Southern California Respiratory Viral Isolates

RSV has arrived!

2012-02-09T15:30:00.000-08:00

We are now seeing both RSV (at a rate >10%) and Influenza A (both H3N1 and 2009 H1N1). The rates for RSV have increased from 9.4% to 14% and now 19% over the past three weeks. We continue to see a lot of human metpneumovirus (hMPV) as well as the occasional Adeno and Parainfluenza. No significant influenza B is being reported from our various sites.

Respiratory Viral Activity

2012-02-09T14:38:00.000-08:00

Not much going on in Southern California!

2012-01-30T11:05:00.002-08:00

We have very low numbers of both RSV and Influenza circulating. Our current RSV rates remain below 10% (above 10% is considered endemic) and we have just occasional influenza. We have seen H1N1 influenza in addition to influenza B but at very low rates. The most common virus we are seeing in our testing is human metapneumovirus-approaching 30% of specimens submitted at some institutions!
Stay tuned!

RSV Activity

2012-01-30T11:05:00.001-08:00

Respiratory Viral Isolates in Southern California

2012-01-30T11:04:00.000-08:00

Respiratory Viral Activity

2012-01-03T12:06:00.001-08:00

RSV Activity

2012-01-03T12:05:00.001-08:00

Respiratory Viral Isolates in Southern California

2011-12-29T09:48:00.000-08:00

Respiratory Viral Isolates in Southern California

2011-12-01T13:23:00.001-08:00

Respiratory Viral Activity

2011-11-30T12:48:00.001-08:00

Respiratory Viral Activity

2011-11-28T14:14:00.001-08:00

Welcome back to the LA Bugs Respiratory Viral Isolates blog.
The respiratory viral season is just heating up and I will be posting the total numbers from 7 Southern California hospitals and when the RSV season picks up I will be posting the percentage of RSV isolates that are positive.
Currently we are running at 2% positive throughout the region.
Note that the predominant virus remains Parainfluenza (mostly type 1) and that we are starting to see a few positive Influenza (both A and B) but not in high numbers.
Stay tuned!

Respiratory Viral Isolates in Southern California

2011-11-28T14:13:00.001-08:00

RSV Activity FINAL 2010-11

2011-05-23T11:44:00.000-07:00

Respiratory Viruses FINAL 2010-11

2011-05-23T11:39:00.001-07:00

Respiratory Viral Activity

2011-04-25T15:32:00.000-07:00

We are seeing the end of RSV season with less than 3% positivity. There are other viruses circulating, however. Most notably Parainfluenza 3 and human metapneumovirus. We are having occasional Adenovirus as well. All of these other viruses outnumber RSV and Influenza combined!

Respiratory Viral Isolates in Southern California

2011-04-25T15:31:00.000-07:00

RSV Activity in Southern CA: on the way out

2011-04-25T15:11:00.000-07:00

RSV Activity in Southern California

2011-04-11T13:09:00.000-07:00

RSV in rapid decline

2011-04-11T13:06:00.001-07:00

Over the last three weeks RSV has predictably declined in Southern California. As is evident from the graph, we have fallen from persistently endemic levels of 23% the week ending March 19 to a current level of 5%. We are continuing to see occasional influenza (mostly influenza A) as well as parainfluenza, adenovirus and human metapneumovirus. Stay tuned to see if the anticipated decline continues.

Respiratory Viral Activity

2011-04-11T12:30:00.000-07:00

RSV on the decline but not gone

2011-03-22T09:49:00.001-07:00

We are continuing to see RSV at endemic levels (>10% in the community). The most recent numbers show that 13% of specimens submitted for testing are positive for RSV. From this, we estimate that RSV season will continue for another 4-6 weeks, through the month of April. We also continue to see quite a bit of influenza (both A and B) circulating. The As outnumber the Bs but both are prevalent. In addition to RSV and Influenza, we have seen a uptick in the numbers of other respiratory viruses, both Parainfluenza and Adenovirus are circulating but not much human metapneumovirus as compared with previous years.

