Announcement

Collapse
No announcement yet.

Canada FluWatch Weekly Reports 2018-2019 Season Week 49

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

  • Canada FluWatch Weekly Reports 2018-2019 Season Week 49

    FluWatch report: November 18, 2018 to November 24, 2018 (Week 47)


    Download the alternative format
    (PDF format, 909 KB, 9 pages)
    Organization: Public Health Agency of Canada
    Date published: 2018-11-30

    Related Topics





    Overall Summary

    • Influenza activity continued to increase in week 47.
    • Influenza A is the most common influenza virus circulating in Canada, and the majority of these viruses are A(H1N1)pdm09.
    • The number of influenza-associated hospitalizations continued to increase in week 47. In particular, the number of pediatric hospitalizations is significantly higher than in recent years.


    On this page

    Influenza/Influenza-like Illness Activity (geographic spread)

    During week 47, influenza activity levels increased slightly compared to the previous week (Figure 1):
    • One region reported widespread activity: in Que.(1),
    • Four regions reported localized activity: in Alta.(1), Ont.(2), and N.B.(1),
    • Sporadic activity was reported by 32 regions, in B.C.(5), Alta.(4), Sask.(3), Man.(3), Ont.(3), Que.(5), N.B.(2), N.S.(1), P.E.I.(1), N.L.(2), N.W.T(2) and Nvt.(1).
    • No activity was reported by 16 regions.



    Figure 1 Map of overall influenza/ILI activity by province and territory, Canada, week 2018-47

    Figure 1 - Text description Laboratory Confirmed Influenza Detections

    In week 47, the following results were reported from sentinel laboratories across Canada (Figure 2):
    • The percentage of tests positive for influenza continued to increase to 15.3% of tests positive.
    • The percentage of tests positive for influenza A is higher for this time of year compared to the same period during the previous eight seasons.
    • In week 47, 950 laboratory detections of influenza were reported, of which 99% were influenza A.
    To date this season 3,176 laboratory-confirmed influenza detections have been reported (Figure 3):
    • 92% have been influenza A.
    • Among the 1,760 influenza A viruses subtyped, 82% have been A(H1N1)pdm09.
    • Provincial and territorial differences in influenza type/subtype distribution are observed (Figure 3).
    To date this season, detailed information on age and type/subtype has been received for 3,155 laboratory-confirmed influenza cases (Table 1):
    • 69% of all influenza A(H1N1)pdm09 detections have been reported in individuals younger than 45 years of age.
    • 70% of all influenza A(H3N2) detections have been reported in adults 65 years of age and older.
    For more detailed weekly and cumulative influenza data, see the text descriptions for Figures 2 and 3 or the Respiratory Virus Detections in Canada Report.
    Figure 2 Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, weeks 2018-35 to 2018-47

    The shaded area indicates weeks where the positivity rate was at least 5% and a minimum of 15 positive tests were observed, signalling the period of seasonal influenza activity.
    Figure 2 - Text description Figure 3 Cumulative numbers of positive influenza specimens by type/subtype and province/territory, Canada, weeks 2018-35 to 2018-47

    Figure 3 - Text description
    0-4 632 377 3 252 5 637 20%
    5-19 650 334 5 311 11 661 21%
    20-44 797 399 15 383 9 806 26%
    45-64 565 285 32 248 7 572 18
    65+ 465 206 131 128 14 479 15%
    Total 3109 1601 186 1322 46 3155 100%
    Table 1 - Note 1 UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available;
    Return to Table 1 - Note1
    Syndromic/Influenza-like Illness Surveillance

    Healthcare Professionals Sentinel Syndromic Surveillance

    In week 47, 1.9% of visits to healthcare professionals were due to influenza-like illness (ILI) (Figure 4). The percentage of visits for ILI is within expected levels.
    Figure 4 Percentage of visits for ILI reported by sentinels by report week, Canada, weeks 2018-35 to 2018-47

    Number of Sentinels Reporting in Week 47: 84
    The shaded area represents the maximum and minimum percentage of visits for ILI reported by week from seasons 2013-14 to 2017-18
    Figure 4 - Text description Participatory Syndromic Surveillance

