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Rahm Emanuel Mayor

Bechara Choucair, MD Commissioner

Influenza Update February 6, 2013

Bechara Choucair, MD Commissioner

Chicago Department of Public Health @choucair on

Influenza

• Highly contagious respiratory illness

• Causes yearly epidemics and sporadic pandemics

• Affects all age groups – Highest illness rates in young children

• Severe illness, hospitalizations and deaths disproportionately affect very young, elderly, pregnant women and persons with certain medical conditions

Influenza

• About half of hospitalizations and 90% of influenza-related deaths occur among persons >65 years – Severe illness can occur in any age group

• Significant cost burden to the US economy - $10.3 billion in direct cost to the medical system annually

• Influenza vaccination primary means to prevent illness and complications from influenza

Molinari et al 2007

Prevention

• Vaccine is the best form of protection – Recommended for everyone > 6 months

– Safe and effective

– Does not cause “the flu”

• Vaccine supply, US – Doses manufactured: 145 million

– Doses distributed: 128 million

Shot or Spray?

Anyone > 6 months Healthy, non pregnant, 2-49 years

Additional Prevention Measures

• Wash your hands often with soap and water. Use an alcohol-based hand sanitizer if soap and water are not available.

• Avoid touching your eyes, nose and mouth.

• Don't share cups, straws or anything that goes in the mouth.

• Cover your nose and mouth when you cough and sneeze, and promptly discard used facial tissues

• If you are sick, stay home.

Influenza 2012-13 Season, US

• Influenza activity increased early (December)

• Predominant strain was influenza A (H3N2) – Typically associated with more severe seasons

• Seniors disproportionately affected – Hospitalizations: 50% among persons 65 years and older – Deaths: 80% among persons 65 years and older

• Over 45 pediatric deaths reported – Unvaccinated: ~80%

Laboratory-Confirmed Influenza Hospitalizations, US, October 1- January 26,2013

0

20

40

60

80

100

120

140

6 13 20 27 3 10 17 24 1 8 15 22 29 5 12 19 26 2 9 16 23 2 9 16 23 30 6 13 20 27 4 11 18

Oct Nov Dec Jan Feb Mar Apr May

5-17 yrs

18-49 yrs

50-64 yrs

0-4 yrs

Week Ending Date

65+ yrs

Cas

es p

er

10

0,0

00

Number of Reported Influenza-Associated ICU Hospitalizations

for Current Season and Previous Season, Chicago

0

5

10

15

20

25

30

35

40

6 13 20 27 3 10 17 24 1 8 15 22 29 5 12 19 26 2 9 16 23 2 9 16 23 30 6 13 20 27 4 11 18

2011-2012

2012-2013

Oct Nov Dec Jan Feb Mar Apr May

Week Ending Date

N=159

N=63

0

1

2

3

4

5

6

7

8

9

10

6 13 20 27 3 10 17 24 1 8 15 22 29 5 12 19 26 2 9 16 23 2 9 16 23 30 6 13 20 27 4 11 18

Week Ending Date

Oct MayAprMarFebJanDecNov

2012-2013

2010-2011

2011-2012

5.5% 6.1%

7.6%

Percent of ED Visits Attributed to ILI, Chicago, by Week for

Current Influenza Season and Previous Two Seasons

0

1

2

3

4

5

6

7

8

9

10

6 13 20 27 3 10 17 24 1 8 15 22 29 5 12 19 26 2 9 16 23 2 9 16 23 30 6 13 20 27 4 11 18

Week Ending Date

Oct Nov Dec Jan Feb Mar Apr May

2012-2013

2010-2011

2011-2012

7.2%

4.4%

7.4%

Percent of Outpatient Visits Attributed to ILI (ILINet), Chicago, by Week

for Current Influenza Season and Previous Two Seasons

Influenza Season

Laboratory Results 2011-2012 2012-2013

# Specimens Tested* 2,642 7,709

# Specimens Positive 16 1,302

Positive for Influenza A 13 1,262

Subtype H3N2 7 1,014

Subtype 2009 H1N1 2 78

Not Subtyped 4 170

Positive for Influenza B 3 40 *Seven Chicago laboratories performing influenza subtyping that have consistently

reported results for both seasons.

Influenza Testing Results Reported by Chicago Laboratories

Performing Influenza Testing by RT-PCR

Public Health Emergency?

Assuring Access to Vaccine

• Illinois law (2012) allows pharmacists to administer influenza vaccine to children > 10 years

• Influenza vaccine clinic map “app” – Enter address to find a nearby clinic – Code shared with Boston and Philadelphia to create their version of the app

• Vaccine distribution – Vaccines for Children Providers: > 235,000 – Federally Qualified Health Centers: > 27,010

• Walk-in vaccination clinics (Sept-Dec 2012) – Vaccinated > 11,400

• Fasttrack Immunization Clinics/CareVan – Vaccinated >20-60/site/day

Aldermanic Office Influenza Vaccine Clinics

• CDPH coordinated sites: 47

– October 1 – December 8, 2012

– Number vaccinated: 5,294

• Vaccine purchase supported through Corporate Budget

– $442,000 annually

Increasing Public Awareness

• “Vote Healthy” Campaign – October and November

• Vaccinate Chicago Week (December 2 – 8, 2012) – Traditional media (Sun Times, Tribune, radio) and social

media (Facebook, Twitter)

– Partnered with Illinois AAP, Blue Cross Blue Shield of IL, and

Chicago Area Immunization campaign to communicate to providers and organize community outreach initiatives

– CDPH, Walgreens and U of C administered > 17,000 flu vaccines

Increasing Public Awareness

What Can You Do?

• Set an example – Get Vaccinated!

• Stay informed – www.cityofchicago.org/health; click on ‘influenza’ – Email brian.richardson@cityofchicago.org to receive

regular updates on CDPH community events and public information

• Share influenza disease and prevention information with your constituents

• Host influenza vaccine clinics

facebook.com/ChicagoPublicHealth

@ChiPublicHealth

Gplus.to/ChiPublicHealth

CityofChicago.org/Health

HealthyChicago@CityofChicago.org

312.747.9884