Week ending 1 March 218 (week 1) SUMMARY Influenza Vaccination Coverage* In week 1, 278 influenza A-positive specimens were reported by Army medical treatment facilities, which is a 27% decrease from the 38 positive specimens reported in surveillance week 9. Fourteen influenza-associated hospitalizations were reported in DRSi in week 1, 2 (Active Duty) and 12 non-. Eight (67%) were reported as not vaccinated and four (33%) were vaccinated. The two Service Members (SMs) were vaccinated. So far this season, 169 cases have been reported in DRSi. During surveillance week 1, 13% of clinical specimens from Active Duty SMs and non- beneficiaries tested positive for respiratory pathogens; 32% were reported as influenza A. As of 22 February 218 N/A DoD 97% Army Active Duty 88% Army Guard 82% Army Reserve *Data Source: MEDPROS, ASIMS, MRRS GEOGRAPHIC SPRE Click to enlarge images UNITED STATES In week 1, widespread influenza activity was reported to the CDC by Puerto Rico and 26 states. Regional activity was reported by Guam and 18 states, local activity was reported by the District of Columbia and 5 states, and sporadic activity was reported by Vermont. No influenza activity was reported by the U.S. Virgin Islands. DEMOGRAPHICS : I n w eek 1, there w as a total of 32 positive respiratory illness specimens from Active Duty () Service Members; 37% (12) from individuals in the 18-29 age group, followed by 31% (1) in the 3-39 age group, 25% (8) in the 4-49 age group, and 6% (2) in the 5-59 age group. No cases in 6+ group. Positive Respiratory Specimen Results from Army MTFs by Age Group and Beneficiary Status, 217218 Influenza Season 2 Number of Positive Tests 175 15 125 1 Non-: A total of 246 positive respiratory illness specimens were among non- beneficiaries, a 19% decrease from last week. 7% (171) of specimens came from patients under 18 years old. 75 5 25 < 18 18-29 3-39 4-49 5-59 6+ Age Group Non- Ben INFLUENZA-ASSOCIATED HOSPITALIZATIONS In week 1, 14 influenza-associated hospitalizations were reported in DRSi; 12 non- and 2. Eight (57%) were reported as not vaccinated, four (29%) were vaccinated, and two had unknown vaccination statuses. Seven cases tested positive for influenza type A and seven tested positive for influenza type B. In the same week last year, 2 cases were reported in DRSi. Army Influenza-Associated Hospitalizations Reported in DRSi by Week of Symptom Onset 19 18 17 16 15 14 13 Cases Reported 12 11 1 9 8 7 6 5 4 3 2 1 39 4 41 42 43 44 45 46 47 48 49 5 51 52 1 2 3 4 5 6 7 8 9 1 11 12 13 14 15 16 17 18 There has been a total of 169 hospitalizations this season; 146 non - and 23. By this time last season, 64 hospitalizations were reported in DRSi. Calendar Week 217-218 217-218 Non- 216-217 216-217 Non- Additional Resources: Arm y I nfluenza R eports; ARD Reports; AFHSC Influenza Reports; NHRC FRI Reports; DoD Global Influenza Surveillance Program; DoD Pandemic Influenza Watchboard; CDC Key: I LI -Influenza-Like Illness; DRSi- Disease Reporting System Internet; NHRC- Naval Health Research Center; V-Adenovirus; RSV-Respiratory Syncytial Virus; DED- Disease Epidemiology Division; SM-Service Member Questions? Email APHC DEP 41-436-765
