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Canada FluWatch Weekly Reports 2015-2016 Season Weeks 21-24

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  • Canada FluWatch Weekly Reports 2015-2016 Season Weeks 21-24


    FluWatch report: October 11 to October 17, 2015 (week 41)

    Overall Summary
    • Overall, there is low influenza activity in Canada.
    • Influenza activity and detections decreased from the previous week.
    • In week 41, no new influenza outbreaks were reported.
    • So far this season, influenza A(H3N2) has been the most common subtype affecting Canadians.
    • For more information on the flu, see our Flu (influenza) web page.
    Download the alternative format
    (PDF format, 757 KB, 7 pages)
    Organization: Public Health Agency of Canada
    Date published: 2015-10-23

    Related Topics

    Are you a primary health care practitioner (General Practitioner, Nurse Practitioner or Registered Nurse) interested in becoming a FluWatch sentinel for the 2015-16 influenza season? Contact us at FluWatch@phac-aspc.gc.ca


    On this pageInfluenza/Influenza-like Illness Activity (geographic spread)

    In week 41, sporadic influenza activity were reported in a few regions across Canada. One region in Ontario reported localized activity. Overall, the majority of regions in Canada have reported no influenza activity.
    Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 41




    Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the Flu Activity website.
    Figure 1 - Text Description Laboratory Confirmed Influenza Detections

    The number of positive influenza tests decreased from the previous week. In week 41, the percent positive for influenza detections remained low at 1.4%; however, this is the highest recorded value compared the previous five seasons during the same period (Figure 2).
    Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2015-16

    Figure 2 - Text Description In week 41, the majority of detections in Canada have been reported from BC, AB, and ON, accounting for 86% of the influenza detections in Canada. A total of six jurisdictions have yet to report any influenza cases. To date, 92% of influenza detections have been influenza A and the majority of those subtyped have been A(H3).
    Figure 3. Cumulative numbers of positive influenza specimens by type/subtype and province, Canada, 2015-16

    Note: Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
    Figure 3 - Text Description Among cases with reported age, the largest proportion was in those ≥65 years of age (48%) (Table 1). Compared to the previous year during the same period, a greater proportion of cases in the 20-44 and 45-64 age groups have been reported to date (39% this year vs 22% last year).
    Table 1 - Footnote 1 Table 1 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
    Return to Table 1 - Footnote1referrer
    Table 1 - Footnote 2 Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
    Return to Table 1 - Footnote2referrer
    Table 1 - Footnote UnS Unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
    Return to Table 1 - FootnoteUnSreferrer
    1 0 1 0 0 7 1 6 0 1 8 4.4%
    0 0 0 0 0 9 1 5 3 4 13 7.1%
    3 1 0 2 0 22 5 9 8 3 25 13.7%
    1 0 0 1 0 44 7 27 10 3 47 25.8%
    11 0 6 5 2 84 2 59 23 4 88 48.4%
    0 0 0 0 0 1 0 1 0 0 1 0.5%
    16 1 7 8 2 167 16 107 44 15 182 100.0%
    88.9% 6.3% 43.8% 50.0% 11.1% 91.8% 9.6% 64.1% 26.3% 8.2%
    For additional data on other respiratory virus detections see the Respiratory Virus Detections in Canada Report on the Public Health Agency of Canada website.
    Influenza-like Illness Consultation Rate

    The national influenza-like-illness (ILI) consultation rate increased from 17.1 consultations per 1,000 patient visits in week 40 to 22.3 per 1,000 visits in week 41. In week 41, the highest ILI consultation rate was found in the 0-4 age group and the lowest was found in the 5-19 age group (Figure 4).
    Figure 4. Influenza-like-illness (ILI) consultation rates by age group and week, Canada, 2015-16

    Delays in the reporting of data may cause data to change retrospectively. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. Not all sentinel physicians report every week.
    Figure 4 - Text Description Influenza Outbreak Surveillance

    In week 41, no new outbreaks of influenza were reported (Figure 5).
    Figure 5. Overall number of new laboratory-confirmed influenza outbreaksFigure 5 - Footnote1 by report week, Canada, 2015-2016

    Figure 5 - Footnote 1 All provinces and territories except NU report influenza outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
    Return to Figure 5 - Footnote1referrer
    Figure 5 - Text Description Sentinel Pediatric Hospital Influenza Surveillance

    Paediatric Influenza Hospitalizations and Deaths (IMPACT)

    To date, less than five laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations have been reported by the Immunization Monitoring Program Active (IMPACT) network. All hospitalized cases were due to influenza A.
    Figure 6. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2015-16, Paediatric hospitalizations (≤16 years of age, IMPACT)

    Figure 6 - Text Description Figure 7. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2015-16 Paediatric hospitalizations (≤16 years of age, IMPACT)

    Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
    Figure 7 - Text Description Provincial/Territorial Influenza Hospitalizations and Deaths

    Since the start of the 2015-16 season, 30 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territoriesFootnote*. All but one hospitlaization was due to influenza A. The majority of were patients ≥65 years of age. Three ICU admissions have been reported.
    Footnote * Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, and QC. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT networks. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting.
    Return to footnote*referrer
    Figure 8. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada 2015-16

    Figure 8 - Text Description See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2011-12 to 2015-16 on the Public Health Agency of Canada website.
    Influenza Strain Characterizations

    During the 2015-16 influenza season, the National Microbiology Laboratory (NML) has characterized eight influenza viruses [5 A(H3N2) and 3 influenza B].
    Influenza A (H3N2): Sequence analysis of the H3N2 viruses showed that all five viruses belonged to a genetic group for which most viruses were antigenically related to A/Switzerland/9715293/2013, the A(H3N2) component of the Northern Hemisphere's vaccine.
    Influenza B: The three influenza B viruses characterized were antigenically similar to the vaccine strain B/Phuket/3073/2013.
    The recommended components for the 2015-2016 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an /Switzerland/9715293/2013(H3N2)-like virus, and a B/Phuket/3073/2013 -like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus is recommended.
    The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
    Antiviral Resistance

    During the 2015-16 season, the National Microbiology Laboratory (NML) as tested nine influenza viruses for resistance to oseltamivir and zanamivir. All viruses were sensitive to zanamivir and oseltamivir. All influenza A viruses tested were resistant to amantadine (Table 2).
    Table 2 - Footnote * NA - not applicable

    Return to Table 2 - Footnote*referrer
    6 0 6 0 7 7 (100%)
    0 0 0 0 0 0
    3 0 3 0 NA Table 2 - Footnote* NA Table 2 - Footnote*
    9 0 9 0 7 7
    .../
    http://www.healthycanadians.gc.ca/pu.../index-eng.php

    Previous reports:
    http://www.healthycanadians.gc.ca/di...pports-eng.php

    "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
    -Nelson Mandela

  • #2
    FluWatch report: October 18 to October 24, 2015 (week 42)

    Overall Summary

    • Overall, there is low influenza activity in Canada.
    • Influenza activity and detections decreased from the previous week.
    • No laboratory confirmed outbreaks have been reported in the last two weeks.
    • So far this season, influenza A(H3N2) has been the most common subtype affecting Canadians.
    • To date, the majority of influenza laboratory detections and hospitalizations have been in seniors greater than 65 years of age.
    • For more information on the flu, see our Flu (influenza) web page.

    Download the alternative format
    (PDF format, 753 KB, 7 pages)
    Organization: Public Health Agency of Canada
    Date published: 2015-10-30

    Related Topics


    Are you a primary health care practitioner (General Practitioner, Nurse Practitioner or Registered Nurse) interested in becoming a FluWatch sentinel for the 2015-16 influenza season? Contact us at FluWatch@phac-aspc.gc.ca


    On this page

    Influenza/Influenza-like Illness Activity (geographic spread)

    In week 42, sporadic influenza activity were reported in a few regions across Canada. One region in Ontario reported localized activity. The number of regions reporting influenza activity decreased from the previous week,from 12 regions reporting influenza activity in week 41 to 10 regions reporting influenza activity in week 42. Overall, the majority of regions in Canada reported no influenza activity.
    Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 42




    Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the Flu Activity website.
    Figure 1 - Text Description Laboratory Confirmed Influenza Detections

    In week 42, the percent positive for influenza detections remained low at 0.85%. The percent positive reported this week is lower than the percent positive reported the same week last season (1.96%). Since week 39, the percent positive for influenza detections have been decreasing (Figure 2).
    Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2015-16

    Figure 2 - Text Description In week 42, the majority of detections in Canada have been reported from BC and ON, accounting for 75% of the influenza detections in Canada. A total of six jurisdictions have not reported any influenza cases. To date, 92% of influenza detections have been influenza A and the majority of those subtyped have been A(H3).
    Figure 3. Cumulative numbers of positive influenza specimens by type/subtype and province, Canada, 2015-16

    Note: Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
    Figure 3 - Text Description Among cases with reported age, the largest proportion was in those ≥65 years of age (48%) (Table 1). Compared to the previous year during the same period, a greater proportion of cases in the 20-44 and 45-64 age groups have been reported to date (40% this year vs 24% last year)
    Table 1 - Footnote 1 Table 1 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
    Return to Table 1 - Footnote1referrer
    Table 1 - Footnote 2 Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
    Return to Table 1 - Footnote2referrer
    Table 1 - Footnote UnS Unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
    Return to Table 1 - FootnoteUnSreferrer
    0 0 0 0 0 7 1 6 0 1 8 4.0%
    1 0 0 1 0 10 1 5 4 4 14 7.0%
    2 0 2 0 0 25 5 12 8 3 28 14.0%
    3 0 1 2 0 48 7 29 12 3 51 25.5%
    2 0 0 2 2 92 2 71 19 6 98 49.0%
    0 0 0 0 0 1 0 1 0 0 1 0.5%
    8 0 3 5 2 183 16 124 43 17 200 100.0%
    80.0% 0.0% 37.5% 62.5% 20.0% 91.5% 8.7% 67.8% 23.5% 8.5%
    For additional data on other respiratory virus detections see the Respiratory Virus Detections in Canada Report on the Public Health Agency of Canada website.
    Influenza-like Illness Consultation Rate

    The national influenza-like-illness (ILI) consultation rate increased from 22.3 consultations per 1,000 patient visits in week 41 to 31.4 per 1,000 visits in week 42. In week 42, the highest ILI consultation rate was found in the 0-4 age group and the lowest was found in the ≥65 years of age group (Figure 4).
    Figure 4. Influenza-like-illness (ILI) consultation rates by age group and week, Canada, 2015-16

    Delays in the reporting of data may cause data to change retrospectively. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. Not all sentinel physicians report every week.
    Figure 4 - Text Description Influenza Outbreak Surveillance

    In week 42, no new laboratory-confirmed outbreaks of influenza were reported (Figure 5). There was one outbreak of ILI reported in a school. To date this season, seven outbreaks have been reported, which is lower than the number of outbreaks reported last year at this time (n=11).
    Figure 5. Overall number of new laboratory-confirmed influenza outbreaksFigure 5 - Footnote1 by report week, Canada, 2015-2016

    Figure 5 - Footnote 1 All provinces and territories except NU report influenza outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
    Return to Figure 5 - Footnote1referrer
    Figure 5 - Text Description Sentinel Pediatric Hospital Influenza Surveillance

    Paediatric Influenza Hospitalizations and Deaths (IMPACT)

    To date this season, less than five laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations have been reported by the Immunization Monitoring Program Active (IMPACT) network. All hospitalized cases were due to influenza A. To date, less than five ICU admissions have been reported.
    Figure 6. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2015-16, Paediatric hospitalizations (≤16 years of age, IMPACT)

    Figure 6 - Text Description Figure 7. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2015-16 Paediatric hospitalizations (≤16 years of age, IMPACT)

    Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
    Figure 7 - Text Description Provincial/Territorial Influenza Hospitalizations and Deaths

    Since the start of the 2015-16 season, 37 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territoriesFootnote*. All but three hospitlaizations were due to influenza A. The majority (60%) of patients were ≥65 years of age. Four ICU admissions have been reported.
    Footnote * Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, and QC. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT networks. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting.
    Return to footnote*referrer
    Figure 8. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada 2015-16

    Figure 8 - Text Description See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2011-12 to 2015-16 on the Public Health Agency of Canada website.
    Influenza Strain Characterizations

    During the 2015-16 influenza season, the National Microbiology Laboratory (NML) has characterized 12 influenza viruses [8 A(H3N2), 1 A(H1N1) and 3 influenza B].
    Influenza A (H3N2): When tested by hemagglutination inhibition (HI), one H3N2 virus was antigenically characterized as A/Switzerland/9715293/2013-like using antiserum raised against cell-propagated A/Switzerland/9715293/2013.
    Sequence analysis was done on seven H3N2 viruses. All seven viruses belonged to a genetic group for which most viruses were antigenically related to A/Switzerland/9715293/2013.
    A/Switzerland/9715293/2013 is the A(H3N2) component of the Northern Hemisphere's vaccine.
    Influenza A (H1N1): One H1N1 virus characterized was antigenically similar to A/California/7/2009, the A(H1N1) component of the 2015-16 influenza vaccine.
    Influenza B: The three influenza B viruses characterized were antigenically similar to the vaccine strain B/Phuket/3073/2013.
    The recommended components for the 2015-2016 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an /Switzerland/9715293/2013(H3N2)-like virus, and a B/Phuket/3073/2013 -like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus is recommended.
    The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
    Antiviral Resistance

    During the 2015-16 season, the National Microbiology Laboratory (NML) has tested 17 influenza viruses for resistance to oseltamivir and zanamivir. All viruses were sensitive to zanamivir and oseltamivir. All influenza A viruses tested were resistant to amantadine (Table 2).
    Table 2 - Footnote * NA - not applicable
    Return to Table 2 - Footnote*referrer
    13 0 13 0 12 12 (100%)
    1 0 1 0 1 1 (100%)
    3 0 3 0 NA Table 2 - Footnote* NA Table 2 - Footnote*
    17 0 17 0 13 13
    .../
    http://www.healthycanadians.gc.ca/pu.../index-eng.php
    "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
    -Nelson Mandela

    Comment


    • #3
      FluWatch report: October 25 to October 31, 2015 (week 43)

      Overall Summary

      • Overall, Canada continues to experience low influenza activity, which is normally seen at this time of year
      • One new laboratory confirmed outbreak was reported in week 43.
      • So far this season, influenza A(H3N2) has been the most common subtype affecting Canadians – it is too early in the season to know if this is likely to continue.
      • To date, the majority of influenza laboratory detections and hospitalizations have been in seniors greater than 65 years of age.
      • For more information on the flu, see our Flu (influenza) web page.

      Download the alternative format
      (PDF format, 837 KB, 7 pages)
      Organization: Public Health Agency of Canada
      Date published: 2015-11-06

      Related Topics


      Are you a primary health care practitioner (General Practitioner, Nurse Practitioner or Registered Nurse) interested in becoming a FluWatch sentinel for the 2015-16 influenza season? Contact us at FluWatch@phac-aspc.gc.ca


      On this page

      Influenza/Influenza-like Illness Activity (geographic spread)

      In week 43, sporadic influenza activity was reported in a few regions across Canada (NS, QC, ON, AB and BC). One region in Ontario and two regions in BC reported localized activity. Overall, the majority of regions in Canada reported no influenza activity.
      Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 43




      Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the Flu Activity website.
      Figure 1 - Text Description Laboratory Confirmed Influenza Detections

      The percent positive for influenza detections increased from 0.88% in week 42 to 1.0% in week 43 (Figure 2).
      Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2015-16

      Figure 2 - Text Description There were 28 laboratory cases of influenza reported in week 43. The majority of influenza detections have been reported from BC and ON, accounting for 79% of the influenza detections in Canada. To date, 90% of influenza detections have been influenza A and the majority of those subtyped have been A(H3) (88%).
      Figure 3. Cumulative numbers of positive influenza specimens by type/subtype and province, Canada, 2015-16

      Note: Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
      Figure 3 - Text Description Among influenza cases with reported age, the largest proportion was in those ≥65 years of age (50%) (Table 1).
      Table 1 - Footnote 1 Table 1 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
      Return to Table 1 - Footnote1referrer
      Table 1 - Footnote 2 Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
      Return to Table 1 - Footnote2referrer
      Table 1 - Footnote UnS Unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
      Return to Table 1 - FootnoteUnSreferrer
      1 0 0 1 0 8 1 6 1 1 9 4.1%
      1 0 1 0 1 11 1 7 3 5 16 7.3%
      1 0 0 1 0 26 5 12 9 3 29 13.2%
      4 0 0 4 0 53 7 31 15 3 56 25.5%
      7 0 0 7 2 101 2 72 27 8 109 49.5%
      0 0 0 0 0 1 0 1 0 0 1 0.5%
      14 0 1 13 3 200 16 129 55 20 220 100.0%
      82.4% 0.0% 7.1% 92.9% 17.6% 90.9% 8.0% 64.5% 27.5% 9.1%
      For additional data on other respiratory virus detections see the Respiratory Virus Detections in Canada Report on the Public Health Agency of Canada website.
      Influenza-like Illness Consultation Rate

      The national influenza-like-illness (ILI) consultation rate decreased from 31.4 consultations per 1,000 patient visits in week 42 to 17.5 per 1,000 visits in week 43. In week 43, the highest ILI consultation rate was found in the 20-64 age group and the lowest was found in the ≥65 years of age group (Figure 4).
      Figure 4. Influenza-like-illness (ILI) consultation rates by age group and week, Canada, 2015-16

      Delays in the reporting of data may cause data to change retrospectively. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. Not all sentinel physicians report every week.
      Figure 4 - Text Description Influenza Outbreak Surveillance

      In week 43, one new laboratory-confirmed outbreak of influenza was reported in a long-term care facility (LTCF) (Figure 5). An additional two outbreaks of ILI were reported in schools. To date this season, eight outbreaks have been reported (6 of which occurred in LTCFs). Last year at this time, 14 outbreaks were reported (13 of which occurred in LTCFs).
      Figure 5. Overall number of new laboratory-confirmed influenza outbreaksFigure 5 - Footnote1 by report week, Canada, 2015-2016

      Figure 5 - Footnote 1 All provinces and territories except NU report influenza outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
      Return to Figure 5 - Footnote1referrer
      Figure 5 - Text Description Sentinel Pediatric Hospital Influenza Surveillance

      Paediatric Influenza Hospitalizations and Deaths (IMPACT)

      To date this season, six laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations have been reported by the Immunization Monitoring Program Active (IMPACT) network. Four hospitalized cases were due to influenza A and 2 cases were due to influenza B. To date, less than five ICU admissions have been reported.
      Figure 6. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2015-16, Paediatric hospitalizations (≤16 years of age, IMPACT)

      Figure 6 - Text Description Figure 7. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2015-16 Paediatric hospitalizations (≤16 years of age, IMPACT)

      Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
      Figure 7 - Text Description Provincial/Territorial Influenza Hospitalizations and Deaths

      Since the start of the 2015-16 season, 39 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territoriesFootnote*. All but four hospitlaizations were due to influenza A. The majority (56%) of patients were ≥65 years of age. Four ICU admissions have been reported.
      Footnote * Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, and QC. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT networks. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting.
      Return to footnote*referrer
      Figure 8. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada 2015-16

      Figure 8 - Text Description See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2011-12 to 2015-16 on the Public Health Agency of Canada website.
      Influenza Strain Characterizations

      During the 2015-16 influenza season, the National Microbiology Laboratory (NML) has characterized 22 influenza viruses [15 A(H3N2), 1 A(H1N1) and 6 influenza B].
      Influenza A (H3N2):When tested by hemagglutination inhibition (HI), one H3N2 virus was antigenically characterized as A/Switzerland/9715293/2013-like using antiserum raised against cell-propagated A/Switzerland/9715293/2013.
      Sequence analysis was done on 14 H3N2 viruses. All 14 viruses belonged to a genetic group for which most viruses were antigenically related to A/Switzerland/9715293/2013.
      A/Switzerland/9715293/2013 is the A(H3N2) component of the Northern Hemisphere's vaccine.
      Influenza A (H1N1): One H1N1 virus characterized was antigenically similar to A/California/7/2009, the A(H1N1) component of the 2015-16 influenza vaccine.
      Influenza B: The six influenza B viruses characterized were antigenically similar to the vaccine strain B/Phuket/3073/2013.
      The recommended components for the 2015-2016 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an /Switzerland/9715293/2013(H3N2)-like virus, and a B/Phuket/3073/2013 -like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus is recommended.
      The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.

