<TABLE border=0 cellSpacing=0 cellPadding=0><TBODY><TR><TD><H1>January 30 to February 5, 2011 (Week 05)</H1></TD></TR></TBODY></TABLE>
Posted 2011-02-11
Overall Influenza Summary ? Week 5 (January 30 to February 5, 2011)
In week 05, 18 regions reported localized activity (in BC(2), AB(2), ON(6), QC(2), NS(1), NB(4) & PE(1)), 27 regions reported sporadic activity (in all provinces and territories except YK) and 11 regions presented no activity. (See Activity level Map). Compared to the previous week (week 04), 10 regions reported an increased level of influenza activity, 8 regions reported decreased activity, and 29 regions maintained a stable level of influenza activity (sporadic or higher). During week 05, 29 new ILI/influenza outbreaks were reported: 11 in long-term care facilities (LTCF) in ON(4), QC(4), NB (2) and PE(1); 9 school outbreaks in BC(1), NB(7) and NL(1); 2 outbreaks in hospitals in ON; and 7 outbreaks in other facilities in BC(1) and ON(6).
<TABLE class=widthFull border=0 cellSpacing=0 cellPadding=0><TBODY><TR class=alignCenter><TD colSpan=2>Map of overall Influenza activity level by province and territory, Canada, Week 5
</TD></TR><TR class=alignCenter><TD class=alignCenter>
</TD><TD class=alignCenter><TABLE border=0 cellSpacing=0 cellPadding=1><TBODY><TR><TD><TABLE class=border-lite cellSpacing=1 cellPadding=1><TBODY><TR><TD class=alignCenter>No Data </TD><TD class=alignCenter>
</TD></TR><TR class=alignCenter><TD class=alignCenter>No Activity</TD><TD class=alignCenter>
</TD></TR><TR class=alignCenter><TD class=alignCenter>Sporadic Activity</TD><TD class=alignCenter>
</TD></TR><TR><TD class=alignCenter>Localized Activity</TD><TD class=alignCenter>
</TD></TR><TR><TD class=alignCenter>Widespread Activity</TD><TD class=alignCenter>
</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR><TR><TD class=fontSize85 colSpan=2>Note: Influenza activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.</TD></TR></TBODY></TABLE>
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Number of influenza surveillance regions<SUP title="sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in">?</SUP> reporting widespread or localized influenza activity, Canada, by report week, 2010-2011 (N=56)
? sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.
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Overall Number of Influenza Outbreaks, Canada, by Report Week, 2010-2011
Note that this was the first year that all the provinces and territories were reporting on influenza outbreaks in schools (greater than 10% absenteeism on any day most likely due to ILI) which has increased considerably the total number of outbreaks reported compared to previous years.
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ILI consultation rate
During week 05, the national ILI consultation rate was 29.9 consultations per 1,000 patient visits, which is similar to week 04 with 26.6 consultations per 1,000. This rate is still within the expected levels for this time of year (see ILI graph). Children under 5 years of age had the highest consultation rates (72.5 per 1,000 consultations in week 05) followed by children between 5 and 19 years (54.1 per 1,000).
Influenza-like illness (ILI) consultation rates, Canada, by report week, 2010-2011 compared to 1996/97 through to 2008/09 seasons
Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons). Delays in the reporting of data may cause data to change retrospectively.
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Laboratory Surveillance Summary
The proportion of tests that were positive for influenza during week 05 was 19.8%. The proportion of positive
tests decreased from a peak at week 52, but increased slightly in week 05, likely due to an increase in the
proportion of positive tests in Ontario and the Atlantic provinces. Of the 1359 positive tests reported during week
05, 401 (30%) specimens were reported as influenza A/H3N2, 88 (7%) as pandemic H1N1 2009, 101 (7%) as
influenza B and 769 (57%) as unsubtyped influenza A. The majority of influenza virus detections to date this
season were influenza A viruses (96.8% or 10471/10821). Since the beginning of the season, 88.0% of the
subtyped positive influenza A specimens were influenza A/H3N2. In week 05, detections of pandemic H1N1 2009
represented 18.0% of all subtyped influenza A specimens, an increase from 12.6% in week 04. Detections of
influenza B increased slightly from 5.4% of all positive influenza specimens in week 04 to 7.4% in week 05.
During week 05, 51.8% (72/139) of cases with A/H3N2 reported through the detailed case-based laboratory
reporting were aged 65 years or older, while since August 29, 2010, the proportion was 49.8% (1384/2778) (see
Tests detailed table). In week 05, the proportion of positive tests for respiratory syncytial virus detections (RSV)
increased slightly from at 15.0% to 16.9% of specimens tested while low levels of parainfluenza (2.1%) and
rhinovirus (4.0%) continue to be reported (see Respiratory viruses graph).
