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

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  • #31
    Re: Canada FluWatch Weekly Reports 2012-2013 Season Week 18

    FluWatch report: April 28 to May 4, 2013 (Week 18)

    Posted 2013-05-10For 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/w18_13/pdf/fw2013-18-eng.pdf">FluWatch report: April 28 to May 4, 2013 (Week 18) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 113 <ABBR title=Kilobytes>KB</ABBR> - 8 pages)

    »» Help with PDF documents


    Overall Summary
    • Influenza activity in Canada continued its slow decline in week 18, with the percentage of laboratory tests positive for influenza at 10%. Influenza B was the predominant strain, but detections continued to decrease.
    • Detections of rhinovirus continued to increase, while detections of other respiratory viruses were stable or decreasing in week 18.
    • The ILI consultation rate increased slightly and was above the expected range. However, fewer regions reported localized activity compared to the previous week.
    Influenza Activity (geographic spread) and Outbreaks

    In week 18, seven regions [AB(1), ON(4), QC(1) and NB(1)] reported localized activity and 25 regions reported sporadic activity. The number of regions reporting widespread or localized activity decreased compared to the previous week (Figures 1 and 2). Six new influenza outbreaks were reported: five 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 18





    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 overall percentage of positive influenza tests decreased slightly compared to recent weeks, from 11.2 in week 17 to 10.0% in week 18. Detections of influenza B decreased for the second consecutive week, and represented 86.4% of total positive influenza detections in week 18 (Figure 4). Among the influenza viruses detected in week 18 (n=301), 13.6% were positive for influenza A viruses [of which 48.8% were A(H1N1)pdm09, 9.8% were A(H3), and 41.5% were A(unsubtyped)] (Table 1). Cumulative influenza virus detections by type/subtype to date are as follows: 86.5% influenza A [34.5% A(H3), 4.6% A(H1N1)pdm09 and 61.0% A(unsubtyped)] and 13.5% influenza B (Table 1).
    Detailed information on age and type/subtype has been received for 23,888 cases to date this season (Table 2). The proportion of cases by age group is as follows: 14.1% <5 years; 9.9% between 5-19 years; 15.7% between 20-44 years; 17.0% between 45-64 years of age; 43.2% ≥65 years.
    The percentage of positive tests for rhinovirus increased from 12.5% in week 17 to 14.1% in week 18, and has been slowly increasing since week 01. The percentage of positive tests for parainfluenza (5.4%) was stable since week 16, but has been increasing gradually over the past 10 weeks. The percentage of tests positive for respiratory syncytial virus (RSV) (4.5%) continued its decline from a peak in week 08. The percentage of positive tests for human metapneumovirus (hMPV) (5.0%) has been stable since week 16, and the percentage of positive tests for coronavirus (0.8%) 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 28 to May 4, 2013)
    </TH><TH id=ac9 colSpan=6>Cumulative
    (August 26, 2012 to May 4, 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">3</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">2</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac7">0</TD><TD class=alignRight headers="ar1 ar2 ac1 ac8">11</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac11">1907</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac13">1450</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac14">218</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac15">239</TD><TD class=alignRight headers="ar1 ar2 ac9 ac16">397</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">2</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">4</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac7">1</TD><TD class=alignRight headers="ar1 ar3 ac1 ac8">40</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac11">2347</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac13">1766</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac14">437</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac15">144</TD><TD class=alignRight headers="ar1 ar3 ac9 ac16">748</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">2</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">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac7">2</TD><TD class=alignRight headers="ar1 ar4 ac1 ac8">27</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac11">836</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">287</TD><TD class=alignRight headers="ar1 ar4 ac9 ac16">285</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">0</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">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac8">2</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">84</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">7</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">1</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">4</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac7">2</TD><TD class=alignRight headers="ar1 ar6 ac1 ac8">57</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac11">8248</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac13">3778</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac14">369</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac15">4101</TD><TD class=alignRight headers="ar1 ar6 ac9 ac16">843</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">12</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">2</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac7">10</TD><TD class=alignRight headers="ar1 ar7 ac1 ac8">109</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac11">9797</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">35</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac15">9216</TD><TD class=alignRight headers="ar1 ar7 ac9 ac16">1768</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">6</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">6</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac7">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac8">13</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac11">1859</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">71</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac15">1017</TD><TD class=alignRight headers="ar1 ar8 ac9 ac16">60</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">0</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">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac8">1</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">7</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">116</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">9</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">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">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac11">717</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">565</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">41</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">20</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac7">17</TD><TD class=alignRight headers="ar1 ar12 ac1 ac8">260</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac11">26872</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac13">9258</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac14">1230</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac15">16384</TD><TD class=alignRight headers="ar1 ar12 ac9 ac16">4209</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 28 to May 4, 2013)
    </TH><TH id=bc8 colSpan=5>Cumulative
    (August 26, 2012 to May 4, 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>5</TD><TD class=alignRight>2</TD><TD class=alignRight>0</TD><TD class=alignRight>3</TD><TD class=alignRight>32</TD><TD class=alignRight>2674</TD><TD class=alignRight>214</TD><TD class=alignRight>861</TD><TD class=alignRight>1599</TD><TD class=alignRight>706</TD></TR><TR><TH id=br3 headers=br1>5-19</TH><TD class=alignRight>0</TD><TD class=alignRight>0</TD><TD class=alignRight>0</TD><TD class=alignRight>0</TD><TD class=alignRight>34</TD><TD class=alignRight>1455</TD><TD class=alignRight>66</TD><TD class=alignRight>639</TD><TD class=alignRight>750</TD><TD class=alignRight>908</TD></TR><TR><TH id=br4 headers=br1>20-44</TH><TD class=alignRight>4</TD><TD class=alignRight>1</TD><TD class=alignRight>0</TD><TD class=alignRight>3</TD><TD class=alignRight>23</TD><TD class=alignRight>3170</TD><TD class=alignRight>339</TD><TD class=alignRight>1217</TD><TD class=alignRight>1614</TD><TD class=alignRight>586</TD></TR><TR><TH id=br5 headers=br1>45-64</TH><TD class=alignRight>4</TD><TD class=alignRight>2</TD><TD class=alignRight>0</TD><TD class=alignRight>2</TD><TD class=alignRight>27</TD><TD class=alignRight>3463</TD><TD class=alignRight>312</TD><TD class=alignRight>1233</TD><TD class=alignRight>1918</TD><TD class=alignRight>597</TD></TR><TR><TH id=br6 headers=br1>65+</TH><TD class=alignRight>2</TD><TD class=alignRight>0</TD><TD class=alignRight>0</TD><TD class=alignRight>2</TD><TD class=alignRight>45</TD><TD class=alignRight>9611</TD><TD class=alignRight>132</TD><TD class=alignRight>3713</TD><TD class=alignRight>5766</TD><TD class=alignRight>718</TD></TR><TR><TH id=br7 headers=br1>Unknown</TH><TD class=alignRight>0</TD><TD class=alignRight>0</TD><TD class=alignRight>0</TD><TD class=alignRight>0</TD><TD class=alignRight>0</TD><TD class=alignRight>166</TD><TD class=alignRight>20</TD><TD class=alignRight>144</TD><TD class=alignRight>2</TD><TD class=alignRight>1</TD></TR><TR><TH id=br8 headers=br1>Total</TH><TD class=alignRight>15</TD><TD class=alignRight>5</TD><TD class=alignRight>0</TD><TD class=alignRight>10</TD><TD class=alignRight>161</TD><TD class=alignRight>20539</TD><TD class=alignRight>1083</TD><TD class=alignRight>7807</TD><TD class=alignRight>11649</TD><TD class=alignRight>3516</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 1221 influenza viruses. The 600 influenza A(H3N2) viruses were antigenically similar to the vaccine strain A/Victoria/361/2011 and the 193 A(H1N1)pdm09 viruses were antigenically similar to the vaccine strain A/California/07/09. Among the influenza B viruses, 338 were antigenically similar to the vaccine strain B/Wisconsin/01/2010 (Yamagata lineage) and 90 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 =1221

    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 1149 influenza viruses for resistance to oseltamivir, and 1145 influenza viruses for resistance to zanamivir. Among these, one A(H3N2) virus was resistant to oseltamivir and zanamivir. A total of 1180 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">572</TD><TD class=alignRight headers="cr2 cc3">1 (0.2%)</TD><TD class=alignRight headers="cr2 cc5">573</TD><TD class=alignRight headers="cr2 cc6">1 (0.2%)</TD><TD class=alignRight headers="cr2 cc8">955</TD><TD class=alignRight headers="cr2 cc9">954 (99.9%)</TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignRight headers="cr3 cc2">194</TD><TD class=alignRight headers="cr3 cc3">0</TD><TD class=alignRight headers="cr3 cc5">190</TD><TD class=alignRight headers="cr3 cc6">0</TD><TD class=alignRight headers="cr3 cc8">225</TD><TD class=alignRight headers="cr3 cc9">225 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignRight headers="cr4 cc2">383</TD><TD class=alignRight headers="cr4 cc3">0</TD><TD class=alignRight headers="cr4 cc5">382</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">1149</TD><TD class=alignRight headers="cr5 cc3">1 (0.1%)</TD><TD class=alignRight headers="cr5 cc5">1145</TD><TD class=alignRight headers="cr5 cc6">1 (0.1%)</TD><TD class=alignRight headers="cr5 cc8">1180</TD><TD class=alignRight headers="cr5 cc9">1179 (99.9%)</TD></TR></TBODY></TABLE>
    Influenza-like Illness (ILI) Consultation Rate

    The national influenza-like-illness (ILI) consultation rate increased from 14.5 ILI consultations per 1,000 patient visits in week 17 to 17.6 / 1,000 in week 18, and is above the expected range (Figure 7). In week 18, the highest consultation rate was observed in children under 5 years of age (63.2/1,000).
    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 18, 16 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 17. All of the cases reported in week 18 were identified with influenza B. The age distribution is as follows: 3 (18.8%) between 0-5 months, 2 (12.5%) between 6-23 months, 4 (25.0%) 2-4 years of age, and 7 (43.8%) 5-9 years of age. Two cases were admitted to an intensive care unit (ICU) during week 18, one child 2-4 years of age and one 5-9 years of age; both with influenza B. No deaths were reported in week 18.
    Since the start of the 2012-13 season, a total of 855 influenza-associated paediatric hospitalizations have been reported by the IMPACT network: 621 (72.6%) with influenza A [of which 120 (19.3%) were A(H3N2), 25 (4.0%) were A(H1N1)pdm09 and the remaining 476 were A(unsubtyped); and 234 (27.4%) with influenza B. The distribution of cases by age group is as follows: 157 (18.4%) <6 months of age; 199 (23.3%) age 6-23 months; 244 (28.5%) age 2-4 years; 183 (21.4%) age 5-9 years; and 72 (8.4%) age 10-16 years. Ninety-two (10.8%) of the 855 cases were admitted to the ICU. Of the 70 ICU admissions with available data, 60 (85.7%) 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, 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)

    PCIRN-SOS surveillance has concluded for the 2012-13 influenza season. In week 18, eight 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. All eight hospitalizations were cases of influenza B; three cases were ≥65 years of age, two were 45-64 years, two were 20-44 years and one was <20 years of age. Two ICU admissions were reported, both cases with influenza B; one ≥65 years of age and one 45-64 years of age. No deaths were reported in week 18. Only nine of the 17 PCIRN centres reported data in week 18. A summary of final data will be included in the 2012-13 FluWatch annual report.

    From November 4, 2012 to May 4, 2013, 1,779 influenza-associated adult hospitalizations were reported by the PCIRN-SOS network: 1,620 (91.1%) with influenza A [of which 310 were A(H3N2), 19 were A(H1N1)pdm09, and 1,291 were A(unsubtyped)]; 113 (6.4%) with influenza B, and the type has not been reported for 46 cases. The age distribution of hospitalizations is as follows: 1,212 (68.1%) were ≥65 years of age, 364 (20.5%) were 45-64 years, 194 (10.9%) were 20-44 years, and 9 (0.5%) were <20 years of age. ICU admission was required for 214 hospitalizations; the majority of which were adults ≥65 years of age (124; 57.9%). Of the ICU admissions, 90 (42.1%) had at least one co-morbidity, five (2.3%) had no co-morbidities, and 119 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 18, 69 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories<SUP>*</SUP>. The majority of cases were influenza A (56.5%). The highest proportion of hospitalisations were in adults ≥65 years of age (40.6%), followed by children 0-4 years of age (21.7%). Of the 17 cases with available data, six cases were admitted to the ICU, three with influenza A(H1N1)pdm09 and three with influenza B; four were ≥65 years of age, one was 45-64 years of age, and one was 5-14 years of age. Two deaths were reported in week 18, both adults ≥65 years of age with influenza A.

    To date this season, 4,733 influenza-associated hospitalizations have been reported, of which 89.1% have been influenza A. Of those subtyped (48.8%), influenza A(H3) was the predominant influenza strain. The cumulative proportion of hospitalizations with influenza B continues to increase (10.9% in week 18). Age information was available for 4,730 cases, and the age distribution is as follows: 2,518 (53.2%) were ≥65 years of age; 789 (16.7%) were 45-64 years of age; 429 (9.1%) were 20-44 years of age; 40 (0.8%) were 15-19 years of age; 228 (4.8%) were 5-14 years; and 726 (15.3%) were 0-4 years of age. Of the 1,293 cases with available data, there have been 204 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 (35.8% and 34.3%, respectively). To date, 297 deaths have been reported: 245 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.


