Colorado 2013-14 Flu Season Wks 44-02

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Week 44, ending Nov 2, 2013

Case Reporting: Due to the currently low influenza activity and the concern of false positive results from rapid antigen tests, influenza-associated hospitalizations are currently being counted as cases only if they are positive by PCR, DFA or viral culture. This will change as influenza activity increases.

Synopsis: For the week ending 11/02, influenza activity was minimal, based primarily on a single influenza-associated hospitalization and virology surveillance data.
* The second influenza-associated hospitalization of the 2013/14 season was reported during the most recent week. The first confirmed influenza-associated hospitalization was identified during the week ending 10/05/2013. Both hospitalizations were from Kit Carson County and both specimens were subtyped; one was 2009 H1N1 and the other was H3.
* Influenza-like illness reported by Kaiser Permanente for the Denver-Boulder metropolitan area remained similar to summer ?baseline? levels at less than 1.0%. Influenza-like illness reported by Mesa County was 0%.
* Sentinel hospital labs (19/21 reporting) tested 301 specimens and 8 (2.7%) were positive for influenza A (compared to 1.3% during the previous week). Caution should be used when interpreting these data based on the possibility of false positive results with the current use of rapid flu tests.
* There were eight reported PCR-confirmed specimens tested for the period 09/30/13-11/02/13, by the state laboratory (two from inpatient hospital visits and four from outpatient hospital visits). Of which, six have subtyped as H3, and two as 2009 H1N1. No specimens confirmed positive for influenza B.

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Re: Colorado 2013-14 Influenza Season Wks 44-46

Week 45, ending Nov 9

Synopsis: For the week ending 11/09, influenza activity was minimal, based primarily on virology surveillance data.

* No additional hospitalizations were reported during the most recent week. Two hospitalizations were reported from Kit Carson County (one during the week ending 10/5 and one during the week ending 11/02). Both specimens were subtyped; one was 2009 H1N1 and the other was H3.

* Influenza-like illness reported by Kaiser Permanente for the Denver-Boulder metropolitan area remained similar to summer ?baseline? levels at less than 1.0%. Influenza-like illness reported by Mesa County remained near 0%.

* Sentinel hospital labs (15/21 reporting) tested 307 specimens and 12 (3.9%) were positive for influenza A (compared to 2.5% during the previous week). Caution should be used when interpreting these data based on the possibility of false positive results with the current use of rapid flu tests.

* There were 10 additional specimens (out of 18 submitted) that tested positive for influenza by PCR at the state laboratory. Cumulatively, 10 (56%) of 18 PCR positive specimens have subtyped as H3, and 8 (44%) as 2009 H1N1. No specimens have confirmed as type B.

* No influenza-associated pediatric deaths have been reported thus far.

* No influenza-associated outbreaks have been reported thus far.

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Re: Colorado 2013-14 Influenza Season Wks 44-45

Week 46, ending Nov 18

Synopsis: For the week ending 11/16, influenza activity was minimal but increased compared to the
previous week.

 Six additional hospitalizations were reported during the most recent week. The cumulative total of hospitalizations is 8 from the following four counties; Arapahoe (4), Jefferson (1), Kit Carson (2), and Pueblo (1).

 Influenza-like illness reported by Kaiser Permanente for the Denver-Boulder metropolitan area remained similar to summer ?baseline? levels at less than 1.0%. Influenza-like illness reported by Mesa County remained near 0%.

 Sentinel hospital lab data is incomplete for the most recent week with only 13/21 hospitals reporting.

 There were 18 additional specimens (out of 31 submitted) that tested positive for influenza by PCR at the state laboratory. Cumulatively, 23 (64%) of 36 PCR positive specimens have subtyped as 2009 H1N1 and 13 (36%) as H3. No specimens have confirmed as type B.

 No influenza-associated pediatric deaths have been reported thus far in Colorado. Nationally, the first two influenza-associated pediatric deaths of the 2013-2014 season were reported to CDC during the week November 3-9. One of the deaths was associated with an influenza A virus for which the subtype was not determined. The other death was associated with an influenza A and influenza B co-infection (both an influenza A and influenza B virus were identified in the patient).

