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

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

    FluWatch report: April 20 to 26, 2014 (Week 17)

    Posted 2014-05-02For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
    <A title="Flu Watch (Version PDF, 113 KB - 6 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/13-14/w17_14/pdf/fw2014-17-eng.pdf">FluWatch report: April 20 to 26, 2014 (Week 17) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 291 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

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    Overall Summary
    • In week 17, influenza B continued to circulate in several regions across Canada. This sustained influenza activity remains within expected levels for this time of year, and is consistent with late-season circulation of influenza B.
    • Influenza B is having a greater impact on adults 65 years of age and older and young persons 5 to 19 years of age, compared to influenza A(H1N1) which circulated earlier in the year. The proportion of hospitalizations with influenza among these age-groups has increased in recent weeks, and outbreaks of influenza B have been reported in long-term care facilities.
    • As of week 17, 4,393 hospitalizations and 244 deaths have been reported from participating regions, which is fewer than were reported last year.
    Influenza/ILI Activity (geographic spread)

    The number of regions reporting localized or widespread influenza activity has been stable during March and April. In week 17, no region reported widespread activity and six regions (MB(1) and ON(5)) reported localized activity (Figure 1).
    Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 17





    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 slightly from 619 in week 16 to 576 (13.4% of tests) in week 17 (Figure 2). Influenza B remained the predominant virus in week 17, representing 88% of influenza detections. Influenza B continues to circulate in many regions across Canada with many jurisdictions reporting sustained levels of influenza detections over recent weeks. An exception is Ontario, where, after a sharp increase in mid-April, detections have since declined (Table 1). The pattern of influenza circulation during the 2012-13 and 2013-14 seasons has been similar, although this season the predominant circulating subtype of influenza A was A(H1N1)pdm09 and there has been more late-season circulation of influenza B. 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. Among cases for which information on age and type/subtype has been received, 43% of the cases in week 17 were ≥65 years of age compared to 20% of cases for the season to date (Table 2). However, in some jurisdictions, detections of influenza B may be a reflection of testing related to outbreaks in long-term care facilities.
    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 and coronavirus continued to decline, in keeping with their seasonal pattern of winter circulation. The number of positive tests for parainfluenza and adenovirus have been variable in recent weeks. More detections human metapneumovirus have been reported compared to the previous three seasons, but have been declining since mid-March. Detections of rhinovirus have been relatively stable during the winter months, but have been increasing during late-March and April, in keeping with its seasonal distribution in recent years demonstrating a small peak of detections in the spring and a larger peak in the fall (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


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    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 margin10px">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
    (April 20, 2013 to April 26, 2014)</TH><TH id=ac8 colSpan=5>Cumulative
    (August 25, 2013 to April 26, 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=alignRight headers="ar1 ar2 ac1 ac2 ac3">9</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">9</TD><TD class=alignRight headers="ar1 ar2 ac1 ac7">27</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac10">1800</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac11">1612</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac12">49</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac13">139</TD><TD class=alignRight headers="ar1 ar2 ac8 ac14">318</TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">8</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">5</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">3</TD><TD class=alignRight headers="ar1 ar3 ac1 ac7">42</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac10">3843</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac11">3451</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac12">75</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac13">317</TD><TD class=alignRight headers="ar1 ar3 ac8 ac14">348</TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">3</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">1</TD><TD class=alignRight headers="ar1 ar4 ac1 ac7">17</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac10">1383</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac11">988</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac12">8</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac13">387</TD><TD class=alignRight headers="ar1 ar4 ac8 ac14">115</TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">16</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">2</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">2</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">12</TD><TD class=alignRight headers="ar1 ar5 ac1 ac7">8</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac10">676</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac11">462</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac12">5</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac13">209</TD><TD class=alignRight headers="ar1 ar5 ac8 ac14">30</TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">19</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">2</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">12</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">5</TD><TD class=alignRight headers="ar1 ar6 ac1 ac7">274</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac10">5711</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac11">2486</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac12">354</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac13">2871</TD><TD class=alignRight headers="ar1 ar6 ac8 ac14">2461</TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">12</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">12</TD><TD class=alignRight headers="ar1 ar7 ac1 ac7">109</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac10">5346</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac11">677</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac12">4</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac13">4665</TD><TD class=alignRight headers="ar1 ar7 ac8 ac14">2511</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">17</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">86</TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac7">3</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac10">174</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">36</TD><TD class=alignRight headers="ar1 ar9 ac8 ac14">15</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">119</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac11">118</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">2</TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">5</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac6">5</TD><TD class=alignRight headers="ar1 ar11 ac1 ac7">7</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac10">369</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">265</TD><TD class=alignRight headers="ar1 ar11 ac8 ac14">218</TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">72</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac4">6</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac5">19</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac6">47</TD><TD class=alignRight headers="ar1 ar12 ac1 ac7">504</TD><TD class=alignRight headers="ar1 ar12 ac8 ac9 ac10">20909</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac11">10402</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac12">500</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac13">10007</TD><TD class=alignRight headers="ar1 ar12 ac8 ac14">6104</TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="ar1 ar13 ac1 ac2 ac3">12.5%</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac4">8.3%</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac5">26.4%</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac6">65.3%</TD><TD class=alignRight headers="ar1 ar13 ac1 ac7">87.5%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac9 ac10">77.4%</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac11">49.7%</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac12">2.4%</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac13">47.9%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac14">22.6%</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
    (April 20 to April 26, 2014)</TH><TH id=bc8 colSpan=7>Cumulative
    (August 25, 2013 to April 26, 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=alignRight headers="br1 br2 bc1 bc2 bc3">2</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">2</TD><TD class=alignRight headers="br1 br2 bc1 bc7">18</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">3252</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">1447</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">40</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1765</TD><TD class=alignRight headers="br1 br2 bc8 bc14">479</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc16">3731</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc17">17.0%</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">0</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">4</TD><TD class=alignRight headers="br1 br3 bc1 bc7">30</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1324</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">706</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">22</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">596</TD><TD class=alignRight headers="br1 br3 bc8 bc14">727</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc16">2051</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc17">9.4%</TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">9</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">1</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">7</TD><TD class=alignRight headers="br1 br4 bc1 bc7">24</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">5073</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">2807</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">43</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">2223</TD><TD class=alignRight headers="br1 br4 bc8 bc14">855</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc16">5928</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc17">27.0%</TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">8</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">4</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">4</TD><TD class=alignRight headers="br1 br5 bc1 bc7">65</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">4452</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">2385</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">59</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">2008</TD><TD class=alignRight headers="br1 br5 bc8 bc14">1244</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc16">5696</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc17">26.0%</TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">17</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">4</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">13</TD><TD class=alignRight headers="br1 br6 bc1 bc7">104</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">2553</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">997</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">153</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">1403</TD><TD class=alignRight headers="br1 br6 bc8 bc14">1823</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc16">4376</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc17">20.0%</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">1</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc10">136</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">102</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">21</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">13</TD><TD class=alignRight headers="br1 br7 bc8 bc14">7</TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc16">143</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">41</TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc4">1</TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc5">10</TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc6">30</TD><TD class=alignRight headers="br1 br8 bc1 bc7">242</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">16790</TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc11">8444</TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc12">338</TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc13">8008</TD><TD class=alignRight headers="br1 br8 bc8 bc14">5135</TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc16">21925</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">14.5%</TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc4">2.4%</TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc5">24.4%</TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc6">73.2%</TD><TD class=alignRight headers="br1 br9 bc1 bc7">85.5%</TD><TD class=alignRight headers="br1 br9 bc8 bc9 bc10">76.6%</TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc11">50.3%</TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc12">2.0%</TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc13">47.7%</TD><TD class=alignRight headers="br1 br9 bc8 bc14">23.4%</TD><TD class=alignRight></TD><TD class=alignRight></TD></TR></TBODY></TABLE>

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    Influenza Strain Characterizations

    During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 1,830 influenza viruses [94 A(H3N2), 1,325 A(H1N1)pdm09 and 411 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. Twenty-two 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 = 1830

    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 1,636 influenza viruses for resistance to oseltamivir and all but two were sensitive. All 1,635 viruses tested for resistance to zanamivir were sensitive. All 1,499 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">80</TD><TD class=alignRight headers="cr1 cr2 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr2 cc4 cc5">80</TD><TD class=alignRight headers="cr1 cr2 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr2 cc7 cc8">128</TD><TD class=alignRight headers="cr1 cr2 cc7 cc9">128 (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">1254</TD><TD class=alignRight headers="cr1 cr3 cc1 cc3">2 (0.2%)</TD><TD class=alignRight headers="cr1 cr3 cc4 cc5">1254</TD><TD class=alignRight headers="cr1 cr3 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr3 cc7 cc8">1371</TD><TD class=alignRight headers="cr1 cr3 cc7 cc9">1371 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignRight headers="cr1 cr4 cc1 cc2">302</TD><TD class=alignRight headers="cr1 cr4 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr4 cc4 cc5">301</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">1636</TD><TD class=alignRight headers="cr1 cr5 cc1 cc3">2 (0.1%)</TD><TD class=alignRight headers="cr1 cr5 cc4 cc5">1635</TD><TD class=alignRight headers="cr1 cr5 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr5 cc7 cc8">1474</TD><TD class=alignRight headers="cr1 cr5 cc7 cc9">1499 (100%)</TD></TR></TBODY></TABLE>
    Influenza-like Illness (ILI) Consultation Rate

    The national influenza-like-illness (ILI) consultation rate decreased from 23.5 consultations per 1,000 patient visits in week 16 to 21.8 / 1,000 in week 17; which was within the expected range for week 17 (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

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    Influenza Outbreak Surveillance

    In week 17, eight new influenza outbreaks were reported, all in Ontario: seven in long-term care facilities and one in a hospital. All were outbreaks of influenza B (Figure 6). To date, fewer outbreaks in long-term care facilities, and a similar number of hospital outbreaks, have been reported compared to last season.
    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 17, the proportion of prescriptions for antivirals was similar to the previous week, in keeping with laboratory detections of influenza. The proportion of prescriptions for antivirals increased among infants <2 years of age and adults ≥65 years of age, although these rates are more variable. 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 (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

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    Sentinel Hospital Influenza Surveillance

    Paediatric Influenza Hospitalizations and Deaths (IMPACT)
    In week 17, nine new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 11 in week 16. Six cases reported in week 17 had influenza B, and the remaining cases had influenza A(unsubtyped) (Figure 8a). 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 17.
    To date this season, a total of 683 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 82% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children <5 years of age represent 73% of cases to date (Table 4). Ninety-seven ICU admissions have been reported, of which 66 (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 94 ICU cases with available data, 60 (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 17, 19 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 53 in week 16 (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. Since the beginning of March the majority of hospitalizations have been associated with influenza B, with a greater proportion of cases among adults ≥65 years of age. Three ICU admissions were reported in week 17, one adult 45-64 years of age with influenza A and two adults ≥65 years of age, one with influenza A and one with influenza B. No deaths were reported in week 17.
    To date this season, 1,724 influenza-associated hospitalizations have been reported by the PCIRN-SOS network, 1,270 (73.7%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). Overall, fewer cases have been reported this season compared to the 2012-13 season, however, more than four times more cases of influenza B have been reported compared to last year. ICU admission was required for 276 hospitalizations, all but 37 of which were cases with influenza A (126 A(H1N1)pdm09, eight A(H3N2) and 105 A(unsubtyped)). A greater proportion of cases have been admitted to the ICU this season compared to last year, but the proportion of deaths has been similar. Of the 196 ICU admissions with available information, 168 (85.7%) were reported to have at least one comorbidity and of the 229 ICU admissions with available information 160 (69.9%) reported not having been vaccinated this season. Eighty-four deaths have been reported, all but 11 with influenza A (45 A(H1N1)pdm09, three A(H3N2) and 25 A(unsubtyped)); eight cases 20-44 years of age, 32 cases 45-64 years of age and 44 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 April 26, 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=alignRight headers="dr1 dr2 dc1 dc2 dc3">104</TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc4">34</TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc5">0</TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc6">70</TD><TD class=alignRight headers="dr1 dr2 dc1 dc7">8</TD><TD class=alignRight headers="dr1 dr2 dc1 dc8">112 (16%)</TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc3">163</TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc4">51</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">21</TD><TD class=alignRight headers="dr1 dr3 dc1 dc8">184 (27%)</TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc3">166</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">108</TD><TD class=alignRight headers="dr1 dr4 dc1 dc7">37</TD><TD class=alignRight headers="dr1 dr4 dc1 dc8">203 (30%)</TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc3">84</TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc4">27</TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc5">1</TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc6">56</TD><TD class=alignRight headers="dr1 dr5 dc1 dc7">48</TD><TD class=alignRight headers="dr1 dr5 dc1 dc8">132 (19%)</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">14</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">12</TD><TD class=alignRight headers="dr1 dr6 dc1 dc8">52 (8%)</TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignRight headers="dr1 dr7 dc1 dc2 dc3">557</TD><TD class="alignRight bg-colour-blue" headers="dr1 dr7 dc1 dc2 dc4">181</TD><TD class="alignRight bg-colour-blue" headers="dr1 dr7 dc1 dc2 dc5">6</TD><TD class="alignRight bg-colour-blue" headers="dr1 dr7 dc1 dc2 dc6">370</TD><TD class=alignRight headers="dr1 dr7 dc1 dc7">126</TD><TD class=alignRight headers="dr1 dr7 dc1 dc8">683</TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP> </TH><TD class=alignRight headers="dr1 dr8 dc1 dc2 dc3">81.6%</TD><TD class="alignRight bg-colour-blue" headers="dr1 dr8 dc1 dc2 dc4">32.5%</TD><TD class="alignRight bg-colour-blue" headers="dr1 dr8 dc1 dc2 dc5">1.1%</TD><TD class="alignRight bg-colour-blue" headers="dr1 dr8 dc1 dc2 dc6">66.4%</TD><TD class=alignRight headers="dr1 dr8 dc1 dc7">18.4%</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 April 26, 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> Two cases for which the influenza type has not yet been reported, and six 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">5</TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec5">0</TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec6">8</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">267</TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec4">142</TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec5">6</TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec6">119</TD><TD class=alignRight headers="er1 er3 ec1 ec7">31</TD><TD class=alignRight headers="er1 er3 ec1 ec8">298 (17%)</TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignRight headers="er1 er4 ec1 ec2 ec3">492</TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec4">235</TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec5">9</TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec6">248</TD><TD class=alignRight headers="er1 er4 ec1 ec7">104</TD><TD class=alignRight headers="er1 er4 ec1 ec8">596 (35%)</TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignRight headers="er1 er5 ec1 ec2 ec3">493</TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec4">229</TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec5">51</TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec6">213</TD><TD class=alignRight headers="er1 er5 ec1 ec7">315</TD><TD class=alignRight headers="er1 er5 ec1 ec8">808 (47%)</TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignRight headers="er1 er6 ec1 ec2 ec3">1265</TD><TD class="alignRight bg-colour-blue" headers="er1 er6 ec1 ec2 ec4">611</TD><TD class="alignRight bg-colour-blue" headers="er1 er6 ec1 ec2 ec5">66</TD><TD class="alignRight bg-colour-blue" headers="er1 er6 ec1 ec2 ec6">588</TD><TD class=alignRight headers="er1 er6 ec1 ec7">452</TD><TD class=alignRight headers="er1 er6 ec1 ec8">1717</TD></TR><TR><TH id=er7 class=alignLeft headers=er1>%<SUP>1</SUP></TH><TD class=alignRight headers="er1 er7 ec1 ec2 ec3">74%</TD><TD class="alignRight bg-colour-blue" headers="er1 er7 ec1 ec2 ec4">48%</TD><TD class="alignRight bg-colour-blue" headers="er1 er7 ec1 ec2 ec5">5%</TD><TD class="alignRight bg-colour-blue" headers="er1 er7 ec1 ec2 ec6">46%</TD><TD class=alignRight headers="er1 er7 ec1 ec7">26%</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)

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    Provincial/Territorial Influenza Hospitalizations and Deaths

    In week 17, 170 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories<SUP>*</SUP>. As with other surveillance indicators in week 17, the majority were cases of influenza B (149, 87.6%). One ICU admission was reported in week 17, an adult 20-44 years of age with influenza A(H1N1)pdm09. Eight deaths were reported this week; two children 2-14 years of age with influenza A, and six adults ≥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, 4,393 influenza-associated hospitalizations have been reported, 80.7% with influenza A. The majority (59.9%) 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 346 ICU admissions have been reported this season, of which 65.3% were adults 20-64 years of age. A total of 244 deaths have been reported. The highest proportion of deaths has been among adults ≥65 years of age (48.0%) followed by adults 20-64 years of age (43.0%). 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 19.3% of hospitalizations and 17.2% 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 April 26, 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=alignRight headers="fr1 fr2 fc1 fc2 fc3">607</TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc4">287</TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc5">10</TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc6">310</TD><TD class=alignRight headers="fr1 fr2 fc1 fc7">90</TD><TD class=alignRight headers="fr1 fr2 fc1 fc8">697 (16%)</TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years</TH><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc3">133</TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc4">65</TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc5">6</TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc6">62</TD><TD class=alignRight headers="fr1 fr3 fc1 fc7">84</TD><TD class=alignRight headers="fr1 fr3 fc1 fc8">217 (5%)</TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years</TH><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc3">36</TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc4">21</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">5</TD><TD class=alignRight headers="fr1 fr4 fc1 fc8">41 (1%)</TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc3">607</TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc4">424</TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc5">4</TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc6">179</TD><TD class=alignRight headers="fr1 fr5 fc1 fc7">53</TD><TD class=alignRight headers="fr1 fr5 fc1 fc8">660 (15%)</TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc3">1105</TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc4">699</TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc5">27</TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc6">379</TD><TD class=alignRight headers="fr1 fr6 fc1 fc7">166</TD><TD class=alignRight headers="fr1 fr6 fc1 fc8">1271 (29%)</TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc3">921</TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc4">461</TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc5">87</TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc6">373</TD><TD class=alignRight headers="fr1 fr7 fc1 fc7">439</TD><TD class=alignRight headers="fr1 fr7 fc1 fc8">1360 (31%)</TD></TR><TR><TH id=fr10 class=alignLeft headers=fr1>Unknown</TH><TD class=alignRight headers="fc1 fc2 fc3">134</TD><TD class=alignRight headers="fc1 fc2 fc4">99</TD><TD class=alignRight headers="fc1 fc2 fc5">3</TD><TD class=alignRight headers="fc1 fc2 fc6">32</TD><TD class=alignRight headers="fc1 fc7">13</TD><TD class=alignRight headers="fc1 fc8">147 (3%)</TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignRight headers="fr1 fr8 fc1 fc2 fc3">3543</TD><TD class="alignRight bg-colour-blue" headers="fr1 fr8 fc1 fc2 fc4">2056</TD><TD class="alignRight bg-colour-blue" headers="fr1 fr8 fc1 fc2 fc5">140</TD><TD class="alignRight bg-colour-blue" headers="fr1 fr8 fc1 fc2 fc6">1347</TD><TD class=alignRight headers="fr1 fr8 fc1 fc7">850</TD><TD class=alignRight headers="fr1 fr8 fc1 fc8">4393</TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP> </TH><TD class=alignRight headers="fr1 fr9 fc1 fc2 fc3">80.7%</TD><TD class="alignRight bg-colour-blue" headers="fr1 fr9 fc1 fc2 fc4">58.0%</TD><TD class="alignRight bg-colour-blue" headers="fr1 fr9 fc1 fc2 fc5">4.0%</TD><TD class="alignRight bg-colour-blue" headers="fr1 fr9 fc1 fc2 fc6">38.0%</TD><TD class=alignRight headers="fr1 fr9 fc1 fc7">19.3%</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

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    • #32
      Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 18

      FluWatch report: April 27 to 3 May, 2014 (Week 18)

      Posted 2014-05-09

      For 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/w18_14/pdf/fw2014-18-eng.pdf">FluWatch report: April 27 to 3 May, 2014 (Week 18) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 291 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

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      Overall Summary
      • In week 18, influenza B continued to circulate in several regions across Canada. This sustained influenza activity remains within expected levels for this time of year, and is consistent with late-season circulation of influenza B.
      • Influenza B is having a greater impact on adults 65 years of age and older and young persons 5 to 19 years of age, compared to influenza A(H1N1) which circulated earlier in the year.
      • As of week 18, 4,623 hospitalizations and 258 deaths have been reported from participating regions, which is fewer than were reported last year.
      • Globally, influenza activity in the northern hemisphere continues to decline, approaching inter-seasonal levels; influenza activity in the southern hemisphere remains low.
      Influenza/ILI Activity (geographic spread)

      After holding steady in March and April, the number of regions reporting localized or widespread influenza activity increased in week 18. In week 18, no region reported widespread activity and 12 regions (BC(1), MB(1), 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 18





      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 580 in week 17 to 441 (11.7% of tests) in week 18 (Figure 2). Influenza B remained the predominant virus in week 18, representing 90% of influenza detections. Influenza B continues to circulate in many regions across Canada. Most jurisdictions report stable or declining levels of influenza detections over recent weeks. In week 18, Nova Scotia reported a sharp increase in influenza B detections which may have been due to testing related to outbreaks in long-term care facilities (Table 1). The pattern of influenza circulation during the 2012-13 and 2013-14 seasons has been similar, although this season the predominant circulating subtype of influenza A was A(H1N1)pdm09 and there has been more late-season circulation of influenza B. 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. Among cases for which information on age and type/subtype has been received, 51% of the cases in week 18 were ≥65 years of age compared to 20% of cases for the season to date (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 and coronavirus continued to decline, in keeping with their seasonal pattern of winter circulation. The number of positive tests for parainfluenza and adenovirus have been variable in recent weeks. More detections of human metapneumovirus have been reported compared to the previous three seasons, but have been declining since mid-March. Detections of rhinovirus have been relatively stable during the winter months, but have been increasing during late-March and April, in keeping with its seasonal distribution in recent years demonstrating a small peak of detections in the spring and a larger peak in the fall (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


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      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 margin10px">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
      (April 27, 2013 to May 3, 2014)</TH><TH id=ac8 colSpan=5>Cumulative
      (August 25, 2013 to May 3, 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=alignRight headers="ar1 ar2 ac1 ac2 ac3">13 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">2 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">10 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">1 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac7">6 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac10">1813 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac11">1616 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac12">57 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac13">140 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac14">324 </TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">0 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac7">32 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac10">3844 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac11">3454 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac12">76 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac13">314 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac14">381 </TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">0 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac7">19 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac10">1383 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac11">988 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac12">8 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac13">387 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac14">134 </TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">4 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">4 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac7">10 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac10">680 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac11">462 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac12">5 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac13">213 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac14">40 </TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">18 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">3 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">10 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">5 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac7">209 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac10">5729 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac11">2489 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac12">364 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac13">2876 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac14">2670 </TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">7 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">1 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">6 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac7">88 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac10">5353 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac11">677 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac12">5 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac13">4671 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac14">2601 </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">93 </TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">0 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac7">18 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac10">174 </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">36 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac14">33 </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">119 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac11">118 </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">2 </TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">2 </TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac6">2 </TD><TD class=alignRight headers="ar1 ar11 ac1 ac7">8 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac10">371 </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">267 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac14">226 </TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">44 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac4">5 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac5">21 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac6">18 </TD><TD class=alignRight headers="ar1 ar12 ac1 ac7">397 </TD><TD class=alignRight headers="ar1 ar12 ac8 ac9 ac10">20954 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac11">10412 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac12">520 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac13">10022 </TD><TD class=alignRight headers="ar1 ar12 ac8 ac14">6504 </TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="ar1 ar13 ac1 ac2 ac3">10.0% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac4">11.4% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac5">47.7% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac6">40.9% </TD><TD class=alignRight headers="ar1 ar13 ac1 ac7">90.0% </TD><TD class=alignRight headers="ar1 ar13 ac8 ac9 ac10">76.3% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac11">49.7% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac12">2.5% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac13">47.8% </TD><TD class=alignRight headers="ar1 ar13 ac8 ac14">23.7% </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
      (April 27 to May 3, 2014)</TH><TH id=bc8 colSpan=7>Cumulative
      (August 25, 2013 to May 3, 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=alignRight headers="br1 br2 bc1 bc2 bc3">1 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">1 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">0 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">0 </TD><TD class=alignRight headers="br1 br2 bc1 bc7">10 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">3257 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">1450 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">40 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1767 </TD><TD class=alignRight headers="br1 br2 bc8 bc14">501 </TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc16">3758 </TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc17">16.9% </TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">1 </TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">0 </TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">0 </TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">1 </TD><TD class=alignRight headers="br1 br3 bc1 bc7">15 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1326 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">706 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">22 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">598 </TD><TD class=alignRight headers="br1 br3 bc8 bc14">757 </TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc16">2083 </TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc17">9.3% </TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">4 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">0 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">1 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">3 </TD><TD class=alignRight headers="br1 br4 bc1 bc7">22 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">5077 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">2807 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">45 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">2225 </TD><TD class=alignRight headers="br1 br4 bc8 bc14">907 </TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc16">5984 </TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc17">26.8% </TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">0 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">0 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">0 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">0 </TD><TD class=alignRight headers="br1 br5 bc1 bc7">38 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">4456 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">2387 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">60 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">2009 </TD><TD class=alignRight headers="br1 br5 bc8 bc14">1331 </TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc16">5787 </TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc17">26.0% </TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">5 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">0 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">2 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">3 </TD><TD class=alignRight headers="br1 br6 bc1 bc7">91 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">2567 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">1000 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">163 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">1404 </TD><TD class=alignRight headers="br1 br6 bc8 bc14">1968 </TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc16">4535 </TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc17">20.3% </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">136 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">102 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">21 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">13 </TD><TD class=alignRight headers="br1 br7 bc8 bc14">7 </TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc16">143 </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">11 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc4">1 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc5">3 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc6">7 </TD><TD class=alignRight headers="br1 br8 bc1 bc7">176 </TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">16819 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc11">8452 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc12">351 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc13">8016 </TD><TD class=alignRight headers="br1 br8 bc8 bc14">5471 </TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc16">22290 </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">5.9% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc4">9.1% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc5">27.3% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc6">63.6% </TD><TD class=alignRight headers="br1 br9 bc1 bc7">94.1% </TD><TD class=alignRight headers="br1 br9 bc8 bc9 bc10">75.5% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc11">50.3% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc12">2.1% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc13">47.7% </TD><TD class=alignRight headers="br1 br9 bc8 bc14">24.5% </TD><TD class=alignRight></TD><TD class=alignRight></TD></TR></TBODY></TABLE>

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      Influenza Strain Characterizations

      During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 1,970 influenza viruses [106 A(H3N2), 1,353 A(H1N1)pdm09 and 511 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. Twenty-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, 2013-2014, N = 1970

      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 1,714 influenza viruses for resistance to oseltamivir and all but three were sensitive. All 1,718 viruses tested for resistance to zanamivir were sensitive. All 1,511 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">84</TD><TD class=alignRight headers="cr1 cr2 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr2 cc4 cc5">84</TD><TD class=alignRight headers="cr1 cr2 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr2 cc7 cc8">129</TD><TD class=alignRight headers="cr1 cr2 cc7 cc9">129 (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">1288</TD><TD class=alignRight headers="cr1 cr3 cc1 cc3">3 (0.2%)</TD><TD class=alignRight headers="cr1 cr3 cc4 cc5">1293</TD><TD class=alignRight headers="cr1 cr3 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr3 cc7 cc8">1382</TD><TD class=alignRight headers="cr1 cr3 cc7 cc9">1382 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignRight headers="cr1 cr4 cc1 cc2">342</TD><TD class=alignRight headers="cr1 cr4 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr4 cc4 cc5">341</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">1714</TD><TD class=alignRight headers="cr1 cr5 cc1 cc3">3 (0.1%)</TD><TD class=alignRight headers="cr1 cr5 cc4 cc5">1718</TD><TD class=alignRight headers="cr1 cr5 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr5 cc7 cc8">1511</TD><TD class=alignRight headers="cr1 cr5 cc7 cc9">1511 (100%)</TD></TR></TBODY></TABLE>
      Influenza-like Illness (ILI) Consultation Rate

      The national influenza-like-illness (ILI) consultation rate decreased from 23.3 consultations per 1,000 patient visits in week 17 to 21.7 / 1,000 in week 18; which was slightly above the expected range for week 18 (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

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      Influenza Outbreak Surveillance

      The number of new influenza outbreaks increased sharply from eight in week 17 to 21 in week 18: 19 in long-term care facilities, one in a hospital (Figure 6), and one in another setting or community. However, overall laboratory detections of influenza declined in 5 of the 6 regions reporting outbreaks. Among the 21 influenza outbreaks, 12 had data on the influenza type, of which 10 were 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 18, the proportion of prescriptions for antivirals was similar to the previous week, in keeping with laboratory detections of influenza. The proportion of prescriptions for antivirals decreased among infants <2 years of age and increased among adults ≥65 years of age, although these rates are more variable. 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 (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

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      Sentinel Hospital Influenza Surveillance

      Paediatric Influenza Hospitalizations and Deaths (IMPACT)
      In week 18, five new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to nine in week 17. Four cases reported in week 18 had influenza B (Figure 8a). 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. One ICU admission was reported in week 18 in a child 5-9 years of age with influenza A(unsubtyped), and no deaths were reported.
      To date this season, a total of 684 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 81% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children <5 years of age represent 73% of cases to date (Table 4). Ninety-eight ICU admissions have been reported, of which 66 (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 95 ICU cases with available data, 61 (64%) were reported to have underlying medical conditions. No deaths have been reported. A slightly smaller number of paediatric hospital admissions have been reported this year compared to the 2012-13 season.
      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 18, nine 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 31 in week 17 (Figure 8b). Since the beginning of March the majority of hospitalizations have been associated with influenza B. This season, a significantly greater proportion of cases of influenza B have been ≥65 years of age compared to cases of A(H1N1)pdm09. The proportion of cases among adults ≥65 years of age has followed the distribution of influenza B, and has declined in recent weeks. No ICU admissions or deaths were reported in week 18.
      To date this season, 1,798 influenza-associated hospitalizations have been reported by the PCIRN-SOS network, 1,284 (71.4%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). Overall, slightly fewer cases have been reported this season compared to the 2012-13 season, however, nearly five times more cases of influenza B have been reported compared to last year. ICU admission was required for 291 hospitalizations, all but 43 of which were cases with influenza A (131 A(H1N1)pdm09, eight A(H3N2) and 109 A(unsubtyped)). A greater proportion of cases have been admitted to the ICU this season compared to last year, but the proportion of deaths has been similar. Of the 201 ICU admissions with available information, 172 (85.6%) were reported to have at least one comorbidity and of the 244 ICU admissions with available information 169 (69.3%) reported not having been vaccinated this season. Ninety-two deaths have been reported, all but 15 with influenza A (47 A(H1N1)pdm09, four A(H3N2) and 26 A(unsubtyped)); nine cases 20-44 years of age, 33 cases 45-64 years of age and 50 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 May 3, 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=alignRight headers="dr1 dr2 dc1 dc2 dc3">104 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc4">34 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc5">0 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc6">70 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc7">8 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc8">112 (16%) </TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc3">163 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc4">51 </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">21 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc8">184 (27%) </TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc3">166 </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">108 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc7">39 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc8">205 (30%) </TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc3">82 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc4">27 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc5">1 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc6">54 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc7">50 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc8">132 (19%) </TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc3">39 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc4">14 </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">12 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc8">51 (7%) </TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignRight headers="dr1 dr7 dc1 dc2 dc3">554 </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr7 dc1 dc2 dc4">181 </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr7 dc1 dc2 dc5">6 </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr7 dc1 dc2 dc6">367 </TD><TD class=alignRight headers="dr1 dr7 dc1 dc7">130 </TD><TD class=alignRight headers="dr1 dr7 dc1 dc8">684 </TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP> </TH><TD class=alignRight headers="dr1 dr8 dc1 dc2 dc3">81.0% </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr8 dc1 dc2 dc4">32.7% </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr8 dc1 dc2 dc5">1.1% </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr8 dc1 dc2 dc6">66.2% </TD><TD class=alignRight headers="dr1 dr8 dc1 dc7">19.0% </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 May 3, 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> Two cases for which the influenza type has not yet been reported, and six 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">5 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec5">0 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec6">8 </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">269 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec4">143 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec5">6 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec6">120 </TD><TD class=alignRight headers="er1 er3 ec1 ec7">37 </TD><TD class=alignRight headers="er1 er3 ec1 ec8">306 (17%) </TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignRight headers="er1 er4 ec1 ec2 ec3">498 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec4">236 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec5">10 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec6">252 </TD><TD class=alignRight headers="er1 er4 ec1 ec7">118 </TD><TD class=alignRight headers="er1 er4 ec1 ec8">616 (34%) </TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignRight headers="er1 er5 ec1 ec2 ec3">499 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec4">234 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec5">53 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec6">212 </TD><TD class=alignRight headers="er1 er5 ec1 ec7">354 </TD><TD class=alignRight headers="er1 er5 ec1 ec8">853 (48%) </TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignRight headers="er1 er6 ec1 ec2 ec3">1279 </TD><TD class="alignRight bg-colour-blue" headers="er1 er6 ec1 ec2 ec4">618 </TD><TD class="alignRight bg-colour-blue" headers="er1 er6 ec1 ec2 ec5">69 </TD><TD class="alignRight bg-colour-blue" headers="er1 er6 ec1 ec2 ec6">592 </TD><TD class=alignRight headers="er1 er6 ec1 ec7">511 </TD><TD class=alignRight headers="er1 er6 ec1 ec8">1790 </TD></TR><TR><TH id=er7 class=alignLeft headers=er1>%<SUP>1</SUP></TH><TD class=alignRight headers="er1 er7 ec1 ec2 ec3">71% </TD><TD class="alignRight bg-colour-blue" headers="er1 er7 ec1 ec2 ec4">48% </TD><TD class="alignRight bg-colour-blue" headers="er1 er7 ec1 ec2 ec5">5% </TD><TD class="alignRight bg-colour-blue" headers="er1 er7 ec1 ec2 ec6">46% </TD><TD class=alignRight headers="er1 er7 ec1 ec7">29% </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 18, 206 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories<SUP>*</SUP>. As with other surveillance indicators in week 18, the majority were cases of influenza B (171, 83.0%). One ICU admission was reported in week 18, an adult 45-64 years of age with influenza A(H1N1)pdm09. Thirteen deaths were reported this week; two adults 45-64 years of age and 11 adults ≥65 years of age, 12 of the 13 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, 4,623 influenza-associated hospitalizations have been reported, 77.6% with influenza A. The majority (60.8%) 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 351 ICU admissions have been reported this season, of which 65.5% were adults 20-64 years of age. A total of 258 deaths have been reported. The highest proportion of deaths has been among adults ≥65 years of age (49.6%) followed by adults 20-64 years of age (41.9%). 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 22.4% of hospitalizations and 21.3% 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 May 3, 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=alignRight headers="fr1 fr2 fc1 fc2 fc3">614 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc4">287 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc5">12 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc6">315 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc7">105 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc8">719 (16%) </TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years</TH><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc3">134 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc4">65 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc5">6 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc6">63 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc7">93 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc8">227 (5%) </TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years</TH><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc3">36 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc4">21 </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">5 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc8">41 (1%) </TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc3">608 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc4">423 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc5">4 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc6">181 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc7">63 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc8">671 (15%) </TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc3">1117 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc4">704 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc5">30 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc6">383 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc7">201 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc8">1318 (29%) </TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc3">942 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc4">465 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc5">98 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc6">379 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc7">553 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc8">1495 (32%) </TD></TR><TR><TH id=fr10 class=alignLeft headers=fr1>Unknown</TH><TD class=alignRight headers="fc1 fc2 fc3">136 </TD><TD class=alignRight headers="fc1 fc2 fc4">99 </TD><TD class=alignRight headers="fc1 fc2 fc5">3 </TD><TD class=alignRight headers="fc1 fc2 fc6">34 </TD><TD class=alignRight headers="fc1 fc7">16 </TD><TD class=alignRight headers="fc1 fc8">152 (3%) </TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignRight headers="fr1 fr8 fc1 fc2 fc3">3587 </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr8 fc1 fc2 fc4">2064 </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr8 fc1 fc2 fc5">156 </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr8 fc1 fc2 fc6">1367 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc7">1036 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc8">4623 </TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP> </TH><TD class=alignRight headers="fr1 fr9 fc1 fc2 fc3">77.6% </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr9 fc1 fc2 fc4">57.5% </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr9 fc1 fc2 fc5">4.3% </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr9 fc1 fc2 fc6">38.1% </TD><TD class=alignRight headers="fr1 fr9 fc1 fc7">22.4% </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


