Seasonal Flu 2008 - 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 headers="header1" align="right"> 40 </td> <td headers="header2" align="right"> 3 </td> <td headers="header3" align="right"> 0 </td> <td headers="header4" align="right"> 8 </td> <td headers="header5" align="right"> 6 </td> <td headers="header6" align="right"> 2612 </td> <td headers="header7" align="right"> 0.65 </td></tr> <tr><td headers="header1" align="right"> 41 </td> <td headers="header2" align="right"> 4 </td> <td headers="header3" align="right"> 4 </td> <td headers="header4" align="right"> 8 </td> <td headers="header5" align="right"> 6 </td> <td headers="header6" align="right"> 2645 </td> <td headers="header7" align="right"> 0.83 </td></tr> <tr><td headers="header1" align="right"> 42 </td> <td headers="header2" align="right"> 13 </td> <td headers="header3" align="right"> 3 </td> <td headers="header4" align="right"> 15 </td> <td headers="header5" align="right"> 6 </td> <td headers="header6" align="right"> 2775 </td> <td headers="header7" align="right"> 1.33 </td></tr> <tr><td headers="header1" align="right"> 43 </td> <td headers="header2" align="right"> 22 </td> <td headers="header3" align="right"> 0 </td> <td headers="header4" align="right"> 24 </td> <td headers="header5" align="right"> 14 </td> <td headers="header6" align="right"> 3201 </td> <td headers="header7" align="right"> 1.87 </td></tr> <tr><td headers="header1" align="right"> 44 </td> <td headers="header2" align="right"> 11 </td> <td headers="header3" align="right"> 2 </td> <td headers="header4" align="right"> 21 </td> <td headers="header5" align="right"> 5 </td> <td headers="header6" align="right"> 3345 </td> <td headers="header7" align="right"> 1.17 </td></tr> <tr><td headers="header1" align="right"> 45 </td> <td headers="header2" align="right"> 30 </td> <td headers="header3" align="right"> 2 </td> <td headers="header4" align="right"> 23 </td> <td headers="header5" align="right"> 11 </td> <td headers="header6" align="right"> 3936 </td> <td headers="header7" align="right"> 1.68 </td></tr> <tr><td headers="header1" align="right"> 46 </td> <td headers="header2" align="right"> 25 </td> <td headers="header3" align="right"> 2 </td> <td headers="header4" align="right"> 23 </td> <td headers="header5" align="right"> 12 </td> <td headers="header6" align="right"> 4162 </td> <td headers="header7" align="right"> 1.49 </td></tr> <tr><td headers="header1" align="right"> 47 </td> <td headers="header2" align="right"> 27 </td> <td headers="header3" align="right"> 1 </td> <td headers="header4" align="right"> 31 </td> <td headers="header5" align="right"> 23 </td> <td headers="header6" align="right"> 4517 </td> <td headers="header7" align="right"> 1.82 </td></tr> <tr><td headers="header1" align="right"> 48 </td> <td headers="header2" align="right"> 40 </td> <td headers="header3" align="right"> 1 </td> <td headers="header4" align="right"> 46 </td> <td headers="header5" align="right"> 24 </td> <td headers="header6" align="right"> 4614 </td> <td headers="header7" align="right"> 2.41 </td></tr> <tr><td headers="header1" align="right"> 49 </td> <td headers="header2" align="right"> 41 </td> <td headers="header3" align="right"> 4 </td> <td headers="header4" align="right"> 57 </td> <td headers="header5" align="right"> 14 </td> <td headers="header6" align="right"> 5322 </td> <td headers="header7" align="right"> 2.18 </td></tr> <tr><td headers="header1" align="right"> 50 </td> <td headers="header2" align="right"> 70 </td> <td headers="header3" align="right"> 9 </td> <td headers="header4" align="right"> 66 </td> <td headers="header5" align="right"> 36 </td> <td headers="header6" align="right"> 5663 </td> <td headers="header7" align="right"> 3.2 </td></tr> <tr><td headers="header1" align="right"> 51 </td> <td headers="header2" align="right"> 73 </td> <td headers="header3" align="right"> 17 </td> <td headers="header4" align="right"> 107 </td> <td headers="header5" align="right"> 56 </td> <td headers="header6" align="right"> 5932 </td> <td headers="header7" align="right"> 4.27 </td></tr> <tr><td headers="header1" align="right"> 52 </td> <td headers="header2" align="right"> 70 </td> <td headers="header3" align="right"> 12 </td> <td headers="header4" align="right"> 150 </td> <td headers="header5" align="right"> 51 </td> <td headers="header6" align="right"> 5729 </td> <td headers="header7" align="right"> 4.94 </td></tr> <tr><td headers="header1" align="right"> 53 </td> <td headers="header2" align="right"> 108 </td> <td headers="header3" align="right"> 17 </td> <td headers="header4" align="right"> 167 </td> <td headers="header5" align="right"> 47 </td> <td headers="header6" align="right"> 6009 </td> <td headers="header7" align="right"> 5.64 </td></tr> <tr><td headers="header1" align="right"> 01 </td> <td headers="header2" align="right"> 153 </td> <td headers="header3" align="right"> 25 </td> <td headers="header4" align="right"> 240 </td> <td headers="header5" align="right"> 76 </td> <td headers="header6" align="right"> 6384 </td> <td headers="header7" align="right"> 7.74 </td></tr> <tr><td headers="header1" align="right"> 02 </td> <td headers="header2" align="right"> 173 </td> <td headers="header3" align="right"> 20 </td> <td headers="header4" align="right"> 365 </td> <td headers="header5" align="right"> 86 </td> <td headers="header6" align="right"> 6062 </td> <td headers="header7" align="right"> 10.62 </td></tr> <tr><td headers="header1" align="right"> 03 </td> <td headers="header2" align="right"> 237 </td> <td headers="header3" align="right"> 38 </td> <td headers="header4" align="right"> 496 </td> <td headers="header5" align="right"> 141 </td> <td headers="header6" align="right"> 6238 </td> <td headers="header7" align="right"> 14.62 </td></tr> <tr><td headers="header1" align="right"> 04 </td> <td headers="header2" align="right"> 370 </td> <td headers="header3" align="right"> 56 </td> <td headers="header4" align="right"> 668 </td> <td headers="header5" align="right"> 231 </td> <td headers="header6" align="right"> 7138 </td> <td headers="header7" align="right"> 18.56 </td></tr> <tr><td headers="header1" align="right"> 05 </td> <td headers="header2" align="right"> 378 </td> <td headers="header3" align="right"> 24 </td> <td headers="header4" align="right"> 938 </td> <td headers="header5" align="right"> 424 </td> <td headers="header6" align="right"> 8370 </td> <td headers="header7" align="right"> 21.08 </td></tr> <tr><td headers="header1" align="right"> 06 </td> <td headers="header2" align="right"> 272 </td> <td headers="header3" align="right"> 12 </td> <td headers="header4" align="right"> 620 </td> <td headers="header5" align="right"> 409 </td> <td headers="header6" align="right"> 5380 </td> <td headers="header7" align="right"> 24.41 </td></tr> </tbody></table>

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[HenryN]

Re: Seasonal Flu 2008 - 2009

2008-2009 Influenza Season Week 6 ending February 14, 2009
(All data are preliminary and may change as more reports are received.) Synopsis:

During week 6 (February 8-14, 2009), influenza activity continued to increase in the United States.

• One thousand three hundred thirteen (24.4%) 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.
• Six influenza-associated pediatric deaths were reported.
• The proportion of outpatient visits for influenza-like illness (ILI) was above the national baseline. ILI increased in seven of the nine regions compared to the previous week, and the East North Central, East South Central, Mid-Atlantic, Mountain, New England, South Atlantic, West North Central, and West South Central regions reported ILI above their region-specific baselines.
• Twenty-four states reported widespread influenza activity, 13 states reported regional activity; the District of Columbia and 11 states reported local influenza activity; and Puerto Rico and two states reported sporadic influenza activity.

