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Canada FluWatch Weekly Reports 2012-2013 Season Weeks 33 & 34

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  • #16
    Re: Canada FluWatch Weekly Reports 2012-2013 Season Week 2

    2012-2013 FluWatch report: January 6 to January 12, 2013 (Week 2)

    Posted 2013-01-18For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
    <A title="Flu Watch (Version PDF, 113 KB - 6 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/12-13/w02_13/pdf/fw2013-02-eng.pdf">2012-2013 FluWatch report: January 6 to January 12, 2013 (Week 2) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 113 <ABBR title=Kilobytes>KB</ABBR> - 6 pages)

    »» Help with PDF documents


    Overall Influenza Summary
    • The percentage of positive laboratory tests for influenza declined in week 02; however, more regions across Canada reported widespread and localized influenza activity and 130 new influenza outbreaks were reported.
    • The ILI consultation rate increased and is well above the expected range for this time of year.
    • A total of 3744 laboratory detections of influenza were reported, of which 97.8% were for influenza A viruses, predominantly A(H3N2).
    • 51 new paediatric influenza-associated hospitalizations were reported through the IMPACT network.
    • 44 new adult influenza-associated hospitalizations were reported through the PCIRN-SOS network.
    Influenza Activity (geographic spread) and Outbreaks

    In week 02, 15 regions [in BC(2), AB(2), ON(5), QC(3) and NL(3)] reported widespread activity and 25 regions [in BC(2), AB(3), SK(2), MB(4), ON(2), QC(2), NB(5), NS(3), NL(1) and NU(1)] reported localized activity (Figures 1 and 2). In week 02, 130 new influenza outbreaks were reported: 98 in long-term-care facilities, 2 in hospitals, 5 in schools, and 25 in other facilities or communities (Figure 3).
    Figure 1. Map of overall Influenza activity level by province and territory,
    Canada, Week 02





    Note: Influenza activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.
    Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
    Figure 2. Number of influenza surveillance regions<SUP title="sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in"></SUP> reporting widespread or localized influenza activity, Canada, by report week, 2012-2013 (N<SUP>*</SUP>=58)


    †sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.
    * Total number of influenza surveillance regions in Canada
    Text equivalent for figure 2Number of influenza surveillance regions reporting widespread or localized influenza activity, Canada, by report week, 2011-2012 (N=56)
    Figure 3. Overall Number of Influenza Outbreaks, Canada, by Report Week, 2012-2013


    Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2011-2012

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    Influenza and Other Respiratory Virus Detections

    The percentage of positive influenza tests decreased from 32.5% in week 01 to 30.7% in week 02 (Figure 4).Among the influenza viruses detected in week 02 (n=3744), 97.8% were positive for influenza A viruses [of which 34.6% were A(H3), 1.9% were A(H1N1)pdm09, and 63.6% were A(unsubtyped)]; and 2.2% were positive for influenza B (Table 1). Cumulative influenza virus detections by type/subtype to date are as follows: 97.6% influenza A [34.3% A(H3), 1.4% A(H1N1)pdm09 and 64.3% A(unsubtyped)] and 2.4% influenza B (Table 1).

    Detailed information on age and type/subtype was received for 13,556 cases to date this season (Table 2). The proportions of cases by age group were as follows: 12.5% were < 5 years; 7.1% were between 5-19 years; 15.1% were between 20-44 years; 16.2% were between 45-64 years of age; 49.1% were ≥ 65 years.

    The percentage of tests positive for RSV was similar to week 01 (10.7%) at 10.4% in week 02. The percentage of tests positive for rhinovirus (3.9%), parainfluenza (2.3%), and coronavirus (3.6%) each increased slightly compared to the previous week. Other percentages of positive tests remained low in week 02: adenovirus 0.7%; hMPV 1.0% (Figure 5). For more details, see the weekly Respiratory Virus Detections in Canada Report.
    <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly & Cumulative numbers of positive influenza specimens
    by Provincial Laboratories, Canada, 2012-2013
    </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces</TH><TH id=ac1 colSpan=6>Weekly
    (January 6 to January 12, 2013)
    </TH><TH id=ac9 colSpan=6>Cumulative
    (August 26, 2012 to January 12, 2013)
    </TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=5 headers=ac1>Influenza A</TH><TH id=ac8 headers=ac1>Influenza
    B
    </TH><TH id=ac10 colSpan=5 headers=ac9>Influenza A</TH><TH id=ac16 headers=ac9>Influenza
    B
    </TH></TR><TR class=bg-colour-yellow><TH id=ac3 headers=ac2>A Total</TH><TH id=ac4 headers=ac2>A(H1)</TH><TH id=ac5 headers=ac2>A(H3)</TH><TH id=ac6 headers=ac2>Pand H1N1</TH><TH id=ac7 class=noWrap headers=ac2>A
    ( <ABBR title=unsubtyped>Un S</ABBR>)Table 1 note*
    </TH><TH headers="ac1 ac8">Total</TH><TH id=ac11 headers=ac10>A Total</TH><TH id=ac12 headers=ac10>A(H1)</TH><TH id=ac13 headers=ac10>A(H3)</TH><TH id=ac14 headers=ac10>Pand H1N1</TH><TH id=ac15 class=noWrap headers=ac10>A
    (Un S) Table 1 note*
    </TH><TH headers=ac16>Total</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13>* Unsubtyped: The specimen was typed as influenza A, but no test for subtyping was performed. Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Note: Weekly data is based on week of positive lab detection. Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals.</TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=bg-colour-yellow headers=ar1><ABBR title="British Columbia ">BC</ABBR></TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">217</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">146</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">6</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac7">65</TD><TD class=alignRight headers="ar1 ar2 ac1 ac8">17</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac11">608</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac13">519</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac14">12</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac15">77</TD><TD class=alignRight headers="ar1 ar2 ac9 ac16">37</TD></TR><TR><TH id=ar3 class=bg-colour-yellow headers=ar1><ABBR title=Alberta>AB</ABBR></TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">297</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">197</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">36</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac7">64</TD><TD class=alignRight headers="ar1 ar3 ac1 ac8">15</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac11">1628</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac13">1378</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac14">112</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac15">138</TD><TD class=alignRight headers="ar1 ar3 ac9 ac16">101</TD></TR><TR><TH id=ar4 class=bg-colour-yellow headers=ar1><ABBR title=Saskatchewan>SK</ABBR></TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">121</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">78</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac7">43</TD><TD class=alignRight headers="ar1 ar4 ac1 ac8">9</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac11">533</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac13">366</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac14">4</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac15">163</TD><TD class=alignRight headers="ar1 ar4 ac9 ac16">34</TD></TR><TR><TH id=ar5 class=bg-colour-yellow headers=ar1><ABBR title=Manitoba>MB</ABBR></TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">109</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">19</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">1</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac7">89</TD><TD class=alignRight headers="ar1 ar5 ac1 ac8">4</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac11">233</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac13">61</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac14">1</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac15">171</TD><TD class=alignRight headers="ar1 ar5 ac9 ac16">19</TD></TR><TR><TH id=ar6 class=bg-colour-yellow headers=ar1><ABBR title=Ontario>ON</ABBR></TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">1202</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">422</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">18</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac7">762</TD><TD class=alignRight headers="ar1 ar6 ac1 ac8">18</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac11">5053</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac13">2560</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac14">79</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac15">2414</TD><TD class=alignRight headers="ar1 ar6 ac9 ac16">89</TD></TR><TR><TH id=ar7 class=bg-colour-yellow headers=ar1><ABBR title=Quebec>QC</ABBR>

    </TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">1408</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">188</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">7</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac7">1213</TD><TD class=alignRight headers="ar1 ar7 ac1 ac8">19</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac11">7780</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac13">451</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac14">14</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac15">7315</TD><TD class=alignRight headers="ar1 ar7 ac9 ac16">119</TD></TR><TR><TH id=ar8 class=bg-colour-yellow headers=ar1><ABBR title="New Brunswick">NB</ABBR>

    </TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">212</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac5">212</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac7">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac8">1</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac11">341</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac13">271</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac14">10</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac15">60</TD><TD class=alignRight headers="ar1 ar8 ac9 ac16">2</TD></TR><TR><TH id=ar9 class=bg-colour-yellow headers=ar1><ABBR title="Nova Scotia ">NS</ABBR>

    </TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">22</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac7">22</TD><TD class=alignRight headers="ar1 ar9 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac11">35</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac13">0</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac14">0</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac15">35</TD><TD class=alignRight headers="ar1 ar9 ac9 ac16">2</TD></TR><TR><TH id=ar10 class=bg-colour-yellow headers=ar1><ABBR title="Prince Edward Island ">PE</ABBR>

    </TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">3</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac5">3</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac7">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac11">25</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac13">24</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac14">1</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac15">0</TD><TD class=alignRight headers="ar1 ar10 ac9 ac16">1</TD></TR><TR><TH id=ar11 class=bg-colour-yellow headers=ar1><ABBR title="Newfoundland/Labrador ">NL</ABBR>

    </TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">70</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac7">70</TD><TD class=alignRight headers="ar1 ar11 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac11">241</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac13">16</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac14">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac15">225</TD><TD class=alignRight headers="ar1 ar11 ac9 ac16">1</TD></TR><TR><TH id=ar12 class=bg-colour-yellow headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">3661</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac5">1265</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac6">68</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac7">2328</TD><TD class=alignRight headers="ar1 ar12 ac1 ac8">83</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac11">16477</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac13">5646</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac14">233</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac15">10598</TD><TD class=alignRight headers="ar1 ar12 ac9 ac16">405</TD></TR></TBODY></TABLE>
    <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 2. Weekly & Cumulative numbers of positive influenza specimens by age groups
    reported through case-based laboratory reporting, Canada, 2012-2013 Table 2 note*
    </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups</TH><TH id=bc1 colSpan=5>Weekly
    (January 6 to January 12, 2013)
    </TH><TH id=bc8 colSpan=5>Cumulative
    (August 26, 2012 to January 12, 2013)
    </TH></TR><TR class=bg-colour-yellow><TH id=bc2 colSpan=4 headers=bc1>Influenza A</TH><TH id=bc7 headers=bc1>B</TH><TH id=bc9 colSpan=4 headers=bc8>Influenza A</TH><TH id=bc14 headers=bc8>B</TH></TR><TR class=bg-colour-yellow><TH id=bc3 headers=bc2>A Total</TH><TH id=bc4 headers=bc2>Pandemic H1N1</TH><TH id=bc5 headers=bc2>A/H3N2</TH><TH id=bc6 headers=bc2>A unsubtyped</TH><TH headers="bc1 bc7">Total</TH><TH id=bc10 headers=bc9>A Total</TH><TH id=bc11 headers=bc9>Pandemic H1N1</TH><TH id=bc12 headers=bc9>A/H3N2</TH><TH id=bc13 headers=bc9>A unsubtyped</TH><TH headers=bc14>Total</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11>* Please note that this table reflects the number of specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported. Delays in the reporting of data may cause data to change retrospectively. </TD></TR></TFOOT><TBODY><TR><TH id=br2 headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">172</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">11</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">35</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">126</TD><TD class=alignRight headers="br1 br2 bc1 bc7">5</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">1631</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">44</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">546</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1041</TD><TD class=alignRight headers="br1 br2 bc8 bc14">68</TD></TR><TR><TH id=br3 headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">48</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">1</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">18</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">29</TD><TD class=alignRight headers="br1 br3 bc1 bc7">6</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">892</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">13</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">410</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">469</TD><TD class=alignRight headers="br1 br3 bc8 bc14">66</TD></TR><TR><TH id=br4 headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">187</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">10</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">44</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">133</TD><TD class=alignRight headers="br1 br4 bc1 bc7">8</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">1995</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">59</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">776</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">1160</TD><TD class=alignRight headers="br1 br4 bc8 bc14">52</TD></TR><TR><TH id=br5 headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">249</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">9</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">48</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">192</TD><TD class=alignRight headers="br1 br5 bc1 bc7">7</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">2143</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">54</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">747</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">1342</TD><TD class=alignRight headers="br1 br5 bc8 bc14">51</TD></TR><TR><TH id=br6 headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">955</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">4</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">220</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">731</TD><TD class=alignRight headers="br1 br6 bc1 bc7">11</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">6584</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">30</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">2287</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">4267</TD><TD class=alignRight headers="br1 br6 bc8 bc14">74</TD></TR><TR><TH id=br7 headers=br1>Unknown</TH><TD class=alignRight headers="br1 br7 bc1 bc2 bc3">2</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc6">1</TD><TD class=alignRight headers="br1 br7 bc1 bc7">0</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc10">65</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">2</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">61</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">2</TD><TD class=alignRight headers="br1 br7 bc8 bc14">0</TD></TR><TR><TH id=br8 headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">1613</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc4">35</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc5">366</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc6">1212</TD><TD class=alignRight headers="br1 br8 bc1 bc7">37</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">13310</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc11">202</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc12">4827</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc13">8281</TD><TD class=alignRight headers="br1 br8 bc8 bc14">311</TD></TR></TBODY></TABLE>


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    Figure 4. Influenza tests reported and percentage of tests positive, Canada,
    by report week, 2012-2013


    Text equivalent for figure 4Influenza tests reported and percentage of tests positive, Canada, by report week, 2011-2012
    Figure 5. Percent positive influenza tests, compared to other respiratory viruses,
    Canada, by reporting week, 2012-2013


    Text equivalent for figure 5Percent positive influenza tests, compared to other respiratory viruses, Canada, by reporting week, 2011-2012

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    Influenza strain characterizations

    During the 2012-13 season, the National Microbiology Laboratory (NML) has antigenically characterized 248 influenza viruses [172 A(H3N2), 36 A(H1N1)pdm09 , and 40 influenza B]. The 172 influenza A(H3N2) viruses were antigenically similar to the vaccine strain A/Victoria/361/2011 and the 36 A(H1N1)pdm09 viruses were antigenically similar to the vaccine strain A/California/07/09. Among the influenza B viruses, 31 were antigenically similar to the vaccine strain B/Wisconsin/01/2010 (Yamagata lineage) and 9 were similar to B/Brisbane/60/2008 (Victoria lineage; component of the 2011-2012 seasonal influenza vaccine) (Figure 6).
    Figure 6. Influenza strain characterizations, Canada, 2012-2013, N = 248

    Note:The recommended components for the 2012-2013 Northern Hemisphere influenza vaccine include: an A/Victoria/361/2011 (H3N2)-like virus; an A/California/7/2009 (H1N1)pdm09-like virus; and a B/Wisconsin/1/2010-like virus.
    Text equivalent for figure 6Influenza strain characterizations, Canada, 2011-2012

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    Antiviral resistance

    During the 2012-13 season, NML has tested 214 influenza viruses for resistance to oseltamivir, and 213 influenza viruses for resistance to zanamivir. All viruses tested were sensitive to oseltamivir and zanamivir. A total of 333 influenza A viruses were tested for amantadine resistance and all were resistant (Table 3).


    <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2012-2013</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=cr1 rowSpan=2>Virus type and subtype</TH><TH id=cc1 colSpan=2>Oseltamivir</TH><TH id=cc4 colSpan=2>Zanamivir</TH><TH id=cc7 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=cc2 headers=cc1># tested</TH><TH id=cc3 headers=cc1># resistant (%)</TH><TH id=cc5 headers=cc4># tested</TH><TH id=cc6 headers=cc4># resistant (%)</TH><TH id=cc8 headers=cc7># tested</TH><TH id=cc9 headers=cc7># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=cr2 class="alignLeft bg-colour-blue" headers=cr1>A (H3N2)</TH><TD class=alignCenter headers="cr2 cc2">163</TD><TD class=alignCenter headers="cr2 cc3">0</TD><TD class=alignCenter headers="cr2 cc5">162</TD><TD class=alignCenter headers="cr2 cc6">0</TD><TD class=alignCenter headers="cr2 cc8">306</TD><TD class=alignCenter headers="cr2 cc9">306 (100%)</TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignCenter headers="cr3 cc2">25</TD><TD class=alignCenter headers="cr3 cc3">0</TD><TD class=alignCenter headers="cr3 cc5">25</TD><TD class=alignCenter headers="cr3 cc6">0</TD><TD class=alignCenter headers="cr3 cc8">27</TD><TD class=alignCenter headers="cr3 cc9">27</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignCenter headers="cr4 cc2">26</TD><TD class=alignCenter headers="cr4 cc3">0</TD><TD class=alignCenter headers="cr4 cc5">26</TD><TD class=alignCenter headers="cr4 cc6">0</TD><TD class=alignCenter headers="cr4 cc8">NA <SUP>*</SUP></TD><TD class=alignCenter headers="cr4 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft bg-colour-blue" headers=cr1>TOTAL</TH><TD class=alignCenter headers="cr5 cc2">214</TD><TD class=alignCenter headers="cr5 cc3">0</TD><TD class=alignCenter headers="cr5 cc5">213</TD><TD class=alignCenter headers="cr5 cc6">0</TD><TD class=alignCenter headers="cr5 cc8">333</TD><TD class=alignCenter headers="cr5 cc9">333 (100%)</TD></TR></TBODY></TABLE>

    Influenza-like Illness (ILI) Consultation Rate

    The national influenza-like-illness (ILI) consultation rate increased from 58.7 ILI consultations per 1,000 patient visits in week 01 to 62.1 in week 02. This rate is well above the expected level for this time of year, which is between 24.0 and 42.5 ILI consultations per 1,000 visits (Figure 7). The increased ILI consultation rate may be due in part to ongoing influenza and RSV activity across Canada, as well as increased public attention to the early influenza season. In week 02, the highest consultation rates were observed in children <5 years of age (90.8/1,000) followed by children 5-19 years of age (78.2/1,000).
    Figure 7. Influenza-like illness (ILI) consultation rates, Canada, by report week, 2012-2013 compared to 1996/97 through to 2011/12 seasons (with pandemic data suppressed)



    Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons). Delays in the reporting of data may cause data to change retrospectively.
    Text equivalent for figure 7Influenza-like illness (ILI) consultation rates, Canada, by report week, 2011-2012 compared to 1996/97 through to 2010/11 seasons (with pandemic data suppressed)

    Pharmacy Surveillance

    The Canadian antiviral prescription rate decreased from 337.6 antiviral prescriptions per 100,000 new prescriptions dispensed in week 01 to 285.7 in week 02. In week 02, the antiviral prescription rate decreased for adult and senior age groups, and was stable for infants and children. The highest rate was observed among seniors ≥65 years, at 475.1/100,000. The current proportion of antiviral prescriptions of 285.7/100,000 is higher than the rate observed during the peak period of influenza activity last year (50-100/100,000); however, it continues to follow the trend of the percentage of positive laboratory tests for influenza.

    Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group.

    Severe Respiratory Illness Surveillance

    Paediatric Influenza Hospitalizations and Deaths (IMPACT)

    In week 02, 51 new laboratory-confirmed influenza-associated paediatric (16 years of age and under) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 74 in week 01. Among the 49 cases identified with influenza A, 42 (85.7%) were A(unsubtyped), 6 (12.2%) were A(H3N2) and 1 (2.0%) was A(H1N1)pdm09. Two cases were identified with influenza B. The age distribution is as follows: 10 cases (19.6%) under 6 months of age, 16 (31.4%) between 6-23 months, 16 (31.4%) aged 2-4 years, 8 (15.7%) aged 5-9 years, and 1 (2.0%) aged 10-16 years. Five ICU admissions were reported during this week, four cases between 6-23 months and one aged 2-4 years.

    Since the start of the 2012-13 season, a total of 394 influenza-associated paediatric hospitalizations have been reported by the IMPACT network: 380 (96.4%) with influenza A [of which 56 (14.7%) were A(H3N2), 3 (0.8%) were A(H1N1)pdm09 and 321 (84.5%) were A(unsubtyped)], and 14 (3.6%) with influenza B. The distribution of cases by age group is as follows: 90 (22.8%) <6 months of age; 83 (21.1%) age 6-23 months; 112 (28.4%) age 2-4 years; 71 (18.0%) age 5-9 years; and 38 (9.6%) age 10-16 years. Thirty-six of the 394 cases (9.1%) were admitted to the ICU. No deaths have been reported to date.

    Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associate paediatric hospitalizations in Canada.

    Adult Influenza Hospitalizations and Deaths (PCIRN)

    In week 02, 44 new laboratory-confirmed influenza-associated adult (16 years of age and older) hospitalizations were reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 26 in week 01. The age distribution is as follows: 34 cases (77.3%) were ≥65 years of age, 7 cases (15.9%) were aged 45-64 years, and 3 cases (6.8%) were aged 20-44 years. Among the 42 cases identified with influenza A, one was A(H3N2), and the rest were A(unsubtyped). Two cases were identified with influenza B. One ICU admission was reported during the current week in a case of influenza A(unsubtyped) in an individual ≥65 years of age. Three deaths were reported with influenza A(unsubtyped): two individuals were ≥65 years of age, and the third was 45-64 years of age.

    From November 4, 2012 to January 12, 2013, a total of 276 influenza-associated adult hospitalizations were reported by the PCIRN-SOS network: 262 (94.9%) with influenza A [of which 30 (11.5%) were A(H3N2), 2 (0.8%) were A(H1N1), and 230 (87.8%) were A(unsubtyped)]; 6 (2.2%) with influenza B, and the type has not yet been reported for 8 (2.9%) cases. The distribution of cases by age group is as follows: 190 cases (68.8%) were aged ≥65 years, 60 cases (21.7%) were aged 45-64 years, 23 cases (8.3%) were aged 20-44 years, and 3 cases (1.1%) were <20 years of age. Thirteen of the 276 cases (4.7%) were admitted to the ICU. Six admissions were in adults aged ≥65 years, three were aged 45-64 years, and four were aged 20-44 years. Of the thirteen ICU admissions, eight cases (61.5%) had at least one comorbidity, one case (7.7%) had no co-morbidities, and four cases (30.8%) had no available information on comorbidities to date. Nine deaths have been reported to date, all in cases with influenza A(unsubtyped). Seven deaths were in adults aged ≥65 years, one was in a person aged 45-64 years, and one was in a person aged 20-44 years. Detailed clinical information on comorbidities is not known for these cases.

    Note: The number of hospitalizations reported through PCIRN represents a subset of all influenza-associate adult hospitalizations in Canada.

    Provincial/Territorial Influenza Hospitalizations and Deaths (Aggregate Surveillance System<SUP>*</SUP>)

    In week 02, 823 laboratory-confirmed influenza-associated hospitalizations were reported*. Ninety eight percent of cases (810/823) were influenza A [42% A(H3); 2.3% A(H1N1)pdm09; 55.7% A(unsubtyped)], and 1.6% (13/823) were influenza B. More than half of the cases (60% 497/823) were ≥65 years of age, 16.5% were adults aged 46-64 years and 13% were children aged 0-4 years. Of the 130 cases with available data, 15.4% (20/130) were admitted to the Intensive Care Unit (ICU). Fifty-one deaths were reported in week 02, the majority of which were persons ≥65 years of age (78.4%; 40/51); 10 were adults aged 45-64 yeas and one was an adult aged 20-44 years. It is important to note that the cause of death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.

    To date this season, 1675 influenza-associated hospitalizations have been reported. Of these, 97.7% (1636/1675) have been influenza A [predominately A(H3) (45.7%; 748/1636)] and 2.3% have been influenza B. Half of the cases (55.7% 933/1675) were ≥65 years of age, 16.4% (275/1675) were adults aged 45-64 years and 14.4% (241/1675) were children aged 0-4 years. Among the 428 cases with available data, there have been 66 hospitalisations for which admission to ICU was required; 24 were persons ≥65 years of age, 24 were persons aged 45-64 years, 9 were adults aged 20-44 years, 1 was an individual aged 15-19 years, 3 were children aged 5-14 years and 5 were children aged 0-4 years. To date this season, 104 deaths have been reported: 86 were adults aged ≥ 65 years of age, 11 were adults aged 45-64 years; 4 were adults aged 20-44 years; and 3 were children aged 0-4 years. It is important to note that the cause of death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.

    * Note: The number of new influenza-associated hospitalizations and deaths reported by the Aggregate Surveillance System each week may be overestimated, as it may include retrospective updates to data from Ontario for previous weeks. These data may also include cases reported by the IMPACT and PCIRN networks. Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, NS, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not reported in Ontario.

    .../
    http://www.phac-aspc.gc.ca/fluwatch/.../index-eng.php
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    Comment


    • #17
      Re: Canada FluWatch Weekly Reports 2012-2013 Season Week 3

      2012-2013 FluWatch report: January 13 to January 19, 2013 (Week 3)

      Posted 2013-01-25For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
      <A title="Flu Watch (Version PDF, 113 KB - 6 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/12-13/w03_13/pdf/fw2013-03-eng.pdf">2012-2013 FluWatch report: January 13 to January 19, 2013 (Week 3) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 113 <ABBR title=Kilobytes>KB</ABBR> - 8 pages)

      »» Help with PDF documents


      Overall Influenza Summary
      • The percentage of positive laboratory tests for influenza declined in week 03 for the third week in a row. Influenza A(H3N2) continues to be the predominant strain in Canada.
      • Many regions across Canada continue to report widespread and localized influenza activity and 118 new influenza outbreaks were reported.
      • The ILI consultation rate decreased but continues to be above the expected range for this time of year, possibly due in part to the circulation of both influenza and RSV in many regions.
      • Similar to previous years, older adults (persons aged ≥65 years) are the most affected this season; with 49.4% of laboratory detections to date, 67.6% of adult hospitalizations reported through the PCIRN-SOS network, outbreaks in long-term care facilities, and a high proportion of antiviral prescriptions.
      Influenza Activity (geographic spread) and Outbreaks

      In week 03, 10 regions [in BC(2), AB(2), ON(1), QC(2) and NL(3)] reported widespread activity and 29 regions [in BC(2), AB(3), SK(2), MB(3), ON(6), QC(4), NB(5), NS(3), and PE(1)] reported localized activity (Figures 1 and 2). In week 03, 118 new influenza outbreaks were reported: 71 in long-term-care facilities, 6 in hospitals, 10 in schools, and 31 in other facilities or communities (Figure 3).
      Figure 1. Map of overall Influenza activity level by province and territory,
      Canada, Week 03





      Note: Influenza activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.
      Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
      Figure 2. Number of influenza surveillance regions<SUP title="sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in"></SUP> reporting widespread or localized influenza activity, Canada, by report week, 2012-2013 (N<SUP>*</SUP>=56)


      †sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.
      * Total number of influenza surveillance regions in Canada
      Text equivalent for figure 2Number of influenza surveillance regions reporting widespread or localized influenza activity, Canada, by report week, 2011-2012 (N=56)
      Figure 3. Overall Number of Influenza Outbreaks, Canada, by Report Week, 2012-2013


      Note that last year was the first year that provinces and territories were reporting on influenza outbreaks in schools (greater than 10% absenteeism on any day most likely due to ILI) which has increased considerably the total number of outbreaks reported compared to previous years.
      Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2011-2012

      Top of Page

      Influenza and Other Respiratory Virus Detections

      The percentage of positive influenza tests decreased from 30.8% in week 02 to 27.1% in week 03 (Figure 4). Among the influenza viruses detected in week 03 (n=2840), 97.9% were positive for influenza A viruses [of which 35.6% were A(H3), 3.7% were A(H1N1)pdm09, and 60.8% were A(unsubtyped)]; and 2.1% were positive for influenza B (Table 1). Cumulative influenza virus detections by type/subtype to date are as follows: 97.6% influenza A [35.6% A(H3), 1.8% A(H1N1)pdm09 and 62.6% A(unsubtyped)] and 2.4% influenza B (Table 1).
      Detailed information on age and type/subtype was received for 15,833 cases to date this season (Table 2). The proportions of cases by age group were as follows: 12.6% were < 5 years; 6.9% were between 5-19 years; 14.9% were between 20-44 years; 16.1% were between 45-64 years of age; 49.4% were ≥ 65 years.
      The percentage of tests positive for RSV was steady at 11.4% in week 03. The percentage of tests positive for rhinovirus (4.2%), parainfluenza (2.4%), and coronavirus (4.7%) each decreased slightly compared to the previous week. Other percentages of positive tests remained low in week 03: adenovirus 0.9%; hMPV 1.3% (Figure 5). For more details, see the weekly Respiratory Virus Detections in Canada Report.
      <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly & Cumulative numbers of positive influenza specimens
      by Provincial Laboratories, Canada, 2012-2013
      </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces</TH><TH id=ac1 colSpan=6>Weekly
      (January 13 to January 19, 2013)
      </TH><TH id=ac9 colSpan=6>Cumulative
      (August 26, 2012 to January 19, 2013)
      </TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=5 headers=ac1>Influenza A</TH><TH id=ac8 headers=ac1>Influenza
      B
      </TH><TH id=ac10 colSpan=5 headers=ac9>Influenza A</TH><TH id=ac16 headers=ac9>Influenza
      B
      </TH></TR><TR class=bg-colour-yellow><TH id=ac3 headers=ac2>A Total</TH><TH id=ac4 headers=ac2>A(H1)</TH><TH id=ac5 headers=ac2>A(H3)</TH><TH id=ac6 headers=ac2>Pand H1N1</TH><TH id=ac7 class=noWrap headers=ac2>A
      ( <ABBR title=unsubtyped>Un S</ABBR>)Table 1 note*
      </TH><TH headers="ac1 ac8">Total</TH><TH id=ac11 headers=ac10>A Total</TH><TH id=ac12 headers=ac10>A(H1)</TH><TH id=ac13 headers=ac10>A(H3)</TH><TH id=ac14 headers=ac10>Pand H1N1</TH><TH id=ac15 class=noWrap headers=ac10>A
      (Un S) Table 1 note*
      </TH><TH headers=ac16>Total</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13>* Unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available. Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Note: Weekly data is based on week of positive lab detection. Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals.</TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=bg-colour-yellow headers=ar1><ABBR title="British Columbia ">BC</ABBR></TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">255</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">149</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">15</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac7">91</TD><TD class=alignRight headers="ar1 ar2 ac1 ac8">16</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac11">805</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac13">684</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac14">28</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac15">93</TD><TD class=alignRight headers="ar1 ar2 ac9 ac16">61</TD></TR><TR><TH id=ar3 class=bg-colour-yellow headers=ar1><ABBR title=Alberta>AB</ABBR></TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">195</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">118</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">31</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac7">46</TD><TD class=alignRight headers="ar1 ar3 ac1 ac8">12</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac11">1823</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac13">1531</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac14">154</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac15">138</TD><TD class=alignRight headers="ar1 ar3 ac9 ac16">113</TD></TR><TR><TH id=ar4 class=bg-colour-yellow headers=ar1><ABBR title=Saskatchewan>SK</ABBR></TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">73</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">33</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">1</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac7">39</TD><TD class=alignRight headers="ar1 ar4 ac1 ac8">4</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac11">606</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac13">399</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac14">5</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac15">202</TD><TD class=alignRight headers="ar1 ar4 ac9 ac16">38</TD></TR><TR><TH id=ar5 class=bg-colour-yellow headers=ar1><ABBR title=Manitoba>MB</ABBR></TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">130</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac7">130</TD><TD class=alignRight headers="ar1 ar5 ac1 ac8">5</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac11">363</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac13">61</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac14">1</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac15">301</TD><TD class=alignRight headers="ar1 ar5 ac9 ac16">24</TD></TR><TR><TH id=ar6 class=bg-colour-yellow headers=ar1><ABBR title=Ontario>ON</ABBR></TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">1116</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">525</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">48</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac7">543</TD><TD class=alignRight headers="ar1 ar6 ac1 ac8">7</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac11">6200</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac13">3115</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac14">128</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac15">2957</TD><TD class=alignRight headers="ar1 ar6 ac9 ac16">97</TD></TR><TR><TH id=ar7 class=bg-colour-yellow headers=ar1><ABBR title=Quebec>QC</ABBR>

      </TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">684</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">53</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">2</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac7">629</TD><TD class=alignRight headers="ar1 ar7 ac1 ac8">15</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac11">8487</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac13">504</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac14">16</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac15">7967</TD><TD class=alignRight headers="ar1 ar7 ac9 ac16">134</TD></TR><TR><TH id=ar8 class=bg-colour-yellow headers=ar1><ABBR title="New Brunswick">NB</ABBR>

      </TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">143</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac5">111</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac6">5</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac7">27</TD><TD class=alignRight headers="ar1 ar8 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac11">484</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac13">382</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac14">15</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac15">87</TD><TD class=alignRight headers="ar1 ar8 ac9 ac16">2</TD></TR><TR><TH id=ar9 class=bg-colour-yellow headers=ar1><ABBR title="Nova Scotia ">NS</ABBR>

      </TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">24</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac7">24</TD><TD class=alignRight headers="ar1 ar9 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac11">37</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac13">0</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac14">0</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac15">37</TD><TD class=alignRight headers="ar1 ar9 ac9 ac16">2</TD></TR><TR><TH id=ar10 class=bg-colour-yellow headers=ar1><ABBR title="Prince Edward Island ">PE</ABBR>

      </TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">12</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac7">12</TD><TD class=alignRight headers="ar1 ar10 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac11">37</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac13">24</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac14">1</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac15">12</TD><TD class=alignRight headers="ar1 ar10 ac9 ac16">1</TD></TR><TR><TH id=ar11 class=bg-colour-yellow headers=ar1><ABBR title="Newfoundland/Labrador ">NL</ABBR>

      </TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">149</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac7">149</TD><TD class=alignRight headers="ar1 ar11 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac11">390</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac13">152</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac14">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac15">238</TD><TD class=alignRight headers="ar1 ar11 ac9 ac16">1</TD></TR><TR><TH id=ar12 class=bg-colour-yellow headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">2781</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac5">989</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac6">102</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac7">1690</TD><TD class=alignRight headers="ar1 ar12 ac1 ac8">59</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac11">19232</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac13">6852</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac14">348</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac15">12032</TD><TD class=alignRight headers="ar1 ar12 ac9 ac16">473</TD></TR></TBODY></TABLE>
      <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 2. Weekly & Cumulative numbers of positive influenza specimens by age groups
      reported through case-based laboratory reporting, Canada, 2012-2013 Table 2 note*
      </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups</TH><TH id=bc1 colSpan=5>Weekly
      (January 13 to January 19, 2013)
      </TH><TH id=bc8 colSpan=5>Cumulative
      (August 26, 2012 to January 19, 2013)
      </TH></TR><TR class=bg-colour-yellow><TH id=bc2 colSpan=4 headers=bc1>Influenza A</TH><TH id=bc7 headers=bc1>B</TH><TH id=bc9 colSpan=4 headers=bc8>Influenza A</TH><TH id=bc14 headers=bc8>B</TH></TR><TR class=bg-colour-yellow><TH id=bc3 headers=bc2>A Total</TH><TH id=bc4 headers=bc2>Pandemic H1N1</TH><TH id=bc5 headers=bc2>A/H3N2</TH><TH id=bc6 headers=bc2>A unsubtyped</TH><TH headers="bc1 bc7">Total</TH><TH id=bc10 headers=bc9>A Total</TH><TH id=bc11 headers=bc9>Pandemic H1N1</TH><TH id=bc12 headers=bc9>A/H3N2</TH><TH id=bc13 headers=bc9>A unsubtyped</TH><TH headers=bc14>Total</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11>* Please note that this table reflects the number of specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported. Delays in the reporting of data may cause data to change retrospectively. </TD></TR></TFOOT><TBODY><TR><TH id=br2 headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">172</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">9</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">48</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">115</TD><TD class=alignRight headers="br1 br2 bc1 bc7">3</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">1921</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">61</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">645</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1215</TD><TD class=alignRight headers="br1 br2 bc8 bc14">80</TD></TR><TR><TH id=br3 headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">79</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">1</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">17</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">61</TD><TD class=alignRight headers="br1 br3 bc1 bc7">4</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1023</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">15</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">453</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">555</TD><TD class=alignRight headers="br1 br3 bc8 bc14">74</TD></TR><TR><TH id=br4 headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">203</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">14</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">78</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">111</TD><TD class=alignRight headers="br1 br4 bc1 bc7">8</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">2286</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">79</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">909</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">1298</TD><TD class=alignRight headers="br1 br4 bc8 bc14">71</TD></TR><TR><TH id=br5 headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">240</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">11</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">88</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">141</TD><TD class=alignRight headers="br1 br5 bc1 bc7">5</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">2493</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">72</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">892</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">1529</TD><TD class=alignRight headers="br1 br5 bc8 bc14">60</TD></TR><TR><TH id=br6 headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">896</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">9</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">388</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">499</TD><TD class=alignRight headers="br1 br6 bc1 bc7">11</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">7735</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">40</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">2823</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">4872</TD><TD class=alignRight headers="br1 br6 bc8 bc14">90</TD></TR><TR><TH id=br7 headers=br1>Unknown</TH><TD class=alignRight headers="br1 br7 bc1 bc2 bc3">56</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc4">4</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc5">52</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc6">0</TD><TD class=alignRight headers="br1 br7 bc1 bc7">0</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc10">121</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">6</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">113</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">2</TD><TD class=alignRight headers="br1 br7 bc8 bc14">0</TD></TR><TR><TH id=br8 headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">1646</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc4">48</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc5">671</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc6">927</TD><TD class=alignRight headers="br1 br8 bc1 bc7">31</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">15579</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc11">273</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc12">5835</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc13">9471</TD><TD class=alignRight headers="br1 br8 bc8 bc14">375</TD></TR></TBODY></TABLE>


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      Figure 4. Influenza tests reported and percentage of tests positive, Canada,
      by report week, 2012-2013


      Text equivalent for figure 4Influenza tests reported and percentage of tests positive, Canada, by report week, 2011-2012
      Figure 5. Percent positive influenza tests, compared to other respiratory viruses,
      Canada, by reporting week, 2012-2013


      Text equivalent for figure 5Percent positive influenza tests, compared to other respiratory viruses, Canada, by reporting week, 2011-2012

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      Influenza strain characterizations

      During the 2012-13 season, the National Microbiology Laboratory (NML) has antigenically characterized 285 influenza viruses [201 A(H3N2), 37 A(H1N1)pdm09 , and 47 influenza B]. The 201 influenza A(H3N2) viruses were antigenically similar to the vaccine strain A/Victoria/361/2011 and the 37 A(H1N1)pdm09 viruses were antigenically similar to the vaccine strain A/California/07/09. Among the influenza B viruses, 37 were antigenically similar to the vaccine strain B/Wisconsin/01/2010 (Yamagata lineage) and 10 were similar to B/Brisbane/60/2008 (Victoria lineage; component of the 2011-2012 seasonal influenza vaccine) (Figure 6).
      Figure 6. Influenza strain characterizations, Canada, 2012-2013, N = 285

      Note:The recommended components for the 2012-2013 Northern Hemisphere influenza vaccine include: an A/Victoria/361/2011 (H3N2)-like virus; an A/California/7/2009 (H1N1)pdm09-like virus; and a B/Wisconsin/1/2010-like virus.
      Text equivalent for figure 6Influenza strain characterizations, Canada, 2011-2012

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      Antiviral resistance

      During the 2012-13 season, NML has tested 274 influenza viruses for resistance to oseltamivir and zanamivir, respectively. All viruses tested were sensitive to oseltamivir and zanamivir. A total of 407 influenza A viruses were tested for amantadine resistance and all were resistant (Table 3).


      <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2012-2013</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=cr1 rowSpan=2>Virus type and subtype</TH><TH id=cc1 colSpan=2>Oseltamivir</TH><TH id=cc4 colSpan=2>Zanamivir</TH><TH id=cc7 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=cc2 headers=cc1># tested</TH><TH id=cc3 headers=cc1># resistant (%)</TH><TH id=cc5 headers=cc4># tested</TH><TH id=cc6 headers=cc4># resistant (%)</TH><TH id=cc8 headers=cc7># tested</TH><TH id=cc9 headers=cc7># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=cr2 class="alignLeft bg-colour-blue" headers=cr1>A (H3N2)</TH><TD class=alignCenter headers="cr2 cc2">196</TD><TD class=alignCenter headers="cr2 cc3">0</TD><TD class=alignCenter headers="cr2 cc5">195</TD><TD class=alignCenter headers="cr2 cc6">0</TD><TD class=alignCenter headers="cr2 cc8">369</TD><TD class=alignCenter headers="cr2 cc9">369 (100%)</TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignCenter headers="cr3 cc2">36</TD><TD class=alignCenter headers="cr3 cc3">0</TD><TD class=alignCenter headers="cr3 cc5">37</TD><TD class=alignCenter headers="cr3 cc6">0</TD><TD class=alignCenter headers="cr3 cc8">38</TD><TD class=alignCenter headers="cr3 cc9">38</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignCenter headers="cr4 cc2">42</TD><TD class=alignCenter headers="cr4 cc3">0</TD><TD class=alignCenter headers="cr4 cc5">42</TD><TD class=alignCenter headers="cr4 cc6">0</TD><TD class=alignCenter headers="cr4 cc8">NA <SUP>*</SUP></TD><TD class=alignCenter headers="cr4 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft bg-colour-blue" headers=cr1>TOTAL</TH><TD class=alignCenter headers="cr5 cc2">274</TD><TD class=alignCenter headers="cr5 cc3">0</TD><TD class=alignCenter headers="cr5 cc5">274</TD><TD class=alignCenter headers="cr5 cc6">0</TD><TD class=alignCenter headers="cr5 cc8">407</TD><TD class=alignCenter headers="cr5 cc9">407 (100%)</TD></TR></TBODY></TABLE>
      Influenza-like Illness (ILI) Consultation Rate

      The national influenza-like-illness (ILI) consultation rate decreased from 54.0 ILI consultations per 1,000 patient visits in week 02 to 43.8 in week 03. This rate is above the expected level for this time of year (between 23.5 and 36.5 ILI consultations per 1,000 visits) (Figure 7). The elevated ILI consultation rate relative to the expected range for this time of year may be due to the unusually early influenza season, as well as continued circulation of influenza and RSV across Canada. In week 03, the highest consultation rates were observed in children 5-19 years of age (60.5/1,000) followed by adults ≥65 years of age (57.9/1,000).
      Figure 7. Influenza-like illness (ILI) consultation rates, Canada, by report week, 2012-2013 compared to 1996/97 through to 2011/12 seasons (with pandemic data suppressed)



      Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons). Delays in the reporting of data may cause data to change retrospectively.
      Text equivalent for figure 7Influenza-like illness (ILI) consultation rates, Canada, by report week, 2011-2012 compared to 1996/97 through to 2010/11 seasons (with pandemic data suppressed)

      Pharmacy Surveillance

      The Canadian antiviral prescription rate increased slightly from 285.5 antiviral prescriptions per 100,000 new prescriptions dispensed in week 02 to 294.8 in week 03. In week 03, the antiviral prescription rate decreased for the adult age group, and increased for infants, children and seniors. The highest rate continued to be observed for seniors ≥65 years, at 644.8/100,000. The current proportion of antiviral prescriptions of 294.8/100,000 is higher than the rate observed during the peak period of influenza activity last year (50-100/100,000). While the percentage of positive laboratory tests for influenza has declined over recent weeks, the proportion of antiviral prescriptions continues at similar levels, possibly due to sustained influenza activity in many regions across Canada.

      Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group.
      Severe Respiratory Illness Surveillance

      Paediatric Influenza Hospitalizations and Deaths (IMPACT)

      In week 03, 49 new laboratory-confirmed influenza-associated paediatric (16 years of age and under) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 61 in week 02.
      Among the 47 cases identified with influenza A, 38 (80.9%) were A(unsubtyped), 5 (10.6%) were A(H3N2) and 4 (8.5%) were A(H1N1)pdm09. Two cases were identified with influenza B. The age distribution is as follows: 5 cases (10.2%) under 6 months of age, 18 (36.7%) between 6-23 months, 19 (38.8%) aged 2-4 years, 5 (10.2%) aged 5-9 years, and 2 (4.1%) aged 10-16 years. Four ICU admissions were reported during this week, two <6 months of age, one 6-23 months of age and one aged 2-4 years.

      Since the start of the 2012-13 season, a total of 461 influenza-associated paediatric hospitalizations have been reported by the IMPACT network: 444 (96.3%) with influenza A [of which 61 (13.7%) were A(H3N2), 7 (1.6%) were A(H1N1)pdm09 and 376 (84.7%) were A(unsubtyped)], and 17 (3.7%) with influenza B. The distribution of cases by age group is as follows: 100 (21.7%) <6 months of age; 108 (23.4%) age 6-23 months; 135 (29.3%) age 2-4 years; 77 (16.7%) age 5-9 years; and 41 (8.9%) age 10-16 years. Forty of the 461 cases (8.7%) were admitted to the ICU. No deaths have been reported to date.

      Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associate paediatric hospitalizations in Canada.

      Adult Influenza Hospitalizations and Deaths (PCIRN)

      In week 03, 43 new laboratory-confirmed influenza-associated adult (16 years of age and older) hospitalizations were reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 72 in week 02. The age distribution is as follows: 25 cases (58.1%) were ≥65 years of age, 11 (25.6%) cases were aged 45-64 years, and 7 (16.3%) cases were aged 20-44 years. Among the 41 cases identified with influenza A, one was A(H3N2), and the rest were A(unsubtyped). One case was identified with influenza B, and in one case the influenza type has yet to be reported. Three ICU admissions were reported during the current week. All three had influenza A(unsubtyped), with two individuals aged ≥65 years, and the third aged 45-64 years. Three deaths were reported with influenza A(unsubtyped) in individuals ≥65 years of age.

      From November 4, 2012 to January 19, 2013, a total of 539 influenza-associated adult hospitalizations were reported by the PCIRN-SOS network: 504 (93.5%) with influenza A [of which 46 (9.1%) were A(H3N2), 3 (0.6%) were A(H1N1)pdm09, and 455 (90.3%) were A(unsubtyped)]; 11 (2.0%) with influenza B, and the type has not yet been reported for 24 (4.5%) cases. Among the 537 cases with available data, the distribution of cases by age group is as follows: 363 cases (67.6%) were aged ≥65 years, 119 cases (22.2%) were aged 45-64 years, 52 (9.7%) were aged 20-44 years, and 3 cases (0.6%) were <20 years of age. Thirty-two of the 539 cases (5.9%) were admitted to ICU: 19 (59.4%) were in adults aged ≥65 years, 7 (21.9%) were aged 45-64 years, and 6 (18.8%) were aged 20-44 years. Of the 32 ICU admissions, 10 cases (31.3%) had at least one co-morbidity or chronic illness, 2 (6.3%) had no co-morbidities or chronic illnesses, and 20 (62.5%) had no available information to date. A total of 25 deaths have been reported, 3 (12.0%) with influenza A(H3N2), and the remaining 22 (88.0%) with influenza A(unsubtyped). Twenty-one of the 25 deaths (84%) were in adults aged ≥65 years, three were aged 45-64 years, and one was aged 20-44 years. Three deaths occurred in individuals who had at least one co-morbidity or chronic illness. Detailed clinical information on comorbidities and chronic illnesses is not known for the remaining 22 cases.

      Note: The number of hospitalizations reported through PCIRN represents a subset of all influenza-associate adult hospitalizations in Canada.

      Provincial/Territorial Influenza Hospitalizations and Deaths (Aggregate Surveillance System<SUP>*</SUP>)

      The number of laboratory confirmed influenza associated hospitalizations declined in week 03 to 583 (from 823 in week 2)*. The majority of cases were influenza A (97.8%), predominately A(H3). More than half of the cases (61.9%, 361/583) were aged 65+. Of the 96 cases with available data, 11 (11.5%) were admitted to the Intensive Care Unit (ICU). Thirty-nine deaths were reported in week 03: 30 (76.9%) were persons aged 65+; 8 (20.5%) were adults aged 45-64 yeas and one was a child aged 0-4 years. It is important to note that the cause of death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.

