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California 2009-2010 Flu Season

Re: California Week 4-- 8 New Deaths

Re: California Week 4-- 8 New Deaths

Week 4:

8 New Deaths
? There have been 8,641 hospitalizations and/or fatalities reported to date since the beginning of the pandemic, of which 1,826 cases required intensive care.
? The statewide cumulative incidence rate of reported 2009 H1N1 influenza hospitalizations and/or fatalities is 22.3 per 100,000 population.
? CDPH received 8 reports of fatal 2009 H1N1 influenza cases for the week ending on January 30, 2010, all of which were delayed reports from prior to the reporting week (January 24 - 30, 2010); a total of 506 deaths caused by 2009 H1N1 influenza have been reported to CDPH to date.
? The hospitalized case-fatality ratio is highest among individuals aged 50-64 years (10.1%, an increase of 0.1% from the previous reporting week) and second-highest among individuals aged 36-49 years (10.0%, an increase of 0.1% from the previous reporting week). The hospitalized case-fatality ratio for all ages combined is 5.9%.
? A total of 3,025 hospitalized and/or fatal 2009 H1N1 influenza cases in pediatric patients 18 years or younger, including 51 deaths, have been reported to CDPH to date.
? Three new cases meeting the case definition for severe pediatric influenza were reported this week; no fatalities were reported. All of these cases are confirmed/probable 2009 H1N1 influenza.
? From January 24 ? 30, 2010, two pregnant 2009 H1N1 influenza cases were reported to CDPH as aggregate numbers, both of which were delayed reports from prior to the current reporting period (January 24 - 30, 2010). A total of 559 pregnant hospitalized and/or fatal cases, including 17 deaths (case-fatality proportion 3.0%), have been reported to CDPH to date.
? In recent months, almost all influenza A-positive specimens tested by PCR at VRDL and by the RLN have been subsequently confirmed as 2009 H1N1 influenza, reflecting that the predominant circulating influenza strain in California remains 2009 H1N1 influenza.
? Three percent of specimens received by the Respiratory Laboratory Network (RLN) were positive for influenza, which is a decrease from four percent from the previous reporting week.
? Of 2,111 specimens tested, nine cases of oseltamivir resistance have been identified in California residents with laboratory-confirmed 2009 H1N1 influenza infections. Available data indicate that prevalence of oseltamivir-resistant 2009 H1N1 influenza is quite limited.

Influenza A detections decreased slightly during week 4 (January 24-30, 2010). RSV detections increased from 21% in week 3 (January 17-23, 2010) to 30% in week 4. This is within the range seen in previous years.
http://www.cdph.ca.gov/programs/vrdl/Documents/Flu Update 01.30.10.pdf
http://www.cdph.ca.gov/data/statistics/Pages/CISPDataArchive.aspx
 
Re: California Week 4 -- 8 New Deaths

Re: California Week 4 -- 8 New Deaths

Hospitalized case-fatality ratio of 10% in ages 36-49 and 50-64!!

Is the rate that high for those 2 age groups throughout the US?

The report also mentions detections of human metapneumovirus and rhinovirus are also increasing. Metapneumovirus is a fairly new one and can cause serious problems in older adults.
 
Re: California Week 4 -- 8 New Deaths

Re: California Week 4 -- 8 New Deaths

Do you think we are starting to see an uptick in California? I had to look up that one virus. Never heard of it and of course knew about rhinovirus.
The age brackets that you mentioned maybe higher due to lack of getting vaccinated? What is your take on this?
Thank you
 
Re: California Week 4 -- 8 New Deaths

Re: California Week 4 -- 8 New Deaths

CFR has always been highest for ages 45-59 (in the US) The CDC has done some estimates, but has combined ages 18-64. Thus, not making ages 45-59 look as fatal. Earlier CDC reports had ages 50-64 combined.

"Deaths are calculated as a percentage of hospitalizations using data from the Aggregate Hospitalization and Death Reporting Activity (AHDRA) surveillance system. This system has up to 35 states reporting. Using data of hospitalizations and deaths from AHDRA, by age group as reported through week 49, deaths as a percentage of hospitalizations were: 0-18 years of age – 1.48%; 19-64 years of age – 6.30%; 65+ years of age – 6.80%."
http://www.cdc.gov/h1n1flu/estimates/results_2009_h1n1.htm
 
Re: California Week 5 -- 9 New Deaths

Re: California Week 5 -- 9 New Deaths

Week 5: sporadic activity

9 new deaths
Laboratory detections of influenza declined slightly while detections of respiratory syncytial virus (RSV) continue to increase.