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

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

Region

</th> <th colspan="3" align="center" width="300" nowrap="nowrap">Data for current week</th> <th colspan="5" align="center" width="276" nowrap="nowrap">Data cumulative for the season</th> </tr> <tr valign="top"> <th align="center" width="72">Out-patient ILI*</th> <th align="center" width="72">% positive for flu?</th> <th align="center" width="96">Number of jurisdictions reporting regional or widespread activity?</th> <th align="center" width="48" nowrap="nowrap">A (H1)</th> <th align="center" width="48" nowrap="nowrap">A (H3)</th> <th align="center" width="60">A Unsub-typed</th> <th align="center" width="48" nowrap="nowrap">B</th> <th align="center" width="72">Pediatric Deaths</th> </tr> <tr> <td align="left" width="85">Nation</td> <td align="center" width="72" nowrap="nowrap">Elevated</td> <td align="center" width="72" nowrap="nowrap">24.4 % </td> <td align="center" width="96" nowrap="nowrap">37 of 51 </td> <td align="center" width="48" nowrap="nowrap">2,120</td> <td align="center" width="48" nowrap="nowrap">249</td> <td align="center" width="60" nowrap="nowrap">4,073</td> <td align="center" width="48" nowrap="nowrap">1,678</td> <td align="center" width="72" nowrap="nowrap">9</td> </tr> <tr> <td align="left" width="85">New England</td> <td align="center" width="72" nowrap="nowrap">Elevated</td> <td align="center" width="72" nowrap="nowrap">25.1 % </td> <td align="center" width="96" nowrap="nowrap">5 of 6</td> <td align="center" width="48" nowrap="nowrap">175</td> <td align="center" width="48" nowrap="nowrap">19</td> <td align="center" width="60" nowrap="nowrap">338</td> <td align="center" width="48" nowrap="nowrap">120</td> <td align="center" width="72" nowrap="nowrap">0</td> </tr> <tr> <td align="left" width="85">Mid-Atlantic</td> <td align="center" width="72" nowrap="nowrap">Elevated</td> <td align="center" width="72" nowrap="nowrap">17.2 % </td> <td align="center" width="96" nowrap="nowrap">3 of 3</td> <td align="center" width="48" nowrap="nowrap">195</td> <td align="center" width="48" nowrap="nowrap">19</td> <td align="center" width="60" nowrap="nowrap">319</td> <td align="center" width="48" nowrap="nowrap">134</td> <td align="center" width="72" nowrap="nowrap">2</td> </tr> <tr> <td align="left" width="85">East North Central</td> <td align="center" width="72" nowrap="nowrap">Elevated</td> <td align="center" width="72" nowrap="nowrap">39.5 % </td> <td align="center" width="96" nowrap="nowrap">4 of 5</td> <td align="center" width="48" nowrap="nowrap">355</td> <td align="center" width="48" nowrap="nowrap">40</td> <td align="center" width="60" nowrap="nowrap">37</td> <td align="center" width="48" nowrap="nowrap">111</td> <td align="center" width="72" nowrap="nowrap">0</td> </tr> <tr> <td align="left" width="85">West North Central</td> <td align="center" width="72" nowrap="nowrap">Elevated</td> <td align="center" width="72" nowrap="nowrap">15.4 % </td> <td align="center" width="96" nowrap="nowrap">4 of 7</td> <td align="center" width="48" nowrap="nowrap">209</td> <td align="center" width="48" nowrap="nowrap">20</td> <td align="center" width="60" nowrap="nowrap">298</td> <td align="center" width="48" nowrap="nowrap">60</td> <td align="center" width="72" nowrap="nowrap">0</td> </tr> <tr> <td align="left" width="85">South Atlantic</td> <td align="center" width="72" nowrap="nowrap">Elevated</td> <td align="center" width="72" nowrap="nowrap">19.8 % </td> <td align="center" width="96" nowrap="nowrap">7 of 9</td> <td align="center" width="48" nowrap="nowrap">374</td> <td align="center" width="48" nowrap="nowrap">38</td> <td align="center" width="60" nowrap="nowrap">502</td> <td align="center" width="48" nowrap="nowrap">359</td> <td align="center" width="72" nowrap="nowrap">2</td> </tr> <tr> <td align="left" width="85">East South Central</td> <td align="center" width="72" nowrap="nowrap">Elevated</td> <td align="center" width="72" nowrap="nowrap">15.1 % </td> <td align="center" width="96" nowrap="nowrap">3 of 4</td> <td align="center" width="48" nowrap="nowrap">49</td> <td align="center" width="48" nowrap="nowrap">5</td> <td align="center" width="60" nowrap="nowrap">8</td> <td align="center" width="48" nowrap="nowrap">30</td> <td align="center" width="72" nowrap="nowrap">1</td> </tr> <tr> <td align="left" width="85">West South Central</td> <td align="center" width="72" nowrap="nowrap">Elevated</td> <td align="center" width="72" nowrap="nowrap">29.5 % </td> <td align="center" width="96" nowrap="nowrap">1 of 4</td> <td align="center" width="48" nowrap="nowrap">300</td> <td align="center" width="48" nowrap="nowrap">23</td> <td align="center" width="60" nowrap="nowrap">2,037</td> <td align="center" width="48" nowrap="nowrap">776</td> <td align="center" width="72" nowrap="nowrap">2</td> </tr> <tr> <td align="left" width="85">Mountain</td> <td align="center" width="72" nowrap="nowrap">Elevated</td> <td align="center" width="72" nowrap="nowrap">12.3 % </td> <td align="center" width="96" nowrap="nowrap">7 of 8</td> <td align="center" width="48" nowrap="nowrap">105</td> <td align="center" width="48" nowrap="nowrap">61</td> <td align="center" width="60" nowrap="nowrap">349</td> <td align="center" width="48" nowrap="nowrap">35</td> <td align="center" width="72" nowrap="nowrap">2</td> </tr> <tr> <td align="left" width="85">Pacific</td> <td align="center" width="72" nowrap="nowrap">Normal</td> <td align="center" width="72" nowrap="nowrap">7.2 % </td> <td align="center" width="96" nowrap="nowrap">3 of 5</td> <td align="center" width="48" nowrap="nowrap">358</td> <td align="center" width="48" nowrap="nowrap">24</td> <td align="center" width="60" nowrap="nowrap">185</td> <td align="center" width="48" nowrap="nowrap">53</td> <td align="center" width="72" nowrap="nowrap">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" align="center" border="0" cellpadding="3" cellspacing="0"> <tbody><tr> <th align="left" width="200">
</th> <th align="center" width="150" nowrap="nowrap">Week 5</th> <th align="center" width="150" nowrap="nowrap">Cumulative for the Season</th> </tr> <tr> <td align="left" width="200">No. of specimens tested</td> <td align="center" width="150" nowrap="nowrap">5,380</td> <td align="center" width="150" nowrap="nowrap">100,034</td> </tr> <tr> <td align="left" width="200">No. of positive specimens (%)</td> <td align="center" width="150" nowrap="nowrap">1,313 (24.4%)</td> <td align="center" width="150" nowrap="nowrap">8,120 (8.1%)</td> </tr> <tr> <td colspan="3" align="left">Positive specimens by type/subtype</td> </tr> <tr> <td align="left" width="170"> Influenza A</td> <td align="center" width="150" nowrap="nowrap">904 (68.8%)</td> <td align="center" width="150" nowrap="nowrap">6,442 (79.3%)</td> </tr> <tr> <td align="left" width="170"> A (H1)</td> <td align="center" width="150" nowrap="nowrap"> 272 (30.1%)</td> <td align="center" width="150" nowrap="nowrap"> 2,120 (32.9%)</td> </tr> <tr> <td align="left" width="170"> A (H3)</td> <td align="center" width="150" nowrap="nowrap"> 12 (1.3%)</td> <td align="center" width="150" nowrap="nowrap"> 249 (3.9%)</td> </tr> <tr> <td align="left" width="170"> A (unsubtyped)</td> <td align="center" width="150" nowrap="nowrap"> 620 (68.6%)</td> <td align="center" width="150" nowrap="nowrap"> 4,037 (63.2%)</td> </tr> <tr> <td align="left" width="170"> Influenza B</td> <td align="center" width="150" nowrap="nowrap">409 (31.2%)</td> <td align="center" width="150" nowrap="nowrap"> 1,678 (20.7%)</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, 90% 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 390 influenza viruses [239 influenza A (H1), 37 influenza A (H3) and 114 influenza B viruses] collected by U.S. laboratories since October 1, 2008.
All 239 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. Thirty-three influenza B viruses tested belong to the B/Yamagata lineage and are related to the vaccine strain (B/Florida/04/2006). The remaining 81 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, 268 influenza A (H1N1), 51 influenza A (H3N2), and 110 influenza B viruses have been tested for resistance to the neuraminidase inhibitors (oseltamivir and zanamivir). Two hundred sixty-eight influenza A (H1N1) and 51 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" align="center" border="0" cellpadding="3" cellspacing="0"> <tbody><tr> <th rowspan="1" align="left" width="160">
</th> <th align="center" width="100" nowrap="nowrap">Isolates tested (n)</th> <th colspan="2" align="center" width="200" nowrap="nowrap">Resistant Viruses,
Number (%)</th> <th align="center" width="100" nowrap="nowrap">Isolates tested (n)</th> <th align="center" width="120" nowrap="nowrap">Resistant Viruses, Number (%)</th> </tr> <tr> <th align="left" width="160">
</th> <th align="center" width="100" nowrap="nowrap">
</th> <th align="center" width="100" nowrap="nowrap">Oseltamivir</th> <th align="center" width="100" nowrap="nowrap">Zanamivir</th> <th align="center" width="100" nowrap="nowrap">
</th> <th align="center" width="120" nowrap="nowrap">Adamantanes</th> </tr> <tr> <td align="left" width="160" nowrap="nowrap">Influenza A (H1N1)</td> <td align="center" width="100" nowrap="nowrap">268</td> <td align="center" width="100" nowrap="nowrap">264 (98.5%)</td> <td align="center" width="100" nowrap="nowrap">0 (0)</td> <td align="center" width="100" nowrap="nowrap">268</td> <td align="center" width="120" nowrap="nowrap">2 (0.7%)</td> </tr> <tr> <td align="left" width="160" nowrap="nowrap">Influenza A (H3N2)</td> <td align="center" width="100" nowrap="nowrap">51</td> <td align="center" width="100" nowrap="nowrap">0 (0)</td> <td align="center" width="100" nowrap="nowrap">0 (0)</td> <td align="center" width="100" nowrap="nowrap">51</td> <td align="center" width="120" nowrap="nowrap">51 (100%)</td> </tr> <tr> <td align="left" width="160" nowrap="nowrap">Influenza B</td> <td align="center" width="100" nowrap="nowrap">110</td> <td align="center" width="100" nowrap="nowrap">0 (0)</td> <td align="center" width="100" nowrap="nowrap">0 (0)</td> <td align="center" width="100" nowrap="nowrap">N/A*</td> <td align="center" width="120" nowrap="nowrap">N/A*</td> </tr> </tbody></table> ^{*The adamantanes (amantadine and rimantadine) are not effective against influenza B viruses.}

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/...AlertNum=00279
Pneumonia and Influenza (P&I) Mortality Surveillance

During week 6, 6.8% of all deaths reported through the 122-Cities Mortality Reporting System were due to P&I. This percentage is below the epidemic threshold of 8.0% for week 6.
<center>
View Full Screen</center> Influenza-Associated Pediatric Mortality

Six influenza-associated pediatric deaths were reported to CDC during week 6 (Arkansas, Colorado, Florida, North Carolina [2], and Pennsylvania). One death occurred during week 8 of the 2006-07 season (week ending February 24, 2007), bringing the total number of reported pediatric deaths occurring during that season to 78. The remaining five deaths reported this week occurred between January 25 and February 14, 2009. Since September 28, 2008, CDC has received nine reports of influenza-associated pediatric deaths that occurred during the current season.
Bacterial coinfections were confirmed in six (66.7%) of the nine children; Staphylococcus aureus was identified in four (66.7%) of the six children. Two of the S. aureus isolates were sensitive to methicillin and two were methicillin resistant. All six children with bacterial coinfections were five years of age or older. An increase in the number of influenza-associated pediatric deaths with bacterial coinfections was first recognized during the 2006-07 influenza season. In January 2008, interim testing and reporting recommendations were released regarding influenza and bacterial coinfections in children and are available at (http://www2a.cdc.gov/HAN/ArchiveSys/...AlertNum=00268).
<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 ? February 14, 2009, preliminary laboratory-confirmed influenza-associated hospitalization rates reported by the EIP for children aged 0-4 years and 5-17 years were 1.0 per 10,000 and 0.1 per 10,000, respectively. For adults aged 18-49 years, 50-64 years, and = 65 years, the rates were 0.1 per 10,000, 0.1 per 10,000, and 0.4 per 10,000, respectively.
<center>
View Full Screen</center> Outpatient Illness Surveillance:

Nationwide during week 6, 3.6% 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 seven of the nine regions compared to the previous week and ranged from 1.7% to 6.6%. Eight of nine surveillance regions reported ILI percentages above their region specific baselines.
<table class="table" align="center" border="0" cellpadding="3" cellspacing="0"> <tbody><tr> <th align="left" width="80">Region</th> <th align="center" width="60" nowrap="nowrap">New England</th> <th align="center" width="60" nowrap="nowrap">Mid Atlantic</th> <th align="center" width="60" nowrap="nowrap">East North Central</th> <th align="center" width="60" nowrap="nowrap">West North Central</th> <th align="center" width="60" nowrap="nowrap">South Atlantic</th> <th align="center" width="60" nowrap="nowrap">East South Central</th> <th align="center" width="60" nowrap="nowrap">West South Central</th> <th align="center" width="60" nowrap="nowrap">Mountain</th> <th align="center" width="60" nowrap="nowrap">Pacific</th> </tr> <tr> <td align="left" width="80" nowrap="nowrap">Reported ILI (%)</td> <td align="center" width="60" nowrap="nowrap">4.8</td> <td align="center" width="60" nowrap="nowrap">4.3</td> <td align="center" width="60" nowrap="nowrap">2.5</td> <td align="center" width="60" nowrap="nowrap">2.0</td> <td align="center" width="60" nowrap="nowrap">3.7</td> <td align="center" width="60" nowrap="nowrap">3.4</td> <td align="center" width="60" nowrap="nowrap">6.6</td> <td align="center" width="60" nowrap="nowrap">1.7</td> <td align="center" width="60" nowrap="nowrap">2.9</td> </tr> <tr> <td align="left" width="80" nowrap="nowrap">Region-Specific Baseline</td> <td align="center" width="60" nowrap="nowrap">1.5</td> <td align="center" width="60" nowrap="nowrap">2.9</td> <td align="center" width="60" nowrap="nowrap">1.9</td> <td align="center" width="60" nowrap="nowrap">1.7</td> <td align="center" width="60" nowrap="nowrap">2.2</td> <td align="center" width="60" nowrap="nowrap">2.5</td> <td align="center" width="60" nowrap="nowrap">4.8</td> <td align="center" width="60" nowrap="nowrap">1.5</td> <td align="center" width="60" nowrap="nowrap">3.0</td> </tr> </tbody></table> Geographic Spread of Influenza as Assessed by State and Territorial Epidemiologists:

During week 6, the following influenza activity was reported:

• Widespread influenza activity was reported by 24 states (Alabama, Arizona, Colorado, Connecticut, Delaware, Florida, Georgia, Indiana, Iowa, Maine, Maryland, Massachusetts, Nevada, New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, and Virginia).
• Regional influenza activity was reported by 13 states (Alaska, California, Hawaii, Idaho, Michigan, Minnesota, Mississippi, Montana, Nebraska, New Mexico, North Dakota, Wisconsin, and Wyoming).
• Local influenza activity was reported by the District of Columbia and 11 states (Arkansas, Kansas, Kentucky, Louisiana, Missouri, Oklahoma, Oregon, South Dakota, Utah, Vermont, and Washington).
• Sporadic activity was reported by Puerto Rico and two states (Illinois and West Virginia).

• Content Source: Coordinating Center for Infectious Diseases (CCID)
• National Center for Immunization and Respiratory Diseases (NCIRD)

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View Full Screen

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A description of surveillance methods is available at: http://www.cdc.gov/flu/weekly/fluactivity.htm

[HenryN]

Re: Seasonal Flu 2008 - 2009

Overall influenza activity in Canada continues to increase
During week 05, influenza activity in Canada continued to increase with one region reporting widespread influenza activity (in BC) and more regions reporting localized (n=11; in BC, AB, MB, ON, QC, NB & NL) and sporadic activity (n=29) (see map). The proportion of tests that were positive for influenza continued to increase (percentage positive = 11.7%; 568/4,865) (see table). Although the majority of influenza virus detections to date this season were influenza A viruses (57% or 1,003/1,746) detections for influenza B viruses are also increasing (see graph). This week, the ILI consultation rate declined to 21 ILI consultations per 1,000 patient visits (see ILI graph) which is below the expected range. The sentinel response rate was 64%. In week 05, 23 new influenza outbreaks were reported: 6 in LTCFs (AB, ON & QC), 1 in a hospital (NL) and 16 in schools (BC, AB, MB &NB).
Antigenic Characterization:
Since 1 September 2008, the NML has antigenically characterized 290 influenza viruses: 76 influenza A/Brisbane/59/2007(H1N1)-like (from BC, AB, SK, ON, QC, NS & PEI), 29 influenza A/Brisbane/10/2007(H3N2)-like (from BC, AB, SK, ON, QC, PEI & NL), 6 influenza B/Florida/4/2006-like (from AB, ON & QC) and 179 B/Malaysia/2506/2004-like (in all provinces except BC). A/Brisbane/59/2007(H1N1), A/Brisbane/10/2007(H3N2) and B/Florida/4/2006 are the influenza A and influenza B components recommended for the 2008-09 influenza vaccine. B/Malaysia/2506/2004 was the influenza B component for the 2007-2008 season vaccine (see pie chart).
*** The <acronym title="World Health Organization">WHO</acronym> recommends that the vaccines to be used in the 2009-2010 season (northern hemisphere) contain the following: an A/Brisbane/59/2007 (H1N1)-like virus; an A/Brisbane/10/2007 (H3N2)-like virus; and a B/Brisbane/60/2008-like virus.

