Weekly Influenza & Respiratory Illness Activity Report A summary of influenza surveillance indicators prepared by the Division of Infectious Disease Epidemiology Prevention & Control Week Ending December 23, 217 WEEK 51 All data are preliminary and may change as more information is received Minnesota Influenza Geographic Spread No Activity Sporadic Local Regional Widespread During the week ending December 23, 217 (Week 51), surveillance indicators showed widespread geographic spread of influenza. Since the start of the influenza season, no pediatric influenza-related deaths have been reported. Based on CDC s Activity Estimates Definitions: http://www.cdc.gov/flu/weekly/overview.htm Minnesota Influenza Surveillance: http://www.health.state.mn.us/divs/idepc/diseases/flu/stats/ Weekly U.S. Influenza Surveillance Report: http://www.cdc.gov/flu/weekly/ World Health Organization (WHO) Surveillance: http://www.who.int/influenza/surveillance_monitoring/updates/en/ Neighboring states influenza information: Iowa http://www.idph.state.ia.us/idpharchive/archive.aspx?channel=flureports Wisconsin http://www.dhs.wisconsin.gov/communicable/influenza/surveillance.htm North Dakota http://www.ndflu.com/default.aspx South Dakota http://doh.sd.gov/diseases/infectious/flu/ Minnesota Department of Health 651-21-5414 or 1-877-676-5414 www.health.state.mn.us 12/28/217
Hospitalized Influenza Surveillance Hospitalized influenza cases are based on disease reports of laboratory-positive influenza (via DFA, IFA, viral culture, EIA, rapid test, paired serological tests or RT-PCR) and specimens from hospitalized patients with acute respiratory illness submitted to MDH-PHL by hospitals and laboratories. Due to the need to confirm reports and reporting delays, consider current week data preliminary. Hospitalized Influenza Cases by Type Minnesota (FluSurv-NET*) Hospitalized Influenza Cases by Season, Minnesota (FluSurv-NET*) 3 275 2 2 175 15 1 1 75 5 4 42 44 46 48 5 52 2 4 6 8 1 12 14 16 18 2 Hospitalizations this week *Influenza Surveillance Network Hospitalizations last week B (no genotype) B (Yamagata) B (Victoria) A (not subtyped) A H3 A H1 (unspecified) A (H1N1)pdm9 A (H1N2v) A (H3N2v) A&B Unknown Total hospitalizations (to date) 172 132 585 Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending December 23, 217 WEEK 51 2 75 7 65 6 55 5 45 4 35 3 2 15 1 5 4 42 44 46 48 5 52 2 4 6 8 1 12 14 16 18 2 Season Total hospitalizations (historic) 212-213 3,68 213-214 1,54 214-215 4,138 215-216 1,541 216-217 3,738 217-218 585 (to date) 212-13 213-14 214-15 215-16 216-17 217-18
Hospitalized Influenza Surveillance (continued) Number of Influenza Hospitalizations and Incidence by Region, Minnesota October 1, 217 December 23, 217 Number of Influenza Hospitalizations and Incidence by Age, Minnesota October 1, 217 December 23, 217 5 45 4 35 3 2 15 1 5 8.7 Region 13.4 3.1 5. 5.5 Region Hospitalizations this week # of hospitalizations Incidence (cases) per 1, Persons 9.1 5.1 8.7 Total (to date) 5. 45. 4. 35. 3.. 2. 15. 1. 5.. Hospitalizations per 1, Persons Central 18 (1%) 65 (11%) Metro 117 (68%) 48 (7%) 71. Northeast 1 (1%) 1 (2%) Northwest 4 (2%) 8 (1%) South Central 9 (5%) 16 (3%) Southeast 11 (6%) 46 (8%) Southwest 6 (3%) 11 (2%) West Central 6 (3%) 21 (4%) Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending December 23, 217 WEEK 51 3 5 45 4 35 3 2 15 1 5 4.3 # of hospitalizations Incidence (cases) per 1, Persons 2.6 4. 9.6 42.7-4 5-24 -49 5-64 65+ Age Group (years) Median age (years) at time of admission 5. 45. 4. 35. 3.. 2. 15. 1. 5.. Hospitalizations per 1, Persons
