2018-2019 Columbus & Franklin County Seasonal Influenza Activity

Weekly Summary (Week 52, Dec. 23rd, 2018– Dec. 29th, 2018)

, 2010)
Highlights
09/8/2009- 9/11/09 (Week 36)
 In week 52 of 2018, the majority of key individual local flu activity indicator trends increased compared to the previous
week. As a whole, flu intensity (composite indicator) increased compared to the previous week and is moderate.
 Geographic spread and local intensity designation (Click here for definitions) = WIDESPREAD, MODERATE
 Local medical facility labs reported 1,948 tests run with 182 (9.3%) positive results for week 52 of 2018.
 The percentage of ED visits for both influenza-like-illness (ILI) and respiratory symptoms increased compared to last week.
 In week 52 of 2018, trends for local over-the-counter medication category sales tracked were mixed compared to last week
(increase in electrolyte and chest rub sales; decrease in thermometer, pediatric anti-fever, adult anti-fever, and throat
lozenge sales; stable sough and cold sales) compared to last week.
 In the U.S., influenza activity is increasing. Please visit the CDC website for specific information.

Local Flu Activity Dashboard (All data are preliminary and may change as updated reports are received.)
Current Week's Composite Intensity Indicator* Composite Intensity Indicator* Weekly Trend (DRAFT)

Intensity Level High

r Mod
Minimal Low Mod High

Low
*Combination of Lab Data, Primary Care Physician Min
Medical Claims Data, ED Visit Data, and Influenza
Associated Hospitalizations. 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
Oct Nov Dec Jan Feb Mar Apr May
2
Week Number(s) Current Week % Change Chart from Last Week1 # Weeks General Trend Line Chart3
Indicators
Available Value (-) | (+) ▲• ▼ (black = current, red = historical avg.)

Medical Facility Lab Data 35-52 9.3% Pos. 61% 3▲

35 - 2017 Week Number 20 - 2018

4
athenaHealth Network 12.5 per 1,000
35-52 87% 3▲
PCP Flu or ILI Visit (Ohio) visits
35 - 2017 Week Number 20 - 2018

EMS Cold/Flu Symptom

35-52 29 runs -14.7% 2▼
Runs
35 - 2017 Week Number 20 - 2018

School Absences 35-51 13.8% Absent Update not available

20.9% 1▲
due to winter break
35 - 2017 Week Number 20 - 2018

Hospital ED Data5:
23.7% of All
Complaint Defined as ILI 35-52 15.0% 1▲
ED Visits
35 - 2017 Week Number 20 - 2018

19.7% of All
Categorized as Respiratory 35-52 16.3% 2▲
ED Visits 35 - 2017 Week Number 20 - 2018

Medication Data:
22,368 Total
OTC Cough & Cold Sales 35-52 1.3% 1●
Sales
35 - 2017 Week Number 20 - 2018

Thermometer 35-52 81 Total Sales -21.4% 1▼

35 - 2017 Week Number 20 - 2018

16 Admitted
Confirmed Influenza -
35-52 (42 Since wk. >100% 1▲
Associated Hospitalizations6
35, 2017) 35 - 2017 Week Number 20 - 2018

Reportable Conditions (Cumulative Numbers as of Jan. 3, 2019) 2013 2014 2015 2016 2017 2018 YTD
Pediatric Influenza Associated Death Reported by Year (based on date of death) 0 0 0 0 0 0
Influenza Associated Hospitalizations (IAH) Reported by Admission Year6 301 875 447 293 846 1,030
IAH comparison by Flu Season (October - May or Weeks 35 - 20) 2013-14 2014-15 2015-16 2016-17 2017-18 2018-19*
*Current season (2018-19) is from week 35 through week 52. 486 871 265 619 1,234 42
1
Interpret with caution. Indicators with small numbers subject to large weekly percentage fluctuations.
2
Number of weeks "p" = Increase (>2%), "q" = Decrease (>2%), "" = Stable (-2% to +2%).
3
Black line is current years data. Based on data availability, red line is historical average (excluding pandemic year).
4
Data Source: Medical claims data from athenaHealth (www.athenahealth.com). Rate of Flu or ILI visits to Ohio (statewide) athenaHealth network primary care
practices/physicians. Claims data are subject to filing and processing time lags. Historical data are updated when they are recieved.
5
Franklin County, OH residents only (based on zipcode). NOTE: Excludes one hospital system included in the past due to technical changes affecting visit classification assignment
and numbers.
6
Confirmed cases only. Based on jurisdiction equal to Franklin County or City of Columbus and admission date available in ODRS.
 Columbus & Franklin County Influenza Monitoring Summary – Week 52, 2018 (12/23/2018-12/29/2018)