      • #33
        Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 19

        FluWatch report: May 4 to May 10, 2014 (Week 19)

        Posted 2014-05-16For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
        <A title="Flu Watch (Version PDF, 113 KB - 6 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/13-14/w19_14/pdf/fw2014-19-eng.pdf">FluWatch report: May 4 to May 10, 2014 (Week 19) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 291 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

        Help with PDF documents

        Overall Summary
        • In week 19, influenza B continued to circulate in several regions across Canada, but levels are stable or declining. Late-season influenza B activity is past its peak, and remains within expected levels for this time of year. Influenza A activity has been steadily declining over the last four weeks.
        • Influenza B is having a greater impact on adults 65 years of age and older and young persons 5 to 19 years of age, compared to influenza A(H1N1) which circulated earlier in the year.
        • As of week 19, 4,731 hospitalizations and 275 deaths have been reported from participating regions, which is fewer than were reported last year.
        Influenza/ILI Activity (geographic spread)

        In week 19, no region reported widespread activity and eight regions reported localized activity, including all seven regions in Ontario and one region in Quebec (Figure 1). Two provinces did not report data for week 19, but both have reported only sporadic or no activity since early February.
        Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 19





        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 445 in week 18 to 401 (11.0% of tests) in week 19. Nationally, late-season circulation of influenza B peaked in week 15 and continues to decline (Figure 2). Influenza B remained the predominant virus in week 19, representing 92% of influenza detections. Most jurisdictions have reported stable or declining levels of influenza detections over recent weeks (Table 1). 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. Among cases for which information on age and type/subtype has been received, 38% of the cases in week 19 were ≥65 years of age compared to 21% of cases for the season to date (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, coronavirus, human metapneumovirus, and rhinovirus has continued to decline in recent weeks. The number of positive tests for parainfluenza and adenovirus have been following a general upward trend in recent weeks, in keeping with their broader year-round circulation (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 margin10px">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
        (May 4 to 10, 2014)</TH><TH id=ac8 colSpan=5>Cumulative
        (August 25, 2013 to May 10, 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=alignRight headers="ar1 ar2 ac1 ac2 ac3">7</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">6</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">1</TD><TD class=alignRight headers="ar1 ar2 ac1 ac7">20</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac10">1820</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac11">1616</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac12">63</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac13">141</TD><TD class=alignRight headers="ar1 ar2 ac8 ac14">344</TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">6</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">1</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">3</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">2</TD><TD class=alignRight headers="ar1 ar3 ac1 ac7">38</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac10">3852</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac11">3455</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac12">81</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac13">316</TD><TD class=alignRight headers="ar1 ar3 ac8 ac14">422</TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac7">22</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac10">1383</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac11">988</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac12">8</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac13">387</TD><TD class=alignRight headers="ar1 ar4 ac8 ac14">156</TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">2</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">1</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">7</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac10">682</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac11">463</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac12">5</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac13">214</TD><TD class=alignRight headers="ar1 ar5 ac8 ac14">47</TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">11</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">1</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">7</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">3</TD><TD class=alignRight headers="ar1 ar6 ac1 ac7">211</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac10">5739</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac11">2490</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac12">371</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac13">2878</TD><TD class=alignRight headers="ar1 ar6 ac8 ac14">2881</TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">4</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">4</TD><TD class=alignRight headers="ar1 ar7 ac1 ac7">48</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac10">5357</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac11">677</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac12">5</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac13">4675</TD><TD class=alignRight headers="ar1 ar7 ac8 ac14">2649</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">100</TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac7">6</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac10">174</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">36</TD><TD class=alignRight headers="ar1 ar9 ac8 ac14">39</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">119</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac11">118</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">2</TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">2</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac6">2</TD><TD class=alignRight headers="ar1 ar11 ac1 ac7">10</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac10">373</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">269</TD><TD class=alignRight headers="ar1 ar11 ac8 ac14">236</TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">32</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac4">3</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac5">16</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac6">13</TD><TD class=alignRight headers="ar1 ar12 ac1 ac7">369</TD><TD class=alignRight headers="ar1 ar12 ac8 ac9 ac10">20987</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac11">10415</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac12">538</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac13">10034</TD><TD class=alignRight headers="ar1 ar12 ac8 ac14">6876</TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="ar1 ar13 ac1 ac2 ac3">8.0%</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac4">9.4%</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac5">50.0%</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac6">40.6%</TD><TD class=alignRight headers="ar1 ar13 ac1 ac7">92.0%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac9 ac10">75.3%</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac11">49.6%</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac12">2.6%</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac13">47.8%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac14">24.7%</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
        (May 4 to May 10, 2014)</TH><TH id=bc8 colSpan=7>Cumulative
        (August 25, 2013 to May 10, 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=alignRight headers="br1 br2 bc1 bc2 bc3">0</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">0</TD><TD class=alignRight headers="br1 br2 bc1 bc7">5</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">3260</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">1451</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">39</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1770</TD><TD class=alignRight headers="br1 br2 bc8 bc14">515</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc16">3775</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc17">16.7%</TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">2</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">2</TD><TD class=alignRight headers="br1 br3 bc1 bc7">7</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1329</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">707</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">23</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">599</TD><TD class=alignRight headers="br1 br3 bc8 bc14">777</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc16">2106</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc17">9.3%</TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">4</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">2</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">2</TD><TD class=alignRight headers="br1 br4 bc1 bc7">27</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">5080</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">2811</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">43</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">2226</TD><TD class=alignRight headers="br1 br4 bc8 bc14">960</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc16">6040</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc17">26.7%</TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">3</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">2</TD><TD class=alignRight headers="br1 br5 bc1 bc7">46</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">4464</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">2388</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">62</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">2014</TD><TD class=alignRight headers="br1 br5 bc8 bc14">1408</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc16">5872</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc17">26.0%</TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">10</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">3</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">7</TD><TD class=alignRight headers="br1 br6 bc1 bc7">49</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">2578</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">1000</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">165</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">1413</TD><TD class=alignRight headers="br1 br6 bc8 bc14">2084</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc16">4662</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc17">20.6%</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">137</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">102</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">22</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">13</TD><TD class=alignRight headers="br1 br7 bc8 bc14">9</TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc16">146</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">20</TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc4">2</TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc5">5</TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc6">13</TD><TD class=alignRight headers="br1 br8 bc1 bc7">134</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">16848</TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc11">8459</TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc12">354</TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc13">8035</TD><TD class=alignRight headers="br1 br8 bc8 bc14">5753</TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc16">22601</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">13.0%</TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc4">10.0%</TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc5">25.0%</TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc6">65.0%</TD><TD class=alignRight headers="br1 br9 bc1 bc7">87.0%</TD><TD class=alignRight headers="br1 br9 bc8 bc9 bc10">74.5%</TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc11">50.2%</TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc12">2.1%</TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc13">47.7%</TD><TD class=alignRight headers="br1 br9 bc8 bc14">25.5%</TD><TD class=alignRight></TD><TD class=alignRight></TD></TR></TBODY></TABLE>

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        Influenza Strain Characterizations

        During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 2,039 influenza viruses [112 A(H3N2), 1,366 A(H1N1)pdm09 and 561 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, and one A(H3N2) virus showed reduced titres to antiserum against the reference A/Texas/50/2012 strain. Twenty-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, 2013-2014, N = 2,039

        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 1,796 influenza viruses for resistance to oseltamivir and all but five were sensitive. All 1,796 viruses tested for resistance to zanamivir were sensitive. All 1,556 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">92</TD><TD class=alignRight headers="cr1 cr2 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr2 cc4 cc5">92</TD><TD class=alignRight headers="cr1 cr2 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr2 cc7 cc8">143</TD><TD class=alignRight headers="cr1 cr2 cc7 cc9">143 (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">1320</TD><TD class=alignRight headers="cr1 cr3 cc1 cc3">5 (0.4%)</TD><TD class=alignRight headers="cr1 cr3 cc4 cc5">1321</TD><TD class=alignRight headers="cr1 cr3 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr3 cc7 cc8">1413</TD><TD class=alignRight headers="cr1 cr3 cc7 cc9">1413 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignRight headers="cr1 cr4 cc1 cc2">384</TD><TD class=alignRight headers="cr1 cr4 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr4 cc4 cc5">383</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">1796</TD><TD class=alignRight headers="cr1 cr5 cc1 cc3">5 (0.3%)</TD><TD class=alignRight headers="cr1 cr5 cc4 cc5">1796</TD><TD class=alignRight headers="cr1 cr5 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr5 cc7 cc8">1556</TD><TD class=alignRight headers="cr1 cr5 cc7 cc9">1556 (100%)</TD></TR></TBODY></TABLE>
        Influenza-like Illness (ILI) Consultation Rate

        The national influenza-like-illness (ILI) consultation rate was similar to the previous week at 20.2 consultations per 1,000 patient visits in week 19; which was slightly above the expected range for week 19 (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

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        Influenza Outbreak Surveillance

        The number of new influenza outbreaks decreased from 21 in week 18 to seven in week 19 (Figure 6). All were in long-term care facilities and six of the seven outbreaks were influenza B. The 7th was an outbreak of influenza A(unsubtyped). Two provinces did not report data for week 19.
        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 19, the proportion of prescriptions for antivirals declined, in keeping with laboratory detections of influenza. 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 (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

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        Sentinel Hospital Influenza Surveillance

        Paediatric Influenza Hospitalizations and Deaths (IMPACT)
        In week 19, seven new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to six in week 18. Six cases reported in week 19 had influenza B (Figure 8a). 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. Two ICU admissions were reported in week 19 both children 6-23 months of age with influenza B, and no deaths were reported.
        To date this season, a total of 689 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 80% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children <5 years of age represent 73% of cases to date (Table 4). One hundred and five ICU admissions have been reported, of which 70 (67%) were children <5 years of age (Figure 9a). All but 13 were cases with influenza A, and 97% of those subtyped were A(H1N1)pdm09. Among the 102 ICU cases with available data, 65 (64%) were reported to have underlying medical conditions. No deaths have been reported. A smaller number of paediatric hospital admissions have been reported this year compared to the 2012-13 season.
        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 19, 14 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 15 in week 18 (Figure 8b). Since the beginning of March the majority of hospitalizations have been associated with influenza B. This season, a significantly greater proportion of cases of influenza B have been ≥65 years of age compared to cases of A(H1N1)pdm09. Two ICU admissions were reported in week 19, one adult 45-64 years of age and one ≥65 years of age, both with influenza A(unsubtyped). No deaths were reported in week 19.
        To date this season, 1,862 influenza-associated hospitalizations have been reported by the PCIRN-SOS network, 1,308 (70.2%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). Compared to the 2012-13 season, slightly more cases have been reported, although the peak number of cases was smaller. A greater number of cases have been reported during March and April compared to last year, with five times more cases of influenza B reported to date. ICU admission was required for 300 hospitalizations, all but 44 of which were cases with influenza A (133 A(H1N1)pdm09, eight A(H3N2) and 114 A(unsubtyped)). A greater proportion of cases have been admitted to the ICU this season compared to last year, but the proportion of deaths has been similar. Of the ICU admissions with available information, 85.0% (176/207) were reported to have at least one comorbidity, and 69.0% (171/248) reported not having been vaccinated this season. Ninety-nine deaths have been reported, all but 18 with influenza A (51 A(H1N1)pdm09, three A(H3N2) and 27 A(unsubtyped)); nine cases 20-44 years of age, 35 cases 45-64 years of age and 55 cases ≥65 years of age (Figure 9b). Among fatal cases with available information, 47.4% (36/76) were reported to have at least one comorbidity, and 93.2% (55/59) reported not having been vaccinated this season.
        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 May 10, 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=alignRight headers="dr1 dr2 dc1 dc2 dc3">103 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc4">35 </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">8 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc8">111 (16%) </TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc3">162 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc4">56 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc5">1 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc6">105 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc7">25 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc8">187 (27%) </TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc3">165 </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">107 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc7">42 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc8">207 (30%) </TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc3">82 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc4">27 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc5">1 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc6">54 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc7">50 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc8">132 (19%) </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">14 </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">12 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc8">52 (8%) </TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignRight headers="dr1 dr7 dc1 dc2 dc3">552 </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr7 dc1 dc2 dc4">187 </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr7 dc1 dc2 dc5">6 </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr7 dc1 dc2 dc6">359 </TD><TD class=alignRight headers="dr1 dr7 dc1 dc7">137 </TD><TD class=alignRight headers="dr1 dr7 dc1 dc8">689 </TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP> </TH><TD class=alignRight headers="dr1 dr8 dc1 dc2 dc3">80.1% </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr8 dc1 dc2 dc4">33.9% </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr8 dc1 dc2 dc5">1.1% </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr8 dc1 dc2 dc6">65.0% </TD><TD class=alignRight headers="dr1 dr8 dc1 dc7">19.9% </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 May 10, 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> Two cases for which the influenza type has not yet been reported, and six 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">12 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec4">5 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec5">0 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec6">7 </TD><TD class=alignRight headers="er1 er2 ec1 ec7">2 </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">271 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec4">142 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec5">6 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec6">123 </TD><TD class=alignRight headers="er1 er3 ec1 ec7">41 </TD><TD class=alignRight headers="er1 er3 ec1 ec8">312 (17%) </TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignRight headers="er1 er4 ec1 ec2 ec3">509 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec4">239 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec5">9 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec6">261 </TD><TD class=alignRight headers="er1 er4 ec1 ec7">123 </TD><TD class=alignRight headers="er1 er4 ec1 ec8">632 (34%) </TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignRight headers="er1 er5 ec1 ec2 ec3">511 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec4">236 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec5">54 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec6">221 </TD><TD class=alignRight headers="er1 er5 ec1 ec7">385 </TD><TD class=alignRight headers="er1 er5 ec1 ec8">896 (48%) </TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignRight headers="er1 er6 ec1 ec2 ec3">1303 </TD><TD class="alignRight bg-colour-blue" headers="er1 er6 ec1 ec2 ec4">622 </TD><TD class="alignRight bg-colour-blue" headers="er1 er6 ec1 ec2 ec5">69 </TD><TD class="alignRight bg-colour-blue" headers="er1 er6 ec1 ec2 ec6">612 </TD><TD class=alignRight headers="er1 er6 ec1 ec7">551 </TD><TD class=alignRight headers="er1 er6 ec1 ec8">1854 </TD></TR><TR><TH id=er7 class=alignLeft headers=er1>%<SUP>1</SUP></TH><TD class=alignRight headers="er1 er7 ec1 ec2 ec3">70% </TD><TD class="alignRight bg-colour-blue" headers="er1 er7 ec1 ec2 ec4">48% </TD><TD class="alignRight bg-colour-blue" headers="er1 er7 ec1 ec2 ec5">5% </TD><TD class="alignRight bg-colour-blue" headers="er1 er7 ec1 ec2 ec6">47% </TD><TD class=alignRight headers="er1 er7 ec1 ec7">30% </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)

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        Provincial/Territorial Influenza Hospitalizations and Deaths

        In week 19, 104 laboratory-confirmed influenza-associated hospitalizations were reported from seven of the nine participating provinces and territories<SUP>*</SUP>. As with other surveillance indicators in week 19, the majority were cases of influenza B (92, 88.5%). No ICU admissions were reported in week 19. Fourteen deaths were reported this week: one child under 6 months of age, one adult 45-64 years of age and 12 adults ≥65 years of age; 11 of the 14 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, 4,731 influenza-associated hospitalizations have been reported, 76.1% with influenza A. The majority (61.1%) 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 353 ICU admissions have been reported this season, of which 65.4% were adults 20-64 years of age. A total of 275 deaths have been reported. The highest proportion of deaths has been among adults ≥65 years of age (51.2%) followed by adults 20-64 years of age (39.6%). 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 23.9% of hospitalizations and 25.1% 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 May 10, 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=alignRight headers="fr1 fr2 fc1 fc2 fc3">616 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc4">287 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc5">12 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc6">317 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc7">111 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc8">727 (15%) </TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years</TH><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc3">134 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc4">65 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc5">6 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc6">63 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc7">102 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc8">236 (5%) </TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years</TH><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc3">36 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc4">21 </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">5 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc8">41 (1%) </TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc3">613 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc4">424 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc5">5 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc6">184 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc7">68 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc8">681 (14%) </TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc3">1118 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc4">704 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc5">30 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc6">384 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc7">216 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc8">1334 (28%) </TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc3">947 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc4">467 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc5">100 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc6">380 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc7">610 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc8">1557 (33%) </TD></TR><TR><TH id=fr10 class=alignLeft headers=fr1>Unknown</TH><TD class=alignRight headers="fc1 fc2 fc3">136 </TD><TD class=alignRight headers="fc1 fc2 fc4">99 </TD><TD class=alignRight headers="fc1 fc2 fc5">3 </TD><TD class=alignRight headers="fc1 fc2 fc6">34 </TD><TD class=alignRight headers="fc1 fc7">19 </TD><TD class=alignRight headers="fc1 fc8">155 (3%) </TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignRight headers="fr1 fr8 fc1 fc2 fc3">3600 </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr8 fc1 fc2 fc4">2067 </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr8 fc1 fc2 fc5">159 </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr8 fc1 fc2 fc6">1374 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc7">1131 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc8">4731 </TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP> </TH><TD class=alignRight headers="fr1 fr9 fc1 fc2 fc3">76.1% </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr9 fc1 fc2 fc4">57.4% </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr9 fc1 fc2 fc5">4.4% </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr9 fc1 fc2 fc6">38.2% </TD><TD class=alignRight headers="fr1 fr9 fc1 fc7">23.9% </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


        • #34
          Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 20

          FluWatch report: May 11 to May 17, 2014 (Week 20)

          Posted 2014-05-23For 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/w20_14/pdf/fw2014-20-eng.pdf">FluWatch report: May 11 to May 17, 2014 (Week 20) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 291 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

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          Overall Summary
          • In week 20, influenza activity in Canada continued to decline, although some regions reported small increases in circulation of influenza B. Late-season influenza B activity is past its peak, and remains within expected levels for this time of year. Influenza A activity has been steadily declining over the last five weeks.
          • Influenza B is having a greater impact on adults 65 years of age and older and young persons 5 to 19 years of age, compared to influenza A(H1N1) which circulated earlier in the year.
          • As of week 20, 4,862 hospitalizations and 291 deaths have been reported from participating regions, which is fewer than were reported last year.
          Note: This is the final weekly report for the 2013-14 influenza season. Fortnightly reports will commence on June 6th (for weeks 21 and 22). However, laboratory detections reported through the RVDSS and influenza activity level maps will be updated weekly on the FluWatch website.

          Are you a primary health care practitioner (General Practitioner, Nurse Practitioner or Registered Nurse) interested in becoming a FluWatch sentinel for the 2014-15 influenza season? Contact us at FluWatch@phac-aspc.gc.ca
          Influenza/ILI Activity (geographic spread)

          In week 20, one region in Newfoundland & Labrador reported widespread activity and nine regions reported localized activity (MB(1), ON(6), QC(1), and NL(1)) (Figure 1).
          Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 20





          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 400 in week 19 to 283 (9.2% of tests) in week 20. Nationally, late-season circulation of influenza B peaked in week 15 and continues to decline (Figure 2). Influenza B remained the predominant virus in week 20, representing 83% of influenza detections. Most jurisdictions have reported stable or declining levels of influenza detections over recent weeks, although slight increases were reported in week 20 in AB, SK and NL (Table 1). 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. Among cases for which information on age and type/subtype has been received, 43% of the cases in week 20 were ≥65 years of age compared to 21% of cases for the season to date (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, coronavirus, human metapneumovirus, and rhinovirus has continued to decline in recent weeks. The number of positive tests for parainfluenza has been following a general upward trend in recent weeks, and detections of adenovirus have been variable but declining over the past two weeks. These viruses show broader year-round circulation (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


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          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 margin10px">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
          (May 11 to 17, 2014)</TH><TH id=ac8 colSpan=5>Cumulative
          (August 25, 2013 to May 17, 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">0 </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">0 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac7">11 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac10">1,807 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac11">1,614 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac12">53 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac13">140 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac14">362 </TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac3">18 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac4">5 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac5">7 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac6">6 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac7">43 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac10">3,871 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac11">3,460 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac12">90 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac13">321 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac14">465 </TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac3">0 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac4">0 </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">23 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac10">1,383 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac11">988 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac12">8 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac13">387 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac14">179 </TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac3">0 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac6">0 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac7">0 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac10">682 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac11">463 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac12">5 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac13">214 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac14">47 </TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac3">18 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac5">8 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac6">10 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac7">104 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac10">5,757 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac11">2,490 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac12">380 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac13">2,887 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac14">2,984 </TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac3">6 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac6">6 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac7">35 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac10">5,363 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac11">677 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac12">5 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac13">4,681 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac14">2,684 </TD></TR><TR><TH id=ar8 class=alignLeft headers=ar1>NB</TH><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac3">2 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac5">1 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac6">1 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac7">4 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac10">1,490 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac11">370 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac12">2 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac13">1,118 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac14">104 </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">1 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac6">0 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac7">4 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac10">175 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac11">134 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac12">5 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac13">36 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac14">43 </TD></TR><TR><TH id=ar10 class=alignLeft headers=ar1>PE</TH><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac3">-- </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac4">-- </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac5">-- </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac6">-- </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac7">-- </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac10">119 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac11">118 </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">2 </TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac3">4 </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">4 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac7">10 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac10">377 </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">273 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac14">246 </TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignCenter headers="ar1 ar12 ac1 ac2 ac3">49 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac1 ac2 ac4">5 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac1 ac2 ac5">17 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac1 ac2 ac6">27 </TD><TD class=alignCenter headers="ar1 ar12 ac1 ac7">234 </TD><TD class=alignCenter headers="ar1 ar12 ac8 ac9 ac10">21,024 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac8 ac9 ac11">10,418 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac8 ac9 ac12">548 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac8 ac9 ac13">10,058 </TD><TD class=alignCenter headers="ar1 ar12 ac8 ac14">7,116 </TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignCenter headers="ar1 ar13 ac1 ac2 ac3">17.3% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac1 ac2 ac4">10.2% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac1 ac2 ac5">34.7% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac1 ac2 ac6">55.1% </TD><TD class=alignCenter headers="ar1 ar13 ac1 ac7">82.7% </TD><TD class=alignCenter headers="ar1 ar13 ac8 ac9 ac10">74.7% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac8 ac9 ac11">49.6% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac8 ac9 ac12">2.6% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac8 ac9 ac13">47.8% </TD><TD class=alignCenter headers="ar1 ar13 ac8 ac14">25.3% </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
          (May 11 to May 17, 2014)</TH><TH id=bc8 colSpan=7>Cumulative
          (August 25, 2013 to May 17, 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">2 </TD><TD class=alignCenter headers="br1 br2 bc1 bc2 bc4">0 </TD><TD class=alignCenter headers="br1 br2 bc1 bc2 bc5">2 </TD><TD class=alignCenter headers="br1 br2 bc1 bc2 bc6">0 </TD><TD class=alignCenter headers="br1 br2 bc1 bc7">12 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc10">3,264 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc11">1,451 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc12">44 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc13">1,769 </TD><TD class=alignCenter headers="br1 br2 bc8 bc14">532 </TD><TD class=alignCenter headers="br1 br2 bc8 bc15 bc16">3,796 </TD><TD class=alignCenter headers="br1 br2 bc8 bc15 bc17">16.6% </TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignCenter headers="br1 br3 bc1 bc2 bc3">1 </TD><TD class=alignCenter headers="br1 br3 bc1 bc2 bc4">0 </TD><TD class=alignCenter headers="br1 br3 bc1 bc2 bc5">0 </TD><TD class=alignCenter headers="br1 br3 bc1 bc2 bc6">1 </TD><TD class=alignCenter headers="br1 br3 bc1 bc7">20 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc10">1,331 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc11">707 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc12">25 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc13">599 </TD><TD class=alignCenter headers="br1 br3 bc8 bc14">807 </TD><TD class=alignCenter headers="br1 br3 bc8 bc15 bc16">2,138 </TD><TD class=alignCenter headers="br1 br3 bc8 bc15 bc17">9.4% </TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignCenter headers="br1 br4 bc1 bc2 bc3">5 </TD><TD class=alignCenter headers="br1 br4 bc1 bc2 bc4">5 </TD><TD class=alignCenter headers="br1 br4 bc1 bc2 bc5">0 </TD><TD class=alignCenter headers="br1 br4 bc1 bc2 bc6">0 </TD><TD class=alignCenter headers="br1 br4 bc1 bc7">17 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc10">5,089 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc11">2,817 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc12">46 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc13">2,226 </TD><TD class=alignCenter headers="br1 br4 bc8 bc14">989 </TD><TD class=alignCenter headers="br1 br4 bc8 bc15 bc16">6,078 </TD><TD class=alignCenter headers="br1 br4 bc8 bc15 bc17">26.6% </TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignCenter headers="br1 br5 bc1 bc2 bc3">3 </TD><TD class=alignCenter headers="br1 br5 bc1 bc2 bc4">0 </TD><TD class=alignCenter headers="br1 br5 bc1 bc2 bc5">1 </TD><TD class=alignCenter headers="br1 br5 bc1 bc2 bc6">2 </TD><TD class=alignCenter headers="br1 br5 bc1 bc7">36 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc10">4,470 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc11">2,389 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc12">64 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc13">2,017 </TD><TD class=alignCenter headers="br1 br5 bc8 bc14">1,460 </TD><TD class=alignCenter headers="br1 br5 bc8 bc15 bc16">5,930 </TD><TD class=alignCenter headers="br1 br5 bc8 bc15 bc17">26.0% </TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignCenter headers="br1 br6 bc1 bc2 bc3">17 </TD><TD class=alignCenter headers="br1 br6 bc1 bc2 bc4">0 </TD><TD class=alignCenter headers="br1 br6 bc1 bc2 bc5">9 </TD><TD class=alignCenter headers="br1 br6 bc1 bc2 bc6">8 </TD><TD class=alignCenter headers="br1 br6 bc1 bc7">56 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc10">2,598 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc11">1,000 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc12">174 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc13">1,424 </TD><TD class=alignCenter headers="br1 br6 bc8 bc14">2,162 </TD><TD class=alignCenter headers="br1 br6 bc8 bc15 bc16">4,760 </TD><TD class=alignCenter headers="br1 br6 bc8 bc15 bc17">20.8% </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">137 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc11">102 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc12">22 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc13">13 </TD><TD class=alignCenter headers="br1 br7 bc8 bc14">9 </TD><TD class=alignCenter headers="br1 br7 bc8 bc15 bc16">146 </TD><TD class=alignCenter headers="br1 br7 bc8 bc15 bc17">0.6% </TD></TR><TR><TH id=br8 class=alignLeft headers=br1>Total</TH><TD class=alignCenter headers="br1 br8 bc1 bc2 bc3">28 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc1 bc2 bc4">5 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc1 bc2 bc5">12 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc1 bc2 bc6">11 </TD><TD class=alignCenter headers="br1 br8 bc1 bc7">141 </TD><TD class=alignCenter headers="br1 br8 bc8 bc9 bc10">16,889 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc8 bc9 bc11">8,466 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc8 bc9 bc12">375 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc8 bc9 bc13">8,048 </TD><TD class=alignCenter headers="br1 br8 bc8 bc14">5,959 </TD><TD class=alignCenter headers="br1 br8 bc8 bc15 bc16">22,848 </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">16.6% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc1 bc2 bc4">17.9% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc1 bc2 bc5">42.9% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc1 bc2 bc6">39.3% </TD><TD class=alignCenter headers="br1 br9 bc1 bc7">83.4% </TD><TD class=alignCenter headers="br1 br9 bc8 bc9 bc10">73.9% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc8 bc9 bc11">50.1% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc8 bc9 bc12">2.2% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc8 bc9 bc13">47.7% </TD><TD class=alignCenter headers="br1 br9 bc8 bc14">26.1% </TD><TD class=alignCenter></TD><TD class=alignCenter></TD></TR></TBODY></TABLE>

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          Influenza Strain Characterizations

          During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 2,052 influenza viruses [114 A(H3N2), 1,367 A(H1N1)pdm09 and 571 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, and one A(H3N2) virus showed reduced titres to antiserum against the reference A/Texas/50/2012 strain. Twenty-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, 2013-2014, N = 2052

          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 1,883 influenza viruses for resistance to oseltamivir and all but five were sensitive. All 1,796 viruses tested for resistance to zanamivir were sensitive. All 1,570 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">95</TD><TD class=alignCenter headers="cr1 cr2 cc1 cc3">0</TD><TD class=alignCenter headers="cr1 cr2 cc4 cc5">92</TD><TD class=alignCenter headers="cr1 cr2 cc4 cc6">0</TD><TD class=alignCenter headers="cr1 cr2 cc7 cc8">150</TD><TD class=alignCenter headers="cr1 cr2 cc7 cc9">150 (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">1338</TD><TD class=alignCenter headers="cr1 cr3 cc1 cc3">5 (0.4%)</TD><TD class=alignCenter headers="cr1 cr3 cc4 cc5">1321</TD><TD class=alignCenter headers="cr1 cr3 cc4 cc6">0</TD><TD class=alignCenter headers="cr1 cr3 cc7 cc8">1420</TD><TD class=alignCenter headers="cr1 cr3 cc7 cc9">1420 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignCenter headers="cr1 cr4 cc1 cc2">450</TD><TD class=alignCenter headers="cr1 cr4 cc1 cc3">0</TD><TD class=alignCenter headers="cr1 cr4 cc4 cc5">383</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">1883</TD><TD class=alignCenter headers="cr1 cr5 cc1 cc3">5 (0.3%)</TD><TD class=alignCenter headers="cr1 cr5 cc4 cc5">1796</TD><TD class=alignCenter headers="cr1 cr5 cc4 cc6">0</TD><TD class=alignCenter headers="cr1 cr5 cc7 cc8">1570</TD><TD class=alignCenter headers="cr1 cr5 cc7 cc9">1570 (100%)</TD></TR></TBODY></TABLE>
          Influenza-like Illness (ILI) Consultation Rate

