Weekly Influenza & Respiratory Illness Activity Report A summary of influenza surveillance indicators prepared by the Division of Infectious Disease Epidemiology Prevention & Control Week Ending October 8, 2016 | Week 40 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 October 8, 2016 (Week 40), surveillance indicators showed sporadic geographic spread of influenza. Since the start of the influenza season, 0 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 651-201-5414 or 1-877-676-5414 www.health.state.mn.us 10/13/2016 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*) B (no genotype) 45 B (Yamagata) 40 A (not subtyped) B (Victoria) A H3 35 A H1 (unspecified) A (H1N1)pdm09 30 A (H1N2v) A (H3N2v) 25 A&B 20 15 Unknown Current week 10 Number of Hospitalizations Number of Hospitalizations 50 Hospitalized Influenza Cases by Season, Minnesota (FluSurv-NET*) 700 650 600 550 500 450 400 350 300 250 200 150 100 50 0 2011-12 2012-13 2013-14 2014-15 2015-16 2016-17 Current week 40 42 44 46 48 50 52 2 4 6 8 10 12 14 16 18 20 MMWR Week 5 0 40 42 44 46 48 50 52 2 4 6 8 10 12 14 16 18 20 MMWR Week Hospitalizations this week Hospitalizations last week Total hospitalizations (to date) 3 0 3 *Influenza Surveillance Network Season 2011-2012 2012-2013 2013-2014 2014-2015 2015-2016 2016-2017 Total hospitalizations (historic) 556 3,068 1,540 4,138 1,541 3 (to date) Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending October 8, 2016 | Week 40 2 Hospitalized Influenza Surveillance (continued) Number of Hospitalizations # of hospitalizations 9 8 0.90 0.80 Incidence (cases) per 100,000 Persons 7 0.70 6 0.60 5 0.50 0.4 4 0.40 3 0.30 2 0.20 1 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.10 0.00 10 9 0.8 7 0.7 6 0.6 0.4 5 0.5 4 0.4 3 0.3 2 0.2 1 0.0 0.0 0.0 0-4 5-24 25-49 0.1 0.0 50-64 65+ 0.0 Age Group (years) Region Central Metro Northeast Northwest South Central Southeast Southwest West Central 0.9 Incidence (cases) per 100,000 Persons 8 0 Region 1.0 # of hospitalizations Hospitalizations per 100,000 Persons 1.00 Hospitalizations per 100,000 Persons 10 Number of Influenza Hospitalizations and Incidence by Age, Minnesota October 2, 2016 – October 8, 2016 Number of Hospitalizations Number of Influenza Hospitalizations and Incidence by Region, Minnesota October 2, 2016 – October 8, 2016 Hospitalizations this week Total (to date) 0 (0%) 1 (33%) 0 (0%) 0 (0%) 0 (0%) 2 (67%) 0 (0%) 0 (0%) 0 (0%) 1 (33%) 0 (0%) 0 (0%) 0 (0%) 2 (67%) 0 (0%) 0 (0%) Median age (years) at time of admission 80.0 Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending October 8, 2016 | Week 40 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 300 2012-13 2013-14 2014-15 250 2015-16 2016-17 200 150 100 Current week 50 0 40 41 42 43 44 45 46 47 48 49 50 51 52 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 MMWR Week New school outbreaks this week New school outbreaks last week Total this season (to date) 1 N/A 1 Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending October 8, 2016 | Week 40 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 70 Number of lab-confirmed outbreaks 65 2012-13 60 2013-14 55 2014-15 50 2015-16 45 2016-17 40 35 30 25 20 Current week 15 10 5 0 40 41 42 43 44 45 46 47 48 49 50 51 52 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 MMWR Week New LTC outbreaks this week New LTC outbreaks last week Total this season (to date) 0 N/A 0 Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending October 8, 2016 | Week 40 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 2012-13 Percent with Influenza-like Illness 8 2013-14 2014-15 7 2015-16 6 2016-17 5 4 Current week* 3 2 1 0 40 41 42 43 44 45 46 47 48 49 50 51 52 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 MMWR Week % of outpatients with ILI this week % of outpatients with ILI last week 2.1% 1.8% Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending October 8, 2016 | Week 40 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 25 B A H3 20 A (H1N1) pdm09 2013-14 % + by PCR 15 2014-15 % + by PCR Current week 2015-16 % + by PCR 2016-17 % + by PCR 10 30 25 20 15 Percent of RT-PCR Positive Number of RT-PCR Positives A (not subtyped) 35 10 5 0 5 40 41 42 43 44 45 46 47 48 49 50 51 52 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 0 MMWR Week % RT-PCR positive this week % RT-PCR positive last week 2.2% N/A Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending October 8, 2016 | Week 40 7 Laboratory Surveillance (continued) MLS Laboratories – Influenza Testing MLS Laboratories – RSV Testing Specimens Positive by Influenza Rapid Test, by Week Specimens Positive by RSV Rapid Test, by Week A+ (2015-16 Season) 50 45 2013-14 % + 45 40 2014-15% + 40 35 2015-16 % + 35 30 2016-17 % + 30 25 25 20 20 Current week 15 15 10 10 5 5 0 0 40 42 44 46 48 50 52 2 4 6 MMWR Week Region Northeast South Central Southwest Southeast Metro Central West Central Northwest State (overall) 8 10 12 14 16 18 20 % rapid influenza tests + (current week) 0% 0% 8% 0% 2% 0% 5% 0% 2% 50 Number + 45 2013-14 % + 40 2014-15 % + 35 2015-16 % + 2016-17 % + 30 25 20 Current week 15 10 5 0 40 42 44 46 48 50 52 2 4 6 8 10 12 14 16 18 20 MMWR Week Region Northeast South Central Southwest Southeast Metro Central West Central Northwest State (overall) 75 70 65 60 55 50 45 40 35 30 25 20 15 10 5 0 Percentage of Rapid RSV Tests Positive A/B+ (2015-16 Season) Number of Positive RSV Tests 50 Percentage of Rapid Influenza Tests Positive Number of Positive Influenza Specimens B+ (2015-16 Season) % rapid RSV tests + (current week) 0% 0% 17% 0% 13% 0% 0% 0% 6% Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending October 8, 2016 | Week 40 8 Laboratory Surveillance (continued) Minnesota Influenza Incidence Surveillance Project (MIISP) Positive Respiratory Pathogens by PCR, by MMWR Week Number Positive by RT-PCR 20 Influenza B Influenza A H3 Influenza A (H1N1) pdm09 Influenza A Unspecified Influenza C RSV Human Metapneumovirus Rhinovirus/Enterovirus Adenovirus Coronavirus NL63 Coronavirus OC43 Coronavirus 229E Coronavirus HKU1 Parainfluenza-1 Parainfluenza-2 Parainfluenza-3 Parainfluenza-4 15 10 5 0 30 32 34 36 38 40 42 44 46 48 50 52 1 2 4 6 8 10 12 14 16 18 20 MMWR Week* *Indicates current week-data may be delayed by 2 or more weeks Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending October 8, 2016 | Week 40 9
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