Weekly & Cumulative numbers of positive influenza specimens by Provincial Laboratories, Canada, 2010-2011
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><TFOOT><TR><TD class=fontSize85 colSpan=13>* Unsubtyped: The specimen was typed as influenza A, but no test for subtyping was performed. Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Note: Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals.
</TD></TR></TFOOT><TBODY><TR class=alignCenter><TH class=bg-colour-blue rowSpan=3 scope=col>Reporting provinces</TH><TH class="bg-colour-blue fontSize85" colSpan=6 scope=colgroup>Weekly (January 30 to February 5, 2011)</TH><TH class="bg-colour-blue fontSize85" colSpan=6 scope=colgroup>Cumulative (August 29, 2010 to February 5, 2011)</TH></TR><TR class=alignCenter><TH class="bg-colour-blue fontSize85" colSpan=5 scope=colgroup>Influenza A</TH><TH class="bg-colour-blue fontSize85" scope=col>B</TH><TH class="bg-colour-blue fontSize85" colSpan=5 scope=colgroup>Influenza A</TH><TH class=bg-colour-blue scope=col>B</TH></TR><TR class=alignCenter><TH class="fontSize85 bg-colour-blue" scope=col>A Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H3)</TH><TH class="fontSize85 bg-colour-blue" scope=col>Pand H1N1</TH><TH class="fontSize85 bg-colour-blue noWrap" scope=col>A (Un S)*</TH><TH class="fontSize85 bg-colour-blue" scope=col>Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H3)</TH><TH class="fontSize85 bg-colour-blue" scope=col>Pand H1N1</TH><TH class="fontSize85 bg-colour-blue noWrap" scope=col>A (Un S)*</TH><TH class="fontSize85 bg-colour-blue" scope=col>Total</TH></TR><TR><TH class=bg-colour-blue scope=row>BC</TH><TD class=alignCenter>21</TD><TD class=alignCenter>0</TD><TD class=alignCenter>4</TD><TD class=alignCenter>14</TD><TD class=alignCenter>3</TD><TD class=alignCenter>8</TD><TD class=alignCenter>161</TD><TD class=alignCenter>0</TD><TD class=alignCenter>54</TD><TD class=alignCenter>54</TD><TD class=alignCenter>53</TD><TD class=alignCenter>29</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>70</TD><TD class=alignCenter>0</TD><TD class=alignCenter>36</TD><TD class=alignCenter>17</TD><TD class=alignCenter>17</TD><TD class=alignCenter>19</TD><TD class=alignCenter>448</TD><TD class=alignCenter>0</TD><TD class=alignCenter>341</TD><TD class=alignCenter>78</TD><TD class=alignCenter>29</TD><TD class=alignCenter>51</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>42</TD><TD class=alignCenter>0</TD><TD class=alignCenter>36</TD><TD class=alignCenter>2</TD><TD class=alignCenter>4</TD><TD class=alignCenter>1</TD><TD class=alignCenter>112</TD><TD class=alignCenter>0</TD><TD class=alignCenter>76</TD><TD class=alignCenter>3</TD><TD class=alignCenter>33</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>480</TD><TD class=alignCenter>0</TD><TD class=alignCenter>56</TD><TD class=alignCenter>1</TD><TD class=alignCenter>423</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>582</TD><TD class=alignCenter>0</TD><TD class=alignCenter>155</TD><TD class=alignCenter>21</TD><TD class=alignCenter>406</TD><TD class=alignCenter>48</TD><TD class=alignCenter>5147</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1986</TD><TD class=alignCenter>217</TD><TD class=alignCenter>2944</TD><TD class=alignCenter>184</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>442</TD><TD class=alignCenter>0</TD><TD class=alignCenter>106</TD><TD class=alignCenter>9</TD><TD class=alignCenter>327</TD><TD class=alignCenter>19</TD><TD class=alignCenter>3898</TD><TD class=alignCenter>0</TD><TD class=alignCenter>498</TD><TD class=alignCenter>22</TD><TD class=alignCenter>3378</TD><TD class=alignCenter>72</TD></TR><TR><TH class=bg-colour-blue scope=row>NB</TH><TD class=alignCenter>84</TD><TD class=alignCenter>0</TD><TD class=alignCenter>57</TD><TD class=alignCenter>21</TD><TD class=alignCenter>6</TD><TD class=alignCenter>5</TD><TD class=alignCenter>175</TD><TD class=alignCenter>0</TD><TD class=alignCenter>110</TD><TD class=alignCenter>43</TD><TD class=alignCenter>22</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>4</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>20</TD><TD class=alignCenter>0</TD><TD