      .../

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

      Comment


      • #4
        FluWatch report: November 1 to November 7, 2015 (week 44)

        Overall Summary

        • Overall, Canada continues to experience low influenza activity.
        • Two new laboratory confirmed outbreaks in the Atlantic region were reported in week 44.
        • So far this season, influenza A(H3N2) has been the most common subtype affecting Canadians.
        • To date, the majority of influenza laboratory detections and hospitalizations have been in seniors greater than 65 years of age.
        • For more information on the flu, see our Flu (influenza) web page.

        Download the alternative format
        (PDF format, 774 KB, 7 pages)
        Organization: Public Health Agency of Canada
        Date published: 2015-11-13

        Related Topics


        Are you a primary health care practitioner (General Practitioner, Nurse Practitioner or Registered Nurse) interested in becoming a FluWatch sentinel for the 2015-16 influenza season? Contact us at FluWatch@phac-aspc.gc.ca


        On this page

        Influenza/Influenza-like Illness Activity (geographic spread)

        In week 44, sporadic influenza activity was reported in a few regions across Canada (NS, ON, AB and BC). Overall, the majority of regions in Canada reported no influenza activity.
        Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 44




        Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available in the mapping feature found in the Weekly Influenza Reports.
        Figure 1 - Text Description Laboratory Confirmed Influenza Detections

        The percent positive for influenza detections increased from 0.88% in week 43 to 1.2% in week 44 (Figure 2).
        Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2015-16

        Figure 2 - Text Description In week 44, there were 40 laboratory detections of influenza reported (up from 28 detections reported in week 43). BC accounted for 53% (n=21) of the influenza detections in Canada in week 44. To date, 91% of influenza detections have been influenza A and the majority of those subtyped have been A(H3) (87%).
        Figure 3. Cumulative numbers of positive influenza specimens by type/subtype and province, Canada, 2015-16

        Note: Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
        Figure 3 - Text Description Among influenza cases with reported age, the largest proportion was in those ≥65 years of age (49%) (Table 1).
        Table 1 - Footnote 1 Table 1 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
        Return to Table 1 - Footnote1referrer
        Table 1 - Footnote 2 Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
        Return to Table 1 - Footnote2referrer
        Table 1 - Footnote UnS Unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
        Return to Table 1 - FootnoteUnSreferrer
        2 0 0 2 1 10 1 7 2 2 12 4.9%
        3 0 1 2 1 14 1 8 5 6 20 8.1%
        1 0 0 1 0 28 5 14 9 4 32 13.0%
        4 1 1 2 1 58 9 36 13 4 62 25.1%
        9 2 5 2 0 112 5 86 21 8 120 48.6%
        0 0 0 0 0 1 0 1 0 0 1 0.4%
        19 3 7 9 3 223 21 152 50 24 247 100.0%
        86.4% 15.8% 36.8% 47.4% 13.6% 90.3% 9.4% 68.2% 22.4% 9.7%
        For additional data on other respiratory virus detections see the Respiratory Virus Detections in Canada Report on the Public Health Agency of Canada website.
        Influenza-like Illness Consultation Rate

        The national influenza-like-illness (ILI) consultation rate increased from 17.8 consultations per 1,000 patient visits in week 43 to 33.9 per 1,000 visits in week 44. In week 44, the highest ILI consultation rate was found in the 5-19 age group and the lowest was found in the ≥65 years of age group (Figure 4).
        Figure 4. Influenza-like-illness (ILI) consultation rates by age group and week, Canada, 2015-16

        Delays in the reporting of data may cause data to change retrospectively. In BC, AB, and SK, data are compiled by a provincial sentinel surveillance program for reporting to FluWatch. Not all sentinel physicians report every week.
        Figure 4 - Text Description Influenza Outbreak Surveillance

        In week 44, two new laboratory-confirmed outbreaks of influenza were reported. One outbreak was reported in a long-term care facility (LTCF) and the other in an institutional or community setting (Figure 5). An additional two outbreaks of ILI were reported in schools. To date this season, ten outbreaks have been reported (seven of which occurred in LTCFs). Last year at this time, 15 outbreaks were reported (14 of which occurred in LTCFs).
        Figure 5. Overall number of new laboratory-confirmed influenza outbreaksFigure 5 - Footnote1 by report week, Canada, 2015-2016

        Figure 5 - Footnote 1 All provinces and territories except NU report influenza outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
        Return to Figure 5 - Footnote1referrer
        Figure 5 - Text Description Sentinel Pediatric Hospital Influenza Surveillance

        Paediatric Influenza Hospitalizations and Deaths

        To date this season, nine laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations have been reported by the Immunization Monitoring Program Active (IMPACT) network. Six hospitalized cases were due to influenza A and three cases were due to influenza B. To date, less than five intensive care unit (ICU) admissions have been reported.
        Figure 6. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2015-16, Paediatric hospitalizations (≤16 years of age, IMPACT)

        Figure 6 - Text Description Figure 7. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2015-16 paediatric hospitalizations (≤16 years of age, IMPACT)

        Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
        Figure 7 - Text Description Provincial/Territorial Influenza Hospitalizations and Deaths

        Since the start of the 2015-16 season, 47 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territoriesFootnote*; all but 6 with influenza A. Among cases for which the subtype of influenza A was reported, 76% (16/21) were A(H3). The majority (55%) of patients were ≥65 years of age. Five ICU admissions and two deaths have been reported. Both deaths reported were in adults.
        Footnote * Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, and QC. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT networks. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting.
        Return to footnote*referrer
        Figure 8. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada 2015-16

        Figure 8 - Text Description See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2011-12 to 2015-16 on the Public Health Agency of Canada website.
        Influenza Strain Characterizations

        During the 2015-16 influenza season, the National Microbiology Laboratory (NML) has characterized 30 influenza viruses [22 A(H3N2), 1 A(H1N1) and 7 influenza B].
        Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assays, one H3N2 virus was antigenically characterized as A/Switzerland/9715293/2013-like using antiserum raised against cell-propagated A/Switzerland/9715293/2013.
        Sequence analysis was done on 21 H3N2 viruses. All 21 viruses belonged to a genetic group for which most viruses were antigenically related to A/Switzerland/9715293/2013.
        A/Switzerland/9715293/2013 is the A(H3N2) component of the 2015-16 Northern Hemisphere's vaccine.
        Influenza A (H1N1): One H1N1 virus characterized was antigenically similar to A/California/7/2009, the A(H1N1) component of the 2015-16 influenza vaccine.
        Influenza B: Six influenza B viruses characterized were antigenically similar to the vaccine strain B/Phuket/3073/2013. One influenza B virus was characterized as B/Brisbane/60/2008-like, one of the influenza B components of the 2015-16 Northern Hemisphere quadrivalent influenza vaccine.
        The recommended components for the 2015-2016 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an /Switzerland/9715293/2013(H3N2)-like virus, and a B/Phuket/3073/2013 -like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus (Victoria lineage) is recommended.
        The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition testing compared to the reference influenza strains recommended by WHO.


        .../
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        "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
        -Nelson Mandela

        Comment


        • #5
          --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

          FluWatch report: January 3, 2016 - January 9, 2016 (week 01)

          Overall Summary
          • Overall, in week 01, seasonal influenza activity increased in Canada.
          • Laboratory detections of influenza increased but remain below expected levels for this time of the year.
          • In week 01, there was an increase in the number of laboratory detections and hospitalizations associated with influenza A(H1N1).
          • To date, the majority of influenza laboratory detections and hospitalizations have been in seniors greater than 65 years of age.
          • For more information on the flu, see our Flu(influenza) web page.
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          Organization: Public Health Agency of Canada
          Date published: 2016-01-15

          Related Topics

          Are you a primary health care practitioner (General Practitioner, Nurse Practitioner or Registered Nurse) interested in becoming a FluWatch sentinel for the 2015-16 influenza season? Contact us at FluWatch@phac-aspc.gc.ca


          On this pageInfluenza/Influenza-like Illness Activity (geographic spread)

          In week 01, 25 regions across Canada reported sporadic influenza/ILI activity. Localized activity was reported in four regions in Canada (two in ON, one each in AB and NL).
          Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 01




          Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available in the mapping feature found in the Weekly Influenza Reports.
          Figure 1 - Text Description Laboratory Confirmed Influenza Detections

          Laboratory confirmed influenza detections continue to increase steadily. The percent positive for influenza increased from 4.3% in week 52 to 6.0% in week 01 (Figure 2). Compared to the previous five seasons, the percent positive (6.0%) reported in week 01 was below the five year average for that week and below expected levels (range 14.3%-33.2%).
          Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2015-16

          Figure 2 - Text Description In week 01, there were 306 positive influenza tests reported. Similar to the previous two weeks, the majority of subtyped influenza A viruses detected in Canada were influenza A(H1N1). Influenza A(H1N1) was the most common influenza A subtype detected in AB, SK, ON, NB, and PE in week 01. To date, 83% of influenza detections have been influenza A and among those subtyped approximately half have been influenza A(H3N2) [52% (344/659)].
          Figure 3. Cumulative numbers of positive influenza specimens by type/subtype and province, Canada, 2015-16

          Note: Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
          Figure 3 - Text Description To date this season, detailed information on age and type/subtype has been received for 864 cases. Adults aged 65 years and older accounted for 35% of reported influenza cases (Table 1). Adults aged 65 years and older also represented 47% of reported A(H3N2) cases. Adults aged 20-44 years represented 27% of reported influenza A(H1N1) cases and 24% of reported influenza B cases.
          Table 1 - Footnote 1 Table 1 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
          Return to Table 1 - Footnote1referrer
          Table 1 - Footnote 2 Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
          Return to Table 1 - Footnote2referrer
          Table 1 - Footnote UnS Unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
          Return to Table 1 - FootnoteUnSreferrer
          11 3 0 8 5 80 29 24 27 20 100 11.6%
          12 1 3 8 5 60 10 30 20 44 104 12.0%
          26 2 3 21 12 118 33 44 41 45 163 18.9%
          18 0 1 17 9 155 31 70 54 38 193 22.3%
          23 1 3 19 6 260 16 147 97 40 300 34.7%
          1 1 0 0 0 3 2 1 0 1 4 0.5%
          91 8 10 73 37 676 121 316 239 188 864 100.0%
          71.1% 8.8% 11.0% 80.2% 28.9% 78.2% 17.9% 46.7% 35.4% 21.8%
          For additional data on other respiratory virus detections see the Respiratory Virus Detections in Canada Report on the Public Health Agency of Canada website.
          Influenza-like Illness Consultation Rate

          The national ILI consultation rate decreased from the previous week from 41.5 per 1,000 patient visits in week 52, to 28.4 per 1,000 patient visits in week 01. In week 01, the highest ILI consultation rate was found in those 0-4 years (62.5 per 1,000) of age and the lowest was found in the ≥65 years age group (Figure 4).
          Figure 4. Influenza-like-illness (ILI) consultation rates by age group and week, Canada, 2015-16

          Delays in the reporting of data may cause data to change retrospectively. In BC, AB, and SK, data are compiled by a provincial sentinel surveillance program for reporting to FluWatch. Not all sentinel physicians report every week.
          Figure 4 - Text Description Influenza Outbreak Surveillance

          In week 01, three new laboratory confirmed influenza outbreaks were reported. Two outbreaks were reported in long-term care facilities (LTCF) and one was due to influenza A. The other outbreak was reported in a institutional or community setting. To date this season, 36 outbreaks have been reported (17 of which occurred in LTCFs). In comparison, at week 01 in the 2014-15 season, 601 outbreaks were reported (471 of which occurred in LTCFs) and in the 2013-14 season, 34 outbreaks were reported (28 of which occurred in LTCFs).
          Figure 5. Overall number of new laboratory-confirmed influenza outbreaksFigure 5 - Footnote1 by report week, Canada, 2015-2016

          Figure 5 - Footnote 1 All provinces and territories except NU report influenza outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
          Return to Figure 5 - Footnote1referrer
          Figure 5 - Text Description Sentinel Pediatric Hospital Influenza Surveillance

          Paediatric Influenza Hospitalizations and Deaths

          In week 01, sixteen hospitalizations were reported by the the Immunization Monitoring Program Active (IMPACT) network (Figure 6). Eight hospitalizations were due to influenza A(H1N1) (50%).
          To date this season, 54 laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations have been reported by the IMPACT network. Forty-three hospitalized cases were due to influenza A and eleven cases were due to influenza B. The majority of hospitalized cases were among children aged 2-4 years (53%). Additionally, not included in Table 2 and Figure 6, two cases were due to co-infections of influenza A and B. To date, seven intensive care unit (ICU) admissions and less than five influenza-associated deaths have been reported.
          Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
          Data suppressed due to small values
          Figure 6. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2015-16, paediatric and adult hospitalizations (≤16 years of age, IMPACT; ≥16 years of age, CIRN-SOS)

          Figure 6 - Text Description Adult Influenza Hospitalizations and Deaths

          In week 01, sixteen hospitalizations were reported by the Canadian Immunization Research Network Serious Outcome Surveillance (CIRN-SOS),up from eight hospitalizations reported in week 52 (Figure 6). The majority of hospitalizations were in adults ≥65 years of age (63%) and due to influenza A (63%).
          To date this season, 41 laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations have been reported by CIRN-SOS. The majority of hospitalized cases were due to influenza A (78%) and were among adults ≥65 years of age (54%). One intensive care unit (ICU) admission has been reported. No deaths have been reported.
          Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
          1 1 0 0 0 1 (2%)
          4 1 0 3 4 8 (20%)
          8 0 1 7 2 10 (24%)
          19 1 7 11 3 22 (54%)
          32 3 8 21 9 41
          78% 9% 25% 66% 22% 100%
          Figure 7. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group (≥16 year of age), Canada 2015-16

          Figure 7 - Text Description Provincial/Territorial Influenza Hospitalizations and Deaths

          In week 01, 40 hospitalizations have been reported from participating provinces and territoriesFootnote*. The majority of hospitalizations were in adults ≥65 years of age (30%); however, the 0-4 age group and 45-64 age group followed closely representing 28% and 25% of hospitalizations respectively. Influenza A(H1N1) accounted for 60% of hospitalizations and among influenza A(H1N1) hospitalizations, nine (38%) were among children aged 0-4.
          Since the start of the 2015-16 season, 201 laboratory-confirmed influenza-associated hospitalizations have been reported. One hundred and seventy-six hospitalizations (88%) were due to influenza A and twenty-five (12%) were due to influenza B. Among cases for which the subtype of influenza A was reported, 53% (40/96) were influenza A(H1N1). The majority (43%) of hospitalized cases were ≥65 years of age. Eighteen ICU admissions and ten deaths have been reported.
          Figure 8. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada 2015-16

          Figure 8 - Text Description Footnote * Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, and QC. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT networks. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting.
          Return to footnote*referrer
          See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2011-12 to 2015-16 on the Public Health Agency of Canada website.
          Influenza Strain Characterizations

          During the 2015-16 influenza season, the National Microbiology Laboratory (NML) has characterized 156 influenza viruses [86 A(H3N2), 39 A(H1N1) and 31 influenza B].
          Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assays, eight H3N2 virus were antigenically characterized as A/Switzerland/9715293/2013-like using antiserum raised against cell-propagated A/Switzerland/9715293/2013.
          Sequence analysis was done on 78 H3N2 viruses. All viruses belonged to a genetic group for which most viruses were antigenically related to A/Switzerland/9715293/2013.
          A/Switzerland/9715293/2013 is the A(H3N2) component of the 2015-16 Northern Hemisphere's vaccine.
          Influenza A (H1N1): Thirty-nine H1N1 viruses characterized were antigenically similar to A/California/7/2009, the A(H1N1) component of the 2015-16 influenza vaccine.
          Influenza B: Twenty influenza B viruses characterized were antigenically similar to the vaccine strain B/Phuket/3073/2013. Eleven influenza B viruses were characterized as B/Brisbane/60/2008-like, one of the influenza B components of the 2015-16 Northern Hemisphere quadrivalent influenza vaccine.
          The recommended components for the 2015-2016 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an /Switzerland/9715293/2013(H3N2)-like virus, and a B/Phuket/3073/2013 -like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus (Victoria lineage) is recommended.
          The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition testing compared to the reference influenza strains recommended by WHO.
          Antiviral Resistance

          During the 2015-16 season, the National Microbiology Laboratory (NML) has tested 152 influenza viruses for resistance to oseltamivir and 151 influenza viruses for zanamivir. All viruses were sensitive to zanamivir and oseltamivir. A total of 113 influenza A viruses (99%) were resistant to amantadine (Table 4).
          Table 4 - Footnote * NA - not applicable
          Return to Table 4 - Footnote*referrer
          79 0 79 0 86 85 (98.8%)
          40 0 39 0 28 28 (100%)
          33 0 33 0 NA Table 4 - Footnote* NA Table 4 - Footnote*
          152 0 151 0 114 113
          .../
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          "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
          -Nelson Mandela

          Comment


          • #6
            FluWatch report: January 10, 2016 - January 16, 2016 (week 02)

            Overall Summary

            • Overall in week 02, seasonal influenza activity was similar to the previous week.
            • Laboratory detections of influenza slightly increased but remain below expected levels for this time of the year.
            • To date, the majority of influenza laboratory detections and hospitalizations have been in seniors greater than 65 years of age.
            • During week 02, influenza A was the most frequently reported virus type reported, with influenza A(H1N1) predominating.
            • For more information on the flu, see our Flu(influenza) web page.

