Download Table 1. Cuyahoga County Influenza Data Dashboard

November 8 - November 14, 2015 (MMWR Week 45)
Highlights
Flu activity is ‘low’ for 6th straight week. The flu rating scale is here: https://ccbh-new.squarespace.com/flu-weekly-reports/?rq=flu
Pneumonia-related deaths accounted for 4.0% of all deaths. No flu related deaths were reported this week.
One confirmed case of flu associated hospitalization was reported this week.
2.2% of emergency room visits were due to flu like illness this week.
Local Flu Activity Dashboard
Current Week Flu Activity
X
Low
Mod
High
(All data are preliminary and may change as updated information are received.)
Oct
Weekly
Intensity
Nov
Dec
Jan
40 41 42 43 44 45 46 47 48 49 50 51 52 1
Feb
2
3
4
5
6
Mar
7
8
Apr
May
9 10 11 12 13 14 15 16 17 18 19 20
Table 1. Cuyahoga County Influenza Data Dashboard
Influenza (Flu) Indicator
Current
Activity Level
Pneumonia: 4.0%
Flu: 0 deaths
Cuyahoga: N/A
Activity Compared
to Last Week
#Weeks1234
2015-2016 Season
Total/Trend
1
5
N/A
1
1
1
2
N/A
1
1
3
N/A
N/A
1
Pneumonia death below 5-year
median. No flu deaths.
Emergency room visit due to ILI [Fig 5]
2.2%
(34.4%)
Stable
N/A
(21.1%)
(1)
(73.1%)
(11.4%)
N/A
78.6%
75.5%
(3.8%)
N/A
N/A
2.7%
Sales of over-the-counter medications
used to treat ILI. [Fig 6]
Congestion & cough complaints [Fig 8}
Vomiting & nausea complaints [Fig 9]
295
(10.3%)
1
Trend data will begin week 45.
11.4%
10.0%
2.5%
6.3%
4.2%
(0.9%)
1
5
2
Trend data will begin week 45.
Trend data will begin week 45.
Percent of pneumonia deaths & number
of flu related deaths - [Fig 1]
Influenza like illness (ILI) doctor
visits [Fig 2]
Flu associated hospitalizations [Fig 3]
School absenteeism due to ILLNESS
ONLY – [Fig 4A]
School absenteeism due to ALL
CAUSES – [Fig 4B]
Diarrhea complaints [Fig 10]
athenahealth: 0.15%
1
Northeast:
Northwest:
Southeast:
Southwest:
Northeast:
Northwest:
Southeast:
Southwest:
1.8%
3.1%
N/A
2.5%
8.6%
2.5%
N/A
0.7%
1
athenahealth flu visits below
5-year median.
N=7. Near 5-year median.
Trend data will begin in week
45.
Trend data will begin in week
45.
Trend data will begin week 45.
Trend data will begin week 45.
Due to small percentages, caution should be used while interpreting the ‘Activity Compared to Last Week’ box.
For figures 1-2 & 4-5, = (Increase > 20%), = (Decrease > -20%), = Stable (-19.9% to +19.9%)
3
For figures 6-10, = (Increase > 10%), = (Decrease > -10%), = Stable (-9.9% to +9.9%)
4
For flu related deaths (Fig 1) & Fig 3, = (Increase # of deaths/cases), = (Decrease # of deaths/cases), = Stable (Same # of deaths/cases)
2
Page 1 of 8
November 8 - November 14, 2015 (MMWR Week 45)
Flu Summary
This report is intended to provide an overview of influenza related activity occurring in Cuyahoga County while
providing some information on state activity that is one week behind the current week. It will be published on a
weekly basis and can be found at the following website: http://www.ccbh.net/flu-weekly-reports/?rq=flu
Note: Data are provisional and subject to change. Updates will be included in future reports.
Pneumonia and Influenza (P&I) Mortality
4.0% of all deaths reported to vital statistics departments in our county were due to pneumonia. Adults 65 years old
and older accounted for 81.8% of all pneumonia related deaths. No influenza related deaths this season to date.
(Figure 1).
Influenza-Like Illness (ILI) Reports
Athenahealth reported that 0.15% of patients had flu-like symptoms this week. No sentinel providers reported this
week. (Figure 2). ILI is defined as a fever (≥ 100◦ F), and cough and/or sore throat.
Influenza-Associated Hospitalizations and Influenza-Associated Pediatric Mortality
One confirmed case of influenza-associated hospitalization in Cuyahoga County was reported this week (Figure 3).
Twenty-two statewide confirmed influenza associated hospitalizations in week 44. No statewide pediatric flu related
deaths has occurred so far this flu season.
School Absenteeism
Participating schools in Cuyahoga County reported the percentage (median = 2.5%) of absenteeism due to any illness
on Tuesday (Figure 4A). Figure 4B shows the total absenteeism due to any reason (median = 2.6%).
Emergency Department (ED) visits and Over-the-Counter Medication Sales
2.2% of all ED visits were for fever + ILI symptoms. Approximately 35 more patients visited EDs for fever and ILI
symptoms this year compared to the 5-year median (Figure 5). Figure 6 shows approximately 135 more OTC
products per drugstore were purchased this year than the 5-year median for the same time period.
