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Canada FluWatch Weekly Reports 2010-2011 Season Week 20 - 224 deaths total (excluding BC, QC, NB and NU)

Pathfinder

Pathfinder

Editor, Senior Moderator
Source: http://www.phac-aspc.gc.ca/fluwatch/09-10/w42_09/index-eng.php



Overall Influenza Summary - Week 42 (October 18 to October 24, 2009)

Striking increases in overall influenza activity were reported this week. All indicators (proportion of positive influenza tests, national ILI consultation rate, number of regions reporting widespread activity and number of influenza outbreaks) were considerably higher this week compared to the previous weeks.
Ten regions reported widespread activity in BC, SK, NL & NT and fourteen regions in BC, AB, SK, ON, QC, NB & NS reported localized activity, while twenty-three regions reported sporadic activity in MB, ON, QC, NB, PEI, NS, NL, YK & NU and seven regions in NB, NS & NL reported no activity. The 226 influenza outbreaks reported this week were all in schools except 6 in hospitals (ON, NL), 3 in long-term care facility (BC, QC) and 3 in an unspecified location (AB, ON). The schools outbreaks were in BC (100), AB (87), NT (16), SK (4), NS (4), NL (2) and NB (1). Note that this is the first year that all the provinces and territories are reporting on influenza outbreaks in schools (greater than 10% absenteeism on any day most likely due to ILI) which is increasing considerably the total number of outbreaks reported compared to the previous years.


Map of overall Influenza activity level
by provinces and territories, Week 42, Canada

<TABLE class=widthFull cellSpacing=0 cellPadding=0><TBODY><TR><TD class=alignCenter></TD><TD><TABLE cellSpacing=0 cellPadding=1 border=0><TBODY><TR><TD align=middle><TABLE class=border-lite cellSpacing=1 cellPadding=1><TBODY><TR align=middle><TD>No Data </TD><TD>
leg_dots.gif
</TD></TR><TR align=middle><TD>No Activity</TD><TD>
leg_ffffff.gif
</TD></TR><TR align=middle><TD>Sporadic Activity</TD><TD>
leg_ccccff.gif
</TD></TR><TR align=middle><TD>Localized Activity</TD><TD>
leg_6666ff.gif
</TD></TR><TR align=middle><TD>Widespread
Activity

</TD><TD>
leg_000066.gif
</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE>
Note: Influenza 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 (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.


Overall Number of Influenza Outbreaks, Canada, by Report Week, 2009-2010

2009-w42-fg2-eng.gif

flu0910-leg-fg2-eng.gif




Influenza-like illness (ILI) consultation rates, Canada, by report week,
2009-2010 compared to 1996/97 through to 2007/08 seasons

2009-w42-fg3-eng.gif

flu0910-leg-fg3-eng.gif


Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons).
*Delays in the reporting of data may cause data to change restrospectively.


Laboratory Surveillance Summary
This week, the proportion of tests that were positive for influenza was 29.0% which is a significant increase compared to the previous weeks (see Tests table). All provinces and territories had a high proportion of positive tests for influenza this week, especially British Columbia with more than 52% of positive tests for influenza. This week, a total of 3,962 specimens tested positive for influenza this week (all A) and 99.7% of the positive influenza A subtyped specimens were Pandemic (H1N1) 2009.



Influenza tests reported and percentage of tests positive, Canada,
by report week, 2009-2010

2009-w42-fg4-eng.gif

flu0910-leg-fg4-eng.gif




Percent positive influenza tests, compared to other respiratory viruses, Canada,
by reporting week, 2009-2010

2009-w42-fg5-eng.gif

flu0910-leg-fg5-eng.gif



Weekly & Cumulative numbers of positive influenza specimens, by Provincial Laboratories

<TABLE class=widthFull cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD class=fontSize85 id=gr12 headers=gr1 colSpan=13>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces.
Note: Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals.
* Not subtyped

</TD></TR></TFOOT><TBODY><TR><TH class=bg-colour-blue scope=col rowSpan=3>Reporting provinces</TH><TH class="fontSize85 bg-colour-blue" scope=colgroup colSpan=6>Weekly (Oct. 18-24, 2009)</TH><TH class="fontSize85 bg-colour-blue" scope=colgroup colSpan=6>Cumulative (Aug. 30-Oct. 24, 2009)</TH></TR><TR><TH class="fontSize85 bg-colour-blue" scope=colgroup colSpan=5>Influenza A</TH><TH class="fontSize85 bg-colour-blue" scope=col>B</TH><TH class="fontSize85 bg-colour-blue" scope=colgroup colSpan=5>Influenza A</TH><TH class="fontSize85 bg-colour-blue" scope=col>B</TH></TR><TR><TH class="fontSize85 bg-colour-blue" scope=col>A Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H3)</TH><TH class="fontSize85 bg-colour-blue" scope=col>Pand (H1N1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A (NS)*</TH><TH class="bg-colour-blue fontSize85" scope=col>Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H3)</TH><TH class="fontSize85 bg-colour-blue" scope=col>Pand (H1N1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A (NS)*</TH><TH class="fontSize85 bg-colour-blue" scope=col>Total</TH></TR><TR><TH class=bg-colour-blue scope=row>BC</TH><TD class=alignCenter>1176</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1170</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2648</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2091</TD><TD class=alignCenter>557</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>1212</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>538</TD><TD class=alignCenter>674</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1847</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>769</TD><TD class=alignCenter>1078</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>127</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>92</TD><TD class=alignCenter>35</TD><TD class=alignCenter>0</TD><TD class=alignCenter>213</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>162</TD><TD class=alignCenter>50</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>21</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>19</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>40</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>34</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>818</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>467</TD><TD class=alignCenter>351</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1280</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>724</TD><TD class=alignCenter>555</TD><TD class=alignCenter>2</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>457</TD><TD class=alignCenter>0</TD><TD class=alignCenter>8</TD><TD class=alignCenter>449</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>676</TD><TD class=alignCenter>34</TD><TD class=alignCenter>9</TD><TD class=alignCenter>566</TD><TD class=alignCenter>67</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NB</TH><TD class=alignCenter>8</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>7</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>13</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>9</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>67</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>63</TD><TD class=alignCenter>4</TD><TD class=alignCenter>0</TD><TD class=alignCenter>87</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>77</TD><TD class=alignCenter>10</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>7</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>12</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>11</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>69</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>69</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>77</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>77</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>3962</TD><TD class=alignCenter>1</TD><TD class=alignCenter>8</TD><TD class=alignCenter>2880</TD><TD class=alignCenter>1073</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6893</TD><TD class=alignCenter>36</TD><TD class=alignCenter>11</TD><TD class=alignCenter>4520</TD><TD class=alignCenter>2326</TD><TD class=alignCenter>3</TD></TR></TBODY></TABLE>
 
Re: Canada - FluWatch Pandemic (H1N1) 2009 virus Surveillance Week 43

Re: Canada - FluWatch Pandemic (H1N1) 2009 virus Surveillance Week 43

Source: http://www.phac-aspc.gc.ca/fluwatch/09-10/w43_09/index-eng.php

October 25, 2009 to October 31, 2009 (Week 43)



Considerable increases in overall influenza activity were reported this week. All indicators (proportion of positive influenza tests, national ILI consultation rate, number of regions reporting widespread activity and number of influenza outbreaks) were considerably higher this week compared to the previous weeks.

Nineteen regions reported widespread activity in BC, AB, SK, ON, NL & NT and sixteen regions in ON, QC, NB, NS, PEI & YK reported localized activity, while eighteen regions reported sporadic activity in MB, QC, NB, NS, NL & NU and one region in NB reported no activity. The 737 influenza outbreaks reported this week were all in schools except 11 in hospitals (NL, ON), 9 in an unspecified location (AB, ON, NL & YK) and 7 in long-term care facility (BC, SK, QC & NL). The schools outbreaks were in AB (361), BC (146), SK (105), NS (66), PEI (16), NB (11), NL (3) and NT (2). Note that this is the first year that all the provinces and territories are reporting on influenza outbreaks in schools (greater than 10% absenteeism on any day most likely due to ILI) which is increasing considerably the total number of outbreaks reported compared to the previous years.
Map of overall Influenza activity level
by provinces and territories, Week 43, Canada

<TABLE class=widthFull cellSpacing=0 cellPadding=0><TBODY><TR><TD class=alignCenter></TD><TD><TABLE cellSpacing=0 cellPadding=1 border=0><TBODY><TR><TD align=middle><TABLE class=border-lite cellSpacing=1 cellPadding=1><TBODY><TR align=middle><TD>No Data </TD><TD>
leg_dots.gif
</TD></TR><TR align=middle><TD>No Activity</TD><TD>
leg_ffffff.gif
</TD></TR><TR align=middle><TD>Sporadic Activity</TD><TD>
leg_ccccff.gif
</TD></TR><TR align=middle><TD>Localized Activity</TD><TD>
leg_6666ff.gif
</TD></TR><TR align=middle><TD>Widespread
Activity
</TD><TD>
leg_000066.gif
</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE>
Note: Influenza 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 (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.

Number of influenza surveillance regions<SUP>?</SUP> reporting widespread or localized influenza activity,
Canada, by report week, 2009-2010 (N=54)

2009-w43-fg1-eng.gif

flu0910-leg-fg1-eng.gif

? sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.

Overall Number of Influenza Outbreaks, Canada, by Report Week, 2009-2010

2009-w43-fg2-eng.gif

flu0910-leg-fg2-eng.gif


ILI consultation rate
This week, the national ILI consultation rate was 111 consultations per 1,000 patient visits (see ILI graph) which is significantly higher compared to the previous weeks and still highly above the expected range for this time of the year. All provinces and territories had higher ILI consultation rates compared to last week except for BC, SK, YK and NT which had similar rates in comparison to the previous week. People under 20 years of age had the highest consultations rates with 293 and 239 per 1,000 patient visits among children under 5 years of age and among those 5 and 19 years of age, respectively.

Influenza-like illness (ILI) consultation rates, Canada, by report week,
2009-2010 compared to 1996/97 through to 2008/09 seasons

2009-w43-fg3-eng.gif

flu0910-leg-fg3-eng.gif


Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons).
*Delays in the reporting of data may cause data to change restrospectively.
Paediatric Influenza Hospitalizations and deaths
In week 43, 120 laboratory-confirmed influenza-associated paediatric hospitalizations were reported through the Immunization Monitoring Program Active (IMPACT) network. 116 Pandemic (H1N1) 2009 and 4 other hospitalizations due to unsubtyped influenza A were reported this week. 605 hospitalizations had been reported since week 17 (April 26); 95.2% of these hospitalizations were due to Pandemic (H1N1) 2009. Since the beginning of the pandemic, four deaths due to Pandemic (H1N1) 2009 had been reported through the IMPACT network among children under 16 years of age.
Laboratory Surveillance Summary
This week, the proportion of tests that were positive for influenza was 36.3% which is a significant increase compared to the previous weeks (see Tests table). All provinces and territories had a high proportion of positive tests for influenza this week, except British Columbia which had a slightly lower proportion this week. This week, the number of specimen tested positive for influenza was two times higher with 7,970 specimen (all A and 2 B) and the proportion of positive subtyped influenza A specimens that were Pandemic (H1N1) 2009 was 99.7%.

Influenza tests reported and percentage of tests positive, Canada,
by report week, 2009-2010

2009-w43-fg4-eng.gif

flu0910-leg-fg4-eng.gif


Percent positive influenza tests, compared to other respiratory viruses, Canada,
by reporting week, 2009-2010

2009-w43-fg5-eng.gif

flu0910-leg-fg5-eng.gif

Weekly & Cumulative numbers of positive influenza specimens, by Provincial Laboratories

<TABLE class=widthFull cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD class=fontSize85 id=gr12 headers=gr1 colSpan=13>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces.
Note: Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals.
* Not subtyped
</TD></TR></TFOOT><TBODY><TR><TH class=bg-colour-blue scope=col rowSpan=3>Reporting provinces</TH><TH class=bg-colour-blue scope=colgroup colSpan=6>Weekly (Oct. 25-31, 2009)</TH><TH class=bg-colour-blue scope=colgroup colSpan=6>Cumulative (Aug. 30-Oct. 31, 2009)</TH></TR><TR><TH class=bg-colour-blue scope=colgroup colSpan=5>Influenza A</TH><TH class=bg-colour-blue scope=col>B</TH><TH class=bg-colour-blue scope=colgroup colSpan=5>Influenza A</TH><TH class=bg-colour-blue scope=col>B</TH></TR><TR><TH class=bg-colour-blue scope=col>A Total</TH><TH class=bg-colour-blue scope=col>A(H1)</TH><TH class=bg-colour-blue scope=col>A(H3)</TH><TH class=bg-colour-blue scope=col>Pand (H1N1)</TH><TH class=bg-colour-blue scope=col>A (NS)*</TH><TH class="bg-colour-blue fontSize85" scope=col>Total</TH><TH class=bg-colour-blue scope=col>A Total</TH><TH class=bg-colour-blue scope=col>A(H1)</TH><TH class=bg-colour-blue scope=col>A(H3)</TH><TH class=bg-colour-blue scope=col>Pand (H1N1)</TH><TH class=bg-colour-blue scope=col>A (NS)*</TH><TH class=bg-colour-blue scope=col>Total</TH></TR><TR><TH class=bg-colour-blue scope=row>BC</TH><TD class=alignCenter>1243</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1239</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3891</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>3330</TD><TD class=alignCenter>560</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>2254</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2254</TD><TD class=alignCenter>0</TD><TD class=alignCenter>4101</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>769</TD><TD class=alignCenter>3332</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>487</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>443</TD><TD class=alignCenter>44</TD><TD class=alignCenter>0</TD><TD class=alignCenter>700</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>605</TD><TD class=alignCenter>94</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>53</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>37</TD><TD class=alignCenter>16</TD><TD class=alignCenter>0</TD><TD class=alignCenter>93</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>71</TD><TD class=alignCenter>22</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>1501</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>665</TD><TD class=alignCenter>834</TD><TD class=alignCenter>1</TD><TD class=alignCenter>2834</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1442</TD><TD class=alignCenter>1389</TD><TD class=alignCenter>3</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>1796</TD><TD class=alignCenter>0</TD><TD class=alignCenter>11</TD><TD class=alignCenter>1785</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>2418</TD><TD class=alignCenter>1</TD><TD class=alignCenter>23</TD><TD class=alignCenter>2394</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>NB</TH><TD class=alignCenter>67</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>67</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>80</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>76</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>244</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>241</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>331</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>318</TD><TD class=alignCenter>13</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>42</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>42</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>54</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>53</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>283</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>283</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>360</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>360</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>7970</TD><TD class=alignCenter>1</TD><TD class=alignCenter>13</TD><TD class=alignCenter>4802</TD><TD class=alignCenter>3154</TD><TD class=alignCenter>2</TD><TD class=alignCenter>14862</TD><TD class=alignCenter>4</TD><TD class=alignCenter>27</TD><TD class=alignCenter>9418</TD><TD class=alignCenter>5413</TD><TD class=alignCenter>5</TD></TR></TBODY></TABLE>
 
Re: Canada - FluWatch Pandemic (H1N1) 2009 virus Surveillance Week 44

Re: Canada - FluWatch Pandemic (H1N1) 2009 virus Surveillance Week 44

:tiphat: Missouriwatcher

Source: http://www.phac-aspc.gc.ca/fluwatch/.../index-eng.php

FluWatch Pandemic (H1N1) 2009 virus Surveillance Week 43

Weekly and cumulative numbers of hospitalizations, ICU admissions and deaths among
Pandemic (H1N1) 2009 confirmed cases, Canada, to 7 November, 2009


<TABLE class="widthFull fontSize85" cellSpacing=0 cellPadding=2 border=1><TBODY><TR><TH class=bg-colour-blue scope=col rowSpan=2>Province/Territory</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>This week (Nov. 1-7, 2009)*</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>From August 30, 2009 to
November 7, 2009**


</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>From April to August 29, 2009**</TH></TR><TR><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH></TR><TR><TH class=bg-colour-blue scope=row>BC<SUP>1 </SUP></TH><TD class=alignCenter>240</TD><TD class=alignCenter>14</TD><TD class=alignCenter>9</TD><TD class=alignCenter>550</TD><TD class=alignCenter>68</TD><TD class=alignCenter>18</TD><TD class=alignCenter>51</TD><TD class=alignCenter>19</TD><TD class=alignCenter>5</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>217</TD><TD class=alignCenter>46</TD><TD class=alignCenter>6</TD><TD class=alignCenter>352</TD><TD class=alignCenter>75</TD><TD class=alignCenter>13</TD><TD class=alignCenter>128</TD><TD class=alignCenter>29</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>SK<SUP>2 </SUP></TH><TD class=alignCenter>--</TD><TD class=alignCenter>--</TD><TD class=alignCenter>1</TD><TD class=alignCenter>4</TD><TD class=alignCenter>3</TD><TD class=alignCenter>2</TD><TD class=alignCenter>23</TD><TD class=alignCenter>12</TD><TD class=alignCenter>4</TD></TR><TR><TH class=bg-colour-blue scope=row>MB<SUP>3 </SUP></TH><TD class=alignCenter>11</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>11</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>227</TD><TD class=alignCenter>43</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>214</TD><TD class=alignCenter>19</TD><TD class=alignCenter>7</TD><TD class=alignCenter>385</TD><TD class=alignCenter>46</TD><TD class=alignCenter>14</TD><TD class=alignCenter>373</TD><TD class=alignCenter>66</TD><TD class=alignCenter>23</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>435</TD><TD class=alignCenter>54</TD><TD class=alignCenter>8</TD><TD class=alignCenter>696</TD><TD class=alignCenter>86</TD><TD class=alignCenter>8</TD><TD class=alignCenter>572</TD><TD class=alignCenter>104</TD><TD class=alignCenter>27</TD></TR><TR><TH class=bg-colour-blue scope=row>NB<SUP>1</SUP></TH><TD class=alignCenter>40</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>46</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>50</TD><TD class=alignCenter>9</TD><TD class=alignCenter>1</TD><TD class=alignCenter>66</TD><TD class=alignCenter>12</TD><TD class=alignCenter>1</TD><TD class=alignCenter>17</TD><TD class=alignCenter>8</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>18</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>21</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NL<SUP>1 </SUP></TH><TD class=alignCenter>89</TD><TD class=alignCenter>15</TD><TD class=alignCenter>1</TD><TD class=alignCenter>116</TD><TD class=alignCenter>15</TD><TD class=alignCenter>2</TD><TD class=alignCenter>3</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>YT</TH><TD class=alignCenter>4</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>8</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NT</TH><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>40</TD><TD class=alignCenter>5</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NU</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>66</TD><TD class=alignCenter>6</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>1324</TD><TD class=alignCenter>163</TD><TD class=alignCenter>35</TD><TD class=alignCenter>2295</TD><TD class=alignCenter>317</TD><TD class=alignCenter>60</TD><TD class=alignCenter>1469</TD><TD class=alignCenter>289</TD><TD class=alignCenter>75</TD></TR><TR><TD colSpan=10>*Based on reporting date.
** Based on epidemiological date and reporting date.
<SUP>1 </SUP>These two provinces reported aggregate counts this week.
<SUP>2</SUP> No report received this week from SK.
<SUP>3</SUP> The new numbers reflect the situation since week 41.
Note that the criteria used to select the cases up to August 29, 2009 have changed, which may explain the differences compared to the previous week.





