Influenza Season Surveillance Week 1 Dallas County Health and Human Services Ending 1/9/16

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1 nfluenza Season Surveillance Week 1 allas County ealth and uman Services Epidemiologic Summary nfluenza activity is starting to increase in allas County with 2.% of tests returning positive during week 1. Nationally, 3.% of specimens reported to CC were positive for influenza. aily numbers of emergency department visits for influenza-like illness in allas County are slightly above baseline and numbers of new influenza-associated hospitalizations remain low. n the United States, all circulating influenza viruses tested have been susceptible to the neuraminidase inhibitor antiviral medications, oseltamivir and zanamivir; however, rare sporadic instances of oseltamivir-resistant 29 1N1 and (3N2) viruses have been detected worldwide. No influenza-associated pediatric deaths have been reported in the season in allas County. RSV activity remains high with 24.4% of tests from area surveillance sites testing positive. Table 1. nfluenza Surveillance Summary: allas County Providers, ospitals and Viral abs: September 27, 215 January 9, 216 Week Ending 12/5 12/12 12/19 12/26 1/2 1/9 9/27 CC Week Present nfluenza tests performed weekly 1,373 1,11 1,86 1,317 1,327 1,356 14,874 Total positive influenza tests Percent positive influenza tests Positive influenza tests Positive influenza B tests Non-differentiated influenza tests nfluenza hospitalizations Confirmed pediatric deaths 5 Confirmed adult deaths 6 Possible influenza-associated deaths 7 *ndicates preliminary results which are subject to change with late-arriving data from surveillance sites designated for CS seasonal influenza program; 1 ncludes positive rapid antigen, PCR, F, or culture results; 2 Further subtyping is performed only for specimens referred by institutions for PCR-testing; 3 Non-differentiated refers to rapid test results which did not differentiate between influenza and B; 4 Reflects all influenza-associated hospitalizations reported from hospitals located within allas County by week of positive test; 5 Confirmed influenza-associated deaths of allas County residents <18 years of age; 6 Confirmed influenza-associated deaths as defined by a positive laboratory test, compatible symptoms, and clear progression from illness to death, or determination by the County Medical Examiner s office (ME) of no alternate cause of death; 7 Possible influenza-associated deaths are defined as cases with laboratory-confirmed influenza, but pending final autopsy results for determination of primary cause of death. Table 2. nfluenza-associated Pediatric and dult eaths, allas County: Seasons Confirmed eaths Pediatric dult ata source(s): Reports of confirmed influenza-associated deaths, as defined above. Page 1 of 5

2 CS nfluenza Season Surveillance Week 1 Figure 1. Percent Positive nfluenza Tests by Week, allas County: Seasons 35 Percent Positive CC Week Note: For figure 1 and all subsequent trend overlays there is no week 53 for the influenza season, therefore week 53 data point for this season is an average of weeks 52 and 1. Figure 2. Syndromic Surveillance of Emergency epartment Visits for nfluenzalike llness (), allas County: September 1, 215 January 14, 216 Number of Reports Sep15 5Sep15 9Sep15 13Sep15 17Sep15 21Sep15 25Sep15 29Sep15 3ct15 7ct15 11ct15 15ct15 19ct15 23ct15 27ct15 31ct15 4Nov15 8Nov15 12Nov15 16Nov15 2Nov15 24Nov15 28Nov15 2ec15 6ec15 1ec15 14ec15 18ec15 22ec15 26ec15 3ec15 3Jan16 7Jan16 11Jan16 ata alert ata warning ata normal ata source: 18 emergency departments in allas County hospitals participating in the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) voluntarily reporting the numbers of persons presenting with self-reported chief complaints of. Page 2 of 5

3 CS nfluenza Season Surveillance Week 1 Figure 3. ospitalized nfluenza Patients by Week of dmission, allas County: Season Compared with Season 2 CU dmissions ospitalizations 15 Number of Patients Season Season CC Week ata from 214 through the current reporting period reflect all patients from hospitals located within allas County with influenza as documented by any positive influenza test (rapid antigen, PCR, F, or culture). Table 3. nfluenza Typing and Subtyping from Cumulative allas County, Texas, and U.S. aboratory Surveillance ata: Season allas 1 (n=1) Texas 2 (n=365) U.S. 3 (n=1,237) nfluenza 5 (5.%) 177 (48.5%) 966 (78.1%) 1N1 29 subtype 3 (6.%) 9 (16.7%) 421 (46.7%) 3N2 subtype 2 (4.%) 15 (83.3%) 48 (53.3%) Not subtyped nfluenza B 5 (5.%) 188 (51.5%) 271 (21.9%) 1 CS RN laboratory PCR testing of designated allas County surveillance site isolates; 2 SS Texas nfluenza Surveillance nformation ctivity Report available at 3 CC FluView Weekly nfluenza Surveillance Report available at Table 4: Non-nfluenza Respiratory Virus Testing by North Texas aboratories Reported to NREVSS, Week 1 Virus Number of aboratories Reporting Tests Performed Total Positive Tests Percentage of Tests Positive denovirus (respiratory) % MPV % Parainfluenza virus % Rhinovirus/enterovirus % RSV % ata source: National Respiratory and Enteric Virus Surveillance System (NREVSS) Page 3 of 5

4 CS nfluenza Season Surveillance Week 1 Figure 4. Percentage of Student bsences by Week, allas County: and Percentage of Student bsences ue to Reported 7.% 6.% 5.% 4.% 3.% 2.% 1.%.% CC Week ata source: Voluntary reporting from ndependent School istricts representing over 51 elementary, middle, and secondary schools and over 42, students in allas County Figure 5. Percentage of Student bsences ue to by Week, allas County: and % Percentage of Student bsences ue to Reported.5%.4%.3%.2%.1%.% CC Week ata source: Voluntary reporting from ndependent School istricts representing over 51 elementary, middle, and secondary schools and over 42, students in allas County Page 4 of 5

5 CS nfluenza Season Surveillance Week 1 Figure 6. Number and Percent Positive RSV Rapid ntigen and PCR Tests by Week, NREVSS Surveillance ata, North Texas: ugust 1, 214 January 9, Number of Positive RSV Tests # Positive # Positive % Positive % Positive Percent Positive RSV Tests CC Week ata source: National Respiratory and Enteric Virus Surveillance System (NREVSS) Table 5. Number and Percent Positive RSV Rapid ntigen and PCR Tests by Week, NREVSS Surveillance ata, North Texas: ugust 16, 215 January 9, 216 Week Ending 11/28 12/5 12/12 12/19 12/26 1/2 1/9 8/16 CC Week * Present RSV tests performed weekly ,286 Total positive RSV tests Percent positive RSV tests *ndicates preliminary results which are subject to change as adjustments are made for late-arriving data. ata source: National Respiratory and Enteric Virus Surveillance System (NREVSS) Please report any of the following patients to CS within 1 working day: ospitalized patients with influenza (any subtype). Confirmation can be by any laboratory test, rapid antigen, culture, PCR, F/F, or performed in an outpatient or inpatient laboratory. eaths of persons with confirmed influenza (any subtype). We are requesting all pediatric influenza-associated deaths to be reported immediately to facilitate specimen procurement and testing. Suspected influenza infections involving institutional outbreaks or a resident of any ong Term Care facility (please report immediately). Phone: (214) influenza@dallascounty.org Page 5 of 5