This week at a glance

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This week at a glance

Updated: 03JAN2020 MMWR week: 52

Ending on: 12/28/2019 Season: 2019-2020

Activity: The rate of emergency-department visits for influenza-like illness (ED-ILI) continues to increase. The rate is higher than the peak of all but one of the last five influenza seasons (Page 2). Severity: The percentage of deaths attributable to pneumonia and influenza (P&I) is unavailable for week 52. In week 51, 7.2% of deaths recorded in LA County were attributable to P&I, which is lower than in previous seasons (Page 3). Virology: The percentage of specimens testing positive for influenza during week 52 was higher than the peak of all but one of the past 5 seasons. Influenza B continues to predominate in Los Angeles County (Page 4). Nationally, influenza B/Victoria was the most commonly detected virus, followed by influenza A(H1N1)pdm09. Vaccine match and effectiveness: Vaccine effectiveness data will not be available until mid-season. CDC conducts viral antigen testing to assess how similar circulating viral strains are to the strains included in the vaccine. To date, CDC reports the following:

100% of tested influenza A (H1N1) viruses are antigenically similar to the vaccine strain. 34% of tested influenza A (H3N2) viruses are antigenically similar to the vaccine strain. 58% of tested influenza B/Victoria viruses are antigenically similar to the vaccine strain. 100% of tested influenza B/Yamagata viruses are antigenically similar to the vaccine strain.

Trend

This week 101 Rate per 1,000 visits to a Los Angeles County* emergency department for

Last week

70

influenza-like illness (ED-ILI).

P&I ED-ILI

This week Unavailable Number of deaths recorded in Los Angeles County* that were caused by

Last week 7.2%

pneumonia or influenza (P&I).

Viral Surveillance

This week 33.3% Percent of respiratory specimens tested by participating clinical laboratories

Last week 29.7%

in Los Angeles County were positive for influenza .

Percent postive, current week compared with previous five seasons

40%

30%

20%

Positive influenza tests by type, current week

Influenza A Influenza B

598, 34%

10%

0% 2019-20 2018-19 2017-18 2016-17 2015-16 2014-15

1184, 66%

*Los Angeles County DPH surveillance data excludes the cities of Long Beach and Pasadena. **The influenza-surveillance period starts with MMWR week 40 and runs through week 39 of the following year. The 2019-20 season started on September 29, 2019.

Los Angeles County Department of Public Health (DPH) prepares this newsletter to summarize current influenza surveillance data in Los Angeles County. Weekly surveillance data are preliminary and subject to change. More

information regarding methods can be found on the surveillance system specific pages of this report.

Los Angeles Couty Department of Public Health

Acute Communicable Disease Control

(213) 240-7941 publichealth.acd

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Influenza-like illness

Updated: 03JAN2020 MMWR week: 52

Ending on: 12/28/2019 Season: 2019-2020

ACDC's Syndromic Surveillance Project monitors initial self-reported symptoms from patients presenting to participating emergency departments throughout Los Angeles County. These symptoms are categorized into different clinical syndromes according to specific code words. The syndrome of ILI includes symptoms such as: fever, congestion, sneezing, sore throat, runny nose, and cough. The proportion of ILI emergency department (ED) visits for all ages and by age group is analyzed weekly and is conducted year-round.

Emergency department visits for influenza-like illness, per 1,000, Los Angeles County, 2015-16 through 2019-20 influenza seasons

Emergency department visits for influenza-like illness by age groups, Los Angeles County, 2019-20 influenza season

Los Angeles Couty Department of Public Health

Acute Communicable Disease Control

(213) 240-7941 publichealth.acd

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Volume 14, Issue 5

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Pneumonia and Influenza

Updated: 03JAN2020 MMWR week: 52

Ending on: 12/28/2019 Season: 2019-2020

Each week, the Office of Health Assessment and Epidemiology at LACDPH reports the total number of death certificates received and the number of those for which pneumonia or influenza (P&I) was listed as the underlying or contributing cause of death by age group. The percentage of all deaths due to P & I is calculated and compared to previous season's data.

