Epidemiologic Notes and Reports Update: Influenza -- United States, 1988-89 Season

National surveillance for the 1988-89 influenza season (1) began in October. As of November 26, one outbreak in Ohio and culture-confirmed, sporadically occurring cases in Arizona, Hawaii, Maryland, Michigan, and Texas have been reported to CDC. On November 22, the first outbreak of the season was reported from Ohio. At the beginning of the school year, the Ohio Department of Health provides each school district with guidelines on recognizing possible outbreaks of influenza and other diseases and requests that such outbreaks be reported promptly to the local or state health department. On November 14, an outbreak of influenza-like illness was reported to the state health department from one elementary and one middle school in the same school district. On November 16, throat swabs were obtained from eight ill children and a 25-year-old teacher in the elementary school. Influenza type B was recovered from the specimens obtained from the teacher and four of the children. All persons have recovered without complications. Six cases of influenza type B virus have also been reported in children in Texas. The first case occurred in Houston in a 5-year-old boy who had onset of an upper respiratory infection (URI) with fever of 100 F (37.8 C) on October 11. A throat swab was taken 2 days later, and influenza type B virus was isolated on October 17. Although the patient's 11-year-old brother had symptoms of influenza-like illness on October 19, a specimen obtained from him on October 21 did not yield influenza virus. Two other isolates of influenza B reported from Houston were recovered from specimens obtained from two children, aged 5 and 10 years, on November 1 and 2, respectively; these children were patients of a pediatrician serving as a sentinel physician for the Baylor College of Medicine Influenza Research Center. In addition, three isolates of influenza type B have been recovered from specimens obtained from children 9, 11, and 12 years of age in Austin, Texas, since late October. Influenza B virus has also been isolated from a 4-year-old child in Arizona and a 1-year-old child in Michigan. Influenza type A virus has been reported from Maryland and Hawaii. The first case occurred in a 27-year-old male student in Bethesda, Maryland. He had onset of severe headache, sore throat, myalgias, arthralgias, and fever of 103 F (39.4 C) on Novem- ber 9. A throat swab obtained on November 10 by a physician participating in the Sentinel Physician Surveillance Network yielded influenza type A virus, identified by rapid culture confirmation on November 14. The health center at the student's university has since noted an increase in cases of influenza-like illness, but specimens obtained from other ill persons at the university have not yielded influenza viruses. One other case of influenza type A has been reported; this case occurred in a 33-year-old woman in Hawaii during early November. Further antigenic analysis of the isolates obtained from the sporadically occurring cases and the cases in the outbreak of influenza B continues. Also, subtyping of the influenza A viruses is pending. Reported by: L McAllister, T Payton, Ohio Dept of Health. Participating state and territorial epidemiologists and state laboratory directors. WHO Collaborating Laboratories. Sentinel Physicians of the American Academy of Family Physicians. Influenza Research Center, Baylor College of Medicine, Houston, Texas. Div of Surveillance and Epidemiologic Studies, Epidemiology Program Office; WHO Collaborating Center for Influenza, Influenza Br, and Epidemiology Office, Div of Viral Diseases, Center for Infectious Diseases, CDC.

Reference

1. CDC. Influenza--United States, 1987-88 season. MMWR 1988;37:497-503.

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