Influenza Morbidity and Influenza-Like Illness (ILI) Reports

In week 52, the preliminary Ohio1 (statewide) influenza and influenza-like-Illness (ILI) visit rate to
athenaHealth providers (12.5 per 1,000 visits) increased compared to the previous week and is above its
baseline average for the week (Figure 1). The week 52 percentage of all Emergency Department (ED) visits
categorized as ILI increased compared to the previous week (Figure 3) and is above its historic baseline for the
week.

Nationally, during week 52 of 2018, 4.1% of patient visits reported through ILINet were due to influenza-like
illness (ILI). The percentage is above the national baseline of 2.2% for week 52.

Laboratory Surveillance
During week 52 of 2018, reporting Franklin County sentinel medical facility laboratories tested 1,948
specimens, with 182 (9.3%) positive (Figure 4). The total number of tests done by local reporting labs from
week 35 of 2018 through week 52 of 2018 is 19,139 with 515 (2.7%) positives (433 type A, 80 type B, 0 type A
and B, 2 type unknown).

Nationally in week 52 of 2018, clinical laboratories reported 26,603 specimens tested for influenza viruses,
3,636 (13.7%) of which were positive (3,532 type A, 104 type B). Public health laboratories reported testing
856 specimens, 536 of which were positive (522 type A – of which 439 were A(H1N1)pdm09, 52 were H3N2,
and 31 were not subtyped; 14 type B – of which 2 were Yamagata lineage, 6 were Victoria lineage, and 6
where lineage was not performed). Please visit the CDC website for more information, including cumulative
data.

In week 52, Ohio clinical labs reported 23,994 specimens tested for influenza this season thus far. Positive
results include: (39) A(H1N1)pdm09; (26) A/H3N2; (1,068) Flu A Not Subtyped, and (33) Flu B (through
12/29/2018). In week 52, ODH Public Health Lab reported 69 positive influenza tests from specimens sent by
various submitters this season so far. Positive results include: (56) A(H1N1)pdm09; (12) A/H3N2; (1) Influenza
B (through 12/29/2018). Please visit the ODH website for more information.

ED Respiratory Visits
In the 52nd week of 2018, the percentage of all ED visits categorized as respiratory increased compared to the
percentage seen the previous week and is above its baseline for the week (Figure 5).

Over-the-Counter (OTC) Medication Sales

In week 52 of 2018, trends for local over-the-counter medication category sales tracked were mixed compared
to last week (increase in electrolyte and chest rub sales; decrease in thermometer, pediatric anti-fever, adult
anti-fever, and throat lozenge sales; stable sough and cold sales) compared to last week.

Additional Influenza Activity Web Links:

Ohio Seasonal Flu Surveillance: https://odh.ohio.gov
CDC National Seasonal Flu Surveillance Reports: http://www.cdc.gov/flu/weekly/
World Health Organization Situation Updates: http://www.who.int/influenza/surveillance_monitoring/en/

1
Note: County level athenaHealth network primary care medical claims data is no longer available.

Page 2 of 4
 Columbus & Franklin County Influenza Monitoring Summary – Week 52, 2018 (12/23/2018-12/29/2018)

Figure 1: Ohio Outpatient Primary Care Provider Influenza or Influenza-Like-Illness Visit Rate* Figure 2: Percentage of Ohio Outpatient Participating Provider* and CDC National Outpatient
Sentinel Health Care Provider** visits for ILI and Associated Illnesses, 2018-19
45.0 6%

40.0

Trend Close-Up
35.0 6.0

30.0 4.0
4%
Rate per 1,000 visits

Percent of Visits
25.0 2.0

20.0 0.0
36 37 38 39 40 41 42 43 44 45 46 47 48 49 50
CDC M M WR Week
2%
15.0

10.0

5.0

0%
0.0 35 36 37 38 39 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
35 36 37 38 39 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
CDC MMWR Week
CDC MMWR Week Ohiol Flu or ILI Visit* Ohio Unspecified Viral or ILI Visit* Ohio Upper Respiratory Infection Visit*

2012-13 2013-14 2014-15 2015-16 2016-17 2017-18 5 Year Baseline Average** 2018-19 US Region 5 Sentinel outpatient ILI Visit** US Sentinel Outpatient ILI Visit**

*Source: Ohio (Statewide) medical claims data from athenaHealth

*Source: Ohio (statewide) medical claims data provided by athenaHealth. Data are subject to filing and processing time lags. Historical data
**Seasons : 2010-11, 2011-12, 2013-14, 2015-16, 2016-17
are updated when recieved.
Note: athenaHealthclaims data are subject to filing and processing time lags. Historical data are updated when they are received.
**Source: U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) sentinel provider visits.

