Week ending 5 January 2019 (week 1)

The number of positive respiratory specimens in week 1 decreased by 7% from the previous week, with 277 positive specimens in week 1 compared to 297 positive specimens in week 52 (with 84% of installations reporting influenza data in week 1). Influenza A and RSV accounted for 74% and 21% of the total respiratory specimen tests, respectively. The percentage of influenza-like illness visits in the Active Duty population increased by 35% when compared to the previous week. Four non-AD cases of influenza-associated hospitalization with an onset date in week 1 were reported to DRSi. The peak of this influenza season has yet to hit, so it is strongly recom-mended for leadership to encourage proper hand hygiene and respiratory etiquette, as well as, to urge troops to seek medical attention for influenza like symptoms.

Additional Resources: Army Influenza Reports; ARD Reports; AFHSC Influenza Reports; NHRC FRI Reports; DoD Pandemic Influenza Watchboard; CDC Key: ILI -Influenza-Like Illness; DRSi-Disease Reporting System Internet; NHRC-Naval Health Research Center; ADV-Adenovirus; RSV-Respiratory Syncytial Virus; DEP-Disease Epidemiology Program; SM-Service Member

Questions? Email APHC DEP 410-436-7605

*Data Source: MEDPROS, ASIMS, MRRS

INFLUENZA-ASSOCIATED HOSPITALIZATIONS

DEMOGRAPHICS

Influenza Vaccination Coverage*

As of 9 January 2019

N/A DoD

93% Army Active Duty

85% Army Guard

75% Army Reserve

SUMMARY

AD: In week 1, a total of 39 cases tested positive for a respiratory specimen in the AD population. The majority of them (43%) were in the 30-39 group, followed by 25% in the 18-29 group, 20% in the 40-49 age group, and 8% in the 50-59 group. The 60+ group accounted for 2% of the cases.

Non-AD: Of the 238 positive specimens among non -AD individuals, 56% (134) were among individuals less than 18 years old.

In the civilian population, 30 states reported widespread in-fluenza activity. This is an increased from two weeks ago where six states and Guam reported widespread activity. Re-gional influenza activity was reported to the CDC by Puerto Rico and 17 states, local activity was reported by 2 states, and sporadic activity was reported by the District of Colum-bia, the US Virgin Islands, and one state. Guam did not re-port.

Four cases of influenza-associated hospitalization with onset dates in week 1 were reported in non-AD. In the same week last season, nine non-AD cases had been reported. So far this season, thirteen cases of influenza-associated hospitali-zation have been reported to DRSi in non-AD patients, and one case has been reported in the AD population.

*DRSi does not capture cases older than 65 years old for influenza-associated hospitalizations.

Click to enlarge image GEOGRAPHIC SPREAD

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Positive Respiratory Specimen Results from Army MTFs by Age Group and Beneficiary Status, 2018-2019 Influenza Season

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Army Influenza-Associated Hospitalizations Reported in DRSi by Onset Date

2018-2019 AD 2018-2019 Non-AD 2017-2018 AD 2017-2018 Non-AD

https://phc.amedd.army.mil/news/Pages/PublicationDetails.aspx?type=APHC+Influenza+Surveillance+Activityhttps://phc.amedd.army.mil/news/Pages/PublicationDetails.aspx?type=APHC+ARDS+Reporthttp://www.health.mil/Military-Health-Topics/Health-Readiness/Armed-Forces-Health-Surveillance-Branch/Reports-and-Publications/Influenza-Summary-and-Reportshttp://www.med.navy.mil/sites/nhrc/Pages/Research-and-Development-Focus-Areas.aspx?Category=INFECTIOUS-RPANDPUBhttps://www.health.mil/Military-Health-Topics/Health-Readiness/Pandemic-Diseases/Pandemic-Influenza-Watchboardhttp://www.cdc.gov/flu/weekly/mailto:disease.epidemiology@amedd.army.mil?subject=US%20Army%20Influenza%20Activity%20Reportmailto:usarmy.apg.medcom-aphc.mbx.disease-epidemiologyprogram13@mail.mil?subject=Influenza%20Report

Week ending 5 January 2019 (week 1) Army Influenza Activity Report U.S. Army Public Health Center

LABORATORY RESPIRATORY SPECIMEN TESTING

ILI ACTIVITY - ARMY ILI ACTIVITY - UNITED STATES

The number of positive specimens in week 1 de-creased by 7% from week 52, with 277 positive specimens in week 1 compared to 297 positive specimens in week 52*. Influenza A accounted for 74% of the positive specimens. This was fol-lowed by 59 (21%) RSV, 7 (3%) influenza B, and 4 (1%) adenovirus cases. Parainfluenza account-ed for

Week ending 5 January 2019 (week 1) Army Influenza Activity Report U.S. Army Public Health Center

LABORATORY RESPIRATORY SPECIMEN TESTING

No.: Number of specimens tested during MMWR week 1 2019.

