Announcement

Collapse
No announcement yet.

Canada FluWatch Weekly Reports 2013-2014 Season Weeks 33 and 34

Collapse
This is a sticky topic.
X
X
  • Filter
  • Time
  • Show
Clear All
new posts

  • #16
    Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 1

    FluWatch report: December 29, 2013 to January 4, 2014 (Week 01)

    Posted 2014-01-10For 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/13-14/w01_14/pdf/fw2014-01-eng.pdf">FluWatch report: December 29, 2013 to January 4, 2014 (Week 01) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 291 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

    »» Help with PDF documents


    Overall Summary
    • Influenza activity in Canada continued to increase in week 01 with increases in laboratory detections of influenza, ILI consultations, hospitalizations with influenza and prescriptions for influenza antivirals. A(H1N1)pdm09 remains the predominant virus subtype this season.
    • A greater proportion of cases have been reported among adults 20-64 years of age compared to those ≥65 years of age, which is a change from the demographics of the 2012-13 season when A(H3N2) was predominant.
    • A fatal case of A(H5N1) was reported in Alberta on 8 January 2014 in a patient with a travel history to China. Close contacts have shown no signs of infection and continue to be monitored. The risk to Canadians of transmission of A(H5N1) from this case is very low.
    Influenza/ILI Activity (geographic spread)

    In week 01, two regions in Alberta continued to report widespread activity, and 12 regions (in AB(1), SK(1), MB(1) ON(4), QC(3), NS(1) and NT(1)) reported localized activity (Figure 1).
    Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 01





    Note: Influenza/ILI 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 and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
    Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
    Influenza and Other Respiratory Virus Detections

    The number of positive influenza tests continued to increase, from 1,201 in week 52 to 2,308 in week 01, bringing the percentage of positive influenza tests to 28.4% (Figure 2). Cumulative influenza virus detections to date have been predominantly influenza A (95%). Among subtyped influenza A viruses, 96% (3,035/3,164) were A(H1N1)pdm09 (Table 1). Detailed information on age and type/subtype has been received for 3,842 cases to date this season. A significantly greater proportion of laboratory detections of influenza have been reported in adults 20-64 years of age compared to those ≥65 years of age this season compared to the 2012-13 season (Table 2). This is expected given the predominance of A(H1N1)pdm09 this season compared to 2012-13 when A(H3N2) was the dominant circulating subtype.
    Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14

    Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
    In week 01, the number of positive tests for RSV continued to increase, and RSV remained the second most frequently detected virus, after influenza. The number of positive tests for coronavirus and human metapneumovirus increased, while detections of rhinovirus and parainfluenza were stable in week 01, compared to week 52 (Figure 3).
    For more details, see the weekly Respiratory Virus Detections in Canada Report.
    Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2013-14


    Top of Page

    RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
    Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
    <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly and cumulative numbers of positive influenza specimens
    by type, subtype and province, Canada, 2013-14
    </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=ac1 colSpan=5>Weekly
    (December 29, 2013 to January 4, 2014)
    </TH><TH id=ac8 colSpan=5>Cumulative
    (August 25, 2013 to January 4, 2014)
    </TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=4 headers=ac1>Influenza A</TH><TH id=ac7 headers=ac1>B</TH><TH id=ac9 colSpan=4 headers=ac8>Influenza A</TH><TH id=ac14 headers=ac8>B</TH></TR><TR class=bg-colour-grey-light><TH id=ac3 headers="ac1 ac2">A Total</TH><TH id=ac4 class=lightred headers="ac1 ac2">A(H1)pdm09</TH><TH id=ac5 class=lightred headers="ac1 ac2">A(H3)</TH><TH id=ac6 class=lightred headers="ac1 ac2">A(UnS)</TH><TH class=alignCenter headers="ac1 ac7">B Total</TH><TH id=ac10 headers="ac8 ac9">A Total</TH><TH id=ac11 class=lightred headers="ac8 ac9">A(H1)pdm09</TH><TH id=ac12 class=lightred headers="ac8 ac9">A(H3)</TH><TH id=ac13 class=lightred headers="ac8 ac9">A(UnS)</TH><TD class=alignCenter headers="ac8 ac14">B Total</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
    <SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
    UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
    </TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=alignLeft headers=ar1>BC</TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">207</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">85</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">122</TD><TD class=alignRight headers="ar1 ar2 ac1 ac7">4</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac10">415</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac11">274</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac12">12</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac13">129</TD><TD class=alignRight headers="ar1 ar2 ac8 ac14">15</TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">630</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">502</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">2</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">126</TD><TD class=alignRight headers="ar1 ar3 ac1 ac7">0</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac10">1503</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac11">1348</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac12">14</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac13">141</TD><TD class=alignRight headers="ar1 ar3 ac8 ac14">21</TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">198</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">138</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">60</TD><TD class=alignRight headers="ar1 ar4 ac1 ac7">0</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac10">365</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac11">230</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac13">135</TD><TD class=alignRight headers="ar1 ar4 ac8 ac14">0</TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">29</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">16</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">13</TD><TD class=alignRight headers="ar1 ar5 ac1 ac7">0</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac10">57</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac11">37</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac13">20</TD><TD class=alignRight headers="ar1 ar5 ac8 ac14">6</TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">676</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">300</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">17</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">359</TD><TD class=alignRight headers="ar1 ar6 ac1 ac7">10</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac10">1702</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac11">1033</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac12">100</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac13">569</TD><TD class=alignRight headers="ar1 ar6 ac8 ac14">37</TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">426</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">58</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">368</TD><TD class=alignRight headers="ar1 ar7 ac1 ac7">65</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac10">793</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac11">91</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac12">1</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac13">701</TD><TD class=alignRight headers="ar1 ar7 ac8 ac14">167</TD></TR><TR><TH id=ar8 class=alignLeft headers=ar1>NB</TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">29</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac4">4</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac6">25</TD><TD class=alignRight headers="ar1 ar8 ac1 ac7">0</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac10">41</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac11">5</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac12">1</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac13">35</TD><TD class=alignRight headers="ar1 ar8 ac8 ac14">0</TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">9</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">9</TD><TD class=alignRight headers="ar1 ar9 ac1 ac7">0</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac10">17</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac11">2</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac12">1</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac13">14</TD><TD class=alignRight headers="ar1 ar9 ac8 ac14">0</TD></TR><TR><TH id=ar10 class=alignLeft headers=ar1>PE</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 ac7">0</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac10">1</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac11">1</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac13">0</TD><TD class=alignRight headers="ar1 ar10 ac8 ac14">0</TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">23</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">23</TD><TD class=alignRight headers="ar1 ar11 ac1 ac7">2</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac10">38</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac11">14</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac13">24</TD><TD class=alignRight headers="ar1 ar11 ac8 ac14">6</TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">2227</TD><TD class="lightred alignRight" headers="ar1 ar12 ac1 ac2 ac4">1103</TD><TD class="lightred alignRight" headers="ar1 ar12 ac1 ac2 ac5">19</TD><TD class="lightred alignRight" headers="ar1 ar12 ac1 ac2 ac6">1105</TD><TD class=alignRight headers="ar1 ar12 ac1 ac7">81</TD><TD class=alignRight headers="ar1 ar12 ac8 ac9 ac10">4932</TD><TD class="lightred alignRight" headers="ar1 ar12 ac8 ac9 ac11">3035</TD><TD class="lightred alignRight" headers="ar1 ar12 ac8 ac9 ac12">129</TD><TD class="lightred alignRight" headers="ar1 ar12 ac8 ac9 ac13">1768</TD><TD class=alignRight headers="ar1 ar12 ac8 ac14">252</TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="ar1 ar13 ac1 ac2 ac3">96.5%</TD><TD class="lightred alignRight" headers="ar1 ar13 ac1 ac2 ac4">49.5%</TD><TD class="lightred alignRight" headers="ar1 ar13 ac1 ac2 ac5">0.9%</TD><TD class="lightred alignRight" headers="ar1 ar13 ac1 ac2 ac6">49.6%</TD><TD class=alignRight headers="ar1 ar13 ac1 ac7">3.5%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac9 ac10">95.1%</TD><TD class="lightred alignRight" headers="ar1 ar13 ac8 ac9 ac11">61.5%</TD><TD class="lightred alignRight" headers="ar1 ar13 ac8 ac9 ac12">2.6%</TD><TD class="lightred alignRight" headers="ar1 ar13 ac8 ac9 ac13">35.8%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac14">4.9%</TD></TR></TBODY></TABLE>

    <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups (years)</TH><TH id=bc1 colSpan=5>Weekly
    (December 29, 2013 to January 4, 2014)
    </TH><TH id=bc8 colSpan=7>Cumulative
    (August 25, 2013 to January 4, 2014)
    </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><TH id=bc15 colSpan=2 headers=bc8>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=bc3 headers="bc1 bc2">A Total</TH><TH id=bc4 class="lightred " headers="bc1 bc2">A(H1) pdm09</TH><TH id=bc5 class="lightred " headers="bc1 bc2">A(H3)</TH><TH id=bc6 class="lightred " headers="bc1 bc2">A (UnS)</TH><TD class=alignCenter headers="bc1 bc7">Total</TD><TH id=bc10 headers="bc8 bc9">A Total</TH><TH id=bc11 class="lightred " headers="bc8 bc9">A(H1) pdm09</TH><TH id=bc12 class="lightred " headers="bc8 bc9">A(H3)</TH><TH id=bc13 class="lightred " headers="bc8 bc9">A (UnS)</TH><TD class=alignCenter headers="bc8 bc14">Total</TD><TH id=bc16 headers="bc8 bc15">#</TH><TH id=bc17 headers="bc8 bc15">%</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13><SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
    <SUP>3 </SUP>Table 2 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
    UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
    </TD></TR></TFOOT><TBODY><TR><TH id=br2 class=alignLeft headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">120</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">49</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">71</TD><TD class=alignRight headers="br1 br2 bc1 bc7">3</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">625</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">356</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">15</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">254</TD><TD class=alignRight headers="br1 br2 bc8 bc14">42</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc16">667</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc17">17.2%</TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">25</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">11</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">14</TD><TD class=alignRight headers="br1 br3 bc1 bc7">4</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">281</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">195</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">6</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">80</TD><TD class=alignRight headers="br1 br3 bc8 bc14">43</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc16">324</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc17">8.4%</TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">240</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">102</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">138</TD><TD class=alignRight headers="br1 br4 bc1 bc7">11</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">1161</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">716</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">11</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">434</TD><TD class=alignRight headers="br1 br4 bc8 bc14">51</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc16">1212</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc17">31.3%</TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">206</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">70</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">136</TD><TD class=alignRight headers="br1 br5 bc1 bc7">21</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">968</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">558</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">16</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">394</TD><TD class=alignRight headers="br1 br5 bc8 bc14">77</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc16">1045</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc17">27.0%</TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">119</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">37</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">81</TD><TD class=alignRight headers="br1 br6 bc1 bc7">22</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">480</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">221</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">24</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">235</TD><TD class=alignRight headers="br1 br6 bc8 bc14">114</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc16">594</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc17">15.4%</TD></TR><TR><TH id=br7 class=alignLeft headers=br1>Unknown</TH><TD class=alignRight headers="br1 br7 bc1 bc2 bc3">1</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">1</TD><TD class=alignRight headers="br1 br7 bc1 bc7">0</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc10">26</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">16</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">4</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">6</TD><TD class=alignRight headers="br1 br7 bc8 bc14">0</TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc16">26</TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc17">0.7%</TD></TR><TR><TH id=br8 class=alignLeft headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">711</TD><TD class="lightred alignRight" headers="br1 br8 bc1 bc2 bc4">269</TD><TD class="lightred alignRight" headers="br1 br8 bc1 bc2 bc5">1</TD><TD class="lightred alignRight" headers="br1 br8 bc1 bc2 bc6">441</TD><TD class=alignRight headers="br1 br8 bc1 bc7">61</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">3541</TD><TD class="lightred alignRight" headers="br1 br8 bc8 bc9 bc11">2062</TD><TD class="lightred alignRight" headers="br1 br8 bc8 bc9 bc12">76</TD><TD class="lightred alignRight" headers="br1 br8 bc8 bc9 bc13">1403</TD><TD class=alignRight headers="br1 br8 bc8 bc14">327</TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc16">3868</TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc17">100.0%</TD></TR><TR><TH id=br9 class=alignLeft headers=br1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="br1 br9 bc1 bc2 bc3">92.1%</TD><TD class="lightred alignRight" headers="br1 br9 bc1 bc2 bc4">37.8%</TD><TD class="lightred alignRight" headers="br1 br9 bc1 bc2 bc5">0.1%</TD><TD class="lightred alignRight" headers="br1 br9 bc1 bc2 bc6">62.0%</TD><TD class=alignRight headers="br1 br9 bc1 bc7">7.9%</TD><TD class=alignRight headers="br1 br9 bc8 bc9 bc10">91.5%</TD><TD class="lightred alignRight" headers="br1 br9 bc8 bc9 bc11">58.2%</TD><TD class="lightred alignRight" headers="br1 br9 bc8 bc9 bc12">2.1%</TD><TD class="lightred alignRight" headers="br1 br9 bc8 bc9 bc13">39.6%</TD><TD class=alignRight headers="br1 br9 bc8 bc14">8.5%</TD><TD class=alignRight></TD><TD class=alignRight></TD></TR></TBODY></TABLE>

    Top of Page

    Influenza Strain Characterizations

    During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 234 influenza viruses [22 A(H3N2), 179 A(H1N1)pdm09 and 33 influenza B]. The vast majority (97.9%) of viruses were similar to the strains recommended by the WHO for the 2013-14 seasonal influenza vaccine. Two A(H1N1)pdm09 viruses showed reduced titres to antiserum against the reference A/California/07/2009 strain. Five influenza B viruses were similar to the strain recommended by the WHO for the 2011-12 vaccine (Figure 4).
    Figure 4. Influenza strain characterizations, Canada, 2013-14, N = 234

    The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
    The recommended components for the 2013-2014 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009 (H1N1)pdm09-like virus, an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b (e.g. A/Texas/50/2012), and a B/Massachusetts/2/2012-like virus (Yamagata lineage).


    Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
    Antiviral Resistance

    During the 2013-2014 influenza season, NML has tested 197 influenza viruses for resistance to oseltamivir and for resistance to zanamivir, and all were sensitive. All 166 influenza A viruses tested for amantadine resistance 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, 2013-2014</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 lightred" headers=cr1>A (H3N2)</TH><TD class=alignRight headers="cr1 cr2 cc1 cc2">23 </TD><TD class=alignRight headers="cr1 cr2 cc1 cc3">0 </TD><TD class=alignRight headers="cr1 cr2 cc4 cc5">23 </TD><TD class=alignRight headers="cr1 cr2 cc4 cc6">0 </TD><TD class=alignRight headers="cr1 cr2 cc7 cc8">29 </TD><TD class=alignRight headers="cr1 cr2 cc7 cc9">29 (100%) </TD></TR><TR><TH id=cr3 class="alignLeft lightred" headers=cr1>A (H1N1)</TH><TD class=alignRight headers="cr1 cr3 cc1 cc2">143 </TD><TD class=alignRight headers="cr1 cr3 cc1 cc3">0 </TD><TD class=alignRight headers="cr1 cr3 cc4 cc5">143 </TD><TD class=alignRight headers="cr1 cr3 cc4 cc6">0 </TD><TD class=alignRight headers="cr1 cr3 cc7 cc8">137 </TD><TD class=alignRight headers="cr1 cr3 cc7 cc9">137 (100%) </TD></TR><TR><TH id=cr4 class="alignLeft lightred" headers=cr1>B</TH><TD class=alignRight headers="cr1 cr4 cc1 cc2">31 </TD><TD class=alignRight headers="cr1 cr4 cc1 cc3">0 </TD><TD class=alignRight headers="cr1 cr4 cc4 cc5">31 </TD><TD class=alignRight headers="cr1 cr4 cc4 cc6">0 </TD><TD class=alignRight headers="cr1 cr4 cc7 cc8">NA <SUP>*</SUP></TD><TD class=alignRight headers="cr1 cr4 cc7 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft lightred" headers=cr1>TOTAL</TH><TD class=alignRight headers="cr1 cr5 cc1 cc2">197 </TD><TD class=alignRight headers="cr1 cr5 cc1 cc3">0 </TD><TD class=alignRight headers="cr1 cr5 cc4 cc5">197 </TD><TD class=alignRight headers="cr1 cr5 cc4 cc6">0 </TD><TD class=alignRight headers="cr1 cr5 cc7 cc8">166 </TD><TD class=alignRight headers="cr1 cr5 cc7 cc9">166 (100%) </TD></TR></TBODY></TABLE>
    Influenza-like Illness (ILI) Consultation Rate

    The national influenza-like-illness (ILI) consultation rate increased from 36.2/1,000 in week 52 to 48.5/1,000 in week 01, but is still within the expected range for this time of year (Figure 5).
    Figure 5. Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

    Note: No data available for mean rate for weeks 19 to 39 for the 1996-1997 through 2002-2003 seasons. Delays in the reporting of data may cause data to change retrospectively. The calculation of the average ILI consultation rate over 17 seasons was aligned with influenza activity in each season. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. The number of sentinel physicians in each province or territory is as follows: BC(21), AB(80), SK(11), MB(18), ON(169), QC(14), NB(29), NS(26), PE(4), NL(16), NU(1), NT(14), YT(13). Not all sentinel physicians report every week.
    Text equivalent for figure 5Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

    Top of Page

    Influenza Outbreak Surveillance

    In week 01, nine new influenza outbreaks were reported: eight in long-term care facilities and one in a hospital (Figure 6).
    Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2013-2014

    1 All provinces and territories except NU report outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
    Text equivalent for figure 6 Overall number of new influenza outbreaks by report week, Canada, 2013-2014
    Pharmacy Surveillance

    The rate of prescriptions for influenza antivirals followed a trend consistent with laboratory detections of influenza this season, compared with the two previous seasons. The largest proportions of prescriptions for antivirals are among adults 19-64 years of age and children 2-18 years of age. This is in keeping with the age-distribution observed among laboratory detections and hospitalizations during the season to date (Figure 7).
    Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

    Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group. Age-groups: Infant: 0-2y, Child: 2-18y; Adult: 19-64y, Senior: ≥65y.
    Text equivalent for figure 7Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

    Top of Page

    Sentinel Hospital Influenza Surveillance

    Paediatric Influenza Hospitalizations and Deaths (IMPACT)
    In week 01, 40 new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 53 in week 52. All 40 hospitalizations in week 01 were cases with influenza A; 30% of these were A(H1N1)pdm09 and the remainder were A(unsubtyped) (Figure 8a). All but three of the cases were <5 years of age: of these, 13 (32.5%) were under 6 months of age, 9 (22.5%) 6-23 months of age, and 15 (37.5%) 2-4 years of age. Six ICU admissions were reported in week 01, two children 6-23 months of age, one 2-4 years of age, and three 5-9 years of age; all with influenza A. No deaths were reported.
    To date this season, a total of 183 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 93% of which have been influenza A, and the majority of those subtyped were A(H1N1)pdm09 (Table 4). Eighty-five (46.4%) cases have been children under 2 years of age, and 143 (78.1%) have been under 5 years of age. Twenty-four ICU admissions have been reported; all but two cases with influenza A, and the majority A(H1N1)pdm09. The age-distribution is as follows: two children under 6 months of age, nine children 6-23 months of age, six 2-4 years of age, two 5-9 years of age, and five 10-16 years of age (Figure 9a). Among the 22 ICU cases with available data, 16 were reported to have comorbidities or concurrent infection. No deaths have been reported.

    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)
    The number of new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations reported through active* surveillance by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network increased from 63 in week 52 to 89 in week 01. Among cases in week 01, 86 (96.6%) were influenza A, of which 19 (22.1%) were A(H1N1)pdm09 and 67 (77.9%) were A(unsubtyped). The highest proportion of hospitalizations occurred among adults ≥65 years of age (36; 40.4%), followed by adults aged 45-64 years (31; 34.8%). Nineteen ICU admissions were reported in week 01: five (26.3%) cases 20-44 years of age, and eight (36.8%) cases in each of the age-groups 45-64 years and ≥65 years of age. One death was reported, in an adult ≥65 years of age with influenza A(unsubtyped) (Figure 8b).

    To date this season, 270 influenza-associated hospitalizations have been reported by the PCIRN-SOS network, 261 (96.7%) with influenza A, predominantly A(H1N1)pdm09. The majority (71%) have been adults over 45 years of age (Table 5). ICU admission was required for 48 hospitalizations: 47 of which were cases of influenza A (25 A(H1N1)pdm09 and 22 A(unsubtyped)); 34 (70.8%) of the ICU admissions were >45 years of age. Of the 18 cases with information on influenza vaccination, 14 reported not having been vaccinated this season. One death has been reported, a case ≥65 years of age with A(unsubtyped) (Figure 9b).

    Note: PCIRN-SOS conducted passive surveillance from April 30th to November 14th, 2013. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance began November 15th during which time PCIRN site coordinators investigate cases potentially related to influenza. Data from both active and passive surveillance reported during the 2013-14 season are included in this report. 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.
    <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=dr1 rowSpan=3>Age groups </TH><TH id=dc1 colSpan=6>Cumulative (Aug. 25, 2013 to January 4, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=dc2 colSpan=4 headers=dc1>Influenza A </TH><TH id=dc7 headers=dc1>B </TH><TH id=dc8 headers=dc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=dc3 headers="dc1 dc2">A Total </TH><TH id=dc4 class="lightred " headers="dc1 dc2">A(H1) pdm09 </TH><TH id=dc5 class="lightred " headers="dc1 dc2">A(H3) </TH><TH id=dc6 class="lightred " headers="dc1 dc2">A (UnS) </TH><TD class=alignCenter headers="dc1 dc7">Total</TD><TD class=alignCenter headers="dc1 dc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
    UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
    </TD></TR></TFOOT><TBODY><TR><TH id=dr2 class=alignLeft headers=dr1>0-5m </TH><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc3">37 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc4">10 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc5">0 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc6">27 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc7">1 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc8">38 (21%) </TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc3">46 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc4">23 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc5">0 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc6">23 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc7">1 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc8">47 (26%) </TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc3">53 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc4">20 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc5">1 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc6">32 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc7">5 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc8">58 (32%) </TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc3">22 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc4">10 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc5">0 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc6">12 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc7">3 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc8">25 (14%) </TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc3">13 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc4">7 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc5">0 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc6">6 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc7">2 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc8">15 (8%) </TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignRight headers="dr1 dr7 dc1 dc2 dc3">171 </TD><TD class="lightred alignRight" headers="dr1 dr7 dc1 dc2 dc4">70 </TD><TD class="lightred alignRight" headers="dr1 dr7 dc1 dc2 dc5">1 </TD><TD class="lightred alignRight" headers="dr1 dr7 dc1 dc2 dc6">100 </TD><TD class=alignRight headers="dr1 dr7 dc1 dc7">12 </TD><TD class=alignRight headers="dr1 dr7 dc1 dc8">183 </TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP> </TH><TD class=alignRight headers="dr1 dr8 dc1 dc2 dc3">93.4% </TD><TD class="lightred alignRight" headers="dr1 dr8 dc1 dc2 dc4">40.9% </TD><TD class="lightred alignRight" headers="dr1 dr8 dc1 dc2 dc5">0.6% </TD><TD class="lightred alignRight" headers="dr1 dr8 dc1 dc2 dc6">58.5% </TD><TD class=alignRight headers="dr1 dr8 dc1 dc7">6.6% </TD><TD class=alignRight headers="dr1 dr8 dc1 dc8">100.0% </TD></TR></TBODY></TABLE>
    <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 5 - Cumulative numbers of adult hospitalizations with influenza
    reported by the PCIRN-SOS network, Canada, 2013-14
    </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=er1 rowSpan=3>Age groups </TH><TH id=ec1 class=noWrap colSpan=6>Cumulative (Aug. 25, 2013 to January 4, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=ec2 colSpan=4 headers=ec1>Influenza A </TH><TH id=ec7 headers=ec1>B </TH><TH id=ec8 headers=ec1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=ec3 headers="ec1 ec2">A Total </TH><TH id=ec4 class="lightred " headers="ec1 ec2">A(H1) pdm09 </TH><TH id=ec5 class="lightred " headers="ec1 ec2">A(H3) </TH><TH id=ec6 class="lightred " headers="ec1 ec2">A(UnS) </TH><TD class=alignCenter headers="ec1 ec7">Total</TD><TD class=alignCenter headers="ec1 ec8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
    UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
    </TD></TR></TFOOT><TBODY><TR><TH id=er2 class=alignLeft headers=er1>16-20 </TH><TD class=alignRight headers="er1 er2 ec1 ec2 ec3">5 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec4">2 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec5">0 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec6">3 </TD><TD class=alignRight headers="er1 er2 ec1 ec7">0 </TD><TD class=alignRight headers="er1 er2 ec1 ec8">5 (2%) </TD></TR><TR><TH id=er3 class=alignLeft headers=er1>20-44 </TH><TD class=alignRight headers="er1 er3 ec1 ec2 ec3">73 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec4">23 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec5">1 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec6">49 </TD><TD class=alignRight headers="er1 er3 ec1 ec7">0 </TD><TD class=alignRight headers="er1 er3 ec1 ec8">73 (27%) </TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignRight headers="er1 er4 ec1 ec2 ec3">100 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec4">32 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec5">1 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec6">67 </TD><TD class=alignRight headers="er1 er4 ec1 ec7">4 </TD><TD class=alignRight headers="er1 er4 ec1 ec8">104 (39%) </TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignRight headers="er1 er5 ec1 ec2 ec3">83 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec4">34 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec5">4 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec6">45 </TD><TD class=alignRight headers="er1 er5 ec1 ec7">4 </TD><TD class=alignRight headers="er1 er5 ec1 ec8">87 (32%) </TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignRight headers="er1 er6 ec1 ec2 ec3">261 </TD><TD class="lightred alignRight" headers="er1 er6 ec1 ec2 ec4">91 </TD><TD class="lightred alignRight" headers="er1 er6 ec1 ec2 ec5">6 </TD><TD class="lightred alignRight" headers="er1 er6 ec1 ec2 ec6">164 </TD><TD class=alignRight headers="er1 er6 ec1 ec7">8 </TD><TD class=alignRight headers="er1 er6 ec1 ec8">269 </TD></TR><TR><TH id=er7 class=alignLeft headers=er1>%<SUP>1</SUP> </TH><TD class=alignRight headers="er1 er7 ec1 ec2 ec3">97% </TD><TD class="lightred alignRight" headers="er1 er7 ec1 ec2 ec4">35% </TD><TD class="lightred alignRight" headers="er1 er7 ec1 ec2 ec5">2% </TD><TD class="lightred alignRight" headers="er1 er7 ec1 ec2 ec6">63% </TD><TD class=alignRight headers="er1 er7 ec1 ec7">3% </TD><TD class=alignRight headers="er1 er7 ec1 ec8">100% </TD></TR></TBODY></TABLE>
    Figure 8. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14
    A) Paediatric hospitalizations (≤16 years of age, IMPACT)


    Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
    B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)

    * See footnote above following the section related to PCIRN-SOS data.
    Text equivalent for figure 8bNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Adult hospitalizations (>16 year of age, PCIRN-SOS)
    Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14
    A) Paediatric hospitalizations (≤16 years of age, IMPACT)

    Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
    B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)

    Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Adult hospitalizations (≥16 year of age, PCIRN-SOS)

    Top of Page

    Provincial/Territorial Influenza Hospitalizations and Deaths

    In week 01, 236 new laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories.* The majority were cases of influenza A (97%), of which 102 (44.5%) were A(H1N1)pdm09, five were A(H3N2), and 122 were A(unsubtyped). There were 13 ICU admissions in week 01, all with influenza A. More than three quarters of the ICU admissions were among adults 20-64 years of age. Twelve deaths were reported in adults 20 years of age and older, all with influenza A. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total.
    To date this season, 882 influenza-associated hospitalizations have been reported, of which 97.2% had influenza A (Table 6). The largest proportion of hospitalizations has been among cases 45-64 years of age (33%). To date, a significantly greater proportion of adult cases (≥20 years of age) have been 20-64 years of age this season compared to the 2012-13 season which is consistent with the predominant circulation of A(H1N1)pdm09 this season. One hundred and eighteen ICU admissions have been reported this season, all cases of influenza A; and 77% were among adults aged 20-64 years. Thirty-three deaths have been reported, and all but one were cases of influenza A. The highest proportion of deaths has been among adults 20-64 years of age (64%), followed by adults ≥65 years of age (27%). It is important to note that the hospitalization or 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: 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 distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks.

    <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=fr1 rowSpan=3>Age groups </TH><TH id=fc1 colSpan=6>Cumulative (Aug. 25, 2013 to January 4, 2014)* </TH></TR><TR class=bg-colour-yellow><TH id=fc2 colSpan=4 headers=fc1>Influenza A </TH><TH id=fc7 headers=fc1>B </TH><TH id=fc8 headers=fc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=fc3 headers="fc1 fc2">A Total </TH><TH id=fc4 class=lightred headers="fc1 fc2">A(H1) pdm09 </TH><TH id=fc5 class=lightred headers="fc1 fc2">A(H3) </TH><TH id=fc6 class=lightred headers="fc1 fc2">A (UnS) </TH><TD class=alignCenter headers="fc1 fc7">Total</TD><TD class=alignCenter headers="fc1 fc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=8><SUP>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
    UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
    * Two cases for which age information is not available have not been included in Table 6.
    </TD></TR></TFOOT><TBODY><TR><TH id=fr2 class=alignLeft headers=fr1>0-4 years </TH><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc3">167 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc4">94 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc5">4 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc6">69 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc7">12 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc8">179 (20%) </TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years </TH><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc3">45 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc4">25 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc5">1 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc6">19 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc7">3 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc8">48 (5%) </TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years </TH><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc3">13 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc4">7 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc5">0 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc6">6 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc7">0 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc8">13 (1%) </TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc3">165 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc4">104 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc5">1 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc6">60 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc7">0 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc8">165 (19%) </TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc3">289 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc4">177 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc5">9 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc6">103 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc7">1 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc8">290 (33%) </TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc3">176 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc4">110 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc5">12 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc6">54 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc7">9 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc8">185 (21%) </TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignRight headers="fr1 fr8 fc1 fc2 fc3">855 </TD><TD class="lightred alignRight" headers="fr1 fr8 fc1 fc2 fc4">517 </TD><TD class="lightred alignRight" headers="fr1 fr8 fc1 fc2 fc5">27 </TD><TD class="lightred alignRight" headers="fr1 fr8 fc1 fc2 fc6">311 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc7">25 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc8">880 </TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP> </TH><TD class=alignRight headers="fr1 fr9 fc1 fc2 fc3">97.2% </TD><TD class="lightred alignRight" headers="fr1 fr9 fc1 fc2 fc4">60.5% </TD><TD class="lightred alignRight" headers="fr1 fr9 fc1 fc2 fc5">3.2% </TD><TD class="lightred alignRight" headers="fr1 fr9 fc1 fc2 fc6">36.4% </TD><TD class=alignRight headers="fr1 fr9 fc1 fc7">2.8% </TD><TD class=alignRight headers="fr1 fr9 fc1 fc8">100% </TD></TR></TBODY></TABLE>

    .../
    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


    • #17
      Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 2

      FluWatch report: January 5 to January 11, 2014 (Week 02)

      Posted 2014-01-17For 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/13-14/w02_14/pdf/fw2014-02-eng.pdf">FluWatch report: January 5 to January 11, 2014 (Week 02) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 291 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

      »» Help with PDF documents


      Overall Summary
      • Influenza activity in Canada continued to increase in week 02, with most indicators following a similar trend to the 2012-13 season but lagging by 2-3 weeks. However, over 90% of laboratory detections this season have been A(H1N1)pdm09 compared to 10% in 2012-13.
      • Surveillance of laboratory detections, hospitalizations with influenza and prescriptions for influenza antivirals all show a greater proportion of cases among adults 20-64 years of age compared to those ≥65 years of age, which is a change from the demographics of the 2012-13 season.
      • At this point, it is too early in the season to predict the total number of cases that may be seen, or when flu season will peak.
      Influenza/ILI Activity (geographic spread)

      In week 02, three regions in Alberta and one in Quebec reported widespread activity, and 13 regions (in ON(7), QC(2), NS(1), NB(1) and NT(2)) reported localized activity (Figure 1).
      Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 02





      Note: Influenza/ILI 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 and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
      Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
      Influenza and Other Respiratory Virus Detections

      The number of positive influenza tests continued to increase, from 2,304 in week 01 to 3,403 in week 02. However, due to an increase in the number of tests performed, the percentage of positive influenza tests was stable at 28.7% (Figure 2). Cumulative influenza virus detections to date have been predominantly influenza A (96%). Among subtyped influenza A viruses, 97% (5,215/5,386) were A(H1N1)pdm09 (Table 1). Detailed information on age and type/subtype has been received for 7,467 cases to date this season. A significantly greater proportion of laboratory detections of influenza have been reported in adults 20-64 years of age compared to those ≥65 years of age this season compared to the 2012-13 season (Table 2). This is expected given the predominance of A(H1N1)pdm09 this season compared to 2012-13 when A(H3N2) was the dominant circulating subtype.
      Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14

      Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
      In week 02, the number of positive tests for RSV decreased very slightly. RSV in Canada shows a seasonal pattern with a broad peak over the winter months. The number of positive tests for coronavirus and human metapneumovirus increased, while detections of rhinovirus and parainfluenza were stable compared to the previous week (Figure 3).
      For more details, see the weekly Respiratory Virus Detections in Canada Report.
      Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2013-14


      Top of Page

      RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
      Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
      <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly and cumulative numbers of positive influenza specimens
      by type, subtype and province, Canada, 2013-14
      </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=ac1 colSpan=5>Weekly
      (January 5, 2013 to January 11, 2014)
      </TH><TH id=ac8 colSpan=5>Cumulative
      (August 25, 2013 to January 11, 2014)
      </TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=4 headers=ac1>Influenza A</TH><TH id=ac7 headers=ac1>B</TH><TH id=ac9 colSpan=4 headers=ac8>Influenza A</TH><TH id=ac14 headers=ac8>B</TH></TR><TR class=bg-colour-grey-light><TH id=ac3 headers="ac1 ac2">A Total</TH><TH id=ac4 class=lightred headers="ac1 ac2">A(H1)pdm09</TH><TH id=ac5 class=lightred headers="ac1 ac2">A(H3)</TH><TH id=ac6 class=lightred headers="ac1 ac2">A(UnS)</TH><TH class=alignCenter headers="ac1 ac7">B Total</TH><TH id=ac10 headers="ac8 ac9">A Total</TH><TH id=ac11 class=lightred headers="ac8 ac9">A(H1)pdm09</TH><TH id=ac12 class=lightred headers="ac8 ac9">A(H3)</TH><TH id=ac13 class=lightred headers="ac8 ac9">A(UnS)</TH><TD class=alignCenter headers="ac8 ac14">B Total</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
      <SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
      UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
      </TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=alignLeft headers=ar1>BC</TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">463 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">405 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">11 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">47 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac7">6 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac10">887 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac11">779 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac12">26 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac13">82 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac14">21 </TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">800 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">684 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">5 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">111 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac7">4 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac10">2332 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac11">2169 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac12">20 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac13">143 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac14">25 </TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">360 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">254 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">106 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac7">1 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac10">725 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac11">484 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac12">0 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac13">241 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac14">1 </TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">63 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">62 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">1 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac7">3 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac10">120 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac11">99 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac12">0 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac13">21 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac14">9 </TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">859 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">269 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">15 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">575 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac7">19 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac10">2590 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac11">1319 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac12">121 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac13">1150 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac14">56 </TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">607 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">67 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">540 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac7">91 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac10">1410 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac11">158 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac12">1 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac13">1251 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac14">259 </TD></TR><TR><TH id=ar8 class=alignLeft headers=ar1>NB</TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">194 </TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac4">139 </TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac6">55 </TD><TD class=alignRight headers="ar1 ar8 ac1 ac7">1 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac10">235 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac11">144 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac12">1 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac13">90 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac14">1 </TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">13 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">10 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">1 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">2 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac7">0 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac10">30 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac11">12 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac12">2 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac13">16 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac14">0 </TD></TR><TR><TH id=ar10 class=alignLeft headers=ar1>PE</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 ac7">0 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac10">1 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac11">1 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac12">0 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac13">0 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac14">0 </TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">44 </TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac4">15 </TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac6">29 </TD><TD class=alignRight headers="ar1 ar11 ac1 ac7">20 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac10">82 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac11">50 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac12">0 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac13">32 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac14">26 </TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">3403 </TD><TD class="lightred alignRight" headers="ar1 ar12 ac1 ac2 ac4">1905 </TD><TD class="lightred alignRight" headers="ar1 ar12 ac1 ac2 ac5">32 </TD><TD class="lightred alignRight" headers="ar1 ar12 ac1 ac2 ac6">1466 </TD><TD class=alignRight headers="ar1 ar12 ac1 ac7">145 </TD><TD class=alignRight headers="ar1 ar12 ac8 ac9 ac10">8412 </TD><TD class="lightred alignRight" headers="ar1 ar12 ac8 ac9 ac11">5215 </TD><TD class="lightred alignRight" headers="ar1 ar12 ac8 ac9 ac12">171 </TD><TD class="lightred alignRight" headers="ar1 ar12 ac8 ac9 ac13">3026 </TD><TD class=alignRight headers="ar1 ar12 ac8 ac14">398 </TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="ar1 ar13 ac1 ac2 ac3">95.9% </TD><TD class="lightred alignRight" headers="ar1 ar13 ac1 ac2 ac4">56.0% </TD><TD class="lightred alignRight" headers="ar1 ar13 ac1 ac2 ac5">0.9% </TD><TD class="lightred alignRight" headers="ar1 ar13 ac1 ac2 ac6">43.1% </TD><TD class=alignRight headers="ar1 ar13 ac1 ac7">4.1% </TD><TD class=alignRight headers="ar1 ar13 ac8 ac9 ac10">95.5% </TD><TD class="lightred alignRight" headers="ar1 ar13 ac8 ac9 ac11">62.0% </TD><TD class="lightred alignRight" headers="ar1 ar13 ac8 ac9 ac12">2.0% </TD><TD class="lightred alignRight" headers="ar1 ar13 ac8 ac9 ac13">36.0% </TD><TD class=alignRight headers="ar1 ar13 ac8 ac14">4.5% </TD></TR></TBODY></TABLE>

      <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups (years)</TH><TH id=bc1 colSpan=5>Weekly
      (January 5 to January 11, 2014)
      </TH><TH id=bc8 colSpan=7>Cumulative
      (August 25, 2013 to January 11, 2014)
      </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><TH id=bc15 colSpan=2 headers=bc8>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=bc3 headers="bc1 bc2">A Total</TH><TH id=bc4 class="lightred " headers="bc1 bc2">A(H1) pdm09</TH><TH id=bc5 class="lightred " headers="bc1 bc2">A(H3)</TH><TH id=bc6 class="lightred " headers="bc1 bc2">A (UnS)</TH><TD class=alignCenter headers="bc1 bc7">Total</TD><TH id=bc10 headers="bc8 bc9">A Total</TH><TH id=bc11 class="lightred " headers="bc8 bc9">A(H1) pdm09</TH><TH id=bc12 class="lightred " headers="bc8 bc9">A(H3)</TH><TH id=bc13 class="lightred " headers="bc8 bc9">A (UnS)</TH><TD class=alignCenter headers="bc8 bc14">Total</TD><TH id=bc16 headers="bc8 bc15">#</TH><TH id=bc17 headers="bc8 bc15">%</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13><SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
      <SUP>3 </SUP>Table 2 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
      UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
      </TD></TR></TFOOT><TBODY><TR><TH id=br2 class=alignLeft headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">244 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">104 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">1 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">139 </TD><TD class=alignRight headers="br1 br2 bc1 bc7">2 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">1132 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">616 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">16 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">500 </TD><TD class=alignRight headers="br1 br2 bc8 bc14">53 </TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc16">1185 </TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc17">15.8% </TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">104 </TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">56 </TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">0 </TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">48 </TD><TD class=alignRight headers="br1 br3 bc1 bc7">3 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">488 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">319 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">10 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">159 </TD><TD class=alignRight headers="br1 br3 bc8 bc14">51 </TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc16">539 </TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc17">7.2% </TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">589 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">314 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">1 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">274 </TD><TD class=alignRight headers="br1 br4 bc1 bc7">22 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">2336 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">1393 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">16 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">927 </TD><TD class=alignRight headers="br1 br4 bc8 bc14">92 </TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc16">2428 </TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc17">32.3% </TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">507 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">252 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">4 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">251 </TD><TD class=alignRight headers="br1 br5 bc1 bc7">25 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">1978 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">1150 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">22 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">806 </TD><TD class=alignRight headers="br1 br5 bc8 bc14">134 </TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc16">2112 </TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc17">28.1% </TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">247 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">87 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">7 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">153 </TD><TD class=alignRight headers="br1 br6 bc1 bc7">38 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">1019 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">470 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">36 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">513 </TD><TD class=alignRight headers="br1 br6 bc8 bc14">184 </TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc16">1203 </TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc17">16.0% </TD></TR><TR><TH id=br7 class=alignLeft headers=br1>Unknown</TH><TD class=alignRight headers="br1 br7 bc1 bc2 bc3">14 </TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc4">13 </TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc5">0 </TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc6">1 </TD><TD class=alignRight headers="br1 br7 bc1 bc7">0 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc10">52 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">40 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">4 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">8 </TD><TD class=alignRight headers="br1 br7 bc8 bc14">0 </TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc16">52 </TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc17">0.7% </TD></TR><TR><TH id=br8 class=alignLeft headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">1,705 </TD><TD class="lightred alignRight" headers="br1 br8 bc1 bc2 bc4">826 </TD><TD class="lightred alignRight" headers="br1 br8 bc1 bc2 bc5">13 </TD><TD class="lightred alignRight" headers="br1 br8 bc1 bc2 bc6">866 </TD><TD class=alignRight headers="br1 br8 bc1 bc7">90 </TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">7005 </TD><TD class="lightred alignRight" headers="br1 br8 bc8 bc9 bc11">3988 </TD><TD class="lightred alignRight" headers="br1 br8 bc8 bc9 bc12">104 </TD><TD class="lightred alignRight" headers="br1 br8 bc8 bc9 bc13">2913 </TD><TD class=alignRight headers="br1 br8 bc8 bc14">514 </TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc16">7519 </TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc17">100.0% </TD></TR><TR><TH id=br9 class=alignLeft headers=br1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="br1 br9 bc1 bc2 bc3">95.0% </TD><TD class="lightred alignRight" headers="br1 br9 bc1 bc2 bc4">48.4% </TD><TD class="lightred alignRight" headers="br1 br9 bc1 bc2 bc5">0.8% </TD><TD class="lightred alignRight" headers="br1 br9 bc1 bc2 bc6">50.8% </TD><TD class=alignRight headers="br1 br9 bc1 bc7">5.0% </TD><TD class=alignRight headers="br1 br9 bc8 bc9 bc10">93.2% </TD><TD class="lightred alignRight" headers="br1 br9 bc8 bc9 bc11">56.9% </TD><TD class="lightred alignRight" headers="br1 br9 bc8 bc9 bc12">1.5% </TD><TD class="lightred alignRight" headers="br1 br9 bc8 bc9 bc13">41.6% </TD><TD class=alignRight headers="br1 br9 bc8 bc14">6.8% </TD><TD class=alignRight></TD><TD class=alignRight></TD></TR></TBODY></TABLE>

      Top of Page

      Influenza Strain Characterizations

      During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 303 influenza viruses [24 A(H3N2), 243 A(H1N1)pdm09 and 36 influenza B]. The vast majority (98.3%) of viruses were similar to the strains recommended by the WHO for the 2013-14 seasonal influenza vaccine. Two A(H1N1)pdm09 viruses showed reduced titres to antiserum against the reference A/California/07/2009 strain. Five influenza B viruses were similar to the strain recommended by the WHO for the 2011-12 vaccine (Figure 4).
      Figure 4. Influenza strain characterizations, Canada, 2013-14, N = 303

      The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
      The recommended components for the 2013-2014 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009 (H1N1)pdm09-like virus, an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b (e.g. A/Texas/50/2012), and a B/Massachusetts/2/2012-like virus (Yamagata lineage).


      Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
      Antiviral Resistance

      During the 2013-2014 influenza season, NML has tested 257 influenza viruses for resistance to oseltamivir and 255 viruses for resistance to zanamivir, and all were sensitive. All 167 influenza A viruses tested for amantadine resistance 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, 2013-2014</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 lightred" headers=cr1>A (H3N2)</TH><TD class=alignRight headers="cr1 cr2 cc1 cc2">23 </TD><TD class=alignRight headers="cr1 cr2 cc1 cc3">0 </TD><TD class=alignRight headers="cr1 cr2 cc4 cc5">23 </TD><TD class=alignRight headers="cr1 cr2 cc4 cc6">0 </TD><TD class=alignRight headers="cr1 cr2 cc7 cc8">29 </TD><TD class=alignRight headers="cr1 cr2 cc7 cc9">29 (100%) </TD></TR><TR><TH id=cr3 class="alignLeft lightred" headers=cr1>A (H1N1)</TH><TD class=alignRight headers="cr1 cr3 cc1 cc2">201 </TD><TD class=alignRight headers="cr1 cr3 cc1 cc3">0 </TD><TD class=alignRight headers="cr1 cr3 cc4 cc5">199 </TD><TD class=alignRight headers="cr1 cr3 cc4 cc6">0 </TD><TD class=alignRight headers="cr1 cr3 cc7 cc8">138 </TD><TD class=alignRight headers="cr1 cr3 cc7 cc9">138 (100%) </TD></TR><TR><TH id=cr4 class="alignLeft lightred" headers=cr1>B</TH><TD class=alignRight headers="cr1 cr4 cc1 cc2">33 </TD><TD class=alignRight headers="cr1 cr4 cc1 cc3">0 </TD><TD class=alignRight headers="cr1 cr4 cc4 cc5">33 </TD><TD class=alignRight headers="cr1 cr4 cc4 cc6">0 </TD><TD class=alignRight headers="cr1 cr4 cc7 cc8">NA <SUP>*</SUP></TD><TD class=alignRight headers="cr1 cr4 cc7 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft lightred" headers=cr1>TOTAL</TH><TD class=alignRight headers="cr1 cr5 cc1 cc2">257 </TD><TD class=alignRight headers="cr1 cr5 cc1 cc3">0 </TD><TD class=alignRight headers="cr1 cr5 cc4 cc5">255 </TD><TD class=alignRight headers="cr1 cr5 cc4 cc6">0 </TD><TD class=alignRight headers="cr1 cr5 cc7 cc8">167 </TD><TD class=alignRight headers="cr1 cr5 cc7 cc9">167 (100%) </TD></TR></TBODY></TABLE>
      Influenza-like Illness (ILI) Consultation Rate

      The national influenza-like-illness (ILI) consultation rate increased slightly from 48.8/1,000 in week 01 to 50.3 in week 02, which is above the expected range for week 02 but in keeping with the trend at this time of year (Figure 5).
      Figure 5. Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

      Note: No data available for mean rate for weeks 19 to 39 for the 1996-1997 through 2002-2003 seasons. Delays in the reporting of data may cause data to change retrospectively. The calculation of the average ILI consultation rate over 17 seasons was aligned with influenza activity in each season. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. The number of sentinel physicians in each province or territory is as follows: BC(21), AB(80), SK(11), MB(18), ON(169), QC(14), NB(29), NS(26), PE(4), NL(16), NU(1), NT(14), YT(13). Not all sentinel physicians report every week.
      Text equivalent for figure 5Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

      Top of Page

      Influenza Outbreak Surveillance

      In week 02, eight new influenza outbreaks were reported: five in long-term care facilities and three in hospitals (Figure 6). In addition, six outbreaks of influenza-like-illness were reported in week 02: one in a school and five in other facilities or communities.
      Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2013-2014

      1 All provinces and territories except NU report outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
      Text equivalent for figure 6 Overall number of new influenza outbreaks by report week, Canada, 2013-2014
      Pharmacy Surveillance

      The rate of prescriptions for influenza antivirals continues to follow a trend consistent with the timing and demographics of laboratory detections of influenza this season. The largest proportions of prescriptions for antivirals are among adults 19-64 years of age and children 2-18 years of age (Figure 7).
      Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

      Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group. Age-groups: Infant: 0-2y, Child: 2-18y; Adult: 19-64y, Senior: ≥65y.
      Text equivalent for figure 7Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

      Top of Page

      Sentinel Hospital Influenza Surveillance

      Paediatric Influenza Hospitalizations and Deaths (IMPACT)
      In week 02, 47 new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 43 in week 01. All 47 hospitalizations in week 02 were cases with influenza A; 23% of these were A(H1N1)pdm09 and the remainder were A(unsubtyped) (Figure 8a). All but seven of the cases were <5 years of age. Three ICU admissions were reported in week 02, one child under 6 months of age, one child 6-23 months of age, and one 5-9 years of age; all with influenza A. No deaths were reported.
      To date this season, a total of 235 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 95% of which have been influenza A, and the majority of those subtyped were A(H1N1)pdm09 (Table 4). One hundred and eighty-eight cases have been under 5 years of age. Thirty ICU admissions have been reported; all but two cases with influenza A, and the majority A(H1N1)pdm09. The highest proportion of ICU admissions have been among children aged 6-23 months (33.3%) (Figure 9a). Among the 25 ICU cases with available data, 20 were reported to have comorbidities or concurrent infection. No deaths have been reported.
      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)
      In week 02, 82 new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations reported through active surveillance by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 129 in week 01. Among cases in week 02, 77 (93.9%) were influenza A, of which 22 (28.6%) were A(H1N1)pdm09 and 55 (71.4%) were A(unsubtyped). The highest proportion of hospitalizations occurred among adults 45-64 years (36; 43.9%) followed by adults aged ≥65 years of age (29; 35.4%). Seven ICU admissions were reported in week 02: one case 20-44 years of age, and six cases 45-64 years of age. One death was reported in an adult ≥65 years of age with influenza A(H1N1)pdm09 (Figure 8b).
      To date this season, 399 influenza-associated hospitalizations have been reported by the PCIRN-SOS network, 384 (96.2%) with influenza A, predominantly A(H1N1)pdm09. The majority (74.2%) have been adults over 45 years of age (Table 5). As observed in other surveillance indicators, a significantly greater proportion of cases have been under 65 years of age this season compared to the 2012-13 season. ICU admission was required for 61 hospitalizations: 59 of which were cases of influenza A (37 A(H1N1)pdm09 and 22 A(unsubtyped)); 46 (75.4%) of the ICU admissions were >45 years of age. A greater proportion of cases reported this season have been admitted to the ICU compared to the 2012-13 season. Of the 24 ICU admissions with information on influenza vaccination, 17 reported not having been vaccinated this season. Five deaths have been reported: two cases ≥65 years of age with A(H1N1)pdm09, one case ≥65 years of age with A(unsubtyped), one case 45-64 years of age with influenza A(unsubtyped), and one case 20-44 years of age with influenza A(H1N1)pdm09 (Figure 9b).
      Note: PCIRN-SOS conducted passive surveillance from April 30th to November 14th, 2013. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance began November 15th during which time PCIRN site coordinators investigate cases potentially related to influenza. Data from both active and passive surveillance reported during the 2013-14 season are included in this report. 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.
      <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t4 class=alignCenter>Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=dr1 rowSpan=3>Age groups </TH><TH id=dc1 colSpan=6>Cumulative (Aug. 25, 2013 to January11, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=dc2 colSpan=4 headers=dc1>Influenza A </TH><TH id=dc7 headers=dc1>B </TH><TH id=dc8 headers=dc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=dc3 headers="dc1 dc2">A Total </TH><TH id=dc4 class="lightred " headers="dc1 dc2">A(H1) pdm09 </TH><TH id=dc5 class="lightred " headers="dc1 dc2">A(H3) </TH><TH id=dc6 class="lightred " headers="dc1 dc2">A (UnS) </TH><TD class=alignCenter headers="dc1 dc7">Total</TD><TD class=alignCenter headers="dc1 dc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
      UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
      </TD></TR></TFOOT><TBODY><TR><TH id=dr2 class=alignLeft headers=dr1>0-5m </TH><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc3">49 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc4">13 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc5">0 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc6">36 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc7">1 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc8">50 (21%) </TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc3">59 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc4">26 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc5">0 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc6">33 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc7">2 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc8">61 (26%) </TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc3">72 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc4">27 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc5">1 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc6">44 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc7">5 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc8">77 (33%) </TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc3">26 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc4">10 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc5">0 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc6">16 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc7">3 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc8">29 (12%) </TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc3">16 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc4">7 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc5">0 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc6">9 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc7">2 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc8">18 (8%) </TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignRight headers="dr1 dr7 dc1 dc2 dc3">222 </TD><TD class="lightred alignRight" headers="dr1 dr7 dc1 dc2 dc4">83 </TD><TD class="lightred alignRight" headers="dr1 dr7 dc1 dc2 dc5">1 </TD><TD class="lightred alignRight" headers="dr1 dr7 dc1 dc2 dc6">138 </TD><TD class=alignRight headers="dr1 dr7 dc1 dc7">13 </TD><TD class=alignRight headers="dr1 dr7 dc1 dc8">235 </TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP> </TH><TD class=alignRight headers="dr1 dr8 dc1 dc2 dc3">94.5% </TD><TD class="lightred alignRight" headers="dr1 dr8 dc1 dc2 dc4">37.4% </TD><TD class="lightred alignRight" headers="dr1 dr8 dc1 dc2 dc5">0.5% </TD><TD class="lightred alignRight" headers="dr1 dr8 dc1 dc2 dc6">62.2% </TD><TD class=alignRight headers="dr1 dr8 dc1 dc7">5.5% </TD><TD class=alignRight headers="dr1 dr8 dc1 dc8">100.0% </TD></TR></TBODY></TABLE>
      <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 5 - Cumulative numbers of adult hospitalizations with influenza
      reported by the PCIRN-SOS network, Canada, 2013-14
      </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=er1 rowSpan=3>Age groups </TH><TH id=ec1 class=noWrap colSpan=6>Cumulative (Aug. 25, 2013 to January 11, 2014)<SUP>*</SUP></TH></TR><TR class=bg-colour-yellow><TH id=ec2 colSpan=4 headers=ec1>Influenza A </TH><TH id=ec7 headers=ec1>B </TH><TH id=ec8 headers=ec1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=ec3 headers="ec1 ec2">A Total </TH><TH id=ec4 class="lightred " headers="ec1 ec2">A(H1) pdm09 </TH><TH id=ec5 class="lightred " headers="ec1 ec2">A(H3) </TH><TH id=ec6 class="lightred " headers="ec1 ec2">A(UnS) </TH><TD class=alignCenter headers="ec1 ec7">Total</TD><TD class=alignCenter headers="ec1 ec8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t5_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
      UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.

      <SUP id=footnote_t5_star>*</SUP> Four cases for which the influenza type has not yet been reported, and one case for which the age-group was not reported are not included in Table 5.
      </TD></TR></TFOOT><TBODY><TR><TH id=er2 class=alignLeft headers=er1>16-20 </TH><TD class=alignRight headers="er1 er2 ec1 ec2 ec3">6 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec4">2 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec5">0 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec6">4 </TD><TD class=alignRight headers="er1 er2 ec1 ec7">0 </TD><TD class=alignRight headers="er1 er2 ec1 ec8">6 (2%) </TD></TR><TR><TH id=er3 class=alignLeft headers=er1>20-44 </TH><TD class=alignRight headers="er1 er3 ec1 ec2 ec3">94 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec4">36 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec5">1 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec6">57 </TD><TD class=alignRight headers="er1 er3 ec1 ec7">0 </TD><TD class=alignRight headers="er1 er3 ec1 ec8">94 (24%) </TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignRight headers="er1 er4 ec1 ec2 ec3">152 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec4">56 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec5">1 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec6">95 </TD><TD class=alignRight headers="er1 er4 ec1 ec7">4 </TD><TD class=alignRight headers="er1 er4 ec1 ec8">156 (40%) </TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignRight headers="er1 er5 ec1 ec2 ec3">131 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec4">51 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec5">4 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec6">76 </TD><TD class=alignRight headers="er1 er5 ec1 ec7">7 </TD><TD class=alignRight headers="er1 er5 ec1 ec8">138 (35%) </TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignRight headers="er1 er6 ec1 ec2 ec3">383 </TD><TD class="lightred alignRight" headers="er1 er6 ec1 ec2 ec4">145 </TD><TD class="lightred alignRight" headers="er1 er6 ec1 ec2 ec5">6 </TD><TD class="lightred alignRight" headers="er1 er6 ec1 ec2 ec6">232 </TD><TD class=alignRight headers="er1 er6 ec1 ec7">11 </TD><TD class=alignRight headers="er1 er6 ec1 ec8">394 </TD></TR><TR><TH id=er7 class=alignLeft headers=er1>% <SUP>1</SUP></TH><TD class=alignRight headers="er1 er7 ec1 ec2 ec3">97% </TD><TD class="lightred alignRight" headers="er1 er7 ec1 ec2 ec4">38% </TD><TD class="lightred alignRight" headers="er1 er7 ec1 ec2 ec5">2% </TD><TD class="lightred alignRight" headers="er1 er7 ec1 ec2 ec6">61% </TD><TD class=alignRight headers="er1 er7 ec1 ec7">3% </TD><TD class=alignRight headers="er1 er7 ec1 ec8">100% </TD></TR></TBODY></TABLE>
      Figure 8. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14
      A) Paediatric hospitalizations (≤16 years of age, IMPACT)


      Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
      B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)

      * See footnote above following the section related to PCIRN-SOS data.
      Text equivalent for figure 8bNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Adult hospitalizations (>16 year of age, PCIRN-SOS)
      Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14
      A) Paediatric hospitalizations (≤16 years of age, IMPACT)

      Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
      B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)

      Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Adult hospitalizations (≥16 year of age, PCIRN-SOS)

      Top of Page

      Provincial/Territorial Influenza Hospitalizations and Deaths

      In week 02, 426 new laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories.<SUP>*</SUP> The majority were cases of influenza A (420, 99%), of which 215 (51.2%) were A(H1N1)pdm09, 16 (3.8%) were A(H3N2), and 189 (45.0%) were A(unsubtyped). There were 19 ICU admissions in week 02, all with influenza A. Sixty-eight percent of the ICU admissions were among adults 20-64 years of age. Twenty-seven deaths were reported, all but two in adults 20 years of age and older, all with influenza A. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total.
      To date this season, 1301 influenza-associated hospitalizations have been reported, 97.6% with influenza A (Table 6). Nearly 60% of hospitalizations have been cases 45 years of age or older. To date, a significantly greater proportion of adult cases (≥20 years of age) have been 20-64 years of age this season compared to the 2012-13 season which is consistent with the predominant circulation of A(H1N1)pdm09 this season. One hundred and thirty-five ICU admissions have been reported this season, all cases of influenza A; and 79% were among adults 20-64 years of age. Sixty deaths have been reported, and all but one were cases of influenza A. The highest proportion of deaths has been among adults 20-64 years of age (48.3%), followed by adults ≥65 years of age (43.3%). It is important to note that the hospitalization or 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: 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 distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks.
      <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t6 class=alignCenter>Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=fr1 rowSpan=3>Age groups </TH><TH id=fc1 colSpan=6>Cumulative (Aug. 25, 2013 to January 11, 2014)* </TH></TR><TR class=bg-colour-yellow><TH id=fc2 colSpan=4 headers=fc1>Influenza A </TH><TH id=fc7 headers=fc1>B </TH><TH id=fc8 headers=fc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=fc3 headers="fc1 fc2">A Total </TH><TH id=fc4 class=lightred headers="fc1 fc2">A(H1) pdm09 </TH><TH id=fc5 class=lightred headers="fc1 fc2">A(H3) </TH><TH id=fc6 class=lightred headers="fc1 fc2">A (UnS) </TH><TD class=alignCenter headers="fc1 fc7">Total</TD><TD class=alignCenter headers="fc1 fc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=8><SUP>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
      UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
      * Two cases for which age information is not available have not been included in Table 6.
      </TD></TR></TFOOT><TBODY><TR><TH id=fr2 class=alignLeft headers=fr1>0-4 years </TH><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc3">242 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc4">120 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc5">4 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc6">118 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc7">12 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc8">254 (20%) </TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years </TH><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc3">53 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc4">33 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc5">2 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc6">18 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc7">4 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc8">57 (4%) </TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years </TH><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc3">19 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc4">11 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc5">1 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc6">7 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc7">0 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc8">19 (1%) </TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc3">220 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc4">143 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc5">2 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc6">75 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc7">1 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc8">221 (17%) </TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc3">430 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc4">257 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc5">9 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc6">164 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc7">2 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc8">432 (33%) </TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc3">304 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc4">166 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc5">25 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc6">113 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc7">12 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc8">316 (24%) </TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignRight headers="fr1 fr8 fc1 fc2 fc3">1268 </TD><TD class="lightred alignRight" headers="fr1 fr8 fc1 fc2 fc4">730 </TD><TD class="lightred alignRight" headers="fr1 fr8 fc1 fc2 fc5">43 </TD><TD class="lightred alignRight" headers="fr1 fr8 fc1 fc2 fc6">495 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc7">31 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc8">1299 </TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP> </TH><TD class=alignRight headers="fr1 fr9 fc1 fc2 fc3">97.6% </TD><TD class="lightred alignRight" headers="fr1 fr9 fc1 fc2 fc4">57.6% </TD><TD class="lightred alignRight" headers="fr1 fr9 fc1 fc2 fc5">3.4% </TD><TD class="lightred alignRight" headers="fr1 fr9 fc1 fc2 fc6">39.0% </TD><TD class=alignRight headers="fr1 fr9 fc1 fc7">2.4% </TD><TD class=alignRight headers="fr1 fr9 fc1 fc8">100% </TD></TR></TBODY></TABLE>
      See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2013-14 on the Public Health Agency of Canada website.

      .../
      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


      • #18
        Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 3

        FluWatch report: January 12 to January 18, 2014 (Week 03)

        Posted 2014-01-24For 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/13-14/w03_14/pdf/fw2014-03-eng.pdf">FluWatch report: January 12 to January 18, 2014 (Week 03) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 291 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

        »» Help with PDF documents


        Overall Summary
        • In week 03, overall laboratory detections of influenza decreased slightly, reflecting decreased activity in some regions that experienced an earlier start to the influenza season, and increases in activity in other regions. Prescriptions for antiviral medications to treat influenza have also decreased.
        • The influenza A(H1N1)pdm09 virus is the most common influenza virus detected thus far this season, accounting for more than 90% of influenza viruses detected. Adults 20-64 years of age have been the most impacted thus far this influenza season, as reflected by laboratory detections of influenza, hospitalizations and antiviral prescriptions for treatment of influenza.
        • The number of Canadians seeking medical attention for influenza-like-illness continued to increase in week 03, as did paediatric hospitalizations.
        Influenza/ILI Activity (geographic spread)

        In week 03, three regions in Alberta reported widespread activity, and 19 regions (in BC(1), AB(2), SK(1), ON(7), QC(2), NB(3), NT(2) and NU(1)) reported localized activity (Figure 1).
        Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 03





        Note: Influenza/ILI 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 and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
        Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
        Influenza and Other Respiratory Virus Detections

        The number of positive influenza tests decreased from 3,615 in week 02 to 3,364 in week 03. The percentage of positive influenza tests decreased slightly from 28.2% to 27.2% (Figure 2). Cumulative influenza virus detections to date have been predominantly influenza A (95%). Among subtyped influenza A viruses, 97% (7,068/7,282) were A(H1N1)pdm09 (Table 1). Detailed information on age and type/subtype has been received for 8,793 cases to date this season. A significantly greater proportion of laboratory detections of influenza have been reported in adults 20-64 years of age compared to those ≥65 years of age this season compared to the 2012-13 season (Table 2).
        Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14

        Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
        In week 03, the number of positive tests for RSV decreased slightly, but the percentage of positive tests decreased for the second week in a row. RSV in Canada shows a seasonal pattern with a broad peak over the winter months. The number of positive tests for coronavirus increased, while detections of other respiratory viruses were stable in week 03 compared to the previous week (Figure 3).
        For more details, see the weekly Respiratory Virus Detections in Canada Report.
        Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2013-14


        Top of Page

        RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
        Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
        <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly and cumulative numbers of positive influenza specimens
        by type, subtype and province, Canada, 2013-14
        </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=ac1 colSpan=5>Weekly
        (January 12, 2013 to January 18, 2014)
        </TH><TH id=ac8 colSpan=5>Cumulative
        (August 25, 2013 to January 18, 2014)
        </TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=4 headers=ac1>Influenza A</TH><TH id=ac7 headers=ac1>B</TH><TH id=ac9 colSpan=4 headers=ac8>Influenza A</TH><TH id=ac14 headers=ac8>B</TH></TR><TR class=bg-colour-grey-light><TH id=ac3 headers="ac1 ac2">A Total</TH><TH id=ac4 class=lightred headers="ac1 ac2">A(H1)pdm09</TH><TH id=ac5 class=lightred headers="ac1 ac2">A(H3)</TH><TH id=ac6 class=lightred headers="ac1 ac2">A(UnS)</TH><TH class=alignCenter headers="ac1 ac7">B Total</TH><TH id=ac10 headers="ac8 ac9">A Total</TH><TH id=ac11 class=lightred headers="ac8 ac9">A(H1)pdm09</TH><TH id=ac12 class=lightred headers="ac8 ac9">A(H3)</TH><TH id=ac13 class=lightred headers="ac8 ac9">A(UnS)</TH><TD class=alignCenter headers="ac8 ac14">B Total</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
        <SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
        UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
        </TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=alignLeft headers=ar1>BC</TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">442 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">376 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">16 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">50 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac7">12 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac10">1281 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac11">1152 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac12">45 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac13">84 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac14">31 </TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">469 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">407 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">4 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">58 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac7">9 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac10">2831 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac11">2696 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac12">28 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac13">107 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac14">36 </TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">225 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">176 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">49 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac7">0 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac10">950 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac11">660 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac12">0 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac13">290 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac14">1 </TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">124 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">28 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">96 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac7">4 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac10">244 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac11">127 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac12">0 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac13">117 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac14">13 </TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">824 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">366 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">11 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">447 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac7">19 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac10">3497 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac11">1750 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac12">136 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac13">1611 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac14">73 </TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">712 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">66 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">1 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">645 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac7">107 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac10">2122 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac11">224 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac12">2 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac13">1896 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac14">366 </TD></TR><TR><TH id=ar8 class=alignLeft headers=ar1>NB</TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">310 </TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac4">168 </TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac6">142 </TD><TD class=alignRight headers="ar1 ar8 ac1 ac7">0 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac10">545 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac11">312 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac12">1 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac13">232 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac14">1 </TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">14 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">12 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">2 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac7">0 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac10">44 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac11">24 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac12">2 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac13">18 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac14">0 </TD></TR><TR><TH id=ar10 class=alignLeft headers=ar1>PE</TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">18 </TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac4">18 </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 ac7">0 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac10">19 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac11">19 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac12">0 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac13">0 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac14">0 </TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">48 </TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac4">29 </TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac6">19 </TD><TD class=alignRight headers="ar1 ar11 ac1 ac7">27 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac10">130 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac11">104 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac12">0 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac13">26 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac14">53 </TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">3186 </TD><TD class="lightred alignRight" headers="ar1 ar12 ac1 ac2 ac4">1646 </TD><TD class="lightred alignRight" headers="ar1 ar12 ac1 ac2 ac5">32 </TD><TD class="lightred alignRight" headers="ar1 ar12 ac1 ac2 ac6">1508 </TD><TD class=alignRight headers="ar1 ar12 ac1 ac7">178 </TD><TD class=alignRight headers="ar1 ar12 ac8 ac9 ac10">11663 </TD><TD class="lightred alignRight" headers="ar1 ar12 ac8 ac9 ac11">7068 </TD><TD class="lightred alignRight" headers="ar1 ar12 ac8 ac9 ac12">214 </TD><TD class="lightred alignRight" headers="ar1 ar12 ac8 ac9 ac13">4381 </TD><TD class=alignRight headers="ar1 ar12 ac8 ac14">574 </TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="ar1 ar13 ac1 ac2 ac3">94.7% </TD><TD class="lightred alignRight" headers="ar1 ar13 ac1 ac2 ac4">51.7% </TD><TD class="lightred alignRight" headers="ar1 ar13 ac1 ac2 ac5">1.0% </TD><TD class="lightred alignRight" headers="ar1 ar13 ac1 ac2 ac6">47.3% </TD><TD class=alignRight headers="ar1 ar13 ac1 ac7">5.3% </TD><TD class=alignRight headers="ar1 ar13 ac8 ac9 ac10">95.3% </TD><TD class="lightred alignRight" headers="ar1 ar13 ac8 ac9 ac11">60.6% </TD><TD class="lightred alignRight" headers="ar1 ar13 ac8 ac9 ac12">1.8% </TD><TD class="lightred alignRight" headers="ar1 ar13 ac8 ac9 ac13">37.6% </TD><TD class=alignRight headers="ar1 ar13 ac8 ac14">4.7% </TD></TR></TBODY></TABLE>

        <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups (years)</TH><TH id=bc1 colSpan=5>Weekly
        (January 12 to January 18, 2014)
        </TH><TH id=bc8 colSpan=7>Cumulative
        (August 25, 2013 to January 18, 2014)
        </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><TH id=bc15 colSpan=2 headers=bc8>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=bc3 headers="bc1 bc2">A Total</TH><TH id=bc4 class="lightred " headers="bc1 bc2">A(H1) pdm09</TH><TH id=bc5 class="lightred " headers="bc1 bc2">A(H3)</TH><TH id=bc6 class="lightred " headers="bc1 bc2">A (UnS)</TH><TD class=alignCenter headers="bc1 bc7">Total</TD><TH id=bc10 headers="bc8 bc9">A Total</TH><TH id=bc11 class="lightred " headers="bc8 bc9">A(H1) pdm09</TH><TH id=bc12 class="lightred " headers="bc8 bc9">A(H3)</TH><TH id=bc13 class="lightred " headers="bc8 bc9">A (UnS)</TH><TD class=alignCenter headers="bc8 bc14">Total</TD><TH id=bc16 headers="bc8 bc15">#</TH><TH id=bc17 headers="bc8 bc15">%</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13><SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
        <SUP>3 </SUP>Table 2 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
        UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
        </TD></TR></TFOOT><TBODY><TR><TH id=br2 class=alignLeft headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">341 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">115 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">2 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">224 </TD><TD class=alignRight headers="br1 br2 bc1 bc7">20 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">1378 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">862 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">16 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">500 </TD><TD class=alignRight headers="br1 br2 bc8 bc14">53 </TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc16">1431 </TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc17">16.2% </TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">133 </TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">57 </TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">1 </TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">75 </TD><TD class=alignRight headers="br1 br3 bc1 bc7">15 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">601 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">432 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">10 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">159 </TD><TD class=alignRight headers="br1 br3 bc8 bc14">51 </TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc16">652 </TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc17">7.4% </TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">443 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">188 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">0 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">255 </TD><TD class=alignRight headers="br1 br4 bc1 bc7">16 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">2759 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">1816 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">16 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">927 </TD><TD class=alignRight headers="br1 br4 bc8 bc14">92 </TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc16">2851 </TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc17">32.2% </TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">387 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">177 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">0 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">210 </TD><TD class=alignRight headers="br1 br5 bc1 bc7">26 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">2370 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">1542 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">22 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">806 </TD><TD class=alignRight headers="br1 br5 bc8 bc14">134 </TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc16">2504 </TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc17">28.3% </TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">247 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">78 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">1 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">168 </TD><TD class=alignRight headers="br1 br6 bc1 bc7">44 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">1171 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">622 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">36 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">513 </TD><TD class=alignRight headers="br1 br6 bc8 bc14">184 </TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc16">1355 </TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc17">15.3% </TD></TR><TR><TH id=br7 class=alignLeft headers=br1>Unknown</TH><TD class=alignRight headers="br1 br7 bc1 bc2 bc3">9 </TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc4">9 </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">52 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">40 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">4 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">8 </TD><TD class=alignRight headers="br1 br7 bc8 bc14">0 </TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc16">52 </TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc17">0.6% </TD></TR><TR><TH id=br8 class=alignLeft headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">1,560 </TD><TD class="lightred alignRight" headers="br1 br8 bc1 bc2 bc4">624 </TD><TD class="lightred alignRight" headers="br1 br8 bc1 bc2 bc5">4 </TD><TD class="lightred alignRight" headers="br1 br8 bc1 bc2 bc6">932 </TD><TD class=alignRight headers="br1 br8 bc1 bc7">121 </TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">8331 </TD><TD class="lightred alignRight" headers="br1 br8 bc8 bc9 bc11">5314 </TD><TD class="lightred alignRight" headers="br1 br8 bc8 bc9 bc12">104 </TD><TD class="lightred alignRight" headers="br1 br8 bc8 bc9 bc13">2913 </TD><TD class=alignRight headers="br1 br8 bc8 bc14">514 </TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc16">8845 </TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc17">100.0% </TD></TR><TR><TH id=br9 class=alignLeft headers=br1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="br1 br9 bc1 bc2 bc3">92.8% </TD><TD class="lightred alignRight" headers="br1 br9 bc1 bc2 bc4">40.0% </TD><TD class="lightred alignRight" headers="br1 br9 bc1 bc2 bc5">0.3% </TD><TD class="lightred alignRight" headers="br1 br9 bc1 bc2 bc6">59.7% </TD><TD class=alignRight headers="br1 br9 bc1 bc7">7.2% </TD><TD class=alignRight headers="br1 br9 bc8 bc9 bc10">94.2% </TD><TD class="lightred alignRight" headers="br1 br9 bc8 bc9 bc11">63.8% </TD><TD class="lightred alignRight" headers="br1 br9 bc8 bc9 bc12">1.2% </TD><TD class="lightred alignRight" headers="br1 br9 bc8 bc9 bc13">35.0% </TD><TD class=alignRight headers="br1 br9 bc8 bc14">5.8% </TD><TD class=alignRight></TD><TD class=alignRight></TD></TR></TBODY></TABLE>

        Top of Page

        Influenza Strain Characterizations

        During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 428 influenza viruses [29 A(H3N2), 356 A(H1N1)pdm09 and 43 influenza B]. The vast majority (98.8%) of viruses were similar to the strains recommended by the WHO for the 2013-14 seasonal influenza vaccine. Two A(H1N1)pdm09 viruses showed reduced titres to antiserum against the reference A/California/07/2009 strain. Five influenza B viruses were similar to the strain recommended by the WHO for the 2011-12 vaccine (Figure 4).
        Figure 4. Influenza strain characterizations, Canada, 2013-14, N = 428

        The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
        The recommended components for the 2013-2014 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009 (H1N1)pdm09-like virus, an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b (e.g. A/Texas/50/2012), and a B/Massachusetts/2/2012-like virus (Yamagata lineage).


        Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
        Antiviral Resistance

        During the 2013-2014 influenza season, NML has tested 326 influenza viruses for resistance to oseltamivir and 320 viruses for resistance to zanamivir, and all were sensitive. All 254 influenza A viruses tested for amantadine resistance 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, 2013-2014</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 lightred" headers=cr1>A (H3N2)</TH><TD class=alignRight headers="cr1 cr2 cc1 cc2">25 </TD><TD class=alignRight headers="cr1 cr2 cc1 cc3">0 </TD><TD class=alignRight headers="cr1 cr2 cc4 cc5">25 </TD><TD class=alignRight headers="cr1 cr2 cc4 cc6">0 </TD><TD class=alignRight headers="cr1 cr2 cc7 cc8">3 </TD><TD class=alignRight headers="cr1 cr2 cc7 cc9">31 (100%) </TD></TR><TR><TH id=cr3 class="alignLeft lightred" headers=cr1>A (H1N1)</TH><TD class=alignRight headers="cr1 cr3 cc1 cc2">262 </TD><TD class=alignRight headers="cr1 cr3 cc1 cc3">0 </TD><TD class=alignRight headers="cr1 cr3 cc4 cc5">256 </TD><TD class=alignRight headers="cr1 cr3 cc4 cc6">0 </TD><TD class=alignRight headers="cr1 cr3 cc7 cc8">223 </TD><TD class=alignRight headers="cr1 cr3 cc7 cc9">223(100%) </TD></TR><TR><TH id=cr4 class="alignLeft lightred" headers=cr1>B</TH><TD class=alignRight headers="cr1 cr4 cc1 cc2">39 </TD><TD class=alignRight headers="cr1 cr4 cc1 cc3">0 </TD><TD class=alignRight headers="cr1 cr4 cc4 cc5">39 </TD><TD class=alignRight headers="cr1 cr4 cc4 cc6">0 </TD><TD class=alignRight headers="cr1 cr4 cc7 cc8">NA <SUP>*</SUP></TD><TD class=alignRight headers="cr1 cr4 cc7 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft lightred" headers=cr1>TOTAL</TH><TD class=alignRight headers="cr1 cr5 cc1 cc2">326 </TD><TD class=alignRight headers="cr1 cr5 cc1 cc3">0 </TD><TD class=alignRight headers="cr1 cr5 cc4 cc5">320 </TD><TD class=alignRight headers="cr1 cr5 cc4 cc6">0 </TD><TD class=alignRight headers="cr1 cr5 cc7 cc8">254 </TD><TD class=alignRight headers="cr1 cr5 cc7 cc9">254 (100%) </TD></TR></TBODY></TABLE>
        Influenza-like Illness (ILI) Consultation Rate

        The national influenza-like-illness (ILI) consultation rate increased from 51.2/1,000 in week 02 to 66.8/1,000 in week 03; which is above the expected range for week 03 (Figure 5).
        Figure 5. Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

        Note: No data available for mean rate for weeks 19 to 39 for the 1996-1997 through 2002-2003 seasons. Delays in the reporting of data may cause data to change retrospectively. The calculation of the average ILI consultation rate over 17 seasons was aligned with influenza activity in each season. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. The number of sentinel physicians in each province or territory is as follows: BC(21), AB(80), SK(11), MB(18), ON(169), QC(14), NB(29), NS(26), PE(4), NL(16), NU(1), NT(14), YT(13). Not all sentinel physicians report every week.
        Text equivalent for figure 5Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

        Top of Page

        Influenza Outbreak Surveillance

        In week 03, nine new influenza outbreaks were reported: four in hospitals and five in long-term care facilities (Figure 6). In addition, three outbreaks of influenza-like-illness were reported in week 03: two in schools and one in another facility or community.
        Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2013-2014

        1 All provinces and territories except NU report outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
        Text equivalent for figure 6 Overall number of new influenza outbreaks by report week, Canada, 2013-2014
        Pharmacy Surveillance

        The rate of prescriptions for influenza antivirals continues to follow a trend consistent with the timing and demographics of laboratory detections of influenza this season. In week 03, the largest proportion of prescriptions for antivirals was among children 2-18 years of age followed by adults 19-64 years of age (Figure 7).
        Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

        Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group. Age-groups: Infant: 0-2y, Child: 2-18y; Adult: 19-64y, Senior: ≥65y.
        Text equivalent for figure 7Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

        Top of Page

        Sentinel Hospital Influenza Surveillance

        Paediatric Influenza Hospitalizations and Deaths (IMPACT)
        In week 03, 60 new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 55 in week 02. All but two of the hospitalizations in week 03 were cases with influenza A (Figure 8a). Fifty (83%) of the cases were <5 years of age. Nine ICU admissions were reported in week 03, one child under 6 months of age, two children 6-23 months of age, two 2-4 years of age, and four 5-9 years of age; all with influenza A. No deaths were reported.
        To date this season, a total of 310 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 95% of which have been influenza A, and 98% of those subtyped were A(H1N1)pdm09 (Table 4). Two hundred and fifty one cases (81%) have been under 5 years of age. Forty ICU admissions have been reported; all but two cases with influenza A, and the majority A(H1N1)pdm09. The highest proportion of ICU admissions have been among children aged 6-23 months (32.4%) (Figure 9a). Among the 33 ICU cases with available data, 25 were reported to have comorbidities or concurrent infection. No deaths have been reported.
        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)
        In week 03, 69 new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations reported through active surveillance by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 121 in week 02. Among cases in week 03, 68 (98.6%) were influenza A, of which four were A(H1N1)pdm09 and 64 were A(unsubtyped). Almost half of the hospitalizations occurred among adults 45-64 years (32; 46.4%). Five ICU admissions were reported in week 03: one case 20-44 years of age, three cases 45-64 years of age and one case ≥65 years of age. One death was reported in an adult 45-64 years of age with influenza A(unsubtyped) (Figure 8b).
        To date this season, 532 influenza-associated hospitalizations have been reported by the PCIRN-SOS network, 504 (94.7%) with influenza A, predominantly A(H1N1)pdm09. The majority (76.5%) have been adults over 45 years of age (Table 5). ICU admission was required for 66 hospitalizations: all but four were influenza A (36 A(H1N1)pdm09 and 26 A(unsubtyped)). Three quarters of the ICU admissions were >45 years of age. Of the 45 ICU admissions with information on influenza vaccination, 32 (71%) reported not having been vaccinated this season. Six deaths have been reported: one case ≥65 years of age with A(H1N1)pdm09, one case ≥65 years of age with A(unsubtyped), three cases 45-64 years of age, one with A(H1N1)pdm09 and two with influenza A(unsubtyped), and one case 20-44 years of age with influenza A(H1N1)pdm09 (Figure 9b).
        Note: PCIRN-SOS conducted passive surveillance from April 30th to November 14th, 2013. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance began November 15th during which time PCIRN site coordinators investigate cases potentially related to influenza. Data from both active and passive surveillance reported during the 2013-14 season are included in this report. 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.
        <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t4 class=alignCenter>Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=dr1 rowSpan=3>Age groups </TH><TH id=dc1 colSpan=6>Cumulative (Aug. 25, 2013 to January18, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=dc2 colSpan=4 headers=dc1>Influenza A </TH><TH id=dc7 headers=dc1>B </TH><TH id=dc8 headers=dc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=dc3 headers="dc1 dc2">A Total </TH><TH id=dc4 class="lightred " headers="dc1 dc2">A(H1) pdm09 </TH><TH id=dc5 class="lightred " headers="dc1 dc2">A(H3) </TH><TH id=dc6 class="lightred " headers="dc1 dc2">A (UnS) </TH><TD class=alignCenter headers="dc1 dc7">Total</TD><TD class=alignCenter headers="dc1 dc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
        UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
        </TD></TR></TFOOT><TBODY><TR><TH id=dr2 class=alignLeft headers=dr1>0-5m </TH><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc3">63 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc4">16 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc5">0 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc6">47 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc7">2 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc8">65 (21%) </TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc3">84 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc4">29 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc5">0 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc6">55 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc7">3 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc8">87 (28%) </TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc3">93 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc4">32 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc5">2 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc6">59 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc7">6 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc8">99 (32%) </TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc3">35 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc4">12 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc5">0 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc6">23 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc7">3 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc8">38 (12%) </TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc3">19 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc4">9 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc5">0 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc6">10 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc7">2 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc8">21 (7%) </TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignRight headers="dr1 dr7 dc1 dc2 dc3">294 </TD><TD class="lightred alignRight" headers="dr1 dr7 dc1 dc2 dc4">98 </TD><TD class="lightred alignRight" headers="dr1 dr7 dc1 dc2 dc5">2 </TD><TD class="lightred alignRight" headers="dr1 dr7 dc1 dc2 dc6">194 </TD><TD class=alignRight headers="dr1 dr7 dc1 dc7">16 </TD><TD class=alignRight headers="dr1 dr7 dc1 dc8">310 </TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP> </TH><TD class=alignRight headers="dr1 dr8 dc1 dc2 dc3">94.8% </TD><TD class="lightred alignRight" headers="dr1 dr8 dc1 dc2 dc4">33.3% </TD><TD class="lightred alignRight" headers="dr1 dr8 dc1 dc2 dc5">0.7% </TD><TD class="lightred alignRight" headers="dr1 dr8 dc1 dc2 dc6">66.0% </TD><TD class=alignRight headers="dr1 dr8 dc1 dc7">5.2% </TD><TD class=alignRight headers="dr1 dr8 dc1 dc8">100.0% </TD></TR></TBODY></TABLE>
        <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 5 - Cumulative numbers of adult hospitalizations with influenza
        reported by the PCIRN-SOS network, Canada, 2013-14
        </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=er1 rowSpan=3>Age groups </TH><TH id=ec1 class=noWrap colSpan=6>Cumulative (Aug. 25, 2013 to January 18, 2014)<SUP>*</SUP></TH></TR><TR class=bg-colour-yellow><TH id=ec2 colSpan=4 headers=ec1>Influenza A </TH><TH id=ec7 headers=ec1>B </TH><TH id=ec8 headers=ec1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=ec3 headers="ec1 ec2">A Total </TH><TH id=ec4 class="lightred " headers="ec1 ec2">A(H1) pdm09 </TH><TH id=ec5 class="lightred " headers="ec1 ec2">A(H3) </TH><TH id=ec6 class="lightred " headers="ec1 ec2">A(UnS) </TH><TD class=alignCenter headers="ec1 ec7">Total</TD><TD class=alignCenter headers="ec1 ec8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t5_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
        UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.

        <SUP id=footnote_t5_star>*</SUP> Fourteen cases for which the influenza type has not yet been reported, and four cases for which the age-group was not reported, are not included in Table 5.
        </TD></TR></TFOOT><TBODY><TR><TH id=er2 class=alignLeft headers=er1>16-20 </TH><TD class=alignRight headers="er1 er2 ec1 ec2 ec3">4 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec4">2 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec5">0 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec6">2 </TD><TD class=alignRight headers="er1 er2 ec1 ec7">0 </TD><TD class=alignRight headers="er1 er2 ec1 ec8">4 (1%) </TD></TR><TR><TH id=er3 class=alignLeft headers=er1>20-44 </TH><TD class=alignRight headers="er1 er3 ec1 ec2 ec3">113 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec4">44 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec5">1 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec6">68 </TD><TD class=alignRight headers="er1 er3 ec1 ec7">2 </TD><TD class=alignRight headers="er1 er3 ec1 ec8">115 (22%) </TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignRight headers="er1 er4 ec1 ec2 ec3">204 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec4">75 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec5">2 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec6">127 </TD><TD class=alignRight headers="er1 er4 ec1 ec7">4 </TD><TD class=alignRight headers="er1 er4 ec1 ec8">208 (40%) </TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignRight headers="er1 er5 ec1 ec2 ec3">179 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec4">62 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec5">6 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec6">111 </TD><TD class=alignRight headers="er1 er5 ec1 ec7">8 </TD><TD class=alignRight headers="er1 er5 ec1 ec8">187 (36%) </TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignRight headers="er1 er6 ec1 ec2 ec3">500 </TD><TD class="lightred alignRight" headers="er1 er6 ec1 ec2 ec4">183 </TD><TD class="lightred alignRight" headers="er1 er6 ec1 ec2 ec5">9 </TD><TD class="lightred alignRight" headers="er1 er6 ec1 ec2 ec6">308 </TD><TD class=alignRight headers="er1 er6 ec1 ec7">14 </TD><TD class=alignRight headers="er1 er6 ec1 ec8">514 </TD></TR><TR><TH id=er7 class=alignLeft headers=er1>% <SUP>1</SUP></TH><TD class=alignRight headers="er1 er7 ec1 ec2 ec3">97% </TD><TD class="lightred alignRight" headers="er1 er7 ec1 ec2 ec4">37% </TD><TD class="lightred alignRight" headers="er1 er7 ec1 ec2 ec5">2% </TD><TD class="lightred alignRight" headers="er1 er7 ec1 ec2 ec6">62% </TD><TD class=alignRight headers="er1 er7 ec1 ec7">3% </TD><TD class=alignRight headers="er1 er7 ec1 ec8">100% </TD></TR></TBODY></TABLE>
        Figure 8. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14
        A) Paediatric hospitalizations (≤16 years of age, IMPACT)


        Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
        B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)

        * See footnote above following the section related to PCIRN-SOS data.
        Text equivalent for figure 8bNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Adult hospitalizations (>16 year of age, PCIRN-SOS)
        Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14
        A) Paediatric hospitalizations (≤16 years of age, IMPACT)

        Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
        B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)

        Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Adult hospitalizations (≥16 year of age, PCIRN-SOS)

        Top of Page

        Provincial/Territorial Influenza Hospitalizations and Deaths

        In week 03, 396 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories.* The majority were cases of influenza A (387, 97.7%), of which 204 (52.7%) were A(H1N1)pdm09, four were A(H3N2), and 179 (46.3%) were A(unsubtyped). Among the 12 ICU admissions reported in week 03, 10 were adults 20-64 years of age. Thirteen deaths were reported, nine of which were adults 20-64 years of age. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total.
        To date this season, 1875 influenza-associated hospitalizations have been reported, 97.7% with influenza A (Table 6). The majority of hospitalizations have been cases 45-64 years of age. A total of 182 ICU admissions have been reported this season, all but one with influenza A; and 76% were among adults 20-64 years of age. Eighty-four deaths have been reported, and all but one with influenza A. The highest proportion of deaths has been among adults 20-64 years of age (52%), followed by adults ≥65 years of age (38%). It is important to note that the hospitalization or 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: 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 distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks.
        <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t6 class=alignCenter>Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=fr1 rowSpan=3>Age groups </TH><TH id=fc1 colSpan=6>Cumulative (Aug. 25, 2013 to January 18, 2014)* </TH></TR><TR class=bg-colour-yellow><TH id=fc2 colSpan=4 headers=fc1>Influenza A </TH><TH id=fc7 headers=fc1>B </TH><TH id=fc8 headers=fc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=fc3 headers="fc1 fc2">A Total </TH><TH id=fc4 class=lightred headers="fc1 fc2">A(H1) pdm09 </TH><TH id=fc5 class=lightred headers="fc1 fc2">A(H3) </TH><TH id=fc6 class=lightred headers="fc1 fc2">A (UnS) </TH><TD class=alignCenter headers="fc1 fc7">Total</TD><TD class=alignCenter headers="fc1 fc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=8><SUP>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
        UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
        * Six cases for which age information is not available have not been included in Table 6.
        </TD></TR></TFOOT><TBODY><TR><TH id=fr2 class=alignLeft headers=fr1>0-4 years </TH><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc3">345 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc4">181</TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc5">4 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc6">160 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc7">13 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc8">358 (19%) </TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years </TH><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc3">68 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc4">39 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc5">3 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc6">26 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc7">3 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc8">71 (4%) </TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years </TH><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc3">22 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc4">14 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc5">1 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc6">7 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc7">0 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc8">22 (1%) </TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc3">326 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc4">250 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc5">2 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc6">74 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc7">3 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc8">329 (18%) </TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc3">614 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc4">410 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc5">11 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc6">193 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc7">5 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc8">619 (33%) </TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc3">451 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc4">266 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc5">29 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc6">156 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc7">19 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc8">470 (25%) </TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignRight headers="fr1 fr8 fc1 fc2 fc3">1826 </TD><TD class="lightred alignRight" headers="fr1 fr8 fc1 fc2 fc4">1160 </TD><TD class="lightred alignRight" headers="fr1 fr8 fc1 fc2 fc5">50 </TD><TD class="lightred alignRight" headers="fr1 fr8 fc1 fc2 fc6">616 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc7">43 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc8">1869 </TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP> </TH><TD class=alignRight headers="fr1 fr9 fc1 fc2 fc3">97.7% </TD><TD class="lightred alignRight" headers="fr1 fr9 fc1 fc2 fc4">63.5% </TD><TD class="lightred alignRight" headers="fr1 fr9 fc1 fc2 fc5">2.7% </TD><TD class="lightred alignRight" headers="fr1 fr9 fc1 fc2 fc6">33.7% </TD><TD class=alignRight headers="fr1 fr9 fc1 fc7">2.3% </TD><TD class=alignRight headers="fr1 fr9 fc1 fc8">100% </TD></TR></TBODY></TABLE>
        See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2013-14 on the Public Health Agency of Canada website.

