Centers for Disease Control and Prevention

• Ted Cieslak COL MC USA, Department of Defense Liaison Officer
• 50 pages
• For Official Use Only
• Sensitive But Unclassified
• September 22, 2009

Pandemic Influenza in the Past

• Past Pandemics
• 1918 (H1N1)
• 40-50 million deaths, 500K in US
• 1957 (H2N2)
• 2 million deaths, 70K in US
• 1968 (H3N2)
• 1-4 million deaths, 34K in US

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U.S. Military Laboratory-Based Influenza Surveillance

• Sentinel Site Surveillance
• Through USAFSAM, Brooks City Base TX
• Hospital & Clinic-Based
• Recruit Training Surveillance
• Through NHRC, San Diego CA
• Overseas Surveillance
• Through NAMRUs, other labs

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Response to H1N1
• Strategic National Stockpile
• Distributed 25% pro rata supply
• Enhanced Surveillance Initiated
• PCR panH1N1 kits for testing
• Development at CDC, EUA at FDA, manufacture at ATCC, and ready to ship in ~ 2.5 weeks
• Distributed Kits, so far:
• Domestic: 95 labs
• DOD: 15 labs
• International: >250 labs in 140 countries
• Virus Characterization
• >1000 genes sequenced from >260 viruses
• Submitted to GenBank

…

H1N1 “Current” Status

• Lab-Confirmed Cases
• 44,317 total cases when reporting stopped in July
• 8,842 hospitalized
• 555 deaths
• Represents approximately 3 M cases
• Overall activity has declined since schools closed, but focal areas of activity have increased
• Viruses in US and Internationally show no evidence of significant genetic/antigenic change

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• Disease likely persists through summer in US, possible surge in late August when school returns
• Monitor closely for genetic and antigenic virus changes
• Expected higher attack rate (20-30%) than in spring (6-15%), notably affecting younger individuals
• Vaccine availability possibly mid October, Federal funds for distribution and administration are available
• Healthcare facility support in part from HPP grants
• SNS Antiviral stocks likely to be distributed
• Drifted H3N2 may co-circulate with novel H1N1

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