Institute for Disease Control weekly reports winter 2012-2013

[Ronan Kelly]

Re: Institute for Disease Control weekly reports winter 2012-2013

Influenza Report, Week 9 (25/2 - 3/3), 2013
Report on the current flu situation
Editors: H?l?ne Englund, Anna Sara Carnahan

Influenza in Sweden
During week 9, a total of 782 laboratory-confirmed cases of influenza, a decrease of 20% compared with week 8 ( Table 1 ). The cases were fairly evenly divided between seasonal influenza strains A and B and A (H1N1) pdm09, but seasonal influenza B decreased only marginally. Halland J?mtland ?rebro and Kronoberg reported slightly more cases than 8 weeks but in all other counties reduced influence cases ( map ).

Of the total 2289 cases of A (H1N1) pdm09 reported during the season, 835 hospitalized (36%). Of these, 91 (11%) received treatment intensive, seven of which have required ECMO treatment. About 60% of the intensive caring is set to belong to any risk group. In total, during the season 12 deaths reported through SmiNet and no new deaths have been reported in week 9. If an already notified the patient's death, this is not notifiable and from previous seasons, we know that we may continuously aware of all deaths. When the season is over, it is a complementary analysis and the number of deaths associated with A (H1N1) pdm09 may then rise.

Despite the decline in the number of cases, influenza activity remains high, and it is also seen in both sentinel reporting ( Figure 4 ) as sentinel sampling ( Figure 5 ). In sentinel sampling, the proportion of influenza B positive samples increased. Sentinel reporting mainly reflect cases that sought outpatient, while laboratory reporting ( Table 2 ) reflects the seeking inpatient and emergency rooms. Relatively few influenza B patients usually need medical care. The increase of B-positive samples in the sentinel sampling therefore indicates that the spread of this influenza type has increased in society in week 9. This may also be the cause of the decline of influenza increases V?rdguiden ( Web Search ) and telephone inquiries about the fever and cough leveled off during the week ( Contact Causes 1177 ).

In summary, influenza activity remained high during the week 9, but still declining. All three types of flu still circulating, and probably increased the number of cases of influenza B in the community.
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Influenza type // Current week 9/2013 // Previous Week 8/2013 // Change // Cumulatively during the season

A (H1N1) pdm09 // 159 // 229 // -31% // 2,104
Seasonal Influenza A // 230 // 293 // -22% // 2,172
Seasonal influenza B // 239 // 260 // -8% // 1,278
Total cases // 628 // 782 // -20% // 5,554
Number of samples analyzed // 1,907 // 2,169 // - // 20,830
Percentage of positive samples // 32.9% // 36.1% // - // 26.7%
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http://www.smittskyddsinstitutet.se...ongen-20122013/influensarapport-vecka-9-2013/

 

[Ronan Kelly]

Re: Institute for Disease Control weekly reports winter 2012-2013

Influenza Report, Week 10 (4/3 - 10/3), 2013
Report on the current flu situation
Editors: Hélène Englund, Anna Sara Carnahan

ts / Flu Reports / Season 2012/2013 / Flu Report, Week 10 (4/3 - 10/3), 2013
Influenza Report, Week 10 (4/3 - 10/3), 2013
Report on the current flu situation

Influenza in Sweden
In weeks 10 454 reported cases of influenza, compared with 626 cases week 9 ( Table 1 ). During week 10 were influenza B almost half of all laboratory confirmed cases, but continued to circulate even A (H1N1) pdm09 and seasonal influenza A. The number of cases seems to have fallen for all flu types in week 10 ( Table 1 ), but we do not have reports of a few laboratories. The incidence of laboratory-confirmed influenza cases, in terms of population, is highest in Halland Jämtland, Värmland and Örebro County (see map ).

Of a total of 2396 reported, laboratory-confirmed cases of A (H1N1) pdm09 through week 10, 902 hospitalized (38%). Of these, 106 (12%) intensive cared. Among the intensive cared, about 60% stated to belong to a risk group, while the corresponding proportion among other hospitalized is approximately 50%. Almost half of the intensive caring is between 40 and 64 years and about a quarter are over 65. Since the previous weekly report, four more persons with laboratory-confirmed A (H1N1) infection pdm09 reported to have died. A total of 16 deaths have been reported in SmiNet and almost all belonged to a risk group for severe disease.

