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    Infectious Disease Control Unit
    Mail Code: 1960
    PO BOX 149347 - Austin, TX 78714-9347
    1100 West 49th Street, Suite T801
    Austin, TX 78714

    Phone: 512 776 7676
    Fax: (512) 776-7616


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week 13

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Surveillance

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Influenza Influenza
(Flu)
ICD-9 487; ICD-10 J10,11
Related Topics: Protecting Yourself During the Cold and Flu Season, Avian Flu, Vaccine Preventable Diseases, Asthma and SARS

2008 - 2009 Texas Influenza Surveillance Information

Influenza Surveillance Report for MMWR Week 13

The influenza (flu) activity level for Texas for the week ending April 4, 2009 was “local.” During week 13, 17 (3.7%) specimens tested by NREVSS laboratories in Texas were positive for influenza. The percentage of visits for influenza-like illness as reported by ILINet providers in Texas was below the regional baseline.

 

Reports from Health Service Regions

Reports were received from all Health Service Regions (HSRs) for week 13. HSRs 8 and 11 reported the same level of flu activity compared to week 12. All other HSRs reported a decreased level of flu activity compared to week 12. For a map of Health Service Regions, please visit the following website:

 

http://www.dshs.state.tx.us/regions/state.shtm

 

Laboratory Results

During week 13, nine hospital laboratories and public health agencies across Texas reported conducting a total of 460 influenza tests (antigen, culture, and PCR) to the National Respiratory and Enteric Virus Surveillance System (NREVSSnew window) sponsored by the Centers for Disease Control and Prevention (CDC). Of the 357 antigen detection tests that were performed, 6 were positive for influenza A/not subtyped and 7 were positive for influenza B. The positive results were reported from Harris, Lubbock, Nueces, and Tarrant counties. One PCR test positive for influenza A/not subtyped and seven PCR tests positive for influenza B were reported for Bell, Harris, and Tarrant counties. [There may be some overlap in the PCR and culture positive results described in this report (i.e., some of the PCR results may be from some of the same patients as the culture results).] A total of 5 reports of culture-confirmed influenza were received from public health laboratories, Scott & White Memorial Hospital in Temple, the United States Air Force School of Aerospace Medicine, NREVSS, and other sources for the following counties:

 

 

Influenza A/H1 Influenza A/H3 Influenza A/not subtyped Influenza B
(none) (none) (none) Bexar County
      Dallas County
      El Paso County (2)
      Wichita County

Additional positive results from point-of-care rapid flu tests were reported by providers throughout the state (see Texas map below).

 

Antigenic Characterization

CDC has reported antigenic characterization results from 41 influenza isolates [18 influenza A/H1, 5 influenza A/H3, and 18 influenza B viruses] received from the DSHS Laboratory since the beginning of the 2008–09 flu season.

 

Influenza A/H1 [18]

  • All 18 viruses were characterized as A/Brisbane/59/2007, the influenza A/H1 component of the 2008–09 influenza vaccine for the Northern Hemisphere.
Influenza A/H3 [5]
  • All 5 viruses were characterized as A/Brisbane/10/2007, the influenza A/H3 component of the 2008-09 influenza vaccine for the Northern Hemisphere.
Influenza B (B/Victoria/02/87 and B/Yamagata/16/88 lineages) [18]
    Victoria lineage [12]
  • Two (17%) of the twelve viruses were characterized as B/Ohio/01/2005-like viruses.
  • Ten (83%) of the twelve viruses showed somewhat reduced titers with antisera produced against B/Malaysia/2506/2004 and B/Ohio/01/2005.
    Yamagata lineage [6]
  • Six viruses were characterized as B/Florida/4/2006, the influenza B component for the 2008-09 influenza vaccine for the Northern Hemisphere.

 

 

Antiviral Resistance

Since September 28, 2008, 20 influenza A/H1 isolates, 5 influenza A/H3 isolates, and 17 influenza B isolates from the DSHS laboratory have been tested by CDC for antiviral resistance.

 

  Isolates Tested (n) Resistant Viruses,
Number (%)
Isolates Tested (n) Resistant Viruses,
Number (%)
Oseltamivir Zanamivir Adamantanes
Influenza A/H1 20 19 (95%) 0 (0) 20 0 (0)
Influenza A/H3 5 0 (0) 0 (0) 5 5 (100%)
Influenza B 17 0 (0) 0 (0) N/A* N/A*
                                     *Adamantanes are not effective against influenza B viruses.

