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Chung JR, Kim SS, Kondor RJ, Smith C, Budd AP, Tartof SY, Florea A, Talbot HK, Grijalva CG, Wernli KJ, Phillips CH, Monto AS, Martin ET, Belongia EA, McLean HQ, Gaglani M, Reis M, Geffel KM, Nowalk MP, DaSilva J, Keong LM, Stark TJ, Barnes JR, Wentworth DE, Brammer L, Burns E, Fry AM, Patel MM, Flannery B. Interim Estimates of 2021-22 Seasonal Influenza Vaccine Effectiveness - United States, February 2022. MMWR Morb Mortal Wkly Rep 2022; 71:365-370. [PMID: 35271561 PMCID: PMC8911998 DOI: 10.15585/mmwr.mm7110a1] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
In the United States, annual vaccination against seasonal influenza is recommended for all persons aged ≥6 months except when contraindicated (1). Currently available influenza vaccines are designed to protect against four influenza viruses: A(H1N1)pdm09 (the 2009 pandemic virus), A(H3N2), B/Victoria lineage, and B/Yamagata lineage. Most influenza viruses detected this season have been A(H3N2) (2). With the exception of the 2020-21 season, when data were insufficient to generate an estimate, CDC has estimated the effectiveness of seasonal influenza vaccine at preventing laboratory-confirmed, mild/moderate (outpatient) medically attended acute respiratory infection (ARI) each season since 2004-05. This interim report uses data from 3,636 children and adults with ARI enrolled in the U.S. Influenza Vaccine Effectiveness Network during October 4, 2021-February 12, 2022. Overall, vaccine effectiveness (VE) against medically attended outpatient ARI associated with influenza A(H3N2) virus was 16% (95% CI = -16% to 39%), which is considered not statistically significant. This analysis indicates that influenza vaccination did not reduce the risk for outpatient medically attended illness with influenza A(H3N2) viruses that predominated so far this season. Enrollment was insufficient to generate reliable VE estimates by age group or by type of influenza vaccine product (1). CDC recommends influenza antiviral medications as an adjunct to vaccination; the potential public health benefit of antiviral medications is magnified in the context of reduced influenza VE. CDC routinely recommends that health care providers continue to administer influenza vaccine to persons aged ≥6 months as long as influenza viruses are circulating, even when VE against one virus is reduced, because vaccine can prevent serious outcomes (e.g., hospitalization, intensive care unit (ICU) admission, or death) that are associated with influenza A(H3N2) virus infection and might protect against other influenza viruses that could circulate later in the season.
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2
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Olsen SJ, Winn AK, Budd AP, Prill MM, Steel J, Midgley CM, Kniss K, Burns E, Rowe T, Foust A, Jasso G, Merced-Morales A, Davis CT, Jang Y, Jones J, Daly P, Gubareva L, Barnes J, Kondor R, Sessions W, Smith C, Wentworth DE, Garg S, Havers FP, Fry AM, Hall AJ, Brammer L, Silk BJ. Changes in influenza and other respiratory virus activity during the COVID-19 pandemic-United States, 2020-2021. Am J Transplant 2021; 21:3481-3486. [PMID: 34624182 PMCID: PMC8653380 DOI: 10.1111/ajt.16049] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Sonja J. Olsen
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA,Correspondence Sonja J. Olsen, Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, USA.
| | - Amber K. Winn
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA,Amber K. Winn, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, USA.