U.S. Army Public Health Center Week ending 1 March 218 (week 1) Army Influenza Activity Report ILI ACTIVITY - ARMY ILI ACTIVITY - UNITED STATES ESSENCE Weekly Outpatient Clinic Visits for Influenza-like Illness Army MTFs, All Services, 215-218 16, 14, Number of Visits 12, 1, 8, 6, 4, 2, Calendar Week 217-218 Non- 217-218 215-216 216-217 All 217-218 The number of patient visits due to influenza-like illness reported through the U.S. Outpatient Influenza-Like Illness Surveillance Network decreased slightly from week 1 to week 9, from 3.7% to 3.3%. This percentage is above the national baseline of 2.2%. Data from ESSENCE was unavailable for week 1; the graph above displays ILI activity through week 8. LABORATORY RESPIRATORY SPECIMEN TESTING 5 Total Tested (217-18) Average Tested (214-17) % Influenza A Positive 4 3 2 1 1 9 8 7 6 5 4 3 2 1 Percent Positive Total Number of Patients Tested Proportion of Positive Influenza A Specimens for U.S. Army 217-218 6 4 41 42 43 44 45 46 47 48 49 5 51 52 53 1 2 3 4 5 6 7 8 9 1 11 12 13 14 15 16 17 Week Nationwide, 43.1% of specimens tested positive for influenza A, and 56.9% were positive for influenza B in week 1. In the Army population, (8.2%) of 1469 specimens tested were positive for influenza A. Of the positive influenza A specimens, 13 (86%) were from non-active duty individuals. Data was unavailable from RHC-E from weeks 8 1 which may affect these results. Test Types Among RAT Positive Influenza A Culture Specimens PCR Influenza A Influenza B Adenovirus Army MTF Enterovirus Laboratory Results, Parainfluenza 217-18 RSV Negative Total Week 7 Week 8 Week 9 Week 1 Season Total 94 512 26 119 835 58 26 14 9 497 139 98 36 2 2118 64 254 148 12 176 64 342 24 132 4224 14 3 4 2 195 1 1 14 5 9 2 1 199 42 26 22 23 911 563 428 2968 2567 78874 699 4663 3348 2845 95123 *In week 1, 1% (278) of specimens tested positive for a respiratory pathogen. Influenza A and B accounted for 43% and 47% of the positive specimens, respectively. RSV accounted for 8% (23) of the positive specimens this week. Parainfluenza and adenovirus accounted for approximately 1% of the total positive specimens this week combined. Although the total number of positive respiratory specimens decreased in weeks 9 and 1, missing data may have affected recent results. Locations providing week 1 laboratory data as of 14 March 218: K orea, Ft Belvoir, Ft Benning, Ft B liss, Ft Bragg, Ft Cam pbell, Ft Carson, Ft Drum, Ft Eustis, Ft Gordon, Ft Hood, Ft Huachuca, Ft Irwin, Ft Jackson, Ft Knox, Ft Leavenworth, Ft Lee, Ft Leonard Wood, Ft Meade, Ft Polk, Ft Riley, Ft Rucker, Ft Sam Houston, Ft Sill, Ft Stewart, Redstone Arsenal, Tripler, West Point, and Walter Reed. *Missing data affected this week s results. NOTE: Madigan AMC data was not received due to the switch from AHLTA/CHCS to MHS Genesis
