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  • Pathfinder
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    FluWatch report: January 25 to January 31, 2015 (Week 4)

    Posted 2015-02-06 For readers interested in the PDF version, the document is available for downloading or viewing:
    FluWatch report: January 25 to January 31, 2015 (Week 4) (PDF Version - 385KB - 10 pages)

    ?? Help with PDF documents

    Overall Summary
    • In week 4, all influenza indicators continue to decline indicating that peak of the influenza season in Canada has passed.
    • A(H3N2) continues to be the most common type of influenza affecting Canadians. In both laboratory detections, hospitalizations and deaths and the majority of cases have been among seniors ≥65 years of age.
    • Detections of respiratory syncytial virus (RSV) continue to be the second most frequently detected virus after influenza. Since week 38, detections of RSV have been higher than in the previous season.
    • On February 5, 2015, a Canadian interim vaccine effectiveness (VE) study by the PCIRN-SOS Network was published in Eurosurveillance. This study which examined VE for those seriously ill and in hospital found the overall VE for those under 65 years of age to be 11% and minus 25% for those over 65 years of age. Almost all (99%) cases were laboratory confirmed with H3N2. These poor VE estimates are not unexpected given the high degree of drift of the circulating virus from the vaccine strain observed in Canada this season.
    • Evidence from the National Microbiology Laboratory does indicate that the other vaccine components will continue to provide protection against the circulating A(H1N1) and B strains.

    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 04, 6 regions reported widespread activity: in ON(3), QC(2), NF. Twenty-seven regions reported localized activity: in BC(4), SK, MB, ON(4), QC(3), NB(6), NS(6), NL and PEI and fifteen regions reported sporadic activity: in NWT, YK, BC, SK(2), MB(4), QC, NB, NS(2) and NF(2). NU and AB did not report data for week 04.
    Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 4



    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 tests decreased from 2,959 in week 03 to 2,388 in week 04. The percentage of positive influenza tests also decreased from 28.3% to 25.0% (Figure 2). To date, 97% of influenza detections have been influenza A, and 99.8% of those subtyped have been A(H3N2) (Table 1). To date this season, detailed information on age and type/subtype has been received for 25,918 cases. A significantly greater proportion of laboratory detections of influenza have been reported in adults ≥65 years of age (62%) this season (Table 2) compared to the 2013-14 season when only 15.5% of cases were in adults ≥65 years of age.
    Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2014-15
    Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
    In week 04, the number of positive respiratory syncytial virus (RSV) tests decreased to 936 RSV detections and remains the second most frequently detected virus after influenza. Detections of RSV since week 38 have been higher than in the previous season. During the past few weeks detections of other respiratory viruses have been relatively stable. Detections of other respiratory viruses have generally been lower this season compared to the previous season (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, 2014-15
    RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
    Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
    B Total
    1 Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
    2 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.
    314 3 252 59 13 2700 8 2067 625 71
    52 0 40 12 32 3410 2 3271 137 263
    30 0 0 34 2 1206 0 0 1206 13
    54 0 6 48 5 1011 0 357 654 24
    1,005 2 511 492 11 7819 10 3597 4212 93
    477 0 0 477 73 9720 3 422 9295 443
    149 0 41 108 9 426 0 66 360 17
    70 0 32 38 6 257 0 123 134 19
    13 0 13 0 0 60 1 57 2 1
    40 0 0 40 0 498 0 53 445 3
    2,204 5 895 1,308 151 27107 24 10013 17070 947
    93.6% 0.2% 40.6% 59.3% 6.4% 96.6% 0.1% 36.9% 63.0% 3.4%

    Total Total
    1 Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
    2 Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
    3 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.
    84 0 8 76 14 1695 5 663 1027 86 1781 6.9%
    73 1 14 58 19 1525 1 812 712 118 1643 6.3%
    110 0 24 86 17 2879 5 1309 1565 139 3018 11.6%
    139 0 31 108 27 3153 2 1247 1904 214 3367 13.0%
    552 1 119 432 35 15667 6 5838 9823 347 16014 61.8%
    15 0 13 2 0 93 0 78 15 2 95 0.4%
    973 2 209 762 112 25012 19 9947 15046 906 25918 100.0%
    89.7% 0.2% 21.5% 78.3% 10.3% 96.5% 0.1% 39.8% 60.2% 3.5%

    Antiviral Resistance

    During the 2014-2015 influenza season, the NML has tested 425 influenza viruses for resistance to oseltamivir and 424 influenza viruses for resistance to zanamivir and all were sensitive to both agents. A total of 692 (99.8%) influenza viruses were resistant to amantadine (Table 3).
    * NA - not applicable
    352 0 351 0 691 690 (99.9%)
    2 0 2 0 2 2 (100%)
    71 0 71 0 NA * NA *
    425 0 424 0 693 692
    Influenza Strain Characterizations

    During the 2014-2015 influenza season, the National Microbiology Laboratory (NML) has characterized 151 influenza viruses [75 A(H3N2), 2 A(H1N1) and 74 influenza B]. Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assay (n=75), one virus was antigenically similar to A/Texas/50/2012, five showed reduced titers to A/Texas/50/2012 and 69 were antigenically similar to A/Switzerland/9715293/2013, which is the influenza A(H3N2) component recommended for the 2015 Southern Hemisphere influenza vaccine. Additionally, 538 A(H3N2) viruses were unable to be tested by HI assay; however, sequence analysis showed that 536 belonged to a genetic group that typically shows reduced titers to A/Texas/50/2012. Influenza A(H1N1): Two A(H1N1) viruses characterized were antigenically similar to A/California/7/2009. Influenza B: Of the 74 influenza B viruses characterized, 67 viruses were antigenically similar to B/Massachusetts/2/2012, three viruses showed reduced titers against B/Massachusetts/2/2012, and four were B/Brisbane/60/2008-like (Figure 4).
    Figure 4. Influenza strain characterizations, Canada, 2014-2015, N = 151

    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 2014-2015 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A/Texas/50/2012 (H3N2)-like virus, and a B/Massachusetts/2/2012-like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus is recommended.


    Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
    Influenza-like Illness (ILI) Consultation Rate

    The national influenza-like-illness (ILI) consultation remained relatively the same as the previous week at 66.8 consultations per 1,000, which is above expected levels (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, 2014-2015
    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. 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
    Influenza Outbreak Surveillance

    In week 04, 93 new outbreaks of influenza were reported, up from the number of outbreaks reported in the previous week. Sixty-four outbreaks were reported in long-term care facilities (LTCF), 13 in hospitals and 16 in institutional or community settings (Figure 6). An additional 17 outbreaks of ILI were reported in schools. Among the outbreaks in which the influenza subtype was known, eight LTCF outbreaks and one institutional or community setting outbreak were associated with A(H3N2). To date this season, 859 outbreaks in LTCFs have been reported and the majority of those with known subtypes were attributable to A(H3N2). There has been a higher number of reported influenza outbreaks to date this season compared to the same period in previous seasons.
    Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2014-2015
    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

    During week 04, the proportion of prescriptions for antivirals decreased to 395.7 antiviral prescriptions per 100,000 total prescriptions (down from 512.3 per 100,000). The rate for antivirals since week 48 has been higher than the previous three seasons (Figure 7). The rate in all age groups decreased in week 04. The antiviral prescription rate remains the highest amongst seniors at 650.0 per 100,000 total prescriptions.
    Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2014-15
    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
    Sentinel Hospital Influenza Surveillance

    Paediatric Influenza Hospitalizations and Deaths (IMPACT)
    In week 04, 23 laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network: 22 cases of influenza A and one case of influenza B (Figure 8a). Among the reported cases, 5 (22%) were <2 years of age, 13 (56%) were 2 to 9 years of age and five (22%) were 10-16 years of age. Two cases were admitted to the ICU. To date this season, 467 hospitalizations have been reported by the IMPACT network, 441 (94%) of which were cases of influenza A. Among cases for which the influenza A subtype was reported, 99% (139/141) were A(H3N2) (Table 4). To date, 53 cases were admitted to the ICU, of which 33 (60%) were 2 to 9 years of age (Figure 9a). Three deaths have been reported.
    Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
    Adult Influenza Hospitalizations and Deaths (PCIRN)
    In week 04, 78 laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network. Among the cases in week 04, 63 cases (81%) were in adults over the age of 65 and 74 cases (95%) had influenza A (Figure 8b). To date this season, 1,411 cases have been reported; 1,392 (99%) with influenza A. The majority of cases (83%) were among adults ≥65 years of age (Table 5). One hundred ICU admissions have been reported and 76 cases were adults ≥65 years of age. A total of 79 ICU cases reported to have at least one underlying condition or comorbidity. Of the 74 ICU cases with known immunization status, 24 (32%) reported not having been vaccinated this season. Sixty-four deaths have been reported, 57 (89%) of the deaths were adults >65 years of age (Figure 9b).
    Note: The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
    Total # (%)
    1 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.
    68 0 14 54 2 70 (15.0%)
    96 1 30 65 11 107 (22.9%)
    106 1 35 70 4 110 (23.6%)
    113 0 39 74 6 119 (25.5%)
    58 0 21 37 3 61 (13.1%)
    441 2 139 300 26 467
    94.4% 0.5% 31.5% 68.0% 5.6% 100.0%
    Total # (%)
    1 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.
    3 0 0 3 0 3(%)
    80 1 27 52 1 81(6%)
    150 0 63 87 2 152(11%)
    1159 2 380 777 16 1175(83%)
    1392 3 470 919 19 1411
    99% 0% 34% 66% 1% 100%
    Figure 8 - Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15
    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, 2014-15
    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)
    Provincial/Territorial Influenza Hospitalizations and Deaths

    In week 04, 345 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories*; all but six with influenza A, and 75% were patients ≥65 years of age. Since the start of the 2014-15 season, 4,079 hospitalizations have been reported; 4,001 (98%) with influenza A. Among cases for which the subtype of influenza A was reported, 99.7% (1930/1935) were A(H3N2). The majority of cases (71%) were ≥65 years of age (Table 6). A total of 120 ICU admissions have been reported in adults ≥65 years of age with influenza A and 63 ICU admissions have been reported in adults 20-64 years. A total of 275 deaths have been reported since the start of the season: three children <5 years of age, two children 5-19 years, 19 adults 20-64 years, and 251 adults ≥65 years of age. Adults 65 years of age or older represent 91% of all deaths reported this season. 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. 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. 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.
    Total # (%)
    1 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.
    285 2 110 173 4 289 (7%)
    190 0 98 92 5 195 (5%)
    200 1 109 90 7 207 (5%)
    419 2 209 208 13 432 (11%)
    2855 0 1354 1501 45 2900 (71%)
    52 0 50 2 4 56 (1%)
    4001 5 1930 2066 78 4079
    98.1% 0.1% 48.2% 51.6% 1.9% 100.0%
    See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2014-15 on the Public Health Agency of Canada website.
    Emerging Respiratory Pathogens

    Human Avian Influenza
    Influenza A(H7N9): On January 26, 2015, the first imported human case of avian influenza A (H7N9) from China was confirmed in Canada. A second case was confirmed on January 29, 2015. They traveled together to China and recently returned to Canada. All evidence regarding the Canadian cases indicates they were likely infected following exposure in China. They were not symptomatic during travel and only became ill after arrival in Canada. These are the first documented cases of H7N9 infection in humans in North America. The risk to Canadians of getting sick with H7N9 remains very low as evidence suggests that it does not transmit easily from person-to-person.

    Since the last FluWatch report, one new laboratory-confirmed case of human infection with avian influenza A(H7N9) virus was reported by the World Health Organization. Globally to February, 3 2015, the WHO reported a total of 486 laboratory-confirmed human cases with avian influenza A(H7N9) virus, including 185 deaths.
    Documents related to the public health risk of influenza A(H7N9), as well as guidance for health professionals and advice for the public is updated regularly on the following websites:
    PHAC - Avian influenza A(H7N9)
    WHO - Avian Influenza A(H7N9)

    Influenza A(H5N6): Since the last FluWatch report, no new cases of human infection with avian influenza A (H5N6) virus from China has been reported by the World Health Organization. Globally to February 3, 2015, the WHO has been informed of a total of two cases of avian influenza A (H5N6) virus, including one death.

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

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  • Pathfinder
    replied
    FluWatch report: January 18 to January 24, 2015 (Week 3)

    Posted 2015-01-30 For readers interested in the PDF version, the document is available for downloading or viewing:
    FluWatch report: January 18 to January 24, 2015 (Week 3) (PDF Version - 385KB - 10 pages)

    ?? Help with PDF documents

    Overall Summary
    • In week 3, all influenza indicators declined from the previous week, indicating that peak of the influenza season in Canada may have passed.
    • A(H3N2) continues to be the most common type of influenza affecting Canadians. In both laboratory detections, hospitalizations and deaths, the majority of cases have been among seniors ≥65 years of age.
    • On January 26, 2015, the first imported human case of avian influenza A (H7N9) from China was confirmed in Canada. A second case was confirmed on January 29, 2015. They are the first North Americans known to have been infected with this virus. The individuals were from British Columbia and travelled together to China. Neither required hospitalization and both have recovered. Close contacts are being monitored by appropriate public health authorities. The risk of Canadians getting sick with avian influenza A (H7N9) is very low.
    • A Canadian study has examined the mid-season data on the current flu vaccine?s effectiveness in Canada. The study observed little to no vaccine protection against the A(H3N2) virus, this season?s most common influenza virus. The results of this study are not unexpected. As flu viruses move through the population, they can change or drift. The time it takes from the start to the finish of a vaccine production, is sometimes sufficient time for the virus to change, which is what happened this year in particular with H3N2. Evidence from the NML, however, still suggests that the vaccine continues to provide protection against the circulating A(H1N1) and B strains.

    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 atFluWatch@phac-aspc.gc.ca
    Influenza/ILI Activity (geographic spread)

    In week 03, 15 regions reported widespread activity: in BC(2), ON(5), QC(4), NF(3) and PEI. Twenty-five regions reported localized activity: in BC(3), AB(5), MB(5), ON(2), QC(2), NB(6), NS(6) and NL and seven regions reported sporadic activity: in NWT, YK, SK(3), NB and NF. NU did not report data for week 03.
    Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 3



    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 tests decreased from 3,829 in week 02 to 2,928 in week 03. The percentage of positive influenza tests also decreased slightly from 28.3% to 27.4% (Figure 2). To date, 97% of influenza detections have been influenza A, and 99.8% of those subtyped have been A(H3N2)(Table 1). To date this season, detailed information on age and type/subtype has been received for 24,071 cases. A significantly greater proportion of laboratory detections of influenza have been reported in adults ≥65 years of age (63%) this season compared to the 2013-14 season when only 15.4% of cases were in 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, 2014-15
    Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
    In week 03, the number of positive respiratory syncytial virus (RSV) tests decreased to 894 RSV detections and remains the second most frequently detected virus after influenza. Detections of RSV since week 38 have been higher than in the previous season. Detections of other respiratory viruses have been declining and have generally been lower this season compared to the previous season (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, 2014-15
    RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
    Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
    B Total
    1 Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
    2 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.
    514 3 369 142 12 2386 5 1815 566 58
    124 1 94 29 32 3340 2 3194 144 224
    41 0 0 41 0 1028 0 0 1028 9
    129 0 25 104 2 957 0 351 606 19
    1092 2 609 481 7 6814 8 3067 3739 82
    617 0 0 617 53 9243 3 422 8818 370
    145 0 20 125 5 277 0 25 252 8
    52 0 36 16 0 187 0 91 96 13
    10 0 10 0 0 47 1 44 2 1
    64 0 0 64 1 458 0 53 405 3
    2788 6 1163 1,619 112 24737 19 9062 15656 787
    96.1% 0.2% 41.7% 58.1% 3.9% 96.9% 0.1% 36.6% 63.3% 3.1%

    Total Total
    1 Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
    2 Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
    3 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.
    104 0 26 78 4 1560 5 634 921 71 1631 6.8%
    85 0 25 60 12 1379 0 756 623 92 1471 6.1%
    162 2 60 100 12 2652 4 1187 1461 117 2769 11.5%
    225 1 93 131 34 2891 4 1121 1766 179 3070 12.8%
    1155 0 497 658 35 14763 5 5367 9391 302 15065 62.6%
    18 0 16 2 0 63 0 49 14 2 65 0.3%
    1749 3 717 1029 97 23308 18 9114 14176 763 24071 100.0%
    94.7% 0.2% 41.0% 58.8% 5.3% 96.8% 0.1% 39.1% 60.8% 3.2%

    Antiviral Resistance

    During the 2014-2015 influenza season, the NML has tested 317 influenza viruses for resistance to oseltamivir and 313 influenza viruses for resistance to zanamivir and all were sensitive to both agents. A total of 605 (99.8%) of influenza A viruses were resistant to amantadine (Table 3).
    * NA - not applicable
    274 0 270 0 604 603 (99.8%)
    2 0 2 0 2 2 (100%)
    41 0 41 0 NA * NA *
    317 0 313 0 606 605
    Influenza Strain Characterizations

    During the 2014-2015 influenza season, the National Microbiology Laboratory (NML) has characterized 132 influenza viruses [68 A(H3N2), 2 A(H1N1) and 62 influenza B]. The majority of circulating influenza B and A(H1N1) viruses have been antigenically similar (good match) to the recommended strains for the 2014-15 seasonal influenza vaccine, while the majority of A(H3N2) viruses have shown evidence of an antigenic drift (sub-optimal match) from the vaccine strain. Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assay (n=68), one virus was antigenically similar to A/Texas/50/2012, five showed reduced titers to A/Texas/50/2012 and 62 were antigenically similar to A/Switzerland/9715293/2013, which is the influenza A(H3N2) component recommended for the 2015 Southern Hemisphere influenza vaccine. Additionally, 474 A(H3N2) viruses were unable to be tested by HI assay; however, sequence analysis showed that 472 belonged to a genetic group that typically shows reduced titers to A/Texas/50/2012.
    Influenza A(H1N1): Two A(H1N1) viruses characterized were antigenically similar to A/California/7/2009.
    Influenza B: Of the 62 influenza B viruses characterized, 56 viruses were antigenically similar to B/Massachusetts/2/2012, three viruses showed reduced titers against B/Massachusetts/2/2012, and three were B/Brisbane/60/2008-like (Figure 4).

    Figure 4. Influenza strain characterizations, Canada, 2014-2015, N = 132

    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 2014-2015 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A/Texas/50/2012 (H3N2)-like virus, and a B/Massachusetts/2/2012-like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus is recommended.


    Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
    Influenza-like Illness (ILI) Consultation Rate

    The national influenza-like-illness (ILI) consultation increased in week 03 to 45.3 consultations per 1,000, which is slightly above expected levels (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, 2014-2015
    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. 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
    Influenza Outbreak Surveillance

    In week 03, 72 new outbreaks of influenza were reported, nearly half the number of outbreaks reported in the previous week. Fifty-four outbreaks were reported in long-term care facilities (LTCF), six in hospitals and 12 in institutional or community settings (Figure 6). Among the outbreaks in which the influenza subtype was known, seven LTCF outbreaks and one institutional or community setting outbreak were associated with A(H3N2), and four LTCF outbreaks associated with influenza B. To date this season, 795 outbreaks in LTCFs have been reported and the majority of those with known subtypes were attributable to A(H3N2). There has been a higher number of reported influenza outbreaks to date this season compared to the same period in previous seasons.
    Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2014-2015
    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

    During week 03, the proportion of prescriptions for antivirals decreased to 511.3 antiviral prescriptions per 100,000 total prescriptions (down from 806.1 per 100,000). The rate for antivirals since week 48 has been higher than the previous three seasons (Figure 7). The rate in age groups except in infants decreased in week 03. The antiviral prescription rate remains the highest amongst seniors at 859.9 per 100,000 total prescriptions.
    Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2014-15
    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
    Sentinel Hospital Influenza Surveillance

    Paediatric Influenza Hospitalizations and Deaths (IMPACT)
    In week 03, 29 laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network: 28 cases of influenza A and one case of influenza B (Figure 8a). Among the reported cases, 12 (41%) were <2 years of age, 15 (52%) were 2 to 9 years of age and two (7%) were 10-16 years of age. Three cases were admitted to the ICU. To date this season, 446 hospitalizations have been reported by the IMPACT network, 421 (94%) of which were cases of influenza A. Among cases for which the influenza A subtype was reported, 99% (137/139) were A(H3N2) (Table 4). To date, 50 cases were admitted to the ICU, of which 32 (64%) were 2 to 9 years of age (Figure 9a). Two deaths have been reported.
    Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
    Adult Influenza Hospitalizations and Deaths (PCIRN)
    In week 03, 98 laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network. Among cases in week 03, 81 cases (83%) were in adults over the age of 65 and 94 cases (96%) had influenza A (Figure 8b). To date this season, 1259 cases have been reported; 1244 (99%) with influenza A. The majority of cases (84%) were among adults ≥65 years of age (Table 5). Eighty-eight ICU admissions have been reported and the majority of cases (80%) were adults ≥65 years of age, most (83%) with known underlying conditions or comorbidities. Fifty-four deaths have been reported, all but three were adults >65 years of age (Figure 9b).
    Note: The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
    Total # (%)
    1 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.
    68 0 13 55 2 70 (15.7%)
    92 1 28 63 10 102 (22.9%)
    101 1 35 65 4 105 (23.5%)
    105 0 38 67 6 111 (24.9%)
    55 0 23 32 3 58 (13.0%)
    421 2 137 282 25 446
    94.4% 0.5% 32.5% 67.0% 5.6% 100.0%
    Total # (%)
    1 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.
    3 0 0 3 0 3 (%)
    71 0 22 49 1 72 (6%)
    129 0 47 82 2 131 (10%)
    1041 2 318 721 12 1053 (84%)
    1244 2 387 855 15 1259
    99% 0% 31% 69% 1% 100%

    Figure 8 - Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15
    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, 2014-15
    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)
    Provincial/Territorial Influenza Hospitalizations and Deaths

    In week 03, 357 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories*; all but one with influenza A, and 74% were patients ≥65 years of age. Since the start of the 2014-15 season, 3,589 hospitalizations have been reported; 3,523 (98%) with influenza A. Among cases for which the subtype of influenza A was reported, 99.7% (1720/1725) were A(H3N2). The majority of cases (71%) were ≥65 years of age (Table 6). A total of 104 ICU admissions have been reported in adults ≥65 years of age with influenza A and 52 ICU admissions have been reported in adults 20-64 years. A total of 236 deaths have been reported since the start of the season: one child <5 years of age, two children 5-19 years, sixteen adults 20-64 years, and 217 adults ≥65 years of age. Adults 65 years of age or older represent 92% of all deaths reported this season. 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. 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. 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.
    Total # (%)
    1 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.
    258 2 103 153 3 261 (7%)
    171 0 95 76 5 176 (5%)
    186 1 104 81 6 192 (5%)
    366 2 182 182 8 374 (10%)
    2493 0 1189 1304 40 2533 (71%)
    49 0 47 2 4 53 (1%)
    3523 5 1720 1798 66 3589
    98.2% 0.1% 48.8% 51.0% 1.8% 100.0%
    See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2014-15 on the Public Health Agency of Canada website.
    Emerging Respiratory Pathogens

    Human Avian Influenza
    Influenza A(H7N9): On January 26, 2015, the first imported human case of avian influenza A (H7N9) from China was confirmed in Canada. A second case was confirmed on January 29, 2015. They traveled together to China and recently returned to Canada. All evidence regarding the Canadian cases indicates they were likely infected following exposure in China. They were not symptomatic during travel and only became ill after arrival in Canada. These are the first documented cases of H7N9 infection in humans in North America. The risk to Canadians of getting sick with H7N9 remains very low as evidence suggests that it does not transmit easily from person-to-person.

    Since the last FluWatch report, one new laboratory-confirmed case of human infection with avian influenza A(H7N9) virus was reported by the World Health Organization (not including the Canadian cases). The case was a 79 year-old male with a history of exposure to live poultry. The case has been in stable condition all along. Globally to January 30, 2015, the WHO reported a total of 486 laboratory-confirmed human cases with avian influenza A(H7N9) virus, including 185 deaths.
    Documents related to the public health risk of influenza A(H7N9), as well as guidance for health professionals and advice for the public is updated regularly on the following websites:
    PHAC - Avian influenza A(H7N9)
    WHO - Avian Influenza A(H7N9)

    Influenza A(H5N6): Since the last FluWatch report, no new cases of human infection with avian influenza A (H5N6) virus from China has been reported by the World Health Organization. Globally to January 16, 2015, the WHO has been informed of a total of two cases of avian influenza A (H5N6) virus, including one death.
    Middle East Respiratory Syndrome Coronavirus (MERS-CoV)
    Since the last FluWatch report, 6 new laboratory-confirmed cases of MERS-CoV have been reported by the World Health Organization from Saudi Arabia (5) and Oman (1). Globally, from September 2012 to January 30, 2015, the WHO has been informed of a total of 956 laboratory-confirmed cases of infection with MERS-CoV, including 351 deaths. All cases have either occurred in the Middle East or have had direct links to a primary case infected in the Middle East. The public health risk posed by MERS-CoV in Canada remains low (see the PHAC Assessment of Public Health Risk).

    Documents related to the public health risk of MERS-CoV, as well as guidance for health professionals and advice for the public is updated regularly on the following websites:
    PHAC - Middle East respiratory syndrome coronavirus (MERS-CoV)
    WHO - Coronavirus infections

    Avian Influenza A(H5)
    The Canadian Food Inspection Agency (CFIA) is continuing its investigation into an outbreak of highly pathogenic avian influenza H5N2 virus in British Columbia's Fraser Valley. No new sites have been identified since December 19, 2014. Further information on the outbreak is provided on the following CFIA website.

    CFIA - Notifiable Avian Influenza
    Enterovirus D68 (EV-D68)
    Information related to enterovirus D68, as well as guidance for health professionals and advice for the public is updated regularly on the following website:

    PHAC ? Non-polio enterovirus

    .../

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

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    FluWatch report: January 11 to January 17, 2015 (Week 2)

    Posted 2015-01-23 For readers interested in the PDF version, the document is available for downloading or viewing:
    FluWatch report: January 11 to January 17, 2015 (Week 2) (PDF Version - 385KB - 10 pages)

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    Overall Summary
    • In week 2, influenza activity levels decreased slightly from the previous week with fewer regions reporting widespread activity. Many regions continue to report localized and sporadic influenza activity.
    • Several indicators (number of laboratory detections, outbreaks and hospitalizations, and the ILI consultation rate) declined from the previous week, indicating that peak of the influenza season in Canada may have passed.
    • RSV is the second most frequently detected virus after influenza and since week 38 detections of RSV have been higher than in the previous season.
    • A(H3N2) continues to be the most common type of influenza affecting Canadians. In both laboratory detections, hospitalizations and deaths, the majority of cases have been among seniors ≥65 years of age.
    • To date, the NML has found that the majority of A(H3N2) influenza specimens are not optimally matched to the vaccine strain. This may result in reduced vaccine effectiveness against the A(H3N2) virus. However, the vaccine can still provide some protection against A(H3N2) influenza illness and can offer protection against other influenza strains such as A(H1N1) and B. Data from the NML suggests that the circulating A(H1N1) and B strains are a good match for this year?s vaccine and will continue to provide protection for the rest of the flu season.

    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 02, 17 regions reported widespread activity: in BC(3), AB(1), MB(2), ON(6), QC(3) and NF(2). Twenty four regions reported localized activity: in BC (1), AB (4) SK (2), MB(3), ON (1),QC(3), NB(6), and NS(4), seven regions reported sporadic activity: in YT (1), BC(1), SK(1), NB(1), PE(1) and NF(2). One province reported no activity in 5 regions (NS) and no data were received from NT and NU.
    Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 2



    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 tests decreased from 4,579 in week 01 to 3,761 in week 02; however the percentage of positive influenza tests increased slightly from 26.4% to 29.5% (Figure 2). This may be an indication that we have reached the peak in laboratory detections with the percent positive for influenza peaking in week 52 (35.9%) and the number of positive influenza tests peaking in week 53. To date, 97% of influenza detections have been influenza A, and 99.8% of those subtyped have been A(H3) (Table 1). The timing of the season and predominant A(H3N2) subtype is similar to the pattern observed during the 2012-13 influenza season when percent positive for influenza peaked in week 52 (35%). To date, among the cases of influenza with reported age, the largest proportion was in adults ≥65 years of age (63%) (Table 2).
    Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2014-15
    Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
    In week 02, the number of positive RSV tests decreased to 875 RSV detections from 1047 RSV detections in week 01. RSV remains the second most frequently detected virus after influenza. Detections of RSV since week 38 have been higher than in the previous season while detections of parainfluenza and adenovirus continue to follow their seasonal patterns of broad winter 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, 2014-15
    RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
    Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
    B Total
    1 Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
    2 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.
    961 0 720 241 7 1872 2 1446 424 46
    213 0 170 43 48 3211 1 3065 145 190
    89 0 0 89 4 987 0 0 987 9
    210 0 34 176 5 1105 0 326 779 24
    1,100 0 491 609 16 5722 5 2421 3296 75
    838 0 0 838 74 8626 3 422 8201 317
    62 0 0 62 1 132 0 5 127 3
    63 0 26 37 4 135 0 55 80 13
    14 0 14 0 0 37 1 34 2 1
    52 0 0 52 0 394 0 53 341 2
    3602 0 1455 2147 159 22221 12 7827 14382 680
    95.8% 0.0% 40.4% 59.6% 4.2% 97.0% 0.1% 35.2% 64.7% 3.0%

    Total Total
    1 Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
    2 Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
    3 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.
    124 0 16 108 6 1399 4 577 818 65 1464 6.7%
    85 0 12 73 13 1228 0 673 555 77 1305 6.0%
    178 0 31 147 19 2423 1 1033 1389 100 2523 11.6%
    204 0 33 171 36 2591 1 954 1636 141 2732 12.6%
    1223 0 233 990 59 13388 4 4550 8834 260 13648 62.8%
    3 0 1 2 1 44 0 31 13 2 46 0.2%
    1,817 0 326 1,491 134 21073 10 7818 13245 645 21718 100.0%
    99.9% 0.0% 17.9% 82.1% 6.9% 97.0% 0.0% 37.1% 62.9% 3.0%

    Antiviral Resistance

    During the 2014-2015 influenza season, NML has tested 280 influenza viruses for resistance to oseltamivir and 278 influenza viruses for resistance to zanamivir and all were sensitive to both agents. A total of 512 (99.8%) of influenza A viruses tested for amantadine resistance were resistant (Table 3).
    * NA - not applicable
    237 0 235 0 511 510 (99.8%)
    2 0 2 0 2 2 (100%)
    41 0 41 0 NA * NA *
    280 0 278 0 513 512
    Influenza Strain Characterizations

    During the 2014-2015 influenza season, the National Microbiology Laboratory (NML) has characterized 106 influenza viruses [62 A(H3N2), 2 A(H1N1) and 42 influenza B]. The majority of circulating influenza B and A(H1N1) viruses have been antigenically similar (good match) to the recommended strains for the 2014-15 seasonal influenza vaccine, while the majority of A(H3N2) viruses have shown evidence of an antigenic drift (sub-optimal match) from the vaccine strain. Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assay (n=62), one virus was antigenically similar to A/Texas/50/2012, five showed reduced titers to A/Texas/50/2012 and 56 were antigenically similar to A/Switzerland/9715293/2013, which is the influenza A(H3N2) component recommended for the 2015 Southern Hemisphere influenza vaccine. Additionally, 395 A(H3N2) viruses were unable to be tested by HI assay; however, sequence analysis showed that 393 belonged to a genetic group that typically shows reduced titers to A/Texas/50/2012. Influenza A(H1N1): Two A(H1N1) viruses characterized were antigenically similar to A/California/7/2009. Influenza B: Of the 42 influenza B viruses characterized, 38 viruses were antigenically similar to B/Massachusetts/2/2012, three viruses showed reduced titers to B/Massachusetts/2/2012 and one was B/Brisbane/60/2008-like (Figure 4).
    Figure 4. Influenza strain characterizations, Canada, 2014-2015, N = 106

    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 2014-2015 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A/Texas/50/2012 (H3N2)-like virus, and a B/Massachusetts/2/2012-like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus is recommended.


    Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
    Influenza-like Illness (ILI) Consultation Rate

    The national influenza-like-illness (ILI) consultation rate decreased in week 02 to 37.7 ILI consultations per 1,000 patient visits, which is within expected levels for week 02 (Figure 5). The rates were highest among the 20 to 64 and <5 year age group (55.9 and 50.0 ILI consultations per 1,000).
    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, 2014-2015
    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. 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
    Influenza Outbreak Surveillance

    In week 02, 145 new outbreaks of influenza were reported (118 in long-term care facilities (LTCF), eight in hospitals and 19 in institutional or community settings) and is fewer than the number of outbreaks reported in week 01 (Figure 6). Among the outbreaks in which the influenza subtype was known, three LTCF outbreaks were associated with A(H3N2). To date this season, 741 outbreaks in LTCFs have been reported. The number of outbreaks reported since week 47 is above those of previous seasons and is similar to the numbers reported during the 2012-13 influenza season when influenza A(H3N2) also predominated.
    Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2014-2015
    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

    During week 02, the proportion of prescription sales for antivirals decreased to 799.8 antiviral prescriptions per 100,000 total prescriptions (down from 870.2 per 100,000 total prescriptions). The antiviral prescription rate increased in infants in week 2. The rate for antivirals since week 48 has been higher than the previous three seasons (Figure 7). The antiviral prescription rate remains the highest amongst seniors at 1,405.1 per 100,000 total prescriptions.
    Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2014-15
    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
    Sentinel Hospital Influenza Surveillance

    Paediatric Influenza Hospitalizations and Deaths (IMPACT)
    In week 02, 42 laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network: 40 cases of influenza A and two cases of influenza B (Figure 8a). Among the reported cases, 20 (48%) were <2 years of age, 13 (31%) were 2 to 9 years of age and 9 (21%) were 10-16 years of age. Four cases were admitted to the ICU. To date this season, 408 hospitalizations have been reported by the IMPACT network, 384 (94%) of which were cases of influenza A. Among cases for which the influenza A subtype was reported, 98% (132/134) were A(H3N2). Children <5 years of age represented 62% of cases (Table 4). To date, 46 cases were admitted to the ICU, of which 30 (65%) were 2 to 9 years of age (Figure 9a).
    Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
    Adult Influenza Hospitalizations and Deaths (PCIRN)
    In week 02, 121 laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 211 in week 01. Among the 121 cases in week 02, 102 (84%) were in adults over the age of 65 and all cases (100%) had influenza A (Figure 8b). To date this season, 884 cases have been reported; 875 (99%) with influenza A. The majority of cases (84%) were among adults ≥65 years of age (Table 5). To date, 118 ICU admissions have been reported and the majority of cases (79.7%) were adults ≥65 years of age, most (74%) with known underlying conditions or comorbidities. Seventy-three deaths have been reported, all but six were adults >65 years of age (Figure 9b).
    Note: The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
    Total # (%)
    1 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.
    60 0 13 47 2 62 (15.2%)
    81 1 26 54 10 91 (22.3%)
    94 1 34 59 4 98 (24.0%)
    94 0 36 58 5 99 (24.3%)
    55 0 23 32 3 58 (14.2%)
    384 2 132 250 24 408
    94.1% 0.5% 34.4% 65.1% 5.9% 100.0%
    Total # (%)
    1 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.
    3 0 0 3 0 3(%)
    50 0 15 35 1 51(6%)
    85 0 29 56 2 87(10%)
    737 1 196 540 6 743(84%)
    875 1 240 634 9 884
    99% 0% 27% 72% 1% 100%
    Figure 8 - Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15
    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, 2014-15
    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)
    Provincial/Territorial Influenza Hospitalizations and Deaths

    In week 02, 461 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories*; all but five with influenza A, and 77% were reported in adults ≥65 years of age. Since the start of the 2014-15 season, 3127 hospitalizations have been reported; 3072 (98%) with influenza A. Among cases for which the subtype of influenza A was reported, 99.7% (1483/1487) were A(H3N2). The majority of hospitalizations (70%) were reported in adults ≥65 years of age (Table 6). A total of 168 ICU admissions have been reported to date, including 94 ICU admissions in adults ≥65 years of age. A total of 179 deaths have been reported since the start of the season: one child <5 years of age, two children 5-19 years, ten adults 20-64 years, and 166 adults ≥65 years of age. Adults 65 years of age or older represent 93% of all deaths reported this season. 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. 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. 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.
    Total # (%)
    1 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.
    235 1 99 135 3 238 (8%)
    147 0 89 58 4 151 (5%)
    168 1 96 71 5 173 (6%)
    317 2 158 157 7 324 (10%)
    2164 0 1001 1163 33 2197 (70%)
    41 0 40 1 3 44 (1%)
    3072 4 1483 1585 55 3127
    98.2% 0.1% 48.3% 51.6% 1.8% 100.0%
    See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2014-15 on the Public Health Agency of Canada website.


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    FluWatch report: January 4 to January 10, 2015 (Week 1)

    Posted 2015-01-16 For readers interested in the PDF version, the document is available for downloading or viewing:
    FluWatch report: January 4 to January 10, 2015 (Week 1) (PDF Version - 385 KB- 10 pages)

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    Overall Summary
    • In week 1, seven of the thirteen provinces and territories reported widespread activity within their jurisdictions- the highest levels reported to date.
    • Similar to the previous week, there were a large number of newly-reported laboratory-confirmed outbreaks of influenza: 195 outbreaks in 9 provinces, of which 152 were in long-term care facilities (LTCF). This is record number of LTCF outbreaks reported over the last five influenza seasons.
    • The percent positive for laboratory detections of influenza decreased in week 01 in Canada - suggesting that the seasonal influenza has peaked.
    • Overall in week 01, many indicators such as laboratory detections, prescriptions for antiviral medications, paediatric hospitalizations and ILI consultations rate have decreased.
    • To date, the NML has found that the majority of A(H3N2) influenza specimens are not optimally matched to the vaccine strain. This may result in reduced vaccine effectiveness against the A(H3N2) virus. However, the vaccine can still provide some protection against A(H3N2) influenza illness and can offer protection against other influenza strains such as A(H1N1) and B

    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 01, 22 regions reported widespread activity: in BC(3), AB(5), SK, MB(2), ON(5), QC(3), NF(3). The same five regions in Alberta have reported widespread activity for the past 3 weeks. Thirteen regions reported localized activity: in SK, MB(3), ON, QC(3), NB(4) and PE and eight regions reported sporadic activity: in BC(2), SK, ON, NB(2), NF and NWT.
    Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 1




    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 tests decreased from 5,313 in week 53 to 4,579 in week 01. The percentage of positive influenza tests also decreased from 34.4% to 28.5% (Figure 2). This may be an indication that we have reached the peak in laboratory detections with the percent positive for influenza peaking in week 52 (35%) and the number of positive influenza tests peaking in week 53 (5,313). To date, 98% of influenza detections have been influenza A, and 99.8% of those subtyped have been A(H3) (Table 1). The timing of the season and predominant A(H3N2) subtype is similar to the pattern observed during the 2012-13 influenza season when percent positive for influenza peaked in week 52 (35%). To date, among the cases of influenza with reported age, the largest proportion was in adults ≥65 years of age (63%) (Table 2).
    Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2014-15
    Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
    In week 01, the number of positive RSV tests increased to 1,001 RSV detections up from 979 RSV detections in week 53. RSV remains the second most frequently detected virus after influenza. Detections of RSV since week 38 have been higher than in the previous season while detections of parainfluenza and adenovirus continue to follow their seasonal patterns of broad winter 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, 2014-15

    RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
    Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
    B Total
    1 Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
    2 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.
    807 0 264 543 12 1699 2 726 971 39
    394 0 257 137 32 3517 2 3279 236 152
    104 0 0 104 0 898 0 0 898 5
    267 0 41 226 7 617 0 186 431 12
    1216 0 305 911 11 4622 5 1906 2711 59
    1332 0 0 1332 66 8301 3 422 7876 245
    37 0 0 37 0 70 0 5 65 2
    25 0 12 13 2 72 0 29 43 9
    8 0 8 0 0 23 1 20 2 1
    130 0 0 130 0 342 0 53 289 2
    4320 0 887 3433 130 20161 13 6626 13522 526
    97.1% 0.0% 20.5% 79.5% 2.9% 97.5% 0.1% 32.9% 67.1% 2.5%
    Total Total
    1 Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
    2 Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
    3 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.
    126 0 17 109 10 1210 4 520 686 55 1265 6.8%
    81 0 13 68 8 1085 0 622 463 62 1147 6.1%
    256 0 35 221 15 2127 1 870 1256 77 2204 11.8%
    325 0 36 289 28 2229 1 759 1469 99 2328 12.5%
    1800 0 240 1560 43 11525 4 3561 7960 194 11719 62.7%
    3 0 1 2 1 30 0 18 12 1 31 0.2%
    2591 0 342 2249 105 18206 10 6350 11846 488 18694 100.0%
    96.1% 0.0% 13.2% 86.8% 3.9% 97.4% 0.1% 34.9% 65.1% 2.6%

    Antiviral Resistance

    During the 2014-2015 influenza season, NML has tested 235 influenza viruses for resistance to oseltamivir and 233influenza viruses for resistance to zanamivir and all were sensitive to both agents. A total of 339 (99.7%) of influenza A viruses tested for amantadine resistance were resistant (Table 3).
    * NA - not applicable
    206 0 204 0 338 337 (99.7%)
    2 0 2 0 2 2 (100%)
    27 0 27 0 NA * NA *
    235 0 235 0 340 339
    Influenza Strain Characterizations

    During the 2014-2015 influenza season, the National Microbiology Laboratory (NML) has characterized 89 influenza viruses [55 A(H3N2), 2 A(H1N1) and 32 influenza B]. The majority of circulating influenza B and A(H1N1) viruses have been antigenically similar (good match) to the recommended strains for the 2014-15 seasonal influenza vaccine, while the majority of A(H3N2) viruses have shown evidence of an antigenic drift (sub-optimal match) from the vaccine strain.
    Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assay (n=55), one virus was antigenically similar to A/Texas/50/2012, five showed reduced titers to A/Texas/50/2012 and 49 were antigenically similar to A/Switzerland/9715293/2013, which is the influenza A(H3N2) component recommended for the 2015 Southern Hemisphere influenza vaccine. Additionally, 250 A(H3N2) viruses were unable to be tested by HI assay; however, sequence analysis showed that 249 belonged to a genetic group that typically shows reduced titers to A/Texas/50/2012. Influenza A(H1N1): Two A(H1N1) viruses characterized were antigenically similar to A/California/7/2009. Influenza B: Of the 32 influenza B viruses characterized, 29 viruses were antigenically similar to B/Massachusetts/2/2012, and three viruses showed reduced titers (Figure 4).
    Figure 4. Influenza strain characterizations, Canada, 2014-2015, N = 89

    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 2014-2015 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A/Texas/50/2012 (H3N2)-like virus, and a B/Massachusetts/2/2012-like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus is recommended.



    Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
    Influenza-like Illness (ILI) Consultation Rate

    The national influenza-like-illness (ILI) consultation decreased in week 01 to 50.1 consultations per 1,000, which is above expected levels for week 01 (Figure 5). The rates were highest among the 0 to 4 years of age group (269.8 consultations per 1,000) and lowest among the adults ≥65 years of age (12.0 consultations per 1,000).
    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, 2014-2015
    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. 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
    Influenza Outbreak Surveillance

    In week 01, 195 new outbreaks of influenza were reported: 152 in long-term care facilities (LTCF), 12 in hospitals and 31 in institutional or community settings (Figure 6). Among the outbreaks in which the influenza subtype was known, two LTCF outbreaks and four institutional or community setting outbreaks were associated with A(H3N2). To date this season, 623 outbreaks in LTCFs have been reported. The number of outbreaks reported since week 47 is above those of previous seasons and is similar to the numbers reported during the 2012-13 influenza season when influenza A(H3N2) also predominated. The majority of the outbreaks with known subtypes are attributable to A(H3N2).
    Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2014-2015
    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

    During week 01, the proportion of prescriptions for antivirals decreased to 918.5 antiviral prescriptions per 100,000 total prescriptions (down from 969.6 per 100,000 total prescriptions). The rate for antivirals since week 48 has been higher than the previous three seasons (Figure 7). The rate in age groups except children decreased in week 01. The antiviral prescription rate remains the highest amongst seniors at 1,552.8 per 100,000 total prescriptions.
    Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2014-15
    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
    Sentinel Hospital Influenza Surveillance

    Paediatric Influenza Hospitalizations and Deaths (IMPACT)
    In week 01, 44 laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network: 41 cases of influenza A and one case of influenza B(Figure 8a). Among the reported cases, 21 (48%) were <2 years of age, 19 (43%) were 2 to 9 years of age and 4 (9%) were 10-16 years of age. Four cases were admitted to the ICU. To date this season, 358 hospitalizations have been reported by the IMPACT network, 337 (94%) of which were cases of influenza A. Among cases for which the influenza A subtype was reported, 98% (127/129) were A(H3N2). Children <5 years of age represented 61% of cases (Table 4). To date, 38 cases were admitted to the ICU, of which 22 (58%) were 2 to 9 years of age (Figure 9a).
    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 01, 106 laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 137 in week 53. Among cases in week 01, 96 cases (91%) were in adults over the age of 65 and 105 cases (99%) had influenza A (Figure 8b). To date this season, 672 cases have been reported; 664 (99%) with influenza A. The majority of cases (85%) were among adults ≥65 years of age (Table 5). Forty ICU admissions have been reported and the majority of cases (75%) were adults ≥65 years of age, most (69%) with known underlying conditions or comorbidities. Twenty-six deaths have been reported, all but three were adults >65 years of age (Figure 9b).
    Note: The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
    Total # (%)
    1 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.
    42 0 13 29 2 44 (12.3%)
    78 1 25 52 8 86 (24.0%)
    87 1 34 52 4 91 (25.4%)
    85 0 35 50 5 90 (25.1%)
    45 0 20 25 2 47 (13.1%)
    337 2 127 208 21 358
    94.1% 0.6% 37.7% 61.7% 5.9% 100.0%
    Total # (%)
    1 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.
    3 0 0 3 0 3(%)
    38 0 10 28 0 38(6%)
    63 0 21 42 0 63(9%)
    560 2 131 427 8 568(85%)
    664 2 162 500 8 672
    99% 0% 24% 75% 1% 100%
    Figure 8 - Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15
    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, 2014-15
    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)
    Provincial/Territorial Influenza Hospitalizations and Deaths

    In week 01, 566 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories*; all but eight with influenza A, and 79% were patients ≥65 years of age. Since the start of the 2014-15 season, 2161 hospitalizations have been reported; 2121 (98%) with influenza A. Among cases for which the subtype of influenza A was reported, 99.6% (914/917) were A(H3N2). The majority of cases (69%) were ≥65 years of age (Table 6). Sixty two ICU admissions have been reported in adults ≥65 years of age with influenza A and 34 ICU admissions have been reported in adults 20-64 years. A total of 125 deaths have been reported since the start of the season: one child <5 years of age, one child 5-19 years, six adults 20-64 years, and 117 adults ≥65 years of age. Adults 65 years of age or older represent 94% of all deaths reported this season. 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. 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. 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.
    Total # (%)
    1 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.
    175 1 74 100 3 178 (8%)
    115 0 67 48 2 117 (5%)
    117 1 56 60 5 122 (6%)
    226 1 109 116 5 231 (11%)
    1471 0 591 880 24 1495 (69%)
    17 0 17 0 1 18 (1%)
    2121 3 914 1204 40 2161
    97.4% 0.3% 70.3% 29.4% 2.6% 100.0%
    See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2014-15 on the Public Health Agency of Canada website.
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    FluWatch report: December 21, 2014 to January 3, 2015 (Weeks 52-53)

    Posted 2015-01-09 For readers interested in the PDF version, the document is available for downloading or viewing:
    FluWatch report: December 21, 2014 to January 3, 2015 (Weeks 52-53) (PDFVersion - 633 KB - 10 pages)

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    Overall Summary
    • The percent positive for laboratory detections of influenza increased in week 52 but remained stable in week 53; perhaps indicating that we are nearing the peak in laboratory detections for the season. The majority of laboratory detections continued to be reported in AB, ON and QC; but with increasing activity in BC and MB.
    • A(H3N2) continues to be the most common type of influenza affecting Canadians. In both laboratory detections, hospitalizations and deaths, the majority of cases have been among seniors ≥65 years of age.
    • There were a large number of newly-reported laboratory-confirmed outbreaks of influenza over the two-week period (n=309). In week 53, there were 166 influenza outbreaks in 8 provinces, of which 122 were in long-term care facilities (LTCF).
    • To date, the NML has found that the majority of A(H3N2) influenza specimens are not optimally matched to the vaccine strain. This may result in reduced vaccine effectiveness against the A(H3N2) virus. However, the vaccine can still provide some protection against A(H3N2) influenza illness and can offer protection against other influenza strains such as A(H1N1) and B.

    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 52, 12 regions reported widespread activity and increased to 16 regions in week 53: in BC(2), AB(5), MB(1), ON(4), QC(2) and NL(2). The same five regions in Alberta reported widespread activity for both weeks. In week 53, 14 regions reported localized activity (down from 18, the previous week): BC, SK, MB(2), ON(2), QC(3), NB, NS(3) and NL. Fourteen regions reported sporadic activity in week 53 (up from 11 the previous week): BC(2), SK(2), MB(2), ON, QC, NB(3), NS, NT, and YK. No data was reported in NU for weeks 52 and 53 (Figure 1).
    Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 53



    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 tests increased during weeks 52 and 53. In week 53, the number of positive influenza tests increased to 5,550 influenza detections from 3,723 in week 52. The percent positive for influenza A detections rose to 34.6% in week 52 and stayed relatively stable in week 53 at 34.2% (Figure 2). To date, 98% of influenza detections have been influenza A, and 99.8% of those subtyped have been A(H3) (Table 1). The timing of the season and predominant A(H3N2) subtype is similar to the pattern observed during the 2012-13 influenza season when percent positive for influenza peaked in week 52 (35%). To date, among the cases of influenza with reported age, the largest proportion was in adults ≥65 years of age (62%) (Table 2).
    Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2014-15
    Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
    In week 53, the number of positive RSV tests increased to 807 RSV detections up from 764 RSV detections in week 52. RSV remains the second most frequently detected virus after influenza. Detections of RSV since week 38 have been higher than in the previous season while detections of parainfluenza and adenovirus continue to follow their seasonal patterns of broad winter 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, 2014-15
    RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
    Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
    B Total
    1 Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
    2 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.
    336 0 83 253 4 892 2 462 428 27
    546 0 425 121 37 3105 0 2905 200 119
    160 0 147 13 0 600 0 387 213 3
    201 0 21 180 1 350 0 145 205 5
    1368 1 509 858 10 3266 5 1512 1749 47
    2179 3 231 1945 45 6969 3 422 6544 179
    16 0 0 16 0 33 0 5 28 2
    15 0 0 15 4 47 0 17 30 7
    5 0 5 0 0 15 1 12 2 1
    104 0 0 104 1 212 0 53 159 2
    4930 4 1421 3505 102 15489 11 5920 9558 392
    98.0% 0.1% 28.8% 71.1% 2.0% 97.5% 0.1% 38.2% 61.7% 2.5%
    Total Total
    1 Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
    2 Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
    3 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.
    169 0 33 136 3 976 4 468 504 42 1018 6.9%
    72 0 23 49 5 954 0 568 386 51 1005 6.8%
    278 0 57 221 13 1727 0 834 893 55 1782 12.1%
    379 1 77 301 15 1722 1 698 1023 68 1790 12.2%
    2115 2 430 1683 48 8916 4 3034 5878 141 9057 61.7%
    2 0 0 2 0 26 0 15 11 0 26 0.2%
    3015 3 620 2392 84 14321 9 5617 8695 357 14678 100.0%
    97.3% 0.1% 20.6% 79.3% 2.7% 97.6% 0.1% 39.2% 60.7% 2.4%

    Antiviral Resistance

    During the 2014-2015 influenza season, NML has tested 198 influenza viruses for resistance to oseltamivir and 196 influenza viruses for resistance to zanamivir and all were sensitive to both agents. A total of 298 (99.7%) of influenza A viruses tested for amantadine resistance were resistant (Table 3).
    * NA - not applicable
    175 0 173 0 297 296 (99.7%)
    2 0 2 0 2 2 (100%)
    21 0 21 0 NA * NA *
    198 0 196 0 299 298

    Influenza Strain Characterizations

    During the 2014-2015 influenza season, the National Microbiology Laboratory (NML) has characterized 66 influenza viruses [40 A(H3N2), 2 A(H1N1) and 24 influenza B]. The majority of circulating influenza B and A(H1N1) viruses have been antigenically similar (good match) to the recommended strains for the 2014-15 seasonal influenza vaccine, while the majority of A(H3N2) viruses have shown evidence of an antigenic drift (sub-optimal match) from the vaccine strain.
    Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assay (n=40), one virus was antigenically similar to A/Texas/50/2012, five showed reduced titers to A/Texas/50/2012 and 34 were antigenically similar to A/Switzerland/9715293/2013, which is the influenza A(H3N2) component recommended for the 2015 Southern Hemisphere influenza vaccine. Additionally, 120 A(H3N2) viruses were unable to be tested by HI assay; however, sequence analysis showed that 119 belonged to a genetic group that typically shows reduced titers to A/Texas/50/2012.
    Influenza A(H1N1): Two A(H1N1) viruses characterized were antigenically similar to A/California/7/2009.
    Influenza B: Of the 24 influenza B viruses characterized, 21 viruses were antigenically similar to B/Massachusetts/2/2012, and three viruses showed reduced titers (Figure 4).

    Figure 4. Influenza strain characterizations, Canada, 2014-2015, N = 66

    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 2014-2015 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A/Texas/50/2012 (H3N2)-like virus, and a B/Massachusetts/2/2012-like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus is recommended.


    Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
    Influenza-like Illness (ILI) Consultation Rate

    The national influenza-like-illness (ILI) consultation increased in week 52 and 53 to 69.1 consultations per 1,000, which is above expected levels for week 53 (Figure 5). In week 52, the rates were highest among the 20 to 64 years of age group (76.0 consultations per 1,000) and in week 53, the rates were highest among the adults ≥65 years of age (216.3 consultations per 1,000).
    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, 2014-2015
    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. Not all sentinel physicians report every week.
    NOTE: The ILI consultation rate for week 51 should be interpreted with caution due to very low sentinel reporting rates over the holiday season.

    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
    Influenza Outbreak Surveillance

    The number of outbreaks increased during weeks 52 and 53. In week 53, 166 new outbreaks of influenza were reported (up from 143 outbreaks in week 52): 122 in long-term care facilities (LTCF), nine in hospitals and 35 in institutional or community settings. Among the outbreaks in which the influenza subtype was known, three LTCF outbreaks and one institutional or community setting outbreak were associated with A(H3N2). To date this season, 471 outbreaks in LTCFs have been reported. The number of outbreaks reported since week 47 is above those of previous seasons and is similar to the numbers reported during the 2012-13 influenza season when influenza A(H3N2) also predominated (Figure 6).
    Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2014-2015
    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

    Among the outbreaks in which the influenza subtype was known, three LTCF outbreaks and one institutional or community setting outbreak were associated with A(H3N2). To date this season, 471 outbreaks in LTCFs have been reported. The number of outbreaks reported since week 47 is above those of previous seasons and is similar to the numbers reported during the 2012-13 influenza season when influenza A(H3N2) also predominated. (Figure 7). The rate in infants and children decreased from week 52 to week 53 while the rates in adults and seniors increased. The antiviral prescription rate was highest amongst seniors and was 1,798 per 100,000 total prescriptions in week 53.
    Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2014-15
    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
    Sentinel Hospital Influenza Surveillance

    Paediatric Influenza Hospitalizations and Deaths (IMPACT)
    The number of new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations reported by the Immunization Monitoring Program Active (IMPACT) network increased from 55 in week 51 to 67 in week 52 and decreased to 46 in week 53. Among these 113 cases (reported in weeks 52 and 53), 110 (97%) had influenza A (Figure 8a). Forty-one (36%) were <2 years of age, 59 (52%) were 2 to 9 years of age and 13 (12%) were 10-16 years of age. Twelve cases were admitted to the ICU. To date this season, 308 hospitalizations have been reported by the IMPACT network, 291 (95%) of which were cases of influenza A. Among cases for which the influenza A subtype was reported, 98% (121/123) were A(H3N2). Children <5 years of age represented 60% of cases (Table 4). To date, 30 cases were admitted to the ICU, of which 17 (57%) were 2 to 9 years of age (Figure 9a).
    Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
    Adult Influenza Hospitalizations and Deaths (PCIRN)
    The number of new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network increased to 139 in week 52 (from 73 in week 51), and decreased to 92 in week 53. Seventy-five cases (82%) were in adults over the age of 65. Ninety cases (98%) had influenza A (Figure 8b). To date this season, 500 cases have been reported; 493 (99%) with influenza A. The majority of cases (83%) were among adults ≥65 years of age (Table 5). Twenty-one ICU admissions have been reported and the majority of cases (81%) were adults ≥65 years of age with underlying conditions or comorbidities. Sixteen deaths have been reported, all adults >65 years of age (Figure 9b).
    Note: The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
    Total # (%)
    1 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.
    33 0 12 21 2 35 (11.4%)
    64 1 23 40 5 69 (22.4%)
    77 1 34 42 4 81 (26.3%)
    75 0 34 41 4 79 (25.6%)
    42 0 18 24 2 44 (14.3%)
    291 2 121 168 17 308
    94.5% 0.7% 41.6% 57.7% 5.5% 100.0%
    Total # (%)
    1 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.
    2 0 0 2 0 2 (%)
    31 0 10 21 0 31 (6%)
    50 0 12 38 0 50 (10%)
    410 2 67 341 7 417 (83%)
    493 2 89 402 7 500
    99% 0% 18% 82% 1% 100%

    Figure 8 - Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15
    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, 2014-15
    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)
    Provincial/Territorial Influenza Hospitalizations and Deaths

    In week 53, 358 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories*; all but four with influenza A, and 70% were patients ≥65 years of age. Since the start of the 2014-15 season, 1302 hospitalizations have been reported; 1276 (98%) with influenza A. Among cases for which the subtype of influenza A was reported, 99% (660/662) were A(H3N2). The majority of cases (65%) were ≥65 years of age (Table 6). A total of 50 ICU admissions have been reported and the majority (54%) have been in adults ≥65 years of age. A total of 69 deaths have been reported since the start of the season: one child <5 years of age, one adult 20-44 years, three adults 45-64 years and 64 adults ≥65 years of age. 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. 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. 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.
    Total # (%)
    1 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.
    129 1 62 66 3 132 (10%)
    86 0 51 35 2 88 (7%)
    76 1 48 27 4 80 (6%)
    132 0 80 52 2 134 (10%)
    838 0 404 434 14 852 (65%)
    15 0 15 0 1 16 (1%)
    1276 2 660 614 26 1302
    98.0% 0.2% 51.7% 48.1% 2.0% 100.0%
    See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2014-15 on the Public Health Agency of Canada website.

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    FluWatch report: December 14 to December 20, 2014 (Week 51)

    Posted 2015-01-02 For readers interested in the PDF version, the document is available for downloading or viewing:
    FluWatch report: December 14 to December 20, 2014 (Week 51) (PDF Version - 385 KB - 10 pages)

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    Overall Summary
    • In week 51, laboratory detections of influenza increased sharply for the fifth consecutive week. The majority of laboratory detections continued to be reported in AB, ON and QC; but with increasing activity in SK and NL.
    • A(H3N2) continues to be the most common type of influenza affecting Canadians. In both laboratory detections and hospitalizations, the majority of cases have been among seniors ≥65 years of age.
    • Similar to the previous week, there were a large number of newly-reported laboratory-confirmed outbreaks of influenza: 125 influenza outbreaks in 7 provinces, of which 94 were in long-term care facilities (LTCF).
    • The rate of antiviral prescriptions more than doubled from the previous week, increasing especially among seniors.


    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 51, eight regions reported widespread activity [in BC, AB(4), ON, QC(2)], 17 regions reported localized activity [in BC, AB, SK(2), MB(4) ON(5), QC(3), NS], and 12 regions [in NT, YK, BC(3), SK, MB, ON, QC, NB(2), PE] reported sporadic activity.
    Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 51





    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

    In week 51, the number of positive influenza tests increased sharply to 2,833 influenza detections (29.1% of tests), predominantly due to influenza A (Figure 2). To date, 97% of influenza detections have been influenza A, and 99.8% of those subtyped have been A(H3) (Table 1). The timing of the season and predominant A(H3N2) subtype is similar to the pattern observed during the 2012-13 influenza season when percent positive for influenza peaked in week 52 (35%). To date, among the cases of influenza with reported age, the largest proportion was in adults ≥65 years of age (56%) (Table 2).
    Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2014-15

    Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
    In week 51, the number of positive RSV tests increased to 655 RSV detections and was the second most frequently detected virus, after influenza. Detections of parainfluenza and adenovirus also continue to follow their seasonal patterns of broad winter 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, 2014-15


    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
    B Total
    1 Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
    2 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.
    118 0 84 34 3 380 2 302 76 16
    556 0 367 189 16 2006 0 1774 232 68
    124 0 95 29 0 247 0 142 105 3
    44 0 42 2 2 80 0 70 10 4
    591 0 375 216 4 1232 4 862 366 29
    1238 0 0 1238 30 2995 0 0 2995 101
    4 0 1 3 0 10 0 4 6 0
    12 0 10 2 0 23 0 17 6 3
    1 0 1 0 0 7 0 5 2 1
    52 0 0 52 0 73 0 16 57 1
    2740 0 975 1765 55 7053 6 3192 3855 226
    98.0% 0.0% 35.6% 64.4% 2.0% 96.9% 0.1% 45.3% 54.7% 3.1%
    Total Total
    1 Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
    2 Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
    3 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.
    126 0 36 90 7 496 4 293 199 33 529 7.9%
    171 0 73 98 4 607 0 405 202 33 640 9.6%
    265 0 91 174 9 898 0 494 404 30 928 13.9%
    265 0 89 176 8 784 0 369 415 43 827 12.4%
    1283 0 315 968 17 3664 2 1339 2323 62 3726 56.0%
    4 0 4 0 0 8 0 6 2 0 8 0.1%
    2114 0 608 1506 45 6457 6 2906 3545 201 6658 100.0%
    97.9% 0.0% 28.8% 71.2% 2.1% 97.0% 0.1% 45.0% 54.9% 3.0%

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    Antiviral Resistance

    During the 2014-2015 influenza season, NML has tested 123 influenza viruses for resistance to oseltamivir and zanamivir and all were sensitive to both agents. A total of 154 (99%) of influenza A viruses tested for amantadine resistance were resistant (Table 3).
    * NA - not applicable
    103 0 103 0 153 152 (99.3%)
    2 0 2 0 2 2 (100%)
    18 0 18 0 NA * NA *
    123 0 123 0 155 154
    Influenza Strain Characterizations

    During the 2014-2015 influenza season, the National Microbiology Laboratory (NML) has characterized 59 influenza viruses [37 A(H3N2), 2 A(H1N1) and 20 influenza B]. Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assay, 31 of the 37 A(H3N2) viruses characterized were antigenically similar to A/Switzerland/9715293/2013, which is the influenza A(H3N2) component recommended for the 2015 Southern Hemisphere influenza vaccine. One was antigenically similar to A/Texas/50/2012, which is the influenza A(H3N2) component recommended for the 2014-15 influenza vaccine. The remaining five A(H3N2)viruses showed reduced titer to A/Texas/50/2012. Additionally, 112 A(H3N2)viruses were unable to be tested by HI assay; however, sequence analysis showed that 111 belonged to a genetic group that typically shows reduced titers to A/Texas/50/2012. Influenza A(H1N1): Two A(H1N1) viruses characterized were antigenically similar to A/California/7/2009, which is the influenza A(H1N1) component recommended for the 2014-15 influenza vaccine. Influenza B: Of the 20 influenza B viruses characterized, 17 viruses were antigenically similar to the vaccine strain B/Massachusetts/2/2012. Three viruses showed reduced titers with antiserum produced against strains recommended for the seasonal influenza vaccine (Figure 4).
    Figure 4. Influenza strain characterizations, Canada, 2014-2015, N = 59

    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 2014-2015 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A/Texas/50/2012 (H3N2)-like virus, and a B/Massachusetts/2/2012-like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus is recommended.


    Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
    Influenza-like Illness (ILI) Consultation Rate

    The national influenza-like-illness (ILI) consultation decreased in week 51 to 14.97 consultations per 1,000, which is below expected levels for week 51 (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, 2014-2015

    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. 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 51, 125 new outbreaks of influenza were reported: 94 in long-term care facilities (LTCF), nine in hospitals and 22 in institutional or community settings (Figure 6). An additional five outbreaks of ILI were reported in schools. Among the outbreaks in which the influenza subtype was known, two LTCF outbreaks, two institutional or community setting outbreaks, and one hospital outbreak were associated with A(H3N2). To date this season, 235 outbreaks in LTCF have been reported. The number of outbreaks reported is similar to the number reported in week 51 during the 2012-13 influenza season when influenza A(H3N2) also predominated.
    Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2014-2015

    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

    During week 51, the proportion of prescriptions for antivirals increased to 328.5 antiviral prescriptions per 100,000 total prescriptions (up from 150.3 antiviral prescriptions per 100,000 total prescriptions from the previous week). The rate for antivirals is higher than the previous three seasons (Figure 7). The rates in all age groups increased from the previous week; however, the rate doubled among seniors (205.7 to 509.03 per 100,000 total prescriptions).
    Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2014-15

    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 51, 56 laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network: 55 cases of influenza A and one case of influenza B (Figure 8a). Among reported cases, 19 (34%) were <2 years of age, 22 (39%) were 2 to 9 years of age and 15 (27%) were 10-16 years of age. Four cases were admitted to the ICU. To date this season, 203 hospitalizations have been reported by the IMPACT network, 187 (92%) of which were cases of influenza A. Among cases for which the influenza A subtype was reported, 98% (92/94) were A(H3N2). Children <5 years of age represented 56% of cases (Table 4). To date, 16 cases were admitted to the ICU, of which 10 (63%) were 2 to 9 years of age (Figure 9a). Among cases admitted to the ICU with available data, 79% (11/14) were reported to have underlying conditions or comorbidities.
    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 51, 73 laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network. Sixty cases (82%) were in adults over the age of 65. Seventy-one cases (97%) were influenza A (Figure 8b). To date this season, 230 cases have been reported; 227 (99%) with influenza A. The majority of cases (85%) were among adults ≥65 years of age (Table 5). Eighteen ICU admissions have been reported and the majority of cases (77.8%) were adults ≥65 years of age with underlying conditions or comorbidities. Eight deaths have been reported, all adults >65 years of age (Figure 9b).
    Note: The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
    Total # (%)
    1 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.
    20 0 10 10 2 22 (10.8%)
    39 1 16 22 2 41 (20.2%)
    45 1 24 20 6 51 (25.1%)
    53 0 27 26 4 57 (28.1%)
    30 0 15 15 2 32 (15.8%)
    187 2 92 93 16 203
    92.1% 1.1% 49.2% 49.7% 7.9% 100.0%
    Total # (%)
    1 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.
    2 0 0 2 0 2(1%)
    13 0 4 9 0 13(6%)
    20 0 7 13 0 20(9%)
    192 1 22 169 3 195(85%)
    227 1 33 193 3 230
    99% 0% 15% 85% 1% 100%
    Figure 8 - Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15
    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, 2014-15
    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 51, 187 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories*; all but three with influenza A, and 63% were patients ≥65 years of age. Since the start of the 2014-15 season, 782 hospitalizations have been reported; 762 (97%) with influenza A. Among cases for which the subtype of influenza A was reported, 99% (536/538) were A(H3N2). The majority of cases (60%) were ≥65 years of age (Table 6). Seventeen ICU admissions have been reported in adults ≥65 years of age with influenza A. Forty deaths with influenza A have been reported: one child <5 years of age, one adult 45-64 years and 38 adults ≥65 years of age. 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. 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. 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.
    Total # (%)
    1 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.
    78 1 52 25 2 80 (10%)
    67 0 46 21 2 69 (9%)
    54 1 40 13 4 58 (7%)
    86 0 69 17 2 88 (11%)
    462 0 314 148 9 471 (60%)
    15 0 15 0 1 16 (2%)
    762 2 536 224 20 782
    97.4% 0.3% 70.3% 29.4% 2.6% 100.0%
    See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2014-15 on the Public Health Agency of Canada website.

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

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    FluWatch report: December 7 to 13, 2014 (Week 50)

    Posted 2014-12-19 For readers interested in the PDF version, the document is available for downloading or viewing:
    FluWatch report: December 7 to 13, 2014 (Week 50) (PDF Version - 633 KB - 10 pages)

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    Overall Summary
    • In week 50, laboratory detections of influenza increased sharply for the fourth consecutive week. The majority of laboratory detections continued to be reported in AB, ON and QC; but with increasing activity in SK, MB and NL.
    • A(H3N2) continues to be the most common type of influenza affecting Canadians. In both laboratory detections and hospitalizations, the majority of cases have been among seniors ≥65 years of age.
    • Similar to the previous week, there were a large number of newly-reported laboratory-confirmed outbreaks of influenza: 72 influenza A outbreaks in 8 provinces, of which 57 were in long-term care facilities (LTCF).
    • To date, the NML has found that the majority H3N2 influenza specimens are not optimally matched to the vaccine strain which may result in reduced vaccine effectiveness against the H3N2 influenza virus. However, the vaccine can still provide some protection against H3N2 influenza illness and can offer protection against other influenza strains such as A(H1N1) and B.


    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 50, four regions reported widespread activity (in AB), 17 regions reported localized activity (in BC(2), SK, MB(2), ON(5), QC(5), NS, NL), and 16 regions (in NT, YK, BC(3), AB, SK(2), MB(3), ON, QC, NB, PE, and NL) reported sporadic activity.
    Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 50





    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

    In week 50, the number of positive influenza tests increased sharply for the fourth week in a row, to 1,963 influenza detections (25.9% of tests), predominantly due to influenza A (Figure 2). To date, 96% of influenza detections have been influenza A, and 99.6% of those subtyped have been A(H3) (Table 1). The timing of the season and predominant A(H3N2) subtype is similar to the pattern observed during the 2012-13 influenza season when percent positive for influenza peaked in week 52 (35%). To date, among the cases of influenza with reported age, the largest proportion was in adults ≥65 years of age (56%) (Table 2).
    Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2014-15

    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 increased sharply in week 50 and was the second most frequently detected virus, after influenza. Detections of parainfluenza and adenovirus also continue to follow their seasonal patterns of broad winter circulation. Detections of rhinovirus peaked in week 39 and continue to follow a downward trend (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, 2014-15


    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
    B Total
    1 Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
    2 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.
    82 0 55 27 2 262 2 218 42 13
    520 0 310 210 10 1441 0 1203 238 52
    52 0 23 28 1 113 0 49 62 2
    22 0 14 8 1 36 0 28 8 2
    287 0 210 77 4 630 4 477 149 23
    933 0 0 933 23 1757 0 0 1757 71
    3 0 2 1 0 6 0 3 3 0
    4 0 0 4 1 11 0 7 4 3
    1 0 0 1 0 6 0 4 2 1
    16 0 12 4 1 21 0 16 5 1
    1,920 0 626 1,293 43 4283 6 2005 2270 168
    97.8% 0.0% 32.6% 67.3% 2.2% 96.2% 0.1% 46.8% 53.0% 3.8%
    Total Total
    1 Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
    2 Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
    3 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.
    55 0 7 48 4 281 4 156 121 23 304 8.5%
    52 0 5 47 2 304 0 167 137 29 333 9.3%
    120 0 4 116 3 461 0 204 257 19 480 13.4%
    145 0 34 111 6 427 0 159 268 31 458 12.8%
    650 0 41 609 8 1963 2 546 1415 42 2005 56.0%
    0 0 0 0 0 1 0 0 1 0 1 0.0%
    1,022 0 91 931 23 3437 6 1232 2199 144 3581 100.0%
    97.8% 0.0% 8.9% 91.1% 2.2% 96.0% 0.2% 35.8% 64.0% 4.0%

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    Antiviral Resistance

    During the 2014-2015 influenza season, NML has tested 93 influenza viruses for resistance to oseltamivir and zanamivir and all were sensitive to both agents. A total of 130 (99%) influenza A viruses tested for amantadine resistance were resistant (Table 3).
    * NA - not applicable
    79 0 79 0 129 128 (99.2%)
    0 0 0 0 2 2 (100%)
    14 0 14 0 NA * NA *
    93 0 93 0 131 131
    Influenza Strain Characterizations

    During the 2014-2015 influenza season, the National Microbiology Laboratory (NML) has characterized 30 influenza viruses [13 A(H3N2), 2 A(H1N1) and 15 influenza B]. When tested by hemagglutination inhibition (HI) assay, one influenza A (H3N2) virus was antigenically similar to A/Texas/50/2012, two influenza A (H1N1) viruses were antigenically similar to A/California/7/2009 and 12 influenza B viruses were antigenically similar to the B/Massachusetts/2/2012 (Yamagata lineage) recommended by the WHO for the 2014-15 seasonal influenza vaccine. Five influenza A(H3N2) viruses and three influenza B viruses showed reduced titers to antisera produced against strains recommended for the seasonal influenza vaccine. Seven of the 13 influenza A (H3N2) viruses were antigenically similar to the A/Switzerland/9715293/2013, which is the influenza A/H3N2 component recommended for the 2015 Southern Hemisphere influenza vaccine (Figure 4). Additionally, 58 A(H3N2) viruses were unable to be tested by HI assay; however, sequence analysis showed that 57 belonged to a genetic group that typically shows reduced titers to A/Texas/50/2012.
    Figure 4. Influenza strain characterizations, Canada, 2014-2015, N = 30

    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 2014-2015 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A/Texas/50/2012 (H3N2)-like virus, and a B/Massachusetts/2/2012-like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus is recommended.


    Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
    Influenza-like Illness (ILI) Consultation Rate

    The national influenza-like-illness (ILI) consultation increased in week 50 to 30.91 consultations per 1,000, which is within expected levels for week 50 (Figure 5). This week, the rates were highest among the 0 to 5 years of age group and lowest among the 5 to 19 years of age group.
    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, 2014-2015

    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. 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 50, 72 new outbreaks of influenza A were reported: 57 in long-term care facilities (LTCF), two in hospitals and 13 in institutional or community settings (Figure 6). An additional six outbreaks of ILI were reported in schools. Among the outbreaks in which the influenza subtype was known, 12 LTCF outbreaks, eight institutional or community setting outbreaks, and one hospital outbreak were associated with A(H3N2). To date this season, 141 outbreaks in LTCF have been reported. The number of outbreaks reported is similar to the number reported in week 51 during the 2012-13 influenza season when influenza A(H3N2) also predominated.
    Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2014-2015

    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

    During week 50, the proportion of prescriptions for antivirals increased to 150.8 antiviral prescriptions per 100,000 total prescriptions, which is higher than the previous three seasons (Figure 7). The rates were highest in seniors and children (207 and 197 per 100,000 antiviral prescriptions respectively).
    Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2014-15

    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 50, 38 laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network: 37 cases of influenza A and one case of influenza B (Figure 8a). Among reported cases, 16 (42%) were <2 years of age, 19 (46%) were 2 to 9 years of age and three (8%) were 10-16 years of age. Three cases, all 5-9 years of age, were admitted to the ICU. To date this season, 139 hospitalizations have been reported by the IMPACT network, 125 (90%) of which were cases of influenza A. Among cases for which the influenza A subtype was reported, 97% (72/74) were A(H3N2). Children <5 years of age represented 62% of cases (Table 4). To date, 12 cases were admitted to the ICU, of which 8 (67%) were 2 to 9 years of age (Figure 9a).
    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 50, 60 laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network. Fifty-eight cases (97%) were influenza A (Figure 8b). To date this season, 139 cases have been reported; 137 (98.5%) with influenza A. The majority of cases (86%) were among adults ≥65 years of age (Table 5). Nine ICU admissions have been reported and the majority of cases (77.8%) were adults ≥65 years of age with underlying conditions or comorbidities. Four deaths have been reported, all adults >65 years of age (Figure 9b).
    Note: The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
    Total # (%)
    1 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.
    17 0 11 6 2 19 (13.7%)
    24 1 11 12 1 25 (18.0%)
    37 1 22 14 5 42 (30.2%)
    34 0 22 12 4 38 (27.3%)
    13 0 6 7 2 15 (10.8%)
    125 2 72 51 14 139
    89.9% 1.6% 57.6% 40.8% 10.1% 100.0%
    Total # (%)
    1 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.
    0 0 0 0 0 0(%)
    8 0 3 5 1 8(6%)
    11 0 5 6 0 11(8%)
    118 0 20 98 2 120(86%)
    137 0 28 109 2 139
    99% 0% 20% 80% 1% 100%
    Figure 8 - Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15
    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, 2014-15
    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 50, 113 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories*; all but four with influenza A, and 65% were patients ≥65 years of age. Since the start of the 2014-15 season, 492 hospitalizations have been reported; 476 (97%) with influenza A. Among cases for which the subtype of influenza A was reported, 99% (374/376) were A(H3N2). The majority of cases (59%) were ≥65 years of age (Table 6). Ten ICU admissions have been reported in adults ≥65 years of age with influenza A. Twenty-seven deaths with influenza A have been reported: one child <5 years of age, one adult 45-64 years and 25 adults ≥65 years of age. 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. 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. 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.
    Total # (%)
    1 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.
    50 1 40 9 0 50 (10%)
    39 0 29 10 2 41 (8%)
    34 1 26 7 4 38 (8%)
    58 0 50 8 2 60 (12%)
    283 0 217 66 7 290 (59%)
    12 0 12 0 1 13 (3%)
    476 2 374 100 16 492
    96.7% 0.4% 78.6% 21.0% 3.3% 100.0%
    See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2014-15 on the Public Health Agency of Canada website.
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    Re: Canada FluWatch Weekly Reports 2014-2015 Season Week 48

    FluWatch report: November 30 to December 6, 2014 (Week 49)
    Posted 2014-12-12


    For readers interested in the <abbr title="Portable Document Format">PDF</abbr> version, the document is available for downloading or viewing:
    <a href="http://www.phac-aspc.gc.ca/fluwatch/14-15/w49_14/pdf/fw2014-49-eng.pdf" title="Flu Watch (Version PDF, 288 KB - 10 pages)">FluWatch report: November 30 to December 6, 2014 (Week 49) (<abbr title="Portable Document Format">PDF</abbr> Version - 346 <abbr title="Kilobytes">KB</abbr> - 10 pages)

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    Overall Summary
    • In week 49, laboratory detections of influenza increased sharply for the third consecutive week. The majority of laboratory detections continued to be reported in BC, AB, ON and QC; but with increasing activity in SK and NS.
    • A(H3N2) continues to be the most common type of influenza affecting Canadians. In both laboratory detections and hospitalizations, the majority of cases have been among seniors ≥65 years of age.
    • Similar to the previous week, there were a large number of newly-reported laboratory-confirmed outbreaks of influenza: 37 influenza A outbreaks in 6 provinces, of which 32 were in long-term care facilities (LTCF). Among the outbreaks with known subtype all were due to A(H3N2).
    • The rate of antiviral prescriptions among seniors increased significantly in week 49.


    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 49, two regions reported widespread activity (QC (1), BC(1)), six regions reported localized activity (BC(1), AB(3), SK(1), ON(5), QC(2), and NS(1)), and nine regions (in BC(2), AB(2), SK(2), MB(1), QC(3), NB(1), PE(1), YK(1), and NT(1)) reported sporadic activity (figure 1).
    Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 49





    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

    In week 49, the number of positive influenza tests increased sharply for the third week in a row, to 1,011 influenza detections (19.5% of tests), predominantly due to influenza A (Figure 2). To date, 95% of influenza detections have been influenza A, and 99.5% of those subtyped have been A(H3) (Table 1). The timing of the season and predominant A(H3N2) subtype is similar to the pattern observed during the 2012-13 influenza season when percent positive for influenza peaked in week 52 (35%). To date, among the cases of influenza with reported age, the largest proportion was in adults ≥65 years of age (52.2%) (Table 2).
    Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2014-15

    Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
    In week 49, detections of RSV were similar to the previous week, keeping with its usual pattern of seasonal circulation. Detections of parainfluenza and adenovirus also continue to follow their seasonal patterns of broad winter circulation. Detections of rhinovirus peaked in week 39 and continue to follow a downward trend (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, 2014-15


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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 class="widthFull" id="t1" border="1" cellpadding="2" cellspacing="0"> <caption class="alignCenter"> Table 1: Weekly and cumulative numbers of positive influenza specimens
    by type, subtype and province, Canada, 2014-15
    </caption> <thead> <tr class="bg-colour-yellow"> <th id="ar1" rowspan="3">Reporting provinces <sup>1</sup></th> <th id="ac1" colspan="5">Weekly
    (November 30 to December 6, 2014)</th> <th id="ac8" colspan="5">Cumulative
    (August 24 to December 6, 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 colspan="11" class="fontSize85"><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"> 55 </td> <td class="alignCenter" headers="ar1 ar2 ac1 ac2 ac4"> 0 </td> <td class="alignCenter" headers="ar1 ar2 ac1 ac2 ac5"> 41 </td> <td class="alignCenter" headers="ar1 ar2 ac1 ac2 ac6"> 14 </td> <td class="alignCenter" headers="ar1 ar2 ac1 ac7"> 2 </td> <td class="alignCenter" headers="ar1 ar2 ac8 ac9 ac10"> 180 </td> <td class="alignCenter" headers="ar1 ar2 ac8 ac9 ac11"> 2 </td> <td class="alignCenter" headers="ar1 ar2 ac8 ac9 ac12"> 163 </td> <td class="alignCenter" headers="ar1 ar2 ac8 ac9 ac13"> 15 </td> <td class="alignCenter" headers="ar1 ar2 ac8 ac14"> 11 </td> </tr> <tr> <th id="ar3" class="alignLeft" headers="ar1">AB</th> <td class="alignCenter" headers="ar1 ar3 ac1 ac2 ac3"> 323 </td> <td class="alignCenter" headers="ar1 ar3 ac1 ac2 ac4"> 0 </td> <td class="alignCenter" headers="ar1 ar3 ac1 ac2 ac5"> 189 </td> <td class="alignCenter" headers="ar1 ar3 ac1 ac2 ac6"> 134 </td> <td class="alignCenter" headers="ar1 ar3 ac1 ac7"> 11 </td> <td class="alignCenter" headers="ar1 ar3 ac8 ac9 ac10"> 916 </td> <td class="alignCenter" headers="ar1 ar3 ac8 ac9 ac11"> 0 </td> <td class="alignCenter" headers="ar1 ar3 ac8 ac9 ac12"> 767 </td> <td class="alignCenter" headers="ar1 ar3 ac8 ac9 ac13"> 149 </td> <td class="alignCenter" headers="ar1 ar3 ac8 ac14"> 42 </td> </tr> <tr> <th id="ar4" class="alignLeft" headers="ar1">SK</th> <td class="alignCenter" headers="ar1 ar4 ac1 ac2 ac3"> 34 </td> <td class="alignCenter" headers="ar1 ar4 ac1 ac2 ac4"> 0 </td> <td class="alignCenter" headers="ar1 ar4 ac1 ac2 ac5"> 12 </td> <td class="alignCenter" headers="ar1 ar4 ac1 ac2 ac6"> 22</td> <td class="alignCenter" headers="ar1 ar4 ac1 ac7"> 1</td> <td class="alignCenter" headers="ar1 ar4 ac8 ac9 ac10"> 60</td> <td class="alignCenter" headers="ar1 ar4 ac8 ac9 ac11"> 0 </td> <td class="alignCenter" headers="ar1 ar4 ac8 ac9 ac12"> 23</td> <td class="alignCenter" headers="ar1 ar4 ac8 ac9 ac13"> 37</td> <td class="alignCenter" headers="ar1 ar4 ac8 ac14"> 1</td> </tr> <tr> <th id="ar5" class="alignLeft" headers="ar1">MB</th> <td class="alignCenter" headers="ar1 ar5 ac1 ac2 ac3"> 2 </td> <td class="alignCenter" headers="ar1 ar5 ac1 ac2 ac4"> 0 </td> <td class="alignCenter" headers="ar1 ar5 ac1 ac2 ac5"> 2 </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"> 14 </td> <td class="alignCenter" headers="ar1 ar5 ac8 ac9 ac11"> 0 </td> <td class="alignCenter" headers="ar1 ar5 ac8 ac9 ac12"> 14 </td> <td class="alignCenter" headers="ar1 ar5 ac8 ac9 ac13"> 0 </td> <td class="alignCenter" headers="ar1 ar5 ac8 ac14"> 1 </td> </tr> <tr> <th id="ar6" class="alignLeft" headers="ar1">ON</th> <td class="alignCenter" headers="ar1 ar6 ac1 ac2 ac3"> 132 </td> <td class="alignCenter" headers="ar1 ar6 ac1 ac2 ac4"> 0 </td> <td class="alignCenter" headers="ar1 ar6 ac1 ac2 ac5"> 105 </td> <td class="alignCenter" headers="ar1 ar6 ac1 ac2 ac6"> 27 </td> <td class="alignCenter" headers="ar1 ar6 ac1 ac7"> 2 </td> <td class="alignCenter" headers="ar1 ar6 ac8 ac9 ac10"> 340 </td> <td class="alignCenter" headers="ar1 ar6 ac8 ac9 ac11"> 4 </td> <td class="alignCenter" headers="ar1 ar6 ac8 ac9 ac12"> 259 </td> <td class="alignCenter" headers="ar1 ar6 ac8 ac9 ac13"> 77 </td> <td class="alignCenter" headers="ar1 ar6 ac8 ac14"> 18 </td> </tr> <tr> <th id="ar7" class="alignLeft" headers="ar1">QC</th> <td class="alignCenter" headers="ar1 ar7 ac1 ac2 ac3"> 413 </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"> 413 </td> <td class="alignCenter" headers="ar1 ar7 ac1 ac7"> 18 </td> <td class="alignCenter" headers="ar1 ar7 ac8 ac9 ac10"> 824 </td> <td class="alignCenter" headers="ar1 ar7 ac8 ac9 ac11"> 0 </td> <td class="alignCenter" headers="ar1 ar7 ac8 ac9 ac12"> 0 </td> <td class="alignCenter" headers="ar1 ar7 ac8 ac9 ac13"> 824 </td> <td class="alignCenter" headers="ar1 ar7 ac8 ac14"> 48 </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"> 0 </td> <td class="alignCenter" headers="ar1 ar8 ac8 ac9 ac10"> 3 </td> <td class="alignCenter" headers="ar1 ar8 ac8 ac9 ac11"> 0 </td> <td class="alignCenter" headers="ar1 ar8 ac8 ac9 ac12"> 1 </td> <td class="alignCenter" headers="ar1 ar8 ac8 ac9 ac13"> 2 </td> <td class="alignCenter" headers="ar1 ar8 ac8 ac14"> 0 </td> </tr> <tr> <th id="ar9" class="alignLeft" headers="ar1">NS</th> <td class="alignCenter" headers="ar1 ar9 ac1 ac2 ac3"> 6 </td> <td class="alignCenter" headers="ar1 ar9 ac1 ac2 ac4"> 0 </td> <td class="alignCenter" headers="ar1 ar9 ac1 ac2 ac5"> 6 </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"> 7 </td> <td class="alignCenter" headers="ar1 ar9 ac8 ac9 ac11"> 0 </td> <td class="alignCenter" headers="ar1 ar9 ac8 ac9 ac12"> 7 </td> <td class="alignCenter" headers="ar1 ar9 ac8 ac9 ac13"> 0 </td> <td class="alignCenter" headers="ar1 ar9 ac8 ac14"> 2 </td> </tr> <tr> <th id="ar10" class="alignLeft" headers="ar1">PE</th> <td class="alignCenter" headers="ar1 ar10 ac1 ac2 ac3"> 1 </td> <td class="alignCenter" headers="ar1 ar10 ac1 ac2 ac4"> 0 </td> <td class="alignCenter" headers="ar1 ar10 ac1 ac2 ac5"> 1 </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"> 5 </td> <td class="alignCenter" headers="ar1 ar10 ac8 ac9 ac11"> 0 </td> <td class="alignCenter" headers="ar1 ar10 ac8 ac9 ac12"> 4 </td> <td class="alignCenter" headers="ar1 ar10 ac8 ac9 ac13"> 1 </td> <td class="alignCenter" headers="ar1 ar10 ac8 ac14"> 1 </td> </tr> <tr> <th id="ar11" class="alignLeft" headers="ar1">NL</th> <td class="alignCenter" headers="ar1 ar11 ac1 ac2 ac3"> 3 </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"> 3 </td> <td class="alignCenter" headers="ar1 ar11 ac1 ac7"> 0 </td> <td class="alignCenter" headers="ar1 ar11 ac8 ac9 ac10"> 5 </td> <td class="alignCenter" headers="ar1 ar11 ac8 ac9 ac11"> 0 </td> <td class="alignCenter" headers="ar1 ar11 ac8 ac9 ac12"> 1 </td> <td class="alignCenter" headers="ar1 ar11 ac8 ac9 ac13"> 4 </td> <td class="alignCenter" headers="ar1 ar11 ac8 ac14"> 0 </td> </tr> <tr> <th id="ar12" class="alignLeft" headers="ar1">Canada</th> <td class="alignCenter" headers="ar1 ar12 ac1 ac2 ac3"> 969 </td> <td class="bg-colour-blue alignCenter" headers="ar1 ar12 ac1 ac2 ac4"> 0 </td> <td class="bg-colour-blue alignCenter" headers="ar1 ar12 ac1 ac2 ac5"> 356</td> <td class="bg-colour-blue alignCenter" headers="ar1 ar12 ac1 ac2 ac6"> 613</td> <td class="alignCenter" headers="ar1 ar12 ac1 ac7"> 34</td> <td class="alignCenter" headers="ar1 ar12 ac8 ac9 ac10"> 2354</td> <td class="bg-colour-blue alignCenter" headers="ar1 ar12 ac8 ac9 ac11"> 6 </td> <td class="bg-colour-blue alignCenter" headers="ar1 ar12 ac8 ac9 ac12"> 1239</td> <td class="bg-colour-blue alignCenter" headers="ar1 ar12 ac8 ac9 ac13"> 1109</td> <td class="alignCenter" headers="ar1 ar12 ac8 ac14"> 124</td> </tr> <tr> <th id="ar13" class="alignLeft" headers="ar1">Percentage<sup>2</sup></th> <td class="alignCenter" headers="ar1 ar13 ac1 ac2 ac3"> 96.6% </td> <td class="bg-colour-blue alignCenter" headers="ar1 ar13 ac1 ac2 ac4"> 0.0% </td> <td class="bg-colour-blue alignCenter" headers="ar1 ar13 ac1 ac2 ac5"> 36.7% </td> <td class="bg-colour-blue alignCenter" headers="ar1 ar13 ac1 ac2 ac6"> 63.3% </td> <td class="alignCenter" headers="ar1 ar13 ac1 ac7"> 3.4% </td> <td class="alignCenter" headers="ar1 ar13 ac8 ac9 ac10"> 95.0% </td> <td class="bg-colour-blue alignCenter" headers="ar1 ar13 ac8 ac9 ac11"> 0.3% </td> <td class="bg-colour-blue alignCenter" headers="ar1 ar13 ac8 ac9 ac12"> 52.6% </td> <td class="bg-colour-blue alignCenter" headers="ar1 ar13 ac8 ac9 ac13"> 47.1% </td> <td class="alignCenter" headers="ar1 ar13 ac8 ac14"> 5.0% </td> </tr> </tbody> </table>
    <table class="widthFull" id="t2" border="1" cellpadding="2" cellspacing="0"> <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, 2014-15 </caption> <thead> <tr class="bg-colour-yellow"> <th rowspan="3" id="br1">Age groups (years)</th> <th colspan="5" id="bc1">Weekly
    (November 30 to December 6, 2014)</th> <th colspan="7" id="bc8">Cumulative
    (August 24 to December 6, 2014)</th> </tr> <tr class="bg-colour-yellow"> <th colspan="4" id="bc2" headers="bc1">Influenza A</th> <th id="bc7" headers="bc1">B</th> <th colspan="4" id="bc9" headers="bc8">Influenza A</th> <th id="bc14" headers="bc8">B</th> <th colspan="2" id="bc15" headers="bc8">Influenza A and B</th> </tr> <tr class="bg-colour-grey-light"> <th id="bc3" headers="bc1 bc2">A Total</th> <th class="bg-colour-blue " id="bc4" headers="bc1 bc2">A(H1) pdm09</th> <th class="bg-colour-blue " id="bc5" headers="bc1 bc2">A(H3)</th> <th class="bg-colour-blue " id="bc6" headers="bc1 bc2">A (UnS)</th> <td headers="bc1 bc7" class="alignCenter">Total</td> <th id="bc10" headers="bc8 bc9">A Total</th> <th class="bg-colour-blue " id="bc11" headers="bc8 bc9">A(H1) pdm09</th> <th class="bg-colour-blue" id="bc12" headers="bc8 bc9">A(H3)</th> <th class="bg-colour-blue " id="bc13" headers="bc8 bc9">A (UnS)</th> <td headers="bc8 bc14" class="alignCenter">Total</td> <th id="bc16" headers="bc8 bc15">#</th> <th id="bc17" headers="bc8 bc15">%</th> </tr> </thead> <tfoot> <tr> <td colspan="13" class="fontSize85"><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 class="alignLeft" id="br2" headers="br1"><5</th> <td class="alignCenter" headers="br1 br2 bc1 bc2 bc3"> 60 </td> <td class="alignCenter" headers="br1 br2 bc1 bc2 bc4"> 0 </td> <td class="alignCenter" headers="br1 br2 bc1 bc2 bc5"> 26 </td> <td class="alignCenter" headers="br1 br2 bc1 bc2 bc6"> 34 </td> <td class="alignCenter" headers="br1 br2 bc1 bc7"> 6 </td> <td class="alignCenter" headers="br1 br2 bc8 bc9 bc10"> 210 </td> <td class="alignCenter" headers="br1 br2 bc8 bc9 bc11"> 4 </td> <td class="alignCenter" headers="br1 br2 bc8 bc9 bc12"> 138 </td> <td class="alignCenter" headers="br1 br2 bc8 bc9 bc13"> 68 </td> <td class="alignCenter" headers="br1 br2 bc8 bc14"> 19 </td> <td class="alignCenter" headers="br1 br2 bc8 bc15 bc16"> 229 </td> <td class="alignCenter" headers="br1 br2 bc8 bc15 bc17"> 9.8% </td> </tr> <tr> <th class="alignLeft" id="br3" headers="br1">5-19</th> <td class="alignCenter" headers="br1 br3 bc1 bc2 bc3"> 81 </td> <td class="alignCenter" headers="br1 br3 bc1 bc2 bc4"> 0 </td> <td class="alignCenter" headers="br1 br3 bc1 bc2 bc5"> 27 </td> <td class="alignCenter" headers="br1 br3 bc1 bc2 bc6"> 54 </td> <td class="alignCenter" headers="br1 br3 bc1 bc7"> 6 </td> <td class="alignCenter" headers="br1 br3 bc8 bc9 bc10"> 237 </td> <td class="alignCenter" headers="br1 br3 bc8 bc9 bc11"> 0 </td> <td class="alignCenter" headers="br1 br3 bc8 bc9 bc12"> 153 </td> <td class="alignCenter" headers="br1 br3 bc8 bc9 bc13"> 84 </td> <td class="alignCenter" headers="br1 br3 bc8 bc14"> 25 </td> <td class="alignCenter" headers="br1 br3 bc8 bc15 bc16"> 262 </td> <td class="alignCenter" headers="br1 br3 bc8 bc15 bc17"> 11.2% </td> </tr> <tr> <th class="alignLeft" id="br4" headers="br1">20-44</th> <td class="alignCenter" headers="br1 br4 bc1 bc2 bc3"> 107 </td> <td class="alignCenter" headers="br1 br4 bc1 bc2 bc4"> 0 </td> <td class="alignCenter" headers="br1 br4 bc1 bc2 bc5"> 43 </td> <td class="alignCenter" headers="br1 br4 bc1 bc2 bc6"> 64 </td> <td class="alignCenter" headers="br1 br4 bc1 bc7"> 5 </td> <td class="alignCenter" headers="br1 br4 bc8 bc9 bc10"> 321 </td> <td class="alignCenter" headers="br1 br4 bc8 bc9 bc11"> 0 </td> <td class="alignCenter" headers="br1 br4 bc8 bc9 bc12"> 186 </td> <td class="alignCenter" headers="br1 br4 bc8 bc9 bc13"> 135 </td> <td class="alignCenter" headers="br1 br4 bc8 bc14"> 16 </td> <td class="alignCenter" headers="br1 br4 bc8 bc15 bc16"> 337 </td> <td class="alignCenter" headers="br1 br4 bc8 bc15 bc17"> 14.4% </td> </tr> <tr> <th class="alignLeft" id="br5" headers="br1">45-64</th> <td class="alignCenter" headers="br1 br5 bc1 bc2 bc3"> 93 </td> <td class="alignCenter" headers="br1 br5 bc1 bc2 bc4"> 0 </td> <td class="alignCenter" headers="br1 br5 bc1 bc2 bc5"> 26 </td> <td class="alignCenter" headers="br1 br5 bc1 bc2 bc6"> 67 </td> <td class="alignCenter" headers="br1 br5 bc1 bc7"> 4 </td> <td class="alignCenter" headers="br1 br5 bc8 bc9 bc10"> 266 </td> <td class="alignCenter" headers="br1 br5 bc8 bc9 bc11"> 0 </td> <td class="alignCenter" headers="br1 br5 bc8 bc9 bc12"> 112 </td> <td class="alignCenter" headers="br1 br5 bc8 bc9 bc13"> 154 </td> <td class="alignCenter" headers="br1 br5 bc8 bc14"> 25 </td> <td class="alignCenter" headers="br1 br5 bc8 bc15 bc16"> 291 </td> <td class="alignCenter" headers="br1 br5 bc8 bc15 bc17"> 12.4% </td> </tr> <tr> <th class="alignLeft" id="br6" headers="br1">65+</th> <td class="alignCenter" headers="br1 br6 bc1 bc2 bc3"> 426 </td> <td class="alignCenter" headers="br1 br6 bc1 bc2 bc4"> 0 </td> <td class="alignCenter" headers="br1 br6 bc1 bc2 bc5"> 85 </td> <td class="alignCenter" headers="br1 br6 bc1 bc2 bc6"> 341 </td> <td class="alignCenter" headers="br1 br6 bc1 bc7"> 7 </td> <td class="alignCenter" headers="br1 br6 bc8 bc9 bc10"> 1194 </td> <td class="alignCenter" headers="br1 br6 bc8 bc9 bc11"> 2 </td> <td class="alignCenter" headers="br1 br6 bc8 bc9 bc12"> 456 </td> <td class="alignCenter" headers="br1 br6 bc8 bc9 bc13"> 736 </td> <td class="alignCenter" headers="br1 br6 bc8 bc14"> 31 </td> <td class="alignCenter" headers="br1 br6 bc8 bc15 bc16"> 1225 </td> <td class="alignCenter" headers="br1 br6 bc8 bc15 bc17"> 52.2% </td> </tr> <tr> <th class="alignLeft" id="br7" 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"> 1 </td> <td class="alignCenter" headers="br1 br7 bc8 bc9 bc11"> 0 </td> <td class="alignCenter" headers="br1 br7 bc8 bc9 bc12"> 0 </td> <td class="alignCenter" headers="br1 br7 bc8 bc9 bc13"> 1 </td> <td class="alignCenter" headers="br1 br7 bc8 bc14"> 0 </td> <td class="alignCenter" headers="br1 br7 bc8 bc15 bc16"> 1 </td> <td class="alignCenter" headers="br1 br7 bc8 bc15 bc17"> 0.0% </td> </tr> <tr> <th class="alignLeft" id="br8" headers="br1">Total</th> <td class="alignCenter" headers="br1 br8 bc1 bc2 bc3"> 767 </td> <td class="bg-colour-blue alignCenter" headers="br1 br8 bc1 bc2 bc4"> 0 </td> <td class="bg-colour-blue alignCenter" headers="br1 br8 bc1 bc2 bc5"> 207 </td> <td class="bg-colour-blue alignCenter" headers="br1 br8 bc1 bc2 bc6"> 560 </td> <td class="alignCenter" headers="br1 br8 bc1 bc7"> 28 </td> <td class="alignCenter" headers="br1 br8 bc8 bc9 bc10"> 2229 </td> <td class="bg-colour-blue alignCenter" headers="br1 br8 bc8 bc9 bc11"> 6 </td> <td class="bg-colour-blue alignCenter" headers="br1 br8 bc8 bc9 bc12"> 1045 </td> <td class="bg-colour-blue alignCenter" headers="br1 br8 bc8 bc9 bc13"> 1178 </td> <td class="alignCenter" headers="br1 br8 bc8 bc14"> 116 </td> <td class="alignCenter" headers="br1 br8 bc8 bc15 bc16"> 2345 </td> <td class="alignCenter" headers="br1 br8 bc8 bc15 bc17"> 100.0% </td> </tr> <tr> <th class="alignLeft" id="br9" headers="br1">Percentage<sup>2</sup></th> <td class="alignCenter" headers="br1 br9 bc1 bc2 bc3"> 96.5% </td> <td class="bg-colour-blue alignCenter" headers="br1 br9 bc1 bc2 bc4"> 0.0% </td> <td class="bg-colour-blue alignCenter" headers="br1 br9 bc1 bc2 bc5"> 27.0% </td> <td class="bg-colour-blue alignCenter" headers="br1 br9 bc1 bc2 bc6"> 73.0% </td> <td class="alignCenter" headers="br1 br9 bc1 bc7"> 3.5% </td> <td class="alignCenter" headers="br1 br9 bc8 bc9 bc10"> 95.1% </td> <td class="bg-colour-blue alignCenter" headers="br1 br9 bc8 bc9 bc11"> 0.3% </td> <td class="bg-colour-blue alignCenter" headers="br1 br9 bc8 bc9 bc12"> 46.9% </td> <td class="bg-colour-blue alignCenter" headers="br1 br9 bc8 bc9 bc13"> 52.8% </td> <td class="alignCenter" headers="br1 br9 bc8 bc14"> 4.9% </td> <td class="alignCenter">
    </td> <td class="alignCenter">
    </td> </tr> </tbody> </table>

