Saturday, September 30, 2023

Seasonal Flu Cases Per Year

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The Flu Shot Is Your Best Defence

Although flu cases are up compared to last year, Houston is still seeing a relatively mild season

This years flu season is taking place at the same time as COVID-19. Dont take any unnecessary risks with your health. Get the flu shot as early in the season as possible.

The flu shot is recommended for everyone 6 months old and older. It is:

  • safe
  • free
  • available from your doctor or nurse practitioner, and at participating pharmacies and local public health units across the province
  • proven to reduce the number of doctor visits, hospitalizations and deaths related to the flu
  • different each year because the virus changes frequently so you need to get it every fall

Provincial/territorial Influenza Hospitalizations And Deaths

Nine provinces and territories report influenza associated hospitalizations and deaths for all ages to FluWatch each week Alberta, Manitoba, Saskatchewan, Newfoundland, Prince Edward Island, Nova Scotia, New Brunswick, Yukon and the Northwest Territories. The number of reporting provinces/territories varied over the course of the season. On average, seven provinces/territories reported each week.

A total of 3,657 influenza-associated hospitalizations were reported which corresponds to an annual seasonal hospitalization incidence of 45 hospitalizations per 100,000 population in the 2018-19 season .

Table 1 Estimated annual seasonal incidence of influenza hospitalizations by age group reported by participating provinces and territories, Canada, 2013/14 to 2018/19 influenza seasons

Age Groups

Highlighted boxes indicate the age group with the highest rate during the season.

A total of 613 ICU admissions and 224 deaths were reported this season.

United States Influenza Statistics By Flu Season

US influenza statistics by flu season. From the Centers for Disease Control and Prevention page called “Disease Burden of Flu”:”Each year CDC estimates the burden of influenza in the U.S. CDC uses modeling to estimate the number of flu illnesses, medical visits, hospitalizations, and deaths related to flu that occurred in a given season. The methods used to calculate these estimates are described on CDCs webpage, How CDC Estimates the Burden of Seasonal Flu in the U.S.

The tables below include the latest available years the CDC has provided on their website.

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Disease Specific Treatment And Prophylaxis

Although vaccination is the preferred option for preventing influenza, antivirals can be useful when the vaccine fails or is unavailable, for example, due to: antigenic mismatch with circulating virus, waning immunity in elderly, patient being immunocompromised, the vaccine not yet available, or during an outbreak of an emerging influenza strain or pandemic.

Neuraminidase inhibitors, oral oseltamivir and inhaled zanamivir, are useful for treatment and prophylactic use. Since 1999 inhaled zanamivir is authorised in all EU/EEA Member States except Cyprus, and since 2002 oral oseltamivir is authorised in all EU Member States.

The use of these drugs is very variable between European countries , as are the policies.

For the best clinical benefit, treatment with antivirals should be given early in the infection, within 48 hours, . However, at least one observational study of Apdm09 found improved survival in the severely ill when antiviral treatment was provided within five days of symptom onset .

Influenza A Vs Influenza B


Both strains of influenza cause typical flu symptoms, like fever, fatigue, body aches, chills, sore throat, and cough. Its unlikely patients would be able to tell the difference between A or B without a lab test. However, Influenza B is slower to develop, which is why it typically appears later in the season. Its also more likely to impact children and younger adults instead of the elderly. This could explain why more people were infected with the flu earlier in the year over previous years, but the number of hospitalizations and deaths were lower.

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Outpatient Respiratory Illness Visits By Age Group

More than 70% of ILINet participants provide both the number of patient visits for respiratory illness and the total number of patient visits for the week broken out by age group. Data from this subset of providers are used to calculate the percentages of patient visits for respiratory illness by age group.

The percentage of visits for respiratory illness reported in ILINet are trending upward for all age groups .

* Effective October 3, 2021 , the ILI definition no longer includes without a known cause other than influenza.

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Variants: Antigenic Drift Versus Antigenic Shift

Seasonal Flu and Pandemic: A novel influenza virus strain emerges every year and causes a flu epidemic, the so-called seasonal flu.24 This seasonal flu is caused by a novel variant that exhibits antigenicity that is distinct from the past strains due to accumulated mutations. In other words, antibodies elicited by the past infection cannot provide protective immunity against seasonal variants. In fact, a flu epidemic that is more formidable than seasonal flu is pandemic flu. A few flu pandemics25 have occurred in the past, including Spanish flu that killed more than 40 million people during 19181919 . The 2009 H1N1 flu epidemic is the most recent pandemic. Now, we consider how these influenza variants are generated.

Figure 15.15. Antigenic drift and antigenic shift.

Antigenic drift: mutations in the RNA genome are highlighted in pink. Antigenic shift: antigenic differences between two strains are denoted in different colors.

Figure 15.16. Antigenic changes in viral proteins of Flu epidemic.

The extent of antigenic changes in three viral proteins are compared. The major shifts in antigenicity of HA and NA proteins occurred during three pandemics between 1930 and 1970. In contrast, the antigenicity of NP remained unchanged.

Flu Pandemic

A diagram illustrating how pandemic flu viruses were generated.

