Greg Scott

Greg Scott

Academic Research

By Greg Scott

Influenza activity continues to increase in North America, with most regions reporting high levels of influenza-like-illness (ILI), and the seasonal peak still yet to come, according to the Centers for Disease Control and Prevention (CDC) and Public Health Agency of Canada.

Arthur Yancey, M.D., medical director for Grady Emergency Medical Services in Atlanta, Ga., and medical adviser for the International Academies of Emergency Dispatch (IAED) Chemical, Biological, Radiological, and Nuclear (CBRN) Committee said the state of Georgia is experiencing the worst flu season since 2009-2010.

“We’re definitely seeing more cases in the emergency department at Grady this year,” he said.

Several key indicators, updated weekly by both the CDC and Public Health Agency of Canada, are pointing to a virulent and still-intensifying North American (2012-2013) flu season. In the U.S., 47 states are reporting widespread geographic influenza activity for the week of Dec. 30–Jan. 5, an increase from 41 states the previous week. Twenty-four states and New York City are experiencing high ILI activity. Boston, Mass., has declared a public health emergency.

Influenza A (H3N2), 2009 influenza A (H1N1), and influenza B viruses have all been identified in the U.S. this season. During the same week, 4,222 influenza-positive tests were reported. Two influenza-associated pediatric deaths were reported, bringing the total number of confirmed pediatric deaths to 20 this season.

In Canada, a total of 4,632 laboratory detections of influenza were reported for the week ending Dec. 29, 2012, of which 97.7% were for influenza A viruses, predominantly A (H3N2). New influenza outbreaks totaled 127, of which 87 were in long-term care facilities. There were 114 new pediatric influenza-associated hospitalizations reported through the countrywide IMPACT network and 176 hospitalizations, including 15 deaths among adults up to 20 years of age, according to aggregate surveillance.

For severe flu outbreaks, the Academy provides ProQA software users with an SRI (Severe Respiratory Infection) surveillance tool allowing EMDs to capture specific flu symptoms from callers reporting suspected flu patients. The use of this feature is optional (and not part of the standard MPDS Protocol questioning), to be used at the direction of the system’s medical director.

Protocol 36—also available to ProQA users—is for the most extreme flu outbreaks (disaster-level), and not recommended by the IAED for use anywhere in the world at the time the article was written (Jan. 11, 2013). All 9-1-1 agencies, however, should have a modified response matrix prepared for situations of extreme EMS system overload, as part of their pandemic flu preparedness plan.

The CDC recommends influenza vaccinations for people who have not yet been vaccinated this season and antiviral treatment as early as possible for people who get sick and are at high risk of flu complications.


Centers for Disease Control and Prevention. 2012-2013 Influenza Season Week 52 Ending Dec. 29, 2012. Accessed Jan. 10, 2013.

Public Health Agency of Canada. 2012-2013 Influenza Season Week 52 Ending Dec. 29, 2012. Accessed Jan. 10, 2013.

Landau, Elizabeth. Flu picks up steam across the U.S. CNN Health 2013. Accessed Jan. 10, 2013.

Pam Farber contributed to this article.