| | - Alicia P. Budd
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Mila M. Prill
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - John Steel
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Claire M. Midgley
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Krista Kniss
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Erin Burns
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Thomas Rowe
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Angela Foust
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Gabriela Jasso
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Angiezel Merced-Morales
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - C. Todd Davis
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Yunho Jang
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Joyce Jones
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Peter Daly
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Larisa Gubareva
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - John Barnes
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Rebecca Kondor
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Wendy Sessions
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Catherine Smith
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - David E. Wentworth
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Shikha Garg
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Fiona P. Havers
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Alicia M. Fry
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Aron J. Hall
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Lynnette Brammer
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Benjamin J. Silk
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
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3
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Olsen SJ, Winn AK, Budd AP, Prill MM, Steel J, Midgley CM, Kniss K, Burns E, Rowe T, Foust A, Jasso G, Merced-Morales A, Davis CT, Jang Y, Jones J, Daly P, Gubareva L, Barnes J, Kondor R, Sessions W, Smith C, Wentworth DE, Garg S, Havers FP, Fry AM, Hall AJ, Brammer L, Silk BJ. Changes in Influenza and Other Respiratory Virus Activity During the COVID-19 Pandemic - United States, 2020-2021. MMWR Morb Mortal Wkly Rep 2021; 70:1013-1019. [PMID: 34292924 PMCID: PMC8297694 DOI: 10.15585/mmwr.mm7029a1] [Citation(s) in RCA: 255] [Impact Index Per Article: 85.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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4
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Olsen SJ, Azziz-Baumgartner E, Budd AP, Brammer L, Sullivan S, Pineda RF, Cohen C, Fry AM. Decreased influenza activity during the COVID-19 pandemic-United States, Australia, Chile, and South Africa, 2020. Am J Transplant 2020; 20:3681-3685. [PMID: 33264506 PMCID: PMC7753605 DOI: 10.1111/ajt.16381] [Citation(s) in RCA: 159] [Impact Index Per Article: 39.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Transplant recipients are among the groups for whom the updated recommendations for 2020–2021 influenza vaccination should generally be considered essential, notably in the face of the COVID-19 pandemic.
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Affiliation(s)
- Sonja J. Olsen
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA,Correspondence Sonja J. Olsen, Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA.
| | - Eduardo Azziz-Baumgartner
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Alicia P. Budd
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Lynnette Brammer
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
| | - Sheena Sullivan
- Doherty Department, World Health Organization Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Rodrigo F. Pineda
- Virology Department, Public Health Institute of Chile, Santiago, Chile
| | - Cheryl Cohen
- Center for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa,Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Alicia M. Fry
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia, USA
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5
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Olsen SJ, Azziz-Baumgartner E, Budd AP, Brammer L, Sullivan S, Pineda RF, Cohen C, Fry AM. Decreased Influenza Activity During the COVID-19 Pandemic - United States, Australia, Chile, and South Africa, 2020. MMWR Morb Mortal Wkly Rep 2020; 69:1305-1309. [PMID: 32941415 PMCID: PMC7498167 DOI: 10.15585/mmwr.mm6937a6] [Citation(s) in RCA: 348] [Impact Index Per Article: 87.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
After recognition of widespread community transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), by mid- to late February 2020, indicators of influenza activity began to decline in the Northern Hemisphere. These changes were attributed to both artifactual changes related to declines in routine health seeking for respiratory illness as well as real changes in influenza virus circulation because of widespread implementation of measures to mitigate transmission of SARS-CoV-2. Data from clinical laboratories in the United States indicated a 61% decrease in the number of specimens submitted (from a median of 49,696 per week during September 29, 2019-February 29, 2020, to 19,537 during March 1-May 16, 2020) and a 98% decrease in influenza activity as measured by percentage of submitted specimens testing positive (from a median of 19.34% to 0.33%). Interseasonal (i.e., summer) circulation of influenza in the United States (May 17-August 8, 2020) is currently at historical lows (median = 0.20% tests positive in 2020 versus 2.35% in 2019, 1.04% in 2018, and 2.36% in 2017). Influenza data reported to the World Health Organization's (WHO's) FluNet platform from three Southern Hemisphere countries that serve as robust sentinel sites for influenza from Oceania (Australia), South America (Chile), and Southern Africa (South Africa) showed very low influenza activity during June-August 2020, the months that constitute the typical Southern Hemisphere influenza season. In countries or jurisdictions where extensive community mitigation measures are maintained (e.g., face masks, social distancing, school closures, and teleworking), those locations might have little influenza circulation during the upcoming 2020-21 Northern Hemisphere influenza season. The use of community mitigation measures for the COVID-19 pandemic, plus influenza vaccination, are likely to be effective in reducing the incidence and impact of influenza, and some of these mitigation measures could have a role in preventing influenza in future seasons. However, given the novelty of the COVID-19 pandemic and the uncertainty of continued community mitigation measures, it is important to plan for seasonal influenza circulation in the United States this fall and winter. Influenza vaccination of all persons aged ≥6 months remains the best method for influenza prevention and is especially important this season when SARS-CoV-2 and influenza virus might cocirculate (1).