          The national influenza-like-illness (ILI) consultation rate decreased from 20.2 consultations per 1,000 patient visits in week 19 to 17.2 per 1,000 in week 20; which was within the expected range for week 20 (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

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          Influenza Outbreak Surveillance

          The number of new influenza outbreaks decreased from eight in week 19 to four in week 20. Three of the four were in long-term care facilities (Figure 6) and the fourth was in another type of facility or community setting. Two of the four outbreaks for which the influenza type was identified were influenza B. One additional outbreak of ILI was reported in another type of facility or community setting.
          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 20, the proportion of prescriptions for antivirals was the same as the previous week, in keeping with laboratory detections of influenza. 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 (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

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          Sentinel Hospital Influenza Surveillance

          Paediatric Influenza Hospitalizations and Deaths (IMPACT)
          In week 20, two new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to seven in week 19. Both cases reported in week 20 had influenza B (Figure 8a). 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. One ICU admission was reported in week 20 of a child 2-4 years of age with influenza B, and no deaths were reported.
          To date this season, a total of 692 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 80% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children <5 years of age represent 73% of cases to date (Table 4). One hundred and six ICU admissions have been reported, of which 70 (66%) were children <5 years of age (Figure 9a). All but 14 were cases with influenza A, and 97% of those subtyped were A(H1N1)pdm09. Among the 103 ICU cases with available data, 66 (64%) were reported to have underlying medical conditions. No deaths have been reported. A smaller number of paediatric hospital admissions have been reported this year compared to the 2012-13 season.
          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 20, six 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 23 in week 19 (Figure 8b). May 15th marked the end of the active surveillance period for PCIRN-SOS. Since the beginning of March the majority of hospitalizations have been associated with influenza B, and the total number of cases has been declining since mid-April. No ICU admissions or deaths were reported in week 20.
          To date this season, 1,919 influenza-associated hospitalizations have been reported by the PCIRN-SOS network, 1,320 (68.8%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). Compared to the 2012-13 season, slightly more cases have been reported, although the peak number of cases was smaller. A greater number of cases have been reported during March and April compared to last year, with nearly six times more cases of influenza B reported to date. ICU admission was required for 307 hospitalizations, of which 259 were cases with influenza A (134 A(H1N1)pdm09, nine A(H3N2) and 116 A(unsubtyped)), 47 were cases with influenza B and the influenza type was not reported for one case. A greater proportion of cases have been admitted to the ICU this season compared to last year, but the proportion of deaths has been similar. Of the ICU admissions with available information, 85.5% (183/214) were reported to have at least one comorbidity, and 69.2% (173/250) reported not having been vaccinated this season. Among the 104 deaths reported this season, all but 22 have been cases of influenza A (51 A(H1N1)pdm09, three A(H3N2) and 28 A(unsubtyped)); ten cases 20-44 years of age, 36 cases 45-64 years of age and 58 cases ≥65 years of age (Figure 9b). Among fatal cases with available information, 93.3% (56/60) were reported to have at least one comorbidity, and 49.4% (39/79) reported not having been vaccinated this season.
          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 May 17, 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">104 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc4">36 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc5">0 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc6">68 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc7">8 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc8">112 (16%) </TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc3">162 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc4">56 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc5">1 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc6">105 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc7">25 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc8">187 (27%) </TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc3">165 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc4">55 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc5">3 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc6">107 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc7">43 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc8">208 (30%) </TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc3">82 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc4">28 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc5">1 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc6">53 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc7">51 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc8">133 (19%) </TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc3">40 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc4">14 </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">12 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc8">52 (8%) </TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignCenter headers="dr1 dr7 dc1 dc2 dc3">553</TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc4">189 </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc5">6 </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc6">358 </TD><TD class=alignCenter headers="dr1 dr7 dc1 dc7">139 </TD><TD class=alignCenter headers="dr1 dr7 dc1 dc8">692 </TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP> </TH><TD class=alignCenter headers="dr1 dr8 dc1 dc2 dc3">79.9% </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc4">34.2% </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc5">1.1% </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc6">64.7% </TD><TD class=alignCenter headers="dr1 dr8 dc1 dc7">20.1% </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 May 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=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> Two 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=alignCenter headers="er1 er2 ec1 ec2 ec3">12 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec4">5 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec5">0 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec6">7 </TD><TD class=alignCenter headers="er1 er2 ec1 ec7">3 </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">272 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec4">142 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec5">6 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec6">124 </TD><TD class=alignCenter headers="er1 er3 ec1 ec7">44 </TD><TD class=alignCenter headers="er1 er3 ec1 ec8">316 (17%) </TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignCenter headers="er1 er4 ec1 ec2 ec3">516 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec4">240 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec5">10 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec6">266 </TD><TD class=alignCenter headers="er1 er4 ec1 ec7">132 </TD><TD class=alignCenter headers="er1 er4 ec1 ec8">648 (34%) </TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignCenter headers="er1 er5 ec1 ec2 ec3">516 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec4">236 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec5">57 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec6">223 </TD><TD class=alignCenter headers="er1 er5 ec1 ec7">417 </TD><TD class=alignCenter headers="er1 er5 ec1 ec8">933 (49%) </TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignCenter headers="er1 er6 ec1 ec2 ec3">1316 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec4">623 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec5">73 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec6">620 </TD><TD class=alignCenter headers="er1 er6 ec1 ec7">596 </TD><TD class=alignCenter headers="er1 er6 ec1 ec8">1912 </TD></TR><TR><TH id=er7 class=alignLeft headers=er1>%<SUP>1</SUP></TH><TD class=alignCenter headers="er1 er7 ec1 ec2 ec3">69% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec4">47% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec5">6% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec6">47% </TD><TD class=alignCenter headers="er1 er7 ec1 ec7">31% </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)

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          Provincial/Territorial Influenza Hospitalizations and Deaths

          In week 20, 108 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories.* As with other surveillance indicators in week 20, the majority were cases of influenza B (99, 91.7%). Three ICU admissions and 14 deaths were reported in week 20. Ten of the 14 deaths were cases with influenza B; of these, 8 cases were adults ≥65 years of age, one was 45-64 years of age and one had no age reported. Among fatal cases with influenza A, two cases were 20-44 years of age, one was 45-64 years of age and one was ≥65 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, 4,862 influenza-associated hospitalizations have been reported, 74.4% with influenza A. The majority (61.7%) 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 362 ICU admissions have been reported this season, of which 64.6% were adults 20-64 years of age. A total of 291 deaths have been reported. The highest proportion of deaths has been among adults ≥65 years of age (51.9%) followed by adults 20-64 years of age (39.2%). 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 25.6% of hospitalizations and 27.1% 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, 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 May 17, 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">617 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc4">287 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc5">12 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc6">318 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc7">116 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc8">733 (15%) </TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years</TH><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc3">134 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc4">65 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc5">6 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc6">63 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc7">103 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc8">237 (5%) </TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years</TH><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc3">38 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc4">21 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc5">4 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc6">13 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc7">6 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc8">44 (1%) </TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc3">615 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc4">424 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc5">5 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc6">186 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc7">76 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc8">691 (14%) </TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc3">1121 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc4">706 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc5">30 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc6">385 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc7">245 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc8">1366 (28%) </TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc3">952 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc4">467 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc5">104 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc6">381 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc7">680 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc8">1632 (34%) </TD></TR><TR><TH id=fr10 class=alignLeft headers=fr1>Unknown</TH><TD class=alignCenter headers="fc1 fc2 fc3">138 </TD><TD class=alignCenter headers="fc1 fc2 fc4">99 </TD><TD class=alignCenter headers="fc1 fc2 fc5">3 </TD><TD class=alignCenter headers="fc1 fc2 fc6">36 </TD><TD class=alignCenter headers="fc1 fc7">21 </TD><TD class=alignCenter headers="fc1 fc8">159 (3%) </TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignCenter headers="fr1 fr8 fc1 fc2 fc3">3615 </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc4">2069 </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc5">164 </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc6">1382 </TD><TD class=alignCenter headers="fr1 fr8 fc1 fc7">1247 </TD><TD class=alignCenter headers="fr1 fr8 fc1 fc8">4862 </TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP> </TH><TD class=alignCenter headers="fr1 fr9 fc1 fc2 fc3">74.4% </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc4">57.2% </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc5">4.5% </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc6">38.2% </TD><TD class=alignCenter headers="fr1 fr9 fc1 fc7">25.6% </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


          • #35
            Re: Canada FluWatch Weekly Reports 2013-2014 Season Weeks 21 and 22

            FluWatch report: May 18 to May 31, 2014 (Weeks 21 and 22)

            Posted 2014-06-06For 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, 421 KB - 10 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/13-14/w22_14/pdf/fw2014-22-eng.pdf">FluWatch report: May 18 to May 31, 2014 (Weeks 21 and 22) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 421 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

            Help with PDF documents

            Overall Summary
            • In weeks 21 and 22, influenza activity in Canada continued to decline. Low-level circulation of influenza B continues to be reported, but activity remains within expected levels for this time of year.
            • Influenza B is having a greater impact on adults 65 years of age and older and young persons 5 to 19 years of age, compared to influenza A(H1N1) which circulated earlier in the year.
            • As of week 22, 5,086 hospitalizations and 313 deaths have been reported from participating regions, which is similar to the number reported last year.
            Are you a primary health care practitioner (General Practitioner, Nurse Practitioner or Registered Nurse) interested in becoming a FluWatch sentinel for the 2014-15 influenza season? Contact us at FluWatch@phac-aspc.gc.ca
            Influenza/ILI Activity (geographic spread)

            In week 21, eight regions reported localized activity: seven regions in Ontario and one in Newfoundland & Labrador. In week 22, nine regions reported localized activity: seven were the same regions as in week 21, with one additional region each in Newfoundland & Labrador and Saskatchewan (Figure 1). Five regions did not report data in week 21 and in week 22.
            Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 22





            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 decline from 310 in week 20 to 203 in week 21, and 133 (5.5% of tests) in week 22 (Figure 2). Influenza B remained the predominant virus in weeks 21 and 22, representing 80% of influenza detections. However, most jurisdictions have reported low or declining numbers of influenza detections in weeks 21 and 22 (Table 1). This season, A(H1N1)pdm09 predominantly affected adults 20-64 years of age and children <5 years of age, while influenza B affected greater proportions of adults ≥65 years of age and children 5-19 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
            Detections of RSV, coronavirus, and human metapneumovirus have continued to decline and are approaching inter-seasonal levels. The number of positive tests for parainfluenza continued to follow an upward trend in recent weeks, and detections of adenovirus have been stable over the past three weeks, in keeping with the broader year-round circulation of these viruses. Detections of rhinovirus in recent weeks have been higher than during the same period over the past three seasons, however the number of positive tests decreased in weeks 21 and 22 (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


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            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 margin10px">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=t1hc1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=t1hc2 colSpan=5>Weekly
            (May 18 to 31, 2014)</TH><TH id=t1hc3 colSpan=5>Cumulative
            (August 25, 2013 to May 31, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=t1hc4 colSpan=4 headers=t1hc2>Influenza A</TH><TH id=t1hc5 headers=t1hc2>B</TH><TH id=t1hc6 colSpan=4 headers=t1hc3>Influenza A</TH><TH id=t1hc7 headers=t1hc3>B</TH></TR><TR class=bg-colour-grey-light><TH id=t1hc8 headers="t1hc2 t1hc4">A Total</TH><TH id=t1hc9 class=" bg-colour-blue" headers="t1hc2 t1hc4">A(H1)pdm09</TH><TH id=t1hc10 class=" bg-colour-blue" headers="t1hc2 t1hc4">A(H3)</TH><TH id=t1hc11 class=" bg-colour-blue" headers="t1hc2 t1hc4">A(UnS)</TH><TH id=t1hc12 class=alignCenter headers="t1hc2 t1hc5">B Total</TH><TH id=t1hc13 headers="t1hc3 t1hc6">A Total</TH><TH id=t1hc14 class=" bg-colour-blue" headers="t1hc3 t1hc6">A(H1)pdm09</TH><TH id=t1hc15 class=" bg-colour-blue" headers="t1hc3 t1hc6">A(H3)</TH><TH id=t1hc16 class=" bg-colour-blue" headers="t1hc3 t1hc6">A(UnS)</TH><TD class=alignCenter headers="t1hc3 t1hc7">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=t1hr1 class=alignLeft headers=t1hc1>BC</TH><TD class=alignCenter headers="t1hr1 t1hc2 t1hc4 t1hc8">3</TD><TD class=alignCenter headers="t1hr1 t1hc2 t1hc4 t1hc9">0</TD><TD class=alignCenter headers="t1hr1 t1hc2 t1hc4 t1hc10">2</TD><TD class=alignCenter headers="t1hr1 t1hc2 t1hc4 t1hc11">1</TD><TD class=alignCenter headers="t1hr1 t1hc2 t1hc5 t1hc12">14</TD><TD class=alignCenter headers="t1hr1 t1hc3 t1hc6 t1hc13">1811</TD><TD class=alignCenter headers="t1hr1 t1hc3 t1hc6 t1hc14">1614</TD><TD class=alignCenter headers="t1hr1 t1hc3 t1hc6 t1hc15">57</TD><TD class=alignCenter headers="t1hr1 t1hc3 t1hc6 t1hc16">140</TD><TD class=alignCenter headers="t1hr1 t1hc3 t1hc7">374</TD></TR><TR><TH id=t1hr2 class=alignLeft headers=t1hc1>AB</TH><TD class=alignCenter headers="t1hr2 t1hc2 t1hc4 t1hc8">11</TD><TD class=alignCenter headers="t1hr2 t1hc2 t1hc4 t1hc9">1</TD><TD class=alignCenter headers="t1hr2 t1hc2 t1hc4 t1hc10">9</TD><TD class=alignCenter headers="t1hr2 t1hc2 t1hc4 t1hc11">1</TD><TD class=alignCenter headers="t1hr2 t1hc2 t1hc5 t1hc12">69</TD><TD class=alignCenter headers="t1hr2 t1hc3 t1hc6 t1hc13">3882</TD><TD class=alignCenter headers="t1hr2 t1hc3 t1hc6 t1hc14">3462</TD><TD class=alignCenter headers="t1hr2 t1hc3 t1hc6 t1hc15">103</TD><TD class=alignCenter headers="t1hr2 t1hc3 t1hc6 t1hc16">317</TD><TD class=alignCenter headers="t1hr2 t1hc3 t1hc7">535</TD></TR><TR><TH id=t1hr3 class=alignLeft headers=t1hc1>SK</TH><TD class=alignCenter headers="t1hr3 t1hc2 t1hc4 t1hc8">1</TD><TD class=alignCenter headers="t1hr3 t1hc2 t1hc4 t1hc9">0</TD><TD class=alignCenter headers="t1hr3 t1hc2 t1hc4 t1hc10">0</TD><TD class=alignCenter headers="t1hr3 t1hc2 t1hc4 t1hc11">1</TD><TD class=alignCenter headers="t1hr3 t1hc2 t1hc5 t1hc12">14</TD><TD class=alignCenter headers="t1hr3 t1hc3 t1hc6 t1hc13">1384</TD><TD class=alignCenter headers="t1hr3 t1hc3 t1hc6 t1hc14">988</TD><TD class=alignCenter headers="t1hr3 t1hc3 t1hc6 t1hc15">8</TD><TD class=alignCenter headers="t1hr3 t1hc3 t1hc6 t1hc16">388</TD><TD class=alignCenter headers="t1hr3 t1hc3 t1hc7">193</TD></TR><TR><TH id=t1hr4 class=alignLeft headers=t1hc1>MB</TH><TD class=alignCenter headers="t1hr4 t1hc2 t1hc4 t1hc8">2</TD><TD class=alignCenter headers="t1hr4 t1hc2 t1hc4 t1hc9">0</TD><TD class=alignCenter headers="t1hr4 t1hc2 t1hc4 t1hc10">2</TD><TD class=alignCenter headers="t1hr4 t1hc2 t1hc4 t1hc11">0</TD><TD class=alignCenter headers="t1hr4 t1hc2 t1hc5 t1hc12">11</TD><TD class=alignCenter headers="t1hr4 t1hc3 t1hc6 t1hc13">685</TD><TD class=alignCenter headers="t1hr4 t1hc3 t1hc6 t1hc14">463</TD><TD class=alignCenter headers="t1hr4 t1hc3 t1hc6 t1hc15">7</TD><TD class=alignCenter headers="t1hr4 t1hc3 t1hc6 t1hc16">215</TD><TD class=alignCenter headers="t1hr4 t1hc3 t1hc7">65</TD></TR><TR><TH id=t1hr5 class=alignLeft headers=t1hc1>ON</TH><TD class=alignCenter headers="t1hr5 t1hc2 t1hc4 t1hc8">37</TD><TD class=alignCenter headers="t1hr5 t1hc2 t1hc4 t1hc9">5</TD><TD class=alignCenter headers="t1hr5 t1hc2 t1hc4 t1hc10">25</TD><TD class=alignCenter headers="t1hr5 t1hc2 t1hc4 t1hc11">7</TD><TD class=alignCenter headers="t1hr5 t1hc2 t1hc5 t1hc12">84</TD><TD class=alignCenter headers="t1hr5 t1hc3 t1hc6 t1hc13">5796</TD><TD class=alignCenter headers="t1hr5 t1hc3 t1hc6 t1hc14">2495</TD><TD class=alignCenter headers="t1hr5 t1hc3 t1hc6 t1hc15">407</TD><TD class=alignCenter headers="t1hr5 t1hc3 t1hc6 t1hc16">2894</TD><TD class=alignCenter headers="t1hr5 t1hc3 t1hc7">3081</TD></TR><TR><TH id=t1hr6 class=alignLeft headers=t1hc1>QC</TH><TD class=alignCenter headers="t1hr6 t1hc2 t1hc4 t1hc8">7</TD><TD class=alignCenter headers="t1hr6 t1hc2 t1hc4 t1hc9">0</TD><TD class=alignCenter headers="t1hr6 t1hc2 t1hc4 t1hc10">1</TD><TD class=alignCenter headers="t1hr6 t1hc2 t1hc4 t1hc11">6</TD><TD class=alignCenter headers="t1hr6 t1hc2 t1hc5 t1hc12">50</TD><TD class=alignCenter headers="t1hr6 t1hc3 t1hc6 t1hc13">5370</TD><TD class=alignCenter headers="t1hr6 t1hc3 t1hc6 t1hc14">677</TD><TD class=alignCenter headers="t1hr6 t1hc3 t1hc6 t1hc15">6</TD><TD class=alignCenter headers="t1hr6 t1hc3 t1hc6 t1hc16">4687</TD><TD class=alignCenter headers="t1hr6 t1hc3 t1hc7">2734</TD></TR><TR><TH id=t1hr7 class=alignLeft headers=t1hc1>NB</TH><TD class=alignCenter headers="t1hr7 t1hc2 t1hc4 t1hc8">1</TD><TD class=alignCenter headers="t1hr7 t1hc2 t1hc4 t1hc9">0</TD><TD class=alignCenter headers="t1hr7 t1hc2 t1hc4 t1hc10">0</TD><TD class=alignCenter headers="t1hr7 t1hc2 t1hc4 t1hc11">1</TD><TD class=alignCenter headers="t1hr7 t1hc2 t1hc5 t1hc12">10</TD><TD class=alignCenter headers="t1hr7 t1hc3 t1hc6 t1hc13">1491</TD><TD class=alignCenter headers="t1hr7 t1hc3 t1hc6 t1hc14">370</TD><TD class=alignCenter headers="t1hr7 t1hc3 t1hc6 t1hc15">2</TD><TD class=alignCenter headers="t1hr7 t1hc3 t1hc6 t1hc16">1119</TD><TD class=alignCenter headers="t1hr7 t1hc3 t1hc7">114</TD></TR><TR><TH id=t1hr8 class=alignLeft headers=t1hc1>NS</TH><TD class=alignCenter headers="t1hr8 t1hc2 t1hc4 t1hc8">0</TD><TD class=alignCenter headers="t1hr8 t1hc2 t1hc4 t1hc9">0</TD><TD class=alignCenter headers="t1hr8 t1hc2 t1hc4 t1hc10">0</TD><TD class=alignCenter headers="t1hr8 t1hc2 t1hc4 t1hc11">0</TD><TD class=alignCenter headers="t1hr8 t1hc2 t1hc5 t1hc12">4</TD><TD class=alignCenter headers="t1hr8 t1hc3 t1hc6 t1hc13">175</TD><TD class=alignCenter headers="t1hr8 t1hc3 t1hc6 t1hc14">134</TD><TD class=alignCenter headers="t1hr8 t1hc3 t1hc6 t1hc15">5</TD><TD class=alignCenter headers="t1hr8 t1hc3 t1hc6 t1hc16">36</TD><TD class=alignCenter headers="t1hr8 t1hc3 t1hc7">47</TD></TR><TR><TH id=t1hr9 class=alignLeft headers=t1hc1>PE</TH><TD class=alignCenter headers="t1hr9 t1hc2 t1hc4 t1hc8">0</TD><TD class=alignCenter headers="t1hr9 t1hc2 t1hc4 t1hc9">0</TD><TD class=alignCenter headers="t1hr9 t1hc2 t1hc4 t1hc10">0</TD><TD class=alignCenter headers="t1hr9 t1hc2 t1hc4 t1hc11">0</TD><TD class=alignCenter headers="t1hr9 t1hc2 t1hc5 t1hc12">2</TD><TD class=alignCenter headers="t1hr9 t1hc3 t1hc6 t1hc13">119</TD><TD class=alignCenter headers="t1hr9 t1hc3 t1hc6 t1hc14">118</TD><TD class=alignCenter headers="t1hr9 t1hc3 t1hc6 t1hc15">0</TD><TD class=alignCenter headers="t1hr9 t1hc3 t1hc6 t1hc16">1</TD><TD class=alignCenter headers="t1hr9 t1hc3 t1hc7">4</TD></TR><TR><TH id=t1hr10 class=alignLeft headers=t1hc1>NL</TH><TD class=alignCenter headers="t1hr10 t1hc2 t1hc4 t1hc8">4</TD><TD class=alignCenter headers="t1hr10 t1hc2 t1hc4 t1hc9">0</TD><TD class=alignCenter headers="t1hr10 t1hc2 t1hc4 t1hc10">0</TD><TD class=alignCenter headers="t1hr10 t1hc2 t1hc4 t1hc11">4</TD><TD class=alignCenter headers="t1hr10 t1hc2 t1hc5 t1hc12">12</TD><TD class=alignCenter headers="t1hr10 t1hc3 t1hc6 t1hc13">381</TD><TD class=alignCenter headers="t1hr10 t1hc3 t1hc6 t1hc14">104</TD><TD class=alignCenter headers="t1hr10 t1hc3 t1hc6 t1hc15">0</TD><TD class=alignCenter headers="t1hr10 t1hc3 t1hc6 t1hc16">277</TD><TD class=alignCenter headers="t1hr10 t1hc3 t1hc7">258</TD></TR><TR><TH id=t1hr11 class=alignLeft headers=t1hc1>Canada</TH><TD class=alignCenter headers="t1hr11 t1hc2 t1hc4 t1hc8">66</TD><TD class="alignCenter bg-colour-blue" headers="t1hr11 t1hc2 t1hc4 t1hc9">6</TD><TD class="alignCenter bg-colour-blue" headers="t1hr11 t1hc2 t1hc4 t1hc10">39</TD><TD class="alignCenter bg-colour-blue" headers="t1hr11 t1hc2 t1hc4 t1hc11">21</TD><TD class=alignCenter headers="t1hr11 t1hc2 t1hc5 t1hc12">270</TD><TD class=alignCenter headers="t1hr11 t1hc3 t1hc6 t1hc13">21094</TD><TD class="alignCenter bg-colour-blue" headers="t1hr11 t1hc3 t1hc6 t1hc14">10425</TD><TD class="alignCenter bg-colour-blue" headers="t1hr11 t1hc3 t1hc6 t1hc15">595</TD><TD class="alignCenter bg-colour-blue" headers="t1hr11 t1hc3 t1hc6 t1hc16">10074</TD><TD class=alignCenter headers="t1hr11 t1hc3 t1hc7">7405</TD></TR><TR><TH id=t1hr12 class=alignLeft headers=t1hc1>Percentage<SUP>2</SUP></TH><TD class=alignCenter headers="t1hr12 t1hc2 t1hc4 t1hc8">19.6%</TD><TD class="alignCenter bg-colour-blue" headers="t1hr12 t1hc2 t1hc4 t1hc9">9.1%</TD><TD class="alignCenter bg-colour-blue" headers="t1hr12 t1hc2 t1hc4 t1hc10">59.1%</TD><TD class="alignCenter bg-colour-blue" headers="t1hr12 t1hc2 t1hc4 t1hc11">31.8%</TD><TD class=alignCenter headers="t1hr12 t1hc2 t1hc5 t1hc12">80.4%</TD><TD class=alignCenter headers="t1hr12 t1hc3 t1hc6 t1hc13">74.0%</TD><TD class="alignCenter bg-colour-blue" headers="t1hr12 t1hc3 t1hc6 t1hc14">49.4%</TD><TD class="alignCenter bg-colour-blue" headers="t1hr12 t1hc3 t1hc6 t1hc15">2.8%</TD><TD class="alignCenter bg-colour-blue" headers="t1hr12 t1hc3 t1hc6 t1hc16">47.8%</TD><TD class=alignCenter headers="t1hr12 t1hc3 t1hc7">26.0%</TD></TR></TBODY></TABLE>
            <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t2 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=t2hc1 rowSpan=3>Age groups (years)</TH><TH id=t2hc2 colSpan=5>Weekly
            (May 18 to May 31, 2014)</TH><TH id=t2hc3 colSpan=7>Cumulative
            (August 25, 2013 to May 31, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=t2hc4 colSpan=4 headers=t2hc2>Influenza A</TH><TH id=t2hc5 headers=t2hc2>B</TH><TH id=t2hc6 colSpan=4 headers=t2hc3>Influenza A</TH><TH id=t2hc7 headers=t2hc3>B</TH><TH id=t2hc8 colSpan=2>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=t2hc9 headers="t2hc2 t2hc4">A Total</TH><TH id=t2hc10 class=bg-colour-blue headers="t2hc2 t2hc4">A(H1) pdm09</TH><TH id=t2hc11 class="bg-colour-blue " headers="t2hc2 t2hc4">A(H3)</TH><TH id=t2hc12 class="bg-colour-blue " headers="t2hc2 t2hc4">A (UnS)</TH><TD class=alignCenter headers="t2hc2 t2hc5">Total</TD><TH id=t2hc13 headers="t2hc3 t2hc6">A Total</TH><TH id=t2hc14 class="bg-colour-blue " headers="t2hc3 t2hc6">A(H1) pdm09</TH><TH id=t2hc15 class="bg-colour-blue " headers="t2hc3 t2hc6">A(H3)</TH><TH id=t2hc16 class="bg-colour-blue " headers="t2hc3 t2hc6">A (UnS)</TH><TD class=alignCenter headers="t2hc3 t2hc7">Total</TD><TH id=t2hc17 headers="t2hc3 t2hc8">#</TH><TH id=t2hc18 headers="t2hc3 t2hc8">%</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=t2hr1 class=alignLeft headers=t2hc1><5</TH><TD class=alignCenter headers="t2hr1 t2hc2 t2hc4 t2hc9">6</TD><TD class=alignCenter headers="t2hr1 t2hc2 t2hc4 t2hc10">3</TD><TD class=alignCenter headers="t2hr1 t2hc2 t2hc4 t2hc11">1</TD><TD class=alignCenter headers="t2hr1 t2hc2 t2hc4 t2hc12">2</TD><TD class=alignCenter headers="t2hr1 t2hc2 t2hc5">19</TD><TD class=alignCenter headers="t2hr1 t2hc3 t2hc6 t2hc13">3269</TD><TD class=alignCenter headers="t2hr1 t2hc3 t2hc6 t2hc14">1453</TD><TD class=alignCenter headers="t2hr1 t2hc3 t2hc6 t2hc15">45</TD><TD class=alignCenter headers="t2hr1 t2hc3 t2hc6 t2hc16">1771</TD><TD class=alignCenter headers="t2hr1 t2hc3 t2hc7">554</TD><TD class=alignCenter headers="t2hr1 t2hc3 t2hc8 t2hc17">3823</TD><TD class=alignCenter headers="t2hr1 t2hc3 t2hc8 t2hc18">16.6%</TD></TR><TR><TH id=t2hr2 class=alignLeft headers=t2hc1>5-19</TH><TD class=alignCenter headers="t2hr2 t2hc2 t2hc4 t2hc9">0</TD><TD class=alignCenter headers="t2hr2 t2hc2 t2hc4 t2hc10">0</TD><TD class=alignCenter headers="t2hr2 t2hc2 t2hc4 t2hc11">0</TD><TD class=alignCenter headers="t2hr2 t2hc2 t2hc4 t2hc12">0</TD><TD class=alignCenter headers="t2hr2 t2hc2 t2hc5">10</TD><TD class=alignCenter headers="t2hr2 t2hc3 t2hc6 t2hc13">1333</TD><TD class=alignCenter headers="t2hr2 t2hc3 t2hc6 t2hc14">707</TD><TD class=alignCenter headers="t2hr2 t2hc3 t2hc6 t2hc15">27</TD><TD class=alignCenter headers="t2hr2 t2hc3 t2hc6 t2hc16">599</TD><TD class=alignCenter headers="t2hr2 t2hc3 t2hc7">819</TD><TD class=alignCenter headers="t2hr2 t2hc3 t2hc8 t2hc17">2152</TD><TD class=alignCenter headers="t2hr2 t2hc3 t2hc8 t2hc18">9.3%</TD></TR><TR><TH id=t2hr3 class=alignLeft headers=t2hc1>20-44</TH><TD class=alignCenter headers="t2hr3 t2hc2 t2hc4 t2hc9">8</TD><TD class=alignCenter headers="t2hr3 t2hc2 t2hc4 t2hc10">1</TD><TD class=alignCenter headers="t2hr3 t2hc2 t2hc4 t2hc11">5</TD><TD class=alignCenter headers="t2hr3 t2hc2 t2hc4 t2hc12">2</TD><TD class=alignCenter headers="t2hr3 t2hc2 t2hc5">21</TD><TD class=alignCenter headers="t2hr3 t2hc3 t2hc6 t2hc13">5097</TD><TD class=alignCenter headers="t2hr3 t2hc3 t2hc6 t2hc14">2818</TD><TD class=alignCenter headers="t2hr3 t2hc3 t2hc6 t2hc15">51</TD><TD class=alignCenter headers="t2hr3 t2hc3 t2hc6 t2hc16">2228</TD><TD class=alignCenter headers="t2hr3 t2hc3 t2hc7">1017</TD><TD class=alignCenter headers="t2hr3 t2hc3 t2hc8 t2hc17">6114</TD><TD class=alignCenter headers="t2hr3 t2hc3 t2hc8 t2hc18">26.5%</TD></TR><TR><TH id=t2hr4 class=alignLeft headers=t2hc1>45-64</TH><TD class=alignCenter headers="t2hr4 t2hc2 t2hc4 t2hc9">5</TD><TD class=alignCenter headers="t2hr4 t2hc2 t2hc4 t2hc10">3</TD><TD class=alignCenter headers="t2hr4 t2hc2 t2hc4 t2hc11">2</TD><TD class=alignCenter headers="t2hr4 t2hc2 t2hc4 t2hc12">0</TD><TD class=alignCenter headers="t2hr4 t2hc2 t2hc5">34</TD><TD class=alignCenter headers="t2hr4 t2hc3 t2hc6 t2hc13">4476</TD><TD class=alignCenter headers="t2hr4 t2hc3 t2hc6 t2hc14">2392</TD><TD class=alignCenter headers="t2hr4 t2hc3 t2hc6 t2hc15">66</TD><TD class=alignCenter headers="t2hr4 t2hc3 t2hc6 t2hc16">2018</TD><TD class=alignCenter headers="t2hr4 t2hc3 t2hc7">1503</TD><TD class=alignCenter headers="t2hr4 t2hc3 t2hc8 t2hc17">5979</TD><TD class=alignCenter headers="t2hr4 t2hc3 t2hc8 t2hc18">25.9%</TD></TR><TR><TH id=t2hr5 class=alignLeft headers=t2hc1>65+</TH><TD class=alignCenter headers="t2hr5 t2hc2 t2hc4 t2hc9">26</TD><TD class=alignCenter headers="t2hr5 t2hc2 t2hc4 t2hc10">0</TD><TD class=alignCenter headers="t2hr5 t2hc2 t2hc4 t2hc11">19</TD><TD class=alignCenter headers="t2hr5 t2hc2 t2hc4 t2hc12">7</TD><TD class=alignCenter headers="t2hr5 t2hc2 t2hc5">73</TD><TD class=alignCenter headers="t2hr5 t2hc3 t2hc6 t2hc13">2630</TD><TD class=alignCenter headers="t2hr5 t2hc3 t2hc6 t2hc14">1001</TD><TD class=alignCenter headers="t2hr5 t2hc3 t2hc6 t2hc15">184</TD><TD class=alignCenter headers="t2hr5 t2hc3 t2hc6 t2hc16">1445</TD><TD class=alignCenter headers="t2hr5 t2hc3 t2hc7">2245</TD><TD class=alignCenter headers="t2hr5 t2hc3 t2hc8 t2hc17">4875</TD><TD class=alignCenter headers="t2hr5 t2hc3 t2hc8 t2hc18">21.1%</TD></TR><TR><TH id=t2hr6 class=alignLeft headers=t2hc1>Unknown</TH><TD class=alignCenter headers="t2hr6 t2hc2 t2hc4 t2hc9">0</TD><TD class=alignCenter headers="t2hr6 t2hc2 t2hc4 t2hc10">0</TD><TD class=alignCenter headers="t2hr6 t2hc2 t2hc4 t2hc11">0</TD><TD class=alignCenter headers="t2hr6 t2hc2 t2hc4 t2hc12">0</TD><TD class=alignCenter headers="t2hr6 t2hc2 t2hc5">0</TD><TD class=alignCenter headers="t2hr6 t2hc3 t2hc6 t2hc13">137</TD><TD class=alignCenter headers="t2hr6 t2hc3 t2hc6 t2hc14">102</TD><TD class=alignCenter headers="t2hr6 t2hc3 t2hc6 t2hc15">22</TD><TD class=alignCenter headers="t2hr6 t2hc3 t2hc6 t2hc16">13</TD><TD class=alignCenter headers="t2hr6 t2hc3 t2hc7">9</TD><TD class=alignCenter headers="t2hr6 t2hc3 t2hc8 t2hc17">146</TD><TD class=alignCenter headers="t2hr6 t2hc3 t2hc8 t2hc18">0.6%</TD></TR><TR><TH id=t2hr7 class=alignLeft headers=t2hc1>Total</TH><TD class=alignCenter headers="t2hr7 t2hc2 t2hc4 t2hc9">45</TD><TD class="alignCenter bg-colour-blue" headers="t2hr7 t2hc2 t2hc4 t2hc10">7</TD><TD class="alignCenter bg-colour-blue" headers="t2hr7 t2hc2 t2hc4 t2hc11">27</TD><TD class="alignCenter bg-colour-blue" headers="t2hr7 t2hc2 t2hc4 t2hc12">11</TD><TD class=alignCenter headers="t2hr7 t2hc2 t2hc5">157</TD><TD class=alignCenter headers="t2hr7 t2hc3 t2hc6 t2hc13">16942</TD><TD class="alignCenter bg-colour-blue" headers="t2hr7 t2hc3 t2hc6 t2hc14">8473</TD><TD class="alignCenter bg-colour-blue" headers="t2hr7 t2hc3 t2hc6 t2hc15">395</TD><TD class="alignCenter bg-colour-blue" headers="t2hr7 t2hc3 t2hc6 t2hc16">8074</TD><TD class=alignCenter headers="t2hr7 t2hc3 t2hc7">6147</TD><TD class=alignCenter headers="t2hr7 t2hc3 t2hc8 t2hc17">23089</TD><TD class=alignCenter headers="t2hr7 t2hc3 t2hc8 t2hc18">100.0%</TD></TR><TR><TH id=t2hr8 class=alignLeft headers=t2hc1>Percentage<SUP>2</SUP></TH><TD class=alignCenter headers="t2hr8 t2hc2 t2hc4 t2hc9">22.3%</TD><TD class="alignCenter bg-colour-blue" headers="t2hr8 t2hc2 t2hc4 t2hc10">15.6%</TD><TD class="alignCenter bg-colour-blue" headers="t2hr8 t2hc2 t2hc4 t2hc11">60.0%</TD><TD class="alignCenter bg-colour-blue" headers="t2hr8 t2hc2 t2hc4 t2hc12">24.4%</TD><TD class=alignCenter headers="t2hr8 t2hc2 t2hc5">77.7%</TD><TD class=alignCenter headers="t2hr8 t2hc3 t2hc6 t2hc13">73.4%</TD><TD class="alignCenter bg-colour-blue" headers="t2hr8 t2hc3 t2hc6 t2hc14">50.0%</TD><TD class="alignCenter bg-colour-blue" headers="t2hr8 t2hc3 t2hc6 t2hc15">2.3%</TD><TD class="alignCenter bg-colour-blue" headers="t2hr8 t2hc3 t2hc6 t2hc16">47.7%</TD><TD class=alignCenter headers="t2hr8 t2hc3 t2hc7">26.6%</TD><TD class=alignCenter headers=t2hr8></TD><TD class=alignCenter headers=t2hr8></TD></TR></TBODY></TABLE>


