FOa mmISTBb'SIa USE

CDG m L m Z i S S U R m U C I E mP0RT NO, 44 MLRCH 13, 1959

'Cr , S, D E P A R m T OF HWm, EDUUTION, AND tJmAAE; Publie Health Service Bureau of S t a t e Services

Cornmicable Disease Center - Robert J, Anderson, M, D., Chief Surveillance Section - Mario Pizzi, M, B,, Chief

Inf luenaa Survaillancs Unit 50 Seventh Street, N. E, ALlanta 23, Georgia Telephone No, TRinity 6-3311

EWension 5454

Information contained i n t h i s report i s a swrnz~lry o f data reported t o CBC by S ta t e Health Beparments, Egidemie Ilzttalligsncs Service Officers, coUlaborating influenza diagnostic laboratories, and other pert inent sources. Much of it i s p r e l s n a r y i n nature and is intended f o r those involved i n influenza control a c t i v i t i e s . Anyone desiring t o gusta t h i s information i s urged t o contact the person o r persons primarily responsible f o r the items reported i n order t h a t the exact in te rpre ta t ion of the repart and the current s t a tus of the investigation be obtained. State Health Officers, o f course, w i l l judge the advisabi l i ty of releasing any information f ram t h e i r own s t a t e s .

Table of Contents

Z. Smmay of In fa rmt ion

61. Current Status of Influenza i n the United States

111, Current Analysis of Influenza and Pneumonia Mortality

TV, Influenza i n Europe

V, Comparison of Several Type B Influenza St ra ins by Hernoagglutination-Inhibition Tests

S h r p , wall defined outbreaks of r e s p i r a l m y i l l n e s s , r d l d i n

character and affecfislg, mainly. children of 8ch001 agel have contjnued

t o occw i n aeveratJ, areas. Besides the £3 i so la t ions preIdously reported

;kn lrlaxylasd and Mchigan, influenza B Yirus has been recavered from

th roa t washings a f cases i n schools in IcFaskiagton, D,C, SerologieaUy

confirmed outbreaks have been reported i n Massachusetts, InEbiana, Iowa,

and U a b w , Epidedes of resp i ra tory i'blnesa of et iology no% yet

iden t i f i ed have been reported in some counties i n California, Mew York,

M s s i s ~ i g p i , and Georgia.

During the last three weeks, influenza and pnemonia deaths in

lO$ selected c i t i e s have levelled off a t about 10% above "te deaths

reporte4 the week ending February 14, They are s t i l l well within the

%qxi.demic thresholdf"d f i r below the number reported during the

eorresgonang period o f IasL year when the country was experiencing

the secand wave of the A-2 epidemic,

I n Europe, outbreaks are ocourring: in West Germany, Belgium,

France, S~~%l;sler3and, and England where a sharp increase i n influenza

and pnemonfa mortality has been noted in the l a s t three weeks. Strains

similar t o A-2 have been i so l a t ed in Bdgarh according t o the WHO Weekly

Qidsmjalogical Record.

A cornprison of several type B hf lwenas strains by WX t e s t s

parformed by Dr. R,Q. Robhson from the CDC Virus ZaZlo~atol~y in MontgmrYj

itaabamta i s presented.

his report prepared by Dr. Mario Pizz i , Chief, Surveillance Section, CDC*)

-3-

11, Ctrrrent Status of Snfl~eruza 3 United S ta t e s

Localised outbreaks of mild respiratory i l l n e s s - compatible with

influenza - have continued t o occur irtl the l a s t thee weeks in differen.t:

areas of the country and affect ing nrainly childran of scho01 age,

Laboratory s tudies a r e being conducted i n a number of these outbreaks,

but "te r e s d t s are not yet avai lable , Besides the B s t r a i n s isiolaties

previously reported (Influenza Surveillance Report 43 ) i n Maryland a d

Michigan, two more B i so l a t e s were obtained in an outbreak amow high

school students i n lit'ashington, B.C. On Pebrmry 20, Dr, F,#, Davenport,

Udvers i ty of Mchigan, isolated an influenza C s t r a i n from a fatal

ease of staph. l aba r pneumonia jm a 6 months old g i r l , Previous type G

i so l a t ions had been reported in 1947 and 1950,

Influenza-like i l lness causing up t o 50% school absenteeism was

reported on February 26, i n Denver and Jefferson County, Colorado, A t

Che t h e of this writing t he epidemic is subsiding, No viruses have

been recovered from throa t waskaings of some o f the cases,

O r , H,F, Feemster, S t a t e Egidemiolagist, Massachusetts Sta te

Department of Public Health, reports high absenteeism i n two schools in

Belmont and one in WeZ?lesley, These outbreclks have been serologically

i d e n t i f i e d as being caused by Lype 8 ,

R e Alabama State Health Degartmen"l:qported on February 20, a

sesalogicaSly iden t i f i ed type O case.

An outbreak in a school i n Roland, Xowa was i den t i f i ed serological ly

a s due t o influenza B by Dr. A,B , McKee, University o f Iowa,

Dr. H,Q, Robinson, GDC Virus Laboratory i n Montgomery, Alabama

reported seven serological ly confirmed influenza 8 eases from an outbreak

isr schools in northern Indiana.

