Announcement

Collapse
No announcement yet.

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

Collapse
This is a sticky topic.
X
X
  • Filter
  • Time
  • Show
Clear All
new posts

  • Pathfinder
    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

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


  • Pathfinder
    replied
    FluWatch report: May 22 to June 18, 2016 (weeks 21-24)

    Overall Summary

    • Overall, influenza activity continues to decrease across Canada and has reached interseasonal levels.
    • Sporadic activity is being reported in several parts of Canada; however, the majority of regions are reporting no influenza activity.
    • No influenza outbreaks have been reported since week 22 (beginning of June).
    • Influenza-associated hospitalizations continue to decrease. Ten hospitalizations were reported in week 24
    • For more information on the flu, see our Flu (influenza) web page.
    Many thanks to all the sentinels participating in our influenza-like illness surveillance network. Your hard work is greatly appreciated!

    Download the alternative format
    (PDF format, 951 KB, 9 pages)
    Organization: Public Health Agency of Canada
    Date published: 2016-06-24

    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 24, influenza activity continues to be reported in parts of Canada. Sporadic activity was reported in 14 regions across six provinces (BC, AB, MB, ON, QC, NB and NU). A total of 34 regions reported no influenza activity.
    Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, week 24




    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 weeks 21-24, the percentage of tests positive for influenza continued to decrease [from 6.2% in week 21 to 1.1% in week 24]. Compared to the previous five seasons, the percent positive (1.1%) reported in week 24 was within expected levels (confidence interval 1.0-2.6%) and has retuned to interseasonal 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 Nationally in weeks 21-24, there were 389 positive influenza tests reported. Influenza B continues to account for the majority of influenza detections, representing 79% of detections in weeks 21-24. Overall in week 24, laboratory detections of influenza were low across Canada with total of 24 influenza detections reported. To date, 72% of influenza detections have been influenza A and among those subtyped, the vast majority have been influenza A(H1N1) [91% (11019/12147)].
    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 33,414 cases. Children and teenagers (0-19yrs) accounted for 48% of influenza B cases and approximately one third of all influenza cases. Children and teenagers (0-19yrs), young adults (20-44yrs) and middle-aged adults (45-64yrs) accounted for approximately an equal proportion of influenza A(H1N1) 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 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
    9 <5 <5 7 60 4533 1714 76 2743 1768 6305 19%
    9 <5 <5 <5 25 2408 1026 101 1281 2695 5105 15%
    14 <5 <5 8 14 5816 2758 166 2892 2197 8017 24%
    <5 0 0 <5 46 6396 2797 201 3398 1103 7505 22%
    15 <5 6 Table 1 - Footnotex 42 4863 1624 446 2793 1610 6482 19%
    48 11 12 25 187 24016 9919 990 13107 9373 33414 100%
    20% 23% 25% 52% 80% 72% 41% 4% 55% 28%
    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 previous weeks from 30.1 per 1,000 patient visits in week 22, to 13.4 per 1,000 patient visits in week 24. The ILI rate for week 21 was lower than expected due to a low response rate resulting from a technical error in data collection. In week 24, the highest ILI consultation rate was found in the 5-19 years age group (30.3 per 1,000) and the lowest was found in the 0-4 years age group (3.6 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 Pharmacy Surveillance

    In the period of weeks 21-24, the proportion of prescriptions for antivirals continued to decrease steadily to 2.9 antiviral prescriptions per 100,000 total prescriptions in week 24. This rate is lower than the five year historical average for week 24. The proportion of prescriptions for antivirals remains highest among children. In week 24, the proportion reported among children was 8.1 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 weeks 21-24, four new laboratory confirmed influenza outbreaks were reported: two in long-term care facilities (LTCF) and two in hospitals. All outbreaks were reported in weeks 21 and 22. Three outbreaks were due to influenza B and one was due to influenza A(unsubtyped).
    To date this season, 427 outbreaks have been reported. At week 24 in the 2014-15 season, 1,732 outbreaks were reported and in the 2013-14 season, 268 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 weeks 21-24, 16 laboratory-confirmed influenza-associated pediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network (Figure 7). The majority of hospitalizations (81%) were due to influenza B.
    A total of 222 intensive care unit (ICU) admissions have been reported. Children aged 2 to 4 and 5 to 9 years accounted for 27% and 26% of ICU admissions respectively. A total of 158 ICU cases (71%) reported at least one underlying condition or comorbidity. Eight influenza-associated deaths have been reported.
    To date this season, 1,364 hospitalizations have been reported by the IMPACT network: 900 cases (66%) were due to influenza A and 464 cases (34%) were due to influenza B. This season's count of pediatric hospitalizations is nearly double that reported up to week 24 in the 2014-15 season (N=711). The current year total number of cases also exceeds the total number of cases reported in the past five seasons.
    Table 2 - Footnote x Suppressed to prevent residual disclosure.
    Return to Table 2 - Footnotexreferrer
    122 33 <5 Table 2 - Footnotex 40 162 (12%)
    281 80 7 194 99 380 (28%)
    255 80 5 170 119 374 (27%)
    183 49 <5 Table 2 - Footnotex 146 329 (24%)
    59 18 <5 Table 2 - Footnotex 60 119 (9%)
    900 260 21 619 464 1364 (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

    Surveillance for the 2015-2016 influenza season ended on April 30th, 2016.
    For the 2015-16 season, 1,153 hospitalizations have been reported by CIRN-SOS (Table 3). The majority of hospitalized cases were due to influenza A (81%) and the largest reported proportion was among adults ≥65 years of age (50%). One hundred and ninety-one intensive care unit (ICU) admissions have been reported of which 132 cases reported at least one underlying condition or comorbidity. A total of 55 deaths have been reported this season with the majority of deaths reported in adults ≥65 years of age (62%).
    Table 3 - Footnote x Suppressed to prevent residual disclosure.
    Return to Table 3 - Footnotexreferrer
    Table 3 - Footnotex <5 0 <5 <5 Table 3 - Footnotex
    144 50 <5 Table 3 - Footnotex 46 190(16%)
    331 105 <5 Table 3 - Footnotex 46 377(33%)
    452 125 24 303 123 575 (50%)
    <5 Table 3 - Footnotex 0 <5 <5 <5 (x%)
    934 285 28 621 219 1153
    81% 31% 3% 66% 19% 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 24, 10 hospitalizations were reported by participating provinces and territoriesFootnote*. In total, 98 hospitalizations were reported in weeks 21-24, with the number of cases decreasing each week. Three ICU admissions were reported during the week 21-24 period.
    Since the start of the 2015-16 season, 5,267 laboratory-confirmed influenza-associated hospitalizations have been reported. A total of 4,094 hospitalizations (78%) were due to influenza A and 1,173 (22%) were due to influenza B. Of the 537 ICU admissions reported, 474 (88%) were due to influenza A. A total of 264 deaths have been reported; all but 41 were associated with influenza A.
    Overall this season, hospitalizations have been reported more frequently among adults ≥65 years of age. The largest proportion of ICU admissions was reported in adults 45-64years of age and the highest proportion of fatal cases was reported in adults ≥65 years of age (Figure 9). Pediatric (0-19 years) accounted for 29% of all hospitalizations and 5% of all deaths reported to date this season. Similar to findings from the IMPACT network, there have been more pediatric hospitalizations reported to date compared to the year-end totals in each of the previous four influenza seasons.
    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 2,871 influenza viruses [236 A(H3N2), 1,450 A(H1N1) and 1,185 influenza B].
    Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assays, 75 A(H3N2) viruses were antigenically characterized as A/Switzerland/9715293/2013-like using antiserum raised against cell-propagated A/Switzerland/9715293/2013.
    Sequence analysis was done on 161 A(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): All of the 1,450 A(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 248 influenza B viruses characterized were antigenically similar to the vaccine strain B/Phuket/3073/2013. A total of 937 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 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://www.healthycanadians.gc.ca/pu.../index-eng.php

