N.C. Weekly Influenza Summary - May 20, 2017 1
Final Summary 2016-2017
NORTH CAROLINA WEEKLY INFLUENZA SURVEILLANCE SUMMARY2016-2017 INFLUENZA SEASON
WEEK 20: ENDING MAY 20, 2017
By Week: North Carolina
Percentage of Outpatient Visits with Influenza-like Illness (ILI)
04/29 05/06 05/13 05/20
Week Ending Date
0
1
% IL
I
StatewideUpdates
Influenza-like illness (ILI) decreased during week 20.
The geographic spread of flu was SPORADIC for week 20 ending 5/20/2017.
Of the 4 samples submitted to the State Laboratory of Public Health (SLPH) for viral testing this week; 1was positive for influenza A(H3) and 3 positive for influenza B.
Hospital-based Public Health Epidemiologists (PHEs) reported 4 positive influenza results out of 251samples tested during week 20 (ending 5/20/2017); 2 positive for influenza B and 2 positive for influenzaA(H3).
RegionalUpdates
The proportion of visits due to ILI in Region 4 (Southeastern US) was below baseline at 0.5% for week 19(ending 5/13/2017). The baseline for the region is 1.7%.
NationalUpdates
The proportion of outpatient visits due to ILI nationally was at 1.3% for week 19 (ending 5/13/2017). Thenational baseline for ILI is 2.2%.
InternationalUpdates
May 15, 2017 - Influenza activity in the temperate zone of the northern hemisphere continued to decrease.In the temperate zone of the southern hemisphere, influenza activity reached seasonal thresholds in somecountries, but remained low in general. In tropical South America, influenza activity remained low in mostof the region. Other respiratory virus activities remained low in general, except in Colombia whereelevated activity of respiratory syncytial virus (RSV) continued to be reported. In the Caribbean andCentral America countries, respiratory virus activity remained low. In East Asia, influenza activitycontinued to be reported with all seasonal influenza types/subtypes detected. In Southern Asia, influenzaactivity decreased. In Western Asia, low influenza activity was reported with influenza B virusespredominant. In East and West Africa, low influenza activity was reported in recent weeks, with allseasonal influenza types/subtypes detected. In Northern Africa, influenza activity remained low. In Europe,influenza activity continued to decrease. In Northern and Eastern Europe, influenza activity continued todecrease with influenza B viruses predominant. In North America, overall influenza activity continued todecrease with predominantly influenza B viruses reported in recent weeks. In Mexico, low levels of allseasonal influenza types/subtypes continued to be detected.
Flu Information and Guidance
North Carolinawww.flu.nc.gov
CDCwww.cdc.gov/flu
N.C. Weekly Influenza Summary - May 20, 2017 2
Final Summary 2016-2017
INFLUENZA-LIKE ILLNESSES REPORTED BY SENTINEL SITES, 2016-2017
Week # - Ending (Sentinels Reporting) # ILI # Patients % ILI
#40 - 10/08/2016 38 122 14,693 0.83
#41 - 10/15/2016 41 129 13,992 0.92
#42 - 10/22/2016 45 154 16,190 0.95
#43 - 10/29/2016 44 184 17,269 1.07
#44 - 11/05/2016 47 171 18,014 0.95
#45 - 11/12/2016 47 243 17,343 1.40
#46 - 11/19/2016 45 265 16,777 1.58
#47 - 11/26/2016 47 218 11,138 1.96
#48 - 12/03/2016 48 280 17,358 1.61
#49 - 12/10/2016 50 252 16,435 1.53
#50 - 12/17/2016 47 294 13,609 2.16
#51 - 12/24/2016 45 273 9,073 3.01
#52 - 12/31/2016 44 194 5,687 3.41
#1 - 01/07/2017 50 293 11,433 2.56
#2 - 01/14/2017 48 290 13,276 2.18
#3 - 01/21/2017 48 397 14,885 2.67
#4 - 01/28/2017 48 431 15,138 2.85
#5 - 02/04/2017 47 773 14,918 5.18
#6 - 02/11/2017 46 877 15,516 5.65
#7 - 02/18/2017 45 1044 15,644 6.67
#8 - 02/25/2017 47 1178 15,227 7.74
#9 - 03/04/2017 48 994 16,634 5.98
#10 - 03/11/2017 45 670 12,758 5.25
#11 - 03/18/2017 47 423 12,958 3.26
#12 - 03/25/2017 47 848 15,523 5.46
#13 - 04/01/2017 44 603 14,739 4.09
#14 - 04/08/2017 43 560 15,368 3.64
