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Is There More Geographic Spread of Influenza than What Meets the Eye?

Missouriwatcher

Editor, Senior Moderator
CDC relies on the states to accurately report their influenza activity.
The CDC has definitions of influenza activity which may be difficult to apply:
? No Activity: No laboratory-confirmed cases of influenza and no reported increase in the number of cases of ILI.
? Sporadic: Small numbers of laboratory-confirmed influenza cases or a single laboratory-confirmed influenza outbreak has been reported, but there is no increase in cases of ILI.
? Local: Outbreaks of influenza or increases in ILI cases and recent laboratory-confirmed influenza in a single region of the state.
? Regional: Outbreaks of influenza or increases in ILI and recent laboratory confirmed influenza in at least two but less than half the regions of the state with recent laboratory evidence of influenza in those regions.
? Widespread: Outbreaks of influenza or increases in ILI cases and recent laboratory-confirmed influenza in at least half the regions of the state with recent laboratory evidence of influenza in the state http://www.cdc.gov/flu/weekly/

Some states are finding difficulty in reporting influenza activity to the CDC. Delaware has gone from ?sporadic? to ?no activity? (weeks 40-44), although they have reported two positive labs. Massachusetts finally reported ?sporadic? after reporting ?no activity? when labs were testing positive. Guam reported (weeks 40-44) ?sporadic?, ?no activity?, ?local?, then ?no activity? ? bouncing all over the place. Nebraska inadvertently reported ?no activity? in week 44, when their report indicated ?sporadic?. Nebraska has corrected its problem, yet it still shows up on Fluview as ?no activity?. North Dakota reported ?no activity? while reporting two new cases. Louisiana, Maine, Minnesota, Mississippi , Oklahoma and Utah reported ?sporadic? when, by definition, should probably be ?local?. Georgia , Florida and Texas reported ?sporadic? (week 44), yet, by CDC definitions, should be either ?local? or ?regional?, depending on which counties had positive lab specimens. Wyoming reported ?sporadic? when PCR?s came back negative. Some states, such as Illinois and New Jersey, expand the CDC definition for more clarification, possibly averting this ?ping-pong? reporting.
http://www.idph.state.il.us/flu/fluupdate10-11.htm
http://www.nj.gov/health/flu/fluinfo.shtml#rep

There appears to be more geographic spread of influenza activity within the US than what is being represented in the Weekly Influenza Activity Surveillance Map.
 
Re: Is There More Geographic Spread of Influenza than What Meets the Eye?

Looking at Distribute (proportion of ED visits for ILI):

There has been a steady rise in ILI in Region 4, especially for GA & FL
There has been a steady rise in ILI for AR, MA, NE and WA State (North Sound)
http://isds.cirg.washington.edu/distribute/countstimeseries.php?period=weekly

Additionally, today shows a sharp rise in ILI for NE & MA
http://isds.cirg.washington.edu/distribute/countstimeseries.php?period=daily

Distribute compares last year's flu season with this year's. Although the US is behind in cases of ILI by comparison, some states are definitely progressing in cases.
http://www.isdsdistribute.org/
 
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