• <a target="_blank" href="http://www.who.int/csr/disease/influenza/recommendations2009_10north/en/index.html" rel="x"><acronym title="World Health Organization">WHO</acronym>

Antiviral Resistance:
Results from the NML:
Since the start of the season, the NML has tested 101 influenza A isolates (54 H1N1 and 47 H3N2) for amantadine resistance. All of the H1N1 isolates were susceptible; however all of the H3N2 isolates were resistant to amantadine (resistance = 100% or 47/47). The resistant isolates were from BC, AB, SK, ON, QC, PEI, NL & NT.
The NML has also tested 180 influenza isolates (52 A/H1N1, 17 A/H3N2 & 111 B) for oseltamivir (Tamiflu) resistance. All of the A/H3N2 and B isolates were sensitive; however all of the A/H1N1 isolates were resistant to oseltamivir due to the H274Y mutation (resistance = 100% or 52/52). The resistant isolates were from BC, AB, SK, ON, NS & PEI.
All 175 influenza isolates (45 A/H1N1, 18 A/H3N2 & 112 B) tested for zanamivir resistance to date were sensitive to zanamivir.
Oseltamivir resistance findings from Provincial laboratories:
To date this season, 76 influenza isolates in BC have been sub-typed as A/H1 and were assessed genotypically for oseltamivir resistance using an SNP assay. Sixty-eight isolates tested positive for the H274Y mutation (resistance = 100% or 68/68), with the other 8 specimens still pending confirmatory testing.
Influenza-associated Paediatric Hospitalizations:
In week 05, 29 laboratory-confirmed influenza-associated paediatric hospitalizations were reported through the Immunization Monitoring Program Active (IMPACT) network. The cases were from BC, AB, ON & QC and 72% were due to influenza A. To date, 91 hospitalizations have been reported of which 73% (66/91) have been due to influenza A. The proportion of cases to date by age group are as follows: 19% were 0-5 month olds; 16% were 6-23 month olds; 14% were 2-4 year-olds; 14% were 5-9 year-olds; and 36% were 10-16 year-olds. The distribution of cases to date by province are as follows:8% from BC, 8% from AB, 68% from ON, 14% from QC & 2% from NS.
International:

CDC: During week 04, influenza activity continued to increase in the United States; 792 (16.2%) specimens tested positive for influenza, of which 85% were influenza A and 15% were influenza B. Testing for antiviral resistance indicated that of the influenza A/H1N1, 97.4% were resistant to oseltamivir and 1.1% resistant to amantadine. Of the influenza A/H3N2 viruses tested for resistance, 100% were resistant to amantadine. All tested viruses remain sensitive to zanamivir. One influenza-associated pediatric death was reported during week 04.

• <a target="_blank" href="http://www.cdc.gov/flu/weekly/" rel="x"><acronym title="Centers for Disease Control and Prevention">CDC</acronym>

EISS: Influenza activity continues to increase in eastern Europe, however in western Europe it is generally decreasing. Influenza A(H3N2) continues to be the dominant influenza virus circulating in Europe. Of the 115 A(H3N2) isolates that were tested for adamantanes susceptibility, 115 (100%) were resistant. Of the 110 A(H1N1) virus isolates tested for resistance against neuraminidase inhibitors, 107 (97%) were resistant to oseltamivir, but all were sensitive to zanamivir.

• <a target="_blank" href="http://www.eiss.org/cgi-files/bulletin_v2.cgi" rel="x"><acronym title=" European Influenza Surveillance Scheme">EISS</acronym>

Human Avian Influenza: Since 7 February 2009, the WHO has reported 2 new cases of human H5N1 avian influenza infection from Egypt and Viet Nam.

• <a target="_blank" href="http://www.who.int/csr/disease/avian_influenza/en/index.html" rel="x"><acronym title="World Health Organization">WHO</acronym>

<hr> Total number of influenza tests performed and number of positive tests by province/territory of testing laboratory, Canada, 2008-2009

<table class="widthFull" id="fluwatchtable" border="1" cellpadding="2" cellspacing="0"> <tbody><tr class="bg-colour-blue"> <td rowspan="3" class="alignCenter">Province of
reporting
laboratories </td> <td colspan="4" class="alignCenter" valign="bottom"> Report Period:
February 1, 2009 to February 7, 2009 </td> <td colspan="4" class="alignCenter" valign="bottom"> Season to Date:
August 24, 2008 to February 7, 2009</td> </tr> <tr class="bg-colour-blue"> <td rowspan="2" class="alignCenter">Total #
Influenza
Tests </td> <td colspan="3" class="alignCenter"># of Positive Tests </td> <td rowspan="2" class="alignCenter">Total #
Influenza
Tests</td> <td colspan="3" class="alignCenter"># of Positive Tests </td> </tr> <tr class="bg-colour-blue"> <td class="alignCenter">Influenza A</td> <td class="alignCenter">Influenza B</td> <td class="alignCenter">Total </td> <td class="alignCenter"> Influenza A</td> <td class="alignCenter">Influenza B</td> <td class="alignCenter">Total </td> </tr> <tr> <td class="bg-colour-blue">NL
</td> <td class="alignRight">25</td> <td class="alignRight">4</td> <td class="alignRight">1</td> <td class="alignRight">5</td> <td class="alignRight">299</td> <td class="alignRight">8</td> <td class="alignRight">3</td> <td class="alignRight">11</td> </tr> <tr> <td class="bg-colour-blue">PE
</td> <td class="alignRight">16</td> <td class="alignRight">3</td> <td class="alignRight">0</td> <td class="alignRight">3</td> <td class="alignRight">109</td> <td class="alignRight">8</td> <td class="alignRight">4</td> <td class="alignRight">12</td> </tr> <tr> <td class="bg-colour-blue">NS
</td> <td class="alignRight">72</td> <td class="alignRight">9</td> <td class="alignRight">6</td> <td class="alignRight">15</td> <td class="alignRight">463</td> <td class="alignRight">14</td> <td class="alignRight">11</td> <td class="alignRight">25</td> </tr> <tr> <td class="bg-colour-blue">NB
</td> <td class="alignRight">103</td> <td class="alignRight">20</td> <td class="alignRight">3</td> <td class="alignRight">23</td> <td class="alignRight">486</td> <td class="alignRight">27</td> <td class="alignRight">18</td> <td class="alignRight">45</td> </tr> <tr> <td class="bg-colour-blue">QC
</td> <td class="alignRight">1505</td> <td class="alignRight">136</td> <td class="alignRight">68</td> <td class="alignRight">204</td> <td class="alignRight">12774</td> <td class="alignRight">369</td> <td class="alignRight">98</td> <td class="alignRight">467</td> </tr> <tr> <td class="bg-colour-blue">ON
</td> <td class="alignRight">1546</td> <td class="alignRight">68</td> <td class="alignRight">120</td> <td class="alignRight">188</td> <td class="alignRight">15285</td> <td class="alignRight">214</td> <td class="alignRight">451</td> <td class="alignRight">665</td> </tr> <tr> <td class="bg-colour-blue">MB
</td> <td class="alignRight">90</td> <td class="alignRight">1</td> <td class="alignRight">2</td> <td class="alignRight">3</td> <td class="alignRight">1207</td> <td class="alignRight">1</td> <td class="alignRight">4</td> <td class="alignRight">5</td> </tr> <tr> <td class="bg-colour-blue">SK
</td> <td class="alignRight">252</td> <td class="alignRight">2</td> <td class="alignRight">8</td> <td class="alignRight">10</td> <td class="alignRight">2478</td> <td class="alignRight">19</td> <td class="alignRight">13</td> <td class="alignRight">32</td> </tr> <tr> <td class="bg-colour-blue">AB
</td> <td class="alignRight">1080</td> <td class="alignRight">45</td> <td class="alignRight">13</td> <td class="alignRight">58</td> <td class="alignRight">11532</td> <td class="alignRight">177</td> <td class="alignRight">98</td> <td class="alignRight">275</td> </tr> <tr> <td class="bg-colour-blue">BC
</td> <td class="alignRight">176</td> <td class="alignRight">36</td> <td class="alignRight">23</td> <td class="alignRight">59</td> <td class="alignRight">1300</td> <td class="alignRight">166</td> <td class="alignRight">43</td> <td class="alignRight">209</td> </tr> <tr> <td class="bg-colour-blue">Canada
</td> <td class="alignRight">4865</td> <td class="alignRight">324</td> <td class="alignRight">244</td> <td class="alignRight">568</td> <td class="alignRight">45933</td> <td class="alignRight">1003</td> <td class="alignRight">743</td> <td class="alignRight">1746</td> </tr> </tbody></table> Specimens from NT, YT, and NU are sent to reference laboratories in other provinces.
Note: Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals.
Abbreviations: Newfoundland/Labrador (NL), Prince Edward Island (PE), New Brunswick (NB), Nova Scotia (NS), Quebec (QC), Ontario (ON), Manitoba (MB), Saskatchewan (SK), Alberta (AB), British Columbia (BC), Yukon (YT), Northwest Territories (NT), Nunavut (NU)
Respiratory virus laboratory detections in Canada, by geographic regions, are available weekly on the following website:
<http://www.phac-aspc.gc.ca/bid-bmi/d.../index-eng.php>


Number of influenza surveillance regions? reporting widespread or localized influenza activity, Canada, by report week, 2008-2009 (N=54)



? sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.


<table width="100%"> <tbody><tr align="center"> <td colspan="2">Influenza Activity Level by Provincial and Territorial
Influenza Surveillance Regions, Canada,
February 1, 2009 to February 7, 2009 (Week 05)

</td> </tr> <tr align="center"> <td class="alignCenter"></td> <td><table border="0" cellpadding="1" cellspacing="0"> <tbody><tr> <td align="center"><table class="border-lite" cellpadding="1" cellspacing="1"> <tbody><tr align="center"> <td>No Data </td> <td></td> </tr> <tr align="center"> <td>No Activity</td> <td></td> </tr> <tr align="center"> <td>Sporadic Activity</td> <td></td> </tr> <tr align="center"> <td>Localized Activity</td> <td></td> </tr> <tr align="center"> <td>Widespread
Activity</td> <td></td> </tr> </tbody></table></td> </tr> </tbody></table></td> </tr> </tbody></table> Note: Influenza activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates (see graphs and tables) and outbreaks. Please refer to detailed definitions. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website. Select single maps by report week to get this updated information.
<http://dsol-smed.phac-aspc.gc.ca/dso...h.phtml?lang=e>
Click on the map to view provinces/territories and maps for other weeks.


Influenza tests reported and percentage of tests positive, Canada, by report week, 2008-2009




Percent positive influenza tests, compared to other respiratory viruses, Canada, by reporting week, 2008-2009







Influenza strain characterization, Canada, cumulative, 2008-2009 influenza season by the Respiratory Viruses Section at the National Microbiology Laboratory
[N=290]


{Strain characterization, number identified, per cent of total number}
NACI recommends that the trivalent vaccine for the 2008-2009 season in Canada contain
A/Brisbane/59/2007 (H1N1)-like virus; an A/Brisbane/10/2007 (H3N2)-like virus; and a B/Florida/4/2006-like virus.


Influenza-like illness (ILI) consultation rates, Canada, by report week,
2008-2009 compared to 1996/97 through to 2007/08 seasons



Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons).


Number of New Outbreaks in Long Term Care Facilities, Canada, by Report Week, 2008-2009



Please note that the above graphs may change as late returns come in.

[HenryN]

Re: Seasonal Flu 2008 - 2009

In Canada H274Y in H1N1 is in 120/120 tested.

[Giuseppe]

Re: Seasonal Flu 2008 - 2009

USA. Arizona Teen Dies From Influenza

Arizona Teen Dies From Influenza

Article Date: 23 Feb 2009 - 3:00 PST

The first Arizona pediatric death of the 2008-09 influenza season happened last week in Coconino County.


The teenager is the fifth pediatric death in the country this flu season. In general, influenza is getting off to a slow start in Arizona and around the country this year.

"Flu season is here and you need to protect yourself from germs," said Interim Health Services Director Will Humble. "Influenza can be lethal, but you don't have to be a victim. Wash your hands. If you get sick, cover your cough and don't go to work or school."

Influenza is much worse than a regular cold. Symptoms include high fever, achiness, cough, and tiredness. The main distinction from a cold is influenza comes on strong. With the flu, you can be fine in the morning and by lunch, you feel like you were hit by a truck.

So far this year, 262 laboratory-confirmed cases of influenza have been identified in Arizona. At this time last year, there were 2,116 cases. There were 2 pediatric deaths in Arizona during the 2007-08 flu season. On average about 36,000 people die from influenza and related pneumonia every year in the U.S. The latest Arizona statistics are on the ADHS website.