#15 - 04/15/2017 41 217 11,869 1.83
#16 - 04/22/2017 42 190 13,107 1.45
#17 - 04/29/2017 35 60 11,754 0.51
#18 - 05/06/2017 29 64 10,438 0.61
#19 - 05/13/2017 27 31 7,855 0.39
#20 - 05/20/2017 22 15 5,997 0.25
N.C. Weekly Influenza Summary - May 20, 2017 3
Final Summary 2016-2017
Influenza-Like Illness in ILINET Outpatient VisitsINFLUENZA SURVEILLANCE, NC 2014-2017
0%
1%
2%
3%
4%
5%
6%
7%
8%
9%
10%
% IL
I
10/08
10/15
10/22
10/29
11/05
11/12
11/19
11/26
12/03
12/10
12/17
12/24
12/31
01/07
01/14
01/21
01/28
02/04
02/11
02/18
02/25
03/04
03/11
03/18
03/25
04/01
04/08
04/15
04/22
04/29
05/06
05/13
05/20
Week Ending Date
2016-20172015-20162014-2015
For more information about comparable national data, visit www.cdc.gov/ncidod/diseases/flu/weekly.htm and in particular, clickon the link “View Chart Data” below “Percentage of Visits for Influenza-like Illness Reported by the US Outpatient Influenza-likeIllness Surveillance Network (ILINet)”.
N.C. Weekly Influenza Summary - May 20, 2017 4
Final Summary 2016-2017
PHE Respiratory Viral Pathogen Surveillance
Positive test results for selected respiratory viruses are reported on a weekly basis by Public Health Epidemiologists (PHEs) locatedin seven of the largest hospital networks across North Carolina. The graph below shows the number of positive tests for respiratorysyncytial virus (RSV), parainfluenza, adenovirus, rhinovirus, and human metapneumovirus (hMPV) by week.
These data provide a useful indication of which other respiratory viruses are circulating and possibly contributing to ILI in the state.Please note that the total number of tests performed is not available from all hospital networks, so the overall proportion testingpositive cannot be calculated. Also, testing protocols and practices differ among hospitals. Finally, these numbers reflect testresults from participating hospitals only and might not be reflective of the entire state.
Data source: NC DETECT
PHE Surveillance: Positive Respiratory Virus Test Results by Week
* Most facilities use tests that do not distinguish rhinoviruses from enteroviruses.
050
100150200250300350400450500550600650700750800850900950
10001050
Co
un
t
10/08
10/15
10/22
10/29
11/05
11/12
11/19
11/26
12/03
12/10
12/17
12/24
12/31
01/07
01/14
01/21
01/28
02/04
02/11
02/18
02/25
03/04
03/11
03/18
03/25
04/01
04/08
04/15
04/22
04/29
05/06
05/13
05/20
Week Ending Date
InfluenzahMPVRhinovirus*AdenovirusParainfluenzaRSV
Da
ta in
sha
de
d a
rea
ma
y be
inc
om
ple
te
● Rhinovirus* was the most frequently identified respiratory viral pathogen during week 20 (ending 05/20/2017) followed by Parainfluenza.
INFLUENZA VIRUS ISOLATES IDENTIFIED BY PHE FACILITIES FOR 2016–2017 SEASON*INFLUENZA VIRUS ISOLATES IDENTIFIED BY PHE FACILITIES FOR 2016–2017 SEASON*
Virus Type # New positive results(5/14/2017-5/20/2017)
# Cumulative positive results(10/2/2016-5/20/2017)
A(H1) 0 254
A(H3) 2 1772
A (subtype unknown) 0 3269
B 2 2418
Total 4 7713
N.C. Weekly Influenza Summary - May 20, 2017 5
Final Summary 2016-2017
PHE Acute Respiratory Admissions Surveillance
The number of patients admitted to the hospital with fever plus respiratory symptoms in the absence of a known cause other thaninfluenza is reported on a weekly basis by Public Health Epidemiologists (PHEs) located in seven of the largest hospital networksacross North Carolina. The graph below shows the number of acute respiratory illness admissions to participating hospitals by agegroup.
In conjunction with other surveillance information, these data help us monitor for changes in severity of respiratory illness duringperiods when influenza is circulating. Please note that these reports are not limited to patients with laboratory-confirmedinfluenza infection. Also, these numbers reflect admissions to participating hospitals only and are not be reflective of the entirestate.
