H1N1 Influenza Update Presentation

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A powerpoint presentation for the City of Somerville\'s Medical Reserve Corp on H1N1.

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H1N1 Influenza Update Presentation

  1. 1. H1N1 INFLUENZA UPDATE
  2. 2. <ul><li>Seasonal flu update </li></ul><ul><ul><li>At risk groups </li></ul></ul><ul><ul><li>In the U.S. </li></ul></ul><ul><ul><ul><li>Reported cases </li></ul></ul></ul><ul><ul><li>Vaccine expectations </li></ul></ul><ul><ul><li>What happened </li></ul></ul><ul><li>H1N1 update </li></ul><ul><ul><li>Background </li></ul></ul><ul><ul><li>Expectations </li></ul></ul><ul><ul><ul><li>Operation PanVax </li></ul></ul></ul><ul><ul><li>What happened </li></ul></ul><ul><ul><ul><li>Reported cases and vaccine distribution </li></ul></ul></ul><ul><ul><li>New findings (NIH study) </li></ul></ul>OUTLINE
  3. 3. AT RISK GROUPS FOR HEALTH COMPLICATIONS <ul><li>Pregnant women </li></ul><ul><li>Children less than 5 years of age </li></ul><ul><li>Adults 65 years of age or older </li></ul><ul><li>People living in nursing homes and long-term care facilities </li></ul><ul><li>People with underlying health conditions: </li></ul><ul><ul><li>Asthma − Heart disease </li></ul></ul><ul><ul><li>Diabetes − Kidney disease </li></ul></ul><ul><ul><li>Weak immune − Children and systems adolescents receiving long- term aspirin therapy </li></ul></ul>
  4. 4. SEASONAL FLU <ul><li>In the U.S. </li></ul><ul><ul><li>5-20% of population is infected </li></ul></ul><ul><ul><li>200,000 or more hospitalizations in U.S. </li></ul></ul><ul><ul><ul><li>Estimate >2,600 in MA </li></ul></ul></ul><ul><ul><li>36,000 deaths in U.S </li></ul></ul><ul><ul><ul><li>Estimate >800 in MA </li></ul></ul></ul>
  5. 5. REPORTED CASES Figure 1: Percentage of Influenza-like illness visits reported by sentinel provider sites
  6. 6. REPORTED CASES Table 1: Percent Influenza-like illnesses reported weekly by Massachusetts sentinel sites 2009-2010 2008-2009 %ILI Report. Sites Total enroll. %ILI Report. Sites Total enroll. Boston 1.44 4 7 1.23 4 5 Central 2.43 6 12 2.36 6 8 Inner Metro Boston 1.91 4 9 0.35 2 2 Northeast 2.35 6 12 0.78 8 9 Outer Metro Boston 5.21 2 4 0.96 2 2 Southeast 0.75 3 6 0.88 6 6 West 3.16 6 9 1.03 8 10
  7. 7. REPORTED CASES Figure 2: Laboratory-confirmed Influenza Cases and Influenza-like Illness Massachusetts, October 4, 2009 - December 10, 2009
  8. 8. PREDICTED 2009-2010 SEASONAL FLU VACCINES <ul><li>National supply predicted to be early and adequate </li></ul><ul><li>885,000 doses state-supplied </li></ul><ul><li>Multiple shipments in August through October </li></ul><ul><li>Vaccinations begin in Aug., as soon as vaccines are available </li></ul>
  9. 9. SEASONAL FLU CLINICS AND VACCINES <ul><li>Insert quick synopsis of how flu clinics have gone and number of vaccines that were administered </li></ul>
  10. 10. H1N1 FLU <ul><li>Caused by a new virus </li></ul><ul><li>Disease of body’s breathing system much like “seasonal flu” </li></ul><ul><li>Symptoms and spread of virus very similar to “seasonal flu” </li></ul><ul><li>Younger age groups are most affected </li></ul><ul><li>Adults over 60 years of age may have some protection from the H1N1 virus </li></ul><ul><li>Most infected people have mild illness and get better without medicine </li></ul><ul><ul><li>Severe illness and death have occurred in a small number of cases </li></ul></ul>
  11. 11. H1N1 CASES Figure 3: H1N1 Cases in U.S. 4/25/09-7/10/09
  12. 12. H1N1 CASES Figure 4: H1N1 Cases in U.S. by Age Group, between 4/25/09- 7/24/09