</TD></TR></TBODY></TABLE>

Descriptive characteristics of laboratory-confirmed Canadian Pandemic (H1N1) 2009 hospitalized cases, ICU-admitted cases and deaths with core information available, reported to PHAC as of November 31, 2009

<TABLE class=widthFull cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD class=fontSize85 id=cr6 colSpan=7><SUP>1</SUP> Proportion of cases with at least one underlying medical condition (excluding pregnancy) among those for whom the information was available.
<SUP>2</SUP> Percent of pregnant women among women 15 to 44 years of age. Note that the criteria used to select the cases up to August 29, 2009 have changed, which may explain the differences compared to the previous week.


</TD></TR></TFOOT><TBODY><TR class=bg-colour-blue><TD rowSpan=2></TD><TH id=cc1 colSpan=3>From August 30, 2009 to October 31, 2009</TH><TH id=cc5 colSpan=3>From April to August 29, 2009</TH></TR><TR class=bg-colour-blue><TH class=fontSize85 id=cc2 headers=cc1>Hospitalized cases (n=854)</TH><TH class=fontSize85 id=cc3 headers=cc1>Cases admitted to ICU (n=147)</TH><TH class=fontSize85 id=cc4 headers=cc1>Deaths (n=24)</TH><TH class=fontSize85 id=cc6 headers=cc5>Hospitalized cases (n=1,492)</TH><TH class=fontSize85 id=cc7 headers=cc5>Cases admitted to ICU (n=296)</TH><TH class=fontSize85 id=cc8 headers=cc5>Deaths (n=76)</TH></TR><TR><TH class="bg-colour-blue alignLeft" id=cr1>Females, %</TH><TD class=alignCenter headers="cr1 cc1 cc2">51.4</TD><TD class=alignCenter headers="cr1 cc1 cc3">52.8</TD><TD class=alignCenter headers="cr1 cc1 cc4">60.7</TD><TD class=alignCenter headers="cr1 cc5 cc6">51.3</TD><TD class=alignCenter headers="cr1 cc5 cc7">57.1</TD><TD class=alignCenter headers="cr1 cc5 cc8">61.3</TD></TR><TR><TH class="bg-colour-blue alignLeft" id=cr2>Median age</TH><TD class=alignCenter headers="cr2 cc1 cc2">25.0</TD><TD class=alignCenter headers="cr2 cc1 cc3">45.0</TD><TD class=alignCenter headers="cr2 cc1 cc4">51.0</TD><TD class=alignCenter headers="cr2 cc5 cc6">23.0</TD><TD class=alignCenter headers="cr2 cc5 cc7">37.0</TD><TD class=alignCenter headers="cr2 cc5 cc8">51.0</TD></TR><TR><TH class="bg-colour-blue alignLeft" id=cr3>Aboriginal status, % </TH><TD class=alignCenter headers="cr3 cc1 cc2">11.1</TD><TD class=alignCenter headers="cr3 cc1 cc3">11.3</TD><TD class=alignCenter headers="cr3 cc1 cc4">14.3</TD><TD class=alignCenter headers="cr3 cc5 cc6">18.0</TD><TD class=alignCenter headers="cr3 cc5 cc7">15.2</TD><TD class=alignCenter headers="cr3 cc5 cc8">12.0</TD></TR><TR><TH class="bg-colour-blue alignLeft" id=cr4>Underlying medical conditions<SUP>1 </SUP>, %</TH><TD class=alignCenter headers="cr4 cc1 cc2">57.5(441/767)</TD><TD class=alignCenter headers="cr4 cc1 cc3">68.3(142/208)</TD><TD class=alignCenter headers="cr4 cc1 cc4">73.0(27/37)</TD><TD class=alignCenter headers="cr4 cc5 cc6">62.7(616/982)</TD><TD class=alignCenter headers="cr4 cc5 cc7">72.2(151/209)</TD><TD class=alignCenter headers="cr4 cc5 cc8">79.7(47/59)</TD></TR><TR><TH class=bg-colour-blue id=cr5>Pregnancy<SUP>2</SUP> , %</TH><TD class=alignCenter headers="cr5 cc1 cc2">17.4 (60/345)</TD><TD class=alignCenter headers="cr5 cc1 cc3">12.9 (8/62)</TD><TD class=alignCenter headers="cr5 cc1 cc4">0.0</TD><TD class=alignCenter headers="cr5 cc5 cc6">28.5 (78/274)</TD><TD class=alignCenter headers="cr5 cc5 cc7">19.7 (15/76)</TD><TD class=alignCenter headers="cr5 cc5 cc8">28.6 (4/14)</TD></TR></TBODY></TABLE>

Overall Influenza Summary - Week 44 (November 1 to November 7, 2009)

Nationally, there was a considerable increase in the influenza activity level reported this week with a proportion of positive influenza tests of more than 38%, the national ILI consultation rate of almost 100 per 1,000 patient visits, 25 regions reporting widespread activity and over 750 influenza outbreaks reported. This increased activity occurred in almost all provinces and territories.
Twenty-five regions reported widespread activity in BC, AB, SK, ON, QC, PE, NS & NL and fifteen regions in MB, ON, QC, NB & NL reported localized activity, while thirteen regions reported sporadic activity in MB, ON, QC, NB, NS, NL, YK, NT & NU and one region in NU reported no activity. The 755 influenza outbreaks reported this week were all in schools except 22 in hospitals and residential institutions (BC, AB, ON, QC, NB & NL) and 10 in an unspecified location (AB, MB, ON & PE). The schools outbreaks were in NS (173), BC (157), SK (150), AB (148), PE (47), NB (45), NL (2) and MB (1). Note that this is the first year that all the provinces and territories are reporting on influenza outbreaks in schools (greater than 10% absenteeism on any day most likely due to ILI) which is increasing considerably the total number of outbreaks reported compared to the previous years.
<TBODY><TR>
Map of overall Influenza activity level
by provinces and territories, Week 44, Canada

<TABLE class=widthFull cellSpacing=0 cellPadding=0><TBODY><TR><TD class=alignCenter></TD><TD><TABLE cellSpacing=0 cellPadding=1 border=0><TBODY><TR><TD align=middle><TABLE class=border-lite cellSpacing=1 cellPadding=1><TBODY><TR align=middle><TD>No Data </TD><TD>
leg_dots.gif
</TD></TR><TR align=middle><TD>No Activity</TD><TD>
leg_ffffff.gif
</TD></TR><TR align=middle><TD>Sporadic Activity</TD><TD>
leg_ccccff.gif
</TD></TR><TR align=middle><TD>Localized Activity</TD><TD>
leg_6666ff.gif
</TD></TR><TR align=middle><TD>Widespread
Activity


</TD><TD>
leg_000066.gif
</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE>
Note: Influenza 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 (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.

Number of influenza surveillance regions<SUP>?</SUP> reporting widespread or localized influenza activity,
Canada, by report week, 2009-2010 (N=54)

2009-w44-fg1-eng.gif

flu0910-leg-fg1-eng.gif

? sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.

Overall Number of Influenza Outbreaks, Canada, by Report Week, 2009-2010

2009-w44-fg2-eng.gif

flu0910-leg-fg2-eng.gif


ILI consultation rate
This week, the national ILI consultation rate was 99 consultations per 1,000 patient visits (see ILI graph) which was lower compared to the previous week. This is likely due to the fact that many P/T have established special clinics for assessing patients with ILI. Five provinces and territories (SK, NB, NS, NL and YK) had higher ILI consultation rates compared to their ILI rates in previous weeks. People under 20 years of age had the highest consultations rates, with 153 and 226 per 1,000 patient visits among children under 5 years of age and among those 5 and 19 years of age, respectively.

Influenza-like illness (ILI) consultation rates, Canada, by report week,
2009-2010 compared to 1996/97 through to 2008/09 seasons

2009-w44-fg3-eng.gif

flu0910-leg-fg3-eng.gif


Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons).
*Delays in the reporting of data may cause data to change restrospectively.
Paediatric Influenza Hospitalizations and deaths
In week 44, 198 laboratory-confirmed influenza-associated paediatric hospitalizations and 1 death were reported through the Immunization Monitoring Program Active (IMPACT) network. The new death was a male aged between 5 and 9 years of age with underlying medical conditions. 194 Pandemic (H1N1) 2009 and 4 other hospitalizations due to unsubtyped influenza A were reported this week. 861 hospitalizations had been reported since week 17 (April 26); 96.3% of these hospitalizations were due to Pandemic (H1N1) 2009. Since the beginning of the pandemic, five deaths due to Pandemic (H1N1) 2009 had been reported through the IMPACT network among children under 16 years of age.
Laboratory Surveillance Summary
This week, the proportion of tests that were positive for influenza was 38.1% which is a slight increase compared to the previous week (see Tests table). While the Atlantic provinces and Quebec had a higher proportion of positive tests for influenza this week, the Prairies and Ontario had a lower proportion and British Columbia had a similar proportion. This week, a total of 8,054 specimens tested positive for influenza this week (all A except 2 B) and 99.8% of the positive influenza A subtyped specimens were Pandemic (H1N1) 2009. Note that QC has reported this week 10 positive specimens for A/H3N2.

Influenza tests reported and percentage of tests positive, Canada,
by report week, 2009-2010

2009-w44-fg4-eng.gif

flu0910-leg-fg4-eng.gif


Percent positive influenza tests, compared to other respiratory viruses, Canada,
by reporting week, 2009-2010

2009-w44-fg5-eng.gif

flu0910-leg-fg5-eng.gif

Weekly & Cumulative numbers of positive influenza specimens, by Provincial Laboratories

<TABLE class=widthFull cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD class=fontSize85 id=gr12 headers=gr1 colSpan=13>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces.
Note: Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals.
* Not subtyped


</TD></TR></TFOOT><TBODY><TR><TH class=bg-colour-blue scope=col rowSpan=3>Reporting provinces</TH><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=6>Weekly (Nov. 1-7, 2009)</TH><TH class=bg-colour-blue scope=colgroup colSpan=6>Cumulative (Aug. 30-Nov. 7, 2009)</TH></TR><TR><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=5>Influenza A</TH><TH class="bg-colour-blue fontSize85" scope=col>B</TH><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=5>Influenza A</TH><TH class=bg-colour-blue scope=col>B</TH></TR><TR><TH class=bg-colour-blue scope=col>A Total</TH><TH class="bg-colour-blue fontSize85" scope=col>A(H1)</TH><TH class="bg-colour-blue fontSize85" scope=col>A(H3)</TH><TH class="bg-colour-blue fontSize85" scope=col>Pand (H1N1)</TH><TH class="bg-colour-blue fontSize85" scope=col>A (NS)*</TH><TH class="bg-colour-blue fontSize85" scope=col>Total</TH><TH class="bg-colour-blue fontSize85" scope=col>A Total</TH><TH class="bg-colour-blue fontSize85" scope=col>A(H1)</TH><TH class="bg-colour-blue fontSize85" scope=col>A(H3)</TH><TH class="bg-colour-blue fontSize85" scope=col>Pand (H1N1)</TH><TH class="bg-colour-blue fontSize85" scope=col>A (NS)*</TH><TH class="bg-colour-blue fontSize85" scope=col>Total</TH></TR><TR><TH class=bg-colour-blue scope=row>BC</TH><TD class=alignCenter>1155</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1153</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5046</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>4483</TD><TD class=alignCenter>562</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>711</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>711</TD><TD class=alignCenter>0</TD><TD class=alignCenter>4812</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>769</TD><TD class=alignCenter>4043</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>606</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>505</TD><TD class=alignCenter>101</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1306</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1110</TD><TD class=alignCenter>195</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>218</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>218</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>311</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>289</TD><TD class=alignCenter>22</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>1392</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>329</TD><TD class=alignCenter>1063</TD><TD class=alignCenter>1</TD><TD class=alignCenter>4421</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1856</TD><TD class=alignCenter>2564</TD><TD class=alignCenter>4</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>2678</TD><TD class=alignCenter>0</TD><TD class=alignCenter>10</TD><TD class=alignCenter>2668</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>5096</TD><TD class=alignCenter>1</TD><TD class=alignCenter>33</TD><TD class=alignCenter>5062</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD></TR><TR><TH class=bg-colour-blue scope=row>NB</TH><TD class=alignCenter>752</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>739</TD><TD class=alignCenter>13</TD><TD class=alignCenter>0</TD><TD class=alignCenter>832</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>815</TD><TD class=alignCenter>15</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>146</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>143</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>477</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>461</TD><TD class=alignCenter>16</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>22</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>22</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>76</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>75</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>374</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>374</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>734</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>734</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>8054</TD><TD class=alignCenter>0</TD><TD class=alignCenter>10</TD><TD class=alignCenter>6151</TD><TD class=alignCenter>1893</TD><TD class=alignCenter>2</TD><TD class=alignCenter>23111</TD><TD class=alignCenter>3</TD><TD class=alignCenter>36</TD><TD class=alignCenter>15654</TD><TD class=alignCenter>7418</TD><TD class=alignCenter>7</TD></TR></TBODY></TABLE>
 
Last edited:
Re: Canada - FluWatch Pandemic (H1N1) 2009 virus Surveillance Week 45

Re: Canada - FluWatch Pandemic (H1N1) 2009 virus Surveillance Week 45

Pandemic (H1N1) 2009 virus Surveillance November 8, 2009 to November 14, 2009 (Week 45)



Source:http://www.phac-aspc.gc.ca/fluwatch/09-10/w45_09/index-eng.php

Weekly and cumulative numbers of hospitalizations, ICU admissions and deaths among
Pandemic (H1N1) 2009 confirmed cases, Canada, to 14 November, 2009<SUP>?</SUP>


<TABLE class="widthFull fontSize85" cellSpacing=0 cellPadding=2 border=1><TBODY><TR><TH class=bg-colour-blue scope=col rowSpan=2>Province/Territory</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>This week (Nov. 8-14, 2009)*</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>From August 30, 2009 to
November 14, 2009**
</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>From April to August 29, 2009**?</TH></TR><TR><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH></TR><TR><TH class=bg-colour-blue scope=row>BC<SUP>1 </SUP></TH><TD class=alignCenter>154</TD><TD class=alignCenter>20</TD><TD class=alignCenter>6</TD><TD class=alignCenter>703</TD><TD class=alignCenter>87</TD><TD class=alignCenter>24</TD><TD class=alignCenter>52</TD><TD class=alignCenter>20</TD><TD class=alignCenter>5</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>413</TD><TD class=alignCenter>80</TD><TD class=alignCenter>22</TD><TD class=alignCenter>765</TD><TD class=alignCenter>155</TD><TD class=alignCenter>35</TD><TD class=alignCenter>128</TD><TD class=alignCenter>29</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>9</TD><TD class=alignCenter>8</TD><TD class=alignCenter>2</TD><TD class=alignCenter>13</TD><TD class=alignCenter>11</TD><TD class=alignCenter>4</TD><TD class=alignCenter>23</TD><TD class=alignCenter>12</TD><TD class=alignCenter>4</TD></TR><TR><TH class=bg-colour-blue scope=row>MB<SUP>1 </SUP></TH><TD class=alignCenter>12</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>25</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>225</TD><TD class=alignCenter>43</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>311</TD><TD class=alignCenter>41</TD><TD class=alignCenter>24</TD><TD class=alignCenter>691</TD><TD class=alignCenter>86</TD><TD class=alignCenter>36</TD><TD class=alignCenter>378</TD><TD class=alignCenter>67</TD><TD class=alignCenter>25</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>695</TD><TD class=alignCenter>98</TD><TD class=alignCenter>23</TD><TD class=alignCenter>1391</TD><TD class=alignCenter>184</TD><TD class=alignCenter>31</TD><TD class=alignCenter>572</TD><TD class=alignCenter>104</TD><TD class=alignCenter>27</TD></TR><TR><TH class=bg-colour-blue scope=row>NB<SUP>1</SUP></TH><TD class=alignCenter>36</TD><TD class=alignCenter>6</TD><TD class=alignCenter>2</TD><TD class=alignCenter>82</TD><TD class=alignCenter>8</TD><TD class=alignCenter>2</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NS<SUP>2</SUP></TH><TD class=alignCenter>--</TD><TD class=alignCenter>--</TD><TD class=alignCenter>--</TD><TD class=alignCenter>66</TD><TD class=alignCenter>12</TD><TD class=alignCenter>1</TD><TD class=alignCenter>17</TD><TD class=alignCenter>8</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>PE<SUP>1</SUP></TH><TD class=alignCenter>15</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>36</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NL<SUP>1 </SUP></TH><TD class=alignCenter>23</TD><TD class=alignCenter>3</TD><TD class=alignCenter>5</TD><TD class=alignCenter>139</TD><TD class=alignCenter>18</TD><TD class=alignCenter>7</TD><TD class=alignCenter>3</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>YT</TH><TD class=alignCenter>3</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>11</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NT</TH><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>42</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NU</TH><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>66</TD><TD class=alignCenter>6</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>1674</TD><TD class=alignCenter>261</TD><TD class=alignCenter>84</TD><TD class=alignCenter>3965</TD><TD class=alignCenter>576</TD><TD class=alignCenter>142</TD><TD class=alignCenter>1473</TD><TD class=alignCenter>291</TD><TD class=alignCenter>77</TD></TR><TR><TD colSpan=10>*Based on reporting date.
** ** Based on epidemiological date, hospitalization date and reporting date.
<SUP>1 </SUP>These two provinces reported aggregate counts this week.
<SUP>2</SUP> No report received this week from NS.
? Note that the criteria used to select the cases up to August 29, 2009 have changed, which may explain the differences compared to the previous week.