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            Influenza Strain Characterizations

            During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 2,210 influenza viruses [136 A(H3N2), 1,389 A(H1N1)pdm09 and 685 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, and one A(H3N2) virus showed reduced titres to antiserum against the reference A/Texas/50/2012 strain. Twenty-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, 2013-2014, N = 2,210

            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 2,047 influenza viruses for resistance to oseltamivir and all but five were sensitive. All 2,048 viruses tested for resistance to zanamivir were sensitive. All 1,604 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=t3hc1 rowSpan=2>Virus type and subtype</TH><TH id=t3hc2 colSpan=2>Oseltamivir</TH><TH id=t3hc3 colSpan=2>Zanamivir</TH><TH id=t3hc4 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=t3hc5 headers=t3hc2># tested</TH><TH id=t3hc6 headers=t3hc2># resistant (%)</TH><TH id=t3hc7 headers=t3hc3># tested</TH><TH id=t3hc8 headers=t3hc3># resistant (%)</TH><TH id=t3hc9 headers=t3hc4># tested</TH><TH id=t3hc10 headers=t3hc4># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=t3hr1 class="alignLeft bg-colour-blue" headers=t3hc1>A (H3N2)</TH><TD class=alignCenter headers="t3hr1 t3hc2 t3hc5">111</TD><TD class=alignCenter headers="t3hr1 t3hc2 t3hc6">0</TD><TD class=alignCenter headers="t3hr1 t3hc3 t3hc7">111</TD><TD class=alignCenter headers="t3hr1 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr1 t3hc4 t3hc9">170</TD><TD class=alignCenter headers="t3hr1 t3hc4 t3hc10">170 (100%)</TD></TR><TR><TH id=t3hr2 class="alignLeft bg-colour-blue" headers=t3hc1>A (H1N1)</TH><TD class=alignCenter headers="t3hr2 t3hc2 t3hc5">1373</TD><TD class=alignCenter headers="t3hr2 t3hc2 t3hc6">5 (0.4%)</TD><TD class=alignCenter headers="t3hr2 t3hc3 t3hc7">1375</TD><TD class=alignCenter headers="t3hr2 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr2 t3hc4 t3hc9">1434</TD><TD class=alignCenter headers="t3hr2 t3hc4 t3hc10">1434 (100%)</TD></TR><TR><TH id=t3hr3 class="alignLeft bg-colour-blue" headers=t3hc1>B</TH><TD class=alignCenter headers="t3hr3 t3hc2 t3hc5">563</TD><TD class=alignCenter headers="t3hr3 t3hc2 t3hc6">0</TD><TD class=alignCenter headers="t3hr3 t3hc3 t3hc7">562</TD><TD class=alignCenter headers="t3hr3 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr3 t3hc4 t3hc9">NA1</TD><TD class=alignCenter headers="t3hr3 t3hc4 t3hc10">NA1</TD></TR><TR><TH id=t3hr4 class="alignLeft bg-colour-blue" headers=t3hc1>TOTAL</TH><TD class=alignCenter headers="t3hr4 t3hc2 t3hc5">2047</TD><TD class=alignCenter headers="t3hr4 t3hc2 t3hc6">5 (0.2%)</TD><TD class=alignCenter headers="t3hr4 t3hc3 t3hc7">2048</TD><TD class=alignCenter headers="t3hr4 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr4 t3hc4 t3hc9">1604</TD><TD class=alignCenter headers="t3hr4 t3hc4 t3hc10">1604 (100%)</TD></TR></TBODY></TABLE>
            Influenza-like Illness (ILI) Consultation Rate

            The national influenza-like-illness (ILI) consultation rate continued to decrease from 16.6 consultations per 1,000 patient visits in week 20 to 18.1 per 1,000 in week 21 and 13.2 per 1,000 in week 22. Rates for weeks 21 and 22 were above 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

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            Influenza Outbreak Surveillance

            The number of new influenza outbreaks was low in weeks 21 and 22, with three outbreaks reported in long-term care facilities (Figure 6). Three additional outbreaks of ILI were reported in other types of facilities or community settings during this two-week period.
            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 weeks 21 and 22, the proportion of prescriptions for antivirals continued to decline and is approaching inter-seasonal levels. 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 (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

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            Sentinel Hospital Influenza Surveillance

            Paediatric Influenza Hospitalizations and Deaths (IMPACT)
            In weeks 21 and 22, four new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network. All four were cases of influenza B, one child 6-23 months of age and three 2-4 years of age (Figure 8a). 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 were reported in weeks 21 or 22. One death was reported which occurred in early April, a child <6 months of age with influenza B.
            To date this season, a total of 696 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 79% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children <5 years of age represent 73% of cases to date (Table 4). One hundred and ten ICU admissions have been reported, of which 72 (65%) were children <5 years of age (Figure 9a). All but 14 were cases with influenza A, and 97% of those subtyped were A(H1N1)pdm09. Among the 106 ICU cases with available data, 67 (63%) were reported to have underlying medical conditions. One death has been reported this season. A smaller number of paediatric hospital admissions have been reported this year compared to the 2012-13 season.
            Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
            Adult Influenza Hospitalizations and Deaths (PCIRN)
            Active surveillance of laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network ended on May 15th. During the period of passive surveillance from May 16 to 31, 2014, 29 new influenza-associated hospitalizations were reported, including four ICU admissions and one death (Figure 8b). Among these 29 cases, 26 (90%) were cases ≥65 years of age and 62% were associated with influenza B. May 31st marks the end of PCIRN-SOS reporting for the 2013-14 season.
            To date this season, 1,985 influenza-associated hospitalizations have been reported by the PCIRN-SOS network, 1,338 (67.4%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). Compared to the 2012-13 season, slightly more cases have been reported, although the peak number of cases was smaller. A greater number of cases have been reported during March and April compared to last year, with six times more cases of influenza B reported. ICU admission was required for 321 hospitalizations, of which 263 were cases with influenza A (137 A(H1N1)pdm09, ten A(H3N2) and 116 A(unsubtyped)), 57 were cases with influenza B and the influenza type was not reported for one case. A greater proportion of cases have been admitted to the ICU this season compared to last year, but the proportion of deaths has been similar. Of the ICU admissions with available information, 85.9% (189/220) were reported to have at least one comorbidity, and 68.2% (176/258) reported not having been vaccinated this season. Among the 112 deaths reported this season, all but 28 have been cases of influenza A (51 A(H1N1)pdm09, three A(H3N2) and 30 A(unsubtyped)); ten cases 20-44 years of age, 37 cases 45-64 years of age and 65 cases ≥65 years of age (Figure 9b). Among fatal cases with available information, 93.8% (60/64) were reported to have at least one comorbidity, and 48.2% (40/83) reported not having been vaccinated this season.
            Note: During the 2013-14 influenza season, PCIRN-SOS conducted passive surveillance from August 25<SUP>th</SUP> to November 14<SUP>th</SUP>, 2013, and May 16<SUP>th</SUP> to 31<SUP>st</SUP>. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance was conducted between November 15<SUP>th</SUP>, 2013 and May 15<SUP>th</SUP>, 2014 during which time PCIRN site coordinators investigated 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=t4hc1 rowSpan=3>Age groups </TH><TH id=t4hc2 colSpan=6>Cumulative (Aug. 25, 2013 to May 31, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=t4hc3 colSpan=4 headers=t4hc2>Influenza A </TH><TH id=t4hc4 headers=t4hc2>B </TH><TH id=t4hc5 headers=t4hc2>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=t4hc6 headers="t4hc2 t4hc3">A Total </TH><TH id=t4hc7 class=bg-colour-blue headers="t4hc2 t4hc3">A(H1) pdm09 </TH><TH id=t4hc8 class="bg-colour-blue " headers="t4hc2 t4hc3">A(H3) </TH><TH id=t4hc9 class="bg-colour-blue " headers="t4hc2 t4hc3">A (UnS) </TH><TD class=alignCenter headers="t4hc2 t4hc4">Total</TD><TD class=alignCenter headers="t4hc2 t4hc5"># (%)</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=t4hr1 class=alignLeft headers=t4hc1>0-5m </TH><TD class=alignCenter headers="t4hr1 t4hc2 t4hc3 t4hc6">104</TD><TD class=alignCenter headers="t4hr1 t4hc2 t4hc3 t4hc7">37</TD><TD class=alignCenter headers="t4hr1 t4hc2 t4hc3 t4hc8">0</TD><TD class=alignCenter headers="t4hr1 t4hc2 t4hc3 t4hc9">67</TD><TD class=alignCenter headers="t4hr1 t4hc2 t4hc4">9</TD><TD class=alignCenter headers="t4hr1 t4hc2 t4hc5">113 (16%)</TD></TR><TR><TH id=t4hr2 class=alignLeft headers=t4hc1>6-23m </TH><TD class=alignCenter headers="t4hr2 t4hc2 t4hc3 t4hc6">162</TD><TD class=alignCenter headers="t4hr2 t4hc2 t4hc3 t4hc7">57</TD><TD class=alignCenter headers="t4hr2 t4hc2 t4hc3 t4hc8">1</TD><TD class=alignCenter headers="t4hr2 t4hc2 t4hc3 t4hc9">104</TD><TD class=alignCenter headers="t4hr2 t4hc2 t4hc4">26</TD><TD class=alignCenter headers="t4hr2 t4hc2 t4hc5">188 (27%)</TD></TR><TR><TH id=t4hr3 class=alignLeft headers=t4hc1>2-4y </TH><TD class=alignCenter headers="t4hr3 t4hc2 t4hc3 t4hc6">164</TD><TD class=alignCenter headers="t4hr3 t4hc2 t4hc3 t4hc7">55</TD><TD class=alignCenter headers="t4hr3 t4hc2 t4hc3 t4hc8">3</TD><TD class=alignCenter headers="t4hr3 t4hc2 t4hc3 t4hc9">106</TD><TD class=alignCenter headers="t4hr3 t4hc2 t4hc4">46</TD><TD class=alignCenter headers="t4hr3 t4hc2 t4hc5">210 (30%)</TD></TR><TR><TH id=t4hr4 class=alignLeft headers=t4hc1>5-9y </TH><TD class=alignCenter headers="t4hr4 t4hc2 t4hc3 t4hc6">81</TD><TD class=alignCenter headers="t4hr4 t4hc2 t4hc3 t4hc7">28</TD><TD class=alignCenter headers="t4hr4 t4hc2 t4hc3 t4hc8">1</TD><TD class=alignCenter headers="t4hr4 t4hc2 t4hc3 t4hc9">52</TD><TD class=alignCenter headers="t4hr4 t4hc2 t4hc4">52</TD><TD class=alignCenter headers="t4hr4 t4hc2 t4hc5">133 (19%)</TD></TR><TR><TH id=t4hr5 class=alignLeft headers=t4hc1>10-16y </TH><TD class=alignCenter headers="t4hr5 t4hc2 t4hc3 t4hc6">40</TD><TD class=alignCenter headers="t4hr5 t4hc2 t4hc3 t4hc7">14</TD><TD class=alignCenter headers="t4hr5 t4hc2 t4hc3 t4hc8">1</TD><TD class=alignCenter headers="t4hr5 t4hc2 t4hc3 t4hc9">25</TD><TD class=alignCenter headers="t4hr5 t4hc2 t4hc4">12</TD><TD class=alignCenter headers="t4hr5 t4hc2 t4hc5">52 (7%)</TD></TR><TR><TH id=t4hr6 class=alignLeft headers=t4hc1>Total </TH><TD class=alignCenter headers="t4hr6 t4hc2 t4hc3 t4hc6">551</TD><TD class="alignCenter bg-colour-blue" headers="t4hr6 t4hc2 t4hc3 t4hc7">191</TD><TD class="alignCenter bg-colour-blue" headers="t4hr6 t4hc2 t4hc3 t4hc8">6</TD><TD class="alignCenter bg-colour-blue" headers="t4hr6 t4hc2 t4hc3 t4hc9">354</TD><TD class=alignCenter headers="t4hr6 t4hc2 t4hc4">145</TD><TD class=alignCenter headers="t4hr6 t4hc2 t4hc5">696</TD></TR><TR><TH id=t4hr7 class=alignLeft headers=t4hc1>% <SUP>1</SUP></TH><TD class=alignCenter headers="t4hr7 t4hc2 t4hc3 t4hc6">79.2%</TD><TD class="alignCenter bg-colour-blue" headers="t4hr7 t4hc2 t4hc3 t4hc7">34.7%</TD><TD class="alignCenter bg-colour-blue" headers="t4hr7 t4hc2 t4hc3 t4hc8">1.1%</TD><TD class="alignCenter bg-colour-blue" headers="t4hr7 t4hc2 t4hc3 t4hc9">64.2%</TD><TD class=alignCenter headers="t4hr7 t4hc2 t4hc4">20.8%</TD><TD class=alignCenter headers="t4hr7 t4hc2 t4hc5">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=t5hc1 rowSpan=3>Age groups </TH><TH id=t5hc2 class=noWrap colSpan=6>Cumulative (Aug. 25, 2013 to 31 May, 2014)<SUP>*</SUP></TH></TR><TR class=bg-colour-yellow><TH id=t5hc3 colSpan=4 headers=t5hc2>Influenza A </TH><TH id=t5hc4 headers=t5hc2>B </TH><TH id=t5hc5 headers=t5hc2>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=t5hc6 headers="t5hc2 t5hc3">A Total </TH><TH id=t5hc7 class=bg-colour-blue headers="t5hc2 t5hc3">A(H1) pdm09 </TH><TH id=t5hc8 class=bg-colour-blue headers="t5hc2 t5hc3">A(H3) </TH><TH id=t5hc9 class=bg-colour-blue headers="t5hc2 t5hc3">A(UnS) </TH><TD class=alignCenter headers="t5hc2 t5hc4">Total</TD><TD class=alignCenter headers="t5hc2 t5hc5"># (%)</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>Two 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=t5hr1 class=alignLeft headers=t5hc1>16-20 </TH><TD class=alignCenter headers="t5hr1 t5hc2 t5hc3 t5hc6">13</TD><TD class=alignCenter headers="t5hr1 t5hc2 t5hc3 t5hc7">5</TD><TD class=alignCenter headers="t5hr1 t5hc2 t5hc3 t5hc8">1</TD><TD class=alignCenter headers="t5hr1 t5hc2 t5hc3 t5hc9">7</TD><TD class=alignCenter headers="t5hr1 t5hc2 t5hc4">2</TD><TD class=alignCenter headers="t5hr1 t5hc2 t5hc5">15 (1%)</TD></TR><TR><TH id=t5hr2 class=alignLeft headers=t5hc1>20-44 </TH><TD class=alignCenter headers="t5hr2 t5hc2 t5hc3 t5hc6">276</TD><TD class=alignCenter headers="t5hr2 t5hc2 t5hc3 t5hc7">142</TD><TD class=alignCenter headers="t5hr2 t5hc2 t5hc3 t5hc8">7</TD><TD class=alignCenter headers="t5hr2 t5hc2 t5hc3 t5hc9">127</TD><TD class=alignCenter headers="t5hr2 t5hc2 t5hc4">47</TD><TD class=alignCenter headers="t5hr2 t5hc2 t5hc5">323 (16%)</TD></TR><TR><TH id=t5hr3 class=alignLeft headers=t5hc1>45-64 </TH><TD class=alignCenter headers="t5hr3 t5hc2 t5hc3 t5hc6">521</TD><TD class=alignCenter headers="t5hr3 t5hc2 t5hc3 t5hc7">245</TD><TD class=alignCenter headers="t5hr3 t5hc2 t5hc3 t5hc8">12</TD><TD class=alignCenter headers="t5hr3 t5hc2 t5hc3 t5hc9">264</TD><TD class=alignCenter headers="t5hr3 t5hc2 t5hc4">135</TD><TD class=alignCenter headers="t5hr3 t5hc2 t5hc5">656 (33%)</TD></TR><TR><TH id=t5hr4 class=alignLeft headers=t5hc1>65+ </TH><TD class=alignCenter headers="t5hr4 t5hc2 t5hc3 t5hc6">525</TD><TD class=alignCenter headers="t5hr4 t5hc2 t5hc3 t5hc7">238</TD><TD class=alignCenter headers="t5hr4 t5hc2 t5hc3 t5hc8">61</TD><TD class=alignCenter headers="t5hr4 t5hc2 t5hc3 t5hc9">226</TD><TD class=alignCenter headers="t5hr4 t5hc2 t5hc4">460</TD><TD class=alignCenter headers="t5hr4 t5hc2 t5hc5">985 (50%)</TD></TR><TR><TH id=t5hr5 class=alignLeft headers=t5hc1>Total </TH><TD class=alignCenter headers="t5hr5 t5hc2 t5hc3 t5hc6">1335</TD><TD class="alignCenter bg-colour-blue" headers="t5hr5 t5hc2 t5hc3 t5hc7">630</TD><TD class="alignCenter bg-colour-blue" headers="t5hr5 t5hc2 t5hc3 t5hc8">81</TD><TD class="alignCenter bg-colour-blue" headers="t5hr5 t5hc2 t5hc3 t5hc9">624</TD><TD class=alignCenter headers="t5hr5 t5hc2 t5hc4">644</TD><TD class=alignCenter headers="t5hr5 t5hc2 t5hc5">1979</TD></TR><TR><TH id=t5hr6 class=alignLeft headers=t5hc1>%<SUP>1</SUP></TH><TD class=alignCenter headers="t5hr6 t5hc2 t5hc3 t5hc6">67%</TD><TD class="alignCenter bg-colour-blue" headers="t5hr6 t5hc2 t5hc3 t5hc7">47%</TD><TD class="alignCenter bg-colour-blue" headers="t5hr6 t5hc2 t5hc3 t5hc8">6%</TD><TD class="alignCenter bg-colour-blue" headers="t5hr6 t5hc2 t5hc3 t5hc9">47%</TD><TD class=alignCenter headers="t5hr6 t5hc2 t5hc4">33%</TD><TD class=alignCenter headers="t5hr6 t5hc2 t5hc5">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)

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            Provincial/Territorial Influenza Hospitalizations and Deaths

            In weeks 21 and 22, 218 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories.* As with other surveillance indicators in weeks 21 and 22, the majority were cases of influenza B (202, 92.7%). Two ICU admissions and 22 deaths were reported in weeks 21 and 22. Nineteen of the 22 deaths were cases with influenza B; two were adults 45-64 years of age, and 20 were adults ≥65 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, 5,086 influenza-associated hospitalizations have been reported, 71.4% with influenza A. The majority (62.6%) 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 367 ICU admissions have been reported this season, of which 64.5% were adults 20-64 years of age. A total of 313 deaths have been reported. The highest proportion of deaths has been among adults ≥65 years of age (54.3%) followed by adults 20-64 years of age (37.1%). 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 28.6% of hospitalizations and 31.3% 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, 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=t6hc1 rowSpan=3>Age groups </TH><TH id=t6hc2 colSpan=6>Cumulative (Aug. 25, 2013 to May 31, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=t6hc3 colSpan=4 headers=t6hc2>Influenza A</TH><TH id=t6hc4 headers=t6hc2>B</TH><TH id=t6hc5 headers=t6hc2>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=t6hc6 headers="t6hc2 t6hc3">A Total</TH><TH id=t6hc7 class=bg-colour-blue headers="t6hc2 t6hc3">A(H1) pdm09</TH><TH id=t6hc8 class=bg-colour-blue headers="t6hc2 t6hc3">A(H3)</TH><TH id=t6hc9 class=bg-colour-blue headers="t6hc2 t6hc3">A (UnS)</TH><TD class=alignCenter headers="t6hc2 t6hc4">Total</TD><TD class=alignCenter headers="t6hc2 t6hc5"># (%)</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=t6hr1 class=alignLeft headers=t6hc1>0-4 years</TH><TD class=alignCenter headers="t6hr1 t6hc2 t6hc3 t6hc6">620</TD><TD class=alignCenter headers="t6hr1 t6hc2 t6hc3 t6hc7">288</TD><TD class=alignCenter headers="t6hr1 t6hc2 t6hc3 t6hc8">13</TD><TD class=alignCenter headers="t6hr1 t6hc2 t6hc3 t6hc9">319</TD><TD class=alignCenter headers="t6hr1 t6hc2 t6hc4">124</TD><TD class=alignCenter headers="t6hr1 t6hc2 t6hc5">744 (15%)</TD></TR><TR><TH id=t6hr2 class=alignLeft headers=t6hc1>5-14 years</TH><TD class=alignCenter headers="t6hr2 t6hc2 t6hc3 t6hc6">135</TD><TD class=alignCenter headers="t6hr2 t6hc2 t6hc3 t6hc7">65</TD><TD class=alignCenter headers="t6hr2 t6hc2 t6hc3 t6hc8">6</TD><TD class=alignCenter headers="t6hr2 t6hc2 t6hc3 t6hc9">64</TD><TD class=alignCenter headers="t6hr2 t6hc2 t6hc4">109</TD><TD class=alignCenter headers="t6hr2 t6hc2 t6hc5">244 (5%)</TD></TR><TR><TH id=t6hr3 class=alignLeft headers=t6hc1>15-19 years</TH><TD class=alignCenter headers="t6hr3 t6hc2 t6hc3 t6hc6">39</TD><TD class=alignCenter headers="t6hr3 t6hc2 t6hc3 t6hc7">22</TD><TD class=alignCenter headers="t6hr3 t6hc2 t6hc3 t6hc8">4</TD><TD class=alignCenter headers="t6hr3 t6hc2 t6hc3 t6hc9">13</TD><TD class=alignCenter headers="t6hr3 t6hc2 t6hc4">6</TD><TD class=alignCenter headers="t6hr3 t6hc2 t6hc5">45 (1%)</TD></TR><TR><TH id=t6hr4 class=alignLeft headers=t6hc1>20-44 years </TH><TD class=alignCenter headers="t6hr4 t6hc2 t6hc3 t6hc6">616</TD><TD class=alignCenter headers="t6hr4 t6hc2 t6hc3 t6hc7">425</TD><TD class=alignCenter headers="t6hr4 t6hc2 t6hc3 t6hc8">5</TD><TD class=alignCenter headers="t6hr4 t6hc2 t6hc3 t6hc9">186</TD><TD class=alignCenter headers="t6hr4 t6hc2 t6hc4">88</TD><TD class=alignCenter headers="t6hr4 t6hc2 t6hc5">704 (14%)</TD></TR><TR><TH id=t6hr5 class=alignLeft headers=t6hc1>45-64 years </TH><TD class=alignCenter headers="t6hr5 t6hc2 t6hc3 t6hc6">1125</TD><TD class=alignCenter headers="t6hr5 t6hc2 t6hc3 t6hc7">707</TD><TD class=alignCenter headers="t6hr5 t6hc2 t6hc3 t6hc8">31</TD><TD class=alignCenter headers="t6hr5 t6hc2 t6hc3 t6hc9">387</TD><TD class=alignCenter headers="t6hr5 t6hc2 t6hc4">277</TD><TD class=alignCenter headers="t6hr5 t6hc2 t6hc5">1402 (28%)</TD></TR><TR><TH id=t6hr6 class=alignLeft headers=t6hc1>65+ years </TH><TD class=alignCenter headers="t6hr6 t6hc2 t6hc3 t6hc6">960</TD><TD class=alignCenter headers="t6hr6 t6hc2 t6hc3 t6hc7">468</TD><TD class=alignCenter headers="t6hr6 t6hc2 t6hc3 t6hc8">107</TD><TD class=alignCenter headers="t6hr6 t6hc2 t6hc3 t6hc9">385</TD><TD class=alignCenter headers="t6hr6 t6hc2 t6hc4">821</TD><TD class=alignCenter headers="t6hr6 t6hc2 t6hc5">1781 (35%)</TD></TR><TR><TH id=t6hr7 class=alignLeft headers=t6hc1>Unknown</TH><TD class=alignCenter headers="t6hr7 t6hc2 t6hc3 t6hc6">138</TD><TD class=alignCenter headers="t6hr7 t6hc2 t6hc3 t6hc7">99</TD><TD class=alignCenter headers="t6hr7 t6hc2 t6hc3 t6hc8">3</TD><TD class=alignCenter headers="t6hr7 t6hc2 t6hc3 t6hc9">36</TD><TD class=alignCenter headers="t6hr7 t6hc2 t6hc4">28</TD><TD class=alignCenter headers="t6hr7 t6hc2 t6hc5">166 (3%)</TD></TR><TR><TH id=t6hr8 class=alignLeft headers=t6hc1>Total </TH><TD class=alignCenter headers="t6hr8 t6hc2 t6hc3 t6hc6">3633</TD><TD class="alignCenter bg-colour-blue" headers="t6hr8 t6hc2 t6hc3 t6hc7">2074</TD><TD class="alignCenter bg-colour-blue" headers="t6hr8 t6hc2 t6hc3 t6hc8">169</TD><TD class="alignCenter bg-colour-blue" headers="t6hr8 t6hc2 t6hc3 t6hc9">1390</TD><TD class=alignCenter headers="t6hr8 t6hc2 t6hc4">1453</TD><TD class=alignCenter headers="t6hr8 t6hc2 t6hc5">5086</TD></TR><TR><TH id=t6hr9 class=alignLeft headers=t6hc1>Percentage <SUP>1</SUP></TH><TD class=alignCenter headers="t6hr9 t6hc2 t6hc3 t6hc6">71.4%</TD><TD class="alignCenter bg-colour-blue" headers="t6hr9 t6hc2 t6hc3 t6hc7">57.1%</TD><TD class="alignCenter bg-colour-blue" headers="t6hr9 t6hc2 t6hc3 t6hc8">4.7%</TD><TD class="alignCenter bg-colour-blue" headers="t6hr9 t6hc2 t6hc3 t6hc9">38.3%</TD><TD class=alignCenter headers="t6hr9 t6hc2 t6hc4">28.6%</TD><TD class=alignCenter headers="t6hr9 t6hc2 t6hc5">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
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            Comment


            • #36
              Re: Canada FluWatch Weekly Reports 2013-2014 Season Weeks 23 and 24

              FluWatch report: June 1 to June 14, 2014 (Weeks 23 and 24)

              Posted 2014-06-20For 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, 421 KB - 10 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/13-14/w24_14/pdf/fw2014-24-eng.pdf">FluWatch report: June 1 to June 14, 2014 (Weeks 23 and 24) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 421 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

              Help with PDF documents

              Overall Summary
              • In weeks 23 and 24, influenza activity in Canada continued to decline and is approaching inter-seasonal levels. Influenza B has circulated later into the spring than in previous seasons, but overall activity remains within expected levels.
              • As of week 24, 5,272 hospitalizations and 326 deaths have been reported from participating regions, which is slightly more hospitalizations but fewer deaths than were reported last year.
              Are you a primary health care practitioner (General Practitioner, Nurse Practitioner or Registered Nurse) interested in becoming a FluWatch sentinel for the 2014-15 influenza season? Contact us at FluWatch@phac-aspc.gc.ca
              Influenza/ILI Activity (geographic spread)

              In week 23, nine regions reported localized activity (ON(6), PE(1), NS(1), NL(1)). In week 24, four of these regions continued to report localized activity (ON(3) and NL(1)) (Figure 1). Five regions did not report data in week 23 and in week 24.
              Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 24





              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 decline from 141 in week 22 to 60 in week 23, and 57 (2.8% of tests) in week 24 (Figure 2). Influenza B remained the predominant virus in weeks 23 and 24, representing 69% of influenza detections. Most jurisdictions have reported low numbers of influenza detections in weeks 23 and 24 (Table 1). This season, A(H1N1)pdm09 predominantly affected adults 20-64 years of age and children <5 years of age, while influenza B affected greater proportions of adults ≥65 years of age and children 5-19 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
              Detections of RSV, coronavirus, and human metapneumovirus have continued to decline and are approaching inter-seasonal levels. The number of positive tests for parainfluenza declined slightly in weeks 23 and 24, and detections of adenovirus have been stable over recent weeks, in keeping with the broader year-round circulation of these viruses. Detections of rhinovirus in recent weeks have been higher than during the same period over the past three seasons, however the number of positive tests decreased in weeks 23 and 24 (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


