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Summary of Influenza Risk Assessment Tool (IRAT) Results: 2018

CDC

The Influenza Risk Assessment Tool (IRAT) is an evaluation tool conceived by CDC and further developed with assistance from global animal and human health influenza experts. The IRAT is used to assess the potential pandemic risk posed by influenza A viruses that are not currently circulating in people. Input is provided by U.S. government animal and human health influenza experts. Information about the IRAT is available at Influenza Risk Assessment Tool (IRAT) Questions and Answers(https://www.cdc.gov/flu/pandemic-resources/national-strategy/risk-assessment.htm).

Below is a table of results for influenza A viruses that have been assessed using IRAT because they serve as a representative of a particular subtype or are of unique interest.
Virus Most Recent Date Evaluated Potential Emergence Risk(https://www.cdc.gov/flu/pandemic-resources/tools/risk-assessment.htm#emergence-risk) Potential Impact Risk(https://www.cdc.gov/flu/pandemic-resources/tools/risk-assessment.htm#impact-risk) Overall Summary
H1N1 [A/duck/New York/1996] Nov 2011 2.3 2.4 Low
H3N2 variant [A/Indiana/08/2011] Dec 2012 6.0 4.5 Moderate
H3N2 [A/canine/Illinois/12191/2015] June 2016 3.7 3.7 Low
H5N1 Clade 1 [A/Vietnam/1203/2004] Nov 2011 5.2 6.6 Moderate
H5N1 [A/American green-winged teal/Washington/1957050/2014] Mar 2015 3.6 4.1 Low-Moderate
H5N2 [A/Northern pintail/Washington/40964/2014] Mar 2015 3.8 4.1 Low-Moderate
H5N6 [A/Yunnan/14564/2015] – like Apr 2016 5.0 6.6 Moderate
H5N8 [A/gyrfalcon/Washington/41088/2014] Mar 2015 4.2 4.6 Low-Moderate
H7N7 [A/Netherlands/219/2003] Jun 2012 4.6 5.8 Moderate
H7N8 [A/turkey/Indiana/1573-2/2016] July 2017 3.4 3.9 Low
H7N9 [A/chicken/Tennessee/17-007431-3/2017] Oct 2017 3.1  3.5 Low
H7N9 [A/ chicken/Tennessee /17-007147-2/2017] Oct 2017 2.8  3.5 Low
H7N9 [A/Hong Kong/125/2017] May 2017 6.5 7.5 Moderate-High
H7N9 [A/Shanghai/02/2013] Apr 2016 6.4 7.2 Moderate-High
H9N2 G1 lineage [A/Bangladesh/0994/2011] Feb 2014 5.6 5.4 Moderate
H10N8 [A/Jiangxi-Donghu/346/2013] Feb 2014 4.3 6.0 Moderate

 

H1N1: [North American avian H1N1 [A/duck/New York/1996]

Avian influenza A viruses are designated as highly pathogenic avian influenza (HPAI) or low pathogenic avian influenza (LPAI) based on molecular characteristics of the virus and the ability of the virus to cause disease and death in chickens in a laboratory setting. North American avian H1N1 [A/duck/New York/1996] is a LPAI virus and in the context of the IRAT serves as an example of a low risk virus.

Summary: The summary average risk score for the virus to achieve sustained human-to-human transmission was in the low risk category (less than 3). Similarly the average risk score for the virus to significantly impact public health if it were to achieve sustained human-to-human transmission also falls into the low risk range (less than 3).

H3N2 Variant:[A/Indiana/08/11]

Swine-origin flu viruses do not normally infect humans. However, sporadic human infections with swine-origin influenza viruses have occurred. When this happens, these viruses are called “variant viruses.” Influenza A H3N2 variant viruses (also known as “H3N2v” viruses) with the matrix (M) gene from the 2009 H1N1 pandemic virus were first detected in people in July 2011. The viruses were first identified in U.S. pigs in 2010. In 2011, 12 cases of H3N2v infection were detected in the United States. In 2012, 309 cases of H3N2v infection across 12 states were detected. The latest risk assessment for this virus was conducted in December 2012 and incorporated data regarding population immunity that was lacking a year earlier.

