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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


    E-mail

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

2009 - 2010 Texas Influenza Surveillance Information

The "new" flu season (2009-2010) officially began October 4, 2009. For reports from the
2008-2009 season, please see www.idcu.org/disease/influenza/surveillance/2009/.

Influenza Surveillance Report for MMWR week 8

The influenza (flu) activity level for Texas for the week ending February 27, 2010 was “sporadic.” For definitions of flu activity levels please see http://www.cdc.gov/flu/weekly/fluactivity.htm. During week 8, 43 (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 during week 8.

Reports from Health Service Regions

Reports were received from all Health Service Regions (HSRs) for week 8. HSR 1 and HSR 6/5S reported a slightly increased level of flu activity compared to week 7. HSRs 2/3, 4/5N, 7, 8, 9/10 and 11 reported the same level of flu activity compared to week 7. For a map of Health Service Regions please visit the following website: www.dshs.state.tx.us/regions/state.shtm

Laboratory Results

During week 8, five hospital laboratories and public health agencies across Texas reported conducting a total of 493 influenza tests (antigen, culture, and PCR) to the National Respiratory and Enteric Virus Surveillance System (NREVSSwindow_ext ) sponsored by the Centers for Disease Control and Prevention (CDC). Fifty-nine percent of 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.
Testing Information Week 8
No. of specimens tested 493
No. of positive specimens (%) 43 (8.7%)
Positive specimens by type/subtype
Influenza A 28 (65.1%)
          Subtyping performed 9 (32.1%)
                 A (novel H1N1) 9(100%)
                 A (H3) 0 (0%)
                 A (Seasonal H1) 0 (0%)
           Subtyping not performed 19 (67.9%)
Influenza B 15 (34.9%)

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

Novel Influenza A Virus Infections

Please see the Texas Department of State Health Services (DSHS) novel influenza website (http://www.texasflu.org) and the CDC website (http://www.cdc.gov/h1n1flu/) for more information. Data collection for confirmed novel influenza A (H1N1) hospitalizations, intensive care unit (ICU) admissions, and deaths began in Texas on September 20, 2009. Forty-six confirmed novel influenza A (H1N1) deaths were reported in Texas residents and one child from Mexico who died in HSR 6/5S prior to September 20, 2009 (these deaths are included in the cumulative data table below). The table below summarizes the current data by Health Service Region. For more data, please see www.dshs.state.tx.us/txflu/splash/news_media.html.

Cumulative Surveillance Case Summary for Novel Influenza A (H1N1)
by Health Service Region and County as of 2/27/2010
Health Service Region Hospitalizations* Intensive Care Unit (ICU) Admissions* Deaths**
Region 1 Total 45 22 8
Region 2/3 Total 717 112 49
Region 4/5N Total 78 26 10
Region 6/5S Total 314 143 39
Region 7 Total 109 32 19
Region 8 Total 199 37 26
Region 9/10 Total 413 58 19
Region 11 Total 331 106 52
Texas Total 2,206 536 222
*Reporting for hospitalizations and ICU admissions began on 9/20/2009. ICU admissions are included in the hospitalization totals.
**Reporting for deaths began 4/15/2009 and includes a child from Mexico.

Antigenic Characterization

Since June 9, 2009, CDC has reported antigenic characterization results from 45 novel influenza A (H1N1) viruses and 1 seasonal influenza A (H1N1) virus received from the Texas Department of State Health Services (DSHS) Laboratory since April 26, 2009.

Novel Influenza A (H1N1) [ 45 ]

  • All 45 viruses were characterized as A/California/07/2009-like (H1N1), the reference virus selected by the World Health Organization (WHO) as the vaccine strain for the novel influenza A (H1N1) vaccine.
Influenza A (H3N2) [0]
  • No influenza A (H3N2) viruses from Texas have been characterized since April 15, 2009.
Influenza A (H1N1) seasonal [1]
  • One seasonal influenza A (H1N1) virus from Texas has been characterized as A/Brisbane/59/2007-like (H1N1), the influenza A/H1 component of the 2009-2010 seasonal influenza vaccine for the Northern Hemisphere.
Influenza B (B/Victoria/02/87 and B/Yamagata/16/88 lineages) [0]
    Victoria lineage [0]
  • No influenza B viruses from Texas have been characterized since April 15, 2009.
    Yamagata lineage [0]
  • No influenza B viruses from Texas have been characterized since April 15, 2009.

