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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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Surveillance

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image1 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 23

The influenza (flu) activity level for Texas for the week ending June 13, 2009 was “local.” During week 23, 28 (8.7%) 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 23. HSRs 2/3 and 4/5N reported an increased level of flu activity compared to week 22. HSRs 6/5S, 8, and 9/10 reported the same level of flu activity compared to week 22. All other HSRs reported a decreased level of flu activity compared to week 22. 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 23, eight hospital laboratories and public health agencies across Texas reported conducting a total of 323 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 290 antigen detection tests that were performed, 25 were positive for influenza A/not subtyped and one was positive for influenza B. The positive results were reported from Bexar, Collin, Dallas, Harris, Lubbock, Nueces, and Tarrant counties.

A total of 53 reports of PCR- or culture-confirmed seasonal influenza were received from public health laboratories, Texas Children's Hospital in Houston, and NREVSS for the following counties during week 23 (June 7-June 13):

Influenza A/H1 (seasonal) Influenza A/H3 Influenza A/not subtyped Influenza B
(none) (none) Dallas County (2) (none)
    Dimmit County (2)  
    Gillespie County  
    Harris County (45)  
    Kendall County  
    Victoria County  
    Webb County  

Positive point-of-care rapid tests for influenza were reported by providers throughout the state (see county map below).

Novel Influenza A Virus Infections

Case investigations are ongoing, and the number of confirmed cases changes frequently. Please see the DSHS website (http://www.dshs.state.tx.us/swineflu/default.shtm) and the CDC website (http://www.cdc.gov/h1n1flu/) for more information on the current investigation.

Antigenic Characterization

CDC has reported antigenic characterization results from 51 influenza isolates [20 influenza A/H1, 8 influenza A/H3, and 23 influenza B viruses] received from the DSHS Laboratory since the beginning of the 2008–09 flu season.

Influenza A/H1 [20]

  • All 20 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 [8]
  • All 8 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) [23]
    Victoria lineage [16]
  • Sixteen of the influenza B viruses were characterized as belonging to the B/Victoria lineage.

  • Yamagata lineage [7]
  • Seven 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, 22 seasonal influenza A/H1 isolates, 7 influenza A/H3 isolates, and 22 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 22 22 (100%) 0 (0) 22 0 (0)
Influenza A/H3 7 0 (0) 0 (0) 7 7 (100%)
Influenza B 22 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

No influenza-associated pediatric fatalities were reported during week 23. Texas has reported thirteen influenza-associated pediatric fatalities during the 2008-09 influenza season.

School Closures and Institutional Outbreaks

No school closures or institutional outbreaks were reported for week 23. HSR 4/5N reported two camps with ILI and at least one confirmed case of novel influenza A H1N1 in each camp during week 23. CDC has issued interim guidance for cases of novel influenza A H1N1 in summer camps. This guidance is available at http://www.cdc.gov/h1n1flu/camp.htm.

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 23. Of the 40 providers who reported seeing patients during week 23, 17 (43%) providers saw at least one patient with ILI. Of all patient visits during this week, 1.97% were due to ILI. The ILI baseline for HHS Region 6 (Arkansas, Louisiana, New Mexico, Oklahoma, and Texas) of the United States is 4.6% 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 6/19/2009 12:23:01 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 80 120 152 106 20 398 19857 2.00
2008-44 82 136 199 104 26 465 20972 2.22
2008-45 79 110 111 122 27 370 20959 1.77
2008-46 74 110 107 103 23 343 19890 1.72
2008-47 76 137 143 122 19 421 19907 2.11
2008-48 80 132 132 125 37 426 17012 2.50
2008-49 78 143 159 153 24 479 20446 2.34
2008-50 76 133 146 108 28 415 19450 2.13
2008-51 70 172 177 175 24 548 17663 3.10
2008-52 77 194 153 154 34 535 13509 3.96
2008-53 78 176 141 165 46 528 15329 3.44
2009-01 79 162 182 188 38 570 18646 3.06
2009-02 78 178 287 235 41 741 20222 3.66
2009-03 79 174 468 341 43 1026 23058 4.45
2009-04 79 260 679 333 47 1319 24350 5.42
2009-05 74 282 884 467 40 1673 24734 6.76
2009-06 80 301 965 392 59 1717 24320 7.06
2009-07 80 320 816 316 57 1509 26024 5.80
2009-08 74 221 552 283 57 1113 24664 4.51
2009-09 77 194 423 245 71 933 22428 4.16
2009-10 80 221 325 212 77 835 22635 3.69
2009-11 77 167 269 178 58 672 19656 3.42
2009-12 72 109 150 179 18 456 20910 2.18
2009-13 73 114 143 163 16 436 18660 2.34
2009-14 80 158 197 234 51 640 20843 3.07
2009-15 77 92 136 156 23 407 21124 1.93
2009-16 85 131 197 163 28 519 21938 2.37
2009-17 77 260 570 348 44 1222 25406 4.81
2009-18 72 200 361 185 31 777 22503 3.45
2009-19 65 125 253 183 24 585 19066 3.07
2009-20 63 122 255 134 7 518 19150 2.70
2009-21 64 115 238 115 31 499 39616 1.26
2009-22 58 105 182 92 23 402 39494 1.02
2009-23 41 49 70 13 5 137 6957 1.97


ILIPercentageChart

National Influenza Activity Map

The current U.S. flu weekly report may be found at http://www.cdc.gov/flu/weekly/fluactivity.htm.
USMapweekly

*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.



*Influenza activity level corresponds to current MMWR week only and does not reflect previous weeks' activity.
**Positives are reported according to specimen collection date or date received in the lab, if the former is unknown



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 -

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Last updated December 22, 2010