2012 — Sep-Jan 2013, Pediatric Influenza, multiple States — 171

–171  CDC. “[No.]…Influenza-Associated Pediatric Deaths by Week…: 2011-12 season to present.”[1]

–169  Pediatric (<18) deaths associated with laboratory-confirmed influenza infections. CDC.[2]

–363  Blanchard notation of the flu deaths shown in State breakouts below.[3]

 

Arizona                      (  1)

— 1  Pediatric. Recombinomics. “US Pediatric Flu Deaths Increase to 62.” 2-2-2013.

 

Arkansas                    (  9)

— 9  Associated Press. “A snapshot of influenza activity in all 50 states.” Boston.com, 1-11-2013.

— 7  Cohen, Elizabeth. “Official: Flu deaths continue to rise among children.” CNN, 1-11-2013.

— 1  Pediatric. Recombinomics. “US Pediatric Flu Deaths Increase to 62.” 2-2-2013.

 

California                   (  6)

–106  CNN (Miriam Falco). “Some states hit harder by flu this year.” 1-17-2014.[4]

—    6  ABC10 News. “4 more flu-related deaths reported in San Diego County.” 1-16-2013.

—    4  AP. “A snapshot of influenza activity in all 50 states.” Boston.com, 1-11-2013.

—    2  Dec.  Craft. “Sacramento region…two deaths from flu last month.” Modesto Bee, 1-9-2013.

 

Colorado                    (  5)

–5  Pediatric. Recombinomics. “US Pediatric Flu Deaths Increase to 62.” 2-2-2013.

–4  Booth. “Colorado flu still ramping up; 2 new infant deaths logged.” Denver Post, 1-15-2013.

–2  State. AP. “A snapshot of influenza activity in all 50 states.” Boston.com, 1-11-2013.

–1  Huerfano Co. Pediatric. Recombinomics. “Colorado Pediatric Flu Deaths Increase to 5.”[5]

 

Connecticut                (  3)

— 3  Assoc. Press. “A snapshot of influenza activity in all 50 states.” Boston.com, 1-11-2013.[6]

 

Delaware                    (  1)

–1  Delaware.newszap.com. “Delaware’s first flu death reported; precautions urged.” 1-15-2013.

 

Florida                        (  5)

— 5  Pediatric. Recombinomics. “US Pediatric Flu Deaths Increase to 62.” 2-2-2013.

— 2  Grossman. “Deaths increase, misery mounts as flu sweeps nation.” USA Today, 1-10-2013.[7]

 

Georgia                      (  2)

— 2  Associated Press. “A snapshot of influenza activity in all 50 states.” Boston.com, 1-11-2013.

 

Hawaii                        (  1)

— 1  Pediatric. Recombinomics. “US Pediatric Flu Deaths Increase to 62.” 2-2-2013.

 

Idaho                          (  8)

— 8  Associated Press. “A snapshot of influenza activity in all 50 states.” Boston.com, 1-11-2013.

 

Illinois                         (27)

–27  Thomas, Monifa. “27 flu deaths reported in Illinois.” Chicago Sun-Times, 1-11-2013.

—  6  Landau, Elizabeth. “Flu picks up steam across the U.S.” CNN, 1-10-2013.

 

Indiana                       (21)

— 21  Fox59 News, Indianapolis. “Number of flu deaths rises to 21 in Indiana.” 1-14-2013.

— 15  Neely, Shameka. “Flu Deaths in Indiana Rise to 15.” Indiana Public Media. 1-10-2013.

— 13  Cohen, Elizabeth. “Official: Flu deaths continue to rise among children.” CNN, 1-11-2013.

—   1  Pediatric. Recombinomics. “US Pediatric Flu Deaths Increase to 62.” 2-2-2013.

 

Kansas                        (  1)

— 1  Pediatric. Recombinomics. “US Pediatric Flu Deaths Increase to 62.” 2-2-2013.

 

Maine                         (  1)

— 1  Benton, ~Dec 11. Girl, Avery Lane, 6.[8]

 

Massachusetts            (18)

— 18  Salzberg, Bob “Flu season has Boston declaring health emergency.” AP, 1-9-2013.

—   1  Pediatric. Recombinomics. “US Pediatric Flu Deaths Increase to 62.” 2-2-2013.

 

Michigan                    (  6)

—  6  Anderson. “Flu causes two deaths…in Muskegon County…” Mlive, 1-11-2013.[9]

—  4  State.  Landau, Elizabeth. “Flu picks up steam across the U.S.” CNN, 1-10-2013.

—  4  State. Pediatric. Recombinomics. “US Pediatric Flu Deaths Increase to 62.” 2-2-2013.

—  1  Genesee County, Lake Fenton, 15-year-old Joshua Polehna.[10]

—  2  Muskegon County. Two Elderly people.[11]

 

Minnesota                  (27)

— 27  Grossman. “Deaths increase, misery mounts as flu sweeps nation.” USA Today, 1-10-2013.

—   1  St. Paul, Dec 29. Maxwell Thomas Schwolert of Lewisville, TX, visiting grandparents.[12]

 

Montana                     (  1)

— 1  Associated Press. “A snapshot of influenza activity in all 50 states.” Boston.com, 1-11-2013.

 

Nebraska                    (  3)

— 3  Associated Press. “A snapshot of influenza activity in all 50 states.” Boston.com, 1-11-2013.

— 1  Pediatric. Recombinomics. “US Pediatric Flu Deaths Increase to 62.” 2-2-2013.

 

New Hampshire         (16)

–16  McMahon, Charles. “New Hampshire flu death toll rises to 16.” Seacoastonline. 1-15-2013.

–14  Associated Press. “14 flu deaths reported in NH.” Boston.com, 1-11-2013.

–13  Dec.  McMahon. “Portsmouth Hospital slammed…flu…” Seacoastonline.com, 1-10-2013.

 

New Jersey                 (  4)

— 4  State. Pediatric. Recombinomics. “US Pediatric Flu Deaths Increase to 62.” 2-2-2013.

— 3  Associated Press. “A snapshot of influenza activity in all 50 states.” Boston.com, 1-11-2013.

 

New York                   (12)

–12  Associated Press. “A snapshot of influenza activity in all 50 states.” Boston.com, 1-11-2013

—  9  Grossman. “Deaths increase, misery mounts as flu sweeps nation.” USA Today, 1-10-2013.[13]

—  4  State. Pediatric. Recombinomics. “US Pediatric Flu Deaths Increase to 62.” 2-2-2013.