Percent P&I

P&I Deaths

Pneumonia and Influenza (P&I) Listed As a Cause of Death, Number and Percent of All Deaths Los Angeles County, 2019-20

160

14%

Pneumonia

140

12%

Influenza

120

P&I percent

10%

100

8%

80

6% 60

40

4%

20

2%

0

0%

40 42 44 46 48 50 52 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39

MMWR week

Pneumonia and Influenza (P&I) as a Percent of All Deaths, Los Angeles County, 2013-14 to 2019-20

2014-15

18%

2015-16

16%

2016-17

14%

2017-18 2018-19

12%

2019-20

10%

8%

6%

4%

2%

0% 40 42 44 46 48 50 52 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38

MMWR Week

Percent P&I

Vital statistic data :*The reporting period is a 7-day week ending on Saturday. The number of deaths is the number of certificates received by the Office of Vital Records during the reporting period regardless of date of death. The count includes all certificates of deaths (excludes fetal deaths) occurring in the County of Los Angeles* regardless of the residence of the deceased. As a result, many deaths included in this report are from out of county.*Deaths that occurred in Long Beach and Pasadena are excluded. When confirmed, any influenza associated deaths are included in the death count above.

Los Angeles Couty Department of Public Health

Acute Communicable Disease Control

(213) 240-7941 publichealth.acd

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Updated: 03JAN2020 MMWR week: 52

Ending on: 12/28/2019 Season: 2019-2020

INFLUENZASenWtinAeTl LCabHoratory Surveillance

Viral surveillance data is provided by eight clinical laboratories serving hospitals and healthcare networks across Los Angeles County. Participating laboratories provide the number of positive tests and total number of specimens tested for influenza and respiratory syncytial virus. Data is reported on a weekly basis; weeks start on Sunday and end the following Saturday. Many participating laboratories also report data on other respiratory viruses.

Respiratory specimens testing positive for Influenza at LAC Sentinel Surveillance Labs, 2013-14 through 2019-20 influenza seasons

45%

Percent positive

40%

2014-15

35%

2015-16

30%

2016-17

2017-18

25% 2018-19

20%

2019-20

15%

10%

5%

0% 40 42 44 46 48 50 52 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 MMWR Week

Respiratory Specimens Testing Positive for Influenza at LA County Sentinel Surveillance Laboratories 2019-20 Season

Percent positive

Positive tests by influenza type

2500

Influenza A

50%

Influenza B

45%

2000

Percent Positive

40%

35%

1500

30%

25%

1000

20%

15%

500

10%

5%

0

0%

40 42 44 46 48 50 52 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37

MMWR Week

Los Angeles Couty Department of Public Health

Acute Communicable Disease Control

(213) 240-7941 publichealth.acd

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Percent positive

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Updated: 03JAN2020 MMWR week: 52

Ending on: 12/28/2019 Season: 2019-2020

Percent respiratory specimens positive by viral etiology, Los Angeles County Sentinal Surveillance Labs 2019-20 Influenza Season

45%

Adenovirus

40%

Metapneumovirus

35%

Rhino/Enterovirus

30%

Parainfluenza

25%

Coronavirus

20%

RSV

Influenza 15%

10%

5%

0% 40 42 44 46 48 50 52 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37

MMWR Week

Percent positive

Respiratory specimens testing positive for RSV at LA County Sentinel Laboratories, 2019-20 season

600

20%

18%

500

Positive Specimens

Percent positive

16%

14% 400

12%

300

10%

8%

200

6%

100

4%

2%

0

0%

40 42 44 46 48 50 52 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37

MMWR week

Positive specimens

Los Angeles Couty Department of Public Health

Acute Communicable Disease Control

(213) 240-7941 publichealth.acd

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Volume 14, Issue 5

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