    Leave a comment:


  • Pathfinder
    replied
    FluWatch report: May 1 to May 21, 2016 (weeks 18-20)

    Overall Summary

    • In weeks 18-20, all influenza indicators declined from the previous weeks.
    • Elevated influenza B activity persisted in many regions across Canada: influenza B accounted for the majority of influenza detections in weeks 18-20. Additionally, the majority of outbreaks reported this week were due to Influenza B.
    • This increase in influenza B is expected as influenza B often shows up later in the flu season.
    • Hospitalizations, ICU admissions and deaths among the pediatric population, while declining, continue to remain above expected levels based on the past several influenza seasons.
    • For more information on the flu, see our Flu(influenza) web page.

    Download the alternative format
    (PDF format, 876 KB, 9 pages)
    Organization: Public Health Agency of Canada
    Date published: 2016-05-27

    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)

    Influenza activity continues to be reported in Canada; however, the number of regions reporting influenza activity decreased in weeks 18-20. During week 20, localized activity was reported in a total of six regions across Ontario and Nunavut. Sporadic activity levels were reported in 26 regions across all provinces and territories. A total of 13 regions reported no influenza activity and a total of 8 regions did not report data in week 20.
    Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, week 20




    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 weeks 18-20, the percentage of tests positive for influenza continued to decrease [from 17% in week 17.0 to 9.4% in week 20], driven by the decline in influenza A. Compared to the previous five seasons, the percent positive (9.4%) reported in week 20 was above the five year average for that week and exceeded the expected levels (confidence interval 5.0-9.2%). With the late start to the 2015-16 influenza season, these elevated 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 Nationally in weeks 18-20, there were 1,555 positive influenza tests reported. Influenza B continues to account for an increasing proportion of influenza detections accounting for 80% of detections in weeks 18-20. Laboratory detections of influenza in the provinces of Ontario and Quebec accounted for 78% of all detections for week 20. To date, 73% of influenza detections have been influenza A and among those subtyped, the vast majority have been influenza A(H1N1) [91% (11,003/12,103)].
    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 In weeks 18-20, the number of laboratory detections decreased across all age groups, most notably among individuals under the age of 5 years. In week 20, Influenza B detections accounted for 85% of all detections (table 1).
    To date this season, detailed information on age and type/subtype has been received for 33,165 cases. Children and teenagers (0-19) accounted for 47% of influenza B cases and approximately one third of all influenza cases. Children and teenagers (0-19), young adults (20-44) and middle-aged adults (45-64) accounted for approximately an equal proportion of influenza A(H1N1) cases (26-29%).
    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
    24 <5 Table 1 - Footnotex 20 252 4036 1225 75 2736 1701 6229 19%
    11 <5 Table 1 - Footnotex 10 261 2081 700 101 1280 2649 5058 15%
    26 <5 <5 21 154 4764 1713 163 2888 2168 7981 24%
    52 9 6 37 95 5382 1792 199 3391 1088 7476 23%
    57 7 15 35 178 4453 1225 440 2788 1563 6421 19%
    170 23 24 123 940 20716 6655 978 13083 9169 33165 100%
    15% 14% 14% 72% 85% 62% 32% 5% 63% 28%
    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 remained constant from previous weeks from 31.1 per 1,000 patient visits in week 17, to 31.1 per 1,000 patient visits in week 20. The highest ILI consultation rate was found in the 0-4 years age group (65.0 per 1,000) and the lowest was found in the 20-64 years age group (23.4 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

    In the period of weeks 18-20, the proportion of prescriptions for antivirals decreased by 73% compared to week 17. The antiviral prescriptions per 100,000 total prescriptions in week 20 was 6.0; this rate is lower than the five year historical average for week 20. The proportion of prescriptions for antivirals remains highest among children. In week 20, the proportion reported among children was 11.3 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 weeks 18-20, fourteen new laboratory confirmed influenza outbreaks were reported: twelve in long-term care facilities (LTCF), one in a hospital and and one in an institution or community setting. Of the outbreaks with known strains or subtypes, six outbreaks were due to influenza B, one was due to A(H3N2) and three were due to influenza A(unsubtyped).
    To date this season, 423 outbreaks have been reported. At week 20 in the 2014-15 season, 1,724 outbreaks were reported and in the 2013-14 season, 260 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 weeks 18-20, 66 laboratory-confirmed influenza-associated pediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network (Figure 7). An equal proportion of hospitalizations were reported in children 6-23 months, 2-4 years and 5-9 years, accounting for 26%, 23% and 26% of the hospitalizations respectively. Similar to the trend of increased laboratory detections of influenza B, 88% of pediatric hospitalizations reported in weeks 18-20 were due to influenza B.
    To date this season, 1,337 hospitalizations have been reported by the IMPACT network: 893 hospitalized cases (67%) were due to influenza A and 444 cases (33%) were due to influenza B. This seasonís count of pediatric hospitalizations is nearly double that reported up to week 20 in the 2014-15 season (n=697). The current year total number of cases also exceeds the total number of cases reported in the past five seasons.
    A total of 205 intensive care unit (ICU) admissions have been reported. Children aged 2 to 4 and 5 to 9 years accounted for 29% and 26% of ICU admissions respectively . A total of 131 ICU cases (64%) reported at least one underlying condition or comorbidity. Eight influenza-associated deaths have been reported.
    Table 2 - Footnote x Suppressed to prevent residual disclosure.
    Return to Table 2 - Footnotexreferrer
    122 32 <5 Table 2 - Footnotex 40 162 (12%)
    275 76 7 192 92 367 (27%)
    257 82 <5 Table 2 - Footnotex 114 371 (28%)
    181 46 <5 Table 2 - Footnotex 142 323 (24%)
    58 18 <5 Table 2 - Footnotex 56 114 (9%)
    893 254 21 618 444 1337 (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

    Surveillance for the 2015-2016 influenza season ended on April 30th, 2016.
    To date this season, 1,153 hospitalizations have been reported by CIRN-SOS (Table 3). The majority of hospitalized cases were due to influenza A (81%) and the largest reported proportion was among adults ≥65 years of age (50%). One hundred and ninety-one intensive care unit (ICU) admissions have been reported of which 132 cases reported at least one underlying condition or comorbidity. A total of 55 deaths have been reported this season with the majority of deaths reported in adults ≥65 years of age (62%).
    Table 3 - Footnote x Suppressed to prevent residual disclosure.
    Return to Table 3 - Footnotexreferrer
    Table 3 - Footnotex <5 0 <5 <5 Table 3 - Footnotex
    144 50 <5 Table 3 - Footnotex 46 190(16%)
    331 105 <5 Table 3 - Footnotex 46 377(33%)
    452 125 24 303 123 575 (50%)
    <5 Table 3 - Footnotex 0 <5 <5 <5 (x%)
    934 285 28 621 219 1153
    81% 31% 3% 66% 19% 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

