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March 18^th Immunization Coalition 2025 Spring Meeting: Central OR Respiratory Season Update

Adrienne Hoyt, PhD

Regional Epidemiologist

Crook – Deschutes – Jefferson Counties

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Agenda

Respiratory Update: Trends & Points to Ponder

Influenza
COVID19
RSV

Finding Local/State/National

Respiratory Data

Process Flow for Building & Disseminating Respiratory Reports

Staying Informed

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Why Respiratory Surveillance is Important

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Note: Data above was pulled from the CDC National Respiratory & Enteric Virus Surveillance System (NREVSS)

Early Outbreak Detection: By monitoring respiratory trends, PH can identify outbreaks early—allowing for prompt response to limit spread

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Note: Data above was pulled from the CDC National Respiratory & Enteric Virus Surveillance System (NREVSS)

Early Outbreak Detection: By monitoring respiratory trends, PH can identify outbreaks early—allowing for prompt response to limit spread

Inform vaccine development: Vaccines are updated regularly based on surveillance findings

Why Respiratory Surveillance is Important

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Why Respiratory Surveillance is Important

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Note: Data above was pulled from the CDC National Respiratory & Enteric Virus Surveillance System (NREVSS)

Early Outbreak Detection: By monitoring respiratory trends, PH can identify outbreaks early—allowing for prompt response to limit spread

Inform vaccine development: Vaccines are updated regularly based on surveillance findings

Timely Communication: Accurate/up-to-date

surveillance allows PH to provide updates &

guidance to public on risks & preventive measures

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Influenza Update

*The influenza virus [Adobe Stock Image]

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Influenza Trends: Central OR

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Note: By using MMWR weeks, all public health agencies report flu data on the same time scale—allowing for direct comparisons between different locations

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Influenza Trends: Central OR

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Image: Influenza A

Note: Data above was pulled from the CDC National Respiratory & Enteric Virus Surveillance System (NREVSS)

MMWR [CDC]: Morbidity & Mortality Weekly Report

Week 9 (19%/+): 2/23-3/1/25

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Influenza Trends: Central OR

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Image: Influenza A

Note: Data above was pulled from the CDC National Respiratory & Enteric Virus Surveillance System (NREVSS)

MMWR [CDC]: Morbidity & Mortality Weekly Report

Week 9 (19%/+): 2/23-3/1/25

Week 52 (29%/+): 12/22-12/28/24

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Influenza Trends: Central OR

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Image: Influenza A

Note: Data above was pulled from the CDC National Respiratory & Enteric Virus Surveillance System (NREVSS)

MMWR [CDC]: Morbidity & Mortality Weekly Report

Week 9 (19%/+): 2/23-3/1/25

Week 52 (29%/+): 12/22-12/28/24

Week 13 (17%/+): 3/24-3/30/24

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Influenza Trends: Central OR

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Image: Influenza A

Note: Data above was pulled from the CDC National Respiratory & Enteric Virus Surveillance System (NREVSS)

MMWR [CDC]: Morbidity & Mortality Weekly Report

Week 9 (19%/+): 2/23-3/1/25

Week 52 (29%/+): 12/22-12/28/24

Week 13 (17%/+): 3/24-3/30/24

Week 22 (14%/+): 5/26-6/1/24

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Influenza Trends: Central OR

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Image: Influenza A

Note: Data above was pulled from the CDC National Respiratory & Enteric Virus Surveillance System (NREVSS)

MMWR [CDC]: Morbidity & Mortality Weekly Report

Week 9 (19%/+): 2/23-3/1/25

Week 52 (29%/+): 12/22-12/28/24

Week 13 (17%/+): 3/24-3/30/24

Week 22 (14%/+): 5/26-6/1/24

Week 49 (29%/+): 12/4-12/10/22

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Emergency Room Visits Due to Influenza-Like Illness

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Image: Influenza A

*Weeks on X-axis above follow the current MMWR (Morbidity & Mortality Weekly Report) weeks (as provided by CDC)

Week 9:

[2/23-3/1/25]

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Flu Status: What we know & where are we going?

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Image: Influenza A

*Link to CDC FluView Reports: https://www.cdc.gov/fluview/index.html

In the US, flu activity generally starts to increase in Oct, peaking between Dec-Feb

Why flu thrives in winter? Influenza viruses thrive in cold/dry winter conditions; Low temps also affect bacteria-fighting cells in nose—reducing the power of our immune system to fight flu/cold viruses

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Flu Status: What we know & where are we going?

