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Chart shows Recent ILI Activity Above the Epidemic Level

NEW FLU BUG: Aussie Sydney Strain Now Causing 53% of Outbreaks in U.S.

Older Folks More Susceptible, Reports Center for Disease Control

January 27, 2013       Leave a Comment
By: Dave Rogers

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A new strain of influenza, GII.4 Sydney, has emerged from Australia to bug the American public.

CDC (Center for Disease Control) collects information on norovirus strains associated with outbreaks in the United States through an electronic laboratory surveillance network called CaliciNet.

This report documents the recent emergence of a new GII.4 strain, GII.4 Sydney, which caused most (53 percent) of the norovirus outbreaks reported through CaliciNet during September-December 2012.

Continued surveillance will enable further assessment of the public health implications and significance of this new strain.

Influenza-associated hospitalization rates continue to be highest among people 65 and older. Of the 6,191 influenza-associated hospitalizations that have been reported this season, 50.1 percent have been among people 65 and older.

In March 2012, a new GII.4 norovirus strain was identified in Australia. Named GII.4 Sydney, this emergent strain has since caused acute gastroenteritis outbreaks in multiple countries.

In the United Kingdom, an early onset of the 2012 winter norovirus season was reported in association with emergence of GII.4 Sydney as the dominant strain implicated in outbreaks.

In the United States, GII.4 Sydney has spread rapidly nationwide, causing an increasing number of outbreaks. During September-December 2012, a total of 141 (53 percent) of the 266 norovirus outbreaks reported to CaliciNet were caused by GII.4 Sydney.

According to the latest FluView report, influenza activity remains elevated in most of the country. Similar to last week, some national indicators are declining while others are increasing.

In general, influenza-like-illness (ILI) activity levels are declining in the South, Southeast, New England and the Midwest, but increasing in the Mid-Atlantic, Southwest and the Northwest. Key indicators reflecting severity, such as hospitalizations and deaths, increased significantly again this week, with the greatest impact among people 65 and older. Below is a summary of the key indicators for the week of January 13-19:

For the week of January 13-19, the proportion of people seeing their health care provider for influenza-like illness (ILI) seems to be leveling off but remains elevated.

Twenty-six states and New York City are reporting high ILI activity. Last week CDC reported 30 states with high ILI activity.

Additionally, 14 states are now reporting moderate levels of ILI activity. States reporting high ILI activity for the week of January 13-19 include Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Indiana, Kansas, Louisiana, Maryland, Michigan, Missouri, Nevada, New Jersey, North Carolina, North Dakota, Oklahoma, Oregon, Pennsylvania, Texas, Utah, Virginia, and West Virginia. ILI activity data indicate the amount of flu-like illness that is occurring in each state.

Forty-seven states reported widespread geographic influenza activity for the week of January 13-19, 2013. This decreased from 48 states in the previous week. Geographic Spread data show how many areas within a state or territory are seeing flu activity.

Since October 1, 2012, 6,191 laboratory-confirmed influenza-associated hospitalizations have been reported; an increase of 942 hospitalizations from the previous week. This translates to a rate of 22.2 influenza-associated hospitalizations per 100,000 people in the United States.

Hospitalization data are collected from 15 states to calculate a rate of laboratory-confirmed influenza-associated hospitalizations that is reasonably representative of the nation. These data do not reflect the actual total number of influenza-associated hospitalizations in the United States.

The proportion of deaths attributed to pneumonia and influenza (P&I) based on the 122 Cities Mortality Reporting System increased sharply again this week; remaining above the epidemic threshold for the third consecutive week. Overall, P&I deaths are significantly elevated at this time with most of the deaths among people 65 and older.

Eight influenza-related pediatric deaths were reported during the week of January 13-19, 2013. Six of the deaths were associated with an influenza B virus and 2 were associated with an influenza A virus of unknown subtype. This brings the total number of influenza-associated pediatric deaths reported to CDC for 2012-2013 to 37.

Additional information regarding pediatric deaths is available through FluView Interactive.

Nationally, the percentage of respiratory specimens testing positive for influenza in the United States during the week of January 13-19 decreased from 32.5 percent in the previous week to 26.1 percent.

Influenza A (H3N2), 2009 influenza A (H1N1), and influenza B viruses have all been identified in the U.S. this season. During the week of January 13-19, 2,515 of the 3,129 influenza positive tests reported to CDC were influenza A and 614 were influenza B viruses. Of the 1,636 influenza A viruses that were sub-typed, 97 percent were H3 viruses and 3 percent were 2009 H1N1 viruses.

Since October 1, 2012, CDC has antigenically characterized 751 influenza viruses, including 54 2009 influenza A (H1N1) viruses, 465 influenza A (H3N2) viruses and 232 influenza B viruses.

All 54 of the 2009 influenza A (H1N1) viruses were characterized as A/California/7/2009-like. This is the influenza A (H1N1) component of the Northern Hemisphere vaccine for the 2012-2013 season. Of the 465 influenza A (H3N2) viruses, 463 (99.6 percent) were characterized as A/Victoria/361/2011-like. This is the influenza A (H3N2) component of the Northern Hemisphere influenza vaccine for the 2012-2013 season.

Of the 232 influenza B viruses characterized, 69 percent belonged to the B/Yamagata lineage of viruses, and were characterized as B/Wisconsin/1/2010-like, the influenza B component for the 2012-2013 Northern Hemisphere influenza vaccine. The remaining 31 percent of the tested influenza B viruses belonged to the B/Victoria lineage of viruses.

Since October 1, 2012, CDC has tested 119 2009 influenza A (H1N1), 762 influenza A (H3N2), and 274 influenza B virus samples for resistance to neuraminidase inhibitors this season.

While the majority of the tested viruses showed susceptibility to the antiviral drugs oseltamivir and zanamivir, one 2009 H1N1 virus proved resistant to oseltamivir. High levels of resistance to the adamantanes (amantadine and rimantadine) persist among 2009 influenza A (H1N1) and A (H3N2) viruses. Adamantanes are not effective against influenza B viruses. ###

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Dave Rogers

Dave Rogers is a former editorial writer for the Bay City Times and a widely read,
respected journalist/writer in and around Bay City.
(Contact Dave Via Email at carraroe@aol.com)

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