Seasonal Flu 2008 - 2009

[Giuseppe]

Re: Seasonal Flu 2008 - 2009 --

Italy. VIROLOGIC SURVEILLANCE OF INFLUENZA (From Ministry of Health - February 5, 2009)

VIROLOGIC SURVEILLANCE OF INFLUENZA

February 4, 2009

Weekly Update: 5/09

[Original PDF Document (In Italian) at this link Ministero della Salute. Translation by IOH. EDITED.]


-- ITALY

It continues the collection of clinical samples by Influnet peripheal Network laboratories.

During current surveillance week, 163 clinical samples have been collected, of these 21 were Influenza virus positive.

Among them, 19 were Influenza virus type A (12 type H3). Two were Influenza B.

University of Genoa has collected eight samples positive for Respiratory Syncitial Virus (RSV).

Table below summarizes virologic surveillance results since the start of season (week 46-08) to date (week 5-09).

[ WEEK 46 - 47 - 48 - 49 - 50 - 51 - 52 - 1 - 2 - 3 - 4 - 5 - TOTAL POSITIVE ]

-- FLU A - 3 - 4 - 4 - 8 - 7 - 11 - 17 - 35 - 47 - 84 - 60 - 19 - 299
-- A (not yet subtyped) - ... - ... - ... - ... - ... - 2 - 2 - 13 - 11 - 9 - 4 - 7 - 48
-- A/H3N2 - 3 - 4 - 4 - 8 - 7 - 9 - 15 - 22 - 36 - 69 - 54 - 12 - 243
-- A/H1N1 - ... - ... - ... - ... - ... - ... - ... - ... - ... - 6 - 2 - ... - 8
-- FLU B - 0 - 0 - 2 - 0 - 1 - 1 - 0 - 1 - 0 - 0 - 2 - 2 - 9

-- TOT POSITIVE SAMPLES - 3 - 4 - 6 - 8 - 8 - 12 - 17 - 36 - 47 - 84 - 62 - 21 - 308


<table style="width: auto;"><tbody><tr><td></td></tr><tr><td style="font-family: arial,sans-serif; font-size: 11px; text-align: right;">From TABLES</td></tr></tbody></table>

<table style="width: auto;"><tbody><tr><td></td></tr><tr><td style="font-family: arial,sans-serif; font-size: 11px; text-align: right;">From TABLES</td></tr></tbody></table>

Phylogenetic tree for relation between A/(H3N2) HA1 portions in Italian isolations during 2008/2009 epidemic season compared with previous season isolates.

Current season H3N2 isolates evidently derived from A/Brisbane/10/2007 vaccine reference strain lineage, with the two amino acids changes (G50E e K140I) that differentiate from previous reference strain A/Wisconsin/67/2005. However, Italian isolates showed also to possess another important substitution (K173Q) at E antigenic site, reported also in the most recent reference strain A/Wisconsin/5/2008


-- FROM THE WORLD

- EUROPE

Influenza viruses circulation continues to rise; to date influenza virus subtype A/H3 is predominant. During current surveillance week 3779 clinical samples have been collecte: of these 1904 (50&#37 were influenza virus positive.

Among them 1824 were type A (803 H3, 59 H1 and 962 not yet typed) and 80 type B.

97 per cent of influenza A/(H1N1) isolates tested for antiviral resistance have been found to be oseltamivir resistant, but retained susceptibility to both zanamivir and adamantanes. All A/(H3N2) influenza virus isolates tested to date have been found to be susceptible both to oseltamivir and zanamivir but resistant to adamantanes.

Further informations at:

http://www.eiss.org/index.cgi

http://www.grog.org/

-- USA

Influenza virus circulation continues to rise. 3711 samples have been collected, of these 588 (15.8%) were influenza positive. Among them, 508 were type A (74 H1, 14 H3, 420 not yet subtyped). The remaining 80 were type B.

Influenza virus type A have been characterized as closely related to seasonal vaccine reference strains.

In addition, a human case of swine influenza virus type A/(H1N1) infection has been reported during surveillance week 03.

Further informations at:

http://www.cdc.gov/flu/

-
-----

[HenryN]

Re: Seasonal Flu 2008 - 2009 --

PA Influenza Weekly Report
Week ending January 31, 2009 (Week 04)

<HR id=main style="WIDTH: 526px" SIZE=2>
<TABLE cellSpacing=5 cellPadding=5 width=560 align=center bgColor=#ffff80 border=0><TBODY><TR><TD>Pennsylvania Influenza Activity Level Reported To CDC For Week 04:</TD><TD>

Regional

</TD></TR></TBODY></TABLE>
Levels of activity are
1) no activity;
2) sporadic: isolated laboratory-confirmed influenza cases or laboratory-confirmed outbreak in one institution, with no increase in activity;
3) local: increased influenza-like illness (ILI) in one region, or at least two institutional outbreaks (ILI or laboratory-confirmed influenza) in one region; virus activity no greater than sporadic in other regions;
4) regional: increased ILI activity or outbreaks (ILI or laboratory-confirmed influenza) in at least two but fewer than half of the regions in the state; and
5) widespread: increased ILI activity or outbreaks (ILI or laboratory-confirmed influenza) in at least half the regions in the state.


To see a map of US influenza activity levels for the preceding week (week 03), go to http://www.cdc.gov/flu/weekly/usmap.htm

<HR id=main>

Comparison of PA influenza case counts* for current season with case counts for the previous 5 seasons

*Patients with positive antigen, nucleic acid, and culture test results reported to Pennsylvania's electronic disease reporting system, PA-NEDSS

<HR id=main style="WIDTH: 562px" SIZE=2>

Influenza strains circulating in Pennsylvania by county*
(as of January 31, 2009)

<TABLE style="BORDER-RIGHT: medium none; BORDER-TOP: medium none; MARGIN: auto 6.75pt; BORDER-LEFT: medium none; BORDER-BOTTOM: medium none; BORDER-COLLAPSE: collapse" cellSpacing=0 cellPadding=0 align=left border=1><TBODY><TR style="HEIGHT: 17.5pt"><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: windowtext 1pt solid; WIDTH: 48.6pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; HEIGHT: 17.5pt" vAlign=top width=65 rowSpan=2>District
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 91.8pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; HEIGHT: 17.5pt" vAlign=top width=122 rowSpan=2>County
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 2in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; HEIGHT: 17.5pt" vAlign=top width=192 colSpan=2>A(H1N1)
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.75in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; HEIGHT: 17.5pt" vAlign=top width=72 rowSpan=2>A(H3N2)
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; HEIGHT: 17.5pt" vAlign=top width=84 rowSpan=2>A Unsub- typed
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 27pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; HEIGHT: 17.5pt" vAlign=top width=36 rowSpan=2>B
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.5in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; HEIGHT: 17.5pt" vAlign=top width=48 rowSpan=2>Total
</TD></TR><TR style="HEIGHT: 13.5pt"><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; HEIGHT: 13.5pt" vAlign=top width=96>Pending
antiviral resistance test results<?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-com:office:smarttags" /><ST1:STATE w:st="on"><ST1:PLACE w:st="on">?</ST1:PLACE></ST1:STATE>
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; HEIGHT: 13.5pt" vAlign=top width=96>Resistant to Oseltamivir
</TD></TR><TR><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: windowtext 1pt solid; WIDTH: 48.6pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=65 rowSpan=2>NW
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 91.8pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=122><st1:place w:st="on"><st1:City w:st="on">Erie</st1:City></st1:place>
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=96>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: red; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=96>1
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.75in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=72>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=84>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 27pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=36>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.5in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=48>1
</TD></TR><TR><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 91.8pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=122><st1:place w:st="on"><st1:City w:st="on">Warren</st1:City></st1:place>
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=96>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=96>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.75in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=72>2
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=84>1
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 27pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=36>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.5in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=48>3
</TD></TR><TR><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: windowtext 1pt solid; WIDTH: 48.6pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=65 rowSpan=8>NE
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 91.8pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=122><st1:place w:st="on"><st1:City w:st="on">Allentown</st1:City></st1:place>
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=96>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=96>*
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.75in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=72>1
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=84>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 27pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=36>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.5in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=48>1
</TD></TR><TR><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 91.8pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=122><st1:place w:st="on"><st1:City w:st="on">Bethlehem</st1:City></st1:place>
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=96>2
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=96>*
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.75in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=72>1
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=84>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 27pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=36>2
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.5in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=48>5
</TD></TR><TR><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 91.8pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=122>Carbon
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=96>2
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=96>*
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.75in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=72>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=84>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 27pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=36>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.5in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=48>2
</TD></TR><TR><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 91.8pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=122>Lehigh
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=96>19
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: red; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=96>1
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.75in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=72>2
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=84>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 27pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=36>2
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.5in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=48>24
</TD></TR><TR><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 91.8pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=122>Luzerne
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=96>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=96>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.75in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=72>1
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=84>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 27pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=36>1
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.5in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=48>2
</TD></TR><TR><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 91.8pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=122><st1:place w:st="on"><st1:City w:st="on">Lackawanna</st1:City></st1:place>
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=96>4
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=96>*
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.75in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=72>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=84>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 27pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=36>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.5in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=48>4
</TD></TR><TR><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 91.8pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=122><st1:place w:st="on"><st1:City w:st="on">Northampton</st1:City></st1:place>
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=96>8
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=96>*
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.75in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=72>3
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=84>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 27pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=36>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.5in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=48>11
</TD></TR><TR><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 91.8pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=122>Munroe
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=96>5
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=96>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.75in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=72>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=84>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 27pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=36>1
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.5in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=48>6
</TD></TR><TR><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: windowtext 1pt solid; WIDTH: 48.6pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=65 rowSpan=2>NC
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 91.8pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=122>Centre
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=96>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=96>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.75in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=72>1
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=84>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 27pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=36>3
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.5in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=48>4
</TD></TR><TR><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 91.8pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=122>Northumberland
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=96>1
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=96>*
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.75in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=72>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=84>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 27pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=36>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.5in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=48>1
</TD></TR><TR><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: windowtext 1pt solid; WIDTH: 48.6pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=65 rowSpan=4>SE
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 91.8pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=122>Berks
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=96>12
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=96>*
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.75in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=72>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=84>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 27pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=36>5
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.5in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=48>17
</TD></TR><TR><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 91.8pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=122>Bucks
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=96>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: red; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=96>1
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.75in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=72>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=84>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 27pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=36>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.5in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=48>1
</TD></TR><TR><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 91.8pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=122><st1:place w:st="on"><st1:City w:st="on">Chester</st1:City></st1:place>
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=96>1
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=96>*
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.75in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=72>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=84>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 27pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=36>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.5in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=48>1
</TD></TR><TR><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 91.8pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=122><st1:place w:st="on"><st1:City w:st="on">Philadelphia</st1:City></st1:place>
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=96>2
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=96>*
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.75in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=72>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=84>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 27pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=36>1
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.5in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=48>3
</TD></TR><TR><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: windowtext 1pt solid; WIDTH: 48.6pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=65 rowSpan=2>SC
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 91.8pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=122>Blair
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=96>1
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=96>*
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.75in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=72>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=84>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 27pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=36>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.5in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=48>1
</TD></TR><TR><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 91.8pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=122><st1:place w:st="on"><st1:City w:st="on">Fulton</st1:City></st1:place>
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=96>2
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=96>*
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.75in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=72>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=84>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 27pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=36>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.5in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=48>2
</TD></TR><TR><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: windowtext 1pt solid; WIDTH: 48.6pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=65 rowSpan=2>SW
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 91.8pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=122>Allegheny
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=96>1
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=96>*
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.75in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=72>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=84>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 27pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=36>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.5in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=48>1
</TD></TR><TR><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 91.8pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=122><st1:place w:st="on"><st1:City w:st="on">Butler</st1:City></st1:place>
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=96>3
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=96>*
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.75in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=72>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=84>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 27pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=36>0
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: #cccccc; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.5in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=48>3
</TD></TR><TR><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: windowtext 1pt solid; WIDTH: 1.95in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=187 colSpan=2>G. Total
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=96>63
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; BACKGROUND: red; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=96>3
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.75in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=72>11
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=84>1
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 27pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=36>15
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 0.5in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=48>93
</TD></TR></TBODY></TABLE>