Three other maps show, by zip code, the frequency of ED visits for three symptoms that are common during the fall
and winter seasons and are of interest to the general public: congestion and cough (Figure 8), vomiting and nausea
(Figure 9), and diarrhea (Figure 10).
Descriptions of data sources used to complete the weekly influenza write-up can be found on the last page of this
report.
Additional Influenza Activity Links
• Weekly U.S. Influenza Surveillance Report – http://www.cdc.gov/flu/weekly
• Ohio Influenza Surveillance – http://www.odh.ohio.gov/features/odhfeatures/seasflu/ohfluactivity.aspx
Page 2 of 8
Figure 1. Percentage of Deaths Due to Pneumonia and Influenza (P&I)
Cleveland Bureau of Vital Statistics
9%
8%
7%
6%
5%
4%
3%
2%
1%
0%
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 19 20
MMWR Week
Percent Pneumonia
Percent Influenza
5-Yr Median 2010-11 - 2014-15
Figure 2. Percent of Influenza-Like Illness (ILI) Visits U.S. Influenza Sentinel
Provider Surveillance Network and ILI visits data via athenahealth
2.4%
2.0%
1.6%
1.2%
0.8%
0.4%
0.0%
40 41 42 43 44 45 46 47 48 49 50 51 52 1
2 3 4 5 6
MMWR Week
Cuyahoga County
7
8
9 10 11 12 13 14 15 16 17 18 19 20
athenahealth
Figure 3. Number of Influenza-Associated Hospitalizations in
Cuyahoga County (using event date)
120
110
100
90
80
70
60
50
40
30
20
10
0
40 41 42 43 44 45 46 47 48 49 50 51 52 1
Current Year
2
3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
MMWR Week
5 Year Median 2010-2011 - 2014-2015
Page 3 of 8
Figure 4a. School Absenteeism (Due to any Illness) in Cuyahoga County
7%
N
O
6%
5%
S
C
H
O
O
L
4%
3%
2%
1%
0%
40 41 42
43 44 45
46 47 48
49 50 51
5-year Median (2010-11 - 2014-15)
52
1
2
Northeast Suburbs
3 4 5
6
MMWR Week
7
8
Northwest Suburbs
9
10
11 12 13
Southeast Suburbs
14 15
16 17 18
19 20
Southwest Suburbs
Figure 4b. School Absenteeism (Due to any Reason) in Cuyahoga County
11%
10%
N
O
9%
8%
7%
S
C
H
O
O
L
6%
5%
4%
3%
2%
1%
0%
40
41
42
43
44 45 46
47
48
5-year Median (2010-11 - 2014-15)
49
50
51
52
1
2
Northeast Suburbs
3
4
5
6
MMWR Week
7
Northwest Suburbs
Page 4 of 8
8
9
10 11 12
13 14 15
Southeast Suburbs
16
17
18
Southwest Suburbs
19
20
Figure 5. Cuyahoga County Hospital ED Visits for ILI & Fever Symptoms by Age Group
300
250
200
150
100
50
0
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
19
20
MMWR Week
O - 4 Years Old
5 - 24 Years Old
25 - 49 Years Old
50 - 64 Years Old
65 Years and Older
5 Year Median (2010-11 - 2014-15)
Figure 6. Comparison of Average Weekly OTC Products Sold in Cuyhaoga County Drugstores
350
300
250
200
150
100
50
0
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
19
20
MMWR Week
Antifever
Cold_liquid_ped
Cold_tablet_ped
Cough_syrup_ped
Page 5 of 8
Electrolytes_ped
Thermometers
5 Year Median 2010-11 - 2014-15
Figure 7 Rate of Fever and Influenza-Like
Illness Complaints per 100,000 by Zip Code
November 8th - November 14th 2015 - MMWR Week 45
Rate
0 - 4.9
5.0 - 11.6
44140
44145
44116
44126
44070
44138
11.7 - 19.2
19.3 - 58.5
44107
44111
44135
44142
44017
4410844112
44109
44144
44130
44105
10.5 - 31.1
31.2 - 62.6
44140
44145
44116
44126
44070
44138
104.2 - 253.4
44111
44135
44142
44017
Page 6 of 8
44129
44130
44149 44136
44119
44117
44110
44133
44114 44103 44106
44105
44125
44134 44131
44147
44139
44128
Ü
4
Miles
44143
44040
44124
44022
44137
44146
44141
0 1 2
44121
44118
44115
44113
44104
44102
44120
44122
44127
44144
44022
4412344132
4410844112
44109
44124
Map created and analysis performed
by Epidemiology, Surveillance, and
Informatics at the Cuyahoga County
Board of Health. Data are preliminary.
44141
62.7 - 104.1
44107
44040
44146
November 8th - November 14th 2015 - MMWR Week 45
4
Miles
44137
44134 44131
44133
Ü
44143
44128
44125
44147
0 1 2
44121
4411444103 44106
Figure 8 Rate of Congestion and Cough
Complaints per 100,000 by Zip Code
Rate
44119
44117
44110
44118
44115
44113
44104
44102
44120
44122
44127
44129
44149 44136
4412344132
44139
Map created and analysis performed
by Epidemiology, Surveillance, and
Informatics at the Cuyahoga County
Board of Health. Data are preliminary.
