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USA: 2014-15 FluView: Influenza Season Weekly Summary, Wks 40+

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  • USA: 2014-15 FluView: Influenza Season Weekly Summary, Wks 40+

    2014-2015 Influenza Season Week 40 ending October 4, 2014


    All data are preliminary and may change as more reports are received.
    Background: The Centers for Disease Control and Prevention’s (CDC) Influenza Division collects and analyzes influenza surveillance data year-round and produces a weekly report on U.S. influenza activity during the influenza season which begins at week 40 each year. The U.S. influenza surveillance system provides information in five categories collected from eight data sources. This is the first report of the 2014-2015 influenza season, which began on September 28, 2014, and also summarizes influenza activity in the United States during the summer weeks of the 2013-14 season.
    The five categories and eight data components of CDC influenza surveillance are:
    • Viral Surveillance: U.S. World Health Organization (WHO) collaborating laboratories, the National Respiratory and Enteric Virus Surveillance System (NREVSS), and human infection with novel influenza A virus case reporting;
    • Mortality: 122 Cities Mortality Reporting System and influenza-associated pediatric deaths;
    • Hospitalizations: Influenza Hospitalization Network (FluSurv-NET) including the Emerging Infections Program (EIP),
    • Outpatient Illness Surveillance: U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet);
    • Geographic Spread of Influenza: State and territorial epidemiologists’ reports.

    In addition to the eight data components described above, for the 2014-2015 influenza season, the use of National Center for Health Statistics (NCHS) pneumonia and influenza mortality surveillance data for the rapid assessment of influenza-associated mortality will be piloted. An overview of influenza surveillance, including a description of the NCHS mortality surveillance data, is available at http://www.cdc.gov/flu/weekly/overview.htm
    Synopsis:

    During week 40 (September 28-October 4, 2014), influenza activity was low in the United States.
    • Viral Surveillance: Of 6,192 specimens tested and reported by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories during week 40, 199 (3.2&#37 were positive for influenza.
    • Pneumonia and Influenza Mortality:The proportion of deaths attributed to pneumonia and influenza (P&I) was below the epidemic threshold.
    • Influenza-associated Pediatric Deaths: No influenza-associated pediatric deaths were reported.
    • Outpatient Illness Surveillance: The proportion of outpatient visits for influenza-like illness (ILI) was 1.3%, which is below the national baseline of 2.0%. All 10 regions reported ILI below region-specific baseline levels. Puerto Rico experienced high ILI activity, all 50 states and New York City experienced minimal ILI activity and the District of Columbia had insufficient data.
    • Geographic Spread of Influenza: The geographic spread of influenza in Guam was reported as widespread; Puerto Rico reported regional activity; three states reported local activity; 28 states, the District of Columbia, and the U.S. Virgin Islands reported sporadic activity; 18 states reported no influenza activity; and one state did not report.

    <table class="table" border="0" cellpadding="3" cellspacing="0" width="100%"> <caption>National and Regional Summary of Select Surveillance Components

    </caption> <tbody><tr style="vertical-align:top" bgcolor="#c5bee1"> <th rowspan="2" style="vertical-align:bottom" width="12%">HHS Surveillance Regions*</th> <th colspan="8" style="text-align: center;" nowrap="nowrap">Data for week 40 (September 28-October 4, 2014)</th> </tr> <tr style="vertical-align:middle; background-image: url(../images/purplegrad.jpg); background-repeat: repeat-x;"> <th style="text-align: center;" width="8%">Out-patient ILI†</th> <th style="text-align: center;" width="8%">% positive for flu‡</th> <th style="text-align: center;" width="15%">Number of jurisdictions reporting regional or widespread activity&#167;</th> <th style="text-align: center;" nowrap="nowrap" width="7%">2009 H1N1</th> <th style="text-align: center;" width="11%">A (H3)</th> <th style="text-align: center;" width="18%">A(Subtyping not performed)</th> <th style="text-align: center;" nowrap="nowrap" width="7%">B</th> <th style="text-align: center;" width="11%">Pediatric Deaths</th> </tr> <tr> <td style="text-align: left;" width="12%">Nation</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">3.2%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">2 of 54</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">32</td> <td style="text-align: center;" nowrap="nowrap" width="18%">90</td> <td style="text-align: center;" nowrap="nowrap" width="7%">77</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 1</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">1.3%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">2</td> <td style="text-align: center;" nowrap="nowrap" width="18%">6</td> <td style="text-align: center;" nowrap="nowrap" width="7%">1</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 2</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">0.8%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">1 of 4</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> <td style="text-align: center;" nowrap="nowrap" width="18%">0</td> <td style="text-align: center;" nowrap="nowrap" width="7%">3</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 3</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">1.2%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">3</td> <td style="text-align: center;" nowrap="nowrap" width="18%">2</td> <td style="text-align: center;" nowrap="nowrap" width="7%">2</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 4</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">7.0%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 8</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">9</td> <td style="text-align: center;" nowrap="nowrap" width="18%">61</td> <td style="text-align: center;" nowrap="nowrap" width="7%">57</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 5</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">2.0%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">4</td> <td style="text-align: center;" nowrap="nowrap" width="18%">5</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 6</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">2.6%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 5</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">7</td> <td style="text-align: center;" nowrap="nowrap" width="18%">3</td> <td style="text-align: center;" nowrap="nowrap" width="7%">8</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 7</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">0.7%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 4</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> <td style="text-align: center;" nowrap="nowrap" width="18%">6</td> <td style="text-align: center;" nowrap="nowrap" width="7%">2</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 8</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">0.9%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">3</td> <td style="text-align: center;" nowrap="nowrap" width="18%">1</td> <td style="text-align: center;" nowrap="nowrap" width="7%">3</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 9</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">5.4%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">1 of 5</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">2</td> <td style="text-align: center;" nowrap="nowrap" width="18%">5</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 10</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">1.8%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 4</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">2</td> <td style="text-align: center;" nowrap="nowrap" width="18%">1</td> <td style="text-align: center;" nowrap="nowrap" width="7%">1</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> </tbody></table>
    *HHS regions (Region 1 CT, ME, MA, NH, RI, VT; Region 2: NJ, NY, Puerto Rico, US Virgin Islands; Region 3: DE, DC, MD, PA, VA, WV; Region 4: AL, FL, GA, KY, MS, NC, SC, TN; Region 5: IL, IN, MI, MN, OH, WI; Region 6: AR, LA, NM, OK, TX; Region 7: IA, KS, MO, NE; Region 8: CO, MT, ND, SD, UT, WY; Region 9: AZ, CA, Guam, HI, NV; and Region 10: AK, ID, OR, WA).
    † Elevated means the % of visits for ILI is at or above the national or region-specific baseline
    ‡ National data are for current week; regional data are for the most recent three weeks
    &#194;&#167; Includes all 50 states, the District of Columbia, Guam, Puerto Rico, and U.S. Virgin Islands




    U.S. Virologic Surveillance:

    WHO and NREVSS collaborating laboratories located in all 50 states, Puerto Rico, and the District of Columbia report to CDC the number of respiratory specimens tested for influenza and the number positive by influenza virus type and influenza A virus subtype. The results of tests performed during the current week are summarized in the table below. Region specific data are available at http://gis.cdc.gov/grasp/fluview/flu...dashboard.html.
    Starting during week 40 (week ending October 4, 2014) of the 2014-2015 season, virologic surveillance data from approximately 120 additional NREVSS laboratories will be added to the national influenza laboratory surveillance system. Please note that historical data from these additional NREVSS laboratories will not be added to previous influenza seasons, including the 2013-2014 season.
    <table class="table" align="center" border="0" cellpadding="2" cellspacing="0"> <tbody><tr style="background-image: url(../images/purplegrad.jpg); background-repeat: repeat-x;"> <th style="text-align: left;" width="270">
    </th> <th style="text-align: center;" nowrap="nowrap" width="150">Week 40</th> </tr> <tr> <th style="text-align: left;" width="270">No. of specimens tested</th> <td style="text-align: center;" nowrap="nowrap" width="150">6,192</td> </tr> <tr> <th style="text-align: left;" width="270">No. of positive specimens (%)</th> <td style="text-align: center;" nowrap="nowrap" width="150">199 (3.2%)</td> </tr> <tr> <th style="text-align: left;" width="270">Positive specimens by type/subtype</th> <td style="text-align: center;" nowrap="nowrap" width="150">
    </td> </tr> <tr> <th style="text-align: left;" width="270"> Influenza A</th> <td style="text-align: center;" nowrap="nowrap" width="150">122 (61.3%)</td> </tr> <tr> <th style="text-align: left;" width="270"> 2009 H1N1</th> <td style="text-align: right;" nowrap="nowrap" width="150"> 0 (0%) </td> </tr> <tr> <th style="text-align: left;" width="270"> H3</th> <td style="text-align: right;" nowrap="nowrap" width="150"> 32 (26.2%) </td> </tr> <tr> <th style="text-align: left;" width="270"> Subytping not performed</th> <td style="text-align: right;" nowrap="nowrap" width="150"> 90 (73.8%) </td> </tr> <tr> <th style="text-align: left;" width="270"> Influenza B</th> <td style="text-align: center;" nowrap="nowrap" width="150">77 (38.7%)</td> </tr> </tbody></table> <center>
    View National and Regional Level Graphs and Data | View Chart Data | View Full Screen | View PowerPoint Presentation </center>

    Novel Influenza A Viruses:

    No novel influenza A virus infections were reported to CDC during week 40, however, from May 18 through September 27, 2014, two human infections with influenza A (H3N2) variant viruses were reported by Ohio. More information is available at http://www.cdc.gov/flu/swineflu/h3n2v-case-count.htm.


    Antigenic Characterization:

    No antigenic characterization data is available for specimens collected after October 1, 2014.
    During May 18 &#226;€“ September 27, 2014, CDC antigenically characterized 225 viruses collected from the United States, including six pH1N1 viruses, 93 influenza A (H3N2) viruses, and 126 influenza B viruses. All six (100%) pH1N1 viruses were antigenically similar to A/California/7/2009, the influenza A (H1N1) component of the 2014-2015 Northern Hemisphere influenza vaccine. Of the 93 influenza A (H3N2) viruses characterized, 39 (42%) were antigenically similar to A/Texas/50/2012, the influenza A (H3N2) component of the 2014-2015 Northern Hemisphere influenza vaccine.
    Of the 126 influenza B viruses collected and analyzed during this period, 95 (75%) belonged to the B/Yamagata-lineage, and were antigenically similar to the B/Massachusetts/2/2012 virus, the influenza B component for the 2014&#226;€“2015 Northern Hemisphere trivalent vaccine. The remaining 31 viruses (25%) belonged to the B/Victoria lineage and were antigenically similar to the B/Brisbane/60/2008 virus, the B/Victoria-lineage component of the 2014&#226;€“2015 Northern Hemisphere quadrivalent influenza vaccine.

    Antiviral Resistance:

    No antiviral resistance data is available for specimens collected after October 1, 2014. During May 18 &#226;€“ September 27, 2014, 229 specimens (six 2009 H1N1, 113 influenza A (H3N2), and 110 influenza B viruses) collected in the United States were tested for susceptibility to the neuraminidase inhibitors (oseltamivir and zanamivir), none of the tested viruses were found to be resistant to either oseltamivir or zanamivir.
    The majority of currently circulating influenza viruses are susceptible to the neuraminidase inhibitor antiviral medications, oseltamivir and zanamivir; however, rare sporadic instances of oseltamivir-resistant 2009 H1N1 and A (H3N2) viruses have been detected worldwide. Antiviral treatment with oseltamivir or zanamivir is recommended as early as possible for patients with confirmed or suspected influenza who have severe, complicated, or progressive illness; who require hospitalization; or who are at high risk for serious influenza-related complications. Additional information on recommendations for treatment and chemoprophylaxis of influenza virus infection with antiviral agents is available at http://www.cdc.gov/flu/antivirals/index.htm.


    Pneumonia and Influenza (P&I) Mortality Surveillance:

    During week 40, 5.4% of all deaths reported through the 122 Cities Mortality Reporting System were due to P&I. This percentage was below the epidemic threshold of 6.0% for week 40.
    <center>
    View Full Screen | View PowerPoint Presentation </center>

    For the 2014-2015 influenza season, CDC/Influenza Division and the National Center for Health Statistics (NCHS) are collaborating on a pilot project to use NCHS mortality surveillance data for the rapid assessment of pneumonia and influenza (P&I) mortality. To view the data, please click here (http://www.cdc.gov/flu/weekly/nchs.htm).


    Influenza-Associated Pediatric Mortality:

    No influenza-associated pediatric deaths were reported to CDC during week 40. However, five influenza-associated pediatric deaths occurring during May 18-September 27, 2014 were reported. Two deaths were associated with an influenza A (H3N2) virus, one was associated with an influenza A virus for which no subtyping was performed, and two were associated with an influenza B virus. A total of 108 influenza-associated pediatric deaths have been reported during the 2013-2014 season.

    Additional data can be found at: http://gis.cdc.gov/GRASP/Fluview/PedFluDeath.html.
    <center>
    View Interactive Application | View Full Screen | View PowerPoint Presentation </center>



    Influenza-Associated Hospitalizations:

    The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts all age population-based surveillance for laboratory-confirmed influenza-related hospitalizations in select counties in the Emerging Infections Program (EIP) states and Influenza Hospitalization Surveillance Project (IHSP) states. FluSurv-NET estimated hospitalization rates will be updated weekly starting later this season. Additional FluSurv-NET data can be found at: http://gis.cdc.gov/GRASP/Fluview/FluHospRates.html and http://gis.cdc.gov/grasp/fluview/FluHospChars.html.


    Outpatient Illness Surveillance:

    Nationwide during week 40, 1.3% of patient visits reported through the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) were due to influenza-like illness (ILI). This percentage is below the national baseline of 2.0%.
    (ILI is defined as fever (temperature of 100&#194;&#176;F [37.8&#194;&#176;C] or greater) and cough and/or sore throat.)

    Additional data are available at http://gis.cdc.gov/grasp/fluview/flu...dashboard.html.
    <center>
    View National and Regional Level Graphs and Data | View Chart Data | View Full Screen | View PowerPoint Presentation
    </center>

    On a regional level, the percentage of outpatient visits for ILI ranged from 0.5% to 2.1% during week 40. All 10 regions reported a proportion of outpatient visits for ILI below their region-specific baseline levels.



    ILINet State Activity Indicator Map:

    Data collected in ILINet are used to produce a measure of ILI activity* by state. Activity levels are based on the percent of outpatient visits in a state due to ILI and are compared to the average percent of ILI visits that occur during weeks with little or no influenza virus circulation. Activity levels range from minimal, which would correspond to ILI activity from outpatient clinics being below, or only slightly above, the average, to high, which would correspond to ILI activity from outpatient clinics being much higher than average.
    During week 40, the following ILI activity levels were experienced:
    • Puerto Rico experienced high ILI activity.
    • All 50 states and New York City experienced minimal ILI activity.
    • Data were insufficient to calculate an ILI activity level from the District of Columbia.

    Click on map to launch interactive tool

    *This map uses the proportion of outpatient visits to health care providers for influenza-like illness to measure the ILI activity level within a state. It does not, however, measure the extent of geographic spread of flu within a state. Therefore, outbreaks occurring in a single city could cause the state to display high activity levels.
    Data collected in ILINet may disproportionally represent certain populations within a state, and therefore, may not accurately depict the full picture of influenza activity for the whole state.
    Data displayed in this map are based on data collected in ILINet, whereas the State and Territorial flu activity map is based on reports from state and territorial epidemiologists. The data presented in this map is preliminary and may change as more data is received.
    Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.


    Geographic Spread of Influenza as Assessed by State and Territorial Epidemiologists

    The influenza activity reported by state and territorial epidemiologists indicates geographic spread of influenza viruses, but does not measure the severity of influenza activity.
    During week 40, the following influenza activity was reported:
    • Widespread influenza activity was reported by Guam.
    • Regional influenza activity was reported by Puerto Rico.
    • Local influenza activity was reported by three states (Alabama, New Hampshire, and North Dakota).
    • Sporadic influenza activity was reported by the District of Columbia, the U.S. Virgin Islands, and 28 states (Alaska, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Hawaii, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, South Carolina, South Dakota, Texas, Utah, Vermont, Virginia, Washington, Wisconsin, and Wyoming).
    • No influenza activity was reported by 18 states (Arizona, Delaware, Idaho, Illinois, Indiana, Kansas, Kentucky, Maryland, Maine, Mississippi, Missouri, Montana, Nebraska, Nevada, Oklahoma, Rhode Island, Tennessee, and West Virginia).
    • One state (Iowa) did not report.



    Additional National and International Influenza Surveillance Information


    FluView Interactive: FluView includes enhanced web-based interactive applications that can provide dynamic visuals of the influenza data collected and analyzed by CDC. These FluView Interactive applications allow people to create customized, visual interpretations of influenza data, as well as make comparisons across flu seasons, regions, age groups and a variety of other demographics. To access these tools, visit http://www.cdc.gov/flu/weekly/fluviewinteractive.htm.
    U.S. State and local influenza surveillance: Click on a jurisdiction below to access the latest local influenza information.
    <table> <tbody><tr border="1"> <td height="8" width="139">Alabama
    </td> <td height="8" width="139">Alaska
    </td> <td height="8" width="139">Arizona
    </td> <td height="8" width="139">Arkansas
    </td> <td height="8" width="139">California
    </td> </tr> <tr border="1"> <td height="8" width="139">Colorado
    </td> <td height="8" width="139">Connecticut
    </td> <td height="8" width="139">Delaware
    </td> <td height="8" width="139">District of Columbia
    </td> <td height="8" width="139">Florida
    </td> </tr> <tr border="1"> <td height="8" width="139">Georgia
    </td> <td height="8" width="139">Hawaii
    </td> <td height="8" width="139">Idaho
    </td> <td height="8" width="139">Illinois
    </td> <td height="8" width="139">Indiana
    </td> </tr> <tr border="1"> <td height="8" width="139">Iowa
    </td> <td height="8" width="139">Kansas
    </td> <td height="8" width="139">Kentucky
    </td> <td height="8" width="139">Louisiana
    </td> <td height="8" width="139">Maine
    </td> </tr> <tr border="1"> <td height="8" width="139">Maryland
    </td> <td height="8" width="139">Massachusetts
    </td> <td height="8" width="139">Michigan
    </td> <td height="8" width="139">Minnesota
    </td> <td height="8" width="139">Mississippi
    </td> </tr> <tr border="1"> <td height="8" width="139">Missouri
    </td> <td height="8" width="139">Montana
    </td> <td height="8" width="139">Nebraska
    </td> <td height="8" width="139">Nevada
    </td> <td height="8" width="139">New Hampshire
    </td> </tr> <tr border="1"> <td height="8" width="139">New Jersey
    </td> <td height="8" width="139">New Mexico
    </td> <td height="8" width="139">New York
    </td> <td height="8" width="139">North Carolina
    </td> <td height="8" width="139">North Dakota
    </td> </tr> <tr border="1"> <td height="8" width="139">Ohio
    </td> <td height="8" width="139">Oklahoma
    </td> <td height="8" width="139">Oregon
    </td> <td height="8" width="139">Pennsylvania
    </td> <td height="8" width="139">Rhode Island
    </td> </tr> <tr border="1"> <td height="8" width="139">South Carolina
    </td> <td height="8" width="139">South Dakota
    </td> <td height="8" width="139">Tennessee
    </td> <td height="8" width="139">Texas
    </td> <td height="8" width="139">Utah
    </td> </tr> <tr border="1"> <td height="8" width="139">Vermont
    </td> <td height="8" width="139">Virginia
    </td> <td height="8" width="139">Washington
    </td> <td height="8" width="139">West Virginia
    </td> <td height="8" width="139">Wisconsin
    </td> </tr> <tr border="1"> <td height="8" width="139">Wyoming
    </td> <td height="8" width="139">New York City
    </td> <td height="8" width="139">Virgin Islands
    </td> <td height="8" width="139">
    </td> <td height="8" width="139">
    </td> </tr> </tbody></table>



    World Health Organization: Additional influenza surveillance information from participating WHO member nations is available through FluNet and the Global Epidemiology Reports.
    WHO Collaborating Centers for Influenza located in Australia, China, Japan, the United Kingdom, and the United States (CDC in Atlanta, Georgia).
    Europe: for the most recent influenza surveillance information from Europe, please see WHO/Europe at http://www.euroflu.org/index.php and visit the European Centre for Disease Prevention and Control at http://ecdc.europa.eu/en/publications/surveillance_reports/influenza/Pages/weekly_influenza_surveillance_overview.aspx
    Public Health Agency of Canada: The most up-to-date influenza information from Canada is available at http://www.phac-aspc.gc.ca/fluwatch/
    Health Protection Agency (United Kingdom): The most up-to-date influenza information from the United Kingdom is available at http://www.hpa.org.uk/Topics/Infecti...onalInfluenza/


  • #2
    Re: USA: 2013-14 FluView: Influenza Season Weekly Summary, Wks 40+

    2014-2015 Influenza Season Week 41 ending October 11, 2014


    All data are preliminary and may change as more reports are received.
    Synopsis:

    During week 41 (October 5-11, 2014), influenza activity was low in the United States.
    • Viral Surveillance: Of 7,655 specimens tested and reported by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories during week 41, 282 (3.7%) were positive for influenza.
    • Pneumonia and Influenza Mortality:The proportion of deaths attributed to pneumonia and influenza (P&I) was below the epidemic threshold.
    • Influenza-associated Pediatric Deaths: No influenza-associated pediatric deaths were reported.
    • Outpatient Illness Surveillance: The proportion of outpatient visits for influenza-like illness (ILI) was 1.3%, which is below the national baseline of 2.0%. All 10 regions reported ILI below region-specific baseline levels. Puerto Rico experienced moderate ILI activity; New York City and 49 states experienced minimal ILI activity and the District of Columbia and one state had insufficient data.
    • Geographic Spread of Influenza: The geographic spread of influenza in Guam was reported as widespread; Puerto Rico and four states reported local activity; the District of Columbia and 36 states reported sporadic activity; and the U.S. Virgin Islands and 10 states reported no influenza activity.

    <table class="table" border="0" cellpadding="3" cellspacing="0" width="100%"> <caption>National and Regional Summary of Select Surveillance Components

    </caption> <tbody><tr style="vertical-align:top" bgcolor="#c5bee1"> <th rowspan="2" style="vertical-align:bottom" width="12%">HHS Surveillance Regions*</th> <th colspan="8" style="text-align: center;" nowrap="nowrap">Data cumulative since September 28, 2014 (week 40)</th> </tr> <tr style="vertical-align:middle; background-image: url(images/purplegrad.jpg); background-repeat: repeat-x;"> <th style="text-align: center;" width="8%">Out-patient ILI?</th> <th style="text-align: center;" width="8%">% positive for flu?</th> <th style="text-align: center;" width="15%">Number of jurisdictions reporting regional or widespread activity?</th> <th style="text-align: center;" nowrap="nowrap" width="7%">2009 H1N1</th> <th style="text-align: center;" width="11%">A (H3)</th> <th style="text-align: center;" width="18%">A(Subtyping not performed)</th> <th style="text-align: center;" nowrap="nowrap" width="7%">B</th> <th style="text-align: center;" width="11%">Pediatric Deaths</th> </tr> <tr> <td style="text-align: left;" width="12%">Nation</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">3.7%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">1 of 54</td> <td style="text-align: center;" nowrap="nowrap" width="7%">2</td> <td style="text-align: center;" nowrap="nowrap" width="11%">83</td> <td style="text-align: center;" nowrap="nowrap" width="18%">227</td> <td style="text-align: center;" nowrap="nowrap" width="7%">210</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 1</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">1.3%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">2</td> <td style="text-align: center;" nowrap="nowrap" width="18%">8</td> <td style="text-align: center;" nowrap="nowrap" width="7%">2</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 2</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">0.4%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 4</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> <td style="text-align: center;" nowrap="nowrap" width="18%">2</td> <td style="text-align: center;" nowrap="nowrap" width="7%">3</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 3</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">1.2%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">6</td> <td style="text-align: center;" nowrap="nowrap" width="18%">5</td> <td style="text-align: center;" nowrap="nowrap" width="7%">5</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 4</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">7.3%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 8</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">22</td> <td style="text-align: center;" nowrap="nowrap" width="18%">157</td> <td style="text-align: center;" nowrap="nowrap" width="7%">155</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 5</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">1.9%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="7%">2</td> <td style="text-align: center;" nowrap="nowrap" width="11%">12</td> <td style="text-align: center;" nowrap="nowrap" width="18%">11</td> <td style="text-align: center;" nowrap="nowrap" width="7%">6</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 6</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">3.4%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 5</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">7</td> <td style="text-align: center;" nowrap="nowrap" width="18%">10</td> <td style="text-align: center;" nowrap="nowrap" width="7%">21</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 7</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">1.1%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 4</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">4</td> <td style="text-align: center;" nowrap="nowrap" width="18%">11</td> <td style="text-align: center;" nowrap="nowrap" width="7%">3</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 8</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">0.8%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">5</td> <td style="text-align: center;" nowrap="nowrap" width="18%">5</td> <td style="text-align: center;" nowrap="nowrap" width="7%">4</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 9</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">3.5%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">1 of 5</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">9</td> <td style="text-align: center;" nowrap="nowrap" width="18%">15</td> <td style="text-align: center;" nowrap="nowrap" width="7%">6</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 10</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">2.8%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 4</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">16</td> <td style="text-align: center;" nowrap="nowrap" width="18%">3</td> <td style="text-align: center;" nowrap="nowrap" width="7%">5</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> </tbody></table>
    *HHS regions (Region 1 CT, ME, MA, NH, RI, VT; Region 2: NJ, NY, Puerto Rico, US Virgin Islands; Region 3: DE, DC, MD, PA, VA, WV; Region 4: AL, FL, GA, KY, MS, NC, SC, TN; Region 5: IL, IN, MI, MN, OH, WI; Region 6: AR, LA, NM, OK, TX; Region 7: IA, KS, MO, NE; Region 8: CO, MT, ND, SD, UT, WY; Region 9: AZ, CA, Guam, HI, NV; and Region 10: AK, ID, OR, WA).
    ? Elevated means the % of visits for ILI is at or above the national or region-specific baseline
    ? National data are for current week; regional data are for the most recent three weeks
    ? Includes all 50 states, the District of Columbia, Guam, Puerto Rico, and U.S. Virgin Islands




    U.S. Virologic Surveillance:

    WHO and NREVSS collaborating laboratories located in all 50 states, Puerto Rico, and the District of Columbia report to CDC the number of respiratory specimens tested for influenza and the number positive by influenza virus type and influenza A virus subtype. The results of tests performed during the current week are summarized in the table below. Region specific data are available at http://gis.cdc.gov/grasp/fluview/flu...dashboard.html.
    <table class="table" align="center" border="0" cellpadding="2" cellspacing="0"> <tbody><tr style="background-image: url(images/purplegrad.jpg); background-repeat: repeat-x;"> <th style="text-align: left;" width="270">
    </th> <th style="text-align: center;" nowrap="nowrap" width="150">Week 41</th> </tr> <tr> <th style="text-align: left;" width="270">No. of specimens tested</th> <td style="text-align: center;" nowrap="nowrap" width="150">7,655</td> </tr> <tr> <th style="text-align: left;" width="270">No. of positive specimens (%)</th> <td style="text-align: center;" nowrap="nowrap" width="150">282 (3.7%)</td> </tr> <tr> <th style="text-align: left;" width="270">Positive specimens by type/subtype</th> <td style="text-align: center;" nowrap="nowrap" width="150">
    </td> </tr> <tr> <th style="text-align: left;" width="270"> Influenza A</th> <td style="text-align: center;" nowrap="nowrap" width="150">164 (58.2%)</td> </tr> <tr> <th style="text-align: left;" width="270"> 2009 H1N1</th> <td style="text-align: right;" nowrap="nowrap" width="150"> 2 (1.2%) </td> </tr> <tr> <th style="text-align: left;" width="270"> H3</th> <td style="text-align: right;" nowrap="nowrap" width="150"> 28 (17.1%) </td> </tr> <tr> <th style="text-align: left;" width="270"> Subytping not performed</th> <td style="text-align: right;" nowrap="nowrap" width="150"> 134 (81.7%) </td> </tr> <tr> <th style="text-align: left;" width="270"> Influenza B</th> <td style="text-align: center;" nowrap="nowrap" width="150">118 (41.8%)</td> </tr> </tbody></table> <center>
    View National and Regional Level Graphs and Data | View Chart Data | View Full Screen | View PowerPoint Presentation </center>



    Antigenic Characterization:

    No antigenic characterization data is available for specimens collected after October 1, 2014.

    Antiviral Resistance:

    No antiviral resistance data is available for specimens collected after October 1, 2014.
    The majority of currently circulating influenza viruses are susceptible to the neuraminidase inhibitor antiviral medications, oseltamivir and zanamivir; however, rare sporadic instances of oseltamivir-resistant 2009 H1N1 and A (H3N2) viruses have been detected worldwide. Antiviral treatment with oseltamivir or zanamivir is recommended as early as possible for patients with confirmed or suspected influenza who have severe, complicated, or progressive illness; who require hospitalization; or who are at high risk for serious influenza-related complications. Additional information on recommendations for treatment and chemoprophylaxis of influenza virus infection with antiviral agents is available at http://www.cdc.gov/flu/antivirals/index.htm.


    Pneumonia and Influenza (P&I) Mortality Surveillance:

    During week 41, 5.4% of all deaths reported through the 122 Cities Mortality Reporting System were due to P&I. This percentage was below the epidemic threshold of 6.0% for week 41.
    <center>
    View Full Screen | View PowerPoint Presentation </center>

    For the 2014-2015 influenza season, CDC/Influenza Division and the National Center for Health Statistics (NCHS) are collaborating on a pilot project to use NCHS mortality surveillance data for the rapid assessment of pneumonia and influenza (P&I) mortality. To view the data, please click here (http://www.cdc.gov/flu/weekly/nchs.htm).


    Influenza-Associated Pediatric Mortality:

    No influenza-associated pediatric deaths were reported to CDC during week 41.

    Additional data can be found at: http://gis.cdc.gov/GRASP/Fluview/PedFluDeath.html.
    <center>
    View Interactive Application | View Full Screen | View PowerPoint Presentation </center>



    Influenza-Associated Hospitalizations:

    The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts all age population-based surveillance for laboratory-confirmed influenza-related hospitalizations in select counties in the Emerging Infections Program (EIP) states and Influenza Hospitalization Surveillance Project (IHSP) states. FluSurv-NET estimated hospitalization rates will be updated weekly starting later this season. Additional FluSurv-NET data can be found at: http://gis.cdc.gov/GRASP/Fluview/FluHospRates.html and http://gis.cdc.gov/grasp/fluview/FluHospChars.html.


    Outpatient Illness Surveillance:

    Nationwide during week 41, 1.3% of patient visits reported through the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) were due to influenza-like illness (ILI). This percentage is below the national baseline of 2.0%.
    (ILI is defined as fever (temperature of 100?F [37.8?C] or greater) and cough and/or sore throat.)

    Additional data are available at http://gis.cdc.gov/grasp/fluview/flu...dashboard.html.
    <center>
    View National and Regional Level Graphs and Data | View Chart Data | View Full Screen | View PowerPoint Presentation
    </center>

    On a regional level, the percentage of outpatient visits for ILI ranged from 0.7% to 2.0% during week 41. All 10 regions reported a proportion of outpatient visits for ILI below their region-specific baseline levels.



    ILINet State Activity Indicator Map:

    Data collected in ILINet are used to produce a measure of ILI activity* by state. Activity levels are based on the percent of outpatient visits in a state due to ILI and are compared to the average percent of ILI visits that occur during weeks with little or no influenza virus circulation. Activity levels range from minimal, which would correspond to ILI activity from outpatient clinics being below, or only slightly above, the average, to high, which would correspond to ILI activity from outpatient clinics being much higher than average.
    During week 41, the following ILI activity levels were experienced:
    • Puerto Rico experienced moderate ILI activity.
    • New York City and 49 states (Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming) experienced minimal ILI activity.
    • Data were insufficient to calculate an ILI activity level from the District of Columbia and one state (Vermont).

    Click on map to launch interactive tool

    *This map uses the proportion of outpatient visits to health care providers for influenza-like illness to measure the ILI activity level within a state. It does not, however, measure the extent of geographic spread of flu within a state. Therefore, outbreaks occurring in a single city could cause the state to display high activity levels.
    Data collected in ILINet may disproportionally represent certain populations within a state, and therefore, may not accurately depict the full picture of influenza activity for the whole state.
    Data displayed in this map are based on data collected in ILINet, whereas the State and Territorial flu activity map is based on reports from state and territorial epidemiologists. The data presented in this map is preliminary and may change as more data is received.
    Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.


    Geographic Spread of Influenza as Assessed by State and Territorial Epidemiologists

    The influenza activity reported by state and territorial epidemiologists indicates geographic spread of influenza viruses, but does not measure the severity of influenza activity.
    During week 41, the following influenza activity was reported:
    • Widespread influenza activity was reported by Guam.
    • Local influenza activity was reported by Puerto Rico and four states (Florida, New Hampshire, North Dakota, and Virginia).
    • Sporadic influenza activity was reported by the District of Columbia and 36 states (Alabama, Alaska, Arkansas, California, Colorado, Connecticut, Delaware, Georgia, Hawaii, Idaho, Indiana, Iowa, Kentucky, Louisiana, Maine, Maryland, Michigan, Minnesota, Nebraska, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Washington, West Virginia, Wisconsin, and Wyoming).
    • No influenza activity was reported by the U.S. Virgin Islands and 10 states (Arizona, Illinois, Kansas, Massachusetts, Mississippi, Missouri, Montana, Oklahoma, Nevada, and Rhode Island).





    Additional National and International Influenza Surveillance Information


    FluView Interactive: FluView includes enhanced web-based interactive applications that can provide dynamic visuals of the influenza data collected and analyzed by CDC. These FluView Interactive applications allow people to create customized, visual interpretations of influenza data, as well as make comparisons across flu seasons, regions, age groups and a variety of other demographics. To access these tools, visit http://www.cdc.gov/flu/weekly/fluviewinteractive.htm.
    U.S. State and local influenza surveillance: Click on a jurisdiction below to access the latest local influenza information.
    <table> <tbody><tr border="1"> <td height="8" width="139">Alabama
    </td> <td height="8" width="139">Alaska
    </td> <td height="8" width="139">Arizona
    </td> <td height="8" width="139">Arkansas
    </td> <td height="8" width="139">California
    </td> </tr> <tr border="1"> <td height="8" width="139">Colorado
    </td> <td height="8" width="139">Connecticut
    </td> <td height="8" width="139">Delaware
    </td> <td height="8" width="139">District of Columbia
    </td> <td height="8" width="139">Florida
    </td> </tr> <tr border="1"> <td height="8" width="139">Georgia
    </td> <td height="8" width="139">Hawaii
    </td> <td height="8" width="139">Idaho
    </td> <td height="8" width="139">Illinois
    </td> <td height="8" width="139">Indiana
    </td> </tr> <tr border="1"> <td height="8" width="139">Iowa
    </td> <td height="8" width="139">Kansas
    </td> <td height="8" width="139">Kentucky
    </td> <td height="8" width="139">Louisiana
    </td> <td height="8" width="139">Maine
    </td> </tr> <tr border="1"> <td height="8" width="139">Maryland
    </td> <td height="8" width="139">Massachusetts
    </td> <td height="8" width="139">Michigan
    </td> <td height="8" width="139">Minnesota
    </td> <td height="8" width="139">Mississippi
    </td> </tr> <tr border="1"> <td height="8" width="139">Missouri
    </td> <td height="8" width="139">Montana
    </td> <td height="8" width="139">Nebraska
    </td> <td height="8" width="139">Nevada
    </td> <td height="8" width="139">New Hampshire
    </td> </tr> <tr border="1"> <td height="8" width="139">New Jersey
    </td> <td height="8" width="139">New Mexico
    </td> <td height="8" width="139">New York
    </td> <td height="8" width="139">North Carolina
    </td> <td height="8" width="139">North Dakota
    </td> </tr> <tr border="1"> <td height="8" width="139">Ohio
    </td> <td height="8" width="139">Oklahoma
    </td> <td height="8" width="139">Oregon
    </td> <td height="8" width="139">Pennsylvania
    </td> <td height="8" width="139">Rhode Island
    </td> </tr> <tr border="1"> <td height="8" width="139">South Carolina
    </td> <td height="8" width="139">South Dakota
    </td> <td height="8" width="139">Tennessee
    </td> <td height="8" width="139">Texas
    </td> <td height="8" width="139">Utah
    </td> </tr> <tr border="1"> <td height="8" width="139">Vermont
    </td> <td height="8" width="139">Virginia
    </td> <td height="8" width="139">Washington
    </td> <td height="8" width="139">West Virginia
    </td> <td height="8" width="139">Wisconsin
    </td> </tr> <tr border="1"> <td height="8" width="139">Wyoming
    </td> <td height="8" width="139">New York City
    </td> <td height="8" width="139">Virgin Islands
    </td> <td height="8" width="139">
    </td> <td height="8" width="139">
    </td> </tr> </tbody></table>

    Google Flu Trends: Google Flu Trends uses aggregated Google search data in a model created in collaboration with CDC to estimate influenza activity in the United States. For more information and activity estimates from the U.S. and worldwide, see http://www.google.org/flutrends/
    World Health Organization: Additional influenza surveillance information from participating WHO member nations is available through FluNet and the Global Epidemiology Reports.
    WHO Collaborating Centers for Influenza located in Australia, China, Japan, the United Kingdom, and the United States (CDC in Atlanta, Georgia).
    Europe: for the most recent influenza surveillance information from Europe, please see WHO/Europe at http://www.euroflu.org/index.php and visit the European Centre for Disease Prevention and Control at http://ecdc.europa.eu/en/publications/surveillance_reports/influenza/Pages/weekly_influenza_surveillance_overview.aspx
    Public Health Agency of Canada: The most up-to-date influenza information from Canada is available at http://www.phac-aspc.gc.ca/fluwatch/
    Health Protection Agency (United Kingdom): The most up-to-date influenza information from the United Kingdom is available at http://www.hpa.org.uk/Topics/Infecti...onalInfluenza/


    Any links provided to non-Federal organizations are provided solely as a service to our users. These links do not constitute an endorsement of these organizations or their programs by CDC or the Federal Government, and none should be inferred. CDC is not responsible for the content of the individual organization web pages found at these links.
    In addition to the eight data components of CDC influenza surveillance for the 2014-2015 influenza season, the use of National Center for Health Statistics (NCHS) pneumonia and influenza mortality surveillance data for the rapid assessment of influenza-associated mortality will be piloted. An overview of influenza surveillance, including a description of the NCHS mortality surveillance data, is available at http://www.cdc.gov/flu/weekly/overview.htm
    -------------------------------------------------------------------------------- Full report also available as PDF




    Learn more about the weekly influenza surveillance report (FluView) prepared by the Influenza Division.