 No influenza-associated outbreaks have been reported thus far.

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Re: Colorado 2013-14 Influenza Season Wks 44-47

Week 47, ending Nov 23

Case Reporting: Due to the concern of false positive results from rapid antigen tests, influenza associated hospitalizations are currently being counted as cases only if they are positive by PCR, DFA or viral culture. However, with the increased influenza activity noted below, any hospitalization with a positive influenza test will be counted as a case beginning with the week ending November 30.

Synopsis: For the week ending November 23rd, influenza activity remained at a low level but increased compared to the previous week with most activity along the Front Range. Influenza A (2009 H1N1) is the predominate circulating subtype.
? There were 25 additional hospitalizations reported; 11 with a collection date during the previous week (week ending 11/16) and 14 with a collection date during the most recent week. The cumulative total of hospitalizations is 33 from 10 counties.
? Influenza-like illness reported by Kaiser Permanente for the Denver-Boulder metropolitan area remained similar to summer ?baseline? levels at less than 1.0%. Influenza-like illness reported by Mesa County remained near 0%.
? There were 28 additional specimens (out of 46 submitted) that tested positive for influenza by PCR at the state laboratory. Cumulatively, 51 (80%) of 64 PCR positive specimens have subtyped as 2009 H1N1 and 13 (20%) as H3. No specimens have confirmed as type B.
? No influenza-associated pediatric deaths have been reported thus far.
? No influenza-associated outbreaks have been confirmed thus far.

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Re: Colorado 2013-14 Influenza Season Wks 44-47

Week 48, ending Nov 30

Synopsis: For the week ending November 30th, influenza activity remained at a low level but continued to increase. Influenza A (2009 H1N1) is the predominate circulating subtype making up 87% of the hospitalizations.

? There were 22 additional hospitalizations reported; 8 with a collection date during the previous week (week ending 11/23) and 14 with a collection date during the most recent week. The cumulative total of hospitalizations is 52 from 12 counties.

? Influenza-like illness reported by Kaiser Permanente for the Denver-Boulder metropolitan area remained similar to summer ?baseline? levels at less than 1.0% but is showing signs of increased ILI activity. Influenza-like illness reported by Mesa County remained near 0%.

? There were 18 additional specimens (out of 26 submitted) that tested positive for influenza by PCR at the state laboratory. Cumulatively, 81 (84%) of 96 PCR positive specimens have subtyped as 2009 H1N1 and 15 (16%) as H3. No specimens have confirmed as type B.

? No influenza-associated pediatric deaths have been reported thus far.

? No influenza-associated outbreaks have been confirmed thus far.

http://www.colorado.gov/cs/Satellite?blobcol=urldata&blobheadername1=Content-Disposition&blobheadername2=Content-Type&blobheadervalue1=inline%3B+filename%3D%22Colorado+Flu+Report.pdf%22&blobheadervalue2=application%2Fpdf&blobkey=id&blobtable=MungoBlobs&blobwhere=1251915224658&ssbinary=true

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Re: Colorado 2013-14 Influenza Season Wks 44-49

Week 49 ending Dec 7

Synopsis: For the week ending December 7, influenza activity continued to increase with most of the activity along the Front Range. Influenza A (2009 H1N1) continued to be the predominant
circulating subtype.

? There were 46 additional hospitalizations reported; 23 with a collection date during the
previous week (week ending 11/30) and 23 with a collection date during the most recent week.
The cumulative total of hospitalizations is 99 from 16 counties.

? Influenza-like illness reported by Kaiser Permanente for the Denver-Boulder metropolitan area
increased to 1.5%. Influenza-like illness reported by Mesa County remained near zero.

? There were 81 additional specimens (out of 93 submitted) that tested positive for influenza by PCR at the state laboratory. Cumulatively, 206 (93%) of 222 PCR positive specimens have
subtyped as 2009 H1N1 and 16 (7%) as H3. No specimens have confirmed as type B.

? No influenza-associated pediatric deaths have been reported thus far.
? No influenza-associated outbreaks have been confirmed thus far.