</TD></TR></TBODY></TABLE>

Descriptive characteristics of laboratory-confirmed Canadian Pandemic (H1N1) 2009 hospitalized cases, ICU-admitted cases and deaths with core information available, reported to PHAC as of November 14, 2009

<TABLE class="widthFull fontSize85" cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD id=cr6 colSpan=7><SUP>1</SUP> Proportion of cases with at least one underlying medical condition (excluding pregnancy) among those for whom the information was available. Please note that a reclassification of underlying medical conditions was performed this week which may have affected the observed proportion of those with underlying conditions.
<SUP>2</SUP> Percent of pregnant women among women 15 to 44 years of age.
? Note that the criteria used to select the cases up to August 29, 2009 have changed, which may explain the small differences compared to the previous week.

</TD></TR></TFOOT><TBODY><TR class=bg-colour-blue><TD rowSpan=2></TD><TH id=cc1 colSpan=3>From August 30, 2009 to November 14, 2009</TH><TH id=cc5 colSpan=3>From April to August 29, 2009</TH></TR><TR class=bg-colour-blue><TH class=fontSize85 id=cc2 headers=cc1>Hospitalized cases (n=3,432)</TH><TH class=fontSize85 id=cc3 headers=cc1>Cases admitted to ICU (n=558)</TH><TH class=fontSize85 id=cc4 headers=cc1>Deaths (n=129)</TH><TH class=fontSize85 id=cc6 headers=cc5>Hospitalized cases (n=1,473)</TH><TH class=fontSize85 id=cc7 headers=cc5>Cases admitted to ICU (n=291)</TH><TH class=fontSize85 id=cc8 headers=cc5>Deaths (n=77)</TH></TR><TR><TH class="bg-colour-blue alignLeft" id=cr1>Females, %</TH><TD class=alignCenter>49.6</TD><TD class=alignCenter>48.7</TD><TD class=alignCenter>51.9</TD><TD class=alignCenter>51.4</TD><TD class=alignCenter>57.0</TD><TD class=alignCenter>62.3</TD></TR><TR><TH class="bg-colour-blue alignLeft" id=cr2>Median age</TH><TD class=alignCenter>26.0</TD><TD class=alignCenter>45.5</TD><TD class=alignCenter>52.5</TD><TD class=alignCenter>23.0</TD><TD class=alignCenter>37.0</TD><TD class=alignCenter>51.0</TD></TR><TR><TH class="bg-colour-blue alignLeft" id=cr3>Aboriginal status, % </TH><TD class=alignCenter>4.5</TD><TD class=alignCenter>5.9</TD><TD class=alignCenter>7.8</TD><TD class=alignCenter>17.9</TD><TD class=alignCenter>15.1</TD><TD class=alignCenter>11.7</TD></TR><TR><TH class="bg-colour-blue alignLeft" id=cr4>Underlying medical conditions<SUP>1 </SUP>, %</TH><TD class=alignCenter>59.0 (800/1,356)</TD><TD class=alignCenter>64.2 (249/388)</TD><TD class="alignCenter noWrap">70.4 (57/81)</TD><TD class=alignCenter>63.7 (634/996)</TD><TD class=alignCenter>73.9 (156/211)</TD><TD class="alignCenter noWrap">84.7 (50/59)</TD></TR><TR><TH class=bg-colour-blue id=cr5>Pregnancy<SUP>2</SUP> , %</TH><TD class=alignCenter>16.8 (94/558)</TD><TD class=alignCenter>10.9 (11/101)</TD><TD class=alignCenter>0.0</TD><TD class=alignCenter>28.4 (78/275)</TD><TD class=alignCenter>19.7 (15/76)</TD><TD class=alignCenter>28.6 (4/14)</TD></TR></TBODY></TABLE>

Overall Influenza Summary - Week 45 (November 8 to November 14, 2009)

Nationally, the overall activity level reported this week remained similar to the previous week. While the number of hospitalizations and deaths still increased, the proportion of positive influenza tests was comparable and the national ILI consultation rate and the number of influenza outbreaks reported decreased.
Seventeen regions reported widespread activity in BC, SK, ON, NS & NL and twenty-one regions in AB, ON, QC, NB, NS & PE reported localized activity, while fifteen regions reported sporadic activity in MB, QC, NB, NS, YK, NT & NU and one region in NU reported no activity. The 374 influenza outbreaks reported this week were all in schools except 14 in hospitals and residential institutions (BC, AB, ON, QC, NB & NL) and 10 in an unspecified location (AB, SK & ON). The schools outbreaks were in SK (152), BC (100), NS (61), PE (14), AB (12) and NB (11). Note that this is the first year that all the provinces and territories are reporting on influenza outbreaks in schools (greater than 10% absenteeism on any day most likely due to ILI) which is increasing considerably the total number of outbreaks reported compared to previous years.
<TBODY><TR>
Map of overall Influenza activity level
by provinces and territories, Week 45, Canada

<TABLE class=widthFull cellSpacing=0 cellPadding=0><TBODY><TR><TD class=alignCenter></TD><TD><TABLE cellSpacing=0 cellPadding=1 border=0><TBODY><TR><TD align=middle><TABLE class=border-lite cellSpacing=1 cellPadding=1><TBODY><TR align=middle><TD>No Data </TD><TD>
leg_dots.gif
</TD></TR><TR align=middle><TD>No Activity</TD><TD>
leg_ffffff.gif
</TD></TR><TR align=middle><TD>Sporadic Activity</TD><TD>
leg_ccccff.gif
</TD></TR><TR align=middle><TD>Localized Activity</TD><TD>
leg_6666ff.gif
</TD></TR><TR align=middle><TD>Widespread
Activity
</TD><TD>
leg_000066.gif
</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE>
Note: Influenza 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 (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.

Number of influenza surveillance regions<SUP>?</SUP> reporting widespread or localized influenza activity,
Canada, by report week, 2009-2010 (N=54)

2009-w45-fg1-eng.gif

flu0910-leg-fg1-eng.gif

? sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.

Overall Number of Influenza Outbreaks, Canada, by Report Week, 2009-2010

2009-w45-fg2-eng.gif

flu0910-leg-fg2-eng.gif


ILI consultation rate
This week, the national ILI consultation rate was 91 consultations per 1,000 patient visits (see ILI graph) which was lower for a second consecutive week. This is likely due to the fact that many P/T have established special clinics for assessing patients with ILI. Six provinces and territories (BC, SK, MB, ON, NB and NL) had higher ILI consultation rates compared to their ILI rates in previous weeks. People under 20 years of age still had the highest consultation rates, with 173 and 208 per 1,000 patient visits among children under 5 years of age and among those 5 and 19 years of age, respectively.

Influenza-like illness (ILI) consultation rates, Canada, by report week,
2009-2010 compared to 1996/97 through to 2008/09 seasons

2009-w45-fg3-eng.gif

flu0910-leg-fg3-eng.gif


Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons).
*Delays in the reporting of data may cause data to change restrospectively.
Paediatric Influenza Hospitalizations and deaths
In week 45, 184 laboratory-confirmed influenza-associated paediatric hospitalizations and 1 death were reported through the Immunization Monitoring Program Active (IMPACT) network. The new death was a female aged between 10 and 16 years of age without any known underlying medical conditions. 180 Pandemic (H1N1) 2009 and 4 other hospitalizations due to unsubtyped influenza A were reported this week. 1,138 hospitalizations had been reported since week 17 (April 26): 96.7% of these hospitalizations were due to Pandemic (H1N1) 2009. Since the beginning of the pandemic, six deaths due to Pandemic (H1N1) 2009 had been reported through the IMPACT network among children under 16 years of age.
Laboratory Surveillance Summary
This week, the proportion of tests that were positive for influenza was 40.6% which is similar to the past two weeks (see Tests table). While British Columbia and the Prairies had a lower proportion of positive tests for influenza compared to the previous weeks, Quebec had a higher proportion and Atlantic had a similar proportion. This week, a total of 7,023 specimens tested positive for influenza this week (all A except 1 B) and 99.9% of the positive influenza A subtyped specimens were Pandemic (H1N1) 2009. Note that QC has reported this week 4 positive specimens for A/H3N2 and 1 B.

Influenza tests reported and percentage of tests positive, Canada,
by report week, 2009-2010

2009-w45-fg4-eng.gif

flu0910-leg-fg4-eng.gif


Percent positive influenza tests, compared to other respiratory viruses, Canada,
by reporting week, 2009-2010

2009-w45-fg5-eng.gif

flu0910-leg-fg5-eng.gif

Weekly & Cumulative numbers of positive influenza specimens, by Provincial Laboratories

<TABLE class=widthFull cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD class=fontSize85 id=gr12 headers=gr1 colSpan=13>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces.
Note: Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals.
* Not subtyped
</TD></TR></TFOOT><TBODY><TR><TH class=bg-colour-blue scope=col rowSpan=3>Reporting provinces</TH><TH class=bg-colour-blue scope=colgroup colSpan=6>Weekly (Nov. 8-14, 2009)</TH><TH class=bg-colour-blue scope=colgroup colSpan=6>Cumulative (Aug. 30-Nov. 14, 2009)</TH></TR><TR><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=5>Influenza A</TH><TH class="bg-colour-blue fontSize85" scope=col>B</TH><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=5>Influenza A</TH><TH class=bg-colour-blue scope=col>B</TH></TR><TR><TH class=bg-colour-blue scope=col>A Total</TH><TH class="bg-colour-blue fontSize85" scope=col>A(H1)</TH><TH class="bg-colour-blue fontSize85" scope=col>A(H3)</TH><TH class="bg-colour-blue fontSize85" scope=col>Pand (H1N1)</TH><TH class="bg-colour-blue fontSize85" scope=col>A (NS)*</TH><TH class="bg-colour-blue fontSize85" scope=col>Total</TH><TH class="bg-colour-blue fontSize85" scope=col>A Total</TH><TH class="bg-colour-blue fontSize85" scope=col>A(H1)</TH><TH class="bg-colour-blue fontSize85" scope=col>A(H3)</TH><TH class="bg-colour-blue fontSize85" scope=col>Pand (H1N1)</TH><TH class="bg-colour-blue fontSize85" scope=col>A (NS)*</TH><TH class="bg-colour-blue fontSize85" scope=col>Total</TH></TR><TR><TH class=bg-colour-blue scope=row>BC</TH><TD class=alignCenter>717</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>717</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5763</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>5200</TD><TD class=alignCenter>562</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>442</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>352</TD><TD class=alignCenter>90</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5264</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>4715</TD><TD class=alignCenter>547</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>588</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>550</TD><TD class=alignCenter>38</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1894</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1660</TD><TD class=alignCenter>233</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>263</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>258</TD><TD class=alignCenter>5</TD><TD class=alignCenter>0</TD><TD class=alignCenter>574</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>547</TD><TD class=alignCenter>27</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>1279</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>395</TD><TD class=alignCenter>884</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6601</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2824</TD><TD class=alignCenter>3776</TD><TD class=alignCenter>4</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>2871</TD><TD class=alignCenter>0</TD><TD class=alignCenter>4</TD><TD class=alignCenter>2867</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>7967</TD><TD class=alignCenter>1</TD><TD class=alignCenter>37</TD><TD class=alignCenter>7929</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3</TD></TR><TR><TH class=bg-colour-blue scope=row>NB</TH><TD class=alignCenter>594</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>594</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1426</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1409</TD><TD class=alignCenter>15</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>141</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>138</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>618</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>599</TD><TD class=alignCenter>19</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>10</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>9</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>86</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>84</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>127</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>127</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>861</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>861</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>7032</TD><TD class=alignCenter>0</TD><TD class=alignCenter>4</TD><TD class=alignCenter>6007</TD><TD class=alignCenter>1021</TD><TD class=alignCenter>1</TD><TD class=alignCenter>31054</TD><TD class=alignCenter>4</TD><TD class=alignCenter>41</TD><TD class=alignCenter>25828</TD><TD class=alignCenter>5181</TD><TD class=alignCenter>8</TD></TR></TBODY></TABLE>
 
Re: Canada - FluWatch Pandemic (H1N1) 2009 virus Surveillance Week 45

Re: Canada - FluWatch Pandemic (H1N1) 2009 virus Surveillance Week 45

Posted 2009-11-27

November 15, 2009 to November 21, 2009 (Week 46)



Weekly and cumulative numbers of hospitalizations, ICU admissions and deaths among
Pandemic (H1N1) 2009 confirmed cases, Canada, to November 21, 2009


<TABLE class="widthFull fontSize85" cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD colSpan=10>*Based on reporting date.
** Based on epidemiological date, hospitalization date and reporting date.
<SUP>1 </SUP>These provinces reported aggregate counts this week.
<SUP>2</SUP> Since no report was received from NS last week, this week's update reflects the situation since week 44.
? Note that due to reporting delays, some PTs are reporting retrospectively on first wave's cases.


