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Friday

CDC: 90% of Pediatric Deaths Not Vaccinated Against Flu

Pediatric vaccination rate low, but same as other years

The Centers for Disease Control and Prevention believe that 90% of pediatric deaths from influenza this season were not vaccinated. There have been 105 pediatric deaths attributed to influenza-like-illness (ILI) to date this flu season. The CDC defines pediatric cases as those less than 18 years of age.


The report also indicates that 60% of these cases were in pediatrics who are considered “high risk” while the remainder had no known chronic health or medical problems. Conditions such as asthma/respiratory pathology, heart conditions, or neurological problems along with anyone who has a weak or compromised immune system put children at high risk for complications or severe cases of influenza.

The CDC also points out that these numbers are consistent with experience from previous flu seasons. See the latest 2012/2013 Flu Update for additional flu data.

According to the CDC:
"CDC began tracking flu-associated pediatric deaths after the 2003-2004 flu season – a season that, like the current flu season, started early and was intense. In addition, it took a high toll on children. In the 2003-2004 season, 153 pediatric deaths were reported to CDC from 40 states. Flu-associated pediatric deaths became nationally reportable the following season. Since that time, reported pediatric deaths during regular influenza seasons have ranged from 34 deaths (during 2011-2012) to 122 deaths (during 2010-2011). However, during the 2009 H1N1 influenza pandemic, which lasted from April 15, 2009 to October 2, 2010, 348 pediatric deaths were reported to CDC."

Despite recommending vaccination of children aged 6 months to 18 years, and subsequently adults, pediatric vaccination rates have remained low. The CDC claims this years vaccine was estimated 60% effective against flu with slightly lower effectiveness in those over 65 years old.

Vaccination continues to be the first-line of defense in preventing influenza followed by antiviral treatment for those at high risk.

Wednesday

POD Sites of the Future - Public Health Preparedness Summit

How we respond to biologic events continues to evolve. 

Points of Distribution, or POD's, are critical parts of public health emergency management during a biologic event. In this conference segment from Mitigation Journal, we hear from Wesley McDermott, Public Health Adviser and Garrett Simonsen, Regional Public Health Preparedness Planner, while covering the Public Health Preparedness Summit 2013 in Atlanta, Georgia, on the topic of POD sites of the future.

The Summit is sponsored by the National Association of City and County Health Officials. Special thanks to Jamie Davis, RN, EMTP, (MedicCast Productions and Promed Network) for his expertise in the creation of this video segment. 


Tuesday

MJ Podcast #246: Smallpox, SARS, Flu


Mitigation Journal Podcast #246
This week:
Flu Update - Influenza B causing majority of problems
CDC Report: 90% of Peds deaths from flu were not vaccinated
SARS 10 Years Later - Where has our little SARS Gone? Will it be back?
Smallpox Vaccine Buy Out: US stockpiles for 2 million people, $410 million

Hosted by Rick Russotti, RN, Paramedic
Please visit Mitigation Journal at www.mitigationjournal.org

Check out this episode!

Monday

2012/2013 Flu Update #12

Update #12 for the week of March 16, 2013
Flu generally declining but, Influenza B cases rise

This weeks Mitigation Journal Flu Update includes publicly available data from the CDC FluView, Google Flu Trends and other media sources.

This report contains data from the Centers for Disease Control and Prevention 2012/2013 Influenza season week 11 for the period ending March 16, 2013. In this reporting period (March 10-16, 2013) significant areas of ILI activity continues to steadily decline for most areas of the United States.


Accounting for 72% of all influenza cases reported during this period, influenza B virus is now the most prevalent strain according to the CDC.

The number of hospitalizations remained elevated at 40.6  per 100,000 (up from 38.5 last week) population during this reporting period. Those greater than 65 years of age account for 51% of those hospitalized. Influenza and pneumonia related deaths are reported to be above the epidemic threshold.

 Michigan is the only state to report high ILI activity (down from nine states in previous report) with five other states reporting moderate activity. Six states and NYC report low ILI activity while thirty-eight states now report minimal activity. 

