These data are from Virginia’s syndromic surveillance system, ESSENCE (Electronic Surveillance System for the Early Notification of Community-based Epidemics).

Visits for respiratory illness are emergency department (ED) visits meeting the CDC Broad Acute Respiratory DD v1 syndrome definition, which measures diagnosed acute respiratory illness (ARI). This includes viral illnesses such as COVID-19, influenza, and RSV, and other respiratory illnesses, such as cough or pneumonia.

The statewide respiratory illness activity level is calculated using a moving epidemic method to compare the ARI percent for the current season to previous respiratory seasons.

The trends (trending down, stable, trending up) describe percentage point change from the previous week. For overall respiratory illness, weekly visits that are 0.5 percentage points higher or lower than the previous week are considered ‘stable’. Weekly visits greater than or equal to 0.5 percentage points higher than the previous week are ‘trending up’ and greater than or equal to 0.5 percentage points lower than the previous week are ‘trending down’.  For COVID-19, flu, and RSV, weekly visits with less than a 0.2 percentage point change compared to the previous week are considered ‘stable’. Weekly visits greater than or equal to 0.2 percentage points higher are ‘trending up’ and greater than or equal to 0.2 percentage points lower are ‘trending down’.    

Diagnosed COVID-19, flu, and RSV are identified using discharge diagnosis codes, described in this companion guide. The percentages represent the percent of visits for the diagnosed condition out of all emergency department visits for each week.

These data are from Virginia’s syndromic surveillance system, ESSENCE (Electronic Surveillance System for the Early Notification of Community-based Epidemics).

Visits for respiratory illness are emergency department (ED) visits meeting the CDC Broad Acute Respiratory DD v1 syndrome definition, which measures diagnosed acute respiratory illness (ARI). This includes viral illnesses such as COVID-19, influenza, and RSV, and other respiratory illnesses, such as cough or pneumonia. ED visits are those occurring at Virginia facilities among Virginia and out-of-state residents.

The map displays Virginia's five health planning regions. The respiratory illness activity level displayed on the map is calculated using a moving epidemic method for each region. This method compares the ARI percent for the current season to previous respiratory seasons. Each region has its own activity levels because respiratory illness activity varies by region. For example, if 17% of ED visits are for acute respiratory illness in Central region, it is considered “moderate” activity, while 17% in Northern region is considered “low” activity.

These data are from Virginia’s syndromic surveillance system, ESSENCE (Electronic Surveillance System for the Early Notification of Community-based Epidemics).

The data is the weekly percentage of emergency department (ED) visits with diagnosed COVID-19, flu, or RSV. The data represent the percentage out of all ED visits in a week. ED visits are categorized based on the discharge diagnosis. The discharge diagnosis codes used to identify ED visits with COVID-19, flu, and RSV are included in this companion guide developed by the CDC. ED visits are those occurring at Virginia facilities among Virginia and out-of-state residents.

The data on the right displays the percent of visits for COVID-19, flu, and RSV in each age group. Notably, this represents the percent of specific ED visits in that age group as a fraction of all ED visits for that age group. An example interpretation would be, “Out of all ED visits for 5-17 year old children, 4% were for COVID-19 during the week ending November 10th". 

These data are sourced from Virginia’s vital record statistics. The VDH Office of Vital Records collects and maintains death certificates on all Virginia residents. These records are sent to the National Center for Health Statistics (NCHS) for cause-of-death coding.  

The graph on the left displays deaths where COVID-19, influenza, or RSV were listed on the death certification. VDH uses the ACME code to identify the underlying cause of death. This means a death would only be counted once, and not twice if a person with COVID-19 had a coinfection of influenza. RSV is not often listed on the death certificate, but it is a disease of importance for us to monitor and helps us identify more respiratory-related deaths. Deaths are displayed for the date of death and as number of all deaths reported that week.    

ACME Codes included:  COVID-19 [U07.1], Influenza [J09, J10, J10.0, J10.1, J10.2, J10.8, J11.0, J11.1, J11.2, J11.8], and RSV [J21.0, J12.1, J20.5]

While the majority of death records for natural deaths (which includes most deaths due to illness) are certified and filed within two weeks of the date of death, death data should be considered preliminary due to reporting delays and potential changes to death data. Death certificates often take significantly longer to finalize when an autopsy is conducted and/or when toxicology testing is completed.   

