H1N1 Pandemic Year In Review

April 2009 - February 2010

History and Planning:

2001 – Winnebago County Health Department (WCHD) receives a state grant to develop a

bio-agent preparedness plan alongside community partners.

2004 – WCHD receives national recognition as “Project Public Health Ready” through

NACCHO (one of only 11 health departments nationwide to receive first round certification).

2006 – Pandemic Influenza Plan developed (one of the first state-wide).

2008 – Pandemic Influenza Plan expanded to All-Hazards format & receives recognition by

NACCHO as a “Public Health Ready” recertification site (only 1 of 4 health departments in the

country). Plan tested with a Full-Scale Exercise including over 300 participants from 15 local,

state & federal agencies.

2009 – In April, Mexican Health Officials report cases of influenza with chief complaints of

fever & cough. Several days later, Texas & California report similar cases. In May, WCHD

received verification of the first positive H1N1 case within our county. The Pandemic Influenza

Plan was implemented upon confirmation; calling together preventive, containment & control

measures, prophylaxis & treatment for exposed cases, in addition to a mass-vaccination

program.

Case Review:

Below is the epidemic curve of all H1N1 cases from Winnebago County residents.

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Case Review (continued) As of February 27, 2010 the WCHD had received 234 confirmed

2009 H1N1 test results. Of these confirmed, 54% were in patients under the age of 25. This

data mirrors the national trend. There were also 161confirmed hospitalized H1N1 cases. The

mean, median and age range are shown below.

2009 H1N1 Age Profile Mean Median Range

Confirmed Cases

n=234 27.67 20.5 1 mo to 85 y

Hospitalized Cases

n=161 33.87 37 1 mo to 85 y

Deaths

n=5 46.40 47.00 7 y to 81 y

Age

Range

Total Cases

n / %

Rate per

100,000

Total Hosps

n / %

Rate per

100,000

0-4 45 / 19% 218.35 27 / 17% 131.01

5-17 62 / 26% 114.68 27 / 17% 49.94

18-44 54 / 23% 49.05 39 / 24% 35.43

45-64 55 / 24% 72.30 50 / 31% 65.73

65+ 18 / 8% 45.67 18 / 11% 45.67

Total 234 / 100% 77.39 161 / 100% 53.62

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As shown, the H1N1 pandemic was more prevalent in those younger than 25. The below

figure gives the percentage of cases and hospitalizations per 100,000 population.

School Absenteeism - School Absenteeism rates were a useful tool for monitoring influenza

activity. Since a large percentage of the at-risk population fell within the school-age range, this

tracking method proved the most useful. The first chart shows the northern districts com-

pared to the Rockford District 205. The peak for the northern districts was during week 41,

while it occurred during week 43 for Rockford District 205.

Another tool utilized in the monitoring of H1N1 activity was Influenza-Like Illness (ILI)

reporting— a collection of Sentinel-Site reports showing the number of patients who

presented with symptoms of fever, cough and sore throat. A weekly visualization of ILI

incidence is shown in the graph to the left. While there was a small rise in the data around

week 18, there was a very large peak beginning around week 40. This peak lasted until around

week 47. Since then, data have fallen back to below the Epidemic values but remain above the

seasonal baseline.

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Vaccination Program

The mass vaccination program was a public-private partnership, targeting those who were

considered „at risk,‟ meaning they were within the targeted age range (6 months to 24 years)

or had any number of selected medical conditions such as asthma, diabetes or were pregnant.

Overall, Winnebago County providers administered nearly 60,000 H1N1 vaccines. The pie

graph shows the percentage of vaccine distributed by community partners and WCHD.

Mass-vaccination programs began in mid-November, once vaccine supplies were made

available from the Centers of Disease Control and Prevention and the Illinois Department of

Public Health.

Assessment

Overall, Winnebago County experienced 234 H1N1 Influenza illnesses from April 2009 to

February 2010, with a majority of those cases occurring in those under the age of 25. When

compared to state-wide data, Winnebago County (53.62 hospitalizations per 100,000

population) saw higher H1N1 prevalence than the State of Illinois (23.21 hospitalizations per

100,000 population).

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Photo

Court

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Assessment (continued)

With elevated prevalence of illnesses, it was important to work alongside the various

community partners to slow the spread of the H1N1 Influenza. Health care providers were

seeing elevated numbers of patient visits, running additional tests, and admitting more patients.

While the pandemic continued, local media partners aired public service announcements and

generated media stories to keep the public well-educated throughout the duration. In total, 28

News Releases were generated in partnership with the local hospital Public Information

Officers. Over 1,300 radio and television ads ran throughout the course of the pandemic, in

addition to 90 articles in the Rockford Register Star and the distribution of over 20,000

handouts. Signs were also placed at the CherryVale Mall, the Chicago-Rockford International

Airport and on selected Rockford Mass Transit District buses. Numerous groups assisted in

the planning, preparation and execution of the vaccination clinics.

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What’s in the Future?

Currently, WCHD staff is utilizing After Action Reviews in order to evaluate the strengths and

weaknesses of the current response plans, and to assess the opportunities and threats

presented by the H1N1 pandemic influenza outbreak. Using this evaluation process, the health

department will work through intra-agency collaboration to update the Emergency Operations

Plan. This will also strengthen community preparedness for response to future public health

emergencies. We continue to monitor and report (on a weekly basis) the current seasonal

influenza data. An updated Training and Exercise Plan is being prepared, to include large-scale

trainings and exercises involving the entire Northern Illinois region. Preparations are being

made to apply the lessons learned from the H1N1 pandemic to the following flu season to

include obtaining and distributing the flu vaccine in an effective manner.

Public Health Administrator Mike Bacon being interviewed by Mike DeDoncker

from the Rockford Register Star at a Heartland Church clinic

H1N1 Year in Review - April 2010

Our Appreciation

The Winnebago County Department of Public Health would like to thank all of the public and

private community partners, consortium members and volunteers who assisted during this

past year. There are too many to list by name, but your preparation for and responsiveness to

the 2009 H1N1 Influenza pandemic was an essential factor in protecting the health of our

community.

“Public Health is what we do collectively to assure conditions in which our residents

can be healthy”

401 Division Street

Rockford, IL 61104

815-720-4000

www.wchd.org