Stay tuned to this site for further updates about the season!

RSV Activity in Southern California

2011-03-17T14:30:00.002-07:00

Respiratory Viral Activity

2011-03-17T14:30:00.001-07:00

Respiratory Viral Isolates in Southern California

2011-02-22T13:22:00.001-08:00

RSV Activity in Southern California

2011-02-22T13:15:00.001-08:00

RSV rates continue stable but high in Southern California

2011-02-09T10:22:00.000-08:00

Respiratory Viral Activity

2011-02-09T10:13:00.001-08:00

RSV continues at endemic levels in Southern California

2011-02-01T08:55:00.002-08:00

The RSV rates have stayed above the 10% threshold mark since before the holidays. We are currently running around 30-35% positive samples from all of our sites. Influenza is also prevalent in the community, with both A and B circulating. Reports from the CDC suggest that the circulating strains are indeed the ones contained in this year's seasonal influenza vaccine (both A and B).
We continue to see the occasional parainfluenza, adenovirus and even enterovirus.

Respiratory Viral Activity

2011-02-01T08:55:00.001-08:00

RSV rates significantly increase in Southern California

2011-01-07T12:49:00.000-08:00

We are seeing significant increases in the numbers of positive RSV tests from our reporting sites in Southern California. The week of 12/25 we recorded 25% positive samples and last week it was up to 33%. A similar trend is being seen throughout the state as reported by the California Department of health:

"A sharp increase in the percentage of RSV detections in sentinel labs was observed this week. Table 3 shows positive influenza and RSV results reported from sentinel laboratories during Week 52. Of 1,397 specimens tested for RSV during Week 52, 614 (44.0%) were positive. This was a substantial increase from the previous week, when 462 (32.4%) of 1,409 specimens tested positive for RSV".

Data from the 65 sentinel laboratories can be seen on the California DPH website: www.cdph.ca.gov/

RSV is here (and Influenza B!)

2010-12-23T10:11:00.000-08:00

We have now reached endemic rates of circulating RSV in the Southern California area. Last week we hit a positive rate of 18% of specimens submitted. This was a quick jump from 8.7% the previous week. We are also seeing quite a bit of influenza, primarily influenza B. Per the CDC's website:

"Influenza viruses identified so far include 2009 H1N1 viruses, influenza A (H3N2) viruses and influenza B viruses. These viruses remain similar to the viruses chosen for the 2010-2011 flu vaccine, and remain susceptible to the antiviral drugs oseltamivir and zanamivir"

Stay tuned for more updates as the season continues. Happy Holidays from the LABUGS blog!

Southern California RSV Activity (>10%)

2010-12-23T10:09:00.001-08:00

Southern California Respiratory Viral Isolates

2010-12-23T10:03:00.001-08:00

Respiratory Viral Activity

2010-12-08T14:13:00.000-08:00

RSV Activity in Southern California

2010-12-08T14:10:00.001-08:00

Respiratory Viral Isolates in Southern California

2010-12-01T14:12:00.001-08:00

RSV Activity in Southern California

2010-12-01T13:58:00.001-08:00

RSV Activity in Southern California

2010-12-01T13:58:00.000-08:00

RSV in Southern California

2010-11-15T13:08:00.001-08:00

Southern California Respiratory Viral Isolates

2010-11-11T13:33:00.001-08:00

Southern California Viral Isolates

2010-11-08T15:13:00.000-08:00

Still no RSV activity to speak of, just a few positives circulating. The big news is that we have quite a bit of Parainfluenza (mostly type 2, but all types are circulating in the community). This is the reason we are seeing so much croup in our clinics and emergency rooms! Stay tuned for RSV and influenza information. We have had a couple of influenza B positives and one influenza A reported in the last 3 weeks.

