Missouri Weekly Influenza Surveillance Report 2019-2020 Influenza Season

2020·14.9 MB·English

by  Missouri Department of Health and Senior Services

Missouri Weekly Influenza Surveillance Report
2019-2020 Influenza Season1

Week 40: September 29, 2019 – October 5, 2019

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

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

 During Week 40, a total of 46 laboratory-positive3 influenza cases (27 influenza A and 19 influenza B) were
reported. No laboratory-positive cases of influenza were reported by the Missouri State Public Health Laboratory
(MSPHL) during Week 40. The percentage of respiratory specimens testing positive for influenza in Missouri
laboratories reporting to the National Respiratory and Enteric Virus Surveillance System (NREVSS) remained
low during Week 40 (Figure 6).

 Influenza-like illness (ILI) activity was below baseline for both the Missouri Outpatient ILI Surveillance Network
(ILINet) and the hospital emergency room visit chief complaint data reported through ESSENCE. The reported
percentage of visits for ILI was 0.73% (Figure 5) and 1.36% (Figure 7) through ILINet and ESSENCE
respectively.4 The ILI data from a small number of sites located in the Northwest Region of the state is currently
unavailable in ESSENCE. Therefore, the ILI data for the Northwest Region should be interpreted with caution.

 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.

 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 2019-2020 influenza season begins CDC Week 40 (week ending October 5, 2019) and ends CDC Week 39 (week ending September 26, 2020).

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 ILI.

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. ILI is defined by ESSENCE as Emergency Department chief complaints for Influenza or (FeverPlus and (Cough or SoreThroat) and not NonILIFevers).

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

Page 1 of 7
Surveillance Data:

Interactive Maps

The jurisdiction-specific influenza data are provided though interactive maps available at
http://bit.ly/moflu19. 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 (September 29, 2019 - October 5, 2019)*

2019-2020*
Influenza Type Week 40
Season-to-Date
Influenza A 27 27
Influenza B 19 19
Influenza Unknown Or Untyped
0 0
Total 46 46
†
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 5, 2019 (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 (September 29, 2019 - October 5, 2019)*‡

Week 40 Week 40 2019-2020* 2019-2020*
Age Group
Cases Rate‡ Season-to-Date Season-to-Date Rate‡
00-04 13 3.47 13 3.47
05-24 14 0.87 14 0.87
25-49 5 0.26 5 0.26
50-64 7 0.57 7 0.57
65+ 7 0.73 7 0.73
Total 46 0.76 46 0.76
†
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 5, 2019 (CDC Week 40) Data Source: Missouri Health Information Surveillance System (WebSurv)
‡
Incidence Rate per 100,000 population

Page 2 of 7
Figure 3. Number of Laboratory-positive† Influenza Cases and Case Rates by Region,
Missouri, CDC Week 40 (September 29, 2019 - October 5, 2019)*‡

Week 40 Week 40 2019-2020* 2019-2020*
Region
Cases Rate‡ Season-to-Date Season-to-Date Rate‡
Central 2 0.30 2 0.30
Eastern 15 0.66 15 0.66
Northwest 4 0.25 4 0.25
Southeast 17 3.60 17 3.60
Southwest 8 0.75 8 0.75
Total 46 0.76 46 0.76
†
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 5, 2019 (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, 2016-2020*
16,000
14,000
12,000
10,000
C
0
u 8,iDOO
n
t
6,000
4,000
2,'IH>O
3 f i ! 2 ! : 1 3 3 i i I , I 3 i I 3 9 g 3 1 l 3 1 1 J 1 J I I 3
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.
*2019-2020 season-to-date through the week ending May 16, 2020 (Week 20).Data Source: Missouri Health Information Surveillance System (WebSurv).
Page 3 of 7
Figure 5. Percentage of Outpatient Visits for Influenza-like Illness (ILI), Missouri Outpatient ILI
Surveillance Network (ILINet) 2016-2020*†
12.0 • • • • • • Missouri Baseline*
11.0
10.0
9.0
8.0
::::; 7.0
...
.E
"' 6.0
~
>
....
5.0
C
<II
:;::;
s"-' 4.0
::,
0
0 3.0
<II
00
~C 2.0
:<:II
<II
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

*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).
†
2019-2020 season-to-date through the week ending May 16, 2020 (Week 20).

