FW: Centers for Disease Control and Prevention (CDC) H1N1 Influenza Update

[Guest guest]

Dear Colleagues, Here is the end of the week email from CDC on the

HINI state of the nation. Please note quote from below:

·

“This virus is not ‘going away’ as

some people seem to think.”

Bobbi

Bobbi Ryder

President & CEO

National Center for Farmworker Health, Inc.

1770 FM 967

Buda, TX

(512) 312-5453 direct line

(512) 312-5451 Mendoza , Assistant

(512) 312-2600

www.ncfh.org

Surveillance & Reporting

Today CDC

issues its seasonal influenza surveillance system report, FluView,

for the week ending May 9.

·

FluView is a weekly report that

tracks U.S. influenza activity through multiple systems across five categories.

·

There

are higher levels of influenza-like illness in the United States than is normal

for this time of year.

The FluView

report shows that the proportion of outpatient visits for influenza-like

illness (ILI) was above the national baseline during the week ending

May 9.

Three

of the ten surveillance regions reported ILI above their region-specific

baselines.

FluView also

reports the

estimated level of spread of influenza activity in each state, according

to state health departments and the FluView report has a color

coded map indicated influenza activity levels by state.

For

the week ending May 9, eight (8) U.S. states reported geographically widespread

influenza activity: Arizona,

California, Delaware, Georgia, New Jersey< /st1:state>, New Mexico, Texas,

and Virginia.

Widespread

activity is defined outbreaks of influenza or increases in ILI cases and

recent laboratory-confirmed influenza in at least half the regions of the

state with recent laboratory evidence of influenza in the state.

Fourteen (14)

states reported regional activity: Alabama, Alaska, Colorado,

Connecticut, Florida, Hawaii, Maine, land, Massachusetts, Nevada, New

Hampshire, New York, Tennessee, and Utah

These

are states that are reporting outbreaks of influenza or increases in ILI

and recent laboratory confirmed influenza in at least two but less than

half the regions of the state with recent laboratory evidence of influenza

in those regions.

The District of

Columbia and fifteen (15) states reported local influenza activity:

Idaho, Illinois, Iowa, Kansas, Michigan, Montana, North Carolina,

Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Washington,

Wisconsin, and Wyoming

These

are states reporting outbreaks of influenza or increases in ILI cases and

recent laboratory-confirmed influenza in a single region of the state

Thirteen (13)

states reported sporadic influenza activity: Arkansas, Indiana, Kentucky,

Louisiana, Minnesota, Mississippi, Missouri, Nebraska, North Dakota, Ohio,

South Dakota, Vermont, and West Virginia

These

are states with small numbers of laboratory-confirmed influenza cases or a

single laboratory-confirmed influenza outbreak has been reported, but

there is no increase in cases of ILI.

·

We can

see from these reports that significant influenza activity is still ongoing in

much of the country.

About half of all

influenza viruses being detected through laboratory surveillance are novel

H1N1 viruses, with the other half being regular seasonal influenza virus,

including seasonal A H1N1, influenza A H3N2 and type B viruses.

There is a

graph in FluView that shows the proportion of viruses that are novel H1N1,

seasonal H1N1, seasonal H3N2 and seasonal B viruses. The graph also shows

the number of viruses that are unsubtypable.

Unsubtypable

viruses are viruses that are influenza A positive at the state level, but

are negative for regular human seasonal viruses. About 99% of unsubtypable

viruses have been novel H1N1.

·

The list of

states with the numbers of people who are confirmed and probable cases of novel

H1N1 infection will be available online and updated Monday - Friday at

approximately 11 a.m. at http://www.cdc.gov/h1n1flu/. (Most states do not report

over the weekend.)

·

Today CDC is

reporting a total of 4,714 probable and confirmed cases of novel H1N1 infection

·

In addition,

the nation’s fourth fatality from novel H1N1 has been reported by the

state of Arizona.

·

The death

occurred in Maricopa County in a woman in her late 40s.