Influenza is a vaccine-preventable disease. The influenza vaccine is recommended yearly for all adults over 50 years, children 6-months to 18-years old, pregnant women, those with chronic health problems, and anyone who comes into contact with these groups. Since October of last year, more than a quarter-million influenza vaccines were given in Arizona. Centers for Disease Control recommends people continue to be vaccinated even after the flu season begins.

You can find places still giving vaccinations at http://www.fluaz.org.
Source Laura Oxley
Public Information Officer
Office of the Director
Arizona Department of Health Services http://www.azdhs.gov
-

<cite cite="http://www.medicalnewstoday.com/articles/139926.php">Arizona Teen Dies From Influenza</cite>

[Giuseppe]

Re: Seasonal Flu 2008 - 2009

Italy. 2008/2009 Influenza Season. Update, Incidence of Influenza-like Illness among population, Feb. 25 2009.

Global Trend of Influenza-like Illness among population.

Further information about CIRI (Centro Interuniversitario per lo Studio dell'Influenza) activities and more details about research performed are available following this LINK (in Italian language).

Graphs show incidence of Influenza-like Illness for current surveillance week; data is provided by epidemiological surveillance done by the network of sentinel family doctors.

<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>

Dati Aggiornati al 25-02-2009 alle ore: 11:06:13


[ Surveillance Week - Sentinel Doctors - Patients - Cases - Incidence for classes of age: (0-4 years-old) - (5-14) - (15-65) - (+65) - Total Incidence (x1,000 inhabitants ]

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 - 418 - 550625 - 2990 - 16,31 - 11,96 - 4,62 - 1,82 - 5,43
2009-06 - 414 - 544169 - 2601 - 12,59 - 8,91 - 4,37 - 1,96 - 4,78
2009-07 - 411 - 540847 - 1916 - 11,57 - 7,34 - 2,91 - 1,43 - 3,54
2009-08 - 344 - 452180 - 1324 - 7,84 - 5,27 - 2,63 - 1,29 - 2,93

-
----

[HenryN]

Re: Seasonal Flu 2008 - 2009

PA Influenza Weekly Report
Week ending February 21, 2009 (Week 07)

<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 07:</TD><TD>

WIDESPREAD

</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 06), 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 February 21, 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>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>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: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; HEIGHT: 17.5pt" vAlign=top width=84>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: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; HEIGHT: 17.5pt" vAlign=top width=96>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: 1.25in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; HEIGHT: 17.5pt" vAlign=top width=120>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>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>Total
</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><?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-com:office:smarttags" /><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: 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: 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: 1.25in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=120>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: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=84>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: 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: 1.25in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=120>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>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: 0.5in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=48>7
</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=9>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: 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: 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: 1.25in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=120>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: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=84>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>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: 1.25in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=120>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: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=84>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>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: 1.25in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=120>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: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=84>34
</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>6
</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: 1.25in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=120>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>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: 0.5in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=48>43
</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: 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: 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: 1.25in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=120>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: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=84>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>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: 1.25in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=120>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>8
</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: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=84>31
</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: 1.25in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=120>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>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: 0.5in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=48>38
</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: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=84>7
</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: 1.25in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=120>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>9
</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>Susquehanna
</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: 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: 1.25in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=120>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>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: windowtext 1pt solid; WIDTH: 48.6pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=65 rowSpan=3>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: 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: 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: 1.25in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=120>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: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=84>8
</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: 1.25in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=120>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>8
</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">Union</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: 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: 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: 1.25in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=120>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>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: 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=6>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: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=84>28
</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: 1.25in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=120>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>7
</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>35
</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: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=84>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>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: 1.25in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=120>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>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: #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: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=84>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>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: 1.25in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=120>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>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:State w:st="on">Delaware</st1:State></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: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=84>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>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: 1.25in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=120>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><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: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=84>7
</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: 1.25in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=120>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: 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>9
</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">Montgomery</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: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=84>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: 1.25in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=120>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>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: 0.5in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=48>8
</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=7>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: 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: 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: 1.25in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=120>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>Dauphin
</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: 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: 1.25in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=120>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>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: 0.5in; 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; 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: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=84>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>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: 1.25in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=120>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; 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">Franklin</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: 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: 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: 1.25in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=120>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>6
</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>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: #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">Lancaster</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: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=84>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: 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: 1.25in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=120>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>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: #ece9d8; WIDTH: 91.8pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=122>Snyder
</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: 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: 1.25in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=120>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:City w:st="on"><st1:place w:st="on">York</st1:place></st1:City>
</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: 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: 1.25in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=120>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>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: 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: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=84>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>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: 1.25in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=120>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: 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; 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: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=84>6
</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: 1.25in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top width=120>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>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: 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: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=84>159
</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>16
</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: 1.25in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=120>4
</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>41
</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>220
</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

? Results based on a Based on a few specimens that are voluntarily submitted to the State Lab by physicians, hospitals and Influenza sentinel providers. Speciments are submitted for confirmatory testing. Results in the above table do not represent all Influenza positive tests in Pennsylvania.

</st1:place></st1:State>

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

Influenza antiviral Resistance test results for Pennsylvania
(as of February 21, 2009)

<TABLE style="BORDER-RIGHT: medium none; BORDER-TOP: medium none; MARGIN: auto auto auto -0.05in; BORDER-LEFT: medium none; BORDER-BOTTOM: medium none; BORDER-COLLAPSE: collapse" cellSpacing=0 cellPadding=0 border=1><TBODY><TR><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: windowtext 1pt solid; 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: windowtext 1pt solid; 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>Isolates tested (n)
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 135pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=180 colSpan=2>Resistant Viruses
Number (%)
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; 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>Isolates tested (n)
</TD><TD style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top>Resistant Viruses, Number (%)
</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: 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: 63pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=84>
</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: 71.55pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=95>Oseltamivir
</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: 63.45pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=85>Zanamivir
</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>
</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; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top>Adamantanes
</TD></TR><TR style="HEIGHT: 22pt"><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: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; HEIGHT: 22pt; BACKGROUND-COLOR: transparent" vAlign=top width=96>Influenza A (H1N1)
</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; HEIGHT: 22pt; BACKGROUND-COLOR: transparent" vAlign=top width=84>
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: 71.55pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; HEIGHT: 22pt" vAlign=top width=95>
19 (100%)
</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: 63.45pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; HEIGHT: 22pt; BACKGROUND-COLOR: transparent" vAlign=top width=85>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; HEIGHT: 22pt; BACKGROUND-COLOR: transparent" vAlign=top width=84>
19
</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; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; HEIGHT: 22pt; BACKGROUND-COLOR: transparent" vAlign=top>
0 (0%)
</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: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=96>Influenza A (H3N2)
</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: 71.55pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=95>
0 (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: 63.45pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=85>
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>
1
</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; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid" vAlign=top>
1 (100%)
</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: 1in; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=96>
Influenza B
</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>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: 71.55pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=95>0 (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: 63.45pt; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top width=85>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>N/A*
</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; PADDING-TOP: 0in; BORDER-BOTTOM: windowtext 1pt solid; BACKGROUND-COLOR: transparent" vAlign=top>N/A*
</TD></TR></TBODY></TABLE>
<SUP>*The adamantanes (amantadine and rimantadine) are not effective against influenza B </SUP>
Data in the above table only represents a few Influenza isolates from Pennsylvania that have been tested by CDC so far. More comprehensive information on the level of antiviral resistance can be found at http://www.cdc.gov/flu/weekly/weeklyarchives2008-2009/weekly03.htm

<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 7



<TABLE class=Table cellSpacing=1 cellPadding=7 rules=none summary="Procedure Freq: One-Way Frequencies" frame=box><COLGROUP><COL></COLGROUP><COLGROUP><COL><COL></COLGROUP><THEAD><TR><TH class="c 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">10</TD><TD class="r Data">0.37</TD></TR><TR><TH class="l RowHeader" scope=row>ALLEGHENY</TH><TD class="r Data">310</TD><TD class="r Data">11.44</TD></TR><TR><TH class="l RowHeader" scope=row>ARMSTRONG</TH><TD class="r Data">29</TD><TD class="r Data">1.07</TD></TR><TR><TH class="l RowHeader" scope=row>BEAVER</TH><TD class="r Data">4</TD><TD class="r Data">0.15</TD></TR><TR><TH class="l RowHeader" scope=row>BEDFORD</TH><TD class="r Data">6</TD><TD class="r Data">0.22</TD></TR><TR><TH class="l RowHeader" scope=row>BERKS</TH><TD class="r Data">78</TD><TD class="r Data">2.88</TD></TR><TR><TH class="l RowHeader" scope=row>BLAIR</TH><TD class="r Data">22</TD><TD class="r Data">0.81</TD></TR><TR><TH class="l RowHeader" scope=row>BRADFORD</TH><TD class="r Data">2</TD><TD class="r Data">0.07</TD></TR><TR><TH class="l RowHeader" scope=row>BUCKS</TH><TD class="r Data">139</TD><TD class="r Data">5.13</TD></TR><TR><TH class="l RowHeader" scope=row>BUTLER</TH><TD class="r Data">66</TD><TD class="r Data">2.44</TD></TR><TR><TH class="l RowHeader" scope=row>CAMBRIA</TH><TD class="r Data">27</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">0.04</TD></TR><TR><TH class="l RowHeader" scope=row>CARBON</TH><TD class="r Data">36</TD><TD class="r Data">1.33</TD></TR><TR><TH class="l RowHeader" scope=row>CENTRE</TH><TD class="r Data">73</TD><TD class="r Data">2.69</TD></TR><TR><TH class="l RowHeader" scope=row>CHESTER</TH><TD class="r Data">95</TD><TD class="r Data">3.51</TD></TR><TR><TH class="l RowHeader" scope=row>CLARION</TH><TD class="r Data">15</TD><TD class="r Data">0.55</TD></TR><TR><TH class="l RowHeader" scope=row>CLEARFIELD</TH><TD class="r Data">9</TD><TD class="r Data">0.33</TD></TR><TR><TH class="l RowHeader" scope=row>CLINTON</TH><TD class="r Data">9</TD><TD class="r Data">0.33</TD></TR><TR><TH class="l RowHeader" scope=row>COLUMBIA</TH><TD class="r Data">6</TD><TD class="r Data">0.22</TD></TR><TR><TH class="l RowHeader" scope=row>CRAWFORD</TH><TD class="r Data">14</TD><TD class="r Data">0.52</TD></TR><TR><TH class="l RowHeader" scope=row>CUMBERLAND</TH><TD class="r Data">6</TD><TD class="r Data">0.22</TD></TR><TR><TH class="l RowHeader" scope=row>DAUPHIN</TH><TD class="r Data">13</TD><TD class="r Data">0.48</TD></TR><TR><TH class="l RowHeader" scope=row>DELAWARE</TH><TD class="r Data">87</TD><TD class="r Data">3.21</TD></TR><TR><TH class="l RowHeader" scope=row>ELK</TH><TD class="r Data">5</TD><TD class="r Data">0.18</TD></TR><TR><TH class="l RowHeader" scope=row>ERIE</TH><TD class="r Data">158</TD><TD class="r Data">5.83</TD></TR><TR><TH class="l RowHeader" scope=row>FAYETTE</TH><TD class="r Data">11</TD><TD class="r Data">0.41</TD></TR><TR><TH class="l RowHeader" scope=row>FRANKLIN</TH><TD class="r Data">53</TD><TD class="r Data">1.96</TD></TR><TR><TH class="l RowHeader" scope=row>FULTON</TH><TD class="r Data">7</TD><TD class="r Data">0.26</TD></TR><TR><TH class="l RowHeader" scope=row>GREENE</TH><TD class="r Data">5</TD><TD class="r Data">0.18</TD></TR><TR><TH class="l RowHeader" scope=row>HUNTINGDON</TH><TD class="r Data">13</TD><TD class="r Data">0.48</TD></TR><TR><TH class="l RowHeader" scope=row>INDIANA</TH><TD class="r Data">19</TD><TD class="r Data">0.70</TD></TR><TR><TH class="l RowHeader" scope=row>JEFFERSON</TH><TD class="r Data">4</TD><TD class="r Data">0.15</TD></TR><TR><TH class="l RowHeader" scope=row>JUNIATA</TH><TD class="r Data">6</TD><TD class="r Data">0.22</TD></TR><TR><TH class="l RowHeader" scope=row>LACKAWANNA</TH><TD class="r Data">36</TD><TD class="r Data">1.33</TD></TR><TR><TH class="l RowHeader" scope=row>LANCASTER</TH><TD class="r Data">39</TD><TD class="r Data">1.44</TD></TR><TR><TH class="l RowHeader" scope=row>LAWRENCE</TH><TD class="r Data">3</TD><TD class="r Data">0.11</TD></TR><TR><TH class="l RowHeader" scope=row>LEBANON</TH><TD class="r Data">58</TD><TD class="r Data">2.14</TD></TR><TR><TH class="l RowHeader" scope=row>LEHIGH</TH><TD class="r Data">150</TD><TD class="r Data">5.54</TD></TR><TR><TH class="l RowHeader" scope=row>LUZERNE</TH><TD class="r Data">79</TD><TD class="r Data">2.92</TD></TR><TR><TH class="l RowHeader" scope=row>LYCOMING</TH><TD class="r Data">37</TD><TD class="r Data">1.37</TD></TR><TR><TH class="l RowHeader" scope=row>MCKEAN</TH><TD class="r Data">8</TD><TD class="r Data">0.30</TD></TR><TR><TH class="l RowHeader" scope=row>MERCER</TH><TD class="r Data">18</TD><TD class="r Data">0.66</TD></TR><TR><TH class="l RowHeader" scope=row>MIFFLIN</TH><TD class="r Data">15</TD><TD class="r Data">0.55</TD></TR><TR><TH class="l RowHeader" scope=row>MONROE</TH><TD class="r Data">79</TD><TD class="r Data">2.92</TD></TR><TR><TH class="l RowHeader" scope=row>MONTGOMERY</TH><TD class="r Data">155</TD><TD class="r Data">5.72</TD></TR><TR><TH class="l RowHeader" scope=row>MONTOUR</TH><TD class="r Data">6</TD><TD class="r Data">0.22</TD></TR><TR><TH class="l RowHeader" scope=row>NORTHAMPTON</TH><TD class="r Data">128</TD><TD class="r Data">4.72</TD></TR><TR><TH class="l RowHeader" scope=row>NORTHUMBERLAND</TH><TD class="r Data">20</TD><TD class="r Data">0.74</TD></TR><TR><TH class="l RowHeader" scope=row>PHILADELPHIA</TH><TD class="r Data">137</TD><TD class="r Data">5.06</TD></TR><TR><TH class="l RowHeader" scope=row>PIKE</TH><TD class="r Data">12</TD><TD class="r Data">0.44</TD></TR><TR><TH class="l RowHeader" scope=row>SCHUYLKILL</TH><TD class="r Data">25</TD><TD class="r Data">0.92</TD></TR><TR><TH class="l RowHeader" scope=row>SNYDER</TH><TD class="r Data">36</TD><TD class="r Data">1.33</TD></TR><TR><TH class="l RowHeader" scope=row>SOMERSET</TH><TD class="r Data">7</TD><TD class="r Data">0.26</TD></TR><TR><TH class="l RowHeader" scope=row>SUSQUEHANNA</TH><TD class="r Data">3</TD><TD class="r Data">0.11</TD></TR><TR><TH class="l RowHeader" scope=row>TIOGA</TH><TD class="r Data">1</TD><TD class="r Data">0.04</TD></TR><TR><TH class="l RowHeader" scope=row>UNION</TH><TD class="r Data">86</TD><TD class="r Data">3.17</TD></TR><TR><TH class="l RowHeader" scope=row>VENANGO</TH><TD class="r Data">6</TD><TD class="r Data">0.22</TD></TR><TR><TH class="l RowHeader" scope=row>WARREN</TH><TD class="r Data">3</TD><TD class="r Data">0.11</TD></TR><TR><TH class="l RowHeader" scope=row>WASHINGTON</TH><TD class="r Data">74</TD><TD class="r Data">2.73</TD></TR><TR><TH class="l RowHeader" scope=row>WAYNE</TH><TD class="r Data">8</TD><TD class="r Data">0.30</TD></TR><TR><TH class="l RowHeader" scope=row>WESTMORELAND</TH><TD class="r Data">123</TD><TD class="r Data">4.54</TD></TR><TR><TH class="l RowHeader" scope=row>WYOMING</TH><TD class="r Data">2</TD><TD class="r Data">0.07</TD></TR><TR><TH class="l RowHeader" scope=row>YORK</TH><TD class="r Data">18</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
</DSFCONTENTBODY>