*Based on a few specimens that are submitted to the State Lab by physicians and hospitals from across Pennsylvania.
<st1:State w:st="on"><st1:place w:st="on">?Influenza isolates which are confirmed by the state lab are sent to CDC for antiviral resistance testing and antigenic characterization. *Denotes i</st1:place></st1:State><st1:State w:st="on"><st1:place w:st="on">solates that are </st1:place></st1:State><st1:State w:st="on"><st1:place w:st="on">pending results from CDC. I</st1:place></st1:State><st1:State w:st="on"><st1:place w:st="on">t may take up to two months to collect results from CDC. For up-to-date data on antiviral resistance resistance testing visit the CDC website at http://www.cdc.gov/flu/weekly/.</st1:place></st1:State>
<st1:State w:st="on"><st1:place w:st="on"></st1:place></st1:State>

<HR id=main style="WIDTH: 562px" SIZE=2>

Number of people per county in PA with positive laboratory tests for influenza,* current season through Week 04

<TABLE class=Table cellSpacing=1 cellPadding=7 rules=none summary="Procedure Freq: One-Way Frequencies" frame=box><THEAD><TR><TH class=" b Header" scope=colgroup colSpan=3>COUNTY</TH></TR><TR><TH class="l b Header" scope=col>RESPJURIS</TH><TH class="r b Header" scope=col>Frequency</TH><TH class="r b Header" scope=col>Percent</TH></TR></THEAD><TBODY><TR><TH class="l RowHeader" scope=row>ADAMS</TH><TD class="r Data">5</TD><TD class="r Data">0.83</TD></TR><TR><TH class="l RowHeader" scope=row>ALLEGHENY</TH><TD class="r Data">66</TD><TD class="r Data">10.96</TD></TR><TR><TH class="l RowHeader" scope=row>ARMSTRONG</TH><TD class="r Data">4</TD><TD class="r Data">0.66</TD></TR><TR><TH class="l RowHeader" scope=row>BEAVER</TH><TD class="r Data">1</TD><TD class="r Data">0.17</TD></TR><TR><TH class="l RowHeader" scope=row>BERKS</TH><TD class="r Data">32</TD><TD class="r Data">5.32</TD></TR><TR><TH class="l RowHeader" scope=row>BLAIR</TH><TD class="r Data">6</TD><TD class="r Data">1.00</TD></TR><TR><TH class="l RowHeader" scope=row>BRADFORD</TH><TD class="r Data">1</TD><TD class="r Data">0.17</TD></TR><TR><TH class="l RowHeader" scope=row>BUCKS</TH><TD class="r Data">48</TD><TD class="r Data">7.97</TD></TR><TR><TH class="l RowHeader" scope=row>BUTLER</TH><TD class="r Data">17</TD><TD class="r Data">2.82</TD></TR><TR><TH class="l RowHeader" scope=row>CAMBRIA</TH><TD class="r Data">6</TD><TD class="r Data">1.00</TD></TR><TR><TH class="l RowHeader" scope=row>CAMERON</TH><TD class="r Data">1</TD><TD class="r Data">0.17</TD></TR><TR><TH class="l RowHeader" scope=row>CARBON</TH><TD class="r Data">4</TD><TD class="r Data">0.66</TD></TR><TR><TH class="l RowHeader" scope=row>CENTRE</TH><TD class="r Data">33</TD><TD class="r Data">5.48</TD></TR><TR><TH class="l RowHeader" scope=row>CHESTER</TH><TD class="r Data">11</TD><TD class="r Data">1.83</TD></TR><TR><TH class="l RowHeader" scope=row>CLARION</TH><TD class="r Data">1</TD><TD class="r Data">0.17</TD></TR><TR><TH class="l RowHeader" scope=row>CLEARFIELD</TH><TD class="r Data">1</TD><TD class="r Data">0.17</TD></TR><TR><TH class="l RowHeader" scope=row>CLINTON</TH><TD class="r Data">1</TD><TD class="r Data">0.17</TD></TR><TR><TH class="l RowHeader" scope=row>CRAWFORD</TH><TD class="r Data">3</TD><TD class="r Data">0.50</TD></TR><TR><TH class="l RowHeader" scope=row>CUMBERLAND</TH><TD class="r Data">2</TD><TD class="r Data">0.33</TD></TR><TR><TH class="l RowHeader" scope=row>DAUPHIN</TH><TD class="r Data">2</TD><TD class="r Data">0.33</TD></TR><TR><TH class="l RowHeader" scope=row>DELAWARE</TH><TD class="r Data">6</TD><TD class="r Data">1.00</TD></TR><TR><TH class="l RowHeader" scope=row>ELK</TH><TD class="r Data">3</TD><TD class="r Data">0.50</TD></TR><TR><TH class="l RowHeader" scope=row>ERIE</TH><TD class="r Data">19</TD><TD class="r Data">3.16</TD></TR><TR><TH class="l RowHeader" scope=row>FAYETTE</TH><TD class="r Data">4</TD><TD class="r Data">0.66</TD></TR><TR><TH class="l RowHeader" scope=row>FRANKLIN</TH><TD class="r Data">16</TD><TD class="r Data">2.66</TD></TR><TR><TH class="l RowHeader" scope=row>FULTON</TH><TD class="r Data">3</TD><TD class="r Data">0.50</TD></TR><TR><TH class="l RowHeader" scope=row>HUNTINGDON</TH><TD class="r Data">4</TD><TD class="r Data">0.66</TD></TR><TR><TH class="l RowHeader" scope=row>INDIANA</TH><TD class="r Data">3</TD><TD class="r Data">0.50</TD></TR><TR><TH class="l RowHeader" scope=row>JEFFERSON</TH><TD class="r Data">3</TD><TD class="r Data">0.50</TD></TR><TR><TH class="l RowHeader" scope=row>JUNIATA</TH><TD class="r Data">3</TD><TD class="r Data">0.50</TD></TR><TR><TH class="l RowHeader" scope=row>LACKAWANNA</TH><TD class="r Data">15</TD><TD class="r Data">2.49</TD></TR><TR><TH class="l RowHeader" scope=row>LANCASTER</TH><TD class="r Data">7</TD><TD class="r Data">1.16</TD></TR><TR><TH class="l RowHeader" scope=row>LAWRENCE</TH><TD class="r Data">1</TD><TD class="r Data">0.17</TD></TR><TR><TH class="l RowHeader" scope=row>LEBANON</TH><TD class="r Data">3</TD><TD class="r Data">0.50</TD></TR><TR><TH class="l RowHeader" scope=row>LEHIGH</TH><TD class="r Data">50</TD><TD class="r Data">8.31</TD></TR><TR><TH class="l RowHeader" scope=row>LUZERNE</TH><TD class="r Data">14</TD><TD class="r Data">2.33</TD></TR><TR><TH class="l RowHeader" scope=row>LYCOMING</TH><TD class="r Data">1</TD><TD class="r Data">0.17</TD></TR><TR><TH class="l RowHeader" scope=row>MCKEAN</TH><TD class="r Data">5</TD><TD class="r Data">0.83</TD></TR><TR><TH class="l RowHeader" scope=row>MERCER</TH><TD class="r Data">8</TD><TD class="r Data">1.33</TD></TR><TR><TH class="l RowHeader" scope=row>MIFFLIN</TH><TD class="r Data">5</TD><TD class="r Data">0.83</TD></TR><TR><TH class="l RowHeader" scope=row>MONROE</TH><TD class="r Data">29</TD><TD class="r Data">4.82</TD></TR><TR><TH class="l RowHeader" scope=row>MONTGOMERY</TH><TD class="r Data">35</TD><TD class="r Data">5.81</TD></TR><TR><TH class="l RowHeader" scope=row>MONTOUR</TH><TD class="r Data">3</TD><TD class="r Data">0.50</TD></TR><TR><TH class="l RowHeader" scope=row>NORTHAMPTON</TH><TD class="r Data">38</TD><TD class="r Data">6.31</TD></TR><TR><TH class="l RowHeader" scope=row>NORTHUMBERLAND</TH><TD class="r Data">1</TD><TD class="r Data">0.17</TD></TR><TR><TH class="l RowHeader" scope=row>PHILADELPHIA</TH><TD class="r Data">27</TD><TD class="r Data">4.49</TD></TR><TR><TH class="l RowHeader" scope=row>PIKE</TH><TD class="r Data">3</TD><TD class="r Data">0.50</TD></TR><TR><TH class="l RowHeader" scope=row>SCHUYLKILL</TH><TD class="r Data">4</TD><TD class="r Data">0.66</TD></TR><TR><TH class="l RowHeader" scope=row>SNYDER</TH><TD class="r Data">2</TD><TD class="r Data">0.33</TD></TR><TR><TH class="l RowHeader" scope=row>SOMERSET</TH><TD class="r Data">2</TD><TD class="r Data">0.33</TD></TR><TR><TH class="l RowHeader" scope=row>TIOGA</TH><TD class="r Data">1</TD><TD class="r Data">0.17</TD></TR><TR><TH class="l RowHeader" scope=row>UNION</TH><TD class="r Data">2</TD><TD class="r Data">0.33</TD></TR><TR><TH class="l RowHeader" scope=row>VENANGO</TH><TD class="r Data">2</TD><TD class="r Data">0.33</TD></TR><TR><TH class="l RowHeader" scope=row>WARREN</TH><TD class="r Data">3</TD><TD class="r Data">0.50</TD></TR><TR><TH class="l RowHeader" scope=row>WASHINGTON</TH><TD class="r Data">11</TD><TD class="r Data">1.83</TD></TR><TR><TH class="l RowHeader" scope=row>WAYNE</TH><TD class="r Data">2</TD><TD class="r Data">0.33</TD></TR><TR><TH class="l RowHeader" scope=row>WESTMORELAND</TH><TD class="r Data">15</TD><TD class="r Data">2.49</TD></TR><TR><TH class="l RowHeader" scope=row>YORK</TH><TD class="r Data">4</TD><TD class="r Data">0.66</TD></TR></TBODY></TABLE>

*Positive antigen, nucleic acid, and culture test results reported to Pennsylvania's electronic disease reporting system, PA-NEDSS


<HR id=main style="WIDTH: 510px; HEIGHT: 2px" SIZE=2>

Useful Links

US Centers for Disease Control and Prevention Weekly Influenza Surveillance Report:
http://www.cdc.gov/flu/weekly /
US Influenza Sentinel Provider Surveillance submission login page:
http://www2.ncid.cdc.gov/flu/
PA Department of Health, Focus on Flu:
http://www.health.state.pa.us/flu
Pennsylvania Pandemic Influenza Preparedness:
http://www.pandemicflu.state.pa.us
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<TABLE cellSpacing=0 cellPadding=0 border=0><TBODY><TR height=15><TD colSpan=2></TD></TR></TBODY></TABLE>

Content Last Modified on 2/5/2009 10:22:11 AM
http://www.dsf.health.state.pa.us/he...a=171&q=246529

[Gert van der Hoek]

Re: Seasonal Flu 2008 - 2009 --

EISS - Weekly Electronic Bulletin

Week 5 : 26/01/2009-01/02/2009 06 February 2009, Issue N? 291


Influenza activity increasing in eastern Europe while starting to decrease in the west

Summary: In week 05/2009, influenza activity continued to intensify across eastern Europe with most countries now reporting medium to high intensity. There are indications that activity may have peaked in countries in western Europe during week 5. Influenza A(H3) continues to be the predominant circulating virus and all the A(H3N2) viruses tested for antiviral resistance were resistant to M2 inhibitors but susceptible to neuraminidase inhibitors. Although low numbers of influenza B viruses are circulating, these have increased during week 05/2009 compared to previous weeks.

Epidemiological situation - week 05/2009: For the intensity indicator, the national network levels of influenza-like illness (ILI) and/or acute respiratory infection (ARI) were high in Austria, Estonia, Germany, Luxembourg, Poland, Sweden and Switzerland, medium in 18 countries, and low in the other six countries that reported this indicator. Of the 25 countries that reported medium to high influenza activity this week, two (Estonia and Lithuania) did so for the first time during the current season.