      To date this season, 2212 influenza-associated hospitalizations have been reported. Of these, 97.8% (2164/2212) have been influenza A, predominately A(H3) [95.8% (925/966) of subtyped influenza A]; and 2.2% have been influenza B. More than half (57.6%) of the 2209 cases with available age were aged ≥65 years; 16.5% were 45-64 years; 8.4% were 20-44 years; 1.1% were 15-19 years; 3.2% were children aged 5-14 years and 13.3% were children aged 0-4 years. Among the 478 cases with available data, there have been 66 hospitalisations for which admission to ICU was required; the highest proportions were among adults ≥65 years of age (37.9%), and between 45 and 64 years of age (33.3%). To date this season, 146 deaths have been reported: 81.5% were persons aged ≥65 years of age, 13.0% were adults aged 45-64 years; 2.7% were adults aged 20-44 years and 2.7% were children aged 0-4 years. It is important to note that the cause of death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.

      * Note: The number of new influenza-associated hospitalizations and deaths reported by the Aggregate Surveillance System each week may be overestimated, as it may include retrospective updates to data from Ontario for previous weeks. These data may also include cases reported by the IMPACT and PCIRN networks. Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, NS, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not reported in Ontario.

      .../
      http://www.phac-aspc.gc.ca/fluwatch/.../index-eng.php
      "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
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      Comment


      • #18
        Re: Canada FluWatch Weekly Reports 2012-2013 Season Week 4

        FluWatch report: January 20 to January 26, 2013 (Week 4)

        Posted 2013-02-01For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
        <A title="Flu Watch (Version PDF, 113 KB - 6 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/12-13/w04_13/pdf/fw2013-04-eng.pdf">FluWatch report: January 20 to January 26, 2013 (Week 4) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 113 <ABBR title=Kilobytes>KB</ABBR> - 8 pages)

        »» Help with PDF documents


        Overall Influenza Summary
        • In week 04, several indicators of influenza activity decreased: the percentage of positive laboratory tests for influenza, the ILI consultation rate, the proportion of antiviral prescriptions, and the number of adult and paediatric influenza-associated hospitalizations reported by the PCIRN-SOS and IMPACT networks.
        • Many regions across Canada continue to report widespread and localized influenza activity and 104 new influenza outbreaks were reported.
        • The ILI consultation rate decreased but continues to be above the expected range for this time of year.
        Influenza Activity (geographic spread) and Outbreaks

        In week 04, 7 regions [in BC(1), ON(2), QC(1) and NL(3)] reported widespread activity and 28 regions [in BC(1), AB(5), SK(1), MB(3), ON(5), QC(2), NB(6), NS(4), and PE(1)] reported localized activity (Figures 1 and 2). In week 04, 104 new influenza outbreaks were reported: 31 in long-term-care facilities, 6 in hospitals, 45 in schools, and 22 in other facilities or communities (Figure 3). The greater proportion of school outbreaks in week 04 may reflect the increasing circulation of influenza in regions where school surveillance is in place.
        Figure 1. Map of overall Influenza activity level by province and territory,
        Canada, Week 04





        Note: Influenza activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.
        Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
        Figure 2. Number of influenza surveillance regions<SUP title="sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in"></SUP> reporting widespread or localized influenza activity, Canada, by report week, 2012-2013 (N<SUP>*</SUP>=58)


        †sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.
        * Total number of influenza surveillance regions in Canada
        Text equivalent for figure 2Number of influenza surveillance regions reporting widespread or localized influenza activity, Canada, by report week, 2011-2012 (N=56)
        Figure 3. Overall Number of Influenza Outbreaks, Canada, by Report Week, 2012-2013


        Note that last year was the first year that provinces and territories were reporting on influenza outbreaks in schools (greater than 10% absenteeism on any day most likely due to ILI) which has increased considerably the total number of outbreaks reported compared to previous years.
        Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2011-2012

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        Influenza and Other Respiratory Virus Detections

        The percentage of positive influenza tests decreased from 26.5% in week 03 to 22.3% in week 04 (Figure 4). Among the influenza viruses detected in week 04 (n=1919), 96.5% were positive for influenza A viruses [of which 29.9% were A(H3), 4.1% were A(H1N1)pdm09, and 66.0% were A(unsubtyped)]; and 3.5% were positive for influenza B (Table 1). Cumulative influenza virus detections by type/subtype to date are as follows: 97.5% influenza A [35.5% A(H3), 2.2% A(H1N1)pdm09 and 62.3% A(unsubtyped)] and 2.5% influenza B (Table 1).
        Detailed information on age and type/subtype was received for 17,164 cases to date this season (Table 2). The proportions of cases by age group were as follows: 12.8% were < 5 years; 7.3% were between 5-19 years; 15.0% were between 20-44 years; 16.3% were between 45-64 years of age; 48.5% were ≥ 65 years.
        The percentage of tests positive for RSV increased from 12.0% in week 03 to 13.7% in week 04. The percentage of tests positive for rhinovirus (4.8%) and coronavirus (5.4%) were stable compared to the previous week. Other percentages of positive tests remained low in week 04: parainfluenza 2.3%; adenovirus 0.8%; hMPV 1.4% (Figure 5). For more details, see the weekly Respiratory Virus Detections in Canada Report.
        <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly & Cumulative numbers of positive influenza specimens
        by Provincial Laboratories, Canada, 2012-2013
        </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces</TH><TH id=ac1 colSpan=6>Weekly
        (January 20 to January 26, 2013)
        </TH><TH id=ac9 colSpan=6>Cumulative
        (August 26, 2012 to January 26, 2013)
        </TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=5 headers=ac1>Influenza A</TH><TH id=ac8 headers=ac1>Influenza
        B
        </TH><TH id=ac10 colSpan=5 headers=ac9>Influenza A</TH><TH id=ac16 headers=ac9>Influenza
        B
        </TH></TR><TR class=bg-colour-yellow><TH id=ac3 headers=ac2>A Total</TH><TH id=ac4 headers=ac2>A(H1)</TH><TH id=ac5 headers=ac2>A(H3)</TH><TH id=ac6 headers=ac2>Pand H1N1</TH><TH id=ac7 class=noWrap headers=ac2>A
        ( <ABBR title=unsubtyped>Un S</ABBR>)Table 1 note*
        </TH><TH headers="ac1 ac8">Total</TH><TH id=ac11 headers=ac10>A Total</TH><TH id=ac12 headers=ac10>A(H1)</TH><TH id=ac13 headers=ac10>A(H3)</TH><TH id=ac14 headers=ac10>Pand H1N1</TH><TH id=ac15 class=noWrap headers=ac10>A
        (Un S) Table 1 note*
        </TH><TH headers=ac16>Total</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13>* Unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available. Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Note: Weekly data is based on week of positive lab detection. Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals.</TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=bg-colour-yellow headers=ar1><ABBR title="British Columbia ">BC</ABBR></TH><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac3">292 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac5">144 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac6">16 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac7">132 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac8">23 </TD><TD class=alignCenter headers="ar1 ar2 ac9 ac10 ac11">1005 </TD><TD class=alignCenter headers="ar1 ar2 ac9 ac10 ac12">0 </TD><TD class=alignCenter headers="ar1 ar2 ac9 ac10 ac13">820 </TD><TD class=alignCenter headers="ar1 ar2 ac9 ac10 ac14">51 </TD><TD class=alignCenter headers="ar1 ar2 ac9 ac10 ac15">134 </TD><TD class=alignCenter headers="ar1 ar2 ac9 ac16">85 </TD></TR><TR><TH id=ar3 class=bg-colour-yellow headers=ar1><ABBR title=Alberta>AB</ABBR></TH><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac3">138 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac5">69 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac6">34 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac7">35 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac8">14 </TD><TD class=alignCenter headers="ar1 ar3 ac9 ac10 ac11">1976 </TD><TD class=alignCenter headers="ar1 ar3 ac9 ac10 ac12">0 </TD><TD class=alignCenter headers="ar1 ar3 ac9 ac10 ac13">1632 </TD><TD class=alignCenter headers="ar1 ar3 ac9 ac10 ac14">206 </TD><TD class=alignCenter headers="ar1 ar3 ac9 ac10 ac15">138 </TD><TD class=alignCenter headers="ar1 ar3 ac9 ac16">128 </TD></TR><TR><TH id=ar4 class=bg-colour-yellow headers=ar1><ABBR title=Saskatchewan>SK</ABBR></TH><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac3">56 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac5">39 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac6">0 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac7">17 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac8">4 </TD><TD class=alignCenter headers="ar1 ar4 ac9 ac10 ac11">662 </TD><TD class=alignCenter headers="ar1 ar4 ac9 ac10 ac12">0 </TD><TD class=alignCenter headers="ar1 ar4 ac9 ac10 ac13">438 </TD><TD class=alignCenter headers="ar1 ar4 ac9 ac10 ac14">5 </TD><TD class=alignCenter headers="ar1 ar4 ac9 ac10 ac15">219 </TD><TD class=alignCenter headers="ar1 ar4 ac9 ac16">42 </TD></TR><TR><TH id=ar5 class=bg-colour-yellow headers=ar1><ABBR title=Manitoba>MB</ABBR></TH><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac3">69 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac5">11 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac6">1 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac7">57 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac8">5 </TD><TD class=alignCenter headers="ar1 ar5 ac9 ac10 ac11">432 </TD><TD class=alignCenter headers="ar1 ar5 ac9 ac10 ac12">0 </TD><TD class=alignCenter headers="ar1 ar5 ac9 ac10 ac13">72 </TD><TD class=alignCenter headers="ar1 ar5 ac9 ac10 ac14">2 </TD><TD class=alignCenter headers="ar1 ar5 ac9 ac10 ac15">358 </TD><TD class=alignCenter headers="ar1 ar5 ac9 ac16">29 </TD></TR><TR><TH id=ar6 class=bg-colour-yellow headers=ar1><ABBR title=Ontario>ON</ABBR></TH><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac3">604 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac5">185 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac6">24 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac7">395 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac8">15 </TD><TD class=alignCenter headers="ar1 ar6 ac9 ac10 ac11">6803 </TD><TD class=alignCenter headers="ar1 ar6 ac9 ac10 ac12">0 </TD><TD class=alignCenter headers="ar1 ar6 ac9 ac10 ac13">3332 </TD><TD class=alignCenter headers="ar1 ar6 ac9 ac10 ac14">155 </TD><TD class=alignCenter headers="ar1 ar6 ac9 ac10 ac15">3316 </TD><TD class=alignCenter headers="ar1 ar6 ac9 ac16">112 </TD></TR><TR><TH id=ar7 class=bg-colour-yellow headers=ar1><ABBR title=Quebec>QC</ABBR>

        </TH><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac3">360 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac5">23 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac6">0 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac7">337 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac8">7 </TD><TD class=alignCenter headers="ar1 ar7 ac9 ac10 ac11">8847 </TD><TD class=alignCenter headers="ar1 ar7 ac9 ac10 ac12">0 </TD><TD class=alignCenter headers="ar1 ar7 ac9 ac10 ac13">527 </TD><TD class=alignCenter headers="ar1 ar7 ac9 ac10 ac14">16 </TD><TD class=alignCenter headers="ar1 ar7 ac9 ac10 ac15">8304 </TD><TD class=alignCenter headers="ar1 ar7 ac9 ac16">141 </TD></TR><TR><TH id=ar8 class=bg-colour-yellow headers=ar1><ABBR title="New Brunswick">NB</ABBR>

        </TH><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac3">236 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac5">46 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac6">0 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac7">190 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac8">0 </TD><TD class=alignCenter headers="ar1 ar8 ac9 ac10 ac11">720 </TD><TD class=alignCenter headers="ar1 ar8 ac9 ac10 ac12">0 </TD><TD class=alignCenter headers="ar1 ar8 ac9 ac10 ac13">428 </TD><TD class=alignCenter headers="ar1 ar8 ac9 ac10 ac14">15 </TD><TD class=alignCenter headers="ar1 ar8 ac9 ac10 ac15">277 </TD><TD class=alignCenter headers="ar1 ar8 ac9 ac16">2 </TD></TR><TR><TH id=ar9 class=bg-colour-yellow headers=ar1><ABBR title="Nova Scotia ">NS</ABBR>

        </TH><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac3">32 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac5">24 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac6">0 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac7">8 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac8">0 </TD><TD class=alignCenter headers="ar1 ar9 ac9 ac10 ac11">69 </TD><TD class=alignCenter headers="ar1 ar9 ac9 ac10 ac12">0 </TD><TD class=alignCenter headers="ar1 ar9 ac9 ac10 ac13">24 </TD><TD class=alignCenter headers="ar1 ar9 ac9 ac10 ac14">0 </TD><TD class=alignCenter headers="ar1 ar9 ac9 ac10 ac15">45 </TD><TD class=alignCenter headers="ar1 ar9 ac9 ac16">2 </TD></TR><TR><TH id=ar10 class=bg-colour-yellow headers=ar1><ABBR title="Prince Edward Island ">PE</ABBR>

        </TH><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac3">14 </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac5">13 </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac6">1 </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac7">0 </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac8">0 </TD><TD class=alignCenter headers="ar1 ar10 ac9 ac10 ac11">51 </TD><TD class=alignCenter headers="ar1 ar10 ac9 ac10 ac12">0 </TD><TD class=alignCenter headers="ar1 ar10 ac9 ac10 ac13">37 </TD><TD class=alignCenter headers="ar1 ar10 ac9 ac10 ac14">2 </TD><TD class=alignCenter headers="ar1 ar10 ac9 ac10 ac15">12 </TD><TD class=alignCenter headers="ar1 ar10 ac9 ac16">1 </TD></TR><TR><TH id=ar11 class=bg-colour-yellow headers=ar1><ABBR title="Newfoundland/Labrador ">NL</ABBR>

        </TH><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac3">50 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac6">0 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac7">50 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac8">0 </TD><TD class=alignCenter headers="ar1 ar11 ac9 ac10 ac11">440 </TD><TD class=alignCenter headers="ar1 ar11 ac9 ac10 ac12">0 </TD><TD class=alignCenter headers="ar1 ar11 ac9 ac10 ac13">152 </TD><TD class=alignCenter headers="ar1 ar11 ac9 ac10 ac14">0 </TD><TD class=alignCenter headers="ar1 ar11 ac9 ac10 ac15">288 </TD><TD class=alignCenter headers="ar1 ar11 ac9 ac16">1 </TD></TR><TR><TH id=ar12 class=bg-colour-yellow headers=ar1>Canada</TH><TD class=alignCenter headers="ar1 ar12 ac1 ac2 ac3">1851 </TD><TD class=alignCenter headers="ar1 ar12 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar12 ac1 ac2 ac5">554 </TD><TD class=alignCenter headers="ar1 ar12 ac1 ac2 ac6">76 </TD><TD class=alignCenter headers="ar1 ar12 ac1 ac2 ac7">1221 </TD><TD class=alignCenter headers="ar1 ar12 ac1 ac8">68 </TD><TD class=alignCenter headers="ar1 ar12 ac9 ac10 ac11">21005 </TD><TD class=alignCenter headers="ar1 ar12 ac9 ac10 ac12">0 </TD><TD class=alignCenter headers="ar1 ar12 ac9 ac10 ac13">7462 </TD><TD class=alignCenter headers="ar1 ar12 ac9 ac10 ac14">452 </TD><TD class=alignCenter headers="ar1 ar12 ac9 ac10 ac15">13091 </TD><TD class=alignCenter headers="ar1 ar12 ac9 ac16">543 </TD></TR></TBODY></TABLE>
        <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 2. Weekly & Cumulative numbers of positive influenza specimens by age groups
        reported through case-based laboratory reporting, Canada, 2012-2013 Table 2 note*
        </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups</TH><TH id=bc1 colSpan=5>Weekly
        (January 20 to January 26, 2013)
        </TH><TH id=bc8 colSpan=5>Cumulative
        (August 26, 2012 to January 26, 2013)
        </TH></TR><TR class=bg-colour-yellow><TH id=bc2 colSpan=4 headers=bc1>Influenza A</TH><TH id=bc7 headers=bc1>B</TH><TH id=bc9 colSpan=4 headers=bc8>Influenza A</TH><TH id=bc14 headers=bc8>B</TH></TR><TR class=bg-colour-yellow><TH id=bc3 headers=bc2>A Total</TH><TH id=bc4 headers=bc2>Pandemic H1N1</TH><TH id=bc5 headers=bc2>A/H3N2</TH><TH id=bc6 headers=bc2>A unsubtyped</TH><TH headers="bc1 bc7">Total</TH><TH id=bc10 headers=bc9>A Total</TH><TH id=bc11 headers=bc9>Pandemic H1N1</TH><TH id=bc12 headers=bc9>A/H3N2</TH><TH id=bc13 headers=bc9>A unsubtyped</TH><TH headers=bc14>Total</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11>* Please note that this table reflects the number of specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported. Delays in the reporting of data may cause data to change retrospectively. </TD></TR></TFOOT><TBODY><TR><TH id=br2 headers=br1><5</TH><TD class=alignCenter headers="br1 br2 bc1 bc2 bc3">108 </TD><TD class=alignCenter headers="br1 br2 bc1 bc2 bc4">10 </TD><TD class=alignCenter headers="br1 br2 bc1 bc2 bc5">24 </TD><TD class=alignCenter headers="br1 br2 bc1 bc2 bc6">74 </TD><TD class=alignCenter headers="br1 br2 bc1 bc7">5 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc10">2110 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc11">89 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc12">722 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc13">1299 </TD><TD class=alignCenter headers="br1 br2 bc8 bc14">94 </TD></TR><TR><TH id=br3 headers=br1>5-19</TH><TD class=alignCenter headers="br1 br3 bc1 bc2 bc3">80 </TD><TD class=alignCenter headers="br1 br3 bc1 bc2 bc4">3 </TD><TD class=alignCenter headers="br1 br3 bc1 bc2 bc5">15 </TD><TD class=alignCenter headers="br1 br3 bc1 bc2 bc6">62 </TD><TD class=alignCenter headers="br1 br3 bc1 bc7">15 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc10">1152 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc11">26 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc12">515 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc13">611 </TD><TD class=alignCenter headers="br1 br3 bc8 bc14">97 </TD></TR><TR><TH id=br4 headers=br1>20-44</TH><TD class=alignCenter headers="br1 br4 bc1 bc2 bc3">135 </TD><TD class=alignCenter headers="br1 br4 bc1 bc2 bc4">10 </TD><TD class=alignCenter headers="br1 br4 bc1 bc2 bc5">33 </TD><TD class=alignCenter headers="br1 br4 bc1 bc2 bc6">92 </TD><TD class=alignCenter headers="br1 br4 bc1 bc7">12 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc10">2494 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc11">117 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc12">1002 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc13">1375 </TD><TD class=alignCenter headers="br1 br4 bc8 bc14">86 </TD></TR><TR><TH id=br5 headers=br1>45-64</TH><TD class=alignCenter headers="br1 br5 bc1 bc2 bc3">140 </TD><TD class=alignCenter headers="br1 br5 bc1 bc2 bc4">15 </TD><TD class=alignCenter headers="br1 br5 bc1 bc2 bc5">25 </TD><TD class=alignCenter headers="br1 br5 bc1 bc2 bc6">100 </TD><TD class=alignCenter headers="br1 br5 bc1 bc7">4 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc10">2740 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc11">114 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc12">986 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc13">1640 </TD><TD class=alignCenter headers="br1 br5 bc8 bc14">64 </TD></TR><TR><TH id=br6 headers=br1>65+</TH><TD class=alignCenter headers="br1 br6 bc1 bc2 bc3">306 </TD><TD class=alignCenter headers="br1 br6 bc1 bc2 bc4">2 </TD><TD class=alignCenter headers="br1 br6 bc1 bc2 bc5">86 </TD><TD class=alignCenter headers="br1 br6 bc1 bc2 bc6">218 </TD><TD class=alignCenter headers="br1 br6 bc1 bc7">4 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc10">8230 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc11">47 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc12">3064 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc13">5119 </TD><TD class=alignCenter headers="br1 br6 bc8 bc14">97 </TD></TR><TR><TH id=br7 headers=br1>Unknown</TH><TD class=alignCenter headers="br1 br7 bc1 bc2 bc3">7 </TD><TD class=alignCenter headers="br1 br7 bc1 bc2 bc4">0 </TD><TD class=alignCenter headers="br1 br7 bc1 bc2 bc5">6 </TD><TD class=alignCenter headers="br1 br7 bc1 bc2 bc6">1 </TD><TD class=alignCenter headers="br1 br7 bc1 bc7">0 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc10">135 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc11">6 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc12">126 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc13">3 </TD><TD class=alignCenter headers="br1 br7 bc8 bc14">0 </TD></TR><TR><TH id=br8 headers=br1>Total</TH><TD class=alignCenter headers="br1 br8 bc1 bc2 bc3">776 </TD><TD class=alignCenter headers="br1 br8 bc1 bc2 bc4">40 </TD><TD class=alignCenter headers="br1 br8 bc1 bc2 bc5">189 </TD><TD class=alignCenter headers="br1 br8 bc1 bc2 bc6">547 </TD><TD class=alignCenter headers="br1 br8 bc1 bc7">40 </TD><TD class=alignCenter headers="br1 br8 bc8 bc9 bc10">16861 </TD><TD class=alignCenter headers="br1 br8 bc8 bc9 bc11">399 </TD><TD class=alignCenter headers="br1 br8 bc8 bc9 bc12">6415 </TD><TD class=alignCenter headers="br1 br8 bc8 bc9 bc13">10047 </TD><TD class=alignCenter headers="br1 br8 bc8 bc14">438 </TD></TR></TBODY></TABLE>


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        Figure 4. Influenza tests reported and percentage of tests positive, Canada,
        by report week, 2012-2013


        Text equivalent for figure 4Influenza tests reported and percentage of tests positive, Canada, by report week, 2011-2012
        Figure 5. Percent positive influenza tests, compared to other respiratory viruses,
        Canada, by reporting week, 2012-2013


        Text equivalent for figure 5Percent positive influenza tests, compared to other respiratory viruses, Canada, by reporting week, 2011-2012

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        Influenza strain characterizations

        During the 2012-13 season, the National Microbiology Laboratory (NML) has antigenically characterized 372 influenza viruses [269 A(H3N2), 45 A(H1N1)pdm09 , and 58 influenza B]. The 269 influenza A(H3N2) viruses were antigenically similar to the vaccine strain A/Victoria/361/2011 and the 45 A(H1N1)pdm09 viruses were antigenically similar to the vaccine strain A/California/07/09. Among the influenza B viruses, 47 were antigenically similar to the vaccine strain B/Wisconsin/01/2010 (Yamagata lineage) and 11 were similar to B/Brisbane/60/2008 (Victoria lineage; component of the 2011-2012 seasonal influenza vaccine) (Figure 6).
        Figure 6. Influenza strain characterizations, Canada, 2012-2013, N = 372

        Note:The recommended components for the 2012-2013 Northern Hemisphere influenza vaccine include: an A/Victoria/361/2011 (H3N2)-like virus; an A/California/7/2009 (H1N1)pdm09-like virus; and a B/Wisconsin/1/2010-like virus.
        Text equivalent for figure 6Influenza strain characterizations, Canada, 2011-2012

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        Antiviral resistance

        During the 2012-13 season, NML has tested 329 influenza viruses for resistance to oseltamivir, and 328 influenza viruses for resistance to zanamivir. All viruses tested were sensitive to oseltamivir and zanamivir. A total of 479 influenza A viruses were tested for amantadine resistance and all were resistant (Table 3).


        <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2012-2013</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=cr1 rowSpan=2>Virus type and subtype</TH><TH id=cc1 colSpan=2>Oseltamivir</TH><TH id=cc4 colSpan=2>Zanamivir</TH><TH id=cc7 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=cc2 headers=cc1># tested</TH><TH id=cc3 headers=cc1># resistant (%)</TH><TH id=cc5 headers=cc4># tested</TH><TH id=cc6 headers=cc4># resistant (%)</TH><TH id=cc8 headers=cc7># tested</TH><TH id=cc9 headers=cc7># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=cr2 class="alignLeft bg-colour-blue" headers=cr1>A (H3N2)</TH><TD class=alignCenter headers="cr2 cc2">241</TD><TD class=alignCenter headers="cr2 cc3">0</TD><TD class=alignCenter headers="cr2 cc5">241</TD><TD class=alignCenter headers="cr2 cc6">0</TD><TD class=alignCenter headers="cr2 cc8">437</TD><TD class=alignCenter headers="cr2 cc9">437 (100%)</TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignCenter headers="cr3 cc2">40</TD><TD class=alignCenter headers="cr3 cc3">0</TD><TD class=alignCenter headers="cr3 cc5">39</TD><TD class=alignCenter headers="cr3 cc6">0</TD><TD class=alignCenter headers="cr3 cc8">42</TD><TD class=alignCenter headers="cr3 cc9">42</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignCenter headers="cr4 cc2">48</TD><TD class=alignCenter headers="cr4 cc3">0</TD><TD class=alignCenter headers="cr4 cc5">48</TD><TD class=alignCenter headers="cr4 cc6">0</TD><TD class=alignCenter headers="cr4 cc8">NA <SUP>*</SUP></TD><TD class=alignCenter headers="cr4 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft bg-colour-blue" headers=cr1>TOTAL</TH><TD class=alignCenter headers="cr5 cc2">329</TD><TD class=alignCenter headers="cr5 cc3">0</TD><TD class=alignCenter headers="cr5 cc5">328</TD><TD class=alignCenter headers="cr5 cc6">0</TD><TD class=alignCenter headers="cr5 cc8">479</TD><TD class=alignCenter headers="cr5 cc9">479 (100%)</TD></TR></TBODY></TABLE>
        Influenza-like Illness (ILI) Consultation Rate

        The national influenza-like-illness (ILI) consultation rate decreased from 43.8 ILI consultations per 1,000 patient visits in week 03 to 40.3 in week 04. This rate is above the expected level for this time of year (between 22.4 and 31.7 ILI consultations per 1,000 visits) (Figure 7). The elevated ILI consultation rate relative to the expected range for this time of year may be due to the unusually early influenza season, as well as continued circulation of influenza and RSV across Canada. In week 04, the highest consultation rates were observed in children 5-19 years of age (64.6/1,000) followed by children <5 years of age (58.1/1,000).
        Figure 7. Influenza-like illness (ILI) consultation rates, Canada, by report week, 2012-2013 compared to 1996/97 through to 2011/12 seasons (with pandemic data suppressed)



        Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons). Delays in the reporting of data may cause data to change retrospectively.
        Text equivalent for figure 7Influenza-like illness (ILI) consultation rates, Canada, by report week, 2011-2012 compared to 1996/97 through to 2010/11 seasons (with pandemic data suppressed)
        Pharmacy Surveillance

        The Canadian antiviral prescription rate decreased from 294.7 antiviral prescriptions per 100,000 new prescriptions dispensed in week 03 to 214.1 in week 04. In week 04, the antiviral prescription rate decreased for all age groups. The highest rate continued to be observed for seniors ≥65 years of age, at 436.7/100,000. The current proportion of antiviral prescriptions of 214.1/100,000 is higher than the rate observed during the peak period of influenza activity last year (50-100/100,000). Since week 01, the proportion of antiviral prescriptions has followed the downward trend in the percentage of positive laboratory tests for influenza.
        Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group.
        Severe Respiratory Illness Surveillance

        Paediatric Influenza Hospitalizations and Deaths (IMPACT)
        In week 04, 30 new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 52 in week 03. Among the 29 cases identified with influenza A, 26 (89.7%) were A(unsubtyped), 2 (6.9%) were A(H3N2) and 1 (3.4%) were A(H1N1)pdm09. One case was identified with influenza B. The age distribution is as follows: 4 cases (13.3%) under 6 months of age, 9 (30.0%) between 6-23 months, 5 (16.7%) 2-4 years of age, 8 (26.7%) 5-9 years of age, and 4 (13.3%) 10-16 years of age. Two ICU admissions were reported during this week, one case 6-23 months of age and one case 5-9 years of age.
        Since the start of the 2012-13 season, a total of 490 influenza-associated paediatric hospitalizations have been reported by the IMPACT network: 472 (96.3%) with influenza A [of which 62 (13.1%) were A(H3N2), 8 (1.7%) were A(H1N1)pdm09 and 402 (85.2%) were A(unsubtyped)], and 18 (3.7%) with influenza B. The distribution of cases by age group is as follows: 104 (21.2%) <6 months of age; 117 (23.9%) age 6-23 months; 144 (29.4%) age 2-4 years; 83 (16.9%) age 5-9 years; and 42 (8.6%) age 10-16 years. Forty-two of the 490 cases (8.6%) were admitted to the ICU. No deaths have been reported to date.

        Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada.

        Adult Influenza Hospitalizations and Deaths (PCIRN)
        In week 04, 44 new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 57 in week 03. The age distribution is as follows: 23 cases (52.3%) were ≥65 years of age, 12 cases (27.3%) were 45-64 years of age, and 9 cases (20.5%) were 20-44 years of age. Among the 41 cases identified with influenza A, one was A(H3N2), and the rest were A(unsubtyped). Two cases were identified with influenza B, and in one case the influenza type has yet to be reported. Five ICU admissions were reported during the current week. Four had influenza A(unsubtyped), and the fifth had influenza B. Three of the ICU admissions were individuals ≥65 years of age, one was 45-64 years of age, and one was 20-44 years of age. One death was reported with influenza A(unsubtyped) in an individual ≥65 years of age.

        From November 4, 2012 to January 26, 2013, a total of 685 influenza-associated adult hospitalizations were reported by the PCIRN-SOS network: 647 (94.5%) with influenza A [of which 57 (8.8%) were A(H3N2), 4 (0.6%) were A(H1N1)pdm09, and 586 (90.6%) were A(unsubtyped)]; 14 (2.0%) with influenza B, and the type has not been reported for 24 (3.5%) cases. Among the 683 cases with available data, the distribution of cases by age group is as follows: 465 cases (68.1%) were aged ≥65 years, 144 cases (21.1%) were aged 45-64 years, 71 cases (10.4%) were aged 20-44 years, and 3 cases (0.4%) were <20 years of age. Fifty-nine of the 685 cases (8.6%) were admitted to the ICU. Among the 57 cases with available data: 34 (59.6%) were in adults ≥65 years of age, 16 (28.1%) were 45-64 years of age, and 7 (12.3%) were 20-44 years of age. Of the 59 ICU admissions, 15 cases (25.4%) had at least one co-morbidity, 2 (3.4%) had no co-morbidities, and 42 (71.2%) had no available information to date. A total of 34 deaths have been reported, 3 (8.8%) with influenza A(H3N2), and the remaining 31 (91.2%) with influenza A(unsubtyped). Thirty of the 34 deaths (88.2%) were in adults ≥65 years of age, three (8.8%) were 45-64 years of age, and one (2.9%) was 20-44 years of age. Nine deaths occurred in individuals who had at least one co-morbidity. Detailed clinical information on comorbidities is not known for the remaining 25 cases.

        Note: The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated adult hospitalizations in Canada.

        Provincial/Territorial Influenza Hospitalizations and Deaths (Aggregate Surveillance System)
        The number of laboratory confirmed influenza associated hospitalizations declined in week 04 to 472 (from 583 in week 03)*. The majority of cases were influenza A (97.7%), predominately A(H3). More than half of the cases (62.1%, 293/472) were ≥65 years of age. Of the 104 cases with available data, 12 (11.5%) were admitted to the Intensive Care Unit (ICU). Thirty-four deaths were reported in week 04: 30 (88.2%) were persons ≥65 years of age; 2 (5.9%) were adults 45-64 years of age and 2 (5.9%) were adults 20-44 years of age. It is important to note that the cause of death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.
        To date this season, 2732 influenza-associated hospitalizations have been reported. Of these, 97.7% (2671/2732) have been influenza A, predominately A(H3) [95.0% (1228/1293) of subtyped influenza A]; and 2.2% have been influenza B. More than half (58.1%) of the 2730 cases with available age were ≥65 years of age; 16.5% were 45-64 years; 8.5% were 20-44 years; 1.1% were 15-19 years; 2.9% were children aged 5-14 years and 12.9% were children 0-4 years of age. Among the 625 cases with available data, there have been 66 hospitalisations for which admission to ICU was required; the highest proportions were among adults ≥65 years of age (37.9%), and between 45 and 64 years of age (33.3%). To date this season, 182 deaths have been reported: 83.5% were persons ≥65 years of age, 11.0% were adults 45-64 years; 3.3% were adults 20-44 years and 2.2% were children 0-4 years of age. It is important to note that the cause of death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.

        Note: * The number of new influenza-associated hospitalizations and deaths reported by the Aggregate Surveillance System each week may be overestimated, as it may include retrospective updates to data from Ontario for previous weeks. These data may also include cases reported by the IMPACT and PCIRN networks. Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, NS, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not reported in Ontario.

        .../
        http://www.phac-aspc.gc.ca/fluwatch/.../index-eng.php
        "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
        -Nelson Mandela

        Comment


        • #19
          Re: Canada FluWatch Weekly Reports 2012-2013 Season Week 4

          FluWatch report: January 27 to February 2, 2013 (Week 5)

          Posted 2013-02-08For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
          <A title="Flu Watch (Version PDF, 113 KB - 6 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/12-13/w05_13/pdf/fw2013-05-eng.pdf">FluWatch report: January 27 to February 2, 2013 (Week 5) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 113 <ABBR title=Kilobytes>KB</ABBR> - 8 pages)

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          Overall Influenza Summary
          • In week 05, the percentage of laboratory detections positive for influenza was similar to the previous week; the percentage of tests positive for RSV increased sharply.
          • Many regions across Canada continue to report widespread and localized influenza activity and 99 new influenza outbreaks were reported.
          • The ILI consultation rate increased and remains above the expected range for this time of year.
          • The number of paediatric influenza-associated hospitalizations reported by the IMPACT network increased whereas the number of hospitalizations reported by the provinces and territories decreased.
          Influenza Activity (geographic spread) and Outbreaks

          In week 05, 5 regions [in BC(1), ON(1) and NL(3)] reported widespread activity and 32 regions [in BC(3), AB(5), SK(1), MB(3), ON(6), QC(4), NB(5), NS(3), NL(1) and NU(1)] reported localized activity (Figures 1 and 2). In week 05, 99 new influenza outbreaks were reported: 30 in long-term-care facilities, 3 in hospitals, 41 in schools, and 25 in other facilities or communities (Figure 3).
          Figure 1. Map of overall Influenza activity level by province and territory,
          Canada, Week 05





          Note: Influenza activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.
          Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
          Figure 2. Number of influenza surveillance regions<SUP title="sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in"></SUP> reporting widespread or localized influenza activity, Canada, by report week, 2012-2013 (N<SUP>*</SUP>=58)


          †sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.
          * Total number of influenza surveillance regions in Canada
          Text equivalent for figure 2Number of influenza surveillance regions reporting widespread or localized influenza activity, Canada, by report week, 2011-2012 (N=56)
          Figure 3. Overall Number of Influenza Outbreaks, Canada, by Report Week, 2012-2013


          Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2011-2012

          Top of Page

          Influenza and Other Respiratory Virus Detections

          The percentage of positive influenza tests was stable at 22.4% in week 05 (Figure 4). Among the influenza viruses detected in week 05 (n=1,598), 94.6% were positive for influenza A viruses [of which 24.0% were A(H3), 5.8% were A(H1N1)pdm09, and 70.2% were A(unsubtyped)]; and 5.4% were positive for influenza B (Table 1). Cumulative influenza virus detections by type/subtype to date are as follows: 97.3% influenza A [34.8% A(H3), 2.5% A(H1N1)pdm09 and 62.7% A(unsubtyped)] and 2.7% influenza B (Table 1).
          Detailed information on age and type/subtype was received for 18,114 cases to date this season (Table 2). The proportions of cases by age group were as follows: 13.1% were < 5 years; 7.6% were between 5-19 years; 15.1% were between 20-44 years; 16.5% were between 45-64 years of age; 47.8% were ≥ 65 years.
          The percentage of tests positive for RSV increased sharply from 14.0% in week 04 to 17.2% in week 05. The percentage of tests positive for rhinovirus increased from 5.3% in week 04 to 6.4% in week 05. The percentage of tests positive for coronavirus also increased from 5.5% in week 04 to 5.9% in week 05. Other percentages of positive tests remained low, but also increased in week 05: parainfluenza 2.6%; adenovirus 1.3%; hMPV 1.6% (Figure 5). For more details, see the weekly Respiratory Virus Detections in Canada Report.
          <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly & Cumulative numbers of positive influenza specimens
          by Provincial Laboratories, Canada, 2012-2013

          </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces</TH><TH id=ac1 colSpan=6>Weekly
          (January 27 to February 2, 2013)

          </TH><TH id=ac9 colSpan=6>Cumulative
          (August 26, 2012 to February 2, 2013)

          </TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=5 headers=ac1>Influenza A</TH><TH id=ac8 headers=ac1>Influenza
          B

          </TH><TH id=ac10 colSpan=5 headers=ac9>Influenza A</TH><TH id=ac16 headers=ac9>Influenza
          B

          </TH></TR><TR class=bg-colour-yellow><TH id=ac3 headers=ac2>A Total</TH><TH id=ac4 headers=ac2>A(H1)</TH><TH id=ac5 headers=ac2>A(H3)</TH><TH id=ac6 headers=ac2>Pand H1N1</TH><TH id=ac7 class=noWrap headers=ac2>A
          ( <ABBR title=unsubtyped>Un S</ABBR>)Table 1 note*

          </TH><TH headers="ac1 ac8">Total</TH><TH id=ac11 headers=ac10>A Total</TH><TH id=ac12 headers=ac10>A(H1)</TH><TH id=ac13 headers=ac10>A(H3)</TH><TH id=ac14 headers=ac10>Pand H1N1</TH><TH id=ac15 class=noWrap headers=ac10>A
          (Un S) Table 1 note*

          </TH><TH headers=ac16>Total</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13>* Unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available. Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Note: Weekly data is based on week of positive lab detection. Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals.</TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=bg-colour-yellow headers=ar1><ABBR title="British Columbia ">BC</ABBR></TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">255</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">135</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">23</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac7">97</TD><TD class=alignRight headers="ar1 ar2 ac1 ac8">10</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac11">1260</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac13">955</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac14">74</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac15">231</TD><TD class=alignRight headers="ar1 ar2 ac9 ac16">95</TD></TR><TR><TH id=ar3 class=bg-colour-yellow headers=ar1><ABBR title=Alberta>AB</ABBR></TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">99</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">44</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">25</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac7">30</TD><TD class=alignRight headers="ar1 ar3 ac1 ac8">17</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac11">2080</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac13">1688</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac14">249</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac15">143</TD><TD class=alignRight headers="ar1 ar3 ac9 ac16">146</TD></TR><TR><TH id=ar4 class=bg-colour-yellow headers=ar1><ABBR title=Saskatchewan>SK</ABBR></TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">33</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">15</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">5</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac7">13</TD><TD class=alignRight headers="ar1 ar4 ac1 ac8">13</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac11">695</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac13">453</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac14">10</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac15">232</TD><TD class=alignRight headers="ar1 ar4 ac9 ac16">55</TD></TR><TR><TH id=ar5 class=bg-colour-yellow headers=ar1><ABBR title=Manitoba>MB</ABBR></TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">67</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">3</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">1</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac7">63</TD><TD class=alignRight headers="ar1 ar5 ac1 ac8">5</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac11">499</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac13">75</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac14">3</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac15">421</TD><TD class=alignRight headers="ar1 ar5 ac9 ac16">34</TD></TR><TR><TH id=ar6 class=bg-colour-yellow headers=ar1><ABBR title=Ontario>ON</ABBR></TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">353</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">113</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">30</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac7">210</TD><TD class=alignRight headers="ar1 ar6 ac1 ac8">24</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac11">7155</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac13">3448</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac14">186</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac15">3521</TD><TD class=alignRight headers="ar1 ar6 ac9 ac16">136</TD></TR><TR><TH id=ar7 class=bg-colour-yellow headers=ar1><ABBR title=Quebec>QC</ABBR>


          </TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">240</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">10</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">4</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac7">226</TD><TD class=alignRight headers="ar1 ar7 ac1 ac8">15</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac11">9087</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac13">537</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac14">20</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac15">8530</TD><TD class=alignRight headers="ar1 ar7 ac9 ac16">156</TD></TR><TR><TH id=ar8 class=bg-colour-yellow headers=ar1><ABBR title="New Brunswick">NB</ABBR>


          </TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">310</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac7">310</TD><TD class=alignRight headers="ar1 ar8 ac1 ac8">1</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac11">1030</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac13">428</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac14">15</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac15">587</TD><TD class=alignRight headers="ar1 ar8 ac9 ac16">3</TD></TR><TR><TH id=ar9 class=bg-colour-yellow headers=ar1><ABBR title="Nova Scotia ">NS</ABBR>


          </TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">51</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">43</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac7">8</TD><TD class=alignRight headers="ar1 ar9 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac11">120</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac13">67</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac14">0</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac15">53</TD><TD class=alignRight headers="ar1 ar9 ac9 ac16">2</TD></TR><TR><TH id=ar10 class=bg-colour-yellow headers=ar1><ABBR title="Prince Edward Island ">PE</ABBR>


          </TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">15</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac7">15</TD><TD class=alignRight headers="ar1 ar10 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac11">66</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac13">37</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac14">2</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac15">27</TD><TD class=alignRight headers="ar1 ar10 ac9 ac16">1</TD></TR><TR><TH id=ar11 class=bg-colour-yellow headers=ar1><ABBR title="Newfoundland/Labrador ">NL</ABBR>


          </TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">88</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac7">88</TD><TD class=alignRight headers="ar1 ar11 ac1 ac8">2</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac11">527</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac13">152</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac14">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac15">375</TD><TD class=alignRight headers="ar1 ar11 ac9 ac16">4</TD></TR><TR><TH id=ar12 class=bg-colour-yellow headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">1511</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac5">363</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac6">88</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac7">1060</TD><TD class=alignRight headers="ar1 ar12 ac1 ac8">87</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac11">22519</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac13">7840</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac14">559</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac15">14120</TD><TD class=alignRight headers="ar1 ar12 ac9 ac16">632</TD></TR></TBODY></TABLE>
          <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 2. Weekly & Cumulative numbers of positive influenza specimens by age groups
          reported through case-based laboratory reporting, Canada, 2012-2013 Table 2 note*

          </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups</TH><TH id=bc1 colSpan=5>Weekly
          (January 27 to February 2, 2013)

          </TH><TH id=bc8 colSpan=5>Cumulative
          (August 26, 2012 to February 2, 2013)

          </TH></TR><TR class=bg-colour-yellow><TH id=bc2 colSpan=4 headers=bc1>Influenza A</TH><TH id=bc7 headers=bc1>B</TH><TH id=bc9 colSpan=4 headers=bc8>Influenza A</TH><TH id=bc14 headers=bc8>B</TH></TR><TR class=bg-colour-yellow><TH id=bc3 headers=bc2>A Total</TH><TH id=bc4 headers=bc2>Pandemic H1N1</TH><TH id=bc5 headers=bc2>A/H3N2</TH><TH id=bc6 headers=bc2>A unsubtyped</TH><TH headers="bc1 bc7">Total</TH><TH id=bc10 headers=bc9>A Total</TH><TH id=bc11 headers=bc9>Pandemic H1N1</TH><TH id=bc12 headers=bc9>A/H3N2</TH><TH id=bc13 headers=bc9>A unsubtyped</TH><TH headers=bc14>Total</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11>* Please note that this table reflects the number of specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported. Delays in the reporting of data may cause data to change retrospectively.</TD></TR></TFOOT><TBODY><TR><TH id=br2 headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">101</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">5</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">17</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">79</TD><TD class=alignRight headers="br1 br2 bc1 bc7">8</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">2257</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">105</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">771</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1381</TD><TD class=alignRight headers="br1 br2 bc8 bc14">108</TD></TR><TR><TH id=br3 headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">59</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">2</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">4</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">53</TD><TD class=alignRight headers="br1 br3 bc1 bc7">11</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1256</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">34</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">566</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">656</TD><TD class=alignRight headers="br1 br3 bc8 bc14">116</TD></TR><TR><TH id=br4 headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">71</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">7</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">4</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">60</TD><TD class=alignRight headers="br1 br4 bc1 bc7">8</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">2633</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">155</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">1051</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">1427</TD><TD class=alignRight headers="br1 br4 bc8 bc14">98</TD></TR><TR><TH id=br5 headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">96</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">12</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">13</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">71</TD><TD class=alignRight headers="br1 br5 bc1 bc7">7</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">2904</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">151</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">1040</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">1713</TD><TD class=alignRight headers="br1 br5 bc8 bc14">76</TD></TR><TR><TH id=br6 headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">214</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">3</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">50</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">161</TD><TD class=alignRight headers="br1 br6 bc1 bc7">5</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">8555</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">55</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">3201</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">5299</TD><TD class=alignRight headers="br1 br6 bc8 bc14">111</TD></TR><TR><TH id=br7 headers=br1>Unknown</TH><TD class=alignRight headers="br1 br7 bc1 bc2 bc3">3</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc4">1</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc5">2</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc6">0</TD><TD class=alignRight headers="br1 br7 bc1 bc7">0</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc10">148</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">11</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">135</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">2</TD><TD class=alignRight headers="br1 br7 bc8 bc14">0</TD></TR><TR><TH id=br8 headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">544</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc4">30</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc5">90</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc6">424</TD><TD class=alignRight headers="br1 br8 bc1 bc7">39</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">17753</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc11">511</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc12">6764</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc13">10478</TD><TD class=alignRight headers="br1 br8 bc8 bc14">509</TD></TR></TBODY></TABLE>


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          Figure 4. Influenza tests reported and percentage of tests positive, Canada,
          by report week, 2012-2013


          Text equivalent for figure 4Influenza tests reported and percentage of tests positive, Canada, by report week, 2011-2012
          Figure 5. Percent positive influenza tests, compared to other respiratory viruses,
          Canada, by reporting week, 2012-2013


          Text equivalent for figure 5Percent positive influenza tests, compared to other respiratory viruses, Canada, by reporting week, 2011-2012

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          Influenza strain characterizations

          During the 2012-13 season, the National Microbiology Laboratory (NML) has antigenically characterized 425 influenza viruses [297 A(H3N2), 56 A(H1N1)pdm09 , and 72 influenza B]. The 297 influenza A(H3N2) viruses were antigenically similar to the vaccine strain A/Victoria/361/2011 and the 56 A(H1N1)pdm09 viruses were antigenically similar to the vaccine strain A/California/07/09. Among the influenza B viruses, 58 were antigenically similar to the vaccine strain B/Wisconsin/01/2010 (Yamagata lineage) and 14 were similar to B/Brisbane/60/2008 (Victoria lineage; component of the 2011-2012 seasonal influenza vaccine) (Figure 6).
          Figure 6. Influenza strain characterizations, Canada, 2012-2013, N = 425

          Note: The recommended components for the 2012-2013 Northern Hemisphere influenza vaccine include: an A/Victoria/361/2011 (H3N2)-like virus; an A/California/7/2009 (H1N1)pdm09-like virus; and a B/Wisconsin/1/2010-like virus.
          Text equivalent for figure 6Influenza strain characterizations, Canada, 2011-2012

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          Antiviral resistance

          During the 2012-13 season, NML has tested 397 influenza viruses for resistance to oseltamivir, and 396 influenza viruses for resistance to zanamivir. All viruses tested were sensitive to oseltamivir and zanamivir. A total of 545 influenza A viruses were tested for amantadine resistance and all were resistant (Table 3).


