Outbreak Response/Epidemiology Influenza Weekly Report Arkansas

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Nathaniel Smith, MD, MPH, Director and State Health Officer Outbreak Response/Epidemiology Influenza Weekly Report Arkansas 7- Week Ending Saturday // Dirk Haselow, MD, PhD State Epidemiologist, Medical Director, Outbreak Response Shirley Louie, MS, CIH Deputy State Epidemiologist, Director, Center for Public Health Practice Prepared by: Haytham Safi, MD, MPH Influenza Surveillance Coordinator Haytham.Safi@Arkansas.gov 5--9 Quinyatta Mumford, MPH, CHES Mike Cima, PhD Public Health Preparedness Epidemiologists January 9,

During the flu season the Arkansas Department of Health (ADH) produces a Weekly Influenza Report for clinicians. The report provides information on flu activity in the state. The report also compares influenza like illness (ILI) in Arkansas to activity in the U.S. ADH receives reports of only a fraction of flu cases. Therefore, it is important to understand that the information in the weekly update is representative of the timing and location of activity, but it does not reflect the overall burden of disease. It is presumed that there are many more people actually affected than the report shows. Clinicians and policy makers may find the report helpful in terms of communicating to colleagues and patients about the current status of the flu season. Report Key Points: For Week, Arkansas reported Widespread activity to the Centers for Disease Control and Prevention (CDC) for geographic spread of influenza, and High or / for ILI intensity. Since October, 7, over, positive influenza tests have been reported to the ADH online database by health care providers. In Week, 7 counties reported influenza cases. The majority of reports came from Benton, Pulaski, Faulkner, Washington, Craighead, White, Saline, Garland, Jefferson, Sebastian, Pope, Lonoke, Independence, and Baxter. Among flu antigen tests that can distinguish between influenza A and B virus types, 7 percent were influenza A, and percent were influenza B. There were positive PCR flu tests last week from private labs: influenza A, and 59 influenza B; positive influenza A subtype HN and positive influenza A subtype HN. There were positive influenza A subtype HN, and positive influenza B subtype Yamagata from the ADH lab; samples tested negative for influenza this week. About.5 percent of patients visiting emergency rooms last week were there for ILI. About.9 percent of outpatient visits were for ILI. The average school absenteeism rate last week was.7 percent among public schools. To date, influenza-related deaths have been reported in Arkansas this flu season among adult persons. No pediatric death has been reported in Arkansas this flu season. Since October, 7, facilities including 7 nursing homes have reported influenza outbreaks. The proportion of deaths reported to the National Center for Health Statistics attributed to pneumonia and influenza (P&I) was below the system-specific epidemic threshold. For Week 5, the geographic spread of influenza was reported as widespread in states, states reported regional activity, the District of Columbia reported local activity; and Guam, Puerto Rico and the U.S. Virgin Islands did not report. You can report flu year-round and view the weekly influenza report during the influenza season at: http://www.healthy.arkansas.gov/programs-services/topics/influenza. You can also access the reporting website directly at: https://flureport.adh.arkansas.gov For Additional National and International Influenza Surveillance Information: World Health Organization (WHO): http://www.who.int/influenza/gisrs_laboratory/flunet/en/index.html. CDC - Seasonal Influenza (Flu) - Weekly Report: http://www.cdc.gov/flu/weekly/

7- Influenza CD/Epi Weekly Report (Week : //7 - //) Death Report for Week Deaths from all causes: Deaths due to Pneumonia: 7 PCR confirmed Flu Deaths: Death Certificate or Flu Antigen only: 5 Cumulative Flu Deaths since //7 PCR confirmed Flu deaths: 9 Death Certificate or Flu Antigen only: 7 Cumulative Flu deaths: ER Visits Week Ending: // Weighted Average:.5% Total Visits:, Visits with ILI:,79 Previous Week Weighted Average:.% Total Visits:, Visits with ILI:,59 Total Flu-Related Hospital Admissions PCR Confirmed: Cumulative: 7 Week ending //: 57 Antigen Positive: Cumulative: Week ending //: 97 Weekly Arkansas ILI Intensity Level Reported by Sentinel Providers PCR Lab Confirmed Influenza Total Cases since //7:,557 Week Ending //: 9 PCR Tests ADH Lab Week Other Labs Week Cumulative Cases Since //7 A+, B+ 59 B/Victoria B/ Yamagata HN+ H+ Unsubtypeable 5 Total,557 Negative -- -- PCR Confirmed Influenza Cases since //7 Age Groups PCR+ Hospitalized Deaths - yr. 5 5- yr. 9 9 9- yr. 9 5 5- yr. 5 5- yr. 9 >= 5 yr. Unknown Total,557 7 9 School Absenteeism* Week Ending: // - Percent Absent:.7 - Previous Week: Holiday Average daily absenteeism for all public schools during this reporting week. Geographic ILI Activity Level Reported for Week :

School Report Weekly School Absenteeism Rates, Arkansas Public Schools Percent Absent 9 7 5 5 7 9 5 5 9 5 7 9 5 7 9 5 7 9 5 7 Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Week, Month of Report Off Season Baseline -7 7- Average -7

Influenza Mortality by Age Group, Arkansas -7 (Provisional) Report Updated: /9/ Number of Deaths 5 5 5+ Yrs 5- Yrs 5- Yrs 9- Yrs 5- Yrs 9 7 7 5 5 5 - Yrs Flu Season * * All seasons range from week to week 9 except 9- started week Source: ADH Immunization Section, Center for Health Statistics Hospital Report Downloaded from ESSENCE (Syndromic Surveillance) Percent ER Visits with ILI

Number of Claims Paid Each Week US Outpatients Influenza Surveillance (ILINET) Percentage of Outpatient Visits Due to Influenza-like Illness Reported by the US Outpatient Influenza-like-Illness Surveillance Network (ILINet) in Arkansas Percent of Outpatients Visits Due to ILI 5 7 9 5 5 5 5 7 9 5 7 9 5 7 9 5 7 9 Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Week, Month of Report 7- Average -7 Off Season Rate -7 Weekly Influenza Claims Paid by Medicaid and BCBS Influenza Claims Paid by Medicaid and BCBS of Arkansas 5 5 5 5 5 5 5 7 9 5 5 5 5 7 9 5 7 9 5 7 9 5 7 9 Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Week, Month of Report Average -7 YR -7 Off Season Baseline YR 7-5

Influenza Positive Tests Reported to CDC and ILI Activity, by HHS Region, 7- Season, Week Ending December, 7 Values in legend is for the highlighted HHS region (Region ) Weekly Influenza Activity Estimates Reported by State and Territorial Epidemiologists Arkansas Flu Activity Level Reported for Week : Widespread

Antigen Report: Reported Influenza Positive Antigens by Age Group, Arkansas 7-5 Number of Positive Tests 5 5 5 7 7 7 7 7 7 5 7 5 7 Year Week 7 7 7 7 7 5 7 5 Number of Positive Tests - Yrs 5- Yrs 9- Yrs 5- Yrs 5- Yrs 5+ Yrs Reported Influenza Positive Antigens by Type, Arkansas 7-5 5 5 5 Year Week A+ Antigen B+ Antigen Undetermined Antigen + 7

Influenza Positive Tests Reported to CDC by U.S. Public Health Laboratories, National Summary, 7- Season Pneumonia and Influenza Mortality from the National Center for Health Statistics Mortality Surveillance System Data through the week ending December, 7, as of January,