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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,
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
"a' '.an ' , " "m.' k. :i i2 I: ii ' 7 ' 'r.' ' r ' >' I ' ' r ' i .j '.l :.' '.: i-' '* >< 1 rig I IY Im 1 1 YAV I JIM I JUI I LIK. 1
EdST NDATH CENTRAL. 18 Citlcs
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lq581tg50
'I E M X SOURI CENTRAL, 8 C l t b
WE= M CENTRAL, 13 Citlat
A
M)CIRI CENTRAL, 9 crti- mT MOUHTAIN, a c i t l ~ s
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