Weekly Report 2015 Week 50 (December 13 – December 19) through 2016 Week 50 (December 11 – December 17)

Department of Health and Human Services

Divis ion of Publ ic and Behavioral Health

Office of Publ ic Health Informatics and Epidemiology

Brian Sandoval

Governor

State of Nevada

Richard Whitley, MS

Director

Department of Health and Human Services

Cody L. Phinney, MPH

Administrator

Division of Public and Behavioral Health

John DiMuro, DO, MBA

Chief Medical Officer

Division of Public and Behavioral Health

January 2017

Edition 1.0

Influenza Weekly Report v 2016 i 50 (December 11 – December 17, 2016)

Page 1 of 5

Data for the graphs and tables on the following pages are provisional and may be updated as additional information becomes available.

Purpose

The purpose of this report is to provide an overview of and statistics for the influenza season in Nevada for the local public health authorities, sentinel

providers and the public.

Sentinel Provider Data: Influenza-Like Illness Network Surveillance (ILINet)

Respiratory specimens are tested for influenza by the World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance

System (NRVESS) collaborating laboratories by sub-type. During week 50, there were 20,400 specimens collected and tested for influenza, of those

1,790 were positive (8.8%).

Figure 1

Source of Data: CDC: FluView Weekly Report.

The Nevada total includes laboratory tests for all Nevada residents tested by sentinel providers including out of state laboratories. During week 50,

there were 59 specimens collected and 23 were positive (39.0%).

Figure 2

Source of Data: CDC: ILINet.

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National Influenza Positive Tests by Week53 Week Comparison (2015 WK 50- 2016 WK 50)

2009H1N1 A(H3) A(Unknown Subtyping) B (Victoria Lineage)

B (Yamagata Lineage) B(Unknown Subtyping) Percent Positive

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Nevada (ILI Providers) Influenza Laboratory Confirmed Positive by Week53 Week Comparison (2015 WK 50 - 2016 WK 50)

2009H1N1 A(H3) A(Subtyping not performed) B (Victoria Lineage)B (Yamagata Lineage) B(Unknown Subtyping) Percent Positive

Influenza Weekly Report v 2016 i 50 (December 11 – December 17, 2016)

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Nevada State Public Health Laboratory (NSPHL) has tested 124 specimens for influenza from sentinel providers, of which there have been 101

positive (81.5%). Southern Nevada Public Health Laboratory (SNPHL) has tested 33 specimens this season of which there have been 0

positives. Nationally, there have been 196,055 specimens sent to the WHO and NERVSS laboratories of which 7,187 have been positive (4.0%).

The national numbers in Table 1 are reflected in Figure 1. The state of Nevada data in Table 1 is reflected in Figure 2. The Nevada total

includes laboratory test for all Nevada residents tested by sentinel providers, including out of state laboratories.

Table 1

Influenza Specimens Tested State and Nationally through Sentinel Providers

NSPHL

SNPHL

All Other Laboratories

State of Nevada (Week 50)

State of Nevada (Season)

National (Week 50)

National (Season)

# % # % # % # %

Specimens Tested 124 33 157 59 314 20,400 196,055

Influenza Positives 101 0 14 23 39.0 115 36.6 1,790 8.8 7,809 4.0

Influenza A: 101 0 12 23 100 113 98.3 1,572 87.8 6,187 79.2

A (2009 H1N1) 7 0 1 0 0.0 8 7.1 12 .08 107 1.7

A (H3) 94 0 1 18 78.3 95 84.1 458 29.1 2,110 34.1

A (Sub-typing not performed) 0 0 10 5 21.7 10 8.8 1,102 70.1 3,970 64.2

Influenza B: 0 0 2 0 0.0 2 1.7 218 12.2 1,622 20.8

B (Victoria Lineage) 0 0 0 0 0.0 0 0.0 10 4.6 72 4.4

B (Yamagata Lineage) 0 0 0 0 0.0 0 0.0 10 4.6 52 3.2

B (Sub-typing not performed)

0 0 2 0 0.0 2 100 198 90.8 1,498 92.4

Source of Data: CDC: FluView Report and CDC: ILINet.