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    Influenza Strain Characterizations

    During the 2014-2015 influenza season, the National Microbiology Laboratory (NML) has characterized 25 influenza viruses [11 A(H3N2) and 14 influenza B]. When tested by hemagglutination inhibition (HI) assay, two influenza A viruses were antigenically similar to A/Texas/50/2012, and 11 influenza B viruses were antigenically similar to the B/Massachusetts/2/2012 (Yamagata lineage) recommended by the WHO for the 2014-15 seasonal influenza vaccine. Nine influenza A(H3N2) viruses and three influenza B viruses showed reduced titers to antisera produced against strains recommended for the seasonal influenza vaccine (Figure 4). Additionally, 38 A(H3N2) viruses were unable to be tested by HI assay; however, sequence analysis showed that they belonged to a genetic group that typically shows reduced titers to A/Texas/50/2012.
    Figure 4. Influenza strain characterizations, Canada, 2014-2015, N = 25

    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 2014-2015 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A/Texas/50/2012 (H3N2)-like virus, and a B/Massachusetts/2/2012-like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus is recommended.


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

    During the 2014-2015 influenza season, NML has tested 74 influenza viruses for resistance to oseltamivir and zanamivir and all were sensitive to both agents. The 70 influenza A(H3N2) viruses tested for amantadine resistance were all resistant (Table 3).
    <table class="widthFull" border="1" cellpadding="2" cellspacing="0"> <caption> Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2014-15 </caption> <thead> <tr class="bg-colour-yellow"> <th rowspan="2" id="t3hc1">Virus type and subtype</th> <th colspan="2" id="t3hc2">Oseltamivir</th> <th colspan="2" id="t3hc3">Zanamivir</th> <th colspan="2" id="t3hc4">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 colspan="7" class="fontSize85"> <sup>*</sup> NA - not applicable</td> </tr> </tfoot> <tbody> <tr> <th class="alignLeft bg-colour-blue" id="t3hr1" headers="t3hc1">A (H3N2)</th> <td class="alignCenter" headers="t3hr1 t3hc2 t3hc5">60</td> <td class="alignCenter" headers="t3hr1 t3hc2 t3hc6">0</td> <td class="alignCenter" headers="t3hr1 t3hc3 t3hc7">60</td> <td class="alignCenter" headers="t3hr1 t3hc3 t3hc8">0</td> <td class="alignCenter" headers="t3hr1 t3hc4 t3hc9">70</td> <td class="alignCenter" headers="t3hr1 t3hc4 t3hc10">70(100%)</td> </tr> <tr> <th class="alignLeft bg-colour-blue" id="t3hr2" headers="t3hc1">A (H1N1)</th> <td class="alignCenter" headers="t3hr2 t3hc2 t3hc5">0</td> <td class="alignCenter" headers="t3hr2 t3hc2 t3hc6">0</td> <td class="alignCenter" headers="t3hr2 t3hc3 t3hc7">0</td> <td class="alignCenter" headers="t3hr2 t3hc3 t3hc8">0</td> <td class="alignCenter" headers="t3hr2 t3hc4 t3hc9">0</td> <td class="alignCenter" headers="t3hr2 t3hc4 t3hc10">0</td> </tr> <tr> <th class="alignLeft bg-colour-blue" id="t3hr3" headers="t3hc1">B</th> <td class="alignCenter" headers="t3hr3 t3hc2 t3hc5">14</td> <td class="alignCenter" headers="t3hr3 t3hc2 t3hc6">0</td> <td class="alignCenter" headers="t3hr3 t3hc3 t3hc7">14</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 class="alignLeft bg-colour-blue" id="t3hr4" headers="t3hc1">TOTAL</th> <td class="alignCenter" headers="t3hr4 t3hc2 t3hc5">74</td> <td class="alignCenter" headers="t3hr4 t3hc2 t3hc6">0</td> <td class="alignCenter" headers="t3hr4 t3hc3 t3hc7">74</td> <td class="alignCenter" headers="t3hr4 t3hc3 t3hc8">0</td> <td class="alignCenter" headers="t3hr4 t3hc4 t3hc9">70</td> <td class="alignCenter" headers="t3hr4 t3hc4 t3hc10">70</td> </tr> </tbody> </table> Influenza-like Illness (ILI) Consultation Rate

    The national influenza-like-illness (ILI) consultation rate increased in week 49 to 44.3 consultations per 1,000, which is above expected levels for week 49 (Figure 5). This week, the rates were highest among the 20 to 64 years of age group. In previous weeks, the ILI consultation rates of this group have been among the lowest.
    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, 2014-2015

    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. 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 49, 37 new outbreaks of influenza A were reported: 32 in long-term care facilities (LTCF), two in hospitals and three in institutional or community settings (Figure 6). An additional three outbreaks of ILI were reported in schools. Among the outbreaks in which the influenza subtype was known, four LTCF outbreaks and one hospital outbreak were associated with A(H3N2). To date this season, 84 outbreaks in LTCF have been reported.
    Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2014-2015

    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

    During week 49, the proportion of prescriptions for antivirals increased to 92.8 antiviral prescriptions per 100,000 total prescriptions, which is slightly higher than previous seasons (Figure 7). The rates in all age groups increased from the previous week; however, the rate increased six-fold among seniors.
    Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2014-15

    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 49, 28 laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network: 26 cases of influenza A and two cases of influenza B (Figure 8a). Among the cases with known age, 57% were 2 to 9 years of age. To date this season, 95 hospitalizations have been reported by the IMPACT network, 82 (86%) of which were cases of influenza A. Among cases for which the influenza A subtype was reported, 96% (55/57) were A(H3N2). Children 2 to 9 years of age represented 60% of cases (Table 4). To date, nine cases were admitted to the ICU (Figure 9a).
    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 49, 28 laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network. All 28 cases were influenza A (Figure 8b). To date this season, 71 cases have been reported; 70 (99%) with influenza A. The majority of cases (86%) were among adults ≥65 years of age (Table 5). Five ICU admissions have been reported and the majority of cases (80%) were adults ≥65 years of age with underlying conditions or comorbidities. One death has been reported (Figure 9b).
    Note: The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
    <table class="widthFull" border="1" cellpadding="2" cellspacing="0"> <caption class="alignCenter" id="t4"> Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2014-15 </caption> <thead> <tr class="bg-colour-yellow"> <th rowspan="3" id="dr1">Age groups </th> <th colspan="6" id="dc1">Cumulative (Aug. 24, 2014 to December 6, 2014) </th> </tr> <tr class="bg-colour-yellow"> <th colspan="4" id="dc2" 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 colspan="7" class="fontSize85"><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"> 9 </td> <td class="alignCenter" headers="dr1 dr2 dc1 dc2 dc4"> 0</td> <td class="alignCenter" headers="dr1 dr2 dc1 dc2 dc5"> 8</td> <td class="alignCenter" headers="dr1 dr2 dc1 dc2 dc6"> 1</td> <td class="alignCenter" headers="dr1 dr2 dc1 dc7"> 2</td> <td class="alignCenter" headers="dr1 dr2 dc1 dc8"> 11(11.6%)</td> </tr> <tr> <th id="dr3" class="alignLeft" headers="dr1">6-23m </th> <td class="alignCenter" headers="dr1 dr3 dc1 dc2 dc3"> 16 </td> <td class="alignCenter" headers="dr1 dr3 dc1 dc2 dc4"> 1</td> <td class="alignCenter" headers="dr1 dr3 dc1 dc2 dc5"> 8</td> <td class="alignCenter" headers="dr1 dr3 dc1 dc2 dc6"> 7</td> <td class="alignCenter" headers="dr1 dr3 dc1 dc7"> 0</td> <td class="alignCenter" headers="dr1 dr3 dc1 dc8"> 16(16.8%)</td> </tr> <tr> <th id="dr4" class="alignLeft" headers="dr1">2-4y </th> <td class="alignCenter" headers="dr1 dr4 dc1 dc2 dc3"> 26</td> <td class="alignCenter" headers="dr1 dr4 dc1 dc2 dc4"> 1</td> <td class="alignCenter" headers="dr1 dr4 dc1 dc2 dc5"> 19</td> <td class="alignCenter" headers="dr1 dr4 dc1 dc2 dc6"> 6</td> <td class="alignCenter" headers="dr1 dr4 dc1 dc7"> 5</td> <td class="alignCenter" headers="dr1 dr4 dc1 dc8"> 31(32.6%)</td> </tr> <tr> <th id="dr5" class="alignLeft" headers="dr1">5-9y </th> <td class="alignCenter" headers="dr1 dr5 dc1 dc2 dc3"> 22</td> <td class="alignCenter" headers="dr1 dr5 dc1 dc2 dc4"> 0</td> <td class="alignCenter" headers="dr1 dr5 dc1 dc2 dc5"> 15</td> <td class="alignCenter" headers="dr1 dr5 dc1 dc2 dc6"> 7</td> <td class="alignCenter" headers="dr1 dr5 dc1 dc7"> 4</td> <td class="alignCenter" headers="dr1 dr5 dc1 dc8"> 26(27.4%)</td> </tr> <tr> <th id="dr6" class="alignLeft" headers="dr1">10-16y </th> <td class="alignCenter" headers="dr1 dr6 dc1 dc2 dc3"> 9</td> <td class="alignCenter" headers="dr1 dr6 dc1 dc2 dc4"> 0</td> <td class="alignCenter" headers="dr1 dr6 dc1 dc2 dc5"> 5</td> <td class="alignCenter" headers="dr1 dr6 dc1 dc2 dc6"> 4</td> <td class="alignCenter" headers="dr1 dr6 dc1 dc7"> 2</td> <td class="alignCenter" headers="dr1 dr6 dc1 dc8"> 11(11.6%)</td> </tr> <tr> <th id="dr7" class="alignLeft" headers="dr1">Total </th> <td class="alignCenter" headers="dr1 dr7 dc1 dc2 dc3"> 82</td> <td class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc4"> 2</td> <td class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc5"> 55</td> <td class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc6"> 25</td> <td class="alignCenter" headers="dr1 dr7 dc1 dc7"> 13</td> <td class="alignCenter" headers="dr1 dr7 dc1 dc8"> 95</td> </tr> <tr> <th id="dr8" class="alignLeft" headers="dr1">% <sup>1</sup></th> <td class="alignCenter" headers="dr1 dr8 dc1 dc2 dc3"> 86.3% </td> <td class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc4"> 2.4% </td> <td class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc5"> 67.1% </td> <td class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc6"> 30.5% </td> <td class="alignCenter" headers="dr1 dr8 dc1 dc7"> 13.7% </td> <td class="alignCenter" headers="dr1 dr8 dc1 dc8"> 100.0% </td> </tr> </tbody> </table>
    <table class="widthFull" border="1" cellpadding="2" cellspacing="0"> <caption class="alignCenter"> Table 5 - Cumulative numbers of adult hospitalizations with influenza reported by the PCIRN-SOS network, Canada, 2014-15 </caption> <thead> <tr class="bg-colour-yellow"> <th rowspan="3" id="er1">Age groups </th> <th id="ec1" colspan="6" class="noWrap">Cumulative (15 November 2014 to 6 December 2014)</th> </tr> <tr class="bg-colour-yellow"> <th colspan="4" id="ec2" 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 colspan="7" class="fontSize85"><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.</td> </tr> </tfoot> <tbody> <tr> <th id="er2" class="alignLeft" headers="er1">16-20 </th> <td class="alignCenter" headers="er1 er2 ec1 ec2 ec3"> 2</td> <td class="alignCenter" headers="er1 er2 ec1 ec2 ec4"> 0</td> <td class="alignCenter" headers="er1 er2 ec1 ec2 ec5"> 0</td> <td class="alignCenter" headers="er1 er2 ec1 ec2 ec6"> 2</td> <td class="alignCenter" headers="er1 er2 ec1 ec7"> 0</td> <td class="alignCenter" headers="er1 er2 ec1 ec8"> 2(3%)</td> </tr> <tr> <th id="er3" class="alignLeft" headers="er1">20-44 </th> <td class="alignCenter" headers="er1 er3 ec1 ec2 ec3"> 3</td> <td class="alignCenter" headers="er1 er3 ec1 ec2 ec4"> 0</td> <td class="alignCenter" headers="er1 er3 ec1 ec2 ec5"> 1</td> <td class="alignCenter" headers="er1 er3 ec1 ec2 ec6"> 2</td> <td class="alignCenter" headers="er1 er3 ec1 ec7"> 1</td> <td class="alignCenter" headers="er1 er3 ec1 ec8">4(6%)</td> </tr> <tr> <th id="er4" class="alignLeft" headers="er1">45-64 </th> <td class="alignCenter" headers="er1 er4 ec1 ec2 ec3"> 4</td> <td class="alignCenter" headers="er1 er4 ec1 ec2 ec4"> 0</td> <td class="alignCenter" headers="er1 er4 ec1 ec2 ec5"> 1</td> <td class="alignCenter" headers="er1 er4 ec1 ec2 ec6"> 3</td> <td class="alignCenter" headers="er1 er4 ec1 ec7"> 0</td> <td class="alignCenter" headers="er1 er4 ec1 ec8">4(6%)</td> </tr> <tr> <th id="er5" class="alignLeft" headers="er1">65+ </th> <td class="alignCenter" headers="er1 er5 ec1 ec2 ec3"> 61</td> <td class="alignCenter" headers="er1 er5 ec1 ec2 ec4"> 0</td> <td class="alignCenter" headers="er1 er5 ec1 ec2 ec5"> 9</td> <td class="alignCenter" headers="er1 er5 ec1 ec2 ec6"> 52</td> <td class="alignCenter" headers="er1 er5 ec1 ec7"> 0</td> <td class="alignCenter" headers="er1 er5 ec1 ec8"> 61(86%)</td> </tr> <tr> <th id="er6" class="alignLeft" headers="er1">Total </th> <td class="alignCenter" headers="er1 er6 ec1 ec2 ec3"> 70</td> <td class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec4"> 0</td> <td class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec5"> 11</td> <td class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec6"> 59</td> <td class="alignCenter" headers="er1 er6 ec1 ec7"> 1</td> <td class="alignCenter" headers="er1 er6 ec1 ec8"> 71</td> </tr> <tr> <th id="er7" class="alignLeft" headers="er1">% <sup>1</sup> </th> <td class="alignCenter" headers="er1 er7 ec1 ec2 ec3">99%</td> <td class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec4"> 0%</td> <td class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec5"> 16%</td> <td class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec6"> 84%</td> <td class="alignCenter" headers="er1 er7 ec1 ec7">1%</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, 2014-15
    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, 2014-15
    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 49, 45 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories*; all but one with influenza A, and 67% were patients ≥65 years of age. Since the start of the 2014-15 season, 312 hospitalizations have been reported; 301 (97%) with influenza A. Among cases for which the subtype of influenza A was reported, 99% (245/247) were A(H3N2). The majority of cases (60%) were ≥65 years of age (Table 6). Seven ICU admissions have been reported in adults ≥65 years of age with influenza A. Twenty-three deaths with influenza A have been reported: one child <5 years of age, one adult 45-64 years and 21 adults ≥65 years of age. 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. 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. 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.
    <table class="widthFull" id="t6" border="1" cellpadding="2" cellspacing="0"> <caption class="alignCenter"> Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2014-15 </caption> <thead> <tr class="bg-colour-yellow"> <th id="fr1" rowspan="3">Age groups </th> <th id="fc1" colspan="6">Cumulative (24 August 2014 to 6 December 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 class="bg-colour-blue" id="fc4" headers="fc1 fc2">A(H1) pdm09 </th> <th class="bg-colour-blue" id="fc5" headers="fc1 fc2">A(H3) </th> <th class="bg-colour-blue" id="fc6" 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 colspan="8" class="fontSize85"><sup>1</sup> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
    UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</td> </tr> </tfoot> <tbody> <tr> <th class="alignLeft" id="fr2" headers="fr1">0-4 years </th> <td class="alignCenter" headers="fr1 fr2 fc1 fc2 fc3"> 33 </td> <td class="alignCenter" headers="fr1 fr2 fc1 fc2 fc4"> 1</td> <td class="alignCenter" headers="fr1 fr2 fc1 fc2 fc5"> 28</td> <td class="alignCenter" headers="fr1 fr2 fc1 fc2 fc6"> 4</td> <td class="alignCenter" headers="fr1 fr2 fc1 fc7"> 0 </td> <td class="alignCenter" headers="fr1 fr2 fc1 fc8">33 (11%) </td> </tr> <tr> <th class="alignLeft" id="fr3" headers="fr1">5-19 years </th> <td class="alignCenter" headers="fr1 fr3 fc1 fc2 fc3"> 25</td> <td class="alignCenter" headers="fr1 fr3 fc1 fc2 fc4"> 0 </td> <td class="alignCenter" headers="fr1 fr3 fc1 fc2 fc5"> 21</td> <td class="alignCenter" headers="fr1 fr3 fc1 fc2 fc6"> 4</td> <td class="alignCenter" headers="fr1 fr3 fc1 fc7"> 1</td> <td class="alignCenter" headers="fr1 fr3 fc1 fc8"> 26 (8%) </td> </tr> <tr> <th class="alignLeft" id="fr4" headers="fr1">20-44 years </th> <td class="alignCenter" headers="fr1 fr4 fc1 fc2 fc3"> 24 </td> <td class="alignCenter" headers="fr1 fr4 fc1 fc2 fc4"> 1 </td> <td class="alignCenter" headers="fr1 fr4 fc1 fc2 fc5"> 19</td> <td class="alignCenter" headers="fr1 fr4 fc1 fc2 fc6"> 4</td> <td class="alignCenter" headers="fr1 fr4 fc1 fc7"> 3</td> <td class="alignCenter" headers="fr1 fr4 fc1 fc8"> 27 (9%) </td> </tr> <tr> <th class="alignLeft" id="fr5" headers="fr1">45-64 years </th> <td class="alignCenter" headers="fr1 fr5 fc1 fc2 fc3"> 33 </td> <td class="alignCenter" headers="fr1 fr5 fc1 fc2 fc4"> 0 </td> <td class="alignCenter" headers="fr1 fr5 fc1 fc2 fc5"> 25</td> <td class="alignCenter" headers="fr1 fr5 fc1 fc2 fc6"> 8</td> <td class="alignCenter" headers="fr1 fr5 fc1 fc7"> 2 </td> <td class="alignCenter" headers="fr1 fr5 fc1 fc8"> 35 (11%) </td> </tr> <tr> <th class="alignLeft" id="fr6" headers="fr1">65+ years </th> <td class="alignCenter" headers="fr1 fr6 fc1 fc2 fc3"> 182</td> <td class="alignCenter" headers="fr1 fr6 fc1 fc2 fc4"> 0</td> <td class="alignCenter" headers="fr1 fr6 fc1 fc2 fc5"> 148</td> <td class="alignCenter" headers="fr1 fr6 fc1 fc2 fc6"> 34</td> <td class="alignCenter" headers="fr1 fr6 fc1 fc7"> 5</td> <td class="alignCenter" headers="fr1 fr6 fc1 fc8"> 187 (60%) </td> </tr> <tr> <th class="alignLeft" id="fr7" headers="fr1">Unknown</th> <td class="alignCenter" headers="fr1 fr7 fc1 fc2 fc3"> 4 </td> <td class="alignCenter" headers="fr1 fr7 fc1 fc2 fc4"> 0 </td> <td class="alignCenter" headers="fr1 fr7 fc1 fc2 fc5"> 4</td> <td class="alignCenter" headers="fr1 fr7 fc1 fc2 fc6"> 0 </td> <td class="alignCenter" headers="fr1 fr7 fc1 fc7"> 0 </td> <td class="alignCenter" headers="fr1 fr7 fc1 fc8"> 4 (1%) </td> </tr> <tr> <th class="alignLeft" id="fr8" headers="fr1">Total </th> <td class="alignCenter" headers="fr1 fr8 fc1 fc2 fc3"> 301 </td> <td class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc4"> 2</td> <td class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc5">245</td> <td class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc6"> 54</td> <td class="alignCenter" headers="fr1 fr8 fc1 fc7"> 11</td> <td class="alignCenter" headers="fr1 fr8 fc1 fc8"> 312</td> </tr> <tr> <th class="alignLeft" id="fr9" headers="fr1">Percentage <sup> 1</sup></th> <td class="alignCenter" headers="fr1 fr9 fc1 fc2 fc3"> 96.5% </td> <td class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc4"> 0.7% </td> <td class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc5"> 81.4% </td> <td class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc6"> 17.9% </td> <td class="alignCenter" headers="fr1 fr9 fc1 fc7"> 3.5% </td> <td class="alignCenter" headers="fr1 fr9 fc1 fc8"> 100.0% </td> </tr> </tbody> </table> See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2014-15 on the Public Health Agency of Canada website.
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    Re: Canada FluWatch Weekly Reports 2014-2015 Season Week 48

    FluWatch report: November 23 to November 29, 2014 (Week 48)

    Posted 2014-12-05 For readers interested in the <abbr title="Portable Document Format">PDF</abbr> version, the document is available for downloading or viewing:
    <a href="http://www.phac-aspc.gc.ca/fluwatch/14-15/w48_14/pdf/fw2014-48-eng.pdf" title="Flu Watch (Version PDF, 288 KB - 10 pages)">FluWatch report: November 23 to November 29, 2014 (Week 48) (<abbr title="Portable Document Format">PDF</abbr> Version - 346 <abbr title="Kilobytes">KB</abbr> - 10 pages)

    ?? Help with PDF documents

    Overall Summary
    • In week 48, laboratory detections of influenza increased sharply for the second consecutive week (twice the number detected in week 47) and hospitalizations with influenza also increased. The majority of laboratory detections and hospitalizations continued to be reported in BC, AB, ON and QC; but with increasing activity in SK and MB.
    • A(H3N2) continues to be the most common type of influenza affecting Canadians. In both laboratory detections and hospitalizations, the majority of cases have been among seniors ≥65 years of age.
    • Similar to the previous week, there was a large number of newly-reported laboratory-confirmed outbreaks of influenza in week 48: 21 reported in 5 provinces, of which 17 were in long-term care facilities.