The diagram shows how three pandemics occurred in 20th century are generated.

J. Dong, … D.H. Walker, in, 2017

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National Influenza Surveillance Scheme

This paper provides a comprehensive summary and analysis of the National Influenza Surveillance Scheme, including surveillance systems that function outside of the Scheme, in 2015. The Scheme is coordinated by the Australian Government Department of Health and supported by a number of surveillance systems that aim to be nationally representative and monitor important aspects of severity, incidence and virology. Influenza activity monitored through its systems is presented in reports available on this page. Several jurisdictionally based surveillance systems that operate outside of the Scheme are used to inform local influenza activity trends. This paper describes the strengths and limitations of these influenza surveillance systems in terms of the aspects of influenza activity that they inform and their contribution to the overall monitoring of influenza activity in Australia.

Who Should Get The Flu Shot

Doctors expect more flu cases this year

The flu season in Canada normally runs from November to April. Anyone can get the flu, which can sometimes lead to severe complications or death. Some people are at higher risk for complications due to the flu, including:

The influenza vaccine, also known as the flu shot, is the best way to prevent the disease. Every Canadian aged 6 months or older should get the flu shot every year.

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Purpose Of This Survey

Results from the survey provide information about how well Canadians are protected against vaccine preventable diseases as well as what they know and think about vaccines.

Survey results are used to:

Why Can The Flu Be So Deadly

The flu is a contagious respiratory illness thats caused by influenza viruses that infect the nose, throat, and lungs, the CDC explains. There are two main typesinfluenza A and Bthat regularly circulate each year. While plenty of people get the flu, have a miserable period of illness, and then recover, others can actually die of the virus.

Influenza is a respiratory virus that has the ability to kill at a very high rate, even in the modern era, says infectious disease expert Amesh A. Adalja, M.D., a senior scholar at the Johns Hopkins Center for Health Security. In severe cases, it causes pneumonia that can be complicated with a secondary bacterial infection.

Other possible serious complications triggered by the flu, per the CDC, can include:

  • inflammation of the heart
  • inflammation of the brain
  • inflammation of the muscle tissues
  • multi-organ failure

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How To Protect Yourself From The Flu

If you havent already gotten your flu shot, Dr. Schaffner recommends doing it ASAP, as it takes time to build immunity. Flu season continues through May, after all. Its still not too late to get vaccinated, he says.

The following precautions can also protect you from the flu:

  • Avoid close contact with people who are sick.
  • Wash your hands often with soap and water for at least 20 seconds.
  • If soap and water arent available, use an alcohol-based hand sanitizer.
  • Avoid touching your eyes, nose, and mouth.
  • Clean and disinfect high-touch surfaces and objects.

Methods that help prevent the spread of COVID-19, like wearing a mask when youre around people who arent in your household and practicing social distancing, can also help you prevent a cold, flu, and other respiratory illnesses. The flus impact on deaths in the U.S. may well be blunted by our behaviors in trying to avoid COVID-19, Dr. Schaffner says.

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Antigenic Drift And Shift


Two key processes that influenza viruses evolve through are antigenic drift and antigenic shift. Antigenic drift is when an influenza virus’s antigens change due to the gradual accumulation of mutations in the antigen’s gene. This can occur in response to evolutionary pressure exerted by the host immune response. Antigenic drift is especially common for the HA protein, in which just a few amino acid changes in the head region can constitute antigenic drift. The result is the production of novel strains that can evade pre-existing antibody-mediated immunity. Antigenic drift occurs in all influenza species but is slower in B than A and slowest in C and D. Antigenic drift is a major cause of seasonal influenza, and requires that flu vaccines be updated annually. HA is the main component of inactivated vaccines, so surveillance monitors antigenic drift of this antigen among circulating strains. Antigenic evolution of influenza viruses of humans appears to be faster than influenza viruses in swine and equines. In wild birds, within-subtype antigenic variation appears to be limited but has been observed in poultry.

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Reasons To Refuse The Vaccine

  • The most common reason across all adults for not getting their flu shot was they were healthy and/or never had the flu .
  • Among adults aged 1864 years with chronic medical conditions, not getting around to the vaccine was the most commonly provided response for not getting the flu shot .
  • Among seniors, concerns about vaccine safety was the most common reason for not receiving the flu shot .

Influenza Estimating Burden Of Disease

During the winter months, seasonal influenza can infect up to 20% of the population, depending on which viruses are circulating, and can cause substantial mortality. A recent study found that worldwide up to 650 000 people die of respiratory diseases linked to seasonal influenza each year, and up to 72 000 of these deaths occur in the WHO European Region.

While it is generally recognized that influenza has a significant economic impact in the form of health-care costs and lost working hours, it is often challenging for countries to estimate the full economic impact of morbidity and mortality from influenza. Furthermore, the burden of influenza will vary year to year, depending upon which viruses are circulating and which people are affected.

Some of the challenges of estimating burden of disease include:

  • the difficulty of distinguishing influenza from other respiratory illnesses without good laboratory testing
  • the fact that much of the morbidity and mortality resulting from influenza is due to complications and infections not unique to influenza, many of which may not be captured in seasonal influenza surveillance data and
  • incomplete and low-quality surveillance data from which estimates are made.