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

        Comment


        • #19
          Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 4

          FluWatch report: January 19 to January 25, 2014 (Week 04)

          Posted 2014-01-31For 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/13-14/w04_14/pdf/fw2014-04-eng.pdf">FluWatch report: January 19 to January 25, 2014 (Week 04) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 291 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

          »» Help with PDF documents


          Overall Summary
          • In week 04, overall influenza activity decreased in Canada, particularly in western Canada and Ontario which experienced an earlier start to the influenza season. Prince Edward Island was the only province reporting widespread influenza activity.
          • The influenza A(H1N1) virus remains the most common influenza virus circulating this season.
          • Overall influenza activity in Canada during the 2013-14 season has been similar to the 2012-13 season and is within expected levels for this time of year, although adults 20-64 years of age have been more affected by influenza this season.
          • To date this season, 2,298 influenza-associated hospitalizations and 113 deaths have been reported by participating provinces and territories.
          Influenza/ILI Activity (geographic spread)

          In week 04, Prince Edward Island reported widespread activity, and 22 regions (in AB(5), ON(7), QC(3), NB(5), NS(1) and NL(1)) reported localized activity (Figure 1). Compared to week 03, activity was stable or decreased in regions in BC, AB, SK, ON and NT; stable in MB and YT; and stable or increased in regions in QC, NS, NB, NL. A mixed pattern of activity was reported among regions in NU.
          Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 04





          Note: Influenza/ILI 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 and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
          Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
          Influenza and Other Respiratory Virus Detections

          The number of positive influenza tests decreased for the second week in a row, from 3,313 in week 03 to 2,620 in week 04. The percentage of positive influenza tests decreased from 26.7% to 24.3% (Figure 2). Cumulative influenza virus detections to date remain predominantly influenza A (95%), and among those subtyped, 97% (8,029/8,274) were A(H1N1)pdm09. However, the percentage of positive tests for influenza B has been rising slowly in recent weeks to 6.5% of influenza detections in week 04 (Table 1). Among the 11,889 cases for which information on age and type/subtype has been received this season, 58.7% were 20-64 years of age and 15.5% were ≥65 years of age, which is different from the proportions observed during the 2012-13 season when 33.3% of cases were 20-64 years of age and 41.5% were ≥65 years of age (Table 2).
          Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14

          Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
          The number of positive tests for RSV has been stable for the past three weeks, but the percentage of the total number of tests that were positive increased in week 04. RSV in Canada shows a seasonal pattern with a broad peak over the winter months, and the current fluctuations are in keeping with the trend over recent years. The percentage of positive tests for coronavirus and human metapneumovirus increased in week 04, while detections of other respiratory viruses were stable or declining (Figure 3).
          For more details, see the weekly Respiratory Virus Detections in Canada Report.
          Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2013-14


          Top of Page

          RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
          Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
          <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly and cumulative numbers of positive influenza specimens
          by type, subtype and province, Canada, 2013-14
          </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=ac1 colSpan=5>Weekly
          (January 19, 2013 to January 25, 2014)
          </TH><TH id=ac8 colSpan=5>Cumulative
          (August 25, 2013 to January 25, 2014)
          </TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=4 headers=ac1>Influenza A</TH><TH id=ac7 headers=ac1>B</TH><TH id=ac9 colSpan=4 headers=ac8>Influenza A</TH><TH id=ac14 headers=ac8>B</TH></TR><TR class=bg-colour-grey-light><TH id=ac3 headers="ac1 ac2">A Total</TH><TH id=ac4 class=lightred headers="ac1 ac2">A(H1)pdm09</TH><TH id=ac5 class=lightred headers="ac1 ac2">A(H3)</TH><TH id=ac6 class=lightred headers="ac1 ac2">A(UnS)</TH><TH class=alignCenter headers="ac1 ac7">B Total</TH><TH id=ac10 headers="ac8 ac9">A Total</TH><TH id=ac11 class=lightred headers="ac8 ac9">A(H1)pdm09</TH><TH id=ac12 class=lightred headers="ac8 ac9">A(H3)</TH><TH id=ac13 class=lightred headers="ac8 ac9">A(UnS)</TH><TD class=alignCenter headers="ac8 ac14">B Total</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
          <SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
          UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
          </TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=alignLeft headers=ar1>BC</TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">217 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">182 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">9 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">26 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac7">6 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac10">1362 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac11">1251 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac12">50 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac13">61 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac14">38 </TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">280 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">228 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">1 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">51 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac7">7 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac10">3115 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac11">2968 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac12">29 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac13">118 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac14">43 </TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">133 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">121 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">1 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">11 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac7">3 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac10">1083 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac11">781 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac12">1 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac13">301 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac14">4 </TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">103 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">94 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">1 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">8 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac7">0 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac10">347 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac11">221 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac12">1 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac13">125 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac14">13 </TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">520 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">187 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">13 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">320 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac7">12 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac10">4092 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac11">1959 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac12">159 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac13">1974 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac14">85 </TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">702 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">101 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">601 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac7">110 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac10">2828 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac11">325 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac12">2 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac13">2501 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac14">476 </TD></TR><TR><TH id=ar8 class=alignLeft headers=ar1>NB</TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">378 </TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac4">22 </TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac6">356 </TD><TD class=alignRight headers="ar1 ar8 ac1 ac7">2 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac10">923 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac11">334 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac12">1 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac13">588 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac14">3 </TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">19 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">19 </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 ac7">0 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac10">63 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac11">43 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac12">2 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac13">18 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac14">0 </TD></TR><TR><TH id=ar10 class=alignLeft headers=ar1>PE</TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">24 </TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac4">24 </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 ac7">0 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac10">43 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac11">43 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac12">0 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac13">0 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac14">0 </TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">75 </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">75 </TD><TD class=alignRight headers="ar1 ar11 ac1 ac7">29 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac10">205 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac11">104 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac12">0 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac13">101 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac14">82 </TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">2451 </TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac4">978 </TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac5">25 </TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac6">1448 </TD><TD class=alignRight headers="ar1 ar12 ac1 ac7">169 </TD><TD class=alignRight headers="ar1 ar12 ac8 ac9 ac10">14061 </TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac11">8029 </TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac12">245 </TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac13">5787 </TD><TD class=alignRight headers="ar1 ar12 ac8 ac14">744 </TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="ar1 ar13 ac1 ac2 ac3">93.5% </TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac4">39.9% </TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac5">1.0% </TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac6">59.1% </TD><TD class=alignRight headers="ar1 ar13 ac1 ac7">6.5% </TD><TD class=alignRight headers="ar1 ar13 ac8 ac9 ac10">95.0% </TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac11">57.1% </TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac12">1.7% </TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac13">41.2% </TD><TD class=alignRight headers="ar1 ar13 ac8 ac14">5.0% </TD></TR></TBODY></TABLE>

          <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups (years)</TH><TH id=bc1 colSpan=5>Weekly
          (January 19 to January 25, 2014)
          </TH><TH id=bc8 colSpan=7>Cumulative
          (August 25, 2013 to January 25, 2014)
          </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><TH id=bc15 colSpan=2 headers=bc8>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=bc3 headers="bc1 bc2">A Total</TH><TH id=bc4 class="lightred " headers="bc1 bc2">A(H1) pdm09</TH><TH id=bc5 class="lightred " headers="bc1 bc2">A(H3)</TH><TH id=bc6 class="lightred " headers="bc1 bc2">A (UnS)</TH><TD class=alignCenter headers="bc1 bc7">Total</TD><TH id=bc10 headers="bc8 bc9">A Total</TH><TH id=bc11 class="lightred " headers="bc8 bc9">A(H1) pdm09</TH><TH id=bc12 class="lightred " headers="bc8 bc9">A(H3)</TH><TH id=bc13 class="lightred " headers="bc8 bc9">A (UnS)</TH><TD class=alignCenter headers="bc8 bc14">Total</TD><TH id=bc16 headers="bc8 bc15">#</TH><TH id=bc17 headers="bc8 bc15">%</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13><SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
          <SUP>3 </SUP>Table 2 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
          UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
          </TD></TR></TFOOT><TBODY><TR><TH id=br2 class=alignLeft headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">264 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">97 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">0 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">167 </TD><TD class=alignRight headers="br1 br2 bc1 bc7">8 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">2041 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">1035 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">18 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">988 </TD><TD class=alignRight headers="br1 br2 bc8 bc14">83 </TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc16">2124 </TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc17">17.7% </TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">89 </TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">29 </TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">1 </TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">59 </TD><TD class=alignRight headers="br1 br3 bc1 bc7">24 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">847 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">514 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">14 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">319 </TD><TD class=alignRight headers="br1 br3 bc8 bc14">99 </TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc16">946 </TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc17">7.9% </TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">325 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">121 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">1 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">203 </TD><TD class=alignRight headers="br1 br4 bc1 bc7">20 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">3576 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">2094 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">19 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">1463 </TD><TD class=alignRight headers="br1 br4 bc8 bc14">132 </TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc16">3708 </TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc17">30.9% </TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">309 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">122 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">1 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">186 </TD><TD class=alignRight headers="br1 br5 bc1 bc7">28 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">3068 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">1789 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">28 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">1251 </TD><TD class=alignRight headers="br1 br5 bc8 bc14">200 </TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc16">3268 </TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc17">27.3% </TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">136 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">39 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">1 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">96 </TD><TD class=alignRight headers="br1 br6 bc1 bc7">38 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">1562 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">704 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">55 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">803 </TD><TD class=alignRight headers="br1 br6 bc8 bc14">281 </TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc16">1843 </TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc17">15.4% </TD></TR><TR><TH id=br7 class=alignLeft headers=br1>Unknown</TH><TD class=alignRight headers="br1 br7 bc1 bc2 bc3">7 </TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc4">7 </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">94 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">81 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">5 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">8 </TD><TD class=alignRight headers="br1 br7 bc8 bc14">0 </TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc16">94 </TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc17">0.8% </TD></TR><TR><TH id=br8 class=alignLeft headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">1130 </TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc4">415 </TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc5">4 </TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc6">711 </TD><TD class=alignRight headers="br1 br8 bc1 bc7">118 </TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">11188 </TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc11">6217 </TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc12">139 </TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc13">4832 </TD><TD class=alignRight headers="br1 br8 bc8 bc14">795 </TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc16">11983 </TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc17">100.0% </TD></TR><TR><TH id=br9 class=alignLeft headers=br1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="br1 br9 bc1 bc2 bc3">90.5% </TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc4">36.7% </TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc5">0.4% </TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc6">62.9% </TD><TD class=alignRight headers="br1 br9 bc1 bc7">9.5% </TD><TD class=alignRight headers="br1 br9 bc8 bc9 bc10">93.4% </TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc11">55.6% </TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc12">1.2% </TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc13">43.2% </TD><TD class=alignRight headers="br1 br9 bc8 bc14">6.6% </TD><TD class=alignRight></TD><TD class=alignRight></TD></TR></TBODY></TABLE>

          Top of Page

          Influenza Strain Characterizations

          During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 556 influenza viruses [35 A(H3N2), 473 A(H1N1)pdm09 and 48 influenza B]. The vast majority (99%) of viruses were similar to the strains recommended by the WHO for the 2013-14 seasonal influenza vaccine. Two A(H1N1)pdm09 viruses showed reduced titres to antiserum against the reference A/California/07/2009 strain. Five influenza B viruses were similar to the strain recommended by the WHO for the 2011-12 vaccine (Figure 4).
          Figure 4. Influenza strain characterizations, Canada, 2013-14, N = 556

          The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
          The recommended components for the 2013-2014 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009 (H1N1)pdm09-like virus, an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b (e.g. A/Texas/50/2012), and a B/Massachusetts/2/2012-like virus (Yamagata lineage).


          Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
          Antiviral Resistance

          During the 2013-2014 influenza season, NML has tested 397 influenza viruses for resistance to oseltamivir and 390 viruses for resistance to zanamivir, and all were sensitive. All 341 influenza A viruses tested for amantadine resistance 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, 2013-2014</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 lightred" headers=cr1>A (H3N2)</TH><TD class=alignRight headers="cr1 cr2 cc1 cc2">29 </TD><TD class=alignRight headers="cr1 cr2 cc1 cc3">0 </TD><TD class=alignRight headers="cr1 cr2 cc4 cc5">29 </TD><TD class=alignRight headers="cr1 cr2 cc4 cc6">0 </TD><TD class=alignRight headers="cr1 cr2 cc7 cc8">37 </TD><TD class=alignRight headers="cr1 cr2 cc7 cc9">37 (100%) </TD></TR><TR><TH id=cr3 class="alignLeft lightred" headers=cr1>A (H1N1)</TH><TD class=alignRight headers="cr1 cr3 cc1 cc2">325</TD><TD class=alignRight headers="cr1 cr3 cc1 cc3">0 </TD><TD class=alignRight headers="cr1 cr3 cc4 cc5">319</TD><TD class=alignRight headers="cr1 cr3 cc4 cc6">0 </TD><TD class=alignRight headers="cr1 cr3 cc7 cc8">304</TD><TD class=alignRight headers="cr1 cr3 cc7 cc9">304 (100%) </TD></TR><TR><TH id=cr4 class="alignLeft lightred" headers=cr1>B</TH><TD class=alignRight headers="cr1 cr4 cc1 cc2">43</TD><TD class=alignRight headers="cr1 cr4 cc1 cc3">0 </TD><TD class=alignRight headers="cr1 cr4 cc4 cc5">42</TD><TD class=alignRight headers="cr1 cr4 cc4 cc6">0 </TD><TD class=alignRight headers="cr1 cr4 cc7 cc8">NA <SUP>*</SUP></TD><TD class=alignRight headers="cr1 cr4 cc7 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft lightred" headers=cr1>TOTAL</TH><TD class=alignRight headers="cr1 cr5 cc1 cc2">397</TD><TD class=alignRight headers="cr1 cr5 cc1 cc3">0 </TD><TD class=alignRight headers="cr1 cr5 cc4 cc5">390 </TD><TD class=alignRight headers="cr1 cr5 cc4 cc6">0 </TD><TD class=alignRight headers="cr1 cr5 cc7 cc8">341</TD><TD class=alignRight headers="cr1 cr5 cc7 cc9">341 (100%) </TD></TR></TBODY></TABLE>
          Influenza-like Illness (ILI) Consultation Rate

          The national influenza-like-illness (ILI) consultation rate decreased from 65.4/1,000 in week 03 to 39.8/1,000 in week 04; which is within the expected range for week 04 (Figure 5).
          Figure 5. Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

          Note: No data available for mean rate for weeks 19 to 39 for the 1996-1997 through 2002-2003 seasons. Delays in the reporting of data may cause data to change retrospectively. The calculation of the average ILI consultation rate over 17 seasons was aligned with influenza activity in each season. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. The number of sentinel physicians in each province or territory is as follows: BC(21), AB(80), SK(11), MB(18), ON(169), QC(14), NB(29), NS(26), PE(4), NL(16), NU(1), NT(14), YT(13). Not all sentinel physicians report every week.
          Text equivalent for figure 5Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

          Top of Page

          Influenza Outbreak Surveillance

          In week 04, four new influenza outbreaks were reported in long-term care facilities (Figure 6). In addition, three outbreaks of influenza-like-illness were reported in other facilities or communities.
          Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2013-2014

          1 All provinces and territories except NU report outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
          Text equivalent for figure 6 Overall number of new influenza outbreaks by report week, Canada, 2013-2014
          Pharmacy Surveillance

          The rate of prescriptions for influenza antivirals declined for the second week in a row, following the downward trend in laboratory detections of influenza. In week 04, the largest proportion of prescriptions for antivirals continued to be among children 2-18 years of age followed by adults 19-64 years of age. The proportion of prescriptions for antivirals increased for infants <2 years of age and adults ≥65 years of age in week 04 (Figure 7).
          Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

          Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group. Age-groups: Infant: 0-2y, Child: 2-18y; Adult: 19-64y, Senior: ≥65y.
          Text equivalent for figure 7Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

          Top of Page

          Sentinel Hospital Influenza Surveillance

          Paediatric Influenza Hospitalizations and Deaths (IMPACT)
          In week 04, 51 new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 62 in week 03. All but three of the hospitalizations in week 04 were cases with influenza A (Figure 8a). Thirty-two (63%) of the cases were <5 years of age. Eleven ICU admissions were reported in week 04, one child under 6 months of age, two children 6-23 months of age, two 2-4 years of age, and six 5-9 years of age; all but one with influenza A. No deaths were reported.
          To date this season, a total of 359 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 95% of which have been influenza A, and almost all of those subtyped were A(H1N1)pdm09 (Table 4). Two hundred and eighty cases (78%) have been under 5 years of age. Fifty-eight ICU admissions have been reported; all but three cases with influenza A (the majority A(H1N1)pdm09), and 44.8% have been among children under 2 years of age (Figure 9a). Among the 52 ICU cases with available data, 35 (67%) were reported to have underlying medical conditions. No deaths have been reported.
          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)
          In week 04, 60 new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations reported through active surveillance by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 99 in week 03. Among cases in week 04, 56 (93.3%) were influenza A, of which 12 were A(H1N1)pdm09, one was A(H3N2) and 43 were A(unsubtyped). Two cases with influenza B were reported (Figure 8b). Almost half of the hospitalizations occurred among adults 45-64 years (29; 48.3%). Four ICU admissions were reported in week 04: three cases 45-64 years of age and one case ≥65 years of age. No deaths were reported (Figure 8b).
          To date this season, 645 influenza-associated hospitalizations have been reported by the PCIRN-SOS network, 619 (96.0%) with influenza A, predominantly A(H1N1)pdm09(Table 5). ICU admission was required for 101 hospitalizations, the majority of which were influenza A. Three quarters of hospitalizations and over 80% of ICU admissions were ≥45 years of age. Of the 67 ICU admissions with available information, 83.5% (56/67) were reported to have at least one comorbidity. Of the 86 ICU admissions with information on influenza vaccination, 58 (67%) reported not having been vaccinated this season. Twenty deaths have been reported, all with influenza A (13 A(H1N1)pdm09 and 7 A(unsubtyped)); ten cases 45-64 years of age, and ten cases ≥65 years of age (Figure 9b).
          Note: PCIRN-SOS conducted passive surveillance from April 30th to November 14th, 2013. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance began November 15th during which time PCIRN site coordinators investigate cases potentially related to influenza. Data from both active and passive surveillance reported during the 2013-14 season are included in this report. 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.
          <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t4 class=alignCenter>Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=dr1 rowSpan=3>Age groups </TH><TH id=dc1 colSpan=6>Cumulative (Aug. 25, 2013 to January 25, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=dc2 colSpan=4 headers=dc1>Influenza A </TH><TH id=dc7 headers=dc1>B </TH><TH id=dc8 headers=dc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=dc3 headers="dc1 dc2">A Total </TH><TH id=dc4 class="lightred " headers="dc1 dc2">A(H1) pdm09 </TH><TH id=dc5 class="lightred " headers="dc1 dc2">A(H3) </TH><TH id=dc6 class="lightred " headers="dc1 dc2">A (UnS) </TH><TD class=alignCenter headers="dc1 dc7">Total</TD><TD class=alignCenter headers="dc1 dc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
          UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
          </TD></TR></TFOOT><TBODY><TR><TH id=dr2 class=alignLeft headers=dr1>0-5m </TH><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc3">71 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc4">19 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc5">0 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc6">52 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc7">2 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc8">73 (20%) </TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc3">97 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc4">33 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc5">0 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc6">64 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc7">4 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc8">101 (28%) </TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc3">99 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc4">35 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc5">2 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc6">62 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc7">7 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc8">106 (30%) </TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc3">51 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc4">18 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc5">0 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc6">33 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc7">4 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc8">55 (15%) </TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc3">22 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc4">10 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc5">0 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc6">12 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc7">2 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc8">24 (7%) </TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignRight headers="dr1 dr7 dc1 dc2 dc3">340 </TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc4">115 </TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc5">2 </TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc6">223 </TD><TD class=alignRight headers="dr1 dr7 dc1 dc7">19 </TD><TD class=alignRight headers="dr1 dr7 dc1 dc8">359 </TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP> </TH><TD class=alignRight headers="dr1 dr8 dc1 dc2 dc3">94.7% </TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc4">33.8% </TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc5">0.6% </TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc6">65.6% </TD><TD class=alignRight headers="dr1 dr8 dc1 dc7">5.3% </TD><TD class=alignRight headers="dr1 dr8 dc1 dc8">100.0% </TD></TR></TBODY></TABLE>
          <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 5 - Cumulative numbers of adult hospitalizations with influenza
          reported by the PCIRN-SOS network, Canada, 2013-14
          </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=er1 rowSpan=3>Age groups </TH><TH id=ec1 class=noWrap colSpan=6>Cumulative (Aug. 25, 2013 to January 25, 2014)<SUP>*</SUP></TH></TR><TR class=bg-colour-yellow><TH id=ec2 colSpan=4 headers=ec1>Influenza A </TH><TH id=ec7 headers=ec1>B </TH><TH id=ec8 headers=ec1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=ec3 headers="ec1 ec2">A Total </TH><TH id=ec4 class="lightred " headers="ec1 ec2">A(H1) pdm09 </TH><TH id=ec5 class="lightred " headers="ec1 ec2">A(H3) </TH><TH id=ec6 class="lightred " headers="ec1 ec2">A(UnS) </TH><TD class=alignCenter headers="ec1 ec7">Total</TD><TD class=alignCenter headers="ec1 ec8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t5_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
          UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.

          <SUP id=footnote_t5_star>*</SUP> Fourteen cases for which the influenza type has not yet been reported, and four cases for which the age-group was not reported, are not included in Table 5.
          </TD></TR></TFOOT><TBODY><TR><TH id=er2 class=alignLeft headers=er1>16-20 </TH><TD class=alignRight headers="er1 er2 ec1 ec2 ec3">3 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec4">2 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec5">0 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec6">1 </TD><TD class=alignRight headers="er1 er2 ec1 ec7">1 </TD><TD class=alignRight headers="er1 er2 ec1 ec8">4 (1%) </TD></TR><TR><TH id=er3 class=alignLeft headers=er1>20-44 </TH><TD class=alignRight headers="er1 er3 ec1 ec2 ec3">143 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec4">73 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec5">2 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec6">68 </TD><TD class=alignRight headers="er1 er3 ec1 ec7">2 </TD><TD class=alignRight headers="er1 er3 ec1 ec8">145 (23%) </TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignRight headers="er1 er4 ec1 ec2 ec3">248 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec4">97 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec5">3 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec6">148 </TD><TD class=alignRight headers="er1 er4 ec1 ec7">4 </TD><TD class=alignRight headers="er1 er4 ec1 ec8">252 (40%) </TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignRight headers="er1 er5 ec1 ec2 ec3">220 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec4">98 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec5">9 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec6">113 </TD><TD class=alignRight headers="er1 er5 ec1 ec7">13 </TD><TD class=alignRight headers="er1 er5 ec1 ec8">233 (37%) </TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignRight headers="er1 er6 ec1 ec2 ec3">614 </TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec4">270 </TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec5">14 </TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec6">330 </TD><TD class=alignRight headers="er1 er6 ec1 ec7">20 </TD><TD class=alignRight headers="er1 er6 ec1 ec8">634 </TD></TR><TR><TH id=er7 class=alignLeft headers=er1>% <SUP>1</SUP></TH><TD class=alignRight headers="er1 er7 ec1 ec2 ec3">97% </TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec4">44% </TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec5">2% </TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec6">54% </TD><TD class=alignRight headers="er1 er7 ec1 ec7">3% </TD><TD class=alignRight headers="er1 er7 ec1 ec8">100% </TD></TR></TBODY></TABLE>
          Figure 8. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14
          A) Paediatric hospitalizations (≤16 years of age, IMPACT)


          Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
          B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)

          * See footnote above following the section related to PCIRN-SOS data.
          Text equivalent for figure 8bNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Adult hospitalizations (>16 year of age, PCIRN-SOS)
          Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14
          A) Paediatric hospitalizations (≤16 years of age, IMPACT)

          Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
          B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)

          Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Adult hospitalizations (≥16 year of age, PCIRN-SOS)

          Top of Page

          Provincial/Territorial Influenza Hospitalizations and Deaths

          In week 04, 302 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories.<SUP>*</SUP> The majority were cases of influenza A (293, 97.0%), of which 169 (57.7%) were A(H1N1)pdm09, 11 (3.8%) were A(H3N2), and 113 (38.6%) were A(unsubtyped). Among the 20 ICU admissions reported in week 04, 14 (70%) were adults 20-64 years of age. Twenty-six deaths were reported, half of which were adults 20-64 years of age. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total.
          To date this season, 2,298 influenza-associated hospitalizations have been reported, 97.7% with influenza A. The majority (58%) of hospitalizations have been cases 45 years of age of older (Table 6). A total of 217 ICU admissions have been reported this season: 77% were among adults 20-64 years of age. One hundred and thirteen deaths have been reported. The highest proportion of deaths has been among adults 20-64 years of age (51%), followed by adults ≥65 years of age (37%). Influenza B has been detected infrequently among severe cases of influenza to date this season: in only 2.3% of hospitalizations, 1.1% of ICU admissions, and 1.0% of deaths. It is important to note that the hospitalization or 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: 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 distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks.
          <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t6 class=alignCenter>Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=fr1 rowSpan=3>Age groups </TH><TH id=fc1 colSpan=6>Cumulative (Aug. 25, 2013 to January 25, 2014)* </TH></TR><TR class=bg-colour-yellow><TH id=fc2 colSpan=4 headers=fc1>Influenza A </TH><TH id=fc7 headers=fc1>B </TH><TH id=fc8 headers=fc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=fc3 headers="fc1 fc2">A Total </TH><TH id=fc4 class=lightred headers="fc1 fc2">A(H1) pdm09 </TH><TH id=fc5 class=lightred headers="fc1 fc2">A(H3) </TH><TH id=fc6 class=lightred headers="fc1 fc2">A (UnS) </TH><TD class=alignCenter headers="fc1 fc7">Total</TD><TD class=alignCenter headers="fc1 fc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=8><SUP>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
          UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
          * Six cases for which age information is not available have not been included in Table 6.
          </TD></TR></TFOOT><TBODY><TR><TH id=fr2 class=alignLeft headers=fr1>0-4 years </TH><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc3">393 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc4">205 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc5">5 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc6">183 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc7">14 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc8">407 (18%) </TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years </TH><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc3">80 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc4">46 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc5">3 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc6">31 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc7">3 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc8">83 (4%) </TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years </TH><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc3">25 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc4">16 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc5">1 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc6">8 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc7">1 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc8">26 (1%) </TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc3">395 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc4">303 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc5">3 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc6">89 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc7">3 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc8">398 (18%) </TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc3">739 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc4">498 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc5">12 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc6">229 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc7">7 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc8">746 (33%) </TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc3">564 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc4">334 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc5">37 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc6">193 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc7">25 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc8">589 (26%) </TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignRight headers="fr1 fr8 fc1 fc2 fc3">2196 </TD><TD class="alignRight lightred" headers="fr1 fr8 fc1 fc2 fc4">1402 </TD><TD class="alignRight lightred" headers="fr1 fr8 fc1 fc2 fc5">61 </TD><TD class="alignRight lightred" headers="fr1 fr8 fc1 fc2 fc6">733 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc7">53 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc8">2249 </TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP> </TH><TD class=alignRight headers="fr1 fr9 fc1 fc2 fc3">97.6% </TD><TD class="alignRight lightred" headers="fr1 fr9 fc1 fc2 fc4">63.8% </TD><TD class="alignRight lightred" headers="fr1 fr9 fc1 fc2 fc5">2.8% </TD><TD class="alignRight lightred" headers="fr1 fr9 fc1 fc2 fc6">33.4% </TD><TD class=alignRight headers="fr1 fr9 fc1 fc7">2.4% </TD><TD class=alignRight headers="fr1 fr9 fc1 fc8">100% </TD></TR></TBODY></TABLE>
          See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2013-14 on the Public Health Agency of Canada website.

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

          Comment


          • #20
            Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 5

            FluWatch report: January 26 to February 1, 2014 (Week 05)

            Posted 2014-02-07For 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/13-14/w05_14/pdf/fw2014-05-eng.pdf">FluWatch report: January 26 to February 1, 2014 (Week 05) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 291 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

            »» Help with PDF documents


            Overall Summary
            • In week 05, overall influenza activity continued to decrease in Canada, with most activity identified in eastern provinces.
            • The influenza A(H1N1) virus remains the most common influenza virus circulating this season. A Canadian vaccine effectiveness study has estimated that immunization with the 2013-14 seasonal influenza vaccine has been 74% effective in reducing doctors’ visits (Skowronski, Chambers, Sabaiduc et al., 2014). Influenza B virus detections are also starting to increase.
            • Adults 20-64 years of age continue to be more affected by influenza this season.
            • To week 05, 2,588 hospitalizations have been reported, slightly decreased compared to the same period last season. However, a greater proportion of hospitalizations have been admitted to the ICU. One hundred and thirty-eight deaths have been reported, which represents a similar proportion of deaths compared to last year.
            • Overall influenza activity in Canada during the 2013-14 season has been similar to the 2012-13 season and is within expected levels for this time of year.
            Influenza/ILI Activity (geographic spread)

            In week 05, one region in Quebec and one in Manitoba reported widespread activity, and 15 regions (in AB(1), ON(6), QC(4), NB(3) and NS(1)) reported localized activity (Figure 1). Compared to week 04, activity was stable or decreased in regions in AB, ON, PE, NL and NU; stable in BC, SK, NT and YT; and stable or increased in regions in MB and QC. A mixed pattern of activity was reported among regions in NB and NS.
            Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 05





            Note: Influenza/ILI 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 and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
            Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
            Influenza and Other Respiratory Virus Detections

            The number of positive influenza tests decreased for the third week in a row, from 2,568 in week 04 to 2,219 in week 05. The percentage of positive influenza tests decreased from 23.5% to 21.9% (Figure 2). Cumulative influenza virus detections to date remain predominantly influenza A (95%), and among those subtyped, 97% (8,679/8,977) were A(H1N1)pdm09. However, the percentage of positive tests for influenza B has been rising slowly in recent weeks to 9.5% of influenza detections in week 05 (Table 1). Among the 13,241 cases for which information on age and type/subtype has been received this season, 57.4% were 20-64 years of age and 15.5% were ≥65 years of age, which is different from the proportions observed during the 2012-13 season when 33.1% of cases were 20-64 years of age and 41.2% were ≥65 years of age (Table 2).
            Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14

            Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
            The number of positive tests for RSV continued the gradual increase observed since late November 2013. The percentage of the total number of tests that were positive has fluctuated during this period, but increased during the past two weeks. RSV in Canada shows a seasonal pattern with a broad peak over the winter months. The percentage of positive tests for coronavirus and human metapneumovirus continued to increase in week 05 (Figure 3).
            For more details, see the weekly Respiratory Virus Detections in Canada Report.
            Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2013-14


            Top of Page

            RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
            Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
            <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly and cumulative numbers of positive influenza specimens
            by type, subtype and province, Canada, 2013-14
            </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=ac1 colSpan=5>Weekly
            (January 26, 2013 to February 1, 2014)
            </TH><TH id=ac8 colSpan=5>Cumulative
            (August 25, 2013 to February 1, 2014)
            </TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=4 headers=ac1>Influenza A</TH><TH id=ac7 headers=ac1>B</TH><TH id=ac9 colSpan=4 headers=ac8>Influenza A</TH><TH id=ac14 headers=ac8>B</TH></TR><TR class=bg-colour-grey-light><TH id=ac3 headers="ac1 ac2">A Total</TH><TH id=ac4 class=lightred headers="ac1 ac2">A(H1)pdm09</TH><TH id=ac5 class=lightred headers="ac1 ac2">A(H3)</TH><TH id=ac6 class=lightred headers="ac1 ac2">A(UnS)</TH><TH class=alignCenter headers="ac1 ac7">B Total</TH><TH id=ac10 headers="ac8 ac9">A Total</TH><TH id=ac11 class=lightred headers="ac8 ac9">A(H1)pdm09</TH><TH id=ac12 class=lightred headers="ac8 ac9">A(H3)</TH><TH id=ac13 class=lightred headers="ac8 ac9">A(UnS)</TH><TD class=alignCenter headers="ac8 ac14">B Total</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
            <SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
            UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
            </TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=alignLeft headers=ar1>BC</TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">165 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">127 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">16 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">22 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac7">7 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac10">1474 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac11">1347 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac12">69 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac13">58 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac14">44 </TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">151 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">103 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">2 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">46 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac7">14 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac10">3268 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac11">3086 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac12">33 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac13">149 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac14">57 </TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">94 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">67 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">1 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">26 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac7">6 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac10">1177 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac11">848 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac12">2 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac13">327 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac14">10 </TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">71 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">55 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">16 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac7">0 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac10">418 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac11">276 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac12">1 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac13">141 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac14">13 </TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">474 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">127 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">24 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">323 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac7">25 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac10">4566 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac11">2094 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac12">185 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac13">2287 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac14">110 </TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">715 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">100 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">1 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">614 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac7">140 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac10">3375 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac11">425 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac12">3 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac13">2947 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac14">580 </TD></TR><TR><TH id=ar8 class=alignLeft headers=ar1>NB</TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">234 </TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac4">30 </TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac6">204 </TD><TD class=alignRight headers="ar1 ar8 ac1 ac7">1 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac10">1157 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac11">364 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac12">1 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac13">792 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac14">4 </TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">23 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">20 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">2 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">1 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac7">0 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac10">86 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac11">63 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac12">4 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac13">19 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac14">0 </TD></TR><TR><TH id=ar10 class=alignLeft headers=ar1>PE</TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">29 </TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac4">29 </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 ac7">0 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac10">72 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac11">72 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac12">0 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac13">0 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac14">0 </TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">53 </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">53 </TD><TD class=alignRight headers="ar1 ar11 ac1 ac7">17 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac10">258 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac11">104 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac12">0 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac13">154 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac14">99 </TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">2009 </TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac4">658 </TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac5">46 </TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac6">1305 </TD><TD class=alignRight headers="ar1 ar12 ac1 ac7">210 </TD><TD class=alignRight headers="ar1 ar12 ac8 ac9 ac10">15851 </TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac11">8679 </TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac12">298 </TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac13">6874 </TD><TD class=alignRight headers="ar1 ar12 ac8 ac14">917 </TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="ar1 ar13 ac1 ac2 ac3">90.5% </TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac4">32.8% </TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac5">2.3% </TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac6">65.0% </TD><TD class=alignRight headers="ar1 ar13 ac1 ac7">9.5% </TD><TD class=alignRight headers="ar1 ar13 ac8 ac9 ac10">94.5% </TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac11">54.8% </TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac12">1.9% </TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac13">43.4% </TD><TD class=alignRight headers="ar1 ar13 ac8 ac14">5.5% </TD></TR></TBODY></TABLE>

            <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups (years)</TH><TH id=bc1 colSpan=5>Weekly
            (January 26 to February 1, 2014)
            </TH><TH id=bc8 colSpan=7>Cumulative
            (August 25, 2013 to February 1, 2014)
            </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><TH id=bc15 colSpan=2 headers=bc8>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=bc3 headers="bc1 bc2">A Total</TH><TH id=bc4 class="lightred " headers="bc1 bc2">A(H1) pdm09</TH><TH id=bc5 class="lightred " headers="bc1 bc2">A(H3)</TH><TH id=bc6 class="lightred " headers="bc1 bc2">A (UnS)</TH><TD class=alignCenter headers="bc1 bc7">Total</TD><TH id=bc10 headers="bc8 bc9">A Total</TH><TH id=bc11 class="lightred " headers="bc8 bc9">A(H1) pdm09</TH><TH id=bc12 class="lightred " headers="bc8 bc9">A(H3)</TH><TH id=bc13 class="lightred " headers="bc8 bc9">A (UnS)</TH><TD class=alignCenter headers="bc8 bc14">Total</TD><TH id=bc16 headers="bc8 bc15">#</TH><TH id=bc17 headers="bc8 bc15">%</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13><SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
            <SUP>3 </SUP>Table 2 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
            UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
            </TD></TR></TFOOT><TBODY><TR><TH id=br2 class=alignLeft headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">218 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">53 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">0 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">165 </TD><TD class=alignRight headers="br1 br2 bc1 bc7">15 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">2307 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">1122 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">18 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1167 </TD><TD class=alignRight headers="br1 br2 bc8 bc14">98 </TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc16">2405 </TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc17">18.2% </TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">89 </TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">26 </TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">0 </TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">63 </TD><TD class=alignRight headers="br1 br3 bc1 bc7">24 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">963 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">562 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">15 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">386 </TD><TD class=alignRight headers="br1 br3 bc8 bc14">126 </TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc16">1089 </TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc17">8.2% </TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">246 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">89 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">2 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">155 </TD><TD class=alignRight headers="br1 br4 bc1 bc7">27 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">3886 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">2241 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">23 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">1622 </TD><TD class=alignRight headers="br1 br4 bc8 bc14">161 </TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc16">4047 </TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc17">30.6% </TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">215 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">69 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">1 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">145 </TD><TD class=alignRight headers="br1 br5 bc1 bc7">32 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">3321 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">1891 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">29 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">1401 </TD><TD class=alignRight headers="br1 br5 bc8 bc14">234 </TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc16">3555 </TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc17">26.8% </TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">126 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">26 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">1 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">99 </TD><TD class=alignRight headers="br1 br6 bc1 bc7">53 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">1713 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">740 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">56 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">917 </TD><TD class=alignRight headers="br1 br6 bc8 bc14">338 </TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc16">2051 </TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc17">15.5% </TD></TR><TR><TH id=br7 class=alignLeft 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">94 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">81 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">5 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">8 </TD><TD class=alignRight headers="br1 br7 bc8 bc14">0 </TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc16">94 </TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc17">0.7% </TD></TR><TR><TH id=br8 class=alignLeft headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">894 </TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc4">263 </TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc5">4 </TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc6">627 </TD><TD class=alignRight headers="br1 br8 bc1 bc7">151 </TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">12284 </TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc11">6637 </TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc12">146 </TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc13">5501 </TD><TD class=alignRight headers="br1 br8 bc8 bc14">957 </TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc16">13241 </TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc17">100.0% </TD></TR><TR><TH id=br9 class=alignLeft headers=br1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="br1 br9 bc1 bc2 bc3">85.6% </TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc4">29.4% </TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc5">0.4% </TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc6">70.1% </TD><TD class=alignRight headers="br1 br9 bc1 bc7">14.4% </TD><TD class=alignRight headers="br1 br9 bc8 bc9 bc10">92.8% </TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc11">54.0% </TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc12">1.2% </TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc13">44.8% </TD><TD class=alignRight headers="br1 br9 bc8 bc14">7.2% </TD><TD class=alignRight></TD><TD class=alignRight></TD></TR></TBODY></TABLE>

            Top of Page

            Influenza Strain Characterizations

            During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 750 influenza viruses [43 A(H3N2), 635 A(H1N1)pdm09 and 72 influenza B]. The vast majority (99%) of viruses were similar to the strains recommended by the WHO for the 2013-14 seasonal influenza vaccine. Two A(H1N1)pdm09 viruses showed reduced titres to antiserum against the reference A/California/07/2009 strain. Six influenza B viruses were similar to the strain recommended by the WHO for the 2011-12 vaccine (Figure 4).
            Figure 4. Influenza strain characterizations, Canada, 2013-14, N = 750

            The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
            The recommended components for the 2013-2014 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009 (H1N1)pdm09-like virus, an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b (e.g. A/Texas/50/2012), and a B/Massachusetts/2/2012-like virus (Yamagata lineage).


            Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
            Antiviral Resistance

            During the 2013-2014 influenza season, NML has tested 483 influenza viruses for resistance to oseltamivir and 479 viruses for resistance to zanamivir, and all were sensitive. All 418 influenza A viruses tested for amantadine resistance 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, 2013-2014</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 lightred" headers=cr1>A (H3N2)</TH><TD class=alignRight headers="cr1 cr2 cc1 cc2">34 </TD><TD class=alignRight headers="cr1 cr2 cc1 cc3">0 </TD><TD class=alignRight headers="cr1 cr2 cc4 cc5">34 </TD><TD class=alignRight headers="cr1 cr2 cc4 cc6">0 </TD><TD class=alignRight headers="cr1 cr2 cc7 cc8">40 </TD><TD class=alignRight headers="cr1 cr2 cc7 cc9">40 (100%) </TD></TR><TR><TH id=cr3 class="alignLeft lightred" headers=cr1>A (H1N1)</TH><TD class=alignRight headers="cr1 cr3 cc1 cc2">404</TD><TD class=alignRight headers="cr1 cr3 cc1 cc3">0 </TD><TD class=alignRight headers="cr1 cr3 cc4 cc5">400</TD><TD class=alignRight headers="cr1 cr3 cc4 cc6">0 </TD><TD class=alignRight headers="cr1 cr3 cc7 cc8">378</TD><TD class=alignRight headers="cr1 cr3 cc7 cc9">378 (100%) </TD></TR><TR><TH id=cr4 class="alignLeft lightred" headers=cr1>B</TH><TD class=alignRight headers="cr1 cr4 cc1 cc2">45</TD><TD class=alignRight headers="cr1 cr4 cc1 cc3">0 </TD><TD class=alignRight headers="cr1 cr4 cc4 cc5">45</TD><TD class=alignRight headers="cr1 cr4 cc4 cc6">0 </TD><TD class=alignRight headers="cr1 cr4 cc7 cc8">NA <SUP>*</SUP></TD><TD class=alignRight headers="cr1 cr4 cc7 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft lightred" headers=cr1>TOTAL</TH><TD class=alignRight headers="cr1 cr5 cc1 cc2">483</TD><TD class=alignRight headers="cr1 cr5 cc1 cc3">0 </TD><TD class=alignRight headers="cr1 cr5 cc4 cc5">479 </TD><TD class=alignRight headers="cr1 cr5 cc4 cc6">0 </TD><TD class=alignRight headers="cr1 cr5 cc7 cc8">418</TD><TD class=alignRight headers="cr1 cr5 cc7 cc9">418 (100%) </TD></TR></TBODY></TABLE>
            Influenza-like Illness (ILI) Consultation Rate

            The national influenza-like-illness (ILI) consultation rate continued to decrease from 34.6/1,000 in week 04 to 28.8/1,000 in week 05; which is within the expected range for week 05 (Figure 5).
            Figure 5. Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

            Note: No data available for mean rate for weeks 19 to 39 for the 1996-1997 through 2002-2003 seasons. Delays in the reporting of data may cause data to change retrospectively. The calculation of the average ILI consultation rate over 17 seasons was aligned with influenza activity in each season. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. The number of sentinel physicians in each province or territory is as follows: BC(21), AB(80), SK(11), MB(18), ON(169), QC(14), NB(29), NS(26), PE(4), NL(16), NU(1), NT(14), YT(13). Not all sentinel physicians report every week.
            Text equivalent for figure 5Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

            Top of Page

            Influenza Outbreak Surveillance

            In week 05, ten new influenza outbreaks were reported in long-term care facilities (Figure 6). In addition, five outbreaks of influenza-like-illness were reported: three in schools and two in other facilities or communities.
            Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2013-2014

            1 All provinces and territories except NU report outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
            Text equivalent for figure 6 Overall number of new influenza outbreaks by report week, Canada, 2013-2014
            Pharmacy Surveillance

            The rate of prescriptions for influenza antivirals declined for the third week in a row, following the downward trend in laboratory detections of influenza. In week 05, the largest proportion of prescriptions for antivirals continued to be among children 2-18 years of age followed by adults 19-64 years of age. The proportion of prescriptions for antivirals increased for infants <2 years of age in week 05 (Figure 7).
            Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

            Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group. Age-groups: Infant: 0-2y, Child: 2-18y; Adult: 19-64y, Senior: ≥65y.
            Text equivalent for figure 7Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

            Top of Page

            Sentinel Hospital Influenza Surveillance

            Paediatric Influenza Hospitalizations and Deaths (IMPACT)
            In week 05, 50 new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 56 in week 04. All but one of the hospitalizations in week 05 were cases with influenza A (Figure 8a). Forty-one (82%) of the cases were <5 years of age. Eight ICU admissions were reported in week 05, one child under 6 months of age, two children 6-23 months of age, three 2-4 years of age, and two 5-9 years of age; all with influenza A. No deaths were reported.
            To date this season, a total of 410 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 95% of which have been influenza A, and almost all of those subtyped were A(H1N1)pdm09. Children under 5 years of age represent 78.5% of cases to date (Table 4). Sixty-five ICU admissions have been reported; all but three cases with influenza A (the majority A(H1N1)pdm09), and 26 (40%) have been among children under 2 years of age (Figure 9a). Among the 55 ICU cases with available data, 38 (69%) were reported to have underlying medical conditions. No deaths have been reported.
            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)
            In week 05, 28 new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations reported through active surveillance by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 84 in week 04. Among cases in week 05, 26 (92.9%) were influenza A, of which four were A(H1N1)pdm09 and 22 were A(unsubtyped). One case with influenza B and one case without information on the influenza type were reported (Figure 8b). The majority of hospitalizations occurred among adults ≥45 years of age (22; 78.6%). Three ICU admissions were reported in week 05: one case in an adult 45-64 years of age and two cases ≥65 years of age. One death was reported in an adult 45-64 years of age with influenza A(unsubtyped).
            To date this season, 767 influenza-associated hospitalizations have been reported by the PCIRN-SOS network, 736 (96.0%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). ICU admission was required for 137 hospitalizations, all but six of which were cases with influenza A. More than three quarters of hospitalizations and over 85% of ICU admissions were ≥45 years of age. Of the 125 ICU admissions with available information, 85.6% (107/125) were reported to have at least one comorbidity. Of the 115 ICU admissions with information on influenza vaccination, 83 (72.2%) reported not having been vaccinated this season. Thirty-eight deaths have been reported, all with influenza A (22 A(H1N1)pdm09, one A(H3N2) and 15 A(unsubtyped)); five cases 20-44 years of age, 19 cases 45-64 years of age and 14 cases ≥65 years of age (Figure 9b).
            Note: PCIRN-SOS conducted passive surveillance from April 30th to November 14th, 2013. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance began November 15th during which time PCIRN site coordinators investigate cases potentially related to influenza. Data from both active and passive surveillance reported during the 2013-14 season are included in this report. 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.
            <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t4 class=alignCenter>Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=dr1 rowSpan=3>Age groups </TH><TH id=dc1 colSpan=6>Cumulative (Aug. 25, 2013 to February 1, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=dc2 colSpan=4 headers=dc1>Influenza A </TH><TH id=dc7 headers=dc1>B </TH><TH id=dc8 headers=dc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=dc3 headers="dc1 dc2">A Total </TH><TH id=dc4 class="lightred " headers="dc1 dc2">A(H1) pdm09 </TH><TH id=dc5 class="lightred " headers="dc1 dc2">A(H3) </TH><TH id=dc6 class="lightred " headers="dc1 dc2">A (UnS) </TH><TD class=alignCenter headers="dc1 dc7">Total</TD><TD class=alignCenter headers="dc1 dc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
            UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
            </TD></TR></TFOOT><TBODY><TR><TH id=dr2 class=alignLeft headers=dr1>0-5m </TH><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc3">78 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc4">22 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc5">0 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc6">56 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc7">2 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc8">80 (20%) </TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc3">114 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc4">36 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc5">1 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc6">77 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc7">4 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc8">118 (29%) </TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc3">116 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc4">39 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc5">2 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc6">75</TD><TD class=alignRight headers="dr1 dr4 dc1 dc7">8 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc8">124 (30%) </TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc3">58 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc4">18 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc5">0 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc6">40 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc7">4 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc8">62 (15%) </TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc3">24 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc4">11 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc5">0 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc6">13 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc7">2 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc8">26 (6%) </TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignRight headers="dr1 dr7 dc1 dc2 dc3">390 </TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc4">126 </TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc5">3 </TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc6">261 </TD><TD class=alignRight headers="dr1 dr7 dc1 dc7">20 </TD><TD class=alignRight headers="dr1 dr7 dc1 dc8">410 </TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP> </TH><TD class=alignRight headers="dr1 dr8 dc1 dc2 dc3">95.1% </TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc4">32.3% </TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc5">0.8% </TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc6">66.9% </TD><TD class=alignRight headers="dr1 dr8 dc1 dc7">4.9% </TD><TD class=alignRight headers="dr1 dr8 dc1 dc8">100.0% </TD></TR></TBODY></TABLE>
            <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 5 - Cumulative numbers of adult hospitalizations with influenza
            reported by the PCIRN-SOS network, Canada, 2013-14
            </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=er1 rowSpan=3>Age groups </TH><TH id=ec1 class=noWrap colSpan=6>Cumulative (Aug. 25, 2013 to February 1, 2014)<SUP>*</SUP></TH></TR><TR class=bg-colour-yellow><TH id=ec2 colSpan=4 headers=ec1>Influenza A </TH><TH id=ec7 headers=ec1>B </TH><TH id=ec8 headers=ec1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=ec3 headers="ec1 ec2">A Total </TH><TH id=ec4 class="lightred " headers="ec1 ec2">A(H1) pdm09 </TH><TH id=ec5 class="lightred " headers="ec1 ec2">A(H3) </TH><TH id=ec6 class="lightred " headers="ec1 ec2">A(UnS) </TH><TD class=alignCenter headers="ec1 ec7">Total</TD><TD class=alignCenter headers="ec1 ec8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t5_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
            UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.

            <SUP id=footnote_t5_star>*</SUP> Five cases for which the influenza type has not yet been reported, and five cases for which the age-group was not reported, are not included in Table 5.
            </TD></TR></TFOOT><TBODY><TR><TH id=er2 class=alignLeft headers=er1>16-20 </TH><TD class=alignRight headers="er1 er2 ec1 ec2 ec3">5 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec4">2 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec5">0 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec6">3 </TD><TD class=alignRight headers="er1 er2 ec1 ec7">1 </TD><TD class=alignRight headers="er1 er2 ec1 ec8">6 (1%) </TD></TR><TR><TH id=er3 class=alignLeft headers=er1>20-44 </TH><TD class=alignRight headers="er1 er3 ec1 ec2 ec3">166 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec4">94 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec5">2 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec6">70 </TD><TD class=alignRight headers="er1 er3 ec1 ec7">2 </TD><TD class=alignRight headers="er1 er3 ec1 ec8">168 (22%) </TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignRight headers="er1 er4 ec1 ec2 ec3">301 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec4">143 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec5">3 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec6">155 </TD><TD class=alignRight headers="er1 er4 ec1 ec7">5 </TD><TD class=alignRight headers="er1 er4 ec1 ec8">306 (40%) </TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignRight headers="er1 er5 ec1 ec2 ec3">259 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec4">141 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec5">13 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec6">105 </TD><TD class=alignRight headers="er1 er5 ec1 ec7">18 </TD><TD class=alignRight headers="er1 er5 ec1 ec8">277 (37%) </TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignRight headers="er1 er6 ec1 ec2 ec3">731 </TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec4">380 </TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec5">18 </TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec6">333 </TD><TD class=alignRight headers="er1 er6 ec1 ec7">26 </TD><TD class=alignRight headers="er1 er6 ec1 ec8">757 </TD></TR><TR><TH id=er7 class=alignLeft headers=er1>% <SUP>1</SUP></TH><TD class=alignRight headers="er1 er7 ec1 ec2 ec3">97% </TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec4">52% </TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec5">2% </TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec6">46% </TD><TD class=alignRight headers="er1 er7 ec1 ec7">3% </TD><TD class=alignRight headers="er1 er7 ec1 ec8">100% </TD></TR></TBODY></TABLE>
            Figure 8. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14
            A) Paediatric hospitalizations (≤16 years of age, IMPACT)


            Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
            B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)

            * See footnote above following the section related to PCIRN-SOS data.
            Text equivalent for figure 8bNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Adult hospitalizations (>16 year of age, PCIRN-SOS)
            Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14
            A) Paediatric hospitalizations (≤16 years of age, IMPACT)

            * One ICU admission for which age information is not available has not been included in Figure 9a.
            Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
            B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)

            Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Adult hospitalizations (≥16 year of age, PCIRN-SOS)

            Top of Page


            Provincial/Territorial Influenza Hospitalizations and Deaths

            In week 05, 244 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories.<SUP>*</SUP> The majority were cases of influenza A (236, 96.7%), of which 99 (41.9%) were A(H1N1)pdm09, 7 (3.0%) were A(H3N2), and 130 (55.1%) were A(unsubtyped). Among the 15 ICU admissions reported in week 05, the majority (11, 73.3%) were adults 20-64 years of age. Twenty-one deaths were reported, just over half of which were adults 20-64 years of age. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total.