Outbreak Summary

·

Influenza

illness, including illness associated with the novel influenza A H1N1 virus is

ongoing in this country.

·

This

virus is not “going away” as some people seem to think.

·

It’s

uncertain at this time how severe this novel H1N1 outbreak will be in terms of

illness and death compared with other influenza viruses.

·

Because

this is a new virus, most people will not have immunity to it, and illness may

be more severe and widespread as a result.

·

In

addition, currently there is no vaccine to protect against this novel H1N1

virus as we have for seasonal influenza.

·

Influenza is

always serious – each year in the United States, seasonal influenza

results, on average, in an estimated 36,000 deaths and more than 200,000

hospitalizations from flu-related causes.

·

This outbreak

certainly poses the potential to be at least as serious as seasonal flu, if not

more so, especially given the fact that there currently is no vaccine against

this virus and there is no immunity against this virus in the population.

·

Because of

these factors, CDC anticipates that there will be more cases, more

hospitalizations and more deaths associated with this new virus in the coming

days and weeks.

·

Like seasonal flu, some people may be at greater risk of

serious complications related to novel H1N1 infection and illness.

·

People who are at high risk of serious seasonal flu-related

complications include pregnant women, children younger than 5 years old, people

with chronic medical conditions, and people 65 years and older.

·

CDC believes

this information from seasonal flu applies to the novel H1N1 (swine flu)

viruses as well, but studies on this virus are ongoing to learn more about its

characteristics and to learn what groups are at highest risk.

·

The

media spotlight may have shifted, but CDC’s response and focus has not.

Now is not the time for complacency or to let down our guard.

· The United

States is already engaged in implementing its pandemic response plan.

Response:

The Federal

Government is mounting an aggressive response to this outbreak.

CDC’s

goals during this public health emergency are to reduce illness and death,

and to provide information to assist health care providers, public health

officials and the public in addressing the challenges posed by this newly

identified influenza virus.

CDC

continues to update guidance continuously as more information becomes

available.

This includes

guidance for clinicians on the use of antiviral drugs to treat this

illness.

The

priority use for influenza antiviral drugs during this outbreak is to

treat severe influenza illness (including those who are hospitalized or

ill people who are considered at high risk of serious influenza-related

complications).

·

Visit http://www.cdc.gov/h1n1flu/guidance/

for the most updated guidance.

CDC

continues to watch this virus closely for changes that may make it more

virulent or resistant to antiviral drugs.

·

Deployment

of 25 percent of the SNS supplies has been completed to all 62 states or

project areas.

·

There

are currently more than 100 CDC staff persons deployed in the field to support

the outbreak response.

CDC is taking early steps in

the vaccine manufacturing process, working closely with manufacturing and

the rest of the government. (More vaccine information below.)

A

CDC-developed PCR diagnostic test kits to detect this virus has been sent

to all 50 states, the District of Columbia and Puerto Rico. Kits are being

sent internationally too.

Much of

CDC’s guidance is informed by studies and past experience with

seasonal (human) influenza and past influenza pandemics.

This is a

rapidly evolving situation and guidance should be considered interim and

will be updated frequently as more information becomes available.

Visit

the CDC website at http://www.cdc.gov/h1n1flu/ for more

information or call 1-800-CDC-INFO.

· Everyday, we learn

more about this virus and what we learn will continue to inform the actions

that we take in response.

Novel

H1N1 Flu Virus

·

The hallmark of influenza viruses is their ability to undergo

constant and dramatic change.

·

Many different animals and, of course, humans get infected with

influenza viruses, but the viruses generally stick with one species or

another.

·

However, sometimes flu viruses jump from one species to another,

and sometimes, viruses from different species can infect the same host and

result in a new combination of virus genes.

·

This last scenario is what happened and resulted in the novel H1N1

flu virus.

·

This is a very unusual virus. This particular genetic combination

of influenza virus segments has not been recognized before in the U.S. or

elsewhere.

·

Testing of a number of the virus samples submitted to CDC show

that they are very similar, which means that they likely originated from the

same source.