Respiratory Disease Outbreak Surveillance School Outbreaks K-12 schools report an outbreak of influenza-like illness (ILI) when the number of students absent with ILI reaches 5% of total enrollment or three or more students with ILI are absent from the same elementary classroom. Influenza-like Illness (ILI) in Schools by Season 3 Number of influenza-like illness outbreaks 2 15 1 5 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 19 2 21 213-14 214-15 215-16 216-17 217-18 New school outbreaks this week New school outbreaks last week Total this season (to date) 3 19 39 Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending December 23, 217 WEEK 51 4
Respiratory Disease Outbreak Surveillance (continued) Long-Term Care (LTC) Outbreaks LTC facilities report to MDH when they suspect an outbreak of influenza in their facility. Laboratory-confirmed outbreaks are reported here. Confirmed Influenza Outbreaks in LTC by Season Number of lab-confirmed outbreaks 7 65 6 55 5 45 4 35 3 2 15 1 5 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 19 2 21 New LTC outbreaks this week New LTC outbreaks last week Total this season (to date) 1 3 13 213-14 214-15 215-16 216-17 217-18 Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending December 23, 217 WEEK 51 5
Sentinel Provider Surveillance (Outpatients) MDH collaborates with healthcare providers who report the total number of patients seen and the total number of those patients presenting to outpatient clinics with influenza-like illness. Percentage of Persons Presenting to Outpatient Clinics with Influenza-Like Illness (ILI) 9 Percent with Influenza-like Illness 8 7 6 5 4 3 2 213-14 214-15 215-16 216-17 217-18 1 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 19 2 21 % of outpatients with ILI this week % of outpatients with ILI last week 3.4% 2.6% * Indicates current week-data may be delayed by 1 or more weeks Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending December 23, 217 WEEK 51 6
Laboratory Surveillance The MN Lab System (MLS) Laboratory Influenza Surveillance Program is made up of more than 31 clinic- and hospital-based laboratories, voluntarily submitting testing data weekly. These laboratories perform rapid testing for influenza and Respiratory Syncytial Virus (RSV). Significantly fewer labs perform PCR testing for influenza and three also perform PCR testing for other respiratory viruses. MDH-PHL provides further characterization of submitted influenza isolates to determine the hemagglutinin serotype to indicate vaccine coverage. Tracking the laboratory results assists healthcare providers with patient diagnosis of influenza-like illness and provides an indicator of the progression of the influenza season as well as prevalence of disease in the community. Specimens Positive for Influenza by Molecular Testing*, by Week Number of positive molecular tests 2 175 15 1 1 75 5 B A (not subtyped) A H3 A (H1N1) pdm9 214-15 % + by PCR 215-16 % + by PCR 216-17 % + by PCR 217-18 % + by PCR 35 3 2 15 1 5 Percent of positive molecular tests 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 19 2 21 % molecular tests positive this week % molecular tests positive last week 22.2% 1.6% * Beginning in 216-17, laboratories report results for rapid molecular influenza tests in addition to RT-PCR results Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending December 23, 217 WEEK 51 7
Laboratory Surveillance (continued) MLS Laboratories Influenza Testing Specimens Positive by Influenza Rapid Antigen Test, by Week MLS Laboratories RSV Testing Specimens Positive by RSV Rapid Antigen Test, by Week Number of Positive Influenza Specimens 5 45 4 35 3 2 15 1 5 B+ (215-16 Season) A+ (215-16 Season) A/B+ (215-16 Season) 214-15% + 215-16 % + 216-17 % + 217-18%+ 4 42 44 46 48 5 52 2 4 6 8 1 12 14 16 18 2 5 45 4 35 3 2 15 1 5 Percentage of Rapid Antigen Influenza Tests Positive Number of Positive RSV Tests 15 1 1 75 5 Number + 214-15 % + 215-16 % + 216-17 % + 217-18 %+ 4 42 44 46 48 5 52 2 4 6 8 1 12 14 16 18 2 75 7 65 6 55 5 45 4 35 3 2 15 1 5 Percentage of Rapid Antigen RSV Tests Positive Region % rapid antigen influenza tests + (current week) Northeast 8% South Central 16% Southwest 21% Southeast 13% Metro % Central 19% West Central 19% Northwest 5% State (overall) 22% Region % rapid antigen RSV tests + (current week) Northeast 33% South Central 58% Southwest 57% Southeast 2% Metro 4% Central 28% West Central 33% Northwest --- State (overall) 41% Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending December 23, 217 WEEK 51 8