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


    • #32
      Re: Canada FluWatch Weekly Reports 2012-2013 Season Week 18

      FluWatch report: May 5 to May 11, 2013 (Week 19)

      Posted 2013-05-17For 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/w19_13/pdf/fw2013-19-eng.pdf">FluWatch report: May 5 to May 11, 2013 (Week 19) (<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 19, with the percentage of laboratory tests positive for influenza at 8.6%. Influenza B was the predominant strain, but detections continued to decrease.
      • Detections of rhinovirus and parainfluenza continued to increase slowly, while detections of most other respiratory viruses decreased in week 19.
      • The ILI consultation rate decreased slightly, but was above the expected range. Fewer regions reported localized activity compared to the previous week.
      Influenza Activity (geographic spread) and Outbreaks

      In week 19, five regions in Ontario reported localized activity and 28 regions reported sporadic activity. The number of regions reporting widespread or localized activity decreased compared to the previous week (Figures 1 and 2). Three new influenza outbreaks were reported: one in a long-term-care facility and two in other facilities or communities (Figure 3).
      Figure 1. Map of overall Influenza activity level by province and territory,
      Canada, Week 19





      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 overall percentage of positive influenza tests decreased slightly compared to recent weeks, from 9.8% in week 18 to 8.6% in week 19. Detections of influenza B decreased for the third consecutive week, and represented 86.5% of total positive influenza detections in week 19 (Figure 4). Among the influenza viruses detected in week 19 (n=229), 13.5% were positive for influenza A viruses [of which 41.9% were A(H1N1)pdm09, 19.4% were A(H3), and 38.7% were A(unsubtyped)] (Table 1). Cumulative influenza virus detections by type/subtype to date are as follows: 85.9% influenza A [34.4% A(H3), 4.6% A(H1N1)pdm09 and 60.9% A(unsubtyped)] and 14.1% influenza B (Table 1).
      Detailed information on age and type/subtype has been received for 26,985 cases to date this season (Table 2). The proportion of cases by age group is as follows: 14.9% <5 years; 10.5% between 5-19 years; 16.4% between 20-44 years; 17.5% between 45-64 years of age; 40.7% ≥65 years.

      The percentage of positive tests for rhinovirus decreased slightly from 16.5% in week 18 to 15.8% in week 19, but has been slowly increasing since week 01. The percentage of positive tests for parainfluenza (7.4%) increased, continuing its gradual increase over the past 11 weeks. The percentage of tests positive for respiratory syncytial virus (RSV) (3.1%) continued its decline from a peak in week 08. The percentage of positive tests for human metapneumovirus (hMPV) (4.2%) has been decreasing slowly since week 14. The percentage of positive tests for coronavirus (2.3%) increased in week 19 after a slow decline from week 04 to 18 (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
      (May 5 to May 11, 2013)
      </TH><TH id=ac9 colSpan=6>Cumulative
      (August 26, 2012 to May 11, 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 headers="ar1 ar2 ac1 ac2 ac3">4</TD><TD headers="ar1 ar2 ac1 ac2 ac4">0</TD><TD headers="ar1 ar2 ac1 ac2 ac5">1</TD><TD headers="ar1 ar2 ac1 ac2 ac6">1</TD><TD headers="ar1 ar2 ac1 ac2 ac7">2</TD><TD headers="ar1 ar2 ac1 ac8">11</TD><TD headers="ar1 ar2 ac9 ac10 ac11">1910</TD><TD headers="ar1 ar2 ac9 ac10 ac12">0</TD><TD headers="ar1 ar2 ac9 ac10 ac13">1450</TD><TD headers="ar1 ar2 ac9 ac10 ac14">219</TD><TD headers="ar1 ar2 ac9 ac10 ac15">241</TD><TD headers="ar1 ar2 ac9 ac16">405</TD></TR><TR><TH id=ar3 class=bg-colour-yellow headers=ar1><ABBR title=Alberta>AB</ABBR></TH><TD headers="ar1 ar3 ac1 ac2 ac3">7</TD><TD headers="ar1 ar3 ac1 ac2 ac4">0</TD><TD headers="ar1 ar3 ac1 ac2 ac5">2</TD><TD headers="ar1 ar3 ac1 ac2 ac6">4</TD><TD headers="ar1 ar3 ac1 ac2 ac7">1</TD><TD headers="ar1 ar3 ac1 ac8">36</TD><TD headers="ar1 ar3 ac9 ac10 ac11">2354</TD><TD headers="ar1 ar3 ac9 ac10 ac12">0</TD><TD headers="ar1 ar3 ac9 ac10 ac13">1769</TD><TD headers="ar1 ar3 ac9 ac10 ac14">441</TD><TD headers="ar1 ar3 ac9 ac10 ac15">144</TD><TD headers="ar1 ar3 ac9 ac16">786</TD></TR><TR><TH id=ar4 class=bg-colour-yellow headers=ar1><ABBR title=Saskatchewan>SK</ABBR></TH><TD headers="ar1 ar4 ac1 ac2 ac3">0</TD><TD headers="ar1 ar4 ac1 ac2 ac4">0</TD><TD headers="ar1 ar4 ac1 ac2 ac5">0</TD><TD headers="ar1 ar4 ac1 ac2 ac6">0</TD><TD headers="ar1 ar4 ac1 ac2 ac7">0</TD><TD headers="ar1 ar4 ac1 ac8">13</TD><TD headers="ar1 ar4 ac9 ac10 ac11">836</TD><TD headers="ar1 ar4 ac9 ac10 ac12">0</TD><TD headers="ar1 ar4 ac9 ac10 ac13">476</TD><TD headers="ar1 ar4 ac9 ac10 ac14">73</TD><TD headers="ar1 ar4 ac9 ac10 ac15">287</TD><TD headers="ar1 ar4 ac9 ac16">298</TD></TR><TR><TH id=ar5 class=bg-colour-yellow headers=ar1><ABBR title=Manitoba>MB</ABBR></TH><TD headers="ar1 ar5 ac1 ac2 ac3">1</TD><TD headers="ar1 ar5 ac1 ac2 ac4">0</TD><TD headers="ar1 ar5 ac1 ac2 ac5">1</TD><TD headers="ar1 ar5 ac1 ac2 ac6">0</TD><TD headers="ar1 ar5 ac1 ac2 ac7">0</TD><TD headers="ar1 ar5 ac1 ac8">16</TD><TD headers="ar1 ar5 ac9 ac10 ac11">658</TD><TD headers="ar1 ar5 ac9 ac10 ac12">0</TD><TD headers="ar1 ar5 ac9 ac10 ac13">79</TD><TD headers="ar1 ar5 ac9 ac10 ac14">10</TD><TD headers="ar1 ar5 ac9 ac10 ac15">569</TD><TD headers="ar1 ar5 ac9 ac16">100</TD></TR><TR><TH id=ar6 class=bg-colour-yellow headers=ar1><ABBR title=Ontario>ON</ABBR></TH><TD headers="ar1 ar6 ac1 ac2 ac3">9</TD><TD headers="ar1 ar6 ac1 ac2 ac4">0</TD><TD headers="ar1 ar6 ac1 ac2 ac5">2</TD><TD headers="ar1 ar6 ac1 ac2 ac6">5</TD><TD headers="ar1 ar6 ac1 ac2 ac7">2</TD><TD headers="ar1 ar6 ac1 ac8">34</TD><TD headers="ar1 ar6 ac9 ac10 ac11">8257</TD><TD headers="ar1 ar6 ac9 ac10 ac12">0</TD><TD headers="ar1 ar6 ac9 ac10 ac13">3780</TD><TD headers="ar1 ar6 ac9 ac10 ac14">374</TD><TD headers="ar1 ar6 ac9 ac10 ac15">4103</TD><TD headers="ar1 ar6 ac9 ac16">881</TD></TR><TR><TH id=ar7 class=bg-colour-yellow headers=ar1><ABBR title=Quebec>QC</ABBR>

      </TH><TD headers="ar1 ar7 ac1 ac2 ac3">5</TD><TD headers="ar1 ar7 ac1 ac2 ac4">0</TD><TD headers="ar1 ar7 ac1 ac2 ac5">0</TD><TD headers="ar1 ar7 ac1 ac2 ac6">1</TD><TD headers="ar1 ar7 ac1 ac2 ac7">4</TD><TD headers="ar1 ar7 ac1 ac8">77</TD><TD headers="ar1 ar7 ac9 ac10 ac11">9802</TD><TD headers="ar1 ar7 ac9 ac10 ac12">0</TD><TD headers="ar1 ar7 ac9 ac10 ac13">546</TD><TD headers="ar1 ar7 ac9 ac10 ac14">36</TD><TD headers="ar1 ar7 ac9 ac10 ac15">9220</TD><TD headers="ar1 ar7 ac9 ac16">1846</TD></TR><TR><TH id=ar8 class=bg-colour-yellow headers=ar1><ABBR title="New Brunswick">NB</ABBR>

      </TH><TD headers="ar1 ar8 ac1 ac2 ac3">4</TD><TD headers="ar1 ar8 ac1 ac2 ac4">0</TD><TD headers="ar1 ar8 ac1 ac2 ac5">0</TD><TD headers="ar1 ar8 ac1 ac2 ac6">2</TD><TD headers="ar1 ar8 ac1 ac2 ac7">2</TD><TD headers="ar1 ar8 ac1 ac8">11</TD><TD headers="ar1 ar8 ac9 ac10 ac11">1863</TD><TD headers="ar1 ar8 ac9 ac10 ac12">0</TD><TD headers="ar1 ar8 ac9 ac10 ac13">771</TD><TD headers="ar1 ar8 ac9 ac10 ac14">73</TD><TD headers="ar1 ar8 ac9 ac10 ac15">1019</TD><TD headers="ar1 ar8 ac9 ac16">71</TD></TR><TR><TH id=ar9 class=bg-colour-yellow headers=ar1><ABBR title="Nova Scotia ">NS</ABBR>

      </TH><TD headers="ar1 ar9 ac1 ac2 ac3">0</TD><TD headers="ar1 ar9 ac1 ac2 ac4">0</TD><TD headers="ar1 ar9 ac1 ac2 ac5">0</TD><TD headers="ar1 ar9 ac1 ac2 ac6">0</TD><TD headers="ar1 ar9 ac1 ac2 ac7">0</TD><TD headers="ar1 ar9 ac1 ac8">0</TD><TD headers="ar1 ar9 ac9 ac10 ac11">388</TD><TD headers="ar1 ar9 ac9 ac10 ac12">0</TD><TD headers="ar1 ar9 ac9 ac10 ac13">165</TD><TD headers="ar1 ar9 ac9 ac10 ac14">8</TD><TD headers="ar1 ar9 ac9 ac10 ac15">215</TD><TD headers="ar1 ar9 ac9 ac16">7</TD></TR><TR><TH id=ar10 class=bg-colour-yellow headers=ar1><ABBR title="Prince Edward Island ">PE</ABBR>

      </TH><TD headers="ar1 ar10 ac1 ac2 ac3">0</TD><TD headers="ar1 ar10 ac1 ac2 ac4">0</TD><TD headers="ar1 ar10 ac1 ac2 ac5">0</TD><TD headers="ar1 ar10 ac1 ac2 ac6">0</TD><TD headers="ar1 ar10 ac1 ac2 ac7">0</TD><TD headers="ar1 ar10 ac1 ac8">0</TD><TD headers="ar1 ar10 ac9 ac10 ac11">116</TD><TD headers="ar1 ar10 ac9 ac10 ac12">0</TD><TD headers="ar1 ar10 ac9 ac10 ac13">76</TD><TD headers="ar1 ar10 ac9 ac10 ac14">9</TD><TD headers="ar1 ar10 ac9 ac10 ac15">31</TD><TD 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 headers="ar1 ar11 ac1 ac2 ac3">1</TD><TD headers="ar1 ar11 ac1 ac2 ac4">0</TD><TD headers="ar1 ar11 ac1 ac2 ac5">0</TD><TD headers="ar1 ar11 ac1 ac2 ac6">0</TD><TD headers="ar1 ar11 ac1 ac2 ac7">1</TD><TD headers="ar1 ar11 ac1 ac8">0</TD><TD headers="ar1 ar11 ac9 ac10 ac11">718</TD><TD headers="ar1 ar11 ac9 ac10 ac12">0</TD><TD headers="ar1 ar11 ac9 ac10 ac13">152</TD><TD headers="ar1 ar11 ac9 ac10 ac14">0</TD><TD headers="ar1 ar11 ac9 ac10 ac15">566</TD><TD headers="ar1 ar11 ac9 ac16">16</TD></TR><TR><TH id=ar12 class=bg-colour-yellow headers=ar1>Canada</TH><TD headers="ar1 ar12 ac1 ac2 ac3">31</TD><TD headers="ar1 ar12 ac1 ac2 ac4">0</TD><TD headers="ar1 ar12 ac1 ac2 ac5">6</TD><TD headers="ar1 ar12 ac1 ac2 ac6">13</TD><TD headers="ar1 ar12 ac1 ac2 ac7">12</TD><TD headers="ar1 ar12 ac1 ac8">198</TD><TD headers="ar1 ar12 ac9 ac10 ac11">26902</TD><TD headers="ar1 ar12 ac9 ac10 ac12">0</TD><TD headers="ar1 ar12 ac9 ac10 ac13">9264</TD><TD headers="ar1 ar12 ac9 ac10 ac14">1243</TD><TD headers="ar1 ar12 ac9 ac10 ac15">16395</TD><TD headers="ar1 ar12 ac9 ac16">4411</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
      (May 5 to May 11, 2013)
      </TH><TH id=bc8 colSpan=5>Cumulative
      (August 26, 2012 to May 11, 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">2</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">1</TD><TD class=alignRight headers="br1 br2 bc1 bc7">24</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">3127</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">333</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">1166</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1628</TD><TD class=alignRight headers="br1 br2 bc8 bc14">901</TD></TR><TR><TH id=br3 headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">1</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">0</TD><TD class=alignRight headers="br1 br3 bc1 bc7">21</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1687</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">95</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">825</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">767</TD><TD class=alignRight headers="br1 br3 bc8 bc14">1142</TD></TR><TR><TH id=br4 headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">4</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">1</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">3</TD><TD class=alignRight headers="br1 br4 bc1 bc7">19</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">3661</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">478</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">1539</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">1644</TD><TD class=alignRight headers="br1 br4 bc8 bc14">764</TD></TR><TR><TH id=br5 headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">2</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">1</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">0</TD><TD class=alignRight headers="br1 br5 bc1 bc7">23</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">3956</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">443</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">1563</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">1950</TD><TD class=alignRight headers="br1 br5 bc8 bc14">754</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">26</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">10140</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">163</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">4165</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">5812</TD><TD class=alignRight headers="br1 br6 bc8 bc14">853</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">20</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">143</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">1</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">13</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc4">3</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc5">2</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc6">8</TD><TD class=alignRight headers="br1 br8 bc1 bc7">113</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">22735</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc11">1532</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc12">9401</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc13">11802</TD><TD class=alignRight headers="br1 br8 bc8 bc14">4415</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 1251 influenza viruses. The 603 influenza A(H3N2) viruses were antigenically similar to the vaccine strain A/Victoria/361/2011 and the 194 A(H1N1)pdm09 viruses were antigenically similar to the vaccine strain A/California/07/09. Among the influenza B viruses, 356 were antigenically similar to the vaccine strain B/Wisconsin/01/2010 (Yamagata lineage) and 98 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 =1251

