Director’s Update Brief

Friday

05 JUN 2009 1100 EDT

Day 48

The Week of IPRs

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Situation Awareness

05 JUN 2009

•

Severe Weather:

– No cyclone activity, any region
– Large fire in McGrath, Alaska 41% contained
– Severe thunderstorms possible across most of the West and

Upper Midwest

– Flooding possible in the Middle Atlantic Region

(FEMA Daily Report 4 June 2009)

•

Recalls:

– In-shell pistachios possibly contaminated with

Salmonella

(FDA Recall Report 4 June 2009)

•

Polio (Wild Type)

– Asia (UPDATE) -10 new cases

– Africa (UPDATE) - 21 new cases

(GDD Ops Center Daily Report 4 June 2009)

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Key Events

Novel Influenza A (H1N1) 05 JUN 2009

•

Novel Influenza A (H1N1) Declarations

–

WHO: Pandemic Phase 5 (29 Apr 1600 EDT)

–

USG: Public Health Emergency declared (26 Apr 2009)

–

HHS: Downgraded to Phase 1 – Awareness (9 May 2009)

•

International Cases: 19,273 confirmed cases in 66 countries*

–

4 new countries: Bulgaria, Lebanon, Egypt, Nicaragua

•

Deployments: 9

•

US Cases: As of 05 JUN 2009 0100 EDT (all states reporting cases)

Cases

Hosp

Deaths

13,217

1,027

27

52

41

10

SLTTs AFFECTED

US TOTALS

CASES

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Epidemiology/Surveillance

Descriptive Statistics of Novel Influenza A (H1N1) Cases Reported to CDC

by States-As of 05 JUN 2009 1100 EDT (n=13,217)

•

Secondary attack rate in household contacts:

– ARI—19%

– ILI—12%

•

Generation time:

– ARI—2.0-3.1 days

– ILI—2.4-3.1 days

•

Hospitalizations: 1,027 (7.8%)

•

Deaths: 27 (0.20%) in 10 states

Epidemiology/Surveillance

Number of Novel Influenza A (H1N1) Cases Reported to CDC by State

As of 05 JUN 2009 1100 EDT (n=13,217)

200-400

51-200

1-50

0

400-1000

>1000

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Epidemiology/Surveillance

Confirmed and Probable Novel Influenza A (H1N1) Cases by Report Date

As of 05 JUN 2009 1100 EDT (n=13,217) (Weekly*)

*Data for week ending 06 JUN 2009 include reports submitted between 5/31/2009 0001 EDT and 6/04/2009 1159 EDT

0

0

5

19

915

2,144

1,879

1,710

3,289

3,164

0

500

1000

1500

2000

2500

3000

3500

4000

28

-M

ar

4-

Ap

r

11

-A

pr

18

-A

pr

25

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pr

2-

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ay

9-

M

ay

16

-M

ay

23

-M

ay

30

-M

ay

6-

Ju

n

Week Ending Date

C

a

se

s

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-Sensitive But Unclassified (SBU) 7

*Data for week ending 06 Jun 2009 include reports submitted between 8:00 AM EDT 5/31/2009 and 5:00 PM 6/04/2009.

3

2

1

51

65

83

114

336

374

0

50

100

150

200

250

300

350

400

11

-A

pr

18

-A

pr

25

-A

pr

2-M

ay

9-

M

ay

16

-M

ay

23

-M

ay

30

-M

ay

6-

Ju

n

Week Ending Date

H

o

s

p

it

a

li

z

a

ti

o

n

n

Epidemiology/Surveillance

Confirmed and Probable Novel Influenza A (H1N1) Hospitalizations

by Report Date

As of 05 JUN 2009 1100 EDT (n=1,027) (Weekly*)

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Epidemiology/Surveillance

Confirmed and Probable Novel Influenza A (H1N1) Cases by Age

Data reported as of 05 JUN 2009 1100 EDT (n=13,217)

1,265

7,502

2,327

98

2,025

0

1000

2000

3000

4000

5000

6000

7000

8000

C

o

n

fi

rm

e

d

a

n

d

P

ro

b

a

b

le

C

a

s

e

s

0-4 Yrs

5-24 Yrs 25-64 Yrs

≥65 Yrs Unknown

Age Groups

10%

57%

18%

1%

15%

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Epidemiology/Surveillance

Confirmed and Probable Novel Influenza A (H1N1) Hospitalizations by Age

Data reported as of 05 JUN 2009 1100 EDT (n=1,027)