—  1  NYC. Recombinomics. “US Pediatric Flu Deaths Increase to 62.” 2-2-2013.

 

North Carolina          (17)

–17  Assoc. Press. “A snapshot of influenza activity in all 50 states.” Boston.com, 1-11-2013.

–14  Ohnesorge, Lauren. “Flu hits N.C. hard, but why?” Triangle Business Journal, 1-11-2013.

 

North Dakota            (  1)

— 1  Associated Press. “A snapshot of influenza activity in all 50 states.” Boston.com, 1-11-2013.

 

Ohio                            (  3)

— 1  Fairborn, Jan 8, 22-year-old Amelia Catherine Perry, at Kettering Medical Center.[14]

— 1  Warren County, late Dec., elderly man.[15]

— 1  Child. Aurora Advocate. “Child Death from Flu Reported in Ohio.” 1-11-2013.

 

Oklahoma                  (  8)

—  8  Hulstine, R. “6 New Flu Deaths Reported in Oklahoma.” NewsOn6.com, Tulsa, 1-10-2013.

 

Pennsylvania              (23)

–23  State. AP. “A snapshot of influenza activity in all 50 states.” Boston.com, 1-11-2013.

–22  State. Landau, Elizabeth. “Flu picks up steam across the U.S.” CNN, 1-10-2013.

–18     “  Wenner, David. “New Year brings a surge of flue deaths in [PA].” PennLive, 1-9-2012.

 

South Carolina          (22)

— 22  State. Landau, Elizabeth. “Flu picks up steam across the U.S.” CNN, 1-10-2013.

— 22  Scarpelli. “What is Being Done…to Stop…Flu?” WSPA.com, Spartanburg, SC, 1-10-2013.

—   1  State. Pediatric. Recombinomics. “US Pediatric Flu Deaths Increase to 62.” 2-2-2013.

 

South Dakota             (  9)

— 9  Associated Press. “A snapshot of influenza activity in all 50 states.” Boston.com, 1-11-2013

 

Tennessee                   (  1)

— 1  Associated Press. “A snapshot of influenza activity in all 50 states.” Boston.com, 1-11-2013

— 1  Pediatric. Recombinomics. “US Pediatric Flu Deaths Increase to 62.” 2-2-2013.

 

Texas                          (  6)

— 6  State. AP. “A snapshot of influenza activity in all 50 states.” Boston.com, 1-11-2013.

— 1      “    Pediatric. Recombinomics. “US Pediatric Flu Deaths Increase to 62.” 2-2-2013.

— 1  Dallas, Jan 8, 2013. Tahlia Johnson, 6. AP. “100 kids die of flu each year.” 1-16-2013.

— 3  Nueces Co.  Meyers. “Three flu-related deaths confirmed in Nueces County.” 1-15-2013.

 

Vermont                     (  3)

— 3  Associated Press. “A snapshot of influenza activity in all 50 states.” Boston.com, 1-11-2013

 

Washington                (  6)

— 6  State. AP. “3 more influenza deaths in Washington.” Seattle Times, 1-7-2013.

— 1      “    Pediatric. Recombinomics. “US Pediatric Flu Deaths Increase to 62.” 2-2-2013.

 

Wisconsin                   (  1)

— 1  State. AP. “A snapshot of influenza activity in all 50 states.” Boston.com, 1-11-2013.

— 1      “    Pediatric. Recombinomics. “US Pediatric Flu Deaths Increase to 62.” 2-2-2013.

 

General

 

CDC: “During the 2012–13 influenza season in the United States, influenza activity increased through November and December before peaking in late December. Influenza A (H3N2) viruses

predominated overall, but influenza B viruses and, to a lesser extent, 2009 influenza A (H1N1) (2009 H1N1) viruses also were reported in the United States. This influenza season was  moderately severe, with a higher percentage of outpatient visits for influenza-like illness (ILI), higher rates of hospitalization, and more reported deaths attributed to pneumonia and influenza compared with recent years….

 

“The 2012-2013 influenza season was influenza A (H3N2) predominant from week 40 (the week

ending October 6, 2012) through the peak of activity (week 52, the week ending December 29, 2012) until week 7 (the week ending February 16, 2013). As the activity declined, influenza B viruses were reported more frequently than influenza A viruses from mid-February to early June, and 2009 H1N1 viruses were more commonly reported than influenza A (H3N2) or influenza B viruses from mid-June to the end of the season in late September. All ten HHS regions were influenza A (H3N2) predominate….

 

Pneumonia and Influenza (P&I) Mortality Surveillance. From September 30, 2012 to September 28, 2013, the weekly percentage of deaths attributed to pneumonia and influenza ranged from 5.5% to 9.9%, and was elevated above the epidemic threshold for 13 consecutive weeks during the peak of influenza activity from week 1 to week 13 (weeks ending January 5, 2013 and March 30, 2013….

 

Influenza-Associated Pediatric Mortality. From September 30, 2012 to September 28, 2013 169 deaths associated with laboratory-confirmed influenza infections occurred among children aged <18 years during the 2012-2013 influenza season and were reported to the CDC. These deaths were reported from Chicago, New York City, the District of Columbia, Puerto Rico, and 38 states. The mean and median ages of children who died were 7.8 and 7.2 respectively; 17 children were aged <6 months, 23 were aged 6-23 months, 22 were aged 2-4 years, 58 were aged 5-11 years, and 49 were aged 12-17 years. Of the 169 deaths, 78 (46%) were associated with influenza A viruses (6 were associated with 2009 H1N1, 35 with influenza A (H3N2), 37 with influenza A viruses for which subtyping was not performed), 87 (51%) with influenza B, one for which the type was not distinguished, and three influenza virus co-infections. Excluding the 2009 pandemic season (April 15, 2009 to October 2, 2010) during which 348 influenza-associated pediatric deaths were reported, the number of deaths reported each season since influenza-associated pediatric mortality became a nationally notifiable condition in 2004 has ranged from 46 to 165 with a median of 72 deaths.” (CDC. “2012-2013 Influenza Season Surveillance Summary.” FluView (A Weekly Influenza Season Surveillance Summary). 12-6-2013.)

