ARKANSAS DEPARTMENT OF HEALTH

José R. Romero, MD, FAAP, FIDSA, FPIDS, FAAAS,

Secretary of Health

Outbreak Response/Epidemiology
Influenza Weekly Report
Arkansas 2020-2021

Week Ending Saturday 10/10/2020

Jennifer Dillaha, MD,

State Epidemiologist, Medical Director, Immunizations/Outbreak Response
Shirley Louie, MS, CIH
Deputy State Epidemiologist; Director, Center for Public Health Practice

Prepared by:

Haytham Safi, MD, MPH

Influenza Surveillance Coordinator
Haytham.Safi@Arkansas.gov
501-661-2920

Reviewed by:
Lori Simmons, MS, Branch Chief, Epidemiology
Kellye McCartney, Branch Chief, Immunizations/Outbreak Control
Mike Cima, PhD, Chief Epidemiologist, Associate Director for Science, CHP

October 13, 2020

 During flu season, the Arkansas Department of Health (ADH) produces a Weekly Influenza Report for
clinicians. The report provides information on flu activity in the state. The report also compares influenza-
like-illness (ILI) in Arkansas to activity in the U.S. ADH receives reports of only a fraction of flu cases
since it only requires reports of hospitalizations, deaths, and outbreaks. Therefore, it is important to
understand that the information in the weekly update is representative of the timing and location of activity,
but it does not reflect the overall burden of disease. It is presumed that there are many more people actually
affected than the report shows. Clinicians and policy makers may find the report helpful in terms of
communicating to colleagues and patients about the current status of the flu season.

Report Key Points:

• For Week 41, Arkansas reported “Minimal” or 1 out of 13 for Influenza-Like-Illness (ILI) activity level
indicator determined by data reported to ILINet.
• Since September 27, 2020, 31 positive influenza tests have been reported to the ADH online database by
health care providers. Please note that reported cases reflect only a portion of the actual numbers of flu
cases in the state.
• Among flu antigen tests this season that can distinguish between influenza A and B virus types, 61 percent
were influenza A, and 39 percent were influenza B.

• About 1 percent of patients visiting emergency rooms this week were there for ILI (Syndromic
Surveillance). Less than 1 percent of outpatient visits were for ILI (ILINet sentinel providers).

• The average school absenteeism rate last week was 5.8 percent among public schools.

• To date, no influenza-related deaths have been reported in Arkansas this flu season, but one death was
reported the last week of 2019-20 season (last week in September), that will increase the total of 2019-20 to
125 influenza related deaths.

• No nursing homes have reported influenza outbreaks this season.

• Nationally, the proportion of deaths reported to the National Center for Health Statistics attributed to
pneumonia and influenza (P&I) is above the epidemic threshold this week.

You can report flu year-round and view the weekly influenza report during the influenza season at:
http://www.healthy.arkansas.gov/programs-services/topics/influenza.You can also access the reporting
website directly at: https://FluReport.ADH.Arkansas.gov.

For Additional National and International Influenza Surveillance Information:

World Health Organization (WHO): http://www.who.int/influenza/gisrs_laboratory/flunet/en/index.html.
CDC - Seasonal Influenza (Flu) - Weekly Report: http://www.cdc.gov/flu/weekly/

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2020-2021 Influenza Outbreak Response/Epi Report (Week 41: 10/04/2020 – 10/10/2020)

Death Report for Week 41 PCR Lab Confirmed Influenza Cases

• Deaths from all causes: 740 • Total Cases since 09/27/2020: 2
• Deaths due to Pneumonia: 97 • Week ending 10/10/2020: 1
• PCR confirmed Flu Deaths: 0 Reported cases reflect only a portion of the actual numbers of flu cases in the state.
• Death Certificate or Flu Antigen only: 0
Cumulative Cases
Cumulative Flu Deaths since 09/27/2020 PCR Tests Week 41
Since 09/27/2020
• PCR confirmed Flu deaths: 0
• Death Certificate or Antigen only: 0 A+ 0 0
• Cumulative Flu deaths: 0 B+ 1 2
Both A and B 0 0
B/Victoria 0 0
Total Flu-Related Hospital Admissions B/ Yamagata 0 0
• PCR Confirmed: H1N1+ 0 0
– Cumulative: 0 H3+ 0 0
–Week ending 10/10/2020: 0
Unsubtypeable 0 0
• Antigen Positive:
Total 1 2
– Cumulative: 1
Negative _ _
–Week ending 10/10/2020: 0

