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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 43

The influenza (flu) activity level for Texas for the week ending October 31, 2009 was “widespread.” For definitions of flu activity levels please see http://www.cdc.gov/flu/weekly/fluactivity.htm. During week 43, 280 (15.1%) 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 above the regional baseline during week 43.

Reports from Health Service Regions

Reports were received from all Health Service Regions (HSRs) for week 43. HSRs 8 and 9/10 reported the same level of flu activity compared to week 42. All other HSRs reported a decreased level of flu activity compared to week 42. For a map of Health Service Regions please visit the following website: www.dshs.state.tx.us/regions/state.shtm

Laboratory Results

During week 43, ten hospital laboratories and public health agencies across Texas reported conducting a total of 1,858 influenza tests (antigen, culture, and PCR) to the National Respiratory and Enteric Virus Surveillance System (NREVSSwindow_new) sponsored by the Centers for Disease Control and Prevention (CDC). The majority (64%) 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 43
No. of specimens tested 1,858
No. of positive specimens (%) 280 (15.1%)
Positive specimens by type/subtype
Influenza A 274 (97.9%)
          Subtyping performed 86 (31.4%)
                A (novel H1N1) 86 (100%)
                A (H3) 0 (0%)
                A (Seasonal H1) 0 (0%)
          Subtyping not performed 188 (68.6%)
Influenza B 6 (2.1%)

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 10/31/2009
Health Service Region Hospitalizations* Intensive Care Unit (ICU) Admissions* Deaths**
Region 1 Total 31 14 5
Region 2/3 Total 332 43 22
Region 4/5N Total 50 15 10
Region 6/5S Total 223 97 32
Region 7 Total 78 20 13
Region 8 Total 130 22 15
Region 9/10 Total 217 28 10
Region 11 Total 214 63 34
Texas Total 1,275 302 141
*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 13 novel influenza A (H1N1) viruses received from the Texas Department of State Health Services (DSHS) Laboratory since April 26, 2009.

Novel Influenza A (H1N1) [13]

  • All 13 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 [0]
  • No seasonal influenza A (H1N1) viruses from Texas have been characterized since April 15, 2009.
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) 110 2 (2%) 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

Two schools in Coleman County closed during week 43. 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

Eighty-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 43. Of these 83 providers who saw patients, 70 (84%) saw at least one patient with ILI. Of all patient visits during this week, 9.49% 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
11/05/2009 2:38:58 PM
Week # Reporting Age 0-4 Age 5-24 Age 25-49 Age 50-64 Age over 64 Total ILI Total Patients % ILI
2009-31 59 56 92 95 9 252 17727 1.42%
2009-32 57 56 109 81 9 255 17856 1.43%
2009-33 54 46 111 124 13 294 19431 1.51%
2009-34 53 74 267 99 4 444 19483 2.28%
2009-35 53 129 430 99 7 665 20850 3.19%
2009-36 53 136 616 177 10 939 20752 4.52%
2009-37 52 255 1103 307 16 1681 25342 6.63%
2009-38 51 207 687 106 13 1013 14451 7.01%
2009-39 48 326 1459 494 14 2293 24164 9.49%
2009-40 97 1152 2284 507 173 64 4180 32876 12.71%
2009-41 94 1199 2029 401 123 42 3794 30613 12.39%
2009-42 98 1171 1836 386 114 37 3544 327.41 10.82%
2009-43 83 904 1081 301 76 39 2401 25300 9.49%


ILI Percentage in Texas Chart
ILI Data in Texas Chart

National Influenza Activity Map

The current 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 our main surveillance page.



Influenza in Texas Map

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 -

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Last updated January 10, 2011