    In week 47, 2,182 participants reported to FluWatchers, of which 29 (1.3%) reported symptoms of cough and fever (Figure 5).
    Among the 29 participants who reported fever and cough:
    • 28% consulted a healthcare professional;
    • 83% reported days missed from work or school, resulting in a combined total of 66 missed days of work or school.
    Figure 5 Percentage of participants reporting cough and fever, Canada, weeks 2018-40 to 2018-47

    Number of Participants Reporting in Week 47: 2,182
    Figure 5 - Text description Influenza Outbreak Surveillance

    In week 47, five new laboratory-confirmed influenza outbreaks were reported in long-term care (3) and acute care (2) facilities.
    To date this season, 36 laboratory-confirmed influenza outbreaks have been reported (Figure 6):
    • 19 outbreaks were in LTCF, eight were in schools, and five were in other settings.
    • All of the 30 outbreaks for which the influenza type was available were associated with influenza A.
    • Among the 21 outbreaks for which the influenza A subtype was available:
      • 17 were associated with influenza A(H1N1)pdm09;
      • Four were associated with A(H3N2);
    One new ILI outbreak in a LTCF was reported in week 47.
    To date this season, 25 ILI outbreaks have been reported; 23 occurred in LTCF, one in a school, and one in an acute care facility.
    Figure 6 Number of new outbreaks of laboratory-confirmed influenza by report week, Canada, weeks 2018-35 to 2018-47

    Figure 6 - Text description Severe Outcomes Influenza Surveillance

    Provincial/Territorial Influenza Hospitalizations and Deaths

    To date this season, more than 471 influenza-associated hospitalizations have been reported by participating provinces and territoriesFootnote1.
    Hospitalizations (Table 2):
    • 99% (471) were associated with influenza A
    • The highest estimated rates of hospitalization are among children under 5 years of age.
    Intensive Care Unit (ICU) cases and deaths:
    • To date this season 49 ICU admissions and nine deaths have been reported.
    Footnote 1 Influenza-associated hospitalizations are reported by Alberta, Manitoba, New Brunswick, Newfoundland and Labrador, Northwest Territories, Nova Scotia, Prince Edward Island and Yukon. Only hospitalizations that require intensive medical care are reported by Saskatchewan. The cumulative rate of hospitalizations is calculated using the total population by age-group in participating provinces and territories.
    Return to footnote1referrer
    0-4 95 0 7.77
    5-19 64 0 2.31
    20-44 72 0 1.20
    45-64 115 0 2.39
    65+ 125 <5 5.18
    Total 471 <5
    % 99% 1%
    Table 2 - Footnote 1 Influenza-associated hospitalizations are reported by Alberta, Manitoba, New Brunswick, Newfoundland and Labrador, Northwest Territories, Nova Scotia, Prince Edward Island and Yukon. Only hospitalizations that require intensive medical care are reported by Saskatchewan. The cumulative rate of hospitalizations is calculated using the total population by age-group in participating provinces and territories.
    Return to Table 2 - Footnote1referrer
    Pediatric Influenza Hospitalizations and Deaths

    In week 47, 34 pediatric (≤16 years of age) hospitalizations with influenza have been reported by the Immunization Monitoring Program Active (IMPACT) network. Pediatric hospitalizations reported by IMPACT are at levels not normally seen until late December (4-6 weeks earlier than in recent seasons) (Figure 7).
    To date this season, 145 pediatric hospitalizations have been reported (Figure 8):
    • All but two cases have been associated with influenza A.
    • Among the 109 cases for which the influenza subtype was available, 108 were associated with A(H1N1)pdm09.
    To date this season, 18 ICU admissions, and no deaths have been reported.
    Figure 7 Number of pediatric (≤16 years of age) hospitalizations reported by the IMPACT network, by week, Canada, weeks 2018-35 to 2018-47

