Weekly Influenza & Respiratory
Illness Activity Report
A summary of influenza surveillance indicators prepared by the Division of Infectious Disease Epidemiology Prevention & Control
Week Ending December 31, 2016 | WEEK 52
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 December 31, 2016 (Week 52),
surveillance indicators showed
regional 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
1/5/2017
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
Current week
A H1 (unspecified)
A (H1N1)pdm09
30
A (H1N2v)
A (H3N2v)
25
A&B
20
Unknown
15
10
Number of Hospitalizations
Number of Hospitalizations
50
Hospitalized Influenza Cases by Season, Minnesota
(FluSurv-NET*)
750
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)
24
27
124
*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
124 (to date)
Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending December 31, 2016 | WEEK 52
2
Hospitalized Influenza Surveillance (continued)
Number of Hospitalizations
Incidence (cases) per
100,000 Persons
80
9.0
8.0
70
7.0
60
6.0
50
5.0
40
30
3.6
2.7
20
10
2.4
2.2
0.9
0.6
1.4
0
3.8
4.0
3.0
2.0
1.0
0.0
9.4
100
# of hospitalizations
90
9.0
Incidence (cases) per
100,000 Persons
80
8.0
70
7.0
60
6.0
50
5.0
40
4.0
30
20
3.0
1.9
1.1
10
0.7
0.7
5-24
25-49
2.0
1.0
0.0
0
0-4
Central
Metro
Northeast
Northwest
South Central
Southeast
Southwest
West Central
50-64
65+
Age Group (years)
Region
Region
10.0
Hospitalizations per 100,000 Persons
90
10.0
Hospitalizations per 100,000 Persons
# of hospitalizations
100
Number of Influenza Hospitalizations and Incidence by
Age, Minnesota
October 2, 2016 – December 31, 2016
Number of Hospitalizations
Number of Influenza Hospitalizations and Incidence by
Region, Minnesota
October 2, 2016 – December 31, 2016
Hospitalizations
this week
Total
(to date)
5 (21%)
14 (58%)
0 (0%)
1 (4%)
1 (4%)
0 (0%)
0 (0%)
3 (13%)
20 (16%)
68 (55%)
3 (2%)
1 (1%)
4 (3%)
11 (9%)
8 (6%)
9 (7%)
Median age (years)
at time of admission
70.5
Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending December 31, 2016 | WEEK 52
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
Current week
100
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 21
MMWR Week
New school
outbreaks this week
New school
outbreaks last week
Total this season
(to date)
0
3
21
Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending December 31, 2016 | WEEK 52
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
Number of lab-confirmed outbreaks
70
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 21
MMWR Week
New LTC outbreaks
this week
New LTC outbreaks
last week
Total this season
(to date)
2
1
8
Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending December 31, 2016 | WEEK 52
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
6
2015-16
2016-17
Current week*
5
4
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
1.54%
0.8%
*Indicates current week-data may be
delayed by 1 or more weeks
Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending December 31, 2016 | WEEK 52
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.