          <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2012-2013</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=cr1 rowSpan=2>Virus type and subtype</TH><TH id=cc1 colSpan=2>Oseltamivir</TH><TH id=cc4 colSpan=2>Zanamivir</TH><TH id=cc7 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=cc2 headers=cc1># tested</TH><TH id=cc3 headers=cc1># resistant (%)</TH><TH id=cc5 headers=cc4># tested</TH><TH id=cc6 headers=cc4># resistant (%)</TH><TH id=cc8 headers=cc7># tested</TH><TH id=cc9 headers=cc7># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=cr2 class="alignLeft bg-colour-blue" headers=cr1>A (H3N2)</TH><TD class=alignCenter headers="cr2 cc2">285</TD><TD class=alignCenter headers="cr2 cc3">0</TD><TD class=alignCenter headers="cr2 cc5">285</TD><TD class=alignCenter headers="cr2 cc6">0</TD><TD class=alignCenter headers="cr2 cc8">495</TD><TD class=alignCenter headers="cr2 cc9">495 (100%)</TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignCenter headers="cr3 cc2">52</TD><TD class=alignCenter headers="cr3 cc3">0</TD><TD class=alignCenter headers="cr3 cc5">51</TD><TD class=alignCenter headers="cr3 cc6">0</TD><TD class=alignCenter headers="cr3 cc8">50</TD><TD class=alignCenter headers="cr3 cc9">50</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignCenter headers="cr4 cc2">60</TD><TD class=alignCenter headers="cr4 cc3">0</TD><TD class=alignCenter headers="cr4 cc5">60</TD><TD class=alignCenter headers="cr4 cc6">0</TD><TD class=alignCenter headers="cr4 cc8">NA <SUP>*</SUP></TD><TD class=alignCenter headers="cr4 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft bg-colour-blue" headers=cr1>TOTAL</TH><TD class=alignCenter headers="cr5 cc2">397</TD><TD class=alignCenter headers="cr5 cc3">0</TD><TD class=alignCenter headers="cr5 cc5">396</TD><TD class=alignCenter headers="cr5 cc6">0</TD><TD class=alignCenter headers="cr5 cc8">407</TD><TD class=alignCenter headers="cr5 cc9">545 (100%)</TD></TR></TBODY></TABLE>
          Influenza-like Illness (ILI) Consultation Rate

          The national influenza-like-illness (ILI) consultation rate increased from 36.6 ILI consultations per 1,000 patient visits in week 04 to 53.7 in week 05. This rate remains above the expected level for this time of year (between 27.9 and 39.8 ILI consultations per 1,000 visits) for the sixth consecutive week (Figure 7). The elevated ILI consultation rate relative to the expected range for this time of year may be due to the continued circulation of influenza, combined with an increase in detections of RSV as well as other respiratory viruses across Canada. In week 05, the highest consultation rates were observed in children 5-19 years of age (89.6/1,000) followed by children <5 years of age (79.1/1,000).
          Figure 7. Influenza-like illness (ILI) consultation rates, Canada, by report week, 2012-2013 compared to 1996/97 through to 2011/12 seasons (with pandemic data suppressed)



          Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons). Delays in the reporting of data may cause data to change retrospectively.
          Text equivalent for figure 7Influenza-like illness (ILI) consultation rates, Canada, by report week, 2011-2012 compared to 1996/97 through to 2010/11 seasons (with pandemic data suppressed)
          Pharmacy Surveillance

          The Canadian antiviral prescription rate decreased from 213.7 antiviral prescriptions per 100,000 new prescriptions dispensed in week 04 to 186.6 in week 05; which continues to follow the downward trend in the percentage of positive laboratory tests for influenza. In week 05, the antiviral prescription rate was stable for infants, and decreased for children and adults. The highest rate continued to be observed for seniors ≥65 years of age, which increased in week 05 to 480.4/100,000. The current rate of antiviral prescriptions of 186.6/100,000 is higher than that observed during the peak period of influenza activity last year (50-100/100,000).
          Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group.

          Severe Respiratory Illness Surveillance

          Paediatric Influenza Hospitalizations and Deaths (IMPACT)

          In week 05, 46 new laboratory-confirmed, influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 34 in week 04. Among the 37 cases identified with influenza A, 33 (89.2%) were A(unsubtyped), 2 (5.4%) were A(H3N2) and 2 (5.4%) were A(H1N1)pdm09. Nine cases (19.6%) were identified with influenza B. The age distribution is as follows: 9 cases (19.6%) under 6 months of age, 7 (15.2%) between 6-23 months, 16 (34.8%) 2-4 years of age, 8 (17.4%) 5-9 years of age, and 6 (13.0%) 10-16 years of age. Two ICU admissions were reported during this week: one in a child 6-23 months of age with influenza A(unsubtyped), the other in a child 5-9 years of age with influenza B.

          Since the start of the 2012-13 season, a total of 542 influenza-associated paediatric hospitalizations have been reported by the IMPACT network: 515 (95.0%) with influenza A [of which 65 (12.6%) were A(H3N2), 10 (1.9%) were A(H1N1)pdm09 and 440 (85.4%) were A(unsubtyped)], and 27 (5.0%) with influenza B. The distribution of cases by age group is as follows: 115 (21.2%) <6 months of age; 125 (23.1%) age 6-23 months; 163 (30.1%) age 2-4 years; 91 (16.8%) age 5-9 years; and 48 (8.9%) age 10-16 years. Forty-nine of the 542 cases (9.0%) were admitted to the ICU. No deaths have been reported to date.
          Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associate paediatric hospitalizations in Canada.

          Adult Influenza Hospitalizations and Deaths (PCIRN)

          In week 05, 49 new laboratory-confirmed, influenza-associated adult (≥16 years of age) hospitalizations were reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 56 in week 04. The age distribution is as follows: 32 cases (65.3%) were ≥65 years of age, 12 cases (24.5%) were 45-64 years of age, 4 cases (8.2%) were 20-44 years of age, and 1 case (2.0%) was <20 years of age. Forty-five cases identified with influenza A(unsubtyped), one case identified with influenza B, and three cases have yet to report the influenza type. Three ICU admissions were reported during the current week, all with influenza A(unsubtyped). Two of the ICU admissions were individuals ≥65 years of age, and the third was an individual 45-64 years of age. Four deaths were reported and all were identified with influenza A(unsubtyped). Three individuals were ≥65 years of age, and one was 45-64 years of age.

          From November 4, 2012 to February 2, 2013, a total of 893 influenza-associated adult hospitalizations were reported by the PCIRN-SOS network: 847 (94.8%) with influenza A [of which 90 (10.6%) were A(H3N2), 5 (0.6%) were A(H1N1)pdm09, and 752 (88.8%) were A(unsubtyped)]; 18 (2.0%) with influenza B, and the type has not been reported for 28 (3.1%) cases. Among 892 cases with available data, the distribution of cases by age group is as follows: 609 cases (68.3%) were aged ≥65 years, 185 cases (20.7%) were aged 45-64 years, 94 cases (10.5%) were aged 20-44 years, and 4 cases (0.4%) were <20 years of age. Seventy-eight of the 893 cases (7.1%) were admitted to the ICU.
          The age distribution of the ICU cases is as follows: 47 (60.3%) were in adults ≥65 years of age, 22 (28.2%) were in adults 45-64 years of age, and 9 (11.5%) were in adults 20-44 years of age. Of the 78 ICU admissions, 21 (26.9%) had at least one co-morbidity, 2 (2.6%) had no co-morbidities, and 55 (70.5%) had no information to date. A total of 40 deaths have been reported, 3 (7.5%) with influenza A(H3N2), 36 (90.0%) with influenza A(unsubtyped), and one with influenza untyped. Thirty-four of the 40 deaths (85.0%) were in adults ≥65 years of age, five (12.5%) were adults 45-64 years of age, and one (2.5%) was 20-44 years of age. Twelve deaths occurred in individuals who had at least one co-morbidity. Detailed clinical information on co-morbidities is not known for the remaining 28 cases.

          Note: The number of hospitalizations reported through PCIRN represents a subset of all influenza-associate adult hospitalizations in Canada.
          Provincial/Territorial Influenza Hospitalizations and Deaths (Aggregate Surveillance System<SUP>*</SUP>)
          The number of laboratory-confirmed influenza-associated hospitalizations continued to decline in week 05 (275 compared to 472 in week 04*). The majority of cases were influenza A (96.7%), predominantly A(H3). Almost 60% of cases were ≥65 years of age (159/275). Of the 124 cases with available data, 18 (14.5%) were admitted to the ICU. Twenty-one deaths were reported in week 05: 17 were adults ≥65 years of age; three were adults 45-64 years of age and one was a child 0-4 years of age. It is important to note that the cause of death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.
          To date this season, 3,010 influenza-associated hospitalizations have been reported. Of these, 97.6% have been influenza A, predominately A(H3); and 2.4% have been influenza B. Age information was available for 3,008 cases. The age distribution is as follows: 57.9% ≥65 years; 16.3% 45-64 years; 8.5% 20-44 years; 1.0% 15-19; 3.0% 5-14 years and 13.3% 0-4 years of age. Among the 755 cases with available data, there have been 109 hospitalisations for which admission to ICU was required; the highest proportions were among adults ≥65 years of age (36.7%), and between 45 and 64 years of age (34.9%). To date this season, 203 deaths have been reported: 169 were persons ≥65 years of age, 23 were adults 45-64 years; 6 were adults 20-44 years and 5 were children 0-4 years of age. It is important to note that the cause of death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.
          * Note: The number of new influenza-associated hospitalizations and deaths reported by the Aggregate Surveillance System each week may be overestimated, as it may include retrospective updates to data from Ontario for previous weeks. These data may also include cases reported by the IMPACT and PCIRN networks. Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, NS, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not reported in Ontario.

          .../
          http://www.phac-aspc.gc.ca/fluwatch/.../index-eng.php
          "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
          -Nelson Mandela

          Comment


          • #20
            Re: Canada FluWatch Weekly Reports 2012-2013 Season Week 6

            FluWatch report: February 3 to February 9, 2013 (Week 6)

            Posted 2013-02-15For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
            <A title="Flu Watch (Version PDF, 113 KB - 6 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/12-13/w06_13/pdf/fw2013-06-eng.pdf">FluWatch report: February 3 to February 9, 2013 (Week 6) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 113 <ABBR title=Kilobytes>KB</ABBR> - 8 pages)

            »» Help with PDF documents


            Overall Influenza Summary
            • In week 06, the percentage of laboratory detections positive for influenza continued to decrease; whereas the percentage of tests positive for RSV continued to increase.
            • The number of regions reporting widespread and localized influenza activity decreased, with activity primarily in central and eastern regions of Canada. Fewer new influenza/ILI outbreaks were reported compared to the past 5 weeks.
            • The ILI consultation rate decreased and is now within the expected range for this time of year.
            • Both the number of paediatric influenza-associated hospitalizations reported by the IMPACT network and the number of hospitalizations reported by the provinces and territories decreased.
            Influenza Activity (geographic spread) and Outbreaks

            In week 06, 5 regions [in ON(1), QC(1) and NL(3)] reported widespread activity and 29 regions [in BC(2), AB(5), SK(2), MB(1), ON(5), QC(3), NB(5), NS(5), and PE(1)] reported localized activity (Figures 1 and 2). In week 06, 72 new influenza outbreaks were reported: 35 in long-term-care facilities, 3 in hospitals, 12 in schools, and 22 in other facilities or communities (Figure 3).
            Figure 1. Map of overall Influenza activity level by province and territory,
            Canada, Week 06





            Note: Influenza activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.
            Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
            Figure 2. Number of influenza surveillance regions<SUP title="sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in"></SUP> reporting widespread or localized influenza activity, Canada, by report week, 2012-2013 (N<SUP>*</SUP>=58)


            †sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.
            * Total number of influenza surveillance regions in Canada
            Text equivalent for figure 2Number of influenza surveillance regions reporting widespread or localized influenza activity, Canada, by report week, 2011-2012 (N=56)
            Figure 3. Overall Number of Influenza Outbreaks, Canada, by Report Week, 2012-2013


            Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2011-2012

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            Influenza and Other Respiratory Virus Detections

            The percentage of positive influenza tests decreased from 23.3% in week 05 to 19.6% in week 06 (Figure 4). Among the influenza viruses detected in week 06 (n=1,149), 90.7% were positive for influenza A viruses [of which 32.1% were A(H3), 7.6% were A(H1N1)pdm09, and 60.3% were A(unsubtyped)]. Although influenza B remains a very small percentage of laboratory detections, the proportion has increased over the past 3 weeks from 2.1% in week 03 to 9.3% in week 06 (Table 1). Cumulative influenza virus detections by type/subtype to date are as follows: 96.8% influenza A [35.5% A(H3), 2.9% A(H1N1)pdm09 and 61.6% A(unsubtyped)] and 3.2% influenza B (Table 1).

            Detailed information on age and type/subtype was received for 18,920 cases to date this season (Table 2). The proportion of cases by age group were as follows: 13.1% were < 5 years; 7.8% were between 5-19 years; 15.2% were between 20-44 years; 16.6% were between 45-64 years of age; 47.3% were ≥ 65 years.

            The percentage of tests positive for RSV continued to increase from 17.6% in week 05 to 19.9% in week 06. The percentage of tests positive for rhinovirus decreased from 6.5% in week 05 to 5.3% in week 06. The percentage of tests positive for coronavirus also decreased from 5.3% in week 05 to 4.8% in week 06. Other percentages of positive tests remained low in week 06: parainfluenza increased to 2.7%; hMPV increased to 2.4%; adenovirus decreased to 0.8% (Figure 5). For more details, see the weekly Respiratory Virus Detections in Canada Report.
            <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly & Cumulative numbers of positive influenza specimens
            by Provincial Laboratories, Canada, 2012-2013
            </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces</TH><TH id=ac1 colSpan=6>Weekly
            (February 3 to February 9, 2013)
            </TH><TH id=ac9 colSpan=6>Cumulative
            (August 26, 2012 to February 9, 2013)
            </TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=5 headers=ac1>Influenza A</TH><TH id=ac8 headers=ac1>Influenza
            B
            </TH><TH id=ac10 colSpan=5 headers=ac9>Influenza A</TH><TH id=ac16 headers=ac9>Influenza
            B
            </TH></TR><TR class=bg-colour-yellow><TH id=ac3 headers=ac2>A Total</TH><TH id=ac4 headers=ac2>A(H1)</TH><TH id=ac5 headers=ac2>A(H3)</TH><TH id=ac6 headers=ac2>Pand H1N1</TH><TH id=ac7 class=noWrap headers=ac2>A
            ( <ABBR title=unsubtyped>Un S</ABBR>)Table 1 note*
            </TH><TH headers="ac1 ac8">Total</TH><TH id=ac11 headers=ac10>A Total</TH><TH id=ac12 headers=ac10>A(H1)</TH><TH id=ac13 headers=ac10>A(H3)</TH><TH id=ac14 headers=ac10>Pand H1N1</TH><TH id=ac15 class=noWrap headers=ac10>A
            (Un S) Table 1 note*
            </TH><TH headers=ac16>Total</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13>* The specimen was typed as influenza A, but no result for subtyping was available. Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Note: Weekly data is based on week of positive lab detection. Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals. </TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=bg-colour-yellow headers=ar1><ABBR title="British Columbia ">BC</ABBR></TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">250</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">142</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">24</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac7">84</TD><TD class=alignRight headers="ar1 ar2 ac1 ac8">30</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac11">1886</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac13">1419</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac14">148</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac15">319</TD><TD class=alignRight headers="ar1 ar2 ac9 ac16">161</TD></TR><TR><TH id=ar3 class=bg-colour-yellow headers=ar1><ABBR title=Alberta>AB</ABBR></TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">83</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">38</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">24</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac7">21</TD><TD class=alignRight headers="ar1 ar3 ac1 ac8">14</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac11">2174</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac13">1741</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac14">286</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac15">147</TD><TD class=alignRight headers="ar1 ar3 ac9 ac16">164</TD></TR><TR><TH id=ar4 class=bg-colour-yellow headers=ar1><ABBR title=Saskatchewan>SK</ABBR></TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">32</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">7</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">7</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac7">18</TD><TD class=alignRight headers="ar1 ar4 ac1 ac8">19</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac11">727</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac13">460</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac14">17</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac15">250</TD><TD class=alignRight headers="ar1 ar4 ac9 ac16">74</TD></TR><TR><TH id=ar5 class=bg-colour-yellow headers=ar1><ABBR title=Manitoba>MB</ABBR></TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">38</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">3</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">1</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac7">34</TD><TD class=alignRight headers="ar1 ar5 ac1 ac8">1</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac11">537</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac13">78</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac14">4</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac15">455</TD><TD class=alignRight headers="ar1 ar5 ac9 ac16">35</TD></TR><TR><TH id=ar6 class=bg-colour-yellow headers=ar1><ABBR title=Ontario>ON</ABBR></TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">184</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">83</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">19</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac7">82</TD><TD class=alignRight headers="ar1 ar6 ac1 ac8">13</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac11">7396</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac13">3533</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac14">205</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac15">3658</TD><TD class=alignRight headers="ar1 ar6 ac9 ac16">151</TD></TR><TR><TH id=ar7 class=bg-colour-yellow headers=ar1><ABBR title=Quebec>QC</ABBR>

            </TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">167</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">4</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">3</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac7">160</TD><TD class=alignRight headers="ar1 ar7 ac1 ac8">30</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac11">9254</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac13">541</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac14">23</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac15">8690</TD><TD class=alignRight headers="ar1 ar7 ac9 ac16">186</TD></TR><TR><TH id=ar8 class=bg-colour-yellow headers=ar1><ABBR title="New Brunswick">NB</ABBR>

            </TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">144</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac7">144</TD><TD class=alignRight headers="ar1 ar8 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac11">1174</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac13">428</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac14">15</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac15">731</TD><TD class=alignRight headers="ar1 ar8 ac9 ac16">3</TD></TR><TR><TH id=ar9 class=bg-colour-yellow headers=ar1><ABBR title="Nova Scotia ">NS</ABBR>

            </TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">66</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">57</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">1</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac7">8</TD><TD class=alignRight headers="ar1 ar9 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac11">186</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac13">124</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac14">1</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac15">61</TD><TD class=alignRight headers="ar1 ar9 ac9 ac16">2</TD></TR><TR><TH id=ar10 class=bg-colour-yellow headers=ar1><ABBR title="Prince Edward Island ">PE</ABBR>

            </TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">12</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac5">1</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac7">11</TD><TD class=alignRight headers="ar1 ar10 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac11">78</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac13">47</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac14">3</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac15">28</TD><TD class=alignRight headers="ar1 ar10 ac9 ac16">1</TD></TR><TR><TH id=ar11 class=bg-colour-yellow headers=ar1><ABBR title="Newfoundland/Labrador ">NL</ABBR>

            </TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">66</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac7">66</TD><TD class=alignRight headers="ar1 ar11 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac11">593</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac13">152</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac14">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac15">441</TD><TD class=alignRight headers="ar1 ar11 ac9 ac16">4</TD></TR><TR><TH id=ar12 class=bg-colour-yellow headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">1042</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac5">335</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac6">79</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac7">628</TD><TD class=alignRight headers="ar1 ar12 ac1 ac8">107</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac11">24005</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac13">8523</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac14">702</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac15">14780</TD><TD class=alignRight headers="ar1 ar12 ac9 ac16">781</TD></TR></TBODY></TABLE>
            <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 2. Weekly & Cumulative numbers of positive influenza specimens by age groups
            reported through case-based laboratory reporting, Canada, 2012-2013 Table 2 note*
            </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups</TH><TH id=bc1 colSpan=5>Weekly
            (February 3 to February 9, 2013)
            </TH><TH id=bc8 colSpan=5>Cumulative
            (August 26, 2012 to February 9, 2013)
            </TH></TR><TR class=bg-colour-yellow><TH id=bc2 colSpan=4 headers=bc1>Influenza A</TH><TH id=bc7 headers=bc1>B</TH><TH id=bc9 colSpan=4 headers=bc8>Influenza A</TH><TH id=bc14 headers=bc8>B</TH></TR><TR class=bg-colour-yellow><TH id=bc3 headers=bc2>A Total</TH><TH id=bc4 headers=bc2>Pandemic H1N1</TH><TH id=bc5 headers=bc2>A/H3N2</TH><TH id=bc6 headers=bc2>A unsubtyped</TH><TH headers="bc1 bc7">Total</TH><TH id=bc10 headers=bc9>A Total</TH><TH id=bc11 headers=bc9>Pandemic H1N1</TH><TH id=bc12 headers=bc9>A/H3N2</TH><TH id=bc13 headers=bc9>A unsubtyped</TH><TH headers=bc14>Total</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11>* Please note that this table reflects the number of specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported. Delays in the reporting of data may cause data to change retrospectively.</TD></TR></TFOOT><TBODY><TR><TH id=br2 headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">63</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">10</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">7</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">46</TD><TD class=alignRight headers="br1 br2 bc1 bc7">19</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">2354</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">121</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">796</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1437</TD><TD class=alignRight headers="br1 br2 bc8 bc14">133</TD></TR><TR><TH id=br3 headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">27</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">1</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">3</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">23</TD><TD class=alignRight headers="br1 br3 bc1 bc7">24</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1321</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">44</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">597</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">680</TD><TD class=alignRight headers="br1 br3 bc8 bc14">152</TD></TR><TR><TH id=br4 headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">70</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">4</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">6</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">60</TD><TD class=alignRight headers="br1 br4 bc1 bc7">13</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">2760</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">180</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">1099</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">1481</TD><TD class=alignRight headers="br1 br4 bc8 bc14">121</TD></TR><TR><TH id=br5 headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">75</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">13</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">11</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">51</TD><TD class=alignRight headers="br1 br5 bc1 bc7">11</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">3046</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">178</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">1101</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">1767</TD><TD class=alignRight headers="br1 br5 bc8 bc14">91</TD></TR><TR><TH id=br6 headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">188</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">2</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">34</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">152</TD><TD class=alignRight headers="br1 br6 bc1 bc7">7</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">8822</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">60</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">3328</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">5434</TD><TD class=alignRight headers="br1 br6 bc8 bc14">120</TD></TR><TR><TH id=br7 headers=br1>Unknown</TH><TD class=alignRight headers="br1 br7 bc1 bc2 bc3">5</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc4">4</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc6">0</TD><TD class=alignRight headers="br1 br7 bc1 bc7">0</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc10">156</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">15</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">139</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">2</TD><TD class=alignRight headers="br1 br7 bc8 bc14">0</TD></TR><TR><TH id=br8 headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">428</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc4">34</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc5">62</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc6">332</TD><TD class=alignRight headers="br1 br8 bc1 bc7">74</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">18459</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc11">598</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc12">7060</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc13">10801</TD><TD class=alignRight headers="br1 br8 bc8 bc14">617</TD></TR></TBODY></TABLE>


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            Figure 4. Influenza tests reported and percentage of tests positive, Canada,
            by report week, 2012-2013


            Text equivalent for figure 4Influenza tests reported and percentage of tests positive, Canada, by report week, 2011-2012
            Figure 5. Percent positive influenza tests, compared to other respiratory viruses,
            Canada, by reporting week, 2012-2013


            Text equivalent for figure 5Percent positive influenza tests, compared to other respiratory viruses, Canada, by reporting week, 2011-2012

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            Influenza strain characterizations

            During the 2012-13 season, the National Microbiology Laboratory (NML) has antigenically characterized 513 influenza viruses. The 374 influenza A(H3N2) viruses were antigenically similar to the vaccine strain A/Victoria/361/2011 and the 60 A(H1N1)pdm09 viruses were antigenically similar to the vaccine strain A/California/07/09. Among the influenza B viruses, 64 were antigenically similar to the vaccine strain B/Wisconsin/01/2010 (Yamagata lineage) and 15 were similar to B/Brisbane/60/2008 (Victoria lineage; component of the 2011-2012 seasonal influenza vaccine) (Figure 6).
            Figure 6. Influenza strain characterizations, Canada, 2012-2013, N = 513

            Note: The recommended components for the 2012-2013 Northern Hemisphere influenza vaccine include: an A/Victoria/361/2011 (H3N2)-like virus; an A/California/7/2009 (H1N1)pdm09-like virus; and a B/Wisconsin/1/2010-like virus.
            Text equivalent for figure 6Influenza strain characterizations, Canada, 2011-2012

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            Antiviral resistance

            During the 2012-13 season, NML has tested 447 influenza viruses for resistance to oseltamivir, and 444 influenza viruses for resistance to zanamivir. All viruses tested were sensitive to oseltamivir and zanamivir. A total of 562 influenza A viruses were tested for amantadine resistance and all were resistant (Table 3).


            <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2012-2013</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=cr1 rowSpan=2>Virus type and subtype</TH><TH id=cc1 colSpan=2>Oseltamivir</TH><TH id=cc4 colSpan=2>Zanamivir</TH><TH id=cc7 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=cc2 headers=cc1># tested</TH><TH id=cc3 headers=cc1># resistant (%)</TH><TH id=cc5 headers=cc4># tested</TH><TH id=cc6 headers=cc4># resistant (%)</TH><TH id=cc8 headers=cc7># tested</TH><TH id=cc9 headers=cc7># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=cr2 class="alignLeft bg-colour-blue" headers=cr1>A (H3N2)</TH><TD class=alignCenter headers="cr2 cc2">319</TD><TD class=alignCenter headers="cr2 cc3">0</TD><TD class=alignCenter headers="cr2 cc5">318</TD><TD class=alignCenter headers="cr2 cc6">0</TD><TD class=alignCenter headers="cr2 cc8">511</TD><TD class=alignCenter headers="cr2 cc9">511 (100%)</TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignCenter headers="cr3 cc2">57</TD><TD class=alignCenter headers="cr3 cc3">0</TD><TD class=alignCenter headers="cr3 cc5">55</TD><TD class=alignCenter headers="cr3 cc6">0</TD><TD class=alignCenter headers="cr3 cc8">51</TD><TD class=alignCenter headers="cr3 cc9">51</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignCenter headers="cr4 cc2">71</TD><TD class=alignCenter headers="cr4 cc3">0</TD><TD class=alignCenter headers="cr4 cc5">71</TD><TD class=alignCenter headers="cr4 cc6">0</TD><TD class=alignCenter headers="cr4 cc8">NA <SUP>*</SUP></TD><TD class=alignCenter headers="cr4 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft bg-colour-blue" headers=cr1>TOTAL</TH><TD class=alignCenter headers="cr5 cc2">447</TD><TD class=alignCenter headers="cr5 cc3">0</TD><TD class=alignCenter headers="cr5 cc5">444</TD><TD class=alignCenter headers="cr5 cc6">0</TD><TD class=alignCenter headers="cr5 cc8">562</TD><TD class=alignCenter headers="cr5 cc9">562 (100%)</TD></TR></TBODY></TABLE>
            Influenza-like Illness (ILI) Consultation Rate

            The national influenza-like-illness (ILI) consultation rate decreased from 52.8 ILI consultations per 1,000 patient visits in week 05 to 34.9 in week 06. After 6 weeks with ILI rates above the expected level for this time of year, the rate in week 06 is within the expected range (Figure 7). In week 06, the highest consultation rate was observed in children 5-19 years of age (62.8/1,000) followed by nearly identical rates for children <5 years of age (30.9/1,000) and adults 20-64 years of age (30.0/1,000).
            Figure 7. Influenza-like illness (ILI) consultation rates, Canada, by report week, 2012-2013 compared to 1996/97 through to 2011/12 seasons (with pandemic data suppressed)



            Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons). Delays in the reporting of data may cause data to change retrospectively.
            Text equivalent for figure 7Influenza-like illness (ILI) consultation rates, Canada, by report week, 2011-2012 compared to 1996/97 through to 2010/11 seasons (with pandemic data suppressed)

            Pharmacy Surveillance

            The Canadian antiviral prescription rate decreased from 186.3 antiviral prescriptions per 100,000 new prescriptions dispensed in week 05 to 151.7 in week 06; which continues to follow the downward trend in the percentage of positive laboratory tests for influenza. In week 06, the antiviral prescription rate increased for infants, and decreased for other age-groups. The highest rate continued to be observed for seniors ≥65 years of age, which decreased in week 06 to 453.8/100,000.
            Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group.
            Severe Respiratory Illness Surveillance

            Paediatric Influenza Hospitalizations and Deaths (IMPACT)

            In week 06, 38 new laboratory-confirmed, influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 48 in week 05. Among the 30 cases identified with influenza A, 24 (80.0%) were A(unsubtyped), 2 (6.7%) were A(H3N2) and 4 (13.3%) were A(H1N1)pdm09. Eight cases (21.1%) were identified with influenza B. The age distribution is as follows: 7 cases (18.4%) under 6 months of age, 6 (15.8%) between 6-23 months, 15 (39.5%) 2-4 years of age, 8 (21.1%) 5-9 years of age, and 2 (5.3%) 10-16 years of age. Three ICU admissions were reported during this week.

            Since the start of the 2012-13 season, a total of 576 influenza-associated paediatric hospitalizations have been reported by the IMPACT network: 540 (93.8%) with influenza A [of which 66 (12.2%) were A(H3N2), 14 (2.6%) were A(H1N1)pdm09 and 460 (85.2%) were A(unsubtyped)], and 36 (6.3%) with influenza B. The distribution of cases by age group is as follows: 120 (20.8%) <6 months of age; 132 (22.9%) age 6-23 months; 175 (30.4%) age 2-4 years; 98 (17.0%) age 5-9 years; and 51 (8.9%) age 10-16 years. Fifty of the 576 cases (8.7%) were admitted to the ICU. No deaths have been reported to date.

            Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associate paediatric hospitalizations in Canada.

            Adult Influenza Hospitalizations and Deaths (PCIRN)
            In week 06, 40 new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 67 in week 05. Of the 39 cases with age information, the distribution is as follows: 24 cases (61.5%) were ≥65 years of age, 10 cases (25.6%) were 45-64 years of age, and 5 cases (12.8%) were 20-44 years of age. Thirty-six cases were identified with influenza A(unsubtyped), two cases with influenza B, and two cases have yet to report the influenza type. Three ICU admissions were reported during the current week, two with influenza A(unsubtyped) and one with influenza B. Of the ICU admissions, one individual was ≥65 years of age, one 45-64 years of age, and one 20-44 years of age. Two deaths were reported, both were ≥65 years of age with influenza A(unsubtyped).

            From November 4, 2012 to February 9, 2013, a total of 1,057 influenza-associated adult hospitalizations were reported by the PCIRN-SOS network: 1,001 (94.7%) with influenza A [of which 121 (12.1%) were A(H3N2), 5 (0.5%) were A(H1N1)pdm09, and 875 (87.4%) were A(unsubtyped)]; 23 (2.2%) with influenza B, and the type has not been reported for 33 (3.1%) cases. Among 1,056 with available data, the distribution of cases by age group is as follows: 721 cases (68.3%) were aged ≥65 years, 218 cases (20.6%) were aged 45-64 years, 113 cases (10.7%) were aged 20-44 years, and 4 cases (0.4%) were <20 years of age. Ninety-one of the 1,057 (8.6%) were admitted to the ICU; the majority of which were persons ≥65 years of age (58.2%). Of the 91 ICU admissions, 27 (29.7%) had at least one co-morbidity, 2 (2.2%) had no co-morbidities, and 62 (68.1%) had no information to date. A total of 45 deaths have been reported, 4 (8.9%) with influenza A(H3N2), 39 (86.7%) with influenza A(unsubtyped), one with influenza B (2.2%), and one (2.2%) with influenza untyped. Thirty-nine of the 45 deaths (86.7%) were in adults ≥65 years of age, five (11.1%) were adults 45-64 years of age, and one (2.2%) was 20-44 years of age. Eighteen deaths occurred in individuals who had at least one co-morbidity. Detailed clinical information on co-morbidities is not known for the remaining 27 cases.

            Note: The number of hospitalizations reported through PCIRN represents a subset of all influenza-associate adult hospitalizations in Canada.

            Provincial/Territorial Influenza Hospitalizations and Deaths (Aggregate Surveillance System<SUP>*</SUP>)

            The number of laboratory confirmed influenza associated hospitalizations continued to decline in week 06 (251 compared to 275 in week 05*). The majority of cases were influenza A (94.4%), predominately A(H3). Over half of cases were ≥65 years of age (131/251, 52.9%). Of the 82 cases with available data, 17 (20.7%) were admitted to the Intensive Care Unit (ICU). Twelve deaths were reported: 10 were adults ≥65 years of age; one 45-64 years of age and one 20-44 years of age. It is important to note that the cause of death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.

            To date this season, 3262 influenza-associated hospitalizations have been reported. Of these, 97.2% have been influenza A, predominately A(H3); and 2.8% have been influenza B. Age information was available for 3260 cases, and the age distribution is as follows: 57.4% ≥65 years; 16.4% 45-64 years; 8.5% 20-44 years; 1.0% 15-19; 3.3% 5-14 years and 13.3% 0-4 years of age. Among the 836 cases with available data, there have been 127 (15.2%) hospitalisations for which admission to ICU was required; the highest proportions were among adults aged 45-64 years of age (37.0%), and ≥65 years of age (34.6%). To date this season, 217 deaths have been reported: 180 (83.0%) were persons ≥65 years of age, 25 (11.5%) were adults 45-64 years; 7 (3.2%) were adults 20-44 years and 5 (2.3%) were children 0-4 years of age. It is important to note that the cause of death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.

            * Note: The number of new influenza-associated hospitalizations and deaths reported by the Aggregate Surveillance System each week may be overestimated, as it may include retrospective updates to data from Ontario for previous weeks. These data may also include cases reported by the IMPACT and PCIRN networks. Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, NS, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not reported in Ontario.

            .../
            http://www.phac-aspc.gc.ca/fluwatch/.../index-eng.php
            "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
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            Comment


            • #21
              Re: Canada FluWatch Weekly Reports 2012-2013 Season Week 7

              FluWatch report: February 10 to February 16, 2013 (Week 7)

              Posted 2013-02-22For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
              <A title="Flu Watch (Version PDF, 113 KB - 6 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/12-13/w07_13/pdf/fw2013-07-eng.pdf">FluWatch report: February 10 to February 16, 2013 (Week 7) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 113 <ABBR title=Kilobytes>KB</ABBR> - 8 pages)

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              Overall Influenza Summary
              • In week 07, several indicators of influenza circulation continued to decrease, including: the percentage of laboratory detections positive for influenza, the number of regions reporting widespread and localized activity, the number of new influenza/ILI outbreaks, and influenza-associated hospitalizations reported by the IMPACT network and by participating provinces and territories.
              • The percentage of tests positive for RSV was stable at 19.6% and the percentage of tests positive for rhinovirus increased slightly.
              • The ILI consultation rate increased slightly but is within the expected range for this time of year.
              Influenza Activity (geographic spread) and Outbreaks

              In week 07, 4 regions [in ON(1), QC(1) and NL(2)] reported widespread activity and 19 regions [in BC(1), SK(1), ON(5), QC(2), NB(5), NS(1), PE(1), NL(2) and NU(1)] reported localized activity (Figures 1 and 2). In week 07, 45 new influenza outbreaks were reported: 23 in long-term-care facilities, 3 in hospitals, 5 in schools, and 14 in other facilities or communities (Figure 3).
              Figure 1. Map of overall Influenza activity level by province and territory,
              Canada, Week 07






              Note: Influenza activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.
              Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
              Figure 2. Number of influenza surveillance regions<SUP title="sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in"></SUP> reporting widespread or localized influenza activity, Canada, by report week, 2012-2013 (N<SUP>*</SUP>=58)


              †sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.
              * Total number of influenza surveillance regions in Canada
              Text equivalent for figure 2Number of influenza surveillance regions reporting widespread or localized influenza activity, Canada, by report week, 2011-2012 (N=56)
              Figure 3. Overall Number of Influenza Outbreaks, Canada, by Report Week, 2012-2013


              Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2011-2012

              Top of Page

              Influenza and Other Respiratory Virus Detections

              The percentage of positive influenza tests decreased from 17.0% in week 06 to 15.2% in week 07 (Figure 4). Among the influenza viruses detected in week 07 (n=926), 86.8% were positive for influenza A viruses [of which 28.6% were A(H3), 8.0% were A(H1N1)pdm09, and 63.4% were A(unsubtyped)] (Table 1). The proportion of influenza B detections has increased over the past 4 weeks from 2.1% in week 03 to 13.2% in week 07(Figure 4). Cumulative influenza virus detections by type/subtype to date are as follows: 96.4% influenza A [35.2% A(H3), 3.1% A(H1N1)pdm09 and 61.7% A(unsubtyped)] and 3.6% influenza B (Table 1).
              Detailed information on age and type/subtype has been received for 19,508 cases to date this (Table 2). The proportion of cases by age group is as follows: 13.2% < 5 years; 7.9% between 5-19 years; 15.3% between 20-44 years; 16.7% between 45-64 years of age; 46.9% ≥ 65 years.
              The percentage of tests positive for RSV in week 07 (19.6%) was similar to week 06. The percentage of tests positive for rhinovirus increased from 5.7% in week 06 to 7.6% in week 07. The percentages of tests positive for coronavirus and parainfluenza were similar to the previous week at 4.8% and 2.3%, respectively. Other percentages of positive tests increased slightly in week 07: hMPV at 2.9%; adenovirus at 1.5% (Figure 5). For more details, see the weekly Respiratory Virus Detections in Canada Report.
              <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly & Cumulative numbers of positive influenza specimens
              by Provincial Laboratories, Canada, 2012-2013
              </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces</TH><TH id=ac1 colSpan=6>Weekly
              (February 10 to February 16, 2013)</TH><TH id=ac9 colSpan=6>Cumulative
              (August 26, 2012 to February 16, 2013)</TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=5 headers=ac1>Influenza A</TH><TH id=ac8 headers=ac1>Influenza
              B</TH><TH id=ac10 colSpan=5 headers=ac9>Influenza A</TH><TH id=ac16 headers=ac9>Influenza
              B</TH></TR><TR class=bg-colour-yellow><TH id=ac3 headers=ac2>A Total</TH><TH id=ac4 headers=ac2>A(H1)</TH><TH id=ac5 headers=ac2>A(H3)</TH><TH id=ac6 headers=ac2>Pand H1N1</TH><TH id=ac7 class=noWrap headers=ac2>A
              ( <ABBR title=unsubtyped>Un S</ABBR>)Table 1 note*</TH><TH headers="ac1 ac8">Total</TH><TH id=ac11 headers=ac10>A Total</TH><TH id=ac12 headers=ac10>A(H1)</TH><TH id=ac13 headers=ac10>A(H3)</TH><TH id=ac14 headers=ac10>Pand H1N1</TH><TH id=ac15 class=noWrap headers=ac10>A
              (Un S) Table 1 note*</TH><TH headers=ac16>Total</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13>* The specimen was typed as influenza A, but no result for subtyping was available. Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Note: Weekly data is based on week of positive lab detection. Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals. </TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=bg-colour-yellow headers=ar1><ABBR title="British Columbia ">BC</ABBR></TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">150</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">90</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">14</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac7">46</TD><TD class=alignRight headers="ar1 ar2 ac1 ac8">21</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac11">1899</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac13">1462</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac14">150</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac15">287</TD><TD class=alignRight headers="ar1 ar2 ac9 ac16">181</TD></TR><TR><TH id=ar3 class=bg-colour-yellow headers=ar1><ABBR title=Alberta>AB</ABBR></TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">49</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">21</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">21</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac7">7</TD><TD class=alignRight headers="ar1 ar3 ac1 ac8">32</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac11">2227</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac13">1770</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac14">317</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac15">140</TD><TD class=alignRight headers="ar1 ar3 ac9 ac16">197</TD></TR><TR><TH id=ar4 class=bg-colour-yellow headers=ar1><ABBR title=Saskatchewan>SK</ABBR></TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">20</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">6</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">9</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac7">5</TD><TD class=alignRight headers="ar1 ar4 ac1 ac8">7</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac11">747</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac13">466</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac14">26</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac15">255</TD><TD class=alignRight headers="ar1 ar4 ac9 ac16">81</TD></TR><TR><TH id=ar5 class=bg-colour-yellow headers=ar1><ABBR title=Manitoba>MB</ABBR></TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">25</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">2</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac7">23</TD><TD class=alignRight headers="ar1 ar5 ac1 ac8">4</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac11">562</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac13">78</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac14">6</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac15">478</TD><TD class=alignRight headers="ar1 ar5 ac9 ac16">39</TD></TR><TR><TH id=ar6 class=bg-colour-yellow headers=ar1><ABBR title=Ontario>ON</ABBR></TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">199</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">65</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">14</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac7">120</TD><TD class=alignRight headers="ar1 ar6 ac1 ac8">30</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac11">7647</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac13">3599</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac14">219</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac15">3829</TD><TD class=alignRight headers="ar1 ar6 ac9 ac16">190</TD></TR><TR><TH id=ar7 class=bg-colour-yellow headers=ar1><ABBR title=Quebec>QC</ABBR>
              </TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">135</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">4</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">1</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac7">130</TD><TD class=alignRight headers="ar1 ar7 ac1 ac8">27</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac11">9389</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac13">545</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac14">24</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac15">8820</TD><TD class=alignRight headers="ar1 ar7 ac9 ac16">214</TD></TR><TR><TH id=ar8 class=bg-colour-yellow headers=ar1><ABBR title="New Brunswick">NB</ABBR>
              </TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">134</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac7">134</TD><TD class=alignRight headers="ar1 ar8 ac1 ac8">1</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac11">1308</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac13">428</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac14">15</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac15">865</TD><TD class=alignRight headers="ar1 ar8 ac9 ac16">4</TD></TR><TR><TH id=ar9 class=bg-colour-yellow headers=ar1><ABBR title="Nova Scotia ">NS</ABBR>
              </TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">46</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">38</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">3</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac7">5</TD><TD class=alignRight headers="ar1 ar9 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac11">232</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac13">162</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac14">4</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac15">66</TD><TD class=alignRight headers="ar1 ar9 ac9 ac16">2</TD></TR><TR><TH id=ar10 class=bg-colour-yellow headers=ar1><ABBR title="Prince Edward Island ">PE</ABBR>
              </TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">6</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac5">6</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac7">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac11">84</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac13">53</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac14">3</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac15">28</TD><TD class=alignRight headers="ar1 ar10 ac9 ac16">1</TD></TR><TR><TH id=ar11 class=bg-colour-yellow headers=ar1><ABBR title="Newfoundland/Labrador ">NL</ABBR>
              </TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">40</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac7">40</TD><TD class=alignRight headers="ar1 ar11 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac11">633</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac13">152</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac14">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac15">481</TD><TD class=alignRight headers="ar1 ar11 ac9 ac16">4</TD></TR><TR><TH id=ar12 class=bg-colour-yellow headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">804</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac5">230</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac6">64</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac7">510</TD><TD class=alignRight headers="ar1 ar12 ac1 ac8">122</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac11">24728</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac13">8715</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac14">764</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac15">15249</TD><TD class=alignRight headers="ar1 ar12 ac9 ac16">913</TD></TR></TBODY></TABLE>
              <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 2. Weekly & Cumulative numbers of positive influenza specimens by age groups
              reported through case-based laboratory reporting, Canada, 2012-2013
              Table 2 note*</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups</TH><TH id=bc1 colSpan=5>Weekly
              (February 10 to February 16, 2013)</TH><TH id=bc8 colSpan=5>Cumulative
              (August 26, 2012 to February 16, 2013)</TH></TR><TR class=bg-colour-yellow><TH id=bc2 colSpan=4 headers=bc1>Influenza A</TH><TH id=bc7 headers=bc1>B</TH><TH id=bc9 colSpan=4 headers=bc8>Influenza A</TH><TH id=bc14 headers=bc8>B</TH></TR><TR class=bg-colour-yellow><TH id=bc3 headers=bc2>A Total</TH><TH id=bc4 headers=bc2>Pandemic H1N1</TH><TH id=bc5 headers=bc2>A/H3N2</TH><TH id=bc6 headers=bc2>A unsubtyped</TH><TH headers="bc1 bc7">Total</TH><TH id=bc10 headers=bc9>A Total</TH><TH id=bc11 headers=bc9>Pandemic H1N1</TH><TH id=bc12 headers=bc9>A/H3N2</TH><TH id=bc13 headers=bc9>A unsubtyped</TH><TH headers=bc14>Total</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11>* Please note that this table reflects the number of specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported. Delays in the reporting of data may cause data to change retrospectively.</TD></TR></TFOOT><TBODY><TR><TH id=br2 headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">54</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">10</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">8</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">36</TD><TD class=alignRight headers="br1 br2 bc1 bc7">12</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">2425</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">141</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">818</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1466</TD><TD class=alignRight headers="br1 br2 bc8 bc14">152</TD></TR><TR><TH id=br3 headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">23</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">2</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">7</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">14</TD><TD class=alignRight headers="br1 br3 bc1 bc7">25</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1356</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">47</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">611</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">698</TD><TD class=alignRight headers="br1 br3 bc8 bc14">189</TD></TR><TR><TH id=br4 headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">48</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">9</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">6</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">33</TD><TD class=alignRight headers="br1 br4 bc1 bc7">14</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">2837</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">200</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">1132</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">1505</TD><TD class=alignRight headers="br1 br4 bc8 bc14">142</TD></TR><TR><TH id=br5 headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">63</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">6</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">7</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">50</TD><TD class=alignRight headers="br1 br5 bc1 bc7">9</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">3149</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">195</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">1133</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">1821</TD><TD class=alignRight headers="br1 br5 bc8 bc14">105</TD></TR><TR><TH id=br6 headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">128</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">3</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">24</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">101</TD><TD class=alignRight headers="br1 br6 bc1 bc7">10</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">9016</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">65</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">3419</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">5532</TD><TD class=alignRight headers="br1 br6 bc8 bc14">137</TD></TR><TR><TH id=br7 headers=br1>Unknown</TH><TD class=alignRight headers="br1 br7 bc1 bc2 bc3">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc6">0</TD><TD class=alignRight headers="br1 br7 bc1 bc7">0</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc10">159</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">16</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">141</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">2</TD><TD class=alignRight headers="br1 br7 bc8 bc14">0</TD></TR><TR><TH id=br8 headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">316</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc4">30</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc5">52</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc6">234</TD><TD class=alignRight headers="br1 br8 bc1 bc7">70</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">18942</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc11">664</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc12">7254</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc13">11024</TD><TD class=alignRight headers="br1 br8 bc8 bc14">725</TD></TR></TBODY></TABLE>


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              Figure 4. Influenza tests reported and percentage of tests positive, Canada,
              by report week, 2012-2013



              Text equivalent for figure 4Influenza tests reported and percentage of tests positive, Canada, by report week, 2011-2012
              Figure 5. Percent positive influenza tests, compared to other respiratory viruses,
              Canada, by reporting week, 2012-2013



              Text equivalent for figure 5Percent positive influenza tests, compared to other respiratory viruses, Canada, by reporting week, 2011-2012

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              Influenza strain characterizations

              During the 2012-13 season, the National Microbiology Laboratory (NML) has antigenically characterized 569 influenza viruses. The 405 influenza A(H3N2) viruses were antigenically similar to the vaccine strain A/Victoria/361/2011 and the 76 A(H1N1)pdm09 viruses were antigenically similar to the vaccine strain A/California/07/09. Among the influenza B viruses, 73 were antigenically similar to the vaccine strain B/Wisconsin/01/2010 (Yamagata lineage) and 15 were similar to B/Brisbane/60/2008 (Victoria lineage; component of the 2011-2012 seasonal influenza vaccine) (Figure 6).
              Figure 6. Influenza strain characterizations, Canada, 2012-2013, N = 569

              Note: The recommended components for the 2012-2013 Northern Hemisphere influenza vaccine include: an A/Victoria/361/2011 (H3N2)-like virus; an A/California/7/2009 (H1N1)pdm09-like virus; and a B/Wisconsin/1/2010-like virus.
              Text equivalent for figure 6Influenza strain characterizations, Canada, 2011-2012

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              Antiviral resistance

              During the 2012-13 season, NML has tested 517 influenza viruses for resistance to oseltamivir, and 514 influenza viruses for resistance to zanamivir. All viruses tested were sensitive to oseltamivir and zanamivir. A total of 651 influenza A viruses were tested for amantadine resistance and all were resistant (Table 3).