    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 48, one region in BC reported widespread activity, 13 regions (in BC(1), AB(3), SK(1), ON(4), QC(3), and NL(1)) reported localized activity and 14 regions (BC(1), AB(2), SK(2), MB(2), ON(1), QC(3), NB(1), PE(1) and YT(1)) reported sporadic activity (Figure 1).
    Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 48





    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

    In week 48, the number of positive influenza tests increased sharply for the second week in a row, to 630 influenza detections (15.2% of tests), predominantly due to influenza A (Figure 2). To date, 94% of influenza detections have been influenza A, and 99% of those subtyped have been A(H3) (Table 1). The timing of the season and predominant A(H3N2) subtype is similar to the pattern observed during the 2012-13 influenza season. To date, among the cases of influenza A with reported age, the largest proportion was in adults ≥65 years of age (61%) (Table 2).
    Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2014-15

    Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
    In week 48, detections of RSV continued to follow an upward trend, in keeping with its usual pattern of seasonal circulation. Detections of parainfluenza and adenovirus also continue to follow their seasonal patterns of broad winter circulation. Detections of rhinovirus peaked in week 39 and continue to follow a downward trend (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, 2014-15


    Top of Page

    RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
    Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
    <table class="widthFull" id="t1" border="1" cellpadding="2" cellspacing="0"> <caption class="alignCenter"> Table 1: Weekly and cumulative numbers of positive influenza specimens
    by type, subtype and province, Canada, 2014-15
    </caption> <thead> <tr class="bg-colour-yellow"> <th id="ar1" rowspan="3">Reporting provinces <sup>1</sup></th> <th id="ac1" colspan="5">Weekly
    (November 23 to 29, 2014, 2014)</th> <th id="ac8" colspan="5">Cumulative
    (August 24 to November 29, 2014)</th> </tr> <tr class="bg-colour-yellow"> <th id="ac2" colspan="4" headers="ac1">Influenza A</th> <th id="ac7" headers="ac1">B</th> <th id="ac9" colspan="4" headers="ac8">Influenza A</th> <th id="ac14" headers="ac8">B</th> </tr> <tr class="bg-colour-grey-light"> <th id="ac3" headers="ac1 ac2">A Total</th> <th id="ac4" class=" 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 colspan="11" class="fontSize85"><sup>1 </sup> Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
    <sup>2 </sup> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
    UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</td> </tr> </tfoot> <tbody> <tr> <th id="ar2" class="alignLeft" headers="ar1">BC</th> <td class="alignRight" headers="ar1 ar2 ac1 ac2 ac3"> 32 </td> <td class="alignRight" headers="ar1 ar2 ac1 ac2 ac4"> 0 </td> <td class="alignRight" headers="ar1 ar2 ac1 ac2 ac5"> 22 </td> <td class="alignRight" headers="ar1 ar2 ac1 ac2 ac6"> 10 </td> <td class="alignRight" headers="ar1 ar2 ac1 ac7"> 0 </td> <td class="alignRight" headers="ar1 ar2 ac8 ac9 ac10"> 131 </td> <td class="alignRight" headers="ar1 ar2 ac8 ac9 ac11"> 2 </td> <td class="alignRight" headers="ar1 ar2 ac8 ac9 ac12"> 118 </td> <td class="alignRight" headers="ar1 ar2 ac8 ac9 ac13"> 11 </td> <td class="alignRight" headers="ar1 ar2 ac8 ac14"> 9 </td> </tr> <tr> <th id="ar3" class="alignLeft" headers="ar1">AB</th> <td class="alignRight" headers="ar1 ar3 ac1 ac2 ac3"> 228 </td> <td class="alignRight" headers="ar1 ar3 ac1 ac2 ac4"> 0 </td> <td class="alignRight" headers="ar1 ar3 ac1 ac2 ac5"> 195 </td> <td class="alignRight" headers="ar1 ar3 ac1 ac2 ac6"> 33 </td> <td class="alignRight" headers="ar1 ar3 ac1 ac7"> 7 </td> <td class="alignRight" headers="ar1 ar3 ac8 ac9 ac10"> 589 </td> <td class="alignRight" headers="ar1 ar3 ac8 ac9 ac11"> 0 </td> <td class="alignRight" headers="ar1 ar3 ac8 ac9 ac12"> 545 </td> <td class="alignRight" headers="ar1 ar3 ac8 ac9 ac13"> 44 </td> <td class="alignRight" headers="ar1 ar3 ac8 ac14"> 30 </td> </tr> <tr> <th id="ar4" class="alignLeft" headers="ar1">SK</th> <td class="alignRight" headers="ar1 ar4 ac1 ac2 ac3"> 14 </td> <td class="alignRight" headers="ar1 ar4 ac1 ac2 ac4"> 0 </td> <td class="alignRight" headers="ar1 ar4 ac1 ac2 ac5"> 9 </td> <td class="alignRight" headers="ar1 ar4 ac1 ac2 ac6"> 5 </td> <td class="alignRight" headers="ar1 ar4 ac1 ac7"> 1 </td> <td class="alignRight" headers="ar1 ar4 ac8 ac9 ac10"> 25 </td> <td class="alignRight" headers="ar1 ar4 ac8 ac9 ac11"> 0 </td> <td class="alignRight" headers="ar1 ar4 ac8 ac9 ac12"> 14 </td> <td class="alignRight" headers="ar1 ar4 ac8 ac9 ac13"> 11 </td> <td class="alignRight" headers="ar1 ar4 ac8 ac14"> 1 </td> </tr> <tr> <th id="ar5" class="alignLeft" headers="ar1">MB</th> <td class="alignRight" headers="ar1 ar5 ac1 ac2 ac3"> 6 </td> <td class="alignRight" headers="ar1 ar5 ac1 ac2 ac4"> 0 </td> <td class="alignRight" headers="ar1 ar5 ac1 ac2 ac5"> 1 </td> <td class="alignRight" headers="ar1 ar5 ac1 ac2 ac6"> 5 </td> <td class="alignRight" headers="ar1 ar5 ac1 ac7"> 0 </td> <td class="alignRight" headers="ar1 ar5 ac8 ac9 ac10"> 12 </td> <td class="alignRight" headers="ar1 ar5 ac8 ac9 ac11"> 0 </td> <td class="alignRight" headers="ar1 ar5 ac8 ac9 ac12"> 7 </td> <td class="alignRight" headers="ar1 ar5 ac8 ac9 ac13"> 5 </td> <td class="alignRight" headers="ar1 ar5 ac8 ac14"> 1 </td> </tr> <tr> <th id="ar6" class="alignLeft" headers="ar1">ON</th> <td class="alignRight" headers="ar1 ar6 ac1 ac2 ac3"> 82 </td> <td class="alignRight" headers="ar1 ar6 ac1 ac2 ac4"> 0 </td> <td class="alignRight" headers="ar1 ar6 ac1 ac2 ac5"> 57 </td> <td class="alignRight" headers="ar1 ar6 ac1 ac2 ac6"> 25 </td> <td class="alignRight" headers="ar1 ar6 ac1 ac7"> 1 </td> <td class="alignRight" headers="ar1 ar6 ac8 ac9 ac10"> 206 </td> <td class="alignRight" headers="ar1 ar6 ac8 ac9 ac11"> 4 </td> <td class="alignRight" headers="ar1 ar6 ac8 ac9 ac12"> 147 </td> <td class="alignRight" headers="ar1 ar6 ac8 ac9 ac13"> 55 </td> <td class="alignRight" headers="ar1 ar6 ac8 ac14"> 16 </td> </tr> <tr> <th id="ar7" class="alignLeft" headers="ar1">QC</th> <td class="alignRight" headers="ar1 ar7 ac1 ac2 ac3"> 244 </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"> 244 </td> <td class="alignRight" headers="ar1 ar7 ac1 ac7"> 12 </td> <td class="alignRight" headers="ar1 ar7 ac8 ac9 ac10"> 396 </td> <td class="alignRight" headers="ar1 ar7 ac8 ac9 ac11"> 0 </td> <td class="alignRight" headers="ar1 ar7 ac8 ac9 ac12"> 0 </td> <td class="alignRight" headers="ar1 ar7 ac8 ac9 ac13"> 396 </td> <td class="alignRight" headers="ar1 ar7 ac8 ac14"> 30 </td> </tr> <tr> <th id="ar8" class="alignLeft" headers="ar1">NB</th> <td class="alignRight" headers="ar1 ar8 ac1 ac2 ac3"> 1 </td> <td class="alignRight" headers="ar1 ar8 ac1 ac2 ac4"> 0 </td> <td class="alignRight" headers="ar1 ar8 ac1 ac2 ac5"> 1 </td> <td class="alignRight" headers="ar1 ar8 ac1 ac2 ac6"> 0 </td> <td class="alignRight" headers="ar1 ar8 ac1 ac7"> 0 </td> <td class="alignRight" headers="ar1 ar8 ac8 ac9 ac10"> 3 </td> <td class="alignRight" headers="ar1 ar8 ac8 ac9 ac11"> 0 </td> <td class="alignRight" headers="ar1 ar8 ac8 ac9 ac12"> 1 </td> <td class="alignRight" headers="ar1 ar8 ac8 ac9 ac13"> 2 </td> <td class="alignRight" headers="ar1 ar8 ac8 ac14"> 0 </td> </tr> <tr> <th id="ar9" class="alignLeft" headers="ar1">NS</th> <td class="alignRight" headers="ar1 ar9 ac1 ac2 ac3"> 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"> 1 </td> <td class="alignRight" headers="ar1 ar9 ac8 ac9 ac11"> 0 </td> <td class="alignRight" headers="ar1 ar9 ac8 ac9 ac12"> 1 </td> <td class="alignRight" headers="ar1 ar9 ac8 ac9 ac13"> 0 </td> <td class="alignRight" headers="ar1 ar9 ac8 ac14"> 2 </td> </tr> <tr> <th id="ar10" class="alignLeft" headers="ar1">PE</th> <td class="alignRight" headers="ar1 ar10 ac1 ac2 ac3"> 2 </td> <td class="alignRight" headers="ar1 ar10 ac1 ac2 ac4"> 0 </td> <td class="alignRight" headers="ar1 ar10 ac1 ac2 ac5"> 2 </td> <td class="alignRight" headers="ar1 ar10 ac1 ac2 ac6"> 0 </td> <td class="alignRight" headers="ar1 ar10 ac1 ac7"> 0 </td> <td class="alignRight" headers="ar1 ar10 ac8 ac9 ac10"> 4 </td> <td class="alignRight" headers="ar1 ar10 ac8 ac9 ac11"> 0 </td> <td class="alignRight" headers="ar1 ar10 ac8 ac9 ac12"> 3 </td> <td class="alignRight" headers="ar1 ar10 ac8 ac9 ac13"> 1 </td> <td class="alignRight" headers="ar1 ar10 ac8 ac14"> 1 </td> </tr> <tr> <th id="ar11" class="alignLeft" headers="ar1">NL</th> <td class="alignRight" headers="ar1 ar11 ac1 ac2 ac3"> 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"> 0 </td> <td class="alignRight" headers="ar1 ar11 ac8 ac9 ac10"> 2 </td> <td class="alignRight" headers="ar1 ar11 ac8 ac9 ac11"> 0 </td> <td class="alignRight" headers="ar1 ar11 ac8 ac9 ac12"> 1 </td> <td class="alignRight" headers="ar1 ar11 ac8 ac9 ac13"> 1 </td> <td class="alignRight" headers="ar1 ar11 ac8 ac14"> 0 </td> </tr> <tr> <th id="ar12" class="alignLeft" headers="ar1">Canada</th> <td class="alignRight" headers="ar1 ar12 ac1 ac2 ac3"> 609 </td> <td class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac4"> 0 </td> <td class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac5"> 287 </td> <td class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac6"> 322 </td> <td class="alignRight" headers="ar1 ar12 ac1 ac7"> 21 </td> <td class="alignRight" headers="ar1 ar12 ac8 ac9 ac10"> 1369 </td> <td class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac11"> 6 </td> <td class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac12"> 837 </td> <td class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac13"> 526 </td> <td class="alignRight" headers="ar1 ar12 ac8 ac14"> 90 </td> </tr> <tr> <th id="ar13" class="alignLeft" headers="ar1">Percentage<sup>2</sup></th> <td class="alignRight" headers="ar1 ar13 ac1 ac2 ac3"> 96.7% </td> <td class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac4"> 0.0% </td> <td class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac5"> 47.1% </td> <td class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac6"> 52.9% </td> <td class="alignRight" headers="ar1 ar13 ac1 ac7"> 3.3% </td> <td class="alignRight" headers="ar1 ar13 ac8 ac9 ac10"> 93.8% </td> <td class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac11"> 0.4% </td> <td class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac12"> 61.1% </td> <td class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac13"> 38.4% </td> <td class="alignRight" headers="ar1 ar13 ac8 ac14"> 6.2% </td> </tr> </tbody> </table>

    <table class="widthFull" id="t2" border="1" cellpadding="2" cellspacing="0"> <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, 2014-15 </caption> <thead> <tr class="bg-colour-yellow"> <th rowspan="3" id="br1">Age groups (years)</th> <th colspan="5" id="bc1">Weekly
    (November 23 to November 29, 2014)</th> <th colspan="7" id="bc8">Cumulative
    (August 24 to November 29, 2014)</th> </tr> <tr class="bg-colour-yellow"> <th colspan="4" id="bc2" headers="bc1">Influenza A</th> <th id="bc7" headers="bc1">B</th> <th colspan="4" id="bc9" headers="bc8">Influenza A</th> <th id="bc14" headers="bc8">B</th> <th colspan="2" id="bc15" headers="bc8">Influenza A and B</th> </tr> <tr class="bg-colour-grey-light"> <th id="bc3" headers="bc1 bc2">A Total</th> <th class="bg-colour-blue " id="bc4" headers="bc1 bc2">A(H1) pdm09</th> <th class="bg-colour-blue " id="bc5" headers="bc1 bc2">A(H3)</th> <th class="bg-colour-blue " id="bc6" headers="bc1 bc2">A (UnS)</th> <td headers="bc1 bc7" class="alignCenter">Total</td> <th id="bc10" headers="bc8 bc9">A Total</th> <th class="bg-colour-blue " id="bc11" headers="bc8 bc9">A(H1) pdm09</th> <th class="bg-colour-blue" id="bc12" headers="bc8 bc9">A(H3)</th> <th class="bg-colour-blue " id="bc13" headers="bc8 bc9">A (UnS)</th> <td headers="bc8 bc14" class="alignCenter">Total</td> <th id="bc16" headers="bc8 bc15">#</th> <th id="bc17" headers="bc8 bc15">%</th> </tr> </thead> <tfoot> <tr> <td colspan="13" class="fontSize85"><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 class="alignLeft" id="br2" headers="br1"><5</th> <td class="alignRight" headers="br1 br2 bc1 bc2 bc3"> 48 </td> <td class="alignRight" headers="br1 br2 bc1 bc2 bc4"> 0 </td> <td class="alignRight" headers="br1 br2 bc1 bc2 bc5"> 34 </td> <td class="alignRight" headers="br1 br2 bc1 bc2 bc6"> 14 </td> <td class="alignRight" headers="br1 br2 bc1 bc7"> 2 </td> <td class="alignRight" headers="br1 br2 bc8 bc9 bc10"> 29 </td> <td class="alignRight" headers="br1 br2 bc8 bc9 bc11"> 2 </td> <td class="alignRight" headers="br1 br2 bc8 bc9 bc12"> 14 </td> <td class="alignRight" headers="br1 br2 bc8 bc9 bc13"> 13 </td> <td class="alignRight" headers="br1 br2 bc8 bc14"> 7 </td> <td class="alignRight" headers="br1 br2 bc8 bc15 bc16"> 36 </td> <td class="alignRight" headers="br1 br2 bc8 bc15 bc17"> 3.5% </td> </tr> <tr> <th class="alignLeft" id="br3" headers="br1">5-19</th> <td class="alignRight" headers="br1 br3 bc1 bc2 bc3"> 52 </td> <td class="alignRight" headers="br1 br3 bc1 bc2 bc4"> 0 </td> <td class="alignRight" headers="br1 br3 bc1 bc2 bc5"> 35 </td> <td class="alignRight" headers="br1 br3 bc1 bc2 bc6"> 17 </td> <td class="alignRight" headers="br1 br3 bc1 bc7"> 4 </td> <td class="alignRight" headers="br1 br3 bc8 bc9 bc10"> 71 </td> <td class="alignRight" headers="br1 br3 bc8 bc9 bc11"> 2 </td> <td class="alignRight" headers="br1 br3 bc8 bc9 bc12"> 36 </td> <td class="alignRight" headers="br1 br3 bc8 bc9 bc13"> 33 </td> <td class="alignRight" headers="br1 br3 bc8 bc14"> 9 </td> <td class="alignRight" headers="br1 br3 bc8 bc15 bc16"> 80 </td> <td class="alignRight" headers="br1 br3 bc8 bc15 bc17"> 7.8% </td> </tr> <tr> <th class="alignLeft" id="br4" headers="br1">20-44</th> <td class="alignRight" headers="br1 br4 bc1 bc2 bc3"> 67 </td> <td class="alignRight" headers="br1 br4 bc1 bc2 bc4"> 0 </td> <td class="alignRight" headers="br1 br4 bc1 bc2 bc5"> 36 </td> <td class="alignRight" headers="br1 br4 bc1 bc2 bc6"> 31 </td> <td class="alignRight" headers="br1 br4 bc1 bc7"> 7 </td> <td class="alignRight" headers="br1 br4 bc8 bc9 bc10"> 87 </td> <td class="alignRight" headers="br1 br4 bc8 bc9 bc11"> 0 </td> <td class="alignRight" headers="br1 br4 bc8 bc9 bc12"> 44 </td> <td class="alignRight" headers="br1 br4 bc8 bc9 bc13"> 43 </td> <td class="alignRight" headers="br1 br4 bc8 bc14"> 20 </td> <td class="alignRight" headers="br1 br4 bc8 bc15 bc16"> 107 </td> <td class="alignRight" headers="br1 br4 bc8 bc15 bc17"> 10.4% </td> </tr> <tr> <th class="alignLeft" id="br5" headers="br1">45-64</th> <td class="alignRight" headers="br1 br5 bc1 bc2 bc3"> 72 </td> <td class="alignRight" headers="br1 br5 bc1 bc2 bc4"> 0 </td> <td class="alignRight" headers="br1 br5 bc1 bc2 bc5"> 27 </td> <td class="alignRight" headers="br1 br5 bc1 bc2 bc6"> 45 </td> <td class="alignRight" headers="br1 br5 bc1 bc7"> 7 </td> <td class="alignRight" headers="br1 br5 bc8 bc9 bc10"> 159 </td> <td class="alignRight" headers="br1 br5 bc8 bc9 bc11"> 0 </td> <td class="alignRight" headers="br1 br5 bc8 bc9 bc12"> 105 </td> <td class="alignRight" headers="br1 br5 bc8 bc9 bc13"> 54 </td> <td class="alignRight" headers="br1 br5 bc8 bc14"> 13 </td> <td class="alignRight" headers="br1 br5 bc8 bc15 bc16"> 172 </td> <td class="alignRight" headers="br1 br5 bc8 bc15 bc17"> 16.8% </td> </tr> <tr> <th class="alignLeft" id="br6" headers="br1">65+</th> <td class="alignRight" headers="br1 br6 bc1 bc2 bc3"> 282 </td> <td class="alignRight" headers="br1 br6 bc1 bc2 bc4"> 0 </td> <td class="alignRight" headers="br1 br6 bc1 bc2 bc5"> 83 </td> <td class="alignRight" headers="br1 br6 bc1 bc2 bc6"> 199 </td> <td class="alignRight" headers="br1 br6 bc1 bc7"> 12 </td> <td class="alignRight" headers="br1 br6 bc8 bc9 bc10"> 604 </td> <td class="alignRight" headers="br1 br6 bc8 bc9 bc11"> 1 </td> <td class="alignRight" headers="br1 br6 bc8 bc9 bc12"> 357 </td> <td class="alignRight" headers="br1 br6 bc8 bc9 bc13"> 246 </td> <td class="alignRight" headers="br1 br6 bc8 bc14"> 25 </td> <td class="alignRight" headers="br1 br6 bc8 bc15 bc16"> 629 </td> <td class="alignRight" headers="br1 br6 bc8 bc15 bc17"> 61.4% </td> </tr> <tr> <th class="alignLeft" id="br7" headers="br1">Unknown</th> <td class="alignRight" headers="br1 br7 bc1 bc2 bc3"> 0 </td> <td class="alignRight" headers="br1 br7 bc1 bc2 bc4"> 0 </td> <td class="alignRight" headers="br1 br7 bc1 bc2 bc5"> 0 </td> <td class="alignRight" headers="br1 br7 bc1 bc2 bc6"> 0 </td> <td class="alignRight" headers="br1 br7 bc1 bc7"> 0 </td> <td class="alignRight" headers="br1 br7 bc8 bc9 bc10"> 1 </td> <td class="alignRight" headers="br1 br7 bc8 bc9 bc11"> 0 </td> <td class="alignRight" headers="br1 br7 bc8 bc9 bc12"> 0 </td> <td class="alignRight" headers="br1 br7 bc8 bc9 bc13"> 1 </td> <td class="alignRight" headers="br1 br7 bc8 bc14"> 0 </td> <td class="alignRight" headers="br1 br7 bc8 bc15 bc16"> 1 </td> <td class="alignRight" headers="br1 br7 bc8 bc15 bc17"> 0.1% </td> </tr> <tr> <th class="alignLeft" id="br8" headers="br1">Total</th> <td class="alignRight" headers="br1 br8 bc1 bc2 bc3"> 521 </td> <td class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc4"> 0 </td> <td class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc5"> 215 </td> <td class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc6"> 306 </td> <td class="alignRight" headers="br1 br8 bc1 bc7"> 32 </td> <td class="alignRight" headers="br1 br8 bc8 bc9 bc10"> 951 </td> <td class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc11"> 5 </td> <td class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc12"> 556 </td> <td class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc13"> 390 </td> <td class="alignRight" headers="br1 br8 bc8 bc14"> 74 </td> <td class="alignRight" headers="br1 br8 bc8 bc15 bc16"> 1025 </td> <td class="alignRight" headers="br1 br8 bc8 bc15 bc17"> 100.0% </td> </tr> <tr> <th class="alignLeft" id="br9" headers="br1">Percentage<sup>2</sup></th> <td class="alignRight" headers="br1 br9 bc1 bc2 bc3"> 94.2% </td> <td class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc4"> 0.0% </td> <td class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc5"> 41.3% </td> <td class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc6"> 58.7% </td> <td class="alignRight" headers="br1 br9 bc1 bc7"> 5.8% </td> <td class="alignRight" headers="br1 br9 bc8 bc9 bc10"> 92.8% </td> <td class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc11"> 0.5% </td> <td class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc12"> 58.5% </td> <td class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc13"> 41.0% </td> <td class="alignRight" headers="br1 br9 bc8 bc14"> 7.2% </td> <td class="alignRight"> </td> <td class="alignRight"> </td> </tr> </tbody> </table>

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    Influenza Strain Characterizations

    During the 2014-2015 influenza season, the National Microbiology Laboratory (NML) has characterized 23 influenza viruses [10 A(H3N2) and 13 influenza B]. Two influenza A viruses were antigenically similar to A/Texas/50/2012, and 10 influenza B viruses were antigenically similar to the B/Massachusetts/2/2012 (Yamagata lineage) recommended by the WHO for the 2014-15 seasonal influenza vaccine. Eight influenza A(H3N2) viruses and three influenza B viruses showed reduced titers to antisera produced against strains recommended for the seasonal influenza vaccine (Figure 4).
    Figure 4. Influenza strain characterizations, Canada, 2014-2015, N = 23

    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 2014-2015 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A/Texas/50/2012 (H3N2)-like virus, and a B/Massachusetts/2/2012-like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus is recommended.


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

    During the 2014-2015 influenza season, NML has tested 49 influenza viruses for resistance to oseltamivir and zanamivir and all were sensitive to both agents. The 57 influenza A(H3N2) viruses tested for amantadine resistance were all resistant (Table 3).
    <table class="widthFull" border="1" cellpadding="2" cellspacing="0"> <caption> Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2014-15 </caption> <thead> <tr class="bg-colour-yellow"> <th rowspan="2" id="t3hc1">Virus type and subtype</th> <th colspan="2" id="t3hc2">Oseltamivir</th> <th colspan="2" id="t3hc3">Zanamivir</th> <th colspan="2" id="t3hc4">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 colspan="7" class="fontSize85"> <sup>*</sup> NA - not applicable</td> </tr> </tfoot> <tbody> <tr> <th class="alignLeft bg-colour-blue" id="t3hr1" headers="t3hc1">A (H3N2)</th> <td class="alignRight" headers="t3hr1 t3hc2 t3hc5">36</td> <td class="alignRight" headers="t3hr1 t3hc2 t3hc6">0</td> <td class="alignRight" headers="t3hr1 t3hc3 t3hc7">36</td> <td class="alignRight" headers="t3hr1 t3hc3 t3hc8">0</td> <td class="alignRight" headers="t3hr1 t3hc4 t3hc9">57</td> <td class="alignRight" headers="t3hr1 t3hc4 t3hc10">57(100%)</td> </tr> <tr> <th class="alignLeft bg-colour-blue" id="t3hr2" headers="t3hc1">A (H1N1)</th> <td class="alignRight" headers="t3hr2 t3hc2 t3hc5">0</td> <td class="alignRight" headers="t3hr2 t3hc2 t3hc6">0</td> <td class="alignRight" headers="t3hr2 t3hc3 t3hc7">0</td> <td class="alignRight" headers="t3hr2 t3hc3 t3hc8">0</td> <td class="alignRight" headers="t3hr2 t3hc4 t3hc9">0</td> <td class="alignRight" headers="t3hr2 t3hc4 t3hc10">0</td> </tr> <tr> <th class="alignLeft bg-colour-blue" id="t3hr3" headers="t3hc1">B</th> <td class="alignRight" headers="t3hr3 t3hc2 t3hc5">13</td> <td class="alignRight" headers="t3hr3 t3hc2 t3hc6">0</td> <td class="alignRight" headers="t3hr3 t3hc3 t3hc7">13</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 class="alignLeft bg-colour-blue" id="t3hr4" headers="t3hc1">TOTAL</th> <td class="alignRight" headers="t3hr4 t3hc2 t3hc5">49</td> <td class="alignRight" headers="t3hr4 t3hc2 t3hc6">0</td> <td class="alignRight" headers="t3hr4 t3hc3 t3hc7">49</td> <td class="alignRight" headers="t3hr4 t3hc3 t3hc8">0</td> <td class="alignRight" headers="t3hr4 t3hc4 t3hc9">57</td> <td class="alignRight" headers="t3hr4 t3hc4 t3hc10">57</td> </tr> </tbody> </table> Influenza-like Illness (ILI) Consultation Rate

    The national influenza-like-illness (ILI) consultation rate increased in week 48 to 29.1 consultations per 1,000, which is above expected levels for week 48 (Figure 5). To date this season, the rates have been highest among those <20 years of age.
    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, 2014-2015

    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. 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 48, 21 new outbreaks of influenza A were reported: 17 in long-term care facilities (LTCF), three in hospitals and one in another institutional or community setting (Figure 6). Among the five LTCF outbreaks in which the influenza subtype was known, all were A(H3N2); the outbreak in another setting was associated with A(H1N1)pdm09. To date this season, 52 outbreaks in LTCF have been reported.
    Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2014-2015

    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

    During week 48, the proportion of prescriptions for antivirals increased to 35.5 antiviral prescriptions per 100,000 total prescriptions, which is in keeping with previous seasons (Figure 7).
    Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2014-15

    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 48, 13 laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network: 12 cases of influenza A and one case of influenza B (Figure 8a). To date this season, 51 hospitalizations have been reported by the IMPACT network, 46 (90%) of which were cases of influenza A. Among cases for which the influenza A subtype was reported, 35/37 were A(H3N2). The majority of cases (67%) were in children <5 years of age (Table 4). To date, six cases were admitted to the ICU (Figure 9a).
    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 48, 26 laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network: 25 cases of influenza A and one case of influenza B (Figure 8b). To date this season, 36 cases have been reported; 35 (97%) with influenza A. The majority of cases (83%) were among adults ≥65 years of age (Table 5). Two ICU admissions and one death have been reported, all adults ≥65 years of age with underlying conditions or comorbidities (Figure 8b).
    Note: The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
    <table class="widthFull" border="1" cellpadding="2" cellspacing="0"> <caption class="alignCenter" id="t4"> Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2014-15 </caption> <thead> <tr class="bg-colour-yellow"> <th rowspan="3" id="dr1">Age groups </th> <th colspan="6" id="dc1">Cumulative (Aug. 24, 2014 to November 29, 2014) </th> </tr> <tr class="bg-colour-yellow"> <th colspan="4" id="dc2" 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 colspan="7" class="fontSize85"><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"> 6 </td> <td class="alignRight" headers="dr1 dr2 dc1 dc2 dc4"> 0</td> <td class="alignRight" headers="dr1 dr2 dc1 dc2 dc5"> 6</td> <td class="alignRight" headers="dr1 dr2 dc1 dc2 dc6"> 0</td> <td class="alignRight" headers="dr1 dr2 dc1 dc7"> 0</td> <td class="alignRight" headers="dr1 dr2 dc1 dc8"> 6 (11.8%)</td> </tr> <tr> <th id="dr3" class="alignLeft" headers="dr1">6-23m </th> <td class="alignRight" headers="dr1 dr3 dc1 dc2 dc3"> 8</td> <td class="alignRight" headers="dr1 dr3 dc1 dc2 dc4"> 1</td> <td class="alignRight" headers="dr1 dr3 dc1 dc2 dc5"> 7</td> <td class="alignRight" headers="dr1 dr3 dc1 dc2 dc6"> 0</td> <td class="alignRight" headers="dr1 dr3 dc1 dc7"> 0</td> <td class="alignRight" headers="dr1 dr3 dc1 dc8"> 8 (15.7%)</td> </tr> <tr> <th id="dr4" class="alignLeft" headers="dr1">2-4y </th> <td class="alignRight" headers="dr1 dr4 dc1 dc2 dc3"> 17</td> <td class="alignRight" headers="dr1 dr4 dc1 dc2 dc4"> 1</td> <td class="alignRight" headers="dr1 dr4 dc1 dc2 dc5"> 13</td> <td class="alignRight" headers="dr1 dr4 dc1 dc2 dc6"> 3</td> <td class="alignRight" headers="dr1 dr4 dc1 dc7"> 1</td> <td class="alignRight" headers="dr1 dr4 dc1 dc8"> 18 (35.3%)</td> </tr> <tr> <th id="dr5" class="alignLeft" headers="dr1">5-9y </th> <td class="alignRight" headers="dr1 dr5 dc1 dc2 dc3"> 7</td> <td class="alignRight" headers="dr1 dr5 dc1 dc2 dc4">0</td> <td class="alignRight" headers="dr1 dr5 dc1 dc2 dc5">4</td> <td class="alignRight" headers="dr1 dr5 dc1 dc2 dc6">3</td> <td class="alignRight" headers="dr1 dr5 dc1 dc7"> 3</td> <td class="alignRight" headers="dr1 dr5 dc1 dc8">10 (19.6%)</td> </tr> <tr> <th id="dr6" class="alignLeft" headers="dr1">10-16y </th> <td class="alignRight" headers="dr1 dr6 dc1 dc2 dc3"> 8</td> <td class="alignRight" headers="dr1 dr6 dc1 dc2 dc4"> 0</td> <td class="alignRight" headers="dr1 dr6 dc1 dc2 dc5"> 5</td> <td class="alignRight" headers="dr1 dr6 dc1 dc2 dc6"> 3</td> <td class="alignRight" headers="dr1 dr6 dc1 dc7"> 1</td> <td class="alignRight" headers="dr1 dr6 dc1 dc8"> 9 (17.6%)</td> </tr> <tr> <th id="dr7" class="alignLeft" headers="dr1">Total </th> <td class="alignRight" headers="dr1 dr7 dc1 dc2 dc3"> 46</td> <td class="alignRight bg-colour-blue" headers="dr1 dr7 dc1 dc2 dc4"> 2</td> <td class="alignRight bg-colour-blue" headers="dr1 dr7 dc1 dc2 dc5"> 35</td> <td class="alignRight bg-colour-blue" headers="dr1 dr7 dc1 dc2 dc6"> 9</td> <td class="alignRight" headers="dr1 dr7 dc1 dc7"> 5</td> <td class="alignRight" headers="dr1 dr7 dc1 dc8"> 51</td> </tr> <tr> <th id="dr8" class="alignLeft" headers="dr1">% <sup>1</sup></th> <td class="alignRight" headers="dr1 dr8 dc1 dc2 dc3"> 90.2% </td> <td class="alignRight bg-colour-blue" headers="dr1 dr8 dc1 dc2 dc4"> 4.3% </td> <td class="alignRight bg-colour-blue" headers="dr1 dr8 dc1 dc2 dc5"> 76.1% </td> <td class="alignRight bg-colour-blue" headers="dr1 dr8 dc1 dc2 dc6"> 19.6% </td> <td class="alignRight" headers="dr1 dr8 dc1 dc7"> 9.8% </td> <td class="alignRight" headers="dr1 dr8 dc1 dc8"> 100.0% </td> </tr> </tbody> </table>
    <table class="widthFull" border="1" cellpadding="2" cellspacing="0"> <caption class="alignCenter"> Table 5 - Cumulative numbers of adult hospitalizations with influenza reported by the PCIRN-SOS network, Canada, 2014-15 </caption> <thead> <tr class="bg-colour-yellow"> <th rowspan="3" id="er1">Age groups </th> <th id="ec1" colspan="6" class="noWrap">Cumulative (23 Nov. 2014 to 29 Nov. 2014)</th> </tr> <tr class="bg-colour-yellow"> <th colspan="4" id="ec2" 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 colspan="7" class="fontSize85"><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.</td> </tr> </tfoot> <tbody> <tr> <th id="er2" class="alignLeft" headers="er1">16-20 </th> <td class="alignRight">2</td> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">2</td> <td class="alignRight">0</td> <td class="alignRight">2 (6%)</td> </tr> <tr> <th id="er3" class="alignLeft" headers="er1">20-44 </th> <td class="alignRight">1</td> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">1</td> <td class="alignRight">1</td> <td class="alignRight">2 (6%)</td> </tr> <tr> <th id="er4" class="alignLeft" headers="er1">45-64 </th> <td class="alignRight">2</td> <td class="alignRight">0</td> <td class="alignRight">1</td> <td class="alignRight">1</td> <td class="alignRight">0</td> <td class="alignRight">2 (6%)</td> </tr> <tr> <th id="er5" class="alignLeft" headers="er1">65+ </th> <td class="alignRight">30</td> <td class="alignRight">0</td> <td class="alignRight">2</td> <td class="alignRight">28</td> <td class="alignRight">0</td> <td class="alignRight">30 (83%)</td> </tr> <tr> <th id="er6" class="alignLeft" headers="er1">Total </th> <td class="alignRight">35</td> <td class="alignRight bg-colour-blue">0</td> <td class="alignRight bg-colour-blue">3</td> <td class="alignRight bg-colour-blue">32</td> <td class="alignRight">1</td> <td class="alignRight">36</td> </tr> <tr> <th id="er7" class="alignLeft" headers="er1">% <sup>1</sup> </th> <td class="alignRight">97%</td> <td class="alignRight bg-colour-blue">0%</td> <td class="alignRight bg-colour-blue">9%</td> <td class="alignRight bg-colour-blue">91%</td> <td class="alignRight">3%</td> <td class="alignRight">100%</td> </tr> </tbody> </table> Figure 8 - Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15
    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)

