Michigan Flu Focus

Weekly Influenza Surveillance Report

Editor: Sue Kim, MPH Editor Email: KimS2@michigan.gov January 3, 2020 Vol. 17; No. 13

Week Ending December 28, 2019 | WEEK 52

Michigan Influenza Activity

No Activity
Sporadic
Local
Regional
Widespread
*Clicking on the current activity level will direct
you to the CDC webpage defining each activity
level for the geographic spread of influenza

Updates of Interest
The Michigan flu code has been increased to
Widespread activity for Week 52. This is due to
Influenza-associated Pediatric Mortality
increases in lab-confirmed flu in the Northern region
of the state. Nationally, 27 influenza-associated pediatric deaths have been
reported thus far for the 2019-2020 flu season. No (0) pediatric
Please see Michigan Influenza Activity (above) for an overview influenza deaths have been confirmed by MDHHS for the 2019-
of flu activity definitions. 2020 flu season.
Influenza-like Illness Outpatient Surveillance Week Ending Dec 28, 2019

U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet)

Michigan participates in ILINet, a collaborative effort between the CDC, state and local health departments, and volunteer
sentinel clinicians as part of Michigan’s influenza surveillance. ILINet provides data on the total number outpatient visits to health
care providers seen for any reason and the number of those patients with influenza-like illness (ILI). For this system, ILI is defined
as fever (temperature of 100°F [37.8°C] or greater) and a cough and/or a sore throat without a known cause other than influenza.
Number of Reports and ILI % by Region in Michigan during this time period:
Region C N SE SW Michigan ILI Activity
No. of Reporters
10 5 7 2
Total (24) 3.0%
ILI % 2.0 3.2 8.6 0.9 (Last week: 2.7%)
Data is provisional and may change as additional reports are received.
Regional Baseline*: 1.9%
10.0
Michigan Statewide ILINet and Syndromic Surveillance, A total of 132 patient visits due to ILI
9.0
2019-2020 were reported out of 4,422 office
ILINet visits during this period.
8.0
Syndromic
7.0 *Regional baseline is determined by calculating the
ILINet Baseline
mean percentage of patient visits due to ILI during
6.0 Syndromic ILI Baseline non-influenza weeks for the previous three
Rate

5.0 seasons and adding two standard deviations

4.0
3.0
2.0
National Surveillance
1.0
In the United States, 6.9% of outpatient
0.0
visits were due to ILI. (Last week: 5.1%)
5-Oct-19

14-Dec-19
21-Dec-19
28-Dec-19

7-Mar-20

4-Apr-20
11-Apr-20
18-Apr-20
25-Apr-20

16-May-20
12-Oct-19
19-Oct-19
26-Oct-19
2-Nov-19
9-Nov-19

4-Jan-20
11-Jan-20
18-Jan-20
25-Jan-20
1-Feb-20
8-Feb-20

14-Mar-20
21-Mar-20
28-Mar-20
16-Nov-19
23-Nov-19
30-Nov-19

15-Feb-20
22-Feb-20
29-Feb-20
7-Dec-19

2-May-20
9-May-20

This is above the national baseline of 2.4%

Week Ending

Become an ILINET provider!

Contact Shelly Doebler at DoeblerM@michigan.gov
Influenza-associated Hospitalization Surveillance Week Ending Dec 28, 2019

Influenza Hospitalization Surveillance Project (IHSP) Join the

The CDC’s Influenza Hospitalization Surveillance Network (FluSurv-NET) provides population-
Influenza Sentinel
based rates of laboratory-confirmed influenza-associated hospitalizations from October 1st Hospital Network (ISHN)!
through April 30th each year. Michigan participates as an IHSP state in FluSurv-NET for Clinton, What is it? ISHN is a group of
hospitals in Michigan that
Eaton, Genesee, Ingham, and Washtenaw Counties.
voluntarily report weekly
aggregate counts of influenza
There were 58 (11 pediatric, 47 adult) influenza-associated hospitalizations reported to MDHHS positive inpatients to assist
for the IHSP during this time period. Since October 1st, 172 (43 pediatric, 129 adult) influenza- MDHHS with statewide flu
related hospitalizations were reported in the catchment area for the 2019-2020 season. surveillance
How it works: As a participating
Total IHSP Cases, 2014-15 through 2019-2020 hospital in the ISHN, you would
160 complete a brief Survey Monkey
every week containing:
140 • Number of hospitalizations
with a positive influenza test
120 by age group during that time
Number of Cases