Summary: The summary average risk score for the virus to achieve sustained human-to-human transmission was in the moderate risk category (less than 6). The summary average risk score for the virus to significantly impact public health if it were to achieve sustained human-to-human transmission was in the low-moderate risk category (less than 5).

H3N2: [A/canine/Illinois/12191/2015]

The H3N2 canine influenza virus is an avian flu virus that adapted to infect dogs. This virus is different from human seasonal H3N2 viruses. Canine influenza A H3N2 virus was first detected in dogs in South Korea in 2007 and has since been reported in China and Thailand. It was first detected in dogs in the United States in April 2015(https://www.cdc.gov/flu/news/canine-influenza-update.htm). H3N2 canine influenza has reportedly infected some cats as well as dogs. There have been no reports of human cases.

Summary: The average summary risk score for the virus to achieve sustained human-to-human transmission was low risk (less than 4). The average summary risk score for the virus to significantly impact public health if it were to achieve sustained human-to-human transmission was in the low risk range (less than 4). For a full report, click here[186 KB, 4 pages](https://www.cdc.gov/flu/pandemic-resources/pdf/cdc-irat-virus-canine-h3n2.pdf).

H5N1 clade 1: [A/Vietnam/1203/2004]

The first human cases of highly pathogenic avian influenza (HPAI) H5N1 virus were reported from Hong Kong in 1997. Since 2003, highly pathogenic H5N1 avian influenza viruses have caused over 850 laboratory-confirmed human cases; mortality among these cases was high. A risk assessment of this H5N1 clade 1 virus was conducted in 2011 soon after the IRAT was first developed and when 12 hemagglutinin (HA) clades were officially recognized.

Summary: The summary average risk score for the virus to achieve sustained human-to-human transmission was in the moderate risk category (less than 6). The summary average risk score for the virus to significantly impact public health if it were to achieve sustained human-to-human transmission was in the high-moderate risk category (less than 7).

H5N1: [A/American green winged teal/Washington/1957050/2014]

In December 2014, an H5N1 highly pathogenic avian influenza virus was first isolated from an American green-winged teal in the state of Washington. This virus is a recombinant virus containing four genes of Eurasian lineage (PB2, HA, NP and M) and four genes of North American lineage (PB1, PA, NA and NS).In February 2015, the Canadian government reported isolating this virus from a backyard flock in the Fraser Valley. When this risk assessment was conducted in 2015, these were the only reported isolations of this virus. There have been no reports of human cases.

Summary: The summary average risk score for the virus to achieve sustained human-to-human transmission was in the low risk category (less than 4). The summary average risk score for the virus to significantly impact public health if it were to achieve sustained human-to-human transmission was in the low-moderate risk category (less than 5).

H5N2: [A/Northern pintail/Washington/40964/2014]

In December 2014, an H5N2 highly pathogenic avian influenza virus was first reported by the Canadian government from commercial poultry in the Fraser Valley.Subsequently this virus was isolated from wild birds, captive wild birds, backyard flocks and commercial flocks in the United States.This virus is a recombinant virus composed of five Eurasian lineage (PB2, PA, HA, M and NS) genes and three North American lineage (PB1, NP and NA) genes. There have been no reports of human cases.

Summary: The average summary risk score for the virus to achieve sustained human-to-human transmission was low risk (less than 4).The average summary risk score for the virus to significantly impact public health if it were to achieve sustained human-to-human transmission was in the low-moderate risk range (less than 5).

H5N6: [A/Yunnan/14564/2015 (H5N6-like)]

Between January 2014 and March 2016, there have been 10 human cases of H5N6 highly pathogenic avian influenza reported. Nine reportedly experienced severe disease and six died. Avian outbreaks of this virus were first reported from China in 2013. Subsequently avian outbreaks have been reported in at least three countries (China, Vietnam and Lao PDR) through 2015.

Summary: The summary average risk score for the virus to achieve sustained human-to-human transmission was in the moderate range (less than 6).The average summary risk score for the virus to significantly impact on public health if it were to achieve sustained human-to-human transmission fell in the moderate range (less than 7).

