MINNESOTA DEPARTMENT OF HEALTH
Weekly Influenza & Respiratory Illness Activity Report
A summary of influenza surveillance indicators prepared by the Division of Infectious Disease Epidemiology Prevention & Control
Summary of the 2014-15 Influenza Season
All data are preliminary and may change as more reports are received
Summary of the 2014-15 Season
•
4,153 people were hospitalized with laboratory-confirmed influenza
•
10 pediatric influenza-related deaths were confirmed
•
192 outbreaks of influenza in long-term care were reported
•
706 outbreaks of ILI in schools were reported
Minnesota Influenza Surveillance Website: 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/
Google Flu Trends: http://www.google.org/flutrends/us/#US
Neighboring states’ influenza information:
Iowa
Wisconsin
North Dakota
South Dakota
http://www.idph.state.ia.us/IdphArchive/Archive.aspx?channel=FluReports
http://www.dhs.wisconsin.gov/communicable/influenza/surveillance.htm
http://www.ndflu.com/default.aspx
http://doh.sd.gov/diseases/infectious/flu/
Minnesota Department of Health Weekly Influenza & Respiratory Activity | Summary 2014-15
1
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.
Hospitalized Influenza Cases by
Season, Minnesota (FluSurv-NET*)
B (no genotype)
750
B (Yamagata)
700
B (Victoria)
650
A (not subtyped)
600
A H3
550
A H1 (unspecified)
500
A (H1N1)pdm09
450
400
A (H1N2v)
350
A (H3N2v)
300
A&B
250
Unknown
200
150
100
50
0
40 42 44 46 48 50 52 1
3
5
7
MMWR Week
9 11 13 15 17 19 21
*Influenza Surveillance Network
Minnesota Department of Health Weekly Influenza & Respiratory Activity | Summary 2014-15
Number of Hospitalizations
Number of Hospitalizations
Hospitalized Influenza Cases by Type
Minnesota (FluSurv-NET*)
750
700
650
600
550
500
450
400
350
300
250
200
150
100
50
0
2009-10
2010-11
2011-12
2012-13
2013-14
2014-15
40 42 44 46 48 50 52 1 3 5 7 9 11 13 15 17 19
Season
2009-2010
2010-2011
2011-2012
2012-2013
2013-2014
2014-2015
MMWR Week
Total Hospitalizations (historic)
2,060
965
556
3,068
1,540
4,138
2
Number of Hospitalizations
# of hospitalizations
Incidence (cases) per
100,000 Persons
68.6
73.9
124.1
107.8
51.0
500.0
450.0
400.0
350.0
300.0
250.0
91.6
78.3
200.0
44.9
150.0
100.0
50.0
0.0
Region
Region
Central
Metro
Northeast
Northwest
South Central
Southeast
Southwest
West Central
Total (to date)
500 (12%)
2,107 (51%)
405 (10%)
80 (2%)
314 (8%)
453 (11%)
174 (4%)
105 (3%)
Minnesota Department of Health Weekly Influenza & Respiratory Activity | Summary 2014-15
3000
2800
2600
2400
2200
2000
1800
1600
1400
1200
1000
800
600
400
200
0
Number of Influenza Hospitalizations and
Incidence by Age, Minnesota
Sept 28, 2014 – May 23, 2015
# of hospitalizations
410.6
Incidence (cases) per
100,000 Persons
500.0
450.0
400.0
350.0
300.0
250.0
200.0
53.4
0-4
150.0
100.0
52.1
20.1
17.8
5-24
25-49
50-64
Age Group (years)
65+
50.0
0.0
Hospitalizations per 100,000 Persons
2400
2200
2000
1800
1600
1400
1200
1000
800
600
400
200
0
Hospitalizations per 100,000 Persons
Number of Influenza Hospitalizations and
Incidence by Region, Minnesota
Sept 28, 2014 – May 23, 2015
Number of Hospitalizations
Hospitalized Influenza Surveillance - continued
Median age (years) at time of admission
76.0
3
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
Number of influenza-like illness outbreaks
Influenza-like Illness (ILI) in Schools by Season
350
2010-11
300
2011-12
2012-13
250
2013-14
2014-15
200
150
100
50
0
36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 1
2
MMWR Week
3
4
5
6
7
8
9 10 11 12 13 14 15 16 17 18 19 20
Total
705
Minnesota Department of Health Weekly Influenza & Respiratory Activity | Summary 2014-15
4
Respiratory Disease Outbreak Surveillance
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
Influenza-like Illness (ILI) in LTC by Season
Number of influenza-like illness outbreaks
70
65
2010-11
60
2011-12
55
2012-13
50
2013-14
45
2014-15
40
35
30
25
20
15
10
5
0
40 41 42 43 44 45 46 47 48 49 50 51 52 53 1
2
3
4
5
6
7
8
9 10 11 12 13 14 15 16 17 18 19 20
MMWR Week
Total
192
Minnesota Department of Health Weekly Influenza & Respiratory Activity | Summary 2014-15
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.
