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    Infectious Disease Prevention Section
    Mail Code: 1927
    PO BOX 149347 - Austin, TX 78714-9347
    1100 West 49th Street, Suite G401
    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

2009 - 2010 Texas Influenza Surveillance Information

Please note: Novel influenza A (H1N1)-specific surveillance activities were discontinued after the week ending May 22, 2010. Limited surveillance for all influenza types and subtypes will continue throughout the summer.

During week 32 in Texas:

  • No specimens tested by NREVSS laboratories in Texas were positive for influenza; however, the DSHS Austin Laboratory reported a PCR positive result for influenza A (H3N2) from a flu specimen submitted by a provider in Dallas County. The patient developed flu-like symptoms on the return flight from a 7-day trip to Honduras.
  • 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 32. HSR 2/3 reported a decreased level of flu activity compared to week 31. HSRs 4/5N, 6/5S, 7, 8, 9/10, and 11 reported the same level of flu activity compared to week 31. HSR 1 did not determine a flu activity level for week 32 compared to week 31. 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 32, three hospital laboratories and public health agencies across Texas reported conducting a total of 87 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). Thirty-two 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.
Testing Information Week 32
No. of specimens tested 87
No. of positive specimens (%) 0 (0%)
Positive specimens by type/subtype
Influenza A 0 (0%)
          Subtyping performed 0 (0%)
                 A (novel H1N1) 0 (0%)
                 A (H3) 0 (0%)
                 A (Seasonal H1) 0 (0%)
           Subtyping not performed 0 (0%)
Influenza B 0 (0%)

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 32 are summarized below.

Virus Number of Laboratories Testing Tests Performed Positive Tests Percentage of Tests Positive
Adenovirus (respiratory) 2 79 4 5.06%
HMPV 2 42 0 0.00%
Parainfluenza 2 79 3 3.80%
Rhinovirus 2 42 7 16.67%
RSV 5 170 1 0.59%

Novel Influenza A Virus Infections

Novel influenza A (H1N1)-specific surveillance was discontinued after May 22, 2010. For final novel influenza A (H1N1)-specific reports, 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/).

Antigenic Characterization

Since June 9, 2009, CDC has reported antigenic characterization results from 48 novel influenza A (H1N1) viruses, 1 seasonal influenza A (H1N1) virus, and 1 influenza B virus received from the Texas Department of State Health Services (DSHS) Laboratory.
Influenza
Types/Subtypes 		Total number of Texas viruses characterized Do the viruses match the vaccine strains?
Yes No
Novel influenza A (H1N1) 48 48 (100%) 0
Influenza A (H3N2) 0 n/a n/a
Influenza A (H1N1) (seasonal ) 1 1 (100%) 0
Influenza B 1 1 (100%) 0

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 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.

Influenza–Associated Pediatric Mortality

No new influenza-associated pediatric fatalities were reported during week 32. 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.

School Closures and Institutional Outbreaks

No institutional outbreaks or school closures were reported during week 32. 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

Thirty-nine 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 32. Of the 29 providers who saw patients, 10 (34%) saw at least one patient with ILI. Of all patient visits during this week, 0.80% 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
08/19/2010 11:06:00 AM
Week # Reporting Age 0-4 Age 5-24 Age 25-49 Age 50-64 Age 65 and older 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 99 323 305 146 53 16 843 28720 2.94%
2010-02 101 535 430 157 77 23 1222 30883 3.96%
2010-03 95 364 387 148 41 18 958 31327 3.06%
2010-04 92 326 478 159 30 16 1009 30818 3.27%
2010-05 88 351 452 163 39 13 1018 30686 3.32%
2010-06 89 325 393 173 47 18 956 31178 3.07%
2010-07 83 354 375 184 35 14 962 32800 2.93%
2010-08 85 260 422 195 66 29 972 33040 2.94%
2010-09 85 311 439 208 59 27 1044 32859 3.18%
2010-10 83 439 423 181 64 20 1127 32771 3.44%
2010-11 87 167 205 147 44 18 581 27731 2.10%
2010-12 87 211 289 162 44 23 729 30838 2.36%
2010-13 86 201 246 114 21 16 598 27047 2.21%
2010-14 87 213 210 132 33 15 603 29600 2.04%
2010-15 87 249 275 110 44 24 702 30726 2.28%
2010-16 84 268 318 100 22 15 723 30865 2.34%
2010-17 94 271 251 112 33 16 683 30981 2.20%
2010-18 89 203 238 115 36 19 611 31089 1.97%
2010-19 85 243 248 129 32 7 659 30074 2.19%
2010-20 74 146 169 102 22 13 452 26540 1.70%
2010-21 71 178 188 90 23 13 492 25147 1.96%
2010-22 58 107 184 87 17 6 401 20352 1.97%
2010-23 59 109 122 89 13 9 342 24039 1.42%
2010-24 56 72 140 58 12 3 285 22719 1.25%
2010-25 56 108 146 44 18 5 321 21587 1.49%
2010-26 56 106 120 66 16 13 321 20257 1.58%
2010-27 57 96 130 55 24 10 315 19985 1.58%
2010-28 52 78 137 94 14 8 331 19372 1.71%
2010-29 49 96 85 52 20 8 261 19516 1.34%
2010-30 44 86 70 64 20 1 241 20209 1.19%
2010-31 38 57 43 20 3 5 128 13064 0.98%
2010-32 29 27 32 25 5 2 91 11330 0.80%


ILI Data in Texas Chart

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/



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