              <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2012-2013</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=cr1 rowSpan=2>Virus type and subtype</TH><TH id=cc1 colSpan=2>Oseltamivir</TH><TH id=cc4 colSpan=2>Zanamivir</TH><TH id=cc7 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=cc2 headers=cc1># tested</TH><TH id=cc3 headers=cc1># resistant (%)</TH><TH id=cc5 headers=cc4># tested</TH><TH id=cc6 headers=cc4># resistant (%)</TH><TH id=cc8 headers=cc7># tested</TH><TH id=cc9 headers=cc7># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=cr2 class="alignLeft bg-colour-blue" headers=cr1>A (H3N2)</TH><TD class=alignCenter headers="cr2 cc2">382</TD><TD class=alignCenter headers="cr2 cc3">0</TD><TD class=alignCenter headers="cr2 cc5">381</TD><TD class=alignCenter headers="cr2 cc6">0</TD><TD class=alignCenter headers="cr2 cc8">589</TD><TD class=alignCenter headers="cr2 cc9">589 (100%)</TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignCenter headers="cr3 cc2">58</TD><TD class=alignCenter headers="cr3 cc3">0</TD><TD class=alignCenter headers="cr3 cc5">56</TD><TD class=alignCenter headers="cr3 cc6">0</TD><TD class=alignCenter headers="cr3 cc8">62</TD><TD class=alignCenter headers="cr3 cc9">62</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignCenter headers="cr4 cc2">77</TD><TD class=alignCenter headers="cr4 cc3">0</TD><TD class=alignCenter headers="cr4 cc5">77</TD><TD class=alignCenter headers="cr4 cc6">0</TD><TD class=alignCenter headers="cr4 cc8">NA <SUP>*</SUP></TD><TD class=alignCenter headers="cr4 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft bg-colour-blue" headers=cr1>TOTAL</TH><TD class=alignCenter headers="cr5 cc2">517</TD><TD class=alignCenter headers="cr5 cc3">0</TD><TD class=alignCenter headers="cr5 cc5">514</TD><TD class=alignCenter headers="cr5 cc6">0</TD><TD class=alignCenter headers="cr5 cc8">651</TD><TD class=alignCenter headers="cr5 cc9">651 (100%)</TD></TR></TBODY></TABLE>
              Influenza-like Illness (ILI) Consultation Rate

              The national influenza-like-illness (ILI) consultation rate increased slightly from 34.2 ILI consultations per 1,000 patient visits in week 06 to 38.0 in week 07, likely due in part to the circulation of other respiratory viruses such as RSV. After 6 weeks with ILI rates above the expected level for this time of year from weeks 52 to 05, the rate has been within the expected range for weeks 06 and 07 (Figure 7). In week 07, the highest consultation rate was observed in children 5-19 years of age (73.9/1,000) followed by children <5 years of age (54.0/1,000).
              Figure 7. Influenza-like illness (ILI) consultation rates, Canada, by report week, 2012-2013 compared to 1996/97 through to 2011/12 seasons (with pandemic data suppressed)



              Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons). Delays in the reporting of data may cause data to change retrospectively.
              Text equivalent for figure 7Influenza-like illness (ILI) consultation rates, Canada, by report week, 2011-2012 compared to 1996/97 through to 2010/11 seasons (with pandemic data suppressed)
              Pharmacy Surveillance

              The Canadian antiviral prescription rate decreased from 151.0 antiviral prescriptions per 100,000 new prescriptions dispensed in week 06 to 123.3 in week 07; which continues to follow the downward trend in the percentage of positive laboratory tests for influenza. In week 07, the antiviral prescription rate decreased for all age-groups. The highest rate continued to be observed for seniors ≥65 years of age, at 379.9/100,000.
              Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group.
              Severe Respiratory Illness Surveillance

              Paediatric Influenza Hospitalizations and Deaths (IMPACT)

              In week 07, 22 new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 40 in week 06. Among the 15 cases identified with influenza A, 13 (86.7%) were A(unsubtyped), 1 (6.7%) was A(H3N2) and 1 (6.7%) was A(H1N1)pdm09. Seven cases (31.8%) were identified with influenza B. The age distribution is as follows: 4 cases (18.2%) under 6 months of age, 5 (22.7%) between 6-23 months, 6 (27.3%) 2-4 years of age, 5 (22.7%) 5-9 years of age, and 2 (9.1%) 10-16 years of age. No ICU admissions were reported during week 07.

              Since the start of the 2012-13 season, a total of 597 influenza-associated paediatric hospitalizations have been reported by the IMPACT network: 554 (92.8%) with influenza A [of which 67 (12.1%) were A(H3N2), 16 (2.9%) were A(H1N1)pdm09 and 471 (85.0 %) were A(unsubtyped)], and 43 (7.2%) with influenza B. The distribution of cases by age group is as follows: 122 (20.4%) <6 months of age; 137 (22.9%) age 6-23 months; 182 (30.5%) age 2-4 years; 104 (17.4%) age 5-9 years; and 52 (8.7%) age 10-16 years. Fifty-one of the 576 cases (8.5%) were admitted to the ICU. No deaths have been reported to date.
              Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associate paediatric hospitalizations in Canada.

              Adult Influenza Hospitalizations and Deaths (PCIRN)

              In week 07, 39 new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 49 in week 06. The majority of hospitalizations continue to be adults aged ≥65 years25 cases (64.1%). Thirty-eight cases identified with influenza A: 37 with influenza A(unsubtyped), and one with influenza A(H3N2). The influenza type has not been reported for one case. Nine ICU admissions were reported during the current week, all with influenza A(unsubtyped). Six of the nine adults admitted to the ICU were ≥65 years of age, two were 45-64 years of age, and one was 20-44 years of age. Three deaths were reported and all identified with influenza A(unsubtyped):two individuals were ≥65 years of age, and the third was 45-64 years of age.

              From November 4, 2012 to February 16, 2013, a total of 1,195 influenza-associated adult hospitalizations were reported by the PCIRN-SOS network: 1,130 (94.6%) with influenza A [of which 143 (12.7%) were A(H3N2), 6 (0.5%) were A(H1N1)pdm09, 981 (86.8%) were A(unsubtyped).]; and 24 (2.0%) with influenza B, and the influenza type has not been reported for 41 (3.4%) cases. Among 1,194 cases with available data, the age distribution is as follows: 816 cases (68.3%) were aged ≥65 years, 246 cases (20.6%) were aged 45-64 years, 128 cases (10.7%) were aged 20-44 years, and 4 cases (0.3%) were <20 years of age. Of the 1,195 cases, 111 (9.3%) were admitted to the ICU. The age distribution of those admitted to the ICU is as follows: 65 (58.6%) were in adults ≥65 years of age, 32 (28.8%) were in adults 45-64 years of age, and 14 (12.6%) were in adults 20-44 years of age. Of the adults admitted to the ICU, 33 (29.7%) had at least one co-morbidity, two (1.8%) had no co-morbidities, and 76 (68.5%) had no information to date. A total of 53 deaths have been reported, 7 (13.2%) with influenza A(H3N2), 44 (83.0%) with influenza A(unsubtyped), and 1 (1.9%) with influenza B, and one (1.9%) for which the influenza type has not been reported. Forty-six of the 53 deaths (86.8%) were in adults ≥65 years of age, 6 (11.3%) were adults 45-64 years of age, and 1 (1.9%) was 20-44 years of age. Twenty-three deaths occurred in individuals who had at least one co-morbidity. Detailed clinical information on co-morbidities is not known for the remaining 30 cases.

              Note: The number of hospitalizations reported through PCIRN represents a subset of all influenza-associate adult hospitalizations in Canada.

              Provincial/Territorial Influenza Hospitalizations and Deaths (Aggregate Surveillance System<SUP>*</SUP>)

              The number of laboratory-confirmed influenza-associated hospitalizations continued to decline in week 07 (126 compared to 251 in week 06*). The majority of cases were influenza A (95.2%), predominately A(H3). Over half of cases were ≥65 years of age (67/126, 53.2%). Of the 49 cases with available data, 10 (20.4%) were admitted to the Intensive Care Unit (ICU). Twelve deaths were reported: 11 were adults ≥65 years of age, and one 20-44 years of age. It is important to note that the cause of death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.

              To date this season, 3316 influenza-associated hospitalizations have been reported. Of these, 97.2% have been influenza A, predominately A(H3); and 2.8% have been influenza B. Age information was available for 3260 cases, and the age distribution is as follows: 57.2% ≥65 years; 16.5% 45-64 years; 8.5% 20-44 years; 1.0% 15-19; 3.4% 5-14 years and 13.4% 0-4 years of age. Among the 890 cases with available data, there have been 140 (15.7%) hospitalisations for which admission to ICU was required; the highest proportions were among adults aged 45-64 years of age (37.1%), and ≥65 years of age (35.0%). To date this season, 217 deaths have been reported: 180 (83.0%) were adults ≥65 years of age, 25 (11.5%) were adults 45-64 years; 7 (3.2%) were adults 20-44 years and 5 (2.3%) were children 0-4 years of age. It is important to note that the cause of death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.

              * Note: The number of new influenza-associated hospitalizations and deaths reported by the Aggregate Surveillance System each week may be overestimated, as it may include retrospective updates to data from Ontario for previous weeks. These data may also include cases reported by the IMPACT and PCIRN networks. Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, NS, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not reported in Ontario.

              .../
              http://www.phac-aspc.gc.ca/fluwatch/.../index-eng.php
              "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
              -Nelson Mandela

              Comment


              • #22
                Re: Canada FluWatch Weekly Reports 2012-2013 Season Week 8

                FluWatch report: February 17 to February 23, 2013 (Week 8)

                Posted 2013-03-01For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
                <A title="Flu Watch (Version PDF, 113 KB - 6 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/12-13/w08_13/pdf/fw2013-08-eng.pdf">FluWatch report: February 17 to February 23, 2013 (Week 8) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 113 <ABBR title=Kilobytes>KB</ABBR> - 8 pages)

                »» Help with PDF documents



                Overall Summary
                • In week 08, specific indicators of influenza activity continued to decrease, while indicators of the circulation of respiratory viruses such as the ILI consultation rate were similar to recent weeks.
                • The percentage of laboratory detections positive for influenza continues to decrease, while the proportion of positive tests for influenza B has increased in recent weeks. The percentage of laboratory detections positive for RSV and rhinovirus were similar to recent weeks.
                • The number of regions reporting widespread or localized activity was similar in weeks 07 and 08; however, there is an overall decline in influenza/ILI activity from the peak in early January.
                Influenza Activity (geographic spread) and Outbreaks

                In week 08, 2 regions [in ON(1) and NL(1)] reported widespread activity and 22 regions [in BC(2), AB(1), MB(1), ON(5), QC(3), NB(2), NS(5), NL(2) and NU(1)] reported localized activity. The number of regions reporting widespread or localized activity was similar in weeks 07 and 08; however, there is an overall decline in influenza/ILI activity from the peak in early January (Figures 1 and 2). In week 08, 34 new influenza outbreaks were reported: 18 in long-term-care facilities, 3 in hospitals, 2 in schools, and 11 in other facilities or communities (Figure 3).
                Figure 1. Map of overall Influenza activity level by province and territory,
                Canada, Week 08





                Note: Influenza activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.
                Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
                Figure 2. Number of influenza surveillance regions<SUP title="sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in"></SUP> reporting widespread or localized influenza activity, Canada, by report week, 2012-2013 (N<SUP>*</SUP>=58)


                †sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.
                * Total number of influenza surveillance regions in Canada
                Text equivalent for figure 2Number of influenza surveillance regions reporting widespread or localized influenza activity, Canada, by report week, 2011-2012 (N=56)
                Figure 3. Overall Number of Influenza Outbreaks, Canada, by Report Week, 2012-2013


                Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2011-2012

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                Influenza and Other Respiratory Virus Detections

                The percentage of positive influenza tests continued to decline, from 14.1% in week 07 to 12.7% in week 08 (Figure 4). Among the influenza viruses detected in week 08 (n=671), 71.5% were positive for influenza A viruses [of which 29.8% were A(H3), 11.7% were A(H1N1)pdm09, and 58.5% were A(unsubtyped)] (Table 1). The proportion of A(H1N1)pdm09 among positive influenza A detections has increased from 1.0% in week 52 to 11.7% in week 08. The proportion of influenza B detections has increased over the past 5 weeks from 2.1% in week 03 to 28.5% in week 08 (Figure 4). Cumulative influenza virus detections by type/subtype to date are as follows: 95.8% influenza A [35.1% A(H3), 3.3% A(H1N1)pdm09 and 61.6% A(unsubtyped)] and 4.2% influenza B (Table 1).
                Detailed information on age and type/subtype has been received for 20,023 cases to date this season (Table 2). The proportion of cases by age group is as follows: 13.3% < 5 years; 8.2% between 5-19 years; 15.3% between 20-44 years; 16.7% between 45-64 years of age; 46.6% ≥ 65 years.
                The percentage of tests positive for RSV in week 08 (20.5%) was similar to weeks 06 and 07. The percentage of tests positive for rhinovirus in week 08 (8.5%) was similar to week 07. In week 08, the percentages of tests positive for coronavirus and parainfluenza both decreased slightly at 3.8% and 2.1%, respectively. The percentage of tests positive increased slightly for hMPV (3.2%) and was stable for adenovirus (1.3%) (Figure 5). For more details, see the weekly Respiratory Virus Detections in Canada Report.
                <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly & Cumulative numbers of positive influenza specimens
                by Provincial Laboratories, Canada, 2012-2013
                </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces</TH><TH id=ac1 colSpan=6>Weekly
                (February 17 to February 23, 2013)
                </TH><TH id=ac9 colSpan=6>Cumulative
                (August 26, 2012 to February 23, 2013)
                </TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=5 headers=ac1>Influenza A</TH><TH id=ac8 headers=ac1>Influenza
                B
                </TH><TH id=ac10 colSpan=5 headers=ac9>Influenza A</TH><TH id=ac16 headers=ac9>Influenza
                B
                </TH></TR><TR class=bg-colour-yellow><TH id=ac3 headers=ac2>A Total</TH><TH id=ac4 headers=ac2>A(H1)</TH><TH id=ac5 headers=ac2>A(H3)</TH><TH id=ac6 headers=ac2>Pand H1N1</TH><TH id=ac7 class=noWrap headers=ac2>A
                ( <ABBR title=unsubtyped>Un S</ABBR>)Table 1 note*
                </TH><TH headers="ac1 ac8">Total</TH><TH id=ac11 headers=ac10>A Total</TH><TH id=ac12 headers=ac10>A(H1)</TH><TH id=ac13 headers=ac10>A(H3)</TH><TH id=ac14 headers=ac10>Pand H1N1</TH><TH id=ac15 class=noWrap headers=ac10>A
                (Un S) Table 1 note*
                </TH><TH headers=ac16>Total</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13>* The specimen was typed as influenza A, but no result for subtyping was available. Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Note: Weekly data is based on week of positive lab detection. Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals. </TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=bg-colour-yellow headers=ar1><ABBR title="British Columbia ">BC</ABBR></TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">94</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">65</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">17</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac7">12</TD><TD class=alignRight headers="ar1 ar2 ac1 ac8">29</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac11">1908</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac13">1494</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac14">170</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac15">244</TD><TD class=alignRight headers="ar1 ar2 ac9 ac16">208</TD></TR><TR><TH id=ar3 class=bg-colour-yellow headers=ar1><ABBR title=Alberta>AB</ABBR></TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">40</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">17</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">16</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac7">7</TD><TD class=alignRight headers="ar1 ar3 ac1 ac8">50</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac11">2267</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac13">1787</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac14">338</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac15">142</TD><TD class=alignRight headers="ar1 ar3 ac9 ac16">247</TD></TR><TR><TH id=ar4 class=bg-colour-yellow headers=ar1><ABBR title=Saskatchewan>SK</ABBR></TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">11</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">1</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">2</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac7">8</TD><TD class=alignRight headers="ar1 ar4 ac1 ac8">12</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac11">758</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac13">467</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac14">28</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac15">263</TD><TD class=alignRight headers="ar1 ar4 ac9 ac16">93</TD></TR><TR><TH id=ar5 class=bg-colour-yellow headers=ar1><ABBR title=Manitoba>MB</ABBR></TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">17</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac7">17</TD><TD class=alignRight headers="ar1 ar5 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac11">579</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac13">78</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac14">6</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac15">495</TD><TD class=alignRight headers="ar1 ar5 ac9 ac16">39</TD></TR><TR><TH id=ar6 class=bg-colour-yellow headers=ar1><ABBR title=Ontario>ON</ABBR></TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">129</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">48</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">18</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac7">63</TD><TD class=alignRight headers="ar1 ar6 ac1 ac8">43</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac11">7776</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac13">3651</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac14">237</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac15">3888</TD><TD class=alignRight headers="ar1 ar6 ac9 ac16">233</TD></TR><TR><TH id=ar7 class=bg-colour-yellow headers=ar1><ABBR title=Quebec>QC</ABBR>

                </TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">102</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">1</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">2</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac7">99</TD><TD class=alignRight headers="ar1 ar7 ac1 ac8">57</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac11">9491</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac13">546</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac14">26</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac15">8919</TD><TD class=alignRight headers="ar1 ar7 ac9 ac16">271</TD></TR><TR><TH id=ar8 class=bg-colour-yellow headers=ar1><ABBR title="New Brunswick">NB</ABBR>

                </TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">15</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac7">15</TD><TD class=alignRight headers="ar1 ar8 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac11">1323</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac13">428</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac14">15</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac15">880</TD><TD class=alignRight headers="ar1 ar8 ac9 ac16">4</TD></TR><TR><TH id=ar9 class=bg-colour-yellow headers=ar1><ABBR title="Nova Scotia ">NS</ABBR>

                </TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">28</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">3</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">1</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac7">24</TD><TD class=alignRight headers="ar1 ar9 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac11">260</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac13">165</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac14">5</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac15">90</TD><TD class=alignRight headers="ar1 ar9 ac9 ac16">2</TD></TR><TR><TH id=ar10 class=bg-colour-yellow headers=ar1><ABBR title="Prince Edward Island ">PE</ABBR>

                </TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">8</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac5">8</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac7">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac11">92</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac13">61</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac14">3</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac15">28</TD><TD class=alignRight headers="ar1 ar10 ac9 ac16">1</TD></TR><TR><TH id=ar11 class=bg-colour-yellow headers=ar1><ABBR title="Newfoundland/Labrador ">NL</ABBR>

                </TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">36</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac7">36</TD><TD class=alignRight headers="ar1 ar11 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac11">669</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac13">152</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac14">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac15">517</TD><TD class=alignRight headers="ar1 ar11 ac9 ac16">4</TD></TR><TR><TH id=ar12 class=bg-colour-yellow headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">480</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac5">143</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac6">56</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac7">281</TD><TD class=alignRight headers="ar1 ar12 ac1 ac8">191</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac11">25123</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac13">8829</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac14">828</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac15">15466</TD><TD class=alignRight headers="ar1 ar12 ac9 ac16">1102</TD></TR></TBODY></TABLE>
                <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 2. Weekly & Cumulative numbers of positive influenza specimens by age groups
                reported through case-based laboratory reporting, Canada, 2012-2013 Table 2 note*
                </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups</TH><TH id=bc1 colSpan=5>Weekly
                (February 17 to February 23, 2013)
                </TH><TH id=bc8 colSpan=5>Cumulative
                (August 26, 2012 to February 23, 2013)
                </TH></TR><TR class=bg-colour-yellow><TH id=bc2 colSpan=4 headers=bc1>Influenza A</TH><TH id=bc7 headers=bc1>B</TH><TH id=bc9 colSpan=4 headers=bc8>Influenza A</TH><TH id=bc14 headers=bc8>B</TH></TR><TR class=bg-colour-yellow><TH id=bc3 headers=bc2>A Total</TH><TH id=bc4 headers=bc2>Pandemic H1N1</TH><TH id=bc5 headers=bc2>A/H3N2</TH><TH id=bc6 headers=bc2>A unsubtyped</TH><TH headers="bc1 bc7">Total</TH><TH id=bc10 headers=bc9>A Total</TH><TH id=bc11 headers=bc9>Pandemic H1N1</TH><TH id=bc12 headers=bc9>A/H3N2</TH><TH id=bc13 headers=bc9>A unsubtyped</TH><TH headers=bc14>Total</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11>* Please note that this table reflects the number of specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported. Delays in the reporting of data may cause data to change retrospectively.</TD></TR></TFOOT><TBODY><TR><TH id=br2 headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">35</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">3</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">5</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">27</TD><TD class=alignRight headers="br1 br2 bc1 bc7">23</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">2479</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">149</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">832</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1498</TD><TD class=alignRight headers="br1 br2 bc8 bc14">181</TD></TR><TR><TH id=br3 headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">16</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">2</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">5</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">9</TD><TD class=alignRight headers="br1 br3 bc1 bc7">59</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1376</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">51</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">623</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">702</TD><TD class=alignRight headers="br1 br3 bc8 bc14">264</TD></TR><TR><TH id=br4 headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">40</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">11</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">7</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">22</TD><TD class=alignRight headers="br1 br4 bc1 bc7">14</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">2899</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">220</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">1152</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">1527</TD><TD class=alignRight headers="br1 br4 bc8 bc14">162</TD></TR><TR><TH id=br5 headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">48</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">10</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">5</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">33</TD><TD class=alignRight headers="br1 br5 bc1 bc7">16</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">3215</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">214</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">1156</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">1845</TD><TD class=alignRight headers="br1 br5 bc8 bc14">126</TD></TR><TR><TH id=br6 headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">105</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">4</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">25</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">76</TD><TD class=alignRight headers="br1 br6 bc1 bc7">17</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">9159</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">73</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">3478</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">5608</TD><TD class=alignRight headers="br1 br6 bc8 bc14">162</TD></TR><TR><TH id=br7 headers=br1>Unknown</TH><TD class=alignRight headers="br1 br7 bc1 bc2 bc3">5</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc4">2</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc5">3</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc6">0</TD><TD class=alignRight headers="br1 br7 bc1 bc7">0</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc10">164</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">18</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">144</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">2</TD><TD class=alignRight headers="br1 br7 bc8 bc14">0</TD></TR><TR><TH id=br8 headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">249</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc4">32</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc5">50</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc6">167</TD><TD class=alignRight headers="br1 br8 bc1 bc7">129</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">19292</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc11">725</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc12">7385</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc13">11182</TD><TD class=alignRight headers="br1 br8 bc8 bc14">895</TD></TR></TBODY></TABLE>


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                Figure 4. Influenza tests reported and percentage of tests positive, Canada,
                by report week, 2012-2013


                Text equivalent for figure 4Influenza tests reported and percentage of tests positive, Canada, by report week, 2011-2012
                Figure 5. Percent positive influenza tests, compared to other respiratory viruses,
                Canada, by reporting week, 2012-2013


                Text equivalent for figure 5Percent positive influenza tests, compared to other respiratory viruses, Canada, by reporting week, 2011-2012

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                Influenza strain characterizations

                During the 2012-13 season, the National Microbiology Laboratory (NML) has antigenically characterized 624 influenza viruses. The 425 influenza A(H3N2) viruses were antigenically similar to the vaccine strain A/Victoria/361/2011 and the 86 A(H1N1)pdm09 viruses were antigenically similar to the vaccine strain A/California/07/09. Among the influenza B viruses, 94 were antigenically similar to the vaccine strain B/Wisconsin/01/2010 (Yamagata lineage) and 19 were similar to B/Brisbane/60/2008 (Victoria lineage; component of the 2011-2012 seasonal influenza vaccine) (Figure 6).
                Figure 6. Influenza strain characterizations, Canada, 2012-2013, N = 624

                Note: The recommended components for the 2012-2013 Northern Hemisphere influenza vaccine include: an A/Victoria/361/2011 (H3N2)-like virus; an A/California/7/2009 (H1N1)pdm09-like virus; and a B/Wisconsin/1/2010-like virus.
                Text equivalent for figure 6Influenza strain characterizations, Canada, 2011-2012

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                Antiviral resistance

                During the 2012-13 season, NML has tested 583 influenza viruses for resistance to oseltamivir, and 581 influenza viruses for resistance to zanamivir. All viruses tested were sensitive to oseltamivir and zanamivir. A total of 695 influenza A viruses were tested for amantadine resistance and all were resistant (Table 3).


                <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2012-2013</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=cr1 rowSpan=2>Virus type and subtype</TH><TH id=cc1 colSpan=2>Oseltamivir</TH><TH id=cc4 colSpan=2>Zanamivir</TH><TH id=cc7 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=cc2 headers=cc1># tested</TH><TH id=cc3 headers=cc1># resistant (%)</TH><TH id=cc5 headers=cc4># tested</TH><TH id=cc6 headers=cc4># resistant (%)</TH><TH id=cc8 headers=cc7># tested</TH><TH id=cc9 headers=cc7># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=cr2 class="alignLeft bg-colour-blue" headers=cr1>A (H3N2)</TH><TD class=alignCenter headers="cr2 cc2">412</TD><TD class=alignCenter headers="cr2 cc3">0</TD><TD class=alignCenter headers="cr2 cc5">412</TD><TD class=alignCenter headers="cr2 cc6">0</TD><TD class=alignCenter headers="cr2 cc8">630</TD><TD class=alignCenter headers="cr2 cc9">630 (100%)</TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignCenter headers="cr3 cc2">77</TD><TD class=alignCenter headers="cr3 cc3">0</TD><TD class=alignCenter headers="cr3 cc5">76</TD><TD class=alignCenter headers="cr3 cc6">0</TD><TD class=alignCenter headers="cr3 cc8">65</TD><TD class=alignCenter headers="cr3 cc9">65</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignCenter headers="cr4 cc2">94</TD><TD class=alignCenter headers="cr4 cc3">0</TD><TD class=alignCenter headers="cr4 cc5">93</TD><TD class=alignCenter headers="cr4 cc6">0</TD><TD class=alignCenter headers="cr4 cc8">NA <SUP>*</SUP></TD><TD class=alignCenter headers="cr4 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft bg-colour-blue" headers=cr1>TOTAL</TH><TD class=alignCenter headers="cr5 cc2">583</TD><TD class=alignCenter headers="cr5 cc3">0</TD><TD class=alignCenter headers="cr5 cc5">581</TD><TD class=alignCenter headers="cr5 cc6">0</TD><TD class=alignCenter headers="cr5 cc8">695</TD><TD class=alignCenter headers="cr5 cc9">695 (100%)</TD></TR></TBODY></TABLE>
                Influenza-like Illness (ILI) Consultation Rate

                The national influenza-like-illness (ILI) consultation rate decreased slightly from 37.0 ILI consultations per 1,000 patient visits in week 07 to 33.2 in week 08. After 6 weeks with ILI rates above the expected level for this time of year (from weeks 52 to 05), the rate has been within the expected range since week 06 (Figure 7). In week 08, the highest consultation rate was observed in children <5 years of age (64.3/1,000), followed by children 5-19 years of age (62.6/1,000).
                Figure 7. Influenza-like illness (ILI) consultation rates, Canada, by report week, 2012-2013 compared to 1996/97 through to 2011/12 seasons (with pandemic data suppressed)



                Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons). Delays in the reporting of data may cause data to change retrospectively.
                Text equivalent for figure 7Influenza-like illness (ILI) consultation rates, Canada, by report week, 2011-2012 compared to 1996/97 through to 2010/11 seasons (with pandemic data suppressed)
                Pharmacy Surveillance

                The Canadian antiviral prescription rate was stable at 123.1 antiviral prescriptions per 100,000 new prescriptions dispensed in week 08, which continues to follow the downward trend in the percentage of positive laboratory tests for influenza. In week 08, the antiviral prescription rate decreased for all age-groups except seniors. The highest rate continued to be observed for seniors ≥65 years of age, at 460.4/100,000.
                Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group.
                Severe Respiratory Illness Surveillance

                Paediatric Influenza Hospitalizations and Deaths (IMPACT)

                In week 08, 18 new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 27 in week 07. Among the cases reported in week 08, 11 (61.1%) were identified with influenza A and 7 (38.9%) with influenza B. The age distribution is as follows: 2 cases (11.1%) under 6 months of age, 7 (38.9%) between 6-23 months, 6 (33.3%) 2-4 years of age, 2 (11.1%) 5-9 years of age, and one (5.6%) 10-16 years of age. One ICU admission was reported during week 08 in a child between 6-23 months of age with influenza A.

                Since the start of the 2012-13 season, a total of 620 influenza-associated paediatric hospitalizations have been reported by the IMPACT network: 571 (92.1%) with influenza A [of which 67 (11.7%) were A(H3N2), 15 (2.6%) were A(H1N1)pdm09 and the remaining 489 were A(unsubtyped)], and 49 (7.9%) with influenza B. The distribution of cases by age group is as follows: 125 (20.2%) <6 months of age; 142 (22.9%) age 6-23 months; 191 (30.8%) age 2-4 years; 110 (17.7%) age 5-9 years; and 52 (8.4%) age 10-16 years. Fifty-four of the 620 cases (8.7%) were admitted to the ICU. No deaths have been reported to date.

                Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associate paediatric hospitalizations in Canada.

                Adult Influenza Hospitalizations and Deaths (PCIRN)

                In week 08, 20 new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 51 in week 07. The majority of hospitalizations (16) were cases with influenza A: one influenza A(H3N2) and the rest A(unsubtyped). Four cases were reported with influenza B. The age distribution is as follows: 12 cases were ≥65 years of age, 7 cases were 45-64 years of age, and one case was 20-44 years of age. Four ICU admissions were reported during the current week, three with influenza A(unsubtyped) and one with influenza B. Two individuals admitted to the ICU were ≥65 years of age and two were 45-64 years of age. No deaths were reported this week.

                From November 4, 2012 to February 23, 2013, a total of 1,300 influenza-associated adult hospitalizations were reported by the PCIRN-SOS network: 1,226 (94.3%) cases with influenza A [of which 162 (13.2%) were A(H3N2), 8 (0.7%) were A(H1N1)pdm09, and 1,056 (86.1%) were A(unsubtyped)]; 33 (2.5%) cases with influenza B; and 41 (3.2%) cases for which the influenza type has not yet been reported. The age distribution of hospitalizations is as follows: 895 cases (68.8%) were aged ≥65 years, 265 cases (20.4%) were aged 45-64 years, 135 cases (10.4%) were aged 20-44 years, and 5 cases (0.4%) were <20 years of age. There have been 121 hospitalizations for which admission to the ICU was required; the majority of which were adults ≥65 years of age (58.7%). Of the 121 ICU admissions, 37 (30.6%) had at least one co-morbidity, two (1.7%) had no co-morbidities, and 82 had no information to date. A total of 53 deaths have been reported, 8 (15.1%) with influenza A(H3N2), 43 (81.1%) with influenza A(unsubtyped), one (1.9%) with influenza B, and one (1.9%) with influenza untyped. Forty-six of the 53 deaths (86.8%) were in adults ≥65 years of age, 6 (11.3%) were adults 45-64 years of age, and one (1.9%) was 20-44 years of age. Twenty-four deaths occurred in individuals who had at least one co-morbidity. Detailed clinical information on co-morbidities is not known for the remaining cases.

                Note: The number of hospitalizations reported through PCIRN represents a subset of all influenza-associate adult hospitalizations in Canada.

                Provincial/Territorial Influenza Hospitalizations and Deaths (Aggregate Surveillance System<SUP>*</SUP>)

                In week 08, 231 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories*. The majority of cases were influenza A (88.3%), predominantly A(H3). The proportion of cases of influenza B among hospitalizations has been increasing in recent weeks. The highest proportion of hospitalisations were adults ≥65 years (42.9%), followed by adults aged 46-64 (20.3%) and children aged 0-4 years (18.2%). Of the 61 cases with available data, 10 (16.4%) were admitted to the Intensive Care Unit (ICU). Fourteen deaths were reported: 12 were adults ≥65 years of age, one adult aged 45-64 years and one adult 20-44 years of age. It is important to note that the cause of death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.

                To date this season, 3,625 influenza-associated hospitalizations have been reported. Of these, 96.6% have been influenza A, predominately A(H3); and 3.4% have been influenza B. Age information was available for 3,622 cases, and the age distribution is as follows: 56.4% ≥65 years; 16.8% 45-64 years; 8.7% 20-44 years; 0.9% 15-19; 3.6% 5-14 years and 13.6% 0-4 years of age. Among the 952 cases with available data, there have been 148 (15.5%) hospitalisations for which admission to ICU was required; the highest proportions were among adults aged 45-64 years of age (37.8%), and ≥65 years of age (33.8%). To date this season, 243 deaths have been reported: 203 were adults ≥65 years of age, 26 were adults 45-64 years; 9 were adults 20-44 years and 5 were children 0-4 years of age. It is important to note that the cause of death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.

                * Note: The number of new influenza-associated hospitalizations and deaths reported by the Aggregate Surveillance System each week may be overestimated, as it may include retrospective updates to data from Ontario for previous weeks. These data may also include cases reported by the IMPACT and PCIRN networks. Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, NS, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not reported in Ontario.

                .../
                http://www.phac-aspc.gc.ca/fluwatch/.../index-eng.php
                "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                -Nelson Mandela

                Comment


                • #23
                  Re: Canada FluWatch Weekly Reports 2012-2013 Season Week 9

                  FluWatch report: February 24 to March 2, 2013 (Week 9)

                  Posted 2013-03-09For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
                  <A title="Flu Watch (Version PDF, 113 KB - 6 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/12-13/w09_13/pdf/fw2013-09-eng.pdf">FluWatch report: February 24 to March 2, 2013 (Week 9) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 113 <ABBR title=Kilobytes>KB</ABBR> - 8 pages)

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                  Overall Summary
                  • Detections of influenza A and B increased slightly, primarily in Eastern Canada. The proportion of positive tests for influenza B has increased in recent weeks.
                  • The number of paediatric hospitalizations was similar to the previous 2 weeks. In week 09, 50% of cases were associated with influenza B.
                  • Nationally, the number of regions reporting widespread or localized activity, as well as the ILI consultation rate continued to decline.
                  • The percentage of laboratory detections positive for RSV and rhinovirus both decreased.
                  Influenza Activity (geographic spread) and Outbreaks

                  In week 09, 2 regions [in ON(1) and NL(1)] reported widespread activity and 18 regions [in BC(1), AB(1), SK(1), MB(1), ON(5), QC(5), NB(1), NS(2), and NL(1)] reported localized activity. The number of regions reporting widespread or localized activity decreased compared to the previous week and continued to follow the overall decline in influenza/ILI activity from the peak in early January (Figures 1 and 2). Thirty-one new influenza outbreaks were reported: 21 in long-term-care facilities, 3 in hospitals, and 7 in other facilities or communities (Figure 3).
                  Figure 1. Map of overall Influenza activity level by province and territory,
                  Canada, Week 09





                  Note: Influenza activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.
                  Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
                  Figure 2. Number of influenza surveillance regions<SUP title="sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in"></SUP> reporting widespread or localized influenza activity, Canada, by report week, 2012-2013 (N<SUP>*</SUP>=58)


                  †sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.
                  * Total number of influenza surveillance regions in Canada
                  Text equivalent for figure 2Number of influenza surveillance regions reporting widespread or localized influenza activity, Canada, by report week, 2011-2012 (N=56)
                  Figure 3. Overall Number of Influenza Outbreaks, Canada, by Report Week, 2012-2013


                  Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2011-2012

                  Top of Page

                  Influenza and Other Respiratory Virus Detections

                  The percentage of positive influenza tests increased from 12.1% in week 08 to 14.9% in week 09 (Figure 4). Among the influenza viruses detected in week 09 (n=793), 64.1% were positive for influenza A viruses [of which 20.5% were A(H3), 17.3% were A(H1N1)pdm09, and 62.2% were A(unsubtyped)] (Table 1). The proportion of influenza B detections has increased over the past 6 weeks from 2.1% in week 03 to 35.9% in week 09 (Figure 4). The increase in influenza B detections in week 09 was driven primarily by data from Quebec, where 64.6% of influenza detections were influenza B. The proportion of influenza B was also high in Alberta (52.2%) and Saskatchewan (45.8%) compared to other provinces <SUP>*</SUP>. Cumulative influenza virus detections by type/subtype to date are as follows: 94.8% influenza A [35.1% A(H3), 3.6% A(H1N1)pdm09 and 61.3% A(unsubtyped)] and 5.2% influenza B (Table 1).
                  Detailed information on age and type/subtype has been received for 20,521 cases to date this season (Table 2). The proportion of cases by age group is as follows: 13.3% < 5 years; 8.4% between 5-19 years; 15.3% between 20-44 years; 16.8% between 45-64 years of age; 46.1% ≥ 65 years.
                  The percentage of tests positive for RSV decreased slightly from 21.3% in week 08 to 17.7% in week 09. The percentage of tests positive for rhinovirus also decreased from 8.7% in week 08 to 6.2% in week 09. The percentage of tests positive decreased slightly for both coronavirus (2.7%) and hMPV (2.6%). The percentage of tests positive increased slightly for both parainfluenza virus (2.1%) and adenovirus (1.5%) (Figure 5)<SUP>*</SUP>.
                  * For more details, see the weekly Respiratory Virus Detections in Canada Report.
                  <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly & Cumulative numbers of positive influenza specimens
                  by Provincial Laboratories, Canada, 2012-2013
                  </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces</TH><TH id=ac1 colSpan=6>Weekly
                  (February 24 to March 2, 2013)
                  </TH><TH id=ac9 colSpan=6>Cumulative
                  (August 26, 2012 to March 2, 2013)
                  </TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=5 headers=ac1>Influenza A</TH><TH id=ac8 headers=ac1>Influenza
                  B
                  </TH><TH id=ac10 colSpan=5 headers=ac9>Influenza A</TH><TH id=ac16 headers=ac9>Influenza
                  B
                  </TH></TR><TR class=bg-colour-yellow><TH id=ac3 headers=ac2>A Total</TH><TH id=ac4 headers=ac2>A(H1)</TH><TH id=ac5 headers=ac2>A(H3)</TH><TH id=ac6 headers=ac2>Pand H1N1</TH><TH id=ac7 class=noWrap headers=ac2>A
                  ( <ABBR title=unsubtyped>Un S</ABBR>)Table 1 note*
                  </TH><TH headers="ac1 ac8">Total</TH><TH id=ac11 headers=ac10>A Total</TH><TH id=ac12 headers=ac10>A(H1)</TH><TH id=ac13 headers=ac10>A(H3)</TH><TH id=ac14 headers=ac10>Pand H1N1</TH><TH id=ac15 class=noWrap headers=ac10>A
                  (Un S) Table 1 note*
                  </TH><TH headers=ac16>Total</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13>* The specimen was typed as influenza A, but no result for subtyping was available. Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Note: Weekly data is based on week of positive lab detection. Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals. </TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=bg-colour-yellow headers=ar1><ABBR title="British Columbia ">BC</ABBR></TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">53</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">28</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">19</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac7">6</TD><TD class=alignRight headers="ar1 ar2 ac1 ac8">26</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac11">1836</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac13">1412</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac14">186</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac15">238</TD><TD class=alignRight headers="ar1 ar2 ac9 ac16">249</TD></TR><TR><TH id=ar3 class=bg-colour-yellow headers=ar1><ABBR title=Alberta>AB</ABBR></TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">33</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">6</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">21</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac7">6</TD><TD class=alignRight headers="ar1 ar3 ac1 ac8">36</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac11">2228</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac13">1722</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac14">361</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac15">145</TD><TD class=alignRight headers="ar1 ar3 ac9 ac16">281</TD></TR><TR><TH id=ar4 class=bg-colour-yellow headers=ar1><ABBR title=Saskatchewan>SK</ABBR></TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">13</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">6</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac7">7</TD><TD class=alignRight headers="ar1 ar4 ac1 ac8">11</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac11">771</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac13">467</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac14">34</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac15">270</TD><TD class=alignRight headers="ar1 ar4 ac9 ac16">104</TD></TR><TR><TH id=ar5 class=bg-colour-yellow headers=ar1><ABBR title=Manitoba>MB</ABBR></TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">12</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac7">12</TD><TD class=alignRight headers="ar1 ar5 ac1 ac8">5</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac11">591</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac13">78</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac14">6</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac15">507</TD><TD class=alignRight headers="ar1 ar5 ac9 ac16">44</TD></TR><TR><TH id=ar6 class=bg-colour-yellow headers=ar1><ABBR title=Ontario>ON</ABBR></TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">128</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">32</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">15</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac7">81</TD><TD class=alignRight headers="ar1 ar6 ac1 ac8">56</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac11">7904</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac13">3685</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac14">255</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac15">3964</TD><TD class=alignRight headers="ar1 ar6 ac9 ac16">289</TD></TR><TR><TH id=ar7 class=bg-colour-yellow headers=ar1><ABBR title=Quebec>QC</ABBR>

                  </TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">81</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac7">81</TD><TD class=alignRight headers="ar1 ar7 ac1 ac8">148</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac11">9572</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac13">546</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac14">26</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac15">9000</TD><TD class=alignRight headers="ar1 ar7 ac9 ac16">419</TD></TR><TR><TH id=ar8 class=bg-colour-yellow headers=ar1><ABBR title="New Brunswick">NB</ABBR>

                  </TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">136</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac5">33</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac6">27</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac7">76</TD><TD class=alignRight headers="ar1 ar8 ac1 ac8">1</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac11">1721</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac13">723</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac14">42</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac15">956</TD><TD class=alignRight headers="ar1 ar8 ac9 ac16">5</TD></TR><TR><TH id=ar9 class=bg-colour-yellow headers=ar1><ABBR title="Nova Scotia ">NS</ABBR>

                  </TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">28</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac7">28</TD><TD class=alignRight headers="ar1 ar9 ac1 ac8">1</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac11">288</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac13">165</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac14">5</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac15">118</TD><TD class=alignRight headers="ar1 ar9 ac9 ac16">3</TD></TR><TR><TH id=ar10 class=bg-colour-yellow headers=ar1><ABBR title="Prince Edward Island ">PE</ABBR>

                  </TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">5</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac5">5</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac7">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac11">97</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac13">66</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac14">3</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac15">28</TD><TD class=alignRight headers="ar1 ar10 ac9 ac16">1</TD></TR><TR><TH id=ar11 class=bg-colour-yellow headers=ar1><ABBR title="Newfoundland/Labrador ">NL</ABBR>

                  </TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">19</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac7">19</TD><TD class=alignRight headers="ar1 ar11 ac1 ac8">1</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac11">688</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac13">152</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac14">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac15">536</TD><TD class=alignRight headers="ar1 ar11 ac9 ac16">5</TD></TR><TR><TH id=ar12 class=bg-colour-yellow headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">508</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac5">104</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac6">88</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac7">316</TD><TD class=alignRight headers="ar1 ar12 ac1 ac8">285</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac11">25696</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac13">9016</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac14">918</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac15">15762</TD><TD class=alignRight headers="ar1 ar12 ac9 ac16">1400</TD></TR></TBODY></TABLE>
                  <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 2. Weekly & Cumulative numbers of positive influenza specimens by age groups
                  reported through case-based laboratory reporting, Canada, 2012-2013 Table 2 note*
                  </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups</TH><TH id=bc1 colSpan=5>Weekly
                  (February 24 to March 2, 2013)
                  </TH><TH id=bc8 colSpan=5>Cumulative
                  (August 26, 2012 to March 2, 2013)
                  </TH></TR><TR class=bg-colour-yellow><TH id=bc2 colSpan=4 headers=bc1>Influenza A</TH><TH id=bc7 headers=bc1>B</TH><TH id=bc9 colSpan=4 headers=bc8>Influenza A</TH><TH id=bc14 headers=bc8>B</TH></TR><TR class=bg-colour-yellow><TH id=bc3 headers=bc2>A Total</TH><TH id=bc4 headers=bc2>Pandemic H1N1</TH><TH id=bc5 headers=bc2>A/H3N2</TH><TH id=bc6 headers=bc2>A unsubtyped</TH><TH headers="bc1 bc7">Total</TH><TH id=bc10 headers=bc9>A Total</TH><TH id=bc11 headers=bc9>Pandemic H1N1</TH><TH id=bc12 headers=bc9>A/H3N2</TH><TH id=bc13 headers=bc9>A unsubtyped</TH><TH headers=bc14>Total</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11>* Please note that this table reflects the number of specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported. Delays in the reporting of data may cause data to change retrospectively.</TD></TR></TFOOT><TBODY><TR><TH id=br2 headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">28</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">6</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">2</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">20</TD><TD class=alignRight headers="br1 br2 bc1 bc7">29</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">2519</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">159</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">836</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1524</TD><TD class=alignRight headers="br1 br2 bc8 bc14">219</TD></TR><TR><TH id=br3 headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">14</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">1</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">13</TD><TD class=alignRight headers="br1 br3 bc1 bc7">60</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1398</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">57</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">625</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">716</TD><TD class=alignRight headers="br1 br3 bc8 bc14">331</TD></TR><TR><TH id=br4 headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">25</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">6</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">3</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">16</TD><TD class=alignRight headers="br1 br4 bc1 bc7">26</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">2948</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">245</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">1165</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">1538</TD><TD class=alignRight headers="br1 br4 bc8 bc14">197</TD></TR><TR><TH id=br5 headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">24</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">4</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">7</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">13</TD><TD class=alignRight headers="br1 br5 bc1 bc7">43</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">3265</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">230</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">1172</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">1863</TD><TD class=alignRight headers="br1 br5 bc8 bc14">175</TD></TR><TR><TH id=br6 headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">68</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">4</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">14</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">50</TD><TD class=alignRight headers="br1 br6 bc1 bc7">32</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">9267</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">79</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">3511</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">5677</TD><TD class=alignRight headers="br1 br6 bc8 bc14">202</TD></TR><TR><TH id=br7 headers=br1>Unknown</TH><TD class=alignRight headers="br1 br7 bc1 bc2 bc3">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc6">0</TD><TD class=alignRight headers="br1 br7 bc1 bc7">0</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc10">164</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">18</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">144</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">2</TD><TD class=alignRight headers="br1 br7 bc8 bc14">0</TD></TR><TR><TH id=br8 headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">159</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc4">21</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc5">26</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc6">112</TD><TD class=alignRight headers="br1 br8 bc1 bc7">190</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">19561</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc11">788</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc12">7453</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc13">11320</TD><TD class=alignRight headers="br1 br8 bc8 bc14">1124</TD></TR></TBODY></TABLE>


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                  Figure 4. Influenza tests reported and percentage of tests positive, Canada,
                  by report week, 2012-2013


                  Text equivalent for figure 4Influenza tests reported and percentage of tests positive, Canada, by report week, 2011-2012
                  Figure 5. Percent positive influenza tests, compared to other respiratory viruses,
                  Canada, by reporting week, 2012-2013


                  Text equivalent for figure 5Percent positive influenza tests, compared to other respiratory viruses, Canada, by reporting week, 2011-2012

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                  Influenza strain characterizations

                  During the 2012-13 season, the National Microbiology Laboratory (NML) has antigenically characterized 703 influenza viruses. The 463 influenza A(H3N2) viruses were antigenically similar to the vaccine strain A/Victoria/361/2011 and the 93 A(H1N1)pdm09 viruses were antigenically similar to the vaccine strain A/California/07/09. Among the influenza B viruses, 115 were antigenically similar to the vaccine strain B/Wisconsin/01/2010 (Yamagata lineage) and 32 were similar to B/Brisbane/60/2008 (Victoria lineage; component of the 2011-2012 seasonal influenza vaccine) (Figure 6).
                  Figure 6. Influenza strain characterizations, Canada, 2012-2013, N = 703

                  Note: The recommended components for the 2012-2013 Northern Hemisphere influenza vaccine include: an A/Victoria/361/2011 (H3N2)-like virus; an A/California/7/2009 (H1N1)pdm09-like virus; and a B/Wisconsin/1/2010-like virus.
                  Text equivalent for figure 6Influenza strain characterizations, Canada, 2011-2012

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                  Antiviral resistance

                  During the 2012-13 season, NML has tested 633 influenza viruses for resistance to oseltamivir, and 632 influenza viruses for resistance to zanamivir. All viruses tested were sensitive to oseltamivir and zanamivir. A total of 819 influenza A viruses were tested for amantadine resistance and all were resistant (Table 3).


