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Eleven influenza-associated pediatric deaths were reported to CDC during week 41 (Georgia [2], Hawaii, Louisiana, Oklahoma [2], Ohio, North Carolina, Oregon, Texas, and Virginia). Nine of these deaths were associated with 2009 influenza A (H1N1) virus infection and two were associated with an influenza A virus for which the subtype is undetermined. These deaths occurred between June 14 and October 10, 2009. One death reported during week 41 occurred during the 2008-09 season. Since August 30, 2009, CDC has received 53 reports of influenza-associated pediatric deaths that occurred during the current influenza season (three deaths in children less than 2 years, seven deaths in children 2-4 years, 21 deaths in children 5-11 years, and 22 deaths in individuals 12-17 years). Forty-seven of the 53 deaths were due to 2009 influenza A (H1N1) virus infections, and the remaining six were associated with influenza A virus for which the subtype is undetermined. A total of 95 deaths in children associated with 2009 H1N1 virus have been reported to CDC.
Among the 53 deaths in children, 32 children had specimens collected for bacterial culture from normally sterile sites and seven (21.9%) of the 32 were positive; Staphylococcus aureus was identified in five (71.4%) of the seven children. One S. aureus isolate was sensitive to methicillin, three were methicillin resistant, and one did not have sensitivity testing performed. All seven children with bacterial coinfections were five years of age or older and four (57.1%) of the seven children were 12 years of age or older.
FOR IMMEDIATE RELEASE:
H1N1 Flu (Swine Flu)
Site last updated May 3, 2009, 11:00 AM ET
illness severity, and
- Provide information to help health care providers, public health officials and the public address the challenges posed by this emergency.
CDC continues to issue and update interim guidance daily in response to the rapidly evolving situation. CDC will issue updated interim guidance for clinicians on how to identify and care for people who are sick with novel H1N1 flu illness. This guidance will provide priorities for testing and treatment for novel H1N1 flu infection. The priority use for influenza antiviral drugs during this outbreak will be to treat people with severe flu illness.
On May 3, CDC is scheduled to complete deployment of 25 percent of the supplies in the Strategic National Stockpile (SNS) to all states in the continental United States. These supplies and medicines will help states and U.S. territories respond to the outbreak. In addition, the Federal Government and manufacturers have begun the process of developing a vaccine against the novel H1N1 flu virus.
Response actions are aggressive, but they may vary across states and communities depending on local circumstances. Communities, businesses, places of worship, schools and individuals can all take action to slow the spread of this outbreak. People who are sick are urged to stay home from work or school and to avoid contact with others, except to seek medical care. This action can avoid spreading illness further.
Percentage of Visits for Influenza-like Illness
(ILI) Reported by the U.S. Outpatient Influenza-like Illness
Surveillance Network (ILINet), National Summary 2008-2009 and Previous
Two Seasons
(Posted October 23, 2009, 5:30 PM ET, for Week Ending October 17, 2009)
Synopsis:
During week 41 (October 11-17, 2009), influenza activity increased in the U.S.
- 4,855 (37.5%) specimens tested by U.S. World Health
Organization (WHO) and National Respiratory and Enteric Virus
Surveillance System (NREVSS) collaborating laboratories and reported to
CDC/Influenza Division were positive for influenza.
- All subtyped influenza A viruses being reported to CDC were 2009 influenza A (H1N1) viruses.
- The proportion of deaths attributed to pneumonia and influenza (P&I) was above the epidemic threshold.
- Eleven
influenza-associated pediatric deaths were reported. Nine of these
deaths were associated with 2009 influenza A (H1N1) virus infection and
two were associated with an influenza A virus for which subtype is
undetermined.
- The proportion of outpatient visits for
influenza-like illness (ILI) was above the national baseline. All 10
regions reported ILI above region-specific baseline levels.
- Forty-six
states reported geographically widespread influenza activity, Guam and
three states reported regional influenza activity, one state, the
District of Columbia, and Puerto Rico reported local influenza
activity, and the U.S. Virgin Islands did not report.