      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 1223 influenza viruses for resistance to oseltamivir, and 1221 influenza viruses for resistance to zanamivir. Among these, one A(H3N2) virus was resistant to oseltamivir and zanamivir. A total of 1210 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">595</TD><TD class=alignRight headers="cr2 cc3">1 (0.2%)</TD><TD class=alignRight headers="cr2 cc5">596</TD><TD class=alignRight headers="cr2 cc6">1 (0.2%)</TD><TD class=alignRight headers="cr2 cc8">980</TD><TD class=alignRight headers="cr2 cc9">979 (99.9%)</TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignRight headers="cr3 cc2">199</TD><TD class=alignRight headers="cr3 cc3">0</TD><TD class=alignRight headers="cr3 cc5">196</TD><TD class=alignRight headers="cr3 cc6">0</TD><TD class=alignRight headers="cr3 cc8">230</TD><TD class=alignRight headers="cr3 cc9">230 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignRight headers="cr4 cc2">429</TD><TD class=alignRight headers="cr4 cc3">0</TD><TD class=alignRight headers="cr4 cc5">429</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">1223</TD><TD class=alignRight headers="cr5 cc3">1 (0.1%)</TD><TD class=alignRight headers="cr5 cc5">1221</TD><TD class=alignRight headers="cr5 cc6">1 (0.1%)</TD><TD class=alignRight headers="cr5 cc8">1210</TD><TD class=alignRight headers="cr5 cc9">1209 (99.9%)</TD></TR></TBODY></TABLE>
      Influenza-like Illness (ILI) Consultation Rate

      The national influenza-like-illness (ILI) consultation rate decreased from 18.3 ILI consultations per 1,000 patient visits in week 18 to 16.1 / 1,000 in week 19, and is above the expected range (Figure 7). In week 19, the highest consultation rate was observed in children 5-19 years of age (33.1/1,000).
      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 19, 11 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 18. All of the cases reported in week 19 were identified with influenza B. The age distribution is as follows: two cases 0-5 months of age, two 6-23 months of age, four 2-4 years of age, and three 5-9 years of age. Four cases were admitted to an intensive care unit (ICU) during week 19, one child 0-5 months of age, one 6-23 months of age, one 2-4 years of age and one 5-9 years of age; all with influenza B. No deaths were reported in week 19.

      Since the start of the 2012-13 season, a total of 863 influenza-associated paediatric hospitalizations have been reported by the IMPACT network: 621 (72.0%) with influenza A [of which 120 (19.3%) were A(H3N2), 25 (4.0%) were A(H1N1)pdm09 and the remaining 476 were A(unsubtyped); and 242 (28.0%) with influenza B. The distribution of cases by age group is as follows: 159 (18.4%) <6 months of age; 200 (23.2%) age 6-23 months; 247 (28.6%) age 2-4 years; 186 (21.6%) age 5-9 years; and 71 (8.2%) age 10-16 years. Of the 863 cases, 94 (10.9%) were admitted to the ICU. Of the 72 ICU admissions with available data, 62 (86.1%) cases had at least one underlying condition. One death has been reported to date this season in a child 6-23 months of age with an underlying condition, 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)

      Active surveillance of laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network has concluded for the 2012-13 influenza season. However, the PCIRN-SOS network will continue to report limited data on laboratory-confirmed cases of influenza. In week 19, 13 hospitalizations were reported from 14 of the 17 PCIRN sites: 12 were cases of influenza B and one case of influenza A. Nine cases were ≥65 years of age, one was 45-64 years, and one was <20 years of age. One ICU admission and no deaths were reported in week 19.

      Cumulative data for the season to date includes data from active surveillance from November 4, 2012 to April 30, 2013 and data from passive surveillance since May 1, 2013. The cumulative number of cases reported by the PCIRN-SOS network was 1,792 influenza-associated adult hospitalizations: 90.5% with influenza A [of which 310 were A(H3N2), 19 were A(H1N1)pdm09, and 1292 were A(unsubtyped)]; 125 with influenza B, and the type has not been reported for 46 cases. The age distribution of hospitalizations is as follows: 1221 (68.1%) were ≥65 years of age, 365 (20.4%) were 45-64 years, 194 (10.8%) were 20-44 years, and 10 (0.6%) were <20 years of age. ICU admission was required for 215 hospitalizations; the majority of which were adults ≥65 years of age (125; 58.1%). 115 deaths have been reported: 26 with influenza A(H3N2), one with A(H1N1)pdm09, 82 with A(unsubtyped), 5 with influenza B, and one untyped. More than 85% of the deaths (98/115) were in adults ≥65 years of age, 12.2 (14%) were adults 45-64 years of age, and 3 (2.6%) were 20-44 years of age.

      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 19, 44 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories<SUP>*</SUP>. For the first time during the 2012-13 season, the majority of cases were influenza B (77.3%). The highest proportion of hospitalisations were in adults ≥65 years of age (40.9%), followed by children 0-4 years of age (22.7%). Of the 21 cases with available data, three cases were admitted to the ICU, all with influenza A(unsubtyped); two were ≥65 years of age and one was 45-64 years of age. One death was reported in week 19, an adult ≥65 years of age with influenza B.

      To date this season, 4,763 influenza-associated hospitalizations have been reported, of which 88.7% have been influenza A. Of those subtyped (48.9%), influenza A(H3) was the predominant influenza strain. The cumulative proportion of hospitalizations with influenza B continues to increase (11.3% in week 19). Age information was available for 4,760 cases, and the age distribution is as follows: 2,529 (53.1%) were ≥65 years of age; 794 (16.7%) were 45-64 years of age; 429 (9.0%) were 20-44 years of age; 40 (0.8%) were 15-19 years of age; 230 (4.8%) were 5-14 years; and 738 (15.5%) were 0-4 years of age. Of the 1,300 cases with available data, there have been 213 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 (35.4% and 34.4%, respectively). To date, 298 deaths have been reported: 246 adults ≥65 years of age, 35 adults 45-64 years; 11 adults 20-44 years, one child 5-14 years of age, and 5 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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      Comment


      • #33
        Re: Canada FluWatch Weekly Reports 2012-2013 Season Week 20

        FluWatch report: May 12 to May 18, 2013 (Week 20)

        Posted 2013-05-24For 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/w20_13/pdf/fw2013-20-eng.pdf">FluWatch report: May 12 to May 18, 2013 (Week 20) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 113 <ABBR title=Kilobytes>KB</ABBR> - 8 pages)

        »» Help with PDF documents



        Overall Summary
        • Influenza activity in Canada continued its slow decline in week 20, with the percentage of laboratory tests positive for influenza at 6.7%. Influenza B was the predominant type, and detections continued to decrease.
        • Detections of rhinovirus and parainfluenza continued to increase slowly, while detections of most other respiratory viruses were stable or decreasing in week 20.
        • The ILI consultation rate decreased and was within the expected range. The number of regions reporting localized activity was similar to previous weeks.
        Note: This is the final weekly report for the 2012-13 influenza season. Bi-weekly reports will commence on June 7th (for weeks 21 and 22). However, laboratory detections reported through the RVDSS and influenza activity level maps will be updated weekly on the FluWatch website.

        Influenza Activity (geographic spread) and Outbreaks

        In week 20, six regions [AB(1), MB(1), ON(3), NB(1)] reported localized activity and 21 regions reported sporadic activity. The number of regions reporting localized activity has been similar for the past three weeks (Figures 1 and 2). Three new influenza outbreaks were reported, all in long-term-care facilities (Figure 3).
        Figure 1. Map of overall Influenza activity level by province and territory,
        Canada, Week 20





        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 overall percentage of positive influenza tests continued to decrease, from 8.4% in week 19 to 6.7% in week 20. Detections of influenza B decreased, and represented 80.1% of total positive influenza detections in week 20 (Figure 4). Among the influenza viruses detected in week 20 (n=161), 19.9% were positive for influenza A viruses [of which 28.1% were A(H1N1)pdm09, 18.8% were A(H3), and 53.1% were A(unsubtyped)] (Table 1). Cumulative influenza virus detections by type/subtype to date are as follows: 85.6% influenza A [34.4% A(H3), 4.6% A(H1N1)pdm09 and 60.9% A(unsubtyped)] and 14.4% influenza B (Table 1).
        Detailed information on age and type/subtype has been received for 24,026 cases to date this season (Table 2). The proportion of cases by age group is as follows: 14.2% <5 years; 10.0% between 5-19 years; 15.8% between 20-44 years; 17.0% between 45-64 years of age; 43.0% ≥65 years.
        The percentage of positive tests for rhinovirus increased slightly from 16.8% in week 19 to 17.2% in week 20, continuing its upward trend since week 01. The percentage of positive tests for parainfluenza (7.7%) also continued the gradual increase observed since week 08. The percentage of tests positive for respiratory syncytial virus (RSV) (2.4%) continued its decline from a peak in week 08. The percentages of positive tests for human metapneumovirus (hMPV) (4.2%) and coronavirus (1.2%) were stable in week 20 (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
        (May 12 to May 18, 2013)
        </TH><TH id=ac9 colSpan=6>Cumulative
        (August 26, 2012 to May 18, 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">5 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">2 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">1 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac7">2 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac8">13 </TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac11">1913 </TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac12">0 </TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac13">1453 </TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac14">219 </TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac15">241 </TD><TD class=alignRight headers="ar1 ar2 ac9 ac16">413 </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">3 </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">3 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac7">0 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac8">20 </TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac11">2358 </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">444 </TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac15">144 </TD><TD class=alignRight headers="ar1 ar3 ac9 ac16">806 </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">0 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">1 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac7">2 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac8">8 </TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac11">839 </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">74 </TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac15">289 </TD><TD class=alignRight headers="ar1 ar4 ac9 ac16">306 </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">4 </TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac11">659 </TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac12">0 </TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac13">79 </TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac14">10 </TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac15">570 </TD><TD class=alignRight headers="ar1 ar5 ac9 ac16">104 </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">11 </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">3 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac7">4 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac8">31 </TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac11">8268 </TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac12">0 </TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac13">3784 </TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac14">377 </TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac15">4107 </TD><TD class=alignRight headers="ar1 ar6 ac9 ac16">912 </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">3 </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">3 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac8">38 </TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac11">9805 </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">36 </TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac15">9223 </TD><TD class=alignRight headers="ar1 ar7 ac9 ac16">1898 </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">5 </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">5 </TD><TD class=alignRight headers="ar1 ar8 ac1 ac8">15 </TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac11">1868 </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">73 </TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac15">1024 </TD><TD class=alignRight headers="ar1 ar8 ac9 ac16">86 </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">0 </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">0 </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">7 </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">1 </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">1 </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">117 </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">10 </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">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">718 </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">566 </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">32 </TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac5">6 </TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac6">9 </TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac7">17 </TD><TD class=alignRight headers="ar1 ar12 ac1 ac8">129 </TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac11">26933 </TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac12">0 </TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac13">9272 </TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac14">1251 </TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac15">16410 </TD><TD class=alignRight headers="ar1 ar12 ac9 ac16">4549 </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
        (May 12 to May 18, 2013)
        </TH><TH id=bc8 colSpan=5>Cumulative
        (August 26, 2012 to May 18, 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">6 </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">2 </TD><TD class=alignRight headers="br1 br2 bc1 bc7">10 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">2662 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">220 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">840 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1602 </TD><TD class=alignRight headers="br1 br2 bc8 bc14">751 </TD></TR><TR><TH id=br3 headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">1 </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">1 </TD><TD class=alignRight headers="br1 br3 bc1 bc7">11 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1446 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">71 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">623 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">752 </TD><TD class=alignRight headers="br1 br3 bc8 bc14">961 </TD></TR><TR><TH id=br4 headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">1 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">1 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">0 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">0 </TD><TD class=alignRight headers="br1 br4 bc1 bc7">8 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">3163 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">346 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">1200 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">1617 </TD><TD class=alignRight headers="br1 br4 bc8 bc14">635 </TD></TR><TR><TH id=br5 headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">2 </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">1 </TD><TD class=alignRight headers="br1 br5 bc1 bc7">6 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">3446 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">319 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">1206 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">1921 </TD><TD class=alignRight headers="br1 br5 bc8 bc14">642 </TD></TR><TR><TH id=br6 headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">3 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">0 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">1 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">2 </TD><TD class=alignRight headers="br1 br6 bc1 bc7">16 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">9542 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">133 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">3638 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">5771 </TD><TD class=alignRight headers="br1 br6 bc8 bc14">778 </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">20 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">143 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">1 </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">13 </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">6 </TD><TD class=alignRight headers="br1 br8 bc1 bc7">51 </TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">20423 </TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc11">1109 </TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc12">7650 </TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc13">11664 </TD><TD class=alignRight headers="br1 br8 bc8 bc14">3768 </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 1299 influenza viruses. The 630 influenza A(H3N2) viruses were antigenically similar to the vaccine strain A/Victoria/361/2011 and the 200 A(H1N1)pdm09 viruses were antigenically similar to the vaccine strain A/California/07/09. Among the influenza B viruses, 366 were antigenically similar to the vaccine strain B/Wisconsin/01/2010 (Yamagata lineage) and 103 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 =1299

        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 1261 influenza viruses for resistance to oseltamivir, and 1222 influenza viruses for resistance to zanamivir. Among these, one A(H3N2) virus was resistant to oseltamivir and zanamivir. A total of 1224 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">597</TD><TD class=alignRight headers="cr2 cc3">1 (0.2%)</TD><TD class=alignRight headers="cr2 cc5">596</TD><TD class=alignRight headers="cr2 cc6">1 (0.2%)</TD><TD class=alignRight headers="cr2 cc8">986</TD><TD class=alignRight headers="cr2 cc9">985 (99.9%)</TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignRight headers="cr3 cc2">201</TD><TD class=alignRight headers="cr3 cc3">0</TD><TD class=alignRight headers="cr3 cc5">197</TD><TD class=alignRight headers="cr3 cc6">0</TD><TD class=alignRight headers="cr3 cc8">238</TD><TD class=alignRight headers="cr3 cc9">238 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignRight headers="cr4 cc2">463</TD><TD class=alignRight headers="cr4 cc3">0</TD><TD class=alignRight headers="cr4 cc5">429</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">1261</TD><TD class=alignRight headers="cr5 cc3">1 (0.1%)</TD><TD class=alignRight headers="cr5 cc5">1222</TD><TD class=alignRight headers="cr5 cc6">1 (0.1%)</TD><TD class=alignRight headers="cr5 cc8">1224</TD><TD class=alignRight headers="cr5 cc9">1223 (99.9%)</TD></TR></TBODY></TABLE>
        Influenza-like Illness (ILI) Consultation Rate

        The national influenza-like-illness (ILI) consultation rate decreased from 15.6 ILI consultations per 1,000 patient visits in week 19 to 13.0 / 1,000 in week 20, and is within the expected range (Figure 7). In week 20, the highest consultation rate was observed in children less than 5 years of age (31.0/1,000).
        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)

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        Severe Respiratory Illness Surveillance

        Paediatric Influenza Hospitalizations and Deaths (IMPACT)

        In week 20, 11 laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, the same number as in week 19. Nine of the 11 cases reported in week 20 were identified with influenza B. The age distribution is as follows: two cases 0-5 months of age, three 6-23 months of age, three 2-4 years of age, and three 10-16 years of age. Two cases were admitted to an intensive care unit (ICU) during week 20, one child 2-4 years of age and one 10-16 years of age. No deaths were reported in week 20.

