U.S. Army Influenza Activity Report Week Ending 25 January 2014 (Week 4)

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Click on images to enlarge. 2013-2014 Seasonal Influenza Vaccination Coverage As of 22 JAN 2014 93% DOD 97% Army Active Duty 90% Army Guard 80% Army Reserve U.S. Army Influenza Activity Report Week Ending 25 January 2014 (Week 4) SYNOPSIS: During week four, civilian influenza-like illness activity continued to decrease, although it remains above baseline. Activity is starting to shift westward as evidenced by trends in percent positive influenza lab samples. ILI Activity: Army incident ILI outpatient visits in week four were 13% higher than for the same week last year. Influenza cases: Eleven hospitalized influenza cases (eight Active Duty [AD]) have been reported in week four. Investigation into the AD cases revealed no epidemiological links. Viral specimens: During week four, 476 of 1,694 (28%) laboratory specimens tested positive for respiratory pathogens. Most of the influenza A positive specimens have been from SRMC (42%), while WRMC and NRMC accounted for 26% and 23%, respectively. Geographic Spread United States In week four, 48 states reported widespread or regional activity, while DC and Mississippi reported only local influenza activity. Guam, Puerto Rico, and Hawaii reported sporadic influenza activity, and the US Virgin Islands reported none. The predominate strain remains H1N1. World Health Organization In Europe, a slight increase in influenza activity has been observed, which may indicate the start of the influenza season. ILI Activity United States In week four, 3.3% of outpatient visits reported in ILINet were due to ILI, which is above the national baseline of 2.0%. The percentage of ILI outpatient visits ranged from 2.1% to 5.2% across regions. ILI Activity Army During week four, incident ILI activity was 13% higher than the same time last year and 29% lower than the 2011-2012 season. AD SMs accounted for 29% of incident ILI clinic visits during week three; in 2012-2013, AD SMs comprised 26% of ILI clinic visits on average. Laboratory Respiratory Specimen Testing In week four, 28% (476) of respiratory specimens were positive. Influenza A accounted for 78% of positive specimens. RSV accounted for 16% of positive specimens, adenovirus for 2%, and parainfluenza for 2%. Influenza B accounted for <1% of positive specimens. DRSi Influenza Case Reporting In week four, eleven cases of influenza-associated hospitalizations were reported in DRSi, eight of which were in AD SMs. Sixty-eight hospitalized influenza cases have been reported since the beginning of this influenza season. At the same time last influenza season, 59 hospitalized influenza cases were reported. Laboratory Testing for Influenza A In week four, 25% of influenza A tests were positive. This was a slight decrease from week three (29%). In week four, 291 of the 370 (79%) positive influenza A specimens were reported in non-ad personnel. SRMC reported 154 (42%) of the total influenza cases. WRMC reported 98 (26%) positive influenza A specimens, and NRMC reported 85 (23%). PRMC reported 18 cases (5%) and ERMC reported 15 cases (4%). CENTCOM reported zero positive influenza A specimens. Additional Resources: Army Influenza Reports; ARD Reports; AFHSC Influenza Reports; NHRC FRI Reports; DoD Global Influenza Surveillance Program; DoD Pandemic Influenza Watchboard; CDC; WHO Key: ILI-Influenza-Like Illness; DRSi- Disease Reporting System Internet; NHRC- Naval Health Research Center; ADV- Adenovirus; RSV-Respiratory Syncytial Virus; DEP- Disease Epidemiology Program; SM-Service Member Questions? Email USAPHC-DEP 410-417-3774

U.S. Army Influenza Activity Report Proportion of Influenza A Positive Specimens by Week and Region, Army Medical Laboratories, 2013-2014 as Compared to 2012-2013 Northern Regional Medical Command (NRMC) Southern Regional Medical Command (SRMC) Western Regional Medical Command (WRMC) Europe Regional Medical Command (ERMC) Pacific Regional Medical Command (PRMC) Locations providing week 4 laboratory data as of 28 January 2014: Korea, Ft Belvoir, Ft Benning, Ft Bliss, Ft Bragg, Ft Campbell, Ft Carson, Ft Drum, Ft Eustis, Ft Gordon, Ft Hood, Ft Irwin, Ft Jackson, Ft Leavenworth, Ft Lee, Ft Leonard Wood, Ft Lewis, Ft Meade, Ft Polk, Ft Riley, Ft Rucker, Ft Sam Houston, Ft Sill, Ft Stewart, Ft Wainwright, Landstuhl, Redstone Arsenal, Tripler, and West Point.

Clinic visits for ILI are obtained from ESSENCE. Data as of 28 January 2014.

Note: Reportable influenza cases are defined as only cases that have been hospitalized and are under the age of 65. See Armed Forces Reportable Medical Events Guidelines and Case Definitions for more information Data as of 28 January 2014.