• The statewide cumulative incidence rate of reported 2009 H1N1 influenza hospitalizations and/or fatalities is 22.5 per 100,000 population.
• CDPH received 9 reports of fatal 2009 H1N1 influenza cases for the week ending on February 6, 2010, none of which occurred during the reporting week (January 31 – February 6, 2010); a total of 515 deaths caused by 2009 H1N1 influenza have been reported to CDPH to date.
• The case-fatality ratio is highest among individuals aged 50-64 years (10.4%, an increase of 0.3% from the previous reporting week) and second-highest among individuals aged 36-49 years (10.1%, an increase of 0.1% from the previous reporting week). The case-fatality ratio for all ages combined is 5.9%.
• A total of 3,041 hospitalized and/or fatal 2009 H1N1 influenza cases in pediatric patients 18 years or younger, including 51 deaths, have been reported to CDPH to date.
• Four new cases meeting the case definition for severe pediatric influenza were reported this week, with no fatalities. Two of these cases are confirmed/probable 2009 H1N1 influenza.
• From January 31 – February 6, 2010, 2 pregnant 2009 H1N1 influenza cases were reported to CDPH as aggregate numbers, both of which were from the current reporting period (January 31 – February 6, 2010) and none of which were delayed reports from prior to January 31, 2010. A total of 565 pregnant hospitalized and/or fatal cases, including 17 deaths (case-fatality proportion 3.0%), have been reported to CDPH to date.
• In recent months, almost all influenza A-positive specimens tested by PCR by the RLN have been subsequently confirmed as 2009 H1N1 influenza, reflecting that the predominant circulating influenza strain in California remains 2009 H1N1 influenza.
• One percent of specimens received by the Respiratory Laboratory Network (RLN) were positive for influenza, which is a decrease from eight percent the previous reporting week.
• This week, none of the specimens tested by the RLNs that were positive for influenza A was A/H1 or A/H3, while 100% were unsubtypeable.

1% of specimens received by the Respiratory Laboratory Network were positive for influenza A. This is a decrease from 8% in the previous week.
http://www.cdph.ca.gov/programs/vrdl/Documents/FluUpdate02.06.10.pdf
http://www.cdph.ca.gov/data/statistics/Pages/CISPDataArchive.aspx
 
Re: California Week 5 -- 9 New Deaths

Re: California Week 5 -- 9 New Deaths

Are we seeing a trend of increasing case fatality rate due to possible/probable A/H1N1 or is it RSV?
 
Re: California Week 5 -- 9 New Deaths

Re: California Week 5 -- 9 New Deaths

CDPH received 9 reports of fatal 2009 H1N1 influenza cases for the week ending on February 6, 2010, none of which occurred during the reporting week (January 31 ? February 6, 2010)

These deaths are confirmed cases of H1N1 not occurring recently. I think it's still too soon to say if wave 3 has hit.
 
Re: California Week 6 -- 12 New Deaths

Re: California Week 6 -- 12 New Deaths

Week 6: sporadic

12 new deaths; total 527 with 51 pediatric deaths (unsure if that if for season)

Reported cases of new hospitalizations decreased from 62 cases last week to 36 cases this week. As in previous weeks, the rate of hospitalizations remains highest among children under one year of age. A total of 12 fatalities were reported to CDPH this week, one of which occurred during this reporting week (February 7 - 13, 2010). Reports of ILI from sentinel providers decreased this past week (February 7 - 13, 2010) but may increase as delayed reports are received. Detections of respiratory syncytial virus (RSV) continue to increase. One percent of specimens tested by the Respiratory Laboratory Network (RLN) were influenza A, 100% of which were unsubtypeable.

The case-fatality ratio is highest among individuals aged 50-64 years (10.6%, an increase of 0.2% from the previous reporting week) and second-highest among individuals aged 36-49 years (10.3%, an increase of 0.2% from the previous reporting week). The case-fatality ratio for all ages combined is 6.0%.

No isolates reported this week from the RLN were positive for influenza A/H1 or A/H3 or for influenza B; there was one isolate positive for influenza B from a sentinel lab.

This week, 11% of specimens tested for other respiratory viruses were positive, which is the same as last week. Detections of human metapnuemovirus decreased from 48 in week 5 to 13 in week 6.
http://www.cdph.ca.gov/data/statistics/Pages/CISPDataArchive.aspx

San Diego County:
http://www.sdcounty.ca.gov/hhsa/programs/phs/community_epidemiology/disease_surveillance.html
 
Re: California Week 7 -- 15 New Deaths

Re: California Week 7 -- 15 New Deaths

Week 7: sporadic

California total deaths are at 542. CDPH received 15 reports of fatal 2009 H1N1 influenza cases for the week ending on February 20, 2010, none of which occurred during the reporting week (February 14 - 20, 2010); a total of 542 deaths caused by 2009 H1N1 influenza have been reported to CDPH to date.

