A new paper from a team led but Mauricio Santillana, a mathematician, and member of the computational health informatics team at Boston Children’s Hospital, offers this in a new paper:
We show that information from Internet-based data sources, when combined using an informed, robust methodology, can be effectively used as early indicators of influenza activity at fine geographic resolutions.
Crowdsourced data can be valuable, especially in developing countries where official health data can lag by months. But on their own, these maps tend to overpredict, said Mauricio Santillana, a mathematician, assistant professor at Harvard Medical School, and faculty member of the Computational Health Informatics Program at Boston Children’s Hospital. “They don’t add the nuances when they try to predict at a hyperlocal level,” he said. Many are also commercially driven, so he questions their objectivity. “They’re produced by people who’d benefit by people rushing into pharmacies.”
Provider offices across the US report the amount of influenza‐like illness (ILI) they see in their patients each week during regular flu season. These outpatient providers’ offices, which include doctors’ offices, school health services, and community health centers, are called ‘sentinel sites.’ Here we present Massachusetts sentinel site data. Please note that the data represent not only confirmed influenza cases, but also those just with ILI, which may be caused by other viruses.
The latest weekly flu report shows that rates of flu-like illness have dropped in the past seven days. However, flu is unpredictable and it’s too soon to know whether we’ve seen its peak this season. The one thing we know for sure is that it’s not too late to get a flu shot if you haven’t gotten one yet. Call your health care provider or visit a local pharmacy which offers flu vaccinations.
Week 51 ILI Activity (representing intensity of ILI activity): High
Provider offices across the US report the amount of influenza-like illness (ILI) they see in their patients each week during regular flu season. These outpatient providers’ offices, which include doctors’ offices, school health services, and community health centers, are called ‘sentinel sites.’ Here we present Massachusetts sentinel site data. Please note that the data do not represent only confirmed influenza cases, but also those just with ILI, which may be caused by other viruses. ILI is defined as fever above 100.01 in addition to either cough or sore throat. ILI is a marker of influenza and is used throughout the regular influenza season to monitor influenza since most people are not tested for influenza. Figure 1 shows that ILI activity continues to increase and is much higher than what is typically seen at this time of year. For more information, see CDC’s influenza surveillance website at www.cdc.gov/flu/weekly/fluactivitysurv.htm.
Figure 1: Percentage of ILI visits reported by sentinel provider sites
 CDC activity indicator also used in past seasons – indicates how widespread influenza activity level is in the state.
 New CDC activity indicator, introduced for 2010-2011 season – more quantitative indicator of the level of ILI activity across the state.
Massachusetts has now received more than 1.2 million H1N1 doses. As we move into December, we expect that there will continue to be regular shipments with significant amounts of vaccine. Therefore, every week more and more public clinics should be added to flu.masspro.org. If you don’t see a flu clinic listed in your area, we encourage you to check the site regularly for updates. We know that the delays have been extremely frustrating and we appreciate your patience as we all await more vaccine from the Federal government
11/4 According to a report from a worker’s rights group “Wal-Mart’s stingy sick-leave policy may contribute to swine flu’s spread.” Workers there are punished for taking too many sick days. Via the fine folks at the Institute for Southern Studies.
The report found that the only time the company is removing sick workers from the food section is when they are coughing too loudly or violently — and then the person is merely transferred to another department rather than being sent home.
10/30 Today’s weekly update of Mass residents with flu like symptoms shows “ a continuous, dramatic increase in ILI (influenza-like illness) activity over the past few weeks in excess of what was seen at the same time the last two years.”
It also includes an update on vaccine availability for n women.
(N)ot all obstetrical practices in Massachusetts are registered to receive the vaccine. This poses a problem for women who go to these providers and who wish to be vaccinated.
If your doctor is not currently registered to administer H1N1 vaccine, you might recommend that they do so through the DPH website at the DPH vaccine provider registry . Registration is fast and easy, and continues to be open for new registrants. You may also ask your provider to refer you to a medical associate who is enrolled to administer the vaccine.