<TABLE cellSpacing=0 cellPadding=0 border=0><TBODY><TR height=15><TD colSpan=2></TD></TR></TBODY></TABLE>

Content Last Modified on 2/24/2009 4:09:04 PM
http://www.dsf.health.state.pa.us/he...a=171&q=246529

[HenryN]

Re: Seasonal Flu 2008 - 2009

Reporting period: Week 08 (16/02/2009 - 22/02/2009)
Influenza activity is at low levels across all the countries of the United Kingdom during week 08/09. Clinical indicators of influenza have decreased in England, Wales and Scotland and remain 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. 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 12 in week 07/09 to three in week 08/09, in the same time period the number of influenza B reports fell from 21 to 15 and RSV from 102 to 73. In week 08/09 nine samples referred to the Centre for Infections' Respiratory Virus Unit (RVU) tested positive for influenza A (two A (H3) and seven A (H1)), 15 samples were positive for influenza B (an increase from five in week 07/08) and none were positive for RSV. In Scotland in weeks 07 and 08/09, nine of 47 sentinel samples tested positive for influenza (three A and six B) and three for RSV; 29 of 54 non-sentinel samples tested positive for influenza (10 A and 19 B) and 25 for RSV. In Northern Ireland one non-sentinel sample tested positive for influenza B and seven for RSV in week 08/09. In Wales to date this season 15 sentinel and 72 non-sentinel samples have been positive for influenza A and one sentinel and one non-sentinel for influenza B.
Neuraminidase inhibitor susceptibility testing: all 229 influenza A (H3) isolates tested since week 40/08 were sensitive to oseltamivir and zanamivir, but resistant to amantadine. Seventy influenza A (H1) isolates have been tested, of which 69 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 07/2009, influenza activity continued to intensify across central Europe, with most countries reporting medium to high intensity. Influenza activity is generally declining in western Europe, while in eastern Europe it continues to be low but increasing (e.g. Russia and Ukraine). Influenza A (H3) continues to be the predominant circulating virus though increases in influenza B detections over recent weeks resulted in six countries reporting a prevalence of influenza B, generally in combination with influenza A (H3), in week 07/2009.



Last reviewed: 25 February 2009

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

[Giuseppe]

Re: Seasonal Flu 2008 - 2009

USA. Pediatric flu death: Howard Co. teen is ninth pediatric flu death in nation this year -- baltimoresun.com

Howard County teen dies from flu

Unusual case is ninth pediatric flu death nationally this year, county health officials say


By Larry Carson | larry.carson@baltsun.com 1:13 PM EST, February 25, 2009

A Howard County teenager died of the flu this week, the latest of nine pediatric flu deaths nationally this year, the county health officials said today.

"This tragic death is highly unusual," county health officer Dr. Peter L. Beilenson said in a news release. "Most people who get the flu recover after a few days, but getting a flu shot and following common hygiene precautions can greatly reduce the risk of contracting the flu."

Federal patient privacy laws prohibit the county from releasing the victim's identity or any details of the case, health department spokeswoman Lisa de Hernandez said.

The teenager became ill with "flu symptoms that got progressively worse," de Hernandez said, and died sometime since Sunday in a hospital that she declined to identify.

The health department is urging citizens to get vaccinated and said free flu shots are available at the county health department (410-313-7500).

Preventive measures recommended by the Centers for Disease Control and Prevention include getting a flu shot, covering your mouth when you sneeze or cough, washing hands frequently and trying to avoid contact with sick people.

According to the CDC, symptoms may include fever, headache, tiredness, cough, sore throat, runny or stuffy nose, body aches, and diarrhea and vomiting.
-

<cite cite="http://www.baltimoresun.com/news/health/bal-flu0225,0,1799129.story">Pediatric flu death: Howard Co. teen is ninth pediatric flu death in nation this year -- baltimoresun.com</cite>

[Giuseppe]

Re: Seasonal Flu 2008 - 2009

Italy. Virological Surveillance of Influenza, February 27, 2009 Update [From Ministry of Health]

VIROLOGICAL SURVEILLANCE OF INFLUENZA

February 25, 2009


Weekly Update 8/09

[Original PDF Document is available in Italian language at Ministry of Health website, following this LINK. Translated from Italian to English, Edited and Adapted by IOH.]


-- ITALY

The number of identified viruses continues to decrease. During last surveillance week, 53 clinical samples have been collected and among them only 5 were influenza positive, all of Type A.

Genoa University isolated 3 A/H3N2 viruses whereas Padua and Parma University isolated 1 A/H1N1 respectively.

The table and graph show comprehensive results of virological surveillance of influenza since the start of current season (week 46-08) to date (week 8-09).


[Surv week..............: 46 - 47 - 48 - 49 - 50 - 51 - 52 - 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - TOT POSITIVE SAMPLES]

- FLU A................... - 3 - 4 - 5 - 8 - 7 - 11 - 19 - 35 - 57 - 127 - 99 - 67 - 32 - 15 - 5 - 494
- A (unsubtyped) - . - . - . - . - . - 2 - 2 - 13 - 16 - 44 - 18 - 13 - 5 - 1 - . - 114
- A/H3N2.................. - 3 - 4 - 5 - 8 - 7 - 9 - 17 - 22 - 41 - 77 - 79 - 50 - 23 - 14 - 3 - 362
- A/H1N1................ - . - . - . - . - . - . - . - . - . - 6 - 2 - 4 - 4 - .. - 2 - 18
- FLU B................. - 0 - 0 - 4 - 0 - 1 - 1 - 0 - 1 - 0 - 0 - 3 - 2 - 1 - 0 - 0 - 13

- TOT Positive Samples - 3 - 4 - 9 - 8 - 8 - 12 - 19 - 36 - 57 - 127 - 102 - 69 - 33 - 15 - 5 - 507


<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>

-- NEWS FROM THE WORLD

- EUROPE
Influenza virus circulation continues to rise in the eastern european nations. This week, 3.181 clinical samples have been collected, of these 1.442 (45&#37 were influenza positive. Among them 1219 were Influenza A viruses (426 H3, 81 H1 and 722 not yet subtyped) and 223 type B.

Further informations:

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

http://www.grog.org/

-- USA
Influenza virus circulation continues to increase. 5.380 clinical samples have been collected and analysed; of these, 1.313 (24.4%) were influenza positive. Among them, 904 were type A (12 H3, 272 H1 and 620 not yet subtyped) and 409 type B.

98.5% of A/H1 viruses isolated were also resistant to oseltamivir.

Further informations:

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

-
-----

[Giuseppe]

Re: Seasonal Flu 2008 - 2009

EISS - Weekly Electronic Bulletin Week 8 - 27 February 2009, Issue N? 294 - Influenza activity increasing in central and eastern Europe while continuing to decrease in western Europe

EISS - Weekly Electronic Bulletin Week 8 : 16/02/2009-22/02/2009 - 27 February 2009, Issue N? 294 - Influenza activity increasing in central and eastern Europe while continuing to decrease in western Europe


-- Summary:

In week 08/2009, influenza activity remained little changed across Europe compared to last week. Most countries in central Europe continue to report medium intensity activity, and activity is low but increasing in eastern Europe.

Influenza activity is generally declining in western Europe.

Influenza A(H3) continues to be the predominant circulating virus although the proportion of influenza B virus detections continues to increase.

All the A(H3N2) viruses tested for antiviral resistance were resistant to M2 inhibitors but susceptible to neuraminidase inhibitors.


-- Epidemiological situation - week 08/2009:

For the intensity indicator, the national network levels of influenza-like illness (ILI) and/or acute respiratory infection (ARI) were high in Slovakia for the first time this season, medium in 20 countries, and low in the other twelve countries that reported this indicator.

The majority of countries reporting increasing trends for the intensity indicator in week 08/2009 were located in central and eastern Europe, while most countries in western Europe reported unchanged or decreasing intensity compared to the previous week. There has been a sharp increase in consultation rates in Greece where influenza virus type B is now the dominant type and influenza A detections continue to decrease.

For the geographical spread indicator, widespread influenza activity was reported in nine countries, regional activity in nine countries, local activity in six countries and sporadic or no activity in the remaining ten countries.


-- Cumulative epidemiological situation - 2008-2009 season (weeks 40/2008-08/2009):

Since week 49/2008 consultation rates for ILI and/or ARI rose above baseline levels in most western and central European countries following a general west to east progression. High influenza intensity, again following a general west to east progression, has been reported in 13 countries since week 51/2008, but intensity has declined in all but Slovakia.

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 08/2009:

The total number of respiratory specimens collected by sentinel physicians in week 08/2009 was 1960, of which 518 (26%) were positive for influenza virus: 349 type A (133 subtype H3, 9 subtype H1 and 207 not subtyped) and 169 type B.

In addition, 674 non-sentinel source specimens (e.g. specimens collected for diagnostic purposes in hospitals) were reported positive for influenza virus: 584 type A (150 subtype H3, 61 subtype H1 and 373 not subtyped) and 90 type B.

A total of 13 countries reported that influenza virus type B, generally in combination with influenza virus type A subtype H3, was dominant in week 08/2009.


-- Cumulative virological situation - 2008-2009 season (weeks 40/2008-08/2009):

Of 20698 virus detections (sentinel and non-sentinel) since week 40/2008, 19280 (93%) were type A (7843 subtype H3, 703 subtype H1 and 10734 not subtyped) and 1418 (7%) were type B.