        Since the start of the 2012-13 season, a total of 873 influenza-associated paediatric hospitalizations have been reported by the IMPACT network: 622 (71.2%) with influenza A [of which 120 (19.3%) were A(H3N2), 25 (4.0%) were A(H1N1)pdm09 and the remaining 477 were A(unsubtyped); and 251 (28.8%) with influenza B. The distribution of cases by age group is as follows: 161 (18.4%) <6 months of age; 202 (23.1%) age 6-23 months; 250 (28.6%) age 2-4 years; 186 (21.3%) age 5-9 years; and 74 (8.5%) age 10-16 years. Of the 873 cases, 98 (11.2%) were admitted to the ICU. Of the 73 ICU admissions with available data, 61 (83.6%) cases had at least one underlying condition. One death has been reported to date this season in a child 6-23 months of age with an underlying condition, with influenza B.

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

        Adult Influenza Hospitalizations and Deaths (PCIRN)

        Active surveillance of laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network concluded for the 2012-13 influenza season on April 30th, 2013. However, the PCIRN-SOS network continues to report limited data on laboratory-confirmed cases of influenza identified through passive surveillance at 16 out of 17 hospital sites. In week 20, five hospitalizations were reported: four of the five were cases of influenza B and one was influenza A(H3N2); two cases were ≥65 years of age, two were 45-64 years, and one case was <20 years of age. No ICU admissions or deaths were reported in week 20.

        The cumulative data for the season to date includes data from active surveillance from November 4, 2012 to April 30, 2013 and data from passive surveillance from May 1 to 18, 2013. The cumulative number of cases was 1,798: 1,622 (90.2%) with influenza A [of which 311 were A(H3N2), 19 were A(H1N1)pdm09, and 1292 were A(unsubtyped)]; 130 (7.2%) with influenza B, and the type has not been reported for 46 cases. The age distribution of hospitalizations is as follows: 1225 (68.1%) were ≥65 years of age, 368 (20.5%) were 45-64 years, 194 (10.8%) were 20-44 years, and 11 (0.6%) were <20 years of age. ICU admission was required for 216 hospitalizations; the majority of which were adults ≥65 years of age (123; 56.9%). A total of 116 deaths have been reported: 26 with influenza A(H3N2), one with A(H1N1)pdm09, 82 with A(unsubtyped), 6 with influenza B, and one untyped. More than 85% of the deaths (99/116) were in adults ≥65 years of age, 14 (12.1%) were adults 45-64 years of age, and 3 (2.6%) were 20-44 years of age.

        Note: The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated 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 20, 46 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories*. For the second week in a row, the majority of cases were influenza B (58.7%). The highest proportion of hospitalisations were in adults ≥65 years of age (50.0%), followed by children 0-4 years of age (23.9%). Of the 15 cases with available data, two were admitted to the ICU; one adult ≥65 years of age with influenza A(H3), and the other a child 0-4 years of age with influenza B. Four deaths were reported in week 20; two children 0-4 years of age and two adults ≥65 years of age, all with influenza A.

        To date this season, 4,859 influenza-associated hospitalizations have been reported, of which 87.5% have been influenza A. Of those subtyped (49.0%), influenza A(H3) was the predominant influenza strain. The cumulative proportion of influenza B among hospitalizations with influenza continues to increase (12.5% in week 20). Age information was available for 4,856 cases, and the age distribution is as follows: 2,573 (53.0%) were ≥65 years of age; 804 (16.6%) were 45-64 years of age; 437 (9.0%) were 20-44 years of age; 39 (0.8%) were 15-19 years of age; 249 (5.1%) were 5-14 years; and 754 (15.5%) were 0-4 years of age. Of the 1,365 cases with available data, there have been 218 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 33.9%, respectively). To date, 302 deaths have been reported: 248 adults ≥65 years of age, 35 adults 45-64 years; 11 adults 20-44 years, one child 5-14 years of age, and seven 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


        • #34
          Re: Canada FluWatch Weekly Reports 2012-2013 Season Weeks 23-24

          FluWatch report: June 2 to 15, 2013 (Weeks 23 & 24)

          Posted 2013-06-21For 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/w24_13/pdf/fw2013-24-eng.pdf">FluWatch report: June 2 to 15, 2013 (Weeks 23 & 24) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 113 <ABBR title=Kilobytes>KB</ABBR> - 8 pages)

          »» Help with PDF documents

          Overall Summary
          • Influenza activity in Canada continued to decline, with only one region reporting localized activity during this 2-week period.
          • Detections of rhinovirus continued to follow an overall upward trend, while detections of other respiratory viruses decreased. The percentage of laboratory tests positive for influenza was 1.1% in week 24.
          • The ILI consultation rate has been fairly stable over the past 10 weeks, and has been above the expected range for the past seven weeks.
          Influenza Activity (geographic spread) and Outbreaks

          The number of regions reporting influenza activity continued to decrease in weeks 23 and 24. In week 23, one region in Quebec reported localized activity and 15 regions reported sporadic activity. In week 24, no region reported localized activity and 8 regions reported sporadic activity (Figures 1 and 2). One new influenza outbreak in a long-term-care facility was reported in week 23 (Figure 3).
          Figure 1. Map of overall Influenza activity level by province and territory,
          Canada, Week 24






          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 overall percentage of positive influenza tests continued to decrease, and was 2.0% in week 23 and 1.1% in week 24. Among the influenza viruses detected in weeks 23 & 24 (n=53), 75.5% were positive for influenza B viruses; all influenza A viruses were either A(H3) or A(unsubtyped) (Table 1). Cumulative influenza virus detections by type/subtype to date are as follows: 85.2% influenza A [34.4% A(H3), 4.7% A(H1N1)pdm09 and 60.9% A(unsubtyped)] and 14.8% influenza B (Table 1).
          Detailed information on laboratory detections of influenza was received for 26,276 cases to date this season. Data on age and type/subtype was complete for 26,064 cases (Table 2). The proportion of cases by age group is as follows: 14.8% <5 years; 10.4% between 5-19 years; 16.3% between 20-44 years; 17.0% between 45-64 years of age; 41.5% ≥65 years.
          The percentage of positive tests for rhinovirus continued the upward trend observed since week 01, and was 20.7% in week 23 and 18.9% in week 24. The percentage of positive tests for all other viruses decreased over weeks 23 and 24: parainfluenza (5.2%), respiratory syncytial virus (RSV) (1.2%), human metapneumovirus (hMPV) (1.7%) and coronavirus (0.6%) (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
          (June 2 to June 15, 2013)</TH><TH id=ac9 colSpan=6>Cumulative
          (August 26, 2012 to June 15, 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">1 </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">0 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac7">0 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac8">2 </TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac11">1916 </TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac12">0 </TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac13">1457 </TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac14">220 </TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac15">239 </TD><TD class=alignRight headers="ar1 ar2 ac9 ac16">407 </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">0 </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">0 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac7">0 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac8">12 </TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac11">2363 </TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac12">0 </TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac13">1771 </TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac14">448 </TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac15">144 </TD><TD class=alignRight headers="ar1 ar3 ac9 ac16">840 </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">0 </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">0 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac7">0 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac8">2 </TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac11">839 </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">74 </TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac15">289 </TD><TD class=alignRight headers="ar1 ar4 ac9 ac16">323 </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">0 </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">0 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac8">2 </TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac11">659 </TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac12">0 </TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac13">79 </TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac14">10 </TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac15">570 </TD><TD class=alignRight headers="ar1 ar5 ac9 ac16">114 </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">8 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">6 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac7">2 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac8">10 </TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac11">8282 </TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac12">0 </TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac13">3790 </TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac14">382 </TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac15">4110 </TD><TD class=alignRight headers="ar1 ar6 ac9 ac16">948 </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">4 </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">4 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac8">7 </TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac11">9815 </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">36 </TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac15">9233 </TD><TD class=alignRight headers="ar1 ar7 ac9 ac16">1938 </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">5 </TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac11">1872 </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">75 </TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac15">1026 </TD><TD class=alignRight headers="ar1 ar8 ac9 ac16">100 </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">0 </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">0 </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">9 </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">117 </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">10 </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">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">719 </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">567 </TD><TD class=alignRight headers="ar1 ar11 ac9 ac16">18 </TD></TR><TR><TH id=ar12 class=bg-colour-yellow headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">13 </TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac5">7 </TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac7">6 </TD><TD class=alignRight headers="ar1 ar12 ac1 ac8">40 </TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac11">26970 </TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac12">0 </TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac13">9283 </TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac14">1263 </TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac15">16424 </TD><TD class=alignRight headers="ar1 ar12 ac9 ac16">4698 </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
          (June 2 to June 15, 2013)</TH><TH id=bc8 colSpan=5>Cumulative
          (August 26, 2012 to June 15, 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">0 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">0 </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">4 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">3004 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">223 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">838 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1943 </TD><TD class=alignRight headers="br1 br2 bc8 bc14">849 </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">8 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1631 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">71 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">613 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">947 </TD><TD class=alignRight headers="br1 br3 bc8 bc14">1076 </TD></TR><TR><TH id=br4 headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">1 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">0 </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">2 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">3529 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">355 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">1215 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">1959 </TD><TD class=alignRight headers="br1 br4 bc8 bc14">728 </TD></TR><TR><TH id=br5 headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">3 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">0 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">1 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">2 </TD><TD class=alignRight headers="br1 br5 bc1 bc7">2 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">3719 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">327 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">1216 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">2176 </TD><TD class=alignRight headers="br1 br5 bc8 bc14">702 </TD></TR><TR><TH id=br6 headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">1 </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">1 </TD><TD class=alignRight headers="br1 br6 bc1 bc7">2 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">9985 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">135 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">3708 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">6142 </TD><TD class=alignRight headers="br1 br6 bc8 bc14">841 </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">210 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">29 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">178 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">3 </TD><TD class=alignRight headers="br1 br7 bc8 bc14">2 </TD></TR><TR><TH id=br8 headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">5 </TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc4">0 </TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc5">1 </TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc6">4 </TD><TD class=alignRight headers="br1 br8 bc1 bc7">18 </TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">22078 </TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc11">1140 </TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc12">7768 </TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc13">13170 </TD><TD class=alignRight headers="br1 br8 bc8 bc14">4198 </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 1396 influenza viruses. The 640 influenza A(H3N2) viruses were antigenically similar to the vaccine strain A/Victoria/361/2011 and the 229 A(H1N1)pdm09 viruses were antigenically similar to the vaccine strain A/California/07/09. Among the influenza B viruses, 409 were antigenically similar to the vaccine strain B/Wisconsin/01/2010 (Yamagata lineage) and 118 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 =1396

          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 1378 influenza viruses for resistance to oseltamivir, and 1375 influenza viruses for resistance to zanamivir. Among these, one A(H3N2) virus was resistant to oseltamivir and zanamivir and one A(H1N1)pdm09 virus was resistant to oseltamivir. A total of 1285 influenza A viruses were tested for amantadine resistance and all but one A(H3N2) virus 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">628</TD><TD class=alignRight headers="cr2 cc3">1 (0.2%)</TD><TD class=alignRight headers="cr2 cc5">628</TD><TD class=alignRight headers="cr2 cc6">1 (0.2%)</TD><TD class=alignRight headers="cr2 cc8">1018</TD><TD class=alignRight headers="cr2 cc9">1017 (99.9%)</TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignRight headers="cr3 cc2">229</TD><TD class=alignRight headers="cr3 cc3">1 (0.4%)</TD><TD class=alignRight headers="cr3 cc5">226</TD><TD class=alignRight headers="cr3 cc6">0</TD><TD class=alignRight headers="cr3 cc8">267</TD><TD class=alignRight headers="cr3 cc9">267 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignRight headers="cr4 cc2">521</TD><TD class=alignRight headers="cr4 cc3">0</TD><TD class=alignRight headers="cr4 cc5">521</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">1378</TD><TD class=alignRight headers="cr5 cc3">2 (0.1%)</TD><TD class=alignRight headers="cr5 cc5">1375</TD><TD class=alignRight headers="cr5 cc6">1 (0.1%)</TD><TD class=alignRight headers="cr5 cc8">1285</TD><TD class=alignRight headers="cr5 cc9">1284 (99.9%)</TD></TR></TBODY></TABLE>
          Influenza-like Illness (ILI) Consultation Rate

          The national influenza-like-illness (ILI) consultation rate has been similar for the past ten weeks, ranging from 14.3 to 24.4 ILI consultations per 1,000 patient visits, and was 14.4/1,000 in week 24. The rates observed in weeks 18 to 24 were above the expected range (Figure 7). The highest consultation rate was observed in children 5-19 years of age (48.2/1,000 visits) in week 23, and in children under 5 years of age (16.8/1,000 visits) in week 24.
          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 weeks 23 and 24, three laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network. Two cases of influenza B: one in a child <6 months of age, and the other in a child 10-16 years of age; and one case of influenza A(unsubtyped) in a child 5-9 years of age were reported. No admissions to an intensive care unit (ICU) and no deaths were reported during weeks 23 and 24.