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Budd AP, Beacham L, Smith CB, Garten RJ, Reed C, Kniss K, Mustaquim D, Ahmad FB, Cummings CN, Garg S, Levine MZ, Fry AM, Brammer L. Birth Cohort Effects in Influenza Surveillance Data: Evidence That First Influenza Infection Affects Later Influenza-Associated Illness. J Infect Dis 2020; 220:820-829. [PMID: 31053844 DOI: 10.1093/infdis/jiz201] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 04/26/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The evolution of influenza A viruses results in birth cohorts that have different initial influenza virus exposures. Historically, A/H3 predominant seasons have been associated with more severe influenza-associated disease; however, since the 2009 pandemic, there are suggestions that some birth cohorts experience more severe illness in A/H1 predominant seasons. METHODS United States influenza virologic, hospitalization, and mortality surveillance data during 2000-2017 were analyzed for cohorts born between 1918 and 1989 that likely had different initial influenza virus exposures based on viruses circulating during early childhood. Relative risk/rate during H3 compared with H1 predominant seasons during prepandemic versus pandemic and later periods were calculated for each cohort. RESULTS During the prepandemic period, all cohorts had more influenza-associated disease during H3 predominant seasons than H1 predominant seasons. During the pandemic and later period, 4 cohorts had higher hospitalization and mortality rates during H1 predominant seasons than H3 predominant seasons. CONCLUSIONS Birth cohort differences in risk of influenza-associated disease by influenza A virus subtype can be seen in US influenza surveillance data and differ between prepandemic and pandemic and later periods. As the population ages, the amount of influenza-associated disease may be greater in future H1 predominant seasons than H3 predominant seasons.
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Affiliation(s)
- Alicia P Budd
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lauren Beacham
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.,Battelle Memorial Institute, Atlanta, Georgia
| | - Catherine B Smith
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Rebecca J Garten
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Carrie Reed
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Krista Kniss
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Desiree Mustaquim
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Farida B Ahmad
- Division of Vital Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Charisse N Cummings
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Shikha Garg
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Min Z Levine
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Alicia M Fry
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lynnette Brammer
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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7
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Flannery B, Kondor RJG, Chung JR, Gaglani M, Reis M, Zimmerman RK, Nowalk MP, Jackson ML, Jackson LA, Monto AS, Martin ET, Belongia EA, McLean HQ, Kim SS, Blanton L, Kniss K, Budd AP, Brammer L, Stark TJ, Barnes JR, Wentworth DE, Fry AM, Patel M. Spread of Antigenically Drifted Influenza A(H3N2) Viruses and Vaccine Effectiveness in the United States During the 2018-2019 Season. J Infect Dis 2020; 221:8-15. [PMID: 31665373 PMCID: PMC7325528 DOI: 10.1093/infdis/jiz543] [Citation(s) in RCA: 118] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 10/16/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Increased illness due to antigenically drifted A(H3N2) clade 3C.3a influenza viruses prompted concerns about vaccine effectiveness (VE) and vaccine strain selection. We used US virologic surveillance and US Influenza Vaccine Effectiveness (Flu VE) Network data to evaluate consequences of this clade. METHODS Distribution of influenza viruses was described using virologic surveillance data. The Flu VE Network enrolled ambulatory care patients aged ≥6 months with acute respiratory illness at 5 sites. Respiratory specimens were tested for influenza by means of reverse-transcriptase polymerase chain reaction and were sequenced. Using a test-negative design, we estimated VE, comparing the odds of influenza among vaccinated versus unvaccinated participants. RESULTS During the 2018-2019 influenza season, A(H3N2) clade 3C.3a viruses caused an increasing proportion of influenza cases. Among 2763 Flu VE Network case patients, 1325 (48%) were infected with A(H1N1)pdm09 and 1350 (49%) with A(H3N2); clade 3C.3a accounted for 977 (93%) of 1054 sequenced A(H3N2) viruses. VE was 44% (95% confidence interval, 37%-51%) against A(H1N1)pdm09 and 9% (-4% to 20%) against A(H3N2); VE was 5% (-10% to 19%) against A(H3N2) clade 3C.3a viruses. CONCLUSIONS The predominance of A(H3N2) clade 3C.3a viruses during the latter part of the 2018-2019 season was associated with decreased VE, supporting the A(H3N2) vaccine component update for 2019-2020 northern hemisphere influenza vaccines.
