• Visits to doctors for influenza-like illness (ILI) continued to increase in the United States, and overall, are higher than levels expected for this time of the year.

• Total influenza hospitalization rates for laboratory-confirmed influenza are higher than expected for this time of year for adults and children. And for children 5-17 and adults 18-49 years of age, hospitalization rates from April – October 2009 exceed average flu season rates (for October through April).

• The proportion of deaths attributed to pneumonia and influenza (P&I) based on the 122 Cities Report has increased and now exceeds what is normally expected at this time of year. In addition, 19 flu-related pediatric deaths were reported this week; 16 of these deaths were confirmed 2009 H1N1 and 3 were unsubtyped influenza A and likely to be 2009 H1N1. A total of 76 laboratory confirmed 2009 H1N1 pediatric deaths have been reported to CDC since April.

• Thirty-seven states are reporting widespread influenza activity at this time. They are: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Texas, Tennessee, Virginia, Washington, and Wyoming. Any reports of widespread influenza activity in September and October are very unusual.

• Almost all of the influenza viruses identified so far are 2009 H1N1 influenza A viruses. These viruses remain similar to the virus chosen for the 2009 H1N1 vaccine, and remain susceptible to the antiviral drugs oseltamivir and zanamivir with rare exception.

Swine Influenza A (H1N1) Virus Biosafety Guidelines for Laboratory Workers
www2a.cdc.gov says: This guidance is for laboratory workers who may be processing or performing diagnostic testing on clinical specimens from patients with suspected swine influenza A (H1N1) virus infection, or performing viral isolation.
Human Swine Influenza Investigation

www2a.cdc.gov says: Human cases of swine influenza A (H1N1) virus infection have been identified in the U.S. in San Diego County and Imperial County, California as well as in San Antonio, Texas. Internationally, human cases of swine influenza A (H1N1) virus infection have been identified in Mexico.
Swine Flu Updates on CDC’s Twitter Feed
www2a.cdc.gov says: Follow CDC on Twitter to get real-time updates on the swine flu investigation
Swine Flu Video Podcast
www2a.cdc.gov says: Dr. Joe Bresee, with the CDC Influenza Division, describes swine flu – its signs and symptoms, how it’s transmitted, medicines to treat it, steps people can take to protect themselves from it, and what people should do if they become ill.
Daily Update – Human Swine Influenza Investigation

www2a.cdc.gov says: Investigations are ongoing to determine the source of the infection and whether additional people have been infected with similar swine influenza viruses. CDC is working very closely with state and local officials in California, Texas, as well as with health officials in Mexico, Canada and the World Health Organization.
CDC Health Advisory
www2a.cdc.gov says: Investigation and Interim Recommendations: Swine Influenza (H1N1)
Distributed via Health Alert Network
CDCHAN-000281-2009-04-25-ALT-N
Swine Flu and Safe Travel in the United States
www2a.cdc.gov says: CDC has NOT recommended that people avoid travel at this time. However, if you are planning travel, please follow recommendations to reduce your risk of infection and stay healthy.
Travel Health Precaution – Swine Influenza and Severe Cases of Respiratory Illness in Mexico

www2a.cdc.gov says: CDC has NOT recommended that people avoid travel to Mexico at this time. However, if you are planning travel to Mexico, follow recommendations to help you and your family stay safe and healthy.
Interim Guidance for Swine influenza A (H1N1): Taking Care of a Sick Person in Your Home
www2a.cdc.gov says: Interim Guidance for Swine influenza A (H1N1): Taking Care of a Sick Person in Your Home
Update: U.S. Human Cases of Swine Flu Infection
www2a.cdc.gov says: Human cases of swine influenza A (H1N1) virus infection have been identified in the U.S.
Interim Recommendations for Facemask and Respirator Use in Certain Community Settings Where Swine Influenza A (H1N1) Virus Transmission Has Been Detected
www2a.cdc.gov says: Information on the effectiveness of facemasks and respirators for the control of influenza in community settings is extremely limited. These interim recommendations have been developed on the basis of public health judgment and the historical use of facemasks and respirators in other settings.
Media Availability on CDC Investigation of Human Cases of Swine Influenza
www2a.cdc.gov says: Press briefing from April 25, 2009. CDC’s Dr. Anne Schuchat, Interim Director for Science and Public Health Programs and and Dr. Daniel Jernigan, Director of the Influenza Division.