</TD></TR></TFOOT><TBODY><TR><TH class=bg-colour-blue scope=col rowSpan=2>Province/Territory</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>This week (Nov. 15-21, 2009)*</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>From August 30, 2009 to
November 21, 2009**
</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>From April 18, 2009 to August 29, 2009**<SUP>?</SUP></TH></TR><TR><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH></TR><TR><TH class=bg-colour-blue scope=row>BC<SUP>1 </SUP></TH><TD class=alignCenter>103</TD><TD class=alignCenter>15</TD><TD class=alignCenter>5</TD><TD class=alignCenter>807</TD><TD class=alignCenter>103</TD><TD class=alignCenter>29</TD><TD class=alignCenter>51</TD><TD class=alignCenter>19</TD><TD class=alignCenter>5</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>210</TD><TD class=alignCenter>35</TD><TD class=alignCenter>8</TD><TD class=alignCenter>974</TD><TD class=alignCenter>190</TD><TD class=alignCenter>43</TD><TD class=alignCenter>129</TD><TD class=alignCenter>29</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>6</TD><TD class=alignCenter>5</TD><TD class=alignCenter>3</TD><TD class=alignCenter>19</TD><TD class=alignCenter>16</TD><TD class=alignCenter>7</TD><TD class=alignCenter>23</TD><TD class=alignCenter>12</TD><TD class=alignCenter>4</TD></TR><TR><TH class=bg-colour-blue scope=row>MB<SUP>1 </SUP></TH><TD class=alignCenter height=19>9</TD><TD class=alignCenter>4</TD><TD class=alignCenter>1</TD><TD class=alignCenter>34</TD><TD class=alignCenter>5</TD><TD class=alignCenter>2</TD><TD class=alignCenter>225</TD><TD class=alignCenter>43</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>256</TD><TD class=alignCenter>38</TD><TD class=alignCenter>18</TD><TD class=alignCenter>946</TD><TD class=alignCenter>124</TD><TD class=alignCenter>54</TD><TD class=alignCenter>379</TD><TD class=alignCenter>67</TD><TD class=alignCenter>25</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>665</TD><TD class=alignCenter>96</TD><TD class=alignCenter>18</TD><TD class=alignCenter>2056</TD><TD class=alignCenter>280</TD><TD class=alignCenter>49</TD><TD class=alignCenter>572</TD><TD class=alignCenter>104</TD><TD class=alignCenter>27</TD></TR><TR><TH class=bg-colour-blue scope=row>NB<SUP>1</SUP></TH><TD class=alignCenter height=19>47</TD><TD class=alignCenter>9</TD><TD class=alignCenter>4</TD><TD class=alignCenter>126</TD><TD class=alignCenter>17</TD><TD class=alignCenter>6</TD><TD class=alignCenter>5</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NS<SUP>2</SUP></TH><TD class=alignCenter height=19>139</TD><TD class=alignCenter>18</TD><TD class=alignCenter>2</TD><TD class=alignCenter>204</TD><TD class=alignCenter>29</TD><TD class=alignCenter>3</TD><TD class=alignCenter>18</TD><TD class=alignCenter>9</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>PE<SUP>1</SUP></TH><TD class=alignCenter height=19>10</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>46</TD><TD class=alignCenter>7</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NL<SUP>1 </SUP></TH><TD class=alignCenter height=19>96</TD><TD class=alignCenter>21</TD><TD class=alignCenter>0</TD><TD class=alignCenter>235</TD><TD class=alignCenter>39</TD><TD class=alignCenter>7</TD><TD class=alignCenter>3</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>YT</TH><TD class=alignCenter>3</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>14</TD><TD class=alignCenter>3</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NT</TH><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>44</TD><TD class=alignCenter>6</TD><TD class=alignCenter>1</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NU</TH><TD class=alignCenter>8</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>73</TD><TD class=alignCenter>6</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>1554</TD><TD class=alignCenter>243</TD><TD class=alignCenter>61</TD><TD class=alignCenter>5507</TD><TD class=alignCenter>819</TD><TD class=alignCenter>203</TD><TD class=alignCenter>1485</TD><TD class=alignCenter>291</TD><TD class=alignCenter>77</TD></TR></TBODY></TABLE>

Descriptive characteristics of laboratory-confirmed Canadian Pandemic (H1N1) 2009 hospitalized cases, ICU-admitted cases and deaths with core information available, reported to PHAC as of November 21, 2009<SUP><SUP>?</SUP> </SUP>

<TABLE class="widthFull fontSize85" cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD class=fontSize85 id=cr6 colSpan=7><SUP>1</SUP> Proportion of cases with at least one underlying medical condition (excluding pregnancy) among those for whom the information was available. Missing/unknown information has been removed from all calculations except for data reported on underlying condition from MB and ON, where it was not possible to delineate missing information from absence of underlying condition. This may have affected the observed proportion this week. For these two provinces, missing information has been included in the denominator.
<SUP>2</SUP> Percent of pregnant women among women 15 to 44 years of age.
? Note that due to reporting delays, some PTs are reporting retrospectively on first wave's cases.

</TD></TR></TFOOT><TBODY><TR class=bg-colour-blue><TD rowSpan=2></TD><TH scope=colgroup colSpan=3>From August 30, 2009 to November 21, 2009</TH><TH scope=colgroup colSpan=3>From Apri 18, 2009 to August 29, 2009</TH></TR><TR class=bg-colour-blue><TH scope=col>Hospitalized cases (n=4,843)</TH><TH scope=col>Cases admitted to ICU (n=776)</TH><TH scope=col>Deaths (n=129)</TH><TH scope=col>Hospitalized cases (n=1,485)</TH><TH scope=col>Cases admitted to ICU (n=291)</TH><TH scope=col>Deaths (n=77)</TH></TR><TR><TH class="bg-colour-blue alignLeft" scope=row>Females, %</TH><TD class=alignCenter>49.0</TD><TD class=alignCenter>47.6</TD><TD class=alignCenter>47.9</TD><TD class=alignCenter>51.4</TD><TD class=alignCenter>57.4</TD><TD class=alignCenter>62.3</TD></TR><TR><TH class="bg-colour-blue alignLeft" scope=row>Median age</TH><TD class=alignCenter>27.0</TD><TD class=alignCenter>47.0</TD><TD class=alignCenter>54.0</TD><TD class=alignCenter>23.0</TD><TD class=alignCenter>37.0</TD><TD class=alignCenter>51.0</TD></TR><TR><TH class="bg-colour-blue alignLeft" scope=row>Aboriginal status, % </TH><TD class=alignCenter>4.0</TD><TD class=alignCenter>6.4</TD><TD class=alignCenter>6.8</TD><TD class=alignCenter>18.3</TD><TD class=alignCenter>15.1</TD><TD class=alignCenter>11.7</TD></TR><TR><TH class="bg-colour-blue alignLeft" scope=row>Underlying medical conditions<SUP>1 </SUP>, %</TH><TD class=alignCenter>51.6
(1 136/2 202)
</TD><TD class=alignCenter>60.2
(360/598)
</TD><TD class=alignCenter>67.4
(91/135)
</TD><TD class=alignCenter>46.6
(642/1 379)
</TD><TD class=alignCenter>56.6
(156/274)
</TD><TD class=alignCenter>65.3
(49/75)
</TD></TR><TR><TH class="bg-colour-blue alignLeft" scope=row>Pregnancy<SUP>2</SUP> , %</TH><TD class=alignCenter>16.2 (119/736)</TD><TD class=alignCenter>9.8 (12/123)</TD><TD class=alignCenter>0.0</TD><TD class=alignCenter>28.5 (79/277)</TD><TD class=alignCenter>20.8 (16/77)</TD><TD class=alignCenter>28.6 (4/14)</TD></TR></TBODY></TABLE>

Overall Influenza Summary - Week 46 (November 15 to November 21, 2009)

Nationally, the activity level reported this week decreased compared to the previous week. All influenza indicators declined during week 46.
Ten regions reported widespread activity in BC, SK, ON, QC & NL and twenty-four regions in BC, MB, ON, QC, NB, PE, NS & NL reported localized activity, while nineteen regions reported sporadic activity in BC, AB, MB, ON, QC, NB, NS, YK, NT & NU and one region in NU reported no activity. The 330 influenza outbreaks reported this week were all in schools except 14 in hospitals and residential institutions (BC, AB, QC, NS & NL) and 1 in an unspecified location (AB). The schools outbreaks were in QC (217), SK (32), NS (22), BC (18), NB (10), AB (7), MB (6), NL (2) and PE (1). Note that this is the first year that all the provinces and territories are reporting on influenza outbreaks in schools (greater than 10% absenteeism on any day most likely due to ILI) which has considerably increased the total number of outbreaks reported compared to previous years.


<TABLE class=widthFull cellSpacing=0 cellPadding=0><TBODY><TR class=alignCenter><TD colSpan=2>Map of overall Influenza activity level by provinces and territories, Week 46, Canada



</TD></TR><TR class=alignCenter><TD>

</TD><TD><TABLE cellSpacing=0 cellPadding=1 border=0><TBODY><TR><TD align=middle><TABLE class=border-lite cellSpacing=1 cellPadding=1><TBODY><TR align=middle><TD>No Data </TD><TD>
leg_dots.gif
</TD></TR><TR class=alignCenter><TD>No Activity</TD><TD>
leg_ffffff.gif
</TD></TR><TR class=alignCenter><TD>Sporadic Activity</TD><TD>
leg_ccccff.gif
</TD></TR><TR align=middle><TD>Localized Activity</TD><TD>
leg_6666ff.gif
</TD></TR><TR align=middle><TD>Widespread
Activity
</TD><TD>
leg_000066.gif
</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR><TR><TD class=fontSize85 colSpan=2>Note: Influenza 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 (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.

</TD></TR></TBODY></TABLE>
Number of influenza surveillance regions<SUP>?</SUP> reporting widespread or localized influenza activity,
Canada, by report week, 2009-2010 (N=54)

2009-w46-fg1-eng.gif

flu0910-leg-fg1-eng.gif

? sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.

Overall Number of Influenza Outbreaks, Canada, by Report Week, 2009-2010

2009-w46-fg2-eng.gif

flu0910-leg-fg2-eng.gif


ILI consultation rate
This week, the national ILI consultation rate was 57 consultations per 1,000 patient visits (see ILI graph) which was significantly lower than the previous weeks. All provinces and territories had lower ILI consultations rates compared to previous weeks except QC and PE. Those under 20 years of age still had the highest consultation rates, with 96 and 107 per 1,000 patient visits among children under 5 years of age and among those 5 and 19 years of age, respectively.
Influenza-like illness (ILI) consultation rates, Canada, by report week,
2009-2010 compared to 1996/97 through to 2008/09 seasons

2009-w46-fg3-eng.gif


flu0910-leg-fg3-eng.gif

Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons).
Delays in the reporting of data may cause data to change retrospectively.
Paediatric Influenza Hospitalizations and deaths
In week 46, 99 laboratory-confirmed influenza-associated paediatric hospitalizations were reported through the Immunization Monitoring Program Active (IMPACT) network. Of these, 22 were reported as Pandemic (H1N1) 2009 and 77 were reported as unsubtyped influenza A. 1,250 hospitalizations had been reported since week 17 (April 26): 88.0% of these hospitalizations were officially due to Pandemic (H1N1) 2009. Since the beginning of the pandemic, six deaths due to Pandemic (H1N1) 2009 had been reported through the IMPACT network among children under 16 years of age.
Laboratory Surveillance Summary
This week, the proportion of tests that were positive for influenza was 34.3% which is lower than the three previous weeks (see Tests table). All provinces and territories had a lower proportion of positive tests for influenza compared to the previous weeks except MB and PE. This week, a total of 4,189 specimens tested positive for influenza (all A except 1 B) and 99.9% of the positive influenza A subtyped specimens were Pandemic (H1N1) 2009. Note that QC reported this week 2 positive specimens for A/H3N2 and 1 B.

Influenza tests reported and percentage of tests positive, Canada,
by report week, 2009-2010

2009-w46-fg4-eng.gif

flu0910-leg-fg4-eng.gif


Percent positive influenza tests, compared to other respiratory viruses, Canada,
by reporting week, 2009-2010


2009-w46-fg5-eng.gif


flu0910-leg-fg5-eng.gif

Weekly & Cumulative numbers of positive influenza specimens, by Provincial Laboratories

<TABLE class=widthFull cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD class=fontSize85 colSpan=13>Note: Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals.
* Not subtyped
Note that an error occurred in the numbers PHAC reported for AB last week. Corrected numbers are presented.

</TD></TR></TFOOT><TBODY><TR><TH class=bg-colour-blue scope=col rowSpan=3>Reporting provinces</TH><TH class=bg-colour-blue scope=colgroup colSpan=6>Weekly (Nov. 15-21, 2009)</TH><TH class=bg-colour-blue scope=colgroup colSpan=6>Cumulative (Aug. 30-Nov. 21, 2009)</TH></TR><TR><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=5>Influenza A</TH><TH class="bg-colour-blue fontSize85" scope=col>B</TH><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=5>Influenza A</TH><TH class=bg-colour-blue scope=col>B</TH></TR><TR><TH class="fontSize85 bg-colour-blue" scope=col>A Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H3)</TH><TH class="fontSize85 bg-colour-blue" scope=col>Pand (H1N1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A (NS)*</TH><TH class="fontSize85 bg-colour-blue" scope=col>Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H3)</TH><TH class="fontSize85 bg-colour-blue" scope=col>Pand (H1N1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A (NS)*</TH><TH class="fontSize85 bg-colour-blue" scope=col>Total</TH></TR><TR><TH class=bg-colour-blue scope=row>BC</TH><TD class=alignCenter>345</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>345</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6108</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>5545</TD><TD class=alignCenter>562</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>209</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>203</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5473</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1416</TD><TD class=alignCenter>4057</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>403</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>369</TD><TD class=alignCenter>34</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2297</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>2029</TD><TD class=alignCenter>267</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>757</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>696</TD><TD class=alignCenter>61</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1331</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1243</TD><TD class=alignCenter>88</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>543</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>189</TD><TD class=alignCenter>354</TD><TD class=alignCenter>0</TD><TD class=alignCenter>7293</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3162</TD><TD class=alignCenter>4130</TD><TD class=alignCenter>4</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>1477</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1475</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>9444</TD><TD class=alignCenter>1</TD><TD class=alignCenter>39</TD><TD class=alignCenter>9404</TD><TD class=alignCenter>0</TD><TD class=alignCenter>4</TD></TR><TR><TH class=bg-colour-blue scope=row>NB</TH><TD class=alignCenter>261</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>257</TD><TD class=alignCenter>4</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1687</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1666</TD><TD class=alignCenter>19</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>119</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>116</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>737</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>715</TD><TD class=alignCenter>22</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>11</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>11</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>97</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>95</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>64</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>64</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>925</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>925</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>4189</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>3725</TD><TD class=alignCenter>462</TD><TD class=alignCenter>1</TD><TD class=alignCenter>35392</TD><TD class=alignCenter>3</TD><TD class=alignCenter>42</TD><TD class=alignCenter>26200</TD><TD class=alignCenter>9147</TD><TD class=alignCenter>9</TD></TR></TBODY></TABLE>
http://www.phac-aspc.gc.ca/fluwatch/09-10/w46_09/index-eng.php
 
Re: Canada - FluWatch Pandemic (H1N1) 2009 virus Surveillance Week 47

Re: Canada - FluWatch Pandemic (H1N1) 2009 virus Surveillance Week 47

November 22, 2009 to November 28, 2009 (Week 47)



Weekly and cumulative numbers of hospitalizations, ICU admissions and deaths among
Pandemic (H1N1) 2009 confirmed cases, Canada, to November 28, 2009


<TABLE class="widthFull fontSize85" cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD colSpan=10><SUP>*</SUP>Based on reporting date.
<SUP>**</SUP> Based on epidemiological date, hospitalization date and reporting date.
<SUP>1 </SUP>These provinces reported aggregate counts this week.
<SUP>2</SUP> No report received from MB.
<SUP>3</SUP> The total number of hosp. cases decreased for NU this week due to a duplicate count.
? Note that due to reporting delays, some PTs are reporting retrospectively on first wave's cases.

</TD></TR></TFOOT><TBODY><TR><TH class=bg-colour-blue scope=col rowSpan=2>Province/Territory</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>This week (Nov. 22-28, 2009)*</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>From August 30, 2009 to
November 28, 2009**
</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>From April 18, 2009 to August 29, 2009**<SUP>?</SUP></TH></TR><TR><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH></TR><TR><TH class=bg-colour-blue scope=row>BC<SUP>1 </SUP></TH><TD class=alignCenter>99</TD><TD class=alignCenter>14</TD><TD class=alignCenter>8</TD><TD class=alignCenter>906</TD><TD class=alignCenter>117</TD><TD class=alignCenter>37</TD><TD class=alignCenter>51</TD><TD class=alignCenter>19</TD><TD class=alignCenter>5</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>93</TD><TD class=alignCenter>6</TD><TD class=alignCenter>7</TD><TD class=alignCenter>1067</TD><TD class=alignCenter>196</TD><TD class=alignCenter>50</TD><TD class=alignCenter>129</TD><TD class=alignCenter>29</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>8</TD><TD class=alignCenter>7</TD><TD class=alignCenter>1</TD><TD class=alignCenter>27</TD><TD class=alignCenter>23</TD><TD class=alignCenter>8</TD><TD class=alignCenter>23</TD><TD class=alignCenter>12</TD><TD class=alignCenter>4</TD></TR><TR><TH class=bg-colour-blue scope=row>MB<SUP>2 </SUP></TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>35</TD><TD class=alignCenter>5</TD><TD class=alignCenter>2</TD><TD class=alignCenter>224</TD><TD class=alignCenter>43</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>216</TD><TD class=alignCenter>46</TD><TD class=alignCenter>16</TD><TD class=alignCenter>1161</TD><TD class=alignCenter>169</TD><TD class=alignCenter>70</TD><TD class=alignCenter>380</TD><TD class=alignCenter>68</TD><TD class=alignCenter>25</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>299</TD><TD class=alignCenter>42</TD><TD class=alignCenter>13</TD><TD class=alignCenter>2355</TD><TD class=alignCenter>322</TD><TD class=alignCenter>62</TD><TD class=alignCenter>572</TD><TD class=alignCenter>104</TD><TD class=alignCenter>27</TD></TR><TR><TH class=bg-colour-blue scope=row>NB<SUP>1</SUP></TH><TD class=alignCenter>31</TD><TD class=alignCenter>7</TD><TD class=alignCenter>1</TD><TD class=alignCenter>160</TD><TD class=alignCenter>24</TD><TD class=alignCenter>7</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>46</TD><TD class=alignCenter>10</TD><TD class=alignCenter>2</TD><TD class=alignCenter>250</TD><TD class=alignCenter>39</TD><TD class=alignCenter>5</TD><TD class=alignCenter>18</TD><TD class=alignCenter>9</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>1</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>47</TD><TD class=alignCenter>9</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NL<SUP>1 </SUP></TH><TD class=alignCenter>10</TD><TD class=alignCenter>5</TD><TD class=alignCenter>8</TD><TD class=alignCenter>245</TD><TD class=alignCenter>44</TD><TD class=alignCenter>15</TD><TD class=alignCenter>3</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>YT</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>14</TD><TD class=alignCenter>3</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NT</TH><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>45</TD><TD class=alignCenter>6</TD><TD class=alignCenter>1</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NU<SUP>3</SUP></TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>72</TD><TD class=alignCenter>6</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>804</TD><TD class=alignCenter>139</TD><TD class=alignCenter>56</TD><TD class=alignCenter>6314</TD><TD class=alignCenter>957</TD><TD class=alignCenter>259</TD><TD class=alignCenter>1481</TD><TD class=alignCenter>292</TD><TD class=alignCenter>77</TD></TR></TBODY></TABLE>
Descriptive characteristics of laboratory-confirmed Canadian Pandemic (H1N1) 2009 hospitalized cases, ICU-admitted cases and deaths with core information available, reported to PHAC as of November 28, 2009<SUP><SUP>?</SUP> </SUP>