            Download the alternative format
            (PDF format, 1.01 MB, 8 pages)
            Organization: Public Health Agency of Canada
            Date published: 2016-01-22

            Related Topics


            Are you a primary health care practitioner (General Practitioner, Nurse Practitioner or Registered Nurse) interested in becoming a FluWatch sentinel for the 2015-16 influenza season? Contact us at FluWatch@phac-aspc.gc.ca


            On this page

            Influenza/Influenza-like Illness Activity (geographic spread)

            In week 02, 24 regions across Canada reported sporadic influenza/ILI activity. Localized activity was reported in three regions in Canada (AB and two in ON).
            Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 02




            Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available in the mapping feature found in the Weekly Influenza Reports.
            Figure 1 - Text Description Laboratory Confirmed Influenza Detections

            Laboratory confirmed influenza detections continue to increase steadily. The percent positive for influenza increased from 6.0% in week 01 to 7.2% in week 02 (Figure 2). Compared to the previous five seasons, the percent positive (7.2%) reported in week 02 was below the five year average for that week and below expected levels (range 13.5%-30.6%).
            Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2015-16

            Figure 2 - Text Description In week 02, there were 355 positive influenza tests reported. Similar to previous weeks, influenza A was the most frequently detected influenza type nationally with influenza A(H1N1) the most common subtype detected.The majority of influenza detections were reported from Western Canada, where BC and AB accounted for 71% of influenza detections in Canada in week 02. To date, 82% of influenza detections have been influenza A and among those subtyped over half have been influenza A(H1N1) [55% (473/859)].
            Figure 3. Cumulative numbers of positive influenza specimens by type/subtype and province, Canada, 2015-16

            Note: Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
            Figure 3 - Text Description To date this season, detailed information on age and type/subtype has been received for 1,056 cases. Adults aged 65 years and older accounted for 31% of reported influenza cases (Table 1). Adults aged 65 years and older also represented 46% of reported A(H3N2) cases. Adults aged 20-44 years represented 26% of reported influenza A(H1N1) cases and 27% of reported influenza B cases.
            Table 1 - Footnote 1 Table 1 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
            Return to Table 1 - Footnote1referrer
            Table 1 - Footnote 2 Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
            Return to Table 1 - Footnote2referrer
            Table 1 - Footnote UnS Unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
            Return to Table 1 - FootnoteUnSreferrer
            12 4 0 8 7 93 35 25 33 28 121 11.5%
            14 1 2 11 11 77 14 37 26 59 136 12.9%
            35 2 2 31 20 155 39 50 66 71 226 21.4%
            25 1 2 22 12 182 35 79 68 52 234 22.2%
            16 1 6 9 12 279 25 163 91 53 332 31.4%
            3 2 1 0 0 6 4 2 0 1 7 0.7%
            105 11 13 81 62 792 152 356 284 264 1056 100.0%
            62.9% 10.5% 12.4% 77.1% 37.1% 75.0% 19.2% 44.9% 35.9% 25.0%
            For additional data on other respiratory virus detections see the Respiratory Virus Detections in Canada Report on the Public Health Agency of Canada website.
            Influenza-like Illness Consultation Rate

            The national ILI consultation rate decreased from the previous week from 28.4 per 1,000 patient visits in week 01, to 12.5 per 1,000 patient visits in week 02. In week 02, the highest ILI consultation rate was found in those 5-19 years of age (15.1 per 1,000) and the lowest was found in the ≥65 years age group (4.9 per 1,000) (Figure 4).
            Figure 4. Influenza-like-illness (ILI) consultation rates by age group and week, Canada, 2015-16

            Delays in the reporting of data may cause data to change retrospectively. In BC, AB, and SK, data are compiled by a provincial sentinel surveillance program for reporting to FluWatch. Not all sentinel physicians report every week.
            Figure 4 - Text Description Influenza Outbreak Surveillance

            In week 02, two new laboratory confirmed influenza outbreaks were reported in long-term care facilities (LTCF). One outbreak was due to influenza A(H3N2) and the other was unknown. To date this season, 39 outbreaks have been reported (19 of which occurred in LTCFs). In comparison, at week 02 in the 2014-15 season, 796 outbreaks were reported (623 of which occurred in LTCFs) and in the 2013-14 season, 48 outbreaks were reported (28 of which occurred in LTCFs).
            Figure 5. Overall number of new laboratory-confirmed influenza outbreaksFigure 5 - Footnote1 by report week, Canada, 2015-2016

            Figure 5 - Footnote 1 All provinces and territories except NU report influenza outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
            Return to Figure 5 - Footnote1referrer
            Figure 5 - Text Description Sentinel Pediatric Hospital Influenza Surveillance

            Paediatric Influenza Hospitalizations and Deaths

            In week 02, fourteen hospitalizations were reported by the the Immunization Monitoring Program Active (IMPACT) network (Figure 6). Five hospitalizations were due to influenza A(H1N1) (36%) and seven were due to influenza B (50%).
            To date this season, 70 laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations have been reported by the IMPACT network. Fifty-one hospitalized cases were due to influenza A and nineteen cases were due to influenza B. Additionally, not included in Table 2 and Figure 6, two cases were due to co-infections of influenza A and B. The majority of hospitalized cases were among children aged 2-4 years (37%).To date, eight intensive care unit (ICU) admissions and less than five influenza-associated deaths have been reported.
            Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
            7 0 1 6 3
            12 6 3 3 4
            19 8 2 9 7
            7 4 0 3 4
            6 1 1 4 1
            Figure 6. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2015-16, paediatric and adult hospitalizations (≤16 years of age, IMPACT; ≥16 years of age, CIRN-SOS)

            Figure 6 - Text Description Adult Influenza Hospitalizations and Deaths

            In week 02, ten hospitalizations were reported by the Canadian Immunization Research Network Serious Outcome Surveillance (CIRN-SOS) (Figure 6). The majority of hospitalizations were in adults 45-64 years of age (50%) and due to influenza A (90%).
            To date this season, 53* laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations have been reported by CIRN-SOS. The majority of hospitalized cases were due to influenza A (78%) and were among adults ≥65 years of age (49%). Two intensive care unit (ICU) admissions have been reported. No deaths have been reported.
            Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
            1 1 0 0 0 1 (2%)
            4 1 0 3 5 9 (17%)
            13 0 1 12 3 16 (31%)
            23 1 7 15 3 26 (50%)
            41 3 8 30 11 52
            79% 7% 20% 73% 21% 100%
            Figure 7. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group (≥16 year of age), Canada 2015-16

            Figure 7 - Text Description Provincial/Territorial Influenza Hospitalizations and Deaths

            In week 02, 36 hospitalizations have been reported from participating provinces and territoriesFootnote*. The majority of hospitalizations were in adults ≥65 years of age (40%). Influenza A(H1N1) accounted for 64% of hospitalizations and among influenza A(H1N1) hospitalizations, 30% of those were 20-44 yrs and ≥65 years of age.
            Since the start of the 2015-16 season, 274 laboratory-confirmed influenza-associated hospitalizations have been reported. Two hundred and forty hospitalizations (88%) were due to influenza A and 34 (12%) were due to influenza B. Among cases for which the subtype of influenza A was reported, 65% (101/156) were influenza A(H1N1). The majority (40%) of hospitalized cases were ≥65 years of age. Twenty-eight ICU admissions and 12 deaths have been reported.
            Figure 8. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada 2015-16

            Figure 8 - Text Description Footnote * Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, and QC. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT networks. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting.
            Return to footnote*referrer
            See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2011-12 to 2015-16 on the Public Health Agency of Canada website.
            Influenza Strain Characterizations

            During the 2015-16 influenza season, the National Microbiology Laboratory (NML) has characterized 184 influenza viruses [95 A(H3N2), 55 A(H1N1) and 34 influenza B].
            When tested by hemagglutination inhibition (HI) assays, twelve H3N2 virus were antigenically characterized as A/Switzerland/9715293/2013-like using antiserum raised against cell-propagated A/Switzerland/9715293/2013.
            Sequence analysis was done on 83 H3N2 viruses. All viruses belonged to a genetic group for which most viruses were antigenically related to A/Switzerland/9715293/2013.
            A/Switzerland/9715293/2013 is the A(H3N2) component of the 2015-16 Northern Hemisphere's vaccine.
            Influenza A (H1N1): Fifty-five H1N1 viruses characterized were antigenically similar to A/California/7/2009, the A(H1N1) component of the 2015-16 influenza vaccine.
            Influenza B: Twenty-two influenza B viruses characterized were antigenically similar to the vaccine strain B/Phuket/3073/2013. Twelve influenza B viruses were characterized as B/Brisbane/60/2008-like, one of the influenza B components of the 2015-16 Northern Hemisphere quadrivalent influenza vaccine.
            The recommended components for the 2015-2016 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an /Switzerland/9715293/2013(H3N2)-like virus, and a B/Phuket/3073/2013 -like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus (Victoria lineage) is recommended.
            The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition testing compared to the reference influenza strains recommended by WHO.

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

            Comment


            • #7
              FluWatch report: January 17, 2016 - January 23, 2016 (week 03)

              Overall Summary

              • Overall in week 03, seasonal influenza activity increased from the previous week but remains below expected levels for this time of the year.
              • Hospitalizations among the pediatric population increased in week 03.
              • Influenza A(H1N1) is the most common influenza subtype circulating in Canada.
              • Influenza strains characterized by the National Microbiology Laboratory this season appear to be a good match to the World Health Organization's recommended vaccine strains.
              • For more information on the flu, see our Flu(influenza) web page.

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              Organization: Public Health Agency of Canada
              Date published: 2016-01-29

              Related Topics


              Are you a primary health care practitioner (General Practitioner, Nurse Practitioner or Registered Nurse) interested in becoming a FluWatch sentinel for the 2015-16 influenza season? Contact us at FluWatch@phac-aspc.gc.ca


              On this page

              Influenza/Influenza-like Illness Activity (geographic spread)

              In week 03, influenza/ILI activity increased in Canada. A total of 27 regions across Canada reported sporadic influenza/ILI activity. Localized activity was reported in six regions in Canada (one each in BC, AB and NS, and three in ON).
              Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 03




              Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available in the mapping feature found in the Weekly Influenza Reports.
              Figure 1 - Text Description Laboratory Confirmed Influenza Detections

              Laboratory confirmed influenza detections continue to increase steadily. The percent positive for influenza increased from 7.0% in week 02 to 12.4% in week 03 (Figure 2). Compared to the previous five seasons, the percent positive (12.4%) reported in week 03 was below the five year average for that week and below expected levels (range 13.2%-29.7%).
              Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2015-16

              Figure 2 - Text Description In week 03, there were 594 positive influenza tests reported. Influenza A(H1N1) was the most common subtype detected. The majority of influenza detections were reported from Western Canada, where BC and AB accounted for 69% of influenza detections in Canada in week 03. To date, 79% of influenza detections have been influenza A and among those subtyped, the majority have been influenza A(H1N1) [63% (744/1186)].
              Figure 3. Cumulative numbers of positive influenza specimens by type/subtype and province, Canada, 2015-16

              Note: Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
              Figure 3 - Text Description To date this season, detailed information on age and type/subtype has been received for 1,435 cases. Adults aged 65 years and older accounted for 27% of reported influenza cases (Table 1). Adults aged 65 years and older also represented 44% of reported A(H3N2) cases. Adults aged 20-44 years represented 26% of reported influenza A(H1N1) cases and 29% of reported influenza B cases.
              Table 1 - Footnote 1 Table 1 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
              Return to Table 1 - Footnote1referrer
              Table 1 - Footnote 2 Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
              Return to Table 1 - Footnote2referrer
              Table 1 - Footnote UnS Unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
              Return to Table 1 - FootnoteUnSreferrer
              43 12 2 29 7 146 58 30 58 38 184 12.8%
              21 5 1 15 44 107 30 45 32 115 222 15.5%
              63 13 6 44 38 219 66 65 88 117 336 23.4%
              33 5 2 26 13 230 61 89 80 68 298 20.8%
              28 3 8 17 11 316 31 180 105 71 387 27.0%
              1 1 0 0 0 7 5 2 0 1 8 0.6%
              189 39 19 131 113 1025 251 411 363 410 1435 100.0%
              62.6% 20.6% 10.1% 69.3% 37.4% 71.4% 24.5% 40.1% 35.4% 28.6%
              For additional data on other respiratory virus detections see the Respiratory Virus Detections in Canada Report on the Public Health Agency of Canada website.
              Influenza-like Illness Consultation Rate

              The national ILI consultation rate increased from the previous week from 12.5 per 1,000 patient visits in week 02, to 15.6 per 1,000 patient visits in week 03. In week 03, the highest ILI consultation rate was found in those 0-4 years of age (26.9 per 1,000) and the lowest was found in the ≥65 years age group (2.7 per 1,000) (Figure 4).
              Figure 4. Influenza-like-illness (ILI) consultation rates by age group and week, Canada, 2015-16

              Delays in the reporting of data may cause data to change retrospectively. In BC, AB, and SK, data are compiled by a provincial sentinel surveillance program for reporting to FluWatch. Not all sentinel physicians report every week.
              Figure 4 - Text Description Influenza Outbreak Surveillance

              In week 03, six new laboratory confirmed influenza outbreaks: four in long-term care facilities (LTCF), one in a hospital and one in an institutional or community setting. Two outbreaks were due to influenza B, one outbreak was due to influenza A (UnS) and the remainder were unknown. To date this season, 46 outbreaks have been reported (23 of which occurred in LTCFs). In comparison, at week 03 in the 2014-15 season, 941 outbreaks were reported (741 of which occurred in LTCFs) and in the 2013-14 season, 60 outbreaks were reported (33 of which occurred in LTCFs).
              Figure 5. Overall number of new laboratory-confirmed influenza outbreaksFigure 5 - Footnote1 by report week, Canada, 2015-2016

              Figure 5 - Footnote 1 All provinces and territories except NU report influenza outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
              Return to Figure 5 - Footnote1referrer
              Figure 5 - Text Description Sentinel Pediatric Hospital Influenza Surveillance

              Paediatric Influenza Hospitalizations and Deaths

              In week 03, 24 hospitalizations were reported by the the Immunization Monitoring Program Active (IMPACT) network (Figure 6). Nine hospitalizations were due to influenza A(H1N1) (38%), five were due to influenza B (21%) and the remainder were influenza A (UnS).
              To date this season, 94 laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations have been reported by the IMPACT network. Seventy-one hospitalized cases were due to influenza A and 23 cases were due to influenza B. The majority of hospitalized cases were among children aged 2-4 years (32%). To date, 13 intensive care unit (ICU) admissions have been reported. The majority of ICU admissions were reported in children 2-4 years (46%) and due to influenza A(H1N1) (38%). Less than five influenza-associated deaths have been reported.
              11 2 2 7 5 16 (17%)
              17 9 3 5 4 21 (22%)
              24 10 2 12 6 30 (32%)
              10 4 0 6 6 16 (17%)
              10 4 0 6 6 11 (12%)
              71 28 8 35 23 94 (100%)
              Figure 6. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2015-16, paediatric and adult hospitalizations (≤16 years of age, IMPACT; ≥16 years of age, CIRN-SOS)

              Not included in Table 2 and Figure 6 are two IMPACT cases that were due to co-infections of influenza A and B.
              Figure 6 - Text Description Adult Influenza Hospitalizations and Deaths

              In week 03, 15 hospitalizations were reported by the Canadian Immunization Research Network Serious Outcome Surveillance (CIRN-SOS). The majority of hospitalizations were in adults 45-64 years of age (47%) and due to influenza A (73%).
              To date this season, 71 laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations have been reported by CIRN-SOS (Table 3). The majority of hospitalized cases were due to influenza A (77%) and were among adults ≥65 years of age (49%). Five intensive care unit (ICU) admissions have been reported and among those, four (80%) were due to influenza A. No deaths have been reported.
              1 1 0 0 0 1 (1%)
              4 1 0 3 7 11 (15%)
              17 3 2 12 5 22 (31%)
              32 2 12 18 3 35 (49%)
              1 0 0 1 1 2 (3%)
              55 7 14 34 16 71
              77% 13% 25% 62% 23% 100%
              Figure 7. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group (≥16 year of age), Canada 2015-16

              Note: The number of hospitalizations reported through CIRN-SOS and IMPACT represents a subset of all influenza-associated adult and paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
              Figure 7 - Text Description Provincial/Territorial Influenza Hospitalizations and Deaths

              In week 03, 51 hospitalizations have been reported from participating provinces and territoriesFootnote*. The majority of hospitalizations were due to influenza A (86%) and reported in the 0-4 years age group (35%).
              Since the start of the 2015-16 season, 343 laboratory-confirmed influenza-associated hospitalizations have been reported. Two hundred and ninety-nine hospitalizations (87%) were due to influenza A and 44 (13%) were due to influenza B. Among cases for which the subtype of influenza A was reported, 69% (129/187) were influenza A(H1N1). The majority (37%) of hospitalized cases were ≥65 years of age. Thirty-two ICU admissions have been reported of which 26 (82%) were due to influenza A and 12 (38%) were in the 45-64 age group. A total of 14 deaths have been reported, all due to influenza A.
              Figure 8. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada 2015-16

              Figure 8 - Text Description Footnote * Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, and QC. Only hospitalizations that require intensive medical care are reported by SK. ICU admissions are not distinguished among hospital admissions reported from ON. Data may also include cases reported by the IMPACT networks. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from ON that occurred in previous weeks, as a result of retrospective updates to the cumulative total. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting.
              Return to footnote*referrer
              See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2011-12 to 2015-16 on the Public Health Agency of Canada website.
              Influenza Strain Characterizations

              During the 2015-16 influenza season, the National Microbiology Laboratory (NML) has characterized 234 influenza viruses [100 A(H3N2), 94 A(H1N1) and 40 influenza B].
              Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assays, twelve H3N2 virus were antigenically characterized as A/Switzerland/9715293/2013-like using antiserum raised against cell-propagated A/Switzerland/9715293/2013.
              Sequence analysis was done on 88 H3N2 viruses. All viruses belonged to a genetic group for which most viruses were antigenically related to A/Switzerland/9715293/2013.
              A/Switzerland/9715293/2013 is the A(H3N2) component of the 2015-16 Northern Hemisphere's vaccine.
              Influenza A (H1N1): Ninety-four H1N1 viruses characterized were antigenically similar to A/California/7/2009, the A(H1N1) component of the 2015-16 influenza vaccine.
              Influenza B: Twenty-five influenza B viruses characterized were antigenically similar to the vaccine strain B/Phuket/3073/2013. Fifteen influenza B viruses were characterized as B/Brisbane/60/2008-like, one of the influenza B components of the 2015-16 Northern Hemisphere quadrivalent influenza vaccine.
              The recommended components for the 2015-2016 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an /Switzerland/9715293/2013(H3N2)-like virus, and a B/Phuket/3073/2013 -like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus (Victoria lineage) is recommended.
              The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition testing compared to the reference influenza strains recommended by WHO.