Consequently, there is a need for reliable national disease burden estimates for influenza to:

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Thursday 16 January 2020

The latest Public Health England report published at 2pm on 16 January 2020, shows that seasonal flu continues to circulate across the UK, but there are signs it has peaked.

Over the last week, flu had a low impact on hospital admissions as well as intensive care unit and high dependency unit admissions.

Flu hospitalisation and intensive care admission rates both decreased from 4.33 per 100,000 to 2.43 per 100,000 and 0.36 per 100,000 to 0.21 per 100,000 respectively.

GP consultations with flu-like illness also decreased, from 16.6 per 100,000 to 14.7 per 100,000, but remain above baseline levels.

The report also shows that in week 2, 2020, no statistically significant excess all-cause mortality by week of death had been seen yet overall or by age group in England this season.

Despite the decrease in flu activity, the virus is still circulating in the community and PHE and NHS England are strongly encouraging GPs and pharmacies to continue to vaccinate as many people as possible, as uptake remains lower than last year.

At this stage of the flu season, providers would usually begin to wind down their vaccination efforts.

However, vaccination clinics began later this season due to a delay in the World Health Organizations recommendation on influenza strains and manufacturing delays with the nasal spray for children. All supply issues have now been resolved.

Dr Jamie Lopez Bernal, Head of Flu, Public Health England said:

Thursday 9 January 2019

Friday 3 January 2019

Outpatient Respiratory Illness Activity Map

How COVID hospitalizations compare to worst year for flu infections in recent memory

Data collected in ILINet are used to produce a measure of ILI activity* by state/jurisdiction and Core Based Statistical Areas .

ILI Activity by State/Jurisdiction and Core Based Statistical Area

Activity Level

*Data collected in ILINet may disproportionally represent certain populations within a jurisdiction or CBSA, and therefore, may not accurately depict the full picture of influenza activity for the entire jurisdiction or CBSA. Differences in the data presented here by CDC and independently by some health departments likely represent differing levels of data completeness with data presented by the health department likely being the more complete.

Additional information about medically attended visits for ILI for current and past seasons:

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Seasonal Influenza Vaccination Coverage Survey Results 2019

The Seasonal Influenza Vaccination Coverage Survey is a yearly telephone survey that collects information about the flu shot in Canada. Each flu season, the survey estimates how many people get the flu shot as well as knowledge, attitudes, and beliefs about the flu shot. This year, the participants were also questioned about the sources of information regarding the flu shot.

When To Get The Flu Shot

Flu season typically runs from late fall to early spring.

Flu shots are now available for all Ontarians. You should get a flu shot as soon as possible because it takes two weeks to take effect.

The National Advisory Committee on Immunization now recommends that COVID-19 vaccines may be given at the same time as the flu vaccine.

Talk to your doctor or pharmacy to learn more.

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Research By The University Of Otago Wellington Has Found That Influenza Kills About 500 New Zealanders Each Year Making It Probably New Zealands Biggest Single Infectious Disease Killer

The study, published in the Journal of Infection based on work by Dr Trang Khieu as part of her PhD, found the risk of premature death is much higher for Mori, Pasifika, men and those living in relative poverty.

This is the first time in any country that the distribution of flu deaths has been estimated in relation to ethnicity and social deprivation .

The researchers used a series of quasi-poisson regression models to estimate flu deaths in each population group, because only a small proportion of flu deaths is recognised and recorded on death certificates. The largest numbers of flu deaths are recorded as circulatory conditions such as heart attacks and strokes. In most instances, flu will not even be suspected as the cause, particularly in cases of sudden death.

The study by Trang, Professor Michael Baker and other public health researchers, was based on 15 years of data from 1994 to 2008, prior to the last influenza pandemic .

We found striking inequalities in influenza deaths, showing that its important to target flu vaccination and other interventions to the most vulnerable groups, particularly Mori and Pacific people, men aged 65-79, and those living in the most deprived areas, Baker says.

Photo: Luke Pilkington-Ching

Severe Outcomes Influenza Surveillance


Data on severe outcomes associated with influenza in Canada are reported by participating provincial and territorial ministries of health as well as two sentinel hospital networks: the Immunization Monitoring Program Active network and the Canadian Immunization Research Network’s Serious Outcome Surveillance Network .

PT-SOS comprises of both pediatric and adult influenza hospitalizations from acute care hospitals in nine province and territoriesFootnote 2. CIRN-SOS reports adult influenza hospitalizations and deaths while IMPACT reports pediatric influenza hospitalizations. CIRN-SOS network consist of nine hospitals across four provincesFootnote 3 and the IMPACT network consists of 12 pediatric hospitals across eight provincesFootnote 4.

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Younger Americans Tend To Fall Ill With The Flu More Often

Children younger than five are likeliest to get the flu, as well as to see a doctor about it, followed by older children and adults the CDC notes that adults aged 18 to 64 tend to have lower rates of vaccination. But older Americans, despite being the least likely to get sick, are the most likely to be hospitalized and die.

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