Hospitalized RSV Surveillance Surveillance for respiratory syncytial virus (RSV) began in September 216. Hospitalized inpatients of all ages who reside in the 7-county Twin Cities metropolitan area (Anoka, Carver, Dakota, Hennepin, Ramsey, Scott, and Washington) with laboratory-confirmed RSV are reportable. Due to the need to confirm reports and reporting delays, consider current week data preliminary. Hospitalized RSV Cases by Subtype, Minnesota Number of RSV Hospitalizations and Incidence by Age, Minnesota 1 9 8 7 6 5 4 3 2 1 RSV A RSV B RSV, Unspecified 4 42 44 46 48 5 52 2 4 6 8 1 12 14 16 18 2 2 15 1 5 121.9 5.3 1.2.4.6 2.3 <2 2-4 5-17 18-49 5-64 65+ Age Group (years) # of hospitalizations Incidence (cases) per 1, Persons Median age at time of admission 7.7 months 14. 12. 1. 8. 6. 4. 2.. Hospitalizations per 1, Persons Hospitalizations this week Hospitalizations last week Total hospitalizations (to date) 8 26 9 Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending December 23, 217 WEEK 51 9
Weekly U.S. Influenza Surveillance Report 217-218 Influenza Season Week 5 ending December 16, 217 National Influenza Surveillance (CDC): http://www.cdc.gov/flu/weekly/ During week 5 (December 1-16, 217), influenza activity sharply increased in the United States. Viral Surveillance: The most frequently identified influenza virus subtype reported by public health laboratories during week 5 was influenza A(H3). The percentage of respiratory specimens testing positive for influenza in clinical laboratories increased. Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia and influenza (P&I) was below the system-specific epidemic threshold in the National Center for Health Statistics (NCHS) Mortality Surveillance System. Influenza-associated Pediatric Deaths: One influenza-associated pediatric death was reported. Influenza-associated Hospitalizations: A cumulative rate of 6.2 laboratory-confirmed influenza-associated hospitalizations per 1, population was reported. Outpatient Illness Surveillance: The proportion of outpatient visits for influenza-like illness (ILI) was 3.5%, which is above the national baseline of 2.2%. Nine of the 1 regions reported ILI at or above region-specific baseline levels. Ten states experienced high ILI activity; Puerto Rico and eight states experienced moderate ILI activity; New York City, the District of Columbia, and 11 states experienced low ILI activity; and 21 states experienced minimal ILI activity. Geographic Spread of Influenza: The geographic spread of influenza in 23 states was reported as widespread; Puerto Rico and 23 states reported regional activity; the District of Columbia and four states reported local activity; the U.S. Virgin Islands reported sporadic activity; and Guam did not report. A Weekly Influenza Surveillance Report Prepared by the Influenza Division Weekly Influenza Activity Estimates Reported by State and Territorial Epidemiologists* A Weekly Influenza Surveillance Report Prepared by the Influenza Division Influenza-Like Illness (ILI) Activity Level Indicator Determined by Data Reported to ILINet *This map indicates geographic spread and does not measure the severity of influenza activity. Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending December 23, 217 WEEK 51 1