Washington 2013-14 Flu Season Wks 44-04

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http://www.doh.wa.gov/portals/1/Documents/5100/fluupdate.pdf

Week 44, ending Nov 2, 2013

* Influenza viruses were rarely detected in Washington State during week 44.
* The proportion of outpatient and emergency room visits for influenza-like illness (ILI) remained low.
* No laboratory-confirmed influenza-associated deaths have been reported to the Department this flu season.

Antigenic Characterization:
Antigenic characterization has been performed on one influenza virus from WA State this season.
Influenza A (2009 H1N1) (n=1): One influenza A (2009 H1N1) virus was characterized as A/California/07/2009-like, the influenza A (H1N1) component of the 2013?2014 vaccine.

Novel Influenza A Viruses:
No influenza A (H3N2v) or avian influenza A (H7N9) virus infections have been detected in Washington.

Antiviral Resistance Testing:
Testing for osel-tamivir-resistance has not been performed this season.

Public Health Reporting of Aggregate Influenza Data (PHRAID):
During CDC week 44, 12 western Washington facilities reported 4 (2.4%) positive influenza specimens out of 168 influenza tests (Figure 2a). Three specimens were positive for influenza A and one was positive for influenza B. No data are available from eastern Washington facilities.

Outpatient Influenza-like Illness Surveillance Network (ILINet) Data:
During CDC week 44, 15 sentinel providers in Washington reported data through the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet). Of 6318 visits reported, 19 (0.3%) were due to ILI.

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Re: Washington 2013-14 Influenza Season Wks 44

Week 46, ending Nov 16

State Summary:
* Influenza activity remained low in Washington State during week 46.
* The proportion of outpatient and emergency room visits for influenza-like illness (ILI) remained low.
* No laboratory-confirmed influenza-associated deaths have been reported to the Department this flu season.

Antigenic Characterization
Antigenic characterization has been performed on two influenza viruses from WA State this season.

* Influenza A(2009 H1N1) (n=1): One influenza A(2009 H1N1) virus was characterized as A/California/07/2009-like, the influenza A(H1N1) component of the 2013?2014 vaccine.

* Influenza A(H3N2) (n=1): One influenza A(H3N2) virus was characterized as A/Texas/50/2012-like, the influenza A(H3N2) component of the 2013?2014 vaccine.

Novel Influenza A Viruses
No influenza A(H3N2v) or avian influenza A(H7N9) virus infections have been detected in Washington.

Antiviral Resistance Testing
Testing for oseltamivir resistance has not been performed this season.

Public Health Reporting of Aggregate Influenza Data (PHRAID)
During CDC week 46, 13 western Washington facilities reported 14 (4%) positive influenza specimens out of 350 influenza tests. All 14 specimens were positive for influenza A. No data are available from eastern Washington facilities.

Outpatient Influenza-like Illness Surveillance Network (ILINet) Data
During CDC week 46, 14 sentinel providers in Washington reported data through the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet). Of 6,539 visits reported, 29 (0.4%) were due to ILI.

http://www.doh.wa.gov/portals/1/Documents/5100/fluupdate.pdf

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

Week 47, ending Nov 23

? Influenza activity remained low in Washington State during week 47.
? The proportion of outpatient and emergency room visits for influenza-like illness (ILI) remained low.
? No laboratory-confirmed influenza-associated deaths have been reported to the Department this flu season.

Washington Influenza Specimens Cumulative:
A 2009 H1N1: 3
A H3: 5
Subtyping not preformed: 3
B: 2
Total: 13 (total tested: 955)

During week 47, 40 (8.0%) of 498 reported deaths were due to P&I.

http://www.doh.wa.gov/portals/1/Documents/5100/fluupdate.pdf

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Re: Washington 2013-14 Influenza Season Wks 44-48

Week 48, ending Nov 30

State Summary: Influenza activity remained low in Washington during week 48.

? During week 48, 8 (3.2%) of 250 specimens tested by the World Health Organization (WHO) collaborating laboratories in Washington were positive for influenza. During the past month, influenza A(2009 H1N1), influenza A(H3N2) and influenza B viruses were detected in the state.

? The proportion of tests positive for influenza at select clinical laboratories increased slightly but remained low.

? The proportion of emergency room visits attributed to influenza-like illness (ILI) increased in both western and eastern Washington but remained consistent with previous seasons and below the epidemic threshold.

? One laboratory-confirmed influenza-associated death has been reported to the department this flu season.