    Provincial/Territorial Influenza Hospitalizations and Deaths



    In week 20, 37 hospitalizations were reported by participating provinces and territoriesootnote*. Influenza B accounted for the greatest proportion of hospitalizations, accounting for 65% of hospitalizations reported in week 20. The largest proportion of cases reported was in adults 65+ years of age (49%). Among hospitalizations for influenza B, children (0-19 years) represented 41% of cases.
    Since the start of the 2015-16 season, 5,169 laboratory-confirmed influenza-associated hospitalizations have been reported. A total of 4,054 hospitalizations (78%) were due to influenza A and 1115 (22%) were due to influenza B. Of the 529 ICU admissions reported, 271 (51%) were due to influenza A(H1N1). A total of 255 deaths have been reported; all but 36 were associated with influenza A.
    Overall this season, hospitalizations have been reported more frequently among adults ≥65 years of age. The largest proportion of ICU admissions was reported in adults 45-64years of age and the highest proportion of fatal cases was reported in adults ≥65 years of age (figure 9). Pediatric (0-19 years) and young to middle-aged adults (20-44 years) accounted for 29% of all hospitalizations and 5% of all deaths reported to date this season. Similar to findings from the IMPACT network, there have been more pediatric hospitalizations reported to date compared to the year-end totals in each of the previous four influenza seasons.
    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 2,678 influenza viruses [217 A(H3N2), 1,367 A(H1N1) and 1094 influenza B].
    Influenza A (H3N2):When tested by hemagglutination inhibition (HI) assays, 64 A(H3N2) viruses were antigenically characterized as A/Switzerland/9715293/2013-like using antiserum raised against cell-propagated A/Switzerland/9715293/2013.
    Sequence analysis was done on 153 A(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): All of the 1,367 A(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 232 influenza B viruses characterized were antigenically similar to the vaccine strain B/Phuket/3073/2013. A total of 862 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 included: 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

    Leave a comment:


  • Pathfinder
    replied
    FluWatch report: April 24 to April 30, 2016 (week 17)

    Overall Summary

    • In week 17, all influenza indicators declined from the previous week.
    • Elevated influenza B activity persisited in many regions across Canada: influenza B accounted for the majority of influenza detections in week 17. Additionally, all outbreaks reported this week were due to Influenza B. This increase in influenza B is expected as influenza B often shows up later in the flu season.
    • Hospitalizations, ICU admissions and deaths among the pediatric population, while declining, continue to remain above expected levels based on the past several influenza seasons.
    • For more information on the flu, see our Flu(influenza) web page.
    • The current FluWatch report is the last weekly report for the 2015-2016 season. During the summer, monthly reports will be published starting on May 27, 2016. We will continue to monitor influenza and other respiratory infections via the RVDSS report, published every Thursday.

    Download the alternative format
    (PDF format, 911 KB, 9 pages)
    Organization: Public Health Agency of Canada
    Date published: 2016-05-06

    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)

    Influenza activity continues to be reported in the majority of regions in Canada; however, the number of regions reporting influenza activity decreased in week 17. Localized activity was reported in a total of 12 regions across six provinces. Sporadic activity levels were reported in 28 regions across all provinces and territories. A total of 10 regions reported no influenza activity in week 17.
    Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, week 17




    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 17, the percentage of tests positive for influenza continued to decrease from the previous week [from 18% in week 16 to 17% in week 17], driven by the decline in influenza A. Compared to the previous five seasons, the percent positive (17%) reported in week 17 was above the five year average for that week and exceeded the range of expected levels (9.8%-14.0%). With the late start to the 2015-16 influenza season, these elevated 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 Nationally in week 17, there were 881 positive influenza tests reported. Influenza B continues to account for an increasing proportion of influenza detections accounting for 70% of detections in week 17. Detections remain predominantly influenza A in British Columbia and the Atlantic Region. To date, 75% of influenza detections have been influenza A and among those subtyped, the vast majority have been influenza A(H1N1) [91% (10933/11990)].
    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 In week 17, individuals under the age of 45 accounted for 64% of influenza B detections.
    To date this season, detailed information on age and type/subtype has been received for 31,858 cases. Children and teenagers (0-19) accounted for 47% of influenza B cases and approximately one third of all influenza cases. Children and teenagers (0-19), young adults (20-44) and middle-aged adults (45-64) accounted for approximately an equal proportion of influenza A(H1N1) cases (28%).
    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
    23 <5 Table 1 - Footnotex 20 106 4491 1708 72 2711 1432 5925 19%
    12 <5 <5 10 117 2393 1026 100 1267 2371 4766 15%
    19 6 <5 12 82 5769 2750 155 2864 1986 7755 24%
    39 7 <5 Table 1 - Footnotex 48 6312 2772 190 3350 970 7282 23%
    51 6 <5 Table 1 - Footnotex 120 4778 1612 420 2746 1351 6130 19%
    144 23 6 115 473 23743 9868 937 12938 8110 31858 100%
    23% 16% 4% 80% 77% 75% 42% 4% 54% 25%
    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 36.1 per 1,000 patient visits in week 16, to 31.1 per 1,000 patient visits in week 17. The highest ILI consultation rate was found in the 5-19 years age group (53.8 per 1,000) and the lowest was found in the 20-64 years age group (24.4 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 17, the proportion of prescriptions for antivirals decreased from the previous week to 21.2 antiviral prescriptions per 100,000 total prescriptions, which is lower than the five year historical average for week 17. The proportion of prescriptions for antivirals remains highest among children. In week 17, the proportion reported among children was 62.5 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 17, eight new laboratory confirmed influenza outbreaks were reported: seven in long-term care facilities (LTCF) and one in an institution or community setting. Of the seven outbreaks with known strains or subtypes, all were due to influenza B.
    To date this season, 409 outbreaks have been reported. At week 17 in the 2014-15 season, 1,696 outbreaks were reported and in the 2013-14 season, 226 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 17, the number of laboratory-confirmed influenza-associated pediatric hospitlaizations slightly decreased. A total of 34 laboratory-confirmed influenza-associated pediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network (Figure 7). The largest proportion of hospitalizations were in children aged 2-4 years, accounting for 35% of the hospitalizations. Similar to the trend of increased laboratory detections of influenza B, 82% of pediatric hospitalizations reported in week 17 were due to influenza B.
    To date this season, 1,272 hospitalizations have been reported by the IMPACT network: 887 hospitalized cases (69%) were due to influenza A and 385 cases (31%) were due to influenza B. This seasonís count of pediatric hospitalizations is nearly double that reported up to week 17 (676) in the 2014-15 season. The current year total number of cases also exceeds the total number of cases reported in the past five seasons.
    A total of 195 intensive care unit (ICU) admissions have been reported. Children aged 2 to 4 and 5 to 9 years accounted for 29% and 26% respectively of ICU admissions. A total of 131 ICU cases (67%) reported at least one underlying condition or comorbidity. Eight influenza-associated deaths have been reported which is above the number of deaths reported at this time in the last five season.
    Table 2 - Footnote x Suppressed to prevent residual disclosure.
    Return to Table 2 - Footnotexreferrer
    120 32 5 83 33 153 (12%)
    275 75 8 192 76 351 (28%)
    254 81 <5 Table 2 - Footnotex 104 358 (28%)
    180 45 <5 Table 2 - Footnotex 124 304 (24%)
    58 18 <5 Table 2 - Footnotex 48 106 (8%)
    887 251 22 614 385 1272 (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

