WEEKLY INFLUENZA REPORT

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Mark Pfister Executive Director 12 18 Nov, 2017 Week 46 3010 Grand Ave, Waukegan, IL 60085 health.lakecountyil.gov (847) 377-8000 For questions regarding influenza and what is reportable to the Lake County Health Department, contact the Communicable Disease (CD) Program at (847) 377-8130 What is Influenza? The Centers for Disease Control and Prevention (CDC) defines influenza (flu) as a contagious respiratory illness caused by influenza viruses. It can cause mild to severe illness. Serious outcomes of flu infection can result in hospitalization or death. Some people, such as older people, young children, and people with certain health conditions, are at high risk for serious flu complications. The best way to prevent the flu is by getting vaccinated against the flu, each year. Weekly Summary The 2016-17 U.S. Three component (Trivalent) influenza vaccine contains: A/California/7/2009 (H1N1) pdm09-like virus, A/ Hong Kong/4801/2014 (H3N2)-like virus, and a B/Brisbane/60/2008-like virus (B/Victoria lineage). The 4 component (Quadrivalent) influenza vaccine will also include a B/Phuket/3073/2013- like virus (B/Yamagata lineage) for this year s flu season. Geographic Area Lake County Flu/Influenza-Like Illness (ILI) Activity Visits for Upper Respiratory Illness/Influenza-like-illness (ILI) at LCHD Health Centers dropped sharply by 27% after 4 straight weeks of increases. Lake County Schools: Total absenteeism increased by 7.5% when compared to the previous week. Cook County Flu/ILI Activity is currently: LOW (Week 45). Wisconsin (Southeast Region) Flu/ILI Activity is currently: LOW (Week 45). Illinois Flu/ILI Activity is currently LOW (Week 45). United States Flu/ILI Activity is currently: LOW (Week 45). Based on ILINet and most states falling into this category. Note: Our report contains different flu weeks for some geographic areas due to different reporting dates of sources. The Centers for Disease Control and Surveillance (CDC) have classified flu/influenza- Like-Illness (ILI) activity levels as minimal (levels 1-3), Low (levels 4-5), Moderate (levels 6-7), and High (levels 8-10). This classification helps in summarizing weekly flu/ili surveillance information for a geographic area and making flu/ili activity easier to interpret.

Patients Page 2 2 County Data LCHD/CHC (Federally Qualified Health Center): Week 46 (12 18 Nov 17) Visits to the Lake County Health Departments Community Health Center clinics (LCHD/CHC), for both upper respiratory infections (URI), and/or influenza-like-illness (ILI), dropped by 27% over the previous reporting week. # of Patients with URI and ILI by Week 160 120 80 80 77 90 97 92 85 71 96 102 119 128 94 40 0 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 Week Source: Lake County Health Department Electronic Health Records, 2017. Reportable to the Lake County Health Department: Week 46 (12 18 Nov 17) Quick Stats Week 46 Prior Week Cumulative* Flu - Intensive care unit (ICU) admissions 1 0 1 Flu - Pediatric Deaths (0-18) 0 0 0 Flu - Outbreaks reported (Congregate settings) ** 0 0 0 Source: Illinois National Electronic Disease Surveillance System (I-NEDSS) *Cumulative since week 35. Single positive flu tests are not reportable in Illinois. **Correctional, Long Term Care (LTC) Facilities, group homes and Hospitals.

Percent Page 3 School Influenza-Like Activity Surveillance: Week 46 (12 18 Nov 17) Reporting School Districts: Antioch (34), Community (128), Libertyville (70), North Shore (112), Waukegan (60), and Zion (6). Quick Stats Current Week Previous Week Schools tracking and reporting absenteeism data 45 44 Schools reporting ILI absenteeism (> 5%) 0 0 Schools/Pre-schools reporting general absenteeism (> 10%) 13 15 *Average % Absenteeism and Influenza-like-Illness (ILI) Lake County Schools (2017-18) 5 4.5 4 3.5 Thanksgiving Break Winter Break 3 2.5 2 1.5 Average Total Average ILI 1 0.5 0 Source: Lake County Schools 2017-2018

Page 4 4 Sentinel Pharmacies: Past 15 months (19 Aug 16 18 Nov 17) There are 71 pharmacies in Lake County who report the sales amount of over-the-counter (OTC) cough and cold medications for Upper Respiratory Infections. This report includes All Sales which refers to all cough and cold medicines that were sold in total, as well as Un-promoted Sales, which are cough and cold medicines not promoted but sold. Source: Real Time Outbreak and Disease Surveillance (RODS), 2017-2018.

Page 5 State Data Illinois: Week 45 (5 11 Nov 17) Illinois Influenza Geographical Spread Current Week Quick Stats Sporadic (see flu activity chart below for definition) Percent of outpatient visits for ILI 1.3% (baseline: 1.80%) Percent of Influenza Positive Tests Current Week: 2.1% Season: 1.5% Influenza-Associated ICU Admissions Current Week: 1 Season: 13 Influenza Outbreaks Current Week: 0 Season: 2 Influenza Associated Pediatric Deaths (Season Total) 0 Source: Illinois Department of Public Health, Influenza Surveillance, 2017-2018. Illinois Department of Public Health (IDPH) Flu Activity Rating by Geographical Spread No Activity Sporadic Activity Local Activity Regional Activity Widespread Activity No laboratory confirmed cases of influenza. Isolated lab-confirmed cases OR lab confirmed outbreak in one institution. Recent (within the past 3 weeks) lab evidence of influenza in region with increased ILI OR recent (within the past 3 weeks) lab evidence of influenza in region with the outbreaks; virus activity is no greater than sporadic in other regions. Increased ILI in > 2 but less than half of the regions AND recent (within the past 3 weeks) lab confirmed influenza in affected regions. OR institutional outbreaks (ILI or lab confirmed) in > 2 and less than half or regions AND recent lab confirmed influenza in affected regions. A region is defined as the regions States use for public health purposes. Increased ILI and/or institutional outbreaks (ILI or lab confirmed) in at least half of the regions AND recent (within the past weeks) lab confirmed influenza in the state. Source: Illinois Department of Public Health, Influenza Surveillance, 2017.

Page 6 6 National Data Center for Disease Control and Prevention (CDC): Week 45 (5 11 Nov 17) Flu/Influenza-Like Illness (ILI) activity is increasing in the United States Viral Surveillance: The most frequently identified influenza virus type reported by public health laboratories during week 45 was influenza A. The percentage of respiratory specimens testing positive for influenza in clinical laboratories is increasing. Influenza-Associated Pediatric Deaths: No influenza-associated pediatric deaths were reported. Geographic Spread of Influenza: The geographic spread of influenza in Guam, Puerto Rico and nine states was reported as regional; 13 states reported local activity; the U.S. Virgin Islands and 26 states reported sporadic activity; and the District of Columbia and two states reported no activity. For this reporting Source: Centers for Disease Control and Prevention, Flu Activity and Surveillance, 2017.