              .../

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

              Comment


              • #8
                FluWatch report: January 24, 2016 - January 30, 2016 (week 04)

                Overall Summary

                • Overall in week 04, seasonal influenza activity increased from the previous week. Laboratory detections remain lower than average but are now within expected levels for this time of the year.
                • An increase in the number of outbreaks was reported in week 04 with the majority due to influenza A.
                • Influenza A(H1N1) is the most common influenza subtype circulating in Canada.
                • Influenza strains characterized by the National Microbiology Laboratory this season appear to be a good match to the World Health Organization’s recommended vaccine strains.
                • For more information on the flu, see our Flu(influenza) web page.

                Download the alternative format
                (PDF format, 916 KB, 8 pages)
                Organization: Public Health Agency of Canada
                Date published: 2016-02-05

                Related Topics


                Are you a primary health care practitioner (General Practitioner, Nurse Practitioner or Registered Nurse) interested in becoming a FluWatch sentinel for the 2015-16 influenza season? Contact us at FluWatch@phac-aspc.gc.ca


                On this page

                Influenza/Influenza-like Illness Activity (geographic spread)

                In week 04, influenza/ILI activity continued to increase in Canada. A total of 17 regions across Canada reported sporadic influenza/ILI activity. Localized activity was reported in 12 regions in Canada (one in YK, two in BC, three in AB, two in MB, three in ON and one in NS).
                Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 04




                Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available in the mapping feature found in the Weekly Influenza Reports.
                Figure 1 - Text Description Laboratory Confirmed Influenza Detections

                Laboratory confirmed influenza detections continued to increase. The percent positive for influenza increased from 12.1% in week 03 to 16.0% in week 04 (Figure 2). Compared to the previous five seasons, the percent positive (16.0%) reported in week 04 was below the five year average for that week but within expected levels (range 12.4%-26.4%).
                Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2015-16

                Figure 2 - Text Description In week 04, there were 895 positive influenza tests reported. Influenza A(H1N1) was the most common subtype detected. The majority of influenza detections were reported from Western Canada, where BC and AB accounted for 58% of influenza detections in Canada in week 04. To date, 79% of influenza detections have been influenza A and among those subtyped, the majority have been influenza A(H1N1) [71% (1202/1704)].
                Figure 3. Cumulative numbers of positive influenza specimens by type/subtype and province, Canada, 2015-16

                Note: Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
                Figure 3 - Text Description To date this season, detailed information on age and type/subtype has been received for 2,056 cases. Adults aged 20-44 years and older accounted for the greatest proportion of influenza cases (Table 1). Adults aged 20-44 and 45-64 years accounted for 51% of reported influenza A(H1N1) cases. Adults aged 65 years and older represented 44% of all reported A(H3N2) cases.
                Table 1 - Footnote 1 Table 1 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
                Return to Table 1 - Footnote1referrer
                Table 1 - Footnote 2 Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                Return to Table 1 - Footnote2referrer
                Table 1 - Footnote UnS Unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
                Return to Table 1 - FootnoteUnSreferrer
                41 7 2 32 13 207 82 35 90 57 264 12.8%
                43 9 2 32 52 159 48 48 63 183 342 16.6%
                104 10 5 89 47 341 97 73 171 186 527 25.6%
                84 19 7 58 18 342 98 103 141 93 435 21.2%
                46 12 8 26 19 381 54 203 124 95 476 23.2%
                3 1 2 0 0 11 7 4 0 1 12 0.6%
                321 58 26 237 149 1441 386 466 589 615 2056 100.0%
                68.3% 18.1% 8.1% 73.8% 31.7% 70.1% 26.8% 32.3% 40.9% 29.9%
                For additional data on other respiratory virus detections see the Respiratory Virus Detections in Canada Report on the Public Health Agency of Canada website.
                Influenza-like Illness Consultation Rate

                The national ILI consultation rate increased from the previous week from 16.0 per 1,000 patient visits in week 03, to 35.9 per 1,000 patient visits in week 04. In week 04, the highest ILI consultation rate was found in those 0-4 years of age (88.4 per 1,000) and the lowest was found in the ≥65 years age group (19.4 per 1,000) (Figure 4).
                Figure 4. Influenza-like-illness (ILI) consultation rates by age group and week, Canada, 2015-16

                Delays in the reporting of data may cause data to change retrospectively. In BC, AB, and SK, data are compiled by a provincial sentinel surveillance program for reporting to FluWatch. Not all sentinel physicians report every week.
                Figure 4 - Text Description Influenza Outbreak Surveillance

                In week 04, 13 new laboratory confirmed influenza outbreaks were reported: six in long-term care facilities (LTCF), four in hospitals and three in an institutional or community setting. Of the outbreaks with known strains or subtypes, two outbreaks were due to Influenza A(H1N1), one was due to Influenza A(H3N2), three outbreaks were due to influenza A (UnS) and one outbreak was due to influenza B. Additionally, four ILI outbreaks were reported in schools.
                To date this season, 63 outbreaks have been reported (29 of which occurred in LTCFs). In comparison, at week 04 in the 2014-15 season, 1,146 outbreaks were reported (589 of which occurred in LTCFs) and in the 2013-14 season, 67 outbreaks were reported (37 of which occurred in LTCFs).
                Figure 5. Overall number of new laboratory-confirmed influenza outbreaksFigure 5 - Footnote1 by report week, Canada, 2015-2016

                Figure 5 - Footnote 1 All provinces and territories except NU report influenza outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
                Return to Figure 5 - Footnote1referrer
                Figure 5 - Text Description Sentinel Pediatric Hospital Influenza Surveillance

                Paediatric Influenza Hospitalizations and Deaths

                In week 04, 38 hospitalizations were reported by the the Immunization Monitoring Program Active (IMPACT) network (Figure 6). Nineteen hospitalizations were due to influenza A(H1N1) (50%), one was due to A(H3N2) (2.7%) nine were due to influenza B (24%) and the remainder were influenza A (UnS).
                To date this season, 134 laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations have been reported by the IMPACT network: 102 hospitalized cases were due to influenza A and 32 cases were due to influenza B. The majority of hospitalized cases were among children aged 2-4 years (34%). To date, 15 intensive care unit (ICU) admissions have been reported. The majority of ICU admissions were reported in children 2-4 years (40%) and due to influenza A(H1N1) (27%). Less than five influenza-associated deaths have been reported.
                13 3 2 8 5 18 (13%)
                26 15 3 8 4 30 (22%)
                36 17 3 16 10 46 (34%)
                18 9 0 9 10 28 (21%)
                18 9 0 9 10 12 (9%)
                102 48 9 45 32 134 (100%)
                Figure 6. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2015-16, paediatric and adult hospitalizations (≤16 years of age, IMPACT; ≥16 years of age, CIRN-SOS)

                Not included in Table 2 and Figure 6 are two IMPACT cases that were due to co-infections of influenza A and B.
                Figure 6 - Text Description Adult Influenza Hospitalizations and Deaths

                In week 04, 11 hospitalizations were reported by the Canadian Immunization Research Network Serious Outcome Surveillance (CIRN-SOS). The majority of hospitalizations were in adults 65+ years of age (64%) and due to influenza A (91%).
                To date this season, 82 laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations have been reported by CIRN-SOS (Table 3). The majority of hospitalized cases were due to influenza A (79%) and were among adults ≥65 years of age (54%). Six intensive care unit (ICU) admissions have been reported and among those, five (83%) were due to influenza A. Less than five deaths have been reported this season.
                1 1 0 0 0 1 (1%)
                6 1 0 5 8 14 (17%)
                18 4 2 12 5 23 (28%)
                40 5 12 23 4 44 (54%)
                0 0 0 0 0 0 (%)
                65 11 14 40 17 82
                79% 17% 22% 62% 21% 100%
                Figure 7. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group (≥16 year of age), Canada 2015-16

                Note: The number of hospitalizations reported through CIRN-SOS and IMPACT represents a subset of all influenza-associated adult and paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
                Figure 7 - Text Description Provincial/Territorial Influenza Hospitalizations and Deaths

                In week 04, 44 hospitalizations have been reported from participating provinces and territoriesFootnote*. The majority of hospitalizations were due to influenza A (82%). The largest proportion of cases reported in week 04 were in children 0-19 years (39%).
                Since the start of the 2015-16 season, 421 laboratory-confirmed influenza-associated hospitalizations have been reported. A total of 365 hospitalizations (87%) were due to influenza A and 56 (13%) were due to influenza B. Among cases for which the subtype of influenza A was reported, 75% (176/235) were influenza A(H1N1). The majority (34%) of hospitalized cases were ≥65 years of age. Forty-one ICU admissions have been reported of which 35 (85%) were due to influenza A and 15 (37%) were in the 45-64 age group. A total of 14 deaths have been reported, all due to influenza A. The majority of deaths were reported in adults 65+ of age (57%).
                Figure 8. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada 2015-16

                Figure 8 - Text Description Footnote * Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, and QC. Only hospitalizations that require intensive medical care are reported by SK. ICU admissions are not distinguished among hospital admissions reported from ON. Data may also include cases reported by the IMPACT networks. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from ON that occurred in previous weeks, as a result of retrospective updates to the cumulative total. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting.
                Return to footnote*referrer
                See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2011-12 to 2015-16 on the Public Health Agency of Canada website.
                Influenza Strain Characterizations

                During the 2015-16 influenza season, the National Microbiology Laboratory (NML) has characterized 282 influenza viruses [106 A(H3N2), 132 A(H1N1) and 44 influenza B].
                Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assays, 15 H3N2 virus were antigenically characterized as A/Switzerland/9715293/2013-like using antiserum raised against cell-propagated A/Switzerland/9715293/2013.
                Sequence analysis was done on 91 H3N2 viruses. All viruses belonged to a genetic group for which most viruses were antigenically related to A/Switzerland/9715293/2013.
                A/Switzerland/9715293/2013 is the A(H3N2) component of the 2015-16 Northern Hemisphere's vaccine.
                Influenza A (H1N1): One hundred and thrity-two H1N1 viruses characterized were antigenically similar to A/California/7/2009, the A(H1N1) component of the 2015-16 influenza vaccine.
                Influenza B: Twenty-seven influenza B viruses characterized were antigenically similar to the vaccine strain B/Phuket/3073/2013. Seventeen influenza B viruses were characterized as B/Brisbane/60/2008-like, one of the influenza B components of the 2015-16 Northern Hemisphere quadrivalent influenza vaccine.
                The recommended components for the 2015-2016 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an /Switzerland/9715293/2013(H3N2)-like virus, and a B/Phuket/3073/2013 -like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus (Victoria lineage) is recommended.
                The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition testing compared to the reference influenza strains recommended by WHO.

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

                Comment


                • #9
                  FluWatch report: January 31, 2016 - February 6, 2016 (week 05)

                  Overall Summary

                  • Overall in week 05, several seasonal influenza indicators increased from the previous week.
                  • Laboratory detections reached expected levels for this time of the year.
                  • An increase in the number of outbreaks was reported in week 05 with the majority due to influenza A.
                  • In the past 3 weeks young/middle age adults are accounting for an increasing proportion of hospitalizations as reported by participating provinces and territories.
                  • Influenza A(H1N1) is the most common influenza subtype circulating in Canada.
                  • For more information on the flu, see our Flu(influenza) web page.

                  Download the alternative format
                  (PDF format, 862 KB, 8 pages)
                  Organization: Public Health Agency of Canada
                  Date published: 2016-02-12

                  Related Topics


                  Are you a primary health care practitioner (General Practitioner, Nurse Practitioner or Registered Nurse) interested in becoming a FluWatch sentinel for the 2015-16 influenza season? Contact us at FluWatch@phac-aspc.gc.ca


                  On this page

                  Influenza/Influenza-like Illness Activity (geographic spread)

                  In week 05, influenza/ILI activity continued to increase in Canada. A total of 32 regions across Canada reported sporadic influenza/ILI activity. Localized activity was reported in 8 regions in Canada and widespread activity was reported in 2 regions of NL.
                  Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 05




                  Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available in the mapping feature found in the Weekly Influenza Reports.
                  Figure 1 - Text Description Laboratory Confirmed Influenza Detections

                  Laboratory confirmed influenza detections are on the rise in Canada. The percent positive for influenza increased from 16.0% in week 04 to 20.4% in week 05 (Figure 2). Compared to the previous five seasons, the percent positive (20.4%) reported in week 05 was above the five year average for that week but remained within expected levels (range 13.2%-24.4%).
                  Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2015-16

                  Figure 2 - Text Description In week 05, there were 1,271 positive influenza tests reported. Influenza A(H1N1) was the most common subtype detected. The majority of influenza detections were reported in the provinces of AB, ON and QC. To date, 80% of influenza detections have been influenza A and among those subtyped, the majority have been influenza A(H1N1) [77% (1834/2390)].
                  Figure 3. Cumulative numbers of positive influenza specimens by type/subtype and province, Canada, 2015-16

                  Note: Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
                  Figure 3 - Text Description To date this season, detailed information on age and type/subtype has been received for 3,694 cases. Adults aged 20-44 years accounted for the greatest proportion of influenza cases (Table 1). Adults aged 20-44 and 45-64 years accounted for 57% of reported influenza A(H1N1) cases. Children 5-19 years and adults 20-44 years accounted for 60% of all influenza B cases reported.
                  Table 1 - Footnote 1 Table 1 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
                  Return to Table 1 - Footnote1referrer
                  Table 1 - Footnote 2 Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                  Return to Table 1 - Footnote2referrer
                  Table 1 - Footnote UnS Unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
                  Return to Table 1 - FootnoteUnSreferrer
                  114 55 0 59 10 469 294 37 138 70 539 14.6%
                  74 39 2 33 24 339 208 52 79 214 553 15.0%
                  208 100 0 108 22 838 530 78 230 212 1050 28.4%
                  220 97 6 117 10 760 421 112 227 106 866 23.4%
                  86 42 2 42 16 558 196 205 157 112 670 18.1%
                  4 2 2 0 0 15 9 6 0 1 16 0.4%
                  706 335 12 359 82 2979 1658 490 831 715 3694 100.0%
                  89.6% 47.5% 1.7% 50.8% 10.4% 80.6% 55.7% 16.4% 27.9% 19.4%
                  For additional data on other respiratory virus detections see the Respiratory Virus Detections in Canada Report on the Public Health Agency of Canada website.
                  Influenza-like Illness Consultation Rate

                  The national ILI consultation rate increased from the previous week from 35.9 per 1,000 patient visits in week 04, to 75.4 per 1,000 patient visits in week 05. In week 05, the highest ILI consultation rate was found in those 0-4 years of age (136.4 per 1,000) and the lowest was found in the ≥65 years age group (11.2 per 1,000) (Figure 4).
                  Figure 4. Influenza-like-illness (ILI) consultation rates by age group and week, Canada, 2015-16

                  Delays in the reporting of data may cause data to change retrospectively. In BC, AB, and SK, data are compiled by a provincial sentinel surveillance program for reporting to FluWatch. Not all sentinel physicians report every week.
                  Figure 4 - Text Description Influenza Outbreak Surveillance

                  In week 05, the number of outbreaks reported continued to increase. A total of 16 new laboratory confirmed influenza outbreaks were reported: nine in long-term care facilities (LTCF), four in hospitals and three in an institutional or community setting. Of the outbreaks with known strains or subtypes, one outbreak was due to Influenza A(H1N1). Additionally, one ILI outbreak was reported in a school.
                  To date this season, 80 outbreaks have been reported. In comparison, at week 05 in the 2014-15 season, 1,225 outbreaks were reported and in the 2013-14 season, 82 outbreaks were reported.
                  Figure 5. Overall number of new laboratory-confirmed influenza outbreaksFigure 5 - Footnote1 by report week, Canada, 2015-2016

                  Figure 5 - Footnote 1 All provinces and territories except NU report influenza outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
                  Return to Figure 5 - Footnote1referrer
                  Figure 5 - Text Description Sentinel Pediatric Hospital Influenza Surveillance

                  Paediatric Influenza Hospitalizations and Deaths

                  In week 05, 41 hospitalizations were reported by the the Immunization Monitoring Program Active (IMPACT) network (Figure 6). Eighteen hospitalizations were due to influenza A(H1N1) (44%), one was due to A(H3N2) (2.4%), eight were due to influenza B (20%) and the remainder were influenza A (UnS).
                  To date this season, 175 laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations have been reported by the IMPACT network: 135 hospitalized cases were due to influenza A and 40 cases were due to influenza B. The highest proportion of hospitalizations was among children aged 2-4 years (34%). To date, 20 intensive care unit (ICU) admissions have been reported. The highest proportion of ICU admissions was reported in children 2-4 years (30%). Among ICU admissions for which the subtype of influenza A was reported, 75% were due to influenza A(H1N1). Less than five influenza-associated deaths have been reported.
                  15 4 3 8 6 21 (12%)
                  33 20 3 10 5 38 (22%)
                  47 22 4 21 12 59 (34%)
                  30 18 0 12 13 43 (25%)
                  30 18 0 12 13 14 (8%)
                  135 69 11 55 40 175 (100%)
                  Figure 6. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2015-16, paediatric and adult hospitalizations (≤16 years of age, IMPACT; ≥16 years of age, CIRN-SOS)

                  Not included in Table 2 and Figure 6 are two IMPACT cases that were due to co-infections of influenza A and B.
                  Figure 6 - Text Description Adult Influenza Hospitalizations and Deaths

                  In week 05, 38 hospitalizations were reported by the Canadian Immunization Research Network Serious Outcome Surveillance (CIRN-SOS). The majority of hospitalizations were in adults 65+ years of age (58%) and have been due to influenza A (82%).
                  To date this season, 128 laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations have been reported by CIRN-SOS (Table 3). The majority of hospitalized cases were due to influenza A (80%) and were among adults ≥65 years of age (54%). Ten intensive care unit (ICU) admissions have been reported and among those, nine (90%) were due to influenza A. Less than five deaths have been reported this season.
                  1 1 0 0 0 1 (1%)
                  11 2 0 9 10 21 (16%)
                  32 8 2 22 5 37 (29%)
                  59 10 13 36 10 69 (54%)
                  0 0 0 0 0 0 (%)
                  103 21 15 67 25 128
                  80% 20% 15% 65% 20% 100%
                  Figure 7. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group (≥16 year of age), Canada 2015-16

                  Note: The number of hospitalizations reported through CIRN-SOS and IMPACT represents a subset of all influenza-associated adult and paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
                  Figure 7 - Text Description Provincial/Territorial Influenza Hospitalizations and Deaths

                  In week 05, 171 hospitalizations have been reported from participating provinces and territoriesFootnote*. The majority of hospitalizations were due to influenza A (93%). The largest proportion of cases reported in week 05 were in adults 20-64 years (44%).
                  Since the start of the 2015-16 season, 675 laboratory-confirmed influenza-associated hospitalizations have been reported. A total of 599 hospitalizations (89%) were due to influenza A and 76 (11%) were due to influenza B. Among cases for which the subtype of influenza A was reported, 83% (329/395) were influenza A(H1N1). The highest proportion (32%) of hospitalized cases of were among those aged ≥65 years. Sixty-eight ICU admissions have been reported of which 58 (85%) were due to influenza A and 29 (43%) were in the 45-64 age group. A total of 19 deaths have been reported, all due to influenza A. The majority of deaths were reported in adults 65+ of age (53%).
                  Figure 8. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada 2015-16

                  Figure 8 - Text Description Footnote * Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, and QC. Only hospitalizations that require intensive medical care are reported by SK. ICU admissions are not distinguished among hospital admissions reported from ON. Data may also include cases reported by the IMPACT networks. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from ON that occurred in previous weeks, as a result of retrospective updates to the cumulative total. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting.
                  Return to footnote*referrer
                  See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2011-12 to 2015-16 on the Public Health Agency of Canada website.
                  Influenza Strain Characterizations

                  During the 2015-16 influenza season, the National Microbiology Laboratory (NML) has characterized 330 influenza viruses [107 A(H3N2), 152 A(H1N1) and 71 influenza B].
                  Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assays, 15 H3N2 virus were antigenically characterized as A/Switzerland/9715293/2013-like using antiserum raised against cell-propagated A/Switzerland/9715293/2013.
                  Sequence analysis was done on 92 H3N2 viruses. All viruses belonged to a genetic group for which most viruses were antigenically related to A/Switzerland/9715293/2013.
                  A/Switzerland/9715293/2013 is the A(H3N2) component of the 2015-16 Northern Hemisphere's vaccine.
                  Influenza A (H1N1): One hundred and fifty-two H1N1 viruses characterized were antigenically similar to A/California/7/2009, the A(H1N1) component of the 2015-16 influenza vaccine.
                  Influenza A (H1N1): One hundred and thrity-two H1N1 viruses characterized were antigenically similar to A/California/7/2009, the A(H1N1) component of the 2015-16 influenza vaccine.
                  Influenza B: Twenty-two influenza B viruses characterized were antigenically similar to the vaccine strain B/Phuket/3073/2013. Thirty-nine influenza B viruses were characterized as B/Brisbane/60/2008-like, one of the influenza B components of the 2015-16 Northern Hemisphere quadrivalent influenza vaccine.
                  The recommended components for the 2015-2016 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an /Switzerland/9715293/2013(H3N2)-like virus, and a B/Phuket/3073/2013 -like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus (Victoria lineage) is recommended.
                  The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition testing compared to the reference influenza strains recommended by WHO.

