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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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2012-2013 DSHS Flu Report Week 15

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Current Flu Activity Report in PDF Format

Please note: The 2012-2013 influenza season began on September 30, 2012. For reports from the 2011-2012 season, please see http://www.dshs.state.tx.us/idcu/disease/influenza/surveillance/2012/.

During week 15 in Texas: 

  • The influenza (flu) activity level (geographic spread of influenza) for Texas was “sporadic” and the ILINet Activity Level Indicator (intensity of influenza-like illness) was “minimal”.  For more information please seehttp://www.cdc.gov/flu/weekly/fluactivitysurv.htm and the national FluView weekly report at http://www.cdc.gov/flu/weekly/.
  • 17 (2.9%) specimens tested by NREVSS laboratories in Texas were positive for influenza.
  • The percentage of visits for influenza-like illness (ILI) as reported by ILINet providers was 3.29%, which is below the Texas baseline.
  • One influenza-associated pediatric death was reported.
  • No influenza or ILI outbreaks were reported.
  • No variant influenza viruses were reported.

Reports from Health Service Regions

Reports were received from Health Service Regions (HSRs) 1, 2/3, 4/5N, 6/5S, 8, 9/10, and 11 during week 15. HSR 2/3 reported an increased level of flu activity compared to week 14. HSRs 4/5N, 8, 9/10, and 11 reported the same level of flu activity compared to week 14. All other HSRs reported a decreased level of flu activity compared to week 14. 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 15, seven hospital laboratories and public health agencies across Texas reported conducting a total of 579 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). Forty-six 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. 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)  

Influenza Testing Results Reported by Texas NREVSS Laboratories

Testing Information

Week 15

No. of specimens tested

579

No. of positive specimens (%) 17 (2.9%)
Positive specimens by type/subtype
Influenza A

8 (47.1%)

          Subtyping performed

0 (0%)

                A (H1N1)

3 (37.5%)

                A (H3N2)

0 (0%)

           Subtyping not performed

5(62.5%)

Influenza B

9 (52.9%)

Influenza results (antigen detection, culture, and PCR) from NREVSS reporters for the 2012–13 season are presented in the graph below.

NREVSS Positives Graph

Other Respiratory Viruses
The NREVSS system collects information on a variety of respiratory viruses in addition to influenza including parainfluenza virus, respiratory syncytial virus (RSV), rhinovirus, human metapneumovirus (HMPV), and respiratory adenovirus. The results from week 15 are summarized below. (Three non-NREVSS laboratories also contribute to the RSV data 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)

7

381

20

5.25%

HMPV

4

305

45

14.75%

Parainfluenza

6

380

17

4.47%

Rhinovirus

3

294

95

32.31%

RSV

18

368

28

7.61%

Antigenic Characterization
Since September 1, 2012, CDC has reported antigenic characterization results from 12 influenza A (H1N1) viruses, 53 influenza A (H3N2) viruses, and 38 influenza B viruses received from the Texas Department of State Health Services (DSHS) Laboratory. 

  • Influenza A (H1N1) [12]
    Twelve viruses was related to A/California/07/2009. This virus strain was included in the 2012-2013 influenza vaccine for the Northern Hemisphere.
  •  Influenza A (H3N2) [53] 
    Fifty-three viruses were related to A/Victoria/361/2011. This virus strain was included in the 2012-2013 influenza vaccine for the Northern Hemisphere.

  • Influenza B [38]
    • Thirty-three (86.8%) viruses were related to B/Wisconsin/01/2010 (Yamagata lineage). This influenza B lineage was included in the 2012-2013 influenza vaccine for the Northern Hemisphere.
    • Five (13.2%) viruses were related to B/Brisbane/60/2008 (Victoria lineage). This influenza B lineage was not included in the 2012-2013 influenza vaccine for the Northern Hemisphere.

 The national antigenic characterization and antiviral resistance testing results may be found in the CDC weekly flu report at http://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 October 1, 2013, 125 influenza viruses from Texas have been tested for antiviral resistance. The results are displayed below.

 

Oseltamivir

Zanamivir

Virus samples tested (n)

Resistant viruses, number (%)

Virus samples tested (n)

Resistant viruses, number (%)

2009 influenza A (H1N1)

12

0 (0%)

12

0 (0%)

Influenza A (H3N2)

65

1 (1.5%)

65

0 (0%)

Influenza B

48

0 (0%)

48

0 (0%)

For more information on antiviral medications please see http://www.cdc.gov/flu/professionals/antivirals/index.htm

Variant Influenza Viruses
    No variant or novel influenza viruses have been detected in Texas during 2012 or 2013.