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              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 margin10px">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
              (June 1 to June 14, 2014)</TH><TH id=ac8 colSpan=5>Cumulative
              (August 25, 2013 to June 14, 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=alignRight headers="ar1 ar2 ac1 ac2 ac3">11 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">11 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac7">6 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac10">1,822 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac11">1,614 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac12">69 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac13">139 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac14">377 </TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">7 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">3 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">4 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac7">19 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac10">3,889 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac11">3,462 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac12">107 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac13">320 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac14">554 </TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">0 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac7">2 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac10">1,384 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac11">988 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac12">8 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac13">388 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac14">195 </TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">0 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac7">7 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac10">685 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac11">463 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac12">7 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac13">215 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac14">72 </TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">12 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">2 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">3 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">7 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac7">18 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac10">5,816 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac11">2,497 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac12">410 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac13">2,909 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac14">3,102 </TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">6 </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">6 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac7">8 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac10">5,376 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac11">677 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac12">6 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac13">4,693 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac14">2,742 </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">1,491 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac11">370 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac12">2 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac13">1,119 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac14">122 </TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">0 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac7">5 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac10">175 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac11">134 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac12">5 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac13">36 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac14">52 </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">1 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac10">119 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac11">118 </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">5 </TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">0 </TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar11 ac1 ac7">7 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac10">381 </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">277 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac14">265 </TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">36 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac4">2 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac5">17 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac6">17 </TD><TD class=alignRight headers="ar1 ar12 ac1 ac7">81 </TD><TD class=alignRight headers="ar1 ar12 ac8 ac9 ac10">21,138 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac11">10,427 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac12">614 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac13">10,097 </TD><TD class=alignRight headers="ar1 ar12 ac8 ac14">7,486 </TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="ar1 ar13 ac1 ac2 ac3">30.8% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac4">5.6% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac5">47.2% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac6">47.2% </TD><TD class=alignRight headers="ar1 ar13 ac1 ac7">69.2% </TD><TD class=alignRight headers="ar1 ar13 ac8 ac9 ac10">73.8% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac11">49.3% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac12">2.9% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac13">47.8% </TD><TD class=alignRight headers="ar1 ar13 ac8 ac14">26.2% </TD></TR></TBODY></TABLE>
              <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t2 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
              (June 1 to June 14, 2014)</TH><TH id=bc8 colSpan=7>Cumulative
              (August 25, 2013 to June 14, 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=alignRight headers="br1 br2 bc1 bc2 bc3">1 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">0 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">0 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">1 </TD><TD class=alignRight headers="br1 br2 bc1 bc7">2 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">3,270 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">1,453 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">41 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1,776 </TD><TD class=alignRight headers="br1 br2 bc8 bc14">557 </TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc16">3,827 </TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc17">16.5% </TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">1 </TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">0 </TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">0 </TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">1 </TD><TD class=alignRight headers="br1 br3 bc1 bc7">4 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1,334 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">707 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">27 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">600 </TD><TD class=alignRight headers="br1 br3 bc8 bc14">823 </TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc16">2,157 </TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc17">9.3% </TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">7 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">1 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">2 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">4 </TD><TD class=alignRight headers="br1 br4 bc1 bc7">8 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">5,104 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">2,818 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">54 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">2,232 </TD><TD class=alignRight headers="br1 br4 bc8 bc14">1,027 </TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc16">6,131 </TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc17">26.5% </TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">4 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">1 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">1 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">2 </TD><TD class=alignRight headers="br1 br5 bc1 bc7">13 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">4,481 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">2,394 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">66 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">2,021 </TD><TD class=alignRight headers="br1 br5 bc8 bc14">1,519 </TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc16">6,000 </TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc17">25.9% </TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">9 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">0 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">0 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">9 </TD><TD class=alignRight headers="br1 br6 bc1 bc7">16 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">2,644 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">1,001 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">177 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">1,466 </TD><TD class=alignRight headers="br1 br6 bc8 bc14">2,269 </TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc16">4,913 </TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc17">21.2% </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">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">137 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">102 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">21 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">14 </TD><TD class=alignRight headers="br1 br7 bc8 bc14">9 </TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc16">146 </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">23 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc4">2 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc5">3 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc6">18 </TD><TD class=alignRight headers="br1 br8 bc1 bc7">43 </TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">16,970 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc11">8,475 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc12">386 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc13">8,109 </TD><TD class=alignRight headers="br1 br8 bc8 bc14">6,204 </TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc16">23,174 </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">34.8% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc4">8.7% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc5">13.0% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc6">78.3% </TD><TD class=alignRight headers="br1 br9 bc1 bc7">65.2% </TD><TD class=alignRight headers="br1 br9 bc8 bc9 bc10">73.2% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc11">49.9% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc12">2.3% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc13">47.8% </TD><TD class=alignRight headers="br1 br9 bc8 bc14">26.8% </TD><TD class=alignRight></TD><TD class=alignRight></TD></TR></TBODY></TABLE>


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              Influenza Strain Characterizations

              During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 2,261 influenza viruses [150 A(H3N2), 1,389 A(H1N1)pdm09 and 722 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, and one A(H3N2) virus showed reduced titres to antiserum against the reference A/Texas/50/2012 strain. Twenty-seven 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 = 2,261

              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 2,125 influenza viruses for resistance to oseltamivir and all but five were sensitive. All 2,130 viruses tested for resistance to zanamivir were sensitive. All 1,630 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=t3hc1 rowSpan=2>Virus type and subtype</TH><TH id=t3hc2 colSpan=2>Oseltamivir</TH><TH id=t3hc3 colSpan=2>Zanamivir</TH><TH id=t3hc4 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=t3hc5 headers=t3hc2># tested</TH><TH id=t3hc6 headers=t3hc2># resistant (%)</TH><TH id=t3hc7 headers=t3hc3># tested</TH><TH id=t3hc8 headers=t3hc3># resistant (%)</TH><TH id=t3hc9 headers=t3hc4># tested</TH><TH id=t3hc10 headers=t3hc4># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=t3hr1 class="alignLeft bg-colour-blue" headers=t3hc1>A (H3N2)</TH><TD class=alignRight headers="t3hr1 t3hc2 t3hc5">128</TD><TD class=alignRight headers="t3hr1 t3hc2 t3hc6">0</TD><TD class=alignRight headers="t3hr1 t3hc3 t3hc7">128</TD><TD class=alignRight headers="t3hr1 t3hc3 t3hc8">0</TD><TD class=alignRight headers="t3hr1 t3hc4 t3hc9">188</TD><TD class=alignRight headers="t3hr1 t3hc4 t3hc10">188 (100%)</TD></TR><TR><TH id=t3hr2 class="alignLeft bg-colour-blue" headers=t3hc1>A (H1N1)</TH><TD class=alignRight headers="t3hr2 t3hc2 t3hc5">1378</TD><TD class=alignRight headers="t3hr2 t3hc2 t3hc6">5 (0.4%)</TD><TD class=alignRight headers="t3hr2 t3hc3 t3hc7">1384</TD><TD class=alignRight headers="t3hr2 t3hc3 t3hc8">0</TD><TD class=alignRight headers="t3hr2 t3hc4 t3hc9">1442</TD><TD class=alignRight headers="t3hr2 t3hc4 t3hc10">1442 (100%)</TD></TR><TR><TH id=t3hr3 class="alignLeft bg-colour-blue" headers=t3hc1>B</TH><TD class=alignRight headers="t3hr3 t3hc2 t3hc5">619</TD><TD class=alignRight headers="t3hr3 t3hc2 t3hc6">0</TD><TD class=alignRight headers="t3hr3 t3hc3 t3hc7">618</TD><TD class=alignRight headers="t3hr3 t3hc3 t3hc8">0</TD><TD class=alignRight headers="t3hr3 t3hc4 t3hc9">NA <SUP>*</SUP></TD><TD class=alignRight headers="t3hr3 t3hc4 t3hc10">NA <SUP>*</SUP></TD></TR><TR><TH id=t3hr4 class="alignLeft bg-colour-blue" headers=t3hc1>TOTAL</TH><TD class=alignRight headers="t3hr4 t3hc2 t3hc5">2125</TD><TD class=alignRight headers="t3hr4 t3hc2 t3hc6">5 (0.2%)</TD><TD class=alignRight headers="t3hr4 t3hc3 t3hc7">2130</TD><TD class=alignRight headers="t3hr4 t3hc3 t3hc8">0</TD><TD class=alignRight headers="t3hr4 t3hc4 t3hc9">1630</TD><TD class=alignRight headers="t3hr4 t3hc4 t3hc10">1630 (100%)</TD></TR></TBODY></TABLE>
              Influenza-like Illness (ILI) Consultation Rate

              The national influenza-like-illness (ILI) consultation rate continued to decrease from 13.2 consultations per 1,000 patient visits in week 22 to 11.6 per 1,000 in week 23 and 8.4 per 1,000 in week 24. The rate for week 23 was slightly above the expected range for this time of year, but the rate for week 24 with within the expected range (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

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              Influenza Outbreak Surveillance

              The number of new influenza outbreaks was low in weeks 23 and 24, with two outbreaks reported in long-term care facilities (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 6Overall number of new influenza outbreaks by report week, Canada, 2013-2014
              Pharmacy Surveillance

              In weeks 23 and 24, the proportion of prescriptions for antivirals continued to decline and is approaching inter-seasonal levels. 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 (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

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              Sentinel Hospital Influenza Surveillance

              Paediatric Influenza Hospitalizations and Deaths (IMPACT)
              In weeks 23 and 24, two new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network. Both were cases of influenza B in children 2-4 years of age (Figure 8a). 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 weeks 23 or 24. Five of the 12 IMPACT hospitals have not had an influenza-associated paediatric admission in at least four weeks.
              To date this season, a total of 709 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 78% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children <5 years of age represent 73% of cases to date (Table 4). One hundred and ten ICU admissions have been reported, of which 72 (65%) were children <5 years of age (Figure 9a). All but 14 were cases with influenza A, and 97% of those subtyped were A(H1N1)pdm09. Among the 107 ICU cases with available data, 68 (64%) were reported to have underlying medical conditions. One death has been reported this season. A smaller number of paediatric hospital admissions have been reported this year compared to the 2012-13 season.
              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)
              Surveillance of laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network has ended for the 2013-14 season (Figure 8b). A summary of PCIRN-SOS data for the 2013-14 season will be included in the FluWatch annual report of influenza surveillance in Canada.
              During passive and active surveillance<SUP>*</SUP> from August 25th, 2013 to May 31st, 2014, 1,985 influenza-associated hospitalizations were reported by the PCIRN-SOS network, 1,338 (67.4%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). Compared to the 2012-13 season, slightly more cases were reported, although the peak number of cases was smaller. A greater number of cases were reported during March and April compared to last year, with six times more cases of influenza B reported. ICU admission was required for 321 hospitalizations, of which 263 were cases with influenza A (137 A(H1N1)pdm09, ten A(H3N2) and 116 A(unsubtyped)), 57 were cases with influenza B and the influenza type was not reported for one case. A greater proportion of cases were admitted to the ICU this season compared to last year, but the proportion of deaths was similar. Of the ICU admissions with available information, 85.9% (189/220) were reported to have at least one comorbidity, and 68.2% (176/258) reported not having been vaccinated this season. Among the 112 deaths reported this season, all but 28 were cases of influenza A (51 A(H1N1)pdm09, three A(H3N2) and 30 A(unsubtyped)); ten cases 20-44 years of age, 37 cases 45-64 years of age and 65 cases ≥65 years of age (Figure 9b). Among fatal cases with available information, 93.8% (60/64) were reported to have at least one comorbidity, and 48.2% (40/83) reported not having been vaccinated this season.
              Note: During the 2013-14 influenza season, PCIRN-SOS conducted passive surveillance from August 25<SUP>th</SUP> to November 14<SUP>th</SUP>, 2013, and May 16<SUP>th</SUP> to 31<SUP>st</SUP>. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance was conducted between November 15<SUP>th</SUP>, 2013 and May 15<SUP>th</SUP>, 2014 during which time PCIRN site coordinators investigated 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 June 14, 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=alignRight headers="dr1 dr2 dc1 dc2 dc3">107 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc4">37 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc5">0 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc6">70 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc7">10 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc8">117 (17%) </TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc3">162 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc4">57 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc5">1 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc6">104 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc7">29 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc8">191 (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">49 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc8">212 (30%) </TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc3">85 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc4">31 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc5">1 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc6">53 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc7">54 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc8">139 (20%) </TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc3">38 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc4">13 </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">12 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc8">50 (7%) </TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignRight headers="dr1 dr7 dc1 dc2 dc3">555 </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr7 dc1 dc2 dc4">193 </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr7 dc1 dc2 dc5">6 </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr7 dc1 dc2 dc6">356 </TD><TD class=alignRight headers="dr1 dr7 dc1 dc7">154 </TD><TD class=alignRight headers="dr1 dr7 dc1 dc8">709 </TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP></TH><TD class=alignRight headers="dr1 dr8 dc1 dc2 dc3">78.3% </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr8 dc1 dc2 dc4">34.8% </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr8 dc1 dc2 dc5">1.1% </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr8 dc1 dc2 dc6">64.1% </TD><TD class=alignRight headers="dr1 dr8 dc1 dc7">21.7% </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 May 31, 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>Two 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">13 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec4">5 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec5">1 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec6">7 </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">276 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec4">142 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec5">7 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec6">127 </TD><TD class=alignRight headers="er1 er3 ec1 ec7">47 </TD><TD class=alignRight headers="er1 er3 ec1 ec8">323 (16%) </TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignRight headers="er1 er4 ec1 ec2 ec3">521 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec4">245 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec5">12 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec6">264 </TD><TD class=alignRight headers="er1 er4 ec1 ec7">135 </TD><TD class=alignRight headers="er1 er4 ec1 ec8">656 (33%) </TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignRight headers="er1 er5 ec1 ec2 ec3">525 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec4">238 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec5">61 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec6">226 </TD><TD class=alignRight headers="er1 er5 ec1 ec7">460 </TD><TD class=alignRight headers="er1 er5 ec1 ec8">985 (50%) </TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignRight headers="er1 er6 ec1 ec2 ec3">1335 </TD><TD class="alignRight bg-colour-blue" headers="er1 er6 ec1 ec2 ec4">630 </TD><TD class="alignRight bg-colour-blue" headers="er1 er6 ec1 ec2 ec5">81 </TD><TD class="alignRight bg-colour-blue" headers="er1 er6 ec1 ec2 ec6">624 </TD><TD class=alignRight headers="er1 er6 ec1 ec7">644 </TD><TD class=alignRight headers="er1 er6 ec1 ec8">1979 </TD></TR><TR><TH id=er7 class=alignLeft headers=er1>%<SUP>1</SUP></TH><TD class=alignRight headers="er1 er7 ec1 ec2 ec3">67% </TD><TD class="alignRight bg-colour-blue" headers="er1 er7 ec1 ec2 ec4">47% </TD><TD class="alignRight bg-colour-blue" headers="er1 er7 ec1 ec2 ec5">6% </TD><TD class="alignRight bg-colour-blue" headers="er1 er7 ec1 ec2 ec6">47% </TD><TD class=alignRight headers="er1 er7 ec1 ec7">33% </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)

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              Provincial/Territorial Influenza Hospitalizations and Deaths

              In weeks 23 and 24, 141 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories.<SUP>*</SUP>As with other surveillance indicators in weeks 23 and 24, the majority were cases of influenza B (115, 81.6%). There were no ICU admissions reported in weeks 23 & 24. Twelve deaths were reported: one adult 45-64 years of age, and 11 adults ≥65 years of age; 11 of the 12 were cases of 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, 5,272 influenza-associated hospitalizations have been reported, 69.6% with influenza A. The majority of hospitalizations have been cases 45 years of age of older: 27.1% 45-64 years of age and 35.9% ≥65 years of age. 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 375 ICU admissions have been reported this season, of which 64.0% were adults 20-64 years of age. A total of 326 deaths have been reported. The highest proportion of deaths has been among adults ≥65 years of age (55.8%) followed by adults 20-64 years of age (35.9%). 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 30.4% of hospitalizations and 33.7% 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, 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 June 14 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=alignRight headers="fr1 fr2 fc1 fc2 fc3">623 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc4">288 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc5">13 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc6">322 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc7">133 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc8">756 (14%) </TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years</TH><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc3">137 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc4">65 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc5">6 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc6">66 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc7">115 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc8">252 (5%) </TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years</TH><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc3">39 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc4">22 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc5">4 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc6">13 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc7">9 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc8">48 (1%) </TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc3">620 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc4">424 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc5">7 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc6">189 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc7">97 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc8">717 (14%) </TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc3">1130 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc4">710 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc5">32 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc6">388 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc7">301 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc8">1431 (27%) </TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc3">981 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc4">469 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc5">115 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc6">397 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc7">914 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc8">1895 (36%) </TD></TR><TR><TH id=fr10 class=alignLeft headers=fr1>Unknown</TH><TD class=alignRight headers="fc1 fc2 fc3">138 </TD><TD class=alignRight headers="fc1 fc2 fc4">99 </TD><TD class=alignRight headers="fc1 fc2 fc5">3 </TD><TD class=alignRight headers="fc1 fc2 fc6">36 </TD><TD class=alignRight headers="fc1 fc7">35 </TD><TD class=alignRight headers="fc1 fc8">173 (3%) </TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignRight headers="fr1 fr8 fc1 fc2 fc3">3668 </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr8 fc1 fc2 fc4">2077 </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr8 fc1 fc2 fc5">180 </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr8 fc1 fc2 fc6">1411 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc7">1604 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc8">5272 </TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP></TH><TD class=alignRight headers="fr1 fr9 fc1 fc2 fc3">69.6% </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr9 fc1 fc2 fc4">56.6% </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr9 fc1 fc2 fc5">4.9% </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr9 fc1 fc2 fc6">38.5% </TD><TD class=alignRight headers="fr1 fr9 fc1 fc7">30.4% </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


              • #37
                Re: Canada FluWatch Weekly Reports 2013-2014 Season Weeks 25 and 26

                FluWatch report: June 15 to June 28, 2014 (Weeks 25 and 26)

                Posted 2014-07-04For 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, 421 KB - 10 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/13-14/w26_14/pdf/fw2014-26-eng.pdf">FluWatch report: June 15 to June 28, 2014 (Weeks 25 and 26) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 421 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

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                Overall Summary
                • In weeks 25 and 26, influenza activity in Canada continued to decline and is approaching inter-seasonal levels. Influenza B has circulated later into the spring than in previous seasons, but overall activity remains within expected levels. There have been no new influenza outbreaks reported in the last three weeks.
                • As of week 26, 5,358 hospitalizations and 332 deaths have been reported from participating regions, which is slightly more hospitalizations but fewer deaths than were reported last year.
                Are you a primary health care practitioner (General Practitioner, Nurse Practitioner or Registered Nurse) interested in becoming a FluWatch sentinel for the 2014-15 influenza season? Contact us at FluWatch@phac-aspc.gc.ca
                Influenza/ILI Activity (geographic spread)

                In week 25, two regions in Ontario reported localized activity. In week 26, one of these regions continued to report localized activity (Figure 1). Eight regions did not report data in week 25 and one region did not report data in week 26.
                Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 26





                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 decline from 57 in week 24 to 35 in week 25, and remained stable at 35 (2.0% of tests) in week 26 (Figure 2). Influenza B declined in weeks 25 and 26, representing 46% of influenza detections. Most jurisdictions have reported low numbers of influenza detections in weeks 25 and 26 (Table 1). This season, A(H1N1)pdm09 predominantly affected adults 20-64 years of age and children <5 years of age, while influenza B affected greater proportions of adults ≥65 years of age and children 5-19 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
                Detections of RSV, coronavirus, and human metapneumovirus have continued to decline and are approaching inter-seasonal levels. The number of positive tests for parainfluenza declined slightly in weeks 25 and 26, and detections of adenovirus have been stable over recent weeks, in keeping with the broader year-round circulation of these viruses. Detections of rhinovirus in recent weeks have been higher than during the same period over the past three seasons, however the number of positive tests decreased in weeks 25 and 26 (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


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                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 margin10px">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
                (June 15 to June 28, 2014)
                </TH><TH id=ac8 colSpan=5>Cumulative
                (August 25, 2013 to June 28, 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">6 </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">6 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac7">10 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac10">1825 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac11">1614 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac12">67 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac13">144 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac14">384 </TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac3">12 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac5">10 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac6">2 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac7">8 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac10">3899 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac11">3462 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac12">120 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac13">317 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac14">569 </TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac3">0 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac4">0 </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">2 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac10">1384 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac11">988 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac12">8 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac13">388 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac14">197 </TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac3">0 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac6">0 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac7">0 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac10">685 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac11">463 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac12">7 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac13">215 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac14">72 </TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac3">16 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac4">2 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac5">6 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac6">8 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac7">6 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac10">5826 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac11">2499 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac12">413 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac13">2914 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac14">3109 </TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac3">2 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac6">2 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac7">2 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac10">5377 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac11">677 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac12">6 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac13">4694 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac14">2745 </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">4 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac10">1491 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac11">370 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac12">2 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac13">1119 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac14">130 </TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac3">0 </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">0 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac7">0 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac10">175 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac11">134 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac12">5 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac13">36 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac14">52 </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">119 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac11">118 </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">5 </TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac3">2 </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">2 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac7">0 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac10">383 </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">279 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac14">265 </TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignCenter headers="ar1 ar12 ac1 ac2 ac3">38 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac1 ac2 ac4">2 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac1 ac2 ac5">16 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac1 ac2 ac6">20 </TD><TD class=alignCenter headers="ar1 ar12 ac1 ac7">32 </TD><TD class=alignCenter headers="ar1 ar12 ac8 ac9 ac10">21164 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac8 ac9 ac11">10429 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac8 ac9 ac12">628 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac8 ac9 ac13">10107 </TD><TD class=alignCenter headers="ar1 ar12 ac8 ac14">7528 </TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignCenter headers="ar1 ar13 ac1 ac2 ac3">54.3% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac1 ac2 ac4">5.3% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac1 ac2 ac5">42.1% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac1 ac2 ac6">52.6% </TD><TD class=alignCenter headers="ar1 ar13 ac1 ac7">45.7% </TD><TD class=alignCenter headers="ar1 ar13 ac8 ac9 ac10">73.8% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac8 ac9 ac11">49.3% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac8 ac9 ac12">3.0% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac8 ac9 ac13">47.8% </TD><TD class=alignCenter headers="ar1 ar13 ac8 ac14">26.2% </TD></TR></TBODY></TABLE>
                <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t2 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
                (June 15 to June 28, 2014)
                </TH><TH id=bc8 colSpan=7>Cumulative
                (August 25, 2013 to June 28, 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">0 </TD><TD class=alignCenter headers="br1 br2 bc1 bc2 bc4">0 </TD><TD class=alignCenter headers="br1 br2 bc1 bc2 bc5">0 </TD><TD class=alignCenter headers="br1 br2 bc1 bc2 bc6">0 </TD><TD class=alignCenter headers="br1 br2 bc1 bc7">1 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc10">3270 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc11">1453 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc12">42 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc13">1775 </TD><TD class=alignCenter headers="br1 br2 bc8 bc14">558 </TD><TD class=alignCenter headers="br1 br2 bc8 bc15 bc16">3828 </TD><TD class=alignCenter headers="br1 br2 bc8 bc15 bc17">16.5% </TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignCenter headers="br1 br3 bc1 bc2 bc3">1 </TD><TD class=alignCenter headers="br1 br3 bc1 bc2 bc4">0 </TD><TD class=alignCenter headers="br1 br3 bc1 bc2 bc5">0 </TD><TD class=alignCenter headers="br1 br3 bc1 bc2 bc6">1 </TD><TD class=alignCenter headers="br1 br3 bc1 bc7">2 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc10">1334 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc11">707 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc12">25 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc13">602 </TD><TD class=alignCenter headers="br1 br3 bc8 bc14">828 </TD><TD class=alignCenter headers="br1 br3 bc8 bc15 bc16">2162 </TD><TD class=alignCenter headers="br1 br3 bc8 bc15 bc17">9.3% </TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignCenter headers="br1 br4 bc1 bc2 bc3">2 </TD><TD class=alignCenter headers="br1 br4 bc1 bc2 bc4">0 </TD><TD class=alignCenter headers="br1 br4 bc1 bc2 bc5">0 </TD><TD class=alignCenter headers="br1 br4 bc1 bc2 bc6">2 </TD><TD class=alignCenter headers="br1 br4 bc1 bc7">2 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc10">5107 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc11">2819 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc12">54 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc13">2234 </TD><TD class=alignCenter headers="br1 br4 bc8 bc14">1029 </TD><TD class=alignCenter headers="br1 br4 bc8 bc15 bc16">6136 </TD><TD class=alignCenter headers="br1 br4 bc8 bc15 bc17">26.4% </TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignCenter headers="br1 br5 bc1 bc2 bc3">5 </TD><TD class=alignCenter headers="br1 br5 bc1 bc2 bc4">0 </TD><TD class=alignCenter headers="br1 br5 bc1 bc2 bc5">2 </TD><TD class=alignCenter headers="br1 br5 bc1 bc2 bc6">3 </TD><TD class=alignCenter headers="br1 br5 bc1 bc7">8 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc10">4486 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc11">2394 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc12">68 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc13">2024 </TD><TD class=alignCenter headers="br1 br5 bc8 bc14">1528 </TD><TD class=alignCenter headers="br1 br5 bc8 bc15 bc16">6014 </TD><TD class=alignCenter headers="br1 br5 bc8 bc15 bc17">25.9% </TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignCenter headers="br1 br6 bc1 bc2 bc3">14 </TD><TD class=alignCenter headers="br1 br6 bc1 bc2 bc4">1 </TD><TD class=alignCenter headers="br1 br6 bc1 bc2 bc5">10 </TD><TD class=alignCenter headers="br1 br6 bc1 bc2 bc6">3 </TD><TD class=alignCenter headers="br1 br6 bc1 bc7">7 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc10">2657 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc11">1002 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc12">179 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc13">1476 </TD><TD class=alignCenter headers="br1 br6 bc8 bc14">2279 </TD><TD class=alignCenter headers="br1 br6 bc8 bc15 bc16">4936 </TD><TD class=alignCenter headers="br1 br6 bc8 bc15 bc17">21.3% </TD></TR><TR><TH id=br7 class=alignLeft headers=br1>Unknown</TH><TD class=alignCenter headers="br1 br7 bc1 bc2 bc3">1 </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">1 </TD><TD class=alignCenter headers="br1 br7 bc1 bc7">0 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc10">137 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc11">102 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc12">21 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc13">14 </TD><TD class=alignCenter headers="br1 br7 bc8 bc14">9 </TD><TD class=alignCenter headers="br1 br7 bc8 bc15 bc16">146 </TD><TD class=alignCenter headers="br1 br7 bc8 bc15 bc17">0.6% </TD></TR><TR><TH id=br8 class=alignLeft headers=br1>Total</TH><TD class=alignCenter headers="br1 br8 bc1 bc2 bc3">23 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc1 bc2 bc4">1 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc1 bc2 bc5">12 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc1 bc2 bc6">10 </TD><TD class=alignCenter headers="br1 br8 bc1 bc7">20 </TD><TD class=alignCenter headers="br1 br8 bc8 bc9 bc10">16991 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc8 bc9 bc11">8477 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc8 bc9 bc12">389 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc8 bc9 bc13">8125 </TD><TD class=alignCenter headers="br1 br8 bc8 bc14">6231 </TD><TD class=alignCenter headers="br1 br8 bc8 bc15 bc16">23222 </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">53.5% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc1 bc2 bc4">4.3% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc1 bc2 bc5">52.2% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc1 bc2 bc6">43.5% </TD><TD class=alignCenter headers="br1 br9 bc1 bc7">46.5% </TD><TD class=alignCenter headers="br1 br9 bc8 bc9 bc10">73.2% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc8 bc9 bc11">49.9% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc8 bc9 bc12">2.3% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc8 bc9 bc13">47.8% </TD><TD class=alignCenter headers="br1 br9 bc8 bc14">26.8% </TD><TD class=alignCenter></TD><TD class=alignCenter></TD></TR></TBODY></TABLE>


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                Influenza Strain Characterizations

                During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 2,358 influenza viruses [169 A(H3N2), 1,397 A(H1N1)pdm09 and 792 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, and one A(H3N2) virus showed reduced titres to antiserum against the reference A/Texas/50/2012 strain. Twenty-eight 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 = 2358

                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 2,302 influenza viruses for resistance to oseltamivir and all but five were sensitive. All 2,300 viruses tested for resistance to zanamivir were sensitive. All 1,647 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=t3hc1 rowSpan=2>Virus type and subtype</TH><TH id=t3hc2 colSpan=2>Oseltamivir</TH><TH id=t3hc3 colSpan=2>Zanamivir</TH><TH id=t3hc4 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=t3hc5 headers=t3hc2># tested</TH><TH id=t3hc6 headers=t3hc2># resistant (%)</TH><TH id=t3hc7 headers=t3hc3># tested</TH><TH id=t3hc8 headers=t3hc3># resistant (%)</TH><TH id=t3hc9 headers=t3hc4># tested</TH><TH id=t3hc10 headers=t3hc4># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=t3hr1 class="alignLeft bg-colour-blue" headers=t3hc1>A (H3N2)</TH><TD class=alignCenter headers="t3hr1 t3hc2 t3hc5">157</TD><TD class=alignCenter headers="t3hr1 t3hc2 t3hc6">0</TD><TD class=alignCenter headers="t3hr1 t3hc3 t3hc7">156</TD><TD class=alignCenter headers="t3hr1 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr1 t3hc4 t3hc9">204</TD><TD class=alignCenter headers="t3hr1 t3hc4 t3hc10">204 (100%)</TD></TR><TR><TH id=t3hr2 class="alignLeft bg-colour-blue" headers=t3hc1>A (H1N1)</TH><TD class=alignCenter headers="t3hr2 t3hc2 t3hc5">1397</TD><TD class=alignCenter headers="t3hr2 t3hc2 t3hc6">5 (0.4%)</TD><TD class=alignCenter headers="t3hr2 t3hc3 t3hc7">1398</TD><TD class=alignCenter headers="t3hr2 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr2 t3hc4 t3hc9">1443</TD><TD class=alignCenter headers="t3hr2 t3hc4 t3hc10">1443 (100%)</TD></TR><TR><TH id=t3hr3 class="alignLeft bg-colour-blue" headers=t3hc1>B</TH><TD class=alignCenter headers="t3hr3 t3hc2 t3hc5">748</TD><TD class=alignCenter headers="t3hr3 t3hc2 t3hc6">0</TD><TD class=alignCenter headers="t3hr3 t3hc3 t3hc7">746</TD><TD class=alignCenter headers="t3hr3 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr3 t3hc4 t3hc9">NA <SUP>*</SUP></TD><TD class=alignCenter headers="t3hr3 t3hc4 t3hc10">NA <SUP>*</SUP></TD></TR><TR><TH id=t3hr4 class="alignLeft bg-colour-blue" headers=t3hc1>TOTAL</TH><TD class=alignCenter headers="t3hr4 t3hc2 t3hc5">2302</TD><TD class=alignCenter headers="t3hr4 t3hc2 t3hc6">5 (0.2%)</TD><TD class=alignCenter headers="t3hr4 t3hc3 t3hc7">2300</TD><TD class=alignCenter headers="t3hr4 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr4 t3hc4 t3hc9">1647</TD><TD class=alignCenter headers="t3hr4 t3hc4 t3hc10">1647 (100%)</TD></TR></TBODY></TABLE>
                Influenza-like Illness (ILI) Consultation Rate

                The national influenza-like-illness (ILI) consultation rate increased from 8.2 consultations per 1,000 patient visits in week 24 to 13.7 per 1,000 in week 25. The rate decreased again in week 26 to 9.0 per 1,000. The rates for week 25 and 26 were above 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

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                Influenza Outbreak Surveillance

                No new influenza outbreaks were reported in weeks 25 and 26 (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 6Overall number of new influenza outbreaks by report week, Canada, 2013-2014
                Pharmacy Surveillance

                In weeks 25 and 26, the proportion of prescriptions for antivirals continued to decline and is approaching inter-seasonal levels. 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 (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

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                Sentinel Hospital Influenza Surveillance