                  <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2012-2013</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=cr1 rowSpan=2>Virus type and subtype</TH><TH id=cc1 colSpan=2>Oseltamivir</TH><TH id=cc4 colSpan=2>Zanamivir</TH><TH id=cc7 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=cc2 headers=cc1># tested</TH><TH id=cc3 headers=cc1># resistant (%)</TH><TH id=cc5 headers=cc4># tested</TH><TH id=cc6 headers=cc4># resistant (%)</TH><TH id=cc8 headers=cc7># tested</TH><TH id=cc9 headers=cc7># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=cr2 class="alignLeft bg-colour-blue" headers=cr1>A (H3N2)</TH><TD class=alignCenter headers="cr2 cc2">430</TD><TD class=alignCenter headers="cr2 cc3">0</TD><TD class=alignCenter headers="cr2 cc5">430</TD><TD class=alignCenter headers="cr2 cc6">0</TD><TD class=alignCenter headers="cr2 cc8">724</TD><TD class=alignCenter headers="cr2 cc9">724 (100%)</TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignCenter headers="cr3 cc2">85</TD><TD class=alignCenter headers="cr3 cc3">0</TD><TD class=alignCenter headers="cr3 cc5">84</TD><TD class=alignCenter headers="cr3 cc6">0</TD><TD class=alignCenter headers="cr3 cc8">95</TD><TD class=alignCenter headers="cr3 cc9">95</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignCenter headers="cr4 cc2">118</TD><TD class=alignCenter headers="cr4 cc3">0</TD><TD class=alignCenter headers="cr4 cc5">118</TD><TD class=alignCenter headers="cr4 cc6">0</TD><TD class=alignCenter headers="cr4 cc8">NA <SUP>*</SUP></TD><TD class=alignCenter headers="cr4 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft bg-colour-blue" headers=cr1>TOTAL</TH><TD class=alignCenter headers="cr5 cc2">633</TD><TD class=alignCenter headers="cr5 cc3">0</TD><TD class=alignCenter headers="cr5 cc5">632</TD><TD class=alignCenter headers="cr5 cc6">0</TD><TD class=alignCenter headers="cr5 cc8">819</TD><TD class=alignCenter headers="cr5 cc9">819 (100%)</TD></TR></TBODY></TABLE>
                  Influenza-like Illness (ILI) Consultation Rate

                  The national influenza-like-illness (ILI) consultation rate decreased from 31.8 ILI consultations per 1,000 patient visits in week 08 to 20.5 in week 09 and is below the expected range for week 09 (Figure 7). In week 09, the highest consultation rate was observed in children <5 years of age (28.2/1,000), followed by children 5-19 years of age (25.3/1,000).
                  Figure 7. Influenza-like illness (ILI) consultation rates, Canada, by report week, 2012-2013 compared to 1996/97 through to 2011/12 seasons (with pandemic data suppressed)



                  Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons). Delays in the reporting of data may cause data to change retrospectively.
                  Text equivalent for figure 7Influenza-like illness (ILI) consultation rates, Canada, by report week, 2011-2012 compared to 1996/97 through to 2010/11 seasons (with pandemic data suppressed)
                  Pharmacy Surveillance

                  The Canadian antiviral prescription rate increased slightly from 85.7 antiviral prescriptions per 100,000 new prescriptions dispensed in week 08 to 102.5/100,000 in week 09. The antiviral prescription rate decreased for children and adults, and increased slightly among infants, but this rate was the lowest of all age-groups at 32.5/100,000. The highest rate continued to be observed for seniors ≥65 years of age, which increased in week 09 to 350.8/100,000.
                  Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group.
                  Severe Respiratory Illness Surveillance

                  Paediatric Influenza Hospitalizations and Deaths (IMPACT)
                  In week 09, 26 new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 23 in week 08. Among the cases reported in week 09, 50.0% (13) were identified with influenza B and 50.0% with influenza A [12 A(unsubtyped) and one A(H1N1)pdm09]. More hospitalizations were reported in older age groups compared to the previous week. The age distribution is as follows: 3 cases (11.5%) under 6 months of age, 6 (23.1%) between 6-23 months, 4 (15.4%) 2-4 years of age, 9 (34.6%) 5-9 years of age, and 4 (15.4%) 10-16 years of age. Two ICU admissions were reported during week 09, both with influenza B.

                  Since the start of the 2012-13 season, a total of 654 influenza-associated paediatric hospitalizations have been reported by the IMPACT network: 589 (90.1%) with influenza A [of which 66 (11.2%) were A(H3N2), 16 (2.7%) were A(H1N1)pdm09 and the remaining 507 were A(unsubtyped)], and 65 (9.9%) with influenza B. The distribution of cases by age group is as follows: 131 (20.0%) <6 months of age; 150 (22.9%) age 6-23 months; 196 (30.0%) age 2-4 years; 120 (18.3%) age 5-9 years; and 57 (8.7%) age 10-16 years. Fifty-six of the 654 cases (8.6%) were admitted to the ICU. No deaths have been reported to date.

                  Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associate paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.

                  Adult Influenza Hospitalizations and Deaths (PCIRN)

                  In week 09, 15 new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 31 in week 08. The majority of hospitalizations (12) were cases with influenza A(unsubtyped), and three cases were reported with influenza B. The age distribution is as follows: 11 cases were ≥65 years of age, 3 cases were 45-64 years of age, and one case was 20-44 years of age. One ICU admission was reported during the current week, an adult ≥65 years of age with influenza A(unsubtyped). No deaths were reported this week.

                  From November 4, 2012 to March 2, 2013, 1,385 influenza-associated adult hospitalizations were reported by the PCIRN-SOS network: 1,309 (94.5%) cases with influenza A [of which 187 were A(H3N2), 9 were A(H1N1)pdm09, and 1,113 were A(unsubtyped)]. Thirty-seven (2.7%) hospitalizations were cases with influenza B; and the type has not been reported for 39 (2.8%) cases. The age distribution of hospitalizations is as follows: 952 (68.7%) were aged ≥65 years, 280 (20.2%) were aged 45-64 years, 147 (10.6%) were aged 20-44 years, and 6 (0.4%) were <20 years of age. There have been 133 hospitalizations for which admission to the ICU was required; the majority (58.6%) of which were adults ≥65 years of age. Of the 133 ICU admissions, 44 (33.1%) had at least one co-morbidity, two (1.5%) had no co-morbidities, and 87 had no information to date. A total of 65 deaths have been reported, 11 (16.9%) with influenza A(H3N2), 52 (80.0%) with influenza A(unsubtyped), one (1.5%) with influenza B, and one (1.5%) with influenza untyped. Fifty-four of the 65 deaths (83.1%) were in adults ≥65 years of age, 9 (13.8%) were adults 45-64 years of age, and two (3.1%) were 20-44 years of age. Twenty-eight deaths occurred in individuals who had at least one co-morbidity. Detailed clinical information on co-morbidities is not known for the remaining cases.

                  Note: The number of hospitalizations reported through PCIRN represents a subset of all influenza-associate adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
                  Provincial/Territorial Influenza Hospitalizations and Deaths (Aggregate Surveillance System<SUP>*</SUP>)
                  In week 09, 112 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories<SUP>*</SUP>. The majority of cases were influenza A (83.0%), predominantly A(H3). The highest proportion of hospitalisations continued to be adults ≥65 years of age (45.5%). Of the 34 cases with available data, 5 were admitted to the Intensive Care Unit (ICU). Eleven deaths were reported: eight were adults ≥65 years of age, two adults aged 45-64 years and one child aged 5-14 years. It is important to note that the cause of death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.
                  To date this season 3,739 influenza-associated hospitalizations have been reported. Of these, 96.2% have been influenza A and 3.8% have been influenza B. Age information was available for 3,736 cases; and the age distribution is as follows: 2,093 (56.0%) ≥65 years; 629 (16.8%) 45-64 years; 328 (8.8%) 20-44 years; 34 (0.9%) 15-19; 140 (3.7%) 5-14 years and 512 (13.7%) 0-4 years of age. Among the 988 cases with available data, there have been 153 (15.5%) hospitalisations for which admission to ICU was required; the highest proportions being adults aged 45-64 years of age and ≥65 years of age (37.2% and 34.6% respectively). To date this season, 254 deaths have been reported: 211 (83.1%) were adults ≥65 years of age, 28 (11.0%) were adults 45-64 years; 9 were adults 20-44 years, one child aged 5-14 years and 5 aged 0-4 years. It is important to note that the cause of death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.
                  * Note: The number of new influenza-associated hospitalizations and deaths reported by the Aggregate Surveillance System each week may be overestimated, as it may include retrospective updates to data from Ontario for previous weeks. These data may also include cases reported by the IMPACT and PCIRN networks. Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, NS, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not reported in Ontario.

                  .../
                  http://www.phac-aspc.gc.ca/fluwatch/.../index-eng.php
                  "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                  -Nelson Mandela

                  Comment


                  • #24
                    Re: Canada FluWatch Weekly Reports 2012-2013 Season Week 10

                    FluWatch report: March 3 to March 9, 2013 (Week 10)

                    Posted 2013-03-15For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
                    <A title="Flu Watch (Version PDF, 113 KB - 6 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/12-13/w10_13/pdf/fw2013-10-eng.pdf">FluWatch report: March 3 to March 9, 2013 (Week 10) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 113 <ABBR title=Kilobytes>KB</ABBR> - 8 pages)

                    »» Help with PDF documents



                    Overall Summary
                    • Overall detections of influenza continued to decline, however the proportion of influenza B detections increased.
                    • In week 10, 75% of paediatric hospitalizations were associated with influenza B.
                    • Nationally, the number of regions reporting widespread or localized activity decreased.
                    • The ILI consultation rate increased but was within the expected range for this time of year.
                    Influenza Activity (geographic spread) and Outbreaks

                    In week 10, one region [in ON] reported widespread activity and 14 regions [in AB(1), ON(4), QC(3), NB(2), NS(2), PE(1) and NL(1)] reported localized activity. The number of regions reporting widespread or localized activity decreased compared to the previous week and continued to follow the overall decline in influenza/ILI activity from the peak in early January (Figures 1 and 2). Twenty-three new influenza outbreaks were reported: 19 in long-term-care facilities, 1 in a hospital, and 3 in other facilities or communities (Figure 3).
                    Figure 1. Map of overall Influenza activity level by province and territory,
                    Canada, Week 10





                    Note: Influenza activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.
                    Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
                    Figure 2. Number of influenza surveillance regions<SUP title="sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in"></SUP> reporting widespread or localized influenza activity, Canada, by report week, 2012-2013 (N<SUP>*</SUP>=58)


                    †sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.
                    * Total number of influenza surveillance regions in Canada
                    Text equivalent for figure 2Number of influenza surveillance regions reporting widespread or localized influenza activity, Canada, by report week, 2011-2012 (N=56)
                    Figure 3. Overall Number of Influenza Outbreaks, Canada, by Report Week, 2012-2013


                    Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2011-2012

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                    Influenza and Other Respiratory Virus Detections

                    The percentage of positive influenza tests decreased from 14.6% in week 09 to 13.5% in week 10 (Figure 4). Among the influenza viruses detected in week 10 (n=616), 55.7% were positive for influenza A viruses [of which 26.5% were A(H3), 20.4% were A(H1N1)pdm09, and 53.1% were A(unsubtyped)] (Table 1). The proportion of influenza B detections has increased over the past 7 weeks from 2.1% in week 03 to 44.3% in week 10 (Figure 4). The proportion of A(H1N1)pdm09 among positive influenza A detections has increased from 1.0% in week 52 to 20.4% in week 10. Cumulative influenza virus detections by type/subtype to date are as follows: 94.0% influenza A [35.0% A(H3), 3.8% A(H1N1)pdm09 and 61.2% A(unsubtyped)] and 6.0% influenza B (Table 1).
                    Detailed information on age and type/subtype has been received for 21,007 cases to date this season (Table 2). The proportion of cases by age group is as follows: 13.5% < 5 years; 8.6% between 5-19 years; 15.4% between 20-44 years; 16.8% between 45-64 years of age; 45.7% ≥ 65 years.
                    The percentage of tests positive decreased slightly for RSV, from 18.1% in week 09 to 17.3% in week 10; and increased for both parainfluenza (3.4%) and hMPV (4.8%). The percentage of tests positive for rhinovirus (8.7%), coronavirus (3.6%) and adenovirus (1.5%) were similar to previous weeks (Figure 5)<SUP>*</SUP>.
                    * For more details, see the weekly Respiratory Virus Detections in Canada Report.
                    <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly & Cumulative numbers of positive influenza specimens
                    by Provincial Laboratories, Canada, 2012-2013
                    </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces</TH><TH id=ac1 colSpan=6>Weekly
                    (March 3 to March 9, 2013)
                    </TH><TH id=ac9 colSpan=6>Cumulative
                    (August 26, 2012 to March 9, 2013)
                    </TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=5 headers=ac1>Influenza A</TH><TH id=ac8 headers=ac1>Influenza
                    B
                    </TH><TH id=ac10 colSpan=5 headers=ac9>Influenza A</TH><TH id=ac16 headers=ac9>Influenza
                    B
                    </TH></TR><TR class=bg-colour-yellow><TH id=ac3 headers=ac2>A Total</TH><TH id=ac4 headers=ac2>A(H1)</TH><TH id=ac5 headers=ac2>A(H3)</TH><TH id=ac6 headers=ac2>Pand H1N1</TH><TH id=ac7 class=noWrap headers=ac2>A
                    ( <ABBR title=unsubtyped>Un S</ABBR>)Table 1 note*
                    </TH><TH headers="ac1 ac8">Total</TH><TH id=ac11 headers=ac10>A Total</TH><TH id=ac12 headers=ac10>A(H1)</TH><TH id=ac13 headers=ac10>A(H3)</TH><TH id=ac14 headers=ac10>Pand H1N1</TH><TH id=ac15 class=noWrap headers=ac10>A
                    (Un S) Table 1 note*
                    </TH><TH headers=ac16>Total</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13>* Unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available. Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Note: Weekly data is based on week of positive lab detection. Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals. </TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=bg-colour-yellow headers=ar1><ABBR title="British Columbia ">BC</ABBR></TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">30</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">13</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">8</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac7">9</TD><TD class=alignRight headers="ar1 ar2 ac1 ac8">23</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac11">1846</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac13">1420</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac14">185</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac15">241</TD><TD class=alignRight headers="ar1 ar2 ac9 ac16">272</TD></TR><TR><TH id=ar3 class=bg-colour-yellow headers=ar1><ABBR title=Alberta>AB</ABBR></TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">24</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">8</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">13</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac7">3</TD><TD class=alignRight headers="ar1 ar3 ac1 ac8">40</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac11">2254</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac13">1733</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac14">377</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac15">144</TD><TD class=alignRight headers="ar1 ar3 ac9 ac16">322</TD></TR><TR><TH id=ar4 class=bg-colour-yellow headers=ar1><ABBR title=Saskatchewan>SK</ABBR></TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">22</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">1</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">17</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac7">4</TD><TD class=alignRight headers="ar1 ar4 ac1 ac8">9</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac11">793</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac13">468</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac14">51</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac15">274</TD><TD class=alignRight headers="ar1 ar4 ac9 ac16">113</TD></TR><TR><TH id=ar5 class=bg-colour-yellow headers=ar1><ABBR title=Manitoba>MB</ABBR></TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">13</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">2</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac7">11</TD><TD class=alignRight headers="ar1 ar5 ac1 ac8">3</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac11">604</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac13">78</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac14">8</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac15">518</TD><TD class=alignRight headers="ar1 ar5 ac9 ac16">47</TD></TR><TR><TH id=ar6 class=bg-colour-yellow headers=ar1><ABBR title=Ontario>ON</ABBR></TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">87</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">30</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">19</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac7">38</TD><TD class=alignRight headers="ar1 ar6 ac1 ac8">35</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac11">7990</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac13">3720</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac14">276</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac15">3994</TD><TD class=alignRight headers="ar1 ar6 ac9 ac16">324</TD></TR><TR><TH id=ar7 class=bg-colour-yellow headers=ar1><ABBR title=Quebec>QC</ABBR>

                    </TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">57</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">1</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">3</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac7">53</TD><TD class=alignRight headers="ar1 ar7 ac1 ac8">157</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac11">9629</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac13">547</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac14">29</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac15">9053</TD><TD class=alignRight headers="ar1 ar7 ac9 ac16">576</TD></TR><TR><TH id=ar8 class=bg-colour-yellow headers=ar1><ABBR title="New Brunswick">NB</ABBR>

                    </TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">74</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac5">34</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac6">8</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac7">32</TD><TD class=alignRight headers="ar1 ar8 ac1 ac8">4</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac11">1795</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac13">757</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac14">50</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac15">988</TD><TD class=alignRight headers="ar1 ar8 ac9 ac16">9</TD></TR><TR><TH id=ar9 class=bg-colour-yellow headers=ar1><ABBR title="Nova Scotia ">NS</ABBR>

                    </TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">24</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac7">24</TD><TD class=alignRight headers="ar1 ar9 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac11">312</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac13">165</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac14">5</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac15">142</TD><TD class=alignRight headers="ar1 ar9 ac9 ac16">3</TD></TR><TR><TH id=ar10 class=bg-colour-yellow headers=ar1><ABBR title="Prince Edward Island ">PE</ABBR>

                    </TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">4</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac5">4</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac7">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac11">101</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac13">70</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac14">3</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac15">28</TD><TD class=alignRight headers="ar1 ar10 ac9 ac16">1</TD></TR><TR><TH id=ar11 class=bg-colour-yellow headers=ar1><ABBR title="Newfoundland/Labrador ">NL</ABBR>

                    </TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">8</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac7">8</TD><TD class=alignRight headers="ar1 ar11 ac1 ac8">2</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac11">696</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac13">152</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac14">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac15">544</TD><TD class=alignRight headers="ar1 ar11 ac9 ac16">7</TD></TR><TR><TH id=ar12 class=bg-colour-yellow headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">343</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac5">91</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac6">70</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac7">182</TD><TD class=alignRight headers="ar1 ar12 ac1 ac8">273</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac11">26020</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac13">9110</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac14">984</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac15">15926</TD><TD class=alignRight headers="ar1 ar12 ac9 ac16">1674</TD></TR></TBODY></TABLE>
                    <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 2. Weekly & Cumulative numbers of positive influenza specimens by age groups
                    reported through case-based laboratory reporting, Canada, 2012-2013 Table 2 note*
                    </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups</TH><TH id=bc1 colSpan=5>Weekly
                    (March 3 to March 9, 2013)
                    </TH><TH id=bc8 colSpan=5>Cumulative
                    (August 26, 2012 to March 9, 2013)
                    </TH></TR><TR class=bg-colour-yellow><TH id=bc2 colSpan=4 headers=bc1>Influenza A</TH><TH id=bc7 headers=bc1>B</TH><TH id=bc9 colSpan=4 headers=bc8>Influenza A</TH><TH id=bc14 headers=bc8>B</TH></TR><TR class=bg-colour-yellow><TH id=bc3 headers=bc2>A Total</TH><TH id=bc4 headers=bc2>Pandemic H1N1</TH><TH id=bc5 headers=bc2>A/H3N2</TH><TH id=bc6 headers=bc2>A unsubtyped</TH><TH headers="bc1 bc7">Total</TH><TH id=bc10 headers=bc9>A Total</TH><TH id=bc11 headers=bc9>Pandemic H1N1</TH><TH id=bc12 headers=bc9>A/H3N2</TH><TH id=bc13 headers=bc9>A unsubtyped</TH><TH headers=bc14>Total</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11>* Please note that this table reflects the number of specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported. Delays in the reporting of data may cause data to change retrospectively. </TD></TR></TFOOT><TBODY><TR><TH id=br2 headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">17</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">3</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">13</TD><TD class=alignRight headers="br1 br2 bc1 bc7">43</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">2556</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">168</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">841</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1547</TD><TD class=alignRight headers="br1 br2 bc8 bc14">274</TD></TR><TR><TH id=br3 headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">6</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">5</TD><TD class=alignRight headers="br1 br3 bc1 bc7">59</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1411</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">59</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">627</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">725</TD><TD class=alignRight headers="br1 br3 bc8 bc14">399</TD></TR><TR><TH id=br4 headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">36</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">10</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">6</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">20</TD><TD class=alignRight headers="br1 br4 bc1 bc7">32</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">3007</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">267</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">1176</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">1564</TD><TD class=alignRight headers="br1 br4 bc8 bc14">236</TD></TR><TR><TH id=br5 headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">22</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">10</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">11</TD><TD class=alignRight headers="br1 br5 bc1 bc7">31</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">3310</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">250</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">1180</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">1880</TD><TD class=alignRight headers="br1 br5 bc8 bc14">214</TD></TR><TR><TH id=br6 headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">54</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">6</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">14</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">34</TD><TD class=alignRight headers="br1 br6 bc1 bc7">39</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">9347</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">91</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">3542</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">5714</TD><TD class=alignRight headers="br1 br6 bc8 bc14">253</TD></TR><TR><TH id=br7 headers=br1>Unknown</TH><TD class=alignRight headers="br1 br7 bc1 bc2 bc3">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc6">0</TD><TD class=alignRight headers="br1 br7 bc1 bc7">0</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc10">164</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">18</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">144</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">2</TD><TD class=alignRight headers="br1 br7 bc8 bc14">0</TD></TR><TR><TH id=br8 headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">135</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc4">29</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc5">23</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc6">83</TD><TD class=alignRight headers="br1 br8 bc1 bc7">204</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">19795</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc11">853</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc12">7510</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc13">11432</TD><TD class=alignRight headers="br1 br8 bc8 bc14">1376</TD></TR></TBODY></TABLE>


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                    Figure 4. Influenza tests reported and percentage of tests positive, Canada,
                    by report week, 2012-2013


                    Text equivalent for figure 4Influenza tests reported and percentage of tests positive, Canada, by report week, 2011-2012
                    Figure 5. Percent positive influenza tests, compared to other respiratory viruses,
                    Canada, by reporting week, 2012-2013


                    Text equivalent for figure 5Percent positive influenza tests, compared to other respiratory viruses, Canada, by reporting week, 2011-2012

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                    Influenza strain characterizations

                    During the 2012-13 season, the National Microbiology Laboratory (NML) has antigenically characterized 730 influenza viruses. The 464 influenza A(H3N2) viruses were antigenically similar to the vaccine strain A/Victoria/361/2011 and the 103 A(H1N1)pdm09 viruses were antigenically similar to the vaccine strain A/California/07/09. Among the influenza B viruses, 127 were antigenically similar to the vaccine strain B/Wisconsin/01/2010 (Yamagata lineage) and 36 were similar to B/Brisbane/60/2008 (Victoria lineage; component of the 2011-2012 seasonal influenza vaccine) (Figure 6).
                    Figure 6. Influenza strain characterizations, Canada, 2012-2013, N = 730

                    Note: The recommended components for the 2012-2013 Northern Hemisphere influenza vaccine include: an A/Victoria/361/2011 (H3N2)-like virus; an A/California/7/2009 (H1N1)pdm09-like virus; and a B/Wisconsin/1/2010-like virus.
                    Text equivalent for figure 6Influenza strain characterizations, Canada, 2011-2012

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                    Antiviral resistance

                    During the 2012-13 season, NML has tested 699 influenza viruses for resistance to oseltamivir, and 696 influenza viruses for resistance to zanamivir. All viruses tested were sensitive to oseltamivir and zanamivir. A total of 859 influenza A viruses were tested for amantadine resistance and all were resistant (Table 3).


                    <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2012-2013</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=cr1 rowSpan=2>Virus type and subtype</TH><TH id=cc1 colSpan=2>Oseltamivir</TH><TH id=cc4 colSpan=2>Zanamivir</TH><TH id=cc7 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=cc2 headers=cc1># tested</TH><TH id=cc3 headers=cc1># resistant (%)</TH><TH id=cc5 headers=cc4># tested</TH><TH id=cc6 headers=cc4># resistant (%)</TH><TH id=cc8 headers=cc7># tested</TH><TH id=cc9 headers=cc7># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=cr2 class="alignLeft bg-colour-blue" headers=cr1>A (H3N2)</TH><TD class=alignCenter headers="cr2 cc2">460</TD><TD class=alignCenter headers="cr2 cc3">0</TD><TD class=alignCenter headers="cr2 cc5">459</TD><TD class=alignCenter headers="cr2 cc6">0</TD><TD class=alignCenter headers="cr2 cc8">756</TD><TD class=alignCenter headers="cr2 cc9">756(100%)</TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignCenter headers="cr3 cc2">94</TD><TD class=alignCenter headers="cr3 cc3">0</TD><TD class=alignCenter headers="cr3 cc5">92</TD><TD class=alignCenter headers="cr3 cc6">0</TD><TD class=alignCenter headers="cr3 cc8">103</TD><TD class=alignCenter headers="cr3 cc9">103</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignCenter headers="cr4 cc2">145</TD><TD class=alignCenter headers="cr4 cc3">0</TD><TD class=alignCenter headers="cr4 cc5">145</TD><TD class=alignCenter headers="cr4 cc6">0</TD><TD class=alignCenter headers="cr4 cc8">NA <SUP>*</SUP></TD><TD class=alignCenter headers="cr4 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft bg-colour-blue" headers=cr1>TOTAL</TH><TD class=alignCenter headers="cr5 cc2">699</TD><TD class=alignCenter headers="cr5 cc3">0</TD><TD class=alignCenter headers="cr5 cc5">696</TD><TD class=alignCenter headers="cr5 cc6">0</TD><TD class=alignCenter headers="cr5 cc8">859</TD><TD class=alignCenter headers="cr5 cc9">859 (100%)</TD></TR></TBODY></TABLE>
                    Influenza-like Illness (ILI) Consultation Rate

                    The national influenza-like-illness (ILI) consultation rate increased from 20.9 ILI consultations per 1,000 patient visits in week 09 to 30.7 in week 10 and is within the expected range for week 10 (Figure 7). In week 10, the highest consultation rate was observed in children 5-19 years of age (70.1/1,000).
                    Figure 7. Influenza-like illness (ILI) consultation rates, Canada, by report week, 2012-2013 compared to 1996/97 through to 2011/12 seasons (with pandemic data suppressed)



                    Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons). Delays in the reporting of data may cause data to change retrospectively.
                    Text equivalent for figure 7Influenza-like illness (ILI) consultation rates, Canada, by report week, 2011-2012 compared to 1996/97 through to 2010/11 seasons (with pandemic data suppressed)
                    Pharmacy Surveillance

                    The Canadian antiviral prescription rate decreased slightly from 111.1 antiviral prescriptions per 100,000 new prescriptions dispensed in week 09 to 85.7/100,000 in week 10. The antiviral prescription rate was stable for children and decreased among all other age-groups. The highest rate continued to be observed for seniors ≥65 years of age, which decreased in week 10 to 289.0/100,000.

                    Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group.
                    Severe Respiratory Illness Surveillance

                    Paediatric Influenza Hospitalizations and Deaths (IMPACT)
                    In week 10, 20 new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 43 in week 09. Among the cases reported in week 10, 75% (15) were identified with influenza B and 25% (5) with influenza A(unsubtyped). For the second week in a row, the number of influenza B cases exceeded the number of influenza A cases, a reversal of the pattern seen earlier in the season. The age distribution is as follows: 4 cases (20.0%) under 6 months of age, 3 (15.0%) between 6-23 months, 6 (30.0%) 2-4 years of age, 5 (25.0%) 5-9 years of age, and 2 (10.0%) 10-16 years of age. Two ICU admissions were reported during week 10, one 6-23 months of age, one between 2-4 years of age, both with influenza B.

                    Since the start of the 2012-13 season, a total of 694 influenza-associated paediatric hospitalizations have been reported by the IMPACT network: 601 (86.6%) with influenza A [of which 67 (11.1%) were A(H3N2), 16 (2.7%) were A(H1N1)pdm09 and the remaining 518 were A(unsubtyped)], and 93 (13.4%) with influenza B. The distribution of cases by age group is as follows: 139 (20.0%) <6 months of age; 160 (23.1%) age 6-23 months; 206 (29.7%) age 2-4 years; 130 (18.7%) age 5-9 years; and 59 (8.5%) age 10-16 years. Sixty of the 694 cases (8.6%) were admitted to the ICU. No deaths have been reported to date.

                    Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associate paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.

                    Adult Influenza Hospitalizations and Deaths (PCIRN)

                    In week 10, 21 new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network. Seventy-six percent of the hospitalizations were among cases identified with influenza A(unsubtyped) and the rest were with influenza B. Ten cases were ≥65 years of age, seven were 45-64 years of age, and four were 20-44 years of age. Three ICU admissions were reported during the current week all with influenza A(unsubtyped): one case was 20-44 years of age and the two others ≥65 years of age. Two deaths were reported, both were ≥65 years of age, one with influenza A(H3N2) and influenza A(unsubtyped).

                    From week 45 to week 10, 1,474 influenza-associated adult hospitalizations have been reported by the PCIRN-SOS network: 1,382 (93.8%) with influenza A [of which 198 were A(H3N2), 11 were A(H1N1)pdm09, and 1173 were A(unsubtyped). Forty-six hospitalizations were among cases with influenza B, and the type has not been reported for 46 cases. The age distribution of hospitalizations is as follows: 1014 cases (68.9%) were aged ≥65 years, 293 cases (19.9%) were aged 45-64 years, 157 cases (10.7%) were aged 20-44 years, and 8 cases (0.5%) were <20 years of age. There have been 146 (9.9%) hospitalizations for which admission to the ICU was required: the majority (61.0%) were adults ≥65 years of age. Of the ICU admissions, 51 (34.9%) had at least one co-morbidity, two (1.4%) had no co-morbidities, and 93 had no information to date. A total of 77 deaths have been reported: 74 (96.0%) with influenza A [13 (17.6%) with influenza A(H3N2), one (1.4%) with influenza A(H1N1)pdm09 and 60 (81.1%) with influenza A(unsubtyped)], and 2 (2.6%) with influenza B, and one with influenza for which the type has not been reported. Sixty-four of the 77 deaths (83.1%) were in adults ≥65 years of age, 9 (14.3%) were adults 45-64 years of age, and 2 (2.6%) was 20-44 years of age. Thirty-three deaths (42.9%) occurred in individuals who had at least one co-morbidity. Detailed clinical information on co-morbidities is not known for the remaining cases.

                    Note: The number of hospitalizations reported through PCIRN represents a subset of all influenza-associate adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.

                    Provincial/Territorial Influenza Hospitalizations and Deaths (Aggregate Surveillance System<SUP>*</SUP>)

                    In week 10, 108 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories<SUP>*</SUP>. The majority of cases were influenza A (88; 81.5%), predominantly A(H3). The highest proportion of hospitalisations continued to be adults ≥65 years of age (54.6%). Of the 25 cases with available data, 7 were admitted to the ICU - all adults ≥ 20 years and older. Fifteen deaths were reported: 12 were adults ≥65 years of age, 1 aged 45-64 years and 2 aged 20-44 years. It is important to note that the cause of death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases. Data was not received for the Northwest Territories in week 10.

                    To date this season 3,849 influenza-associated hospitalizations have been reported; compared to 281 hospitalizations reported for the same time period during the 2011-2012 influenza season. Of the hospitalizations to date, 95.7% have been influenza A. The cumulative proportion of hospitalizations in cases with influenza B has increased from 1.6% in week 01, to 4.2% in week 10; which follows the trend of influenza B detections in Canada this season.

                    Age information was available for 3,846 cases, and the age distribution is as follows: 2,152 (56.0%) were ≥65 years; 645 (16.8%) 45-64 years; 342 (8.9%) 20-44 years; 37 (1.0%) 15-19; 145 (3.8%) 5-14 years and 525 (13.7%) 0-4 years of age. Among the 1,015 cases with available data, there have been 160 (15.8%) hospitalisations for which admission to ICU was required; the highest proportions being adults aged 45-64 years of age and ≥65 years of age (36.9% and 35.6% respectively). To date, 269 deaths have been reported: 223 (82.9%) were adults ≥65 years of age, 29 (10.8%) were adults 45-64 years; 11 (4.1%) were adults 20-44 years, one child aged 5-14 years and 5 (1.9%) aged 0-4 years. It is important to note that the cause of death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.

                    * Note: The number of new influenza-associated hospitalizations and deaths reported by the Aggregate Surveillance System each week may be overestimated, as it may include retrospective updates to data from Ontario for previous weeks. These data may also include cases reported by the IMPACT and PCIRN networks. Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, NS, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not reported in Ontario.

                    .../
                    http://www.phac-aspc.gc.ca/fluwatch/.../index-eng.php
                    "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                    -Nelson Mandela

                    Comment


                    • #25
                      Re: Canada FluWatch Weekly Reports 2012-2013 Season Week 11

                      FluWatch report: March 10 to March 16, 2013 (Week 11)

                      Posted 2013-03-22For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
                      <A title="Flu Watch (Version PDF, 113 KB - 6 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/12-13/w11_13/pdf/fw2013-11-eng.pdf">FluWatch report: March 10 to March 16, 2013 (Week 11) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 113 <ABBR title=Kilobytes>KB</ABBR> - 8 pages)

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                      Overall Summary
                      • Overall detections of influenza continued to decline, however the proportion of influenza B detections increased.
                      • The proportions of tests positive for other respiratory viruses increased.
                      • In week 11, 62% of paediatric hospitalizations were associated with influenza B.
                      • Several indicators, including the number of regions reporting widespread or localized activity, the ILI consultation rate, and the proportion of prescriptions for antivirals decreased in week 11.
                      • Similar to previous years, older adults (persons aged ≥65 years) are the most affected this season; with 45.0% of laboratory detections to date, 69.2% of adult hospitalizations reported through the PCIRN-SOS network, outbreaks in long-term care facilities, and the highest proportion of antiviral prescriptions.
                      Influenza Activity (geographic spread) and Outbreaks

                      In week 11, one region [in ON] reported widespread activity and 12 regions [in BC(1), AB(1), ON(6), QC(1), NS(2) and NL(1)] reported localized activity. The number of regions reporting widespread or localized activity decreased compared to the previous week and continued to follow the overall decline in influenza/ILI activity from the peak in early January (Figures 1 and 2). Twenty-four new influenza outbreaks were reported: 17 in long-term-care facilities, one in a hospital, one in a school, and five in other facilities or communities (Figure 3).
                      Figure 1. Map of overall Influenza activity level by province and territory,
                      Canada, Week 11






                      Note: Influenza activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.
                      Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
                      Figure 2. Number of influenza surveillance regions<SUP title="sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in"></SUP> reporting widespread or localized influenza activity, Canada, by report week, 2012-2013 (N<SUP>*</SUP>=58)


                      †sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.
                      * Total number of influenza surveillance regions in Canada
                      Text equivalent for figure 2Number of influenza surveillance regions reporting widespread or localized influenza activity, Canada, by report week, 2011-2012 (N=56)
                      Figure 3. Overall Number of Influenza Outbreaks, Canada, by Report Week, 2012-2013


                      Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2011-2012

                      Top of Page

                      Influenza and Other Respiratory Virus Detections

                      The percentage of positive influenza tests decreased from 13.1% in week 10 to 12.2% in week 11 (Figure 4). Among the influenza viruses detected in week 10 (n=507), 55.4% were positive for influenza A viruses [of which 22.6% were A(H3), 20.8% were A(H1N1)pdm09, and 56.6% were A(unsubtyped)] (Table 1). The proportion of influenza B detections has increased over the past 8 weeks from 2.1% in week 03 to 55.4% in week 11 (Figure 4). Cumulative influenza virus detections by type/subtype to date are as follows: 93.0% influenza A [34.9% A(H3), 4.0% A(H1N1)pdm09 and 61.1% A(unsubtyped)] and 7.0% influenza B (Table 1).
                      Detailed information on age and type/subtype has been received for 22,036 cases to date this season (Table 2). ). The proportion of cases by age group is as follows: 13.7% < 5 years; 8.9% between 5-19 years; 15.6% between 20-44 years; 16.8% between 45-64 years of age; 45.0% ≥ 65 years.
                      The percentage of tests positive decreased for RSV, from 17.6% in week 10 to 15.4% in week 11. The percentage of positive tests increased for all other viruses: rhinovirus (9.4%), hMPV (5.2%), coronavirus (4.2%), parainfluenza (4.1%) and adenovirus (1.9%) (Figure 5)<SUP>*</SUP>.
                      * For more details, see the weekly Respiratory Virus Detections in Canada Report.
                      <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly & Cumulative numbers of positive influenza specimens
                      by Provincial Laboratories, Canada, 2012-2013
                      </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces</TH><TH id=ac1 colSpan=6>Weekly
                      (March 10 to March 16, 2013)</TH><TH id=ac9 colSpan=6>Cumulative
                      (August 26, 2012 to March 16, 2013)</TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=5 headers=ac1>Influenza A</TH><TH id=ac8 headers=ac1>Influenza
                      B</TH><TH id=ac10 colSpan=5 headers=ac9>Influenza A</TH><TH id=ac16 headers=ac9>Influenza
                      B</TH></TR><TR class=bg-colour-yellow><TH id=ac3 headers=ac2>A Total</TH><TH id=ac4 headers=ac2>A(H1)</TH><TH id=ac5 headers=ac2>A(H3)</TH><TH id=ac6 headers=ac2>Pand H1N1</TH><TH id=ac7 class=noWrap headers=ac2>A
                      ( <ABBR title=unsubtyped>Un S</ABBR>)Table 1 note*</TH><TH headers="ac1 ac8">Total</TH><TH id=ac11 headers=ac10>A Total</TH><TH id=ac12 headers=ac10>A(H1)</TH><TH id=ac13 headers=ac10>A(H3)</TH><TH id=ac14 headers=ac10>Pand H1N1</TH><TH id=ac15 class=noWrap headers=ac10>A
                      (Un S) Table 1 note*</TH><TH headers=ac16>Total</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13>* Unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available. Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Note: Weekly data is based on week of positive lab detection. Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals. </TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=bg-colour-yellow headers=ar1><ABBR title="British Columbia ">BC</ABBR></TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">32</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">15</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">12</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac7">5</TD><TD class=alignRight headers="ar1 ar2 ac1 ac8">27</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac11">1872</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac13">1435</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac14">200</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac15">237</TD><TD class=alignRight headers="ar1 ar2 ac9 ac16">299</TD></TR><TR><TH id=ar3 class=bg-colour-yellow headers=ar1><ABBR title=Alberta>AB</ABBR></TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">21</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">8</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">10</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac7">3</TD><TD class=alignRight headers="ar1 ar3 ac1 ac8">47</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac11">2276</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac13">1741</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac14">391</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac15">144</TD><TD class=alignRight headers="ar1 ar3 ac9 ac16">370</TD></TR><TR><TH id=ar4 class=bg-colour-yellow headers=ar1><ABBR title=Saskatchewan>SK</ABBR></TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">16</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">6</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">8</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac7">2</TD><TD class=alignRight headers="ar1 ar4 ac1 ac8">15</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac11">809</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac13">474</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac14">59</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac15">276</TD><TD class=alignRight headers="ar1 ar4 ac9 ac16">128</TD></TR><TR><TH id=ar5 class=bg-colour-yellow headers=ar1><ABBR title=Manitoba>MB</ABBR></TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">7</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac7">7</TD><TD class=alignRight headers="ar1 ar5 ac1 ac8">3</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac11">611</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac13">78</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac14">8</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac15">525</TD><TD class=alignRight headers="ar1 ar5 ac9 ac16">50</TD></TR><TR><TH id=ar6 class=bg-colour-yellow headers=ar1><ABBR title=Ontario>ON</ABBR></TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">68</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">20</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">16</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac7">32</TD><TD class=alignRight headers="ar1 ar6 ac1 ac8">50</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac11">8070</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac13">3743</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac14">294</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac15">4033</TD><TD class=alignRight headers="ar1 ar6 ac9 ac16">391</TD></TR><TR><TH id=ar7 class=bg-colour-yellow headers=ar1><ABBR title=Quebec>QC</ABBR>
                      </TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">43</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">1</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac7">42</TD><TD class=alignRight headers="ar1 ar7 ac1 ac8">136</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac11">9671</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac13">546</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac14">30</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac15">9095</TD><TD class=alignRight headers="ar1 ar7 ac9 ac16">712</TD></TR><TR><TH id=ar8 class=bg-colour-yellow headers=ar1><ABBR title="New Brunswick">NB</ABBR>
                      </TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">9</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac7">9</TD><TD class=alignRight headers="ar1 ar8 ac1 ac8">1</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac11">1804</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac13">757</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac14">50</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac15">997</TD><TD class=alignRight headers="ar1 ar8 ac9 ac16">10</TD></TR><TR><TH id=ar9 class=bg-colour-yellow headers=ar1><ABBR title="Nova Scotia ">NS</ABBR>
                      </TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">23</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac7">23</TD><TD class=alignRight headers="ar1 ar9 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac11">335</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac13">165</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac14">5</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac15">165</TD><TD class=alignRight headers="ar1 ar9 ac9 ac16">3</TD></TR><TR><TH id=ar10 class=bg-colour-yellow headers=ar1><ABBR title="Prince Edward Island ">PE</ABBR>
                      </TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">2</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac5">2</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac7">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac11">104</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac13">73</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac14">3</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac15">28</TD><TD class=alignRight headers="ar1 ar10 ac9 ac16">1</TD></TR><TR><TH id=ar11 class=bg-colour-yellow headers=ar1><ABBR title="Newfoundland/Labrador ">NL</ABBR>
                      </TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">5</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac7">5</TD><TD class=alignRight headers="ar1 ar11 ac1 ac8">2</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac11">701</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac13">152</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac14">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac15">549</TD><TD class=alignRight headers="ar1 ar11 ac9 ac16">9</TD></TR><TR><TH id=ar12 class=bg-colour-yellow headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">226</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac5">51</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac6">47</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac7">128</TD><TD class=alignRight headers="ar1 ar12 ac1 ac8">281</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac11">26253</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac13">9164</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac14">1040</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac15">16049</TD><TD class=alignRight headers="ar1 ar12 ac9 ac16">1973</TD></TR></TBODY></TABLE>
                      <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 2. Weekly & Cumulative numbers of positive influenza specimens by age groups
                      reported through case-based laboratory reporting, Canada, 2012-2013
                      Table 2 note*</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups</TH><TH id=bc1 colSpan=5>Weekly
                      (March 10 to March 16, 2013)</TH><TH id=bc8 colSpan=5>Cumulative
                      (August 26, 2012 to March 16, 2013)</TH></TR><TR class=bg-colour-yellow><TH id=bc2 colSpan=4 headers=bc1>Influenza A</TH><TH id=bc7 headers=bc1>B</TH><TH id=bc9 colSpan=4 headers=bc8>Influenza A</TH><TH id=bc14 headers=bc8>B</TH></TR><TR class=bg-colour-yellow><TH id=bc3 headers=bc2>A Total</TH><TH id=bc4 headers=bc2>Pandemic H1N1</TH><TH id=bc5 headers=bc2>A/H3N2</TH><TH id=bc6 headers=bc2>A unsubtyped</TH><TH headers="bc1 bc7">Total</TH><TH id=bc10 headers=bc9>A Total</TH><TH id=bc11 headers=bc9>Pandemic H1N1</TH><TH id=bc12 headers=bc9>A/H3N2</TH><TH id=bc13 headers=bc9>A unsubtyped</TH><TH headers=bc14>Total</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11>* Please note that this table reflects the number of specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported. Delays in the reporting of data may cause data to change retrospectively. </TD></TR></TFOOT><TBODY><TR><TH id=br2 headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">10</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">2</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">8</TD><TD class=alignRight headers="br1 br2 bc1 bc7">36</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">2669</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">188</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">926</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1555</TD><TD class=alignRight headers="br1 br2 bc8 bc14">348</TD></TR><TR><TH id=br3 headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">10</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">4</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">6</TD><TD class=alignRight headers="br1 br3 bc1 bc7">58</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1470</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">69</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">669</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">732</TD><TD class=alignRight headers="br1 br3 bc8 bc14">499</TD></TR><TR><TH id=br4 headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">19</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">6</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">3</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">10</TD><TD class=alignRight headers="br1 br4 bc1 bc7">26</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">3140</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">301</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">1268</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">1571</TD><TD class=alignRight headers="br1 br4 bc8 bc14">289</TD></TR><TR><TH id=br5 headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">22</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">7</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">4</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">11</TD><TD class=alignRight headers="br1 br5 bc1 bc7">36</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">3439</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">284</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">1261</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">1894</TD><TD class=alignRight headers="br1 br5 bc8 bc14">272</TD></TR><TR><TH id=br6 headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">56</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">2</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">19</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">35</TD><TD class=alignRight headers="br1 br6 bc1 bc7">28</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">9617</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">98</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">3760</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">5759</TD><TD class=alignRight headers="br1 br6 bc8 bc14">293</TD></TR><TR><TH id=br7 headers=br1>Unknown</TH><TD class=alignRight headers="br1 br7 bc1 bc2 bc3">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc6">0</TD><TD class=alignRight headers="br1 br7 bc1 bc7">0</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc10">165</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">19</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">144</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">2</TD><TD class=alignRight headers="br1 br7 bc8 bc14">0</TD></TR><TR><TH id=br8 headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">117</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc4">21</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc5">26</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc6">70</TD><TD class=alignRight headers="br1 br8 bc1 bc7">184</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">20500</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc11">959</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc12">8028</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc13">11513</TD><TD class=alignRight headers="br1 br8 bc8 bc14">1701</TD></TR></TBODY></TABLE>


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                      Figure 4. Influenza tests reported and percentage of tests positive, Canada,
                      by report week, 2012-2013



                      Text equivalent for figure 4Influenza tests reported and percentage of tests positive, Canada, by report week, 2011-2012
                      Figure 5. Percent positive influenza tests, compared to other respiratory viruses,
                      Canada, by reporting week, 2012-2013



                      Text equivalent for figure 5Percent positive influenza tests, compared to other respiratory viruses, Canada, by reporting week, 2011-2012

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                      Influenza strain characterizations

                      During the 2012-13 season, the National Microbiology Laboratory (NML) has antigenically characterized 798 influenza viruses. The 470 influenza A(H3N2) viruses were antigenically similar to the vaccine strain A/Victoria/361/2011 and the 128 A(H1N1)pdm09 viruses were antigenically similar to the vaccine strain A/California/07/09. Among the influenza B viruses, 160 were antigenically similar to the vaccine strain B/Wisconsin/01/2010 (Yamagata lineage) and 40 were similar to B/Brisbane/60/2008 (Victoria lineage; component of the 2011-2012 seasonal influenza vaccine) (Figure 6).
                      Figure 6. Influenza strain characterizations, Canada, 2012-2013, N = 798

                      Note: The recommended components for the 2012-2013 Northern Hemisphere influenza vaccine include: an A/Victoria/361/2011 (H3N2)-like virus; an A/California/7/2009 (H1N1)pdm09-like virus; and a B/Wisconsin/1/2010-like virus.
                      Text equivalent for figure 6Influenza strain characterizations, Canada, 2011-2012

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                      Antiviral resistance

                      During the 2012-13 season, NML has tested 730 influenza viruses for resistance to oseltamivir, and 727 influenza viruses for resistance to zanamivir. All viruses tested were sensitive to oseltamivir and zanamivir. A total of 886 influenza A viruses were tested for amantadine resistance and all were resistant (Table 3).


