FOR ADMliNISTMTSVE; USE

CDG INFLZlEWZk SURVEEWGE REPORT NO, 47 APSifL 22, 1959

T OF mL'TH, mUCATIQF1, AND fmLFA% Public Health Service Bureau of S ta t e Services

Cornmicable Disease Center - Hobest J. hdersen; M. D,, Chiaf' Swrveillance Section - Hario Pizx i , Me D,, Chief

XnFluenaa Suma5Zbance Unlt 50 Seventh St ree t , No E, Atlanta 23, Georgia Telephone No, TRinity 6-3311

f i tens ion 5454

SPECIAL ~ O T E

In fo rmt ion contained i n this report i s a surcnary of data reported to CDC by State Wealth Departments, Epidemic Intell igence Service Officers, collaborating influenza diagnostic laboratories, and other pertinen% sources. Pluch of it is psellireinary i n nature and i s intended f o r those involved i n influenza control a c t i v i t i e s 4 Anyone desiring t o quote this infonttation is urged to contact the person o r persons primarily responsible for the items reported i n order t h a t the exace in te rpre ta t ion of the repar t and the current s t a tus af the investigation be obtained. Sta te Health Officers, of course, w i l l judge the advisabi l i ty of releashg any infor- mation f rom t h e i r o m s t a t e s ,

Table of Contents

X, S m r y o f Informt ion

61, Cwrent Status sf Influenza in the United S t a t e s

1x1, Current Analysis of Influenza and k e m o n i a Mortality

X , - of fnfomt ion I

Influenza rand pneumonia deaths reported from 108 United States cities

rose sharply above the aeasoaral threshold during the week ending April 4,

peaked durjrmg the week ending April 11, and f e l l back toward the normal

level during tho f oUowjlal; week, Closer e nation of these reports

reveals chat chs U P B W ~ I M ~ was due prirnarfly t o incsaasss jxl reported deaths

i n New York Civ (Middls Atlantic region), and Detroit and Gbcago @ast

North Central region), Other wban areas in these regions showed o d y smia3.l

increases i n ambers of influenza and gnemonia deaths during the two week

psriad, Much o f the excess mrtal i ty occurred i n persons over 65 years o f

age in a l l three c i t i e s , apparently reflecting spread of influenza3 illnessas

into age gsoslps older than those that have been prhar i ly affected by the

dfaaaae in the past three months" Xn ms% States, however, influenza-like

illness s t i l l appears to be affecting persons o f school and college age

, prharizy, and ladustrial absefiteeism continues to fernin at norma seasonal

Though April 22, 31959, the Influen~ca Surveillance Unit has Zsamed

o f laboratory identifi~atibns o f aype B influenza in 20 states, of Type A

(zsubgraup unspecified) hflluenza i n 5 statss , and of Asian ( ~ 2 ) influenaa

in 5 states. Adenovjisuses have recentxy been lidentlified from cases of

bfluenza-like i lhess In 83;aska and Mssissippi. Utogether, 32 states

have aaw axgerienlcrjd outbreaks sr increased prevalence o f illnesses

(This report was prepared by mederick I. Dmn, M.D., CMsf, X&luena;s SmaQXance Unit, CDC , )

11, Current Status of Influenza i n the United States

Through the date of t h i s Report the Influenza Surveillance Unit has received reports of influenza i n the United States during the February- April 2959 period as follows:

20 States (plus the Dis t r i c t of Columbia) with laboratory-confimed Type B Influenza, States added t o t h i s l i s t since Repart Ho, 46: Kentucky, Minnesota, Mssiss ippi , lfisconsin.

5 States with laboratory-conf irmed Asian ( ~ 2 ) Influenza : California, Florida, I l l i no i s , New York, Wisconsin.

5 Sta tes with I a b o r a t ~ r y - ~ ~ n f i m @ d Type A Influenza (by CF test-- subgroup unspecified) : Alaska, Minnesota, Hississippi, South Dakota, Utah.

I n a d a t i o n , 32 States and the District of Columbia have reported outbreaks, increased school absenteeism, etc , due t o influenza-like i l l n e s s during the February-April 1959 period. Two States, Alaska and Gss i s s ipp i , have confirmed adenoviruses as the causative agents of influenza-like i l l ness . Tn Canada nmberous outbreaks of influenza-like i l l ness have been reported from many par t s of the country during the first quarter of 1959. Type B influenza has been ident i f ied from several areas (see below), but no Type A or adenovirus infections have been detected t o date.

Persons of school and college age continue t o be most heavily affected, and indus t r ia l absentee ra tes remain normal f o r the season. Significant increases i n influenza and pneumonia mortali ty i n the Middle Atlantic and East North Central regions during the weeks ending Apri l 4 and 11, however, suggest t h a t the disease has moved in to the older age groups i n a t l e a s t some of the urban poptflations of these areas. Analysis of the deaths reported from the two regions during the two week period r e v e d s tha t the increases were primarily due t o influenza and pneumonia deaths in New York C i t y , Chicago, and Detroit i& persons 65 and over.

