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Weekly Report: Influenza Summary Update

Week ending April 6, 2002-Week 14

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The following information may be quoted:

Synopsis:

During week 14 (March 31 - April 6, 2002)*, 123 (11.7%) of 1,052 respiratory specimens tested by World Health Organization (WHO) and National Respiratory Virus Surveillance System (NREVSS) laboratories were positive for influenza. The overall proportion of patient visits to sentinel physicians for influenza-like illness (ILI) was 1.4%, which is below the national baseline of 1.9%. The proportion of deaths attributed to pneumonia and influenza was 7.8%, which is below the epidemic threshold of 8.0% for week 14. Eight state and territorial health departments reported regional influenza activity, 33 reported sporadic activity, and 8 reported no influenza activity **.

Laboratory Surveillance*:

During week 14, WHO and NREVSS laboratories reported 1,052 specimens tested for influenza viruses, of which 123 (11.7%) were positive. Three (2%) were influenza A(H3N2) viruses, 32 (26%) were unsubtyped influenza A viruses, and 88 (72%) were influenza B viruses. During the past 3 weeks (weeks 12-14), the percentage of respiratory specimens testing positive for influenza ranged from 19% to 22% in the South Atlantic, West North Central, New England, and East North Central regions. In the Pacific, East South Central, West South Central, Mid-Atlantic, and Mountain regions the percentage of respiratory specimens testing positive for influenza ranged from 9% to 13%.

Since September 30, WHO and NREVSS laboratories have tested a total of 81,102 specimens for influenza viruses and 13,405 (16.5%) were positive. Of the 13,405 isolates identified, 12,521 (93%) were influenza A viruses and 884 (7%) were influenza B viruses. Three thousand eight hundred and thirty-four (31%) of the 12,521 influenza A viruses identified have been subtyped; 3,777 (99%) were H3 viruses and 57 (1%) were H1 viruses. The percentage of influenza isolates that are influenza type B has increased from 3% for the week ending February 23 to 72% for the week ending April 6. For the week ending April 6, influenza B viruses were the predominant viruses identified (57% to 100%) in 7 of 9 surveillance regions.

Influenza Virus Isolated
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Antigenic Characterization:

CDC has antigenically characterized 420 influenza viruses collected from U.S. laboratories since October 1: 279 influenza A(H3N2) viruses, 16 influenza A H1 viruses, and 125 influenza B viruses. The influenza A (H3N2) and A H1 viruses were similar to the vaccine strains A/Panama/2007/99 (H3N2) and A/New Caledonia/ 20/99 (H1N1), respectively. Ten of the H1 viruses are H1N2 viruses collected in Wisconsin (December 2001 through February 2002) and Pennsylvania (February 2002). Two additional H1N2 viruses have been identified from patient specimens collected during July and September in Texas and Nevada, respectively.

Click here for more information about influenza A(H1N2) viruses

Influenza B viruses currently circulating worldwide can be divided into 2 antigenically distinct lineages, B/Yamagata/16/88 and B/Victoria/2/87. Viruses of the B/Yamagata lineage have circulated widely since 1990. The B component of the current influenza vaccine belongs to the B/Yamagata lineage. Viruses of the B/Victoria lineage had not been identified outside of Asia between 1991 and March 2001. Since March 2001, B/Victoria lineage viruses have been identified in Canada, China, Hong Kong, India, Italy, Japan, the Netherlands, Oman, the Philippines, Thailand, and the United States (Arizona, California, Georgia, Idaho, Iowa, Hawaii, Maryland, Massachusetts, Michigan, New Jersey, New York, Pennsylvania, South Carolina, and Wisconsin). CDC has antigenically characterized 125 influenza B viruses received from U.S. laboratories and collected since October 1; 53 belonged to the B/Yamagata lineage and 72 belonged to the B/Victoria lineage. Of the 53 B/Yamagata lineage viruses, 15 were similar to the vaccine strain, B/Sichuan/379/99, and 38 showed somewhat reduced titers to ferret antisera produced against B/Sichuan/379/99. The B component of the current influenza vaccine is expected to provide lower levels of protection against viruses of the B/Victoria lineage.

Pneumonia and Influenza (P&I) Mortality Surveillance:

During week 14, the percentage of all deaths due to pneumonia and influenza as reported by the vital statistics offices of 122 U.S. cities was 7.8%. This percentage is below the epidemic threshold of 8.0% for week 14.

Pneumonia And Influenza Mortality

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Influenza-like Illness Surveillance *:

During week 14, 1.4% of patient visits to U.S. sentinel physicians were due to ILI. This is below the national baseline of 1.9%. On a regional level, the percentage of visits for ILI ranged from 0.3% to 3.2%.*** Due to wide variability in regional level data, it is not possible to calculate region-specific baselines and it is not appropriate to apply the national baseline to regional level data.

Bar Chart for Influenza-like Illness
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Influenza Activity as Assessed by State and Territorial Epidemiologists**:

Influenza activity was reported as regional in Maine, Maryland, Massachusetts, Michigan, Missouri, Ohio, South Carolina, and Tennessee. Thirty-three states, New York City, and Washington D.C. reported sporadic influenza activity, and 8 states reported no influenza activity. One state did not report.

U. S. map for Weekly Influenza Activity


* Reporting is incomplete for this week. Numbers may change as more reports are received.

** Influenza activity is defined as influenza-like illness and/or culture-confirmed influenza.

*** Surveillance Regions: New England (Connecticut, Maine, Massachusetts, New Hampshire, Vermont, Rhode Island); Mid-Atlantic (New Jersey, New York City, Pennsylvania, Upstate New York); East North Central (Illinois, Indiana, Michigan, Ohio, Wisconsin); West North Central (Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, South Dakota); South Atlantic (Delaware, Florida, Georgia, Maryland, North Carolina, South Carolina, Virginia, Washington, D.C., West Virginia); East South Central (Alabama, Kentucky, Mississippi, Tennessee); West South Central (Arkansas, Louisiana, Oklahoma, Texas); Mountain (Arizona, Colorado, Idaho, Montana, Nevada, New Mexico, Utah, Wyoming); Pacific (Alaska, California, Hawaii, Oregon, Washington)

Report prepared April 4, 2002

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