‍Seasonal ‍Illness ‍Update ‍(Week ‍7, ‍2019)

‍by ‍Stuart ‍Pologe

‍COO, ‍Night ‍Nurse ‍Triage, ‍Inc.

‍Night ‍Nurse ‍Inc. ‍analysis ‍of ‍actual ‍patient ‍triage ‍data ‍provides ‍advance ‍view ‍of ‍Seasonal ‍Illness ‍trends.


‍This ‍Seasonal ‍Illness ‍Update ‍is ‍produced ‍utilizing ‍data ‍samples ‍from ‍the ‍week ‍ending ‍February ‍16, ‍2019 ‍(Week ‍7), ‍from ‍actual ‍patient ‍triage ‍call ‍encounters ‍and ‍compares ‍those ‍trends ‍to ‍those ‍obtained ‍from ‍CDC ‍sources ‍in ‍the ‍same ‍time ‍period.

‍Night ‍Nurse ‍Triage ‍data ‍is ‍intended ‍to ‍provide ‍an ‍advance ‍look ‍at ‍how ‍the ‍trending ‍spread ‍of ‍influenza ‍and ‍Total ‍After-Hours ‍Patient ‍Call ‍Volume ‍may ‍affect ‍your ‍patient ‍care ‍and ‍staffing ‍operations. ‍This ‍information ‍is ‍derived ‍from ‍a ‍Night ‍Nurse ‍weekly ‍sample ‍size ‍of ‍approximately ‍5,000 ‍RN-based ‍actual ‍triage ‍calls. ‍Data ‍includes ‍patients ‍from ‍Pediatric, ‍Adult ‍and ‍Family ‍Medicine ‍practices, ‍from ‍more ‍than ‍30 ‍states.


‍TrendsTrends ‍Night ‍Nurse ‍utilizes ‍to ‍produce ‍these ‍reports ‍include:

‍Night ‍Nurse ‍Influenza ‍Like ‍Illness ‍(ILI ‍)Activity ‍vs. ‍CDC ‍FluView ‍Report ‍

‍Night ‍Nurse ‍Total ‍patient ‍call ‍volume


‍Night ‍Nurse ‍statistics ‍reflect ‍the ‍percentage ‍of ‍after-hours ‍calls ‍assessed ‍by ‍our ‍RN’s, ‍that ‍fit ‍the ‍protocol ‍which ‍meets ‍the ‍criteria ‍for ‍influenza. ‍Night ‍Nurse ‍data ‍typically ‍is ‍a ‍one ‍or ‍more ‍week ‍advance ‍informational ‍source ‍of ‍that ‍from ‍the ‍CDC ‍FluView ‍Report.

‍CDC ‍FluView ‍information ‍is ‍taken ‍from ‍Public ‍Health ‍Centers. ‍It’s ‍not ‍the ‍comparative ‍numbers ‍that ‍are ‍of ‍focus, ‍but ‍the ‍comparative ‍trending ‍data, ‍as ‍the ‍data ‍sourcing ‍and ‍sample ‍sizes ‍differ ‍in ‍collection ‍methodology.


‍The ‍CDC’s ‍data ‍used ‍in ‍this ‍update ‍can ‍be ‍reviewed ‍from ‍the ‍latest ‍CDC ‍FluView ‍Report ‍released ‍for ‍the ‍week ‍ending ‍February ‍9 ‍(Week ‍6) ‍and ‍can ‍be ‍found ‍at ‍https://www.cdc.gov/flu/weekly/summary.htm


‍The ‍CDC ‍FluView ‍Report ‍for ‍Week ‍6 ‍indicates ‍widespread ‍influenza ‍levels ‍now ‍in ‍48 ‍states ‍an ‍increase ‍from ‍47 ‍states ‍in ‍the ‍previous ‍week, ‍with ‍Influenza ‍A ‍being ‍97.8% ‍of ‍laboratory ‍tested ‍cases; ‍a ‍decrease ‍from ‍98.3% ‍from ‍Week-5. ‍Within ‍the ‍Influenza-A ‍cases, ‍H1N1 ‍is ‍the ‍most ‍predominant ‍strain, ‍showing ‍in ‍64.5% ‍of ‍subtyped ‍cases; ‍a ‍decrease ‍from ‍65.0% ‍during ‍the ‍previous ‍week.

‍H3N2 ‍is ‍being ‍predominately ‍detected ‍in ‍the ‍South ‍Eastern ‍US ‍representing ‍approximately ‍35.5% ‍of ‍subtyped ‍cases, ‍which ‍is ‍an ‍increase ‍from ‍the ‍35.0% ‍of ‍subtyped ‍cases, ‍as ‍reported ‍during ‍the ‍previous ‍week.


‍This ‍suggests ‍a ‍continued ‍and ‍increasing ‍amount ‍of ‍H3N2 ‍influenza ‍spread, ‍from ‍its ‍high-activity, ‍in ‍the ‍South-Eastern ‍part ‍of ‍the ‍country. ‍H3N2 ‍is ‍likely ‍to ‍spread ‍beyond ‍the ‍South-Eastern ‍part ‍of ‍the ‍country ‍and ‍be ‍the ‍cause ‍of ‍a ‍continued ‍high-level ‍of ‍influenza ‍for ‍several ‍weeks.

‍The ‍CDC ‍reports ‍6 ‍pediatric ‍flu-related ‍deaths, ‍during ‍the ‍week ‍ending ‍February ‍9 ‍(Week ‍6). ‍A ‍total ‍of ‍34 ‍influenza-associated ‍pediatric ‍deaths ‍have ‍been ‍reported ‍for ‍the ‍2018-2019 ‍season.

