Global & Disaster Medicine

Archive for the ‘Influenza’ Category

CDC: During week 17 (April 22-28, 2018), influenza activity decreased in the United States.

CDC

 

  • Viral Surveillance:Overall, influenza A(H3) viruses have predominated this season. Since early March, influenza B viruses have been more frequently reported than influenza A viruses. The percentage of respiratory specimens testing positive for influenza in clinical laboratories decreased.
  • 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 106.0 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 1.5%, which is below the national baseline of 2.2%. One of 10 regions reported ILI at or above their region-specific baseline level. Two states experienced low ILI activity; and New York City, the District of Columbia, Puerto Rico, and 48 states experienced minimal ILI activity.
  • Geographic Spread of Influenza: The geographic spread of influenza in three states was reported as widespread; Guam, Puerto Rico and seven states reported regional activity; 24 states reported local activity; the District of Columbia, and 14 states reported sporadic activity; and the U.S. Virgin Islands and two states reported no influenza activity.

INFLUENZA Virus Isolated

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national levels of ILI and ARI


2017-2018 Influenza Season Week 14 ending April 7, 2018

CDC

Synopsis:

During week 14 (April 1-7, 2018), influenza activity decreased in the United States.

  • Viral Surveillance: Overall, influenza A(H3) viruses have predominated this season. Since early March, influenza B viruses have been more frequently reported than influenza A viruses. The percentage of respiratory specimens testing positive for influenza in clinical laboratories decreased.
  • 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: Nine influenza-associated pediatric deaths were reported.
  • Influenza-associated Hospitalizations: A cumulative rate of 101.6 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 2.1%, which is below the national baseline of 2.2%. Six of 10 regions reported ILI at or above region-specific baseline levels. Two states experienced high ILI activity; two states experienced moderate ILI activity; 11 states experienced low ILI activity; and New York City, the District of Columbia, Puerto Rico, and 35 states experienced minimal ILI activity.
  • Geographic Spread of Influenza: The geographic spread of influenza in seven states was reported as widespread; Guam, Puerto Rico and 22 states reported regional activity; the District of Columbia and 16 states reported local activity; and the U.S. Virgin Islands and five states reported sporadic activity.

INFLUENZA Virus Isolated

Click on image to launch interactive tool

national levels of ILI and ARI

 

 


CDC: During week 13 (March 25-31, 2018), influenza activity decreased in the United States.

CDC

Synopsis:

 

  • Viral Surveillance: Overall, influenza A(H3) viruses have predominated this season. Since early March, influenza B viruses have been more frequently reported than influenza A viruses. The percentage of respiratory specimens testing positive for influenza in clinical laboratories remains elevated.
  • 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: Five influenza-associated pediatric deaths were reported.
  • Influenza-associated Hospitalizations: A cumulative rate of 99.9 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 2.4%, which is above the national baseline of 2.2%. Seven of 10 regions reported ILI at or above region-specific baseline levels. Two states experienced high ILI activity; eight states experienced moderate ILI activity; New York City and 12 states experienced low ILI activity; and the District of Columbia, Puerto Rico, and 28 states experienced minimal ILI activity.
  • Geographic Spread of Influenza: The geographic spread of influenza in 11 states was reported as widespread; Guam, Puerto Rico and 26 states reported regional activity; the District of Columbia and 10 states reported local activity; and the U.S. Virgin Islands and three states reported sporadic activity.

INFLUENZA Virus Isolated

Click on image to launch interactive tool

Click on graph to launch interactive tool

national levels of ILI and ARI

 


During week 12 (March 18-24, 2018), influenza activity decreased in the United States.

CDC

During week 12 (March 18-24, 2018), influenza activity decreased in the United States.

  • Viral Surveillance: Overall, influenza A(H3) viruses have predominated this season. However, in recent weeks the proportion of influenza A viruses has declined, and during week 12, influenza B viruses were more frequently reported than influenza A viruses. The percentage of respiratory specimens testing positive for influenza in clinical laboratories decreased.
  • Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia and influenza (P&I) was above the system-specific epidemic threshold in the National Center for Health Statistics (NCHS) Mortality Surveillance System.
  • Influenza-associated Pediatric Deaths: Four influenza-associated pediatric deaths were reported.
  • Influenza-associated Hospitalizations: A cumulative rate of 96.1 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 2.5%, which is above the national baseline of 2.2%. Nine of 10 regions reported ILI at or above region-specific baseline levels. Four states experienced high ILI activity; eight states experienced moderate ILI activity; New York City, Puerto Rico, the District of Columbia, and 14 states experienced low ILI activity; and 24 states experienced minimal ILI activity.
  • Geographic Spread of Influenza: The geographic spread of influenza in Puerto Rico and 16 states was reported as widespread; 22 states reported regional activity; the District of Columbia, Guam and eight states reported local activity; four states reported sporadic activity; and the U.S. Virgin Islands reported no influenza activity.