H5N8: [A/gyrfalcon/Washington/41088/2014]

In December 2014, an H5N8 highly pathogenic avian influenza virus was first isolated from a sample collected in the United States from a captive gyrfalcon.Subsequently this virus was isolated from wild birds, captive wild birds, backyard flocks and commercial flocks in the United States.This virus (clade 2.3.4.4) is similar to Eurasian lineage H5N8 viruses that have been isolated in South Korea, China, Japan, the Netherlands, the United Kingdom and Germany in late 2014-early 2015.There have been no reports of human cases.

Summary: The average risk score for the virus to achieve sustained human-to-human transmission was in the low-moderate range< (less than 5). The average summary risk score for the virus to significantly impact public health if it were to achieve sustained human-to-human transmission fell in the low-moderate range (less than 5).

H7N7: [A/Netherlands/219/03]

In 2003 the Netherlands reported highly pathogenic avian influenza (HPAI) in approximately 255 commercial flocks.Coinciding with human activities around these infected flocks, 89 human cases of H7N7 were identified.Cases primarily reported conjunctivitis, although a few also reported mild influenza-like illness.There was one death.

Summary: The summary average risk score for this virus to achieve sustained human-to-human transmission was in the low-moderate risk range (less than 5). The summary average risk score for this virus to significantly impact the public’s health if it were to achieve sustained human-to-human transmission fell in the moderate risk range (less than 7).

H7N8: [A/turkey/Indiana/1573-2/2016]

In January 2016, a highly pathogenic avian influenza (HPAI) virus of North American lineage was identified in a turkey flock in Indiana. Putative low pathogenic avian influenza (LPAI) viruses similar to A/turkey/Indiana/1573-2/2016 were subsequently isolated from 9 other turkey flocks in the area. There were no reports of human cases associated with this virus at the time of the IRAT scoring.

Summary: A risk assessment of this LPAI virus was conducted in July 2017. The overall IRAT risk assessment score for this virus falls into the low risk category (< 4). The summary average risk score for the virus to achieve sustained human-to-human transmission is in the low risk category (3.4). The summary average risk score for the virus to significantly impact public health if it were to achieve sustained human-to-human transmission was also in the low risk category (3.9).

H7N9: [A/Hong Kong/125/2017]

Low pathogenic avian influenza (LPAI) H7N9 viruses were first reported from China in March 2013. These viruses were first scored using the IRAT in April 2013, and then annually in 2014, 2015, and 2016 with no change in overall risk scores. Between October 2016 and May 2017 evidence of two divergent lineages of these viruses was detected – the Pearl River Delta lineage and the Yangtze River Delta lineage. The IRAT was used to assess LPAI H7N9 [A/Hong Kong/125/2017], a representative of the Yangtze River Delta viruses.

Summary: A risk assessment of H7N9 [A/Hong Kong/125/2017] was conducted in May 2017. The overall IRAT risk assessment score for this virus falls into the moderate-high risk category and is similar to the scores for the previous H7N9 viruses. The summary average risk score for the virus to achieve sustained human-to-human transmission is in the moderate risk category (less than 7). The summary average risk score for the virus to significantly impact public health if it were to achieve sustained human-to-human transmission was in the moderate-high risk category (less than 8).

H7N9: Avian H7N9 [A/Shanghai/02/2013]

On 31 March 2013, the China Health and Family Planning Commission notified the World Health Organization (WHO) of three cases of human infection with influenza H7N9. As of August 2016, the WHO has received reports of 821 cases, 305 have died. This low pathogenic avian influenza virus was rescored most recently in April 2016 with no substantive change in risk scores since May 2013.

Summary: The summary average risk score for the virus to achieve sustained human-to-human transmission was in the moderate risk category (less than 7). The average risk score for the virus to significantly impact public health if it were to achieve sustained human-to-human transmission fell in the high-moderate risk range (less than 8).

H7N9: Low Pathogenic North American avian [A/chicken/Tennessee/17-007431-3/2017]

Surveillance conducted in March 2017 during the investigation of a highly pathogenic avian influenza (HPAI) A(H7N9) virus in commercial poultry in Tennessee revealed the contemporaneous presence of North American lineage low pathogenic avian influenza (LPAI) A(H7N9) virus in commercial and backyard poultry flocks in Tennessee and three other states. The outbreak in poultry appeared limited with no further detections in subsequent surveillance. There were no reports of human cases associated with this virus.