As of today, more than 480,000 doses of H1N1 vaccine have been distributed to providers in Massachusetts –- just the tip of the iceberg of the total 3.5 million doses of vaccine that we expect to receive this flu season. This is not where we expected to be at this point based on what we were initially told by the federal government, and it creates a difficult and frustrating situation for everyone, especially those people at greatest risk of complications from the H1N1 flu…
10/29 Sacha Pfeiffer at WBUR tries to sort out who is getting the vaccine and who isn’t:With the H1N1 swine flu vaccine in high demand and short supply in Massachusetts and nationwide, people considered “high-risk” are supposed to be vaccinated first. But some high-risk patients can’t find the vaccine even though some seemingly healthier patients can. That has many people wondering if there’s any rhyme or reason to how the vaccine is being divvied up.
10/28: I’m lapsed but go to Mass now and then. I was wondering what it would take to get the Catholic Church to see the risks involved in shaking hands with seven or eight strangers. The Globe reports that it was H1N1 .
10/27 — The latest from the state on access to the vaccine, or lack of it. Now looking at late November for most people. Their “limited supply is reserved for people at especially high risk for flu, which includes pregnant women, children, caregivers of infants and healthcare workers with direct patient contact. As supplies grow, this will expand to include the additional priority groups of young adults up to the age of 24, and people between the ages of 25 and 64 with underlying health conditions like asthma and diabetes.
Flu activity is widespread in Massachusetts for the first time this fall, public health officials said today, leading a Central Massachusetts high school to close its doors until Wednesday and almost certainly reflecting cases caused by the swine flu virus, whose return has been expected since it first emerged in the spring.
So far the state has distributed 270,500 doses of vaccine against swine flu, also known as H1N1. Boston’s allotment of 27,000 doses has gone to health-care providers in hospitals, community health centers, and primary care offices so they could inoculate their high-risk patients.
Shipments are running three weeks behind schedule, forcing the cancellation of some swine flu clinics around the state.
The state alerted local health departments on Oct. 16 that municipal H1N1 vaccine clinics should be postponed due to production delays of the H1N1 vaccine. Once the Cambridge Public Health Department receives its shipment of the H1N1 vaccine, special clinics will be organized that target pregnant women, children, and people with chronic health conditions.
The Department of Public Health has already distributed tens of thousands of H1N1 vaccine doses to hundreds of medical sites around the state to begin the vaccination of children, pregnant women and health care workers, consistent with the federal guidance. Our ability to share H1N1 vaccines is dependent on the vaccine manufacturers’ ability to produce the vaccine and the federal Centers for Disease Control’s (CDC) distribution plan to states. Unfortunately, the timeline associated with the distribution of the vaccines is quite fluid as production estimates vary week to week due to the unprecedented volume and short timetable for planning.
Our top priority is and will remain those members of the public who are at greatest risk. Initially that category includes children, pregnant women and health care workers. As supplies allow, we will also target young adults below the age of 25, and 25-64 year olds with certain underlying health conditions. Public clinics will only be held at the point that there is sufficient volume to shift beyond the focus on these target groups. The CDC states that eventually there will be enough H1N1 vaccine to protect anyone in the population who wishes to be immunized.
We will not be sending vaccines to prison settings to vaccinate the general prison population before the vaccine has been made available to the general public
Supplies for the H1N1 vaccine will arrive in Massachusetts three weeks later than anticipated, forcing local health departments to adjust their plans for H1N1 flu clinics, John Auerbach, the state’s public health commissioner, said today.
“It might mean rather than have large clinics at Town Hall that would be open to everyone, the first clinics might be more targeted to children or young adults” in schools, he said.
