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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 9

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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 9 in Texas:

  • The influenza (flu) activity level (geographic spread of influenza) for Texas was "widespread" and the ILINet Activity Level Indicator was "high". 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/
  • Two hundred and nine (16.9%) specimens tested by NREVSS laboratories in Texas were positive for influenza. Eleven specimens were positive for 2009 influenza A (H1N1), 31 specimens were positive for influenza A (H3N2), 25 specimens were positive for influenza A (not subtyped), and 47 specimens were positive for influenza B by viral culture or PCR testing; the remaining positive results were obtained by antigen detection test.
  • The percentage of visits for influenza-like illness as reported by ILINet providers in Texas exceeded the regional baseline and the state baseline.
  • Two influenza-associated pediatric deaths were reported.
  • One institutional outbreak was reported.

Reports from Health Service Regions

Reports were received from all Health Service Regions (HSRs) for week 9. HSRs 1, 8, 9/10, and 11 reported the same level of flu activity compared to week 8. HSRs 2/3, 4/5N, 6/5S, and 7 reported a decreased level of flu activity compared to week 8.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 9, nine hospital laboratories and public health agencies across Texas reported conducting a total of 1,238 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). Fifty-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.

 

Influenza Testing Results Reported by Texas NREVSS Laboratories
Testing Information Week 9
No. of specimens tested

1,238

No. of positive specimens (%)

209 (16.9%)

Positive specimens by type/subtype

Influenza A

120 (57.4%)

          Subtyping performed

42 (35%)

                 A (2009 H1N1)

11 (26.2%)

                 A  (Seasonal H1)

0 (0%)

                 A (H3N2)

31 (73.8%)

           Subtyping not performed

78 (65%)

Influenza B

89 (42.6%)

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

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 9 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) 4 403 7 1.74%
HMPV 4 335 24 7.16%
Parainfluenza 4 402 8 1.49%
Rhinovirus 3 319 51 15.99%
RSV 17 1,159 185 15.96%

Antigenic Characterization

Since October 3 2010, CDC has reported antigenic characterization results from 6 influenza A (H1N1) viruses, 21 influenza A (H3N2) viruses, and 12 influenza B viruses received from the Texas Department of State Health Services (DSHS) Laboratory.

  • Influenza A (H1N1) [6]
    Six viruses were 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) [21]
    Twenty-one viruses were 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 [12]
    • Victoria lineage [12]
      Twelve 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

No Texas influenza isolates tested so far in the 2010-2011 influenza season have demonstrated resistance to oseltamivir or zanamivir. Resistance to the adamantanes has been detected in most of the 2009 influenza A (H1N1) and influenza A (H3N2) isolates tested over the last two influenza seasons. For more information on antiviral medications please see http://www.cdc.gov/flu/professionals/antivirals/index.htm.

Influenza–Associated Pediatric Mortality

Two influenza-associated pediatric deaths were reported for week 9. The first death occurred during week 7 (week ending February 19, 2011) in an 11-year-old resident of HSR 2/3 with underlying medical conditions. A specimen collected from the child was positive for influenza A (not subtyped) by rapid test. It is unknown whether the child was vaccinated for influenza for the current season.

The second death occurred during week 7 in a 17-year-old resident of HSR 8 with underlying medical conditions. A specimen obtained from the child was positive for 2009 influenza A (H1N1) by PCR test. The child was not vaccinated for influenza during the current season.  Nine influenza-associated pediatric fatalities have been reported in Texas since the beginning of the 2010-2011 influenza season. Eight deaths have been reported during calendar year 2011. Please see the table below for more information.

 

Influenza-Associated Pediatric Deaths in Texas Residents by Type, Subtype, and Month
Month of
Pediatric Death
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

2010

October 0 0 0 1 1 0 1
November 0 0 0 0 0 0 0
December 0 0 0 0 0 0 0

2011

January 0 0 1 1 2 1 3
February 2 0 1 2 5 0 5
March 0 0 0 0 0 0 0
Total 2 0 2 4 8 1 9

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 influenza-associated deaths were reported in pregnant or postpartum women during week 9.

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

One outbreak of influenza was reported in a long-term care facility in HSR 2/3 during week 9. Seven of the ill persons were positive for influenza A (not subtyped) by rapid test. All residents had been vaccinated for the current influenza season.  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-four 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 9. Of the 64 providers who saw patients, 53 (83%) saw at least one patient with ILI. Of all patient visits during this week, 6.23% 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
(3/10/2011 3:00:00 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 97 375  375  209  55 27 1041 37881 2.75%
2011-41 96  400 389  193 53 19 1054 37677 2.80%

2011-42

97

374

443

202

36

22

1077

38758

2.78%

2011-43

95

395

429

188

59

37

1109

37514

2.96%

2011-44

98

398

525

191

66

29

1209

38431

3.15%

2011-45

96

437

553

189

67

35

1281

38838

3.30%

2011-46

93

372

471

181

46

35

1105

36536

3.02%

2011-47

89

429

309

153

36

27

954

27258

3.50%

2011-48

92

504

438

199

75

34

1250

36096

3.46%

2011-49

91

306

540

219

43

24

1132

34985

3.24%

2011-50

86

395

605

218

67

27

1312

33988

3.86%

2011-51

79

408

555

293

85

42

1383

26254

5.27%

2011-52

79

397

372

341

89

51

1250

28849

4.33%

2011-01

88

499

520

307

80

55

1461

33407

4.37%

2011-02

88

576

771

365

99

56

1867

34458

5.42%

2011-03

90

680

1029

491

145

54

2399

38850

6.18%

2011-04

93

725

1363

678

161

63

2990

41703

7.17%

2011-05

92

609

1329

655

147

62

2802

33580

8.34%

2011-06

86

586

1380

883

195

55

3099

38997

7.95%

2011-07

81

644

1907

1138

326

86

4101

41316

9.93%

2011-08

81

697

1394

734

175

57

3057

37748

8.10%

2011-09

64

374

496

283

81

90

1324

21267

6.23%

ILI Percentage Chart

ILI Data 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

 

International Influenza Activity

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

  
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 June 03, 2011