Missouri Weekly Influenza Surveillance Report 2017-2018 Influenza Season

2018·13.9 MB·English

by  Missouri Department of Health and Senior Services

Missouri Weekly Influenza Surveillance Report
1
2017-2018 Influenza Season

Week 40: October 1 – 7, 2017

All data are preliminary and may change as more reports are received.

Summary:
• The 2017-2018 influenza season began with Week 40 (week ending October 7, 2017) and ends Week 39 (week
ending September 29, 2018). This is the first Weekly Influenza Surveillance Report of the 2017-2018 influenza
season.

• The estimated influenza activity in Missouri is Sporadic2.

• During Week 40, a total of 47 laboratory-positive3 influenza cases (42 influenza A and 5 influenza B) were
reported in Missouri. County specific influenza data is available through interactive maps accessible on the
Interactive Maps section located on page 2 of this report. No laboratory-confirmed cases of influenza were
reported by the Missouri State Public Health Laboratory (MSPHL) during Week 40.

• Influenza-like illness (ILI) activity was below baseline for the Missouri Outpatient ILI Surveillance Network
(ILINet). The reported percentage of outpatient visits for ILI was 1.08% (Figure 5).4 The percentage of
respiratory specimens testing positive for influenza in Missouri laboratories reporting to the National Respiratory
and Enteric Virus Surveillance System (NREVSS) was low during Week 40 (Figure 6). The ILI data from
ESSENCE is currently not available due to system upgrades. The data and subsequent analysis will be included
in future reports as available.

• No influenza-associated deaths have been reported in Missouri as of Week 40.5

• No influenza or ILI-associated outbreaks or school closures have been reported in Missouri as of Week 40.

• Influenza activity remained low in the U.S. during Week 40. National influenza surveillance information is
prepared by CDC and is included in the weekly FluView report, which is available online
at http://www.cdc.gov/flu/weekly/fluactivitysurv.htm.

1The 2017-2018 influenza season begins CDC Week 40 (week ending October 7, 2017) and ends CDC Week 39 (week ending September 29,
2018).

2Sporadic is defined as: Small numbers of laboratory-confirmed influenza cases or a single laboratory-confirmed influenza outbreak has been reported, but there is no
increase in cases of influenza-like illness.

3Laboratory-positive influenza includes the following test methods: rapid influenza diagnostic tests (antigen), reverse transcriptase polymerase chain
reaction (RT-PCR) and other molecular assays, immunofluorescence antibody staining (Direct (DFA) or Indirect (IFA)), or viral culture.

4Influenza-like illness (ILI) is defined by ILINet as fever (temperature of 100oF [37.8oC] or greater) and a cough and/or a sore throat without a
known cause other than influenza. Influenza-like illness (ILI) is defined by ESSENCE as Emergency Department chief complaints that contain
keywords such as “flu”, “flulike”, “influenza” or “fever” plus “cough” or “fever” plus “sore throat”.

5All influenza-associated deaths became reportable in Missouri in 2016.

Page 1 of 5
Surveillance Data:

Interactive Maps

The jurisdiction-specific influenza data are provided though interactive maps available at
http://arcg.is/1zWLfW. Click on the jurisdiction to view the influenza data specific to that jurisdiction.
• Reported Laboratory-positive Influenza Cases by Influenza Type by Jurisdiction, CDC Week 40
• Reported Week-specific Rate per 100,000 Population, CDC Week 40
• Reported Laboratory-positive Influenza Cases by Influenza Type by Jurisdiction, Season-to-Date
• Reported Rate per 100,000 Population, Season-to-Date

Data Figures

Figure 1. Number of Laboratory-positive† Influenza Cases by Influenza Type,
Missouri, CDC Week 40 (October 1 – 7, 2017)*

2017-2018*
Influenza Type Week 40
Season-to-Date
Influenza A
42 42
Influenza B
5 5
Influenza Unknown Or Untyped
0 0
Total
47 47
†
Laboratory-positive influenza includes the following test methods: rapid influenza diagnostic tests (antigen), reverse transcriptase polymerase chain
reaction (RT-PCR) and other molecular assays, immunofluorescence antibody staining (Direct (DFA) or Indirect (IFA)), or viral culture.
*Influenza season begins week ending October 7, 2017 (CDC Week 40) Data Source: Missouri Health Information Surveillance System (WebSurv).