 

Dec 18: Portland Press Herald, ME: “It’s rare that people die from the flu, rarer still when that person is young and healthy and not elderly and frail. During the 2011-12 flu season, there were only 34 deaths among children under the age of 18 in the entire country, according to the U.S. Centers for Disease Control and Prevention.  That was the lowest number of pediatric deaths reported during a flu season since records started being kept.” (Portland Press Herald (Eric Russell), ME. “6-year-old’s flu death prompts alert in Maine.” 12-18-2012.)

 

Jan 10, ABC: “This flu season seems especially bad this year now that Boston has declared a public health emergency and a Pennsylvania hospital was forced to construct a tent to handle flu cases. But doctors – backed up by the numbers – say that this season is a shock partly because we had so little flu last year.

 

“The Centers for Disease Control and Prevention has reported 22,048 flu cases from Sept. 30 through the end of 2012. By the same time last year, only 849 flu cases had been reported nationwide. That’s 26 times more flu cases by the last week of this year than by the last week of 2011….

 

“…the dominant virus from 2009 through last year was the H1N1 flu strain, nicknamed swine flu. Although many people came down with it in 2009, most of them had been vaccinated against it by last year, resulting in fewer infected people. But this year, the flu season started early with a different dominant strain: H3N2. ‘This year, we’re seeing a lot of H3N2, which you see in the past tends to affect young kids and the elderly more,” said CDC spokesman Tom Skinner. “That may be some of the explanation for why we’re having more of a severe flu season this year.’

 

“Schaffner[16] said children and the elderly are always the most vulnerable to the flu, because they have weaker immune systems than everyone else. Children actually exhale more flu virus than adults when they get sick, and they exhale it longer, making them the ‘great distributors of influenza virus,’ he said….

 

“When the flu season was first dominated by H1N1, there were almost four times as many flu cases by the last week of December 2009 compared to the last week of December 2012: 80,724 cases in all. Of those, 60,847 were H1N1. There were also 229 pediatric deaths by that time last year compared with 18 so far this year.” (ABC News (Sydney Lupkin). “Flu Season 2012-13 By the Numbers: How Bad Is It?” 1-10-2013.)

 

Jan 10, USA Today: “The annual influenza death toll varies steeply — from fewer than 3,000 to nearly 49,000 — according to the Centers for Disease Control and Prevention. The center will release this season’s mortality numbers on Friday.  But it appears the speed of the flu’s spread this winter “has been pretty much unparalleled,” said one physician on the flu front lines, John Hick, an emergency physician at Hennepin County Medical Center in Minneapolis….

 

“So far this season 42 states have reported widespread levels of the illness with the hard-hit areas in the East, South and Midwest, said Michael Jhung with CDC’s influenza division. The West and Southwest have had very little flu….

 

“The 2013 season is particularly wretched because one of the major strains in this year’s flu mix hasn’t been seen for five to nine years and people’s antibodies for it have waned, said Arnold Monto, a professor of epidemiology and member of the Infectious Diseases Society of America’s Influenza Advisory Group, which works with the CDC. There are three types of flu circulating in the USA: H3N2, H1N1 and Influenza B. H3N2 is by far the most common and most likely to put people in the hospital with complications. All three are included in this year’s flu vaccine.” (Grossman, Cathy Lynn, Elizabeth Weise and Judy Keen. “Deaths increase, misery mounts as flu sweeps nation.” USA Today, 1-10-2013.)

 

Jan 11:  “Atlanta (CNN) — The spread of the flu across the United States appears to have slowed in portions of five states in the South and Southeast, a federal official told CNN early Friday, even as a National Institutes of Health director warned of the onset of “a classic flu epidemic.”….

 

“With more than 40 states reporting widespread activity, according to the CDC’s flu advisory report put out last week, “… We are into what would classically be described as a flu epidemic,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, told CNN’s Wolf Blitzer on Thursday….

 

“The Centers for Disease Control and Prevention flu advisory report issued last week, which covers the period of December 23 to 29, suggests that 41 states have widespread influenza activity, which was an increase of 31 states from the previous week. Of those states, high level flu activity was reported in at least 24 states….” (Cohen, Elizabeth. “Official: Flu deaths continue to rise among children.” CNN, 1-11-2013.)

 

Jan 11: “The flu kills about 36,000 people a year in the United States, according to the Centers for Disease Control and Prevention, though the range varies greatly. The flu shot reduces one’s chances of getting the flu by 60%.” (Hudson, William, Elizabeth Cohen and John Bonifield. “Flu leads to Texas teen’s death.” CNN, 1-11-2013.)

 

“(Reuters) — The proportion of all deaths in the United States last week caused by pneumonia and influenza reached 7.3 percent, above the epidemic threshold of 7.2 percent, the U.S. Centers for Disease Control and Prevention said on Friday [Jan 11].  Only the Southwest and California had “normal” flu activity last week, the agency said. The other nine regions had “elevated” activity, confirming that seasonal flu has spread across the country and reached high levels several weeks before the usual time of late January or February.  The vaccine against the flu strain that was forecast to predominate this year, called H3N2, is 62 percent effective, scientists reported on Friday in the CDC’s weekly publication.  hat is considered “moderate” effectiveness and means that almost four in 10 people who receive the vaccine and are exposed to the virus will nevertheless become infected. But the vaccine can reduce the severity of the illness, preventing pneumonia and other life-threatening results of flu.” (Begley, Sharon. “CDC says pneumonia, flu were 7.3 percent of U.S. deaths last week.” Reuters, 1-11-2013.)

 

California

 

Jan 9: “After a slow approach, the flu season is suddenly upon the Sacramento region, with two influenza deaths recorded in late December, officials said. “We are getting a late start here,” said Kate McAuley, immunization project coordinator for Sacramento County. “We really didn’t see much activity in the fall, with the weather so nice. But the influenza seems to have had a rapid uptick here in December.” Of the two residents who died of the flu, one was a young man and the other was an elderly patient. Their identities were being withheld.” (Craft, Cynthia H. “Sacramento region reports two deaths from flu last month.” Modesto Bee, 1-9-2013.)

 

Jan 16: “San Diego – Four more deaths from influenza were reported in San Diego County on Tuesday by the  Health and Human Services Agency. Combined with two prior fatalities, the total in the region during the flu season now stands at six, all of whom had pre-existing medical conditions….According to the HHSA, the victims were three elderly women — aged 89, 91 and 92 — a 49-year-old woman and two men, aged 49 and 66….

 

“The county has tallied 670 reported influenza cases during flu season, with nearly half occurring last week, according to the HHSA. The week before, 143 cases were reported….”  (ABC10 News. “4 more flu-related deaths reported in San Diego County.” 1-16-2013.)