INFLUENZA Virus Isolated

Click on image to launch interactive tool

Click on graph to launch interactive tool

national levels of ILI and ARI

 


CDC: During week 11 (March 11-17, 2018), influenza activity decreased in the United States.

CDC

During week 11 (March 11-17, 2018), influenza activity decreased in the United States.

  • Viral Surveillance: Overall, influenza A(H3) viruses have predominated this season. However, in recent weeks the proportion of influenza A viruses has declined, and during week 11, influenza B viruses were more frequently reported than influenza A viruses. The percentage of respiratory specimens testing positive for influenza in clinical laboratories decreased.
  • Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia and influenza (P&I) was above the system-specific epidemic threshold in the National Center for Health Statistics (NCHS) Mortality Surveillance System.
  • Influenza-associated Pediatric Deaths: Five influenza-associated pediatric deaths were reported.
  • Influenza-associated Hospitalizations: A cumulative rate of 93.5 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 2.7%, which is above the national baseline of 2.2%. Nine of 10 regions reported ILI at or above region-specific baseline levels. Six states experienced high ILI activity; nine states experienced moderate ILI activity; New York City, Puerto Rico, the District of Columbia, and 17 states experienced low ILI activity; and 18 states experienced minimal ILI activity.
  • Geographic Spread of Influenza: The geographic spread of influenza in 17 states was reported as widespread; Guam, Puerto Rico and 26 states reported regional activity; the District of Columbia and five states reported local activity; and the U.S. Virgin Islands and two states reported sporadic activity.

INFLUENZA Virus Isolated

Click on image to launch interactive tool

Click on graph to launch interactive tool

national levels of ILI and ARI


CDC: During week 10 (March 4-10, 2018), influenza activity decreased in the United States.

CDC-Flu

INFLUENZA Virus Isolated

Click on image to launch interactive tool

Click on graph to launch interactive tool

national levels of ILI and ARI

 

 


CDC: influenza-like illness (ILI) activity is markedly down across the country this week, a clear sign that this year’s severe flu season continues to wind down.

CDC

Synopsis:

During week 9 (February 25-March 3, 2018), influenza activity decreased in the United States.

  • Viral Surveillance: Overall, influenza A(H3) viruses have predominated this season. However, in recent weeks the proportion of influenza A viruses has declined, and during week 9, the numbers of influenza A and influenza B viruses reported were similar. The percentage of respiratory specimens testing positive for influenza in clinical laboratories decreased.
  • Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia and influenza (P&I) was above the system-specific epidemic threshold in the National Center for Health Statistics (NCHS) Mortality Surveillance System.
  • Influenza-associated Pediatric Deaths: Five influenza-associated pediatric deaths were reported.
  • Influenza-associated Hospitalizations: A cumulative rate of 86.3 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 3.7%, which is above the national baseline of 2.2%. All 10 regions reported ILI at or above region-specific baseline levels. New York City and 21 states experienced high ILI activity; 15 states experienced moderate ILI activity; the District of Columbia, Puerto Rico, and five states experienced low ILI activity; and nine states experienced minimal ILI activity.
  • Geographic Spread of Influenza:The geographic spread of influenza in Puerto Rico and 34 states was reported as widespread; Guam and 12 states reported regional activity; the District of Columbia and four states reported local activity; and the U.S. Virgin Islands reported no activity.

INFLUENZA Virus Isolated

Click on image to launch interactive tool

Click on graph to launch interactive tool

national levels of ILI and ARI

 


CDC: Week 8 (February 18-24, 2018), influenza activity decreased in the United States.

CDC

Synopsis:

During week 8 (February 18-24, 2018), influenza activity decreased in the United States.

  • Viral Surveillance: While influenza A(H3) viruses continue to be predominant this season, during week 8 the overall proportion of influenza A viruses is declining and the proportion of influenza B viruses is increasing. The percentage of respiratory specimens testing positive for influenza in clinical laboratories decreased.
  • Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia and influenza (P&I) was above the system-specific epidemic threshold in the National Center for Health Statistics (NCHS) Mortality Surveillance System.
  • Influenza-associated Pediatric Deaths: Seventeen influenza-associated pediatric deaths were reported.
  • Influenza-associated Hospitalizations: A cumulative rate of 81.7 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. New York City, the District of Columbia, and 32 states experienced high ILI activity; Puerto Rico and nine states experienced moderate ILI activity; six states experienced low ILI activity; and three states experienced minimal ILI activity.
  • Geographic Spread of Influenza: The geographic spread of influenza in Puerto Rico and 45 states was reported as widespread; Guam and two states reported regional activity; the District of Columbia and three states reported local activity; and the U.S. Virgin Islands reported no activity.

INFLUENZA Virus Isolated

Click on image to launch interactive tool

Click on graph to launch interactive tool

national levels of ILI and ARI

 


NIAID (National Institute of Allergy and Infectious Diseases): A strategic plan for developing a universal influenza vaccine

NIAID

“…..To develop a universal influenza vaccine, NIAID will focus resources on three key areas of influenza research: improving the understanding of the transmission, natural history and pathogenesis of influenza infection; precisely characterizing how protective influenza immunity occurs and how to tailor vaccination responses to achieve it; and supporting the rational design of universal influenza vaccines, including designing new immunogens and adjuvants to boost immunity and extend the duration of protection.…..”