From outpatient reported still very flu-like illness (ILI), although the trend has been downward since week 6 ( Figure 4 ). SMI analyzed 54 sentinel samples from week 10, of which 33% were positive for influenza; half for influenza A and half for influenza B ( Figure 5 ). All influenza B strains were similar to the vaccine strain (B-Yamagata-like). Both the number of submitted samples and the proportion of positive samples decreased from week 9 when the 119 samples submitted for analysis, and 44% were positive for influenza.

Web Search and telephone inquiries to 1177 give similar pictures of a slowly declining influenza activity ( Contact Causes 1177 ).
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Influenza type // Current week 10/2013 // Previous Week 9/2013 // Change // Cumulatively during the season

A (H1N1) pdm09 // 102 // 159 // -36% // 2,206
Seasonal Influenza A // 145 // 223 // -35% // 2,310
Seasonal influenza B // 207 // 244 // -15% // 1,490
Total cases // 454 // 626 // -27% // 6,006
Number of samples analyzed // 1,676 // 1,961 // - // 22,560
Percentage of positive samples // 27.1% // 31.9% // - // 26.6%
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http://www.smittskyddsinstitutet.se...ngen-20122013/influensarapport-vecka-10-2013/

 

[Ronan Kelly]

Re: Institute for Disease Control weekly reports winter 2012-2013

Influenza Report, Week 11 (11/3 - 17/3), 2013
Report on the current flu situation
Editors: Hélène Englund, Anna Sara Carnahan

Influenza in Sweden
For week 11, 433 reported cases of influenza, compared with 501 cases reported overall in week 10 ( Table 1 , Table 2 ). More than half of these were influenza B ( Figure 3 ). Influenza activity continues to decline throughout the country (see map ), but the incidence of influenza B helps to make the flu season lengthy.

The incidence of seasonal influenza A is normally highest among persons over 65 years, while the influenza A (H1N1) pdm09 mainly affects the young children under five. Influenza B is present in almost all age groups, but children between 5 and 14 years are slightly overrepresented among cases ( Table 3 ).

Of a total of 2472 reported, laboratory-confirmed cases of A (H1N1) pdm09 season has 962 hospitalized (39%). Since the previous weekly report has a death of a person with severe underlying disease reported by SmiNet. A total of 17 deaths reported during the season.

Through the Swedish Intensive Care Registry has this season a hundred intensive nursed patients with influenza reported. More than half have had influenza A (H1N1) pdm09, but almost a third have been infected with influenza A (not H1N1) and 15% of patients had influenza B. Half of the intense nursed cases over 59 years, but the average age is slightly different ate between influenza types: Influenza A (not H1N1) was 65 years, while it was 51 years for A (H1N1) pdm09 and 47 years for influenza B.

The reports from sentinel physicians in outpatient care shows that the proportion of patients with influenza-like illness (ILI) has remained at medium level in the last three weeks ( Figure 4 , Table 4 ). Of the 64 sentinel specimens collected in sentinel surveillance week 11, almost half (48%) were positive for influenza. This is the highest percentage of positive samples for the season and an increase compared to week 10 when 39% were positive for influenza ( Figure 5 , Table 5 ). Nearly 75% of the positive samples from week 11 were influenza B and the majority (91%) were similar to the vaccine strain (B-Yamagata-like). Of the influenza A positive samples subtypats were all A (H3N2), no influenza A (H1N1) pdm09 was diagnosed.

A similar picture of moderate but slowing activity also shows Web Search and the number of calls to Sjukvårdsrådgivningen 1177 with questions about the flu-like symptoms ( Contact Causes 1177 ).

After a long and unusually severe influenza A season points are that we approach the end of this. Influenza B tends however to circulate for a longer period and monitoring systems show that this activity is still high. We can therefore expect more cases of influenza in the coming weeks, but it is unusual for influenza B causes severe illness.
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Influenza type // Current week 11/2013 // Previous Week 10/2013 // Change // Cumulatively during the season

A (H1N1) pdm09 // 69 // 102 // -32% // 2,275
Seasonal Influenza A // 126 // 169 // -25% // 2,460
Seasonal influenza B // 238 // 230 // +3% // 1,751
Total cases // 433 // 501 // -14% // 6,486
Number of samples analyzed // 1,500 // 1,729 // - // 24,113
Percentage of positive samples // 28.9% // 29.0% // - // 26.9%
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http://www.smittskyddsinstitutet.se...ngen-20122013/influensarapport-vecka-11-2013/