Figure 6. Season-to-Date PCR (+) Tests for Influenza in Missouri
600 45.00%
■
40.00%
"'
C 500
<II
·E;:; 35.00%
<II
0..
.".<> ,I,'I 400 30.00%
·;;;
0 25.00%
Cl.
."..'. 300
C 20.00%
:<:I,I
:;:::
-= 200 15.00%
0...
.<cII 10.00%
E
::, 100
z
5.00%
0 0.00%
40424446485052 2 4 6 8 10121416182022242628303234363840424446485052 2 4 6 8 101214161820
2018-2019 CDC Week 2019-2020
- 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).
2019-2020 season-to-date through the week ending May 16, 2020 (Week 20).
Page 4 of 7
Figure 7. Percentage of Emergency Department (ED) Visits for Influenza-like Illness (ILI) in ESSENCE
Participating Hospitals, 2016-2020 Influenza Seasons*‡
9
~ 2016-2017
8 ~ 2017-2018
7 ~ 2018-2019
~ 2019-2020
•,. • • • ESSENCE I LI Base I ine *
'o
2
1
0
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 ESSENCE ILI Baseline is the mean percent of ILI visits for each week during the previous three years (2016-18) when percentage of ILI
visits were less than 2% of total visits, plus two standard deviations. Data Source: Missouri Department of Health and Senior Services (DHSS),
Bureau of Reportable Disease Informatics, ESSENCE version 1.20.
‡
The ILI data from a small number of sites located in the Northwest Region of the state is temporarily unavailable in ESSENCE. Therefore, the
ILI data for the Northwest Region should be interpreted with caution.

Figure 8. Percentage of Emergency Department (ED) Visits for Influenza-like Illness (ILI) in ESSENCE
Participating Hospitals, by Age Group, Region and Statewide, Week 40, 2019*
30
28
26
2~
22
...
"' 20
·;;;
> 18 ■ 0-4 Yrs
C
.w... 16 ■ 5-24 Yrs
.0.. 14
C: ■ 25-49 Yrs
.au.., 12
a, ■ 50-64 Yrs
Cl. 10
8 ■ 65 Yrs+
6
4
2
0
CENTRAL EASTERN NORTHWEST SOUTHEAST SOUTHWEST STATEWIDE

Data Source: Missouri Department of Health and Senior Services (DHSS), Bureau of Reportable Disease Informatics, ESSENCE version 1.20.
*The ILI data from a small number of sites located in the Northwest Region of the state is temporarily unavailable in ESSENCE. Therefore, the
ILI data for the Northwest Region should be interpreted with caution.
Page 5 of 7
Figure 9. Percentage of Emergency Department (ED) Visits for Influenza-like Illness (ILI) in ESSENCE
Participating Hospitals, by Region and Statewide, 2019-2020 Influenza Season*
14
13
12
11
10
...,. 9 ~ CENTRAL
·;;;
>
8 ~ EASTERN
:::;
....
.0.. 7 ~ NORTHWEST
C 6 ~ SOUTHEAST
4>
4~> 5 ~ SOUTHWEST
Q.
4 •
~ STATEWIDE
3
2 •
•
1
0
40414243444546474849505152 1 2 3 4 5 6 7 8 9 W111213M15ffiUIB1920
CDC Week

Data Source: Missouri Department of Health and Senior Services (DHSS), Bureau of Reportable Disease Informatics, ESSENCE version 1.20.
*The ILI data from a small number of sites located in the Northwest Region of the state is temporarily unavailable in ESSENCE. Therefore, the
ILI data for the Northwest Region should be interpreted with caution.

Figure 10. Weekly Rate of Patients Hospitalized with Influenza and/or Pneumonia Syndromes in Missouri
Hospitals, 2016-2020 Influenza Seasons
22
20
18
C
.0:; 16
"'
[ 14
0
gQ. 12 ~ 2016-2017
g0 ~ 2017-2018
... 10
-e-2018-2019
oi 8
.C.. . ~ 2019-2020
4>
6
"'
a:
4
2
0
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

Data Source: Missouri Department of Health and Senior Services (DHSS), Bureau of Reportable Disease Informatics, HL7 Messaging Portal.
Population data from Missouri Census Data Center 2017 (https://census.missouri.edu).

Page 6 of 7
Figure 11. Number of Patients Hospitalized with Influenza and/or Pneumonia Syndromes in Participating
Missouri Hospitals, by Age Group, Week 40, 2019-2020 Influenza Season
- 0-4Yrs
350 14
- 5-14Yrs
"' 300 12 C0:
C: :;::;
0 <a - 15-64Yrs
~ I
111 250 10
~... 0 - 65+Yrs
111 C.
·a 200 8 00
"' 0 - 0-4Yrs
0 o'
.:.:.0:..c.. 150 6 0,.-. i. - 5R-a1te4 Yrs
.aQ..I. Rate
Qj
.c 100 4 QI - 15-64Yrs
E <a
::::, 0::: Rate
z - 65+Yrs
50 2
Rate
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 1112 13 14 15 16 17 18 19 20
CDC Week

Data Source: Missouri Department of Health and Senior Services (DHSS), Bureau of Reportable Disease Informatics, HL7 Messaging Portal.

