Michigan Flu Focus

Weekly Influenza Surveillance Report

Editor: Sue Kim, MPH Editor Email: KimS2@michigan.gov December 20, 2019 Vol. 17; No. 11

Week Ending December 14, 2019 | WEEK 50

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
Nationally, influenza B/Victoria viruses continue to be
the most frequently reported, followed by influenza Influenza-associated Pediatric Mortality
A/H1N1 viruses. The predominant virus varies by state
Nationally, 19 influenza-associated pediatric deaths have been
and age group.
reported thus far for the 2019-2020 flu season. No (0) pediatric
Please see the following link to CDC’s FluView report for more influenza deaths have been confirmed by MDHHS for the 2019-
details: https://www.cdc.gov/flu/weekly/ 2020 flu season.
Influenza-like Illness Outpatient Surveillance Week Ending Dec 14, 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
8 5 10 2
Total (25) 1.6%
ILI % 0.7 2.2 3.2 0.6 (Last week: 1.2%)
Data is provisional and may change as additional reports are received.
Regional Baseline*: 1.9%
8 Michigan Statewide ILINet and Syndromic Surveillance, A total of 158 patient visits due to ILI
7 2019-2020 were reported out of 10,071 office
6
ILINet visits during this period.
Syndromic *Regional baseline is determined by calculating the
5 ILINet Baseline mean percentage of patient visits due to ILI during
Syndromic ILI Baseline non-influenza weeks for the previous three
Rate

4
seasons and adding two standard deviations
3

1
National Surveillance
In the United States, 3.9% of outpatient
0
visits were due to ILI. (Last week: 3.2%)
5-Oct-19

4-Apr-20
3-Aug-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
10-Aug-19
17-Aug-19
24-Aug-19
31-Aug-19

14-Mar-20
21-Mar-20
28-Mar-20
12-Oct-19
19-Oct-19
26-Oct-19
2-Nov-19
9-Nov-19
7-Sep-19

16-Nov-19
23-Nov-19
30-Nov-19

11-Jan-20
18-Jan-20
25-Jan-20
1-Feb-20
8-Feb-20
14-Sep-19
21-Sep-19
28-Sep-19

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

2-May-20
9-May-20
7-Dec-19

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 14, 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 23 (5 pediatric, 18 adult) influenza-associated hospitalizations reported to MDHHS positive inpatients to assist
for the IHSP during this time period. Since October 1st, 86 (17 pediatric, 69 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 14, 2019

There were 21 new positive influenza results (6, 4N, 0SE, 11SW) reported by the Michigan Sentinel Clinical Lab Network
MDHHS Bureau of Laboratories (BOL) during this time period. Respiratory Virus Data
# of Positive Respiratory Virus Results by Region Twelve (12) sentinel clinical labs (3SE, 2SW, 5C, 2N)
reported during this week
C N SE SW Total
SE Region
H1N1 18 4 14 18 54
Influenza A: elevated; increasing
H3N2 4 0 8 1 13 Influenza B: elevated; strong increases
Infl B 22 2 49 49 122 Parainfluenza: elevated
Total 44 6 71 68 189 RSV: elevated; strong increases
Data is provisional and may change as additional results are reported. Adenovirus: slightly elevated
hMPV: elevated; some increases
115
110
Influenza Positive Test Results, 2019-2020 Central Region
105 Influenza A: low
100 Flu A, no subtype Influenza B: low – elevated
95
90 A, H1N1 Parainfluenza: low – slightly elevated
85 A, H3 RSV: low – elevated
Number of Positive Specimens

80
75 Flu B, no lineage Adenovirus: low – slightly elevated
70 hMPV: low – elevated
B, Yamagata
65
60 B, Victoria SW Region
55 Influenza A: elevated
50 Influenza B: elevated; increasing
45
40 Parainfluenza: low
35 RSV: elevated; increasing
30
25 Adenovirus: low
20 hMPV: low
15
10 North Region
5 Influenza A: low
0 Influenza B: sporadic
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
12-Oct-19
19-Oct-19
26-Oct-19

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

Parainfluenza: sporadic – very low

RSV: low
Week Ending Adenovirus: sporadic
Note: Flu B subtyping will be reported based on MDHHS BOL testing runs and will be backtracked into this graph hMPV: low
Latest MDHHS BOL Flu B lineage determination run: December 17, 2019
Congregate Setting Outbreaks Week Ending Dec 14, 2019

There were no (0) new respiratory outbreaks 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
1 1 0 2 4 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 1 1 0 2 4

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 14, 2019

Influenza Vaccine Updates Influenza News Blast Influenza Burden Estimates

37% of Americans Do Not Plan to Get a Flu Shot This Season • Vaccine Requirements in Childcare The Centers for Disease Control and
The National Opinion Research Center (NORC) at the University of Centers Across the U.S. Prevention (CDC) have once again begun
Chicago revealed results from nationally representative poll on • MDHHS- Influenza Vaccine F.A.Q. to release preliminary burden
influenza vaccination opinions and the results were worrying. • New Study: Antivirals Aid in Recovery estimates for the 2019-2020 influenza
of Severe Flu
The survey results revealed that 44% of adults have been vaccinated season.
• Flu Increasing Across Northern
against influenza for the 2019-2020 flu season, but alarmingly 37% Hemisphere Between October 1, 2019 through
have no plans to get vaccinated. An age breakdown of these results • Vaccine Comparison in Inducing November 30, 2019 it is estimated that
can be found in the table below. Immune Response there have been:
The top reasons survey participants indicated for not receiving a flu • Flu Forecasting Tool: FluSight
• Cold and Flu Virus Interactions • 2.6 million – 3.7 million flu
vaccine include concerns about vaccine side effects, beliefs that the illnesses
vaccine does not work very well, and beliefs that they never get sick Additional Resources • 1.2 million – 1.8 million flu
with the flu.
• MDHHS Influenza Webpage medical visits
Providers should work with their patients to address these concerns • MDHHS Bureau of Laboratories • 23,000 – 41, 000 flu
and encourage vaccination for everyone 6 months and older. (BOL) Webpage and Test Request hospitalizations
Forms • 1,300 – 3,300 flu deaths
Adults’ Plans to Receive the Flu Vaccination for 2019-2020 Season
• CDC FluView Weekly Report
Have Been Plan to Get Do Not Plan Other Additionally, there have been 10
• NFID Flu and Chronic Health
Vaccinated Vaccinated to Get confirmed flu-associated pediatric
Conditions Toolkit
Vaccinated deaths for the 2019-2020 flu season.
All Ages 44% 18% 37% 1% • CDC Healthcare Professionals Flu
18-29 35% 22% 39% 4% Toolkit Influenza activity is greatly increasing
years • Immunization Action Coalition: Ask around the country and flu-like illness
30-44 36% 16% 47% 1% the Experts- Flu has been above or at the national
years baseline for four weeks.
45-59 34% 18% 46% 2% View Michigan Flu Focus Report archives
years here Remember: It is not too late to get
60+ years 65% 16% 19% - 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