DoD Global Influenza Surveillance Program Linda C. Canas Brooks City-Base San Antonio, TX 20 Feb 2003

Population Based Surveillance Naval Health Research Center San Diego, California Etiology Based Surveillance Brooks City-Base San Antonio, Texas Influenza Surveillance

DoD GEIS Laboratory Funding & Guidance Routine & Annual Reports; End of Season business meeting Supplies and Instructions Program Guidance & routine reports Collect and ship Samples Info entered into AF database Flu Isolated Conventional Laboratory Methods Sentinel Sites Notification CDC Vaccine Decisions Selected Samples DoD Global Influenza Surveillance IN ACTION IN ACTION Epi Services Branch

DoD GEIS Laboratory Funding & Guidance Routine & Annual Reports; End of Season business meeting Supplies and Instructions Program Guidance & routine reports Collect and ship Samples Info entered into AF database Flu Isolated Conventional Laboratory Methods Sentinel Sites Notification CDC Vaccine Decisions Selected Samples DoD Global Influenza Surveillance IN ACTION IN ACTION Epi Services Branch

U.S. Department of Defense Surveillance Sites KEY: = Sentinel Sites = Hawaiian Sentinel Sites ( 3 Total ) = Clinics & Hospitals Associated with Overseas Research Labs = Participating Overseas Local Labs

S ENTINEL S ITES USAF Academy COLORADO Andersen AFB GUAM Andrews AFB WASHINGTON DC Elmendorf AFB ALASKA Tripler AMC HAWAII Hickam AFB HAWAII NH Pearl Harbor HAWAII Incirlik AFB TURKEY Kadena AFB OKINAWA Kunsan AFB KOREA Lakenheath AFB UNITED KINGDOM Madigan AMC WASHINGTON Maxwell AFB ALABAMA McGuire AFB NEW JERSEY Misawa AFB JAPAN NAB Little Creek VIRGINIA Osan AFB KOREA Ramstein AFB GERMANY Sheppard AFB TEXAS Travis AFB CALIFORNIA Yokosuka NH JAPAN Yokota AFB JAPAN Armed Forces Research Institute of Medical Sciences (AFRIMS) NEPAL THAILAND Naval Medical Research Institute Detachment (NAMRID) PERU ECUADOR BOLIVIA ARGENTINA Walter Reed Army Institute of Research (WRAIR) UGANDA

AFIERA | ESOH Service CenterESOH Service Center 24 Jan 02 Number of newly identified isolates: 30 (influenza A) Locations: Andrews AFB, MD (2)NS Pearl Harbor, HI (3) Columbus AFB, MS (1)RAF Lakenheath, U.K. (7) Kadena AB, Japan (2)Randolph AFB, TX (1) Maxwell AFB, AL (1)Robins AFB, GA (1) McGuire AFB/Ft. Dix, NJ (6)Sheppard AFB, TX (3) NAB Little Creek, VA (1)Travis AFB, CA (2) Demographics: This page accessed 156 times since 16 November Send mail to Influenza Surveillance with questions pertaining to Influenza Surveillance.Influenza Surveillance AFIERA | ESOH Service CenterESOH Service Center Send mail to the webmaster with questions or comments about this web site. Last modified: 25 Jan 02 webmaster Total Number of Specimens & Percent Positive for Influenza (as of 11 February, 2003)

Influenza A Isolates by Week Collected N= 95 (as of 11 February, 2003)

Influenza B Isolates by Week Collected N=129 (as of 11 February, 2003)

Influenza A&B Isolates by Week~Compared Flu AFlu B

Asia/Pacific: Influenza Isolates * Over 50% of the specimens are not complete for February

* Over 50% of the specimens are not complete for February The Americas: Influenza Isolates

Europe/Middle East: Influenza Isolates * Over 50% of the specimens are not complete for February

OCTOBER 48% (172/360) of samples pos for any respiratory virus 11% (19/172) of all resp viruses were Influenza 11% (2/19) of the flus subtyped (H3N2) 5 A 11 B 1 H3N2 1 B * Pacific US includes AK and HI data 1 H3N2 10 H3N2 6 B Totals 5 A 17 B 4 B Hong Kong Totals 1 A 4 B NOVEMBER 36% (131/360) of samples pos for any respiratory virus 17% (22/131) of all resp viruses pos for Influenza 73% (16/22) of the flus subtyped: 11 H3N2; 5 B/HK 1 B/HK 4 B Totals 5 A 21 B 1 A 3 H3N2 8 B 4 B/HK 1 B Totals 1 A 1 B 1 A 2 B 2 H3N2 * 4 A 13 H3N2 Totals 27 A 18 B 9 B/HK 1 H1N1 Totals: 1 A 28 B DECEMBER 34% (153/446) of samples pos for any respiratory virus 48% (73/153) of all resp viruses were Influenza 45% (33/73) of the flus were subtyped: 1 H1N1, 18 H3N2, 14 B/HK 1 A Totals 2 A 1 B 1 B/HK 1 H1N1 2 B 1 A * 1 H1N1 Totals 4 A 6 A 3 H1N1 3 B 1 B/HK Totals 10 A, 6 B 2 B 2 B/HK Totals 3 B 17 A 16 H3N2 2 B Totals 37 A, 14 B 1 B 3 B/HK 2 A 30 B 3 B/HK Totals 3 A 61 B JANUARY 38% (207/549) of samples pos for any respiratory virus* 48% (99/207) of all resp viruses were Influenza 31% (31/99) of the flus were Subtyped: 5 H1N1, 16 H3N2, 10B/HK

Percent Positive Isolates by Type N=641 (as of 11 February 2003)

Percent of All Positive Isolates WITHOUT Adenovirus N = 324 (as of 11 February 2003)

Summary Overall this has been an exceptional year Great diversity of isolates H3N2: Asia/Pacific H1N1: Americas B/Hong Kong: Everywhere Molecular Analysis H3N2 viruses: some show hemagglutinin variation compared to viruses

Count of All Isolates by Week Collected N=1593 (as of February 11, 20003) *Does not include incomplete specimens

Count of All Isolates by Week Collected N=1810 (as of 11 February, 2003)

FEBRUARY (Through 10 Feb 03) 14% (16/118) of samples pos for any respiratory virus* 69% (11/16) of all resp viruses were positive for influenza * Subtyping not yet performed 1 A 1 B 3 B 1 B 1 A 1 B 1 A 1 B