Chapman L E, Tipple M A, Folger S G, Harmon M, Kendal A P, Cox N J, Schonberger L B
Connaught Laboratories, Pasteur-Mirieux Company, Swiftwater, Pennsylvania.
MMWR CDC Surveill Summ. 1993 Mar 19;42(1):9-22.
PROBLEM/CONDITION: CDC monitors the emergence and spread of new influenza virus variants and the impact of influenza on morbidity and mortality annually from October through May.
This report covers United States influenza surveillance conducted from October 1988 through May 1989.
Weekly reports from the vital statistics offices of 121 cities provided an index of influenza's impact on mortality; 58 WHO collaborating laboratories reported weekly identification of influenza viruses; weekly morbidity reports were received both from the state and territorial epidemiologists and from 153 sentinel family practice physicians. Nonsystematic reports of outbreaks and unusual illnesses were received throughout the year.
During the 1988-89 influenza season, influenza A (H1N1) and B viruses were identified in the United States with essentially equal frequency overall, although both regional and temporal patterns of predominance shifted over the course of the season. Throughout the season increases in the indices of influenza morbidity in regions where influenza B predominated. Only 7% of identified viruses were influenza A (H3N2), but not isolations of this subtype increased as the season waned and it subsequently predominated during the 1989-90 season. During the 1988-89 season outbreaks in nursing homes were reported in association with influenza B and A (H3N2), but not influenza A (H1N1).
The alternating temporal and geographic predominance of influenza strains A (H1N1) and B during the 1988-89 season emphasizes the importance of continual attention to regional viral strain surveillance, since amantadine is effective only for treatment and prophylaxis of influenza A.
Weekly interim analyses of surveillance data produced throughout the season allow physicians and public health officials to make informed choices regarding appropriate use of amantadine. CDC's annual surveillance allows the observed viral variants to be assessed as candidates for inclusion as components in vaccines used in subsequent influenza seasons.
问题/状况：美国疾病控制与预防中心（CDC）每年从10月至次年5月监测新型流感病毒变种的出现与传播，以及流感对发病率和死亡率的影响。
本报告涵盖1988年10月至1989年5月在美国开展的流感监测。
来自121个城市生命统计办公室的每周报告提供了流感对死亡率影响的指标；58个世界卫生组织合作实验室每周报告流感病毒的鉴定情况；每周发病率报告既来自州和地区流行病学家，也来自153名定点家庭医生。全年都收到了关于疫情爆发和异常疾病的非系统性报告。
在1988 - 1989年流感季节，在美国鉴定出的甲型（H1N1）和乙型流感病毒总体频率基本相同，不过在该季节过程中，两种病毒占主导的区域和时间模式都发生了变化。在整个季节中，乙型流感占主导的地区流感发病率指数上升。鉴定出的病毒中只有7%是甲型（H3N2），但该亚型的分离株随着季节临近结束而增加，随后在1989 - 1990年季节占主导地位。在1988 - 1989年季节，疗养院报告了与乙型流感和甲型（H3N2）相关的疫情爆发，但未出现与甲型（H1N1）相关的疫情爆发。
在1988 - 1989年季节，甲型（H1N1）和乙型流感毒株在时间和地理上交替占主导地位，这凸显了持续关注区域病毒株监测的重要性，因为金刚烷胺仅对甲型流感的治疗和预防有效。
在整个季节对监测数据进行每周中期分析，使医生和公共卫生官员能够就金刚烷胺的适当使用做出明智选择。美国疾病控制与预防中心的年度监测能够对观察到的病毒变种进行评估，以确定其是否可作为后续流感季节所用疫苗成分的候选毒株。