            To date this season, 2,588 influenza-associated hospitalizations have been reported, 97.6% with influenza A. The majority (58%) of hospitalizations have been cases 45 years of age of older (Table 6). A total of 250 ICU admissions have been reported this season, and 71% were among adults 20-64 years of age. A total of 138 deaths have been reported. The highest proportion of deaths has been among adults 20-64 years of age (51%), followed by adults ≥65 years of age (36%). Influenza B has been detected infrequently among severe cases of influenza to date this season: in only 2.4% of hospitalizations, 0.4% of ICU admissions, and 1.4% of deaths. It is important to note that the hospitalization or 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: 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 distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks.
            <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t6 class=alignCenter>Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=fr1 rowSpan=3>Age groups </TH><TH id=fc1 colSpan=6>Cumulative (Aug. 25, 2013 to February 1, 2014)* </TH></TR><TR class=bg-colour-yellow><TH id=fc2 colSpan=4 headers=fc1>Influenza A </TH><TH id=fc7 headers=fc1>B </TH><TH id=fc8 headers=fc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=fc3 headers="fc1 fc2">A Total </TH><TH id=fc4 class=lightred headers="fc1 fc2">A(H1) pdm09 </TH><TH id=fc5 class=lightred headers="fc1 fc2">A(H3) </TH><TH id=fc6 class=lightred headers="fc1 fc2">A (UnS) </TH><TD class=alignCenter headers="fc1 fc7">Total</TD><TD class=alignCenter headers="fc1 fc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=8><SUP>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
            UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
            * Sixty-one cases for which age information is not available have not been included in Table 6.
            </TD></TR></TFOOT><TBODY><TR><TH id=fr2 class=alignLeft headers=fr1>0-4 years </TH><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc3">440 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc4">232 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc5">5 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc6">203 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc7">14 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc8">454 (18%) </TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years </TH><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc3">92 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc4">51 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc5">3 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc6">38 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc7">6 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc8">98 (4%) </TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years </TH><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc3">26 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc4">16 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc5">2 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc6">8 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc7">1 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc8">27 (1%) </TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc3">449 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc4">333 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc5">3 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc6">113 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc7">4 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc8">453 (18%) </TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc3">816 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc4">542 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc5">14 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc6">260 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc7">8 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc8">824 (33%) </TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc3">642 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc4">361 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc5">41 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc6">240 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc7">29 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc8">671 (27%) </TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignRight headers="fr1 fr8 fc1 fc2 fc3">2465 </TD><TD class="alignRight lightred" headers="fr1 fr8 fc1 fc2 fc4">1535 </TD><TD class="alignRight lightred" headers="fr1 fr8 fc1 fc2 fc5">68 </TD><TD class="alignRight lightred" headers="fr1 fr8 fc1 fc2 fc6">862 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc7">62 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc8">2527 </TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP> </TH><TD class=alignRight headers="fr1 fr9 fc1 fc2 fc3">97.5% </TD><TD class="alignRight lightred" headers="fr1 fr9 fc1 fc2 fc4">62.3% </TD><TD class="alignRight lightred" headers="fr1 fr9 fc1 fc2 fc5">2.8% </TD><TD class="alignRight lightred" headers="fr1 fr9 fc1 fc2 fc6">35.0% </TD><TD class=alignRight headers="fr1 fr9 fc1 fc7">2.5% </TD><TD class=alignRight headers="fr1 fr9 fc1 fc8">100% </TD></TR></TBODY></TABLE>
            See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2013-14 on the Public Health Agency of Canada website.
            .../

            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


            • #21
              Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 6

              FluWatch report: February 2 to 8, 2014 (Week 06)

              Posted 2014-02-14For 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/13-14/w06_14/pdf/fw2014-06-eng.pdf">FluWatch report: February 2 to 8, 2014 (Week 06) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 291 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

              »» Help with PDF documents


              Overall Summary
              • In week 06, overall influenza activity continued to decrease in Canada, with the exception of ongoing activity in the more eastern provinces which experienced a later start to the influenza season.
              • The influenza A(H1N1) virus remains the most common influenza virus circulating this season although influenza B virus detections continue to increase.
              • Adults 20-64 years of age continue to be more affected by influenza this season.
              • To week 06, 2,818 hospitalizations have been reported, which is slightly lower compared to the same period last season. One hundred and forty-three deaths have been reported.
              • Overall influenza activity in Canada during the 2013-14 season has been similar to the 2012-13 season and is within expected levels for this time of year.
              Influenza/ILI Activity (geographic spread)

              In week 06, one region in Manitoba reported widespread activity, and 11 regions (in BC(1), AB(1), ON(6), QC(2) and NS(1)) reported localized activity (Figure 1). Influenza activity levels are declining, with fewer regions reporting widespread or localized activity.
              Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 06





              Note: Influenza/ILI 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 and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
              Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
              Influenza and Other Respiratory Virus Detections

              The number of positive influenza tests continued to decrease, from 2,183 in week 05 to 1,811 in week 06. The percentage of positive influenza tests decreased from 21.5% to 20.0% (Figure 2). Cumulative influenza virus detections to date remain predominantly influenza A (94%), and among those subtyped, 97% (9,203/9,505) were A(H1N1)pdm09. However, the percentage of positive tests for influenza B has been rising slowly in recent weeks to 12.8% of influenza detections in week 06 (Table 1). Among the 15,051 cases for which information on age and type/subtype has been received this season, 56.9% were 20-64 years of age and 15.6% were ≥65 years of age, which is different from the proportions observed during the 2012-13 season when 33.1% of cases were 20-64 years of age and 41.2% were ≥65 years of age (Table 2).
              Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14

              Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
              The number of positive tests for RSV continued the gradual increase observed since late November 2013. The percentage of the total number of tests that were positive has fluctuated during this period, but increased during the past three weeks. RSV in Canada shows a seasonal pattern with a broad peak over the winter months. The number of positive tests for other respiratory viruses has been relatively stable in recent weeks (Figure 3).
              For more details, see the weekly Respiratory Virus Detections in Canada Report.
              Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2013-14


              Top of Page

              RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
              Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
              <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly and cumulative numbers of positive influenza specimens
              by type, subtype and province, Canada, 2013-14
              </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=ac1 colSpan=5>Weekly
              (February 2, 2013 to February 8, 2014)
              </TH><TH id=ac8 colSpan=5>Cumulative
              (August 25, 2013 to February 8, 2014)
              </TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=4 headers=ac1>Influenza A</TH><TH id=ac7 headers=ac1>B</TH><TH id=ac9 colSpan=4 headers=ac8>Influenza A</TH><TH id=ac14 headers=ac8>B</TH></TR><TR class=bg-colour-grey-light><TH id=ac3 headers="ac1 ac2">A Total</TH><TH id=ac4 class=lightred headers="ac1 ac2">A(H1)pdm09</TH><TH id=ac5 class=lightred headers="ac1 ac2">A(H3)</TH><TH id=ac6 class=lightred headers="ac1 ac2">A(UnS)</TH><TH class=alignCenter headers="ac1 ac7">B Total</TH><TH id=ac10 headers="ac8 ac9">A Total</TH><TH id=ac11 class=lightred headers="ac8 ac9">A(H1)pdm09</TH><TH id=ac12 class=lightred headers="ac8 ac9">A(H3)</TH><TH id=ac13 class=lightred headers="ac8 ac9">A(UnS)</TH><TD class=alignCenter headers="ac8 ac14">B Total</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
              <SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
              UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
              </TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=alignLeft headers=ar1>BC</TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">123</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">100</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">11</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">12</TD><TD class=alignRight headers="ar1 ar2 ac1 ac7">8</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac10">1562</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac11">1436</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac12">54</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac13">72</TD><TD class=alignRight headers="ar1 ar2 ac8 ac14">52</TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">127</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">86</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">3</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">38</TD><TD class=alignRight headers="ar1 ar3 ac1 ac7">16</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac10">3394</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac11">3186</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac12">36</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac13">172</TD><TD class=alignRight headers="ar1 ar3 ac8 ac14">74</TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">77</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">57</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">1</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">19</TD><TD class=alignRight headers="ar1 ar4 ac1 ac7">6</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac10">1254</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac11">905</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac12">3</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac13">346</TD><TD class=alignRight headers="ar1 ar4 ac8 ac14">16</TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">55</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">43</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">12</TD><TD class=alignRight headers="ar1 ar5 ac1 ac7">0</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac10">473</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac11">319</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac12">1</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac13">153</TD><TD class=alignRight headers="ar1 ar5 ac8 ac14">13</TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">356</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">104</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">15</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">237</TD><TD class=alignRight headers="ar1 ar6 ac1 ac7">60</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac10">4922</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac11">2198</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac12">200</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac13">2524</TD><TD class=alignRight headers="ar1 ar6 ac8 ac14">170</TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">625</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">88</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">537</TD><TD class=alignRight headers="ar1 ar7 ac1 ac7">130</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac10">4024</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac11">537</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac12">3</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac13">3484</TD><TD class=alignRight headers="ar1 ar7 ac8 ac14">710</TD></TR><TR><TH id=ar8 class=alignLeft headers=ar1>NB</TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">141</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">141</TD><TD class=alignRight headers="ar1 ar8 ac1 ac7">2</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac10">1298</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac11">364</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac12">1</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac13">933</TD><TD class=alignRight headers="ar1 ar8 ac8 ac14">6</TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">14</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">13</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">1</TD><TD class=alignRight headers="ar1 ar9 ac1 ac7">1</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac10">100</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac11">76</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac12">4</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac13">20</TD><TD class=alignRight headers="ar1 ar9 ac8 ac14">1</TD></TR><TR><TH id=ar10 class=alignLeft headers=ar1>PE</TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">30</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac4">30</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 ac7">0</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac10">78</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac11">78</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac13">0</TD><TD class=alignRight headers="ar1 ar10 ac8 ac14">0</TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">32</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">32</TD><TD class=alignRight headers="ar1 ar11 ac1 ac7">8</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac10">290</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac11">104</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac13">186</TD><TD class=alignRight headers="ar1 ar11 ac8 ac14">107</TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">1580</TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac4">521</TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac5">30</TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac6">1029</TD><TD class=alignRight headers="ar1 ar12 ac1 ac7">231</TD><TD class=alignRight headers="ar1 ar12 ac8 ac9 ac10">17395</TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac11">9203</TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac12">302</TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac13">7890</TD><TD class=alignRight headers="ar1 ar12 ac8 ac14">1149</TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="ar1 ar13 ac1 ac2 ac3">87.2%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac4">33.0%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac5">1.9%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac6">65.1%</TD><TD class=alignRight headers="ar1 ar13 ac1 ac7">12.8%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac9 ac10">93.8%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac11">52.9%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac12">1.7%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac13">45.4%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac14">6.2%</TD></TR></TBODY></TABLE>
              <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups (years)</TH><TH id=bc1 colSpan=5>Weekly
              (February 2 to February 8, 2014)
              </TH><TH id=bc8 colSpan=7>Cumulative
              (August 25, 2013 to February 8, 2014)
              </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><TH id=bc15 colSpan=2 headers=bc8>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=bc3 headers="bc1 bc2">A Total</TH><TH id=bc4 class="lightred " headers="bc1 bc2">A(H1) pdm09</TH><TH id=bc5 class="lightred " headers="bc1 bc2">A(H3)</TH><TH id=bc6 class="lightred " headers="bc1 bc2">A (UnS)</TH><TD class=alignCenter headers="bc1 bc7">Total</TD><TH id=bc10 headers="bc8 bc9">A Total</TH><TH id=bc11 class="lightred " headers="bc8 bc9">A(H1) pdm09</TH><TH id=bc12 class="lightred " headers="bc8 bc9">A(H3)</TH><TH id=bc13 class="lightred " headers="bc8 bc9">A (UnS)</TH><TD class=alignCenter headers="bc8 bc14">Total</TD><TH id=bc16 headers="bc8 bc15">#</TH><TH id=bc17 headers="bc8 bc15">%</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13><SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
              <SUP>3 </SUP>Table 2 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
              UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
              </TD></TR></TFOOT><TBODY><TR><TH id=br2 class=alignLeft headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">185</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">52</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">133</TD><TD class=alignRight headers="br1 br2 bc1 bc7">17</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">2617</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">1226</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">20</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1371</TD><TD class=alignRight headers="br1 br2 bc8 bc14">124</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc16">2741</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc17">18.2%</TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">77</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">17</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">60</TD><TD class=alignRight headers="br1 br3 bc1 bc7">38</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1104</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">614</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">16</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">474</TD><TD class=alignRight headers="br1 br3 bc8 bc14">178</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc16">1282</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc17">8.5%</TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">229</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">71</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">157</TD><TD class=alignRight headers="br1 br4 bc1 bc7">33</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">4329</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">2421</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">26</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">1882</TD><TD class=alignRight headers="br1 br4 bc8 bc14">206</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc16">4535</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc17">30.1%</TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">232</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">74</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">4</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">154</TD><TD class=alignRight headers="br1 br5 bc1 bc7">40</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">3742</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">2068</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">36</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">1638</TD><TD class=alignRight headers="br1 br5 bc8 bc14">289</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc16">4031</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc17">26.8%</TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">147</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">39</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">4</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">104</TD><TD class=alignRight headers="br1 br6 bc1 bc7">39</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">1960</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">817</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">78</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">1065</TD><TD class=alignRight headers="br1 br6 bc8 bc14">390</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc16">2350</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc17">15.6%</TD></TR><TR><TH id=br7 class=alignLeft headers=br1>Unknown</TH><TD class=alignRight headers="br1 br7 bc1 bc2 bc3">9</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc4">7</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc6">2</TD><TD class=alignRight headers="br1 br7 bc1 bc7">0</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc10">112</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">95</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">7</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">10</TD><TD class=alignRight headers="br1 br7 bc8 bc14">0</TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc16">112</TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc17">0.7%</TD></TR><TR><TH id=br8 class=alignLeft headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">879</TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc4">260</TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc5">9</TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc6">610</TD><TD class=alignRight headers="br1 br8 bc1 bc7">167</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">13864</TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc11">7241</TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc12">183</TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc13">6440</TD><TD class=alignRight headers="br1 br8 bc8 bc14">1,187</TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc16">15051</TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc17">100.0%</TD></TR><TR><TH id=br9 class=alignLeft headers=br1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="br1 br9 bc1 bc2 bc3">84.0%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc4">29.6%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc5">1.0%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc6">69.4%</TD><TD class=alignRight headers="br1 br9 bc1 bc7">16.0%</TD><TD class=alignRight headers="br1 br9 bc8 bc9 bc10">92.1%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc11">52.2%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc12">1.3%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc13">46.5%</TD><TD class=alignRight headers="br1 br9 bc8 bc14">7.9%</TD><TD class=alignRight></TD><TD class=alignRight></TD></TR></TBODY></TABLE>

              Top of Page

              Influenza Strain Characterizations

              During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 894 influenza viruses [48 A(H3N2), 755 A(H1N1)pdm09 and 91 influenza B]. The vast majority (99%) of viruses were similar to the strains recommended by the WHO for the 2013-14 seasonal influenza vaccine. Two A(H1N1)pdm09 viruses showed reduced titres to antiserum against the reference A/California/07/2009 strain. Nine influenza B viruses were similar to the strain recommended by the WHO for the 2011-12 vaccine (Figure 4).
              Figure 4. Influenza strain characterizations, Canada, 2013-14, N = 894

              The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
              The recommended components for the 2013-2014 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009 (H1N1)pdm09-like virus, an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b (e.g. A/Texas/50/2012), and a B/Massachusetts/2/2012-like virus (Yamagata lineage).


              Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
              Antiviral Resistance

              During the 2013-2014 influenza season, NML has tested 561 influenza viruses for resistance to oseltamivir and 552 viruses for resistance to zanamivir, and all were sensitive. All 549 influenza A viruses tested for amantadine resistance 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, 2013-2014</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 lightred" headers=cr1>A (H3N2)</TH><TD class=alignRight headers="cr1 cr2 cc1 cc2">41</TD><TD class=alignRight headers="cr1 cr2 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr2 cc4 cc5">41</TD><TD class=alignRight headers="cr1 cr2 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr2 cc7 cc8">53</TD><TD class=alignRight headers="cr1 cr2 cc7 cc9">53 (100%)</TD></TR><TR><TH id=cr3 class="alignLeft lightred" headers=cr1>A (H1N1)</TH><TD class=alignRight headers="cr1 cr3 cc1 cc2">472</TD><TD class=alignRight headers="cr1 cr3 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr3 cc4 cc5">463</TD><TD class=alignRight headers="cr1 cr3 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr3 cc7 cc8">496</TD><TD class=alignRight headers="cr1 cr3 cc7 cc9">496 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft lightred" headers=cr1>B</TH><TD class=alignRight headers="cr1 cr4 cc1 cc2">48</TD><TD class=alignRight headers="cr1 cr4 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr4 cc4 cc5">48</TD><TD class=alignRight headers="cr1 cr4 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr4 cc7 cc8">NA <SUP>*</SUP></TD><TD class=alignRight headers="cr1 cr4 cc7 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft lightred" headers=cr1>TOTAL</TH><TD class=alignRight headers="cr1 cr5 cc1 cc2">561</TD><TD class=alignRight headers="cr1 cr5 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr5 cc4 cc5">552</TD><TD class=alignRight headers="cr1 cr5 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr5 cc7 cc8">549</TD><TD class=alignRight headers="cr1 cr5 cc7 cc9">549 (100%)</TD></TR></TBODY></TABLE>
              Influenza-like Illness (ILI) Consultation Rate

              The national influenza-like-illness (ILI) consultation rate continued to decrease from 32.5/1,000 in week 05 to 27.2/1,000 in week 06; which is within the expected range for week 06 (Figure 5).
              Figure 5. Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

              Note: No data available for mean rate for weeks 19 to 39 for the 1996-1997 through 2002-2003 seasons. Delays in the reporting of data may cause data to change retrospectively. The calculation of the average ILI consultation rate over 17 seasons was aligned with influenza activity in each season. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. The number of sentinel physicians in each province or territory is as follows: BC(21), AB(80), SK(11), MB(18), ON(169), QC(14), NB(29), NS(26), PE(4), NL(16), NU(1), NT(14), YT(13). Not all sentinel physicians report every week.
              Text equivalent for figure 5Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

              Top of Page

              Influenza Outbreak Surveillance

              In week 06, 13 new influenza outbreaks were reported: three in hospitals and 10 in long-term care (Figure 6). In addition, six outbreaks of influenza-like-illness were reported: one in a school and five in other facilities or communities.
              Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2013-2014

              1 All provinces and territories except NU report outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
              Text equivalent for figure 6Overall number of new influenza outbreaks by report week, Canada, 2013-2014
              Pharmacy Surveillance

              In week 06, the proportion of prescriptions for influenza antivirals continued to decrease for all age groups, following the downward trend in laboratory detections of influenza. The largest proportion of prescriptions for antivirals continued to be among children 2-18 years of age followed by adults 19-64 years of age (Figure 7).
              Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

              Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group. Age-groups: Infant: 0-2y, Child: 2-18y; Adult: 19-64y, Senior: ≥65y.
              Text equivalent for figure 7Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

              Top of Page

              Sentinel Hospital Influenza Surveillance

              Paediatric Influenza Hospitalizations and Deaths (IMPACT)
              In week 06, 32 new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 55 in week 05, indicating that the number of new cases may be starting to decline. In week 06, influenza A was reported in 28 cases and influenza B in four cases (Figure 8a). Twenty-two (69%) of the cases were <5 years of age. Four ICU admissions were reported in week 06, one child under 6 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 A. No deaths were reported.
              To date this season, a total of 450 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 95% of which have been influenza A, and almost all of those subtyped were A(H1N1)pdm09. Children under 5 years of age represent 77.8% of cases to date (Table 4). Sixty-eight ICU admissions have been reported; all but three cases with influenza A (the majority A(H1N1)pdm09), and 29 (43%) among children under 2 years of age (Figure 9a). Among the 56 ICU cases with available data, 38 (68%) were reported to have underlying medical conditions. No deaths have been reported.
              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)
              In week 06, 40 new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations reported through active surveillance by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 52 in week 05. There has been a steady decline in the number of new cases over recent weeks. Among cases in week 06, 35 (87.5%) were influenza A, of which two were A(H1N1)pdm09 and 33 were A(unsubtyped). Four cases with influenza B and one case without information on the influenza type were reported (Figure 8b). The majority of hospitalizations occurred among adults ≥45 years of age (30; 75%). Three ICU admissions were reported in week 06: one case <20 years of age, one case 45-64 years of age and one case ≥65 years of age. No deaths were reported in week 06.
              To date this season, 887 influenza-associated hospitalizations have been reported by the PCIRN-SOS network, 851 (95.9%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). ICU admission was required for 155 hospitalizations, all but five of which were cases with influenza A. More than three quarters of hospitalizations and approximately 80% of ICU admissions were ≥45 years of age. Of the 134 ICU admissions with available information, 86.6% (116/134) were reported to have at least one comorbidity. Of the 133 ICU admissions with information on influenza vaccination, 97 (72.9%) reported not having been vaccinated this season. Forty-three deaths have been reported, all with influenza A (26 A(H1N1)pdm09, one A(H3N2) and 13 A(unsubtyped)); five cases 20-44 years of age, 23 cases 45-64 years of age and 15 cases ≥65 years of age (Figure 9b).
              Note: PCIRN-SOS conducted passive surveillance from April 30th to November 14th, 2013. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance began November 15th during which time PCIRN site coordinators investigate cases potentially related to influenza. Data from both active and passive surveillance reported during the 2013-14 season are included in this report. 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.
              <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t4 class=alignCenter>Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=dr1 rowSpan=3>Age groups </TH><TH id=dc1 colSpan=6>Cumulative (Aug. 25, 2013 to February 8, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=dc2 colSpan=4 headers=dc1>Influenza A </TH><TH id=dc7 headers=dc1>B </TH><TH id=dc8 headers=dc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=dc3 headers="dc1 dc2">A Total </TH><TH id=dc4 class="lightred " headers="dc1 dc2">A(H1) pdm09 </TH><TH id=dc5 class="lightred " headers="dc1 dc2">A(H3) </TH><TH id=dc6 class="lightred " headers="dc1 dc2">A (UnS) </TH><TD class=alignCenter headers="dc1 dc7">Total</TD><TD class=alignCenter headers="dc1 dc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
              UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
              </TD></TR></TFOOT><TBODY><TR><TH id=dr2 class=alignLeft headers=dr1>0-5m </TH><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc3">83</TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc4">23</TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc5">0</TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc6">60</TD><TD class=alignRight headers="dr1 dr2 dc1 dc7">2</TD><TD class=alignRight headers="dr1 dr2 dc1 dc8">85 (19%)</TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc3">127</TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc4">38</TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc5">1</TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc6">88</TD><TD class=alignRight headers="dr1 dr3 dc1 dc7">4</TD><TD class=alignRight headers="dr1 dr3 dc1 dc8">131 (29%)</TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc3">125</TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc4">43</TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc5">2</TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc6">80</TD><TD class=alignRight headers="dr1 dr4 dc1 dc7">9</TD><TD class=alignRight headers="dr1 dr4 dc1 dc8">134 (30%)</TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc3">64</TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc4">18</TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc5">0</TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc6">46</TD><TD class=alignRight headers="dr1 dr5 dc1 dc7">7</TD><TD class=alignRight headers="dr1 dr5 dc1 dc8">71 (16%)</TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc3">27</TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc4">11</TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc5">0</TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc6">16</TD><TD class=alignRight headers="dr1 dr6 dc1 dc7">2</TD><TD class=alignRight headers="dr1 dr6 dc1 dc8">29 (6%)</TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignRight headers="dr1 dr7 dc1 dc2 dc3">426</TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc4">133</TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc5">3</TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc6">290</TD><TD class=alignRight headers="dr1 dr7 dc1 dc7">24</TD><TD class=alignRight headers="dr1 dr7 dc1 dc8">450</TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP> </TH><TD class=alignRight headers="dr1 dr8 dc1 dc2 dc3">94.7%</TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc4">31.2%</TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc5">0.7%</TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc6">68.1%</TD><TD class=alignRight headers="dr1 dr8 dc1 dc7">5.3%</TD><TD class=alignRight headers="dr1 dr8 dc1 dc8">100.0%</TD></TR></TBODY></TABLE>
              <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 5 - Cumulative numbers of adult hospitalizations with influenza
              reported by the PCIRN-SOS network, Canada, 2013-14
              </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=er1 rowSpan=3>Age groups </TH><TH id=ec1 class=noWrap colSpan=6>Cumulative (Aug. 25, 2013 to February 8, 2014)<SUP>*</SUP></TH></TR><TR class=bg-colour-yellow><TH id=ec2 colSpan=4 headers=ec1>Influenza A </TH><TH id=ec7 headers=ec1>B </TH><TH id=ec8 headers=ec1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=ec3 headers="ec1 ec2">A Total </TH><TH id=ec4 class="lightred " headers="ec1 ec2">A(H1) pdm09 </TH><TH id=ec5 class="lightred " headers="ec1 ec2">A(H3) </TH><TH id=ec6 class="lightred " headers="ec1 ec2">A(UnS) </TH><TD class=alignCenter headers="ec1 ec7">Total</TD><TD class=alignCenter headers="ec1 ec8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t5_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
              UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.

              <SUP id=footnote_t5_star>*</SUP>Three cases for which the influenza type has not yet been reported, and five cases for which the age-group was not reported, are not included in Table 5.
              </TD></TR></TFOOT><TBODY><TR><TH id=er2 class=alignLeft headers=er1>16-20 </TH><TD class=alignRight headers="er1 er2 ec1 ec2 ec3">7</TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec4">3</TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec5">0</TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec6">4</TD><TD class=alignRight headers="er1 er2 ec1 ec7">1</TD><TD class=alignRight headers="er1 er2 ec1 ec8">8 (1%)</TD></TR><TR><TH id=er3 class=alignLeft headers=er1>20-44 </TH><TD class=alignRight headers="er1 er3 ec1 ec2 ec3">191</TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec4">105</TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec5">2</TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec6">84</TD><TD class=alignRight headers="er1 er3 ec1 ec7">2</TD><TD class=alignRight headers="er1 er3 ec1 ec8">193 (22%)</TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignRight headers="er1 er4 ec1 ec2 ec3">339</TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec4">157</TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec5">3</TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec6">179</TD><TD class=alignRight headers="er1 er4 ec1 ec7">5</TD><TD class=alignRight headers="er1 er4 ec1 ec8">344 (39%)</TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignRight headers="er1 er5 ec1 ec2 ec3">309</TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec4">159</TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec5">15</TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec6">135</TD><TD class=alignRight headers="er1 er5 ec1 ec7">25</TD><TD class=alignRight headers="er1 er5 ec1 ec8">334 (38%)</TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignRight headers="er1 er6 ec1 ec2 ec3">846</TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec4">424</TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec5">20</TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec6">402</TD><TD class=alignRight headers="er1 er6 ec1 ec7">33</TD><TD class=alignRight headers="er1 er6 ec1 ec8">879</TD></TR><TR><TH id=er7 class=alignLeft headers=er1>% <SUP>1</SUP></TH><TD class=alignRight headers="er1 er7 ec1 ec2 ec3">96%</TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec4">50%</TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec5">2%</TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec6">48%</TD><TD class=alignRight headers="er1 er7 ec1 ec7">4%</TD><TD class=alignRight headers="er1 er7 ec1 ec8">100%</TD></TR></TBODY></TABLE>
              Figure 8. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14
              A) Paediatric hospitalizations (≤16 years of age, IMPACT)


              Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
              B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)

              * See footnote above following the section related to PCIRN-SOS data.
              Text equivalent for figure 8bNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Adult hospitalizations (>16 year of age, PCIRN-SOS)
              Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14
              A) Paediatric hospitalizations (≤16 years of age, IMPACT)

              * One ICU admission for which age information is not available has not been included in Figure 9a.
              Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
              B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)

              Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Adult hospitalizations (≥16 year of age, PCIRN-SOS)

              Top of Page

              Provincial/Territorial Influenza Hospitalizations and Deaths

              In week 06, 208 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories.<SUP>*</SUP> The majority were cases of influenza A (198, 95.2%), of which 96 (48.5%) were A(H1N1)pdm09, 8 (4.0%) were A(H3N2), and 94 (47.5%) were A(unsubtyped). Among the 12 ICU admissions reported in week 06, the majority (7, 58.3%) were adults 20-64 years of age. Fourteen deaths were reported, over half of which were adults 20-64 years of age. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total.
              To date this season, 2,818 influenza-associated hospitalizations have been reported, 97.4% with influenza A. The majority (57.7%) of hospitalizations have been cases 45 years of age of older (Table 6). A total of 277 ICU admissions have been reported this season, and 70.4% were among adults 20-64 years of age. A total of 143 deaths have been reported. The highest proportion of deaths has been among adults 20-64 years of age (55.9%), followed by adults ≥65 years of age (35.7%). Influenza B has been detected infrequently among severe cases of influenza to date this season: in only 2.6% of hospitalizations, 1.1% of ICU admissions, and 1.4% of deaths. It is important to note that the hospitalization or 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: 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 distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks.
              <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t6 class=alignCenter>Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=fr1 rowSpan=3>Age groups </TH><TH id=fc1 colSpan=6>Cumulative (Aug. 25, 2013 to February 8, 2014)* </TH></TR><TR class=bg-colour-yellow><TH id=fc2 colSpan=4 headers=fc1>Influenza A </TH><TH id=fc7 headers=fc1>B </TH><TH id=fc8 headers=fc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=fc3 headers="fc1 fc2">A Total </TH><TH id=fc4 class=lightred headers="fc1 fc2">A(H1) pdm09 </TH><TH id=fc5 class=lightred headers="fc1 fc2">A(H3) </TH><TH id=fc6 class=lightred headers="fc1 fc2">A (UnS) </TH><TD class=alignCenter headers="fc1 fc7">Total</TD><TD class=alignCenter headers="fc1 fc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=8><SUP>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
              UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
              * Seventy-seven cases for which age information is not available have not been included in Table 6.
              </TD></TR></TFOOT><TBODY><TR><TH id=fr2 class=alignLeft headers=fr1>0-4 years </TH><TD class=alignRight headers="fr10 fr11 fc9 fc10 fc13">466</TD><TD class=alignRight headers="fr10 fr11 fc9 fc10 fc14">239</TD><TD class=alignRight headers="fr10 fr11 fc9 fc10 fc15">6</TD><TD class=alignRight headers="fr10 fr11 fc9 fc10 fc16">221</TD><TD class=alignRight headers="fr10 fr11 fc9 fc11">16</TD><TD class=alignRight headers="fr10 fr11 fc9 fc12">482 (18%)</TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years </TH><TD class=alignRight headers="fr10 fr12 fc9 fc10 fc13">104</TD><TD class=alignRight headers="fr10 fr12 fc9 fc10 fc14">56</TD><TD class=alignRight headers="fr10 fr12 fc9 fc10 fc15">5</TD><TD class=alignRight headers="fr10 fr12 fc9 fc10 fc16">43</TD><TD class=alignRight headers="fr10 fr12 fc9 fc11">8</TD><TD class=alignRight headers="fr10 fr12 fc9 fc12">112 (4%)</TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years </TH><TD class=alignRight headers="fr10 fr13 fc9 fc10 fc13">27</TD><TD class=alignRight headers="fr10 fr13 fc9 fc10 fc14">16</TD><TD class=alignRight headers="fr10 fr13 fc9 fc10 fc15">2</TD><TD class=alignRight headers="fr10 fr13 fc9 fc10 fc16">9</TD><TD class=alignRight headers="fr10 fr13 fc9 fc11">1</TD><TD class=alignRight headers="fr10 fr13 fc9 fc12">28 (1%)</TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignRight headers="fr10 fr14 fc9 fc10 fc13">488</TD><TD class=alignRight headers="fr10 fr14 fc9 fc10 fc14">357</TD><TD class=alignRight headers="fr10 fr14 fc9 fc10 fc15">3</TD><TD class=alignRight headers="fr10 fr14 fc9 fc10 fc16">128</TD><TD class=alignRight headers="fr10 fr14 fc9 fc11">4</TD><TD class=alignRight headers="fr10 fr14 fc9 fc12">492 (18%)</TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignRight headers="fr10 fr15 fc9 fc10 fc13">887</TD><TD class=alignRight headers="fr10 fr15 fc9 fc10 fc14">586</TD><TD class=alignRight headers="fr10 fr15 fc9 fc10 fc15">16</TD><TD class=alignRight headers="fr10 fr15 fc9 fc10 fc16">285</TD><TD class=alignRight headers="fr10 fr15 fc9 fc11">11</TD><TD class=alignRight headers="fr10 fr15 fc9 fc12">898 (33%)</TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignRight headers="fr10 fr16 fc9 fc10 fc13">697</TD><TD class=alignRight headers="fr10 fr16 fc9 fc10 fc14">384</TD><TD class=alignRight headers="fr10 fr16 fc9 fc10 fc15">44</TD><TD class=alignRight headers="fr10 fr16 fc9 fc10 fc16">269</TD><TD class=alignRight headers="fr10 fr16 fc9 fc11">32</TD><TD class=alignRight headers="fr10 fr16 fc9 fc12">729 (27%)</TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignRight headers="fr10 fr17 fc9 fc10 fc13">2669</TD><TD class="alignRight lightred" headers="fr10 fr17 fc9 fc10 fc14">1638</TD><TD class="alignRight lightred" headers="fr10 fr17 fc9 fc10 fc15">76</TD><TD class="alignRight lightred" headers="fr10 fr17 fc9 fc10 fc16">955</TD><TD class=alignRight headers="fr10 fr17 fc9 fc11">72</TD><TD class=alignRight headers="fr10 fr17 fc9 fc12">2741</TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP> </TH><TD class=alignRight headers="fr10 fr18 fc9 fc10 fc13">97.4%</TD><TD class="alignRight lightred" headers="fr10 fr18 fc9 fc10 fc14">61.4%</TD><TD class="alignRight lightred" headers="fr10 fr18 fc9 fc10 fc15">2.8%</TD><TD class="alignRight lightred" headers="fr10 fr18 fc9 fc10 fc16">35.8%</TD><TD class=alignRight headers="fr10 fr18 fc9 fc11">2.6%</TD><TD class=alignRight headers="fr10 fr18 fc9 fc12">100%</TD></TR></TBODY></TABLE>
              See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2013-14 on the Public Health Agency of Canada website.

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

              Comment


              • #22
                Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 8

                FluWatch report: February 16 to 22, 2014 (Week 08)

                Posted 2014-02-28For 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/13-14/w08_14/pdf/fw2014-08-eng.pdf">FluWatch report: February 16 to 22, 2014 (Week 08) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 291 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

                »» Help with PDF documents


                Overall Summary
                • In week 08, overall influenza activity continued to decrease in Canada except in the eastern provinces which experienced a later start to the influenza season.
                • The influenza A(H1N1) virus remains the most common influenza virus circulating this season although influenza B virus detections continue to increase.
                • Adults 20-64 years of age continue to be more affected by influenza this season. However, the increasing circulation of influenza B may result in greater impact on older adults and children in the coming weeks.
                • To week 08, 3,093 hospitalizations and 171 deaths have been reported, which is fewer than were reported during the same period last season.
                • Overall influenza activity in Canada during the 2013-14 season has been similar to the 2012-13 season and is within expected levels for this time of year.
                Influenza/ILI Activity (geographic spread)

                In week 08, influenza activity levels continued to decline. No regions reported widespread activity and ten regions in eastern Canada (ON(5), QC(3) and NS(2)) reported localized activity (Figure 1).
                Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 08





                Note: Influenza/ILI 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 and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
                Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
                Influenza and Other Respiratory Virus Detections

                The number of positive influenza tests continued to decrease, from 1,315 in week 07 to 1,014 in week 08. The percentage of positive influenza tests decreased from 16.9% to 14.3% (Figure 2). Laboratory detections continue to follow a similar trend to the 2012-13 season, despite the difference in the predominant circulating virus. Cumulative influenza virus detections to date remain predominantly influenza A (92%), and among those subtyped, 97% (9,724/10,060) were A(H1N1)pdm09. However, the percentage of positive tests for influenza B has been rising slowly in recent weeks to 28.7% of influenza detections in week 08 (Table 1). A similar late-season wave of influenza B was observed during the 2012-13 and 2010-11 influenza seasons. Among the 16,968 cases for which information on age and type/subtype has been received this season, 56.1% were 20-64 years of age (Table 2).
                Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14

                Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
                The percentages of positive tests for RSV, human metapneumovirus and rhinovirus have been increasing over recent weeks. The percentage of positive tests for coronavirus and parainfluenza have been declining (Figure 3).
                For more details, see the weekly Respiratory Virus Detections in Canada Report.
                Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2013-14


                Top of Page

                RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
                Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
                <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly and cumulative numbers of positive influenza specimens
                by type, subtype and province, Canada, 2013-14
                </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=ac1 colSpan=5>Weekly
                (February 16, 2013 to February 22, 2014)
                </TH><TH id=ac8 colSpan=5>Cumulative
                (August 25, 2013 to February 22, 2014)
                </TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=4 headers=ac1>Influenza A</TH><TH id=ac7 headers=ac1>B</TH><TH id=ac9 colSpan=4 headers=ac8>Influenza A</TH><TH id=ac14 headers=ac8>B</TH></TR><TR class=bg-colour-grey-light><TH id=ac3 headers="ac1 ac2">A Total</TH><TH id=ac4 class=lightred headers="ac1 ac2">A(H1)pdm09</TH><TH id=ac5 class=lightred headers="ac1 ac2">A(H3)</TH><TH id=ac6 class=lightred headers="ac1 ac2">A(UnS)</TH><TH class=alignCenter headers="ac1 ac7">B Total</TH><TH id=ac10 headers="ac8 ac9">A Total</TH><TH id=ac11 class=lightred headers="ac8 ac9">A(H1)pdm09</TH><TH id=ac12 class=lightred headers="ac8 ac9">A(H3)</TH><TH id=ac13 class=lightred headers="ac8 ac9">A(UnS)</TH><TD class=alignCenter headers="ac8 ac14">B Total</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
                <SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
                </TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=alignLeft headers=ar1>BC</TH><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac3">80 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac4">43 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac5">8 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac6">29 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac7">12 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac10">1687 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac11">1526 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac12">51 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac13">110 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac14">77 </TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac3">75 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac4">35 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac5">3 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac6">37 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac7">7 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac10">3542 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac11">3265 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac12">42 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac13">235 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac14">90 </TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac3">17 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac4">11 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac6">6 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac7">3 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac10">1317 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac11">950 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac12">4 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac13">363 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac14">24 </TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac3">31 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac4">29 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac6">2 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac7">0 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac10">538 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac11">378 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac12">1 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac13">159 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac14">15 </TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac3">98 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac4">19 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac5">14 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac6">65 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac7">80 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac10">5248 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac11">2305 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac12">230 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac13">2713 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac14">305 </TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac3">323 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac4">37 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac6">286 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac7">178 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac10">4807 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac11">616 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac12">3 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac13">4188 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac14">1038 </TD></TR><TR><TH id=ar8 class=alignLeft headers=ar1>NB</TH><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac3">71 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac6">71 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac7">2 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac10">1418 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac11">364 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac12">1 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac13">1053 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac14">10 </TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac3">14 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac4">11 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac6">3 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac7">0 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac10">129 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac11">102 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac12">4 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac13">23 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac14">1 </TD></TR><TR><TH id=ar10 class=alignLeft headers=ar1>PE</TH><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac3">7 </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac4">6 </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac6">1 </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac7">0 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac10">115 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac11">114 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac12">0 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac13">1 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac14">0 </TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac3">7 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac6">7 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac7">9 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac10">324 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac11">104 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac12">0 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac13">220 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac14">123 </TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignCenter headers="ar1 ar12 ac1 ac2 ac3">723 </TD><TD class="alignCenter lightred" headers="ar1 ar12 ac1 ac2 ac4">191 </TD><TD class="alignCenter lightred" headers="ar1 ar12 ac1 ac2 ac5">25 </TD><TD class="alignCenter lightred" headers="ar1 ar12 ac1 ac2 ac6">507 </TD><TD class=alignCenter headers="ar1 ar12 ac1 ac7">291 </TD><TD class=alignCenter headers="ar1 ar12 ac8 ac9 ac10">19125 </TD><TD class="alignCenter lightred" headers="ar1 ar12 ac8 ac9 ac11">9724 </TD><TD class="alignCenter lightred" headers="ar1 ar12 ac8 ac9 ac12">336 </TD><TD class="alignCenter lightred" headers="ar1 ar12 ac8 ac9 ac13">9065 </TD><TD class=alignCenter headers="ar1 ar12 ac8 ac14">1683 </TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignCenter headers="ar1 ar13 ac1 ac2 ac3">71.3% </TD><TD class="alignCenter lightred" headers="ar1 ar13 ac1 ac2 ac4">26.4% </TD><TD class="alignCenter lightred" headers="ar1 ar13 ac1 ac2 ac5">3.5% </TD><TD class="alignCenter lightred" headers="ar1 ar13 ac1 ac2 ac6">70.1% </TD><TD class=alignCenter headers="ar1 ar13 ac1 ac7">28.7% </TD><TD class=alignCenter headers="ar1 ar13 ac8 ac9 ac10">91.9% </TD><TD class="alignCenter lightred" headers="ar1 ar13 ac8 ac9 ac11">50.8% </TD><TD class="alignCenter lightred" headers="ar1 ar13 ac8 ac9 ac12">1.8% </TD><TD class="alignCenter lightred" headers="ar1 ar13 ac8 ac9 ac13">47.4% </TD><TD class=alignCenter headers="ar1 ar13 ac8 ac14">8.1% </TD></TR></TBODY></TABLE>
                <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups (years)</TH><TH id=bc1 colSpan=5>Weekly
                (February 16 to February 22, 2014)
                </TH><TH id=bc8 colSpan=7>Cumulative
                (August 25, 2013 to February 22, 2014)
                </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><TH id=bc15 colSpan=2 headers=bc8>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=bc3 headers="bc1 bc2">A Total</TH><TH id=bc4 class="lightred " headers="bc1 bc2">A(H1) pdm09</TH><TH id=bc5 class="lightred " headers="bc1 bc2">A(H3)</TH><TH id=bc6 class="lightred " headers="bc1 bc2">A (UnS)</TH><TD class=alignCenter headers="bc1 bc7">Total</TD><TH id=bc10 headers="bc8 bc9">A Total</TH><TH id=bc11 class="lightred " headers="bc8 bc9">A(H1) pdm09</TH><TH id=bc12 class="lightred " headers="bc8 bc9">A(H3)</TH><TH id=bc13 class="lightred " headers="bc8 bc9">A (UnS)</TH><TD class=alignCenter headers="bc8 bc14">Total</TD><TH id=bc16 headers="bc8 bc15">#</TH><TH id=bc17 headers="bc8 bc15">%</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13><SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                <SUP>3 </SUP>Table 2 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
                UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
                </TD></TR></TFOOT><TBODY><TR><TH id=br2 class=alignLeft headers=br1><5</TH><TD class=alignCenter headers="br1 br2 bc1 bc2 bc3">102 </TD><TD class=alignCenter headers="br1 br2 bc1 bc2 bc4">24 </TD><TD class=alignCenter headers="br1 br2 bc1 bc2 bc5">2 </TD><TD class=alignCenter headers="br1 br2 bc1 bc2 bc6">76 </TD><TD class=alignCenter headers="br1 br2 bc1 bc7">20 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc10">2936 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc11">1324 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc12">23 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc13">1589 </TD><TD class=alignCenter headers="br1 br2 bc8 bc14">173 </TD><TD class=alignCenter headers="br1 br2 bc8 bc15 bc16">3109 </TD><TD class=alignCenter headers="br1 br2 bc8 bc15 bc17">18.3% </TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignCenter headers="br1 br3 bc1 bc2 bc3">32 </TD><TD class=alignCenter headers="br1 br3 bc1 bc2 bc4">7 </TD><TD class=alignCenter headers="br1 br3 bc1 bc2 bc5">0 </TD><TD class=alignCenter headers="br1 br3 bc1 bc2 bc6">25 </TD><TD class=alignCenter headers="br1 br3 bc1 bc7">30 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc10">1216 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc11">654 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc12">18 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc13">544 </TD><TD class=alignCenter headers="br1 br3 bc8 bc14">261 </TD><TD class=alignCenter headers="br1 br3 bc8 bc15 bc16">1477 </TD><TD class=alignCenter headers="br1 br3 bc8 bc15 bc17">8.7% </TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignCenter headers="br1 br4 bc1 bc2 bc3">109 </TD><TD class=alignCenter headers="br1 br4 bc1 bc2 bc4">24 </TD><TD class=alignCenter headers="br1 br4 bc1 bc2 bc5">1 </TD><TD class=alignCenter headers="br1 br4 bc1 bc2 bc6">84 </TD><TD class=alignCenter headers="br1 br4 bc1 bc7">48 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc10">4729 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc11">2581 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc12">33 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc13">2115 </TD><TD class=alignCenter headers="br1 br4 bc8 bc14">305 </TD><TD class=alignCenter headers="br1 br4 bc8 bc15 bc16">5034 </TD><TD class=alignCenter headers="br1 br4 bc8 bc15 bc17">29.7% </TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignCenter headers="br1 br5 bc1 bc2 bc3">102 </TD><TD class=alignCenter headers="br1 br5 bc1 bc2 bc4">20 </TD><TD class=alignCenter headers="br1 br5 bc1 bc2 bc5">0 </TD><TD class=alignCenter headers="br1 br5 bc1 bc2 bc6">82 </TD><TD class=alignCenter headers="br1 br5 bc1 bc7">44 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc10">4102 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc11">2215 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc12">37 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc13">1850 </TD><TD class=alignCenter headers="br1 br5 bc8 bc14">389 </TD><TD class=alignCenter headers="br1 br5 bc8 bc15 bc16">4491 </TD><TD class=alignCenter headers="br1 br5 bc8 bc15 bc17">26.5% </TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignCenter headers="br1 br6 bc1 bc2 bc3">96 </TD><TD class=alignCenter headers="br1 br6 bc1 bc2 bc4">21 </TD><TD class=alignCenter headers="br1 br6 bc1 bc2 bc5">3 </TD><TD class=alignCenter headers="br1 br6 bc1 bc2 bc6">72 </TD><TD class=alignCenter headers="br1 br6 bc1 bc7">58 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc10">2211 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc11">900 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc12">88 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc13">1223 </TD><TD class=alignCenter headers="br1 br6 bc8 bc14">519 </TD><TD class=alignCenter headers="br1 br6 bc8 bc15 bc16">2730 </TD><TD class=alignCenter headers="br1 br6 bc8 bc15 bc17">16.1% </TD></TR><TR><TH id=br7 class=alignLeft headers=br1>Unknown</TH><TD class=alignCenter headers="br1 br7 bc1 bc2 bc3">7 </TD><TD class=alignCenter headers="br1 br7 bc1 bc2 bc4">0 </TD><TD class=alignCenter headers="br1 br7 bc1 bc2 bc5">5 </TD><TD class=alignCenter headers="br1 br7 bc1 bc2 bc6">2 </TD><TD class=alignCenter headers="br1 br7 bc1 bc7">1 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc10">125 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc11">98 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc12">14 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc13">13 </TD><TD class=alignCenter headers="br1 br7 bc8 bc14">2 </TD><TD class=alignCenter headers="br1 br7 bc8 bc15 bc16">127 </TD><TD class=alignCenter headers="br1 br7 bc8 bc15 bc17">0.7% </TD></TR><TR><TH id=br8 class=alignLeft headers=br1>Total</TH><TD class=alignCenter headers="br1 br8 bc1 bc2 bc3">448 </TD><TD class="alignCenter lightred " headers="br1 br8 bc1 bc2 bc4">96 </TD><TD class="alignCenter lightred " headers="br1 br8 bc1 bc2 bc5">11 </TD><TD class="alignCenter lightred " headers="br1 br8 bc1 bc2 bc6">341 </TD><TD class=alignCenter headers="br1 br8 bc1 bc7">201 </TD><TD class=alignCenter headers="br1 br8 bc8 bc9 bc10">15319 </TD><TD class="alignCenter lightred " headers="br1 br8 bc8 bc9 bc11">7772 </TD><TD class="alignCenter lightred " headers="br1 br8 bc8 bc9 bc12">213 </TD><TD class="alignCenter lightred " headers="br1 br8 bc8 bc9 bc13">7334 </TD><TD class=alignCenter headers="br1 br8 bc8 bc14">1649 </TD><TD class=alignCenter headers="br1 br8 bc8 bc15 bc16">16968 </TD><TD class=alignCenter headers="br1 br8 bc8 bc15 bc17">100.0% </TD></TR><TR><TH id=br9 class=alignLeft headers=br1>Percentage<SUP>2</SUP></TH><TD class=alignCenter headers="br1 br9 bc1 bc2 bc3">69.0% </TD><TD class="alignCenter lightred " headers="br1 br9 bc1 bc2 bc4">21.4% </TD><TD class="alignCenter lightred " headers="br1 br9 bc1 bc2 bc5">2.5% </TD><TD class="alignCenter lightred " headers="br1 br9 bc1 bc2 bc6">76.1% </TD><TD class=alignCenter headers="br1 br9 bc1 bc7">31.0% </TD><TD class=alignCenter headers="br1 br9 bc8 bc9 bc10">90.3% </TD><TD class="alignCenter lightred " headers="br1 br9 bc8 bc9 bc11">50.7% </TD><TD class="alignCenter lightred " headers="br1 br9 bc8 bc9 bc12">1.4% </TD><TD class="alignCenter lightred " headers="br1 br9 bc8 bc9 bc13">47.9% </TD><TD class=alignCenter headers="br1 br9 bc8 bc14">9.7% </TD><TD class=alignCenter></TD><TD class=alignCenter></TD></TR></TBODY></TABLE>

                Top of Page

                Influenza Strain Characterizations

                During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 1150 influenza viruses [49 A(H3N2), 956 A(H1N1)pdm09 and 145 influenza B]. The vast majority (99%) of viruses were similar to the strains recommended by the WHO for the 2013-14 seasonal influenza vaccine. Two A(H1N1)pdm09 viruses showed reduced titres to antiserum against the reference A/California/07/2009 strain. Eleven influenza B viruses were similar to the strain recommended by the WHO for the 2011-12 vaccine (Figure 4).
                Figure 4. Influenza strain characterizations, Canada, 2013-14, N = 1150

                The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
                The recommended components for the 2013-2014 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009 (H1N1)pdm09-like virus, an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b (e.g. A/Texas/50/2012), and a B/Massachusetts/2/2012-like virus (Yamagata lineage).


                Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
                Antiviral Resistance

                During the 2013-2014 influenza season, NML has tested 774 influenza viruses for resistance to oseltamivir and 772 viruses for resistance to zanamivir, and all were sensitive. All 939 influenza A viruses tested for amantadine resistance 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, 2013-2014</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 lightred" headers=cr1>A (H3N2)</TH><TD class=alignCenter headers="cr1 cr2 cc1 cc2">45</TD><TD class=alignCenter headers="cr1 cr2 cc1 cc3">0</TD><TD class=alignCenter headers="cr1 cr2 cc4 cc5">45</TD><TD class=alignCenter headers="cr1 cr2 cc4 cc6">0</TD><TD class=alignCenter headers="cr1 cr2 cc7 cc8">74</TD><TD class=alignCenter headers="cr1 cr2 cc7 cc9">74 (100%)</TD></TR><TR><TH id=cr3 class="alignLeft lightred" headers=cr1>A (H1N1)</TH><TD class=alignCenter headers="cr1 cr3 cc1 cc2">654</TD><TD class=alignCenter headers="cr1 cr3 cc1 cc3">0</TD><TD class=alignCenter headers="cr1 cr3 cc4 cc5">652</TD><TD class=alignCenter headers="cr1 cr3 cc4 cc6">0</TD><TD class=alignCenter headers="cr1 cr3 cc7 cc8">865</TD><TD class=alignCenter headers="cr1 cr3 cc7 cc9">865 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft lightred" headers=cr1>B</TH><TD class=alignCenter headers="cr1 cr4 cc1 cc2">75</TD><TD class=alignCenter headers="cr1 cr4 cc1 cc3">0</TD><TD class=alignCenter headers="cr1 cr4 cc4 cc5">75</TD><TD class=alignCenter headers="cr1 cr4 cc4 cc6">0</TD><TD class=alignCenter headers="cr1 cr4 cc7 cc8">NA <SUP>*</SUP></TD><TD class=alignCenter headers="cr1 cr4 cc7 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft lightred" headers=cr1>TOTAL</TH><TD class=alignCenter headers="cr1 cr5 cc1 cc2">774</TD><TD class=alignCenter headers="cr1 cr5 cc1 cc3">0</TD><TD class=alignCenter headers="cr1 cr5 cc4 cc5">772</TD><TD class=alignCenter headers="cr1 cr5 cc4 cc6">0</TD><TD class=alignCenter headers="cr1 cr5 cc7 cc8">939</TD><TD class=alignCenter headers="cr1 cr5 cc7 cc9">939 (100%)</TD></TR></TBODY></TABLE>
                Influenza-like Illness (ILI) Consultation Rate

                The national influenza-like-illness (ILI) consultation rate decreased from 45.4/1,000 in week 07 to 22.0/1,000 in week 08; which is below the expected range for week 08 (Figure 5).
                Figure 5. Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

                Note: No data available for mean rate for weeks 19 to 39 for the 1996-1997 through 2002-2003 seasons. Delays in the reporting of data may cause data to change retrospectively. The calculation of the average ILI consultation rate over 17 seasons was aligned with influenza activity in each season. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. The number of sentinel physicians in each province or territory is as follows: BC(21), AB(80), SK(11), MB(18), ON(169), QC(14), NB(29), NS(26), PE(4), NL(16), NU(1), NT(14), YT(13). Not all sentinel physicians report every week.
                Text equivalent for figure 5Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

                Top of Page

                Influenza Outbreak Surveillance

                In week 08, 11 new influenza outbreaks were reported: one in a hospital and ten in long-term care facilities (Figure 6). In addition, five outbreaks of influenza-like-illness were reported: four in schools and one in another facility or community.
                Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2013-2014

                1 All provinces and territories except NU report outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
                Text equivalent for figure 6Overall number of new influenza outbreaks by report week, Canada, 2013-2014
                Pharmacy Surveillance

                In week 08, the proportion of prescriptions for influenza antivirals continued to decrease, following the downward trend in laboratory detections of influenza. The largest proportion of prescriptions for antivirals continued to be among children 2-18 years of age followed by adults 19-64 years of age (Figure 7). Within these age-groups, higher proportions of prescriptions for antivirals were observed among children >5 years of age and adults <45 years of age.
                Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

                Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group. Age-groups: Infant: 0-2y, Child: 2-18y; Adult: 19-64y, Senior: ≥65y.
                Text equivalent for figure 7Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

                Top of Page

                Sentinel Hospital Influenza Surveillance

                Paediatric Influenza Hospitalizations and Deaths (IMPACT)
                In week 08, 28 new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 42 in week 07. In week 08, influenza A was reported in 17 cases and influenza B in 11 cases. An increasing number of influenza B cases have been reported in the past two weeks (Figure 8a). Twenty-two (79%) of the cases in week 08 were ≥2 years of age. Two ICU admissions were reported in week 08, one 5-9 years of age and one 10-16 years of age. No deaths were reported.
                To date this season, a total of 520 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 92% of which have been influenza A, and almost all of those subtyped (98%) were A(H1N1)pdm09. Children ≥2 years of age represent 54.6% of cases to date (Table 4). Seventy-nine ICU admissions have been reported, of which 46 (58%) were children ≥2 years of age (Figure 9a). Among the 76 ICU admission for which the influenza type reported, all but four were cases with influenza A, and 96% of those subtyped were A(H1N1)pdm09. Among the 65 ICU cases with available data, 44 (68%) were reported to have underlying medical conditions. No deaths have been reported.
                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)
                In week 08, 27 new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations reported through active surveillance by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 45 in week 07. There has been a steady decline in the number of new cases over recent weeks. Among cases in week 08, 22 (81.5%) were influenza A, and four were influenza B (Figure 8b). The majority of hospitalizations occurred among adults ≥45 years of age (20; 74%). Three ICU admissions were reported in week 08, all 45-64 years of age with influenza A. No deaths were reported in week 08.
                To date this season, 1030 influenza-associated hospitalizations have been reported by the PCIRN-SOS network, 980 (95.1%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). ICU admission was required for 180 hospitalizations, all but five of which were cases with influenza A (102 A(H1N1)pdm09, three A(H3N2) and 70 A(unsubtyped). More than three quarters of hospitalizations and approximately 80% of ICU admissions were ≥45 years of age. Of the 152 ICU admissions with available information, 133 (87.5%) were reported to have at least one comorbidity and of the 155 ICU admissions with available information 112 (72.3%) reported not having been vaccinated this season. Fifty-one deaths have been reported, all but one with influenza A (32 A(H1N1)pdm09, one A(H3N2) and 17 A(unsubtyped)); five cases 20-44 years of age, 26 cases 45-64 years of age and 20 cases ≥65 years of age (Figure 9b).
                Note: PCIRN-SOS conducted passive surveillance from April 30th to November 14th, 2013. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance began November 15th during which time PCIRN site coordinators investigate cases potentially related to influenza. Data from both active and passive surveillance reported during the 2013-14 season are included in this report. 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.
                <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t4 class=alignCenter>Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=dr1 rowSpan=3>Age groups </TH><TH id=dc1 colSpan=6>Cumulative (Aug. 25, 2013 to February 22, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=dc2 colSpan=4 headers=dc1>Influenza A </TH><TH id=dc7 headers=dc1>B </TH><TH id=dc8 headers=dc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=dc3 headers="dc1 dc2">A Total </TH><TH id=dc4 class="lightred " headers="dc1 dc2">A(H1) pdm09 </TH><TH id=dc5 class="lightred " headers="dc1 dc2">A(H3) </TH><TH id=dc6 class="lightred " headers="dc1 dc2">A (UnS) </TH><TD class=alignCenter headers="dc1 dc7">Total</TD><TD class=alignCenter headers="dc1 dc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
                </TD></TR></TFOOT><TBODY><TR><TH id=dr2 class=alignLeft headers=dr1>0-5m </TH><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc3">92 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc4">27 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc5">0 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc6">65 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc7">2 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc8">94 (18%) </TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc3">137 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc4">38 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc5">1 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc6">98 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc7">5 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc8">142 (27%) </TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc3">146 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc4">46 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc5">2 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc6">98 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc7">14 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc8">160 (31%) </TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc3">73 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc4">22 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc5">0 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc6">51 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc7">17 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc8">90 (17%) </TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc3">31 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc4">13 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc5">0 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc6">18 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc7">3 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc8">34 (7%) </TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignCenter headers="dr1 dr7 dc1 dc2 dc3">479 </TD><TD class="lightred alignCenter" headers="dr1 dr7 dc1 dc2 dc4">146 </TD><TD class="lightred alignCenter" headers="dr1 dr7 dc1 dc2 dc5">3 </TD><TD class="lightred alignCenter" headers="dr1 dr7 dc1 dc2 dc6">330 </TD><TD class=alignCenter headers="dr1 dr7 dc1 dc7">41 </TD><TD class=alignCenter headers="dr1 dr7 dc1 dc8">520 </TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP> </TH><TD class=alignCenter headers="dr1 dr8 dc1 dc2 dc3">92.1% </TD><TD class="lightred alignCenter" headers="dr1 dr8 dc1 dc2 dc4">30.5% </TD><TD class="lightred alignCenter" headers="dr1 dr8 dc1 dc2 dc5">0.6% </TD><TD class="lightred alignCenter" headers="dr1 dr8 dc1 dc2 dc6">68.9% </TD><TD class=alignCenter headers="dr1 dr8 dc1 dc7">7.9% </TD><TD class=alignCenter headers="dr1 dr8 dc1 dc8">100.0% </TD></TR></TBODY></TABLE>
                <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 5 - Cumulative numbers of adult hospitalizations with influenza
                reported by the PCIRN-SOS network, Canada, 2013-14
                </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=er1 rowSpan=3>Age groups </TH><TH id=ec1 class=noWrap colSpan=6>Cumulative (Aug. 25, 2013 to February 22, 2014)<SUP>*</SUP></TH></TR><TR class=bg-colour-yellow><TH id=ec2 colSpan=4 headers=ec1>Influenza A </TH><TH id=ec7 headers=ec1>B </TH><TH id=ec8 headers=ec1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=ec3 headers="ec1 ec2">A Total </TH><TH id=ec4 class=lightred headers="ec1 ec2">A(H1) pdm09 </TH><TH id=ec5 class=lightred headers="ec1 ec2">A(H3) </TH><TH id=ec6 class=lightred headers="ec1 ec2">A(UnS) </TH><TD class=alignCenter headers="ec1 ec7">Total</TD><TD class=alignCenter headers="ec1 ec8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t5_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.

                <SUP id=footnote_t5_star>*</SUP>One case for which the influenza type has not yet been reported, and four cases for which the age-group was not reported, are not included in Table 5.
                </TD></TR></TFOOT><TBODY><TR><TH id=er2 class=alignLeft headers=er1>16-20 </TH><TD class=alignCenter headers="er1 er2 ec1 ec2 ec3">11</TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec4">3</TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec5">0</TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec6">8</TD><TD class=alignCenter headers="er1 er2 ec1 ec7">1</TD><TD class=alignCenter headers="er1 er2 ec1 ec8">12 (1%)</TD></TR><TR><TH id=er3 class=alignLeft headers=er1>20-44 </TH><TD class=alignCenter headers="er1 er3 ec1 ec2 ec3">218</TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec4">117</TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec5">3</TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec6">98</TD><TD class=alignCenter headers="er1 er3 ec1 ec7">3</TD><TD class=alignCenter headers="er1 er3 ec1 ec8">221 (22%)</TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignCenter headers="er1 er4 ec1 ec2 ec3">395</TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec4">182</TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec5">4</TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec6">209</TD><TD class=alignCenter headers="er1 er4 ec1 ec7">10</TD><TD class=alignCenter headers="er1 er4 ec1 ec8">405 (40%)</TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignCenter headers="er1 er5 ec1 ec2 ec3">352</TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec4">178</TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec5">22</TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec6">152</TD><TD class=alignCenter headers="er1 er5 ec1 ec7">35</TD><TD class=alignCenter headers="er1 er5 ec1 ec8">387 (38%)</TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignCenter headers="er1 er6 ec1 ec2 ec3">976</TD><TD class="alignCenter lightred" headers="er1 er6 ec1 ec2 ec4">480</TD><TD class="alignCenter lightred" headers="er1 er6 ec1 ec2 ec5">29</TD><TD class="alignCenter lightred" headers="er1 er6 ec1 ec2 ec6">467</TD><TD class=alignCenter headers="er1 er6 ec1 ec7">49</TD><TD class=alignCenter headers="er1 er6 ec1 ec8">1025</TD></TR><TR><TH id=er7 class=alignLeft headers=er1>% <SUP>1</SUP></TH><TD class=alignCenter headers="er1 er7 ec1 ec2 ec3">95%</TD><TD class="alignCenter lightred " headers="er1 er7 ec1 ec2 ec4">49%</TD><TD class="alignCenter lightred " headers="er1 er7 ec1 ec2 ec5">3%</TD><TD class="alignCenter lightred " headers="er1 er7 ec1 ec2 ec6">48%</TD><TD class=alignCenter headers="er1 er7 ec1 ec7">5%</TD><TD class=alignCenter headers="er1 er7 ec1 ec8">100%</TD></TR></TBODY></TABLE>
                Figure 8. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14
                A) Paediatric hospitalizations (≤16 years of age, IMPACT)


                Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
                B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)

                * See footnote above following the section related to PCIRN-SOS data.
                Text equivalent for figure 8bNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Adult hospitalizations (>16 year of age, PCIRN-SOS)
                Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14
                A) Paediatric hospitalizations (≤16 years of age, IMPACT)

                Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
                B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)

                Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Adult hospitalizations (≥16 year of age, PCIRN-SOS)

                Top of Page

                Provincial/Territorial Influenza Hospitalizations and Deaths

                In week 08, 119 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories.* The majority were cases of influenza A (103, 86.6%), of which 36 (35.0%) were A(H1N1)pdm09, one (1.0%) was A(H3N2), and 66 (64.1%) were A(unsubtyped). Seven of the eight ICU admissions reported in week 08 included age information, of which six were adults 20-64 years of age. Thirteen deaths were reported, 11 of which were adults ≥45 years of age. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total.
                To date this season, 3,093 influenza-associated hospitalizations have been reported, 96.8% with influenza A. The majority (57.5%) of hospitalizations have been cases 45 years of age of older (Table 6). A total of 298 ICU admissions have been reported this season, of which 67.4% were among adults 20-64 years of age. A total of 171 deaths have been reported. The highest proportion of deaths has been among adults 20-64 years of age (52.6%), followed by adults ≥65 years of age (38.0%). Influenza B has been detected infrequently among severe cases of influenza to date this season: in only 3.2% of hospitalizations, 1.0% of ICU admissions, and 4.1 % of deaths. It is important to note that the hospitalization or 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: 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 distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks.
                <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t6 class=alignCenter>Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=fr1 rowSpan=3>Age groups </TH><TH id=fc1 colSpan=6>Cumulative (Aug. 25, 2013 to Fabruary 22, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=fc2 colSpan=4 headers=fc1>Influenza A</TH><TH id=fc7 headers=fc1>B</TH><TH id=fc8 headers=fc1>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=fc3 headers="fc1 fc2">A Total</TH><TH id=fc4 class=lightred headers="fc1 fc2">A(H1) pdm09</TH><TH id=fc5 class=lightred headers="fc1 fc2">A(H3)</TH><TH id=fc6 class=lightred headers="fc1 fc2">A (UnS)</TH><TD class=alignCenter headers="fc1 fc7">Total</TD><TD class=alignCenter headers="fc1 fc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=8><SUP>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
                </TD></TR></TFOOT><TBODY><TR><TH id=fr2 class=alignLeft headers=fr1>0-4 years</TH><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc3">515 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc4">259 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc5">6 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc6">250 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc7">19 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc8">534 (17%) </TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years</TH><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc3">112 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc4">57 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc5">5 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc6">50 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc7">11 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc8">123 (4%) </TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years</TH><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc3">28 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc4">17 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc5">2 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc6">9 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc7">1 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc8">29 (1%) </TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc3">525 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc4">377 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc5">3 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc6">145 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc7">6 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc8">531 (17%) </TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc3">965 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc4">626 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc5">16 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc6">323 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc7">17 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc8">982 (32%) </TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc3">750 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc4">402 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc5">46 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc6">302 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc7">45 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc8">795 (26%) </TD></TR><TR><TH id=fr10 class=alignLeft headers=fr1>Unknown</TH><TD class=alignCenter headers="fr1 fr10 fc1 fc2 fc3">98 </TD><TD class=alignCenter headers="fr1 fr10 fc1 fc2 fc4">78 </TD><TD class=alignCenter headers="fr1 fr10 fc1 fc2 fc5">3 </TD><TD class=alignCenter headers="fr1 fr10 fc1 fc2 fc6">17 </TD><TD class=alignCenter headers="fr1 fr10 fc1 fc7">1 </TD><TD class=alignCenter headers="fr1 fr10 fc1 fc8">99 (3%) </TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignCenter headers="fr1 fr8 fc1 fc2 fc3">2993 </TD><TD class="alignCenter lightred" headers="fr1 fr8 fc1 fc2 fc4">1816 </TD><TD class="alignCenter lightred" headers="fr1 fr8 fc1 fc2 fc5">81 </TD><TD class="alignCenter lightred" headers="fr1 fr8 fc1 fc2 fc6">1096 </TD><TD class=alignCenter headers="fr1 fr8 fc1 fc7">100 </TD><TD class=alignCenter headers="fr1 fr8 fc1 fc8">3093 </TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP> </TH><TD class=alignCenter headers="fr1 fr9 fc1 fc2 fc3">96.8% </TD><TD class="alignCenter lightred" headers="fr1 fr9 fc1 fc2 fc4">60.7% </TD><TD class="alignCenter lightred" headers="fr1 fr9 fc1 fc2 fc5">2.7% </TD><TD class="alignCenter lightred" headers="fr1 fr9 fc1 fc2 fc6">36.6% </TD><TD class=alignCenter headers="fr1 fr9 fc1 fc7">3.2% </TD><TD class=alignCenter headers="fr1 fr9 fc1 fc8">100% </TD></TR></TBODY></TABLE>
                See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2013-14 on the Public Health Agency of Canada website.

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

                Comment


                • #23
                  Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 9

                  FluWatch report: February 23 to March 1, 2014 (Week 09)

                  Posted 2014-03-07For 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/13-14/w09_14/pdf/fw2014-09-eng.pdf">FluWatch report: February 23 to March 1, 2014 (Week 09) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 291 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

                  »» Help with PDF documents


                  Overall Summary
                  • In week 09, influenza activity in Canada continues to decrease, following a pattern similar to the 2012-13 season.
                  • The influenza A(H1N1) virus remains the most common influenza virus circulating this season, affecting a greater proportion of adults 20-64 years of age compared to last season.
                  • Circulation of influenza B virus continues to increase.
                  • The number of sentinel paediatric and adult hospitalizations continues to decline. To week 09, 3,238 hospitalizations and 182 deaths have been reported. Compared to the same period last season, fewer hospitalizations but a similar number of deaths have been reported.
                  • A Canadian vaccine effectiveness study has estimated that immunization with the 2013-14 seasonal influenza vaccine has been 58.5% effective in reducing influenza-related hospitalizations (McNeil S, Shinde V, Andrew M et al.).
                  Influenza/ILI Activity (geographic spread)

                  In week 09, influenza activity levels continued to decline. One region in Quebec reported widespread activity and seven regions in eastern Canada (ON(4), QC(2) and NS(1)) reported localized activity (Figure 1).
                  Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 09





                  Note: Influenza/ILI 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 and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
                  Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
                  Influenza and Other Respiratory Virus Detections

                  The number of positive influenza tests continued to decrease, from 985 in week 08 to 864 in week 09. The percentage of positive influenza tests decreased from 13.9% to 13.3% (Figure 2). Cumulative influenza virus detections to date remain predominantly influenza A (91%), and among those subtyped, 97% (9,933/10,290) were A(H1N1)pdm09. However, the percentage of positive tests for influenza B has been rising slowly in recent weeks to 36.7% of influenza detections in week 09 (Table 1). Among the 17,709 cases for which information on age and type/subtype has been received this season, 55.8% were 20-64 years of age (Table 2).
                  Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14

                  Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
                  The number of positive tests for RSV declined slightly in week 09. The number of positive tests for parainfluenza increased slightly in week 09, interrupting the decline observed since early January. The number of positive tests for rhinovirus has been relatively stable, while the number of positive tests for coronavirus and human metapneumovirus has been declining over recent weeks (Figure 3).
                  For more details, see the weekly Respiratory Virus Detections in Canada Report.
                  Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2013-14


                  Top of Page

                  RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
                  Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
                  <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly and cumulative numbers of positive influenza specimens
                  by type, subtype and province, Canada, 2013-14
                  </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=ac1 colSpan=5>Weekly
                  (February 23, 2013 to March 1, 2014)
                  </TH><TH id=ac8 colSpan=5>Cumulative
                  (August 25, 2013 to March 1, 2014)
                  </TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=4 headers=ac1>Influenza A</TH><TH id=ac7 headers=ac1>B</TH><TH id=ac9 colSpan=4 headers=ac8>Influenza A</TH><TH id=ac14 headers=ac8>B</TH></TR><TR class=bg-colour-grey-light><TH id=ac3 headers="ac1 ac2">A Total</TH><TH id=ac4 class=lightred headers="ac1 ac2">A(H1)pdm09</TH><TH id=ac5 class=lightred headers="ac1 ac2">A(H3)</TH><TH id=ac6 class=lightred headers="ac1 ac2">A(UnS)</TH><TH class=alignCenter headers="ac1 ac7">B Total</TH><TH id=ac10 headers="ac8 ac9">A Total</TH><TH id=ac11 class=lightred headers="ac8 ac9">A(H1)pdm09</TH><TH id=ac12 class=lightred headers="ac8 ac9">A(H3)</TH><TH id=ac13 class=lightred headers="ac8 ac9">A(UnS)</TH><TD class=alignCenter headers="ac8 ac14">B Total</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
                  <SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                  UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
                  </TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=alignLeft headers=ar1>BC</TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">73</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">50</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">13</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">10</TD><TD class=alignRight headers="ar1 ar2 ac1 ac7">20</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac10">1731</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac11">1573</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac12">58</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac13">100</TD><TD class=alignRight headers="ar1 ar2 ac8 ac14">98</TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">43</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">16</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">1</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">26</TD><TD class=alignRight headers="ar1 ar3 ac1 ac7">15</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac10">3585</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac11">3297</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac12">44</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac13">244</TD><TD class=alignRight headers="ar1 ar3 ac8 ac14">105</TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">15</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">12</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">3</TD><TD class=alignRight headers="ar1 ar4 ac1 ac7">3</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac10">1332</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac11">962</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac12">4</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac13">366</TD><TD class=alignRight headers="ar1 ar4 ac8 ac14">27</TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">34</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">29</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">5</TD><TD class=alignRight headers="ar1 ar5 ac1 ac7">0</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac10">572</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac11">407</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac12">1</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac13">164</TD><TD class=alignRight headers="ar1 ar5 ac8 ac14">15</TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">105</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">32</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">12</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">61</TD><TD class=alignRight headers="ar1 ar6 ac1 ac7">94</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac10">5352</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac11">2341</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac12">242</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac13">2769</TD><TD class=alignRight headers="ar1 ar6 ac8 ac14">395</TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">214</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">35</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">179</TD><TD class=alignRight headers="ar1 ar7 ac1 ac7">174</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac10">5021</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac11">651</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac12">3</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac13">4367</TD><TD class=alignRight headers="ar1 ar7 ac8 ac14">1212</TD></TR><TR><TH id=ar8 class=alignLeft headers=ar1>NB</TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">37</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac4">2</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac6">35</TD><TD class=alignRight headers="ar1 ar8 ac1 ac7">2</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac10">1455</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac11">366</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac12">1</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac13">1088</TD><TD class=alignRight headers="ar1 ar8 ac8 ac14">12</TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">17</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">15</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">2</TD><TD class=alignRight headers="ar1 ar9 ac1 ac7">1</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac10">146</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac11">117</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac12">4</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac13">25</TD><TD class=alignRight headers="ar1 ar9 ac8 ac14">2</TD></TR><TR><TH id=ar10 class=alignLeft headers=ar1>PE</TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">1</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac4">1</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 ac7">0</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac10">116</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac11">115</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac13">1</TD><TD class=alignRight headers="ar1 ar10 ac8 ac14">0</TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">8</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac6">8</TD><TD class=alignRight headers="ar1 ar11 ac1 ac7">8</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac10">332</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac11">104</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac13">228</TD><TD class=alignRight headers="ar1 ar11 ac8 ac14">131</TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">547</TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac4">192</TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac5">26</TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac6">329</TD><TD class=alignRight headers="ar1 ar12 ac1 ac7">317</TD><TD class=alignRight headers="ar1 ar12 ac8 ac9 ac10">19642</TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac11">9933</TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac12">357</TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac13">9352</TD><TD class=alignRight headers="ar1 ar12 ac8 ac14">1997</TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="ar1 ar13 ac1 ac2 ac3">63.3%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac4">35.1%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac5">4.8%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac6">60.1%</TD><TD class=alignRight headers="ar1 ar13 ac1 ac7">36.7%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac9 ac10">90.8%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac11">50.6%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac12">1.8%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac13">47.6%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac14">9.2%</TD></TR></TBODY></TABLE>
                  <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups (years)</TH><TH id=bc1 colSpan=5>Weekly
                  (February 23 to March 1, 2014)
                  </TH><TH id=bc8 colSpan=7>Cumulative
                  (August 25, 2013 to March 1, 2014)
                  </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><TH id=bc15 colSpan=2 headers=bc8>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=bc3 headers="bc1 bc2">A Total</TH><TH id=bc4 class="lightred " headers="bc1 bc2">A(H1) pdm09</TH><TH id=bc5 class="lightred " headers="bc1 bc2">A(H3)</TH><TH id=bc6 class="lightred " headers="bc1 bc2">A (UnS)</TH><TD class=alignCenter headers="bc1 bc7">Total</TD><TH id=bc10 headers="bc8 bc9">A Total</TH><TH id=bc11 class="lightred " headers="bc8 bc9">A(H1) pdm09</TH><TH id=bc12 class="lightred " headers="bc8 bc9">A(H3)</TH><TH id=bc13 class="lightred " headers="bc8 bc9">A (UnS)</TH><TD class=alignCenter headers="bc8 bc14">Total</TD><TH id=bc16 headers="bc8 bc15">#</TH><TH id=bc17 headers="bc8 bc15">%</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
                  <SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                  <SUP>3 </SUP>Table 2 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
                  UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
                  </TD></TR></TFOOT><TBODY><TR><TH id=br2 class=alignLeft headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">67</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">16</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">51</TD><TD class=alignRight headers="br1 br2 bc1 bc7">28</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">3034</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">1358</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">23</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1653</TD><TD class=alignRight headers="br1 br2 bc8 bc14">212</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc16">3246</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc17">18.3%</TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">19</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">4</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">15</TD><TD class=alignRight headers="br1 br3 bc1 bc7">37</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1246</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">669</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">18</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">559</TD><TD class=alignRight headers="br1 br3 bc8 bc14">317</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc16">1563</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc17">8.8%</TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">74</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">22</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">52</TD><TD class=alignRight headers="br1 br4 bc1 bc7">39</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">4843</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">2644</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">33</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">2166</TD><TD class=alignRight headers="br1 br4 bc8 bc14">361</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc16">5204</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc17">29.4%</TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">76</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">28</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">47</TD><TD class=alignRight headers="br1 br5 bc1 bc7">47</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">4217</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">2269</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">40</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">1908</TD><TD class=alignRight headers="br1 br5 bc8 bc14">453</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc16">4670</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc17">26.4%</TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">57</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">17</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">3</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">37</TD><TD class=alignRight headers="br1 br6 bc1 bc7">63</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">2292</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">936</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">95</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">1261</TD><TD class=alignRight headers="br1 br6 bc8 bc14">602</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc16">2894</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc17">16.3%</TD></TR><TR><TH id=br7 class=alignLeft headers=br1>Unknown</TH><TD class=alignRight headers="br1 br7 bc1 bc2 bc3">4</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc4">1</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc5">3</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc6">0</TD><TD class=alignRight headers="br1 br7 bc1 bc7">0</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc10">130</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">100</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">17</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">13</TD><TD class=alignRight headers="br1 br7 bc8 bc14">2</TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc16">132</TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc17">0.7%</TD></TR><TR><TH id=br8 class=alignLeft headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">297</TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc4">88</TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc5">7</TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc6">202</TD><TD class=alignRight headers="br1 br8 bc1 bc7">214</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">15762</TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc11">7976</TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc12">226</TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc13">7560</TD><TD class=alignRight headers="br1 br8 bc8 bc14">1947</TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc16">17709</TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc17">100.0%</TD></TR><TR><TH id=br9 class=alignLeft headers=br1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="br1 br9 bc1 bc2 bc3">58.1%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc4">29.6%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc5">2.4%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc6">68.0%</TD><TD class=alignRight headers="br1 br9 bc1 bc7">41.9%</TD><TD class=alignRight headers="br1 br9 bc8 bc9 bc10">89.0%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc11">50.6%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc12">1.4%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc13">48.0%</TD><TD class=alignRight headers="br1 br9 bc8 bc14">11.0%</TD><TD class=alignRight></TD><TD class=alignRight></TD></TR></TBODY></TABLE>

                  Top of Page

                  Influenza Strain Characterizations

                  During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 1248 influenza viruses [55 A(H3N2), 1022 A(H1N1)pdm09 and 171 influenza B]. The vast majority (99%) of viruses were similar to the strains recommended by the WHO for the 2013-14 seasonal influenza vaccine. Two A(H1N1)pdm09 viruses showed reduced titres to antiserum against the reference A/California/07/2009 strain. Thirteen influenza B viruses were similar to the strain recommended by the WHO for the 2011-12 vaccine (Figure 4).
                  Figure 4. Influenza strain characterizations, Canada, 2013-14, N = 1248

                  The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
                  The recommended components for the 2013-2014 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009 (H1N1)pdm09-like virus, an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b (e.g. A/Texas/50/2012), and a B/Massachusetts/2/2012-like virus (Yamagata lineage).


                  Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
                  Antiviral Resistance

                  During the 2013-2014 influenza season, NML has tested 883 influenza viruses for resistance to oseltamivir and all but two were sensitive. All 882 viruses tested for resistance to zanamivir were sensitive. All 1104 influenza A viruses tested for amantadine resistance 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, 2013-2014</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 lightred" headers=cr1>A (H3N2)</TH><TD class=alignRight headers="cr1 cr2 cc1 cc2">48</TD><TD class=alignRight headers="cr1 cr2 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr2 cc4 cc5">48</TD><TD class=alignRight headers="cr1 cr2 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr2 cc7 cc8">76</TD><TD class=alignRight headers="cr1 cr2 cc7 cc9">76 (100%)</TD></TR><TR><TH id=cr3 class="alignLeft lightred" headers=cr1>A (H1N1)</TH><TD class=alignRight headers="cr1 cr3 cc1 cc2">742</TD><TD class=alignRight headers="cr1 cr3 cc1 cc3">2 (0.3%)</TD><TD class=alignRight headers="cr1 cr3 cc4 cc5">741</TD><TD class=alignRight headers="cr1 cr3 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr3 cc7 cc8">1028</TD><TD class=alignRight headers="cr1 cr3 cc7 cc9">1028 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft lightred" headers=cr1>B</TH><TD class=alignRight headers="cr1 cr4 cc1 cc2">93</TD><TD class=alignRight headers="cr1 cr4 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr4 cc4 cc5">93</TD><TD class=alignRight headers="cr1 cr4 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr4 cc7 cc8">NA <SUP>*</SUP></TD><TD class=alignRight headers="cr1 cr4 cc7 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft lightred" headers=cr1>TOTAL</TH><TD class=alignRight headers="cr1 cr5 cc1 cc2">883</TD><TD class=alignRight headers="cr1 cr5 cc1 cc3">2 (0.2%)</TD><TD class=alignRight headers="cr1 cr5 cc4 cc5">882</TD><TD class=alignRight headers="cr1 cr5 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr5 cc7 cc8">1104</TD><TD class=alignRight headers="cr1 cr5 cc7 cc9">1104 (100%)</TD></TR></TBODY></TABLE>
                  Influenza-like Illness (ILI) Consultation Rate

                  The national influenza-like-illness (ILI) consultation rate increased from 20.3/1,000 in week 08 to 32.7/1,000 in week 09; which is within the expected range for week 09 (Figure 5).
                  Figure 5. Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

                  Note: No data available for mean rate for weeks 19 to 39 for the 1996-1997 through 2002-2003 seasons. Delays in the reporting of data may cause data to change retrospectively. The calculation of the average ILI consultation rate over 17 seasons was aligned with influenza activity in each season. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. The number of sentinel physicians in each province or territory is as follows: BC(21), AB(80), SK(11), MB(18), ON(169), QC(14), NB(29), NS(26), PE(4), NL(16), NU(1), NT(14), YT(13). Not all sentinel physicians report every week.
                  Text equivalent for figure 5Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

                  Top of Page

                  Influenza Outbreak Surveillance

                  In week 09, five new influenza outbreaks in long-term care facilities were reported (Figure 6). In addition, one outbreak of influenza-like-illness was reported in a school.
                  Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2013-2014

                  1 All provinces and territories except NU report outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
                  Text equivalent for figure 6Overall number of new influenza outbreaks by report week, Canada, 2013-2014
                  Pharmacy Surveillance

                  In week 09, the proportion of prescriptions for influenza antivirals continued to decrease, with the largest proportion of prescriptions for antivirals continuing to be among children 2-18 years of age and adults 19-64 years of age (Figure 7). Within these age-groups, higher proportions of prescriptions for antivirals were observed among persons between 5 and 45 years of age.
                  Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

                  Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group. Age-groups: Infant: 0-2y, Child: 2-18y; Adult: 19-64y, Senior: ≥65y.
                  Text equivalent for figure 7Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

                  Top of Page

                  Sentinel Hospital Influenza Surveillance

                  Paediatric Influenza Hospitalizations and Deaths (IMPACT)
                  In week 09, 18 new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 30 in week 08. In week 09, influenza A was reported in 14 cases and influenza B in four cases. A greater proportion of cases have been reported with influenza B cases in recent weeks, following the trend in laboratory detections (Figure 8a). Although the number of cases is small, a greater proportion of cases with influenza B have been children between 2 and 10 years of age compared to the younger age-groups affected by A(H1N1)pdm09 this season. No ICU admissions or deaths were reported in week 09.
                  To date this season, a total of 542 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 92% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children ≥2 years of age represent 55% of cases to date (Table 4). Seventy-nine ICU admissions have been reported, of which 46 (58%) were children ≥2 years of age (Figure 9a). Among the 77 ICU admission for which the influenza type reported, all but four were cases with influenza A, and 96% of those subtyped were A(H1N1)pdm09. Among the 67 ICU cases with available data, 45 (67%) were reported to have underlying medical conditions. No deaths have been reported.
                  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)
                  In week 09, 21 new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations reported through active surveillance by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 44 in week 08. There has been a steady decline in the number of new cases over recent weeks, and a greater number of cases of influenza B. Among cases in week 09, 14 (66.7%) were influenza A, and seven were influenza B (Figure 8b). All but two hospitalizations occurred among adults ≥45 years of age. Three ICU admissions were reported in week 09, all ≥45 years of age, two with influenza A and one with influenza B. No deaths were reported in week 09.
                  To date this season, 1104 influenza-associated hospitalizations have been reported by the PCIRN-SOS network, 1036 (93.8%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). ICU admission was required for 192 hospitalizations, all but seven of which were cases with influenza A (107 A(H1N1)pdm09, four A(H3N2) and 74 A(unsubtyped)). More than three quarters of hospitalizations and approximately 80% of ICU admissions were ≥45 years of age. Of the 156 ICU admissions with available information, 137 (87.8%) were reported to have at least one comorbidity and of the 165 ICU admissions with available information 119 (72.1%) reported not having been vaccinated this season. Fifty-three deaths have been reported, all but two with influenza A (32 A(H1N1)pdm09, two A(H3N2) and 17 A(unsubtyped)); five cases 20-44 years of age, 26 cases 45-64 years of age and 22 cases ≥65 years of age (Figure 9b).
                  Note: PCIRN-SOS conducted passive surveillance from April 30th to November 14th, 2013. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance began November 15th during which time PCIRN site coordinators investigate cases potentially related to influenza. Data from both active and passive surveillance reported during the 2013-14 season are included in this report. 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.
                  <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t4 class=alignCenter>Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=dr1 rowSpan=3>Age groups </TH><TH id=dc1 colSpan=6>Cumulative (Aug. 25, 2013 to March 1, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=dc2 colSpan=4 headers=dc1>Influenza A </TH><TH id=dc7 headers=dc1>B </TH><TH id=dc8 headers=dc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=dc3 headers="dc1 dc2">A Total </TH><TH id=dc4 class="lightred " headers="dc1 dc2">A(H1) pdm09 </TH><TH id=dc5 class="lightred " headers="dc1 dc2">A(H3) </TH><TH id=dc6 class="lightred " headers="dc1 dc2">A (UnS) </TH><TD class=alignCenter headers="dc1 dc7">Total</TD><TD class=alignCenter headers="dc1 dc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                  UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
                  </TD></TR></TFOOT><TBODY><TR><TH id=dr2 class=alignLeft headers=dr1>0-5m </TH><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc3">96 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc4">28 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc5">0 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc6">68 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc7">2 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc8">98 (18%) </TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc3">142 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc4">39 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc5">1 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc6">102 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc7">5 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc8">147 (27%) </TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc3">148 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc4">47 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc5">2 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc6">99 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc7">15 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc8">163 (30%) </TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc3">75 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc4">22 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc5">1 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc6">52 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc7">20 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc8">95 (18%) </TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc3">35 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc4">13 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc5">0 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc6">22 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc7">4 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc8">39 (7%) </TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignRight headers="dr1 dr7 dc1 dc2 dc3">496 </TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc4">149 </TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc5">4 </TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc6">343 </TD><TD class=alignRight headers="dr1 dr7 dc1 dc7">46 </TD><TD class=alignRight headers="dr1 dr7 dc1 dc8">542 </TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP> </TH><TD class=alignRight headers="dr1 dr8 dc1 dc2 dc3">91.5% </TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc4">30.0% </TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc5">0.8% </TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc6">69.2% </TD><TD class=alignRight headers="dr1 dr8 dc1 dc7">8.5% </TD><TD class=alignRight headers="dr1 dr8 dc1 dc8">100.0% </TD></TR></TBODY></TABLE>
                  <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 5 - Cumulative numbers of adult hospitalizations with influenza
                  reported by the PCIRN-SOS network, Canada, 2013-14
                  </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=er1 rowSpan=3>Age groups </TH><TH id=ec1 class=noWrap colSpan=6>Cumulative (Aug. 25, 2013 to March 1, 2014)<SUP>*</SUP></TH></TR><TR class=bg-colour-yellow><TH id=ec2 colSpan=4 headers=ec1>Influenza A </TH><TH id=ec7 headers=ec1>B </TH><TH id=ec8 headers=ec1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=ec3 headers="ec1 ec2">A Total </TH><TH id=ec4 class="lightred " headers="ec1 ec2">A(H1) pdm09 </TH><TH id=ec5 class="lightred " headers="ec1 ec2">A(H3) </TH><TH id=ec6 class="lightred " headers="ec1 ec2">A(UnS) </TH><TD class=alignCenter headers="ec1 ec7">Total</TD><TD class=alignCenter headers="ec1 ec8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                  UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.

                  <SUP id=t5_star>*</SUP> One case for which the influenza type has not yet been reported, and three cases for which the age-group was not reported, are not included in Table 5.
                  </TD></TR></TFOOT><TBODY><TR><TH id=er2 class=alignLeft headers=er1>16-20 </TH><TD class=alignRight headers="er1 er2 ec1 ec2 ec3">13</TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec4">3</TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec5">0</TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec6">10</TD><TD class=alignRight headers="er1 er2 ec1 ec7">1</TD><TD class=alignRight headers="er1 er2 ec1 ec8">14 (1%)</TD></TR><TR><TH id=er3 class=alignLeft headers=er1>20-44 </TH><TD class=alignRight headers="er1 er3 ec1 ec2 ec3">225</TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec4">123</TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec5">4</TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec6">98</TD><TD class=alignRight headers="er1 er3 ec1 ec7">4</TD><TD class=alignRight headers="er1 er3 ec1 ec8">229 (21%)</TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignRight headers="er1 er4 ec1 ec2 ec3">411</TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec4">191</TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec5">4</TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec6">216</TD><TD class=alignRight headers="er1 er4 ec1 ec7">13</TD><TD class=alignRight headers="er1 er4 ec1 ec8">424 (39%)</TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignRight headers="er1 er5 ec1 ec2 ec3">384</TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec4">189</TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec5">29</TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec6">166</TD><TD class=alignRight headers="er1 er5 ec1 ec7">49</TD><TD class=alignRight headers="er1 er5 ec1 ec8">433 (39%)</TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignRight headers="er1 er6 ec1 ec2 ec3">1033</TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec4">506</TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec5">37</TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec6">490</TD><TD class=alignRight headers="er1 er6 ec1 ec7">67</TD><TD class=alignRight headers="er1 er6 ec1 ec8">1100</TD></TR><TR><TH id=er7 class=alignLeft headers=er1>%<SUP>1</SUP></TH><TD class=alignRight headers="er1 er7 ec1 ec2 ec3">94%</TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec4">49%</TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec5">4%</TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec6">47%</TD><TD class=alignRight headers="er1 er7 ec1 ec7">6%</TD><TD class=alignRight headers="er1 er7 ec1 ec8">100%</TD></TR></TBODY></TABLE>
                  Figure 8. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14
                  A) Paediatric hospitalizations (≤16 years of age, IMPACT)


                  Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
                  B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)

                  * See footnote above following the section related to PCIRN-SOS data.
                  Text equivalent for figure 8bNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Adult hospitalizations (>16 year of age, PCIRN-SOS)
                  Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14
                  A) Paediatric hospitalizations (≤16 years of age, IMPACT)

                  Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
                  B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)

                  Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Adult hospitalizations (≥16 year of age, PCIRN-SOS)

                  Top of Page

                  Provincial/Territorial Influenza Hospitalizations and Deaths

                  In week 09, 134 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories.* The majority were cases of influenza A (101, 75.4%), of which 57 (56.4%) were A(H1N1)pdm09, four (4.0%) was A(H3N2), and 40 (39.6%) were A(unsubtyped). The proportion of cases with influenza B has been increasing in recent weeks. Six ICU admissions were reported in week 09, all with influenza A: three adults 45-64 years of age, one ≥65 years of age, and two with age not reported. Nine deaths were reported, two thirds of which were adults 65 years of age and older. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total.
                  To date this season, 3,238 influenza-associated hospitalizations have been reported, 95.9% with influenza A. The majority (57.6%) of hospitalizations have been cases 45 years of age of older (Table 6). A total of 307 ICU admissions have been reported this season, of which 67.1% were among adults 20-64 years of age. A total of 182 deaths have been reported. The highest proportion of deaths has been among adults 20-64 years of age (51.1%), followed by adults ≥65 years of age (39.6%). Influenza B has been detected infrequently among severe cases of influenza to date this season: in only 4.1% of hospitalizations, 1.0% of ICU admissions, and 4.4 % of deaths. It is important to note that the hospitalization or 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: 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 distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks.
                  <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t6 class=alignCenter>Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=fr1 rowSpan=3>Age groups </TH><TH id=fc1 colSpan=6>Cumulative (Aug. 25, 2013 to March 1, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=fc2 colSpan=4 headers=fc1>Influenza A</TH><TH id=fc7 headers=fc1>B</TH><TH id=fc8 headers=fc1>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=fc3 headers="fc1 fc2">A Total</TH><TH id=fc4 class=lightred headers="fc1 fc2">A(H1) pdm09</TH><TH id=fc5 class=lightred headers="fc1 fc2">A(H3)</TH><TH id=fc6 class=lightred headers="fc1 fc2">A (UnS)</TH><TD class=alignCenter headers="fc1 fc7">Total</TD><TD class=alignCenter headers="fc1 fc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=8><SUP>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                  UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
                  </TD></TR></TFOOT><TBODY><TR><TH id=fr2 class=alignLeft headers=fr1>0-4 years</TH><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc3">530</TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc4">261</TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc5">6</TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc6">263</TD><TD class=alignRight headers="fr1 fr2 fc1 fc7">22</TD><TD class=alignRight headers="fr1 fr2 fc1 fc8">552 (17%)</TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years</TH><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc3">116</TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc4">60</TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc5">5</TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc6">51</TD><TD class=alignRight headers="fr1 fr3 fc1 fc7">15</TD><TD class=alignRight headers="fr1 fr3 fc1 fc8">131 (4%)</TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years</TH><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc3">32</TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc4">19</TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc5">2</TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc6">11</TD><TD class=alignRight headers="fr1 fr4 fc1 fc7">1</TD><TD class=alignRight headers="fr1 fr4 fc1 fc8">33 (1%)</TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc3">543</TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc4">391</TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc5">3</TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc6">149</TD><TD class=alignRight headers="fr1 fr5 fc1 fc7">9</TD><TD class=alignRight headers="fr1 fr5 fc1 fc8">552 (17%)</TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc3">999</TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc4">652</TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc5">17</TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc6">330</TD><TD class=alignRight headers="fr1 fr6 fc1 fc7">24</TD><TD class=alignRight headers="fr1 fr6 fc1 fc8">1023 (32%)</TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc3">784</TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc4">422</TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc5">50</TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc6">312</TD><TD class=alignRight headers="fr1 fr7 fc1 fc7">58</TD><TD class=alignRight headers="fr1 fr7 fc1 fc8">842 (26%)</TD></TR><TR><TH id=fr10 class=alignLeft headers=fr1>Unknown</TH><TD class=alignRight headers="fr1 fr10 fc1 fc2 fc3">101</TD><TD class=alignRight headers="fr1 fr10 fc1 fc2 fc4">79</TD><TD class=alignRight headers="fr1 fr10 fc1 fc2 fc5">3</TD><TD class=alignRight headers="fr1 fr10 fc1 fc2 fc6">19</TD><TD class=alignRight headers="fr1 fr10 fc1 fc7">4</TD><TD class=alignRight headers="fr1 fr10 fc1 fc8">105 (3%)</TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignRight headers="fr1 fr8 fc1 fc2 fc3">3105</TD><TD class="alignRight lightred" headers="fr1 fr8 fc1 fc2 fc4">1884</TD><TD class="alignRight lightred" headers="fr1 fr8 fc1 fc2 fc5">86</TD><TD class="alignRight lightred" headers="fr1 fr8 fc1 fc2 fc6">1135</TD><TD class=alignRight headers="fr1 fr8 fc1 fc7">133</TD><TD class=alignRight headers="fr1 fr8 fc1 fc8">3238</TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP> </TH><TD class=alignRight headers="fr1 fr9 fc1 fc2 fc3">95.9%</TD><TD class="alignRight lightred" headers="fr1 fr9 fc1 fc2 fc4">60.7%</TD><TD class="alignRight lightred" headers="fr1 fr9 fc1 fc2 fc5">2.8%</TD><TD class="alignRight lightred" headers="fr1 fr9 fc1 fc2 fc6">36.6%</TD><TD class=alignRight headers="fr1 fr9 fc1 fc7">4.1%</TD><TD class=alignRight headers="fr1 fr9 fc1 fc8">100%</TD></TR></TBODY></TABLE>
                  See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2013-14 on the Public Health Agency of Canada website.