 

Colorado

 

“Colorado joins most of the nation in a continuing surge of influenza cases, the state Department of Public Health and Environment said Tuesday. Two more pediatric deaths from flu were reported to the state, one in Denver and one in El Paso County, making a total of four child deaths this season. Statewide, flu has sent 674 people to hospitalization this season, in 36 counties….” (Booth, Michael. “Colorado flu still ramping up; 2 new infant deaths logged.” Denver Post, 1-15-2013.)

Delaware

 

“The Delaware Division of Public Health reported Tuesday that a 2-month-old female from New Castle County died of complications from the flu. It is the state’s first flu death of the 2012-2013 flu season….” (Delaware.newszap.com. “Delaware’s first flu death reported; precautions urged.” 1-15-2013.)

Idaho

 

“In Idaho, eight older adults have died from flu-related illness and doctors are seeing an increase in patients with flu-like symptoms. ‘‘It’s definitely shaping up to be a more serious flu season than we’ve seen in the past several years,’’ said spokeswoman Nikki Forbing-Orr of Idaho’s Department of Health and Welfare.” (AP. “A snapshot of influenza activity in all 50 states.” Boston.com, 1-11-2013.)

Illinois

 

Jan 10: “In Illinois, Department of Public Health Director Dr. LaMar Hasbrouck said Wednesday that since October, six flu-related deaths of patients in intensive-care units have occurred. “We have been and continue to see an increase in flu activity across the state. The flu strain that is predominately circulating this year is typically more severe, with more hospitalizations and deaths,” Hasbrouck said. “From the beginning of October through the end of December we’ve seen almost 150 people admitted to hospital intensive care units (ICU) with influenza like illness.  “This compares to last year at this time when there were only two ICU hospitalizations and no deaths.”” (Landau. “Flu picks up steam across…U.S.” CNN, 1-10-2013.)

 

Jan 11: “Nearly 370 people have been admitted to intensive care units with the flu this season in Illinois, and 27 have died, the Illinois Department of Public Health reported Friday. That’s a big jump from the Dec. 29 totals of almost 150 Illinois residents hospitalized and six deaths.  The majority of hospitalizations and death are in their 50s and older, IDPH said.

 

“In Chicago, there were 121 influenza-associated ICU hospitalizations reported, almost double the total number of cases reported last year, from Sept. 30 to Jan. 5.

 

“On Friday, IDPH sent a memo to hospitals recommending that they temporarily not allow visitors younger than 18, limit the number of visitors to two per patient at a time and other visitor restrictions, in light of the increased incidence of influenza-like illness in Illinois….” (Thomas, Monifa. “27 flu deaths reported in Illinois.” Chicago Sun-Times, 1-11-2013.)

 

Indiana

 

Jan 11:  “The Indiana Department of Health says the number of flu deaths in the state has risen to 15.  Respiratory Epidemiologist Shawn Richards says influenza cases remain moderately severe across the state. Of the five latest deaths, she says two patients were in long term care facilities.  Two patients in two separate facilities that were identified as Influenza AH3 and co-infected with Influenza B of which we did receive reports overnight that both those patients have expired,” she says. Richards says they will not identify the facilities or their locations until there have been five deaths connected with them…. The number of flu deaths each year in Indiana typically ranges between seven and 30, according to the state health department.” (Neely, Shameka. “Flu Deaths in Indiana Rise to 15.” Indiana Public Media. 1-10-2013.)

 

Jan 14: “Indianapolis – The number of flu-related deaths in Indiana has risen to 21, according to the Indiana State Department of Health. Health officials said two of the deaths involve people under the age of 18….” (Fox59 News, Indianapolis. “Number of flu deaths rises to 21 in Indiana.” 1-14-2013.)

Maine

 

“Authorities say flu cases are increasing and reaching ‘‘epidemic proportions’’ with widespread illness throughout the state. Most hospitals are near capacity, and there have been some spot shortages of vaccine. Maine doesn’t tally flu deaths but one school-aged child has died — Maine’s first flu-related death in a healthy child in years.” (AP. “A snapshot of influenza activity in all 50 states.” Boston.com, 1-11-2013.)

 

Massachusetts

 

Jan 9: “Boston (AP) — Boston declared a public health emergency Wednesday [Jan 9] as flu season struck in earnest and the state reported 18 flu-related deaths so far. The city is working with health care centers to offer free flu vaccines and hopes to set up places where people can get vaccinated. The city said there have been four flu-related deaths, all elderly residents, since the unofficial start of the flu season Oct. 1…. The city was experiencing its worst flu season since at least 2009, Menino[17] said, with about 700 confirmed cases of the flu, compared with 70 all of last season.

 

“Massachusetts was one of 29 states reporting high levels of ‘‘influenza-like illness,’’ according to the most recent weekly flu advisory issued by the Centers for Disease Control and Prevention.

The CDC said the proportion of people visiting health care providers with flu-like symptoms climbed from 2.8 percent to 5.6 percent in four weeks. By contrast, the rate peaked at only 2.2 percent during the relatively mild 2011-12 flu season….

 

“Barbara Ferrer, director of the Boston public health commission, said the emergency was declared in part to get residents’ attention. She said that the 700 confirmed cases represent only those reported to the city and that thousands of other people may be ill.  Boston hospitals had counted about 1,500 emergency room visits since December by people with flu-like symptoms. Menino said people with symptoms shouldn’t go to work or school….

 

“The CDC said 18 children have died from the flu so far this season. While the CDC doesn’t keep a tab of deaths overall from the flu, it estimates that 24,000 Americans die each year.” (Salzberg, Bob. “Flu season has Boston declaring health emergency.” AP, 1-9-2013.)

 

Michigan

 

Jan 10: “In Michigan, there have been four pediatric deaths related to the flu, said Angela Minicuci, public information officer for the Michigan Department of Community Health.”  (Landau, Elizabeth. “Flu picks up steam across the U.S.” CNN, 1-10-2013.)

 

Jan 11:  “Muskegon County, MI — The flu has led to the deaths of two elderly Muskegon County residents this season, according to Public Health-Muskegon County….

 

“There have been four confirmed flu-related pediatric deaths statewide, with the youngest victim being only 6 months old….

