Flu Increasing in Connecticut, As Official Data and Marketing Ads Differ on Severity

Sometimes, the numbers just don’t add up.  How can a city with a population of 125,000 have 156,598 incidences of the flu reported – in just one week?  That question was posed, in a letter to the editor published in the Hartford Courant, by H. Wayne Carver, Connecticut’s former Chief Medical Examiner. Carver noticed a full page ad in the newspaper which ran on Christmas Day, asserting the number of flu incidences “reported in Hartford.”  That ad ran again on New Year’s Day and Sunday, January 4, promoting Puff’s tissues, and offering a 25 cent coupon to "soften the blow.”  Puffs is a product of Procter & Gamble.

A visit to the Puffs website reveals a national interactive map which can provide the incidence flu merely by typing in the name of a town or zip code.  The result for Hartford? “Current cold and flu levels in HARTFORD are MILD.  Mild means that 3% to 8% of the population is sick.”hartford flu ad - Courant  One does not need to be a math major to determine that 8 percent of 125,000 is not 156,598. And for a city of 125,000, how can this statement, on the Puffs facebook page, be accurate:  "FYI, Hartford. 156,598* of you have the flu."

So, where did the numbers come from? P&G The small print in the ad cites ”FAN Data, IMS Health, Affected Population in Hartford for Week Ending Saturday, December 6, 2014.”

IMS Health is a Danbury-based global company that provides information, services and technology for the healthcare industry.  IMS’s Flu Activity Notification (FAN) program is, according to the company website, “a comprehensive program that measures the total affected population with upper respiratory illness at the national level down to 135 markets.”head_logo

Within the past week, spurred by new data from the Centers for Disease Control and Prevention, increases in flu incidence around the nation, including Connecticut, have been reported.  The state Department of Public Health (DPH) reports a total of 444 positive influenza reports for the current season. Influenza was reported in all eight Connecticut counties: New Haven (141 reports), Fairfield (137), Hartford (68), Litchfield (30), New London (24), Middlesex (22), Windham (13), and Tolland County (9).

According to the CDC, widespread influenza activity was reported by 36 states, including New York, New Jersey and Massachusetts, in addition to Connecticut. As of last week, a total of 180 hospitalized patients with laboratory-confirmed influenza have been reported in Connecticut, DPH data indicates, with 19 associated with Type A (H3N2) influenza, 153 with Type A (subtype unspecified), and 8 with Type B. No flu-associated deaths have been reported to date in Connecticut, although the CDC reports more than a dozen deaths nationwide.

Public health numbers and marketing numbers are vastly different, with DPH reporting that “Connecticut influenza activity has been increasing during the last several weeks," but at levels in the hundreds statewide, not tens of thousands in a single city.  Advertisements for Puffs tissues in other major markets include these triple-digit numbers:  904,564 in Philadelphia, 369,631 in Detroit, 132,047 in Milwaukee, 157,298 in Kansas City and 348,801 in ColumbusCDC map

“FAN provides critical status levels for each regional market area, reflecting seasonal severity and potential spread rate of illness throughout the season. With consumers only purchasing cough-cold and flu-related products when afflicted, this data is vital for maximizing ROI on promotions, marketing, product placement, and supply chain. The FAN program offers retailer-specific reporting as well, designed to each retailer’s specific trading area and distribution network,” the IMS website indicates.

The website goes on to explain that “For today's consumers, managing health is often a do-it-yourself project. IMS Health provides the most in-depth and reliable information and tools available to monitor health and make informed decisions about care.”

Founded in 1954, Danbury, Connecticut-based IMS is now the largest vendor of U.S. physician prescribing data, according to the company’s website. IMS pays pharmacies for anonymized prescription data, which it sells to drug makers curious about individual doctors’ prescribing habits.

IMS Health Global Headquarters remain in Danbury, at 83 Wooster Heights Road. The company website lists more than two dozen locations throughout the United States and in Canada, Japan, China, Latin America, Asia Pacific, North Europe and Africa, South Europe and the Middle East, Central Europe and Eastern Europe.