Based on the antigenic and/or genetic characterisation of 2784 influenza viruses, 2441 (87.7%) were reported as A/Brisbane/10/2007 (H3N2)-like, 117 (4.2%) as A/Brisbane/59/2007 (H1N1)-like, 28 (1.0%) as B/Florida/4/2006-like (B/Yamagata/16/88 lineage) and 198 (7.1%) as B/Malaysia/2506/2004-like (B/Victoria/2/87 lineage) .

Twelve countries have reported antiviral susceptibility data.

All influenza A(H3N2) viruses tested were sensitive to oseltamivir (324) and zanamivir (303), but resistant to M2 inhibitors (198).

Ninety-eight percent of influenza A(H1N1) viruses analysed (150/153) were resistant to oseltamivir, but all those tested against zanamivir and M2 inhibitors were sensitive. The small number of influenza B viruses analysed (27) were sensitive to oseltamivir and zanamivir.


-- Comment:

Influenza activity continued to decline in western Europe and has continued to increase in several countries in central (Greece and Slovakia) and eastern (Lithuania, Russia and Ukraine) Europe, following a general west-to-east trend.

For Russia as a whole, influenza activity is increasing; by region, influenza activity is increasing in all regions except the Far East where it appears to be declining. Activity has decreased to baseline levels in countries that experienced the influenza epidemic first this season (Ireland, Portugal, the UK).

Whilst A(H3N2) continues to be the dominant influenza virus circulating in the Europe region, the proportion of type B influenza virus detections per week continues to show a rising trend, with an increasing number of countries reporting type B as the dominant or co-dominant virus type.

Antigenic and/or genetic characterisation indicates that, with the exception of the B/Victoria lineage viruses (7.1% of the viruses subjected to antigenic and/or genetic characterisation), the viruses circulating are similar to the three components - A(H1N1), A(H3N2) and B/Yamagata lineage - included in the 2008/2009 Northern Hemisphere influenza vaccine.


-- Background:

The Weekly Electronic Bulletin presents and comments on influenza activity in the 53 countries that report to EISS.

Of these countries, 32 reported both clinical and virological data, four reported virological data only and two reported clinical data only to EISS in week 08/2009. The spread of influenza virus strains and their epidemiological impact in Europe are being monitored by the network under the aegis of the European Centre for Disease Prevention and Control in Stockholm (Sweden) and the WHO Regional Office for Europe in Copenhagen (Denmark), in collaboration with the WHO Collaborating Centre for Reference and Research on Influenza in London (UK).


-- Other bulletins:

The EISS bulletin is prepared using reports from GP consultations and other sources, depending on individual country arrangements. It is important to recognise that different health care systems and types of measurement should also be considered when assessing the impact of influenza.


-- Map

The map presents the intensity of influenza activity and the geographical spread as assessed by each of the networks in EISS.

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Europe Year 2009 / Week 8

A = Dominant virus A
H1N1 = Dominant virus A(H1N1)
H3N2 = Dominant virus A(H3N2)
H1N2 = Dominant virus A(H1N2)
B = Dominant virus B
A & B = Dominant virus A & B
= : stable clinical activity
+ : increasing clinical activity
- : decreasing clinical activity
Low = no influenza activity or influenza at baseline levels
Medium = usual levels of influenza activity
High = higher than usual levels of influenza activity
Very high = particularly severe levels of influenza activity
No activity = no evidence of influenza virus activity (clinical activity remains at baseline levels)
Sporadic = isolated cases of laboratory confirmed influenza infection
Local outbreak = increased influenza activity in local areas (e.g. a city) within a region,or outbreaks in two or more institutions (e.g. schools) within a region. Laboratory confirmed.
Regional activity = influenza activity above baseline levels in one or more regions witha population comprising less than 50% of the country's total population. Laboratory confirmed.
Widespread = influenza activity above baseline levels in one or more regions with a populationcomprising 50% or more of the country's population. Laboratory confirmed.
Finland : Where available, the epidemiological data are provided by a health-care district inSouth-Western Finland (the health-care district serves 54,000 inhabitants i.e. approximately onepercent of the Finnish population).


-- Network comments (where available)

- Italy. During this week, the number of influenza positive samples remarkably decreased. Only 5 type A influenza viruses (3 H3 and 2 H1) were isolated.
- The former Yugoslav Republic of Macedonia. Mandatory reporting
- Russian Federation. 12 (66.7%) strains of influenza A(H1N1) virus from 16 viruses of this subtype isolated earlier in Vladivostok and analyzed during week 8 appeared to be resistant to oseltamivir.
- Serbia. All B viruses detected in week 8. originated from the southern parts of Serbia. In additions to A (H3) viruses detected up to now, the number of type B viruses continues to show rising trends, from north to south part of country.
- Switzerland. Influenza activity is now decreasing in Switzerland. Influenza B viruses started to predominate now.
-

<cite cite="http://www.eiss.org/cgi-files/bulletin_v2.cgi">EISS - Bulletin Review</cite>

[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 headers="header1" align="right"> 40 </td> <td headers="header2" align="right"> 3 </td> <td headers="header3" align="right"> 0 </td> <td headers="header4" align="right"> 8 </td> <td headers="header5" align="right"> 6 </td> <td headers="header6" align="right"> 2612 </td> <td headers="header7" align="right"> 0.65 </td></tr> <tr><td headers="header1" align="right"> 41 </td> <td headers="header2" align="right"> 4 </td> <td headers="header3" align="right"> 4 </td> <td headers="header4" align="right"> 8 </td> <td headers="header5" align="right"> 6 </td> <td headers="header6" align="right"> 2645 </td> <td headers="header7" align="right"> 0.83 </td></tr> <tr><td headers="header1" align="right"> 42 </td> <td headers="header2" align="right"> 13 </td> <td headers="header3" align="right"> 3 </td> <td headers="header4" align="right"> 15 </td> <td headers="header5" align="right"> 6 </td> <td headers="header6" align="right"> 2775 </td> <td headers="header7" align="right"> 1.33 </td></tr> <tr><td headers="header1" align="right"> 43 </td> <td headers="header2" align="right"> 22 </td> <td headers="header3" align="right"> 0 </td> <td headers="header4" align="right"> 24 </td> <td headers="header5" align="right"> 14 </td> <td headers="header6" align="right"> 3201 </td> <td headers="header7" align="right"> 1.87 </td></tr> <tr><td headers="header1" align="right"> 44 </td> <td headers="header2" align="right"> 11 </td> <td headers="header3" align="right"> 2 </td> <td headers="header4" align="right"> 21 </td> <td headers="header5" align="right"> 5 </td> <td headers="header6" align="right"> 3345 </td> <td headers="header7" align="right"> 1.17 </td></tr> <tr><td headers="header1" align="right"> 45 </td> <td headers="header2" align="right"> 30 </td> <td headers="header3" align="right"> 2 </td> <td headers="header4" align="right"> 23 </td> <td headers="header5" align="right"> 11 </td> <td headers="header6" align="right"> 3936 </td> <td headers="header7" align="right"> 1.68 </td></tr> <tr><td headers="header1" align="right"> 46 </td> <td headers="header2" align="right"> 25 </td> <td headers="header3" align="right"> 2 </td> <td headers="header4" align="right"> 23 </td> <td headers="header5" align="right"> 12 </td> <td headers="header6" align="right"> 4162 </td> <td headers="header7" align="right"> 1.49 </td></tr> <tr><td headers="header1" align="right"> 47 </td> <td headers="header2" align="right"> 27 </td> <td headers="header3" align="right"> 1 </td> <td headers="header4" align="right"> 31 </td> <td headers="header5" align="right"> 23 </td> <td headers="header6" align="right"> 4517 </td> <td headers="header7" align="right"> 1.82 </td></tr> <tr><td headers="header1" align="right"> 48 </td> <td headers="header2" align="right"> 40 </td> <td headers="header3" align="right"> 1 </td> <td headers="header4" align="right"> 46 </td> <td headers="header5" align="right"> 24 </td> <td headers="header6" align="right"> 4614 </td> <td headers="header7" align="right"> 2.41 </td></tr> <tr><td headers="header1" align="right"> 49 </td> <td headers="header2" align="right"> 41 </td> <td headers="header3" align="right"> 4 </td> <td headers="header4" align="right"> 57 </td> <td headers="header5" align="right"> 14 </td> <td headers="header6" align="right"> 5322 </td> <td headers="header7" align="right"> 2.18 </td></tr> <tr><td headers="header1" align="right"> 50 </td> <td headers="header2" align="right"> 70 </td> <td headers="header3" align="right"> 9 </td> <td headers="header4" align="right"> 66 </td> <td headers="header5" align="right"> 36 </td> <td headers="header6" align="right"> 5663 </td> <td headers="header7" align="right"> 3.2 </td></tr> <tr><td headers="header1" align="right"> 51 </td> <td headers="header2" align="right"> 73 </td> <td headers="header3" align="right"> 17 </td> <td headers="header4" align="right"> 107 </td> <td headers="header5" align="right"> 56 </td> <td headers="header6" align="right"> 5932 </td> <td headers="header7" align="right"> 4.27 </td></tr> <tr><td headers="header1" align="right"> 52 </td> <td headers="header2" align="right"> 70 </td> <td headers="header3" align="right"> 12 </td> <td headers="header4" align="right"> 150 </td> <td headers="header5" align="right"> 51 </td> <td headers="header6" align="right"> 5729 </td> <td headers="header7" align="right"> 4.94 </td></tr> <tr><td headers="header1" align="right"> 53 </td> <td headers="header2" align="right"> 108 </td> <td headers="header3" align="right"> 17 </td> <td headers="header4" align="right"> 167 </td> <td headers="header5" align="right"> 47 </td> <td headers="header6" align="right"> 6009 </td> <td headers="header7" align="right"> 5.64 </td></tr> <tr><td headers="header1" align="right"> 01 </td> <td headers="header2" align="right"> 153 </td> <td headers="header3" align="right"> 25 </td> <td headers="header4" align="right"> 240 </td> <td headers="header5" align="right"> 76 </td> <td headers="header6" align="right"> 6384 </td> <td headers="header7" align="right"> 7.74 </td></tr> <tr><td headers="header1" align="right"> 02 </td> <td headers="header2" align="right"> 173 </td> <td headers="header3" align="right"> 20 </td> <td headers="header4" align="right"> 365 </td> <td headers="header5" align="right"> 86 </td> <td headers="header6" align="right"> 6062 </td> <td headers="header7" align="right"> 10.62 </td></tr> <tr><td headers="header1" align="right"> 03 </td> <td headers="header2" align="right"> 237 </td> <td headers="header3" align="right"> 38 </td> <td headers="header4" align="right"> 496 </td> <td headers="header5" align="right"> 141 </td> <td headers="header6" align="right"> 6238 </td> <td headers="header7" align="right"> 14.62 </td></tr> <tr><td headers="header1" align="right"> 04 </td> <td headers="header2" align="right"> 370 </td> <td headers="header3" align="right"> 56 </td> <td headers="header4" align="right"> 668 </td> <td headers="header5" align="right"> 231 </td> <td headers="header6" align="right"> 7138 </td> <td headers="header7" align="right"> 18.56 </td></tr> <tr><td headers="header1" align="right"> 05 </td> <td headers="header2" align="right"> 378 </td> <td headers="header3" align="right"> 24 </td> <td headers="header4" align="right"> 938 </td> <td headers="header5" align="right"> 424 </td> <td headers="header6" align="right"> 8370 </td> <td headers="header7" align="right"> 21.08 </td></tr> <tr><td headers="header1" align="right"> 06 </td> <td headers="header2" align="right"> 272 </td> <td headers="header3" align="right"> 12 </td> <td headers="header4" align="right"> 620 </td> <td headers="header5" align="right"> 409 </td> <td headers="header6" align="right"> 5380 </td> <td headers="header7" align="right"> 24.41 </td></tr> </tbody></table>

Return to Current Report

[HenryN]

Re: Seasonal Flu 2008 - 2009

2008-2009 Influenza Season Week 7 ending February 21, 2009
(All data are preliminary and may change as more reports are received.) Synopsis:

During week 7 (February 15-21, 2009), influenza activity increased slightly in the United States.

• One thousand four hundred five (24.6&#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.
• Eight influenza-associated pediatric deaths were reported.
• The proportion of outpatient visits for influenza-like illness (ILI) was above the national baseline. ILI decreased nationally and in six of the nine regions compared to the previous week. The East North Central, East South Central, Mountain, New England, South Atlantic, West North Central, and West South Central regions reported ILI above their region-specific baselines.
• Twenty-seven states reported widespread influenza activity, 17 states reported regional activity; the District of Columbia and six states reported local influenza activity; and Puerto Rico reported sporadic influenza activity.