The majority of countries reporting increasing trends for the intensity indicator in week 05/2009 were located in eastern Europe, while most countries in western Europe reported unchanging or decreasing intensity compared to the previous week; only Belgium in the west reported a slight increase in activity compared to the previous week. For the geographical spread indicator, widespread influenza activity was reported in 15 countries covering most of Europe, regional activity in four countries, local activity in five countries and sporadic or no activity in the remaining seven countries. Definitions for the epidemiological indicators can be found here.

Cumulative epidemiological situation ? 2008-2009 season (weeks 40/2008-05/2009): Consultation rates for ILI and/or ARI above baseline levels, corresponding to influenza activity of medium intensity, were first reported in Portugal, Ireland and the UK (England and Northern Ireland) in week 49/2008, which peaked in weeks 52/2008 to 01/2009, and have since declined. Since week 49/2008 consultation rates rose above baseline levels in most European countries following a general west to east progression. Of the countries reporting in week 05/2009, Latvia, Serbia and Slovakia continued to report low intensity. High influenza intensity has been reported in Portugal (week 51/2008), Ireland (week 01/2009), Switzerland (week 02/2009), Austria, Denmark and Luxembourg (week 03/2009), Germany, Poland and Sweden (week 04/2009) and Estonia (week 05/2009), but this status has now declined for Denmark, Portugal and Ireland. Generally, the highest consultation rates have been in the 0-4 and 5-14 age groups, but Ireland, UK, Norway and Romania have reported their highest ILI consultation rates in the 15-64 age group.

Virological situation - week 05/2009: The total number of respiratory specimens collected by sentinel physicians in week 05/2009 was 2345, of which 999 (42.6%) were positive for influenza virus: 909 type A (388 subtype H3, 33 subtype H1 and 488 not subtyped) and 90 type B. In addition, 1056 non-sentinel source specimens (e.g. specimens collected for diagnostic purposes in hospitals) were reported positive for influenza virus: 1019 type A (165 subtype H3, six subtype H1 and 848 not subtyped) and 37 type B.

Cumulative virological situation ? 2008-2009 season (weeks 40/2008-05/2009): Of 14321 virus detections (sentinel and non-sentinel) since week 40/2008, 13768 (96%) were type A (5463 subtype H3, 333 subtype H1 and 7972 not subtyped) and 553 (4%) were type B. Based on the antigenic and/or genetic characterisation of 1563 influenza viruses, 1417 (90.7%) were reported as A/Brisbane/10/2007 (H3N2)-like, 73 (4.7%) as A/Brisbane/59/2007 (H1N1)-like, 19 (1.2%) as B/Florida/4/2006-like (B/Yamagata/16/88 lineage) and 54 (3.4%) as B/Malaysia/2506/2004-like (B/Victoria/2/87 lineage) (click here).

Eight countries have reported antiviral susceptibility data. Ninety-seven percent of influenza A(H1N1) viruses analysed were resistant to oseltamivir, but all those tested against zanamivir and M2 inhibitors were sensitive. All influenza A(H3N2) viruses tested were sensitive to oseltamivir and zanamivir, but resistant to M2 inhibitors. The small number of influenza B viruses analysed were sensitive to oseltamivir and zanamivir (click here).

Comment: Influenza activity has continued to increase in eastern Europe, following a west-to-east trend, with one additional country reporting high intensity. The three countries still reporting low activity are in eastern Europe. Influenza activity has peaked or has started to decline in most western countries.

Whilst type A(H3N2) continues to be the dominant influenza virus circulating in Europe, the number of type B viruses continues to show a rising trend. Antigenic and/or genetic characterisation indicates that, with the exception of the B/Victoria lineage viruses (3.4% of the viruses subjected to antigenic and/or genetic characterization), the viruses circulating are similar to the three components (A(H1N1), A(H3N2) and B/Yamagata lineage) included in the current influenza vaccine.

http://www.eiss.org/cgi-files/bulletin_v2.cgi

[Giuseppe]

Re: Seasonal Flu 2008 - 2009 --

Hong Kong: Close watch on influenza-like illness in primary school (2/6/2009) [CHP]

In response to media enquiries, a spokesman for the Centre of Health Protection (CHP) of the Department of Health said today (February 6) that CHP was investigating an influenza-like illness outbreak in a primary school in Mong Kok which was uploaded onto the CHP's website yesterday.

The latest development of the outbreak affected four boys and seven girls, aged 6 years old, since February 1, the spokesman said.

The symptoms were mild and no hospitalisation was required.

CHP will liaise with the school and the Education Bureau during the weekend to assess the latest situation and further course of actions, he added.
-

View Original Article

[HenryN]

Re: Seasonal Flu 2008 - 2009 --

2008-2009 Influenza Season Week ending January 31, 2009
(All data are preliminary and may change as more reports are received.)
Synopsis:

During week 4 (January 25-31, 2009), influenza activity continued to increase in the United States.

• Seven hundred ninety-two (16.2&#37 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 were positive for influenza.
• The proportion of deaths attributed to pneumonia and influenza (P&I) was below the epidemic threshold.
• One influenza-associated pediatric death was reported.
• The proportion of outpatient visits for influenza-like illness (ILI) was below the national baseline. ILI increased in eight of the nine regions compared to week 3, and the East North Central, East South Central, New England, and West South Central regions reported ILI at or above their region-specific baselines.
• Five states reported widespread influenza activity, 21 states reported regional activity; the District of Columbia and 13 states reported local influenza activity; and Puerto Rico and 11 states reported sporadic influenza activity.

<table class="table ie7_class362 ie7_class403" align="center" border="0" cellpadding="3" cellspacing="0"><caption>National and Regional Summary of Select Surveillance Components

</caption><tbody><tr valign="top"><th class="ie7_class405" rowspan="2" valign="bottom" width="85">

Region

</th><th class="ie7_class405" colspan="3" align="middle" nowrap="nowrap" width="300">Data for current week</th><th class="ie7_class405" colspan="5" align="middle" nowrap="nowrap" width="276">Data cumulative for the season</th></tr><tr valign="top"><th class="ie7_class405" align="middle" width="72">Out-patient ILI*</th><th class="ie7_class405" align="middle" width="72">% positive for flu†</th><th class="ie7_class405" align="middle" width="96">Number of jurisdictions reporting regional or widespread activity‡</th><th class="ie7_class405" align="middle" nowrap="nowrap" width="48">A (H1)</th><th class="ie7_class405" align="middle" nowrap="nowrap" width="48">A (H3)</th><th class="ie7_class405" align="middle" width="60">A Unsub-typed</th><th class="ie7_class405" align="middle" nowrap="nowrap" width="48">B</th><th class="ie7_class405" align="middle" width="72">Pediatric Deaths</th></tr><tr><td class="ie7_class404" align="left" width="85">Nation</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="72">Normal</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="72">16.2 % </td><td class="ie7_class404" align="middle" nowrap="nowrap" width="96">26 of 51 </td><td class="ie7_class404" align="middle" nowrap="nowrap" width="48">1135</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="48">170</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="60">2336</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="48">695</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="72">3</td></tr><tr><td class="ie7_class404" align="left" width="85">New England</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="72">Elevated</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="72">15.0 % </td><td class="ie7_class404" align="middle" nowrap="nowrap" width="96">5 of 6</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="48">69</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="48">15</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="60">139</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="48">31</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="72">0</td></tr><tr><td class="ie7_class404" align="left" width="85">Mid-Atlantic</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="72">Normal</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="72">8.8 % </td><td class="ie7_class404" align="middle" nowrap="nowrap" width="96">3 of 3</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="48">84</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="48">13</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="60">169</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="48">36</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="72">1</td></tr><tr><td class="ie7_class404" align="left" width="85">East North Central</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="72">Elevated</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="72">24.1 % </td><td class="ie7_class404" align="middle" nowrap="nowrap" width="96">2 of 5</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="48">139</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="48">32</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="60">33</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="48">37</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="72">0</td></tr><tr><td class="ie7_class404" align="left" width="85">West North Central</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="72">Normal</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="72">7.1 % </td><td class="ie7_class404" align="middle" nowrap="nowrap" width="96">1 of 7</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="48">77</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="48">7</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="60">117</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="48">19</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="72">0</td></tr><tr><td class="ie7_class404" align="left" width="85">South Atlantic</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="72">Normal</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="72">11.5 % </td><td class="ie7_class404" align="middle" nowrap="nowrap" width="96">7 of 9</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="48">163</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="48">25</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="60">337</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="48">175</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="72">0</td></tr><tr><td class="ie7_class404" align="left" width="85">East South Central</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="72">Elevated</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="72">7.8 % </td><td class="ie7_class404" align="middle" nowrap="nowrap" width="96">2 of 4</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="48">13</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="48">3</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="60">0</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="48">10</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="72">0</td></tr><tr><td class="ie7_class404" align="left" width="85">West South Central</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="72">Elevated</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="72">22.6 % </td><td class="ie7_class404" align="middle" nowrap="nowrap" width="96">1 of 4</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="48">183</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="48">9</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="60">1199</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="48">335</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="72">1</td></tr><tr><td class="ie7_class404" align="left" width="85">Mountain</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="72">Normal</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="72">13.6 % </td><td class="ie7_class404" align="middle" nowrap="nowrap" width="96">4 of 8</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="48">98</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="48">48</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="60">204</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="48">23</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="72">1</td></tr><tr><td class="ie7_class404" align="left" width="85">Pacific</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="72">Normal</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="72">5.0 % </td><td class="ie7_class404" align="middle" nowrap="nowrap" width="96">1 of 5</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="48">309</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="48">18</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="60">138</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="48">29</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="72">0</td></tr></tbody></table>
* Elevated means the % of visits for ILI is at or above the national or region-specific baseline
† National data is for current week; regional data is for the most recent three weeks.
‡ Includes all 50 states and the District of Columbia
U.S. Virologic Surveillance:

WHO and NREVSS collaborating laboratories located in all 50 states and Washington D.C. report to CDC the number of respiratory specimens tested for influenza each week. The results of tests performed during the current week and cumulative totals for the season are summarized in the table below.
<table class="table ie7_class362 ie7_class403" align="center" border="0" cellpadding="3" cellspacing="0"><tbody><tr><th class="ie7_class405" align="left" width="200">
</th><th class="ie7_class405" align="middle" nowrap="nowrap" width="150">Week 4</th><th class="ie7_class405" align="middle" nowrap="nowrap" width="150">Cumulative for the Season</th></tr><tr><td class="ie7_class404" align="left" width="200">No. of specimens tested</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="150">4895</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="150">81842</td></tr><tr><td class="ie7_class404" align="left" width="200">No. of positive specimens (%)</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="150">792 (16.2%)</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="150">4,336 (5.3%)</td></tr><tr><td class="ie7_class404" colspan="3" align="left">Positive specimens by type/subtype</td></tr><tr><td class="ie7_class404" align="left" width="170"> Influenza A</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="150">673 (85.0%)</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="150">3,641 (84.0%)</td></tr><tr><td class="ie7_class404" align="left" width="170"> A (H1)</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="150"> 151 (22.4%)</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="150"> 1,135 (31.2%)</td></tr><tr><td class="ie7_class404" align="left" width="170"> A (H3)</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="150"> 20 (3.0%)</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="150"> 170 (4.7%)</td></tr><tr><td class="ie7_class404" align="left" width="170"> A (unsubtyped)</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="150"> 502 (74.6%)</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="150"> 2,336 (64.2%)</td></tr><tr><td class="ie7_class404" align="left" width="170"> Influenza B</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="150">119 (15.0%)</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="150">695 (16.0%)</td></tr></tbody></table>
The District of Columbia and 46 states from all nine surveillance regions have reported laboratory-confirmed influenza this season.
<center>
View WHO-NREVSS Regional Bar Charts| View Chart Data | View Full Screen </center>Antigenic Characterization:

CDC has antigenically characterized 255 influenza viruses [142 influenza A (H1), 35 influenza A (H3) and 78 influenza B viruses] collected by U.S. laboratories since October 1, 2008.
All 142 influenza A (H1) viruses are related to the influenza A (H1N1) component of the 2008-09 influenza vaccine (A/Brisbane/59/2007). All 35 influenza A (H3N2) viruses are related to the A (H3N2) vaccine component (A/Brisbane/10/2007).
Influenza B viruses currently circulating can be divided into two distinct lineages represented by the B/Yamagata/16/88 and B/Victoria/02/87 viruses. Twenty-three influenza B viruses tested belong to the B/Yamagata lineage and are related to the vaccine strain (B/Florida/04/2006). The remaining 55 viruses belong to the B/Victoria lineage and are not related to the vaccine strain.
Data on antigenic characterization should be interpreted with caution given that antigenic characterization data is based on hemagglutination inhibition (HI) testing using a panel of reference ferret antisera and results may not correlate with clinical protection against circulating viruses provided by influenza vaccination.
Annual influenza vaccination is expected to provide the best protection against those virus strains that are related to the vaccine strains, but limited to no protection may be expected when the vaccine and circulating virus strains are so different as to be from different lineages, as is seen with the two lineages of influenza B viruses.
Antiviral Resistance:

Since October 1, 2008, 190 influenza A (H1N1), 41 influenza A (H3N2), and 77 influenza B viruses have been tested for resistance to the neuraminidase inhibitors (oseltamivir and zanamivir). One hundred ninety influenza A (H1N1) and 41 influenza A (H3N2) viruses have been tested for resistance to the adamantanes (amantadine and rimantadine). The results of antiviral resistance testing performed on these viruses are summarized in the table below.
<table class="table ie7_class362 ie7_class403" align="center" border="0" cellpadding="3" cellspacing="0"><tbody><tr><th class="ie7_class405" align="left" width="160">
</th><th class="ie7_class405" align="middle" nowrap="nowrap" width="100">Isolates tested (n)</th><th class="ie7_class405" colspan="2" align="middle" nowrap="nowrap" width="200">Resistant Viruses,
Number (%)</th><th class="ie7_class405" align="middle" nowrap="nowrap" width="100">Isolates tested (n)</th><th class="ie7_class405" align="middle" nowrap="nowrap" width="120">Resistant Viruses, Number (%)</th></tr><tr><th class="ie7_class405" align="left" width="160">
</th><th class="ie7_class405" align="middle" nowrap="nowrap" width="100">
</th><th class="ie7_class405" align="middle" nowrap="nowrap" width="100">Oseltamivir</th><th class="ie7_class405" align="middle" nowrap="nowrap" width="100">Zanamivir</th><th class="ie7_class405" align="middle" nowrap="nowrap" width="100">
</th><th class="ie7_class405" align="middle" nowrap="nowrap" width="120">Adamantanes</th></tr><tr><td class="ie7_class404" align="left" nowrap="nowrap" width="160">Influenza A (H1N1)</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="100">190</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="100">185 (97.4%)</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="100">0 (0)</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="100">190</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="120">2 (1.1%)</td></tr><tr><td class="ie7_class404" align="left" nowrap="nowrap" width="160">Influenza A (H3N2)</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="100">41</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="100">0 (0)</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="100">0 (0)</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="100">41</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="120">41 (100%)</td></tr><tr><td class="ie7_class404" align="left" nowrap="nowrap" width="160">Influenza B</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="100">77</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="100">0 (0)</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="100">0 (0)</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="100">N/A*</td><td class="ie7_class404" align="middle" nowrap="nowrap" width="120">N/A*</td></tr></tbody></table>^{*The adamantanes (amantadine and rimantadine) are not effective against influenza B viruses.}


Influenza A (H1N1) viruses from 30 states have been tested for antiviral resistance to oseltamivir so far this season. To date, all influenza A (H3N2) viruses tested are resistant to the adamantanes and all oseltamivir-resistant influenza A (H1N1) viruses tested are sensitive to the adamantanes. Influenza activity in the United States, although increasing, remains relatively low with influenza A (H1N1) viruses predominating overall. However, the level of activity and the relative proportion of circulating virus type or subtype has varied by region and may vary over the course of the season. This presents challenges for the selection of antiviral medications for the treatment and chemoprophylaxis of influenza and highlights the importance of testing patients for influenza and consulting local surveillance data when evaluating patients with acute respiratory infections during the influenza season. CDC issued interim recommendations for the use of influenza antiviral medications in the setting of oseltamivir resistance among circulating influenza A (H1N1) viruses on December 19, 2008. These interim recommendations are available at http://www2a.cdc.gov/HAN/ArchiveSys/ViewMsgV.asp?AlertNum=00279
Pneumonia and Influenza (P&I) Mortality Surveillance

During week 4, 7.0% of all deaths reported through the 122-Cities Mortality Reporting System were due to P&I. This percentage is below the epidemic threshold of 7.9% for week 4.
<center>
View Full Screen</center>Influenza-Associated Pediatric Mortality

One influenza-associated pediatric death was reported to CDC during week 4 (New York City). This death occurred during week 3 (the week ending January 24, 2009). Since September 28, 2008, CDC has received three reports of influenza-associated pediatric deaths that occurred during the current season.
<center>
View Full Screen</center>Influenza-Associated Hospitalizations

Laboratory-confirmed influenza-associated hospitalizations are monitored in two population-based surveillance networks: the Emerging Infections Program (EIP) and the New Vaccine Surveillance Network (NVSN).
No influenza-associated hospitalizations have been reported from the New Vaccine Surveillance Network this season.
During October 1, 2008 – January 31, 2009, preliminary laboratory-confirmed influenza-associated hospitalization rates reported by the EIP for children aged 0-4 years and 5-17 years were 0.8 per 10,000 and 0.04 per 10,000, respectively. For adults aged 18-49 years, 50-64 years, and ≥ 65 years, the rates were 0.07 per 10,000, 0.1 per 10,000, and 0.3 per 10,000, respectively.
<center>
View Full Screen</center>Outpatient Illness Surveillance:

During week 4, 2.3% 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 less than the national baseline of 2.4%. On a regional level, the percentage of visits for ILI increased in eight of the nine regions compared to last week and ranged from 1.4% to 5.1%. The East North Central, East South Central, New England, and West South Central regions reported ILI at or above their region-specific baselines.
<center>
View Sentinel Providers Regional Charts | View Chart Data |View Full Screen
</center>Geographic Spread of Influenza as Assessed by State and Territorial Epidemiologists:


During week 4, the following influenza activity was reported:

• Widespread influenza activity was reported by five states (Colorado, Delaware, New York, Texas, and Virginia).
• Regional influenza activity was reported by 21 states (Alabama, Arizona, Connecticut, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Maine, Maryland, Massachusetts, Montana, Nevada, New Hampshire, New Jersey, North Carolina, Pennsylvania, Rhode Island, South Carolina, and Tennessee).
• Local influenza activity was reported by the District of Columbia 13 states (California, Kansas, Michigan, Minnesota, Mississippi, Nebraska, New Mexico, North Dakota, Ohio, Oklahoma, Utah, Vermont, and Wyoming).
• Sporadic activity was reported by Puerto Rico, and 11 states (Alaska, Arkansas, Idaho, Kentucky, Louisiana, Missouri, Oregon, South Dakota, Washington, West Virginia, and Wisconsin).

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View Full Screen

--------------------------------------------------------------------------------
A description of surveillance methods is available at: http://www.cdc.gov/flu/weekly/fluactivity.htm
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• <!--
• Page last reviewed-->
• Page last updated February 6, 2009.

[HenryN]

Re: Seasonal Flu 2008 - 2009 --

<TABLE border=1><CAPTION>INFLUENZA VIRUSES ISOLATED BY
WHO/NREVSS Collaborating Laboratories
2008 - 2009 Season </CAPTION><TBODY><TR><TH id=header1 width=70>Week</TH><TH id=header2 width=90>A(H1)</TH><TH id=header3 width=70>A(H3)</TH><TH id=header4 width=70>A(Unk)</TH><TH id=header5 width=70>B </TH><TH id=header6 align=right>Total # Tested</TH><TH id=header7 align=right>% Positive</TH></TR><TR><TD align=right headers=header1>40 </TD><TD align=right headers=header2>3 </TD><TD align=right headers=header3>0 </TD><TD align=right headers=header4>8 </TD><TD align=right headers=header5>7 </TD><TD align=right headers=header6>2611 </TD><TD align=right headers=header7>0.69 </TD></TR><TR><TD align=right headers=header1>41 </TD><TD align=right headers=header2>4 </TD><TD align=right headers=header3>4 </TD><TD align=right headers=header4>8 </TD><TD align=right headers=header5>6 </TD><TD align=right headers=header6>2643 </TD><TD align=right headers=header7>0.83 </TD></TR><TR><TD align=right headers=header1>42 </TD><TD align=right headers=header2>13 </TD><TD align=right headers=header3>3 </TD><TD align=right headers=header4>15 </TD><TD align=right headers=header5>6 </TD><TD align=right headers=header6>2741 </TD><TD align=right headers=header7>1.35 </TD></TR><TR><TD align=right headers=header1>43 </TD><TD align=right headers=header2>22 </TD><TD align=right headers=header3>0 </TD><TD align=right headers=header4>24 </TD><TD align=right headers=header5>14 </TD><TD align=right headers=header6>3177 </TD><TD align=right headers=header7>1.89 </TD></TR><TR><TD align=right headers=header1>44 </TD><TD align=right headers=header2>12 </TD><TD align=right headers=header3>2 </TD><TD align=right headers=header4>21 </TD><TD align=right headers=header5>5 </TD><TD align=right headers=header6>3313 </TD><TD align=right headers=header7>1.21 </TD></TR><TR><TD align=right headers=header1>45 </TD><TD align=right headers=header2>30 </TD><TD align=right headers=header3>2 </TD><TD align=right headers=header4>23 </TD><TD align=right headers=header5>11 </TD><TD align=right headers=header6>3902 </TD><TD align=right headers=header7>1.69 </TD></TR><TR><TD align=right headers=header1>46 </TD><TD align=right headers=header2>25 </TD><TD align=right headers=header3>2 </TD><TD align=right headers=header4>23 </TD><TD align=right headers=header5>12 </TD><TD align=right headers=header6>4127 </TD><TD align=right headers=header7>1.5 </TD></TR><TR><TD align=right headers=header1>47 </TD><TD align=right headers=header2>27 </TD><TD align=right headers=header3>1 </TD><TD align=right headers=header4>31 </TD><TD align=right headers=header5>23 </TD><TD align=right headers=header6>4474 </TD><TD align=right headers=header7>1.83 </TD></TR><TR><TD align=right headers=header1>48 </TD><TD align=right headers=header2>40 </TD><TD align=right headers=header3>1 </TD><TD align=right headers=header4>47 </TD><TD align=right headers=header5>24 </TD><TD align=right headers=header6>4568 </TD><TD align=right headers=header7>2.45 </TD></TR><TR><TD align=right headers=header1>49 </TD><TD align=right headers=header2>40 </TD><TD align=right headers=header3>5 </TD><TD align=right headers=header4>57 </TD><TD align=right headers=header5>14 </TD><TD align=right headers=header6>5240 </TD><TD align=right headers=header7>2.21 </TD></TR><TR><TD align=right headers=header1>50 </TD><TD align=right headers=header2>71 </TD><TD align=right headers=header3>9 </TD><TD align=right headers=header4>66 </TD><TD align=right headers=header5>36 </TD><TD align=right headers=header6>5604 </TD><TD align=right headers=header7>3.25 </TD></TR><TR><TD align=right headers=header1>51 </TD><TD align=right headers=header2>72 </TD><TD align=right headers=header3>17 </TD><TD align=right headers=header4>106 </TD><TD align=right headers=header5>56 </TD><TD align=right headers=header6>5883 </TD><TD align=right headers=header7>4.27 </TD></TR><TR><TD align=right headers=header1>52 </TD><TD align=right headers=header2>70 </TD><TD align=right headers=header3>10 </TD><TD align=right headers=header4>148 </TD><TD align=right headers=header5>50 </TD><TD align=right headers=header6>5623 </TD><TD align=right headers=header7>4.94 </TD></TR><TR><TD align=right headers=header1>53 </TD><TD align=right headers=header2>105 </TD><TD align=right headers=header3>17 </TD><TD align=right headers=header4>163 </TD><TD align=right headers=header5>45 </TD><TD align=right headers=header6>5774 </TD><TD align=right headers=header7>5.72 </TD></TR><TR><TD align=right headers=header1>01 </TD><TD align=right headers=header2>143 </TD><TD align=right headers=header3>25 </TD><TD align=right headers=header4>236 </TD><TD align=right headers=header5>68 </TD><TD align=right headers=header6>6079 </TD><TD align=right headers=header7>7.76 </TD></TR><TR><TD align=right headers=header1>02 </TD><TD align=right headers=header2>148 </TD><TD align=right headers=header3>17 </TD><TD align=right headers=header4>363 </TD><TD align=right headers=header5>78 </TD><TD align=right headers=header6>5567 </TD><TD align=right headers=header7>10.89 </TD></TR><TR><TD align=right headers=header1>03 </TD><TD align=right headers=header2>159 </TD><TD align=right headers=header3>35 </TD><TD align=right headers=header4>495 </TD><TD align=right headers=header5>121 </TD><TD align=right headers=header6>5621 </TD><TD align=right headers=header7>14.41 </TD></TR><TR><TD align=right headers=header1>04 </TD><TD align=right headers=header2>151 </TD><TD align=right headers=header3>20 </TD><TD align=right headers=header4>502 </TD><TD align=right headers=header5>119 </TD><TD align=right headers=header6>4895 </TD><TD align=right headers=header7>16.18 </TD></TR></TBODY></TABLE>
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[Giuseppe]