The national antigenic characterization and antiviral resistance testing results may be found in the 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 110 novel influenza A (H1N1) isolates received from multiple Texas laboratories since April 26, 2009.
Flu
Types/Subtypes
Isolates Tested (n) Resistant Viruses,
Number (%)
Isolates Tested (n) Resistant Viruses,
Number (%)
Oseltamivir Zanamivir Adamantanes
Influenza A (H1N1) (novel) 111 3 (3%) 0 (0) 42 42 (100%)
Influenza A (H3N2) 0 0 (0) 0 (0) 0 0 (0)
Influenza A (H1N1) (seasonal 0 0 (0) 0 (0) 0 0 (00)
Influenza B 0 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 2009-10 influenza season. Those recommendations are available at: http://www.cdc.gov/h1n1flu/recommendations.htm.

Influenza–Associated Pediatric Mortality

Please see www.dshs.state.tx.us/txflu/splash/news_media.html for more information.

School Closures and Institutional Outbreaks

No school closures or institutional outbreaks were reported in week 8. 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. For information on school closures, please see the Texas Education Agency's website at http://www.tea.state.tx.us/index4.aspx?id=5402.

U.S. Outpatient Influenza-like Illness Surveillance Network

Fifty-three 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 8. Of the 54 providers who saw patients, 25 (47%) saw at least one patient with ILI. Of all patient visits during this week, 2.64% 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.
Percentage of Visits for Influenza–Like Illness Reported by
the US Outpatient Influenza–Like Illness Surveillance Network (ILINet) in Texas
03/04/2010 4:23:58 PM
Week # Reporting Age 0-4 Age 5-24 Age 25-49 Age 50-64 Age over 64 Total ILI Total Patients % ILI
2009-40 101 1411 2402 510 178 64 4565 34309 13.31%
2009-41 101 1411 2130 403 123 42 4109 32059 12.82%
2009-42 104 1343 1914 387 115 37 3796 33981 11.17%
2009-43 99 1112 1243 309 83 40 2787 29700 9.38%
2009-44 106 990 1384 344 72 24 2814 33139 8.49%
2009-45 104 709 1024 234 82 37 2086 30325 6.88%
2009-46 103 699 814 220 69 26 1828 29893 6.12%
2009-47 111 575 520 112 48 23 1278 22441 5.69%
2009-48 104 652 578 164 74 27 1495 27439 5.45%
2009-49 103 609 503 176 68 30 1386 28110 4.93%
2009-50 99 419 347 154 66 22 1008 25411 3.97%
2009-51 97 376 277 91 29 22 795 15834 5.02%
2009-52 94 393 286 155 50 28 912 23430 3.89%
2010-01 98 318 305 146 53 16 838 28585 2.93%
2010-02 99 531 428 155 77 23 1214 30487 3.98%
2010-03 90 361 387 148 41 18 955 30643 3.12%
2010-04 86 320 477 159 30 16 1002 29581 3.39%
2010-05 76 336 435 161 38 13 983 28325 3.47%
2010-06 74 285 350 171 46 18 870 27849 3.12%
2010-07 67 238 303 183 34 14 772 28823 2.68%
2010-08 54 104 226 83 35 15 463 17542 2.64%


ILIPercentageChart1
ILIDataChart1

National Influenza Activity Map

The current U.S. flu weekly report (FluView) may be found at http://www.cdc.gov/flu/weekly/fluactivity.htm.
USMapweekly1

*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.



flumap1

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.



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 January 10, 2011