Summary:  A risk assessment this North American lineage LPAI A(H7N9) virus was conducted in October 2017. The overall IRAT risk assessment score for this virus falls into the low risk category (< 4). The summary average risk score for the virus to achieve sustained human-to-human transmission was in the low risk category (score 3.1).  The average risk score for the virus to significantly impact public health if it were to achieve sustained human-to-human transmission was between the low to low-moderate range (score 3.5). For a full report, click here[228 KB, 4 pages](https://www.cdc.gov/flu/pandemic-resources/pdf/cdc-irat-virus-lpai.pdf).

H7N9: High Pathogenic North American avian [A/chicken/Tennessee/17-007147-2/2017]

In March 2017, the U.S. Department of Agriculture (USDA) reported the detection of a highly pathogenic avian influenza (HPAI) A(H7N9) virus in 2 commercial poultry flocks in Tennessee. Full genome sequence analysis indicated that all eight gene segments of the virus were of North American wild bird lineage and genetically distinct from the lineage of influenza A(H7N9) viruses infecting poultry and humans in China since 2013. The outbreak investigation revealed that a related North American low pathogenic avian influenza A(H7N9) was circulating in poultry prior to the detection of the HPAI A(H7N9). There were no reports of human cases associated with this virus.

Summary:  A risk assessment this North American lineage HPAI A(H7N9) virus was conducted in October 2017. The overall IRAT risk assessment score for this virus falls into the low risk category (< 4). The summary average risk score for the virus to achieve sustained human-to-human transmission is in the low risk category (2.8). The summary average risk score for the virus to significantly impact public health if it were to achieve sustained human-to-human transmission was also in the low risk category (3.5). For a full report, click here[225 KB, 4 pages](https://www.cdc.gov/flu/pandemic-resources/pdf/cdc-irat-virus-hpai.pdf).

H9N2: Avian H9N2 G1 lineage [A/Bangladesh/0994/2011]

Human infections with influenza AH9N2 virus have been reported sporadically, cases reportedly exhibited mild influenza-like illness. Historically these low pathogenic avian influenza viruses have been isolated from wild and domestic birds. In response to these reports, a risk assessment of this H9N2 influenza virus was conducted in 2014.

Summary: The summary average risk score for the virus to achieve sustained human-to-human transmission was in the moderate risk category (less than 6). The summary average risk score for the virus to significantly impact public health if it were to achieve sustained human-to-human transmission also fell in the moderate risk range (less than 6).

H10N8: Avian H10N8 [A/Jiangxi-Donghu/346/2013]

Two human infections with influenza A(H10N8) virus were reported by the China Health and Family Planning Commission in 2013 and 2014 (one each year). Both cases were hospitalized and one died. Historically low pathogenic avian influenza H10 and N8 viruses have been recovered from birds. A risk assessment of the H10N8 influenza was conducted in 2014.

Summary: The summary average risk score for the virus to achieve sustained human-to-human transmission was low-moderate (less than 5). The average risk score for the virus to significantly impact public health if it were to achieve sustained human-to-human transmission was in the moderate risk range (less than 7).

 


CDC has now confirmed 132 cases in 32 states tied to the use of kratom, an herbal alternative to opioids.

CDC

What’s New?

  • Forty-five more ill people from 19 states were added to this investigation since the last update on March 15, 2018.
  • Three additional states have reported ill people: Connecticut, Iowa, and Idaho.

 

Highlights

  • At this time, CDC recommends that people not consume any brand of kratom in any form because it could be contaminated with Salmonella.
    • Kratom products from several companies have been recalled because they might be contaminated with Salmonella. The list of recalled kratom products is available on the U.S. Food and Drug Administration website.
    • Kratom is also known as Thang, Kakuam, Thom, Ketom, and Biak.
    • Kratom is a plant consumed for its stimulant effects and as an opioid substitute.
  • CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration are investigating a multistate outbreak of Salmonella infections.
  • Epidemiologic and laboratory evidence indicates that kratom is the likely source of this multistate outbreak.
    • No common brands or suppliers of kratom products have been identified at this time.
    • Because no common source of Salmonella-contaminated kratom has been identified, CDC is recommending against consuming any kratom.
  • A total of 132 people infected with outbreak strains of Salmonella I 4,[5],12:b:- (61), Salmonella Javiana (15), Salmonella Okatie (21), or Salmonella Thompson (35) have been reported from 38 states.
    • Forty percent of ill people have been hospitalized, and no deaths have been reported.
  • This investigation is ongoing. CDC will provide updates when more information is available.