    Overall, adult hospitalizations decreased in week 17. A total of 12 laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported by the Canadian Immunization Research Network Serious Outcome Surveillance (CIRN-SOS) (Figure 7). The majority of hospitalizations were in adults ≥65 years of age (67%) and due to influenza B (70%). In recent weeks, the weekly number of hospitalizations reported by CIRN has been decreasing and an increasing proportion of hospitalizations have been due to influenza B.
    To date this season, 1,131 hospitalizations have been reported by CIRN-SOS (Table 3). The majority of hospitalized cases were due to influenza A (82%) and the largest reported proportion was among adults ≥65 years of age (50%). One hundred and eighty-five intensive care unit (ICU) admissions have been reported of which 130 cases reported at least one underlying condition or comorbidity. A total of 50 deaths have been reported this season with the majority of deaths reported in adults ≥65 years of age (66%).
    Table 3 - Footnote x Suppressed to prevent residual disclosure.
    Return to Table 3 - Footnotexreferrer
    Table 3 - Footnotex <5 0 <5 <5 7 (1%)
    141 50 <5 Table 3 - Footnotex 41 182 (16%)
    330 104 <5 Table 3 - Footnotex 43 373(33%)
    445 124 24 297 120 565 (50%)
    <5 0 0 <5 <5 <5 (x%)
    23 283 28 612 208 1131
    82% 31% 3% 66% 18% 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 17, the number of hospitalizations reported by participating provinces and territories decreased from the previous week (from 129 in week 16 to 93 in week 17)Footnote*. Influenza B accounted for the greatest proportion of hospitalizations (63%) in week 17. The largest proportion of cases reported was in adults ≥65 years of age (43%). Among hospitalizations with influenza B, children represented 31% of cases.
    Since the start of the 2015-16 season, 4,963 laboratory-confirmed influenza-associated hospitalizations have been reported. A total of 3,978 hospitalizations (80%) were due to influenza A and 985 (20%) were due to influenza B. Of the 522 ICU admissions reported, 269 (52%) were due to influenza A(H1N1). A total of 236 deaths have been reported; all but 33 were associated with influenza A (86%).
    Overall this season, hospitalizations have been reported more frequently among adults ≥65 years of age. The largest proportion of ICU admissions was reported in adults 45-64 years of age and the highest proportion of fatal cases was reported in adults ≥65 years of age. Pediatric (0-19 years) and young to middle-aged adults (20-44 years) accounted for 42% of all hospitalizations and 13% of all deaths reported to date this season. Similar to findings from the IMPACT network, there have been more pediatric hospitalizations reported to date compared to the year-end totals in each of the previous four influenza seasons. 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 2,233 influenza viruses [209 A(H3N2), 1,230 A(H1N1) and 794 influenza B].
    Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assays, 58 A(H3N2) viruses were antigenically characterized as A/Switzerland/9715293/2013-like using antiserum raised against cell-propagated A/Switzerland/9715293/2013.
    Sequence analysis was done on 151 A(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): All of the 1,230 A(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 162 influenza B viruses characterized were antigenically similar to the vaccine strain B/Phuket/3073/2013. A total of 632 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 included: 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

    Leave a comment:


  • Pathfinder
    replied
    FluWatch report: April 17 to April 23, 2016 (week 16)

    Overall Summary

    • In week 16, all influenza indicators remained similar to, or declined from the previous week.
    • Elevated influenza activity was mostly reported in the Ontario, Quebec and Atlantic provinces.
    • Many regions across Canada are reporting a greater proportion of influenza B detections. This increase in influenza B is expected as influenza B often shows up later in the flu season.
    • Influenza B continues to account for a increasing proportion of hospitalizations among children and adults.
    • Hospitalizations, ICU admissions and deaths among the pediatric population, while declining, continue to remain above expected levels based on the past several influenza seasons.
    • For more information on the flu, see our Flu(influenza) web page.

    Download the alternative format
    (PDF format, 911 KB, 9 pages)
    Organization: Public Health Agency of Canada
    Date published: 2016-04-29

    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)

    Influenza activity continues to be reported in the majority of regions in Canada; however, the number of regions reporting influenza activity decreased in week 16. Localized activity was reported in a total of 13 regions across five provinces. Sporadic activity levels were reported in 30 regions across all provinces and territories.
    Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, week 16