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

                  Comment


                  • #24
                    Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 10

                    FluWatch report: March 2 to 8, 2014 (Week 10)

                    Posted 2014-03-14For 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/13-14/w10_14/pdf/fw2014-10-eng.pdf">FluWatch report: March 2 to 8, 2014 (Week 10) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 291 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

                    »» Help with PDF documents

                    Overall Summary
                    • In week 10, influenza activity in Canada continues to decrease overall, and is consistent with activity at this time in past influenza seasons.
                    • The influenza A(H1N1) virus remains the most common influenza virus circulating this season. Circulation of influenza B virus continues to increase in recent weeks, resulting in increased paediatric and adult hospitalizations.
                    • While the influenza A(H1N1) virus has mostly affected adults 20-64 years of age, influenza B cases are having a greater impact on adults 65 year of age and older.
                    • As of week 10, 3,450 hospitalizations and 189 deaths have been reported from participating regions, which is comparable to reports in past influenza seasons.
                    Influenza/ILI Activity (geographic spread)

                    In week 10, influenza activity levels continued to decline. No region reported widespread activity and eight regions (SK(1), ON(5), and QC(2)) reported localized activity (Figure 1).
                    Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 10





                    Note: Influenza/ILI 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 and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
                    Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
                    Influenza and Other Respiratory Virus Detections

                    The number of positive influenza tests continued to decrease, from 842 in week 09 to 752 in week 10. The percentage of positive influenza tests was similar to last week at 12.5% (Figure 2). Cumulative influenza virus detections to date have been predominantly influenza A (89%), and among those subtyped, 97% (10,089/10,458) were A(H1N1)pdm09. The percentage of positive tests for influenza B has been rising slowly in recent weeks, and was approximately equal to detections of influenza A in week 10 (Table 1). Among the 18,182 cases for which information on age and type/subtype has been received this season, 55.4% were 20-64 years of age (Table 2).
                    Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14

                    Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
                    The number of positive tests for RSV has been declining gradually over recent weeks. The number of positive tests for parainfluenza, adenovirus and rhinovirus decreased in week 10, but increased for coronavirus, interrupting a decline since week 05. The number of positive tests for human metapneumovirus has been higher than during the same period last season and declined slightly in week 10 (Figure 3).
                    For more details, see the weekly Respiratory Virus Detections in Canada Report.
                    Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2013-14


                    Top of Page

                    RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
                    Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
                    <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly and cumulative numbers of positive influenza specimens
                    by type, subtype and province, Canada, 2013-14
                    </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=ac1 colSpan=5>Weekly
                    (March 2, 2013 to March 8, 2014)</TH><TH id=ac8 colSpan=5>Cumulative
                    (August 25, 2013 to March 8, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=4 headers=ac1>Influenza A</TH><TH id=ac7 headers=ac1>B</TH><TH id=ac9 colSpan=4 headers=ac8>Influenza A</TH><TH id=ac14 headers=ac8>B</TH></TR><TR class=bg-colour-grey-light><TH id=ac3 headers="ac1 ac2">A Total</TH><TH id=ac4 class=lightred headers="ac1 ac2">A(H1)pdm09</TH><TH id=ac5 class=lightred headers="ac1 ac2">A(H3)</TH><TH id=ac6 class=lightred headers="ac1 ac2">A(UnS)</TH><TH class=alignCenter headers="ac1 ac7">B Total</TH><TH id=ac10 headers="ac8 ac9">A Total</TH><TH id=ac11 class=lightred headers="ac8 ac9">A(H1)pdm09</TH><TH id=ac12 class=lightred headers="ac8 ac9">A(H3)</TH><TH id=ac13 class=lightred headers="ac8 ac9">A(UnS)</TH><TD class=alignCenter headers="ac8 ac14">B Total</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
                    <SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                    UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=alignLeft headers=ar1>BC</TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">35</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">22</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">9</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">4</TD><TD class=alignRight headers="ar1 ar2 ac1 ac7">28</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac10">1734</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac11">1575</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac12">53</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac13">106</TD><TD class=alignRight headers="ar1 ar2 ac8 ac14">124</TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">63</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">31</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">1</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">31</TD><TD class=alignRight headers="ar1 ar3 ac1 ac7">17</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac10">3671</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac11">3360</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac12">49</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac13">262</TD><TD class=alignRight headers="ar1 ar3 ac8 ac14">122</TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">11</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">5</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">1</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">5</TD><TD class=alignRight headers="ar1 ar4 ac1 ac7">7</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac10">1343</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac11">967</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac12">5</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac13">371</TD><TD class=alignRight headers="ar1 ar4 ac8 ac14">34</TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">23</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">15</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">8</TD><TD class=alignRight headers="ar1 ar5 ac1 ac7">0</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac10">595</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac11">422</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac12">1</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac13">172</TD><TD class=alignRight headers="ar1 ar5 ac8 ac14">15</TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">82</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">33</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">9</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">40</TD><TD class=alignRight headers="ar1 ar6 ac1 ac7">128</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac10">5433</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac11">2386</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac12">253</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac13">2794</TD><TD class=alignRight headers="ar1 ar6 ac8 ac14">523</TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">130</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">14</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">116</TD><TD class=alignRight headers="ar1 ar7 ac1 ac7">179</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac10">5151</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac11">665</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac12">3</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac13">4483</TD><TD class=alignRight headers="ar1 ar7 ac8 ac14">1391</TD></TR><TR><TH id=ar8 class=alignLeft headers=ar1>NB</TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">25</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac4">4</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac6">21</TD><TD class=alignRight headers="ar1 ar8 ac1 ac7">6</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac10">1480</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac11">370</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac12">1</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac13">1109</TD><TD class=alignRight headers="ar1 ar8 ac8 ac14">18</TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">7</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">7</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 ac7">1</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac10">153</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac11">124</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac12">4</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac13">25</TD><TD class=alignRight headers="ar1 ar9 ac8 ac14">3</TD></TR><TR><TH id=ar10 class=alignLeft headers=ar1>PE</TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">1</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac4">1</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 ac7">1</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac10">117</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac11">116</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac13">1</TD><TD class=alignRight headers="ar1 ar10 ac8 ac14">1</TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">7</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">7</TD><TD class=alignRight headers="ar1 ar11 ac1 ac7">1</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac10">339</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac11">104</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac13">235</TD><TD class=alignRight headers="ar1 ar11 ac8 ac14">132</TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">384</TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac4">132</TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac5">20</TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac6">232</TD><TD class=alignRight headers="ar1 ar12 ac1 ac7">368</TD><TD class=alignRight headers="ar1 ar12 ac8 ac9 ac10">20016</TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac11">10089</TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac12">369</TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac13">9558</TD><TD class=alignRight headers="ar1 ar12 ac8 ac14">2363</TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="ar1 ar13 ac1 ac2 ac3">51.1%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac4">34.4%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac5">5.2%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac6">60.4%</TD><TD class=alignRight headers="ar1 ar13 ac1 ac7">48.9%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac9 ac10">89.4%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac11">50.4%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac12">1.8%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac13">47.8%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac14">10.6%</TD></TR></TBODY></TABLE>
                    <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups (years)</TH><TH id=bc1 colSpan=5>Weekly
                    (March 2 to March 8, 2014)</TH><TH id=bc8 colSpan=7>Cumulative
                    (August 25, 2013 to March 8, 2014)</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><TH id=bc15 colSpan=2 headers=bc8>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=bc3 headers="bc1 bc2">A Total</TH><TH id=bc4 class="lightred " headers="bc1 bc2">A(H1) pdm09</TH><TH id=bc5 class="lightred " headers="bc1 bc2">A(H3)</TH><TH id=bc6 class="lightred " headers="bc1 bc2">A (UnS)</TH><TD class=alignCenter headers="bc1 bc7">Total</TD><TH id=bc10 headers="bc8 bc9">A Total</TH><TH id=bc11 class="lightred " headers="bc8 bc9">A(H1) pdm09</TH><TH id=bc12 class="lightred " headers="bc8 bc9">A(H3)</TH><TH id=bc13 class="lightred " headers="bc8 bc9">A (UnS)</TH><TD class=alignCenter headers="bc8 bc14">Total</TD><TH id=bc16 headers="bc8 bc15">#</TH><TH id=bc17 headers="bc8 bc15">%</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
                    <SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                    <SUP>3 </SUP>Table 2 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
                    UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=br2 class=alignLeft headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">44</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">10</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">34</TD><TD class=alignRight headers="br1 br2 bc1 bc7">22</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">3098</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">1377</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">24</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1697</TD><TD class=alignRight headers="br1 br2 bc8 bc14">235</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc16">3333</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc17">18.3%</TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">18</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">5</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">13</TD><TD class=alignRight headers="br1 br3 bc1 bc7">33</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1268</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">676</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">18</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">574</TD><TD class=alignRight headers="br1 br3 bc8 bc14">355</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc16">1623</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc17">8.9%</TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">52</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">21</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">30</TD><TD class=alignRight headers="br1 br4 bc1 bc7">18</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">4913</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">2680</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">36</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">2197</TD><TD class=alignRight headers="br1 br4 bc8 bc14">385</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc16">5298</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc17">29.1%</TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">44</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">12</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">32</TD><TD class=alignRight headers="br1 br5 bc1 bc7">50</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">4269</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">2292</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">40</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">1937</TD><TD class=alignRight headers="br1 br5 bc8 bc14">507</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc16">4776</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc17">26.3%</TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">36</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">10</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">26</TD><TD class=alignRight headers="br1 br6 bc1 bc7">71</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">2337</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">949</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">96</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">1292</TD><TD class=alignRight headers="br1 br6 bc8 bc14">683</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc16">3020</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc17">16.6%</TD></TR><TR><TH id=br7 class=alignLeft 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">130</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">100</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">17</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">13</TD><TD class=alignRight headers="br1 br7 bc8 bc14">2</TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc16">132</TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc17">0.7%</TD></TR><TR><TH id=br8 class=alignLeft headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">194</TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc4">58</TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc5">1</TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc6">135</TD><TD class=alignRight headers="br1 br8 bc1 bc7">194</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">16015</TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc11">8074</TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc12">231</TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc13">7710</TD><TD class=alignRight headers="br1 br8 bc8 bc14">2167</TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc16">18182</TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc17">100.0%</TD></TR><TR><TH id=br9 class=alignLeft headers=br1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="br1 br9 bc1 bc2 bc3">50.0%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc4">29.9%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc5">0.5%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc6">69.6%</TD><TD class=alignRight headers="br1 br9 bc1 bc7">50.0%</TD><TD class=alignRight headers="br1 br9 bc8 bc9 bc10">88.1%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc11">50.4%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc12">1.4%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc13">48.1%</TD><TD class=alignRight headers="br1 br9 bc8 bc14">11.9%</TD><TD class=alignRight></TD><TD class=alignRight></TD></TR></TBODY></TABLE>

                    Top of Page

                    Influenza Strain Characterizations

                    During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 1401 influenza viruses [64 A(H3N2), 1131 A(H1N1)pdm09 and 206 influenza B]. The vast majority (99%) of viruses were similar to the strains recommended by the WHO for the 2013-14 seasonal influenza vaccine. Two A(H1N1)pdm09 viruses showed reduced titres to antiserum against the reference A/California/07/2009 strain. Fourteen influenza B viruses were similar to the strain recommended by the WHO for the 2011-12 vaccine (Figure 4).
                    Figure 4. Influenza strain characterizations, Canada, 2013-14, N = 1401

                    The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
                    The recommended components for the 2013-2014 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009 (H1N1)pdm09-like virus, an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b (e.g. A/Texas/50/2012), and a B/Massachusetts/2/2012-like virus (Yamagata lineage).


                    Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
                    Antiviral Resistance

                    During the 2013-2014 influenza season, NML has tested 996 influenza viruses for resistance to oseltamivir and all but two were sensitive. All 993 viruses tested for resistance to zanamivir were sensitive. All 1165 influenza A viruses tested for amantadine resistance 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, 2013-2014</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 lightred" headers=cr1>A (H3N2)</TH><TD class=alignRight headers="cr1 cr2 cc1 cc2">53</TD><TD class=alignRight headers="cr1 cr2 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr2 cc4 cc5">53</TD><TD class=alignRight headers="cr1 cr2 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr2 cc7 cc8">88</TD><TD class=alignRight headers="cr1 cr2 cc7 cc9">88 (100%)</TD></TR><TR><TH id=cr3 class="alignLeft lightred" headers=cr1>A (H1N1)</TH><TD class=alignRight headers="cr1 cr3 cc1 cc2">883</TD><TD class=alignRight headers="cr1 cr3 cc1 cc3">2 (0.2%)</TD><TD class=alignRight headers="cr1 cr3 cc4 cc5">830</TD><TD class=alignRight headers="cr1 cr3 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr3 cc7 cc8">1077</TD><TD class=alignRight headers="cr1 cr3 cc7 cc9">1077 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft lightred" headers=cr1>B</TH><TD class=alignRight headers="cr1 cr4 cc1 cc2">110</TD><TD class=alignRight headers="cr1 cr4 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr4 cc4 cc5">110</TD><TD class=alignRight headers="cr1 cr4 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr4 cc7 cc8">NA <SUP>*</SUP></TD><TD class=alignRight headers="cr1 cr4 cc7 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft lightred" headers=cr1>TOTAL</TH><TD class=alignRight headers="cr1 cr5 cc1 cc2">996</TD><TD class=alignRight headers="cr1 cr5 cc1 cc3">2 (0.2%)</TD><TD class=alignRight headers="cr1 cr5 cc4 cc5">993</TD><TD class=alignRight headers="cr1 cr5 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr5 cc7 cc8">1165</TD><TD class=alignRight headers="cr1 cr5 cc7 cc9">1165 (100%)</TD></TR></TBODY></TABLE>
                    Influenza-like Illness (ILI) Consultation Rate

                    The national influenza-like-illness (ILI) consultation rate increased from 32.7/1,000 in week 09 to 39.8/1,000 in week 10; but is still within the expected range for this time of year (Figure 5).
                    Figure 5. Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

                    Note: No data available for mean rate for weeks 19 to 39 for the 1996-1997 through 2002-2003 seasons. Delays in the reporting of data may cause data to change retrospectively. The calculation of the average ILI consultation rate over 17 seasons was aligned with influenza activity in each season. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. The number of sentinel physicians in each province or territory is as follows: BC(21), AB(80), SK(11), MB(18), ON(169), QC(14), NB(29), NS(26), PE(4), NL(16), NU(1), NT(14), YT(13). Not all sentinel physicians report every week.
                    Text equivalent for figure 5Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

                    Top of Page

                    Influenza Outbreak Surveillance

                    In week 10, five new influenza outbreaks in long-term care facilities were reported, the same number as in week (Figure 6). In addition, two outbreaks of influenza-like-illness were reported in schools.
                    Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2013-2014

                    1 All provinces and territories except NU report outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
                    Text equivalent for figure 6Overall number of new influenza outbreaks by report week, Canada, 2013-2014
                    Pharmacy Surveillance

                    In week 10, the overall proportion of prescriptions for influenza antivirals continued to decrease. The largest proportion of prescriptions for antivirals continuing to be among children 2-18 years of age and adults 19-64 years of age, although the proportion of prescriptions for infants increased in week 10 (Figure 7).
                    Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

                    Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group. Age-groups: Infant: 0-2y, Child: 2-18y; Adult: 19-64y, Senior: ≥65y.
                    Text equivalent for figure 7Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

                    Top of Page

                    Sentinel Hospital Influenza Surveillance

                    Paediatric Influenza Hospitalizations and Deaths (IMPACT)
                    In week 10, 35 new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 26 in week 09. In week 10, influenza A was reported in 23 cases and influenza B in 12 cases. A greater proportion of cases have been reported with influenza B cases in recent weeks, following the trend in laboratory detections (Figure 8a). Although the number of cases is small, a greater proportion of cases with influenza B this season have been children between 2 and 10 years of age compared to A(H1N1)pdm09. In week 10, one ICU admission was reported in a child 5-9 years of age with influenza B. No deaths were reported in week 10.
                    To date this season, a total of 591 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 90% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children <5 years of age represent 74% of cases to date (Table 4). Eighty-two ICU admissions have been reported, of which 55 (67%) were children <5 years of age (Figure 9a). All but four were cases with influenza A, and 96% of those subtyped were A(H1N1)pdm09. Among the 72 ICU cases with available data, 47 (65%) were reported to have underlying medical conditions. No deaths have been reported.
                    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)
                    In week 10, 36 new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported through active surveillance by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 35 in week 09. In week 10, influenza B-associated hospitalizations surpassed those associated with influenza A for the first time this season. Among cases in week 10, 16 (44.4%) were influenza A, and 20 were influenza B (Figure 8b). All but five hospitalizations occurred among adults ≥45 years of age. No ICU admissions or deaths were reported in week 10.
                    To date this season, 1176 influenza-associated hospitalizations have been reported by the PCIRN-SOS network, 1074 (91.3%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). ICU admission was required for 201 hospitalizations, all but seven of which were cases with influenza A (110 A(H1N1)pdm09, five A(H3N2) and 79 A(unsubtyped)). More than three quarters of hospitalizations and approximately 80% of ICU admissions were ≥45 years of age. Of the 163 ICU admissions with available information, 143 (87.7%) were reported to have at least one comorbidity and of the 172 ICU admissions with available information 125 (72.7%) reported not having been vaccinated this season. Fifty-six deaths have been reported, all but three with influenza A (32 A(H1N1)pdm09, two A(H3N2) and 19 A(unsubtyped)); six cases 20-44 years of age, 27 cases 45-64 years of age and 23 cases ≥65 years of age (Figure 9b).
                    Note: PCIRN-SOS conducted passive surveillance from April 30th to November 14th, 2013. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance began November 15th during which time PCIRN site coordinators investigate cases potentially related to influenza. Data from both active and passive surveillance reported during the 2013-14 season are included in this report. 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.
                    <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t4 class=alignCenter>Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=dr1 rowSpan=3>Age groups </TH><TH id=dc1 colSpan=6>Cumulative (Aug. 25, 2013 to March 8, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=dc2 colSpan=4 headers=dc1>Influenza A </TH><TH id=dc7 headers=dc1>B </TH><TH id=dc8 headers=dc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=dc3 headers="dc1 dc2">A Total </TH><TH id=dc4 class="lightred " headers="dc1 dc2">A(H1) pdm09 </TH><TH id=dc5 class="lightred " headers="dc1 dc2">A(H3) </TH><TH id=dc6 class="lightred " headers="dc1 dc2">A (UnS) </TH><TD class=alignCenter headers="dc1 dc7">Total</TD><TD class=alignCenter headers="dc1 dc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                    UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=dr2 class=alignLeft headers=dr1>0-5m </TH><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc3">101</TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc4">30</TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc5">0</TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc6">71</TD><TD class=alignRight headers="dr1 dr2 dc1 dc7">3</TD><TD class=alignRight headers="dr1 dr2 dc1 dc8">104 (18%)</TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc3">153</TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc4">44</TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc5">1</TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc6">108</TD><TD class=alignRight headers="dr1 dr3 dc1 dc7">7</TD><TD class=alignRight headers="dr1 dr3 dc1 dc8">160 (27%)</TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc3">156</TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc4">51</TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc5">3</TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc6">102</TD><TD class=alignRight headers="dr1 dr4 dc1 dc7">18</TD><TD class=alignRight headers="dr1 dr4 dc1 dc8">174 (29%)</TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc3">80</TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc4">23</TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc5">0</TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc6">57</TD><TD class=alignRight headers="dr1 dr5 dc1 dc7">27</TD><TD class=alignRight headers="dr1 dr5 dc1 dc8">107 (18%)</TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc3">40</TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc4">15</TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc5">1</TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc6">24</TD><TD class=alignRight headers="dr1 dr6 dc1 dc7">6</TD><TD class=alignRight headers="dr1 dr6 dc1 dc8">46 (8%)</TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignRight headers="dr1 dr7 dc1 dc2 dc3">530</TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc4">163</TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc5">5</TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc6">362</TD><TD class=alignRight headers="dr1 dr7 dc1 dc7">61</TD><TD class=alignRight headers="dr1 dr7 dc1 dc8">591</TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP> </TH><TD class=alignRight headers="dr1 dr8 dc1 dc2 dc3">89.7%</TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc4">30.8%</TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc5">0.9%</TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc6">68.3%</TD><TD class=alignRight headers="dr1 dr8 dc1 dc7">10.3%</TD><TD class=alignRight headers="dr1 dr8 dc1 dc8">100.0%</TD></TR></TBODY></TABLE>
                    <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 5 - Cumulative numbers of adult hospitalizations with influenza
                    reported by the PCIRN-SOS network, Canada, 2013-14
                    </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=er1 rowSpan=3>Age groups </TH><TH id=ec1 class=noWrap colSpan=6>Cumulative (Aug. 25, 2013 to March 8, 2014)<SUP>*</SUP></TH></TR><TR class=bg-colour-yellow><TH id=ec2 colSpan=4 headers=ec1>Influenza A </TH><TH id=ec7 headers=ec1>B </TH><TH id=ec8 headers=ec1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=ec3 headers="ec1 ec2">A Total </TH><TH id=ec4 class="lightred " headers="ec1 ec2">A(H1) pdm09 </TH><TH id=ec5 class="lightred " headers="ec1 ec2">A(H3) </TH><TH id=ec6 class="lightred " headers="ec1 ec2">A(UnS) </TH><TD class=alignCenter headers="ec1 ec7">Total</TD><TD class=alignCenter headers="ec1 ec8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                    UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.

                    <SUP id=t5_star>*</SUP> One case for which the influenza type has not yet been reported, and three cases for which the age-group was not reported, are not included in Table 5.</TD></TR></TFOOT><TBODY><TR><TH id=er2 class=alignLeft headers=er1>16-20 </TH><TD class=alignRight headers="er1 er2 ec1 ec2 ec3">13 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec4">3 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec5">0 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec6">10 </TD><TD class=alignRight headers="er1 er2 ec1 ec7">1 </TD><TD class=alignRight headers="er1 er2 ec1 ec8">14 (1%) </TD></TR><TR><TH id=er3 class=alignLeft headers=er1>20-44 </TH><TD class=alignRight headers="er1 er3 ec1 ec2 ec3">234 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec4">126 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec5">4 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec6">104 </TD><TD class=alignRight headers="er1 er3 ec1 ec7">6 </TD><TD class=alignRight headers="er1 er3 ec1 ec8">240 (20%) </TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignRight headers="er1 er4 ec1 ec2 ec3">423 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec4">194 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec5">4 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec6">225 </TD><TD class=alignRight headers="er1 er4 ec1 ec7">25 </TD><TD class=alignRight headers="er1 er4 ec1 ec8">448 (38%) </TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignRight headers="er1 er5 ec1 ec2 ec3">401 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec4">193 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec5">31 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec6">177 </TD><TD class=alignRight headers="er1 er5 ec1 ec7">69 </TD><TD class=alignRight headers="er1 er5 ec1 ec8">470 (40%) </TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignRight headers="er1 er6 ec1 ec2 ec3">1071 </TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec4">516 </TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec5">39 </TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec6">516 </TD><TD class=alignRight headers="er1 er6 ec1 ec7">101 </TD><TD class=alignRight headers="er1 er6 ec1 ec8">1172 </TD></TR><TR><TH id=er7 class=alignLeft headers=er1>%<SUP>1</SUP></TH><TD class=alignRight headers="er1 er7 ec1 ec2 ec3">91% </TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec4">48% </TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec5">4% </TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec6">48% </TD><TD class=alignRight headers="er1 er7 ec1 ec7">9% </TD><TD class=alignRight headers="er1 er7 ec1 ec8">100% </TD></TR></TBODY></TABLE>
                    Figure 8. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14
                    A) Paediatric hospitalizations (≤16 years of age, IMPACT)


                    Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
                    B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)

                    * See footnote above following the section related to PCIRN-SOS data.
                    Text equivalent for figure 8bNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Adult hospitalizations (>16 year of age, PCIRN-SOS)
                    Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14
                    A) Paediatric hospitalizations (≤16 years of age, IMPACT)

                    Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
                    B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)

                    Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Adult hospitalizations (≥16 year of age, PCIRN-SOS)

                    Top of Page

                    Provincial/Territorial Influenza Hospitalizations and Deaths

                    In week 10, 194 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories.* The majority were cases of influenza A (136, 70.1%), of which 58 (42.6%) were A(H1N1)pdm09, 12 (8.8%) were A(H3N2), and 66 (48.5%) were A(unsubtyped). The proportion of cases with influenza B has been increasing in recent weeks. Five of the seven ICU admissions in week 10 included age information: four of which were adults ≥45 years of age; all but one with influenza A. Seven deaths were reported, four of which were adults 65 years of age and older. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total.
                    To date this season, 3,450 influenza-associated hospitalizations have been reported, 94.5% with influenza A. The majority (57.7%) of hospitalizations have been cases 45 years of age of older (Table 6). A total of 316 ICU admissions have been reported this season, of which 66.5% were among adults 20-64 years of age. A total of 189 deaths have been reported. The highest proportion of deaths has been among adults 20-64 years of age (50.3%), followed by adults ≥65 years of age (40.2%). Influenza B has been detected infrequently among severe cases of influenza to date this season: in only 5.5% of hospitalizations, 1.3% of ICU admissions, and 5.3 % of deaths. It is important to note that the hospitalization or 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: 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 distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks.
                    <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t6 class=alignCenter>Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=fr1 rowSpan=3>Age groups </TH><TH id=fc1 colSpan=6>Cumulative (Aug. 25, 2013 to March 8, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=fc2 colSpan=4 headers=fc1>Influenza A</TH><TH id=fc7 headers=fc1>B</TH><TH id=fc8 headers=fc1>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=fc3 headers="fc1 fc2">A Total</TH><TH id=fc4 class=lightred headers="fc1 fc2">A(H1) pdm09</TH><TH id=fc5 class=lightred headers="fc1 fc2">A(H3)</TH><TH id=fc6 class=lightred headers="fc1 fc2">A (UnS)</TH><TD class=alignCenter headers="fc1 fc7">Total</TD><TD class=alignCenter headers="fc1 fc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=8><SUP>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                    UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=fr2 class=alignLeft headers=fr1>0-4 years</TH><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc3">554 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc4">273 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc5">6 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc6">275 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc7">31 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc8">585 (17%) </TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years</TH><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc3">121 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc4">62 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc5">5 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc6">54 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc7">26 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc8">147 (4%) </TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years</TH><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc3">32 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc4">19 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc5">2 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc6">11 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc7">1 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc8">33 (1%) </TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc3">571 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc4">404 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc5">4 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc6">163 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc7">11 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc8">582 (17%) </TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc3">1038 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc4">667 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc5">20 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc6">351 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc7">40 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc8">1078 (31%) </TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc3">830 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc4">440 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc5">59 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc6">331 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc7">77 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc8">907 (26%) </TD></TR><TR><TH id=fr10 class=alignLeft headers=fr1>Unknown</TH><TD class=alignRight headers="fr1 fr10 fc1 fc2 fc3">114 </TD><TD class=alignRight headers="fr1 fr10 fc1 fc2 fc4">87 </TD><TD class=alignRight headers="fr1 fr10 fc1 fc2 fc5">3 </TD><TD class=alignRight headers="fr1 fr10 fc1 fc2 fc6">24 </TD><TD class=alignRight headers="fr1 fr10 fc1 fc7">4 </TD><TD class=alignRight headers="fr1 fr10 fc1 fc8">118 (3%) </TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignRight headers="fr1 fr8 fc1 fc2 fc3">3260 </TD><TD class="alignRight lightred" headers="fr1 fr8 fc1 fc2 fc4">1952 </TD><TD class="alignRight lightred" headers="fr1 fr8 fc1 fc2 fc5">99 </TD><TD class="alignRight lightred" headers="fr1 fr8 fc1 fc2 fc6">1209 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc7">190 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc8">3450 </TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP> </TH><TD class=alignRight headers="fr1 fr9 fc1 fc2 fc3">94.5% </TD><TD class="alignRight lightred" headers="fr1 fr9 fc1 fc2 fc4">59.9% </TD><TD class="alignRight lightred" headers="fr1 fr9 fc1 fc2 fc5">3.0% </TD><TD class="alignRight lightred" headers="fr1 fr9 fc1 fc2 fc6">37.1% </TD><TD class=alignRight headers="fr1 fr9 fc1 fc7">5.5% </TD><TD class=alignRight headers="fr1 fr9 fc1 fc8">100% </TD></TR></TBODY></TABLE>
                    See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2013-14 on the Public Health Agency of Canada website.

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

                    Comment


                    • #25
                      Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 11

                      FluWatch report: March 9 to 15, 2014 (Week 11)

                      Posted 2014-03-21For 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/13-14/w11_14/pdf/fw2014-11-eng.pdf">FluWatch report: March 9 to 15, 2014 (Week 11) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 291 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

                      »» Help with PDF documents

                      Overall Summary
                      • In week 11, influenza activity in Canada has increased slightly, with the majority of influenza viruses detected being influenza B. Overall, the influenza A(H1N1) virus remains the most common influenza virus circulating this season, and influenza activity remains within expected levels for this time of year.
                      • While the influenza A(H1N1) virus has mostly affected adults 20-64 years of age this season, influenza B is having a greater impact on adults 65 years of age and older, as well as young persons 5 to 19 years of age.
                      • As of week 11, 3,570 hospitalizations and 197 deaths have been reported from participating regions, which is comparable to reports in past influenza seasons.
                      • A Public Health Agency of Canada survey, conducted in February 2014, estimates that 39% of the Canadian population received the 2013-14 seasonal influenza vaccine, with higher coverage of 69.5% in Canadians aged 65 years and older.
                      Influenza/ILI Activity (geographic spread)

                      In week 11, influenza activity levels increased slightly. One region in Quebec reported widespread activity and nine regions (BC(1), ON(5), and QC(3)) reported localized activity (Figure 1).
                      Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 11





                      Note: Influenza/ILI 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 and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
                      Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
                      Influenza and Other Respiratory Virus Detections

                      The number of positive influenza tests increased slightly, from 743 in week 10 to 750 in week 11, driven by increasing detections of influenza B. The percentage of positive influenza tests increased from 12.3% in week 10 to 13.4% in week 11, with 65% of positive tests being influenza B (Figure 2). The highest percentages of influenza B among positive tests have been reported from Newfoundland & Labrador (29.2%) and Quebec (23.8%), followed by Ontario (11.1%) and British Columbia (8.1%). Despite the late-season circulation of influenza B, the predominant influenza virus this season remains A(H1N1)pdm09 (Table 1). Among the 18,962 cases for which information on age and type/subtype has been received this season, 54.9% were 20-64 years of age (Table 2). Significantly greater proportions of influenza B cases have been ≥65 years of age and 5-19 years of age compared to cases of A(H1N1)pdm09.

                      Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14

                      Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
                      The number of positive tests for RSV has been declining gradually over recent weeks, similar to the trend observed in recent seasons. The number of positive tests for parainfluenza was stable in week 11 and has been on a downward trend since week 02. The number of positive tests for adenovirus and rhinovirus have decreased in recent weeks; and in week 11, detections of coronavirus resumed a decline that started in week 05. The number of positive tests for human metapneumovirus has been higher than during the same period last season and has been similar over the past 5 weeks (Figure 3).
                      For more details, see the weekly Respiratory Virus Detections in Canada Report.
                      Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2013-14


                      Top of Page

                      RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
                      Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
                      <TABLE id=t1 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly and cumulative numbers of positive influenza specimens
                      by type, subtype and province, Canada, 2013-14
                      </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=ac1 colSpan=5>Weekly
                      (March 9, 2013 to March 15, 2014)</TH><TH id=ac8 colSpan=5>Cumulative
                      (August 25, 2013 to March 15, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=4 headers=ac1>Influenza A</TH><TH id=ac7 headers=ac1>B</TH><TH id=ac9 colSpan=4 headers=ac8>Influenza A</TH><TH id=ac14 headers=ac8>B</TH></TR><TR class=bg-colour-grey-light><TH id=ac3 headers="ac1 ac2">A Total</TH><TH id=ac4 class=lightred headers="ac1 ac2">A(H1)pdm09</TH><TH id=ac5 class=lightred headers="ac1 ac2">A(H3)</TH><TH id=ac6 class=lightred headers="ac1 ac2">A(UnS)</TH><TH class=alignCenter headers="ac1 ac7">B Total</TH><TH id=ac10 headers="ac8 ac9">A Total</TH><TH id=ac11 class=lightred headers="ac8 ac9">A(H1)pdm09</TH><TH id=ac12 class=lightred headers="ac8 ac9">A(H3)</TH><TH id=ac13 class=lightred headers="ac8 ac9">A(UnS)</TH><TD class=alignCenter headers="ac8 ac14">B Total</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
                      <SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                      UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=alignLeft headers=ar1>BC</TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">30</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">18</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">6</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">6</TD><TD class=alignRight headers="ar1 ar2 ac1 ac7">33</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac10">1755</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac11">1592</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac12">50</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac13">113</TD><TD class=alignRight headers="ar1 ar2 ac8 ac14">155</TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">46</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">5</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">4</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">37</TD><TD class=alignRight headers="ar1 ar3 ac1 ac7">28</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac10">3719</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac11">3371</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac12">53</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac13">295</TD><TD class=alignRight headers="ar1 ar3 ac8 ac14">151</TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">6</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">5</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">1</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac7">10</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac10">1349</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac11">972</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac12">6</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac13">371</TD><TD class=alignRight headers="ar1 ar4 ac8 ac14">44</TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">27</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">24</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">3</TD><TD class=alignRight headers="ar1 ar5 ac1 ac7">0</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac10">622</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac11">446</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac12">1</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac13">175</TD><TD class=alignRight headers="ar1 ar5 ac8 ac14">15</TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">56</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">26</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">11</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">19</TD><TD class=alignRight headers="ar1 ar6 ac1 ac7">159</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac10">5488</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac11">2416</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac12">265</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac13">2807</TD><TD class=alignRight headers="ar1 ar6 ac8 ac14">682</TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">80</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">7</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">73</TD><TD class=alignRight headers="ar1 ar7 ac1 ac7">242</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac10">5231</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac11">672</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac12">3</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac13">4556</TD><TD class=alignRight headers="ar1 ar7 ac8 ac14">1633</TD></TR><TR><TH id=ar8 class=alignLeft headers=ar1>NB</TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">8</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac6">8</TD><TD class=alignRight headers="ar1 ar8 ac1 ac7">5</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac10">1488</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac11">370</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac12">1</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac13">1117</TD><TD class=alignRight headers="ar1 ar8 ac8 ac14">23</TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">10</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">10</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 ac7">0</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac10">163</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac11">134</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac12">4</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac13">25</TD><TD class=alignRight headers="ar1 ar9 ac8 ac14">3</TD></TR><TR><TH id=ar10 class=alignLeft headers=ar1>PE</TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">1</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac4">1</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 ac7">0</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac10">118</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac11">117</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac13">1</TD><TD class=alignRight headers="ar1 ar10 ac8 ac14">1</TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">1</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac6">1</TD><TD class=alignRight headers="ar1 ar11 ac1 ac7">8</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac10">340</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac11">104</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac13">236</TD><TD class=alignRight headers="ar1 ar11 ac8 ac14">140</TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">265</TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac4">96</TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac5">22</TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac6">147</TD><TD class=alignRight headers="ar1 ar12 ac1 ac7">485</TD><TD class=alignRight headers="ar1 ar12 ac8 ac9 ac10">20273</TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac11">10194</TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac12">383</TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac13">9696</TD><TD class=alignRight headers="ar1 ar12 ac8 ac14">2847</TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="ar1 ar13 ac1 ac2 ac3">35.3%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac4">36.2%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac5">8.3%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac6">55.5%</TD><TD class=alignRight headers="ar1 ar13 ac1 ac7">64.7%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac9 ac10">87.7%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac11">50.3%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac12">1.9%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac13">47.8%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac14">12.3%</TD></TR></TBODY></TABLE>
                      <TABLE id=t2 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups (years)</TH><TH id=bc1 colSpan=5>Weekly
                      (March 9 to March 15, 2014)</TH><TH id=bc8 colSpan=7>Cumulative
                      (August 25, 2013 to March 15, 2014)</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><TH id=bc15 colSpan=2 headers=bc8>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=bc3 headers="bc1 bc2">A Total</TH><TH id=bc4 class="lightred " headers="bc1 bc2">A(H1) pdm09</TH><TH id=bc5 class="lightred " headers="bc1 bc2">A(H3)</TH><TH id=bc6 class="lightred " headers="bc1 bc2">A (UnS)</TH><TD class=alignCenter headers="bc1 bc7">Total</TD><TH id=bc10 headers="bc8 bc9">A Total</TH><TH id=bc11 class="lightred " headers="bc8 bc9">A(H1) pdm09</TH><TH id=bc12 class="lightred " headers="bc8 bc9">A(H3)</TH><TH id=bc13 class="lightred " headers="bc8 bc9">A (UnS)</TH><TD class=alignCenter headers="bc8 bc14">Total</TD><TH id=bc16 headers="bc8 bc15">#</TH><TH id=bc17 headers="bc8 bc15">%</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13><SUP id=footnote_t2_1>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
                      <SUP id=footnote_t2_2>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                      <SUP id=footnote_t2_3>3 </SUP>Table 2 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
                      UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=br2 class=alignLeft headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">36</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">6</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">5</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">25</TD><TD class=alignRight headers="br1 br2 bc1 bc7">30</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">3157</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">1404</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">31</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1722</TD><TD class=alignRight headers="br1 br2 bc8 bc14">277</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc16">3434</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc17">18.1%</TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">13</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">3</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">9</TD><TD class=alignRight headers="br1 br3 bc1 bc7">43</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1288</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">687</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">19</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">582</TD><TD class=alignRight headers="br1 br3 bc8 bc14">447</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc16">1735</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc17">9.1%</TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">39</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">17</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">21</TD><TD class=alignRight headers="br1 br4 bc1 bc7">45</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">4971</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">2751</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">40</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">2180</TD><TD class=alignRight headers="br1 br4 bc8 bc14">462</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc16">5433</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc17">28.7%</TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">49</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">10</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">38</TD><TD class=alignRight headers="br1 br5 bc1 bc7">78</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">4342</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">2339</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">45</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">1958</TD><TD class=alignRight headers="br1 br5 bc8 bc14">632</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc16">4974</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc17">26.2%</TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">39</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">9</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">29</TD><TD class=alignRight headers="br1 br6 bc1 bc7">116</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">2402</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">975</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">102</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">1325</TD><TD class=alignRight headers="br1 br6 bc8 bc14">849</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc16">3251</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc17">17.1%</TD></TR><TR><TH id=br7 class=alignLeft 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">132</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">102</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">18</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">12</TD><TD class=alignRight headers="br1 br7 bc8 bc14">3</TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc16">135</TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc17">0.7%</TD></TR><TR><TH id=br8 class=alignLeft headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">176</TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc4">45</TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc5">9</TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc6">122</TD><TD class=alignRight headers="br1 br8 bc1 bc7">312</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">16292</TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc11">8258</TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc12">255</TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc13">7779</TD><TD class=alignRight headers="br1 br8 bc8 bc14">2670</TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc16">18962</TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc17">100.0%</TD></TR><TR><TH id=br9 class=alignLeft headers=br1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="br1 br9 bc1 bc2 bc3">36.1%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc4">25.6%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc5">5.1%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc6">69.3%</TD><TD class=alignRight headers="br1 br9 bc1 bc7">63.9%</TD><TD class=alignRight headers="br1 br9 bc8 bc9 bc10">85.9%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc11">50.7%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc12">1.6%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc13">47.7%</TD><TD class=alignRight headers="br1 br9 bc8 bc14">14.1%</TD><TD class=alignRight></TD><TD class=alignRight></TD></TR></TBODY></TABLE>

                      Top of Page

                      Influenza Strain Characterizations

                      During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 1465 influenza viruses [67 A(H3N2), 1168 A(H1N1)pdm09 and 230 influenza B]. The vast majority (99%) of viruses were similar to the strains recommended by the WHO for the 2013-14 seasonal influenza vaccine. Two A(H1N1)pdm09 viruses showed reduced titres to antiserum against the reference A/California/07/2009 strain. Fifteen influenza B viruses were similar to the strain recommended by the WHO for the 2011-12 vaccine (Figure 4).
                      Figure 4. Influenza strain characterizations, Canada, 2013-14, N = 1465

                      The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
                      The recommended components for the 2013-2014 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009 (H1N1)pdm09-like virus, an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b (e.g. A/Texas/50/2012), and a B/Massachusetts/2/2012-like virus (Yamagata lineage).


