Nicole Schlaefli, MPH Epidemiologist Health Data and Evaluation

1. Influenza Season, Tulsa County 2012-2013 Nicole Schlaefli, MPH Epidemiologist Health Data and Evaluation

2. Influenza vs. Cold Influenza Common Cold Runny/Stuffy Fever Watery Mucous (Day 1-3) Thicker, may be colored (3-10) Slight to no fever Sneezing Drainage Cough Lasts 3-7 days • Sudden Onset • Fever/Fatigue • Dry cough/sore throat • Runny Nose • Body/head aches • Lasts 3-7 days, • week recovery time Vomiting and Diarrhea are more common in children than adults Health Data and Evaluation

3. Influenza • Contagious respiratory illness caused by influenza specific viruses • A/B strains A has high likely hood of mutation • 3 strains per vaccine year 2012-2013: A(H1N1), A(H3N2), B • At most risk are: older adults, young children, and persons considered to be immunocompromised, 65 and over High risk individuals: diabetic, emphysema/COPD/chronic bronchitis, heart disease/angina/coronary heart /endocarditis, cancer within last 12 mos, kidney disease diagnosis within last 12 mos or asthma attack in last 12 mos

4. How Flu Spreads • Influenza can cause mild to severe illness • At times can lead to death • Propagated Transmission • Person to person within 6 ft. • Heavy droplets made when person coughs, sneezes, or talks • Surface transmission: Touching objects with virus on them • Infectivity • Symptoms start 1-4 days after virus has entered body • Adults contagious day before symptoms start • Contagious while experiencing symptoms

5. Health Department Surveillance • “Flu Season” October 1 through March 31 • 2012-2013: Sept 30 – March 30 • Outpatient visits from Sentinel Sites • The percentage of outpatient visits meeting the criteria for ILI was 4.9% (225/4,594). • The northwest, southeast, central, Tulsa County, and Oklahoma County regions had a percentage of patients meeting the ILI criteria that was at or above the 3.5% baseline. • Lab Reporting • 132 (21.2%) of the 623 rapid influenza tests performed by sentinel laboratories were positive for influenza; 52 (39%) were positive for influenza A, and 80 (61%) were positive for influenza B. • Since September 30, 2012, 84% specimens tested by the OSDH PHL by PCR were positive for influenza. • 79% positive for influenza A (H3), 3% positive for influenza A 2009 (H1), and 17% specimens were positive for influenza B. Health Data and Evaluation

6. Past vs. Present Flu Season Peak Month of Flu Activity 1982 - 2012

7. Prevention Health Data and Evaluation

8. Hand Hygiene Health Data and Evaluation

9. Hand Hygiene Health Data and Evaluation

10. Respiratory Hygiene • Cover your mouth and nose with a tissue when you cough or sneeze • Put used tissues in the wastebasket • Always try to cough or sneeze into your elbow • Wear a facemask to protect others • Wash your hands after! Health Data and Evaluation

11. Flu vaccine • Shot is recommended for everyone over 6 months • Especially high risk individuals- people with medical conditions such as asthma, diabetes, and chronic lung disease, pregnant women, and people 65 years and older • Protects against 3 different influenza virus strains • According to early reports, the vaccine is ~73% effective this year • Slightly lower than last year at 78-83% • Takes ~2 weeks to develop immunity after receiving the shot

12. Treatment Options • You may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick • Stay home when sick & avoid sick people • Anti-Virals • Oseltamivir (Tamiflu) • Zanamivir (Relenza) • Benefits of Anti-Viral Treatment • Lessen duration of illness 1-2 days • Lessen Symptoms • Prevent Serious Side Effects & Complications Health Data and Evaluation

13. Contact Information: Tulsa City County Health Department 918-582-9355 Nicole Schlaefli, MPH Epidemiologist Health Data and Evaluation 918-595-4096 nschlaefli@tulsa-city.org Health Data and Evaluation