    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 16, the percentage of tests positive for influenza continued to decrease from the previous week [from 21% in week 15 to 19% in week 16], driven by the decline in influenza A. Compared to the previous five seasons, the percent positive (19%) reported in week 16 was above the five year average for that week and exceeded the expected levels (range 10.1%-16.2%). With the late start to the 2015-16 influenza season, these elevated 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 Nationally in week 16, there were 1,140 positive influenza tests reported. Influenza B continues to account for an increasing proportion of influenza detections accounting for 64% of detections in week 16. Detections remain predominantly influenza A in British Columbia and the Atlantic Region. To date, 76% of influenza detections have been influenza A and among those subtyped, the vast majority have been influenza A(H1N1) [92% (10866/11855)].
    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 In week 16, individuals under the age of 44 accounted for 69% of influenza B detections.
    To date this season, detailed information on age and type/subtype has been received for 31,063 cases. Children and teenagers (0-19) accounted for 47% of influenza B cases and approximately one third of all influenza cases. Children and teenagers (0-19), young adults (20-44) and middle-aged adults (45-64) accounted for approximately an equal proportion of influenza A(H1N1) cases (28%).
    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
    41 <5 <5 34 112 4450 1698 69 2683 1309 5761 19%
    14 <5 Table 1 - Footnotex 12 153 2373 1017 99 1257 2231 4606 15%
    51 10 0 41 114 5735 2717 154 2864 1876 7611 25%
    65 13 <5 Table 1 - Footnotex 66 6255 2739 185 3331 905 7160 23%
    82 18 <5 Table 1 - Footnotex 105 4712 1587 417 2708 1212 5925 19%
    253 47 <5 202 550 23525 9758 924 12843 7533 31063 100%
    32% 19% 2% 80% 68% 76% 41% 4% 55% 24%
    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 56.4 per 1,000 patient visits in week 15, to 36.1 per 1,000 patient visits in week 16. The highest ILI consultation rate was found in the 0-4 years age group (104.4 per 1,000) and the lowest was found in the ≥65 years age group (18.8 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 16, the proportion of prescriptions for antivirals decreased from the previous week to 27.7 antiviral prescriptions per 100,000 total prescriptions, which is lower than the five year historical average for week 16. The proportion of prescriptions for antivirals remains highest among children. In week 16, the proportion reported among children was 71.5 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 16, 13 new laboratory confirmed influenza outbreaks were reported: nine in long-term care facilities (LTCF). three in hospitals and one in an institution or community setting. Of the outbreaks with known strains or subtypes, all three outbreaks were due to influenza B (two in LTCFs and one in an institution or community setting). Additionally, one ILI outbreak was reported in a school.
    To date this season, 401 outbreaks have been reported. At week 16 in the 2014-15 season, 1,607 outbreaks were reported and in the 2013-14 season, 218 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 16, 33 laboratory-confirmed influenza-associated pediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network (Figure 7). The largest proportion of hospitalizations were in children aged 5-9 years, accounting for 30% of the hospitalizations. Similar to the trend of increased laboratory detections of influenza B, 82% of pediatric hospitalizations reported in week 16 were due to influenza B.
    To date this season, 1,233 hospitalizations have been reported by the IMPACT network: 878 hospitalized cases (71%) were due to influenza A and 355 cases (29%) were due to influenza B. This season's count of pediatric hospitalizations is nearly double that reported up to week 16 (667) in the 2015-16 season. The current year total number of cases also exceeds the total number of cases reported in the past five seasons.
    A total of 193 intensive care unit (ICU) admissions have been reported. Children aged 2 to 4 and 5 to 9 years accounted for 29% and 26% respectively of ICU admissions. A total of 128 ICU cases (66%) reported at least one underlying condition or comorbidity. Eight influenza-associated deaths have been reported.
    Table 2 - Footnote x Suppressed to prevent residual disclosure.
    Return to Table 2 - Footnotexreferrer
    118 32 5 81 29 147 (12%)
    271 73 7 191 71 342 (28%)
    250 79 <5 Table 2 - Footnotex 96 346 (28%)
    181 47 <5 Table 2 - Footnotex 115 296 (24%)
    58 18 <5 Table 2 - Footnotex 44 102 (8%)
    878 249 21 608 355 1233 (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 16, 28 laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported by the Canadian Immunization Research Network Serious Outcome Surveillance (CIRN-SOS) (Figure 7). The largest proportion of hospitalizations was in adults 65+ years of age (53%) and due to influenza A (53%). In recent weeks, the weekly number of hospitalizations reported by CIRN has been decreasing and an increasing proportion of hospitalizations have been due to influenza B.
    To date this season, 1,108 hospitalizations have been reported by CIRN-SOS (Table 3). The majority of hospitalized cases were due to influenza A (82%) and the largest reported proportion was among adults ≥65 years of age (50%). One hundred and seventy-four intensive care unit (ICU) admissions have been reported of which 118 cases reported at least one underlying condition or comorbidity. A total of 48 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
    Table 3 - Footnotex <5 0 <5 <5 7 (1%)
    140 48 <5 Table 3 - Footnotex 39 179 (16%)
    321 97 <5 Table 3 - Footnotex 40 361 (33%)
    443 123 23 297 113 556 (50%)
    <5 0 0 <5 <5 5 (%)
    912 273 27 612 196 1108
    82% 30% 3% 67% 18% 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 16, 129 hospitalizations were reported by participating provinces and territoriesFootnote*. Influenza B accounted for the greatest proportion of hospitalizations, accounting for 55% of hospitalizations reported in week 16. The largest proportion of cases reported was in adults 65+ years of age (37%). Among hospitalizations for influenza B, children represented 35% of cases.
    Since the start of the 2015-16 season, 4,840 laboratory-confirmed influenza-associated hospitalizations have been reported. A total of 3,929 hospitalizations (81%) were due to influenza A and 911 (19%) were due to influenza B. Of the 510 ICU admissions reported, 267 (52%) were due to influenza A(H1N1). A total of 229 deaths have been reported; all but 30 were associated with influenza A.
    Overall this season, hospitalizations have been reported more frequently among adults ≥65 years of age. The largest proportion of ICU admissions was reported in adults 45-64 years of age and the highest proportion of fatal cases was reported in adults ≥65 years of age. Pediatric (0-19 years) and young to middle-aged adults (20-44 years) accounted for 42% of all hospitalizations and 14% of all deaths reported to date this season. Similar to findings from the IMPACT network, there have been more pediatric hospitalizations reported to date compared to the year-end totals in each of the previous four influenza seasons.
    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 2,117 influenza viruses [194 A(H3N2), 1,188 A(H1N1) and 735 influenza B].
    Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assays, 50 A(H3N2) viruses were antigenically characterized as A/Switzerland/9715293/2013-like using antiserum raised against cell-propagated A/Switzerland/9715293/2013.
    Sequence analysis was done on 144 A(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): All of the 1,188 A(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 154 influenza B viruses characterized were antigenically similar to the vaccine strain B/Phuket/3073/2013. A total of 581 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

    Leave a comment:


  • Pathfinder
    replied
    FluWatch report: April 10 to April 16, 2016 (week 15)

    Overall Summary

    • Influenza activity peaked nationally in the second week of March; however, lower but sustained activity continues to be reported throughout the country.
    • Many regions across Canada are reporting a greater number of influenza B detections; however, in British Columbia and the Atlantic Region, detections remain predominantly influenza A.
    • Hospitalizations, ICU admissions and deaths among the pediatric population, while declining, remain above expected levels based on the past several influenza seasons.
    • Despite higher pediatric hospitalizations reported, the pediatric population accounts for the smallest proportion of all deaths reported.
    • For more information on the flu, see our Flu(influenza) web page.

    Download the alternative format
    (PDF format, 908 KB, 9 pages)
    Organization: Public Health Agency of Canada
    Date published: 2016-04-22

    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)

    Influenza activity continues to be reported in the majority of regions in Canada. Localized activity was reported in a total of 14 regions across seven provinces. Sporadic activity levels were reported in 31 regions.
    Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, week 15




