Public Health Update

Ulyee Choe, DODirector, Florida Department of Health in Pinellas

February 10, 2020

Influenza

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What is Influenza?• Acute respiratory disease caused by

influenza virus

• Transmitted through respiratory droplets

• Incubation period: 1-4 days

• Peak shedding: 1 day before onset of symptoms up to 3 days after

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Symptoms • Acute symptoms persist for 2-7 days

• Malaise and cough may continue for 2 weeks or longer

• Complications include pneumonia, sinus or ear infections, inflammation of the heart (myocarditis), brain (encephalitis) or muscle tissues (myositis, rhabdomyolysis), and possible death

• Influenza-like illness (ILI):• Fever over 100.4°F, cough and/or

sore throat

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Cold or Flu?

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Treatment • Treatment with antiviral medication within the

first 48 hours of the onset of symptoms to be most effective

• Lessens symptoms and can shorten illness duration

• Prevents flu complications including pneumonia

• Other FDA approved antiviral drugs include:• Zanamivir (Relenza)• Peramivir (Rapivab)• Baloxavir marboxil (Xofluza)

ANTIBIOTICS ARE NOT AN EFFECTIVE TREATMENT FOR INFLUENZA!

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Vaccination • Everyone 6 months and older needs a flu vaccine annually

• Should be received early in the season• As long a flu is circulating, vaccination is recommended

• Flu vaccine prevents millions of illnesses and flu-related doctor’s visits each year

• Flu vaccine can be life-saving in children• A 2017 study, which looked at data from four flu seasons between 2010 and 2014, found

that flu vaccination reduced the risk of flu-associated death by half (51%) among children with underlying high-risk medical conditions and by nearly two-thirds (65%) among healthy children.

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• 2019-2020 Influenza Vaccine: • A/Brisbane/02/2018 (H1N1)pdm09-like virus (updated)• A/Kansas/14/2017 (H3N2)-like virus (updated)• B/Colorado/06/2017-like (Victoria lineage) and B/Yamagata virus

• Flu vaccine effectiveness estimates are not available yet this season, but vaccination is always the best way to prevent flu and its potentially serious complications

• In general, current flu vaccines tend to work better against influenza B and influenza A(H1N1) viruses and offer lower protection against influenza A(H3N2) viruses

Influenza Vaccine

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• Influenza is unpredictable

• The US experiences annual epidemics of seasonal flu

• Flu viruses are constantly changing so it’s not unusual for new flu viruses to appear each year

• Seasonal flu activity begins as early as October and November and can continue to occur as late as May; Typically peaks in the US between December and February

Flu Activity

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2019-2020 Flu Activity in the US

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2019-2020 Influenza Season – Florida

• Florida is currently reporting widespread flu activity

• Influenza A 2009 (H1N1) activity increased notably in recent weeks and overtook influenza B Victoria lineage as the most common strain so far this season• Both are included in the quadrivalent vaccine offered this season

• Seven influenza-associated pediatric deaths have been reported in Florida so far this season, all in unvaccinated children

• Influenza activity is estimated to remain elevated for several more weeks

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• Pinellas County is currently reporting moderate influenza activity

• Influenza A is the most common strain circulating at this time

• 83% of positive ELR results

• Emergency Department (ED) visits related to Influenza-like Illness (ILI) are currently higher than expected (Figure 1)

2019-2020 Influenza Season Pinellas County

Figure 1: Percentage of ED Visits for ILI for Facilities Participating in ESSENCE-FL (n=16), Pinellas County, Week 40, 2015 through Week 5, 2020

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Surveillance Reports

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Prevent the Spread of Flu

• Get vaccinated!• Wash your hands often• Stay home if you are sick• Cover your cough or sneeze • Avoid touching your eyes, nose, and mouth

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CDC https://www.cdc.gov/flu/index.htm

Florida DOH http://www.floridahealth.gov/diseases-and-conditions/influenza/index.html

References

Partner Institutions

FactorsInfluencing

Health

Health Impact Pyramid

Internal Infrastructure

Emphasize collaborative engagement among community institutions to address the community's social determinants of health.

Objective: Increase Cross Sector Collaborations

Approach: Form Jurisdictional Working Groups Organize and utilize HiAP jurisdictional working groups within Pinellas Park, St. Petersburg, and Pinellas County governments to discuss solutions for local health barriers and disparities.

Maximize the positive health and equity effects and minimize the potentially unforeseen negative health and equity effects of proposed policies, plans, projects, and/or programs.

Objective: Reduce Health Barriers and PreventHealth Disparities

Approach: Incorporate Health Considerations into Decision-Making Processes

Prevent health-dissuading environments and make the healthy choice the most easily accessible choice.

Decision Support Tools

Assessments created and customized by the HiAP team to analyze the health and equity impacts of different policies, plans, projects, and/or programs

Resolutions and Executive Orders Establishing HiAP

Pinellas Park HiAP Resolution Pinellas County HiAP Resolution

St. Petersburg HiAP Resolution St. Petersburg HiAP Executive Order

Resolutions and Executive Orders Establishing HiAP

Health Impact Assessments (HIA)

St. Petersburg HIA Pinellas County HIA Pinellas Park HIA

Other Applied Health and Equity AssessmentsHealth Planning Matrix

Health Lens Analysis

Health Consultations

- Pinellas County Planning Department's Comprehensive Plan- City of St. Petersburg Economic Development Department's Commercial Revitalization Grant Program- City of St. Petersburg Transportation Department's 28th Street Trail Development

- City of Pinellas Park Community Redevelopment Agency's Community Redevelopment Plan

Health Note- City of Pinellas Park Planning & Development Services Department's Visibility Triangle Ordinances- City of St. Petersburg Transportation Department's Complete Streets Implementation Plan

- Pinellas County Administration on Municipal Tax Service Unit Funding- City of St. Petersburg Office of Urban Affairs' Healthy Neighborhood Plan- City of St. Petersburg Office of Sustainability's GreenLink Analysis of Utility Burden- City of St. Petersburg Planning & Development Services Department's Vision 2050 Planning Process and Coastal High Hazard Land Development Regulations

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Ulyee Choe, DOulyee.choe@flhealth.gov727-824-6921

Contact Information

Questions?