Seven new cases meeting the case definition for severe pediatric influenza were reported this week, with 2 fatalities. All of these cases are confirmed/probable 2009 H1N1 influenza (not sure if this is part of the 15 deaths, or addition to the 15)
http://www.cdph.ca.gov/HealthInfo/discond/Pages/H1N1Home.aspx
http://www.cdph.ca.gov/programs/vrdl/Documents/FluUpdate02.20.10.pdf

Percent positive specimens: 4% (decreasing)
• This week, 28% of specimens tested for RSV were positive, which is a decrease of 6% from last week.
• This week, 12% of specimens tested for other respiratory viruses were positive, which is an increase of 1% from last week. Of those that tested positive for other respiratory viruses, 48% were human metapneumovirus and 37% were rhinovirus.

California Data on Deaths (April 28, 2009- Feb 20, 2010)
The overall mortality rate is highest among individuals aged 50-64 years (2.7 influenza fatalities per 100,000 population), and lowest among children aged 1-4 years (0.2 influenza fatalities per 100,000 population). The influenza mortality rate for all ages combined is 1.4 fatalities per 100,000 population.

The rate of hospitalizations and/or fatalities is highest among infants under 1 year of age (115.2 cases per 100,000 population). This compares to a rate of hospitalizations and/or fatalities of 22.7 cases per 100,000 population for all ages combined.

There was a steady increase in the occurrence of fatal cases from early June through July. The number of fatalities began decreasing from July 29 – September 12, but a second increase in fatal cases occurred from September 13 – November 7, with the highest number of fatalities occurring in the two week period of October 25 – November 7. The number of fatalities has since been declining, though reports from recent weeks may be underestimated due to delays in reporting.
http://www.cdph.ca.gov/data/statistics/Documents/H1N1Graphs022010.pdf
 
Re: California Week 8 -- 4 New Deaths

Re: California Week 8 -- 4 New Deaths

Week 8: sporadic

4 new deaths; total 546
ILI: decreasing
Percent positive: 2% (decreasing) One specimen A/H3
This week, 16% of specimens tested for other respiratory viruses were positive, which is an increase of 1% from last week. Of those that tested positive for other respiratory viruses, 10% were human metapneumovirus and 5% were rhinovirus.
RSV: 30% (stable)

A total of four fatalities were reported to CDPH this week, all of which were delayed reports from prior to this reporting week (February 21 - 27, 2010). Reports of ILI from sentinel providers decreased this past week (February 21-27, 2010) but may increase as delayed reports are received. Detections of RSV appear to be decreasing. Two percent of specimens tested by the RLN were influenza A, of which one was influenza A/H3.

http://www.cdph.ca.gov/HealthInfo/discond/Pages/H1N1Home.aspx
http://www.cdph.ca.gov/data/statistics/Documents/H1N1DataTable022710.pdf
http://www.cdph.ca.gov/data/statistics/Pages/h1n1graphs.aspx
 
Re: California Week 9 -- 7 New Deaths

Re: California Week 9 -- 7 New Deaths

Week 9: sporadic DATA NOW ONLY UPDATED MONTHLY according to website

7 New deaths; total 553

ILI:decreased
RSV: 31% (increasing)
Percent positive: 0
P&I: decreased (After increasing for four weeks, Kaiser hospitalizations for pneumonia and influenza (P&I) decreased this week in northern California)

• CDPH received seven reports of fatal 2009 H1N1 influenza cases for the week ending on March 6, 2010, all of which were delayed reports from prior to the reporting week (February 28 – March 6, 2010); a total of 553 deaths caused by 2009 H1N1 influenza have been reported to CDPH to date.
• Two new cases meeting the case definition for severe pediatric influenza were reported this week; no fatalities were reported. One of these cases are confirmed/probable 2009 H1N1 influenza.
• This week, 20% of specimens tested were positive for other respiratory viruses, which is an increase of 5% from last week. Of those that tested positive for other respiratory viruses, 66% were human metapneumovirus and 32% were rhinovirus
http://www.cdph.ca.gov/HealthInfo/discond/Pages/H1N1Home.aspx
http://www.cdph.ca.gov/data/statistics/Pages/CISPDataArchive.aspx

A total of 79 sentinel providers reported in Week 9.
 
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