% Pos.: Percentage of positive specimens reported during MMWR week 1, 2019.

Baseline % Pos.: Percentage of positive specimens reported in MMWR week 1 during influenza seasons from September 2012 - May 2018.

Missing values indicate that specimens were not tested for the disease during the week of interest.

No. Tested

% PositiveBaseline %

PositiveNo.

Tested% Positive

Baseline % Positive

No. Tested

% PositiveBaseline %

Positive

Ft. Belvoir 157 9.6 20.1 96 0 100 56 1.8 100

Ft. Benning 74 14.9 29.2 74 0 4.6

Ft. Bragg 51 15.7 15.3 100

Ft. Campbell 98 11.2 28.6 97 0 4.1 100

Ft. Drum 0 100 100

Ft. Eustis 42.9 100

Ft. Gordon 73 5.5 14.7 71 0 9.3 1 100 100

Ft. Jackson 48 6.3 18.9 48 2.1 6.7

Ft. Knox 19 5.3 10 19 0 10

Ft. Lee 12 25 9.1

Ft. Meade 23.1

Ft. Rucker 5 20 33.3 5 0 0

Ft. Sam Houston 287 13.6 35.7 286 0.3 4.6 100

Ft. Stewart 48 12.5 29 48 0 3.3 100

Redstone Arsenal 5.9 0

West Point 2 0 40 100 100

Ft. Bliss 195 27.2 24.9 94 1.1 3.7 28 3.6 8.5

Ft. Carson 70 11.4 17.6 100

Ft. Hood 66 4.5 24.8 66 4.5 5.6

Ft. Huachuca 6 16.7 16 6 0 4

Ft. Irwin 28 10.7 23.4 28 0 0

Ft. Leavenworth 30 13.3 15.2 30 0 8.7

Ft. Leonard Wood 25 4 24.2 25 0 4.2

Ft. Polk 33 18.2 22.1 1 100 100

Ft. Riley 65 7.7 19.9 64 0 5.4

Ft. Sill 8 12.5 13.5 100

RHCE Landstuhl Regional 14 21.4 15.3 11 0 16.7 11 0 3.3

Ft. Wainwright 19 0 34.6 19 0 0

Korea 51 25.5 33.3 28 0 5.6 28 3.6 3.7

Tripler Army Medical 55 3.6 6.7 37 0 1.2 37 0 2.4

No. Tested

% PositiveBaseline %

Pos.No.

Tested% Positive

Baseline % Pos.

No. Tested

% PositiveBaseline %

Pos.

Ft. Belvoir 59 1.7 100 105 18.1 30

Ft. Campbell 100 100

Ft. Drum 0

Ft. Gordon 100 100

Ft. Sam Houston 100 100

Ft. Stewart 12 16.7 14.3

West Point 100

Ft. Bliss 111 8.1 27.3

Ft. Carson 20 25 28.9

Ft. Hood 61

Ft. Leavenworth 12 41.7 0

Ft. Polk 5 20 31.3

Ft. Riley 42 19 21.4

Ft. Sill 2 0 66.7

RHCE Landstuhl Regional 11 0 0 18 16.7 11.4

Ft. Wainwright 19 21.1 7.1

Korea 0 28 3.6 0 28 0 12.7

Tripler Army Medical 37 0 0 37 0 3.6 3 100 100

RHCC

RHCP

RHCA

Influenza B Adenovirus

RSVRegion Installation

Enterovirus Parainfluenza

Region Installation

Influenza A

RHCA

RHCC

RHCP

Week ending 5 January 2019 (week 1) Army Influenza Activity Report U.S. Army Public Health Center

Regional Health Command - Atlantic (RHC-A)

Regional Health Command - Central (RHC-C)

Regional Health Command - Europe (RHC-E)

Regional Health Command - Pacific (RHC-P)

Proportion of Influenza A Positive Specimens by Week and Region, Army Medical Laboratories, 2018-2019 as Compared to 2014-2018