          Since the start of the 2012-13 season, a total of 880 influenza-associated paediatric hospitalizations have been reported by the IMPACT network: 624 (70.9%) with influenza A [of which 124 (19.9%) were A(H3N2), 27 (4.3%) were A(H1N1)pdm09 and the remaining 473 were A(unsubtyped); and 256 (29.1%) with influenza B. The distribution of cases by age group is as follows: 162 (18.4%) <6 months of age; 202 (23.0%) age 6-23 months; 253 (28.8%) age 2-4 years; 188 (21.4%) age 5-9 years; and 75 (8.5%) age 10-16 years. Of the 880 cases, 99 (11.3%) were admitted to the ICU. Of the 76 ICU admissions with available data, 63 (82.9%) cases had at least one underlying condition. One death has been reported to date this season in a child 6-23 months of age with an underlying condition, with influenza B.

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

          Adult Influenza Hospitalizations and Deaths (PCIRN)

          Active surveillance of laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network concluded for the 2012-13 influenza season on April 30th, 2013. However, the PCIRN-SOS network continues to report limited data on laboratory-confirmed cases of influenza identified through passive surveillance at 15 out of 17 hospital sites. In weeks 23 and 24, no hospitalizations, ICU admissions or deaths were reported.

          The cumulative data for the season to date includes data from active surveillance from November 4, 2012 to April 30, 2013 and data from passive surveillance since May 1, 2013. The cumulative number of cases is 1,809: 1,624 (89.8%) with influenza A [of which 312 were A(H3N2), 20 were A(H1N1)pdm09, and 1,292 were A(unsubtyped)]; 139 (7.7%) with influenza B, and the type has not been reported for 46 cases. The age distribution of hospitalizations is as follows: 1,230 (68.0%) were ≥65 years of age, 373 (20.6%) were 45-64 years, 194 (10.7%) were 20-44 years, and 12 (0.7%) were <20 years of age. ICU admission was required for 216 hospitalizations; the majority of which were adults ≥65 years of age (123; 56.9%). A total of 116 deaths have been reported: 26 with influenza A(H3N2), one with A(H1N1)pdm09, 82 with A(unsubtyped), 6 with influenza B, and one untyped. More than 85% of the deaths (99/116) were in adults ≥65 years of age, 14 (12.1%) were adults 45-64 years of age, and 3 (2.6%) were 20-44 years of age.

          Note: The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated 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 weeks 23 and 24, 45 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories*. The majority of cases were influenza B (51.1%). The highest proportion of hospitalisations was adults ≥65 years of age (44.4%), followed by adults 45-64 years of age (24.4%). There were no ICU admissions reported among the four cases with available data. Two deaths were reported: one case of influenza A(H3) in an adult aged 20-44 years, and one case of influenza B in an adult ≥65 years of age.

          To date this season, 5,042 influenza-associated hospitalizations have been reported, of which 86.4% have been influenza A. Of those subtyped (49.3%), influenza A(H3) was the predominant influenza strain. Age information was available for 5,039 cases, and the age distribution is as follows: 2,653 (52.6%) were ≥65 years of age; 836 (16.6%) were 45-64 years of age; 450 (8.9%) were 20-44 years of age; 41 (0.8%) were 15-19 years of age; 273 (5.4%) were 5-14 years; and 786 (15.6%) were 0-4 years of age. Of the 1,397 cases with available data, there have been 221 hospitalisations for which admission to an ICU was required; the highest proportions have been in adults ≥65 years of age, followed by adults 45-64 years of age (35.8% and 33.9%, respectively). To date, 312 deaths have been reported: 256 adults ≥65 years of age, 36 adults 45-64 years; 12 adults 20-44 years, one child 5-14 years of age, and seven 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


          • #35
            Re: Canada FluWatch Weekly Reports 2012-2013 Season Weeks 25-26

            FluWatch report: June 16 to 29, 2013 (Weeks 25 & 26)

            Posted 2013-07-05For 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/w26_13/pdf/fw2013-26-eng.pdf">FluWatch report: June 16 to 29, 2013 (Weeks 25 & 26) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 113 <ABBR title=Kilobytes>KB</ABBR> - 8 pages)

            »» Help with PDF documents


            Overall Summary
            • Influenza activity in Canada continued to decline, with only one region reporting localized activity during this 2-week period.
            • Detections of rhinovirus continued to follow an overall upward trend. Detections of most other respiratory viruses declined. The percentage of laboratory tests positive for influenza was 0.7% in week 26.
            • The ILI consultation rate has been fairly stable over the past 12 weeks, and has been above the expected range for the past nine weeks.
            Influenza Activity (geographic spread) and Outbreaks

            The number of regions reporting influenza activity was at inter-seasonal levels in weeks 25 and 26. In week 25, eight regions reported sporadic activity. In week 26, Yukon reported localized activity and six regions reported sporadic activity (Figures 1 and 2). One new influenza outbreak in a long-term-care facility was reported in week 26 (Figure 3).
            Figure 1. Map of overall Influenza activity level by province and territory,
            Canada, Week 26





            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 overall percentage of positive influenza tests continued to decrease, and was 0.8% in week 25 and 0.7% in week 26. Among the 23 influenza viruses detected in weeks 25 & 26, 13 were influenza A (Table 1). Cumulative influenza virus detections by type/subtype to date are as follows: 85.1% influenza A [34.4% A(H3), 4.7% A(H1N1)pdm09 and 60.9% A(unsubtyped)] and 14.9% influenza B (Table 1).
            Detailed information on laboratory detections of influenza was received for 26,300 cases to date this season. Data on age and type/subtype was complete for 26,088 cases (Table 2).The proportion of cases by age group is as follows: 14.8% <5 years; 10.4% between 5-19 years; 16.3% between 20-44 years; 17.0% between 45-64 years of age; 41.5% ≥65 years.
            The percentage of positive tests for rhinovirus continued to follow the upward trend observed since week 01, and was 24.8% in week 25 and decreased slightly to 22.9% in week 26. The percentage of positive tests for parainfluenza increased from 4.7% in week 25 to 6.5% in week 26, interrupting the downward trend observed over the previous six weeks. The percentage of positive tests for human metapneumovirus (hMPV) increased slightly to 2.6% in week 26, but continued to follow a downward trend. The percentages of positive tests for respiratory syncytial virus (RSV) (1.1%), coronavirus (0.8%) and adenovirus (1.4%) were low in weeks 25 and 26 (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
            (June 16 to June 29, 2013)
            </TH><TH id=ac9 colSpan=6>Cumulative
            (August 26, 2012 to June 29, 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">7</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">0</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac7">2</TD><TD class=alignRight headers="ar1 ar2 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac11">1923</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">220</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac15">241</TD><TD class=alignRight headers="ar1 ar2 ac9 ac16">407</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">0</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">0</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac7">0</TD><TD class=alignRight headers="ar1 ar3 ac1 ac8">3</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac11">2363</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac13">1771</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac14">448</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac15">144</TD><TD class=alignRight headers="ar1 ar3 ac9 ac16">844</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">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac7">1</TD><TD class=alignRight headers="ar1 ar4 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac11">840</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">74</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac15">290</TD><TD class=alignRight headers="ar1 ar4 ac9 ac16">324</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">0</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">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac11">659</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac13">79</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac14">10</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac15">570</TD><TD class=alignRight headers="ar1 ar5 ac9 ac16">114</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">3</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">1</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">1</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac7">1</TD><TD class=alignRight headers="ar1 ar6 ac1 ac8">4</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac11">8285</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac13">3791</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac14">383</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac15">4111</TD><TD class=alignRight headers="ar1 ar6 ac9 ac16">952</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">2</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">2</TD><TD class=alignRight headers="ar1 ar7 ac1 ac8">1</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac11">9817</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">36</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac15">9235</TD><TD class=alignRight headers="ar1 ar7 ac9 ac16">1939</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">2</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac11">1872</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">75</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac15">1026</TD><TD class=alignRight headers="ar1 ar8 ac9 ac16">102</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">0</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">0</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">9</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">117</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">10</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">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">719</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">567</TD><TD class=alignRight headers="ar1 ar11 ac9 ac16">18</TD></TR><TR><TH id=ar12 class=bg-colour-yellow headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">13</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac5">6</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac6">1</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac7">6</TD><TD class=alignRight headers="ar1 ar12 ac1 ac8">10</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac11">26983</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac13">9289</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac14">1264</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac15">16430</TD><TD class=alignRight headers="ar1 ar12 ac9 ac16">4710</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
            (June 16 to June 29, 2013)
            </TH><TH id=bc8 colSpan=5>Cumulative
            (August 26, 2012 to June 29, 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">0</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">0</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">0</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">3005</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">223</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">838</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1944</TD><TD class=alignRight headers="br1 br2 bc8 bc14">852</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">3</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1631</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">71</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">613</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">947</TD><TD class=alignRight headers="br1 br3 bc8 bc14">1080</TD></TR><TR><TH id=br4 headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">2</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">1</TD><TD class=alignRight headers="br1 br4 bc1 bc7">0</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">3533</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">355</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">1219</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">1959</TD><TD class=alignRight headers="br1 br4 bc8 bc14">730</TD></TR><TR><TH id=br5 headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">5</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">3</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">2</TD><TD class=alignRight headers="br1 br5 bc1 bc7">0</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">3724</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">327</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">1219</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">2178</TD><TD class=alignRight headers="br1 br5 bc8 bc14">702</TD></TR><TR><TH id=br6 headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">3</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">1</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">2</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">0</TD><TD class=alignRight headers="br1 br6 bc1 bc7">0</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">9990</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">136</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">3711</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">6143</TD><TD class=alignRight headers="br1 br6 bc8 bc14">841</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">210</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">29</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">178</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">3</TD><TD class=alignRight headers="br1 br7 bc8 bc14">2</TD></TR><TR><TH id=br8 headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">10</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc4">1</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc5">6</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc6">3</TD><TD class=alignRight headers="br1 br8 bc1 bc7">3</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">22093</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc11">1141</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc12">7778</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc13">13174</TD><TD class=alignRight headers="br1 br8 bc8 bc14">4207</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 1453 influenza viruses. The 644 influenza A(H3N2) viruses were antigenically similar to the vaccine strain A/Victoria/361/2011 and the 243 A(H1N1)pdm09 viruses were antigenically similar to the vaccine strain A/California/07/09. Among the influenza B viruses, 439 were antigenically similar to the vaccine strain B/Wisconsin/01/2010 (Yamagata lineage) and 127 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 =1453

            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 1422 influenza viruses for resistance to oseltamivir, and 1419 influenza viruses for resistance to zanamivir. Among these, one A(H3N2) virus was resistant to oseltamivir and zanamivir, one A(H1N1)pdm09 virus was resistant to oseltamivir, and one influenza B virus was resistant to both oseltamivir and zanamivir. A total of 1312 influenza A viruses were tested for amantadine resistance and all but one A(H3N2) virus 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">639</TD><TD class=alignRight headers="cr2 cc3">1 (0.2%)</TD><TD class=alignRight headers="cr2 cc5">639</TD><TD class=alignRight headers="cr2 cc6">1 (0.2%)</TD><TD class=alignRight headers="cr2 cc8">1031</TD><TD class=alignRight headers="cr2 cc9">1030 (99.9%)</TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignRight headers="cr3 cc2">242</TD><TD class=alignRight headers="cr3 cc3">1 (0.4%)</TD><TD class=alignRight headers="cr3 cc5">239</TD><TD class=alignRight headers="cr3 cc6">0</TD><TD class=alignRight headers="cr3 cc8">281</TD><TD class=alignRight headers="cr3 cc9">281 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignRight headers="cr4 cc2">541</TD><TD class=alignRight headers="cr4 cc3">1 (0.2%)</TD><TD class=alignRight headers="cr4 cc5">541</TD><TD class=alignRight headers="cr4 cc6">1 (0.2%)</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">1422</TD><TD class=alignRight headers="cr5 cc3">3 (0.2%)</TD><TD class=alignRight headers="cr5 cc5">1419</TD><TD class=alignRight headers="cr5 cc6">2 (0.1%)</TD><TD class=alignRight headers="cr5 cc8">1312</TD><TD class=alignRight headers="cr5 cc9">1311 (99.9%)</TD></TR></TBODY></TABLE>
            Influenza-like Illness (ILI) Consultation Rate

            The national influenza-like-illness (ILI) consultation rate has been similar for the past twelve weeks, ranging from 14.3 to 24.4 ILI consultations per 1,000 patient visits, and was 19.3/1,000 in week 26. The rates observed in weeks 18 to 26 were above the expected range (Figure 7). The highest consultation rate was observed in children 5-19 years of age (30.1/1,000 visits) in week 25, and in children under 5 years of age (49.0/1,000 visits) in week 26.
            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 25, one laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalization of influenza B in a child 5-9 years of age was reported by the Immunization Monitoring Program Active (IMPACT) network. No cases were reported in week 26. No admissions to an intensive care unit (ICU) and no deaths were reported in weeks 25 and 26.