<TABLE class=fontSize85 cellSpacing=0 cellPadding=2 border=1><COLGROUP><COL width=98><COL width=95><COL width=82><COL width=69><COL width=97><COL width=77><COL width=59><COL width=96><COL width=82><COL width=67><TBODY><TR><TD rowSpan=2></TD><TH class=bg-colour-blue colSpan=3>From April to August 29, 2009</TH><TH class=bg-colour-blue colSpan=3>From Aug. 30, 2009 to Nov. 28, 2009</TH><TH class=bg-colour-blue colSpan=3>Cumulative:
From April to Nov. 28, 2009
</TH></TR><TR><TH class=bg-colour-blue>Hospitalized cases (n=1,481)</TH><TH class=bg-colour-blue>ICU-admitted
(n=292)
</TH><TH class=bg-colour-blue>Deaths
(n=77)
</TH><TH class=bg-colour-blue>Hospitalized
cases (n=5,577)
</TH><TH class=bg-colour-blue>ICU-admitted
(n=913)
</TH><TH class=bg-colour-blue>Deaths
(n=242)
</TH><TH class=bg-colour-blue>Hospitalized
cases
(n=7,058)
</TH><TH class=bg-colour-blue>ICU-admitted
(n=1,205)
</TH><TH class=bg-colour-blue>Deaths
(n=319)
</TH></TR><TR><TH class="bg-colour-blue alignLeft">Females, %</TH><TD class=alignCenter>51.5</TD><TD class=alignCenter>57.5</TD><TD class=alignCenter>62.3</TD><TD class=alignCenter>49.4</TD><TD class=alignCenter>49.1</TD><TD class=alignCenter>48.3</TD><TD class=alignCenter>49.9</TD><TD class=alignCenter>51.1</TD><TD class=alignCenter>51.7</TD></TR><TR><TH class="bg-colour-blue alignLeft">Median age</TH><TD class=alignCenter>23.0</TD><TD class=alignCenter>37.0</TD><TD class=alignCenter>51.0</TD><TD class=alignCenter>28.0</TD><TD class=alignCenter>47.0</TD><TD class=alignCenter>53.0</TD><TD class=alignCenter>27.0</TD><TD class=alignCenter>45.0</TD><TD class=alignCenter>52.0</TD></TR><TR><TH class="bg-colour-blue alignLeft">Aboriginal status, % </TH><TD class=alignCenter>20.3</TD><TD class=alignCenter>16.1</TD><TD class=alignCenter>11.7</TD><TD class=alignCenter>3.8</TD><TD class=alignCenter>6.4</TD><TD class=alignCenter>7.0</TD><TD class=alignCenter>7.3</TD><TD class=alignCenter>8.7</TD><TD class=alignCenter>8.2</TD></TR><TR><TH class="bg-colour-blue alignLeft">Underlying medical conditions<SUP>1</SUP>, %</TH><TD class=alignCenter>47.0
(646/1,374)
</TD><TD class=alignCenter>57.3
(157/274)
</TD><TD class=alignCenter>65.3
(49/75)
</TD><TD class=alignCenter>52.2
(1,295/2,480)
</TD><TD class=alignCenter>61.0
(426/698)
</TD><TD class=alignCenter>66.7
(110/165)
</TD><TD class=alignCenter>50.4
(1,941/3,854)
</TD><TD class=alignCenter>60.0
(583/972)
</TD><TD class=alignCenter>66.3
(159/240)
</TD></TR><TR><TH class="bg-colour-blue alignLeft">Pregnancy<SUP>2</SUP>, %</TH><TD class=alignCenter>28.3 (78/276)</TD><TD class=alignCenter>20.8
(16/77)
</TD><TD class=alignCenter>28.6
(4/14)
</TD><TD class=alignCenter>16.4
(139/847)
</TD><TD class=alignCenter>9.1
(13/142)
</TD><TD class=alignCenter>0.0</TD><TD class=alignCenter>19.3
(217/1,123)
</TD><TD class=alignCenter>13.2
(29/219)
</TD><TD class=alignCenter>9.3
(4/43)
</TD></TR><TR><TD colSpan=10><SUP>1</SUP> Proportion of cases with at least one underlying medical condition (excluding pregnancy) among those for whom the information was available. Missing/unknown information has been removed from all calculations except for data reported on underlying condition from MB and ON, where it was not possible to delineate missing information from absence of underlying condition. For these two provinces, missing information has been included in the denominator. This may have affected the observed proportion this week.
<SUP>2</SUP> Percent of pregnant women among women 15 to 44 years of age.
<SUP>?</SUP>Note that due to reporting delays, some PTs are reporting retrospectively on first wave's cases.
</TD></TR></TBODY></TABLE>



<TABLE class=widthFull cellSpacing=0 cellPadding=0><TBODY><TR class=alignCenter><TD colSpan=2>Map of overall Influenza activity level by provinces and territories, Week 47, Canada



</TD></TR><TR class=alignCenter><TD>

</TD><TD><TABLE cellSpacing=0 cellPadding=1 border=0><TBODY><TR><TD align=middle><TABLE class=border-lite cellSpacing=1 cellPadding=1><TBODY><TR align=middle><TD>No Data </TD><TD>
leg_dots.gif
</TD></TR><TR class=alignCenter><TD>No Activity</TD><TD>
leg_ffffff.gif
</TD></TR><TR class=alignCenter><TD>Sporadic Activity</TD><TD>
leg_ccccff.gif
</TD></TR><TR align=middle><TD>Localized Activity</TD><TD>
leg_6666ff.gif
</TD></TR><TR align=middle><TD>Widespread
Activity
</TD><TD>
leg_000066.gif
</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR><TR><TD class=fontSize85 colSpan=2>Note: Influenza 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 (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.

</TD></TR></TBODY></TABLE>
Number of influenza surveillance regions<SUP>?</SUP> reporting widespread or localized influenza activity,
Canada, by report week, 2009-2010 (N=54)

2009-w47-fg1-eng.gif

flu0910-leg-fg1-eng.gif

? sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.

Overall Number of Influenza Outbreaks, Canada, by Report Week, 2009-2010

2009-w47-fg2-eng.gif

flu0910-leg-fg2-eng.gif


ILI consultation rate
This week, the national ILI consultation rate was 37 consultations per 1,000 patient visits (see ILI graph) which was significantly lower compared to the previous weeks. Provinces and territories that had lower ILI consultations rates compared to their ILI rates in previous weeks included NL, PE, ON, MB, AB and YK. Those under 20 years of age still had the highest consultation rates, with 96 and 107 per 1,000 patient visits among children under 5 years of age and among those 5 and 19 years of age, respectively.
Influenza-like illness (ILI) consultation rates, Canada, by report week,
2009-2010 compared to 1996/97 through to 2008/09 seasons

2009-w47-fg3-eng.gif


flu0910-leg-fg3-eng.gif

Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons).
Delays in the reporting of data may cause data to change retrospectively.
Paediatric Influenza Hospitalizations and deaths
In week 47, 21 laboratory-confirmed influenza-associated paediatric hospitalizations and 1 death (QC) were reported through the Immunization Monitoring Program Active (IMPACT) network. All of these cases were reported as Pandemic (H1N1) 2009. 1,278 hospitalizations had been reported since week 17 (April 26): 97.0% of these hospitalizations were officially due to Pandemic (H1N1) 2009. Since the beginning of the pandemic, nine deaths due to Pandemic (H1N1) 2009 had been reported through the IMPACT network among children under 16 years of age. The death reported this week was in a 10-16 year old who had multiple underlying medical conditions.
Laboratory Surveillance Summary
This week, the proportion of tests that were positive for influenza was 24.2% which is lower than the four previous weeks (see Tests table). All provinces and territories had a lower proportion of positive tests for influenza compared to the previous weeks except MB. This week, a total of 1,915 specimens tested positive for influenza (all A) and 99.9% of the positive influenza A subtyped specimens were Pandemic (H1N1) 2009. Note that QC reported this week 1 positive specimen for A/H3N2 and forty since August 30, 2009.

Influenza tests reported and percentage of tests positive, Canada,
by report week, 2009-2010

2009-w47-fg4-eng.gif

flu0910-leg-fg4-eng.gif


Percent positive influenza tests, compared to other respiratory viruses, Canada,
by reporting week, 2009-2010


2009-w47-fg5-eng.gif


flu0910-leg-fg5-eng.gif

Weekly & Cumulative numbers of positive influenza specimens, by Provincial Laboratories

<TABLE class=widthFull cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD class=fontSize85 colSpan=13>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces.
Note: Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals.
<SUP>*</SUP> Not subtyped

</TD></TR></TFOOT><TBODY><TR><TH class=bg-colour-blue scope=col rowSpan=3>Reporting provinces</TH><TH class=bg-colour-blue scope=colgroup colSpan=6>Weekly (Nov. 22-28, 2009)</TH><TH class=bg-colour-blue scope=colgroup colSpan=6>Cumulative (Aug. 30-Nov. 28, 2009)</TH></TR><TR><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=5>Influenza A</TH><TH class="bg-colour-blue fontSize85" scope=col>B</TH><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=5>Influenza A</TH><TH class=bg-colour-blue scope=col>B</TH></TR><TR><TH class="fontSize85 bg-colour-blue" scope=col>A Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H3)</TH><TH class="fontSize85 bg-colour-blue" scope=col>Pand (H1N1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A (NS)*</TH><TH class="fontSize85 bg-colour-blue" scope=col>Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H3)</TH><TH class="fontSize85 bg-colour-blue" scope=col>Pand (H1N1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A (NS)*</TH><TH class="fontSize85 bg-colour-blue" scope=col>Total</TH></TR><TR><TH class=bg-colour-blue scope=row>BC</TH><TD class=alignCenter>154</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>153</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6262</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>5698</TD><TD class=alignCenter>563</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>74</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>63</TD><TD class=alignCenter>11</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5528</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>5044</TD><TD class=alignCenter>482</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>188</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>170</TD><TD class=alignCenter>18</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2485</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>2199</TD><TD class=alignCenter>285</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>377</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>360</TD><TD class=alignCenter>17</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1708</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1603</TD><TD class=alignCenter>105</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>187</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>86</TD><TD class=alignCenter>101</TD><TD class=alignCenter>0</TD><TD class=alignCenter>7636</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3376</TD><TD class=alignCenter>4259</TD><TD class=alignCenter>4</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>774</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>773</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>10218</TD><TD class=alignCenter>1</TD><TD class=alignCenter>40</TD><TD class=alignCenter>10177</TD><TD class=alignCenter>0</TD><TD class=alignCenter>4</TD></TR><TR><TH class=bg-colour-blue scope=row>NB</TH><TD class=alignCenter>121</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>121</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1808</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1787</TD><TD class=alignCenter>19</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>22</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>20</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>759</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>735</TD><TD class=alignCenter>24</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>98</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>96</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>17</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>17</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>942</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>942</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>1915</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1764</TD><TD class=alignCenter>150</TD><TD class=alignCenter>0</TD><TD class=alignCenter>37444</TD><TD class=alignCenter>4</TD><TD class=alignCenter>44</TD><TD class=alignCenter>31657</TD><TD class=alignCenter>5739</TD><TD class=alignCenter>9</TD></TR></TBODY></TABLE>
http://www.phac-aspc.gc.ca/fluwatch/09-10/w47_09/index-eng.php
 
Re: Canada - FluWatch Pandemic (H1N1) 2009 virus Surveillance Week 48

Re: Canada - FluWatch Pandemic (H1N1) 2009 virus Surveillance Week 48

November 29, 2009 to December 5, 2009 (Week 48)



Weekly and cumulative numbers of hospitalized cases, ICU admissions and deaths among Pandemic (H1N1) 2009 confirmed cases, Canada, to December 5, 2009


<TABLE class="widthFull fontSize85" cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD colSpan=10><SUP id=star>*</SUP>Based on reporting date.
<SUP id=dstar>**</SUP> Based on epidemiological date, hospitalization date and reporting date.
<SUP>1 </SUP>These provinces reported aggregate counts this week.
<SUP>2</SUP> No report received from MB.
<!--<sup>3</sup> The total number of hosp. cases decreased for NU this week due to a duplicate count.
-->? Note that due to reporting delays, some PTs are reporting retrospectively on first wave cases.

</TD></TR></TFOOT><TBODY><TR><TH class=bg-colour-blue scope=col rowSpan=2>Province/Territory</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>This week (Nov. 29-Dec. 5, 2009)*</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>From August 30, 2009 to
December 5, 2009**
</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>From April 18, 2009 to August 29, 2009**</TH></TR><TR><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH></TR><TR><TH class=bg-colour-blue scope=row>BC<SUP>1 </SUP></TH><TD class=alignCenter height=20>52</TD><TD class=alignCenter>5</TD><TD class=alignCenter>5</TD><TD class=alignCenter>958</TD><TD class=alignCenter>122</TD><TD class=alignCenter>42</TD><TD class=alignCenter>51</TD><TD class=alignCenter>19</TD><TD class=alignCenter>5</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter height=17>40</TD><TD class=alignCenter>6</TD><TD class=alignCenter>5</TD><TD class=alignCenter>1107</TD><TD class=alignCenter>202</TD><TD class=alignCenter>55</TD><TD class=alignCenter>129</TD><TD class=alignCenter>29</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter height=17>2</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>29</TD><TD class=alignCenter>25</TD><TD class=alignCenter>9</TD><TD class=alignCenter>23</TD><TD class=alignCenter>12</TD><TD class=alignCenter>4</TD></TR><TR><TH class=bg-colour-blue scope=row>MB<SUP>2 </SUP></TH><TD class=alignCenter height=19>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>35</TD><TD class=alignCenter>5</TD><TD class=alignCenter>2</TD><TD class=alignCenter>224</TD><TD class=alignCenter>43</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter height=17>115</TD><TD class=alignCenter>35</TD><TD class=alignCenter>9</TD><TD class=alignCenter>1275</TD><TD class=alignCenter>204</TD><TD class=alignCenter>79</TD><TD class=alignCenter>381</TD><TD class=alignCenter>68</TD><TD class=alignCenter>25</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter height=17>67</TD><TD class=alignCenter>26</TD><TD class=alignCenter>10</TD><TD class=alignCenter>2422</TD><TD class=alignCenter>348</TD><TD class=alignCenter>72</TD><TD class=alignCenter>572</TD><TD class=alignCenter>104</TD><TD class=alignCenter>27</TD></TR><TR><TH class=bg-colour-blue scope=row>NB<SUP>1</SUP></TH><TD class=alignCenter height=19>6</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>166</TD><TD class=alignCenter>27</TD><TD class=alignCenter>7</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NS<SUP>1</SUP></TH><TD class=alignCenter height=19>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>253</TD><TD class=alignCenter>40</TD><TD class=alignCenter>6</TD><TD class=alignCenter>17</TD><TD class=alignCenter>8</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter height=17>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>49</TD><TD class=alignCenter>9</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NL<SUP>1 </SUP></TH><TD class=alignCenter height=19>17</TD><TD class=alignCenter>5</TD><TD class=alignCenter>1</TD><TD class=alignCenter>262</TD><TD class=alignCenter>49</TD><TD class=alignCenter>16</TD><TD class=alignCenter>3</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>YT</TH><TD class=alignCenter height=17>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>14</TD><TD class=alignCenter>3</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NT</TH><TD class=alignCenter height=17>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>46</TD><TD class=alignCenter>7</TD><TD class=alignCenter>1</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NU</TH><TD class=alignCenter height=17>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>72</TD><TD class=alignCenter>6</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter height=18>307</TD><TD class=alignCenter>83</TD><TD class=alignCenter>33</TD><TD class=alignCenter>6621</TD><TD class=alignCenter>1041</TD><TD class=alignCenter>292</TD><TD class=alignCenter>1481</TD><TD class=alignCenter>291</TD><TD class=alignCenter>77</TD></TR></TBODY></TABLE>
Descriptive characteristics of laboratory-confirmed Canadian Pandemic (H1N1) 2009 hospitalized cases, ICU-admitted cases and deaths with core information available, reported to PHAC as of December 5, 2009<SUP><SUP>?</SUP> </SUP>