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Affiliation(s)
- Brendan Flannery
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Jessie R Chung
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Manjusha Gaglani
- Baylor Scott & White Health, Texas A&M University College of Medicine, Temple, Texas
| | - Michael Reis
- Baylor Scott & White Health, Texas A&M University College of Medicine, Temple, Texas
| | - Richard K Zimmerman
- University of Pittsburgh Schools of Health Sciences and University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Mary Patricia Nowalk
- University of Pittsburgh Schools of Health Sciences and University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Michael L Jackson
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | - Lisa A Jackson
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | - Arnold S Monto
- University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Emily T Martin
- University of Michigan School of Public Health, Ann Arbor, Michigan
| | | | - Huong Q McLean
- Marshfield Clinic Research Institute, Marshfield, Wisconsin
| | - Sara S Kim
- Oak Ridge Institute for Science and Education Fellowship Program, Oak Ridge, Tennessee
| | - Lenee Blanton
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Krista Kniss
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Alicia P Budd
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lynnette Brammer
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Thomas J Stark
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - John R Barnes
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - David E Wentworth
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Alicia M Fry
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Manish Patel
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
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8
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Epperson S, Davis CT, Brammer L, Abd Elal AI, Ajayi N, Barnes J, Budd AP, Burns E, Daly P, Dugan VG, Fry AM, Jang Y, Johnson SJ, Kniss K, Kondor R, Grohskopf LA, Gubareva L, Merced-Morales A, Sessions W, Stevens J, Wentworth DE, Xu X, Jernigan D. Update: Influenza Activity - United States and Worldwide, May 19-September 28, 2019, and Composition of the 2020 Southern Hemisphere Influenza Vaccine. MMWR Morb Mortal Wkly Rep 2019; 68:880-884. [PMID: 31600182 PMCID: PMC6788403 DOI: 10.15585/mmwr.mm6840a3] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Scott Epperson
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - C Todd Davis
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Lynnette Brammer
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Anwar Isa Abd Elal
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Noreen Ajayi
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - John Barnes
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Alicia P Budd
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Erin Burns
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Peter Daly
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Vivien G Dugan
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Alicia M Fry
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Yunho Jang
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Sara Jo Johnson
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Krista Kniss
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Rebecca Kondor
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Lisa A Grohskopf
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Larisa Gubareva
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | | | - Wendy Sessions
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - James Stevens
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - David E Wentworth
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Xiyan Xu
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Daniel Jernigan
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
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9
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Xu X, Blanton L, Elal AIA, Alabi N, Barnes J, Biggerstaff M, Brammer L, Budd AP, Burns E, Cummings CN, Garg S, Kondor R, Gubareva L, Kniss K, Nyanseor S, O'Halloran A, Rolfes M, Sessions W, Dugan VG, Fry AM, Wentworth DE, Stevens J, Jernigan D. Update: Influenza Activity in the United States During the 2018-19 Season and Composition of the 2019-20 Influenza Vaccine. MMWR Morb Mortal Wkly Rep 2019; 68:544-551. [PMID: 31220057 PMCID: PMC6586370 DOI: 10.15585/mmwr.mm6824a3] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Influenza activity* in the United States during the 2018-19 season (September 30, 2018-May 18, 2019) was of moderate severity (1). Nationally, influenza-like illness (ILI)† activity began increasing in November, peaked during mid-February, and returned to below baseline in mid-April; the season lasted 21 weeks,§ making it the longest season in 10 years. Illness attributed to influenza A viruses predominated, with very little influenza B activity. Two waves of influenza A were notable during this extended season: influenza A(H1N1)pdm09 viruses from October 2018 to mid-February 2019 and influenza A(H3N2) viruses from February through May 2019. Compared with the 2017-18 influenza season, rates of hospitalization this season were lower for adults, but were similar for children. Although influenza activity is currently below surveillance baselines, testing for seasonal influenza viruses and monitoring for novel influenza A virus infections should continue year-round. Receiving a seasonal influenza vaccine each year remains the best way to protect against seasonal influenza and its potentially severe consequences.
