CONNECTICUT PUBLIC HEALTH ASSOCIATIONHEALTH EDUCATION COMMITTEE

6-12-2013

DEBBYE ROSEN, BSN, MSADULT IMMUNIZATION

COORDINATORCT DEPARTMENT OF PUBLIC HEALTH

860-509-7729debbye.rosen@ct.gov

• REVIEW INFLUENZA SURVEILLANCE FOR 2012-2013, CT AND NATIONAL

• REVIEW INFLUENZA VACCINATION DATA, NATIONAL 2012-2013

• INFLUENZA VACCINE RECOMMENDATIONS 2013-2014

• INFLUENZA VACCINE PRODUCTS 2013-2014

• UPDATE H7N9 – IS THIS THE “NEW” PANDEMIC

OBJECTIVES

• DESCRIBE THE INFLUENZA SURVEILLANCE PROCESS

• LIST THE 2012-2013 INFLUENZA VACCINATION RECOMMENDATIONS

• LIST THE KEY POINTS TO FOLLOW IN THE H7N9 INFLUENZA

OUTBREAK

BURDEN OF DISEASE, U.S. ADULTS

INFLUENZA• 3,000 to 49,000 total related deaths per year • ~90% among adults 65 years and older

Invasive pneumococcal disease (IPD)1 • 39,750 total cases and 4,000 total deaths in 2010

• 86% of IPD and nearly all IPD deaths among adults

Pertussis• 41,880 total reported cases 2012 • ~9,000 among adults

Hepatitis B • 3,350 acute cases reported 2010 • 35,000 estimated

Zoster • about 1 million cases of zoster annually in the U.S.

1.CDC. Active Bacterial Core Surveillance. http://www.cdc.gov/abcs/reports-findings/survreports/spneu10.pdf. 2.CDC. Estimates of deaths associated with seasonal influenza – United States, 1976-2007. MMWR. 2010;59(33):1057-1062.

3.CDC. Notifiable Diseases and Mortality Tables. MMWR 2013. 61(51&52): ND-719 – ND 732. 4.CDC. Viral Hepatitis Surveillance United States, 2010. National Center for HIV/AIDS, Viral Hepatitis, STD& TB Prevention/Division of Viral Hepatitis.

5.CDC. Prevention of Herpes Zoster. MMWR 2008. 57(RR-5): 1-30.

WHERE DO THE NUMBERS COME FROM?????

INFLUENZA SURVEILLANCE

NATIONAL DATA•CULTURE CONFIRMED FROM STATES •INFLUENZA LIKE ILLNESS•DEATHS FROM PNEUMONIA AND INFLUENZA-CITIES

• DEATHS IN CHILDREN <5 YRS•CULTURE POSITIVE HOSPITALIZED PATIENTS

CONNECTICUT•EMERGENCY ROOM VISITS

DEATHS , INFLUENZA RELATED CT 2012-2013

• TOTAL= 37• 89% >65 YRS, 11% 55-64 YRS

• NO DEATHS < 5 YRS.

• MODERATE TO SEVERE SEASON• EARLY DISEASE• ELDERLY SEVERELY IMPACTED

http://www.google.com/url?sa=i&rct=j&q=flu+cartoons+free&source=images&cd=&cad=rja&docid=LB-tRR6U6_p1NM&tbnid=DF6GrvEntRjPzM:&ved=&url=http%3A%2F%2Fwww.funnytimes.com%2Feditorials_tag_result.php%3Ftag%3Dflu&ei=HSCuUYvrIK-34AO1tIGgAw&bvm=bv.47244034,d.dmg&psig=AFQjCNHD1MG3pdAGRSjt5R9ttRrlxlv2Yw&ust=1370452381962353

MEASURING INFLUENZA VACCINATIONS

VACCINATION RATES• BRFSS (ADULTS)

• NATIONAL IMMUNIZATION SURVEY (CHILDREN)

• NHIS (ADULTS)

• NATIONAL FLU SURVEY (ADULTS,HCP, PREGNANT)

VACCINE EFFECTIVENESS

VACCINE EFFECTIVENESS

• INFLUENZA A & B VIRUS ASSOCIATED WITH MEDICALLY ATTENDED ACUTE RESPIRATORY ILLNESS 56%

47% AGAINST INFLUENZA A (H3N2)67 % AGAINST INFLEUNZA B

23% (9%) AGAINST INFLUENZA A (H3N2) PEOPLE > 65 YRS

FLU VACCINE RECOMMENDATIONS

WHO SHOULD GET VACCINATED IN 2013-2014

•> 6 MONTHS

WHO SHOULD NOT GET VACCINATED•SEVERE REACTION TO PREVIOUS FLU VACCINE•GUILLAIN-BARRÉ•< 6 MONTHS•MODERATE SEVERE ILLNESS•EGG ALLERGY ????????

FLU VACCINE PRODUCTS 2013-2014

• 10 VACCINE PRODUCTS

• 6 MANUFACTURERS

• NEW PRODUCTS• LIV4

• IIV4

• CELL CULTURE (ccIIV3)• RECOMBINANT HEMAGGLUTIN

INFLUENZA VACCINE (RIV3 FLUBLOK)

H7N9 ????????THE NEXT PANDEMIC

• > 130 CASES IDENTIFIED IN 10 CHINA PROVINCES

• NO U.S. CASES

• NO SUSTAINED HUMAN TO HUMAN TRANSMISSION

• TESTING KITS ARE AVAILABLE

• CANDIDATE VACCINE DEVELOPED• CLINICAL TRIALS• # OF DOSES NEEDED• ADJUVANT TO BOOST RESPONSE

RESOURCES

• CENTERS FOR DISEASE CONTROL AND PREVENTION www.cdc.gov/flu

• DEPARTMENT OF PUBLIC HEALTH IMMUNIZATION PROGRAM

www.ct.gov/dph/immunizations

• IMMUNIZATION ACTION COALITIION www.immunize.org

DEBBYE ROSEN, BSN, MSADULT IMMUNIZATION

COORDINATORCT DEPARTMENT OF PUBLIC HEALTH

860-509-7729debbye.rosen@ct.gov

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