From the CDC: "The percentage of specimens testing positive for influenza identified so far in the United States is low. The largest numbers of respiratory specimens testing positive for influenza have been reported in Regions 4 (AL, FL, GA, KY, MS, NC, SC, TN) and 9 (AZ, CA, HI, NV)"

"Influenza viruses identified so far include 2009 H1N1 viruses, influenza A (H3N2) viruses and influenza B viruses. These viruses remain similar to the viruses chosen for the 2010-2011 flu vaccine, and remain susceptible to the antiviral drugs oseltamivir and zanamivir"

More can be found on the CDC's influenza website: http://www.cdc.gov/flu/
as well as on the LA County website:http://www.publichealth.lacounty.gov/acd/Flu.htm

Southern California Respiratory Viral Isolates

2010-10-19T11:53:00.000-07:00

The season is just beginning and not all my sites are reporting out their numbers. We have had a few sporadic RSV reports (positive PCR or DFA) from a few sites but the virus we are seeing in slightly larger numbers is Parainfluenza (1, 2 and 3). No states reported widespread or regional influenza activity. As per the CDC's influenza site: "Influenza viruses identified so far include 2009 H1N1 viruses, influenza A (H3N2) viruses and influenza B viruses. These viruses remain similar to the viruses chosen for the 2010-2011 flu vaccine, and remain susceptible to the antiviral drugs oseltamivir and zanamivir".

Keep checking back on this site to get up dates on RSV and other respiratory viruses circulating.

RSV in Southern California

2010-05-04T13:41:00.001-07:00

Respiratory Viral Activity: END OF SEASON!

2010-05-04T13:39:00.000-07:00

RSV running below 10%

2010-04-13T12:50:00.000-07:00

Respiratory Viral Isolates in Southern California

2010-04-13T08:26:00.001-07:00

% Positive RSV

2010-03-30T11:08:00.001-07:00

Respiratory Viral Isolates

2010-03-30T11:03:00.001-07:00

RSV in Southern California

2010-03-15T12:39:00.000-07:00

RSV continues to be circulating a endemic levels (we are at 19% of specimens submitted). Both RSV and Human Metapneumovirus have both come down in the last 3 weeks from a high of 32% for RSV back during the week of February 20th and 29% for hMPV the week of February 13th. Human metapneumovirus is now running around 15%. There is very little, if any, circulating influenza A and B and only a very occasional adenovirus or parainfluenza virus.

Percent Positive RSV: Reporting Hospitals

2010-03-15T12:38:00.000-07:00

Respiratory Viral Isolates

2010-03-01T14:25:00.001-08:00

Respiratory Viral Activity

2010-02-19T12:42:00.001-08:00

Respiratory Viral Isolates in Southern California

2010-02-08T09:21:00.000-08:00

RSV is finally here!

2010-02-08T09:14:00.000-08:00

Influenza has slowed to almost a complete stop in LA County. But now it is time for the rise of RSV. We are approaching 20-30% positivity (well above endemic levels of 10%).
This is a bit later than last year but overall numbers are comparable. Interestingly, from the few sites that report out positive human metapneumovirus (hMPV), those numbers are running almost as high as RSV! This is an important (and under recognized) respiratory virus producing symptoms similar to those of RSV.
Stay tuned for further updates in numbers.

RSV in Southern California

2010-01-11T13:02:00.001-08:00

Respiratory Viral Isolates

2010-01-11T12:55:00.001-08:00

Respiratory Viral Activity

2010-01-11T12:45:00.001-08:00

The last few weeks have shown a significant decline in the number of influenza A (H1N1) cases throughout Southern California.
We are also starting to see the start of an RSV season (significantly later this year than in previous years!) We are now at almost 6% of specimens testing positive for RSV but this number is sure to jump in the next few weeks. When we hit 10% we declare RSV to be circulating in an endemic fashion. We are also continuing to see some parainfluenza 1 as well as human metapneumovirus in the community. Stay tuned for more viral information and percentages.