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Affiliation(s)
- Xiyan Xu
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Lenee Blanton
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Anwar Isa Abd Elal
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Noreen Alabi
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - John Barnes
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Matthew Biggerstaff
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Lynnette Brammer
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Alicia P Budd
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Erin Burns
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Charisse N Cummings
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Shikha Garg
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Rebecca Kondor
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Larisa Gubareva
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Krista Kniss
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Sankan Nyanseor
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Alissa O'Halloran
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Melissa Rolfes
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Wendy Sessions
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Vivien G Dugan
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Alicia M Fry
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - David E Wentworth
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - James Stevens
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Daniel Jernigan
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
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10
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Blanton L, Dugan VG, Abd Elal AI, Alabi N, Barnes J, Brammer L, Budd AP, Burns E, Cummings CN, Garg S, Garten R, Gubareva L, Kniss K, Kramer N, O'Halloran A, Reed C, Rolfes M, Sessions W, Taylor C, Xu X, Fry AM, Wentworth DE, Katz J, Jernigan D. Update: Influenza Activity - United States, September 30, 2018-February 2, 2019. MMWR Morb Mortal Wkly Rep 2019; 68:125-134. [PMID: 30763296 PMCID: PMC6375659 DOI: 10.15585/mmwr.mm6806a1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Lenee Blanton
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Vivien G Dugan
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Anwar Isa Abd Elal
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Noreen Alabi
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - John Barnes
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Lynnette Brammer
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Alicia P Budd
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Erin Burns
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Charisse N Cummings
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Shikha Garg
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Rebecca Garten
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Larisa Gubareva
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Krista Kniss
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Natalie Kramer
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Alissa O'Halloran
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Carrie Reed
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Melissa Rolfes
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Wendy Sessions
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Calli Taylor
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Xiyan Xu
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Alicia M Fry
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - David E Wentworth
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Jacqueline Katz
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Daniel Jernigan
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
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11
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Budd AP, Abd Elal AI, Alabi N, Barnes J, Blanton L, Brammer L, Burns E, Cummings CN, Dugan VG, Garg S, Garten R, Grohskopf LA, Gubareva L, Kniss K, Kramer N, O'Halloran A, Sessions W, Taylor C, Wentworth DE, Xu X, Fry AM, Katz J, Jernigan D. Influenza Activity - United States, September 30-December 1, 2018. MMWR Morb Mortal Wkly Rep 2018; 67:1369-1371. [PMID: 30543604 PMCID: PMC6300078 DOI: 10.15585/mmwr.mm6749a4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Influenza activity in the United States was low during October 2018, and, although it increased slowly during November, activity remains low across most of the country.