National and Regional Summary of Select Surveillance Components
HHS Surveillance Regions*
Data for current week
Data cumulative for the season
Out-patient ILI†
% positive for flu‡
Number of jurisdictions reporting regional or widespread activity§
A (H1)
A (H3)
2009 A (H1N1)
A (unable to sub-type)¥
A(Subtyping not performed)
B
Pediatric Deaths
Nation
Elevated
37.5 %
50 of 54
15
34
17,108
270
10,025
68
53
Region 1
Elevated
9.0 %
6 of 6
5
2
268
2
27
3
0
Region 2
Elevated
6.1 %
2 of 4
1
5
91
0
72
2
0
Region 3
Elevated
49.4 %
5 of 6
1
5
2,694
11
313
6
4
Region 4
Elevated
28.9 %
8 of 8
0
1
2,537
48
2,830
8
16
Region 5
Elevated
37.3 %
6 of 6
3
14
2,618
69
399
6
3
Region 6
Elevated
20.5 %
5 of 5
0
3
1,495
3
2,932
5
19
Region 7
Elevated
45.4 %
4 of 4
3
2
1,641
122
501
10
1
Region 8
Elevated
32.4 %
6 of 6
2
0
2,547
0
2,525
24
5
Region 9
Elevated
24.3 %
4 of 5
0
1
2,163
11
351
3
2
Region 10
Elevated
36.8 %
4 of 4
0
1
1,054
4
75
1
3
*Influenza season officially begins each
year at week 40. This season data from week 35 will be included to show
the trend of influenza activity before the official start of the
2009-10 influenza season.
**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
¥ The majority of influenza A viruses that cannot be sub-typed as
seasonal influenza viruses are 2009 A (H1N1) influenza viruses upon
further testing
U.S. Virologic Surveillance:
WHO and NREVSS collaborating laboratories located in all 50 states
and Washington D.C. report to CDC the number of respiratory specimens
tested for influenza and the number positive by influenza type and
subtype. The results of tests performed during the current week are
summarized in the table below.
Week 41
No. of specimens tested
12,943
No. of positive specimens (%)
4,855 (37.5%)
Positive specimens by type/subtype
Influenza A
4,844 (99.8%)
A (2009 H1N1)
3,378 (69.7%)
A (subtyping not performed)
1,436 (29.6%)
A (unable to subtype)
30 (0.6%)
A (H3)
0 (0.0%)
A (H1)
0 (0.0%)
Influenza B
11 (0.2%)
U.S. Human Cases of H1N1 Flu Infection
(As of May 15, 2009, 11:00 AM ET)
States*
Confirmed and Probable
Cases
Deaths
Alabama
55
Arkansas
2
Arizona
435
1
California
504
Colorado
55
Connecticut
47
Delaware
60
Florida
68
Georgia
18
Hawaii
10
Idaho
5
Illinois
638
Indiana
71
Iowa
66
Kansas
30
Kentucky**
13
Louisiana
57
Maine
14
Maryland
28
Massachusetts
135
Michigan
142
Minnesota
36
Missouri
19
Montana
4
Nebraska
27
Nevada
26
New Hampshire
18
New Jersey
14
New Mexico
68
New York
242
North Carolina
12
North Dakota
2
Ohio
14
Oklahoma
26
Oregon
94
Pennsylvania
47
Rhode Island
8
South Carolina
36
South Dakota
4
Tennessee
74
Texas
506
2
Utah
91
Vermont
1
Virginia
21
Washington
246
1
Washington, D.C.
12
Wisconsin
613
TOTAL*(47)
4,714 cases
4 deaths
*includes the District of Columbia
More on the Situation
U.S. Human Cases of H1N1 Flu Infection
(As of May 7, 2009, 11:00 AM ET)
States
Laboratory
confirmed
cases
Deaths
Alabama
4
Arizona
48
California
106
Colorado
17
Connecticut
4
Delaware
38
Florida
5
Georgia
3
Hawaii
3
Idaho
1
Illinois
204
Indiana
15
Iowa
5
Kansas
7
Kentucky*
2
Louisiana
7
Maine
4
Maryland
4
Massachusetts
71
Michigan
9
Minnesota
1
Missouri
4
Nebraska
4
Nevada
5
New Hampshire
2
New Jersey
7
New Mexico
8
New York
98
North Carolina
7
Ohio
5
Oklahoma
1
Oregon
15
Pennsylvania
2
Rhode Island
2
South Carolina
17
Tennessee
2
Texas
91
2
Utah
8
Virginia
11
Washington
23
Wisconsin
26
TOTAL (41)
896 cases
2 deaths
International Human Cases of Swine Flu Infection
See: World Health Organization
Info for Specific Groups
What You Can Do to Stay Healthy
- Stay informed. This website will be updated regularly as information becomes available.
- Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people.
- Take everyday actions to stay healthy.
- Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
- Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hands cleaners are also effective.
- Avoid touching your eyes, nose or mouth. Germs spread that way.
- Stay home if you get sick. CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.
- Follow public health advice regarding school closures, avoiding crowds and other social distancing measures.
- Develop a family emergency plan as a precaution. This should include storing a supply of food, medicines, facemasks, alcohol-based hand rubs and other essential supplies.
- Call 1-800-CDC-INFO for more information.