            Since the start of the 2012-13 season, a total of 883 influenza-associated paediatric hospitalizations have been reported by the IMPACT network: 623 (70.6%) with influenza A [of which 124 (19.9%) were A(H3N2), 27 (4.3%) were A(H1N1)pdm09 and the remaining 472 were A(unsubtyped); and 260 (29.4%) with influenza B. The distribution of cases by age group is as follows: 162 (18.3%) <6 months of age; 204 (23.1%) age 6-23 months; 252 (28.5%) age 2-4 years; 190 (21.5%) age 5-9 years; and 75 (8.5%) age 10-16 years. Of the 883 cases, 102 (11.6%) were admitted to the ICU. Of the 78 ICU admissions with available data, 65 (83.3%) cases had at least one underlying condition. One death has been reported to date this season in a child 6-23 months of age with an underlying condition, with influenza B.

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

            Adult Influenza Hospitalizations and Deaths (PCIRN)

            Active surveillance of laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network concluded for the 2012-13 influenza season on April 30th, 2013. However, the PCIRN-SOS network continues to report limited data on laboratory-confirmed cases of influenza identified through passive surveillance at 15 out of 17 hospital sites. In weeks 25 and 26, no hospitalizations, ICU admissions or deaths were reported.

            The cumulative data for the season to date includes data from active surveillance from November 4, 2012 to April 30, 2013 and data from passive surveillance since May 1, 2013. The cumulative number of cases is 1,809: 1,624 (89.8%) with influenza A [of which 312 were A(H3N2), 20 were A(H1N1)pdm09, and 1,292 were A(unsubtyped)]; 139 (7.7%) with influenza B, and the type has not been reported for 46 cases. The age distribution of hospitalizations is as follows: 1,230 (68.0%) were ≥65 years of age, 373 (20.6%) were 45-64 years, 194 (10.7%) were 20-44 years, and 12 (0.7%) were <20 years of age. ICU admission was required for 216 hospitalizations; the majority of which were adults ≥65 years of age (123; 56.9%). A total of 116 deaths have been reported: 26 with influenza A(H3N2), one with A(H1N1)pdm09, 82 with A(unsubtyped), 6 with influenza B, and one untyped. More than 85% of the deaths (99/116) were in adults ≥65 years of age, 14 (12.1%) were adults 45-64 years of age, and 3 (2.6%) were 20-44 years of age.

            Note: The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated 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 weeks 25 and 26, 11 laboratory-confirmed influenza-associated hospitalizations were reported from six of the eight participating provinces and territories<SUP>*</SUP>. The majority of cases were influenza A (63.6%). Four hospitalizations were adults ≥65 years of age, two 45-64 years of age, two 20-44 years of age, two 5-14 years of age and one child 0-4 years of age. There was one ICU admission reported among the four cases with available data: a case of influenza A(H3) in an adult ≥65 years of age. Two deaths were reported in adults ≥65 years of age: one case of influenza A(H3) and one case of influenza A(unsubtyped).

            To date this season, 5,053 influenza-associated hospitalizations have been reported, of which 86.4% have been influenza A. Of those subtyped (49.3%), influenza A(H3) was the predominant influenza strain. Age information was available for 5,050 cases, and the age distribution is as follows: 2,657 (52.6%) were ≥65 years of age; 838 (16.6%) were 45-64 years of age; 452 (9.0%) were 20-44 years of age; 41 (0.8%) were 15-19 years of age; 275 (5.4%) were 5-14 years; and 787 (15.6%) were 0-4 years of age. Of the 1,401 cases with available data, there have been 222 hospitalisations for which admission to an ICU was required; the highest proportions have been in adults ≥65 years of age, followed by adults 45-64 years of age (35.0% and 33.8%, respectively). To date, 314 deaths have been reported: 258 adults ≥65 years of age, 36 adults 45-64 years; 12 adults 20-44 years, one child 5-14 years of age, and seven 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


            • #36
              Re: Canada FluWatch Weekly Reports 2012-2013 Season Weeks 29-30

              FluWatch report: July 14 to 27, 2013 (Weeks 29 & 30)

              Posted 2013-08-02For 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/w30_13/pdf/fw2013-30-eng.pdf">FluWatch report: July 14 to 27, 2013 (Weeks 29 & 30) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 113 <ABBR title=Kilobytes>KB</ABBR> - 8 pages)

              »» Help with PDF documents

              Overall Summary
              • Influenza activity in Canada remained at inter-seasonal levels during this 2-week period.
              • Detections of rhinovirus declined. Detections of all other respiratory viruses were low. The percentage of laboratory tests positive for influenza was 0.2% in week 30.
              • The ILI consultation rate has been fairly stable over weeks 15 to 29, but decreased in week 30.
              Influenza Activity (geographic spread) and Outbreaks

              The number of regions reporting influenza activity was at inter-seasonal levels in weeks 29 and 30. No regions reported localized activity; in weeks 29 and 30, five and two regions reported sporadic activity, respectively (Figures 1 and 2). No new influenza outbreaks were reported in weeks 29 or 30 (Figure 3).
              Figure 1. Map of overall Influenza activity level by province and territory,
              Canada, Week 30






              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 overall percentage of positive influenza tests was low and stable, at 0.8% in week 29 and 0.2% in week 30. Among the 12 influenza viruses detected in weeks 29 and 30, nine were influenza A (Table 1). Cumulative influenza virus detections by type/subtype to date are as follows: 85.1% influenza A [34.8% A(H3), 4.7% A(H1N1)pdm09 and 60.5% A(unsubtyped)] and 14.9% influenza B (Table 1).
              Detailed information on laboratory detections of influenza was received for 26,324 cases to date this season. Data on age and type/subtype was complete for 26,112 cases (Table 2). The proportion of cases by age group is as follows: 14.8% <5 years; 10.4% between 5-19 years; 16.3% between 20-44 years; 17.0% between 45-64 years of age; 41.5% ≥65 years.
              The percentage of positive tests for rhinovirus decreased from its peak of 25.6% in week 26 to 19.4% in week 29 and to 11.0% in week 30. The percentage of positive tests for parainfluenza was stable at 4.5% in weeks 29 and 30. The percentages of positive tests for other respiratory viruses were low in week 30: human metapneumovirus (hMPV) (0.7%), respiratory syncytial virus (RSV) (0.8%), coronavirus (0.2%) and adenovirus (2.2%) (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
              (July 14 to July 27, 2013)</TH><TH id=ac9 colSpan=6>Cumulative
              (August 26, 2012 to July 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">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">0</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac11">1935</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac13">1473</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac14">221</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac15">241</TD><TD class=alignRight headers="ar1 ar2 ac9 ac16">407</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">0</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">0</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac7">0</TD><TD class=alignRight headers="ar1 ar3 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac11">2363</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac13">1771</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac14">448</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac15">144</TD><TD class=alignRight headers="ar1 ar3 ac9 ac16">843</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">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac7">1</TD><TD class=alignRight headers="ar1 ar4 ac1 ac8">1</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac11">843</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">74</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac15">293</TD><TD class=alignRight headers="ar1 ar4 ac9 ac16">325</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">0</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">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac8">1</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac11">660</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac13">79</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac14">10</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac15">571</TD><TD class=alignRight headers="ar1 ar5 ac9 ac16">115</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">3</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">2</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac7">1</TD><TD class=alignRight headers="ar1 ar6 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac11">8291</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac13">3793</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac14">385</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac15">4113</TD><TD class=alignRight headers="ar1 ar6 ac9 ac16">953</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">1</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">1</TD><TD class=alignRight headers="ar1 ar7 ac1 ac8">1</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac11">9821</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">36</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac15">9239</TD><TD class=alignRight headers="ar1 ar7 ac9 ac16">1940</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">0</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac11">1872</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">75</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac15">1026</TD><TD class=alignRight headers="ar1 ar8 ac9 ac16">102</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">0</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">0</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">9</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">117</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">10</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">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">718</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac13">240</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac14">2</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac15">476</TD><TD class=alignRight headers="ar1 ar11 ac9 ac16">20</TD></TR><TR><TH id=ar12 class=bg-colour-yellow headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">9</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac5">5</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac7">4</TD><TD class=alignRight headers="ar1 ar12 ac1 ac8">3</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac11">27008</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac13">9390</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac14">1269</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac15">16349</TD><TD class=alignRight headers="ar1 ar12 ac9 ac16">4715</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
              (July 14 to July 27, 2013)</TH><TH id=bc8 colSpan=5>Cumulative
              (August 26, 2012 to July 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">1</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">1</TD><TD class=alignRight headers="br1 br2 bc1 bc7">0</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">3007</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">224</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">838</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1945</TD><TD class=alignRight headers="br1 br2 bc8 bc14">853</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">0</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1632</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">71</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">613</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">948</TD><TD class=alignRight headers="br1 br3 bc8 bc14">1080</TD></TR><TR><TH id=br4 headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">0</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">0</TD><TD class=alignRight headers="br1 br4 bc1 bc7">0</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">3537</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">356</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">1223</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">1958</TD><TD class=alignRight headers="br1 br4 bc8 bc14">730</TD></TR><TR><TH id=br5 headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">3</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">2</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">1</TD><TD class=alignRight headers="br1 br5 bc1 bc7">0</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">3731</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">329</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">1223</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">2179</TD><TD class=alignRight headers="br1 br5 bc8 bc14">702</TD></TR><TR><TH id=br6 headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">2</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">1</TD><TD class=alignRight headers="br1 br6 bc1 bc7">1</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">9998</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">136</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">3716</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">6146</TD><TD class=alignRight headers="br1 br6 bc8 bc14">842</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">210</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">29</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">178</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">3</TD><TD class=alignRight headers="br1 br7 bc8 bc14">2</TD></TR><TR><TH id=br8 headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">6</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc5">3</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc6">3</TD><TD class=alignRight headers="br1 br8 bc1 bc7">1</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">22115</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc11">1145</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc12">7791</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc13">13179</TD><TD class=alignRight headers="br1 br8 bc8 bc14">4209</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 1499 influenza viruses. The 654 influenza A(H3N2) viruses were antigenically similar to the vaccine strain A/Victoria/361/2011 and the 245 A(H1N1)pdm09 viruses were antigenically similar to the vaccine strain A/California/07/09. Among the influenza B viruses, 462 were antigenically similar to the vaccine strain B/Wisconsin/01/2010 (Yamagata lineage) and 138 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 =1499

              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 1495 influenza viruses for resistance to oseltamivir, and 1492 influenza viruses for resistance to zanamivir. Among these, one A(H3N2) virus was resistant to oseltamivir and zanamivir, one A(H1N1)pdm09 virus was resistant to oseltamivir, and three influenza B virus samples were resistant to both oseltamivir and zanamivir. A total of 1334 influenza A viruses were tested for amantadine resistance and all but one A(H3N2) virus 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">648</TD><TD class=alignRight headers="cr2 cc3">1 (0.2%)</TD><TD class=alignRight headers="cr2 cc5">648</TD><TD class=alignRight headers="cr2 cc6">1 (0.2%)</TD><TD class=alignRight headers="cr2 cc8">1044</TD><TD class=alignRight headers="cr2 cc9">1043 (99.9%)</TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignRight headers="cr3 cc2">251</TD><TD class=alignRight headers="cr3 cc3">1 (0.4%)</TD><TD class=alignRight headers="cr3 cc5">248</TD><TD class=alignRight headers="cr3 cc6">0</TD><TD class=alignRight headers="cr3 cc8">290</TD><TD class=alignRight headers="cr3 cc9">290 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignRight headers="cr4 cc2">596</TD><TD class=alignRight headers="cr4 cc3">3 (0.5%)</TD><TD class=alignRight headers="cr4 cc5">596</TD><TD class=alignRight headers="cr4 cc6">3 (0.5%)</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">1495</TD><TD class=alignRight headers="cr5 cc3">5 (0.3%)</TD><TD class=alignRight headers="cr5 cc5">1492</TD><TD class=alignRight headers="cr5 cc6">4 (0.3%)</TD><TD class=alignRight headers="cr5 cc8">1334</TD><TD class=alignRight headers="cr5 cc9">1333 (99.9%)</TD></TR></TBODY></TABLE>
              Influenza-like Illness (ILI) Consultation Rate

              The national influenza-like-illness (ILI) consultation rate was similar between weeks 15 and 29, ranging from 13.9 to 24.6 ILI consultations per 1,000 patient visits, but the rate decreased to 10.0/1,000 in week 30. The rates observed in weeks 18 to 30 were above the expected range (Figure 7). The highest consultation rate was observed in children 5-19 years of age in both weeks 29 (28.7/1,000 visits) and 30 (20.0/1,000 visits).
              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 29, one laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalization was reported by the Immunization Monitoring Program Active (IMPACT) network, in a child <6 months of age with influenza A. No hospitalizations were reported in week 30. No intensive care unit (ICU) admissions or deaths were reported during weeks 29 and 30.

              Since the start of the 2012-13 season, a total of 885 influenza-associated paediatric hospitalizations have been reported by the IMPACT network: 623 (70.4%) with influenza A [of which 124 (19.9%) were A(H3N2), 29 (4.7 %) were A(H1N1)pdm09 and the remaining 470 were A(unsubtyped); and 262 (29.6%) with influenza B. The distribution of cases by age group is as follows: 164 (18.5%) <6 months of age; 203 (22.9%) age 6-23 months; 254 (28.7 %) age 2-4 years; 189 (21.4%) age 5-9 years; and 75 (8.5%) age 10-16 years. Of the 885 cases, 110 (12.4%) were admitted to the ICU. Of the 82 ICU admissions with available data, 68 (82.9%) cases had at least one underlying condition. One death has been reported to date this season in a child 6-23 months of age with an underlying condition, with influenza B.

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

              Adult Influenza Hospitalizations and Deaths (PCIRN)

              Active surveillance of laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network concluded for the 2012-13 influenza season on April 30th, 2013. However, the PCIRN-SOS network continues to report limited data on laboratory-confirmed cases of influenza identified through passive surveillance at 15 out of 17 hospital sites. No hospitalizations, ICU admissions or deaths were reported in week 29 or 30.

