Washoe County Health District 2008-2009 Influenza Surveillance Program Weekly Report CDC Week #20: May 17 – May 23, 2009
Date: To: From: Thursday, May 28, 2009 Participating Health Care Providers Influenza Surveillance Coordinator: Denise Stokich, Epidemiologist Division of Epidemiology & Public Health Preparedness (EPHP) 775-328-6188 Report Preparer: Sharon Clodfelter, Statistician Division of Epidemiology & Public Health Preparedness (EPHP) 775-328-2495
Summary:
The six participating providers reported a total of 115 patients with influenza-like-illness (ILI) for week ending May 23, 2009 (week 20). The percentage of persons seen with ILI by the six providers was 2.9% (115/3902). During week 18, the percentage of patient visits to U.S. sentinel providers due to ILI was 1.7%. This percentage is below the national baseline of 2.4%. On a regional level, the percentage of visits for ILI ranged from 0.5 to 2.8%.
Level of Influenza Activity: Number of ILI Cases by Week and Age Group Reported by Sentinel Providers, Washoe County Influenza Surveillance, 2008 – 2009.
Number of ILI Cases 250 200 150 100 50 0 40 41 42 43 44 45 46 47 48 49 50 51 52 53 1 2 2008 0-4 yrs. CDC Week 5-24 yrs. 25-64 yrs. 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 2009 >64 yrs.
Proportion of Patients Seen with ILI by Sentinel Physicians, Washoe County Influenza Surveillance, 2008 - 2009.
% of ILI Cases Reported 6.0 4.0 2.0 0.0 40 41 42 43 44 45 46 47 48 49 50 51 52 53 1 2008 Washoe County 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 2009 National Baseline
CDC Week U.S.
Data source for U.S. and National Baseline: CDC Influenza Summary Update.
Pneumonia & Influenza Mortality:
The local pneumonia (P) and influenza (I) data will continue to be monitored; however, it will no longer be included in the following graph. The data has become too inconsistent due to staffing issues. The epidemic threshold set by CDC for week 18 was 7.3%. The national P & I for week 18 was 6.7%.
Pneumonia and Influenza Mortality, United States, 2008 – 2009.
10.0 Percent of all Deaths Due to P&I 8.0 6.0 4.0 2.0 0.0 40 41 42 43 44 45 46 47 48 49 50 51 52 53 1 2 3 4 5 6 2008 7 8 9 10 11 12 13 14 15 16 17 18 19 20 2009
CDC Week U.S.
Epidemic Threshold
Sentinel Provider Testing Results:
Weekly Testing Results: Week # 20
*
# Specimens Submitted* 1
Results 1 negative
This # may vary from one weekly report to the next as providers do not always include all specimens obtained for that reporting week on their tally sheet.
Specimens Submitted To Date: Total specimens 80 Total Reported for Washoe Co.: Influenza type A 23 Influenza type B 16 Influenza type B 190 Negative 37 Pending 4
Influenza type A 316 [21 A (H1), 32 A (H3), 36 A (H1N1 - Swine); 225 A (unk subtype)]
Influenza type unknown 44
Number of Influenza & RSV Cases, Washoe County Communicable Disease Surveillance, 2008– 2009.
50 45 40 Number of Lab Reports Received 35 30 25 20 15 10 5 0 40 41 42 43 44 45 46 47 48 49 50 51 52 53 1 2008 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 2009
CDC Week Influenza RSV
2008-2009 Influenza Surveillance Program Weekly Report
Page 2
Laboratory Confirmed Influenza Reports, 2003-2009 Seasons:
Figure 1. Laboratory Confirmed Influenza Reports, 2003-2009 Season (October-June), Washoe County (As of CDC Week #20 of 2009 Ending on 05/23/2009)
No. Lab Confirmed Influenza Reports
250 225 200 175 150 125 100 75 50 25 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
CDC Week
2003-04 2004-05 2005-06 2006-07 2007-08 2008-09
Washoe County ILI Cases Reported by Sentinel Providers, 2003-2009 Seasons:
8.0 7.0 Washoe County ILI % 6.0 5.0 4.0 3.0 2.0 1.0 0.0 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
CDC Week
2003-04
2004-05
2005-06
2006-07
2007-08
2008-09
Syndromic Surveillance: REMSA Respiratory Calls – Washoe County
REMSA calls which include: Breathing problem – ineffective breathing, severe respiratory distress, not alert, clammy, abnormal breathing, and/or cardiac history.
(Source: First Watch Surveillance, Data coverage in Washoe : 100%)
2008-2009 Influenza Surveillance Program Weekly Report
Page 3
Over-the-Counter (OTC) sales for cough and/or cold remedies include: Cold Relief Adult/Pediatric
Liquid/Tablet (plain cold liquids or tablets, antihistamines, decongestants, night-time liquid cold relief products, and allergy relief products); Cough Syrup Adult Liquid/Tablet (Any cough whip products, cough syrups, cough tablets, capsules, squares for relief of cough in adults); Cough Syrup Pediatric Liquid (Any cough whip products, cough syrups for relief of cough in children).
(Data source: National Retail Data Monitor Data coverage in Washoe County: ~40%)
Emergency Room Visits for Respiratory Illness: Respiratory
illnesses are defined as problems of the nose (coryza) and throat (pharyngitis), as well as the lungs. Examples of Respiratory illness include congestion, sore throat, tonsillitis, sinusitis, cold symptoms, bronchitis, cough, shortness of breath, asthma, chronic obstructive pulmonary disease (COPD), and pneumonia. The presence of both cold and flu symptoms is counted in this category, not constitutional.
(Source: EPI Center formerly known as Realtime Outbreak & Disease Surveillance, Data coverage in Washoe: 100%)
Nationally:
For week 19, the following influenza activity was reported: • Widespread influenza activity was reported by five states (Arizona, California, New Jersey, Texas, and Virginia). • Regional influenza activity was reported 13 states (Alabama, Connecticut, Georgia, Hawaii, Illinois, Massachusetts, Nevada, New Hampshire, New York, Pennsylvania, South Carolina, and Tennessee). • Local influenza activity was reported by District of Columbia and 15 states (Alaska, Colorado, Florida, Kansas, Louisiana, Maine, Maryland, Michigan, North Carolina, Oklahoma, Oregon, Rhode Island, Utah, Washington, and Wisconsin). • Sporadic activity was reported by 16 states (Arkansas, Delaware, Idaho, Indiana, Iowa, Kentucky, Minnesota, Mississippi, Missouri, Montana, Nebraska, North Dakota, Ohio, South Dakota, Vermont, and Wyoming). • No influenza activity was reported by one state (West Virginia). To see the complete CDC Influenza Summary Update, please visit http://www.cdc.gov/flu/weekly/.
2008-2009 Influenza Surveillance Program Weekly Report
Page 4