Influenza Report Week 52

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2014-2015 Influenza Report Week 52 December 21 December 27, 2014 About our flu activity reporting MSDH relies upon selected sentinel health practitioners across the state to report the percentage of total patient visits consistent with an influenza-like illness (ILI: fever of 100 F or higher AND cough and/or sore throat). Also, providers are supplied with specimen collection kits. Samples are submitted to the Mississippi Public Health Laboratory for influenza PCR testing. Reports are used to estimate the state s ILI rate and the magnitude of the state s influenza activity. Reports represent only the distribution of flu in the state, not an actual count of all flu cases statewide. Information is provisional only and may change depending on additional reporting from sentinel providers. State ILI Surveillance During week 52 (12/21/14-12/27/14), the overall state ILI rate (9.9%) decreased from the previous week (10.9%), but was higher than this time last year (8.2%). Figure 1 Total number of patients treated by sentinel providers in the last three weeks. Table 1 2014-2015 Influenza Season CDC Week Week Ending Total patients ILI symptoms ILI Rate (%) 52 Dec. 27 17716 1759 9.9% 51 Dec. 20 19902 2167 10.8% 50 Dec. 13 21287 1532 7.2%

During week 52, three districts (3, 4, and 9) had an increase in ILI activity, while three districts (1, 5, and 6) had a decrease. Three districts (2, 7, and 8) remained about the same. Information is provisional only and may change depending on additional reporting from sentinel providers. Table 2 MSDH District ILI Rates (%) 2014-2015 District Week 51 Week 52 State 10.9 9.9 I 9.5 4.4 II 14.6 14.2 III 13.0 19.4 IV 9.1 18.3 V 9.6 7.2 VI 16.5 10.1 VII 11.7 11.2 VIII 11.1 11.3 IX 10.9 11.6 Since week 35, the percentage of reported ILI cases has been highest among those in the 5-24 years of age group. This trend continued into week 52. Figure 2 Page 2 of 14

The 2014-15 state ILI rate was above the national, Region 4, and state baselines for week 52. Figure 3 Mississippi ILI Rates 2011-2014 Figure 4 Page 3 of 14

Flu Testing Reports 2014-2015 Influenza Season Week 52 Influenza Report Dec. 21 Dec. 27, 2014 From week 40 (week ending October 4 th ) through week 52 (week ending December 27 th ), 85 positive influenza samples were identified by MSDH. Seventy-nine samples were identified as influenza A (H3), three as influenza A (H1), and three were identified as influenza B. The influenza cases were identified from the following counties: Benton (2), Forrest (1), Franklin (1), Harrison (13), Itawamba (2), Jackson (1), Jefferson Davis (1), Jones (3), Lauderdale (6), Madison (5), Marion (1), Marshall (10), Monroe (3), Neshoba (3), Pike (2), Pontotoc (1), Rankin (4), Simpson (3), Sunflower (1), Tate (4), Union (1), Washington (5), Webster (4), Wilkinson (3), and Yazoo (4). One case was from an unidentified county. Figure 5 National and Mississippi Pediatric Mortality Surveillance Nationally, six influenza-associated pediatric deaths were reported to CDC during week 52. Three deaths were associated with an influenza A (H3) virus and occurred during weeks 51 and 52 (weeks ending December 20 th and December 27 th, respectively). Two deaths were associated with an influenza A virus for which no subtyping was performed and occurred during weeks 51 and 52. One death was associated with an influenza virus for which the type was not determined and occurred during week 51. To date, twenty-one influenza-associated pediatric deaths have been reported nationally during the 2014-2015 influenza season. Mississippi has had no influenza-associated pediatric deaths reported during this influenza season. For additional information on influenza-associated pediatric deaths, please refer to the CDC s FluView. Page 4 of 14

National ILI Surveillance For week 52, the MS ILI rate (9.9%) remained above the national ILI rate (5.9%). Figure 6 US ILI rates from the Centers for Disease Control and Prevention: http://www.cdc.gov/flu/weekly/ Mississippi reported Widespread flu activity for week 52. Table 3 Level of Flu Activity No Activity Sporadic Local Regional Widespread Definition Overall clinical activity remains low and there are no lab confirmed cases. Isolated cases of lab confirmed influenza in the state; ILI activity is not increased OR A labconfirmed outbreak in a single institution in the state; ILI activity is not increased. Increased ILI within a single region AND recent (within the past 3 weeks) laboratory evidence of influenza in that region. ILI activity in other regions is not increased OR two of more institutional outbreaks (ILI or lab confirmed) within a single region AND recent (within the past 3 weeks) lab confirmed influenza in that region. Other regions do not have increased ILI and virus activity is no greater than sporadic in those regions Increased ILI in at least 2 regions but fewer than half of the regions AND recent (within the past 3 weeks) lab confirmed influenza in the affected regions OR Institutional outbreaks (ILI or lab confirmed) in at least 2 regions but fewer than half of the regions AND recent lab confirmed influenza in the affected regions. Increased ILI and/or institutional outbreaks (ILI or lab confirmed) in at least half of the regions AND recent (within the past 3 weeks) lab confirmed influenza in the state. Page 5 of 14

During week 52, influenza activity continued to increase in the United States. 1 Figure 7 For up-to-date information on flu activity nationwide, please refer to the CDC s website: http://www.cdc.gov/flu/weekly/fluactivitysurv.htm. Additional information: Centers for Disease Control and Prevention Centers for Disease Control and Prevention FluView Flu.gov MSDH Flu and Pneumonia Google Flu Trends World Health Organization FluNet http://cdc.gov/flu/ http://www.cdc.gov/flu/weekly/ http://www.flu.gov/ http://msdh.ms.gov/msdhsite/_static/14,0,199.html http://www.google.org/flutrends/ http://www.who.int/influenza/gisrs_laboratory/flunet/en/ Page 6 of 14

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Appendix Figure 1 Page 8 of 14

Figure 2 Page 9 of 14

Figure 3 Page 10 of 14

Figure 4 Page 11 of 14

Figure 5 Page 12 of 14

Figure 6 US ILI rates from the Centers for Disease Control and Prevention: http://www.cdc.gov/flu/weekly/ Page 13 of 14

Figure 7 Page 14 of 14