                      <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2012-2013</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=cr1 rowSpan=2>Virus type and subtype</TH><TH id=cc1 colSpan=2>Oseltamivir</TH><TH id=cc4 colSpan=2>Zanamivir</TH><TH id=cc7 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=cc2 headers=cc1># tested</TH><TH id=cc3 headers=cc1># resistant (%)</TH><TH id=cc5 headers=cc4># tested</TH><TH id=cc6 headers=cc4># resistant (%)</TH><TH id=cc8 headers=cc7># tested</TH><TH id=cc9 headers=cc7># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=cr2 class="alignLeft bg-colour-blue" headers=cr1>A (H3N2)</TH><TD class=alignCenter headers="cr2 cc2">462</TD><TD class=alignCenter headers="cr2 cc3">0</TD><TD class=alignCenter headers="cr2 cc5">461</TD><TD class=alignCenter headers="cr2 cc6">0</TD><TD class=alignCenter headers="cr2 cc8">772</TD><TD class=alignCenter headers="cr2 cc9">772 (100%)</TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignCenter headers="cr3 cc2">106</TD><TD class=alignCenter headers="cr3 cc3">0</TD><TD class=alignCenter headers="cr3 cc5">104</TD><TD class=alignCenter headers="cr3 cc6">0</TD><TD class=alignCenter headers="cr3 cc8">114</TD><TD class=alignCenter headers="cr3 cc9">114</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignCenter headers="cr4 cc2">162</TD><TD class=alignCenter headers="cr4 cc3">0</TD><TD class=alignCenter headers="cr4 cc5">162</TD><TD class=alignCenter headers="cr4 cc6">0</TD><TD class=alignCenter headers="cr4 cc8">NA <SUP>*</SUP></TD><TD class=alignCenter headers="cr4 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft bg-colour-blue" headers=cr1>TOTAL</TH><TD class=alignCenter headers="cr5 cc2">730</TD><TD class=alignCenter headers="cr5 cc3">0</TD><TD class=alignCenter headers="cr5 cc5">727</TD><TD class=alignCenter headers="cr5 cc6">0</TD><TD class=alignCenter headers="cr5 cc8">886</TD><TD class=alignCenter headers="cr5 cc9">886 (100%)</TD></TR></TBODY></TABLE>
                      Influenza-like Illness (ILI) Consultation Rate

                      The national influenza-like-illness (ILI) consultation rate decreased from 26.5 ILI consultations per 1,000 patient visits in week 10, to 23.2 in week 11 and is within the expected range (Figure 7). In week 11, the highest consultation rate was observed in children less than 5 years of age (68.6/1,000).
                      Figure 7. Influenza-like illness (ILI) consultation rates, Canada, by report week, 2012-2013 compared to 1996/97 through to 2011/12 seasons (with pandemic data suppressed)



                      Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons). Delays in the reporting of data may cause data to change retrospectively.
                      Text equivalent for figure 7Influenza-like illness (ILI) consultation rates, Canada, by report week, 2011-2012 compared to 1996/97 through to 2010/11 seasons (with pandemic data suppressed)
                      Pharmacy Surveillance

                      The Canadian antiviral prescription rate decreased from 93.5 antiviral prescriptions per 100,000 new prescriptions dispensed in week 10 to 47.2/100,000 in week 11; a rate similar to that observed at the end of November 2012 (week 47). The antiviral prescription rate decreased for children, adults and seniors, and was stable for infants, but this rate was the lowest of all age-groups at 11.7/100,000. The highest rate continued to be observed for seniors ≥65 years of age at 94.7/100,000.
                      Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group.
                      Severe Respiratory Illness Surveillance

                      Paediatric Influenza Hospitalizations and Deaths (IMPACT)

                      In week 11, 21 new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 22 in week 10. Among the cases reported in week 11, 62% (13) were identified with influenza B, 14% (3) with A(H1N1)pdm09 and 24% (5) with A(unsubtyped). For the third week in a row, the number of influenza B cases exceeded the number of influenza A cases, a reversal of the pattern seen earlier in the season. The age distribution is as follows: 2 cases (9.5%) under 6 months of age, 7 (33.3%) between 6-23 months, 3 (14.3%) 2-4 years of age, 7 (33.3%) 5-9 years of age, and 2 (9.5%) 10-16 years of age. One admission to an Intensive Care Unit (ICU) was reported during week 11, a child 2-4 years of age with influenza B.

                      Since the start of the 2012-13 season, a total of 713 influenza-associated paediatric hospitalizations have been reported by the IMPACT network: 605 (84.9%) with influenza A [of which 112 (18.5%) were A(H3N2), 19 (3.1%) were A(H1N1)pdm09 and the remaining 474 were A(unsubtyped)]; and 108 (15.1%) with influenza B. The distribution of cases by age group is as follows: 140 (19.6%) <6 months of age; 169 (23.7%) age 6-23 months; 208 (29.2%) age 2-4 years; 135 (18.9%) age 5-9 years; and 61 (8.6%) age 10-16 years. Sixty-one of the 713 cases (8.6%) were admitted to the ICU. No deaths have been reported to date.

                      Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associate paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.

                      Adult Influenza Hospitalizations and Deaths (PCIRN)

                      In week 11, 21 new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network. Ninety-one percent (19) of the hospitalizations were cases of influenza A. Fourteen cases were ≥65 years of age, six were 45-64 years of age, and one was 20-44 years of age. One ICU admission was reported during the current week, in a person ≥65 years of age with influenza A(unsubtyped). Three deaths were reported: all three with influenza A(unsubtyped), two ≥65 years and one 20-44 years of age.

                      From week 45 to week 11, 1,538 influenza-associated adult hospitalizations have been reported by the PCIRN-SOS network: 1,441 (93.7%) with influenza A [of which 206 were A(H3N2), 12 were A(H1N1)pdm09, and 1,223 were A(unsubtyped)]; 52 (3.4%) with influenza B, and the type has not been reported for 45 cases. The age distribution of hospitalizations is as follows: 1064 (69.2%) were ≥65 years of age, 305 (19.8%) were 45-64 years, 161 (10.5%) were 20-44 years, and 8 (0.5%) were <20 years of age. ICU admission was required for 161 hospitalizations; the majority of which were adults ≥65 years of age (100; 62.1%). Of the ICU admissions, 60 (37.3%) had at least one co-morbidity, two (1.2%) had no co-morbidities, and 99 had no information to date. A total of 87 deaths have been reported: 15 with influenza A(H3N2), 67 with influenza A(unsubtyped), 4 with influenza B, and one untyped. More than 80% of the deaths (73/87) were in adults ≥65 years of age, 11 (12.6%) were adults 45-64 years of age, and 3 (3.4%) were 20-44 years of age.

                      Thirty-six deaths occurred in individuals who had at least one co-morbidity. Detailed clinical information on co-morbidities is not known for the remaining cases.

                      Note: The number of hospitalizations reported through PCIRN represents a subset of all influenza-associate adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.

                      Provincial/Territorial Influenza Hospitalizations and Deaths (Aggregate Surveillance System<SUP>*</SUP>)

                      In week 11, 95 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories<SUP>*</SUP>. The majority of cases were influenza A (61; 64.2%), predominantly A(H3). The highest proportion of hospitalisations continued to be adults ≥65 years of age (40.0%), followed by children 0-4 years of age (25.3%). Of the 37 cases with available data, seven were admitted to the ICU - one child aged 0-4 years; one aged 5-14 years; three adults aged 45-64 years; and two aged ≥65 years. Two deaths were reported: both adults aged ≥65 years; one influenza B and one A(H3). It is important to note that the cause of death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases. Data were not received for the Yukon Territories in week 11.

                      To date this season 3,944 influenza-associated hospitalizations have been reported; of which 95.0% have been influenza A, predominantly A(H3). The cumulative proportion of hospitalizations in cases with influenza B has increased from 1.6% in week 01, to 5.0% in week 11; which follows the trend of influenza B detections in Canada this season. Age information was available for 3,941 cases, and the age distribution is as follows: 2,190 (55.6%) were ≥65 years; 663 (16.8%) 45-64 years; 350 (8.9%) 20-44 years; 37 (0.9%) 15-19 years; 152 (3.9%) 5-14 years and 549 (13.9%) 0-4 years of age. Among the 1,052 cases with available data, there have been 168 (16.0%) hospitalisations for which admission to an ICU was required; the highest proportions being adults between 45-64 years of age and ≥65 years of age (36.9% and 35.1% respectively). To date, 271 deaths have been reported: 225 (83.0%) were adults ≥65 years of age, 29 (10.7%) were adults between 45-64 years of age; 11 (4.1%) were adults between 20-44 years of age, one child between 5-14 years of age and 5 (1.9%) between 0-4 years of age. It is important to note that the cause of death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.

                      * Note: The number of new influenza-associated hospitalizations and deaths reported by the Aggregate Surveillance System each week may be overestimated, as it may include retrospective updates to data from Ontario for previous weeks. These data may also include cases reported by the IMPACT and PCIRN networks. Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, NS, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not reported in Ontario.

                      .../
                      http://www.phac-aspc.gc.ca/fluwatch/.../index-eng.php
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                      Comment


                      • #26
                        Re: Canada FluWatch Weekly Reports 2012-2013 Season Week 13

                        FluWatch report: March 24 to March 30, 2013 (Week 13)

                        Posted 2013-04-05For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
                        <A title="Flu Watch (Version PDF, 113 KB - 6 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/12-13/w13_13/pdf/fw2013-13-eng.pdf">FluWatch report: March 24 to March 30, 2013 (Week 13) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 113 <ABBR title=Kilobytes>KB</ABBR> - 8 pages)

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                        Overall Summary
                        • Overall influenza activity continued to decline. The number of regions reporting widespread or localized activity decreased in week 13.
                        • The ILI consultation rate increased slightly but was within the expected range for this time of year.
                        • Laboratory detections of influenza were similar to the past 2 weeks, and the proportion of influenza B continued to increase. Detections of other respiratory viruses were stable or decreasing compared to recent weeks.
                        • Between March 31 and April 5, the WHO reported 16 human cases of influenza A(H7N9) in China.
                        Influenza Activity (geographic spread) and Outbreaks

                        In week 13, one region in NL reported widespread activity and 10 regions [in AB(1), SK(1), MB(1), ON(3), QC(2), NS (1) and NL(1)] reported localized activity. The number of regions reporting widespread or localized activity decreased compared to the previous week and continued to follow the overall decline in influenza/ILI activity from the peak in early January (Figures 1 and 2). Fourteen new influenza outbreaks were reported: nine in long-term-care facilities, two in school and three in other facilities or communities (Figure 3).
                        Figure 1. Map of overall Influenza activity level by province and territory,
                        Canada, Week 13





                        Note: Influenza activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.
                        Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
                        Figure 2. Number of influenza surveillance regions<SUP title="sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in"></SUP> reporting widespread or localized influenza activity, Canada, by report week, 2012-2013 (N<SUP>*</SUP>=58)


                        †sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.
                        * Total number of influenza surveillance regions in Canada
                        Text equivalent for figure 2Number of influenza surveillance regions reporting widespread or localized influenza activity, Canada, by report week, 2011-2012 (N=56)
                        Figure 3. Overall Number of Influenza Outbreaks, Canada, by Report Week, 2012-2013


                        Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2011-2012

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                        Influenza and Other Respiratory Virus Detections

                        The percentage of positive influenza tests was stable for the third week in a row at 12.2% in week 13 (Figure 4). Among the influenza viruses detected in week 13 (n=433), 25.9% were positive for influenza A viruses [of which 26.8% were A(H1N1)pdm09, 16.1% were A(H3), and 57.1% were A(unsubtyped)] (Table 1). The proportion of influenza B detections has increased over the past 10 weeks from 2.1% in week 03 to 74.1% in week 13 (Figure 4). Cumulative influenza virus detections by type/subtype to date are as follows: 91.0% influenza A [34.7% A(H3), 4.1% A(H1N1)pdm09 and 61.1% A(unsubtyped)] and 9.0% influenza B (Table 1).
                        Detailed information on age and type/subtype has been received for 21,821 cases from 26 August 2012 to 23 March 2013 (Table 2). The proportion of cases by age group is as follows: 13.6% < 5 years; 9.0% between 5-19 years; 15.5% between 20-44 years; 16.9% between 45-64 years of age; 45.0% ≥ 65 years.
                        The percentage of tests positive for RSV decreased to 11.8% in week 13, continuing its decline from a peak in week 08. The percentage of positive tests also decreased for rhinovirus (8.9%); and was stable for parainfluenza (3.8%), coronavirus (3.5%), hMPV (5.3%) and adenovirus (1.4%) (Figure 5)<SUP>*</SUP>.
                        * For more details, see the weekly Respiratory Virus Detections in Canada Report.
                        <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly & Cumulative numbers of positive influenza specimens
                        by Provincial Laboratories, Canada, 2012-2013
                        </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces</TH><TH id=ac1 colSpan=6>Weekly
                        (March 24 to March 30, 2013)
                        </TH><TH id=ac9 colSpan=6>Cumulative
                        (August 26, 2012 to March 30, 2013)
                        </TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=5 headers=ac1>Influenza A</TH><TH id=ac8 headers=ac1>Influenza
                        B
                        </TH><TH id=ac10 colSpan=5 headers=ac9>Influenza A</TH><TH id=ac16 headers=ac9>Influenza
                        B
                        </TH></TR><TR class=bg-colour-yellow><TH id=ac3 headers=ac2>A Total</TH><TH id=ac4 headers=ac2>A(H1)</TH><TH id=ac5 headers=ac2>A(H3)</TH><TH id=ac6 headers=ac2>Pand H1N1</TH><TH id=ac7 class=noWrap headers=ac2>A
                        ( <ABBR title=unsubtyped>Un S</ABBR>)Table 1 note*
                        </TH><TH headers="ac1 ac8">Total</TH><TH id=ac11 headers=ac10>A Total</TH><TH id=ac12 headers=ac10>A(H1)</TH><TH id=ac13 headers=ac10>A(H3)</TH><TH id=ac14 headers=ac10>Pand H1N1</TH><TH id=ac15 class=noWrap headers=ac10>A
                        (Un S) Table 1 note*
                        </TH><TH headers=ac16>Total</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13>* Unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available. Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Note: Weekly data is based on week of positive lab detection. Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals. </TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=bg-colour-yellow headers=ar1><ABBR title="British Columbia ">BC</ABBR></TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">4</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">3</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac7">1</TD><TD class=alignRight headers="ar1 ar2 ac1 ac8">10</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac11">1881</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac13">1443</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac14">203</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac15">235</TD><TD class=alignRight headers="ar1 ar2 ac9 ac16">323</TD></TR><TR><TH id=ar3 class=bg-colour-yellow headers=ar1><ABBR title=Alberta>AB</ABBR></TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">16</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">5</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">8</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac7">3</TD><TD class=alignRight headers="ar1 ar3 ac1 ac8">55</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac11">2298</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac13">1751</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac14">403</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac15">144</TD><TD class=alignRight headers="ar1 ar3 ac9 ac16">490</TD></TR><TR><TH id=ar4 class=bg-colour-yellow headers=ar1><ABBR title=Saskatchewan>SK</ABBR></TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">9</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">7</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac7">2</TD><TD class=alignRight headers="ar1 ar4 ac1 ac8">19</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac11">822</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac13">474</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac14">69</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac15">279</TD><TD class=alignRight headers="ar1 ar4 ac9 ac16">170</TD></TR><TR><TH id=ar5 class=bg-colour-yellow headers=ar1><ABBR title=Manitoba>MB</ABBR></TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">17</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac7">17</TD><TD class=alignRight headers="ar1 ar5 ac1 ac8">4</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac11">641</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac13">78</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac14">10</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac15">553</TD><TD class=alignRight headers="ar1 ar5 ac9 ac16">60</TD></TR><TR><TH id=ar6 class=bg-colour-yellow headers=ar1><ABBR title=Ontario>ON</ABBR></TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">23</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">5</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">12</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac7">6</TD><TD class=alignRight headers="ar1 ar6 ac1 ac8">56</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac11">8148</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac13">3758</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac14">318</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac15">4072</TD><TD class=alignRight headers="ar1 ar6 ac9 ac16">520</TD></TR><TR><TH id=ar7 class=bg-colour-yellow headers=ar1><ABBR title=Quebec>QC</ABBR>

                        </TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">26</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac7">26</TD><TD class=alignRight headers="ar1 ar7 ac1 ac8">172</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac11">9733</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac13">546</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac14">31</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac15">9156</TD><TD class=alignRight headers="ar1 ar7 ac9 ac16">1028</TD></TR><TR><TH id=ar8 class=bg-colour-yellow headers=ar1><ABBR title="New Brunswick">NB</ABBR>

                        </TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">9</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac5">5</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac6">2</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac7">2</TD><TD class=alignRight headers="ar1 ar8 ac1 ac8">2</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac11">1828</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac13">768</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac14">57</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac15">1003</TD><TD class=alignRight headers="ar1 ar8 ac9 ac16">14</TD></TR><TR><TH id=ar9 class=bg-colour-yellow headers=ar1><ABBR title="Nova Scotia ">NS</ABBR>

                        </TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">6</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">1</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac7">5</TD><TD class=alignRight headers="ar1 ar9 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac11">361</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac13">165</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac14">6</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac15">190</TD><TD class=alignRight headers="ar1 ar9 ac9 ac16">3</TD></TR><TR><TH id=ar10 class=bg-colour-yellow headers=ar1><ABBR title="Prince Edward Island ">PE</ABBR>

                        </TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac7">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac11">106</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac13">73</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac14">3</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac15">30</TD><TD class=alignRight headers="ar1 ar10 ac9 ac16">1</TD></TR><TR><TH id=ar11 class=bg-colour-yellow headers=ar1><ABBR title="Newfoundland/Labrador ">NL</ABBR>

                        </TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">2</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac7">2</TD><TD class=alignRight headers="ar1 ar11 ac1 ac8">3</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac11">711</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac13">152</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac14">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac15">559</TD><TD class=alignRight headers="ar1 ar11 ac9 ac16">14</TD></TR><TR><TH id=ar12 class=bg-colour-yellow headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">112</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac5">18</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac6">30</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac7">64</TD><TD class=alignRight headers="ar1 ar12 ac1 ac8">321</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac11">26529</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac13">9208</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac14">1100</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac15">16221</TD><TD class=alignRight headers="ar1 ar12 ac9 ac16">2623</TD></TR></TBODY></TABLE>
                        <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 2. Weekly & Cumulative numbers of positive influenza specimens by age groups
                        reported through case-based laboratory reporting, Canada, 2012-2013 Table 2 note*
                        </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups</TH><TH id=bc1 colSpan=5>Weekly
                        (March 17 to March 23, 2013)
                        </TH><TH id=bc8 colSpan=5>Cumulative
                        (August 26, 2012 to March 23, 2013)
                        </TH></TR><TR class=bg-colour-yellow><TH id=bc2 colSpan=4 headers=bc1>Influenza A</TH><TH id=bc7 headers=bc1>B</TH><TH id=bc9 colSpan=4 headers=bc8>Influenza A</TH><TH id=bc14 headers=bc8>B</TH></TR><TR class=bg-colour-yellow><TH id=bc3 headers=bc2>A Total</TH><TH id=bc4 headers=bc2>Pandemic H1N1</TH><TH id=bc5 headers=bc2>A/H3N2</TH><TH id=bc6 headers=bc2>A unsubtyped</TH><TH headers="bc1 bc7">Total</TH><TH id=bc10 headers=bc9>A Total</TH><TH id=bc11 headers=bc9>Pandemic H1N1</TH><TH id=bc12 headers=bc9>A/H3N2</TH><TH id=bc13 headers=bc9>A unsubtyped</TH><TH headers=bc14>Total</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11>* Please note that this table reflects the number of specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported. Delays in the reporting of data may cause data to change retrospectively. </TD></TR></TFOOT><TBODY><TR><TH id=br2 headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">12</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">3</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">9</TD><TD class=alignRight headers="br1 br2 bc1 bc7">43</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">2589</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">183</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">843</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1563</TD><TD class=alignRight headers="br1 br2 bc8 bc14">379</TD></TR><TR><TH id=br3 headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">2</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">2</TD><TD class=alignRight headers="br1 br3 bc1 bc7">45</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1428</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">64</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">628</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">736</TD><TD class=alignRight headers="br1 br3 bc8 bc14">538</TD></TR><TR><TH id=br4 headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">19</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">4</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">2</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">13</TD><TD class=alignRight headers="br1 br4 bc1 bc7">32</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">3062</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">289</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">1192</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">1581</TD><TD class=alignRight headers="br1 br4 bc8 bc14">319</TD></TR><TR><TH id=br5 headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">16</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">1</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">15</TD><TD class=alignRight headers="br1 br5 bc1 bc7">36</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">3375</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">275</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">1191</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">1909</TD><TD class=alignRight headers="br1 br5 bc8 bc14">315</TD></TR><TR><TH id=br6 headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">31</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">1</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">4</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">26</TD><TD class=alignRight headers="br1 br6 bc1 bc7">36</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">9476</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">102</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">3583</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">5791</TD><TD class=alignRight headers="br1 br6 bc8 bc14">340</TD></TR><TR><TH id=br7 headers=br1>Unknown</TH><TD class=alignRight headers="br1 br7 bc1 bc2 bc3">1</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc4">1</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc6">0</TD><TD class=alignRight headers="br1 br7 bc1 bc7">0</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc10">166</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">20</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">144</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">2</TD><TD class=alignRight headers="br1 br7 bc8 bc14">0</TD></TR><TR><TH id=br8 headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">81</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc4">10</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc5">6</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc6">65</TD><TD class=alignRight headers="br1 br8 bc1 bc7">192</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">20096</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc11">933</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc12">7581</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc13">11582</TD><TD class=alignRight headers="br1 br8 bc8 bc14">1891</TD></TR></TBODY></TABLE>


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                        Figure 4. Influenza tests reported and percentage of tests positive, Canada,
                        by report week, 2012-2013


                        Text equivalent for figure 4Influenza tests reported and percentage of tests positive, Canada, by report week, 2011-2012
                        Figure 5. Percent positive influenza tests, compared to other respiratory viruses,
                        Canada, by reporting week, 2012-2013


                        Text equivalent for figure 5Percent positive influenza tests, compared to other respiratory viruses, Canada, by reporting week, 2011-2012

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                        Influenza strain characterizations

                        During the 2012-13 season, the National Microbiology Laboratory (NML) has antigenically characterized 902 influenza viruses. The 515 influenza A(H3N2) viruses were antigenically similar to the vaccine strain A/Victoria/361/2011 and the 150 A(H1N1)pdm09 viruses were antigenically similar to the vaccine strain A/California/07/09. Among the influenza B viruses, 190 were antigenically similar to the vaccine strain B/Wisconsin/01/2010 (Yamagata lineage) and 47 were similar to B/Brisbane/60/2008 (Victoria lineage; component of the 2011-2012 seasonal influenza vaccine) (Figure 6).
                        Figure 6. Influenza strain characterizations, Canada, 2012-2013, N =902

                        Note: The recommended components for the 2012-2013 Northern Hemisphere influenza vaccine include: an A/Victoria/361/2011 (H3N2)-like virus; an A/California/7/2009 (H1N1)pdm09-like virus; and a B/Wisconsin/1/2010-like virus.
                        Text equivalent for figure 6Influenza strain characterizations, Canada, 2011-2012

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                        Antiviral resistance

                        During the 2012-13 season, NML has tested 835 influenza viruses for resistance to oseltamivir, and 833 influenza viruses for resistance to zanamivir. All viruses tested were sensitive to oseltamivir and zanamivir. A total of 937 influenza A viruses were tested for amantadine resistance and all were resistant (Table 3).


                        <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2012-2013</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=cr1 rowSpan=2>Virus type and subtype</TH><TH id=cc1 colSpan=2>Oseltamivir</TH><TH id=cc4 colSpan=2>Zanamivir</TH><TH id=cc7 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=cc2 headers=cc1># tested</TH><TH id=cc3 headers=cc1># resistant (%)</TH><TH id=cc5 headers=cc4># tested</TH><TH id=cc6 headers=cc4># resistant (%)</TH><TH id=cc8 headers=cc7># tested</TH><TH id=cc9 headers=cc7># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=cr2 class="alignLeft bg-colour-blue" headers=cr1>A (H3N2)</TH><TD class=alignCenter headers="cr2 cc2">486</TD><TD class=alignCenter headers="cr2 cc3">0</TD><TD class=alignCenter headers="cr2 cc5">485</TD><TD class=alignCenter headers="cr2 cc6">0</TD><TD class=alignCenter headers="cr2 cc8">792</TD><TD class=alignCenter headers="cr2 cc9">792 (100%)</TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignCenter headers="cr3 cc2">142</TD><TD class=alignCenter headers="cr3 cc3">0</TD><TD class=alignCenter headers="cr3 cc5">141</TD><TD class=alignCenter headers="cr3 cc6">0</TD><TD class=alignCenter headers="cr3 cc8">145</TD><TD class=alignCenter headers="cr3 cc9">145</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignCenter headers="cr4 cc2">207</TD><TD class=alignCenter headers="cr4 cc3">0</TD><TD class=alignCenter headers="cr4 cc5">207</TD><TD class=alignCenter headers="cr4 cc6">0</TD><TD class=alignCenter headers="cr4 cc8">NA <SUP>*</SUP></TD><TD class=alignCenter headers="cr4 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft bg-colour-blue" headers=cr1>TOTAL</TH><TD class=alignCenter headers="cr5 cc2">835</TD><TD class=alignCenter headers="cr5 cc3">0</TD><TD class=alignCenter headers="cr5 cc5">833</TD><TD class=alignCenter headers="cr5 cc6">0</TD><TD class=alignCenter headers="cr5 cc8">937</TD><TD class=alignCenter headers="cr5 cc9">937 (100%)</TD></TR></TBODY></TABLE>
                        Influenza-like Illness (ILI) Consultation Rate

                        The national influenza-like-illness (ILI) consultation rate increased from 11.3 ILI consultations per 1,000 patient visits in week 12, to 21.2 in week 13 but remains within the expected range (Figure 7). In week 13, the highest consultation rate was observed in children less than 5 years of age (47.9/1,000).
                        Figure 7. Influenza-like illness (ILI) consultation rates, Canada, by report week, 2012-2013 compared to 1996/97 through to 2011/12 seasons (with pandemic data suppressed)



                        Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons). Delays in the reporting of data may cause data to change retrospectively.
                        Text equivalent for figure 7Influenza-like illness (ILI) consultation rates, Canada, by report week, 2011-2012 compared to 1996/97 through to 2010/11 seasons (with pandemic data suppressed)
                        Pharmacy Surveillance

                        Pharmacy surveillance has been concluded for the 2012-13 influenza season. The antiviral prescription rate peaked in week 01 at 343.9 antiviral prescriptions per 100,000 new prescriptions dispensed. From week 52, 2012 to week 11, 2013, the proportion of prescriptions for influenza antivirals was highest among seniors ≥65 years of age (average 435.1 / 1,000), and lowest for infants under 2 years of age (average 69.5 / 1,000). A summary of final pharmacy surveillance data will be included in the 2012-13 FluWatch annual report.
                        Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group.

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                        Severe Respiratory Illness Surveillance

                        Paediatric Influenza Hospitalizations and Deaths (IMPACT)

                        In week 13, 19 new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 26 in week 12. Among the cases reported in week 13, 73.7% (14) were identified with influenza B and the rest were A(unsubtyped). For the fifth week in a row, the number of influenza B cases exceeded the number of influenza A cases, a reversal of the pattern seen earlier in the season. The age distribution is as follows: one (5.3%) between 0-5 months, 8 (42.1%) between 6-23 months, 4 (21.1%) 2-4 years of age, 4 (21.1%) 5-9 years of age, and 2 (10.5%) 10-16 years of age. Three admissions to intensive care unit (ICU) were reported during the week 13, one child 6-23 months of age (influenza type unknown); and one 2-4 years of age and one 10-16 years of age, both with influenza B.

                        Since the start of the 2012-13 season, a total of 755 influenza-associated paediatric hospitalizations have been reported by the IMPACT network: 611 (80.9%) with influenza A [of which 118 (19.3%) were A(H3N2), 22 (3.6%) were A(H1N1)pdm09 and the remaining 471 were A(unsubtyped); and 144 (19.1%) with influenza B. The distribution of cases by age group is as follows: 141 (18.7%) < 6 months of age; 186 (24.6%) age 6-23 months; 213 (28.2%) age 2-4 years; 151 (20.0%) age 5-9 years; and 64 (8.5%) age 6-10 years. Seventy-four (9.8%) of the 755 cases were admitted to the ICU. No deaths have been reported to date.

                        Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associate paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.

                        Adult Influenza Hospitalizations and Deaths (PCIRN)

                        In week 13, five laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 14 in week 12. Two of the five hospitalizations were cases of influenza A(unsubtyped), two were influenza B and one was untyped. All five cases were ≥65 years of age. One ICU admission was reported during the current week, in a person ≥65 years of age with influenza B. One death was reported, also a case ≥65 years of age, with influenza A(unsubtyped).

                        From week 45 to week 13, 1,614 influenza-associated adult hospitalizations were reported by the PCIRN-SOS network: 1,498 (92.8%) with influenza A [of which 242 were A(H3N2), 13 were A(H1N1)pdm09, and 1,243 were A(unsubtyped)]; 62 (3.8%) with influenza B, and the type has not been reported for 54 cases. The age distribution of hospitalizations is as follows: 1,123 (69.6%) were ≥65 years of age, 315 (19.5%) were 45-64 years, 168 (10.4%) were 20-44 years, and 8 (0.5%) were <20 years of age. ICU admission was required for 176 hospitalizations; the majority of which were adults ≥65 years of age (111; 63.1%). Of the ICU admissions, 68 (38.6%) had at least one co-morbidity, three (1.7%) had no co-morbidities, and 105 had no information to date. A total of 93 deaths have been reported: 16 with influenza A(H3N2), 71 with influenza A(unsubtyped), 5 with influenza B, and one untyped. More than 80% of the deaths (78/93) were in adults ≥65 years of age, 12 (12.9%) were adults 45-64 years of age, and 3 (3.2%) were 20-44 years of age. Thirty-nine deaths occurred in individuals who had at least one co-morbidity. Detailed clinical information on co-morbidities is not known for the remaining cases.
                        Note: The number of hospitalizations reported through PCIRN represents a subset of all influenza-associate adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.

                        Provincial/Territorial Influenza Hospitalizations and Deaths (Aggregate Surveillance System<SUP>*</SUP>)

                        In week 13, 83 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories<SUP>*</SUP>. The majority of cases were influenza A (57; 68.7%). The highest proportion of hospitalisations were in adults ≥65 years of age (43.4%), followed by children 0-4 years of age (21.7%). Of the 20 cases with available data, four were admitted to the ICU: two children, one 0-4 and one 5-14 years of age; and two adults, one 20-44 and one 45-64 years of age. No deaths were reported in week 13. Data was not received for the Yukon Territories.

                        To date this season 4,126 influenza-associated hospitalizations have been reported, of which 93.5% have been influenza A. Of those subtyped (48.4%), influenza A(H3) was the predominant influenza strain. The cumulative proportion of hospitalizations with influenza B continues to increase (6.4% in week 13). Age information was available for 4,123 cases, and the age distribution is as follows: 2,272 (55.1%) were ≥65 years of age; 686 (16.6%) were 45-64 years of age; 368 (8.9%) were 20-44 years of age; 38 (0.9%) were 15-19 years of age; 172 (4.2%) were 5-14 years; and 587 (14.2%) were 0-4 years of age. Of the 1,105 cases with available data, there have been 175 hospitalisations for which admission to an ICU was required; the highest proportions are adults 45-64 years of age, followed by adults ≥65 years of age (36.6% and 34.3%, respectively). To date, 276 deaths have been reported: 229 were adults ≥65 years of age, 30 were adults 45-64 years; 11 were adults 20-44 years, one was a child 5-14 years of age, and 5 were children 0-4 years of age. It is important to note that the cause of death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.

                        * Note: The number of new influenza-associated hospitalizations and deaths reported by the Aggregate Surveillance System each week may be overestimated, as it may include retrospective updates to data from Ontario for previous weeks. These data may also include cases reported by the IMPACT and PCIRN networks. Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, NS, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not reported in Ontario.

                        .../
                        http://www.phac-aspc.gc.ca/fluwatch/.../index-eng.php
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                        • #27
                          Re: Canada FluWatch Weekly Reports 2012-2013 Season Week 14

                          FluWatch report: March 31 to April 6, 2013 (Week 14)

                          Posted 2013-04-12For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
                          <A title="Flu Watch (Version PDF, 113 KB - 6 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/12-13/w14_13/pdf/fw2013-14-eng.pdf">FluWatch report: March 31 to April 6, 2013 (Week 14) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 113 <ABBR title=Kilobytes>KB</ABBR> - 8 pages)

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                          Overall Summary
                          • Overall influenza activity continued to decline in week 14.
                          • Laboratory detections of influenza decreased slightly compared to the past 2 weeks. Detections of influenza B also decreased, although influenza B continued to represent 72.7% of positive specimens in week 14.
                          • The number of regions reporting widespread or localized activity was the same as in the previous week.
                          • The ILI consultation rate increased but was within the expected range for this time of year.
                          • Detections of RSV and human metapneumovirus (hMPV) increased while detections of other respiratory viruses were stable or decreasing.
                          Influenza Activity (geographic spread) and Outbreaks

                          In week 14, no regions reported widespread activity and 11 regions [in BC(1), AB(1), SK(1), ON(5), QC(1), NS (1) and NL(1)] reported localized activity. The number of regions reporting widespread or localized activity was the same as the previous week and continued to follow the overall decline in influenza/ILI activity from the peak in early January (Figures 1 and 2). Eight new influenza outbreaks were reported: seven in long-term-care facilities and one in another facility or community (Figure 3).
                          Figure 1. Map of overall Influenza activity level by province and territory,
                          Canada, Week 14





                          Note: Influenza activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.
                          Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
                          Figure 2. Number of influenza surveillance regions<SUP title="sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in"></SUP> reporting widespread or localized influenza activity, Canada, by report week, 2012-2013 (N<SUP>*</SUP>=56)


                          †sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.
                          * Total number of influenza surveillance regions in Canada
                          Text equivalent for figure 2Number of influenza surveillance regions reporting widespread or localized influenza activity, Canada, by report week, 2011-2012 (N=56)
                          Figure 3. Overall Number of Influenza Outbreaks, Canada, by Report Week, 2012-2013


                          Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2011-2012

                          Top of Page

                          Influenza and Other Respiratory Virus Detections

                          The percentage of positive influenza tests declined slightly to 11.1% in week 14 (Figure 4). Among the influenza viruses detected in week 14 (n=429), 27.3% were positive for influenza A viruses [of which 20.5% were A(H1N1)pdm09, 15.4% were A(H3), and 64.1% were A(unsubtyped)](Table 1). Detections of influenza B decreased after rising over the past 10 weeks, and influenza B was detected in 72.7% of positive influenza detections in week 14 (Figure 4). Cumulative influenza virus detections by type/subtype to date are as follows: 90.1% influenza A [34.6% A(H3), 4.2% A(H1N1)pdm09 and 61.2% A(unsubtyped)] and 9.9% influenza B (Table 1).
                          Detailed information on age and type/subtype has been received for 21,821 cases from 26 August 2012 to 23 March 2013 (Table 2). The proportion of cases by age group is as follows: 13.6% <5 years; 9.0% between 5-19 years; 15.5% between 20-44 years; 16.9% between 45-64 years of age; 45.0% ≥ 65 years.
                          The percentage of tests positive for RSV decreased slightly to 11.3% in week 14, continuing its decline from a peak in week 08. The percentage of positive tests for hMPV increased sharply to 7.4% while the percentage of positive tests for rhinovirus continued its slow increase since week 01 to 9.1% in week 14. The percentage of positive tests decreased slightly for parainfluenza (3.4%), coronavirus (3.0%) and adenovirus (0.8%) (Figure 5)<SUP>*</SUP>.
                          * For more details, see the weekly Respiratory Virus Detections in Canada Report.
                          <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly & Cumulative numbers of positive influenza specimens
                          by Provincial Laboratories, Canada, 2012-2013
                          </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces</TH><TH id=ac1 colSpan=6>Weekly
                          (March 31 to April 6, 2013)
                          </TH><TH id=ac9 colSpan=6>Cumulative
                          (August 26, 2012 to April 6, 2013)
                          </TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=5 headers=ac1>Influenza A</TH><TH id=ac8 headers=ac1>Influenza
                          B
                          </TH><TH id=ac10 colSpan=5 headers=ac9>Influenza A</TH><TH id=ac16 headers=ac9>Influenza
                          B
                          </TH></TR><TR class=bg-colour-yellow><TH id=ac3 headers=ac2>A Total</TH><TH id=ac4 headers=ac2>A(H1)</TH><TH id=ac5 headers=ac2>A(H3)</TH><TH id=ac6 headers=ac2>Pand H1N1</TH><TH id=ac7 class=noWrap headers=ac2>A
                          ( <ABBR title=unsubtyped>Un S</ABBR>)Table 1 note*
                          </TH><TH headers="ac1 ac8">Total</TH><TH id=ac11 headers=ac10>A Total</TH><TH id=ac12 headers=ac10>A(H1)</TH><TH id=ac13 headers=ac10>A(H3)</TH><TH id=ac14 headers=ac10>Pand H1N1</TH><TH id=ac15 class=noWrap headers=ac10>A
                          (Un S) Table 1 note*
                          </TH><TH headers=ac16>Total</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13>* Unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available. Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Note: Weekly data is based on week of positive lab detection. Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals. </TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=bg-colour-yellow headers=ar1><ABBR title="British Columbia ">BC</ABBR></TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">13</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">5</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">4</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac7">4</TD><TD class=alignRight headers="ar1 ar2 ac1 ac8">8</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac11">1894</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac13">1448</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac14">207</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac15">239</TD><TD class=alignRight headers="ar1 ar2 ac9 ac16">331</TD></TR><TR><TH id=ar3 class=bg-colour-yellow headers=ar1><ABBR title=Alberta>AB</ABBR></TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">9</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">4</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">2</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac7">3</TD><TD class=alignRight headers="ar1 ar3 ac1 ac8">64</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac11">2307</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac13">1755</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac14">405</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac15">147</TD><TD class=alignRight headers="ar1 ar3 ac9 ac16">554</TD></TR><TR><TH id=ar4 class=bg-colour-yellow headers=ar1><ABBR title=Saskatchewan>SK</ABBR></TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">5</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">3</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac7">2</TD><TD class=alignRight headers="ar1 ar4 ac1 ac8">26</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac11">827</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac13">474</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac14">72</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac15">281</TD><TD class=alignRight headers="ar1 ar4 ac9 ac16">196</TD></TR><TR><TH id=ar5 class=bg-colour-yellow headers=ar1><ABBR title=Manitoba>MB</ABBR></TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">12</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac7">12</TD><TD class=alignRight headers="ar1 ar5 ac1 ac8">5</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac11">653</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac13">78</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac14">10</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac15">565</TD><TD class=alignRight headers="ar1 ar5 ac9 ac16">65</TD></TR><TR><TH id=ar6 class=bg-colour-yellow headers=ar1><ABBR title=Ontario>ON</ABBR></TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">36</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">4</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">11</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac7">21</TD><TD class=alignRight headers="ar1 ar6 ac1 ac8">65</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac11">8184</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac13">3763</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac14">329</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac15">4092</TD><TD class=alignRight headers="ar1 ar6 ac9 ac16">585</TD></TR><TR><TH id=ar7 class=bg-colour-yellow headers=ar1><ABBR title=Quebec>QC</ABBR>

                          </TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">17</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac7">17</TD><TD class=alignRight headers="ar1 ar7 ac1 ac8">136</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac11">9750</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac13">546</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac14">31</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac15">9173</TD><TD class=alignRight headers="ar1 ar7 ac9 ac16">1164</TD></TR><TR><TH id=ar8 class=bg-colour-yellow headers=ar1><ABBR title="New Brunswick">NB</ABBR>

                          </TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">14</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac5">2</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac6">4</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac7">8</TD><TD class=alignRight headers="ar1 ar8 ac1 ac8">7</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac11">1842</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac13">770</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac14">61</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac15">1011</TD><TD class=alignRight headers="ar1 ar8 ac9 ac16">21</TD></TR><TR><TH id=ar9 class=bg-colour-yellow headers=ar1><ABBR title="Nova Scotia ">NS</ABBR>

                          </TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">6</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac7">6</TD><TD class=alignRight headers="ar1 ar9 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac11">367</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac13">165</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac14">6</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac15">196</TD><TD class=alignRight headers="ar1 ar9 ac9 ac16">3</TD></TR><TR><TH id=ar10 class=bg-colour-yellow headers=ar1><ABBR title="Prince Edward Island ">PE</ABBR>

                          </TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">3</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac5">3</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac7">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac11">109</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac13">76</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac14">3</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac15">30</TD><TD class=alignRight headers="ar1 ar10 ac9 ac16">1</TD></TR><TR><TH id=ar11 class=bg-colour-yellow headers=ar1><ABBR title="Newfoundland/Labrador ">NL</ABBR>

                          </TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">2</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac7">2</TD><TD class=alignRight headers="ar1 ar11 ac1 ac8">1</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac11">713</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac13">152</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac14">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac15">561</TD><TD class=alignRight headers="ar1 ar11 ac9 ac16">15</TD></TR><TR><TH id=ar12 class=bg-colour-yellow headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">117</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac5">18</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac6">24</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac7">75</TD><TD class=alignRight headers="ar1 ar12 ac1 ac8">312</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac11">26646</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac13">9227</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac14">1124</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac15">16295</TD><TD class=alignRight headers="ar1 ar12 ac9 ac16">2935</TD></TR></TBODY></TABLE>
                          <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 2. Weekly & Cumulative numbers of positive influenza specimens by age groups
                          reported through case-based laboratory reporting, Canada, 2012-2013 Table 2 note*
                          </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups</TH><TH id=bc1 colSpan=5>Weekly
                          (March 17 to March 23, 2013)
                          </TH><TH id=bc8 colSpan=5>Cumulative
                          (August 26, 2012 to March 23, 2013)
                          </TH></TR><TR class=bg-colour-yellow><TH id=bc2 colSpan=4 headers=bc1>Influenza A</TH><TH id=bc7 headers=bc1>B</TH><TH id=bc9 colSpan=4 headers=bc8>Influenza A</TH><TH id=bc14 headers=bc8>B</TH></TR><TR class=bg-colour-yellow><TH id=bc3 headers=bc2>A Total</TH><TH id=bc4 headers=bc2>Pandemic H1N1</TH><TH id=bc5 headers=bc2>A/H3N2</TH><TH id=bc6 headers=bc2>A unsubtyped</TH><TH headers="bc1 bc7">Total</TH><TH id=bc10 headers=bc9>A Total</TH><TH id=bc11 headers=bc9>Pandemic H1N1</TH><TH id=bc12 headers=bc9>A/H3N2</TH><TH id=bc13 headers=bc9>A unsubtyped</TH><TH headers=bc14>Total</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11>* Please note that this table reflects the number of specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported. Delays in the reporting of data may cause data to change retrospectively. </TD></TR></TFOOT><TBODY><TR><TH id=br2 headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">12</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">3</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">9</TD><TD class=alignRight headers="br1 br2 bc1 bc7">43</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">2589</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">183</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">843</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1563</TD><TD class=alignRight headers="br1 br2 bc8 bc14">379</TD></TR><TR><TH id=br3 headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">2</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">2</TD><TD class=alignRight headers="br1 br3 bc1 bc7">45</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1428</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">64</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">628</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">736</TD><TD class=alignRight headers="br1 br3 bc8 bc14">538</TD></TR><TR><TH id=br4 headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">19</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">4</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">2</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">13</TD><TD class=alignRight headers="br1 br4 bc1 bc7">32</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">3062</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">289</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">1192</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">1581</TD><TD class=alignRight headers="br1 br4 bc8 bc14">319</TD></TR><TR><TH id=br5 headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">16</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">1</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">15</TD><TD class=alignRight headers="br1 br5 bc1 bc7">36</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">3375</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">275</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">1191</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">1909</TD><TD class=alignRight headers="br1 br5 bc8 bc14">315</TD></TR><TR><TH id=br6 headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">31</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">1</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">4</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">26</TD><TD class=alignRight headers="br1 br6 bc1 bc7">36</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">9476</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">102</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">3583</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">5791</TD><TD class=alignRight headers="br1 br6 bc8 bc14">340</TD></TR><TR><TH id=br7 headers=br1>Unknown</TH><TD class=alignRight headers="br1 br7 bc1 bc2 bc3">1</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc4">1</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc6">0</TD><TD class=alignRight headers="br1 br7 bc1 bc7">0</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc10">166</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">20</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">144</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">2</TD><TD class=alignRight headers="br1 br7 bc8 bc14">0</TD></TR><TR><TH id=br8 headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">81</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc4">10</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc5">6</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc6">65</TD><TD class=alignRight headers="br1 br8 bc1 bc7">192</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">20096</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc11">933</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc12">7581</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc13">11582</TD><TD class=alignRight headers="br1 br8 bc8 bc14">1891</TD></TR></TBODY></TABLE>


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                          Figure 4. Influenza tests reported and percentage of tests positive, Canada,
                          by report week, 2012-2013


                          Text equivalent for figure 4Influenza tests reported and percentage of tests positive, Canada, by report week, 2011-2012
                          Figure 5. Percent positive influenza tests, compared to other respiratory viruses,
                          Canada, by reporting week, 2012-2013


                          Text equivalent for figure 5Percent positive influenza tests, compared to other respiratory viruses, Canada, by reporting week, 2011-2012

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                          Influenza strain characterizations

                          During the 2012-13 season, the National Microbiology Laboratory (NML) has antigenically characterized 938 influenza viruses. The 522 influenza A(H3N2) viruses were antigenically similar to the vaccine strain A/Victoria/361/2011 and the 155 A(H1N1)pdm09 viruses were antigenically similar to the vaccine strain A/California/07/09. Among the influenza B viruses, 209 were antigenically similar to the vaccine strain B/Wisconsin/01/2010 (Yamagata lineage) and 52 were similar to B/Brisbane/60/2008 (Victoria lineage; component of the 2011-2012 seasonal influenza vaccine) (Figure 6).
                          Figure 6. Influenza strain characterizations, Canada, 2012-2013, N =938

                          Note: The recommended components for the 2012-2013 Northern Hemisphere influenza vaccine include: an A/Victoria/361/2011 (H3N2)-like virus; an A/California/7/2009 (H1N1)pdm09-like virus; and a B/Wisconsin/1/2010-like virus.
                          Text equivalent for figure 6Influenza strain characterizations, Canada, 2011-2012

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                          Antiviral resistance

                          During the 2012-13 season, NML has tested 900 influenza viruses for resistance to oseltamivir, and 902 influenza viruses for resistance to zanamivir. All viruses tested were sensitive to oseltamivir and zanamivir. A total of 1017 influenza A viruses were tested for amantadine resistance and all but one were resistant (Table 3).