    * Note: Data for week 46 is based on data collected for 1 day only and do not represent the number of hospitalizations for the entire week.
    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, 2014-15
    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 48, 50 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories<sup>*</sup>; all but one with influenza A, and 78% were patients ≥65 years of age. Since the start of the 2014-15 season, 224 hospitalizations have been reported; 215 (96%) with influenza A. Among cases for which the subtype of influenza A was reported, 175/177 were A(H3N2). The majority of cases (59%) were ≥65 years of age (Table 6). Three ICU admissions have been reported in adults ≥65 years of age with influenza A. Eighteen deaths with influenza A have been reported: one child <5 years of age, one adult 45-64 years and 16 adults ≥65 years of age. 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. 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. 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.
    <table class="widthFull" id="t6" border="1" cellpadding="2" cellspacing="0"> <caption class="alignCenter"> Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2014-15 </caption> <thead> <tr class="bg-colour-yellow"> <th id="fr1" rowspan="3">Age groups </th> <th id="fc1" colspan="6">Cumulative (24 August 2014 to 29 November 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 class="bg-colour-blue" id="fc4" headers="fc1 fc2">A(H1) pdm09 </th> <th class="bg-colour-blue" id="fc5" headers="fc1 fc2">A(H3) </th> <th class="bg-colour-blue" id="fc6" 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 colspan="8" class="fontSize85"><sup>1</sup> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
    UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</td> </tr> </tfoot> <tbody> <tr> <th class="alignLeft" id="fr2" headers="fr1">0-4 years </th> <td class="alignRight" headers="fr1 fr2 fc1 fc2 fc3"> 21 </td> <td class="alignRight" headers="fr1 fr2 fc1 fc2 fc4"> 1 </td> <td class="alignRight" headers="fr1 fr2 fc1 fc2 fc5"> 18 </td> <td class="alignRight" headers="fr1 fr2 fc1 fc2 fc6"> 2 </td> <td class="alignRight" headers="fr1 fr2 fc1 fc7"> 0 </td> <td class="alignRight" headers="fr1 fr2 fc1 fc8"> 21 (9%) </td> </tr> <tr> <th class="alignLeft" id="fr3" headers="fr1">5-19 years </th> <td class="alignRight" headers="fr1 fr3 fc1 fc2 fc3"> 20 </td> <td class="alignRight" headers="fr1 fr3 fc1 fc2 fc4"> 0 </td> <td class="alignRight" headers="fr1 fr3 fc1 fc2 fc5"> 18 </td> <td class="alignRight" headers="fr1 fr3 fc1 fc2 fc6"> 2 </td> <td class="alignRight" headers="fr1 fr3 fc1 fc7"> 1 </td> <td class="alignRight" headers="fr1 fr3 fc1 fc8"> 21 (9%) </td> </tr> <tr> <th class="alignLeft" id="fr4" headers="fr1">20-44 years </th> <td class="alignRight" headers="fr1 fr4 fc1 fc2 fc3"> 21 </td> <td class="alignRight" headers="fr1 fr4 fc1 fc2 fc4"> 1 </td> <td class="alignRight" headers="fr1 fr4 fc1 fc2 fc5"> 18 </td> <td class="alignRight" headers="fr1 fr4 fc1 fc2 fc6"> 2 </td> <td class="alignRight" headers="fr1 fr4 fc1 fc7"> 2 </td> <td class="alignRight" headers="fr1 fr4 fc1 fc8"> 23 (10%) </td> </tr> <tr> <th class="alignLeft" id="fr5" headers="fr1">45-64 years </th> <td class="alignRight" headers="fr1 fr5 fc1 fc2 fc3"> 22 </td> <td class="alignRight" headers="fr1 fr5 fc1 fc2 fc4"> 0 </td> <td class="alignRight" headers="fr1 fr5 fc1 fc2 fc5"> 19 </td> <td class="alignRight" headers="fr1 fr5 fc1 fc2 fc6"> 3 </td> <td class="alignRight" headers="fr1 fr5 fc1 fc7"> 2 </td> <td class="alignRight" headers="fr1 fr5 fc1 fc8"> 24 (11%) </td> </tr> <tr> <th class="alignLeft" id="fr6" headers="fr1">65+ years </th> <td class="alignRight" headers="fr1 fr6 fc1 fc2 fc3"> 127 </td> <td class="alignRight" headers="fr1 fr6 fc1 fc2 fc4"> 0 </td> <td class="alignRight" headers="fr1 fr6 fc1 fc2 fc5"> 98 </td> <td class="alignRight" headers="fr1 fr6 fc1 fc2 fc6"> 29 </td> <td class="alignRight" headers="fr1 fr6 fc1 fc7"> 4 </td> <td class="alignRight" headers="fr1 fr6 fc1 fc8"> 131 (58%) </td> </tr> <tr> <th class="alignLeft" id="fr7" headers="fr1">Unknown</th> <td class="alignRight" headers="fr1 fr7 fc1 fc2 fc3"> 4 </td> <td class="alignRight" headers="fr1 fr7 fc1 fc2 fc4"> 0 </td> <td class="alignRight" headers="fr1 fr7 fc1 fc2 fc5"> 4 </td> <td class="alignRight" headers="fr1 fr7 fc1 fc2 fc6"> 0 </td> <td class="alignRight" headers="fr1 fr7 fc1 fc7"> 0 </td> <td class="alignRight" headers="fr1 fr7 fc1 fc8"> 4 (2%) </td> </tr> <tr> <th class="alignLeft" id="fr8" headers="fr1">Total </th> <td class="alignRight" headers="fr1 fr8 fc1 fc2 fc3"> 215 </td> <td class="alignRight bg-colour-blue" headers="fr1 fr8 fc1 fc2 fc4"> 2 </td> <td class="alignRight bg-colour-blue" headers="fr1 fr8 fc1 fc2 fc5"> 175 </td> <td class="alignRight bg-colour-blue" headers="fr1 fr8 fc1 fc2 fc6"> 38 </td> <td class="alignRight" headers="fr1 fr8 fc1 fc7"> 9 </td> <td class="alignRight" headers="fr1 fr8 fc1 fc8"> 224 </td> </tr> <tr> <th class="alignLeft" id="fr9" headers="fr1">Percentage <sup> 1</sup></th> <td class="alignRight" headers="fr1 fr9 fc1 fc2 fc3"> 96.0% </td> <td class="alignRight bg-colour-blue" headers="fr1 fr9 fc1 fc2 fc4"> 0.9% </td> <td class="alignRight bg-colour-blue" headers="fr1 fr9 fc1 fc2 fc5"> 81.4% </td> <td class="alignRight bg-colour-blue" headers="fr1 fr9 fc1 fc2 fc6"> 17.7% </td> <td class="alignRight" headers="fr1 fr9 fc1 fc7"> 4.0% </td> <td class="alignRight" headers="fr1 fr9 fc1 fc8"> 100.0% </td> </tr> </tbody> </table> See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2014-15 on the Public Health Agency of Canada website.
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    Re: Canada FluWatch Weekly Reports 2014-2015 Season Week 46

    FluWatch report: November 16 to November 22, 2014 (Week 47)

    Posted 2014-11-28 For readers interested in the <abbr title="Portable Document Format">PDF</abbr> version, the document is available for downloading or viewing:
    <a href="http://www.phac-aspc.gc.ca/fluwatch/14-15/w47_14/pdf/fw2014-47-eng.pdf" title="Flu Watch (Version PDF, 288 KB - 10 pages)">FluWatch report: November 16 to November 22, 2014 (Week 47) (<abbr title="Portable Document Format">PDF</abbr> Version - 346 <abbr title="Kilobytes">KB</abbr> - 10 pages)

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    Overall Summary
    • In week 47, overall influenza activity increased compared to the previous week with localized activity reported in six provinces, and a sharp increase in laboratory detections in western and central provinces.
    • A(H3N2) continues to be the most common type of influenza affecting Canadians. In both laboratory detections and hospitalizations, the majority of cases have been among seniors ≥65 years of age.
    • In week 47, 16 new outbreaks of influenza in long-term care facilities were reported.


    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 47, eleven regions (in BC(2), AB(2), SK(1), ON(3), QC(2), and PE(1)) reported localized activity and 15 regions (BC(2), AB(3), SK(1), MB(1), ON(1), QC(4), NS(1), NL(1) and YT(1)) reported sporadic activity (Figure 1).
    Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 47





    Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
    Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
    Influenza and Other Respiratory Virus Detections

    The number of positive influenza tests increased sharply to 295 influenza detections (8.6% of tests) in week 47, predominantly due to influenza A (Figure 2). To date, 97% of influenza detections have been influenza A, and the vast majority of those subtyped have been A(H3) (Table 1). The timing of the season and predominant A(H3N2) subtype is similar to the pattern observed during the 2012-13 influenza season. To date, among the cases of influenza A with reported age, the largest proportion was in adults ≥65 years of age (47%) (Table 2).
    Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2014-15

    Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
    In week 47, detections of RSV and adenovirus continued to follow an upward trend, in keeping with their usual pattern of seasonal circulation. Detections of rhinovirus peaked in week 39 and continue to follow a downward trend (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, 2014-15


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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 class="widthFull" id="t1" border="1" cellpadding="2" cellspacing="0"> <caption class="alignCenter"> Table 1: Weekly and cumulative numbers of positive influenza specimens
    by type, subtype and province, Canada, 2014-15
    </caption> <thead> <tr class="bg-colour-yellow"> <th id="ar1" rowspan="3">Reporting provinces <sup>1</sup></th> <th id="ac1" colspan="5">Weekly
    (November 16 to 22, 2014, 2014)</th> <th id="ac8" colspan="5">Cumulative
    (August 24 to November 22, 2014)</th> </tr> <tr class="bg-colour-yellow"> <th id="ac2" colspan="4" headers="ac1">Influenza A</th> <th id="ac7" headers="ac1">B</th> <th id="ac9" colspan="4" headers="ac8">Influenza A</th> <th id="ac14" headers="ac8">B</th> </tr> <tr class="bg-colour-grey-light"> <th id="ac3" headers="ac1 ac2">A Total</th> <th id="ac4" class=" bg-colour-blue" headers="ac1 ac2">A(H1)pdm09</th> <th id="ac5" class=" bg-colour-blue" headers="ac1 ac2">A(H3)</th> <th id="ac6" class=" bg-colour-blue" headers="ac1 ac2">A(UnS)</th> <th class="alignCenter" headers="ac1 ac7">B Total</th> <th id="ac10" headers="ac8 ac9">A Total</th> <th id="ac11" class=" bg-colour-blue" headers="ac8 ac9">A(H1)pdm09</th> <th id="ac12" class=" bg-colour-blue" headers="ac8 ac9">A(H3)</th> <th id="ac13" class=" bg-colour-blue" headers="ac8 ac9">A(UnS)</th> <td class="alignCenter" headers="ac8 ac14">B Total</td> </tr> </thead> <tfoot> <tr> <td colspan="11" class="fontSize85"><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"> 26 </td> <td class="alignCenter" headers="ar1 ar2 ac1 ac2 ac4"> 0 </td> <td class="alignCenter" headers="ar1 ar2 ac1 ac2 ac5"> 24 </td> <td class="alignCenter" headers="ar1 ar2 ac1 ac2 ac6"> 2 </td> <td class="alignCenter" headers="ar1 ar2 ac1 ac7"> 1 </td> <td class="alignCenter" headers="ar1 ar2 ac8 ac9 ac10"> 105 </td> <td class="alignCenter" headers="ar1 ar2 ac8 ac9 ac11"> 2 </td> <td class="alignCenter" headers="ar1 ar2 ac8 ac9 ac12"> 100 </td> <td class="alignCenter" headers="ar1 ar2 ac8 ac9 ac13"> 3 </td> <td class="alignCenter" headers="ar1 ar2 ac8 ac14"> 9 </td> </tr> <tr> <th id="ar3" class="alignLeft" headers="ar1">AB</th> <td class="alignCenter" headers="ar1 ar3 ac1 ac2 ac3"> 139 </td> <td class="alignCenter" headers="ar1 ar3 ac1 ac2 ac4"> 0 </td> <td class="alignCenter" headers="ar1 ar3 ac1 ac2 ac5"> 99 </td> <td class="alignCenter" headers="ar1 ar3 ac1 ac2 ac6"> 40 </td> <td class="alignCenter" headers="ar1 ar3 ac1 ac7"> 5 </td> <td class="alignCenter" headers="ar1 ar3 ac8 ac9 ac10"> 357 </td> <td class="alignCenter" headers="ar1 ar3 ac8 ac9 ac11"> 0 </td> <td class="alignCenter" headers="ar1 ar3 ac8 ac9 ac12"> 309 </td> <td class="alignCenter" headers="ar1 ar3 ac8 ac9 ac13"> 48 </td> <td class="alignCenter" headers="ar1 ar3 ac8 ac14"> 23 </td> </tr> <tr> <th id="ar4" class="alignLeft" headers="ar1">SK</th> <td class="alignCenter" headers="ar1 ar4 ac1 ac2 ac3"> 3 </td> <td class="alignCenter" headers="ar1 ar4 ac1 ac2 ac4"> 0 </td> <td class="alignCenter" headers="ar1 ar4 ac1 ac2 ac5"> 2</td> <td class="alignCenter" headers="ar1 ar4 ac1 ac2 ac6"> 1</td> <td class="alignCenter" headers="ar1 ar4 ac1 ac7"> 0 </td> <td class="alignCenter" headers="ar1 ar4 ac8 ac9 ac10"> 8</td> <td class="alignCenter" headers="ar1 ar4 ac8 ac9 ac11"> 0</td> <td class="alignCenter" headers="ar1 ar4 ac8 ac9 ac12"> 4</td> <td class="alignCenter" headers="ar1 ar4 ac8 ac9 ac13"> 4</td> <td class="alignCenter" headers="ar1 ar4 ac8 ac14"> 0</td> </tr> <tr> <th id="ar5" class="alignLeft" headers="ar1">MB</th> <td class="alignCenter" headers="ar1 ar5 ac1 ac2 ac3"> 1 </td> <td class="alignCenter" headers="ar1 ar5 ac1 ac2 ac4"> 0 </td> <td class="alignCenter" headers="ar1 ar5 ac1 ac2 ac5"> 1 </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"> 6 </td> <td class="alignCenter" headers="ar1 ar5 ac8 ac9 ac11"> 0 </td> <td class="alignCenter" headers="ar1 ar5 ac8 ac9 ac12"> 6 </td> <td class="alignCenter" headers="ar1 ar5 ac8 ac9 ac13"> 0 </td> <td class="alignCenter" headers="ar1 ar5 ac8 ac14"> 1 </td> </tr> <tr> <th id="ar6" class="alignLeft" headers="ar1">ON</th> <td class="alignCenter" headers="ar1 ar6 ac1 ac2 ac3"> 37 </td> <td class="alignCenter" headers="ar1 ar6 ac1 ac2 ac4"> 1 </td> <td class="alignCenter" headers="ar1 ar6 ac1 ac2 ac5"> 28 </td> <td class="alignCenter" headers="ar1 ar6 ac1 ac2 ac6"> 8 </td> <td class="alignCenter" headers="ar1 ar6 ac1 ac7"> 0 </td> <td class="alignCenter" headers="ar1 ar6 ac8 ac9 ac10"> 124 </td> <td class="alignCenter" headers="ar1 ar6 ac8 ac9 ac11"> 4 </td> <td class="alignCenter" headers="ar1 ar6 ac8 ac9 ac12"> 88 </td> <td class="alignCenter" headers="ar1 ar6 ac8 ac9 ac13"> 32 </td> <td class="alignCenter" headers="ar1 ar6 ac8 ac14"> 15 </td> </tr> <tr> <th id="ar7" class="alignLeft" headers="ar1">QC</th> <td class="alignCenter" headers="ar1 ar7 ac1 ac2 ac3"> 74 </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"> 74 </td> <td class="alignCenter" headers="ar1 ar7 ac1 ac7"> 2 </td> <td class="alignCenter" headers="ar1 ar7 ac8 ac9 ac10"> 152 </td> <td class="alignCenter" headers="ar1 ar7 ac8 ac9 ac11"> 0 </td> <td class="alignCenter" headers="ar1 ar7 ac8 ac9 ac12"> 0 </td> <td class="alignCenter" headers="ar1 ar7 ac8 ac9 ac13"> 152 </td> <td class="alignCenter" headers="ar1 ar7 ac8 ac14"> 18 </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"> 0 </td> <td class="alignCenter" headers="ar1 ar8 ac1 ac2 ac6"> 2 </td> <td class="alignCenter" headers="ar1 ar8 ac1 ac7"> 0 </td> <td class="alignCenter" headers="ar1 ar8 ac8 ac9 ac10"> 2 </td> <td class="alignCenter" headers="ar1 ar8 ac8 ac9 ac11"> 0 </td> <td class="alignCenter" headers="ar1 ar8 ac8 ac9 ac12"> 0 </td> <td class="alignCenter" headers="ar1 ar8 ac8 ac9 ac13"> 2 </td> <td class="alignCenter" headers="ar1 ar8 ac8 ac14"> 0 </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"> 0 </td> <td class="alignCenter" headers="ar1 ar9 ac8 ac9 ac10"> 1 </td> <td class="alignCenter" headers="ar1 ar9 ac8 ac9 ac11"> 0 </td> <td class="alignCenter" headers="ar1 ar9 ac8 ac9 ac12"> 1 </td> <td class="alignCenter" headers="ar1 ar9 ac8 ac9 ac13"> 0 </td> <td class="alignCenter" headers="ar1 ar9 ac8 ac14"> 2 </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"> 1 </td> <td class="alignCenter" headers="ar1 ar10 ac8 ac9 ac10"> 2 </td> <td class="alignCenter" headers="ar1 ar10 ac8 ac9 ac11"> 0 </td> <td class="alignCenter" headers="ar1 ar10 ac8 ac9 ac12"> 1 </td> <td class="alignCenter" headers="ar1 ar10 ac8 ac9 ac13"> 1 </td> <td class="alignCenter" headers="ar1 ar10 ac8 ac14"> 1 </td> </tr> <tr> <th id="ar11" class="alignLeft" headers="ar1">NL</th> <td class="alignCenter" headers="ar1 ar11 ac1 ac2 ac3"> 0 </td> <td class="alignCenter" headers="ar1 ar11 ac1 ac2 ac4"> 0 </td> <td class="alignCenter" headers="ar1 ar11 ac1 ac2 ac5"> 0 </td> <td class="alignCenter" headers="ar1 ar11 ac1 ac2 ac6"> 0 </td> <td class="alignCenter" headers="ar1 ar11 ac1 ac7"> 0 </td> <td class="alignCenter" headers="ar1 ar11 ac8 ac9 ac10"> 2 </td> <td class="alignCenter" headers="ar1 ar11 ac8 ac9 ac11"> 0 </td> <td class="alignCenter" headers="ar1 ar11 ac8 ac9 ac12"> 1 </td> <td class="alignCenter" headers="ar1 ar11 ac8 ac9 ac13"> 1 </td> <td class="alignCenter" headers="ar1 ar11 ac8 ac14"> 0 </td> </tr> <tr> <th id="ar12" class="alignLeft" headers="ar1">Canada</th> <td class="alignCenter" headers="ar1 ar12 ac1 ac2 ac3"> 283 </td> <td class="bg-colour-blue alignCenter" headers="ar1 ar12 ac1 ac2 ac4"> 1 </td> <td class="bg-colour-blue alignCenter" headers="ar1 ar12 ac1 ac2 ac5"> 155</td> <td class="bg-colour-blue alignCenter" headers="ar1 ar12 ac1 ac2 ac6"> 127</td> <td class="alignCenter" headers="ar1 ar12 ac1 ac7"> 9 </td> <td class="alignCenter" headers="ar1 ar12 ac8 ac9 ac10"> 759</td> <td class="bg-colour-blue alignCenter" headers="ar1 ar12 ac8 ac9 ac11"> 6</td> <td class="bg-colour-blue alignCenter" headers="ar1 ar12 ac8 ac9 ac12"> 510</td> <td class="bg-colour-blue alignCenter" headers="ar1 ar12 ac8 ac9 ac13"> 243</td> <td class="alignCenter" headers="ar1 ar12 ac8 ac14"> 69</td> </tr> <tr> <th id="ar13" class="alignLeft" headers="ar1">Percentage<sup>2</sup></th> <td class="alignCenter" headers="ar1 ar13 ac1 ac2 ac3"> 96.9% </td> <td class="bg-colour-blue alignCenter" headers="ar1 ar13 ac1 ac2 ac4"> 0.4% </td> <td class="bg-colour-blue alignCenter" headers="ar1 ar13 ac1 ac2 ac5"> 54.8% </td> <td class="bg-colour-blue alignCenter" headers="ar1 ar13 ac1 ac2 ac6"> 44.9% </td> <td class="alignCenter" headers="ar1 ar13 ac1 ac7"> 3.1% </td> <td class="alignCenter" headers="ar1 ar13 ac8 ac9 ac10"> 91.7% </td> <td class="bg-colour-blue alignCenter" headers="ar1 ar13 ac8 ac9 ac11"> 0.8% </td> <td class="bg-colour-blue alignCenter" headers="ar1 ar13 ac8 ac9 ac12"> 67.2% </td> <td class="bg-colour-blue alignCenter" headers="ar1 ar13 ac8 ac9 ac13"> 32.0% </td> <td class="alignCenter" headers="ar1 ar13 ac8 ac14"> 8.3% </td> </tr> </tbody> </table>
    <table class="widthFull" id="t2" border="1" cellpadding="2" cellspacing="0"> <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, 2014-15 </caption> <thead> <tr class="bg-colour-yellow"> <th rowspan="3" id="br1">Age groups (years)</th> <th colspan="5" id="bc1">Weekly
    (November 16 to November 22, 2014)</th> <th colspan="7" id="bc8">Cumulative
    (August 24 to November 22, 2014)</th> </tr> <tr class="bg-colour-yellow"> <th colspan="4" id="bc2" headers="bc1">Influenza A</th> <th id="bc7" headers="bc1">B</th> <th colspan="4" id="bc9" headers="bc8">Influenza A</th> <th id="bc14" headers="bc8">B</th> <th colspan="2" id="bc15" headers="bc8">Influenza A and B</th> </tr> <tr class="bg-colour-grey-light"> <th id="bc3" headers="bc1 bc2">A Total</th> <th class="bg-colour-blue " id="bc4" headers="bc1 bc2">A(H1) pdm09</th> <th class="bg-colour-blue " id="bc5" headers="bc1 bc2">A(H3)</th> <th class="bg-colour-blue " id="bc6" headers="bc1 bc2">A (UnS)</th> <td headers="bc1 bc7" class="alignCenter">Total</td> <th id="bc10" headers="bc8 bc9">A Total</th> <th class="bg-colour-blue " id="bc11" headers="bc8 bc9">A(H1) pdm09</th> <th class="bg-colour-blue" id="bc12" headers="bc8 bc9">A(H3)</th> <th class="bg-colour-blue " id="bc13" headers="bc8 bc9">A (UnS)</th> <td headers="bc8 bc14" class="alignCenter">Total</td> <th id="bc16" headers="bc8 bc15">#</th> <th id="bc17" headers="bc8 bc15">%</th> </tr> </thead> <tfoot> <tr> <td colspan="13" class="fontSize85"><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 class="alignLeft" id="br2" headers="br1"><5</th> <td class="alignCenter" headers="br1 br2 bc1 bc2 bc3"> 21 </td> <td class="alignCenter" headers="br1 br2 bc1 bc2 bc4"> 0 </td> <td class="alignCenter" headers="br1 br2 bc1 bc2 bc5"> 15 </td> <td class="alignCenter" headers="br1 br2 bc1 bc2 bc6"> 6 </td> <td class="alignCenter" headers="br1 br2 bc1 bc7"> 0 </td> <td class="alignCenter" headers="br1 br2 bc8 bc9 bc10"> 84 </td> <td class="alignCenter" headers="br1 br2 bc8 bc9 bc11"> 4 </td> <td class="alignCenter" headers="br1 br2 bc8 bc9 bc12"> 61 </td> <td class="alignCenter" headers="br1 br2 bc8 bc9 bc13"> 19 </td> <td class="alignCenter" headers="br1 br2 bc8 bc14"> 9 </td> <td class="alignCenter" headers="br1 br2 bc8 bc15 bc16"> 93 </td> <td class="alignCenter" headers="br1 br2 bc8 bc15 bc17"> 12.1% </td> </tr> <tr> <th class="alignLeft" id="br3" headers="br1">5-19</th> <td class="alignCenter" headers="br1 br3 bc1 bc2 bc3"> 18 </td> <td class="alignCenter" headers="br1 br3 bc1 bc2 bc4"> 0 </td> <td class="alignCenter" headers="br1 br3 bc1 bc2 bc5"> 11 </td> <td class="alignCenter" headers="br1 br3 bc1 bc2 bc6"> 7 </td> <td class="alignCenter" headers="br1 br3 bc1 bc7"> 4 </td> <td class="alignCenter" headers="br1 br3 bc8 bc9 bc10"> 85 </td> <td class="alignCenter" headers="br1 br3 bc8 bc9 bc11"> 0 </td> <td class="alignCenter" headers="br1 br3 bc8 bc9 bc12"> 68 </td> <td class="alignCenter" headers="br1 br3 bc8 bc9 bc13"> 17 </td> <td class="alignCenter" headers="br1 br3 bc8 bc14"> 14 </td> <td class="alignCenter" headers="br1 br3 bc8 bc15 bc16"> 99 </td> <td class="alignCenter" headers="br1 br3 bc8 bc15 bc17"> 12.9% </td> </tr> <tr> <th class="alignLeft" id="br4" headers="br1">20-44</th> <td class="alignCenter" headers="br1 br4 bc1 bc2 bc3"> 52 </td> <td class="alignCenter" headers="br1 br4 bc1 bc2 bc4"> 0 </td> <td class="alignCenter" headers="br1 br4 bc1 bc2 bc5"> 35 </td> <td class="alignCenter" headers="br1 br4 bc1 bc2 bc6"> 17 </td> <td class="alignCenter" headers="br1 br4 bc1 bc7"> 0 </td> <td class="alignCenter" headers="br1 br4 bc8 bc9 bc10"> 119 </td> <td class="alignCenter" headers="br1 br4 bc8 bc9 bc11"> 0 </td> <td class="alignCenter" headers="br1 br4 bc8 bc9 bc12"> 82 </td> <td class="alignCenter" headers="br1 br4 bc8 bc9 bc13"> 37 </td> <td class="alignCenter" headers="br1 br4 bc8 bc14"> 5 </td> <td class="alignCenter" headers="br1 br4 bc8 bc15 bc16"> 124 </td> <td class="alignCenter" headers="br1 br4 bc8 bc15 bc17"> 16.1% </td> </tr> <tr> <th class="alignLeft" id="br5" headers="br1">45-64</th> <td class="alignCenter" headers="br1 br5 bc1 bc2 bc3"> 19 </td> <td class="alignCenter" headers="br1 br5 bc1 bc2 bc4"> 0 </td> <td class="alignCenter" headers="br1 br5 bc1 bc2 bc5"> 10 </td> <td class="alignCenter" headers="br1 br5 bc1 bc2 bc6"> 9 </td> <td class="alignCenter" headers="br1 br5 bc1 bc7"> 0 </td> <td class="alignCenter" headers="br1 br5 bc8 bc9 bc10"> 76 </td> <td class="alignCenter" headers="br1 br5 bc8 bc9 bc11"> 0 </td> <td class="alignCenter" headers="br1 br5 bc8 bc9 bc12"> 52 </td> <td class="alignCenter" headers="br1 br5 bc8 bc9 bc13"> 24 </td> <td class="alignCenter" headers="br1 br5 bc8 bc14"> 16 </td> <td class="alignCenter" headers="br1 br5 bc8 bc15 bc16"> 92 </td> <td class="alignCenter" headers="br1 br5 bc8 bc15 bc17"> 11.9% </td> </tr> <tr> <th class="alignLeft" id="br6" headers="br1">65+</th> <td class="alignCenter" headers="br1 br6 bc1 bc2 bc3"> 123 </td> <td class="alignCenter" headers="br1 br6 bc1 bc2 bc4"> 0 </td> <td class="alignCenter" headers="br1 br6 bc1 bc2 bc5"> 56 </td> <td class="alignCenter" headers="br1 br6 bc1 bc2 bc6"> 67 </td> <td class="alignCenter" headers="br1 br6 bc1 bc7"> 4 </td> <td class="alignCenter" headers="br1 br6 bc8 bc9 bc10"> 342 </td> <td class="alignCenter" headers="br1 br6 bc8 bc9 bc11"> 2 </td> <td class="alignCenter" headers="br1 br6 bc8 bc9 bc12"> 232 </td> <td class="alignCenter" headers="br1 br6 bc8 bc9 bc13"> 108 </td> <td class="alignCenter" headers="br1 br6 bc8 bc14"> 19 </td> <td class="alignCenter" headers="br1 br6 bc8 bc15 bc16"> 361 </td> <td class="alignCenter" headers="br1 br6 bc8 bc15 bc17"> 46.9% </td> </tr> <tr> <th class="alignLeft" id="br7" 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"> 1 </td> <td class="alignCenter" headers="br1 br7 bc8 bc9 bc11"> 0 </td> <td class="alignCenter" headers="br1 br7 bc8 bc9 bc12"> 0 </td> <td class="alignCenter" headers="br1 br7 bc8 bc9 bc13"> 1 </td> <td class="alignCenter" headers="br1 br7 bc8 bc14"> 0 </td> <td class="alignCenter" headers="br1 br7 bc8 bc15 bc16"> 1 </td> <td class="alignCenter" headers="br1 br7 bc8 bc15 bc17"> 0.1% </td> </tr> <tr> <th class="alignLeft" id="br8" headers="br1">Total</th> <td class="alignCenter" headers="br1 br8 bc1 bc2 bc3"> 233 </td> <td class="bg-colour-blue alignCenter" headers="br1 br8 bc1 bc2 bc4"> 0 </td> <td class="bg-colour-blue alignCenter" headers="br1 br8 bc1 bc2 bc5"> 127 </td> <td class="bg-colour-blue alignCenter" headers="br1 br8 bc1 bc2 bc6"> 106 </td> <td class="alignCenter" headers="br1 br8 bc1 bc7"> 8 </td> <td class="alignCenter" headers="br1 br8 bc8 bc9 bc10"> 707 </td> <td class="bg-colour-blue alignCenter" headers="br1 br8 bc8 bc9 bc11"> 6 </td> <td class="bg-colour-blue alignCenter" headers="br1 br8 bc8 bc9 bc12"> 495 </td> <td class="bg-colour-blue alignCenter" headers="br1 br8 bc8 bc9 bc13"> 206 </td> <td class="alignCenter" headers="br1 br8 bc8 bc14"> 63 </td> <td class="alignCenter" headers="br1 br8 bc8 bc15 bc16"> 770 </td> <td class="alignCenter" headers="br1 br8 bc8 bc15 bc17"> 100.0% </td> </tr> <tr> <th class="alignLeft" id="br9" headers="br1">Percentage<sup>2</sup></th> <td class="alignCenter" headers="br1 br9 bc1 bc2 bc3"> 96.7% </td> <td class="bg-colour-blue alignCenter" headers="br1 br9 bc1 bc2 bc4"> 0.0% </td> <td class="bg-colour-blue alignCenter" headers="br1 br9 bc1 bc2 bc5"> 54.5% </td> <td class="bg-colour-blue alignCenter" headers="br1 br9 bc1 bc2 bc6"> 45.5% </td> <td class="alignCenter" headers="br1 br9 bc1 bc7"> 3.3% </td> <td class="alignCenter" headers="br1 br9 bc8 bc9 bc10"> 91.8% </td> <td class="bg-colour-blue alignCenter" headers="br1 br9 bc8 bc9 bc11"> 0.8% </td> <td class="bg-colour-blue alignCenter" headers="br1 br9 bc8 bc9 bc12"> 70.0% </td> <td class="bg-colour-blue alignCenter" headers="br1 br9 bc8 bc9 bc13"> 29.1% </td> <td class="alignCenter" headers="br1 br9 bc8 bc14"> 8.2% </td> <td class="alignCenter"> </td> <td class="alignCenter"> </td> </tr> </tbody> </table>

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    Influenza Strain Characterizations

    During the 2014-2015 influenza season, the National Microbiology Laboratory (NML) has characterized 22 influenza viruses [10 A(H3N2) and 12 influenza B]. Two influenza A viruses were antigenically similar to A/Texas/50/2012, and nine influenza B viruses were antigenically similar to the B/Massachusetts/2/2012 (Yamagata lineage) recommended by the WHO for the 2014-15 seasonal influenza vaccine. Eight influenza A(H3N2) viruses and three influenza B viruses showed reduced titers to antisera produced against strains recommended for the seasonal influenza vaccine (Figure 4).
    Figure 4. Influenza strain characterizations, Canada, 2014-2015, N = 22

    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 2014-2015 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A/Texas/50/2012 (H3N2)-like virus, and a B/Massachusetts/2/2012-like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus is recommended.