Viral surveillance results for week 11, 2013 showed 16.3% of 5,526 samples testing positive for influenza as compared to last week when 17.2% of 6,259  samples were positive. Influenza A accounted for 28.1% of results with 2009 H1N1 4.7%, H3 34.4%, and Influenza B 71.9% (646 samples).

Outpatient ILI surveillance (those seen at clinics and doctors offices for ILI complaints) has returned to the national base line of 2.2% for the first time since November, 2012. The CDC cautions that this number may once again rise above the baseline as additional cases (due to late reporting) are added.

Antiviral resistance is a non-issue at this point. None of the circulating strains (H1N1, H3N2 or Influenza B) are resistant to Oseltamivir or Zanamivir.

Friday

Jack Herrmann at Public Health Preparedness Summit 2013

Jack Herrmann at Public Health Preparedness Summit 2013
with Jamie Davis of the MedicCast

 From MedicCast.TV

MedicCast host Jamie Davis, the Podmedic is joined by Jack Herrmann, Senior Advisor and Chief of Public Health Preparedness at NACCHO. Jack is the chairman of the Public Health Preparedness Summit and shares his views on this incredibly successful conference. Find more videos from this conference at MedicCast.tv.


Wednesday

Education and Technology at Public Health Preparedness Summit 2013

Education and Technology at Public Health Preparedness Summit 2013
with Jamie Davis of the MedicCast

Technology needs proper education and training to make it work and attendees got both at Public Health Preparedness Summit 2013.

A special thank-you to Jamie Davis of The MedicCast for his efforts in the production of these video segment.

Sunday

International Attendees and High-Tech at Summit at Public Health Preparedness Summit 2013

International Attendees and High-Tech at Summit at Public Health Preparedness Summit 2013
with Jamie Davis of the MedicCast

The Public Health Preparedness Summit 2013 was host to an large domestic and international audience along with a wide variety of high-tech products and services geared to enhance public health efforts during a crisis.

Summit 2013 in Atlanta, Georgia, gathered over 1600 dedicated public health experts under one roof for education and sharing of information. Every state in the United States was represented this year. We were also joined by public health colleagues from Canada, China, Cuba, Guam, Kenya, the American Samoa, the US Virgin Islands, and Vietnam.



Saturday

Opening the Doors at Public Health Preparedness Summit 2013

Opening comments on Public Health Preparedness Summit 2013
with Jamie Davis of the MedicCast

After getting  the podcast studio set up we were able to recon the exhibit hall floor and take note of the  offerings at the Public Health Preparedness Summit. Many of the governmental services including several branches of the Centers for Disease Control and Prevention.

In addition to highlights from the Summit, Mitigation Journal along with The MedicCast, conducted a variety of interviews with Summit presenters on a variety of topics. Those interviews will be posted in the near future.



Friday

JAMA Busts Flu Vaccine Myths

Worthy of Myth Busters, JAMA debunks common influenza vaccine myths

The 2012/2013 influenza season may be winding down, but the excuses for not being vaccinated against seasonal flu continue. Vaccination rates seem to be low despite an early and ferocious flu season and healthcare workers seem to be on the lower end of the vaccine numbers. In response to the reluctance of many to get the flu shot, JAMA recently published a paper outlining (and debunking) common arguments against flu vaccination.