Company President Ari Bousbib points to IMS Health’s 10,000 professionals as their “most valuable asset. They include clinicians, epidemiologists, technologists, software engineers, data scientists, health informatics specialists and services experts—all with a deep understanding of customers and local markets around the world.”phoenix

The company does consulting work and trend analysis of the drug business. That portion of the company is growing faster than its data business, driving the 4.1 percent increase in the company’s total revenue last year, according to published reports. IMS Health became a public company last April, following four years as a private company.  As a corporation, IMS Health has made support for cancer prevention, treatment and research a focus of corporate philanthropy efforts.  That support has included major contributions to the Connecticut-based Hole in the Wall Gang Camp, for children with cancer.

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Spring Flu Hits Connecticut and Northeast Harder than Rest of USA

Not only does winter refuse to quit in Connecticut, the flu season is also slow to recede, with a second wave hitting the region this month.  According to data monitored by the state Department of Public Health, Connecticut is one of only a handful of states where flu cases have remained widespread well into April.

Overall, more than 5,000 cases of various strains of flu have been reported in Connecticut since the start of flu season last fall, with the largest number coming in New Haven County, followed by Hartford and Fairfield Counties.

The latest “Flu View” map from the national Centers for Disease Control and Prevention (CDC) indicate while flu season appears to have ended across most of the nation, Connecticut is one of less than a half-dozen states that continue to have “widespread” influenza activity.

flu CTConnecticut is joined by regional neighbors New York, Massachusetts, New Jersey and Delaware in the recent spike in flu cases.  New York has recently been reporting its highest volumes of the entire flu season.  The states of Maine, New Hampshire, Rhode Island and Oklahoma have the next highest level of flu cases, according to the CDC data.

The most recent data, for the week ending April 5, indicates that statewide emergency department visits attributed to the “fever/flu syndrome” have recently increased in Connecticut and continue at a level near or above 5 percent statewide during the last 16 weeks.  The CDC reports that the region including Connecticut, Maine, Massachusetts, New Hampshire Vermont and Rhode Island is one of only two in the nation with “elevated” out-patient flu levels as of early April; the other region with elevated levels includes New York and New Jersey.  The rest of the nation is characterized as being at “normal” levels of flu incidence.

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A total of 5,162 positive influenza reports have been reported for the current season, which is due to conclude, for data collection purposes, next month.  The initial peak in January brought record emergency volumes to some facilities, including Hartford Hospital.  This year’s second wave, is occurring later than a year ago, into April.  Last year's second wave occurred in March.

Influenza has been reported in all eight Connecticut counties since the start of flu season: New Haven (1,559 reports), Hartford (1,384), Fairfield (1,221), Windham (242), New London (220), Tolland (186), Middlesex (179), and Litchfield (171).

This month, Connecticut influenza activity continues to be classified geographically as “widespread” according to the state Department of Health, and many regions in the state are experiencing a second wave of flu activity, led by the influenza B strain, often referred to as “spring flu.”

In Connecticut, the Department of Public Health (DPH) uses multiple systems to monitor circulating influenza viruses. During the influenza season, weekly flu updates are posted from October of the current year, through May of the following year.

Last winter’s flu season brought 57 flu-related deaths to Connecticut, all were among patients at least 55 years of age including 48 (84%) who were greater than 65 years old. The year-long stats, reflecting August 2012 – August 2013, reflected flu instances from residents of all eight Connecticut counties and included: 4,177 from Fairfield County, 2,789 from New Haven County, 1,915 from Hartford County, 672 in Windham, 638 New London, 613 Middlesex, 388 Litchfield, and 319 from Tolland County.  Last year’s total was 11,511 confirmed flu cases, with the number of cases peaking twice, in the week ending Jan. 12, predominantly Type A flu, and the week ending March 23, predominantly Type B.

All data for the current flu season are considered preliminary and are updated with available information each week starting in October and ending in May; a final report will be available from DPH before the start of the next season.