Antigenic Characterization
Antigenic characterization has been performed on four influenza viruses from Washington State this season.
Influenza A(2009 H1N1) (n=2): Two influenza A(2009 H1N1) viruses were characterized as A/California/07/2009-like, the influenza A(H1N1) component of the 2013?2014 vaccine.
Influenza A(H3N2) (n=2): Two influenza A(H3N2) viruses were characterized as A/Texas/50/2012-like, the influ-enza A(H3N2) component of the 2013?2014 vaccine.

Western WA:
During week 48, 104 (0.67%) of 15,433 emergency department visits in western Washington were for influenza-like illness (ILI).

Eastern WA:
During week 48, 29 (2.1%) of 1,400 emergency department visits in eastern Washington were for influenza-like illness (ILI).

Pneumonia and Influenza (P&I) Mortality
During week 48, 20 (5.2%) of 383 reported deaths were due to P&I.

Reported Laboratory-Confirmed Influenza-Associated Deaths
Since week 30 (7/31/13), one laboratory-confirmed influenza-associated death has been reported to the Department of Health in a patient with multiple chronic medical problems. (This death was in the 50-64 age group)

http://www.doh.wa.gov/portals/1/Documents/5100/fluupdate.pdf

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

Week 49, ending Dec 7

State Summary: Influenza activity remained low but increased slightly in week 49.

? During week 49, 9 (3.3%) of 270 specimens tested by the WHO collaborating laboratories in Washington were positive for influenza. Most viruses circulating are influenza A viruses.
? The number and proportion of positive influenza tests at select clinical laboratories increased.
? The proportion of emergency room visits attributed to ILI remained below the epidemic threshold and consistent with previous seasons.
? One laboratory-confirmed influenza-associated death has been reported to the department this flu season.

Public Health Reporting of Aggregate Influenza Data (PHRAID):
During week 49, 12 western Washington facilities reported 38 (7.9%) positive influenza specimens out of 484 influenza tests. Of these 38 positives, 37 (97%) were influenza A viruses. No data are available from eastern Washington facilities.

Western WA:
During week 49, 119 (0.8%) of 14,825 emergency department visits in western Washington were for ILI.

Eastern WA:
During week 49, 24 (1.8%) of 1,342 emergency department visits in eastern Washington were for ILI.

During week 49, 34 (8.1%) of 419 reported deaths were due to P&I.

http://www.doh.wa.gov/portals/1/Documents/5100/fluupdate.pdf

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

Week 51, ending Dec 21

? During week 51, 49 (13%) of 377 specimens tested by the World Health Organization (WHO) collaborating laboratories in Washington were positive for influenza. Most viruses were influenza A(2009 H1N1) viruses.
? The number and proportion of positive influenza tests at select clinical laboratories increased.
? The proportion of emergency room visits attributed to influenza-like illness (ILI) was above the baseline in western Washington for the first week and remained below the baseline in eastern Washington.

Washington Influenza Specimens Cumulative:
A 2009 H1N1: 85
A H3: 9
A (No subtyping): 19
Flu B: 2
Total Flu: 115
Total Tested: 1239
Flu Positive: 9.3%

Pneumonia and Influenza (P&I) Mortality
During week 51, 20 (7.0%) of 286 reported deaths were due to P&I.

Reported Laboratory-Confirmed Influenza-Associated Deaths
Since week 30 (7/31/13), three laboratory-confirmed influenza-associated deaths have been reported to the Department of Health. All 3 were in the 50-64 age group.

Reported Laboratory-confirmed Influenza Hospitalizations (Spokane County Only)
Spokane Regional Health District requires hospitals and providers to report laboratory-confirmed influenza hospitalizations. Since week 40 (9/29/13), 12 hospitalizations have been reported among Spokane County residents. Of these 12 patients, 11 were infected with an influenza A virus and 1 was infected with an influenza virus of unknown type. No data were available for week 51.

http://www.doh.wa.gov/portals/1/Documents/5100/fluupdate.pdf

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

Week 52, ending Dec 28

Flu activity continued to increase and was widespread in during week 52.

Pneumonia and Influenza (P&I) Mortality
During week 52, 30 (8.7%) of 343 reported deaths were due to P&I. Since week 30 (7/31/13), five laboratory-confirmed influenza-associated deaths have been reported to the Department of Health.
50-64: 4
65+: 1

Reported Laboratory-confirmed Influenza Hospitalizations (Spokane County Only)
Since week 40 (9/29/13), 48 hospitalizations have been reported among Spokane County residents. Of these 48 patients, 45 were infected with an influenza A virus, 2 were infected with influenza B virus, and 1 was infected with an influenza virus of unknown type.

