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Canada FluWatch Weekly Reports 2010-2011 Season Week 20 - 224 deaths total (excluding BC, QC, NB and NU)

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  • Pathfinder
    replied
    Re: Canada FluWatch Weekly Reports 2010-2011 Season Week 20 - 224 deaths total (excluding BC, QC, NB and NU)

    <TABLE border=0 cellSpacing=0 cellPadding=0><TBODY><TR><TD>May 15 to 21, 2011 (Week 20)

    </TD></TR></TBODY></TABLE>


    Posted 2011-05-27

    Overall Influenza Summary
    • The 2010-11 influenza season in Canada is drawing to a close, with most regions of the country reporting sporadic or no activity. The ILI consultation rate, number of outbreaks, paediatric and adult hospitalizations all continue to decrease.
    • Laboratory detections of both influenza A and B continue to decrease, and in week 20 the proportion of positive tests for parainfluenza viruses declined.

    Note: This is the final weekly report for the 2010-11 influenza season. Bi-weekly reports will commence on June 10th (for weeks 21 and 22). However, laboratory detections reported through the RVDSS and influenza activity level maps will be updated weekly on the FluWatch website.
    Influenza Activity and Outbreaks

    In week 20, 4 regions reported localized activity: AB(1), NS(2) and NL(1); 21 regions reported sporadic activity; and 31 regions presented no activity (see Activity level Map). Three new outbreaks were reported in wk 20, one outbreak of influenza in a long-term care facility (LTCF) in Alberta, and 2 ILI outbreaks in communities in Nova Scotia.

    Map of overall Influenza activity level by province and territory, Canada, Week 20





    No Data

    No Activity

    Sporadic Activity

    Localized Activity

    Widespread Activity



    Note: Influenza activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.
    Text Equivalent

    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.
    Text Equivalent


    Top of Page

    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.
    Text Equivalent
    ILI consultation rate
    During week 20, the national ILI consultation rate was 10.0 consultations per 1,000 patient visits, which is decreased compared to the previous week and within the expected rate for this time of year (see ILI graph). Children 5-19 years of age had the highest consultation rates (21.6 per 1,000 consultations) in week 20.
    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.
    Text Equivalent
    Laboratory Surveillance Summary
    The overall proportion of tests that were positive for influenza during week 20 was 2.9% (1.0% influenza A, 1.9% influenza B), which is decreased compared to week 19 (3.8%). The proportion of positive tests peaked in week 52 (see Influenza tests graph). Since the beginning of the season, 85.5% (16,847/19,706) of influenza virus detections have been influenza A viruses, of which 84.8% (5,578/6,578) of subtyped specimens have been A/H3N2. Detections of influenza B have been increasing steadily since week 03 and peaked in week 15. Through detailed case-based laboratory reporting where age data is provided, since August 29, 2010, 50.7% (2,059/4,059) of cases with A/H3N2 were aged 65 years or older. In contrast, the majority of cases with pandemic H1N1 2009 (94.5%, 751/795) and influenza B (90.3%, 1,348/1,492) were under 65 years of age (see Tests detailed table). Following an increasing proportion of positive tests for parainfluenza viruses since week 11, the proportion decreased in week 20 (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 (May 15 to May 21, 2011)</TH><TH class="bg-colour-blue fontSize85" colSpan=6 scope=colgroup>Cumulative (August 29, 2010 to May 21, 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>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>0</TD><TD class=alignCenter>477</TD><TD class=alignCenter>0</TD><TD class=alignCenter>200</TD><TD class=alignCenter>164</TD><TD class=alignCenter>113</TD><TD class=alignCenter>179</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>8</TD><TD class=alignCenter>0</TD><TD class=alignCenter>7</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1081</TD><TD class=alignCenter>0</TD><TD class=alignCenter>765</TD><TD class=alignCenter>279</TD><TD class=alignCenter>37</TD><TD class=alignCenter>736</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>320</TD><TD class=alignCenter>0</TD><TD class=alignCenter>213</TD><TD class=alignCenter>30</TD><TD class=alignCenter>77</TD><TD class=alignCenter>175</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>515</TD><TD class=alignCenter>0</TD><TD class=alignCenter>56</TD><TD class=alignCenter>2</TD><TD class=alignCenter>457</TD><TD class=alignCenter>15</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>8</TD><TD class=alignCenter>6884</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2437</TD><TD class=alignCenter>275</TD><TD class=alignCenter>4172</TD><TD class=alignCenter>841</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>17</TD><TD class=alignCenter>6026</TD><TD class=alignCenter>0</TD><TD class=alignCenter>957</TD><TD class=alignCenter>41</TD><TD class=alignCenter>5028</TD><TD class=alignCenter>757</TD></TR><TR><TH class=bg-colour-blue scope=row>NB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>959</TD><TD class=alignCenter>0</TD><TD class=alignCenter>669</TD><TD class=alignCenter>176</TD><TD class=alignCenter>114</TD><TD class=alignCenter>102</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>2</TD><TD class=alignCenter>272</TD><TD class=alignCenter>0</TD><TD class=alignCenter>80</TD><TD class=alignCenter>11</TD><TD class=alignCenter>181</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>97</TD><TD class=alignCenter>0</TD><TD class=alignCenter>79</TD><TD class=alignCenter>16</TD><TD class=alignCenter>2</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>2</TD><TD class=alignCenter>216</TD><TD class=alignCenter>0</TD><TD class=alignCenter>122</TD><TD class=alignCenter>6</TD><TD class=alignCenter>88</TD><TD class=alignCenter>40</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>17</TD><TD class=alignCenter>0</TD><TD class=alignCenter>10</TD><TD class=alignCenter>1</TD><TD class=alignCenter>6</TD><TD class=alignCenter>34</TD><TD class=alignCenter>16847</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5578</TD><TD class=alignCenter>1000</TD><TD class=alignCenter>10269</TD><TD class=alignCenter>2859</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
    (May 15 to May 21, 2011)</TH><TH colSpan=5 scope=colgroup>Cumulative
    (Aug. 29, 2010 to May 21, 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>4</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1015</TD><TD class=alignCenter>129</TD><TD class=alignCenter>738</TD><TD class=alignCenter>148</TD><TD class=alignCenter>410</TD></TR><TR><TD>5-19</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>517</TD><TD class=alignCenter>103</TD><TD class=alignCenter>296</TD><TD class=alignCenter>118</TD><TD class=alignCenter>533</TD></TR><TR><TD>20-44</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>1082</TD><TD class=alignCenter>332</TD><TD class=alignCenter>530</TD><TD class=alignCenter>220</TD><TD class=alignCenter>291</TD></TR><TR><TD>45-64</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>791</TD><TD class=alignCenter>187</TD><TD class=alignCenter>436</TD><TD class=alignCenter>168</TD><TD class=alignCenter>114</TD></TR><TR><TD>65+</TD><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>2509</TD><TD class=alignCenter>44</TD><TD class=alignCenter>2059</TD><TD class=alignCenter>406</TD><TD class=alignCenter>144</TD></TR><TR><TD>Unknown</TD><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>231</TD><TD class=alignCenter>3</TD><TD class=alignCenter>224</TD><TD class=alignCenter>4</TD><TD class=alignCenter>1</TD></TR><TR><TD>Total</TD><TD class=alignCenter>9</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5</TD><TD class=alignCenter>4</TD><TD class=alignCenter>2</TD><TD class=alignCenter>6145</TD><TD class=alignCenter>798</TD><TD class=alignCenter>4283</TD><TD class=alignCenter>1064</TD><TD class=alignCenter>1493</TD></TR></TBODY></TABLE>


    Top of Page

    Influenza tests reported and percentage of tests positive, Canada, by report week, 2010-2011


    Text Equivalent

    Percent positive influenza tests, compared to other respiratory viruses, Canada, by reporting week, 2010-2011


    Text Equivalent
    Antigenic Characterization
    Between September 1 and May 27, 2011, the National Microbiology Laboratory (NML) has antigenically characterized 950 influenza viruses that were received from provincial laboratories: 270 A/H3N2, 142 pandemic H1N1 2009 and 538 B viruses. Of the 270 influenza A/H3N2 viruses characterized, 267 (98.9%) were antigenically related to A/Perth/16/2009, which is the influenza A/H3N2 component recommended for the 2010-11 influenza vaccine. Three viruses (1.1%) tested showed reduced titer with antiserum produced against A/Perth/16/2009. Of the 142 pandemic H1N1 2009 viruses characterized, 140 (98.6%) were antigenically related to the pandemic vaccine virus A/California/7/2009, which is the recommended H1N1 component for the 2010-11 influenza vaccine. Two viruses (1.4%) tested showed reduced titer with antiserum produced against A/California/7/2009. Of the 538 influenza B viruses characterized, 509 (94.6%) were antigenically related to B/Brisbane/60/08 (Victoria lineage), which is the recommended influenza B component for the 2010-11 influenza vaccine. Four of the 509 viruses tested showed reduced titer with antisera produced against B/Brisbane/60/08. Twenty-five (4.6%) influenza B viruses were characterized as B/Wisconsin/01/2010-like, which belongs to the Yamagata lineage. B/Wisconsin/01/2010-like viruses are antigenically and genetically different from the previous Yamagata lineage vaccine strain B/Florida/04/2006.
    Antiviral Resistance
    Since the beginning of the 2010-2011 season, NML has tested 633 influenza A isolates (474 A/H3N2 and 159 pandemic H1N1 2009) for amantadine resistance and found that 473 influenza A/H3N2 were resistant and one was sensitive. All 159 influenza A/H1N1 viruses were resistant to amantadine. Of 923 influenza viruses (248 A/H3N2, 146 pandemic H1N1 2009, and 529 influenza B) tested for resistance to oseltamivir, 247 A/H3N2 viruses were sensitive and one was resistant with the E119V mutation. The resistant case was associated with oseltamivir prophylaxis/treatment. Of the 146 pandemic H1N1 2009 isolates tested for oseltamivir resistance, 145 were sensitive and one was resistant with the H275Y mutation. The resistant case was associated with oseltamivir treatment. Of the 529 B virus isolates tested, 528 were sensitive to oseltamivir and one was resistant with the D198N mutation. Of 914 influenza viruses (244 A/H3N2, 143 pandemic H1N1 2009, and 527 influenza B) tested for zanamivir resistance all 244 A/H3N2 and 143 pandemic H1N1 2009 isolates were found to be sensitive. Of the 527 B virus isolates tested, 526 were sensitive to zanamivir and one was resistant with the D198N mutation.
    Severe Illness Surveillance

    Note that all numbers are preliminary and numbers may fluctuate because of delays in reporting
    Paediatric Influenza Hospitalizations and Deaths
    In week 20, 6 new laboratory-confirmed influenza-associated paediatric (16 years of age and under) hospitalizations were reported through the Immunization Monitoring Program Active (IMPACT) network: all with influenza B, from BC(1), QC(4) and NL(1). Influenza A was associated with the majority of hospitalizations earlier in the season (weeks 47 to 09). Since week 10, however, influenza B accounted for more cases than influenza A each week. Six paediatric deaths have been reported via IMPACT this season: 3 children between 6 and 23 months old, two with pandemic H1N1 2009 and one with influenza B; two children between 2 and 4 years old, both with influenza B; and one child between 10 and 16 years old with influenza A/H3. All cases had underlying comorbidities.
    Since the beginning of the season, 668 hospitalizations with laboratory-confirmed influenza have been reported: 103 (15.4%) as influenza A/H3N2, 23 (3.4%) pandemic H1N1 2009, 326 (48.8%) as un-subtyped influenza A, and 216 (32.3%) influenza B. The distribution of cases to date by age group was as follows: 16.8% among 0-5 month olds; 27.5% among 6-23 month olds; 28.7% among the 2-4 year-olds; 16.5% among 5-9 year-olds; and 10.5% among children 10-16 years old.
    Adult Influenza Hospitalizations and Deaths
    During week 20, no new hospitalizations with laboratory-confirmed influenza among adults (16 years of age and older) were reported through the Canadian Nosocomial Infection Surveillance Program (CNISP). Since the beginning of the season, 969 hospitalized cases have been reported: 202 (20.8%) A/H3N2, 48 (5.0%) pandemic H1N1 2009, 644 (66.5%) influenza A unsubtyped, and 75 (7.7%) influenza B, from all reporting provinces. To date, 651 of the 969 (67.2%) cases were aged 65 years or older and 437 (45.1%) were males.

    Aggregate Influenza Hospitalizations and Deaths
    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 20, no deaths with influenza were reported. Among the 224 fatal cases reported since the beginning of the influenza season, influenza A/H3N2 was identified in 60.7% (136/224), unsubtyped influenza A in 28.1% (63/224), pandemic H1N1 2009 in 6.7% (15/224), and influenza B in 4.5% (10/224). Seventy-nine percent (177/224) of these fatal cases were among persons 65 years of age or older, and another 11% (25/224) 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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  • Pathfinder
    replied
    Re: Canada FluWatch Weekly Reports 2010-2011 Season Week 19 - 224 deaths total (excluding BC, QC, NB and NU)

    <TABLE border=0 cellSpacing=0 cellPadding=0><TBODY><TR><TD>May 8 to 14, 2011 (Week 19)


    </TD></TR></TBODY></TABLE>
    </B>

    Posted 2011-05-20


    Overall Influenza Summary
    • In week 19, influenza activity in Canada continues to decline with most of the country reporting sporadic or no activity. Localized activity persists in a few regions of Quebec and Newfoundland.
    • Both influenza A and B detections continue to decrease. The proportion of positive tests for parainfluenza viruses continues to increase in many regions of the country.
    • The ILI consultation rate and adult hospitalizations with influenza continue on a downward trend. Paediatric hospitalizations with influenza increased slightly compared to the previous week, although few cases were reported.

    Influenza Activity and Outbreaks

    In week 19, 3 regions reported localized activity: NL(2) and QC(1); 21 regions reported sporadic activity; and 32 regions presented no activity (see Activity level Map). Compared to the previous week (week 18), 4 regions reported an increased level of influenza activity, 10 regions reported decreased activity, and 20 regions maintained a stable level of influenza activity (sporadic or higher). Eight new outbreaks were reported: 1 outbreak of influenza A (unsubtyped) in a long-term care facility (LTCF) in QC; 1 influenza outbreak in a LTCF in NB; 5 ILI outbreaks in schools in NB(1), NS(2) and NL(2); and one outbreak of ILI in another facility in NL.

    Map of overall Influenza activity level by province and territory, Canada, Week 19





    No Data

    No Activity

    Sporadic Activity

    Localized Activity

    Widespread Activity



    Note: Influenza activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.
    Text Equivalent

    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.
    Text Equivalent


    Top of Page

    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.
    Text Equivalent
    ILI consultation rate
    During week 19, the national ILI consultation rate was 13.2 consultations per 1,000 patient visits, which is decreased compared to the previous week and still within the expected rate for this time of year (see ILI graph). Children under 5 years of age had the highest consultation rates (37.8 per 1,000 consultations), followed by children 5-19 years of age (17.3 per 1,000 consultations) in week 19.
    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.
    Text Equivalent
    Laboratory Surveillance Summary
    The overall proportion of tests that were positive for influenza during week 19 was 4.0% (1.3% influenza A, 2.7% influenza B), which is decreased compared to week 18 (5.2%). The proportion of positive tests peaked in week 52 (see Influenza tests graph). Since the beginning of the season, 85.4% (16,466/19,286) of influenza virus detections have been influenza A viruses, of which 84.6% (5,487/6,483) of subtyped specimens have been A/H3N2. Detections of influenza B have been increasing steadily since week 03 and appear to have reached a peak in week 15. Through detailed case-based laboratory reporting where age data is provided, since August 29, 2010, 50.7% (2,056/4,052) of cases with A/H3N2 were aged 65 years or older. In contrast, the majority of cases with pandemic H1N1 2009 (94.5%, 750/794) and influenza B (90.3%, 1,345/1,489) were under 65 years of age (see Tests detailed table). The proportion of positive tests for respiratory syncytial virus detections (RSV) continues to decrease (peak in week 07). Since week 11, the proportion of positive tests for parainfluenza viruses has been increasing and reaching 7.2% in week 19 (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 (May 8 to May 14, 2011)</TH><TH class="bg-colour-blue fontSize85" colSpan=6 scope=colgroup>Cumulative (August 29, 2010 to May 14, 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>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>0</TD><TD class=alignCenter>477</TD><TD class=alignCenter>0</TD><TD class=alignCenter>200</TD><TD class=alignCenter>164</TD><TD class=alignCenter>113</TD><TD class=alignCenter>179</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>5</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>8</TD><TD class=alignCenter>1073</TD><TD class=alignCenter>0</TD><TD class=alignCenter>757</TD><TD class=alignCenter>279</TD><TD class=alignCenter>37</TD><TD class=alignCenter>734</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>5</TD><TD class=alignCenter>318</TD><TD class=alignCenter>0</TD><TD class=alignCenter>212</TD><TD class=alignCenter>30</TD><TD class=alignCenter>76</TD><TD class=alignCenter>174</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>515</TD><TD class=alignCenter>0</TD><TD class=alignCenter>56</TD><TD class=alignCenter>2</TD><TD class=alignCenter>457</TD><TD class=alignCenter>14</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>11</TD><TD class=alignCenter>6883</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2437</TD><TD class=alignCenter>274</TD><TD class=alignCenter>4172</TD><TD class=alignCenter>833</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>15</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>15</TD><TD class=alignCenter>27</TD><TD class=alignCenter>5660</TD><TD class=alignCenter>0</TD><TD class=alignCenter>877</TD><TD class=alignCenter>38</TD><TD class=alignCenter>4745</TD><TD class=alignCenter>735</TD></TR><TR><TH class=bg-colour-blue scope=row>NB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>959</TD><TD class=alignCenter>0</TD><TD class=alignCenter>669</TD><TD class=alignCenter>176</TD><TD class=alignCenter>114</TD><TD class=alignCenter>102</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>271</TD><TD class=alignCenter>0</TD><TD class=alignCenter>80</TD><TD class=alignCenter>11</TD><TD class=alignCenter>180</TD><TD class=alignCenter>5</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>97</TD><TD class=alignCenter>0</TD><TD class=alignCenter>79</TD><TD class=alignCenter>16</TD><TD class=alignCenter>2</TD><TD class=alignCenter>6</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>5</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5</TD><TD class=alignCenter>5</TD><TD class=alignCenter>213</TD><TD class=alignCenter>0</TD><TD class=alignCenter>120</TD><TD class=alignCenter>6</TD><TD class=alignCenter>87</TD><TD class=alignCenter>38</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>28</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>2</TD><TD class=alignCenter>24</TD><TD class=alignCenter>59</TD><TD class=alignCenter>16466</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5487</TD><TD class=alignCenter>996</TD><TD class=alignCenter>9983</TD><TD class=alignCenter>2820</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
    (May 8 to May 14, 2011)
    </TH><TH colSpan=5 scope=colgroup>Cumulative
    (Aug. 29, 2010 to May 14, 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>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>4</TD><TD class=alignCenter>1011</TD><TD class=alignCenter>129</TD><TD class=alignCenter>736</TD><TD class=alignCenter>146</TD><TD class=alignCenter>409</TD></TR><TR><TD>5-19</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3</TD><TD class=alignCenter>515</TD><TD class=alignCenter>103</TD><TD class=alignCenter>295</TD><TD class=alignCenter>117</TD><TD class=alignCenter>532</TD></TR><TR><TD>20-44</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>1080</TD><TD class=alignCenter>331</TD><TD class=alignCenter>529</TD><TD class=alignCenter>220</TD><TD class=alignCenter>290</TD></TR><TR><TD>45-64</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>791</TD><TD class=alignCenter>187</TD><TD class=alignCenter>436</TD><TD class=alignCenter>168</TD><TD class=alignCenter>114</TD></TR><TR><TD>65+</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>2505</TD><TD class=alignCenter>44</TD><TD class=alignCenter>2056</TD><TD class=alignCenter>405</TD><TD class=alignCenter>144</TD></TR><TR><TD>Unknown</TD><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>231</TD><TD class=alignCenter>3</TD><TD class=alignCenter>224</TD><TD class=alignCenter>4</TD><TD class=alignCenter>1</TD></TR><TR><TD>Total</TD><TD class=alignCenter>3</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>8</TD><TD class=alignCenter>6133</TD><TD class=alignCenter>797</TD><TD class=alignCenter>4276</TD><TD class=alignCenter>1060</TD><TD class=alignCenter>1490</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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    Antigenic Characterization
    Between September 1 and May 19, 2011, the National Microbiology Laboratory (NML) has antigenically characterized 920 influenza viruses that were received from provincial laboratories: 269 A/H3N2, 141 pandemic H1N1 2009 and 510 B viruses. Of the 269 influenza A/H3N2 viruses characterized, 266 (98.9%) were antigenically related to A/Perth/16/2009, which is the influenza A/H3N2 component recommended for the 2010-11 influenza vaccine. Three viruses (1.1%) tested showed reduced titer with antiserum produced against A/Perth/16/2009. Of the 141 pandemic H1N1 2009 viruses characterized, 139 (98.6%) were antigenically related to the pandemic vaccine virus A/California/7/2009, which is the recommended H1N1 component for the 2010-11 influenza vaccine. Two viruses (1.4%) tested showed reduced titer with antiserum produced against A/California/7/2009. Of the 510 influenza B viruses characterized, 488 (95.7%) were antigenically related to B/Brisbane/60/08 (Victoria lineage), which is the recommended influenza B component for the 2010-11 influenza vaccine. Four of the 488 viruses tested showed reduced titer with antisera produced against B/Brisbane/60/08. Twenty-two (4.3%) influenza B viruses were characterized as B/Wisconsin/01/2010-like, which belongs to the Yamagata lineage. B/Wisconsin/01/2010-like viruses are antigenically and genetically different from the previous Yamagata lineage vaccine strain B/Florida/04/2006.
    Antiviral Resistance
    Since the beginning of the 2010-2011 season, NML has tested 628 influenza A isolates (470 A/H3N2 and 158 pandemic H1N1 2009) for amantadine resistance and found that 469 influenza A/H3N2 were resistant and one was sensitive. All 158 influenza A/H1N1 viruses were resistant to amantadine. Of 893 influenza viruses (246 A/H3N2, 145 pandemic H1N1 2009, and 502 influenza B) tested for resistance to oseltamivir, 245 A/H3N2 viruses were sensitive and one was resistant with the E119V mutation. The resistant case was associated with oseltamivir prophylaxis/treatment. Of the 145 pandemic H1N1 2009 isolates tested for oseltamivir resistance, 144 were sensitive and one was resistant with the H275Y mutation. The resistant case was associated with oseltamivir treatment. Of the 502 B virus isolates tested, 501 were sensitive to oseltamivir and one was resistant with the D198N mutation. Of 884 influenza viruses (242 A/H3N2, 142 pandemic H1N1 2009, and 500 influenza B) tested for zanamivir resistance all isolates were found to be sensitive.
    Severe Illness Surveillance

    Note that all numbers are preliminary and numbers may fluctuate because of delays in reporting.
    Paediatric Influenza Hospitalizations and Deaths
    In week 19, 5 new laboratory-confirmed influenza-associated paediatric (16 years of age and under) hospitalizations were reported through the Immunization Monitoring Program Active (IMPACT) network: 4 with influenza B, one with influenza A. This number is increased compared to the previous week (week 18) in which 2 paediatric hospitalizations were reported. Influenza A was associated with the majority of hospitalizations earlier in the season (weeks 47 to 09). Since week 10, however, influenza B accounted for more cases than influenza A each week. Six paediatric deaths have been reported via IMPACT this season: 3 children between 6 and 23 months old, two with pandemic H1N1 2009 and one with influenza B; two children between 2 and 4 years old, both with influenza B; and one child between 10 and 16 years old with influenza A/H3. All cases had underlying comorbidities.
    Since the beginning of the season, 660 hospitalizations with laboratory-confirmed influenza have been reported: 103 (15.6%) as influenza A/H3N2, 23 (3.5%) pandemic H1N1 2009, 326 (49.4%) as un-subtyped influenza A, and 208 (31.5%) influenza B. The distribution of cases to date by age group was as follows: 16.7% among 0-5 month olds; 27.7% among 6-23 month olds; 28.6% among the 2-4 year-olds; 16.4% among 5-9 year-olds; and 10.6% among children 10-16 years old.
    Adult Influenza Hospitalizations and Deaths
    During week 19, 2 new hospitalizations with laboratory-confirmed influenza among adults (16 years of age and older) were reported through the Canadian Nosocomial Infection Surveillance Program (CNISP), both with influenza B, similar to the previous week. Since the beginning of the season, 968 hospitalized cases have been reported: 202 (20.9%) A/H3N2, 48 (5.0%) pandemic H1N1 2009, 643 (66.4%) influenza A unsubtyped, and 75 (7.7%) influenza B, from all reporting provinces. To date, 651 of the 968 (67.3%) cases were aged 65 years or older and 437 (45.1%) were males.

