More than 450 public health, clinical, and commercial laboratories located throughout the United States voluntarily participate in surveillance for respiratory syncytial virus (RSV) through CDC's National Respiratory and Enteric Virus Surveillance System (NREVSS) (https://www.cdc.gov/surveillance/nrevss/labs/index.html). The data contain weekly, aggregate counts of RSV tests performed and RSV detections as reported to NREVSS since April 11, 2020.

NREVSS data are reported weekly at the national and 10 HHS regional levels (https://www.hhs.gov/about/agencies/iea/regional-offices/index.html). The presented data are RSV Nucleic Acid Amplification Test (NAAT) results, which include reverse transcription-polymerase chain reaction (RT-PCR) tests. These data exclude antigen, antibody, and at-home test results. Less than 5% of RSV tests reported to NREVSS are from antigen tests. All data are provisional and subject to change. Reporting is less complete for the most recent weeks, but relatively complete (>90%) for the period up to 2 weeks earlier.

Percent positivity is a surveillance metric used to monitor RSV activity over time and by geographic area. Participating laboratories send weekly reports of the total number of RSV tests performed that week, and the number of those tests that were positive. In the table and upon hovering on the map, the total test counts reflect the latest data reported to NREVSS and may differ from data presented by public health jurisdictions. Public health jurisdictions may have additional data not reported to NREVSS and may use a different reporting cadence. The RSV trend graphs display the weekly average percent of tests positive for RSV among all the tests performed. Each point on the regional table displays the average number of RSV tests that were performed, and the average percent of those that were positive during a 3-week period (i.e., the specified week, and the weeks immediately preceding and following it). This is also known as a centered, 3-week moving average. The RSV detections displayed are the 5-week moving average (average of the 4 previous and current weeks) in accordance with the recommendations for assessing RSV trends by detections (https://academic.oup.com/jid/article/216/3/345/3860464).

NREVSS strives to present precise estimates of respiratory viral trends and minimize reporting burden for participating laboratories. However, there are several limitations to this surveillance system. NREVSS is a laboratory-based surveillance system that does not have patient-specific data; multiple tests from a single patient may be included. In addition, NREVSS does not collect demographic or clinical data (i.e., hospitalizations or deaths). Testing practices may vary regionally, and the number of participating laboratories may change from year to year. Laboratories from all 50 states report data weekly, but reporting is voluntary and may not be representative of local RSV activity. The data do not include all test results within a jurisdiction and therefore do not reflect all RSV NAATs administered regionally or nationally. Participating laboratories vary in size, testing capabilities, and areas and populations served. Geographic results from clinical laboratories are based on testing location and laboratories may test samples from across one or more states. For more information on NREVSS and RSV surveillance please visit: https://www.cdc.gov/surveillance/nrevss.

MMWR Surveillance Summary 66 (No. SS-1):1-8 found that nonmetropolitan areas have significant numbers of potentially excess deaths from the five leading causes of death. These figures accompany this report by presenting information on potentially excess deaths in nonmetropolitan and metropolitan areas at the state level. They also add additional years of data and options for selecting different age ranges and benchmarks.

Potentially excess deaths are defined in MMWR Surveillance Summary 66(No. SS-1):1-8 as deaths that exceed the numbers that would be expected if the death rates of states with the lowest rates (benchmarks) occurred across all states. They are calculated by subtracting expected deaths for specific benchmarks from observed deaths.

Not all potentially excess deaths can be prevented; some areas might have characteristics that predispose them to higher rates of death. However, many potentially excess deaths might represent deaths that could be prevented through improved public health programs that support healthier behaviors and neighborhoods or better access to health care services.

Mortality data for U.S. residents come from the National Vital Statistics System. Estimates based on fewer than 10 observed deaths are not shown and shaded yellow on the map.

Underlying cause of death is based on the International Classification of Diseases, 10th Revision (ICD-10)

Heart disease (I00-I09, I11, I13, and I20–I51)
Cancer (C00–C97)
Unintentional injury (V01–X59 and Y85–Y86)
Chronic lower respiratory disease (J40–J47)
Stroke (I60–I69)
Locality (nonmetropolitan vs. metropolitan) is based on the Office of Management and Budget’s 2013 county-based classification scheme.

