H5 viruses as having the potential to cause severe disease in humans and recommends the following:

Clinicians should consider the possibility of HPAI H5 virus infection in persons showing signs or symptoms of respiratory illness who have relevant exposure history. This includes persons who have had contact with potentially-infected birds (e.g., handling, slaughtering, defeathering, butchering, culling, preparation for consumption); direct contact with surfaces contaminated with feces or parts (carcasses, internal organs, etc.) of potentially-infected birds; and persons who have had prolonged exposure to potentially-infected birds in a confined space.

State health departments are encouraged to investigate potential human cases of HPAI H5 virus infection as described below and should notify CDC within 24 hours of identifying a case under investigation. Rapid detection and characterization of novel influenza A viruses in humans remain critical components of national efforts to prevent further cases, evaluate clinical illness associated with them, and assess any ability for these viruses to spread among humans.

People should avoid unprotected exposure to sick or dead birds, bird feces, litter, or materials contaminated with suspected or confirmed HPAI H5 viruses.All recommended personal protective equipment (PPE) should be worn when in direct or close contact (within about 6 feet) with sick or dead poultry, poultry feces, litter or materials contaminated with suspected or confirmed HPAI H5 viruses.

People exposed to HPAI H5-infected birds (including people wearing PPE) should be monitored for signs and symptoms consistent with influenza beginning after their first exposure and for 10 days after their last exposure. Influenza antiviral prophylaxis may be considered to prevent infection (see below). Persons who develop respiratory illness after exposure to HPAI H5-infected birds should be tested immediately for influenza by the state health department and be given influenza antiviral treatment (see below). State health departments are encouraged to investigate all possible human infections with HPAI H5 virus and should notify CDC promptly when testing for avian influenza in people.

Recommendations for Surveillance and Testing
Patients who meet clinical and exposure criteria should be tested for HPAI H5 virus infection by reverse-transcription polymerase chain reaction (RT-PCR) assay using H5-specific primers and probes. Additional persons in whom clinicians suspect HPAI H5 virus infection also may be tested.

Clinical Illness Criteria: Patients with new-onset influenza-like illness (ILI) or acute respiratory infection (ARI), which may include conjunctivitis, which has been associated with avian influenza in humans.

Clinical presentation of persons infected with these HPAI H5 viruses may vary somewhat from seasonal influenza or infection with other novel influenza A viruses. Thus, clinicians are encouraged to consider a range of respiratory signs and symptoms when evaluating a patient with appropriate exposure for HPAI H5 virus infection.

Bird Exposure Criteria: Patients who have had recent contact [2] (within 10 days of illness onset) with potentially-infected (i.e., sick or dead birds, or flocks where HPAI H5 virus infection has been confirmed) in any of the following categories:

  • Domestic poultry (e.g., chickens, turkeys, ducks, geese)
  • Wild aquatic birds (e.g., ducks, geese, swans)
  • Birds of prey (e.g., falcons) that have had contact with wild aquatic birds

Multiple respiratory tract specimens should be collected from persons with suspected HPAI H5 virus infection, including nasopharyngeal, nasal, and throat swabs. Patients with severe respiratory disease also should have lower respiratory tract specimens collected, if possible. For more information on surveillance and testing of persons under investigation for avian HPAI H5 virus infection, please see http://www.cdc.gov/flu/avianflu/severe-potential.htm.

Recommendations for Worker Protection
To reduce their risk of HPAI H5 virus infection, poultry workers and responders should avoid unprotected direct physical contact with sick or dead birds, and carcasses, feces, or litter from potentially-infected poultry. Poultry workers should wear recommended PPE when in direct contact with sick or dead birds, and carcasses, feces, or litter from potentially-infected poultry, and when going into any buildings with sick or dead poultry, or carcasses, feces, or litter from potentially-infected poultry. Workers should receive training on and demonstrate an understanding of when to use PPE; what PPE is necessary; how to properly put on, use, take off, properly dispose of, and maintain PPE; and the limitations of PPE. For additional guidance on worker protection, please see http://www.cdc.gov/flu/avianflu/h5/worker-protection-ppe.htm.