    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 15, the percentage of tests positive for influenza continued to decrease from the previous week [from 23% in week 14 to 21% in week 15] (Figure 2). Compared to the previous five seasons, the percent positive (21%) reported in week 15 was above the five year average for that week and exceeded the expected levels (range 11.7%-16.9%). With the late start to the 2015-16 influenza season, these elevated 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 Nationally in week 15, there were 1,522 positive influenza tests reported. The number of influenza A and influenza B detections were roughly equal in week 15. Many of regions across Canada reported more influenza B detections than influenza A; however, in British Columbia and the Atlantic Region, detections remain predominantly influenza A. To date, 78% of influenza detections have been influenza A and among those subtyped, the vast majority have been influenza A(H1N1) [86% (10715/12443)].
    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 In week 15, individuals under the age of 44 accounted for 74% of influenza B detections. To date this season, detailed information on age and type/subtype has been received for 30,052 cases. Children and teenagers (0-19) accounted for 47% of influenza B cases and approximately one third of all influenza cases. Children and teenagers (0-19), young adults (20-44) and middle-aged adults (45-64) accounted for approximately an equal proportion of influenza A(H1N1) cases (28%).
    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
    80 6 <5 Table 1 - Footnotex 118 4396 1690 67 2639 1179 5577 19%
    37 <5 0 Table 1 - Footnotex 160 2346 1011 97 1238 2043 4391 15%
    74 17 0 57 110 5669 2699 151 2819 1726 7395 25%
    121 28 <5 Table 1 - Footnotex 47 6165 2709 181 3275 827 6992 23%
    101 17 7 77 91 4608 1558 410 2640 1088 5697 19%
    413 72 11 330 526 23184 9667 906 12611 6863 30052 100%
    44% 17% 3% 80% 56% 77% 42% 4% 54% 23%
    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 26.1 per 1,000 patient visits in week 14, to 56.4 per 1,000 patient visits in week 15. The highest ILI consultation rate was found in the 5-19 years age group (107.7 per 1,000) and the lowest was found in the ≥65 years age group (14.2 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 15, the proportion of prescriptions for antivirals remained similar to the previous week at 50.6 antiviral prescriptions per 100,000 total prescriptions, which is lower than the five year historical average for week 15. The proportion of prescriptions for antivirals remains highest among children. In week 15, the proportion reported among children was 100.1 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 15, 12 new laboratory confirmed influenza outbreaks were reported: 11 in long-term care facilities (LTCF) and one in a hospital. Of the seven outbreaks with known strains or subtypes, four outbreaks were due to influenza B (three in LTCFs and one in a hospital), one outbreak each was due to influenza A(H1N1) and influenza A(H3N2) (both in LTCFs), and one outbreak in a LTCF was due to influenza A(UnS). Additionally, one ILI outbreak was reported in a school.
    To date this season, 387 outbreaks have been reported. At week 15 in the 2014-15 season, 1,586 outbreaks were reported and in the 2013-14 season, 210 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 15, 63 laboratory-confirmed influenza-associated pediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network (Figure 7). The largest proportion of hospitalizations were in children aged 5-9 years, accounting for 33% of the hospitalizations. Similar to the previous week, more influenza B cases were reported than influenza A cases (41 vs. 22 respectively).
    To date this season, 1,207 hospitalizations have been reported by the IMPACT network: 874 hospitalized cases (72%) were due to influenza A and 333 cases (28%) were due to influenza B. The greatest proportion of hospitalized cases were in children aged 0-2 years (40%). To date,192 intensive care unit (ICU) admissions have been reported. Children aged 2 to 4 and 5 to 9 years accounted for 28% and 26% respectively of ICU admissions. A total of 122 ICU cases (64%) reported at least one underlying condition or comorbidity. Eight influenza-associated deaths have been reported.
    Table 2 - Footnote x Suppressed to prevent residual disclosure.
    Return to Table 2 - Footnotexreferrer
    116 32 5 79 26 142 (12%)
    270 73 7 190 66 336 (28%)
    251 79 <5 Table 2 - Footnotex 93 344 (29%)
    179 47 <5 Table 2 - Footnotex 106 285 (24%)
    58 18 <5 Table 2 - Footnotex 42 100 (8%)
    874 249 21 604 333 1207 (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 15, 39 laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported by the Canadian Immunization Research Network Serious Outcome Surveillance (CIRN-SOS) (Figure 7). The largest proportion of hospitalizations was in adults 65+ years of age (54%) and due to influenza A (62%). In recent weeks, the weekly number of hospitalizations reported by CIRN has been decreasing and an increasing proportion of hospitalizations have been due to influenza B.
    To date this season, 1,077 hospitalizations have been reported by CIRN-SOS (Table 3). The majority of hospitalized cases were due to influenza A (83%) and the largest reported proportion was among adults ≥65 years of age (50%). One hundred and sixty-five intensive care unit (ICU) admissions have been reported. A total of 112 ICU cases reported at least one underlying condition or comorbidity. A total of 45 deaths have been reported this season with the majority of deaths reported in adults ≥65 years of age (64%).
    Table 3 - Footnote x Suppressed to prevent residual disclosure.
    Return to Table 3 - Footnotexreferrer
    Table 3 - Footnotex <5 0 <5 <5 7 (1%)
    140 45 <5 Table 3 - Footnotex 36 176 (16%)
    312 94 <5 Table 3 - Footnotex 39 351 (33%)
    434 119 23 292 103 537 (50%)
    <5 0 0 <5 <5 6 (1%)
    895 264 27 604 182 1077
    83% 29% 3% 67% 17% 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 15, 182 hospitalizations were reported by participating provinces and territoriesFootnote*. The majority of reported hospitalizations continue to be due to influenza A, accounting for 63% of hospitalizations reported in week 15. The largest proportion of cases reported in week 15 was in adults 65+ years of age (43%).
    Since the start of the 2015-16 season, 4,606 laboratory-confirmed influenza-associated hospitalizations have been reported. A total of 3,802 hospitalizations (83%) were due to influenza A and 804 (17%) were due to influenza B. Of the 486 ICU admissions reported, 258 (53%) were due to influenza A(H1N1). A total of 193 deaths have been reported; all but 24 were associated with influenza A.
    Overall this season, hospitalizations have been reported more frequently among adults ≥65 years of age. The largest proportion of ICU admissions was reported in adults 45-64 years of age and the highest proportion of fatal cases was reported in adults ≥65 years of age. Pediatric (0-19 years) and young to middle-aged adults (20-44 years) accounted for 42% of all hospitalizations and 14% of all deaths reported to date this season. There have been more pediatric hospitalizations reported to date compared to the year-end totals in each of the previous four influenza seasons.
    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 1,901 influenza viruses [189 A(H3N2), 1,099 A(H1N1) and 613 influenza B].
    Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assays, 48 A(H3N2) viruses were antigenically characterized as A/Switzerland/9715293/2013-like using antiserum raised against cell-propagated A/Switzerland/9715293/2013.
    Sequence analysis was done on 141 A(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): All of the 1,099 A(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 142 influenza B viruses characterized were antigenically similar to the vaccine strain B/Phuket/3073/2013. A total of 471 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

    Leave a comment:


  • Pathfinder
    replied
    FluWatch report: April 3 to April 9, 2016 (week 14)

    Overall Summary

    • Influenza activity peaked nationally in in the second week of March; however, lower but sustained activity is being reported throughout the country.
    • All regions of Canada reported sporadic or localized influenza activity.
    • Both influenza B and influenza A detections decreased in week 14. To date this season, a total of 34,105 positive influenza tests have been reported.
    • Hospitalizations, ICU admissions and deaths among the pediatric population, while declining, remain above expected levels based on the past several influenza seasons.
    • Despite higher pediatric hospitalizations reported, the pediatric population account for the smallest proportion of all deaths reported.
    • For more information on the flu, see our Flu(influenza) web page.