                      Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
                      Antiviral Resistance

                      During the 2013-2014 influenza season, NML has tested 1098 influenza viruses for resistance to oseltamivir and all but two were sensitive. All 1102 viruses tested for resistance to zanamivir were sensitive. All 1264 influenza A viruses tested for amantadine resistance 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, 2013-2014</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 lightred" headers=cr1>A (H3N2)</TH><TD class=alignRight headers="cr1 cr2 cc1 cc2">55</TD><TD class=alignRight headers="cr1 cr2 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr2 cc4 cc5">55</TD><TD class=alignRight headers="cr1 cr2 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr2 cc7 cc8">91</TD><TD class=alignRight headers="cr1 cr2 cc7 cc9">91 (100%)</TD></TR><TR><TH id=cr3 class="alignLeft lightred" headers=cr1>A (H1N1)</TH><TD class=alignRight headers="cr1 cr3 cc1 cc2">913</TD><TD class=alignRight headers="cr1 cr3 cc1 cc3">2 (0.2%)</TD><TD class=alignRight headers="cr1 cr3 cc4 cc5">918</TD><TD class=alignRight headers="cr1 cr3 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr3 cc7 cc8">1173</TD><TD class=alignRight headers="cr1 cr3 cc7 cc9">1173 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft lightred" headers=cr1>B</TH><TD class=alignRight headers="cr1 cr4 cc1 cc2">130</TD><TD class=alignRight headers="cr1 cr4 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr4 cc4 cc5">129</TD><TD class=alignRight headers="cr1 cr4 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr4 cc7 cc8">NA <SUP>*</SUP></TD><TD class=alignRight headers="cr1 cr4 cc7 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft lightred" headers=cr1>TOTAL</TH><TD class=alignRight headers="cr1 cr5 cc1 cc2">1098</TD><TD class=alignRight headers="cr1 cr5 cc1 cc3">2 (0.2%)</TD><TD class=alignRight headers="cr1 cr5 cc4 cc5">1102</TD><TD class=alignRight headers="cr1 cr5 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr5 cc7 cc8">1264</TD><TD class=alignRight headers="cr1 cr5 cc7 cc9">1264 (100%)</TD></TR></TBODY></TABLE>
                      Influenza-like Illness (ILI) Consultation Rate

                      The national influenza-like-illness (ILI) consultation rate decreased from 36.9/1,000 in week 10 to 31.2/1,000 in week 11; and was below the expected range for week 11 (Figure 5).
                      Figure 5. Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

                      Note: No data available for mean rate for weeks 19 to 39 for the 1996-1997 through 2002-2003 seasons. Delays in the reporting of data may cause data to change retrospectively. The calculation of the average ILI consultation rate over 17 seasons was aligned with influenza activity in each season. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. The number of sentinel physicians in each province or territory is as follows: BC(21), AB(80), SK(11), MB(18), ON(169), QC(14), NB(29), NS(26), PE(4), NL(16), NU(1), NT(14), YT(13). Not all sentinel physicians report every week.
                      Text equivalent for figure 5Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

                      Top of Page

                      Influenza Outbreak Surveillance

                      In week 11, nine new influenza outbreaks were reported: eight in long-term care facilities (LTCF) and one in a hospital (Figure 6). In addition, one outbreak of influenza-like-illness was reported in a school. Among the seven LTCF outbreaks with available data, three were reported to be due to influenza B.
                      Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2013-2014

                      1 All provinces and territories except NU report outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
                      Text equivalent for figure 6Overall number of new influenza outbreaks by report week, Canada, 2013-2014
                      Pharmacy Surveillance

                      In week 11, the overall proportion of prescriptions for influenza antivirals increased slightly, based on increases in all age-groups except children 2-18 years of age. The proportion of prescriptions for infants (<2 years of age) increased for the second week in a row, however, the number of prescriptions in this age-group is small. Overall this season, the largest proportion of prescriptions for antivirals has been among children 2-18 years of age and adults 19-64 years of age, in keeping with laboratory detections of influenza (Figure 7).
                      Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

                      Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group. Age-groups: Infant: 0-2y, Child: 2-18y; Adult: 19-64y, Senior: ≥65y.
                      Text equivalent for figure 7Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

                      Top of Page

                      Sentinel Hospital Influenza Surveillance

                      Paediatric Influenza Hospitalizations and Deaths (IMPACT)
                      In week 11, 22 new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 38 in week 10. In keeping with the increased circulation of influenza B, influenza B was reported in 12 of the 22 cases in week 11 (Figure 8a). Although the number of cases is small, a greater proportion of cases with influenza B this season have been children between 2 and 10 years of age compared to A(H1N1)pdm09. In week 11, one ICU admission was reported in a child 6-23 months of age with influenza A(unsubtyped). No deaths were reported in week 11.
                      To date this season, a total of 613 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 88% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children <5 years of age represent 74% of cases to date (Table 4). Eighty-six ICU admissions have been reported, of which 58 (67%) were children <5 years of age (Figure 9a). All but five were cases with influenza A, and 96% of those subtyped were A(H1N1)pdm09. Among the 79 ICU cases with available data, 51 (65%) were reported to have underlying medical conditions. No deaths have been reported.
                      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)
                      In week 11, 32 new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported through active surveillance by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 55 in week 10. In week 11, there continued to be more hospitalizations associated with influenza B than influenza A (Figure 8b). All but seven hospitalizations occurred among adults ≥45 years of age. No ICU admissions or deaths were reported in week 11.
                      To date this season, 1250 influenza-associated hospitalizations have been reported by the PCIRN-SOS network, 1105 (88.4%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). ICU admission was required for 209 hospitalizations, all but eight of which were cases with influenza A (112 A(H1N1)pdm09, five A(H3N2) and 84 A(unsubtyped)). More than three quarters of hospitalizations and approximately 80% of ICU admissions were ≥45 years of age. Of the 168 ICU admissions with available information, 148 (88.1%) were reported to have at least one comorbidity and of the 180 ICU admissions with available information 131 (72.8%) reported not having been vaccinated this season. Fifty-eight deaths have been reported, all but four with influenza A (32 A(H1N1)pdm09, two A(H3N2) and 20 A(unsubtyped)); six cases 20-44 years of age, 27 cases 45-64 years of age and 25 cases ≥65 years of age (Figure 9b).
                      Note: PCIRN-SOS conducted passive surveillance from April 30th to November 14th, 2013. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance began November 15th during which time PCIRN site coordinators investigate cases potentially related to influenza. Data from both active and passive surveillance reported during the 2013-14 season are included in this report. 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.
                      <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t4 class=alignCenter>Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=dr1 rowSpan=3>Age groups </TH><TH id=dc1 colSpan=6>Cumulative (Aug. 25, 2013 to March 15, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=dc2 colSpan=4 headers=dc1>Influenza A </TH><TH id=dc7 headers=dc1>B </TH><TH id=dc8 headers=dc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=dc3 headers="dc1 dc2">A Total </TH><TH id=dc4 class="lightred " headers="dc1 dc2">A(H1) pdm09 </TH><TH id=dc5 class="lightred " headers="dc1 dc2">A(H3) </TH><TH id=dc6 class="lightred " headers="dc1 dc2">A (UnS) </TH><TD class=alignCenter headers="dc1 dc7">Total</TD><TD class=alignCenter headers="dc1 dc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t4_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                      UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=dr2 class=alignLeft headers=dr1>0-5m </TH><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc3">102</TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc4">33</TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc5">0</TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc6">69</TD><TD class=alignRight headers="dr1 dr2 dc1 dc7">3</TD><TD class=alignRight headers="dr1 dr2 dc1 dc8">105 (17%)</TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc3">157</TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc4">45</TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc5">1</TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc6">111</TD><TD class=alignRight headers="dr1 dr3 dc1 dc7">9</TD><TD class=alignRight headers="dr1 dr3 dc1 dc8">166 (27%)</TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc3">159</TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc4">53</TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc5">3</TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc6">103</TD><TD class=alignRight headers="dr1 dr4 dc1 dc7">24</TD><TD class=alignRight headers="dr1 dr4 dc1 dc8">183 (30%)</TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc3">81</TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc4">25</TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc5">0</TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc6">56</TD><TD class=alignRight headers="dr1 dr5 dc1 dc7">30</TD><TD class=alignRight headers="dr1 dr5 dc1 dc8">111 (18%)</TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc3">41</TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc4">15</TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc5">1</TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc6">25</TD><TD class=alignRight headers="dr1 dr6 dc1 dc7">7</TD><TD class=alignRight headers="dr1 dr6 dc1 dc8">48 (8%)</TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignRight headers="dr1 dr7 dc1 dc2 dc3">540</TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc4">171</TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc5">5</TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc6">364</TD><TD class=alignRight headers="dr1 dr7 dc1 dc7">73</TD><TD class=alignRight headers="dr1 dr7 dc1 dc8">613</TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP> </TH><TD class=alignRight headers="dr1 dr8 dc1 dc2 dc3">88.1%</TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc4">31.7%</TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc5">0.9%</TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc6">67.4%</TD><TD class=alignRight headers="dr1 dr8 dc1 dc7">11.9%</TD><TD class=alignRight headers="dr1 dr8 dc1 dc8">100.0%</TD></TR></TBODY></TABLE>
                      <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 5 - Cumulative numbers of adult hospitalizations with influenza
                      reported by the PCIRN-SOS network, Canada, 2013-14
                      </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=er1 rowSpan=3>Age groups </TH><TH id=ec1 class=noWrap colSpan=6>Cumulative (Aug. 25, 2013 to March 15, 2014)<SUP>*</SUP></TH></TR><TR class=bg-colour-yellow><TH id=ec2 colSpan=4 headers=ec1>Influenza A </TH><TH id=ec7 headers=ec1>B </TH><TH id=ec8 headers=ec1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=ec3 headers="ec1 ec2">A Total </TH><TH id=ec4 class="lightred " headers="ec1 ec2">A(H1) pdm09 </TH><TH id=ec5 class="lightred " headers="ec1 ec2">A(H3) </TH><TH id=ec6 class="lightred " headers="ec1 ec2">A(UnS) </TH><TD class=alignCenter headers="ec1 ec7">Total</TD><TD class=alignCenter headers="ec1 ec8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t5_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                      UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.

                      <SUP id=t5_star>*</SUP> One case for which the influenza type has not yet been reported, and three cases for which the age-group was not reported, are not included in Table 5.</TD></TR></TFOOT><TBODY><TR><TH id=er2 class=alignLeft headers=er1>16-20 </TH><TD class=alignRight headers="er1 er2 ec1 ec2 ec3">13</TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec4">3</TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec5">0</TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec6">10</TD><TD class=alignRight headers="er1 er2 ec1 ec7">1</TD><TD class=alignRight headers="er1 er2 ec1 ec8">14 (1%)</TD></TR><TR><TH id=er3 class=alignLeft headers=er1>20-44 </TH><TD class=alignRight headers="er1 er3 ec1 ec2 ec3">241</TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec4">127</TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec5">4</TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec6">110</TD><TD class=alignRight headers="er1 er3 ec1 ec7">10</TD><TD class=alignRight headers="er1 er3 ec1 ec8">251 (20%)</TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignRight headers="er1 er4 ec1 ec2 ec3">433</TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec4">201</TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec5">5</TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec6">227</TD><TD class=alignRight headers="er1 er4 ec1 ec7">35</TD><TD class=alignRight headers="er1 er4 ec1 ec8">468 (38%)</TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignRight headers="er1 er5 ec1 ec2 ec3">415</TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec4">201</TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec5">32</TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec6">182</TD><TD class=alignRight headers="er1 er5 ec1 ec7">98</TD><TD class=alignRight headers="er1 er5 ec1 ec8">513 (41%)</TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignRight headers="er1 er6 ec1 ec2 ec3">1102</TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec4">532</TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec5">41</TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec6">529</TD><TD class=alignRight headers="er1 er6 ec1 ec7">144</TD><TD class=alignRight headers="er1 er6 ec1 ec8">1246</TD></TR><TR><TH id=er7 class=alignLeft headers=er1>%<SUP>1</SUP></TH><TD class=alignRight headers="er1 er7 ec1 ec2 ec3">88%</TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec4">48%</TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec5">4%</TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec6">48%</TD><TD class=alignRight headers="er1 er7 ec1 ec7">12%</TD><TD class=alignRight headers="er1 er7 ec1 ec8">100%</TD></TR></TBODY></TABLE>
                      Figure 8. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14
                      A) Paediatric hospitalizations (≤16 years of age, IMPACT)


                      Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
                      B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)

                      * See footnote above following the section related to PCIRN-SOS data.
                      Text equivalent for figure 8bNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Adult hospitalizations (>16 year of age, PCIRN-SOS)
                      Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14
                      A) Paediatric hospitalizations (≤16 years of age, IMPACT)

                      Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
                      B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)

                      Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Adult hospitalizations (≥16 year of age, PCIRN-SOS)

                      Top of Page

                      Provincial/Territorial Influenza Hospitalizations and Deaths

                      In week 11, 94 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories.* As with other surveillance indicators in week 11, the majority were cases of influenza B (52, 55.3%). Among the five ICU admissions reported in week 11, three were adults 45-64 years of age. One death was reported in week 11, an adult ≥65 years of age with influenza B. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total.
                      To date this season, 3,570 influenza-associated hospitalizations have been reported, 93.2% with influenza A. The majority (57.4%) of hospitalizations have been cases 45 years of age of older. A significantly greater proportion of cases of influenza B have been ≥65 years of age compared to cases of A(H1N1)pdm09 this season (Table 6). A total of 324 ICU admissions have been reported this season, of which 66.6% were among adults 20-64 years of age. A total of 197 deaths have been reported. The highest proportion of deaths has been among adults 20-64 years of age (49.7%), followed by adults ≥65 years of age (40.6%). In keeping with the late-season circulation, influenza B has been increasingly reported among severe cases of influenza. To date this season, influenza B has been reported in 6.8% of hospitalizations, 1.5% of ICU admissions, and 5.6 % of deaths. It is important to note that the hospitalization or 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: 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 distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks.
                      <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t6 class=alignCenter>Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=fr1 rowSpan=3>Age groups </TH><TH id=fc1 colSpan=6>Cumulative (Aug. 25, 2013 to March 15, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=fc2 colSpan=4 headers=fc1>Influenza A</TH><TH id=fc7 headers=fc1>B</TH><TH id=fc8 headers=fc1>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=fc3 headers="fc1 fc2">A Total</TH><TH id=fc4 class=lightred headers="fc1 fc2">A(H1) pdm09</TH><TH id=fc5 class=lightred headers="fc1 fc2">A(H3)</TH><TH id=fc6 class=lightred headers="fc1 fc2">A (UnS)</TH><TD class=alignCenter headers="fc1 fc7">Total</TD><TD class=alignCenter headers="fc1 fc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=8><SUP id=footnote_t6_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                      UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=fr2 class=alignLeft headers=fr1>0-4 years</TH><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc3">568</TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc4">275</TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc5">6</TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc6">287</TD><TD class=alignRight headers="fr1 fr2 fc1 fc7">36</TD><TD class=alignRight headers="fr1 fr2 fc1 fc8">604 (17%)</TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years</TH><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc3">125</TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc4">64</TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc5">6</TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc6">55</TD><TD class=alignRight headers="fr1 fr3 fc1 fc7">35</TD><TD class=alignRight headers="fr1 fr3 fc1 fc8">160 (4%)</TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years</TH><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc3">34</TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc4">19</TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc5">3</TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc6">12</TD><TD class=alignRight headers="fr1 fr4 fc1 fc7">1</TD><TD class=alignRight headers="fr1 fr4 fc1 fc8">35 (1%)</TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc3">577</TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc4">408</TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc5">4</TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc6">165</TD><TD class=alignRight headers="fr1 fr5 fc1 fc7">15</TD><TD class=alignRight headers="fr1 fr5 fc1 fc8">592 (17%)</TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc3">1052</TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc4">675</TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc5">21</TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc6">356</TD><TD class=alignRight headers="fr1 fr6 fc1 fc7">52</TD><TD class=alignRight headers="fr1 fr6 fc1 fc8">1104 (31%)</TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc3">844</TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc4">448</TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc5">63</TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc6">333</TD><TD class=alignRight headers="fr1 fr7 fc1 fc7">100</TD><TD class=alignRight headers="fr1 fr7 fc1 fc8">944 (26%)</TD></TR><TR><TH id=fr10 class=alignLeft headers=fr1>Unknown</TH><TD class=alignRight headers="fc1 fc2 fc3">127</TD><TD class=alignRight headers="fc1 fc2 fc4">92</TD><TD class=alignRight headers="fc1 fc2 fc5">3</TD><TD class=alignRight headers="fc1 fc2 fc6">29</TD><TD class=alignRight headers="fc1 fc7">4</TD><TD class=alignRight headers="fc1 fc8">128 (4%)</TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignRight headers="fr1 fr8 fc1 fc2 fc3">3327</TD><TD class="alignRight lightred" headers="fr1 fr8 fc1 fc2 fc4">1981</TD><TD class="alignRight lightred" headers="fr1 fr8 fc1 fc2 fc5">106</TD><TD class="alignRight lightred" headers="fr1 fr8 fc1 fc2 fc6">1237</TD><TD class=alignRight headers="fr1 fr8 fc1 fc7">243</TD><TD class=alignRight headers="fr1 fr8 fc1 fc8">3567</TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP> </TH><TD class=alignRight headers="fr1 fr9 fc1 fc2 fc3">93.3%</TD><TD class="alignRight lightred" headers="fr1 fr9 fc1 fc2 fc4">59.5%</TD><TD class="alignRight lightred" headers="fr1 fr9 fc1 fc2 fc5">3.2%</TD><TD class="alignRight lightred" headers="fr1 fr9 fc1 fc2 fc6">37.2%</TD><TD class=alignRight headers="fr1 fr9 fc1 fc7">6.8%</TD><TD class=alignRight headers="fr1 fr9 fc1 fc8">100%</TD></TR></TBODY></TABLE>
                      See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2013-14 on the Public Health Agency of Canada website.

                      .../
                      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


                      • #26
                        Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 12

                        FluWatch report: March 16 to 22, 2014 (Week 12)

                        Posted 2014-03-28For 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/13-14/w12_14/pdf/fw2014-12-eng.pdf">FluWatch report: March 16 to 22, 2014 (Week 12) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 291 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

                        »» Help with PDF documents

                        Overall Summary
                        • In week 12, influenza activity in Canada continued to decrease slowly. Overall, the influenza A(H1N1) virus remains the most common influenza virus this season, however, most influenza viruses circulating in recent weeks have been influenza B.
                        • While the influenza A(H1N1) virus has mostly affected adults 20-64 years of age this season, influenza B is having a greater impact on adults 65 years of age and older, as well as young persons 5 to 19 years of age.
                        • As of week 12, 3,700 hospitalizations and 204 deaths have been reported from participating regions, which is comparable to reports in past influenza seasons.
                        • Influenza activity remains within expected levels for this time of year.
                        Influenza/ILI Activity (geographic spread)

                        The number of regions reporting localized or widespread influenza activity has been stable in recent weeks, with the majority of activity reported in Eastern Canada. In week 12, no regions reported widespread activity and eight regions (BC(1), ON(5), and QC(2)) reported localized activity (Figure 1).
                        Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 12





                        Note: Influenza/ILI 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 and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
                        Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
                        Influenza and Other Respiratory Virus Detections

                        The number of positive influenza tests decreased from 759 in week 11 to 619 (12.4% of tests) in week 12. Influenza B remained the predominant virus in week 12, representing 75% of influenza detections (Figure 2). The highest proportions of influenza B have been reported from Newfoundland & Labrador (30.4%) and Quebec (25.8%), followed by Ontario (13.6%) and British Columbia (9.3%). Despite the late-season circulation of influenza B, the predominant influenza virus this season remains A(H1N1)pdm09 (Table 1). Among the 19,468 cases for which information on age and type/subtype has been received this season, 54.5% were 20-64 years of age (Table 2). Significantly greater proportions of influenza B cases have been ≥65 years of age and 5-19 years of age compared to cases of A(H1N1)pdm09. Influenza detections among persons ≥65 years of age have been similar for the past 6 weeks, while detections in other age-groups are declining.

                        Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14

                        Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
                        The number of positive tests for RSV has been declining gradually over recent weeks, similar to the trend observed in recent seasons. The number of positive tests for parainfluenza, adenovirus and coronavirus decreased in week 12, and has been declining since early February. Detections of rhinovirus have been relatively stable during the winter months, although these detections represent an increasing percentage of tests positive since early January. The number of positive tests for human metapneumovirus has been higher than during the same period last season and does not yet appear to have reached its peak (Figure 3).
                        For more details, see the weekly Respiratory Virus Detections in Canada Report.
                        Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2013-14


                        Top of Page

                        RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
                        Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
                        <TABLE id=t1 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly and cumulative numbers of positive influenza specimens
                        by type, subtype and province, Canada, 2013-14
                        </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=ac1 colSpan=5>Weekly
                        (March 16, 2013 to March 22, 2014)</TH><TH id=ac8 colSpan=5>Cumulative
                        (August 25, 2013 to March 22, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=4 headers=ac1>Influenza A</TH><TH id=ac7 headers=ac1>B</TH><TH id=ac9 colSpan=4 headers=ac8>Influenza A</TH><TH id=ac14 headers=ac8>B</TH></TR><TR class=bg-colour-grey-light><TH id=ac3 headers="ac1 ac2">A Total</TH><TH id=ac4 class=bg-colour-blue headers="ac1 ac2">A(H1)pdm09</TH><TH id=ac5 class=bg-colour-blue headers="ac1 ac2">A(H3)</TH><TH id=ac6 class=bg-colour-blue headers="ac1 ac2">A(UnS)</TH><TH class=alignCenter headers="ac1 ac7">B Total</TH><TH id=ac10 headers="ac8 ac9">A Total</TH><TH id=ac11 class=bg-colour-blue headers="ac8 ac9">A(H1)pdm09</TH><TH id=ac12 class=bg-colour-blue headers="ac8 ac9">A(H3)</TH><TH id=ac13 class=bg-colour-blue headers="ac8 ac9">A(UnS)</TH><TD class=alignCenter headers="ac8 ac14">B Total</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
                        <SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                        UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=alignLeft headers=ar1>BC</TH><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac3">17 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac6">17 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac7">24 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac10">1770 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac11">1589 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac12">52 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac13">129 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac14">181 </TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac3">38 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac4">4 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac5">2 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac6">32 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac7">24 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac10">3763 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac11">3393 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac12">57 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac13">313 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac14">176 </TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac3">1 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac4">1 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac6">0 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac7">5 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac10">1350 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac11">973 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac12">6 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac13">371 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac14">49 </TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac3">8 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac4">5 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac6">3 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac7">2 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac10">630 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac11">451 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac12">1 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac13">178 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac14">17 </TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac3">53 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac4">28 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac5">11 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac6">14 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac7">191 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac10">5537 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac11">2447 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac12">276 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac13">2814 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac14">873 </TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac3">33 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac4">3 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac6">30 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac7">197 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac10">5266 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac11">675 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac12">3 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac13">4588 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac14">1834 </TD></TR><TR><TH id=ar8 class=alignLeft headers=ar1>NB</TH><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac3">0 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac6">0 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac7">7 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac10">1488 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac11">370 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac12">1 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac13">1117 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac14">30 </TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac3">1 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac6">1 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac7">1 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac10">164 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac11">134 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac12">4 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac13">26 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac14">4 </TD></TR><TR><TH id=ar10 class=alignLeft headers=ar1>PE</TH><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac3">0 </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac6">0 </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac7">0 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac10">118 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac11">117 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac12">0 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac13">1 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac14">1 </TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac3">6 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac6">6 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac7">11 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac10">346 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac11">104 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac12">0 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac13">242 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac14">151 </TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignCenter headers="ar1 ar12 ac1 ac2 ac3">157 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac1 ac2 ac4">41 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac1 ac2 ac5">13 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac1 ac2 ac6">103 </TD><TD class=alignCenter headers="ar1 ar12 ac1 ac7">462 </TD><TD class=alignCenter headers="ar1 ar12 ac8 ac9 ac10">20432 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac8 ac9 ac11">10253 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac8 ac9 ac12">400 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac8 ac9 ac13">9779 </TD><TD class=alignCenter headers="ar1 ar12 ac8 ac14">3316 </TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignCenter headers="ar1 ar13 ac1 ac2 ac3">25.4% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac1 ac2 ac4">26.1% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac1 ac2 ac5">8.3% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac1 ac2 ac6">65.6% </TD><TD class=alignCenter headers="ar1 ar13 ac1 ac7">74.6% </TD><TD class=alignCenter headers="ar1 ar13 ac8 ac9 ac10">86.0% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac8 ac9 ac11">50.2% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac8 ac9 ac12">2.0% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac8 ac9 ac13">47.9% </TD><TD class=alignCenter headers="ar1 ar13 ac8 ac14">14.0% </TD></TR></TBODY></TABLE>
                        <TABLE id=t2 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups (years)</TH><TH id=bc1 colSpan=5>Weekly
                        (March 16 to March 22, 2014)</TH><TH id=bc8 colSpan=7>Cumulative
                        (August 25, 2013 to March 22, 2014)</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><TH id=bc15 colSpan=2 headers=bc8>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=bc3 headers="bc1 bc2">A Total</TH><TH id=bc4 class="bg-colour-blue " headers="bc1 bc2">A(H1) pdm09</TH><TH id=bc5 class="bg-colour-blue " headers="bc1 bc2">A(H3)</TH><TH id=bc6 class="bg-colour-blue " headers="bc1 bc2">A (UnS)</TH><TD class=alignCenter headers="bc1 bc7">Total</TD><TH id=bc10 headers="bc8 bc9">A Total</TH><TH id=bc11 class="bg-colour-blue " headers="bc8 bc9">A(H1) pdm09</TH><TH id=bc12 class="bg-colour-blue " headers="bc8 bc9">A(H3)</TH><TH id=bc13 class="bg-colour-blue " headers="bc8 bc9">A (UnS)</TH><TD class=alignCenter headers="bc8 bc14">Total</TD><TH id=bc16 headers="bc8 bc15">#</TH><TH id=bc17 headers="bc8 bc15">%</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13><SUP id=footnote_t2_1>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
                        <SUP id=footnote_t2_2>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                        <SUP id=footnote_t2_3>3 </SUP>Table 2 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
                        UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=br2 class=alignLeft headers=br1><5</TH><TD class=alignCenter headers="br1 br2 bc1 bc2 bc3">22 </TD><TD class=alignCenter headers="br1 br2 bc1 bc2 bc4">2 </TD><TD class=alignCenter headers="br1 br2 bc1 bc2 bc5">3 </TD><TD class=alignCenter headers="br1 br2 bc1 bc2 bc6">17 </TD><TD class=alignCenter headers="br1 br2 bc1 bc7">26 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc10">3195 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc11">1415 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc12">34 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc13">1746 </TD><TD class=alignCenter headers="br1 br2 bc8 bc14">312 </TD><TD class=alignCenter headers="br1 br2 bc8 bc15 bc16">3507 </TD><TD class=alignCenter headers="br1 br2 bc8 bc15 bc17">18.0% </TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignCenter headers="br1 br3 bc1 bc2 bc3">6 </TD><TD class=alignCenter headers="br1 br3 bc1 bc2 bc4">1 </TD><TD class=alignCenter headers="br1 br3 bc1 bc2 bc5">0 </TD><TD class=alignCenter headers="br1 br3 bc1 bc2 bc6">5 </TD><TD class=alignCenter headers="br1 br3 bc1 bc7">16 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc10">1297 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc11">694 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc12">17 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc13">586 </TD><TD class=alignCenter headers="br1 br3 bc8 bc14">478 </TD><TD class=alignCenter headers="br1 br3 bc8 bc15 bc16">1775 </TD><TD class=alignCenter headers="br1 br3 bc8 bc15 bc17">9.1% </TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignCenter headers="br1 br4 bc1 bc2 bc3">22 </TD><TD class=alignCenter headers="br1 br4 bc1 bc2 bc4">6 </TD><TD class=alignCenter headers="br1 br4 bc1 bc2 bc5">1 </TD><TD class=alignCenter headers="br1 br4 bc1 bc2 bc6">15 </TD><TD class=alignCenter headers="br1 br4 bc1 bc7">41 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc10">5006 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc11">2766 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc12">39 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc13">2201 </TD><TD class=alignCenter headers="br1 br4 bc8 bc14">523 </TD><TD class=alignCenter headers="br1 br4 bc8 bc15 bc16">5529 </TD><TD class=alignCenter headers="br1 br4 bc8 bc15 bc17">28.4% </TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignCenter headers="br1 br5 bc1 bc2 bc3">16 </TD><TD class=alignCenter headers="br1 br5 bc1 bc2 bc4">3 </TD><TD class=alignCenter headers="br1 br5 bc1 bc2 bc5">0 </TD><TD class=alignCenter headers="br1 br5 bc1 bc2 bc6">13 </TD><TD class=alignCenter headers="br1 br5 bc1 bc7">54 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc10">4374 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc11">2361 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc12">49 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc13">1964 </TD><TD class=alignCenter headers="br1 br5 bc8 bc14">709 </TD><TD class=alignCenter headers="br1 br5 bc8 bc15 bc16">5083 </TD><TD class=alignCenter headers="br1 br5 bc8 bc15 bc17">26.1% </TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignCenter headers="br1 br6 bc1 bc2 bc3">20 </TD><TD class=alignCenter headers="br1 br6 bc1 bc2 bc4">1 </TD><TD class=alignCenter headers="br1 br6 bc1 bc2 bc5">1 </TD><TD class=alignCenter headers="br1 br6 bc1 bc2 bc6">18 </TD><TD class=alignCenter headers="br1 br6 bc1 bc7">128 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc10">2427 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc11">980 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc12">104 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc13">1343 </TD><TD class=alignCenter headers="br1 br6 bc8 bc14">1012 </TD><TD class=alignCenter headers="br1 br6 bc8 bc15 bc16">3439 </TD><TD class=alignCenter headers="br1 br6 bc8 bc15 bc17">17.7% </TD></TR><TR><TH id=br7 class=alignLeft headers=br1>Unknown</TH><TD class=alignCenter headers="br1 br7 bc1 bc2 bc3">0 </TD><TD class=alignCenter headers="br1 br7 bc1 bc2 bc4">0 </TD><TD class=alignCenter headers="br1 br7 bc1 bc2 bc5">0 </TD><TD class=alignCenter headers="br1 br7 bc1 bc2 bc6">0 </TD><TD class=alignCenter headers="br1 br7 bc1 bc7">0 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc10">132 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc11">102 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc12">18 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc13">12 </TD><TD class=alignCenter headers="br1 br7 bc8 bc14">3 </TD><TD class=alignCenter headers="br1 br7 bc8 bc15 bc16">135 </TD><TD class=alignCenter headers="br1 br7 bc8 bc15 bc17">0.7% </TD></TR><TR><TH id=br8 class=alignLeft headers=br1>Total</TH><TD class=alignCenter headers="br1 br8 bc1 bc2 bc3">86 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc1 bc2 bc4">13 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc1 bc2 bc5">5 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc1 bc2 bc6">68 </TD><TD class=alignCenter headers="br1 br8 bc1 bc7">265 </TD><TD class=alignCenter headers="br1 br8 bc8 bc9 bc10">16431 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc8 bc9 bc11">8318 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc8 bc9 bc12">261 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc8 bc9 bc13">7852 </TD><TD class=alignCenter headers="br1 br8 bc8 bc14">3037 </TD><TD class=alignCenter headers="br1 br8 bc8 bc15 bc16">19468 </TD><TD class=alignCenter headers="br1 br8 bc8 bc15 bc17">100.0% </TD></TR><TR><TH id=br9 class=alignLeft headers=br1>Percentage<SUP>2</SUP></TH><TD class=alignCenter headers="br1 br9 bc1 bc2 bc3">24.5% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc1 bc2 bc4">15.1% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc1 bc2 bc5">5.8% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc1 bc2 bc6">79.1% </TD><TD class=alignCenter headers="br1 br9 bc1 bc7">75.5% </TD><TD class=alignCenter headers="br1 br9 bc8 bc9 bc10">84.4% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc8 bc9 bc11">50.6% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc8 bc9 bc12">1.6% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc8 bc9 bc13">47.8% </TD><TD class=alignCenter headers="br1 br9 bc8 bc14">15.6% </TD><TD class=alignCenter></TD><TD class=alignCenter></TD></TR></TBODY></TABLE>

                        Top of Page

                        Influenza Strain Characterizations

                        During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 1,586 influenza viruses [76 A(H3N2), 1227 A(H1N1)pdm09 and 283 influenza B]. The vast majority (99%) of viruses were similar to the strains recommended by the WHO for the 2013-14 seasonal influenza vaccine. Two A(H1N1)pdm09 viruses showed reduced titres to antiserum against the reference A/California/07/2009 strain. Sixteen influenza B viruses were similar to the strain recommended by the WHO for the 2011-12 vaccine (Figure 4).
                        Figure 4. Influenza strain characterizations, Canada, 2013-2014, N = 1586

                        The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
                        The recommended components for the 2013-2014 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009 (H1N1)pdm09-like virus, an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b (e.g. A/Texas/50/2012), and a B/Massachusetts/2/2012-like virus (Yamagata lineage).


                        Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
                        Antiviral Resistance

                        During the 2013-2014 influenza season, NML has tested 1,191 influenza viruses for resistance to oseltamivir and all but two were sensitive. All 1,176 viruses tested for resistance to zanamivir were sensitive. All 1,320 influenza A viruses tested for amantadine resistance 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, 2013-2014</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=cr1 rowSpan=2>Virus type and subtype</TH><TH id=cc1 colSpan=2>Oseltamivir</TH><TH id=cc4 colSpan=2>Zanamivir</TH><TH id=cc7 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=cc2 headers=cc1># tested</TH><TH id=cc3 headers=cc1># resistant (%)</TH><TH id=cc5 headers=cc4># tested</TH><TH id=cc6 headers=cc4># resistant (%)</TH><TH id=cc8 headers=cc7># tested</TH><TH id=cc9 headers=cc7># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=cr2 class="alignLeft bg-colour-blue" headers=cr1>A (H3N2)</TH><TD class=alignCenter headers="cr1 cr2 cc1 cc2">55</TD><TD class=alignCenter headers="cr1 cr2 cc1 cc3">0</TD><TD class=alignCenter headers="cr1 cr2 cc4 cc5">55</TD><TD class=alignCenter headers="cr1 cr2 cc4 cc6">0</TD><TD class=alignCenter headers="cr1 cr2 cc7 cc8">94</TD><TD class=alignCenter headers="cr1 cr2 cc7 cc9">94 (100%)</TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignCenter headers="cr1 cr3 cc1 cc2">989</TD><TD class=alignCenter headers="cr1 cr3 cc1 cc3">2 (0.2%)</TD><TD class=alignCenter headers="cr1 cr3 cc4 cc5">977</TD><TD class=alignCenter headers="cr1 cr3 cc4 cc6">0</TD><TD class=alignCenter headers="cr1 cr3 cc7 cc8">1226</TD><TD class=alignCenter headers="cr1 cr3 cc7 cc9">1226 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignCenter headers="cr1 cr4 cc1 cc2">147</TD><TD class=alignCenter headers="cr1 cr4 cc1 cc3">0</TD><TD class=alignCenter headers="cr1 cr4 cc4 cc5">144</TD><TD class=alignCenter headers="cr1 cr4 cc4 cc6">0</TD><TD class=alignCenter headers="cr1 cr4 cc7 cc8">NA <SUP>*</SUP></TD><TD class=alignCenter headers="cr1 cr4 cc7 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft bg-colour-blue" headers=cr1>TOTAL</TH><TD class=alignCenter headers="cr1 cr5 cc1 cc2">1191</TD><TD class=alignCenter headers="cr1 cr5 cc1 cc3">2 (0.2%)</TD><TD class=alignCenter headers="cr1 cr5 cc4 cc5">1176</TD><TD class=alignCenter headers="cr1 cr5 cc4 cc6">0</TD><TD class=alignCenter headers="cr1 cr5 cc7 cc8">1320</TD><TD class=alignCenter headers="cr1 cr5 cc7 cc9">1320 (100%)</TD></TR></TBODY></TABLE>
                        Influenza-like Illness (ILI) Consultation Rate

                        The national influenza-like-illness (ILI) consultation rate increased from 27.4/1,000 in week 11 to 37.7/1,000 in week 12; which was within the expected range for week 12 (Figure 5).
                        Figure 5. Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

                        Note: No data available for mean rate for weeks 19 to 39 for the 1996-1997 through 2002-2003 seasons. Delays in the reporting of data may cause data to change retrospectively. The calculation of the average ILI consultation rate over 17 seasons was aligned with influenza activity in each season. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. The number of sentinel physicians in each province or territory is as follows: BC(21), AB(80), SK(11), MB(18), ON(169), QC(14), NB(29), NS(26), PE(4), NL(16), NU(1), NT(14), YT(13). Not all sentinel physicians report every week.
                        Text equivalent for figure 5Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

                        Top of Page

                        Influenza Outbreak Surveillance

                        In week 12, thirteen new influenza outbreaks were reported: 12 in long-term care facilities (LTCF) and one in a hospital (Figure 6). Among the ten outbreaks with available data, eight (seven LTCF and the hospital outbreak) were reported to be due to influenza B.
                        Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2013-2014

                        1 All provinces and territories except NU report outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
                        Text equivalent for figure 6Overall number of new influenza outbreaks by report week, Canada, 2013-2014
                        Pharmacy Surveillance

                        In week 12, the proportion of prescriptions for antivirals among children 2-18 years of age and adults 19-64 years of age was similar to the previous week. Within the 2-18 year age-group, increases in the proportion of prescriptions for antivirals were observed among children 2-9 years of age and decreases among those 10-19 years of age. Overall this season, the largest proportion of prescriptions for antivirals has been among children 2-18 years of age and adults 19-64 years of age, in keeping with laboratory detections of influenza (Figure 7).
                        Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

                        Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group. Age-groups: Infant: 0-2y, Child: 2-18y; Adult: 19-64y, Senior: ≥65y.
                        Text equivalent for figure 7Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

                        Top of Page

                        Sentinel Hospital Influenza Surveillance

                        Paediatric Influenza Hospitalizations and Deaths (IMPACT)
                        In week 12, 12 new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 22 in week 11; however, two centres did not report in week 12. In keeping with the increased circulation of influenza B, influenza B was reported in 5 of the 12 cases in week 12 (Figure 8a). Although the number of cases is small, a greater proportion of cases with influenza B this season have been children between 2 and 10 years of age compared to A(H1N1)pdm09. No ICU admissions or deaths were reported in week 12.
                        To date this season, a total of 625 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 87% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children <5 years of age represent 74% of cases to date (Table 4). Eighty-eight ICU admissions have been reported, of which 58 (68%) were children <5 years of age (Figure 9a). All but six were cases with influenza A, and 96% of those subtyped were A(H1N1)pdm09. Among the 85 ICU cases with available data, 54 (64%) were reported to have underlying medical conditions. No deaths have been reported.
                        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)
                        In week 12, 15 new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported through active surveillance by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 62 in week 11. For a third week in a row, the majority of hospitalizations were associated with influenza B(Figure 8b). All but three hospitalizations occurred among adults ≥45 years of age. There was one ICU admission in an adult ≥65 years of age with influenza B, and no deaths reported in week 12.
                        To date this season, 1328 influenza-associated hospitalizations have been reported by the PCIRN-SOS network, 1138 (85.7%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). ICU admission was required for 220 hospitalizations, all but 11 of which were cases with influenza A (115 A(H1N1)pdm09, seven A(H3N2) and 87 A(unsubtyped)). Approximately 80% of hospitalizations and ICU admissions were ≥45 years of age. Of the 170 ICU admissions with available information, 150 (88.2%) were reported to have at least one comorbidity and of the 188 ICU admissions with available information 134 (71.3%) reported not having been vaccinated this season. Sixty-one deaths have been reported, all but five with influenza A (33 A(H1N1)pdm09, two A(H3N2) and 21 A(unsubtyped)); seven cases 20-44 years of age, 27 cases 45-64 years of age and 27 cases ≥65 years of age (Figure 9b).
                        Note: PCIRN-SOS conducted passive surveillance from April 30th to November 14th, 2013. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance began November 15th during which time PCIRN site coordinators investigate cases potentially related to influenza. Data from both active and passive surveillance reported during the 2013-14 season are included in this report. 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.
                        <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t4 class=alignCenter>Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=dr1 rowSpan=3>Age groups </TH><TH id=dc1 colSpan=6>Cumulative (Aug. 25, 2013 to March 22, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=dc2 colSpan=4 headers=dc1>Influenza A </TH><TH id=dc7 headers=dc1>B </TH><TH id=dc8 headers=dc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=dc3 headers="dc1 dc2">A Total </TH><TH id=dc4 class="bg-colour-blue " headers="dc1 dc2">A(H1) pdm09 </TH><TH id=dc5 class="bg-colour-blue " headers="dc1 dc2">A(H3) </TH><TH id=dc6 class="bg-colour-blue " headers="dc1 dc2">A (UnS) </TH><TD class=alignCenter headers="dc1 dc7">Total</TD><TD class=alignCenter headers="dc1 dc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t4_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                        UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=dr2 class=alignLeft headers=dr1>0-5m </TH><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc3">103</TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc4">33</TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc5">0</TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc6">70</TD><TD class=alignCenter headers="dr1 dr2 dc1 dc7">4</TD><TD class=alignCenter headers="dr1 dr2 dc1 dc8">107 (17%)</TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc3">160</TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc4">46</TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc5">1</TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc6">113</TD><TD class=alignCenter headers="dr1 dr3 dc1 dc7">11</TD><TD class=alignCenter headers="dr1 dr3 dc1 dc8">171 (27%)</TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc3">161</TD><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc4">53</TD><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc5">3</TD><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc6">105</TD><TD class=alignCenter headers="dr1 dr4 dc1 dc7">26</TD><TD class=alignCenter headers="dr1 dr4 dc1 dc8">187 (30%)</TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc3">81</TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc4">25</TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc5">0</TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc6">56</TD><TD class=alignCenter headers="dr1 dr5 dc1 dc7">31</TD><TD class=alignCenter headers="dr1 dr5 dc1 dc8">112 (18%)</TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc3">41</TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc4">15</TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc5">1</TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc6">25</TD><TD class=alignCenter headers="dr1 dr6 dc1 dc7">7</TD><TD class=alignCenter headers="dr1 dr6 dc1 dc8">48 (8%)</TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignCenter headers="dr1 dr7 dc1 dc2 dc3">546</TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc4">172</TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc5">5</TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc6">369</TD><TD class=alignCenter headers="dr1 dr7 dc1 dc7">79</TD><TD class=alignCenter headers="dr1 dr7 dc1 dc8">625</TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP> </TH><TD class=alignCenter headers="dr1 dr8 dc1 dc2 dc3">87.4%</TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc4">31.5%</TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc5">0.9%</TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc6">67.6%</TD><TD class=alignCenter headers="dr1 dr8 dc1 dc7">12.6%</TD><TD class=alignCenter headers="dr1 dr8 dc1 dc8">100.0%</TD></TR></TBODY></TABLE>
                        <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 5 - Cumulative numbers of adult hospitalizations with influenza
                        reported by the PCIRN-SOS network, Canada, 2013-14
                        </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=er1 rowSpan=3>Age groups </TH><TH id=ec1 class=noWrap colSpan=6>Cumulative (Aug. 25, 2013 to March 22, 2014)<SUP>*</SUP></TH></TR><TR class=bg-colour-yellow><TH id=ec2 colSpan=4 headers=ec1>Influenza A </TH><TH id=ec7 headers=ec1>B </TH><TH id=ec8 headers=ec1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=ec3 headers="ec1 ec2">A Total </TH><TH id=ec4 class="bg-colour-blue " headers="ec1 ec2">A(H1) pdm09 </TH><TH id=ec5 class="bg-colour-blue " headers="ec1 ec2">A(H3) </TH><TH id=ec6 class="bg-colour-blue " headers="ec1 ec2">A(UnS) </TH><TD class=alignCenter headers="ec1 ec7">Total</TD><TD class=alignCenter headers="ec1 ec8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t5_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                        UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.

                        <SUP id=t5_star>*</SUP> One case for which the influenza type has not yet been reported, and three cases for which the age-group was not reported, are not included in Table 5.</TD></TR></TFOOT><TBODY><TR><TH id=er2 class=alignLeft headers=er1>16-20 </TH><TD class=alignCenter headers="er1 er2 ec1 ec2 ec3">13</TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec4">4</TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec5">0</TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec6">9</TD><TD class=alignCenter headers="er1 er2 ec1 ec7">2</TD><TD class=alignCenter headers="er1 er2 ec1 ec8">15 (1%)</TD></TR><TR><TH id=er3 class=alignLeft headers=er1>20-44 </TH><TD class=alignCenter headers="er1 er3 ec1 ec2 ec3">244</TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec4">128</TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec5">4</TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec6">112</TD><TD class=alignCenter headers="er1 er3 ec1 ec7">12</TD><TD class=alignCenter headers="er1 er3 ec1 ec8">256 (19%)</TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignCenter headers="er1 er4 ec1 ec2 ec3">444</TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec4">206</TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec5">7</TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec6">231</TD><TD class=alignCenter headers="er1 er4 ec1 ec7">43</TD><TD class=alignCenter headers="er1 er4 ec1 ec8">487 (37%)</TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignCenter headers="er1 er5 ec1 ec2 ec3">434</TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec4">207</TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec5">36</TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec6">191</TD><TD class=alignCenter headers="er1 er5 ec1 ec7">132</TD><TD class=alignCenter headers="er1 er5 ec1 ec8">566 (43%)</TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignCenter headers="er1 er6 ec1 ec2 ec3">1135</TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec4">545</TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec5">47</TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec6">543</TD><TD class=alignCenter headers="er1 er6 ec1 ec7">189</TD><TD class=alignCenter headers="er1 er6 ec1 ec8">1324</TD></TR><TR><TH id=er7 class=alignLeft headers=er1>%<SUP>1</SUP></TH><TD class=alignCenter headers="er1 er7 ec1 ec2 ec3">86%</TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec4">48%</TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec5">4%</TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec6">48%</TD><TD class=alignCenter headers="er1 er7 ec1 ec7">14%</TD><TD class=alignCenter headers="er1 er7 ec1 ec8">100%</TD></TR></TBODY></TABLE>
                        Figure 8. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14
                        A) Paediatric hospitalizations (≤16 years of age, IMPACT)


                        Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
                        B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)

                        * See footnote above following the section related to PCIRN-SOS data.
                        Text equivalent for figure 8bNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Adult hospitalizations (>16 year of age, PCIRN-SOS)
                        Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14
                        A) Paediatric hospitalizations (≤16 years of age, IMPACT)

                        Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
                        B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)

                        Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Adult hospitalizations (≥16 year of age, PCIRN-SOS)

                        Top of Page

                        Provincial/Territorial Influenza Hospitalizations and Deaths

                        In week 12, 119 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories.* As with other surveillance indicators in week 12, the majority were cases of influenza B (71, 59.7%). Two ICU admissions were reported in week 12, one adult 20-44 years of age and the other with age not reported, both with influenza A. Seven deaths were reported in week 12; four cases were ≥65 years of age, and three of the seven had influenza B. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total.
                        To date this season, 3,700 influenza-associated hospitalizations have been reported, 91.4% with influenza A. The majority (58.0%) of hospitalizations have been cases 45 years of age of older. A significantly greater proportion of cases of influenza B have been ≥65 years of age, and 5-19 years of age, compared to cases of A(H1N1)pdm09 this season (Table 6). A total of 326 ICU admissions have been reported this season, of which 66.8% were adults 20-64 years of age. A total of 204 deaths have been reported. The highest proportion of deaths has been among adults 20-64 years of age (49.5%), followed by adults ≥65 years of age (41.1%). In keeping with the late-season circulation, influenza B has been increasingly reported among hospitalized cases of influenza. To date this season, influenza B has been reported in 8.6% of hospitalizations and 6.9 % of deaths. It is important to note that the hospitalization or 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: 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 distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks.
                        <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t6 class=alignCenter>Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=fr1 rowSpan=3>Age groups </TH><TH id=fc1 colSpan=6>Cumulative (Aug. 25, 2013 to March 22, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=fc2 colSpan=4 headers=fc1>Influenza A</TH><TH id=fc7 headers=fc1>B</TH><TH id=fc8 headers=fc1>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=fc3 headers="fc1 fc2">A Total</TH><TH id=fc4 class=bg-colour-blue headers="fc1 fc2">A(H1) pdm09</TH><TH id=fc5 class=bg-colour-blue headers="fc1 fc2">A(H3)</TH><TH id=fc6 class=bg-colour-blue headers="fc1 fc2">A (UnS)</TH><TD class=alignCenter headers="fc1 fc7">Total</TD><TD class=alignCenter headers="fc1 fc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=8><SUP id=footnote_t6_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                        UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=fr2 class=alignLeft headers=fr1>0-4 years</TH><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc3">579</TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc4">277</TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc5">7</TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc6">295</TD><TD class=alignCenter headers="fr1 fr2 fc1 fc7">44</TD><TD class=alignCenter headers="fr1 fr2 fc1 fc8">623 (17%)</TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years</TH><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc3">127</TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc4">64</TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc5">5</TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc6">58</TD><TD class=alignCenter headers="fr1 fr3 fc1 fc7">41</TD><TD class=alignCenter headers="fr1 fr3 fc1 fc8">168 (5%)</TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years</TH><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc3">34</TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc4">19</TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc5">3</TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc6">12</TD><TD class=alignCenter headers="fr1 fr4 fc1 fc7">2</TD><TD class=alignCenter headers="fr1 fr4 fc1 fc8">36 (1%)</TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc3">584</TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc4">413</TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc5">4</TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc6">167</TD><TD class=alignCenter headers="fr1 fr5 fc1 fc7">17</TD><TD class=alignCenter headers="fr1 fr5 fc1 fc8">601 (16%)</TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc3">1068</TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc4">680</TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc5">23</TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc6">365</TD><TD class=alignCenter headers="fr1 fr6 fc1 fc7">71</TD><TD class=alignCenter headers="fr1 fr6 fc1 fc8">1139 (31%)</TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc3">869</TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc4">451</TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc5">67</TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc6">351</TD><TD class=alignCenter headers="fr1 fr7 fc1 fc7">137</TD><TD class=alignCenter headers="fr1 fr7 fc1 fc8">1006 (27%)</TD></TR><TR><TH id=fr10 class=alignLeft headers=fr1>Unknown</TH><TD class=alignCenter headers="fc1 fc2 fc3">122</TD><TD class=alignCenter headers="fc1 fc2 fc4">95</TD><TD class=alignCenter headers="fc1 fc2 fc5">3</TD><TD class=alignCenter headers="fc1 fc2 fc6">24</TD><TD class=alignCenter headers="fc1 fc7">5</TD><TD class=alignCenter headers="fc1 fc8">127 (3%)</TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignCenter headers="fr1 fr8 fc1 fc2 fc3">3383</TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc4">1999</TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc5">112</TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc6">1272</TD><TD class=alignCenter headers="fr1 fr8 fc1 fc7">317</TD><TD class=alignCenter headers="fr1 fr8 fc1 fc8">3700</TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP> </TH><TD class=alignCenter headers="fr1 fr9 fc1 fc2 fc3">91.4%</TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc4">59.1%</TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc5">3.3%</TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc6">37.6%</TD><TD class=alignCenter headers="fr1 fr9 fc1 fc7">8.6%</TD><TD class=alignCenter headers="fr1 fr9 fc1 fc8">100%</TD></TR></TBODY></TABLE>
                        See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2013-14 on the Public Health Agency of Canada website.

