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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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2010-2011 DSHS Flu Report Week 43

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2010 - 2011 Texas Influenza Surveillance Information

Please note: The 2010-2011 influenza season began on October 3, 2010. For reports from the 2009-2010 season, please see http://www.dshs.state.tx.us/idcu/disease/influenza/surveillance/2010/.

During week 43 in Texas:

  • The influenza (flu) activity level (geographic spread of influenza) for Texas was "sporadic" and the ILINet Activity Level Indicator was "minimal". For more information please see http://www.cdc.gov/flu/weekly/fluactivity.htm and the national FluView weekly report at http://www.cdc.gov/flu/weekly/.
  • Fifteen (2.7%) specimens tested by NREVSS laboratories in Texas were positive for influenza. Four specimens were positive for influenza A (H3N2) and one specimen was positive for influenza B by PCR testing; all other positive results were obtained by antigen detection test.
  • The percentage of visits for influenza-like illness as reported by ILINet providers in Texas was below the state and regional baselines.
  • One influenza-associated pediatric death was reported.
  • No outbreaks or school closures were reported.  

Reports from Health Service Regions

Reports were received from all Health Service Regions (HSRs) for week 43. HSRs 2/3 and 8 reported an increased level of flu activity compared to week 42. All other HSRs reported the same level of flu activity compared to week 42. For a map of Health Service Regions please visit the following website: http://www.dshs.state.tx.us/regions/state.shtm 

Laboratory Results

Influenza

During week 43, ten hospital laboratories and public health agencies across Texas reported conducting a total of 552 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). Sixty-three 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. 

 

 

Influenza Testing Results Reported by Texas NREVSS Laboratories
Testing Information Week 43
No. of specimens tested 552
No. of positive specimens (%) 15 (2.7%)
Positive specimens by type/subtype
Influenza A 13 (86.7%)
          Subtyping performed 4 (30.8%)
                 A (2009 H1N1) 0 (0%)
                 A (other H1N1) 0 (0%)
                 A (H3N2) 4 (100%)
           Subtyping not performed 9 (69.2%)
Influenza B 2 (13.3%)

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

Other Respiratory 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 43 are summarized below.

 

 

Other Respiratory Virus Results Reported by Texas NREVSS Laboratories
Virus Number of
Laboratories
Testing
Tests
Performed
Positive
Tests
Percentage
of Tests
Positive
Adenovirus (respiratory) 4 182 5 2.75%
HMPV 4 141 6 4.26%
Parainfluenza 5 183 4 2.19%
Rhinovirus 3 136 32 23.53%
RSV 15 509 18 3.54%

Antigenic Characterization

Since July 2010, CDC has reported antigenic characterization results from 1 influenza A (H1N1) virus, 1 influenza A (H3N2) virus, and 2 influenza B viruses received from the Texas Department of State Health Services (DSHS) Laboratory.  

  • Influenza A (H1N1) [1]
    One virus was related to A/California/07/2009-like (H1N1), the influenza A (H1N1) component of the 2010-2011 influenza vaccine for the Northern Hemisphere.
  • Influenza A (H3N2) [1]
    One virus was related to A/Perth/16/2009-like (H3N2), the influenza A (H3N2) component of the 2010-2011 influenza vaccine for the Northern Hemisphere.
  • Influenza B [2]
    • Victoria lineage [2]
      Two influenza B viruses were related to B/Brisbane/60/2008-like, the influenza B component of the 2010-2011 influenza vaccine for the Northern Hemisphere.
    • Yamagata lineage [0]
      No influenza B viruses of the Yamagata lineage have been characterized since 2009. 

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 July 2010, CDC has not reported any antiviral resistance testing results on influenza isolates received from Texas laboratories.  

Influenza–Associated Pediatric Mortality

One influenza-associated pediatric death occurred during week 43 in a resident of HSR 2/3. The child did not have underlying medical conditions; however, a blood specimen collected from the child was positive for Streptococcus pneumoniae. It is unknown if the child was vaccinated for influenza for the current season. A respiratory specimen collected from the child was positive for influenza A (not subtyped) by rapid test. This is the first influenza-associated pediatric fatality that has been reported in Texas since the beginning of the 2010-2011 influenza season. Seven deaths have been reported during calendar year 2010. Please see the table below for more information. 

 

Influenza-Associated Pediatric Deaths in Texas Residents by Type, Subtype, and Month
Month of
Pediatric death,
2010
Influenza Type A Total
Influenza
Type B
Total,
All Influenza
Types and
Subtypes
Subtypes Total
Influenza A,
All Subtypes
2009
H1N1
Other
H1N1
H3N2 Not Subtyped
January 0 0 0 0 0 0 0
February 1 0 0 1 2 0 2
March 2 0 0 1 3 0 3
April 0 0 0 0 0 0 0
May 0 0 0 0 0 0 0
June 0 0 0 1 1 0 1
July 0 0 0 0 0 0 0
August 0 0 0 0 0 0 0
September 0 0 0 0 0 0 0
October 0 0 0 1 1 0 1
November 0 0 0 0 0 0 0
Unknown 0 0 0 0 0 0 0
Total 3 0 0 4 7 0 7


Cases of influenza-associated pediatric mortality (children <18 years of age) are reportable year-round and by law in Texas. Please see http://www.dshs.state.tx.us/idcu/investigation/conditions/ for more information. 

Influenza-Associated Deaths in Pregnant and Postpartum Women

No new influenza-associated deaths were reported in pregnant or postpartum women during week 43.

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 school closures or institutional outbreaks were reported during week 43. Information on the control of influenza in various settings may be found on the CDC website at http://www.cdc.gov/flu/professionals/infectioncontrol/

U.S. Outpatient Influenza-like Illness Surveillance Network

Sixty-eight 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 the 68 providers who saw patients, 34 (50%) saw at least one patient with ILI. Of all patient visits during this week, 3.11% were due to ILI. The Texas ILI baseline is 6.09% for the 2010-2011 season. The ILI baseline for HHS Region 6 (Arkansas, Louisiana, New Mexico, Oklahoma, and Texas) of the United States is 4.9% for the 2010-2011 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. The baselines displayed on the graph below were calculated for the official influenza reporting season only (approximately October to May).

Percentage of Visits for Influenza–Like Illness Reported by
the US Outpatient Influenza–Like Illness Surveillance Network (ILINet) in Texas
11/4/2010 4:33:00 PM
Week # Reporting Age 0-4 Age 5-24 Age 25-49 Age 50-64 Age 65 and older Total ILI Total Patients % ILI
2011-40 87 347 330 185 41 25 928 32410 2.86%
2011-41 86 373 349 180 45 13 960 33617 2.86%
2011-42 86 335 384 177 29 21 946 33257 2.84%
2011-43 68 260 228 106 36 22 652 20953 3.11%

 

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.  

Influenza in USA Map

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

International Influenza Activity Map

The CDC compiles information from several sources and releases an international influenza summary. This report can be found at http://www.cdc.gov/flu/international/activity.htm.  

International Co-circulation of Seasonal Influenza Map

 

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.


 

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Last updated March 21, 2011