class=alignCenter>7</TD><TD class=alignCenter>4</TD><TD class=alignCenter>9</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>7</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>21</TD><TD class=alignCenter>0</TD><TD class=alignCenter>14</TD><TD class=alignCenter>7</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>9</TD><TD class=alignCenter>0</TD><TD class=alignCenter>8</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>1258</TD><TD class=alignCenter>0</TD><TD class=alignCenter>401</TD><TD class=alignCenter>88</TD><TD class=alignCenter>769</TD><TD class=alignCenter>101</TD><TD class=alignCenter>10471</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3150</TD><TD class=alignCenter>430</TD><TD class=alignCenter>6891</TD><TD class=alignCenter>351</TD></TR></TBODY></TABLE>
Weekly & Cumulative numbers of positive influenza specimens by age groups reported through case-based laboratory reporting, Canada, 2010-2011*
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><TFOOT><TR><TD class=fontSize85 colSpan=11> * Please note that this table reflects the number of specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported. Five provinces have reported detailed case-by-case data since the beginning of the season (BC, AB, SK, MB and ON). Delays in the reporting of data may cause data to change retrospectively.
</TD></TR></TFOOT><TBODY><TR class=bg-colour-yellow><TH rowSpan=3 scope=col>Age groups</TH><TH colSpan=5 scope=colgroup>Weekly
(January 30 to February 5, 2011)</TH><TH colSpan=5 scope=colgroup>Cumulative
(Aug. 29, 2010 to Feb. 5, 2011)
</TH></TR><TR class=bg-colour-yellow><TH colSpan=4 scope=colgroup>Influenza A</TH><TH>B</TH><TH colSpan=4 scope=colgroup>Influenza A</TH><TH>B</TH></TR><TR class=bg-colour-yellow><TH scope=col>A Total</TH><TH scope=col>Pandemic H1N1</TH><TH scope=col>A/H3N2</TH><TH scope=col>A unsubtyped</TH><TH scope=col>Total</TH><TH scope=col>A Total</TH><TH scope=col>Pandemic H1N1</TH><TH scope=col>A/H3N2</TH><TH scope=col>A unsubtyped</TH><TH scope=col>Total</TH></TR><TR><TD><5</TD><TD class=alignCenter>37</TD><TD class=alignCenter>7</TD><TD class=alignCenter>21</TD><TD class=alignCenter>9</TD><TD class=alignCenter>7</TD><TD class=alignCenter>623</TD><TD class=alignCenter>66</TD><TD class=alignCenter>435</TD><TD class=alignCenter>122</TD><TD class=alignCenter>45</TD></TR><TR><TD>5-19</TD><TD class=alignCenter>19</TD><TD class=alignCenter>4</TD><TD class=alignCenter>13</TD><TD class=alignCenter>2</TD><TD class=alignCenter>12</TD><TD class=alignCenter>302</TD><TD class=alignCenter>46</TD><TD class=alignCenter>163</TD><TD class=alignCenter>93</TD><TD class=alignCenter>49</TD></TR><TR><TD>20-44</TD><TD class=alignCenter>38</TD><TD class=alignCenter>14</TD><TD class=alignCenter>16</TD><TD class=alignCenter>8</TD><TD class=alignCenter>5</TD><TD class=alignCenter>631</TD><TD class=alignCenter>143</TD><TD class=alignCenter>333</TD><TD class=alignCenter>155</TD><TD class=alignCenter>34</TD></TR><TR><TD>45-64</TD><TD class=alignCenter>27</TD><TD class=alignCenter>2</TD><TD class=alignCenter>17</TD><TD class=alignCenter>8</TD><TD class=alignCenter>0</TD><TD class=alignCenter>472</TD><TD class=alignCenter>80</TD><TD class=alignCenter>272</TD><TD class=alignCenter>120</TD><TD class=alignCenter>20</TD></TR><TR><TD>65+</TD><TD class=alignCenter>94</TD><TD class=alignCenter>2</TD><TD class=alignCenter>72</TD><TD class=alignCenter>20</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1632</TD><TD class=alignCenter>24</TD><TD class=alignCenter>1384</TD><TD class=alignCenter>224</TD><TD class=alignCenter>23</TD></TR><TR><TD>Unknown</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>197</TD><TD class=alignCenter>3</TD><TD class=alignCenter>191</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD></TR><TR><TD>Total</TD><TD class=alignCenter>216</TD><TD class=alignCenter>29</TD><TD class=alignCenter>139</TD><TD class=alignCenter>48</TD><TD class=alignCenter>26</TD><TD class=alignCenter>3857</TD><TD class=alignCenter>362</TD><TD class=alignCenter>2778</TD><TD class=alignCenter>717</TD><TD class=alignCenter>171</TD></TR></TBODY></TABLE>