Recommendations for Infection Control
For patients presenting for medical care or evaluation who have illness consistent with influenza and recent exposure to potentially-infected birds, standard, contact, and airborne precautions are recommended. For additional guidance on infection control precautions for patients who may be infected with HPAI H5 virus, please refer to guidance for infections with novel influenza A viruses associated with severe disease found at http://www.cdc.gov/flu/avianflu/novel-flu-infection-control.htm.

Recommendations for Influenza Antiviral Treatment and Chemoprophylaxis
Chemoprophylaxis with influenza antiviral medications can be considered for all persons meeting bird exposure criteria. Decisions to initiate antiviral chemoprophylaxis should be based on clinical judgment, with consideration given to the type of exposure and to whether the exposed person is at high risk for complications from influenza.

Chemoprophylaxis is not routinely recommended for personnel who used proper PPE while handling sick or potentially-infected birds or decontaminating infected environments (including animal disposal).

If antiviral chemoprophylaxis is initiated, treatment dosing for the neuraminidase inhibitors oseltamivir or zanamivir (one dose twice daily) is recommended instead of the typical antiviral chemoprophylaxis regimen (once daily). [3] For specific dosage recommendations for treatment by age group, please see Influenza Antiviral Medications: Summary for Clinicians. Physicians should consult the manufacturer’s package insert for dosing, limitations of populations studied, contraindications, and adverse effects. If exposure was time-limited and not ongoing, five days of medication (one dose twice daily) from the last known exposure is recommended.

Treatment of Symptomatic Persons with Bird Exposure: Patients meeting bird exposure criteria who develop symptoms compatible with influenza should be referred for prompt medical evaluation and empiric initiation of influenza antiviral treatment with a neuraminidase inhibitor as soon as possible. Clinical benefit is greatest when antiviral treatment is administered early, especially within 48 hours of illness onset. Antiviral treatment should not be delayed while waiting for laboratory testing results. For detailed guidance, please see Interim Guidance of the Use of Antiviral Medications for the Treatment of Human Infection with Novel Influenza A Viruses Associated with Severe Human Disease.

Monitoring and Chemoprophylaxis of Close Contacts of Persons with HPAI H5 virus infection: If a case of human infection with HPAI H5 virus is identified in the United States, recommendations for monitoring and chemoprophylaxis of close contacts of the infected person are different than those that apply to persons who meet bird exposure criteria. For detailed guidance, please see Interim Guidance on Follow-up of close Contacts of Persons Infected with Novel Influenza A Viruses Associated with Severe Human Disease.

No human vaccines for HPAI (H5N1), (H5N2), or (H5N8) are available in the United States. Efforts are underway to develop vaccines against these HPAI H5 viruses. Seasonal influenza vaccines do not provide any protection against human infection with HPAI H5 viruses.

For More Information


[1] The H5N1 virus isolated from US wild birds is a new mixed-origin virus (a “reassortant”) that is genetically different from the HPAI H5N1 viruses that have caused human infections with high mortality in other countries (notably in Asia and Africa). No human infections with this new reassortant H5N1 virus have been reported in any country.

[2] Contact may include: direct contact with birds (e.g., handling, slaughtering, defeathering, butchering, culling, preparation for consumption); or direct contact with surfaces contaminated with feces or bird parts (carcasses, internal organs, etc.); or prolonged exposure to birds in a confined space.

[3] This recommendation for twice daily antiviral chemoprophylaxis dosing frequency is based on limited data that support higher chemoprophylaxis dosing in animals for avian A (H5N1) virus (Boltz DA, et al JID 2008;197:1315) and the desire to reduce the potential for development of resistance while receiving once daily dosing (BazM, et al NEJM 2009;361:2296; Cane A et al PIDJ 2010;29:384; MMWR 2009;58:969).

CDC Provides Measles Information to Its Partners (May 7, 2015)

CDC has new measles information and resources available which it invites you to share with your membership.

Current information about measles cases and outbreaks is available from CDC. The agency also has developed corresponding information (available to Summit partners) to assist you as you receive questions about measles, develop new materials for your members, post to social media, etc. Let CDC know if you have any additional questions or would like to request resources from them.

