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2009 H1N1 Influenza in Minnesota Epidemiology

2009 H1N1 Influenza in Minnesota Epidemiology. Infectious Disease Epidemiology, Prevention and Control Division PO Box 64975 St. Paul, MN 55164-0975. Number of Hospitalized Cases of Influenza by Influenza Type, Minnesota, October 2008 – April 2010. 2009-2010 Influenza Season

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2009 H1N1 Influenza in Minnesota Epidemiology

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  1. 2009 H1N1 Influenza in Minnesota Epidemiology Infectious Disease Epidemiology, Prevention and Control DivisionPO Box 64975St. Paul, MN 55164-0975

  2. Number of Hospitalized Cases of Influenza by Influenza Type, Minnesota, October 2008 – April 2010 2009-2010 Influenza Season September 1, 2009 – April, 2010 Spring Influenza Surveillance May 1, 2009 – August 31, 2009 2008-2009 Influenza Season October 1, 2008 – April 30, 2009 1st H1N1 hospitalized case

  3. Number of Hospitalized PCR-confirmed 2009 H1N1 Influenza Cases, Minnesota, April 2009 – April 2010 Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb

  4. Cumulative Incidence of Hospitalized PCR-confirmed 2009 H1N1 Influenza Cases, Minnesota, April 2009 - April 2010

  5. Percentage of Outpatient Visits for ILI*, Sentinel Surveillance Sites by Season, Minnesota, September 2007 – April 2010 Fall Wave 2009 Spring Wave 2009 Normal Flu Surveillance October 1 – April 30 *Influenza-like Illness

  6. Number and Percentage of Schools Reporting Outbreaks of ILI*, Minnesota, September 2009 – April 2010 *Influenza-like Illness

  7. Number and Percentage of Culture-Confirmed Influenza Specimens, Minnesota Virology Laboratories, September 2007 – April 2010

  8. Number and Percentage of Positive Influenza Rapid Test Results, Minnesota Rapid Testing Sites, September 2007 – April 2010

  9. Circulating Respiratory Viruses, Laboratory Influenza Surveillance Program, Minnesota, October 2009 – April 2010

  10. Number and Incidence of Hospitalized PCR-confirmed 2009 H1N1 Influenza by Age Group, Minnesota, April 2009 – April 2010

  11. Number of Cases Incidence per 100,000 26.2 259 45 43.2 104.2 140 83 1,179 68.0 73.9 White Black Native American Hispanic Asian Number and Incidence of Hospitalized PCR-confirmed 2009 H1N1 Influenza Cases by Race/Ethnicity,Minnesota, April 2009 – April 2010

  12. Spring Wave Fall Wave Proportion of Hospitalized PCR-confirmed 2009 H1N1 Influenza Cases by Race/Ethnicity,Minnesota, April 2009 – April 2010

  13. Median Age of Hospitalized PCR-confirmed 2009 H1N1 Influenza Cases by Race/Ethnicity,Minnesota, April 2009 – April 2010

  14. Incidence of Hospitalized PCR-confirmed 2009 H1N1 Influenza by Week, Minnesota, April 2009 – April 2010 “Fall Wave” “Spring Wave” Smoothed lines

  15. Northwest 18 Central 280 West Central 57 Todd Douglas Grant 71 t Hennepin Southeast 156 South Central 92 Dodge Olmsted Steele Martin Faribault Number of Hospitalized PCR-confirmed 2009 H1N1 Cases by District of Residence, April 2009 – April 2010 Northeast 129 Metro 1025 Southwest 67

  16. Incidence of Hospitalized PCR-confirmed 2009 H1N1 Influenza by District of Residence,Minnesota, April 2009 – April 2010

  17. Incidence of Hospitalized PCR-confirmed 2009 H1N1 Influenza by District of Residence and Wave, Minnesota, April 2009 – April 2010

  18. Hospitalized PCR-confirmed 2009 H1N1 Influenza Cases by Age Group and Presence of Underlying Medical Conditions, Minnesota, April 2009 – April 2010

  19. Underlying Medical Conditions of Hospitalized PCR-confirmed 2009 H1N1 Influenza Adult (≥ 18 yrs.) Cases, Minnesota, April 2009 – April 2010

  20. Underlying Medical Conditions of Hospitalized PCR-confirmed 2009 H1N1 Influenza Pediatric (<18 yrs.) Cases, Minnesota, April 2009 – April 2010

  21. Proportion of Hospitalized PCR-confirmed 2009 H1N1 Influenza Cases Admitted to ICU by Age Group and Presence of Underlying Medical Conditions, Minnesota, April 2009 – April 2010 19% All Cases