Data source: NC DETECT
PHE Surveillance: Hospital Admissions for Acute Respiratory Illness by Week
0
30
60
90
120
150
180
210
240
270
300
330
360
390
420
Co
un
t
10/08
10/15
10/22
10/29
11/05
11/12
11/19
11/26
12/03
12/10
12/17
12/24
12/31
01/07
01/14
01/21
01/28
02/04
02/11
02/18
02/25
03/04
03/11
03/18
03/25
04/01
04/08
04/15
04/22
04/29
05/06
05/13
05/20
Week Ending Date
TotalAge UnknownAge 65+Age 25 - 64Age 5 - 24Age 0 - 4
Da
ta in
sha
de
d a
rea
ma
y be
inc
om
ple
te
● Acute respiratory admissions decreased during week 20 (ending 05/20/2017).
● The highest number of acute respiratory admissions during week 20 was for patients Age 25 - 64 followed by Age 65+.
N.C. Weekly Influenza Summary - May 20, 2017 6
Final Summary 2016-2017
By Week Ending Date
Influenza Positive Tests Reported by the NC State Laboratory of Public Health (SLPH)
† Percent of submitted specimens for any influenza
0
10
20
30
40
50
# P
osi
tive
Sp
eci
me
ns
10/08
10/15
10/22
10/29
11/05
11/12
11/19
11/26
12/03
12/10
12/17
12/24
12/31
01/07
01/14
01/21
01/28
02/04
02/11
02/18
02/25
03/04
03/11
03/18
03/25
04/01
04/08
04/15
04/22
04/29
05/06
05/13
05/20
Week Ending Date
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
% P
osi
tive
†
B (not subtyped)B (Yamagata)B (Victoria)Seasonal A (H3)2009 A (H1N1)A (not subtyped)
Percent Positive †
INFLUENZA VIRUS ISOLATES FROM IN-STATE PATIENTS IDENTIFIED BY THE STATE LABORATORY OF PUBLIC HEALTH 2016–2017 SEASON*INFLUENZA VIRUS ISOLATES FROM IN-STATE PATIENTS IDENTIFIED BY THE STATE LABORATORY OF PUBLIC HEALTH 2016–2017 SEASON*
Virus Type # New Positive Results(5/14/2017 - 5/20/2017)
# Cumulative Positive Results(10/2/16 - 5/20/17)
A (unknown) 0 3
2009 A(H1N1) 0 32
A(H3) 1 243
B (unknown) 0 5
B (Victoria) 0 25
B (Yamagata) 3 53
Total 4 361
* 2016-2017 influenza season began October 2, 2016.NOTE: This table includes isolates tested as of 10/02/2016
This table does not include influenza isolates identified by other laboratories
By Week Ending Date
Influenza Positive Tests Reported by the NC State Laboratory of Public Health (SLPH) and PHE Facilities
† Percent of submitted specimens for any influenza
0
200
400
600
800
1000
# P
osi
tive
Sp
eci
me
ns
10/08
10/15
10/22
10/29
11/05
11/12
11/19
11/26
12/03
12/10
12/17
12/24
12/31
01/07
01/14
01/21
01/28
02/04
02/11
02/18
02/25
03/04
03/11
03/18
03/25
04/01
04/08
04/15
04/22
04/29
05/06
05/13
05/20
Week Ending Date
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
% P
osi
tive
†
Seasonal BSeasonal A (H3)A (H1)A (not subtyped)
Percent Positive †
N.C. Weekly Influenza Summary - May 20, 2017 7
Final Summary 2016-2017
North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT) ILI Surveillance
Near real-time syndromic surveillance for ILI is conducted through the North Carolina Disease Event Tracking and Epidemiologic Collection Tool(NC DETECT). This system uses a variety of data sources including emergency departments (EDs). NC DETECT is currently receiving data dailyfrom 122 of the 123 24/7 EDs in North Carolina. The NC DETECT ILI syndrome case definition includes any case with the term 'flu' or 'influenza',or at least one fever term and one influenza-related symptom.
The proportion of ED visits meeting the ILI syndrome definition is monitored throughout the year and compared to data obtained fromInfluenza-like Illness Surveillance Network (ILINet). In past years, data from the two systems have shown similar trends (below). The higherproportion of ILI seen in NC DETECT compared to ILINet reflects differences in the case definitions and patient populations rather than adifference in the sensitivity of these surveillance systems.