It’s too

soon to predict what will happen or how the virus might change.

CDC continues

to watch this virus closely for changes that may make it more virulent or

resistant to antiviral drugs.

There is no

indication that this has occurred at this time.

There is the

possibility of reassortment (swapping virus genes) between this novel

influenza A (H1N1) virus and circulating seasonal influenza viruses.

Such a

reassortant virus could be resistant to the antiviral drug oseltamivir

because most of currently circulating seasonal H1 viruses are resistant to

oseltamivir. (They are sensitive to zanamivir and the adamantane drugs

amantadine and rimantidine.)

That is one

reason why it’s important to continue to watch the novel H1N1 virus

and human seasonal viruses carefully over the coming weeks and months and

to continue to be prepared and proactive.

In addition,

as always, we must continue to look for emergence of other flu viruses

with pandemic potential.

The Southern Hemisphere is just

going into their flu season and how this virus behaves will give us some

clues about what we can expect for the Northern Hemisphere.

Vaccine

Vaccines are a very important

part of a response to influenza, including novel influenza that may become

pandemic.

CDC has isolated the novel H1N1

flu virus and is working to make a candidate vaccine virus that can be

provided to industry so that manufacturers can scale up for production of

a vaccine, if necessary.

There are many steps involved

with producing a vaccine, and we are committed to going forward with the

NIH, and FDA, BARDA, and the manufacturers of influenza vaccines, to see

about developing full scale vaccine production.

If

things go well, and we achieve full scale production, it will be several

months until the vaccine will be available.

So

a vaccine is an important tool for the future.

Seasonal Flu

Vaccine.

Production of the seasonal flu vaccine for next season is nearly complete

and will be completed. Seasonal flu is responsible for causing an

estimated 36,000 flu-related deaths and 200,000 flu-related

hospitalizations in the U.S. each year. Seasonal flu vaccine is always a

public health priority.

Public/Personal Responsibility:

·

It’s

important that people continue to take steps to protect their health and the

health of their family.

·

Stay

informed. Health officials will provide additional information as it becomes

available. Visit www.cdc.gov

· Everyone

should take everyday steps to protect your health and lessen the spread of this

new virus:

o

Cover your nose and mouth with a tissue when you cough or sneeze.

Throw the tissue in the trash after you use it.

o

Wash your hands often with soap and water, especially after you

cough or sneeze. Alcohol-based hand cleaners are also effective.

o

Avoid touching your eyes, nose or mouth. Germs spread this way.

o

Try to avoid close contact with sick people.

o

Stay

home if you are sick for 7 days after your symptoms begin or until you have

been symptom-free for 24 hours, whichever is longer. This is to keep from

infecting others and spreading the virus further.

Children, especially younger children,

might potentially be contagious for longer periods. CDC is studying the

virus and its capabilities to try to learn more and will provide more

information as it becomes available.

We

do have antiviral medications in our arsenal against flu.

The

priority use for influenza antiviral drugs during this outbreak is to

treat severe influenza illness (including those who are hospitalized or

ill people who are considered at high risk of serious influenza-related

complications).

FluView

·

The Epidemiology and Prevention Branch in the Influenza Division

at CDC collects, compiles and analyzes information on influenza activity year

round in the United States and produces a weekly report published each Friday

called “FluView” (normally from October through mid-May).

·

In light of the current outbreak, weekly publication of FluView

will continue over the spring and summer.

·

The U.S. influenza surveillance system is a collaborative effort

between CDC and its many partners in state and local health departments, public

health and clinical laboratories, vital statistics offices, healthcare

providers, clinics and emergency departments.

·

Information in five categories is collected from nine different

data sources that allow CDC to:

o

Find out when and where influenza activity is occurring

o

Track influenza-related illness

o

Determine what influenza viruses are circulating

o

Detect changes in influenza viruses

o

Measure the impact influenza is having on deaths in the United

States

More

information about CDC’ s influenza surveillance systems can be found

at http://www.cdc.gov/flu/weekly/fluactivity.htm

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