    Comment


    • #3
      Re: USA: 2013-14 FluView: Influenza Season Weekly Summary, Wks 40+


      2014-2015 Influenza Season Week 42 ending October 18, 2014


      All data are preliminary and may change as more reports are received.
      Synopsis:

      During week 42 (October 12-18, 2014), influenza activity was low in the United States.
      • Viral Surveillance: Of 8,412 specimens tested and reported by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories during week 42, 403 (4.8%) were positive for influenza.
      • Novel Influenza A Virus: One human infection with a novel influenza A virus was reported.
      • Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia and influenza (P&I) was below the epidemic threshold.
      • Influenza-associated Pediatric Deaths: Two influenza-associated pediatric deaths were reported, including one influenza-associated pediatric death that occurred during the 2013-2014 season.
      • Outpatient Illness Surveillance: The proportion of outpatient visits for influenza-like illness (ILI) was 1.4%, which is below the national baseline of 2.0%. One region reported ILI above their region-specific baseline level. Puerto Rico experienced high ILI activity; one state experienced low ILI activity; New York City and 49 states experienced minimal ILI activity and the District of Columbia had insufficient data.
      • Geographic Spread of Influenza: The geographic spread of influenza in Guam was reported as widespread; Puerto Rico and five states reported local activity; the U.S. Virgin Islands and 36 states reported sporadic activity; and the District of Columbia and nine states reported no influenza activity.

      <table class="table" border="0" cellpadding="3" cellspacing="0" width="100%"> <caption>National and Regional Summary of Select Surveillance Components

      </caption> <tbody><tr style="vertical-align:top" bgcolor="#c5bee1"> <th rowspan="2" style="vertical-align:bottom" width="12%">HHS Surveillance Regions*</th> <th colspan="8" style="text-align: center;" nowrap="nowrap">Data cumulative since September 28, 2014 (week 40)</th> </tr> <tr style="vertical-align:middle; background-image: url(images/purplegrad.jpg); background-repeat: repeat-x;"> <th style="text-align: center;" width="8%">Out-patient ILI?</th> <th style="text-align: center;" width="8%">% positive for flu?</th> <th style="text-align: center;" width="15%">Number of jurisdictions reporting regional or widespread activity?</th> <th style="text-align: center;" nowrap="nowrap" width="7%">2009 H1N1</th> <th style="text-align: center;" width="11%">A (H3)</th> <th style="text-align: center;" width="18%">A(Subtyping not performed)</th> <th style="text-align: center;" nowrap="nowrap" width="7%">B</th> <th style="text-align: center;" width="11%">Pediatric Deaths</th> </tr> <tr> <td style="text-align: left;" width="12%">Nation</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">4.8%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">1 of 54</td> <td style="text-align: center;" nowrap="nowrap" width="7%">7</td> <td style="text-align: center;" nowrap="nowrap" width="11%">267</td> <td style="text-align: center;" nowrap="nowrap" width="18%">405</td> <td style="text-align: center;" nowrap="nowrap" width="7%">392</td> <td style="text-align: center;" nowrap="nowrap" width="11%">1</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 1</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">1.6%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">8</td> <td style="text-align: center;" nowrap="nowrap" width="18%">8</td> <td style="text-align: center;" nowrap="nowrap" width="7%">4</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 2</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Elevated</td> <td style="text-align: center;" nowrap="nowrap" width="8%">1.1%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 4</td> <td style="text-align: center;" nowrap="nowrap" width="7%">1</td> <td style="text-align: center;" nowrap="nowrap" width="11%">17</td> <td style="text-align: center;" nowrap="nowrap" width="18%">17</td> <td style="text-align: center;" nowrap="nowrap" width="7%">11</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 3</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">1.7%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">16</td> <td style="text-align: center;" nowrap="nowrap" width="18%">16</td> <td style="text-align: center;" nowrap="nowrap" width="7%">69</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 4</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">8.0%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 8</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">56</td> <td style="text-align: center;" nowrap="nowrap" width="18%">290</td> <td style="text-align: center;" nowrap="nowrap" width="7%">246</td> <td style="text-align: center;" nowrap="nowrap" width="11%">1</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 5</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">2.1%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="7%">3</td> <td style="text-align: center;" nowrap="nowrap" width="11%">28</td> <td style="text-align: center;" nowrap="nowrap" width="18%">15</td> <td style="text-align: center;" nowrap="nowrap" width="7%">12</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 6</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">4.3%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 5</td> <td style="text-align: center;" nowrap="nowrap" width="7%">2</td> <td style="text-align: center;" nowrap="nowrap" width="11%">32</td> <td style="text-align: center;" nowrap="nowrap" width="18%">26</td> <td style="text-align: center;" nowrap="nowrap" width="7%">69</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 7</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">1.9%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 4</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">12</td> <td style="text-align: center;" nowrap="nowrap" width="18%">15</td> <td style="text-align: center;" nowrap="nowrap" width="7%">9</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 8</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">1.2%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">15</td> <td style="text-align: center;" nowrap="nowrap" width="18%">5</td> <td style="text-align: center;" nowrap="nowrap" width="7%">6</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 9</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">3.2%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">1 of 5</td> <td style="text-align: center;" nowrap="nowrap" width="7%">1</td> <td style="text-align: center;" nowrap="nowrap" width="11%">27</td> <td style="text-align: center;" nowrap="nowrap" width="18%">27</td> <td style="text-align: center;" nowrap="nowrap" width="7%">19</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 10</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">5.5%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 4</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">56</td> <td style="text-align: center;" nowrap="nowrap" width="18%">4</td> <td style="text-align: center;" nowrap="nowrap" width="7%">7</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> </tbody></table>
      *HHS regions (Region 1 CT, ME, MA, NH, RI, VT; Region 2: NJ, NY, Puerto Rico, US Virgin Islands; Region 3: DE, DC, MD, PA, VA, WV; Region 4: AL, FL, GA, KY, MS, NC, SC, TN; Region 5: IL, IN, MI, MN, OH, WI; Region 6: AR, LA, NM, OK, TX; Region 7: IA, KS, MO, NE; Region 8: CO, MT, ND, SD, UT, WY; Region 9: AZ, CA, Guam, HI, NV; and Region 10: AK, ID, OR, WA).
      ? Elevated means the % of visits for ILI is at or above the national or region-specific baseline
      ? National data are for current week; regional data are for the most recent three weeks
      ? Includes all 50 states, the District of Columbia, Guam, Puerto Rico, and U.S. Virgin Islands




      U.S. Virologic Surveillance:

      WHO and NREVSS collaborating laboratories located in all 50 states, Puerto Rico, and the District of Columbia report to CDC the number of respiratory specimens tested for influenza and the number positive by influenza virus type and influenza A virus subtype. The results of tests performed during the current week are summarized in the table below. Region specific data are available at http://gis.cdc.gov/grasp/fluview/flu...dashboard.html.
      <table class="table" align="center" border="0" cellpadding="2" cellspacing="0"> <tbody><tr style="background-image: url(images/purplegrad.jpg); background-repeat: repeat-x;"> <th style="text-align: left;" width="270">
      </th> <th style="text-align: center;" nowrap="nowrap" width="150">Week 42</th> </tr> <tr> <th style="text-align: left;" width="270">No. of specimens tested</th> <td style="text-align: center;" nowrap="nowrap" width="150">8,412</td> </tr> <tr> <th style="text-align: left;" width="270">No. of positive specimens (%)</th> <td style="text-align: center;" nowrap="nowrap" width="150">403 (4.8%)</td> </tr> <tr> <th style="text-align: left;" width="270">Positive specimens by type/subtype</th> <td style="text-align: center;" nowrap="nowrap" width="150">
      </td> </tr> <tr> <th style="text-align: left;" width="270"> Influenza A</th> <td style="text-align: center;" nowrap="nowrap" width="150">268 (66.5%)</td> </tr> <tr> <th style="text-align: left;" width="270"> 2009 H1N1</th> <td style="text-align: right;" nowrap="nowrap" width="150"> 3 (1.1%) </td> </tr> <tr> <th style="text-align: left;" width="270"> H3</th> <td style="text-align: right;" nowrap="nowrap" width="150"> 96 (35.8%) </td> </tr> <tr> <th style="text-align: left;" width="270"> Subytping not performed</th> <td style="text-align: right;" nowrap="nowrap" width="150"> 168 (62.7%) </td> </tr> <tr> <th style="text-align: left;" width="270"> Influenza B</th> <td style="text-align: center;" nowrap="nowrap" width="150">135 (33.5%)</td> </tr> </tbody></table> <center>
      View National and Regional Level Graphs and Data | View Chart Data | View Full Screen | View PowerPoint Presentation </center>

      Novel Influenza A Viruses:

      One human infection with a novel influenza A virus was reported by Wisconsin. The person was infected with an influenza A (H3N2) variant (H3N2v) virus, and has completely recovered from their illness. No ongoing human-to-human transmission has been identified and the case patient reported close contact with swine in the week prior to illness onset. This is the first H3N2v infection reported for the 2014-2015 influenza season, which began on September 28, 2014.
      Early identification and investigation of human infections with novel influenza A viruses is critical in order to evaluate the extent of the outbreak and possible human-to-human transmission. Additional information on influenza in swine, variant influenza infection in humans, and strategies to interact safely with swine can be found at http://www.cdc.gov/flu/swineflu/h3n2v-case-count.htm.


      Antigenic Characterization:

      No antigenic characterization data is available for specimens collected after October 1, 2014.

      Antiviral Resistance:

      No antiviral resistance data is available for specimens collected after October 1, 2014.
      The majority of currently circulating influenza viruses are susceptible to the neuraminidase inhibitor antiviral medications, oseltamivir and zanamivir; however, rare sporadic instances of oseltamivir-resistant 2009 H1N1 and A (H3N2) viruses have been detected worldwide. Antiviral treatment with oseltamivir or zanamivir is recommended as early as possible for patients with confirmed or suspected influenza who have severe, complicated, or progressive illness; who require hospitalization; or who are at high risk for serious influenza-related complications. Additional information on recommendations for treatment and chemoprophylaxis of influenza virus infection with antiviral agents is available at http://www.cdc.gov/flu/antivirals/index.htm.


      Pneumonia and Influenza (P&I) Mortality Surveillance:

      During week 42, 5.3% of all deaths reported through the 122 Cities Mortality Reporting System were due to P&I. This percentage was below the epidemic threshold of 6.0% for week 42.
      <center>
      View Full Screen | View PowerPoint Presentation </center>

      For the 2014-2015 influenza season, CDC/Influenza Division and the National Center for Health Statistics (NCHS) are collaborating on a pilot project to use NCHS mortality surveillance data for the rapid assessment of pneumonia and influenza (P&I) mortality. To view the data, please click here (http://www.cdc.gov/flu/weekly/nchs.htm).


      Influenza-Associated Pediatric Mortality:

      Two influenza-associated pediatric deaths were reported to CDC during week 42. One death was associated with an influenza A (H3) virus and occurred during week 40 (week ending October 4, 2014). This is the first influenza-associated pediatric death reported for the 2014-2015 season.
      One death was associated with an influenza B virus and occurred during the 2013-2014 season and brings the total number of reported pediatric deaths occurring during that season to 109.

      Additional data can be found at: http://gis.cdc.gov/GRASP/Fluview/PedFluDeath.html.
      <center>
      View Interactive Application | View Full Screen | View PowerPoint Presentation </center>



      Influenza-Associated Hospitalizations:

      The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts all age population-based surveillance for laboratory-confirmed influenza-related hospitalizations in select counties in the Emerging Infections Program (EIP) states and Influenza Hospitalization Surveillance Project (IHSP) states. FluSurv-NET estimated hospitalization rates will be updated weekly starting later this season. Additional FluSurv-NET data can be found at: http://gis.cdc.gov/GRASP/Fluview/FluHospRates.html and http://gis.cdc.gov/grasp/fluview/FluHospChars.html.


      Outpatient Illness Surveillance:

      Nationwide during week 42, 1.4% of patient visits reported through the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) were due to influenza-like illness (ILI). This percentage is below the national baseline of 2.0%.
      (ILI is defined as fever (temperature of 100?F [37.8?C] or greater) and cough and/or sore throat.)

      Additional data are available at http://gis.cdc.gov/grasp/fluview/flu...dashboard.html.
      <center>
      View National and Regional Level Graphs and Data | View Chart Data | View Full Screen | View PowerPoint Presentation
      </center>

      On a regional level, the percentage of outpatient visits for ILI ranged from 0.7% to 2.8% during week 42. One region (Region 2) reported a proportion of outpatient visits for ILI above their region-specific baseline level. The increase in ILI in Region 2 was due primarily to high ILI activity in Puerto Rico.



      ILINet State Activity Indicator Map:

      Data collected in ILINet are used to produce a measure of ILI activity* by state. Activity levels are based on the percent of outpatient visits in a state due to ILI and are compared to the average percent of ILI visits that occur during weeks with little or no influenza virus circulation. Activity levels range from minimal, which would correspond to ILI activity from outpatient clinics being below, or only slightly above, the average, to high, which would correspond to ILI activity from outpatient clinics being much higher than average.
      During week 42, the following ILI activity levels were experienced:
      • Puerto Rico experienced high ILI activity.
      • One state (Louisiana) experienced low ILI activity.
      • New York City and 49 states (Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming) experienced minimal ILI activity.
      • Data were insufficient to calculate an ILI activity level from the District of Columbia.

      Click on map to launch interactive tool

      *This map uses the proportion of outpatient visits to health care providers for influenza-like illness to measure the ILI activity level within a state. It does not, however, measure the extent of geographic spread of flu within a state. Therefore, outbreaks occurring in a single city could cause the state to display high activity levels.
      Data collected in ILINet may disproportionally represent certain populations within a state, and therefore, may not accurately depict the full picture of influenza activity for the whole state.
      Data displayed in this map are based on data collected in ILINet, whereas the State and Territorial flu activity map is based on reports from state and territorial epidemiologists. The data presented in this map is preliminary and may change as more data is received.
      Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.


      Geographic Spread of Influenza as Assessed by State and Territorial Epidemiologists

      The influenza activity reported by state and territorial epidemiologists indicates geographic spread of influenza viruses, but does not measure the severity of influenza activity.
      During week 42, the following influenza activity was reported:
      • Widespread influenza activity was reported by Guam.
      • Local influenza activity was reported by Puerto Rico and five states (Alaska, Connecticut, Florida, North Carolina, and Texas).
      • Sporadic influenza activity was reported by the U.S. Virgin Islands and 36 states (Alabama, Arkansas, California, Colorado, Delaware, Georgia, Hawaii, Indiana, Iowa, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, New Hampshire, Nebraska, New Jersey, New Mexico, New York, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming).
      • No influenza activity was reported by the District of Columbia and nine states (Arizona, Idaho, Illinois, Kansas, Missouri, Montana, Nevada, Rhode Island, and Tennessee).







      Additional National and International Influenza Surveillance Information


      FluView Interactive: FluView includes enhanced web-based interactive applications that can provide dynamic visuals of the influenza data collected and analyzed by CDC. These FluView Interactive applications allow people to create customized, visual interpretations of influenza data, as well as make comparisons across flu seasons, regions, age groups and a variety of other demographics. To access these tools, visit http://www.cdc.gov/flu/weekly/fluviewinteractive.htm.
      U.S. State and local influenza surveillance: Click on a jurisdiction below to access the latest local influenza information.
      <table> <tbody><tr border="1"> <td height="8" width="139">Alabama
      </td> <td height="8" width="139">Alaska
      </td> <td height="8" width="139">Arizona
      </td> <td height="8" width="139">Arkansas
      </td> <td height="8" width="139">California
      </td> </tr> <tr border="1"> <td height="8" width="139">Colorado
      </td> <td height="8" width="139">Connecticut
      </td> <td height="8" width="139">Delaware
      </td> <td height="8" width="139">District of Columbia
      </td> <td height="8" width="139">Florida
      </td> </tr> <tr border="1"> <td height="8" width="139">Georgia
      </td> <td height="8" width="139">Hawaii
      </td> <td height="8" width="139">Idaho
      </td> <td height="8" width="139">Illinois
      </td> <td height="8" width="139">Indiana
      </td> </tr> <tr border="1"> <td height="8" width="139">Iowa
      </td> <td height="8" width="139">Kansas
      </td> <td height="8" width="139">Kentucky
      </td> <td height="8" width="139">Louisiana
      </td> <td height="8" width="139">Maine
      </td> </tr> <tr border="1"> <td height="8" width="139">Maryland
      </td> <td height="8" width="139">Massachusetts
      </td> <td height="8" width="139">Michigan
      </td> <td height="8" width="139">Minnesota
      </td> <td height="8" width="139">Mississippi
      </td> </tr> <tr border="1"> <td height="8" width="139">Missouri
      </td> <td height="8" width="139">Montana
      </td> <td height="8" width="139">Nebraska
      </td> <td height="8" width="139">Nevada
      </td> <td height="8" width="139">New Hampshire
      </td> </tr> <tr border="1"> <td height="8" width="139">New Jersey
      </td> <td height="8" width="139">New Mexico
      </td> <td height="8" width="139">New York
      </td> <td height="8" width="139">North Carolina
      </td> <td height="8" width="139">North Dakota
      </td> </tr> <tr border="1"> <td height="8" width="139">Ohio
      </td> <td height="8" width="139">Oklahoma
      </td> <td height="8" width="139">Oregon
      </td> <td height="8" width="139">Pennsylvania
      </td> <td height="8" width="139">Rhode Island
      </td> </tr> <tr border="1"> <td height="8" width="139">South Carolina
      </td> <td height="8" width="139">South Dakota
      </td> <td height="8" width="139">Tennessee
      </td> <td height="8" width="139">Texas
      </td> <td height="8" width="139">Utah
      </td> </tr> <tr border="1"> <td height="8" width="139">Vermont
      </td> <td height="8" width="139">Virginia
      </td> <td height="8" width="139">Washington
      </td> <td height="8" width="139">West Virginia
      </td> <td height="8" width="139">Wisconsin
      </td> </tr> <tr border="1"> <td height="8" width="139">Wyoming
      </td> <td height="8" width="139">New York City
      </td> <td height="8" width="139">Virgin Islands
      </td> <td height="8" width="139">
      </td> <td height="8" width="139">
      </td> </tr> </tbody></table>

      Google Flu Trends: Google Flu Trends uses aggregated Google search data in a model created in collaboration with CDC to estimate influenza activity in the United States. For more information and activity estimates from the U.S. and worldwide, see http://www.google.org/flutrends/
      World Health Organization: Additional influenza surveillance information from participating WHO member nations is available through FluNet and the Global Epidemiology Reports.
      WHO Collaborating Centers for Influenza located in Australia, China, Japan, the United Kingdom, and the United States (CDC in Atlanta, Georgia).
      Europe: for the most recent influenza surveillance information from Europe, please see WHO/Europe at http://www.euroflu.org/index.php and visit the European Centre for Disease Prevention and Control at http://ecdc.europa.eu/en/publications/surveillance_reports/influenza/Pages/weekly_influenza_surveillance_overview.aspx
      Public Health Agency of Canada: The most up-to-date influenza information from Canada is available at http://www.phac-aspc.gc.ca/fluwatch/
      Health Protection Agency (United Kingdom): The most up-to-date influenza information from the United Kingdom is available at http://www.hpa.org.uk/Topics/Infecti...onalInfluenza/


      Any links provided to non-Federal organizations are provided solely as a service to our users. These links do not constitute an endorsement of these organizations or their programs by CDC or the Federal Government, and none should be inferred. CDC is not responsible for the content of the individual organization web pages found at these links.
      In addition to the eight data components of CDC influenza surveillance for the 2014-2015 influenza season, the use of National Center for Health Statistics (NCHS) pneumonia and influenza mortality surveillance data for the rapid assessment of influenza-associated mortality will be piloted. An overview of influenza surveillance, including a description of the NCHS mortality surveillance data, is available at http://www.cdc.gov/flu/weekly/overview.htm


      Learn more about the weekly influenza surveillance report (FluView) prepared by the Influenza Division.

      Comment


      • #4
        Re: USA: 2014-15 FluView: Influenza Season Weekly Summary, Wks 40+

        google flu trend has a big peak in Alaska:
        Google.org connects nonprofits to funding & additional resources. Learn about our philanthropy program & goal to aid underserved communities.

        there is also an unusual early outbreak in British Columbia (H3)


        however, CDC and Alaska reports are not so unusual:

        week 42: Local activity in AK,CT,FL,NC,TX
        week 43: 49 States including Alaska reported minimal activity


        weekly cases reported: 9,30,66,87

        81,Anc/Mat-Su
        24,Gulf Coast
        48,Interior
        2,Northern
        5,Southeast
        30,Southwest
        190,TOTAL

        In Alaska, the percentage of influenza-like illness (ILI) visits to sentinel providers for the
        week ending October 25, 2014 was 1.57%. Nationally, the percentage of ILI was 1.4%.

        0.8,0.8,0.8,1.5



        .
        I'm interested in expert panflu damage estimates
        my current links: http://bit.ly/hFI7H ILI-charts: http://bit.ly/CcRgT

        Comment


        • #5
          Re: USA: 2014-15 FluView: Influenza Season Weekly Summary, Wks 40+

          2014-2015 Influenza Season Week 43 ending October 25, 2014


          All data are preliminary and may change as more reports are received.
          Synopsis:

          During week 43 (October 19-25, 2014), influenza activity was low in the United States.
          • Viral Surveillance: Of 7,449 specimens tested and reported by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories during week 43, 320 (4.3%) were positive for influenza.
          • Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia and influenza (P&I) was below the epidemic threshold.
          • Influenza-associated Pediatric Deaths: No influenza-associated pediatric deaths were reported.
          • Outpatient Illness Surveillance: The proportion of outpatient visits for influenza-like illness (ILI) was 1.4%, which is below the national baseline of 2.0%. All 10 regions reported ILI below region-specific baseline levels. One state experienced low ILI activity; Puerto Rico, New York City and 49 states experienced minimal ILI activity; and the District of Columbia had insufficient data.
          • Geographic Spread of Influenza: The geographic spread of influenza in Guam was reported as widespread; one state reported regional activity; Puerto Rico and eight states reported local activity; the U.S. Virgin Islands and 32 states reported sporadic activity; and the District of Columbia and nine states reported no influenza activity.

          <table class="table" border="0" cellpadding="3" cellspacing="0" width="100%"> <caption>National and Regional Summary of Select Surveillance Components

          </caption> <tbody><tr style="vertical-align:top" bgcolor="#c5bee1"> <th rowspan="2" style="vertical-align:bottom" width="12%">HHS Surveillance Regions*</th> <th colspan="8" style="text-align: center;" nowrap="nowrap">Data cumulative since September 28, 2014 (week 40)</th> </tr> <tr style="vertical-align:middle; background-image: url(images/purplegrad.jpg); background-repeat: repeat-x;"> <th style="text-align: center;" width="8%">Out-patient ILI?</th> <th style="text-align: center;" width="8%">% positive for flu?</th> <th style="text-align: center;" width="15%">Number of jurisdictions reporting regional or widespread activity?</th> <th style="text-align: center;" nowrap="nowrap" width="7%">2009 H1N1</th> <th style="text-align: center;" width="11%">A (H3)</th> <th style="text-align: center;" width="18%">A(Subtyping not performed)</th> <th style="text-align: center;" nowrap="nowrap" width="7%">B</th> <th style="text-align: center;" width="11%">Pediatric Deaths</th> </tr> <tr> <td style="text-align: left;" width="12%">Nation</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">4.3%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">2 of 54</td> <td style="text-align: center;" nowrap="nowrap" width="7%">18</td> <td style="text-align: center;" nowrap="nowrap" width="11%">483</td> <td style="text-align: center;" nowrap="nowrap" width="18%">563</td> <td style="text-align: center;" nowrap="nowrap" width="7%">491</td> <td style="text-align: center;" nowrap="nowrap" width="11%">1</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 1</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">1.2%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="7%">1</td> <td style="text-align: center;" nowrap="nowrap" width="11%">11</td> <td style="text-align: center;" nowrap="nowrap" width="18%">11</td> <td style="text-align: center;" nowrap="nowrap" width="7%">5</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 2</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">2.0%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 4</td> <td style="text-align: center;" nowrap="nowrap" width="7%">4</td> <td style="text-align: center;" nowrap="nowrap" width="11%">58</td> <td style="text-align: center;" nowrap="nowrap" width="18%">5</td> <td style="text-align: center;" nowrap="nowrap" width="7%">14</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 3</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">2.0%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">22</td> <td style="text-align: center;" nowrap="nowrap" width="18%">15</td> <td style="text-align: center;" nowrap="nowrap" width="7%">17</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 4</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">8.2%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 8</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">100</td> <td style="text-align: center;" nowrap="nowrap" width="18%">388</td> <td style="text-align: center;" nowrap="nowrap" width="7%">289</td> <td style="text-align: center;" nowrap="nowrap" width="11%">1</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 5</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">2.9%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="7%">7</td> <td style="text-align: center;" nowrap="nowrap" width="11%">40</td> <td style="text-align: center;" nowrap="nowrap" width="18%">33</td> <td style="text-align: center;" nowrap="nowrap" width="7%">25</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 6</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">5.4%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 5</td> <td style="text-align: center;" nowrap="nowrap" width="7%">2</td> <td style="text-align: center;" nowrap="nowrap" width="11%">54</td> <td style="text-align: center;" nowrap="nowrap" width="18%">47</td> <td style="text-align: center;" nowrap="nowrap" width="7%">88</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 7</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">2.4%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 4</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">19</td> <td style="text-align: center;" nowrap="nowrap" width="18%">16</td> <td style="text-align: center;" nowrap="nowrap" width="7%">12</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 8</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">1.4%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">15</td> <td style="text-align: center;" nowrap="nowrap" width="18%">9</td> <td style="text-align: center;" nowrap="nowrap" width="7%">10</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 9</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">3.7%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">1 of 5</td> <td style="text-align: center;" nowrap="nowrap" width="7%">4</td> <td style="text-align: center;" nowrap="nowrap" width="11%">63</td> <td style="text-align: center;" nowrap="nowrap" width="18%">30</td> <td style="text-align: center;" nowrap="nowrap" width="7%">24</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 10</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">8.0%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">1 of 4</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">101</td> <td style="text-align: center;" nowrap="nowrap" width="18%">9</td> <td style="text-align: center;" nowrap="nowrap" width="7%">7</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> </tbody></table>
          *HHS regions (Region 1 CT, ME, MA, NH, RI, VT; Region 2: NJ, NY, Puerto Rico, US Virgin Islands; Region 3: DE, DC, MD, PA, VA, WV; Region 4: AL, FL, GA, KY, MS, NC, SC, TN; Region 5: IL, IN, MI, MN, OH, WI; Region 6: AR, LA, NM, OK, TX; Region 7: IA, KS, MO, NE; Region 8: CO, MT, ND, SD, UT, WY; Region 9: AZ, CA, Guam, HI, NV; and Region 10: AK, ID, OR, WA).
          ? Elevated means the % of visits for ILI is at or above the national or region-specific baseline
          ? National data are for current week; regional data are for the most recent three weeks
          ? Includes all 50 states, the District of Columbia, Guam, Puerto Rico, and U.S. Virgin Islands




          U.S. Virologic Surveillance:

          WHO and NREVSS collaborating laboratories located in all 50 states, Puerto Rico, and the District of Columbia report to CDC the number of respiratory specimens tested for influenza and the number positive by influenza virus type and influenza A virus subtype. The results of tests performed during the current week are summarized in the table below. Region specific data are available at http://gis.cdc.gov/grasp/fluview/flu...dashboard.html.
          <table class="table" align="center" border="0" cellpadding="2" cellspacing="0"> <tbody><tr style="background-image: url(images/purplegrad.jpg); background-repeat: repeat-x;"> <th style="text-align: left;" width="270">
          </th> <th style="text-align: center;" nowrap="nowrap" width="150">Week 43</th> </tr> <tr> <th style="text-align: left;" width="270">No. of specimens tested</th> <td style="text-align: center;" nowrap="nowrap" width="150">7,449</td> </tr> <tr> <th style="text-align: left;" width="270">No. of positive specimens (%)</th> <td style="text-align: center;" nowrap="nowrap" width="150">320 (4.3%)</td> </tr> <tr> <th style="text-align: left;" width="270">Positive specimens by type/subtype</th> <td style="text-align: center;" nowrap="nowrap" width="150">
          </td> </tr> <tr> <th style="text-align: left;" width="270"> Influenza A</th> <td style="text-align: center;" nowrap="nowrap" width="150">237 (74.1%)</td> </tr> <tr> <th style="text-align: left;" width="270"> 2009 H1N1</th> <td style="text-align: right;" nowrap="nowrap" width="150"> 3 (1.3%) </td> </tr> <tr> <th style="text-align: left;" width="270"> H3</th> <td style="text-align: right;" nowrap="nowrap" width="150"> 79 (33.3%) </td> </tr> <tr> <th style="text-align: left;" width="270"> Subytping not performed</th> <td style="text-align: right;" nowrap="nowrap" width="150"> 155 (65.4%) </td> </tr> <tr> <th style="text-align: left;" width="270"> Influenza B</th> <td style="text-align: center;" nowrap="nowrap" width="150">83 (25.9%)</td> </tr> </tbody></table> <center>
          View National and Regional Level Graphs and Data | View Chart Data | View Full Screen | View PowerPoint Presentation </center>



          Antigenic Characterization:

          CDC has antigenically characterized 10 influenza A (H3N2) viruses collected by U.S. laboratories since October 1, 2014 by hemagglutination inhibition (HI).
          Influenza A (H3N2) [10]:
          • Seven (70%) of the 10 influenza A (H3N2) viruses tested have been characterized as A/Texas/50/2012-like, the influenza A (H3N2) component of the 2014-2015 Northern Hemisphere influenza vaccine. Three (30%) viruses showed reduced titers with antiserum raised against A/Texas/50/2012 but were antigenically similar to A/Switzerland/9715293/2013, the H3N2 virus selected for the 2015 Southern Hemisphere influenza vaccine. A/Switzerland/9715293/2013 is related to, but antigenically and genetically distinguishable from the A/Texas/50/2012 vaccine virus. A/Switzerland-like H3N2 viruses were first detected in the United States in small numbers in March of 2014 and began to circulate in greater numbers over the spring and summer.

          This is the first antigenic characterization data available for H3N2 viruses collected in the United States since October 1, 2014. CDC previously reported that 49% of H3N2 viruses collected worldwide from May 18-September 20, 2014 were antigenically similar to A/Texas/50/2012 ("Update: Influenza Activity ? United States and Worldwide, May 18-September 20, 2013" in the MMWR) and 42% of viruses collected in the United States during that time were antigenically similar to A/Texas/50/2012 (FluView Week 40). CDC conducts antigenic characterization of influenza viruses year-round to compare how similar currently circulating influenza viruses are to those included in the influenza vaccine, and to monitor for changes in circulating influenza viruses.


          Antiviral Resistance:

          No antiviral resistance data is available for specimens collected after October 1, 2014.
          The majority of recently circulating influenza viruses have been susceptible to the neuraminidase inhibitor antiviral medications, oseltamivir and zanamivir; however, rare sporadic instances of oseltamivir-resistant 2009 H1N1 and A (H3N2) viruses have been detected worldwide. Antiviral treatment with oseltamivir or zanamivir is recommended as early as possible for patients with confirmed or suspected influenza who have severe, complicated, or progressive illness; who require hospitalization; or who are at high risk for serious influenza-related complications. Additional information on recommendations for treatment and chemoprophylaxis of influenza virus infection with antiviral agents is available at http://www.cdc.gov/flu/antivirals/index.htm.


          Pneumonia and Influenza (P&I) Mortality Surveillance:

          During week 43, 5.5% of all deaths reported through the 122 Cities Mortality Reporting System were due to P&I. This percentage was below the epidemic threshold of 6.1% for week 43.
          <center>
          View Full Screen | View PowerPoint Presentation </center>

          For the 2014-2015 influenza season, CDC/Influenza Division and the National Center for Health Statistics (NCHS) are collaborating on a pilot project to use NCHS mortality surveillance data for the rapid assessment of pneumonia and influenza (P&I) mortality. To view the data, please click here.


          Influenza-Associated Pediatric Mortality:

          No influenza-associated pediatric deaths were reported to CDC during week 43. One influenza-associated pediatric death has been reported for the 2014-2015 season at this time.

          Additional data can be found at: http://gis.cdc.gov/GRASP/Fluview/PedFluDeath.html.
          <center>
          View Interactive Application | View Full Screen | View PowerPoint Presentation </center>



          Influenza-Associated Hospitalizations:

          The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts all age population-based surveillance for laboratory-confirmed influenza-related hospitalizations in select counties in the Emerging Infections Program (EIP) states and Influenza Hospitalization Surveillance Project (IHSP) states. FluSurv-NET estimated hospitalization rates will be updated weekly starting later this season. Additional FluSurv-NET data can be found at: http://gis.cdc.gov/GRASP/Fluview/FluHospRates.html and http://gis.cdc.gov/grasp/fluview/FluHospChars.html.


          Outpatient Illness Surveillance:

          Nationwide during week 43, 1.4% of patient visits reported through the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) were due to influenza-like illness (ILI). This percentage is below the national baseline of 2.0%.
          (ILI is defined as fever (temperature of 100?F [37.8?C] or greater) and cough and/or sore throat.)

          Additional data are available at http://gis.cdc.gov/grasp/fluview/flu...dashboard.html.
          <center>
          View National and Regional Level Graphs and Data | View Chart Data | View Full Screen | View PowerPoint Presentation
          </center>

          On a regional level, the percentage of outpatient visits for ILI ranged from 0.8% to 2.2% during week 43. All 10 regions reported a proportion of outpatient visits for ILI below their region-specific baseline levels.



          ILINet State Activity Indicator Map:

          Data collected in ILINet are used to produce a measure of ILI activity* by state. Activity levels are based on the percent of outpatient visits in a state due to ILI and are compared to the average percent of ILI visits that occur during weeks with little or no influenza virus circulation. Activity levels range from minimal, which would correspond to ILI activity from outpatient clinics being below, or only slightly above, the average, to high, which would correspond to ILI activity from outpatient clinics being much higher than average.
          During week 43, the following ILI activity levels were experienced:
          • One state (Florida) experienced low ILI activity.
          • New York City, Puerto Rico and 49 states (Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming) experienced minimal ILI activity.
          • Data were insufficient to calculate an ILI activity level from the District of Columbia.

          Click on map to launch interactive tool

          *This map uses the proportion of outpatient visits to health care providers for influenza-like illness to measure the ILI activity level within a state. It does not, however, measure the extent of geographic spread of flu within a state. Therefore, outbreaks occurring in a single city could cause the state to display high activity levels.
          Data collected in ILINet may disproportionally represent certain populations within a state, and therefore, may not accurately depict the full picture of influenza activity for the whole state.
          Data displayed in this map are based on data collected in ILINet, whereas the State and Territorial flu activity map is based on reports from state and territorial epidemiologists. The data presented in this map is preliminary and may change as more data is received.
          Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.


          Geographic Spread of Influenza as Assessed by State and Territorial Epidemiologists

          The influenza activity reported by state and territorial epidemiologists indicates geographic spread of influenza viruses, but does not measure the severity of influenza activity.
          During week 43, the following influenza activity was reported:
          • Widespread influenza activity was reported by Guam.
          • Regional influenza activity was reported by one state (Alaska).
          • Local influenza activity was reported by Puerto Rico and eight states (Connecticut, Florida, Maryland, Massachusetts, New Hampshire, Oregon, Texas, and Utah).
          • Sporadic influenza activity was reported by the U.S. Virgin Islands and 32 states (Alabama, Arkansas, California, Colorado, Delaware, Georgia, Hawaii, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maine, Michigan, Minnesota, Mississippi, Montana, Nebraska, New Jersey, New Mexico, New York, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Vermont, Virginia, Washington, Wisconsin, and Wyoming).
          • No influenza activity was reported by the District of Columbia and nine states (Arizona, Idaho, Kansas, Missouri, North Carolina, Nevada, Rhode Island, Tennessee, and West Virginia).





          Additional National and International Influenza Surveillance Information


          FluView Interactive: FluView includes enhanced web-based interactive applications that can provide dynamic visuals of the influenza data collected and analyzed by CDC. These FluView Interactive applications allow people to create customized, visual interpretations of influenza data, as well as make comparisons across flu seasons, regions, age groups and a variety of other demographics. To access these tools, visit http://www.cdc.gov/flu/weekly/fluviewinteractive.htm.
          U.S. State and local influenza surveillance: Click on a jurisdiction below to access the latest local influenza information.
          <table> <tbody><tr border="1"> <td height="8" width="139">Alabama
          </td> <td height="8" width="139">Alaska
          </td> <td height="8" width="139">Arizona
          </td> <td height="8" width="139">Arkansas
          </td> <td height="8" width="139">California
          </td> </tr> <tr border="1"> <td height="8" width="139">Colorado
          </td> <td height="8" width="139">Connecticut
          </td> <td height="8" width="139">Delaware
          </td> <td height="8" width="139">District of Columbia
          </td> <td height="8" width="139">Florida
          </td> </tr> <tr border="1"> <td height="8" width="139">Georgia
          </td> <td height="8" width="139">Hawaii
          </td> <td height="8" width="139">Idaho
          </td> <td height="8" width="139">Illinois
          </td> <td height="8" width="139">Indiana
          </td> </tr> <tr border="1"> <td height="8" width="139">Iowa
          </td> <td height="8" width="139">Kansas
          </td> <td height="8" width="139">Kentucky
          </td> <td height="8" width="139">Louisiana
          </td> <td height="8" width="139">Maine
          </td> </tr> <tr border="1"> <td height="8" width="139">Maryland
          </td> <td height="8" width="139">Massachusetts
          </td> <td height="8" width="139">Michigan
          </td> <td height="8" width="139">Minnesota
          </td> <td height="8" width="139">Mississippi
          </td> </tr> <tr border="1"> <td height="8" width="139">Missouri
          </td> <td height="8" width="139">Montana
          </td> <td height="8" width="139">Nebraska
          </td> <td height="8" width="139">Nevada
          </td> <td height="8" width="139">New Hampshire
          </td> </tr> <tr border="1"> <td height="8" width="139">New Jersey
          </td> <td height="8" width="139">New Mexico
          </td> <td height="8" width="139">New York
          </td> <td height="8" width="139">North Carolina
          </td> <td height="8" width="139">North Dakota
          </td> </tr> <tr border="1"> <td height="8" width="139">Ohio
          </td> <td height="8" width="139">Oklahoma
          </td> <td height="8" width="139">Oregon
          </td> <td height="8" width="139">Pennsylvania
          </td> <td height="8" width="139">Rhode Island
          </td> </tr> <tr border="1"> <td height="8" width="139">South Carolina
          </td> <td height="8" width="139">South Dakota
          </td> <td height="8" width="139">Tennessee
          </td> <td height="8" width="139">Texas
          </td> <td height="8" width="139">Utah
          </td> </tr> <tr border="1"> <td height="8" width="139">Vermont
          </td> <td height="8" width="139">Virginia
          </td> <td height="8" width="139">Washington
          </td> <td height="8" width="139">West Virginia
          </td> <td height="8" width="139">Wisconsin
          </td> </tr> <tr border="1"> <td height="8" width="139">Wyoming
          </td> <td height="8" width="139">New York City
          </td> <td height="8" width="139">Virgin Islands
          </td> <td height="8" width="139">
          </td> <td height="8" width="139">
          </td> </tr> </tbody></table>

          Google Flu Trends: Google Flu Trends uses aggregated Google search data in a model created in collaboration with CDC to estimate influenza activity in the United States. For more information and activity estimates from the U.S. and worldwide, see http://www.google.org/flutrends/
          World Health Organization: Additional influenza surveillance information from participating WHO member nations is available through FluNet and the Global Epidemiology Reports.
          WHO Collaborating Centers for Influenza located in Australia, China, Japan, the United Kingdom, and the United States (CDC in Atlanta, Georgia).
          Europe: for the most recent influenza surveillance information from Europe, please see WHO/Europe at http://www.euroflu.org/index.php and visit the European Centre for Disease Prevention and Control at http://ecdc.europa.eu/en/publications/surveillance_reports/influenza/Pages/weekly_influenza_surveillance_overview.aspx
          Public Health Agency of Canada: The most up-to-date influenza information from Canada is available at http://www.phac-aspc.gc.ca/fluwatch/
          Health Protection Agency (United Kingdom): The most up-to-date influenza information from the United Kingdom is available at http://www.hpa.org.uk/Topics/Infecti...onalInfluenza/


          Any links provided to non-Federal organizations are provided solely as a service to our users. These links do not constitute an endorsement of these organizations or their programs by CDC or the Federal Government, and none should be inferred. CDC is not responsible for the content of the individual organization web pages found at these links.
          In addition to the eight data components of CDC influenza surveillance for the 2014-2015 influenza season, the use of National Center for Health Statistics (NCHS) pneumonia and influenza mortality surveillance data for the rapid assessment of influenza-associated mortality will be piloted. An overview of influenza surveillance, including a description of the NCHS mortality surveillance data, is available here.
          -------------------------------------------------------------------------------- Full report also available as PDF






          Learn more about the weekly influenza surveillance report (FluView) prepared by the Influenza Division.

