Influenza Surveillance Report

[Pages:8]Influenza Surveillance Report

Division of Disease Prevention and Control Public Health Informatics CDC MMWR Week 22:

May 26, 2019 to June 01, 2019 Influenza Activity by County, State, and National Levels

Houston/ Harris County: Decreased

Texas: Decreased

CDC: Decreased

Highlights ? The Houston Health Department (HHD) conducts seasonal influenza surveillance from October (week 40) to May (week 22). In week 22, the percentage of reported influenza-like illnesses (ILI) detected in emergency centers in Houston/Harris County was 0.62% which increased from the previous week. The flu vaccine is recommended for the entire season.

Influenza Like Illness (ILI) ? The percentage of Athena ILI reports decreased to 0.04% in week 22 compared to the previous week.

Virology ? HHD receives electronic lab reports from clinical labs. During week 22, the volume of flu tests received remained comparable to the previous week. Flu A activity accounts for 97% of the cumulative flu positives this season.

Texas ? The proportion of outpatient visits for ILI (2.42%) was below the baseline (5.60%) and 1,865 pneumonia and influenza deaths have been reported in Texas during the 2018-19 flu season. No influenza-associated pediatric death was reported during week 22. A total of ten influenza-associated pediatric deaths have been reported in Texas during the 2018-2019 influenza season. No institutional outbreaks were reported in week 22.

National ? At the national level during week 22, 4.63% of specimens tested and reported to the CDC by clinical labs were positive for influenza.

Houston Health Department

1

8000 North Stadium Drive, Houston, TX

77054 (832) 393-5169



ILI Percent (%)

Syndromic Surveillance: ILI activity trend in 2018-2019

3.00% 2.50% 2.00% 1.50% 1.00% 0.50% 0.00%

Percent 0.62%

CDC MMWR Week

Syndromic Surveillance: 2018-2019 Influenza Season Age and Gender Distribution

Age group

6% 3% 23%

00-04 years

38%

05-17 years

18-44 years

45-64 years

65+ years

Gender

Female 46%

Male 54%

30%

During week 22, 0.62% of emergency center (EC) visits were due to influenza-like illness (ILI) complaints. Of the 746 patients presenting with ILI, the age group that recorded the most EC visits was the 00 to 04 years old (38%). Females accounted for 54% of patients presenting with ILI.

NOTE: ILI activity is assessed using information provided by the Southeast Texas Syndromic Surveillance System and includes data from 67

hospitals and 17 school-based clinics. Influenza-like illness (ILI) is defined as the mention of fever AND cough, OR fever AND sore throat, OR

flu in the patient's Emergency Department (ED) chief complaint. These data do not represent laboratory confirmed cases of influenza nor do

they represent all ED visits in Houston/Harris County.

Houston Health Department

2

8000 North Stadium Drive, Houston, TX

77054 (832) 393-5169



Syndromic Surveillance: Geographic Distribution Map of ILI

During week 22, the zip codes with the highest percent of ED visits (1.35 or greater) were: 77072, 77039, 77081, 77031, 77036, 77565, 77085, 77504, 77045 and 77037

NOTE: Houston/Harris County ILI report distribution map was created using data provided by the Southeast Texas Syndromic Surveillance System and includes data from 67 hospitals and 17 school-based clinics. This map reflects the number of ILI cases from each residential zip code during the current week of reporting. Influenza-like illness (ILI) is defined as the mention of fever AND cough, OR fever AND sore throat, OR flu in the patient's ED chief complaint. These data do not represent laboratory confirmed cases of influenza nor do they represent all ED visits in Houston/Harris County.

Houston Health Department

3

8000 North Stadium Drive, Houston, TX

77054 (832) 393-5169



Athena: ILI percentage per week from 2018-19

ILI Percent

0.45% 0.40% 0.35% 0.30% 0.25% 0.20% 0.15% 0.10% 0.05% 0.00%

0.06%

10/7/2018 10/14/2018 10/21/2018 10/28/2018

11/4/2018 11/11/2018 11/18/2018 11/25/2018

12/2/2018 12/9/2018 12/16/2018 12/23/2018 12/30/2018

1/6/2019 1/13/2019 1/20/2019 1/27/2019

2/3/2019 2/10/2019 2/17/2019 2/24/2019

3/3/2019 3/10/2019 3/17/2019 3/24/2019 3/31/2019

4/7/2019 4/14/2019 4/21/2019 4/28/2019

5/5/2019 5/12/2019 5/19/2019 5/26/2019

Week Start Date

Athena: ILI per week by age group

60

50

ILI Count

40

Age: 65 or Older

30

Age: 50 - 64

Age: 18 - 49

20

Age: 5 - 17

Age: 0 - 4

10

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 22 Week

In week 22, ILI accounted for 0.06% of outpatient visits in the Athena network. The total count of ILI visits reported within the network was 4.

Houston Health Department

4

8000 North Stadium Drive, Houston, TX

77054 (832) 393-5169



Flu Near You: ILI per week

ILI Count

ILI

50

45

40

35

30

25

20

15

10

5

4

0

10/8/2018 10/15/2018 10/22/2018 10/29/2018

11/5/2018 11/12/2018 11/19/2018 11/26/2018

12/3/2018 12/10/2018 12/17/2018 12/24/2018 12/31/2018

1/7/2019 1/14/2019 1/21/2019 1/28/2019

2/4/2019 2/11/2019 2/18/2019 2/25/2019

3/4/2019 3/11/2019 3/18/2019 3/25/2019

4/1/2019 4/8/2019 4/15/2019 4/22/2019 4/29/2019 5/6/2019 5/13/2019 5/20/2019 5/27/2019

Week Start Date

Flu near You (FNY) is a participatory surveillance tool that compliments traditional disease surveillance. The count of Flu Near You () users reporting ILI in the week of 05/27/2019 increased from 1 to 4 in the previous week. See the last page for information on how to participate.

