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It has been recognized for many years that older people are at greater risk of serious complications from the flu compared with young, healthy adults. It’s estimated that 90 percent of seasonal flu-related deaths and more than 60 percent of seasonal flu-related hospitalizations in the United States each year occur in people 65 years and older.

During week 39 (September 27-October 3, 2009), influenza activity remained stable in the United States; however, there were still higher levels of influenza-like illness than is normal for this time of year.

This report provides an update to the international situation as of October 9, 2009. The World Health Organization (WHO) continues to report updated 2009 H1N1 flu-associated laboratory-confirmed cases and deaths on its Web page.

This document provides interim guidance for state and local health departments, hospitals, and clinicians participating in surveillance activities regarding which patients to prioritize for testing by RT-PCR for influenza surveillance. Based on the continuing spread of 2009 H1N1 virus since the spring and continuing into the fall and increased demand for influenza testing, these guidelines have been developed in an effort to prioritize patients for testing by RT-PCR for influenza for surveillance purposes.

During the week of September 27 – October 3, 2009, influenza activity continued to increase in the United States. Flu activity is now widespread in 37 states. Nationwide, visits to doctors for influenza-like-illness increased over last week and are higher than expected for this time of year. In addition, flu-related hospitalizations and deaths are increasing as well, and are higher than expected.