          Comment


          • #6
            Re: USA: 2014-15 FluView: Influenza Season Weekly Summary, Wks 40+

            2014-2015 Influenza Season Week 44 ending November 1, 2014


            All data are preliminary and may change as more reports are received.
            Synopsis:

            During week 44 (October 26 ? November 1, 2014), influenza activity was low in the United States.
            • Viral Surveillance: Of 8,439 specimens tested and reported by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories during week 44, 504 (6.0%) were positive for influenza.
            • Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia and influenza (P&I) was below the epidemic threshold.
            • Influenza-associated Pediatric Deaths: No influenza-associated pediatric deaths were reported.
            • Outpatient Illness Surveillance: The proportion of outpatient visits for influenza-like illness (ILI) was 1.5%, which is below the national baseline of 2.0%. All 10 regions reported ILI below region-specific baseline levels. Puerto Rico experienced high ILI activity; one state experienced low ILI activity; New York City and 49 states experienced minimal ILI activity; and the District of Columbia had insufficient data.
            • Geographic Spread of Influenza: The geographic spread of influenza in Guam was reported as widespread; two states reported regional activity; Puerto Rico and three states reported local activity; the District of Columbia and 40 states reported sporadic activity; five states reported no influenza activity; and the U.S. Virgin Islands did not report.

            <table class="table" border="0" cellpadding="3" cellspacing="0" width="100%"> <caption>National and Regional Summary of Select Surveillance Components

            </caption> <tbody><tr style="vertical-align:top" bgcolor="#c5bee1"> <th rowspan="2" style="vertical-align:bottom" width="12%">HHS Surveillance Regions*</th> <th colspan="8" style="text-align: center;" nowrap="nowrap">Data cumulative since September 28, 2014 (week 40)</th> </tr> <tr style="vertical-align:middle; background-image: url(images/purplegrad.jpg); background-repeat: repeat-x;"> <th style="text-align: center;" width="8%">Out-patient ILI?</th> <th style="text-align: center;" width="8%">% positive for flu?</th> <th style="text-align: center;" width="15%">Number of jurisdictions reporting regional or widespread activity?</th> <th style="text-align: center;" nowrap="nowrap" width="7%">2009 H1N1</th> <th style="text-align: center;" width="11%">A (H3)</th> <th style="text-align: center;" width="18%">A(Subtyping not performed)</th> <th style="text-align: center;" nowrap="nowrap" width="7%">B</th> <th style="text-align: center;" width="11%">Pediatric Deaths</th> </tr> <tr> <td style="text-align: left;" width="12%">Nation</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">6.0%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">3 of 54</td> <td style="text-align: center;" nowrap="nowrap" width="7%">20</td> <td style="text-align: center;" nowrap="nowrap" width="11%">702</td> <td style="text-align: center;" nowrap="nowrap" width="18%">890</td> <td style="text-align: center;" nowrap="nowrap" width="7%">645</td> <td style="text-align: center;" nowrap="nowrap" width="11%">1</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 1</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">1.2%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="7%">1</td> <td style="text-align: center;" nowrap="nowrap" width="11%">12</td> <td style="text-align: center;" nowrap="nowrap" width="18%">12</td> <td style="text-align: center;" nowrap="nowrap" width="7%">8</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 2</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">1.7%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 4</td> <td style="text-align: center;" nowrap="nowrap" width="7%">4</td> <td style="text-align: center;" nowrap="nowrap" width="11%">66</td> <td style="text-align: center;" nowrap="nowrap" width="18%">6</td> <td style="text-align: center;" nowrap="nowrap" width="7%">20</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 3</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">3.6%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">36</td> <td style="text-align: center;" nowrap="nowrap" width="18%">25</td> <td style="text-align: center;" nowrap="nowrap" width="7%">24</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 4</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">9.3%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">1 of 8</td> <td style="text-align: center;" nowrap="nowrap" width="7%">1</td> <td style="text-align: center;" nowrap="nowrap" width="11%">133</td> <td style="text-align: center;" nowrap="nowrap" width="18%">581</td> <td style="text-align: center;" nowrap="nowrap" width="7%">379</td> <td style="text-align: center;" nowrap="nowrap" width="11%">1</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 5</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">3.2%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="7%">8</td> <td style="text-align: center;" nowrap="nowrap" width="11%">64</td> <td style="text-align: center;" nowrap="nowrap" width="18%">36</td> <td style="text-align: center;" nowrap="nowrap" width="7%">31</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 6</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">7.0%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 5</td> <td style="text-align: center;" nowrap="nowrap" width="7%">2</td> <td style="text-align: center;" nowrap="nowrap" width="11%">105</td> <td style="text-align: center;" nowrap="nowrap" width="18%">127</td> <td style="text-align: center;" nowrap="nowrap" width="7%">114</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 7</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">2.6%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 4</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">30</td> <td style="text-align: center;" nowrap="nowrap" width="18%">16</td> <td style="text-align: center;" nowrap="nowrap" width="7%">20</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 8</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">2.0%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">26</td> <td style="text-align: center;" nowrap="nowrap" width="18%">23</td> <td style="text-align: center;" nowrap="nowrap" width="7%">13</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 9</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">4.2%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">1 of 5</td> <td style="text-align: center;" nowrap="nowrap" width="7%">4</td> <td style="text-align: center;" nowrap="nowrap" width="11%">84</td> <td style="text-align: center;" nowrap="nowrap" width="18%">47</td> <td style="text-align: center;" nowrap="nowrap" width="7%">28</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 10</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">9.0%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">1 of 4</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">146</td> <td style="text-align: center;" nowrap="nowrap" width="18%">17</td> <td style="text-align: center;" nowrap="nowrap" width="7%">8</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> </tbody></table>
            *HHS regions (Region 1 CT, ME, MA, NH, RI, VT; Region 2: NJ, NY, Puerto Rico, US Virgin Islands; Region 3: DE, DC, MD, PA, VA, WV; Region 4: AL, FL, GA, KY, MS, NC, SC, TN; Region 5: IL, IN, MI, MN, OH, WI; Region 6: AR, LA, NM, OK, TX; Region 7: IA, KS, MO, NE; Region 8: CO, MT, ND, SD, UT, WY; Region 9: AZ, CA, Guam, HI, NV; and Region 10: AK, ID, OR, WA).
            ? Elevated means the % of visits for ILI is at or above the national or region-specific baseline
            ? National data are for current week; regional data are for the most recent three weeks
            ? Includes all 50 states, the District of Columbia, Guam, Puerto Rico, and U.S. Virgin Islands




            U.S. Virologic Surveillance:

            WHO and NREVSS collaborating laboratories located in all 50 states, Puerto Rico, and the District of Columbia report to CDC the number of respiratory specimens tested for influenza and the number positive by influenza virus type and influenza A virus subtype. The results of tests performed during the current week are summarized in the table below. Region specific data are available at http://gis.cdc.gov/grasp/fluview/flu...dashboard.html.
            <table class="table" align="center" border="0" cellpadding="2" cellspacing="0"> <tbody><tr style="background-image: url(images/purplegrad.jpg); background-repeat: repeat-x;"> <th style="text-align: left;" width="270">
            </th> <th style="text-align: center;" nowrap="nowrap" width="150">Week 44</th> </tr> <tr> <th style="text-align: left;" width="270">No. of specimens tested</th> <td style="text-align: center;" nowrap="nowrap" width="150">8,439</td> </tr> <tr> <th style="text-align: left;" width="270">No. of positive specimens (%)</th> <td style="text-align: center;" nowrap="nowrap" width="150">504 (6.0%)</td> </tr> <tr> <th style="text-align: left;" width="270">Positive specimens by type/subtype</th> <td style="text-align: center;" nowrap="nowrap" width="150">
            </td> </tr> <tr> <th style="text-align: left;" width="270"> Influenza A</th> <td style="text-align: center;" nowrap="nowrap" width="150">394 (78.2%)</td> </tr> <tr> <th style="text-align: left;" width="270"> 2009 H1N1</th> <td style="text-align: right;" nowrap="nowrap" width="150"> 1 (0.2%) </td> </tr> <tr> <th style="text-align: left;" width="270"> H3</th> <td style="text-align: right;" nowrap="nowrap" width="150"> 120 (30.5%) </td> </tr> <tr> <th style="text-align: left;" width="270"> Subytping not performed</th> <td style="text-align: right;" nowrap="nowrap" width="150"> 273 (69.3%) </td> </tr> <tr> <th style="text-align: left;" width="270"> Influenza B</th> <td style="text-align: center;" nowrap="nowrap" width="150">110 (21.8%)</td> </tr> </tbody></table> <center>
            View National and Regional Level Graphs and Data | View Chart Data | View Full Screen | View PowerPoint Presentation </center>



            Antigenic Characterization:

            CDC has antigenically characterized 10 influenza A (H3N2) viruses collected by U.S. laboratories since October 1, 2014 by hemagglutination inhibition (HI).
            Influenza A (H3N2) [10]:
            • Seven (70%) of the 10 influenza A (H3N2) viruses tested have been characterized as A/Texas/50/2012-like, the influenza A (H3N2) component of the 2014-2015 Northern Hemisphere influenza vaccine. Three (30%) viruses showed reduced titers with antiserum raised against A/Texas/50/2012 but were antigenically similar to A/Switzerland/9715293/2013, the H3N2 virus selected for the 2015 Southern Hemisphere influenza vaccine. A/Switzerland/9715293/2013 is related to, but antigenically and genetically distinguishable from the A/Texas/50/2012 vaccine virus. A/Switzerland-like H3N2 viruses were first detected in the United States in small numbers in March of 2014 and began to circulate in greater numbers over the spring and summer.

            CDC previously reported that 49% of H3N2 viruses collected worldwide from May 18-September 20, 2014 were antigenically similar to A/Texas/50/2012 ("Update: Influenza Activity ? United States and Worldwide, May 18-September 20, 2013" in the MMWR) and 42% of H3N2 viruses collected in the United States during that time were antigenically similar to A/Texas/50/2012 (FluView Week 40). CDC conducts antigenic characterization of influenza viruses year-round to compare how similar currently circulating influenza viruses are to those included in the influenza vaccine, and to monitor for changes in circulating influenza viruses.


            Antiviral Resistance:

            Testing of 2009 H1N1, influenza A (H3N2), and influenza B virus isolates for resistance to neuraminidase inhibitors (oseltamivir and zanamivir) is performed at CDC using a functional assay. Additional 2009 H1N1 and influenza A (H3N2) clinical samples are tested for mutations of the virus known to confer oseltamivir resistance. The data summarized below combine the results of both testing methods. These samples are routinely obtained for surveillance purposes rather than for diagnostic testing of patients suspected to be infected with antiviral-resistant virus.
            High levels of resistance to the adamantanes (amantadine and rimantadine) persist among 2009 influenza A (H1N1) and A (H3N2) viruses (the adamantanes are not effective against influenza B viruses). Therefore, data from adamantane resistance testing are not presented below.
            <table class="table" style="text-align: center;" align="center" border="0" cellpadding="3" cellspacing="0"> <caption> Neuraminidase Inhibitor Resistance Testing Results on Samples Collected Since October 1, 2014

            </caption> <tbody><tr bgcolor="#c5bee1"> <td rowspan="2" style="width:81.0pt;border:1.0pt; padding:0in 5.4pt 0in 5.4pt;height:27.85pt;" width="108">
            </td> <th colspan="2" style="width:2.0in;border:1.0pt;vertical-align:middle;height:27.85pt" width="192">Oseltamivir</th> <th colspan="2" style="width:2.0in;border:1.0pt;vertical-align:middle;;height:27.85pt" width="192">Zanamivir</th> </tr> <tr style="height:25.15pt;text-align:center;background-image: url(file://///cdc.gov/ahb_apps/WWWLINK_CDC_GOV/flu/weekly/images/purplegrad.jpg); background-repeat:repeat-x;"> <th style="width:63.0pt;text-align:center;" align="center" width="84">Virus Samples tested (n)</th> <th style="width:63.0pt;text-align:center;" align="center" width="84">Resistant Viruses, Number (%)</th> <th style="width:63.0pt;text-align:center;" align="center" width="84">Virus Samples tested (n)</th> <th style="width:63.0pt;text-align:center;" align="center" width="84">Resistant Viruses, Number (%)</th> </tr> <tr> <th style="text-align: left;" bgcolor="#dad5eb" nowrap="nowrap" width="160">Influenza A (H3N2)</th> <td style="text-align: center;" nowrap="nowrap" width="100">6</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> <td style="text-align: center;" nowrap="nowrap" width="100">6</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> </tr> <tr> <th style="text-align: left;" bgcolor="#dad5eb" nowrap="nowrap" width="160">Influenza B</th> <td style="text-align: center;" nowrap="nowrap" width="100">0</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> <td style="text-align: center;" nowrap="nowrap" width="100">0</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> </tr> <tr> <th style="text-align: left;" bgcolor="#dad5eb" nowrap="nowrap" width="160">2009 H1N1</th> <td style="text-align: center;" nowrap="nowrap" width="100">0</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> <td style="text-align: center;" nowrap="nowrap" width="100">0</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> </tr> </tbody></table>
            In the United States, all recently circulating influenza viruses have been susceptible to the neuraminidase inhibitor antiviral medications, oseltamivir and zanamivir; however, rare sporadic instances of oseltamivir-resistant 2009 H1N1 and A (H3N2) viruses have been detected worldwide. Antiviral treatment with oseltamivir or zanamivir is recommended as early as possible for patients with confirmed or suspected influenza who have severe, complicated, or progressive illness; who require hospitalization; or who are at high risk for serious influenza-related complications. Additional information on recommendations for treatment and chemoprophylaxis of influenza virus infection with antiviral agents is available at http://www.cdc.gov/flu/antivirals/index.htm.


            Pneumonia and Influenza (P&I) Mortality Surveillance:

            During week 44, 5.7% of all deaths reported through the 122 Cities Mortality Reporting System were due to P&I. This percentage was below the epidemic threshold of 6.2% for week 44.
            <center>
            View Full Screen | View PowerPoint Presentation </center>

            For the 2014-2015 influenza season, CDC/Influenza Division and the National Center for Health Statistics (NCHS) are collaborating on a pilot project to use NCHS mortality surveillance data for the rapid assessment of pneumonia and influenza (P&I) mortality. To view the data, please click here.


            Influenza-Associated Pediatric Mortality:

            No influenza-associated pediatric deaths were reported to CDC during week 44. To date, one influenza-associated pediatric death has been reported for the 2014-2015 season.

            Additional data can be found at: http://gis.cdc.gov/GRASP/Fluview/PedFluDeath.html.
            <center>
            View Interactive Application | View Full Screen | View PowerPoint Presentation </center>



            Influenza-Associated Hospitalizations:

            The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts all age population-based surveillance for laboratory-confirmed influenza-related hospitalizations in select counties in the Emerging Infections Program (EIP) states and Influenza Hospitalization Surveillance Project (IHSP) states. FluSurv-NET estimated hospitalization rates will be updated weekly starting later this season. Additional FluSurv-NET data can be found at: http://gis.cdc.gov/GRASP/Fluview/FluHospRates.html and http://gis.cdc.gov/grasp/fluview/FluHospChars.html.


            Outpatient Illness Surveillance:

            Nationwide during week 44, 1.5% of patient visits reported through the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) were due to influenza-like illness (ILI). This percentage is below the national baseline of 2.0%.
            (ILI is defined as fever (temperature of 100?F [37.8?C] or greater) and cough and/or sore throat.)

            Additional data are available at http://gis.cdc.gov/grasp/fluview/flu...dashboard.html.
            <center>
            View National and Regional Level Graphs and Data | View Chart Data | View Full Screen | View PowerPoint Presentation
            </center>

            On a regional level, the percentage of outpatient visits for ILI ranged from 0.8% to 2.3% during week 44. All 10 regions reported a proportion of outpatient visits for ILI below their region-specific baseline levels.



            ILINet State Activity Indicator Map:

            Data collected in ILINet are used to produce a measure of ILI activity* by state. Activity levels are based on the percent of outpatient visits in a state due to ILI and are compared to the average percent of ILI visits that occur during weeks with little or no influenza virus circulation. Activity levels range from minimal, which would correspond to ILI activity from outpatient clinics being below, or only slightly above, the average, to high, which would correspond to ILI activity from outpatient clinics being much higher than average.
            During week 44, the following ILI activity levels were experienced:
            • Puerto Rico experienced high ILI activity.
            • One state (Louisiana) experienced low ILI activity.
            • New York City and 49 states (Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming) experienced minimal ILI activity.
            • Data were insufficient to calculate an ILI activity level from the District of Columbia.

            Click on map to launch interactive tool

            *This map uses the proportion of outpatient visits to health care providers for influenza-like illness to measure the ILI activity level within a state. It does not, however, measure the extent of geographic spread of flu within a state. Therefore, outbreaks occurring in a single city could cause the state to display high activity levels.
            Data collected in ILINet may disproportionally represent certain populations within a state, and therefore, may not accurately depict the full picture of influenza activity for the whole state.
            Data displayed in this map are based on data collected in ILINet, whereas the State and Territorial flu activity map is based on reports from state and territorial epidemiologists. The data presented in this map is preliminary and may change as more data is received.
            Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.


            Geographic Spread of Influenza as Assessed by State and Territorial Epidemiologists

            The influenza activity reported by state and territorial epidemiologists indicates geographic spread of influenza viruses, but does not measure the severity of influenza activity.
            During week 44, the following influenza activity was reported:
            • Widespread influenza activity was reported by Guam.
            • Regional influenza activity was reported by two states (Alaska and Florida).
            • Local influenza activity was reported by Puerto Rico and three states (Connecticut, Oregon, and Texas).
            • Sporadic influenza activity was reported by the District of Columbia and 40 states (Alabama, Arizona, Arkansas, California, Colorado, Delaware, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Montana, Nebraska, Nevada, New Jersey, New Mexico, New York, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming).
            • No influenza activity was reported by five states (Idaho, Missouri, New Hampshire, North Carolina, and Rhode Island).
            • The U.S. Virgin Islands did not report.





            Additional National and International Influenza Surveillance Information


            FluView Interactive: FluView includes enhanced web-based interactive applications that can provide dynamic visuals of the influenza data collected and analyzed by CDC. These FluView Interactive applications allow people to create customized, visual interpretations of influenza data, as well as make comparisons across flu seasons, regions, age groups and a variety of other demographics. To access these tools, visit http://www.cdc.gov/flu/weekly/fluviewinteractive.htm.
            U.S. State and local influenza surveillance: Click on a jurisdiction below to access the latest local influenza information.
            <table> <tbody><tr border="1"> <td height="8" width="139">Alabama
            </td> <td height="8" width="139">Alaska
            </td> <td height="8" width="139">Arizona
            </td> <td height="8" width="139">Arkansas
            </td> <td height="8" width="139">California
            </td> </tr> <tr border="1"> <td height="8" width="139">Colorado
            </td> <td height="8" width="139">Connecticut
            </td> <td height="8" width="139">Delaware
            </td> <td height="8" width="139">District of Columbia
            </td> <td height="8" width="139">Florida
            </td> </tr> <tr border="1"> <td height="8" width="139">Georgia
            </td> <td height="8" width="139">Hawaii
            </td> <td height="8" width="139">Idaho
            </td> <td height="8" width="139">Illinois
            </td> <td height="8" width="139">Indiana
            </td> </tr> <tr border="1"> <td height="8" width="139">Iowa
            </td> <td height="8" width="139">Kansas
            </td> <td height="8" width="139">Kentucky
            </td> <td height="8" width="139">Louisiana
            </td> <td height="8" width="139">Maine
            </td> </tr> <tr border="1"> <td height="8" width="139">Maryland
            </td> <td height="8" width="139">Massachusetts
            </td> <td height="8" width="139">Michigan
            </td> <td height="8" width="139">Minnesota
            </td> <td height="8" width="139">Mississippi
            </td> </tr> <tr border="1"> <td height="8" width="139">Missouri
            </td> <td height="8" width="139">Montana
            </td> <td height="8" width="139">Nebraska
            </td> <td height="8" width="139">Nevada
            </td> <td height="8" width="139">New Hampshire
            </td> </tr> <tr border="1"> <td height="8" width="139">New Jersey
            </td> <td height="8" width="139">New Mexico
            </td> <td height="8" width="139">New York
            </td> <td height="8" width="139">North Carolina
            </td> <td height="8" width="139">North Dakota
            </td> </tr> <tr border="1"> <td height="8" width="139">Ohio
            </td> <td height="8" width="139">Oklahoma
            </td> <td height="8" width="139">Oregon
            </td> <td height="8" width="139">Pennsylvania
            </td> <td height="8" width="139">Rhode Island
            </td> </tr> <tr border="1"> <td height="8" width="139">South Carolina
            </td> <td height="8" width="139">South Dakota
            </td> <td height="8" width="139">Tennessee
            </td> <td height="8" width="139">Texas
            </td> <td height="8" width="139">Utah
            </td> </tr> <tr border="1"> <td height="8" width="139">Vermont
            </td> <td height="8" width="139">Virginia
            </td> <td height="8" width="139">Washington
            </td> <td height="8" width="139">West Virginia
            </td> <td height="8" width="139">Wisconsin
            </td> </tr> <tr border="1"> <td height="8" width="139">Wyoming
            </td> <td height="8" width="139">New York City
            </td> <td height="8" width="139">Virgin Islands
            </td> <td height="8" width="139">
            </td> <td height="8" width="139">
            </td> </tr> </tbody></table>

            Google Flu Trends: Google Flu Trends uses aggregated Google search data in a model created in collaboration with CDC to estimate influenza activity in the United States. For more information and activity estimates from the United States and worldwide, see http://www.google.org/flutrends/
            World Health Organization: Additional influenza surveillance information from participating WHO member nations is available through FluNet and the Global Epidemiology Reports.
            WHO Collaborating Centers for Influenza located in Australia, China, Japan, the United Kingdom, and the United States (CDC in Atlanta, Georgia).
            Europe: for the most recent influenza surveillance information from Europe, please see WHO/Europe at http://www.euroflu.org/index.php and visit the European Centre for Disease Prevention and Control at http://ecdc.europa.eu/en/publications/surveillance_reports/influenza/Pages/weekly_influenza_surveillance_overview.aspx
            Public Health Agency of Canada: The most up-to-date influenza information from Canada is available at http://www.phac-aspc.gc.ca/fluwatch/
            Health Protection Agency (United Kingdom): The most up-to-date influenza information from the United Kingdom is available at http://www.hpa.org.uk/Topics/Infecti...onalInfluenza/


            Any links provided to non-Federal organizations are provided solely as a service to our users. These links do not constitute an endorsement of these organizations or their programs by CDC or the Federal Government, and none should be inferred. CDC is not responsible for the content of the individual organization web pages found at these links.
            In addition to the eight data components of CDC influenza surveillance for the 2014-2015 influenza season, the use of National Center for Health Statistics (NCHS) pneumonia and influenza mortality surveillance data for the rapid assessment of influenza-associated mortality will be piloted. An overview of influenza surveillance, including a description of the NCHS mortality surveillance data, is available here.
            -------------------------------------------------------------------------------- Full report also available as PDF






            Learn more about the weekly influenza surveillance report (FluView) prepared by the Influenza Division.

            Comment


            • #7
              Re: USA: 2014-15 FluView: Influenza Season Weekly Summary, Wks 40+

              2014-2015 Influenza Season Week 45 ending November 8, 2014


              All data are preliminary and may change as more reports are received.
              Synopsis:

              During week 45 (November 2 - 8, 2014), influenza activity was low in the United States.
              • Viral Surveillance: Of 9,138 specimens tested and reported by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories during week 45, 678 (7.4%) were positive for influenza.
              • Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia and influenza (P&I) was below the epidemic threshold.
              • Influenza-associated Pediatric Deaths: No influenza-associated pediatric deaths were reported.
              • Outpatient Illness Surveillance: The proportion of outpatient visits for influenza-like illness (ILI) was 1.6%, which is below the national baseline of 2.0%. All 10 regions reported ILI below region-specific baseline levels. Puerto Rico experienced moderate ILI activity; two states experienced low ILI activity; New York City and 48 states experienced minimal ILI activity; and the District of Columbia had insufficient data.
              • Geographic Spread of Influenza: The geographic spread of influenza in Guam was reported as widespread; three states reported regional activity; Puerto Rico, the U.S. Virgin Islands, and 13 states reported local activity; the District of Columbia and 31 states reported sporadic activity; and three states reported no influenza activity.

              <table class="table" border="0" cellpadding="3" cellspacing="0" width="100%"> <caption>National and Regional Summary of Select Surveillance Components

              </caption> <tbody><tr style="vertical-align:top" bgcolor="#c5bee1"> <th rowspan="2" style="vertical-align:bottom" width="12%">HHS Surveillance Regions*</th> <th colspan="8" style="text-align: center;" nowrap="nowrap">Data cumulative since September 28, 2014 (week 40)</th> </tr> <tr style="vertical-align:middle; background-image: url(images/purplegrad.jpg); background-repeat: repeat-x;"> <th style="text-align: center;" width="8%">Out-patient ILI?</th> <th style="text-align: center;" width="8%">% positive for flu?</th> <th style="text-align: center;" width="15%">Number of jurisdictions reporting regional or widespread activity?</th> <th style="text-align: center;" nowrap="nowrap" width="7%">2009 H1N1</th> <th style="text-align: center;" width="11%">A (H3)</th> <th style="text-align: center;" width="18%">A(Subtyping not performed)</th> <th style="text-align: center;" nowrap="nowrap" width="7%">B</th> <th style="text-align: center;" width="11%">Pediatric Deaths</th> </tr> <tr> <td style="text-align: left;" width="12%">Nation</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">7.4%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">4 of 54</td> <td style="text-align: center;" nowrap="nowrap" width="7%">23</td> <td style="text-align: center;" nowrap="nowrap" width="11%">1,008</td> <td style="text-align: center;" nowrap="nowrap" width="18%">1,263</td> <td style="text-align: center;" nowrap="nowrap" width="7%">776</td> <td style="text-align: center;" nowrap="nowrap" width="11%">1</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 1</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">1.0%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">1 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="7%">1</td> <td style="text-align: center;" nowrap="nowrap" width="11%">16</td> <td style="text-align: center;" nowrap="nowrap" width="18%">12</td> <td style="text-align: center;" nowrap="nowrap" width="7%">11</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 2</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">0.7%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 4</td> <td style="text-align: center;" nowrap="nowrap" width="7%">5</td> <td style="text-align: center;" nowrap="nowrap" width="11%">67</td> <td style="text-align: center;" nowrap="nowrap" width="18%">10</td> <td style="text-align: center;" nowrap="nowrap" width="7%">22</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 3</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">4.1%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">53</td> <td style="text-align: center;" nowrap="nowrap" width="18%">33</td> <td style="text-align: center;" nowrap="nowrap" width="7%">28</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 4</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">9.3%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">1 of 8</td> <td style="text-align: center;" nowrap="nowrap" width="7%">1</td> <td style="text-align: center;" nowrap="nowrap" width="11%">175</td> <td style="text-align: center;" nowrap="nowrap" width="18%">843</td> <td style="text-align: center;" nowrap="nowrap" width="7%">449</td> <td style="text-align: center;" nowrap="nowrap" width="11%">1</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 5</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">3.3%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="7%">8</td> <td style="text-align: center;" nowrap="nowrap" width="11%">84</td> <td style="text-align: center;" nowrap="nowrap" width="18%">47</td> <td style="text-align: center;" nowrap="nowrap" width="7%">34</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 6</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">8.8%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 5</td> <td style="text-align: center;" nowrap="nowrap" width="7%">2</td> <td style="text-align: center;" nowrap="nowrap" width="11%">149</td> <td style="text-align: center;" nowrap="nowrap" width="18%">163</td> <td style="text-align: center;" nowrap="nowrap" width="7%">146</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 7</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">3.6%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 4</td> <td style="text-align: center;" nowrap="nowrap" width="7%">1</td> <td style="text-align: center;" nowrap="nowrap" width="11%">49</td> <td style="text-align: center;" nowrap="nowrap" width="18%">29</td> <td style="text-align: center;" nowrap="nowrap" width="7%">26</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 8</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">3.3%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">42</td> <td style="text-align: center;" nowrap="nowrap" width="18%">42</td> <td style="text-align: center;" nowrap="nowrap" width="7%">18</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 9</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">4.4%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">1 of 5</td> <td style="text-align: center;" nowrap="nowrap" width="7%">4</td> <td style="text-align: center;" nowrap="nowrap" width="11%">111</td> <td style="text-align: center;" nowrap="nowrap" width="18%">111</td> <td style="text-align: center;" nowrap="nowrap" width="7%">34</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 10</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">14.5%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">1 of 4</td> <td style="text-align: center;" nowrap="nowrap" width="7%">1</td> <td style="text-align: center;" nowrap="nowrap" width="11%">262</td> <td style="text-align: center;" nowrap="nowrap" width="18%">262</td> <td style="text-align: center;" nowrap="nowrap" width="7%">8</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> </tbody></table>
              *HHS regions (Region 1 CT, ME, MA, NH, RI, VT; Region 2: NJ, NY, Puerto Rico, US Virgin Islands; Region 3: DE, DC, MD, PA, VA, WV; Region 4: AL, FL, GA, KY, MS, NC, SC, TN; Region 5: IL, IN, MI, MN, OH, WI; Region 6: AR, LA, NM, OK, TX; Region 7: IA, KS, MO, NE; Region 8: CO, MT, ND, SD, UT, WY; Region 9: AZ, CA, Guam, HI, NV; and Region 10: AK, ID, OR, WA).
              ? Elevated means the % of visits for ILI is at or above the national or region-specific baseline
              ? National data are for current week; regional data are for the most recent three weeks
              ? Includes all 50 states, the District of Columbia, Guam, Puerto Rico, and U.S. Virgin Islands




              U.S. Virologic Surveillance:

              WHO and NREVSS collaborating laboratories located in all 50 states, Puerto Rico, and the District of Columbia report to CDC the number of respiratory specimens tested for influenza and the number positive by influenza virus type and influenza A virus subtype. The results of tests performed during the current week are summarized in the table below. Region specific data are available at http://gis.cdc.gov/grasp/fluview/flu...dashboard.html.
              <table class="table" align="center" border="0" cellpadding="2" cellspacing="0"> <tbody><tr style="background-image: url(images/purplegrad.jpg); background-repeat: repeat-x;"> <th style="text-align: left;" width="270">
              </th> <th style="text-align: center;" nowrap="nowrap" width="150">Week 45</th> </tr> <tr> <th style="text-align: left;" width="270">No. of specimens tested</th> <td style="text-align: center;" nowrap="nowrap" width="150">9,138</td> </tr> <tr> <th style="text-align: left;" width="270">No. of positive specimens (%)</th> <td style="text-align: center;" nowrap="nowrap" width="150">678 (7.4%)</td> </tr> <tr> <th style="text-align: left;" width="270">Positive specimens by type/subtype</th> <td style="text-align: center;" nowrap="nowrap" width="150">
              </td> </tr> <tr> <th style="text-align: left;" width="270"> Influenza A</th> <td style="text-align: center;" nowrap="nowrap" width="150">567 (83.6%)</td> </tr> <tr> <th style="text-align: left;" width="270"> 2009 H1N1</th> <td style="text-align: right;" nowrap="nowrap" width="150"> 2 (0.4%) </td> </tr> <tr> <th style="text-align: left;" width="270"> H3</th> <td style="text-align: right;" nowrap="nowrap" width="150"> 192 (33.9%) </td> </tr> <tr> <th style="text-align: left;" width="270"> Subytping not performed</th> <td style="text-align: right;" nowrap="nowrap" width="150"> 373 (65.8%) </td> </tr> <tr> <th style="text-align: left;" width="270"> Influenza B</th> <td style="text-align: center;" nowrap="nowrap" width="150">111 (16.4%)</td> </tr> </tbody></table> <center>
              View National and Regional Level Graphs and Data | View Chart Data | View Full Screen | View PowerPoint Presentation </center>



              Antigenic Characterization*:

              CDC has antigenically characterized 19 influenza viruses (one 2009 H1N1 virus, 13 influenza A (H3N2) viruses, and five influenza B viruses) collected by U.S. laboratories since October 1, 2014 by hemagglutination inhibition (HI).
              2009 H1N1 [1]:
              • The 2009 H1N1 virus tested was characterized as A/California/7/2009-like, the influenza A (H1N1) component of the 2014-2015 Northern Hemisphere influenza vaccine.

              Influenza A (H3N2) [13]:
              • Seven (54%) of the 13 influenza A (H3N2) viruses tested have been characterized as A/Texas/50/2012-like, the influenza A (H3N2) component of the 2014-2015 Northern Hemisphere influenza vaccine. Six (46%) of the 13 viruses tested showed reduced titers with antiserum produced against A/Texas/50/2012. Among viruses that showed reduced titers with antiserum raised against A/Texas/50/2012, the majority were antigenically similar to A/Switzerland/9715293/2013, the H3N2 virus selected for the 2015 Southern Hemisphere influenza vaccine. A/Switzerland/9715293/2013 is related to, but antigenically and genetically distinguishable, from the A/Texas/50/2012 vaccine virus. A/Switzerland-like H3N2 viruses were first detected in the United States in small numbers in March of 2014 and began to circulate in greater numbers over the spring and summer.

              Influenza B [5]: Both B/Victoria and B/Yamagata-lineage viruses are currently circulating in the United States. However to date, results of antigenic characterization are available only for B/Victoria lineage viruses.
              • Victoria Lineage [5]: All five B/Victoria-lineage viruses were characterized as B/Brisbane/60/2008-like, which is included as an influenza B component of the 2014-2015 Northern Hemisphere quadrivalent influenza vaccine.

              • Yamagata Lineage: No antigenic characterization data is available for influenza B/Yamagata-lineage viruses collected after October 1, 2014.

              *CDC conducts antigenic characterization of influenza viruses year-round to compare how similar currently circulating influenza viruses are to those included in the influenza vaccine, and to monitor for changes in circulating influenza viruses.


              Antiviral Resistance:

              Testing of 2009 H1N1, influenza A (H3N2), and influenza B virus isolates for resistance to neuraminidase inhibitors (oseltamivir and zanamivir) is performed at CDC using a functional assay. Additional 2009 H1N1 and influenza A (H3N2) clinical samples are tested for mutations of the virus known to confer oseltamivir resistance. The data summarized below combine the results of both testing methods. These samples are routinely obtained for surveillance purposes rather than for diagnostic testing of patients suspected to be infected with antiviral-resistant virus.
              High levels of resistance to the adamantanes (amantadine and rimantadine) persist among 2009 influenza A (H1N1) and A (H3N2) viruses (the adamantanes are not effective against influenza B viruses). Therefore, data from adamantane resistance testing are not presented below.
              <table class="table" style="text-align: center;" align="center" border="0" cellpadding="3" cellspacing="0"> <caption> Neuraminidase Inhibitor Resistance Testing Results on Samples Collected Since October 1, 2014

              </caption> <tbody><tr bgcolor="#c5bee1"> <td rowspan="2" style="width:81.0pt;border:1.0pt; padding:0in 5.4pt 0in 5.4pt;height:27.85pt;" width="108">
              </td> <th colspan="2" style="width:2.0in;border:1.0pt;vertical-align:middle;height:27.85pt" width="192">Oseltamivir</th> <th colspan="2" style="width:2.0in;border:1.0pt;vertical-align:middle;;height:27.85pt" width="192">Zanamivir</th> </tr> <tr style="height:25.15pt;text-align:center;background-image: url(file://///cdc.gov/ahb_apps/WWWLINK_CDC_GOV/flu/weekly/images/purplegrad.jpg); background-repeat:repeat-x;"> <th style="width:63.0pt;text-align:center;" align="center" width="84">Virus Samples tested (n)</th> <th style="width:63.0pt;text-align:center;" align="center" width="84">Resistant Viruses, Number (%)</th> <th style="width:63.0pt;text-align:center;" align="center" width="84">Virus Samples tested (n)</th> <th style="width:63.0pt;text-align:center;" align="center" width="84">Resistant Viruses, Number (%)</th> </tr> <tr> <th style="text-align: left;" bgcolor="#dad5eb" nowrap="nowrap" width="160">Influenza A (H3N2)</th> <td style="text-align: center;" nowrap="nowrap" width="100">11</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> <td style="text-align: center;" nowrap="nowrap" width="100">11</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> </tr> <tr> <th style="text-align: left;" bgcolor="#dad5eb" nowrap="nowrap" width="160">Influenza B</th> <td style="text-align: center;" nowrap="nowrap" width="100">5</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> <td style="text-align: center;" nowrap="nowrap" width="100">5</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> </tr> <tr> <th style="text-align: left;" bgcolor="#dad5eb" nowrap="nowrap" width="160">2009 H1N1</th> <td style="text-align: center;" nowrap="nowrap" width="100">1</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> <td style="text-align: center;" nowrap="nowrap" width="100">1</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> </tr> </tbody></table>
              In the United States, all recently circulating influenza viruses have been susceptible to the neuraminidase inhibitor antiviral medications, oseltamivir and zanamivir; however, rare sporadic instances of oseltamivir-resistant 2009 H1N1 and A (H3N2) viruses have been detected worldwide. Antiviral treatment with oseltamivir or zanamivir is recommended as early as possible for patients with confirmed or suspected influenza who have severe, complicated, or progressive illness; who require hospitalization; or who are at high risk for serious influenza-related complications. Additional information on recommendations for treatment and chemoprophylaxis of influenza virus infection with antiviral agents is available at http://www.cdc.gov/flu/antivirals/index.htm.


              Pneumonia and Influenza (P&I) Mortality Surveillance:

              During week 45, 6.0% of all deaths reported through the 122 Cities Mortality Reporting System were due to P&I. This percentage was below the epidemic threshold of 6.3% for week 45.
              <center>
              View Full Screen | View PowerPoint Presentation </center>

              For the 2014-2015 influenza season, CDC/Influenza Division and the National Center for Health Statistics (NCHS) are collaborating on a pilot project to use NCHS mortality surveillance data for the rapid assessment of pneumonia and influenza (P&I) mortality. To view the data, please click here.