    Aggregate Influenza Hospitalizations and Deaths
    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 19, one death with pandemic H1N1 2009 influenza was reported from Alberta. Among the 224 fatal cases reported since the beginning of the influenza season, influenza A/H3N2 was identified in 60.7% (136/224), unsubtyped influenza A in 28.1% (63/224), pandemic H1N1 2009 in 6.7% (15/224), and influenza B in 4.5% (10/224). Seventy-nine percent (177/224) of these fatal cases were among persons 65 years of age or older, and another 11% (25/224) 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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    Re: Canada FluWatch Weekly Reports 2010-2011 Season Week 18 - 221 deaths total (excluding BC, QC, NB and NU)

    <TABLE border=0 cellSpacing=0 cellPadding=0><TBODY><TR><TD>May 1 to 7, 2011 (Week 18)

    </TD></TR></TBODY></TABLE>


    Posted 2011-05-13

    Overall Influenza Summary
    • In week 18, influenza activity in Canada continues to decline with most of the country reporting sporadic or no activity. Localized activity persists in a few regions of Nova Scotia and Newfoundland.
    • Both influenza A and B detections continue to decrease. The proportion of positive tests for parainfluenza viruses continues to increase in many regions of the country.
    • The ILI consultation rate, as well as paediatric and adult hospitalizations with influenza continue on a downward trend with few reports in week 18.


    Influenza Activity and Outbreaks

    In week 18, 4 regions reported localized activity: NS(2) and NL(2); 27 regions reported sporadic activity (in all provinces and territories except NS, PE and YT) and 25 regions presented no activity (see Activity level Map). Compared to the previous week (week 17), 3 regions reported an increased level of influenza activity, 15 regions reported decreased activity, and 25 regions maintained a stable level of influenza activity (sporadic or higher). Seven new outbreaks were reported: 4 influenza outbreaks in long-term care facilities (LTCF) in NL(2) and NS(2); 2 ILI outbreaks in schools in NB(1) and NL(1); and one outbreak of ILI in another facility in NL.

    Map of overall Influenza activity level by province and territory, Canada, Week 18





    No Data

    No Activity

    Sporadic Activity

    Localized Activity

    Widespread Activity



    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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    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.
    Text Equivalent


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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.
    Text Equivalent
    ILI consultation rate
    During week 18, the national ILI consultation rate was 15.1 consultations per 1,000 patient visits, which is increased compared to the previous week but is within the expected rate for this time of year (see ILI graph). Children under 5 years of age had the highest consultation rates (81.8 per 1,000 consultations), followed by children 5-19 years of age (23.9 per 1,000 consultations) in week 18.
    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.
    Text Equivalent
    Laboratory Surveillance Summary
    The overall proportion of tests that were positive for influenza during week 18 was 5.2% (1.5% influenza A, 3.7% influenza B), which is decreased compared to week 17 (7.1%). The proportion of positive tests peaked in week 52 (see Influenza tests graph). Since the beginning of the season, 85.6% (16,433/19,193) of influenza virus detections have been influenza A viruses, of which 84.7% (5,481/6,474) of subtyped specimens have been A/H3N2. Detections of influenza B have been increasing steadily since week 03 and appear to have reached a peak in week 15. Among influenza A detections in week 18, 14 (38.9%) specimens were reported as influenza A/H3N2, 3 (8.3%) as pandemic H1N1 2009, and 19 (52.8%) as un-subtyped influenza A. Through detailed case-based laboratory reporting where age data is provided, since August 29, 2010, 51.0% (2,056/4,034) of cases with A/H3N2 were aged 65 years or older. In contrast, the majority of cases with pandemic H1N1 2009 (94.4%, 746/790) and influenza B (90.3%, 1,313/1,454) were under 65 years of age (see Tests detailed table). The proportion of positive tests for respiratory syncytial virus detections (RSV) continues to decrease (peak in week 07). Since week 11, the proportion of positive tests for parainfluenza viruses has been increasing and reaching 6.9% in week 18, predominantly due to parainfluenza type 3 (52.9%) and type 1 (35.5%). (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 (May 1 to May 7, 2011)</TH><TH class="bg-colour-blue fontSize85" colSpan=6 scope=colgroup>Cumulative (August 29, 2010 to May 7, 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>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>477</TD><TD class=alignCenter>0</TD><TD class=alignCenter>200</TD><TD class=alignCenter>164</TD><TD class=alignCenter>113</TD><TD class=alignCenter>179</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>9</TD><TD class=alignCenter>1063</TD><TD class=alignCenter>0</TD><TD class=alignCenter>751</TD><TD class=alignCenter>276</TD><TD class=alignCenter>36</TD><TD class=alignCenter>725</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>8</TD><TD class=alignCenter>316</TD><TD class=alignCenter>0</TD><TD class=alignCenter>212</TD><TD class=alignCenter>30</TD><TD class=alignCenter>74</TD><TD class=alignCenter>169</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>515</TD><TD class=alignCenter>0</TD><TD class=alignCenter>56</TD><TD class=alignCenter>2</TD><TD class=alignCenter>457</TD><TD class=alignCenter>13</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>2</TD><TD class=alignCenter>17</TD><TD class=alignCenter>6882</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2437</TD><TD class=alignCenter>274</TD><TD class=alignCenter>4171</TD><TD class=alignCenter>822</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>8</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>8</TD><TD class=alignCenter>45</TD><TD class=alignCenter>5645</TD><TD class=alignCenter>0</TD><TD class=alignCenter>877</TD><TD class=alignCenter>38</TD><TD class=alignCenter>4730</TD><TD class=alignCenter>708</TD></TR><TR><TH class=bg-colour-blue scope=row>NB</TH><TD class=alignCenter>10</TD><TD class=alignCenter>0</TD><TD class=alignCenter>4</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6</TD><TD class=alignCenter>7</TD><TD class=alignCenter>959</TD><TD class=alignCenter>0</TD><TD class=alignCenter>669</TD><TD class=alignCenter>176</TD><TD class=alignCenter>114</TD><TD class=alignCenter>100</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>271</TD><TD class=alignCenter>0</TD><TD class=alignCenter>80</TD><TD class=alignCenter>11</TD><TD class=alignCenter>180</TD><TD class=alignCenter>5</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>97</TD><TD class=alignCenter>0</TD><TD class=alignCenter>79</TD><TD class=alignCenter>16</TD><TD class=alignCenter>2</TD><TD class=alignCenter>6</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>4</TD><TD class=alignCenter>208</TD><TD class=alignCenter>0</TD><TD class=alignCenter>120</TD><TD class=alignCenter>6</TD><TD class=alignCenter>82</TD><TD class=alignCenter>33</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>36</TD><TD class=alignCenter>0</TD><TD class=alignCenter>14</TD><TD class=alignCenter>3</TD><TD class=alignCenter>19</TD><TD class=alignCenter>91</TD><TD class=alignCenter>16433</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5481</TD><TD class=alignCenter>993</TD><TD class=alignCenter>9959</TD><TD class=alignCenter>2760</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
    (May 1 to May 7, 2011)</TH><TH colSpan=5 scope=colgroup>Cumulative
    (Aug. 29, 2010 to May 7, 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>3</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>5</TD><TD class=alignCenter>927</TD><TD class=alignCenter>128</TD><TD class=alignCenter>728</TD><TD class=alignCenter>71</TD><TD class=alignCenter>392</TD></TR><TR><TD>5-19</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>441</TD><TD class=alignCenter>103</TD><TD class=alignCenter>294</TD><TD class=alignCenter>44</TD><TD class=alignCenter>525</TD></TR><TR><TD>20-44</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>977</TD><TD class=alignCenter>328</TD><TD class=alignCenter>520</TD><TD class=alignCenter>129</TD><TD class=alignCenter>286</TD></TR><TR><TD>45-64</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>713</TD><TD class=alignCenter>187</TD><TD class=alignCenter>436</TD><TD class=alignCenter>90</TD><TD class=alignCenter>110</TD></TR><TR><TD>65+</TD><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>2369</TD><TD class=alignCenter>44</TD><TD class=alignCenter>2056</TD><TD class=alignCenter>269</TD><TD class=alignCenter>141</TD></TR><TR><TD>Unknown</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>231</TD><TD class=alignCenter>3</TD><TD class=alignCenter>224</TD><TD class=alignCenter>4</TD><TD class=alignCenter>1</TD></TR><TR><TD>Total</TD><TD class=alignCenter>9</TD><TD class=alignCenter>2</TD><TD class=alignCenter>3</TD><TD class=alignCenter>4</TD><TD class=alignCenter>9</TD><TD class=alignCenter>5658</TD><TD class=alignCenter>793</TD><TD class=alignCenter>4258</TD><TD class=alignCenter>607</TD><TD class=alignCenter>1455</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

    Antigenic Characterization
    Between September 1 and May 12, 2011, the National Microbiology Laboratory (NML) has antigenically characterized 904 influenza viruses that were received from provincial laboratories: 267 A/H3N2, 140 pandemic H1N1 2009 and 497 B viruses. Of the 267 influenza A/H3N2 viruses characterized, 264 (98.9%) were antigenically related to A/Perth/16/2009, which is the influenza A/H3N2 component recommended for the 2010-11 influenza vaccine. Three viruses (1.1%) tested showed reduced titer with antiserum produced against A/Perth/16/2009. Of the 140 pandemic H1N1 2009 viruses characterized, 138 (99.6%) were antigenically related to the pandemic vaccine virus A/California/7/2009, which is the recommended H1N1 component for the 2010-11 influenza vaccine. Two viruses (1.4%) tested showed reduced titer with antiserum produced against A/California/7/2009. Of the 497 influenza B viruses characterized, 475 (95.6%) were antigenically related to B/Brisbane/60/08 (Victoria lineage), which is the recommended influenza B component for the 2010-11 influenza vaccine. Four of the 475 viruses tested showed reduced titer with antisera produced against B/Brisbane/60/08. Twenty-two (4.4%) influenza B viruses were characterized as B/Wisconsin/01/2010-like, which belongs to the Yamagata lineage. B/Wisconsin/01/2010-like viruses are antigenically and genetically different from the previous Yamagata lineage vaccine strain B/Florida/04/2006.
    Antiviral Resistance
    Since the beginning of the 2010-2011 season, NML has tested 617 influenza A isolates (461 A/H3N2 and 156 pandemic H1N1 2009) for amantadine resistance and found that 460 influenza A/H3N2 were resistant and one was sensitive. All 156 influenza A/H1N1 viruses were resistant to amantadine. Of 857 influenza viruses (246 A/H3N2, 143 pandemic H1N1 2009, and 468 influenza B) tested for resistance to oseltamivir, 245 A/H3N2 viruses were sensitive and one was resistant with E119V mutation. The resistant case was associated with oseltamivir prophylaxis/treatment. Of the 143 pandemic H1N1 2009 isolates tested for oseltamivir resistance, 142 were sensitive and one was resistant with the H275Y mutation. The resistant case was associated with oseltamivir treatment. All 468 B viruses were sensitive to oseltamivir. Of 847 influenza viruses (242 A/H3N2, 138 pandemic H1N1 2009, and 467 influenza B) tested for zanamivir resistance all isolates were found to be sensitive.
    Severe Illness Surveillance

    Paediatric Influenza Hospitalizations and Deaths
    In week 18, 2 new laboratory-confirmed influenza-associated paediatric (16 years of age and under) hospitalizations were reported through the Immunization Monitoring Program Active (IMPACT) network: both with influenza B from SK. This number is decreased compared to the previous week (week 17) in which 12 paediatric hospitalizations were reported (note that numbers may fluctuate because of the delays in reporting). In week 17 a paediatric death associated with influenza B in a child between 2 and 4 years of age was reported in Alberta. The child had underlying co-morbidities. This is the sixth pediatric death this season. The five previous deaths were: 3 children between 6 and 23 months old, two with pandemic H1N1 2009 and one with influenza B; one child between 2 and 4 years old with influenza B; and one child between 10 and 16 years old with influenza A/H3. All cases had underlying comorbidities. None were vaccinated.
    Since the beginning of the season, 656 hospitalizations with laboratory-confirmed influenza have been reported: 103 (15.7%) as influenza A/H3N2, 22 (3.4%) pandemic H1N1 2009, 327 (49.8%) as un-subtyped influenza A, and 204 (31.1%) influenza B. The distribution of cases to date by age group was as follows: 16.6% among 0-5 month olds; 27.6% among 6-23 month olds; 28.7% among the 2-4 year-olds; 16.2% among 5-9 year-olds; and 11.0% among children 10-16 years old.
    Adult Influenza Hospitalizations and Deaths
    During week 18, 2 new hospitalizations with laboratory-confirmed influenza among adults (16 years of age and older) were reported through the Canadian Nosocomial Infection Surveillance Program (CNISP), both with influenza B. This number is similar to the 3 cases reported in week 17 (note that numbers may fluctuate because of the delays in reporting). Since the beginning of the season, 966 hospitalized cases have been reported: 202 (20.9%) A/H3N2, 48 (5.0%) pandemic H1N1 2009, 643 (66.6%) influenza A unsubtyped, and 73 (7.6%) influenza B, from all reporting provinces. To date, 650 of the 966 (67.3%) cases were aged 65 years or older and 436 (45.1%) were males.

    Aggregate Influenza Hospitalizations and Deaths

    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 18, no deaths with influenza were reported. Among the 221 fatal cases reported since the beginning of the influenza season, influenza A/H3N2 was identified in 61.1% (135/221), unsubtyped influenza A in 28.5% (63/221), pandemic H1N1 2009 in 5.9% (13/221), and influenza B in 4.5% (10/221). Eighty percent (176/221) of these fatal cases were among persons 65 years of age or older, and another 11% (24/221) were between the ages of 45 and 64 years old, in keeping with the age-groups usually affected by A/H3N2. (Note that numbers may fluctuate because of the delays in reporting).

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    Re: Canada FluWatch Weekly Reports 2010-2011 Season Week 17 - 221 deaths total (excluding BC, QC, NB and NU)

    <TABLE border=0 cellSpacing=0 cellPadding=0><TBODY><TR><TD>April 24 to 30, 2011 (Week 17)


    </TD></TR></TBODY></TABLE>
    </B>

    Posted 2011-05-06


    Overall Influenza Summary
    • In week 17, influenza activity in Canada continues to decline with only a few pockets of localized influenza activity in Ontario and the Atlantic provinces.
    • Influenza B continues to be detected more frequently than influenza A, however, the overall percentage of influenza positive specimens continues to decrease.
    • This week the number of outbreaks reported decreased considerably, as well as the ILI consultation rate. Both adult and paediatric hospitalizations with influenza are also low.

    Influenza Activity and Outbreaks

    In week 17, 5 regions reported localized activity: ON(1), NB(1), NS(1), and NL(2); 36 regions reported sporadic activity (in all provinces and territories except PE and YT) and 15 regions presented no activity (see Activity level Map). Compared to the previous week (week 16), 8 regions reported an increased level of influenza activity, 8 regions reported decreased activity, and 28 regions maintained a stable level of influenza activity (sporadic or higher). Five new outbreaks were reported: 1 outbreak of influenza in long-term care facilities (LTCF) in NL; 3 ILI outbreaks in schools in NB; and one outbreak of ILI in another facility in NL.

    Map of overall Influenza activity level by province and territory, Canada, Week 17





    No Data

    No Activity

    Sporadic Activity

    Localized Activity

    Widespread Activity



    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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    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 17, the national ILI consultation rate was 10.5 consultations per 1,000 patient visits, which is decreased compared to the previous week and is within the expected rate for this time of year (see ILI graph). Children under 5 years of age had the highest consultation rates (23.6 per 1,000 consultations), followed by children 5-19 years of age (12.9 per 1,000 consultations) in week 17.
    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.
    Text Equivalent
    Laboratory Surveillance Summary
    The overall proportion of tests that were positive for influenza during week 17 was 7.0% (2.3% influenza A, 4.7% influenza B), which is similar to week 16 (7.1%). The proportion of positive tests peaked in week 52 (see Influenza tests graph). Since the beginning of the season, 86.1% (16,395/19,041) of influenza virus detections have been influenza A viruses, of which 84.7% (5,467/6,456) of subtyped specimens have been A/H3N2. Detections of influenza B have been increasing steadily since week 03 and appear to have reached a peak in week 15. Among influenza A detections in week 17, 19 (25.7%) specimens were reported as influenza A/H3N2, 2 (2.7%) as pandemic H1N1 2009, and 53 (71.6%) as unsubtyped influenza A. Through detailed case-based laboratory reporting where age data is provided, since August 29, 2010, 50.8% (2,058/4,049) of cases with A/H3N2 were aged 65 years or older. In contrast, the majority of cases with pandemic H1N1 2009 (94.4%, 745/789) and influenza B (90.2%, 1,295/1,435) were under 65 years of age (see Tests detailed table). In week 17, the proportion of positive tests for respiratory syncytial virus detections (RSV) were similar to the previous week at 9.2% of specimens tested. The proportion of positive RSV tests appears to have peaked in week 07. Since week 11, the proportion of positive tests for parainfluenza viruses has been increasing, reaching 6.2% in week 17, predominantly due to parainfluenza type 3 (51.4%) and type 1 (36.7%). (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 (April 24 to April 30, 2011)</TH><TH class="bg-colour-blue fontSize85" colSpan=6 scope=colgroup>Cumulative (August 29, 2010 to April 30, 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>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>477</TD><TD class=alignCenter>0</TD><TD class=alignCenter>200</TD><TD class=alignCenter>164</TD><TD class=alignCenter>113</TD><TD class=alignCenter>178</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>14</TD><TD class=alignCenter>0</TD><TD class=alignCenter>12</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>25</TD><TD class=alignCenter>1057</TD><TD class=alignCenter>0</TD><TD class=alignCenter>748</TD><TD class=alignCenter>273</TD><TD class=alignCenter>36</TD><TD class=alignCenter>715</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>13</TD><TD class=alignCenter>315</TD><TD class=alignCenter>0</TD><TD class=alignCenter>211</TD><TD class=alignCenter>30</TD><TD class=alignCenter>74</TD><TD class=alignCenter>161</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>515</TD><TD class=alignCenter>0</TD><TD class=alignCenter>56</TD><TD class=alignCenter>2</TD><TD class=alignCenter>457</TD><TD class=alignCenter>13</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>5</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>2</TD><TD class=alignCenter>26</TD><TD class=alignCenter>6879</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2437</TD><TD class=alignCenter>273</TD><TD class=alignCenter>4169</TD><TD class=alignCenter>805</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>19</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>19</TD><TD class=alignCenter>46</TD><TD class=alignCenter>5635</TD><TD class=alignCenter>0</TD><TD class=alignCenter>877</TD><TD class=alignCenter>38</TD><TD class=alignCenter>4720</TD><TD class=alignCenter>641</TD></TR><TR><TH class=bg-colour-blue scope=row>NB</TH><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3</TD><TD class=alignCenter>25</TD><TD class=alignCenter>949</TD><TD class=alignCenter>0</TD><TD class=alignCenter>665</TD><TD class=alignCenter>176</TD><TD class=alignCenter>108</TD><TD class=alignCenter>93</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>12</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>12</TD><TD class=alignCenter>2</TD><TD class=alignCenter>269</TD><TD class=alignCenter>0</TD><TD class=alignCenter>80</TD><TD class=alignCenter>11</TD><TD class=alignCenter>178</TD><TD class=alignCenter>5</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>97</TD><TD class=alignCenter>0</TD><TD class=alignCenter>79</TD><TD class=alignCenter>16</TD><TD class=alignCenter>2</TD><TD class=alignCenter>6</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>15</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>15</TD><TD class=alignCenter>13</TD><TD class=alignCenter>202</TD><TD class=alignCenter>0</TD><TD class=alignCenter>114</TD><TD class=alignCenter>6</TD><TD class=alignCenter>82</TD><TD class=alignCenter>29</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>74</TD><TD class=alignCenter>0</TD><TD class=alignCenter>19</TD><TD class=alignCenter>2</TD><TD class=alignCenter>53</TD><TD class=alignCenter>153</TD><TD class=alignCenter>16395</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5467</TD><TD class=alignCenter>989</TD><TD class=alignCenter>9939</TD><TD class=alignCenter>2646</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
    (April 24 to April 30, 2011)
    </TH><TH colSpan=5 scope=colgroup>Cumulative
    (Aug. 29, 2010 to Apr. 30, 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>10</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>7</TD><TD class=alignCenter>10</TD><TD class=alignCenter>1005</TD><TD class=alignCenter>127</TD><TD class=alignCenter>733</TD><TD class=alignCenter>145</TD><TD class=alignCenter>386</TD></TR><TR><TD>5-19</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6</TD><TD class=alignCenter>7</TD><TD class=alignCenter>516</TD><TD class=alignCenter>103</TD><TD class=alignCenter>296</TD><TD class=alignCenter>117</TD><TD class=alignCenter>515</TD></TR><TR><TD>20-44</TD><TD class=alignCenter>7</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>5</TD><TD class=alignCenter>5</TD><TD class=alignCenter>1075</TD><TD class=alignCenter>328</TD><TD class=alignCenter>528</TD><TD class=alignCenter>219</TD><TD class=alignCenter>284</TD></TR><TR><TD>45-64</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>788</TD><TD class=alignCenter>187</TD><TD class=alignCenter>434</TD><TD class=alignCenter>167</TD><TD class=alignCenter>110</TD></TR><TR><TD>65+</TD><TD class=alignCenter>17</TD><TD class=alignCenter>8</TD><TD class=alignCenter>6</TD><TD class=alignCenter>3</TD><TD class=alignCenter>1</TD><TD class=alignCenter>2505</TD><TD class=alignCenter>44</TD><TD class=alignCenter>2058</TD><TD class=alignCenter>403</TD><TD class=alignCenter>140</TD></TR><TR><TD>Unknown</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>231</TD><TD class=alignCenter>3</TD><TD class=alignCenter>224</TD><TD class=alignCenter>4</TD><TD class=alignCenter>1</TD></TR><TR><TD>Total</TD><TD class=alignCenter>41</TD><TD class=alignCenter>12</TD><TD class=alignCenter>8</TD><TD class=alignCenter>21</TD><TD class=alignCenter>24</TD><TD class=alignCenter>6120</TD><TD class=alignCenter>792</TD><TD class=alignCenter>4273</TD><TD class=alignCenter>1055</TD><TD class=alignCenter>1436</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

    Antigenic Characterization
    Between September 1 and May 5, 2011, the National Microbiology Laboratory (NML) has antigenically characterized 875 influenza viruses that were received from provincial laboratories: 261 A/H3N2, 138 pandemic H1N1 2009 and 476 B viruses. Of the 261 influenza A/H3N2 viruses characterized, 258 (98.7%) were antigenically related to A/Perth/16/2009, which is the influenza A/H3N2 component recommended for the 2010-11 influenza vaccine. Three viruses (1.1%) tested showed reduced titer with antiserum produced against A/Perth/16/2009. Of the 138 pandemic H1N1 2009 viruses characterized, 137 (99.3%) were antigenically related to the pandemic vaccine virus A/California/7/2009, which is the recommended H1N1 component for the 2010-11 influenza vaccine. One virus (0.7%) tested showed reduced titer with antiserum produced against A/California/7/2009. Of the 476 influenza B viruses characterized, 456 (95.8%) were antigenically related to B/Brisbane/60/08 (Victoria lineage), which is the recommended influenza B component for the 2010-11 influenza vaccine. Four of the 456 viruses tested showed reduced titer with antisera produced against B/Brisbane/60/08. Twenty (4.2%) influenza B viruses were characterized as B/Wisconsin/01/2010-like, which belongs to the Yamagata lineage. B/Wisconsin/01/2010-like viruses are antigenically and genetically different from the previous Yamagata lineage vaccine strain B/Florida/04/2006.
    Antiviral Resistance
    Since the beginning of the 2010-2011 season, NML has tested 616 influenza A isolates (460 A/H3N2 and 156 pandemic H1N1 2009) for amantadine resistance and found that 459 influenza A/H3N2 were resistant and one was sensitive. All 156 influenza A/H1N1 viruses were resistant to amantadine. Of 763 influenza viruses (233 A/H3N2, 140 pandemic H1N1 2009, and 390 influenza B) tested for resistance to oseltamivir, 232 A/H3N2 viruses were sensitive and one was resistant with E119V mutation. The resistant case was associated with oseltamivir prophylaxis/treatment. Of the 140 pandemic H1N1 2009 isolates tested for oseltamivir resistance, 139 were sensitive and one was resistant with the H275Y mutation. The resistant case was associated with oseltamivir treatment. All 390 B viruses were sensitive to oseltamivir. Of 755 influenza viruses (230 A/H3N2, 136 pandemic H1N1 2009, and 389 influenza B) tested for zanamivir resistance all isolates were found to be sensitive.
    Severe Illness Surveillance

    Paediatric Influenza Hospitalizations and Deaths
    In week 17, 9 new laboratory-confirmed influenza-associated paediatric (16 years of age and under) hospitalizations were reported through the Immunization Monitoring Program Active (IMPACT) network: 1 from AB, 2 from ON, 5 from QC, and 1 from NL. This number is decreased compared to the previous week (week 16) in which 11 paediatric hospitalizations were reported (note that numbers may fluctuate because of the delays in reporting). Five paediatric deaths have been reported via IMPACT this season all with underlying comorbidities.
    Since the beginning of the season, 651 hospitalizations with laboratory-confirmed influenza have been reported: 102 (15.7%) as influenza A/H3N2, 22 (3.4%) pandemic H1N1 2009, 328 (50.4%) as unsubytped influenza A, and 199 (30.6%) influenza B. The distribution of cases to date by age group was as follows: 16.7% among 0-5 month olds; 27.8% among 6-23 month olds; 28.7% among the 2-4 year-olds; 15.8% among 5-9 year-olds; and 10.9% among children 10-16 years old.
    Adult Influenza Hospitalizations and Deaths
    During week 17, 3 new hospitalizations with laboratory-confirmed influenza among adults (16 years of age and older) were reported through the Canadian Nosocomial Infection Surveillance Program (CNISP), all with influenza B. This number is decreased compared to the 5 cases reported in week 16 (note that numbers may fluctuate because of the delays in reporting). Since the beginning of the season, 964 hospitalized cases have been reported: 202 (21.0%) A/H3N2, 48 (5.0%) pandemic H1N1 2009, 643 (66.7%) influenza A unsubtyped, and 71 (7.4%) influenza B, from all reporting provinces. To date, 649 of the 964 (67.3%) cases were aged 65 years or older and 436 (45.2%) were males.

