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| Rhode Island Department of Health |
3 Capitol Hill
Providence, RI 02908
Immunization:
Phone: (401) 222-4604 Fax: (401) 222-1442
Becky Bessette
Surveillance:
Phone: (401) 222-2577
Fax: (401) 222-2488 |
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Influenza (Flu)
RHODE ISLAND INFLUENZA ACTIVITY
CDC Criteria for reporting Influenza activity
“Influenza activity” is reported to the Division of Public Health Surveillance and Informatics, Epidemiology Program Office, CDC, via the National Electronic Telecommunications System for Surveillance (NETSS) via Secure Data Network (SDN).
Activity Level |
ILI Activity*/Outbreaks |
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Laboratory Data |
No activity |
Low |
And |
No lab confirmed cases† |
Sporadic |
Not increased |
And |
Isolated lab-confirmed cases |
OR |
Not increased |
And |
Lab confirmed outbreak in one institution‡ |
Local |
Increased ILI in 1 region**; ILI activity in other regions is not increased |
And |
Recent (within the past 3 weeks) lab evidence of influenza in region with increased ILI |
OR |
2 or more institutional outbreaks (ILI or lab confirmed) in 1 region; ILI activity in other regions is not increased |
And |
Recent (within the past 3 weeks) lab evidence of influenza in region with the outbreaks; virus activity is no greater than sporadic in other regions |
Regional (doesn’t apply to states with ≤4 regions) |
Increased ILI in ≥2 but less than half of the regions |
And |
Recent (within the past 3 weeks) lab confirmed influenza in the affected regions |
OR |
Institutional outbreaks (ILI or lab confirmed) in ≥2 and less than half of the regions |
And |
Recent (within the past 3 weeks) lab confirmed influenza in the affected regions |
Widespread |
Increased ILI and/or institutional outbreaks (ILI or lab confirmed) in at least half of the regions |
And |
Recent (within the past 3 weeks) lab confirmed influenza in the state. |
* ILI activity can be assessed using a variety of data sources including sentinel providers, school/workplace absenteeism, and other syndromic surveillance systems that monitor influenza-like illness.
† Lab confirmed case = case confirmed by rapid diagnostic test, antigen detection, culture, or PCR. Care should be given when relying on results of point of care rapid diagnostic test kits during times when influenza is not circulating widely. The sensitivity and specificity of these tests vary and the predicative value positive may be low outside the time of peak influenza activity. Therefore, a state may wish to obtain laboratory confirmation of influenza by testing methods other than point of care rapid tests for reporting the first laboratory confirmed case of influenza of the season.
‡ Institution includes nursing home, hospital, prison, school, etc.
**Region: population under surveillance in a defined geographical subdivision of a state. A region could be comprised of 1 or more counties and would be based on each state’s specific circumstances. Depending on the size of the state, the number of regions could range from 2 to approximately 12. The definition of regions would be left to the state but existing state health districts could be used in many states. Allowing states to define regions would avoid somewhat arbitrary county lines and allow states to make divisions that make sense based on geographic population clusters. Focusing on regions larger than counties would also improve the likelihood that data needed for estimating activity would be available.
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