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All data are preliminary and may change as more reports are received.
During week 47 (November 21-27, 2010), influenza activity in the United States remained relatively low overall, but increased slightly in the Southeast.
Of the 3,430 specimens tested by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories and reported to CDC/Influenza Division, 366 (10.7%) were positive for influenza.The proportion of deaths attributed to pneumonia and influenza (P&I) was below the epidemic threshold. No influenza-associated pediatric deaths were reported. The proportion of outpatient visits for influenza-like illness (ILI) was 1.9%, which is below the national baseline of 2.5%. One of the 10 regions (Region 4) reported ILI above region-specific baseline levels; one state experienced high ILI activity; one state experienced low ILI activity, and 48 states experienced minimal ILI activity.The geographic spread of influenza in one state was reported as regional, Puerto Rico and nine states reported local activity; the District of Columbia, Guam, the U.S. Virgin Islands, and 33 states reported sporadic activity; and seven states reported no influenza activity.HHS Surveillance Regions*Data for current weekData cumulative since October 3, 2010 (Week 40)Out-patient ILI†% positive for flu‡Number of jurisdictions reporting regional or widespread activity§A (H3)2009 A (H1N1)A(Subtyping not performed)BPediatric DeathsWHO and NREVSS collaborating laboratories located in all 50 states and Washington D.C. report to CDC the number of respiratory specimens tested for influenza and the number positive by influenza type and subtype. The results of tests performed during the current week are summarized in the table below.
Positive specimens by type/subtypeThe District of Columbia and 44 states from all 10 surveillance regions have reported laboratory-confirmed influenza this season. Region 4 in the Southeastern United States has accounted for 1,231 (69.7%) of all 1,766 reported influenza viruses this season, including 680 (88.2%) of the 771 influenza B viruses.
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This system tracks weekly counts of laboratory-confirmed influenza-associated hospitalizations and deaths and was implemented on August 30, 2009, during the 2009 pandemic, and ended on April 4, 2010. AHDRA surveillance during the 2010-11 season is being continued on a voluntary basis and 11 jurisdictions reported during week 47. From October 3-November 27, 2010, 271 laboratory-confirmed influenza associated hospitalizations and four laboratory-confirmed influenza associated deaths were reported to CDC.
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CDC has antigenically characterized 18 influenza viruses [four 2009 influenza A (H1N1) viruses, eight influenza A (H3N2) viruses, and six influenza B viruses] collected by U.S. laboratories since October 1, 2010.
Testing of 2009 influenza A (H1N1), influenza A (H3N2), and influenza B virus isolates for resistance to neuraminidase inhibitors (oseltamivir and zanamivir) is performed at CDC using a functional assay. Additional 2009 influenza A (H1N1) clinical samples are tested for a single known mutation in the neuraminidase protein of the virus that confers oseltamivir resistance (H275Y). The data summarized below combine the results of both test methods and includes samples that were tested as part of routine surveillance purposes; it does not include diagnostic testing specifically done because of clinical suspicion of antiviral resistance.
High levels of resistance to the adamantanes (amantadine and rimantadine) persist among 2009 influenza A (H1N1) and A (H3N2) viruses (the adamantanes are not effective against influenza B viruses) circulating globally. As a result of the sustained high levels of resistance, data from adamantane resistance testing are not presented weekly in the table below.
Samples tested (n)Resistant Viruses,Number (%)Samples tested (n)Resistant Viruses, Number (%)
To prevent the spread of antiviral resistant virus strains, CDC reminds clinicians and the public of the need to continue hand and cough hygiene measures for the duration of any symptoms of influenza, even while taking antiviral medications. Additional information on antiviral recommendations for treatment and chemoprophylaxis of influenza virus infection is available at http://www.cdc.gov/flu/antivirals/index.htm.
During week 47, 6.0% of all deaths reported through the 122-Cities Mortality Reporting System were due to P&I. This percentage was below the epidemic threshold of 7.2% for week 47.
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No influenza-associated pediatric deaths were reported to CDC during week 47.
One death, associated with an influenza A virus for which the subtype was not determined, occurring during the 2010-2011 season has been reported.
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The Influenza Hospitalization Network (FluSurv-NET) conducts surveillance for population-based, laboratory-confirmed influenza-related hospitalizations in children (persons younger than 18 years) and adults. The network covers over 80 counties in the 10 Emerging Infections Program (EIP) states (CA, CO, CT, GA, MD, MN, NM, NY, OR, and TN) and six additional states (ID, MI, OH, OK, RI and UT). FluSurv-NET estimated hospitalization rates will be updated every two weeks starting later this season.
Nationwide during week 47, 1.9% of patient visits reported through the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) were due to influenza-like illness (ILI). This percentage is below the national baseline of 2.5%.
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On a regional level, the percentage of outpatient visits for ILI ranged from 0.4% to 3.2% during week 47. One of the 10 regions (Region 4) reported a proportion of outpatient visits for ILI above their region-specific baseline levels.
Data collected in ILINet are used to produce a measure of ILI activity* by state. Activity levels are based on the percent of outpatient visits in a state due to ILI and are compared to the average percent of ILI visits that occur during spring and fall weeks with little or no influenza virus circulation. Activity levels range from minimal, which would correspond to ILI activity from outpatient clinics being below the average, to high, which would correspond to ILI activity from outpatient clinics being much higher than the average. Because the clinical definition of ILI is very general, not all ILI is caused by influenza; however, when combined with laboratory data, the information on ILI activity provides a clear picture of influenza activity in the United States.
During week 47, the following ILI activity levels were experienced:
One state (Georgia) experienced high ILI activity. While influenza-like illness is a non-specific term and may be caused by a variety of organisms, the increase in ILI in Georgia has occurred at the same time as a significant increase in the number of reported influenza B virus infections.New York City and one state (Alabama) experienced low ILI activity.Forty-eight states experienced minimal ILI activity (Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming).Data were insufficient to calculate an ILI activity level from the District of Columbia.
The influenza activity reported by state and territorial epidemiologists indicates geographic spread of influenza viruses, but does not measure the severity of influenza activity.
During week 47, the following influenza activity was reported:
Regional influenza activity was reported by one state (Georgia).Local influenza activity was reported by Puerto Rico and nine states (Alabama, Connecticut, Hawaii, Louisiana, Mississippi, New York, Oklahoma, Pennsylvania, and South Carolina).Sporadic influenza activity was reported by the District of Columbia, Guam, the U.S. Virgin Islands, and 33 states (Alaska, Arizona, Arkansas, California, Colorado, Florida, Idaho, Illinois, Indiana, Kansas, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, North Carolina, Ohio, Oregon, Rhode Island, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming).No influenza activity was reported by seven states (Delaware, Iowa, Maine, Nebraska, North Dakota, South Dakota, and Vermont).
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