Several autbrrtaks have been reported in C a l i f c r r ~ a . I?ln outbreak

at; Fort 8rd i s being studied by Dr, kennekte, Iaa Alameda Caunty

abseneeeisrn rates o f 30-40% dm to , respiqatwy illness have occurred

a Q n g the employees of a car assembly plant, and at the s k i resort in

Sqaw V a e y approximately 50 cases of respiratory U n e s s have occzlrred

i n the l a s t three weeks among 240 employees. One sehoo1 has been

cZosed in Suffolk County, New York because of high absenteeism, In

Mawlad, thls epidedc in Montgomery Coux~ty passed i t s peak on Febsuary 27,

aecosdjng t a a report fraa Dr, Charlotte Silverman, State Epidedologist,

AbseKt;saism rates of 18% as compared with 10% in the correspondiw weak

of l a s t year were being observed h Balthore dzrring the l a s t week o f

Febrwary,

High absenteeism-in schools 1s bejng reparted i n the Atlanta,

horgi ia area,

Aat outbreak of influenza-like i l lness has been repareed i n west

central Mississippi,

Sporadic cases o f respiratory i l lness are occurring i n Texas, but

no outbreaks have been reported so far,

These are no indicatiaas of influenza ac t iv i ty i n I l l i no i s and

Florida.

The deaths from influenza and pnewnonia i n 108 c i t i e s have been

for the Past three weeks about: 10% higher than those reported for the

week ending on February 14, and are at; the level of the week ending

on January 31. Howewr, they are still, well within the 1

" e p i d d e t h e ~ h o l d . ~ ~ The same i s true fo r each of the regions, with

the exception of the West South Central which s l igh t ly exceeded the

errpected variation. Up to March 7, 4565 deaths from influenza and

p n e m o ~ a have been reported from thasitr 108 citrles, w h i c h can be com-

pared wit31 6266. deaths f o r the correspon&w period of 1958-

In surmna~ there i s avidence that influmsa i s b e c o ~ w active

i q different areas of the country, Very Saw i so lates of B strains have

been made so far, and it i s strongly wged that health departments

col?lect throat washings from typical eases in asder t o get a better

bowledge of the B strain spreading, Qidedologica3Lly speak-, the

f a c t that aecorang to the information available so far, influenza is

occurring mainly in childrav~ of school age suggests that these outbreaks

are essential ly due t o influenza B. iSlthough some influenza B ac t iv i ty

was reported in 3951, no epidemics were reporeed that yeas, and the lase

identifiable B epidemic occurred in 1945-46. This being so, the cursent

0-13 years old pspdation should have very little * 'ty and in view

o f its size (roughly 46 million) should contribu.t;e a substmtiab number

of susceptibles,

3 8

EP m

*rl 2 0 Q & bP a 5 (d .i( G

I 2 2 N

I B t+

relat ion t o the corresponding weeirs in 1958, Out, of the 2129 deaths

fsom imfluer~za reported on the week ending February 22, 952 were in

pessaas aged 55 and over.

According t o the above mentioned report, gtAcute respiratory diseases

have shown a further increase sin many l o c a l i t i e s and influenza remains

generally widespread, Prissslure an genera1 medical and bospital services

has increased bw"t:thm ere indi.cationa that this may have reached its

peak i n some areas

lil, - a f Several - B Influenza %rains & -1nhibitioq Tests

The results of MI t e s t s performed by Dr. A.Q. Robinson fsom the

CBC Virus Laboratory in Hontgomery, Alabama, with several type B strains

tested against Ferret and chicken antisera are presented below:

Mamoa&lutination-ICnMbition Titer Against -*

I3, Neth B, Neth f3, Meth $, Mol B, Lee I3, Allen _IEd_G.Lakes zips--- ~ 3 ~ - -r 45 54 55 FERrnaK" h t i s e r m agaias e B.iLee 40 - 20 - 10 320 20 10 10 ]BeAllen 45 - - - - - 80 20 20 B,Great Lakes 54 80 $0 40 160 20 40 640 320 N osmal - - - - - ... .... - CHICKEN* Antiserm agains t

* A l l , Ferret sera inactivated by ng one-half volume of 0.8 per cent trypsin ( ~ i f c o 1:250) i n bf/Z0 phosphate b ~ s f a r at pH %,2 wjlth one volume o f serum and holang at 56'C for 30 dnutes , * iCUZ chicken sera were inactivated by heating a t 56°C for 30 ~azutes without addition o f trypsin,

The 3 .Netherlands strains a s well as the ttlaryland strains seem to be closely related to the B. Great hkesJ54, and to the B, ~uertig/55, Tbe Netherlands 41/59 appears t o be i n E phase which accounts for the low activity,

CORRJ6GWDUM: In Influenza Swefl lance Report No, 43, the B, Great ~akesJ54

was incorrectly labelled B, Great h k e s / ~ .

F i g WEEKLY PNEUMONIA ond INFLUENZA DEATHS United States

108 C l t ~ r r

NEW ENGIAND, 14 eltics '"1 "I

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EdST NDATH CENTRAL. 18 Citlcs

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'I E M X SOURI CENTRAL, 8 C l t b

WE= M CENTRAL, 13 Citlat

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M)CIRI CENTRAL, 9 crti- mT MOUHTAIN, a c i t l ~ s

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