              Influenza-Associated Pediatric Mortality:

              No influenza-associated pediatric deaths were reported to CDC during week 45. To date, one influenza-associated pediatric death has been reported for the 2014-2015 season.

              Additional data can be found at: http://gis.cdc.gov/GRASP/Fluview/PedFluDeath.html.
              <center>
              View Interactive Application | View Full Screen | View PowerPoint Presentation </center>



              Influenza-Associated Hospitalizations:

              The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts all age population-based surveillance for laboratory-confirmed influenza-related hospitalizations in select counties in the Emerging Infections Program (EIP) states and Influenza Hospitalization Surveillance Project (IHSP) states. FluSurv-NET estimated hospitalization rates will be updated weekly starting later this season. Additional FluSurv-NET data can be found at: http://gis.cdc.gov/GRASP/Fluview/FluHospRates.html and http://gis.cdc.gov/grasp/fluview/FluHospChars.html.


              Outpatient Illness Surveillance:

              Nationwide during week 45, 1.6% 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 below the national baseline of 2.0%.
              (ILI is defined as fever (temperature of 100?F [37.8?C] or greater) and cough and/or sore throat.)

              Additional data are available at http://gis.cdc.gov/grasp/fluview/flu...dashboard.html.
              <center>
              View National and Regional Level Graphs and Data | View Chart Data | View Full Screen | View PowerPoint Presentation
              </center>

              On a regional level, the percentage of outpatient visits for ILI ranged from 0.8% to 2.3% during week 45. All 10 regions reported a proportion of outpatient visits for ILI below their region-specific baseline levels.



              ILINet State Activity Indicator Map:

              Data collected in ILINet are used to produce a measure of ILI activity* by state. Activity levels are based on the percent of outpatient visits in a state due to ILI and are compared to the average percent of ILI visits that occur during weeks with little or no influenza virus circulation. Activity levels range from minimal, which would correspond to ILI activity from outpatient clinics being below, or only slightly above, the average, to high, which would correspond to ILI activity from outpatient clinics being much higher than average.
              During week 45, the following ILI activity levels were experienced:
              • Puerto Rico experienced moderate ILI activity.
              • Two states (Alaska and Louisiana) experienced low ILI activity.
              • New York City and 48 states (Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming) experienced minimal ILI activity.
              • Data were insufficient to calculate an ILI activity level from the District of Columbia.

              Click on map to launch interactive tool

              *This map uses the proportion of outpatient visits to health care providers for influenza-like illness to measure the ILI activity level within a state. It does not, however, measure the extent of geographic spread of flu within a state. Therefore, outbreaks occurring in a single city could cause the state to display high activity levels.
              Data collected in ILINet may disproportionally represent certain populations within a state, and therefore, may not accurately depict the full picture of influenza activity for the whole state.
              Data displayed in this map are based on data collected in ILINet, whereas the State and Territorial flu activity map is based on reports from state and territorial epidemiologists. The data presented in this map is preliminary and may change as more data is received.
              Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.


              Geographic Spread of Influenza as Assessed by State and Territorial Epidemiologists

              The influenza activity reported by state and territorial epidemiologists indicates geographic spread of influenza viruses, but does not measure the severity of influenza activity.
              During week 45, the following influenza activity was reported:
              • Widespread influenza activity was reported by Guam.
              • Regional influenza activity was reported by three states (Alaska, Florida, and Massachusetts).
              • Local influenza activity was reported by Puerto Rico, the U.S. Virgin Islands, and 13 states (California, Connecticut, Delaware, Georgia, Indiana, Louisiana, Maryland, New Hampshire, New York, North Carolina, Oregon, South Carolina, and Texas).
              • Sporadic influenza activity was reported by the District of Columbia and 31 states (Alabama, Arizona, Arkansas, Colorado, Hawaii, Illinois, Indiana, Iowa, Kansas, Kentucky, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Jersey, New Mexico, North Dakota, Ohio, Oklahoma, Pennsylvania, South Dakota, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming).
              • No influenza activity was reported by three states (Maine, Rhode Island, and Tennessee).







              Additional National and International Influenza Surveillance Information


              FluView Interactive: FluView includes enhanced web-based interactive applications that can provide dynamic visuals of the influenza data collected and analyzed by CDC. These FluView Interactive applications allow people to create customized, visual interpretations of influenza data, as well as make comparisons across flu seasons, regions, age groups and a variety of other demographics. To access these tools, visit http://www.cdc.gov/flu/weekly/fluviewinteractive.htm.
              U.S. State and local influenza surveillance: Click on a jurisdiction below to access the latest local influenza information.
              <table> <tbody><tr border="1"> <td height="8" width="139">Alabama
              </td> <td height="8" width="139">Alaska
              </td> <td height="8" width="139">Arizona
              </td> <td height="8" width="139">Arkansas
              </td> <td height="8" width="139">California
              </td> </tr> <tr border="1"> <td height="8" width="139">Colorado
              </td> <td height="8" width="139">Connecticut
              </td> <td height="8" width="139">Delaware
              </td> <td height="8" width="139">District of Columbia
              </td> <td height="8" width="139">Florida
              </td> </tr> <tr border="1"> <td height="8" width="139">Georgia
              </td> <td height="8" width="139">Hawaii
              </td> <td height="8" width="139">Idaho
              </td> <td height="8" width="139">Illinois
              </td> <td height="8" width="139">Indiana
              </td> </tr> <tr border="1"> <td height="8" width="139">Iowa
              </td> <td height="8" width="139">Kansas
              </td> <td height="8" width="139">Kentucky
              </td> <td height="8" width="139">Louisiana
              </td> <td height="8" width="139">Maine
              </td> </tr> <tr border="1"> <td height="8" width="139">Maryland
              </td> <td height="8" width="139">Massachusetts
              </td> <td height="8" width="139">Michigan
              </td> <td height="8" width="139">Minnesota
              </td> <td height="8" width="139">Mississippi
              </td> </tr> <tr border="1"> <td height="8" width="139">Missouri
              </td> <td height="8" width="139">Montana
              </td> <td height="8" width="139">Nebraska
              </td> <td height="8" width="139">Nevada
              </td> <td height="8" width="139">New Hampshire
              </td> </tr> <tr border="1"> <td height="8" width="139">New Jersey
              </td> <td height="8" width="139">New Mexico
              </td> <td height="8" width="139">New York
              </td> <td height="8" width="139">North Carolina
              </td> <td height="8" width="139">North Dakota
              </td> </tr> <tr border="1"> <td height="8" width="139">Ohio
              </td> <td height="8" width="139">Oklahoma
              </td> <td height="8" width="139">Oregon
              </td> <td height="8" width="139">Pennsylvania
              </td> <td height="8" width="139">Rhode Island
              </td> </tr> <tr border="1"> <td height="8" width="139">South Carolina
              </td> <td height="8" width="139">South Dakota
              </td> <td height="8" width="139">Tennessee
              </td> <td height="8" width="139">Texas
              </td> <td height="8" width="139">Utah
              </td> </tr> <tr border="1"> <td height="8" width="139">Vermont
              </td> <td height="8" width="139">Virginia
              </td> <td height="8" width="139">Washington
              </td> <td height="8" width="139">West Virginia
              </td> <td height="8" width="139">Wisconsin
              </td> </tr> <tr border="1"> <td height="8" width="139">Wyoming
              </td> <td height="8" width="139">New York City
              </td> <td height="8" width="139">Virgin Islands
              </td> <td height="8" width="139">
              </td> <td height="8" width="139">
              </td> </tr> </tbody></table>

              Google Flu Trends: Google Flu Trends uses aggregated Google search data in a model created in collaboration with CDC to estimate influenza activity in the United States. For more information and activity estimates from the United States and worldwide, see http://www.google.org/flutrends/
              World Health Organization: Additional influenza surveillance information from participating WHO member nations is available through FluNet and the Global Epidemiology Reports.
              WHO Collaborating Centers for Influenza located in Australia, China, Japan, the United Kingdom, and the United States (CDC in Atlanta, Georgia).
              Europe: for the most recent influenza surveillance information from Europe, please see WHO/Europe at http://www.euroflu.org/index.php and visit the European Centre for Disease Prevention and Control at http://ecdc.europa.eu/en/publications/surveillance_reports/influenza/Pages/weekly_influenza_surveillance_overview.aspx
              Public Health Agency of Canada: The most up-to-date influenza information from Canada is available at http://www.phac-aspc.gc.ca/fluwatch/
              Public Health England: The most up-to-date influenza information from the United Kingdom is available at https://www.gov.uk/government/statistics/weekly-national-flu-reports


              Any links provided to non-Federal organizations are provided solely as a service to our users. These links do not constitute an endorsement of these organizations or their programs by CDC or the Federal Government, and none should be inferred. CDC is not responsible for the content of the individual organization web pages found at these links.
              In addition to the eight data components of CDC influenza surveillance for the 2014-2015 influenza season, the use of National Center for Health Statistics (NCHS) pneumonia and influenza mortality surveillance data for the rapid assessment of influenza-associated mortality will be piloted. An overview of influenza surveillance, including a description of the NCHS mortality surveillance data, is available here.
              -------------------------------------------------------------------------------- Full report also available as PDF





              Learn more about the weekly influenza surveillance report (FluView) prepared by the Influenza Division.

              Comment


              • #8
                Re: USA: 2014-15 FluView: Influenza Season Weekly Summary, Wks 40+


                2014-2015 Influenza Season Week 46 ending November 15, 2014


                All data are preliminary and may change as more reports are received.
                Synopsis:

                During week 46 (November 9-15, 2014), influenza activity was low in the United States.
                • Viral Surveillance: Of 10,304 specimens tested and reported by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories during week 46, 955 (9.3%) were positive for influenza.
                • Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia and influenza (P&I) was below the epidemic threshold.
                • Influenza-associated Pediatric Deaths: No influenza-associated pediatric deaths were reported.
                • Outpatient Illness Surveillance: The proportion of outpatient visits for influenza-like illness (ILI) was 1.6%, which is below the national baseline of 2.0%. All 10 regions reported ILI below region-specific baseline levels. Puerto Rico experienced high ILI activity; two states experienced low ILI activity; New York City and 48 states experienced minimal ILI activity; and the District of Columbia had insufficient data.
                • Geographic Spread of Influenza: The geographic spread of influenza in Puerto Rico and five states was reported as regional; 21 states reported local activity; the District of Columbia, the U.S. Virgin Islands, and 23 states reported sporadic activity; one state reported no influenza activity; and Guam did not report.

                <table class="table" border="0" cellpadding="3" cellspacing="0" width="100%"> <caption>National and Regional Summary of Select Surveillance Components

                </caption> <tbody><tr style="vertical-align:top" bgcolor="#c5bee1"> <th rowspan="2" style="vertical-align:bottom" width="12%">HHS Surveillance Regions*</th> <th colspan="8" style="text-align: center;" nowrap="nowrap">Data cumulative since September 28, 2014 (week 40)</th> </tr> <tr style="vertical-align:middle; background-image: url(images/purplegrad.jpg); background-repeat: repeat-x;"> <th style="text-align: center;" width="8%">Out-patient ILI?</th> <th style="text-align: center;" width="8%">% positive for flu?</th> <th style="text-align: center;" width="15%">Number of jurisdictions reporting regional or widespread activity?</th> <th style="text-align: center;" nowrap="nowrap" width="7%">2009 H1N1</th> <th style="text-align: center;" width="11%">A (H3)</th> <th style="text-align: center;" width="18%">A(Subtyping not performed)</th> <th style="text-align: center;" nowrap="nowrap" width="7%">B</th> <th style="text-align: center;" width="11%">Pediatric Deaths</th> </tr> <tr> <td style="text-align: left;" width="12%">Nation</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">9.3%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">6 of 54</td> <td style="text-align: center;" nowrap="nowrap" width="7%">26</td> <td style="text-align: center;" nowrap="nowrap" width="11%">1,458</td> <td style="text-align: center;" nowrap="nowrap" width="18%">1,969</td> <td style="text-align: center;" nowrap="nowrap" width="7%">926</td> <td style="text-align: center;" nowrap="nowrap" width="11%">1</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 1</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">1.2%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">1 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="7%">1</td> <td style="text-align: center;" nowrap="nowrap" width="11%">17</td> <td style="text-align: center;" nowrap="nowrap" width="18%">14</td> <td style="text-align: center;" nowrap="nowrap" width="7%">14</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 2</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">0.9%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">1 of 4</td> <td style="text-align: center;" nowrap="nowrap" width="7%">6</td> <td style="text-align: center;" nowrap="nowrap" width="11%">92</td> <td style="text-align: center;" nowrap="nowrap" width="18%">15</td> <td style="text-align: center;" nowrap="nowrap" width="7%">26</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 3</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">3.9%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">77</td> <td style="text-align: center;" nowrap="nowrap" width="18%">50</td> <td style="text-align: center;" nowrap="nowrap" width="7%">33</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 4</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">11.0%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">1 of 8</td> <td style="text-align: center;" nowrap="nowrap" width="7%">2</td> <td style="text-align: center;" nowrap="nowrap" width="11%">276</td> <td style="text-align: center;" nowrap="nowrap" width="18%">1,114</td> <td style="text-align: center;" nowrap="nowrap" width="7%">527</td> <td style="text-align: center;" nowrap="nowrap" width="11%">1</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 5</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">7.6%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="7%">9</td> <td style="text-align: center;" nowrap="nowrap" width="11%">132</td> <td style="text-align: center;" nowrap="nowrap" width="18%">230</td> <td style="text-align: center;" nowrap="nowrap" width="7%">39</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 6</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">14.0%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">2 of 5</td> <td style="text-align: center;" nowrap="nowrap" width="7%">2</td> <td style="text-align: center;" nowrap="nowrap" width="11%">257</td> <td style="text-align: center;" nowrap="nowrap" width="18%">363</td> <td style="text-align: center;" nowrap="nowrap" width="7%">185</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 7</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">4.6%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 4</td> <td style="text-align: center;" nowrap="nowrap" width="7%">1</td> <td style="text-align: center;" nowrap="nowrap" width="11%">63</td> <td style="text-align: center;" nowrap="nowrap" width="18%">36</td> <td style="text-align: center;" nowrap="nowrap" width="7%">34</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 8</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">4.3%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">66</td> <td style="text-align: center;" nowrap="nowrap" width="18%">46</td> <td style="text-align: center;" nowrap="nowrap" width="7%">19</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 9</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">3.8%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">0 of 5</td> <td style="text-align: center;" nowrap="nowrap" width="7%">4</td> <td style="text-align: center;" nowrap="nowrap" width="11%">116</td> <td style="text-align: center;" nowrap="nowrap" width="18%">57</td> <td style="text-align: center;" nowrap="nowrap" width="7%">39</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 10</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="8%">18.2%</td> <td style="text-align: center;" nowrap="nowrap" width="15%">1 of 4</td> <td style="text-align: center;" nowrap="nowrap" width="7%">1</td> <td style="text-align: center;" nowrap="nowrap" width="11%">362</td> <td style="text-align: center;" nowrap="nowrap" width="18%">44</td> <td style="text-align: center;" nowrap="nowrap" width="7%">10</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> </tbody></table>
                *HHS regions (Region 1 CT, ME, MA, NH, RI, VT; Region 2: NJ, NY, Puerto Rico, US Virgin Islands; Region 3: DE, DC, MD, PA, VA, WV; Region 4: AL, FL, GA, KY, MS, NC, SC, TN; Region 5: IL, IN, MI, MN, OH, WI; Region 6: AR, LA, NM, OK, TX; Region 7: IA, KS, MO, NE; Region 8: CO, MT, ND, SD, UT, WY; Region 9: AZ, CA, Guam, HI, NV; and Region 10: AK, ID, OR, WA).
                ? Elevated means the % of visits for ILI is at or above the national or region-specific baseline
                ? National data are for current week; regional data are for the most recent three weeks
                ? Includes all 50 states, the District of Columbia, Guam, Puerto Rico, and U.S. Virgin Islands




                U.S. Virologic Surveillance:

                WHO and NREVSS collaborating laboratories located in all 50 states, Puerto Rico, and the District of Columbia report to CDC the number of respiratory specimens tested for influenza and the number positive by influenza virus type and influenza A virus subtype. The results of tests performed during the current week are summarized in the table below. Region specific data are available at http://gis.cdc.gov/grasp/fluview/flu...dashboard.html.
                <table class="table" align="center" border="0" cellpadding="2" cellspacing="0"> <tbody><tr style="background-image: url(images/purplegrad.jpg); background-repeat: repeat-x;"> <th style="text-align: left;" width="270">
                </th> <th style="text-align: center;" nowrap="nowrap" width="150">Week 46</th> </tr> <tr> <th style="text-align: left;" width="270">No. of specimens tested</th> <td style="text-align: center;" nowrap="nowrap" width="150">10,304</td> </tr> <tr> <th style="text-align: left;" width="270">No. of positive specimens (%)</th> <td style="text-align: center;" nowrap="nowrap" width="150">955 (9.3%)</td> </tr> <tr> <th style="text-align: left;" width="270">Positive specimens by type/subtype</th> <td style="text-align: center;" nowrap="nowrap" width="150">
                </td> </tr> <tr> <th style="text-align: left;" width="270"> Influenza A</th> <td style="text-align: center;" nowrap="nowrap" width="150">836 (87.5%)</td> </tr> <tr> <th style="text-align: left;" width="270"> 2009 H1N1</th> <td style="text-align: right;" nowrap="nowrap" width="150"> 0 (0.0%) </td> </tr> <tr> <th style="text-align: left;" width="270"> H3</th> <td style="text-align: right;" nowrap="nowrap" width="150"> 257 (30.7%) </td> </tr> <tr> <th style="text-align: left;" width="270"> Subytping not performed</th> <td style="text-align: right;" nowrap="nowrap" width="150"> 579 (69.3%) </td> </tr> <tr> <th style="text-align: left;" width="270"> Influenza B</th> <td style="text-align: center;" nowrap="nowrap" width="150">119 (12.5%)</td> </tr> </tbody></table> <center>
                View National and Regional Level Graphs and Data | View Chart Data | View Full Screen | View PowerPoint Presentation </center>



                Antigenic Characterization*:

                CDC has antigenically characterized 52 influenza viruses (one 2009 H1N1 virus, 34 influenza A (H3N2) viruses, and 17 influenza B viruses) collected by U.S. laboratories since October 1, 2014 by hemagglutination inhibition (HI).
                2009 H1N1 [1]:
                • The 2009 H1N1 virus tested was characterized as A/California/7/2009-like, the influenza A (H1N1) component of the 2014-2015 Northern Hemisphere influenza vaccine.

                Influenza A (H3N2) [34]:
                • 19 (56%) of the 34 influenza A (H3N2) viruses tested have been characterized as A/Texas/50/2012-like, the influenza A (H3N2) component of the 2014-2015 Northern Hemisphere influenza vaccine. 15 (44%) of the 34 viruses tested showed reduced titers with antiserum produced against A/Texas/50/2012. Among viruses that showed reduced titers with antiserum raised against A/Texas/50/2012, the majority were antigenically similar to A/Switzerland/9715293/2013, the H3N2 virus selected for the 2015 Southern Hemisphere influenza vaccine. A/Switzerland/9715293/2013 is related to, but antigenically and genetically distinguishable, from the A/Texas/50/2012 vaccine virus. A/Switzerland-like H3N2 viruses were first detected in the United States in small numbers in March of 2014 and began to circulate in greater numbers over the spring and summer.

                Influenza B [17]: Ten (58.8%) of the influenza B viruses tested belong to B/Yamagata/16/88 lineage and the remaining seven (41.2%) influenza B viruses tested belong to B/Victoria/02/87 lineage.
                • Yamagata Lineage [10]: All ten B/Yamagata-lineage viruses were characterized as B/Massachusetts/2/2012-like, which is included as an influenza B component of the 2014-2015 Northern Hemisphere trivalent and quadrivalent influenza vaccines.

                • Victoria Lineage [7]: All seven B/Victoria-lineage viruses were characterized as B/Brisbane/60/2008-like, the virus that is included as an influenza B component of the 2014-2015 Northern Hemisphere quadrivalent influenza vaccine.

                *CDC conducts antigenic characterization of influenza viruses year-round to compare how similar currently circulating influenza viruses are to those included in the influenza vaccine, and to monitor for changes in circulating influenza viruses.


                Antiviral Resistance:

                Testing of 2009 H1N1, influenza A (H3N2), and influenza B virus isolates for resistance to neuraminidase inhibitors (oseltamivir and zanamivir) is performed at CDC using a functional assay. Additional 2009 H1N1 and influenza A (H3N2) clinical samples are tested for mutations of the virus known to confer oseltamivir resistance. The data summarized below combine the results of both testing methods. These samples are routinely obtained for surveillance purposes rather than for diagnostic testing of patients suspected to be infected with antiviral-resistant virus.
                High levels of resistance to the adamantanes (amantadine and rimantadine) persist among 2009 influenza A (H1N1) and A (H3N2) viruses (the adamantanes are not effective against influenza B viruses). Therefore, data from adamantane resistance testing are not presented below.
                <table class="table" style="text-align: center;" align="center" border="0" cellpadding="3" cellspacing="0"> <caption> Neuraminidase Inhibitor Resistance Testing Results on Samples Collected Since October 1, 2014

                </caption> <tbody><tr bgcolor="#c5bee1"> <td rowspan="2" style="width:81.0pt;border:1.0pt; padding:0in 5.4pt 0in 5.4pt;height:27.85pt;" width="108">
                </td> <th colspan="2" style="width:2.0in;border:1.0pt;vertical-align:middle;height:27.85pt" width="192">Oseltamivir</th> <th colspan="2" style="width:2.0in;border:1.0pt;vertical-align:middle;;height:27.85pt" width="192">Zanamivir</th> </tr> <tr style="height:25.15pt;text-align:center;background-image: url(file://///cdc.gov/ahb_apps/WWWLINK_CDC_GOV/flu/weekly/images/purplegrad.jpg); background-repeat:repeat-x;"> <th style="width:63.0pt;text-align:center;" align="center" width="84">Virus Samples tested (n)</th> <th style="width:63.0pt;text-align:center;" align="center" width="84">Resistant Viruses, Number (%)</th> <th style="width:63.0pt;text-align:center;" align="center" width="84">Virus Samples tested (n)</th> <th style="width:63.0pt;text-align:center;" align="center" width="84">Resistant Viruses, Number (%)</th> </tr> <tr> <th style="text-align: left;" bgcolor="#dad5eb" nowrap="nowrap" width="160">Influenza A (H3N2)</th> <td style="text-align: center;" nowrap="nowrap" width="100">15</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> <td style="text-align: center;" nowrap="nowrap" width="100">15</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> </tr> <tr> <th style="text-align: left;" bgcolor="#dad5eb" nowrap="nowrap" width="160">Influenza B</th> <td style="text-align: center;" nowrap="nowrap" width="100">7</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> <td style="text-align: center;" nowrap="nowrap" width="100">7</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> </tr> <tr> <th style="text-align: left;" bgcolor="#dad5eb" nowrap="nowrap" width="160">2009 H1N1</th> <td style="text-align: center;" nowrap="nowrap" width="100">2</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> <td style="text-align: center;" nowrap="nowrap" width="100">2</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> </tr> </tbody></table>
                In the United States, all recently circulating influenza viruses have been susceptible to the neuraminidase inhibitor antiviral medications, oseltamivir and zanamivir; however, rare sporadic instances of oseltamivir-resistant 2009 H1N1 and A (H3N2) viruses have been detected worldwide. Antiviral treatment with oseltamivir or zanamivir is recommended as early as possible for patients with confirmed or suspected influenza who have severe, complicated, or progressive illness; who require hospitalization; or who are at high risk for serious influenza-related complications. Additional information on recommendations for treatment and chemoprophylaxis of influenza virus infection with antiviral agents is available at http://www.cdc.gov/flu/antivirals/index.htm.


                Pneumonia and Influenza (P&I) Mortality Surveillance:

                During week 46, 5.0% of all deaths reported through the 122 Cities Mortality Reporting System were due to P&I. This percentage was below the epidemic threshold of 6.4% for week 46.
                <center>
                View Full Screen | View PowerPoint Presentation </center>

                For the 2014-2015 influenza season, CDC/Influenza Division and the National Center for Health Statistics (NCHS) are collaborating on a pilot project to use NCHS mortality surveillance data for the rapid assessment of pneumonia and influenza (P&I) mortality. To view the data, please click here.


                Influenza-Associated Pediatric Mortality:

                No influenza-associated pediatric deaths were reported to CDC during week 46. To date, one influenza-associated pediatric death has been reported for the 2014-2015 season.

                Additional data can be found at: http://gis.cdc.gov/GRASP/Fluview/PedFluDeath.html.
                <center>
                View Interactive Application | View Full Screen | View PowerPoint Presentation </center>



                Influenza-Associated Hospitalizations:

                The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts all age population-based surveillance for laboratory-confirmed influenza-related hospitalizations in select counties in the Emerging Infections Program (EIP) states and Influenza Hospitalization Surveillance Project (IHSP) states. FluSurv-NET estimated hospitalization rates will be updated weekly starting later this season. Additional FluSurv-NET data can be found at: http://gis.cdc.gov/GRASP/Fluview/FluHospRates.html and http://gis.cdc.gov/grasp/fluview/FluHospChars.html.


                Outpatient Illness Surveillance:

                Nationwide during week 46, 1.6% 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 below the national baseline of 2.0%.
                (ILI is defined as fever (temperature of 100?F [37.8?C] or greater) and cough and/or sore throat.)

                Additional data are available at http://gis.cdc.gov/grasp/fluview/flu...dashboard.html.
                <center>
                View National and Regional Level Graphs and Data | View Chart Data | View Full Screen | View PowerPoint Presentation
                </center>

                On a regional level, the percentage of outpatient visits for ILI ranged from 0.8% to 2.3% during week 46. All 10 regions reported a proportion of outpatient visits for ILI below their region-specific baseline levels.



                ILINet State Activity Indicator Map:

                Data collected in ILINet are used to produce a measure of ILI activity* by state. Activity levels are based on the percent of outpatient visits in a state due to ILI and are compared to the average percent of ILI visits that occur during weeks with little or no influenza virus circulation. Activity levels range from minimal, which would correspond to ILI activity from outpatient clinics being below, or only slightly above, the average, to high, which would correspond to ILI activity from outpatient clinics being much higher than average.
                During week 46, the following ILI activity levels were experienced:
                • Puerto Rico experienced high ILI activity.
                • Two states (Alaska and Louisiana) experienced low ILI activity.
                • New York City and 48 states (Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming) experienced minimal ILI activity.
                • Data were insufficient to calculate an ILI activity level from the District of Columbia.

                Click on map to launch interactive tool

                *This map uses the proportion of outpatient visits to health care providers for influenza-like illness to measure the ILI activity level within a state. It does not, however, measure the extent of geographic spread of flu within a state. Therefore, outbreaks occurring in a single city could cause the state to display high activity levels.
                Data collected in ILINet may disproportionally represent certain populations within a state, and therefore, may not accurately depict the full picture of influenza activity for the whole state.
                Data displayed in this map are based on data collected in ILINet, whereas the State and Territorial flu activity map is based on reports from state and territorial epidemiologists. The data presented in this map is preliminary and may change as more data is received.
                Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.


                Geographic Spread of Influenza as Assessed by State and Territorial Epidemiologists

                The influenza activity reported by state and territorial epidemiologists indicates geographic spread of influenza viruses, but does not measure the severity of influenza activity.
                During week 46, the following influenza activity was reported:
                • Regional influenza activity was reported by Puerto Rico and five states (Alaska, Florida, Louisiana, Massachusetts, and Texas).
                • Local influenza activity was reported by 21 states (Alabama, Colorado, Connecticut, Delaware, Georgia, Illinois, Indiana, Kansas, Maine, Maryland, Michigan, Minnesota, New York, North Carolina, Ohio, Oklahoma, Oregon, South Carolina, Utah, Vermont, and Wyoming).
                • Sporadic influenza activity was reported by the District of Columbia, U.S. Virgin Islands, and 23 states (Arizona, Arkansas, California, Hawaii, Idaho, Iowa, Kentucky, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, North Dakota, Pennsylvania, South Dakota, Tennessee, Virginia, Washington, West Virginia, and Wisconsin).
                • No influenza activity was reported by one state (Rhode Island).
                • Guam did not report.









                Additional National and International Influenza Surveillance Information


                FluView Interactive: FluView includes enhanced web-based interactive applications that can provide dynamic visuals of the influenza data collected and analyzed by CDC. These FluView Interactive applications allow people to create customized, visual interpretations of influenza data, as well as make comparisons across flu seasons, regions, age groups and a variety of other demographics. To access these tools, visit http://www.cdc.gov/flu/weekly/fluviewinteractive.htm.
                U.S. State and local influenza surveillance: Click on a jurisdiction below to access the latest local influenza information.
                <table> <tbody><tr border="1"> <td height="8" width="139">Alabama
                </td> <td height="8" width="139">Alaska
                </td> <td height="8" width="139">Arizona
                </td> <td height="8" width="139">Arkansas
                </td> <td height="8" width="139">California
                </td> </tr> <tr border="1"> <td height="8" width="139">Colorado
                </td> <td height="8" width="139">Connecticut
                </td> <td height="8" width="139">Delaware
                </td> <td height="8" width="139">District of Columbia
                </td> <td height="8" width="139">Florida
                </td> </tr> <tr border="1"> <td height="8" width="139">Georgia
                </td> <td height="8" width="139">Hawaii
                </td> <td height="8" width="139">Idaho
                </td> <td height="8" width="139">Illinois
                </td> <td height="8" width="139">Indiana
                </td> </tr> <tr border="1"> <td height="8" width="139">Iowa
                </td> <td height="8" width="139">Kansas
                </td> <td height="8" width="139">Kentucky
                </td> <td height="8" width="139">Louisiana
                </td> <td height="8" width="139">Maine
                </td> </tr> <tr border="1"> <td height="8" width="139">Maryland
                </td> <td height="8" width="139">Massachusetts
                </td> <td height="8" width="139">Michigan
                </td> <td height="8" width="139">Minnesota
                </td> <td height="8" width="139">Mississippi
                </td> </tr> <tr border="1"> <td height="8" width="139">Missouri
                </td> <td height="8" width="139">Montana
                </td> <td height="8" width="139">Nebraska
                </td> <td height="8" width="139">Nevada
                </td> <td height="8" width="139">New Hampshire
                </td> </tr> <tr border="1"> <td height="8" width="139">New Jersey
                </td> <td height="8" width="139">New Mexico
                </td> <td height="8" width="139">New York
                </td> <td height="8" width="139">North Carolina
                </td> <td height="8" width="139">North Dakota
                </td> </tr> <tr border="1"> <td height="8" width="139">Ohio
                </td> <td height="8" width="139">Oklahoma
                </td> <td height="8" width="139">Oregon
                </td> <td height="8" width="139">Pennsylvania
                </td> <td height="8" width="139">Rhode Island
                </td> </tr> <tr border="1"> <td height="8" width="139">South Carolina
                </td> <td height="8" width="139">South Dakota
                </td> <td height="8" width="139">Tennessee
                </td> <td height="8" width="139">Texas
                </td> <td height="8" width="139">Utah
                </td> </tr> <tr border="1"> <td height="8" width="139">Vermont
                </td> <td height="8" width="139">Virginia
                </td> <td height="8" width="139">Washington
                </td> <td height="8" width="139">West Virginia
                </td> <td height="8" width="139">Wisconsin
                </td> </tr> <tr border="1"> <td height="8" width="139">Wyoming
                </td> <td height="8" width="139">New York City
                </td> <td height="8" width="139">Virgin Islands
                </td> <td height="8" width="139">
                </td> <td height="8" width="139">
                </td> </tr> </tbody></table>

                Google Flu Trends: Google Flu Trends uses aggregated Google search data in a model created in collaboration with CDC to estimate influenza activity in the United States. For more information and activity estimates from the United States and worldwide, see http://www.google.org/flutrends/
                World Health Organization: Additional influenza surveillance information from participating WHO member nations is available through FluNet and the Global Epidemiology Reports.
                WHO Collaborating Centers for Influenza located in Australia, China, Japan, the United Kingdom, and the United States (CDC in Atlanta, Georgia).
                Europe: for the most recent influenza surveillance information from Europe, please see WHO/Europe at http://www.euroflu.org/index.php and visit the European Centre for Disease Prevention and Control at http://ecdc.europa.eu/en/publications/surveillance_reports/influenza/Pages/weekly_influenza_surveillance_overview.aspx
                Public Health Agency of Canada: The most up-to-date influenza information from Canada is available at http://www.phac-aspc.gc.ca/fluwatch/
                Public Health England: The most up-to-date influenza information from the United Kingdom is available at https://www.gov.uk/government/statistics/weekly-national-flu-reports


                Any links provided to non-Federal organizations are provided solely as a service to our users. These links do not constitute an endorsement of these organizations or their programs by CDC or the Federal Government, and none should be inferred. CDC is not responsible for the content of the individual organization web pages found at these links.
                In addition to the eight data components of CDC influenza surveillance for the 2014-2015 influenza season, the use of National Center for Health Statistics (NCHS) pneumonia and influenza mortality surveillance data for the rapid assessment of influenza-associated mortality will be piloted. An overview of influenza surveillance, including a description of the NCHS mortality surveillance data, is available here.
                -------------------------------------------------------------------------------- Full report also available as PDF






                Learn more about the weekly influenza surveillance report (FluView) prepared by the Influenza Division.

                Comment


                • #9
                  Re: USA: 2014-15 FluView: Influenza Season Weekly Summary, Wks 40+

                  2014-2015 Influenza Season Week 47 ending November 22, 2014


                  All data are preliminary and may change as more reports are received.
                  Synopsis:

                  During week 47 (November 16-22, 2014), influenza activity increased slightly in the United States.
                  • Viral Surveillance: Of 9,710 specimens tested and reported by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories during week 47, 1,228 (12.6%) were positive for influenza.
                  • Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia and influenza (P&I) was below the epidemic threshold.
                  • Influenza-associated Pediatric Deaths: Four influenza-associated pediatric deaths were reported.
                  • Influenza-associated Hospitalizations: A cumulative rate for the season of 1.1 laboratory-confirmed influenza-associated hospitalizations per 100,000 population was reported.
                  • Outpatient Illness Surveillance: The proportion of outpatient visits for influenza-like illness (ILI) was 2.0%, which is at the national baseline. Four of 10 regions reported ILI at or above region-specific baseline levels. Puerto Rico and one state experienced high ILI activity; two states experienced moderate ILI activity; five states experienced low ILI activity; New York City and 42 states experienced minimal ILI activity; and the District of Columbia had insufficient data.
                  • Geographic Spread of Influenza: The geographic spread of influenza in two states was reported as widespread; Puerto Rico and nine states reported regional activity; 20 states reported local activity; the District of Columbia, the U.S. Virgin Islands, and 17 states reported sporadic activity; two states reported no influenza activity; and Guam did not report.