                Paediatric Influenza Hospitalizations and Deaths (IMPACT)
                In weeks 25 and 26, no new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations, ICU admissions or deaths were reported by the Immunization Monitoring Program Active (IMPACT) network (Figure 8a).
                To date this season, a total of 708 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 79% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children <5 years of age represent 73% of cases to date (Table 4). One hundred and twelve ICU admissions have been reported, of which 74 (66%) were children <5 years of age (Figure 9a). All but 19 were cases with influenza A, and 97% of those subtyped were A(H1N1)pdm09. Among the 98 ICU cases with available data, 71 (72%) were reported to have underlying medical conditions. One death has been reported this season. A smaller number of paediatric hospital admissions have been reported this year compared to the 2012-13 season.
                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)
                Surveillance of laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network has ended for the 2013-14 season (Figure 8b). A summary of PCIRN-SOS data for the 2013-14 season will be included in the FluWatch annual report of influenza surveillance in Canada.
                During passive and active surveillance* from August 25th, 2013 to May 31st, 2014, 1,985 influenza-associated hospitalizations were reported by the PCIRN-SOS network, 1,338 (67.4%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). Compared to the 2012-13 season, slightly more cases were reported, although the peak number of cases was smaller. A greater number of cases were reported during March and April compared to last year, with six times more cases of influenza B reported. ICU admission was required for 321 hospitalizations, of which 263 were cases with influenza A (137 A(H1N1)pdm09, ten A(H3N2) and 116 A(unsubtyped)), 57 were cases with influenza B and the influenza type was not reported for one case. A greater proportion of cases were admitted to the ICU this season compared to last year, but the proportion of deaths was similar. Of the ICU admissions with available information, 85.9% (189/220) were reported to have at least one comorbidity, and 68.2% (176/258) reported not having been vaccinated this season. Among the 112 deaths reported this season, all but 28 were cases of influenza A (51 A(H1N1)pdm09, three A(H3N2) and 30 A(unsubtyped)); ten cases 20-44 years of age, 37 cases 45-64 years of age and 65 cases ≥65 years of age (Figure 9b). Among fatal cases with available information, 93.8% (60/64) were reported to have at least one comorbidity, and 48.2% (40/83) reported not having been vaccinated this season.
                Note: During the 2013-14 influenza season, PCIRN-SOS conducted passive surveillance from August 25<SUP>th</SUP> to November 14<SUP>th</SUP>, 2013, and May 16<SUP>th</SUP> to 31<SUP>st</SUP>. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance was conducted between November 15<SUP>th</SUP>, 2013 and May 15<SUP>th</SUP>, 2014 during which time PCIRN site coordinators investigated 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 June 28, 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">106 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc4">37 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc5">0 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc6">69 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc7">11 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc8">117 (17%) </TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc3">164 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc4">57 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc5">1 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc6">106 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc7">28 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc8">192 (27%) </TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc3">163 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc4">55 </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">48 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc8">211 (30%) </TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc3">85 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc4">31 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc5">1 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc6">53 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc7">54 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc8">139 (20%) </TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc3">38 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc4">13 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc5">1 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc6">24 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc7">11 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc8">49 (7%) </TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignCenter headers="dr1 dr7 dc1 dc2 dc3">556 </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc4">193 </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc5">6 </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc6">357 </TD><TD class=alignCenter headers="dr1 dr7 dc1 dc7">152 </TD><TD class=alignCenter headers="dr1 dr7 dc1 dc8">708 </TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP></TH><TD class=alignCenter headers="dr1 dr8 dc1 dc2 dc3">78.5% </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc4">34.7% </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc5">1.1% </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc6">64.2% </TD><TD class=alignCenter headers="dr1 dr8 dc1 dc7">21.5% </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 June 28, 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>Two 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=alignCenter headers="er1 er2 ec1 ec2 ec3">13 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec4">5 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec5">1 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec6">7 </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">276 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec4">142 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec5">7 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec6">127 </TD><TD class=alignCenter headers="er1 er3 ec1 ec7">47 </TD><TD class=alignCenter headers="er1 er3 ec1 ec8">323 (16%) </TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignCenter headers="er1 er4 ec1 ec2 ec3">521 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec4">245 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec5">12 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec6">264 </TD><TD class=alignCenter headers="er1 er4 ec1 ec7">135 </TD><TD class=alignCenter headers="er1 er4 ec1 ec8">656 (33%) </TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignCenter headers="er1 er5 ec1 ec2 ec3">525 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec4">238 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec5">61 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec6">226 </TD><TD class=alignCenter headers="er1 er5 ec1 ec7">460 </TD><TD class=alignCenter headers="er1 er5 ec1 ec8">985 (50%) </TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignCenter headers="er1 er6 ec1 ec2 ec3">1335 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec4">630 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec5">81 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec6">624 </TD><TD class=alignCenter headers="er1 er6 ec1 ec7">644 </TD><TD class=alignCenter headers="er1 er6 ec1 ec8">1979 </TD></TR><TR><TH id=er7 class=alignLeft headers=er1>%<SUP>1</SUP></TH><TD class=alignCenter headers="er1 er7 ec1 ec2 ec3">67% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec4">47% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec5">6% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec6">47% </TD><TD class=alignCenter headers="er1 er7 ec1 ec7">33% </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)

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                Provincial/Territorial Influenza Hospitalizations and Deaths

                In weeks 25 and 26, 55 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories.* As with other surveillance indicators in weeks 25 and 26, the majority were cases of influenza B (44, 80.0%). There were no ICU admissions reported in weeks 25 & 26. Five deaths were reported: 1 adult 45-64 years of age, and 4 adults ≥65 years of age; 4 of the 5 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, 5,358 influenza-associated hospitalizations have been reported, 68.9% with influenza A. The majority (63.2%) 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 5-14 years of age, compared to cases of A(H1N1)pdm09 this season (Table 6). A total of 380 ICU admissions have been reported this season, of which 63.9% were adults 20-64 years of age. A total of 332 deaths have been reported. The highest proportion of deaths has been among adults ≥65 years of age (56.0%) followed by adults 20-64 years of age (35.8%). 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 31.1% of hospitalizations and 34.6% 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, 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 June 28, 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">626 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc4">289 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc5">13 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc6">324 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc7">141 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc8">767 (14%) </TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years</TH><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc3">136 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc4">65 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc5">6 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc6">65 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc7">121 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc8">257 (5%) </TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years</TH><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc3">40 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc4">23 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc5">4 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc6">13 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc7">9 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc8">49 (1%) </TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc3">623</TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc4">425 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc5">9 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc6">189 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc7">104 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc8">727 (14%) </TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc3">1133 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc4">711 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc5">34 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc6">388 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc7">307 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc8">1440 (27%) </TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc3">997 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc4">471 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc5">123 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc6">403 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc7">948 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc8">1945 (36%) </TD></TR><TR><TH id=fr10 class=alignLeft headers=fr1>Unknown</TH><TD class=alignCenter headers="fc1 fc2 fc3">138 </TD><TD class=alignCenter headers="fc1 fc2 fc4">99 </TD><TD class=alignCenter headers="fc1 fc2 fc5">3 </TD><TD class=alignCenter headers="fc1 fc2 fc6">36 </TD><TD class=alignCenter headers="fc1 fc7">35 </TD><TD class=alignCenter headers="fc1 fc8">173 (3%) </TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignCenter headers="fr1 fr8 fc1 fc2 fc3">3693 </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc4">2083 </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc5">192 </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc6">1418 </TD><TD class=alignCenter headers="fr1 fr8 fc1 fc7">1665 </TD><TD class=alignCenter headers="fr1 fr8 fc1 fc8">5358 </TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP></TH><TD class=alignCenter headers="fr1 fr9 fc1 fc2 fc3">68.6% </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc4">56.4% </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc5">5.2% </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc6">38.4% </TD><TD class=alignCenter headers="fr1 fr9 fc1 fc7">31.1% </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


                • #38
                  Re: Canada FluWatch Weekly Reports 2013-2014 Season Weeks 27 and 28

                  FluWatch report: June 29 to July 12, 2014 (Weeks 27 and 28)

                  Posted 2014-07-18For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
                  <A title="Flu Watch (Version PDF, 411 KB - 10 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/13-14/w28_14/pdf/fw2014-28-eng.pdf">FluWatch report: June 29 to July 12, 2014 (Weeks 27 and 28) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 411 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

                  Help with PDF documents


                  Overall Summary
                  • Influenza activity in Canada is at inter-seasonal levels with most jurisdictions reporting only sporadic detections of influenza and no influenza or ILI outbreaks. Influenza B circulated later into the spring than in previous seasons, but overall activity remained within expected levels.
                  • As of week 28, 5,414 hospitalizations and 340 deaths have been reported from participating regions, which is slightly more hospitalizations but fewer deaths than were reported last year.
                  Are you a primary health care practitioner (General Practitioner, Nurse Practitioner or Registered Nurse) interested in becoming a FluWatch sentinel for the 2014-15 influenza season? Contact us at FluWatch@phac-aspc.gc.ca
                  Influenza/ILI Activity (geographic spread)

                  In week 27, one region in Ontario reported localized influenza/ILI activity. In week 28, no region reported localized activity (Figure 1). Seven regions did not report data in week 27 and 16 regions did not report data in week 28.
                  Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 28





                  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 declined from 30 in week 26 to 21 in week 27, and remained stable at 20 (1.5% of tests) in week 28 (Figure 2). Influenza B circulated later into the spring than in previous seasons, but detections are now at inter-seasonal levels. Most jurisdictions have reported only sporadic numbers of influenza detections in recent weeks (Table 1). This season, A(H1N1)pdm09 predominantly affected adults 20-64 years of age and children <5 years of age, while influenza B affected greater proportions of adults ≥65 years of age and children 5-19 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
                  Detections of RSV, coronavirus, and human metapneumovirus have continued to decline and are near inter-seasonal levels. The number of positive tests for parainfluenza and adenovirus continued to follow a downward trend. Detections of rhinovirus were higher in May and June than during the same period over the past three seasons, however the number of positive tests continues to decrease (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 margin10px">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=t1hc1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=t1hc2 colSpan=5>Weekly
                  (June 29 to July 12, 2014)
                  </TH><TH id=t1hc3 colSpan=5>Cumulative
                  (August 25, 2013 to July 12, 2014)
                  </TH></TR><TR class=bg-colour-yellow><TH id=t1hc4 colSpan=4 headers=t1hc2>Influenza A</TH><TH id=t1hc5 headers=t1hc2>B</TH><TH id=t1hc6 colSpan=4 headers=t1hc3>Influenza A</TH><TH id=t1hc7 headers=t1hc3>B</TH></TR><TR class=bg-colour-grey-light><TH id=t1hc8 headers="t1hc2 t1hc4">A Total</TH><TH id=t1hc9 class=" bg-colour-blue" headers="t1hc2 t1hc4">A(H1)pdm09</TH><TH id=t1hc10 class=" bg-colour-blue" headers="t1hc2 t1hc4">A(H3)</TH><TH id=t1hc11 class=" bg-colour-blue" headers="t1hc2 t1hc4">A(UnS)</TH><TH id=t1hc12 class=alignCenter headers="t1hc2 t1hc5">B Total</TH><TH id=t1hc13 headers="t1hc3 t1hc6">A Total</TH><TH id=t1hc14 class=" bg-colour-blue" headers="t1hc3 t1hc6">A(H1)pdm09</TH><TH id=t1hc15 class=" bg-colour-blue" headers="t1hc3 t1hc6">A(H3)</TH><TH id=t1hc16 class=" bg-colour-blue" headers="t1hc3 t1hc6">A(UnS)</TH><TD class=alignCenter headers="t1hc3 t1hc7">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=t1hr1 class=alignLeft headers=t1hc1>BC</TH><TD class=alignCenter headers="t1hr1 t1hc2 t1hc4 t1hc8">11</TD><TD class=alignCenter headers="t1hr1 t1hc2 t1hc4 t1hc9">1</TD><TD class=alignCenter headers="t1hr1 t1hc2 t1hc4 t1hc10">9</TD><TD class=alignCenter headers="t1hr1 t1hc2 t1hc4 t1hc11">1</TD><TD class=alignCenter headers="t1hr1 t1hc2 t1hc5 t1hc12">3</TD><TD class=alignCenter headers="t1hr1 t1hc3 t1hc6 t1hc13">1836</TD><TD class=alignCenter headers="t1hr1 t1hc3 t1hc6 t1hc14">1615</TD><TD class=alignCenter headers="t1hr1 t1hc3 t1hc6 t1hc15">78</TD><TD class=alignCenter headers="t1hr1 t1hc3 t1hc6 t1hc16">143</TD><TD class=alignCenter headers="t1hr1 t1hc3 t1hc7">387</TD></TR><TR><TH id=t1hr2 class=alignLeft headers=t1hc1>AB</TH><TD class=alignCenter headers="t1hr2 t1hc2 t1hc4 t1hc8">4</TD><TD class=alignCenter headers="t1hr2 t1hc2 t1hc4 t1hc9">1</TD><TD class=alignCenter headers="t1hr2 t1hc2 t1hc4 t1hc10">3</TD><TD class=alignCenter headers="t1hr2 t1hc2 t1hc4 t1hc11">0</TD><TD class=alignCenter headers="t1hr2 t1hc2 t1hc5 t1hc12">3</TD><TD class=alignCenter headers="t1hr2 t1hc3 t1hc6 t1hc13">3903</TD><TD class=alignCenter headers="t1hr2 t1hc3 t1hc6 t1hc14">3463</TD><TD class=alignCenter headers="t1hr2 t1hc3 t1hc6 t1hc15">124</TD><TD class=alignCenter headers="t1hr2 t1hc3 t1hc6 t1hc16">316</TD><TD class=alignCenter headers="t1hr2 t1hc3 t1hc7">572</TD></TR><TR><TH id=t1hr3 class=alignLeft headers=t1hc1>SK</TH><TD class=alignCenter headers="t1hr3 t1hc2 t1hc4 t1hc8">0</TD><TD class=alignCenter headers="t1hr3 t1hc2 t1hc4 t1hc9">0</TD><TD class=alignCenter headers="t1hr3 t1hc2 t1hc4 t1hc10">0</TD><TD class=alignCenter headers="t1hr3 t1hc2 t1hc4 t1hc11">0</TD><TD class=alignCenter headers="t1hr3 t1hc2 t1hc5 t1hc12">1</TD><TD class=alignCenter headers="t1hr3 t1hc3 t1hc6 t1hc13">1384</TD><TD class=alignCenter headers="t1hr3 t1hc3 t1hc6 t1hc14">988</TD><TD class=alignCenter headers="t1hr3 t1hc3 t1hc6 t1hc15">8</TD><TD class=alignCenter headers="t1hr3 t1hc3 t1hc6 t1hc16">388</TD><TD class=alignCenter headers="t1hr3 t1hc3 t1hc7">198</TD></TR><TR><TH id=t1hr4 class=alignLeft headers=t1hc1>MB</TH><TD class=alignCenter headers="t1hr4 t1hc2 t1hc4 t1hc8">0</TD><TD class=alignCenter headers="t1hr4 t1hc2 t1hc4 t1hc9">0</TD><TD class=alignCenter headers="t1hr4 t1hc2 t1hc4 t1hc10">0</TD><TD class=alignCenter headers="t1hr4 t1hc2 t1hc4 t1hc11">0</TD><TD class=alignCenter headers="t1hr4 t1hc2 t1hc5 t1hc12">0</TD><TD class=alignCenter headers="t1hr4 t1hc3 t1hc6 t1hc13">685</TD><TD class=alignCenter headers="t1hr4 t1hc3 t1hc6 t1hc14">463</TD><TD class=alignCenter headers="t1hr4 t1hc3 t1hc6 t1hc15">7</TD><TD class=alignCenter headers="t1hr4 t1hc3 t1hc6 t1hc16">215</TD><TD class=alignCenter headers="t1hr4 t1hc3 t1hc7">72</TD></TR><TR><TH id=t1hr5 class=alignLeft headers=t1hc1>ON</TH><TD class=alignCenter headers="t1hr5 t1hc2 t1hc4 t1hc8">8</TD><TD class=alignCenter headers="t1hr5 t1hc2 t1hc4 t1hc9">0</TD><TD class=alignCenter headers="t1hr5 t1hc2 t1hc4 t1hc10">7</TD><TD class=alignCenter headers="t1hr5 t1hc2 t1hc4 t1hc11">1</TD><TD class=alignCenter headers="t1hr5 t1hc2 t1hc5 t1hc12">4</TD><TD class=alignCenter headers="t1hr5 t1hc3 t1hc6 t1hc13">5830</TD><TD class=alignCenter headers="t1hr5 t1hc3 t1hc6 t1hc14">2499</TD><TD class=alignCenter headers="t1hr5 t1hc3 t1hc6 t1hc15">420</TD><TD class=alignCenter headers="t1hr5 t1hc3 t1hc6 t1hc16">2911</TD><TD class=alignCenter headers="t1hr5 t1hc3 t1hc7">3112</TD></TR><TR><TH id=t1hr6 class=alignLeft headers=t1hc1>QC</TH><TD class=alignCenter headers="t1hr6 t1hc2 t1hc4 t1hc8">1</TD><TD class=alignCenter headers="t1hr6 t1hc2 t1hc4 t1hc9">0</TD><TD class=alignCenter headers="t1hr6 t1hc2 t1hc4 t1hc10">0</TD><TD class=alignCenter headers="t1hr6 t1hc2 t1hc4 t1hc11">1</TD><TD class=alignCenter headers="t1hr6 t1hc2 t1hc5 t1hc12">1</TD><TD class=alignCenter headers="t1hr6 t1hc3 t1hc6 t1hc13">5378</TD><TD class=alignCenter headers="t1hr6 t1hc3 t1hc6 t1hc14">677</TD><TD class=alignCenter headers="t1hr6 t1hc3 t1hc6 t1hc15">6</TD><TD class=alignCenter headers="t1hr6 t1hc3 t1hc6 t1hc16">4695</TD><TD class=alignCenter headers="t1hr6 t1hc3 t1hc7">2746</TD></TR><TR><TH id=t1hr7 class=alignLeft headers=t1hc1>NB</TH><TD class=alignCenter headers="t1hr7 t1hc2 t1hc4 t1hc8">0</TD><TD class=alignCenter headers="t1hr7 t1hc2 t1hc4 t1hc9">0</TD><TD class=alignCenter headers="t1hr7 t1hc2 t1hc4 t1hc10">0</TD><TD class=alignCenter headers="t1hr7 t1hc2 t1hc4 t1hc11">0</TD><TD class=alignCenter headers="t1hr7 t1hc2 t1hc5 t1hc12">3</TD><TD class=alignCenter headers="t1hr7 t1hc3 t1hc6 t1hc13">1491</TD><TD class=alignCenter headers="t1hr7 t1hc3 t1hc6 t1hc14">370</TD><TD class=alignCenter headers="t1hr7 t1hc3 t1hc6 t1hc15">2</TD><TD class=alignCenter headers="t1hr7 t1hc3 t1hc6 t1hc16">1119</TD><TD class=alignCenter headers="t1hr7 t1hc3 t1hc7">133</TD></TR><TR><TH id=t1hr8 class=alignLeft headers=t1hc1>NS</TH><TD class=alignCenter headers="t1hr8 t1hc2 t1hc4 t1hc8">0</TD><TD class=alignCenter headers="t1hr8 t1hc2 t1hc4 t1hc9">0</TD><TD class=alignCenter headers="t1hr8 t1hc2 t1hc4 t1hc10">0</TD><TD class=alignCenter headers="t1hr8 t1hc2 t1hc4 t1hc11">0</TD><TD class=alignCenter headers="t1hr8 t1hc2 t1hc5 t1hc12">0</TD><TD class=alignCenter headers="t1hr8 t1hc3 t1hc6 t1hc13">175</TD><TD class=alignCenter headers="t1hr8 t1hc3 t1hc6 t1hc14">134</TD><TD class=alignCenter headers="t1hr8 t1hc3 t1hc6 t1hc15">5</TD><TD class=alignCenter headers="t1hr8 t1hc3 t1hc6 t1hc16">36</TD><TD class=alignCenter headers="t1hr8 t1hc3 t1hc7">52</TD></TR><TR><TH id=t1hr9 class=alignLeft headers=t1hc1>PE</TH><TD class=alignCenter headers="t1hr9 t1hc2 t1hc4 t1hc8">0</TD><TD class=alignCenter headers="t1hr9 t1hc2 t1hc4 t1hc9">0</TD><TD class=alignCenter headers="t1hr9 t1hc2 t1hc4 t1hc10">0</TD><TD class=alignCenter headers="t1hr9 t1hc2 t1hc4 t1hc11">0</TD><TD class=alignCenter headers="t1hr9 t1hc2 t1hc5 t1hc12">0</TD><TD class=alignCenter headers="t1hr9 t1hc3 t1hc6 t1hc13">119</TD><TD class=alignCenter headers="t1hr9 t1hc3 t1hc6 t1hc14">118</TD><TD class=alignCenter headers="t1hr9 t1hc3 t1hc6 t1hc15">0</TD><TD class=alignCenter headers="t1hr9 t1hc3 t1hc6 t1hc16">1</TD><TD class=alignCenter headers="t1hr9 t1hc3 t1hc7">5</TD></TR><TR><TH id=t1hr10 class=alignLeft headers=t1hc1>NL</TH><TD class=alignCenter headers="t1hr10 t1hc2 t1hc4 t1hc8">2</TD><TD class=alignCenter headers="t1hr10 t1hc2 t1hc4 t1hc9">0</TD><TD class=alignCenter headers="t1hr10 t1hc2 t1hc4 t1hc10">0</TD><TD class=alignCenter headers="t1hr10 t1hc2 t1hc4 t1hc11">2</TD><TD class=alignCenter headers="t1hr10 t1hc2 t1hc5 t1hc12">0</TD><TD class=alignCenter headers="t1hr10 t1hc3 t1hc6 t1hc13">385</TD><TD class=alignCenter headers="t1hr10 t1hc3 t1hc6 t1hc14">104</TD><TD class=alignCenter headers="t1hr10 t1hc3 t1hc6 t1hc15">0</TD><TD class=alignCenter headers="t1hr10 t1hc3 t1hc6 t1hc16">281</TD><TD class=alignCenter headers="t1hr10 t1hc3 t1hc7">265</TD></TR><TR><TH id=t1hr11 class=alignLeft headers=t1hc1>Canada</TH><TD class=alignCenter headers="t1hr11 t1hc2 t1hc4 t1hc8">26</TD><TD class="alignCenter bg-colour-blue" headers="t1hr11 t1hc2 t1hc4 t1hc9">2</TD><TD class="alignCenter bg-colour-blue" headers="t1hr11 t1hc2 t1hc4 t1hc10">19</TD><TD class="alignCenter bg-colour-blue" headers="t1hr11 t1hc2 t1hc4 t1hc11">5</TD><TD class=alignCenter headers="t1hr11 t1hc2 t1hc5 t1hc12">15</TD><TD class=alignCenter headers="t1hr11 t1hc3 t1hc6 t1hc13">21186</TD><TD class="alignCenter bg-colour-blue" headers="t1hr11 t1hc3 t1hc6 t1hc14">10431</TD><TD class="alignCenter bg-colour-blue" headers="t1hr11 t1hc3 t1hc6 t1hc15">650</TD><TD class="alignCenter bg-colour-blue" headers="t1hr11 t1hc3 t1hc6 t1hc16">10105</TD><TD class=alignCenter headers="t1hr11 t1hc3 t1hc7">7542</TD></TR><TR><TH id=t1hr12 class=alignLeft headers=t1hc1>Percentage<SUP>2</SUP></TH><TD class=alignCenter headers="t1hr12 t1hc2 t1hc4 t1hc8">63.4%</TD><TD class="alignCenter bg-colour-blue" headers="t1hr12 t1hc2 t1hc4 t1hc9">7.7%</TD><TD class="alignCenter bg-colour-blue" headers="t1hr12 t1hc2 t1hc4 t1hc10">73.1%</TD><TD class="alignCenter bg-colour-blue" headers="t1hr12 t1hc2 t1hc4 t1hc11">19.2%</TD><TD class=alignCenter headers="t1hr12 t1hc2 t1hc5 t1hc12">36.6%</TD><TD class=alignCenter headers="t1hr12 t1hc3 t1hc6 t1hc13">73.7%</TD><TD class="alignCenter bg-colour-blue" headers="t1hr12 t1hc3 t1hc6 t1hc14">49.2%</TD><TD class="alignCenter bg-colour-blue" headers="t1hr12 t1hc3 t1hc6 t1hc15">3.1%</TD><TD class="alignCenter bg-colour-blue" headers="t1hr12 t1hc3 t1hc6 t1hc16">47.7%</TD><TD class=alignCenter headers="t1hr12 t1hc3 t1hc7">26.3%</TD></TR></TBODY></TABLE>
                  <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t2 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=t2hc1 rowSpan=3>Age groups (years)</TH><TH id=t2hc2 colSpan=5>Weekly
                  (June 29 to July 12, 2014)
                  </TH><TH id=t2hc3 colSpan=7>Cumulative
                  (August 25, 2013 to July 12, 2014)
                  </TH></TR><TR class=bg-colour-yellow><TH id=t2hc4 colSpan=4 headers=t2hc2>Influenza A</TH><TH id=t2hc5 headers=t2hc2>B</TH><TH id=t2hc6 colSpan=4 headers=t2hc3>Influenza A</TH><TH id=t2hc7 headers=t2hc3>B</TH><TH id=t2hc8 colSpan=2>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=t2hc9 headers="t2hc2 t2hc4">A Total</TH><TH id=t2hc10 class="bg-colour-blue " headers="t2hc2 t2hc4">A(H1) pdm09</TH><TH id=t2hc11 class="bg-colour-blue " headers="t2hc2 t2hc4">A(H3)</TH><TH id=t2hc12 class="bg-colour-blue " headers="t2hc2 t2hc4">A (UnS)</TH><TD class=alignCenter headers="t2hc2 t2hc5">Total</TD><TH id=t2hc13 headers="t2hc3 t2hc6">A Total</TH><TH id=t2hc14 class="bg-colour-blue " headers="t2hc3 t2hc6">A(H1) pdm09</TH><TH id=t2hc15 class="bg-colour-blue " headers="t2hc3 t2hc6">A(H3)</TH><TH id=t2hc16 class="bg-colour-blue " headers="t2hc3 t2hc6">A (UnS)</TH><TD class=alignCenter headers="t2hc3 t2hc7">Total</TD><TH id=t2hc17 headers="t2hc3 t2hc8">#</TH><TH id=t2hc18 headers="t2hc3 t2hc8">%</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=t2hr1 class=alignLeft headers=t2hc1><5</TH><TD class=alignCenter headers="t2hr1 t2hc2 t2hc4 t2hc9">1</TD><TD class=alignCenter headers="t2hr1 t2hc2 t2hc4 t2hc10">0</TD><TD class=alignCenter headers="t2hr1 t2hc2 t2hc4 t2hc11">1</TD><TD class=alignCenter headers="t2hr1 t2hc2 t2hc4 t2hc12">0</TD><TD class=alignCenter headers="t2hr1 t2hc2 t2hc5">0</TD><TD class=alignCenter headers="t2hr1 t2hc3 t2hc6 t2hc13">3270</TD><TD class=alignCenter headers="t2hr1 t2hc3 t2hc6 t2hc14">1452</TD><TD class=alignCenter headers="t2hr1 t2hc3 t2hc6 t2hc15">43</TD><TD class=alignCenter headers="t2hr1 t2hc3 t2hc6 t2hc16">1775</TD><TD class=alignCenter headers="t2hr1 t2hc3 t2hc7">558</TD><TD class=alignCenter headers="t2hr1 t2hc3 t2hc8 t2hc17">3828</TD><TD class=alignCenter headers="t2hr1 t2hc3 t2hc8 t2hc18">16.5%</TD></TR><TR><TH id=t2hr2 class=alignLeft headers=t2hc1>5-19</TH><TD class=alignCenter headers="t2hr2 t2hc2 t2hc4 t2hc9">0</TD><TD class=alignCenter headers="t2hr2 t2hc2 t2hc4 t2hc10">0</TD><TD class=alignCenter headers="t2hr2 t2hc2 t2hc4 t2hc11">0</TD><TD class=alignCenter headers="t2hr2 t2hc2 t2hc4 t2hc12">0</TD><TD class=alignCenter headers="t2hr2 t2hc2 t2hc5">0</TD><TD class=alignCenter headers="t2hr2 t2hc3 t2hc6 t2hc13">1334</TD><TD class=alignCenter headers="t2hr2 t2hc3 t2hc6 t2hc14">707</TD><TD class=alignCenter headers="t2hr2 t2hc3 t2hc6 t2hc15">25</TD><TD class=alignCenter headers="t2hr2 t2hc3 t2hc6 t2hc16">602</TD><TD class=alignCenter headers="t2hr2 t2hc3 t2hc7">828</TD><TD class=alignCenter headers="t2hr2 t2hc3 t2hc8 t2hc17">2162</TD><TD class=alignCenter headers="t2hr2 t2hc3 t2hc8 t2hc18">9.3%</TD></TR><TR><TH id=t2hr3 class=alignLeft headers=t2hc1>20-44</TH><TD class=alignCenter headers="t2hr3 t2hc2 t2hc4 t2hc9">2</TD><TD class=alignCenter headers="t2hr3 t2hc2 t2hc4 t2hc10">0</TD><TD class=alignCenter headers="t2hr3 t2hc2 t2hc4 t2hc11">0</TD><TD class=alignCenter headers="t2hr3 t2hc2 t2hc4 t2hc12">2</TD><TD class=alignCenter headers="t2hr3 t2hc2 t2hc5">3</TD><TD class=alignCenter headers="t2hr3 t2hc3 t2hc6 t2hc13">5109</TD><TD class=alignCenter headers="t2hr3 t2hc3 t2hc6 t2hc14">2819</TD><TD class=alignCenter headers="t2hr3 t2hc3 t2hc6 t2hc15">53</TD><TD class=alignCenter headers="t2hr3 t2hc3 t2hc6 t2hc16">2237</TD><TD class=alignCenter headers="t2hr3 t2hc3 t2hc7">1030</TD><TD class=alignCenter headers="t2hr3 t2hc3 t2hc8 t2hc17">6139</TD><TD class=alignCenter headers="t2hr3 t2hc3 t2hc8 t2hc18">26.4%</TD></TR><TR><TH id=t2hr4 class=alignLeft headers=t2hc1>45-64</TH><TD class=alignCenter headers="t2hr4 t2hc2 t2hc4 t2hc9">1</TD><TD class=alignCenter headers="t2hr4 t2hc2 t2hc4 t2hc10">0</TD><TD class=alignCenter headers="t2hr4 t2hc2 t2hc4 t2hc11">0</TD><TD class=alignCenter headers="t2hr4 t2hc2 t2hc4 t2hc12">1</TD><TD class=alignCenter headers="t2hr4 t2hc2 t2hc5">2</TD><TD class=alignCenter headers="t2hr4 t2hc3 t2hc6 t2hc13">4486</TD><TD class=alignCenter headers="t2hr4 t2hc3 t2hc6 t2hc14">2393</TD><TD class=alignCenter headers="t2hr4 t2hc3 t2hc6 t2hc15">68</TD><TD class=alignCenter headers="t2hr4 t2hc3 t2hc6 t2hc16">2025</TD><TD class=alignCenter headers="t2hr4 t2hc3 t2hc7">1521</TD><TD class=alignCenter headers="t2hr4 t2hc3 t2hc8 t2hc17">6007</TD><TD class=alignCenter headers="t2hr4 t2hc3 t2hc8 t2hc18">25.8%</TD></TR><TR><TH id=t2hr5 class=alignLeft headers=t2hc1>65+</TH><TD class=alignCenter headers="t2hr5 t2hc2 t2hc4 t2hc9">3</TD><TD class=alignCenter headers="t2hr5 t2hc2 t2hc4 t2hc10">0</TD><TD class=alignCenter headers="t2hr5 t2hc2 t2hc4 t2hc11">2</TD><TD class=alignCenter headers="t2hr5 t2hc2 t2hc4 t2hc12">1</TD><TD class=alignCenter headers="t2hr5 t2hc2 t2hc5">1</TD><TD class=alignCenter headers="t2hr5 t2hc3 t2hc6 t2hc13">2657</TD><TD class=alignCenter headers="t2hr5 t2hc3 t2hc6 t2hc14">1002</TD><TD class=alignCenter headers="t2hr5 t2hc3 t2hc6 t2hc15">177</TD><TD class=alignCenter headers="t2hr5 t2hc3 t2hc6 t2hc16">1478</TD><TD class=alignCenter headers="t2hr5 t2hc3 t2hc7">2276</TD><TD class=alignCenter headers="t2hr5 t2hc3 t2hc8 t2hc17">4933</TD><TD class=alignCenter headers="t2hr5 t2hc3 t2hc8 t2hc18">21.2%</TD></TR><TR><TH id=t2hr6 class=alignLeft headers=t2hc1>Unknown</TH><TD class=alignCenter headers="t2hr6 t2hc2 t2hc4 t2hc9">2</TD><TD class=alignCenter headers="t2hr6 t2hc2 t2hc4 t2hc10">0</TD><TD class=alignCenter headers="t2hr6 t2hc2 t2hc4 t2hc11">2</TD><TD class=alignCenter headers="t2hr6 t2hc2 t2hc4 t2hc12">0</TD><TD class=alignCenter headers="t2hr6 t2hc2 t2hc5">5</TD><TD class=alignCenter headers="t2hr6 t2hc3 t2hc6 t2hc13">152</TD><TD class=alignCenter headers="t2hr6 t2hc3 t2hc6 t2hc14">106</TD><TD class=alignCenter headers="t2hr6 t2hc3 t2hc6 t2hc15">26</TD><TD class=alignCenter headers="t2hr6 t2hc3 t2hc6 t2hc16">20</TD><TD class=alignCenter headers="t2hr6 t2hc3 t2hc7">28</TD><TD class=alignCenter headers="t2hr6 t2hc3 t2hc8 t2hc17">180</TD><TD class=alignCenter headers="t2hr6 t2hc3 t2hc8 t2hc18">0.8%</TD></TR><TR><TH id=t2hr7 class=alignLeft headers=t2hc1>Total</TH><TD class=alignCenter headers="t2hr7 t2hc2 t2hc4 t2hc9">9</TD><TD class="alignCenter bg-colour-blue" headers="t2hr7 t2hc2 t2hc4 t2hc10">0</TD><TD class="alignCenter bg-colour-blue" headers="t2hr7 t2hc2 t2hc4 t2hc11">5</TD><TD class="alignCenter bg-colour-blue" headers="t2hr7 t2hc2 t2hc4 t2hc12">4</TD><TD class=alignCenter headers="t2hr7 t2hc2 t2hc5">11</TD><TD class=alignCenter headers="t2hr7 t2hc3 t2hc6 t2hc13">17008</TD><TD class="alignCenter bg-colour-blue" headers="t2hr7 t2hc3 t2hc6 t2hc14">8479</TD><TD class="alignCenter bg-colour-blue" headers="t2hr7 t2hc3 t2hc6 t2hc15">392</TD><TD class="alignCenter bg-colour-blue" headers="t2hr7 t2hc3 t2hc6 t2hc16">8137</TD><TD class=alignCenter headers="t2hr7 t2hc3 t2hc7">6241</TD><TD class=alignCenter headers="t2hr7 t2hc3 t2hc8 t2hc17">23249</TD><TD class=alignCenter headers="t2hr7 t2hc3 t2hc8 t2hc18">100.0%</TD></TR><TR><TH id=t2hr8 class=alignLeft headers=t2hc1>Percentage<SUP>2</SUP></TH><TD class=alignCenter headers="t2hr8 t2hc2 t2hc4 t2hc9">45.0%</TD><TD class="alignCenter bg-colour-blue" headers="t2hr8 t2hc2 t2hc4 t2hc10">0.0%</TD><TD class="alignCenter bg-colour-blue" headers="t2hr8 t2hc2 t2hc4 t2hc11">55.6%</TD><TD class="alignCenter bg-colour-blue" headers="t2hr8 t2hc2 t2hc4 t2hc12">44.4%</TD><TD class=alignCenter headers="t2hr8 t2hc2 t2hc5">55.0%</TD><TD class=alignCenter headers="t2hr8 t2hc3 t2hc6 t2hc13">73.2%</TD><TD class="alignCenter bg-colour-blue" headers="t2hr8 t2hc3 t2hc6 t2hc14">49.9%</TD><TD class="alignCenter bg-colour-blue" headers="t2hr8 t2hc3 t2hc6 t2hc15">2.3%</TD><TD class="alignCenter bg-colour-blue" headers="t2hr8 t2hc3 t2hc6 t2hc16">47.8%</TD><TD class=alignCenter headers="t2hr8 t2hc3 t2hc7">26.8%</TD><TD class=alignCenter headers=t2hr8></TD><TD class=alignCenter headers=t2hr8></TD></TR></TBODY></TABLE>


