Flu News: April 12, 2019

The Centers for Disease Control and Prevention (CDC) has reported 4 additional influenza-associated pediatric deaths during the 2018-2019 flu season. 

This new data increases the total number of pediatric deaths to 86, as of April 7, 2019. 

Additionally, the CDC reported influenza activity across the USA has decreased but remains active in 20 states.

The CDC’s Week #14 key influenza indicators for the week ending April 6, 2019: 

• Viral Surveillance: The percentage of respiratory specimens testing positive for influenza viruses in clinical laboratories decreased. Nationally, during the most recent three weeks, influenza A(H3) viruses were reported more frequently than influenza A(H1N1)pdm09 viruses and in all 10 HHS Regions.
• Virus Characterization: The majority of influenza viruses characterized antigenically are similar to the cell-grown reference viruses representing the 2018–2019 Northern Hemisphere influenza vaccine viruses. However, an increasing proportion of influenza A(H3N2) viruses are antigenically distinguishable from  A/Singapore/INFIMH-16-0019/2016 (3C.2a1), a cell-propagated reference virus representing the A(H3N2) component of 2018-19 Northern Hemisphere influenza vaccines.
• Antiviral Resistance: The vast majority of influenza viruses tested (>99%) show susceptibility to oseltamivir and peramivir. All influenza viruses tested showed susceptibility to zanamivir.
• Influenza-like Illness Surveillance: The proportion of outpatient visits for influenza-like illness (ILI) decreased to 2.8%, and remains above the national baseline of 2.2%. Nine of 10 regions reported ILI at or above their region-specific baseline level.
• ILI State Activity Indicator Map: Four states experienced high ILI activity; eight states experienced moderate ILI activity; New York City and 21 states experienced low ILI activity; the District of Columbia, Puerto Rico and 17 states experienced minimal ILI activity; and the U.S. Virgin Islands had insufficient data.
• Geographic Spread of Influenza: The geographic spread of influenza in 20 states was reported as widespread; Puerto Rico and 25 states reported regional activity; the District of Columbia and five states reported local activity; the U.S. Virgin Islands reported sporadic activity; Guam did not report.
• Influenza-associated Hospitalizations: A cumulative rate of 59.9 laboratory-confirmed influenza-associated hospitalizations per 100,000 population was reported. The highest hospitalization rate is among adults 65 years and older (195.9 hospitalizations per 100,000 population).
• Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia and influenza (P&I) was below the system-specific epidemic threshold in the National Center for Health Statistics (NCHS) Mortality Surveillance System. 

As of April 12, 2019, the CDC is now estimating the current flu season’s impact as follows:

• 34,900,000 – 40,100,000 symptomatic illnesses
• 16,100,000 – 18,800,000 medical visits
• 482,000 – 585,000 hospitalizations
• 32,900 - 54,800 influenza-related deaths

Note:  All CDC data are preliminary and may change as more reports are received. The CDC uses a model to estimate the numbers of influenza illnesses, medical visits, and hospitalizations in the United States.

Separately, the World Health Organization (WHO) reported on March 29, 2019, that seasonal influenza A viruses accounted for the majority of detections. 

So far during the 2018-2019 flu season, influenza A viruses were predominant in most countries and accounted for 95% of all influenza viruses detected, according to the WHO.   

In some countries in Europe, A(H3N2) was predominant, such as in Belgium, France, Lithuania, Luxembourg, Turkey, and Ukraine.

Influenza A(H1N1)pdm09 predominated in North America, Europe, Central America, Asia, and Oceania, while influenza A(H3N2) virus was more prominent in Africa and some countries in Asia. 

In the USA, antiviral medications and various flu vaccines remain available in most pharmacies. And, flu vaccine discounts can be found at GoodRx.  

Relevant Links:  CDC Vaccination Schedules, CDC Price List, Report Vaccine Side Effects, International Travel Alerts