• The severity measure listed above is for influenza caused by all strains (regular seasonal flu and the 2009 Pandemic A (H1N1)).  In addition, Utah is collecting data on patient deaths (whether hospitalized or not) known to have been related to the 2009 Pandemic A (H1N1) strain.
• A total of 19 deaths related to 2009 Pandemic A (H1N1) have been reported to public health this influenza season. This is five more than reported last week. Of the five deaths reported this week, two died within the last reporting week (11/08/09 to 11/14/09).
• For more information regarding these deaths, please refer to the Local Health District.
• Deaths not previously reported:
• 1 in Salt Lake Valley Health District
• 1 female, age 50-64 (died within the last reporting week)
• 1 male, age 50-64 (died prior to this last reporting week)
• 1 female, age 25-49 (died prior to this last reporting week)
• 1 in Utah County Health District
• 1 female, age 65 + (died prior to this last reporting week)
• 1 in Southeast Utah Health District
• 1 male, age 25-49 (died prior to this last reporting week)

          0 in Tooele County

• Laboratory data reported from 11/08/09 to 11/14/09 shows that 105 total specimens were submitted to the Utah Public Health Laboratory for confirmatory influenza testing. Of the 105 specimens submitted, 85 were tested. Of the 85 tested, 20 specimens or 23.5% were positive for influenza A. All influenza A positive specimens were identified as the 2009 Pandemic Influenza A (H1N1) strain.
• 100% were 2009 Pandemic Influenza A (H1N1)
• 3% of tested specimens were positive for parainfluenza virus

• Influenza illness is ongoing in the U.S. At this time, national ILI levels are above national baseline levels and are higher than what is expected during this time of year.
• During the past week, widespread influenza activity was reported in 46 states, with regional influenza activity being report in 4 states (see map on next page).
• Nationally, the proportion of deaths attributed to pneumonia and influenza (P&I) during the past week was 7.7%, which is above the

epidemic threshold for this time of year (6.8%). P&I mortality has been above the epidemic threshold for six consecutive weeks. 

     Data in this section comes from the CDC and is collected nationally:

• 99.5% of all influenza isolates typed at national reference labs this week were Influenza A:
• 99.5% of subtyped isolates were 2009 Pandemic A (H1N1).
• 0.00% were seasonal A (H1)
• 0.00% were seasonal A (H3)
• 0.50% of isolates were unable to be subtyped
• 0.5% were Influenza B
• The majority of influenza viruses currently circulating in the U.S. are 2009 Pandemic Influenza A (H1N1)

• This antiviral susceptibility profile is compiled by CDC and represents strains identified since September 1, 2009.

  
  

  Antiviral Susceptibility	Samples Tested	% Resistant to Oseltamivir	Samples Tested	% Resistant to Zanamivir
  2009 Pandemic A (H1N1	1076	0.3%	315	0%
  Seasonal A (H1)	0	0	0	0
  Seasonal A (H3)	0	0	0	0
  Influenza B	0	0	0	0

2009 Pandemic Influenza A (H1N1) Vaccine Information:

• Utah has been allocated for this week 75,800 doses of H1N1 vaccine that should arrive within a week. To date, Utah has received a total of 368,700 doses. When the 75,800 doses arrive, Utah will have received a total of 444,500 doses. 
• Utah health care providers reported having administered 228,367 doses of H1N1 vaccine, as of Tuesday, November 17, 2009.
• 2009 Pandemic A H1N1 vaccine continues to arrive in weekly shipments and vaccine is still in limited supply. Check with your Local Health Department or designated provider to find out what type of vaccine they have available and to whom they are giving it. Follow this link  for a list of local health department websites.
• Although the H1N1 vaccine supply overall is improving every day, there is -- and will be -- variability in supplies and demand at the local provider level (e.g., individual clinics or physicians may have less vaccine than needed).  As the 2009 H1N1 vaccine supply situation improves, more people in priority groups will be able to get vaccinated, and do so with greater ease
• The top priority for available vaccine is reaching people in targeted populations. How people in these groups are reached may vary within communities. Some local health departments may disseminate vaccine through doctors’ offices, schools or other designated health care providers.
• On November 10, the FDA approved the expansion of the age indication for both of CSL Limited's inactivated influenza vaccines: the seasonal formulation (Affluria) and the 2009 H1N1 formulation. These two vaccines are now approved for use in people age 6 months and older; previously, they were licensed for use in people age 18 years and older. Visit the FDA website to access the document, "Influenza A (H1N1) 2009 Monovalent Vaccines Descriptions and Ingredients."

Priority groups for H1n1 vaccinations include:

• Pregnant women because they are at higher risk of complications and can potentially provide protection to infants who cannot be vaccinated;
• Household contacts and caregivers for children younger than 6 months of age because younger infants are at higher risk of influenza-related complications and cannot be vaccinated. Vaccination of those in close contact with infants younger than 6 months old might help protect infants by "cocooning" them from the virus;
• Healthcare and emergency medical services personnel because infections among healthcare workers have been reported and this can be a potential source of infection for vulnerable patients. Also, increased absenteeism in this population could reduce healthcare system capacity;
• Adults 19 through 24 years of age because many cases of 2009 H1N1 influenza have been seen in these healthy young adults and they often live, work, and study in close proximity, and they are a frequently mobile population; and,
• Persons aged 25 through 64 years who have health conditions associated with higher risk of medical complications from influenza.

New CDC guidance available.  Follow this link

• Update: FDA Questions and Answers for Health Care Providers: Renal Dosing and Administration Recommendations for Peramivir IV (Posted Friday, November 13, 2009).
• New: 2009 H1N1 Flu Information for People with Disabilities and Their Caregivers or Personal Assistants (Posted Monday, November 16, 2009).