    Aggregate Influenza Hospitalizations and Deaths
    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 17, no deaths with influenza were reported. Among the 221 fatal cases reported since the beginning of the influenza season, influenza A/H3N2 was identified in 61.1% (135/221), unsubtyped influenza A in 28.5% (63/221), pandemic H1N1 2009 in 5.9% (13/221), and influenza B in 4.5% (10/221). Eighty percent (176/221) of these fatal cases were among persons 65 years of age or older, and another 11% (24/221) were between the ages of 45 and 64 years old, in keeping with the age-groups usually affected by A/H3N2. (Note that numbers may fluctuate because of the delays in reporting).

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    Re: Canada FluWatch Weekly Reports 2010-2011 Season Week 16 - 221 deaths total (excluding BC, QC, NB and NU)

    <TABLE border=0 cellSpacing=0 cellPadding=0><TBODY><TR><TD>April 17 to 23, 2011 (Week 16)

    </TD></TR></TBODY></TABLE>


    Posted 2011-04-29

    Overall Influenza Summary
    • In week 16, influenza activity in Canada continues to decline.
    • The overall percentage of influenza positive specimens continues to decrease.
    • Fewer regions reported localized influenza activity this week compared to the previous week although slightly more outbreaks were reported, all in the Atlantic provinces.
    • The ILI consultation rate decreased, and both adult and paediatric hospitalizations with influenza were similar to the previous week.


    Influenza Activity and Outbreaks

    In week 16, 9 regions reported localized activity: ON(1), NB(2), NS(4), and NL(2); 28 regions reported sporadic activity (in BC(3), AB(5), SK(3), MB(3), ON(4), QC(6), NB(2), YK(1) and NU(1)) and 19 regions presented no activity (see Activity level Map). Compared to the previous week (week 15), 8 regions reported an increased level of influenza activity, 17 regions reported decreased activity, and 23 regions maintained a stable level of influenza activity (sporadic or higher). Fourteen new outbreaks were reported: 7 outbreaks of influenza in long-term care facilities (LTCF) in NS(5), NB(1) and NL(1); 1 outbreak of influenza in a hospital in NS; 5 ILI outbreaks in schools in NS(3), and NB(2); and one outbreak of ILI in another facility in NL.

    Map of overall Influenza activity level by province and territory, Canada, Week 16





    No Data

    No Activity

    Sporadic Activity

    Localized Activity

    Widespread Activity



    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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    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 16, the national ILI consultation rate was 16.7 consultations per 1,000 patient visits, which is decreased compared to the previous week and is within the expected rate for this time of year (see ILI graph). Children 5-19 years of age had the highest consultation rates (45.3 per 1,000 consultations), followed by children under 5 years of age (19.9 per 1,000 consultations) in week 16.
    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.
    Text Equivalent
    Laboratory Surveillance Summary
    The overall proportion of tests that were positive for influenza during week 16 was 7.2% (1.9% influenza A, 5.3% influenza B), which is decreased compared to week 15 (10.3%) and the third week in which more influenza B detections were reported than influenza A. The proportion of positive tests peaked in week 52 (see Influenza tests graph). Since the beginning of the season, 86.8% (16,320/18,810) of influenza virus detections have been influenza A viruses, of which 84.7% (5,446/6,431) of subtyped specimens have been A/H3N2. Detections of influenza B have been increasing steadily since week 03 and appear to have reached a peak in week 15. Among influenza A detections in week 16, 20 (36.4%) specimens were reported as influenza A/H3N2, 1 (1.8%) as pandemic H1N1 2009, and 34 (61.8%) as unsubtyped influenza A. Through detailed case-based laboratory reporting where age data is provided, since August 29, 2010, 50.8% (2049/4033) of cases with A/H3N2 were aged 65 years or older. In contrast, the majority of cases with pandemic H1N1 2009 (94.5%, 741/784) and influenza B (90.2%, 1246/1381) were under 65 years of age (see Tests detailed table). In week 16, the proportion of positive tests for respiratory syncytial virus detections (RSV) decreased to 9.2% of specimens tested. The proportion of positive RSV tests appears to have peaked in week 07. Since week 11, the proportion of positive tests for parainfluenza viruses has been increasing, reaching 5.8% in week 16, predominantly due to parainfluenza type 3 (51.4%) and type 1 (38.1%). (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 (April 17 to April 23, 2011)</TH><TH class="bg-colour-blue fontSize85" colSpan=6 scope=colgroup>Cumulative (August 29, 2010 to April 23, 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>4</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>476</TD><TD class=alignCenter>0</TD><TD class=alignCenter>199</TD><TD class=alignCenter>164</TD><TD class=alignCenter>113</TD><TD class=alignCenter>176</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>10</TD><TD class=alignCenter>0</TD><TD class=alignCenter>7</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3</TD><TD class=alignCenter>25</TD><TD class=alignCenter>1042</TD><TD class=alignCenter>0</TD><TD class=alignCenter>734</TD><TD class=alignCenter>270</TD><TD class=alignCenter>38</TD><TD class=alignCenter>687</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>24</TD><TD class=alignCenter>313</TD><TD class=alignCenter>0</TD><TD class=alignCenter>210</TD><TD class=alignCenter>30</TD><TD class=alignCenter>73</TD><TD class=alignCenter>148</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3</TD><TD class=alignCenter>515</TD><TD class=alignCenter>0</TD><TD class=alignCenter>56</TD><TD class=alignCenter>2</TD><TD class=alignCenter>457</TD><TD class=alignCenter>12</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>5</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3</TD><TD class=alignCenter>39</TD><TD class=alignCenter>6874</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2435</TD><TD class=alignCenter>272</TD><TD class=alignCenter>4167</TD><TD class=alignCenter>779</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>16</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>16</TD><TD class=alignCenter>51</TD><TD class=alignCenter>5616</TD><TD class=alignCenter>0</TD><TD class=alignCenter>877</TD><TD class=alignCenter>38</TD><TD class=alignCenter>4701</TD><TD class=alignCenter>595</TD></TR><TR><TH class=bg-colour-blue scope=row>NB</TH><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>6</TD><TD class=alignCenter>943</TD><TD class=alignCenter>0</TD><TD class=alignCenter>662</TD><TD class=alignCenter>176</TD><TD class=alignCenter>105</TD><TD class=alignCenter>68</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>5</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>257</TD><TD class=alignCenter>0</TD><TD class=alignCenter>80</TD><TD class=alignCenter>11</TD><TD class=alignCenter>166</TD><TD class=alignCenter>3</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>97</TD><TD class=alignCenter>0</TD><TD class=alignCenter>79</TD><TD class=alignCenter>16</TD><TD class=alignCenter>2</TD><TD class=alignCenter>6</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>7</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>7</TD><TD class=alignCenter>8</TD><TD class=alignCenter>187</TD><TD class=alignCenter>0</TD><TD class=alignCenter>114</TD><TD class=alignCenter>6</TD><TD class=alignCenter>67</TD><TD class=alignCenter>16</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>55</TD><TD class=alignCenter>0</TD><TD class=alignCenter>20</TD><TD class=alignCenter>1</TD><TD class=alignCenter>34</TD><TD class=alignCenter>157</TD><TD class=alignCenter>16320</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5446</TD><TD class=alignCenter>985</TD><TD class=alignCenter>9889</TD><TD class=alignCenter>2490</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
    (April 17 to April 23, 2011)</TH><TH colSpan=5 scope=colgroup>Cumulative
    (Aug. 29, 2010 to Apr. 23, 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>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>10</TD><TD class=alignCenter>999</TD><TD class=alignCenter>126</TD><TD class=alignCenter>728</TD><TD class=alignCenter>145</TD><TD class=alignCenter>367</TD></TR><TR><TD>5-19</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>7</TD><TD class=alignCenter>517</TD><TD class=alignCenter>103</TD><TD class=alignCenter>296</TD><TD class=alignCenter>118</TD><TD class=alignCenter>499</TD></TR><TR><TD>20-44</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>5</TD><TD class=alignCenter>1071</TD><TD class=alignCenter>327</TD><TD class=alignCenter>528</TD><TD class=alignCenter>216</TD><TD class=alignCenter>270</TD></TR><TR><TD>45-64</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>785</TD><TD class=alignCenter>185</TD><TD class=alignCenter>432</TD><TD class=alignCenter>168</TD><TD class=alignCenter>110</TD></TR><TR><TD>65+</TD><TD class=alignCenter>5</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>2484</TD><TD class=alignCenter>43</TD><TD class=alignCenter>2049</TD><TD class=alignCenter>392</TD><TD class=alignCenter>135</TD></TR><TR><TD>Unknown</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>231</TD><TD class=alignCenter>3</TD><TD class=alignCenter>224</TD><TD class=alignCenter>4</TD><TD class=alignCenter>1</TD></TR><TR><TD>Total</TD><TD class=alignCenter>14</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6</TD><TD class=alignCenter>8</TD><TD class=alignCenter>24</TD><TD class=alignCenter>6087</TD><TD class=alignCenter>787</TD><TD class=alignCenter>4257</TD><TD class=alignCenter>1043</TD><TD class=alignCenter>1382</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

    Antigenic Characterization
    Between September 1 and April 28, 2011, the National Microbiology Laboratory (NML) has antigenically characterized 804 influenza viruses that were received from provincial laboratories: 252 A/H3N2, 137 pandemic H1N1 2009 and 415 B viruses. Of the 252 influenza A/H3N2 viruses characterized, 249 (98.8%) were antigenically related to A/Perth/16/2009, which is the influenza A/H3N2 component recommended for the 2010-11 influenza vaccine. Three viruses (1.2%) tested showed reduced titer with antiserum produced against A/Perth/16/2009. Of the 137 pandemic H1N1 2009 viruses characterized, 136 (99.3%) were antigenically related to the pandemic vaccine virus A/California/7/2009, which is the recommended H1N1 component for the 2010-11 influenza vaccine. One virus (0.7%) tested showed reduced titer with antiserum produced against A/California/7/2009. Of the 415 influenza B viruses characterized, 396 (95.4%) were antigenically related to B/Brisbane/60/08 (Victoria lineage), which is the recommended influenza B component for the 2010-11 influenza vaccine. Four of the 396 viruses tested showed reduced titer with antisera produced against B/Brisbane/60/08. Nineteen (4.6%) influenza B viruses were characterized as B/Wisconsin/01/2010-like, which belongs to the Yamagata lineage. B/Wisconsin/01/2010-like viruses are antigenically and genetically different from the previous Yamagata lineage vaccine strain B/Florida/04/2006.
    Antiviral Resistance
    Since the beginning of the 2010-2011 season, NML has tested 591 influenza A isolates (445 A/H3N2 and 146 pandemic H1N1 2009) for amantadine resistance and found that 444 influenza A/H3N2 were resistant and one was sensitive. All 146 influenza A/H1N1 viruses were resistant to amantadine. Of 643 influenza viruses (228 A/H3N2, 124 pandemic H1N1 2009, and 291 influenza B) tested for resistance to oseltamivir, 227 A/H3N2 viruses were sensitive and one was resistant with E119V mutation. The resistant case was associated with oseltamivir prophylaxis/treatment. Of the 124 pandemic H1N1 2009 isolates tested for oseltamivir resistance, 123 were sensitive and one was resistant with the H275Y mutation. The resistant case was associated with oseltamivir treatment. All 291 B viruses were sensitive to oseltamivir. Of 633 influenza viruses (224 A/H3N2, 121 pandemic H1N1 2009, and 288 influenza B) tested for zanamivir resistance all isolates were found to be sensitive.
    Severe Illness Surveillance

    Paediatric Influenza Hospitalizations and Deaths
    In week 16, 7 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, 2 from SK and 3 from QC. This number is similar to the previous week (week 15) in which 6 paediatric hospitalizations were reported (note that numbers may fluctuate because of the delays in reporting). Five paediatric deaths have been reported via IMPACT this season all with underlying comorbidities.
    Since the beginning of the season, 632 hospitalizations with laboratory-confirmed influenza have been reported: 102 (16.1%) as influenza A/H3N2, 22 (3.5%) pandemic H1N1 2009, 327 (51.7%) as unsubytped influenza A, and 181 (28.6%) influenza B. The distribution of cases to date by age group was as follows: 16.8% among 0-5 month olds; 28.2% among 6-23 month olds; 28.8% among the 2-4 year-olds; 15.3% among 5-9 year-olds; and 10.9% among children 10-16 years old.

    Adult Influenza Hospitalizations and Deaths
    During week 16, 4 new hospitalizations with laboratory-confirmed influenza among adults (16 years of age and older) were reported through the Canadian Nosocomial Infection Surveillance Program (CNISP), 3 influenza B and 1 influenza A/H3N2. This number is similar to the 5 cases reported in week 15 (note that numbers may fluctuate because of the delays in reporting). Since the beginning of the season, 952 hospitalized cases have been reported: 202 (21.2%) A/H3N2, 45 (4.7%) pandemic H1N1 2009, 640 (67.2%) influenza A unsubtyped, and 65 (6.8%) influenza B, from all reporting provinces. To date, 642 of the 952 (67.4%) cases were aged 65 years or older and 430 (45.2%) were males.

    Aggregate Influenza Hospitalizations and Deaths
    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 16, no deaths with influenza were reported. Among the 221 fatal cases reported since the beginning of the influenza season, influenza A/H3N2 was identified in 61.1% (135/221), unsubtyped influenza A in 28.5% (63/221), pandemic H1N1 2009 in 5.9% (13/221), and influenza B in 4.5% (10/221). Eighty percent (176/221) of these fatal cases were among persons 65 years of age or older, and another 11% (24/221) were between the ages of 45 and 64 years old, in keeping with the age-groups usually affected by A/H3N2. (Note that numbers may fluctuate because of the delays in reporting).

    .../

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    Re: Canada FluWatch Weekly Reports 2010-2011 Season Week 15 - 218 deaths total (excluding BC, QC, NB and NU)

    <TABLE border=0 cellSpacing=0 cellPadding=0><TBODY><TR><TD>April 10 to 16, 2011 (Week 15)

    </TD></TR></TBODY></TABLE>


    Posted 2011-04-21

    Overall Influenza Summary
    • In week 15, influenza B continues to increase and accounted for 63% of positive influenza detections.
    • A few more regions reported localized influenza activity this week compared to the previous week.
    • ILI consultation rate increased slightly, however all other indicators of influenza activity decreased.


    Influenza Activity and Outbreaks

    In week 15, 15 regions reported localized activity: AB(1), SK(1), ON(5), QC(1), NB(2), NS(3), and NL(2); 26 regions reported sporadic activity (in BC(5), AB(4), SK(2), MB(2), QC(5), NB(4), NT(2), and NU(2)) and 13 regions presented no activity (see Activity level Map). Compared to the previous week (week 14), 10 regions reported an increased level of influenza activity, 12 regions reported decreased activity, and 24 regions maintained a stable level of influenza activity (sporadic or higher). Nine new outbreaks were reported: 6 outbreaks of influenza in long-term care facilities (LTCF) in SK(1), QC(1), NL (1), and PE(3); and 3 ILI outbreaks in schools in AB(1), NS(1), and NL(1).

    Map of overall Influenza activity level by province and territory, Canada, Week 15





    No Data

    No Activity

    Sporadic Activity

    Localized Activity

    Widespread Activity



    Note: Influenza activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.
    Text Equivalent

    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.
    Text Equivalent


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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.
    Text Equivalent
    ILI consultation rate
    During week 15, the national ILI consultation rate was 19.3 consultations per 1,000 patient visits, which is increased compared to the previous week and is within the expected rate for this time of year (see ILI graph). Children under 5 years of age had the highest consultation rates (57.2 per 1,000 consultations), followed by children 5-19 years of age (29.5 per 1,000 consultations) in week 15.
    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.
    Text Equivalent
    Laboratory Surveillance Summary
    The overall proportion of tests that were positive for influenza during week 15 was 10.3% (3.8% influenza A, 6.5% influenza B), which is stable compared to week 14 (10.4%) and the second week in which more influenza B detections were reported than influenza A. The proportion of positive tests peaked in week 52 (see Influenza tests graph). Of the 369 positive tests reported during week 15, 136 (36.9%) were influenza A and 233 (63.1%) were influenza B. Since the beginning of the season, 87.5% (16,262/18,595) of influenza virus detections have been influenza A viruses, of which 84.7% (5,425/6,405) of subtyped specimens have been A/H3N2. Detections of influenza B have been increasing steadily since week 03, when it accounted for 3.4% of all positive influenza specimens to 63.1% in week 15. Among influenza A detections in week 15, 60 (44.1%) specimens were reported as influenza A/H3N2, 13 (9.6%) as pandemic H1N1 2009, and 63 (46.3%) as unsubtyped influenza A. Through detailed case-based laboratory reporting where age data is provided, since August 29, 2010, 50.8% (2043/4018) of cases with A/H3N2 were aged 65 years or older. In contrast, the majority (94.5%, 741/784) of cases with pandemic H1N1 2009 were under 65 years of age (see Tests detailed table). In week 15, the proportion of positive tests for respiratory syncytial virus detections (RSV) decreased to 11.0% of specimens tested. The proportion of positive RSV tests appears to have peaked in week 07 (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 (April 10 to April 16, 2011)</TH><TH class="bg-colour-blue fontSize85" colSpan=6 scope=colgroup>Cumulative (August 29, 2010 to April 16, 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>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>472</TD><TD class=alignCenter>0</TD><TD class=alignCenter>196</TD><TD class=alignCenter>163</TD><TD class=alignCenter>113</TD><TD class=alignCenter>175</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>20</TD><TD class=alignCenter>0</TD><TD class=alignCenter>11</TD><TD class=alignCenter>7</TD><TD class=alignCenter>2</TD><TD class=alignCenter>47</TD><TD class=alignCenter>1032</TD><TD class=alignCenter>0</TD><TD class=alignCenter>726</TD><TD class=alignCenter>269</TD><TD class=alignCenter>37</TD><TD class=alignCenter>662</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>14</TD><TD class=alignCenter>0</TD><TD class=alignCenter>10</TD><TD class=alignCenter>0</TD><TD class=alignCenter>4</TD><TD class=alignCenter>26</TD><TD class=alignCenter>311</TD><TD class=alignCenter>0</TD><TD class=alignCenter>209</TD><TD class=alignCenter>30</TD><TD class=alignCenter>72</TD><TD class=alignCenter>124</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3</TD><TD class=alignCenter>515</TD><TD class=alignCenter>0</TD><TD class=alignCenter>56</TD><TD class=alignCenter>2</TD><TD class=alignCenter>457</TD><TD class=alignCenter>9</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>21</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6</TD><TD class=alignCenter>5</TD><TD class=alignCenter>10</TD><TD class=alignCenter>61</TD><TD class=alignCenter>6866</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2433</TD><TD class=alignCenter>269</TD><TD class=alignCenter>4164</TD><TD class=alignCenter>740</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>33</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>31</TD><TD class=alignCenter>83</TD><TD class=alignCenter>5600</TD><TD class=alignCenter>0</TD><TD class=alignCenter>877</TD><TD class=alignCenter>38</TD><TD class=alignCenter>4685</TD><TD class=alignCenter>544</TD></TR><TR><TH class=bg-colour-blue scope=row>NB</TH><TD class=alignCenter>20</TD><TD class=alignCenter>0</TD><TD class=alignCenter>13</TD><TD class=alignCenter>0</TD><TD class=alignCenter>7</TD><TD class=alignCenter>9</TD><TD class=alignCenter>937</TD><TD class=alignCenter>0</TD><TD class=alignCenter>657</TD><TD class=alignCenter>176</TD><TD class=alignCenter>104</TD><TD class=alignCenter>62</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>15</TD><TD class=alignCenter>0</TD><TD class=alignCenter>8</TD><TD class=alignCenter>0</TD><TD class=alignCenter>7</TD><TD class=alignCenter>0</TD><TD class=alignCenter>252</TD><TD class=alignCenter>0</TD><TD class=alignCenter>78</TD><TD class=alignCenter>11</TD><TD class=alignCenter>163</TD><TD class=alignCenter>3</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>97</TD><TD class=alignCenter>0</TD><TD class=alignCenter>79</TD><TD class=alignCenter>16</TD><TD class=alignCenter>2</TD><TD class=alignCenter>6</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>13</TD><TD class=alignCenter>0</TD><TD class=alignCenter>11</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>3</TD><TD class=alignCenter>180</TD><TD class=alignCenter>0</TD><TD class=alignCenter>114</TD><TD class=alignCenter>6</TD><TD class=alignCenter>60</TD><TD class=alignCenter>8</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>136</TD><TD class=alignCenter>0</TD><TD class=alignCenter>60</TD><TD class=alignCenter>13</TD><TD class=alignCenter>63</TD><TD class=alignCenter>233</TD><TD class=alignCenter>16262</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5425</TD><TD class=alignCenter>980</TD><TD class=alignCenter>9857</TD><TD class=alignCenter>2333</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
    (April 10 to April 16, 2011)</TH><TH colSpan=5 scope=colgroup>Cumulative
    (Aug. 29, 2010 to Apr. 16, 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>5</TD><TD class=alignCenter>2</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>14</TD><TD class=alignCenter>994</TD><TD class=alignCenter>125</TD><TD class=alignCenter>726</TD><TD class=alignCenter>143</TD><TD class=alignCenter>338</TD></TR><TR><TD>5-19</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>13</TD><TD class=alignCenter>515</TD><TD class=alignCenter>103</TD><TD class=alignCenter>295</TD><TD class=alignCenter>117</TD><TD class=alignCenter>476</TD></TR><TR><TD>20-44</TD><TD class=alignCenter>4</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>8</TD><TD class=alignCenter>1068</TD><TD class=alignCenter>328</TD><TD class=alignCenter>524</TD><TD class=alignCenter>216</TD><TD class=alignCenter>256</TD></TR><TR><TD>45-64</TD><TD class=alignCenter>4</TD><TD class=alignCenter>1</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>8</TD><TD class=alignCenter>782</TD><TD class=alignCenter>185</TD><TD class=alignCenter>430</TD><TD class=alignCenter>167</TD><TD class=alignCenter>108</TD></TR><TR><TD>65+</TD><TD class=alignCenter>25</TD><TD class=alignCenter>0</TD><TD class=alignCenter>12</TD><TD class=alignCenter>13</TD><TD class=alignCenter>11</TD><TD class=alignCenter>2476</TD><TD class=alignCenter>43</TD><TD class=alignCenter>2043</TD><TD class=alignCenter>390</TD><TD class=alignCenter>132</TD></TR><TR><TD>Unknown</TD><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>229</TD><TD class=alignCenter>3</TD><TD class=alignCenter>224</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD></TR><TR><TD>Total</TD><TD class=alignCenter>39</TD><TD class=alignCenter>5</TD><TD class=alignCenter>18</TD><TD class=alignCenter>16</TD><TD class=alignCenter>54</TD><TD class=alignCenter>6064</TD><TD class=alignCenter>787</TD><TD class=alignCenter>4242</TD><TD class=alignCenter>1035</TD><TD class=alignCenter>1310</TD></TR></TBODY></TABLE>


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    Influenza tests reported and percentage of tests positive, Canada, by report week, 2010-2011


    Text Equivalent

    Percent positive influenza tests, compared to other respiratory viruses, Canada, by reporting week, 2010-2011


    Text Equivalent
    Canadian situation

    Antigenic Characterization
    Between September 1 and April 20, 2011, the National Microbiology Laboratory (NML) has antigenically characterized 726 influenza viruses that were received from provincial laboratories: 248 A/H3N2, 127 pandemic H1N1 2009 and 351 B viruses. Of the 248 influenza A/H3N2 viruses characterized, 245 (98.8%) were antigenically related to A/Perth/16/2009, which is the influenza A/H3N2 component recommended for the 2010-11 influenza vaccine. Three viruses (1.2%) tested showed reduced titer with antiserum produced against A/Perth/16/2009. Of the 127 pandemic H1N1 2009 viruses characterized, 126 (99%) were antigenically related to the pandemic vaccine virus A/California/7/2009, which is the recommended H1N1 component for the 2010-11 influenza vaccine. One virus (1%) tested showed reduced titer with antiserum produced against A/California/7/2009. Of the 351 influenza B viruses characterized, 336 (95.7%) were antigenically related to B/Brisbane/60/08 (Victoria lineage), which is the recommended influenza B component for the 2010-11 influenza vaccine. Four of the 336 viruses tested showed reduced titer with antisera produced against B/Brisbane/60/08. Fifteen (5.1%) influenza B viruses were characterized as B/Wisconsin/01/2010-like, which belongs to the Yamagata lineage. B/Wisconsin/01/2010-like viruses are antigenically and genetically different from the previous Yamagata lineage vaccine strain B/Florida/04/2006.
    Antiviral Resistance
    Since the beginning of the 2010-2011 season, NML has tested 513 influenza A isolates (400 A/H3N2 and 113 pandemic H1N1 2009) for amantadine resistance and found that 399 influenza A/H3N2 were resistant to amantadine and one was sensitive. All 113 influenza A/H1N1 viruses were resistant to amantadine. Of 575 influenza viruses (208 A/H3N2, 103 pandemic H1N1 2009, and 264 influenza B) tested for resistance to oseltamivir, 207 A/H3N2 viruses were sensitive to oseltamivir and one was resistant to oseltamivir with E119V mutation. The resistant case was associated with oseltamivir prophylaxis/treatment. Of the 103 pandemic H1N1 2009 isolates tested, 102 were sensitive to oseltamivir and one was resistant to oseltamivir with the H275Y mutation. The resistant case was associated with oseltamivir treatment. All 264 B viruses were sensitive to oseltamivir. Of 565 influenza viruses (203 A/H3N2, 100 pandemic H1N1 2009, and 262 influenza B) tested for resistance to zanamivir, all isolates were found to be sensitive to zanamivir.
    Severe Illness Surveillance

    Paediatric Influenza Hospitalizations and Deaths
    In week 15, 5 new laboratory-confirmed influenza-associated paediatric (16 years of age and under) hospitalizations were reported through the Immunization Monitoring Program Active (IMPACT) network: 4 from QC, and 1 from NL. This number has decreased compared to the previous week (week 14) in which 27 paediatric hospitalizations were reported (note that numbers may fluctuate because of the delays in reporting). Five paediatric deaths have been reported via IMPACT this season all with underlying comorbidities.
    Since the beginning of the season, 624 hospitalizations with laboratory-confirmed influenza have been reported from all participating provinces; 101 (16.2%) as influenza A/H3N2, 22 (3.5%) pandemic H1N1 2009, 328 (52.6%) as unsubytped influenza A, and 173 (27.7%) influenza B. The distribution of cases to date by age group was as follows: 17.0% among 0-5 month olds; 28.4% among 6-23 month olds; 28.8% among the 2-4 year-olds; 14.9% among 5-9 year-olds; and 10.9% among children 10-16 years old.

