NC IMMUNIZATION COALITION FLU THEN AND NOW NC DHHS COMMUNICABLE DISEASE BRANCH ANITA VALIANI, MPH AUGUST 1, 2018

Transcription

1 NC IMMUNIZATION COALITION FLU THEN AND NOW NC DHHS COMMUNICABLE DISEASE BRANCH ANITA VALIANI, MPH AUGUST 1, 2018

2 OBJECTIVES I Influenza Season Recap of the season nationally Influenza Burden Estimates from Final updates for NC II. Upcoming influenza Season New vaccine information Updates before the season starts

3 Nationally SEASON HOW DID IT END?

4 SEASON Nationally, majority of the specimens tested were influenza A(H3N2) virus followed by influenza B(Yamagata lineage). Majority of lab confirmed influenza hospitalizations were due to heart disease, metabolic disorders, and obesity in adults. Long flu season; record-breaking hospitalizations ILI was above national baseline 19 weeks

5 INFLUENZA BURDEN ESTIMATES CDC uses the estimates of the burden of influenza in the population and the impact of influenza vaccination to inform policy and communications related to influenza was notable because of high hospitalization rates Vaccination prevented lowest proportion of illnesses among adults aged years, had the lowest vaccine coverage; adults aged 65 years, had higher vaccine coverage but the lowest vaccine effectiveness. Vaccination prevented the greatest proportion of outcomes among children aged 6 months to 4 years and 5 to 17 years, where the burden of influenza illness and medical visits was high and the vaccine effectiveness was greatest. Improvements in vaccine coverage could provide a greater public health benefit. CDC estimates that influenza vaccination during the influenza season prevented an estimated 5.29 million illnesses, 2.64 million medical visits, and 84,700 hospitalizations associated with influenza.

6 Table 5: Influenza Vaccine Coverage and Vaccine Effectiveness, by Age Group United States Influenza Season Table 5: Influenza Vaccine Coverage and Vaccine Effectiveness, by Age Group United States Influenza Season Age 6 months-4 years Vaccine coverage* Vaccine effectiveness % 95% CI % 95% CI years years years years Overall

7 Table 3: Estimated Number and Fraction of Influenza Illnesses, Medical Visits, and Hospitalizations Averted by Vaccination, by Age Group United States, Influenza Season Averted medical Age (yrs) Averted illnesses Averted hospitalizations visits No. 95% CI No. 95% CI No. 95% CI Fraction Prevented (%) 95% CI 6 months-4 602, ,000-1,130, , , ,000 4,200 1,120-7, ,920,000 1,320,000-2,700, , ,000-1,400,000 5,270 3,630-7, ,000 32,000-1,010, ,000 11, ,000 2, , ,640, ,000-2,380, , ,000-1,040,000 17,300 9,820-25, , ,470, , ,000 54, , All ages 5,290,000 3,910,000-7,000,000 2,640,000 1,940,000-3,500,000 84,700 26, ,

8 SEASON NC UPDATES In NC, ILI in outpatient settings was above baseline for 14 consecutive weeks Activity started to peak at the end of December 2017 Continued to see high activity until first week of April

9 SEASON NC UPDATES Mainly Flu A(H3N2) circulated until March then Flu B activity picked up Total of 391 flu associated deaths occurred -- 7 pediatric deaths reported for NC 221 Females (57%) and 170 Males (43%) Vaccination status is known for 243 cases out of the 391 reported deaths; 166 (42%) were vaccinated; remaining 225 were unvaccinated or had no documentation of a flu vaccine. 309 (79%) received some antiviral treatment for their illness.

10 FLU ASSOCIATED DEATHS BY WEEK,

11 SEASON NC UPDATES Influenza outbreaks reported over the last 4 seasons : H3N2 predominant season : H1N1 & B predominant season : H3N2 predominant season : H3N2 predominant season Flu Outbreaks 3% 20% 50% %

12 FLU SEASON VACCINE SELECTION Northern Versus Southern Hemisphere Flu Vaccine Composition Northern Hemisphere Flu Vaccines 2018 Southern Hemisphere Flu Vaccines Quadrivalent Trivalent Quadrivalent Trivalent (4-component) (3-component) (4-component) (3-component) A/Michigan/45/2015 (H1N1)pdm09-like A/Michigan/45/2015 (H1N1)pdm09-like A/Michigan/45/2015 (H1N1)pdm09-like A/Michigan/45/2015 (H1N1)pdm09-like A/Singapore/INFIMH /2016 (H3N2)-like* B/Colorado/06/2017 (B/Victoria)* B/Phuket/3073/2013- like (B/Yamagata) A/Singapore/INFIMH /2016 (H3N2)- like* B/Colorado/06/2017 (B/Victoria)* A/Singapore/INFIMH /2016 (H3N2)-like B/Brisbane/60/2008-like (B/Victoria) B/Phuket/3073/2013- like (B/Yamagata) A/Singapore/INFIMH /2016 (H3N2)-like B/Phuket/3073/2013- like (B/Yamagata)

13 NEW THIS SEASON.. New for the season, and different components in the flu vaccine since season are the A/Singapore/INFIMH /2016 (H3N2)-like and the B/Colorado/06/2017 (B/Victoria) ACIP reccommends for the U.S. influenza season, providers may choose to administer any licensed, ageappropriate influenza vaccine (IIV, recombinant influenza vaccine [RIV], or LAIV4). Intranasally administered live attenuated influenza vaccine (LAIV) is now an option for those it is appropriate for.

14 CURRENT FLU ACTIVITY Increased activity in South America Peak activity in Southern Africa Worldwide influenza A viruses are still the majority

15 CURRENT AND START..? What are we seeing? In the past several weeks we are seeing Flu A(H1N1) circulating nationally in very low numbers Seeing parainfluenza activity along the east coast and even here in NC Flu A is predominantly circulating in the southeastern US, again in very low numbers Lastly, we are seeing other outbreaks as well- lots of pertussis, some mumps, a measles, and now Hep A.

16 HEPATITIS A UPDATE

17 CONFIRMED OUTBREAK-ASSOCIATED CASES OF HEPATITIS A IN NORTH CAROLINA: JANUARY 1, 2018 JULY 26, 2018

18 QUESTIONS? THANK YOU