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Update: Influenza Activity -- United States, Worldwide

UNITED STATES

Reports of influenza virus isolates, primarily representing sporadic cases, have begun to increase in the United States. Through January 13, 1986, 16 states have reported influenza isolates this season; 12 states have reported type B isolates; 10 have reported type A(H3N2); and one state, Hawaii, has reported type A(H1N1) (Figure 2).

Arizona, Illinois, Minnesota, South Carolina, and Utah recently reported their first influenza virus isolates this season from patients who became ill in late December or early January. Type B influenza virus was reported from Arizona, South Carolina, and Utah; both type B and A(H3N2) viruses were reported from Illinois and Minnesota. In Colorado, where type A(H3N2) virus was isolated earlier this season, type B virus has now been reported. In Pennsylvania, where type B virus had been isolated, type A(H3N2) virus isolates have now been reported.

Alaska, the only state to report widespread outbreaks of influenza-like illness through December, reported a decrease to regional outbreaks for the week ending January 4. Nationwide, reports of influenza-like illness* and reports of deaths associated with pneumonia and influenza from 121 U.S cities have remained below the levels normally associated with extensive outbreaks.

Outbreaks of influenza A(H3N2) in two long-term-care facilities in upstate New York have been reported. The first occurred in a facility housing approximately 260 elderly residents, 15 of whom developed influenza-like illnesses between December 29, 1985, and January 3, 1986; throat cultures from five ill residents yielded influenza A(H3N2) viruses. The second outbreak began during the second week of January in a 330-bed nursing home. By January 10, approximately 30 residents had developed influenza-like illnesses. Preliminary results of viral cultures indicate that influenza type A(H3N2) virus also caused this outbreak. These are the first reported influenza outbreaks affecting elderly persons in U.S. residential health-care facilities this season. WORLDWIDE

From September through December 1985, influenza virus types A(H3N2), A(H1N1), and B were isolated from various parts of the Northern Hemisphere and the tropics. Type A(H3N2) isolates have usually been associated with sporadic activity, although several countries reported outbreaks. Sporadic cases of type B influenza were reported from several countries, while type A(H1N1) was isolated only from sporadic cases in China and Hong Kong.

Type A(H3N2). Widespread outbreaks of type A(H3N2) influenza were reported in Japan, beginning in mid-October. In England, an explosive outbreak affecting approximately 50% of students occurred in a boarding school. Localized outbreaks were documented in Czechoslovakia. In Brazil, localized outbreaks were reported among the general population of Rio de Janeiro during October, but type A(H3N2) isolates from other parts of the country were associated only with sporadic cases. Jamaica, China, Switzerland, Italy, the German Democratic Republic, and the Soviet Union also reported sporadic isolates of type A(H3N2) viruses.

Type B. Isolates of type B virus associated with sporadic activity have been reported from Brazil, China, Korea, India, and Poland.

Type A(H1N1). In most parts of the world, influenza type A(H1N1) has circulated at very low levels since early 1984. In mainland China, however, more than 70% of influenza viruses isolated from May to October 1985 were type A(H1N1), although the level of activity has remained low. A few type A(H1N1) viruses have also been isolated in Hong Kong. Reported by J Wilkinson, MD, Good Samaritan Medical Center, Phoenix, D Woodall, Health Svcs Laboratory, GG Caldwell, MD, State Epidemiologist, Arizona Dept of Health Svcs; B Haslam, Bureau of Epidemiology, F Urry, PhD, State Public Health Lab, CR Nichols, MPA, State Epidemiologist, Utah Dept of Health; E Saxton, PhD, Viral Laboratory University of Chicago, R Murphy, Virology Laboratory, BJ Francis, MD, State Epidemiologist, Illinois Dept of Public Health; D Stiepan, MPH, H Markowitz, MD, State Laboratory Director, J Braun, MS, MT Osterholm, PhD, State Epidemiologist, Minnesota Dept of Health; A DiSalvo, MD, State Public Health Laboratory Director, RV Parker, DVM, State Epidemiologist, South Carolina Dept of Health; G Meiklejohn, MD, University of Colorado, Denver, SW Ferguson, PhD, State Epidemiologist, Colorado Dept of Health; J Schivers, Regional Clinical Laboratory of Pennsylvania, Erie, B Kleeger, PhD, State Public Health Laboratory, EJ Witte, VMD, State Epidemiologist, Pennsylvania State Dept of Health; DL Morse, MD, State Epidemiologist, New York State Dept of Health; participating physicians of the American Academy of Family Physicians; Virus Diseases Unit, World Health Organization, Geneva, Switzerland; Statistical Svcs Br, Div of Surveillance and Epidemiologic Studies, Div of Field Svcs, Epidemiology Program Office, WHO Collaborating Center for Influenza, Influenza Br, Div of Viral Diseases, Center for Infectious Diseases, CDC. *Cases reported by those members of the American Academy of Family Physicians Research Panel who serve as sentinel physicians for influenza.

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