80
75
70
65
60
55
50
45
40
35
30
25
20
15
10
5
0
B
A (not subtyped)
A H3
A (H1N1) pdm09
Current week
2013-14 % + by PCR
2014-15 % + by PCR
2015-16 % + by PCR
2016-17 % + by PCR
35
30
25
20
15
10
5
Percent of positive molecular tests
Number of positive molecular tests
Specimens Positive for Influenza by Molecular Testing*, by Week
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
% molecular tests
positive this week
% molecular tests
positive last week
5.0%
3.6%
*Beginning in 2016-17, laboratories report
results for rapid molecular influenza tests
in addition to RT-PCR results
Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending December 31, 2016 | WEEK 52
7
Laboratory Surveillance (continued)
MLS Laboratories – Influenza Testing
MLS Laboratories – RSV Testing
Specimens Positive by Influenza Rapid Antigen Test, by Week
Specimens Positive by RSV Rapid Antigen Test, by Week
Current week
2013-14 % +
45
2014-15% +
40
2015-16 % +
35
2016-17 % +
30
25
20
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)
% rapid antigen influenza tests +
(current week)
9%
8%
16%
0%
11%
19%
15%
16%
13%
240
Number +
220
2013-14 % +
200
2014-15 % +
180
2015-16 % +
160
Current week
2016-17 % +
140
120
100
80
60
40
20
0
75
70
65
60
55
50
45
40
35
30
25
20
15
10
5
0
Percentage of Rapid Antigen RSV Tests Positive
A/B+ (2015-16 Season)
50
Number of Positive RSV Tests
A+ (2015-16 Season)
320
300
280
260
240
220
200
180
160
140
120
100
80
60
40
20
0
Percentage of Rapid Antigen Influenza Tests Positive
Number of Positive Influenza Specimens
B+ (2015-16 Season)
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)
% rapid antigen RSV tests +
(current week)
24%
55%
50%
35%
37%
30%
43%
22%
37%
Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending December 31, 2016 | WEEK 52
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 December 31, 2016 | WEEK 52
9
Laboratory Surveillance (continued)
Severe Acute Respiratory Surveillance (SARI) - Inpatients
Positive Respiratory Pathogens by PCR, by MMWR Week
75
Parainfluenza 4
Parainfluenza 3
Parainfluenza 2
Parainfluenza 1
Coronavirus HKU1
Coronavirus 229E
Coronavirus OC43
Coronavirus NL63
Adenovirus
Rhinovirus/Enterovirus
Human Metapneumovirus
RSV
Influenza A Unspecified
Influenza A (H1N1) pdm09
Influenza A H3
Influenza B
Legionella
Mycoplasma pneumoniae
Chlamydophila pneumoniae
Influenza C
Bocavirus
70
65
Number Positive by RT-PCR
60
55
50
45
40
35
30
25
20
15
10
5
0
32
34
36
38
40
42
44
46
*Indicates current week-data may be delayed by 2 or more weeks
48
50
52
2
4
6
8
10
12
14
16
18
20
20
MMWR Week*
Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending December 31, 2016 | WEEK 52
10
Weekly U.S. Influenza Surveillance Report
2016-2017 Influenza Season Week 51 ending December 24, 2016
National Influenza Surveillance (CDC): http://www.cdc.gov/flu/weekly/
Viral Surveillance: The most frequently identified influenza virus subtype reported by public health laboratories during week 51 was influenza A (H3). The percentage of
respiratory specimens testing positive for influenza in clinical laboratories increased.
Novel Influenza A Virus: One human infection with a novel influenza A virus was reported.
Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia and influenza (P&I) was below the system-specific epidemic threshold in the National
Center for Health Statistics (NCHS) Mortality Surveillance System.
Influenza-associated Pediatric Deaths: No influenza-associated pediatric deaths were reported.
Influenza-associated Hospitalizations: A cumulative rate for the season of 3.1 laboratory-confirmed influenza-associated hospitalizations per 100,000 population was
reported.
Outpatient Illness Surveillance: The proportion of outpatient visits for influenza-like illness (ILI) was 2.9%, which is above the national baseline of 2.2%. Nine regions reported
ILI at or above their region-specific baseline levels. Four states, New York City and Puerto Rico experienced high ILI activity; five states experienced moderate ILI activity;
seven states experienced low ILI activity; 34 states experienced minimal ILI activity, and the District of Columbia had insufficient data.
Geographic Spread of Influenza: The geographic spread of influenza in Guam and eight states was reported as widespread, the U.S. Virgin Islands and 17 states reported
regional activity, the District of Columbia and 19 states reported local activity, five states reported sporadic activity, and Puerto Rico and one state did not report.
Influenza-Like Illness (ILI) Activity Level Indicator Determined by Data Reported to ILINet
2016-17 Influenza Season Week 51 ending Dec 24, 2016
Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending December 31, 2016 | WEEK 52
11