Percent with Influenza-like Illness
Percentage of Persons Presenting to Outpatient Clinics with Influenza-Like
Illness (ILI)
9
2010-11
8
2011-12
7
2012-13
6
2013-14
5
2014-15
4
3
2
1
0
40 41 42 43 44 45 46 47 48 49 50 51 52 53 1
2
3
4
5
MMWR Week
6
7
8
9 10 11 12 13 14 15 16 17 18 19 20
Peak % of
outpatients
with ILI
7.85%
Minnesota Department of Health Weekly Influenza & Respiratory Activity | Summary 2014-15
6
Laboratory Surveillance
The MN Lab System (MLS) Laboratory Influenza Surveillance Program is made up of more than 310 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 RT-PCR, by Week
500
400
300
200
B
45
A (not subtyped)
40
A H3
35
A (H1N1) pdm09
2011-12 % + by PCR
30
2012-13 % + by PCR
25
2013-14 % + by PCR
2014-15% + by PCR
20
15
10
100
0
5
4041424344454647484950515253 1 2 3 4 5 6 7 8 9 1011121314151617181920
MMWR Week
Percent of RT-PCR Positive
Number of RT-PCR Positives
600
0
Peak % RTPCR positive
29.65%
Minnesota Department of Health Weekly Influenza & Respiratory Activity | Summary 2014-15
7
Laboratory Surveillance – Rapid Test
MLS Laboratories – Influenza Testing
MLS Laboratories – RSV Testing
2009-10 % +
2010-11 % +
2011-12 % +
2000
2012-13 % +
2013-14 % +
2014-15% +
1500
1000
35
30
25
20
15
10
500
0
40
5
40 42 44 46 48 50 52 1
3
5
7
MMWR Week
9 11 13 15 17 19
0
2009-10 % +
200
Number of Positive RSV Tests
A/B+ (2014-15 Season)
2500
Number +
2010-11 % +
2011-12 % +
175
2012-13 % +
2013-14 % +
150
2014-15 % +
125
100
75
50
25
0
40 42 44 46 48 50 52 1 3 5 7 9 11 13 15 17 19
MMWR Week
Peak % rapid
positive
Peak % rapid
positive
35.28%
31.72%
Minnesota Department of Health Weekly Influenza & Respiratory Activity | Summary 2014-15
75
70
65
60
55
50
45
40
35
30
25
20
15
10
5
0
Percentage of Rapid RSV Tests Positive
A+ (2014-15 Season)
Specimens Positive by RSV Rapid Test, by Week
Percentage of Rapid Influenza Tests Positive
Number of Positive Influenza Specimens
Specimens Positive by Influenza Rapid Test, by
Week
B+ (2014-15 Season)
8
Laboratory Surveillance – PCR
MN Influenza Incidence Project (IISP) - Outpatients
Pathogens Detected, Minnesota IISP
2014-2015
Influenza B
Influenza A Unspecified
Rhinovirus
Coronavirus NL63
Coronavirus HKU1
Parainfluenza-3
Number Positive by RT-PCR
20
15
Influenza A H3
RSV
Enterovirus
Coronavirus OC43
Parainfluenza-1
Parainfluenza-4
Influenza A (H1N1) pdm09
Human Metapneumovirus
Adenovirus
Coronavirus 229E
Parainfluenza-2
10
5
0
32
34
36
38
40
42
44
46
48
*Indicates current week-data may be delayed by 2 or more weeks
50
52 53 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
MMWR Week
Minnesota Department of Health Weekly Influenza & Respiratory Activity | Summary 2014-15
9
Laboratory Surveillance – PCR
Severe Acute Respiratory Illness Surveillance (SARI) - Inpatients
Positive Respiratory Pathogens by PCR, by MMWR Week
Influenza B
Influenza A (H1N1) pdm09
RSV
Rhinovirus
Coronavirus NL63
Coronavirus 229E
Parainfluenza-1
Parainfluenza-3
Legionella
Mycoplasma pneumoniae
Enterovirus
225
Number Positive by RT-PCR
200
175
150
125
Influenza A H3
Influenza A Unspecified
Human Metapneumovirus
Adenovirus
Coronavirus OC43
Coronavirus HKU1
Parainfluenza-2
Parainfluenza-4
Chlamydophila pneumoniae
Bordetella pertussis
100
75
50
25
0
32
34
36
38
40
42
44
46
48
50
*Indicates current week-data may be delayed by 2 or more weeks
*Indicates current week-data may be delayed by 2 or more weeks
53
2
4
MMWR Week*
Minnesota Department of Health Weekly Influenza & Respiratory Activity | Summary 2014-15
6
8
10
12
14
16
18
20
22
24
26
10