‍Night ‍Nurse ‍Influenza ‍Like ‍Illness ‍(ILI ‍)Activity ‍vs. ‍CDC ‍FluView ‍Report


‍Night ‍Nurse ‍actual ‍reported ‍data ‍of ‍the ‍proportional ‍percentage ‍of ‍people ‍seeking ‍after-hours ‍care ‍for ‍Influenza ‍Like ‍Illness ‍(ILI), ‍as ‍compared ‍to ‍the ‍proportional ‍percentage ‍of ‍ILI ‍cases ‍reported ‍by ‍the ‍CDC ‍are ‍as ‍follows:

‍For ‍the ‍week ‍ending ‍January ‍12 ‍(Week ‍2):

‍Night ‍Nurse ‍reports ‍1.65% ‍of ‍ILI ‍cases ‍vs. ‍the ‍FluView ‍report ‍of ‍3.1%

‍For ‍the ‍week ‍ending ‍January ‍19 ‍(Week ‍3):

‍Night ‍Nurse ‍reports ‍2.98% ‍of ‍ILI ‍cases ‍vs. ‍the ‍FluView ‍which ‍is ‍3.3%

‍For ‍the ‍week ‍ending ‍January ‍26 ‍(Week ‍4):

‍Night ‍Nurse ‍reports ‍3.18% ‍of ‍ILI ‍cases ‍vs. ‍the ‍FluView ‍report, ‍of ‍3.8%

‍For ‍the ‍week ‍ending ‍February ‍2nd ‍(Week ‍5):

‍Night ‍Nurse ‍reports ‍3.76% ‍of ‍ILI ‍cases ‍vs. ‍the ‍FluView ‍report, ‍of ‍4.3%

‍For ‍the ‍week ‍ending ‍February ‍9th ‍(Week ‍6):

‍Night ‍Nurse ‍reports ‍3.70% ‍of ‍ILI ‍cases ‍vs. ‍the ‍FluView ‍report, ‍of ‍4.8%

‍For ‍the ‍week ‍ending ‍February ‍16th ‍(Week ‍7):

‍Night ‍Nurse ‍reports ‍3.81% ‍of ‍ILI ‍cases ‍vs. ‍the ‍FluView ‍Report, ‍which ‍is ‍not ‍yet ‍available


Night Nurse data from Week 7 suggests that influenza cases are still increasing, with a steady rise since Week 1. This is confirmed by the CDC Week 6 report, which indicates the highest influenza levels reported so far this season. Both Night Nurse and CDC data suggest that we are likely at the peak levels of ILI this season and that levels will remain high for the next several weeks.

Week 7 indicates the highest ILI Activity so far this season from Night Nurse data, and previous week reports are now confirmed by the FluView Week 6 report, which shows the continued upward trend.

The CDC reports ILI (Influenza Like Illness) with High activity in 26 states, up from 24 states the previous week.

Moderate activity is now in 8 states and Low activity in 11 states.


Actual Night Nurse statistics from selected states:


Night Nurse data suggests that ILI reached its peak in New Hampshire around Week 5 and following 2-weeks of decline may be on the down-side of the bell-curve. Call volume, however, remains at peak levels. It is recommended to maintain staffing levels, until declines in both trends are more clearly evident.

Connecticut also appears to be at or just past the peak of ILI Activity, after declines of ILI, in the previous 2-weeks. The increase of call volume in Week 7 suggests that a second outbreak of ILI is taking place. Decreasing staffing levels should not be undertaken, until both ILI Activity and Call Volume trends suggest declines.

Massachusetts results indicate a rise in both ILI Activity and Call Volume for the last 2-weeks, since a dip in Week 5.

As ILI Activity is at or near the highest levels, this suggests that they are at the bell-curve peak. It is recommended to maintain current staffing levels, as a second wave of ILI may be present.

Texas data indicates ILI Activity is at peak levels while call volume has shown slight declines over the last 2-weeks. This suggests a resurgence of both ILI and non-ILI types and that staffing levels should be maintained, with additional on-call support, until new data suggests declines.

New York area results also indicate peak levels of ILI Activity and a rise in call volume after a decrease in the previous week. It is recommended to maintain current staffing levels.

California results indicate a continued rise in ILI Activity and call volume. There is still a steady increase in ILI Activity and these levels have now risen to the percentages seen in other tracked states. Call volume now appears to also be on the rise, so maintaining staffing levels is recommended

Of the after-hours ILI cases triaged by Night Nurse for the week ending February 16th (Week 7),

40.3% Were directed to PCP via appointment

43.2% were provided Home-care advice

16.5% were directed to be seen immediately

Night Nurse Total patient call volume Trend

This Call Volume Trend update is provided to show the percentage difference in weekly total after-hours call volume as compared to the seasonal low-volume baseline from August 2018.

Night Nurse closely tracks Total After-Hours triage call volume, as an overall indicator of the level of seasonal illness. The same six-states are tracked here.


After declines in most tracked states in Week 6, current Week 7 data shows sharp increases in call volume. With the increased spread of H3N2 now being indicated by the CDC, it is suggested that it is spreading beyond the South-Eastern part of the country and is now in the North-East and West-Coast.

All US regions suggest elevated ILI levels are still present.

I will update these statistics on a weekly basis for the duration of this flu season. If there are any statistics you would like to receive or a state you would like to have us focus for you, please send me a message on Linked-In or from the form on this webpage and I will try to accommodate you.

Feedback is welcome and encouraged. These statistics are for informational purposes only.

Stuart Pologe

Chief Operations Officer

Night Nurse Inc.

508 650 0022



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