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Influenza tests reported and percentage of tests positive, Canada, by report week, 2010-2011
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Percent positive influenza tests, compared to other respiratory viruses, Canada, by reporting week, 2010-2011
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Canadian situation
Paediatric Influenza Hospitalizations and Deaths
In week 05 (ending 5 February 2011), 29 new laboratory-confirmed influenza-associated paediatric (16 years of age and under) hospitalizations were reported through the Immunization Monitoring Program Active (IMPACT) network: 2 from AB, 1 from MB, 13 from ON, 12 from QC, and 1 from NS. This number is decreased compared to the previous week (week 04) in which 35 paediatric hospitalizations were reported (note that numbers may fluctuate because of the delays in reporting). So far this season, two deaths in children have been reported, both in Ontario. One, aged between 6 months and 23 months, who tested positive for pandemic H1N1 2009 was reported in week 48, and one aged 10-16 years, who tested positive for influenza A (unsubtyped), was reported in week 04.
Since the beginning of the season, 330 hospitalizations with laboratory-confirmed influenza have been reported from all provinces except NB and PE; 60 (18.2%) as influenza A/H3N2, 10 (3.0%) pandemic H1N1 2009, 233 (70.6%) as unsubytped influenza A, and 27 (8.2%) influenza B. The distribution of cases to date by age group was as follows: 17.9% among 0-5 month olds; 30.3% among 6-23 month olds; 27.0% among the 2-4 year-olds; 16.1% among 5-9 year-olds; and 8.8% among children 10-16 years old.
Adult Influenza Hospitalizations and Deaths
During week 05 (ending 5 February 2011) 26 new hospitalizations with laboratory-confirmed influenza among adults (16 years of age and older) were reported through the Canadian Nosocomial Infection Surveillance Program (CNISP). This number decreased for the second week in a row, compared to 39 adult hospitalizations in week 04 and 59 in week 03 (note that numbers may fluctuate because of the delays in reporting). Of the 26 new cases reported between January 30 and February 5, 2011, 23 (88.5%) tested positive for unsubtyped influenza A, 2 (7.7%) as influenza A/H3N2, and 1 (3.8%) as influenza B. Since the beginning of the season, 694 hospitalized cases have been reported: 170 (24.5%) A/H3N2, 29 (4.2%) pandemic H1N1 2009, 483 (69.6%) influenza A unsubtyped, and 12 (1.7%) influenza B, from all reporting provinces except NB and NL. To date, 494 of the 694 (71.2%) cases were aged 65 years or older and 305 (43.9%) were males.
Nine provinces and territories (excluding BC, QC, NB and NU) currently conduct severe outcomes surveillance and report weekly numbers of hospitalizations, ICU admissions and deaths with laboratory-confirmed influenza. In week 05, ON reported 5 deaths, 1 with pandemic H1N1 2009, 1 with A/H3N2, and 3 with unsubtyped influenza A (note that numbers may fluctuate because of the delays in reporting). Among the 95 fatal cases currently reported since the beginning of the influenza season, influenza A/H3N2 was identified in 61.1% (58/95), unsubtyped influenza A in 31.6% (30/95), pandemic H1N1 2009 in 6 cases (6.3%), and influenza B in one case (1.1%). Seventy-three percent (69/95) of these fatal cases were among persons 65 years of age or older, and another 15% (14/95) were between the ages of 45 and 64 years old, in keeping with the age-groups usually affected by A/H3N2.
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</TD></TR><TR class=alignCenter><TD class=alignCenter>No Activity</TD><TD class=alignCenter>
</TD></TR><TR class=alignCenter><TD class=alignCenter>Sporadic Activity</TD><TD class=alignCenter>
</TD></TR><TR><TD class=alignCenter>Localized Activity</TD><TD class=alignCenter>
</TD></TR><TR><TD class=alignCenter>Widespread Activity</TD><TD class=alignCenter>
</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR><TR><TD class=fontSize85 colSpan=2>Note: Influenza activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.
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