Figure 2. Number of Laboratory-positive† Influenza Cases and Case Rates by Age Group,
Missouri, CDC Week 40 (October 1 – 7, 2017)*‡

Week 40 Week 40 2017-2018* 2017-2018*
Age Group
Cases Rate‡ Season-to-Date Season-to-Date Rate‡
00-04 4 1 4 1
05-24 10 1 10 1
25-49 7 0 7 0
50-64 5 0 5 0
65+ 21 2 21 2
Total 47 1 47 1
†
Laboratory-positive influenza includes the following test methods: rapid influenza diagnostic tests (antigen), reverse transcriptase polymerase chain
reaction (RT-PCR) and other molecular assays, immunofluorescence antibody staining (Direct (DFA) or Indirect (IFA)), or viral culture.
*Influenza season begins week ending October 7, 2017 (CDC Week 40) Data Source: Missouri Health Information Surveillance System (WebSurv)
‡
Incidence Rate per 100,000 population

Page 2 of 5
Figure 3. Number of Laboratory-positive† Influenza Cases and Case Rates by Region,
Missouri, CDC Week 40 (October 1 – 7, 2017)*‡

Week 40 Week 40 2017-2018* 2017-2018*
District
Cases Rate‡ Season-to-Date Season-to-Date Rate‡
Central 1 0 1 0
Eastern 27 1 27 1
Northwest 2 0 2 0
Southeast 16 3 16 3
Southwest 1 0 1 0
Total 47 1 47 1
†
Laboratory-positive influenza includes the following test methods: rapid influenza diagnostic tests (antigen), reverse transcriptase polymerase chain
reaction (RT-PCR) and other molecular assays, immunofluorescence antibody staining (Direct (DFA) or Indirect (IFA)), or viral culture.
*Influenza season begins week ending October 7, 2017 (CDC Week 40) Data Source: Missouri Health Information Surveillance System (WebSurv)
‡
Incidence Rate per 100,000 population

Figure 4. Number of Laboratory-positive† Influenza Cases by CDC Week, Missouri, 2014-2018*

1-e-2014-2.015 -€- 2015-2016 -8-.2016-2017 ~ .2.017-2018 I
10,000
8,000
6,000
C
0
u
n
t
4,000
2,000
4 4 4 4 4 4 4 4 4 4 5 5 5 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1 1 2
0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0
Week

†
Laboratory-positive influenza includes the following test methods: rapid influenza diagnostic tests (antigen), reverse transcriptase polymerase chain reaction (RT-

PCR) and other molecular assays, immunofluorescence antibody staining (Direct (DFA) or Indirect (IFA)), or viral culture.
*2017-2018 season-to-date through the week ending May 19, 2018 (Week 20). The 2014-2015 season had 53 weeks rather than the usual 52. Week 53, 2014-
2015 flu season has 3,082 reported confirmed cases. Data Source: Missouri Health Information Surveillance System (WebSurv).
Page 3 of 5
Figure 5. Percentage of Outpatient Visits for Influenza-like Illness (ILI), Missouri Outpatient ILI
Surveillance Network (ILINet) 2014-2018*†
9.00
• • • • • • Missouri Baseline•
8.00 - 2014-2015
- 2015-2016
7.00
- 2016-2017
- 2017-2018
6.00
~ 5.00
.E
."..'.
·.;;
> 4.00
....
...C.,.,:
.
.C..L. 3.00
::,
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Q.
0.00
40 41 42 43 44 45 46 47 48 49 so 51 52 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
CDC Week