* During the week ending December 1, 2018, the percentage of outpatient visits for influenza-like illness† (ILI) was equal to the national baseline§ (Figure) and was at or slightly above the region-specific baseline in four of the 10 U.S. Department of Health and Human Services regions¶ (Regions 4 and 7–9). The majority of jurisdictions experienced minimal or low ILI activity since September 30; however, two experienced moderate ILI activity, and two experienced high ILI activity** during the week ending December 1. The percentage of deaths attributed to pneumonia and influenza remains below the epidemic threshold,†† and the rate of influenza-associated hospitalizations remains low. Five laboratory-confirmed, influenza-associated pediatric deaths occurring since September 30 have been reported to CDC. During the week ending December 1, the majority of jurisdictions (40 states, the District of Columbia, Puerto Rico, and U.S. Virgin Islands) reported sporadic or local geographic spread of influenza activity, nine states reported regional activity, and one state reported widespread activity.§§
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Affiliation(s)
- Alicia P Budd
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Anwar Isa Abd Elal
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Noreen Alabi
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - John Barnes
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Lenee Blanton
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Lynnette Brammer
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Erin Burns
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Charisse N Cummings
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Vivien G Dugan
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Shikha Garg
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Rebecca Garten
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Lisa A Grohskopf
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Larisa Gubareva
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Krista Kniss
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Natalie Kramer
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Alissa O'Halloran
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Wendy Sessions
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Calli Taylor
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - David E Wentworth
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Xiyan Xu
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Alicia M Fry
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Jacqueline Katz
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Daniel Jernigan
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
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12
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Chow EJ, Davis CT, Abd Elal AI, Alabi N, Azziz-Baumgartner E, Barnes J, Blanton L, Brammer L, Budd AP, Burns E, Davis WW, Dugan VG, Fry AM, Garten R, Grohskopf LA, Gubareva L, Jang Y, Jones J, Kniss K, Lindstrom S, Mustaquim D, Porter R, Rolfes M, Sessions W, Taylor C, Wentworth DE, Xu X, Zanders N, Katz J, Jernigan D. Update: Influenza Activity - United States and Worldwide, May 20-October 13, 2018. MMWR Morb Mortal Wkly Rep 2018; 67:1178-1185. [PMID: 30359347 PMCID: PMC6290813 DOI: 10.15585/mmwr.mm6742a3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
During May 20-October 13, 2018,* low levels of influenza activity were reported in the United States, with a mix of influenza A and B viruses circulating. Seasonal influenza activity in the Southern Hemisphere was low overall, with influenza A(H1N1)pdm09 predominating in many regions. Antigenic testing of available influenza A and B viruses indicated that no significant antigenic drift in circulating viruses had emerged. In late September, the components for the 2019 Southern Hemisphere influenza vaccine were selected and included an incremental update to the A(H3N2) vaccine virus used in egg-based vaccine manufacturing; no change was recommended for the A(H3N2) component of cell-manufactured or recombinant influenza vaccines. Annual influenza vaccination is the best method for preventing influenza illness and its complications, and all persons aged ≥6 months who do not have contraindications should receive influenza vaccine, preferably before the onset of influenza circulation in their community, which often begins in October and peaks during December-February. Health care providers should offer vaccination by the end of October and should continue to recommend and administer influenza vaccine to previously unvaccinated patients throughout the 2018-19 influenza season (1). In addition, during May 20-October 13, a small number of nonhuman influenza "variant" virus infections† were reported in the United States; most were associated with exposure to swine. Although limited human-to-human transmission might have occurred in one instance, no ongoing community transmission was identified. Vulnerable populations, especially young children and other persons at high risk for serious influenza complications, should avoid swine barns at agricultural fairs, or close contact with swine.§.