Age

GroupAD

Non-AD

Ben

Season

Total

< 18 0 28 228

18-29 4 4 48

30-39 5 1 42

40-49 2 6 43

50-59 2 4 32

60+ 0 7 31

Total 13 50 424

Week 01

Age

GroupAD

Non-AD

Ben

Season

Total

< 18 0 41 241

18-29 4 16 43

30-39 8 9 51

40-49 2 8 31

50-59 1 17 36

60+ 1 17 46

Total 16 108 448

Week 01

Age

GroupAD

Non-AD

Ben

Season

Total

< 18 0 0 6

18-29 1 1 7

30-39 1 0 7

40-49 0 0 0

50-59 0 0 1

60+ 0 0 0

Total 2 1 21

Week 01

Age

GroupAD

Non-AD

Ben

Season

Total

< 18 0 3 40

18-29 0 1 24

30-39 3 2 29

40-49 3 2 23

50-59 0 1 6

60+ 0 0 4

Total 6 9 126

Week 01

AD Non-AD AD Non-AD AD Non-AD AD Non-AD AD Non-AD AD Non-AD AD Non-AD AD Non-AD

RHC-A 2 4 2 5 7 18 4 15 12 54 17 96 19 67 13 50

RHC-C 0 12 1 7 4 12 0 18 2 28 2 79 9 103 16 108

RHC-E 0 2 - - 2 1 0 1 1 1 - - 1 1 2 1

RHC-P 4 6 1 2 7 8 4 7 7 11 13 15 8 4 6 9

CENTCOM - - - - - - - - - - - - - - - -

Number of Positive Influenza A Specimens by Duty Status and Region

RegionWeek 46 Week 47 Week 48 Week 49 Week 50 Week 51 Week 52 Week 01

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Positive Respiratory Specimen Results from Army MTFs by Age Group and Beneficiary Status, 2018-2019 Influenza Season

AD Non-AD Ben

Age

GroupAD

Non-AD

Ben

Season

Total

< 18 0 134 515

18-29 10 23 122

30-39 17 12 129

40-49 8 18 97

50-59 3 23 75

60+ 1 28 81

Total 39 238 1019

Week 01

Note: Reportable influenza cases are defined as only cases that have been hospitalized and are under the age of 65. See Armed Forces Reportable Medical Events Guidelines and Case Definitions for more information.Data as of 10 January 2019.

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Army Influenza-Associated Hospitalizations Reported in DRSi by Onset Date

2018-2019 AD 2018-2019 Non-AD 2017-2018 AD 2017-2018 Non-AD

http://www.health.mil/Military-Health-Topics/Health-Readiness/Armed-Forces-Health-Surveillance-Branch/Reports-and-Publications

Clinic visits for ILI are obtained from ESSENCE. Data as of 10 January 2019.

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Proportion of Positive Influenza A Specimens for U.S. Army 2018-2019

Total Tested (2018-19)

Average Tested (2014-18)

% Influenza A Positive

Week 50 Week 51 Week 52 Week 01 Season Total

RAT 87 193 147 117 735

Culture 3 8 2 2 34

PCR 26 22 63 86 250

Influenza A 116 223 212 205 1019

Influenza B 9 4 9 7 130

Adenovirus 16 15 10 4 154

Enterovirus 0 0 0 0 4

Parainfluenza 12 5 4 2 202

RSV 126 121 62 59 903

Negative 3164 2677 2362 2722 32935

Total 3443 3045 2659 2999 35347

Test Types Among

Positive Influenza A

Specimens

Army MTF

Laboratory Results,

2018-19

AD Non-AD AD Non-AD AD Non-AD AD Non-AD AD Non-AD AD Non-AD AD Non-AD AD Non-AD

RHC-A 2 4 2 5 7 18 4 15 12 54 17 96 19 67 13 50

RHC-C 0 12 1 7 4 12 0 18 2 28 2 79 9 103 16 108

RHC-E 0 2 - - 2 1 0 1 1 1 - - 1 1 2 1

RHC-P 4 6 1 2 7 8 4 7 7 11 13 15 8 4 6 9

CENTCOM - - - - - - - - - - - - - - - -

Number of Positive Influenza A Specimens by Duty Status and Region

RegionWeek 46 Week 47 Week 48 Week 49 Week 50 Week 51 Week 52 Week 01

US Army Influenza Report Week 1 Ending 5 JAN 2019(2) CDC_Map(3) AgeGroup_Graph(4) DRSI Influenza Graph(5) CDC_ILI(6) ILI ESSENCE Graph(7) CDC_Influenza Positive Tests(8) Percent_Pos_ArmyAll(9) Resp_specimen_Table(10) AD_Non AD Table