*The ILINet Region 7 (MO, IA, KS, NE) baseline is the mean percentage of patient visits for ILI during non-influenza weeks for the previous three seasons,
plus two standard deviations. A non-influenza week is defined as periods of two or more consecutive weeks in which each week accounted for less than
2% of the season’s total number of specimens that tested positive for influenza.
Data Source: U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet), Centers for Disease Control and Prevention (CDC).
†
2017-2018 season-to-date through the week ending May 19, 2018 (Week 20). The 2014-2015 season had 53 weeks rather than the usual 52. The

percentage of outpatient visits for ILI during Week 53 was 7.63.

Figure 6. Season-to-Date PCR (+) Tests for Influenza in Missouri
200 20%
180 18%
"'
C:
QI 160 16%
-E
QI
9; 140 14%
..Q>. ,I
120 12%
'.i0i. i
Q.
100 10%
N
C:
:=:Q;::,I 80 8%
'S 60 6%
ai
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E 40 4%
::,
z
20 2%
0 0%
40 42 44 46 48 so 52 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 so 52 2 4 6 8 10 12 14 16 18 20
2016-2017 CDC Week 2017-2018
- Influenza A (H1Nl)pdm09 - Influenza A (H3N2) Influenza A Untyped - Influenza B --Percent Positivity

Data Source: National Respiratory and Enteric Virus Surveillance System (NREVSS), Centers for Disease Control and Prevention (CDC).
2016-2017 season-to-date through the week ending May 19, 2018 (Week 20).
Page 4 of 5
Additional Influenza Data Sources:

Centers for Disease Control and Prevention: National Influenza Surveillance
(FluView): http://www.cdc.gov/flu/weekly/fluactivitysurv.htm

The National Respiratory and Enteric Virus Surveillance System
(NREVSS): https://www.cdc.gov/surveillance/nrevss/

World Health Organization: International Influenza
Surveillance: http://www.who.int/influenza/surveillance_monitoring/en/
Page 5 of 5
Missouri Weekly Influenza Surveillance Report
1
2017-2018 Influenza Season

Week 41: October 8 – 14, 2017

All data are preliminary and may change as more reports are received.

Summary:
• The estimated influenza activity in Missouri is Sporadic2.

• During Week 41, a total of 69 laboratory-positive3 influenza cases (46 influenza A and 23 influenza B) were
reported. A season-to-date total of 151 laboratory-positive influenza cases (112 influenza A, 38 influenza B, and
one untyped) have been reported in Missouri as of Week 41. The influenza type for reported season-to-date cases
includes 74% influenza A, 25% influenza B, and 1% untyped. No laboratory-positive cases of influenza were
reported by the Missouri State Public Health Laboratory (MSPHL) during Week 41.

• Influenza-like illness (ILI) activity was below baseline for the Missouri Outpatient ILI Surveillance Network
(ILINet). The reported percentage of outpatient visits for ILI was 0.68% (Figure 5).4 The percentage of
respiratory specimens testing positive for influenza in Missouri laboratories reporting to the National Respiratory
and Enteric Virus Surveillance System (NREVSS) was low during Week 41 (Figure 6). The ILI data from
ESSENCE is currently not available due to system upgrades. The data and subsequent analysis will be included
in future reports as available.

• One influenza-associated death has been reported in Missouri as of Week 41.5 During Week 40, 32 deaths
involving Pneumonia and Influenza (P&I) were reported to the Bureau of Vital Records, resulting in a season-to-
date total of 32 P&I-associated deaths in Missouri.6

• No influenza or ILI-associated outbreaks or school closures have been reported in Missouri as of Week 41.

• Influenza activity was low in the U.S. during Week 40. National influenza surveillance information is prepared
by CDC and is included in the weekly FluView report, which is available online at
http://www.cdc.gov/flu/weekly/fluactivitysurv.htm.

