Surveillance

2009 - 2010 Texas Influenza Surveillance Information

During week 39 in Texas:

• Two (1.4%) specimens tested by NREVSS laboratories in Texas were positive for influenza B by antigen detection test.
• 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 39. HSR 11 reported an increased level of flu activity compared to week 38. HSRs 1, 2/3, 4/5N, 7, and 8 reported the same level of flu activity compared to week 38. HSRs 6/5S and 9/10 reported a decreased level of flu activity compared to week 38. For a map of Health Service Regions please visit the following website: www.dshs.state.tx.us/regions/state.shtm

Laboratory Results

Influenza

During week 39, six hospital laboratories and public health agencies across Texas reported conducting a total of 141 influenza tests (antigen, culture, and PCR) to the National Respiratory and Enteric Virus Surveillance System (NREVSS ) sponsored by the Centers for Disease Control and Prevention (CDC). Forty-nine percent of the influenza tests reported to NREVSS were antigen detection tests; these tests cannot identify the subtype of influenza detected. The results from Texas participants in NREVSS are summarized in the table below.

Additional influenza test results (rapid tests, culture, PCR) were reported from providers and public health departments throughout the state (see county map below).

Other Viruses

The NREVSS system collects information on a variety of respiratory viruses in addition to influenza including parainfluenza, respiratory syncytial virus (RSV), rhinovirus, human metapneumovirus (HMPV), and respiratory adenovirus. The results from week 39 are summarized below.

Novel Influenza A Virus Infections

2009 influenza A (H1N1)-specific surveillance was discontinued after May 22, 2010. For final 2009 influenza A (H1N1)-specific reports, please see the Texas Department of State Health Services (DSHS) influenza website (http://www.texasflu.org) and the CDC website (http://www.cdc.gov/h1n1flu/).

Antigenic Characterization

Since June 9, 2009, CDC has reported antigenic characterization results from 48 2009 influenza A (H1N1) viruses, 1 seasonal influenza A (H1N1) virus, and 2 influenza B viruses received from the Texas Department of State Health Services (DSHS) Laboratory.

The national antigenic characterization and antiviral resistance testing results may be found in the final CDC weekly flu report at www.cdc.gov/flu/weekly/. The DSHS Laboratory sends a representative sample of influenza viruses to the CDC throughout the flu season.

Antiviral Resistance

Since June 9, 2009, CDC has reported antiviral resistance testing results on 111 2009 influenza A (H1N1) isolates received from multiple Texas laboratories since April 26, 2009.

                                        *Adamantanes are not effective against influenza B viruses.

Influenza–Associated Pediatric Mortality

No new influenza-associated pediatric fatalities were reported during week 39. There have been 33 influenza-associated pediatric fatalities reported in Texas since the beginning of the 2009-2010 influenza season, including 6 deaths during calendar year 2010.

Influenza-Associated Deaths in Pregnant and Postpartum Women

No new influenza-associated deaths were reported in pregnant or postpartum women during week 39.

DSHS is requesting reporting of influenza-associated deaths in pregnant or postpartum (up to 6 weeks) women during the summer of 2010 and continuing throughout the 2010-2011 influenza season. There has been 1 death reported since the beginning of the summer 2010. All influenza types and subtypes should be reported; a positive rapid influenza test is sufficient for confirmation.

School Closures and Institutional Outbreaks

No institutional outbreaks or school closures were reported during week 39. CDC released new guidance for summer camps on May 17, 2010. This can be found at http://www.cdc.gov/h1n1flu/camp.htm. DSHS has issued guidance for cases of ILI and novel influenza A (H1N1) in summer camps, schools, and congregate facilities. Please see www.texasflu.org for more information.

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 39. Of the 41 providers who saw patients, 24 (59%) saw at least one patient with ILI. Of all patient visits during this week, 2.35% 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 2009-2010 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.

National Influenza Activity Map

The national influenza reporting season ended after May 22, 2010 (2010 MMWR week 20). National influenza reporting will resume on October 3, 2010. Archives for the U.S. flu weekly report (FluView) may be found at http://www.cdc.gov/flu/weekly/fluactivity.htm.

For more information on flu surveillance activities in the State of Texas, please visit the following website: www.dshs.state.tx.us/idcu/disease/influenza/surveillance/

¹Influenza activity level corresponds to current MMWR week only and does not reflect previous weeks' activity.
²The majority of influenza cases are not reportable by law to the Texas Department of State Health Services. This map contains data from sentinel sites and does not represent all influenza cases in the state.
³Positive laboratory results are reported according to specimen collection date or date received in the lab if the former is unknown.

2009 - 2010 Texas Influenza Surveillance Information --- Flu Reports

For the week ending: 10/10/09; 10/17/09; 10/24/09; 10/31/09; 11/07/09; 11/14/09; 11/21/09; 11/28/09; 12/05/09; 12/12/09; 12/19/09; 12/26/09; 01/02/10; 01/09/10; 01/16/10; 01/23/10; 01/30/10; 02/06/10; 02/13/10; 02/20/10; 02/27/10; 03/06/10; 03/13/10; 03/20/10; 03/27/10; 04/03/10; 04/10/10; 04/17/10; 04/24/10; 05/01/10; 05/08/10; 05/15/10; 05/22/10; 05/29/10; 06/05/10; 06/12/10; 06/19/10; 06/26/10; 07/03/10; 07/10/10; 07/17/10; 07/24/10; 07/31/10; 08/07/10; 08/14/10; 08/21/10; 08/28/10; 09/04/10; 09/11/10; 09/18/10; 09/25/10; 10/02/10;

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