u.s. influenza surveillance 2004 - 2005 keiji fukuda influenza branch national center for infectious...
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U.S. Influenza Surveillance2004 - 2005
Keiji Fukuda
Influenza Branch
National Center for Infectious Diseases
Centers for Disease Control and Prevention
Evolving U.S. Influenza Surveillance
Core• Viruses
– WHO / NRVESS Laboratory System
• Influenza-like illness– Sentinel Provider (SP)
System• Mortality
– 122 cities – NCHS
• State activity assessment– State & Territorial
Epidemiologists Report
Changes Underway• Current systems
– Enhancements to SP system• New Systems Added
– Pediatric influenza hospitalizations
• New Vaccine Surveillance Network
• Emerging Infections Program
– Pediatric influenza deaths– H5N1 detection in ill
travelers• Under evaluation
– Biosense– Notifiable diseases, etc.
Growth of the Influenza Sentinel Physician Surveillance System
0
500
1000
1500
2000
2500
1996-97 1997-98 1998-99 1999-2000 2000-01 2001-02 2002-03 2003-04 2004-05*
Season
En
roll
ed P
hys
icia
ns
0
1000000
2000000
3000000
4000000
5000000
6000000
7000000
8000000
9000000
10000000
Pat
ien
t vi
sits
enrolled physicians regularly reporting physicians patient visits
* Data as of 1/27/2005
Sentinel Provider System Coverage Map
Visits for Influenza-like Illness to U.S. Sentinel Providers, 2002 - 2005
0
1
2
3
4
5
6
7
8
9
10
40 42 44 46 48 50 52 2 4 6 8 10 12 14 16 18 20
Week
% o
f V
isit
s f
or
ILI
%ILI 2004-05 % ILI 2003-04 %ILI 2002-03 national baseline
2004 – 2005 U.S. Season
Influenza Virus Detections, 2004-05 U.S. WHO/NREVSS Collaborating Laboratories
58,286Negative
1,041 (14.6%)Influenza B
1986 (32.7%) subtyped
6 (0.3%)H1 1980 (99.7%)
H3N2
65,404 specimens tested for influenza viruses
7,118 (10.9%) Positive
6,077 (85.4%) influenza A
U.S. WHO/NREVSS Collaborating LaboratoriesSummary, 2004-05
0
200
400
600
800
1000
1200
1400
40 42 44 46 48 50 52 2 4 6 8 10 12 14 16 18 20
Week
Nu
mb
er
of
Iso
late
s
0
5
10
15
20
25
30
Pe
rce
nt
Po
sit
ive
A(H3N2)
A(H1N1) and A(H1N2)
A(Unsubtyped)
B
Percent Positive
Visits for Influenza-like Illness to U.S. Sentinel Providers, 2002 - 2005
0
1
2
3
4
5
6
7
8
9
10
40 42 44 46 48 50 52 2 4 6 8 10 12 14 16 18 20
Week
% o
f V
isit
s f
or
ILI
%ILI 2004-05 % ILI 2003-04 %ILI 2002-03 national baseline
NVSN Influenza (Lab Confirmed) Hospitalization RatesChildren 0 - 4 Years, 2000 - 2005
0
2
4
6
8
10
12
14
40-41 42-43 44-45 46-47 48-49 50-51 52 -1 2-3 4-5 6-7 8-9 10-11 12-13 14-15 16-17 18-19
2004-05 Influenza Season 2 Week Reporting Period
Po
pu
lati
on
-Bas
ed R
ate
per
10,
000
Ch
ildre
n
2000-2001 2001-2002 2002-2003 2003-2004 2004-2005
This graph has been updated from the January 21, 2004 report due to laboratory confirmation of an additional influenza hospitalization between December 26, 2004 and January 8, 2005.
EIP Influenza (Lab Confirmed) Hospitalization RatesChildren 0-4 years & 5-17 years, 2003 - 2005
0
2
4
6
8
10
12
14
40 41 42 43 44 45 46 47 48 49 50 51 52 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
2004-2005 Reporting Weeks
Pop
ulat
ion-
Bas
ed R
ate
per
10,0
00 C
hild
ren
Cumulative Rate for 0-4 years, 2003-2004 Cumulative Rate for 5-17 years, 2003-2004
Cumulative Rate for 0-4 years, 2004-2005 Cumulative Rate for 5-17 years, 2004-2005
4
6
8
10
12
Weeks
% o
f All
Dea
ths
Due
to P
&I
2001 2002 2003
20 30 40 50 10 20 30 40 50 10 20 30 40 50 10 20 30 40 50
Epidemic Threshold
Seasonal Baseline
Pneumonia and Influenza Mortalityfor 122 U.S. CitiesWeek Ending 2/05/2005
2004
Weekly Influenza Activity Estimates Reportedby State & Territorial Epidemiologists
Week ending February 05, 2005 - Week 5
No Report Sporadic Regional Widespread No Activity Local Activity
Conclusion
• Moderate impact compared with 2003
• Dominated by A (H3N2) viruses
• 6 reported pediatric deaths
• Ongoing activity
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