1The 2017-2018 influenza season begins CDC Week 40 (week ending October 7, 2017) and ends CDC Week 39 (week ending September 29,
2018).

2Sporadic is defined as: Small numbers of laboratory-confirmed influenza cases or a single laboratory-confirmed influenza outbreak has been reported, but there is no
increase in cases of influenza-like illness.

3Laboratory-positive influenza includes the following test methods: rapid influenza diagnostic tests (antigen), reverse transcriptase polymerase chain
reaction (RT-PCR) and other molecular assays, immunofluorescence antibody staining (Direct (DFA) or Indirect (IFA)), or viral culture.

4Influenza-like illness (ILI) is defined by ILINet as fever (temperature of 100oF [37.8oC] or greater) and a cough and/or a sore throat without a
known cause other than influenza. Influenza-like illness (ILI) is defined by ESSENCE as Emergency Department chief complaints that contain
keywords such as “flu”, “flulike”, “influenza” or “fever” plus “cough” or “fever” plus “sore throat”.

5All influenza-associated deaths became reportable in Missouri in 2016.

6The P&I data are available one week later. The P&I data for the CDC Week provided is the most current data available.

Page 1 of 5
Surveillance Data:

Interactive Maps

The jurisdiction-specific influenza data are provided though interactive maps available at
http://arcg.is/C5zy1. Click on the jurisdiction to view the influenza data specific to that jurisdiction.
• Reported Laboratory-positive Influenza Cases by Influenza Type by Jurisdiction, CDC Week 40
• Reported Week-specific Rate per 100,000 Population, CDC Week 40
• Reported Laboratory-positive Influenza Cases by Influenza Type by Jurisdiction, Season-to-Date
• Reported Rate per 100,000 Population, Season-to-Date

Data Figures

Figure 1. Number of Laboratory-positive† Influenza Cases by Influenza Type,
Missouri, CDC Week 41 (October 8 – 14, 2017)*

2017-2018*
Influenza Type Week 40 Week 41
Season-to-Date
Influenza A
66 46 112
Influenza B
15 23 38
Influenza Unknown Or Untyped
1 0 1
Total
82 69 151
†
Laboratory-positive influenza includes the following test methods: rapid influenza diagnostic tests (antigen), reverse transcriptase polymerase chain
reaction (RT-PCR) and other molecular assays, immunofluorescence antibody staining (Direct (DFA) or Indirect (IFA)), or viral culture.
*Influenza season begins week ending October 7, 2017 (CDC Week 40). Data Source: Missouri Health Information Surveillance System (WebSurv).

Figure 2. Number of Laboratory-positive† Influenza Cases and Case Rates by Age Group,
Missouri, CDC Week 41 (October 8 – 14, 2017)*‡

Week 41 Week 41 2017-2018* 2017-2018*
Age Group
Cases Rate‡ Season-to-Date Season-to-Date Rate‡
00-04 14 3.74 26 6.95
05-24 17 1.06 38 2.37
25-49 21 1.10 39 2.04
50-64 7 0.57 15 1.21
65+ 10 1.05 33 3.46
Total 69 1.13 151 2.48
†
Laboratory-positive influenza includes the following test methods: rapid influenza diagnostic tests (antigen), reverse transcriptase polymerase chain
reaction (RT-PCR) and other molecular assays, immunofluorescence antibody staining (Direct (DFA) or Indirect (IFA)), or viral culture.
*Influenza season begins week ending October 7, 2017 (CDC Week 40). Data Source: Missouri Health Information Surveillance System (WebSurv)
‡
Incidence Rate per 100,000 population

Page 2 of 5
Figure 3. Number of Laboratory-positive† Influenza Cases and Case Rates by Region,
Missouri, CDC Week 41 (October 8 – 14, 2017)*‡