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MESH Headings
- Disease Outbreaks
- Drug Resistance, Viral
- Global Health/statistics & numerical data
- Humans
- Influenza A Virus, H1N1 Subtype/drug effects
- Influenza A Virus, H1N1 Subtype/genetics
- Influenza A Virus, H1N1 Subtype/isolation & purification
- Influenza A Virus, H1N2 Subtype/drug effects
- Influenza A Virus, H1N2 Subtype/genetics
- Influenza A Virus, H1N2 Subtype/isolation & purification
- Influenza A Virus, H3N2 Subtype/drug effects
- Influenza A Virus, H3N2 Subtype/genetics
- Influenza A Virus, H3N2 Subtype/isolation & purification
- Influenza B virus/drug effects
- Influenza B virus/genetics
- Influenza B virus/isolation & purification
- Influenza Vaccines/chemistry
- Influenza, Human/epidemiology
- Influenza, Human/virology
- Population Surveillance
- Seasons
- United States/epidemiology
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13
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Lowe L, Dopson SA, Budd AP. Pandemic Influenza Readiness Report on Laboratory and Epidemiology Capacity—United States and Territories, 2015. Health Secur 2018; 16:239-243. [DOI: 10.1089/hs.2018.0021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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14
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Garten R, Blanton L, Elal AIA, Alabi N, Barnes J, Biggerstaff M, Brammer L, Budd AP, Burns E, Cummings CN, Davis T, Garg S, Gubareva L, Jang Y, Kniss K, Kramer N, Lindstrom S, Mustaquim D, O'Halloran A, Sessions W, Taylor C, Xu X, Dugan VG, Fry AM, Wentworth DE, Katz J, Jernigan D. Update: Influenza Activity in the United States During the 2017-18 Season and Composition of the 2018-19 Influenza Vaccine. MMWR Morb Mortal Wkly Rep 2018; 67:634-642. [PMID: 29879098 PMCID: PMC5991814 DOI: 10.15585/mmwr.mm6722a4] [Citation(s) in RCA: 159] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
- Rebecca Garten
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Lenee Blanton
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Anwar Isa Abd Elal
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Noreen Alabi
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - John Barnes
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Matthew Biggerstaff
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Lynnette Brammer
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Alicia P Budd
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Erin Burns
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Charisse N Cummings
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Todd Davis
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Shikha Garg
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Larisa Gubareva
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Yunho Jang
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Krista Kniss
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Natalie Kramer
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Stephen Lindstrom
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Desiree Mustaquim
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Alissa O'Halloran
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Wendy Sessions
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Calli Taylor
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Xiyan Xu
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Vivien G Dugan
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Alicia M Fry
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - David E Wentworth
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Jacqueline Katz
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Daniel Jernigan
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
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15
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Budd AP, Wentworth DE, Blanton L, Elal AIA, Alabi N, Barnes J, Brammer L, Burns E, Cummings CN, Davis T, Flannery B, Fry AM, Garg S, Garten R, Gubareva L, Jang Y, Kniss K, Kramer N, Lindstrom S, Mustaquim D, O'Halloran A, Olsen SJ, Sessions W, Taylor C, Xu X, Dugan VG, Katz J, Jernigan D. Update: Influenza Activity - United States, October 1, 2017-February 3, 2018. MMWR Morb Mortal Wkly Rep 2018; 67:169-179. [PMID: 29447145 PMCID: PMC5815487 DOI: 10.15585/mmwr.mm6706a1] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Alicia P Budd
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - David E Wentworth
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Lenee Blanton
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Anwar Isa Abd Elal
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Noreen Alabi
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - John Barnes
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Lynnette Brammer
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Erin Burns
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Charisse N Cummings
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Todd Davis
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Brendan Flannery
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Alicia M Fry
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Shikha Garg
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Rebecca Garten
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Larisa Gubareva
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Yunho Jang
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Krista Kniss
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Natalie Kramer
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Stephen Lindstrom