    Download the alternative format
    (PDF format, 869 KB, 9 pages)
    Organization: Public Health Agency of Canada
    Date published: 2016-04-15

    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 page

    Influenza/Influenza-like Illness Activity (geographic spread)

    In week 14, influenza activity was reported in 50 regions across Canada. A total of 30 regions reported sporadic activity levels, while the remaining 20 reported localized activity levels.
    Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, week 14




    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 14, the percentage of tests positive for influenza continued to decrease from the previous week [from 28% in week 13 to 23% in week 14] (Figure 2). Compared to the previous five seasons, the percent positive (23%) reported in week 14 was above the five year average for that week and exceeded the expected levels (range 11.1%-16.7%). With the late start to the 2015-16 influenza season, these elevated 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 14, there were 1,914 positive influenza tests reported. The number of positive influenza B tests accounted for an increasing proportion of all positive influenza tests reported. Both influenza B and influenza A detections decreased in week 14. This week, influenza B accounted for 41% of all positive tests. To date, 79% of influenza detections have been influenza A and among those subtyped, the vast majority have been influenza A(H1N1) [91% (10510/11511)].
    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 28,818 cases. Children and teenagers (0-19 years of age) accounted for one third of all influenza cases (33%). Children (0-19), young adults (20-44) and middle-aged adults (45-64) accounted for approximately an equal proportion of influenza A(H1N1) cases (28%).
    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
    125 15 0 110 124 4287 1674 63 2550 1044 5333 19%
    46 7 <5 Table 1 - Footnotex 138 2302 997 95 1210 1832 4136 14%
    118 30 <5 Table 1 - Footnotex 120 5566 2655 150 2761 1574 7140 25%
    171 37 <5 Table 1 - Footnotex 75 5994 2639 178 3177 763 6757 23%
    175 31 6 138 100 4477 1506 396 2575 974 5452 19%
    635 120 10 505 557 22626 9471 882 12273 6187 28818 100%
    53% 19% 2% 80% 47% 79% 42% 4% 54% 21%
    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 45.2 per 1,000 patient visits in week 13, to 26.8 per 1,000 patient visits in week 14. The highest ILI consultation rate was found in the 0-4 years age group (55.9 per 1,000) and the lowest was found in the ≥65 years age group (5.5 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 14, the proportion of prescriptions for antivirals dereaesd to 50.4 antiviral prescriptions per 100,000 total prescriptions, which is lower than the five year historical average for week 14. The proportion of prescriptions for antivirals remains highest among children. In week 14, the proportion reported among children was 102.4 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 14, 17 new laboratory confirmed influenza outbreaks were reported: 14 in long-term care facilities (LTCF), two in hospitals and one in institutions or community settings. Of the outbreaks with known strains or subtypes, three outbreaks were due to influenza B, one outbreak was due to influenza A(H1N1), two outbreaks were due to influenza A(H3N2) and eight were due to influenza A(UnS). Additionally, three ILI outbreaks were reported schools.
    To date this season, 374 outbreaks have been reported. At week 14 in the 2014-15 season, 1646 outbreaks were reported and in the 2013-14 season,198 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

    Hospitalizations reported by the the Immunization Monitoring Program Active (IMPACT) network continue to decrease (Figure 7). In week 14, 58 hospitalizations were reported. The largest proportion of hospitalizations were in children aged 2-4 years, accounting for 46.5% of the hospitalizations. For the first time this season, more influenza B cases were reported than influenza A cases (31 vs. 27 respectively).
    To date this season, 1,138 laboratory-confirmed influenza-associated pediatric (≤16 years of age) hospitalizations have been reported by the IMPACT network: 853 hospitalized cases (75%) were due to influenza A and 285 cases (25%) were due to influenza B. The greatest proportion of hospitalized cases were in children aged 0-2 years (40 %). To date,190 intensive care unit (ICU) admissions have been reported. Children aged 2 to 4 and 5 to 9 years accounted for 28% and 26% respectively of ICU admissions. A total of 113 ICU cases (59%) reported at least one underlying condition or comorbidity. Eight influenza-associated deaths have been reported.
    Table 2 - Footnote x Suppressed to prevent residual disclosure.
    Return to Table 2 - Footnotexreferrer
    112 32 5 75 21 133 (12%)
    261 73 7 181 59 320 (28%)
    246 78 <5 Table 2 - Footnotex 78 324 (28%)
    177 47 <5 Table 2 - Footnotex 89 266 (23%)
    57 18 <5 Table 2 - Footnotex 38 95 (8%)
    853 248 21 584 285 1138 (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 14, 36 hospitalizations were reported by the Canadian Immunization Research Network Serious Outcome Surveillance (CIRN-SOS) (Figure 7). The largest proportion of hospitalizations was in adults 65+ years of age (50%) and due to influenza A (75%).
    To date this season, 956 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 (85%) and the largest reported proportion was among adults ≥65 years of age (49%). One hundred and thirty-seven intensive care unit (ICU) admissions have been reported. A total of 88 ICU cases reported at least one underlying condition or comorbidity. A total of 38 deaths have been reported this season with the majority of deaths reported in adults ≥65 years of age (63%).
    Table 3 - Footnote x Suppressed to prevent residual disclosure.
    Return to Table 3 - Footnotexreferrer
    5 <5 0 <5 <5 6 (1%)
    127 38 <5 Table 3 - Footnotex 28 155 (16%)
    286 84 3 199 30 316 (33%)
    388 96 21 271 84 472 (49%)
    6 0 <5 <5 <5 7 (1%)
    812 225 26 561 144 956
    85% 28% 3% 69% 15% 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 14, 311 hospitalizations were reported by participating provinces and territoriesFootnote*. The majority of hospitalizations were due to influenza A (61%), however a marked increase in the proportion of influenza B cases has been noted in week 14. Influenza B accounted for 39% of all influenza hospitalizations in week 14 compared to 22% in week 13. The largest proportion of cases reported in week 14 was in adults 65+ years of age (35%).
    Since the start of the 2015-16 season, 4,371 laboratory-confirmed influenza-associated hospitalizations have been reported. A total of 3,637 hospitalizations (83%) were due to influenza A and 734 (17%) were due to influenza B. Of the 473 ICU admissions reported, 245 (58%) were due to influenza A(H1N1) A total of 193 deaths have been reported; all but 22 were associated with influenza A.
    Overall this season, hospitalizations have been reported more frequently among adults ≥65 years of age. The largest proportion of ICU admissions were reported in adults 45-64 years of age and the highest proportion of fatal cases was reported in adults ≥65 years of age. Pediatric (0-19 years) and young to middle-aged adults (20-44 years) accounted for 42% of all hospitalizations and 15% of all deaths reported to date this season.
    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 1580 influenza viruses [179 A(H3N2), 889 A(H1N1) and 512 influenza B].
    Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assays, 42 A(H3N2) viruses were antigenically characterized as A/Switzerland/9715293/2013-like using antiserum raised against cell-propagated A/Switzerland/9715293/2013.
    Sequence analysis was done on 137 A(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): All of the 889 A(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 125 influenza B viruses characterized were antigenically similar to the vaccine strain B/Phuket/3073/2013. A total of 387 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

    Leave a comment:


  • Pathfinder
    replied
    FluWatch report: March 27 to April 2, 2016 (week 13)

    Overall Summary

    • Influenza activity peaked nationally in week 10; however, lower but sustained activity is being reported throughout the country.
    • Most regions of Canada reported sporadic or localized influenza activity.
    • Compared to the previous two weeks, there was an increase in the number of provincial and territorial hospitalizations reported in week 13 but the number reported (353) remains below the week 10 peak.
    • The number of influenza B detections is increasing, while influenza A detections are decreasing. Overall, laboratory detections of influenza are steadily decreasing.
    • 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.