    Figure 7 - Text description Figure 8 - Cumulative numbers of pediatric hospitalizations (≤16 years of age) with influenza by age-group reported by the IMPACT network, Canada, weeks 2018-35 to 2018-47

    Figure 8 - Text description Adult Influenza Hospitalizations and Deaths

    Surveillance of laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations by the Canadian Immunization Research Network (CIRN) Serious Outcomes Surveillance (SOS) network began on November 1st for the 2018-19 season.
    To date this season, 17 hospitalizations have been reported, of which 15 were associated with influenza A and 2 with influenza B.
    Influenza Strain Characterizations

    Since September 1, 2018, the National Microbiology Laboratory (NML) has characterized 101 influenza viruses (11 A(H3N2), 80 A(H1N1) and 10 B) that were received from Canadian laboratories.
    Genetic Characterization of Influenza A (H3N2):

    Ten influenza A(H3N2) viruses did not grow to sufficient hemagglutination titer for antigenic characterization by hemagglutination inhibition (HI) assay. Therefore, NML has performed genetic characterization to determine the genetic group identity of these viruses.
    Sequence analysis of the HA gene of the viruses showed that:
    • One virus belonged to genetic group 3C.2a.
    • Nine viruses belonged to subclade 3C.2a1.
    A/Singapore/INFIMH-16-0019/2016-like virus belongs to genetic group 3C.2a1 and is the influenza A(H3N2) component of the 2018-19 Northern Hemisphere influenza vaccine
    Antigenic Characterization:

    Influenza A(H3N2):

    • One influenza A(H3N2) virus was antigenically characterized as A/Singapore/INFIMH-16-0019/2016-like by HI testing using antiserum raised against egg-propagated A/Singapore/INFIMH-16-0019/2016.
    • A/Singapore/INFIMH-16-0019/2016-like virus is the influenza A(H3N2) component of the 2018-19 Northern Hemisphere influenza vaccine.
    • The influenza A (H3N2) virus characterized belonged to genetic group 3C.2a1.
    Influenza A(H1N1):

    • 80 A(H1N1) viruses characterized were antigenically similar to A/Michigan/45/2015, which is the influenza A(H1N1) component of the 2018-19 Northern Hemisphere influenza vaccine.
    Influenza B:

    Influenza B viruses can be divided into two antigenically distinct lineages represented by B/Yamagata/16/88 and B/Victoria/2/87 viruses. The recommended influenza B components for the 2018-19 Northern Hemisphere influenza vaccine are B/Colorado/06/2017 (Victoria lineage) and B/Phuket/3073/2013 (Yamagata lineage).
    • Ten influenza B viruses were characterized as B/Phuket/3073/2013-like, which belongs to the Yamagata lineage and is included as an influenza B component of the 2018-19 Northern Hemisphere quadrivalent influenza vaccine.
    • ...
    https://www.canada.ca/en/public-heal...r-24-2018.html


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

  • #2
    FluWatch report: November 25, 2018 to December 1, 2018 (Week 48)


    Download the alternative format
    (PDF format, 1.2 MB, 9 pages)
    Organization: Public Health Agency of Canada
    Date published: 2018-12-07

    Related Topics



    Overall Summary

    • Influenza activity continued to increase in week 48.
    • Influenza A is the most common influenza virus circulating in Canada, and the majority of these viruses are A(H1N1)pdm09.
    • The number of influenza-associated hospitalizations continued to increase in week 48. In particular, the number of pediatric hospitalizations is significantly higher than in recent years.


    On this page

    Influenza/Influenza-like Illness Activity (geographic spread)

    During week 48, influenza activity levels continued to increase (Figure 1):
    • Nine regions reported localized activity: in Alta.(2), Sask.(1), Man.(1), Ont.(2), Que.(1), N.B.(1) and N.S.(1).
    • Sporadic activity was reported by 29 regions in Alta.(3), Sask.(2), Man.(4), Ont.(5), Que.(5), N.B.(3), N.S.(1), N.L.(2), N.W.T(2), Nvt.(1) and Yt.(1).
    • No activity was reported by 10 regions.