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                  Influenza Strain Characterizations

                  During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 2,424 influenza viruses [171 A(H3N2), 1,396 A(H1N1)pdm09 and 857 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, and one A(H3N2) virus showed reduced titres to antiserum against the reference A/Texas/50/2012 strain. Twenty-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, 2013-2014, N = 2424

                  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 2,390 influenza viruses for resistance to oseltamivir and all but five were sensitive. All 2,387 viruses tested for resistance to zanamivir were sensitive. All 1,667 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=t3hc1 rowSpan=2>Virus type and subtype</TH><TH id=t3hc2 colSpan=2>Oseltamivir</TH><TH id=t3hc3 colSpan=2>Zanamivir</TH><TH id=t3hc4 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=t3hc5 headers=t3hc2># tested</TH><TH id=t3hc6 headers=t3hc2># resistant (%)</TH><TH id=t3hc7 headers=t3hc3># tested</TH><TH id=t3hc8 headers=t3hc3># resistant (%)</TH><TH id=t3hc9 headers=t3hc4># tested</TH><TH id=t3hc10 headers=t3hc4># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=t3hr1 class="alignLeft bg-colour-blue" headers=t3hc1>A (H3N2)</TH><TD class=alignCenter headers="t3hr1 t3hc2 t3hc5">167</TD><TD class=alignCenter headers="t3hr1 t3hc2 t3hc6">0</TD><TD class=alignCenter headers="t3hr1 t3hc3 t3hc7">165</TD><TD class=alignCenter headers="t3hr1 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr1 t3hc4 t3hc9">218</TD><TD class=alignCenter headers="t3hr1 t3hc4 t3hc10">218 (100%)</TD></TR><TR><TH id=t3hr2 class="alignLeft bg-colour-blue" headers=t3hc1>A (H1N1)</TH><TD class=alignCenter headers="t3hr2 t3hc2 t3hc5">1403</TD><TD class=alignCenter headers="t3hr2 t3hc2 t3hc6">5 (0.4%)</TD><TD class=alignCenter headers="t3hr2 t3hc3 t3hc7">1404</TD><TD class=alignCenter headers="t3hr2 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr2 t3hc4 t3hc9">1449</TD><TD class=alignCenter headers="t3hr2 t3hc4 t3hc10">1449 (100%)</TD></TR><TR><TH id=t3hr3 class="alignLeft bg-colour-blue" headers=t3hc1>B</TH><TD class=alignCenter headers="t3hr3 t3hc2 t3hc5">820</TD><TD class=alignCenter headers="t3hr3 t3hc2 t3hc6">0</TD><TD class=alignCenter headers="t3hr3 t3hc3 t3hc7">818</TD><TD class=alignCenter headers="t3hr3 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr3 t3hc4 t3hc9">NA <SUP>*</SUP></TD><TD class=alignCenter headers="t3hr3 t3hc4 t3hc10">NA <SUP>*</SUP></TD></TR><TR><TH id=t3hr4 class="alignLeft bg-colour-blue" headers=t3hc1>TOTAL</TH><TD class=alignCenter headers="t3hr4 t3hc2 t3hc5">2390</TD><TD class=alignCenter headers="t3hr4 t3hc2 t3hc6">5 (0.2%)</TD><TD class=alignCenter headers="t3hr4 t3hc3 t3hc7">2387</TD><TD class=alignCenter headers="t3hr4 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr4 t3hc4 t3hc9">1667</TD><TD class=alignCenter headers="t3hr4 t3hc4 t3hc10">1667 (100%)</TD></TR></TBODY></TABLE>
                  Influenza-like Illness (ILI) Consultation Rate

                  The national influenza-like-illness (ILI) consultation rate increased from 8.7 consultations per 1,000 patient visits in week 26 to 9.9 per 1,000 in week 27 and 11.8 per 1,000 in week 28. The rates for weeks 25 to 28 have been above 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

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                  Influenza Outbreak Surveillance

                  No new influenza outbreaks were reported in Weeks 27 and 28 (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 6Overall number of new influenza outbreaks by report week, Canada, 2013-2014
                  Pharmacy Surveillance

                  In weeks 27 and 28, the proportion of prescriptions for antivirals is approaching inter-seasonal levels. 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 (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

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                  Sentinel Hospital Influenza Surveillance

                  Paediatric Influenza Hospitalizations and Deaths (IMPACT)
                  In weeks 27 and 28, no new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations, ICU admissions or deaths were reported by the Immunization Monitoring Program Active (IMPACT) network (Figure 8a). No paediatric hospitalizations or ICU admissions have been reported from IMPACT since week 23.
                  To date this season, a total of 716 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 78% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children <5 years of age represent 73% of cases to date (Table 4). One hundred and seventeen ICU admissions have been reported, of which 74 (65%) were children <5 years of age (Figure 9a). All but 22 were cases with influenza A, and 98% of those subtyped were A(H1N1)pdm09. Among the 103 ICU cases with available data, 74 (72%) were reported to have underlying medical conditions. One death has been reported this season. A smaller number of paediatric hospital admissions have been reported this year compared to the 2012-13 season.
                  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)
                  Surveillance of laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network has ended for the 2013-14 season (Figure 8b). A summary of PCIRN-SOS data for the 2013-14 season will be included in the FluWatch annual report of influenza surveillance in Canada.
                  During passive and active surveillance* from August 25<SUP>th</SUP>, 2013 to May 31<SUP>st</SUP>, 2014, 1,985 influenza-associated hospitalizations were reported by the PCIRN-SOS network, 1,338 (67.4%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). Compared to the 2012-13 season, slightly more cases were reported, although the peak number of cases was smaller. A greater number of cases were reported during March and April compared to last year, with six times more cases of influenza B reported. ICU admission was required for 321 hospitalizations, of which 263 were cases with influenza A (137 A(H1N1)pdm09, ten A(H3N2) and 116 A(unsubtyped)), 57 were cases with influenza B and the influenza type was not reported for one case. A greater proportion of cases were admitted to the ICU this season compared to last year, but the proportion of deaths was similar. Of the ICU admissions with available information, 85.9% (189/220) were reported to have at least one comorbidity, and 68.2% (176/258) reported not having been vaccinated this season. Among the 112 deaths reported this season, all but 28 were cases of influenza A (51 A(H1N1)pdm09, three A(H3N2) and 30 A(unsubtyped)); ten cases 20-44 years of age, 37 cases 45-64 years of age and 65 cases ≥65 years of age (Figure 9b). Among fatal cases with available information, 93.8% (60/64) were reported to have at least one comorbidity, and 48.2% (40/83) reported not having been vaccinated this season.
                  Note: During the 2013-14 influenza season, PCIRN-SOS conducted passive surveillance from August 25<SUP>th</SUP> to November 14<SUP>th</SUP>, 2013, and May 16<SUP>th</SUP> to 31<SUP>st</SUP>. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance was conducted between November 15<SUP>th</SUP>, 2013 and May 15<SUP>th</SUP>, 2014 during which time PCIRN site coordinators investigated 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 July 12, 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>107</TD><TD class=alignCenter>39</TD><TD class=alignCenter>0</TD><TD class=alignCenter>68</TD><TD class=alignCenter>12</TD><TD class=alignCenter>119 (17%)</TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignCenter>164</TD><TD class=alignCenter>60</TD><TD class=alignCenter>1</TD><TD class=alignCenter>103</TD><TD class=alignCenter>31</TD><TD class=alignCenter>195 (27%)</TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignCenter>162</TD><TD class=alignCenter>59</TD><TD class=alignCenter>3</TD><TD class=alignCenter>100</TD><TD class=alignCenter>47</TD><TD class=alignCenter>209 (29%)</TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignCenter>85</TD><TD class=alignCenter>34</TD><TD class=alignCenter>1</TD><TD class=alignCenter>50</TD><TD class=alignCenter>56</TD><TD class=alignCenter>141 (20%)</TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignCenter>38</TD><TD class=alignCenter>13</TD><TD class=alignCenter>1</TD><TD class=alignCenter>24</TD><TD class=alignCenter>14</TD><TD class=alignCenter>52 (7%)</TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignCenter>556</TD><TD class="alignCenter bg-colour-blue">205</TD><TD class="alignCenter bg-colour-blue">6</TD><TD class="alignCenter bg-colour-blue">345</TD><TD class=alignCenter>160</TD><TD class=alignCenter>716</TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP></TH><TD class=alignCenter>77.7%</TD><TD class="alignCenter bg-colour-blue">36.9%</TD><TD class="alignCenter bg-colour-blue">1.1%</TD><TD class="alignCenter bg-colour-blue">62.1%</TD><TD class=alignCenter>22.3%</TD><TD class=alignCenter>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 31 May, 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>Two 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=alignCenter headers="er1 er2 ec1 ec2 ec3">13 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec4">5 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec5">1 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec6">7 </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">276 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec4">142 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec5">7 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec6">127 </TD><TD class=alignCenter headers="er1 er3 ec1 ec7">47 </TD><TD class=alignCenter headers="er1 er3 ec1 ec8">323 (16%) </TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignCenter headers="er1 er4 ec1 ec2 ec3">521 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec4">245 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec5">12 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec6">264 </TD><TD class=alignCenter headers="er1 er4 ec1 ec7">135 </TD><TD class=alignCenter headers="er1 er4 ec1 ec8">656 (33%) </TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignCenter headers="er1 er5 ec1 ec2 ec3">525 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec4">238 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec5">61 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec6">226 </TD><TD class=alignCenter headers="er1 er5 ec1 ec7">460 </TD><TD class=alignCenter headers="er1 er5 ec1 ec8">985 (50%) </TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignCenter headers="er1 er6 ec1 ec2 ec3">1335 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec4">630 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec5">81 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec6">624 </TD><TD class=alignCenter headers="er1 er6 ec1 ec7">644 </TD><TD class=alignCenter headers="er1 er6 ec1 ec8">1979 </TD></TR><TR><TH id=er7 class=alignLeft headers=er1>%<SUP>1</SUP></TH><TD class=alignCenter headers="er1 er7 ec1 ec2 ec3">67% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec4">47% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec5">6% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec6">47% </TD><TD class=alignCenter headers="er1 er7 ec1 ec7">33% </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)

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                  Provincial/Territorial Influenza Hospitalizations and Deaths

                  In week 27 & 28, 48 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories.* The majority were cases of influenza B (34, 70.8%). One ICU admission was reported in an adult ≥65 years of age. Three deaths were reported in adults ≥65 years of age; two were attributable to influenza A and one to 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, 5,414 influenza-associated hospitalizations have been reported, 68.5% with influenza A. The majority (63.3%) 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 383 ICU admissions have been reported this season, of which 64.0% were adults 20-64 years of age. A total of 340 deaths have been reported. The highest proportion of deaths has been among adults ≥65 years of age (56.8%) followed by adults 20-64 years of age (35.3%). 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 31.5% of hospitalizations and 35.6% 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, 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=t6hc1 rowSpan=3>Age groups </TH><TH id=t6hc2 colSpan=6>Cumulative (Aug. 25, 2013 to July 12, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=t6hc3 colSpan=4 headers=t6hc2>Influenza A</TH><TH id=t6hc4 headers=t6hc2>B</TH><TH id=t6hc5 headers=t6hc2>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=t6hc6 headers="t6hc2 t6hc3">A Total</TH><TH id=t6hc7 class=bg-colour-blue headers="t6hc2 t6hc3">A(H1) pdm09</TH><TH id=t6hc8 class=bg-colour-blue headers="t6hc2 t6hc3">A(H3)</TH><TH id=t6hc9 class=bg-colour-blue headers="t6hc2 t6hc3">A (UnS)</TH><TD class=alignCenter headers="t6hc2 t6hc4">Total</TD><TD class=alignCenter headers="t6hc2 t6hc5"># (%)</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=t6hr1 class=alignLeft headers=t6hc1>0-4 years</TH><TD class=alignCenter headers="t6hr1 t6hc2 t6hc3 t6hc6">627</TD><TD class=alignCenter headers="t6hr1 t6hc2 t6hc3 t6hc7">289</TD><TD class=alignCenter headers="t6hr1 t6hc2 t6hc3 t6hc8">14</TD><TD class=alignCenter headers="t6hr1 t6hc2 t6hc3 t6hc9">324</TD><TD class=alignCenter headers="t6hr1 t6hc2 t6hc4">145</TD><TD class=alignCenter headers="t6hr1 t6hc2 t6hc5">772 (14%)</TD></TR><TR><TH id=t6hr2 class=alignLeft headers=t6hc1>5-14 years</TH><TD class=alignCenter headers="t6hr2 t6hc2 t6hc3 t6hc6">136</TD><TD class=alignCenter headers="t6hr2 t6hc2 t6hc3 t6hc7">65</TD><TD class=alignCenter headers="t6hr2 t6hc2 t6hc3 t6hc8">6</TD><TD class=alignCenter headers="t6hr2 t6hc2 t6hc3 t6hc9">65</TD><TD class=alignCenter headers="t6hr2 t6hc2 t6hc4">123</TD><TD class=alignCenter headers="t6hr2 t6hc2 t6hc5">259 (5%)</TD></TR><TR><TH id=t6hr3 class=alignLeft headers=t6hc1>15-19 years</TH><TD class=alignCenter headers="t6hr3 t6hc2 t6hc3 t6hc6">40</TD><TD class=alignCenter headers="t6hr3 t6hc2 t6hc3 t6hc7">23</TD><TD class=alignCenter headers="t6hr3 t6hc2 t6hc3 t6hc8">4</TD><TD class=alignCenter headers="t6hr3 t6hc2 t6hc3 t6hc9">13</TD><TD class=alignCenter headers="t6hr3 t6hc2 t6hc4">9</TD><TD class=alignCenter headers="t6hr3 t6hc2 t6hc5">49 (1%)</TD></TR><TR><TH id=t6hr4 class=alignLeft headers=t6hc1>20-44 years </TH><TD class=alignCenter headers="t6hr4 t6hc2 t6hc3 t6hc6">625</TD><TD class=alignCenter headers="t6hr4 t6hc2 t6hc3 t6hc7">426</TD><TD class=alignCenter headers="t6hr4 t6hc2 t6hc3 t6hc8">11</TD><TD class=alignCenter headers="t6hr4 t6hc2 t6hc3 t6hc9">188</TD><TD class=alignCenter headers="t6hr4 t6hc2 t6hc4">107</TD><TD class=alignCenter headers="t6hr4 t6hc2 t6hc5">732 (14%)</TD></TR><TR><TH id=t6hr5 class=alignLeft headers=t6hc1>45-64 years </TH><TD class=alignCenter headers="t6hr5 t6hc2 t6hc3 t6hc6">1134</TD><TD class=alignCenter headers="t6hr5 t6hc2 t6hc3 t6hc7">711</TD><TD class=alignCenter headers="t6hr5 t6hc2 t6hc3 t6hc8">34</TD><TD class=alignCenter headers="t6hr5 t6hc2 t6hc3 t6hc9">389</TD><TD class=alignCenter headers="t6hr5 t6hc2 t6hc4">314</TD><TD class=alignCenter headers="t6hr5 t6hc2 t6hc5">1448 (27%)</TD></TR><TR><TH id=t6hr6 class=alignLeft headers=t6hc1>65+ years </TH><TD class=alignCenter headers="t6hr6 t6hc2 t6hc3 t6hc6">1010</TD><TD class=alignCenter headers="t6hr6 t6hc2 t6hc3 t6hc7">473</TD><TD class=alignCenter headers="t6hr6 t6hc2 t6hc3 t6hc8">130</TD><TD class=alignCenter headers="t6hr6 t6hc2 t6hc3 t6hc9">407</TD><TD class=alignCenter headers="t6hr6 t6hc2 t6hc4">971</TD><TD class=alignCenter headers="t6hr6 t6hc2 t6hc5">1981 (37%)</TD></TR><TR><TH id=t6hr7 class=alignLeft headers=t6hc1>Unknown</TH><TD class=alignCenter headers="t6hr7 t6hc2 t6hc3 t6hc6">138</TD><TD class=alignCenter headers="t6hr7 t6hc2 t6hc3 t6hc7">99</TD><TD class=alignCenter headers="t6hr7 t6hc2 t6hc3 t6hc8">3</TD><TD class=alignCenter headers="t6hr7 t6hc2 t6hc3 t6hc9">36</TD><TD class=alignCenter headers="t6hr7 t6hc2 t6hc4">35</TD><TD class=alignCenter headers="t6hr7 t6hc2 t6hc5">173 (3%)</TD></TR><TR><TH id=t6hr8 class=alignLeft headers=t6hc1>Total </TH><TD class=alignCenter headers="t6hr8 t6hc2 t6hc3 t6hc6">3710</TD><TD class="alignCenter bg-colour-blue" headers="t6hr8 t6hc2 t6hc3 t6hc7">2086</TD><TD class="alignCenter bg-colour-blue" headers="t6hr8 t6hc2 t6hc3 t6hc8">202</TD><TD class="alignCenter bg-colour-blue" headers="t6hr8 t6hc2 t6hc3 t6hc9">1422</TD><TD class=alignCenter headers="t6hr8 t6hc2 t6hc4">1704</TD><TD class=alignCenter headers="t6hr8 t6hc2 t6hc5">5414</TD></TR><TR><TH id=t6hr9 class=alignLeft headers=t6hc1>Percentage <SUP>1</SUP></TH><TD class=alignCenter headers="t6hr9 t6hc2 t6hc3 t6hc6">68.5%</TD><TD class="alignCenter bg-colour-blue" headers="t6hr9 t6hc2 t6hc3 t6hc7">56.2%</TD><TD class="alignCenter bg-colour-blue" headers="t6hr9 t6hc2 t6hc3 t6hc8">5.4%</TD><TD class="alignCenter bg-colour-blue" headers="t6hr9 t6hc2 t6hc3 t6hc9">38.3%</TD><TD class=alignCenter headers="t6hr9 t6hc2 t6hc4">31.5%</TD><TD class=alignCenter headers="t6hr9 t6hc2 t6hc5">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."
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                  Comment


                  • #39
                    Re: Canada FluWatch Weekly Reports 2013-2014 Season Weeks 31 and 32

                    FluWatch report: July 27 to August 9, 2014 (Weeks 31 and 32)

                    Posted 2014-08-15For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
                    <A title="Flu Watch (Version PDF, 419 KB - 10 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/13-14/w32_14/pdf/fw2014-32-eng.pdf">FluWatch report: July 27 to August 9, 2014 (Weeks 31 and 32) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 419 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

                    Help with PDF documents

                    Overall Summary
                    • Influenza activity in Canada remains at inter-seasonal levels with only sporadic detections of influenza A(H3N2) and influenza B.
                    • In weeks 31 and 32, one influenza outbreak and one paediatric hospitalization were reported.
                    • As of week 32, 5,442 hospitalizations and 342 deaths have been reported from participating regions, which is more hospitalizations but a similar number of deaths than were reported last year.
                    Are you a primary health care practitioner (General Practitioner, Nurse Practitioner or Registered Nurse) interested in becoming a FluWatch sentinel for the 2014-15 influenza season? Contact us at FluWatch@phac-aspc.gc.ca
                    Influenza/ILI Activity (geographic spread)

                    In weeks 31 and 32, most regions in Canada reported no influenza/ILI activity. During these two weeks, one region in Ontario reported localized activity. In week 32, five regions (BC(1), AB(1), SK(1) and QC(2)) reported sporadic activity (Figure 1). In week 31, six regions did not report data, and in week 32, ten regions did not report.
                    Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 32





                    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 was at inter-seasonal levels in week 31 (9 detections) and week 32 (5 detections), with <1% of tests positive for the past three weeks (Figure 2). Most jurisdictions have reported only sporadic numbers of influenza detections in recent weeks (Table 1). Over the past 6 weeks, 76 influenza detections were reported, of which 67% were influenza A and 35/38 of those subtyped were influenza A(H3N2). Compared to A(H1N1)pdm09 which was predominant earlier this season, both influenza B and A(H3N2) have affected a greater proportion of adults ≥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
                    In weeks 31 and 32, detections of other respiratory viruses were at inter-seasonal levels (RSV, coronavirus, and human metapneumovirus) or on a downward trend in keeping with their usual pattern of seasonal circulation (parainfluenza, adenovirus and rhinovirus) (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


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                    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 margin10px">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=t1hc1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=t1hc2 colSpan=5>Two weeks
                    (July 27 to August 9, 2014)</TH><TH id=t1hc3 colSpan=5>Cumulative
                    (August 25, 2013 to August 9, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=t1hc4 colSpan=4 headers=t1hc2>Influenza A</TH><TH id=t1hc5 headers=t1hc2>B</TH><TH id=t1hc6 colSpan=4 headers=t1hc3>Influenza A</TH><TH id=t1hc7 headers=t1hc3>B</TH></TR><TR class=bg-colour-grey-light><TH id=t1hc8 headers="t1hc2 t1hc4">A Total</TH><TH id=t1hc9 class=bg-colour-blue headers="t1hc2 t1hc4">A(H1)pdm09</TH><TH id=t1hc10 class=" bg-colour-blue" headers="t1hc2 t1hc4">A(H3)</TH><TH id=t1hc11 class=" bg-colour-blue" headers="t1hc2 t1hc4">A(UnS)</TH><TH id=t1hc12 class=alignCenter headers="t1hc2 t1hc5">B Total</TH><TH id=t1hc13 headers="t1hc3 t1hc6">A Total</TH><TH id=t1hc14 class=" bg-colour-blue" headers="t1hc3 t1hc6">A(H1)pdm09</TH><TH id=t1hc15 class=" bg-colour-blue" headers="t1hc3 t1hc6">A(H3)</TH><TH id=t1hc16 class=" bg-colour-blue" headers="t1hc3 t1hc6">A(UnS)</TH><TD class=alignCenter headers="t1hc3 t1hc7">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=t1hr1 class=alignLeft headers=t1hc1>BC</TH><TD class=alignCenter>4</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1838</TD><TD class=alignCenter>1616</TD><TD class=alignCenter>79</TD><TD class=alignCenter>143</TD><TD class=alignCenter>386</TD></TR><TR><TH id=t1hr2 class=alignLeft headers=t1hc1>AB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>3905</TD><TD class=alignCenter>3463</TD><TD class=alignCenter>126</TD><TD class=alignCenter>316</TD><TD class=alignCenter>573</TD></TR><TR><TH id=t1hr3 class=alignLeft headers=t1hc1>SK</TH><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1385</TD><TD class=alignCenter>988</TD><TD class=alignCenter>8</TD><TD class=alignCenter>389</TD><TD class=alignCenter>198</TD></TR><TR><TH id=t1hr4 class=alignLeft headers=t1hc1>MB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>685</TD><TD class=alignCenter>463</TD><TD class=alignCenter>7</TD><TD class=alignCenter>215</TD><TD class=alignCenter>72</TD></TR><TR><TH id=t1hr5 class=alignLeft headers=t1hc1>ON</TH><TD class=alignCenter>5</TD><TD class=alignCenter>0</TD><TD class=alignCenter>4</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>5847</TD><TD class=alignCenter>2499</TD><TD class=alignCenter>433</TD><TD class=alignCenter>2915</TD><TD class=alignCenter>3119</TD></TR><TR><TH id=t1hr6 class=alignLeft headers=t1hc1>QC</TH><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>5381</TD><TD class=alignCenter>677</TD><TD class=alignCenter>6</TD><TD class=alignCenter>4698</TD><TD class=alignCenter>2748</TD></TR><TR><TH id=t1hr7 class=alignLeft headers=t1hc1>NB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1491</TD><TD class=alignCenter>370</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1119</TD><TD class=alignCenter>134</TD></TR><TR><TH id=t1hr8 class=alignLeft headers=t1hc1>NS</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>175</TD><TD class=alignCenter>134</TD><TD class=alignCenter>5</TD><TD class=alignCenter>36</TD><TD class=alignCenter>52</TD></TR><TR><TH id=t1hr9 class=alignLeft headers=t1hc1>PE</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>119</TD><TD class=alignCenter>118</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>5</TD></TR><TR><TH id=t1hr10 class=alignLeft headers=t1hc1>NL</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>385</TD><TD class=alignCenter>104</TD><TD class=alignCenter>0</TD><TD class=alignCenter>281</TD><TD class=alignCenter>265</TD></TR><TR><TH id=t1hr11 class=alignLeft headers=t1hc1>Canada</TH><TD class=alignCenter>11</TD><TD class="alignCenter bg-colour-blue">0</TD><TD class="alignCenter bg-colour-blue">7</TD><TD class="alignCenter bg-colour-blue">4</TD><TD class=alignCenter>3</TD><TD class=alignCenter>21211</TD><TD class="alignCenter bg-colour-blue">10432</TD><TD class="alignCenter bg-colour-blue">666</TD><TD class="alignCenter bg-colour-blue">10113</TD><TD class=alignCenter>7552</TD></TR><TR><TH id=t1hr12 class=alignLeft headers=t1hc1>Percentage<SUP>2</SUP></TH><TD class=alignCenter>78.6%</TD><TD class="alignCenter bg-colour-blue">0.0%</TD><TD class="alignCenter bg-colour-blue">63.6%</TD><TD class="alignCenter bg-colour-blue">36.4%</TD><TD class=alignCenter>21.4%</TD><TD class=alignCenter>73.7%</TD><TD class="alignCenter bg-colour-blue">49.2%</TD><TD class="alignCenter bg-colour-blue">3.1%</TD><TD class="alignCenter bg-colour-blue">47.7%</TD><TD class=alignCenter>26.3%</TD></TR></TBODY></TABLE>
                    <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t2 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=t2hc1 rowSpan=3>Age groups (years)</TH><TH id=t2hc2 colSpan=5>Two weeks
                    (July 27 to August 9, 2014)</TH><TH id=t2hc3 colSpan=7>Cumulative
                    (August 25, 2013 to August 9, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=t2hc4 colSpan=4 headers=t2hc2>Influenza A</TH><TH id=t2hc5 headers=t2hc2>B</TH><TH id=t2hc6 colSpan=4 headers=t2hc3>Influenza A</TH><TH id=t2hc7 headers=t2hc3>B</TH><TH id=t2hc8 colSpan=2>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=t2hc9 headers="t2hc2 t2hc4">A Total</TH><TH id=t2hc10 class=bg-colour-blue headers="t2hc2 t2hc4">A(H1) pdm09</TH><TH id=t2hc11 class=bg-colour-blue headers="t2hc2 t2hc4">A(H3)</TH><TH id=t2hc12 class=bg-colour-blue headers="t2hc2 t2hc4">A (UnS)</TH><TD class=alignCenter headers="t2hc2 t2hc5">Total</TD><TH id=t2hc13 headers="t2hc3 t2hc6">A Total</TH><TH id=t2hc14 class=bg-colour-blue headers="t2hc3 t2hc6">A(H1) pdm09</TH><TH id=t2hc15 class=bg-colour-blue headers="t2hc3 t2hc6">A(H3)</TH><TH id=t2hc16 class=bg-colour-blue headers="t2hc3 t2hc6">A (UnS)</TH><TD class=alignCenter headers="t2hc3 t2hc7">Total</TD><TH id=t2hc17 headers="t2hc3 t2hc8">#</TH><TH id=t2hc18 headers="t2hc3 t2hc8">%</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=t2hr1 class=alignLeft headers=t2hc1><5</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3272</TD><TD class=alignCenter>1454</TD><TD class=alignCenter>43</TD><TD class=alignCenter>1775</TD><TD class=alignCenter>558</TD><TD class=alignCenter>3830</TD><TD class=alignCenter>16.5%</TD></TR><TR><TH id=t2hr2 class=alignLeft headers=t2hc1>5-19</TH><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1336</TD><TD class=alignCenter>707</TD><TD class=alignCenter>27</TD><TD class=alignCenter>602</TD><TD class=alignCenter>831</TD><TD class=alignCenter>2167</TD><TD class=alignCenter>9.3%</TD></TR><TR><TH id=t2hr3 class=alignLeft headers=t2hc1>20-44</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5114</TD><TD class=alignCenter>2819</TD><TD class=alignCenter>55</TD><TD class=alignCenter>2240</TD><TD class=alignCenter>1033</TD><TD class=alignCenter>6147</TD><TD class=alignCenter>26.4%</TD></TR><TR><TH id=t2hr4 class=alignLeft headers=t2hc1>45-64</TH><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>4494</TD><TD class=alignCenter>2396</TD><TD class=alignCenter>73</TD><TD class=alignCenter>2025</TD><TD class=alignCenter>1531</TD><TD class=alignCenter>6025</TD><TD class=alignCenter>25.9%</TD></TR><TR><TH id=t2hr5 class=alignLeft headers=t2hc1>65+</TH><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>2669</TD><TD class=alignCenter>1002</TD><TD class=alignCenter>181</TD><TD class=alignCenter>1486</TD><TD class=alignCenter>2286</TD><TD class=alignCenter>4955</TD><TD class=alignCenter>21.3%</TD></TR><TR><TH id=t2hr6 class=alignLeft headers=t2hc1>Unknown</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>137</TD><TD class=alignCenter>102</TD><TD class=alignCenter>21</TD><TD class=alignCenter>14</TD><TD class=alignCenter>9</TD><TD class=alignCenter>146</TD><TD class=alignCenter>0.6%</TD></TR><TR><TH id=t2hr7 class=alignLeft headers=t2hc1>Total</TH><TD class=alignCenter>4</TD><TD class="alignCenter bg-colour-blue">0</TD><TD class="alignCenter bg-colour-blue">3</TD><TD class="alignCenter bg-colour-blue">1</TD><TD class=alignCenter>2</TD><TD class=alignCenter>17022</TD><TD class="alignCenter bg-colour-blue">8480</TD><TD class="alignCenter bg-colour-blue">400</TD><TD class="alignCenter bg-colour-blue">8142</TD><TD class=alignCenter>6248</TD><TD class=alignCenter>23270</TD><TD class=alignCenter>100.0%</TD></TR><TR><TH id=t2hr8 class=alignLeft headers=t2hc1>Percentage<SUP>2</SUP></TH><TD class=alignCenter>66.7%</TD><TD class="alignCenter bg-colour-blue">0.0%</TD><TD class="alignCenter bg-colour-blue">75.0%</TD><TD class="alignCenter bg-colour-blue">25.0%</TD><TD class=alignCenter>33.3%</TD><TD class=alignCenter>73.1%</TD><TD class="alignCenter bg-colour-blue">49.8%</TD><TD class="alignCenter bg-colour-blue">2.3%</TD><TD class="alignCenter bg-colour-blue">47.8%</TD><TD class=alignCenter>26.9%</TD><TD class=alignCenter></TD><TD class=alignCenter></TD></TR></TBODY></TABLE>


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                    Influenza Strain Characterizations

                    During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 2,468 influenza viruses [179 A(H3N2), 1,402 A(H1N1)pdm09 and 887 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, and one A(H3N2) virus showed reduced titres to antiserum against the reference A/Texas/50/2012 strain. Thirty 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 = 2468