Summary:
? During week 52, 82 (20%) of 421 specimens tested by the World Health Organization (WHO) collaborating laboratories in Washington were positive for influenza. Most viruses were influenza A(2009 H1N1) viruses.
? The number of positive influenza tests at select clinical laboratories increased.
? The proportion of emergency room visits attributed to influenza-like illness (ILI) remained above the baseline in western Washington for the second week and was above the baseline in eastern Washington for the first week.
? Five laboratory-confirmed influenza-associated deaths have been reported to the department this flu season.

WHO/NREVSS Influenza Specimens Wk 52:
A 2009H1N1: 63
A H1: 5
A no subtyping: 12
B: 2

Western WA:
During week 52, 279 (1.7%) of 16,787 emergency department visits
in western Washington were for influenza-like illness (ILI).

Eastern WA:
During week 52, 38 (2.6%) of 1,452 emergency department visits
in eastern Washington were for influenza-like illness (ILI).

http://www.doh.wa.gov/portals/1/Documents/5100/fluupdate.pdf

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

Wk 01, ending Jan 4

During week 1, 15 (6.6%) of 226 reported deaths were due to P&I.

Lab confirmed deaths by age group:
0?4: 0
5-24: 0
25-49: 3
50-64: 5
65+: 3
Total: 11

Western WA:
Week 1: 296 (1.7%) of 17,397 emergency department visits were for ILI.

Eastern WA:
Week 1, 47 (2.9%) of 1,642 emergency department visits were for ILI.

Since week 40 (9/29/13), 97 hospitalizations have been reported among Spokane County residents. Of these 97 patients, 90 were infected with an influenza A virus, 5 were infected with an influenza B virus, and 2 were infected with an influenza virus of unknown type.

Of 39 influenza A(2009 H1N1) viruses tested this season, none had the H275Y mutation.

http://www.doh.wa.gov/portals/1/Documents/5100/fluupdate.pdf

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

Wk 02, ending Jan 11

Number and rate of reported laboratory-confirmed influenza-associated deaths, 2013–2014
Age, numbers, rate per 100,000 population
0-4: 0, 0.0
5-24: 0, 0.0
25-49: 5, 0.21
50-64: 8, 0.59
65+: 6, 0.70
Total: 19, 0.28

During week 2, 48 (10.7&#37 of 449 reported deaths were due to P&I.

The proportion of deaths attributed to pneumonia and influenza (P&I) was above the epidemic threshold.

During 9/29/13–1/4/14, 97 hospitalizations have been reported among Spokane County residents. Of these 97 patients, 90 were infected with an influenza A virus, 5 were infected with an influenza B virus, and 2 were infected with an influenza virus of unknown type. Data are not yet available for week 2.

http://www.doh.wa.gov/portals/1/Documents/5100/fluupdate.pdf

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Re: Washington 2013-14 Flu Season Wks 44-03

Wk 03, ending Jan 18

24 laboratory-confirmed influenza-associated deaths were reported to the Department of Health during 7/21/13 through 1/22/14. 5 of those were in the current week.
Age, numbers, rate per 100,000 population
0-4: 0, 0.0
5-24: 0, 0.0
25-49: 7, 0.30
50-64: 11, 0.81
65+: 6, 0.70
Total: 24, 0.35

During week 3, 38 (8.4%) of 453 reported deaths were due to P&I.

During 9/29/13?1/18/14, 155 hospitalizations have been reported among Spokane County residents. Of these 155 patients, 145 were infected with an influenza A virus, 8 were infected with an influenza B virus, and 2 were infected with an influenza virus of unknown type.

Data from Spokane County show the cumulative rate of laboratory-confirmed influenza-associated hospitalizations is highest in persons 50 years and older.

http://www.doh.wa.gov/portals/1/Documents/5100/fluupdate.pdf

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Re: Washington 2013-14 Flu Season Wks 44-04

Wk 04, ending Jan 25

36 laboratory-confirmed influenza-associated deaths were reported to the Department of Health during 7/21/13 through 1/29/14. 12 of those were in the current week.
Age, numbers, rate per 100,000 population
0-4: 0, 0.0
5-24: 0, 0.0
25-49: 11, 0.47
50-64: 15, 1.10
65+: 10, 1.17
Total: 36, 0.53

During 9/29/13?1/25/14, 162 hospitalizations have been reported among Spokane County residents. Of these 162 patients, 152 were infected with an influenza A virus, 8 were infected with an influenza B virus, and 2 were infected with an influenza virus of unknown type.

Data from Spokane County show the cumulative rate of laboratory-confirmed influenza-associated hospitalizations is highest in persons 50 years and older.

http://www.doh.wa.gov/portals/1/Documents/5100/fluupdate.pdf