    Adult Influenza Hospitalizations and Deaths
    During week 15, 5 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 has decreased compared to the 7 cases reported in week 14 (note that numbers may fluctuate because of the delays in reporting). Of the 5 new cases reported between April 10 and 16, 2011, 3 (60.0%) tested positive for unsubtyped influenza A, and 2 (40.0%) as influenza B. Since the beginning of the season, 948 hospitalized cases have been reported: 201 (21.2%) A/H3N2, 45 (4.7%) pandemic H1N1 2009, 640 (67.5%) influenza A unsubtyped, and 62 (6.5%) influenza B, from all reporting provinces. To date, 641 of the 948 (67.6%) cases were aged 65 years or older and 430 (45.4%) were males.

    Aggregate Influenza Hospitalizations and Deaths
    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 15, one death with influenza was reported in Ontario, in a person >65 years old with unsubtyped influenza A. Among the 218 fatal cases reported since the beginning of the influenza season, influenza A/H3N2 was identified in 61.5% (134/218), unsubtyped influenza A in 28.0% (61/218), pandemic H1N1 2009 in 6.0% (13/218), and influenza B in 4.6% (10/218). Seventy-nine percent (173/218) of these fatal cases were among persons 65 years of age or older, and another 11% (24/218) were between the ages of 45 and 64 years old, in keeping with the age-groups usually affected by A/H3N2. (Note that numbers may fluctuate because of the delays in reporting).

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    Re: Canada FluWatch Weekly Reports 2010-2011 Season Week 14 - 217 deaths total (excluding BC, QC, NB and NU)

    <TABLE border=0 cellSpacing=0 cellPadding=0><TBODY><TR><TD>April 3 to 9, 2011 (Week 14)


    </TD></TR></TBODY></TABLE>
    </B>
    Posted 2011-04-15


    Overall Influenza Summary
    • In week 14, all indicators of influenza activity have decreased.
    • Ten percent of tests were positive for influenza, of which influenza B accounted for a greater proportion than influenza A.
    • The ILI consultation rate declined compared to previous weeks and is slightly below the expected rate for this time of year. Fewer influenza/ILI outbreaks were reported, and both adult and paediatric hospitalizations decreased compared to the previous week.
    Note: The next FluWatch report will be published on Thursday, April 21<SUP>st </SUP>due to the Good Friday holiday. FluWatch will return to Friday publication on April 29<SUP>th </SUP>.
    Influenza Activity and Outbreaks

    In week 14, 9 regions reported localized activity: AB(1), ON(4), NB(2), NS(1), and NL(1); 33 regions reported sporadic activity (in all provinces and territories except YK) and 14 regions presented no activity (see Activity level Map). Compared to the previous week (week 13), 7 regions reported an increased level of influenza activity, 9 regions reported decreased activity, and 28 regions maintained a stable level of influenza activity (sporadic or higher). Eleven new outbreaks were reported: 6 outbreaks of influenza in long-term care facilities (LTCF) in AB(1) ON(1), NB (2), and NS(2); 2 outbreaks of influenza in hospitals in NS; 2 ILI outbreaks in schools in NB; and 1 ILI outbreak in a facility in NL.

    Map of overall Influenza activity level by province and territory, Canada, Week 14





    No Data

    No Activity

    Sporadic Activity

    Localized Activity

    Widespread Activity



    Note: Influenza activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.
    Text Equivalent

    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.
    Text Equivalent


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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.
    Text Equivalent
    ILI consultation rate
    During week 14, the national ILI consultation rate was 17.2 consultations per 1,000 patient visits, which is decreased compared to previous weeks and is slightly below the expected rate for this time of year (see ILI graph). Children 5-19 years of age had the highest consultation rates (32.8 per 1,000 consultations), followed by children under 5 years of age (22.5 per 1,000 consultations) in week 14.
    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.
    Text Equivalent
    Laboratory Surveillance Summary
    The overall proportion of tests that were positive for influenza during week 14 was 10.4% (4.3% influenza A, 6.1% influenza B), which is decreased compared to week 13 (11.7%) and the first week in which more influenza B detections were reported than influenza A. The proportion of positive tests peaked in week 52 (see Influenza tests graph). Of the 412 positive tests reported during week 14, 169 (41.0%) were influenza A and 243 (59.0%) were influenza B. Since the beginning of the season, 88.5% (16,106/18,197) of influenza virus detections have been influenza A viruses, of which 84.7% (5,351/6,317) of subtyped specimens have been A/H3N2. Detections of influenza B have been increasing steadily since week 03, when it accounted for 3.4% of all positive influenza specimens to 59.0% in week 14. Among influenza A detections in week 14, 54 (32.0%) specimens were reported as influenza A/H3N2, 12 (7.1%) as pandemic H1N1 2009, and 103 (60.9%) as unsubtyped influenza A. Through detailed case-based laboratory reporting where age data is provided, since August 29, 2010, 51.3% (1937/3779) of cases with A/H3N2 were aged 65 years or older. In contrast, the majority (94.0%, 632/672) of cases with pandemic H1N1 2009 were under 65 years of age (see Tests detailed table). In week 14, the proportion of positive tests for respiratory syncytial virus detections (RSV) increased slightly to 14.3% of specimens tested. The proportion of positive RSV tests appears to have peaked in week 07 (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 (April 3 to April 9, 2011)</TH><TH class="bg-colour-blue fontSize85" colSpan=6 scope=colgroup>Cumulative (August 29, 2010 to April 9, 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>7</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>8</TD><TD class=alignCenter>472</TD><TD class=alignCenter>0</TD><TD class=alignCenter>196</TD><TD class=alignCenter>163</TD><TD class=alignCenter>113</TD><TD class=alignCenter>174</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>31</TD><TD class=alignCenter>0</TD><TD class=alignCenter>19</TD><TD class=alignCenter>9</TD><TD class=alignCenter>3</TD><TD class=alignCenter>77</TD><TD class=alignCenter>1012</TD><TD class=alignCenter>0</TD><TD class=alignCenter>714</TD><TD class=alignCenter>261</TD><TD class=alignCenter>37</TD><TD class=alignCenter>615</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>36</TD><TD class=alignCenter>297</TD><TD class=alignCenter>0</TD><TD class=alignCenter>199</TD><TD class=alignCenter>30</TD><TD class=alignCenter>68</TD><TD class=alignCenter>98</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>4</TD><TD class=alignCenter>515</TD><TD class=alignCenter>0</TD><TD class=alignCenter>56</TD><TD class=alignCenter>2</TD><TD class=alignCenter>457</TD><TD class=alignCenter>6</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>31</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>25</TD><TD class=alignCenter>44</TD><TD class=alignCenter>6845</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2427</TD><TD class=alignCenter>264</TD><TD class=alignCenter>4154</TD><TD class=alignCenter>679</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>46</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>2</TD><TD class=alignCenter>43</TD><TD class=alignCenter>73</TD><TD class=alignCenter>5567</TD><TD class=alignCenter>0</TD><TD class=alignCenter>876</TD><TD class=alignCenter>37</TD><TD class=alignCenter>4654</TD><TD class=alignCenter>461</TD></TR><TR><TH class=bg-colour-blue scope=row>NB</TH><TD class=alignCenter>N/A</TD><TD class=alignCenter>N/A</TD><TD class=alignCenter>N/A</TD><TD class=alignCenter>N/A</TD><TD class=alignCenter>N/A</TD><TD class=alignCenter>N/A</TD><TD class=alignCenter>897</TD><TD class=alignCenter>0</TD><TD class=alignCenter>631</TD><TD class=alignCenter>176</TD><TD class=alignCenter>90</TD><TD class=alignCenter>44</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>20</TD><TD class=alignCenter>0</TD><TD class=alignCenter>14</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>237</TD><TD class=alignCenter>0</TD><TD class=alignCenter>70</TD><TD class=alignCenter>11</TD><TD class=alignCenter>156</TD><TD class=alignCenter>3</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>8</TD><TD class=alignCenter>0</TD><TD class=alignCenter>8</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>97</TD><TD class=alignCenter>0</TD><TD class=alignCenter>79</TD><TD class=alignCenter>16</TD><TD class=alignCenter>2</TD><TD class=alignCenter>6</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>24</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>24</TD><TD class=alignCenter>1</TD><TD class=alignCenter>167</TD><TD class=alignCenter>0</TD><TD class=alignCenter>103</TD><TD class=alignCenter>6</TD><TD class=alignCenter>58</TD><TD class=alignCenter>5</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>169</TD><TD class=alignCenter>0</TD><TD class=alignCenter>54</TD><TD class=alignCenter>12</TD><TD class=alignCenter>103</TD><TD class=alignCenter>243</TD><TD class=alignCenter>16106</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5351</TD><TD class=alignCenter>966</TD><TD class=alignCenter>9789</TD><TD class=alignCenter>2091</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
    (April 3 to April 9, 2011)
    </TH><TH colSpan=5 scope=colgroup>Cumulative
    (Aug. 29, 2010 to Apr. 9, 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>5</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3</TD><TD class=alignCenter>2</TD><TD class=alignCenter>24</TD><TD class=alignCenter>929</TD><TD class=alignCenter>111</TD><TD class=alignCenter>682</TD><TD class=alignCenter>136</TD><TD class=alignCenter>160</TD></TR><TR><TD>5-19</TD><TD class=alignCenter>3</TD><TD class=alignCenter>1</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>16</TD><TD class=alignCenter>469</TD><TD class=alignCenter>84</TD><TD class=alignCenter>273</TD><TD class=alignCenter>112</TD><TD class=alignCenter>275</TD></TR><TR><TD>20-44</TD><TD class=alignCenter>11</TD><TD class=alignCenter>4</TD><TD class=alignCenter>6</TD><TD class=alignCenter>1</TD><TD class=alignCenter>14</TD><TD class=alignCenter>967</TD><TD class=alignCenter>277</TD><TD class=alignCenter>487</TD><TD class=alignCenter>203</TD><TD class=alignCenter>140</TD></TR><TR><TD>45-64</TD><TD class=alignCenter>6</TD><TD class=alignCenter>1</TD><TD class=alignCenter>2</TD><TD class=alignCenter>3</TD><TD class=alignCenter>15</TD><TD class=alignCenter>712</TD><TD class=alignCenter>160</TD><TD class=alignCenter>400</TD><TD class=alignCenter>152</TD><TD class=alignCenter>43</TD></TR><TR><TD>65+</TD><TD class=alignCenter>21</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6</TD><TD class=alignCenter>15</TD><TD class=alignCenter>7</TD><TD class=alignCenter>2291</TD><TD class=alignCenter>40</TD><TD class=alignCenter>1937</TD><TD class=alignCenter>314</TD><TD class=alignCenter>73</TD></TR><TR><TD>Unknown</TD><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>229</TD><TD class=alignCenter>3</TD><TD class=alignCenter>224</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD></TR><TR><TD>Total</TD><TD class=alignCenter>46</TD><TD class=alignCenter>6</TD><TD class=alignCenter>19</TD><TD class=alignCenter>21</TD><TD class=alignCenter>76</TD><TD class=alignCenter>5597</TD><TD class=alignCenter>675</TD><TD class=alignCenter>4003</TD><TD class=alignCenter>919</TD><TD class=alignCenter>691</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

    Antigenic Characterization
    Between September 1 and April 14, 2011, the National Microbiology Laboratory (NML) has antigenically characterized 632 influenza viruses that were received from provincial laboratories: 228 A/H3N2, 109 pandemic H1N1 2009 and 295 B viruses. Of the 228 influenza A/H3N2 viruses characterized, 225 (98.7%) were antigenically related to A/Perth/16/2009, which is the influenza A/H3N2 component recommended for the 2010-11 influenza vaccine. Three viruses (1.3%) tested showed reduced titer with antiserum produced against A/Perth/16/2009. Of the 109 pandemic H1N1 2009 viruses characterized, 108 (99%) were antigenically related to the pandemic vaccine virus A/California/7/2009, which is the recommended H1N1 component for the 2010-11 influenza vaccine. One virus (1%) tested showed reduced titer with antiserum produced against A/California/7/2009. Of the 295 influenza B viruses characterized, 280 were antigenically related to B/Brisbane/60/08 (Victoria lineage), which is the recommended influenza B component for the 2010-11 influenza vaccine. Four of the 280 viruses tested showed reduced titer with antisera produced against B/Brisbane/60/08. Fifteen influenza B viruses were characterized as B/Wisconsin/01/2010-like, which belongs to the Yamagata lineage. B/Wisconsin/01/2010-like viruses are antigenically and genetically different from the previous Yamagata lineage vaccine strain B/Florida/04/2006.
    Antiviral Resistance
    Since the beginning of the 2010-2011 season, NML has tested 512 influenza A isolates (399 A/H3N2 and 113 pandemic H1N1 2009) for amantadine resistance and found that 398 influenza A/H3N2 were resistant to amantadine and one was sensitive. All 113 influenza A/H1N1 viruses were resistant to amantadine. Of 565 influenza viruses (205 A/H3N2, 103 pandemic H1N1 2009, and 257 influenza B) tested for resistance to oseltamivir, 204 A/H3N2 viruses were sensitive to oseltamivir and one was resistant to oseltamivir with E119V mutation. The resistant case was associated with oseltamivir prophylaxis/treatment. Of the 103 pandemic H1N1 2009 isolates tested, 102 were sensitive to oseltamivir and one was resistant to oseltamivir with the H275Y mutation. The resistant case was associated with oseltamivir treatment. All 257 B viruses were sensitive to oseltamivir. Of 558 influenza viruses (200 A/H3N2, 100 pandemic H1N1 2009, and 258 influenza B) tested for resistance to zanamivir, all isolates were found to be sensitive to zanamivir.
    Severe Illness Surveillance

    Paediatric Influenza Hospitalizations and Deaths
    In week 14, 22 new laboratory-confirmed influenza-associated paediatric (16 years of age and under) hospitalizations were reported through the Immunization Monitoring Program Active (IMPACT) network: 3 from BC, 4 from AB, 1 from SK, 13 from QC, and 1 from NL. This number has decreased slightly compared to the previous week (week 13) in which 25 paediatric hospitalizations were reported (note that numbers may fluctuate because of the delays in reporting). Five paediatric death have been reported via IMPACT this season all with underlying comorbidities.
    Since the beginning of the season, 618 hospitalizations with laboratory-confirmed influenza have been reported from all participating provinces; 100 (16.2%) as influenza A/H3N2, 22 (3.6%) pandemic H1N1 2009, 333 (53.9%) as unsubytped influenza A, and 163 (26.4%) influenza B. The distribution of cases to date by age group was as follows: 16.8% among 0-5 month olds; 28.3% among 6-23 month olds; 29.1% among the 2-4 year-olds; 14.9% among 5-9 year-olds; and 10.8% among children 10-16 years old.
    Adult Influenza Hospitalizations and Deaths
    During week 14, 7 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 has decreased compared to the 11 cases reported in week 13 (note that numbers may fluctuate because of the delays in reporting). Of the 7 new cases reported between April 3 and 9, 2011, 2 (28.6%) tested positive for unsubtyped influenza A, 1 (14.3%) as A/H3N2, and 4 (57.1%) as influenza B. Since the beginning of the season, 943 hospitalized cases have been reported: 201 (21.3%) A/H3N2, 45 (4.8%) pandemic H1N1 2009, 637 (67.6%) influenza A unsubtyped, and 60 (6.4%) influenza B, from all reporting provinces. To date, 638 of the 943 (67.7%) cases were aged 65 years or older and 425 (45.1%) were males.

    Aggregate Influenza Hospitalizations and Deaths
    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 14, three deaths with influenza were reported in Ontario: in persons 45-64 and >65 years old with influenza A/H3N2 or unsubtyped influenza A. Among the 217 fatal cases reported since the beginning of the influenza season, influenza A/H3N2 was identified in 61.8% (134/217), unsubtyped influenza A in 27.6% (60/217), pandemic H1N1 2009 in 6.0% (13/217), and influenza B in 4.6% (10/217). Seventy-nine percent (172/217) of these fatal cases were among persons 65 years of age or older, and another 11% (24/217) were between the ages of 45 and 64 years old, in keeping with the age-groups usually affected by A/H3N2. (Note that numbers may fluctuate because of the delays in reporting).

    .../

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    Canada FluWatch Weekly Reports 2010-2011 Season Week 13 - 208 deaths total (excluding BC, QC, NB and NU)

    <TABLE border=0 cellSpacing=0 cellPadding=0><TBODY><TR><TD>March 27 to April 2, 2011 (Week 13)

    </TD></TR></TBODY></TABLE>


    Posted 2011-04-08

    Summary of FluWatch Findings for the Week ending April 2, 2011
    • In week 13, localized influenza activity is being reported in parts of Saskatchewan, Ontario, Quebec and the Atlantic provinces.
    • Influenza B detections continue to increase steadily in most regions of the country except the Atlantic provinces and now accounts for almost half of the positive tests for influenza (53.0% influenza A, 47.0% were influenza B).
    • In week 13, the ILI consultation rate remained similar to the previous 3 weeks, fewer influenza/ILI outbreaks were reported, and adult hospitalizations decreased compared to the previous week.

    Overall Influenza Summary ? Week 13 (March 27 to April 2, 2011)

    In week 13, 12 regions reported localized activity: SK(1), ON(5), QC(1), NB(1), NS(3), and PE(1); 29 regions reported sporadic activity (in all provinces and territories except PE, NS, and YK ) and 15 regions presented no activity (see Activity level Map). Compared to the previous week (week 12), 5 regions reported an increased level of influenza activity, 17 regions reported decreased activity, and 27 regions maintained a stable level of influenza activity (sporadic or higher). Twelve new outbreaks were reported: 4 outbreaks of influenza in long-term care facilities (LTCF) in ON(2), NB (1), and PE(1); 3 outbreaks of influenza in hospitals in QC(1) and NS(2); 3 ILI outbreaks in schools in NB(1), and NS(2); and 2 ILI outbreaks in other facilities in ON.

    Map of overall Influenza activity level by province and territory, Canada, Week 13





    No Data

    No Activity

    Sporadic Activity

    Localized Activity

    Widespread Activity



    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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    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 13, the national ILI consultation rate was 24.1 consultations per 1,000 patient visits, which has been similar to the past 3 weeks and within the expected rate for this time of year (see ILI graph). Children under 5 years of age had the highest consultation rates (77.0 per 1,000 consultations) in week 13.
    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.
    Text Equivalent
    Laboratory Surveillance Summary
    The overall proportion of tests that were positive for influenza during week 13 was 11.4% (6.0% influenza A, 5.3% influenza B), similar to that of week 12 (11.2%). The proportion of positive tests peaked in week 52 (see Influenza tests graph). Of the 481 positive tests reported during week 13, 255 (53.0%) were influenza A and 226 (47.0%) were influenza B. Since the beginning of the season, 89.6% (15,914/17,753) of influenza virus detections have been influenza A viruses, of which 84.8% (5,282/6230) of subtyped specimens have been A/H3N2. Detections of influenza B have been increasing steadily since week 03, when it accounted for 3.4% of all positive influenza specimens to 47.0% in week 13. Among influenza A detections in week 13, 78 (30.6%) specimens were reported as influenza A/H3N2, 17 (6.7%) as pandemic H1N1 2009, and 160 (62.7%) as unsubtyped influenza A. Through detailed case-based laboratory reporting where age data is provided, since August 29, 2010, 51.2% (1935/3776) of cases with A/H3N2 were aged 65 years or older. In contrast, the majority (94.0%, 631/671) of cases with pandemic H1N1 2009 were under 65 years of age (see Tests detailed table). In week 13, the proportion of positive tests for respiratory syncytial virus detections (RSV) decreased from 17.1% to 12.8% of specimens tested. The proportion of positive RSV tests appears to have peaked in week 07 (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 (March 27 to April 2, 2011)</TH><TH class="bg-colour-blue fontSize85" colSpan=6 scope=colgroup>Cumulative (August 29, 2010 to April 2, 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>11</TD><TD class=alignCenter>9</TD><TD class=alignCenter>1</TD><TD class=alignCenter>8</TD><TD class=alignCenter>465</TD><TD class=alignCenter>0</TD><TD class=alignCenter>191</TD><TD class=alignCenter>162</TD><TD class=alignCenter>112</TD><TD class=alignCenter>166</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>29</TD><TD class=alignCenter>0</TD><TD class=alignCenter>17</TD><TD class=alignCenter>5</TD><TD class=alignCenter>7</TD><TD class=alignCenter>71</TD><TD class=alignCenter>980</TD><TD class=alignCenter>0</TD><TD class=alignCenter>692</TD><TD class=alignCenter>247</TD><TD class=alignCenter>41</TD><TD class=alignCenter>536</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>5</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3</TD><TD class=alignCenter>17</TD><TD class=alignCenter>295</TD><TD class=alignCenter>0</TD><TD class=alignCenter>198</TD><TD class=alignCenter>30</TD><TD class=alignCenter>67</TD><TD class=alignCenter>62</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>515</TD><TD class=alignCenter>0</TD><TD class=alignCenter>56</TD><TD class=alignCenter>2</TD><TD class=alignCenter>457</TD><TD class=alignCenter>2</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>77</TD><TD class=alignCenter>0</TD><TD class=alignCenter>21</TD><TD class=alignCenter>0</TD><TD class=alignCenter>56</TD><TD class=alignCenter>76</TD><TD class=alignCenter>6814</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2421</TD><TD class=alignCenter>264</TD><TD class=alignCenter>4129</TD><TD class=alignCenter>635</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>54</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>54</TD><TD class=alignCenter>50</TD><TD class=alignCenter>5521</TD><TD class=alignCenter>0</TD><TD class=alignCenter>875</TD><TD class=alignCenter>35</TD><TD class=alignCenter>4611</TD><TD class=alignCenter>388</TD></TR><TR><TH class=bg-colour-blue scope=row>NB</TH><TD class=alignCenter> </TD><TD class=alignCenter> </TD><TD class=alignCenter> </TD><TD class=alignCenter> </TD><TD class=alignCenter> </TD><TD class=alignCenter> </TD><TD class=alignCenter>875</TD><TD class=alignCenter>0</TD><TD class=alignCenter>619</TD><TD class=alignCenter>175</TD><TD class=alignCenter>81</TD><TD class=alignCenter>37</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>31</TD><TD class=alignCenter>0</TD><TD class=alignCenter>15</TD><TD class=alignCenter>1</TD><TD class=alignCenter>15</TD><TD class=alignCenter>0</TD><TD class=alignCenter>217</TD><TD class=alignCenter>0</TD><TD class=alignCenter>56</TD><TD class=alignCenter>11</TD><TD class=alignCenter>150</TD><TD class=alignCenter>3</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>12</TD><TD class=alignCenter>0</TD><TD class=alignCenter>12</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>89</TD><TD class=alignCenter>0</TD><TD class=alignCenter>71</TD><TD class=alignCenter>16</TD><TD class=alignCenter>2</TD><TD class=alignCenter>6</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>26</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>24</TD><TD class=alignCenter>3</TD><TD class=alignCenter>143</TD><TD class=alignCenter>0</TD><TD class=alignCenter>103</TD><TD class=alignCenter>6</TD><TD class=alignCenter>34</TD><TD class=alignCenter>4</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>255</TD><TD class=alignCenter>0</TD><TD class=alignCenter>78</TD><TD class=alignCenter>17</TD><TD class=alignCenter>160</TD><TD class=alignCenter>226</TD><TD class=alignCenter>15914</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5282</TD><TD class=alignCenter>948</TD><TD class=alignCenter>9684</TD><TD class=alignCenter>1839</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
    (March 27 to April 2, 2011)</TH><TH colSpan=5 scope=colgroup>Cumulative
    (Aug. 29, 2010 to Apr. 2, 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>15</TD><TD class=alignCenter>0</TD><TD class=alignCenter>10</TD><TD class=alignCenter>5</TD><TD class=alignCenter>20</TD><TD class=alignCenter>928</TD><TD class=alignCenter>111</TD><TD class=alignCenter>681</TD><TD class=alignCenter>136</TD><TD class=alignCenter>159</TD></TR><TR><TD>5-19</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>18</TD><TD class=alignCenter>470</TD><TD class=alignCenter>84</TD><TD class=alignCenter>274</TD><TD class=alignCenter>112</TD><TD class=alignCenter>271</TD></TR><TR><TD>20-44</TD><TD class=alignCenter>16</TD><TD class=alignCenter>8</TD><TD class=alignCenter>5</TD><TD class=alignCenter>3</TD><TD class=alignCenter>16</TD><TD class=alignCenter>967</TD><TD class=alignCenter>277</TD><TD class=alignCenter>487</TD><TD class=alignCenter>203</TD><TD class=alignCenter>139</TD></TR><TR><TD>45-64</TD><TD class=alignCenter>7</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3</TD><TD class=alignCenter>4</TD><TD class=alignCenter>6</TD><TD class=alignCenter>711</TD><TD class=alignCenter>159</TD><TD class=alignCenter>399</TD><TD class=alignCenter>153</TD><TD class=alignCenter>42</TD></TR><TR><TD>65+</TD><TD class=alignCenter>47</TD><TD class=alignCenter>0</TD><TD class=alignCenter>16</TD><TD class=alignCenter>31</TD><TD class=alignCenter>7</TD><TD class=alignCenter>2288</TD><TD class=alignCenter>40</TD><TD class=alignCenter>1935</TD><TD class=alignCenter>313</TD><TD class=alignCenter>70</TD></TR><TR><TD>Unknown</TD><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>229</TD><TD class=alignCenter>3</TD><TD class=alignCenter>224</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD></TR><TR><TD>Total</TD><TD class=alignCenter>87</TD><TD class=alignCenter>8</TD><TD class=alignCenter>35</TD><TD class=alignCenter>44</TD><TD class=alignCenter>67</TD><TD class=alignCenter>5593</TD><TD class=alignCenter>674</TD><TD class=alignCenter>4000</TD><TD class=alignCenter>919</TD><TD class=alignCenter>681</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