 

“In 2010, there were 17 influenza and pneumonia-related deaths in Muskegon County, with 14 of those deaths occurring in people over the age of 75. Data for 2011 and 2012 have not been released yet. Officials say the current strain that has caused the outbreak is influenza A (H3N2). There have been 220 confirmed cases of influenza A and B cases combined reported thus far in Muskegon County. This time last year, there was only one confirmed case of the flu, Peters[18] said….

 

“In neighboring Kent County, health officials confirmed 463 flu cases this season compared to the 94 cases that were reported for the entire duration of last year’s flu season.

 

“Further east in Genesee County, emergency room workers are experiencing a surge of visits with patients reporting flu-like symptoms, although many don’t actually have the flu. That county is home to 15-year-old Joshua Polehna, who is one of he state’s four pediatric deaths….”  (Anderson, M. D. “Flu causes two deaths, 220 illnesses in Muskegon County; health officials urge vaccination.” Mlive, 1-11-2013.)

Minnesota

 

“By Thursday [Jan 10], there were 23 flu deaths in Minnesota, raising the state’s total to 27 flu-related deaths reported so far this season.” (Grossman, Cathy Lynn, Elizabeth Weise and Judy Keen. “Deaths increase, misery mounts as flu sweeps nation.” USA Today, 1-10-2013.)

 

Nebraska

 

“One child and two adults have died from the flu in Nebraska, where cases are up this year compared with last year.” (Associated Press. “A snapshot of influenza activity in all 50 states.” Boston.com, 1-11-2013.)

New Hampshire

 

Jan 10: “Portsmouth – Local health care advocates are encouraging people to be mindful of a widespread flu outbreak that health officials say claimed the lives of 13 people in New Hampshire in December…”  (McMahon Charles. “Portsmouth Hospital slammed with flu-like sicknesses; 13 deaths in N.H.” Seacoastonline.com, 1-10-2013.)

 

Jan 15: “Concord – The number of flu-related deaths in New Hampshire has risen to 16 adults, a state health official said Tuesday. Beth Daly, chief of infectious disease surveillance for the state Department of Health and Human Services, said two more deaths were reported since Friday when the number of adult influenza-related deaths reported to the state stood at 14. Daly said the fact that two more deaths were reported doesn’t necessarily mean they occurred in the past several days. She said the state learns about flu-related deaths through electronically filed death certificates. The deaths are only considered flu related if the health care provider cites influenza as the cause of death. “It’s very limited data we are providing,” she said….The state saw a total of 19 deaths reported in 2012.

 

“So far this season there have been 40 institutional outbreaks; the majority occurring at nursing homes and long-term care facilities. The N.H. Public Health Laboratories has so far tested 408 specimens and 238 were positive for influenza….” (McMahon, Charles. “New Hampshire flu death toll rises to 16.” Seacoastonline. 1-15-2013.)

 

New Jersey

 

“One child and two adults have died from the flu in Nebraska, where cases are up this year compared with last year.” (Associated Press. “A snapshot of influenza activity in all 50 states.” Boston.com, 1-11-2013.)

New York

 

“Flu has been reported in every county in New York state and has been widespread for seven weeks. Reported cases declined last week but hospitalizations for lab-confirmed flu were up. Two children and at least 10 New York City adults have died from flu-related illness. Statewide adult deaths aren’t tracked.” (AP. “A snapshot of influenza activity in all 50 states.” Boston.com, 1-11-2013.)

Ohio

 

“Flu related hospitalizations shot up again last week in Ohio, and at least one woman died this week after testing positive for the flu and being admitted to a local hospital.  The 22-year-old Fairborn woman died Tuesday at Kettering Medical Center after being hospitalized last week with the Influenza A virus, according to the Greene County Combined Health District. Public health officials are still investigating the death of Amelia Catherine Perry for possible chronic health conditions that could have compromised her immune system and contributed to her death. But Perry appeared to have no other complications when she was initially diagnosed with the flu, said Sara Pappa, spokeswoman for the Greene County health department. “In someone that young, you would think diabetes or asthma contributed’’ to her death, Pappa said. “But from what we know, this was a healthy 22-year-old.”  Perry was a junior majoring in communications at Wright State University…

 

“Perry was among 692 Ohioans hospitalized with the flu in the first week of January, up from 388 in the previous week, according to numbers released today by Ohio Department of Health officials…. Since the beginning of the flu season in October, there have been 1,922 flu-related hospitalizations Ohio. There were less than 100 through the same period last year….

 

“An elderly man from Warren County who tested positive for influenza died about two weeks ago, but he also suffered from several other chronic conditions that could have contributed to his death, according to health officials….

 

“According to the Centers for Disease Control and Prevention, this year’s flu season hit earlier and harder than previous years and continues to spread rapidly across the country, flooding emergency rooms and hospitals with sick patients and resulting in dozens of deaths in some areas. So far, 29 states are reporting high levels of influenza-like illness, according to the CDC. Those levels are 10 times higher in some cities than this time last year.” (Tucker, Randy. “2nd area flu death reported.” Dayton Daily News, 1-10-2013.)

 

Oklahoma

 

“Oklahoma City – The number of flu deaths in Oklahoma jumped by six in one week, according to data released Thursday by the Oklahoma Department of Health.  On Thursday, January 3, only two influenza deaths had been reported. For the week ending January 8, the OSDH reports eight flu-related deaths. Three of those death have occurred in Tulsa County; one more from a week ago.  The other deaths occurred in Creek, Mayes, Muskogee, Pittsburg and Rogers counties. Each county recorded one influenza death from January 2-January 8. The data does not say if the deaths were male or female, but it shows four were between the ages of 19-64 and the rest were 65 or older. The OSDH has seen 345 hospitalized cases of flu since September 30, 2012. Ninety-two of those cases were reported January 2-January 8, 2013.

 

“The rise has prompted one school district to close on Friday.  Kiefer Public Schools in Creek County will be closed because of the number of cases in the school district.

 

 

“OSDH data shows since September 30th, Tulsa County has had 115 people admitted to the hospital because of influenza. Oklahoma County has had 43 cases. Latimer, Nowata and Ottawa counties have each had one case of someone in the hospital because of the flu. Adair, McIntosh, Pawnee, Sequoyah and Washington counties have had two cases. Cherokee County has had three cases since September 30, and Osage County has had four. Muskogee and Wagoner counties have had five cases, followed by six in Pittsburg County and seven in Okmulgee County.  Rogers County has reported 11 cases in the past week and Creek County, 17 cases.” (Hulstine, Russell. “6 New Flu Deaths Reported in Oklahoma.” NewsOn6.com, Tulsa, OK, 1-10-2013.)