  13. 13. 2009 INFLUENZA PANDEMIC <ul><li>What is a pandemic </li></ul><ul><ul><li>The spread of a disease worldwide, or over a very large area </li></ul></ul><ul><ul><ul><li>Caused by a new strain of flu virus </li></ul></ul></ul><ul><ul><ul><li>With a new virus, almost no one is protected </li></ul></ul></ul><ul><li>Over 1,000,000 infected in the U.S. (thru 7/09) </li></ul><ul><ul><li>5,000 hospitalized </li></ul></ul><ul><ul><li>Over 300 deaths </li></ul></ul>
  14. 14. 2009 H1N1 PANDEMIC
  15. 15. REPORTED CASES Figure 5: Influenza positive test reported to CDC by HSLI, August-November 2009
  16. 16. REPORTED CASES Table 2: Confirmed H1N1 Cases in MA, 4/26/09-12/10/2009 Age group (N) Age group (%) Female (%) Pregnant (N) Hospitalized (N) Hospitalized (%) Deaths (N) 0-4 years 291 15.4 39.86 0 87 29.90 2 5-12 years 496 26.3 39.92 0 84 16.94 0 13-18 years 367 19.4 49.86 6 45 12.26 1 19-25 years 221 11.7 62.44 21 26 11.76 2 26-44 years 273 14.5 65.93 33 43 15.75 4 45-64 years 200 10.6 57.00 0 66 33.00 10 65+ years 37 1.96 67.57 0 22 59.46 6 Unknown 2 0.11 50.00 0 0 0 0 TOTAL 1887 ~~ 50.61 60 373 19.77 25
  17. 17. H1N1 VACCINE <ul><li>H1N1 vaccine in U.S. is made by 5 manufacturers licensed by the FDA </li></ul><ul><ul><li>Central distribution thru McKesson </li></ul></ul><ul><li>H1N1 vaccine is made and tested the same way as the seasonal flu vaccine </li></ul><ul><li>Most people need 2 doses </li></ul><ul><ul><li>Can be given at same time as seasonal flu vaccine </li></ul></ul><ul><li>It is safe for most people </li></ul><ul><li>Safety of the vaccine is being carefully watched </li></ul><ul><ul><li>Vaccinators are not responsible for a recall </li></ul></ul>
  18. 18. H1N1 VACCINATORS LIABILITY PROTECTION <ul><li>M.G.L. c. 112, § 12C provides complete immunity from liability for physicians and nurses who work in government-funded public health programs </li></ul><ul><li>PREP Act (Public Readiness and Emergency Preparedness Act) provides immunity from tort liability under state and federal law </li></ul>
  19. 19. PREDICTED H1N1 FLU VACCINES <ul><ul><li>Table 3: H1N1 Vaccine Shipments in Massachusetts </li></ul></ul>Time Amount Late September 420,000 doses October 2,000,000 doses November and after 1,700,000 doses/month while demand lasts
  20. 20. PREDICTED H1N1 FLU VACCINES <ul><li>≥ 5 Formulations of H1N1 vaccine </li></ul><ul><ul><li>Approved for different age and risk groups </li></ul></ul><ul><ul><li>Live nasal spray and inactivated injectable </li></ul></ul><ul><li>Provided with vaccine </li></ul><ul><ul><li>Needles, syringes </li></ul></ul><ul><ul><li>Alcohol swaps </li></ul></ul><ul><ul><li>Sharp containers </li></ul></ul><ul><ul><li>Vaccine record cards </li></ul></ul>
  21. 21. INITIAL H1N1 VACCINE PRIORITY GROUPS <ul><li>All pregnant women </li></ul><ul><li>Everyone 6 months through 24 years of age </li></ul><ul><li>People who live with or care for children younger than 6 months of age </li></ul><ul><li>Healthcare and emergency services personnel </li></ul><ul><li>People aged 25 through 64 years of age who are at high risk of complications from flu </li></ul>3.4 Million in MA
  22. 22. PRIORITY GROUPS WHEN DEMAND EXCEEDS SUPPLY <ul><li>Pregnant women </li></ul><ul><li>Everyone 6 months through 24 years of age </li></ul><ul><li>People who live with or care for children younger than 6 months of age </li></ul><ul><li>Healthcare and emergency services personnel with direct contact with pts or infectious material </li></ul><ul><li>People aged 5-18 years of age who are at high risk of complications </li></ul>870,000 in MA
  23. 23. WHEN H1N1 VACCINE SUPPLIES INCREASE* <ul><li>When vaccine supplies are sufficient to vaccinate initial priority groups, vaccinations will be expanded to: </li></ul><ul><ul><li>Healthy adults 25 through 64 years of age </li></ul></ul>2 Million in MA *In consultation with stat and local health departments