Respiratory Viral Isolates

2010-01-06T13:54:00.001-08:00

RSV in Southern California

2010-01-06T13:53:00.000-08:00

Viral Activity

2009-12-16T14:08:00.000-08:00

As you can see from the graph below, the number of influenza A (all of them being H1N1 for the most part) isolates have dramatically dropped off over the past 2-3 weeks. We haven't seen much, if any, influenza B and even the parainfluenza seems to have subsided.
Fewer respiratory specimens are being sent for testing, so that is most likely the reason for fewer numbers of other viruses (i.e. adeno, paraflu) being detected.
We are starting to see SMALL numbers of RSV in the community, we are currently at < 2% of samples submitted for testing. A very small number, but we expect this to pick up as the season continues.

Respiratory Viral Isolates in Southern California

2009-12-16T14:06:00.000-08:00

It's still all H1N1 Influenza

2009-11-23T13:00:00.000-08:00

As you can see from the graph we are still having quite a bit of influenza A circulating and from the CDC and LA County information we know that this is almost exclusively H1N1. We have not yet seen seasonal influenza circulating and have had only a few influenza B. Parainfluenza also is circulating, although in much smaller numbers than influenza A. The overall influenza trend in our reporting sites is paralleling the experience nationwide with a downturn in the number of positive tests and hospital admissions for influenza A and ILI.

There are very few positive RSV tests and we would expect this to increase as we head into December. Stay tuned to this site and we will keep you updated on all respiratory viruses detected in the LA County area.

Respiratory Viral Isolates

2009-11-23T12:59:00.000-08:00

H1N1 Update

2009-10-27T10:23:00.000-07:00

As you can see from the graph below, the cases of influenza A continue to rise and most likely have not yet peaked.
The LA County Department of health and the CDC tell us that 99% of the Influenza A isolated is the novel 2009 H1N1 influenza virus. We have yet to see wide circulation of seasonal influenza, however there have been sporadic cases of influenza B.
We expect the number of cases to continue to rise in the Southern California region and most sites are reporting about a 20-25% positivity rate for specimens submitted for testing. The distribution of the virus is worldwide and vaccine is newly available.
We have seen a few positive RSV cases, consistent with previous seasons at this time of year. We would expect the number of RSV positives to start to pick up in the next month and we will be on the look out for seasonal influenza as well.

It's all Influenza A right now!

2009-10-27T10:22:00.000-07:00

VIral Season to Date

2009-10-01T13:56:00.000-07:00

You may have noticed a different look to the graph AND I have included the entire season from 2008-09. We had a few months of viral respite but starting from late April onwards we have had a consistent number of tests positive for influenza A (99% of the isolates that have been sent for subtyping have been the 2009 Novel H1N1 influenza).
Stay updated on this site for RSV activity information and further information about H1N1 as well as seasonal influenza. What may not be apparent from the graph is the parainfluenza we are seeing as well.

Respiratory Viral Isolates 2009-09

2009-10-01T13:54:00.000-07:00

Respiratory Viral Activity (Just Influenza A!)

2009-09-14T09:05:00.000-07:00

Huge increases in Influenza A (H1N1)

2009-07-10T13:17:00.001-07:00

Respiratory Virus Activity in Southern California

2009-07-02T17:19:00.000-07:00

Respiratory Viral Activity In Southern California

2009-06-29T13:25:00.001-07:00

This blog has been on a month long hiatus due to the normal end of respiratory viral season. However, as you are all aware we are in the midst of an influenza pandemic with a novel virus: H1N1, formerly known as "Swine Flu".

The virus is now at pandemic levels per CDC and WHO criteria and the most up to date information can be accessed at these websites as well as the Los Angeles County website (http://www.lapublichealth.org/acd/Flu_Sea_Surveillance.htm)

The local numbers being reported out of our are not large at the present time, but much higher than what would be expected for this time of the year. As of June 26, 2009, 27,717 confirmed and probable infections with pandemic influenza A (H1N1) virus and 127 deaths (33 deaths in individuals less than 25 years, 89 deaths in adults 25 years of age older, and five deaths with unknown age) have been identified by CDC and state and local public health departments.