                    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 2,473 influenza viruses for resistance to oseltamivir and all but five were sensitive. All 2,470 viruses tested for resistance to zanamivir were sensitive. All 1,685 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=t3hc1 rowSpan=2>Virus type and subtype</TH><TH id=t3hc2 colSpan=2>Oseltamivir</TH><TH id=t3hc3 colSpan=2>Zanamivir</TH><TH id=t3hc4 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=t3hc5 headers=t3hc2># tested</TH><TH id=t3hc6 headers=t3hc2># resistant (%)</TH><TH id=t3hc7 headers=t3hc3># tested</TH><TH id=t3hc8 headers=t3hc3># resistant (%)</TH><TH id=t3hc9 headers=t3hc4># tested</TH><TH id=t3hc10 headers=t3hc4># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=t3hr1 class="alignLeft bg-colour-blue" headers=t3hc1>A (H3N2)</TH><TD class=alignCenter headers="t3hr1 t3hc2 t3hc5">174</TD><TD class=alignCenter headers="t3hr1 t3hc2 t3hc6">0</TD><TD class=alignCenter headers="t3hr1 t3hc3 t3hc7">172</TD><TD class=alignCenter headers="t3hr1 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr1 t3hc4 t3hc9">226</TD><TD class=alignCenter headers="t3hr1 t3hc4 t3hc10">226 (100%)</TD></TR><TR><TH id=t3hr2 class="alignLeft bg-colour-blue" headers=t3hc1>A (H1N1)</TH><TD class=alignCenter headers="t3hr2 t3hc2 t3hc5">1410</TD><TD class=alignCenter headers="t3hr2 t3hc2 t3hc6">5 (0.4%)</TD><TD class=alignCenter headers="t3hr2 t3hc3 t3hc7">1411</TD><TD class=alignCenter headers="t3hr2 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr2 t3hc4 t3hc9">1459</TD><TD class=alignCenter headers="t3hr2 t3hc4 t3hc10">1459 (100%)</TD></TR><TR><TH id=t3hr3 class="alignLeft bg-colour-blue" headers=t3hc1>B</TH><TD class=alignCenter headers="t3hr3 t3hc2 t3hc5">889</TD><TD class=alignCenter headers="t3hr3 t3hc2 t3hc6">0</TD><TD class=alignCenter headers="t3hr3 t3hc3 t3hc7">887</TD><TD class=alignCenter headers="t3hr3 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr3 t3hc4 t3hc9">NA <SUP>*</SUP></TD><TD class=alignCenter headers="t3hr3 t3hc4 t3hc10">NA <SUP>*</SUP></TD></TR><TR><TH id=t3hr4 class="alignLeft bg-colour-blue" headers=t3hc1>TOTAL</TH><TD class=alignCenter headers="t3hr4 t3hc2 t3hc5">2473</TD><TD class=alignCenter headers="t3hr4 t3hc2 t3hc6">5 (0.2%)</TD><TD class=alignCenter headers="t3hr4 t3hc3 t3hc7">2470</TD><TD class=alignCenter headers="t3hr4 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr4 t3hc4 t3hc9">1685</TD><TD class=alignCenter headers="t3hr4 t3hc4 t3hc10">1685 (100%)</TD></TR></TBODY></TABLE>
                    Influenza-like Illness (ILI) Consultation Rate

                    The national influenza-like-illness (ILI) consultation rate decreased from 8.7 consultations per 1,000 patient visits in week 30 to 3.2 per 1,000 in week 31 and increased to 10.2 per 1,000 in week 32. The rates for weeks 25 to 30, and 32, were been above 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

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                    Influenza Outbreak Surveillance

                    No new outbreaks of influenza were reported in week 32. One new outbreak of influenza A(unsubtyped) was reported in a facility in week 31 (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 6Overall number of new influenza outbreaks by report week, Canada, 2013-2014
                    Pharmacy Surveillance

                    In weeks 31 and 32, the proportion of prescriptions for antivirals is at inter-seasonal levels. 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 (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

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                    Sentinel Hospital Influenza Surveillance

                    Paediatric Influenza Hospitalizations and Deaths (IMPACT)
                    In weeks 31 and 32, one new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalization, was reported by the Immunization Monitoring Program Active (IMPACT) network, a case of influenza B in a child 2-4 years of age (Figure 8a). No ICU admissions or deaths have been reported from IMPACT since week 23.
                    To date this season, a total of 714 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 78% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children <5 years of age represent 73% of cases to date (Table 4). One hundred and seventeen ICU admissions have been reported, of which 75 (65%) were children <5 years of age (Figure 9a). All but 23 were cases with influenza A, and 98% of those subtyped were A(H1N1)pdm09. Among the 116 ICU cases with available data, 74 (64%) were reported to have underlying medical conditions. One death has been reported this season. A similar number of paediatric hospital admissions have been reported this year compared to the 2012-13 season.
                    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)
                    Surveillance of laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network has ended for the 2013-14 season (Figure 8b). A summary of PCIRN-SOS data for the 2013-14 season will be included in the FluWatch annual report of influenza surveillance in Canada.
                    During passive and active surveillance* from August 25th, 2013 to May 31st, 2014, 1,985 influenza-associated hospitalizations were reported by the PCIRN-SOS network, 1,338 (67.4%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). Compared to the 2012-13 season, slightly more cases were reported, although the peak number of cases was smaller. A greater number of cases were reported during March and April compared to last year, with six times more cases of influenza B reported. ICU admission was required for 321 hospitalizations, of which 263 were cases with influenza A (137 A(H1N1)pdm09, ten A(H3N2) and 116 A(unsubtyped)), 57 were cases with influenza B and the influenza type was not reported for one case. A greater proportion of cases were admitted to the ICU this season compared to last year, but the proportion of deaths was similar. Of the ICU admissions with available information, 85.9% (189/220) were reported to have at least one comorbidity, and 68.2% (176/258) reported not having been vaccinated this season. Among the 112 deaths reported this season, all but 28 were cases of influenza A (51 A(H1N1)pdm09, three A(H3N2) and 30 A(unsubtyped)); ten cases 20-44 years of age, 37 cases 45-64 years of age and 65 cases ≥65 years of age (Figure 9b). Among fatal cases with available information, 93.8% (60/64) were reported to have at least one comorbidity, and 48.2% (40/83) reported not having been vaccinated this season.
                    Note: During the 2013-14 influenza season, PCIRN-SOS conducted passive surveillance from August 25<SUP>th</SUP> to November 14<SUP>th</SUP>, 2013, and May 16<SUP>th</SUP> to 31<SUP>st</SUP>. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance was conducted between November 15<SUP>th</SUP>, 2013 and May 15<SUP>th</SUP>, 2014 during which time PCIRN site coordinators investigated 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 August 9, 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>106</TD><TD class=alignCenter>38</TD><TD class=alignCenter>0</TD><TD class=alignCenter>68</TD><TD class=alignCenter>12</TD><TD class=alignCenter>118 (17%)</TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignCenter>165</TD><TD class=alignCenter>62</TD><TD class=alignCenter>1</TD><TD class=alignCenter>102</TD><TD class=alignCenter>31</TD><TD class=alignCenter>196 (27%)</TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignCenter>161</TD><TD class=alignCenter>59</TD><TD class=alignCenter>3</TD><TD class=alignCenter>99</TD><TD class=alignCenter>47</TD><TD class=alignCenter>208 (29%)</TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignCenter>84</TD><TD class=alignCenter>33</TD><TD class=alignCenter>1</TD><TD class=alignCenter>50</TD><TD class=alignCenter>55</TD><TD class=alignCenter>139 (19%)</TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignCenter>39</TD><TD class=alignCenter>13</TD><TD class=alignCenter>1</TD><TD class=alignCenter>25</TD><TD class=alignCenter>14</TD><TD class=alignCenter>53 (7%)</TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignCenter>555</TD><TD class="alignCenter bg-colour-blue">205</TD><TD class="alignCenter bg-colour-blue">6</TD><TD class="alignCenter bg-colour-blue">344</TD><TD class=alignCenter>159</TD><TD class=alignCenter>714</TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP></TH><TD class=alignCenter>77.7%</TD><TD class="alignCenter bg-colour-blue">36.9%</TD><TD class="alignCenter bg-colour-blue">1.1%</TD><TD class="alignCenter bg-colour-blue">62.0%</TD><TD class=alignCenter>22.3%</TD><TD class=alignCenter>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 31 May, 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>Two 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=alignCenter headers="er1 er2 ec1 ec2 ec3">13 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec4">5 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec5">1 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec6">7 </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">276 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec4">142 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec5">7 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec6">127 </TD><TD class=alignCenter headers="er1 er3 ec1 ec7">47 </TD><TD class=alignCenter headers="er1 er3 ec1 ec8">323 (16%) </TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignCenter headers="er1 er4 ec1 ec2 ec3">521 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec4">245 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec5">12 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec6">264 </TD><TD class=alignCenter headers="er1 er4 ec1 ec7">135 </TD><TD class=alignCenter headers="er1 er4 ec1 ec8">656 (33%) </TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignCenter headers="er1 er5 ec1 ec2 ec3">525 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec4">238 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec5">61 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec6">226 </TD><TD class=alignCenter headers="er1 er5 ec1 ec7">460 </TD><TD class=alignCenter headers="er1 er5 ec1 ec8">985 (50%) </TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignCenter headers="er1 er6 ec1 ec2 ec3">1335 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec4">630 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec5">81 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec6">624 </TD><TD class=alignCenter headers="er1 er6 ec1 ec7">644 </TD><TD class=alignCenter headers="er1 er6 ec1 ec8">1979 </TD></TR><TR><TH id=er7 class=alignLeft headers=er1>%<SUP>1</SUP></TH><TD class=alignCenter headers="er1 er7 ec1 ec2 ec3">67% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec4">47% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec5">6% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec6">47% </TD><TD class=alignCenter headers="er1 er7 ec1 ec7">33% </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)

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                    Provincial/Territorial Influenza Hospitalizations and Deaths

                    In week 31 and 32, 10 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories.* The majority were cases of influenza B (9, 90%). There were two deaths and no ICU admissions reported in weeks 31 and 32. 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, 5,442 influenza-associated hospitalizations have been reported, 68.3% with influenza A. The majority (63.4%) 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 384 ICU admissions have been reported this season, of which 64.0% were adults 20-64 years of age. A total of 342 deaths have been reported. The highest proportion of deaths has been among adults ≥65 years of age (56.7%) followed by adults 20-64 years of age (35.4%). 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 31.7% of hospitalizations and 35.7% 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, 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=t6hc1 rowSpan=3>Age groups </TH><TH id=t6hc2 colSpan=6>Cumulative (Aug. 25, 2013 to August 9, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=t6hc3 colSpan=4 headers=t6hc2>Influenza A</TH><TH id=t6hc4 headers=t6hc2>B</TH><TH id=t6hc5 headers=t6hc2>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=t6hc6 headers="t6hc2 t6hc3">A Total</TH><TH id=t6hc7 class=bg-colour-blue headers="t6hc2 t6hc3">A(H1) pdm09</TH><TH id=t6hc8 class=bg-colour-blue headers="t6hc2 t6hc3">A(H3)</TH><TH id=t6hc9 class=bg-colour-blue headers="t6hc2 t6hc3">A (UnS)</TH><TD class=alignCenter headers="t6hc2 t6hc4">Total</TD><TD class=alignCenter headers="t6hc2 t6hc5"># (%)</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=t6hr1 class=alignLeft headers=t6hc1>0-4 years</TH><TD class=alignCenter>628</TD><TD class=alignCenter>290</TD><TD class=alignCenter>14</TD><TD class=alignCenter>324</TD><TD class=alignCenter>148</TD><TD class=alignCenter>776 (14%)</TD></TR><TR><TH id=t6hr2 class=alignLeft headers=t6hc1>5-14 years</TH><TD class=alignCenter>136</TD><TD class=alignCenter>65</TD><TD class=alignCenter>6</TD><TD class=alignCenter>65</TD><TD class=alignCenter>124</TD><TD class=alignCenter>260 (5%)</TD></TR><TR><TH id=t6hr3 class=alignLeft headers=t6hc1>15-19 years</TH><TD class=alignCenter>40</TD><TD class=alignCenter>23</TD><TD class=alignCenter>4</TD><TD class=alignCenter>13</TD><TD class=alignCenter>10</TD><TD class=alignCenter>50 (1%)</TD></TR><TR><TH id=t6hr4 class=alignLeft headers=t6hc1>20-44 years </TH><TD class=alignCenter>625</TD><TD class=alignCenter>425</TD><TD class=alignCenter>11</TD><TD class=alignCenter>189</TD><TD class=alignCenter>108</TD><TD class=alignCenter>733 (13%)</TD></TR><TR><TH id=t6hr5 class=alignLeft headers=t6hc1>45-64 years </TH><TD class=alignCenter>1135</TD><TD class=alignCenter>711</TD><TD class=alignCenter>36</TD><TD class=alignCenter>388</TD><TD class=alignCenter>316</TD><TD class=alignCenter>1451 (27%)</TD></TR><TR><TH id=t6hr6 class=alignLeft headers=t6hc1>65+ years </TH><TD class=alignCenter>1013</TD><TD class=alignCenter>473</TD><TD class=alignCenter>135</TD><TD class=alignCenter>405</TD><TD class=alignCenter>986</TD><TD class=alignCenter>1999 (37%)</TD></TR><TR><TH id=t6hr7 class=alignLeft headers=t6hc1>Unknown</TH><TD class=alignCenter>138</TD><TD class=alignCenter>99</TD><TD class=alignCenter>3</TD><TD class=alignCenter>36</TD><TD class=alignCenter>35</TD><TD class=alignCenter>173 (3%)</TD></TR><TR><TH id=t6hr8 class=alignLeft headers=t6hc1>Total </TH><TD class=alignCenter>3715</TD><TD class="alignCenter bg-colour-blue">2086</TD><TD class="alignCenter bg-colour-blue">209</TD><TD class="alignCenter bg-colour-blue">1420</TD><TD class=alignCenter>1727</TD><TD class=alignCenter>5442</TD></TR><TR><TH id=t6hr9 class=alignLeft headers=t6hc1>Percentage <SUP>1</SUP></TH><TD class=alignCenter>68.3%</TD><TD class="alignCenter bg-colour-blue">56.2%</TD><TD class="alignCenter bg-colour-blue">5.6%</TD><TD class="alignCenter bg-colour-blue">38.2%</TD><TD class=alignCenter>31.7%</TD><TD class=alignCenter>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
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                    Comment


                    • #40
                      Re: Canada FluWatch Weekly Reports 2013-2014 Season Weeks 33 and 34

                      FluWatch report: August 10 to August 23, 2014 (Weeks 33 and 34)

                      Posted 2014-08-29For 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, 419 KB - 10 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/13-14/w34_14/pdf/fw2014-34-eng.pdf">FluWatch report: August 10 to August 23, 2014 (Weeks 33 and 34) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 419 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

                      Help with PDF documents


                      Overall Summary
                      • Influenza activity in Canada remains at expected levels for this time of year with very few laboratory detections of influenza.
                      • Other respiratory virus detections (RSV, coronavirus, and human metapneumovirus) are also at expected levels. Detections of parainfluenza and adenovirus have decreased in this reporting period.
                      • In week 34, two influenza outbreaks were reported.
                      • As of week 34, 5,457 hospitalizations and 344 deaths have been reported from participating regions, which is more hospitalizations but a similar number of deaths than were reported last year.
                      Note: This is the final report for the 2013-2014 influenza season. The first FluWatch report of the 2014-2015 influenza season will be published on September 12, 2014. Alternate week reporting will continue until October 10, 2014 when weekly reporting will resume. Laboratory detections reported through the Respiratory Virus Detection Surveillance System and influenza activity level maps continue to be updated weekly on the FluWatch website.

                      Are you a primary health care practitioner (General Practitioner, Nurse Practitioner or Registered Nurse) interested in becoming a FluWatch sentinel for the 2014-15 influenza season? Contact us at FluWatch@phac-aspc.gc.ca
                      Influenza/ILI Activity (geographic spread)

                      In weeks 33 and 34, most regions in Canada reported no influenza/ILI activity. In week 34, four regions (BC(1), QC(1) and NL(2)) reported sporadic activity; and two regions reported localized activity (BC(1), NL(1)). In week 33, nine regions did not report data, and in week 34, 17 regions did not report.
                      Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 34





                      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 was at inter-seasonal levels in week 33 (8 detections) and week 34 (9 detections), with <1% of tests positive for the past five weeks (Figure 2). Most jurisdictions have reported only sporadic numbers of influenza detections in recent weeks (Table 1). Over the past 8 weeks, 91 influenza detections were reported, of which 67% were influenza A and 37/44 of those subtyped were influenza A(H3N2). Compared to A(H1N1)pdm09 which was predominant earlier this season, both influenza B and A(H3N2) have affected a greater proportion of adults ≥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
                      In weeks 33 and 34, detections of most other respiratory viruses were at inter-seasonal levels (RSV, coronavirus, and human metapneumovirus). Parainfluenza and adenovirus are showing a downward trend. Detections of rhinovirus increased in weeks 33 and 34, which is in keeping with the usual pattern of seasonal circulation (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


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                      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>Two weeks (August 10 to 23, 2014)</TH><TH id=ac8 colSpan=5>Cumulative
                      (August 25, 2013 to August 23, 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=alignRight headers="ar1 ar2 ac1 ac2 ac3">4 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">1 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">3 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac7">0 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac10">1838 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac11">1616 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac12">77 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac13">145 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac14">388 </TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">6 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">3 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">3 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac7">0 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac10">3911 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac11">3466 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac12">129 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac13">316 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac14">573 </TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">1 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">1 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac7">0 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac10">1386 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac11">989 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac12">8 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac13">389 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac14">198 </TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">0 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac7">0 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac10">685 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac11">463 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac12">7 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac13">215 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac14">72 </TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">1 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">1 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac7">0 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac10">5848 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac11">2499 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac12">434 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac13">2915 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac14">3119 </TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">1 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">1 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac7">1 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac10">5382 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac11">677 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac12">6 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac13">4699 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac14">2749 </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">0 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac10">1491 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac11">370 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac12">2 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac13">1119 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac14">134 </TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">0 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac7">0 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac10">175 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac11">134 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac12">5 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac13">36 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac14">52 </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">119 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac11">118 </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">5 </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">2 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac10">386 </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">282 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac14">267 </TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">14 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac4">4 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac5">5 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac6">5 </TD><TD class=alignRight headers="ar1 ar12 ac1 ac7">3 </TD><TD class=alignRight headers="ar1 ar12 ac8 ac9 ac10">21221 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac11">10436 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac12">668 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac13">10117 </TD><TD class=alignRight headers="ar1 ar12 ac8 ac14">7557 </TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="ar1 ar13 ac1 ac2 ac3">82.4% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac4">28.6% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac5">35.7% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac6">35.7% </TD><TD class=alignRight headers="ar1 ar13 ac1 ac7">17.6% </TD><TD class=alignRight headers="ar1 ar13 ac8 ac9 ac10">73.7% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac11">49.2% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac12">3.1% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac13">47.7% </TD><TD class=alignRight headers="ar1 ar13 ac8 ac14">26.3% </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>Two weeks
                      (August 10 to 23, 2014)</TH><TH id=bc8 colSpan=7>Cumulative
                      (August 25, 2013 to August 23, 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=alignRight headers="br1 br2 bc1 bc2 bc3">1 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">0 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">1 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">0 </TD><TD class=alignRight headers="br1 br2 bc1 bc7">0 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">3274 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">1454 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">44 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1776 </TD><TD class=alignRight headers="br1 br2 bc8 bc14">558 </TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc16">3832 </TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc17">16.5% </TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">0 </TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">0 </TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">0 </TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">0 </TD><TD class=alignRight headers="br1 br3 bc1 bc7">1 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1336 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">707 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">27 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">602 </TD><TD class=alignRight headers="br1 br3 bc8 bc14">831 </TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc16">2167 </TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc17">9.3% </TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">2 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">2 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">0 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">0 </TD><TD class=alignRight headers="br1 br4 bc1 bc7">0 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">5117 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">2821 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">54 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">2242 </TD><TD class=alignRight headers="br1 br4 bc8 bc14">1033 </TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc16">6150 </TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc17">26.4% </TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">1 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">0 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">1 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">0 </TD><TD class=alignRight headers="br1 br5 bc1 bc7">1 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">4496 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">2396 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">74 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">2026 </TD><TD class=alignRight headers="br1 br5 bc8 bc14">1532 </TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc16">6028 </TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc17">25.9% </TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">3 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">0 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">0 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">3 </TD><TD class=alignRight headers="br1 br6 bc1 bc7">1 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">2673 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">1002 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">182 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">1489 </TD><TD class=alignRight headers="br1 br6 bc8 bc14">2286 </TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc16">4959 </TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc17">21.3% </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">137 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">102 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">21 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">14 </TD><TD class=alignRight headers="br1 br7 bc8 bc14">9 </TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc16">146 </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">7 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc4">2 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc5">2 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc6">3 </TD><TD class=alignRight headers="br1 br8 bc1 bc7">3 </TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">17033 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc11">8482 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc12">402 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc13">8149 </TD><TD class=alignRight headers="br1 br8 bc8 bc14">6249 </TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc16">23282 </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">70.0% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc4">28.6% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc5">28.6% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc6">42.9% </TD><TD class=alignRight headers="br1 br9 bc1 bc7">30.0% </TD><TD class=alignRight headers="br1 br9 bc8 bc9 bc10">73.2% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc11">49.8% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc12">2.4% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc13">47.8% </TD><TD class=alignRight headers="br1 br9 bc8 bc14">26.8% </TD><TD class=alignRight></TD><TD class=alignRight></TD></TR></TBODY></TABLE>


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                      Influenza Strain Characterizations

                      During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 2,486 influenza viruses [187 A(H3N2), 1,404 A(H1N1)pdm09 and 895 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, and one A(H3N2) virus showed reduced titres to antiserum against the reference A/Texas/50/2012 strain. Thirty 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 = 2486

                      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 2,491 influenza viruses for resistance to oseltamivir and all but five were sensitive. All 2,488 viruses tested for resistance to zanamivir were sensitive. All 1,686 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=t3hc1 rowSpan=2>Virus type and subtype</TH><TH id=t3hc2 colSpan=2>Oseltamivir</TH><TH id=t3hc3 colSpan=2>Zanamivir</TH><TH id=t3hc4 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=t3hc5 headers=t3hc2># tested</TH><TH id=t3hc6 headers=t3hc2># resistant (%)</TH><TH id=t3hc7 headers=t3hc3># tested</TH><TH id=t3hc8 headers=t3hc3># resistant (%)</TH><TH id=t3hc9 headers=t3hc4># tested</TH><TH id=t3hc10 headers=t3hc4># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=t3hr1 class="alignLeft bg-colour-blue" headers=t3hc1>A (H3N2)</TH><TD class=alignCenter headers="t3hr1 t3hc2 t3hc5">182</TD><TD class=alignCenter headers="t3hr1 t3hc2 t3hc6">0</TD><TD class=alignCenter headers="t3hr1 t3hc3 t3hc7">180</TD><TD class=alignCenter headers="t3hr1 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr1 t3hc4 t3hc9">227</TD><TD class=alignCenter headers="t3hr1 t3hc4 t3hc10">227 (100%)</TD></TR><TR><TH id=t3hr2 class="alignLeft bg-colour-blue" headers=t3hc1>A (H1N1)</TH><TD class=alignCenter headers="t3hr2 t3hc2 t3hc5">1412</TD><TD class=alignCenter headers="t3hr2 t3hc2 t3hc6">5 (0.4%)</TD><TD class=alignCenter headers="t3hr2 t3hc3 t3hc7">1413</TD><TD class=alignCenter headers="t3hr2 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr2 t3hc4 t3hc9">1459</TD><TD class=alignCenter headers="t3hr2 t3hc4 t3hc10">1459 (100%)</TD></TR><TR><TH id=t3hr3 class="alignLeft bg-colour-blue" headers=t3hc1>B</TH><TD class=alignCenter headers="t3hr3 t3hc2 t3hc5">897</TD><TD class=alignCenter headers="t3hr3 t3hc2 t3hc6">0</TD><TD class=alignCenter headers="t3hr3 t3hc3 t3hc7">895</TD><TD class=alignCenter headers="t3hr3 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr3 t3hc4 t3hc9">NA <SUP>*</SUP></TD><TD class=alignCenter headers="t3hr3 t3hc4 t3hc10">NA <SUP>*</SUP></TD></TR><TR><TH id=t3hr4 class="alignLeft bg-colour-blue" headers=t3hc1>TOTAL</TH><TD class=alignCenter headers="t3hr4 t3hc2 t3hc5">2491</TD><TD class=alignCenter headers="t3hr4 t3hc2 t3hc6">5 (0.2%)</TD><TD class=alignCenter headers="t3hr4 t3hc3 t3hc7">2488</TD><TD class=alignCenter headers="t3hr4 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr4 t3hc4 t3hc9">1686</TD><TD class=alignCenter headers="t3hr4 t3hc4 t3hc10">1686 (100%)</TD></TR></TBODY></TABLE>
                      Influenza-like Illness (ILI) Consultation Rate

                      The national influenza-like-illness (ILI) consultation rate decreased from 9.0 consultations per 1,000 patient visits in week 32 to 5.4 per 1,000 in week 33 and increased to 7.9 per 1,000 in week 34. The rates for weeks 25 to 34 were above 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

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                      Influenza Outbreak Surveillance

                      No new outbreaks of influenza were reported in week 33. Two new outbreaks were reported in week 34: one in a long-term care facility and the other in another setting (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 6Overall number of new influenza outbreaks by report week, Canada, 2013-2014
                      Pharmacy Surveillance

                      In weeks 33 and 34, the proportion of prescriptions for antivirals is at inter-seasonal levels. 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 (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

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                      Sentinel Hospital Influenza Surveillance

                      Paediatric Influenza Hospitalizations and Deaths (IMPACT)
                      In weeks 33 and 34, no new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network (Figure 8a). No ICU admissions or deaths have been reported from IMPACT since week 23.
                      To date this season, a total of 714 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 78% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children <5 years of age represent 73% of cases to date (Table 4). One hundred and sixteen ICU admissions have been reported, of which 75 (65%) were children <5 years of age (Figure 9a). All but 22 were cases with influenza A, and 98% of those subtyped were A(H1N1)pdm09. Among the 116 ICU cases with available data, 74 (64%) were reported to have underlying medical conditions. One death has been reported this season. A similar number of paediatric hospital admissions have been reported this year compared to the 2012-13 season.
                      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)
                      Surveillance of laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network has ended for the 2013-14 season (Figure 8b). A summary of PCIRN-SOS data for the 2013-14 season will be included in the FluWatch annual report of influenza surveillance in Canada.
                      During passive and active surveillance* from August 25th, 2013 to May 31st, 2014, 1,985 influenza-associated hospitalizations were reported by the PCIRN-SOS network, 1,338 (67.4%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). Compared to the 2012-13 season, slightly more cases were reported, although the peak number of cases was smaller. A greater number of cases were reported during March and April compared to last year, with six times more cases of influenza B reported. ICU admission was required for 321 hospitalizations, of which 263 were cases with influenza A (137 A(H1N1)pdm09, ten A(H3N2) and 116 A(unsubtyped)), 57 were cases with influenza B and the influenza type was not reported for one case. A greater proportion of cases were admitted to the ICU this season compared to last year, but the proportion of deaths was similar. Of the ICU admissions with available information, 85.9% (189/220) were reported to have at least one comorbidity, and 68.2% (176/258) reported not having been vaccinated this season. Among the 112 deaths reported this season, all but 28 were cases of influenza A (51 A(H1N1)pdm09, three A(H3N2) and 30 A(unsubtyped)); ten cases 20-44 years of age, 37 cases 45-64 years of age and 65 cases ≥65 years of age (Figure 9b). Among fatal cases with available information, 93.8% (60/64) were reported to have at least one comorbidity, and 48.2% (40/83) reported not having been vaccinated this season.
                      Note: During the 2013-14 influenza season, PCIRN-SOS conducted passive surveillance from August 25<SUP>th</SUP> to November 14<SUP>th</SUP>, 2013, and May 16<SUP>th</SUP> to 31<SUP>st</SUP>. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance was conducted between November 15<SUP>th</SUP>, 2013 and May 15<SUP>th</SUP>, 2014 during which time PCIRN site coordinators investigated 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 August 23, 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">107 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc4">38 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc5">0 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc6">69 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc7">11 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc8">118 (17%) </TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc3">166 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc4">63 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc5">1 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc6">102 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc7">31 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc8">197 (28%) </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">59 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc5">3 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc6">99 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc7">47 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc8">208 (29%) </TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc3">83 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc4">33 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc5">1 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc6">49 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc7">55 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc8">138 (19%) </TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc3">38 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc4">13 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc5">1 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc6">24 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc7">15 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc8">53 (7%) </TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignCenter headers="dr1 dr7 dc1 dc2 dc3">555 </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc4">206 </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc5">6 </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc6">343 </TD><TD class=alignCenter headers="dr1 dr7 dc1 dc7">159 </TD><TD class=alignCenter headers="dr1 dr7 dc1 dc8">714 </TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP></TH><TD class=alignCenter headers="dr1 dr8 dc1 dc2 dc3">77.7% </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc4">37.1% </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc5">1.1% </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc6">61.8% </TD><TD class=alignCenter headers="dr1 dr8 dc1 dc7">22.3% </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 31 May, 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>Two 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=alignCenter headers="er1 er2 ec1 ec2 ec3">13 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec4">5 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec5">1 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec6">7 </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">276 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec4">142 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec5">7 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec6">127 </TD><TD class=alignCenter headers="er1 er3 ec1 ec7">47 </TD><TD class=alignCenter headers="er1 er3 ec1 ec8">323 (16%) </TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignCenter headers="er1 er4 ec1 ec2 ec3">521 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec4">245 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec5">12 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec6">264 </TD><TD class=alignCenter headers="er1 er4 ec1 ec7">135 </TD><TD class=alignCenter headers="er1 er4 ec1 ec8">656 (33%) </TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignCenter headers="er1 er5 ec1 ec2 ec3">525 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec4">238 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec5">61 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec6">226 </TD><TD class=alignCenter headers="er1 er5 ec1 ec7">460 </TD><TD class=alignCenter headers="er1 er5 ec1 ec8">985 (50%) </TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignCenter headers="er1 er6 ec1 ec2 ec3">1335 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec4">630 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec5">81 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec6">624 </TD><TD class=alignCenter headers="er1 er6 ec1 ec7">644 </TD><TD class=alignCenter headers="er1 er6 ec1 ec8">1979 </TD></TR><TR><TH id=er7 class=alignLeft headers=er1>%<SUP>1</SUP></TH><TD class=alignCenter headers="er1 er7 ec1 ec2 ec3">67% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec4">47% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec5">6% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec6">47% </TD><TD class=alignCenter headers="er1 er7 ec1 ec7">33% </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)

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                      Provincial/Territorial Influenza Hospitalizations and Deaths

                      In weeks 33 and 34, two laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories*, both adults ≥65 years of age. There were no deaths and only one ICU admission reported in weeks 33 and 34. 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, 5,457 influenza-associated hospitalizations have been reported, 68.3% with influenza A. The majority (63.4%) 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 394 ICU admissions have been reported this season, of which 65.0% were adults 20-64 years of age. A total of 344 deaths have been reported. The highest proportion of deaths has been among adults ≥65 years of age (56.1%) followed by adults 20-64 years of age (36.6%). 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 31.7% of hospitalizations and 35.5% 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, 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 August 23, 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">630 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc4">295 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc5">14 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc6">321 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc7">148 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc8">778 (14%) </TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years</TH><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc3">136 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc4">65 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc5">6 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc6">65 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc7">124 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc8">260 (5%) </TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years</TH><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc3">40 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc4">23 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc5">4 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc6">13 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc7">10 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc8">50 (1%) </TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc3">628</TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc4">430 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc5">10 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc6">188 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc7">108 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc8">736 (13%) </TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc3">1141 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc4">717 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc5">36 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc6">388 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc7">316 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc8">1457 (27%) </TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc3">1015 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc4">474 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc5">136 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc6">405 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc7">988 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc8">2003 (37%) </TD></TR><TR><TH id=fr10 class=alignLeft headers=fr1>Unknown</TH><TD class=alignCenter headers="fc1 fc2 fc3">138 </TD><TD class=alignCenter headers="fc1 fc2 fc4">99 </TD><TD class=alignCenter headers="fc1 fc2 fc5">3 </TD><TD class=alignCenter headers="fc1 fc2 fc6">36 </TD><TD class=alignCenter headers="fc1 fc7">35 </TD><TD class=alignCenter headers="fc1 fc8">173 (3%) </TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignCenter headers="fr1 fr8 fc1 fc2 fc3">3728</TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc4">2103 </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc5">209 </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc6">1416 </TD><TD class=alignCenter headers="fr1 fr8 fc1 fc7">1729 </TD><TD class=alignCenter headers="fr1 fr8 fc1 fc8">5457 </TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP></TH><TD class=alignCenter headers="fr1 fr9 fc1 fc2 fc3">68.3% </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc4">56.4% </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc5">5.6% </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc6">38.0% </TD><TD class=alignCenter headers="fr1 fr9 fc1 fc7">31.7% </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
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