Figure 3: Franklin County Resident ILI Defined** ED Visits, 2018 -19, Franklin County, OH Figure 4: Percentage of Local Reporting and National Laboratory Positive Influenza Tests by
Week, 2018-19
30%
20%

25% 18%
Percentage of total visits

16%
20%
14%
15%
12%

Percent

9.3%
10% 10%

5% 8%

5.8%
6%
0%

3.1%
10/13/18 (41)
10/20/18 (42)
10/27/18 (43)

11/10/18 (45)
11/17/18 (46)
11/24/18 (47)

12/15/18 (50)
12/22/18 (51)
12/29/18 (52)
1/5/19 (1)

2/9/19 (6)

3/2/19 (9)
2/2/19 (5)
9/1/18 (35)
9/8/18 (36)

1/12/19 (2)
1/19/19 (3)
1/26/19 (4)

2/16/19 (7)
2/23/19 (8)

3/9/19 (10)

4/6/19 (14)

5/4/19 (18)
9/15/18 (37)
9/22/18 (38)
9/29/18 (39)
10/6/18 (40)

11/3/18 (44)

12/1/18 (48)
12/8/18 (49)

3/16/19 (11)
3/23/19 (12)
3/30/19 (13)

4/13/19 (15)
4/20/19 (16)
4/27/19 (17)

5/11/19 (19)
5/18/19 (20)

4%

2.7%

2.5%
2.3%
1.3%

1.1%
1.1%

1.0%
0.9%

0.9%
0.8%
0.7%
2%
0.6%

0.4%
0.0%

0.0%

**Chief complaint classifier category includes fever and cough 0%

OR chief complaint classifier category includes fever and chief Week Ending (CDC MMWR Week) 35 36 37 38 39 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
complaint text includes sore throat OR chief complaint classifier
category includes "ILI"
CDC MMWR Week

Emergency Department 5 Yr. Weekly Average Emergency Department Visits

Franklin County Historical Weekly Avg. Franklin County - Current Year National - Current Year US Region 5 - Current Year

Page 3 of 4
 Number of Cases Percentage of total visits

100
120
140
160

20
40
60
80

0
10%
20%

15%
25%

0%
5%
9/1/18 (35) 9/1/18 (35)
Number of Cases
9/8/18 (36)

10
12
14
16
18

0
2
4
6
8
9/8/18 (36)
9/15/18 (37) 9/15/18 (37)
9/22/18 (38) 9/22/18 (38)
9/29/18 (39) 9/29/18 (39)
10/6/18 (40) 10/6/18 (40)
10/13/18 (41) 10/13/18 (41)
10/20/18 (42) 10/20/18 (42)

3 Season Baseline Average

10/27/18 (43)

Trend Close-Up
10/27/18 (43)
11/3/18 (44) 11/3/18 (44)
11/10/18 (45) 11/10/18 (45)
11/17/18 (46) 11/17/18 (46)

Week Of Admission (CDC M M WR Week)

11/24/18 (47)

2012-13
11/24/18 (47)

38 39 40 41 42 43 44 45 46 47 48 49 50 51 52
12/1/18 (48) 12/1/18 (48)
12/8/18 (49) 12/8/18 (49)
12/15/18 (50) 12/15/18 (50)
12/22/18 (51) 12/22/18 (51)

2013-14
12/29/18 (52) 12/29/18 (52)

Emergency Department 5 Yr. Weekly Average

Week 53* 1/5/19 (1)
1/5/19 (1) 1/12/19 (2)
1/12/19 (2) 1/19/19 (3)

2014-15
1/19/19 (3) 1/26/19 (4)
1/26/19 (4) 2/2/19 (5)
2/2/19 (5) 2/9/19 (6)
2/9/19 (6) 2/16/19 (7)

Week Of Admission (CDC MMWR Week)