<TABLE class=fontSize85 cellSpacing=0 cellPadding=2 border=1><COLGROUP><COL width=98><COL width=95><COL width=82><COL width=69><COL width=97><COL width=77><COL width=59><COL width=96><COL width=82><COL width=67><TBODY><TR><TD rowSpan=2></TD><TH class=bg-colour-blue colSpan=3>From April to August 29, 2009</TH><TH class=bg-colour-blue colSpan=3>From Aug. 30, 2009 to Dec. 5, 2009</TH><TH class=bg-colour-blue colSpan=3>Cumulative:
From April to Dec. 5, 2009
</TH></TR><TR><TH class=bg-colour-blue>Hospitalized cases (n=1,481)</TH><TH class=bg-colour-blue>ICU-admitted
(n=291)
</TH><TH class=bg-colour-blue>Deaths
(n=77)
</TH><TH class=bg-colour-blue>Hospitalized
cases (n=5,841)
</TH><TH class=bg-colour-blue>ICU-admitted
(n=992)
</TH><TH class=bg-colour-blue>Deaths
(n=271)
</TH><TH class=bg-colour-blue>Hospitalized
cases
(n=7,322)
</TH><TH class=bg-colour-blue>ICU-admitted
(n=1,283)
</TH><TH class=bg-colour-blue>Deaths
(n=348)
</TH></TR><TR><TH class="bg-colour-blue alignLeft">Females, %</TH><TD class=alignCenter height=16>51.5</TD><TD class=alignCenter>57.4</TD><TD class=alignCenter>62.3</TD><TD class=alignCenter>49.2</TD><TD class=alignCenter>49.0</TD><TD class=alignCenter>46.9</TD><TD class=alignCenter>49.7</TD><TD class=alignCenter>50.9</TD><TD class=alignCenter>50.3</TD></TR><TR><TH class="bg-colour-blue alignLeft">Median age</TH><TD class=alignCenter height=15>23.0</TD><TD class=alignCenter>37.0</TD><TD class=alignCenter>51.0</TD><TD class=alignCenter>29.0</TD><TD class=alignCenter>47.0</TD><TD class=alignCenter>54.0</TD><TD class=alignCenter>28.0</TD><TD class=alignCenter>45.0</TD><TD class=alignCenter>52.5</TD></TR><TR><TH class="bg-colour-blue alignLeft">Aboriginal status, % </TH><TD class=alignCenter height=15>20.3</TD><TD class=alignCenter>16.1</TD><TD class=alignCenter>11.7</TD><TD class=alignCenter>4.0</TD><TD class=alignCenter>6.0</TD><TD class=alignCenter>7.4</TD><TD class=alignCenter>7.3</TD><TD class=alignCenter>8.3</TD><TD class=alignCenter>8.3</TD></TR><TR><TH class="bg-colour-blue alignLeft">Underlying medical conditions<SUP>1</SUP>, %</TH><TD class=alignCenter>47.1
(646/1,373)
</TD><TD class=alignCenter>57.5
(157/273)
</TD><TD class=alignCenter>65.3
(49/75)
</TD><TD class=alignCenter>52.4
(1,366/2,608)
</TD><TD class=alignCenter>60.8
(455/748)
</TD><TD class=alignCenter>67.4
(126/187)
</TD><TD class=alignCenter>50.5
(2,012/3,981)
</TD><TD class=alignCenter>59.9
(612/1,021)
</TD><TD class=alignCenter>66.8
(175/262)
</TD></TR><TR><TH class="bg-colour-blue alignLeft">Pregnancy<SUP>2</SUP>, %</TH><TD class=alignCenter height=24>28.0 (77/275)</TD><TD class=alignCenter>19.7 (15/76)</TD><TD class=alignCenter>28.6 (4/14)</TD><TD class=alignCenter>18.9 (167/884)</TD><TD class=alignCenter>9.0 (14/155)</TD><TD class=alignCenter>0.0</TD><TD class=alignCenter>21.1 (244/1,159)</TD><TD class=alignCenter>12.6 (29/231)</TD><TD class=alignCenter>8.9 (4/45)</TD></TR><TR><TD colSpan=10><SUP>1</SUP> Proportion of cases with at least one underlying medical condition (excluding pregnancy) among those for whom the information was available. Missing/unknown information has been removed from all calculations except for data reported on underlying condition from MB and ON, where it was not possible to delineate missing information from absence of underlying condition. For these two provinces, missing information has been included in the denominator. This may have affected the observed proportion this week.
<SUP>2</SUP> Percent of pregnant women among women 15 to 44 years of age. Note that Ontario retrospectively provided information on pregnant women this week.
<SUP id=dg>?</SUP>Note that due to reporting delays, some PTs reported retrospectively on first wave cases.
</TD></TR></TBODY></TABLE>

Overall Influenza Summary - Week 48 (November 29 to December 5, 2009)

The overall influenza activity continued to decrease this week at the national level. All FluWatch influenza indicators declined for the third consecutive week.
Two regions reported widespread activity in SK & NL and eight regions in BC, AB, ON, QC, NB & NS reported localized activity, while forty-two regions reported sporadic activity in BC, AB, SK, MB, ON, QC, NB, PE, NS, NL, YT & NU and two regions in NT reported no activity. The 53 influenza outbreaks reported this week were all in schools except 3 in hospitals and/or residential facilities (AB, QC & NL) and 1 in an unspecified location (NS). The school outbreaks were in QC (38), NB (5), NS (4), AB (7), and BC (2). Note that this is the first year that all the provinces and territories are reporting on influenza outbreaks in schools (greater than 10% absenteeism on any day most likely due to ILI) which is increasing considerably the total number of outbreaks reported compared to previous years.


<TABLE class=widthFull cellSpacing=0 cellPadding=0><TBODY><TR class=alignCenter><TD colSpan=2>Map of overall Influenza activity level by provinces and territories, Week 48, Canada



</TD></TR><TR class=alignCenter><TD>

</TD><TD><TABLE cellSpacing=0 cellPadding=1 border=0><TBODY><TR><TD align=middle><TABLE class=border-lite cellSpacing=1 cellPadding=1><TBODY><TR align=middle><TD>No Data </TD><TD>
leg_dots.gif
</TD></TR><TR class=alignCenter><TD>No Activity</TD><TD>
leg_ffffff.gif
</TD></TR><TR class=alignCenter><TD>Sporadic Activity</TD><TD>
leg_ccccff.gif
</TD></TR><TR align=middle><TD>Localized Activity</TD><TD>
leg_6666ff.gif
</TD></TR><TR align=middle><TD>Widespread
Activity
</TD><TD>
leg_000066.gif
</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR><TR><TD class=fontSize85 colSpan=2>Note: Influenza 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 (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.

</TD></TR></TBODY></TABLE>
Number of influenza surveillance regions<SUP>?</SUP> reporting widespread or localized influenza activity,
Canada, by report week, 2009-2010 (N=54)

2009-w48-fg1-eng.gif

flu0910-leg-fg1-eng.gif

? sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.

Overall Number of Influenza Outbreaks, Canada, by Report Week, 2009-2010

2009-w48-fg2-eng.gif

flu0910-leg-fg2-eng.gif


ILI consultation rate
This week, the national ILI consultation rate was 18 consultations per 1,000 patient visits (see ILI graph) which was significantly lower compared to the previous weeks and within the expected range for this time of the year. All provinces and territories had lower ILI consultations rates compared to their respective ILI rates in the previous week except AB and MB. Those under 20 years of age still had the highest consultation rates, with 29 and 37 per 1,000 patient visits among children under 5 years of age and among those 5 and 19 years of age, respectively.
Influenza-like illness (ILI) consultation rates, Canada, by report week,
2009-2010 compared to 1996/97 through to 2008/09 seasons

2009-w48-fg3-eng.gif


flu0910-leg-fg3-eng.gif

Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons).
Delays in the reporting of data may cause data to change retrospectively.
Paediatric Influenza Hospitalizations and Deaths
In week 48, 25 laboratory-confirmed influenza-associated paediatric hospitalizations and 1 death were reported through the Immunization Monitoring Program Active (IMPACT) network. All of these cases were due to Pandemic (H1N1) 2009. 1,306 hospitalizations had been reported since week 17 (April 26): 97.0% of these hospitalizations were officially due to Pandemic (H1N1) 2009. Since the beginning of the pandemic, ten paediatric deaths due to Pandemic (H1N1) 2009 were reported through the IMPACT network among children under 16 years of age. The death reported this week was in an infant from AB who had no known medical conditions.
Laboratory Surveillance Summary
This week, the proportion of tests that were positive for influenza was 12.4% which represents a significant decrease compared to the previous weeks (see Tests table). All provinces and territories had a lower proportion of positive tests for influenza compared to the previous weeks except MB and NS. This week, a total of 760 specimens tested positive for influenza (all A) and 99.9% of the positive influenza A subtyped specimens were Pandemic (H1N1) 2009. Note that QC reported this week 1 positive specimen for A/H3N2 and forty-one since August 30, 2009.

Influenza tests reported and percentage of tests positive, Canada,
by report week, 2009-2010

2009-w48-fg4-eng.gif

flu0910-leg-fg4-eng.gif


Percent positive influenza tests, compared to other respiratory viruses, Canada,
by reporting week, 2009-2010


2009-w48-fg5-eng.gif


flu0910-leg-fg5-eng.gif

Weekly & Cumulative numbers of positive influenza specimens, by Provincial Laboratories

<TABLE class=widthFull cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD class=fontSize85 colSpan=13>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces.
Note: Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals.
<SUP>*</SUP> Not subtyped

</TD></TR></TFOOT><TBODY><TR><TH class=bg-colour-blue scope=col rowSpan=3>Reporting provinces</TH><TH class=bg-colour-blue scope=colgroup colSpan=6>Weekly (Nov. 29-Dec. 5, 2009)</TH><TH class=bg-colour-blue scope=colgroup colSpan=6>Cumulative (Aug. 30 to Dec. 5, 2009)</TH></TR><TR><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=5>Influenza A</TH><TH class="bg-colour-blue fontSize85" scope=col>B</TH><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=5>Influenza A</TH><TH class=bg-colour-blue scope=col>B</TH></TR><TR><TH class="fontSize85 bg-colour-blue" scope=col>A Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H3)</TH><TH class="fontSize85 bg-colour-blue" scope=col>Pand (H1N1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A (NS)*</TH><TH class="fontSize85 bg-colour-blue" scope=col>Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H3)</TH><TH class="fontSize85 bg-colour-blue" scope=col>Pand (H1N1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A (NS)*</TH><TH class="fontSize85 bg-colour-blue" scope=col>Total</TH></TR><TR><TH class=bg-colour-blue scope=row>BC</TH><TD class=alignCenter height=16>50</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>49</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6312</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>5747</TD><TD class=alignCenter>564</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter height=16>50</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>48</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5402</TD><TD class=alignCenter>2</TD><TD class=alignCenter>5</TD><TD class=alignCenter>5304</TD><TD class=alignCenter>91</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter height=16>73</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>63</TD><TD class=alignCenter>10</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2558</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>2262</TD><TD class=alignCenter>295</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter height=16>114</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>97</TD><TD class=alignCenter>17</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1822</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1700</TD><TD class=alignCenter>122</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter height=16>105</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>66</TD><TD class=alignCenter>39</TD><TD class=alignCenter>0</TD><TD class=alignCenter>7772</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3473</TD><TD class=alignCenter>4298</TD><TD class=alignCenter>4</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter height=16>308</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>307</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>10526</TD><TD class=alignCenter>1</TD><TD class=alignCenter>41</TD><TD class=alignCenter>10484</TD><TD class=alignCenter>0</TD><TD class=alignCenter>4</TD></TR><TR><TH class=bg-colour-blue scope=row>NB</TH><TD class=alignCenter height=16>29</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>29</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1837</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1816</TD><TD class=alignCenter>19</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter height=16>17</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>14</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>776</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>749</TD><TD class=alignCenter>27</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter height=16>8</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>8</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>110</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>108</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter height=16>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>948</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>948</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter height=16>760</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>687</TD><TD class=alignCenter>72</TD><TD class=alignCenter>0</TD><TD class=alignCenter>38063</TD><TD class=alignCenter>5</TD><TD class=alignCenter>49</TD><TD class=alignCenter>32591</TD><TD class=alignCenter>5418</TD><TD class=alignCenter>9</TD></TR></TBODY></TABLE>

http://www.phac-aspc.gc.ca/fluwatch/09-10/w48_09/index-eng.php
 
Re: Canada - FluWatch Pandemic (H1N1) 2009 virus Surveillance Week 49

Re: Canada - FluWatch Pandemic (H1N1) 2009 virus Surveillance Week 49

Summary of FluWatch Findings for the
Week ending December 12, 2009

* On week 49, the overall influenza activity continued to decline for the fourth consecutive week in Canada.
* The ILI consultation rate was below the expected range for this time of the year and only 6.6% of the specimens tested were positive for influenza. The Pandemic (H1N1) 2009 strain still accounted for nearly 100% of the positive influenza A subtyped specimens this week.
* The number of hospitalized cases (159 vs. 307), ICU admissions (40 vs. 83) and deaths (21 vs. 33) reported this week are about half of those reported last week. Among reporting provinces and territories (PTs) this week, hospitalized cases occurred in only six provinces (BC, AB, SK, ON, QC & NS). Deaths reported this week were also from the same five provinces except MB (BC, AB, SK, MB, ON & QC).
* From August 30 to December 12, 2009, a total of 6,779 hospitalized cases including 1,081 (15.9%) cases admitted to an intensive care unit (ICU) as well as 313 (4.6%) deaths had been reported.

Pandemic (H1N1) 2009 virus Surveillance and Epidemiology

A total of 8,261 hospitalized cases including 1,372 (16.6%) cases admitted to ICU and 606 (7.3%) cases required ventilation as well as 390 (4.7%) deaths of Pandemic (H1N1) 2009 were reported to PHAC since the beginning of the pandemic. Core data was available for 7,481 (90.6%) hospitalizations, 1,323 (96.4%) ICU admissions and 348 (94.1%) deaths. 8 of the 13 provinces and territories continued to show activity of Pandemic (H1N1) 2009 during the last week. Although activity is present, a continued decline was experienced by all PTs, indicated by the decreasing number of reported hospitalized cases (159 vs. 307), ICU admissions (40 vs. 83) and deaths (21 vs. 33) reported this week compared to the previous week. The number of hospitalizations due to Pandemic (H1N1) 2009 in the second wave was 4.6 times higher than the number reported during the first wave.

The proportion of severe cases (ICU admissions and deaths) among all hospitalized cases to date was still slightly lower in the second wave than in the first wave; however, this difference is continuing to narrow (19.6% vs. 15.9% for ICU admissions and 5.2% vs. 4.6% for fatal cases). Comparing the rates of hospitalization, ICU admissions and deaths between those with underlying medical conditions and those without since the beginning of the pandemic, those with underlying medical conditions were almost 5 times more likely to be hospitalized, 7 times more likely to be admitted to ICU and more than 11 times more likely to die compared to those without underlying medical conditions. As expected, during the second wave, hospitalized cases with no underlying medical conditions have been younger (median age of 24.5 vs. 47.0 years of age) compared to hospitalized cases with underlying medical conditions. Among the hospitalized cases, ICU admissions and deaths, chronic pulmonary disease (including asthma) was the most commonly reported underlying medical condition (34.1%, 37.2% and 42.0%, respectively). Immunosuppression (including cancer) (15.1%) and diabetes (13.8%) were also frequently reported among hospitalized cases, while ICU cases were also affected by diabetes (22.0%) and chronic heart disease (18.1%). Among fatal cases, immunosuppression (27.3%) and chronic heart disease (26.1%) were most commonly reported.
http://www.phac-aspc.gc.ca/fluwatch/09-10/w49_09/index-eng.php
 
Re: Canada - FluWatch Pandemic (H1N1) 2009 virus Surveillance Week 50

Re: Canada - FluWatch Pandemic (H1N1) 2009 virus Surveillance Week 50

December 13 to December 19, 2009 (Week 50)





Weekly and cumulative numbers of hospitalized cases, ICU admissions and deaths among Pandemic (H1N1) 2009 confirmed cases, Canada, to December 19, 2009?

<TABLE class="widthFull fontSize85" cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD colSpan=10><SUP id=star>*</SUP>Based on reporting date.
<SUP id=dstar>**</SUP> Based on epidemiological date, hospitalization date and reporting date.
<SUP>1 </SUP>These provinces reported aggregate counts this week.
<SUP>2</SUP> Note change in total hospitalizations from last week's report: duplicates were removed.
? Note that due to reporting delays, some PTs reported retrospectively on first wave cases.