MYTH: The Vaccine does not work.
JAMA Response: Busted! Notes the flue vaccine is not as effective as common vaccines, but "not as effective" does not mean "not effective". They go on to state that this years influenza vaccine was estimated at 62% effective by mid-season. According to the article:
"A prevention measure that reduced the risk of a serious outcome by 60% in most in- stances would be a noted achievement; yet for influenza vaccine, it is seen as a “failure.” JAMA.
Myth: The vaccine causes the flu.
JAMA Response: Busted!
"...people may develop an influenza-like illness or even laboratory-confirmed influenza after vaccination. This does not mean the illness was vaccine induced but rather was likely due to a noninfluenza viral infection" and "exposure to influenza before immunity from the vaccine had time to develop, or the fact that the vaccine is not 100% effective."
Myth: I have an allergy to eggs.
JAMA Response: Busted! The article states that those with severe allergic reactions or anyphylaxis after exposure to eggs should avoid flu vaccine. Those with such a reaction should consult an allergist for detailed assessment. They further state:
"...recent evidence-based guidance advises that all other egg-allergic patients should receive influenza vaccination based on the rationale that the risks of not vaccinating outweigh the risks of vaccinating these individuals as long as basic precautions are followed."
Myth: I cannot get the vaccine because I am pregnant or have an underlying medical condition or because I live with an immunocompromised person.
JAMA Response: Busted! This may be the most important flu vaccine myth to bust as it directly impacts those who need the vaccine (or protection from flu) the most. Those with comorbid conditions or underlying medical problems are at most risk of complications from seasonal influenza. According to JAMA -
"...these groups have been specifically recommended for influenza vaccination because the vaccine is safe in these persons and can prevent serious morbidity and mortality." and "it is important for clinicians to recognize the individual’s desire to prevent harm in close contacts but to redirect this good intention by emphasizing the morbidity due to transmitted influenza."
Myth: I never get the flu/I am healthy.
JAMA Response: Busted! This excuse sounds a lot like Optimism Bias from the It Wont Happen to Me crowd. According to the JAMA article:
"Refusing vaccination because of a perceived low risk ignores the potential risk to close contacts, especially those who cannot get vaccinated or who will not mount a strong immune response to the vaccine and rely on herd immunity for protection."

References:
Influenza Prevention Update, JAMA. 2013;309(9):881-882. doi:10.1001/jama.2013.453. Examining Common Arguments Against Influenza Vaccination

Related:
NYS Nurses Association Opposes Mandates for Vaccine 
No Vaccine? No Mask? No Job. 
Influenza Vaccine Overrated? 
Best Disease Prevention is Action

Wednesday

2012/2013 Flu Update #11

Update #11 for the week of March 11, 2013

This weeks Mitigation Journal Flu Update includes publicly available data from the CDC FluView, Google Flu Trends and other media sources.

This report contains data from the Centers for Disease Control and Prevention 2012/2013 Influenza season week 9 for the period ending March 2, 2013. In this reporting period (February 24-March 2, 2013)  CDC flu data report ILI activity is relatively unchanged from the prior reporting period  (February 17-23, 2013) for most areas of the United States.


The number of hospitalizations remained elevated at 38.5 (up from 36.7 last week) per 100,000 population during this reporting period. Those greater than 65 years of age continue to account for greater than 50% of those hospitalized. Influenza and pneumonia related deaths are reported to be above the epidemic threshold. A total of 10,721 confirmed cases of influenza requiring hospitalization have been documented better October 1, 2012 and March 2, 1013.

 Nine states reported widespread ILI activity during this reporting period, down from twenty-two states from twenty-six states in week 8.

Viral surveillance results for week 9, 2013 showed 17.2% of 6,259  samples testing positive for influenza as compared to last week when  16.9% of 7,609 samples were positive.

Outpatient ILI surveillance (those seen at clinics and doctors offices for ILI complaints) was down to 2.3% for week 9 as compared to 2.7% for week 8, edging closer to the national base line of 2.2%.

Antiviral resistance is a non-issue at this point. None of the circulating strains (H1N1, H3N2 or Influenza B) are resistant to Oseltamivir or Zanamivir.

State-by-State week 9 reporting (from CDC website)
  • Widespread influenza activity was reported by 9 states (Connecticut, Massachusetts, Nevada, New Jersey, New York, Ohio, Oregon, Pennsylvania, and Virginia).
  • Puerto Rico and 24 states reported regional influenza activity (Alaska, Arizona, Arkansas, California, Colorado, Florida, Idaho, Iowa, Kansas, Kentucky, Illinois, Maine, Maryland, Michigan, Minnesota, Missouri, Montana, Nebraska, North Carolina, Oklahoma, Texas, Utah, Washington, and Wyoming).
  • The District of Columbia and thirteen states (Alabama, Georgia, Louisiana, Mississippi, New Hampshire, New Mexico, North Dakota, South Carolina, South Dakota, Tennessee, Vermont, West Virginia, and Wisconsin) reported local influenza activity.
  • Four states (Delaware, Hawaii, Indiana, and Rhode Island) reported sporadic influenza activity.
  • Guam reported no influenza activity.
  • The U.S. Virgin Islands did not report.