period
100 • The total number of
hospitalizations due to any
80 condition during that time
period (if available)
60
The data you provide is
40 aggregated by region and can
assist providers and public health
20 in recognizing changes in the age
or geographic distribution of flu in
0 this population.
40 41 42 43 44 45 46 47 48 49 50 51 52 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
MMWR Week
If your facility is interested in
2014-15 2015-16 2016-17 2017-18 2018-19 2019-20 participating or would like more
details, please contact Sue Kim
Washtenaw County was added in the 2017-2018 season
(KimS2@michigan.gov)
Laboratory (Virologic) Surveillance Week Ending Dec 28, 2019

There were 18 new positive influenza results (9C, 0N, 4SE, 5SW) reported by the Michigan Sentinel Clinical Lab Network
MDHHS Bureau of Laboratories (BOL) during this time period. Respiratory Virus Data
Thirteen (13) sentinel clinical labs (2SE, 2SW, 6C,
# of Positive Respiratory Virus Results by Region 3N) reported during this week
C N SE SW Total SE Region
H1N1 24 6 17 19 66 Influenza A: high; increasing
H3N2 4 0 8 5 17 Influenza B: very high; sharp increases
Infl B 34 4 51 52 141 Parainfluenza: elevated
Total 62 10 76 76 224 RSV: high; increasing
Adenovirus: slightly elevated
Data is provisional and may change as additional results are reported.
hMPV: elevated
115
110
Influenza Positive Test Results, 2019-2020 Central Region
105 Influenza A: low – elevated; some
100 Flu A, no subtype increases
95 Influenza B: moderate – high; increasing
90 A, H1N1
85 A, H3 Parainfluenza: slightly elevated
Number of Positive Specimens

80 RSV: moderate; increasing

75 Flu B, no lineage
70 Adenovirus: low
B, Yamagata hMPV: low – slightly elevated
65
60 B, Victoria
55 SW Region
50 Influenza A: moderate – high; increasing
45 Influenza B: high; increasing
40
35 Parainfluenza: low
30 RSV: moderate – high; some
25
20 increases
15 Adenovirus: low – slightly elevated
10 hMPV: sporadic – slightly elevated
5
0 North Region
5-Oct-19

4-Apr-20
2-Nov-19
9-Nov-19

14-Dec-19
21-Dec-19
28-Dec-19
4-Jan-20

7-Mar-20

11-Apr-20
18-Apr-20
25-Apr-20

16-May-20
14-Mar-20
21-Mar-20
28-Mar-20
12-Oct-19
19-Oct-19
26-Oct-19

11-Jan-20
18-Jan-20
25-Jan-20
1-Feb-20
8-Feb-20
16-Nov-19
23-Nov-19
30-Nov-19
7-Dec-19

15-Feb-20
22-Feb-20
29-Feb-20

2-May-20
9-May-20

Influenza A: slightly elevated

Influenza B: sporadic – low
Parainfluenza: sporadic – low
Week Ending
RSV: low – slightly elevated
Note: Flu B subtyping will be reported based on MDHHS BOL testing runs and will be backtracked into this graph
Latest MDHHS BOL Flu B lineage determination run: January 3, 2020
Adenovirus: no activity
hMPV: sporadic – low
Congregate Setting Outbreaks Week Ending Dec 28, 2019

There were 6 new respiratory outbreaks (1C, 1N, 0SE, 4SW) reported to MDHHS during this time period. Respiratory outbreaks for
the 2019-2020 season are listed in the table below.
# of Congregate Setting Outbreaks by Region
Facility Type C N SE SW Total Did you know?
Schools: K-12 & College 0 0 0 0 0 Congregate setting outbreaks of
Long-term Care / viral respiratory illnesses are
2 2 0 3 11 required to be reported to your
Assisted Living Facility
Healthcare Facility 0 0 0 0 0 local health department? See:
Daycare 0 0 0 0 0 • Influenza Guidance for
Homeless Shelter 0 0 0 0 0 Healthcare Providers
Correctional Facility 0 0 0 0 0 • Guideline for influenza and
Other 0 0 0 0 0 Respiratory Virus Outbreaks in
Long-Term Care Facilities
Total 2 2 0 7 11