U.S. Army Public Health Center Army Influenza Activity Report Week ending 1 March 218 (week 1) Region RHCA RHCC RHCP Region RHCA RHCC RHCP LABORATORY RESPIRATORY SPECIMEN TESTING Influenza A Influenza B Adenovirus Installation No. Tested % Positive Baseline % Pos. No. Tested % Positive Baseline % Pos. No. Tested % Positive Baseline % Pos. Ft. Belvoir 237 24.9 13.9 34 1 1 5 1 1 Ft. Benning 233 6.4 9.7 234 2.5 12.4 Ft. Bragg 238 18.9 9.2 8 1 1 Ft. Campbell 97 12.4 9.6 122 21.3 6.4 4 1 1 Ft. Drum 25 24 2.6 2 1 1 Ft. Eustis 18 16.7 15.1 1 1 1 Ft. Gordon 222 16.7 12.5 113 8 11.8 6 1 1 Ft. Jackson 117 17.9 1.5 118 12.7 6.3 Ft. Knox 3 1 14.4 3 3.3 4.4 Ft. Lee 51 13.7 6.9 2 1 1 Ft. Meade 13 3.8 2.2 Ft. Rucker 16 37.5 12.5 1 Ft. Stewart 29 1.3 6.8 54 3.7 3.1 Redstone Arsenal 7 1.5 16 4.4 West Point 5 12.4 1 1 1 1 1 1 Ft. Bliss 271 23.6 11.6 138 4.3 9.2 22 9.1 4.5 Ft. Carson 49 6.1 8.2 1 1 1 Ft. Hood 199 16.6 14.2 22 9.9 16.5 Ft. Huachuca 14 14.3 9.7 17 11.8 15.8 Ft. Irwin 15 6.7 2.2 15 Ft. Leavenworth 21 4.8 2.8 21 14.3 12 Ft. Leonard Wood 58 6.9 13.8 58 22.4 15.3 2 1 1 Ft. Polk 26 7.7 4.5 2 1 1 Ft. Riley 112 17.9 11.4 112 4.5 2.6 Ft. Sam Houston 26 24.2 14.4 256 14.5 9.8 2 1 1 Ft. Sill 14 21.2 9.9 14 1 1 Korea 43 2.3 25.3 3 11.8 3 6.7 4.2 Tripler 48 29.2 21.3 1 1 1 7 1 1 Enterovirus Parainfluenza RSV Installation No. % Baseline No. % Baseline No. % Baseline Tested Positive % Pos. Tested Positive % Pos. Tested Positive % Pos. Ft. Belvoir 2 1 1 15 13.3 16.5 Ft. Campbell 3 1 1 Ft. Drum 5 2 14.5 Ft. Gordon 4 1 1 1 1 1 Ft. Stewart 15 13.3 8.6 Ft. Bliss 2 1 7.9 Ft. Carson 23 13 26.4 Ft. Hood 62 54.8 21.6 Ft. Leavenworth 2 5 23.5 Ft. Polk 3 31.7 Ft. Riley 24 4.2 11.5 Ft. Sam Houston 1 1 1 1 1 1 Ft. Sill 4 12.8 Korea 48 33 9.1 2.3 28 2.2 Tripler 14 1 1 2 1 1 4 1 1 No. Tested: Number of specimens tested during MMWR week 1, 218. % Pos.: Percentage of positive specimens reported during MMWR week 1, 218. Baseline % Pos.: Weekly historical average of the percentage of positive specimens reported during influenza seasons from September 212 - May 217. Missing values indicate that specimens were not tested for the disease during the week of interest. Incidence rules: An individual can only test positive once per disease and season; if an individual has tested positive for a specific disease and returns at a later date to be tested for that same disease, their tested specimens will not contribute to the above calculations; an individual will contribute to the number of specimens tested column until they test positive for a disease. High baseline percent positive values may be due to low numbers of specimens tested.
Total Number of Patients Tested Percent Positive Total Number of Patients Tested Percent Positive Total Number of Patients Tested Percent Positive Total Number of Patients Tested Percent Positive U.S. Army Public Health Center Army Influenza Activity Report Week ending 1 March 218 (week 1) Proportion of Influenza A Positive Specimens by Week and Region, Army Medical Laboratories, 217-218 as Compared to 214-217 Regional Health Command - Atlantic (RHC-A) 3 25 2 15 1 5 Total Tested (217-18) Average Tested (214-17) % Influenza A Positive 4 41 42 43 44 45 46 47 48 49 5 51 52 53 1 2 3 4 5 6 7 8 9 1 11 12 13 14 15 16 17 Week 1 9 8 7 6 5 4 3 2 1 Age Group Week 1 Non- Ben Season Total < 18 34 2354 18-29 4 4 67 3-39 1 413 4-49 1 5 36 5-59 5 37 6+ 5 349 Total 6 53 4516 Regional Health Command - Central (RHC-C) 3 Total Tested (217-18) 212-14 Average Tested 25 % Influenza A Positive 2 15 1 5 4 41 42 43 44 45 46 47 48 49 5 51 52 53 1 2 3 4 5 6 7 8 9 1 11 12 13 14 15 16 17 Week Regional Health Command - Europe (RHC-E) - No Update 16 Total