Influenza-like Illness (ILI) Surveillance Network has each sentinel provider report the number of patients seen that meet the ILI case definition

and the total number of patients seen for any reason each week. The “percentage of visits for ILI” is the number of ILI patients divided by the total

number of patients visit per week. Nevada’s percentage of ILI visits for week 50 is 1.5% which is at the state baseline of 1.5%. Region 9 ILI

percentage for week 50 is 2.5% which is at the region baseline 2.5%. Region 9 includes the following states/territory: Arizona, California, Guam,

Hawaii, and Nevada. The national ILI percentage for week 50 is 2.3% which is above the national baseline 2.2%.

Figure 3

Source of Data: CDC: Flu View Report and CDC: ILINet.

During week 50, 1.5% of visits to sentinel providers were due to ILI; this is higher than the 2015-2016 influenza season (1.1%). There were

17,933 patients seen by sentinel providers during week 50, of which 266 patients presented with ILI; week 50 of 2015, there were 182 patients

seen with ILI (17,128 total patients seen).

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Percentage of Visits for ILI Reported to Outpatient ILI Surveillance Network,Comparison Between National, Regional, and State,53 Week Comparison (2015 WK 50 - 2016 WK 50)

Nevada Region 9 NationalNevada Baseline Region 9 Baseline National Baseline

Influenza Weekly Report v 2016 i 50 (December 11 – December 17, 2016)

Page 3 of 5

Figure 4

Source of Data: CDC: ILINet.

Influenza-like Illness is reported by age groups. During week 50, patients age 5-25 were the greatest number of patients seen with ILI, at 87 patients

seen. The rate for week 50 is 9.2 per 100,000 population. The rate is calculated by the number of patients presented with ILI, divided by the state

population, multiplied by 100,000. The estimated state population for 2016 is 2,902,853.

Figure 5

Source of Data: CDC: ILINet.

Influenza Positive Surveillance (NBS and NETSS)

Positive cases of influenza are reported to the state health authority for surveillance purposes. Table 2 and Figure 6 reflect all positive influenza cases

reported to the state. Types of influenza testing include commercial rapid diagnostic test (rapid), viral culture, fluorescent antibody, enzyme

immunoassay, RT-PCR (PCR), and Immunohistochemistry. The two most common test types in Nevada are Rapid and PCR tests. During week 50,

there were 523 influenza cases reported to the state, 495 influenza A, 8 influenza B and 20 unknown subtyping.

Table 2

Reporting Jurisdiction

Reported Influenza Cases by County Jurisdiction and Influenza Type

Current Week (Week 50) Cumulative Influenza Season

A B Unknown Total A B Unknown Total

Carson City Health and Human Services 66 0 0 66 313 0 2 315

Rural Community Health Services 28 0 0 28 193 8 11 212

Southern Nevada Health District 152 6 5 163 432 34 22 488

Washoe County Health District 249 2 15 266 970 19 69 1,058

State of Nevada 495 8 20 523 1,908 61 104 2,073

Source: OPHIE: NBS and SNHD: NETSS.

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Nevada Percentage of Visits for Influenza-like Illness, Weekly Summary53 Week Comparison (2011-2016)

2015WK 50 - 2016WK 50 2014 WK 50 - 2015 WK 50 2013 WK 50 - 2014 WK 50

2012 WK 50 - 2013 WK 50 2011 WK 50 - 2012 WK 50 Baseline

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ILINet: Influenza-like Illness by Age Group and MMWR Week and the Incidence Rate53 Week Comparison (2015 WK 50 - 2016 WK 50)

0-4 5-24 25-49 50-64 65+ Rate

Influenza Weekly Report v 2016 i 50 (December 11 – December 17, 2016)

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Figure 6

Source of Data: OPHIE: NBS and SNHD: NETSS.

Hospitalizations

There were 43 hospitalization associated with influenza reported to the state health authority for week 50.

Table 3

Influenza Hospitalizations

Reporting Jurisdiction Current Week (Week 50) Cumulative Influenza Season

# % # %

Carson City Health and Human Services 0 0.0 3 1.7 Rural Community Health Services 2 4.7 3 1.7

Southern Nevada Health District 13 30.2 56 31.8 Washoe County Health District 28 65.1 114 64.8

State of Nevada 43 100 176 100 Source: Reported to Office of Public Health Informatics and Epidemiology from each Jurisdiction.