2015-16
2/16/19 (7) 2/23/19 (8)
2/23/19 (8)
Week Ending (CDC MMWR Week)

3/2/19 (9)
3/2/19 (9) 3/9/19 (10)
3/9/19 (10) 3/16/19 (11)

2016-17
Hospitalizations by Hospital Admission Week (As of 1/3/2019)
3/16/19 (11) 3/23/19 (12)
3/23/19 (12) 3/30/19 (13)
3/30/19 (13) 4/6/19 (14)
Emergency Department Visits

4/6/19 (14) 4/13/19 (15)

2017-18
4/13/19 (15) 4/20/19 (16)
Figure 7: Columbus and Franklin County Jurisdiction Confirmed Influenza Associated

4/20/19 (16) 4/27/19 (17)

Figure 5: Franklin County Resident Respiratory ED Visits, 2018 -19, Franklin County, OH

4/27/19 (17) 5/4/19 (18)

5/4/19 (18) 5/11/19 (19)
5/11/19 (19)

2018-19
5/18/19 (20)
5/18/19 (20) Cumulative Rate per 100,000 (Y1) Number of Sales

*Note: Certain years have a 53rd week (e.g., season 2014-15) based on CDCs MMWR Weeks.
10
12
14
16
18
20

0
2
4
6
8

Page 4 of 4
1000
1200
1400

200
400
600
800

9/1/18 (35)
10
15
20
25
30

0
5
9/1/18 (35)
9/8/18 (36)
9/8/18 (36)
9/15/18 (37)
9/15/18 (37)
9/22/18 (38) 9/22/18 (38)
9/29/18 (39) 9/29/18 (39)
10/6/18 (40) 10/6/18 (40)
10/13/18 (41) 10/13/18 (41)
10/20/18 (42) 10/20/18 (42)
10/27/18 (43) 10/27/18 (43)

11/3/18 (44) 11/3/18 (44)

(Y2) Cough & Cold Sales

11/10/18 (45)
11/10/18 (45)
11/17/18 (46)
11/17/18 (46)
11/24/18 (47)
11/24/18 (47)
12/1/18 (48)
12/1/18 (48)
12/8/18 (49)
12/8/18 (49)
12/15/18 (50)
12/15/18 (50) 12/22/18 (51)
12/22/18 (51) 12/29/18 (52)
12/29/18 (52) 1/5/19 (1)
1/5/19 (1) 1/12/19 (2)
1/12/19 (2) 1/19/19 (3)
Columbus & Franklin County Influenza Monitoring Summary – Week 52, 2018 (12/23/2018-12/29/2018)

1/19/19 (3) 1/26/19 (4)

1/26/19 (4) 2/2/19 (5)

Franklin County, OH

2/9/19 (6)
2/2/19 (5)
(Y1) Pediatric Electrolytes Sales

2/16/19 (7)
2/9/19 (6)
2/23/19 (8)
2/16/19 (7)
Week Ending (CDC MMWR Week)

3/2/19 (9)
Week Of Admission (CDC MMWR Week)

2/23/19 (8)
3/9/19 (10)
Franklin County, OH, Confirmed Cumulative Influenza
Hospitalization Rates (per 100,000), 2010-2011 Season

Age Group

65+ yr

3/2/19 (9)
3/16/19 (11)
All Ages
50-64 yr
18-49 yr
05-17 yr
00-04 yr

3/9/19 (10) 3/23/19 (12)

3/16/19 (11) 3/30/19 (13)
6
2
4

42
15
15

35 36 37 38 39 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

3/23/19 (12) 4/6/19 (14)

3/30/19 (13) 4/13/19 (15)
4/6/19 (14) 4/20/19 (16)
4/27/19 (17)
Columbus and Franklin County, OH Jurisdiction Confirmed Influenza Hospitalization

4/13/19 (15)
Cumulative Rates (per 100,000) by Age-Group and Admission Week, 2018-2019 Season

5/4/19 (18)
Figure 6: Selected Number of Over-the-Counter Medication Total Sales, 2018-19,

4/20/19 (16)
3.3
2.7
2.5
1.0
4.3

10.5
(Y1) Thermometer Sales

5/11/19 (19)
4/27/19 (17)
5/18/19 (20)
5/4/19 (18)
Case Count Rates (per 100,000 Pop.)

5/11/19 (19)
4K
8K
12K
16K
20K
24K
28K
32K

5/18/19 (20)
(Y2) Number of Sales (Cough & Cold)