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Influenza -- United States, August-November 1983

In November 1983, a community outbreak of influenza type A(H3N2) began in Fairbanks, Alaska. A single type A(H1N1) influenza isolate has been reported from Alabama, and sporadic influenza B isolates have been reported among young children in Texas and West Virginia. Details of laboratory-diagnosed influenza infections in the United States since August follow: Influenza type A(H3N2): An outbreak of influenza was reported in Fairbanks, Alaska, beginning in early November. Type A(H3N2) influenza virus was isolated from a 28-year-old female resident of Fairbanks on November 7, and subsequently, from three other adults in Fairbanks. According to reports from physicians and clinics in Fairbanks, most of the influenza-like illness has been seen among adults of working age. Relatively little activity has been noted among children, and school absentee rates have not increased. In early December, increased influenza-like illness was reported from Anchorage and Bethel.

Serologic evidence of A(H3N2) virus infection has been detected in a 20-year-old woman with pneumonia, originally admitted to a North Carolina hospital on October 6. The woman delivered a healthy but premature child by Cesarean section during the course of her respiratory illness; she subsequently died, and a post mortem showed evidence of extensive interstitial pneumonia. All cultures for fungi, bacteria, and viruses during her hospitalization were negative. The patient's husband, who had symptoms similar to the woman's prehospitalization symptoms, recovered without complications. No evidence of increased respiratory illness had been noted in the community.

In Nashville, Tennessee, an isolate of influenza A(H3N2) and evidence of concurrent rotavirus infection were obtained on August 19 from a 1-year-old child with croup. There was no evidence of increased influenza-like illness in Nashville. Influenza type A(H1N1): Influenza type A(H1N1) virus was isolated from specimens collected on October 18 from a 15-year-old male in Mobile, Alabama. No increase in influenza-like illness was noted in Mobile. Influenza type B: In Nashville, Tennessee, isolates of influenza type B virus were obtained on September 22 from a 9-month-old child and a 6-month-old child with influenza-like illnesses.

In Houston, Texas, isolates of influenza type B have been obtained during November from three children, all younger than 1 year old.

In Huntington, West Virginia, an isolate of influenza type B was obtained from a 5-year-old female who had onset of illness on November 14. After remaining febrile for a week, she was hospitalized, and the cause of illness was investigated. No evidence of bacterial infection was found, and she recovered uneventfully. There has been increased respiratory illness in the Huntington area during November.

All the above influenza B virus isolates appear to be from sporadic cases, although laboratory evidence of more widespread respiratory illness associated with other viral agents has been obtained in Huntington, West Virginia, and Houston, Texas, recently. Reported by D Thieman, MD, R Howard, Tanana Valley Clinic, Fairbanks, D Ritter, J Middaugh, MD, State Epidemiologist, Alaska State Dept of Health and Social Svcs; C Van den Horst, MD, D Achtellik, MD, M Cohen, MD, J Bowdre, PhD, School of Medicine, University of North Carolina--Chapel Hill, F Croud, PhD, N McCormack, MD, MP Hines, DVM, State Epidemiologist, North Carolina State Dept of Human Resources; M Kervina, P Wright, MD, Vanderbilt Medical School, Nashville, S Fricker, R Hutcheson, Jr, MD, State Epidemiologist, Tennessee State Dept of Public Health; W Birch, DVM, State Epidemiologist, Alabama State Dept of Public Health; P Glezen, MD, Baylor School of Medicine, Houston, CE Alexander, MD, Acting State Epidemiologist, Texas State Dept of Health; R Belshe, MD, Marshall University, Huntington, L Haddy, MS, State Epidemiologist, West Virginia State Dept of Health; Div of Field Svcs, Epidemiology Program Office, WHO Collaborating Center for Influenza, Influenza Br, Div of Viral Diseases, Center for Infectious Diseases, CDC.

Editorial Note

Editorial Note: It is not possible with available information to determine whether influenza activity during the 1983-1984 season will be dominated by one virus subtype, as frequently occurs, or whether each of the recently active subtypes will play a substantial role as they did last season. Physicians should keep in mind that the drug, amantadine, which is a supplemental measure for preventing influenza A infection, is ineffective in preventing or treating type B infections. Administration of vaccine to persons at high risk (1) should continue to be promoted. A limited supply of a new brochure, "What You Should Know About Influenza and Flu Shots" is available to persons concerned with educating the public about control and treatment of influenza. Requests for single copies should be sent to the Influenza Branch, CDC.

Reference

  1. ACIP. Influenza vaccines, 1983-1984. MMWR 1983;32:333-7.

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