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  • British Columbia Influenza Surveillance Bulletin 2013-14 Week 4

    British Columbia Influenza Surveillance Bulletin
    Influenza Season 2013-14, Number 07, Weeks 51-52
    December 15 to December 28, 2013

    Ongoing, increased influenza activity in BC, predominantly A(H1N1)pdm09

    In weeks 51-52 (December 15 to 28, 2013), influenza activity increased in BC. Influenza A(H1N1)pdm09continues to be the predominant circulating strain, representing 51/61 (83.6%) of specimens with subtype information available during weeks 51-52. The proportion of respiratory specimens testing positive for influenza increased sharply from 17.3% in week 50 to 25.6% in week 51 and 42.5% in week 52. The BC Medical Services Plan (MSP) claims for influenza illness as a proportion of all claims increased throughout the province and were above 10-year maximum values. The proportion of patients with influenza-like illness among those presenting to sentinel physicians and the consultation rates attributed to ILI at BC Children?s Hospital ER also increased significantly during this period after remaining stable for the past few weeks. Consistency across surveillance indicators suggests a real increase in influenza activity in BC, but may also reflect differences in health care seeking behaviours during the holiday period. Ongoing monitoring is required in the coming weeks.
    ...
    In weeks 51-52, the proportion of patients with influenza-like illness (ILI) among those presenting to sentinel physicians increased from ≤0.2% in weeks 48-50 to 0.31% in week 51 and 0.52% in week 52. Consultation rates exceeded the historical average in week 52 but remained within the expected range for this time of year. Only 45% and 29% of sentinel sites reported data to date for weeks 51 and 52, respectively. Rates are subject to change as data become more complete following the holiday period.
    ...
    In weeks 51-52, the proportion of visits to BC Children?s Hospital Emergency Room (ER) attributed to ILI increased sharply from ≤11% in weeks 48-50 to 15.6% in week 51 and 21.3% in week 52. Rates were slightly above past seasons for this time of year but comparable to the 2012-13 season.
    ...
    To date since week 40 (September 29 ? October 5, 2013), 203 specimens have tested positive for influenza at the BC Public Health Microbiology & Reference Laboratory (PHMRL). Of the 131/203 specimens with subtype information available, 110 (84.0%) were influenza A(H1N1)pdm09, 8 (6.1%) were influenza A(H3N2), and 13 (9.9%) were influenza B. The majority of these detections (133/203 or 65.5%) have occurred in weeks 51-52.
    ...
    In weeks 51-52, 380 specimens (168 in week 51 and 212 in week 52) were tested for influenza at the BC PHMRL. In week 51, 43 (25.6%) were positive for influenza [39 A(H1N1)pdm09, 1 A(H3N2), 2 influenza B, and 1 influenza A (subtype pending)]. In week 52, 90 (42.5%) were positive for influenza [12 A(H1N1)pdm09, 3 A(H3N2), 4 influenza B, and 71 influenza A (subtype pending)]. The percent positivity continued to increase in both weeks compared to previous weeks from <5% in weeks 40-48, 10.6% in week 49 and 17.3% in week 50, to 25.6% in week 51 and 42.5% in week 52. As with previous weeks, influenza A(H1N1)pdm09 continued to predominate during this period. Of the 61 specimens with subtype information available, 51 (83.6%) were influenza A(H1N1)pdm09 in weeks 51-52.

    Among other respiratory viruses, rhino/enteroviruses were the most commonly detected, followed by RSV during this period.
    ...

    Full report:
    http://www.bccdc.ca/NR/rdonlyres/C3C...152_201314.pdf

    http://www.bccdc.ca/dis-cond/Disease...nceReports.htm
    "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
    Re: British Columbia Influenza Surveillance Bulletin 2013-14 Week 1

    British Columbia Influenza Surveillance Bulletin
    Influenza Season 2013-14, Number 08, Week 1
    December 29, 2013 to January 4, 2014