Tested (217-18) 14 212-14 Average Tested / Week 12 % Influenza A Positive 1 8 6 4 2 4 41 42 43 44 45 46 47 48 49 5 51 52 53 1 2 3 4 5 6 7 8 9 1 11 12 13 14 15 16 17 Week Regional Health Command - Pacific (RHC-P) 16 Total Tested (216-17) 14 212-14 Average Tested / Week 12 % Influenza A Positive 1 8 6 4 2 4 41 42 43 44 45 46 47 48 49 5 51 52 53 1 2 3 4 5 6 7 8 9 1 11 12 13 14 15 16 17 Week 1 9 8 7 6 5 4 3 2 1 1 9 8 7 6 5 4 3 2 1 1 9 8 7 6 5 4 3 2 1 Age Group Week 1 Non- Ben Season Total < 18 34 2773 18-29 5 3 89 3-39 2 4 58 4-49 1 371 5-59 2 42 6+ 621 Total 8 43 5556 Age Group Week 1 Non- Ben Season Total < 18 1 18-29 26 3-39 36 4-49 38 5-59 12 6+ 5 Total 217 Age Group Week 1 Non- Ben Season Total < 18 6 213 18-29 2 1 185 3-39 1 115 4-49 67 5-59 28 6+ 26 Total 3 7 634 Number of Positive Influenza A Specimens by Duty Status and Region Region Week 3 Week 4 Week 5 Week 6 Week 7 Week 8 Week 9 Week 1 Non- Non- Non- Non- Non- Non- Non- Non- RHC-A 85 46 12 596 68 54 85 554 53 299 25 127 15 65 6 53 RHC-C 129 635 13 678 91 488 6 353 27 22 14 72 1 43 8 43 RHC-E 8 22 6 24 3 29 6 11 7 25 - - - - - - RHC-P 27 37 35 49 41 3 39 29 1 13 1 6 9 6 3 7 CENTCOM
Number of Positive Tests 2 175 15 125 1 75 5 25 Positive Respiratory Specimen Results from Army MTFs by Age Group and Beneficiary Status, 217-218 Influenza Season < 18 18-29 3-39 4-49 5-59 6+ Age Group Age Group Week 1 Non- Ben Season Total < 18 171 5272 18-29 12 12 1639 3-39 1 8 117 4-49 8 11 812 5-59 2 2 797 6+ 24 978 Total 32 246 165 Non- Ben
Cases Reported 19 18 17 16 15 14 13 12 11 1 9 8 7 6 5 4 3 2 1 Army Influenza-Associated Hospitalizations Reported in DRSi by Week of Symptom Onset 39 4 41 42 43 44 45 46 47 48 49 5 51 52 1 2 3 4 5 6 7 8 9 1 11 12 13 14 15 16 17 18 Calendar Week 217-218 217-218 Non- 216-217 216-217 Non- 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 14 March 218.
Number of Visits ESSENCE Weekly Outpatient Clinic Visits for Influenza-like Illness Army MTFs, All Services, 215-218 16, 14, 12, 1, 8, 6, 4, 2, Calendar Week 217-218 Non- 217-218 215-216 216-217 All 217-218 Clinic visits for ILI are obtained from ESSENCE. Data as of 1 March 218 (no update).
Total Number of Patients Tested 6 5 4 3 2 1 Proportion of Positive Influenza A Specimens for U.S. Army 217-218 Total Tested (217-18) Average Tested (214-17) % Influenza A Positive 4 41 42 43 44 45 46 47 48 49 5 51 52 53 1 2 3 4 5 6 7 8 9 1 11 12 13 14 15 16 17 Week 1 9 8 7 6 5 4 3 2 1 Percent Positive
Test Types Among Positive Influenza A Specimens Army MTF Laboratory Results, 217-18 Week 7 Week 8 Week 9 Week 1 Season Total RAT 94 512 26 119 835 Culture 58 26 14 9 497 PCR 139 98 36 2 2118 Influenza A 64 254 148 12 176 Influenza B 64 342 24 132 4224 Adenovirus 14 3 4 2 195 Enterovirus 1 1 14 Parainfluenza 5 9 2 1 199 RSV 42 26 22 23 911 Negative 563 428 2968 2567 78874 Total 699 4663 3348 2845 95123
Number of Positive Influenza A Specimens by Duty Status and Region Region Week 3 Week 4 Week 5 Week 6 Week 7 Week 8 Week 9 Week 1 Non- Non- Non- Non- Non- Non- Non- Non- RHC-A 85 46 12 596 68 54 85 554 53 299 25 127 15 65 6 53 RHC-C 129 635 13 678 91 488 6 353 27 22 14 72 1 43 8 43 RHC-E 8 22 6 24 3 29 6 11 7 25 - - - - - - RHC-P 27 37 35 49 41 3 39 29 1 13 1 6 9 6 3 7 CENTCOM