    Figure 1 Map of overall influenza/ILI activity by province and territory, Canada, week 2018-48

    Figure 1 - Text description Laboratory Confirmed Influenza Detections

    In week 48, the following results were reported from sentinel laboratories across Canada (Figure 2):
    • The percentage of tests positive for influenza continued to increase to 18.1% of tests positive.
    • The percentage of tests positive for influenza A is higher for this time of year compared to the same period during the previous eight seasons.
    • In week 48, 1,301 laboratory detections of influenza were reported, of which 99% were influenza A.
    To date this season 4,485 laboratory-confirmed influenza detections have been reported (Figure 3):
    • 99% have been influenza A.
    • Among the 2,384 influenza A viruses subtyped, 93% have been A(H1N1)pdm09.
    To date this season, detailed information on age and type/subtype has been received for 4,409 laboratory-confirmed influenza cases (Table 1):
    • 70% of all influenza A(H1N1)pdm09 detections have been reported in individuals younger than 45 years of age.
    • 70% of all influenza A(H3N2) detections have been reported in adults 65 years of age and older.
    For more detailed weekly and cumulative influenza data, see the text descriptions for Figures 2 and 3 or the Respiratory Virus Detections in Canada Report.
    Figure 2 Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, weeks 2018-35 to 2018-48

    The shaded area indicates weeks where the positivity rate was at least 5% and a minimum of 15 positive tests were observed, signalling the period of seasonal influenza activity.
    Figure 2 - Text description Figure 3 Cumulative numbers of positive influenza specimens by type/subtype and province/territory, Canada, weeks 2018-35 to 2018-48

    Figure 3 - Text description
    0-4 908 517 3 388 6 914 21%
    5-19 925 467 5 453 13 938 21%
    20-44 1100 551 17 532 12 1112 25%
    45-64 816 392 38 386 9 825 19%
    65+ 604 259 149 196 16 620 14%
    Total 4353 2186 212 1955 56 4409 100%
    Table 1 - Note 1 UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available;
    Return to Table 1 - Note1
    Syndromic/Influenza-like Illness Surveillance

    Healthcare Professionals Sentinel Syndromic Surveillance

    In week 48, 2.3% of visits to healthcare professionals were due to influenza-like illness (ILI) (Figure 4). The percentage of visits for ILI is slightly above expected levels.
    Figure 4 Percentage of visits for ILI reported by sentinels by report week, Canada, weeks 2018-35 to 2018-48

    Number of Sentinels Reporting in Week 48: 86
    The shaded area represents the maximum and minimum percentage of visits for ILI reported by week from seasons 2013-14 to 2017-18
    Figure 4 - Text description Participatory Syndromic Surveillance

    In week 48, 2,226 participants reported to FluWatchers, of which 53 (2.3%) reported symptoms of cough and fever (Figure 5).
    Among the 53 participants who reported fever and cough:
    • 21% consulted a healthcare professional;
    • 64% reported days missed from work or school, resulting in a combined total of 89 missed days of work or school.
    Figure 5 Percentage of participants reporting cough and fever, Canada, weeks 2018-40 to 2018-48

    Number of Participants Reporting in Week 48: 2,226
    Figure 5 - Text description Influenza Outbreak Surveillance

    In week 48, seven new laboratory-confirmed influenza outbreaks were reported in long-term care (4), acute care facilities (2) and other settings (1).
    To date this season, 44 laboratory-confirmed influenza outbreaks have been reported (Figure 6):
    • 23 outbreaks were in LTCF, nine were in schools, six in acute care facilities, and six were in other settings.
    • All of the 36 outbreaks for which the influenza type was available were associated with influenza A.
    • Among the 27 outbreaks for which the influenza A subtype was available:
      • 21 were associated with influenza A(H1N1)pdm09;
      • 6 were associated with A(H3N2),
    Three new ILI outbreaks were reported in week 48.
    To date this season, 31 ILI outbreaks have been reported; 25 occurred in LTCF, three in schools, and three in acute care facilities.
    Figure 6 Number of new outbreaks of laboratory-confirmed influenza by report week, Canada, weeks 2018-35 to 2018-48