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Re: Colorado 2013-14 Influenza Season Wks 44-50

Week 50, ending Dec 14

For the week ending December 14, influenza activity continued to increase.

?There were 66 additional hospitalizations reported; 32 with a collection date during the previous week (week ending 12/07) and 34 with a collection date during the most recent week. The cumulative total of hospitalizations is 166 from 19 counties.

? Influenza-like illness reported by Kaiser Permanente for the Denver-Boulder metropolitan area increased to 1.7% (compared to 1.5% the previous week). Influenza-like illness reported by Mesa County remained near zero.

? There were 81 additional specimens (out of 93 submitted) that tested positive for influenza by PCR at the state laboratory. Cumulatively, 355 (95%) of 372 PCR positive specimens have subtyped as 2009 H1N1 and 17 (5%) as H3. No specimens have confirmed as type B.

? No influenza-associated pediatric deaths have been reported thus far.

? No influenza-associated outbreaks have been confirmed thus far.

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Re: Colorado 2013-14 Influenza Season Wks 44-51

Week 51, ending Dec 21

For the week 51, influenza activity continued to increase.
? A cumulative total of 263 hospitalizations from 25 counties have been reported.
? Influenza-Like Illness levels from Kaiser Permanente for the Denver-Boulder
metropolitan area increased to 2.5% (compared to 1.7% the previous week). Mesa County ILI remains low at .1%.
? State laboratory virologic surveillance continues to show that virtually all influenza viruses currently circulating in Colorado are the 2009 H1N1 virus.

Influenza-Associated Hospitalizations by Age Group STd:
<6 mo: 10
6-23: 12
2-4: 11
5-18: 20
19-24: 13
25-49: 75
50-64: 75
65+: 47
Total: 263

Hospitalizations: Beginning the week ending November 30th, 2013, a hospitalized patient with any positive influenza test is being counted as an influenza-associated hospitalization (during thesummer months and early season months only cases confirmed by PCR, DFA, or viral culture arecounted as cases).

Due to reporting delays the numbers of hospitalizations by week are recalculated each week.For the week ending December 21st, there were 95 influenza-associated hospitalization sreported, 32 from the previous week (week ending Dec 14th) and 63 from the most recent week.

The county distribution of influenza-associated hospitalizations shows regional influenza activity.There have been a total of 263 influenza hospitalizations reported in 25 counties. For the weekending December 21st, 15 counties reported hospitalizations. All regions are starting to show some increase in influenza-associated hospitalizations. It should be noted that more confirmatory testing is being done in the Denver Metro area due to a CDC funded enhanced surveillance project. This is expected to result in more complete ascertainment of influenza hospitalizations in the Denver Metro area compared to other parts of the state.

http://www.colorado.gov/cs/Satellite?blobcol=urldata&blobheadername1=Content-Disposition&blobheadername2=Content-Type&blobheadervalue1=inline%3B+filename%3D%22Colorado+Flu+Report+-+December+21%2C+2013.pdf%22&blobheadervalue2=application%2Fpdf&blobkey=id&blobtable=MungoBlobs&blobwhere=1251922074746&ssbinary=true

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Re: Colorado 2013-14 Influenza Season Wks 44-52

Week 52, ending Dec 28

Synopsis: For the week ending December 28th, influenza activity continued to increase. Influenza A (2009 H1N1) continues to predominate.

? No influenza-associated pediatric deaths have been reported as of the week ending 12/28.

? Influenza-like illness (ILI) levels from Kaiser Permanente for the Denver-Boulder metropolitan area increased to 3.3% (compared to 2.4% the previous week). Mesa County ILI increased from 0.1% to 0.3%.

? State laboratory virologic surveillance continues to show that virtually all influenza viruses currently circulating in Colorado are the 2009 H1N1 virus.

? One outbreak of influenza was reported in a health care facility in Pueblo County.