    Antigenic Characterization
    Between September 1 and April 5, 2011, the National Microbiology Laboratory (NML) has antigenically characterized 562 influenza viruses that were received from provincial laboratories: 216 A/H3N2 from BC, AB, SK, MB, ON, QC, NB & NU, 101 pandemic H1N1 2009 from BC, AB, ON, QC, NB & NS and 245 B viruses from BC, AB, SK, ON, QC, NB, NT and NU. Of the 216 influenza A/H3N2 viruses characterized, 213 (98.6%) were antigenically related to A/Perth/16/2009, which is the influenza A/H3N2 component recommended for the 2010-11 influenza vaccine. Three viruses (1.4%) tested showed reduced titer with antiserum produced against A/Perth/16/2009. Of the 101 pandemic H1N1 2009 viruses characterized, 94 (99%) were antigenically related to the pandemic vaccine virus A/California/7/2009, which is the recommended H1N1 component for the 2010-11 influenza vaccine. One virus (1%) tested showed reduced titer with antiserum produced against A/California/7/2009. Of the 245 influenza B viruses characterized, 236 were antigenically related to B/Brisbane/60/08 (Victoria lineage), which is the recommended influenza B component for the 2010-11 influenza vaccine. Four of the 236 viruses tested showed reduced titer with antisera produced against B/Brisbane/60/08. Nine influenza B viruses were characterized as B/Wisconsin/01/2010-like, which belongs to the Yamagata lineage. B/Wisconsin/01/2010-like viruses are antigenically and genetically different from the previous Yamagata lineage vaccine strain B/Florida/04/2006.
    Antiviral Resistance
    Since the beginning of the 2010-2011 season, NML has tested 494 influenza A isolates (382 A/H3N2 and 112 pandemic H1N1 2009) for amantadine resistance and found that 381 influenza A/H3N2 were resistant to amantadine and one was sensitive. All 112 influenza A/H1N1 viruses were resistant to amantadine. Of 442 influenza viruses (188 A/H3N2, 94 pandemic H1N1 2009, and 160 influenza B) tested for resistance to oseltamivir, 187 A/H3N2 viruses were sensitive to oseltamivir and one was resistant to oseltamivir with E119V mutation. The resistant case was associated with oseltamivir prophylaxis/treatment. Of the 94 pandemic H1N1 2009 isolates tested, 93 were sensitive to oseltamivir and one was resistant to oseltamivir with the H275Y mutation. The resistant case was associated with oseltamivir treatment. All 160 B viruses were sensitive to oseltamivir. Of 435 influenza viruses (183 A/H3N2, 91 pandemic H1N1 2009, and 161 influenza B) tested for resistance to zanamivir, all isolates were found to be sensitive to zanamivir.
    Severe Illness Surveillance

    Paediatric Influenza Hospitalizations and Deaths
    In week 13, 21 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 BC, 6 from AB, 5 from ON, 5 from QC, 1 from NS and 2 from NL. This number has increased compared to the previous week (week 12) in which 17 paediatric hospitalizations were reported (note that numbers may fluctuate because of the delays in reporting). A death was reported in week 14 (3-9 April 2011) of a child between 6 and 23 months old with unsubtyped influenza A in Alberta. This is the 5th paediatric death reported via IMPACT this season. The four previous deaths occurred in Ontario: 2 children were between 6 and 23 months old, one with pandemic H1N1 2009, and one with influenza B; one child was between 2 and 4 years old with influenza B; and one child was between 10 and 16 years old with unsubtyped influenza A. All cases had underlying comorbidities.
    Since the beginning of the season, 593 hospitalizations with laboratory-confirmed influenza have been reported from all participating provinces; 99 (16.7%) as influenza A/H3N2, 21 (3.5%) pandemic H1N1 2009, 333 (56.2%) as unsubytped influenza A, and 140 (23.6%) influenza B. The distribution of cases to date by age group was as follows: 17.2% among 0-5 month olds; 28.7% among 6-23 month olds; 28.5% among the 2-4 year-olds; 14.8% among 5-9 year-olds; and 10.8% among children 10-16 years old.

    Adult Influenza Hospitalizations and Deaths
    During week 13, 10 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 has decreased compared to the 14 cases reported in week 12 (note that numbers may fluctuate because of the delays in reporting). Of the 10 new cases reported between March 27 and April 2, 2011, 2 (20.0%) tested positive for unsubtyped influenza A, 1 (10.0%) as pandemic H1N1 2009, and 7 (70.0%) as influenza B. Since the beginning of the season, 929 hospitalized cases have been reported: 199 (21.4%) A/H3N2, 42 (4.5%) pandemic H1N1 2009, 634 (68.2%) influenza A unsubtyped, and 54 (5.8%) influenza B, from all reporting provinces except NL. To date, 628 of the 929 (67.6%) cases were aged 65 years or older and 420 (45.2%) were males.

    Aggregate Influenza Hospitalizations and Deaths
    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 13, five deaths with influenza were reported: one in Alberta in a person 20-45 years of age with pandemic H1N1 2009; two in Ontario, both with unsubtyped influenza A, in persons 5-19 years old and over 65 years of age; and one each in PEI and Nova Scotia in persons over 65 years of age with influenza A/H3N2. Among the 208 fatal cases reported since the beginning of the influenza season, influenza A/H3N2 was identified in 60.6% (126/208), unsubtyped influenza A in 28.4% (59/208), pandemic H1N1 2009 in 6.3% (13/208), and influenza B in 4.8% (10/208). Seventy-nine percent (164/208) of these fatal cases were among persons 65 years of age or older, and another 11% (23/208) were between the ages of 45 and 64 years old, in keeping with the age-groups usually affected by A/H3N2. (Note that numbers may fluctuate because of the delays in reporting).

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    Re: Canada FluWatch Weekly Reports 2010-2011 Season Week 12 - 196 deaths total (excluding BC, QC, NB and NU)

    <TABLE border=0 cellSpacing=0 cellPadding=0><TBODY><TR><TD>March 20 to 26, 2011 (Week 12)

    </TD></TR></TBODY></TABLE>


    Posted 2011-04-01

    Summary of FluWatch Findings for the Week ending March 26, 2011
    • In week 12, influenza B continues to increase steadily in most regions of the country except the Atlantic provinces. Of the 520 positive tests reported during week 12, 55.6% were influenza A and 44.4% were influenza B.
    • Influenza activity has declined in most of western Canada but persists in parts of Alberta, Ontario, Quebec and the Atlantic provinces. In week 12, the ILI consultation rate remained similar to the previous 2 weeks, fewer influenza/ILI outbreaks were reported, and both adult and paediatric hospitalizations decreased.

    Overall Influenza Summary ? Week 12 (March 20 to 26, 2011)

    In week 12, 1 region reported widespread activity in QC; 18 regions reported localized activity: AB(2), ON(5), QC(2), NB(3), NS(4), NL(1), and PE(1); 29 regions reported sporadic activity (in all provinces and territories except PE) and 8 regions presented no activity (see Activity level Map). Compared to the previous week (week 11), 10 regions reported an increased level of influenza activity, 12 regions reported decreased activity, and 28 regions maintained a stable level of influenza activity (sporadic or higher). Twenty-three new outbreaks were reported: 13 outbreaks of influenza in long-term care facilities (LTCF) in ON(3), QC(4), NB (1), NS(3), PE(1) and NL(1); 2 outbreaks of influenza B in schools in AB; 7 ILI outbreaks in schools in NB(2), NS(2), NL(3); and one ILI outbreak in a facility in NS.

    Map of overall Influenza activity level by province and territory, Canada, Week 12





    No Data

    No Activity

    Sporadic Activity

    Localized Activity

    Widespread Activity



    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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    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 12, the national ILI consultation rate was 23.4 consultations per 1,000 patient visits, which is decreased slightly compared to 25.9 in week 11 and within the expected rate for this time of year (see ILI graph). Children under 5 years of age had the highest consultation rates (98.0 per 1,000 consultations) followed by children between 5 and 19 years old (53.8 per 1,000) in week 12.
    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.
    Text Equivalent
    Laboratory Surveillance Summary
    The overall proportion of tests that were positive for influenza during week 12 was 11.3% (6.3% influenza A, 5.0% influenza B), a decrease from 13.1% in week 11. The proportion of positive tests peaked in week 52 (see Influenza tests graph). Of the 520 positive tests reported during week 12, 289 (55.6%) were influenza A and 231 (44.4%) were influenza B. Since the beginning of the season, 90.7% (15,660/17,272) of influenza virus detections have been influenza A viruses, of which 84.8% of subtyped specimens have been A/H3N2. Detections of influenza B have been increasing steadily since week 03, when it accounted for 3.4% of all positive influenza specimens to 44.4% in week 12. Among influenza A detections in week 12, 110 (38.1%) specimens were reported as influenza A/H3N2, 33 (11.4%) as pandemic H1N1 2009, and 146 (50.5%) as unsubtyped influenza A. Through detailed case-based laboratory reporting where age data is provided, since August 29, 2010, 51.2% (1927/3767) of cases with A/H3N2 were aged 65 years or older. In contrast, the majority (94.2%, 632/671) of cases with pandemic H1N1 2009 were under 65 years of age (see Tests detailed table). In week 12, the proportion of positive tests for respiratory syncytial virus detections (RSV) was stable at 16.7% of specimens tested. The proportion of positive RSV tests appears to have peaked in week 07 (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 (March 20 to March 26, 2011)</TH><TH class="bg-colour-blue fontSize85" colSpan=6 scope=colgroup>Cumulative (August 29, 2010 to March 26, 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>29</TD><TD class=alignCenter>0</TD><TD class=alignCenter>12</TD><TD class=alignCenter>9</TD><TD class=alignCenter>8</TD><TD class=alignCenter>16</TD><TD class=alignCenter>444</TD><TD class=alignCenter>0</TD><TD class=alignCenter>180</TD><TD class=alignCenter>153</TD><TD class=alignCenter>111</TD><TD class=alignCenter>158</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>49</TD><TD class=alignCenter>0</TD><TD class=alignCenter>27</TD><TD class=alignCenter>11</TD><TD class=alignCenter>11</TD><TD class=alignCenter>92</TD><TD class=alignCenter>952</TD><TD class=alignCenter>0</TD><TD class=alignCenter>672</TD><TD class=alignCenter>240</TD><TD class=alignCenter>40</TD><TD class=alignCenter>464</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>12</TD><TD class=alignCenter>0</TD><TD class=alignCenter>4</TD><TD class=alignCenter>6</TD><TD class=alignCenter>2</TD><TD class=alignCenter>10</TD><TD class=alignCenter>290</TD><TD class=alignCenter>0</TD><TD class=alignCenter>196</TD><TD class=alignCenter>30</TD><TD class=alignCenter>64</TD><TD class=alignCenter>45</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>515</TD><TD class=alignCenter>0</TD><TD class=alignCenter>56</TD><TD class=alignCenter>2</TD><TD class=alignCenter>457</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>53</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5</TD><TD class=alignCenter>1</TD><TD class=alignCenter>47</TD><TD class=alignCenter>74</TD><TD class=alignCenter>6737</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2400</TD><TD class=alignCenter>264</TD><TD class=alignCenter>4073</TD><TD class=alignCenter>559</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>69</TD><TD class=alignCenter>0</TD><TD class=alignCenter>14</TD><TD class=alignCenter>0</TD><TD class=alignCenter>55</TD><TD class=alignCenter>31</TD><TD class=alignCenter>5467</TD><TD class=alignCenter>0</TD><TD class=alignCenter>875</TD><TD class=alignCenter>35</TD><TD class=alignCenter>4557</TD><TD class=alignCenter>338</TD></TR><TR><TH class=bg-colour-blue scope=row>NB</TH><TD class=alignCenter>44</TD><TD class=alignCenter>0</TD><TD class=alignCenter>20</TD><TD class=alignCenter>4</TD><TD class=alignCenter>20</TD><TD class=alignCenter>6</TD><TD class=alignCenter>875</TD><TD class=alignCenter>0</TD><TD class=alignCenter>619</TD><TD class=alignCenter>175</TD><TD class=alignCenter>81</TD><TD class=alignCenter>37</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>7</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3</TD><TD class=alignCenter>1</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>186</TD><TD class=alignCenter>0</TD><TD class=alignCenter>41</TD><TD class=alignCenter>10</TD><TD class=alignCenter>135</TD><TD class=alignCenter>3</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>8</TD><TD class=alignCenter>0</TD><TD class=alignCenter>7</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>77</TD><TD class=alignCenter>0</TD><TD class=alignCenter>59</TD><TD class=alignCenter>16</TD><TD class=alignCenter>2</TD><TD class=alignCenter>6</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>18</TD><TD class=alignCenter>0</TD><TD class=alignCenter>18</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>117</TD><TD class=alignCenter>0</TD><TD class=alignCenter>103</TD><TD class=alignCenter>4</TD><TD class=alignCenter>10</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>289</TD><TD class=alignCenter>0</TD><TD class=alignCenter>110</TD><TD class=alignCenter>33</TD><TD class=alignCenter>146</TD><TD class=alignCenter>231</TD><TD class=alignCenter>15660</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5201</TD><TD class=alignCenter>929</TD><TD class=alignCenter>9530</TD><TD class=alignCenter>1612</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
    (March 20 to March 26, 2011)</TH><TH colSpan=5 scope=colgroup>Cumulative
    (Aug. 29, 2010 to Mar. 26, 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>13</TD><TD class=alignCenter>3</TD><TD class=alignCenter>5</TD><TD class=alignCenter>5</TD><TD class=alignCenter>28</TD><TD class=alignCenter>928</TD><TD class=alignCenter>111</TD><TD class=alignCenter>681</TD><TD class=alignCenter>136</TD><TD class=alignCenter>160</TD></TR><TR><TD>5-19</TD><TD class=alignCenter>11</TD><TD class=alignCenter>5</TD><TD class=alignCenter>3</TD><TD class=alignCenter>3</TD><TD class=alignCenter>32</TD><TD class=alignCenter>470</TD><TD class=alignCenter>84</TD><TD class=alignCenter>274</TD><TD class=alignCenter>112</TD><TD class=alignCenter>271</TD></TR><TR><TD>20-44</TD><TD class=alignCenter>25</TD><TD class=alignCenter>8</TD><TD class=alignCenter>9</TD><TD class=alignCenter>8</TD><TD class=alignCenter>17</TD><TD class=alignCenter>967</TD><TD class=alignCenter>277</TD><TD class=alignCenter>487</TD><TD class=alignCenter>203</TD><TD class=alignCenter>139</TD></TR><TR><TD>45-64</TD><TD class=alignCenter>12</TD><TD class=alignCenter>5</TD><TD class=alignCenter>4</TD><TD class=alignCenter>3</TD><TD class=alignCenter>9</TD><TD class=alignCenter>712</TD><TD class=alignCenter>160</TD><TD class=alignCenter>398</TD><TD class=alignCenter>154</TD><TD class=alignCenter>42</TD></TR><TR><TD>65+</TD><TD class=alignCenter>15</TD><TD class=alignCenter>0</TD><TD class=alignCenter>9</TD><TD class=alignCenter>6</TD><TD class=alignCenter>10</TD><TD class=alignCenter>2287</TD><TD class=alignCenter>39</TD><TD class=alignCenter>1927</TD><TD class=alignCenter>321</TD><TD class=alignCenter>70</TD></TR><TR><TD>Unknown</TD><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>229</TD><TD class=alignCenter>3</TD><TD class=alignCenter>224</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD></TR><TR><TD>Total</TD><TD class=alignCenter>76</TD><TD class=alignCenter>21</TD><TD class=alignCenter>30</TD><TD class=alignCenter>25</TD><TD class=alignCenter>96</TD><TD class=alignCenter>5593</TD><TD class=alignCenter>674</TD><TD class=alignCenter>3991</TD><TD class=alignCenter>928</TD><TD class=alignCenter>682</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

    Antigenic Characterization
    Between September 1 and March 31, 2011, the National Microbiology Laboratory (NML) has antigenically characterized 493 influenza viruses that were received from provincial laboratories: 213 A/H3N2 from BC, AB, SK, MB, ON, QC, NB & NU, 95 pandemic H1N1 2009 from BC, AB, ON, QC, NB & NS and 185 B viruses from BC, AB, SK, ON, QC & NB. Of the 213 influenza A/H3N2 viruses characterized, 210 (98.6%) were antigenically related to A/Perth/16/2009, which is the influenza A/H3N2 component recommended for the 2010-11 influenza vaccine. Three viruses (1.4%) tested showed reduced titer with antiserum produced against A/Perth/16/2009. Of the 95 pandemic H1N1 2009 viruses characterized, 94 (98.9%) were antigenically related to the pandemic vaccine virus A/California/7/2009, which is the recommended H1N1 component for the 2010-11 influenza vaccine. One virus (1.1%) tested showed reduced titer with antiserum produced against A/California/7/2009. Of the 185 influenza B viruses characterized, 176 were antigenically related to B/Brisbane/60/08 (Victoria lineage), which is the recommended influenza B component for the 2010-11 influenza vaccine. Four of the 176 viruses tested showed reduced titer with antisera produced against B/Brisbane/60/08. Nine influenza B viruses were characterized as B/Wisconsin/01/2010-like, which belongs to the Yamagata lineage. B/Wisconsin/01/2010-like viruses are antigenically and genetically different from the previous Yamagata lineage vaccine strain B/Florida/04/2006.
    Antiviral Resistance
    Since the beginning of the 2010-2011 season, NML has tested 455 influenza A isolates (358 A/H3N2 and 97 pandemic H1N1 2009) for amantadine resistance and found that 357 influenza A/H3N2 were resistant to amantadine and one was sensitive. All 97 influenza A/H1N1 viruses were resistant to amantadine. Of 442 influenza viruses (188 A/H3N2, 94 pandemic H1N1 2009, and 160 influenza B) tested for resistance to oseltamivir, 187 A/H3N2 viruses were sensitive to oseltamivir and one was resistant to oseltamivir with E119V mutation. The resistant case was associated with oseltamivir prophylaxis/treatment. Of the 94 pandemic H1N1 2009 isolates tested, 93 were sensitive to oseltamivir and one was resistant to oseltamivir with the H275Y mutation. The resistant case was associated with oseltamivir treatment. All 160 B viruses were sensitive to oseltamivir. Of 435 influenza viruses (183 A/H3N2, 91 pandemic H1N1 2009, and 161 influenza B) tested for resistance to zanamivir, all isolates were found to be sensitive to zanamivir.

    Severe Illness Surveillance
    Paediatric Influenza Hospitalizations and Deaths
    In week 12, 17 new laboratory-confirmed influenza-associated paediatric (16 years of age and under) hospitalizations were reported through the Immunization Monitoring Program Active (IMPACT) network: 3 from BC, 5 from AB, 4 from ON, 4 from QC, and 1 from NS. This number has decreased compared to the previous week (week 11) in which 30 paediatric hospitalizations were reported (note that numbers may fluctuate because of the delays in reporting). To date this season, four deaths in children have been reported, all in Ontario: two children were between 6 and 23 months old, one with pandemic H1N1 2009 and one with influenza B; one child was between 2 and 4 years old with influenza B; and one child was between 10 and 16 years old with unsubtyped influenza A.

    Since the beginning of the season, 576 hospitalizations with laboratory-confirmed influenza have been reported from all participating provinces; 84 (14.6%) as influenza A/H3N2, 18 (3.1%) pandemic H1N1 2009, 349 (60.6%) as unsubytped influenza A, and 125 (21.7%) influenza B. The distribution of cases to date by age group was as follows: 17.4% among 0-5 month olds; 28.6% among 6-23 month olds; 29.0% among the 2-4 year-olds; 14.4% among 5-9 year-olds; and 10.6% among children 10-16 years old.

    Adult Influenza Hospitalizations and Deaths
    During week 12, 12 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 has decreased compared to the 18 cases reported in week 11 (note that numbers may fluctuate because of the delays in reporting). Of the 12 new cases reported between March 20 and 26, 2011, 4 (33.3%) tested positive for unsubtyped influenza A, 1 (8.3%) as pandemic H1N1 2009, 2 (16.7%) as A/H3N2, and 5 (41.7%) as influenza B. Since the beginning of the season, 918 hospitalized cases have been reported: 199 (21.7%) A/H3N2, 41 (4.5%) pandemic H1N1 2009, 630 (68.6%) influenza A unsubtyped, and 48 (5.2%) influenza B, from all reporting provinces except NL. To date, 624 of the 918 (68.0%) cases were aged 65 years or older and 416 (45.3%) were males.

    Aggregate Influenza Hospitalizations and Deaths
    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 12, four deaths with influenza were reported, one in Ontario in a person over 65 years of age with influenza B, one in Nova Scotia in a person over 65 years of age with influenza A/H3N2, and the 2 others in PEI both in persons over 65 years of age with A/H3N2. Among the 196 fatal cases reported since the beginning of the influenza season, influenza A/H3N2 was identified in 60.7% (119/196), unsubtyped influenza A in 28.1% (55/196), pandemic H1N1 2009 in 6.1% (12/196), and influenza B in 5.1% (10/196). Seventy-nine percent (154/196) of these fatal cases were among persons 65 years of age or older, and another 12% (23/196) were between the ages of 45 and 64 years old, in keeping with the age-groups usually affected by A/H3N2. (Note that numbers may fluctuate because of the delays in reporting).