People infected with the outbreak strains of Salmonella, by state of residence, as of April 5, 2018


A multistate Salmonella outbreak linked to kratom supplements has sickened 47 more people and expanded to 8 more states, raising the total to 87 cases from 35 states,

CDC

At A Glance

  • Case Count: 87
  • States: 35
  • Deaths: 0
  • Hospitalizations: 27
  • Recall: Yes

People infected with the outbreak strain of Salmonella, by state of residence, as of March 14, 2018


Multistate Outbreak of Salmonella I 4,[5],12:b:- Infections Linked to Kratom

CDC

  • Case Count: 40
  • States: 27
  • Deaths: 0
  • Hospitalizations: 14

People infected with the outbreak strain of Salmonella I 4,[5],12:b:-, by state of residence, as of February 28, 2018

People infected with the outbreak strain of Salmonella I 4,[5],12:b:- by date of illness onset as of February 28, 2018*


CDC is dramatically downsizing its epidemic prevention activities in 39 out of 49 countries because money is running out

Washington Post

“…..The CDC plans to narrow its focus to 10 “priority countries,” starting in October 2019, the official said. They are India, Thailand and Vietnam in Asia; Jordan in the Middle East; Kenya, Uganda, Liberia, Nigeria and Senegal in Africa; and Guatemala in Central America.

Countries where the CDC is planning to scale back include some of the world’s hot spots for emerging infectious disease, such as China, Pakistan, Haiti, Rwanda and Congo……”

 


CDC plans to scale back or discontinue its work to prevent infectious-disease epidemics and other health threats in 39 foreign countries because it expects funding for the work to end

WSJ

“….The CDC currently works in 49 countries as part of an initiative called the global health security agenda, to prevent, detect and respond to dangerous infectious disease threats. It helps expand surveillance for new viruses and​ ​drug-resistant bacteria, modernize laboratories to detect dangerous pathogens​and train workers who respond to epidemics.The package included $582 million in funds to work with countries around the world after the Ebola crisis in 2014 and 2015. But that funding runs out at the end of fiscal 2019……..[T]he CDC said it anticipates that if its funding situation remains the same, it will have to narrow activities to 10 “priority countries” starting in October 2019……..

 

The 10 countries where global health security activities will remain are India, Thailand, Vietnam, Kenya, Uganda, Liberia, Nigeria, Senegal, Jordan and Guatemala, according to the email—countries of strategic or regional importance for the CDC….”

 


January 7-13: Folic Acid Awareness week

CDC

Facts About Folic Acid

Woman reading nutritional information on a cereal box. Nutrition label highlighting 100% Folic Acid.

CDC urges women to take 400 mcg of folic acid every day, starting at least one month before getting pregnant, to help prevent major birth defects of the baby’s brain and spine.

About folic acid

Folic acid is a B vitamin. Our bodies use it to make new cells. Everyone needs folic acid.

Why folic acid is so important

Folic acid is very important because it can help prevent some major birth defects(https://www.cdc.gov/ncbddd/birthdefects/index.html) of the baby’s brain and spine (anencephaly(https://www.cdc.gov/ncbddd/birthdefects/anencephaly.html) and spina bifida(https://www.cdc.gov/ncbddd/spinabifida)).

How much folic acid a woman needs

400 micrograms (mcg) every day.

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When to start taking folic acid

For folic acid to help prevent some major birth defects, a woman needs to start taking it at least one month before she becomes pregnant and while she is pregnant.

Every woman needs folic acid every day, whether she’s planning to get pregnant or not, for the healthy new cells the body makes daily. Think about the skin, hair, and nails. These – and other parts of the body – make new cells each day.

How a woman can get enough folic acid

There are two easy ways to be sure to get enough folic acid each day:

  1. Take a vitamin that has folic acid in it every day.
    1. Most multivitamins sold in the United States have the amount of folic acid women need each day. Women can also choose to take a small pill (supplement) that has only folic acid in it each day.
    2. Multivitamins and folic acid pills can be found at most local pharmacy, grocery, or discount stores. Check the label to be sure it contains 100% of the daily value (DV) of folic acid, which is 400 micrograms (mcg).
  2. Eat a bowl of breakfast cereal that has 100% of the daily value of folic acid every day.
    1. Not every cereal has this amount. Check the label on the side of the box, and look for one that has “100%” next to folic acid.

