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

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  • Pathfinder
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    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.

    Download the alternative format
    (PDF format, 897 KB, 8 pages)
    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.

    .../

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  • Pathfinder
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    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.

    ...
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  • Pathfinder
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    --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

    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.

    Download the alternative format
    (PDF format, 1.01 MB, 8 pages)
    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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    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.

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    Organization: Public Health Agency of Canada
    Date published: 2015-11-13

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    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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    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.

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    Organization: Public Health Agency of Canada
    Date published: 2015-11-06

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    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.

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    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.

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    Organization: Public Health Agency of Canada
    Date published: 2015-10-30

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    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

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    started a topic Canada FluWatch Weekly Reports 2015-2016 Season Weeks 21-24

    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

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