 

Pennsylvania

 

Jan 9:  “Flu-related deaths in Pennsylvania shot upward during the week ending Jan. 5, the most recent period available.  The Pennsylvania Department of Health said there were 18 flu-related deaths during the week, bringing the state total for the 2012-2013 flu season to 22. Most involved people who were 65 and older.  The health department said there were 4,256 flu cases reported during the week, an increase of more than 1,000 from the previous week. Because many people who have the flu don’t get a lab test, the number reported to the state is considered to be only a fraction of the total….

 

“In Pennsylvania, the most common strain by far is H3N2, which is associated with severe flu seasons as well as severe illnesses among the elderly….

 

“In the week ending Jan. 5, 487 people were hospitalized because of the flu, up from 244 the previous week. Two of the 18 flu-related deaths in the week ending Jan. 5 involved otherwise healthy people under 50. There have been no flu-related deaths of children so far during this flu season, the health department said.

 

“There were 30 flu-related outbreaks at nursing homes, up from 21 the previous week. It’s considered an outbreak when two or more residents of a nursing home have the flu. Flu outbreaks at nursing homes are noteworthy because of the flu’s ability to spread quickly and the heavy toll can take on the elderly and people whose bodies are weakened because of illness.  Nursing homes typically combat the flu by vaccinating residents and urging employees to get flu shots. Recently, some Harrisburg-area nursing homes began taking steps such as requiring visitors and non-vaccinated employees to wear face masks. Some are posting signs telling people with the flu to stay out until they’ve been free of fever for at least 24 hours.

 

“The flu itself isn’t considered fatal, but people sometimes die of the complications, which can include pneumonia. The severity of the flu season varies greatly, depending on what strains circulate in a given year.

 

“The health department estimates between 600,000 and 1.3 million Pennsylvania resident get the flu annually, and between 180-2,000 die, with most of the deaths involving people over 65.”  (Wenner, D. “New Year brings a surge of flue deaths in Pennsylvania.” PennLive, 1-9-2012.)

 

Jan 10: “Pennsylvania has had 22 flu-related deaths so far this season, according to data from the state’s Department of Health. Most of these deaths occurred among people older than 65, but the fatalities included two individuals younger than 50 who were otherwise healthy.

 

“Lehigh Valley Hospital-Cedar Crest in Allentown, Pennsylvania, set up a heated tent outside the hospital to serve as a clinic. Anyone with mild flu symptoms can be treated quickly and discharged, isolated from more serious cases. The hospital has been seeing an additional 80 to 100 patients with flu-like symptoms daily, officials told CNN affiliate WPVI.” (Landau, Elizabeth. “Flu picks up steam across the U.S.” CNN, 1-10-2013.)

 

South Carolina

 

Jan 10: “Spartanburg, S.C…. In South Carolina, there are 22 deaths this season alone….”  (Scarpelli, Christine. “What is Being Done in your Community to Stop the Spread of the Flu?” WSPA.com, Spartanburg, SC, 1-10-2013.)

 

Jan 11:  “Flu is widespread in South Carolina but hospitalizations have slightly decreased. Of 22 flu deaths, one was an infant, the rest adults older than 50.” (AP. “A snapshot of influenza activity in all 50 states.” Boston.com, 1-11-2013.)

 

South Dakota

 

Jan 11: “Flu activity is earlier and occurring at higher levels than usual in South Dakota. Nine people have died from flu-related illness, all older than 75.”  (AP. “A snapshot of influenza activity in all 50 states.” Boston.com, 1-11-2013.)

 

Tennessee

 

“Dr. Kelly Moore, the medical director of the Tennessee Immunization Program, says the flu season seems worse than in recent years but that clinic reporting is often disrupted over the holidays, so whether cases are increasing or not is uncertain. ‘‘We’re not hearing reports of any hospitals being overwhelmed,’’ she said. One child has died from flu-related illness.”  (Associated Press. “A snapshot of influenza activity in all 50 states.” Boston.com, 1-11-2013.)

 

Texas

 

Jan 11: “Flu cases have been reported in more than half of Texas, and several county health departments say this season is worse than in past years. In the last week of December, nearly 12 percent of doctor visits were for flu-like symptoms, almost double the amount for that week in 2011. The number of cases dropped last week. In the Dallas area, many parents say their doctors don’t have the pediatric vaccine so they’ve sought the shots at the county health department. At least six Texas children have died from flu-related illness since last fall.”  (Associated Press. “A snapshot of influenza activity in all 50 states.” Boston.com, 1-11-2013.)

 

Jan 15: “Nueces County – Three elderly women have died from the flu in Nueces County.  The Corpus Christi-Nueces County Public Health District has confirmed that three women, between the ages of 65 and 85, died within the past two weeks. All three had underlying health conditions, although the health district declined to release more information about them. At least one of the women had been vaccinated. Flu cases have been on the rise in the Coastal Bend, and even those who have been vaccinated are catching it. Nearly 1,800 people in Nueces County have had the flu this season, the health district confirmed. That’s 32 times the number of people, 56, who had it at the same time last year. Two of the women who died had the H3N2 strain, which is Type A. One woman who died had Type B. Type B flu, which only affects humans, typically is not as severe as Type A, which can affect people and animals, and is responsible for epidemics….” (Meyers, Rhiannon. “Three flu-related deaths confirmed in Nueces County.” Caller.com, Corpus Christi, TX, 1-15-2013.)

 

Vermont

 

“Flu cases appear to be on the rise in Vermont. Three adults have died, all in December. Vermont Health Department officials say flu rates are higher than other years but the number of deaths does not appear out of the ordinary. A total of 10 people died from the flu last year; seven in 2011 and none in 2010.” (AP. “A snapshot of influenza activity in all 50 states.” Boston.com, 1-11-2013.)

Washington

 

“Seattle – Three more people have died from the flu in Western Washington, bringing the total of reported state deaths to six, health officials said Monday.  The Snohomish Health District reported three deaths in late December in Snohomish hospitals: a Bothell woman in her 40s, an Everett woman in her 80s and an Edmonds woman in her 80s. All three had underlying medical conditions.

 

“State health officials believe the six influenza deaths reported across the state so far are likely just a fraction of the total, because only laboratory-confirmed flu deaths are reportable.  Health Department spokesman Donn Moyer said there are likely more deaths where flu played a role but the person was not tested for influenza.