CDC has posted an updated map which indicates the U.S. is currently experiencing a large, multi-state outbreak of measles linked to an amusement park in California. Check out CDC’s Measles Webpage to find resources for each of your audiences.

Please let CDC know 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 education your membership about measles. Please send CDC an e-mail and let them know. CDC thanks you for your continued support and assistance!

CDC Provides Key Points on Avian Influenza

On May 29, 2015 CDC released key points related to reports of highly pathogenic avian influenza (HPAI) H5 in domestic and wild birds in the United States.

Check it out: CDC’s #VaxWithMe Social Media Campaign

Background: The #VaxWithMe Selfie campaign encourages individuals to share photos and videos of themselves (tagged #VaxWithMe) during or after getting their flu vaccination. Between September 2014 and April 2015, 552 participants used the #vaxwithme hashtag 827 times, generating 18.4 million impressions.

View the interactive timeline (also called a parallax), which displays the #Vaxwithme partner posts across social media platforms. This timeline integrates the functionality within each post that one would have on the actual social media platforms; the ability to follow, comment, retweet, like, favorite, and play videos.

Read the success story to learn more.

Key Points: Investigation of Acute Flaccid Myelitis 4/21/15

CDC has released up-to-date key points about the investigation of acute flaccid myelitis in children, including an update of CDC-verified cases reported by states. You may send an email to request additional information or assistance.

Upcoming and Recent CDC COCA Calls

Emerging and Exotic Diseases of Food Animals Threaten Global Food Security
Date: Thursday, May 28, 2015
Time: 2:00 – 3:00 pm (EDT)
Dial In Number: 800-369-2062 (U.S. Callers); 517-308-9046 (International Callers)
Passcode: 1302224

Webinar information
New diseases of food animals are emerging at an increasing rate and are spreading regionally and globally. Many of the same factors leading to emergence of human diseases are responsible for the emergence of animal diseases, and many of the animal diseases are zoonotic. The challenges of controlling emerging food animal diseases are very different in intensive animal agriculture and small holder animal production and depend upon the veterinary and public health infrastructure available. During the COCA call, participants will learn about reasons for the increasing rate of emergence of food animal diseases, some specific examples, challenges for their control, and implications for public health and food security.

Archived COCA conference calls are available. Free continuing education credits (CME, CNE, ACPE, CEU, CECH, and AAVSB/RACE) are available for most calls.


Funding Announcement Opportunities in Adult Immunization

For your information and potential action, CDC has recently published three funding opportunity announcements that pertain to adult vaccination. One of these is open only to US immunization programs (CDC-RFA-IP15-1502PPHF15) and the other two are open to provider organizations.

Questions about these FOAs should be directed only to the individuals specified in the announcements.

The titles of these funding opportunities are:

Increasing Awareness and Implementation of the Standards for Adult Immunization Practice Through Partnerships With State and Local Immunization Programs – Financed Solely by PPHF 2015 Prevention and Public Health Funds, with a closing date of July 27

Improving Immunization Collaboration Among Pharmacists and Other Healthcare Providers – Financed Solely by PPHF 2015 Prevention and Public Health Funds with a closing date of July 27

Improving Adult Immunization Rates through Partnerships with Providers and National Organizations – with a closing date of July 6

WHO: Avian Influenza Overview for Public Health Professionals

The WHO Regional Office for Europe has announced publication of an overview on avian influenza for public health professionals that provides the most comprehensive picture of avian influenza viruses currently known to infect humans and their spread across the world to date with data from countries from all 6 WHO Regions.

‘We are failing older people’

Civil society organizations must do more to put adult vaccination on the healthy ageing agenda. Too few people know the adult vaccine schedule and fewer still have the immunizations that can help them to live longer, healthier, active lives, according to Dr. Jane Barratt, Secretary General of the International Federation on Ageing (IFA).

Is H7N9 a Greater Pandemic Risk than H5N1?

In a report published in Clinical Infectious Diseases, the authors performed a side-by-side analysis of the epidemiology of sporadic cases and clusters caused by the H7N9 and H5N1 diseases.