</TD></TR></TFOOT><TBODY><TR><TH class=bg-colour-blue scope=col rowSpan=2>Province/Territory</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>This week (Dec. 13-Dec. 19, 2009)*</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>From August 30, 2009 to
December 19, 2009**
</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>From April 12, 2009 to August 29, 2009**</TH></TR><TR><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH></TR><TR><TH class=bg-colour-blue scope=row>BC<SUP>1 </SUP></TH><TD class=alignCenter>5</TD><TD class=alignCenter>3</TD><TD class=alignCenter>1</TD><TD class=alignCenter>986</TD><TD class=alignCenter>129</TD><TD class=alignCenter>47</TD><TD class=alignCenter>51</TD><TD class=alignCenter>19</TD><TD class=alignCenter>5</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>9</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1130</TD><TD class=alignCenter>207</TD><TD class=alignCenter>58</TD><TD class=alignCenter>129</TD><TD class=alignCenter>29</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>3</TD><TD class=alignCenter>3</TD><TD class=alignCenter>1</TD><TD class=alignCenter>37</TD><TD class=alignCenter>33</TD><TD class=alignCenter>11</TD><TD class=alignCenter>23</TD><TD class=alignCenter>12</TD><TD class=alignCenter>4</TD></TR><TR><TH class=bg-colour-blue scope=row>MB<SUP>1 </SUP></TH><TD class=alignCenter>9</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>141</TD><TD class=alignCenter>16</TD><TD class=alignCenter>3</TD><TD class=alignCenter>224</TD><TD class=alignCenter>43</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>38</TD><TD class=alignCenter>6</TD><TD class=alignCenter>5</TD><TD class=alignCenter>1378</TD><TD class=alignCenter>227</TD><TD class=alignCenter>93</TD><TD class=alignCenter>385</TD><TD class=alignCenter>68</TD><TD class=alignCenter>25</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>14</TD><TD class=alignCenter>5</TD><TD class=alignCenter>3</TD><TD class=alignCenter>2475</TD><TD class=alignCenter>358</TD><TD class=alignCenter>79</TD><TD class=alignCenter>572</TD><TD class=alignCenter>104</TD><TD class=alignCenter>27</TD></TR><TR><TH class=bg-colour-blue scope=row>NB<SUP>1,2</SUP></TH><TD class=alignCenter>--</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>162</TD><TD class=alignCenter>33</TD><TD class=alignCenter>7</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NS<SUP>1</SUP></TH><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>266</TD><TD class=alignCenter>42</TD><TD class=alignCenter>6</TD><TD class=alignCenter>17</TD><TD class=alignCenter>8</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>49</TD><TD class=alignCenter>9</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NL<SUP>1 </SUP></TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>262</TD><TD class=alignCenter>49</TD><TD class=alignCenter>16</TD><TD class=alignCenter>3</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>YT</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>14</TD><TD class=alignCenter>3</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NT</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>46</TD><TD class=alignCenter>7</TD><TD class=alignCenter>1</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NU</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>72</TD><TD class=alignCenter>6</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>79</TD><TD class=alignCenter>21</TD><TD class=alignCenter>11</TD><TD class=alignCenter>6951</TD><TD class=alignCenter>1113</TD><TD class=alignCenter>324</TD><TD class=alignCenter>1485</TD><TD class=alignCenter>291</TD><TD class=alignCenter>77</TD></TR></TBODY></TABLE>
Descriptive characteristics of laboratory-confirmed Canadian Pandemic (H1N1) 2009 hospitalized cases, ICU-admitted cases and deaths with core information available, reported to PHAC as of December 19, 2009<SUP><SUP>?</SUP> </SUP>

<TABLE class=fontSize85 cellSpacing=0 cellPadding=2 border=1><COLGROUP><COL width=98><COL width=95><COL width=82><COL width=69><COL width=97><COL width=77><COL width=59><COL width=96><COL width=82><COL width=67><TBODY><TR><TD rowSpan=2></TD><TH class=bg-colour-blue colSpan=3>From April 12 to August 29, 2009</TH><TH class=bg-colour-blue colSpan=3>From Aug. 30, 2009 to Dec. 19, 2009</TH><TH class=bg-colour-blue colSpan=3>Cumulative:
From April 12 to Dec. 19, 2009
</TH></TR><TR><TH class=bg-colour-blue>Hospitalized cases (n=1.485)</TH><TH class=bg-colour-blue>ICU-admitted
(n=291)
</TH><TH class=bg-colour-blue>Deaths
(n=77)
</TH><TH class=bg-colour-blue>Hospitalized
cases (n=6,079)
</TH><TH class=bg-colour-blue>ICU-admitted
(n=1,053)
</TH><TH class=bg-colour-blue>Deaths
(n=302)
</TH><TH class=bg-colour-blue>Hospitalized
cases
(n=7.564)
</TH><TH class=bg-colour-blue>ICU-admitted
(n=1,344)
</TH><TH class=bg-colour-blue>Deaths
(n=379)
</TH></TR><TR><TH class="bg-colour-blue alignLeft">Females, %</TH><TD class=alignCenter>51.4</TD><TD class=alignCenter>57.4</TD><TD class=alignCenter>62.3</TD><TD class=alignCenter>49.4</TD><TD class=alignCenter>49.7</TD><TD class=alignCenter>48.7</TD><TD class=alignCenter>49.8</TD><TD class=alignCenter>51.3</TD><TD class=alignCenter>51.5</TD></TR><TR><TH class="bg-colour-blue alignLeft">Median age</TH><TD class=alignCenter>23.0</TD><TD class=alignCenter>37.0</TD><TD class=alignCenter>51.0</TD><TD class=alignCenter>29.0</TD><TD class=alignCenter>47.0</TD><TD class=alignCenter>53.0</TD><TD class=alignCenter>28.0</TD><TD class=alignCenter>45.0</TD><TD class=alignCenter>53.0</TD></TR><TR><TH class="bg-colour-blue alignLeft">Aboriginal status, % </TH><TD class=alignCenter>20.3</TD><TD class=alignCenter>16.2</TD><TD class=alignCenter>11.7</TD><TD class=alignCenter>3.9</TD><TD class=alignCenter>5.9</TD><TD class=alignCenter>6.6</TD><TD class=alignCenter>7.1</TD><TD class=alignCenter>8.1</TD><TD class=alignCenter>7.7</TD></TR><TR><TH class="bg-colour-blue alignLeft">Underlying medical conditions<SUP>1</SUP>, %</TH><TD class=alignCenter>47.0
(647/1,376)
</TD><TD class=alignCenter>57.5
(157/273)
</TD><TD class=alignCenter>68.0
(51/75)
</TD><TD class=alignCenter>52.5
(1,468/2,794)
</TD><TD class=alignCenter>62.1
(510/821)
</TD><TD class=alignCenter>73.8
(136/202)
</TD><TD class=alignCenter>50.7
(2,115/4,170)
</TD><TD class=alignCenter>61.0
(667/1,094)
</TD><TD class=alignCenter>72.5
(240/331)
</TD></TR><TR><TH class="bg-colour-blue alignLeft">Pregnancy<SUP>2</SUP>, %</TH><TD class=alignCenter>28.0
(77/275)
</TD><TD class=alignCenter>19.7
(15/76)
</TD><TD class=alignCenter>28.6
(4/14)
</TD><TD class=alignCenter>19.1
(173/907)
</TD><TD class=alignCenter>9.2
(15/163)
</TD><TD class=alignCenter>0.0</TD><TD class=alignCenter>21.2
(250/1,182)
</TD><TD class=alignCenter>12.6
(30/239)
</TD><TD class=alignCenter>8.5
(4/47)
</TD></TR><TR><TD colSpan=10><SUP>1</SUP> Proportion of cases with at least one underlying medical condition (excluding pregnancy) among those for whom the information was available. Missing/unknown information has been removed from all calculations except for data reported on underlying condition from MB and ON, where it was not possible to delineate missing information from absence of underlying condition. For these two provinces, missing information has been included in the denominator. Note that Ontario retrospectively provided information to PHAC on underlying medical conditions of fatal cases. This increased the proportion of underlying medical conditions among deaths.
<SUP>2</SUP> Percent of pregnant women among women 15 to 44 years of age.
?Note that due to reporting delays, some PTs reported retrospectively on first wave cases.
</TD></TR></TBODY></TABLE>

Overall Influenza Summary - Week 50 (December 13 to December 19, 2009)

At the national level, the overall influenza activity continued to decrease this week. All FluWatch influenza indicators declined for at least the fifth consecutive week. The ILI consultation rate remained well below the expected ranged for this time of the year.
On week 50, only one region in NL reported localized activity and none have reported widespread activity. The 3 influenza outbreaks reported this week were all in schools and occurred in QC (2) and NB (1). Note that this is the first year that all the provinces and territories are reporting on influenza outbreaks in schools (greater than 10% absenteeism on any day most likely due to ILI) which is increasing considerably the total number of outbreaks reported compared to previous years.


<TABLE class=widthFull cellSpacing=0 cellPadding=0><TBODY><TR class=alignCenter><TD colSpan=2>Map of overall Influenza activity level by provinces and territories, Week 50, Canada



</TD></TR><TR class=alignCenter><TD>

</TD><TD><TABLE cellSpacing=0 cellPadding=1 border=0><TBODY><TR><TD align=middle><TABLE class=border-lite cellSpacing=1 cellPadding=1><TBODY><TR align=middle><TD>No Data </TD><TD>
leg_dots.gif
</TD></TR><TR class=alignCenter><TD>No Activity</TD><TD>
leg_ffffff.gif
</TD></TR><TR class=alignCenter><TD>Sporadic Activity</TD><TD>
leg_ccccff.gif
</TD></TR><TR align=middle><TD>Localized Activity</TD><TD>
leg_6666ff.gif
</TD></TR><TR align=middle><TD>Widespread
Activity
</TD><TD>
leg_000066.gif
</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR><TR><TD class=fontSize85 colSpan=2>Note: Influenza 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 (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.

</TD></TR></TBODY></TABLE>
Number of influenza surveillance regions<SUP>?</SUP> reporting widespread or localized influenza activity,
Canada, by report week, 2009-2010 (N=54)

2009-w50-fg1-eng.gif

flu0910-leg-fg1-eng.gif

? sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.

Overall Number of Influenza Outbreaks, Canada, by Report Week, 2009-2010

2009-w50-fg2-eng.gif

flu0910-leg-fg2-eng.gif


ILI consultation rate
This week, the national ILI consultation rate was 20 consultations per 1,000 patient visits (see ILI graph) which was slightly higher compared to last week but remained well below the expected range for this time of the year. Those under between 5 and 19 years of age still had the highest consultation rates (36 per 1,000 patient visits), while the ILI consultation rate for children under the age of 5 years decreased substantially to 15 per 1000 patients from 57 per 1000 visits during the previous week.
Influenza-like illness (ILI) consultation rates, Canada, by report week,
2009-2010 compared to 1996/97 through to 2008/09 seasons

2009-w50-fg3-eng.gif


flu0910-leg-fg3-eng.gif

Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons).
Delays in the reporting of data may cause data to change retrospectively.
Paediatric Influenza Hospitalizations and Deaths
In week 50, 2 laboratory-confirmed influenza-associated paediatric hospitalizations were reported through the Immunization Monitoring Program Active (IMPACT) network. Both of these cases were due to Pandemic (H1N1) 2009. 1,325 hospitalizations had been reported since week 17 (April 26): 97.0% of these hospitalizations were due to Pandemic (H1N1) 2009. Since the beginning of the pandemic, eleven paediatric deaths due to Pandemic (H1N1) 2009 were reported through the IMPACT network among children equal to or less than 16 years of age.
Laboratory Surveillance Summary
This week, the proportion of tests that were positive for influenza was 3.9% which represents a significant decrease compared to the previous weeks (see Tests table). All provinces and territories had a lower proportion of positive tests for influenza compared to the previous weeks except PE. This week, a total of 121 specimens tested positive for influenza (all A) and 99.1% of the positive influenza A subtyped specimens were Pandemic (H1N1) 2009. Note that QC reported 43 positive specimen for A/H3N2 since August 30, 2009.

Influenza tests reported and percentage of tests positive, Canada,
by report week, 2009-2010

2009-w50-fg4-eng.gif

flu0910-leg-fg4-eng.gif


Percent positive influenza tests, compared to other respiratory viruses, Canada,
by reporting week, 2009-2010


2009-w50-fg5-eng.gif


flu0910-leg-fg5-eng.gif

Weekly & Cumulative numbers of positive influenza specimens, by Provincial Laboratories

<TABLE class=widthFull cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD class=fontSize85 colSpan=13>Note: Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals.
* Not subtyped

</TD></TR></TFOOT><TBODY></TBODY></TABLE>


http://www.phac-aspc.gc.ca/fluwatch/09-10/w50_09/index-eng.php
 
Re: Canada - FluWatch Pandemic (H1N1) 2009 virus Surveillance Week 51 and 52

Re: Canada - FluWatch Pandemic (H1N1) 2009 virus Surveillance Week 51 and 52

<H1>December 20, 2009 to January 2, 2010 (Weeks 51 and 52)</H1>



Weekly and cumulative numbers of hospitalized cases, ICU admissions and deaths among Pandemic (H1N1) 2009 confirmed cases, Canada, to January 2, 2010?

<TABLE class="widthFull fontSize85" cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD colSpan=10><SUP id=star>*</SUP>Based on reporting date.
<SUP id=dstar>**</SUP> Based on epidemiological date, hospitalization date and reporting date.
<SUP>1 </SUP>These provinces reported aggregate counts this week.
<SUP>2</SUP> Note change in total hospitalizations from last week's report: duplicates were removed.
? Note that due to reporting delays, some PTs reported retrospectively on first wave cases.
</TD></TR></TFOOT><TBODY><TR><TH class=bg-colour-blue scope=col rowSpan=2>Province/Territory</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>Weeks 51 & 52
(Dec. 20, 2009-Jan. 2, 2010)*</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>From August 30, 2009 to
January 2, 2010**</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>From April 12, 2009 to August 29, 2009**</TH></TR><TR><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH></TR><TR><TH class=bg-colour-blue scope=row>BC<SUP>1 </SUP></TH><TD class=alignCenter>10</TD><TD class=alignCenter>3</TD><TD class=alignCenter>2</TD><TD class=alignCenter>994</TD><TD class=alignCenter>130</TD><TD class=alignCenter>48</TD><TD class=alignCenter>53</TD><TD class=alignCenter>21</TD><TD class=alignCenter>6</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>5</TD><TD class=alignCenter>0</TD><TD class=alignCenter>4</TD><TD class=alignCenter>1,135</TD><TD class=alignCenter>207</TD><TD class=alignCenter>62</TD><TD class=alignCenter>129</TD><TD class=alignCenter>29</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>2</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>39</TD><TD class=alignCenter>35</TD><TD class=alignCenter>11</TD><TD class=alignCenter>23</TD><TD class=alignCenter>12</TD><TD class=alignCenter>4</TD></TR><TR><TH class=bg-colour-blue scope=row>MB<SUP>1 </SUP></TH><TD class=alignCenter>8</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>149</TD><TD class=alignCenter>18</TD><TD class=alignCenter>4</TD><TD class=alignCenter>224</TD><TD class=alignCenter>43</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>33</TD><TD class=alignCenter>11</TD><TD class=alignCenter>3</TD><TD class=alignCenter>1,407</TD><TD class=alignCenter>238</TD><TD class=alignCenter>96</TD><TD class=alignCenter>389</TD><TD class=alignCenter>68</TD><TD class=alignCenter>25</TD></TR><TR><TH class=bg-colour-blue scope=row>QC<SUP>1 </SUP></TH><TD class=alignCenter>8</TD><TD class=alignCenter>2</TD><TD class=alignCenter>2</TD><TD class=alignCenter>2,483</TD><TD class=alignCenter>360</TD><TD class=alignCenter>81</TD><TD class=alignCenter>572</TD><TD class=alignCenter>104</TD><TD class=alignCenter>27</TD></TR><TR><TH class=bg-colour-blue scope=row>NB<SUP>http://www.phac-aspc.gc.ca/fluwatch/09-10/w51-52_09/index-eng.php#a3</SUP></TH><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>162</TD><TD class=alignCenter>34</TD><TD class=alignCenter>8</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NS<SUP>1,2http://www.phac-aspc.gc.ca/fluwatch/09-10/w51-52_09/index-eng.php#a1</SUP></TH><TD class=alignCenter>--</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>261</TD><TD class=alignCenter>42</TD><TD class=alignCenter>6</TD><TD class=alignCenter>17</TD><TD class=alignCenter>8</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>49</TD><TD class=alignCenter>9</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NL<SUP>1 </SUP></TH><TD class=alignCenter>9</TD><TD class=alignCenter>1</TD><TD class=alignCenter>3</TD><TD class=alignCenter>271</TD><TD class=alignCenter>50</TD><TD class=alignCenter>19</TD><TD class=alignCenter>3</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>YT</TH><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>15</TD><TD class=alignCenter>3</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NT</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>46</TD><TD class=alignCenter>7</TD><TD class=alignCenter>1</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NU</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>72</TD><TD class=alignCenter>6</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>76</TD><TD class=alignCenter>22</TD><TD class=alignCenter>16</TD><TD class=alignCenter>7,016</TD><TD class=alignCenter>1,133</TD><TD class=alignCenter>339</TD><TD class=alignCenter>1,491</TD><TD class=alignCenter>293</TD><TD class=alignCenter>78</TD></TR></TBODY></TABLE>
Descriptive characteristics of laboratory-confirmed Canadian Pandemic (H1N1) 2009 hospitalized cases, ICU-admitted cases and deaths with core information available, reported to PHAC as of January 2, 2010<SUP><SUP>?</SUP> </SUP>