The graph on the right includes the number of influenza-associated pediatric deaths for the past ten influenza seasons, shown by age group and region. Influenza-associated pediatric mortality is a nationally-notifiable condition. VDH reports cases to the CDC that meet the specific criteria used to define a disease for public health surveillance. Only the child’s age group and geographic region are reported to the public in order to maintain privacy and sensitivity.  

These data are sourced from the Virginia Electronic Disease Surveillance System (VEDSS). This system is used by VDH to report, track, and manage laboratory data and case investigations of reportable diseases in Virginia. 

VDH receives reports of positive confirmatory influenza lab results. The confirmatory tests that are available (PCR, viral culture, and DFA [direct fluorescent antigen]) for the flu are not commonly used. For people who seek care for flu, most are diagnosed with a rapid influenza diagnostic test, or by their symptoms alone. These data are not reported to VDH. Therefore, influenza positive labs reported to public health represent only a small proportion of all people testing positive for influenza. 

The influenza laboratory data are shown by viral subtypes and lineages to represent the virus types that are circulating. Influenza A and B viruses cause seasonal flu. Influenza A viruses are divided into subtypes based on two proteins on the surface of the virus: hemagglutinin (H) and neuraminidase (N). Current subtypes of influenza A viruses that routinely circulate in people include A(H1N1) and A(H3N2). Influenza B viruses are not divided into subtypes, but instead are further classified into lineages, including B/Victoria.  

Positive PCR and antigen test results for SARS-CoV-2, the virus that causes COVID-19, are reported to VDH by laboratories and healthcare providers. At-home test results are not reported to VDH. Therefore, this graph is a significant underrepresentation of the number of positive test results for SARS-CoV-2.  

These data are sourced from the Virginia Outbreak Surveillance System (VOSS). VOSS is the surveillance system used to report, track, and manage outbreak investigations of reportable diseases or other health conditions in Virginia.

In Virginia, certain facilities or programs, such as residential or day programs, services or facilities licensed or operated by any agency of the Commonwealth, schools, child-care centers, and summer camps are required to report the presence or suspected presence of an outbreak to the local health department per 12VAC5-90-90D. Other entities/businesses may voluntarily report outbreaks.

The graph displays outbreaks by report week that are caused by COVID-19, flu, or RSV. The combined category (Respiratory Viruses) shows the sum of COVID-19, flu, and RSV outbreaks by report week. Outbreaks are reported by the Earliest Outbreak Report Date. Sometimes there are delays in reporting between facilities and local health departments. Data are subject to change as additional reports are received.

Outbreaks are grouped into six facility types:

• School (K-12)
• Daycare/Pre-K
• Long term care facilities (e.g., nursing homes, assisted living)
• Congregate living settings (e.g., correctional facilities, camps, independent living)
• Healthcare Settings (e.g., hospitals, medical offices, medical facility (non-LTCF).
• Other Congregate Settings (e.g., sports/clubs, restaurants, businesses)

These data are sourced from the Virginia Immunization Information System (VIIS). VIIS is a free statewide registry, which includes immunization (vaccine) history for people of all ages living in Virginia. Healthcare providers are required to report vaccine administration data to VIIS as of January 1, 2022.

Coverage rates use population estimates from the 2022 American Community Survey (ACS). No population estimates are available for out-of-state individuals or those without a reported locality.

As of September 17, 2024, the COVID-19 and flu data represents the percent of people who received doses of the 2024-2025 vaccines. The flu vaccine coverage is displayed by the percent of people who received a dose of the 2024-2025 flu vaccine after July 1, 2024. The COVID-19 vaccine coverage is displayed by the percent of people who received a dose of any 2024-2025 COVID-19 vaccine after August 23, 2024. The updated mRNA COVID-19 vaccines with 2024-2025 formula were granted emergency use authorization by FDA on August 22, 2024. The updated protein-based COVID-19 vaccine with 2024-2025 formula was granted emergency use authorization by FDA on August 30, 2024. The RSV data represents the percent of people 75 years of age and older who have received a RSV vaccine between 2023 and present day.

 Immunization recommendations are available for COVID-19, flu, and RSV.