The authors conclude “The results are consistent with an ascertainment bias towards severe and older cases for sporadic H7N9 but not for H5N1. The lack of evidence for ascertainment bias in sporadic H5N1 cases, the more pronounced clustering of cases, and the higher risk of infection in blood-related contacts, support the hypothesis that susceptibility to H5N1 may be limited and familial. This analysis suggests the potential pandemic risk may be greater for H7N9 than H5N1.”

Ohio Agriculture Officials Cancel All County, State Fair Poultry Shows Over Bird Flu Threat

All poultry shows at the Ohio State Fair and county fairs across the state have been canceled this year because of the threat of a deadly bird flu virus, the state’s agriculture department announced Tuesday.

The virus that has led to the deaths of more than 44 million chickens and turkeys in the Midwest hasn’t been found so far in Ohio, but state officials said banning all poultry shows is a needed step to protect Ohio’s $2.3 billion poultry industry.

Michigan Must Prepare for Meningitis B Vaccine and Protect Students on Every Campus

Their names were Emily Stillman and Carly Glynn. They attended Kalamazoo College and Michigan State University, respectively, and they were both just 19 years old when they died recently of meningitis.

Today, their legacies are prompting new action to boost access to meningitis vaccines. All members of the Michigan Independent Colleges and Universities (MICU) remember and share concerns over student safety, no matter which school they happen to attend, and we believe immunizations are needed to protect students on every Michigan campus.

Currently, Europe, Canada and Australia administer meningitis B immunizations, but the U.S. is still waiting on the Centers for Disease Control and Prevention to issue final recommendations before any inoculations can be administered here at home. MICU members believe the federal Advisory Committee on Immunization Practices (ACIP) must adopt a broad routine recommendation for the immunization of adolescents and young adults against meningitis B.

APhA Recognizes 2015’s Immunization Champions

The American Pharmacists Association’s Immunization Champion Awards recognize pharmacists, pharmacy organizations, and allies of pharmacy that make outstanding efforts to improve vaccination rates within their communities, across the country, and even abroad. Immunization Champions personally administer vaccines, coordinate clinics, train others to vaccinate, and promote legislation to expand pharmacists’ authority to vaccinate.

Don’t Grow Immune to the Value of Vaccines

The fight against rubella, the deadly German measles, has finally paid off. Global health authorities say the terrible disease has been eliminated in the Americas. It’s a rare dose of good news in the fight against the debilitating disease, which can cause birth defects or even fetal death if contracted by a pregnant woman.

The eradication was possible by one of modern medicine’s most indispensable tools — routine vaccination. The value of immunization has never been more apparent. Yet Americans have grown skeptical of vaccines — as well as the science behind them. That has to change. Few medical innovations have saved more lives than vaccines. And they may play an even larger role in the years to come.

PublicHealth.org Dispels Vaccine Myths

PublicHealth.org has developed a video and information guide about the safety and efficacy of vaccines.

2nd Asia-Pacific Influenza Summit 10–12 June 2015

The Asia-Pacific Alliance for the Control of Influenza (APACI) is pleased to announce the 2nd Asia-Pacific Influenza Summit, to take place June 11 & 12, in Hanoi, Vietnam. Please mark the dates on your calendar.

APACI continues to develop new initiatives to promote influenza awareness in the region, and will again be presenting a unique opportunity to meet with key influenza experts and stakeholders from within the region, and from around the world. The summit follows the success of the inaugural Asia-Pacific Influenza summit held in Bangkok in 2012.

The summit will take place immediately prior to the ASVAC 2015 meeting.

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.

2015 NAIIS Information and Follow-up

Special thanks are extended to all who attended and participated in the 2015 NAIIS meeting in Atlanta, GA. We had a lot of discussion and feedback, and the working groups soon will be preparing their plans for 2015–2016. Please email L.J Tan, LaDora Woods, or Carolyn Bridges should you be interested in joining a Summit working group.


Summit calls are now scheduled every other Thursday at 3 p.m. Eastern time, unless cancelled. We will resume the regular weekly call schedule in fall.


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