    Figure 6 - Text description Severe Outcomes Influenza Surveillance

    Provincial/Territorial Influenza Hospitalizations and Deaths

    To date this season, more than 588 influenza-assocaited hospitalizations have been reported by participating provinces and territoriesFootnote1.
    Hospitalizations (Table 2):
    • 99% (588) were associated with influenza A
    • The highest estimated rate of hospitalization is among children under 5 years of age.
    Intensive Care Unit (ICU) cases and deaths:
    • To date this season 65 ICU admissions and 9 deaths have been reported.
    Footnote 1 Influenza-associated hospitalizations are reported by Alberta, Manitoba, New Brunswick, Newfoundland and Labrador, Northwest Territories, Nova Scotia, Prince Edward Island and Yukon. Only hospitalizations that require intensive medical care are reported by Saskatchewan. The cumulative rate of hospitalizations is calculated using the total population by age-group in participating provinces and territories.
    Return to footnote1referrer
    0-4 108 0 22.69
    5-19 75 0 5.41
    20-44 91 0 3.20
    45-64 149 0 6.85
    65+ 165 <5 13.81
    Total 588 <5
    % 99% 1%
    Table 2 - Footnote 1 Influenza-associated hospitalizations are reported by Alberta, Manitoba, New Brunswick, Newfoundland and Labrador, Northwest Territories, Nova Scotia, Prince Edward Island and Yukon. Only hospitalizations that require intensive medical care are reported by Saskatchewan. The cumulative rate of hospitalizations is calculated using the total population by age-group in participating provinces and territories.
    Return to Table 2 - Footnote1referrer
    Pediatric Influenza Hospitalizations and Deaths

    In week 48, 44 pediatric (≤16 years of age) hospitalizations with influenza have been reported by the Immunization Monitoring Program Active (IMPACT) network. Pediatric hospitalizations reported by IMPACT are at levels not normally seen until late December (approximately 4 weeks earlier than in recent seasons) (Figure 7).
    To date this season, 189 pediatric hospitalizations have been reported (Figure 8):
    • All but three cases have been associated with influenza A.
    • Among the 132 cases for which the influenza subtype was available, 130 (98.5%) were associated with A(H1N1)pdm09.
    To date this season, 28 ICU admissions, and no deaths have been reported.
    Figure 7 Number of pediatric (≤16 years of age) hospitalizations reported by the IMPACT network, by week, Canada, weeks 2018-35 to 2018-48

    Figure 7 - Text description Figure 8 - Cumulative numbers of pediatric hospitalizations (≤16 years of age) with influenza by age-group reported by the IMPACT network, Canada, weeks 2018-35 to 2018-48

    Figure 8 - Text description Adult Influenza Hospitalizations and Deaths

    Surveillance of laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations by the Canadian Immunization Research Network (CIRN) Serious Outcomes Surveillance (SOS) network began on November 1st for the 2018-19 season.
    To date this season, 23 hospitalizations have been reported:
    • 20 (87%) were associated with influenza A and 3 with influenza B.
    • 11 of the 23 cases (48%) were adults 65 years of age and older.
    Influenza Strain Characterizations

    Since September 1, 2018, the National Microbiology Laboratory (NML) has characterized 142 influenza viruses (20 A(H3N2), 112 A(H1N1) and 10 B) that were received from Canadian laboratories.
    Genetic Characterization of Influenza A (H3N2):

    19 influenza A(H3N2) viruses did not grow to sufficient hemagglutination titer for antigenic characterization by hemagglutination inhibition (HI) assay. Therefore, NML has performed genetic characterization to determine the genetic group identity of these viruses.
    Sequence analysis of the HA gene of the viruses showed that:
    • Two viruses belonged to genetic group 3C.2a.
    • 17 viruses belonged to subclade 3C.2a1.
    A/Singapore/INFIMH-16-0019/2016-like virus belongs to genetic group 3C.2a1 and is the influenza A(H3N2) component of the 2018-19 Northern Hemisphere influenza vaccine.
    Antigenic Characterization:

