Influenza Report Week 09

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2016-2017 Influenza Report Week 09 February 26 March 4, 2017 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. Content State ILI Surveillance Flu Testing Reports National and Mississippi Pediatric Mortality Surveillance National ILI Surveillance Appendix Figure 1 (Statewide ILI Data, Current Season compared to Previous Season) Figure 2 (Percentage of ILI Cases by Age Group, Mississippi) Figure 3 (Mississippi ILI Rates, 2016-2017 and Previous Seasons) Figure 4 (State ILI/URI Rates 2013-2017 (YTD)) Figure 5 (Comparison of Statewide ILI Rate to Positive Influenza Isolates by Type and Subtype, Mississippi) Figure 6 (Comparison of Nationwide ILI Rates to Mississippi ILI Rates) Figure 7 (CDC FluView Weekly Influenza Activity Map)

State ILI Surveillance During week 09 (02/26/17-03/04/17), the state ILI rate (5.8%) decreased from the previous week (6.8%), but was higher than this time last year (5.0%). Figure 1 CDC Week Total number of patients seen by sentinel providers in the last three weeks. Table 1 Week Ending 2016-2017 Influenza Season Number of ILI Total patients ILI symptoms ILI Rate (%) Reports 09 Mar. 04 140 19974 1166 5.8% 08 Feb. 25 140 20796 1422 6.8% 07 Feb. 18 133 18626 1183 6.4% During week 09, one district (3) had an increase in ILI activity, while six districts (2, 4, 5, 7, 8, and 9) had a decrease. Two districts (1 and 6) remained about the same. Information is provisional only and may change depending on additional reporting from sentinel providers. Table 2 MSDH District ILI Rates (%) 2016-2017 District Week 08 Week 09 State 6.8 5.8 I 7.6 7.2 II 12.9 8.3 III 8.6 10.1 IV 6.1 5.3 V 4.4 2.9 VI 9.8 9.8 VII 6.2 5.6 VIII 7.6 6.5 IX 6.7 5.3 Page 2 of 15

Overall, the percentage of reported ILI cases has been highest among those in the 0-4 and 5-24 years. During week 09, the percentage of reported ILI cases continued to be highest among those in the 5-24 years of age group. Figure 2 The 2016-17 state ILI rate was above the national, Region 4, and state baselines for week 09. Figure 3 Page 3 of 15

Mississippi ILI Rates 2013-2017 Figure 4 Page 4 of 15

Flu Testing Reports From week 40 (week ending Oct. 8 th ) through week 09 (week ending March 4 th ), 124 laboratory confirmed influenza samples were identified by the MSDH Public Health Laboratory. Ninety-nine (80%) samples were identified as influenza A (H3), 17 (14%) were identified as influenza B, and eight (6%) were identified as influenza A (H1). Figure 5 The influenza cases were identified from the following counties: Alcorn (3), Attala (2), Coahoma (8), Copiah (4), Covington (2), DeSoto (1), Forrest (3), George (3), Harrison (2), Hinds (4), Holmes (2), Jones (3), Lafayette (3), Lauderdale (3), Lawrence (1), Lee (4), Leflore (1), Lincoln (12), Lowndes (8), Madison (2), Marion (2), Marshall (4), Monroe (3), Neshoba (4), Newton (2), Oktibbeha (10), Pearl River (2), Pike (3), Pontotoc (3), Rankin (1), Sharkey (1), Tate (2), Tippah (4), Warren (2), Washington (4), Webster (2), and Winston (4). National and Mississippi Pediatric Mortality Surveillance Nationally, eight influenza-associated pediatric deaths were reported to CDC during week 09. Two deaths were associated with an influenza A (H3) virus and occurred during weeks 07 and 08 (weeks ending February 18 th and February 25 th, respectively). One death was associated with an influenza A virus for which no subtyping was performed and occurred during week 08. Five deaths were associated with an influenza B virus and occurred during weeks 06, 07, and 08 (weeks ending February 11 th, February 18 th, and February 25 th ). 48 influenza-associated pediatric deaths have been reported during the 2016-2017 season. Mississippi has had one influenza-associated pediatric death reported during this influenza season. For additional information on influenza-associated pediatric deaths, please refer to the CDC s FluView. Page 5 of 15

National ILI Surveillance For week 09, the MS ILI rate (5.8%) was above the national ILI rate (3.6%). Figure 6 US ILI rates from the Centers for Disease Control and Prevention: http://www.cdc.gov/flu/weekly/. Page 6 of 15

During week 09, influenza activity decreased, but remained elevated in the United States. 1 Figure 7 Mississippi reported Widespread for the influenza activity during week 09. 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 7 of 15

Additional influenza information: Centers for Disease Control and Prevention Centers for Disease Control and Prevention FluView Flu.gov MSDH Flu and Pneumonia 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.who.int/influenza/gisrs_laboratory/flunet/en/ Page 8 of 15

Appendix Figure 1 Page 9 of 15

Figure 2 Page 10 of 15

Figure 3 Page 11 of 15

Figure 4 Page 12 of 15

Figure 5 Page 13 of 15

Figure 6 Page 14 of 15

Figure 7 Page 15 of 15