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    Canada FluWatch Weekly Reports 2010-2011 Season Week 11 - 191 deaths total (excluding BC, QC, NB and NU)

    <TABLE border=0 cellSpacing=0 cellPadding=0><TBODY><TR><TD>March 13 to 19, 2011 (Week 11)

    </TD></TR></TBODY></TABLE>


    Posted 2011-03-25


    Overall Influenza Summary ? Week 11 (March 13 to 19, 2011)

    In week 11, 3 regions reported widespread activity: BC(1), QC(1) and NL(1); 19 regions reported localized activity: BC(1), AB(3), SK(1), ON(7), QC(2), NB(2), NS(1), NL(1), and PE(1); 24 regions reported sporadic activity (in all provinces and territories except ON, NT and PE) and 10 regions presented no activity (see Activity level Map). Compared to the previous week (week 10), 12 regions reported an increased level of influenza activity, 8 regions reported decreased activity, and 30 regions maintained a stable level of influenza activity (sporadic or higher). Forty-one new outbreaks were reported: 13 outbreaks of influenza in long-term care facilities (LTCF) in BC(1), ON(2), QC(5), NB (2), and NS(3); 3 outbreaks of influenza B in schools in AB; 22 ILI outbreaks in schools in BC(5), AB(3), NB(1), NS(8), PE(1) and NL(4); one influenza A/H3N2 outbreak in a facility in PE, and 2 ILI outbreaks in other settings in NL.

    Map of overall Influenza activity level by province and territory, Canada, Week 11





    No Data

    No Activity

    Sporadic Activity

    Localized Activity

    Widespread Activity



    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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    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 11, the national ILI consultation rate was 24.0 consultations per 1,000 patient visits, which is decreased slightly compared to 25.5 in week 10 and within the expected rate for this time of year (see ILI graph). Children under 5 years of age and children between 5 and 19 years old had similar consultation rates (39.3 and 39.2 per 1,000 consultations, respectively) in week 11.
    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.
    Text Equivalent
    Laboratory Surveillance Summary
    The overall proportion of tests that were positive for influenza during week 11 was 12.6% (7.5% influenza A, 5.0% influenza B), a decrease from 15.0% in week 10. The proportion of positive tests peaked in week 52 (see Influenza tests graph). Of the 616 positive tests reported during week 11, 369 (59.9%) were influenza A and 247 (40.1%) were influenza B. Since the beginning of the season, 91.9% (15,346/16,704) of influenza virus detections have been influenza A viruses, of which 85.0% of subtyped specimens have been A/H3N2. Detections of influenza B have been increasing steadily since week 03, where it accounted for 3.4% of all positive influenza specimens to 40.1% in week 11. Among influenza A detections in week 11, 147 (39.8%) specimens were reported as influenza A/H3N2, 49 (13.3%) as pandemic H1N1 2009, and 173 (46.9%) as unsubtyped influenza A. Through detailed case-based laboratory reporting where age data is provided, since August 29, 2010, 51.1% (1921/3761) of cases with A/H3N2 were aged 65 years or older. In contrast, the majority (94.5%, 635/672) of cases with pandemic H1N1 2009 were under 65 years of age (see Tests detailed table). In week 11, the proportion of positive tests for respiratory syncytial virus detections (RSV) decreased slightly to 16.8% of specimens tested and appears to have peaked at week 07 (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 (March 13 to March 19, 2011)</TH><TH class="bg-colour-blue fontSize85" colSpan=6 scope=colgroup>Cumulative (August 29, 2010 to March 19, 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>37</TD><TD class=alignCenter>0</TD><TD class=alignCenter>19</TD><TD class=alignCenter>13</TD><TD class=alignCenter>5</TD><TD class=alignCenter>38</TD><TD class=alignCenter>415</TD><TD class=alignCenter>0</TD><TD class=alignCenter>168</TD><TD class=alignCenter>144</TD><TD class=alignCenter>103</TD><TD class=alignCenter>142</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>45</TD><TD class=alignCenter>0</TD><TD class=alignCenter>28</TD><TD class=alignCenter>17</TD><TD class=alignCenter>0</TD><TD class=alignCenter>58</TD><TD class=alignCenter>878</TD><TD class=alignCenter>0</TD><TD class=alignCenter>626</TD><TD class=alignCenter>224</TD><TD class=alignCenter>28</TD><TD class=alignCenter>350</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>4</TD><TD class=alignCenter>14</TD><TD class=alignCenter>278</TD><TD class=alignCenter>0</TD><TD class=alignCenter>192</TD><TD class=alignCenter>24</TD><TD class=alignCenter>62</TD><TD class=alignCenter>35</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>515</TD><TD class=alignCenter>0</TD><TD class=alignCenter>56</TD><TD class=alignCenter>2</TD><TD class=alignCenter>457</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>101</TD><TD class=alignCenter>0</TD><TD class=alignCenter>16</TD><TD class=alignCenter>1</TD><TD class=alignCenter>84</TD><TD class=alignCenter>83</TD><TD class=alignCenter>6684</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2395</TD><TD class=alignCenter>263</TD><TD class=alignCenter>4026</TD><TD class=alignCenter>485</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>75</TD><TD class=alignCenter>0</TD><TD class=alignCenter>15</TD><TD class=alignCenter>2</TD><TD class=alignCenter>58</TD><TD class=alignCenter>52</TD><TD class=alignCenter>5398</TD><TD class=alignCenter>0</TD><TD class=alignCenter>861</TD><TD class=alignCenter>35</TD><TD class=alignCenter>4502</TD><TD class=alignCenter>307</TD></TR><TR><TH class=bg-colour-blue scope=row>NB</TH><TD class=alignCenter>63</TD><TD class=alignCenter>0</TD><TD class=alignCenter>40</TD><TD class=alignCenter>15</TD><TD class=alignCenter>8</TD><TD class=alignCenter>0</TD><TD class=alignCenter>831</TD><TD class=alignCenter>0</TD><TD class=alignCenter>599</TD><TD class=alignCenter>171</TD><TD class=alignCenter>61</TD><TD class=alignCenter>31</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>13</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>13</TD><TD class=alignCenter>1</TD><TD class=alignCenter>179</TD><TD class=alignCenter>0</TD><TD class=alignCenter>38</TD><TD class=alignCenter>9</TD><TD class=alignCenter>132</TD><TD class=alignCenter>3</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>12</TD><TD class=alignCenter>0</TD><TD class=alignCenter>12</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>69</TD><TD class=alignCenter>0</TD><TD class=alignCenter>52</TD><TD class=alignCenter>15</TD><TD class=alignCenter>2</TD><TD class=alignCenter>4</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>16</TD><TD class=alignCenter>0</TD><TD class=alignCenter>15</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>99</TD><TD class=alignCenter>0</TD><TD class=alignCenter>85</TD><TD class=alignCenter>4</TD><TD class=alignCenter>10</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>369</TD><TD class=alignCenter>0</TD><TD class=alignCenter>147</TD><TD class=alignCenter>49</TD><TD class=alignCenter>173</TD><TD class=alignCenter>247</TD><TD class=alignCenter>15346</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5072</TD><TD class=alignCenter>891</TD><TD class=alignCenter>9383</TD><TD class=alignCenter>1358</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
    (March 13 to March 19, 2011)</TH><TH colSpan=5 scope=colgroup>Cumulative
    (Aug. 29, 2010 to Mar. 19, 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>14</TD><TD class=alignCenter>3</TD><TD class=alignCenter>10</TD><TD class=alignCenter>1</TD><TD class=alignCenter>24</TD><TD class=alignCenter>938</TD><TD class=alignCenter>113</TD><TD class=alignCenter>685</TD><TD class=alignCenter>140</TD><TD class=alignCenter>155</TD></TR><TR><TD>5-19</TD><TD class=alignCenter>14</TD><TD class=alignCenter>5</TD><TD class=alignCenter>5</TD><TD class=alignCenter>4</TD><TD class=alignCenter>58</TD><TD class=alignCenter>471</TD><TD class=alignCenter>85</TD><TD class=alignCenter>272</TD><TD class=alignCenter>114</TD><TD class=alignCenter>265</TD></TR><TR><TD>20-44</TD><TD class=alignCenter>23</TD><TD class=alignCenter>12</TD><TD class=alignCenter>7</TD><TD class=alignCenter>4</TD><TD class=alignCenter>12</TD><TD class=alignCenter>968</TD><TD class=alignCenter>277</TD><TD class=alignCenter>487</TD><TD class=alignCenter>204</TD><TD class=alignCenter>136</TD></TR><TR><TD>45-64</TD><TD class=alignCenter>17</TD><TD class=alignCenter>9</TD><TD class=alignCenter>6</TD><TD class=alignCenter>2</TD><TD class=alignCenter>5</TD><TD class=alignCenter>711</TD><TD class=alignCenter>160</TD><TD class=alignCenter>396</TD><TD class=alignCenter>155</TD><TD class=alignCenter>41</TD></TR><TR><TD>65+</TD><TD class=alignCenter>31</TD><TD class=alignCenter>0</TD><TD class=alignCenter>21</TD><TD class=alignCenter>10</TD><TD class=alignCenter>9</TD><TD class=alignCenter>2279</TD><TD class=alignCenter>37</TD><TD class=alignCenter>1921</TD><TD class=alignCenter>321</TD><TD class=alignCenter>68</TD></TR><TR><TD>Unknown</TD><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>229</TD><TD class=alignCenter>3</TD><TD class=alignCenter>224</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD></TR><TR><TD>Total</TD><TD class=alignCenter>99</TD><TD class=alignCenter>29</TD><TD class=alignCenter>49</TD><TD class=alignCenter>21</TD><TD class=alignCenter>108</TD><TD class=alignCenter>5596</TD><TD class=alignCenter>675</TD><TD class=alignCenter>3985</TD><TD class=alignCenter>936</TD><TD class=alignCenter>665</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

    Antigenic Characterization
    Between September 1 and March 24, 2011, the National Microbiology Laboratory (NML) has antigenically characterized 435 influenza viruses that were received from provincial laboratories: 202 A/H3N2 from BC, AB, SK, MB, ON, QC, NB & NU, 90 pandemic H1N1 2009 from BC, AB, ON, QC, NB & NS and 143 B viruses from BC, AB, SK, ON, QC & NB. All 202 influenza A/H3N2 viruses characterized were antigenically related to A/Perth/16/2009, which is the influenza A/H3N2 component recommended for the 2010-11 influenza vaccine. The 90 pandemic H1N1 2009 viruses characterized were antigenically related to the pandemic vaccine virus A/California/7/2009, which is the recommended H1N1 component for the 2010-11 influenza vaccine. Of the 143 influenza B viruses characterized, 134 were antigenically related to B/Brisbane/60/08 (Victoria lineage), which is the recommended influenza B component for the 2010-11 influenza vaccine. Four of the 134 viruses tested showed reduced titer with antisera produced against B/Brisbane/60/08. Nine influenza B viruses were characterized as B/Wisconsin/01/2010-like, which belongs to the Yamagata lineage. B/Wisconsin/01/2010-like viruses are antigenically and genetically different from the previous Yamagata lineage vaccine strain B/Florida/04/2006.
    Antiviral Resistance
    Since the beginning of the 2010-2011 season, NML has tested 421 influenza A isolates (325 A/H3N2 and 96 pandemic H1N1 2009) for amantadine resistance and found that 324 influenza A/H3N2 were resistant to amantadine and one was sensitive. All 96 influenza A/H1N1 viruses were resistant to amantadine. Of 400 influenza viruses (177 A/H3N2, 89 pandemic H1N1 2009, and 135 influenza B) tested for resistance to oseltamivir, 176 A/H3N2 viruses were sensitive to oseltamivir and one was resistant to oseltamivir with E119V mutation. The resistant case was associated with oseltamivir prophylaxis/treatment. All 135 B viruses were sensitive to oseltamivir. Of the 89 pandemic H1N1 2009 isolates tested, 88 were sensitive to oseltamivir and one was resistant to oseltamivir with the H275Y mutation. The resistant case was associated with oseltamivir treatment. Of 396 influenza viruses (174 A/H3N2, 86 pandemic H1N1 2009, and 136 influenza B) tested for resistance to zanamivir, all isolates were found to be sensitive to zanamivir.
    Severe Illness Surveillance
    Paediatric Influenza Hospitalizations and Deaths
    In week 11, 24 new laboratory-confirmed influenza-associated paediatric (16 years of age and under) hospitalizations were reported through the Immunization Monitoring Program Active (IMPACT) network: 6 from BC, 2 from SK, 6 from ON, 7 from QC, and 3 from NL. This number has decreased compared to the previous week (week 10) in which 32 paediatric hospitalizations were reported (note that numbers may fluctuate because of the delays in reporting). Two influenza associated deaths were retrospectively reported in week 11; one child aged 6-23 months, who tested positive for influenza B (occurred in week 07); and the second child aged 2-4 years, who also tested positive for influenza B (occurred in week 10). So far this season, four deaths in children have been reported, all in Ontario.
    Since the beginning of the season, 553 hospitalizations with laboratory-confirmed influenza have been reported from all participating provinces; 83 (15.0%) as influenza A/H3N2, 17 (3.1%) pandemic H1N1 2009, 341 (61.7%) as unsubytped influenza A, and 112 (20.3%) influenza B. The distribution of cases to date by age group was as follows: 17.2% among 0-5 month olds; 28.6% among 6-23 month olds; 29.5% among the 2-4 year-olds; 14.8% among 5-9 year-olds; and 9.9% among children 10-16 years old.
    Adult Influenza Hospitalizations and Deaths
    During week 11, 18 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 has increased compared to the 11 cases reported in week 10 (note that numbers may fluctuate because of the delays in reporting). Of the 18 new cases reported between March 13 and 19, 2011, 10 (55.6%) tested positive for unsubtyped influenza A, 2 (11.1%) as pandemic H1N1 2009, 1 (5.6%) as A/H3N2, and 5 (27.8%) as influenza B. Since the beginning of the season, 893 hospitalized cases have been reported: 195 (21.8%) A/H3N2, 39 (4.4%) pandemic H1N1 2009, 624 (69.9%) influenza A unsubtyped, and 35 (3.9%) influenza B, from all reporting provinces except NL. To date, 609 of the 893 (68.2%) cases were aged 65 years or older and 403 (45.1%) were males.

    Aggregate Influenza Hospitalizations and Deaths
    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 11, two deaths with influenza were reported in Ontario, one in a person over 65 years of age with influenza A/H3N2 and the other in a child 1-4 years old with influenza B. Among the 191 fatal cases reported since the beginning of the influenza season, influenza A/H3N2 was identified in 61.3% (117/191), unsubtyped influenza A in 28.8% (55/191), pandemic H1N1 2009 in 5.8% (11/191), and influenza B in 4.2% (8/191). Seventy-nine percent (150/191) of these fatal cases were among persons 65 years of age or older, and another 12% (22/191) were between the ages of 45 and 64 years old, in keeping with the age-groups usually affected by A/H3N2. (Note that numbers may fluctuate because of the delays in reporting).

    .../

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    Re: Canada FluWatch Weekly Reports 2010-2011 Season Week 10 - 185 deaths total

    <TABLE border=0 cellSpacing=0 cellPadding=0><TBODY><TR><TD>March 6 to 12, 2011 (Week 10)

    </TD></TR></TBODY></TABLE>


    Posted 2011-03-18

    Summary of FluWatch Findings for the Week ending March 12, 2011
    • In week 10, overall influenza activity is on the decline in many parts of the country. All influenza indicators including the number of outbreaks, the proportion of positive influenza detections, adult and paediatric hospitalizations, and the ILI consultation rate have declined this week.
    • Since the beginning of the season, 85% of the subtyped positive influenza A specimens have been influenza A/H3N2. Influenza B, circulating at low levels, has been slowly increasing since week 03 and now accounts for 28% of all influenza positive specimens. The percentage of positive RSV specimens has been decreasing over the last two weeks and appears to have peaked at week 07.


    Overall Influenza Summary ? Week 10 (March 6 to 12, 2011)

    In week 10, 17 regions reported localized activity (in BC(1), AB(1), SK(2), ON(6), QC(2), NB(2), NS(1), NL(1), and PE(1)), 29 regions reported sporadic activity (in all provinces and territories except NT and PE) and 10 regions presented no activity (see Activity level Map). Compared to the previous week (week 09), 4 regions reported an increased level of influenza activity, 14 regions reported decreased activity, and 31 regions maintained a stable level of influenza activity (sporadic or higher). Twenty-one new outbreaks were reported: 10 outbreaks of influenza in long-term care facilities (LTCF) in ON(1), QC(2), NB (2), NS(4) and PE(1); 8 ILI outbreaks in schools in AB(2), ON(1), NS(4) and PE(1); 1 pandemic H1N1 2009 outbreak in an adult residential facility in BC, and 2 ILI outbreaks in other settings in NB(1) and NL(1).

    Map of overall Influenza activity level by province and territory, Canada, Week 10





    No Data

    No Activity

    Sporadic Activity

    Localized Activity

    Widespread Activity



    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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    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 10, the national ILI consultation rate was 25.3 consultations per 1,000 patient visits, which is a decrease from 37.4 in week 09 and slightly below the expected rate for this time of year (see ILI graph). Children under 5 years of age had the highest consultation rates (52.2 per 1,000 consultations in week 10) followed by children between 5 and 19 years old (49.2 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.
    Text Equivalent
    Laboratory Surveillance Summary
    The proportion of tests that were positive for influenza during week 10 was 14.9%, a decrease from 15.9% in week 09. The proportion of positive tests peaked in week 52. Of the 833 positive tests reported during week 10, 282 (33.9%) specimens were reported as influenza A/H3N2, 66 (7.9%) as pandemic H1N1 2009, 284 (34.0%) as unsubtyped influenza A and 201 (24.1%) as influenza B. Since the beginning of the season, the majority of influenza virus detections have been influenza A viruses (93.1% or 14,970/16,080), and among subtyped influenza A specimens 85.5% have been A/H3N2. Detections of influenza B have been increasing steadily since week 03, where it accounted for 3.4% of all positive influenza specimens to 24.1% in week 10. Through detailed case-based laboratory reporting where age data is provided, since August 29, 2010, 51.4% (1885/3666) of cases with A/H3N2 were aged 65 years or older. In contrast, the majority (94.2%, 604/641) of cases with pandemic H1N1 2009 were under 65 years of age (see Tests detailed table). In week 10, the proportion of positive tests for respiratory syncytial virus detections (RSV) decreased slightly to 17.9% of specimens tested and appears to have peaked at week 07 (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 (March 6 to March 12, 2011)</TH><TH class="bg-colour-blue fontSize85" colSpan=6 scope=colgroup>Cumulative (August 29, 2010 to March 12, 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>55</TD><TD class=alignCenter>0</TD><TD class=alignCenter>19</TD><TD class=alignCenter>28</TD><TD class=alignCenter>8</TD><TD class=alignCenter>19</TD><TD class=alignCenter>378</TD><TD class=alignCenter>0</TD><TD class=alignCenter>149</TD><TD class=alignCenter>131</TD><TD class=alignCenter>98</TD><TD class=alignCenter>104</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>89</TD><TD class=alignCenter>0</TD><TD class=alignCenter>59</TD><TD class=alignCenter>18</TD><TD class=alignCenter>12</TD><TD class=alignCenter>69</TD><TD class=alignCenter>826</TD><TD class=alignCenter>0</TD><TD class=alignCenter>594</TD><TD class=alignCenter>197</TD><TD class=alignCenter>35</TD><TD class=alignCenter>291</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>13</TD><TD class=alignCenter>0</TD><TD class=alignCenter>8</TD><TD class=alignCenter>1</TD><TD class=alignCenter>4</TD><TD class=alignCenter>7</TD><TD class=alignCenter>272</TD><TD class=alignCenter>0</TD><TD class=alignCenter>190</TD><TD class=alignCenter>24</TD><TD class=alignCenter>58</TD><TD class=alignCenter>21</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>514</TD><TD class=alignCenter>0</TD><TD class=alignCenter>56</TD><TD class=alignCenter>1</TD><TD class=alignCenter>457</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>165</TD><TD class=alignCenter>0</TD><TD class=alignCenter>29</TD><TD class=alignCenter>5</TD><TD class=alignCenter>131</TD><TD class=alignCenter>56</TD><TD class=alignCenter>6583</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2379</TD><TD class=alignCenter>262</TD><TD class=alignCenter>3942</TD><TD class=alignCenter>402</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>141</TD><TD class=alignCenter>0</TD><TD class=alignCenter>32</TD><TD class=alignCenter>1</TD><TD class=alignCenter>108</TD><TD class=alignCenter>47</TD><TD class=alignCenter>5323</TD><TD class=alignCenter>0</TD><TD class=alignCenter>846</TD><TD class=alignCenter>33</TD><TD class=alignCenter>4444</TD><TD class=alignCenter>255</TD></TR><TR><TH class=bg-colour-blue scope=row>NB</TH><TD class=alignCenter>122</TD><TD class=alignCenter>0</TD><TD class=alignCenter>110</TD><TD class=alignCenter>9</TD><TD class=alignCenter>3</TD><TD class=alignCenter>2</TD><TD class=alignCenter>768</TD><TD class=alignCenter>0</TD><TD class=alignCenter>559</TD><TD class=alignCenter>156</TD><TD class=alignCenter>53</TD><TD class=alignCenter>31</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>24</TD><TD class=alignCenter>0</TD><TD class=alignCenter>11</TD><TD class=alignCenter>1</TD><TD class=alignCenter>12</TD><TD class=alignCenter>0</TD><TD class=alignCenter>166</TD><TD class=alignCenter>0</TD><TD class=alignCenter>38</TD><TD class=alignCenter>9</TD><TD class=alignCenter>119</TD><TD class=alignCenter>2</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>4</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>57</TD><TD class=alignCenter>0</TD><TD class=alignCenter>40</TD><TD class=alignCenter>15</TD><TD class=alignCenter>2</TD><TD class=alignCenter>3</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>13</TD><TD class=alignCenter>0</TD><TD class=alignCenter>12</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>83</TD><TD class=alignCenter>0</TD><TD class=alignCenter>70</TD><TD class=alignCenter>4</TD><TD class=alignCenter>9</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>632</TD><TD class=alignCenter>0</TD><TD class=alignCenter>282</TD><TD class=alignCenter>66</TD><TD class=alignCenter>284</TD><TD class=alignCenter>201</TD><TD class=alignCenter>14970</TD><TD class=alignCenter>0</TD><TD class=alignCenter>4921</TD><TD class=alignCenter>832</TD><TD class=alignCenter>9217</TD><TD class=alignCenter>1110</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
    (March 6 to March 12, 2011)</TH><TH colSpan=5 scope=colgroup>Cumulative
    (Aug. 29, 2010 to Mar. 12, 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>28</TD><TD class=alignCenter>3</TD><TD class=alignCenter>20</TD><TD class=alignCenter>5</TD><TD class=alignCenter>18</TD><TD class=alignCenter>897</TD><TD class=alignCenter>110</TD><TD class=alignCenter>656</TD><TD class=alignCenter>131</TD><TD class=alignCenter>140</TD></TR><TR><TD>5-19</TD><TD class=alignCenter>14</TD><TD class=alignCenter>3</TD><TD class=alignCenter>8</TD><TD class=alignCenter>3</TD><TD class=alignCenter>46</TD><TD class=alignCenter>450</TD><TD class=alignCenter>82</TD><TD class=alignCenter>265</TD><TD class=alignCenter>103</TD><TD class=alignCenter>245</TD></TR><TR><TD>20-44</TD><TD class=alignCenter>45</TD><TD class=alignCenter>22</TD><TD class=alignCenter>11</TD><TD class=alignCenter>12</TD><TD class=alignCenter>19</TD><TD class=alignCenter>918</TD><TD class=alignCenter>259</TD><TD class=alignCenter>474</TD><TD class=alignCenter>185</TD><TD class=alignCenter>126</TD></TR><TR><TD>45-64</TD><TD class=alignCenter>18</TD><TD class=alignCenter>6</TD><TD class=alignCenter>8</TD><TD class=alignCenter>4</TD><TD class=alignCenter>2</TD><TD class=alignCenter>677</TD><TD class=alignCenter>153</TD><TD class=alignCenter>386</TD><TD class=alignCenter>138</TD><TD class=alignCenter>38</TD></TR><TR><TD>65+</TD><TD class=alignCenter>40</TD><TD class=alignCenter>0</TD><TD class=alignCenter>35</TD><TD class=alignCenter>5</TD><TD class=alignCenter>7</TD><TD class=alignCenter>2166</TD><TD class=alignCenter>37</TD><TD class=alignCenter>1885</TD><TD class=alignCenter>244</TD><TD class=alignCenter>57</TD></TR><TR><TD>Unknown</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>229</TD><TD class=alignCenter>3</TD><TD class=alignCenter>223</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD></TR><TR><TD>Total</TD><TD class=alignCenter>147</TD><TD class=alignCenter>34</TD><TD class=alignCenter>83</TD><TD class=alignCenter>30</TD><TD class=alignCenter>92</TD><TD class=alignCenter>5337</TD><TD class=alignCenter>644</TD><TD class=alignCenter>3889</TD><TD class=alignCenter>804</TD><TD class=alignCenter>606</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 10, 21 new laboratory-confirmed influenza-associated paediatric (16 years of age and under) hospitalizations were reported through the Immunization Monitoring Program Active (IMPACT) network: 7 from BC, 2 from AB, 3 from SK, 2 from ON, 5 from QC, 1 from NS, and 1 from NL. This number has decreased compared to the previous week (week 09) in which 31 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, 519 hospitalizations with laboratory-confirmed influenza have been reported from all provinces except NB and PE; 82 (15.8%) as influenza A/H3N2, 17 (3.3%) pandemic H1N1 2009, 328 (63.2%) as unsubytped influenza A, and 92 (17.7%) influenza B. The distribution of cases to date by age group was as follows: 17.7% among 0-5 month olds; 28.5% among 6-23 month olds; 29.7% among the 2-4 year-olds; 14.8% among 5-9 year-olds; and 9.2% among children 10-16 years old.