    Influenza A(H3N2):

    • One influenza A(H3N2) virus was antigenically characterized as A/Singapore/INFIMH-16-0019/2016-like by HI testing using antiserum raised against egg-propagated A/Singapore/INFIMH-16-0019/2016.
    • A/Singapore/INFIMH-16-0019/2016-like virus is the influenza A(H3N2) component of the 2018-19 Northern Hemisphere influenza vaccine.
    • The influenza A (H3N2) virus characterized belonged to genetic group 3C.2a1.
    Influenza A(H1N1):

    • 112 A(H1N1) viruses characterized were antigenically similar to A/Michigan/45/2015, which is the influenza A(H1N1) component of the 2018-19 Northern Hemisphere influenza vaccine.
    Influenza B:

    Influenza B viruses can be divided into two antigenically distinct lineages represented by B/Yamagata/16/88 and B/Victoria/2/87 viruses. The recommended influenza B components for the 2018-19 Northern Hemisphere influenza vaccine are B/Colorado/06/2017 (Victoria lineage) and B/Phuket/3073/2013 (Yamagata lineage).
    • Ten influenza B viruses were characterized as B/Phuket/3073/2013-like, which belongs to the Yamagata lineage and is included as an influenza B component of the 2018-19 Northern Hemisphere quadrivalent influenza vaccine.
    • ...
    https://www.canada.ca/en/public-heal...er-1-2018.html


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

    Comment


    • #3
      FluWatch report: December 2, 2018 to December 8, 2018 (Week 49)


      Download the alternative format
      (PDF format, 1.2 MB, 9 pages)
      Organization: Public Health Agency of Canada
      Date published: 2018-12-14

      Related Topics



      Overall Summary

      • Influenza activity continued to increase in week 49.
      • Influenza A is the most common influenza virus circulating in Canada, and the majority of these viruses are A(H1N1)pdm09.
      • The majority of lab confirmations and hospitalizations have been among individuals under the age of 65.


      On this page

      Influenza/Influenza-like Illness Activity (geographic spread)

      During week 49, influenza activity levels continued to increase (Figure 1):
      • Eight regions reported localized activity: in B.C.(1), Alta.(1), Sask.(1), Man.(1), Ont.(2), Que.(1), and N.B.(1)
      • Sporadic activity was reported by 34 regions: in B.C.(4), Alta.(4), Sask.(2), Man.(5), Ont.(4), Que.(5), N.B.(3), N.L.(2), P.E.I.(1), N.W.T(2), Nvt.(1) and Yt.(1).
      • No activity was reported by 12 regions.



      Figure 1 Map of overall influenza/ILI activity by province and territory, Canada, week 2018-49

      Figure 1 - Text description Laboratory Confirmed Influenza Detections

      In week 49, the following results were reported from sentinel laboratories across Canada (Figure 2):
      • The percentage of tests positive for influenza continued to 19.3%.
      • 1,500 laboratory detections of influenza were reported, of which 99% were influenza A.
      To date this season 6,158 laboratory-confirmed influenza detections have been reported (Figure 3):
      • 99% have been influenza A.
      • Among the 3,209 influenza A viruses subtyped, 94% have been A(H1N1)pdm09.
      • Provincial and territorial differences in influenza type/subtype distribution are observed.
      To date this season, detailed information on age and type/subtype has been received for 6,024 laboratory-confirmed influenza cases (Table 1):
      • 70% of all influenza A(H1N1)pdm09 detections have been reported in individuals younger than 45 years of age.
      • 68% of all influenza A(H3N2) detections have been reported in adults 65 years of age and older.
      For more detailed weekly and cumulative influenza data, see the text descriptions for Figures 2 and 3 or the Respiratory Virus Detections in Canada Report.
      Figure 2 Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, weeks 2018-35 to 2018-49

      The shaded area indicates weeks where the positivity rate was at least 5% and a minimum of 15 positive tests were observed, signalling the period of seasonal influenza activity.
      Figure 2 - Text description Figure 3 Cumulative numbers of positive influenza specimens by type/subtype and province/territory, Canada, weeks 2018-35 to 2018-49