                          <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2012-2013</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=cr1 rowSpan=2>Virus type and subtype</TH><TH id=cc1 colSpan=2>Oseltamivir</TH><TH id=cc4 colSpan=2>Zanamivir</TH><TH id=cc7 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=cc2 headers=cc1># tested</TH><TH id=cc3 headers=cc1># resistant (%)</TH><TH id=cc5 headers=cc4># tested</TH><TH id=cc6 headers=cc4># resistant (%)</TH><TH id=cc8 headers=cc7># tested</TH><TH id=cc9 headers=cc7># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=cr2 class="alignLeft bg-colour-blue" headers=cr1>A (H3N2)</TH><TD class=alignRight headers="cr2 cc2">508</TD><TD class=alignRight headers="cr2 cc3">0</TD><TD class=alignRight headers="cr2 cc5">510</TD><TD class=alignRight headers="cr2 cc6">0</TD><TD class=alignRight headers="cr2 cc8">849</TD><TD class=alignRight headers="cr2 cc9">848 (99.9 %)</TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignRight headers="cr3 cc2">151</TD><TD class=alignRight headers="cr3 cc3">0</TD><TD class=alignRight headers="cr3 cc5">151</TD><TD class=alignRight headers="cr3 cc6">0</TD><TD class=alignRight headers="cr3 cc8">168</TD><TD class=alignRight headers="cr3 cc9">168 (100 %)</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignRight headers="cr4 cc2">241</TD><TD class=alignRight headers="cr4 cc3">0</TD><TD class=alignRight headers="cr4 cc5">241</TD><TD class=alignRight headers="cr4 cc6">0</TD><TD class=alignRight headers="cr4 cc8">NA <SUP>*</SUP></TD><TD class=alignRight headers="cr4 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft bg-colour-blue" headers=cr1>TOTAL</TH><TD class=alignRight headers="cr5 cc2">900</TD><TD class=alignRight headers="cr5 cc3">0</TD><TD class=alignRight headers="cr5 cc5">902</TD><TD class=alignRight headers="cr5 cc6">0</TD><TD class=alignRight headers="cr5 cc8">1017</TD><TD class=alignRight headers="cr5 cc9">1016 (99.9 %)</TD></TR></TBODY></TABLE>
                          Influenza-like Illness (ILI) Consultation Rate

                          The national influenza-like-illness (ILI) consultation rate increased from 20.5 ILI consultations per 1,000 patient visits in week 13, to 23.4 in week 14 but remains within the expected range (Figure 7). In week 14, the highest consultation rate was observed in children 5 to 19 years of age (35.8/1,000).
                          Figure 7. Influenza-like illness (ILI) consultation rates, Canada, by report week, 2012-2013 compared to 1996/97 through to 2011/12 seasons (with pandemic data suppressed)



                          Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons). Delays in the reporting of data may cause data to change retrospectively.
                          Text equivalent for figure 7Influenza-like illness (ILI) consultation rates, Canada, by report week, 2011-2012 compared to 1996/97 through to 2010/11 seasons (with pandemic data suppressed)

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                          Severe Respiratory Illness Surveillance

                          Paediatric Influenza Hospitalizations and Deaths (IMPACT)

                          In week 14, 12 new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 25 in week 13. Among the cases reported in week 14, 11 were identified with influenza B and one with A(unsubtyped). For the sixth week in a row, the number of influenza B cases exceeded the number of influenza A cases, a reversal of the pattern seen earlier in the season. The age distribution is as follows: one (8.3%) between 0-5 months, 2 (16.7%) between 6-23 months, 5 (41.7%) 2-4 years of age, and 4 (33.3%) 5-9 years of age. No admissions to intensive care unit (ICU) were reported during week 14.

                          Since the start of the 2012-13 season, a total of 771 influenza-associated paediatric hospitalizations have been reported by the IMPACT network: 614 (79.6%) with influenza A [of which 118 (19.2%) were A(H3N2), 22 (2.9%) were A(H1N1)pdm09 and the remaining 474 were A(unsubtyped); and 157 (20.4%) with influenza B. The distribution of cases by age group is as follows: 144 (18.7%) <6 months of age; 187 (24.3%) age 6-23 months; 220 (28.5%) age 2-4 years; 157 (20.4%) age 5-9 years; and 63 (8.2%) age 10-16 years. Seventy-four (9.6%) of the 771 cases were admitted to the ICU. No deaths have been reported to date.

                          Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associate paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.

                          Adult Influenza Hospitalizations and Deaths (PCIRN)

                          In week 14, 12 laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 10 in week 13. Six of the 12 hospitalizations were cases of influenza A(unsubtyped), five were influenza B and one was untyped. Four cases were ≥65 years of age, six were 45-64 years of age, and two were 20-44 years of age. No ICU admissions or deaths were reported during the current week.

                          From week 45 to week 14, 1,658 influenza-associated adult hospitalizations were reported by the PCIRN-SOS network: 1,528 (92.2%) with influenza A [of which 286 were A(H3N2), 15 were A(H1N1)pdm09, and 1,227 were A(unsubtyped)]; 76 (4.6%) with influenza B, and the type has not been reported for 54 cases. The age distribution of hospitalizations is as follows: 1,151 (69.4%) were ≥65 years of age, 327 (19.7%) were 45-64 years, 172 (10.4%) were 20-44 years, and 8 (0.5%) were <20 years of age. ICU admission was required for 190 hospitalizations; the majority of which were adults ≥65 years of age (114; 60.0%). Of the ICU admissions, 74 (38.9%) had at least one co-morbidity, three (1.6%) had no co-morbidities, and 113 had no information to date. A total of 104 deaths have been reported: 22 with influenza A(H3N2), 76 with influenza A(unsubtyped), 5 with influenza B, and one untyped. More than 80% of the deaths (89/104) were in adults ≥65 years of age, 12 (11.5%) were adults 45-64 years of age, and 3 (2.9%) were 20-44 years of age. Forty-four (42.3%) deaths occurred in individuals who had at least one co-morbidity. Detailed clinical information on co-morbidities is not known for the remaining cases.

                          Note: The number of hospitalizations reported through PCIRN represents a subset of all influenza-associate adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.

                          Provincial/Territorial Influenza Hospitalizations and Deaths
                          (Aggregate Surveillance System<SUP>*</SUP>)

                          In week 14, 118 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories<SUP>*</SUP>. The majority of cases were influenza A (78; 66.1%). The highest proportion of hospitalisations were in adults ≥65 years of age (37.3%), followed by adults 45-64 years of age (17.0%). Of the 26 cases with available data, four were admitted to the ICU: three children under 16 years of age, and one adult 45-64 years of age. Four deaths were reported in week 14: two adults aged 45-64 years and two ≥65 years of age. It is important to note that the cause of death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.

                          To date this season 4,249 influenza-associated hospitalizations have been reported, of which 92.8% have been influenza A. Of those subtyped (48.4%), influenza A(H3) was the predominant influenza strain. The cumulative proportion of hospitalizations with influenza B continues to increase (7.2% in week 14). Age information was available for 4,246 cases, and the age distribution is as follows: 2,316 were ≥65 years of age; 706 were 45-64 years of age; 378 were 20-44 years of age; 40 were 15-19 years of age; 182 were 5-14 years; and 624 were 0-4 years of age. Of the 1,131 cases with available data, there have been 180 hospitalisations for which admission to an ICU was required; the highest proportions have been in adults 45-64 years of age, followed by adults ≥65 years of age (36.1% and 33.9%, respectively). To date, 281 deaths have been reported: 232 were adults ≥65 years of age, 32 were adults 45-64 years; 11 were adults 20-44 years, one was a child 5-14 years of age, and 5 were children 0-4 years of age. It is important to note that the cause of death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.

                          * Note: The number of new influenza-associated hospitalizations and deaths reported by the Aggregate Surveillance System each week may be overestimated, as it may include retrospective updates to data from Ontario for previous weeks. These data may also include cases reported by the IMPACT and PCIRN networks. Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, NS, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not reported in Ontario.

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                          International Influenza Update


                          WHO: No new influenza surveillance update has been published by WHO since 2 April 2013.United States: During week 14, influenza activity decreased. Four states reported widespread influenza activity, 7 states reported regional influenza activity, and the District of Columbia, Puerto Rico and 14 states reported local activity. The national percentage of outpatient visits for ILI was 1.5%, which is below the national baseline. Two of 10 regions reported ILI at or above region-specific baseline levels but all states reported low or minimal ILI activity in week 14. The percentage of deaths due to pneumonia and influenza was at or above the epidemic threshold between weeks 01 and 12, but has been below the epidemic threshold for the past two weeks, and was 7.2% in week 14. The peak percentage of deaths due to pneumonia and influenza was observed in week 03 at 9.8%, which was higher than observed during the previous four seasons. The proportion of tests positive for influenza viruses declined to 10.9% in week 14. Of the positive influenza detections, 71.1% were influenza B. Since October 1, 2012, the CDC has antigenically characterized 2,098 influenza viruses. Among influenza A(H3N2) viruses, 1,196 (99.7%) were A/Victoria/361/2011-like, and 4 (0.3%) showed reduced titers to A/Victoria/361/2011 antiserum. Among influenza A(H1N1)pdm09 viruses, 206 (98.6%) were A/California/7/2009-like, and 3 (1.4%) showed reduced titers to A/California/7/2009-like antiserum. Among influenza B viruses, 474 (68.8%) were B/Wisconsin/01/2010-like belonging to the Yamagata lineage of viruses; and 215 (31.2%) to the B/Victoria lineage. Two (0.4%) A(H1N1)pdm09 and two (0.1%) A(H3N2) oseltamivir-resistant viruses have been reported to date this season. Among the 12,052 influenza-associated hospitalizations reported to date this season, 80.3% were associated with influenza A of which 96.2% were A(H3N2), and 50% were among adults ≥65 years. A total of 116 influenza-associated paediatric deaths have been reported to date this season, 57 with influenza A, 57 with influenza B and one with both influenza A and B. Europe: In week 14, ILI and acute respiratory illness (ARI) consultation rates declined throughout the region. Most countries reported low intensity of ILI/ARI activity and a decreasing trend. The proportion of influenza B detections has increased from 24% in week 03 to 54% in week 14. Among influenza A viruses in week 14, 57% were A(H3N2) and 43% were A(H1N1)pdm09. Since the beginning of the season, 64% of detections from sentinel and non-sentinel sources were influenza A [68% A(H1N1)pdm09 and 32% A(H3N2)] and 36% were influenza B. Among influenza B viruses, 92% belonged to the Yamagata lineage and 8% to the Victoria lineage. In week 14, the number of countries reporting a predominance of influenza A circulation continued to decrease, and now includes only Greece, Ireland, the United Kingdom, Belgium, Estonia and Finland. Among the 593 A(H1N1)pdm09 viruses tested for resistance to oseltamivir from 12 countries, 10 were found to contain the H275Y mutation: three were specimens from hospitalized and outpatients not exposed to oseltamivir, while the other seven viruses were detected in hospitalized immunocompromised patients receiving oseltamivir treatment. The number of hospitalizations for severe acute respiratory illness (SARI) are declining, in keeping with ILI/ARI consultation rates. Emerging Respiratory Pathogens

                          Human Avian Influenza


                          Influenza A(H7N9): Between April 6 and April 11, the WHO reported an additional 22 human cases of influenza A(H7N9) in eastern China, including two adults 20-44 years of age, six adults 45-64 years of age, and 14 adults ≥65 years of age. The most recent date of illness onset is 4 April 2013. Of these cases, two were fatal, 14 were hospitalized, and two had mild illness. The health status of four cases was not reported. Two earlier cases were also reported to have died. Since March 2013, a total of 38 cases of influenza A(H7N9) have been reported, with 10 deaths, 19 cases of severe illness, and nine cases of mild illness. More than 760 close contacts of confirmed cases are being closely monitored. Some of the confirmed cases had contact with animals or with an animal environment. Investigations into the source and route of transmission are still in progress, but there has been no evidence of ongoing person-to-person spread. WHO is in contact with national authorities and is following the event closely.Human Swine Influenza

                          No new human cases of infection with swine influenza viruses or variants were reported in week 14.Novel Coronavirus

                          No new cases of novel coronavirus (nCoV) have been reported by WHO since 26 March 2013. Since April 2012, 17 laboratory-confirmed cases of nCoV have been identified, including 11 deaths..../
                          http://www.phac-aspc.gc.ca/fluwatch/.../index-eng.php
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                          Comment


                          • #28
                            Re: Canada FluWatch Weekly Reports 2012-2013 Season Week 15

                            FluWatch report: April 7 to April 13, 2013 (Week 15)

                            Posted 2013-04-19For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
                            <A title="Flu Watch (Version PDF, 113 KB - 6 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/12-13/w15_13/pdf/fw2013-15-eng.pdf">FluWatch report: April 7 to April 13, 2013 (Week 15) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 113 <ABBR title=Kilobytes>KB</ABBR> - 8 pages)

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                            Overall Summary
                            • The percentage of laboratory tests positive for influenza has been stable at approximately 12% over the past five weeks. Detections of influenza B continued to increase, with influenza B detected in 81.1% of positive specimens in week 15.
                            • The number of regions reporting widespread or localized activity decreased compared to the previous week.
                            • The ILI consultation rate decreased and was within the expected range for this time of year.
                            • Detections of rhinovirus and human metapneumovirus (hMPV) continued to increase slowly while detections of other respiratory viruses were stable or decreasing.
                            Influenza Activity (geographic spread) and Outbreaks

                            In week 15, no regions reported widespread activity and seven regions [ AB(1), ON(5) and NS (1)] reported localized activity. The number of regions reporting widespread or localized activity declined compared to the previous week and continued to follow the overall decline in influenza/ILI activity from the peak in early January (Figures 1 and 2). Seven new influenza outbreaks were reported: four in long-term-care facilities, one in a hospital, and two in other facilities or communities (Figure 3).
                            Figure 1. Map of overall Influenza activity level by province and territory,
                            Canada, Week 15





                            Note: Influenza activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.
                            Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
                            Figure 2. Number of influenza surveillance regions<SUP title="sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in"></SUP> reporting widespread or localized influenza activity, Canada, by report week, 2012-2013 (N<SUP>*</SUP>=56)


                            †sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.
                            * Total number of influenza surveillance regions in Canada
                            Text equivalent for figure 2Number of influenza surveillance regions reporting widespread or localized influenza activity, Canada, by report week, 2011-2012 (N=56)
                            Figure 3. Overall Number of Influenza Outbreaks, Canada, by Report Week, 2012-2013


                            Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2011-2012

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                            Influenza and Other Respiratory Virus Detections

                            The percentage of positive influenza tests increased slightly from 11.4% in week 14 to 12.4% in week 15 (Figure 4). Among the influenza viruses detected in week 15 (n=444), 18.9% were positive for influenza A viruses [of which 32.1% were A(H1N1)pdm09, 13.1% were A(H3), and 54.8% were A(unsubtyped)] (Table 1). Detections of influenza B increased to 81.1% of positive influenza detections in week 15, continuing the upward trend observed since week 03 (Figure 4). Cumulative influenza virus detections by type/subtype to date are as follows: 89.1% influenza A [34.6% A(H3), 4.4% A(H1N1)pdm09 and 61.1% A(unsubtyped)] and 10.9% influenza B (Table 1).
                            Detailed information on age and type/subtype has been received for 21,821 cases from 26 August 2012 to 23 March 2013 (Table 2). The proportion of cases by age group is as follows: 13.6% <5 years; 9.0% between 5-19 years; 15.5% between 20-44 years; 16.9% between 45-64 years of age; 45.0% ≥65 years.
                            The percentage of tests positive for RSV decreased to 8.9% in week 15, continuing its decline from a peak in week 08. The percentage of positive tests for rhinovirus continued its slow increase since week 01 to 10.1% in week 15. The percentage of positive tests for hMPV (6.2%) and parainfluenza (4.7%) have also been increasing gradually over the past 8-10 weeks. The percentage of positive tests for coronavirus (2.2%) has been decreasing slowly since week 04 (Figure 5)<SUP>*</SUP>.
                            * For more details, see the weekly Respiratory Virus Detections in Canada Report.
                            <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly & Cumulative numbers of positive influenza specimens
                            by Provincial Laboratories, Canada, 2012-2013
                            </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces</TH><TH id=ac1 colSpan=6>Weekly
                            (April 7 to April 13, 2013)
                            </TH><TH id=ac9 colSpan=6>Cumulative
                            (August 26, 2012 to April 13, 2013)
                            </TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=5 headers=ac1>Influenza A</TH><TH id=ac8 headers=ac1>Influenza
                            B
                            </TH><TH id=ac10 colSpan=5 headers=ac9>Influenza A</TH><TH id=ac16 headers=ac9>Influenza
                            B
                            </TH></TR><TR class=bg-colour-yellow><TH id=ac3 headers=ac2>A Total</TH><TH id=ac4 headers=ac2>A(H1)</TH><TH id=ac5 headers=ac2>A(H3)</TH><TH id=ac6 headers=ac2>Pand H1N1</TH><TH id=ac7 class=noWrap headers=ac2>A
                            ( <ABBR title=unsubtyped>Un S</ABBR>)Table 1 note*
                            </TH><TH headers="ac1 ac8">Total</TH><TH id=ac11 headers=ac10>A Total</TH><TH id=ac12 headers=ac10>A(H1)</TH><TH id=ac13 headers=ac10>A(H3)</TH><TH id=ac14 headers=ac10>Pand H1N1</TH><TH id=ac15 class=noWrap headers=ac10>A
                            (Un S) Table 1 note*
                            </TH><TH headers=ac16>Total</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13>* Unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available. Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Note: Weekly data is based on week of positive lab detection. Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals. </TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=bg-colour-yellow headers=ar1><ABBR title="British Columbia ">BC</ABBR></TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">9</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">3</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">4</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac7">2</TD><TD class=alignRight headers="ar1 ar2 ac1 ac8">20</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac11">1900</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac13">1449</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac14">214</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac15">237</TD><TD class=alignRight headers="ar1 ar2 ac9 ac16">350</TD></TR><TR><TH id=ar3 class=bg-colour-yellow headers=ar1><ABBR title=Alberta>AB</ABBR></TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">10</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">3</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">5</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac7">2</TD><TD class=alignRight headers="ar1 ar3 ac1 ac8">49</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac11">2319</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac13">1760</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac14">415</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac15">144</TD><TD class=alignRight headers="ar1 ar3 ac9 ac16">612</TD></TR><TR><TH id=ar4 class=bg-colour-yellow headers=ar1><ABBR title=Saskatchewan>SK</ABBR></TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">1</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">1</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac7">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac8">27</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac11">828</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac13">474</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac14">73</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac15">281</TD><TD class=alignRight headers="ar1 ar4 ac9 ac16">223</TD></TR><TR><TH id=ar5 class=bg-colour-yellow headers=ar1><ABBR title=Manitoba>MB</ABBR></TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">1</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac7">1</TD><TD class=alignRight headers="ar1 ar5 ac1 ac8">3</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac11">654</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac13">78</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac14">10</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac15">566</TD><TD class=alignRight headers="ar1 ar5 ac9 ac16">68</TD></TR><TR><TH id=ar6 class=bg-colour-yellow headers=ar1><ABBR title=Ontario>ON</ABBR></TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">21</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">4</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">11</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac7">6</TD><TD class=alignRight headers="ar1 ar6 ac1 ac8">62</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac11">8207</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac13">3768</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac14">345</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac15">4094</TD><TD class=alignRight headers="ar1 ar6 ac9 ac16">648</TD></TR><TR><TH id=ar7 class=bg-colour-yellow headers=ar1><ABBR title=Quebec>QC</ABBR>

                            </TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">18</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">1</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac7">17</TD><TD class=alignRight headers="ar1 ar7 ac1 ac8">194</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac11">9763</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac13">546</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac14">32</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac15">9185</TD><TD class=alignRight headers="ar1 ar7 ac9 ac16">1334</TD></TR><TR><TH id=ar8 class=bg-colour-yellow headers=ar1><ABBR title="New Brunswick">NB</ABBR>

                            </TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">8</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac5">1</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac6">3</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac7">4</TD><TD class=alignRight headers="ar1 ar8 ac1 ac8">4</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac11">1850</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac13">771</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac14">64</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac15">1015</TD><TD class=alignRight headers="ar1 ar8 ac9 ac16">25</TD></TR><TR><TH id=ar9 class=bg-colour-yellow headers=ar1><ABBR title="Nova Scotia ">NS</ABBR>

                            </TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">13</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac7">13</TD><TD class=alignRight headers="ar1 ar9 ac1 ac8">1</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac11">380</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac13">165</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac14">6</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac15">209</TD><TD class=alignRight headers="ar1 ar9 ac9 ac16">4</TD></TR><TR><TH id=ar10 class=bg-colour-yellow headers=ar1><ABBR title="Prince Edward Island ">PE</ABBR>

                            </TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">2</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac6">2</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac7">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac11">111</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac13">76</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac14">5</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac15">30</TD><TD class=alignRight headers="ar1 ar10 ac9 ac16">1</TD></TR><TR><TH id=ar11 class=bg-colour-yellow headers=ar1><ABBR title="Newfoundland/Labrador ">NL</ABBR>

                            </TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">1</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac7">1</TD><TD class=alignRight headers="ar1 ar11 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac11">714</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac13">152</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac14">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac15">562</TD><TD class=alignRight headers="ar1 ar11 ac9 ac16">15</TD></TR><TR><TH id=ar12 class=bg-colour-yellow headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">84</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac5">11</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac6">27</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac7">46</TD><TD class=alignRight headers="ar1 ar12 ac1 ac8">360</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac11">26726</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac13">9239</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac14">1164</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac15">16323</TD><TD class=alignRight headers="ar1 ar12 ac9 ac16">3280</TD></TR></TBODY></TABLE>
                            <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 2. Weekly & Cumulative numbers of positive influenza specimens by age groups
                            reported through case-based laboratory reporting, Canada, 2012-2013 Table 2 note*
                            </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups</TH><TH id=bc1 colSpan=5>Weekly
                            (March 17 to March 23, 2013)
                            </TH><TH id=bc8 colSpan=5>Cumulative
                            (August 26, 2012 to March 23, 2013)
                            </TH></TR><TR class=bg-colour-yellow><TH id=bc2 colSpan=4 headers=bc1>Influenza A</TH><TH id=bc7 headers=bc1>B</TH><TH id=bc9 colSpan=4 headers=bc8>Influenza A</TH><TH id=bc14 headers=bc8>B</TH></TR><TR class=bg-colour-yellow><TH id=bc3 headers=bc2>A Total</TH><TH id=bc4 headers=bc2>Pandemic H1N1</TH><TH id=bc5 headers=bc2>A/H3N2</TH><TH id=bc6 headers=bc2>A unsubtyped</TH><TH headers="bc1 bc7">Total</TH><TH id=bc10 headers=bc9>A Total</TH><TH id=bc11 headers=bc9>Pandemic H1N1</TH><TH id=bc12 headers=bc9>A/H3N2</TH><TH id=bc13 headers=bc9>A unsubtyped</TH><TH headers=bc14>Total</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11>* Please note that this table reflects the number of specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported. Delays in the reporting of data may cause data to change retrospectively. </TD></TR></TFOOT><TBODY><TR><TH id=br2 headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">12</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">3</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">9</TD><TD class=alignRight headers="br1 br2 bc1 bc7">43</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">2589</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">183</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">843</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1563</TD><TD class=alignRight headers="br1 br2 bc8 bc14">379</TD></TR><TR><TH id=br3 headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">2</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">2</TD><TD class=alignRight headers="br1 br3 bc1 bc7">45</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1428</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">64</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">628</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">736</TD><TD class=alignRight headers="br1 br3 bc8 bc14">538</TD></TR><TR><TH id=br4 headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">19</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">4</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">2</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">13</TD><TD class=alignRight headers="br1 br4 bc1 bc7">32</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">3062</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">289</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">1192</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">1581</TD><TD class=alignRight headers="br1 br4 bc8 bc14">319</TD></TR><TR><TH id=br5 headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">16</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">1</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">15</TD><TD class=alignRight headers="br1 br5 bc1 bc7">36</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">3375</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">275</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">1191</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">1909</TD><TD class=alignRight headers="br1 br5 bc8 bc14">315</TD></TR><TR><TH id=br6 headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">31</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">1</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">4</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">26</TD><TD class=alignRight headers="br1 br6 bc1 bc7">36</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">9476</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">102</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">3583</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">5791</TD><TD class=alignRight headers="br1 br6 bc8 bc14">340</TD></TR><TR><TH id=br7 headers=br1>Unknown</TH><TD class=alignRight headers="br1 br7 bc1 bc2 bc3">1</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc4">1</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc6">0</TD><TD class=alignRight headers="br1 br7 bc1 bc7">0</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc10">166</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">20</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">144</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">2</TD><TD class=alignRight headers="br1 br7 bc8 bc14">0</TD></TR><TR><TH id=br8 headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">81</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc4">10</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc5">6</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc6">65</TD><TD class=alignRight headers="br1 br8 bc1 bc7">192</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">20096</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc11">933</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc12">7581</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc13">11582</TD><TD class=alignRight headers="br1 br8 bc8 bc14">1891</TD></TR></TBODY></TABLE>


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                            Figure 4. Influenza tests reported and percentage of tests positive, Canada,
                            by report week, 2012-2013


                            Text equivalent for figure 4Influenza tests reported and percentage of tests positive, Canada, by report week, 2011-2012
                            Figure 5. Percent positive influenza tests, compared to other respiratory viruses,
                            Canada, by reporting week, 2012-2013


                            Text equivalent for figure 5Percent positive influenza tests, compared to other respiratory viruses, Canada, by reporting week, 2011-2012

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                            Influenza strain characterizations

                            During the 2012-13 season, the National Microbiology Laboratory (NML) has antigenically characterized 1016 influenza viruses. The 553 influenza A(H3N2) viruses were antigenically similar to the vaccine strain A/Victoria/361/2011 and the 162 A(H1N1)pdm09 viruses were antigenically similar to the vaccine strain A/California/07/09. Among the influenza B viruses, 248 were antigenically similar to the vaccine strain B/Wisconsin/01/2010 (Yamagata lineage) and 53 were similar to B/Brisbane/60/2008 (Victoria lineage; component of the 2011-2012 seasonal influenza vaccine) (Figure 6).
                            Figure 6. Influenza strain characterizations, Canada, 2012-2013, N =1016

                            Note: The recommended components for the 2012-2013 Northern Hemisphere influenza vaccine include: an A/Victoria/361/2011 (H3N2)-like virus; an A/California/7/2009 (H1N1)pdm09-like virus; and a B/Wisconsin/1/2010-like virus.
                            Text equivalent for figure 6Influenza strain characterizations, Canada, 2011-2012

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                            Antiviral resistance

                            During the 2012-13 season, NML has tested 941 influenza viruses for resistance to oseltamivir, and 942 influenza viruses for resistance to zanamivir. All viruses tested were sensitive to oseltamivir and zanamivir. A total of 1029 influenza A viruses were tested for amantadine resistance and all but one were resistant (Table 3).


                            <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2012-2013</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=cr1 rowSpan=2>Virus type and subtype</TH><TH id=cc1 colSpan=2>Oseltamivir</TH><TH id=cc4 colSpan=2>Zanamivir</TH><TH id=cc7 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=cc2 headers=cc1># tested</TH><TH id=cc3 headers=cc1># resistant (%)</TH><TH id=cc5 headers=cc4># tested</TH><TH id=cc6 headers=cc4># resistant (%)</TH><TH id=cc8 headers=cc7># tested</TH><TH id=cc9 headers=cc7># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=cr2 class="alignLeft bg-colour-blue" headers=cr1>A (H3N2)</TH><TD class=alignRight headers="cr2 cc2">528</TD><TD class=alignRight headers="cr2 cc3">0</TD><TD class=alignRight headers="cr2 cc5">532</TD><TD class=alignRight headers="cr2 cc6">0</TD><TD class=alignRight headers="cr2 cc8">855</TD><TD class=alignRight headers="cr2 cc9">854 (99.9 %)</TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignRight headers="cr3 cc2">156</TD><TD class=alignRight headers="cr3 cc3">0</TD><TD class=alignRight headers="cr3 cc5">153</TD><TD class=alignRight headers="cr3 cc6">0</TD><TD class=alignRight headers="cr3 cc8">174</TD><TD class=alignRight headers="cr3 cc9">174 (100 %)</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignRight headers="cr4 cc2">257</TD><TD class=alignRight headers="cr4 cc3">0</TD><TD class=alignRight headers="cr4 cc5">257</TD><TD class=alignRight headers="cr4 cc6">0</TD><TD class=alignRight headers="cr4 cc8">NA <SUP>*</SUP></TD><TD class=alignRight headers="cr4 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft bg-colour-blue" headers=cr1>TOTAL</TH><TD class=alignRight headers="cr5 cc2">941</TD><TD class=alignRight headers="cr5 cc3">0</TD><TD class=alignRight headers="cr5 cc5">942</TD><TD class=alignRight headers="cr5 cc6">0</TD><TD class=alignRight headers="cr5 cc8">1029</TD><TD class=alignRight headers="cr5 cc9">1028 (99.9 %)</TD></TR></TBODY></TABLE>
                            Influenza-like Illness (ILI) Consultation Rate

                            The national influenza-like-illness (ILI) consultation rate decreased from 23.8 ILI consultations per 1,000 patient visits in week 14, to 16.4 in week 15 and remains within the expected range (Figure 7). In week 15, the highest consultation rate was observed in children 5 to 19 years of age (28.1/1,000).
                            Figure 7. Influenza-like illness (ILI) consultation rates, Canada, by report week, 2012-2013 compared to 1996/97 through to 2011/12 seasons (with pandemic data suppressed)



                            Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons). Delays in the reporting of data may cause data to change retrospectively.
                            Text equivalent for figure 7Influenza-like illness (ILI) consultation rates, Canada, by report week, 2011-2012 compared to 1996/97 through to 2010/11 seasons (with pandemic data suppressed)

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                            Severe Respiratory Illness Surveillance

                            Paediatric Influenza Hospitalizations and Deaths (IMPACT)

                            In week 15, 12 laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 15 in week 14. All the cases reported in week 15 were identified with influenza B. The age distribution is as follows: one (8.3%) between 0-5 months, 2 (16.7%) between 6-23 months, 4 (33.3%) 2-4 years of age, 3 (25.0%) 5-9 years of age and 2 (16.7%) 10-16 years of age. One admission to an intensive care unit (ICU) was reported during week 15, a child 6-23 months of age with influenza B.

                            Since the start of the 2012-13 season, a total of 796 influenza-associated paediatric hospitalizations have been reported by the IMPACT network: 615 (77.3%) with influenza A [of which 121 (19.7%) were A(H3N2), 22 (3.6%) were A(H1N1)pdm09 and the remaining 472 were A(unsubtyped); and 181 (22.7%) with influenza B. The distribution of cases by age group is as follows: 148 (18.6%) <6 months of age; 189 (23.7%) age 6-23 months; 227 (28.5%) age 2-4 years; 166 (20.9%) age 5-9 years; and 66 (8.3%) age 10-16 years. Seventy-six (9.5%) of the 796 cases were admitted to the ICU. No deaths have been reported to date.

                            Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associate paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.

                            Adult Influenza Hospitalizations and Deaths (PCIRN)

                            In week 15, 13 laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 12 in week 14. Seven of the 13 hospitalizations were cases of influenza A(unsubtyped), and six were influenza B. Seven cases were ≥65 years of age, and six were 45-64 years of age. No ICU admissions were reported during the current week. One death was reported, a person ≥65 years of age with influenza A(H1N1)pdm09.

                            From November 4, 2012 to April 13, 2013, 1,700 influenza-associated adult hospitalizations were reported by the PCIRN-SOS network: 1,565 (92.1%) with influenza A [of which 300 were A(H3N2), 16 were A(H1N1)pdm09, and 1,249 were A(unsubtyped)]; 87 (5.1%) with influenza B, and the type has not been reported for 48 cases. The age distribution of hospitalizations is as follows: 1,176 (69.2%) were ≥65 years of age, 341 (20.1%) were 45-64 years, 175 (10.3%) were 20-44 years, and 8 (0.5%) were <20 years of age. ICU admission was required for 196 hospitalizations; the majority of which were adults ≥65 years of age (119; 60.7%). Of the ICU admissions, 79 (40.3%) had at least one co-morbidity, three (1.5%) had no co-morbidities, and 114 had no information to date. A total of 105 deaths have been reported: 24 with influenza A(H3N2), one with A(H1N1)pdm09, 74 with A(unsubtyped), 5 with influenza B, and one untyped. More than 80% of the deaths (90/105) were in adults ≥65 years of age, 12 (11.4%) were adults 45-64 years of age, and 3 (2.9%) were 20-44 years of age.
                            Forty-seven (44.8%) deaths occurred in individuals who had at least one co-morbidity. Detailed clinical information on co-morbidities is not known for the remaining cases.

                            Note: The number of hospitalizations reported through PCIRN represents a subset of all influenza-associate adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
                            Provincial/Territorial Influenza Hospitalizations and Deaths (Aggregate Surveillance System<SUP>*</SUP>)

                            In week 15, 91 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories<SUP>*</SUP>. The majority of cases were influenza A (52.7%). The highest proportion of hospitalisations were in adults ≥65 years of age (37.4%), followed by adults 45-64 years of age (33.0%). Of the 25 cases with available data, four cases were admitted to the ICU: three 45-64 years of age and one 20-44 years of age. No deaths were reported in week 15.

                            To date this season, 4,341 influenza-associated hospitalizations have been reported, of which 91.9% have been influenza A. Of those subtyped (48.4%), influenza A(H3) was the predominant influenza strain. The cumulative proportion of hospitalizations with influenza B continues to increase (8.1% in week 15). Age information was available for 4,338 cases, and the age distribution is as follows: 2,350 (54.2%) were ≥65 years of age; 737 (17.0%) were 45-64 years of age; 387 (8.9%) were 20-44 years of age; 40 (0.9%) were 15-19 years of age; 186 (4.3%) were 5-14 years; and 638 (14.7%) were 0-4 years of age. Of the 1,157 cases with available data, there have been 184 hospitalisations for which admission to an ICU was required; the highest proportions have been in adults 45-64 years of age, followed by adults ≥65 years of age (36.9% and 33.2%, respectively). To date, 280 deaths have been reported: 232 were adults ≥65 years of age, 31 were adults 45-64 years; 11 were adults 20-44 years, one was a child 5-14 years of age, and 5 were children 0-4 years of age. It is important to note that the cause of death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.

                            * Note: The number of new influenza-associated hospitalizations and deaths reported by the Aggregate Surveillance System each week may be overestimated, as it may include retrospective updates to data from Ontario for previous weeks. These data may also include cases reported by the IMPACT and PCIRN networks. Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, NS, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not reported in Ontario.

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                            International Influenza Update


                            WHO : The most recent WHO surveillance report (12 April 2013) summarizes global influenza surveillance data from week 13 (24 to 30 March 2013). In North America, the peak of influenza activity in Mexico occurred about 2 weeks after the early-January peak in Canada and the United States. Although the United States reported a greater proportion of influenza B this season, both Canada and the US have seen an increase in circulation of influenza B in the later part of the season. Analysis from 12 European countries revealed a broad peak of excess mortality among older adults, starting in early January, comparable with the mortality levels observed during the 2011-2012 season. In northern Africa and the western Asia region, the peak of influenza activity occurred in late February with a predominance of A(H1N1)pdm09. Influenza activity continued to decrease in temperate regions of Asia since peaking at the end of January, although activity in China and the Republic of Korea peaked a few weeks later than in other countries. Influenza A(H3N2) has been the most commonly detected virus in northern Asia this season although in northern China an increasing proportion of A(H1N1)pdm09 has been detected. In tropical regions of Asia, influenza activity was low, with circulation primarily of A(H3N2) and A(H1N1)pdm09 in India and all three types/subtypes in Sri Lanka. In Central America and the Caribbean, influenza activity was similar to recent weeks, with RSV the most commonly detected agent among cases of acute respiratory illness. Countries in Tropical South America reported low numbers of influenza detections. Most countries in tropical areas of Central Africa reported low-level but persistent influenza circulation with all three virus types. Influenza activity in temperate countries of the southern hemisphere is at inter-seasonal levels. United States : No new influenza surveillance update has been published by the CDC since 6 April 2013. Europe: In week 15, ILI and acute respiratory illness (ARI) consultation rates are below the baseline or at pre-season levels in many countries. Most countries reported low intensity of ILI/ARI activity and a decreasing trend. The percentage of sentinel specimens positive for influenza continues to decline to 27% in week 15. The proportion of influenza B detections has increased from 24% in week 03 to 56% in week 15. Influenza B now dominates in circulation although overall detections of influenza are declining. Among influenza A viruses in week 15, 54% were A(H3N2) and 46% were A(H1N1)pdm09. Since the beginning of the season, 64% of detections from sentinel and non-sentinel sources were influenza A [68% A(H1N1)pdm09 and 32% A(H3N2)] and 36% were influenza B. In week 15, the number of countries reporting a predominance of influenza A circulation continued to decrease, and now includes only Greece, Ireland, the United Kingdom, Belgium, Finland, Italy and some parts of the Russian Federation. Among the 623 A(H1N1)pdm09 viruses tested for resistance to oseltamivir from 12 countries, 13 (2%) were found to contain the H275Y mutation: four were specimens from hospitalized and outpatients not exposed(3) or with unknown(1) exposure to oseltamivir, while the other nine viruses were detected in hospitalized and/or immunocompromised patients receiving oseltamivir treatment. The number of hospitalizations for severe acute respiratory illness (SARI) are declining, in keeping with ILI/ARI consultation rates. Emerging Respiratory Pathogens

                            Human Avian Influenza

                            Influenza A(H7N9): Between April 12 and April 19, the WHO reported an additional 49 cases of avian influenza A(H7N9) in eastern China. Of these cases, five were discovered retrospectively. Since March 2013, 87 cases, of which 17 were fatalities, of avian influenza A(H7N9) have been reported from four provinces and two municipalities. The numbers of cases (and deaths) by jurisdiction is as follows: Anhui 3 (1), Henan 3 (0), Jiangsu 21 (3), Zhejiang 27 (2), Beijing 1 (0) and Shanghai 32 (11). More than 1,000 close contacts of confirmed cases are being closely monitored. Some of the confirmed cases had contact with animals or with an animal environment. Investigations into the source and route of transmission are still in progress, but there has been no evidence of ongoing person-to-person spread. WHO is in contact with national authorities and is following the event closely.Human Swine Influenza

                            No new human cases of infection with swine influenza viruses or variants were reported in week 14..../
                            http://www.phac-aspc.gc.ca/fluwatch/.../index-eng.php
                            "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                            -Nelson Mandela

                            Comment


                            • #29
                              Re: Canada FluWatch Weekly Reports 2012-2013 Season Week 16

                              FluWatch report: April 14 to April 20, 2013 (Week 16)

                              Posted 2013-04-26For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
                              <A title="Flu Watch (Version PDF, 113 KB - 6 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/12-13/w16_13/pdf/fw2013-16-eng.pdf">FluWatch report: April 14 to April 20, 2013 (Week 16) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 113 <ABBR title=Kilobytes>KB</ABBR> - 8 pages)

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                              Overall Summary
                              • The percentage of laboratory tests positive for influenza has been stable at approximately 12% over the past six weeks. Detections of influenza B continued to increase, with influenza B detected in 89.4% of positive specimens in week 16.
                              • The ILI consultation rate was stable, and the number of regions reporting localized activity increased compared to the previous week, both likely due to the continued circulation of influenza B.
                              • Detections of rhinovirus and parainfluenza continued to increase slowly while detections of other respiratory viruses were stable or decreasing.
                              Influenza Activity (geographic spread) and Outbreaks

                              In week 16, no regions reported widespread activity, twelve regions [BC(2), AB(1), ON(5), QC(2) and NS (2)] reported localized activity and 23 regions reported sporadic activity. The number of regions reporting widespread or localized activity increased compared to the previous week (Figures 1 and 2). Ten new influenza outbreaks were reported: nine in long-term-care facilities, and one in a school (Figure 3).
                              Figure 1. Map of overall Influenza activity level by province and territory,
                              Canada, Week 16





                              Note: Influenza activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.
                              Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
                              Figure 2. Number of influenza surveillance regions<SUP title="sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in"></SUP> reporting widespread or localized influenza activity, Canada, by report week, 2012-2013 (N<SUP>*</SUP>=56)


                              †sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.
                              * Total number of influenza surveillance regions in Canada
                              Text equivalent for figure 2Number of influenza surveillance regions reporting widespread or localized influenza activity, Canada, by report week, 2011-2012 (N=56)
                              Figure 3. Overall Number of Influenza Outbreaks, Canada, by Report Week, 2012-2013


                              Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2011-2012

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                              Influenza and Other Respiratory Virus Detections

                              The overall percentage of positive influenza tests was stable for the sixth consecutive week (11.3% in week 16) as a result of the continued upward trend of influenza B detections observed since week 03. Detections of influenza B increased to 89.4% of positive influenza detections in week 16 (Figure 4). Among the influenza viruses detected in week 16 (n=397), 10.6% were positive for influenza A viruses [of which 38.1% were A(H1N1)pdm09, 9.5% were A(H3), and 52.4% were A(unsubtyped)] (Table 1). Detections of influenza B increased to 81.1% of positive influenza detections in week 15, continuing the upward trend observed since week 03 (Figure 4). Cumulative influenza virus detections by type/subtype to date are as follows: 88.0% influenza A [34.5% A(H3), 4.4% A(H1N1)pdm09 and 61.1% A(unsubtyped)] and 12.0% influenza B (Table 1).
                              Detailed information on age and type/subtype has been received for 23,293 cases to date this season (Table 2). The proportion of cases by age group is as follows: 14.0% <5 years; 9.6% between 5-19 years; 15.7% between 20-44 years; 17.0% between 45-64 years of age; 43.7% ≥65 years.
                              The percentage of positive tests for rhinovirus continued its slow increase since week 01 to 11.3% in week 16. The percentage of positive tests for parainfluenza (5.3%) has also been increasing gradually over the past 8-10 weeks. The percentage of tests positive for respiratory syncytial virus (RSV) (6.4%) continued its decline from a peak in week 08. The percentage of positive tests for human metapneumovirus (hMPV) (5.0%) decreased for the second week in a row, and the percentage of positive tests for coronavirus (1.8%) has been decreasing slowly since week 04 (Figure 5)<SUP>*</SUP>.
                              * For more details, see the weekly Respiratory Virus Detections in Canada Report.
                              <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly & Cumulative numbers of positive influenza specimens
                              by Provincial Laboratories, Canada, 2012-2013
                              </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces</TH><TH id=ac1 colSpan=6>Weekly
                              (April 14 to April 20, 2013)
                              </TH><TH id=ac9 colSpan=6>Cumulative
                              (August 26, 2012 to April 20, 2013)
                              </TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=5 headers=ac1>Influenza A</TH><TH id=ac8 headers=ac1>Influenza
                              B
                              </TH><TH id=ac10 colSpan=5 headers=ac9>Influenza A</TH><TH id=ac16 headers=ac9>Influenza
                              B
                              </TH></TR><TR class=bg-colour-yellow><TH id=ac3 headers=ac2>A Total</TH><TH id=ac4 headers=ac2>A(H1)</TH><TH id=ac5 headers=ac2>A(H3)</TH><TH id=ac6 headers=ac2>Pand H1N1</TH><TH id=ac7 class=noWrap headers=ac2>A
                              ( <ABBR title=unsubtyped>Un S</ABBR>)Table 1 note*
                              </TH><TH headers="ac1 ac8">Total</TH><TH id=ac11 headers=ac10>A Total</TH><TH id=ac12 headers=ac10>A(H1)</TH><TH id=ac13 headers=ac10>A(H3)</TH><TH id=ac14 headers=ac10>Pand H1N1</TH><TH id=ac15 class=noWrap headers=ac10>A
                              (Un S) Table 1 note*
                              </TH><TH headers=ac16>Total</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13>* Unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available. Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Note: Weekly data is based on week of positive lab detection. Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals. </TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=bg-colour-yellow headers=ar1><ABBR title="British Columbia ">BC</ABBR></TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">2</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac7">2</TD><TD class=alignRight headers="ar1 ar2 ac1 ac8">23</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac11">1898</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac13">1448</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac14">211</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac15">239</TD><TD class=alignRight headers="ar1 ar2 ac9 ac16">374</TD></TR><TR><TH id=ar3 class=bg-colour-yellow headers=ar1><ABBR title=Alberta>AB</ABBR></TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">7</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">7</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac7">0</TD><TD class=alignRight headers="ar1 ar3 ac1 ac8">36</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac11">2326</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac13">1760</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac14">423</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac15">143</TD><TD class=alignRight headers="ar1 ar3 ac9 ac16">650</TD></TR><TR><TH id=ar4 class=bg-colour-yellow headers=ar1><ABBR title=Saskatchewan>SK</ABBR></TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">3</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">1</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac7">2</TD><TD class=alignRight headers="ar1 ar4 ac1 ac8">14</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac11">831</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac13">475</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac14">73</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac15">283</TD><TD class=alignRight headers="ar1 ar4 ac9 ac16">237</TD></TR><TR><TH id=ar5 class=bg-colour-yellow headers=ar1><ABBR title=Manitoba>MB</ABBR></TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">1</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac7">1</TD><TD class=alignRight headers="ar1 ar5 ac1 ac8">2</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac11">655</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac13">78</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac14">10</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac15">567</TD><TD class=alignRight headers="ar1 ar5 ac9 ac16">70</TD></TR><TR><TH id=ar6 class=bg-colour-yellow headers=ar1><ABBR title=Ontario>ON</ABBR></TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">13</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">3</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">7</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac7">3</TD><TD class=alignRight headers="ar1 ar6 ac1 ac8">73</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac11">8220</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac13">3771</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac14">352</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac15">4097</TD><TD class=alignRight headers="ar1 ar6 ac9 ac16">724</TD></TR><TR><TH id=ar7 class=bg-colour-yellow headers=ar1><ABBR title=Quebec>QC</ABBR>

