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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 04

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2012 - 2013 Texas Influenza Surveillance Information Activity Report

  • The influenza (flu) activity level (geographic spread of influenza) for Texas was “widespread” and the ILINet Activity Level Indicator (intensity of influenza-like illness) was “high”.  For more information please see http://www.cdc.gov/flu/weekly/fluactivitysurv.htm and the national FluView weekly report at http://www.cdc.gov/flu/weekly/.
  • One thousand two hundred seventy-four (32.6%) 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 9.96%, which is above the Texas baseline.
  • Two influenza-associated pediatric deaths occurred.
  • No influenza or ILI outbreaks were reported.
  • No variant influenza viruses were reported.

Reports from Health Service Regions

Reports were received from all Health Service Regions (HSRs) for week 4. HSRs 8, 9/10, and 11 reported the same level of flu activity compared to week 3. HSRs 2/3 and 4/5N reported a decreased level of flu activity compared to week 3. All other HSRs reported an increased level of flu activity compared to week 3. 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 4, nine hospital laboratories and public health agencies across Texas reported conducting a total of 3,913 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). Seventy-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 4

No. of specimens tested

3,913

No. of positive specimens (%) 1,274 (32.6%)
Positive specimens by type/subtype
Influenza A

783 (61.5%)

          Subtyping performed

62 (7.9%)

                A (2009 H1N1)

0 (0%)

                A (other H1N1)

0 (0%)

                A (H3N2)

62 (100%)

           Subtyping not performed

721 (92.1%)

Influenza B

491 (38.5%)

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 4 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

999

11

1.10%

HMPV

6

688

6

0.87%

Parainfluenza

7

999

16

1.60%

Rhinovirus

4

673

110

16.34%

RSV

21

1303

377

28.93%

Antigenic Characterization
Since September 1, 2012, CDC has reported antigenic characterization results from one influenza A (H1N1) virus, nine influenza A (H3N2) viruses, and 13 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. This virus strain was included in the 2012-2013 influenza vaccine for the Northern Hemisphere.
  •  Influenza A (H3N2) [9] 
    Nine 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 [13]
    Thirteen viruses were related to B/Wisconsin/01/2010 (B/Yamagata lineage). This influenza B lineage was 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
No antiviral resistance results for Texas for the 2012-2013 season are available at this time.
For more information on antiviral medications please see http://www.cdc.gov/flu/professionals/antivirals/index.htm

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

 

Influenza–Associated Pediatric Mortality
   Two influenza-associated pediatric deaths occurred during week 4. The first death occurred in a 12-year-old resident of HSR 9/10 who had underlying medical conditions and whose influenza vaccination status was unknown. A specimen collected from the child was positive for influenza A (not subtyped) by rapid test. The second death occurred in a 6-year-old resident of HSR 7 who had underlying medical conditions and had not received an influenza vaccination. A specimen collected from the child was positive for influenza A (H3N2) by PCR test. Nine 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

2

3

December

0

0

1

0

1

1

2

2013
January

0

0

1

1

2

2

4

Total

0

0

3

1

4

5

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. 

School Closures and Institutional Outbreaks
No influenza or ILI outbreaks were reported during week 4.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-five 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 4. Of the 35 providers who saw patients, 32 (91%) saw at least one patient with ILI. Of all patient visits during this week, 9.96% 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
1/31/2013 3:35:00 PM

Week

# Reports

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

2012-40

60 224 331 179  34 7 775 278000 2.79%
2012-41 58 245 409 184 64 23 925 27637 3.35%
2012-42 61 213 361 113 31 13 731 27460 2.66%
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 63 337 581 223 60 21 1222 28045 4.36%
2012-46 60 337 563 196 52 13 1161 26929 4.31%
2012-47 61 364 664 346 122 32 1528 21576 7.08%
2012-48 61 350 650 377 109 40 1526 29232 5.22%
2012-49 63 449 986 466 120 44 2065 29257 7.06%
2012-50 62 479 1142 457 133 57 2268 28865 7.86%
2012-51 58 545 1385 753 225 77 2985 28696 10.40%
2012-52 58 502 1029 792 284 100 2707 22930 11.81%
2013-01 60 559 855 911 344 128 2797 26697 10.48%
2013-02 59 622 1137 1002 255 97 3113 32035

9.72%

2013-03 56 561 1385 685 167 77 2875 29822 9.64%
2013-04 35 240 835 735 202 66 2078 20861 9.96%

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;

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Last updated February 01, 2013