                  .../

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

                  Comment


                  • #10
                    FluWatch report: February 7, 2016 - February 13, 2016 (week 06)

                    Overall Summary

                    • Overall in week 06, influenza activity in Canada continues to increase.
                    • An increase in laboratory detections and outbreaks of influenza were reported in week 06 with the majority due to influenza A.
                    • Young/middle age adults are accounting for an increasing proportion of hospitalizations as reported by participating provinces and territories.
                    • Pediatric hospitalizations reported by the IMPACT network have increased substantially over the past few weeks, reaching 76 hospitalizations in week 06.
                    • Influenza A(H1N1) is the most common influenza subtype circulating in Canada.
                    • With the late start to the influenza season, it is anticipated that influenza activity will continue to increase over the coming weeks.
                    • For more information on the flu, see our Flu(influenza) web page.

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                    Organization: Public Health Agency of Canada
                    Date published: 2016-02-19

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                    Are you a primary health care practitioner (General Practitioner, Nurse Practitioner or Registered Nurse) interested in becoming a FluWatch sentinel for the 2015-16 influenza season? Contact us at FluWatch@phac-aspc.gc.ca


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                    Influenza/Influenza-like Illness Activity (geographic spread)

                    In week 06, influenza/ILI activity continued to increase in Canada. A total of 30 regions across Canada reported sporadic influenza/ILI activity. Localized activity was reported in 14 regions in Canada.
                    Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 06




                    Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available in the mapping feature found in the Weekly Influenza Reports.
                    Figure 1 - Text Description Laboratory Confirmed Influenza Detections

                    Laboratory confirmed influenza detections continue to increase. The percentage of tests positive for influenza increased from 20.6% in week 05 to 26.2% in week 06 (Figure 2). Compared to the previous five seasons, the percent positive (26.2%) reported in week 06 was above the five year average for that week and is above expected levels (range 12.9% - 21.5%) for this time of year. With the late start to the 2015-16 influenza season, these above normal levels are not unexpected and are typical of peak season levels.
                    Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2015-16

                    Figure 2 - Text Description In week 06, there were 1,862 positive influenza tests reported. Influenza A(H1N1) was the most common subtype detected. To date, 82% of influenza detections have been influenza A and among those subtyped, the majority have been influenza A(H1N1) [82% (2819/3448)].
                    Figure 3. Cumulative numbers of positive influenza specimens by type/subtype and province, Canada, 2015-16

                    Note: Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
                    Figure 3 - Text Description To date this season, detailed information on age and type/subtype has been received for 5,580 cases. Adults aged 20-44 years accounted for the greatest proportion of influenza cases (Table 1). Adults aged 20-44 and 45-64 years accounted for 58% of reported influenza A(H1N1) cases. Children 5-19 years and adults 20-44 years accounted for 61% of all influenza B cases reported.
                    Table 1 - Footnote 1 Table 1 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
                    Return to Table 1 - Footnote1referrer
                    Table 1 - Footnote 2 Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                    Return to Table 1 - Footnote2referrer
                    Table 1 - Footnote UnS Unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
                    Return to Table 1 - FootnoteUnSreferrer
                    215 96 1 118 31 747 463 39 245 112 859 15.4%
                    137 63 1 73 62 528 324 58 146 307 835 15.0%
                    365 175 5 185 50 1304 834 91 379 298 1602 28.7%
                    320 147 12 161 28 1172 677 131 364 139 1311 235%
                    198 76 15 107 20 802 302 237 263 141 943 16.9%
                    10 5 2 3 0 28 17 8 3 2 30 0.5%
                    1245 562 36 647 191 4581 2617 564 1400 999 5580 100.0%
                    86.7% 45.1% 2.9% 52.0% 13.3% 82.1% 57.1% 12.3% 30.6% 17.9%
                    For additional data on other respiratory virus detections see the Respiratory Virus Detections in Canada Report on the Public Health Agency of Canada website.
                    Influenza-like Illness Consultation Rate

                    The national ILI consultation rate decreased from the previous week from 75.4 per 1,000 patient visits in week 05, to 50.9 per 1,000 patient visits in week 06. In week 06, the highest ILI consultation rate was found in those 0-4 years of age (86.1 per 1,000) and the lowest was found in the ≥65 years age group (11.6 per 1,000) (Figure 4).
                    Figure 4. Influenza-like-illness (ILI) consultation rates by age group and week, Canada, 2015-16

                    Delays in the reporting of data may cause data to change retrospectively. In BC, AB, and SK, data are compiled by a provincial sentinel surveillance program for reporting to FluWatch. Not all sentinel physicians report every week.
                    Figure 4 - Text Description Influenza Outbreak Surveillance

                    In week 06, a total of 21 new laboratory confirmed influenza outbreaks were reported: ten in long-term care facilities (LTCF), eight in hospitals and three in institutional or community settings. Of the outbreaks with known strains or subtypes: seven outbreaks were due to influenza A (two due to influenza A(H3N2), one due to influenza A(H1N1) and four were due to influenza A(UnS)), one outbreak was due to influenza B and one outbreak was due to both influenza A and B.
                    To date this season, 102 outbreaks have been reported. In comparison at week 06 in the 2014-15 season 1,177 outbreaks were reported and in the 2013-14 season 101 outbreaks were reported. .
                    Figure 5. Overall number of new laboratory-confirmed influenza outbreaksFigure 5 - Footnote1 by report week, Canada, 2015-2016

                    Figure 5 - Footnote 1 All provinces and territories except NU report influenza outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
                    Return to Figure 5 - Footnote1referrer
                    Figure 5 - Text Description Sentinel Pediatric Hospital Influenza Surveillance

                    Paediatric Influenza Hospitalizations and Deaths

                    In week 06, 76 hospitalizations were reported by the the Immunization Monitoring Program Active (IMPACT) network (Figure 6). Twenty-four hospitalizations were due to influenza A(H1N1), 11 were due to influenza B and the remainder were influenza A (UnS). The highest proportion of hospitalizations was among children aged 2-4 years (29%).
                    To date this season, 259 laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations have been reported by the IMPACT network: 205 hospitalized cases were due to influenza A and 54 cases were due to influenza B. The highest proportion of hospitalizations was among children aged 2-4 years (33%). To date, 36 intensive care unit (ICU) admissions have been reported. The highest proportion of ICU admissions was reported in children 5-9 years (30%). Among ICU admissions for which the subtype of influenza A was reported, 86% were due to influenza A(H1N1). Among the ICU admissions, 19 (70%) were reported to have at least one comorbidity. Less than five influenza-associated deaths have been reported.
                    26 10 3 13 6 32 (12%)
                    51 28 3 20 8 59 (23%)
                    70 31 4 35 15 85 (33%)
                    41 18 0 23 18 59 (23%)
                    41 18 0 23 18 24 (9%)
                    205 97 11 97 54 259 (100%)
                    Figure 6. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2015-16, paediatric and adult hospitalizations (≤16 years of age, IMPACT; ≥16 years of age, CIRN-SOS)

                    Not included in Table 2 and Figure 6 are two IMPACT cases that were due to co-infections of influenza A and B.
                    Figure 6 - Text Description Adult Influenza Hospitalizations and Deaths

                    In week 06, 33 hospitalizations were reported by the Canadian Immunization Research Network Serious Outcome Surveillance (CIRN-SOS). The greatest proportion of hospitalizations in week 06 were in adults 65+ years of age (42%), followed by adults aged 45-64. The majority of hospitalizations were due to influenza A (81%).
                    To date this season, 166 laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations have been reported by CIRN-SOS (Table 3). The majority of hospitalized cases were due to influenza A (81%) and were among adults ≥65 years of age (51%). Seventeen intensive care unit (ICU) admissions have been reported and among those, nine (88%) were due to influenza A. Less than five deaths have been reported this season.
                    1 1 0 0 0 1 (1%)
                    6 6 0 10 12 28 (17%)
                    45 12 2 31 6 51 (31%)
                    71 12 14 45 14 85 (51%)
                    1 0 0 1 0 1 (1%)
                    134 31 16 87 32 166
                    81% 23% 12% 65% 19% 100%
                    Figure 7. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group (≥16 year of age), Canada 2015-16

                    Note: The number of hospitalizations reported through CIRN-SOS and IMPACT represents a subset of all influenza-associated adult and paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
                    Figure 7 - Text Description Provincial/Territorial Influenza Hospitalizations and Deaths

                    In week 06, 125 hospitalizations have been reported from participating provinces and territoriesFootnote*. The majority of hospitalizations were due to influenza A (86%). The 0-4 and 45-64 age groups accounted for the largest proportion of cases reported in week 06, each representing 26% of hospitalized cases. The high proportion of hospitalizations reported in these age groups in week 06 were also reported in the sentinel hospital networks.
                    Since the start of the 2015-16 season, 867 laboratory-confirmed influenza-associated hospitalizations have been reported. A total of 767 hospitalizations (89%) were due to influenza A and 100 (11%) were due to influenza B. Among cases for which the subtype of influenza A was reported, 86% (433/502) were influenza A(H1N1). The highest proportion (30%) of hospitalized cases of were among those aged ≥65 years; however, the 45-64 and 0-4 age groups followed closely representing 26% and 21% of hospitalized cases respectively. Ninety-one ICU admissions have been reported.The highest proportion of ICU admissions was reported in the 45-64 age group (45%). Among ICU admissions for which the subtype of influenza A was reported, 92% were due to influenza A(H1N1). A total of 22 deaths have been reported, all due to influenza A. The majority of deaths were reported in adults 65+ of age (46%).
                    Figure 8. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada 2015-16

                    Figure 8 - Text Description Footnote * Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, and QC. Only hospitalizations that require intensive medical care are reported by SK. ICU admissions are not distinguished among hospital admissions reported from ON. Data may also include cases reported by the IMPACT networks. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from ON that occurred in previous weeks, as a result of retrospective updates to the cumulative total. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting.
                    Return to footnote*referrer
                    See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2011-12 to 2015-16 on the Public Health Agency of Canada website.
                    Influenza Strain Characterizations

                    During the 2015-16 influenza season, the National Microbiology Laboratory (NML) has characterized 411 influenza viruses [118 A(H3N2), 206 A(H1N1) and 87 influenza B].
                    Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assays, 23 H3N2 virus were antigenically characterized as A/Switzerland/9715293/2013-like using antiserum raised against cell-propagated A/Switzerland/9715293/2013.
                    Sequence analysis was done on 95 H3N2 viruses. All viruses belonged to a genetic group for which most viruses were antigenically related to A/Switzerland/9715293/2013.
                    A/Switzerland/9715293/2013 is the A(H3N2) component of the 2015-16 Northern Hemisphere's vaccine.
                    Influenza A (H1N1): 206 H1N1 viruses characterized were antigenically similar to A/California/7/2009, the A(H1N1) component of the 2015-16 influenza vaccine.
                    Influenza B: 36 influenza B viruses characterized were antigenically similar to the vaccine strain B/Phuket/3073/2013. 51 influenza B viruses were characterized as B/Brisbane/60/2008-like, one of the influenza B components of the 2015-16 Northern Hemisphere quadrivalent influenza vaccine. The recommended components for the 2015-2016 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an /Switzerland/9715293/2013(H3N2)-like virus, and a B/Phuket/3073/2013 -like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus (Victoria lineage) is recommended.
                    The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition testing compared to the reference influenza strains recommended by WHO.
                    ...

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

                    Comment


                    • #11
                      FluWatch report: February 14, 2016 - February 20, 2016 (week 07)

                      Overall Summary

                      • Overall in week 07, influenza confirmations continued to increase slightly with greater geographic spread
                      • Pediatric hospitalizations reported by the IMPACT network continue to substantially increase, reaching 94 hospitalizations in week 07.
                      • Young/middle age adults are accounting for an increasing proportion of hospitalizations and laboratory confirmed cases as reported by participating provinces and territories.
                      • An increase in the number of outbreaks was reported in week 07 with the majority of outbreaks reported in long-term care facilities.
                      • Influenza A(H1N1) remains the most common influenza subtype circulating in Canada.
                      • The World Health Organization has released their recommended composition of influenza virus vaccines for use in the 2016-2017 northern hemisphere influenza season.
                      • For more information on the flu, see our Flu(influenza) web page.

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                      Organization: Public Health Agency of Canada
                      Date published: 2016-02-26

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                      Are you a primary health care practitioner (General Practitioner, Nurse Practitioner or Registered Nurse) interested in becoming a FluWatch sentinel for the 2015-16 influenza season? Contact us at FluWatch@phac-aspc.gc.ca


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                      Influenza/Influenza-like Illness Activity (geographic spread)

                      In week 07, a larger proportion of regions reported elevated activity levels. A total of 29 regions across Canada reported sporadic influenza/ILI activity. Localized activity was reported in 15 regions in Canada and widespread activity was reported in one region of Quebec.
                      Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 07




                      Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available in the mapping feature found in the Weekly Influenza Reports.
                      Figure 1 - Text Description Laboratory Confirmed Influenza Detections

                      Laboratory confirmed influenza detections continued to increase. The percent positive for influenza increased from 25% in week 06 to 29% in week 07 (Figure 2). Compared to the previous five seasons, the percent positive (29%) reported in week 07 was above the five year average for that week and exceeded the expected levels (range 13.0%-19.7%). With the late start to the 2015-16 influenza season, these above normal levels are not unexpected and are typical of peak season levels.
                      Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2015-16

                      Figure 2 - Text Description In week 07, there were 2,453 positive influenza tests reported. Influenza A(H1N1) was the most common subtype detected. The majority of influenza detections were reported in the provinces of AB, ON and QC. Increased detections of influenza in the central and eastern provinces have been noted in the last few weeks. To date, 83% of influenza detections have been influenza A and among those subtyped, the majority have been influenza A(H1N1) [85% (3963/4654)].
                      Figure 3. Cumulative numbers of positive influenza specimens by type/subtype and province, Canada, 2015-16

                      Note: Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
                      Figure 3 - Text Description To date this season, detailed information on age and type/subtype has been received for 7,622 cases. Adults aged 20-44 years accounted for the greatest proportion of influenza cases (Table 1). Adults aged 20-44 and 45-64 years accounted for 57% of reported influenza A(H1N1) cases. Children 5-19 years and adults 20-44 years accounted for 60% of all influenza B cases reported.

                      Table 1 - Footnote 1 Table 1 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
                      Return to Table 1 - Footnote1referrer
                      Table 1 - Footnote 2 Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                      Return to Table 1 - Footnote2referrer
                      Table 1 - Footnote 3 Unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
                      Return to Table 1 - Footnote3referrer
                      Table 1 - Footnote 4 x - Suppressed to prevent residual disclosure.
                      Return to Table 1 - Footnote4referrer
                      289 129 <5 xTable 1 - Footnote4 36 1089 681 42 366 157 1246 16.3%
                      160 59 <5 xTable 1 - Footnote4 51 716 439 65 212 387 1103 14.5%
                      413 174 <5 xTable 1 - Footnote4 76 1812 1153 101 558 402 2214 29.0%
                      357 142 <5 xTable 1 - Footnote4 37 1598 926 138 534 188 1786 23.4%
                      239 82 10 147 33 1084 429 264 391 189 1273 16.7%
                      1,458 586 17 855 233 6299 3628 610 2061 1323 7622 100.0%
                      86.2% 40.2% 1.2% 58.6% 13.8% 82.6% 57.6% 9.7% 32.7% 17.4%
                      For data on other respiratory virus detections see the Respiratory Virus Detections in Canada Report on the Public Health Agency of Canada website.
                      Influenza-like Illness Consultation Rate

                      The national ILI consultation rate decreased from the previous week from 51.0 per 1,000 patient visits in week 06, to 41.6 per 1,000 patient visits in week 07. In week 07, the highest ILI consultation rate was found in adults 20-64 years of age (47.4 per 1,000) and the lowest was found in the ≥65 years age group (8.8 per 1,000) (Figure 4).
                      Figure 4. Influenza-like-illness (ILI) consultation rates by age group and week, Canada, 2015-16

                      Delays in the reporting of data may cause data to change retrospectively. In BC, AB, and SK, data are compiled by a provincial sentinel surveillance program for reporting to FluWatch. Not all sentinel physicians report every week.
                      Figure 4 - Text Description Pharmacy Surveillance

                      During week 07, the proportion of prescriptions for antivirals increased to 80.2 antiviral prescriptions per 100,000 total prescriptions, which is lower than the five year historical average (5). The rates were highest in children (173.1 per 100,000 total prescriptions).
                      Figure 5. Influenza-like-illness (ILI) consultation rates by age group and week, Canada, 2015-16

                      Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group.
                      * The average weekly proportion includes data from April 2011 to March 2015.
                      Figure 5 - Text Description Influenza Outbreak Surveillance

                      In week 07, 27 new laboratory confirmed influenza outbreaks were reported: 17 in long-term care facilities (LTCF), eight in institutions or community settings and two in hospitals. Of the outbreaks with known strains or subtypes, two outbreaks were due to Influenza A(H1N1) and one outbreak was due to influenza B. Additionally, two ILI outbreaks were reported in schools.
                      To date this season,131 outbreaks have been reported. At week 07 in the 2014-15 season, 1,367 outbreaks were reported and in the 2013-14 season,118 outbreaks were reported.
                      Figure 6. Overall number of new laboratory-confirmed influenza outbreaksFigure 5 - Footnote1 by report week, Canada, 2015-2016

                      Figure 5 - Footnote 1 All provinces and territories except NU report influenza outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
                      Return to Figure 5 - Footnote1referrer
                      Figure 6 - Text Description Sentinel Pediatric Hospital Influenza Surveillance

                      Paediatric Influenza Hospitalizations and Deaths

                      In week 07, 94 hospitalizations were reported by the the Immunization Monitoring Program Active (IMPACT) network (Figure 7). Eighteen hospitalizations were due to influenza A(H1N1) (19%), 18 were due to influenza B (19%) and the remainder were influenza A (UnS).
                      To date this season, 350 laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations have been reported by the IMPACT network: 281 hospitalized cases were due to influenza A and 69 cases were due to influenza B. The largest proportion of hospitalized cases were among children aged 2-4 years (31%). To date, 55 intensive care unit (ICU) admissions have been reported. The largest proportion of ICU admissions were reported in children 2-9 years (51%). Less than five influenza-associated deaths have been reported.