Re: Seasonal Flu 2008 - 2009 --

WHO | Seasonal influenza activity in the world (2/6/2009)

Seasonal influenza activity in the world

6 February 2009

This summary provides an updated report of seasonal influenza activity for weeks 3-4 of 2009. It does not include reports of avian influenza in humans, which are available at: http://www.who.int/csr/disease/avian.../en/index.html


Seasonal influenza activity in the world, weeks 3-4 (as of 6 February 2009)

During the weeks 3-4, the level of overall influenza activity in the world continued to intensify. Influenza activity continued to spread across Europe with most countries reporting regional or widespread activity. Influenza A (H3) viruses continue to predominate. Widespread influenza A activity (H1 and H3) was reported in Japan. In Canada, Hong Kong Special Administrative Region of China and the United States of America influenza activity increased but remained relatively low.

- Austria: Influenza activity increased from regional to widespread activity (H3).

- Belgium: Widespread H3 activity continued to be reported.

- Canada: Influenza B activity continued to increase with some local outbreaks occurring but overall levels remained low. Influenza A H1 and H3 viruses were also detected.

- China, Hong Kong Special Administrative Region: Local outbreaks of H1 have been reported. Both H3 and influenza B continue to circulate at low levels.

- Czech Republic: Influenza activity increased from sporadic to regional (H3).

- Denmark: Widespread influenza A H3 activity continued to be reported.

- Estonia: Influenza activity increased from sporadic to widespread levels (H3). Both H1 and B viruses were detected sporadically.

- Finland: H3 influenza activity increased from regional to widespread.

- France: Widespread influenza A H3 activity was still reported. Influenza H1 and B viruses have also been detected at low levels.

- Germany: Influenza activity has increased from regional to widespread (H3).

- Hungary: Regional influenza activity was reported for the first time this season.

- Italy: Activity is still widespread (H3).

- Japan: Influenza activity has increased to widespread with both H3 and H1 circulating.

- Latvia: Influenza activity increased from sporadic to regional (H3).

- Luxembourg: Activity continued to be widespread (H3).

- Malta: Local influenza activity was reported.

- Netherlands: Widespread influenza A H3 activity was still reported (H3).

- Norway: Influenza activity widespread (H3).

- Poland: Local influenza activity was reported. Influenza H1, H3 and B viruses were detected.

- Romania: Influenza activity increased from sporadic to local (H3).

- Russian Federation: Local outbreaks of H1 occurred. Sporadic H3 and B activity was also reported.

- Slovenia: Influenza activity remained at widespread levels (H3).

- Spain: Widespread activity was still reported (H3).

- Sweden: Influenza activity remained widespread (A).

- Switzerland: Widespread activity continued (H3).

- United Kingdom of Great Britain and Northern Ireland: Influenza H3 activity declined compared to previous weeks. Low numbers of H1N1 and B viruses also circulated.

- United States of America: Influenza activity in the United States continued to slowly increase with widespread activity reported for two states and regional activity for 14 states. Local or sporadic levels were reported for the remaining states.. The predominant strain circulating was still H1. Both H3 and B viruses also detected in low numbers.

Sporadic influenza activity was observed in Brazil (A), Croatia (H1,H3,B), Greece (H1, H3, B), Iran (H1, H3), Mongolia (A), Portugal (H1, H3, B), Serbia (H1, H3, B), Singapore (H1, H3, B), Slovakia (H3) and Turkey (H3, B).

Argentina and Cameroon reported no activity.
-

<cite cite="http://www.who.int/csr/disease/influenza/update/en/index.html">WHO | Seasonal influenza activity in the world</cite>

[Giuseppe]

Re: Seasonal Flu 2008 - 2009 --

Few in US see doctor or get medication for flu - study - Reuters

Few in US see doctor or get medication for flu - study

Mon Feb 9, 2009 11:45pm IST
WASHINGTON, Feb 9 (Reuters) -

Only a small percentage of people who get influenza or a similar illness are ever prescribed drugs shown to help the virus, according to a study released on Monday.


The survey of flu patients also showed that about five percent of U.S. children see a doctor or nurse for influenza-like illness, compared to just about 2 percent of adults.

Thomson Reuters Healthcare surveyed insurance claims covering nearly 20 million people with health insurance over two flu seasons in 2005-2006 and 2006-2007.

Anywhere between 5 percent and 20 percent of the population gets flu in a given flu season, the CDC estimates.

The researchers, part of one of the research divisions of media and information firm Thomson Reuters (...) (TRIL.L: Quote, Profile, Research) (...), were looking at influenza-like illnesses, which include influenza proper but also other respiratory diseases that cause fever, cough and other symptoms.

They found that 4 to 6 percent of patients with influenza like illnesses filled a prescription for an antiviral medication. Roche and Co's (...) Tamiflu and GlaxoSmithKline's (...) Relenza are both recommended for treating influenza.

But most clinics do not use on-the-spot flu tests, and use of the drugs is low.

Doctors usually recommend only rest, fluids and perhaps analgesics for treating viruses such as flu, although influenza kills 36,000 Americans in an average flu season, according to the U.S. Centers for Disease Control and Prevention.

Most of those who die are elderly or have chronic disease, but the Thomson Reuters data showed that patients with flu-like illness who seek medical treatment are more likely to be children.

"Approximately 1 in 18 children, 1 in 38 elderly persons, and 1 in 45 adults used influenza-like-illness-related inpatient or outpatient services in each flu season," the report reads.

This works out to 5.6 percent of children, compared to 2.6 percent of the elderly.

But older people in general did use doctors more often.

"A greater percentage of elderly enrollees (53.4 percent) than adult (32.4 percent) or child enrollees (26.4 percent) used any inpatient or outpatient health services in flu season 2006-2007," the report reads.

(Reporting by Maggie Fox, editing by Jackie Frank)
-

<cite cite="http://in.reuters.com/article/governmentFilingsNews/idINN0952610720090209?sp=true">Few in US see doctor or get medication for flu - study | Deals | Regulatory News | Reuters</cite>

[Giuseppe]

Re: Seasonal Flu 2008 - 2009

2008/2009 INFLUENZA SEASON - SURVEILLANCE FOR INCIDENCE OF INFLUENZA-LIKE ILLNESS (Updated at Feb. 11/2009)

Globale Trend of Influenza-like Illness Incidence among population.

[Data, tables and Graphs are available in original (with details in Italian language) at the website of the ''Centro Interuniversitario per lo Studio dell'Influenza'' (CIRI). Readers are invited to visit the site following this LINK. Translation and adaptation by IOH. EDITED.]

Data provides current scenario for the incidence of influenza-like illness among population. Tables and graphs are the results of elaborations done by CIRI based on epidemiological surveillance by sentinel family doctors network.

Graphs show incidence value of ILIs tabulated for epidemic season, surveillance week and classes of age. Values are intended as per 1,000 inhabitants.

<table style="width: auto;"><tbody><tr><td></td></tr><tr><td style="font-family: arial,sans-serif; font-size: 11px; text-align: right;">From TABLES</td></tr></tbody></table>

<table style="width: auto;"><tbody><tr><td></td></tr><tr><td style="font-family: arial,sans-serif; font-size: 11px; text-align: right;">From TABLES</td></tr></tbody></table>
Updated at 11-02-2009 alle ore: 11:02:09GMT+1

[ Surveillance Week - Family Doctors - Outpatients - CASES - Incidence x1.000 inhab. and for Classes of age: 0-4 - 5-14 - 15-65 - +65 - TOTAL INCIDENCE ]

2008-42 - 392 - 511634 - 141 - 0,59 - 0,2 - 0,3 - 0,16 - 0,28
2008-43 - 386 - 509332 - 133 - 0,57 - 0,4 - 0,25 - 0,14 - 0,26
2008-44 - 405 - 535482 - 147 - 0,7 - 0,22 - 0,29 - 0,16 - 0,27
2008-45 - 410 - 538658 - 177 - 0,96 - 0,44 - 0,3 - 0,2 - 0,33
2008-46 - 395 - 517769 - 177 - 0,51 - 0,48 - 0,36 - 0,16 - 0,34
2008-47 - 412 - 542759 - 272 - 1,45 - 0,64 - 0,47 - 0,27 - 0,5
2008-48 - 421 - 555571 - 338 - 1,38 - 0,81 - 0,6 - 0,32 - 0,61
2008-49 - 417 - 551043 - 414 - 2,1 - 1,31 - 0,68 - 0,34 - 0,75
2008-50 - 421 - 555172 - 491 - 2,66 - 1,49 - 0,82 - 0,32 - 0,88
2008-51 - 407 - 538267 - 705 - 3,39 - 2,38 - 1,18 - 0,67 - 1,31
2008-52 - 401 - 531814 - 757 - 3,95 - 2,94 - 1,22 - 0,64 - 1,42
2009-01 - 400 - 529132 - 1371 - 4,85 - 2,78 - 2,73 - 1,5 - 2,59
2009-02 - 421 - 553505 - 2095 - 6,44 - 4,65 - 4,04 - 1,88 - 3,78
2009-03 - 418 - 548349 - 2643 - 11,22 - 8,55 - 4,57 - 2,01 - 4,82
2009-04 - 414 - 543266 - 3281 - 16,67 - 13,12 - 5,14 - 2,2 - 6,04
2009-05 - 406 - 536141 - 2925 - 16,83 - 12,08 - 4,63 - 1,8 - 5,46
2009-06 - 366 - 484420 - 2366 - 12,98 - 9,38 - 4,42 - 1,96 - 4,88

During this surveillance week, Influenza-like illness incidence among general population continues to decrease, after to have reached peak in week 04/2009. This week global incidence is around 4.88 per 1,000 from 5.46x1,000 of previous week. The most affected class age is 0-4 years-old with 1298 cases for 100,000 inhabitants. All classes of ages report a decrease in ILI incidence, with the exception of people in over 65 class, with a value of 1.96x1,000 compared with 1.8x1,000 reported in week 05/2009.
-
-----

[HenryN]

Re: Seasonal Flu 2008 - 2009

Reporting period: Week 06 (02/02/2009 - 08/02/2009)
Influenza activity is at low levels across all the countries of the United Kingdom during week 06/09. Clinical indicators of influenza have increased slightly in Scotland but remain below baseline levels, in England and Wales the consultation rates have decreased and are below baseline levels. In Northern Ireland the rate has also decreased but thresholds have not yet been set. No outbreaks of respiratory illness have been reported this week. Since week 50/08 HPA estimates that these have been approximately 9200* all-cause excess deaths compared to the expected number at this time of year. It should be noted that this excess is due to all-causes and cannot be specifically attributed to influenza. The proportion vaccinated with the current seasonal influenza vaccine in the over 65 years old group reached 74.1% in week 05/09; in the under 65 years at risk group it was 47.2% and in carers it was 38.9%.
Reports of influenza A from NHS and HPA laboratories have decreased from 66 in week 05/09 to 19 in week 06/09, in the same time period the number of influenza Bs reported fell from 16 to 10 and RSV from 190 to 85. Six samples referred to the Centre for Infections' Respiratory Virus Unit (RVU) tested positive for influenza A (two A (H3) and four A (H1)), which is a decrease from 17 in week 05/09. Four samples were positive for influenza B and one for RSV in week 06/09. In Scotland in week 06/09, one sentinel sample tested positive for influenza A (H3), five for influenza B and one for RSV; seven non-sentinel samples tested positive for influenza A, 11 for influenza B and 18 for RSV. In Northern Ireland one sentinel sample tested positive for influenza B and one non-sentinel sample tested positive for influenza A. In Wales to date this season 15 sentinel and 68 non-sentinel samples have been positive for influenza A and one sentinel and one non-sentinel for influenza B.
Neuraminidase inhibitor susceptibility testing: all influenza A (H3) isolates tested since week 40/08 were sensitive to oseltamivir and zanamivir, but resistant to amantadine. Sixty-two influenza A (H1) isolates have been tested, of which 61 are resistant to oseltamivir but sensitive to zanamivir and amantadine. Eighteen influenza B isolates have been tested and all are sensitive to oseltamivir and zanamivir.
In week 05/2009, influenza activity continued to intensify across eastern Europe but activity may have peaked in countries in western Europe. Influenza A (H3) continues to be the predominant circulating virus, low numbers of influenza B viruses are circulating, which increased during week 05/2009 compared to previous weeks.
* Provisional data, above threshold



Last reviewed: 11 February 2009

http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPAweb_C/1211441457161

[Giuseppe]

Re: Seasonal Flu 2008 - 2009

From CIRI (Centro Interuniversitario per lo Studio dell'Influenza, http://www.influciri.it/frsetcn.html - IOH).