CDC Flu Interactive Map





Influenza-like Illness, ILI, activity indicator map application screenshot.
Click for Week 9 interactive map from CDC



Google Flu Trends

Tuesday

MJ#246 Live from the Public Health Preparedness Summit


Welcome to Mitigation Journal / We're podcasting live from the Public Health Preparedness Summit 2013 in Atlanta GA. / / Please visit www.mitgationjournal.org and follow me on Twitter @rickrussotti for the latest / / Today Mitigation Journal joined over 1600 summit attendees as we set up the Promed podcast studio and made final preparation for live social media coverage of the event.
Check out this episode!

Monday

MJ# 245: BioTerror Lessons for Today, CDC Defines Bio Agents, DAWN Report on Synthetic Drugs


Please visit www.mitigationjournal.org for compete show notes and features

Edition 245 Recorded on March 5, 2013

This week on Mitigation Journal:

Bio Terror: How do we measure up?

CDC Defines Bio Threats

DAWN Report on Synthetic Drugs

Mitigation Journal is:

Hosted by Rick Russotti, RN, Paramedic

Co Host Matt Comer, Paramedic

Please visit Mitigation Journal at www.mitigationjournal.org


Check out this episode!

Thursday

MJ#244: Are we prepared for Flu?, Act to prevent disease, and Great Flu Apps


Please visit www.mitigationjournal.org for compete show notes and features

Edition 244 Recorded on February 25, 2013

This week on Mitigation Journal:

Flu Emergency. How prepared are we?

Personal Action for Disease Prevention

Flu Informed with 3 Great Apps

Mitigation Journal is:

Hosted by Rick Russotti, RN, Paramedic

Co Host Matt Comer, Paramedic

Please visit Mitigation Journal at www.mitigationjournal.org


Check out this episode!

Wednesday

FDA: 2013-2014 Influenza Vaccine Composition

Quadrivalent Vaccines for Add Influenza B Protection Recommended

The strains of influenza virus to be included in next years seasonal flu vaccine have been determined. the 2013-2014 vaccine will provide options for both trivalent and quadrivalent  vaccines and include flu strains from the 2012-2013 vaccine plus addition strains. The typical flu vaccine contains three flu strains (trivalent) two Influenza A and one Influenza B. For the first time, a vaccine containing protection against four strains of influenza, a quadrivalent vaccine, will be an option.

The World Health Organization (WHO) has recommended vaccine viruses for the 2013-2014 Northern Hemisphere vaccines, and the Food and Drug Administration’s Vaccines and Related Biological Products Advisory Committee (VRBPAC) has made recommendations for the composition of the 2013-2014 influenza vaccines to be used in the United States. Both agencies recommend that trivalent vaccines contain an A/California/7/2009-like (2009 H1N1) virus, an A(H3N2) virus antigenically like the cell-propagated, or cell-grown, virus A/Victoria/361/2011 (A/Texas/50/2012), and a B/Massachusetts/2/2012-like (B/Yamagata lineage) virus. It is recommended that quadrivalent vaccines containing an additional influenza B virus contain a B/Brisbane/60/2008-like (B/Victoria lineage) virus in addition to the viruses recommended for the trivalent vaccines. These recommendations were based on global influenza virus surveillance data related to epidemiology and antigenic characteristics, serological responses to 2012-2013 seasonal vaccines, and the availability of candidate strains and reagents.
Additional Commons Sense Influenza

