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
Current: Week Ending October 17, 2015 | WEEK 41
All data are preliminary and may change as more reports are received
Minnesota Influenza Geographic
Spread*
Summary
During the week ending October 17, 2015, (Week 41),
surveillance indicators showed SPORADIC geographic
spread of influenza.
No Activity
Sporadic
Local
Regional
Widespread
*Based on CDC’s Activity Estimates Definitions:
www.cdc.gov/flu/weekly/overview.htm
Minnesota Influenza Surveillance Website: www.health.state.mn.us/divs/idepc/diseases/flu/stats/
Weekly U.S. Influenza Surveillance Report: www.cdc.gov/flu/weekly/
World Health Organization (WHO) Surveillance: www.who.int/influenza/surveillance_monitoring/updates/en/
Neighboring states’ influenza information:
Iowa
ww.idph.state.ia.us/IdphArchive/Archive.aspx?channel=FluReports
Wisconsin
www.dhs.wisconsin.gov/communicable/influenza/Reports/Surveillance.htm
North Dakota
www.ndflu.com/default.aspx
South Dakota
http://doh.sd.gov/diseases/infectious/flu/
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. Due to the need to confirm reports and reporting delays, consider current and recent weeks’ data preliminary.
Hospitalized Influenza Cases by
Season, Minnesota (FluSurv-NET*)
Number of Hospitalizations
24
B
A (not subtyped)
A H3
A H1 (unspecified)
A (H1N1)pdm09
A (H1N2v)
A (H3N2v)
A&B
Unknown
22
20
18
16
14
12
10
Current Week
8
6
4
2
0
40 42 44 46 48 50 52 2 4 6 8 10 12 14 16 18 20 22 24
MMWR Week
Hospitalizations this
week
Hospitalizations last
week
Total (to date)
4
3
7
*Influenza Surveillance Network
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
2010-11
2011-12
2012-13
2013-14
2014-15
2015-16
Current Week
40 42 44 46 48 50 52 1 3 5 7 9 11 13 15 17 19
Season
MMWR Week
Hospitalizations current
week (historic)
Total
1
1
2
3
3
4
965
556
3,068
1,540
4,141
7 (to date)
2010-2011
2011-2012
2012-2013
2013-2014
2014-2015
2015-2016
Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending October 17, 2015 | WEEK 41
2
Number of Hospitalizations
5.0
# of hospitalizations
45
40
4.5
4.0
Incidence (cases) per
100,000 Persons
35
30
3.5
3.0
25
2.5
20
15
10
5
2.0
1.5
0.9
0.1
0
0.1
0.0
0.0
0.0
0.0
0.0
1.0
0.5
0.0
Region
Region
Central
Metro
Northeast
Northwest
South Central
Southeast
Southwest
West Central
Hospitalizations this
week
Total (to date)
0 (0%)
3 (75%)
0 (0%)
0 (0%)
0 (0%)
0 (0%)
1 (25%)
0 (0%)
1 (14%)
4 (57%)
0 (0%)
0 (0%)
0 (0%)
0 (0%)
1 (29%)
0 (0%)
50
Number of Influenza Hospitalizations and
Incidence by Age, Minnesota
October 4, 2015 – October 17, 2015
# of hospitalizations
45
40
4.5
4.0
Incidence (cases) per
100,000 Persons
35
30
3.5
3.0
2.5
25
2.0
20
15
10
5
0
5.0
0.3
0-4
0.0
0.0
5-24
25-49
0.3
50-64
Age Group (years)
0.4
65+
1.5
1.0
0.5
0.0
Hospitalizations per 100,000 Persons
50
Hospitalizations per 100,000 Persons
Number of Influenza Hospitalizations and
Incidence by Region, Minnesota
October 4, 2015 – October 17, 2015
Number of Hospitalizations
Hospitalized Influenza Surveillance - continued
Median age (years) at time of admission
62.8
Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending October 17, 2015 | WEEK 41
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
2011-12
300
2012-13
2013-14
250
2014-15
2015-16
200
150
100
Current week
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
New school
outbreaks this week
New school
outbreaks last week
Total this season
(to date)
0
0
2
Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending October 17, 2015 | WEEK 41
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
Confirmed Influenza Outbreaks in LTC by Season
70
Number of lab-confirmed outbreaks
65
2011-12
60
55
2012-13
50
2013-14
45
2014-15
40
2015-16
35
30
25
20
Current week
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
New LTC outbreaks
this week
New LTC outbreaks
last week
Total this season
(to date)
0
0
1
Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending October 17, 2015 | WEEK 41
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 InfluenzaLike Illness (ILI)
Percent with Influenza-like Illness
9
2011-12
8
2012-13
7
2013-14
2014-15
6
2015-16
5
4
3
Current week*
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
*Indicates current week-data may be delayed by 1 or more weeks
% of outpatients with
ILI this week
% of outpatients with
ILI last week
0.36%
0.45%
Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending October 17, 2015 | WEEK 41
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.
