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Key Flu Indicators
Each week CDC analyzes information about influenza disease activity in the United States and publishes findings of key flu indicators in a report called FluView.* During the week of November 8-14, 2009, influenza activity decreased across all key indicators, but overall remained very high for this time of year. Below is a summary of the most recent key indicators:
- Visits to doctors for influenza-like illness (ILI) nationally decreased again this week over last week. This is the third consecutive week of national decreases in ILI after four consecutive weeks of sharp increases. (All regions showed declines in ILI.) While ILI declined overall nationally, visits to doctors for influenza-like illness remain high.
- Influenza hospitalization rates are beginning to decline but remain higher than expected for this time of year. Hospitalization rates continue to be highest in younger populations with the highest hospitalization rate reported in children 0-4 years old.
- The proportion of deaths attributed to pneumonia and influenza (P&I) based on the 122 Cities Report decreased slightly but is still higher than what is expected for this time of year and has remained elevated for seven weeks now. In addition, 21 flu-related pediatric deaths were reported this week: 15 of these deaths were associated with laboratory confirmed 2009 H1N1; 6 were influenza A viruses, but were not subtyped. Since April 2009, CDC has received reports of 171 laboratory-confirmed pediatric 2009 H1N1 deaths, one influenza B death, and another 28 pediatric deaths that were laboratory confirmed as influenza, but the flu virus subtype was not determined. (Laboratory-confirmed deaths are thought to represent an undercount of the actual number. CDC has provided estimates about the number of 2009 H1N1 cases and related hospitalizations and deaths.
- Forty-three states are reporting widespread influenza activity at this time; a decline of three states from last week. They are: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Dakota, Tennessee, Utah, Vermont, Virginia, Washington, West Virginia, and Wisconsin.
- Almost all of the influenza viruses identified so far continue to be 2009 H1N1 influenza A viruses. These viruses remain similar to the virus chosen for the 2009 H1N1 vaccine, and remain susceptible to the antiviral drugs oseltamivir and zanamivir with rare exception.
*All data are preliminary and may change as more reports are received.
U.S. Situation Update
U.S. Patient Visits Reported for Influenza-like Illness (ILI)
U.S. Influenza-like Illness (ILI) Reported by Regions
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Cases Defined by
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Hospitalizations
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Deaths
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|---|---|---|---|
| Influenza Laboratory-Tests** | 26,315 | 1,049 | |
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*Reports can be based on syndromic, admission or discharge data, or a combination of data elements that could include laboratory-confirmed and influenza-like illness hospitalizations. *Laboratory confirmation includes any positive influenza test (rapid influenza tests, RT-PCR, DFA, IFA, or culture), whether or not typing was done. The table shows aggregate reports of all laboratory confirmed influenza hospitalizations and deaths (including 2009 H1N1 and seasonal flu) since August 30, 2009 received by CDC from U.S. states and territories**. This table will be updated weekly each Friday at 11 a.m. For the 2009-2010 influenza season, states are reporting based on new case definitions for hospitalizations and deaths effective August 30, 2009. CDC will continue to use its traditional surveillance systems to track the progress of the 2009-2010 influenza season. For more information about influenza surveillance, including reporting of influenza-associated hospitalizations and deaths, see Questions and Answers: Monitoring Influenza Activity, Including 2009 H1N1. The number of 2009 H1N1 hospitalizations and deaths reported to CDC from April – August 2009 is available on the Past Situation Updates page. For state level information, refer to state health departments. International Human Cases of 2009 H1N1 Flu Infection
**States report weekly to CDC either 1) laboratory-confirmed influenza hospitalizations and deaths or 2) pneumonia and influenza syndrome-based cases of hospitalization and death resulting from all types or subtypes of influenza. Although only the laboratory confirmed cases are included in this report, CDC continues to analyze data both from laboratory confirmed and syndromic hospitalizations and deaths. |
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Date Reported
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Laboratory-Confirmed 2009 H1N1 Influenza Pediatric Deaths
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Laboratory-Confirmed Influenza A Subtype Unknown Pediatric Deaths
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Laboratory-Confirmed
Seasonal Influenza |
Total |
|---|---|---|---|---|
| This Week (Week 45, November 8-14, 2009) | 15 | 6 | 0 | 21 |
| Since August 30, 2009 | 113 | 25 | 0 | 138 |
| Cumulative since April 26, 2009 | 171 | 28 | 1 | 200 |
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This table is based on data reported to CDC through the Influenza-Associated Pediatric Mortality Surveillance System. Influenza-associated deaths in children (persons less than 18 years) was added as nationally notifiable condition in 2004. For more information about influenza-associated pediatric mortality, see FluView. |
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For more information about the U.S. situation, see the CDC H1N1 Flu U.S. Situation page.