CDC :: Anatomy of an Outbreak: A Disease Threat Anywhere is a Threat Everywhere.

Today’s world is more connected than ever. In as little as 36 hours1, a pathogen from a remote village can spread to all major cities in six continents. That is why it is critical to detect, report and respond to outbreaks in a timely manner.

NATOMY OF AN OUTBREAK

A Disease Threat Anywhere is a Threat Everywhere.

Today’s world is more connected than ever. In as little as  36 hours1, a pathogen from a remote village can spread to all major cities in six continents. That is why it is critical to detect, report and respond to outbreaks in a timely manner.

  1. Incident Occurs

A new or existing pathogen is introduced to a community and starts to spread.

Humans or animals start to feel ill or even die with similar symptoms.

CDC performs 24/7 global disease monitoring to identify potential incidents.

 

  1. Outbreak Suspected

An outbreak is suspected. There are several ways to detect and verify  a disease through reported cases or from event information.

Local clinics and hospitals see more people with symptoms such as fever, persistent diarrhea, cough and unexplained bleeding.

Laboratory confirms cases of disease found at local clinic.

Disease detective and surveillance teams capture and organize information about events that are a potential risk.

Teams monitor official and unofficial reports of potential disease events from a wide variety of sources including media, rumors, blogs, community members, etc.

CDC works with partners and Ministries of Health to find potential  outbreaks through routine reporting of symptoms, lab test  results and official and unofficial reports.

 

  1. Investigation Started

Countries conduct lab tests or send specimens for testing.

CDC trains countries how to test, handle and safeguard samples.

Disease detectives investigate to determine the source and size of the outbreak.

CDC trains disease detectives around the world to stop the outbreak at the source.

Lab results confirm if patients test positive or negative for illness.

Health authorities are alerted.

 

  1. Reporting

Authorities report disease outbreak to appropriate national and international organizations in accordance with the International Health Regulations.

 

  1. Global Response Initiated

CDC’s global rapid responders are deployed when a country requests additional support to:

Implement infection prevention and control measures and distribute medical countermeasures

Conduct public health communication and education

Enhance local surveillance systems to track outbreaks

Improve local lab testing for faster diagnosis

CDC is at the frontline of disease detection and response, working 24/7  to protect the health, safety, and security of American people. CDC’s work

ensures that outbreaks are contained before they can spread and reach the U.S.

 

  1. Jonas, Olga B.. 2013. Pandemic Risk. World Bank, Washington, DC. © World Bank. https://openknowledge.worldbank.org/handle/10986/16343 License: CC BY 3.0 IGO.

This is a snapshot of an outbreak investigation and does not reflect all the steps that may occur. Information presented in this example depicts a prompt outbreak identification. Several factors affect the investigation and can prolong the timing and results. Delays in response activities can lead to outbreaks spreading quickly and spillover to other communities.


CDC: During week 51 (December 17-23, 2017), influenza activity increased sharply in the United States.

CDC

During week 51 (December 17-23, 2017), influenza activity increased sharply in the United States.

  • Viral Surveillance: The most frequently identified influenza virus subtype reported by public health laboratories during week 51 was influenza A(H3). The percentage of respiratory specimens testing positive for influenza in clinical laboratories increased.
  • Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia and influenza (P&I) was below the system-specific epidemic threshold in the National Center for Health Statistics (NCHS) Mortality Surveillance System.
  • Influenza-associated Pediatric Deaths: Three influenza-associated pediatric deaths were reported.
  • Influenza-associated Hospitalizations: A cumulative rate of 8.7 laboratory-confirmed influenza-associated hospitalizations per 100,000 population was reported.
  • Outpatient Illness Surveillance:The proportion of outpatient visits for influenza-like illness (ILI) was 5.0%, which is above the national baseline of 2.2%. All 10 regions reported ILI at or above region-specific baseline levels. Twenty-one states experienced high ILI activity; New York City and five states experienced moderate ILI activity; eight states experienced low ILI activity; 14 states experienced minimal ILI activity; and the District of Columbia, Puerto Rico and two states had insufficient data.
  • Geographic Spread of Influenza:The geographic spread of influenza in 36 states was reported as widespread; Puerto Rico and 13 states reported regional activity; one state reported local activity; and the District of Columbia, the U.S. Virgin Islands, and Guam did not report.

