IHS Clinical Rounds What’s New with Flu? September 18 th , 2014

1. IHS Clinical Rounds What’s New with Flu?September 18th, 2014 Amy V. Groom, MPH IHS Immunization Program Manager Amy.Groom@ihs.gov

2. Acknowledgements • DEDP Influenza team • Cheyenne Jim • Deborah Summons • Larry Layne

3. Overview • 2013-2014 Influenza Season • Recap of the IHS 2013-2014 Influenza Season • IHS Influenza Awareness System Reports for 2014-2015 • Update from the IHS National Supply Service Center

4. 2013-2014 Influenza Season • Influenza-like-illness activity peaked late December • Predominantly H1N1 • First season since 2009 where H1N1 predominated • Lower levels of outpatient illness and mortality than influenza A (H3N2)–predominant seasons • 60% of hospitalizations occurred in adults 18-64 years • 107 Pediatric deaths • Lower than the previous season • 2009-2010 Pandemic – 282 deaths Influenza Activity — United States, 2013–14 Season  http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6322a2.htm?s_cid=mm6322a2_w

5. CDC weekly Influenza Surveillance report

6. CDC Weekly Influenza Surveillance report

7. Recap of the 2013-2014 Influenza Season for IHS

8. IHS Influenza Awareness System Reporting2013-2014

9. All IHS Areas Influenza-Like Illness (ILI) All Surveillance Years - Continuous Percentage of Visits for ILI per week 04/26/09 to 09/06/14 Percentage of ILI visits is number of ILI visits divided by total number of daily visits.

10. Proportion of Outpatient Visits for Influenza-Like Illness (ILI) Percent ILI for FluYear 2013 - 2014 ILINet vs. IIAS 09/29/13 to 09/06/14 Percentage of ILI visits is number of ILI visits divided by total number of daily visits (outpatient visits). The horizontal line represents the 2013-2014 baseline. The baseline is the mean percentage of patient visits for ILI during non-influenza weeks for the previous three seasons plus two standard deviations. Sources: ILINet - CDC Sentinal Surveillance System for Influenza-Like Illness, IIAS - IHS Influenza Awareness System

11. All IHS Areas Influenza-Like Illness (ILI) for All Surveillance Years Percentage of Visits for ILI per week 01/04/09 to 09/06/14 All IHS Areas Influenza-Like Illness (ILI) for All Surveillance Years Percentage of Visits for ILI per week 01/04/09 to 09/06/14 Percentage of ILI visits is number of ILI visits divided by total number of daily visits. The horizontal line represents the 2013-2014 baseline. The baseline is the mean percentage of patient visits for ILI during non-influenza weeks for the previous three seasons plus two standard deviations.

12. Influenza Like Illness by IHS Region2013-2014 Influenza Like Illness by IHS Region2013-2014

13. Influenza Like Illness by IHS Region2013-2014

14. IHS Influenza Vaccine Coverage for 2013-2014

15. IHS Influenza Vaccine Coverage1 dose, All Ages (> 6 months) IHS Influenza Awareness System (IIAS) vs. Quarterly Immunization Package reports from RPMS

16. IHS Influenza Vaccine Coverage2013 - 2014 IIAS – IHS Influenza Awareness System; RPMS – RPMS Quarterly Immunization Report

17. IHS Influenza Vaccine Coverage by IHS Area2013-2014

18. IHS Healthcare Personnel (HCP) Influenza Vaccination Coverage IHS Influenza Vaccine Coverage reports available at: www.ihs.gov/flu

19. HCP Influenza Vaccine Coverage by Area2013-2014 * Tucson Area did not report

20. IHS Influenza Awareness SystemReports

21. NEW IIAS PATCH 29 • The IIAS software is included as part of the RPMS PCC Management Reports Application (APCL) • Version 3.0, Patch 29 was released on 8/7/2014 • Loading of this patch is required to meet MU Stage 2 and EHR certification requirements

22. Weekly IIAS Reports • Proportion of visits with ILI • National and Area, by flu season and cumulatively • Map of ILI by Area • New: National IHS vs. CDC ILINet • Influenza vaccine doses administered, by CVX code • National and Area • Cumulative influenza vaccine coverage – age group, Active and User population • National and Area • Number of exporting databases and facilities • National • Name and Number of exporting databases and facilities • Area

23. Influenza Vaccines in RPMS * Pending – BI Patch 9

24. New Flu Vaccine Code - 161 • On 7/21/14, CDC added a new CVX code for the pediatric preservative-free quadrivalent inactivated influenza vaccine for use in children 6 – 35 months • FluZone quadrivalent by Sanofi Pasteur, 0.25 ml syringes • This code is currently NOT in the RPMS Vaccine Table • Will be in RPMS Immunization Package Patch 9 to be released by the end of September • Flu-PEDIV4 • Until the new code is added, sites using this product can use CVX code 150 to document, and change the volume to 0.25ml

25. Resources • IHS Influenza Website – www.ihs.gov/flu • National IIAS reports posted weekly under “IHS Influenza Surveillance Reports” • Area Flu points of contact to request facility reports and guidance on IIAS exports, under “Facility Data Exports and Reports” • Resources, webinars under “Educational Resources” • CDC Influenza Website – www.cdc.gov/flu • Influenza vaccine and Antiviral treatment recommendations • FluView – weekly influenza surveillance reports • Free resources Print materials, PSAs, eCards, etc.