Of additional interest is that with the increased testing of febrile respiratory illnesses we are also seeing a jump in other non-influenza viruses such as parainfluenza (type 3) and human metapneumonvirus. All that coughs is not influenza!

Influenza Activity Nationwide

2009-06-29T13:23:00.000-07:00

Respiratory Viral Activity In Southern California

2009-05-20T14:36:00.001-07:00

Increased testing from all centers

2009-05-08T12:49:00.001-07:00

There is very little RSV circulating (1.4% of samples submitted were positive) but we have had a huge uptick in the number of specimens being tested. This is due to the recent H1N1 influenza (formerly Swine Flu) pandemic that started at the end of last month. Due to increases in testing we are seeing quite a bit of parainfluenza and influenza B, more than we would normally know about this time of year.

The best source for up to date information about this new influenza strain can be found on the Los Angeles County's Website (www.ladhs.org) and the CDC's website (www.cdc.gov/H1N1flu).

Respiratory Viral Activity In Southern California

2009-05-08T12:47:00.000-07:00

Respiratory Viral Activity In Southern California

2009-04-28T17:32:00.000-07:00

As you can see from the graphs we are at the end of SEASONAL influenza and RSV seasons. We had only a few RSV positive samples last week for 1% of tested samples.

We are seeing some Parainfluenza (mostly 2 and 3) and a few human metapneumoviruses as well.

We have had a few influenza B isolated and of course we are all keeping our eyes fixed on the changing situation here and abroad with Swine Flu (H1N1).
The most up to date information can be obtained on the CDC website: CDC.gov/swineflu and I would recommend consulting this for questions concerning possible suspect cases. Currently , individuals in California with a positive exposure history who are symptomatic and test positive for influenza A are having their isolates analyzed by the county health departments for verification of swine flu. Recommendations for isolation, treatment and prophylaxis can be found on this frequently updated website.

RSV Activity

2009-04-28T17:31:00.001-07:00

Respiratory Viral Activity

2009-04-28T17:30:00.000-07:00

RSV Activity

2009-04-22T14:45:00.001-07:00

All Respiratory Viruses (including hMPV)

2009-04-22T14:41:00.001-07:00

Respiratory Viral Activity In Southern California

2009-04-22T14:39:00.000-07:00

Respiratory Viral Activity In Southern California

2009-04-09T14:48:00.000-07:00

We are certainly winding down RSV (and influenza) season in Southern California. We had a late and slow influenza season and are just now seeing the tail end with more B in the community than A (we had twice as many B isolates last week than A, although the numbers are quite small). Interestingly we are also seeing some late season human metapneumovirus. Only two of our sites report detection of this virus, but hopefully next season we will have more sites performing PCR for this agent. Last week we had more hMPV isolates than RSV, influenza, adenovirus and parinfluenza combined!! We have now been <10% for two consecutive weeks, so officially we are OUT of endemic RSV, but stay tuned for detection of late season influenza and hMPV!

RSV Activity

2009-04-09T14:47:00.001-07:00

RSV Activity

2009-03-25T11:02:00.001-07:00

Respiratory Viral Activity

2009-03-25T10:58:00.000-07:00

Respiratory Viruses in Southern California

2009-03-24T09:21:00.000-07:00

It looks as if the RSV season may be winding down. Our current numbers show us to be running about 12% (details to follow in the next few days). We are still seeing influenza virus (Influenza B are actually exceeding Influenza A isolates nationally).
Based on the strains isolated this year the vaccine for next year has been recommended and includes a new Influenza B strain (a poor match this season).
Also interesting is the number of postive tests for human metapneumovirus. Not all of our reporting sites are testing for this, but from the sites that do, the numbers are up from last year.
Stay tuned to this site for updates.