 

[Ronan Kelly]

Re: Institute for Disease Control weekly reports winter 2012-2013

Influenza Report, Week 12 (18/3 - 24/3), 2013
Report on the current flu situation
Editors: H?l?ne Englund, Anna Sara Carnahan

Influenza in Sweden
Influenza spread further decreased slowly during 12 weeks, and especially influenza B still circulating. Total reported 387 laboratory confirmed cases of influenza, a decrease of 16% compared to week 11 ( Table 1 , Table 2 ). 53 percent of the reported cases were influenza B. Most cases per capita reported from V?stra G?taland (see map ).

A middle-aged man was reported dead with A (H1N1) pdm09 during week 12. In total during the season, we have learned of 18 people died and 115 people have been notified intensive nursed because of A (H1N1) pdm09. From ICU has seven patients infected with seasonal influenza A/H3N2, 25 with an unspecified influenza A infection and 16 influenza B cases reported by Swedish Intensive Care Registry .

The proportion of people who applied sentinel physicians for influenza-like illness was during week 12 at a low level ( Fig. 4 , Table 4 ). The number of sentinel samples were halved compared to week 11, but the percentage positive for influenza, 42%, remains at a relatively high level ( Figure 5 , Table 5 ). Although other monitoring speak too slowly declining influenza activity ( Web Search , Contact Causes 1177 ).

Respiratory infection were acts - like winter weather - linger.
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Influenza type // Current week 12/2013 // Previous Week 11/2013 // Change // Cumulatively during the season

A (H1N1) pdm09 // 65 // 70 // -7% // 2,341
Seasonal Influenza A // 116 // 137 // -15% // 2,571
Seasonal influenza B // 206 // 254 // -19% // 1,972
Total cases // 387 // 461 // -16% // 6,884
Number of samples analyzed // 1,295 // 1,500 // - // 25,408
Percentage of positive samples // 29.9% // 30.7% // - // 27.1%
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http://www.smittskyddsinstitutet.se...ngen-20122013/influensarapport-vecka-12-2013/

 

[Ronan Kelly]

Re: Institute for Disease Control weekly reports winter 2012-2013

Influenza Report, Week 13 (25/3 - 31/3), 2013
Report on the current flu situation
Editors: H?l?ne Englund, Anna Sara Carnahan

Influenza in Sweden
For week 13, a total of 349 influenza cases from the country's laboratories, which is a decrease of 15% compared to week 12. D?rapporterades 412 cases. The percentage of positive samples is still high ( Table 1 , Table 2 ).

Influenza B now represent the majority of laboratory-confirmed cases ( Figure 3 ). Only 32 cases of influenza A (H1N1) pdm09 ("swine flu") was reported, which is half compared to last week. No cases have been reported from Gavlebourg, SWE or V?sternorrland recent weeks ( Table 3 ). Seasonal Influenza A decreases too, but somewhat slower than the A (H1N1) pdm09.

No new deaths from A (H1N1) pdm09 have been reported, but two new intensive cared for flu patients, one with influenza B and one with seasonal influenza A. Both are over 65 and have underlying diseases.

The number of people with flu-like illness visits outpatient decreasing, but at a slow rate ( Figure 4 ). Although the number of samples taken in the sentinel sampling decreases, but is still a relatively high proportion, 31%, positive for influenza, the majority of influenza B ( Figure 5 ). During the season, mainly influenza B Yamagata-line, part of the seasonal flu vaccine demonstrated, but in recent weeks has also influenza B Victoria Line diagnosed.

The number of calls to 1177 with questions about flu symptoms increased slightly in week 13 ( contact causes in 1177 ), but since the total number of calls also increased the proportion of calls that indicates the flu constantly. Although Web Search declined at week 13.

