Texas Influenza Surveillance Overview

In this overview, we delve into the details of influenza surveillance in Texas, covering various aspects such as flu testing, notifiable conditions, and the 2022-2023 flu season review. The information provided includes surveillance structures, reporting requirements, and the vital role of testing in situational awareness and preparedness. Additionally, details on notifiable conditions related to influenza and outbreak reporting criteria are discussed. This comprehensive review aims to enhance understanding and participation in flu surveillance activities in Texas.

• Texas Influenza Surveillance
• Flu Testing
• Notifiable Conditions
• 2022-2023 Season Review
• Public Health

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1. Welcome Dr. Paul Grunenwald

2. Influenza In Texas: A Review and Preview Emilio Gonzales

3. Overview Research outline Flu Surveillance Reporting Requirements Document outline Rewind outline 22-23 Season in Review Future outline Looking Forward How to Participate Group of men outline

4. Texas Flu Surveillance Flu surveillance structure Voluntary reporting from providers Syndromic Surveillance (Essence/TxS2) ILINet (influenza-like illness network) NREVSS Qualtrics Regional Reporting *Week Ending January 14, 2023 (MMWR Week 02) Research outline Document outline Data is aggregated on a weekly basis and published online through a static pdf report. Rewind outline 3 Conditions that are REQUIRED to be reported Influenza Associated Deaths Novel Influenza Respiratory Disease Outbreaks Future outline Group of men outline

5. Texas Flu Surveillance Flu Testing NREVSS PHL s/LRN s Aggregate regional reporting (Qualtrics) Research outline Vital Part of Flu Surveillance Situational Awareness Preparedness and Response Document outline Rewind outline Samples are submitted to LRN s using G2V Facility labs likely already have these forms Future outline Group of men outline

6. Texas Notifiable Conditions: Influenza Influenza Associated Pediatric Mortalities Case Criteria: 18yr and younger Positive influenza testing results Rapid, PCR, Culture No period of recovery from influenza illness onset to death Research outline Novel Influenza Determined through testing Contact your LHD Consideration of Novel Influenza Unexpected or unusually sever illness Illness with current vaccination Exposure to animals/livestock (poultry, birds, swine) Recent travel out of the country Document outline Rewind outline Future outline Outbreaks Any outbreak is reportable, including outbreaks of flu and/or respiratory diseases Outbreaks are determined by the facility Reported to LHD Group of men outline

7. 2022 2023 Flu Season in Review Weekly Flu Report https://www.dshs.texas.gov/2022-2023-texas- influenza-surveillance-activity Aggregated using multiple flu data sources Produced every Friday Provides situational awareness for statewide activity Research outline Document outline Rewind outline Future outline Group of men outline

8. 2022 2023 Flu Season in Review Percentage of Visits Due to Influenza-like Illness Reported by Texas ILINet Participants, 2019 2023 Seasons Research outline Document outline Rewind outline Future outline Group of men outline

9. 2022 2023 Flu Season in Review Percentage of Visits Due to Influenza-like Illness Reported by Texas ILINet Participants, 2022-2023 Season Research outline Document outline Rewind outline Future outline Group of men outline

10. 2022 2023 Flu Season in Review P&I (Pneumonia and Influenza) Death Data Data presented is Season to Date (October 2nd, 2022 Present) Identified by ICD-10 code Number of P&I Deaths+ Mortality Rate (per 100,000) HSR 301 31.34 Research outline 1 Large catchment area of analysis to include all influenza deaths and possibly related causes of death as influenza deaths are not considered reportable conditions. 2232 25.31 2/3 654 42.06 4/5N Document outline 1955 22.57 6/5S 898 25.4 7 Rewind outline 865 20.49 8 Mortality Rate (per 100,000) 2.04 0.50 4.21 27.14 135.56 25.85 Age Category (years) 0 - 4 5 - 17 18 - 49 50 - 64 65 + Overall Number of P&I Deaths+ 45 28 579 1428 5979 8059 423 40.48 9/10 Future outline 729 30.68 11 2 - Unknown 8059 25.85 Group of men outline Overall

11. 2022 2023 Season in Review Influenza-Associated Pediatric Deaths Reported in Texas during the 2022-2023 Season Influenza virus co-infection: A (not subtyped) and B Total, All Influenza Types / Subtypes Month of Pediatric Death Influenza A (Not Subtyped) Influenza, Not Typed / Not Differentiated Influenza A (H1N1) Influenza A (H3N2) Influenza B Research outline 2022 October November December 2023 January February March April May June July Total* 0 0 0 2 2 2 0 1 2 1 0 0 0 0 0 0 0 0 3 3 4 Document outline 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 3 0 1 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 12 Rewind outline Future outline Group of men outline Pediatric deaths are reported directly to HD

12. Looking Forward: Influenza Surveillance Regional Influenza Activity Baselines Streamlined Respiratory Outbreak Reporting System Qualtrics Survey System Research outline Document outline Influenza Sequencing Center Novel flu response and awareness Better response and treatment options Rewind outline Influenza Dashboard Dashboard preview in next slides Future outline Group of men outline

13. Looking Forward: Other Possible Changes Items to be aware of: Pan-Respiratory Disease Surveillance Flu RSV Other Resp. Diseases Research outline Document outline Rewind outline An Expansion of RSV surveillance Prevention products Death reporting? Available data? Case definitions? Future outline Group of men outline

14. Looking Forward: Other Possible Changes Items to be aware of: COVID surveillance Aggregate reporting? Lab testing data? ILI case definition? Research outline Document outline Rewind outline Future outline Group of men outline

15. How to Engage Recognize facilities/providers that may be able to participate in influenza surveillance Syndromic Surveillance hospital outpatient/ER ILINet outpatient facilities NREVSS lab facilities Qualtrics automated survey participation Research outline Document outline Rewind outline Future outline Group of men outline

16. How to Engage Determine which program/method best suite the providers capabilities Research outline Ensure and encourage continued participation Sending samples to LRN for testing Reporting flu and ILI Document outline Rewind outline Review weekly flu and respiratory data to better understand activity statewide Future outline Group of men outline

17. Thank you! Questions? Research outline Document outline Rewind outline Contact: emilio.gonzales@dshs.texas.gov flutexas@dshs.texas.gov Future outline Group of men outline