                              </TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">11</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac7">11</TD><TD class=alignRight headers="ar1 ar7 ac1 ac8">193</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac11">9774</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac13">546</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac14">32</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac15">9196</TD><TD class=alignRight headers="ar1 ar7 ac9 ac16">1527</TD></TR><TR><TH id=ar8 class=bg-colour-yellow headers=ar1><ABBR title="New Brunswick">NB</ABBR>

                              </TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">3</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac6">1</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac7">2</TD><TD class=alignRight headers="ar1 ar8 ac1 ac8">12</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac11">1853</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac13">771</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac14">65</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac15">1017</TD><TD class=alignRight headers="ar1 ar8 ac9 ac16">37</TD></TR><TR><TH id=ar9 class=bg-colour-yellow headers=ar1><ABBR title="Nova Scotia ">NS</ABBR>

                              </TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">2</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">1</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac7">1</TD><TD class=alignRight headers="ar1 ar9 ac1 ac8">2</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac11">382</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac13">165</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac14">7</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac15">210</TD><TD class=alignRight headers="ar1 ar9 ac9 ac16">6</TD></TR><TR><TH id=ar10 class=bg-colour-yellow headers=ar1><ABBR title="Prince Edward Island ">PE</ABBR>

                              </TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac7">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac11">111</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac13">76</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac14">5</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac15">30</TD><TD class=alignRight headers="ar1 ar10 ac9 ac16">1</TD></TR><TR><TH id=ar11 class=bg-colour-yellow headers=ar1><ABBR title="Newfoundland/Labrador ">NL</ABBR>

                              </TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac7">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac11">714</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac13">152</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac14">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac15">562</TD><TD class=alignRight headers="ar1 ar11 ac9 ac16">15</TD></TR><TR><TH id=ar12 class=bg-colour-yellow headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">42</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac5">4</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac6">16</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac7">22</TD><TD class=alignRight headers="ar1 ar12 ac1 ac8">355</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac11">26764</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac13">9242</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac14">1178</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac15">16344</TD><TD class=alignRight headers="ar1 ar12 ac9 ac16">3641</TD></TR></TBODY></TABLE>
                              <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 2. Weekly & Cumulative numbers of positive influenza specimens by age groups
                              reported through case-based laboratory reporting, Canada, 2012-2013 Table 2 note*
                              </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups</TH><TH id=bc1 colSpan=5>Weekly
                              (April 14 to April 20, 2013)
                              </TH><TH id=bc8 colSpan=5>Cumulative
                              (August 26, 2012 to April 20, 2013)
                              </TH></TR><TR class=bg-colour-yellow><TH id=bc2 colSpan=4 headers=bc1>Influenza A</TH><TH id=bc7 headers=bc1>B</TH><TH id=bc9 colSpan=4 headers=bc8>Influenza A</TH><TH id=bc14 headers=bc8>B</TH></TR><TR class=bg-colour-yellow><TH id=bc3 headers=bc2>A Total</TH><TH id=bc4 headers=bc2>Pandemic H1N1</TH><TH id=bc5 headers=bc2>A/H3N2</TH><TH id=bc6 headers=bc2>A unsubtyped</TH><TH headers="bc1 bc7">Total</TH><TH id=bc10 headers=bc9>A Total</TH><TH id=bc11 headers=bc9>Pandemic H1N1</TH><TH id=bc12 headers=bc9>A/H3N2</TH><TH id=bc13 headers=bc9>A unsubtyped</TH><TH headers=bc14>Total</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11>* Please note that this table reflects the number of specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported. Delays in the reporting of data may cause data to change retrospectively. </TD></TR></TFOOT><TBODY><TR><TH id=br2 headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">3</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">3</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">0</TD><TD class=alignRight headers="br1 br2 bc1 bc7">49</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">2648</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">207</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">849</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1592</TD><TD class=alignRight headers="br1 br2 bc8 bc14">617</TD></TR><TR><TH id=br3 headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">0</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">0</TD><TD class=alignRight headers="br1 br3 bc1 bc7">52</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1450</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">66</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">630</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">754</TD><TD class=alignRight headers="br1 br3 bc8 bc14">795</TD></TR><TR><TH id=br4 headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">7</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">2</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">2</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">3</TD><TD class=alignRight headers="br1 br4 bc1 bc7">29</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">3143</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">319</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">1207</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">1617</TD><TD class=alignRight headers="br1 br4 bc8 bc14">512</TD></TR><TR><TH id=br5 headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">4</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">4</TD><TD class=alignRight headers="br1 br5 bc1 bc7">31</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">3442</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">300</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">1196</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">1946</TD><TD class=alignRight headers="br1 br5 bc8 bc14">510</TD></TR><TR><TH id=br6 headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">4</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">4</TD><TD class=alignRight headers="br1 br6 bc1 bc7">64</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">9579</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">120</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">3599</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">5860</TD><TD class=alignRight headers="br1 br6 bc8 bc14">597</TD></TR><TR><TH id=br7 headers=br1>Unknown</TH><TD class=alignRight headers="br1 br7 bc1 bc2 bc3">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc6">0</TD><TD class=alignRight headers="br1 br7 bc1 bc7">0</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc10">167</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">20</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">145</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">2</TD><TD class=alignRight headers="br1 br7 bc8 bc14">0</TD></TR><TR><TH id=br8 headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">18</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc4">5</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc5">2</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc6">11</TD><TD class=alignRight headers="br1 br8 bc1 bc7">225</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">20429</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc11">1032</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc12">7626</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc13">11771</TD><TD class=alignRight headers="br1 br8 bc8 bc14">3031</TD></TR></TBODY></TABLE>


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                              Figure 4. Influenza tests reported and percentage of tests positive, Canada,
                              by report week, 2012-2013


                              Text equivalent for figure 4Influenza tests reported and percentage of tests positive, Canada, by report week, 2011-2012
                              Figure 5. Percent positive influenza tests, compared to other respiratory viruses,
                              Canada, by reporting week, 2012-2013


                              Text equivalent for figure 5Percent positive influenza tests, compared to other respiratory viruses, Canada, by reporting week, 2011-2012

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                              Influenza strain characterizations

                              During the 2012-13 season, the National Microbiology Laboratory (NML) has antigenically characterized 1097 influenza viruses. The 560 influenza A(H3N2) viruses were antigenically similar to the vaccine strain A/Victoria/361/2011 and the 186 A(H1N1)pdm09 viruses were antigenically similar to the vaccine strain A/California/07/09. Among the influenza B viruses, 283 were antigenically similar to the vaccine strain B/Wisconsin/01/2010 (Yamagata lineage) and 68 were similar to B/Brisbane/60/2008 (Victoria lineage; component of the 2011-2012 seasonal influenza vaccine) (Figure 6).
                              Figure 6. Influenza strain characterizations, Canada, 2012-2013, N =1097

                              Note: The recommended components for the 2012-2013 Northern Hemisphere influenza vaccine include: an A/Victoria/361/2011 (H3N2)-like virus; an A/California/7/2009 (H1N1)pdm09-like virus; and a B/Wisconsin/1/2010-like virus.
                              Text equivalent for figure 6Influenza strain characterizations, Canada, 2011-2012

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                              Antiviral resistance

                              During the 2012-13 season, NML has tested 1013 influenza viruses for resistance to oseltamivir, and 1010 influenza viruses for resistance to zanamivir. Among these, one A(H3N2) virus was resistant to oseltamivir and zanamivir. A total of 1110 influenza A viruses were tested for amantadine resistance and all but one were resistant (Table 3).


                              <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2012-2013</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=cr1 rowSpan=2>Virus type and subtype</TH><TH id=cc1 colSpan=2>Oseltamivir</TH><TH id=cc4 colSpan=2>Zanamivir</TH><TH id=cc7 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=cc2 headers=cc1># tested</TH><TH id=cc3 headers=cc1># resistant (%)</TH><TH id=cc5 headers=cc4># tested</TH><TH id=cc6 headers=cc4># resistant (%)</TH><TH id=cc8 headers=cc7># tested</TH><TH id=cc9 headers=cc7># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=cr2 class="alignLeft bg-colour-blue" headers=cr1>A (H3N2)</TH><TD class=alignRight headers="cr2 cc2">554</TD><TD class=alignRight headers="cr2 cc3">1 (0.2%)</TD><TD class=alignRight headers="cr2 cc5">554</TD><TD class=alignRight headers="cr2 cc6">1 (0.2%)</TD><TD class=alignRight headers="cr2 cc8">915</TD><TD class=alignRight headers="cr2 cc9">914 (99.9%)</TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignRight headers="cr3 cc2">164</TD><TD class=alignRight headers="cr3 cc3">0</TD><TD class=alignRight headers="cr3 cc5">161</TD><TD class=alignRight headers="cr3 cc6">0</TD><TD class=alignRight headers="cr3 cc8">195</TD><TD class=alignRight headers="cr3 cc9">195 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignRight headers="cr4 cc2">295</TD><TD class=alignRight headers="cr4 cc3">0</TD><TD class=alignRight headers="cr4 cc5">295</TD><TD class=alignRight headers="cr4 cc6">0</TD><TD class=alignRight headers="cr4 cc8">NA <SUP>*</SUP></TD><TD class=alignRight headers="cr4 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft bg-colour-blue" headers=cr1>TOTAL</TH><TD class=alignRight headers="cr5 cc2">1013</TD><TD class=alignRight headers="cr5 cc3">0</TD><TD class=alignRight headers="cr5 cc5">1010</TD><TD class=alignRight headers="cr5 cc6">0</TD><TD class=alignRight headers="cr5 cc8">1110</TD><TD class=alignRight headers="cr5 cc9">1109 (99.9%)</TD></TR></TBODY></TABLE>
                              Influenza-like Illness (ILI) Consultation Rate

                              The national influenza-like-illness (ILI) consultation rate was stable at 16.1 ILI consultations per 1,000 patient visits in week 16, and remains within the expected range (Figure 7). In week 16, the highest consultation rate was observed in children 5 to 19 years of age (46.9/1,000).
                              Figure 7. Influenza-like illness (ILI) consultation rates, Canada, by report week, 2012-2013 compared to 1996/97 through to 2011/12 seasons (with pandemic data suppressed)



                              Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons). Delays in the reporting of data may cause data to change retrospectively.
                              Text equivalent for figure 7Influenza-like illness (ILI) consultation rates, Canada, by report week, 2011-2012 compared to 1996/97 through to 2010/11 seasons (with pandemic data suppressed)

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                              Severe Respiratory Illness Surveillance

                              Paediatric Influenza Hospitalizations and Deaths (IMPACT)

                              In week 16, 21 laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 16 in week 15. All but one of the cases reported in week 16 were identified with influenza B. The age distribution is as follows: 3 (14.3%) between 0-5 months, 5 (23.8%) between 6-23 months, 7 (33.3%) 2-4 years of age, 4 (19.0%) 5-9 years of age and 2 (9.5%) 10-16 years of age. Five cases were admitted to an intensive care unit (ICU) during week 16, three children 6-23 months of age and two 2-4 years of age, all with influenza B. One death was reported in week 16, a child 6-23 months of age with an underlying condition, infected with influenza B.
                              Since the start of the 2012-13 season, a total of 820 influenza-associated paediatric hospitalizations have been reported by the IMPACT network: 615 (75.0%) with influenza A [of which 121 (19.7%) were A(H3N2), 22 (3.6%) were A(H1N1)pdm09 and the remaining 472 were A(unsubtyped); and 205 (25.0%) with influenza B. The distribution of cases by age group is as follows: 152 (18.5%) <6 months of age; 194 (23.7%) age 6-23 months; 234 (28.5%) age 2-4 years; 171 (20.9%) age 5-9 years; and 69 (8.4%) age 10-16 years. Eighty-five (10.4%) of the 820 cases were admitted to the ICU. Of the 61 ICU admissions with available data, 53 (86.9%) cases had at least one co-morbidity. One death has been reported to date this season.
                              Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associate paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.

                              Adult Influenza Hospitalizations and Deaths (PCIRN)

                              In week 16, seven laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 16 in week 15. Four of the seven hospitalizations were cases of influenza B, and three were untyped. Three cases were ≥65 years of age, two were 45-64 years of age, and two were 20-44 years of age. No ICU admissions or deaths were reported in week 16.

                              From November 4, 2012 to April 20, 2013, 1,735 influenza-associated adult hospitalizations were reported by the PCIRN-SOS network: 1,590 (91.6%) with influenza A [of which 305 were A(H3N2), 16 were A(H1N1)pdm09, and 1,269 were A(unsubtyped)]; 94 (5.4%) with influenza B, and the type has not been reported for 51 cases. The age distribution of hospitalizations is as follows: 1,193 (68.8%) were ≥65 years of age, 349 (20.1%) were 45-64 years, 185 (10.7%) were 20-44 years, and 8 (0.5%) were <20 years of age. ICU admission was required for 201 hospitalizations; the majority of which were adults ≥65 years of age (121; 60.2%). Of the ICU admissions, 82 (40.8%) had at least one co-morbidity, three (1.5%) had no co-morbidities, and 116 had no information to date. A total of 112 deaths have been reported: 26 with influenza A(H3N2), one with A(H1N1)pdm09, 79 with A(unsubtyped), 5 with influenza B, and one untyped. More than 85% of the deaths (96/112) were in adults ≥65 years of age, 13 (11.6%) were adults 45-64 years of age, and 3 (2.7%) were 20-44 years of age. Fifty-one (45.5%) deaths occurred in individuals who had at least one co-morbidity. Detailed clinical information on co-morbidities is not known for the remaining cases.
                              Note: The number of hospitalizations reported through PCIRN represents a subset of all influenza-associate adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.

                              Provincial/Territorial Influenza Hospitalizations and Deaths (Aggregate Surveillance System<SUP>*</SUP>)

                              In week 16, 126 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories<SUP>*</SUP>. The majority of cases were influenza A (67.5%). The highest proportion of hospitalisations were in adults ≥65 years of age (53.2%), followed by adults 45-64 years of age (15.9%). Of the 21 cases with available data, three cases were admitted to the ICU: two 45-64 years of age and one 0-4 years of age. Five deaths were reported in week 16, four ≥65 years of age and one 45-64 years of age, all with influenza A.

                              To date this season, 4,489 influenza-associated hospitalizations have been reported, of which 91.0% have been influenza A. Of those subtyped (48.4%), influenza A(H3) was the predominant influenza strain. The cumulative proportion of hospitalizations with influenza B continues to increase (9.1% in week 16). Age information was available for 4,486 cases, and the age distribution is as follows: 2,429 (54.1%) were ≥65 years of age; 758 (16.9%) were 45-64 years of age; 400 (8.9%) were 20-44 years of age; 40 (0.9%) were 15-19 years of age; 199 (4.4%) were 5-14 years; and 660 (14.7%) were 0-4 years of age. Of the 1,200 cases with available data, there have been 190 hospitalisations for which admission to an ICU was required; the highest proportions have been in adults 45-64 years of age, followed by adults ≥65 years of age (36.3% and 34.2%, respectively). To date, 286 deaths have been reported: 236 adults ≥65 years of age, 33 adults 45-64 years; 11 adults 20-44 years, one child 5-14 years of age, and 5 were children 0-4 years of age. It is important to note that the cause of death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.

                              * Note: The number of new influenza-associated hospitalizations and deaths reported by the Aggregate Surveillance System each week may be overestimated, as it may include retrospective updates to data from Ontario for previous weeks. These data may also include cases reported by the IMPACT and PCIRN networks. Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, NS, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not reported in Ontario.

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                              International Influenza Update


                              WHO : The most recent WHO surveillance report (26 April 2013) summarizes global influenza surveillance data from week 15 (7-13 April 2013). In temperate regions of the northern hemisphere, influenza activity is near inter-seasonal levels, although persistent transmission is reported in many countries due to increasing detections of influenza B. Analysis from 12 European countries in the second week of April revealed levels of pooled all-cause mortality among adults ≥65 years of age higher than observed in the previous three years. Mortality data for younger age groups was similar to previous seasons. In northern Africa and the Middle East, influenza activity has been declining since late February. The timing and pattern of circulating virus types was similar to that seen in Europe, with A(H1N1)pdm09 predominant in most countries. The exception was Egypt where an earlier peak was reported, almost entirely associated with A(H3N2). Influenza activity continued to decrease in temperate regions of Asia since peaking at the end of January, although activity persists in China and the Republic of Korea. Influenza A(H3N2) has been the most commonly detected virus in northern Asia this season although in northern China A(H1N1)pdm09 was predominant in the second half of the season. In tropical regions of Asia, influenza activity was low, with co-circulation of all three types/subtypes.
                              Transmission in India and Sri Lanka appears to have peaked in late March. In southern China, no overall increases in ILI activity have been noted since the appearance of A(H7N9) in Shanghai. In Central America and the Caribbean, a few countries reported low-level circulation of influenza A, but most cases of ILI were associated with other respiratory viruses (predominantly RSV). In Tropical South America Brazil and Ecuador reported increasing influenza A activity in the past several weeks. A few countries in tropical areas of Central Africa reported low-level but persistent influenza circulation with all three virus types. Influenza activity in temperate countries of the southern hemisphere is at inter-seasonal levels. United States : During week 16, influenza activity decreased. Three states reported widespread influenza activity, 3 states reported regional influenza activity, and 8 states reported local activity. The national percentage of outpatient visits for ILI was 1.1%, which is below the national baseline. All 10 regions reported ILI below region-specific baseline levels and all states reported low or minimal ILI activity in week 16. The percentage of deaths due to pneumonia and influenza was at or above the epidemic threshold between weeks 01 and 12, but has been below the epidemic threshold for the past three weeks, and was 6.7% in week 16. The proportion of tests positive for influenza viruses declined to 7.4% in week 16. Of the positive influenza detections, 64.8% were influenza B. Since October 1, 2012, the CDC has antigenically characterized 2,209 influenza viruses. Among influenza A(H3N2) viruses, 1,260 (99.7%) were A/Victoria/361/2011-like, and 4 (0.3%) showed reduced titers to A/Victoria/361/2011 antiserum. Among influenza A(H1N1)pdm09 viruses, 207 (98.6%) were A/California/7/2009-like, and 3 (1.4%) showed reduced titers to A/California/7/2009-like antiserum. Among influenza B viruses, 494 (67.2%) were B/Wisconsin/01/2010-like belonging to the Yamagata lineage of viruses; and 241 (32.8%) to the B/Victoria lineage. Two (0.4%) A(H1N1)pdm09 and two (0.1%) A(H3N2) oseltamivir-resistant viruses have been reported to date this season. Among the 12,250 influenza-associated hospitalizations reported to date this season, 79.4% were associated with influenza A of which 96.1% were A(H3N2), and 50% were among adults ≥65 years. A total of 131 influenza-associated paediatric deaths have been reported to date this season, 61 with influenza A, 68 with influenza B and one with both influenza A and B. Europe: In week 16, influenza activity is below seasonal thresholds in most countries. Most countries reported low intensity of ILI/ARI activity and a stable or decreasing trend. The percentage of sentinel specimens positive for influenza continues to decline to 23% in week 16. The proportion of influenza B detections has increased from 24% in week 03 to 57% in week 16. Among influenza A viruses in week 16, 67% were A(H3N2) and 33% were A(H1N1)pdm09. Since the beginning of the season, 63% of detections from sentinel and non-sentinel sources were influenza A [67% A(H1N1)pdm09 and 33% A(H3N2)] and 37% were influenza B. Among the 623 A(H1N1)pdm09 viruses tested for resistance to oseltamivir from 12 countries, 13 (2%) were found to contain the H275Y mutation: four were specimens from hospitalized and outpatients not exposed(3) or with unknown(1) exposure to oseltamivir, while the other nine viruses were detected in hospitalized and/or immunocompromised patients receiving oseltamivir treatment. The number of hospitalizations for severe acute respiratory illness (SARI) and the number positive for influenza have returned to pre-season levels in most participating countries. Emerging Respiratory Pathogens

                              Human Avian Influenza


                              Influenza A(H7N9): Between April 19 and April 26, the WHO reported an additional 22 cases of avian influenza A(H7N9) in eastern China. The WHO reported the first case in Shandong province on 23 April 2013, and the Taipei Centres for Disease Control, Taiwan, has reported a travel-related case of avian influenza A(H7N9). The individual was working in the Jiangsu province, became ill shortly after arriving in Taiwan, and was subsequently diagnosed with avian influenza A(H7N9). This individual likely acquired the infection in mainland China. The public health risk posed avian influenza A(H7N9) from China to Canada is considered low at this time. Since March 2013, 109 cases, of which 22 were fatalities, of avian influenza A(H7N9) have been reported from six regions and two municipalities. The numbers of cases (and deaths) by jurisdiction is as follows: Anhui 4 (1), Henan 3 (0), Jiangsu 23 (3), Shandong 1 (0), Zhejiang 42 (6), Beijing 1 (0), Shanghai 34 (12) and Taiwan 1 (0). More than 1,800 close contacts of confirmed cases are being closely monitored. Some of the confirmed cases had contact with animals or with an animal environment. Investigations into the source and route of transmission are still in progress, but there has been no evidence of ongoing person-to-person spread. WHO is in contact with national authorities and is following the event closely..../
                              http://www.phac-aspc.gc.ca/fluwatch/.../index-eng.php
                              "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
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                              Comment


                              • #30
                                Re: Canada FluWatch Weekly Reports 2012-2013 Season Week 17

                                FluWatch report: April 21 to April 27, 2013 (Week 17)

                                Posted 2013-05-03For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
                                <A title="Flu Watch (Version PDF, 113 KB - 6 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/12-13/w17_13/pdf/fw2013-17-eng.pdf">FluWatch report: April 21 to April 27, 2013 (Week 17) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 113 <ABBR title=Kilobytes>KB</ABBR> - 8 pages)

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                                Overall Summary
                                • Influenza activity in Canada continued its slow decline in week 17, with the percentage of laboratory tests positive for influenza at 11%. Detections of influenza B decreased to 81.7% of positive specimens in week 17.
                                • The ILI consultation rate decreased slightly, and the number of regions reporting localized activity was the same as the previous week.
                                • The increased circulation of influenza B in recent weeks has been reflected in both adult and paediatric hospitalizations. Overall this season, 20-26% of paediatric hospitalizations have been associated with influenza B compared to 7% of adult hospitalizations.
                                • Detections of rhinovirus and parainfluenza were both stable in week 17, but have been increasing gradually in recent weeks. RSV continued the downward trend observed since week 08.
                                Influenza Activity (geographic spread) and Outbreaks

                                In week 17, no regions reported widespread activity, twelve regions [AB(1), SK(1), MB(1), ON(6), QC(2) and NT(1)] reported localized activity and 24 regions reported sporadic activity. The number of regions reporting widespread or localized activity was the same as the previous week (Figures 1 and 2). Eight new influenza outbreaks were reported: four in long-term-care facilities, two in hospitals, and two in schools (Figure 3).
                                Figure 1. Map of overall Influenza activity level by province and territory,
                                Canada, Week 17





                                Note: Influenza activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.
                                Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
                                Figure 2. Number of influenza surveillance regions<SUP title="sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in"></SUP> reporting widespread or localized influenza activity, Canada, by report week, 2012-2013 (N<SUP>*</SUP>=56)


                                †sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.
                                * Total number of influenza surveillance regions in Canada
                                Text equivalent for figure 2Number of influenza surveillance regions reporting widespread or localized influenza activity, Canada, by report week, 2011-2012 (N=56)
                                Figure 3. Overall Number of Influenza Outbreaks, Canada, by Report Week, 2012-2013


                                Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2011-2012

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                                Influenza and Other Respiratory Virus Detections

                                The overall percentage of positive influenza tests decreased slightly compared to recent weeks, from an average of 11.7% during weeks 11 to 16, to 11.0% in week 17. Detections of influenza B decreased for the second consecutive week, to 81.7% of positive influenza detections in week 17 (Figure 4). Among the influenza viruses detected in week 17 (n=371), 18.3% were positive for influenza A viruses [of which 45.6% were A(H1N1)pdm09, 16.2% were A(H3), and 38.2% were A(unsubtyped)] (Table 1). Cumulative influenza virus detections by type/subtype to date are as follows: 87.2% influenza A [34.5% A(H3), 4.5% A(H1N1)pdm09 and 61.0% A(unsubtyped)] and 12.8% influenza B (Table 1).
                                Detailed information on age and type/subtype has been received for 23,646 cases to date this season (Table 2). The proportion of cases by age group is as follows: 14.1% <5 years; 9.8% between 5-19 years; 15.7% between 20-44 years; 17.0% between 45-64 years of age; 43.4% ≥65 years.

                                The percentage of positive tests for rhinovirus was similar to the previous week at 11.6% in week 17, but has been slowly increasing since week 01. The percentage of positive tests for parainfluenza (5.2%) has also been increasing gradually over the past 10 weeks. The percentage of tests positive for respiratory syncytial virus (RSV) (6.1%) continued its decline from a peak in week 08. The percentage of positive tests for human metapneumovirus (hMPV) (4.7%) decreased for the third week in a row, and the percentage of positive tests for coronavirus (1.6%) has been decreasing slowly since week 04 (Figure 5)<SUP>*</SUP>.
                                * For more details, see the weekly Respiratory Virus Detections in Canada Report.
                                <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly & Cumulative numbers of positive influenza specimens
                                by Provincial Laboratories, Canada, 2012-2013
                                </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces</TH><TH id=ac1 colSpan=6>Weekly
                                (April 21 to April 27, 2013)
                                </TH><TH id=ac9 colSpan=6>Cumulative
                                (August 26, 2012 to April 27, 2013)
                                </TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=5 headers=ac1>Influenza A</TH><TH id=ac8 headers=ac1>Influenza
                                B
                                </TH><TH id=ac10 colSpan=5 headers=ac9>Influenza A</TH><TH id=ac16 headers=ac9>Influenza
                                B
                                </TH></TR><TR class=bg-colour-yellow><TH id=ac3 headers=ac2>A Total</TH><TH id=ac4 headers=ac2>A(H1)</TH><TH id=ac5 headers=ac2>A(H3)</TH><TH id=ac6 headers=ac2>Pand H1N1</TH><TH id=ac7 class=noWrap headers=ac2>A
                                ( <ABBR title=unsubtyped>Un S</ABBR>)Table 1 note*
                                </TH><TH headers="ac1 ac8">Total</TH><TH id=ac11 headers=ac10>A Total</TH><TH id=ac12 headers=ac10>A(H1)</TH><TH id=ac13 headers=ac10>A(H3)</TH><TH id=ac14 headers=ac10>Pand H1N1</TH><TH id=ac15 class=noWrap headers=ac10>A
                                (Un S) Table 1 note*
                                </TH><TH headers=ac16>Total</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13>* Unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available. Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Note: Weekly data is based on week of positive lab detection. Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals. </TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=bg-colour-yellow headers=ar1><ABBR title="British Columbia ">BC</ABBR></TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">8</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">1</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">6</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac7">1</TD><TD class=alignRight headers="ar1 ar2 ac1 ac8">9</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac11">1909</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac13">1448</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac14">220</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac15">241</TD><TD class=alignRight headers="ar1 ar2 ac9 ac16">373</TD></TR><TR><TH id=ar3 class=bg-colour-yellow headers=ar1><ABBR title=Alberta>AB</ABBR></TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">13</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">4</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">9</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac7">0</TD><TD class=alignRight headers="ar1 ar3 ac1 ac8">54</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac11">2340</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac13">1764</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac14">433</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac15">143</TD><TD class=alignRight headers="ar1 ar3 ac9 ac16">706</TD></TR><TR><TH id=ar4 class=bg-colour-yellow headers=ar1><ABBR title=Saskatchewan>SK</ABBR></TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">3</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">1</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac7">2</TD><TD class=alignRight headers="ar1 ar4 ac1 ac8">21</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac11">834</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac13">476</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac14">73</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac15">285</TD><TD class=alignRight headers="ar1 ar4 ac9 ac16">258</TD></TR><TR><TH id=ar5 class=bg-colour-yellow headers=ar1><ABBR title=Manitoba>MB</ABBR></TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">2</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac7">2</TD><TD class=alignRight headers="ar1 ar5 ac1 ac8">12</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac11">657</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac13">78</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac14">10</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac15">569</TD><TD class=alignRight headers="ar1 ar5 ac9 ac16">82</TD></TR><TR><TH id=ar6 class=bg-colour-yellow headers=ar1><ABBR title=Ontario>ON</ABBR></TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">21</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">5</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">12</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac7">4</TD><TD class=alignRight headers="ar1 ar6 ac1 ac8">64</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac11">8241</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac13">3776</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac14">365</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac15">4100</TD><TD class=alignRight headers="ar1 ar6 ac9 ac16">788</TD></TR><TR><TH id=ar7 class=bg-colour-yellow headers=ar1><ABBR title=Quebec>QC</ABBR>

                                </TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">11</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">1</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac7">10</TD><TD class=alignRight headers="ar1 ar7 ac1 ac8">132</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac11">9785</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac13">546</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac14">33</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac15">9206</TD><TD class=alignRight headers="ar1 ar7 ac9 ac16">1659</TD></TR><TR><TH id=ar8 class=bg-colour-yellow headers=ar1><ABBR title="New Brunswick">NB</ABBR>

                                </TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac7">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac8">10</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac11">1853</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac13">771</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac14">65</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac15">1017</TD><TD class=alignRight headers="ar1 ar8 ac9 ac16">47</TD></TR><TR><TH id=ar9 class=bg-colour-yellow headers=ar1><ABBR title="Nova Scotia ">NS</ABBR>

                                </TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">6</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">1</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac7">5</TD><TD class=alignRight headers="ar1 ar9 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac11">388</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac13">165</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac14">8</TD><TD class=alignRight headers="ar1 ar9 ac9 ac10 ac15">215</TD><TD class=alignRight headers="ar1 ar9 ac9 ac16">6</TD></TR><TR><TH id=ar10 class=bg-colour-yellow headers=ar1><ABBR title="Prince Edward Island ">PE</ABBR>

                                </TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">3</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac6">2</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac7">1</TD><TD class=alignRight headers="ar1 ar10 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac11">114</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac13">76</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac14">7</TD><TD class=alignRight headers="ar1 ar10 ac9 ac10 ac15">31</TD><TD class=alignRight headers="ar1 ar10 ac9 ac16">1</TD></TR><TR><TH id=ar11 class=bg-colour-yellow headers=ar1><ABBR title="Newfoundland/Labrador ">NL</ABBR>

                                </TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">1</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac7">1</TD><TD class=alignRight headers="ar1 ar11 ac1 ac8">1</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac11">715</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac13">152</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac14">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac15">563</TD><TD class=alignRight headers="ar1 ar11 ac9 ac16">16</TD></TR><TR><TH id=ar12 class=bg-colour-yellow headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">68</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac5">11</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac6">31</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac7">26</TD><TD class=alignRight headers="ar1 ar12 ac1 ac8">303</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac11">26836</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac13">9252</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac14">1214</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac15">16370</TD><TD class=alignRight headers="ar1 ar12 ac9 ac16">3936</TD></TR></TBODY></TABLE>
                                <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 2. Weekly & Cumulative numbers of positive influenza specimens by age groups
                                reported through case-based laboratory reporting, Canada, 2012-2013 Table 2 note*
                                </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups</TH><TH id=bc1 colSpan=5>Weekly
                                (April 21 to April 27, 2013)
                                </TH><TH id=bc8 colSpan=5>Cumulative
                                (August 26, 2012 to April 27, 2013)
                                </TH></TR><TR class=bg-colour-yellow><TH id=bc2 colSpan=4 headers=bc1>Influenza A</TH><TH id=bc7 headers=bc1>B</TH><TH id=bc9 colSpan=4 headers=bc8>Influenza A</TH><TH id=bc14 headers=bc8>B</TH></TR><TR class=bg-colour-yellow><TH id=bc3 headers=bc2>A Total</TH><TH id=bc4 headers=bc2>Pandemic H1N1</TH><TH id=bc5 headers=bc2>A/H3N2</TH><TH id=bc6 headers=bc2>A unsubtyped</TH><TH headers="bc1 bc7">Total</TH><TH id=bc10 headers=bc9>A Total</TH><TH id=bc11 headers=bc9>Pandemic H1N1</TH><TH id=bc12 headers=bc9>A/H3N2</TH><TH id=bc13 headers=bc9>A unsubtyped</TH><TH headers=bc14>Total</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11>* Please note that this table reflects the number of specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported. Delays in the reporting of data may cause data to change retrospectively. </TD></TR></TFOOT><TBODY><TR><TH id=br2 headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">8</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">1</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">6</TD><TD class=alignRight headers="br1 br2 bc1 bc7">32</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">2668</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">212</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">860</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1596</TD><TD class=alignRight headers="br1 br2 bc8 bc14">667</TD></TR><TR><TH id=br3 headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">0</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">0</TD><TD class=alignRight headers="br1 br3 bc1 bc7">48</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1452</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">66</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">638</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">748</TD><TD class=alignRight headers="br1 br3 bc8 bc14">860</TD></TR><TR><TH id=br4 headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">7</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">6</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">1</TD><TD class=alignRight headers="br1 br4 bc1 bc7">23</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">3163</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">335</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">1217</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">1611</TD><TD class=alignRight headers="br1 br4 bc8 bc14">548</TD></TR><TR><TH id=br5 headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">7</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">4</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">3</TD><TD class=alignRight headers="br1 br5 bc1 bc7">39</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">3454</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">308</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">1231</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">1915</TD><TD class=alignRight headers="br1 br5 bc8 bc14">561</TD></TR><TR><TH id=br6 headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">11</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">4</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">4</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">3</TD><TD class=alignRight headers="br1 br6 bc1 bc7">51</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">9604</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">130</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">3711</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">5763</TD><TD class=alignRight headers="br1 br6 bc8 bc14">669</TD></TR><TR><TH id=br7 headers=br1>Unknown</TH><TD class=alignRight headers="br1 br7 bc1 bc2 bc3">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc6">0</TD><TD class=alignRight headers="br1 br7 bc1 bc7">0</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc10">166</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">20</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">144</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">2</TD><TD class=alignRight headers="br1 br7 bc8 bc14">1</TD></TR><TR><TH id=br8 headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">33</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc4">15</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc5">5</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc6">13</TD><TD class=alignRight headers="br1 br8 bc1 bc7">193</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">20507</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc11">1071</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc12">7801</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc13">11635</TD><TD class=alignRight headers="br1 br8 bc8 bc14">3306</TD></TR></TBODY></TABLE>


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                                Figure 4. Influenza tests reported and percentage of tests positive, Canada,
                                by report week, 2012-2013


                                Text equivalent for figure 4Influenza tests reported and percentage of tests positive, Canada, by report week, 2011-2012
                                Figure 5. Percent positive influenza tests, compared to other respiratory viruses,
                                Canada, by reporting week, 2012-2013


                                Text equivalent for figure 5Percent positive influenza tests, compared to other respiratory viruses, Canada, by reporting week, 2011-2012

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                                Influenza strain characterizations

                                During the 2012-13 season, the National Microbiology Laboratory (NML) has antigenically characterized 1145 influenza viruses. The 565 influenza A(H3N2) viruses were antigenically similar to the vaccine strain A/Victoria/361/2011 and the 189 A(H1N1)pdm09 viruses were antigenically similar to the vaccine strain A/California/07/09. Among the influenza B viruses, 313 were antigenically similar to the vaccine strain B/Wisconsin/01/2010 (Yamagata lineage) and 78 were similar to B/Brisbane/60/2008 (Victoria lineage; component of the 2011-2012 seasonal influenza vaccine) (Figure 6).
                                Figure 6. Influenza strain characterizations, Canada, 2012-2013, N =1145

                                Note: The recommended components for the 2012-2013 Northern Hemisphere influenza vaccine include: an A/Victoria/361/2011 (H3N2)-like virus; an A/California/7/2009 (H1N1)pdm09-like virus; and a B/Wisconsin/1/2010-like virus.
                                Text equivalent for figure 6Influenza strain characterizations, Canada, 2011-2012

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                                Antiviral resistance

                                During the 2012-13 season, NML has tested 1081 influenza viruses for resistance to oseltamivir, and 1078 influenza viruses for resistance to zanamivir. Among these, one A(H3N2) virus was resistant to oseltamivir and zanamivir. A total of 1172 influenza A viruses were tested for amantadine resistance and all but one were resistant (Table 3).


                                <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2012-2013</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=cr1 rowSpan=2>Virus type and subtype</TH><TH id=cc1 colSpan=2>Oseltamivir</TH><TH id=cc4 colSpan=2>Zanamivir</TH><TH id=cc7 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=cc2 headers=cc1># tested</TH><TH id=cc3 headers=cc1># resistant (%)</TH><TH id=cc5 headers=cc4># tested</TH><TH id=cc6 headers=cc4># resistant (%)</TH><TH id=cc8 headers=cc7># tested</TH><TH id=cc9 headers=cc7># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=cr2 class="alignLeft bg-colour-blue" headers=cr1>A (H3N2)</TH><TD class=alignRight headers="cr2 cc2">559</TD><TD class=alignRight headers="cr2 cc3">1 (0.2%)</TD><TD class=alignRight headers="cr2 cc5">559</TD><TD class=alignRight headers="cr2 cc6">1 (0.2%)</TD><TD class=alignRight headers="cr2 cc8">952</TD><TD class=alignRight headers="cr2 cc9">951 (99.9%)</TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignRight headers="cr3 cc2">186</TD><TD class=alignRight headers="cr3 cc3">0</TD><TD class=alignRight headers="cr3 cc5">183</TD><TD class=alignRight headers="cr3 cc6">0</TD><TD class=alignRight headers="cr3 cc8">220</TD><TD class=alignRight headers="cr3 cc9">220 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignRight headers="cr4 cc2">336</TD><TD class=alignRight headers="cr4 cc3">0</TD><TD class=alignRight headers="cr4 cc5">336</TD><TD class=alignRight headers="cr4 cc6">0</TD><TD class=alignRight headers="cr4 cc8">NA <SUP>*</SUP></TD><TD class=alignRight headers="cr4 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft bg-colour-blue" headers=cr1>TOTAL</TH><TD class=alignRight headers="cr5 cc2">1081</TD><TD class=alignRight headers="cr5 cc3">0</TD><TD class=alignRight headers="cr5 cc5">1078</TD><TD class=alignRight headers="cr5 cc6">1 (0.1%)</TD><TD class=alignRight headers="cr5 cc8">1172</TD><TD class=alignRight headers="cr5 cc9">1171 (99.9%)</TD></TR></TBODY></TABLE>
                                Influenza-like Illness (ILI) Consultation Rate

                                The national influenza-like-illness (ILI) consultation rate decreased slightly from 16.1 ILI consultations per 1,000 patient visits in week 16 to 15.2 / 1,000 in week 17; and remains within the expected range (Figure 7). In week 17, the highest consultation rate was observed in children under 5 years of age (33.2/1,000).
                                Figure 7. Influenza-like illness (ILI) consultation rates, Canada, by report week, 2012-2013 compared to 1996/97 through to 2011/12 seasons (with pandemic data suppressed)



                                Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons). Delays in the reporting of data may cause data to change retrospectively.
                                Text equivalent for figure 7Influenza-like illness (ILI) consultation rates, Canada, by report week, 2011-2012 compared to 1996/97 through to 2010/11 seasons (with pandemic data suppressed)

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                                Severe Respiratory Illness Surveillance

                                Paediatric Influenza Hospitalizations and Deaths (IMPACT)

                                In week 17, 15 laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 22 in week 16. Twelve of the cases reported in week 17 were identified with influenza B. The age distribution is as follows: 3 (20.0%) between 0-5 months, 2 (13.3%) between 6-23 months, 5 (33.3%) 2-4 years of age, 3 (20.0%) 5-9 years of age and 2 (13.3%) 10-16 years of age. Two cases were admitted to an intensive care unit (ICU) during week 17, one child 6-23 months of age with A(H1N1)pdm09, and one 10-16 years of age with influenza B. No deaths were reported in week 17.

                                Since the start of the 2012-13 season, a total of 839 influenza-associated paediatric hospitalizations have been reported by the IMPACT network: 621 (74.0%) with influenza A [of which 121 (19.5%) were A(H3N2), 23 (3.7%) were A(H1N1)pdm09 and the remaining 477 were A(unsubtyped); and 218 (26.0%) with influenza B. The distribution of cases by age group is as follows: 154 (18.4%) <6 months of age; 198 (23.6%) age 6-23 months; 240 (28.6%) age 2-4 years; 175 (20.9%) age 5-9 years; and 72 (8.6%) age 10-16 years. Eighty-nine (10.6%) of the 839 cases were admitted to the ICU. Of the 65 ICU admissions with available data, 57 (87.7%) cases had at least one co-morbidity. One death has been reported to date this season in a child 6-23 months of age with an underlying condition, infected with influenza B.

                                Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associate paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.

                                Adult Influenza Hospitalizations and Deaths (PCIRN)

                                In week 17, four laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 11 in week 16. Three of the four hospitalizations were cases of influenza B, and one was A(H1N1)pdm09. Two cases were ≥65 years of age, and two were 45-64 years of age. No ICU admissions or deaths were reported in week 17.

                                From November 4, 2012 to April 27, 2013, 1,771 influenza-associated adult hospitalizations were reported by the PCIRN-SOS network: 1,620 (91.5%) with influenza A [of which 310 were A(H3N2), 19 were A(H1N1)pdm09, and 1,291 were A(unsubtyped)]; 105 (5.9%) with influenza B, and the type has not been reported for 46 cases. The age distribution of hospitalizations is as follows: 1,209 (68.3%) were ≥65 years of age, 362 (20.4%) were 45-64 years, 192 (10.8%) were 20-44 years, and 8 (0.5%) were <20 years of age. ICU admission was required for 212 hospitalizations; the majority of which were adults ≥65 years of age (123; 58.0%). Of the ICU admissions, 90 (42.5%) had at least one co-morbidity, five (2.4%) had no co-morbidities, and 117 had no information to date. A total of 115 deaths have been reported: 26 with influenza A(H3N2), one with A(H1N1)pdm09, 82 with A(unsubtyped), five with influenza B, and one untyped. More than 85% of the deaths (98/115) were in adults ≥65 years of age, 14 (12.2%) were adults 45-64 years of age, and 3 (2.6%) were 20-44 years of age. Fifty-two (45.2%) deaths occurred in individuals who had at least one co-morbidity. Detailed clinical information on co-morbidities is not known for the remaining cases.

                                Note: The number of hospitalizations reported through PCIRN represents a subset of all influenza-associate adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.

                                Provincial/Territorial Influenza Hospitalizations and Deaths (Aggregate Surveillance System<SUP>*</SUP>)

                                In week 17, 129 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories<SUP>*</SUP>. The majority of cases were influenza A (63.6%). The highest proportion of hospitalisations were in adults ≥65 years of age (37.2%), followed by children 0-4 years of age (26.4%). Of the 30 cases with available data, four cases were admitted to the ICU, all with influenza A: two 45-64 years of age, one 20-44 years of age and one 0-4 years of age. Nine deaths were reported in week 17: five adults ≥65 years of age with influenza A; two adults ≥65 years of age and two 45-64 years of age with influenza B.

                                To date this season, 4,639 influenza-associated hospitalizations have been reported, of which 89.8% have been influenza A. Of those subtyped (47.4%), influenza A(H3) was the predominant influenza strain. The cumulative proportion of hospitalizations with influenza B continues to increase (10.2% in week 17). Age information was available for 4,636 cases, and the age distribution is as follows: 2,484 (53.6%) were ≥65 years of age; 774 (16.7%) were 45-64 years of age; 420 (9.1%) were 20-44 years of age; 40 (0.9%) were 15-19 years of age; 218 (4.7%) were 5-14 years; and 700 (15.1%) were 0-4 years of age. Of the 1,251 cases with available data, there have been 196 hospitalisations for which admission to an ICU was required; the highest proportions have been in adults 45-64 years of age, followed by adults ≥65 years of age (36.2% and 33.7%, respectively). To date, 295 deaths have been reported: 243 adults ≥65 years of age, 35 adults 45-64 years; 11 adults 20-44 years, one child 5-14 years of age, and 5 were children 0-4 years of age. It is important to note that the cause of death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.

                                * Note: The number of new influenza-associated hospitalizations and deaths reported by the Aggregate Surveillance System each week may be overestimated, as it may include retrospective updates to data from Ontario for previous weeks. These data may also include cases reported by the IMPACT and PCIRN networks. Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, NS, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not reported in Ontario.

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                                International Influenza Update


                                WHO : No new influenza surveillance update was available from the WHO since the report dated 26 April 2013.United States : No new influenza surveillance update was available from the CDC since the report for week 16. Europe: In week 17, most countries reported low intensity of ILI/ARI activity and a decreasing trend. In the 4 countries reporting results of 20 or more sentinel specimens, a median of 11% were positive for influenza in week 17. The proportion of influenza B detections has increased from 24% in week 03 to 62% in week 17. Among influenza A viruses in week 17, 71% were A(H3N2) and 29% were A(H1N1)pdm09. Since the beginning of the season, 63% of detections from sentinel and non-sentinel sources were influenza A [67% A(H1N1)pdm09 and 33% A(H3N2)] and 37% were influenza B. Among the 695 A(H1N1)pdm09 viruses tested for resistance to oseltamivir from 12 countries, 13 (2%) were found to contain the H275Y mutation. The number of hospitalizations for severe acute respiratory illness (SARI) and the number positive for influenza have returned to pre-season levels in most participating countries. Analysis from 12 countries revealed a broad peak of excess all-cause mortality among adults ≥65 years of age. Excess mortality was observed starting in week 01 to a peak in week 10; it has been declining since but is not yet at normal levels. In countries reporting detections of RSV, the proportion of positive tests has been declining since a peak in week 52.Emerging Respiratory Pathogens


                                Influenza A(H7N9): Between April 27 and May 2, the WHO reported an additional 16 cases of avian influenza A(H7N9) in eastern China. Avian influenza A(H7N9) has been reported in three new provinces: Fujian, Jiangxi and Hunan. The public health risk posed by avian influenza A(H7N9) from China to Canada remains low at this time. Since March 2013, 128 cases and 26 deaths of avian influenza A(H7N9) have been reported from eight provinces and two municipalities. The number of cases (and deaths) by jurisdiction is as follows: Anhui 4 (1), Fujian 3 (0), Henan 4 (0), Hunan 3 (0), Jiangsu 26 (5), Jiangxi 4 (0), Shandong 2 (0), Zhejiang 46 (6), Beijing 1 (0), Shanghai 34 (12) and Taiwan 1(0). The location of the two most recently reported deaths have not yet been identified. More than 1,800 close contacts of confirmed cases are being closely monitored. Some of the confirmed cases had contact with animals or with an animal environment. Investigations into the source and route of transmission are still in progress, but there has been no evidence of ongoing human-to-human transmission. The WHO is in contact with national authorities and is following the event closely.Human Swine Influenza

                                No new human cases of infection with swine influenza viruses or variants were reported in week 16.Novel Coronavirus (HCoV-EMC/2012)

                                Since 26 March 2013, seven new cases of novel coronavirus (HCoV-EMC/2012) from Saudi Arabia have been reported by the WHO. Five of the cases resulted in death, and two are currently in critical condition. Details have not yet been made available, however preliminary investigation show no indication of recent travel or animal contact of any of the confirmed cases. The confirmed cases are not from the same family. Since April 2012, 24 cases of laboratory-confirmed HCoV-EMC/2012 have been identified, including 16 deaths..../
                                http://www.phac-aspc.gc.ca/fluwatch/.../index-eng.php
                                "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                                -Nelson Mandela

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