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The results of tests performed by clinical laboratories nationwide are summarized below. Data from clinical laboratories (the percentage of specimens tested that are positive for influenza virus) are used to monitor whether influenza activity is increasing or decreasing.
The results of tests performed by public health laboratories nationwide are summarized below. Data from public health laboratories are used to monitor the proportion of circulating influenza viruses that belong to each influenza subtype/lineage.
A patient aged >18 years in Michigan developed conjunctivitis while working at a commercial dairy farm where HPAI A(H5N1) virus had been detected in cows. The patient reported their symptom onset to the Michigan Department of Health and Human Services via a text-based symptom monitoring system. Respiratory and conjunctival swab specimens were collected from the patient. The respiratory specimen (a nasopharyngeal swab) tested negative for influenza A virus at the Michigan Public Health Laboratory using a Centers for Disease Control and Prevention (CDC) assay. Both specimens were sent to CDC for further testing, where they were received and tested on May 21, 2024. The conjunctival specimen was positive for A(H5N1) virus using diagnostic RT-PCR and sequencing, and the respiratory specimen tested negative for influenza A and A(H5) virus. The patient did not report symptoms other than eye redness, discharge, and discomfort consistent with conjunctivitis, was not hospitalized, and has fully recovered. ( -evaluating-patients.htm).
In response to this detection, public health officials are conducting surveillance in the area and additional case investigation activities, including contact tracing. Additional symptomatic persons among workers exposed to infected cattle at the same farm have not been identified through monitoring of workers. Additional cases of human infection with A(H5) virus associated with this case and human-to-human transmission of A(H5) virus have not been identified to date.
This is the third person to test positive for A(H5) virus in the United States. The first was reported in April 2022 in Colorado in a person who reported fatigue during culling of poultry infected with HPAI A(H5N1) virus, and the second was reported in April 2024 in a dairy farm worker with conjunctivitis in Texas. This is the second case associated with an ongoing multistate outbreak of HPAI A(H5N1) in dairy cows.
Currently in the United States, HPAI A(H5N1) virus detections among wild birds are widespread. There are outbreaks among animals including poultry, backyard flocks, and dairy cows. Sporadic infections in wild mammals also have been reported by United States Department of Agriculture (USDA) Animal Plant Health Inspection Service (APHIS).
CDC recommends that state and local public health departments monitor people who are exposed to birds or other animals (including livestock) infected or suspected to be infected with avian influenza A viruses for onset of signs and symptoms for 10 days after their last exposure and that people who develop signs or symptoms of respiratory illness and/or conjunctivitis be tested for influenza. Between February 9, 2022 and May 21, 2024, more than 9,000 people were actively monitored following HPAI exposure.
The latest case reports on avian influenza outbreaks in wild birds, commercial poultry, backyard or hobbyist flocks, and mammals in the U.S. are available from the USDA at -disease-information/avian/avian-influenza/2022-hpai.
CDC performs genetic and antigenic characterization of U.S. viruses submitted from state and local public health laboratories according to the Right Size Roadmap submission guidance. These data are used to compare how similar the currently circulating influenza viruses are to the reference viruses representing viruses contained in the current influenza vaccines. The data are also used to monitor evolutionary changes that continually occur in influenza viruses circulating in humans. CDC also tests susceptibility of circulating influenza viruses to antiviral medications including the neuraminidase inhibitors (oseltamivir, zanamivir, and peramivir) and the PA endonuclease inhibitor baloxavir.
CDC antigenically characterizes influenza viruses by hemagglutination inhibition (HI) (H1N1pdm09, H3N2, B/Victoria, and B/Yamagata viruses) or neutralization-based HINT (H3N2 viruses) using antisera that ferrets make after being infected with reference viruses representing the 2023-2024 Northern Hemisphere recommended cell or recombinant-based vaccine viruses. Antigenic differences between viruses are determined by comparing how well the antibodies made against the vaccine reference viruses recognize the circulating viruses that have been grown in cell culture. Ferret antisera are useful because antibodies raised against a particular virus can often recognize small changes in the surface proteins of other viruses. In HI assays, viruses with similar antigenic properties have antibody titer differences of less than or equal to 4-fold when compared to the reference (vaccine) virus. In HINT, viruses with similar antigenic properties have antibody neutralization titer differences of less than or equal to 8-fold. Viruses selected for antigenic characterization are a subset representing the genetic changes in the surface proteins seen in genetically characterized viruses.
CDC assesses susceptibility of influenza viruses to the antiviral medications including the neuraminidase inhibitors (oseltamivir, zanamivir, and peramivir) and the PA endonuclease inhibitor baloxavir using next generation sequence analysis supplemented by laboratory assays. Information about antiviral susceptibility test methods can be found at U.S. Influenza Surveillance: Purpose and Methods | CDC.
Two A(H1N1)pdm09 viruses had NA-H275Y amino acid substitution conferring highly reduced inhibition by oseltamivir and peramivir. One (H1N1)pdm09 virus had NA-I223V and NA-S247N amino acid substitutions and showed reduced inhibition by oseltamivir. One B virus had NA-A245G amino acid substitution and showed reduced inhibition by peramivir.
High levels of resistance to the adamantanes (amantadine and rimantadine) persist among influenza A(H1N1)pdm09 and influenza A(H3N2) viruses (the adamantanes are not effective against influenza B viruses). Therefore, use of these antivirals for treatment and prevention of influenza A virus infection is not recommended and data from adamantane resistance testing are not presented.
About 70% of ILINet participants provide both the number of patient visits for respiratory illness and the total number of patient visits for the week broken out by age group. Data from this subset of providers are used to calculate the percentages of patient visits for respiratory illness by age group.
Additional information about medically attended visits for ILI for current and past seasons:
Surveillance Methods | FluView Interactive: National, Regional, and State Data or ILI Activity Map
The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts population-based surveillance for laboratory-confirmed influenza-related hospitalizations in select counties in 14 states and represents approximately 9% of the U.S. population. FluSurv-NET hospitalization data are preliminary. As data are received each week, prior case counts and rates are updated accordingly.
A total of 24,763 laboratory-confirmed influenza-associated hospitalizations were reported by FluSurv-NET sites between October 1, 2023, and May 18, 2024. The weekly hospitalization rate observed in Week 20 was 0.2 per 100,000 population. The peak weekly hospitalization rate observed this season was 9.0 per 100,000 population and occurred during Week 52.
In these figures, cumulative and weekly rates for all seasons prior to the 2023-2024 season reflect end-of-season rates. For the 2023-2024 season, rates for recent hospitals admissions are subject to reporting delays. As hospitalization data are reviewed each week, prior case counts and rates are updated accordingly.
Additional FluSurv-NET hospitalization surveillance information for current and past seasons and additional age groups:
Surveillance Methods |FluView Interactive: Rates by Age, Sex, and Race/Ethnicity or Data on Patient Characteristics | RESP-NET Interactive
Effective May 1, 2024, hospitals are no longer required to report hospital admissions, hospital capacity, or hospital occupancy data to HHS through NHSN. Voluntarily reported NHSN hospital data can found at Weekly United States Hospitalization Metrics by Jurisdiction. 152ee80cbc
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