1 Novel Influenza A H1N1 Outbreak: The Florida Response Epidemiology Perspective: Situation Update

2 Where are we now? New virus emerged early 2009 in Mexico. H1N1, but not like other recent human H1N1’s. Virus has pieces that came from birds, pigs, and people. Highest attack rate in children and young adults. Adults born before 1957 seem to be spared. Continuing activity this summer.

3 Influenza case and death counts as of 7/24/09 Almost 3000 confirmed cases in FL. Over 300 known hospital admissions. At least 30 deaths, so far. Mortality would be worse if older adults not spared. Probably capturing 5% of morbidity this way. We have stopped publicizing case and death counts. Will show impact in other ways.

4 Influenza surveillance systems Monitor testing in state public health lab. Network of 100 sentinel primary care offices report % of visits for influenza-like illness (ILI) weekly. 114 hospital EDs report % of visits for ILI daily. Weekly assessment of influenza activity by County Health Departments. Weekly count of deaths from influenza and/or pneumonia in 23 counties. Reports of outbreak investigations. Local systems in some counties (e.g. school absenteeism).

5 Influenza activity in Florida Outbreaks since May in diverse settings:  Summer camps  Jails  Prisons  Detention facilities  Child care centers  Long-term care hospitals There will be outbreaks in schools as soon as school starts.

6 FL state lab data so far Sudden increase week 17 due to H1N1 publicity. New virus has rapidly replaced last winter’s. About 275 positives per week.

7 Percent positive in state lab 80% of people being tested for influenza have influenza. Almost all of those have the novel strain.

8 Influenza-like illness visits to 114 emergency departments Big spike was media-driven. ILI % remains well above seasonal baseline.

9 Cases and deaths by age group Deaths are occurring in older age groups than cases

10 Some current recommendations Antiviral treatment for those with chronic illness, pregnant, under age 5, or over age 65.  Don’t treat otherwise.  Some high-risk exposed people should get prophylaxis. Promptly treat people based on clinical diagnosis. Ignore negative rapid test results. Assume people who have fever and cough have influenza.

11 Looking ahead Be prepared for widespread influenza activity in schools. Expect 1 to 3 months of activity BEFORE vaccine becomes available. The vaccine will not be 100% effective. We could have 5 million infections. If one infected person per 1000 dies, that will be 5,000 deaths in Florida.