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

    During the 2014-2015 influenza season, NML has tested 37 influenza viruses for resistance to oseltamivir and zanamivir and all were sensitive to both agents. The 46 influenza A(H3N2) viruses tested for amantadine resistance were all resistant (Table 3).
    <table class="widthFull" border="1" cellpadding="2" cellspacing="0"> <caption> Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2014-15 </caption> <thead> <tr class="bg-colour-yellow"> <th rowspan="2" id="t3hc1">Virus type and subtype</th> <th colspan="2" id="t3hc2">Oseltamivir</th> <th colspan="2" id="t3hc3">Zanamivir</th> <th colspan="2" id="t3hc4">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 colspan="7" class="fontSize85"> <sup>*</sup> NA - not applicable</td> </tr> </tfoot> <tbody> <tr> <th class="alignLeft bg-colour-blue" id="t3hr1" headers="t3hc1">A (H3N2)</th> <td class="alignCenter" headers="t3hr1 t3hc2 t3hc5">27</td> <td class="alignCenter" headers="t3hr1 t3hc2 t3hc6">0</td> <td class="alignCenter" headers="t3hr1 t3hc3 t3hc7">27</td> <td class="alignCenter" headers="t3hr1 t3hc3 t3hc8">0</td> <td class="alignCenter" headers="t3hr1 t3hc4 t3hc9">46</td> <td class="alignCenter" headers="t3hr1 t3hc4 t3hc10">46(100%)</td> </tr> <tr> <th class="alignLeft bg-colour-blue" id="t3hr2" headers="t3hc1">A (H1N1)</th> <td class="alignCenter" headers="t3hr2 t3hc2 t3hc5">0</td> <td class="alignCenter" headers="t3hr2 t3hc2 t3hc6">0</td> <td class="alignCenter" headers="t3hr2 t3hc3 t3hc7">0</td> <td class="alignCenter" headers="t3hr2 t3hc3 t3hc8">0</td> <td class="alignCenter" headers="t3hr2 t3hc4 t3hc9">0</td> <td class="alignCenter" headers="t3hr2 t3hc4 t3hc10">0</td> </tr> <tr> <th class="alignLeft bg-colour-blue" id="t3hr3" headers="t3hc1">B</th> <td class="alignCenter" headers="t3hr3 t3hc2 t3hc5">10</td> <td class="alignCenter" headers="t3hr3 t3hc2 t3hc6">0</td> <td class="alignCenter" headers="t3hr3 t3hc3 t3hc7">10</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 class="alignLeft bg-colour-blue" id="t3hr4" headers="t3hc1">TOTAL</th> <td class="alignCenter" headers="t3hr4 t3hc2 t3hc5">37</td> <td class="alignCenter" headers="t3hr4 t3hc2 t3hc6">0</td> <td class="alignCenter" headers="t3hr4 t3hc3 t3hc7">37</td> <td class="alignCenter" headers="t3hr4 t3hc3 t3hc8">0</td> <td class="alignCenter" headers="t3hr4 t3hc4 t3hc9">46</td> <td class="alignCenter" headers="t3hr4 t3hc4 t3hc10">46</td> </tr> </tbody> </table> Influenza-like Illness (ILI) Consultation Rate

    The national influenza-like-illness (ILI) consultation rate decreased in week 47 to 26.8 consultations per 1,000 (Figure 5). To date this season, the rates have been highest among those <20 years of age.
    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, 2014-2015

    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. 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 47, 16 new outbreaks of influenza A were reported in long-term care facilities (LTCF) (Figure 6). Two additional outbreaks of influenza A were reported, one in a school and one in another setting. To date, 35 outbreaks in LTCF have been reported.
    Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2014-2015

    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

    During week 47, the proportion of prescriptions for antivirals increased to 23.7 antiviral prescriptions per 100,000 total prescriptions, which is in keeping with previous seasons and consistent with other indicators of influenza circulation (Figure 7).
    Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2014-15

    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 47, nine new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network: 8 cases of influenza A and one case of influenza B (Figure 8a). To date this season, 38 hospitalizations have been reported by the IMPACT network, 34 (90%) of which were cases of influenza A, of these 71% were A(H3N2). The majority of cases (55%) were in children <5 years of age (Table 4). To date, five cases were admitted to the ICU (Figure 9a).
    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 for the 2014-15 season began on November 15th, 2014 (Figure 8b). To date, nine cases have been reported, all adults ≥65 years of age with influenza A (Table 5). Two cases were admitted to the ICU (Figure 8b).
    Note: The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
    <table class="widthFull" border="1" cellpadding="2" cellspacing="0"> <caption class="alignCenter" id="t4"> Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2014-15 </caption> <thead> <tr class="bg-colour-yellow"> <th rowspan="3" id="dr1">Age groups </th> <th colspan="6" id="dc1">Cumulative (Aug. 24, 2014 to November 22, 2014) </th> </tr> <tr class="bg-colour-yellow"> <th colspan="4" id="dc2" 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 colspan="7" class="fontSize85"><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"> 2 </td> <td class="alignCenter" headers="dr1 dr2 dc1 dc2 dc4"> 0</td> <td class="alignCenter" headers="dr1 dr2 dc1 dc2 dc5"> 2</td> <td class="alignCenter" headers="dr1 dr2 dc1 dc2 dc6"> 0</td> <td class="alignCenter" headers="dr1 dr2 dc1 dc7"> 0</td> <td class="alignCenter" headers="dr1 dr2 dc1 dc8"> 2(5.3%)</td> </tr> <tr> <th id="dr3" class="alignLeft" headers="dr1">6-23m </th> <td class="alignCenter" headers="dr1 dr3 dc1 dc2 dc3"> 7 </td> <td class="alignCenter" headers="dr1 dr3 dc1 dc2 dc4"> 1</td> <td class="alignCenter" headers="dr1 dr3 dc1 dc2 dc5"> 6</td> <td class="alignCenter" headers="dr1 dr3 dc1 dc2 dc6"> 0</td> <td class="alignCenter" headers="dr1 dr3 dc1 dc7"> 0</td> <td class="alignCenter" headers="dr1 dr3 dc1 dc8"> 7(18.4%)</td> </tr> <tr> <th id="dr4" class="alignLeft" headers="dr1">2-4y </th> <td class="alignCenter" headers="dr1 dr4 dc1 dc2 dc3"> 11</td> <td class="alignCenter" headers="dr1 dr4 dc1 dc2 dc4"> 0</td> <td class="alignCenter" headers="dr1 dr4 dc1 dc2 dc5"> 8</td> <td class="alignCenter" headers="dr1 dr4 dc1 dc2 dc6"> 3</td> <td class="alignCenter" headers="dr1 dr4 dc1 dc7"> 1</td> <td class="alignCenter" headers="dr1 dr4 dc1 dc8"> 12(31.6%)</td> </tr> <tr> <th id="dr5" class="alignLeft" headers="dr1">5-9y </th> <td class="alignCenter" headers="dr1 dr5 dc1 dc2 dc3"> 6</td> <td class="alignCenter" headers="dr1 dr5 dc1 dc2 dc4"> 0</td> <td class="alignCenter" headers="dr1 dr5 dc1 dc2 dc5"> 3</td> <td class="alignCenter" headers="dr1 dr5 dc1 dc2 dc6"> 3</td> <td class="alignCenter" headers="dr1 dr5 dc1 dc7"> 2</td> <td class="alignCenter" headers="dr1 dr5 dc1 dc8"> 8(21.1%)</td> </tr> <tr> <th id="dr6" class="alignLeft" headers="dr1">10-16y </th> <td class="alignCenter" headers="dr1 dr6 dc1 dc2 dc3"> 4</td> <td class="alignCenter" headers="dr1 dr6 dc1 dc2 dc4"> 0</td> <td class="alignCenter" headers="dr1 dr6 dc1 dc2 dc5"> 5</td> <td class="alignCenter" headers="dr1 dr6 dc1 dc2 dc6"> 3</td> <td class="alignCenter" headers="dr1 dr6 dc1 dc7"> 1</td> <td class="alignCenter" headers="dr1 dr6 dc1 dc8"> 9(23.7%)</td> </tr> <tr> <th id="dr7" class="alignLeft" headers="dr1">Total </th> <td class="alignCenter" headers="dr1 dr7 dc1 dc2 dc3"> 34</td> <td class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc4"> 1</td> <td class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc5"> 24</td> <td class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc6"> 9</td> <td class="alignCenter" headers="dr1 dr7 dc1 dc7"> 4</td> <td class="alignCenter" headers="dr1 dr7 dc1 dc8"> 38</td> </tr> <tr> <th id="dr8" class="alignLeft" headers="dr1">% <sup>1</sup></th> <td class="alignCenter" headers="dr1 dr8 dc1 dc2 dc3"> 89.5% </td> <td class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc4"> 2.9% </td> <td class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc5"> 70.6% </td> <td class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc6"> 26.5% </td> <td class="alignCenter" headers="dr1 dr8 dc1 dc7"> 10.5% </td> <td class="alignCenter" headers="dr1 dr8 dc1 dc8"> 100.0% </td> </tr> </tbody> </table>
    <table class="widthFull" border="1" cellpadding="2" cellspacing="0"> <caption class="alignCenter"> Table 5 - Cumulative numbers of adult hospitalizations with influenza reported by the PCIRN-SOS network, Canada, 2014-15 </caption> <thead> <tr class="bg-colour-yellow"> <th rowspan="3" id="er1">Age groups </th> <th id="ec1" colspan="6" class="noWrap">Cumulative (15 Nov. 2014 to 22 Nov. 2014)</th> </tr> <tr class="bg-colour-yellow"> <th colspan="4" id="ec2" 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 colspan="7" class="fontSize85"><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.</td> </tr> </tfoot> <tbody> <tr> <th id="er2" class="alignLeft" headers="er1">16-20 </th> <td class="alignCenter" headers="er1 er2 ec1 ec2 ec3"> 0</td> <td class="alignCenter" headers="er1 er2 ec1 ec2 ec4"> 0</td> <td class="alignCenter" headers="er1 er2 ec1 ec2 ec5"> 0</td> <td class="alignCenter" headers="er1 er2 ec1 ec2 ec6"> 0</td> <td class="alignCenter" headers="er1 er2 ec1 ec7"> 0</td> <td class="alignCenter" headers="er1 er2 ec1 ec8"> 0(%)</td> </tr> <tr> <th id="er3" class="alignLeft" headers="er1">20-44 </th> <td class="alignCenter" headers="er1 er3 ec1 ec2 ec3"> 0</td> <td class="alignCenter" headers="er1 er3 ec1 ec2 ec4"> 0</td> <td class="alignCenter" headers="er1 er3 ec1 ec2 ec5"> 0</td> <td class="alignCenter" headers="er1 er3 ec1 ec2 ec6"> 0</td> <td class="alignCenter" headers="er1 er3 ec1 ec7"> 0</td> <td class="alignCenter" headers="er1 er3 ec1 ec8">0(%)</td> </tr> <tr> <th id="er4" class="alignLeft" headers="er1">45-64 </th> <td class="alignCenter" headers="er1 er4 ec1 ec2 ec3"> 0</td> <td class="alignCenter" headers="er1 er4 ec1 ec2 ec4"> 0</td> <td class="alignCenter" headers="er1 er4 ec1 ec2 ec5"> 0</td> <td class="alignCenter" headers="er1 er4 ec1 ec2 ec6"> 0</td> <td class="alignCenter" headers="er1 er4 ec1 ec7"> 0</td> <td class="alignCenter" headers="er1 er4 ec1 ec8">0(%)</td> </tr> <tr> <th id="er5" class="alignLeft" headers="er1">65+ </th> <td class="alignCenter" headers="er1 er5 ec1 ec2 ec3"> 9</td> <td class="alignCenter" headers="er1 er5 ec1 ec2 ec4"> 0</td> <td class="alignCenter" headers="er1 er5 ec1 ec2 ec5"> 2</td> <td class="alignCenter" headers="er1 er5 ec1 ec2 ec6"> 7</td> <td class="alignCenter" headers="er1 er5 ec1 ec7"> 0</td> <td class="alignCenter" headers="er1 er5 ec1 ec8"> 9(100%)</td> </tr> <tr> <th id="er6" class="alignLeft" headers="er1">Total </th> <td class="alignCenter" headers="er1 er6 ec1 ec2 ec3"> 9</td> <td class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec4"> 0</td> <td class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec5"> 2</td> <td class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec6"> 7</td> <td class="alignCenter" headers="er1 er6 ec1 ec7"> 0</td> <td class="alignCenter" headers="er1 er6 ec1 ec8"> 9</td> </tr> <tr> <th id="er7" class="alignLeft" headers="er1">% <sup>1</sup> </th> <td class="alignCenter" headers="er1 er7 ec1 ec2 ec3">100%</td> <td class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec4"> 0%</td> <td class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec5"> 22%</td> <td class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec6"> 78%</td> <td class="alignCenter" headers="er1 er7 ec1 ec7"> 0</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, 2014-15
    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, 2014-15
    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 47, 22 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories*. Since the start of the 2014-15 season, 145 hospitalizations have been reported; 137 (95%) with influenza A, of which 83% were A(H3N2); 51% were patients ≥65 years of age (Table 6). Three ICU admissions have been reported in adults ≥45 years of age with influenza A. Eleven deaths with influenza A have been reported: one child <5 years of age, one adult 45-64 years and nine adults ≥65 years of age. 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. 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. 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.
    <table class="widthFull" id="t6" border="1" cellpadding="2" cellspacing="0"> <caption class="alignCenter"> Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14 </caption> <thead> <tr class="bg-colour-yellow"> <th id="fr1" rowspan="3">Age groups </th> <th id="fc1" colspan="6">Cumulative (24 August 2014 to 22 November 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 class="bg-colour-blue" id="fc4" headers="fc1 fc2">A(H1) pdm09 </th> <th class="bg-colour-blue" id="fc5" headers="fc1 fc2">A(H3) </th> <th class="bg-colour-blue" id="fc6" 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 colspan="8" class="fontSize85"><sup>1</sup> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
    UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</td> </tr> </tfoot> <tbody> <tr> <th class="alignLeft" id="fr2" headers="fr1">0-4 years </th> <td class="alignCenter" headers="fr1 fr2 fc1 fc2 fc3"> 19 </td> <td class="alignCenter" headers="fr1 fr2 fc1 fc2 fc4"> 1</td> <td class="alignCenter" headers="fr1 fr2 fc1 fc2 fc5"> 15</td> <td class="alignCenter" headers="fr1 fr2 fc1 fc2 fc6"> 3</td> <td class="alignCenter" headers="fr1 fr2 fc1 fc7"> 0 </td> <td class="alignCenter" headers="fr1 fr2 fc1 fc8">19 (13%) </td> </tr> <tr> <th class="alignLeft" id="fr3" headers="fr1">5-19 years </th> <td class="alignCenter" headers="fr1 fr3 fc1 fc2 fc3"> 15</td> <td class="alignCenter" headers="fr1 fr3 fc1 fc2 fc4"> 0 </td> <td class="alignCenter" headers="fr1 fr3 fc1 fc2 fc5"> 14</td> <td class="alignCenter" headers="fr1 fr3 fc1 fc2 fc6"> 1</td> <td class="alignCenter" headers="fr1 fr3 fc1 fc7"> 1</td> <td class="alignCenter" headers="fr1 fr3 fc1 fc8"> 16 (11%) </td> </tr> <tr> <th class="alignLeft" id="fr4" headers="fr1">20-44 years </th> <td class="alignCenter" headers="fr1 fr4 fc1 fc2 fc3"> 13 </td> <td class="alignCenter" headers="fr1 fr4 fc1 fc2 fc4"> 1 </td> <td class="alignCenter" headers="fr1 fr4 fc1 fc2 fc5"> 10</td> <td class="alignCenter" headers="fr1 fr4 fc1 fc2 fc6"> 2</td> <td class="alignCenter" headers="fr1 fr4 fc1 fc7"> 2 </td> <td class="alignCenter" headers="fr1 fr4 fc1 fc8"> 15 (10%) </td> </tr> <tr> <th class="alignLeft" id="fr5" headers="fr1">45-64 years </th> <td class="alignCenter" headers="fr1 fr5 fc1 fc2 fc3"> 17 </td> <td class="alignCenter" headers="fr1 fr5 fc1 fc2 fc4"> 0 </td> <td class="alignCenter" headers="fr1 fr5 fc1 fc2 fc5"> 15</td> <td class="alignCenter" headers="fr1 fr5 fc1 fc2 fc6"> 2 </td> <td class="alignCenter" headers="fr1 fr5 fc1 fc7"> 2 </td> <td class="alignCenter" headers="fr1 fr5 fc1 fc8"> 19 (13%) </td> </tr> <tr> <th class="alignLeft" id="fr6" headers="fr1">65+ years </th> <td class="alignCenter" headers="fr1 fr6 fc1 fc2 fc3"> 71 </td> <td class="alignCenter" headers="fr1 fr6 fc1 fc2 fc4"> 0</td> <td class="alignCenter" headers="fr1 fr6 fc1 fc2 fc5"> 58</td> <td class="alignCenter" headers="fr1 fr6 fc1 fc2 fc6"> 13</td> <td class="alignCenter" headers="fr1 fr6 fc1 fc7"> 3</td> <td class="alignCenter" headers="fr1 fr6 fc1 fc8"> 74 (51%) </td> </tr> <tr> <th class="alignLeft" id="fr7" headers="fr1">Unknown</th> <td class="alignCenter" headers="fr1 fr7 fc1 fc2 fc3"> 2 </td> <td class="alignCenter" headers="fr1 fr7 fc1 fc2 fc4"> 0 </td> <td class="alignCenter" headers="fr1 fr7 fc1 fc2 fc5"> 2</td> <td class="alignCenter" headers="fr1 fr7 fc1 fc2 fc6"> 0 </td> <td class="alignCenter" headers="fr1 fr7 fc1 fc7"> 0 </td> <td class="alignCenter" headers="fr1 fr7 fc1 fc8"> 2 (1%) </td> </tr> <tr> <th class="alignLeft" id="fr8" headers="fr1">Total </th> <td class="alignCenter" headers="fr1 fr8 fc1 fc2 fc3"> 137 </td> <td class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc4"> 2</td> <td class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc5">114</td> <td class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc6"> 21</td> <td class="alignCenter" headers="fr1 fr8 fc1 fc7"> 8</td> <td class="alignCenter" headers="fr1 fr8 fc1 fc8"> 145</td> </tr> <tr> <th class="alignLeft" id="fr9" headers="fr1">Percentage <sup> 1</sup></th> <td class="alignCenter" headers="fr1 fr9 fc1 fc2 fc3"> 94.5% </td> <td class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc4"> 1.5% </td> <td class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc5"> 83.2% </td> <td class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc6"> 15.3% </td> <td class="alignCenter" headers="fr1 fr9 fc1 fc7"> 5.5% </td> <td class="alignCenter" headers="fr1 fr9 fc1 fc8"> 100.0% </td> </tr> </tbody> </table> See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2014-15 on the Public Health Agency of Canada website.


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    Re: Canada FluWatch Weekly Reports 2014-2015 Season Week 45

    FluWatch report: November 9 to November 15, 2014 (Week 46)

    Posted 2014-11-21 For readers interested in the <abbr title="Portable Document Format">PDF</abbr> version, the document is available for downloading or viewing:
    <a href="http://www.phac-aspc.gc.ca/fluwatch/14-15/w46_14/pdf/fw2014-46-eng.pdf" title="Flu Watch (Version PDF, 288 KB - 10 pages)">FluWatch report: November 9 to November 15, 2014 (Week 46) (<abbr title="Portable Document Format">PDF</abbr> Version - 346 <abbr title="Kilobytes">KB</abbr> - 10 pages)

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    Overall Summary
    • In week 46, overall influenza activity increased from the previous week with sporadic activity reported in six provinces and one territory. Low-level activity started earlier this season than in the previous two years, but the geographic spread of influenza is as expected, with regions of western and central Canada most affected to date.
    • A(H3N2) continues to be the most common type of influenza affecting Canadians.
    • To date, 40-50% of influenza laboratory detections and hospitalizations have been in seniors ≥65 years of age.


    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 46, three regions (in AB(1) and ON(2)) reported localized activity and 18 regions (BC(3), AB(4), SK(1), MB(1), ON(3), QC(5) and YT(1)) reported sporadic activity (Figure 1).
    Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 46





    Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
    Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
    Influenza and Other Respiratory Virus Detections

    The number of positive influenza tests increased sharply to 143 influenza detections (4.6% of tests) in week 46, predominantly due to influenza A (Figure 2). To date, 88% of influenza detections have been influenza A, and the vast majority of those subtyped have been A(H3) (Table 1). The timing of the season and predominant A(H3N2) subtype is similar to the pattern observed during the 2012-13 influenza season. To date, among the cases of influenza A with reported age, the largest proportion was in adults ≥65 years of age (40%). Cases of influenza B have been reported among younger age-groups, with 27% being children <5 years of age (Table 2).
    Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2014-15

    Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
    In week 46, detections of RSV and adenovirus continued to follow an upward trend, in keeping with their usual pattern of seasonal circulation. Detections of parainfluenza have been declining gradually in recent weeks. Detections of rhinovirus peaked in week 39 and continue to follow a downward trend (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, 2014-15


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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 class="widthFull" id="t1" border="1" cellpadding="2" cellspacing="0"> <caption class="alignCenter"> Table 1: Weekly and cumulative numbers of positive influenza specimens
    by type, subtype and province, Canada, 2014-15
    </caption> <thead> <tr class="bg-colour-yellow"> <th id="ar1" rowspan="3">Reporting provinces <sup>1</sup></th> <th id="ac1" colspan="5">Weekly
    (November 9 to 15, 2014, 2014)</th> <th id="ac8" colspan="5">Cumulative
    (August 24 to November 15, 2014)</th> </tr> <tr class="bg-colour-yellow"> <th id="ac2" colspan="4" headers="ac1">Influenza A</th> <th id="ac7" headers="ac1">B</th> <th id="ac9" colspan="4" headers="ac8">Influenza A</th> <th id="ac14" headers="ac8">B</th> </tr> <tr class="bg-colour-grey-light"> <th id="ac3" headers="ac1 ac2">A Total</th> <th id="ac4" class=" 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 colspan="11" class="fontSize85"><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">8</td> <td class="alignRight">0</td> <td class="alignRight">2</td> <td class="alignRight">6</td> <td class="alignRight">0</td> <td class="alignRight">79</td> <td class="alignRight">2</td> <td class="alignRight">70</td> <td class="alignRight">7</td> <td class="alignRight">8</td> </tr> <tr> <th id="ar3" class="alignLeft" headers="ar1">AB</th> <td class="alignRight">75</td> <td class="alignRight">0</td> <td class="alignRight">53</td> <td class="alignRight">22</td> <td class="alignRight">1</td> <td class="alignRight">217</td> <td class="alignRight">0</td> <td class="alignRight">189</td> <td class="alignRight">28</td> <td class="alignRight">18</td> </tr> <tr> <th id="ar4" class="alignLeft" headers="ar1">SK</th> <td class="alignRight">1</td> <td class="alignRight">0</td> <td class="alignRight">1</td> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">6</td> <td class="alignRight">0</td> <td class="alignRight">2</td> <td class="alignRight">4</td> <td class="alignRight">8</td> </tr> <tr> <th id="ar5" class="alignLeft" headers="ar1">MB</th> <td class="alignRight">4</td> <td class="alignRight">0</td> <td class="alignRight">4</td> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">5</td> <td class="alignRight">0</td> <td class="alignRight">5</td> <td class="alignRight">0</td> <td class="alignRight">1</td> </tr> <tr> <th id="ar6" class="alignLeft" headers="ar1">ON</th> <td class="alignRight">25</td> <td class="alignRight">1</td> <td class="alignRight">20</td> <td class="alignRight">4</td> <td class="alignRight">1</td> <td class="alignRight">87</td> <td class="alignRight">3</td> <td class="alignRight">60</td> <td class="alignRight">24</td> <td class="alignRight">15</td> </tr> <tr> <th id="ar7" class="alignLeft" headers="ar1">QC</th> <td class="alignRight">22</td> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">22</td> <td class="alignRight">5</td> <td class="alignRight">78</td> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">78</td> <td class="alignRight">16</td> </tr> <tr> <th id="ar8" class="alignLeft" headers="ar1">NB</th> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">0</td> </tr> <tr> <th id="ar9" class="alignLeft" headers="ar1">NS</th> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">2</td> </tr> <tr> <th id="ar10" class="alignLeft" headers="ar1">PE</th> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">2</td> <td class="alignRight">0</td> <td class="alignRight">1</td> <td class="alignRight">1</td> <td class="alignRight">0</td> </tr> <tr> <th id="ar11" class="alignLeft" headers="ar1">NL</th> <td class="alignRight">1</td> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">1</td> <td class="alignRight">0</td> <td class="alignRight">2</td> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">2</td> <td class="alignRight">0</td> </tr> <tr> <th id="ar12" class="alignLeft" headers="ar1">Canada</th> <td class="alignRight">136</td> <td class="alignRight bg-colour-blue">1</td> <td class="alignRight bg-colour-blue">80</td> <td class="alignRight bg-colour-blue">55</td> <td class="alignRight">7</td> <td class="alignRight">476</td> <td class="alignRight bg-colour-blue">5</td> <td class="alignRight bg-colour-blue">327</td> <td class="alignRight bg-colour-blue">144</td> <td class="alignRight">68</td> </tr> <tr> <th id="ar13" class="alignLeft" headers="ar1">Percentage<sup>2</sup></th> <td class="alignRight">95.1%</td> <td class="alignRight bg-colour-blue">0.7%</td> <td class="alignRight bg-colour-blue">58.8%</td> <td class="alignRight bg-colour-blue">40.4%</td> <td class="alignRight">4.9%</td> <td class="alignRight">87.5%</td> <td class="alignRight bg-colour-blue">1.0%</td> <td class="alignRight bg-colour-blue">68.7%</td> <td class="alignRight bg-colour-blue">30.2%</td> <td class="alignRight">12.5%</td> </tr> </tbody> </table>
    <table class="widthFull" id="t2" border="1" cellpadding="2" cellspacing="0"> <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, 2014-15 </caption> <thead> <tr class="bg-colour-yellow"> <th rowspan="3" id="br1">Age groups (years)</th> <th colspan="5" id="bc1">Weekly
    (November 9 to November 15, 2014)</th> <th colspan="7" id="bc8">Cumulative
    (August 24 to November 15, 2014)</th> </tr> <tr class="bg-colour-yellow"> <th colspan="4" id="bc2" headers="bc1">Influenza A</th> <th id="bc7" headers="bc1">B</th> <th colspan="4" id="bc9" headers="bc8">Influenza A</th> <th id="bc14" headers="bc8">B</th> <th colspan="2" id="bc15" headers="bc8">Influenza A and B</th> </tr> <tr class="bg-colour-grey-light"> <th id="bc3" headers="bc1 bc2">A Total</th> <th class="bg-colour-blue " id="bc4" headers="bc1 bc2">A(H1) pdm09</th> <th class="bg-colour-blue " id="bc5" headers="bc1 bc2">A(H3)</th> <th class="bg-colour-blue " id="bc6" headers="bc1 bc2">A (UnS)</th> <td headers="bc1 bc7" class="alignCenter">Total</td> <th id="bc10" headers="bc8 bc9">A Total</th> <th class="bg-colour-blue " id="bc11" headers="bc8 bc9">A(H1) pdm09</th> <th class="bg-colour-blue" id="bc12" headers="bc8 bc9">A(H3)</th> <th class="bg-colour-blue " id="bc13" headers="bc8 bc9">A (UnS)</th> <td headers="bc8 bc14" class="alignCenter">Total</td> <th id="bc16" headers="bc8 bc15">#</th> <th id="bc17" headers="bc8 bc15">%</th> </tr> </thead> <tfoot> <tr> <td colspan="13" class="fontSize85"><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 class="alignLeft" id="br2" headers="br1"><5</th> <td class="alignRight">19</td> <td class="alignRight">0</td> <td class="alignRight">12</td> <td class="alignRight">7</td> <td class="alignRight">0</td> <td class="alignRight">93</td> <td class="alignRight">3</td> <td class="alignRight">35</td> <td class="alignRight">55</td> <td class="alignRight">25</td> <td class="alignRight">118</td> <td class="alignRight">17.0%</td> </tr> <tr> <th class="alignLeft" id="br3" headers="br1">5-19</th> <td class="alignRight">16</td> <td class="alignRight">0</td> <td class="alignRight">10</td> <td class="alignRight">6</td> <td class="alignRight">4</td> <td class="alignRight">81</td> <td class="alignRight">0</td> <td class="alignRight">48</td> <td class="alignRight">33</td> <td class="alignRight">11</td> <td class="alignRight">92</td> <td class="alignRight">13.3%</td> </tr> <tr> <th class="alignLeft" id="br4" headers="br1">20-44</th> <td class="alignRight">19</td> <td class="alignRight">0</td> <td class="alignRight">9</td> <td class="alignRight">10</td> <td class="alignRight">1</td> <td class="alignRight">89</td> <td class="alignRight">0</td> <td class="alignRight">32</td> <td class="alignRight">57</td> <td class="alignRight">5</td> <td class="alignRight">94</td> <td class="alignRight">13.5%</td> </tr> <tr> <th class="alignLeft" id="br5" headers="br1">45-64</th> <td class="alignRight">18</td> <td class="alignRight">0</td> <td class="alignRight">10</td> <td class="alignRight">8</td> <td class="alignRight">0</td> <td class="alignRight">85</td> <td class="alignRight">0</td> <td class="alignRight">26</td> <td class="alignRight">59</td> <td class="alignRight">28</td> <td class="alignRight">113</td> <td class="alignRight">16.3%</td> </tr> <tr> <th class="alignLeft" id="br6" headers="br1">65+</th> <td class="alignRight">41</td> <td class="alignRight">1</td> <td class="alignRight">22</td> <td class="alignRight">18</td> <td class="alignRight">1</td> <td class="alignRight">252</td> <td class="alignRight">2</td> <td class="alignRight">109</td> <td class="alignRight">141</td> <td class="alignRight">23</td> <td class="alignRight">275</td> <td class="alignRight">39.6%</td> </tr> <tr> <th class="alignLeft" id="br7" headers="br1">Unknown</th> <td class="alignRight">2</td> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">2</td> <td class="alignRight">0</td> <td class="alignRight">2</td> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">2</td> <td class="alignRight">0</td> <td class="alignRight">2</td> <td class="alignRight">0.3%</td> </tr> <tr> <th class="alignLeft" id="br8" headers="br1">Total</th> <td class="alignRight">115</td> <td class="alignRight bg-colour-blue">1</td> <td class="alignRight bg-colour-blue">63</td> <td class="alignRight bg-colour-blue">51</td> <td class="alignRight">6</td> <td class="alignRight">602</td> <td class="alignRight bg-colour-blue">5</td> <td class="alignRight bg-colour-blue">250</td> <td class="alignRight bg-colour-blue">347</td> <td class="alignRight">92</td> <td class="alignRight">694</td> <td class="alignRight">100.0%</td> </tr> <tr> <th class="alignLeft" id="br9" headers="br1">Percentage<sup>2</sup></th> <td class="alignRight">95.0%</td> <td class="alignRight bg-colour-blue">0.9%</td> <td class="alignRight bg-colour-blue">54.8%</td> <td class="alignRight bg-colour-blue">44.3%</td> <td class="alignRight">5.0%</td> <td class="alignRight">86.7%</td> <td class="alignRight bg-colour-blue">0.8%</td> <td class="alignRight bg-colour-blue">41.5%</td> <td class="alignRight bg-colour-blue">57.6%</td> <td class="alignRight">13.3%</td> <td class="alignRight"> </td> <td class="alignRight"> </td> </tr> </tbody> </table>

    Top of Page

    Influenza Strain Characterizations

    During the 2014-2015 influenza season, the National Microbiology Laboratory (NML) has characterized 20 influenza viruses [10 A(H3N2) and 10 influenza B]. Two influenza A viruses were antigenically similar to A/Texas/50/2012, and seven influenza B viruses were antigenically similar to the B/Massachusetts/2/2012 (Yamagata lineage) recommended by the WHO for the 2014-15 seasonal influenza vaccine. Eight influenza A(H3N2) viruses and three influenza B viruses showed reduced titers to antisera produced against strains recommended for the seasonal influenza vaccine (Figure 4).
    Figure 4. Influenza strain characterizations, Canada, 2014-2015, N = 20

    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 2014-2015 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A/Texas/50/2012 (H3N2)-like virus, and a B/Massachusetts/2/2012-like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus is recommended.