    Increasing influenza activity in BC,
    predominantly A(H1N1)pdm09

    In week 1 (December 29, 2013 to January 4, 2014), influenza activity continued to increase in BC. Influenza A(H1N1)pdm09 remains the predominant circulating strain. Of the 484 specimens tested by the BC Provincial Health Microbiology & Reference Laboratory in week 1, 214 (44.2%) were positive for influenza, including 104 A(H1N1)pdm09, 2 A(H3N2), 3 influenza B, and 105 influenza A (subtype pending). The influenza positivity rate at BC Children?s and Women?s Health Centre Laboratory increased to 17.6% in week 1. The BC Medical Services Plan (MSP) claims for influenza illness as a proportion of all claims increased to above the 10-year maximum value in most regions. No influenza outbreaks were reported in week 1. So far in week 2, 3 long term care facility (LTCF) and 4 school influenza-like illness (ILI) outbreaks have been reported, including one laboratory-confirmed influenza B outbreak in a LTCF in FHA.
    ...
    The proportion of patients with influenza-like illness (ILI) among those presenting to sentinel physicians has shown gradual increase in the last several weeks. Consistent with previous weeks this season, consultation rates remained below the historic average for this time of year. The increased rate observed in week 52 in our previous bulletin (Weeks 51-52, Number 7) has now declined as reporting became more complete after the holiday period. Approximately 40% of sentinel sites have reported data thus far for week 1.
    ...
    In week 1, the proportion of visits to BC Children?s Hospital Emergency Room (ER) attributed to ILI decreased slightly from 21.3% in week 52 to 19.9% in week 1, consistent with previous seasons for this time of year and as expected following the holiday period.
    ...
    To date since week 40 (September 29 ? October 5, 2013), 422 specimens have tested positive for influenza at the BC Public Health Microbiology & Reference Laboratory (PHMRL). Of the 312 specimens with subtype information available, 285 (91.3%) were influenza A(H1N1)pdm09, 11 (3.5%) were influenza A(H3N2), and 16 (5.1%) were influenza B.

    In week 1, the number of specimens submitted for influenza testing to the BC PHMRL more than doubled compared to the previous week (228 in week 52 vs. 484 in week 1). Among the 484 specimens tested, 214 (44.2%) were positive for influenza, including 104 A(H1N1)pdm09, 2 A(H3N2), 3 influenza B, and 105 influenza A (subtype pending). Influenza A(H1N1)pdm09 continues to predominate so far this season. Of the 109 specimens with subtype information available in week 1, 104 (95.4%) were influenza A(H1N1)pdm09. The percent of isolates testing positive for influenza has remained above 20% since week 51 and above 40% since week 52. Among other respiratory viruses, RSV was the most commonly detected.
    ...
    The influenza positivity rate reported by the BC Children?s and Women?s Health Centre Laboratory increased from 10.1% in week 52 to 17.6% in week 1. Of the 108 respiratory specimens tested for influenza, 19 (17.6%) were positive for influenza viruses in week 1, including 17 (89.5%) influenza A (un-subtyped) and 2 (10.5%) influenza B. RSV was the most commonly detected virus during this period at BC Children?s Laboratory; of the 104 respiratory specimens tested for RSV, 24 (23.1%) were positive. Other respiratory viruses were also sporadically detected.
    ...
    In week 1, no ILI outbreaks were reported. So far in week 2, 7 ILI outbreaks have been reported, including 3 in long-term care facilities (LTCF) (2 in FHA, one due to influenza B and one negative for influenza but pending laboratory results for other respiratory viruses, and one in VIHA pending laboratory results) and 4 in schools. So far during the 2013-14 season, 28 ILI outbreaks have been reported, including 15 in LTCFs and 13 in schools. Of these, 3 were due to laboratory-confirmed influenza viruses: one school outbreak due to A(H1N1)pdm09 in NHA in week 47, one LTCF outbreak due to A(H1N1)pdm09 in IHA in week 51, and one LTCF outbreak due to influenza B in FHA in week 2.
    ...
    No new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported in week 1 by the BC Children?s Hospital to the Immunization Monitoring Program Active (IMPACT) network, PHAC.
    ...
    Fatal Human Case of Avian Influenza A(H5N1) Virus Reported in Canada:

    On 7 January 2014, Alberta health officers in conjunction with the Public Health Agency of Canada reported a laboratory-confirmed fatal human case of avian influenza A(H5N1) in an Alberta resident returning from Beijing, China. The patient traveled from Beijing to Edmonton via Vancouver on 27 December 2013 and died on 3 January 2014 after being treated in hospital for severe respiratory illness. This is the first human case of H5N1 to be reported in North America. According to the WHO, 648 human cases of H5N1 and 384 deaths (case fatality of 58% among recognized cases) have been reported from 15 countries since 2003. The H5N1 virus is not easily transmitted from person to person, and the risk of community-level spread in BC is considered extremely low. Clinicians are reminded to notify their local health authority/Medical Health Officer in the event of severe acute respiratory illness (SARI) or other severe or unusual clinical outcomes in patients with recent travel to affected areas within 14 days prior to onset of symptoms.
    ...
    Full report:
    http://www.bccdc.ca/NR/rdonlyres/53F...ek1_201314.pdf
    "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
      Re: British Columbia Influenza Surveillance Bulletin 2013-14 Week 2

      British Columbia Influenza Surveillance Bulletin
      Influenza Season 2013-14, Number 09, Week 2
      January 5 to January 11, 2014

      A(H1N1)pdm09 activity peaking in BC

      In week 2 (January 5 to 11, 2014), influenza activity predominantly due to A(H1N1)pdm09 virus remained high in BC. Some indicators suggest illness due to A(H1N1)pdm09 is peaking in BC but further monitoring is required to confirm a downward trend in activity. The absolute number of influenza specimens tested at the BC Provincial Health Microbiology & Reference Laboratory increased again in week 2, while the percent of specimens that were positive for influenza fell to below 40% for the first time since week 51. The BC Medical Services Plan claims for influenza illness as a proportion of all claims remained above the 10-year maximum throughout the province, while both this proportion and the absolute number of services showed signs of decrease. One care facility outbreak due to lab-confirmed influenza A(H1N1)pdm09 was reported from FHA in week 2.
      ...
      Sentinel Physicians
      The proportion of patients with influenza-like illness (ILI) among those presenting to sentinel physicians increased to 0.6% in week 1 and 1.6% in week 2. In both weeks, rates were significantly higher than the historical average for this time of year. However, these rates are subject to change as reporting becomes more complete. To date, 68% and 58% of sentinel sites have reported data for weeks 1 and 2, respectively.
      ...
      BC Children?s Hospital Emergency Room
      In week 2, the proportion of visits to BC Children?s Hospital Emergency Room (ER) attributed to ILI decreased slightly from 21.3% in week 52 to 19.9% in week 1 and 19.3% in week 2. Rates remained consistent with those for this time of year compared to previous seasons.
      ...
      Laboratory Reports
      To date since week 40 (September 29 ? October 5, 2013), 845 specimens have tested positive for influenza at the BC Public Health Microbiology & Reference Laboratory (PHMRL). Of the 734 specimens with type/subtype information available, 688 (94%) were influenza A(H1N1)pdm09, 24 (3%) were influenza A(H3N2), and 22 (3%) were influenza B.

      While the absolute number of specimens submitted for influenza testing to the BC PHMRL continued to increase in week 2, the proportion testing positive for influenza fell to below 40% for the first time since week 51. Of the 892 specimens tested, 330 (37%) were positive for influenza, including 284 A(H1N1)pdm09, 9 A(H3N2), 6 influenza B, and 31 influenza A (subtype pending). Influenza A(H1N1)pdm09 continued to predominate in week 2, representing 284/299 (95%) of influenza viruses with type/subtype information available. Among other respiratory viruses, RSV continued to be the most commonly detected virus.
      ...
      In week 2, 142 tests for influenza A and 118 tests for influenza B were performed at the BC Children?s and Women?s Health Centre Laboratory. Of these, 20/142 (14%) were positive for influenza A (un-subtyped) and 1/118 (0.8%) was positive for influenza B. The percent positivity for influenza A was relatively stable at 16% in week 1 and 15% in week 2. The absolute number of positive tests and the percent positivity for influenza A slightly surpassed that of RSV in week 2. These viruses continue to co-circulate and RSV remains the most commonly detected of the other respiratory viruses identified during this period; of the 118 tests performed for RSV, 14 (12%) were positive.
      ...
      Influenza-like Illness (ILI) Outbreaks
      In week 2, four ILI outbreaks were reported from long-term care facilities (LTCF), including three in FHA (one A(H1N1)pdm01, one entero/rhinovirus, and one with no pathogen identified) and one in VIHA with laboratory results pending. Seven school outbreaks were also reported in week 2.
      In total during the 2013-14 season, 37 ILI outbreaks have been reported, including 18 in LTCFs and 19 in schools. Of these, four were due to laboratory-confirmed influenza: two LTCF outbreaks due to A(H1N1)pdm09 (week 51 in IHA and week 2 in FHA); one LTCF outbreak due to influenza B (week 1 in FHA); and one school outbreak due to A(H1N1)pdm09 in NHA in week 47.
      ...
      Full report:
      http://www.bccdc.ca/NR/rdonlyres/857...ek2_201314.pdf
      "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
      -Nelson Mandela