    Download the alternative format
    (PDF format, 863 KB, 9 pages)
    Organization: Public Health Agency of Canada
    Date published: 2016-04-08

    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 13, influenza activity was reported in all but four regions of Canada. A total of 23 regions reported localized activity levels across the country. Sporadic influenza/ILI activity was reported in 26 regions across Canada.
    Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, week 13




    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 13, the percent positive for influenza continued to decrease from the previous week [from 30% in week 12 to 28% in week 13] (Figure 2). Compared to the previous five seasons, the percent positive (28%) reported in week 13 was above the five year average for that week and exceeded the expected levels (range 12.0%-17.9%). 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 13, there were 2,837 positive influenza tests reported. The number of positive influenza B tests reported is accounting for an increasing proportion of all positive influenza tests reported. This week, influenza B accounted for 36% of all positive tests. To date, 80% of influenza detections have been influenza A and among those subtyped, the vast majority have been influenza A(H1N1) [91% (10155/11124)].
    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 27,158 cases. Children and teenagers (0-19 years of age) accounted for almost one third of all influenza cases (32%). Children (0-19), young adults (20-44) and middle-aged adults (45-64) accounted for approximately an equal proportion of influenza A(H1N1) cases (28%).
    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
    171 30 <5 Table 1 - Footnotex 129 4127 1650 63 2414 895 5023 18%
    56 9 0 47 196 2226 984 92 1150 1660 3887 14%
    209 52 <5 Table 1 - Footnotex 155 5387 2595 146 2646 1403 6790 25%
    287 79 0 208 73 5747 2549 175 3023 646 6393 24%
    262 60 <5 Table 1 - Footnotex 118 4233 1437 376 2420 832 5065 19%
    985 230 6 749 671 21720 9215 852 11653 5436 27158 100%
    59% 23% 1% 76% 41% 80% 42% 4% 54% 20%
    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 slightly from the previous week from 43.6 per 1,000 patient visits in week 12, to 45.2 per 1,000 patient visits in week 13. The highest ILI consultation rate was found in the 0-4 years age group (69.7 per 1,000) and the lowest was found in the ≥65 years age group (35.2 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 13, the proportion of prescriptions for antivirals increased slightly to 78.6 antiviral prescriptions per 100,000 total prescriptions, which is slightly higher than the five year historical average for week 13. The proportion of prescriptions for antivirals remains highest among children. In week 13, the proportion reported among children was 162.4 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 13, 21 new laboratory confirmed influenza outbreaks were reported: 12 in long-term care facilities (LTCF), five in hospitals and four in institutions or community settings. Of the outbreaks with known strains or subtypes, three outbreaks were due to influenza B, two outbreaks were due to influenza A(H1N1), one outbreak was due to influenza A(H3N2) and three were due to influenza A(UnS). Additionally, one ILI outbreak was reported in a school.
    To date this season, 354 outbreaks have been reported. At week 13 in the 2014-15 season, 1,527 outbreaks were reported and in the 2013-14 season,184 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

    Hospitalizations reported by the the Immunization Monitoring Program Active (IMPACT) network continue to decrease (Figure 7). In week 13, 61 hospitalizations were reported. The largest proportion of hospitalizations were in children aged 0-2 years, accounting for 38% of the hospitalizations. The majority of hospitalizations in week 13 were due to influenza A (57%); however, the proportion of weekly hospitalizations due to influenza B has been increasing steadily since week 08.
    To date this season, 1,075 laboratory-confirmed influenza-associated pediatric (≤16 years of age) hospitalizations have been reported by the IMPACT network: 822 hospitalized cases (76%) were due to influenza A and 253 cases (24%) were due to influenza B. The greatest proportion of hospitalized cases were in children aged 0-2 years (41 %). To date, 180 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 113 ICU cases (62%) reported at least one underlying condition or comorbidity. Eight influenza-associated deaths have been reported.
    Table 2 - Footnote x Suppressed to prevent residual disclosure.
    Return to Table 2 - Footnotexreferrer
    110 32 5 73 19 129 (12%)
    251 72 7 172 57 308 (29%)
    236 76 <5 Table 2 - Footnotex 61 297 (28%)
    172 46 <5 Table 2 - Footnotex 81 253 (24%)
    53 18 <5 Table 2 - Footnotex 35 88 (8%)
    822 244 20 558 253 1075 (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 13, 73 hospitalizations were reported by the Canadian Immunization Research Network Serious Outcome Surveillance (CIRN-SOS) (Figure 7). The largest proportion of hospitalizations was in adults 65+ years of age (51%) and due to influenza A (73%).
    To date this season, 898 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 (85%) and the largest reported proportion was among adults ≥65 years of age (49%). One hundred and thirty intensive care unit (ICU) admissions have been reported. A total of 69 ICU cases reported to have at least one underlying condition or comorbidity. A total of 32 deaths have been reported this season with the majority of deaths reported in adults ≥65 years of age (63%).
    Table 3 - Footnote x Suppressed to prevent residual disclosure.
    Return to Table 3 - Footnotexreferrer
    Table 3 - Footnotex <5 0 <5 <5 6 (1%)
    118 35 <5 Table 3 - Footnotex 27 145 (16%)
    274 78 <5 Table 3 - Footnotex 29 303 (34%)
    363 81 21 261 76 439 (49%)
    <5 0 0 <5 <5 5 (1%)
    764 200 25 539 134 898
    85% 26% 3% 71% 15% 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 13, 353 hospitalizations were reported by participating provinces and territoriesFootnote*. The majority of hospitalizations were due to influenza A (78%). The largest proportion of cases reported in week 13 was in adults 65+ years of age (35%).
    Since the start of the 2015-16 season, 3,990 laboratory-confirmed influenza-associated hospitalizations have been reported. A total of 3,401 hospitalizations (85%) were due to influenza A and 589 (15%) were due to influenza B. Among cases for which the subtype of influenza A was reported, 93% (1601/1715) 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 ninety-four ICU admissions have been reported of which 225 (57%) were due to influenza A(H1N1) and 183 (46%) were in the 45-64 age group. A total of 161 deaths have been reported; all but 14 were associated with influenza A. Adults ≥65 years of age represent 49% 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 1442 influenza viruses [159 A(H3N2), 857 A(H1N1) and 426 influenza B].
    Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assays, 40 H3N2 viruses were antigenically characterized as A/Switzerland/9715293/2013-like using antiserum raised against cell-propagated A/Switzerland/9715293/2013.
    Sequence analysis was done on 119 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 857 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 112 influenza B viruses characterized were antigenically similar to the vaccine strain B/Phuket/3073/2013. A total of 314 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

    Leave a comment:


  • Pathfinder
    replied

    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.
    Download the alternative format
    (PDF format, 480 KB, 9 pages)
    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.

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

    Leave a comment:


  • Pathfinder
    replied
    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.

    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 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

    Leave a comment:


  • Pathfinder
    replied
    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

    Leave a comment:


  • Pathfinder
    replied
    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.

    Download the alternative format
    (PDF format, 847 KB, 9 pages)
    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


    On this page

    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

    Leave a comment:


  • Pathfinder
    replied
    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.

    Download the alternative format
    (PDF format, 862 KB, 8 pages)
    Organization: Public Health Agency of Canada
    Date published: 2016-02-26

    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 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

    Leave a comment:


  • Pathfinder
    replied
    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.

    Download the alternative format
    (PDF format, 862 KB, 8 pages)
    Organization: Public Health Agency of Canada
    Date published: 2016-02-19

    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 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

    Leave a comment:


  • Pathfinder
    replied
    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

    Leave a comment:

Working...
X