H3N2 Phylogenetic Tree of recent Italian isolates.

<table style="width: auto;"><tbody><tr><td></td></tr><tr><td style="font-family: arial,sans-serif; font-size: 11px; text-align: right;">From TABLES</td></tr></tbody></table>
-
-----

[HenryN]

Re: Seasonal Flu 2008 - 2009

<TABLE border=1><CAPTION>INFLUENZA VIRUSES ISOLATED BY
WHO/NREVSS Collaborating Laboratories
2008 - 2009 Season </CAPTION><TBODY><TR><TH id=header1 width=70>Week</TH><TH id=header2 width=90>A(H1)</TH><TH id=header3 width=70>A(H3)</TH><TH id=header4 width=70>A(Unk)</TH><TH id=header5 width=70>B </TH><TH id=header6 align=right>Total # Tested</TH><TH id=header7 align=right>% Positive</TH></TR><TR><TD align=right headers=header1>40 </TD><TD align=right headers=header2>3 </TD><TD align=right headers=header3>0 </TD><TD align=right headers=header4>8 </TD><TD align=right headers=header5>6 </TD><TD align=right headers=header6>2610 </TD><TD align=right headers=header7>0.65 </TD></TR><TR><TD align=right headers=header1>41 </TD><TD align=right headers=header2>4 </TD><TD align=right headers=header3>4 </TD><TD align=right headers=header4>8 </TD><TD align=right headers=header5>6 </TD><TD align=right headers=header6>2643 </TD><TD align=right headers=header7>0.83 </TD></TR><TR><TD align=right headers=header1>42 </TD><TD align=right headers=header2>13 </TD><TD align=right headers=header3>3 </TD><TD align=right headers=header4>15 </TD><TD align=right headers=header5>6 </TD><TD align=right headers=header6>2741 </TD><TD align=right headers=header7>1.35 </TD></TR><TR><TD align=right headers=header1>43 </TD><TD align=right headers=header2>22 </TD><TD align=right headers=header3>0 </TD><TD align=right headers=header4>24 </TD><TD align=right headers=header5>14 </TD><TD align=right headers=header6>3177 </TD><TD align=right headers=header7>1.89 </TD></TR><TR><TD align=right headers=header1>44 </TD><TD align=right headers=header2>11 </TD><TD align=right headers=header3>2 </TD><TD align=right headers=header4>22 </TD><TD align=right headers=header5>5 </TD><TD align=right headers=header6>3313 </TD><TD align=right headers=header7>1.21 </TD></TR><TR><TD align=right headers=header1>45 </TD><TD align=right headers=header2>30 </TD><TD align=right headers=header3>2 </TD><TD align=right headers=header4>23 </TD><TD align=right headers=header5>11 </TD><TD align=right headers=header6>3902 </TD><TD align=right headers=header7>1.69 </TD></TR><TR><TD align=right headers=header1>46 </TD><TD align=right headers=header2>25 </TD><TD align=right headers=header3>2 </TD><TD align=right headers=header4>23 </TD><TD align=right headers=header5>12 </TD><TD align=right headers=header6>4126 </TD><TD align=right headers=header7>1.5 </TD></TR><TR><TD align=right headers=header1>47 </TD><TD align=right headers=header2>27 </TD><TD align=right headers=header3>1 </TD><TD align=right headers=header4>31 </TD><TD align=right headers=header5>23 </TD><TD align=right headers=header6>4471 </TD><TD align=right headers=header7>1.83 </TD></TR><TR><TD align=right headers=header1>48 </TD><TD align=right headers=header2>40 </TD><TD align=right headers=header3>1 </TD><TD align=right headers=header4>47 </TD><TD align=right headers=header5>24 </TD><TD align=right headers=header6>4568 </TD><TD align=right headers=header7>2.45 </TD></TR><TR><TD align=right headers=header1>49 </TD><TD align=right headers=header2>40 </TD><TD align=right headers=header3>4 </TD><TD align=right headers=header4>58 </TD><TD align=right headers=header5>14 </TD><TD align=right headers=header6>5240 </TD><TD align=right headers=header7>2.21 </TD></TR><TR><TD align=right headers=header1>50 </TD><TD align=right headers=header2>71 </TD><TD align=right headers=header3>9 </TD><TD align=right headers=header4>66 </TD><TD align=right headers=header5>36 </TD><TD align=right headers=header6>5603 </TD><TD align=right headers=header7>3.25 </TD></TR><TR><TD align=right headers=header1>51 </TD><TD align=right headers=header2>72 </TD><TD align=right headers=header3>17 </TD><TD align=right headers=header4>106 </TD><TD align=right headers=header5>56 </TD><TD align=right headers=header6>5883 </TD><TD align=right headers=header7>4.27 </TD></TR><TR><TD align=right headers=header1>52 </TD><TD align=right headers=header2>69 </TD><TD align=right headers=header3>10 </TD><TD align=right headers=header4>149 </TD><TD align=right headers=header5>50 </TD><TD align=right headers=header6>5622 </TD><TD align=right headers=header7>4.94 </TD></TR><TR><TD align=right headers=header1>53 </TD><TD align=right headers=header2>103 </TD><TD align=right headers=header3>17 </TD><TD align=right headers=header4>168 </TD><TD align=right headers=header5>45 </TD><TD align=right headers=header6>5885 </TD><TD align=right headers=header7>5.66 </TD></TR><TR><TD align=right headers=header1>01 </TD><TD align=right headers=header2>143 </TD><TD align=right headers=header3>25 </TD><TD align=right headers=header4>236 </TD><TD align=right headers=header5>68 </TD><TD align=right headers=header6>6147 </TD><TD align=right headers=header7>7.68 </TD></TR><TR><TD align=right headers=header1>02 </TD><TD align=right headers=header2>151 </TD><TD align=right headers=header3>19 </TD><TD align=right headers=header4>366 </TD><TD align=right headers=header5>80 </TD><TD align=right headers=header6>5628 </TD><TD align=right headers=header7>10.95 </TD></TR><TR><TD align=right headers=header1>03 </TD><TD align=right headers=header2>189 </TD><TD align=right headers=header3>35 </TD><TD align=right headers=header4>500 </TD><TD align=right headers=header5>130 </TD><TD align=right headers=header6>5901 </TD><TD align=right headers=header7>14.47 </TD></TR><TR><TD align=right headers=header1>04 </TD><TD align=right headers=header2>243 </TD><TD align=right headers=header3>31 </TD><TD align=right headers=header4>669 </TD><TD align=right headers=header5>184 </TD><TD align=right headers=header6>6520 </TD><TD align=right headers=header7>17.29 </TD></TR><TR><TD align=right headers=header1>05 </TD><TD align=right headers=header2>146 </TD><TD align=right headers=header3>14 </TD><TD align=right headers=header4>741 </TD><TD align=right headers=header5>253 </TD><TD align=right headers=header6>5596 </TD><TD align=right headers=header7>20.62 </TD></TR></TBODY></TABLE>

Return to Current Report

http://cdc.gov/flu/weekly/weeklyarchives2008-2009/data/whoAllregt05.htm

[HenryN]

Re: Seasonal Flu 2008 - 2009

2008-2009 Influenza Season Week ending February 7, 2009
(All data are preliminary and may change as more reports are received.)
Synopsis:

During week 5 (February 1-7, 2009), influenza activity continued to increase in the United States.

• <LI class=" ie7_class15 ie7_class252">One thousand one hundred fifty-four (20.6%) 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 were positive for influenza. <LI class=" ie7_class15 ie7_class252">The proportion of deaths attributed to pneumonia and influenza (P&I) was below the epidemic threshold. <LI class=" ie7_class15 ie7_class252">One influenza-associated pediatric death was reported. <LI class=" ie7_class15 ie7_class252">The proportion of outpatient visits for influenza-like illness (ILI) was above the national baseline. ILI increased in eight of the nine regions compared to the previous week, and the East North Central, East South Central, Mountain, New England, Pacific, South Atlantic, and West South Central regions reported ILI above their region-specific baselines.
• Sixteen states reported widespread influenza activity, 16 states reported regional activity; the District of Columbia and 14 states reported local influenza activity; and Puerto Rico and four states reported sporadic influenza activity.

<TABLE class="table ie7_class362 ie7_class403" cellSpacing=0 cellPadding=3 align=center border=0><CAPTION>National and Regional Summary of Select Surveillance Components

</CAPTION><TBODY><TR vAlign=top><TH class=" ie7_class405" vAlign=bottom width=85 rowSpan=2>