                  <table class="table" border="0" cellpadding="3" cellspacing="0" width="100%"> <caption>National and Regional Summary of Select Surveillance Components

                  </caption> <tbody><tr style="vertical-align:top" bgcolor="#c5bee1"> <th rowspan="2" style="vertical-align:bottom" width="12%">HHS Surveillance Regions*</th> <th colspan="8" style="text-align: center;" nowrap="nowrap">Data cumulative since September 28, 2014 (week 40)</th> </tr> <tr style="vertical-align:middle; background-image: url(../images/purplegrad.jpg); background-repeat: repeat-x;"> <th style="text-align: center;" width="8%">Out-patient ILI?</th> <th style="text-align: center;" width="17%">Number of jurisdictions reporting regional or widespread activity?</th> <th style="text-align: center;" width="8%">% positive for flu?</th> <th style="text-align: center;" nowrap="nowrap" width="7%">2009 H1N1</th> <th style="text-align: center;" width="11%">A (H3)</th> <th style="text-align: center;" width="19%">A(Subtyping not performed)</th> <th style="text-align: center;" nowrap="nowrap" width="7%">B</th> <th style="text-align: center;" width="11%">Pediatric Deaths</th> </tr> <tr> <td style="text-align: left;" width="12%">Nation</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Elevated</td> <td style="text-align: center;" nowrap="nowrap" width="17%">12 of 54</td> <td style="text-align: center;" nowrap="nowrap" width="8%">12.6%</td> <td style="text-align: center;" nowrap="nowrap" width="7%">27</td> <td style="text-align: center;" nowrap="nowrap" width="11%">2,031</td> <td style="text-align: center;" nowrap="nowrap" width="19%">2,737</td> <td style="text-align: center;" nowrap="nowrap" width="7%">1,046</td> <td style="text-align: center;" nowrap="nowrap" width="11%">5</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 1</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="17%">1 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="8%">1.2%</td> <td style="text-align: center;" nowrap="nowrap" width="7%">1</td> <td style="text-align: center;" nowrap="nowrap" width="11%">23</td> <td style="text-align: center;" nowrap="nowrap" width="19%">15</td> <td style="text-align: center;" nowrap="nowrap" width="7%">15</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 2</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Elevated</td> <td style="text-align: center;" nowrap="nowrap" width="17%">1 of 4</td> <td style="text-align: center;" nowrap="nowrap" width="8%">1.0%</td> <td style="text-align: center;" nowrap="nowrap" width="7%">6</td> <td style="text-align: center;" nowrap="nowrap" width="11%">95</td> <td style="text-align: center;" nowrap="nowrap" width="19%">22</td> <td style="text-align: center;" nowrap="nowrap" width="7%">26</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 3</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="17%">1 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="8%">7.0%</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">145</td> <td style="text-align: center;" nowrap="nowrap" width="19%">79</td> <td style="text-align: center;" nowrap="nowrap" width="7%">40</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 4</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Elevated</td> <td style="text-align: center;" nowrap="nowrap" width="17%">3 of 8</td> <td style="text-align: center;" nowrap="nowrap" width="8%">12.9%</td> <td style="text-align: center;" nowrap="nowrap" width="7%">2</td> <td style="text-align: center;" nowrap="nowrap" width="11%">352</td> <td style="text-align: center;" nowrap="nowrap" width="19%">1,457</td> <td style="text-align: center;" nowrap="nowrap" width="7%">583</td> <td style="text-align: center;" nowrap="nowrap" width="11%">4</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 5</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="17%">2 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="8%">12.4%</td> <td style="text-align: center;" nowrap="nowrap" width="7%">9</td> <td style="text-align: center;" nowrap="nowrap" width="11%">238</td> <td style="text-align: center;" nowrap="nowrap" width="19%">454</td> <td style="text-align: center;" nowrap="nowrap" width="7%">47</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 6</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Elevated</td> <td style="text-align: center;" nowrap="nowrap" width="17%">2 of 5</td> <td style="text-align: center;" nowrap="nowrap" width="8%">16.3%</td> <td style="text-align: center;" nowrap="nowrap" width="7%">3</td> <td style="text-align: center;" nowrap="nowrap" width="11%">342</td> <td style="text-align: center;" nowrap="nowrap" width="19%">472</td> <td style="text-align: center;" nowrap="nowrap" width="7%">220</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 7</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="17%">0 of 4</td> <td style="text-align: center;" nowrap="nowrap" width="8%">6.7%</td> <td style="text-align: center;" nowrap="nowrap" width="7%">1</td> <td style="text-align: center;" nowrap="nowrap" width="11%">111</td> <td style="text-align: center;" nowrap="nowrap" width="19%">55</td> <td style="text-align: center;" nowrap="nowrap" width="7%">35</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 8</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="17%">1 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="8%">5.5%</td> <td style="text-align: center;" nowrap="nowrap" width="7%">0</td> <td style="text-align: center;" nowrap="nowrap" width="11%">97</td> <td style="text-align: center;" nowrap="nowrap" width="19%">60</td> <td style="text-align: center;" nowrap="nowrap" width="7%">21</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 9</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="17%">0 of 5</td> <td style="text-align: center;" nowrap="nowrap" width="8%">12.9%</td> <td style="text-align: center;" nowrap="nowrap" width="7%">4</td> <td style="text-align: center;" nowrap="nowrap" width="11%">136</td> <td style="text-align: center;" nowrap="nowrap" width="19%">61</td> <td style="text-align: center;" nowrap="nowrap" width="7%">46</td> <td style="text-align: center;" nowrap="nowrap" width="11%">1</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 10</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Elevated</td> <td style="text-align: center;" nowrap="nowrap" width="17%">1 of 4</td> <td style="text-align: center;" nowrap="nowrap" width="8%">20.3%</td> <td style="text-align: center;" nowrap="nowrap" width="7%">1</td> <td style="text-align: center;" nowrap="nowrap" width="11%">492</td> <td style="text-align: center;" nowrap="nowrap" width="19%">62</td> <td style="text-align: center;" nowrap="nowrap" width="7%">13</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> </tbody></table>
                  *HHS regions (Region 1 CT, ME, MA, NH, RI, VT; Region 2: NJ, NY, Puerto Rico, US Virgin Islands; Region 3: DE, DC, MD, PA, VA, WV; Region 4: AL, FL, GA, KY, MS, NC, SC, TN; Region 5: IL, IN, MI, MN, OH, WI; Region 6: AR, LA, NM, OK, TX; Region 7: IA, KS, MO, NE; Region 8: CO, MT, ND, SD, UT, WY; Region 9: AZ, CA, Guam, HI, NV; and Region 10: AK, ID, OR, WA).
                  ? Elevated means the % of visits for ILI is at or above the national or region-specific baseline
                  ? National data are for current week; regional data are for the most recent three weeks
                  § Includes all 50 states, the District of Columbia, Guam, Puerto Rico, and U.S. Virgin Islands




                  U.S. Virologic Surveillance:

                  WHO and NREVSS collaborating laboratories located in all 50 states, Puerto Rico, and the District of Columbia report to CDC the number of respiratory specimens tested for influenza and the number positive by influenza virus type and influenza A virus subtype. The results of tests performed during the current week are summarized in the table below. Region specific data are available at http://gis.cdc.gov/grasp/fluview/flu...dashboard.html.
                  <table class="table" align="center" border="0" cellpadding="2" cellspacing="0"> <tbody><tr style="background-image: url(../images/purplegrad.jpg); background-repeat: repeat-x;"> <th style="text-align: left;" width="270">
                  </th> <th style="text-align: center;" nowrap="nowrap" width="150">Week 47</th> </tr> <tr> <th style="text-align: left;" width="270">No. of specimens tested</th> <td style="text-align: center;" nowrap="nowrap" width="150">9,710</td> </tr> <tr> <th style="text-align: left;" width="270">No. of positive specimens (%)</th> <td style="text-align: center;" nowrap="nowrap" width="150">1,228 (12.6%)</td> </tr> <tr> <th style="text-align: left;" width="270">Positive specimens by type/subtype</th> <td style="text-align: center;" nowrap="nowrap" width="150">
                  </td> </tr> <tr> <th style="text-align: left;" width="270"> Influenza A</th> <td style="text-align: center;" nowrap="nowrap" width="150">1,123 (91.4%)</td> </tr> <tr> <th style="text-align: left;" width="270"> 2009 H1N1</th> <td style="text-align: right;" nowrap="nowrap" width="150">1 (0.1%) </td> </tr> <tr> <th style="text-align: left;" width="270"> H3</th> <td style="text-align: right;" nowrap="nowrap" width="150">353 (31.4%) </td> </tr> <tr> <th style="text-align: left;" width="270"> Subytping not performed</th> <td style="text-align: right;" nowrap="nowrap" width="150">769 (68.5%)? </td> </tr> <tr> <th style="text-align: left;" width="270"> Influenza B</th> <td style="text-align: center;" nowrap="nowrap" width="150">105 (8.6%)</td> </tr> </tbody></table> <center>
                  View National and Regional Level Graphs and Data | View Chart Data | View Full Screen | View PowerPoint Presentation </center>



                  Antigenic Characterization*:

                  CDC has characterized 103 influenza viruses [1 A(H1N1)pdm09, 85 A(H3N2), and 17 influenza B viruses] collected by U.S. laboratories since October 1, 2014.
                  A(H1N1)pdm09 [1]:
                  • The one H1N1 virus tested was characterized as A/California/7/2009-like, the influenza A (H1N1) component of the 2014-2015 Northern Hemisphere influenza vaccine.

                  A (H3N2) [85]:
                  • 41(48%) of the 85 H3N2 viruses tested have been characterized as A/Texas/50/2012-like, the influenza A (H3N2) component of the 2014-2015 Northern Hemisphere influenza vaccine. 44 (52%) of the 85 viruses tested showed either reduced titers with antiserum produced against A/Texas/50/2012 or belonged to a genetic group that typically shows reduced titers to A/Texas/50/2012. Among viruses that showed reduced titers with antiserum raised against A/Texas/50/2012, most were antigenically similar to A/Switzerland/9715293/2013, the H3N2 virus selected for the 2015 Southern Hemisphere influenza vaccine. A/Switzerland/9715293/2013 is related to, but antigenically and genetically distinguishable, from the A/Texas/50/2012 vaccine virus. A/Switzerland-like H3N2 viruses were first detected in the United States in small numbers in March of 2014 and began to increase through the spring and summer.

                  Influenza B Virus [17]: Ten (58.8%) of the influenza B viruses tested belong to B/Yamagata/16/88 lineage and the remaining seven (41.2%) influenza B viruses tested belong to B/Victoria/02/87 lineage.
                  • Yamagata Lineage [10]: All ten B/Yamagata-lineage viruses were characterized as B/Massachusetts/2/2012-like, which is included as an influenza B component of the 2014-2015 Northern Hemisphere trivalent and quadrivalent influenza vaccines.

                  • Victoria Lineage [7]: All seven B/Victoria-lineage viruses were characterized as B/Brisbane/60/2008-like, the virus that is included as an influenza B component of the 2014-2015 Northern Hemisphere quadrivalent influenza vaccine.

                  *CDC conducts antigenic characterization of influenza viruses year-round to compare how similar currently circulating influenza viruses are to those included in the influenza vaccine, and to monitor for changes in circulating influenza viruses.


                  Antiviral Resistance:

                  Testing of influenza A(H1N1)pdm09, A(H3N2), and influenza B virus isolates for resistance to neuraminidase inhibitors (oseltamivir and zanamivir) is performed at CDC using a functional assay. Additional A(H1N1)pdm09 and A(H3N2) clinical samples are tested for mutations of the virus known to confer oseltamivir resistance. The data summarized below combine the results of both testing methods. These samples are routinely obtained for surveillance purposes rather than for diagnostic testing of patients suspected to be infected with antiviral-resistant virus.
                  High levels of resistance to the adamantanes (amantadine and rimantadine) persist among A(H1N1)pdm09 and A(H3N2) viruses (the adamantanes are not effective against influenza B viruses). Therefore, data from adamantane resistance testing are not presented below.
                  <table class="table" style="text-align: center;" align="center" border="0" cellpadding="3" cellspacing="0"> <caption> Neuraminidase Inhibitor Resistance Testing Results on Samples Collected Since October 1, 2014

                  </caption> <tbody><tr bgcolor="#c5bee1"> <td rowspan="2" style="width:81.0pt;border:1.0pt; padding:0in 5.4pt 0in 5.4pt;height:27.85pt;" width="108">
                  </td> <th colspan="2" style="width:2.0in;border:1.0pt;vertical-align:middle;height:27.85pt" width="192">Oseltamivir</th> <th colspan="2" style="width:2.0in;border:1.0pt;vertical-align:middle;;height:27.85pt" width="192">Zanamivir</th> </tr> <tr style="height:25.15pt;text-align:center;background-image: url(file://///cdc.gov/ahb_apps/WWWLINK_CDC_GOV/flu/weekly/images/purplegrad.jpg); background-repeat:repeat-x;"> <th style="width:63.0pt;text-align:center;" align="center" width="84">Virus Samples tested (n)</th> <th style="width:63.0pt;text-align:center;" align="center" width="84">Resistant Viruses, Number (%)</th> <th style="width:63.0pt;text-align:center;" align="center" width="84">Virus Samples tested (n)</th> <th style="width:63.0pt;text-align:center;" align="center" width="84">Resistant Viruses, Number (%)</th> </tr> <tr> <th style="text-align: left;" bgcolor="#dad5eb" nowrap="nowrap" width="160">Influenza A (H3N2)</th> <td style="text-align: center;" nowrap="nowrap" width="100">15</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> <td style="text-align: center;" nowrap="nowrap" width="100">15</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> </tr> <tr> <th style="text-align: left;" bgcolor="#dad5eb" nowrap="nowrap" width="160">Influenza B</th> <td style="text-align: center;" nowrap="nowrap" width="100">16</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> <td style="text-align: center;" nowrap="nowrap" width="100">16</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> </tr> <tr> <th style="text-align: left;" bgcolor="#dad5eb" nowrap="nowrap" width="160">2009 H1N1</th> <td style="text-align: center;" nowrap="nowrap" width="100">2</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> <td style="text-align: center;" nowrap="nowrap" width="100">2</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> </tr> </tbody></table>
                  In the United States, all recently circulating influenza viruses have been susceptible to the neuraminidase inhibitor antiviral medications, oseltamivir and zanamivir; however, rare sporadic instances of oseltamivir-resistant A(H1N1)pdm09 and A(H3N2) viruses have been detected worldwide. Antiviral treatment with oseltamivir or zanamivir is recommended as early as possible for patients with confirmed or suspected influenza who have severe, complicated, or progressive illness; who require hospitalization; or who are at high risk for serious influenza-related complications. Additional information on recommendations for treatment and chemoprophylaxis of influenza virus infection with antiviral agents is available at http://www.cdc.gov/flu/antivirals/index.htm.


                  Pneumonia and Influenza (P&I) Mortality Surveillance:

                  During week 47, 5.3% of all deaths reported through the 122 Cities Mortality Reporting System were due to P&I. This percentage was below the epidemic threshold of 6.4% for week 47.
                  <center>
                  View Full Screen | View PowerPoint Presentation </center>

                  For the 2014-2015 influenza season, CDC/Influenza Division and the National Center for Health Statistics (NCHS) are collaborating on a pilot project to use NCHS mortality surveillance data for the rapid assessment of pneumonia and influenza (P&I) mortality. To view the data, please click here.


                  Influenza-Associated Pediatric Mortality:

                  Four influenza-associated pediatric deaths were reported to CDC during week 47. Two deaths were associated with an influenza A(H3) virus and occurred during week 46 (week ending November 15, 2014). One death was associated with an influenza A virus for which no subtyping was performed and occurred during week 43 (week ending October 25, 2014). One death was associated with an influenza B virus and occurred during week 46.

                  Additional data can be found at: http://gis.cdc.gov/GRASP/Fluview/PedFluDeath.html.
                  <center>
                  View Interactive Application | View Full Screen | View PowerPoint Presentation </center>



                  Influenza-Associated Hospitalizations:

                  The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts population-based surveillance for laboratory-confirmed influenza-related hospitalizations in children younger than 18 years of age (since the 2003-2004 influenza season) and adults (since the 2005-2006 influenza season).
                  The FluSurv-NET covers more than 70 counties in the 10 Emerging Infections Program (EIP) states (CA, CO, CT, GA, MD, MN, NM, NY, OR, and TN) and additional Influenza Hospitalization Surveillance Project (IHSP) states. The IHSP began during the 2009-2010 season to enhance surveillance during the 2009 H1N1 pandemic. IHSP sites included IA, ID, MI, OK and SD during the 2009-2010 season; ID, MI, OH, OK, RI, and UT during the 2010-2011 season; MI, OH, RI, and UT during the 2011-2012 season; IA, MI, OH, RI, and UT during the 2012-2013 season; and MI, OH, and UT during the 2013-2014 and 2014-15 seasons.
                  Data gathered are used to estimate age-specific hospitalization rates on a weekly basis, and describe characteristics of persons hospitalized with severe influenza illness. The rates provided are likely to be an underestimate as influenza-related hospitalizations can be missed, either because testing is not performed, or because cases may be attributed to other causes of pneumonia or other common influenza-related complications.
                  Between October 1, 2014 and November 22, 2014, 302 laboratory-confirmed influenza-associated hospitalizations were reported. The overall hospitalization rate was 1.1 per 100,000 population. The highest rate of hospitalization was among adults aged ≥65 years (3.5 per 100,000 population). Among all hospitalizations, 252 (83.4%) were associated with influenza A, 45 (14.9%) with influenza B, 3 (1%) with influenza A and B co-infection, and 2 (0.7%) had no virus type information. Among those with influenza A subtype information, 50 (100%) were A(H3N2) virus.
                  Additional FluSurv-NET data can be found at:http://gis.cdc.gov/GRASP/Fluview/FluHospRates.html and http://gis.cdc.gov/grasp/fluview/FluHospChars.html.

                  <center>
                  View Interactive Application | View Full Screen | View PowerPoint Presentation
                  </center>



                  Outpatient Illness Surveillance:

                  Nationwide during week 47, 2.0% 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 at the national baseline of 2.0%.
                  (ILI is defined as fever (temperature of 100°F [37.8°C] or greater) and cough and/or sore throat.)

                  Additional data are available at http://gis.cdc.gov/grasp/fluview/flu...dashboard.html.
                  <center>
                  View National and Regional Level Graphs and Data | View Chart Data | View Full Screen | View PowerPoint Presentation
                  </center>

                  On a regional level, the percentage of outpatient visits for ILI ranged from 0.8% to 2.3% during week 47. All 10 regions reported a proportion of outpatient visits for ILI below their region-specific baseline levels.



                  ILINet State Activity Indicator Map:

                  Data collected in ILINet are used to produce a measure of ILI activity* by state. Activity levels are based on the percent of outpatient visits in a state due to ILI and are compared to the average percent of ILI visits that occur during weeks with little or no influenza virus circulation. Activity levels range from minimal, which would correspond to ILI activity from outpatient clinics being below, or only slightly above, the average, to high, which would correspond to ILI activity from outpatient clinics being much higher than average.
                  During week 47, the following ILI activity levels were experienced:
                  • Puerto Rico and one state (Louisiana) experienced high ILI activity.
                  • Two states (Alabama and Texas) experienced moderate ILI activity.
                  • Five states (Alaska, Florida, Georgia, Idaho and Mississippi) experienced low ILI activity.
                  • New York City and 42 states (Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming) experienced minimal ILI activity.
                  • Data were insufficient to calculate an ILI activity level from the District of Columbia.

                  Click on map to launch interactive tool

                  *This map uses the proportion of outpatient visits to health care providers for influenza-like illness to measure the ILI activity level within a state. It does not, however, measure the extent of geographic spread of flu within a state. Therefore, outbreaks occurring in a single city could cause the state to display high activity levels.
                  Data collected in ILINet may disproportionally represent certain populations within a state, and therefore, may not accurately depict the full picture of influenza activity for the whole state.
                  Data displayed in this map are based on data collected in ILINet, whereas the State and Territorial flu activity map is based on reports from state and territorial epidemiologists. The data presented in this map is preliminary and may change as more data is received.
                  Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.


                  Geographic Spread of Influenza as Assessed by State and Territorial Epidemiologists

                  The influenza activity reported by state and territorial epidemiologists indicates geographic spread of influenza viruses, but does not measure the severity of influenza activity.
                  During week 47, the following influenza activity was reported:
                  • Widespread influenza activity was reported by two states (Alaska and Louisiana).
                  • Regional influenza activity was reported by Puerto Rico and nine states (Alabama, Colorado, Florida, Georgia, Indiana, Maryland, Massachusetts, Minnesota and Texas).
                  • Local influenza activity was reported by 20 states (Connecticut, Delaware, Illinois, Iowa, Kansas, Michigan, Mississippi, Missouri, Montana, New Hampshire, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, Utah, Vermont, Wisconsin, and Wyoming).
                  • Sporadic influenza activity was reported by the District of Columbia, U.S. Virgin Islands, and 17 states (Arizona, Arkansas, California, Hawaii, Idaho, Kentucky, Maine, Nebraska, Nevada, New Jersey, New Mexico, North Dakota, Oregon, South Dakota, Tennessee, Washington, and West Virginia).
                  • No influenza activity was reported by two states (Rhode Island and Virginia).
                  • Guam did not report.





                  Additional National and International Influenza Surveillance Information


                  FluView Interactive: FluView includes enhanced web-based interactive applications that can provide dynamic visuals of the influenza data collected and analyzed by CDC. These FluView Interactive applications allow people to create customized, visual interpretations of influenza data, as well as make comparisons across flu seasons, regions, age groups and a variety of other demographics. To access these tools, visit http://www.cdc.gov/flu/weekly/fluviewinteractive.htm.
                  U.S. State and local influenza surveillance: Click on a jurisdiction below to access the latest local influenza information.
                  <table> <tbody><tr border="1"> <td height="8" width="139">Alabama
                  </td> <td height="8" width="139">Alaska
                  </td> <td height="8" width="139">Arizona
                  </td> <td height="8" width="139">Arkansas
                  </td> <td height="8" width="139">California
                  </td> </tr> <tr border="1"> <td height="8" width="139">Colorado
                  </td> <td height="8" width="139">Connecticut
                  </td> <td height="8" width="139">Delaware
                  </td> <td height="8" width="139">District of Columbia
                  </td> <td height="8" width="139">Florida
                  </td> </tr> <tr border="1"> <td height="8" width="139">Georgia
                  </td> <td height="8" width="139">Hawaii
                  </td> <td height="8" width="139">Idaho
                  </td> <td height="8" width="139">Illinois
                  </td> <td height="8" width="139">Indiana
                  </td> </tr> <tr border="1"> <td height="8" width="139">Iowa
                  </td> <td height="8" width="139">Kansas
                  </td> <td height="8" width="139">Kentucky
                  </td> <td height="8" width="139">Louisiana
                  </td> <td height="8" width="139">Maine
                  </td> </tr> <tr border="1"> <td height="8" width="139">Maryland
                  </td> <td height="8" width="139">Massachusetts
                  </td> <td height="8" width="139">Michigan
                  </td> <td height="8" width="139">Minnesota
                  </td> <td height="8" width="139">Mississippi
                  </td> </tr> <tr border="1"> <td height="8" width="139">Missouri
                  </td> <td height="8" width="139">Montana
                  </td> <td height="8" width="139">Nebraska
                  </td> <td height="8" width="139">Nevada
                  </td> <td height="8" width="139">New Hampshire
                  </td> </tr> <tr border="1"> <td height="8" width="139">New Jersey
                  </td> <td height="8" width="139">New Mexico
                  </td> <td height="8" width="139">New York
                  </td> <td height="8" width="139">North Carolina
                  </td> <td height="8" width="139">North Dakota
                  </td> </tr> <tr border="1"> <td height="8" width="139">Ohio
                  </td> <td height="8" width="139">Oklahoma
                  </td> <td height="8" width="139">Oregon
                  </td> <td height="8" width="139">Pennsylvania
                  </td> <td height="8" width="139">Rhode Island
                  </td> </tr> <tr border="1"> <td height="8" width="139">South Carolina
                  </td> <td height="8" width="139">South Dakota
                  </td> <td height="8" width="139">Tennessee
                  </td> <td height="8" width="139">Texas
                  </td> <td height="8" width="139">Utah
                  </td> </tr> <tr border="1"> <td height="8" width="139">Vermont
                  </td> <td height="8" width="139">Virginia
                  </td> <td height="8" width="139">Washington
                  </td> <td height="8" width="139">West Virginia
                  </td> <td height="8" width="139">Wisconsin
                  </td> </tr> <tr border="1"> <td height="8" width="139">Wyoming
                  </td> <td height="8" width="139">New York City
                  </td> <td height="8" width="139">Virgin Islands
                  </td> <td height="8" width="139">
                  </td> <td height="8" width="139">
                  </td> </tr> </tbody></table>

                  Google Flu Trends: Google Flu Trends uses aggregated Google search data in a model created in collaboration with CDC to estimate influenza activity in the United States. For more information and activity estimates from the United States and worldwide, see http://www.google.org/flutrends/
                  World Health Organization: Additional influenza surveillance information from participating WHO member nations is available through FluNet and the Global Epidemiology Reports.
                  WHO Collaborating Centers for Influenza located in Australia, China, Japan, the United Kingdom, and the United States (CDC in Atlanta, Georgia).
                  Europe: for the most recent influenza surveillance information from Europe, please see WHO/Europe at http://www.euroflu.org/index.php and visit the European Centre for Disease Prevention and Control at http://ecdc.europa.eu/en/publications/surveillance_reports/influenza/Pages/weekly_influenza_surveillance_overview.aspx
                  Public Health Agency of Canada: The most up-to-date influenza information from Canada is available at http://www.phac-aspc.gc.ca/fluwatch/
                  Public Health England: The most up-to-date influenza information from the United Kingdom is available at https://www.gov.uk/government/statistics/weekly-national-flu-reports


                  Any links provided to non-Federal organizations are provided solely as a service to our users. These links do not constitute an endorsement of these organizations or their programs by CDC or the Federal Government, and none should be inferred. CDC is not responsible for the content of the individual organization web pages found at these links.
                  In addition to the eight data components of CDC influenza surveillance for the 2014-2015 influenza season, the use of National Center for Health Statistics (NCHS) pneumonia and influenza mortality surveillance data for the rapid assessment of influenza-associated mortality will be piloted. An overview of influenza surveillance, including a description of the NCHS mortality surveillance data, is available here.


                  Comment


                  • #10
                    Re: USA: 2014-15 FluView: Influenza Season Weekly Summary, Wks 40+

                    2014-2015 Influenza Season Week 48 ending November 29, 2014


                    All data are preliminary and may change as more reports are received.
                    Synopsis:

                    During week 48 (November 23-29, 2014), influenza activity increased in the United States.
                    • Viral Surveillance: Of 13,398 specimens tested and reported by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories during week 48, 2,274 (17.0%) were positive for influenza.
                    • Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia and influenza (P&I) was below the epidemic threshold.
                    • Influenza-associated Pediatric Deaths: No influenza-associated pediatric deaths were reported.
                    • Influenza-associated Hospitalizations: A cumulative rate for the season of 1.8 laboratory-confirmed influenza-associated hospitalizations per 100,000 population was reported.
                    • Outpatient Illness Surveillance:The proportion of outpatient visits for influenza-like illness (ILI) was 2.6%, above the national baseline of 2.0%. Eight of 10 regions reported ILI at or above region-specific baseline levels. Puerto Rico and six states experienced high ILI activity; one state experienced moderate ILI activity; five states experienced low ILI activity; New York City and 38 states experienced minimal ILI activity; and the District of Columbia had insufficient data.
                    • Geographic Spread of Influenza: The geographic spread of influenza in Puerto Rico and six states was reported as widespread; 14 states reported regional activity; the U.S. Virgin Islands and 19 states reported local activity; the District of Columbia and 11 states reported sporadic activity; and Guam did not report.

                    <table class="table" border="0" cellpadding="3" cellspacing="0" width="100%"> <caption>National and Regional Summary of Select Surveillance Components

                    </caption> <tbody><tr style="vertical-align:top" bgcolor="#c5bee1"> <th rowspan="2" style="vertical-align:bottom" width="12%">HHS Surveillance Regions*</th> <th colspan="8" style="text-align: center;" nowrap="nowrap">Data cumulative since September 28, 2014 (week 40)</th> </tr> <tr style="vertical-align:middle; background-image: url(images/purplegrad.jpg); background-repeat: repeat-x;"> <th style="text-align: center;" width="8%">Out-patient ILI?</th> <th style="text-align: center;" width="16%">Number of jurisdictions reporting regional or widespread activity?</th> <th style="text-align: center;" width="10%">% Respiratory specimens positive for flu?</th> <th style="text-align: center;" nowrap="nowrap" width="9%">A(H1N1)pdm09</th> <th style="text-align: center;" width="8%">A (H3)</th> <th style="text-align: center;" width="19%">A(Subtyping not performed)</th> <th style="text-align: center;" nowrap="nowrap" width="7%">B</th> <th style="text-align: center;" width="11%">Pediatric Deaths</th> </tr> <tr> <td style="text-align: left;" width="12%">Nation</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Elevated</td> <td style="text-align: center;" nowrap="nowrap" width="16%">21 of 54</td> <td style="text-align: center;" nowrap="nowrap" width="10%">17.0%</td> <td style="text-align: center;" nowrap="nowrap" width="9%">33</td> <td style="text-align: center;" nowrap="nowrap" width="8%">3,093</td> <td style="text-align: center;" nowrap="nowrap" width="19%">4,502</td> <td style="text-align: center;" nowrap="nowrap" width="7%">1,234</td> <td style="text-align: center;" nowrap="nowrap" width="11%">5</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 1</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Elevated</td> <td style="text-align: center;" nowrap="nowrap" width="16%">3 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="10%">2.3%</td> <td style="text-align: center;" nowrap="nowrap" width="9%">1</td> <td style="text-align: center;" nowrap="nowrap" width="8%">36</td> <td style="text-align: center;" nowrap="nowrap" width="19%">24</td> <td style="text-align: center;" nowrap="nowrap" width="7%">15</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 2</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Elevated</td> <td style="text-align: center;" nowrap="nowrap" width="16%">1 of 4</td> <td style="text-align: center;" nowrap="nowrap" width="10%">1.7%</td> <td style="text-align: center;" nowrap="nowrap" width="9%">6</td> <td style="text-align: center;" nowrap="nowrap" width="8%">114</td> <td style="text-align: center;" nowrap="nowrap" width="19%">33</td> <td style="text-align: center;" nowrap="nowrap" width="7%">29</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 3</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Elevated</td> <td style="text-align: center;" nowrap="nowrap" width="16%">1 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="10%">8.5%</td> <td style="text-align: center;" nowrap="nowrap" width="9%">1</td> <td style="text-align: center;" nowrap="nowrap" width="8%">223</td> <td style="text-align: center;" nowrap="nowrap" width="19%">131</td> <td style="text-align: center;" nowrap="nowrap" width="7%">44</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 4</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Elevated</td> <td style="text-align: center;" nowrap="nowrap" width="16%">6 of 8</td> <td style="text-align: center;" nowrap="nowrap" width="10%">14.1%</td> <td style="text-align: center;" nowrap="nowrap" width="9%">2</td> <td style="text-align: center;" nowrap="nowrap" width="8%">484</td> <td style="text-align: center;" nowrap="nowrap" width="19%">2,039</td> <td style="text-align: center;" nowrap="nowrap" width="7%">646</td> <td style="text-align: center;" nowrap="nowrap" width="11%">4</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 5</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Elevated</td> <td style="text-align: center;" nowrap="nowrap" width="16%">4 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="10%">19.8%</td> <td style="text-align: center;" nowrap="nowrap" width="9%">9</td> <td style="text-align: center;" nowrap="nowrap" width="8%">473</td> <td style="text-align: center;" nowrap="nowrap" width="19%">831</td> <td style="text-align: center;" nowrap="nowrap" width="7%">66</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 6</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Elevated</td> <td style="text-align: center;" nowrap="nowrap" width="16%">3 of 5</td> <td style="text-align: center;" nowrap="nowrap" width="10%">22.7%</td> <td style="text-align: center;" nowrap="nowrap" width="9%">4</td> <td style="text-align: center;" nowrap="nowrap" width="8%">569</td> <td style="text-align: center;" nowrap="nowrap" width="19%">1,116</td> <td style="text-align: center;" nowrap="nowrap" width="7%">296</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 7</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Elevated</td> <td style="text-align: center;" nowrap="nowrap" width="16%">0 of 4</td> <td style="text-align: center;" nowrap="nowrap" width="10%">10.0%</td> <td style="text-align: center;" nowrap="nowrap" width="9%">2</td> <td style="text-align: center;" nowrap="nowrap" width="8%">203</td> <td style="text-align: center;" nowrap="nowrap" width="19%">63</td> <td style="text-align: center;" nowrap="nowrap" width="7%">42</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 8</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="16%">2 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="10%">11.2%</td> <td style="text-align: center;" nowrap="nowrap" width="9%">3</td> <td style="text-align: center;" nowrap="nowrap" width="8%">233</td> <td style="text-align: center;" nowrap="nowrap" width="19%">131</td> <td style="text-align: center;" nowrap="nowrap" width="7%">27</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 9</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="16%">0 of 5</td> <td style="text-align: center;" nowrap="nowrap" width="10%">3.0%</td> <td style="text-align: center;" nowrap="nowrap" width="9%">4</td> <td style="text-align: center;" nowrap="nowrap" width="8%">164</td> <td style="text-align: center;" nowrap="nowrap" width="19%">66</td> <td style="text-align: center;" nowrap="nowrap" width="7%">51</td> <td style="text-align: center;" nowrap="nowrap" width="11%">1</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 10</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Elevated</td> <td style="text-align: center;" nowrap="nowrap" width="16%">1 of 4</td> <td style="text-align: center;" nowrap="nowrap" width="10%">18.4%</td> <td style="text-align: center;" nowrap="nowrap" width="9%">1</td> <td style="text-align: center;" nowrap="nowrap" width="8%">594</td> <td style="text-align: center;" nowrap="nowrap" width="19%">68</td> <td style="text-align: center;" nowrap="nowrap" width="7%">18</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> </tbody></table>
                    *HHS regions (Region 1 CT, ME, MA, NH, RI, VT; Region 2: NJ, NY, Puerto Rico, US Virgin Islands; Region 3: DE, DC, MD, PA, VA, WV; Region 4: AL, FL, GA, KY, MS, NC, SC, TN; Region 5: IL, IN, MI, MN, OH, WI; Region 6: AR, LA, NM, OK, TX; Region 7: IA, KS, MO, NE; Region 8: CO, MT, ND, SD, UT, WY; Region 9: AZ, CA, Guam, HI, NV; and Region 10: AK, ID, OR, WA).
                    ? Elevated means the % of visits for ILI is at or above the national or region-specific baseline
                    ? Includes all 50 states, the District of Columbia, Guam, Puerto Rico, and U.S. Virgin Islands
                    ? National data are for current week; regional data are for the most recent three weeks




                    U.S. Virologic Surveillance:

                    WHO and NREVSS collaborating laboratories located in all 50 states, Puerto Rico, and the District of Columbia report to CDC the number of respiratory specimens tested for influenza and the number positive by influenza virus type and influenza A virus subtype. The results of tests performed during the current week are summarized in the table below. Region specific data are available at http://gis.cdc.gov/grasp/fluview/flu...dashboard.html.
                    <table class="table" align="center" border="0" cellpadding="2" cellspacing="0"> <tbody><tr style="background-image: url(images/purplegrad.jpg); background-repeat: repeat-x;"> <th style="text-align: left;" width="270">
                    </th> <th style="text-align: center;" nowrap="nowrap" width="150">Week 48</th> </tr> <tr> <th style="text-align: left;" width="270">No. of specimens tested</th> <td style="text-align: center;" nowrap="nowrap" width="150">13,398</td> </tr> <tr> <th style="text-align: left;" width="270">No. of positive specimens (%)</th> <td style="text-align: center;" nowrap="nowrap" width="150">2,274 (17.0%)</td> </tr> <tr> <th style="text-align: left;" width="270">Positive specimens by type/subtype</th> <td style="text-align: center;" nowrap="nowrap" width="150">
                    </td> </tr> <tr> <th style="text-align: left;" width="270"> Influenza A</th> <td style="text-align: center;" nowrap="nowrap" width="150">2,129 (93.6%)</td> </tr> <tr> <th style="text-align: left;" width="270"> A(H1N1)pdm09</th> <td style="text-align: right;" nowrap="nowrap" width="150">5 (0.2%) </td> </tr> <tr> <th style="text-align: left;" width="270"> H3</th> <td style="text-align: right;" nowrap="nowrap" width="150">656 (30.8%) </td> </tr> <tr> <th style="text-align: left;" width="270"> Subytping not performed</th> <td style="text-align: right;" nowrap="nowrap" width="150">1,468 (69.0%) </td> </tr> <tr> <th style="text-align: left;" width="270"> Influenza B</th> <td style="text-align: center;" nowrap="nowrap" width="150">145 (6.4%)</td> </tr> </tbody></table> <center>
                    View National and Regional Level Graphs and Data | View Chart Data | View Full Screen | View PowerPoint Presentation </center>



                    Influenza Virus Characterization*:

                    CDC has characterized 132 influenza viruses [1 A(H1N1)pdm09, 114 A(H3N2), and 17 influenza B viruses] collected by U.S. laboratories since October 1, 2014.
                    Influenza A Virus [115]
                    • A(H1N1)pdm09 [1]: The one H1N1 virus tested was characterized as A/California/7/2009-like, the influenza A (H1N1) component of the 2014-2015 Northern Hemisphere influenza vaccine.

                    • A (H3N2) [114]: Forty-eight (42%) of the 114 H3N2 viruses tested have been characterized as A/Texas/50/2012-like, the influenza A (H3N2) component of the 2014-2015 Northern Hemisphere influenza vaccine. Sixty-six (58%) of the 114 viruses tested showed either reduced titers with antiserum produced against A/Texas/50/2012 or belonged to a genetic group that typically shows reduced titers to A/Texas/50/2012. Among viruses that showed reduced titers with antiserum raised against A/Texas/50/2012, most were antigenically similar to A/Switzerland/9715293/2013, the H3N2 virus selected for the 2015 Southern Hemisphere influenza vaccine. A/Switzerland/9715293/2013 is related to, but antigenically and genetically distinguishable, from the A/Texas/50/2012 vaccine virus. A/Switzerland-like H3N2 viruses were first detected in the United States in small numbers in March of 2014 and began to increase through the spring and summer.

                    Influenza B Virus [17]
                    Ten (58.8%) of the influenza B viruses tested belong to B/Yamagata/16/88 lineage and the remaining seven (41.2%) influenza B viruses tested belong to B/Victoria/02/87 lineage.
                    • Yamagata Lineage [10]: All ten B/Yamagata-lineage viruses were characterized as B/Massachusetts/2/2012-like, which is included as an influenza B component of the 2014-2015 Northern Hemisphere trivalent and quadrivalent influenza vaccines.

                    • Victoria Lineage [7]: All seven B/Victoria-lineage viruses were characterized as B/Brisbane/60/2008-like, the virus that is included as an influenza B component of the 2014-2015 Northern Hemisphere quadrivalent influenza vaccine.

                    *CDC routinely uses hemagglutination inhibition (HI) assays to antigenically characterize influenza viruses year-round to compare how similar currently circulating influenza viruses are to those included in the influenza vaccine, and to monitor for changes in circulating influenza viruses. However, a portion of recent influenza A(H3N2) viruses do not grow to sufficient hemagglutination titers for antigenic characterization by HI. For many of these viruses, CDC is also performing genetic characterization to infer antigenic properties.


                    Antiviral Resistance:

                    Testing of influenza A(H1N1)pdm09, A(H3N2), and influenza B virus isolates for resistance to neuraminidase inhibitors (oseltamivir and zanamivir) is performed at CDC using a functional assay. Additional A(H1N1)pdm09 and A(H3N2) clinical samples are tested for mutations of the virus known to confer oseltamivir resistance. The data summarized below combine the results of both testing methods. These samples are routinely obtained for surveillance purposes rather than for diagnostic testing of patients suspected to be infected with antiviral-resistant virus.
                    High levels of resistance to the adamantanes (amantadine and rimantadine) persist among A(H1N1)pdm09 and A(H3N2) viruses (the adamantanes are not effective against influenza B viruses). Therefore, data from adamantane resistance testing are not presented below.
                    <table class="table" style="text-align: center;" align="center" border="0" cellpadding="3" cellspacing="0"> <caption> Neuraminidase Inhibitor Resistance Testing Results on Samples Collected Since October 1, 2014

                    </caption> <tbody><tr bgcolor="#c5bee1"> <td rowspan="2" style="width:81.0pt;border:1.0pt; padding:0in 5.4pt 0in 5.4pt;height:27.85pt;" width="108">
                    </td> <th colspan="2" style="width:2.0in;border:1.0pt;vertical-align:middle;height:27.85pt" width="192">Oseltamivir</th> <th colspan="2" style="width:2.0in;border:1.0pt;vertical-align:middle;;height:27.85pt" width="192">Zanamivir</th> </tr> <tr style="height:25.15pt;text-align:center;background-image: url(file://///cdc.gov/ahb_apps/WWWLINK_CDC_GOV/flu/weekly/images/purplegrad.jpg); background-repeat:repeat-x;"> <th style="width:63.0pt;text-align:center;" align="center" width="84">Virus Samples tested (n)</th> <th style="width:63.0pt;text-align:center;" align="center" width="84">Resistant Viruses, Number (%)</th> <th style="width:63.0pt;text-align:center;" align="center" width="84">Virus Samples tested (n)</th> <th style="width:63.0pt;text-align:center;" align="center" width="84">Resistant Viruses, Number (%)</th> </tr> <tr> <th style="text-align: left;" bgcolor="#dad5eb" nowrap="nowrap" width="160">Influenza A (H3N2)</th> <td style="text-align: center;" nowrap="nowrap" width="100">71</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> <td style="text-align: center;" nowrap="nowrap" width="100">71</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> </tr> <tr> <th style="text-align: left;" bgcolor="#dad5eb" nowrap="nowrap" width="160">Influenza B</th> <td style="text-align: center;" nowrap="nowrap" width="100">24</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> <td style="text-align: center;" nowrap="nowrap" width="100">24</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> </tr> <tr> <th style="text-align: left;" bgcolor="#dad5eb" nowrap="nowrap" width="160">A(H1N1)pdm09</th> <td style="text-align: center;" nowrap="nowrap" width="100">5</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> <td style="text-align: center;" nowrap="nowrap" width="100">5</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> </tr> </tbody></table>
                    In the United States, all recently circulating influenza viruses have been susceptible to the neuraminidase inhibitor antiviral medications, oseltamivir and zanamivir; however, rare sporadic instances of oseltamivir-resistant A(H1N1)pdm09 and A(H3N2) viruses have been detected worldwide. Antiviral treatment with oseltamivir or zanamivir is recommended as early as possible for patients with confirmed or suspected influenza who have severe, complicated, or progressive illness; who require hospitalization; or who are at high risk for serious influenza-related complications. Additional information on recommendations for treatment and chemoprophylaxis of influenza virus infection with antiviral agents is available at http://www.cdc.gov/flu/antivirals/index.htm.