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

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

Region

</th> <th colspan="3" align="center" width="300" nowrap="nowrap">Data for current week</th> <th colspan="5" align="center" width="276" nowrap="nowrap">Data cumulative for the season</th> </tr> <tr valign="top"> <th align="center" width="72">Out-patient ILI*</th> <th align="center" width="72">% positive for flu†</th> <th align="center" width="96">Number of jurisdictions reporting regional or widespread activity‡</th> <th align="center" width="48" nowrap="nowrap">A (H1)</th> <th align="center" width="48" nowrap="nowrap">A (H3)</th> <th align="center" width="60">A Unsub-typed</th> <th align="center" width="48" nowrap="nowrap">B</th> <th align="center" width="72">Pediatric Deaths</th> </tr> <tr> <td align="left" width="85">Nation</td> <td align="center" width="72" nowrap="nowrap">Elevated</td> <td align="center" width="72" nowrap="nowrap">24.6 % </td> <td align="center" width="96" nowrap="nowrap">44 of 51 </td> <td align="center" width="48" nowrap="nowrap">2,918</td> <td align="center" width="48" nowrap="nowrap">328</td> <td align="center" width="60" nowrap="nowrap">5,843</td> <td align="center" width="48" nowrap="nowrap">2,546</td> <td align="center" width="72" nowrap="nowrap">17</td> </tr> <tr> <td align="left" width="85">New England</td> <td align="center" width="72" nowrap="nowrap">Elevated</td> <td align="center" width="72" nowrap="nowrap">24.8 % </td> <td align="center" width="96" nowrap="nowrap">6 of 6</td> <td align="center" width="48" nowrap="nowrap">229</td> <td align="center" width="48" nowrap="nowrap">23</td> <td align="center" width="60" nowrap="nowrap">641</td> <td align="center" width="48" nowrap="nowrap">236</td> <td align="center" width="72" nowrap="nowrap">1</td> </tr> <tr> <td align="left" width="85">Mid-Atlantic</td> <td align="center" width="72" nowrap="nowrap">Normal</td> <td align="center" width="72" nowrap="nowrap">16.0 % </td> <td align="center" width="96" nowrap="nowrap">3 of 3</td> <td align="center" width="48" nowrap="nowrap">256</td> <td align="center" width="48" nowrap="nowrap">30</td> <td align="center" width="60" nowrap="nowrap">660</td> <td align="center" width="48" nowrap="nowrap">268</td> <td align="center" width="72" nowrap="nowrap">2</td> </tr> <tr> <td align="left" width="85">East North Central</td> <td align="center" width="72" nowrap="nowrap">Elevated</td> <td align="center" width="72" nowrap="nowrap">45.9 % </td> <td align="center" width="96" nowrap="nowrap">4 of 5</td> <td align="center" width="48" nowrap="nowrap">449</td> <td align="center" width="48" nowrap="nowrap">47</td> <td align="center" width="60" nowrap="nowrap">73</td> <td align="center" width="48" nowrap="nowrap">154</td> <td align="center" width="72" nowrap="nowrap">0</td> </tr> <tr> <td align="left" width="85">West North Central</td> <td align="center" width="72" nowrap="nowrap">Elevated</td> <td align="center" width="72" nowrap="nowrap">22.1 % </td> <td align="center" width="96" nowrap="nowrap">6 of 7</td> <td align="center" width="48" nowrap="nowrap">436</td> <td align="center" width="48" nowrap="nowrap">21</td> <td align="center" width="60" nowrap="nowrap">395</td> <td align="center" width="48" nowrap="nowrap">136</td> <td align="center" width="72" nowrap="nowrap">0</td> </tr> <tr> <td align="left" width="85">South Atlantic</td> <td align="center" width="72" nowrap="nowrap">Elevated</td> <td align="center" width="72" nowrap="nowrap">24.4 % </td> <td align="center" width="96" nowrap="nowrap">8 of 9</td> <td align="center" width="48" nowrap="nowrap">560</td> <td align="center" width="48" nowrap="nowrap">44</td> <td align="center" width="60" nowrap="nowrap">791</td> <td align="center" width="48" nowrap="nowrap">506</td> <td align="center" width="72" nowrap="nowrap">2</td> </tr> <tr> <td align="left" width="85">East South Central</td> <td align="center" width="72" nowrap="nowrap">Elevated</td> <td align="center" width="72" nowrap="nowrap">16.9 % </td> <td align="center" width="96" nowrap="nowrap">4 of 4</td> <td align="center" width="48" nowrap="nowrap">57</td> <td align="center" width="48" nowrap="nowrap">5</td> <td align="center" width="60" nowrap="nowrap">13</td> <td align="center" width="48" nowrap="nowrap">34</td> <td align="center" width="72" nowrap="nowrap">1</td> </tr> <tr> <td align="left" width="85">West South Central</td> <td align="center" width="72" nowrap="nowrap">Elevated</td> <td align="center" width="72" nowrap="nowrap">27.9 % </td> <td align="center" width="96" nowrap="nowrap">1 of 4</td> <td align="center" width="48" nowrap="nowrap">326</td> <td align="center" width="48" nowrap="nowrap">23</td> <td align="center" width="60" nowrap="nowrap">2,644</td> <td align="center" width="48" nowrap="nowrap">1,064</td> <td align="center" width="72" nowrap="nowrap">6</td> </tr> <tr> <td align="left" width="85">Mountain</td> <td align="center" width="72" nowrap="nowrap">Elevated</td> <td align="center" width="72" nowrap="nowrap">13.2 % </td> <td align="center" width="96" nowrap="nowrap">7 of 8</td> <td align="center" width="48" nowrap="nowrap">189</td> <td align="center" width="48" nowrap="nowrap">93</td> <td align="center" width="60" nowrap="nowrap">401</td> <td align="center" width="48" nowrap="nowrap">54</td> <td align="center" width="72" nowrap="nowrap">5</td> </tr> <tr> <td align="left" width="85">Pacific</td> <td align="center" width="72" nowrap="nowrap">Normal</td> <td align="center" width="72" nowrap="nowrap">12.9 % </td> <td align="center" width="96" nowrap="nowrap">5 of 5</td> <td align="center" width="48" nowrap="nowrap">416</td> <td align="center" width="48" nowrap="nowrap">42</td> <td align="center" width="60" nowrap="nowrap">225</td> <td align="center" width="48" nowrap="nowrap">94</td> <td align="center" width="72" nowrap="nowrap">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" align="center" border="0" cellpadding="3" cellspacing="0"> <tbody><tr> <th align="left" width="200">
</th> <th align="center" width="150" nowrap="nowrap">Week 7 </th> <th align="center" width="150" nowrap="nowrap">Cumulative for the Season</th> </tr> <tr> <td align="left" width="200">No. of specimens tested</td> <td align="center" width="150" nowrap="nowrap">5,715</td> <td align="center" width="150" nowrap="nowrap">115,870</td> </tr> <tr> <td align="left" width="200">No. of positive specimens (%)</td> <td align="center" width="150" nowrap="nowrap">1,405 (24.6%)</td> <td align="center" width="150" nowrap="nowrap">11,635 (10.0%)</td> </tr> <tr> <td colspan="3" align="left">Positive specimens by type/subtype</td> </tr> <tr> <td align="left" width="170"> Influenza A</td> <td align="center" width="150" nowrap="nowrap">950 (67.6%)</td> <td align="center" width="150" nowrap="nowrap">9,089 (78.1%)</td> </tr> <tr> <td align="left" width="170"> A (H1)</td> <td align="center" width="150" nowrap="nowrap"> 297 (31.3%)</td> <td align="center" width="150" nowrap="nowrap"> 2,918 (32.1%)</td> </tr> <tr> <td align="left" width="170"> A (H3)</td> <td align="center" width="150" nowrap="nowrap"> 31 (3.3%)</td> <td align="center" width="150" nowrap="nowrap"> 328 (3.6%)</td> </tr> <tr> <td align="left" width="170"> A (unsubtyped)</td> <td align="center" width="150" nowrap="nowrap"> 622 (65.5%)</td> <td align="center" width="150" nowrap="nowrap"> 5,843 (64.3%)</td> </tr> <tr> <td align="left" width="170"> Influenza B</td> <td align="center" width="150" nowrap="nowrap">455 (32.4%)</td> <td align="center" width="150" nowrap="nowrap"> 2,546 (21.9%)</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, 90% 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> Composition of the 2009-10 Influenza Vaccine:

WHO has recommended vaccine strains for the 2009-10 Northern Hemisphere trivalent influenza vaccine, and FDA has made the same recommendations for the U.S. influenza vaccine. Both agencies recommend that the vaccine contain A/Brisbane/59/2007-like (H1N1), A/Brisbane/10/2007-like (H3N2), and B/Brisbane/60/2008-like (B/Victoria lineage) viruses. Only the influenza B component has been changed from the 2008-09 vaccine formulation. This recommendation was based on surveillance data related to epidemiology and antigenic characteristics, serological responses to 2008-09 vaccines, and the availability of candidate strains and reagents.
Antigenic Characterization:

CDC has antigenically characterized 476 influenza viruses [325 influenza A (H1), 37 influenza A (H3) and 114 influenza B viruses] collected by U.S. laboratories since October 1, 2008.
All 325 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. Thirty-three influenza B viruses tested belong to the B/Yamagata lineage and are related to the vaccine strain (B/Florida/04/2006). The remaining 81 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, 325 influenza A (H1N1), 54 influenza A (H3N2), and 125 influenza B viruses have been tested for resistance to the neuraminidase inhibitors (oseltamivir and zanamivir). Three hundred twenty-five influenza A (H1N1) and 54 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" align="center" border="0" cellpadding="3" cellspacing="0"> <tbody><tr> <th rowspan="1" align="left" width="160">
</th> <th align="center" width="100" nowrap="nowrap">Isolates tested (n)</th> <th colspan="2" align="center" width="200" nowrap="nowrap">Resistant Viruses,
Number (%)</th> <th align="center" width="100" nowrap="nowrap">Isolates tested (n)</th> <th align="center" width="120" nowrap="nowrap">Resistant Viruses, Number (%)</th> </tr> <tr> <th align="left" width="160">
</th> <th align="center" width="100" nowrap="nowrap">
</th> <th align="center" width="100" nowrap="nowrap">Oseltamivir</th> <th align="center" width="100" nowrap="nowrap">Zanamivir</th> <th align="center" width="100" nowrap="nowrap">
</th> <th align="center" width="120" nowrap="nowrap">Adamantanes</th> </tr> <tr> <td align="left" width="160" nowrap="nowrap">Influenza A (H1N1)</td> <td align="center" width="100" nowrap="nowrap">325</td> <td align="center" width="100" nowrap="nowrap">321 (98.8%)</td> <td align="center" width="100" nowrap="nowrap">0 (0)</td> <td align="center" width="100" nowrap="nowrap">325</td> <td align="center" width="120" nowrap="nowrap">2 (0.6%)</td> </tr> <tr> <td align="left" width="160" nowrap="nowrap">Influenza A (H3N2)</td> <td align="center" width="100" nowrap="nowrap">54</td> <td align="center" width="100" nowrap="nowrap">0 (0)</td> <td align="center" width="100" nowrap="nowrap">0 (0)</td> <td align="center" width="100" nowrap="nowrap">54</td> <td align="center" width="120" nowrap="nowrap">54 (100%)</td> </tr> <tr> <td align="left" width="160" nowrap="nowrap">Influenza B</td> <td align="center" width="100" nowrap="nowrap">125</td> <td align="center" width="100" nowrap="nowrap">0 (0)</td> <td align="center" width="100" nowrap="nowrap">0 (0)</td> <td align="center" width="100" nowrap="nowrap">N/A*</td> <td align="center" width="120" nowrap="nowrap">N/A*</td> </tr> </tbody></table> ^{*The adamantanes (amantadine and rimantadine) are not effective against influenza B viruses.}

Influenza A (H1N1) viruses from 35 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/...AlertNum=00279
Pneumonia and Influenza (P&I) Mortality Surveillance

During week 7, 7.4% of all deaths reported through the 122-Cities Mortality Reporting System were due to P&I. This percentage is below the epidemic threshold of 8.0% for week 7.
<center>
View Full Screen</center> Influenza-Associated Pediatric Mortality

Eight influenza-associated pediatric deaths were reported to CDC during week 7 (Arizona, Colorado [2], Massachusetts and Texas [4]). The deaths reported this week occurred between February 1 and February 18, 2009. Since September 28, 2008, CDC has received 17 reports of influenza-associated pediatric deaths that occurred during the current season.
Bacterial coinfections were confirmed in 10 (58.8%) of the 17 children; Staphylococcus aureus was identified in eight (80.0%) of the ten children. Three of the S. aureus isolates were sensitive to methicillin, four were methicillin resistant, and one had no sensitivity results reported. Eight (80.0%) of the 10 children with bacterial coinfections were 12 years of age or older. An increase in the number of influenza-associated pediatric deaths with bacterial coinfections was first recognized during the 2006-07 influenza season. In January 2008, interim testing and reporting recommendations were released regarding influenza and bacterial coinfections in children and are available at (http://www2a.cdc.gov/HAN/ArchiveSys/...AlertNum=00268).
<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). These two systems provide updates of surveillance data every two weeks.
No influenza-associated hospitalizations have been reported from the New Vaccine Surveillance Network this season. Due to case identification methods utilized in this study, a delay exists from the date of hospitalization to the date of report. An update will be provided in subsequent weeks as epidemiologic information and testing results are obtained.
During October 1, 2008 – February 14, 2009, preliminary laboratory-confirmed influenza-associated hospitalization rates reported by the EIP for children aged 0-4 years and 5-17 years were 1.0 per 10,000 and 0.1 per 10,000, respectively. For adults aged 18-49 years, 50-64 years, and = 65 years, the rates were 0.1 per 10,000, 0.1 per 10,000, and 0.4 per 10,000, respectively.
<center>
View Full Screen</center> Outpatient Illness Surveillance:

Nationwide during week 7, 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 decreased in six of the nine regions compared to the previous week and ranged from 1.9% to 5.9%. Seven of nine surveillance regions reported ILI percentages above their region specific baselines.
<table class="table" align="center" border="0" cellpadding="3" cellspacing="0"> <tbody><tr> <th align="left" width="80">Region</th> <th align="center" width="60" nowrap="nowrap">New England</th> <th align="center" width="60" nowrap="nowrap">Mid Atlantic</th> <th align="center" width="60" nowrap="nowrap">East North Central</th> <th align="center" width="60" nowrap="nowrap">West North Central</th> <th align="center" width="60" nowrap="nowrap">South Atlantic</th> <th align="center" width="60" nowrap="nowrap">East South Central</th> <th align="center" width="60" nowrap="nowrap">West South Central</th> <th align="center" width="60" nowrap="nowrap">Mountain</th> <th align="center" width="60" nowrap="nowrap">Pacific</th> </tr> <tr> <td align="left" width="80" nowrap="nowrap">Reported ILI (%)</td> <td align="center" width="60" nowrap="nowrap">2.9</td> <td align="center" width="60" nowrap="nowrap">2.8</td> <td align="center" width="60" nowrap="nowrap">2.6</td> <td align="center" width="60" nowrap="nowrap">1.9</td> <td align="center" width="60" nowrap="nowrap">3.6</td> <td align="center" width="60" nowrap="nowrap">2.7</td> <td align="center" width="60" nowrap="nowrap">5.9</td> <td align="center" width="60" nowrap="nowrap">3.0</td> <td align="center" width="60" nowrap="nowrap">2.9</td> </tr> <tr> <td align="left" width="80" nowrap="nowrap">Region-Specific Baseline</td> <td align="center" width="60" nowrap="nowrap">1.5</td> <td align="center" width="60" nowrap="nowrap">2.9</td> <td align="center" width="60" nowrap="nowrap">1.9</td> <td align="center" width="60" nowrap="nowrap">1.7</td> <td align="center" width="60" nowrap="nowrap">2.2</td> <td align="center" width="60" nowrap="nowrap">2.5</td> <td align="center" width="60" nowrap="nowrap">4.8</td> <td align="center" width="60" nowrap="nowrap">1.5</td> <td align="center" width="60" nowrap="nowrap">3.0</td> </tr> </tbody></table> Geographic Spread of Influenza as Assessed by State and Territorial Epidemiologists:

During week 7, the following influenza activity was reported:

• Widespread influenza activity was reported by 27 states (Alabama, Arizona, Colorado, Connecticut, Delaware, Florida, Georgia, Indiana, Iowa, Maine, Maryland, Massachusetts, Mississippi, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Vermont, and Virginia).
• Regional influenza activity was reported by 17 states (Alaska, California, Hawaii, Idaho, Kansas, Kentucky, Michigan, Minnesota, Montana, Nebraska, North Dakota, Oregon, South Dakota, Washington, West Virginia, Wisconsin, and Wyoming).
• Local influenza activity was reported by the District of Columbia and six states (Arkansas, Illinois, Louisiana, Missouri, Oklahoma, and Utah).
• Sporadic activity was reported by Puerto Rico.

• Content Source: Coordinating Center for Infectious Diseases (CCID)
• National Center for Immunization and Respiratory Diseases (NCIRD)

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--------------------------------------------------------------------------------
A description of surveillance methods is available at: http://www.cdc.gov/flu/weekly/fluactivity.htm
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[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 headers="header1" align="right"> 40 </td> <td headers="header2" align="right"> 3 </td> <td headers="header3" align="right"> 0 </td> <td headers="header4" align="right"> 8 </td> <td headers="header5" align="right"> 6 </td> <td headers="header6" align="right"> 2615 </td> <td headers="header7" align="right"> 0.65 </td></tr> <tr><td headers="header1" align="right"> 41 </td> <td headers="header2" align="right"> 4 </td> <td headers="header3" align="right"> 4 </td> <td headers="header4" align="right"> 8 </td> <td headers="header5" align="right"> 6 </td> <td headers="header6" align="right"> 2655 </td> <td headers="header7" align="right"> 0.83 </td></tr> <tr><td headers="header1" align="right"> 42 </td> <td headers="header2" align="right"> 13 </td> <td headers="header3" align="right"> 3 </td> <td headers="header4" align="right"> 15 </td> <td headers="header5" align="right"> 6 </td> <td headers="header6" align="right"> 2777 </td> <td headers="header7" align="right"> 1.33 </td></tr> <tr><td headers="header1" align="right"> 43 </td> <td headers="header2" align="right"> 22 </td> <td headers="header3" align="right"> 0 </td> <td headers="header4" align="right"> 24 </td> <td headers="header5" align="right"> 14 </td> <td headers="header6" align="right"> 3213 </td> <td headers="header7" align="right"> 1.87 </td></tr> <tr><td headers="header1" align="right"> 44 </td> <td headers="header2" align="right"> 12 </td> <td headers="header3" align="right"> 2 </td> <td headers="header4" align="right"> 21 </td> <td headers="header5" align="right"> 5 </td> <td headers="header6" align="right"> 3353 </td> <td headers="header7" align="right"> 1.19 </td></tr> <tr><td headers="header1" align="right"> 45 </td> <td headers="header2" align="right"> 30 </td> <td headers="header3" align="right"> 2 </td> <td headers="header4" align="right"> 23 </td> <td headers="header5" align="right"> 11 </td> <td headers="header6" align="right"> 3946 </td> <td headers="header7" align="right"> 1.67 </td></tr> <tr><td headers="header1" align="right"> 46 </td> <td headers="header2" align="right"> 25 </td> <td headers="header3" align="right"> 2 </td> <td headers="header4" align="right"> 23 </td> <td headers="header5" align="right"> 12 </td> <td headers="header6" align="right"> 4171 </td> <td headers="header7" align="right"> 1.49 </td></tr> <tr><td headers="header1" align="right"> 47 </td> <td headers="header2" align="right"> 27 </td> <td headers="header3" align="right"> 1 </td> <td headers="header4" align="right"> 31 </td> <td headers="header5" align="right"> 23 </td> <td headers="header6" align="right"> 4526 </td> <td headers="header7" align="right"> 1.81 </td></tr> <tr><td headers="header1" align="right"> 48 </td> <td headers="header2" align="right"> 40 </td> <td headers="header3" align="right"> 1 </td> <td headers="header4" align="right"> 47 </td> <td headers="header5" align="right"> 24 </td> <td headers="header6" align="right"> 4627 </td> <td headers="header7" align="right"> 2.42 </td></tr> <tr><td headers="header1" align="right"> 49 </td> <td headers="header2" align="right"> 41 </td> <td headers="header3" align="right"> 5 </td> <td headers="header4" align="right"> 57 </td> <td headers="header5" align="right"> 14 </td> <td headers="header6" align="right"> 5343 </td> <td headers="header7" align="right"> 2.19 </td></tr> <tr><td headers="header1" align="right"> 50 </td> <td headers="header2" align="right"> 70 </td> <td headers="header3" align="right"> 9 </td> <td headers="header4" align="right"> 66 </td> <td headers="header5" align="right"> 36 </td> <td headers="header6" align="right"> 5671 </td> <td headers="header7" align="right"> 3.19 </td></tr> <tr><td headers="header1" align="right"> 51 </td> <td headers="header2" align="right"> 73 </td> <td headers="header3" align="right"> 17 </td> <td headers="header4" align="right"> 107 </td> <td headers="header5" align="right"> 56 </td> <td headers="header6" align="right"> 5946 </td> <td headers="header7" align="right"> 4.25 </td></tr> <tr><td headers="header1" align="right"> 52 </td> <td headers="header2" align="right"> 71 </td> <td headers="header3" align="right"> 12 </td> <td headers="header4" align="right"> 153 </td> <td headers="header5" align="right"> 51 </td> <td headers="header6" align="right"> 5839 </td> <td headers="header7" align="right"> 4.92 </td></tr> <tr><td headers="header1" align="right"> 53 </td> <td headers="header2" align="right"> 111 </td> <td headers="header3" align="right"> 17 </td> <td headers="header4" align="right"> 169 </td> <td headers="header5" align="right"> 47 </td> <td headers="header6" align="right"> 6194 </td> <td headers="header7" align="right"> 5.55 </td></tr> <tr><td headers="header1" align="right"> 01 </td> <td headers="header2" align="right"> 159 </td> <td headers="header3" align="right"> 26 </td> <td headers="header4" align="right"> 275 </td> <td headers="header5" align="right"> 80 </td> <td headers="header6" align="right"> 6574 </td> <td headers="header7" align="right"> 8.21 </td></tr> <tr><td headers="header1" align="right"> 02 </td> <td headers="header2" align="right"> 188 </td> <td headers="header3" align="right"> 20 </td> <td headers="header4" align="right"> 410 </td> <td headers="header5" align="right"> 90 </td> <td headers="header6" align="right"> 6625 </td> <td headers="header7" align="right"> 10.69 </td></tr> <tr><td headers="header1" align="right"> 03 </td> <td headers="header2" align="right"> 287 </td> <td headers="header3" align="right"> 39 </td> <td headers="header4" align="right"> 593 </td> <td headers="header5" align="right"> 159 </td> <td headers="header6" align="right"> 7261 </td> <td headers="header7" align="right"> 14.85 </td></tr> <tr><td headers="header1" align="right"> 04 </td> <td headers="header2" align="right"> 513 </td> <td headers="header3" align="right"> 91 </td> <td headers="header4" align="right"> 756 </td> <td headers="header5" align="right"> 257 </td> <td headers="header6" align="right"> 8317 </td> <td headers="header7" align="right"> 19.44 </td></tr> <tr><td headers="header1" align="right"> 05 </td> <td headers="header2" align="right"> 471 </td> <td headers="header3" align="right"> 35 </td> <td headers="header4" align="right"> 1217 </td> <td headers="header5" align="right"> 508 </td> <td headers="header6" align="right"> 10246 </td> <td headers="header7" align="right"> 21.77 </td></tr> <tr><td headers="header1" align="right"> 06 </td> <td headers="header2" align="right"> 522 </td> <td headers="header3" align="right"> 34 </td> <td headers="header4" align="right"> 1157 </td> <td headers="header5" align="right"> 663 </td> <td headers="header6" align="right"> 10256 </td> <td headers="header7" align="right"> 23.17 </td></tr> <tr><td headers="header1" align="right"> 07 </td> <td headers="header2" align="right"> 297 </td> <td headers="header3" align="right"> 31 </td> <td headers="header4" align="right"> 622 </td> <td headers="header5" align="right"> 455 </td> <td headers="header6" align="right"> 5715 </td> <td headers="header7" align="right"> 24.58 </td></tr> </tbody></table>

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[Giuseppe]

Re: Seasonal Flu 2008 - 2009

CIDRAP >> CDC reports 8 more pediatric flu deaths

CDC reports 8 more pediatric flu deaths

Lisa Schnirring * Staff Writer
Feb 27, 2009 (CIDRAP News) ?

The number of pediatric influenza deaths outstripped last week's spike, and three more states reported widespread activity, the US Centers for Disease Control and Prevention (CDC) said today in its weekly surveillance update.


The CDC received eight reports of influenza-related deaths in children during the week ending Feb 21, bringing the seasonal total to 17. Four of the deaths occurred in Texas, 2 in Colorado, and 1 each in Arizona and Massachusetts.

Bacterial coinfections have been confirmed in 10 (59%) of the 17 children. Staphylococcus aureus was identified in 8 of the 10 children?3 of the isolates were sensitive to methicillin, 4 were not, and results were not reported for 1. Eight of the 10 children who had coinfections were age 12 or older.

After noting a sharp increase in the number of S aureus infections in children who had the flu during the 2006-07 season, the CDC in January 2008 released interim testing and reporting recommendations regarding influenza and bacterial coinfections in children.

In other developments, the number of states reporting widespread flu activity rose to 27, 3 more than the previous week. Seventeen states reported regional activity, which is up 4 from last week's report.

Of the influenza A/H1N1 samples from 35 states that have been tested, nearly all (98.8%) showed resistance to oseltamivir (Tamiflu). Slightly more than a third of the influenza B viruses that were tested match the Yamagata lineage included in this year's vaccine, and the remaining samples were from the Victoria lineage.
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<cite cite="http://www.cidrap.umn.edu/cidrap/content/influenza/general/news/feb2709pediatric-jw.html">CIDRAP >> CDC reports 8 more pediatric flu deaths</cite>