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Epidemiologic Notes and Reports Update: Influenza Activity -- United States, Worldwide

United States

On November 6, a 62-year-old resident of Tucson, Arizona, had onset of a febrile respiratory illness with exacerbation of his underlying chronic obstructive pulmonary disease. He was hospitalized on November 7, and a nasopharyngeal swab was collected on the day of admission. Type A influenza virus was confirmed by rapid indirect fluorescent antibody staining, and treatment with amantadine began on the same day. The patient recovered from his acute respiratory illness and was discharged to another hospital for treatment of an unrelated problem. He had not traveled before his illness, and influenza had not been previously identified in Arizona this season. Subsequent testing identified the virus isolate as type A(H3N2). This is the first report of this subtype from the United States this season.

Eighteen states and the District of Columbia have now reported isolates of type A(H1N1) influenza virus (Figure 3). Most isolates have been obtained from children and young adults. Two states, California and Texas, have reported isolates of type B influenza from sporadically occurring cases. Worldwide

USSR. Reports from the USSR indicate that during the last week of October acute respiratory disease morbidity reached epidemic levels in 43% of USSR cities (26 of 60) that have surveillance for influenza-like illness. Influenza A(H1N1) and A(H3N2) viruses have been isolated in some cities in the USSR, and there is also preliminary serological evidence of influenza B virus in the country.

Other Reports. In September, an outbreak in a boys' boarding school in England affected about one-third of the students. The outbreak ended within 10 days; influenza A(H1N1) virus was isolated from one student. In November, isolates of A(H1N1) were reported in association with sporadically occurring cases in the German Democratic Republic, the Federal Republic of Germany, and the Democratic Peoples Republic of Korea. Serologic testing implicated influenza A(H1N1) in sporadically occurring cases in France and Norway during November and in outbreaks of influenza-like illness in Jamaica during October.

Influenza type A(H3N2) has been reported in association with sporadically occurring cases in the Democratic Peoples Republic of Korea.

Between late September and early November, influenza B virus was isolated from three children during an outbreak in Panama and from two patients with sporadically occurring cases in Senegal. Serologic testing has also implicated influenza B in sporadically occurring cases in France.

In Turkey, widespread outbreaks of clinically diagnosed influenza among children have forced some schools to close. Reported by State and Territorial Epidemiologists; State Laboratory Directors; E Petersen, MD, L Minnich, G Ray, MD, University Medical Center, Tucson, Arizona; G Meiklejohn, MD, University of Colorado Medical Center; J Critchon, MD, Helena, Montana; National Influenza Centers, Microbiology and Immunology Support Svcs, World Health Organization, Geneva; AN Slepushkin, V Zdhanov, Ivanovsky Institute of Virology, Academy of Medical Sciences of the USSR, Moscow; WHO Collaborating Center for Influenza, Influenza Br, Div of Viral Diseases, Center for Infectious Diseases, CDC.

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