    For more information on the evolving influenza A (H7N9) situation in China, please see CDC’s H7N9 website (http://www.cdc.gov/flu/avianflu/h7n9-virus.htm) and the World Health Organization’s Disease Outbreak News page (http://www.who.int/csr/don/en/). Healthcare providers should consult with their local health department if they see a patient with symptoms of influenza who traveled to China within 10 days of symptom onset.

Influenza–Associated Pediatric Mortality
   One influenza-associated pediatric death that occurred during week 3 (week ending January 19, 2013) was reported during week 15. The 17-year-old resident of HSR 7 had an underlying medical condition. The child’s influenza vaccination status is unknown. A specimen collected from the child was positive for influenza B by rapid test. Seventeen influenza-associated pediatric deaths have been reported in Texas during the 2012-2013 influenza season. 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
2012
October

0

0

0

0

0

0

0

November

0

0

1

0

1

4

5

December

0

0

1

0

1

2

3

2013
January

0

0

1

2

3

5

8

February

0

0

0

0

0

1

1

March

0

0

0

0

0

0

0

Total

0

0

3

2

5

12

17


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. 

School Closures and Institutional Outbreaks
No influenza or ILI outbreaks or school closures were reported during week 15. 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
Thirty-seven providers in Texas reported data to the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) on patients with influenza-like illness (ILI) and total patients seen for any reason during week 15. Of the 35 providers who saw patients, 19 (54%) saw at least one patient with ILI. Of all patient visits during this week, 3.29% were due to ILI. The ILI baseline for Texas is 4.77% for the 2012–2013 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. A “non-influenza week” is defined as a week that accounted for less than 2% of the season’s total number of specimens that tested positive for influenza.

Percentage of Visits for Influenza–Like Illness Reported by
the US Outpatient Influenza–Like Illness Surveillance Network (ILINet) in Texas
4/18/2013 3:45:00 PM

Week

# Reports

Age 0-4 Age 5-24 Age 25-49 Age 50-64 Age 65 + Total ILI Total Patients % ILI

2012-40

61 224 334 179  34 7 778 27892 2.79%
2012-41 59 246 411 185 64 23 929 27730 3.35%
2012-42 62 214 365 113 31 13 736 27556 2.67%
2012-43 61 296 392 167 44 26 925 26703 3.46%
2012-44 62 295 454 204 43 21 1017 26740 3.80%
2012-45 64 337 583 223 60 21 1224 28140 4.35%
2012-46 60 337 563 196 52 13 1161 26929 4.31%
2012-47 62 364 665 346 122 32 1529 21612 7.07%
2012-48 62 350 651 379 111 40 1531 29325 5.22%
2012-49 64 449 987 468 120 45 2069 29342 7.05%
2012-50 63 479 1142 457 133 58 2269 28952 7.84%
2012-51 59 545 1390 755 226 78 2994 28799 10.40%
2012-52 60 512 1048 792 284 100 2736 22959 11.92%
2013-01 63 588 878 926 347 131 2870 26986 10.64%
2013-02 62 640 1162 1016 257 97 3172 32487

9.76%

2013-03 64 684 1486 707 181 93 3151 31535 9.99%
2013-04 62 586 1262 804 283 76 3011 30294 9.94%
2013-05 62 453 938 529 171 77 2168 27993 7.74%
2013-06 63 330 736 425 112 51 1654 26808 6.17%
2013-07 62 313 599 349 102 30 1393 25968 5.36%
2013-08 59 211 485 327 89 34 1146 25836 4.44%
2013-09 61 254 501 321 73 42 1191 26085 4.57%
2013-10 59 286 527 313 79 32 1237 26963 4.59%
2013-11 56 271 311 270 65 56 973 23086 4.21%

2013-12

56 267 348 271 79 30 995 25875 3.85%
2013-13 52 225 344 212 51 22 854 23247 3.67%
2013-14 42 163 276 158 40 19 656 18515 3.54%
2013-15 37 171 272 157 55 20 675 20495 3.29%

ILI Percentage Chart

ILI Data Graph

National Influenza Activity

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


2012 - 2013 Texas Influenza Surveillance Information --- Flu Reports

For the week ending: 10/06/12; 10/13/12; 10/20/12; 10/27/12; 11/3/1211/10/12; 11/17/12; 11/24/12; 12/01/12; 12/08/12; 12/15/12; 12/22/12; 12/29/12; 1/5/13; 1/12/13; 1/19/13; 1/26/13; 2/7/132/14/13; 2/21/13; 2/28/13; 3/2/13; 3/9/13; 3/16/13;
3/23/13; 4/6/13; 4/13/13; 4/20/13;

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Last updated April 19, 2013