Seasonal Illness Update (Week 5, 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 2, 2019 (Week 5), from Night Nurse 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 based on 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 January 26 (Week 4) and can be found at https://www.cdc.gov/flu/weekly/summary.htm


The CDC FluView Report indicates widespread influenza levels now in 45 states an increase from 32 states in the previous week, with Influenza A being 98.0% of laboratory tested cases; a small decrease from 98.4% from Week-3. Within the Influenza-A cases, H1N1 is the most predominant strain, showing in 75.2% of subtyped cases; a decrease from 81.2% during the previous week.

H3N2 is being predominately detected in the South Eastern US representing approximately 24.8% of subtyped cases, which is an increase from the 18.8% of subtyped cases, as reported during the previous week.

This suggests a significant and increasing amount of H3N2 influenza spread, in the South-Eastern part of the country.

The CDC reports two pediatric flu-related deaths, during the week ending January 26 (Week 4). A total of 24 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 05 (Week 1):

Night Nurse reports 1.3% of ILI cases vs. the FluView report of 3.5%.

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 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, which is not yet available.


Night Nurse data from Week 5 suggests that influenza cases are still increasing, with a steady rise since Week 1. This aligns with the CDC Week 4 report of wide-spread flu now in 45 states. Although Night Nurse has not concluded that we are at a seasonal peak, we expect to see that peak level over the next 1-2 weeks, as we are likely at or nearing the top of the bell- curve.

Week 5 shows the highest ILI Activity so far this season from Night Nurse data, and I believe this will be validated upon the release of the FluView Report for Week 5.

The CDC reports ILI (Influenza Like Illness) with High activity in 23 states, up from 18 states the previous week.

Moderate activity remains the same at 10 states and Low activity in 13 states, which is up from 8 states the previous week.


Actual Night Nurse statistics from selected states, by above category:


Night Nurse data suggests that influenza has reached its peak in New Hampshire, although after 2-weeks of decline has now shown a slight increase. This indicates that although the peak was reached around Week 2, ILI activity is still present and may not decline quickly. The call volume trend does show a decrease in Week 5, which suggests that both are past peak levels, but may show a resurgence this season. It is recommended to maintain staffing levels, until declines in both trends are more clearly evident.

Connecticut now appears to be at the peak of ILI Activity but also shows a decrease in Call Volume. This suggests that decreases in call volume are likely the result in lessened amounts of non-ILI calls. Decreasing staffing levels should not be undertaken, until both ILI Activity and Call Volume trends suggest declines.

Massachusetts results now show a decline in both ILI Activity and Call Volume. As ILI Activity is at or near the highest levels, this suggests that they are at or just past the bell-curve peak; confirming the previous week assessment. It is recommended to prepare for staffing level decreases, with confirmation in Week 6 results.

Texas data indicates sharp increases in both ILI Activity and Call Volume. This is suggesting 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 peak levels are present.

New York area results also indicate a sharp rise of ILI Activity, but it is coupled with a decrease in Call Volume. This suggests that while ILI is still on the rise, non-ILI activity is decreasing. It is recommended to maintain current staffing levels and to watch next week’s results for guidance on decreasing staffing levels.

California results also are mixed. There is still a small, but steady increase in ILI Activity, but these levels have not risen to the percentages seen in other tracked states. There has been a decrease in Call Volume. This suggests that overall California staffing levels may cautiously be decreased, with greater confidence to be determined by Week 6 results

Of the after-hours ILI cases triaged by Night Nurse for the week ending February 2nd (Week 5)

45.7% Were directed to PCP via appointment 

36.2% were provided Home-care advice 

18.1% 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.

It should be noted that Week-1 figures include the high-usage period from the end of the 2018 holiday season.


Trends cautiously suggest that seasonal overall Call Volume may have peaked during Week 4, as levels over baseline have decreased from 37.8% down to 31.5%.

Of the states we are tracking, Texas is the only state to show an increase in Call Volume. Texas also shows and increase in ILI Activity, which suggests a resurgence of both ILI and non-ILI Activity, in this state

All other tracked states suggest that overall Seasonal Illness is on the decline, however, coupled with still elevated or increasing ILI Activity, staffing levels should be maintained, until more definitive illness trends are indicated.

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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