              The cumulative data for the season to date includes data from active surveillance from November 4, 2012 to April 30, 2013 and data from passive surveillance since May 1, 2013. The cumulative number of cases is 1,810: 1,625 (89.8%) with influenza A [of which 312 were A(H3N2), 21 were A(H1N1)pdm09, and 1,292 were A(unsubtyped)]; 139 (7.7%) with influenza B, and the type has not been reported for 46 cases. The age distribution of hospitalizations is as follows: 1,230 (68.0%) were ≥65 years of age, 373 (20.6%) were 45-64 years, 195 (10.7%) were 20-44 years, and 12 (0.7%) were <20 years of age. ICU admission was required for 216 hospitalizations; the majority of which were adults ≥65 years of age (123; 56.9%). A total of 116 deaths have been reported: 26 with influenza A(H3N2), one with A(H1N1)pdm09, 82 with A(unsubtyped), 6 with influenza B, and one untyped. More than 85% of the deaths (99/116) were in adults ≥65 years of age, 14 (12.1%) were adults 45-64 years of age, and 3 (2.6%) were 20-44 years of age.
              Note: The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated 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 weeks 29 and 30, one new laboratory-confirmed influenza-associated hospitalization was reported from participating provinces and territories*. To date this season, 5,074 influenza-associated hospitalizations have been reported, of which 86.3% have been influenza A. Of those subtyped (49.2%), influenza A(H3) was the predominant influenza strain. Age information was available for 5,071 cases, and the age distribution is as follows: 2,663 (52.5%) were ≥65 years of age; 843 (16.6%) were 45-64 years of age; 454 (9.0%) were 20-44 years of age; 41 (0.8%) were 15-19 years of age; 278 (5.5%) were 5-14 years; and 792 (15.6%) were 0-4 years of age. Of the 1,401 cases with available data, there have been 222 hospitalisations for which admission to an ICU was required; the highest proportions have been in adults ≥65 years of age, followed by adults 45-64 years of age (36.0% and 33.8%, respectively). To date, 317 deaths have been reported: 258 adults ≥65 years of age, 37 adults 45-64 years; 13 adults 20-44 years, two children 5-14 years of age, and seven 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


              • #37
                Re: Canada FluWatch Weekly Reports 2012-2013 Season Weeks 29-30

                FluWatch report: July 28 to August 10, 2013 (Weeks 31 & 32)

                Posted 2013-08-16For 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/w32_13/pdf/fw2013-32-eng.pdf">FluWatch report: July 28 to August 10, 2013 (Weeks 31 & 32) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 113 <ABBR title=Kilobytes>KB</ABBR> - 8 pages)

                »» Help with PDF documents

                Overall Summary
                • Influenza activity in Canada remained at inter-seasonal levels during this 2-week period.
                • The percentage of tests positive for rhinovirus increased, while those of all other respiratory viruses were low. The percentage of laboratory tests positive for influenza was 0.4% in week 32.
                • The ILI consultation rate was fairly stable, and above the expected range over weeks 18 to 31, and decreased in week 32.
                Influenza Activity (geographic spread) and Outbreaks

                The number of regions reporting influenza activity was at inter-seasonal levels in weeks 31 and 32. In weeks 31 and 32, one and two regions reported sporadic activity, respectively (Figure 1). No region has reported localized activity since week 26 (Figure 2). No new influenza outbreaks were reported in weeks 31 or 32 (Figure 3).
                Figure 1. Map of overall Influenza activity level by province and territory,
                Canada, Week 32






                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 overall percentage of positive influenza tests was low and stable, at 0.1% in week 31 and 0.4% in week 32. Among the five influenza viruses detected in weeks 31 and 32, all were influenza A (Table 1). Cumulative influenza virus detections by type/subtype to date are as follows: 85.1% influenza A [34.8% A(H3), 4.7% A(H1N1)pdm09 and 60.5% A(unsubtyped)] and 14.9% influenza B (Table 1).
                Detailed information on laboratory detections of influenza was received for 26,329 cases to date this season. Data on age and type/subtype was complete for 26,117 cases (Table 2). The proportion of cases by age group is as follows: 14.8% <5 years; 10.4% between 5-19 years; 16.3% between 20-44 years; 17.0% between 45-64 years of age; 41.5% ≥65 years.
                The percentage of positive tests for rhinovirus increased during this 2-week period from 15.2% in week 30 to 16.0% in week 31 and to 20.7% in week 32, although the number of positive tests was similar to previous weeks. The percentage of positive tests for parainfluenza has been stable at 4.5% for the past four weeks. The percentages of positive tests for other respiratory viruses were low in week 32: human metapneumovirus (hMPV) (0.4%), respiratory syncytial virus (RSV) (0.2%), coronavirus (0%) and adenovirus (1.8%) (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
                (July 28 to August 10, 2013)</TH><TH id=ac9 colSpan=6>Cumulative
                (August 26, 2012 to August 10, 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">1 </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">1 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac7">0 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac8">0 </TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac11">1936 </TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac12">0 </TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac13">1474 </TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac14">222 </TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac15">240 </TD><TD class=alignRight headers="ar1 ar2 ac9 ac16">407 </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">0 </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">0 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac7">0 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac8">0 </TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac11">2363 </TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac12">0 </TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac13">1771 </TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac14">448 </TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac15">144 </TD><TD class=alignRight headers="ar1 ar3 ac9 ac16">843 </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">0 </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">0 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac7">0 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac8">0 </TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac11">843 </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">74 </TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac15">293 </TD><TD class=alignRight headers="ar1 ar4 ac9 ac16">325 </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">0 </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">0 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac8">0 </TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac11">660 </TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac12">0 </TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac13">79 </TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac14">10 </TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac15">571 </TD><TD class=alignRight headers="ar1 ar5 ac9 ac16">115 </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">2 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">2 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac7">0 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac8">0 </TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac11">8293 </TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac12">0 </TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac13">3795 </TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac14">385 </TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac15">4113 </TD><TD class=alignRight headers="ar1 ar6 ac9 ac16">953 </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">2 </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">2 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac8">0 </TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac11">9823 </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">36 </TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac15">9241 </TD><TD class=alignRight headers="ar1 ar7 ac9 ac16">1940 </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">0 </TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac11">1872 </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">75 </TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac15">1026 </TD><TD class=alignRight headers="ar1 ar8 ac9 ac16">102 </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">0 </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">0 </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">9 </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">117 </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">10 </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">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">718 </TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac12">0 </TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac13">240 </TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac14">2 </TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac15">476 </TD><TD class=alignRight headers="ar1 ar11 ac9 ac16">20 </TD></TR><TR><TH id=ar12 class=bg-colour-yellow headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">5 </TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac5">2 </TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac6">1 </TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac7">2 </TD><TD class=alignRight headers="ar1 ar12 ac1 ac8">0 </TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac11">27013 </TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac12">0 </TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac13">9393 </TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac14">1270 </TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac15">16350 </TD><TD class=alignRight headers="ar1 ar12 ac9 ac16">4715 </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
                (July 28 to August 10, 2013)</TH><TH id=bc8 colSpan=5>Cumulative
                (August 26, 2012 to August 10, 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">0 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">0 </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">0 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">3007 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">224 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">838 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1945 </TD><TD class=alignRight headers="br1 br2 bc8 bc14">853 </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">0 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1632 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">71 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">613 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">948 </TD><TD class=alignRight headers="br1 br3 bc8 bc14">1080 </TD></TR><TR><TH id=br4 headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">1 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">0 </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">0 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">3538 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">356 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">1223 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">1959 </TD><TD class=alignRight headers="br1 br4 bc8 bc14">730 </TD></TR><TR><TH id=br5 headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">2 </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">1 </TD><TD class=alignRight headers="br1 br5 bc1 bc7">0 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">3733 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">330 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">1223 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">2180 </TD><TD class=alignRight headers="br1 br5 bc8 bc14">702 </TD></TR><TR><TH id=br6 headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">0 </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">0 </TD><TD class=alignRight headers="br1 br6 bc1 bc7">0 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">10000 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">136 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">3719 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">6145 </TD><TD class=alignRight headers="br1 br6 bc8 bc14">842 </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">210 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">29 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">178 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">3 </TD><TD class=alignRight headers="br1 br7 bc8 bc14">2 </TD></TR><TR><TH id=br8 headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">3 </TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc4">1 </TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc5">0 </TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc6">2 </TD><TD class=alignRight headers="br1 br8 bc1 bc7">0 </TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">22120 </TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc11">1146 </TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc12">7794 </TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc13">13180 </TD><TD class=alignRight headers="br1 br8 bc8 bc14">4209 </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 1507 influenza viruses. The 657 influenza A(H3N2) viruses were antigenically similar to the vaccine strain A/Victoria/361/2011 and the 248 A(H1N1)pdm09 viruses were antigenically similar to the vaccine strain A/California/07/09. Among the influenza B viruses, 464 were antigenically similar to the vaccine strain B/Wisconsin/01/2010 (Yamagata lineage) and 138 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 =1507

                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 1508 influenza viruses for resistance to oseltamivir, and 1505 influenza viruses for resistance to zanamivir. Among these, one A(H3N2) virus was resistant to oseltamivir and zanamivir, one A(H1N1)pdm09 virus was resistant to oseltamivir, and three influenza B virus samples were resistant to both oseltamivir and zanamivir. A total of 1341 influenza A viruses were tested for amantadine resistance and all but one A(H3N2) virus 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">653</TD><TD class=alignRight headers="cr2 cc3">1 (0.2%)</TD><TD class=alignRight headers="cr2 cc5">653</TD><TD class=alignRight headers="cr2 cc6">1 (0.2%)</TD><TD class=alignRight headers="cr2 cc8">1048</TD><TD class=alignRight headers="cr2 cc9">1047 (99.9%)</TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignRight headers="cr3 cc2">254</TD><TD class=alignRight headers="cr3 cc3">1 (0.4%)</TD><TD class=alignRight headers="cr3 cc5">251</TD><TD class=alignRight headers="cr3 cc6">0</TD><TD class=alignRight headers="cr3 cc8">293</TD><TD class=alignRight headers="cr3 cc9">293 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignRight headers="cr4 cc2">601</TD><TD class=alignRight headers="cr4 cc3">3 (0.5%)</TD><TD class=alignRight headers="cr4 cc5">601</TD><TD class=alignRight headers="cr4 cc6">3 (0.5%)</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">1508</TD><TD class=alignRight headers="cr5 cc3">5 (0.3%)</TD><TD class=alignRight headers="cr5 cc5">1505</TD><TD class=alignRight headers="cr5 cc6">4 (0.3%)</TD><TD class=alignRight headers="cr5 cc8">1341</TD><TD class=alignRight headers="cr5 cc9">1340 (99.9%)</TD></TR></TBODY></TABLE>
                Influenza-like Illness (ILI) Consultation Rate

                The national influenza-like-illness (ILI) consultation rate was similar between weeks 15 and 29, ranging from 13.9 to 24.6 ILI consultations per 1,000 patient visits. The rate increased from 10.0/1,000 in week 30 to 15.9/1,000 in week 31, but decreased to 8.5/1,000 in week 32. The rates observed in weeks 18 to 31 were above the expected range (Figure 7). The highest consultation rate was observed in children <5 years of age (39.7/1,000 visits) in week 31 and in children 5-19 years of age in week 32 (17.5/1,000 visits).
                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)

                No new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations, intensive care unit (ICU) admissions or deaths were reported by the Immunization Monitoring Program Active (IMPACT) network in weeks 31 and 32.

                Since the start of the 2012-13 season, a total of 886 influenza-associated paediatric hospitalizations have been reported by the IMPACT network: 623 (70.3%) with influenza A [of which 124 (19.9%) were A(H3N2), 29 (4.7 %) were A(H1N1)pdm09 and the remaining 470 were A(unsubtyped); and 263 (29.7%) with influenza B. The distribution of cases by age group is as follows: 165 (18.6%) <6 months of age; 203 (22.9%) age 6-23 months; 254 (28.7 %) age 2-4 years; 189 (21.3%) age 5-9 years; and 75 (8.5%) age 10-16 years. Of the 886 cases, 110 (12.4%) were admitted to the ICU. Of the 90 ICU admissions with available data, 74 (82.2%) cases had at least one underlying condition. One death has been reported to date this season in a child 6-23 months of age with an underlying condition, with influenza B.

                Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
                Adult Influenza Hospitalizations and Deaths (PCIRN)
                Active surveillance of laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network concluded for the 2012-13 influenza season on April 30th, 2013. However, the PCIRN-SOS network continues to report limited data on laboratory-confirmed cases of influenza identified through passive surveillance at 15 out of 17 hospital sites. Two hospitalizations were reported, one in each of weeks 31 and 32; both were cases of influenza A in patients 45-65 years of age. No ICU admissions or deaths were reported in weeks 31and 32.
                The cumulative data for the season to date includes data from active surveillance from November 4, 2012 to April 30, 2013 and data from passive surveillance since May 1, 2013. The cumulative number of cases is 1,812: 1,627 (89.8%) with influenza A [of which 313 were A(H3N2), 22 were A(H1N1)pdm09, and 1,292 were A(unsubtyped)]; 139 (7.7%) with influenza B, and the type has not been reported for 46 cases. The age distribution of hospitalizations is as follows: 1,230 (67.9%) were ≥65 years of age, 375 (20.7%) were 45-64 years, 195 (10.8%) were 20-44 years, and 12 (0.7%) were <20 years of age. ICU admission was required for 216 hospitalizations; the majority of which were adults ≥65 years of age (126; 58.3%). A total of 116 deaths have been reported: 26 with influenza A(H3N2), one with A(H1N1)pdm09, 82 with A(unsubtyped), 6 with influenza B, and one untyped. More than 85% of the deaths (99/116) were in adults ≥65 years of age, 14 (12.1%) were adults 45-64 years of age, and 3 (2.6%) were 20-44 years of age.