Hospital Emergency Department Visits (NC DETECT) and Outpatient Provider Visits (ILINet)
Influenza-Like Illness Surveillance in North Carolina, 2016-2017
0
1
2
3
4
5
6
7
8
9
10
11
12
% I
LI
10/0810/15
10/2210/29
11/0511/12
11/1911/26
12/0312/10
12/1712/24
12/3101/07
01/1401/21
01/2802/04
02/1102/18
02/2503/04
03/1103/18
03/2504/01
04/0804/15
04/2204/29
05/0605/13
05/20
Week Ending Date
2016-17 ILInet2016-17 ED NC DETECT
Past Two Influenza Seasons: Shown For ComparisonHospital Emergency Department Visits (NC DETECT) and Outpatient Provider Visits (ILINet)
Influenza-Like Illness Surveillance in North Carolina, Past Two Seasons
0
1
2
3
4
5
6
7
8
9
10
11
% I
LI
10/08
10/15
10/22
10/29
11/05
11/12
11/19
11/26
12/03
12/10
12/17
12/24
12/31
01/07
01/14
01/21
01/28
02/04
02/11
02/18
02/25
03/04
03/11
03/18
03/25
04/01
04/08
04/15
04/22
04/29
05/06
05/13
05/20
Week Ending Date
2015-16 ILInet2015-16 ED NC DETECT2014-15 ILInet2014-15 ED NC DETECT
N.C. Weekly Influenza Summary - May 20, 2017 8
Final Summary 2016-2017
NC DETECT ED Influenza-Like Illness (ILI), 2016-2017Percentage of Total Visits by Week, Grouped by Flu Surveillance Regions:
5
10
15
% IL
I
10/0810/15
10/2210/29
11/0511/12
11/1911/26
12/0312/10
12/1712/24
12/3101/07
01/1401/21
01/2802/04
02/1102/18
02/2503/04
03/1103/18
03/2504/01
04/0804/15
04/2204/29
05/0605/13
05/20
Week Ending Date
Region 7Region 6Region 5Region 4Region 3Region 2Region 1
NOTE: This graph begins with data starting week ending October 8, 2016 for the 2016-2017 influenza season.
Flu Surveillance Regions
Regions 1 2 3 4 5 6 7
ALAMANCE
ALEXANDER
ALLEGHANY
ANSON
ASHE
AVERY
BEAUFORT
BERTIE
BLADEN
BRUNSWICK
BUNCOMBE
BURKE
CABARRUS
CALDWELL
CAMDEN
CARTERET
CASWELL
CATAWBA CHATHAM
CHEROKEE
CHOWAN
CLAY
CLEVELAND
COLUMBUS
CRAVEN
CUMBERLAND
CURRITUCK
DAREDAVIDSON
DAVIE
DUPLIN
DURHAM
EDGECOMBE
FORSYTH
FRANKLIN
GASTON
GATES
GRAHAM
GRANVILLE
GREENE
GUILFORD
HALIFAX
HARNETT
HAYWOOD
HENDERSON
HERTFORD
HOKE
HYDE
IREDELL
JACKSON
JOHNSTON
JONES
LEE
LENOIR
LINCOLN
MC DOWELL
MACON
MADISON MARTIN
MECKLENBURG
MITCHELL
MONTGOMERY
MOORE
NASH
NEW HANOVER
NORTHAMPTON
ONSLOW
ORANGE
PAMLICO
PASQUOTANK
PENDER
PERQUIMANS
PERSON
PITT
POLK
RANDOLPH
RICHMOND
ROBESON
ROCKINGHAM
ROWAN
RUTHERFORD
SAMPSON
SCOTLAND
STANLY
STOKESSURRY
SWAIN
TRANSYLVANIA
TYRRELL
UNION
VANCE
WAKE
WARREN
WASHINGTON
WATAUGA
WAYNE
WILKES
WILSON
YADKIN
YANCEY
3
45
6
1
7
2
N.C. Weekly Influenza Summary - May 20, 2017 9
Final Summary 2016-2017
NC Influenza-Associated Deaths*Influenza-Associated Deaths
This Week (05/14/2017 – 05/20/2017)Total Influenza-Associated DeathsThis Season (starting 10/02/2016)
0 218
*Influenza-associated Deaths – This number is based on reports submitted by providers to the NC Division of Public Health. Aninfluenza-associated death is defined for surveillance purposes as a death (adult or pediatric) resulting from a clinically compatible illness thatwas confirmed to be influenza by an appropriate laboratory or rapid diagnostic test with no period of complete recovery between the illness anddeath. Deaths that occurred on or after 10/02/2016 will be reflected in this report for the 2016-2017 season.
