Northern Mariana Islands (The United States of America) + 2 more

CNMI’s Weekly Surveillance Report (Reporting Period: September 22 - 28, 2019)

Situation Report
Originally published


The enclosed report is for week 39 – * September 22 - 28, 2019*. The reporting includes the daily captured, weekly reported syndrome indicators of Influenza-Like Illness (representing respiratory diseases such as influenza), Diarrhea (representing typically gastrointestinal diseases),
Prolonged Fever (representing diseases including severe ILI, arboviral diseases, leptospirosis, mumps) and Acute Fever and rash (representing diseases such arboviral diseases, measles, leptospirosis).

  • The report includes syndrome counts as a proportion of encounters (at the 7 sentinel sites reporting data). The proportion of syndromes to encounters is a more meaningful interpretation of the syndrome data than just counts. The count of syndromes fluctuates each week but it cannot be known if an increase in a count is a result of more people going to see a doctor than if it is a real increase in disease in the community. The proportion of syndrome cases to encounters allows an assessment of the community burden of illness, an assessment of the severity of disease and allows comparisons with previous weeks.

  • Syndrome 'traffic light' indicators from green to red - 6 alerts. The 6 indicators are alert flags raising attention to an increase in syndrome cases. Alert flags progress from green to red as the proportion of syndrome cases increase. The alert flags indicate if an increase in syndrome cases is small (green flag) progressing to the likelihood of widespread ongoing (orange flags) and still increasing (red flag) community transmission. There are different threshold algorithms for each flag.

  • 4th The chart shows the proportion of syndrome cases to encounters for the three commonly reported syndromes of ILI (purple) Diarrhea (blue) and PF (green). Fortunately, cases of AFR are very rare and so will only be included if they occur. The chart also shows more detail for the most frequent syndrome ILI. The proportion of ILI for 2017 and 2018 is shown. This allows a visual comparison of the ILI trend last year compared to now and helps understand if current ILI is more widespread than last year. Additionally, the chart shows the alert 3 flag for ILI. Any or all of the 6 alerts could be shown on the chart but for convenience, only the middle number 3 alert flag is shown. The alert 3 threshold is shown as a gold dashed line. This is a trend indicator comprising 28-day weighted moving average with a 'volatility' adjustment (a margin of error). If the proportion of ILI to encounters is greater than the threshold (the purple ILI line is above the gold dashed line) a level 3 alert flag is generated).

Note: Rates of antimicrobial infections per 10,000 outpatient encounters and per 10,000 ER encounters [rates courtesy of the Infection Control Prevention team]