  22. Proportion of Hospitalized PCR-confirmed 2009 H1N1 Influenza Cases Requiring Mechanical Ventilation by Age Group and Presence of Underlying Medical Conditions, Minnesota, April 2009 – April 2010 10% All Cases

  23. Proportion of Hospitalized PCR-confirmed 2009 H1N1 Influenza Cases Diagnosed with Pneumonia by Age Group and Presence of Underlying Medical Conditions,Minnesota, April 2009 – April 2010 37% All Cases

  24. Proportion of Hospitalized PCR-confirmed 2009 H1N1 Influenza Cases with Bacterial Co-Infection* by Age Group and Presence of Underlying Medical Conditions, Minnesota, April 2009 – April 2010 1.6% All Cases *Cultural confirmation of a bacterial pathogen from sterile site within 3 days of admission.

  25. Number and Percentage of Female Hospitalized PCR-confirmed 2009 H1N1 Influenza Cases Ages 13-49 Who Were Pregnant, Minnesota, April 2009 – April 2010

  26. Hospitalized PCR-confirmed 2009 H1N1 Influenza Cases in Minnesota: Summary From April 1, 2009 to April 30, 2010: 1,824 hospitalized PCR-confirmed 2009 H1N1 Influenza cases; 1,564 since September 1, 2009 • In Spring wave: • Median age, 11.8 years • 17% in ICU • 81% Cases from Metro Area • In Fall wave: • Median age, 26.5 years • 20% in ICU • 52% Cases from Metro Area • Pregnancy among hospitalized women 13 - 49 years of age: • 17% (of 384)

  27. Number of Deaths Related to Influenza A, Minnesota, April 2009 – April 2010 67 Deaths Related to Influenza A • 63 2009 H1N1 Influenza • 4 Influenza A, Not Subtyped • 55 Hospitalized • 12 Non-hospitalized

  28. Deaths Related to Influenza A by Wave and Age Group,Minnesota, April 2009 – April 2010

  29. Deaths Related to Influenza A by Race/Ethnicity, Minnesota, April 2009 – April 2010(63=2009 H1N1; 4=unspecified Influenza A)

  30. 13 Metro 12 Northeast 11 Northwest 10 South Central 9 Southeast 8 Southwest 7 Number of Deaths Central 6 West Central 5 4 3 2 1 23 26 9 24 25 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 1 2 51 52 Jun Jul Aug Sep Oct Nov Dec Jan Mar Week of Collection Influenza A Deaths in Minnesota by Week of Collection, (N=67) Minnesota, April 2009 – April 2010

  31. Influenza A Crude Death Rates by District of Residence, Minnesota, April 2009 – April 2010(63=2009 H1N1; 4=unspecified Influenza A) *All 4 deaths in spring wave occurred in Metro district residents

  32. Deaths Related to Influenza A by Age Group and Presence of Underlying Medical Condition(s), Minnesota, April 2009 – April 2010 (63=2009 H1N1; 4=unspecified Influenza A)

  33. Underlying Medical Conditions among Deaths Related to Influenza A, Minnesota, April 2009 – April 2010(63=2009 H1N1; 4=unspecified Influenza A)

  34. BMI of Adult Deaths Related to Influenza A, Minnesota, April 2009 – April 2010(55=2009 H1N1; 4=unspecified Influenza A)

  35. Clinical Outcomes of Deaths Related to Influenza A by Age Group, Minnesota, April 2009 – April 2010(63=2009 H1N1; 4=unspecified Influenza A)

  36. Bacterial Co-Infections in Deaths Related to Influenza A, Minnesota, April 2009 – April 2010(63=2009 H1N1; 4=unspecified Influenza A) *Non-sterile sites include sputum, endotracheal aspirate, lung tissue, and stool **Stenotrophomonas maltophilia, Enterobacter cloacae, Staphylococcus saprophyticus, Staphylococcus coagulase negative, Enterococcal sepsis, Moraxella catarrhalis, Group A Streptococcus, Escherichia coli, VRE

  37. Summary of Deaths Related to Influenza A, Minnesota, April 2009 – April 2010 In Spring wave • 4 deaths (all PCR-confirmed 2009 H1N1) • 2 in children; 1 in an adult age 65 or older • 1 with no underlying conditions • 100% 7-county MSP area In Fall wave • 63 deaths (59 2009 H1N1, 4 Influenza A-type unspecified) • 6 in children; 12 > 65 y • 7 no underlying conditions • 41% (26/63) 7-county MSP area

  38. For More Information Please Contact: Minnesota Department of Health Acute Disease Investigation and Control 651-201-5414 1-877-676-5414 www.health.state.mn.us

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