Flu season gains momentum, especially in South

Wednesday, December 4, 2013
By Paul Martin

Lisa Schnirring
CIDRAP News
Dec 03, 2013

Flu season in the United States is slowly gaining steam, with markers rising above baselines in some southern states, though activity is still low for the country overall, the Centers for Disease Control and Prevention (CDC) said yesterday.

Overall, the percentage of respiratory specimens that tested positive for flu rose for the fourth consecutive week, and increased from 7.6% to 7.9% for the week ending Nov 23. The CDC is seeing wide variation, however, from 1.5% in states reporting little flu circulation to 13.2% in the southeastern states, which are the hot spots so far.

The CDC said 2 of its 10 regions are above their baselines for clinic visits for flulike illness—the ones that include the south central and southeastern states.

Six states are reporting regional geographic flu activity, up from four reported the previous week. They are Alabama, Florida, Kentucky, Mississippi, Texas, and Utah. Six of the 10 states reporting local flu activity are in the south or southeastern part of the country.

Deaths from pneumonia and flu remained below the seasonal baseline, and no new pediatric flu fatalities were reported, keeping the total reported so far this season at two. The CDC said the first data on this season’s flu hospitalizations will appear Dec 6 in its next weekly flu report.

All three seasonal flu strains have been detected in the United States so far, but 87.7% of the positive tests involve influenza A. Of subtyped A strains, 94.6% were the 2009 H1N1 virus and 5.4% were H3N2. The CDC said antiviral sensitivity testing has identified two more 2009 H1N1 samples that are resistant to oseltamivir (Tamiflu), raising the total so far this year to six.

Elsewhere in North America
Canada’s flu activity also continued to increase for the week ending Nov 23, according to a Nov 29 report from the Public Health Agency of Canada (PHAC). The country’s level of clinic visits for flulike illness increased after 4 weeks of remaining stable. Three regions—all in Ontario—are reporting localized flu activity, and 20 regions from six different provinces reported sporadic activity.

PHAC said the percentage of respiratory samples testing positive for flu continues to increase, with the nation’s overall level at 2.2%.

As in the United States, most of the flu viruses detected in Canada so far are influenza A, and most of those that have been subtyped are the 2009 H1N1 strain. So far no oseltamivir-resistant samples have been detected.

In Mexico, flu activity has increased slightly, with 9.5% of respiratory samples testing positive for influenza over the 4 most recent reporting weeks, according to a Dec 2 update from the Pan American Health Organization (PAHO). Of those samples, about 72% were influenza A, of which nearly 61% were the 2009 H1N1 virus.

European activity
In Europe, all 28 countries that submitted flu surveillance data for the week ending Nov 23 reported low-intensity activity, the European Centre for Disease Prevention and Control (ECDC) said its Nov 29 update. So far there is no sign of sustained flu activity in the region, it added.

Countries reporting sporadic activity were Denmark, France, Ireland, Norway, Spain, Sweden, and Scotland. Increasing trends were reported by health officials in Bulgaria, Estonia, Poland, and Northern Ireland, according to the ECDC.

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