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Image: Influenza A

*Link to CDC FluView Reports: https://www.cdc.gov/fluview/index.html

Unusual flu patterns past few seasons:

2020-21: flu season unusually mild—likely due to widespread masking/remote work/social distancing
2022-23: moderately severe & peaking early in season (early Dec)
2023-24: 2 unexpected late in the season peaks (Mar/May)
2024-2025: ?

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Flu Status: What we know & where are we going?

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Image: Influenza A

*Link to Central OR Flu Report above: https://www.deschutes.org/sites/default/files/fileattachments/health_services/page/26726/2020_q2_cd_report_051623.pdf

2024-2025 Season: What we’ve seen so far …

2 Primary Peaks—late Dec & mid-Feb

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Flu Status: What we know & where are we going?

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Image: Influenza A

*Link to Central OR Flu Report above: https://www.deschutes.org/sites/default/files/fileattachments/health_services/page/26726/2020_q2_cd_report_051623.pdf

2024-2025 Season: What we’ve seen so far …

2 Primary Peaks—late Dec & mid-Feb
On course to be similar to 2019-2020 season—with 3 peaks (Dec; late-Jan; late-Feb)

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Flu Status: What we know & where are we going?

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Image: Influenza A

*Link to Central OR Flu Report above: https://www.deschutes.org/sites/default/files/fileattachments/health_services/page/26726/2020_q2_cd_report_051623.pdf

2024-2025 Season: What we’ve seen so far …

2 Primary Peaks—late Dec & mid-Feb
On course to be similar to 2019-2020 season—with 3 peaks (mid-Dec; late-Jan; late-Feb)

12/15-12/21/2019

1/26-2/1/2020

2/23-2/29/2020

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Flu Status: What we know & where are we going?

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Image: Influenza A

*Link to Central OR Flu Report above: https://www.deschutes.org/sites/default/files/fileattachments/health_services/page/26726/2020_q2_cd_report_051623.pdf

2024-2025 Season: What we’ve seen so far …

2 Primary Peaks—late Dec & mid-Feb
On course to be similar to 2019-2020 season—with 3 peaks (mid-Dec; late-Jan; late-Feb)

12/15-12/21/2019

1/26-2/1/2020

2/23-2/29/2020

3^rd peak for 2024-25?

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COVID19 Update

*Image from the National Foundation for Infectious Diseases

(https://www.nfid.org/infectious-disease/coronaviruses/)

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COVID19 Trends: Central OR

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Note: Data above was pulled from the CDC National Respiratory & Enteric Virus Surveillance System (NREVSS)

MMWR [CDC]: Morbidity & Mortality Weekly Report

Week 9 (3.5%/+): 2/23-3/1/25

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COVID19 Trends: Central OR

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Note: Data above was pulled from the CDC National Respiratory & Enteric Virus Surveillance System (NREVSS)

MMWR [CDC]: Morbidity & Mortality Weekly Report

Week 39 (18%/+): 9/22-9/28/24

Week 9 (3.5%/+): 2/23-3/1/25

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COVID19 Trends: Central OR

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Note: Data above was pulled from the CDC National Respiratory & Enteric Virus Surveillance System (NREVSS)

MMWR [CDC]: Morbidity & Mortality Weekly Report

Week 39 (18%/+): 9/22-9/28/24

Week 30 (19%/+): 7/21-7/27/24

Week 9 (3.5%/+): 2/23-3/1/25

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COVID19 Trends: Central OR

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Note: Data above was pulled from the CDC National Respiratory & Enteric Virus Surveillance System (NREVSS)

MMWR [CDC]: Morbidity & Mortality Weekly Report

Week 39 (18%/+): 9/22-9/28/24

Week 30 (19%/+): 7/21-7/27/24

Week 36 (18%/+): 9/3-9/9/22

Week 9 (3.5%/+): 2/23-3/1/25

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Emergency Room Visits Due to COVID19-Like Illness

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*Weeks on X-axis above follow the current MMWR (Morbidity & Mortality Weekly Report) weeks (as provided by CDC)

Week 9: 2/23-3/1/25

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COVID19: Thoughts from the Experts

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Entering Year 6: COVID19 still seen as a threat,

but a manageable one

Deaths per day in the US:

5,000(2021) vs. 280(Feb; 2025)

Now Considered Endemic: Virus still circulating,

but at more predictable levels that are consistent

with other common viral diseases

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COVID19: Thoughts from the Experts

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Severity of infection: As many people have had

at least one infection &/or multiple doses of

vaccines, severity of infection will remain low

Remaining Challenges:

-those with advanced age; medical comorbidities; immunocompromised are still at risk of dying

-continued impact on lives altered from loss of loved ones; multiple illnesses; economic strain; mental health

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COVID19: Current Epidemic Trends

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Note: Map above was pulled from the CDC {CFA: Modeling and Forecasting Current Epidemic Trends for States}

March 4^th, 2025

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COVID19: Current Epidemic Trends

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Note: Map above was pulled from the CDC {CFA: Modeling and Forecasting Current Epidemic Trends for States}

3 states (AL; SC; AK)

March 4^th, 2025

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COVID19: Current Epidemic Trends

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Note: Map above was pulled from the CDC {CFA: Modeling and Forecasting Current Epidemic Trends for States}

3 states (AL; SC; AK)

13 states

March 4^th, 2025

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COVID19: Current Epidemic Trends

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Note: Map above was pulled from the CDC {CFA: Modeling and Forecasting Current Epidemic Trends for States}

3 states (AL; SC; AK)

13 states

29 states

March 4^th, 2025

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Respiratory Syncytial Virus (RSV) Update

*Image credit: Adao/Shutterstock.com

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RSV Trends: Central OR

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Note: Data above was pulled from the CDC National Respiratory & Enteric Virus Surveillance System (NREVSS)

MMWR [CDC]: Morbidity & Mortality Weekly Report

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RSV Trends: Central OR

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Note: Data above was pulled from the CDC National Respiratory & Enteric Virus Surveillance System (NREVSS)

MMWR [CDC]: Morbidity & Mortality Weekly Report

Week 9 (11%/+): 2/13-3/1/25

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RSV Trends: Central OR

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Note: Data above was pulled from the CDC National Respiratory & Enteric Virus Surveillance System (NREVSS)

MMWR [CDC]: Morbidity & Mortality Weekly Report

Week 51 (15%/+): 12/17-12/23/23

Week 9 (11%/+): 2/13-3/1/25

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RSV Trends: Central OR

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Note: Data above was pulled from the CDC National Respiratory & Enteric Virus Surveillance System (NREVSS)

MMWR [CDC]: Morbidity & Mortality Weekly Report

Week 51 (15%/+): 12/17-12/23/23

Week 48 (16%/+): 11/27-12/3/22

Week 9 (11%/+): 2/13-3/1/25

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RSV Trends: Central OR

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Note: Data above was pulled from the CDC National Respiratory & Enteric Virus Surveillance System (NREVSS)

MMWR [CDC]: Morbidity & Mortality Weekly Report

Week 51 (15%/+): 12/17-12/23/23

Week 48 (16%/+): 11/27-12/3/22

May 2023: 1^st RSV Vaccine [Arexvy] approved by FDA (adults 60+yrs)

Week 9 (11%/+): 2/13-3/1/25

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RSV Trends: Central OR

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Note: Data above was pulled from the CDC National Respiratory & Enteric Virus Surveillance System (NREVSS)

MMWR [CDC]: Morbidity & Mortality Weekly Report

Week 51 (15%/+): 12/17-12/23/23

Week 48 (16%/+): 11/27-12/3/22

May 2023: 1^st RSV Vaccine [Arexvy] approved by FDA (adults 60+yrs)

Aug 2023: 2nd RSV Vaccine [Abrysvo] approved by FDA (pregnant individuals)

Week 9 (11%/+): 2/13-3/1/25

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RSV Trends: Central OR

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Note: Data above was pulled from the CDC National Respiratory & Enteric Virus Surveillance System (NREVSS)

MMWR [CDC]: Morbidity & Mortality Weekly Report

Week 51 (15%/+): 12/17-12/23/23

Week 48 (16%/+): 11/27-12/3/22

May 2023: 1^st RSV Vaccine [Arexvy] approved by FDA (adults 60+yrs)

Aug 2023: 2nd RSV Vaccine [Abrysvo] approved by FDA (pregnant individuals)

May 2024: 3^rd RSV Vaccine [mResvia] approved by FDA (adults 60+yrs)