Region

</TH><TH class=" ie7_class405" noWrap align=middle width=300 colSpan=3>Data for current week</STRONG></TH><TH class=" ie7_class405" noWrap align=middle width=276 colSpan=5>Data cumulative for the season</TH></TR><TR vAlign=top><TH class=" ie7_class405" align=middle width=72>Out-patient ILI*</TH><TH class=" ie7_class405" align=middle width=72>% positive for flu?</TH><TH class=" ie7_class405" align=middle width=96>Number of jurisdictions reporting regional or widespread activity?</TH><TH class=" ie7_class405" noWrap align=middle width=48>A (H1)</TH><TH class=" ie7_class405" noWrap align=middle width=48>A (H3)</TH><TH class=" ie7_class405" align=middle width=60>A Unsub-typed</TH><TH class=" ie7_class405" noWrap align=middle width=48>B</TH><TH class=" ie7_class405" align=middle width=72>Pediatric Deaths</TH></TR><TR><TD class=" ie7_class404" align=left width=85>Nation</TD><TD class=" ie7_class404" noWrap align=middle width=72>Elevated</TD><TD class=" ie7_class404" noWrap align=middle width=72>20.6 % </TD><TD class=" ie7_class404" noWrap align=middle width=96>32 of 51 </TD><TD class=" ie7_class404" noWrap align=middle width=48>1402</TD><TD class=" ie7_class404" noWrap align=middle width=48>196</TD><TD class=" ie7_class404" noWrap align=middle width=60>3260</TD><TD class=" ie7_class404" noWrap align=middle width=48>1023</TD><TD class=" ie7_class404" noWrap align=middle width=72>4</TD></TR><TR><TD class=" ie7_class404" align=left width=85>New England</TD><TD class=" ie7_class404" noWrap align=middle width=72>Elevated</TD><TD class=" ie7_class404" noWrap align=middle width=72>17.6 % </TD><TD class=" ie7_class404" noWrap align=middle width=96>5 of 6</TD><TD class=" ie7_class404" noWrap align=middle width=48>70</TD><TD class=" ie7_class404" noWrap align=middle width=48>15</TD><TD class=" ie7_class404" noWrap align=middle width=60>241</TD><TD class=" ie7_class404" noWrap align=middle width=48>51</TD><TD class=" ie7_class404" noWrap align=middle width=72>0</TD></TR><TR><TD class=" ie7_class404" align=left width=85>Mid-Atlantic</TD><TD class=" ie7_class404" noWrap align=middle width=72>Normal</TD><TD class=" ie7_class404" noWrap align=middle width=72>14.2 % </TD><TD class=" ie7_class404" noWrap align=middle width=96>3 of 3</TD><TD class=" ie7_class404" noWrap align=middle width=48>155</TD><TD class=" ie7_class404" noWrap align=middle width=48>16</TD><TD class=" ie7_class404" noWrap align=middle width=60>239</TD><TD class=" ie7_class404" noWrap align=middle width=48>82</TD><TD class=" ie7_class404" noWrap align=middle width=72>1</TD></TR><TR><TD class=" ie7_class404" align=left width=85>East North Central</TD><TD class=" ie7_class404" noWrap align=middle width=72>Elevated</TD><TD class=" ie7_class404" noWrap align=middle width=72>30.3 % </TD><TD class=" ie7_class404" noWrap align=middle width=96>3 of 5</TD><TD class=" ie7_class404" noWrap align=middle width=48>206</TD><TD class=" ie7_class404" noWrap align=middle width=48>36</TD><TD class=" ie7_class404" noWrap align=middle width=60>36</TD><TD class=" ie7_class404" noWrap align=middle width=48>53</TD><TD class=" ie7_class404" noWrap align=middle width=72>0</TD></TR><TR><TD class=" ie7_class404" align=left width=85>West North Central</TD><TD class=" ie7_class404" noWrap align=middle width=72>Normal</TD><TD class=" ie7_class404" noWrap align=middle width=72>9.7 % </TD><TD class=" ie7_class404" noWrap align=middle width=96>3 of 7</TD><TD class=" ie7_class404" noWrap align=middle width=48>81</TD><TD class=" ie7_class404" noWrap align=middle width=48>7</TD><TD class=" ie7_class404" noWrap align=middle width=60>197</TD><TD class=" ie7_class404" noWrap align=middle width=48>28</TD><TD class=" ie7_class404" noWrap align=middle width=72>0</TD></TR><TR><TD class=" ie7_class404" align=left width=85>South Atlantic</TD><TD class=" ie7_class404" noWrap align=middle width=72>Elevated</TD><TD class=" ie7_class404" noWrap align=middle width=72>14.4 % </TD><TD class=" ie7_class404" noWrap align=middle width=96>7 of 9</TD><TD class=" ie7_class404" noWrap align=middle width=48>210</TD><TD class=" ie7_class404" noWrap align=middle width=48>31</TD><TD class=" ie7_class404" noWrap align=middle width=60>436</TD><TD class=" ie7_class404" noWrap align=middle width=48>212</TD><TD class=" ie7_class404" noWrap align=middle width=72>0</TD></TR><TR><TD class=" ie7_class404" align=left width=85>East South Central</TD><TD class=" ie7_class404" noWrap align=middle width=72>Elevated</TD><TD class=" ie7_class404" noWrap align=middle width=72>12.7 % </TD><TD class=" ie7_class404" noWrap align=middle width=96>3 of 4</TD><TD class=" ie7_class404" noWrap align=middle width=48>40</TD><TD class=" ie7_class404" noWrap align=middle width=48>5</TD><TD class=" ie7_class404" noWrap align=middle width=60>6</TD><TD class=" ie7_class404" noWrap align=middle width=48>18</TD><TD class=" ie7_class404" noWrap align=middle width=72>1</TD></TR><TR><TD class=" ie7_class404" align=left width=85>West South Central</TD><TD class=" ie7_class404" noWrap align=middle width=72>Elevated</TD><TD class=" ie7_class404" noWrap align=middle width=72>28.5 % </TD><TD class=" ie7_class404" noWrap align=middle width=96>1 of 4</TD><TD class=" ie7_class404" noWrap align=middle width=48>234</TD><TD class=" ie7_class404" noWrap align=middle width=48>14</TD><TD class=" ie7_class404" noWrap align=middle width=60>1667</TD><TD class=" ie7_class404" noWrap align=middle width=48>517</TD><TD class=" ie7_class404" noWrap align=middle width=72>1</TD></TR><TR><TD class=" ie7_class404" align=left width=85>Mountain</TD><TD class=" ie7_class404" noWrap align=middle width=72>Elevated</TD><TD class=" ie7_class404" noWrap align=middle width=72>11.6 % </TD><TD class=" ie7_class404" noWrap align=middle width=96>5 of 8</TD><TD class=" ie7_class404" noWrap align=middle width=48>75</TD><TD class=" ie7_class404" noWrap align=middle width=48>49</TD><TD class=" ie7_class404" noWrap align=middle width=60>280</TD><TD class=" ie7_class404" noWrap align=middle width=48>25</TD><TD class=" ie7_class404" noWrap align=middle width=72>1</TD></TR><TR><TD class=" ie7_class404" align=left width=85>Pacific</TD><TD class=" ie7_class404" noWrap align=middle width=72>Elevated</TD><TD class=" ie7_class404" noWrap align=middle width=72>5.8 % </TD><TD class=" ie7_class404" noWrap align=middle width=96>2 of 5</TD><TD class=" ie7_class404" noWrap align=middle width=48>331</TD><TD class=" ie7_class404" noWrap align=middle width=48>23</TD><TD class=" ie7_class404" noWrap align=middle width=60>158</TD><TD class=" ie7_class404" noWrap align=middle width=48>37</TD><TD class=" ie7_class404" noWrap align=middle width=72>0</TD></TR></TBODY></TABLE>
* Elevated means the % of visits for ILI is at or above the national or region-specific baseline
? National data is for current week; regional data is for the most recent three weeks.
? Includes all 50 states and the District of Columbia
U.S. Virologic Surveillance:

WHO and NREVSS collaborating laboratories located in all 50 states and Washington D.C. report to CDC the number of respiratory specimens tested for influenza each week. The results of tests performed during the current week and cumulative totals for the season are summarized in the table below.
<TABLE class="table ie7_class362 ie7_class403" cellSpacing=0 cellPadding=3 align=center border=0><TBODY><TR><TH class=" ie7_class405" align=left width=200></TH><TH class=" ie7_class405" noWrap align=middle width=150>Week 5</TH><TH class=" ie7_class405" noWrap align=middle width=150>Cumulative for the Season</TH></TR><TR><TD class=" ie7_class404" align=left width=200>No. of specimens tested</TD><TD class=" ie7_class404" noWrap align=middle width=150>5,596</TD><TD class=" ie7_class404" noWrap align=middle width=150>89,576</TD></TR><TR><TD class=" ie7_class404" align=left width=200>No. of positive specimens (%)</TD><TD class=" ie7_class404" noWrap align=middle width=150>1,154 (20.6%)</TD><TD class=" ie7_class404" noWrap align=middle width=150>5,881 (6.6%)</TD></TR><TR><TD class=" ie7_class404" align=left colSpan=3>Positive specimens by type/subtype</TD></TR><TR><TD class=" ie7_class404" align=left width=170> Influenza A</TD><TD class=" ie7_class404" noWrap align=middle width=150>901 (78.1%)</TD><TD class=" ie7_class404" noWrap align=middle width=150>4,858 (82.6%)</TD></TR><TR><TD class=" ie7_class404" align=left width=170> A (H1)</TD><TD class=" ie7_class404" noWrap align=middle width=150> 146 (16.2%)</TD><TD class=" ie7_class404" noWrap align=middle width=150> 1,402 (28.9%)</TD></TR><TR><TD class=" ie7_class404" align=left width=170> A (H3)</TD><TD class=" ie7_class404" noWrap align=middle width=150> 14 (1.6%)</TD><TD class=" ie7_class404" noWrap align=middle width=150> 196 (4.0%)</TD></TR><TR><TD class=" ie7_class404" align=left width=170> A (unsubtyped)</TD><TD class=" ie7_class404" noWrap align=middle width=150> 741 (82.2%)</TD><TD class=" ie7_class404" noWrap align=middle width=150> 3,260 (67.1%)</TD></TR><TR><TD class=" ie7_class404" align=left width=170> Influenza B</TD><TD class=" ie7_class404" noWrap align=middle width=150>253 (21.9%)</TD><TD class=" ie7_class404" noWrap align=middle width=150>1,023 (17.4%)</TD></TR></TBODY></TABLE>
Since week 1 (the week ending January 10, 2009), when influenza activity began to increase nationally, influenza A (H1) viruses have predominated circulation nationally each week and for the season overall in all regions. Since week 1, 88% of subtyped influenza A viruses reported to CDC were influenza A (H1).
<CENTER>
View WHO-NREVSS Regional Bar Charts| View Chart Data | View Full Screen </CENTER>Antigenic Characterization:

CDC has antigenically characterized 309 influenza viruses [194 influenza A (H1), 37 influenza A (H3) and 78 influenza B viruses] collected by U.S. laboratories since October 1, 2008.
All 194 influenza A (H1) viruses are related to the influenza A (H1N1) component of the 2008-09 influenza vaccine (A/Brisbane/59/2007). All 37 influenza A (H3N2) viruses are related to the A (H3N2) vaccine component (A/Brisbane/10/2007).
Influenza B viruses currently circulating can be divided into two distinct lineages represented by the B/Yamagata/16/88 and B/Victoria/02/87 viruses. Twenty-three influenza B viruses tested belong to the B/Yamagata lineage and are related to the vaccine strain (B/Florida/04/2006). The remaining 55 viruses belong to the B/Victoria lineage and are not related to the vaccine strain.
Data on antigenic characterization should be interpreted with caution given that antigenic characterization data is based on hemagglutination inhibition (HI) testing using a panel of reference ferret antisera and results may not correlate with clinical protection against circulating viruses provided by influenza vaccination.
Annual influenza vaccination is expected to provide the best protection against those virus strains that are related to the vaccine strains, but limited to no protection may be expected when the vaccine and circulating virus strains are so different as to be from different lineages, as is seen with the two lineages of influenza B viruses.
Antiviral Resistance:

Since October 1, 2008, 240 influenza A (H1N1), 49 influenza A (H3N2), and 105 influenza B viruses have been tested for resistance to the neuraminidase inhibitors (oseltamivir and zanamivir). Two hundred forty influenza A (H1N1) and 49 influenza A (H3N2) viruses have been tested for resistance to the adamantanes (amantadine and rimantadine). The results of antiviral resistance testing performed on these viruses are summarized in the table below.
<TABLE class="table ie7_class362 ie7_class403" cellSpacing=0 cellPadding=3 align=center border=0><TBODY><TR><TH class=" ie7_class405" align=left width=160></TH><TH class=" ie7_class405" noWrap align=middle width=100>Isolates tested (n)</TH><TH class=" ie7_class405" noWrap align=middle width=200 colSpan=2>Resistant Viruses,
Number (%)</TH><TH class=" ie7_class405" noWrap align=middle width=100>Isolates tested (n)</TH><TH class=" ie7_class405" noWrap align=middle width=120>Resistant Viruses, Number (%)</TH></TR><TR><TH class=" ie7_class405" align=left width=160></TH><TH class=" ie7_class405" noWrap align=middle width=100></TH><TH class=" ie7_class405" noWrap align=middle width=100>Oseltamivir</TH><TH class=" ie7_class405" noWrap align=middle width=100>Zanamivir</TH><TH class=" ie7_class405" noWrap align=middle width=100></TH><TH class=" ie7_class405" noWrap align=middle width=120>Adamantanes</TH></TR><TR><TD class=" ie7_class404" noWrap align=left width=160>Influenza A (H1N1)</TD><TD class=" ie7_class404" noWrap align=middle width=100>240</TD><TD class=" ie7_class404" noWrap align=middle width=100>236 (98.3%)</TD><TD class=" ie7_class404" noWrap align=middle width=100>0 (0)</TD><TD class=" ie7_class404" noWrap align=middle width=100>240</TD><TD class=" ie7_class404" noWrap align=middle width=120>2 (0.8%)</TD></TR><TR><TD class=" ie7_class404" noWrap align=left width=160>Influenza A (H3N2)</TD><TD class=" ie7_class404" noWrap align=middle width=100>49</TD><TD class=" ie7_class404" noWrap align=middle width=100>0 (0)</TD><TD class=" ie7_class404" noWrap align=middle width=100>0 (0)</TD><TD class=" ie7_class404" noWrap align=middle width=100>49</TD><TD class=" ie7_class404" noWrap align=middle width=120>49 (100%)</TD></TR><TR><TD class=" ie7_class404" noWrap align=left width=160>Influenza B</TD><TD class=" ie7_class404" noWrap align=middle width=100>105</TD><TD class=" ie7_class404" noWrap align=middle width=100>0 (0)</TD><TD class=" ie7_class404" noWrap align=middle width=100>0 (0)</TD><TD class=" ie7_class404" noWrap align=middle width=100>N/A*</TD><TD class=" ie7_class404" noWrap align=middle width=120>N/A*</TD></TR></TBODY></TABLE><SUP>*The adamantanes (amantadine and rimantadine) are not effective against influenza B viruses.</SUP>


