Weekly Influenza & Respiratory Illness Activity Report A summary of influenza surveillance indicators prepared by the Division of Infectious Disease Epidemiology Prevention & Control Week Ending February 17, 218 WEEK 7 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 February 17, 218 (Week 7), surveillance indicators showed widespread geographic spread of influenza. Since the start of the influenza season, four 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 2/22/218
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*) 75 7 65 6 55 5 45 4 35 3 25 2 15 1 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) 261 337 4,699 Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending February 17, 218 WEEK 7 2 75 7 65 6 55 5 45 4 35 3 25 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 3,75 213-214 1,578 214-215 4,81 215-216 1,538 216-217 3,695 217-218 4,699 (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 February 17, 218 Number of Influenza Hospitalizations and Incidence by Age, Minnesota October 1, 217 February 17, 218 5 45 4 35 3 25 2 15 1 5 77.8 Region 95.9 58.8 63.7 Region 94.7 Hospitalizations this week # of hospitalizations Incidence (cases) per 1, Persons 67.8 71.3 59. Total (to date) 5. 45. 4. 35. 3. 25. 2. 15. 1. 5.. Hospitalizations per 1, Persons Central 4 (15%) 583 (13%) Metro 154 (59%) 2,91 (62%) 73. Northeast 9 (3%) 191 (4%) Northwest 5 (2%) 11 (2%) South Central 19 (7%) 275 (6%) Southeast 12 (5%) 342 (7%) Southwest 12 (3%) 155 (3%) West Central 1 (3%) 142 (3%) Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending February 17, 218 WEEK 7 3 5 45 4 35 3 25 2 15 1 5 41.4 # of hospitalizations Incidence (cases) per 1, Persons 19.1 25.6 66.9 369.6-4 5-24 25-49 5-64 65+ Age Group (years) Median age (years) at time of admission 5. 45. 4. 35. 3. 25. 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. 3 Influenza-like Illness (ILI) in Schools by Season Number of influenza-like illness outbreaks 25 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) 63 18 588 Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending February 17, 218 WEEK 7 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 5 Number of lab-confirmed outbreaks 45 4 35 3 25 2 15 1 213-14 214-15 215-16 216-17 217-18 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 12 16 Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending February 17, 218 WEEK 7 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 8 213-14 214-15 Percent with Influenza-like Illness 7 6 5 4 3 2 215-16 216-17 217-18 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 4.1% 5.7% * Indicates current week-data may be delayed by 1 or more weeks Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending February 17, 218 WEEK 7 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 12 11 1 9 8 7 6 5 4 3 2 1 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 25 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 24.3% 24.6% * 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 February 17, 218 WEEK 7 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 22 2 18 16 14 12 1 8 6 4 2 B+ (217-18 Season) A+ (217-18 Season) A/B+ (217-18 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 25 2 15 1 5 Percentage of Rapid Antigen Influenza Tests Positive Number of Positive RSV Tests 2 175 15 125 1 75 5 25 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 25 2 15 1 5 Percentage of Rapid Antigen RSV Tests Positive Region % rapid antigen influenza tests + (current week) Northeast 26% South Central 29% Southwest 32% Southeast --- Metro 31% Central 28% West Central 32% Northwest 22% State (overall) 3% Region % rapid antigen RSV tests + (current week) Northeast 23% South Central 27% Southwest 28% Southeast --- Metro 18% Central 39% West Central 42% Northwest 6% State (overall) 27% Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending February 17, 218 WEEK 7 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. 8 7 6 5 4 3 2 1 4 42 44 46 48 5 52 2 4 6 8 1 12 14 16 18 2 Hospitalizations this week Hospitalized RSV Cases by Subtype, Minnesota Hospitalizations last week RSV A RSV B RSV, Unspecified Total hospitalizations (to date) 35 36 758 Number of RSV Hospitalizations and Incidence by Age, Minnesota 6 5 4 3 2 1 321.1 24.2 4.1.9 3.3 9.6 <2 2-4 5-17 18-49 5-64 65+ Age Group (years) Median age at time of admission 9 months # of hospitalizations Incidence (cases) per 1, Persons 35. 3. 25. 2. 15. 1. 5.. Hospitalizations per 1, Persons Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending February 17, 218 WEEK 7 9
Weekly U.S. Influenza Surveillance Report 217-218 Influenza Season Week 6 ending February 1, 218 National Influenza Surveillance (CDC): http://www.cdc.gov/flu/weekly/ During week 6 (February 4-1, 218), influenza activity remained elevated in the United States. Viral Surveillance: The most frequently identified influenza virus subtype reported by public health laboratories during week 6 was influenza A(H3). The percentage of respiratory specimens testing positive for influenza in clinical laboratories remained elevated. Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia and influenza (P&I) was above the system-specific epidemic threshold in the National Center for Health Statistics (NCHS) Mortality Surveillance System. Influenza-associated Pediatric Deaths: Twenty-two influenza-associated pediatric deaths were reported. Influenza-associated Hospitalizations: A cumulative rate of 67.9 laboratory-confirmed influenza-associated hospitalizations per 1, population was reported. Outpatient Illness Surveillance: The proportion of outpatient visits for influenza-like illness (ILI) was 7.5%, which is above the national baseline of 2.2%. All 1 regions reported ILI at or above region-specific baseline levels. New York City, the District of Columbia, Puerto Rico and 43 states experienced high ILI activity; two states experienced moderate ILI activity; three states experienced low ILI activity; and two states experienced minimal ILI activity. Geographic Spread of Influenza: The geographic spread of influenza in Puerto Rico and 48 states was reported as widespread; one state reported regional activity; the District of Columbia, Guam and one state reported local activity; and the U.S. Virgin Islands reported no activity. 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 February 17, 218 WEEK 7 1