    Adult Influenza Hospitalizations and Deaths
    During week 10, 11 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 has decreased compared to the 17 cases reported in week 09 (note that numbers may fluctuate because of the delays in reporting). Of the 11 new cases reported between March 6 and 12, 2011, 5 (45.5%) tested positive for unsubtyped influenza A, 2 (18.2%) as A/H3N2, 1 (9.1%) as pandemic H1N1 2009, and 3 (27.3%) as influenza B. Since the beginning of the season, 849 hospitalized cases have been reported: 190 (22.4%) A/H3N2, 37 (4.4%) pandemic H1N1 2009, 595 (70.1%) influenza A unsubtyped, and 27 (3.2%) influenza B, from all reporting provinces except NL. To date, 583 of the 849 (68.7%) cases were aged 65 years or older and 383 (45.1%) 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 10, one death with influenza was reported in Ontario, in a person 45 to 64 years of age with influenza A (unsubtyped). Among the 185 fatal cases reported since the beginning of the influenza season, influenza A/H3N2 was identified in 62.2% (115/185), unsubtyped influenza A in 29.2% (54/185), pandemic H1N1 2009 in 5.9% (11/185), and influenza B in 2.7% (5/185). Seventy-eight percent (145/185) of these fatal cases were among persons 65 years of age or older, and another 12% (22/185) were between the ages of 45 and 64 years old, in keeping with the age-groups usually affected by A/H3N2. (Note that numbers may fluctuate because of the delays in reporting).

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    Re: Canada FluWatch Weekly Reports 2010-2011 Season Week 8 - 150 deaths total

    <TABLE border=0 cellSpacing=0 cellPadding=0><TBODY><TR><TD><H1>February 27 to March 5, 2011 (Week 09)</H1></TD></TR></TBODY></TABLE>

    Posted 2011-03-11


    Overall Influenza Summary ? Week 9 (February 27 to March 5, 2011)

    In week 09, 2 regions (in QC(1) and NL(1)) reported widespread activity, 21 regions reported localized activity (in BC(4), AB(1), SK(1), MB(1), ON(5), QC(1), NB(4), NS(3), and NL(1)), 26 regions reported sporadic activity (in all provinces and territories except NT) and 7 regions presented no activity (see Activity level Map). Compared to the previous week (week 08), 12 regions reported an increased level of influenza activity, 14 regions reported decreased activity, and 25 regions maintained a stable level of influenza activity (sporadic or higher). Thirty-two new outbreaks were reported: 17 outbreaks of influenza in long-term care facilities (LTCF) in BC(4), SK (2), MB(1), ON(2), QC(3), NB (2) and NS(3); 1 influenza outbreak in a hospital in NS; 1 influenza B outbreak in a school in AB, 1 outbreak in which both influenza B and pandemic H1N1 2009 were detected in BC, 7 ILI outbreaks in schools in NB(4) and NS(3); 1 pandemic H1N1 2009 outbreak in a residential facility in BC, and 4 ILI outbreaks in other settings in ON(2) and NL(2).

    <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 9


    </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>
    Text Equivalent

    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.
    Text Equivalent


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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.
    Text Equivalent
    ILI consultation rate
    During week 09, the national ILI consultation rate was 37.7 consultations per 1,000 patient visits, a slight increase from 35.8 in week 08 but still within expected range for this time of year (see ILI graph). Children under 5 years of age had the highest consultation rates (108.1 per 1,000 consultations in week 09) followed by children between 5 and 19 years old (83.3 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.
    Text Equivalent
    Laboratory Surveillance Summary
    The proportion of tests that were positive for influenza during week 09 was 15.8%, which decreased from 17.8% in week 08. The proportion of positive tests peaked in week 52. Of the 870 positive tests reported during week 09, 317 (36.4%) specimens were reported as influenza A/H3N2, 59 (6.8%) as pandemic H1N1 2009, 156 (17.9%) as influenza B and 338 (38.9%) as unsubtyped influenza A. Since the beginning of the season, the majority of influenza virus detections have been influenza A viruses (94.2% or 14,342/15,229), and among subtyped influenza A specimens 86.0% have been A/H3N2.In week 09, detections of pandemic H1N1 2009 represented 15.7% of all subtyped influenza A specimens, which is decreased slightly from the proportion of 16.7% observed in week 08. Detections of influenza B increased to 17.9% of all positive influenza specimens in week 09 compared to 12.3% in week 08. Through detailed case-based laboratory reporting where age data is provided, since August 29, 2010, 51.8% (1813/3502) of cases with A/H3N2 were aged 65 years or older. In contrast, the majority (93.8%, 544/580) of cases with pandemic H1N1 2009 were under 65 years of age (see Tests detailed table). In week 09, the proportion of positive tests for respiratory syncytial virus detections (RSV) was stable at 19.2% of specimens tested, reflecting an increasing proportion of positive tests in the East and declining positive tests in BC and Prairie provinces (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 (February 27 to March 5, 2011)</TH><TH class="bg-colour-blue fontSize85" colSpan=6 scope=colgroup>Cumulative (August 29, 2010 to March 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>53</TD><TD class=alignCenter>0</TD><TD class=alignCenter>32</TD><TD class=alignCenter>8</TD><TD class=alignCenter>13</TD><TD class=alignCenter>20</TD><TD class=alignCenter>323</TD><TD class=alignCenter>0</TD><TD class=alignCenter>130</TD><TD class=alignCenter>103</TD><TD class=alignCenter>90</TD><TD class=alignCenter>85</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>51</TD><TD class=alignCenter>0</TD><TD class=alignCenter>28</TD><TD class=alignCenter>19</TD><TD class=alignCenter>4</TD><TD class=alignCenter>27</TD><TD class=alignCenter>741</TD><TD class=alignCenter>0</TD><TD class=alignCenter>544</TD><TD class=alignCenter>172</TD><TD class=alignCenter>25</TD><TD class=alignCenter>200</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>38</TD><TD class=alignCenter>0</TD><TD class=alignCenter>34</TD><TD class=alignCenter>0</TD><TD class=alignCenter>4</TD><TD class=alignCenter>2</TD><TD class=alignCenter>259</TD><TD class=alignCenter>0</TD><TD class=alignCenter>182</TD><TD class=alignCenter>23</TD><TD class=alignCenter>54</TD><TD class=alignCenter>14</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>508</TD><TD class=alignCenter>0</TD><TD class=alignCenter>56</TD><TD class=alignCenter>1</TD><TD class=alignCenter>451</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>211</TD><TD class=alignCenter>0</TD><TD class=alignCenter>73</TD><TD class=alignCenter>17</TD><TD class=alignCenter>121</TD><TD class=alignCenter>49</TD><TD class=alignCenter>6418</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2350</TD><TD class=alignCenter>257</TD><TD class=alignCenter>3811</TD><TD class=alignCenter>346</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>197</TD><TD class=alignCenter>0</TD><TD class=alignCenter>40</TD><TD class=alignCenter>1</TD><TD class=alignCenter>156</TD><TD class=alignCenter>52</TD><TD class=alignCenter>5182</TD><TD class=alignCenter>0</TD><TD class=alignCenter>814</TD><TD class=alignCenter>32</TD><TD class=alignCenter>4336</TD><TD class=alignCenter>208</TD></TR><TR><TH class=bg-colour-blue scope=row>NB</TH><TD class=alignCenter>92</TD><TD class=alignCenter>0</TD><TD class=alignCenter>81</TD><TD class=alignCenter>9</TD><TD class=alignCenter>2</TD><TD class=alignCenter>5</TD><TD class=alignCenter>646</TD><TD class=alignCenter>0</TD><TD class=alignCenter>449</TD><TD class=alignCenter>147</TD><TD class=alignCenter>50</TD><TD class=alignCenter>29</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>27</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>26</TD><TD class=alignCenter>1</TD><TD class=alignCenter>142</TD><TD class=alignCenter>0</TD><TD class=alignCenter>27</TD><TD class=alignCenter>8</TD><TD class=alignCenter>107</TD><TD class=alignCenter>2</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>17</TD><TD class=alignCenter>0</TD><TD class=alignCenter>13</TD><TD class=alignCenter>4</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>53</TD><TD class=alignCenter>0</TD><TD class=alignCenter>38</TD><TD class=alignCenter>13</TD><TD class=alignCenter>2</TD><TD class=alignCenter>2</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>25</TD><TD class=alignCenter>0</TD><TD class=alignCenter>16</TD><TD class=alignCenter>0</TD><TD class=alignCenter>9</TD><TD class=alignCenter>0</TD><TD class=alignCenter>70</TD><TD class=alignCenter>0</TD><TD class=alignCenter>58</TD><TD class=alignCenter>3</TD><TD class=alignCenter>9</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>714</TD><TD class=alignCenter>0</TD><TD class=alignCenter>317</TD><TD class=alignCenter>59</TD><TD class=alignCenter>338</TD><TD class=alignCenter>156</TD><TD class=alignCenter>14342</TD><TD class=alignCenter>0</TD><TD class=alignCenter>4648</TD><TD class=alignCenter>759</TD><TD class=alignCenter>8935</TD><TD class=alignCenter>887</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
    (February 27 to March 5, 2011)</TH><TH colSpan=5 scope=colgroup>Cumulative
    (Aug. 29, 2010 to Mar. 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>32</TD><TD class=alignCenter>8</TD><TD class=alignCenter>14</TD><TD class=alignCenter>10</TD><TD class=alignCenter>15</TD><TD class=alignCenter>853</TD><TD class=alignCenter>102</TD><TD class=alignCenter>606</TD><TD class=alignCenter>145</TD><TD class=alignCenter>118</TD></TR><TR><TD>5-19</TD><TD class=alignCenter>13</TD><TD class=alignCenter>2</TD><TD class=alignCenter>4</TD><TD class=alignCenter>7</TD><TD class=alignCenter>34</TD><TD class=alignCenter>443</TD><TD class=alignCenter>73</TD><TD class=alignCenter>253</TD><TD class=alignCenter>117</TD><TD class=alignCenter>192</TD></TR><TR><TD>20-44</TD><TD class=alignCenter>29</TD><TD class=alignCenter>6</TD><TD class=alignCenter>10</TD><TD class=alignCenter>13</TD><TD class=alignCenter>14</TD><TD class=alignCenter>880</TD><TD class=alignCenter>227</TD><TD class=alignCenter>453</TD><TD class=alignCenter>200</TD><TD class=alignCenter>96</TD></TR><TR><TD>45-64</TD><TD class=alignCenter>26</TD><TD class=alignCenter>8</TD><TD class=alignCenter>12</TD><TD class=alignCenter>6</TD><TD class=alignCenter>5</TD><TD class=alignCenter>667</TD><TD class=alignCenter>142</TD><TD class=alignCenter>377</TD><TD class=alignCenter>148</TD><TD class=alignCenter>36</TD></TR><TR><TD>65+</TD><TD class=alignCenter>81</TD><TD class=alignCenter>0</TD><TD class=alignCenter>41</TD><TD class=alignCenter>40</TD><TD class=alignCenter>6</TD><TD class=alignCenter>2177</TD><TD class=alignCenter>36</TD><TD class=alignCenter>1813</TD><TD class=alignCenter>328</TD><TD class=alignCenter>47</TD></TR><TR><TD>Unknown</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>226</TD><TD class=alignCenter>3</TD><TD class=alignCenter>221</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD></TR><TR><TD>Total</TD><TD class=alignCenter>183</TD><TD class=alignCenter>24</TD><TD class=alignCenter>83</TD><TD class=alignCenter>76</TD><TD class=alignCenter>74</TD><TD class=alignCenter>5246</TD><TD class=alignCenter>583</TD><TD class=alignCenter>3723</TD><TD class=alignCenter>940</TD><TD class=alignCenter>489</TD></TR></TBODY></TABLE>


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    Influenza tests reported and percentage of tests positive, Canada, by report week, 2010-2011


    Text Equivalent

    Percent positive influenza tests, compared to other respiratory viruses, Canada, by reporting week, 2010-2011


    Text Equivalent
    Canadian situation

    Paediatric Influenza Hospitalizations and Deaths
    In week 09, 18 new laboratory-confirmed influenza-associated paediatric (16 years of age and under) hospitalizations were reported through the Immunization Monitoring Program Active (IMPACT) network: 1 from BC, 4 from AB, 6 from ON, 4 from QC, 1 from NS, and 2 from NL. This number is decreased compared to the previous week (week 08) in which 48 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, 485 hospitalizations with laboratory-confirmed influenza have been reported from all provinces except NB and PE; 76 (15.7%) as influenza A/H3N2, 17 (3.5%) pandemic H1N1 2009, 318 (65.6%) as unsubytped influenza A, and 74 (15.3%) influenza B. The distribution of cases to date by age group was as follows: 18.1% among 0-5 month olds; 28.0% among 6-23 month olds; 29.5% among the 2-4 year-olds; 15.5% among 5-9 year-olds; and 8.9% among children 10-16 years old.

    Adult Influenza Hospitalizations and Deaths
    During week 09, 17 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 is decreased compared to the 21 cases reported in week 08 (note that numbers may fluctuate because of the delays in reporting). Of the 17 new cases reported between February 27 and March 5, 2011, 9 (52.9%) tested positive for unsubtyped influenza A, 2 (11.8%) as pandemic H1N1 2009, 3 (17.6%) as A/H3N2, and 3 (17.6%) as influenza B. Since the beginning of the season, 838 hospitalized cases have been reported: 188 (22.4%) A/H3N2, 36 (4.3%) pandemic H1N1 2009, 590 (70.4%) influenza A unsubtyped, and 24 (2.9%) influenza B, from all reporting provinces except NL. To date, 578 of the 838 (69.0%) cases were aged 65 years or older and 377 (45.0%) 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 09, 12 deaths with influenza were reported. Ten deaths were associated with A/H3N2 or unsubtyped influenza A in AB(1), ON(7), and NS(2), all in persons > 65 years old. Two deaths were reported from SK, one in a child between 1-4 years of age with A/H3N2 and the other in an adult between 45-64 years of age with pandemic H1N1 2009. Among the 177 fatal cases reported since the beginning of the influenza season, influenza A/H3N2 was identified in 61.6% (109/177), unsubtyped influenza A in 29.4% (52/177), pandemic H1N1 2009 in 6.8% (12/177), and influenza B in 2.3% (4/177). Seventy-nine percent (139/177) of these fatal cases were among persons 65 years of age or older, and another 11% (20/177) were between the ages of 45 and 64 years old, in keeping with the age-groups usually affected by A/H3N2. (Note that numbers may fluctuate because of the delays in reporting).

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    Re: Canada FluWatch Weekly Reports 2010-2011 Season Week 8 - 150 deaths total

    <TABLE border=0 cellSpacing=0 cellPadding=0><TBODY><TR><TD><H1>February 20 to February 26, 2011 (Week 08)</H1></TD></TR></TBODY></TABLE>

    Posted 2011-03-04


    Overall Influenza Summary ? Week 8 (February 20 to February 26, 2011)

    In week 08, 4 regions (in BC(2) and QC(2)) reported widespread activity, 20 regions reported localized activity (in AB(1), SK(2), ON(5), QC(1), NB(6), NS(4), and NL(1)), 23 regions reported sporadic activity (in all provinces and territories except YK) and 9 regions presented no activity (see Activity level Map). Compared to the previous week (week 07), 7 regions reported an increased level of influenza activity, 18 regions reported decreased activity, and 28 regions maintained a stable level of influenza activity (sporadic or higher). Forty-four new outbreaks were reported: 23 outbreaks of influenza in long-term care facilities (LTCF) in BC(5), SK (2), ON(2), QC(6), NB (6) and NS(2); 1 influenza B school outbreak in AB, 19 ILI outbreaks in schools in NB; and one ILI outbreak in a facility in AB.

    <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 8


    </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>
    Text Equivalent

    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.
    Text Equivalent


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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.
    Text Equivalent
    ILI consultation rate
    During week 08, the national ILI consultation rate was 36.5 consultations per 1,000 patient visits, an increase from 29.3 in week 07 but still within expected range for this time of year (see ILI graph). Children under 5 years of age had the highest consultation rates (87.1 per 1,000 consultations in week 08) followed by children between 5 and 19 years old (68.2 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.
    Text Equivalent
    Laboratory Surveillance Summary
    The proportion of tests that were positive for influenza during week 08 was 17.8%, which decreased slightly from 18.7% in week 07. The proportion of positive tests peaked in week 52. Of the 1055 positive tests reported during week 08, 363 (34.4%) specimens were reported as influenza A/H3N2, 73 (6.9%) as pandemic H1N1 2009, 130 (12.3%) as influenza B and 489 (46.4%) as unsubtyped influenza A. Since the beginning of the season, the majority of influenza virus detections have been influenza A viruses (95.0% or 13,610/14,332), and among subtyped influenza A specimens 86.1% have been A/H3N2.In week 08, detections of pandemic H1N1 2009 represented 16.7% of all subtyped influenza A specimens, which is decreased from the proportion of 21.4% observed in week 07. Detections of influenza B increased to 12.3% of all positive influenza specimens in week 08 compared to 9.8% in week 07. Through detailed case-based laboratory reporting where age data is provided, since August 29, 2010, 52.0% (1723/3315) of cases with A/H3N2 were aged 65 years or older. In contrast, the majority (93.5%, 491/525) of cases with pandemic H1N1 2009 were under 65 years of age (see Tests detailed table). In week 08, the proportion of positive tests for respiratory syncytial virus detections (RSV) was stable at 18.3% of specimens tested (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 (February 20 to February 26, 2011)</TH><TH class="bg-colour-blue fontSize85" colSpan=6 scope=colgroup>Cumulative (August 29, 2010 to February 26, 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>46</TD><TD class=alignCenter>0</TD><TD class=alignCenter>23</TD><TD class=alignCenter>8</TD><TD class=alignCenter>15</TD><TD class=alignCenter>13</TD><TD class=alignCenter>270</TD><TD class=alignCenter>0</TD><TD class=alignCenter>98</TD><TD class=alignCenter>95</TD><TD class=alignCenter>77</TD><TD class=alignCenter>65</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>51</TD><TD class=alignCenter>0</TD><TD class=alignCenter>28</TD><TD class=alignCenter>19</TD><TD class=alignCenter>4</TD><TD class=alignCenter>27</TD><TD class=alignCenter>672</TD><TD class=alignCenter>0</TD><TD class=alignCenter>499</TD><TD class=alignCenter>150</TD><TD class=alignCenter>23</TD><TD class=alignCenter>164</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>32</TD><TD class=alignCenter>0</TD><TD class=alignCenter>20</TD><TD class=alignCenter>2</TD><TD class=alignCenter>10</TD><TD class=alignCenter>3</TD><TD class=alignCenter>221</TD><TD class=alignCenter>0</TD><TD class=alignCenter>148</TD><TD class=alignCenter>23</TD><TD class=alignCenter>50</TD><TD class=alignCenter>12</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>505</TD><TD class=alignCenter>0</TD><TD class=alignCenter>56</TD><TD class=alignCenter>1</TD><TD class=alignCenter>448</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>295</TD><TD class=alignCenter>0</TD><TD class=alignCenter>92</TD><TD class=alignCenter>6</TD><TD class=alignCenter>197</TD><TD class=alignCenter>39</TD><TD class=alignCenter>6207</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2277</TD><TD class=alignCenter>240</TD><TD class=alignCenter>3690</TD><TD class=alignCenter>297</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>292</TD><TD class=alignCenter>0</TD><TD class=alignCenter>72</TD><TD class=alignCenter>2</TD><TD class=alignCenter>218</TD><TD class=alignCenter>38</TD><TD class=alignCenter>4985</TD><TD class=alignCenter>0</TD><TD class=alignCenter>774</TD><TD class=alignCenter>31</TD><TD class=alignCenter>4180</TD><TD class=alignCenter>156</TD></TR><TR><TH class=bg-colour-blue scope=row>NB</TH><TD class=alignCenter>138</TD><TD class=alignCenter>0</TD><TD class=alignCenter>99</TD><TD class=alignCenter>31</TD><TD class=alignCenter>8</TD><TD class=alignCenter>9</TD><TD class=alignCenter>554</TD><TD class=alignCenter>0</TD><TD class=alignCenter>368</TD><TD class=alignCenter>138</TD><TD class=alignCenter>48</TD><TD class=alignCenter>24</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>41</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6</TD><TD class=alignCenter>1</TD><TD class=alignCenter>34</TD><TD class=alignCenter>0</TD><TD class=alignCenter>115</TD><TD class=alignCenter>0</TD><TD class=alignCenter>27</TD><TD class=alignCenter>7</TD><TD class=alignCenter>81</TD><TD class=alignCenter>1</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>5</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>36</TD><TD class=alignCenter>0</TD><TD class=alignCenter>25</TD><TD class=alignCenter>9</TD><TD class=alignCenter>2</TD><TD class=alignCenter>2</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>20</TD><TD class=alignCenter>0</TD><TD class=alignCenter>18</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>45</TD><TD class=alignCenter>0</TD><TD class=alignCenter>42</TD><TD class=alignCenter>3</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>925</TD><TD class=alignCenter>0</TD><TD class=alignCenter>363</TD><TD class=alignCenter>73</TD><TD class=alignCenter>489</TD><TD class=alignCenter>130</TD><TD class=alignCenter>13610</TD><TD class=alignCenter>0</TD><TD class=alignCenter>4314</TD><TD class=alignCenter>697</TD><TD class=alignCenter>8599</TD><TD class=alignCenter>722</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
    (February 20 to February 26, 2011)</TH><TH colSpan=5 scope=colgroup>Cumulative
    (Aug. 29, 2010 to Feb. 26, 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>25</TD><TD class=alignCenter>3</TD><TD class=alignCenter>15</TD><TD class=alignCenter>7</TD><TD class=alignCenter>11</TD><TD class=alignCenter>791</TD><TD class=alignCenter>91</TD><TD class=alignCenter>565</TD><TD class=alignCenter>135</TD><TD class=alignCenter>98</TD></TR><TR><TD>5-19</TD><TD class=alignCenter>18</TD><TD class=alignCenter>5</TD><TD class=alignCenter>9</TD><TD class=alignCenter>4</TD><TD class=alignCenter>21</TD><TD class=alignCenter>422</TD><TD class=alignCenter>70</TD><TD class=alignCenter>245</TD><TD class=alignCenter>107</TD><TD class=alignCenter>150</TD></TR><TR><TD>20-44</TD><TD class=alignCenter>30</TD><TD class=alignCenter>5</TD><TD class=alignCenter>13</TD><TD class=alignCenter>12</TD><TD class=alignCenter>8</TD><TD class=alignCenter>825</TD><TD class=alignCenter>208</TD><TD class=alignCenter>428</TD><TD class=alignCenter>189</TD><TD class=alignCenter>72</TD></TR><TR><TD>45-64</TD><TD class=alignCenter>26</TD><TD class=alignCenter>6</TD><TD class=alignCenter>8</TD><TD class=alignCenter>12</TD><TD class=alignCenter>1</TD><TD class=alignCenter>625</TD><TD class=alignCenter>122</TD><TD class=alignCenter>354</TD><TD class=alignCenter>149</TD><TD class=alignCenter>30</TD></TR><TR><TD>65+</TD><TD class=alignCenter>63</TD><TD class=alignCenter>1</TD><TD class=alignCenter>32</TD><TD class=alignCenter>30</TD><TD class=alignCenter>3</TD><TD class=alignCenter>2058</TD><TD class=alignCenter>34</TD><TD class=alignCenter>1723</TD><TD class=alignCenter>301</TD><TD class=alignCenter>38</TD></TR><TR><TD>Unknown</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>224</TD><TD class=alignCenter>3</TD><TD class=alignCenter>219</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD></TR><TR><TD>Total</TD><TD class=alignCenter>165</TD><TD class=alignCenter>20</TD><TD class=alignCenter>80</TD><TD class=alignCenter>65</TD><TD class=alignCenter>44</TD><TD class=alignCenter>4945</TD><TD class=alignCenter>528</TD><TD class=alignCenter>3534</TD><TD class=alignCenter>883</TD><TD class=alignCenter>388</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 08, 39 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 BC, 11 from AB, 2 from SK, 5 from ON, 16 from QC, 1 from NS, and 2 from NL. This number is increased compared to the previous week (week 07) in which 25 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, 458 hospitalizations with laboratory-confirmed influenza have been reported from all provinces except NB and PE; 74 (16.2%) as influenza A/H3N2, 15 (3.3%) pandemic H1N1 2009, 306 (66.8%) as unsubytped influenza A, and 63 (13.8%) influenza B. The distribution of cases to date by age group was as follows: 18.1% among 0-5 month olds; 28.4% among 6-23 month olds; 29.3% among the 2-4 year-olds; 15.3% among 5-9 year-olds; and 9.0% among children 10-16 years old.