Reports from many States {note, fo r example, the item from Mississippi below) indicate t h a t 1959 cer ta in ly cannot be classed as a ' w e B Influenza yearfQr a +Ty-pe A year Type B predominates i n some areas, .A2 sfan an) in others ( ~ e w York City, f o r example), and elsewhere both influenza viruses {and adeaoviruses too apparently) appear t o be circulat ing s

f r o m the S ta t e s : --L---

, I

Alaska - O f nine paired blood specimens s u b d t t ~ d t o D r . Andrew Fodor, Chief of the CDC Virus Diamostic Methodology Uni.t on Mkrch 30, by the Alaska Department of Health, six have shown evkdence o f recent ademvirus W e e t i o n , one of recent Type A influenaa infection, and one was negative f o r a l l r e s p i r a t o ~ y agents by (2 %eat. T!a specimens, forwarded tram Juneau, had a l l been o b t a h e d by a e saree physician from pat ien ts wkth influenrza- l i k e i l l n e s s e s g

- The CaLifornia S t a t e Department af Public Health reports that through April la, infomation had 'been obtained concerning seven inf%uenza outbreaks i n which the diagnosis was confirmed by the laboratory. t l F ~ u ~ af thm were due 20 h f l u e n e a A virus ( ~ a i a n s t r a in ) , These occurred i n Umeda , Orange, Placer and S m t a Clara Cowntiss. T h e e outbreak.9 were due t o influenza B virus. Two of these occurred i n Los ~ x l g e l e ~ County and one i n Marced @ o ~ l l t y ~ ~ ~ Reports sf outbreaks or increased pravalence o f influflnza-Xike i l h e s s , not co,nfirra?ed by laboratory tea ts , were a l s o received, d u r i w the three weak period prior t o April 10, f r ~ n Vsntwa, San Luis Obispo, &@§no, Santa Clara, Ellano, Sierra , and Hmboldt Gaucsties. Influenza Type A has been serologicably confirmed ia sporadic cases from Sari Francisco, San Nateo, San Joaquin, Napu, Tulare, Stanislaus, Yolo, Alaneda, and Fremo Cornties .

Dr . Eddm W, Lemette, Chisf of the S ta t e Virus Laboratory has a l so % .# repar ted the i so la t ion of a me B influenza virus from a th roa t washing

collectad March 23. The specimens came from a pa t i en t i n a school outbs.eak of respiratory disease i n Dos PkLos, Merced County,

ILl inois - On Aprjl. 10, D r . J e h Procknw, Department of Medicine, University of Chicago, reported a recent i so la t ion of a Type A influensa visua fron a 28 year o ld student a t t he University. The virus was i so la ted i n monkey kidney t i s sue culture and was typed. by MX t e s t with ~/3ap/57 f e r r e t antiserum, Dr . Prochow r w r k s t h a t flt;his i a the first influenza A &at we have been able t o i s o l a t e f r s n the m n y pa t ien ts suffer ing from i n f l u e n z d syrmptoms a t the present time.tf

Kansas - Dr. Charles Hmtsr, Disect~c of hboyator ies , Kansas State Board a F ~ e a l t h , h s f o m r d e d seporss of i so la t ions of Type B influenza viruses f ron hsr> pat ien ts with influenza-1;iXce i l l n e s s in Lawrence.. Throat washings were co l lec ted April. 3 and 8. He a l so reports seven addi t ional seroZogicab c o n f i m t i o n s of Type B influenza from pat ien ts in Junction City, Manhattan, Dodge City, Sabetha, and Lawrence, Acute Uood specimens from these pa t ien ts were col lected during the l a s t t h i r d of March.

- Dr, P,K, Codan, Kentucky State Department of Health, has reported t o MOVS t ha t outbreaks o f i d u e n a a - l i k e i l l n e s s during t he week of March 21, forced several schools i n the S ta t e t o c lose temporariay. Type B influenza has been confirmed by GF t e s t from a t l e a s t one outbreak.

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Dr. Joerlef Preizher, State E p i d d o l o g i s t, reports that the State kboratasy of tZygiene has iqolated Type B izlfiuensa viruses from t h e e persons from specdens subbtted ApriJ, 13, He &so reports thq isolation of a Type! B influenza vims f ~ o m spinal fluid submitted from a Madisou patient on March 31, 1959, Additional informatian about this case is not availfible a t present,

Repart from Canada:

The Epideroislom D3vAsitm of the Department of National Heal* and Welfare has provided the following information on influenza in Canada in a ewvailXance report dated April 10, 1959:

W i n g the periad'frm Piarch 7 to April LQ "cutbreaks sf influenza- like illness b u s bee^ reported from S t , Johnta, NewfoundPand (large percentage of gopaation); ci$y of Halifax, Nova Scotia (up t o 30 per cent of employees of some bua;ines~aea affected)j Halifax County (approxbatdy 3,000 cases); Saint J o h , New Brunswiclc (apprrr~mtaly 1,000 cases); Clinton R, @, A. P, Station, Oatario (500 cases); A y k r A. C, A. F. Station, Quebec (300 cases); Camp Borden R. 6, A. F. Station, Ontario (240 cases); and amang

personnel in central Ontario (approxirnatoly 90 casks). The! illniesls has bees d$acribed as relatiyely mild and lasting 36 to

48 houm. Influenza & virus has been isolated fsm 3 cases in Halifax and 5

eases in Ottawa and serologically confirmed in 8 cases from C m p Petawawa, Ontario

Fig I : WEEKLY PNEUMONIA and INFLUENZA DEATHS United Stotes

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EPSDEMIC THRESHOLD

PACIFIC, 12 title8