CDC has issued interim recommendations for use of antiviral medications in the 2008-09 influenza season. Those recommendations are available at: http://www.cdc.gov/flu/professionals/antivirals/index.htm..

 

Influenza–Associated Pediatric Mortality

Two influenza-associated pediatric fatalities were reported during week 13. The first death occurred during MMWR week 12 in an 11-year-old resident of Health Service Region 11 with a significant underlying medical condition. A specimen from the child was positive by indirect fluorescent antibody (IFA) and enzyme immunoassay (EIA) for influenza B. The influenza vaccination status of the child is not known. The second death occurred during MMWR week 13 in a 14-year-old resident of Health Service Region 6 with significant underlying medical conditions. A specimen from the child was positive for influenza B by IFA and EIA tests. The influenza vaccination status of the child is not known. Texas has reported ten influenza-associated pediatric fatalities during the 2008-09 influenza season.

 

 

School Closures and Institutional Outbreaks

No school closures or institutional outbreaks were reported in week 13.

 

 

U.S. Outpatient Influenza-like Illness Surveillance Network

Forty-one providers in Texas reported data to the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) (formerly known as the U.S. Influenza Sentinel Provider Surveillance System) on patients with influenza–like illness (ILI) and total patients seen for any reason during week 13. Of the 40 providers who reported seeing patients during week 13, 12 (30%) saw at least one patient with ILI. Of all patient visits during this week, 2.27% were due to ILI. The ILI baseline for the West South Central Region (Arkansas, Louisiana, Oklahoma, and Texas) of the United States is 4.8% for the 2008-2009 season. The baseline is the mean percentage of patient visits for ILI during non-influenza weeks for the previous three seasons plus two standard deviations.

 


Percentage of Visits for Influenza–Like Illness Reported by the US Outpatient Influenza–Like Illness Surveillance Network (ILINet) in Texas as of 4/10/2009 12:15:37 PM
Week # Reporting Age 0-4 Age 5-24 Age 25-64 Age over 64 Total ILI Total Patients % ILI
2008-40 78 84 133 127 22 366 20333 1.80
2008-41 78 114 163 124 19 420 20105 2.09
2008-42 79 107 156 90 7 360 19746 1.82
2008-43 79 120 152 106 20 398 19740 2.02
2008-44 80 136 199 103 26 464 20737 2.24
2008-45 78 110 111 122 27 370 20835 1.78
2008-46 73 110 106 103 23 342 19771 1.73
2008-47 75 137 143 122 19 421 19806 2.13
2008-48 79 131 132 125 37 425 16905 2.51
2008-49 77 143 159 153 24 479 20343 2.35
2008-50 75 133 146 108 28 415 19330 2.15
2008-51 69 172 177 175 24 548 17531 3.13
2008-52 76 194 153 154 34 535 13431 3.98
2008-53 77 176 141 165 46 528 15222 3.47
2009-01 78 162 182 188 38 570 18518 3.08
2009-02 77 178 287 235 41 741 20094 3.69
2009-03 78 174 468 341 43 1026 22951 4.47
2009-04 78 260 679 332 47 1318 24244 5.44
2009-05 73 282 883 465 40 1670 24590 6.79
2009-06 79 301 964 391 59 1715 24162 7.10
2009-07 79 320 814 316 57 1507 26669 5.65
2009-08 73 221 552 283 57 1113 25314 4.40
2009-09 75 193 417 244 71 925 21800 4.24
2009-10 78 221 322 210 77 830 21958 3.78
2009-11 72 159 259 168 58 644 18841 3.42
2009-12 60 90 133 169 15 407 18587 2.19
2009-13 41 62 97 142 11 312 13744 2.27


ILI Percentage in Texas Chart

 

ILI Data in Texas Chart

 

 

National Influenza Activity Map

The map showing influenza activity in the United States for MMWR week 13 is displayed below. The current U.S. flu weekly report may be found at: here.

 

 

Influenza in USA Map

*This map indicates geographic spread and does not measure the severity of influenza activity.

 

For more information on flu surveillance activities in the State of Texas, please visit our main surveillance page.




Texas Department of State Health Services - Infectious Disease Control Unit
1100 West 49th Street, Suite T801, Mail Code: 1960 PO BOX 149347 - Austin, TX 78714-9347
(512) 458-7676 - Fax: (512) 458-7616 - E-Mail

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Last updated May 19, 2010