Weekly Arkansas ILI Intensity Level PCR Confirmed Influenza Cases since 09/27/2020
Reported by Sentinel Providers Age Groups PCR+ Hospitalized Deaths
0-4 yr. 1 0 0
5-17 yr. 1 0 0
18-24 yr. 0 0 0
25-44 yr. 0 0 0
45-64 yr. 0 0 0
>= 65 yr. 0 0 0
Unknown 0 0 0
Total 2 0 0

School Absenteeism*
Week Ending: 10/10/2020
- Percent Absent: 5.8
- Previous Week: 6.3
 Average daily absenteeism for all public schools during this reporting week.

ER Visits (Syndromic Surveillance)

• Week Ending: 10/10/2020
Weighted Average: 1.0%
– Total Visits: 13,435
– Visits with ILI: 135
• Previous Week
Weighted Average: 1.1%
– Total Visits: 14,152
– Visits with ILI: 154

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School Report

Weekly School Absenteeism Rates, Arkansas Public Schools

12
11
10
9
8
Percent Absent

7
6
5
4
3
2
1
0
1
2
3
4
5
6
7
8
9
40
41
42
43
44
45
46
47
48
49
50
51
52

10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
Oct | Nov | Dec | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep

Week, Month of Report

Off Season Baseline 2019-20 Average 2015-20 2020-21

3
 Influenza Mortality by Age Group, Arkansas 2005-2021 (Provisional)
Report Updated: 10/13/2020

Hospital Report – Downloaded from ESSENCE (Syndromic Surveillance)

Percent ER Visits with ILI

4
 Arkansas Subset of US Outpatients Influenza Surveillance (ILINET)
Percentage of Outpatient Visits Due to Influenza-like Illness Reported by ILINet in Arkansas

12
Percent of Outpatients Visits Due to ILI

10

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 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39
| Oct | Nov | Dec | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep |

Week, Month of Report

2020-21 Average 2015-20 Off Season Rate 2019-20

Weekly Influenza Claims Paid by Medicaid and BCBS of Arkansas

9000
Number of Claims Paid Each Week

8000

7000

6000

5000

4000

3000

2000

1000

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 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39

| Oct | Nov | Dec | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep
Week, Month of Report
Average 2014-20 YR 2019-20 Off Season Baseline YR 2020-21

5
 Number of Positive Tests Number of Positive Tests

10
15
20
25
30
35
40
45
50

0
5

10
15
20
25
30
35
40
45
50

0
5
2020 40 2020 40
2020 42 2020 42
Antigen Report

2020 44 2020 44
2020 46 2020 46
2020 48 2020 48

0-4 Yrs
2020 50 2020 50
2020 52 2020 52
2021 2 2021 2

A+ Antigen
5-17 Yrs
2021 4 2021 4
2021 6 2021 6
2021 8 2021 8

18-24 Yrs
2021 10 2021 10

B+ Antigen
2021 12 2021 12
2021 14 Year Week 2021 14

Year Week
2021 16 2021 16
25-44 Yrs
2021 18 2021 18
2021 20 2021 20
2021 22 2021 22
45-64 Yrs

2021 24 2021 24
2021 26 2021 26

Positive for Both A & B

2021 28 2021 28
65+ Yrs

2021 30 2021 30
2021 32
Reported Influenza Positive Antigens by Type, Arkansas 2019-20

2021 32
Reported Influenza Positive Antigens by Age Group, Arkansas 2019-20

2021 34 2021 34
2021 36 2021 36
2021 38 2021 38

6
Influenza Positive Tests Reported to CDC and ILI Activity, by HHS Region Clinical Labs,
2020-2021 Season, Week Ending October 3, 2020
Values in legend are for the highlighted HHS region (Region 6)

Influenza-Like-Illness Activity Level Indicator Determined by Data Reported to ILINet

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 Influenza Positive Tests Reported to CDC by U.S. Public Health Laboratories,
National Summary, Sept 29, 2019 - Oct 3, 2020

Pneumonia, Influenza and COVID Mortality from the National Center for Health
Statistics Mortality Surveillance System Data through the week
ending October 3, 2020, as of October 8, 2020