                    Pneumonia and Influenza (P&I) Mortality Surveillance:

                    During week 48, 5.4% of all deaths reported through the 122 Cities Mortality Reporting System were due to P&I. This percentage was below the epidemic threshold of 6.5% for week 48.
                    <center>
                    View Full Screen | View PowerPoint Presentation </center>

                    For the 2014-2015 influenza season, CDC/Influenza Division and the National Center for Health Statistics (NCHS) are collaborating on a pilot project to use NCHS mortality surveillance data for the rapid assessment of pneumonia and influenza (P&I) mortality. To view the data, please click here.


                    Influenza-Associated Pediatric Mortality:

                    No influenza-associated pediatric deaths were reported to CDC during week 48. To date, five influenza-associated pediatric deaths have been reported for the 2014-2015 season.

                    Additional data can be found at: http://gis.cdc.gov/GRASP/Fluview/PedFluDeath.html.
                    <center>
                    View Interactive Application | View Full Screen | View PowerPoint Presentation </center>



                    Influenza-Associated Hospitalizations:

                    The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts population-based surveillance for laboratory-confirmed influenza-related hospitalizations in children younger than 18 years of age (since the 2003-2004 influenza season) and adults (since the 2005-2006 influenza season).
                    The FluSurv-NET covers more than 70 counties in the 10 Emerging Infections Program (EIP) states (CA, CO, CT, GA, MD, MN, NM, NY, OR, and TN) and additional Influenza Hospitalization Surveillance Project (IHSP) states. The IHSP began during the 2009-2010 season to enhance surveillance during the 2009 H1N1 pandemic. IHSP sites included IA, ID, MI, OK and SD during the 2009-2010 season; ID, MI, OH, OK, RI, and UT during the 2010-2011 season; MI, OH, RI, and UT during the 2011-2012 season; IA, MI, OH, RI, and UT during the 2012-2013 season; and MI, OH, and UT during the 2013-2014 and 2014-15 seasons.
                    Data gathered are used to estimate age-specific hospitalization rates on a weekly basis, and describe characteristics of persons hospitalized with severe influenza illness. The rates provided are likely to be an underestimate as influenza-related hospitalizations can be missed, either because testing is not performed, or because cases may be attributed to other causes of pneumonia or other common influenza-related complications.
                    Between October 1, 2014 and November 29, 2014, 500 laboratory-confirmed influenza-associated hospitalizations were reported. The overall hospitalization rate was 1.8 per 100,000 population. The highest rate of hospitalization was among adults aged ≥65 years (5.9 per 100,000 population). Among all hospitalizations, 444 (88.8%) were associated with influenza A, 51 (10.2%) with influenza B, 3 (0.6%) with influenza A and B co-infection, and 2 (0.4%) had no virus type information. Among those with influenza A subtype information, 116 (100%) were H3N2 virus.
                    Clinical findings are preliminary and based on 109 (22%) pediatric and adult cases with complete medical chart abstraction. The majority (93%) of hospitalized adults had at least one reported underlying medical condition; the most commonly reported were metabolic disorders, cardiovascular disease, and obesity. Seven (7%) hospitalized adults had no identified underlying medical conditions. Among the 12 hospitalized children with complete medical chart abstraction, 6 (50%) had no identified underlying medical conditions. Among the nine hospitalized women of childbearing age (15-44 years), four were pregnant.
                    Additional FluSurv-NET data can be found at:http://gis.cdc.gov/GRASP/Fluview/FluHospRates.html and http://gis.cdc.gov/grasp/fluview/FluHospChars.html.

                    <center>
                    View Interactive Application | View Full Screen | View PowerPoint Presentation
                    </center>

                    Outpatient Illness Surveillance:

                    Nationwide during week 48, 2.6% 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 2.0%.
                    (ILI is defined as fever (temperature of 100?F [37.8?C] or greater) and cough and/or sore throat.)

                    Additional data are available at http://gis.cdc.gov/grasp/fluview/flu...dashboard.html.
                    <center>
                    View National and Regional Level Graphs and Data | View Chart Data | View Full Screen | View PowerPoint Presentation
                    </center>

                    On a regional level, the percentage of outpatient visits for ILI ranged from 1.0% to 4.5% during week 48. Eight regions (Regions 1, 2, 3, 4, 5, 6, 7, and 10) reported a proportion of outpatient visits for ILI at or above their region-specific baseline levels.



                    ILINet State Activity Indicator Map:

                    Data collected in ILINet are used to produce a measure of ILI activity* by state. Activity levels are based on the percent of outpatient visits in a state due to ILI and are compared to the average percent of ILI visits that occur during weeks with little or no influenza virus circulation. Activity levels range from minimal, which would correspond to ILI activity from outpatient clinics being below, or only slightly above, the average, to high, which would correspond to ILI activity from outpatient clinics being much higher than average.
                    During week 48, the following ILI activity levels were experienced:
                    • Puerto Rico and six states (Alabama, Florida, Georgia, Louisiana, Mississippi, and Texas) experienced high ILI activity.
                    • One state (Illinois) experienced moderate ILI activity.
                    • Five states (Kansas, Missouri, Nevada, Utah, and Virginia) experienced low ILI activity.
                    • New York City and 38 states (Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Hawaii, Idaho, Indiana, Iowa, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nebraska, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Vermont, Washington, West Virginia, Wisconsin, and Wyoming) experienced minimal ILI activity.
                    • Data were insufficient to calculate an ILI activity level from the District of Columbia.

                    Click on map to launch interactive tool

                    *This map uses the proportion of outpatient visits to health care providers for influenza-like illness to measure the ILI activity level within a state. It does not, however, measure the extent of geographic spread of flu within a state. Therefore, outbreaks occurring in a single city could cause the state to display high activity levels.
                    Data collected in ILINet may disproportionally represent certain populations within a state, and therefore, may not accurately depict the full picture of influenza activity for the whole state.
                    Data displayed in this map are based on data collected in ILINet, whereas the State and Territorial flu activity map is based on reports from state and territorial epidemiologists. The data presented in this map is preliminary and may change as more data is received.
                    Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.


                    Geographic Spread of Influenza as Assessed by State and Territorial Epidemiologists

                    The influenza activity reported by state and territorial epidemiologists indicates geographic spread of influenza viruses, but does not measure the severity of influenza activity.
                    During week 48, the following influenza activity was reported:
                    • Widespread influenza activity was reported by Puerto Rico and six states (Alaska, Florida, Illinois, Louisiana, Maryland, and North Carolina).
                    • Regional influenza activity was reported by 14 states (Alabama, Colorado, Georgia, Indiana, Kentucky, Maine, Massachusetts, Minnesota, Mississippi, New Hampshire, Oklahoma, Texas, Utah, and Wisconsin).
                    • Local influenza activity was reported by the U.S. Virgin Islands and 19 states (Arkansas, Connecticut, Delaware, Iowa, Kansas, Michigan, Missouri, Montana, Nebraska, Nevada, New Jersey, New York, Ohio, Oregon, Pennsylvania, South Carolina, Vermont, Virginia, and Wyoming).
                    • Sporadic influenza activity was reported by the District of Columbia and 11 states (Arizona, California, Hawaii, Idaho, New Mexico, North Dakota, Rhode Island, South Dakota, Tennessee, Washington, and West Virginia).
                    • Guam did not report.







                    Additional National and International Influenza Surveillance Information


                    FluView Interactive: FluView includes enhanced web-based interactive applications that can provide dynamic visuals of the influenza data collected and analyzed by CDC. These FluView Interactive applications allow people to create customized, visual interpretations of influenza data, as well as make comparisons across flu seasons, regions, age groups and a variety of other demographics. To access these tools, visit http://www.cdc.gov/flu/weekly/fluviewinteractive.htm.
                    U.S. State and local influenza surveillance: Click on a jurisdiction below to access the latest local influenza information.
                    <table> <tbody><tr border="1"> <td height="8" width="139">Alabama
                    </td> <td height="8" width="139">Alaska
                    </td> <td height="8" width="139">Arizona
                    </td> <td height="8" width="139">Arkansas
                    </td> <td height="8" width="139">California
                    </td> </tr> <tr border="1"> <td height="8" width="139">Colorado
                    </td> <td height="8" width="139">Connecticut
                    </td> <td height="8" width="139">Delaware
                    </td> <td height="8" width="139">District of Columbia
                    </td> <td height="8" width="139">Florida
                    </td> </tr> <tr border="1"> <td height="8" width="139">Georgia
                    </td> <td height="8" width="139">Hawaii
                    </td> <td height="8" width="139">Idaho
                    </td> <td height="8" width="139">Illinois
                    </td> <td height="8" width="139">Indiana
                    </td> </tr> <tr border="1"> <td height="8" width="139">Iowa
                    </td> <td height="8" width="139">Kansas
                    </td> <td height="8" width="139">Kentucky
                    </td> <td height="8" width="139">Louisiana
                    </td> <td height="8" width="139">Maine
                    </td> </tr> <tr border="1"> <td height="8" width="139">Maryland
                    </td> <td height="8" width="139">Massachusetts
                    </td> <td height="8" width="139">Michigan
                    </td> <td height="8" width="139">Minnesota
                    </td> <td height="8" width="139">Mississippi
                    </td> </tr> <tr border="1"> <td height="8" width="139">Missouri
                    </td> <td height="8" width="139">Montana
                    </td> <td height="8" width="139">Nebraska
                    </td> <td height="8" width="139">Nevada
                    </td> <td height="8" width="139">New Hampshire
                    </td> </tr> <tr border="1"> <td height="8" width="139">New Jersey
                    </td> <td height="8" width="139">New Mexico
                    </td> <td height="8" width="139">New York
                    </td> <td height="8" width="139">North Carolina
                    </td> <td height="8" width="139">North Dakota
                    </td> </tr> <tr border="1"> <td height="8" width="139">Ohio
                    </td> <td height="8" width="139">Oklahoma
                    </td> <td height="8" width="139">Oregon
                    </td> <td height="8" width="139">Pennsylvania
                    </td> <td height="8" width="139">Rhode Island
                    </td> </tr> <tr border="1"> <td height="8" width="139">South Carolina
                    </td> <td height="8" width="139">South Dakota
                    </td> <td height="8" width="139">Tennessee
                    </td> <td height="8" width="139">Texas
                    </td> <td height="8" width="139">Utah
                    </td> </tr> <tr border="1"> <td height="8" width="139">Vermont
                    </td> <td height="8" width="139">Virginia
                    </td> <td height="8" width="139">Washington
                    </td> <td height="8" width="139">West Virginia
                    </td> <td height="8" width="139">Wisconsin
                    </td> </tr> <tr border="1"> <td height="8" width="139">Wyoming
                    </td> <td height="8" width="139">New York City
                    </td> <td height="8" width="139">Virgin Islands
                    </td> <td height="8" width="139">
                    </td> <td height="8" width="139">
                    </td> </tr> </tbody></table>

                    Google Flu Trends: Google Flu Trends uses aggregated Google search data in a model created in collaboration with CDC to estimate influenza activity in the United States. For more information and activity estimates from the United States and worldwide, see http://www.google.org/flutrends/
                    World Health Organization: Additional influenza surveillance information from participating WHO member nations is available through FluNet and the Global Epidemiology Reports.
                    WHO Collaborating Centers for Influenza located in Australia, China, Japan, the United Kingdom, and the United States (CDC in Atlanta, Georgia).
                    Europe: for the most recent influenza surveillance information from Europe, please see WHO/Europe at http://www.euroflu.org/index.php and visit the European Centre for Disease Prevention and Control at http://ecdc.europa.eu/en/publications/surveillance_reports/influenza/Pages/weekly_influenza_surveillance_overview.aspx
                    Public Health Agency of Canada: The most up-to-date influenza information from Canada is available at http://www.phac-aspc.gc.ca/fluwatch/
                    Public Health England: The most up-to-date influenza information from the United Kingdom is available at https://www.gov.uk/government/statistics/weekly-national-flu-reports


                    Any links provided to non-Federal organizations are provided solely as a service to our users. These links do not constitute an endorsement of these organizations or their programs by CDC or the Federal Government, and none should be inferred. CDC is not responsible for the content of the individual organization web pages found at these links.
                    In addition to the eight data components of CDC influenza surveillance for the 2014-2015 influenza season, the use of National Center for Health Statistics (NCHS) pneumonia and influenza mortality surveillance data for the rapid assessment of influenza-associated mortality will be piloted. An overview of influenza surveillance, including a description of the NCHS mortality surveillance data, is available here.
                    -------------------------------------------------------------------------------- Full report also available as PDF





                    Learn more about the weekly influenza surveillance report (FluView) prepared by the Influenza Division.

                    Comment


                    • #11
                      Re: USA: 2014-15 FluView: Influenza Season Weekly Summary, Wks 40+


                      2014-2015 Influenza Season Week 49 ending December 6, 2014


                      All data are preliminary and may change as more reports are received.
                      Synopsis:

                      During week 49 (November 30-December 6, 2014), influenza activity continued to increase in the United States.
                      • Viral Surveillance:Of 16,093 specimens tested and reported by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories during week 49, 3,415 (21.2%) were positive for influenza.
                      • Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia and influenza (P&I) was below the epidemic threshold.
                      • Influenza-associated Pediatric Deaths: Two influenza-associated pediatric deaths were reported.
                      • Influenza-associated Hospitalizations: A cumulative rate for the season of 3.8 laboratory-confirmed influenza-associated hospitalizations per 100,000 population was reported.
                      • Outpatient Illness Surveillance: The proportion of outpatient visits for influenza-like illness (ILI) was 2.5%, above the national baseline of 2.0%. Eight of 10 regions reported ILI at or above region-specific baseline levels. Puerto Rico and six states experienced high ILI activity; two states experienced moderate ILI activity; seven states experienced low ILI activity; New York City and 35 states experienced minimal ILI activity; and the District of Columbia had insufficient data.
                      • Geographic Spread of Influenza: The geographic spread of influenza in 14 states was reported as widespread; Guam, Puerto Rico and 25 states reported regional activity; the U.S. Virgin Islands and seven states reported local activity; and the District of Columbia and four states reported sporadic activity.

                      <table class="table" border="0" cellpadding="3" cellspacing="0" width="100%"> <caption>National and Regional Summary of Select Surveillance Components

                      </caption> <tbody><tr style="vertical-align:top" bgcolor="#c5bee1"> <th rowspan="2" style="vertical-align:bottom" width="143">HHS Surveillance Regions*</th> <th colspan="3" style="text-align:center">Data for Current Week</th> <th colspan="5" style="text-align:center">Data Cumulative Since September 28, 2014 (Week 40)</th> </tr> <tr style="vertical-align:middle; background-image: url(images/purplegrad.jpg); background-repeat: repeat-x;"> <th style="text-align: center;" width="8%">Out-patient ILI?</th> <th style="text-align: center;" width="15%">Number of jurisdictions reporting regional or widespread activity?</th> <th style="text-align: center;" width="11%">% Respiratory specimens positive for flu?</th> <th style="text-align: center;" nowrap="nowrap" width="9%">A(H1N1)pdm09</th> <th style="text-align: center;" width="8%">A (H3)</th> <th style="text-align: center;" width="19%">A(Subtyping not performed)</th> <th style="text-align: center;" nowrap="nowrap" width="7%">B</th> <th style="text-align: center;" width="11%">Pediatric Deaths</th> </tr> <tr> <td style="text-align: left;" width="12%">Nation</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Elevated</td> <td style="text-align: center;" nowrap="nowrap" width="15%">41 of 54</td> <td style="text-align: center;" nowrap="nowrap" width="11%">21.2%</td> <td style="text-align: center;" nowrap="nowrap" width="9%">45</td> <td style="text-align: center;" nowrap="nowrap" width="8%">5,077</td> <td style="text-align: center;" nowrap="nowrap" width="19%">7,052</td> <td style="text-align: center;" nowrap="nowrap" width="7%">1,466</td> <td style="text-align: center;" nowrap="nowrap" width="11%">7</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 1</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="15%">5 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="11%">4.6%</td> <td style="text-align: center;" nowrap="nowrap" width="9%">1</td> <td style="text-align: center;" nowrap="nowrap" width="8%">70</td> <td style="text-align: center;" nowrap="nowrap" width="19%">41</td> <td style="text-align: center;" nowrap="nowrap" width="7%">15</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 2</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Elevated</td> <td style="text-align: center;" nowrap="nowrap" width="15%">2 of 4</td> <td style="text-align: center;" nowrap="nowrap" width="11%">4.5%</td> <td style="text-align: center;" nowrap="nowrap" width="9%">13</td> <td style="text-align: center;" nowrap="nowrap" width="8%">186</td> <td style="text-align: center;" nowrap="nowrap" width="19%">103</td> <td style="text-align: center;" nowrap="nowrap" width="7%">34</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 3</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Elevated</td> <td style="text-align: center;" nowrap="nowrap" width="15%">5 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="11%">16.1%</td> <td style="text-align: center;" nowrap="nowrap" width="9%">2</td> <td style="text-align: center;" nowrap="nowrap" width="8%">494</td> <td style="text-align: center;" nowrap="nowrap" width="19%">185</td> <td style="text-align: center;" nowrap="nowrap" width="7%">51</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 4</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Elevated</td> <td style="text-align: center;" nowrap="nowrap" width="15%">8 of 8</td> <td style="text-align: center;" nowrap="nowrap" width="11%">17.1%</td> <td style="text-align: center;" nowrap="nowrap" width="9%">2</td> <td style="text-align: center;" nowrap="nowrap" width="8%">748</td> <td style="text-align: center;" nowrap="nowrap" width="19%">2,819</td> <td style="text-align: center;" nowrap="nowrap" width="7%">733</td> <td style="text-align: center;" nowrap="nowrap" width="11%">4</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 5</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Elevated</td> <td style="text-align: center;" nowrap="nowrap" width="15%">6 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="11%">27.5%</td> <td style="text-align: center;" nowrap="nowrap" width="9%">11</td> <td style="text-align: center;" nowrap="nowrap" width="8%">1,045</td> <td style="text-align: center;" nowrap="nowrap" width="19%">1,536</td> <td style="text-align: center;" nowrap="nowrap" width="7%">101</td> <td style="text-align: center;" nowrap="nowrap" width="11%">2</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 6</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Elevated</td> <td style="text-align: center;" nowrap="nowrap" width="15%">4 of 5</td> <td style="text-align: center;" nowrap="nowrap" width="11%">26.0%</td> <td style="text-align: center;" nowrap="nowrap" width="9%">3</td> <td style="text-align: center;" nowrap="nowrap" width="8%">847</td> <td style="text-align: center;" nowrap="nowrap" width="19%">1,728</td> <td style="text-align: center;" nowrap="nowrap" width="7%">370</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 7</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Elevated</td> <td style="text-align: center;" nowrap="nowrap" width="15%">3 of 4</td> <td style="text-align: center;" nowrap="nowrap" width="11%">15.9%</td> <td style="text-align: center;" nowrap="nowrap" width="9%">4</td> <td style="text-align: center;" nowrap="nowrap" width="8%">337</td> <td style="text-align: center;" nowrap="nowrap" width="19%">248</td> <td style="text-align: center;" nowrap="nowrap" width="7%">50</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 8</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Elevated</td> <td style="text-align: center;" nowrap="nowrap" width="15%">4 of 6</td> <td style="text-align: center;" nowrap="nowrap" width="11%">19.3%</td> <td style="text-align: center;" nowrap="nowrap" width="9%">3</td> <td style="text-align: center;" nowrap="nowrap" width="8%">404</td> <td style="text-align: center;" nowrap="nowrap" width="19%">225</td> <td style="text-align: center;" nowrap="nowrap" width="7%">32</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 9</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Normal</td> <td style="text-align: center;" nowrap="nowrap" width="15%">2 of 5</td> <td style="text-align: center;" nowrap="nowrap" width="11%">5.8%</td> <td style="text-align: center;" nowrap="nowrap" width="9%">4</td> <td style="text-align: center;" nowrap="nowrap" width="8%">245</td> <td style="text-align: center;" nowrap="nowrap" width="19%">93</td> <td style="text-align: center;" nowrap="nowrap" width="7%">58</td> <td style="text-align: center;" nowrap="nowrap" width="11%">1</td> </tr> <tr> <td style="text-align: left;" width="12%">Region 10</td> <td style="text-align: center;" nowrap="nowrap" width="8%">Elevated</td> <td style="text-align: center;" nowrap="nowrap" width="15%">2 of 4</td> <td style="text-align: center;" nowrap="nowrap" width="11%">15.5%</td> <td style="text-align: center;" nowrap="nowrap" width="9%">2</td> <td style="text-align: center;" nowrap="nowrap" width="8%">701</td> <td style="text-align: center;" nowrap="nowrap" width="19%">74</td> <td style="text-align: center;" nowrap="nowrap" width="7%">22</td> <td style="text-align: center;" nowrap="nowrap" width="11%">0</td> </tr> </tbody></table>
                      *HHS regions (Region 1 CT, ME, MA, NH, RI, VT; Region 2: NJ, NY, Puerto Rico, US Virgin Islands; Region 3: DE, DC, MD, PA, VA, WV; Region 4: AL, FL, GA, KY, MS, NC, SC, TN; Region 5: IL, IN, MI, MN, OH, WI; Region 6: AR, LA, NM, OK, TX; Region 7: IA, KS, MO, NE; Region 8: CO, MT, ND, SD, UT, WY; Region 9: AZ, CA, Guam, HI, NV; and Region 10: AK, ID, OR, WA).
                      ? Elevated means the % of visits for ILI is at or above the national or region-specific baseline
                      ? Includes all 50 states, the District of Columbia, Guam, Puerto Rico, and U.S. Virgin Islands
                      ? National data are for current week; regional data are for the most recent three weeks




                      U.S. Virologic Surveillance:

                      WHO and NREVSS collaborating laboratories located in all 50 states, Puerto Rico, and the District of Columbia report to CDC the number of respiratory specimens tested for influenza and the number positive by influenza virus type and influenza A virus subtype. The results of tests performed during the current week are summarized in the table below. Region specific data are available at http://gis.cdc.gov/grasp/fluview/flu...dashboard.html.
                      <table id="CDCTable_0" class="table table-bordered opt-in"><thead class="primary-bg-color"> <tr> <th class="span9"> </th> <th class="span5" scope="col"> Week 49
                      </th> <th class="span5" scope="col"> Data Cumulative
                      since September 28, 2014
                      (Week 40)

                      </th> </tr> </thead> <tbody><tr> <th scope="row"> No. of specimens tested
                      </th> <td> 16,093
                      </td> <td> 124,618
                      </td> </tr> <tr> <th scope="row"> No. of positive specimens (%)
                      </th> <td> 3,415 (21.2%)
                      </td> <td> 13,641 (10.9%)
                      </td> </tr> <tr> <th scope="row"> Positive specimens by type/subtype
                      </th> <td> </td> <td> </td> </tr> <tr> <th scope="row"> Influenza A
                      </th> <td> 3,252 (95.2%)
                      </td> <td> 12,175 (89.3%)
                      </td> </tr> <tr> <th scope="row"> A(H1N1)pdm09
                      </th> <td> 7 (0.2%)
                      </td> <td> 45 (0.4%)
                      </td> </tr> <tr> <th scope="row"> H3
                      </th> <td> 1,254 (38.6%)
                      </td> <td> 5,077 (41.7%)
                      </td> </tr> <tr> <th scope="row"> Subytping not performed
                      </th> <td> 1,991 (61.2%)
                      </td> <td> 7,052 (57.9%)
                      </td> </tr> <tr> <th scope="row"> Influenza B
                      </th> <td> 163 (4.8%)
                      </td> <td> 1,466 (10.7%)
                      </td> </tr> </tbody></table> <center>
                      View National and Regional Level Graphs and Data | View Chart Data | View Full Screen | View PowerPoint Presentation </center>



                      Influenza Virus Characterization*:

                      CDC has characterized 236 influenza viruses [10 A(H1N1)pdm09, 197 A(H3N2), and 29 influenza B viruses] collected by U.S. laboratories since October 1, 2014.
                      Influenza A Virus [207]
                      • A(H1N1)pdm09 [10]: All 10 H1N1 viruses tested were characterized as A/California/7/2009-like, the influenza A (H1N1) component of the 2014-2015 Northern Hemisphere influenza vaccine.

                      • A (H3N2) [197]: Sixty-four (32.5%) of the 197 H3N2 viruses tested have been characterized as A/Texas/50/2012-like, the influenza A (H3N2) component of the 2014-2015 Northern Hemisphere influenza vaccine. One hundred thirty-three (67.5%) of the 197 viruses tested showed either reduced titers with antiserum produced against A/Texas/50/2012 or belonged to a genetic group that typically shows reduced titers to A/Texas/50/2012. Among viruses that showed reduced titers with antiserum raised against A/Texas/50/2012, most were antigenically similar to A/Switzerland/9715293/2013, the H3N2 virus selected for the 2015 Southern Hemisphere influenza vaccine. A/Switzerland/9715293/2013 is related to, but antigenically and genetically distinguishable, from the A/Texas/50/2012 vaccine virus. A/Switzerland-like H3N2 viruses were first detected in the United States in small numbers in March of 2014 and began to increase through the spring and summer.

                      Influenza B Virus [29]
                      Twenty (69%) of the influenza B viruses tested belong to B/Yamagata/16/88 lineage and the remaining nine (31%) influenza B viruses tested belong to B/Victoria/02/87 lineage.
                      • Yamagata Lineage [20]: All 20 B/Yamagata-lineage viruses were characterized as B/Massachusetts/2/2012-like, which is included as an influenza B component of the 2014-2015 Northern Hemisphere trivalent and quadrivalent influenza vaccines.

                      • Victoria Lineage [9]: Seven (78%) of the nine B/Victoria-lineage viruses were characterized as B/Brisbane/60/2008-like, the virus that is included as an influenza B component of the 2014-2015 Northern Hemisphere quadrivalent influenza vaccine. Two (22%) of the B/Victoria-lineage viruses tested showed reduced titers to B/Brisbane/60/2008.

                      *CDC routinely uses hemagglutination inhibition (HI) assays to antigenically characterize influenza viruses year-round to compare how similar currently circulating influenza viruses are to those included in the influenza vaccine, and to monitor for changes in circulating influenza viruses. However, a portion of recent influenza A(H3N2) viruses do not grow to sufficient hemagglutination titers for antigenic characterization by HI. For many of these viruses, CDC is also performing genetic characterization to infer antigenic properties.


                      Antiviral Resistance:

                      Testing of influenza A(H1N1)pdm09, A(H3N2), and influenza B virus isolates for resistance to neuraminidase inhibitors (oseltamivir and zanamivir) is performed at CDC using a functional assay. Additional A(H1N1)pdm09 and A(H3N2) clinical samples are tested for mutations of the virus known to confer oseltamivir resistance. The data summarized below combine the results of both testing methods. These samples are routinely obtained for surveillance purposes rather than for diagnostic testing of patients suspected to be infected with antiviral-resistant virus.
                      High levels of resistance to the adamantanes (amantadine and rimantadine) persist among A(H1N1)pdm09 and A(H3N2) viruses (the adamantanes are not effective against influenza B viruses). Therefore, data from adamantane resistance testing are not presented below.
                      <table class="table" style="text-align: center;" align="center" border="0" cellpadding="3" cellspacing="0"> <caption> Neuraminidase Inhibitor Resistance Testing Results on Samples Collected Since October 1, 2014

                      </caption> <tbody><tr bgcolor="#c5bee1"> <td rowspan="2" style="width:81.0pt;border:1.0pt; padding:0in 5.4pt 0in 5.4pt;height:27.85pt;" width="108">
                      </td> <th colspan="2" style="width:2.0in;border:1.0pt;vertical-align:middle;height:27.85pt;text-align:center;" width="192">Oseltamivir</th> <th colspan="2" style="width:2.0in;border:1.0pt;vertical-align:middle;;height:27.85pt;text-align:center;" width="192">Zanamivir</th> </tr> <tr style="height:25.15pt;text-align:center;background-image: url(file://///cdc.gov/ahb_apps/WWWLINK_CDC_GOV/flu/weekly/images/purplegrad.jpg); background-repeat:repeat-x;"> <th style="width:63.0pt;text-align:center;" align="center" width="84">Virus Samples tested (n)</th> <th style="width:63.0pt;text-align:center;" align="center" width="84">Resistant Viruses, Number (%)</th> <th style="width:63.0pt;text-align:center;" align="center" width="84">Virus Samples tested (n)</th> <th style="width:63.0pt;text-align:center;" align="center" width="84">Resistant Viruses, Number (%)</th> </tr> <tr> <th style="text-align: left;" bgcolor="#dad5eb" nowrap="nowrap" width="160">Influenza A (H3N2)</th> <td style="text-align: center;" nowrap="nowrap" width="100">106</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> <td style="text-align: center;" nowrap="nowrap" width="100">106</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> </tr> <tr> <th style="text-align: left;" bgcolor="#dad5eb" nowrap="nowrap" width="160">Influenza B</th> <td style="text-align: center;" nowrap="nowrap" width="100">28</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> <td style="text-align: center;" nowrap="nowrap" width="100">28</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> </tr> <tr> <th style="text-align: left;" bgcolor="#dad5eb" nowrap="nowrap" width="160">A(H1N1)pdm09</th> <td style="text-align: center;" nowrap="nowrap" width="100">5</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> <td style="text-align: center;" nowrap="nowrap" width="100">5</td> <td style="text-align: center;" nowrap="nowrap" width="100">0 (0.0)</td> </tr> </tbody></table>
                      In the United States, all recently circulating influenza viruses have been susceptible to the neuraminidase inhibitor antiviral medications, oseltamivir and zanamivir; however, rare sporadic instances of oseltamivir-resistant A(H1N1)pdm09 and A(H3N2) viruses have been detected worldwide. Antiviral treatment with oseltamivir or zanamivir is recommended as early as possible for patients with confirmed or suspected influenza who have severe, complicated, or progressive illness; who require hospitalization; or who are at high risk for serious influenza-related complications. Additional information on recommendations for treatment and chemoprophylaxis of influenza virus infection with antiviral agents is available at http://www.cdc.gov/flu/antivirals/index.htm.


                      Pneumonia and Influenza (P&I) Mortality Surveillance:

                      During week 49, 6.0% of all deaths reported through the 122 Cities Mortality Reporting System were due to P&I. This percentage was below the epidemic threshold of 6.6% for week 49.
                      <center>
                      View Full Screen | View PowerPoint Presentation </center>

                      For the 2014-2015 influenza season, CDC/Influenza Division and the National Center for Health Statistics (NCHS) are collaborating on a pilot project to use NCHS mortality surveillance data for the rapid assessment of pneumonia and influenza (P&I) mortality. To view the data, please click here.


                      Influenza-Associated Pediatric Mortality:

                      Two influenza-associated pediatric deaths were reported to CDC during week 49. One death was associated with an influenza A (H3) virus and one was associated an influenza A virus for which no subtyping was performed. Both deaths occurred during week 48 (week ending November 29, 2014).
                      To date, seven influenza-associated pediatric deaths have been reported for the 2014-2015 season.

                      Additional data can be found at: http://gis.cdc.gov/GRASP/Fluview/PedFluDeath.html.
                      <center>
                      View Interactive Application | View Full Screen | View PowerPoint Presentation </center>



                      Influenza-Associated Hospitalizations:

                      The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts population-based surveillance for laboratory-confirmed influenza-related hospitalizations in children younger than 18 years of age (since the 2003-2004 influenza season) and adults (since the 2005-2006 influenza season).
                      The FluSurv-NET covers more than 70 counties in the 10 Emerging Infections Program (EIP) states (CA, CO, CT, GA, MD, MN, NM, NY, OR, and TN) and additional Influenza Hospitalization Surveillance Project (IHSP) states. The IHSP began during the 2009-2010 season to enhance surveillance during the 2009 H1N1 pandemic. IHSP sites included IA, ID, MI, OK and SD during the 2009-2010 season; ID, MI, OH, OK, RI, and UT during the 2010-2011 season; MI, OH, RI, and UT during the 2011-2012 season; IA, MI, OH, RI, and UT during the 2012-2013 season; and MI, OH, and UT during the 2013-2014 and 2014-15 seasons.
                      Data gathered are used to estimate age-specific hospitalization rates on a weekly basis, and describe characteristics of persons hospitalized with severe influenza illness. The rates provided are likely to be an underestimate as influenza-related hospitalizations can be missed, either because testing is not performed, or because cases may be attributed to other causes of pneumonia or other common influenza-related complications.
                      Between October 1, 2014 and December 6, 2014, 1,028 laboratory-confirmed influenza-associated hospitalizations were reported. The overall hospitalization rate was 3.8 per 100,000 population. The highest rate of hospitalization was among adults aged ≥65 years (13.4 per 100,000 population), followed by children aged 0-4 years (6.2 per 100,000 population). Among all hospitalizations, 952 (92.6%) were associated with influenza A, 68 (6.6%) with influenza B, 4 (0.4%) with influenza A and B co-infection, and 4 (0.4%) had no virus type information. Among those with influenza A subtype information, 274 (100%) were H3N2 virus.
                      Clinical findings are preliminary and based on 174 (17%) cases with complete medical chart abstraction. The majority (95%) of hospitalized adults had at least one reported underlying medical condition; the most commonly reported were metabolic disorders, obesity, and cardiovascular disease. There were 27 hospitalized children with complete medical chart abstraction, 15 (56%) had no identified underlying medical conditions. Among the 17 hospitalized women of childbearing age (15-44 years), seven were pregnant.
                      Additional FluSurv-NET data can be found at:http://gis.cdc.gov/GRASP/Fluview/FluHospRates.html and http://gis.cdc.gov/grasp/fluview/FluHospChars.html.

                      <center>
                      View Interactive Application | View Full Screen | View PowerPoint Presentation
                      </center>

                      Outpatient Illness Surveillance:

                      Nationwide during week 49, 2.5% 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 2.0%.
                      (ILI is defined as fever (temperature of 100?F [37.8?C] or greater) and cough and/or sore throat.)

                      Additional data are available at http://gis.cdc.gov/grasp/fluview/flu...dashboard.html.
                      <center>
                      View National and Regional Level Graphs and Data | View Chart Data | View Full Screen | View PowerPoint Presentation
                      </center>

                      On a regional level, the percentage of outpatient visits for ILI ranged from 1.1% to 4.7% during week 49. Eight regions (Regions 2, 3, 4, 5, 6, 7, 8, and 10) reported a proportion of outpatient visits for ILI at or above their region-specific baseline levels.



                      ILINet State Activity Indicator Map:

                      Data collected in ILINet are used to produce a measure of ILI activity* by state. Activity levels are based on the percent of outpatient visits in a state due to ILI and are compared to the average percent of ILI visits that occur during weeks with little or no influenza virus circulation. Activity levels range from minimal, which would correspond to ILI activity from outpatient clinics being below, or only slightly above, the average, to high, which would correspond to ILI activity from outpatient clinics being much higher than average.
                      During week 49, the following ILI activity levels were experienced:
                      • Puerto Rico and six states (Alabama, Georgia, Illinois, Louisiana, Mississippi, and Texas) experienced high ILI activity.
                      • Two states (Florida and Indiana) experienced moderate ILI activity.
                      • Seven states (Idaho, Kansas, Maryland, Missouri, South Carolina, Utah, and Virginia) experienced low ILI activity.
                      • New York City and 35 states (Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Hawaii, Iowa, Kentucky, Maine, Massachusetts, Michigan, Minnesota, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Dakota, Tennessee, Vermont, Washington, West Virginia, Wisconsin, and Wyoming) experienced minimal ILI activity.
                      • Data were insufficient to calculate an ILI activity level from the District of Columbia.

                      Click on map to launch interactive tool

                      *This map uses the proportion of outpatient visits to health care providers for influenza-like illness to measure the ILI activity level within a state. It does not, however, measure the extent of geographic spread of flu within a state. Therefore, outbreaks occurring in a single city could cause the state to display high activity levels.
                      Data collected in ILINet may disproportionally represent certain populations within a state, and therefore, may not accurately depict the full picture of influenza activity for the whole state.
                      Data displayed in this map are based on data collected in ILINet, whereas the State and Territorial flu activity map is based on reports from state and territorial epidemiologists. The data presented in this map is preliminary and may change as more data is received.
                      Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.


                      Geographic Spread of Influenza as Assessed by State and Territorial Epidemiologists

                      The influenza activity reported by state and territorial epidemiologists indicates geographic spread of influenza viruses, but does not measure the severity of influenza activity.
                      During week 49, the following influenza activity was reported:
                      • Widespread influenza activity was reported by 14 states (Colorado, Delaware, Florida, Georgia, Illinois, Kentucky, Louisiana, Maryland, Minnesota, New York, North Carolina, Ohio, Pennsylvania, and Texas).
                      • Regional influenza activity was reported by Guam, Puerto Rico and 25 states (Alabama, Alaska, Arkansas, Connecticut, Indiana, Iowa, Kansas, Maine, Massachusetts, Michigan, Mississippi, Missouri, Montana, Nevada, North Dakota, Oklahoma, Rhode Island, South Carolina, Tennessee, Utah, Vermont, Virginia, Washington, West Virginia, and Wisconsin).
                      • Local influenza activity was reported by the U.S. Virgin Islands and seven states (Arizona, Idaho, Nebraska, New Hampshire, New Jersey, New Mexico, and Oregon).
                      • Sporadic influenza activity was reported by the District of Columbia and four states (California, Hawaii, South Dakota, and Wyoming).