  24. 24. OPERATION PANVAX <ul><li>Goals </li></ul><ul><ul><li>Ensure that all MA residents have equal access to H1N1 vaccine within the target groups </li></ul></ul><ul><ul><li>Administer vaccine to as many people as possible, as quickly as possible, for maximum protection against H1N1 </li></ul></ul><ul><li>State responsible for vaccine allocation and distribution </li></ul><ul><li>Local public and private sector responsible for vaccine administration </li></ul>
  25. 25. OPERATION PANVAX <ul><li>Partners and vaccinators needed: </li></ul><ul><ul><li>Providers (primary care and specialists) </li></ul></ul><ul><ul><li>Local and regional public health </li></ul></ul><ul><ul><li>Schools </li></ul></ul><ul><ul><li>Hospitals </li></ul></ul><ul><ul><li>Commercial and nonprofit community vaccinators </li></ul></ul><ul><ul><li>Home health </li></ul></ul><ul><ul><li>Pharmacists </li></ul></ul><ul><ul><li>Occupational health </li></ul></ul>
  26. 26. H1N1 VACCINE DISTRIBUTION <ul><li>Public H1N1 clinics </li></ul><ul><ul><li>Ideally one entity in each community </li></ul></ul><ul><li>Coordinate vaccine receipt, storage and distribution for: </li></ul><ul><ul><li>Public health clinics </li></ul></ul><ul><ul><li>Emergency Dispensing Sites (EDS) </li></ul></ul><ul><ul><li>School clinics </li></ul></ul><ul><li>Coordinate weekly usage reporting </li></ul>
  27. 27. H1N1 VACCINE USAGE REPORTING <ul><li>Weekly web-based reporting to MDPH of: </li></ul><ul><ul><li># of doses administered to each age group </li></ul></ul><ul><ul><li># of 1 st and 2 nd doses </li></ul></ul><ul><li>MDPH reports aggregate to CDC </li></ul>
  28. 28. REPORTED H1N1 VACCINE USAGE *PFS = Prefilled syringes MDV = Multidose vial LAIV = Live, attenuated influenza vaccine (nasal spray) Table 4: H1N1 Vaccine Allocations in MA as of December 2, 2009 Date PFS 0.25 PFS 0.5 MDV PFS MDV PFS MDV MDV LAIV Total Age 6 – 35 mo. > 3 yr. ≥ 6 mo. ≥ 4 yr. ≥ 4 yr. > 3 yr. ≥ 6 mo. ≥ 18 yr. 2-49 yr. Totals 92,800 48,900 610,100 174,700 420,600 28,500 6,800 0 405,000 1,787,400
  29. 29. NATIONAL INSTITUTES OF HEALTH (NIH) H1N1 STUDY <ul><li>Autopsies show H1N1 Influenza virus damages entire airway </li></ul><ul><ul><li>Found virus can damage cells throughout the respiratory airway </li></ul></ul><ul><ul><ul><li>Primarily to the upper regions: trachea and bronchial tubes were inflamed </li></ul></ul></ul><ul><li>“ This pattern of pathology in the airway tissues is similar to that reported in autopsy findings of victims of both the 1918 and 1957 influenza pandemics.” Dr. Jeffery K. Taubenberger </li></ul><ul><li>91% of those autopsied had underlying medical conditions </li></ul><ul><ul><li>Including heart disease, respiratory disease, and asthma </li></ul></ul><ul><li>72% were obese </li></ul><ul><ul><li>Links obesity with increased risk of death from 2009 H1N1 flu </li></ul></ul><ul><li>55% were positive for pulmonary bacterial infections </li></ul><ul><ul><li>Indicates community-acquired bacterial pneumonia plays a crucial role </li></ul></ul>
  30. 30. RESOURCES <ul><li>Center for Disease Control and Prevention: http://www.cdc.gov/h1n1flu/ </li></ul><ul><li>Massachusetts Department of Public Health: Flu Facts: What You Need to Know . September 24, 2009 </li></ul><ul><li>Massachusetts Department of Public Health: Novel A (H1N1) Influenza Vaccination . August 10, 2009 </li></ul><ul><li>Massachusetts Department of Public Health: Situation Report-Massachusetts H1N1 Response. December 11, 2009. </li></ul><ul><li>NIH News: New York Autopsies Show 2009 H1N1 Influenza Virus Damages Entire Airway. December 7, 2009. www.niaid.nih.gov/news/newsreleases/2009/fluautopsy.htm/ </li></ul><ul><li>World Health Organization Map Production: Public Health Information. July 31, 2009 </li></ul>

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