      Figure 3 - Text description
      0-4 1277 698 4 575 10 1287 21%
      5-19 1247 637 5 605 15 1262 21%
      20-44 1490 724 27 739 13 1503 25%
      45-64 1131 555 43 533 9 1140 19%
      65+ 813 331 167 315 19 832 14%
      Total 5958 2945 246 2767 66 6024 100%
      Table 1 - Note 1 UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available;
      Return to Table 1 - Note1
      Syndromic/Influenza-like Illness Surveillance

      Healthcare Professionals Sentinel Syndromic Surveillance

      In week 49, 2.1% of visits to healthcare professionals were due to influenza-like illness (ILI) (Figure 4). The percentage of visits for ILI is within expected levels.
      Figure 4 Percentage of visits for ILI reported by sentinels by report week, Canada, weeks 2018-35 to 2018-49

      Number of Sentinels Reporting in Week 49: 102
      The shaded area represents the maximum and minimum percentage of visits for ILI reported by week from seasons 2013-14 to 2017-18
      Figure 4 - Text description Participatory Syndromic Surveillance

      In week 49, 2,218 participants reported to FluWatchers, of which 44 (2.0%) reported symptoms of cough and fever (Figure 5).
      Among the 53 participants who reported fever and cough:
      • 27% consulted a healthcare professional;
      • 80% reported days missed from work or school, resulting in a combined total of 118 missed days of work or school.
      Figure 5 Percentage of participants reporting cough and fever, Canada, weeks 2018-40 to 2018-49

      Number of Participants Reporting in Week 49: 2,218
      Figure 5 - Text description Influenza Outbreak Surveillance

      In week 49, five new laboratory-confirmed influenza outbreaks were reported in long-term care (2), acute care facilities (1) and other settings (2). Four new ILI outbreaks were also reported in week 49.
      To date this season, 52 laboratory-confirmed influenza outbreaks have been reported (Figure 6):
      • 25 outbreaks were in LTCF, 11 were in schools, seven in acute care facilities, and eight were in other settings.
      • All of the 36 outbreaks for which the influenza type was available were associated with influenza A.
      • Among the 33 outbreaks for which the influenza A subtype was available:
        • 25 were associated with influenza A(H1N1)pdm09;
        • 8 were associated with A(H3N2),
      To date this season, 35 ILI outbreaks have been reported; 26 occurred in LTCF, six in schools, and three in acute care facilities.
      Figure 6 Number of new outbreaks of laboratory-confirmed influenza by report week, Canada, weeks 2018-35 to 2018-49

      Figure 6 - Text description Severe Outcomes Influenza Surveillance

      Provincial/Territorial Influenza Hospitalizations and Deaths

      To date this season, 705 influenza-associated hospitalizations have been reported by participating provinces and territoriesFootnote1.
      Hospitalizations (Table 2):
      • 99% (702) were associated with influenza A
      • The highest estimated rate of hospitalization is among children under 5 years of age.
      Intensive Care Unit (ICU) cases and deaths:
      • To date this season 90 ICU admissions and 16 deaths have been reported.
      Footnote 1 Influenza-associated hospitalizations are reported by Alberta, Manitoba, New Brunswick, Newfoundland and Labrador, Northwest Territories, Nova Scotia, Prince Edward Island and Yukon. Only hospitalizations that require intensive medical care are reported by Saskatchewan. The cumulative rate of hospitalizations is calculated using the total population by age-group in participating provinces and territories.
      Return to footnote1referrer
      0-4 131 0 27.5223961
      5-19 88 0 6.3418807
      20-44 115 0 4.0420613
      45-64 182 0 8.3629752
      65+ 186 3 15.5342679
      Total 702 3
      % 100% 0%
      Table 2 - Footnote 1 Influenza-associated hospitalizations are reported by Alberta, Manitoba, New Brunswick, Newfoundland and Labrador, Northwest Territories, Nova Scotia, Prince Edward Island and Yukon. Only hospitalizations that require intensive medical care are reported by Saskatchewan. The cumulative rate of hospitalizations is calculated using the population by age-group in participating provinces and territories.
      Return to Table 2 - Footnote1referrer
      Pediatric Influenza Hospitalizations and Deaths