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

    During the 2014-2015 influenza season, NML has tested 21 influenza viruses for resistance to oseltamivir and zanamivir and all were sensitive to both agents. The 21 influenza A(H3N2) viruses tested for amantadine resistance were all resistant (Table 3).
    <table class="widthFull" border="1" cellpadding="2" cellspacing="0"> <caption> Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2014-15 </caption> <thead> <tr class="bg-colour-yellow"> <th rowspan="2" id="t3hc1">Virus type and subtype</th> <th colspan="2" id="t3hc2">Oseltamivir</th> <th colspan="2" id="t3hc3">Zanamivir</th> <th colspan="2" id="t3hc4">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 colspan="7" class="fontSize85"> <sup>*</sup> NA - not applicable</td> </tr> </tfoot> <tbody> <tr> <th class="alignLeft bg-colour-blue" id="t3hr1" headers="t3hc1">A (H3N2)</th> <td class="alignRight">12</td> <td class="alignRight">0</td> <td class="alignRight">12</td> <td class="alignRight">0</td> <td class="alignRight">21</td> <td class="alignRight">21 (100%)</td> </tr> <tr> <th class="alignLeft bg-colour-blue" id="t3hr2" headers="t3hc1">A (H1N1)</th> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">0</td> </tr> <tr> <th class="alignLeft bg-colour-blue" id="t3hr3" headers="t3hc1">B</th> <td class="alignRight">9</td> <td class="alignRight">0</td> <td class="alignRight">9</td> <td class="alignRight">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 class="alignLeft bg-colour-blue" id="t3hr4" headers="t3hc1">TOTAL</th> <td class="alignRight">21</td> <td class="alignRight">0</td> <td class="alignRight">21</td> <td class="alignRight">0</td> <td class="alignRight" headers="t3hr4 t3hc4 t3hc9">21</td> <td class="alignRight" headers="t3hr4 t3hc4 t3hc10">21</td> </tr> </tbody> </table> Influenza-like Illness (ILI) Consultation Rate

    The national influenza-like-illness (ILI) consultation rate increased in week 46 to 41.1 consultations per 1,000 (Figure 5). To date this season, the rates have been highest among those <20 years of age.
    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, 2014-2015

    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. 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 46, two new outbreaks of influenza were reported in long-term care facilities (LTCF) (Figure 6) and one outbreak of ILI was reported in a school. To date, 18 outbreaks in LTCF have been reported.
    Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2014-2015

    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

    During week 46, the proportion of prescriptions for antivirals increased slightly to 19.5 antiviral prescriptions per 100,000 total prescriptions, which is in keeping with previous seasons and consistent with other indicators of influenza circulation (Figure 7).
    Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2014-15

    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 46, 10 new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network: 8 cases of influenza A and 2 cases of influenza B (Figure 8a). To date this season, 29 hospitalizations have been reported by the IMPACT network, 26 (90%) of which were cases of influenza A, of these 73% were A(H3N2). The majority of cases (59%) were in children <5 years of age (Table 4). To date, two cases were admitted to the ICU (Figure 9a).
    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 not yet begun for the 2014-15 season (Figure 8b).
    Note: The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
    <table class="widthFull" border="1" cellpadding="2" cellspacing="0"> <caption class="alignCenter" id="t4"> Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2014-15 </caption> <thead> <tr class="bg-colour-yellow"> <th rowspan="3" id="dr1">Age groups </th> <th colspan="6" id="dc1">Cumulative (Aug. 24, 2014 to November 15, 2014) </th> </tr> <tr class="bg-colour-yellow"> <th colspan="4" id="dc2" 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 colspan="7" class="fontSize85"><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">2</td> <td class="alignRight">0</td> <td class="alignRight">2</td> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">2 (6.9%)</td> </tr> <tr> <th id="dr3" class="alignLeft" headers="dr1">6-23m </th> <td class="alignRight">6</td> <td class="alignRight">1</td> <td class="alignRight">5</td> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">6 (20.7%)</td> </tr> <tr> <th id="dr4" class="alignLeft" headers="dr1">2-4y </th> <td class="alignRight">8</td> <td class="alignRight">0</td> <td class="alignRight">5</td> <td class="alignRight">3</td> <td class="alignRight">1</td> <td class="alignRight">9 (31.0%)</td> </tr> <tr> <th id="dr5" class="alignLeft" headers="dr1">5-9y </th> <td class="alignRight">5</td> <td class="alignRight">0</td> <td class="alignRight">3</td> <td class="alignRight">2</td> <td class="alignRight">2</td> <td class="alignRight">7 (24.1%)</td> </tr> <tr> <th id="dr6" class="alignLeft" headers="dr1">10-16y </th> <td class="alignRight">5</td> <td class="alignRight">0</td> <td class="alignRight">4</td> <td class="alignRight">1</td> <td class="alignRight">0</td> <td class="alignRight">5 (17.2%)</td> </tr> <tr> <th id="dr7" class="alignLeft" headers="dr1">Total </th> <td class="alignRight">26</td> <td class="alignRight bg-colour-blue">1</td> <td class="alignRight bg-colour-blue">19</td> <td class="alignRight bg-colour-blue">6</td> <td class="alignRight">3</td> <td class="alignRight">29</td> </tr> <tr> <th id="dr8" class="alignLeft" headers="dr1">% <sup>1</sup></th> <td class="alignRight">89.7%</td> <td class="alignRight bg-colour-blue">3.8%</td> <td class="alignRight bg-colour-blue">73.1%</td> <td class="alignRight bg-colour-blue">23.1%</td> <td class="alignRight">10.3%</td> <td class="alignRight">100.0%</td> </tr> </tbody> </table>
    Table 5 - Cumulative numbers of adult hospitalizations with influenza reported by the PCIRN-SOS network, Canada, 2014-15
    PCIRN-SOS surveillance for the 2014-15 season has not yet begun.

    Figure 8 - Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15
    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.
    Figure 9 - Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15
    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)


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    Provincial/Territorial Influenza Hospitalizations and Deaths

    Since the start of the 2014-15 season, 110 laboratory-confirmed influenza-associated hospitalizations have been reported from participating provinces and territories*; 102 were cases of influenza A, of which 80% were A(H3N2); 49% were patients ≥65 years of age (Table 6). One ICU admission was reported in an adult ≥45 years of age. Ten deaths with influenza A have been reported: one child <5 years of age, one adult 45-64 years and eight adults ≥65 years of age. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.
    * Note: 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. 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. 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.
    <table class="widthFull" id="t6" border="1" cellpadding="2" cellspacing="0"> <caption class="alignCenter"> Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14 </caption> <thead> <tr class="bg-colour-yellow"> <th id="fr1" rowspan="3">Age groups </th> <th id="fc1" colspan="6">Cumulative (24 August 2014 to 15 November 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 class="bg-colour-blue" id="fc4" headers="fc1 fc2">A(H1) pdm09 </th> <th class="bg-colour-blue" id="fc5" headers="fc1 fc2">A(H3) </th> <th class="bg-colour-blue" id="fc6" 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 colspan="8" class="fontSize85"><sup>1</sup> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
    UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</td> </tr> </tfoot> <tbody> <tr> <th class="alignLeft" id="fr2" headers="fr1">0-4 years </th> <td class="alignRight">14</td> <td class="alignRight">1</td> <td class="alignRight">11</td> <td class="alignRight">2</td> <td class="alignRight">0</td> <td class="alignRight">14 (13%)</td> </tr> <tr> <th class="alignLeft" id="fr3" headers="fr1">5-19 years </th> <td class="alignRight">14</td> <td class="alignRight">0</td> <td class="alignRight">13</td> <td class="alignRight">1</td> <td class="alignRight">1</td> <td class="alignRight">15 (14%)</td> </tr> <tr> <th class="alignLeft" id="fr4" headers="fr1">20-44 years </th> <td class="alignRight">9</td> <td class="alignRight">1</td> <td class="alignRight">6</td> <td class="alignRight">2</td> <td class="alignRight">2</td> <td class="alignRight">11 (10%)</td> </tr> <tr> <th class="alignLeft" id="fr5" headers="fr1">45-64 years </th> <td class="alignRight">12</td> <td class="alignRight">0</td> <td class="alignRight">11</td> <td class="alignRight">1</td> <td class="alignRight">2</td> <td class="alignRight">14 (13%)</td> </tr> <tr> <th class="alignLeft" id="fr6" headers="fr1">65+ years </th> <td class="alignRight">51</td> <td class="alignRight">0</td> <td class="alignRight">39</td> <td class="alignRight">12</td> <td class="alignRight">3</td> <td class="alignRight">54 (49%)</td> </tr> <tr> <th class="alignLeft" id="fr7" headers="fr1">Unknown</th> <td class="alignRight">2</td> <td class="alignRight">0</td> <td class="alignRight">2</td> <td class="alignRight">0</td> <td class="alignRight">0</td> <td class="alignRight">2 (2%)</td> </tr> <tr> <th class="alignLeft" id="fr8" headers="fr1">Total </th> <td class="alignRight">102</td> <td class="alignRight bg-colour-blue">2</td> <td class="alignRight bg-colour-blue">82</td> <td class="alignRight bg-colour-blue">18</td> <td class="alignRight">8</td> <td class="alignRight">110</td> </tr> <tr> <th class="alignLeft" id="fr9" headers="fr1">Percentage <sup> 1</sup></th> <td class="alignRight">92.7%</td> <td class="alignRight bg-colour-blue">2.0%</td> <td class="alignRight bg-colour-blue">80.4%</td> <td class="alignRight bg-colour-blue">17.6%</td> <td class="alignRight">7.3%</td> <td class="alignRight">100.0%</td> </tr> </tbody> </table> See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2014-15 on the Public Health Agency of Canada website.
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    Re: Canada FluWatch Weekly Reports 2014-2015 Season Week 44

    FluWatch report: November 2 to November 8, 2014 (Week 45)

    Posted 2014-11-14For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
    <A title="Flu Watch (Version PDF, 288 KB - 10 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/14-15/w45_14/pdf/fw2014-45-eng.pdf">FluWatch report: November 2 to November 8, 2014 (Week 45) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 294 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

    ?? Help with PDF documents


    Overall Summary
    • As expected, overall influenza activity in week 45 increased from the previous week. Yukon reported activity for the first time this season but only at sporadic levels.
    • A(H3N2) continues to be the most common type of influenza affecting Canadians.
    • To date, 40-55% of influenza laboratory detections and hospitalizations have been in seniors ≥65 years of age.
    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 45, two regions (in AB(1) and ON(1)) reported localized activity and 13 regions (BC(1), AB(4), ON(2), QC(5) and YT(1)) reported sporadic activity (Figure 1).
    Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 45





    Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
    Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
    Influenza and Other Respiratory Virus Detections

    The number of positive influenza tests increased sharply to 106 influenza detections (3.5% of tests) in week 45 (Figure 2). To date, 85% of influenza detections have been influenza A, and the vast majority of those subtyped have been A(H3) (Table 1). Cases of influenza B have been reported among younger age-groups, with 28% being children <5 years of age (Table 2).
    Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2014-15

    Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
    In week 45, detections of RSV, parainfluenza and adenovirus continued to follow an upward trend, in keeping with their usual pattern of seasonal circulation. Detections of rhinovirus peaked in week 39 and continue to follow a downward trend. More detections of rhinovirus were reported this year compared to previous seasons (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, 2014-15


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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, 2014-15
    </CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=ac1 colSpan=5>Weekly
    (November 2 to November 8, 2014)
    </TH><TH id=ac8 colSpan=5>Cumulative
    (August 24 to November 8, 2014)
    </TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=4 headers=ac1>Influenza A</TH><TH id=ac7 headers=ac1>B</TH><TH id=ac9 colSpan=4 headers=ac8>Influenza A</TH><TH id=ac14 headers=ac8>B</TH></TR><TR class=bg-colour-grey-light><TH id=ac3 headers="ac1 ac2">A Total</TH><TH id=ac4 class=" 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">9</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">2</TD><TD class=alignRight headers="ar1 ar2 ac1 ac7">0</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac10">79</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac11">2</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac12">74</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac13">3</TD><TD class=alignRight headers="ar1 ar2 ac8 ac14">8</TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">56</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">51</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">5</TD><TD class=alignRight headers="ar1 ar3 ac1 ac7">3</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac10">142</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac11">0</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac12">132</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac13">10</TD><TD class=alignRight headers="ar1 ar3 ac8 ac14">17</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">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">1</TD><TD class=alignRight headers="ar1 ar4 ac1 ac7">3</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac10">5</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac11">0</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac12">1</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac13">4</TD><TD class=alignRight headers="ar1 ar4 ac8 ac14">8</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">1</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac11">0</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac12">1</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac13">0</TD><TD class=alignRight headers="ar1 ar5 ac8 ac14">1</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">0</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">8</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">4</TD><TD class=alignRight headers="ar1 ar6 ac1 ac7">1</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac10">61</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac11">2</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac12">38</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac13">21</TD><TD class=alignRight headers="ar1 ar6 ac8 ac14">14</TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">17</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">17</TD><TD class=alignRight headers="ar1 ar7 ac1 ac7">1</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac10">56</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac11">0</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac13">56</TD><TD class=alignRight headers="ar1 ar7 ac8 ac14">11</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">0</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac11">0</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac13">0</TD><TD class=alignRight headers="ar1 ar8 ac8 ac14">0</TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">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">1</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac10">0</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac11">0</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac13">0</TD><TD class=alignRight headers="ar1 ar9 ac8 ac14">2</TD></TR><TR><TH id=ar10 class=alignLeft headers=ar1>PE</TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">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">2</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac11">0</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac12">1</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac13">1</TD><TD class=alignRight headers="ar1 ar10 ac8 ac14">0</TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">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">0</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac10">1</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac11">0</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac13">1</TD><TD class=alignRight headers="ar1 ar11 ac8 ac14">0</TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">97</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac4">0</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac5">68</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac6">29</TD><TD class=alignRight headers="ar1 ar12 ac1 ac7">9</TD><TD class=alignRight headers="ar1 ar12 ac8 ac9 ac10">347</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac11">4</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac12">247</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac13">96</TD><TD class=alignRight headers="ar1 ar12 ac8 ac14">61</TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="ar1 ar13 ac1 ac2 ac3">91.5%</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac4">0.0%</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac5">70.1%</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac6">29.9%</TD><TD class=alignRight headers="ar1 ar13 ac1 ac7">8.5%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac9 ac10">85.0%</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac11">1.2%</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac12">71.2%</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac13">27.7%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac14">15.0%</TD></TR></TBODY></TABLE>
    <TABLE id=t2 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2014-15</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups (years)</TH><TH id=bc1 colSpan=5>Weekly
    (November 2 to November 8, 2014)
    </TH><TH id=bc8 colSpan=7>Cumulative
    (August 24 to November 8, 2014)
    </TH></TR><TR class=bg-colour-yellow><TH id=bc2 colSpan=4 headers=bc1>Influenza A</TH><TH id=bc7 headers=bc1>B</TH><TH id=bc9 colSpan=4 headers=bc8>Influenza A</TH><TH id=bc14 headers=bc8>B</TH><TH id=bc15 colSpan=2 headers=bc8>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=bc3 headers="bc1 bc2">A Total</TH><TH id=bc4 class="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">6 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">0 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">4 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">2 </TD><TD class=alignRight headers="br1 br2 bc1 bc7">1 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">61 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">3 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">19 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">39 </TD><TD class=alignRight headers="br1 br2 bc8 bc14">21 </TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc16">82 </TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc17">16.6% </TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">15 </TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">0 </TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">12 </TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">3 </TD><TD class=alignRight headers="br1 br3 bc1 bc7">1 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">59 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">0 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">35 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">24 </TD><TD class=alignRight headers="br1 br3 bc8 bc14">6 </TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc16">65 </TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc17">13.2% </TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">16 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">0 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">12 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">4 </TD><TD class=alignRight headers="br1 br4 bc1 bc7">1 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">58 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">0 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">22 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">36 </TD><TD class=alignRight headers="br1 br4 bc8 bc14">4 </TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc16">62 </TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc17">12.6% </TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">7 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">0 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">6 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">1 </TD><TD class=alignRight headers="br1 br5 bc1 bc7">2 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">57 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">0 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">16 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">41 </TD><TD class=alignRight headers="br1 br5 bc8 bc14">25 </TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc16">82 </TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc17">16.6% </TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">25 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">0 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">13 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">12 </TD><TD class=alignRight headers="br1 br6 bc1 bc7">0 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">182 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">1 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">79 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">102 </TD><TD class=alignRight headers="br1 br6 bc8 bc14">19 </TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc16">201 </TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc17">40.8% </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">1 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">0 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">0 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">1 </TD><TD class=alignRight headers="br1 br7 bc8 bc14">0 </TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc16">1 </TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc17">0.2% </TD></TR><TR><TH id=br8 class=alignLeft headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">70 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc4">0 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc5">47 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc6">23 </TD><TD class=alignRight headers="br1 br8 bc1 bc7">5 </TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">418 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc11">4 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc12">171 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc13">243 </TD><TD class=alignRight headers="br1 br8 bc8 bc14">75 </TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc16">493 </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">93.3% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc4">0.0% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc5">67.1% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc6">32.9% </TD><TD class=alignRight headers="br1 br9 bc1 bc7">6.7% </TD><TD class=alignRight headers="br1 br9 bc8 bc9 bc10">84.8% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc11">1.0% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc12">40.9% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc13">58.1% </TD><TD class=alignRight headers="br1 br9 bc8 bc14">15.2% </TD><TD class=alignRight></TD><TD class=alignRight></TD></TR></TBODY></TABLE>


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    Influenza Strain Characterizations

    During the 2014-2015 influenza season, the National Microbiology Laboratory (NML) has characterized 12 influenza viruses [four A(H3N2) and eight influenza B]. One influenza A was antigenically similar to A/Texas/50/2012, and four influenza B viruses were antigenically similar to the B/Massachusetts/2/2012 (Yamagata lineage) recommended by the WHO for the 2014-15 seasonal influenza vaccine. Three influenza A(H3N2) viruses and one influenza B virus showed reduced titers to antisera produced against strains recommended for the seasonal influenza vaccine (Figure 4).
    Figure 4. Influenza strain characterizations, Canada, 2014-2015, N = 12

    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 2014-2015 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A/Texas/50/2012 (H3N2)-like virus, and a B/Massachusetts/2/2012-like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus is recommended.


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

    During the 2014-2015 influenza season, NML has tested 16 influenza viruses for resistance to oseltamivir and zanamivir and all were sensitive to both agents. The 17 influenza A(H3N2) viruses tested for amantadine resistance were all resistant (Table 3).
    <TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2014-15</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">8</TD><TD class=alignRight headers="t3hr1 t3hc2 t3hc6">0</TD><TD class=alignRight headers="t3hr1 t3hc3 t3hc7">8</TD><TD class=alignRight headers="t3hr1 t3hc3 t3hc8">0</TD><TD class=alignRight headers="t3hr1 t3hc4 t3hc9">17</TD><TD class=alignRight headers="t3hr1 t3hc4 t3hc10">17(100%)</TD></TR><TR><TH id=t3hr2 class="alignLeft bg-colour-blue" headers=t3hc1>A (H1N1)</TH><TD class=alignRight headers="t3hr2 t3hc2 t3hc5">0</TD><TD class=alignRight headers="t3hr2 t3hc2 t3hc6">0</TD><TD class=alignRight headers="t3hr2 t3hc3 t3hc7">0</TD><TD class=alignRight headers="t3hr2 t3hc3 t3hc8">0</TD><TD class=alignRight headers="t3hr2 t3hc4 t3hc9">0</TD><TD class=alignRight headers="t3hr2 t3hc4 t3hc10">0</TD></TR><TR><TH id=t3hr3 class="alignLeft bg-colour-blue" headers=t3hc1>B</TH><TD class=alignRight headers="t3hr3 t3hc2 t3hc5">8</TD><TD class=alignRight headers="t3hr3 t3hc2 t3hc6">0</TD><TD class=alignRight headers="t3hr3 t3hc3 t3hc7">8</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">16</TD><TD class=alignRight headers="t3hr4 t3hc2 t3hc6">0</TD><TD class=alignRight headers="t3hr4 t3hc3 t3hc7">16</TD><TD class=alignRight headers="t3hr4 t3hc3 t3hc8">0</TD><TD class=alignRight headers="t3hr4 t3hc4 t3hc9">17</TD><TD class=alignRight headers="t3hr4 t3hc4 t3hc10">17</TD></TR></TBODY></TABLE>
    Influenza-like Illness (ILI) Consultation Rate

    The national influenza-like-illness (ILI) consultation rate decreased in week 45 to 23.1 consultations per 1,000 (Figure 5). The rates were highest among those <20 years of age in week 45. The rates since mid-June have been above the expected range for this time of year.
    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, 2014-2015

    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. 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 45, two new outbreaks of influenza A(H3N2) were reported in long-term care facilities (Figure 6).
    Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2014-2015

    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

    During week 45, the proportion of prescriptions for antivirals was stable at 17.8 antiviral prescriptions per 100,000 total prescriptions, which is in keeping with previous seasons (Figure 7).
    Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2014-15

    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 45, four new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network (Figure 8a). To date this season, 19 hospitalizations have been reported by the IMPACT network, 18 of which were cases of influenza A, and 13 of these were A(H3N2). The majority of the cases (58%) were in children <5 years of age (Table 4). To date, two cases were admitted to the ICU (Figure 9a).
    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 not yet begun for the 2014-15 season (Figure 8b).
    Note: The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
    <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, 2014-15</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=dr1 rowSpan=3>Age groups </TH><TH id=dc1 colSpan=6>Cumulative (Aug. 24, 2014 to November 8, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=dc2 colSpan=4 headers=dc1>Influenza A </TH><TH id=dc7 headers=dc1>B </TH><TH id=dc8 headers=dc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=dc3 headers="dc1 dc2">A Total </TH><TH id=dc4 class=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">0 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc4">0 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc5">0 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc6">0 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc7">0 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc8">0 (0%) </TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc3">4 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc4">1 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc5">3 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc6">0 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc7">0 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc8">4 (21.1%) </TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc3">6 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc4">0 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc5">3 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc6">3 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc7">1 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc8">7 (36.8%) </TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc3">3 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc4">0 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc5">3 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc6">0 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc7">0 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc8">3 (15.8%) </TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc3">5 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc4">0 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc5">4 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc6">1 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc7">0 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc8">5 (26.3%) </TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignRight headers="dr1 dr7 dc1 dc2 dc3">18 </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr7 dc1 dc2 dc4">1 </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr7 dc1 dc2 dc5">13 </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr7 dc1 dc2 dc6">4 </TD><TD class=alignRight headers="dr1 dr7 dc1 dc7">1 </TD><TD class=alignRight headers="dr1 dr7 dc1 dc8">19 </TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP></TH><TD class=alignRight headers="dr1 dr8 dc1 dc2 dc3">94.7% </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr8 dc1 dc2 dc4">5.6% </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr8 dc1 dc2 dc5">72.2% </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr8 dc1 dc2 dc6">22.2% </TD><TD class=alignRight headers="dr1 dr8 dc1 dc7">5.3% </TD><TD class=alignRight headers="dr1 dr8 dc1 dc8">100.0% </TD></TR></TBODY></TABLE>

    Table 5 - Cumulative numbers of adult hospitalizations with influenza reported by the PCIRN-SOS network, Canada, 2014-15
    PCIRN-SOS surveillance for the 2014-15 season has not yet begun.

    <!-- <table cellspacing="0" cellpadding="2" border="1" class="widthFull"> <caption class="alignCenter"> Table 5 - Cumulative numbers of adult hospitalizations with influenza reported by the PCIRN-SOS network, Canada, 2014-15 </caption> <thead> <tr class="bg-colour-yellow"> <th rowspan="3" id="er1">Age groups </th> <th id="ec1" colspan="6" class="noWrap">Cumulative (data not yet available for 2014-15)<sup>*</sup></th> </tr> <tr class="bg-colour-yellow"> <th colspan="4" id="ec2" 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 colspan="7" class="fontSize85"><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"> 0</td> <td class="alignCenter" headers="er1 er2 ec1 ec2 ec4"> 0</td> <td class="alignCenter" headers="er1 er2 ec1 ec2 ec5"> 0</td> <td class="alignCenter" headers="er1 er2 ec1 ec2 ec6"> 0</td> <td class="alignCenter" headers="er1 er2 ec1 ec7"> 0</td> <td class="alignCenter" headers="er1 er2 ec1 ec8"> 0</td> </tr> <tr> <th id="er3" class="alignLeft" headers="er1">20-44 </th> <td class="alignCenter" headers="er1 er3 ec1 ec2 ec3"> 0</td> <td class="alignCenter" headers="er1 er3 ec1 ec2 ec4"> 0</td> <td class="alignCenter" headers="er1 er3 ec1 ec2 ec5"> 0</td> <td class="alignCenter" headers="er1 er3 ec1 ec2 ec6"> 0</td> <td class="alignCenter" headers="er1 er3 ec1 ec7"> 0</td> <td class="alignCenter" headers="er1 er3 ec1 ec8"> 0</td> </tr> <tr> <th id="er4" class="alignLeft" headers="er1">45-64 </th> <td class="alignCenter" headers="er1 er4 ec1 ec2 ec3"> 0</td> <td class="alignCenter" headers="er1 er4 ec1 ec2 ec4"> 0</td> <td class="alignCenter" headers="er1 er4 ec1 ec2 ec5"> 0</td> <td class="alignCenter" headers="er1 er4 ec1 ec2 ec6"> 0</td> <td class="alignCenter" headers="er1 er4 ec1 ec7"> 0</td> <td class="alignCenter" headers="er1 er4 ec1 ec8"> 0</td> </tr> <tr> <th id="er5" class="alignLeft" headers="er1">65+ </th> <td class="alignCenter" headers="er1 er5 ec1 ec2 ec3"> 0</td> <td class="alignCenter" headers="er1 er5 ec1 ec2 ec4"> 0</td> <td class="alignCenter" headers="er1 er5 ec1 ec2 ec5"> 0</td> <td class="alignCenter" headers="er1 er5 ec1 ec2 ec6"> 0</td> <td class="alignCenter" headers="er1 er5 ec1 ec7"> 0</td> <td class="alignCenter" headers="er1 er5 ec1 ec8"> 0</td> </tr> <tr> <th id="er6" class="alignLeft" headers="er1">Total </th> <td class="alignCenter" headers="er1 er6 ec1 ec2 ec3"> 0</td> <td class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec4"> 0</td> <td class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec5"> 0</td> <td class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec6"> 0</td> <td class="alignCenter" headers="er1 er6 ec1 ec7"> 0</td> <td class="alignCenter" headers="er1 er6 ec1 ec8"> 0</td> </tr> <tr> <th id="er7" class="alignLeft" headers="er1">% <sup>1</sup> </th> <td class="alignCenter" headers="er1 er7 ec1 ec2 ec3"> 0</td> <td class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec4"> 0</td> <td class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec5"> 0</td> <td class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec6"> 0</td> <td class="alignCenter" headers="er1 er7 ec1 ec7"> 0</td> <td class="alignCenter" headers="er1 er7 ec1 ec8"> 0</td> </tr> </tbody> </table>-->Figure 8 - Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15
    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, 2014-15
    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 (&ge;16 year of age, PCIRN-SOS)
    -->
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    Provincial/Territorial Influenza Hospitalizations and Deaths

    Since the start of the 2014-15 season, 73 laboratory-confirmed influenza-associated hospitalizations have been reported from participating provinces and territories<SUP>*</SUP>; 69 were cases of influenza A, of which the majority were A(H3N2); 55% were patients ≥65 years of age (Table 6). No ICU admissions were reported. Eight deaths with influenza A have been reported: one child <5 years of age and seven adults ≥45 years of age. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.
    * Note: 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. 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. 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.
    <TABLE id=t6 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=fr1 rowSpan=3>Age groups </TH><TH id=fc1 colSpan=6>Cumulative (24 August 2014 to 8 November 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>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">9 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc4">1 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc5">6 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc6">2 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc7">0 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc8">9 (12%) </TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-19 years </TH><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc3">10 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc4">0 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc5">10 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc6">0 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc7">0 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc8">10 (14%) </TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc3">3 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc4">1 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc5">1 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc6">1 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc7">2 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc8">5 (7%) </TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc3">7 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc4">0 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc5">7 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc6">0 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc7">2 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc8">9 (12%) </TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>65+ years </TH><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc3">40 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc4">0 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc5">30 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc6">10 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc7">0 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc8">40 (55%) </TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>Unknown</TH><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc3">0 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc4">0 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc5">0 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc6">0 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc7">0 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc8">0 (0%) </TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignRight headers="fr1 fr8 fc1 fc2 fc3">69 </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr8 fc1 fc2 fc4">2 </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr8 fc1 fc2 fc5">54 </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr8 fc1 fc2 fc6">13 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc7">4 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc8">73 </TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP></TH><TD class=alignRight headers="fr1 fr9 fc1 fc2 fc3">94.5% </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr9 fc1 fc2 fc4">2.9% </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr9 fc1 fc2 fc5">78.3% </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr9 fc1 fc2 fc6">18.8% </TD><TD class=alignRight headers="fr1 fr9 fc1 fc7">5.5% </TD><TD class=alignRight headers="fr1 fr9 fc1 fc8">100.0% </TD></TR></TBODY></TABLE>
    See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2014-15 on the Public Health Agency of Canada website.
    .../

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    Re: Canada FluWatch Weekly Reports 2014-2015 Season Week 43

    FluWatch report: October 26 to November 1, 2014 (Week 44)

    Posted 2014-11-07For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
    <A title="Flu Watch (Version PDF, 288 KB - 10 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/14-15/w44_14/pdf/fw2014-44-eng.pdf">FluWatch report: October 26 to November 1, 2014 (Week 44) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 294 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

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    Overall Summary
    • Influenza activity continued to increase in week 44; mostly in the western and central provinces.
    • So far this season, A(H3N2) has been the most common type of influenza affecting Canadians.
    • To date, 45-50% of influenza laboratory detections and hospitalizations have been in seniors ≥65 years of age.
    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 44, one region in Ontario reported localized activity and 16 regions (BC(2), AB(5), SK(3), ON(3), QC(2) and NS(1)) reported sporadic activity (Figure 1).
    Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 44





    Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
    Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
    Influenza and Other Respiratory Virus Detections

    The number of positive influenza tests increased to 61 influenza detections (2.0% of tests) in week 44 (Figure 2). To date, 83% of influenza detections have been influenza A, and the vast majority of those subtyped have been A(H3) (Table 1). Among cases with reported age, the largest proportion was in those ≥65 years of age (45%). Children <5 years accounted for 17% of all cases (Table 2).
    Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2014-15

    Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
    In week 44, detections of RSV, parainfluenza and adenovirus continued to follow an upward trend, in keeping with their usual pattern of seasonal circulation. Detections of rhinovirus peaked in week 39 and continue to follow a downward trend. More detections of rhinovirus were reported this year compared to previous seasons (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, 2014-15


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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, 2014-15
    </CAPTION&g