North Carolina by Age Group*Laboratory Confirmed Influenza-Associated Deaths Reported in
0102030405060708090
100110120130140150
No
. of
Re
po
rte
d D
ea
ths
0-4 5-17 18-24 25-49 50-64 65+
Age Group (Years)
Reported in North Carolina by Week of Death*Laboratory Confirmed Influenza-Associated Deaths
10 0
10 0 0 0 0 0
2
0
43
4 4 4
2
11
16
22
30
32
16
10
21
16
7
3
6
3
0 00
3
6
9
12
15
18
21
24
27
30
No
. o
f R
ep
ort
ed
De
ath
s
10/08
10/15
10/22
10/29
11/05
11/12
11/19
11/26
12/03
12/10
12/17
12/24
12/31
01/07
01/14
01/21
01/28
02/04
02/11
02/18
02/25
03/04
03/11
03/18
03/25
04/01
04/08
04/15
04/22
04/29
05/06
05/13
05/20
Week Ending Date
PediatricAdult
N.C. Weekly Influenza Summary - May 20, 2017 10
Final Summary 2016-2017
PARTICIPANTS IN NORTH CAROLINA’S INFLUENZA SENTINEL SURVEILLANCE PROGRAM THAT HAVE REPORTED DATA TO CDC
LOCAL HEALTH DEPARTMENT/DISTRICT OFFICES - 25
Alamance County Health Department
Cabarrus Health Alliance
Caldwell County Health Department
Craven County Health Department
Duplin County Health Department
Franklin County Health Department
Henderson County Health Department
Johnston County Health Department
Lee Primary Care
Martin County Office [Martin-Tyrrell-Washington County Health District]
Montgomery County Health Department
Northampton County Health Department
Pender County Health Department
Pitt County Public Health Center
Richmond County Health Department
Rockingham County Health Department
Stanly County Health Department
Stokes Family Health Center
Surry County Health and Nutrition Center
Tyrrell County Office [Martin-Tyrrell-Washington County Health District]
Union County Health Department
Wake County Health Department, Children’s Clinic
Washington County [Martin-Tyrell-Washington County Health District]
Wilkes County Health Department
Wilson County Health Department
COLLEGES AND UNIVERSITIES STUDENT HEALTH PROGRAMS - 14
Appalachian State University Student Health Services
Davidson College Student Health Center
ECU Student Health Services
Elizabeth City State University Student Health Services
Elon University R. N. Ellington Health and Counseling Center
Fayetteville State University
NC Agricultural &Technical State University Student Health Services
NC State University Student Health Services
UNC-Chapel Hill Student Health Services
UNC-Charlotte Student Health Services
UNC-Greensboro Student Health Services
UNC-Pembroke Student Health Services
Wake Forest University Student Health Services
Winston-Salem State University
PRIVATE PRACTITIONERS - 26
Bakersville Community Medical Center
Blue Cross and Blue Shield of N.C.
Blue Ridge Community Health Services
Butner-Creedmoor Family Medicine
Coastal Childrens Clinic
Colerain Primary Care
Dilworth Pediatrics
ECU Brody School of Medicine – Department of Pediatrics
Family Care Center
Growing Child Pediatrics
Haywood Pediatric and Adolescent Medicine Group, PA
High Country Community Health
Hot Springs Health Program
MEDAC Health Services at Shipyard Blvd.
MEDAC Health Services at Porter’s Neck
MEDAC Health Services at Military Cutoff
Murfreesboro Primary Care
Oxford Family Physicians
PrimeCare
PrimeCare of Kernersville
PrimeCare of Northpoint
Roanoke Chowan Community Health Center
SAS Institute Health Care Center
Sisters of Mercy Urgent Care, South
Sisters of Mercy Urgent Care, West
Stanly Family Care Clinic
HOSPITALS - 3
Blue Ridge Regional Hospital
Durham VAMC
Scotland Healthcare System
Total Sentinels Enrolled - 68
Counties Covered - 45:Alamance (2), Alexander (1), Avery (1), Bertie (1), Buncombe (2), Cabarrus (1), Caldwell (1), Craven (2), Cumberland (1), Duplin (1), Durham (2), Forsyth (5),Franklin (1), Granville (2), Guilford (2), Haywood (1), Henderson (2), Hertford (2), Johnston (1), Lee (1), Madison (1), Martin (1), Mecklenburg (3), Mitchell (2),Montgomery (1), New Hanover (3), Northampton (1), Orange (1), Pasquotank (1), Pender (1), Pitt (3), Richmond (1), Robeson (1), Rockingham (1), Scotland(1), Stanly (2), Stokes (1), Surry (1), Tyrrell (1), Union (1), Wake (4), Washington (1), Watauga (1), Wilkes (1), Wilson (1)