                      Additional National and International Influenza Surveillance Information


                      FluView Interactive: FluView includes enhanced web-based interactive applications that can provide dynamic visuals of the influenza data collected and analyzed by CDC. These FluView Interactive applications allow people to create customized, visual interpretations of influenza data, as well as make comparisons across flu seasons, regions, age groups and a variety of other demographics. To access these tools, visit http://www.cdc.gov/flu/weekly/fluviewinteractive.htm.
                      U.S. State and local influenza surveillance: Click on a jurisdiction below to access the latest local influenza information.
                      <table> <tbody><tr border="1"> <td height="8" width="139">Alabama
                      </td> <td height="8" width="139">Alaska
                      </td> <td height="8" width="139">Arizona
                      </td> <td height="8" width="139">Arkansas
                      </td> <td height="8" width="139">California
                      </td> </tr> <tr border="1"> <td height="8" width="139">Colorado
                      </td> <td height="8" width="139">Connecticut
                      </td> <td height="8" width="139">Delaware
                      </td> <td height="8" width="139">District of Columbia
                      </td> <td height="8" width="139">Florida
                      </td> </tr> <tr border="1"> <td height="8" width="139">Georgia
                      </td> <td height="8" width="139">Hawaii
                      </td> <td height="8" width="139">Idaho
                      </td> <td height="8" width="139">Illinois
                      </td> <td height="8" width="139">Indiana
                      </td> </tr> <tr border="1"> <td height="8" width="139">Iowa
                      </td> <td height="8" width="139">Kansas
                      </td> <td height="8" width="139">Kentucky
                      </td> <td height="8" width="139">Louisiana
                      </td> <td height="8" width="139">Maine
                      </td> </tr> <tr border="1"> <td height="8" width="139">Maryland
                      </td> <td height="8" width="139">Massachusetts
                      </td> <td height="8" width="139">Michigan
                      </td> <td height="8" width="139">Minnesota
                      </td> <td height="8" width="139">Mississippi
                      </td> </tr> <tr border="1"> <td height="8" width="139">Missouri
                      </td> <td height="8" width="139">Montana
                      </td> <td height="8" width="139">Nebraska
                      </td> <td height="8" width="139">Nevada
                      </td> <td height="8" width="139">New Hampshire
                      </td> </tr> <tr border="1"> <td height="8" width="139">New Jersey
                      </td> <td height="8" width="139">New Mexico
                      </td> <td height="8" width="139">New York
                      </td> <td height="8" width="139">North Carolina
                      </td> <td height="8" width="139">North Dakota
                      </td> </tr> <tr border="1"> <td height="8" width="139">Ohio
                      </td> <td height="8" width="139">Oklahoma
                      </td> <td height="8" width="139">Oregon
                      </td> <td height="8" width="139">Pennsylvania
                      </td> <td height="8" width="139">Rhode Island
                      </td> </tr> <tr border="1"> <td height="8" width="139">South Carolina
                      </td> <td height="8" width="139">South Dakota
                      </td> <td height="8" width="139">Tennessee
                      </td> <td height="8" width="139">Texas
                      </td> <td height="8" width="139">Utah
                      </td> </tr> <tr border="1"> <td height="8" width="139">Vermont
                      </td> <td height="8" width="139">Virginia
                      </td> <td height="8" width="139">Washington
                      </td> <td height="8" width="139">West Virginia
                      </td> <td height="8" width="139">Wisconsin
                      </td> </tr> <tr border="1"> <td height="8" width="139">Wyoming
                      </td> <td height="8" width="139">New York City
                      </td> <td height="8" width="139">Virgin Islands
                      </td> <td height="8" width="139">
                      </td> <td height="8" width="139">
                      </td> </tr> </tbody></table>

                      Google Flu Trends: Google Flu Trends uses aggregated Google search data in a model created in collaboration with CDC to estimate influenza activity in the United States. For more information and activity estimates from the United States and worldwide, see http://www.google.org/flutrends/
                      World Health Organization: Additional influenza surveillance information from participating WHO member nations is available through FluNet and the Global Epidemiology Reports.
                      WHO Collaborating Centers for Influenza located in Australia, China, Japan, the United Kingdom, and the United States (CDC in Atlanta, Georgia).
                      Europe: for the most recent influenza surveillance information from Europe, please see WHO/Europe at http://www.flunewseurope.org/ and visit the European Centre for Disease Prevention and Control at http://ecdc.europa.eu/en/publications/surveillance_reports/influenza/Pages/weekly_influenza_surveillance_overview.aspx
                      Public Health Agency of Canada: The most up-to-date influenza information from Canada is available at http://www.phac-aspc.gc.ca/fluwatch/
                      Public Health England: The most up-to-date influenza information from the United Kingdom is available at https://www.gov.uk/government/statistics/weekly-national-flu-reports


                      Any links provided to non-Federal organizations are provided solely as a service to our users. These links do not constitute an endorsement of these organizations or their programs by CDC or the Federal Government, and none should be inferred. CDC is not responsible for the content of the individual organization web pages found at these links.
                      In addition to the eight data components of CDC influenza surveillance for the 2014-2015 influenza season, the use of National Center for Health Statistics (NCHS) pneumonia and influenza mortality surveillance data for the rapid assessment of influenza-associated mortality will be piloted. An overview of influenza surveillance, including a description of the NCHS mortality surveillance data, is available here.
                      -------------------------------------------------------------------------------- Full report also available as PDF





                      Learn more about the weekly influenza surveillance report (FluView) prepared by the Influenza Division.

                      Comment


                      • #12

                        2014-2015 Influenza Season Week 50 ending December 13, 2014

                        All data are preliminary and may change as more reports are received.
                        Synopsis:

                        During week 50 (December 7-13, 2014), influenza activity continued to increase in the United States.
                        • Viral Surveillance:Of 20,064 specimens tested and reported by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories during week 50, 5,200 (25.9%) were positive for influenza.
                        • Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia and influenza (P&I) was below the epidemic threshold.
                        • Influenza-associated Pediatric Deaths:Four influenza-associated pediatric deaths were reported.
                        • Influenza-associated Hospitalizations: A cumulative rate for the season of 6.2 laboratory-confirmed influenza-associated hospitalizations per 100,000 population was reported.
                        • Outpatient Illness Surveillance: The proportion of outpatient visits for influenza-like illness (ILI) was 3.7%, above the national baseline of 2.0%. Nine of 10 regions reported ILI at or above region-specific baseline levels. Puerto Rico and 13 states experienced high ILI activity; six states experienced moderate ILI activity; New York City and five states experienced low ILI activity; 26 states experienced minimal ILI activity; and the District of Columbia had insufficient data.
                        • Geographic Spread of Influenza: The geographic spread of influenza in Guam and 29 states was reported as widespread; Puerto Rico and 14 states reported regional activity; the District of Columbia, the U.S. Virgin Islands and five states reported local activity; and two states reported sporadic activity.
                        Nation Elevated 45 of 54 25.9% 63 7,769 10,474 1,730 11
                        Region 1 Elevated 6 of 6 8.2% 2 115 79 19 0
                        Region 2 Elevated 2 of 4 9.2% 21 260 253 42 0
                        Region 3 Elevated 5 of 6 19.4% 2 764 290 58 0
                        Region 4 Elevated 8 of 8 18.7% 2 985 3,492 800 4
                        Region 5 Elevated 6 of 6 32.5% 8 2,099 2,308 137 4
                        Region 6 Elevated 4 of 5 28.1% 10 1,134 2,935 482 2
                        Region 7 Elevated 4 of 4 22.1% 5 540 352 62 0
                        Region 8 Elevated 6 of 6 31.7% 4 687 567 42 0
                        Region 9 Normal 3 of 5 8.8% 5 364 118 58 1
                        Region 10 Elevated 1 of 4 17.9% 4 821 80 30 0
                        *HHS regions (Region 1 CT, ME, MA, NH, RI, VT; Region 2: NJ, NY, Puerto Rico, US Virgin Islands; Region 3: DE, DC, MD, PA, VA, WV; Region 4: AL, FL, GA, KY, MS, NC, SC, TN; Region 5: IL, IN, MI, MN, OH, WI; Region 6: AR, LA, NM, OK, TX; Region 7: IA, KS, MO, NE; Region 8: CO, MT, ND, SD, UT, WY; Region 9: AZ, CA, Guam, HI, NV; and Region 10: AK, ID, OR, WA).
                        ? Elevated means the % of visits for ILI is at or above the national or region-specific baseline
                        ? Includes all 50 states, the District of Columbia, Guam, Puerto Rico, and U.S. Virgin Islands
                        ? National data are for current week; regional data are for the most recent three weeks


                        U.S. Virologic Surveillance:

                        WHO and NREVSS collaborating laboratories located in all 50 states, Puerto Rico, and the District of Columbia report to CDC the number of respiratory specimens tested for influenza and the number positive by influenza virus type and influenza A virus subtype. The results of tests performed during the current week are summarized in the table below. Region specific data are available at http://gis.cdc.gov/grasp/fluview/flu...dashboard.html.
                        20,064
                        148,903
                        5,200 (25.9%)
                        20,037 (13.5%)
                        5,006 (96.3%)
                        18,307 (91.4%)
                        8 (0.2%)
                        63 (0.3%)
                        1,893 (37.8%)
                        7,769 (42.4%)
                        3,105 (62.0%)
                        10,474 (57.2%)
                        194 (3.7%)
                        1,730 (8.6%)

                        View National and Regional Level Graphs and Data | View Chart Data | View Full Screen | View PowerPoint Presentation


                        Influenza Virus Characterization*:

                        CDC has characterized 248 influenza viruses [10 A (H1N1)pdm09, 209 A (H3N2), and 29 influenza B viruses] collected by U.S. laboratories since October 1, 2014.
                        Influenza A Virus [219]
                        • A (H1N1)pdm09 [10]: All 10 H1N1 viruses tested were characterized as A/California/7/2009-like, the influenza A (H1N1) component of the 2014-2015 Northern Hemisphere influenza vaccine.
                        • A (H3N2) [209]: Sixty-four (30.6%) of the 209 H3N2 viruses tested have been characterized as A/Texas/50/2012-like, the influenza A (H3N2) component of the 2014-2015 Northern Hemisphere influenza vaccine. One hundred forty-five (69.4%) of the 209 viruses tested showed either reduced titers with antiserum produced against A/Texas/50/2012 or belonged to a genetic group that typically shows reduced titers to A/Texas/50/2012. Among viruses that showed reduced titers with antiserum raised against A/Texas/50/2012, most were antigenically similar to A/Switzerland/9715293/2013, the H3N2 virus selected for the 2015 Southern Hemisphere influenza vaccine. A/Switzerland/9715293/2013 is related to, but antigenically and genetically distinguishable, from the A/Texas/50/2012 vaccine virus. A/Switzerland-like H3N2 viruses were first detected in the United States in small numbers in March of 2014 and began to increase through the spring and summer.
                        Influenza B Virus [29]
                        Twenty (69%) of the influenza B viruses tested belong to B/Yamagata/16/88 lineage and the remaining nine (31%) influenza B viruses tested belong to B/Victoria/02/87 lineage.
                        • Yamagata Lineage [20]: All 20 B/Yamagata-lineage viruses were characterized as B/Massachusetts/2/2012-like, which is included as an influenza B component of the 2014-2015 Northern Hemisphere trivalent and quadrivalent influenza vaccines.
                        • Victoria Lineage [9]: Seven (78%) of the nine B/Victoria-lineage viruses were characterized as B/Brisbane/60/2008-like, the virus that is included as an influenza B component of the 2014-2015 Northern Hemisphere quadrivalent influenza vaccine. Two (22%) of the B/Victoria-lineage viruses tested showed reduced titers to B/Brisbane/60/2008.
                        *CDC routinely uses hemagglutination inhibition (HI) assays to antigenically characterize influenza viruses year-round to compare how similar currently circulating influenza viruses are to those included in the influenza vaccine, and to monitor for changes in circulating influenza viruses. However, a portion of recent influenza A(H3N2) viruses do not grow to sufficient hemagglutination titers for antigenic characterization by HI. For many of these viruses, CDC is also performing genetic characterization to infer antigenic properties.

                        Antiviral Resistance:

                        Testing of influenza A(H1N1)pdm09, A(H3N2), and influenza B virus isolates for resistance to neuraminidase inhibitors (oseltamivir and zanamivir) is performed at CDC using a functional assay. Additional A(H1N1)pdm09 and A(H3N2) clinical samples are tested for mutations of the virus known to confer oseltamivir resistance. The data summarized below combine the results of both testing methods. These samples are routinely obtained for surveillance purposes rather than for diagnostic testing of patients suspected to be infected with antiviral-resistant virus.
                        High levels of resistance to the adamantanes (amantadine and rimantadine) persist among A(H1N1)pdm09 and A(H3N2) viruses (the adamantanes are not effective against influenza B viruses). Therefore, data from adamantane resistance testing are not presented below.
                        175 0 (0.0) 175 0 (0.0)
                        51 0 (0.0) 51 0 (0.0)
                        10 0 (0.0) 10 0 (0.0)
                        In the United States, all recently circulating influenza viruses have been susceptible to the neuraminidase inhibitor antiviral medications, oseltamivir and zanamivir; however, rare sporadic instances of oseltamivir-resistant A(H1N1)pdm09 and A(H3N2) viruses have been detected worldwide. Antiviral treatment with oseltamivir or zanamivir is recommended as early as possible for patients with confirmed or suspected influenza who have severe, complicated, or progressive illness; who require hospitalization; or who are at high risk for serious influenza-related complications. Additional information on recommendations for treatment and chemoprophylaxis of influenza virus infection with antiviral agents is available athttp://www.cdc.gov/flu/antivirals/index.htm.


                        Pneumonia and Influenza (P&I) Mortality Surveillance:

                        During week 50, 6.0% of all deaths reported through the 122 Cities Mortality Reporting System were due to P&I. This percentage was below the epidemic threshold of 6.7% for week 50.

                        View Full Screen | View PowerPoint Presentation For the 2014-2015 influenza season, CDC/Influenza Division and the National Center for Health Statistics (NCHS) are collaborating on a pilot project to use NCHS mortality surveillance data for the rapid assessment of pneumonia and influenza (P&I) mortality. To view the data, please click here.


                        Influenza-Associated Pediatric Mortality:

                        Four influenza-associated pediatric deaths were reported to CDC during week 50. Two deaths were associated with an influenza A (H3) virus and occurred during week 49 (week ending December 6, 2014). One death was associated with an influenza A virus for which no subtyping was performed and occurred during week 50 (week ending December 13, 2014), and one death was associated with an influenza B virus and occurred during week 49.
                        A total of 11 influenza-associated deaths have been reported during the 2014-2015 season from six states (Florida [2], Minnesota [2], North Carolina [2], Nevada [1], Ohio [2], and Texas [2]).

                        Additional data can be found at: http://gis.cdc.gov/GRASP/Fluview/PedFluDeath.html.

                        View Interactive Application | View Full Screen | View PowerPoint Presentation


                        Influenza-Associated Hospitalizations:

                        The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts population-based surveillance for laboratory-confirmed influenza-related hospitalizations in children younger than 18 years of age (since the 2003-2004 influenza season) and adults (since the 2005-2006 influenza season).
                        The FluSurv-NET covers more than 70 counties in the 10 Emerging Infections Program (EIP) states (CA, CO, CT, GA, MD, MN, NM, NY, OR, and TN) and additional Influenza Hospitalization Surveillance Project (IHSP) states. The IHSP began during the 2009-2010 season to enhance surveillance during the 2009 H1N1 pandemic. IHSP sites included IA, ID, MI, OK and SD during the 2009-2010 season; ID, MI, OH, OK, RI, and UT during the 2010-2011 season; MI, OH, RI, and UT during the 2011-2012 season; IA, MI, OH, RI, and UT during the 2012-2013 season; and MI, OH, and UT during the 2013-2014 and 2014-15 seasons.
                        Data gathered are used to estimate age-specific hospitalization rates on a weekly basis, and describe characteristics of persons hospitalized with severe influenza illness. The rates provided are likely to be an underestimate as influenza-related hospitalizations can be missed, either because testing is not performed, or because cases may be attributed to other causes of pneumonia or other common influenza-related complications.
                        Between October 1, 2014 and December 13, 2014, 1,702 laboratory-confirmed influenza-associated hospitalizations were reported. The overall hospitalization rate was 6.2 per 100,000 population. The highest rate of hospitalization was among adults aged ≥65 years (23.6 per 100,000 population), followed by children aged 0-4 years (9.3 per 100,000 population). Among all hospitalizations, 1,611 (94.7%) were associated with influenza A, 81 (4.7%) with influenza B, five (0.3%) with influenza A and B co-infection, and five (0.3%) had no virus type information. Among those with influenza A subtype information, 463 (100%) were H3N2 virus.
                        Clinical findings are preliminary and based on 247 (15%) cases with complete medical chart abstraction. The majority (95%) of hospitalized adults had at least one reported underlying medical condition; the most commonly reported were metabolic disorders, obesity, and cardiovascular disease. There were 37 hospitalized children with complete medical chart abstraction, 17 (46%) had no identified underlying medical conditions. The most commonly reported underlying medical conditions among pediatric patients were asthma and obesity. Among the 24 hospitalized women of childbearing age (15-44 years), seven were pregnant.
                        Additional FluSurv-NET data can be found at:http://gis.cdc.gov/GRASP/Fluview/FluHospRates.html andhttp://gis.cdc.gov/grasp/fluview/FluHospChars.html.

                        View Interactive Application | View Full Screen | View PowerPoint Presentation Outpatient Illness Surveillance:

                        Nationwide during week 50, 3.7% 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 2.0%.
                        (ILI is defined as fever (temperature of 100?F [37.8?C] or greater) and cough and/or sore throat.)

                        Additional data are available at http://gis.cdc.gov/grasp/fluview/flu...dashboard.html.

                        View National and Regional Level Graphs and Data | View Chart Data | View Full Screen | View PowerPoint Presentation On a regional level, the percentage of outpatient visits for ILI ranged from 1.5% to 8.2% during week 50. Nine regions (Regions 1, 2, 3, 4, 5, 6, 7, 8, and 10) reported a proportion of outpatient visits for ILI at or above their region-specific baseline levels.



                        ILINet State Activity Indicator Map:

                        Data collected in ILINet are used to produce a measure of ILI activity* by state. Activity levels are based on the percent of outpatient visits in a state due to ILI and are compared to the average percent of ILI visits that occur during weeks with little or no influenza virus circulation. Activity levels range from minimal, which would correspond to ILI activity from outpatient clinics being below, or only slightly above, the average, to high, which would correspond to ILI activity from outpatient clinics being much higher than average.
                        During week 50, the following ILI activity levels were experienced:
                        • Puerto Rico and 13 states (Alabama, Arkansas, Georgia, Illinois, Indiana, Kansas, Louisiana, Minnesota, Mississippi, Missouri, Oklahoma, Texas, and Virginia) experienced high ILI activity.
                        • Six states (Idaho, Kentucky, Maryland, North Carolina, Utah, and Wisconsin) experienced moderate ILI activity.
                        • New York City and five states (Colorado, Florida, Nevada, Pennsylvania, and South Carolina) experienced low ILI activity.
                        • 26 states (Alaska, Arizona, California, Connecticut, Delaware, Hawaii, Iowa, Maine, Massachusetts, Michigan, Montana, Nebraska, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Ohio, Oregon, Rhode Island, South Dakota, Tennessee, Vermont, Washington, West Virginia, and Wyoming) experienced minimal ILI activity.
                        • Data were insufficient to calculate an ILI activity level from the District of Columbia.
                        Click on map to launch interactive tool
                        *This map uses the proportion of outpatient visits to health care providers for influenza-like illness to measure the ILI activity level within a state. It does not, however, measure the extent of geographic spread of flu within a state. Therefore, outbreaks occurring in a single city could cause the state to display high activity levels.
                        Data collected in ILINet may disproportionally represent certain populations within a state, and therefore, may not accurately depict the full picture of influenza activity for the whole state.
                        Data displayed in this map are based on data collected in ILINet, whereas the State and Territorial flu activity map is based on reports from state and territorial epidemiologists. The data presented in this map is preliminary and may change as more data is received.
                        Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.


                        Geographic Spread of Influenza as Assessed by State and Territorial Epidemiologists

                        The influenza activity reported by state and territorial epidemiologists indicates geographic spread of influenza viruses, but does not measure the severity of influenza activity.
                        During week 50, the following influenza activity was reported:
                        • Widespread influenza activity was reported by Guam and 29 states (Arkansas, Colorado, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New York, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, Texas, Virginia, Washington, Wisconsin, and Wyoming).
                        • Regional influenza activity was reported by Puerto Rico and 14 states (Alabama, California, Iowa, Kansas, Maine, Montana, Nevada, New Hampshire, Rhode Island, South Dakota, Tennessee, Utah, Vermont, and West Virginia).
                        • Local influenza activity was reported by the District of Columbia, the U.S. Virgin Islands and five states (Alaska, Arizona, Idaho, New Jersey, and New Mexico).
                        • Sporadic influenza activity was reported by two states (Hawaii and Oregon).







                        Additional National and International Influenza Surveillance Information

                        FluView Interactive: FluView includes enhanced web-based interactive applications that can provide dynamic visuals of the influenza data collected and analyzed by CDC. These FluView Interactive applications allow people to create customized, visual interpretations of influenza data, as well as make comparisons across flu seasons, regions, age groups and a variety of other demographics. To access these tools, visithttp://www.cdc.gov/flu/weekly/fluviewinteractive.htm.
                        U.S. State and local influenza surveillance: Click on a jurisdiction below to access the latest local influenza information.

                        Google Flu Trends: Google Flu Trends uses aggregated Google search data in a model created in collaboration with CDC to estimate influenza activity in the United States. For more information and activity estimates from the United States and worldwide, see http://www.google.org/flutrends/
                        World Health Organization: Additional influenza surveillance information from participating WHO member nations is available through FluNet and theGlobal Epidemiology Reports.
                        WHO Collaborating Centers for Influenza located in Australia, China, Japan, the United Kingdom, and the United States (CDC in Atlanta, Georgia).
                        Europe: for the most recent influenza surveillance information from Europe, please see WHO/Europe at http://www.flunewseurope.org/ and visit the European Centre for Disease Prevention and Control athttp://ecdc.europa.eu/en/publication..._overview.aspx
                        Public Health Agency of Canada: The most up-to-date influenza information from Canada is available at http://www.phac-aspc.gc.ca/fluwatch/
                        Public Health England: The most up-to-date influenza information from the United Kingdom is available athttps://www.gov.uk/government/statistics/weekly-national-flu-reports



                        Any links provided to non-Federal organizations are provided solely as a service to our users. These links do not constitute an endorsement of these organizations or their programs by CDC or the Federal Government, and none should be inferred. CDC is not responsible for the content of the individual organization web pages found at these links.
                        In addition to the eight data components of CDC influenza surveillance for the 2014-2015 influenza season, the use of National Center for Health Statistics (NCHS) pneumonia and influenza mortality surveillance data for the rapid assessment of influenza-associated mortality will be piloted. An overview of influenza surveillance, including a description of the NCHS mortality surveillance data, is available here.
                        -------------------------------------------------------------------------------- http://www.cdc.gov/flu/weekly/
                        Full report also available as PDF




                        Comment


                        • #13
                          2014-2015 Influenza Season Week 51 ending December 20, 2014

                          All data are preliminary and may change as more reports are received.
                          Synopsis:

                          During week 51 (December 14-20, 2014), influenza activity continued to increase in the United States.
                          • Viral Surveillance: Of 21,858 specimens tested and reported by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories during week 51, 6,152 (28.1%) were positive for influenza.
                          • Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia and influenza (P&I) was at the epidemic threshold.
                          • Influenza-associated Pediatric Deaths: Four influenza-associated pediatric deaths were reported.
                          • Influenza-associated Hospitalizations: A cumulative rate for the season of 9.7 laboratory-confirmed influenza-associated hospitalizations per 100,000 population was reported.
                          • Outpatient Illness Surveillance: The proportion of outpatient visits for influenza-like illness (ILI) was 5.5%, above the national baseline of 2.0%. All 10 regions reported ILI at or above region-specific baseline levels. Puerto Rico and 22 states experienced high ILI activity; six states experienced moderate ILI activity; New York City and eight states experienced low ILI activity; 14 states experienced minimal ILI activity; and the District of Columbia had insufficient data.
                          • Geographic Spread of Influenza: The geographic spread of influenza in 36 states was reported as widespread; Guam, Puerto Rico, and 10 states reported regional activity; the District of Columbia, the U.S. Virgin Islands, and two states reported local activity; and two states reported sporadic activity.
                          Nation Elevated 48 of 54 28.1% 64 11,006 15,185 1,962 15
                          Region 1 Elevated 6 of 6 11.3% 1 204 146 19 0
                          Region 2 Elevated 3 of 4 14.8% 21 389 524 46 0
                          Region 3 Elevated 5 of 6 27.1% 2 1,260 568 72 1
                          Region 4 Elevated 8 of 8 20.7% 2 1,142 4,745 876 4
                          Region 5 Elevated 6 of 6 34.6% 8 3,069 3,905 195 4
                          Region 6 Elevated 5 of 5 28.4% 10 1,353 3,280 517 3
                          Region 7 Elevated 4 of 4 24.2% 6 836 657 74 0
                          Region 8 Elevated 6 of 6 35.9% 6 1,129 1,096 56 1
                          Region 9 Elevated 3 of 5 13.1% 5 468 171 66 2
                          Region 10 Elevated 2 of 4 25.5% 3 1,156 93 41 0
                          *HHS regions (Region 1 CT, ME, MA, NH, RI, VT; Region 2: NJ, NY, Puerto Rico, US Virgin Islands; Region 3: DE, DC, MD, PA, VA, WV; Region 4: AL, FL, GA, KY, MS, NC, SC, TN; Region 5: IL, IN, MI, MN, OH, WI; Region 6: AR, LA, NM, OK, TX; Region 7: IA, KS, MO, NE; Region 8: CO, MT, ND, SD, UT, WY; Region 9: AZ, CA, Guam, HI, NV; and Region 10: AK, ID, OR, WA).
                          ? Elevated means the % of visits for ILI is at or above the national or region-specific baseline
                          ? Includes all 50 states, the District of Columbia, Guam, Puerto Rico, and U.S. Virgin Islands
                          ? National data are for current week; regional data are for the most recent three weeks


                          U.S. Virologic Surveillance:

                          WHO and NREVSS collaborating laboratories located in all 50 states, Puerto Rico, and the District of Columbia report to CDC the number of respiratory specimens tested for influenza and the number positive by influenza virus type and influenza A virus subtype. The results of tests performed during the current week are summarized in the table below. Region specific data are available at http://gis.cdc.gov/grasp/fluview/flu...dashboard.html.
                          21,858
                          178,004
                          6,152 (28.1%)
                          28,218 (15.9%)
                          5,987 (97.3%)
                          26,256 (93.0%)
                          1 (0.02%)
                          64 (0.2%)
                          2,022 (33.8%)
                          11,006 (41.9%)
                          3,964 (66.2%)
                          15,185 (57.8%)
                          165 (2.7%)
                          1,962 (7.0%)

                          View National and Regional Level Graphs and Data | View Chart Data | View Full Screen | View PowerPoint Presentation


                          Influenza Virus Characterization*:

                          CDC has characterized 305 influenza viruses [10 A(H1N1)pdm09, 239 A(H3N2), and 56 influenza B viruses] collected by U.S. laboratories since October 1, 2014.
                          Influenza A Virus [249]
                          • A (H1N1)pdm09 [10]: All 10 H1N1 viruses tested were characterized as A/California/7/2009-like, the influenza A (H1N1) component of the 2014-2015 Northern Hemisphere influenza vaccine.
                          • A (H3N2) [239]: Seventy-eight (32.6%) of the 239 H3N2 viruses tested have been characterized as A/Texas/50/2012-like, the influenza A (H3N2) component of the 2014-2015 Northern Hemisphere influenza vaccine. One hundred sixty-one (67.4%) of the 239 viruses tested showed either reduced titers with antiserum produced against A/Texas/50/2012 or belonged to a genetic group that typically shows reduced titers to A/Texas/50/2012. Among viruses that showed reduced titers with antiserum raised against A/Texas/50/2012, most were antigenically similar to A/Switzerland/9715293/2013, the H3N2 virus selected for the 2015 Southern Hemisphere influenza vaccine. A/Switzerland/9715293/2013 is related to, but antigenically and genetically distinguishable, from the A/Texas/50/2012 vaccine virus. A/Switzerland-like H3N2 viruses were first detected in the United States in small numbers in March of 2014 and began to increase through the spring and summer.
                          Influenza B Virus [56]
                          Thirty-nine (70%) of the influenza B viruses tested belong to B/Yamagata/16/88 lineage and the remaining 17 (30%) influenza B viruses tested belong to B/Victoria/02/87 lineage.
                          • Yamagata Lineage [39]: All 39 B/Yamagata-lineage viruses were characterized as B/Massachusetts/2/2012-like, which is included as an influenza B component of the 2014-2015 Northern Hemisphere trivalent and quadrivalent influenza vaccines.
                          • Victoria Lineage [17]: Fifteen (88%) of the 17 B/Victoria-lineage viruses were characterized as B/Brisbane/60/2008-like, the virus that is included as an influenza B component of the 2014-2015 Northern Hemisphere quadrivalent influenza vaccine. Two (12%) of the B/Victoria-lineage viruses tested showed reduced titers to B/Brisbane/60/2008.
                          *CDC routinely uses hemagglutination inhibition (HI) assays to antigenically characterize influenza viruses year-round to compare how similar currently circulating influenza viruses are to those included in the influenza vaccine, and to monitor for changes in circulating influenza viruses. However, a portion of recent influenza A(H3N2) viruses do not grow to sufficient hemagglutination titers for antigenic characterization by HI. For many of these viruses, CDC is also performing genetic characterization to infer antigenic properties.

                          Antiviral Resistance:

                          Testing of influenza A(H1N1)pdm09, A(H3N2), and influenza B virus isolates for resistance to neuraminidase inhibitors (oseltamivir, zanamivir, and peramivir) is performed at CDC using a functional assay. Additional A(H1N1)pdm09 and A(H3N2) clinical samples are tested for mutations of the virus known to confer oseltamivir resistance. The data summarized below combine the results of both testing methods. These samples are routinely obtained for surveillance purposes rather than for diagnostic testing of patients suspected to be infected with antiviral-resistant virus.
                          High levels of resistance to the adamantanes (amantadine and rimantadine) persist among A(H1N1)pdm09 and A(H3N2) viruses (the adamantanes are not effective against influenza B viruses). Therefore, data from adamantane resistance testing are not presented below.
                          248
                          0 (0.0)
                          248
                          0 (0.0)
                          248
                          0 (0.0)
                          55
                          0 (0.0)
                          55
                          0 (0.0)
                          55
                          0 (0.0)
                          11
                          0 (0.0)
                          11
                          0 (0.0)
                          11
                          0 (0.0)
                          In the United States, all recently circulating influenza viruses have been susceptible to the neuraminidase inhibitor antiviral medications, oseltamivir, zanamivir, and peramivir; however, rare sporadic instances of oseltamivir-resistant A(H1N1)pdm09 and A(H3N2) viruses have been detected worldwide. Antiviral treatment with oseltamivir, zanamivir, or peramivir is recommended as early as possible for patients with confirmed or suspected influenza who have severe, complicated, or progressive illness; who require hospitalization; or who are at high risk for serious influenza-related complications. Additional information on recommendations for treatment and chemoprophylaxis of influenza virus infection with antiviral agents is available athttp://www.cdc.gov/flu/antivirals/index.htm.


                          Pneumonia and Influenza (P&I) Mortality Surveillance:

                          During week 51, 6.8% of all deaths reported through the 122 Cities Mortality Reporting System were due to P&I. This percentage was at the epidemic threshold of 6.8% for week 51.

                          View Full Screen | View PowerPoint Presentation For the 2014-2015 influenza season, CDC/Influenza Division and the National Center for Health Statistics (NCHS) are collaborating on a pilot project to use NCHS mortality surveillance data for the rapid assessment of pneumonia and influenza (P&I) mortality. To view the data, please click here.


                          Influenza-Associated Pediatric Mortality:

                          Four influenza-associated pediatric deaths were reported to CDC during week 51. Three deaths were associated with an influenza A (H3) virus and occurred during weeks 49 and 50 (weeks ending December 6 and December 13, 2014, respectively). One death was associated with an influenza B virus and occurred during week 51 (week ending December 20, 2014).
                          A total of 15 influenza-associated deaths have been reported during the 2014-2015 season from nine states (Arizona [1], Colorado [1], Florida [2], Minnesota [2], North Carolina [2], Nevada [1], Ohio [2], Texas [3], and Virginia [1]).

                          Additional data can be found at: http://gis.cdc.gov/GRASP/Fluview/PedFluDeath.html.

                          View Interactive Application | View Full Screen | View PowerPoint Presentation


                          Influenza-Associated Hospitalizations:

                          The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts population-based surveillance for laboratory-confirmed influenza-related hospitalizations in children younger than 18 years of age (since the 2003-2004 influenza season) and adults (since the 2005-2006 influenza season).
                          The FluSurv-NET covers more than 70 counties in the 10 Emerging Infections Program (EIP) states (CA, CO, CT, GA, MD, MN, NM, NY, OR, and TN) and additional Influenza Hospitalization Surveillance Project (IHSP) states. The IHSP began during the 2009-2010 season to enhance surveillance during the 2009 H1N1 pandemic. IHSP sites included IA, ID, MI, OK and SD during the 2009-2010 season; ID, MI, OH, OK, RI, and UT during the 2010-2011 season; MI, OH, RI, and UT during the 2011-2012 season; IA, MI, OH, RI, and UT during the 2012-2013 season; and MI, OH, and UT during the 2013-2014 and 2014-15 seasons.
                          Data gathered are used to estimate age-specific hospitalization rates on a weekly basis, and describe characteristics of persons hospitalized with severe influenza illness. The rates provided are likely to be an underestimate as influenza-related hospitalizations can be missed, either because testing is not performed, or because cases may be attributed to other causes of pneumonia or other common influenza-related complications.
                          Between October 1, 2014 and December 20, 2014, 2,643 laboratory-confirmed influenza-associated hospitalizations were reported. The overall hospitalization rate was 9.7 per 100,000 population. The highest rate of hospitalization was among adults aged ≥65 years (38.3 per 100,000 population), followed by children aged 0-4 years (13.4 per 100,000 population). Among all hospitalizations, 2,529 (95.7%) were associated with influenza A, 100 (3.8%) with influenza B, nine (0.3%) with influenza A and B co-infection, and five (0.2%) had no virus type information. Among those with influenza A subtype information, 760 (99.9%) were H3N2 virus and one (0.1%) was 2009 H1N1.
                          Clinical findings are preliminary and based on 367 (14%) cases with complete medical chart abstraction. The majority (96%) of hospitalized adults had at least one reported underlying medical condition; the most commonly reported were metabolic disorders, cardiovascular disease, and obesity. There were 53 hospitalized children with complete medical chart abstraction, 27 (51%) had no identified underlying medical conditions. The most commonly reported underlying medical conditions among pediatric patients were asthma and obesity. Among the 35 hospitalized women of childbearing age (15-44 years), 12 were pregnant.
                          Additional FluSurv-NET data can be found at:http://gis.cdc.gov/GRASP/Fluview/FluHospRates.html andhttp://gis.cdc.gov/grasp/fluview/FluHospChars.html.

                          View Interactive Application | View Full Screen | View PowerPoint Presentation Outpatient Illness Surveillance:

                          Nationwide during week 51, 5.5% 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 2.0%.
                          (ILI is defined as fever (temperature of 100?F [37.8?C] or greater) and cough and/or sore throat.)

                          Additional data are available at http://gis.cdc.gov/grasp/fluview/flu...dashboard.html.

                          View National and Regional Level Graphs and Data | View Chart Data | View Full Screen | View PowerPoint Presentation On a regional level, the percentage of outpatient visits for ILI ranged from 1.6% to 12.4% during week 51. All 10 regions reported a proportion of outpatient visits for ILI at or above their region-specific baseline levels.



                          ILINet State Activity Indicator Map:

                          Data collected in ILINet are used to produce a measure of ILI activity* by state. Activity levels are based on the percent of outpatient visits in a state due to ILI and are compared to the average percent of ILI visits that occur during weeks with little or no influenza virus circulation. Activity levels range from minimal, which would correspond to ILI activity from outpatient clinics being below, or only slightly above, the average, to high, which would correspond to ILI activity from outpatient clinics being much higher than average.
                          During week 51, the following ILI activity levels were experienced:
                          • Puerto Rico and 22 states (Alabama, Arkansas, Florida, Georgia, Idaho, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maryland, Minnesota, Mississippi, Missouri, New Jersey, North Carolina, Ohio, South Carolina, Texas, Utah, Virginia, and Wisconsin) experienced high ILI activity.
                          • Six states (Colorado, Michigan, New Mexico, Oklahoma, Pennsylvania, and West Virginia) experienced moderate ILI activity.
                          • New York City and eight states (Iowa, Nebraska, Nevada, North Dakota, South Dakota, Tennessee, Washington, and Wyoming) experienced low ILI activity.
                          • 14 states (Alaska, Arizona, California, Connecticut, Delaware, Hawaii, Maine, Massachusetts, Montana, New Hampshire, New York, Oregon, Rhode Island, and Vermont) experienced minimal ILI activity.
                          • Data were insufficient to calculate an ILI activity level from the District of Columbia.
                          Click on map to launch interactive tool
                          *This map uses the proportion of outpatient visits to health care providers for influenza-like illness to measure the ILI activity level within a state. It does not, however, measure the extent of geographic spread of flu within a state. Therefore, outbreaks occurring in a single city could cause the state to display high activity levels.
                          Data collected in ILINet may disproportionally represent certain populations within a state, and therefore, may not accurately depict the full picture of influenza activity for the whole state.
                          Data displayed in this map are based on data collected in ILINet, whereas the State and Territorial flu activity map is based on reports from state and territorial epidemiologists. The data presented in this map is preliminary and may change as more data is received.
                          Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.


                          Geographic Spread of Influenza as Assessed by State and Territorial Epidemiologists

                          The influenza activity reported by state and territorial epidemiologists indicates geographic spread of influenza viruses, but does not measure the severity of influenza activity.
                          During week 51, the following influenza activity was reported:
                          • Widespread influenza activity was reported by 36 states (Arkansas, Colorado, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, New York, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Virginia, Washington, Wisconsin, and Wyoming).
                          • Regional influenza activity was reported by Guam, Puerto Rico and 10 states (Alabama, Arizona, Idaho, Maine, Nevada, New Mexico, Rhode Island, Utah, Vermont, and West Virginia).
                          • Local influenza activity was reported by the District of Columbia, the U.S. Virgin Islands, and two states (Alaska and Oregon).
                          • Sporadic influenza activity was reported by two states (California and Hawaii).







                          Additional National and International Influenza Surveillance Information

                          FluView Interactive: FluView includes enhanced web-based interactive applications that can provide dynamic visuals of the influenza data collected and analyzed by CDC. These FluView Interactive applications allow people to create customized, visual interpretations of influenza data, as well as make comparisons across flu seasons, regions, age groups and a variety of other demographics. To access these tools, visithttp://www.cdc.gov/flu/weekly/fluviewinteractive.htm.
                          U.S. State and local influenza surveillance: Click on a jurisdiction below to access the latest local influenza information.

                          Google Flu Trends: Google Flu Trends uses aggregated Google search data in a model created in collaboration with CDC to estimate influenza activity in the United States. For more information and activity estimates from the United States and worldwide, see http://www.google.org/flutrends/
                          World Health Organization: Additional influenza surveillance information from participating WHO member nations is available through FluNet and theGlobal Epidemiology Reports.
                          WHO Collaborating Centers for Influenza located in Australia, China, Japan, the United Kingdom, and the United States (CDC in Atlanta, Georgia).
                          Europe: for the most recent influenza surveillance information from Europe, please see WHO/Europe at http://www.flunewseurope.org/ and visit the European Centre for Disease Prevention and Control athttp://ecdc.europa.eu/en/publication..._overview.aspx
                          Public Health Agency of Canada: The most up-to-date influenza information from Canada is available at http://www.phac-aspc.gc.ca/fluwatch/
                          Public Health England: The most up-to-date influenza information from the United Kingdom is available athttps://www.gov.uk/government/statistics/weekly-national-flu-reports



                          Any links provided to non-Federal organizations are provided solely as a service to our users. These links do not constitute an endorsement of these organizations or their programs by CDC or the Federal Government, and none should be inferred. CDC is not responsible for the content of the individual organization web pages found at these links.
                          In addition to the eight data components of CDC influenza surveillance for the 2014-2015 influenza season, the use of National Center for Health Statistics (NCHS) pneumonia and influenza mortality surveillance data for the rapid assessment of influenza-associated mortality will be piloted. An overview of influenza surveillance, including a description of the NCHS mortality surveillance data, is available here.
                          --------------------------------------------------------------------------------
                          Full report also available as PDF


                          Learn more about the weekly influenza surveillance report (FluView) prepared by the Influenza Division.