Figure 9 Rate of Vomiting and Nausea
Complaints per 100,000 by Zip Code
4412344132
44119
44117
44110
November 8th - November 14th 2015 - MMWR Week 45
Rate
54.0 - 80.4
0.0 - 38.5
80.5 - 175.4
38.6 - 53.9
44140
44145
44116
44126
44070
44138
44107
44111
44135
44142
44017
44114 44103 44106
44144
44129
44133
44105
44109
44147
44140
44145
44116
44126
44070
44138
Page 7 of 8
18.1 - 78.0
44107
44111
4412344132
44135
44142
44017
44114 44103 44106
44144
44129
44133
44105
44125
44134 44131
44147
44128
Ü
4
Miles
44143
44040
44124
44022
44137
44146
44141
0 1 2
44121
44118
44115
44113
44104
44102
44120
44122
44127
44130
44149 44136
44119
44117
44110
4410844112
44109
44139
Map created and analysis performed
by Epidemiology, Surveillance, and
Informatics at the Cuyahoga County
Board of Health. Data are preliminary.
44141
13.5 - 18.0
6.5 - 13.4
44022
44146
November 8th - November 14th 2015 - MMWR Week 45
0 - 6.4
44124
44137
44134 44131
Figure 10 Rate of Diarrhea Complaints
per 100,000 by Zip Code
Rate
44040
44121
44128
44125
4
Miles
44143
44118
44115
44113
44104
44102
44120
44122
44127
44130
44149 44136
4410844112
Ü
0 1 2
44139
Map created and analysis performed
by Epidemiology, Surveillance, and
Informatics at the Cuyahoga County
Board of Health. Data are preliminary.
Sources of Influenza Surveillance Data
Six types of data sources are examined on a weekly basis to help determine the influenza activity level for
Cuyahoga County:
1) Ohio Department of Health (ODH) Seasonal Influenza Activity Summary : The ODH influenza
summary provides state-wide data . Data used from this report include: frequency of fever plus influenzalike illness (ILI) associated hospitalizations, number of influenza-associated pediatric mortalities, and
number of lab-confirmed influenza cases.
A) Influenza-associated Hospitalizations (ODRS): Influenza-associated hospitalizations are reported
by the Cuyahoga County Board of Health (CCBH) and hospitals using the Ohio Disease Reporting
System (ODRS). Hospitalizations can be used as an indicator of the severity of illness during a
particular influenza season. This condition became reportable in January 2009.
B) Influenza-associated Pediatric Mortality (ODRS): Influenza-associated pediatric mortalities are
reported into ODRS by CCBH and hospital staff. Pediatric deaths can be an indicator of the severity
of illness during the influenza season. This condition became reportable in 2005.
C) Sentinel Providers (ILINet): Sentinel providers, through the US Influenza-like Illness Surveillance
Network (ILINet), collect outpatient influenza-like illness (ILI) data. ILI is defined as a fever (> 100
F), and cough and/or sore throat without another known cause. Providers report the total number of
patients seen, by age group, on a weekly basis. Sentinel providers also submit specimens for influenza
testing to the ODH laboratory throughout the influenza season. There are 2 sentinel providers enrolled
in Cuyahoga County for the 2015-2016 season.
D) ODH Laboratory Surveillance: The Ohio Department of Health Laboratory reports the number of
specimens that test positive for influenza each week. Generally, specimens are submitted by sentinel
provider participants. A subset of the positive specimens is sent to CDC for further testing during the
season.
2) Mortality Reporting System (Vital Statistics): Vital Statistics offices in Cuyahoga County (Cleveland,
Euclid, Lakewood, & Parma) reports the percentage of deaths that are due to pneumonia or influenza that
occur within their jurisdiction. Cleveland issues death certificates for 56 of the 59 cities in the county.
3) ILI data (athenahealth) "ILI estimates are based on insurance claims diagnoses, documented in
athenahealth's database. Athenahealth is a healthcare technology and services company for electronic
health records, medical billing, patient engagement, and care coordination."
4) School Absenteeism data (due to illness and due to any reason): More than 50 Cuyahoga County
schools provide absenteeism data for each Tuesday on the number children absent due to any illness or
due to any reason as well as sentinel schools that report week absenteeism data.
5) National Retail Data Monitor (NRDM)-OTC Drug Purchases: The NRDM collects over-the-counter
(OTC) drug sales information from Cuyahoga County chain drug stores and grocery stores. Pediatric cold
products, anti-fever products, and thermometer sales are monitored on a weekly basis.
6) Emergency Department Visits (EpiCenter): EpiCenter collects emergency department chief complaint
data from hospitals and urgent care facilities across Cuyahoga County and classifies them into symptom
and syndrome categories. Rates for chief complaints regarding fever + ILI and other symptoms commonly
detected during the winter are analyzed.
Page 8 of 8