                      37 11 <5 xTable 2 - Footnote1 6 43 (12%)
                      74 34 <5 xTable 2 - Footnote1 13 87 (25%)
                      88 38 <5 xTable 2 - Footnote1 19 107 (31%)
                      59 22 0 37 21 80 (23%)
                      23 10 <5 xTable 2 - Footnote1 10 33 (9%)
                      281 115 11 155 69 350 (100%)
                      Table 2 - Footnote 1 x - Suppressed to prevent residual disclosure
                      Return to Table 1 - Footnote1referrer
                      Figure 7. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2015-16, paediatric and adult hospitalizations (≤16 years of age, IMPACT; ≥16 years of age, CIRN-SOS)

                      Not included in Table 2 and Figure 7 are two IMPACT cases that were due to co-infections of influenza A and B.
                      Figure 7 - Text Description Adult Influenza Hospitalizations and Deaths

                      In week 07, 51 hospitalizations were reported by the Canadian Immunization Research Network Serious Outcome Surveillance (CIRN-SOS). The majority of hospitalizations were in adults 45-64 and 65+ years of age (84%) and due to influenza A (93%).
                      To date this season, 225 laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations have been reported by CIRN-SOS (Table 3). The majority of hospitalized cases were due to influenza A (84%) and the largest reported proption were among adults ≥65 years of age (50%). Twenty-four intensive care unit (ICU) admissions have been reported and among those, 22 (92%) were due to influenza A. Six deaths have been reported this season.
                      <5 <5 <5 <5 <5 <5 (x%)
                      23 8 0 15 13 36 (16%)
                      66 19 <5 x 7 73 (32%)
                      97 16 14 67 15 112 (50%)
                      <5 <5 <5 <5 <5 <5 (x%)
                      189 44 16 129 36 225
                      84% 23% 8% 68% 16% 100%
                      x - Suppressed to prevent residual disclosure
                      Figure 8. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group (≥16 year of age), Canada 2015-16

                      Note: The number of hospitalizations reported through CIRN-SOS and IMPACT represents a subset of all influenza-associated adult and paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
                      Figure 8 - Text Description Provincial/Territorial Influenza Hospitalizations and Deaths

                      In week 07, 222 hospitalizations have been reported from participating provinces and territoriesFootnote*. The majority of hospitalizations were due to influenza A (89%). The largest proportion of cases reported in week 07 were in children 0-19 years (39%).
                      Since the start of the 2015-16 season, 1,235 laboratory-confirmed influenza-associated hospitalizations have been reported. A total of 1,105 hospitalizations (90%) were due to influenza A and 56 (10%) were due to influenza B. Among cases for which the subtype of influenza A was reported, 89% (650/727) were influenza A(H1N1). The majority (29%) of hospitalized cases were ≥65 years of age. One hundred thirty-one ICU admissions have been reported of which 118 (90%) were due to influenza A and 57 (44%) were in the 45-64 age group. A total of 30 deaths have been reported, all due to influenza A. The largest proportion of deaths were reported in adults 45-64 and 65+ of age,representing 86% of deaths).
                      Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada 2015-16

                      Figure 9 - Text Description Footnote * Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, and QC. Only hospitalizations that require intensive medical care are reported by SK. ICU admissions are not distinguished among hospital admissions reported from ON. Data may also include cases reported by the IMPACT networks. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from ON that occurred in previous weeks, as a result of retrospective updates to the cumulative total. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting.
                      x - Suppressed to prevent residual disclosure
                      Return to footnote*referrer
                      See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2011-12 to 2015-16 on the Public Health Agency of Canada website.
                      Influenza Strain Characterizations

                      During the 2015-16 influenza season, the National Microbiology Laboratory (NML) has characterized 521 influenza viruses [122 A(H3N2), 268 A(H1N1) and 131 influenza B].
                      Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assays, 27 H3N2 virus were antigenically characterized as A/Switzerland/9715293/2013-like using antiserum raised against cell-propagated A/Switzerland/9715293/2013.
                      Sequence analysis was done on 95 H3N2 viruses. All viruses belonged to a genetic group for which most viruses were antigenically related to A/Switzerland/9715293/2013. A/Switzerland/9715293/2013 is the A(H3N2) component of the 2015-16 Northern Hemisphere's vaccine.
                      Influenza A (H1N1): Two hundred and sixty-eight H1N1 viruses characterized were antigenically similar to A/California/7/2009, the A(H1N1) component of the 2015-16 influenza vaccine.
                      Influenza B:Forty-six influenza B viruses characterized were antigenically similar to the vaccine strain B/Phuket/3073/2013. Eighty-five influenza B viruses were characterized as B/Brisbane/60/2008-like, one of the influenza B components of the 2015-16 Northern Hemisphere quadrivalent influenza vaccine.
                      The WHO has released the recommended composition of the northern hemisphere influenza vaccine for the 2016-2017 season. Trivalent vaccines are recommended to contain 1) an A/California/7/2009 (H1N1)pdm09-like virus 2) an A/HongKong/4801/2014 (H3N2)-like virus, and 3) a B/Brisbane/60/2008-like virus (Victoria lineage). Quadrivalent vaccines are recommended to additionally contain a B/Phuket/30732013-like virus (Yamagata lineage).
                      The recommended components for the 2015-2016 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an /Switzerland/9715293/2013(H3N2)-like virus, and a B/Phuket/3073/2013 -like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus (Victoria lineage) is recommended.
                      The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition testing compared to the reference influenza strains recommended by WHO.

                      .../

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

                      Comment


                      • #12
                        FluWatch report: February 21, 2016 - February 27, 2016 (week 08)

                        Overall Summary

                        • Overall in week 08, influenza activity continued to increase; the Eastern provinces of Canada accounted for the majority of influenza laboratory confirmations.
                        • In week 08, adults 65+ years of age accounted for the largest proportion of hospitalizations
                        • The number of outbreaks reported in week 08 increased sharply from the previous week with the majority of outbreaks reported in long-term care facilities.
                        • Influenza A(H1N1) remains the most common influenza subtype circulating in Canada.
                        • For more information on the flu, see our Flu(influenza) web page.

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                        Organization: Public Health Agency of Canada
                        Date published: 2016-03-04

                        Related Topics


                        Are you a primary health care practitioner (General Practitioner, Nurse Practitioner or Registered Nurse) interested in becoming a FluWatch sentinel for the 2015-16 influenza season? Contact us at FluWatch@phac-aspc.gc.ca


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                        Influenza/Influenza-like Illness Activity (geographic spread)

                        In week 08, a larger proportion of regions reported elevated activity levels in the Eastern regions of Canada. A total of 20 regions across Canada reported sporadic influenza/ILI activity. Localized activity was reported in 20 regions in Canada and widespread activity was reported in one region of PE.
                        Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, week 08




                        Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available in the mapping feature found in the Weekly Influenza Reports.
                        Figure 1 - Text Description Laboratory Confirmed Influenza Detections

                        Laboratory confirmed influenza detections continued to increase. The percent positive for influenza increased from 29% in week 07 to 33% in week 08 (Figure 2). Compared to the previous five seasons, the percent positive (33%) reported in week 08 was above the five year average for that week and exceeded the expected levels (range 13.0%-17.4%). With the late start to the 2015-16 influenza season, these above normal levels are not unexpected and are typical of peak season levels.
                        Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2015-16

                        Figure 2 - Text Description In week 08, there were 3,411 positive influenza tests reported. Influenza A(H1N1) continues to be the most common subtype detected. Increased detections of influenza in the central and eastern provinces have been noted in the last few weeks. In week 08, the majority of influenza detections were reported in the provinces of ON and QC (69%). To date, 87% of influenza detections have been influenza A and among those subtyped, the majority have been influenza A(H1N1) [85% (5272/6204)].
                        Figure 3. Cumulative numbers of positive influenza specimens by type/subtype and province, Canada, 2015-16

                        Note: Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
                        Figure 3 - Text Description To date this season, detailed information on age and type/subtype has been received for 10,686 cases. Adults aged 20-44 years accounted for the greatest proportion of influenza cases (Table 1). In week 8, children (aged 0-19 years) accounted for 41% of A(H1N1). Additionally, children aged 0-19 years accounted for 42% of influenza B confirmed cases to date this this season.
                        Table 1 - Footnote 1 Table 1 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
                        Return to Table 1 - Footnote1referrer
                        Table 1 - Footnote 2 Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                        Return to Table 1 - Footnote2referrer
                        Table 1 - Footnote 3 Unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
                        Return to Table 1 - Footnote3referrer
                        x - Suppressed to prevent residual disclosure.
                        379 112 0 267 47 1650 932 45 673 215 1865 17.5%
                        264 124 0 140 78 1026 587 69 370 492 1518 14.2%
                        499 161 <5 x 59 2497 1505 107 885 484 2981 27.9%
                        450 129 <5 x 36 2266 1254 146 866 237 2503 23.4%
                        338 50 9 279 38 1577 605 288 684 242 1819 17.0%
                        1930 576 14 1,340 258 9016 4883 655 3478 1670 10686 100.0%
                        88.2% 29.8% 0.7% 69.4% 11.8% 84.4% 54.2% 7.3% 38.6% 15.6%
                        For data on other respiratory virus detections see the Respiratory Virus Detections in Canada Report on the Public Health Agency of Canada website.
                        Influenza-like Illness Consultation Rate

                        The national ILI consultation rate increased from the previous week from 41.6 per 1,000 patient visits in week 07, to 51.7 per 1,000 patient visits in week 08. In week 08, the highest ILI consultation rate was found in children 5-19 years of age (69.0 per 1,000) and the lowest was found in the ≥65 years age group (11.4 per 1,000) (Figure 4).
                        Figure 4. Influenza-like-illness (ILI) consultation rates by age group and week, Canada, 2015-16

                        Delays in the reporting of data may cause data to change retrospectively. In BC, AB, and SK, data are compiled by a provincial sentinel surveillance program for reporting to FluWatch. Not all sentinel physicians report every week.
                        Figure 4 - Text Description Pharmacy Surveillance

                        During week 08, the proportion of prescriptions for antivirals increased to 88.4 antiviral prescriptions per 100,000 total prescriptions, which is lower than the five year historical average. The proportions were highest in children aged 2-18 years (233.4 per 100,000 total prescriptions).
                        Figure 5. Influenza-like-illness (ILI) consultation rates by age group and week, Canada, 2015-16

                        Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group.
                        * The average weekly proportion includes data from April 2011 to March 2015.
                        Figure 5 - Text Description Influenza Outbreak Surveillance

                        In week 08, 38 new laboratory confirmed influenza outbreaks were reported: 25 in long-term care facilities (LTCF), seven in institutions or community settings and six in hospitals. Of the outbreaks with known strains or subtypes, one outbreak was due to Influenza A(H3N2) and three outbreaks were due to influenza B. Additionally, five ILI outbreaks were reported in schools.
                        To date this season,176 outbreaks have been reported. At week 08 in the 2014-15 season, 1,398 outbreaks were reported and in the 2013-14 season,134 outbreaks were reported.
                        Figure 6. Overall number of new laboratory-confirmed influenza outbreaksFigure 5 - Footnote1 by report week, Canada, 2015-2016

                        Figure 6 - Footnote 1 All provinces and territories except NU report influenza outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
                        Return to Figure 5 - Footnote1referrer
                        Figure 6 - Text Description Sentinel Pediatric Hospital Influenza Surveillance

                        Paediatric Influenza Hospitalizations and Deaths

                        In week 08, 121 hospitalizations were reported by the the Immunization Monitoring Program Active (IMPACT) network (Figure 7). Thirty-five hospitalizations were due to influenza A(H1N1) (29.0%), 18 were due to influenza B (15%) and the remainder were influenza A (UnS).
                        To date this season, 480 laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations have been reported by the IMPACT network: 390 hospitalized cases were due to influenza A and 90 cases were due to influenza B. The largest proportion of hospitalized cases were among children under the age of 2 years (37%). To date, 73 intensive care unit (ICU) admissions have been reported. ICU admissions were approximately equally distributed across ages with slightly smaller proportions of children 10-16 years admitted. Less than five influenza-associated deaths have been reported.
                        x - Suppressed to prevent residual disclosure.
                        42 13 <5 x 7 49 (10%)
                        113 47 7 59 18 131 (27%)
                        117 50 <5 x 25 142 (30%)
                        85 29 <5 x 26 111 (23%)
                        85 29 <5 x 26 47 (10%)
                        390 153 18 219 90 480 (100%)
                        Figure 7. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2015-16, paediatric and adult hospitalizations (≤16 years of age, IMPACT; ≥16 years of age, CIRN-SOS)

                        Not included in Table 2 and Figure 7 are two IMPACT cases that were due to co-infections of influenza A and B.
                        Figure 7 - Text Description Adult Influenza Hospitalizations and Deaths

                        In week 08, 88 hospitalizations were reported by the Canadian Immunization Research Network Serious Outcome Surveillance (CIRN-SOS). The largest proportion of hospitalizations were in adults 65+ years of age (45%) and due to influenza A (88%).
                        To date this season, 347 laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations have been reported by CIRN-SOS (Table 3). The majority of hospitalized cases were due to influenza A (86%) and the largest reported proption were among adults ≥65 years of age (50%). Forty-four intensive care unit (ICU) admissions have been reported and among those, 40 (91%) were due to influenza A. Twelve deaths have been reported this season.
                        x - Suppressed to prevent residual disclosure.
                        <5 <5 x <5 x 3 (1%)
                        43 14 0 29 15 58 (17%)
                        103 25 <5 x 9 112 (32%)
                        149 24 16 109 22 171 (49%)
                        <5 x x <5 <5 3 (1%)
                        300 65 18 217 47 347
                        86% 22% 6% 72% 14% 100%
                        Figure 8. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group (≥16 year of age), Canada 2015-16

                        Note: The number of hospitalizations reported through CIRN-SOS and IMPACT represents a subset of all influenza-associated adult and paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
                        x - Suppressed to prevent residual disclosure.
                        Figure 8 - Text Description Provincial/Territorial Influenza Hospitalizations and Deaths

                        In week 08, 276 hospitalizations have been reported from participating provinces and territoriesFootnote*. The majority of hospitalizations were due to influenza A (88%). The largest proportion of cases reported in week 08 were in adults 65+ years of age (29%) followed by adults 45-64 years (18%)
                        Since the start of the 2015-16 season, 1,632 laboratory-confirmed influenza-associated hospitalizations have been reported. A total of 1,451 hospitalizations (89%) were due to influenza A and 181 (11%) were due to influenza B. Among cases for which the subtype of influenza A was reported, 91% (834/921) were influenza A(H1N1). The largest proportion (28%) of hospitalized cases were ≥65 years of age. One hundred seventy-eight ICU admissions have been reported of which 161 (90%) were due to influenza A and 78 (44%) were in the 45-64 age group. A total of 36 deaths have been reported, all due to influenza A. The largest proportion of deaths were reported in adults 65+ years of age,representing 47% of deaths.
                        Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada 2015-16

                        Figure 9 - Text Description Footnote * Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, and QC. Only hospitalizations that require intensive medical care are reported by SK. ICU admissions are not distinguished among hospital admissions reported from ON. Data may also include cases reported by the IMPACT networks. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from ON that occurred in previous weeks, as a result of retrospective updates to the cumulative total. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting.
                        Return to footnote*referrer
                        See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2011-12 to 2015-16 on the Public Health Agency of Canada website.
                        Influenza Strain Characterizations

                        During the 2015-16 influenza season, the National Microbiology Laboratory (NML) has characterized 588 influenza viruses [129 A(H3N2), 307 A(H1N1) and 152 influenza B].
                        Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assays, 28 H3N2 virus were antigenically characterized as A/Switzerland/9715293/2013-like using antiserum raised against cell-propagated A/Switzerland/9715293/2013.
                        Sequence analysis was done on 101 H3N2 viruses. All viruses belonged to a genetic group for which most viruses were antigenically related to A/Switzerland/9715293/2013. A/Switzerland/9715293/2013 is the A(H3N2) component of the 2015-16 Northern Hemisphere's vaccine.
                        Influenza A (H1N1): A total of 307 H1N1 viruses characterized were antigenically similar to A/California/7/2009, the A(H1N1) component of the 2015-16 influenza vaccine.
                        Influenza B: A total of 53 influenza B viruses characterized were antigenically similar to the vaccine strain B/Phuket/3073/2013. Ninety-nine influenza B viruses were characterized as B/Brisbane/60/2008-like, one of the influenza B components of the 2015-16 Northern Hemisphere quadrivalent influenza vaccine.
                        The WHO has released the recommended composition of the northern hemisphere influenza vaccine for the 2016-2017 season. Trivalent vaccines are recommended to contain 1) an A/California/7/2009 (H1N1)pdm09-like virus 2) an A/HongKong/4801/2014 (H3N2)-like virus, and 3) a B/Brisbane/60/2008-like virus (Victoria lineage). Quadrivalent vaccines are recommended to additionally contain a B/Phuket/30732013-like virus (Yamagata lineage).
                        The recommended components for the 2015-2016 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A/Switzerland/9715293/2013(H3N2)-like virus, and a B/Phuket/3073/2013 -like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus (Victoria lineage) is recommended.
                        The NML receives a proportion of the influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition testing compared to the reference influenza strains recommended by WHO.
                        .../

                        http://healthycanadians.gc.ca/public.../index-eng.php

                        "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                        -Nelson Mandela

                        Comment


                        • #13
                          FluWatch report: February 28, 2016 - March 5, 2016 (week 09)

                          Overall Summary

                          • Influenza activity continues to increase and is typical of peak season levels.
                          • For a second week in a row, the Eastern provinces of Canada accounted for the majority of influenza activity nationally. Nearly all reporting regions now have sporadic or localized activity.
                          • In week 09, 45 outbreaks were reported with the majority of outbreaks reported in long-term care facilities.
                          • Adults greater than 45 years of age accounted for the majority of hospitalizations in week 09.
                          • Influenza A(H1N1) remains the most common influenza subtype circulating in Canada.
                          • For more information on the flu, see our Flu(influenza) web page.