                Note: The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated 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 weeks 31 and 32, one new laboratory-confirmed influenza-associated hospitalization was reported from participating provinces and territories*, a case of influenza A in a child 1-4 years of age. To date this season, 5,075 influenza-associated hospitalizations have been reported, of which 86.3% have been influenza A. Of those subtyped (49.2%), influenza A(H3) was the predominant influenza strain. Age information was available for 5,072 cases, and the age distribution is as follows: 2,663 (52.5%) were ≥65 years of age; 843 (16.6%) were 45-64 years of age; 454 (9.0%) were 20-44 years of age; 41 (0.8%) were 15-19 years of age; 278 (5.5%) were 5-14 years; and 793 (15.6%) were 0-4 years of age. Of the 1,401 cases with available data, there have been 222 hospitalisations for which admission to an ICU was required; the highest proportions have been in adults ≥65 years of age, followed by adults 45-64 years of age (36.0% and 33.8%, respectively). To date, 317 deaths have been reported: 258 adults ≥65 years of age, 37 adults 45-64 years; 13 adults 20-44 years, two children 5-14 years of age, and seven 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


                • #38
                  Re: Canada FluWatch Weekly Reports 2012-2013 Season Weeks 31-32

                  FluWatch report: August 11 to August 24, 2013 (Weeks 33 & 34)

                  Posted 2013-08-30For 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/w34_13/pdf/fw2013-34-eng.pdf">FluWatch report: August 11 to August 24, 2013 (Weeks 33 & 34) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 289 <ABBR title=Kilobytes>KB</ABBR> - 8 pages)

                  »» Help with PDF documents

                  Overall Summary
                  • Influenza activity in Canada remained at inter-seasonal levels during this 2-week period.
                  • The percentage of laboratory tests positive for all respiratory viruses decreased in weeks 33 and 34, with the number of tests low and similar to previous weeks.
                  • The ILI consultation rate was stable in recent weeks with a gradual downward trend, although it was above the average range in weeks 33 and 34.
                  NOTE: This is the final report for the 2012-2013 influenza season. The next FluWatch report will be the first for the 2013-2014 influenza season. Bi-weekly reports will continue until October 11, 2013. Laboratory detections reported through the Respiratory Virus Detection Surveillance System and influenza activity level maps continue to be updated weekly on the FluWatch website.

                  Influenza Activity (geographic spread) and Outbreaks

                  The number of regions reporting influenza activity was at inter-seasonal levels in weeks 33 and 34. In weeks 33 and 34, four regions reported sporadic activity (Figure 1). Localized activity has not been reported since week 26 (Figure 2). No new influenza outbreaks were reported in weeks 33 or 34 (Figure 3).
                  Figure 1. Map of overall Influenza activity level by province and territory,
                  Canada, Week 34






                  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 overall percentage of positive influenza tests was low and stable, at 0.6% in week 33 and 0.3% in week 34. Among the nine influenza viruses detected in weeks 33 and 34, seven were influenza A (Table 1). Cumulative influenza virus detections by type/subtype to date are as follows: 85.1% influenza A [34.8% A(H3), 4.7% A(H1N1)pdm09 and 60.5% A(unsubtyped)] and 14.9% influenza B (Table 1).
                  Detailed information on age and type/subtype was complete for 26,123 cases (Table 2). The proportion of cases by age group is as follows: 14.8% <5 years; 10.4% between 5-19 years; 16.3% between 20-44 years; 17.0% between 45-64 years of age; 41.5% ≥65 years.
                  The percentage of positive tests for rhinovirus decreased during this 2-week period from 24.0% in week 32 to to 17.7% in week 34; although the number of positive tests was similar to previous weeks. The percentage of positive tests for parainfluenza declined slightly to 3.4% in week 34. The percentages of positive tests for other respiratory viruses were low in week 34: human metapneumovirus (hMPV) (0%), respiratory syncytial virus (RSV) (0.5%), coronavirus (0.6%) and adenovirus (2.1%) (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
                  (August 11 to August 24, 2013)</TH><TH id=ac9 colSpan=6>Cumulative
                  (August 26, 2012 to August 24, 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">2</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac7">0</TD><TD class=alignRight headers="ar1 ar2 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac11">1938</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac13">1476</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac14">222</TD><TD class=alignRight headers="ar1 ar2 ac9 ac10 ac15">240</TD><TD class=alignRight headers="ar1 ar2 ac9 ac16">407</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">0</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">0</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac7">0</TD><TD class=alignRight headers="ar1 ar3 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac11">2363</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac13">1771</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac14">448</TD><TD class=alignRight headers="ar1 ar3 ac9 ac10 ac15">144</TD><TD class=alignRight headers="ar1 ar3 ac9 ac16">843</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">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac7">1</TD><TD class=alignRight headers="ar1 ar4 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac11">844</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">74</TD><TD class=alignRight headers="ar1 ar4 ac9 ac10 ac15">294</TD><TD class=alignRight headers="ar1 ar4 ac9 ac16">325</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">0</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">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac8">0</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac11">660</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac13">79</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac14">10</TD><TD class=alignRight headers="ar1 ar5 ac9 ac10 ac15">571</TD><TD class=alignRight headers="ar1 ar5 ac9 ac16">115</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">4</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">4</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac7">0</TD><TD class=alignRight headers="ar1 ar6 ac1 ac8">1</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac11">8297</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac13">3795</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac14">389</TD><TD class=alignRight headers="ar1 ar6 ac9 ac10 ac15">4113</TD><TD class=alignRight headers="ar1 ar6 ac9 ac16">954</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">0</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">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac8">1</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac11">9823</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">36</TD><TD class=alignRight headers="ar1 ar7 ac9 ac10 ac15">9241</TD><TD class=alignRight headers="ar1 ar7 ac9 ac16">1941</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">0</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac11">1872</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">75</TD><TD class=alignRight headers="ar1 ar8 ac9 ac10 ac15">1026</TD><TD class=alignRight headers="ar1 ar8 ac9 ac16">102</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">0</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">0</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">9</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">117</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">10</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">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">718</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac13">240</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac14">2</TD><TD class=alignRight headers="ar1 ar11 ac9 ac10 ac15">476</TD><TD class=alignRight headers="ar1 ar11 ac9 ac16">20</TD></TR><TR><TH id=ar12 class=bg-colour-yellow headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">7</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac5">2</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac6">4</TD><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac7">1</TD><TD class=alignRight headers="ar1 ar12 ac1 ac8">2</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac11">27020</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac12">0</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac13">9395</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac14">1274</TD><TD class=alignRight headers="ar1 ar12 ac9 ac10 ac15">16351</TD><TD class=alignRight headers="ar1 ar12 ac9 ac16">4717</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
                  (August 11 to August 24, 2013)</TH><TH id=bc8 colSpan=5>Cumulative
                  (August 26, 2012 to August 24, 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">0</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">0</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">0</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">3007</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">224</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">838</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1945</TD><TD class=alignRight headers="br1 br2 bc8 bc14">853</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">0</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1632</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">71</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">613</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">948</TD><TD class=alignRight headers="br1 br3 bc8 bc14">1080</TD></TR><TR><TH id=br4 headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">0</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">0</TD><TD class=alignRight headers="br1 br4 bc1 bc7">1</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">3540</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">358</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">1223</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">1959</TD><TD class=alignRight headers="br1 br4 bc8 bc14">731</TD></TR><TR><TH id=br5 headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">1</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">0</TD><TD class=alignRight headers="br1 br5 bc1 bc7">0</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">3734</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">330</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">1224</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">2180</TD><TD class=alignRight headers="br1 br5 bc8 bc14">702</TD></TR><TR><TH id=br6 headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">1</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">1</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">0</TD><TD class=alignRight headers="br1 br6 bc1 bc7">0</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">10002</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">138</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">3719</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">6145</TD><TD class=alignRight headers="br1 br6 bc8 bc14">842</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">210</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">29</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">178</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">3</TD><TD class=alignRight headers="br1 br7 bc8 bc14">2</TD></TR><TR><TH id=br8 headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">2</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc4">1</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br8 bc1 bc2 bc6">0</TD><TD class=alignRight headers="br1 br8 bc1 bc7">1</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">22125</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc11">1150</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc12">7795</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc13">13180</TD><TD class=alignRight headers="br1 br8 bc8 bc14">4210</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 1514 influenza viruses. The 662 influenza A(H3N2) viruses were antigenically similar to the vaccine strain A/Victoria/361/2011 and the 250 A(H1N1)pdm09 viruses were antigenically similar to the vaccine strain A/California/07/09. Among the influenza B viruses, 464 were antigenically similar to the vaccine strain B/Wisconsin/01/2010 (Yamagata lineage) and 138 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 =1514

                  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 1508 influenza viruses for resistance to oseltamivir, and 1505 influenza viruses for resistance to zanamivir. Among these, one A(H3N2) virus was resistant to oseltamivir and zanamivir, one A(H1N1)pdm09 virus was resistant to oseltamivir, and three influenza B virus samples were resistant to both oseltamivir and zanamivir. A total of 1344 influenza A viruses were tested for amantadine resistance and all but one A(H3N2) virus 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">653</TD><TD class=alignRight headers="cr2 cc3">1 (0.2%)</TD><TD class=alignRight headers="cr2 cc5">653</TD><TD class=alignRight headers="cr2 cc6">1 (0.2%)</TD><TD class=alignRight headers="cr2 cc8">1049</TD><TD class=alignRight headers="cr2 cc9">1048 (99.9%)</TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignRight headers="cr3 cc2">254</TD><TD class=alignRight headers="cr3 cc3">1 (0.4%)</TD><TD class=alignRight headers="cr3 cc5">251</TD><TD class=alignRight headers="cr3 cc6">0</TD><TD class=alignRight headers="cr3 cc8">295</TD><TD class=alignRight headers="cr3 cc9">295 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignRight headers="cr4 cc2">601</TD><TD class=alignRight headers="cr4 cc3">3 (0.5%)</TD><TD class=alignRight headers="cr4 cc5">601</TD><TD class=alignRight headers="cr4 cc6">3 (0.5%)</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">1508</TD><TD class=alignRight headers="cr5 cc3">5 (0.3%)</TD><TD class=alignRight headers="cr5 cc5">1505</TD><TD class=alignRight headers="cr5 cc6">4 (0.3%)</TD><TD class=alignRight headers="cr5 cc8">1344</TD><TD class=alignRight headers="cr5 cc9">1343 (99.9%)</TD></TR></TBODY></TABLE>
                  Influenza-like Illness (ILI) Consultation Rate

                  The national influenza-like-illness (ILI) consultation rate was similar between weeks 15 and 29, with an average of 16.2 ILI consultations per 1,000 patient visits (range 13.9 to 24.6). The rate continued a gradual downward trend in weeks 30-34, with an average of 12.3/1,000; and was 14.5/1,000 in week 34. The majority of weekly rates observed in weeks 18 to 34 were above the average range (Figure 7). The highest consultation rate was observed in children <5 years of age (41.7/1,000 visits) in week 33 and in children 5-19 years of age in week 34 (30.6/1,000 visits).
                  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)

                  One new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalization was reported in week 34, a child <6 months of age with influenza A. No intensive care unit (ICU) admissions or deaths were reported by the Immunization Monitoring Program Active (IMPACT) network in weeks 33 and 34.

                  Since the start of the 2012-13 season, a total of 888 influenza-associated paediatric hospitalizations have been reported by the IMPACT network: 625 (70.4%) with influenza A [of which 124 (19.8%) were A(H3N2), 31 (5.0 %) were A(H1N1)pdm09 and the remaining 470 were A(unsubtyped); and 263 (29.6%) with influenza B. The distribution of cases by age group is as follows: 168 (18.9%) <6 months of age; 202 (22.7%) age 6-23 months; 254 (28.6 %) age 2-4 years; 189 (21.3%) age 5-9 years; and 75 (8.4%) age 10-16 years. Of the 888 cases, 110 (12.4%) were admitted to the ICU. Of the 92 ICU admissions with available data, 76 (82.6%) cases had at least one underlying condition. One death has been reported to date this season in a child 6-23 months of age with an underlying condition, with influenza B.

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

                  Adult Influenza Hospitalizations and Deaths (PCIRN)

                  Active surveillance of laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network concluded for the 2012-13 influenza season on April 30th, 2013. However, the PCIRN-SOS network continues to report limited data on laboratory-confirmed cases of influenza identified through passive surveillance at 15 out of 17 hospital sites. No new hospitalizations, ICU admissions or deaths were reported in weeks 33 and 34.

                  The cumulative data for the season to date includes data from active surveillance from November 4, 2012 to April 30, 2013 and data from passive surveillance since May 1, 2013. The cumulative number of cases is 1,812: 1,627 (89.8%) with influenza A [of which 313 were A(H3N2), 22 were A(H1N1)pdm09, and 1,292 were A(unsubtyped)]; 139 (7.7%) with influenza B, and the type has not been reported for 46 cases. The age distribution of hospitalizations is as follows: 1,230 (67.9%) were ≥65 years of age, 375 (20.7%) were 45-64 years, 195 (10.8%) were 20-44 years, and 12 (0.7%) were <20 years of age. ICU admission was required for 216 hospitalizations; the majority of which were adults ≥65 years of age (126; 58.3%). A total of 116 deaths have been reported: 26 with influenza A(H3N2), one with A(H1N1)pdm09, 82 with A(unsubtyped), 6 with influenza B, and one untyped. More than 85% of the deaths (99/116) were in adults ≥65 years of age, 14 (12.1%) were adults 45-64 years of age, and 3 (2.6%) were 20-44 years of age.

                  Note: The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated 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 weeks 33 and 34, two new laboratory-confirmed influenza-associated hospitalization was reported from participating provinces and territories*, both cases of influenza A in adults ≥65 years of age. To date this season, 5,077 influenza-associated hospitalizations have been reported, of which 86.3% have been influenza A. Of those subtyped (49.3%), influenza A(H3) was the predominant influenza strain. Age information was available for 5,074 cases, and the age distribution is as follows: 2,665 (52.5%) were ≥65 years of age; 843 (16.6%) were 45-64 years of age; 454 (8.9%) were 20-44 years of age; 41 (0.8%) were 15-19 years of age; 278 (5.5%) were 5-14 years; and 793 (15.6%) were 0-4 years of age. Of the 1,401 cases with available data, there have been 222 hospitalisations for which admission to an ICU was required; the highest proportions have been in adults ≥65 years of age, followed by adults 45-64 years of age (36.0% and 33.8%, respectively). To date, 317 deaths have been reported: 258 adults ≥65 years of age, 37 adults 45-64 years; 13 adults 20-44 years, two children 5-14 years of age, and seven 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.

                  .../
                  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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