Week 9 (11%/+): 2/13-3/1/25

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RSV: A few points to ponder

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Following low activity during COVID19 pandemic, RSV RSV has rebounded in recent seasons

US Trends

Note: Data above derived from CDC/NREVSS [PCR test] data

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RSV: A few points to ponder

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While RSV is often thought of as a disease of infants/children (~100-500 deaths occur in the US

each year), it also causes ~14,000 deaths annually

in adults 65+yrs

Note: Data above derived from CDC/NREVSS [PCR test] data

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RSV: A few points to ponder

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While RSV is often thought of as a disease of infants/children (~100-500 deaths occur in the US

each year), it also causes ~14,000 deaths annually

in adults 65+yrs

Adults 65+yrs with RSV may have ~$12,000-$23,000 in additional healthcare costs {annually} vs. those without RSV

Note: RSV death data provided by CDC; Healthcare resource data derived from [https://www.rsvinadults.com/what-is-rsv/]

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RSV: A few points to ponder

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Healthcare resource data derived from [https://www.rsvinadults.com/what-is-rsv/]; retrospective case-control study

*An RSV episode was defined by an RSV ICD-9-CM code as the principal diagnosis for inpatient admissions, or as the first or secondary diagnosis for outpatient visits

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RSV: A few points to ponder

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Healthcare resource data derived from [https://www.rsvinadults.com/what-is-rsv/]; retrospective case-control study

Key take-away: RSV vaccination can reduce the risk of hospitalization & death …especially in infants & older adults

*An RSV episode was defined by an RSV ICD-9-CM code as the principal diagnosis for inpatient admissions, or as the first or secondary diagnosis for outpatient visits

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Finding Central OR �Respiratory Data

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Where does Central OR respiratory data live?

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Image: Influenza A

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How does NREVSS* work?

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Image: Influenza A

*CDC National Respiratory & Enteric Virus Surveillance System (NREVSS)

Public Health & hospital laboratories across the country voluntarily report weekly test results to NREVSS

Data collated include number of positive tests performed & type of test

AG=antigen test;

PCR=polymerase chain reaction

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Where does Central OR ILI* ED data come from?

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Image: Influenza A

OR ESSENCE is a collaboration between OHA & Johns Hopkins University

*ILI=Influenza Like Illness; ED=Emergency Department

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Where does Central OR ILI* ED data come from?

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Image: Influenza A

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What about state & national level flu data?

*The influenza virus [Adobe Stock Image]

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OHA FluBites Reports*

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Image: Influenza A

*Link to OHA FluBites: https://www.oregon.gov/oha/ph/diseasesconditions/communicabledisease/diseasesurveillancedata/influenza/pages/surveil.aspx

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OHA FluBites Reports*

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Image: Influenza A

*Link to OHA FluBites: https://www.oregon.gov/oha/ph/diseasesconditions/communicabledisease/diseasesurveillancedata/influenza/pages/surveil.aspx

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CDC FluView Reports*

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Image: Influenza A

*Link to CDC FluView Reports: https://www.cdc.gov/fluview/index.html

Note: Due to recent executive order pausing updates to federal sites, CDC/FluView data was not available 1/24-2/3/25

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CDC FluView Reports*

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Image: Influenza A

*Link to CDC FluView Reports: https://www.cdc.gov/fluview/index.htm [map above based on outpatient visits to healthcare providers for ILI]

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Process Flow for Building & Disseminating Central OR Respiratory Reports

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Central OR Weekly Flu/COVID19/RSV Reporting

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Central OR Weekly Flu/COVID19/RSV Reporting

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Central OR Weekly Flu/COVID19/RSV Reporting

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Central OR Weekly Flu/COVID19/RSV Reporting

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Reports shared (via email) with internal Central OR leadership

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Central OR Weekly Flu/COVID19/RSV Reporting

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Reports shared (via email) with internal Central OR leadership

Reports posted on the Deschutes Co website

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Central OR Weekly Flu/COVID19/RSV Reporting

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Reports shared (via email) with internal Central OR leadership

Reports posted on the Deschutes Co website

Constant Contact Report send-out to ~400 providers/

community members

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Stay Informed

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Stay Informed

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Stay Informed

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Link to site above: https://www.deschutes.org/health/page/respiratory-reports

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Thank You

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Questions?

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