Emily J Erbelding, Diane Post, Erik Stemmy, Paul C Roberts, Alison Deckhut Augustine, Stacy Ferguson, Catharine I Paules, Barney S Graham, Anthony S Fauci; A Universal Influenza Vaccine: The Strategic Plan for the National Institute of Allergy and Infectious Diseases, The Journal of Infectious Diseases, , jiy103, https://doi.org/10.1093/infdis/jiy103


Use of Influenza Risk Assessment Tool (IRAT) for Prepandemic Preparedness

CDC

“…..Although only 3 hemagglutinin (HA) subtypes of influenza (H1, H2, and H3) are known to have caused human pandemics, the emergence and spread of influenza A(H5N1) and, more recently, influenza A(H7N9), with associated high death rates in humans, are of great concern. If these or other influenza A viruses not currently circulating among humans develop the capability to transmit efficiently among humans, they pose a risk for causing a pandemic that could be associated with high rates of illness and death…….

The IRAT uses a common decision analysis approach that incorporates input from multiple elements or attributes, applies a weighting scheme, and generates a score to compare various options or decisions (11). In regard to the evaluation of animal-origin influenza viruses for their potential human pandemic risk, 2 specific questions were developed related to the potential risk for emergence and consequent potential impact: 1) What is the risk that a virus not currently circulating in humans has the potential for sustained human-to-human transmission? (emergence question); and 2) If a virus were to achieve sustained human-to-human transmission, what is the risk that a virus not currently circulating among humans has the potential for substantial impact on public health? (impact question).

In developing the IRAT, a working group of international influenza experts in influenza virology, animal health, human health, and epidemiology identified 10 risk elements and definitions. These elements were described previously (10); in brief, they include virus properties (genomic variation, receptor-binding properties, transmissibility in animal models, and antiviral treatment susceptibility) and host properties (population immunity, disease severity, and antigenic relationship to vaccines). The final 3 elements are based on the epidemiologic and ecologic evidence: infection in humans, infections in animals, and global distribution in animals. These elements are used to answer the 2 risk questions to evaluate an influenza virus of interest. The 10 elements are ranked and weighted on the basis of their perceived importance to answering the specific risk questions and an aggregate risk score is generated……….

Individual subject-matter expert point scores by element for the May 2017 scoring of influenza A(H7N9) virus, A/Hong Kong/125/2017, based on risk element definitions. Circles indicate individual point scores; circle sizes (examples indicated by a number inside) correspond to the frequency of each point score.

Individual subject-matter expert point scores by element for the May 2017 scoring of influenza A(H7N9) virus, A/Hong Kong/125/2017, based on risk element definitions. Circles indicate individual point scores; circle sizes (examples indicated by a number inside) correspond to the frequency of each point score.

 

Comparison of average emergence and impact scores for 14 animal-origin influenza viruses using the Influenza Risk Assessment Tool. Circle represents each virus: A, H7N9 A/Hong Kong/125/2017; B, H7N9 A/Shanghai/02/2013; C, H3N2 variant A/Indiana/08/2011; D, H9N2 G1 lineage A/Bangladesh/0994/2011; E, H5N1 clade 1 A/Vietnam/1203/2004; F, H5N6 A/Yunnan/14564/2015-like; G, H7N7 A/Netherlands/2019/2003; H, H10N8 A/Jiangxi-Donghu/346/2013; I, H5N8 A/gyrfalcon/Washington/41088/2014; J, H5N2 A/Northern p

Comparison of average emergence and impact scores for 14 animal-origin influenza viruses using the Influenza Risk Assessment Tool. Circle represents each virus: A, H7N9 A/Hong Kong/125/2017; B, H7N9 A/Shanghai/02/2013; C, H3N2 variant A/Indiana/08/2011; D, H9N2 G1 lineage A/Bangladesh/0994/2011; E, H5N1 clade 1 A/Vietnam/1203/2004; F, H5N6 A/Yunnan/14564/2015-like; G, H7N7 A/Netherlands/2019/2003; H, H10N8 A/Jiangxi-Donghu/346/2013; I, H5N8 A/gyrfalcon/Washington/41088/2014; J, H5N2 A/Northern pintail/Washington/40964/2014; K, H3N2 A/canine/Illinois/12191/2015; L, H5N1 A/American green-winged teal/Washington/1957050/2014; M, H7N8 A/turkey/Indiana/1573-2/2016; N, H1N1 A/duck/New York/1996. Additional information about virus scores and individual viruses is available at https://www.cdc.gov/flu/pandemic-resources/monitoring/irat-virus-summaries.htm.

Burke SA, Trock SC. Use of Influenza Risk Assessment Tool for Prepandemic Preparedness. Emerg Infect Dis. 2018;24(3):471-477. https://dx.doi.org/10.3201/eid2403.171852

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