August 6, 1998
Contact: CDC, Division of Media Relations
(404) 639-3286

Outbreak of Influenza A Infection --
Alaska and the Yukon Territory, June-July 1998

CDC and Health Canada, in cooperation with local public health authorities, are investigating reports of febrile respiratory illness and associated pneumonia among persons traveling on land and sea, both independently and on tour packages, in Alaska and the Yukon Territory. Commonly reported symptoms include fever and cough, and preliminary evidence suggests that influenza A may be a cause of many of the illnesses. Summertime outbreaks of Influenza A have previously been reported among tourists in the United States and Canada(1,2). No evidence suggests increased respiratory illness activity among residents of these areas.

From June 5 through August 4, 1998, a total of 419 cases of acute respiratory infection (ARI), including 20 cases of pneumonia during June-July, have been reported the investigation team in Anchorage. No deaths have been reported. The median age of persons with ARI is 63 years (range: 3-88); the median age of persons with pneumonia is 74 years (range: 61-88). Many cases have occurred in clusters, particularly among groups of 40-50 passengers sharing common transportation and accommodation packages on overland tours between Anchorage and Skagway or Anchorage and Seward during June-July. Affected passengers have traveled on several different tours from different companies. Preliminary information suggests that after touring inland, ill persons are boarding cruise ships, possibly resulting in further spread. In some instances, travelers are becoming ill and seeking medical attention for their respiratory illnesses only after returning home.

During June-September, approximately 70, 000 overland tour and cruise ship passengers visit Alaska and the Yukon Territory each week. Most do not experience febrile respiratory illness. No prevention measures are recommended at this time for travelers in good health.

Systematic surveillance for febrile respiratory illness and pneumonia is being initiated by CDC, Health Canada, and other public health officials in the region to better define the scope of the outbreak. Health care providers who see patients with febrile respiratory illness and /or pneumonia should obtain a travel history and consider influenza A in the differential diagnosis in those with recent travel to Alaska and the Yukon Territory.

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