INFLUENZA REPORT 2018 2019 Influenza Season MMWR Week

INFLUENZA REPORT 2018 -2019 Influenza Season MMWR Week 46 Weekly Report of Influenza and Influenza-like Illness (ILI) Activity Wyoming Department of Health | Updated November 23, 2018

Geographic Spread Influenza and Influenza-like Illness Activity Wyoming reported sporadic activity this week (MMWR Week 46). Healthcare providers reported eight influenza cases (rapid influenza diagnostic tests). Weekly Case Rate per 100, 000 0 to 25 persons 26 to 50 persons 76 to 100 persons >100 persons Wyoming Department of Health | Page 1 51 to 75 persons

Geographic Spread Geographic Activity by Regions Healthcare providers in five counties reported ILI activity with confirmed influenza cases. The influenza cases represent four Infectious Disease Epidemiology (IDE) Geographic Regions. All five IDE Geographic Regions described sporadic activity this week. IDE Geographic Regions of Wyoming Southeastern (sporadic) Big Horn (sporadic) Central (sporadic) Western (sporadic) Northeastern (sporadic) Wyoming Department of Health | Page 2

Geographic Spread Influenza-like Illness Activity Level No activity Sporadic ILI Activity/Outbreaks Low Not increased Increased ILI in 1 region; ILI activity in other regions is not increased Local Laboratory Data And OR And No lab-confirmed cases Isolated lab-confirmed cases Lab-confirmed outbreak in one institution Recent (within the past 3 weeks) lab evidence of influenza in region with increased ILI OR 2 or more institutional outbreaks (ILI or labconfirmed) in 1 region; ILI activity in other regions is not increased ILI in ≥ 2 but less than half of the regions And Recent (within the past 3 weeks) lab evidence of influenza in region with the outbreaks; virus activity is no greater than sporadic in other regions Recent (within the past 3 weeks) lab-confirmed influenza in the affected regions OR Regional Widespread Institutional outbreaks (ILI or lab-confirmed) in ≥ 2 and less than half of the regions Increased ILI and/or institutional outbreaks (ILI or lab-confirmed) in at least half of the regions And Recent (within the past 3 weeks) lab-confirmed influenza in the affected regions Recent (within the past 3 weeks) lab-confirmed influenza in the state. Wyoming Department of Health | Page 3

Influenza-like Illness Surveillance ILINet Providers The percent of patient visits to ILINet Sentinel Providers for influenza-like illness was 0. 64%, which is below Wyoming’s baseline (2. 52%). The Wyoming Department of Health received reports from approximately 50% of the ILINet providers in Wyoming. ILINet providers in 12 counties reported influenza-like illness activity. The ILI activity in Wyoming was minimal. Weekly Percent of ILI Visits 10 Percent Influenza-like Illness (ILI) 8 6 4 2 0 40 42 44 46 48 50 52 2 4 6 MMWR Week 8 10 Wyoming Department of Health | Page 4 12 14 16 18 20

Virologic Surveillance Public Health Laboratory The Wyoming Public Health Laboratory tested one specimen during MMWR Week 46. The specimen was negative for both influenza A and influenza B viruses. Healthcare and Clinical Laboratories Clinical laboratories most frequently reported Influenza B viruses during MMWR Week 46. Reported Influenza Cases by Influenza Season 1000 2014 -2015 -2016 -2017 -2018 -2019 900 Number of Reported Cases 800 700 600 500 400 300 200 100 0 40 42 44 46 48 50 52 2 4 6 8 MMWR Week Wyoming Department of Health | Page 5 10 12 14 16 18 20

Pneumonia and Influenza Mortality Data Tracking death certificates is the best surveillance system to capture and identify pneumonia and influenza-associated deaths in Wyoming. According to the CDC, influenza is infrequently listed on death certificates. Also, testing for seasonal influenza infections is not frequently performed, particularly among the elderly who are at greatest risk for seasonal influenza complications and death. Therefore, public health officials may not identify influenza-associated deaths in many instances; consequently, this surveillance system may underestimate the true impact of influenzaassociated deaths in the state. There were nine pneumonia and influenza (P&I) mortality reports certified since the beginning of the 2018 -2019 Influenza Season. Monthly P&I Mortality Reports 25 2014 -2015 -2016 -2017 -2018 -2019 Number of P&I Deaths 20 15 10 5 0 October November December January February Wyoming Department of Health | Page 6 March April May