1. Influenza Pertussis Meningitis B SPOKANE EPIDEMIOLOGY UPDATE

2. Updates INFLUENZA

3. INFLUENZA HOSPITALIZATIONS BY AGE

4. INFLUENZA HOSPITALIZATION EPI CURVE

5. INFLUENZA HOSPITALIZATION – PAST, PRESENT AND …

6.  Composition of the 2015/16 Flu Vaccine  A/California/7/2009 (H1N1)-like virus, A/Switzerland/9715293/2013 (H3N2)-like virus (new), B/Phuket/3073/2013-like (Yamagata lineage) (new)  Afluria approved by the FDA for intramuscular administration via the Stratis needle-free jet injector, for persons aged 18 through 64 years of age.  Flublok is now indicated for persons aged ≥18 years of age.  Preference for LAIV over IIV is no longer recommended for healthy children aged 2-8 years of age. CHANGES FOR THE UPCOMING FLU SEASON

7. Fall 2015 PERTUSSIS

8.  54 cases in Spokane YTD. WA PERTUSSIS EPIDEMIOLOLGY

9.  WA DOH is looking at getting data on maternal Tdap utilization  Current recommendation is that women get a Tdap immunization in their third trimester with every pregnancy.  Current pilot is looking at what type of information would be available in the major EMRs used in birthing hospitals in the state.  In Spokane we are looking at Valley and Deaconess Hospitals.  Goal is to get maternal Tdap information from all birthing hospitals in WA. RESEARCH IN WASHINGTON STATE

10.  Infants who get pertussis from a known source get it from who?  35.5% from siblings  20.6% from mothers  10.0% from fathers  85.2% for total of immediate and extended family  http://www.medscape.com/viewar ticle/850781 EPI PEARL - PERTUSSIS

11.  Different bug but similar disease…  Outbreak in Minnesota in Fall of 2014. Key points:  Over 31 cases identified with similar clinical picture as pertussis  40% of the patients had post-tussive vomiting  40% had coryza  32% had apnea or sleep disturbances  12% reported a sore throat  Cough persisted for up to 8 weeks  And none had fever  Pertussis vaccine is not effective against parapertussis  PCR testing can distinguish between the two  http://www.medpagetoday.com/MeetingCoverage/IC AAC/53655 I.D. POTPOURRI - PARAPERTUSSIS

12. Fall 2015 MENINGOCOCCAL DISEASE

13.  Historically vaccines for meningococcal disease covered 4 of the 5 strains (A, C, W135 and Y) but a vaccine covering the B strain has not been FDA approved for use in the US  Type B is responsible for roughly a third of meningococcal cases in the US and is more common with infants  In 2013-14 a large number of outbreaks of meningitis B were associated with colleges  The 2013-14 outbreak at Princeton led to CDC requesting and receiving approval from the FDA to import Bexsero to respond to the outbreak. MENINGITIS B

14.  Two vaccines available for Meningitis B protection.  Bexsero is available with 2 doses over 1 month  Approved by FDA in January 2015 for ages 10-25  Trumenba is available with 3 doses over 6 months  Approved by FDA in October 2014 for ages 10-25 MENINGITIS B VACCINES

15. QUESTIONS?