The availability of vaccine at any given provider site at any given time may be sporadic at this time. Every effort is being made to ensure that providers who serve high-priority groups will receive vaccine as soon as possible. The single most effective way that you can stay informed about the availability of seasonal and H1N1 flu vaccine in your community is by staying in touch with your health care provider, and by visiting http://flu.masspro.org where you’ll find a database of locations currently offering flu vaccines, searchable by your zip code.
It’s important to note that there are no public H1N1 vaccination clinics currently scheduled in the state. This is because, like all other states, we have only received a very small allotment of the total amount of H1N1 vaccine expected.
From the state as of 10/14 DPH:
People who are in a high-priority group to get vaccinated should contact their health care provider to find out when they can schedule an appointment to get the H1N1 vaccine. Public health and school-based H1N1 vaccination clinics are expected in November and December, and will be posted at http://flu.masspro.org as they are scheduled. In the meantime, you can find a public flu clinic offering seasonal flu vaccine by visiting http://flu.masspro.org.
At this time MDPH is asking providers to prioritize initial shipments of vaccine to:
• Children 6 months to 9 years of age, because they will require 2 doses, 1 month apart, to be fully protected against the H1N1 influenza virus. This is regardless of how previous doses of seasonal influenza vaccine they have ever received;
• Pregnant women;
• Healthcare workers with direct patient contact;
• Household contacts of infants younger than 6 months of age; and
• Household contacts of pregnant women in their third trimester to ensure their newbornsgo home to a safe environment.
• If the above groups have been vaccinated then target all children younger than 19 years
Swine flu is causing unprecedented illness for so early in the fall — including a worrisome count of child deaths — and the government warned Friday that vaccine supplies will be even more scarce than expected through this month.
Federal health officials said 11 more children have died in the past week because of the virus.
The CDC recommends the following groups to receive the 2009 H1N1 influenza vaccine:
Pregnant women because they are at higher risk of complications and can potentially provide protection to infants who cannot be vaccinated;
Household contacts and caregivers for children younger than 6 months of age because younger infants are at higher risk of influenza-related complications and cannot be vaccinated. Vaccination of those in close contact with infants younger than 6 months old might help protect infants by “cocooning” them from the virus;
Healthcare and emergency medical services personnel because infections among healthcare workers have been reported and this can be a potential source of infection for vulnerable patients. Also, increased absenteeism in this population could reduce healthcare system capacity;
All people from 6 months through 24 years of age
Children from 6 months through 18 years of age because cases of 2009 H1N1 influenza have been seen in children who are in close contact with each other in school and day care settings, which increases the likelihood of disease spread, and
Young adults 19 through 24 years of age because many cases of 2009 H1N1 influenza have been seen in these healthy young adults and they often live, work, and study in close proximity, and they are a frequently mobile population; and,
Persons aged 25 through 64 years who have health conditions associated with higher risk of medical complications from influenza.
Harvard Vanguard expects to receive a small quantity of the 2009 H1N1 vaccine from the CDC in November, with additional shipments arriving through the winter months. Based on CDC guidelines, we will contact our high risk patients first to schedule their 2009 H1N1 flu shots as we expect our supplies to be initially quite limited. We will offer the 2009 H1N1 vaccine to all patients over time as more vaccine becomes available. Please wait to be contacted by your Harvard Vanguard physician’s office regarding scheduling of 2009 H1N1 shots. By order of the Massachusetts Department of Public Health, we will not initially be able to offer 2009 H1N1 vaccine to patients outside of the CDC-specified high-risk groups. Whenever the Department of Public Health broadens the criteria, we will make the vaccine available to more patients.
Mass Health, the state Medicaid program, posted this today:
All Massachusetts hospitals and community health centers, many pediatric care providers, and some obstetric care providers have been allocated small quantities of H1N1 vaccine. However, these quantities represent a very small percentage of the total amount of H1N1 vaccine we expect to receive this flu season. More vaccine is expected from the federal government each week to build on those quantities and expand that distribution.