Additional Links
- PandemicFlu.gov
- FDA: FDA Authorizes Emergency Use of Influenza Medicines, Diagnostic Test in Response to Swine Flu Outbreak in Humans
- GenBank Influenza Virus Resource (swine influenza A [H1N1] sequences)
- WHO: Reducing excess mortality from common illnesses during severe pandemic
- WHO: Pandemic flu preparedness & mitigation in refugee & displaced populations
NOTE: This is a rapidly evolving situation and current guidance and other web content may contain variations in how this new H1N1 virus of swine origin is referred to. Over the coming days and weeks, these inconsistencies will be addressed, but in the interests of meeting the agency's response goals, all guidance will remain posted and new guidance will continue to be issued.
- Links to non-federal organizations are provided solely as a service to our users. These links do
H1N1 Flu (Swine Flu)
illness severity, and
- Provide information to help health care providers, public health officials and the public address the challenges posed by this emergency.
CDC continues to issue and update interim guidance daily in response to the rapidly evolving situation. CDC will issue updated interim guidance for clinicians on how to identify and care for people who are sick with novel H1N1 flu illness. This guidance will provide priorities for testing and treatment for novel H1N1 flu infection. The priority use for influenza antiviral drugs during this outbreak will be to treat people with severe flu illness.
On May 3, CDC is scheduled to complete deployment of 25 percent of the supplies in the Strategic National Stockpile (SNS) to all states in the continental United States. These supplies and medicines will help states and U.S. territories respond to the outbreak. In addition, the Federal Government and manufacturers have begun the process of developing a vaccine against the novel H1N1 flu virus.
Response actions are aggressive, but they may vary across states and communities depending on local circumstances. Communities, businesses, places of worship, schools and individuals can all take action to slow the spread of this outbreak. People who are sick are urged to stay home from work or school and to avoid contact with others, except to seek medical care. This action can avoid spreading illness further.
Percentage of Visits for Influenza-like Illness
(ILI) Reported by the U.S. Outpatient Influenza-like Illness
Surveillance Network (ILINet), National Summary 2008-2009 and Previous
Two Seasons
(Posted October 23, 2009, 5:30 PM ET, for Week Ending October 17, 2009)
Synopsis:
During week 41 (October 11-17, 2009), influenza activity increased in the U.S.
- 4,855 (37.5%) specimens tested by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories and reported to CDC/Influenza Division were positive for influenza.
- All subtyped influenza A viruses being reported to CDC were 2009 influenza A (H1N1) viruses.
- The proportion of deaths attributed to pneumonia and influenza (P&I) was above the epidemic threshold.
- Eleven influenza-associated pediatric deaths were reported. Nine of these deaths were associated with 2009 influenza A (H1N1) virus infection and two were associated with an influenza A virus for which subtype is undetermined.
- The proportion of outpatient visits for influenza-like illness (ILI) was above the national baseline. All 10 regions reported ILI above region-specific baseline levels.
- Forty-six states reported geographically widespread influenza activity, Guam and three states reported regional influenza activity, one state, the District of Columbia, and Puerto Rico reported local influenza activity, and the U.S. Virgin Islands did not report.
HHS Surveillance Regions* |
Data for current week | Data cumulative for the season | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Out-patient ILI† | % positive for flu‡ | Number of jurisdictions reporting regional or widespread activity§ | A (H1) | A (H3) | 2009 A (H1N1) | A (unable to sub-type)¥ | A(Subtyping not performed) | B | Pediatric Deaths | |
| Nation | Elevated | 37.5 % | 50 of 54 | 15 | 34 | 17,108 | 270 | 10,025 | 68 | 53 |
| Region 1 | Elevated | 9.0 % | 6 of 6 | 5 | 2 | 268 | 2 | 27 | 3 | 0 |
| Region 2 | Elevated | 6.1 % | 2 of 4 | 1 | 5 | 91 | 0 | 72 | 2 | 0 |
| Region 3 | Elevated | 49.4 % | 5 of 6 | 1 | 5 | 2,694 | 11 | 313 | 6 | 4 |
| Region 4 | Elevated | 28.9 % | 8 of 8 | 0 | 1 | 2,537 | 48 | 2,830 | 8 | 16 |
| Region 5 | Elevated | 37.3 % | 6 of 6 | 3 | 14 | 2,618 | 69 | 399 | 6 | 3 |
| Region 6 | Elevated | 20.5 % | 5 of 5 | 0 | 3 | 1,495 | 3 | 2,932 | 5 | 19 |
| Region 7 | Elevated | 45.4 % | 4 of 4 | 3 | 2 | 1,641 | 122 | 501 | 10 | 1 |
| Region 8 | Elevated | 32.4 % | 6 of 6 | 2 | 0 | 2,547 | 0 | 2,525 | 24 | 5 |
| Region 9 | Elevated | 24.3 % | 4 of 5 | 0 | 1 | 2,163 | 11 | 351 | 3 | 2 |
| Region 10 | Elevated | 36.8 % | 4 of 4 | 0 | 1 | 1,054 | 4 | 75 | 1 | 3 |
*Influenza season officially begins each
year at week 40. This season data from week 35 will be included to show
the trend of influenza activity before the official start of the
2009-10 influenza season.