      Comment


      • #4
        Re: British Columbia Influenza Surveillance Bulletin 2013-14 Week 2

        British Columbia Influenza Surveillance Bulletin
        Influenza Season 2013-14, Number 10, Week 3
        January 12 to January 18, 2014

        Influenza A(H1N1)pdm09 activity has peaked: elevated but declining levels in BC

        In week 3 (January 12 to 18, 2014), influenza activity remained high in BC, but most surveillance indicators suggest that influenza A(H1N1)pdm09 activity has peaked and is now declining. BC Medical Services Plan claims for influenza illness as a proportion of all claims declined in the past week but remain above the 10-year maximum throughout the province. The percent of specimens positive for influenza at BC Provincial Health Microbiology & Reference Laboratory fell to below 30% for the first time since week 51. Influenza A(H1N1)pdm09 continues to be the predominant circulating influenza virus, representing >90% of viruses with subtype information available. However, a greater proportion of A(H3N2) and B viruses (~5% each) were detected compared to previous weeks. One LTCF facility outbreak due to lab-confirmed influenza A(H1N1)pdm09 was reported from FHA.
        ...
        Sentinel Physicians
        The proportion of patients with influenza-like illness (ILI) among those presenting to sentinel physicians remained above the historical average again in week 3. The ILI consultation rate has increased from 0.6% in week 1 to 1.4% in week 2 and 1.5% in week 3. To date, 76% and 53% of sentinel sites have reported data for weeks 2 and 3, respectively.
        ...
        BC Children?s Hospital Emergency Room
        In week 3, the proportion of visits to BC Children?s Hospital Emergency Room (ER) attributed to ILI continued to decrease for the third week in a row and is now at 17%, down from a peak of 21% in week 52. Rates were consistent with, although slightly higher than, those from previous seasons for this time of year.
        ...
        Laboratory Reports
        To date since week 40 (September 29 ? October 5, 2013), 1026 specimens have tested positive for influenza at the BC Public Health Microbiology & Reference Laboratory (PHMRL), PHSA. Of the 992 specimens with type/subtype information available, 924 (93.1%) were influenza A(H1N1)pdm09, 35 (3.5%) were influenza A(H3N2), and 33 (3.3%) were influenza B.

        In week 3, both the absolute number of specimens submitted for influenza testing to the BC PHMRL and the proportion testing positive for influenza decreased. The proportion testing positive fell to below 30% for the first time since week 51. Of the 853 specimens tested, 241 (28%) were positive for influenza, including 230 influenza A [211 A(H1N1)pdm09, 11 A(H3N2), 8 subtype pending] and 11 influenza B. Influenza A(H1N1)pdm09 continued to predominate in week 3, representing 211/233 (91%) of influenza viruses with type/subtype information available. Among other respiratory viruses, the proportion of specimens positive for RSV continued to increase in week 3, with 45/853 (5%) specimens testing positive.
        ...
        In week 3, the proportion of tests positive for influenza A and influenza B continued to decrease at the BC Children?s and Women?s Health Centre Laboratory. Of the 165 tests for influenza A, 18 (11%) were positive for influenza A (un-subtyped). Of the 122 tests for influenza B, none were positive. RSV continued to be the most commonly detected other respiratory virus. An approximately equal number of tests were positive for influenza A and RSV in week 3.
        ...
        Influenza-like Illness (ILI) Outbreaks
        In week 3, two ILI outbreaks were reported from long-term care facilities (LTCF): one in FHA due to lab-confirmed influenza A(H1N1)pdm09 and one in VIHA with no pathogen identified. Four school outbreaks were also reported in week 3. So far in week 4, two LTCF outbreak and one school outbreak have been reported with no pathogen identified, or lab result pending.