                        .../
                        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


                        • #27
                          Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 13

                          FluWatch report: March 23 to 29, 2014 (Week 13)

                          Posted 2014-04-04For 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/13-14/w13_14/pdf/fw2014-13-eng.pdf">FluWatch report: March 23 to 29, 2014 (Week 13) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 291 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

                          »» Help with PDF documents

                          Overall Summary
                          • In week 13, the decline in influenza activity in Canada has been slowed by continued circulation of influenza B. Overall, the influenza A(H1N1) virus remains the most common influenza virus this season, however, most influenza viruses circulating in recent weeks have been influenza B.
                          • While the influenza A(H1N1) virus has mostly affected adults 20-64 years of age this season, influenza B is having a greater impact on adults 65 years of age and older, as well as young persons 5 to 19 years of age.
                          • As of week 13, 3,856 hospitalizations and 215 deaths have been reported from participating regions, which is comparable to reports in past influenza seasons.
                          • Influenza activity remains within expected levels for this time of year.
                          Influenza/ILI Activity (geographic spread)

                          The number of regions reporting localized or widespread influenza activity has been stable in recent weeks, with the majority of activity reported in Eastern Canada. In week 13, no regions reported widespread activity and eight regions (ON(5) and QC(3)) reported localized activity (Figure 1).
                          Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 13





                          Note: Influenza/ILI 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 and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
                          Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
                          Influenza and Other Respiratory Virus Detections

                          The number of positive influenza tests increased from 608 in week 12 to 692 (14.2% of tests) in week 13. Influenza B remained the predominant virus in week 13, representing 79% of influenza detections (Figure 2). The highest proportions of influenza B this season have been reported from Newfoundland & Labrador (33.0%) and Quebec (27.7%), followed by Ontario (17.0%) and British Columbia (10.2%) (Table 1). Slightly more influenza B has been observed to date this season compared to the same time during the 2012-13 season. Among the 19,992 cases for which information on age and type/subtype has been received this season, 54.1% were 20-64 years of age (Table 2). Significantly greater proportions of influenza B cases have been ≥65 years of age and 5-19 years of age compared to cases of A(H1N1)pdm09. Influenza detections among persons ≥65 years of age increased in weeks 11 and 12 but decreased in week 13; while detections in other age-groups continue to decline.

                          Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14

                          Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
                          The number of positive tests for RSV has been declining gradually over recent weeks, similar to the trend observed in recent seasons. The number of positive tests for parainfluenza and coronavirus continued to follow a downward trend since early February. More detections of adenovirus have been reported compared to last season, and have been relatively stable in recent weeks. Detections of rhinovirus have been relatively stable during the winter months, although these detections represent an increasing percentage of tests positive since early January. The number of positive tests for human metapneumovirus has been higher than during the same period last season; it declined in week 13 (Figure 3).
                          For more details, see the weekly Respiratory Virus Detections in Canada Report.
                          Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2013-14


                          Top of Page

                          RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
                          Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
                          <TABLE id=t1 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly and cumulative numbers of positive influenza specimens
                          by type, subtype and province, Canada, 2013-14
                          </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=ac1 colSpan=5>Weekly
                          (March 23, 2013 to March 29, 2014)</TH><TH id=ac8 colSpan=5>Cumulative
                          (August 25, 2013 to March 29, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=4 headers=ac1>Influenza A</TH><TH id=ac7 headers=ac1>B</TH><TH id=ac9 colSpan=4 headers=ac8>Influenza A</TH><TH id=ac14 headers=ac8>B</TH></TR><TR class=bg-colour-grey-light><TH id=ac3 headers="ac1 ac2">A Total</TH><TH id=ac4 class=lightred headers="ac1 ac2">A(H1)pdm09</TH><TH id=ac5 class=lightred headers="ac1 ac2">A(H3)</TH><TH id=ac6 class=lightred headers="ac1 ac2">A(UnS)</TH><TH class=alignCenter headers="ac1 ac7">B Total</TH><TH id=ac10 headers="ac8 ac9">A Total</TH><TH id=ac11 class=lightred headers="ac8 ac9">A(H1)pdm09</TH><TH id=ac12 class=lightred headers="ac8 ac9">A(H3)</TH><TH id=ac13 class=lightred headers="ac8 ac9">A(UnS)</TH><TD class=alignCenter headers="ac8 ac14">B Total</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
                          <SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                          UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=alignLeft headers=ar1>BC</TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">32</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">12</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">5</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">15</TD><TD class=alignRight headers="ar1 ar2 ac1 ac7">26</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac10">1794</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac11">1613</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac12">49</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac13">132</TD><TD class=alignRight headers="ar1 ar2 ac8 ac14">203</TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">28</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">14</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">14</TD><TD class=alignRight headers="ar1 ar3 ac1 ac7">19</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac10">3792</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac11">3420</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac12">57</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac13">315</TD><TD class=alignRight headers="ar1 ar3 ac8 ac14">195</TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">5</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">2</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">3</TD><TD class=alignRight headers="ar1 ar4 ac1 ac7">4</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac10">1355</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac11">975</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac12">6</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac13">374</TD><TD class=alignRight headers="ar1 ar4 ac8 ac14">53</TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">11</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">3</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">1</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">7</TD><TD class=alignRight headers="ar1 ar5 ac1 ac7">2</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac10">641</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac11">454</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac12">2</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac13">185</TD><TD class=alignRight headers="ar1 ar5 ac8 ac14">19</TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">41</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">13</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">17</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">11</TD><TD class=alignRight headers="ar1 ar6 ac1 ac7">265</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac10">5580</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac11">2462</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac12">293</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac13">2825</TD><TD class=alignRight headers="ar1 ar6 ac8 ac14">1145</TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">22</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">1</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">21</TD><TD class=alignRight headers="ar1 ar7 ac1 ac7">196</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac10">5288</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac11">676</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac12">3</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac13">4609</TD><TD class=alignRight headers="ar1 ar7 ac8 ac14">2030</TD></TR><TR><TH id=ar8 class=alignLeft headers=ar1>NB</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 ac7">8</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac10">1488</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac11">370</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac12">1</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac13">1117</TD><TD class=alignRight headers="ar1 ar8 ac8 ac14">38</TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">3</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">3</TD><TD class=alignRight headers="ar1 ar9 ac1 ac7">0</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac10">167</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac11">134</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac12">4</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac13">29</TD><TD class=alignRight headers="ar1 ar9 ac8 ac14">4</TD></TR><TR><TH id=ar10 class=alignLeft headers=ar1>PE</TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">--</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac4">--</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac5">--</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac6">--</TD><TD class=alignRight headers="ar1 ar10 ac1 ac7">--</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac10">118</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac11">117</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac13">1</TD><TD class=alignRight headers="ar1 ar10 ac8 ac14">1</TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">7</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">7</TD><TD class=alignRight headers="ar1 ar11 ac1 ac7">23</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac10">353</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac11">104</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac13">249</TD><TD class=alignRight headers="ar1 ar11 ac8 ac14">174</TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class="alignRight noWrap" headers="ar1 ar12 ac1 ac2 ac3">149</TD><TD class="alignRight noWrap lightred" headers="ar1 ar12 ac1 ac2 ac4">45</TD><TD class="alignRight noWrap lightred" headers="ar1 ar12 ac1 ac2 ac5">23</TD><TD class="alignRight noWrap lightred" headers="ar1 ar12 ac1 ac2 ac6">81</TD><TD class="alignRight noWrap" headers="ar1 ar12 ac1 ac7">543</TD><TD class="alignRight noWrap" headers="ar1 ar12 ac8 ac9 ac10">20576</TD><TD class="alignRight noWrap lightred" headers="ar1 ar12 ac8 ac9 ac11">10325</TD><TD class="alignRight noWrap lightred" headers="ar1 ar12 ac8 ac9 ac12">415</TD><TD class="alignRight noWrap lightred" headers="ar1 ar12 ac8 ac9 ac13">9836</TD><TD class="alignRight noWrap" headers="ar1 ar12 ac8 ac14">3862</TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="ar1 ar13 ac1 ac2 ac3">21.5%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac4">30.2%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac5">15.4%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac6">54.4%</TD><TD class=alignRight headers="ar1 ar13 ac1 ac7">78.5%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac9 ac10">84.2%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac11">50.2%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac12">2.0%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac13">47.8%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac14">15.8%</TD></TR></TBODY></TABLE>
                          <TABLE id=t2 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups (years)</TH><TH id=bc1 colSpan=5>Weekly
                          (March 23 to March 29, 2014)</TH><TH id=bc8 colSpan=7>Cumulative
                          (August 25, 2013 to March 29, 2014)</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><TH id=bc15 colSpan=2 headers=bc8>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=bc3 headers="bc1 bc2">A Total</TH><TH id=bc4 class="lightred " headers="bc1 bc2">A(H1) pdm09</TH><TH id=bc5 class="lightred " headers="bc1 bc2">A(H3)</TH><TH id=bc6 class="lightred " headers="bc1 bc2">A (UnS)</TH><TD class=alignCenter headers="bc1 bc7">Total</TD><TH id=bc10 headers="bc8 bc9">A Total</TH><TH id=bc11 class="lightred " headers="bc8 bc9">A(H1) pdm09</TH><TH id=bc12 class="lightred " headers="bc8 bc9">A(H3)</TH><TH id=bc13 class="lightred " headers="bc8 bc9">A (UnS)</TH><TD class=alignCenter headers="bc8 bc14">Total</TD><TH id=bc16 headers="bc8 bc15">#</TH><TH id=bc17 headers="bc8 bc15">%</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13><SUP id=footnote_t2_1>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
                          <SUP id=footnote_t2_2>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                          <SUP id=footnote_t2_3>3 </SUP>Table 2 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
                          UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=br2 class=alignLeft headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">11</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">2</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">8</TD><TD class=alignRight headers="br1 br2 bc1 bc7">24</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">3219</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">1436</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">34</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1749</TD><TD class=alignRight headers="br1 br2 bc8 bc14">348</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc16">3567</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc17">17.8%</TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">5</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">4</TD><TD class=alignRight headers="br1 br3 bc1 bc7">34</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1305</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">701</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">18</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">586</TD><TD class=alignRight headers="br1 br3 bc8 bc14">529</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc16">1834</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc17">9.2%</TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">13</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">4</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">9</TD><TD class=alignRight headers="br1 br4 bc1 bc7">31</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">5027</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">2783</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">39</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">2205</TD><TD class=alignRight headers="br1 br4 bc8 bc14">577</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc16">5604</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc17">28.0%</TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">15</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">5</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">2</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">8</TD><TD class=alignRight headers="br1 br5 bc1 bc7">74</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">4400</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">2375</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">53</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">1972</TD><TD class=alignRight headers="br1 br5 bc8 bc14">816</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc16">5216</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc17">26.1%</TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">16</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">4</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">2</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">10</TD><TD class=alignRight headers="br1 br6 bc1 bc7">117</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">2453</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">987</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">115</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">1351</TD><TD class=alignRight headers="br1 br6 bc8 bc14">1182</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc16">3635</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc17">18.2%</TD></TR><TR><TH id=br7 class=alignLeft headers=br1>Unknown</TH><TD class=alignRight headers="br1 br7 bc1 bc2 bc3">1</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc6">0</TD><TD class=alignRight headers="br1 br7 bc1 bc7">0</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc10">133</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">102</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">19</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">12</TD><TD class=alignRight headers="br1 br7 bc8 bc14">3</TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc16">136</TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc17">0.7%</TD></TR><TR><TH id=br8 class=alignLeft headers=br1>Total</TH><TD class="alignRight noWrap" headers="br1 br8 bc1 bc2 bc3">61</TD><TD class="alignRight noWrap lightred" headers="br1 br8 bc1 bc2 bc4">16</TD><TD class="alignRight noWrap lightred" headers="br1 br8 bc1 bc2 bc5">6</TD><TD class="alignRight noWrap lightred" headers="br1 br8 bc1 bc2 bc6">39</TD><TD class="alignRight noWrap" headers="br1 br8 bc1 bc7">280</TD><TD class="alignRight noWrap" headers="br1 br8 bc8 bc9 bc10">16537</TD><TD class="alignRight noWrap lightred" headers="br1 br8 bc8 bc9 bc11">8384</TD><TD class="alignRight noWrap lightred" headers="br1 br8 bc8 bc9 bc12">278</TD><TD class="alignRight noWrap lightred" headers="br1 br8 bc8 bc9 bc13">7875</TD><TD class="alignRight noWrap" headers="br1 br8 bc8 bc14">3455</TD><TD class="alignRight noWrap" headers="br1 br8 bc8 bc15 bc16">19992</TD><TD class="alignRight noWrap" headers="br1 br8 bc8 bc15 bc17">100.0%</TD></TR><TR><TH id=br9 class=alignLeft headers=br1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="br1 br9 bc1 bc2 bc3">17.9%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc4">26.2%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc5">9.8%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc6">63.9%</TD><TD class=alignRight headers="br1 br9 bc1 bc7">82.1%</TD><TD class=alignRight headers="br1 br9 bc8 bc9 bc10">82.7%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc11">50.7%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc12">1.7%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc13">47.6%</TD><TD class=alignRight headers="br1 br9 bc8 bc14">17.3%</TD><TD class=alignRight></TD><TD class=alignRight></TD></TR></TBODY></TABLE>

                          Top of Page

                          Influenza Strain Characterizations

                          During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 1,689 influenza viruses [82 A(H3N2), 1273 A(H1N1)pdm09 and 334 influenza B]. The vast majority (99%) of viruses were similar to the strains recommended by the WHO for the 2013-14 seasonal influenza vaccine. Two A(H1N1)pdm09 viruses showed reduced titres to antiserum against the reference A/California/07/2009 strain. Nineteen influenza B viruses were similar to the strain recommended by the WHO for the 2011-12 vaccine (Figure 4).
                          Figure 4. Influenza strain characterizations, Canada, 2013-2014, N = 1689

                          The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
                          The recommended components for the 2013-2014 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009 (H1N1)pdm09-like virus, an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b (e.g. A/Texas/50/2012), and a B/Massachusetts/2/2012-like virus (Yamagata lineage).


                          Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
                          Antiviral Resistance

                          During the 2013-2014 influenza season, NML has tested 1,290 influenza viruses for resistance to oseltamivir and all but two were sensitive. All 1,290 viruses tested for resistance to zanamivir were sensitive. All 1,378 influenza A viruses tested for amantadine resistance 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, 2013-2014</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="cr1 cr2 cc1 cc2">66 </TD><TD class=alignRight headers="cr1 cr2 cc1 cc3">0 </TD><TD class=alignRight headers="cr1 cr2 cc4 cc5">66 </TD><TD class=alignRight headers="cr1 cr2 cc4 cc6">0 </TD><TD class=alignRight headers="cr1 cr2 cc7 cc8">103 </TD><TD class=alignRight headers="cr1 cr2 cc7 cc9">103 (100%) </TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignRight headers="cr1 cr3 cc1 cc2">1046 </TD><TD class=alignRight headers="cr1 cr3 cc1 cc3">2 (0.2%) </TD><TD class=alignRight headers="cr1 cr3 cc4 cc5">1047 </TD><TD class=alignRight headers="cr1 cr3 cc4 cc6">0 </TD><TD class=alignRight headers="cr1 cr3 cc7 cc8">1275 </TD><TD class=alignRight headers="cr1 cr3 cc7 cc9">1275 (100%) </TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignRight headers="cr1 cr4 cc1 cc2">178 </TD><TD class=alignRight headers="cr1 cr4 cc1 cc3">0 </TD><TD class=alignRight headers="cr1 cr4 cc4 cc5">177 </TD><TD class=alignRight headers="cr1 cr4 cc4 cc6">0 </TD><TD class=alignRight headers="cr1 cr4 cc7 cc8">NA <SUP>*</SUP></TD><TD class=alignRight headers="cr1 cr4 cc7 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft bg-colour-blue" headers=cr1>TOTAL</TH><TD class=alignRight headers="cr1 cr5 cc1 cc2">1290 </TD><TD class=alignRight headers="cr1 cr5 cc1 cc3">2 (0.2%) </TD><TD class=alignRight headers="cr1 cr5 cc4 cc5">1290 </TD><TD class=alignRight headers="cr1 cr5 cc4 cc6">0 </TD><TD class=alignRight headers="cr1 cr5 cc7 cc8">1378 </TD><TD class=alignRight headers="cr1 cr5 cc7 cc9">1378 (100%) </TD></TR></TBODY></TABLE>
                          Influenza-like Illness (ILI) Consultation Rate

                          The national influenza-like-illness (ILI) consultation rate decreased from 37.5/1,000 in week 12 to 25.9/1,000 in week 13; which was within the expected range for week 13 (Figure 5).
                          Figure 5. Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

                          Note: No data available for mean rate for weeks 19 to 39 for the 1996-1997 through 2002-2003 seasons. Delays in the reporting of data may cause data to change retrospectively. The calculation of the average ILI consultation rate over 17 seasons was aligned with influenza activity in each season. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. The number of sentinel physicians in each province or territory is as follows: BC(21), AB(80), SK(11), MB(18), ON(169), QC(14), NB(29), NS(26), PE(4), NL(16), NU(1), NT(14), YT(13). Not all sentinel physicians report every week.
                          Text equivalent for figure 5Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

                          Top of Page

                          Influenza Outbreak Surveillance

                          In week 13, thirteen new influenza outbreaks were reported. Twelve outbreaks were in long-term care facilities, and among the 11 with available data, all were influenza B. One outbreak of A(H1N1)pdm09 was reported in a hospital (Figure 6). In addition, one outbreak of influenza-like illness was reported in a school.
                          Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2013-2014

                          1 All provinces and territories except NU report outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
                          Text equivalent for figure 6Overall number of new influenza outbreaks by report week, Canada, 2013-2014
                          Pharmacy Surveillance

                          In week 13, the proportion of prescriptions for antivirals among adults 19-64 years of age was similar to recent weeks, but declined for other age-groups. Overall this season, the largest proportion of prescriptions for antivirals has been among children 2-18 years of age and adults 19-64 years of age, in keeping with laboratory detections of influenza (Figure 7).
                          Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

                          Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group. Age-groups: Infant: 0-2y, Child: 2-18y; Adult: 19-64y, Senior: ≥65y.
                          Text equivalent for figure 7Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

                          Top of Page

                          Sentinel Hospital Influenza Surveillance

                          Paediatric Influenza Hospitalizations and Deaths (IMPACT)
                          In week 13, 15 new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 13 in week 12. Influenza B was reported in 11 of the 15 cases in week 13 (Figure 8a). Although the number of cases is small, a greater proportion of cases with influenza B this season have been children between 2 and 10 years of age compared to A(H1N1)pdm09. No ICU admissions or deaths were reported in week 13.
                          To date this season, a total of 642 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 86% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children <5 years of age represent 74% of cases to date (Table 4). Ninety-three ICU admissions have been reported, of which 63 (68%) were children <5 years of age (Figure 9a). All but six were cases with influenza A, and 97% of those subtyped were A(H1N1)pdm09. Among the 90 ICU cases with available data, 58 (64%) were reported to have underlying medical conditions. No deaths have been reported.
                          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)
                          In week 13, 25 new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported through active surveillance by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 27 in week 12 (Figure 8b). This season, a significantly greater proportion of cases of influenza B have been ≥65 years of age compared to cases of A(H1N1)pdm09. For a fourth week in a row, the majority of hospitalizations were associated with influenza B, which was associated with a greater proportion of cases among adults ≥65 years of age. No ICU admissions or deaths were reported in week 13.
                          To date this season, 1403 influenza-associated hospitalizations have been reported by the PCIRN-SOS network, 1182 (84.2%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). ICU admission was required for 227 hospitalizations, all but 12 of which were cases with influenza A (119 A(H1N1)pdm09, seven A(H3N2) and 89 A(unsubtyped)). Approximately 80% of hospitalizations and ICU admissions were ≥45 years of age. Of the 176 ICU admissions with available information, 154 (87.5%) were reported to have at least one comorbidity and of the 193 ICU admissions with available information 138 (71.5%) reported not having been vaccinated this season. Sixty-five deaths have been reported, all but six with influenza A (34 A(H1N1)pdm09, three A(H3N2) and 22 A(unsubtyped)); seven cases 20-44 years of age, 27 cases 45-64 years of age and 31 cases ≥65 years of age (Figure 9b).
                          Note: PCIRN-SOS conducted passive surveillance from April 30th to November 14th, 2013. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance began November 15th during which time PCIRN site coordinators investigate cases potentially related to influenza. Data from both active and passive surveillance reported during the 2013-14 season are included in this report. 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.
                          <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t4 class=alignCenter>Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=dr1 rowSpan=3>Age groups </TH><TH id=dc1 colSpan=6>Cumulative (Aug. 25, 2013 to March 29, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=dc2 colSpan=4 headers=dc1>Influenza A </TH><TH id=dc7 headers=dc1>B </TH><TH id=dc8 headers=dc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=dc3 headers="dc1 dc2">A Total </TH><TH id=dc4 class="lightred " headers="dc1 dc2">A(H1) pdm09 </TH><TH id=dc5 class="lightred " headers="dc1 dc2">A(H3) </TH><TH id=dc6 class="lightred " headers="dc1 dc2">A (UnS) </TH><TD class=alignCenter headers="dc1 dc7">Total</TD><TD class=alignCenter headers="dc1 dc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t4_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                          UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=dr2 class=alignLeft headers=dr1>0-5m </TH><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc3">104 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc4">33 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc5">0 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc6">71 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc7">4 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc8">108 (17%) </TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc3">160 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc4">46 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc5">1 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc6">113 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc7">14 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc8">174 (27%) </TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc3">163 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc4">55 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc5">3 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc6">105 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc7">27 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc8">190 (30%) </TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc3">83 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc4">27 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc5">0 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc6">56 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc7">37 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc8">120 (19%) </TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc3">41 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc4">15 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc5">1 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc6">25 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc7">9 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc8">50 (8%) </TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignRight headers="dr1 dr7 dc1 dc2 dc3">551 </TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc4">176 </TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc5">5 </TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc6">370 </TD><TD class=alignRight headers="dr1 dr7 dc1 dc7">91 </TD><TD class=alignRight headers="dr1 dr7 dc1 dc8">642 </TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP> </TH><TD class=alignRight headers="dr1 dr8 dc1 dc2 dc3">85.8% </TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc4">31.9% </TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc5">0.9% </TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc6">67.2% </TD><TD class=alignRight headers="dr1 dr8 dc1 dc7">14.2% </TD><TD class=alignRight headers="dr1 dr8 dc1 dc8">100.0% </TD></TR></TBODY></TABLE>
                          <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 5 - Cumulative numbers of adult hospitalizations with influenza
                          reported by the PCIRN-SOS network, Canada, 2013-14
                          </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=er1 rowSpan=3>Age groups </TH><TH id=ec1 class=noWrap colSpan=6>Cumulative (Aug. 25, 2013 to March 29, 2014)<SUP>*</SUP></TH></TR><TR class=bg-colour-yellow><TH id=ec2 colSpan=4 headers=ec1>Influenza A </TH><TH id=ec7 headers=ec1>B </TH><TH id=ec8 headers=ec1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=ec3 headers="ec1 ec2">A Total </TH><TH id=ec4 class=lightred headers="ec1 ec2">A(H1) pdm09 </TH><TH id=ec5 class=lightred headers="ec1 ec2">A(H3) </TH><TH id=ec6 class=lightred headers="ec1 ec2">A(UnS) </TH><TD class=alignCenter headers="ec1 ec7">Total</TD><TD class=alignCenter headers="ec1 ec8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t5_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                          UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.

                          <SUP id=t5_star>*</SUP> One case for which the influenza type has not yet been reported, and five cases for which the age-group was not reported, are not included in Table 5.</TD></TR></TFOOT><TBODY><TR><TH id=er2 class=alignLeft headers=er1>16-20 </TH><TD class=alignRight headers="er1 er2 ec1 ec2 ec3">13 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec4">4 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec5">0 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec6">9 </TD><TD class=alignRight headers="er1 er2 ec1 ec7">2 </TD><TD class=alignRight headers="er1 er2 ec1 ec8">15 (1%) </TD></TR><TR><TH id=er3 class=alignLeft headers=er1>20-44 </TH><TD class=alignRight headers="er1 er3 ec1 ec2 ec3">249 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec4">131 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec5">5 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec6">113 </TD><TD class=alignRight headers="er1 er3 ec1 ec7">14 </TD><TD class=alignRight headers="er1 er3 ec1 ec8">263 (19%) </TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignRight headers="er1 er4 ec1 ec2 ec3">465 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec4">217 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec5">7 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec6">241 </TD><TD class=alignRight headers="er1 er4 ec1 ec7">55 </TD><TD class=alignRight headers="er1 er4 ec1 ec8">520 (37%) </TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignRight headers="er1 er5 ec1 ec2 ec3">450 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec4">211 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec5">38 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec6">201 </TD><TD class=alignRight headers="er1 er5 ec1 ec7">149 </TD><TD class=alignRight headers="er1 er5 ec1 ec8">599 (43%) </TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignRight headers="er1 er6 ec1 ec2 ec3">1177 </TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec4">563 </TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec5">50 </TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec6">564 </TD><TD class=alignRight headers="er1 er6 ec1 ec7">220 </TD><TD class=alignRight headers="er1 er6 ec1 ec8">1397 </TD></TR><TR><TH id=er7 class=alignLeft headers=er1>%<SUP>1</SUP></TH><TD class=alignRight headers="er1 er7 ec1 ec2 ec3">84% </TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec4">48% </TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec5">4% </TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec6">48% </TD><TD class=alignRight headers="er1 er7 ec1 ec7">16% </TD><TD class=alignRight headers="er1 er7 ec1 ec8">100% </TD></TR></TBODY></TABLE>
                          Figure 8. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14
                          A) Paediatric hospitalizations (≤16 years of age, IMPACT)


                          Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
                          B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)

                          * See footnote above following the section related to PCIRN-SOS data.
                          Text equivalent for figure 8bNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Adult hospitalizations (>16 year of age, PCIRN-SOS)
                          Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14
                          A) Paediatric hospitalizations (≤16 years of age, IMPACT)

                          Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
                          B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)

                          Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Adult hospitalizations (≥16 year of age, PCIRN-SOS)

                          Top of Page

                          Provincial/Territorial Influenza Hospitalizations and Deaths

                          In week 13, 147 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories.<SUP>*</SUP> As with other surveillance indicators in week 13, the majority were cases of influenza B (104, 70.7%). Four ICU admissions were reported in week 13; one adult 20-44 years of age and the other three with age not reported; all with influenza A. Twelve deaths were reported in week 13; of which 11 were ≥65 years of age, and nine of the twelve had influenza B. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total.
                          To date this season, 3,856 influenza-associated hospitalizations have been reported, 89.0% with influenza A. The majority (58.1%) of hospitalizations have been cases 45 years of age of older. A significantly greater proportion of cases of influenza B have been ≥65 years of age, and 5-19 years of age, compared to cases of A(H1N1)pdm09 this season (Table 6). A total of 333 ICU admissions have been reported this season, of which 66.6% were adults 20-64 years of age. A total of 215 deaths have been reported. The highest proportion of deaths has been among adults 20-64 years of age (46.9%), followed by adults ≥65 years of age (44.2%). In keeping with the late-season circulation, influenza B has been increasingly reported among hospitalized cases of influenza. To date this season, influenza B has been reported in 11.0% of hospitalizations and 10.7 % of deaths. It is important to note that the hospitalization or 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: 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 distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks.
                          <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t6 class=alignCenter>Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=fr1 rowSpan=3>Age groups </TH><TH id=fc1 colSpan=6>Cumulative (Aug. 25, 2013 to March 29, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=fc2 colSpan=4 headers=fc1>Influenza A</TH><TH id=fc7 headers=fc1>B</TH><TH id=fc8 headers=fc1>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=fc3 headers="fc1 fc2">A Total</TH><TH id=fc4 class=lightred headers="fc1 fc2">A(H1) pdm09</TH><TH id=fc5 class=lightred headers="fc1 fc2">A(H3)</TH><TH id=fc6 class=lightred headers="fc1 fc2">A (UnS)</TH><TD class=alignCenter headers="fc1 fc7">Total</TD><TD class=alignCenter headers="fc1 fc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=8><SUP id=footnote_t6_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                          UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=fr2 class=alignLeft headers=fr1>0-4 years</TH><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc3">588 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc4">280 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc5">7 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc6">301 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc7">59 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc8">647 (17%) </TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years</TH><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc3">129 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc4">64 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc5">5 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc6">60 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc7">55 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc8">184 (5%) </TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years</TH><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc3">35 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc4">20 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc5">3 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc6">12 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc7">2 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc8">37 (1%) </TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc3">590 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc4">413 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc5">4 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc6">173 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc7">26 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc8">616 (16%) </TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc3">1081 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc4">686 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc5">25 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc6">370 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc7">80 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc8">1161 (30%) </TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc3">881 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc4">456 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc5">72 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc6">353 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc7">198 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc8">1079 (28%) </TD></TR><TR><TH id=fr10 class=alignLeft headers=fr1>Unknown</TH><TD class=alignRight headers="fc1 fc2 fc3">127 </TD><TD class=alignRight headers="fc1 fc2 fc4">97 </TD><TD class=alignRight headers="fc1 fc2 fc5">3 </TD><TD class=alignRight headers="fc1 fc2 fc6">27 </TD><TD class=alignRight headers="fc1 fc7">5 </TD><TD class=alignRight headers="fc1 fc8">132 (3%) </TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignRight headers="fr1 fr8 fc1 fc2 fc3">3431 </TD><TD class="alignRight lightred" headers="fr1 fr8 fc1 fc2 fc4">2016 </TD><TD class="alignRight lightred" headers="fr1 fr8 fc1 fc2 fc5">119 </TD><TD class="alignRight lightred" headers="fr1 fr8 fc1 fc2 fc6">1296 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc7">425 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc8">3856 </TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP> </TH><TD class=alignRight headers="fr1 fr9 fc1 fc2 fc3">89.0% </TD><TD class="alignRight lightred" headers="fr1 fr9 fc1 fc2 fc4">58.8% </TD><TD class="alignRight lightred" headers="fr1 fr9 fc1 fc2 fc5">3.5% </TD><TD class="alignRight lightred" headers="fr1 fr9 fc1 fc2 fc6">37.8% </TD><TD class=alignRight headers="fr1 fr9 fc1 fc7">11.0% </TD><TD class=alignRight headers="fr1 fr9 fc1 fc8">100% </TD></TR></TBODY></TABLE>
                          See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2013-14 on the Public Health Agency of Canada website.

                          .../
                          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


                          • #28
                            Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 14

                            FluWatch report: March 30 to April 5, 2014 (Week 14)

                            Posted 2014-04-11For 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/13-14/w14_14/pdf/fw2014-14-eng.pdf">FluWatch report: March 30 to April 5, 2014 (Week 14) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 291 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

                            »» Help with PDF documents

                            Overall Summary
                            • In week 14, influenza activity in Canada continues to decline slowly, with fewer cases of influenza B reported compared to the previous week. Although the influenza A(H1N1) virus was the most common influenza virus this season, the majority of influenza viruses circulating currently are influenza B.
                            • While the influenza A(H1N1) virus has mostly affected adults 20-64 years of age this season, influenza B is having a greater impact on adults 65 years of age and older, as well as young persons 5 to 19 years of age.
                            • As of week 14, 3,946 hospitalizations and 223 deaths have been reported from participating regions, which is comparable to reports in past influenza seasons.
                            • Influenza activity remains within expected levels for this time of year.
                            Influenza/ILI Activity (geographic spread)

                            The number of regions reporting localized or widespread influenza activity has been stable in recent weeks, with the majority of activity reported in Eastern Canada. In week 14, one region in Ontario reported widespread activity and five regions (ON(4) and QC(1)) reported localized activity (Figure 1).
                            Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 14





                            Note: Influenza/ILI 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 and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
                            Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
                            Influenza and Other Respiratory Virus Detections

                            The number of positive influenza tests decreased from 697 in week 13 to 613 (11.7% of tests) in week 14. Influenza B remained the predominant virus in week 14, representing 81% of influenza detections (Figure 2). The highest proportions of influenza B this season have been reported from Newfoundland & Labrador (34.5%) and Quebec (29.0%), followed by Ontario (20.5%) and British Columbia (10.2%) (Table 1). Slightly more influenza B has been observed to date this season compared to the same time during the 2012-13 season. Among the 20,448 cases for which information on age and type/subtype has been received this season, 53.8% were 20-64 years of age (Table 2). Significantly greater proportions of influenza B cases have been ≥65 years of age and 5-19 years of age compared to cases of A(H1N1)pdm09. The proportion of influenza detections among persons ≥65 years of age has increased in recent weeks, while the proportion of detections in other age-groups was stable or declining.

                            Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14

                            Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
                            The number of positive tests for RSV has been declining gradually over recent weeks, similar to the trend observed in recent seasons. The number of positive tests for parainfluenza and coronavirus have followed a downward trend since early February but both increased in week 14. More detections of adenovirus and human metapneumovirus have been reported compared to the same period last season, but both have declined over the past two weeks. Detections of rhinovirus have been relatively stable during the winter months, although these detections represent an increasing percentage of tests positive since early January (Figure 3).
                            For more details, see the weekly Respiratory Virus Detections in Canada Report.
                            Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2013-14


                            Top of Page

                            RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
                            Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
                            <TABLE id=t1 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly and cumulative numbers of positive influenza specimens
                            by type, subtype and province, Canada, 2013-14
                            </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=ac1 colSpan=5>Weekly
                            (March 30, 2013 to April 5, 2014)</TH><TH id=ac8 colSpan=5>Cumulative
                            (August 25, 2013 to April 5, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=4 headers=ac1>Influenza A</TH><TH id=ac7 headers=ac1>B</TH><TH id=ac9 colSpan=4 headers=ac8>Influenza A</TH><TH id=ac14 headers=ac8>B</TH></TR><TR class=bg-colour-grey-light><TH id=ac3 headers="ac1 ac2">A Total</TH><TH id=ac4 class=lightred headers="ac1 ac2">A(H1)pdm09</TH><TH id=ac5 class=lightred headers="ac1 ac2">A(H3)</TH><TH id=ac6 class=lightred headers="ac1 ac2">A(UnS)</TH><TH class=alignCenter headers="ac1 ac7">B Total</TH><TH id=ac10 headers="ac8 ac9">A Total</TH><TH id=ac11 class=lightred headers="ac8 ac9">A(H1)pdm09</TH><TH id=ac12 class=lightred headers="ac8 ac9">A(H3)</TH><TH id=ac13 class=lightred headers="ac8 ac9">A(UnS)</TH><TD class=alignCenter headers="ac8 ac14">B Total</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
                            <SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                            UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=alignLeft headers=ar1>BC</TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">2</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">2</TD><TD class=alignRight headers="ar1 ar2 ac1 ac7">3</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac10">1780</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac11">1601</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac12">60</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac13">119</TD><TD class=alignRight headers="ar1 ar2 ac8 ac14">203</TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">15</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">13</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">2</TD><TD class=alignRight headers="ar1 ar3 ac1 ac7">31</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac10">3810</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac11">3441</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac12">58</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac13">311</TD><TD class=alignRight headers="ar1 ar3 ac8 ac14">226</TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">7</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">3</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">1</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">3</TD><TD class=alignRight headers="ar1 ar4 ac1 ac7">4</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac10">1362</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac11">978</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac12">7</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac13">377</TD><TD class=alignRight headers="ar1 ar4 ac8 ac14">57</TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">8</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">4</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">1</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">3</TD><TD class=alignRight headers="ar1 ar5 ac1 ac7">0</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac10">649</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac11">458</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac12">3</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac13">188</TD><TD class=alignRight headers="ar1 ar5 ac8 ac14">19</TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">51</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">6</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">24</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">21</TD><TD class=alignRight headers="ar1 ar6 ac1 ac7">300</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac10">5640</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac11">2468</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac12">318</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac13">2854</TD><TD class=alignRight headers="ar1 ar6 ac8 ac14">1458</TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">21</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">21</TD><TD class=alignRight headers="ar1 ar7 ac1 ac7">138</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac10">5309</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac11">676</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac12">3</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac13">4630</TD><TD class=alignRight headers="ar1 ar7 ac8 ac14">2168</TD></TR><TR><TH id=ar8 class=alignLeft headers=ar1>NB</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 ac7">7</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac10">1488</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac11">370</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac12">1</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac13">1117</TD><TD class=alignRight headers="ar1 ar8 ac8 ac14">45</TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">3</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">3</TD><TD class=alignRight headers="ar1 ar9 ac1 ac7">0</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac10">170</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac11">134</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac12">4</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac13">32</TD><TD class=alignRight headers="ar1 ar9 ac8 ac14">4</TD></TR><TR><TH id=ar10 class=alignLeft headers=ar1>PE</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 ac7">0</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac10">118</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac11">117</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac13">1</TD><TD class=alignRight headers="ar1 ar10 ac8 ac14">1</TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">7</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">7</TD><TD class=alignRight headers="ar1 ar11 ac1 ac7">16</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac10">360</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac11">104</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac13">256</TD><TD class=alignRight headers="ar1 ar11 ac8 ac14">190</TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">114</TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac4">26</TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac5">26</TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac6">62</TD><TD class=alignRight headers="ar1 ar12 ac1 ac7">499</TD><TD class=alignRight headers="ar1 ar12 ac8 ac9 ac10">20686</TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac11">10347</TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac12">454</TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac13">9885</TD><TD class=alignRight headers="ar1 ar12 ac8 ac14">4371</TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="ar1 ar13 ac1 ac2 ac3">18.6%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac4">22.8%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac5">22.8%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac6">54.4%</TD><TD class=alignRight headers="ar1 ar13 ac1 ac7">81.4%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac9 ac10">82.6%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac11">50.0%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac12">2.2%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac13">47.8%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac14">17.4%</TD></TR></TBODY></TABLE>
                            <TABLE id=t2 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups (years)</TH><TH id=bc1 colSpan=5>Weekly
                            (March 30 to April 5, 2014)</TH><TH id=bc8 colSpan=7>Cumulative
                            (August 25, 2013 to April 5, 2014)</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><TH id=bc15 colSpan=2 headers=bc8>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=bc3 headers="bc1 bc2">A Total</TH><TH id=bc4 class="lightred " headers="bc1 bc2">A(H1) pdm09</TH><TH id=bc5 class="lightred " headers="bc1 bc2">A(H3)</TH><TH id=bc6 class="lightred " headers="bc1 bc2">A (UnS)</TH><TD class=alignCenter headers="bc1 bc7">Total</TD><TH id=bc10 headers="bc8 bc9">A Total</TH><TH id=bc11 class="lightred " headers="bc8 bc9">A(H1) pdm09</TH><TH id=bc12 class="lightred " headers="bc8 bc9">A(H3)</TH><TH id=bc13 class="lightred " headers="bc8 bc9">A (UnS)</TH><TD class=alignCenter headers="bc8 bc14">Total</TD><TH id=bc16 headers="bc8 bc15">#</TH><TH id=bc17 headers="bc8 bc15">%</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13><SUP id=footnote_t2_1>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
                            <SUP id=footnote_t2_2>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                            <SUP id=footnote_t2_3>3 </SUP>Table 2 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
                            UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=br2 class=alignLeft headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">8</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">4</TD><TD class=alignRight headers="br1 br2 bc1 bc7">21</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">3232</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">1441</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">37</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1754</TD><TD class=alignRight headers="br1 br2 bc8 bc14">378</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc16">3610</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc17">17.7%</TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">3</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">3</TD><TD class=alignRight headers="br1 br3 bc1 bc7">21</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1310</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">703</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">19</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">588</TD><TD class=alignRight headers="br1 br3 bc8 bc14">569</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc16">1879</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc17">9.2%</TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">13</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">5</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">8</TD><TD class=alignRight headers="br1 br4 bc1 bc7">34</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">5043</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">2796</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">39</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">2208</TD><TD class=alignRight headers="br1 br4 bc8 bc14">641</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc16">5684</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc17">27.8%</TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">10</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">2</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">2</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">6</TD><TD class=alignRight headers="br1 br5 bc1 bc7">57</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">4416</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">2380</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">55</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">1981</TD><TD class=alignRight headers="br1 br5 bc8 bc14">911</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc16">5327</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc17">26.1%</TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">18</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">3</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">6</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">9</TD><TD class=alignRight headers="br1 br6 bc1 bc7">96</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">2484</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">992</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">125</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">1367</TD><TD class=alignRight headers="br1 br6 bc8 bc14">1324</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc16">3808</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc17">18.6%</TD></TR><TR><TH id=br7 class=alignLeft headers=br1>Unknown</TH><TD class=alignRight headers="br1 br7 bc1 bc2 bc3">2</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc4">1</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc6">1</TD><TD class=alignRight headers="br1 br7 bc1 bc7">1</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc10">135</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">102</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">20</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">13</TD><TD class=alignRight headers="br1 br7 bc8 bc14">5</TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc16">140</TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc17">0.7%</TD></TR><TR><TH id=br8 class=alignLeft headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">54</TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc4">14</TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc5">9</TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc6">31</TD><TD class=alignRight headers="br1 br8 bc1 bc7">230</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">16620</TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc11">8414</TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc12">295</TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc13">7911</TD><TD class=alignRight headers="br1 br8 bc8 bc14">3828</TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc16">20448</TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc17">100.0%</TD></TR><TR><TH id=br9 class=alignLeft headers=br1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="br1 br9 bc1 bc2 bc3">19.0%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc4">25.9%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc5">16.7%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc6">57.4%</TD><TD class=alignRight headers="br1 br9 bc1 bc7">81.0%</TD><TD class=alignRight headers="br1 br9 bc8 bc9 bc10">81.3%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc11">50.6%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc12">1.8%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc13">47.6%</TD><TD class=alignRight headers="br1 br9 bc8 bc14">18.7%</TD><TD class=alignRight></TD><TD class=alignRight></TD></TR></TBODY></TABLE>

                            Top of Page

                            Influenza Strain Characterizations

                            During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 1,740 influenza viruses [86 A(H3N2), 1,301 A(H1N1)pdm09 and 353 influenza B]. The vast majority (99%) of viruses were similar to the strains recommended by the WHO for the 2013-14 seasonal influenza vaccine. Two A(H1N1)pdm09 viruses showed reduced titres to antiserum against the reference A/California/07/2009 strain. Nineteen influenza B viruses were similar to the strain recommended by the WHO for the 2011-12 vaccine (Figure 4).
                            Figure 4. Influenza strain characterizations, Canada, 2013-2014, N = 1740

                            The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
                            The recommended components for the 2013-2014 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009 (H1N1)pdm09-like virus, an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b (e.g. A/Texas/50/2012), and a B/Massachusetts/2/2012-like virus (Yamagata lineage).


                            Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
                            Antiviral Resistance

                            During the 2013-2014 influenza season, NML has tested 1,368 influenza viruses for resistance to oseltamivir and all but two were sensitive. All 1,370 viruses tested for resistance to zanamivir were sensitive. All 1,454 influenza A viruses tested for amantadine resistance 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, 2013-2014</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="cr1 cr2 cc1 cc2">66</TD><TD class=alignRight headers="cr1 cr2 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr2 cc4 cc5">66</TD><TD class=alignRight headers="cr1 cr2 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr2 cc7 cc8">114</TD><TD class=alignRight headers="cr1 cr2 cc7 cc9">114 (100%)</TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignRight headers="cr1 cr3 cc1 cc2">1105</TD><TD class=alignRight headers="cr1 cr3 cc1 cc3">2 (0.2%)</TD><TD class=alignRight headers="cr1 cr3 cc4 cc5">1108</TD><TD class=alignRight headers="cr1 cr3 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr3 cc7 cc8">1340</TD><TD class=alignRight headers="cr1 cr3 cc7 cc9">1340 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignRight headers="cr1 cr4 cc1 cc2">197</TD><TD class=alignRight headers="cr1 cr4 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr4 cc4 cc5">196</TD><TD class=alignRight headers="cr1 cr4 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr4 cc7 cc8">NA <SUP>*</SUP></TD><TD class=alignRight headers="cr1 cr4 cc7 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft bg-colour-blue" headers=cr1>TOTAL</TH><TD class=alignRight headers="cr1 cr5 cc1 cc2">1368</TD><TD class=alignRight headers="cr1 cr5 cc1 cc3">2 (0.1%)</TD><TD class=alignRight headers="cr1 cr5 cc4 cc5">1370</TD><TD class=alignRight headers="cr1 cr5 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr5 cc7 cc8">1454</TD><TD class=alignRight headers="cr1 cr5 cc7 cc9">1454 (100%)</TD></TR></TBODY></TABLE>
                            Influenza-like Illness (ILI) Consultation Rate

                            The national influenza-like-illness (ILI) consultation rate increased from 22.8/1,000 in week 13 to 32.0/1,000 in week 14; but was still within the expected range for week 14 (Figure 5).
                            Figure 5. Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

                            Note: No data available for mean rate for weeks 19 to 39 for the 1996-1997 through 2002-2003 seasons. Delays in the reporting of data may cause data to change retrospectively. The calculation of the average ILI consultation rate over 17 seasons was aligned with influenza activity in each season. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. The number of sentinel physicians in each province or territory is as follows: BC(21), AB(80), SK(11), MB(18), ON(169), QC(14), NB(29), NS(26), PE(4), NL(16), NU(1), NT(14), YT(13). Not all sentinel physicians report every week.
                            Text equivalent for figure 5Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

                            Top of Page

                            Influenza Outbreak Surveillance

                            In week 14, nine new influenza outbreaks were reported: six outbreaks in long-term care facilities, and three in hospitals (Figure 6). In addition, three outbreaks were reported in other settings or communities. Among the 12 influenza outbreaks, ten had data on the influenza type, and all were influenza B. Two additional outbreaks of influenza-like illness were reported in other settings or communities.
                            Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2013-2014

                            1 All provinces and territories except NU report outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
                            Text equivalent for figure 6Overall number of new influenza outbreaks by report week, Canada, 2013-2014
                            Pharmacy Surveillance

                            In week 14, the proportion of prescriptions for antivirals among all age-groups was similar to the previous week. Overall this season, the largest proportion of prescriptions for antivirals has been among children 2-18 years of age and adults 19-64 years of age, in keeping with laboratory detections of influenza (Figure 7). In contrast, the highest proportion of prescriptions for antivirals during the 2012-13 season was among adults ≥65 years of age.
                            Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

                            Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group. Age-groups: Infant: 0-2y, Child: 2-18y; Adult: 19-64y, Senior: ≥65y.
                            Text equivalent for figure 7Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

                            Top of Page

                            Sentinel Hospital Influenza Surveillance

                            Paediatric Influenza Hospitalizations and Deaths (IMPACT)
                            In week 14, 11 new 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 13. Influenza B was reported in 9 of the 11 cases in week 14 (Figure 8a). Although the number of cases is small, a greater proportion of cases with influenza B this season have been children between 2 and 10 years of age compared to A(H1N1)pdm09. No ICU admissions or deaths were reported in week 14.
                            To date this season, a total of 653 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 85% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children <5 years of age represent 74% of cases to date (Table 4). Ninety-four ICU admissions have been reported, of which 64 (68%) were children <5 years of age (Figure 9a). All but six were cases with influenza A, and 97% of those subtyped were A(H1N1)pdm09. Among the 89 ICU cases with available data, 57 (64%) were reported to have underlying medical conditions. No deaths have been reported.
                            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)
                            In week 14, 24 new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported through active surveillance by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 42 in week 1