                          Download the alternative format
                          (PDF format, 858 KB, 9 pages)
                          Organization: Public Health Agency of Canada
                          Date published: 2016-03-11

                          Related Topics


                          Are you a primary health care practitioner (General Practitioner, Nurse Practitioner or Registered Nurse) interested in becoming a FluWatch sentinel for the 2015-16 influenza season? Contact us at FluWatch@phac-aspc.gc.ca


                          On this page

                          Influenza/Influenza-like Illness Activity (geographic spread)

                          In week 09, influenza activity was present in almost every reporting region in Canada. A total of 19 regions reported localized activity levels with the majority in the central and eastern regions of Canada. Sporadic influenza/ILI activity was reported in 27 regions across Canada.
                          Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, week 09




                          Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available in the mapping feature found in the Weekly Influenza Reports.
                          Figure 1 - Text Description Laboratory Confirmed Influenza Detections

                          The percent positive for influenza increased slightly from 33% in week 08 to 34% in week 09 (Figure 2). This small increase from the previous week may suggest that the influenza season is near its peak. Compared to the previous five seasons, the percent positive (34%) reported in week 09 was above the five year average for that week and exceeded the expected levels (range 14.1%-17.1%). With the late start to the 2015-16 influenza season, these above normal levels are not unexpected and are typical of peak season levels.
                          Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2015-16

                          Figure 2 - Text Description In week 09, there were 4,129 positive influenza tests reported. Increased detections of influenza in the central and eastern provinces have been noted in the last few weeks. In week 09, the majority of influenza detections were reported in the provinces of ON and QC (67%). To date, 84% of influenza detections have been influenza A and among those subtyped, the vast majority have been influenza A(H1N1) [89% (6514/7325)].
                          Figure 3. Cumulative numbers of positive influenza specimens by type/subtype and province, Canada, 2015-16

                          Note: Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
                          Figure 3 - Text Description To date this season, detailed information on age and type/subtype has been received for 14,493 cases. Adults aged 20-44 years accounted for the greatest proportion of influenza cases (Table 1). Adults aged 20-44 and 45-64 years accounted for 56% of reported influenza A(H1N1) cases. Children 5-19 years and adults 20-44 years accounted for 58% of all influenza B cases reported.
                          Table 1 - Footnote 1 Table 1 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
                          Return to Table 1 - Footnote1referrer
                          Table 1 - Footnote 2 Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                          Return to Table 1 - Footnote2referrer
                          Table 1 - Footnote 3 Unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
                          Return to Table 1 - Footnote3referrer
                          Table 1 - Footnote x Suppressed to prevent residual disclosure.
                          Return to Table 1 - Footnotexreferrer
                          488 114 <5 Table 1 - Footnotex 67 2319 1155 50 1114 308 2627 18.1%
                          254 74 <5 Table 1 - Footnotex 107 1369 722 72 575 651 2020 13.9%
                          554 170 5 379 93 3288 1829 123 1336 630 3918 27.0%
                          618 154 <5 Table 1 - Footnotex 40 3123 1575 150 1398 292 3415 23.6%
                          445 113 6 326 67 2180 826 322 1032 333 2513 17.3%
                          2359 625 14 1720 374 12279 6107 717 5455 2214 14493 100.0%
                          86.3% 26.5% 0.6% 72.9% 13.7% 84.7% 49.7% 5.8% 44.4% 15.3%
                          For data on other respiratory virus detections see the Respiratory Virus Detections in Canada Report on the Public Health Agency of Canada website.
                          Influenza-like Illness Consultation Rate

                          The national ILI consultation rate increased from the previous week from 51.7 per 1,000 patient visits in week 08, to 63.3 per 1,000 patient visits in week 09. In week 09, the highest ILI consultation rate was found in children 0-4 years of age (137.0 per 1,000) and the lowest was found in the ≥65 years age group (25.2 per 1,000) (Figure 4).
                          Figure 4. Influenza-like-illness (ILI) consultation rates by age group and week, Canada, 2015-16

                          Delays in the reporting of data may cause data to change retrospectively. In BC, AB, and SK, data are compiled by a provincial sentinel surveillance program for reporting to FluWatch. Not all sentinel physicians report every week.
                          Figure 4 - Text Description Pharmacy Surveillance

                          During week 09, the proportion of prescriptions for antivirals increased to 89.4 antiviral prescriptions per 100,000 total prescriptions, which is lower than the five year historical average. Since week 02, the highest proportion of prescriptions for antivirals has been reported among children. In week 09, the proportion reported among children was 329.1 per 100,000 total prescriptions.
                          Figure 5. Proportion of prescription sales for influenza antivirals by age group and week, Canada, 2015-16

                          Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu[oseltamivir] and Relenza [zanamivir]) and the total number of new prescriptions dispensed by Province/Territory and age group.
                          * The average weekly proportion includes data from April 2011 to March 2015.
                          Figure 5 - Text Description Influenza Outbreak Surveillance

                          In week 09, 45 new laboratory confirmed influenza outbreaks were reported: 24 in long-term care facilities (LTC), 13 in hospitals and eight in institutions or community settings. Of the outbreaks with known strains or subtypes, 12 outbreaks were due to influenza A and six outbreaks were due to influenza B. Additionally, four ILI outbreaks were reported in schools.
                          To date this season, 226 outbreaks have been reported. At week 09 in the 2014-15 season, 1,338 outbreaks were reported and in the 2013-14 season,140 outbreaks were reported.
                          Figure 6. Overall number of new laboratory-confirmed influenza outbreaksFigure 5 - Footnote1 by report week, Canada, 2015-2016

                          Figure 6 - Footnote 1 All provinces and territories except NU report influenza outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
                          Return to Figure 5 - Footnote1referrer
                          Figure 6 - Text Description Sentinel Pediatric Hospital Influenza Surveillance

                          Paediatric Influenza Hospitalizations and Deaths

                          In week 09, 132 hospitalizations were reported by the the Immunization Monitoring Program Active (IMPACT) network (Figure 7). The largest proportion of hospitalizations were in children aged 2-4 years (33%) and the majority of hospitalizations were due to influenza A (87%).
                          To date this season, 642 laboratory-confirmed influenza-associated pediatric (≤16 years of age) hospitalizations have been reported by the IMPACT network: 531 hospitalized cases were due to influenza A and 111 cases were due to influenza B. Children aged less than 2 years of age accounted for the greatest proportion of hosptalizations cases (37%). To date, 103 intensive care unit (ICU) admissions have been reported. Children aged 2 to 4 years accounted for 29% of ICU admissions. Less than five influenza-associated deaths have been reported.
                          Table 2 - Footnote x Suppressed to prevent residual disclosure.
                          Return to Table 2 - Footnotexreferrer
                          64 18 <5 Table 2 - Footnotex 7 71 (11%)
                          148 53 7 88 21 169 (26%)
                          161 62 <5 Table 2 - Footnotex 29 190 (30%)
                          116 34 <5 Table 2 - Footnotex 36 152 (24%)
                          42 16 <5 Table 2 - Footnotex 18 60 (9%)
                          531 183 19 329 111 642 (100%)
                          Figure 7. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2015-16, paediatric and adult hospitalizations (≤16 years of age, IMPACT; ≥16 years of age, CIRN-SOS)

                          Not included in Table 2 and Figure 7 are two IMPACT cases that were due to co-infections of influenza A and B.
                          Figure 7 - Text Description Adult Influenza Hospitalizations and Deaths

                          In week 09, 69 hospitalizations were reported by the Canadian Immunization Research Network Serious Outcome Surveillance (CIRN-SOS). The largest proportion of hospitalizations were in adults 65+ years of age (52%) and due to influenza A (88%).
                          To date this season, 453 laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations have been reported by CIRN-SOS (Table 3). The majority of hospitalized cases were due to influenza A (88%) and the largest reported proption were among adults ≥65 years of age (49%). Fifty-eight intensive care unit (ICU) admissions have been reported and among those, 51 (88%) were due to influenza A. A total of 29 ICU cases (50%) reported to have at least one underlying condition or comorbidity. Fifteen deaths have been reported this season.
                          Table 3 - Footnote x Suppressed to prevent residual disclosure.
                          Return to Table 3 - Footnotexreferrer
                          <5 <5 0 <5 0 <5
                          64 20 <5 Table 3 - Footnotex 16 80 (18%)
                          133 32 <5 Table 3 - Footnotex 12 145 (32%)
                          193 32 16 145 27 220 (49%)
                          <5 Table 3 - Footnotex 0 <5 0 <5
                          398 87 20 291 55 453
                          88% 22% 5% 73% 12% 100%
                          Figure 8. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group (≥16 year of age), Canada 2015-16

                          Note: The number of hospitalizations reported through CIRN-SOS and IMPACT represents a subset of all influenza-associated adult and paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively. x - Suppressed to prevent residual disclosure.
                          Figure 8 - Text Description Provincial/Territorial Influenza Hospitalizations and Deaths

                          In week 09, 417 hospitalizations have been reported from participating provinces and territoriesFootnote*. The majority of hospitalizations were due to influenza A (86%). The largest proportion of cases reported in week 09 were in adults 65+ years of age (29%) followed closely by adults 45-64 years of age (28%).
                          Since the start of the 2015-16 season, 2,081Footnote1 laboratory-confirmed influenza-associated hospitalizations have been reported. A total of 1,832 hospitalizations (88%) were due to influenza A and 249 (12%) were due to influenza B. Among cases for which the subtype of influenza A was reported, 91% (1022/1117) were influenza A(H1N1). The largest proportion (28%) of hospitalized cases were ≥65 years of age, followed closely by adults 45-64 years of age (26%). Two hundred and twenty-five ICU admissions have been reported of which 206 (92%) were due to influenza A and 78 (44%) were in the 45-64 age group. A total of 59 deaths have been reported, all due to influenza A. The largest proportion of deaths were reported in adults 45-64 years of age, representing 49% of deaths.
                          Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada 2015-16

                          Figure 9 - Text Description Footnote * Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, and QC. Only hospitalizations that require intensive medical care are reported by SK. ICU admissions are not distinguished among hospital admissions reported from ON. Data may also include cases reported by the IMPACT networks. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from ON that occurred in previous weeks, as a result of retrospective updates to the cumulative total. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting.
                          Return to footnote*referrer
                          Footnote * Includes three hospitalizations for which age is unknown.
                          Return to footnote1referrer
                          See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2011-12 to 2015-16 on the Public Health Agency of Canada website.
                          Influenza Strain Characterizations

                          During the 2015-16 influenza season, the National Microbiology Laboratory (NML) has characterized 766 influenza viruses [132 A(H3N2), 436 A(H1N1) and 198 influenza B].
                          Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assays, 28 H3N2 virus were antigenically characterized as A/Switzerland/9715293/2013-like using antiserum raised against cell-propagated A/Switzerland/9715293/2013.
                          Sequence analysis was done on 104 H3N2 viruses. All viruses belonged to a genetic group for which most viruses were antigenically related to A/Switzerland/9715293/2013. A/Switzerland/9715293/2013 is the A(H3N2) component of the 2015-16 Northern Hemisphere's vaccine.
                          Influenza A (H1N1): A total of 436 H1N1 viruses characterized were antigenically similar to A/California/7/2009, the A(H1N1) component of the 2015-16 influenza vaccine.
                          Influenza B: A total of 66 influenza B viruses characterized were antigenically similar to the vaccine strain B/Phuket/3073/2013. A total of 132 influenza B viruses were characterized as B/Brisbane/60/2008-like, one of the influenza B components of the 2015-16 Northern Hemisphere quadrivalent influenza vaccine.
                          The recommended components for the 2015-2016 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A/Switzerland/9715293/2013(H3N2)-like virus, and a B/Phuket/3073/2013 -like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus (Victoria lineage) is recommended.
                          The NML receives a proportion of the influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition testing compared to the reference influenza strains recommended by WHO.
                          .../

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

                          Comment


                          • #14
                            FluWatch report: March 6 to March 12, 2016 (week 10)

                            Overall Summary

                            • Influenza activity continues to increase and is typical of peak season levels. The Eastern provinces of Canada accounted for the majority of influenza activity nationally.
                            • Nearly all regions in Canada are reporting sporadic or localized influenza activity.
                            • In week 10, 46 outbreaks were reported and the majority of outbreaks were in long-term care facilities.
                            • Adults greater than 45 years of age accounted for the majority of hospitalizations in week 10.
                            • Hospitalizations and ICU admissions among the pediatric population continue to be above typical peak season levels.
                            • A Canadian study reported an interim estimate of vaccine effectiveness of 64% against influenza A(H1N1) in Canada. This estimate suggests that the 2015-16 northern hemisphere vaccine has provided good protection against the influenza A(H1N1) virus, the most common circulating influenza virus.
                            • For more information on the flu, see our Flu(influenza) web page.

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                            Organization: Public Health Agency of Canada
                            Date published: 2016-03-11

                            Related Topics


                            Are you a primary health care practitioner (General Practitioner, Nurse Practitioner or Registered Nurse) interested in becoming a FluWatch sentinel for the 2015-16 influenza season? Contact us at FluWatch@phac-aspc.gc.ca


                            On this page

                            Influenza/Influenza-like Illness Activity (geographic spread)

                            In week 10, influenza activity was present in almost every region in Canada. A total of 24 regions reported localized activity levels with the majority in the eastern regions of Canada. Sporadic influenza/ILI activity was reported in 27 regions across Canada.
                            Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, week 10




                            Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available in the mapping feature found in the Weekly Influenza Reports.
                            Figure 1 - Text Description Laboratory Confirmed Influenza Detections

                            The percent positive for influenza increased slightly from the previous week [from 34% in week 09 to 36% in week 10 (Figure 2)]. This small increase from the previous week may suggest that the influenza season is near its peak. Compared to the previous five seasons, the percent positive (36%) reported in week 10 was above the five year average for that week and exceeded the expected levels (range 12.8%-18.3%). With the late start to the 2015-16 influenza season, these above normal levels are not unexpected and are typical of peak season levels.
                            Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2015-16

                            Figure 2 - Text Description In week 10, there were 4,359 positive influenza tests reported. The Atlantic provinces reported the greatest percent increase (37%) in the number of positive influenza tests compared to the previous week. To date, 84% of influenza detections have been influenza A and among those subtyped, the vast majority have been influenza A(H1N1) [90% (7818/8679)].
                            Figure 3. Cumulative numbers of positive influenza specimens by type/subtype and province, Canada, 2015-16

                            Note: Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
                            Figure 3 - Text Description To date this season, detailed information on age and type/subtype has been received for 18,729 cases. Adults aged 20-44 years accounted for the greatest proportion of influenza cases, followed closely by adults aged 45-64 (Table 1). Adults aged 20-44 and 45-64 years accounted for 55% of reported influenza A(H1N1) cases. Children 5-19 years and adults 20-44 years accounted for 57% of all influenza B cases reported.
                            Table 1 - Footnote 1 Table 1 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
                            Return to Table 1 - Footnote1referrer
                            Table 1 - Footnote 2 Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                            Return to Table 1 - Footnote2referrer
                            Table 1 - Footnote 3 Unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
                            Return to Table 1 - Footnote3referrer
                            Table 1 - Footnote x Suppressed to prevent residual disclosure.
                            Return to Table 1 - Footnotexreferrer
                            489 118 0 371 106 2973 1392 52 1529 457 3430 18%
                            169 44 <5 Table 1 - Footnotex 167 1671 851 77 743 901 2572 14%
                            587 180 <5 Table 1 - Footnotex 133 4112 2175 130 1907 809 4921 26%
                            722 211 <5 Table 1 - Footnotex 61 4087 1963 159 1965 385 4472 24%
                            549 140 18 391 81 2899 1085 354 1400 435 3334 18%
                            2516 693 29 1794 548 15742 7466 772 7504 2987 18729 100%
                            82% 28% 1% 71% 18% 84% 47% 5% 48% 16%
                            For data on other respiratory virus detections see the Respiratory Virus Detections in Canada Report on the Public Health Agency of Canada website.
                            Influenza-like Illness Consultation Rate

                            The national ILI consultation rate increased from the previous week from 63.3 per 1,000 patient visits in week 09, to 75.6 per 1,000 patient visits in week 10.The highest ILI consultation rate was found in the 5-19 years of age group (151.5 per 1,000) and the lowest was found in the ≥65 years age group (21.8 per 1,000) (Figure 4).
                            Figure 4. Influenza-like-illness (ILI) consultation rates by age group and week, Canada, 2015-16

                            Delays in the reporting of data may cause data to change retrospectively. In BC, AB, and SK, data are compiled by a provincial sentinel surveillance program for reporting to FluWatch. Not all sentinel physicians report every week.
                            Figure 4 - Text Description Pharmacy Surveillance

                            During week 10, the proportion of prescriptions for antivirals increased to 144.7 antiviral prescriptions per 100,000 total prescriptions, which is higher than the five year historical average for week 10. The proportion of antiviral prescriptions among infants more than doubled from week 09. The highest proportion of prescriptions for antivirals remains highest among children. In week 10, the proportion reported among children was 341.8 per 100,000 total prescriptions.
                            Figure 5. Proportion of prescription sales for influenza antivirals by age group and week, Canada, 2015-16

                            Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu[oseltamivir] and Relenza [zanamivir]) and the total number of new prescriptions dispensed by Province/Territory and age group.
                            * The average weekly proportion includes data from April 2011 to March 2015.
                            Figure 5 - Text Description Influenza Outbreak Surveillance

                            In week 10, 46 new laboratory confirmed influenza outbreaks were reported: 23 in long-term care facilities (LTCF), nine in hospitals and 14 in institutions or community settings. Of the reported LTCF outbreaks, 13 were due to influenza A(UnS), six due to influenza A(H1N1), one due to influenza A(H3N2) and three due to influenza B. For the remaining outbreaks in hospitals and community settings: two were due to influenza A(H3N2), one due to influenza A(H1N1), seven due to influenza A(UnS) and three due to influenza B. Additionally, three ILI outbreaks were reported in schools.
                            To date this season, 274 outbreaks have been reported. At week 10 in the 2014-15 season, 1,376 outbreaks were reported and in the 2013-14 season,147 outbreaks were reported.
                            Figure 6. Overall number of new laboratory-confirmed influenza outbreaksFigure 5 - Footnote1 by report week, Canada, 2015-2016

                            Figure 6 - Footnote 1 All provinces and territories except NU report influenza outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
                            Return to Figure 5 - Footnote1referrer
                            Figure 6 - Text Description Sentinel Pediatric Hospital Influenza Surveillance

