Update: Influenza Activity -- United States and Worldwide, 1992-93 Season

Influenza activity in the United States is monitored by CDC through surveillance systems maintained cooperatively with state and local health departments (1); in addition, CDC receives reports of worldwide influenza activity from international World Health Organization (WHO) collaborating laboratories and from WHO, Geneva. This report summarizes surveillance for influenza in the United States and worldwide during the 1992-93 season through December 5, 1992. United States

From October through November 28, 1992, state and territorial epidemiologists reported sporadic levels of influenza-like illness (ILI) or no activity; regional activity was first reported the week ending December 5 from Washington state. In addition, from October through December 5, family practitioners participating in the CDC sentinel physician surveillance system reported baseline levels of 1%-3% of patient visits attributed to ILI.

From October through December 5, Arizona, California, Louisiana, New Mexico, New York, Oregon, Texas, and Wisconsin reported sporadic isolates of influenza B; California, Hawaii, and Illinois reported sporadic influenza A viruses. Washington state reported the first culture-confirmed outbreak of influenza B, which was associated with an outbreak of ILI in a high school; the outbreak began the week ending December 5, when 12% of the students were absent. Type A influenza viruses have not yet been antigenically characterized, but antiserum to B/Panama/45/90 virus, the 1992-93 vaccine component, reacted well with tested influenza B viruses. Worldwide

Asia. In October and November, influenza B was isolated during school outbreaks in Japan. Indonesia and Thailand reported influenza A(H3N2) isolates.

Central and South America. During October, influenza A(H3N2) was isolated from sporadic cases in Trinidad. Chile continued to report serologic evidence of influenza A infection during October.

Europe. During October and November, influenza B was isolated from sporadic cases in France, Czechoslovakia, the Netherlands, and Portugal. One influenza B isolate was obtained from a school outbreak in Sweden in December. Influenza A(H3N2) was isolated from sporadic cases in two patients in northern Sweden and from one patient in the Netherlands; antigen was detected in two patients in southern France. Influenza A(H1N1) was isolated from one patient in the Netherlands in October. Germany and Finland reported serologic evidence of both influenza A and influenza B infections.

Oceania. During October, Papua New Guinea reported serologic detection of influenza A by immunofluorescence in specimens from three patients.

Reported by: World Health Organization National Influenza Centers. Communicable Diseases Div, WHO, Geneva. WHO Collaborating Center for Surveillance, Epidemiology, and Control of Influenza, Influenza Br, and Epidemiology Activity, Office of the Director, Div of Viral and Rickettsial Diseases, National Center for Infectious Diseases, CDC.

Editorial Note

Editorial Note: The Advisory Committee on Immunization Practices has recommended that, even after influenza activity has been documented in a community, influenza vaccination be offered to persons aged greater than or equal to 64 years, persons of any age who have chronic underlying health conditions that require regular physician follow-up (particularly heart or lung disease), and persons aged less than or equal to 18 years receiving chronic aspirin therapy (2). Protective levels of antibody may develop approximately 2 weeks following vaccination. Because early viral surveillance has indicated both influenza A and influenza B activity, continued culturing throughout the season for influenza strain surveillance is important. In addition, because amantadine is effective for prevention and treatment of influenza A only, physicians and other health-care providers should monitor local reports of influenza surveillance findings.

Weekly summaries of influenza surveillance data are available by computer to subscribers to the Public Health Network and to the public through the CDC Voice Information System, telephone (404) 332-4555.

References

1. Chapman LE, Tipple MA, Schmeltz LM, et al. Influenza -- United States, 1989-90 and 1990-91 seasons. In: CDC surveillance summaries (May 29). MMWR 1992;41(no. SS-3):35-46.

2. ACIP. Prevention and control of influenza: recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR 1992;41(no. RR-9).

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