INFLUENZA Virus Isolated

Click on image to launch interactive tool

Click on graph to launch interactive tool

national levels of ILI and ARI

 

 


CDC on hepatitis

CDC

Viral hepatitis is the term that describes inflammation of the liver that is caused by a virus. There are actually five types of hepatitis viruses; each one is named after a letter in the alphabet: A, B, C, D and E.

The most common types of viral hepatitis are A, B and C. These three viruses affect millions of people worldwide, causing both short-term illness and long-term liver disease. The World Health Organization estimates 325 million people worldwide are living with chronic hepatitis B or chronic hepatitis C. In 2015, 1.34 million died from viral hepatitis, a number that is almost equal to the number of deaths caused by tuberculosis and HIV combined.

Hepatitis B and hepatitis C are the most common types of viral hepatitis in the United States, and can cause serious health problems, including liver failure and liver cancer. In the U.S., an estimated 3.5 million people are living with hepatitis C in the US and an estimated 850,000 are living with Hepatitis B. Unfortunately, new liver cancer cases and deaths are on the rise in the United States. This increase is believed to be related to infection with hepatitis B or hepatitis C.

Many people are unaware that they have been infected with hepatitis B and hepatitis C, because many people do not have symptoms or feel sick. CDC developed an online Hepatitis Risk Assessment to help determine if you should get tested or vaccinated for viral hepatitis. The assessment takes only five minutes and will provide personalized testing and vaccination recommendations for hepatitis A, hepatitis B, and hepatitis C.

Hepatitis A

Hepatitis A is a short-term disease caused by infection with the hepatitis A virus. Hepatitis A is usually spread when a person ingests the virus from contact with objects, food, or drinks contaminated by solid waste from an infected person. Hepatitis A was once very common in the United States, but now less than 3,000 cases are estimated to occur every year. Hepatitis A does not lead to liver cancer and most people who get infected recover over time with no lasting effects. However, the disease can be fatal for people in poor health or with certain medical conditions.

Hepatitis A is easily prevented with a safe and effective vaccine, which is believed to have caused the dramatic decline in new cases in recent years. The vaccine is recommended for all children at one year of age and for adults who may be at risk, including people traveling to certain international countries.

Hepatitis B

Hepatitis B is a liver disease that results after infection with the hepatitis B virus. Hepatitis B is common in many parts of the world, including Asia, the Pacific Islands and Africa. Like Hepatitis A, Hepatitis B is also preventable with a vaccine. The hepatitis B virus can be passed from an infected woman to her baby at birth, if her baby does not receive the hepatitis B vaccine. As a result, the hepatitis B vaccine is recommended for all infants at birth.

Unfortunately, many people got infected with hepatitis B before the vaccine was widely available. This is why CDC recommends anyone born in areas where hepatitis B is common, or who have parents who were born in these regions, get tested for hepatitis B. Treatments are available that can delay or reduce the risk of developing liver cancer.

Hepatitis C

Hepatitis C is a liver disease that results from infection with the hepatitis C virus. For reasons that are not entirely understood, people born from 1945 to 1965 are five times more likely to have hepatitis C than other age groups. In the past, hepatitis C was spread through blood transfusions and organ transplants. However, widespread screening of the blood supply in the United States began in 1990.The hepatitis C virus was virtually eliminated from the blood supply by 1992. Today, most people become infected with hepatitis C by sharing needles, syringes, or any other equipment to inject drugs. In fact, rates of new infections have been on the rise since 2010 in young people who inject drugs.

There is currently no vaccine to prevent hepatitis C. Fortunately, new treatments offer a cure for most people. Once diagnosed, most people with hepatitis C can be cured in just 8 to 12 weeks, which reduces their risk for liver cancer.

Find out if you should get tested or vaccinated for viral hepatitis by taking CDC’s quick online Hepatitis Risk Assessment.

For more information visit www.cdc.gov/hepatitis.

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