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%
Page 1PUoBLfIC3HEALTH SERVICES
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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