Influenza Watch - County of San Diego

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Week #17, ending 4/26/14

INFLUENZA WATCH

November 20, 2019 Volume 19, Issue 7

Week 46 Ending 11/16/19

Overview

Influenza activity is increasing in San Diego and is widespread in California. Influenza A(H1N1), A(H3N2) and B/Victoria are all

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being detected locally. It is too early to know which influenza viruses will dominate in the county into the winter or how severe the season might be. Regardless of which viruses may be circulating, the best protection against influenza is an influenza

Page 1: Current Season Page 2: Communiqu?

Influenza Cases by Type Page 3: Activity Level Indicator Page 4: Influenza Epi Curve

vaccination.

Page 5: Influenza Cases by Age

SDIR Immunizations

Current Week 46 (ending 11/16/2019) ? 139 new influenza detections reported

Page 6: Syndromic Indicators Page 7: ED ILI% and P&I Deaths Page 8: Deaths

? No new influenza-related deaths reported this week

Page 9: Reporting Information

? 3% influenza-like illness (ILI) among emergency department visits

? 5% of death certificates registered with pneumonia and/or influenza

Key Points

614

Total Cases

Virus Characteristics

2019-20 FYTD Season Summary

3

Deaths

4

Outbreaks*

Flu deaths less than 18 years of age are reportable to CDPH. * In a congregate living setting, outbreaks are defined as at least one laboratory-confirmed influenza in the setting of a cluster (2 cases) of

influenza-like illness (ILI) within a 72-hour period.

Table 1. Influenza Surveillance Indicators.

Indicator

2019-20 Season

Week Week Total To

46

45

Date

2018-19 Season

Week Total To Season

46

Date Total

Prior 3-Year Average*

Week Total To Season

46

Date Total

All influenza detections reported (rapid or PCR test)

139

74

614

57

247 9,655 71

330 12,110

Percent of emergency department visits for ILI

3%

3%

3%

2%

Percent of deaths registered with pneumonia and/or influenza 5%

3%

3%

5%

Number of influenza-related outbreaks

2

1

4

0

0

25

0

1

59

Number of influenza-related deaths reported^

0

0

3

1

2

77

1

Influenza season is July 1 - June 30, Weeks 27-26. Previous weeks case counts or percentages may change due to delayed processing or reporting.

2

169

* Includes FYs 2016-17, 2017-18, and 2018-19. At least one case of laboratory-confirmed influenza in a setting experiencing two or more cases of influenza like illness (ILI) within a 72-hour period. Total confirmed influenza outbreaks in prior seasons: 25 in 2018-19, 119 in 2017-18, and 34 in 2016-17. ^ Current FY deaths are shown by week of report; by week of death for prior FYs. Total deaths reported in prior seasons: 77 in 2018-19, 343 in 2017-18, and 87 in 2016-17.

PUBLIC HEALTH SERVICES

Epidemiology and Immunization Services Branch

(619) 692-8499 EpiDiv.HHSA@sdcounty.

Page 1 of 9

County of San Diego

INFLUENZA WATCH

Week 46 Ending 11/16/19

Cigarette Smoking and Influenza

The association of current smoking with influenza infection is not widely recognized. A recently published systematic review in the Journal of Infection summarized the risk of influenza infection in tobacco smokers compared to non-smokers based on the medical literature.

Researchers from the United Kingdom systematically searched available medical databases to identify relevant randomized control trials, cohort and case-control studies on smoking and influenza and assessed study quality using the Newcastle?Ottawa Scale. Nine studies were included in their analysis, including six defining influenza as a clinical syndrome and three using confirmatory laboratory tests.

Current smokers were over five times more likely to develop laboratory-confirmed influenza than non-smokers (pooled odds ratio [OR] 5.69, 95% confidence interval [CI] 2.79?11.60). For studies reporting the occurrence of an influenza-like illness (ILI), current smokers were 34% more likely to develop ILI than non-smokers (pooled OR 1.34, 95% CI 1.13?1.59). The mean quality score across the nine studies (n = 40,685 participants) was 5.4 of 9 (SD 1.07).

The researchers concluded that current smokers have an increased risk of developing influenza compared to nonsmokers. The association was strongest in studies examining cases with laboratory confirmed influenza. The study is available here: Cigarette smoking and the occurrence of influenza ? Systematic review.

Table 2. Influenza Cases Reported, 2019-20 Season*

Total To

Positive Test Type/Subtype

Week 46 Week 45 Date

Influenza A, subtype unknown

47

33

297

Influenza A (H1N1)pdm09 Influenza A (H3)

6

0

19

4

2

38

Influenza B, subytpe unknown

80

37

243

Influenza B/Victoria

1

1

8

Influenza B/Yamagata

0

0

0

Influenza, type unknown

1

1

9

Total

139

74

614

* Season is July 1 - June 30, Weeks 27-26.

Percent To Date 48.4% 3.1% 6.2% 39.6% 1.3% 0.0% 1.5%

100.0%

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Epidemiology and Immunization Services Branch

(619) 692-8499 EpiDiv.HHSA@sdcounty.

Page 2 of 9

County of San Diego

INFLUENZA WATCH

Week 46 Ending 11/16/19

Influenza Activity Indicator: The activity level compares the current week's ED ILI% (emergency department influenza-like illness, percent of all visits) to the mean and number of standard deviations above of the mean of the ED ILI% in non-influenza season weeks (CDC disease weeks 27-39) from the current and prior four seasons.

There are 10 activity levels, classified as: Minimal (levels 1-3), Low (levels 4-5), Moderate (levels 6-7), and High (levels 8-10). An activity level of 1 corresponds to when the ED ILI% is below the mean; level 2 corresponds to when the ED ILI% is less than 1 standard deviation above the mean; level 3 corresponds to when the ED ILI% is more than 1 but less than 2 standard deviations above the mean, and so on, with an activity level of 10 corresponding to when the ED ILI% is at 8 or more standard deviations above the mean.

Page 1PUoBLfIC3HEALTH SERVICES

Epidemiology and Immunization Services Branch

(619) 692-8499 EpiDiv.HHSA@sdcounty.

Page 3 of 9

County of San Diego

INFLUENZA WATCH

Week 46 Ending 11/16/19

PUBLIC HEALTH SERVICES

Epidemiology and Immunization Services Branch

(619) 692-8499 EpiDiv.HHSA@sdcounty.

Page 4 of 9

County of San Diego

INFLUENZA WATCH

Week 46 Ending 11/16/19

* Influenza vaccinations administered and entered into the San Diego Immunization Registry (SDIR)

PUBLIC HEALTH SERVICES

Epidemiology and Immunization Services Branch

(619) 692-8499 EpiDiv.HHSA@sdcounty.

Page 5 of 9

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