      In week 49, 37 pediatric (≤16 years of age) hospitalizations with influenza have been reported by the Immunization Monitoring Program Active (IMPACT) network. Pediatric hospitalizations reported by IMPACT are at levels not normally seen until late December (Figure 7).
      To date this season, 228 pediatric hospitalizations have been reported (Figure 8):
      • All but three cases have been associated with influenza A.
      • Among the 154 cases for which the influenza subtype was available, 152 (98.7%) were associated with A(H1N1)pdm09.
      To date this season, 33 ICU admissions, and no deaths have been reported.
      Figure 7 Number of pediatric (≤16 years of age) hospitalizations reported by the IMPACT network, by week, Canada, weeks 2018-35 to 2018-49

      Figure 7 - Text description Figure 8 - Cumulative numbers of pediatric hospitalizations (≤16 years of age) with influenza by age-group reported by the IMPACT network, Canada, weeks 2018-35 to 2018-49

      Figure 8 - Text description Adult Influenza Hospitalizations and Deaths

      Surveillance of laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations by the Canadian Immunization Research Network (CIRN) Serious Outcomes Surveillance (SOS) network began on November 1st for the 2018-19 season.
      To date this season, 38 hospitalizations have been reported:
      • 33 (87%) were associated with influenza A and 5 with influenza B.
      • 20 of the 38 cases (53%) were adults 65 years of age and older.
      Influenza Strain Characterizations

      Since September 1, 2018, the National Microbiology Laboratory (NML) has characterized 182 influenza viruses (25 A(H3N2), 144 A(H1N1) and 13 B) that were received from Canadian laboratories.
      Genetic Characterization of Influenza A (H3N2):

      23 influenza A(H3N2) viruses did not grow to sufficient hemagglutination titer for antigenic characterization by hemagglutination inhibition (HI) assay. Therefore, NML has performed genetic characterization to determine the genetic group identity of these viruses.
      Sequence analysis of the HA gene of the viruses showed that:
      • Three viruses belonged to genetic group 3C.2a.
      • 20 viruses belonged to subclade 3C.2a1.
      A/Singapore/INFIMH-16-0019/2016-like virus belongs to genetic group 3C.2a1 and is the influenza A(H3N2) component of the 2018-19 Northern Hemisphere influenza vaccine.
      Antigenic Characterization:

      Influenza A(H3N2):

      • Two influenza A(H3N2) virus was antigenically characterized as A/Singapore/INFIMH-16-0019/2016-like by HI testing using antiserum raised against egg-propagated A/Singapore/INFIMH-16-0019/2016.
      • A/Singapore/INFIMH-16-0019/2016-like virus is the influenza A(H3N2) component of the 2018-19 Northern Hemisphere influenza vaccine.
      • The two influenza A (H3N2) viruses characterized belonged to genetic group 3C.2a1.
      Influenza A(H1N1):

      • 144 A(H1N1) viruses characterized were antigenically similar to A/Michigan/45/2015, which is the influenza A(H1N1) component of the 2018-19 Northern Hemisphere influenza vaccine.
      Influenza B:

      Influenza B viruses can be divided into two antigenically distinct lineages represented by B/Yamagata/16/88 and B/Victoria/2/87 viruses. The recommended influenza B components for the 2018-19 Northern Hemisphere influenza vaccine are B/Colorado/06/2017 (Victoria lineage) and B/Phuket/3073/2013 (Yamagata lineage).
      • 13 influenza B viruses were characterized as B/Phuket/3073/2013-like, which belongs to the Yamagata lineage and is included as an influenza B component of the 2018-19 Northern Hemisphere quadrivalent influenza vaccine.
      • ...
      https://www.canada.ca/en/public-heal...er-8-2018.html


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

      Comment

      Working...
      X