Pneumonia and Influenza (P&I) Mortality Surveillance

The Pneumonia and Influenza (P&I) mortality percentage is all deaths, where Pneumonia or Influenza is listed as the underlying or contributing cause

of death, divided by the total deaths in Nevada for each week. As of January 3rd, there were 28 P&I deaths and 370 total deaths for week 50 in Nevada.

The P&I mortality percent for Nevada is at 7.6%. Nationally, the P&I mortality percent has not been published for week 50.

Figure 7

Source: OVR: WEVRRS and CDC: FluView.

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Weekly Reported Influenza by Subtype as Compared with Respiratory Syncytial Virus Infections (RSV) 53 Week Comparison (2015 WK 50 - 2016 WK 50)

RSV Influenza A Influenza B Unknown Influenza Subtyping

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Pneumonia and Influenza (P&I) Mortality by Week,NCHS Mortality Surveillance Data Compared to Nevada

53 Week Comparison (2015 WK 50- 2016 WK 50)

Nevada National National Epidemic Threshold

Influenza Weekly Report v 2016 i 50 (December 11 – December 17, 2016)

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Technical Notes Data are subject to changes, additionally, there is a lag in reporting.

Influenza surveillance procedures vary by jurisdiction.

Influenza-like illness (ILI): a fever greater than or equal 100℉ with cough and/or sore throat.

Percent positive: The number of positive influenza laboratory tests divided by the total number of tests performed.

Incidence rate is per 100,000 population as estimated by the state demographer.

This report contains information from national and state-level data sources. Influenza surveillance data is collected by a various systems,

including:

Influenza-like Illness Network (ILINet): a sentinel surveillance system in collaboration with the Centers for the Disease Control and

Prevention (CDC) where outpatient providers report ILI information weekly.

National Electronic Telecommunication System for Surveillance (NETSS): a system whereby data is transmits to CDC. Influenza

data collected through NETSS does not provide influenza sub-typing information.

National Electronic Disease Surveillance System (NEDSS): a system for collecting data and monitoring disease trends and

outbreaks.

NEDSS Based System (NBS): an implementation of the NEDSS standards. It provides a secure, accurate, and efficient means of

collecting, transmitting, and analyzing public health data.

Citations

1. CDC. FluView: A Weekly Influenza Surveillance Report. http://www.cdc.gov/flu/weekly/pastreports.htm.

2. Nevada State Demographer’s Office. 2003-2020 ASRHO Estimates and Projections. Division of Public and Behavioral Health edition.

Vintage 2015.

3. OPHIE. DPBH. NBS. 2015-2016. Accessed December 2017.

4. Office of Vital Records (OVR). DPBH. Web Enabled Vital Records Registry System (WEVRRS) [unpublished data]. 2015-2016. Accessed

January 2017.

5. Southern Nevada Health District (SNHD). NETSS/Trisano. 2015-2016. Accessed January 2017.

Comments, suggestions, and requests for further information may be addressed to:

NEVADA INFLUENZA SURVEILLANCE PROGRAM

OFFICE OF PUBLIC HEALTH INFORMATICS AND EPIDEMIOLOGY

500 DAMONTE RANCH PKWY, STE 657

RENO, NV 89521

TEL: (775) 684-5289

FAX: (775) 684-5999

Compiled and Written by: Liliana E. Wilbert, MPH

Reviewed by: Jennifer Thompson

Melissa Peek-Bullock

Recommended Citation:

Division of Public and Behavioral Health. Office of Public Health Informatics and Epidemiology. Influenza Weekly Report, 2015 Week 50 (December

13) through 2016 Week 50 (December 17), Nevada. December 2016 i 50 edition 1.0.

This publication was supported by Cooperative Agreement Number TP000534-02 from the Centers for

Disease Control and Prevention and/or Assistant Secretary for Preparedness and Response. Its contents

are solely the responsibility of the authors and do not necessarily represent the official views of the

Centers for Disease Control and Prevention and/or Assistant Secretary for Preparedness and Response.