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Desiree Mustaquim
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Alissa O'Halloran
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Sonja J Olsen
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Wendy Sessions
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Calli Taylor
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Xiyan Xu
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Vivien G Dugan
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Jacqueline Katz
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
| | - Daniel Jernigan
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
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16
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Rinke ML, Chen AR, Bundy DG, Colantuoni E, Fratino L, Drucis KM, Panton SY, Kokoszka M, Budd AP, Milstone AM, Miller MR. Implementation of a central line maintenance care bundle in hospitalized pediatric oncology patients. Pediatrics 2012; 130:e996-e1004. [PMID: 22945408 PMCID: PMC3457619 DOI: 10.1542/peds.2012-0295] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To investigate whether a multidisciplinary, best-practice central line maintenance care bundle reduces central line-associated blood stream infection (CLABSI) rates in hospitalized pediatric oncology patients and to further delineate the epidemiology of CLABSIs in this population. METHODS We performed a prospective, interrupted time series study of a best-practice bundle addressing all areas of central line care: reduction of entries, aseptic entries, and aseptic procedures when changing components. Based on a continuous quality improvement model, targeted interventions were instituted to improve compliance with each of the bundle elements. CLABSI rates and epidemiological data were collected for 10 months before and 24 months after implementation of the bundle and compared in a Poisson regression model. RESULTS CLABSI rates decreased from 2.25 CLABSIs per 1000 central line days at baseline to 1.79 CLABSIs per 1000 central line days during the intervention period (incidence rate ratio [IRR]: 0.80, P = .58). Secondary analyses indicated CLABSI rates were reduced to 0.81 CLABSIs per 1000 central line days in the second 12 months of the intervention (IRR: 0.36, P = .091). Fifty-nine percent of infections resulted from Gram-positive pathogens, 37% of patients with a CLABSI required central line removal, and patients with Hickman catheters were more likely to have a CLABSI than patients with Infusaports (IRR: 4.62, P = .02). CONCLUSIONS A best-practice central line maintenance care bundle can be implemented in hospitalized pediatric oncology patients, although long ramp-up times may be necessary to reap maximal benefits. Further research is needed to determine if this CLABSI rate reduction can be sustained and spread.
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Affiliation(s)
| | - Allen R. Chen
- Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Elizabeth Colantuoni
- Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Lisa Fratino
- Department of Pediatrics, Johns Hopkins Hospital, Baltimore, Maryland; and
| | - Kim M. Drucis
- Department of Pediatrics, Johns Hopkins Hospital, Baltimore, Maryland; and
| | | | - Michelle Kokoszka
- Department of Pediatrics, Johns Hopkins Hospital, Baltimore, Maryland; and
| | - Alicia P. Budd
- Department of Pediatrics, Johns Hopkins Hospital, Baltimore, Maryland; and
| | | | - Marlene R. Miller
- Departments of Pediatrics, and,Children’s Hospital Association, Alexandria, Virginia
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17
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Sydnor ERM, Greer A, Budd AP, Pehar M, Munshaw S, Neofytos D, Perl TM, Valsamakis A. An outbreak of human parainfluenza virus 3 infection in an outpatient hematopoietic stem cell transplantation clinic. Am J Infect Control 2012; 40:601-5. [PMID: 22405748 DOI: 10.1016/j.ajic.2011.11.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Revised: 11/12/2011] [Accepted: 11/15/2011] [Indexed: 11/29/2022]
Abstract
BACKGROUND Parainfluenza viruses cause respiratory tract infections in adults and children, with peak activity during the spring and summer months. Human parainfluenza virus type 3 (hPIV-3) can contribute to significant morbidity and mortality in patients undergoing hematopoietic stem cell transplantation (HSCT). METHODS Automated surveillance software was used to identify an hPIV-3 outbreak in an HSCT clinic. Active surveillance for respiratory illness and infection control measures were instituted. A retrospective molecular investigation of outbreak viral strains was performed by direct sequencing. RESULTS Twelve of 196 HSCT recipients attending the clinic during the outbreak period had hPIV-3; one of these patients died. Sequencing demonstrated highly related strains in 9 of 10 patients studied. Despite the ongoing presence of hPIV-3 outside the inpatient/outpatient care continuum clinic, only 2 cases were observed after institution of respiratory season infection control measures. CONCLUSIONS This investigation demonstrates the utility of surveillance software in the identification of respiratory virus outbreaks and the importance of rapid implementation of infection control/prevention measures for containment of outbreaks.
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Affiliation(s)
- Emily R M Sydnor
- Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City, UT 84132, USA.
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