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 7 of 7
Missouri Weekly Influenza Surveillance Report
Missouri 2019-2020 Influenza Season1
DHSS

Oepor11ment ol Heolth
and s,mlor Se,,,Jc~$ Week 41: October 6, 2019 – October 12, 2019

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 60 laboratory-positive3 influenza cases (30 influenza A, 29 influenza B and one
untyped) were reported. A season-to-date total of 139 laboratory-positive influenza cases (72 influenza A,
66 influenza B, and one untyped) have been reported in Missouri as of Week 41. The influenza type for reported
season-to-date cases includes 51.8% influenza, 47.5% influenza B, and 0.7% untyped. No laboratory-positive
cases of influenza were reported by the Missouri State Public Health Laboratory (MSPHL) during Week 41. The
percentage of respiratory specimens testing positive for influenza in Missouri laboratories reporting to the
National Respiratory and Enteric Virus Surveillance System (NREVSS) remained low during Week 41 (Figure 6).

 Influenza-like illness (ILI) activity was above baseline the Missouri Outpatient ILI Surveillance Network (ILINet)
and below baseline for the hospital emergency room visit chief complaint data reported through ESSENCE. The
reported percentage of visits for ILI was 1.88% (Figure 5) and 1.61% (Figure 7) through ILINet and ESSENCE
respectively.4 The ILI data from a small number of sites located in the Northwest Region of the state is currently
unavailable in ESSENCE. Therefore, the ILI data for the Northwest Region should be interpreted with caution.

 No influenza-associated deaths have been reported in Missouri as of Week 41.5 During Week 40, 42 deaths
involving Pneumonia and Influenza (P&I) were reported to the Bureau of Vital Records.

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

 Seasonal influenza activity remains low overall across the United States. 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 2019-2020 influenza season begins CDC Week 40 (week ending October 5, 2019) and ends CDC Week 39 (week ending September 26, 2020).

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 ILI.

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. ILI is defined by ESSENCE as Emergency Department chief complaints for Influenza or (FeverPlus and (Cough or SoreThroat) and not NonILIFevers).

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

Page 1 of 7
Surveillance Data:

Interactive Maps

The jurisdiction-specific influenza data are provided though interactive maps available at
http://bit.ly/moflu19. 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 41
 Reported Week-specific Rate per 100,000 Population, CDC Week 41
 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 6, 2019 - October 12, 2019)*

2019-2020*
Influenza Type Week 40 Week 41
Season-to-Date
Influenza A 42 30 72
Influenza B 37 29 66
Influenza Unknown Or Untyped 0 0 0
Total 79 60 139
†
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 5, 2019 (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 6, 2019 - October 12, 2019)*‡

Week 41 Week 41 2019-2020* 2019-2020*
Age Group
Cases Rate‡ Season-to-Date Season-to-Date Rate‡
00-04 14 3.74 29 7.75
05-24 22 1.37 45 2.80
25-49 15 0.78 30 1.57
50-64 4 0.32 14 1.13
65+ 5 0.52 21 2.20
Total 60 0.99 139 2.28
†
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 5, 2019 (CDC Week 40) Data Source: Missouri Health Information Surveillance System (WebSurv)
‡
Incidence Rate per 100,000 population

Page 2 of 7
Figure 3. Number of Laboratory-positive† Influenza Cases and Case Rates by Region,
Missouri, CDC Week 41 (October 6, 2019 - October 12, 2019)*‡

Week 41 Week 41 2019-2020* 2019-2020*
Region
Cases Rate‡ Season-to-Date Season-to-Date Rate‡
Central 18 2.66 31 4.58
Eastern 15 0.66 33 1.46
Northwest 6 0.38 14 0.88
Southeast 7 1.48 31 6.57
Southwest 14 1.31 30 2.80
Total 60 0.99 139 2.28
†
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 5, 2019 (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, 2016-2020*
16,000
14,000
12,000
10,000
C
0
u 8,000
n
t
6,000
4,000
2,000
0
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.
*2019-2020 season-to-date through the week ending May 16, 2020 (Week 20).Data Source: Missouri Health Information Surveillance System (WebSurv).

Page 3 of 7