10
Congregate Setting Outbreaks by Region, 2019-2020
9 C
8 N
7 SE
# Outbrekas

6 SW
5
4
3
2
1
0
5-Oct-19

4-Apr-20
12-Oct-19
19-Oct-19
26-Oct-19
2-Nov-19
9-Nov-19

14-Dec-19
21-Dec-19
28-Dec-19
4-Jan-20

7-Mar-20

11-Apr-20
18-Apr-20
25-Apr-20

16-May-20
11-Jan-20
18-Jan-20
25-Jan-20
1-Feb-20
8-Feb-20

14-Mar-20
21-Mar-20
28-Mar-20
16-Nov-19
23-Nov-19
30-Nov-19
7-Dec-19

15-Feb-20
22-Feb-20
29-Feb-20

2-May-20
9-May-20
Week Ending
Flu Bytes Week Ending Dec 28, 2019

Influenza Vaccine Updates Influenza News Blast Influenza Burden Estimates

Perceptions of Influenza Vaccine Safety and Effectiveness • Vaccine Requirements in Childcare
Annual flu vaccination is recommended by the Advisory Committee on Centers Across the U.S.
Immunization Practices at the CDC for all people aged 6 months and • MDHHS- Influenza Vaccine F.A.Q.
older without contraindications. It is the primary intervention method to • New Study: Antivirals Aid in Recovery
prevent morbidity and mortality from influenza. of Severe Flu
• Flu Activity is High Across the U.S. –
However, influenza vaccination coverage for adults is typically below 50%
At Least 2,100 Deaths Estimated
each flu season. A new study was conducted to understand the factors
• Vaccine Comparison in Inducing
associated with perceptions of influenza vaccine safety and
Immune Response
effectiveness.
• Flu Forecasting Tool: FluSight
The study published in Vaccine indicates that most Americans think flu • Cold and Flu Virus Interactions
vaccines are safe and effective. The survey, conducted during the 2017-
18 flu season, analyzed 4597 responses to determine flu vaccine Additional Resources
perceptions of adults in the United States. • MDHHS Influenza Webpage
• MDHHS Bureau of Laboratories
Results
(BOL) Webpage and Test Request
• 86.3% of adults reported that the influenza vaccine was safe Forms
• 73.0% of adults believed the flu vaccine was effective • CDC FluView Weekly Report
• Younger adults (19-49 years) were generally less confident with • NFID Flu and Chronic Health
the flu vaccines safety compared to older adults (over 50 years) Conditions Toolkit
• Fewer younger adults reported believing that the flu vaccine • CDC Healthcare Professionals Flu
was effective compared to older adults Toolkit
• Immunization Action Coalition: Ask
The study concluded that generally adults perceived the flu vaccine to be the Experts- Flu
safe and effective. Further research is needed to understand why,
despite positive perceptions adults still choose to forego flu vaccination. View Michigan Flu Focus Report archives
here
For more information about flu vaccine, visit www.michigan.gov/flu.
The Centers for Disease Control and
Prevention (CDC) have once again begun
to release preliminary burden
estimates for the 2019-2020 influenza
season.
Between October 1, 2019 through
December 28, 2019 it is estimated that
there have been:
• 6.4 million – 9.1 million flu
illnesses
• 3.0 million – 4.4 million flu
medical visits
• 55,000 – 93, 000 flu
hospitalizations
• 2,900 – 7,200 flu deaths
Additionally, there have been 27
confirmed flu-associated pediatric
deaths for the 2019-2020 flu season.
Influenza activity is greatly increasing
around the country and flu-like illness
has been above or at the national
baseline for seven weeks.
Remember: It is not too late to get
vaccinated! Get your flu shot!

MDHHS Contributors
Bureau of Epidemiology and Population Health Bureau of Family Health Services Bureau of Laboratories
S. Bidol, MPH, S. Kim, MPH M. Doebler, MPH B. Robeson, MT, V. Vavricka, MS

For questions or to be added to the distribution list,

please contact Sue Kim at KimS2@michigan.gov