RSV Activity

2009-03-10T13:53:00.001-07:00

Respiratory Viral Activity

2009-03-10T13:45:00.000-07:00

Influenza season is in full force

2009-02-23T19:58:00.000-08:00

As you can see from the graphs, influenza has hit Southern California. We are still at high, endemic levels of RSV (well over 10%), however the numbers look like they are leveling off or even declining. For influenza we are seeing primarily influenza A but we have reports of influenza B from all reporting sites. Remember that the CDC is reporting >98% resistance to Oseltamivir for H1N1 influenza A isolates, so recommends either Zanamivir or combination Oseltamivir + Rimantidine for empiric treatment of influenza A. For now, it looks as though the vaccine is a good match for both H1N1 and H3N2 influenza A isolates (H3N2 retaining susceptibility to Oseltamivir) and that the influenza B isolates seems to be different from the vaccine strains, and so will be changed for next year's vaccine. The complete information can be accessed at the CDC influenza site: www.cdc.gov/flu

RSV activity

2009-02-23T19:56:00.000-08:00

Respiratory Viral Isolates

2009-02-23T19:51:00.000-08:00

RSV Activity

2009-01-27T13:31:00.000-08:00

Respiratory Viral Activity In Southern California

2009-01-27T13:30:00.001-08:00

Still not much influenza in Southern California

2009-01-26T08:26:00.001-08:00

We continue to see high levels of RSV in Southern California. This past week we were clocking in at 30% positive of specimens submitted to the local reporting laboratories. Our influenza rates are extremely low. This time last year we were well into influenza season with significant rates throughout the area. Stay tuned to this site for the most up to date numbers on RSV and influenza.
Also please refer to the CDC website: cdc.gov/flu for the most recent updates on resistant influenza. So far this season (with very few isolates available for testing) the majority of H1N1 isolates are RESISTANT to Oseltamivir but retain susceptibility to both Zanamivir and the adamantadines (Rimantidine and Amantidine).
Recommendations for both prophylaxis and treatment of influenza are updated based on the continued surveillance by the CDC and antiviral testing.

Respiratory Viral Activity In Southern California

2009-01-05T10:57:00.000-08:00

RSV is the big player. We are over 1/4 of specimens testing positive. Influenza however, remains at very low levels (3.4% from the most recent CDC reporting). We have had a few sporadic positives from the Southern California reporting hospitals, but haven't yet hit the big time! Stay tuned for the latest counts and this is where you will see Infuenza reported first!

Respiratory Viral Isolates to Date

2009-01-05T10:49:00.001-08:00

RSV Activity

2009-01-05T10:12:00.001-08:00

Southern California Respiratory Viruses

2008-12-22T14:07:00.000-08:00

We continue to see increasing RSV in the community and one hospital last week had an influenza A isolated. We have an occasional Parainfluenza type 2 but that is slowing down as we approach the winter. We expect RSV to continue to increase and stay at endemic levels for the next month before slowing down. The current rates for RSV are well over 10%. We anticipate that influenza will start to pick up over the next week.

Be aware that the CDC has issued a statement in which preliminary data from a limited number of states indicates that the prevalence of influenza A (H1N1) virus strains resistant to the antiviral medication oseltamivir is high. Because of this, the interim recommendations for antiviral treatment and chemoprophylaxis of influenza during the 2008-09 influenza season include the use of Oseltamivir or Zanimivir and not the first generation agents (Amantidine/Rimantidine).
The information can be seen at the following link:

http://www.cdc.gov/flu/professionals/antivirals/index.htm.

RSV Picking up in Southern California

2008-12-10T13:25:00.000-08:00

RSV season has officially arrived. As you can see from the graphs below, the absolute number of positive specimens has picked up over the last two weeks and the percentage of positives has just surpassed the 10% mark (last week, 12%). We expect the trend to continue throughout the next few months and expect the peak sometime in January. As far as influenza, there has been very little influenza activity from all reporting hospitals and we have yet to see a significant increase in influenza like illnesses from reporting hospitals. Stay tuned.

RSV Activity

2008-12-10T13:24:00.003-08:00