                          Comment


                          • #14

                            2014-2015 Influenza Season Week 53 ending January 3, 2015

                            All data are preliminary and may change as more reports are received.
                            Synopsis:

                            During week 53 (December 28, 2014-January 3, 2015), influenza activity continued at elevated levels in the United States.
                            • Viral Surveillance: Of 30,469 specimens tested and reported by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories during week 53, 7,515 (24.7%) were positive for influenza.
                            • Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia and influenza (P&I) was above the epidemic threshold.
                            • Influenza-associated Pediatric Deaths: Five influenza-associated pediatric deaths were reported.
                            • Influenza-associated Hospitalizations: A cumulative rate for the season of 20.1 laboratory-confirmed influenza-associated hospitalizations per 100,000 population was reported.
                            • Outpatient Illness Surveillance: The proportion of outpatient visits for influenza-like illness (ILI) was 5.6%, above the national baseline of 2.0%. All 10 regions reported ILI at or above region-specific baseline levels. Puerto Rico and 26 states experienced high ILI activity; New York City and eight states experienced moderate ILI activity; seven states experienced low ILI activity; eight states experienced minimal ILI activity; and the District of Columbia and one state had insufficient data.
                            • Geographic Spread of Influenza: The geographic spread of influenza in Guam and 46 states was reported as widespread; Puerto Rico, the U.S. Virgin Islands and three states reported regional activity; and the District of Columbia and one state reported local activity.
                            Nation Elevated 52 of 54 24.7% 100 20,066 28,911 2,817 26
                            Region 1 Elevated 6 of 6 19.8% 2 585 450 34 0
                            Region 2 Elevated 4 of 4 24.3% 23 933 1,668 61 1
                            Region 3 Elevated 5 of 6 33.7% 4 2,532 2,340 143 2
                            Region 4 Elevated 8 of 8 25.3% 4 1,932 8,599 1,151 8
                            Region 5 Elevated 6 of 6 33.1% 8 5,067 6,365 285 6
                            Region 6 Elevated 5 of 5 30.5% 27 2,261 5,161 733 5
                            Region 7 Elevated 4 of 4 24.8% 6 1,192 1,188 118 1
                            Region 8 Elevated 6 of 6 37.2% 17 2,622 2,445 106 1
                            Region 9 Elevated 4 of 5 18.9% 6 980 439 103 2
                            Region 10 Elevated 4 of 4 30.9% 3 1,962 256 83 0
                            *HHS regions (Region 1 CT, ME, MA, NH, RI, VT; Region 2: NJ, NY, Puerto Rico, US Virgin Islands; Region 3: DE, DC, MD, PA, VA, WV; Region 4: AL, FL, GA, KY, MS, NC, SC, TN; Region 5: IL, IN, MI, MN, OH, WI; Region 6: AR, LA, NM, OK, TX; Region 7: IA, KS, MO, NE; Region 8: CO, MT, ND, SD, UT, WY; Region 9: AZ, CA, Guam, HI, NV; and Region 10: AK, ID, OR, WA).
                            ? Elevated means the % of visits for ILI is at or above the national or region-specific baseline
                            ? Includes all 50 states, the District of Columbia, Guam, Puerto Rico, and U.S. Virgin Islands
                            ? National data are for current week; regional data are for the most recent three weeks


                            U.S. Virologic Surveillance:

                            WHO and NREVSS collaborating laboratories located in all 50 states, Puerto Rico, and the District of Columbia report to CDC the number of respiratory specimens tested for influenza and the number positive by influenza virus type and influenza A virus subtype. The results of tests performed during the current week are summarized in the table below. Region specific data are available at http://gis.cdc.gov/grasp/fluview/flu...dashboard.html.
                            30,469
                            261,603
                            7,515 (24.7%)
                            51,895 (19.8%)
                            7,218 (96.0%)
                            49,078 (94.6%)
                            8 (0.1%)
                            100 (0.2%)
                            2,486 (34.4%)
                            20,066 (40.9%)
                            4,724 (65.4%)
                            28,911 (58.9%)
                            297 (4.0%)
                            2,817 (5.4%)

                            View National and Regional Level Graphs and Data | View Chart Data | View Full Screen | View PowerPoint Presentation


                            Influenza Virus Characterization*:

                            CDC has characterized 355 influenza viruses [10 A(H1N1)pdm09, 288 A(H3N2), and 57 influenza B viruses] collected by U.S. laboratories since October 1, 2014.
                            Influenza A Virus [298]
                            • A (H1N1)pdm09 [10]: All 10 H1N1 viruses tested were characterized as A/California/7/2009-like, the influenza A (H1N1) component of the 2014-2015 Northern Hemisphere influenza vaccine.
                            • A (H3N2) [288]: 91 (31.6%) of the 288 H3N2 viruses tested have been characterized as A/Texas/50/2012-like, the influenza A (H3N2) component of the 2014-2015 Northern Hemisphere influenza vaccine. 197 (68.4%) of the 288 viruses tested showed either reduced titers with antiserum produced against A/Texas/50/2012 or belonged to a genetic group that typically shows reduced titers to A/Texas/50/2012. Among viruses that showed reduced titers with antiserum raised against A/Texas/50/2012, most were antigenically similar to A/Switzerland/9715293/2013, the H3N2 virus selected for the 2015 Southern Hemisphere influenza vaccine. A/Switzerland/9715293/2013 is related to, but antigenically and genetically distinguishable, from the A/Texas/50/2012 vaccine virus. A/Switzerland-like H3N2 viruses were first detected in the United States in small numbers in March of 2014 and began to increase through the spring and summer.
                            Influenza B Virus [57]
                            Fourty (70.2%) of the influenza B viruses tested belong to B/Yamagata/16/88 lineage and the remaining 17 (29.8%) influenza B viruses tested belong to B/Victoria/02/87 lineage.
                            • Yamagata Lineage [40]: All 40 B/Yamagata-lineage viruses were characterized as B/Massachusetts/2/2012-like, which is included as an influenza B component of the 2014-2015 Northern Hemisphere trivalent and quadrivalent influenza vaccines.
                            • Victoria Lineage [17]: Fifteen (88.2%) of the 17 B/Victoria-lineage viruses were characterized as B/Brisbane/60/2008-like, the virus that is included as an influenza B component of the 2014-2015 Northern Hemisphere quadrivalent influenza vaccine. Two (11.8%) of the B/Victoria-lineage viruses tested showed reduced titers to B/Brisbane/60/2008.
                            *CDC routinely uses hemagglutination inhibition (HI) assays to antigenically characterize influenza viruses year-round to compare how similar currently circulating influenza viruses are to those included in the influenza vaccine, and to monitor for changes in circulating influenza viruses. However, a portion of recent influenza A(H3N2) viruses do not grow to sufficient hemagglutination titers for antigenic characterization by HI. For many of these viruses, CDC is also performing genetic characterization to infer antigenic properties.

                            Antiviral Resistance:

                            Testing of influenza A(H1N1)pdm09, A(H3N2), and influenza B virus isolates for resistance to neuraminidase inhibitors (oseltamivir, zanamivir, and peramivir) is performed at CDC using a functional assay. Additional A(H1N1)pdm09 and A(H3N2) clinical samples are tested for mutations of the virus known to confer oseltamivir resistance. The data summarized below combine the results of both testing methods. These samples are routinely obtained for surveillance purposes rather than for diagnostic testing of patients suspected to be infected with antiviral-resistant virus.
                            High levels of resistance to the adamantanes (amantadine and rimantadine) persist among A(H1N1)pdm09 and A(H3N2) viruses (the adamantanes are not effective against influenza B viruses). Therefore, data from adamantane resistance testing are not presented below.
                            450
                            0 (0.0)
                            450
                            0 (0.0)
                            348
                            0 (0.0)
                            85
                            0 (0.0)
                            85
                            0 (0.0)
                            85
                            0 (0.0)
                            11
                            0 (0.0)
                            11
                            0 (0.0)
                            11
                            0 (0.0)
                            In the United States, all recently circulating influenza viruses have been susceptible to the neuraminidase inhibitor antiviral medications, oseltamivir, zanamivir, and peramivir; however, rare sporadic instances of oseltamivir-resistant A(H1N1)pdm09 and A(H3N2) viruses have been detected worldwide. Antiviral treatment with oseltamivir, zanamivir, or peramivir is recommended as early as possible for patients with confirmed or suspected influenza who have severe, complicated, or progressive illness; who require hospitalization; or who are at high risk for serious influenza-related complications. Additional information on recommendations for treatment and chemoprophylaxis of influenza virus infection with antiviral agents is available athttp://www.cdc.gov/flu/antivirals/index.htm.


                            Pneumonia and Influenza (P&I) Mortality Surveillance:

                            During week 53, 7.0% of all deaths reported through the 122 Cities Mortality Reporting System were due to P&I. This percentage was above the epidemic threshold of 6.9% for week 53.

                            View Full Screen | View PowerPoint Presentation For the 2014-2015 influenza season, CDC/Influenza Division and the National Center for Health Statistics (NCHS) are collaborating on a pilot project to use NCHS mortality surveillance data for the rapid assessment of pneumonia and influenza (P&I) mortality. To view the data, please click here.


                            Influenza-Associated Pediatric Mortality:

                            Five influenza-associated pediatric deaths were reported to CDC during week 53. All five deaths were associated with an influenza A virus for which no subtyping was performed and occurred during weeks 50, 51, 52, and 53 (weeks ending December 13, December 20, December 27, 2014, and January 3, 2015, respectively).
                            A total of 26 influenza-associated deaths have been reported during the 2014-2015 season from New York City [1] and 13 states (Arizona [1], Colorado [1], Florida [2], Georgia [1], Kansas [1], Minnesota [3], North Carolina [2], Nevada [1], Ohio [2], Tennessee [3], Texas [5], Virginia [2], and Wisconsin [1]).

                            Additional data can be found at: http://gis.cdc.gov/GRASP/Fluview/PedFluDeath.html.

                            View Interactive Application | View Full Screen | View PowerPoint Presentation


                            Influenza-Associated Hospitalizations:

                            The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts population-based surveillance for laboratory-confirmed influenza-related hospitalizations in children younger than 18 years of age (since the 2003-2004 influenza season) and adults (since the 2005-2006 influenza season).
                            The FluSurv-NET covers more than 70 counties in the 10 Emerging Infections Program (EIP) states (CA, CO, CT, GA, MD, MN, NM, NY, OR, and TN) and additional Influenza Hospitalization Surveillance Project (IHSP) states. The IHSP began during the 2009-2010 season to enhance surveillance during the 2009 H1N1 pandemic. IHSP sites included IA, ID, MI, OK and SD during the 2009-2010 season; ID, MI, OH, OK, RI, and UT during the 2010-2011 season; MI, OH, RI, and UT during the 2011-2012 season; IA, MI, OH, RI, and UT during the 2012-2013 season; and MI, OH, and UT during the 2013-2014 and 2014-2015 seasons.
                            Data gathered are used to estimate age-specific hospitalization rates on a weekly basis, and describe characteristics of persons hospitalized with severe influenza illness. The rates provided are likely to be an underestimate as influenza-related hospitalizations can be missed, either because testing is not performed, or because cases may be attributed to other causes of pneumonia or other common influenza-related complications.
                            Between October 1, 2014 and January 03, 2015, 5,492 laboratory-confirmed influenza-associated hospitalizations were reported. The overall hospitalization rate was 20.1 per 100,000 population. The highest rate of hospitalization was among adults aged ≥65 years (91.6 per 100,000 population), followed by children aged 0-4 years (22.0 per 100,000 population). Among all hospitalizations, 5,332 (97.1%) were associated with influenza A, 138 (2.5%) with influenza B, 13 (0.2%) with influenza A and B co-infection, and nine (0.2%) had no virus type information. Among those with influenza A subtype information, 1,582 (99.6%) were A(H3N2) virus and six (0.4%) were A(H1N1)pdm09.
                            Clinical findings are preliminary and based on 709 (13%) cases with complete medical chart abstraction. The majority (94%) of hospitalized adults had at least one reported underlying medical condition; the most commonly reported were metabolic disorders, cardiovascular disease, and obesity. There were 105 hospitalized children with complete medical chart abstraction, 43 (41%) had no identified underlying medical conditions. The most commonly reported underlying medical conditions among pediatric patients were asthma, obesity, and immune suppression. Among the 77 hospitalized women of childbearing age (15-44 years), 21 were pregnant.
                            Additional FluSurv-NET data can be found at: http://gis.cdc.gov/GRASP/Fluview/FluHospRates.html andhttp://gis.cdc.gov/grasp/fluview/FluHospChars.html.

                            Data from the Influenza Hospitalization Surveillance Network (FluSurv-NET), a population-based surveillance for influenza related hospitalizations in children and adults in 13 U.S. states. Incidence rates are calculated using the National Center for Health Statistics? (NCHS) population estimates for the counties included in the surveillance catchment area.
                            View Interactive Application | View Full Screen | View PowerPoint Presentation
                            FluSurv-NET data are preliminary and displayed as they become available. Therefore, figures are based on varying denominators as some variables represent information that may require more time to be collected. Data are refreshed and updated weekly. Asthma includes a medical diagnosis of asthma or reactive airway disease; Cardiovascular diseases include conditions such as coronary heart disease, cardiac valve disorders, congestive heart failure, and pulmonary hypertension; does not include isolated hypertension; Chronic lung diseases include conditions such as chronic obstructive pulmonary disease, bronchiolitis obliterans, chronic aspiration pneumonia, and interstitial lung disease; Immune suppression includes conditions such as immunoglobulin deficiency, leukemia, lymphoma, HIV/AIDS, and individuals taking immunosuppressive medications; Metabolic disorders include conditions such as diabetes mellitus; Neurologic diseases include conditions such as seizure disorders, cerebral palsy, and cognitive dysfunction; Neuromuscular diseasesinclude conditions such as multiple sclerosis and muscular dystrophy; Obesity was assigned if indicated in patient's medical chart or if body mass index (BMI) >30 kg/m2; Pregnancy percentage calculated using number of female cases aged between 15 and 44 years of age as the denominator; Renal diseases include conditions such as acute or chronic renal failure, nephrotic syndrome, glomerulonephritis, and impaired creatinine clearance; No known condition indicates that the case did not have any known high risk medical condition indicated in medical chart at the time of hospitalization.
                            View Interactive Application | View Full Screen | View PowerPoint Presentation



                            Outpatient Illness Surveillance:

                            Nationwide during week 53, 5.6% 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 2.0%.
                            (ILI is defined as fever (temperature of 100?F [37.8?C] or greater) and cough and/or sore throat.)
                            The increase in the percentage of patient visits for ILI in weeks 52 and 53, compared to week 51, may be influenced in part by a reduction in routine healthcare visits during the holidays, as has occurred in previous seasons.
                            Additional data are available at http://gis.cdc.gov/grasp/fluview/flu...dashboard.html.

                            View National and Regional Level Graphs and Data | View Chart Data | View Full Screen | View PowerPoint Presentation On a regional level, the percentage of outpatient visits for ILI ranged from 2.4% to 10.2% during week 53. All 10 regions reported a proportion of outpatient visits for ILI at or above their region-specific baseline levels.



                            ILINet State Activity Indicator Map:

                            Data collected in ILINet are used to produce a measure of ILI activity* by state. Activity levels are based on the percent of outpatient visits in a state due to ILI and are compared to the average percent of ILI visits that occur during weeks with little or no influenza virus circulation. Activity levels range from minimal, which would correspond to ILI activity from outpatient clinics being below, or only slightly above, the average, to high, which would correspond to ILI activity from outpatient clinics being much higher than average.
                            During week 53, the following ILI activity levels were experienced:
                            • Puerto Rico and 26 states (Alabama, Arkansas, Colorado, Hawaii, Idaho, Indiana, Kansas, Kentucky, Louisiana, Maryland, Minnesota, Mississippi, Missouri, Nevada, New Mexico, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia, West Virginia, and Wisconsin) experienced high ILI activity.
                            • New York City and eight states (California, Florida, Illinois, Michigan, Nebraska, New Jersey, South Dakota, and Wyoming) experienced moderate ILI activity.
                            • Seven states (Arizona, Georgia, Massachusetts, New York, North Dakota, Vermont, and Washington) experienced low ILI activity.
                            • Eight states (Alaska, Connecticut, Iowa, Maine, Montana, New Hampshire, Oregon, and Rhode Island) experienced minimal ILI activity.
                            • Data were insufficient to calculate an ILI activity level from the District of Columbia and one state (Delaware).
                            Click on map to launch interactive tool
                            *This map uses the proportion of outpatient visits to health care providers for influenza-like illness to measure the ILI activity level within a state. It does not, however, measure the extent of geographic spread of flu within a state. Therefore, outbreaks occurring in a single city could cause the state to display high activity levels.
                            Data collected in ILINet may disproportionally represent certain populations within a state, and therefore, may not accurately depict the full picture of influenza activity for the whole state.
                            Data displayed in this map are based on data collected in ILINet, whereas the State and Territorial flu activity map is based on reports from state and territorial epidemiologists. The data presented in this map is preliminary and may change as more data is received.
                            Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.


                            Geographic Spread of Influenza as Assessed by State and Territorial Epidemiologists

                            The influenza activity reported by state and territorial epidemiologists indicates geographic spread of influenza viruses, but does not measure the severity of influenza activity.
                            During week 53, the following influenza activity was reported:
                            • Widespread influenza activity was reported by Guam and 46 states (Alabama, Arkansas, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming).
                            • Regional influenza activity was reported by Puerto Rico, the U.S. Virgin Islands, and three states (Alaska, Arizona, and California).
                            • Local activity was reported by the District of Columbia and one state (Hawaii).







                            Additional National and International Influenza Surveillance Information

                            FluView Interactive: FluView includes enhanced web-based interactive applications that can provide dynamic visuals of the influenza data collected and analyzed by CDC. These FluView Interactive applications allow people to create customized, visual interpretations of influenza data, as well as make comparisons across flu seasons, regions, age groups and a variety of other demographics. To access these tools, visithttp://www.cdc.gov/flu/weekly/fluviewinteractive.htm.
                            U.S. State and local influenza surveillance: Click on a jurisdiction below to access the latest local influenza information.

                            Google Flu Trends: Google Flu Trends uses aggregated Google search data in a model created in collaboration with CDC to estimate influenza activity in the United States. For more information and activity estimates from the United States and worldwide, see http://www.google.org/flutrends/
                            World Health Organization: Additional influenza surveillance information from participating WHO member nations is available through FluNet and theGlobal Epidemiology Reports.
                            WHO Collaborating Centers for Influenza located in Australia, China, Japan, the United Kingdom, and the United States (CDC in Atlanta, Georgia).
                            Europe: for the most recent influenza surveillance information from Europe, please see WHO/Europe at http://www.flunewseurope.org/ and visit the European Centre for Disease Prevention and Control athttp://ecdc.europa.eu/en/publication..._overview.aspx
                            Public Health Agency of Canada: The most up-to-date influenza information from Canada is available at http://www.phac-aspc.gc.ca/fluwatch/
                            Public Health England: The most up-to-date influenza information from the United Kingdom is available athttps://www.gov.uk/government/statistics/weekly-national-flu-reports



                            Any links provided to non-Federal organizations are provided solely as a service to our users. These links do not constitute an endorsement of these organizations or their programs by CDC or the Federal Government, and none should be inferred. CDC is not responsible for the content of the individual organization web pages found at these links.
                            In addition to the eight data components of CDC influenza surveillance for the 2014-2015 influenza season, the use of National Center for Health Statistics (NCHS) pneumonia and influenza mortality surveillance data for the rapid assessment of influenza-associated mortality will be piloted. An overview of influenza surveillance, including a description of the NCHS mortality surveillance data, is available here.
                            --------------------------------------------------------------------------------
                            Full report also available as PDF

                            Learn more about the weekly influenza surveillance report (FluView) prepared by the Influenza Division.






                            Comment


                            • #15
                              2014-2015 Influenza Season Week 1 ending January 10, 2015

                              All data are preliminary and may change as more reports are received.
                              Synopsis:

                              During week 1 (January 4-10, 2015), influenza activity remained elevated in the United States.
                              • Viral Surveillance: Of 26,204 specimens tested and reported by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories during week 1, 5,284 (20.2%) were positive for influenza.
                              • Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia and influenza (P&I) was above the epidemic threshold.
                              • Influenza-associated Pediatric Deaths: Nineteen influenza-associated pediatric deaths were reported.
                              • Influenza-associated Hospitalizations: A cumulative rate for the season of 29.9 laboratory-confirmed influenza-associated hospitalizations per 100,000 population was reported.
                              • Outpatient Illness Surveillance: The proportion of outpatient visits for influenza-like illness (ILI) was 4.4%, above the national baseline of 2.0%. All 10 regions reported ILI at or above region-specific baseline levels. Puerto Rico and 24 states experienced high ILI activity; New York City and seven states experienced moderate ILI activity; seven states experienced low ILI activity; 11 states experienced minimal ILI activity; and the District of Columbia and one state had insufficient data.
                              • Geographic Spread of Influenza: The geographic spread of influenza in Guam and 46 states was reported as widespread; Puerto Rico, the U.S. Virgin Islands, and three states reported regional activity; and the District of Columbia and one state reported local activity.
                              Nation Elevated 52 of 54 20.2% 114 23,744 33,296 3,153 45
                              Region 1 Elevated 6 of 6 20.5% 4 778 656 41 0
                              Region 2 Elevated 4 of 4 25.5% 31 1,343 2,466 93 1
                              Region 3 Elevated 5 of 6 32.3% 4 3,328 2,952 181 3
                              Region 4 Elevated 8 of 8 21.8% 5 2,210 9,697 1,251 13
                              Region 5 Elevated 6 of 6 28.2% 8 5,802 6,773 318 10
                              Region 6 Elevated 5 of 5 28.2% 27 2,530 5,418 793 10
                              Region 7 Elevated 4 of 4 22.2% 8 1,340 1,689 133 4
                              Region 8 Elevated 6 of 6 34.8% 17 2,870 2,594 124 2
                              Region 9 Elevated 5 of 5 20.2% 6 1,195 736 119 2
                              Region 10 Elevated 3 of 4 29.8% 4 2,348 315 100 0
                              *HHS regions (Region 1 CT, ME, MA, NH, RI, VT; Region 2: NJ, NY, Puerto Rico, US Virgin Islands; Region 3: DE, DC, MD, PA, VA, WV; Region 4: AL, FL, GA, KY, MS, NC, SC, TN; Region 5: IL, IN, MI, MN, OH, WI; Region 6: AR, LA, NM, OK, TX; Region 7: IA, KS, MO, NE; Region 8: CO, MT, ND, SD, UT, WY; Region 9: AZ, CA, Guam, HI, NV; and Region 10: AK, ID, OR, WA).
                              ? Elevated means the % of visits for ILI is at or above the national or region-specific baseline
                              ? Includes all 50 states, the District of Columbia, Guam, Puerto Rico, and U.S. Virgin Islands
                              ? National data are for current week; regional data are for the most recent three weeks


                              U.S. Virologic Surveillance:

                              WHO and NREVSS collaborating laboratories located in all 50 states, Puerto Rico, and the District of Columbia report to CDC the number of respiratory specimens tested for influenza and the number positive by influenza virus type and influenza A virus subtype. The results of tests performed during the current week are summarized in the table below. Region specific data are available at http://gis.cdc.gov/grasp/fluview/flu...dashboard.html.
                              26,204
                              298,603
                              5,284 (20.2%)
                              60,308 (20.2%)
                              5,051 (95.6%)
                              57,155 (94.8%)
                              7 (0.1%)
                              114 (0.2%)
                              1,868 (37.0%)
                              23,744 (41.5%)
                              3,176 (62.9%)
                              33,296 (58.3%)
                              233 (4.4%)
                              3,153 (5.2%)

                              View National and Regional Level Graphs and Data | View Chart Data | View Full Screen | View PowerPoint Presentation


                              Influenza Virus Characterization*:

                              CDC has characterized 462 influenza viruses [10 A(H1N1)pdm09, 349 A(H3N2), and 103 influenza B viruses] collected by U.S. laboratories since October 1, 2014.
                              Influenza A Virus [359]
                              • A (H1N1)pdm09 [10]: All 10 H1N1 viruses tested were characterized as A/California/7/2009-like, the influenza A (H1N1) component of the 2014-2015 Northern Hemisphere influenza vaccine.
                              • A (H3N2) [349]: 122 (35.0%) of the 349 H3N2 viruses tested have been characterized as A/Texas/50/2012-like, the influenza A (H3N2) component of the 2014-2015 Northern Hemisphere influenza vaccine. 227 (65.0%) of the 349 viruses tested showed either reduced titers with antiserum produced against A/Texas/50/2012 or belonged to a genetic group that typically shows reduced titers to A/Texas/50/2012. Among viruses that showed reduced titers with antiserum raised against A/Texas/50/2012, most were antigenically similar to A/Switzerland/9715293/2013, the H3N2 virus selected for the 2015 Southern Hemisphere influenza vaccine. A/Switzerland/9715293/2013 is related to, but antigenically and genetically distinguishable, from the A/Texas/50/2012 vaccine virus. A/Switzerland-like H3N2 viruses were first detected in the United States in small numbers in March of 2014 and began to increase through the spring and summer.
                              Influenza B Virus [103]
                              Sixty-nine (67.0%) of the influenza B viruses tested belong to B/Yamagata/16/88 lineage and the remaining 34 (33.0%) influenza B viruses tested belong to B/Victoria/02/87 lineage.
                              • Yamagata Lineage [69]: All 69 B/Yamagata-lineage viruses were characterized as B/Massachusetts/2/2012-like, which is included as an influenza B component of the 2014-2015 Northern Hemisphere trivalent and quadrivalent influenza vaccines.
                              • Victoria Lineage [34]: Thirty (88.2%) of the 34 B/Victoria-lineage viruses were characterized as B/Brisbane/60/2008-like, the virus that is included as an influenza B component of the 2014-2015 Northern Hemisphere quadrivalent influenza vaccine. Four (11.8%) of the B/Victoria-lineage viruses tested showed reduced titers to B/Brisbane/60/2008.
                              *CDC routinely uses hemagglutination inhibition (HI) assays to antigenically characterize influenza viruses year-round to compare how similar currently circulating influenza viruses are to those included in the influenza vaccine, and to monitor for changes in circulating influenza viruses. However, a portion of recent influenza A(H3N2) viruses do not grow to sufficient hemagglutination titers for antigenic characterization by HI. For many of these viruses, CDC is also performing genetic characterization to infer antigenic properties.

                              Antiviral Resistance:

                              Testing of influenza A(H1N1)pdm09, A(H3N2), and influenza B virus isolates for resistance to neuraminidase inhibitors (oseltamivir, zanamivir, and peramivir) is performed at CDC using a functional assay. Additional A(H1N1)pdm09 and A(H3N2) clinical samples are tested for mutations of the virus known to confer oseltamivir resistance. The data summarized below combine the results of both testing methods. These samples are routinely obtained for surveillance purposes rather than for diagnostic testing of patients suspected to be infected with antiviral-resistant virus.
                              High levels of resistance to the adamantanes (amantadine and rimantadine) persist among A(H1N1)pdm09 and A(H3N2) viruses (the adamantanes are not effective against influenza B viruses). Therefore, data from adamantane resistance testing are not presented below.
                              521
                              0 (0.0)
                              521
                              0 (0.0)
                              419
                              0 (0.0)
                              87
                              0 (0.0)
                              87
                              0 (0.0)
                              87
                              0 (0.0)
                              11
                              0 (0.0)
                              11
                              0 (0.0)
                              11
                              0 (0.0)
                              In the United States, all recently circulating influenza viruses have been susceptible to the neuraminidase inhibitor antiviral medications, oseltamivir, zanamivir, and peramivir; however, rare sporadic instances of oseltamivir-resistant A(H1N1)pdm09 and A(H3N2) viruses have been detected worldwide. Antiviral treatment with oseltamivir, zanamivir, or peramivir is recommended as early as possible for patients with confirmed or suspected influenza who have severe, complicated, or progressive illness; who require hospitalization; or who are at high risk for serious influenza-related complications. Additional information on recommendations for treatment and chemoprophylaxis of influenza virus infection with antiviral agents is available athttp://www.cdc.gov/flu/antivirals/index.htm.


                              Pneumonia and Influenza (P&I) Mortality Surveillance:

                              During week 1, 8.5% of all deaths reported through the 122 Cities Mortality Reporting System were due to P&I. This percentage was above the epidemic threshold of 7.0% for week 1.

                              View Full Screen | View PowerPoint Presentation For the 2014-2015 influenza season, CDC/Influenza Division and the National Center for Health Statistics (NCHS) are collaborating on a pilot project to use NCHS mortality surveillance data for the rapid assessment of pneumonia and influenza (P&I) mortality. To view the data, please click here.


                              Influenza-Associated Pediatric Mortality:

                              Nineteen influenza-associated pediatric deaths were reported to CDC during week 1. Eight deaths were associated with an influenza A (H3) virus and occurred during weeks 51, 52, 53, and 1 (weeks ending December 20, December 27, 2014, January 3, and January 10, 2015, respectively). Nine deaths were associated with an influenza A virus for which no subtyping was performed and occurred during weeks 50, 52, 53, and 1 (weeks ending December 13, December 27, 2014, and January 3, and January 10, 2015, respectively). One death was associated with an influenza virus for which the type was not determined and occurred during week 53, and one death was associated with an influenza B virus and occurred during week 1.
                              A total of 45 influenza-associated deaths have been reported during the 2014-2015 season from New York City [1] and 18 states (Arizona [1], Colorado [2], Florida [2], Georgia [1], Iowa [2], Kansas [2], Kentucky [3], Louisiana [2], Minnesota [4], North Carolina [2], Nevada [1], Ohio [4], Oklahoma [2], South Carolina [1], Tennessee [4], Texas [6], Virginia [3], and Wisconsin [2]).

                              Additional data can be found at: http://gis.cdc.gov/GRASP/Fluview/PedFluDeath.html.

                              View Interactive Application | View Full Screen | View PowerPoint Presentation


                              Influenza-Associated Hospitalizations:

                              The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts population-based surveillance for laboratory-confirmed influenza-related hospitalizations in children younger than 18 years of age (since the 2003-2004 influenza season) and adults (since the 2005-2006 influenza season).
                              The FluSurv-NET covers more than 70 counties in the 10 Emerging Infections Program (EIP) states (CA, CO, CT, GA, MD, MN, NM, NY, OR, and TN) and additional Influenza Hospitalization Surveillance Project (IHSP) states. The IHSP began during the 2009-2010 season to enhance surveillance during the 2009 H1N1 pandemic. IHSP sites included IA, ID, MI, OK and SD during the 2009-2010 season; ID, MI, OH, OK, RI, and UT during the 2010-2011 season; MI, OH, RI, and UT during the 2011-2012 season; IA, MI, OH, RI, and UT during the 2012-2013 season; and MI, OH, and UT during the 2013-2014 and 2014-2015 seasons.
                              Data gathered are used to estimate age-specific hospitalization rates on a weekly basis, and describe characteristics of persons hospitalized with severe influenza illness. The rates provided are likely to be an underestimate as influenza-related hospitalizations can be missed, either because testing is not performed, or because cases may be attributed to other causes of pneumonia or other common influenza-related complications.
                              Between October 1, 2014 and January 10, 2015, 8,199 laboratory-confirmed influenza-associated hospitalizations were reported. The overall hospitalization rate was 29.9 per 100,000 population. The highest rate of hospitalization was among adults aged ≥65 years (143.3 per 100,000 population), followed by children aged 0-4 years (30.0 per 100,000 population). Among all hospitalizations, 7,934 (96.8%) were associated with influenza A, 200 (2.5%) with influenza B, 21 (0.3%) with influenza A and B co-infection, and 38 (0.4%) had no virus type information. Among those with influenza A subtype information, 2,110 (99.6%) were A(H3N2) virus, seven (0.3%) were A(H1N1)pdm09 and one (0.1%) was A(H1) unspecified.
                              Clinical findings are preliminary and based on 984 (12%) cases with complete medical chart abstraction. The majority (93.4%) of hospitalized adults had at least one reported underlying medical condition; the most commonly reported were metabolic disorders, cardiovascular disease, and obesity. There were 164 hospitalized children with complete medical chart abstraction, 68 (41%) had no identified underlying medical conditions. The most commonly reported underlying medical conditions among pediatric patients were asthma, obesity, and immune suppression. Among the 95 hospitalized women of childbearing age (15-44 years), 24 were pregnant.
                              Additional FluSurv-NET data can be found at: http://gis.cdc.gov/GRASP/Fluview/FluHospRates.html andhttp://gis.cdc.gov/grasp/fluview/FluHospChars.html.

                              Data from the Influenza Hospitalization Surveillance Network (FluSurv-NET), a population-based surveillance for influenza related hospitalizations in children and adults in 13 U.S. states. Incidence rates are calculated using the National Center for Health Statistics? (NCHS) population estimates for the counties included in the surveillance catchment area.
                              View Interactive Application | View Full Screen | View PowerPoint Presentation
                              FluSurv-NET data are preliminary and displayed as they become available. Therefore, figures are based on varying denominators as some variables represent information that may require more time to be collected. Data are refreshed and updated weekly. Asthma includes a medical diagnosis of asthma or reactive airway disease; Cardiovascular diseases include conditions such as coronary heart disease, cardiac valve disorders, congestive heart failure, and pulmonary hypertension; does not include isolated hypertension; Chronic lung diseases include conditions such as chronic obstructive pulmonary disease, bronchiolitis obliterans, chronic aspiration pneumonia, and interstitial lung disease; Immune suppression includes conditions such as immunoglobulin deficiency, leukemia, lymphoma, HIV/AIDS, and individuals taking immunosuppressive medications; Metabolic disorders include conditions such as diabetes mellitus; Neurologic diseases include conditions such as seizure disorders, cerebral palsy, and cognitive dysfunction; Neuromuscular diseasesinclude conditions such as multiple sclerosis and muscular dystrophy; Obesity was assigned if indicated in patient's medical chart or if body mass index (BMI) >30 kg/m2; Pregnancy percentage calculated using number of female cases aged between 15 and 44 years of age as the denominator; Renal diseases include conditions such as acute or chronic renal failure, nephrotic syndrome, glomerulonephritis, and impaired creatinine clearance; No known condition indicates that the case did not have any known high risk medical condition indicated in medical chart at the time of hospitalization.
                              View Interactive Application | View Full Screen | View PowerPoint Presentation



                              Outpatient Illness Surveillance:

                              Nationwide during week 1, 4.4% 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 2.0%.
                              (ILI is defined as fever (temperature of 100?F [37.8?C] or greater) and cough and/or sore throat.)
                              Additional data are available at http://gis.cdc.gov/grasp/fluview/flu...dashboard.html.

                              View National and Regional Level Graphs and Data | View Chart Data | View Full Screen | View PowerPoint Presentation On a regional level, the percentage of outpatient visits for ILI ranged from 2.6% to 8.4% during week 1. All 10 regions reported a proportion of outpatient visits for ILI at or above their region-specific baseline levels.



                              ILINet State Activity Indicator Map:

                              Data collected in ILINet are used to produce a measure of ILI activity* by state. Activity levels are based on the percent of outpatient visits in a state due to ILI and are compared to the average percent of ILI visits that occur during weeks with little or no influenza virus circulation. Activity levels range from minimal, which would correspond to ILI activity from outpatient clinics being below, or only slightly above, the average, to high, which would correspond to ILI activity from outpatient clinics being much higher than average.
                              During week 1, the following ILI activity levels were experienced:
                              • Puerto Rico and 24 states (Alabama, Arkansas, Colorado, Georgia, Idaho, Iowa, Kansas, Kentucky, Louisiana, Minnesota, Mississippi, Missouri, Nevada, New Jersey, North Carolina, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia, Washington, and West Virginia) experienced high ILI activity.
                              • New York City and seven states (California, Indiana, Maryland, Nebraska, New Mexico, Ohio, and Wyoming) experienced moderate ILI activity.
                              • Seven states (Arizona, Connecticut, Massachusetts, North Dakota, Rhode Island, South Dakota, and Wisconsin) experienced low ILI activity.
                              • Eleven states (Alaska, Florida, Hawaii, Illinois, Maine, Michigan, Montana, New Hampshire, New York, Oregon, and Vermont) experienced minimal ILI activity.
                              • Data were insufficient to calculate an ILI activity level from the District of Columbia and one state (Delaware).
                              Click on map to launch interactive tool
                              *This map uses the proportion of outpatient visits to health care providers for influenza-like illness to measure the ILI activity level within a state. It does not, however, measure the extent of geographic spread of flu within a state. Therefore, outbreaks occurring in a single city could cause the state to display high activity levels.
                              Data collected in ILINet may disproportionally represent certain populations within a state, and therefore, may not accurately depict the full picture of influenza activity for the whole state.
                              Data displayed in this map are based on data collected in ILINet, whereas the State and Territorial flu activity map is based on reports from state and territorial epidemiologists. The data presented in this map is preliminary and may change as more data is received.
                              Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.


                              Geographic Spread of Influenza as Assessed by State and Territorial Epidemiologists

                              The influenza activity reported by state and territorial epidemiologists indicates geographic spread of influenza viruses, but does not measure the severity of influenza activity.
                              During week 1, the following influenza activity was reported:
                              • Widespread influenza activity was reported by Guam and 46 states (Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming).
                              • Regional influenza activity was reported by Puerto Rico, the U.S. Virgin Islands, and three states (Alabama, Georgia, and Hawaii).
                              • Local activity was reported by the District of Columbia and one state (Alaska).







                              Additional National and International Influenza Surveillance Information

                              FluView Interactive: FluView includes enhanced web-based interactive applications that can provide dynamic visuals of the influenza data collected and analyzed by CDC. These FluView Interactive applications allow people to create customized, visual interpretations of influenza data, as well as make comparisons across flu seasons, regions, age groups and a variety of other demographics. To access these tools, visithttp://www.cdc.gov/flu/weekly/fluviewinteractive.htm.
                              U.S. State and local influenza surveillance: Click on a jurisdiction below to access the latest local influenza information.

                              Google Flu Trends: Google Flu Trends uses aggregated Google search data in a model created in collaboration with CDC to estimate influenza activity in the United States. For more information and activity estimates from the United States and worldwide, see http://www.google.org/flutrends/
                              World Health Organization: Additional influenza surveillance information from participating WHO member nations is available through FluNet and theGlobal Epidemiology Reports.
                              WHO Collaborating Centers for Influenza located in Australia, China, Japan, the United Kingdom, and the United States (CDC in Atlanta, Georgia).
                              Europe: for the most recent influenza surveillance information from Europe, please see WHO/Europe at http://www.flunewseurope.org/ and visit the European Centre for Disease Prevention and Control athttp://ecdc.europa.eu/en/publication..._overview.aspx
                              Public Health Agency of Canada: The most up-to-date influenza information from Canada is available at http://www.phac-aspc.gc.ca/fluwatch/
                              Public Health England: The most up-to-date influenza information from the United Kingdom is available athttps://www.gov.uk/government/statistics/weekly-national-flu-reports



                              Any links provided to non-Federal organizations are provided solely as a service to our users. These links do not constitute an endorsement of these organizations or their programs by CDC or the Federal Government, and none should be inferred. CDC is not responsible for the content of the individual organization web pages found at these links.
                              In addition to the eight data components of CDC influenza surveillance for the 2014-2015 influenza season, the use of National Center for Health Statistics (NCHS) pneumonia and influenza mortality surveillance data for the rapid assessment of influenza-associated mortality will be piloted. An overview of influenza surveillance, including a description of the NCHS mortality surveillance data, is available here.
                              -------------------------------------------------------------------------------- Full report also available as PDF

                              Learn more about the weekly influenza surveillance report (FluView) prepared by the Influenza Division.






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