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Published by the North Dakota Department of Health, Division of Disease Control, 2635 E Main Ave, Bismarck, N.D. 58506-5520,

Phone 701.328.2378 or in ND 1.800.472.2180.

Publication is available in alternative forms; for more information, contact Editor, Epidemiology Re por t. Publication also appears on the department's home page at www.ndhealth.gov

EQUAL OPPORTUNITY EMPLOYER.

Terry Dwelle, MD, MPHTM

State Health Officer

Kirby Kruger

Director, Disease Control

Tracy Miller, MPH

Epidemiologist, Editor Julie Wagendorf, MS

Epidemiologist, Editor

2009-2010 Influenza Summary

In March and April of 2009, a novel flu virus

emerged and began causing illness in the United

States and Mexico. On April 15, 2009, the U.S.

Centers for Disease Control and Prevention (CDC)

confirmed the first novel influenza A H1N1 virus infection in a U.S. patient. As the next few cases were identified, it became evident that person-to-person transmission of the virus was occurring. On June 11,

2009, the World Health Organization raised the

pandemic alert level to phase 6 to reflect the ongoing spread of the virus in multiple countries around the world. The North Dakota Department of Health (NDDoH) has been actively tracking influenza illness through existing and enhanced surveillance activities.

The first case of novel H1N1 in a North Dakota

resident was confirmed May 8, 2009. This marked the beginning of the first wave of 2009 H1N1 influenza illness in North Dakota (Figure 1). Seasonal influenza strains continued to co-circulate through the month of May but soon transitioned to only 2009

H1N1 influenza being detected by PCR testing

methodologies. Influenza surveillance activities continued for the

2009-2010 season which began in September 2009.

The NDDoH utilized multiple surveillance systems to track influenza activity in the state. These surveillance systems include (1) laboratory-identified influenza case reports, (2) influenza-like illness reports from outpatient visits, (3) influenza-like illness syndrome surveillance at eight emergency rooms and one ask-a-nurse call center, (4) laboratory influenza testing reports, (5) school absenteeism due to illness reports and (6) influenza and pneumonia- related death reports. Figure 1. Distribution of confirmed influenza cases using PCR and total reported laboratory identified cases by week of collection, North Dakota, April 18,

2009 to Sept. 5, 2009

A much larger second wave of 2009 H1N1 influenza

illness occurred in the fall following the first spring wave of illness. In contrast to non-pandemic influenza seasons, influenza reached peak activity in the state the week ending October 17, 2009. Influenza activity usually peaks in January, February or March (Figure 2). Minimal flu activity was Figure 2. Number of reported influenza cases 2000-

2001 to 2008-2009 influenza seasons, 2009-2010

influenza season, North Dakota

April-May-June 2010

In this Issue:

2009-2010 Influenza Summary

2009-2010 AGE Outbreak Summary

Summary of Selected Reportable

Conditions

2 documented following the fall peak with only sporadic cases being reported after January in thequotesdbs_dbs3.pdfusesText_6