    Adult Influenza Hospitalizations and Deaths
    During week 08, 21 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 is decreased compared to the 27 cases reported in week 07 (note that numbers may fluctuate because of the delays in reporting). Of the 21 new cases reported between February 20 and 26, 2011, 17 (81.0%) tested positive for unsubtyped influenza A, 1 (4.8%) as pandemic H1N1 2009, and 3 (14.3%) as influenza B. Since the beginning of the season, 821 hospitalized cases have been reported: 185 (22.5%) A/H3N2, 34 (4.1%) pandemic H1N1 2009, 581 (70.8%) influenza A unsubtyped, and 21 (2.6%) influenza B, from all reporting provinces except NL. To date, 570 of the 821 (69.4%) cases were aged 65 years or older and 370 (45.1%) 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 08, 1 death was reported in ON of a person >65 years old with A/H3N2. Among the 150 fatal cases reported since the beginning of the influenza season, influenza A/H3N2 was identified in 64.0% (96/150), unsubtyped influenza A in 28.7% (43/150), pandemic H1N1 2009 in 5.3% (8/150), and influenza B in 2.0% (3/150). Seventy-seven percent (115/150) of these fatal cases were among persons 65 years of age or older, and another 12% (18/150) were between the ages of 45 and 64 years old, in keeping with the age-groups usually affected by A/H3N2. (Note that numbers may fluctuate because of the delays in reporting).

    [...]

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    Re: Canada FluWatch Weekly Reports 2010-2011 Season Week 7 - 134 deaths total

    <TABLE border=0 cellSpacing=0 cellPadding=0><TBODY><TR><TD><H1>February 13 to February 19, 2011 (Week 07)</H1></TD></TR></TBODY></TABLE>

    Posted 2011-02-25


    Overall Influenza Summary ? Week 7 (February 13 to February 19, 2011)

    In week 07, 35 regions reported localized activity (in all provinces except PE), 15 regions reported sporadic activity (in all provinces and territories except YK) and 6 regions presented no activity (see Activity level Map). Compared to the previous week (week 06), 15 regions reported an increased level of influenza activity, 5 regions reported decreased activity, and 33 regions maintained a stable level of influenza activity (sporadic or higher). Fifty-one new ILI/influenza outbreaks were reported: 26 in long-term care facilities (LTCF) in BC(2), SK (5), ON(4), QC(7), NB (2) and NS(6); 20 school outbreaks in AB(2), NB(15), NS(1) and NL(2); 1 hospital outbreak in ON; and 4 outbreaks in other facilities in SK(1), ON(2) and NL(1).

    <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 7


    </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>
    Text Equivalent

    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.
    Text Equivalent


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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.
    Text Equivalent
    ILI consultation rate
    During week 07, the national ILI consultation rate was 29.4 consultations per 1,000 patient visits, a similar rate to that observed during the previous 4 weeks, and still within expected range for this time of year (see ILI graph). Children between 5 and 19 years old had the highest consultation rates (70.3 per 1,000 consultations in week 07) followed by children under 5 years of age (66.8 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.
    Text Equivalent
    Laboratory Surveillance Summary
    The proportion of tests that were positive for influenza during week 07 was 18.7%, which is decreased from 20.2% in week 06. The proportion of positive tests peaked in week 52, deviated slightly from the downward trend during weeks 05 and 06, but decreased in week 07. Of the 1150 positive tests reported during week 07, 337 (29%) specimens were reported as influenza A/H3N2, 92 (8%) as pandemic H1N1 2009, 113 (10%) as influenza B and 608 (53%) as unsubtyped influenza A. Since the beginning of the season, the majority of influenza virus detections have been influenza A viruses (95.6% or 12,651/13,235), and among subtyped influenza A specimens 86.3% have been A/H3N2.In week 07, detections of pandemic H1N1 2009 represented 21.4% of all subtyped influenza A specimens, which is increased from the proportion of 17.3% observed in week 06. Detections of influenza B remained stable at 9.8% of all positive influenza specimens in week 07 compared to 9.3% in week 06. Through detailed case-based laboratory reporting where age data is provided, since August 29, 2010, 52.4% (1619/3090) of cases with A/H3N2 were aged 65 years or older. In contrast, the majority (93.8%) of cases with pandemic H1N1 2009 were under 65 years of age. (see Tests detailed table). In week 07, the proportion of positive tests for respiratory syncytial virus detections (RSV) was 19.0% of specimens tested (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 (February 13 to February 19, 2011)</TH><TH class="bg-colour-blue fontSize85" colSpan=6 scope=colgroup>Cumulative (August 29, 2010 to February 19, 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>33</TD><TD class=alignCenter>0</TD><TD class=alignCenter>12</TD><TD class=alignCenter>19</TD><TD class=alignCenter>2</TD><TD class=alignCenter>12</TD><TD class=alignCenter>224</TD><TD class=alignCenter>0</TD><TD class=alignCenter>75</TD><TD class=alignCenter>87</TD><TD class=alignCenter>62</TD><TD class=alignCenter>52</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>80</TD><TD class=alignCenter>0</TD><TD class=alignCenter>48</TD><TD class=alignCenter>24</TD><TD class=alignCenter>8</TD><TD class=alignCenter>48</TD><TD class=alignCenter>607</TD><TD class=alignCenter>0</TD><TD class=alignCenter>452</TD><TD class=alignCenter>130</TD><TD class=alignCenter>25</TD><TD class=alignCenter>135</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>43</TD><TD class=alignCenter>0</TD><TD class=alignCenter>28</TD><TD class=alignCenter>12</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>189</TD><TD class=alignCenter>0</TD><TD class=alignCenter>128</TD><TD class=alignCenter>21</TD><TD class=alignCenter>40</TD><TD class=alignCenter>9</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>11</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>11</TD><TD class=alignCenter>0</TD><TD class=alignCenter>502</TD><TD class=alignCenter>0</TD><TD class=alignCenter>56</TD><TD class=alignCenter>1</TD><TD class=alignCenter>445</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>346</TD><TD class=alignCenter>0</TD><TD class=alignCenter>73</TD><TD class=alignCenter>7</TD><TD class=alignCenter>266</TD><TD class=alignCenter>29</TD><TD class=alignCenter>5892</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2185</TD><TD class=alignCenter>234</TD><TD class=alignCenter>3473</TD><TD class=alignCenter>252</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>360</TD><TD class=alignCenter>0</TD><TD class=alignCenter>75</TD><TD class=alignCenter>2</TD><TD class=alignCenter>283</TD><TD class=alignCenter>21</TD><TD class=alignCenter>4693</TD><TD class=alignCenter>0</TD><TD class=alignCenter>702</TD><TD class=alignCenter>29</TD><TD class=alignCenter>3962</TD><TD class=alignCenter>118</TD></TR><TR><TH class=bg-colour-blue scope=row>NB</TH><TD class=alignCenter>120</TD><TD class=alignCenter>0</TD><TD class=alignCenter>78</TD><TD class=alignCenter>27</TD><TD class=alignCenter>15</TD><TD class=alignCenter>2</TD><TD class=alignCenter>416</TD><TD class=alignCenter>0</TD><TD class=alignCenter>269</TD><TD class=alignCenter>107</TD><TD class=alignCenter>40</TD><TD class=alignCenter>15</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>29</TD><TD class=alignCenter>0</TD><TD class=alignCenter>10</TD><TD class=alignCenter>1</TD><TD class=alignCenter>18</TD><TD class=alignCenter>0</TD><TD class=alignCenter>74</TD><TD class=alignCenter>0</TD><TD class=alignCenter>21</TD><TD class=alignCenter>6</TD><TD class=alignCenter>47</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>4</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>29</TD><TD class=alignCenter>0</TD><TD class=alignCenter>20</TD><TD class=alignCenter>7</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>9</TD><TD class=alignCenter>0</TD><TD class=alignCenter>9</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>25</TD><TD class=alignCenter>0</TD><TD class=alignCenter>24</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>1037</TD><TD class=alignCenter>0</TD><TD class=alignCenter>337</TD><TD class=alignCenter>92</TD><TD class=alignCenter>608</TD><TD class=alignCenter>113</TD><TD class=alignCenter>12651</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3932</TD><TD class=alignCenter>623</TD><TD class=alignCenter>8096</TD><TD class=alignCenter>584</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
    (February 12 to February 19, 2011)</TH><TH colSpan=5 scope=colgroup>Cumulative
    (Aug. 29, 2010 to Feb. 19, 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>22</TD><TD class=alignCenter>2</TD><TD class=alignCenter>17</TD><TD class=alignCenter>3</TD><TD class=alignCenter>11</TD><TD class=alignCenter>746</TD><TD class=alignCenter>88</TD><TD class=alignCenter>528</TD><TD class=alignCenter>130</TD><TD class=alignCenter>70</TD></TR><TR><TD>5-19</TD><TD class=alignCenter>21</TD><TD class=alignCenter>3</TD><TD class=alignCenter>16</TD><TD class=alignCenter>2</TD><TD class=alignCenter>26</TD><TD class=alignCenter>388</TD><TD class=alignCenter>63</TD><TD class=alignCenter>224</TD><TD class=alignCenter>101</TD><TD class=alignCenter>113</TD></TR><TR><TD>20-44</TD><TD class=alignCenter>29</TD><TD class=alignCenter>11</TD><TD class=alignCenter>12</TD><TD class=alignCenter>6</TD><TD class=alignCenter>7</TD><TD class=alignCenter>774</TD><TD class=alignCenter>195</TD><TD class=alignCenter>394</TD><TD class=alignCenter>185</TD><TD class=alignCenter>52</TD></TR><TR><TD>45-64</TD><TD class=alignCenter>31</TD><TD class=alignCenter>12</TD><TD class=alignCenter>12</TD><TD class=alignCenter>7</TD><TD class=alignCenter>1</TD><TD class=alignCenter>568</TD><TD class=alignCenter>110</TD><TD class=alignCenter>325</TD><TD class=alignCenter>133</TD><TD class=alignCenter>27</TD></TR><TR><TD>65+</TD><TD class=alignCenter>109</TD><TD class=alignCenter>2</TD><TD class=alignCenter>74</TD><TD class=alignCenter>33</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1922</TD><TD class=alignCenter>30</TD><TD class=alignCenter>1619</TD><TD class=alignCenter>273</TD><TD class=alignCenter>30</TD></TR><TR><TD>Unknown</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>219</TD><TD class=alignCenter>3</TD><TD class=alignCenter>214</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD></TR><TR><TD>Total</TD><TD class=alignCenter>214</TD><TD class=alignCenter>30</TD><TD class=alignCenter>133</TD><TD class=alignCenter>51</TD><TD class=alignCenter>47</TD><TD class=alignCenter>4617</TD><TD class=alignCenter>489</TD><TD class=alignCenter>3304</TD><TD class=alignCenter>824</TD><TD class=alignCenter>292</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 07, 23 new laboratory-confirmed influenza-associated paediatric (16 years of age and under) hospitalizations were reported through the Immunization Monitoring Program Active (IMPACT) network: 3 from AB, 6 from ON, 11 from QC and 3 from NL. This number is decreased compared to the previous week (week 06) in which 45 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, 418 hospitalizations with laboratory-confirmed influenza have been reported from all provinces except NB and PE; 66 (15.8%) as influenza A/H3N2, 13 (3.1%) pandemic H1N1 2009, 289 (69.1%) as unsubytped influenza A, and 50 (12.0%) influenza B. The distribution of cases to date by age group was as follows: 18.9% among 0-5 month olds; 28.5% among 6-23 month olds; 28.7% among the 2-4 year-olds; 14.8% among 5-9 year-olds; and 9.1% among children 10-16 years old.
    Adult Influenza Hospitalizations and Deaths
    During week 07, 27 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 is decreased compared to the 39 cases reported in week 06 (note that numbers may fluctuate because of the delays in reporting). Of the 27 new cases reported between February 13 and 19, 2011, 21 (77.8%) tested positive for unsubtyped influenza A, 3 (11.1%) as influenza A/H3N2, and 3 (11.1%) as influenza B. Since the beginning of the season, 784 hospitalized cases have been reported: 184 (23.5%) A/H3N2, 29 (3.7%) pandemic H1N1 2009, 555 (70.8%) influenza A unsubtyped, and 16 (2.0%) influenza B, from all reporting provinces except NL. To date, 544 of the 784 (69.4%) cases were aged 65 years or older and 354 (54.2%) 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 07, 3 deaths were reported, one in each of AB, MB and ON. One case was between 20 and 44 years old with pandemic H1N1 2009 detected, and the other two were in persons >65 years old with A/H3N2. Among the 134 fatal cases reported since the beginning of the influenza season, influenza A/H3N2 was identified in 64.9% (87/134), unsubtyped influenza A in 26.9% (36/134), pandemic H1N1 2009 in 6.0% (8/134), and influenza B in 2.2% (3/134). Seventy-five percent (101/134) of these fatal cases were among persons 65 years of age or older, and another 13% (17/134) were between the ages of 45 and 64 years old, in keeping with the age-groups usually affected by A/H3N2. (Note that numbers may fluctuate because of the delays in reporting).

    [...]

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    Re: Canada FluWatch Weekly Reports 2010-2011 Season Week 6 - 122 deaths total

    <TABLE border=0 cellSpacing=0 cellPadding=0><TBODY><TR><TD><H1>February 6 to February 12, 2011 (Week 06)</H1></TD></TR></TBODY></TABLE>

    Posted 2011-02-18


    Overall Influenza Summary ? Week 6 (February 6 to February 12, 2011)

    In week 06, one region in Quebec (Montreal/Laval) reported widespread influenza/ILI activity, 23 regions reported localized activity (in AB(2), SK(1), MB(1), ON(6), QC(4), NB(5), NS(3), and NL(1)), 25 regions reported sporadic activity (in all provinces and territories) and 7 regions presented no activity. (See Activity level Map). Compared to the previous week (week 05), 18 regions reported an increased level of influenza activity, 8 regions reported decreased activity, and 26 regions maintained a stable level of influenza activity (sporadic or higher). During week 06, 34 new ILI/influenza outbreaks were reported: 21 in long-term care facilities (LTCF) in MB(1), ON(8), QC(7), NB (1) and NS(4); 9 school outbreaks in AB(2), and NB(7); and 4 outbreaks in other facilities in AB(1) and ON(3).

    <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 6


    </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 06, the national ILI consultation rate was 35.7 consultations per 1,000 patient visits, an increase from week 05, however still within expected range for this time of year (see ILI graph). Children under 5 years of age had the highest consultation rates (84.2 per 1,000 consultations in week 06) followed by children between 5 and 19 years (65.4 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.
    Text Equivalent
    Laboratory Surveillance Summary
    The proportion of tests that were positive for influenza during week 06 was 20.2%. The proportion of positive tests has increased slightly in weeks 05 and 06, due to an increase in the proportion of positive tests in BC, QC, and the Atlantic provinces. Of the 1280 positive tests reported during week 06, 420 (33%) specimens were reported as influenza A/H3N2, 88 (7%) as pandemic H1N1 2009, 119 (9%) as influenza B and 653 (51%) as unsubtyped influenza A. The majority of influenza virus detections to date this season were influenza A viruses (96.1% or 11,575/12,044). Since the beginning of the season, 87.0% of the subtyped positive influenza A specimens were influenza A/H3N2.In week 06, detections of pandemic H1N1 2009 represented 17.3% of all subtyped influenza A specimens, which is similar to the proportion observed in week 05. Detections of influenza B increased slightly from 7.4% of all positive influenza specimens in week 05 to 9.3% in week 06. During week 06, 52.8% (57/108) 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 49.4% (1499/3036) (see Tests detailed table). In week 06, the proportion of positive tests for respiratory syncytial virus detections (RSV) increased from 16.9% to 19.0% of specimens tested while low levels of parainfluenza (2.5%) and rhinovirus (5.7%) 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 (February 6 to February 12, 2011)</TH><TH class="bg-colour-blue fontSize85" colSpan=6 scope=colgroup>Cumulative (August 29, 2010 to February 12, 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>30</TD><TD class=alignCenter>0</TD><TD class=alignCenter>9</TD><TD class=alignCenter>14</TD><TD class=alignCenter>7</TD><TD class=alignCenter>11</TD><TD class=alignCenter>191</TD><TD class=alignCenter>0</TD><TD class=alignCenter>63</TD><TD class=alignCenter>68</TD><TD class=alignCenter>60</TD><TD class=alignCenter>40</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>69</TD><TD class=alignCenter>0</TD><TD class=alignCenter>38</TD><TD class=alignCenter>15</TD><TD class=alignCenter>16</TD><TD class=alignCenter>35</TD><TD class=alignCenter>527</TD><TD class=alignCenter>0</TD><TD class=alignCenter>397</TD><TD class=alignCenter>99</TD><TD class=alignCenter>31</TD><TD class=alignCenter>86</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>34</TD><TD class=alignCenter>0</TD><TD class=alignCenter>24</TD><TD class=alignCenter>6</TD><TD class=alignCenter>4</TD><TD class=alignCenter>2</TD><TD class=alignCenter>146</TD><TD class=alignCenter>0</TD><TD class=alignCenter>100</TD><TD class=alignCenter>9</TD><TD class=alignCenter>37</TD><TD class=alignCenter>9</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>11</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>11</TD><TD class=alignCenter>0</TD><TD class=alignCenter>491</TD><TD class=alignCenter>0</TD><TD class=alignCenter>56</TD><TD class=alignCenter>1</TD><TD class=alignCenter>434</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>427</TD><TD class=alignCenter>0</TD><TD class=alignCenter>126</TD><TD class=alignCenter>10</TD><TD class=alignCenter>291</TD><TD class=alignCenter>39</TD><TD class=alignCenter>5507</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2112</TD><TD class=alignCenter>227</TD><TD class=alignCenter>3168</TD><TD class=alignCenter>222</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>435</TD><TD class=alignCenter>0</TD><TD class=alignCenter>129</TD><TD class=alignCenter>5</TD><TD class=alignCenter>301</TD><TD class=alignCenter>25</TD><TD class=alignCenter>4333</TD><TD class=alignCenter>0</TD><TD class=alignCenter>627</TD><TD class=alignCenter>27</TD><TD class=alignCenter>3679</TD><TD class=alignCenter>97</TD></TR><TR><TH class=bg-colour-blue scope=row>NB</TH><TD class=alignCenter>121</TD><TD class=alignCenter>0</TD><TD class=alignCenter>81</TD><TD class=alignCenter>37</TD><TD class=alignCenter>3</TD><TD class=alignCenter>6</TD><TD class=alignCenter>296</TD><TD class=alignCenter>0</TD><TD class=alignCenter>191</TD><TD class=alignCenter>80</TD><TD class=alignCenter>25</TD><TD class=alignCenter>13</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>25</TD><TD class=alignCenter>0</TD><TD class=alignCenter>4</TD><TD class=alignCenter>1</TD><TD class=alignCenter>20</TD><TD class=alignCenter>1</TD><TD class=alignCenter>45</TD><TD class=alignCenter>0</TD><TD class=alignCenter>11</TD><TD class=alignCenter>5</TD><TD class=alignCenter>29</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>23</TD><TD class=alignCenter>0</TD><TD class=alignCenter>16</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>7</TD><TD class=alignCenter>0</TD><TD class=alignCenter>7</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>16</TD><TD class=alignCenter>0</TD><TD class=alignCenter>15</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>1161</TD><TD class=alignCenter>0</TD><TD class=alignCenter>420</TD><TD class=alignCenter>88</TD><TD class=alignCenter>653</TD><TD class=alignCenter>119</TD><TD class=alignCenter>11575</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3588</TD><TD class=alignCenter>524</TD><TD class=alignCenter>7463</TD><TD class=alignCenter>469</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
    (February 6 to February 12, 2011)</TH><TH colSpan=5 scope=colgroup>Cumulative
    (Aug. 29, 2010 to Feb. 12, 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>36</TD><TD class=alignCenter>5</TD><TD class=alignCenter>23</TD><TD class=alignCenter>8</TD><TD class=alignCenter>10</TD><TD class=alignCenter>688</TD><TD class=alignCenter>79</TD><TD class=alignCenter>480</TD><TD class=alignCenter>129</TD><TD class=alignCenter>59</TD></TR><TR><TD>5-19</TD><TD class=alignCenter>24</TD><TD class=alignCenter>3</TD><TD class=alignCenter>11</TD><TD class=alignCenter>10</TD><TD class=alignCenter>23</TD><TD class=alignCenter>347</TD><TD class=alignCenter>54</TD><TD class=alignCenter>190</TD><TD class=alignCenter>103</TD><TD class=alignCenter>76</TD></TR><TR><TD>20-44</TD><TD class=alignCenter>33</TD><TD class=alignCenter>9</TD><TD class=alignCenter>8</TD><TD class=alignCenter>16</TD><TD class=alignCenter>6</TD><TD class=alignCenter>707</TD><TD class=alignCenter>163</TD><TD class=alignCenter>365</TD><TD class=alignCenter>179</TD><TD class=alignCenter>43</TD></TR><TR><TD>45-64</TD><TD class=alignCenter>17</TD><TD class=alignCenter>3</TD><TD class=alignCenter>8</TD><TD class=alignCenter>6</TD><TD class=alignCenter>1</TD><TD class=alignCenter>515</TD><TD class=alignCenter>90</TD><TD class=alignCenter>302</TD><TD class=alignCenter>123</TD><TD class=alignCenter>23</TD></TR><TR><TD>65+</TD><TD class=alignCenter>81</TD><TD class=alignCenter>2</TD><TD class=alignCenter>57</TD><TD class=alignCenter>22</TD><TD class=alignCenter>3</TD><TD class=alignCenter>1765</TD><TD class=alignCenter>27</TD><TD class=alignCenter>1499</TD><TD class=alignCenter>239</TD><TD class=alignCenter>29</TD></TR><TR><TD>Unknown</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>205</TD><TD class=alignCenter>3</TD><TD class=alignCenter>200</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD></TR><TR><TD>Total</TD><TD class=alignCenter>192</TD><TD class=alignCenter>22</TD><TD class=alignCenter>108</TD><TD class=alignCenter>62</TD><TD class=alignCenter>43</TD><TD class=alignCenter>4227</TD><TD class=alignCenter>416</TD><TD class=alignCenter>3036</TD><TD class=alignCenter>775</TD><TD class=alignCenter>230</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 06, 33 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 BC, 2 from AB, 15 from ON, and 14 from QC. This number is decreased compared to the previous week (week 05) in which 36 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, 372 hospitalizations with laboratory-confirmed influenza have been reported from all provinces except NB and PE; 61 (16.4%) as influenza A/H3N2, 11 (3.0%) pandemic H1N1 2009, 265 (71.2%) as unsubytped influenza A, and 35 (9.4%) influenza B. The distribution of cases to date by age group was as follows: 18.5% among 0-5 month olds; 30.4% among 6-23 month olds; 26.6% among the 2-4 year-olds; 16.1% among 5-9 year-olds; and 8.3% among children 10-16 years old.
    Adult Influenza Hospitalizations and Deaths
    During week 06, 39 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 is increased compared to the 26 cases reported in week 05 and the same number of cases as were reported in week 04 (note that numbers may fluctuate because of the delays in reporting). Of the 39 new cases reported between February 6 and 12, 2011, 30 (76.9%) tested positive for unsubtyped influenza A, 6 (15.4%) as influenza A/H3N2, 2 (5.1%) as pandemic H1N1 2009, and 1 (2.6%) as influenza B. Since the beginning of the season, 733 hospitalized cases have been reported: 176 (24.0%) A/H3N2, 31 (4.2%) pandemic H1N1 2009, 513 (70.0%) influenza A unsubtyped, and 13 (1.8%) influenza B, from all reporting provinces except NL. To date, 515 of the 733 (70.3%) cases were aged 65 years or older and 328 (44.7%) 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 06, ON reported 5 deaths, all among persons 65 years of age or older: 3 with A/H3N2, 1 with unsubtyped influenza A, and 1 with influenza B (note that numbers may fluctuate because of the delays in reporting). Among the 122 fatal cases currently reported since the beginning of the influenza season, influenza A/H3N2 was identified in 63.9% (78/122), unsubtyped influenza A in 27.9% (34/122), pandemic H1N1 2009 in 5.7% (7/122), and influenza B in 2.5% (3/122). Seventy-six percent (93/122) of these fatal cases were among persons 65 years of age or older, and another 13% (16/122) 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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