School Surveillance October 2018 - May 2019

Table 1: ILI and Influenza Cases by Type and School Type1 per Month

Month

Oct Nov Dec DJeacn SFuemb Mar Apr May Sum

Total

Lab

Cases Confirmed

#

66 15

64 11

56 10

129 56 33

726 1529853 379 110

271 122

85

44

1776 628

%

23% 17% 18% 1206% 394%44 29% 45% 52% 30%

Flu A

Flu B

A+B

Unclassified

Elementary Schools

Middle Schools

High Schools

Multilevel Schools

2 5 12 1286% 5428% 28 22 7 156

4

0

1

1

0

0

0 12 1

19 115 8

7

2

7

5

6

0

44 17

8 52 0 0 94 0 60 197 1 67 90 31 439

54 55 51 0102 533117 275 221 69 1358

2 0 3 51 15 721342 36 11 10 219

4

6

4

5

1

1

3 9 1 31

64 25 50

55 28 116 18

24

15

1

5

116

81

School surveillance for ILI began in October for the current flu season. In May, a total of 85 cases were

reported. The highest number of cases (69) were among elementary school students.

NOTE: Data on student ILI and influenza cases is collected from 306 schools within Houston Independent school district.1 School will be counted more than once if more than one case from the same school is reported during the same reporting period.

Houston Health Department

5

8000 North Stadium Drive, Houston, TX

77054 (832) 393-5169



Number of positive cases

2018_40 2018_41 2018_42 2018_43 2018_44 2018_45 2018_46 2018_47 2018_48 2018_49 2018_50 2018_51 2018_52 2019_01 2019_02 2019_03 2019_04 2019_05 2019_06 2019_07 2019_08 2019_09 2019_10 2019-11 2019_12 2019-13 2019-14 2019-15 2019-16 2019-17 2019-18 2019-19 2019-20 2019-21 2019-22

Passive Viral Surveillance, Electronic lab reports

Number of flu positives reported via Electronic Lab Reports per Week in 2018 and 2019

250

200 Flu B

Flu A & B

150

Flu A

100

50

0

CDC Week (Year_Week) HHD receives electronic lab reports from clinical laboratories. In Week 22 of 2019, there was 1 laboratory confirmed influenza cases***.

Passive Viral Surveillance, Nonelectronic lab reports

Number of flu positives reported via Non-electronic Lab

6

Reports per Month in 2018-19

Flu B

5

Flu A & B

Flu A 4

Number of positive

3

2

1

0

Month HHD received 3 nonelectronic lab reports of flu-positive results from clinical laboratories during this reporting period. December accounts for the highest counts (n=5) of Flu activity in 2018.

Houston Health Department

6

8000 North Stadium Drive, Houston, TX

77054 (832) 393-5169



Texas and National Influenza and ILI Activity

NOTE: Influenza activity level corresponds to current MMWR week only and does not reflect previous weeks' activity. Most of influenza cases are not reportable by law to the Texas Department of State Health Services. This map contains data from sentinel sites and does not represent all influenza cases in the state. Positive laboratory results are reported according to specimen collection date or date received in the lab if the former is unknown. .

Note: There is no national CDC map for week 22. National flu reporting may have stopped at week20.

Houston Health Department

7

8000 North Stadium Drive, Houston, TX

77054 (832) 393-5169



The Houston Influenza Surveillance Weekly Report is available on the Houston Health Department web site at:

Flu Near You is a participatory surveillance (crowd sourcing) tool which complements traditional disease surveillance activities. Registered users can obtain real-time information on flu activity and influenza vaccines in the Greater Houston Metropolitan Area. Flu Near You features include:

Report symptoms Find vaccines Map flu cases in the Greater Houston Metropolitan area Get flu news Share on social media This season HHD invites you to register for Flu Near You at

MAP CASES

NOTE: Influenza-like Illness (ILI) is defined as fever (temperature 100?F) plus a cough OR a sore throat, in the absence of a known cause other than influenza.

Houston ILI baselines were determined using the same method as the Centers for Disease Control and Prevention Regional ILI baseline.

Data was obtained or accessed through the Southeast Texas Syndromic Surveillance System. However, any conclusions drawn from use of this data do not represent the official views of any consortium member jurisdiction.

Additional information regarding Houston, Texas and national ILI activity can be accessed at:

*Below baseline means the % of visits for ILI is below the region-specific baseline of 4.0%. The numbers for pediatric flu-related deaths may change as information becomes available. ** Flu-related deaths in adults are not required to be reported to the health department. Numbers for flu-related deaths may change as information becomes available. *** During MMWR week 11, electronic laboratory reporting (ELR) was interrupted due to system outage.

Houston Health Department

Division of Disease Prevention and Control

Public Health Informatics

8000 N. Stadium Dr., 4th Floor Houston, TX 77054

Main Phone Number: (832) 393-5080 Disease Reporting Fax Number: (832) 393-5232 24-Hour Disease Reporting Number: (832) 393-5080

Houston Health Department

8

8000 North Stadium Drive, Houston, TX

77054 (832) 393-5169



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