International Situation Update
This report provides an update to the international situation as of November 20, 2009. The World Health Organization (WHO) continues to report laboratory-confirmed 2009 H1N1 flu cases and deaths on its Web page. These laboratory-confirmed cases represent a substantial underestimation of total cases in the world, as many countries focus surveillance and laboratory testing only on people with severe illness. The 2009 H1N1 influenza virus continues to be the dominant influenza virus in circulation in the world. From April 19 to October 31, 2009, 68.8% of influenza specimens
reported to WHO were 2009 H1N1 viruses and from November 1 to November 7, 2009, 79.1% of influenza specimens reported to WHO were 2009 H1N1. In temperate regions of the Southern Hemisphere, little disease activity due to 2009 H1N1 has been reported. In tropical regions of the Americas and Asia, influenza activity due to 2009 H1N1 remains variable. In temperate regions of the Northern Hemisphere, influenza-like illness (ILI) activity due to 2009 H1N1 continues to increase across many countries
in Europe, Asia, and North America, though it may have peaked in most areas of the United States.
For more information about the international situation, see the CDC H1N1 Flu International Situation page.
2009 H1N1 Influenza Vaccine in Pregnancy
Pregnant women are 1 of the 5 initial target groups for the 2009 H1N1 influenza vaccine. In this video commentary, Sonja Rasmussen, MD, MS, Senior Scientist at CDC, reviews the latest guidelines. Watch now >>
Recent Updates of Interest
- 2009 H1N1 Flu: International Situation Update
This report provides an update to the international situation as of November 20, 2009. The World Health Organization (WHO) continues to report updated 2009 H1N1 flu-associated laboratory-confirmed cases and deaths on its Web page. - Weekly FluView Map and Surveillance Report for Week Ending November 14, 2009
During the week of November 8-14, 2009, influenza activity decreased slightly in the United States as reported in FluView. Flu activity is widespread in 43 states. Nationally, visits to doctors for influenza-like-illness declined from last week, but are still higher than expected for this time of year. Flu-related hospitalizations and deaths have declined slightly, but are still very high nation-wide compared to what is expected for this time of year. - Weekly FluView Map and Surveillance Report for Week Ending November 14, 2009
During the week of November 8-14, 2009, influenza activity decreased slightly in the United States as reported in FluView. Flu activity is widespread in 43 states. Nationally, visits to doctors for influenza-like-illness declined from last week, but are still higher than expected for this time of year. Flu-related hospitalizations and deaths have declined slightly, but are still very high nation-wide compared to what is expected for this time of year. - NEW: Information for Vaccine Planners - Supply and Distribution
These tables for healthcare providers and planners provide information related to spacing between the two doses of 2009 H1N1 Vaccine for children 6 months through 9 years of age and for administration of 2009 H1N1 Vaccine with seasonal influenza and other vaccines. - New: Graphical Representations of a Generic Influenza Virus
These pictures provide a 3D graphical representation of the biology and structure of a generic influenza virus, and are not specific to the 2009 H1N1 virus. - U.S. Influenza and Pneumonia-Associated Hospitalizations and Deaths from August 30 to November 14, 2009
During the week of November 8-14, 2009, influenza activity decreased slightly in the United States as reported in FluView. Flu activity is widespread in 43 states. Nationally, visits to doctors for influenza-like-illness declined from last week, but are still higher than expected for this time of year. Flu-related hospitalizations and deaths have declined slightly, but are still very high nation-wide compared to what is expected for this time of year. - New: Updated Guidance for the Use of CSL 2009 H1N1 Monovalent Vaccine
On November 11, 2009, the FDA expanded the approved use of CSL's seasonal and 2009 H1N1 monovalent influenza vaccines to include children aged 6 months and older. Both vaccines had previously been approved only for use in adults, aged 18 years and older. - New: Questions and Answers: 2009 H1N1 and Pneumococcal Disease in the News
What is invasive pneumococcal disease? What does CDC know about invasive pneumococcal disease among people who get 2009 H1N1 or seasonal influenza? What is Active Bacterial Core surveillance (ABCs)? - New: 2009 H1N1 Flu Information for People with Disabilities and Their Caregivers or Personal Assistants
People with certain types of disability have a higher risk of getting flu-related complications, such as pneumonia. The 2009 H1N1 Flu Information for People with Disabilities and Their Caregivers or Personal Assistants is now available to the public.
Additional Updates on the CDC H1N1 Flu Website
To learn about other recent updates made to the CDC H1N1 Flu Website, please check the "What's New" page on the CDC H1N1 Flu website.
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