                            Paediatric Influenza Hospitalizations and Deaths

                            In week 10, 134 hospitalizations were reported by the the Immunization Monitoring Program Active (IMPACT) network, down slightly from the previous two weeks (Figure 7). The largest proportion of hospitalizations were in children aged 6-23 months (34%) and the majority of hospitalizations were due to influenza A (72%).
                            To date this season, 792 laboratory-confirmed influenza-associated pediatric (≤16 years of age) hospitalizations have been reported by the IMPACT network: 641 hospitalized cases were due to influenza A and 151 cases were due to influenza B. The greatest proportion of hosptalizations cases were in children aged 6-23 months and children 2-4 years, each accounting for 28% of hospitalizations. To date, 136 intensive care unit (ICU) admissions have been reported. Children aged 2 to 4 years accounted for 28% of ICU admissions. A total of 71 ICU cases (52%) reported to have at least one underlying condition or comorbidity. Less than five influenza-associated deaths have been reported.
                            Table 2 - Footnote x Suppressed to prevent residual disclosure.
                            Return to Table 2 - Footnotexreferrer
                            85 27 <5 Table 2 - Footnotex 11 96 (12%)
                            186 59 7 120 35 221 (28%)
                            188 68 <5 Table 2 - Footnotex 37 225 (28%)
                            135 42 <5 Table 2 - Footnotex 47 182 (23%)
                            47 16 <5 Table 2 - Footnotex 21 68 (9%)
                            641 212 19 410 151 792 (100%)
                            Figure 7. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2015-16, paediatric and adult hospitalizations (≤16 years of age, IMPACT; ≥16 years of age, CIRN-SOS)

                            Not included in Table 2 and Figure 7 are two IMPACT cases that were due to co-infections of influenza A and B.
                            Figure 7 - Text Description Adult Influenza Hospitalizations and Deaths

                            In week 10, 79 hospitalizations were reported by the Canadian Immunization Research Network Serious Outcome Surveillance (CIRN-SOS) (Figure 7). The largest proportion of hospitalizations were in adults 65+ years of age (56%) and due to influenza A (88%).
                            To date this season, 566 laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations have been reported by CIRN-SOS (Table 3). The majority of hospitalized cases were due to influenza A (88%) and the largest reported proportion were among adults ≥65 years of age (48%). Seventy-four intensive care unit (ICU) admissions have been reported and among those, 64 (86%) were due to influenza A. A total of 38 ICU cases (51%) reported to have at least one underlying condition or comorbidity. Nineteen deaths have been reported this season.
                            Table 3 - Footnote x Suppressed to prevent residual disclosure.
                            Return to Table 3 - Footnotexreferrer
                            <5 <5 0 <5 0 <5
                            81 22 <5 Table 3 - Footnotex 18 99 (17%)
                            166 37 <5 Table 3 - Footnotex 17 183 (32%)
                            240 40 17 183 34 274 (48%)
                            Table 3 - Footnotex <5 0 <5 0 <5
                            497 105 21 371 69 566
                            88% 21% 4% 75% 12% 100%
                            Figure 8. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group (≥16 year of age), Canada 2015-16

                            Note: The number of hospitalizations reported through CIRN-SOS and IMPACT represents a subset of all influenza-associated adult and paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively. x - Suppressed to prevent residual disclosure.
                            Figure 8 - Text Description Provincial/Territorial Influenza Hospitalizations and Deaths

                            In week 10, 399 hospitalizations were reported from participating provinces and territoriesFootnote*. The majority of hospitalizations were due to influenza A (89%). The largest proportion of cases reported in week 10 were in adults 65+ years of age (32%).
                            Since the start of the 2015-16 season, 2,598 laboratory-confirmed influenza-associated hospitalizations have been reported. A total of 2,291 hospitalizations (88%) were due to influenza A and 307 (12%) were due to influenza B. Among cases for which the subtype of influenza A was reported, 92% (1166/1270) were influenza A(H1N1). The largest proportion (29%) of hospitalized cases were ≥65 years of age, followed closely by adults 45-64 years of age (26%). Two hundred and ninety ICU admissions have been reported of which 181 (62%) were due to influenza A(H1N1) and 128 (44%) were in the 45-64 age group. A total of 89 deaths have been reported, all but two were due to influenza A. Adults 45-64 and ≥65 years of age each represented 40% of reported deaths.
                            Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada 2015-16

                            Figure 9 - Text Description Footnote * Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, and QC. Only hospitalizations that require intensive medical care are reported by SK. ICU admissions are not distinguished among hospital admissions reported from ON. Data may also include cases reported by the IMPACT networks. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from ON that occurred in previous weeks, as a result of retrospective updates to the cumulative total. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting.
                            Return to footnote*referrer
                            Footnote * Includes three hospitalizations for which age is unknown.
                            Return to footnote1referrer
                            See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2011-12 to 2015-16 on the Public Health Agency of Canada website.
                            Influenza Strain Characterizations

                            During the 2015-16 influenza season, the National Microbiology Laboratory (NML) has characterized 994 influenza viruses [140 A(H3N2), 611 A(H1N1) and 243 influenza B].
                            Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assays, 29 H3N2 virus were antigenically characterized as A/Switzerland/9715293/2013-like using antiserum raised against cell-propagated A/Switzerland/9715293/2013.
                            Sequence analysis was done on 111 H3N2 viruses. All viruses belonged to a genetic group for which most viruses were antigenically related to A/Switzerland/9715293/2013. A/Switzerland/9715293/2013 is the A(H3N2) component of the 2015-16 Northern Hemisphere's vaccine.
                            Influenza A (H1N1): A total of 611 H1N1 viruses characterized were antigenically similar to A/California/7/2009, the A(H1N1) component of the 2015-16 influenza vaccine.
                            Influenza B: A total of 77 influenza B viruses characterized were antigenically similar to the vaccine strain B/Phuket/3073/2013. A total of 166 influenza B viruses were characterized as B/Brisbane/60/2008-like, one of the influenza B components of the 2015-16 Northern Hemisphere quadrivalent influenza vaccine.
                            The recommended components for the 2015-2016 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A/Switzerland/9715293/2013(H3N2)-like virus, and a B/Phuket/3073/2013 -like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus (Victoria lineage) is recommended.
                            The NML receives a proportion of the influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition testing compared to the reference influenza strains recommended by WHO.

                            .../

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

                            Comment


                            • #15

                              FluWatch report: March 13 to March 19, 2016 (week 11)

                              http://healthycanadians.gc.ca/public.../index-eng.php

                              -------------------------------------------------------------------------------------------------------------------------------------
                              FluWatch report: March 20 to March 26, 2016 (week 12)

                              Overall Summary
                              • For the second consecutive week, influenza activity continued to decrease across Canada.
                              • All regions of Canada reported sporadic or localized influenza activity.
                              • The number of positive influenza B tests reported continues to increase, but still accounted for only 30% of positive influenza tests in week 12
                              • Adults greater than 65 years of age accounted for the majority of hospitalizations in week 12 and account for the largest proportion of hospitalizations to date this season.
                              • Hospitalizations, ICU admissions and deaths among the pediatric population, while declining, remain above expected levels based on the past several influenza seasons.
                              • For more information on the flu, see our Flu(influenza) web page.
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                              Organization: Public Health Agency of Canada
                              Date published: 2016-04-01

                              Related Topics

                              Are you a primary health care practitioner (General Practitioner, Nurse Practitioner or Registered Nurse) interested in becoming a FluWatch sentinel for the 2015-16 influenza season? Contact us at FluWatch@phac-aspc.gc.ca


                              On this pageInfluenza/Influenza-like Illness Activity (geographic spread)

                              In week 12, influenza activity was present in all regions of Canada. A total of 21 regions reported localized activity levels across the country. Sporadic influenza/ILI activity was reported in 32 regions across Canada.
                              Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, week 12




                              Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available in the mapping feature found in the Weekly Influenza Reports.
                              Figure 1 - Text Description Laboratory Confirmed Influenza Detections

                              In week 12, the percent positive for influenza continued to decrease from the previous week [from 31% in week 11 to 30% in week 12 (Figure 2)]. Compared to the previous five seasons, the percent positive (30%) reported in week 12 was above the five year average for that week and exceeded the expected levels (range 11.3%-19.8%). With the late start to the 2015-16 influenza season, these above normal levels are not unexpected.
                              Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2015-16

                              Figure 2 - Text Description In week 12, there were 2,882 positive influenza tests reported. To date, 81% of influenza detections have been influenza A and among those subtyped, the vast majority have been influenza A(H1N1) [91% (9630/10584]. The number of positive influenza B tests reported is accounting for an increasing proportion of all positive influenza tests reported; this week, influenza B positive tests accounted for 30% of all positive tests.
                              Figure 3. Cumulative numbers of positive influenza specimens by type/subtype and province, Canada, 2015-16

                              Note: Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
                              Figure 3 - Text Description To date this season, detailed information on age and type/subtype has been received for 24,173 cases. Adults aged 20-44 years accounted for the greatest proportion of influenza cases, followed closely by adults aged 45-64 (Table 1). Adults aged 20-44 and 45-64 years accounted for 55% of reported influenza A(H1N1) cases. Children 5-19 years and adults 20-44 years accounted for 57% of all influenza B cases reported.
                              Table 1 - Footnote 1 Table 1 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
                              Return to Table 1 - Footnote1referrer
                              Table 1 - Footnote 2 Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
                              Return to Table 1 - Footnote2referrer
                              Table 1 - Footnote 3 Unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
                              Return to Table 1 - Footnote3referrer
                              Table 1 - Footnote x Suppressed to prevent residual disclosure.
                              Return to Table 1 - Footnotexreferrer
                              259 15 <5 Table 1 - Footnotex 112 3794 1564 62 2168 710 4511 19%
                              83 11 <5 Table 1 - Footnotex 148 2055 931 89 1035 1351 3417 14%
                              235 26 <5 Table 1 - Footnotex 122 4893 2404 138 2351 1146 6048 25%
                              303 38 <5 Table 1 - Footnotex 62 5172 2310 172 2690 521 5698 24%
                              293 38 7 248 90 3827 1301 368 2158 667 4499 19%
                              1173 128 15 1030 534 19741 8510 829 10402 4395 24173 100%
                              69% 11% 1% 88% 31% 82% 43% 4% 53% 18%
                              For data on other respiratory virus detections see the Respiratory Virus Detections in Canada Report on the Public Health Agency of Canada website.
                              Influenza-like Illness Consultation Rate

                              The national ILI consultation rate decreased from the previous week from 53.6 per 1,000 patient visits in week 11, to 43.6 per 1,000 patient visits in week 12.The highest ILI consultation rate was found in the 5-19 years age group (84.2 per 1,000) and the lowest was found in the ≥65 years age group (14.7 per 1,000) (Figure 4).
                              Figure 4. Influenza-like-illness (ILI) consultation rates by age group and week, Canada, 2015-16

                              Delays in the reporting of data may cause data to change retrospectively. In BC, AB, and SK, data are compiled by a provincial sentinel surveillance program for reporting to FluWatch. Not all sentinel physicians report every week.
                              Figure 4 - Text Description Pharmacy Surveillance

                              During week 12, the proportion of prescriptions for antivirals decreased to 72.9 antiviral prescriptions per 100,000 total prescriptions, which is slightly higher than the five year historical average for week 12. The proportion of prescriptions for antivirals remains highest among children. In week 12, the proportion reported among children was 199.3 per 100,000 total prescriptions.
                              Figure 5. Proportion of prescription sales for influenza antivirals by age group and week, Canada, 2015-16

                              Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu[oseltamivir] and Relenza [zanamivir]) and the total number of new prescriptions dispensed by Province/Territory and age group.
                              * The average weekly proportion includes data from April 2011 to March 2015.
                              Figure 5 - Text Description Influenza Outbreak Surveillance

                              In week 12, 27 new laboratory confirmed influenza outbreaks were reported: 13 in long-term care facilities (LTCF), nine in hospitals and 5 in institutions or community settings. Of the outbreaks with known strains or subtypes, one outbreak was due to influenza B, three outbreaks were due to influenza A(H1N1) and three were due to influenza A(Uns). Additionally, one ILI outbreak was reported in a school.
                              To date this season, 330 outbreaks have been reported. At week 12 in the 2014-15 season, 1,587 outbreaks were reported and in the 2013-14 season,170 outbreaks were reported.
                              Figure 6. Overall number of new laboratory-confirmed influenza outbreaksFigure 5 - Footnote1 by report week, Canada, 2015-2016

                              Figure 6 - Footnote 1 All provinces and territories except NU report influenza outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
                              Return to Figure 5 - Footnote1referrer
                              Figure 6 - Text Description Sentinel Pediatric Hospital Influenza Surveillance

                              Paediatric Influenza Hospitalizations and Deaths

                              In week 12, 85 hospitalizations were reported by the the Immunization Monitoring Program Active (IMPACT) network, a decrease from the previous three weeks (Figure 7). The largest proportion of hospitalizations were in children aged 5-9 years, accounting for 27% of the hospitalizations. The majority of hospitalizations were due to influenza A (65%).
                              To date this season, 1007 laboratory-confirmed influenza-associated pediatric (≤16 years of age) hospitalizations have been reported by the IMPACT network: 783 hospitalized cases were due to influenza A and 224 cases were due to influenza B. The greatest proportion of hosptalization cases were in children aged 6-23 months and children 2-4 years, each accounting for 28% of hospitalizations. To date, 169 intensive care unit (ICU) admissions have been reported. Children aged 2 to 4 and 5 to 9 years each accounted for 27% of ICU admissions. A total of 135 ICU cases (80%) reported to have at least one underlying condition or comorbidity. Seven influenza-associated deaths have been reported.
                              Table 2 - Footnote x Suppressed to prevent residual disclosure.
                              Return to Table 2 - Footnotexreferrer
                              106 32 <5 Table 2 - Footnotex 17 123 (12%)
                              233 69 7 157 49 282 (28%)
                              226 75 <5 Table 2 - Footnotex 53 279 (28%)
                              166 45 <5 Table 2 - Footnotex 73 239 (24%)
                              52 18 <5 Table 2 - Footnotex 32 84 (8%)
                              783 239 19 525 224 1007 (100%)
                              Figure 7. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2015-16, paediatric and adult hospitalizations (≤16 years of age, IMPACT; ≥16 years of age, CIRN-SOS)

                              Not included in Table 2 and Figure 7 are two IMPACT cases that were due to co-infections of influenza A and B.
                              Figure 7 - Text Description Adult Influenza Hospitalizations and Deaths

                              In week 12, 57 hospitalizations were reported by the Canadian Immunization Research Network Serious Outcome Surveillance (CIRN-SOS) (Figure 7). The largest proportion of hospitalizations were in adults 65+ years of age (53%) and due to influenza A (81%).
                              To date this season, 791 laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations have been reported by CIRN-SOS (Table 3). The majority of hospitalized cases were due to influenza A (86%) and the largest reported proportion were among adults ≥65 years of age (48%). One hundred and twelve intensive care unit (ICU) admissions have been reported and among those, 101 (90%) were due to influenza A. A total of 69 ICU cases (62%) reported to have at least one underlying condition or comorbidity. Twenty-seven deaths have been reported this season with the majority of deaths reported in adults ≥65 years of age (67%).
                              Table 3 - Footnote x Suppressed to prevent residual disclosure.
                              Return to Table 3 - Footnotexreferrer
                              <5 <5 0 <5 0 4 (1%)
                              106 33 <5 Table 3 - Footnotex 21 127 (16%)
                              245 69 <5 Table 3 - Footnotex 25 270 (34%)
                              321 73 21 227 62 383 (48%)
                              6 <5 0 <5 <5 7 (1%)
                              682 182 25 475 109 791
                              86% 27% 4% 70% 14% 100%
                              Figure 8. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group (≥16 year of age), Canada 2015-16

                              Note: The number of hospitalizations reported through CIRN-SOS and IMPACT represents a subset of all influenza-associated adult and paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
                              x - Suppressed to prevent residual disclosure.
                              Figure 8 - Text Description Provincial/Territorial Influenza Hospitalizations and Deaths

                              In week 12, 273 hospitalizations were reported from participating provinces and territoriesFootnote*. The majority of hospitalizations were due to influenza A (78%). The largest proportion of cases reported in week 12 were in adults 65+ years of age (31%).
                              Since the start of the 2015-16 season, 3,491 laboratory-confirmed influenza-associated hospitalizations have been reported. A total of 3,024 hospitalizations (87%) were due to influenza A and 467 (13%) were due to influenza B. Among cases for which the subtype of influenza A was reported, 93% (1442/1554) were influenza A(H1N1). The largest proportion (30%) of hospitalized cases were ≥65 years of age, followed closely by adults 45-64 years of age (27%). Three hundred and eighty nine ICU admissions have been reported of which 225 (58%) were due to influenza A(H1N1) and 175 (45%) were in the 45-64 age group. A total of 140 deaths have been reported; all but 10 were associated with influenza A. Adults ≥65 years of age each represented 46% of reported deaths.
                              Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada 2015-16

                              x - Suppressed to prevent residual disclosure.
                              Figure 9 - Text Description Footnote * Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, and QC. Only hospitalizations that require intensive medical care are reported by SK. ICU admissions are not distinguished among hospital admissions reported from ON. Data may also include cases reported by the IMPACT networks. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from ON that occurred in previous weeks, as a result of retrospective updates to the cumulative total. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting.
                              Return to footnote*referrer
                              Footnote * Includes three hospitalizations for which age is unknown.
                              Return to footnote1referrer
                              See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2011-12 to 2015-16 on the Public Health Agency of Canada website.
                              Influenza Strain Characterizations

                              During the 2015-16 influenza season, the National Microbiology Laboratory (NML) has characterized 1312 influenza viruses [149 A(H3N2), 775 A(H1N1) and 388 influenza B].
                              Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assays, 35 H3N2 virus were antigenically characterized as A/Switzerland/9715293/2013-like using antiserum raised against cell-propagated A/Switzerland/9715293/2013.
                              Sequence analysis was done on 114 H3N2 viruses. All viruses belonged to a genetic group for which most viruses were antigenically related to A/Switzerland/9715293/2013. A/Switzerland/9715293/2013 is the A(H3N2) component of the 2015-16 Northern Hemisphere's vaccine.
                              Influenza A (H1N1): A total of 775 H1N1 viruses characterized were antigenically similar to A/California/7/2009, the A(H1N1) component of the 2015-16 influenza vaccine.
                              Influenza B: A total of 104 influenza B viruses characterized were antigenically similar to the vaccine strain B/Phuket/3073/2013. A total of 284 influenza B viruses were characterized as B/Brisbane/60/2008-like, one of the influenza B components of the 2015-16 Northern Hemisphere quadrivalent influenza vaccine.
                              The recommended components for the 2015-2016 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A/Switzerland/9715293/2013(H3N2)-like virus, and a B/Phuket/3073/2013 -like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus (Victoria lineage) is recommended.
                              The NML receives a proportion of the influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition testing compared to the reference influenza strains recommended by WHO.

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