INFLUENZA (51): USA (FLORIDA) LATE SEASON B ACTIVITY

Kassy · 07-02-2012, 03:10 PM

Published Date: 2012-07-01 16:52:46
Subject: PRO/EDR> Influenza (51): USA (FL) late season B activity
Archive Number: 20120701.1186578

INFLUENZA (51): USA (FLORIDA) LATE SEASON B ACTIVITY.
************************************************** ****
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Sun 1 Jul 2012

Source: Operational Biosurveillance [edited]

http://biosurveillance.typepad.com/b...uenza-flu.html

Report of unusual Influenza B virus Activity in Florida

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We have a report by an astute clinician of unusual levels of influenza B in Orlando, Florida, where Tamiflu is being prescribed at high rates in outpatient clinics. Employees and visitors to Disney World, Sea World, Universal and Legoland have been reportedly admitted to a local hospital. The hospital is described as "full". We are also hearing report of concern for vaccine failure as well.

Cross-check of official state public health reports for Florida indicate unusual activity for Regions 3, 5, and 7 as of June 19th (i.e. 12 days ago). The Centers for Disease Control and Prevention closed out their seasonal reporting for influenza on 25 May 2012, therefore there is no current situational awareness or guidance. According to CDC, the 2011-2012 season was associated with an overal vaccine match of 60%, which they deemed "well matched". When considered at the local level, one might debate this, as was reported in the Pacific NW [see ProMED archived report listed below].

This now raises the bar of interest for the coming 2012-2013 influenza season and whether we will see unusually early cases in the fall... and whether the strains will indeed be "well matched" to the recommended vaccine.

A cross check of social media sources reveal inconsistencies again with what is reported directly on the ground versus what social media would lead an analyst to believe:

- Google's Flu Trends indicate a LOW level of influenza activity in Florida currently.

- HealthMap provides no report of these events.

- SickWeather does provide indication that folks are talking about "flu" in Florida, however there is no indication of volume compared to baseline. There is no indication an operational "forecast" was provided.

The bottom line is nothing beats an astute clinician inclined to report.

--

Communicated by:

James M. Wilson V, M.D.,

Delta Pediatrics, Delta County Memorial Hospital

Chief of Station,

Ascel Bio Black Canyon Infectious Disease Forecast Station

[According to the most recent WHO Update, laboratory confirmed influenza activity remained low in many parts of the northern hemisphere. In the southern hemisphere the influenza season started in some countries with local outbreaks reported. Globally, A(H3N2) viruses remained the dominant virus followed by influenza B and influenza A(H1N1)pdm09 viruses respectively. - Mod.CP]

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1yvG.]

http://www.promedmail.org/direct.php...120701.1186578

CanadaSue · 07-02-2012, 04:24 PM

We had a very light season & I stopped routine checking ages ago.

Gonna go see what FluWatch is reporting.

---------- Post added at 04:24 PM ---------- Previous post was at 04:21 PM ----------

Yeah - B was the prevailing strain this season. Here was the overall summary for the 1st few weeks of June - that will be replaced by a fresh report at the end of the week:

***Overall Influenza Summary

■Overall, influenza activity in Canada remains low and continues to decline. Reports of localized influenza activity were still reported in regions in Ontario in weeks 23 and 24.
■No outbreaks of influenza were reported over the 2-week period.
■In weeks 23 and 24, a total of 78 laboratory detections of influenza were reported of which 40% were for influenza A viruses (45.2% - A(H3); 16.1% - A(H1N1)pdm09; 38.7% - unsubtyped) and 60% for influenza B viruses.
■Twenty influenza-associated hospitalizations were reported over the two-week period (4 paediatric through IMPACT surveillance and 16 adult through aggregate surveillance)
■The ILI consultation rates in weeks 23 and 24 were above expected levels for this time of year and are most likely due to circulation of other respiratory viruses than influenza.***

Kassy · 07-02-2012, 04:46 PM

I wonder if it shows up in other places/other reports.

It could point to flu B moving away from the vaccine.

Since we don't discuss Flu B much i looked around and it looks like it play's a significant part, a little under a quarter of total flu deaths in the reference period.

Mortality due to Influenza in the United States—An Annualized Regression Approach Using Multiple-Cause Mortality Data

TABLE 2.
Annual deaths attributed by the surveillance regression model, categorized by pneumonia and influenza or by all respiratory and circulatory causes appearing anywhere in the death record, United States, 1979–2001
http://aje.oxfordjournals.org/conten...expansion.html

article:
http://aje.oxfordjournals.org/content/163/2/181.full#T2

gsgs · 07-02-2012, 07:09 PM

I remember the strange early H1 activity in hot India

B mutates half as fast as A, when the vaccine doesn't match
it's usually because we basically have 2 strains of B and only
one is in the vax

the vaccine-immunity also degrades over time, so they recommend
to renew it each season even if the vaccine strain doesn't change.

http://www.cdc.gov/flu/weekly/weekly...s/image251.gif

picture 1 region 4 , top : ILI , bottom: flu-virus-isolates by subtype
picture 2 is the same for all 10 USA-HHS regions

there is currently some ILI in region 3, which apparently is not flu

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http://www.doh.state.fl.us/disease_c...ek-25-2012.pdf

gsgs · 07-03-2012, 09:26 AM

Florida had almost no flu this season

Summer outbreak of influenza B on Baltic cruise 2000
"Early warning" has occurred in 2 recent years--with isolation of influenza B/Singapore/222/79-like
strains during summer 1979 and influenza A/Bangkok/1/79-like strains during summer 1980

Summer Influenza in Alaska 2003

surprisingly detected influenza B virus in three patients from non-European community
countries during the summer-fall 2008

16 Mar 2000 – There has been a previous report of a summer influenza B outbreak on
an oil rig anchored in Darwin Harbour,

Italy 2008:
https://docs.google.com/viewer?a=v&q...DnJZ Z_Ai7_EA

penguinzee · 07-03-2012, 04:46 PM

Hmm, very weird... I've been feeling quite bad over the last few days (started last Thursday) and it has felt "different" than the usual bug... felt like I had been beaten up by a truck for a couple days... also, GF and our dog both got sick, starting Saturday-Sunday... our dog's illness was confirmed by the vet (sinus & ear infection, tonsils & lymph nodes swollen, NASTY cough), so I'm wondering if there's a new bug going 'round now... IIRC, was it H7N3 that jumps easily to/from dogs?

BTW, our dog (a chihuahua) should be fine in a couple days...

Franc (penguinzee)