Influenza A (H1N1) viruses from 33 states have been tested for antiviral resistance to oseltamivir so far this season. To date, all influenza A (H3N2) viruses tested are resistant to the adamantanes and all oseltamivir-resistant influenza A (H1N1) viruses tested are sensitive to the adamantanes. Influenza activity in the United States increased this week with influenza A (H1N1) viruses predominating overall. However, the level of activity and the relative proportion of circulating virus types or subtypes have varied by region and may vary over the course of the season. This presents challenges for the selection of antiviral medications for the treatment and chemoprophylaxis of influenza and highlights the importance of testing patients for influenza and consulting local surveillance data when evaluating patients with acute respiratory infections during the influenza season. CDC issued interim recommendations for the use of influenza antiviral medications in the setting of oseltamivir resistance among circulating influenza A (H1N1) viruses on December 19, 2008. These interim recommendations are available at http://www2a.cdc.gov/HAN/ArchiveSys/ViewMsgV.asp?AlertNum=00279
Pneumonia and Influenza (P&I) Mortality Surveillance

During week 5, 7.2% of all deaths reported through the 122-Cities Mortality Reporting System were due to P&I. This percentage is below the epidemic threshold of 7.9% for week 5.
<CENTER>
View Full Screen</CENTER>Influenza-Associated Pediatric Mortality

One influenza-associated pediatric death was reported to CDC during week 5 (Tennessee). This death occurred during week 4 (the week ending January 31, 2009). Since September 28, 2008, CDC has received four reports of influenza-associated pediatric deaths that occurred during the current season.
<CENTER>
View Full Screen</CENTER>Influenza-Associated Hospitalizations

Laboratory-confirmed influenza-associated hospitalizations are monitored in two population-based surveillance networks: the Emerging Infections Program (EIP) and the New Vaccine Surveillance Network (NVSN).
No influenza-associated hospitalizations have been reported from the New Vaccine Surveillance Network this season.
During October 1, 2008 ? January 31, 2009, preliminary laboratory-confirmed influenza-associated hospitalization rates reported by the EIP for children aged 0-4 years and 5-17 years were 0.8 per 10,000 and 0.04 per 10,000, respectively. For adults aged 18-49 years, 50-64 years, and = 65 years, the rates were 0.07 per 10,000, 0.1 per 10,000, and 0.3 per 10,000, respectively.
<CENTER>
View Full Screen</CENTER>Outpatient Illness Surveillance:

Nationwide during week 5, 3.2% 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 above the national baseline of 2.4%.
<CENTER>
View Sentinel Providers Regional Charts | View Chart Data |View Full Screen
</CENTER>

On a regional level, the percentage of visits for ILI increased in eight of the nine regions compared to the previous week and ranged from 1.1% to 6.0%. Seven of nine surveillance regions reported ILI percentages above their region specific baselines.
<TABLE class="table ie7_class362 ie7_class403" cellSpacing=0 cellPadding=3 align=center border=0><TBODY><TR><TH class=" ie7_class405" align=left width=80>Region</TH><TH class=" ie7_class405" noWrap align=middle width=60>New England</TH><TH class=" ie7_class405" noWrap align=middle width=60>Mid Atlantic</TH><TH class=" ie7_class405" noWrap align=middle width=60>East North Central</TH><TH class=" ie7_class405" noWrap align=middle width=60>West North Central</TH><TH class=" ie7_class405" noWrap align=middle width=60>South Atlantic</TH><TH class=" ie7_class405" noWrap align=middle width=60>East South Central</TH><TH class=" ie7_class405" noWrap align=middle width=60>West South Central</TH><TH class=" ie7_class405" noWrap align=middle width=60>Mountain</TH><TH class=" ie7_class405" noWrap align=middle width=60>Pacific</TH></TR><TR><TD class=" ie7_class404" noWrap align=left width=80>Reported ILI (%)</TD><TD class=" ie7_class404" noWrap align=middle width=60>3.9</TD><TD class=" ie7_class404" noWrap align=middle width=60>2.6</TD><TD class=" ie7_class404" noWrap align=middle width=60>2.7</TD><TD class=" ie7_class404" noWrap align=middle width=60>1.1</TD><TD class=" ie7_class404" noWrap align=middle width=60>3.0</TD><TD class=" ie7_class404" noWrap align=middle width=60>4.2</TD><TD class=" ie7_class404" noWrap align=middle width=60>6.0</TD><TD class=" ie7_class404" noWrap align=middle width=60>1.7</TD><TD class=" ie7_class404" noWrap align=middle width=60>3.1</TD></TR><TR><TD class=" ie7_class404" noWrap align=left width=80>Region-Specific Baseline</TD><TD class=" ie7_class404" noWrap align=middle width=60>1.5</TD><TD class=" ie7_class404" noWrap align=middle width=60>2.9</TD><TD class=" ie7_class404" noWrap align=middle width=60>1.9</TD><TD class=" ie7_class404" noWrap align=middle width=60>1.7</TD><TD class=" ie7_class404" noWrap align=middle width=60>2.2</TD><TD class=" ie7_class404" noWrap align=middle width=60>2.5</TD><TD class=" ie7_class404" noWrap align=middle width=60>4.8</TD><TD class=" ie7_class404" noWrap align=middle width=60>1.5</TD><TD class=" ie7_class404" noWrap align=middle width=60>3.0</TD></TR></TBODY></TABLE>
Geographic Spread of Influenza as Assessed by State and Territorial Epidemiologists:


During week 5, the following influenza activity was reported:

• <LI class=" ie7_class15 ie7_class252">Widespread influenza activity was reported by 16 states (Colorado, Delaware, Georgia, Massachusetts, Nevada, New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, and Virginia). <LI class=" ie7_class15 ie7_class252">Regional influenza activity was reported by 16 states (Alabama, Arizona, California, Connecticut, Florida, Hawaii, Indiana, Iowa, Maine, Maryland, Michigan, Minnesota, Mississippi, Montana, Nebraska, and Wyoming). <LI class=" ie7_class15 ie7_class252">Local influenza activity was reported by the District of Columbia and 14 states (Arkansas, Illinois, Kansas, Kentucky, Missouri, New Mexico, North Dakota, Oklahoma, Oregon, South Dakota, Utah, Vermont, Washington, and Wisconsin).
• Sporadic activity was reported by Puerto Rico and four states (Alaska, Idaho, Louisiana, and West Virginia).

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[Commonground]

Re: Seasonal Flu 2008 - 2009

Flu cases surge due to vaccine problems

11 hrs ago

DENVER - Flu season has been underway for weeks, it's been a mild one, and we haven't heard much about it, until now.

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Health officials are reporting a sudden surge in flu cases, and they've pinpointed at least one reason why.
The Centers for Disease Control says every state is now reporting flu, with widespread outbreaks in 16 states, including Colorado.
This year there are two additional problems. One of the major strains of A influenza , the most serious type, is resistant to the drug Tamiflu, often used to treat symptoms and once conceived as the future defense against a severe outbreak - a pandemic
"We're very concerned now that Tamiflu may not be as useful in pandemic circumstances or even year to year now as it has been in the past," Dr. William Schaffner with Vanderbilt University said.
Another problem, the vaccine offers no protection against this year's B influenza, which is not as serious, but can still make people miserable.

[Giuseppe]

Re: Seasonal Flu 2008 - 2009

2008/2009 INFLUENZA SEASON. GLOBAL INCIDENCE OF INFLUENZA-LIKE ILLNESS AMONG POPULATION (data from CIRI, updated at 2/18/200)

Global Trend of Influenza-like Illness Incidence among population.

Data and tables with further details about influenza surveillance activities performed by Centro Interuniversitario per lo studio dell'Influenza (CIRI) are available in Italian language following this LINK.

Graphs show influenza-like illness incidence level trend as calculated by CIRI experts from epidemiological data collected by the sentinel family doctors network during this week.

Figures are intended for 1,000 inhabitants.

Data has been tabulated according epidemic season, surveillance week and classes of age.

<table style="width: auto;"><tbody><tr><td></td></tr><tr><td style="font-family: arial,sans-serif; font-size: 11px; text-align: right;">From TABLES</td></tr></tbody></table>

<table style="width: auto;"><tbody><tr><td></td></tr><tr><td style="font-family: arial,sans-serif; font-size: 11px; text-align: right;">From TABLES</td></tr></tbody></table>

Updated at: 18-02-2009 10:48:21GMT+1

[Surveillance Week - Family Doctors Participant - Outpatients - CASES - Incidence for classes of age: (0-4 years-old) - (5-14) - (15-65) - (+65) - GLOBAL INCIDENCE ]

2008-42 - 392 - 511634 - 141 - 0,59 - 0,2 - 0,3 - 0,16 - 0,28
2008-43 - 386 - 509332 - 133 - 0,57 - 0,4 - 0,25 - 0,14 - 0,26
2008-44 - 405 - 535482 - 147 - 0,7 - 0,22 - 0,29 - 0,16 - 0,27
2008-45 - 410 - 538658 - 177 - 0,96 - 0,44 - 0,3 - 0,2 - 0,33
2008-46 - 395 - 517769 - 177 - 0,51 - 0,48 - 0,36 - 0,16 - 0,34
2008-47 - 412 - 542759 - 272 - 1,45 - 0,64 - 0,47 - 0,27 - 0,5
2008-48 - 421 - 555571 - 338 - 1,38 - 0,81 - 0,6 - 0,32 - 0,61
2008-49 - 417 - 551043 - 414 - 2,1 - 1,31 - 0,68 - 0,34 - 0,75
2008-50 - 421 - 555172 - 491 - 2,66 - 1,49 - 0,82 - 0,32 - 0,88
2008-51 - 407 - 538267 - 705 - 3,39 - 2,38 - 1,18 - 0,67 - 1,31
2008-52 - 401 - 531814 - 757 - 3,95 - 2,94 - 1,22 - 0,64 - 1,42
2009-01 - 401 - 531189 - 1374 - 4,85 - 2,78 - 2,73 - 1,5 - 2,59
2009-02 - 422 - 555562 - 2100 - 6,44 - 4,65 - 4,03 - 1,88 - 3,78
2009-03 - 419 - 550406 - 2644 - 11,22 - 8,54 - 4,55 - 2,01 - 4,8
2009-04 - 416 - 546418 - 3289 - 16,67 - 13,1 - 5,13 - 2,2 - 6,02
2009-05 - 415 - 547629 - 2976 - 16,64 - 12 - 4,63 - 1,83 - 5,43
2009-06 - 406 - 535258 - 2537 - 12,69 - 8,97 - 4,34 - 1,91 - 4,74
2009-07 - 365 - 481366 - 1756 - 12,12 - 7,62 - 2,95 - 1,48 - 3,65

While global incidence of ILI continues to decrease even for this last week, with a value of 3.65 cases for 1,000 inhabitants, sustained influenza-like illnesses activity has been reported in 0-4 years-old population class-age (1212 cases for 100,000 inhabitants).
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