 

“In late December, state health officials reported three other laboratory-confirmed deaths: a Pierce County boy under 12 years old, a King County man in his 80s and a King County woman in her 70s.”  (AP. “3 more influenza deaths in Washington.” Seattle Times, 1-7-2013.)

 

Wisconsin

 

“Flu-related hospitalizations in Wisconsin total more than 1,300, versus 389 for all of last year. One child has died. State officials believe they have an ample supply of vaccine and no shortages. In Milwaukee, hospital emergency department visits have tripled over the past few weeks due to patients with flu-like symptoms and ambulances were being diverted elsewhere, a city Health Department spokeswoman said Friday.” (Associated Press. “A snapshot of influenza activity in all 50 states.” Boston.com, 1-11-2013.)

 

Sources

 

ABC News (Sydney Lupkin). “Flu Season 2012-13 By the Numbers: How Bad Is It?” 1-10-2013. Accessed 7-20-2015 at: http://abcnews.go.com/blogs/health/2013/01/10/flu-season-2012-13-by-the-numbers-how-bad-is-it/

 

ABC10 News. “4 more flu-related deaths reported in San Diego County.” 1-16-2013. Accessed 1-15-2013: http://www.10news.com/news/4-more-flu-related-deaths-reported-in-san-diego-county-01152013

 

Anderson, Michelle D. “Flu causes two deaths, 220 illnesses in Muskegon County; health officials urge vaccination.” Mlive, 1-11-2013. Accessed 1-11-2013 at: http://www.mlive.com/news/muskegon/index.ssf/2013/01/muskegon_county_health_officia_4.html

 

Associated Press. “3 more influenza deaths in Washington.” Seattle Times, 1-7-2013. Accessed 1-10-2013: http://seattletimes.com/html/localnews/2020081265_apwafludeaths2ndldwritethru.html

 

Associated Press. “14 flu deaths reported in NH.” Boston.com, 1-11-2013. Accessed 1-11-2013 at: http://www.boston.com/news/local/new-hampshire/2013/01/11/flu-deaths-reported/3dexeAAU95DOwYu8wOgN1H/story.html

 

Associated Press. (Mike Strobbe). “100 kids die of flu each year.” 1-16-2013. Accessed 7-20-2015 at: http://www.usatoday.com/story/news/nation/2013/01/15/flu-children-deaths/1837725/

 

Associated Press. “A snapshot of influenza activity in all 50 states.” Boston.com, 1-11-2013. Accessed 1-11-2013: http://www.boston.com/lifestyle/health/2013/01/11/snapshot-influenza-activity-all-states/rXgwZMrDgG2HFEsNq1VYZP/story.html

 

Associated Press (Bob Salzberg). “Flu season has Boston declaring health emergency.” 1-9-2013. http://www.boston.com/news/nation/2013/01/09/flu-season-has-boston-declaring-health-emergency/lEa5Nepun76MTxzTAL3qPO/story.html

 

Aurora Advocate. “Child Death from Flu Reported in Ohio.” 1-11-2013. Accessed 1-11-2013 at: http://www.auroraadvocate.com/ap%20state/2013/01/11/child-death-from-flu-reported-in-ohio

 

Begley, Sharon. “CDC says pneumonia, flu were 7.3 percent of U.S. deaths last week.” Reuters, 1-11-2013. Accessed 1-11-2013: http://www.reuters.com/article/2013/01/11/us-usa-flu-idUSBRE9080WD20130111

Booth, Michael. “Colorado flu still ramping up; 2 new infant deaths logged.” Denver Post, 1-15-2013. Accessed 1-15-2013: http://www.denverpost.com/breakingnews/ci_22379521/colorado-flu-still-ramping-up-2-new-infant

 

CBS News (Ryan Jaslow). “CDC: Flue vaccine prevented 6.6 million illnesses, 79,000 hospitalizations last year.” 12-12-2013. Accessed 7-20-2015 at: http://www.cbsnews.com/news/cdc-flu-vaccine-prevented-66-million-illnesses-79000-hospitalizations-last-year/

 

Centers for Disease Control and Prevention. “2012-2013 Influenza Season Surveillance Summary.” FluView (A Weekly Influenza Season Surveillance Summary). 12-6-2013. Accessed 7-20-2015 at: http://www.cdc.gov/flu/weekly/pdf/12-13%20Season%20Summary.pdf

 

Centers for Disease Control and Prevention. “2014-2015 Influenza Season Week 31 ending August 8, 2015.” FluView, Weekly U.S. Influenza Surveillance Report. Accessed 8-15-2015 at: http://www.cdc.gov/flu/weekly/index.htm

 

Centralmaine.com (Matt Hongoltz-Hetling). “Benton girl is Maine’s first child influenza death since 2010.” 12-18-2012. Accessed 7-20-2015 at: http://www.centralmaine.com/2012/12/18/benton-girl-is-maines-first-influenza-death-since-2010/

 

Cohen, Elizabeth. “Official: Flu deaths continue to rise among children.” CNN, 1-11-2013. Accessed 1-11-2013 at: http://www.cnn.com/2013/01/11/health/us-flu-season/index.html

 

Craft, Cynthia H. “Sacramento region reports two deaths from flu last month.” Modesto Bee, 1-9-2013. Accessed 1-10-2013: http://www.modbee.com/2013/01/09/2525368/sacramento-region-reports-two.html

 

Delaware.newszap.com. “Delaware’s first flu death reported; precautions urged.” 1-15-2013. Accessed 1-15-2013: http://delaware.newszap.com/centraldelaware/119187-70/delawares-first-flu-death-reported-precautions-urged

 

Find A Grave. “Maxwell Thomas ‘Max’ Schwolert,” Record added 3-19-2013. Accessed 7-20-2015 at: http://www.findagrave.com/cgi-bin/fg.cgi?page=gr&GRid=106977288

 

Fox59 News, Indianapolis. “Number of flu deaths rises to 21 in Indiana.” 1-14-2013. Accessed 1-14-2013 at: http://fox59.com/2013/01/14/number-of-flu-deaths-rises-to-21-in-indiana/

 

Grossman, Cathy Lynn, Elizabeth Weise and Judy Keen. “Deaths increase, misery mounts as flu sweeps nation.” USA Today, 1-10-2013. Accessed 1-10-2013 at: http://www.usatoday.com/story/news/nation/2013/01/10/flu-nation-sick-elderly-flu-deaths-workplace/1823425/