Benchmarks are based on the three states with the lowest age and cause-specific mortality rates.

Potentially excess deaths for each state are calculated by subtracting deaths at the benchmark rates (expected deaths) from observed deaths.

Users can explore three benchmarks:

“2010 Fixed” is a fixed benchmark based on the best performing States in 2010.
“2005 Fixed” is a fixed benchmark based on the best performing States in 2005.
“Floating” is based on the best performing States in each year so change from year to year.

SOURCES

CDC/NCHS, National Vital Statistics System, mortality data (see http://www.cdc.gov/nchs/deaths.htm); and CDC WONDER (see http://wonder.cdc.gov).

REFERENCES

1. Moy E, Garcia MC, Bastian B, Rossen LM, Ingram DD, Faul M, Massetti GM, Thomas CC, Hong Y, Yoon PW, Iademarco MF. Leading Causes of Death in Nonmetropolitan and Metropolitan Areas – United States, 1999-2014. MMWR Surveillance Summary 2017; 66(No. SS-1):1-8.

2. Garcia MC, Faul M, Massetti G, Thomas CC, Hong Y, Bauer UE, Iademarco MF. Reducing Potentially Excess Deaths from the Five Leading Causes of Death in the Rural United States. MMWR Surveillance Summary 2017; 66(No. SS-2):1–7.

Provisional death counts of diabetes, coronavirus disease 2019 (COVID-19) and other select causes of death, by month, sex, and age.

Effective September 27, 2023, this dataset will no longer be updated. Similar data are accessible from wonder.cdc.gov.

Provisional counts of deaths by the month the death occurred and by select causes of death for 2020-2023.

Effective September 27, 2023, this dataset will no longer be updated. Similar data are accessible from wonder.cdc.gov.

Provisional counts of deaths by the week the deaths occurred, by state of occurrence, and by select underlying causes of death for 2020-2023. The dataset also includes weekly provisional counts of death for COVID-19, coded to ICD-10 code U07.1 as an underlying or multiple cause of death.

NOTE: death counts are presented with a one week lag.

Effective September 27, 2023, this dataset will no longer be updated. Similar data are accessible from wonder.cdc.gov.

This visualization provides weekly data on the number of deaths by jurisdiction of occurrence and cause of death. Counts of deaths in more recent weeks can be compared with counts from earlier years to determine if the number is higher than expected. Selected causes of death are shown, based on analyses of the most prevalent comorbid conditions reported on death certificates where COVID-19 was listed as a cause of death (see https://www.cdc.gov/nchs/nvss/vsrr/covid_weekly/index.htm#Comorbidities). Cause of death counts are based on the underlying cause of death, and presented for Respiratory diseases, Circulatory diseases, Malignant neoplasms, and Alzheimer disease and dementia. Estimated numbers of deaths due to these other causes of death could represent misclassified COVID-19 deaths, or potentially could be indirectly related to COVID-19 (e.g., deaths from other causes occurring in the context of health care shortages or overburdened health care systems). Deaths with an underlying cause of death of COVID-19 are not included in these estimates of deaths due to other causes. Deaths due to external causes (i.e. injuries) or unknown causes are excluded. For more detail, see the Technical Notes.

Final counts of deaths by the week the deaths occurred, by state of occurrence, and by select causes of death for 2014-2019. Death counts in this dataset were derived from the National Vital Statistics System database that provides the most timely access to the data. Therefore, counts may differ slightly from final data due to differences in processing, recoding, and imputation.

Cumulative provisional counts of deaths sex, race/Hispanic origin, age group, and by select underlying causes of death. The dataset also includes provisional counts of death for COVID-19, coded to ICD-10 code U07.1 as an underlying or multiple cause of death. Includes deaths that occurred between January 1, 2020 to July 28, 2020.

Final counts of deaths by the month the deaths occurred and by select causes of death for 2014-2019.

Provisional counts of deaths by the month the deaths occurred, by age group and race/ethnicity, for select underlying causes of death for 2020-2021. Final data is provided for 2019. The dataset also includes monthly provisional counts of death for COVID-19, coded to ICD-10 code U07.1 as an underlying or multiple cause of death.