Everything is talking to flu season is about to slow down, even if the decline is unusually slow, perhaps due to the cold.
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Influenza type // Current week 13/2013 // Previous Week 12/2013 // Change // Cumulatively during the season

A (H1N1) pdm09 // 31 // 65 // -52% // 2,372
Seasonal Influenza A // 90 // 119 // -24% // 2,664
Seasonal influenza B // 228 // 228 // 0% // 2,222
Total cases // 349 // 412 // -15% // 7,258
Number of samples analyzed // 1,116 // 1,295 // - // 26,524
Percentage of positive samples // 31.3% // 31.8% // - // 27.4%
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http://www.smittskyddsinstitutet.se...ngen-20122013/influensarapport-vecka-13-2013/

 

[Ronan Kelly]

Re: Institute for Disease Control weekly reports winter 2012-2013

Influenza Report, Week 14 (1/4 - 7/4), 2013
Report on the current flu situation
Editors: H?l?ne Englund, Anna Sara Carnahan

Influenza in Sweden
For week 14, a total of 274 laboratory-confirmed cases of influenza, which is a decrease compared to the 336 cases reported by week 13 ( Table 1 ). It is still an unusually high figure this time of year ( Figure 1 ), even compared to last year when we had many cases exceptionally late. Influenza A (H1N1) pdm09 and seasonal influenza A continued as before week to decrease, and this week also reduced the number of influenza B cases ( Table 1 ). About a quarter of the samples analyzed were positive for influenza virus.

Still detected virus in all parts of the country, but the slowdown is evident in all counties ( Table 2 , map ).

No new deaths have been reported through SmiNet. From Swedish Intensive Care Registry has five more intensive caring influenza cases reported: two A (H1N1) pdm09-cases fell ill in late February / early March, and an A-cases and two B cases diagnosed in recent weeks. The patients with A (H1N1) pdm09 were both babies were born in 2013, A case was a 85-year-old woman. The two B cases were men in their fifties, reflecting how the virus affects different age groups ( Table 3 ).

From sentinel surveillance reported fewer patients with influenza-like illness and among the samples taken at week 14 was only 16% positive ( figures and tables ).

Web search shows that fewer people searching for flu symptoms V?rdguiden.se, but the decline is unusually slow. Fewer people are calling even to 1177 with questions about fever in children - the clearest indicator of flu in this system ( Contact Causes 1177 ). Cough and sore throat in adults of all ages is increasing, however, which may indicate that other viruses are in circulation.

Although flu season is protracted talks surveillance to the now coming to an end.
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Influenza type // Current week 13/2013 // Previous Week 12/2013 // Change // Cumulatively during the season

A (H1N1) pdm09 // 30 // 31 // -3% // 2,402
Seasonal Influenza A // 68 // 93 // -27% // 2,739
Seasonal influenza B // 176 // 212 // -17% // 2,382
Total cases // 274 // 336 // -18% // 7,523
Number of samples analyzed // 996 // 1,128 // - // 27,543
Percentage of positive samples // 27.5% // 29.8% // - // 27.3%
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http://www.smittskyddsinstitutet.se...ngen-20122013/influensarapport-vecka-14-2013/

 

[Ronan Kelly]

Re: Institute for Disease Control weekly reports winter 2012-2013

Influenza Report, Week 15 (8/4 - 14/4), 2013
Report on the current flu situation

Influenza in Sweden
For week 15 reported 245 laboratory confirmed influenza cases ( Table 1 ). The number of cases and the number of samples analyzed for influenza has declined steadily since week 7, when both had their peak. More than 100 cases of influenza have been reported per week seventeen weeks in a row, which is an unusually long period ( Figure 1 ).

Influenza B now dominate completely. The decline is slow and the number of cases of this type are still high compared to previous seasons ( Figure 3 - influenza B ). It also makes the flu season unusually long.

Sentinel sampling reflects the clinical sample: the number of submitted samples decreases and influenza B predominates. During week 15 were sampled 24 individuals of which had seasonal flu A/H3 and 6 influenza B ( Figure 5 ).

Since the previous weekly report is an influenza A (H1N1) pdm09-cases became ill in February reported as deceased. The woman was 77 years old and had more underlying risk factors for severe disease. The total number of reported A (H1N1) pdm09 cases who died is now 19. No new flu cases have been reported from the Swedish Intensive Care Registry.

Sentinel reporting, Web Search and the number of calls to 1177, all of which reflect influenza activity, also decreases (see syndromic surveillance ).

Although the flu has fallen sharply since the peak week seven, we have unusually high activity for being so late in the season. Hopefully the spring weather to have a braking effect on the spread, but still, one can suffer from influenza B.
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http://www.smittskyddsinstitutet.se...ngen-20122013/influensarapport-vecka-15-2013/