 

Hudson, William, Elizabeth Cohen and John Bonifield. “Flu leads to Texas teen’s death.” CNN, 1-11-2013. http://www.cnn.com/2013/01/10/health/texas-teen-killed-flu/index.html?iid=article_sidebar

 

Hulstine, Russell. “6 New Flu Deaths Reported in Oklahoma.” NewsOn6.com, Tulsa, OK, 1-10-2013. Accessed 1-10-2013: http://www.newson6.com/story/20553888/flu-deaths-jump-in-oklahoma

 

Landau, Elizabeth. “Flu picks up steam across the U.S.” CNN, 1-10-2013. Accessed 1-10-2013 at: http://www.cnn.com/2013/01/09/health/us-flu-season/index.html

 

McMahon, Charles. “New Hampshire flu death toll rises to 16.” Seacoastonline. 1-15-2013. Accessed 1-15-2013 at: http://www.seacoastonline.com/articles/20130115-NEWS-130119842

 

McMahon Charles. “Portsmouth Hospital slammed with flu-like sicknesses; 13 deaths in N.H.” Seacoastonline.com, 1-10-2013. Accessed 1-10-2013 at: http://www.seacoastonline.com/articles/20130110-NEWS-130119984

 

Meyers, Rhiannon. “Three flu-related deaths confirmed in Nueces County.” Caller.com, Corpus Christi, TX, 1-15-2013. Accessed 1-15-2013 at: http://www.caller.com/news/2013/jan/15/three-flu-related-deaths-confirmed-nueces-county/

 

Neely, Shameka. “Flu Deaths in Indiana Rise to 15.” Indiana Public Media. 1-10-2013. Accessed 1-11-2013: http://indianapublicmedia.org/news/indiana-flu-deaths-rises-15-42766/

 

Ohnesorge, Lauren. “Flu hits N.C. hard, but why?” Triangle Business Journal, 1-11-2013. Accessed 1-11-2013: http://www.bizjournals.com/triangle/blog/2013/01/flu-hits-nc-hard-but-why.html

 

Portland Press Herald (Eric Russell), ME. “6-year-old’s flu death prompts alert in Maine.” 12-18-2012. Accessed 7-20-2015 at: http://www.pressherald.com/2012/12/18/maine-cdc-reports-first-flu-death-this-season/

 

Recombinomics. “Colorado Pediatric Flu Deaths Increase to 5.” 1-23-2013. Accessed 7-20-2015 at: http://www.recombinomics.com/News/01231301/Flu_PED_CO_5.html

 

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Scarpelli, Christine. “What is Being Done in your Community to Stop the Spread of the Flu?” WSPA.com, Spartanburg, SC, 1-10-2013. Accessed 1-10-2013 at: http://www2.wspa.com/news/2013/jan/10/what-being-done-your-community-stop-spread-flu-ar-5339220/

 

Thomas, Monifa. “27 flu deaths reported in Illinois.” Chicago Sun-Times, 1-11-2013. Accessed 1-11-2013: http://www.suntimes.com/news/nation/17515824-418/walgreens-feels-pinch-with-run-on-flu-vaccine.html

 

Tucker, Randy. “2nd area flu death reported.” Dayton Daily News, 1-10-2013. Accessed 1-10-2013: http://www.daytondailynews.com/news/news/local/wsu-student-dies-from-influenza-a-virus/nTsJ3/

 

Wenner, David. “New Year brings a surge of flue deaths in Pennsylvania.” PennLive.com, 1-9-2012. Accessed 1-10-2012 at: http://www.pennlive.com/midstate/index.ssf/2013/01/flu_deaths_influenza_cases.html

 

 

 

[1] Title of Chart in the report. Given the increase of two reported deaths we assume this is an updated report.

[2] Centers for Disease Control and Prevention. “2012-2013 Influenza Season Surveillance Summary.” FluView (A Weekly Influenza Season Surveillance Summary). 12-6-2013. Elsewhere reported as the highest pediatric mortality since 2004. CBS News (Ryan Jaslow). “CDC: Flue vaccine prevented 6.6 million illnesses, 79,000 hospitalizations last year.” 12-12-2013.

[3] Adult flu deaths are not required by the CDC to be reported to them, and thus there are no solid numbers to report. The number would no doubt be in the many hundreds, if not thousands. We do show the flu deaths we have noted while looking for pediatric flu deaths, which are more rare, and are reportable. We tally only pediatric deaths.

[4] “Dr. Gil Chavez, deputy director for California’s Center for Infectious Diseases, said 45 people under the age of 65 have died during the 2013-2014 flu season…He said that a year ago, only five deaths had been reported at this time; there were only 106 flu deaths during the entire 2012-2013 flu season.”

[5] Date is 1-23-2013; notes that this death makes “5 pediatric flu deaths since the season began on October 7th.”

[6] All over sixty-five.

[7] Two of 18 pediatric influenza deaths nationwide at this point in reporting.

[8] Portland Press Herald (Eric Russell), ME. “6-year-old’s flu death prompts alert in Maine.” 12-18-2012. Notes “Since 2005, there have been just five pediatric flu deaths reported in Maine.” Another article noted hers was the first pediatric flue fatality in Maine since 2010. (Centralmaine.com (Matt Hongoltz-Hetling). “Benton girl is Maine’s first child influenza death since 2010.” 12-18-2012.)

[9] Four pediatric (youngest, 6 months old), and two elderly.

[10] Anderson. “Flu causes two deaths, 220 illnesses in Muskegon County…urge vaccination.” Mlive, 1-11-2013.

[11] Anderson, Michelle D. “Flu causes two deaths, 220 illnesses in Muskegon County…” Mlive, 1-11-2013.

[12] AP. (Mike Strobbe). “100 kids die of flu each year.” 1-16-2013; Find A Grave. “Maxwell Thomas ‘Max’ Schwolert,” Record added 3-19-2013.

[13] All nursing home residents.

[14] Tucker, Randy. “2nd area flu death reported.” Dayton Daily News, 1-10-2013.

[15] Tucker, Randy. “2nd area flu death reported.” Dayton Daily News, 1-10-2013.

[16] Dr. William Schaffner, chair of preventive medicine, Vanderbilt University Medical Center, Nashville, TN.

[17] Boston Mayor Thomas Menino.

[18] Dori Peters, spokeswoman for Public Health-Muskegon County.