? A cumulative total of 448 hospitalizations from 34 counties have been reported. Of these 446 (98%) are influenza type A, and the remaining 2 (2%) are influenza type B

Due to reporting delays the numbers of hospitalizations by week are recalculated each week. For the week ending December 28th, there were 186 influenza-associated hospitalizations reported, 69 from the previous week (week ending Dec 21st) and 117 from the most recent week

? Influenza-Associated Hospitalizations by Age Group, Colorado 2013-14
10/05/13-12/21/13
<6 mo: 15, 3.3%
6-23mo: 19, 4.2%
2-4: 17, 3.8%
5-18: 35, 7.8%
19-24: 22, 4.9%
25-49: 136, 30.4%
50-64: 120, 26.8%
65+: 84, 18.8%
Total: 448, 100.0%

http://www.colorado.gov/cs/Satellite?blobcol=urldata&blobheadername1=Content-Disposition&blobheadername2=Content-Type&blobheadervalue1=inline%3B+filename%3D%22Colorado+Flu+Report+-+December+28%2C+2013.pdf%22&blobheadervalue2=application%2Fpdf&blobkey=id&blobtable=MungoBlobs&blobwhere=1251924292277&ssbinary=true

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Re: Colorado 2013-14 Flu Season Wks 44-01

Wk 01, ending Jan 4

No influenza-associated pediatric deaths have been reported as of the week ending 01/04.
A cumulative total of 748 hospitalizations from 45 counties have been reported. Of these 734 (98%) are influenza type A, and the remaining 14 (2%) are influenza type B

Children less than 6 months represent 3.1% of all hospitalizations but have the highest hospitalization rate. The 6-23 month and 65+ year age groups have the next two highest hospitalization rates. The 25- 49 and 50-64 year age groups account for the largest proportion of hospitalizations (approx 56% combined) (table 1, figure 4).

Influenza-like illness (ILI) levels from Kaiser Permanente for the Denver-Boulder metropolitan area remained near 3%. Mesa County ILI increased from 0.3% to 1.1%.

There have been five outbreaks reported, four with an onset during a previous week and one with an onset during the most recent week.

Virology Surveillance: For the most recent week, 113 additional specimens (out of 135 submitted) tested positive for influenza by PCR at the state laboratory. Since the season began on September 29th, among 748 PCR positive specimens tested at the state laboratory, 29 (4%) have subtyped as H3, and 719 (96%) as 2009 H1N1. No specimens have confirmed positive as
type B.

http://www.colorado.gov/cs/Satellite?blobcol=urldata&blobheadername1=Content-Disposition&blobheadername2=Content-Type&blobheadervalue1=inline%3B+filename%3D%22January+4%2C+2014.pdf%22&blobheadervalue2=application%2Fpdf&blobkey=id&blobtable=MungoBlobs&blobwhere=1251927475589&ssbinary=true

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Re: Colorado 2013-14 Flu Season Wks 44-02

Wk 02, ending Jan 11

No influenza-associated pediatric deaths have been reported as of the week ending 01/11

? A cumulative total of 990 hospitalizations from 50 counties have been reported. For the week ending January 11th, there were 253 influenza-associated hospitalizations reported: 129 diagnosed the previous week (week ending 1/4) and 124 diagnosed the most recent week.

? Children less than 6 months represent 3.0% of all hospitalizations but have the highest hospitalization rate. The 6-23 month and 65+ year age groups have the next two highest hospitalization rates. The 25-49 and 50-64 year age groups account for the largest proportion of hospitalizations (approx 56% combined) (table 1, figure 4).

? Influenza-like illness (ILI) levels from Kaiser Permanente for the Denver-Boulder metropolitan area remained elevated but declined slightly to 2.63%. Mesa County ILI remained near 1%.

? State laboratory virologic surveillance continues to show that virtually all influenza viruses currently circulating in Colorado are the 2009 H1N1 virus.

? No additional outbreaks were reported during the most recent week. There have been a total of five influenza-associated outbreaks reported thus far.

http://www.colorado.gov/cs/Satellite?blobcol=urldata&blobheadername1=Content-Disposition&blobheadername2=Content-Type&blobheadervalue1=inline%3B+filename%3D%22January+11%2C+2014.pdf%22&blobheadervalue2=application%2Fpdf&blobkey=id&blobtable=MungoBlobs&blobwhere=1251929964907&ssbinary=true