        In total during the 2013-14 season, 22 LTCF outbreaks, including five outbreaks due to influenza viruses: 3 A(H1N1)pdm09, 1 influenza A (subtype unknown), and 1 influenza B, and 21 school outbreaks, including one due to A(H1N1)pdm09 in NHA in week 47, have been reported.
        Compared to previous seasons, the number of reported outbreaks due to laboratory-confirmed influenza is relatively low to date this season. A recent sero-survey in British Columbia has shown schoolchildren and very old adults have higher levels of population immunity to influenza A(H1N1)pdm09, which has predominated so far during the 2013-14 season. This may explain in part the low number of reported outbreaks from LTCFs and schools. In contrast, during the 2012-13 season when influenza A(H3N2) was the predominant circulating virus, a substantially higher number of outbreaks were reported.
        ...
        Full report:
        http://www.bccdc.ca/NR/rdonlyres/1C3...ek3_201314.pdf
        "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
        -Nelson Mandela

        Comment


        • #5
          Re: British Columbia Influenza Surveillance Bulletin 2013-14 Week 4

          British Columbia Influenza Surveillance Bulletin
          Influenza Season 2013-14, Number 11, Week 4
          January 19 to January 25, 2014

          Influenza A(H1N1)pdm09 activity continues to decrease in BC

          In week 4 (January 19 to 25, 2014), influenza A(H1N1)pdm09 activity continued to decrease in BC, with most surveillance indicators suggesting peak activity around weeks 2-3. BC Medical Services Plan claims for influenza illness as a proportion of all claims continued to decrease but remained above 10-year 75th percentiles or maximums throughout the province. The percent of specimens positive for influenza viruses at the BC Provincial Health Microbiology & Reference Laboratory continued to decline from 29% in week 3 to 21% in week 4. Influenza A(H1N1)pdm09 continues to be the predominant circulating influenza virus, representing 86% of viruses with subtype information available over this period. The test positivity rate for influenza A also decreased at BC Children?s and Women?s Health Centre. No laboratory-confirmed influenza outbreaks were reported in week 4.
          ...
          In week 4, the proportion of patients with influenza-like illness (ILI) among those presenting to sentinel physicians remained significantly above the expected range for this time of year for the fourth consecutive week. The ILI consultation rate was 1.45%. To date in week 4, 43% of sentinel sites have reported data.
          ...
          The proportion of visits to BC Children?s Hospital Emergency Room (ER) attributed to ILI continued to decrease from a peak of 21.3% in week 52 to 16.4% in week 4. Overall, rates were consistent with those from previous seasons for this time of year.
          ...
          To date since week 40 (September 29 ? October 5, 2013), 1,180 specimens have tested positive for influenza at the BC Public Health Microbiology & Reference Laboratory (PHMRL), PHSA. Of the 1,137 specimens with type/subtype information available, 1,050 (92%) were influenza A(H1N1)pdm09, 47 (4%) were influenza A(H3N2), and 40 (4%) were influenza B.

          Both the absolute number of specimens submitted to the BC PHMRL and the proportion testing positive for influenza continued to decrease in week 4. Of the 704 specimens tested, 145 (21%) were positive for influenza, including 138 influenza A [110 A(H1N1)pdm09, 11 A(H3N2), 17 subtype pending] and 7 influenza B. Influenza A(H1N1)pdm09 continued to predominate in week 4, representing 110/128 (86%) of influenza viruses with type/subtype information available. Among other respiratory viruses, RSV continued to be the most commonly detected virus.
          ...
          In week 4, two ILI outbreaks from long-term care facilities (LTCF) in IHA with no pathogen identified, and four school outbreaks were reported. So far in week 5, four school outbreaks have been further reported.

          In total during the 2013-14 season, 22 LTCF outbreaks, including 5 outbreaks due to influenza viruses [3 A(H1N1)pdm09, 1 influenza A (subtype unknown), and 1 influenza B] and 28 school outbreaks, including one due to A(H1N1)pdm09 in NHA in week 47, have been reported.
          ...
          Full report:
          http://www.bccdc.ca/NR/rdonlyres/D5E...ek4_201314.pdf
          "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

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