20
B
45
16
A (H1N1) pdm09
35
A (not subtyped)
18
A H3
14
12
10
8
2012-13 % + by PCR
2013-14 % + by PCR
2014-15 % + by PCR
2015-16% + by PCR
Current
week
6
0
30
25
20
15
10
4
2
40
Percent of RT-PCR Positive
Number of RT-PCR Positives
Specimens Positive for Influenza by RT-PCR, by Week
5
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
% RT-PCR positive this
week
% RT-PCR positive last
week
0.89%
1.64%
Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending October 17, 2015 | WEEK 41
0
7
Laboratory Surveillance – Rapid Test
MLS Laboratories – Influenza Testing
MLS Laboratories – RSV Testing
18
16
14
A/B+ (2015-16 Season)
2011-12 % +
2012-13 % +
Current
week
2013-14 % +
2014-15% +
2015-16 % +
12
10
8
35
30
25
20
15
6
10
4
5
2
0
40
40 42 44 46 48 50 52 1
3
5
7
MMWR Week
Region
Northeast
South Central
Southwest
Southeast
Metro
Central
West Central
Northwest
State (overall)
9 11 13 15 17 19
% rapid influenza tests +
(current week)
0%
0%
4%
0%
2%
1%
3%
0%
2%
0
50
Number of Positive RSV Tests
A+ (2015-16 Season)
20
Number +
45
2011-12 % +
2012-13 % +
40
2013-14 % +
35
2014-15 % +
30
25
20
2015-16 % +
70
65
60
55
50
45
40
35
Current
week
30
25
15
20
10
15
10
5
0
75
40 42 44 46 48 50 52 1 3 5 7 9 11 13 15 17 19
MMWR Week
Region
Northeast
South Central
Southwest
Southeast
Metro
Central
West Central
Northwest
State (overall)
Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending October 17, 2015 | WEEK 41
% rapid RSV tests +
(current week)
0%
0%
0%
0%
8%
7%
0%
0%
4%
5
Percentage of Rapid RSV Tests Positive
B+ (2015-16 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
0
8
Laboratory Surveillance – PCR
MN Influenza Incidence Project (IISP) - Outpatients
Pathogens Detected, Minnesota IISP
2015-2016
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
30
32
34
36
38
40
42
44
46
48
50
52 1 2 3 4 5 6 7 8 9 10
MMWR Week*
12
14
16
18
20
*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 17, 2015 | WEEK 41
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
75
Number Positive by RT-PCR
70
65
60
55
50
45
40
35
30
25
Influenza A H3
Influenza A Unspecified
Human Metapneumovirus
Adenovirus
Coronavirus OC43
Coronavirus HKU1
Parainfluenza-2
Parainfluenza-4
Chlamydophila pneumoniae
Bordetella pertussis
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
MMWR Week*
4
6
8
Minnesota Department of Health Weekly Influenza & Respiratory Activity Report for Week Ending October 17, 2015 | WEEK 41
10
12
14
16
18
20
10
Weekly U.S. Influenza Surveillance Report
Current: Week Ending October 10, 2015 | WEEK 40
National Influenza Surveillance (CDC)
Viral Surveillance: The most frequently identified influenza virus type reported by public health laboratories in week 40 was influenza A viruses, with
influenza A (H3) viruses predominating. The percentage of respiratory specimens testing positive for influenza in clinical laboratories is low.
Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia and influenza (P&I) was below their system-specific epidemic threshold
in both the NCHS Mortality Surveillance System and the 122 Cities Mortality Reporting System.
Influenza-associated Pediatric Deaths: No influenza-associated pediatric deaths were reported.
Outpatient Illness Surveillance: The proportion of outpatient visits for influenza-like illness (ILI) was 1.2%, which is below the national baseline of 2.1%. All 10
regions reported ILI below region-specific baseline levels. Georgia experienced low ILI activity; Puerto Rico, New York City and 47 states experienced minimal ILI
activity; and the District of Columbia and two states had insufficient data.
Geographic Spread of Influenza: The geographic spread of influenza in Guam was reported as widespread; one state reported regional activity; one state
reported local activity; Puerto Rico and 27 states reported sporadic activity; the U.S. Virgin Islands and 21 states reported no influenza activity; and the District
of Columbia did not report.
11