**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
¥ The majority of influenza A viruses that cannot be sub-typed as
seasonal influenza viruses are 2009 A (H1N1) influenza viruses upon
further testing
U.S. Virologic Surveillance:
WHO and NREVSS collaborating laboratories located in all 50 states and Washington D.C. report to CDC the number of respiratory specimens tested for influenza and the number positive by influenza type and subtype. The results of tests performed during the current week are summarized in the table below.
| Week 41 | |
|---|---|
| No. of specimens tested | 12,943 |
| No. of positive specimens (%) | 4,855 (37.5%) |
| Positive specimens by type/subtype | |
| Influenza A | 4,844 (99.8%) |
| A (2009 H1N1) | 3,378 (69.7%) |
| A (subtyping not performed) | 1,436 (29.6%) |
| A (unable to subtype) | 30 (0.6%) |
| A (H3) | 0 (0.0%) |
| A (H1) | 0 (0.0%) |
| Influenza B | 11 (0.2%) |
| States* | Confirmed and Probable Cases | Deaths | |
|---|---|---|---|
Alabama |
55 |
||
Arkansas |
2 |
||
Arizona |
435 |
1 |
|
California |
504 | ||
Colorado |
55 |
||
Connecticut |
47 |
||
Delaware |
60 | ||
Florida |
68 |
||
Georgia |
18 |
||
Hawaii |
10 |
||
Idaho |
5 |
||
Illinois |
638 |
||
Indiana |
71 |
||
Iowa |
66 |
||
Kansas |
30 |
||
Kentucky** |
13 |
||
Louisiana |
57 |
||
Maine |
14 |
||
Maryland |
28 |
||
Massachusetts |
135 | ||
Michigan |
142 | ||
Minnesota |
36 |
||
Missouri |
19 |
||
Montana |
4 | ||
Nebraska |
27 |
||
Nevada |
26 |
||
New Hampshire |
18 |
||
New Jersey |
14 |
||
New Mexico |
68 |
||
New York |
242 |
||
North Carolina |
12 |
||
North Dakota |
2 |
||
Ohio |
14 | ||
Oklahoma |
26 |
||
Oregon |
94 |
||
Pennsylvania |
47 |
||
Rhode Island |
8 |
||
South Carolina |
36 |
||
South Dakota |
4 |
||
Tennessee |
74 |
||
Texas |
506 |
2 |
|
Utah |
91 |
||
Vermont |
1 |
||
Virginia |
21 |
||
Washington |
246 |
1 |
|
Washington, D.C. |
12 |
||
Wisconsin |
613 |
||
TOTAL*(47) |
4,714 cases |
4 deaths |
|
*includes the District of Columbia | |||
More on the Situation
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Info for Specific Groups
What You Can Do to Stay Healthy
- Stay informed. This website will be updated regularly as information becomes available.
- Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people.
- Take everyday actions to stay healthy.
- Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
- Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hands cleaners are also effective.
- Avoid touching your eyes, nose or mouth. Germs spread that way.
- Stay home if you get sick. CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.
- Follow public health advice regarding school closures, avoiding crowds and other social distancing measures.
- Develop a family emergency plan as a precaution. This should include storing a supply of food, medicines, facemasks, alcohol-based hand rubs and other essential supplies.
- Call 1-800-CDC-INFO for more information.
Additional Links
- PandemicFlu.gov
- FDA: FDA Authorizes Emergency Use of Influenza Medicines, Diagnostic Test in Response to Swine Flu Outbreak in Humans
- GenBank Influenza Virus Resource (swine influenza A [H1N1] sequences)
- WHO: Reducing excess mortality from common illnesses during severe pandemic
- WHO: Pandemic flu preparedness & mitigation in refugee & displaced populations
NOTE: This is a rapidly evolving situation and current guidance and other web content may contain variations in how this new H1N1 virus of swine origin is referred to. Over the coming days and weeks, these inconsistencies will be addressed, but in the interests of meeting the agency's response goals, all guidance will remain posted and new guidance will continue to be issued.