184

421

353

39

30

0

50

100

150

200

250

300

350

400

450

500

C

o

n

fi

rm

e

d

a

n

d

P

ro

b

a

b

le

C

a

se

s

0-4 Yrs

5-24 Yrs 25-64 Yrs

≥65 Yrs Unknown

Age Groups

41%

34%

4%

3%

18%

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Confirmed and Probable Novel Influenza A (H1N1) Deaths by Age

Data Reported as of 05 JUN 2009 1100 EDT (n=27)

3

6

17

1

0

0

2

4

6

8

10

12

14

16

18

20

C

o

n

fi

rm

e

d

a

n

d

P

ro

b

a

b

le

C

a

s

e

s

0-4 Yrs

5-24 Yrs

25-64 Yrs

≥65 Yrs Unknown

Age Groups

61%

4%

0%

States:

AZ - 4

CT - 1

IL - 5

MI - 1

MO - 1

NY – 8*

TX - 3

UT - 2

VA - 1

WA - 1

*7 in NYC

63%

22%

11%

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International

Novel Influenza A (H1N1) 05 JUN 2009

•

WHO global case count

: 19,273 confirmed cases in 66 countries*

–

4 new countries with confirmed cases in last 3 days:

Bulgaria, Lebanon, Egypt, Nicaragua

• Case in Egypt is 1

st

in Africa (12 yo American girl visiting family)

–

Novel flu activity in North America:

•

Mexico

: 5,029 confirmed cases and 97 deaths (= in last 3 days)

– Update on Mexico novel H1N1 in this week’s MMWR

» Outbreak likely peaked nationally in late April, although

localized transmission continues to occur

•

Canada

: 1,530 ( 194 in last 3 days)

– Recent jump (~600 cases this week) is primarily from Ontario

» Recent community transmission (latest onset 5/27) plus a

testing backlog of cases contributing to rise

•

*Note: WHO case counts are current as of 06/05/09, 6:00 am EDT.

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• 18 schools closed due to H1N1 in 6 states today: FL, MA, NJ, NY, PA, and TX
• The closures impacted 6520 students and 542 teachers
• 3 schools reopened in MA, NJ, and NY affecting 2841 students and 232 teachers

Source: ED and CDC Confirmed School Closing Reports released each weekday at 2:00pm

169,000

245,449

6520

8058

11186

468,282

9662

9628

8075

55,765

13933

49,893

42052

4838

61697

118,033

197,985

369,237

329,834

104

298

433

533

726

589

318

166

5

13

24

36

60

78

32

29

14

18

17

22

17

18

75

0

50000

100000

150000

200000

250000

300000

350000

400000

450000

500000

28

-A

pr

29

-A

pr

30

-A

pr

1-

M

ay

4-

M

ay

5-

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ay

6-

M

ay

7-

M

ay

8-

M

ay

11

-M

ay

15

-M

ay

18

-M

ay

19

-M

ay

20

-M

ay

21

-M

ay

22

-M

ay

26

-M

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27

-M

ay

28

-M

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29

-M

ay

1-

Ju

n

2-

Ju

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3-

Ju

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4-

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Date

S

tu

d

en

ts

A

ff

e

ct

ed

(

R

e

d

)

-100

100

300

500

700

900

1100

1300

1500

S

c

h

o

o

ls C
lo

s

ed
(B

lu

e)

Students Affected

Schools Closed

4/28

School

dismissal

(7 days)

5/1 School

dismissal
(14 days)

5/5 School

dismissal

rescinded

Division of Global Migration and Quarantine

Novel Influenza A (H1N1) - 05 JUN 2009

School Dismissal, United States, 4/29 – 6/4, 2009

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Communications Summary

Novel Influenza A (H1N1) – 05 JUN 2009

Channel Traffic

•

Communication trends fluctuate up and down. Since 2 June:

– Web page views are

up

– Public calls, e-mails, and clinician calls to CDC-INFO

up

– Print-Internet stories slightly

up

– Twitter traffic is

flat

– Media inquiries are

flat

Major Themes

•

TV news stories dominated by local events

•

Print/Internet stories focus on:

– “Swine flu” deaths reported in WI, CA, IL

– “Barbados confirms 1st swine flu case”

– Dozens of countries banning pork imports from U.S.