Week 41 Week 41 2017-2018* 2017-2018*
District
Cases Rate‡ Season-to-Date Season-to-Date Rate‡
Central 4 0.59 11 1.62
Eastern 32 1.41 71 3.13
Northwest 15 0.94 24 1.50
Southeast 13 2.76 34 7.21
Southwest 5 0.47 11 1.03
Total 69 1.13 151 2.48
†
Laboratory-positive influenza includes the following test methods: rapid influenza diagnostic tests (antigen), reverse transcriptase polymerase chain
reaction (RT-PCR) and other molecular assays, immunofluorescence antibody staining (Direct (DFA) or Indirect (IFA)), or viral culture.
*Influenza season begins week ending October 7, 2017 (CDC Week 40). Data Source: Missouri Health Information Surveillance System (WebSurv)
‡
Incidence Rate per 100,000 population

Figure 4. Number of Laboratory-positive† Influenza Cases by CDC Week, Missouri, 2014-2018*

*
+
1-e- 2014-2:015 2015-2016, -B-2016,-2017 2017-2018 1
10,000
8,000
6,000
C
0
u
n
t
4,000
2,000
4 4 4 4 4 4 4 4 4 4 5 5 5 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1 1 2
0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0
Week

†
Laboratory-positive influenza includes the following test methods: rapid influenza diagnostic tests (antigen), reverse transcriptase polymerase chain reaction (RT-

PCR) and other molecular assays, immunofluorescence antibody staining (Direct (DFA) or Indirect (IFA)), or viral culture.
*2017-2018 season-to-date through the week ending May 19, 2018 (Week 20). The 2014-2015 season had 53 weeks rather than the usual 52. During Week 53 of
the 2014-2015 influenza season, 3,082 laboratory-positive cases were reported. Data Source: Missouri Health Information Surveillance System (WebSurv).
Page 3 of 5
Figure 5. Percentage of Outpatient Visits for Influenza-like Illness (ILI), Missouri Outpatient ILI
Surveillance Network (ILINet) 2014-2018*†
9.00
• • • • • • Missouri Baseline•
8.00 - 2014-2015
- 2015-2016
7.00
- 2016-2017
- 2017-2018
6.00
0.00
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

*The ILINet Region 7 (MO, IA, KS, NE) baseline is the mean percentage of patient visits for ILI during non-influenza weeks for the previous three seasons,
plus two standard deviations. A non-influenza week is defined as periods of two or more consecutive weeks in which each week accounted for less than
2% of the season’s total number of specimens that tested positive for influenza.
Data Source: U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet), Centers for Disease Control and Prevention (CDC).
†
2017-2018 season-to-date through the week ending May 19, 2018 (Week 20). The 2014-2015 season had 53 weeks rather than the usual 52. The

percentage of outpatient visits for ILI during Week 53 was 7.63.

Figure 6. Season-to-Date PCR (+) Tests for Influenza in Missouri
200 20%
180 18%
VI
C
EQI 160 16%
·.:;
QI
~ 140 14%
Q>I
~ 120 12%
0
"-
100 10%
~
C
:Q,I 80 8%
~
..
0 60 6%
..,
QI
E 40 4%
:,
z
20 2%
0 n 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 40 42 44 46 48 50 52 2 4 6 8 10 12 14 16 18 20
2016-2017 CDC Week 2017-2018
- Influenza A (H1Nl)pdm09 - Influenza A (H3N2) Influenza A Untyped - Influenza B --Percent Positivity

Data Source: National Respiratory and Enteric Virus Surveillance System (NREVSS), Centers for Disease Control and Prevention (CDC).
2016-2017 season-to-date through the week ending May 19, 2018 (Week 20).

Page 4 of 5
Additional Influenza Data Sources:

Centers for Disease Control and Prevention: National Influenza Surveillance (FluView):
http://www.cdc.gov/flu/weekly/fluactivitysurv.htm

The National Respiratory and Enteric Virus Surveillance System (NREVSS):
https://www.cdc.gov/surveillance/nrevss/

World Health Organization: International Influenza Surveillance:
http://www.who.int/influenza/surveillance_monitoring/en/
Page 5 of 5