 The inclusion of an additional influenza B virus ("It is recommended that quadrivalent vaccines containing an additional influenza B virus...in addition to the viruses recommended for the trivalent vaccines") appears to be a result of the 2012-2013 flu season. As the CDC notes they have characterized 1,340  influenza viruses since October, 2012. Of those influenza viruses, 105 have been H1N1 2009, 827 N3N2 influenza A and 408 influenza B. Also, according to the CDC:
"Since the start of the season, influenza A (H3N2) viruses have predominated nationally, however in recent weeks, the proportion of influenza B viruses has been increasing. During week 8, 53% of all influenza positive specimens reported were influenza B viruses."
made the final recomendation at their meeting in February, 2013. According to the FDA website, the Vaccicnes and Related Biological Products Advisory Committee "reviews and evaluates data concerning the safety, effectiveness, and appropriate use of vaccines and related biological products..."


The FDA committee recommended next years influenza vaccine should retain the current influenza A H1N1 strain and replace the influenza A H3N2 component with an A H3N2 virus. They also recommend replacement of the current influenza B strain, the B/Victoria lineage strain. 

Tuesday

MJ Podcast #243: Active shooters, PODs and Jobs


Please visit www.mitigationjournal.org for compete show notes and features
Edition 243 Recorded on February 4, 2013
This week on Mitigation Journal:
DHS Active Shooter Page
Will your POD work when you need it?
No Mask? No Vaccine? No Job!
Mitigation Journal is:
Hosted by Rick Russotti, RN, Paramedic
Co Host Matt Comer, Paramedic
Please visit Mitigation Journal at www.mitigationjournal.org

Check out this episode!

Monday

2012/2013 Flu Update #10

Update #10 for the week of March 4, 2013

CDC Flu Surveillance Map Week 8
This weeks Mitigation Journal Flu Update includes publicly available data from the CDC FluView, Google Flu Trends and other media sources.

This report contains data from the Centers for Disease Control and Prevention 2012/2013 Influenza season week 8 for the period ending February 23, 2013. In this reporting period (February 17-23, 2013)  CDC flu data report ILI activity elevated but decreasing in most areas of the United States.


The number of hospitalizations remained elevated at 36.7 (up from 34.2 last week) per 100,000 population during this reporting period. Those greater than 65 years of age continue to account for greater than 50% of those hospitalized. Influenza and pneumonia related deaths are reported to be above the epidemic threshold.

Twenty-two states reported widespread ILI activity during this reporting period, down from twenty-four states reported high level of ILI activity in week four and from twenty-six states in  week3.

Viral surveillance results for week 8, 2013 showed 16.9% of 7,609 samples testing positive for influenza. This is basically unchanged from last week when 16.8% of 8,144 samples were positive.

Outpatient ILI surveillance (those seen at clinics and doctors offices for ILI complaints) was 2.7% for week 8, nearly unchanged from the 2.8% reported during week 7,  but  remaining above the national base line of 2.2%.

Antiviral resistance is a non-issue at this point. None of the circulating strains (H1N1, H3N2 or Influenza B) are resistant to Oseltamivir or Zanamivir.

State-by-State week 8 reporting (from CDC website)
  • Widespread influenza activity was reported by 12 states (Connecticut, Indiana, Massachusetts, Michigan, Nevada, New Jersey, New York, Ohio, Oklahoma, Oregon, Pennsylvania, and Virginia).
  • Puerto Rico and 28 states reported regional influenza activity (Alaska, Arizona, Arkansas, California, Colorado, Florida, Idaho, Iowa, Kansas, Kentucky, Illinois, Maine, Maryland, Minnesota, Missouri, Montana, Nebraska, New Mexico, North Carolina, North Dakota, Tennessee, Texas, Utah, Vermont, Washington, West Virginia, Wisconsin, and Wyoming).
  • The District of Columbia and 7 states (Georgia, Louisiana, Mississippi, New Hampshire, Rhode Island, South Carolina, and South Dakota) reported local influenza activity.
  • Three states (Alabama, Delaware, and Hawaii) reported sporadic influenza activity.
  • Guam reported no influenza activity.
  • The U.S. Virgin Islands did not report.


CDC Flu Interactive Map


Google Flu Trends