ILI Syndromic Surveillance

Transcription

1 ILI Syndromic Surveillance

2

3 Race/ethnicity of adult respondents with influenza-like illness (ILI) in the U.S., Behavioral Risk Factor Surveillance System (BRFSS), Sept 1- Sep 30, 2009 Race/ethnicity I L I Total Weighted % I L I Weighted (95% C I) White, non-hispanic ( ) Black, non-hispanic ( ) Hispanic ( ) Other race only, Non- Hispanic Multiracial, Non- Hispanic ( ) ( ) Not asked or missing ( )

4 Health care seeking behavior of adults respondents with ILI in the U.S., by race/ethnicity, BRFSS, Sept 1- Sep 30 Race/Ethnicity Sought medical care for ILI Total Weighted %Yes Weighted (95% CI) White, non-hispanic ( ) Black, non-hispanic ( ) Hispanic ( ) Other race only, non- Hispanic ( ) Multiracial, non-hispanic ( )

5 Influenza Hospitalizations

6

7 EIP Influenza Hospitalization: Race/Ethnicity* by season, all ages, Influenza Season Race/Ethnicity Distribution N=1279 N=3930 N=1693 N=1476 White 63% 57% 65% 52% 40% Black 16% 24% 21% 28% 35% Asian/Pacific Islander Amer. Indian/ Alaska Native 7% 4% 4% 3% 8% 1% <1% <1% <1% <1% Hispanic 13% 15% 9% 15% 15% 9/22/09 *imputed race/ethnicity +Oct 1, 2008 April 14, Apr 15, 2009 Aug 31, 2009 Census 2008 data for catchment area as of to current season Preliminary

8 Influenza Mortality

9

10

11 Influenza Associated Pediatric Mortality Distribution of laboratory-confirmed pediatric 2009 H1N1 and seasonal influenza deaths by race/ethnicity, 2009 H1N1 deaths 4/14-8/31/2009 H1N1 deaths 9/1- present Seasonal Deaths Hispanic any race (15%) 17 (35%) 6 (21%) 18 (25%) White (67%) 19 (40%) 7 (25%) 30 (42%) Black (12%) 6 (13%) 9 (32%) 13 (18%) Asian (4%) 2 (4%) 1 (4%) 5 (7%) Alaska Native or American Indian (1%) 0 1 (4%) 1 (1%) Native Hawaiian or Pacific Islander (0.14%) (3%) Unknown race or race/ethnicity 4 (8%) 4 (14%) 2 (3%) Totals

12 Influenza and Vaccine Knowledge, Attitudes and Behaviors

13 Opinions Regarding Influenza and Influenza Vaccine NHFS, Interview s Conducted Novem ber 8-14, 2009 Among all adults Among adults not intending to get vaccinated Seasonal H1N1 Seasonal H1N1 Seasonal H1N1 Think the vaccine is effective in preventing flu Likely to get sick with flu if not vaccinated Think vaccination may cause me to get sick

14 American Public Views: Safety of H1N1 vs. Seasonal Flu Vaccine Very Safe Generally for Most People to Take 33% 57% Very Safe for Children 6 Months to 2 Years to Take 18% 29% H1N Flu Vaccine Very Safe for Pregnant Women to Take 13% 25% Seasonal Flu Vaccine Harvard Opinion Research Program, Harvard School of Public Health, September 14-20, 2009.

15

16

17 Influenza Vaccine Coverage

18 Influenza Vaccination Coverage Among Children & Adults, US, Influenza Season, BRFSS (January - February 2009) Percentage All ages >= 6 mos 6 mos-17 yrs yrs yrs >=65 yrs High Risk White, non-hispanic Black, non-hispanic Hispanic Other

19 Racial / Ethnic SEASONAL Cumulative Influenza Vaccination Coverage Among CHILDREN/TEENS BRFSS Interviews Conducted October 1 31, 2009 n=2,972 Race/ Ethnicity Sample Size Weighted Coverage (%) 95% CI Weighted Sample Size (million) White Black Hispanic Other Total 2, , * 12.7* , , , , , *p<0.05 when compared to whites From 22 states. Excludes missing, don t know, and refused (142) Note: BRFSS estimates underestimate vaccination occurring in October

20 H1N1 Vaccination Rates (%), NHFS Nov 8 14 by Race/Ethnicity and Target Groups Race/Ethnicity Initial Target Limited Vaccine Subset Total Population White, non- Hispanic 12.7 (9.7, 15.7) 20.2 (13.9, 26.8) 8.3 (6.3, 10.3) Other, non- Hispanic (e.g., Asian, AI/AN) 10.5 (4.2, 16.8)* 9.8 (2.2, 17.4)* 7.0 (2.9, 11.1) Hispanic 5.4 (2.8, 8.4) 6.1 (0, 12.2)* 4.4 (2.1, 6.7) Black, non- Hispanic 8.4 (3.1, 13.7)* Not Available, unestimated due stratum constraints 5.9 (2.4, 9.4) * Estimate may not be reliable, (CI half width/estimate) 0.6 or (CI half width) 10

21 SEASONAL Cumulative Influenza Vaccination Coverage among women (aged 18 49) by PREGNANCY STATUS BRFSS, Interviews Conducted October 1 31, 2009 Pregnant Sample Size Weighted Coverage 95% CI Weighted Sample Size (million) Yes No Total 176 4,900 5, % 18.7% 18.9% 15.8, , , Excludes missing, don t know, and refused Note: BRFSS estimates underestimate vaccination occurring in October

22 Conclusion All race-ethnicities appear to acquire ILI and seek care for that ILI at a similar rate However, African Americans comprise a greater proportion of H1N1 and seasonal influenza hospitalizations than their representation in the Emerging Infections Program (EIP) catchment area. African Americans and Hispanics are overrepresented in the H1N1 and seasonal influenza deaths compared to their representation in the US African Americans and Hispanics are less likely to receive seasonal influenza vaccination than non-hispanic whites Reduction of excess influenza morbidity and mortality in minority populations will require: Elimination of potential structural barriers to vaccination access Education and mobilization of minority communities in partnership with health care providers, community and faith-based organizations, educational institutions and the media Additional investigation of factors contributing to the excess morbidity/mortality

23 Resources html

24 Print Materials Posters, flyers and print ads targeting African American, Hispanic and Native American audiences Available for download from CDC website Vaccine information statements available in 26 languages