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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 October 25-31, 2009, a review of the key indicators found that influenza activity remained high in the United States. Below is a summary of the most recent key indicators:

• Visits to doctors for influenza-like illness (ILI) nationally decreased very slightly this week over last week after four consecutive weeks of sharp increases. While ILI declined slightly, visits to doctors for influenza-like illness remain at much higher levels than what is expected for this time of the year and parts of the country continue to see sharp increases in activity. It’s possible that nationwide ILI could rise again. ILI continues to be higher than what is seen during the peak of most regular flu seasons.
• Total influenza hospitalization rates for laboratory-confirmed flu are climbing and are higher than expected for this time of year. Hospitalization rates continue to be highest is 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 continues to increase and has been higher for five week now than what is expected at this time of year. In addition, 18 flu-related pediatric deaths were reported this week; 15 of these deaths were confirmed 2009 H1N1, and three were influenza A viruses, but were not subtyped. Since April 2009, CDC has received reports of 129 laboratory-confirmed pediatric 2009 H1N1 deaths and another 15 pediatric deaths that were laboratory confirmed as influenza, but where the flu virus subtype was not determined.
• Forty-eight states are reporting widespread influenza activity at this time; a decline of one state over 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, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. This many reports of widespread activity at this time of year are unprecedented during seasonal flu.
• 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.

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U.S. Situation Update

Weekly Flu Activity Estimates

U.S. Patient Visits Reported for Influenza-like Illness (ILI)

U.S. Influenza-like Illness (ILI) Reported by Regions

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 6, 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. Since April 19, 2009, more than 60% of all influenza positive specimens reported to WHO have been 2009 H1N1. In temperate regions of the Southern Hemisphere, disease due to 2009 H1N1 has returned to below baseline. 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 and Asia, as well as parts of the United States, Mexico and Canada.

For more information about the international situation, see the CDC H1N1 Flu International Situation page.

Recent Updates of Interest

• Weekly FluView Map and Surveillance Report for Week Ending October 31, 2009
  During the week of October 25-31, 2009, influenza activity remained high in the United States as reported in FluView. Flu activity is widespread in 48 states. Nationally, visits to doctors for influenza-like-illness declined slightly from last week, but are still very high. Flu-related hospitalizations and deaths continue to increase and are very high nation-wide compared to what is expected for this time of year.
• Update: Poster-Disposable Respirators: General Donning Instructions
  These posters describe general procedures for properly putting on and taking off a disposable respirator.
• Update: Translated Poster-Disposable Respirators: General Donning Instructions in Spanish
  These posters describe general procedures for properly putting on and taking off a disposable respirator in Spanish.
• CDC Health Alert Network (HAN) Info Service Message: Key Issues for Clinicians Concerning Antiviral Treatments for 2009 H1N1
  The 2009 pandemic H1N1 influenza virus continues to be the dominant influenza virus in circulation in the U.S. The benefit of antiviral treatment is greatest when it is initiated as early as possible in the clinical course.
• 2009 H1N1 Influenza Vaccine Supply Status
  Every Friday, CDC will post updated 2009 H1N1 vaccine supply and distribution data. 26,248,100 doses have been shipped as of November 4, 2009.
  
• U.S. Influenza and Pneumonia-Associated Hospitalizations and Deaths from August 30 to October 31, 2009.
  During the week of October 25-31, 2009, influenza activity continued to increase in the United States as reported in FluView. Flu activity is now widespread. Nationwide, visits to doctors for influenza-like-illness are increasing steeply and are now higher than what is seen at the peak of many regular flu seasons. In addition, flu-related hospitalizations and deaths continue to go up nation-wide and are above what is expected for this time of year.
• Questions and Answers about 2009 H1N1 in pets.
  What animals can be infected with the 2009 H1N1 virus? How do companion animals become infected with 2009 H1N1? Can I get 2009 H1N1 influenza from my pet? Is there a vaccine available for my pet? More...
• New: Letter from CDC to States
  Letter About Vaccine Supply From CDC Director to State and Local Health Officials
• New: Influenza Round Table: Warning Signs Video
  Dr. Joe Bresee describes the main symptoms of flu, including the new H1N1 flu, and when it is serious enough to seek medical help.
• New: Influenza Round Table: Take 3 Video
  Dr. Joe Bresee describes how to keep from getting the flu, and spreading it to others by taking these three steps.
• New: Influenza Round Table: Antiviral Drugs Video
  Influenza Round Table: Antiviral Drugs Dr. Joe Bresee explains the nature of antiviral drugs and how they are used.
• New: Don't Get, Don't Spread Video
  Dr. Joe Bresee describes how to keep from getting the flu, and spreading it to others.
• CDC Interim Guidance for Workers who are Employed at Commercial Swine Farms: Preventing the Spread of Influenza A Viruses, Including the 2009 H1N1 Virus
  Influenza viruses can rarely be passed from people to live pigs and from live pigs to people. This interim guidance provides information on precautions for protecting workers exposed to pigs with known or suspected flu infection on production premises AND for protecting pigs from people with flu.
• Update: 2009 H1N1 Flu ("Swine Flu") and You
  Questions & Answers About 2009 H1N1 Hospitalizations in People with Asthma
• Updated: Antiviral Safety Information Web Page
  Added: new links to influenza antiviral safety-related information.
• 2009 H1N1 Vaccine Dosage, Administration, and Storage
  This document provides health care providers, clinicians, and vaccine planners with information about 2009 H1N1 monovalent influenza vaccine dosage, administration and storage.
• Q & A Regarding 2009 H1N1 Influenza Vaccine Supply
  This document provides questions and answers about the current 2009 H1N1 vaccine supply
• Fact Sheet on Guillain-Barre syndrome (GBS)
  General information on GBS, background rate of GBS, and GBS surveillance systems in use during 2009-2010 flu season
• 2009 H1N1 Influenza: Resources for Pharmacists
  Quicklinks for information regarding Peramivir IV and to FDA's Guidance to Pharmacies on Advance Compounding of Tamiflu Oral Suspension to Provide for Multiple Prescriptions
• 2009 H1N1 Influenza Vaccine Supply Status: Daily Allocation Update
  Starting November 2, CDC will post a Daily Allocation Update on the Vaccine Supply Status page Monday through Friday.

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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