San Antonio Metropolitan Health District H1N1 Update to Community Providers
The following snapshot influenza information is provided as a service from the San Antonio Metropolitan Health District. Metro Health has received anecdotal reports that children with conditions such as asthma and other chronic conditions putting them at risk may not have been vaccinated either by the school or by their physicians for a variety of reasons. We mention this to raise awareness and remind the schools and physicians to send reminder notices to the parents. Most ISDs do not plan to provide a second dose of H1N1 to the young children and local providers should expect to see patients requesting second doses of vaccine where the first was provided at school.
Physicians who have vaccine should continue to immunize their high risk patients to ensure they are protected in a timely manner. Vaccine availability for school-based immunization clinics is currently very limited. School clinics and other community providers should consider using the Live Attenuated Influenza Vaccine (LAIV) when possible, as it presently is in abundance, and can be used very safely within the recommended age parameters and exclusion criteria. If local physicians have excess vaccine they no longer need, please make arrangements to transfer to Metro Health. For additional information call our Flu Hotline at 210-207-5779.
NATIONAL Snapshot
2009-2010 Influenza Season Week 48 ending December 5, 2009
During week 48 (November 29 — December 5, 2009) influenza activity continued to decrease in the U.S. and seasonal influenza A (H1N1) and influenza B viruses co-circulated at low levels with 2009 influenza A (H1N1) viruses. Over 99% of all subtyped influenza A viruses reported to CDC this week were 2009 influenza A (H1N1) viruses.
From August 30 – December 5, 2009 there were 33,490 laboratory-confirmed influenza-associated hospitalizations and 1,445 laboratory-confirmed influenza-associated deaths reported to CDC. However, CDC now estimates that between 7,079 and 13,930 H1N1-related deaths occurred between April and November 14, 2009 in a report released December 10, 2009. CDC will continue to use its traditional surveillance systems to track the progress of the 2009-10 influenza season.
Since August 30, 2009, CDC has received 204 reports of influenza-associated pediatric deaths that occurred during the current influenza season (37 deaths in children less than 2 years old, 21 deaths in children 2-4 years old, 76 deaths in children 5-11 years old, and 70 deaths in children 12-17 years old). One hundred sixty-five (81%) of the 204 deaths were due to 2009 influenza A (H1N1) virus infections, and the remaining 38 were associated with influenza A virus for which the subtype is undetermined. A total of 224 deaths in children associated with 2009 influenza A (H1N1) virus infection have been reported to CDC.
TEXAS Snapshot
The influenza (flu) activity level for Texas for Week 48 ending December 5, 2009 was “regional.” Reports were received from all Health Service Regions (HSRs) for week 48. HSRs reported a mixture of activity from ranging from increases in some regions, decreases in others, and some reporting the same level of activity as compared to week 47. No school closures or institutional outbreaks were reported during week 48. There have been 1,994 hospitalizations and 187 deaths in Texas due to influenza from April 15 through December 5, 2009. In addition, Texas has reported 34 cases of influenza-associated pediatric deaths during this period (2 deaths in children less than 6 months of age, 5 deaths in children 6 months to less than 12 months of age, 6 deaths in children 1-4 years old, 6 deaths in children 5-9 years old, and 15 deaths in children 10-18 years old).
SAN ANTONIO/BEXAR COUNTY Snapshot
Surveillance indicators for this past week showed activity remaining stable over the past week for influenza like activity in Bexar County. We expect to see additional increases as we approach the traditional rise in seasonal influenza during the next several weeks. As of December 14, 2009, twenty-one (21) deaths due to any type influenza including H1N1 influenza virus have been reported in Bexar County. Since August 30, 2009, Bexar County and Metro Health have reported 2 cases of influenza-associated pediatric deaths (1 death in a child 6 months to 11 months of age and 1 death in a child 10-18 years of age).
Metro Health continues to support the local independent school districts (ISD) as some initiate vaccination clinics and others continue their operations that began last week. All of the ISDs continue to plan for future vaccination events based on the availability of vaccine. Current ISD vaccination events occurring during the week of December 14-18 include those being implemented in South San ISD, East Central ISD, Somerset, Northside ISD, SAISD, Edgewood ISD, Harlandale ISD, and Northeast ISD. These 8 ISDs will host 55 separate events this week. From December 1, 2009 to December 18, 2009 there have been approximately 162 school events planned or conducted with over 30,000 doses provided to the ISDs. Most school districts continue vaccinating elementary and/or other high risk children, while others continue with middle school students. The last clinics planned for 2009 will be held Friday December 18. Vaccination efforts will begin again in January 2010 and we will continue to support schools providing vaccine to the remainder of their school population.
Community immunizations events on a large scale such as at the Alamodome are on hold until a sufficient supply of H1N1 vaccine is provided to Metro Health by the state. Many healthcare providers and several pharmacies in Bexar County currently have supplies of H1N1 vaccine and are providing immunizations to patients.
A conference call with ISDs was conducted on December 11, 2009 at 3:30pm by Dr. Bryan Alsip, Assistant Director of Health, to recap activities to date, outline expectations for future events based on vaccine availability, and to address any issues that had been discovered over the past week with the school vaccination efforts. Schools are encouraged to provide feedback and request assistance as the situations dictate.
As of December 10, 2009, the state has reportedly shipped over 441,807 doses to medical providers in Bexar County. Please check with your primary care provider regarding availability.