<TABLE class=fontSize85 cellSpacing=0 cellPadding=2 border=1><COLGROUP><COL width=98><COL width=95><COL width=82><COL width=69><COL width=97><COL width=77><COL width=59><COL width=96><COL width=82><COL width=67><TBODY><TR><TD rowSpan=2> </TD><TH class=bg-colour-blue colSpan=3>From April 12 to August 29, 2009</TH><TH class=bg-colour-blue colSpan=3>From Aug. 30, 2009 to Jan. 2, 2010</TH><TH class=bg-colour-blue colSpan=3>Cumulative:
From April 12 to Jan. 2, 2010</TH></TR><TR><TH class=bg-colour-blue>Hospitalized cases (n=1,491)</TH><TH class=bg-colour-blue>ICU-admitted
(n=293)</TH><TH class=bg-colour-blue>Deaths
(n=78)</TH><TH class=bg-colour-blue>Hospitalized
cases (n=6,254)</TH><TH class=bg-colour-blue>ICU-admitted
(n=1,081)</TH><TH class=bg-colour-blue>Deaths
(n=312)</TH><TH class=bg-colour-blue>Hospitalized
cases
(n=7,745)</TH><TH class=bg-colour-blue>ICU-admitted
(n=1,374)</TH><TH class=bg-colour-blue>Deaths
(n=390)</TH></TR><TR><TH class="bg-colour-blue alignLeft">Females, %</TH><TD class=alignCenter>51.2</TD><TD class=alignCenter>57.0</TD><TD class=alignCenter>61.5</TD><TD class=alignCenter>49.5</TD><TD class=alignCenter>49.2</TD><TD class=alignCenter>47.6</TD><TD class=alignCenter>49.8</TD><TD class=alignCenter>50.9</TD><TD class=alignCenter>50.3</TD></TR><TR><TH class="bg-colour-blue alignLeft">Median age</TH><TD class=alignCenter>23.0</TD><TD class=alignCenter>37.0</TD><TD class=alignCenter>51.0</TD><TD class=alignCenter>29.0</TD><TD class=alignCenter>47.0</TD><TD class=alignCenter>54.0</TD><TD class=alignCenter>28.0</TD><TD class=alignCenter>45.0</TD><TD class=alignCenter>53.0</TD></TR><TR><TH class="bg-colour-blue alignLeft">Aboriginal status, % </TH><TD class=alignCenter>20.2</TD><TD class=alignCenter>16</TD><TD class=alignCenter>11.5</TD><TD class=alignCenter>4.4</TD><TD class=alignCenter>5.9</TD><TD class=alignCenter>6.7</TD><TD class=alignCenter>7.4</TD><TD class=alignCenter>8.1</TD><TD class=alignCenter>7.7</TD></TR><TR><TH class="bg-colour-blue alignLeft">Underlying medical conditions<SUP>1</SUP>, %</TH><TD class=alignCenter>47.0
(650/1,382)</TD><TD class=alignCenter>58.2
(160/275)</TD><TD class=alignCenter>71.1
(54/76)</TD><TD class=alignCenter>52.4
(1,539/2,935)</TD><TD class=alignCenter>62.6
(524/837)</TD><TD class=alignCenter>76.2
(199/261)</TD><TD class=alignCenter>50.7
(2,189/4,317)</TD><TD class=alignCenter>61.5
(684/1,112)</TD><TD class=alignCenter>75.1
(253/337)</TD></TR><TR><TH class="bg-colour-blue alignLeft">Pregnancy<SUP>2</SUP>, %</TH><TD class=alignCenter>28.0 (77/275)</TD><TD class=alignCenter>19.7 (15/76)</TD><TD class=alignCenter>28.6 (4/14)</TD><TD class=alignCenter>18.5 (175/947)</TD><TD class=alignCenter>9.0 (15/167)</TD><TD class=alignCenter>0.0</TD><TD class=alignCenter>20.6 (252/1,222)</TD><TD class=alignCenter>12.3 (30/243)</TD><TD class=alignCenter>8.5 (4/47)</TD></TR><TR><TD colSpan=10><SUP>1</SUP> Proportion of cases with at least one underlying medical condition (excluding pregnancy) among those for whom the information was available. Missing/unknown information has been removed from all calculations except for data reported on underlying condition from MB and ON, where it was not possible to delineate missing information from absence of underlying condition. For these two provinces, missing information has been included in the denominator. Note that Ontario retrospectively provided information to PHAC on underlying medical conditions of fatal cases. This increased the proportion of underlying medical conditions among deaths.
<SUP>2</SUP> Percent of pregnant women among women 15 to 44 years of age.
?Note that due to reporting delays, some PTs reported retrospectively on first wave cases.</TD></TR></TBODY></TABLE>

Overall Influenza Summary - Weeks 51 and 52 (December 20, 2009 to January 2, 2010)

During weeks 51 and 52, influenza activity in Canada remained low with all influenza surveillance regions reporting either sporadic or no activity except one region (AB) in week 51 reported localized activity.
In week 52, thirty-four regions in BC, AB, SK, MB, ON, QC, NB, NS, NL & NU reported sporadic activity, while nineteen regions reported no activity in BC, NB, PE, NS, NL, YT & NT. One region in NU did not report in week 52 while one province (ON) and one territory (NU) did not report in week 51. Only 1 influenza outbreak was reported during the two-week period in a hospital or residential institution in Alberta. Note that this was the first year that all the provinces and territories were reporting on influenza outbreaks in schools (greater than 10% absenteeism on any day most likely due to ILI) which has increased considerably the total number of outbreaks reported compared to previous years.


<TABLE class=widthFull cellSpacing=0 cellPadding=0><TBODY><TR class=alignCenter><TD colSpan=2>Map of overall Influenza activity level by provinces and territories, Week 52, Canada


</TD></TR><TR class=alignCenter><TD>
</TD><TD><TABLE cellSpacing=0 cellPadding=1 border=0><TBODY><TR><TD align=middle><TABLE class=border-lite cellSpacing=1 cellPadding=1><TBODY><TR align=middle><TD>No Data </TD><TD>
leg_dots.gif
</TD></TR><TR class=alignCenter><TD>No Activity</TD><TD>
leg_ffffff.gif
</TD></TR><TR class=alignCenter><TD>Sporadic Activity</TD><TD>
leg_ccccff.gif
</TD></TR><TR align=middle><TD>Localized Activity</TD><TD>
leg_6666ff.gif
</TD></TR><TR align=middle><TD>Widespread
Activity</TD><TD>
leg_000066.gif
</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR><TR><TD class=fontSize85 colSpan=2>Note: Influenza 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 (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.
</TD></TR></TBODY></TABLE>
Number of influenza surveillance regions<SUP>?</SUP> reporting widespread or localized influenza activity,
Canada, by report week, 2009-2010 (N=54)

2009-w52-fg1-eng.gif

flu0910-leg-fg1-eng.gif

? sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.

Overall Number of Influenza Outbreaks, Canada, by Report Week, 2009-2010

2009-w52-fg2-eng.gif

flu0910-leg-fg2-eng.gif


ILI consultation rate
During weeks 51 and 52, the national ILI consultations rate were 27 and 19 consultations per 1,000 patient visits (see ILI graph) respectively which were below or within the expected range for these weeks. During week 51, those between 5 and 19 years of age had the highest consultation rate (66 per 1,000 patient visits). During week 52, the ILI consultation rate for children under the age of 5 years increased to 56 per 1000 patients from 36 per 1,000 patient visits during the previous week.
Influenza-like illness (ILI) consultation rates, Canada, by report week,
2009-2010 compared to 1996/97 through to 2008/09 seasons

2009-w52-fg3-eng.gif


flu0910-leg-fg3-eng.gif

Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons).
Delays in the reporting of data may cause data to change retrospectively.
Paediatric Influenza Hospitalizations and Deaths
In weeks 51 and 52, 2 laboratory-confirmed influenza-associated paediatric hospitalizations were reported through the Immunization Monitoring Program Active (IMPACT) network. Both of these cases were due to Pandemic (H1N1) 2009. 1,328 hospitalizations have been reported since week 17 (April 26): 97.1% of these hospitalizations were due to Pandemic (H1N1) 2009. Since the beginning of the pandemic, eleven paediatric deaths due to Pandemic (H1N1) 2009 were reported through the IMPACT network among children 16 years of age or under.
Laboratory Surveillance Summary
The proportion of tests that were positive for influenza was 1.6% as a whole over the two-week period which represents a significant decrease compared to the previous weeks (see Tests table). All provinces and territories had a lower proportion of positive tests for influenza compared to the previous week except NB and NS. During weeks 51 and 52, a total of 79 specimens tested positive for influenza (78 A and 1 B) and 98.5% of the positive influenza A subtyped specimens were Pandemic (H1N1) 2009. Note that QC reported 44 positive specimen for A/H3N2 and 6 specimen for influenza B since August 30, 2009.

Influenza tests reported and percentage of tests positive, Canada,
by report week, 2009-2010

2009-w52-fg4-eng.gif

flu0910-leg-fg4-eng.gif


Percent positive influenza tests, compared to other respiratory viruses, Canada,
by reporting week, 2009-2010


2009-w52-fg5-eng.gif


flu0910-leg-fg5-eng.gif

Weekly & Cumulative numbers of positive influenza specimens, by Provincial Laboratories

<TABLE class=widthFull cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD class=fontSize85 colSpan=13>Note: Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals.
* Not subtyped

</TD></TR></TFOOT><TBODY><TR><TH class=bg-colour-blue scope=col rowSpan=3>Reporting provinces</TH><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=6>Weekly (Dec. 20, 2009 to Jan. 2, 2010)</TH><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=6>Cumulative (Aug. 30, 2009 to Jan. 2, 2010)</TH></TR><TR><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=5>Influenza A</TH><TH class="bg-colour-blue fontSize85" scope=col>B</TH><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=5>Influenza A</TH><TH class=bg-colour-blue scope=col>B</TH></TR><TR><TH class="fontSize85 bg-colour-blue" scope=col>A Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H3)</TH><TH class="fontSize85 bg-colour-blue" scope=col>Pand (H1N1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A (NS)*</TH><TH class="fontSize85 bg-colour-blue" scope=col>Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H3)</TH><TH class="fontSize85 bg-colour-blue" scope=col>Pand (H1N1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A (NS)*</TH><TH class="fontSize85 bg-colour-blue" scope=col>Total</TH></TR><TR><TH class=bg-colour-blue scope=row>BC</TH><TD class=alignCenter>11</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>11</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6,362</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>5,796</TD><TD class=alignCenter>565</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>10</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>8</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5,854</TD><TD class=alignCenter>2</TD><TD class=alignCenter>5</TD><TD class=alignCenter>5,750</TD><TD class=alignCenter>97</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>4</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>4</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2,597</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>2,297</TD><TD class=alignCenter>299</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>23</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>23</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1,907</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1,781</TD><TD class=alignCenter>126</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>15</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>7</TD><TD class=alignCenter>8</TD><TD class=alignCenter>0</TD><TD class=alignCenter>7,862</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3,527</TD><TD class=alignCenter>4,333</TD><TD class=alignCenter>4</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>10</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>9</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>10,679</TD><TD class=alignCenter>1</TD><TD class=alignCenter>44</TD><TD class=alignCenter>10,634</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6</TD></TR><TR><TH class=bg-colour-blue scope=row>NB</TH><TD class=alignCenter>4</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>4</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1,854</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1,833</TD><TD class=alignCenter>19</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>782</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>751</TD><TD class=alignCenter>31</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>103</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>101</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>951</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>951</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>78</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>67</TD><TD class=alignCenter>10</TD><TD class=alignCenter>1</TD><TD class=alignCenter>38,951</TD><TD class=alignCenter>6</TD><TD class=alignCenter>52</TD><TD class=alignCenter>33,421</TD><TD class=alignCenter>5,472</TD><TD class=alignCenter>11</TD></TR></TBODY></TABLE>

http://www.phac-aspc.gc.ca/fluwatch/09-10/w51-52_09/index-eng.php
 
Re: Canada - FluWatch Pandemic (H1N1) 2009 virus Surveillance Week 1

Re: Canada - FluWatch Pandemic (H1N1) 2009 virus Surveillance Week 1

January 3, 2009 to January 9, 2010 (Week 1)



Posted 2010-01-15


Weekly and cumulative numbers of hospitalized cases, ICU admissions and deaths among Pandemic (H1N1) 2009 confirmed cases, Canada, to January 9, 2010?

<TABLE class="widthFull fontSize85" cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD colSpan=10><SUP id=star>*</SUP>Based on reporting date.
<SUP id=dstar>**</SUP> Based on epidemiological date, hospitalization date and reporting date.
<SUP>1 </SUP>These provinces reported aggregate counts this week.
<SUP>2</SUP> Note change in total hospitalizations from last week's report: duplicates were removed.
? Note that due to reporting delays, some PTs reported retrospectively on first wave cases.

</TD></TR></TFOOT><TBODY><TR><TH class=bg-colour-blue scope=col rowSpan=2>Province/Territory</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>Week 1
(Jan. 3, 2010-Jan. 9, 2010)*
</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>From August 30, 2009 to
January 9, 2010**
</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>From April 12, 2009 to August 29, 2009**</TH></TR><TR><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH></TR><TR><TH class=bg-colour-blue scope=row>BC<SUP>1 </SUP></TH><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>997</TD><TD class=alignCenter>132</TD><TD class=alignCenter>49</TD><TD class=alignCenter>52</TD><TD class=alignCenter>20</TD><TD class=alignCenter>6</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>4</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1139</TD><TD class=alignCenter>208</TD><TD class=alignCenter>63</TD><TD class=alignCenter>129</TD><TD class=alignCenter>29</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>4</TD><TD class=alignCenter>4</TD><TD class=alignCenter>0</TD><TD class=alignCenter>43</TD><TD class=alignCenter>39</TD><TD class=alignCenter>11</TD><TD class=alignCenter>23</TD><TD class=alignCenter>12</TD><TD class=alignCenter>4</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>150</TD><TD class=alignCenter>18</TD><TD class=alignCenter>4</TD><TD class=alignCenter>223</TD><TD class=alignCenter>43</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>7</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1414</TD><TD class=alignCenter>239</TD><TD class=alignCenter>96</TD><TD class=alignCenter>389</TD><TD class=alignCenter>68</TD><TD class=alignCenter>25</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2483</TD><TD class=alignCenter>360</TD><TD class=alignCenter>81</TD><TD class=alignCenter>572</TD><TD class=alignCenter>104</TD><TD class=alignCenter>27</TD></TR><TR><TH class=bg-colour-blue scope=row>NB<SUP>1,2</SUP></TH><TD class=alignCenter>--</TD><TD class=alignCenter>--</TD><TD class=alignCenter>0</TD><TD class=alignCenter>161</TD><TD class=alignCenter>33</TD><TD class=alignCenter>8</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>272</TD><TD class=alignCenter>42</TD><TD class=alignCenter>6</TD><TD class=alignCenter>17</TD><TD class=alignCenter>8</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>49</TD><TD class=alignCenter>9</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>274</TD><TD class=alignCenter>51</TD><TD class=alignCenter>18</TD><TD class=alignCenter>3</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>YT</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>15</TD><TD class=alignCenter>3</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NT</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>46</TD><TD class=alignCenter>7</TD><TD class=alignCenter>1</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NU</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>72</TD><TD class=alignCenter>6</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>18</TD><TD class=alignCenter>7</TD><TD class=alignCenter>2</TD><TD class=alignCenter>7048</TD><TD class=alignCenter>1141</TD><TD class=alignCenter>340</TD><TD class=alignCenter>1489</TD><TD class=alignCenter>292</TD><TD class=alignCenter>78</TD></TR></TBODY></TABLE>
Descriptive characteristics of laboratory-confirmed Canadian Pandemic (H1N1) 2009 hospitalized cases, ICU-admitted cases and deaths with core information available, reported to PHAC as of January 9, 2010<SUP><SUP>?</SUP> </SUP>

<TABLE class=fontSize85 cellSpacing=0 cellPadding=2 border=1><COLGROUP><COL width=98><COL width=95><COL width=82><COL width=69><COL width=97><COL width=77><COL width=59><COL width=96><COL width=82><COL width=67><TBODY><TR><TD rowSpan=2></TD><TH class=bg-colour-blue colSpan=3>From April 12 to August 29, 2009</TH><TH class=bg-colour-blue colSpan=3>From Aug. 30, 2009 to Jan. 9, 2010</TH><TH class=bg-colour-blue colSpan=3>Cumulative:
From April 12, 2009 to Jan. 9, 2010
</TH></TR><TR><TH class=bg-colour-blue>Hospitalized cases (n=1,489)</TH><TH class=bg-colour-blue>ICU-admitted
(n=292)
</TH><TH class=bg-colour-blue>Deaths
(n=78)
</TH><TH class=bg-colour-blue>Hospitalized
cases (n=6,564)
</TH><TH class=bg-colour-blue>ICU-admitted
(n=1,141)
</TH><TH class=bg-colour-blue>Deaths
(n=336)
</TH><TH class=bg-colour-blue>Hospitalized
cases
(n=8,053)
</TH><TH class=bg-colour-blue>ICU-admitted
(n=1,433)
</TH><TH class=bg-colour-blue>Deaths
(n=414)
</TH></TR><TR><TH class="bg-colour-blue alignLeft">Females, %</TH><TD class=alignCenter>51.3</TD><TD class=alignCenter>57.2</TD><TD class=alignCenter>62.8</TD><TD class=alignCenter>49.7</TD><TD class=alignCenter>49.6</TD><TD class=alignCenter>47.3</TD><TD class=alignCenter>50.0</TD><TD class=alignCenter>51.2</TD><TD class=alignCenter>50.2</TD></TR><TR><TH class="bg-colour-blue alignLeft">Median age</TH><TD class=alignCenter>23.0</TD><TD class=alignCenter>37.0</TD><TD class=alignCenter>51.0</TD><TD class=alignCenter>30.0</TD><TD class=alignCenter>47.0</TD><TD class=alignCenter>54.0</TD><TD class=alignCenter>29.0</TD><TD class=alignCenter>46.0</TD><TD class=alignCenter>53.0</TD></TR><TR><TH class="bg-colour-blue alignLeft">Aboriginal status<SUP>1</SUP>, % </TH><TD class=alignCenter>20.2</TD><TD class=alignCenter>16.1</TD><TD class=alignCenter>11.5</TD><TD class=alignCenter>4.4</TD><TD class=alignCenter>6.0</TD><TD class=alignCenter>6.3</TD><TD class=alignCenter>7.3</TD><TD class=alignCenter>8.0</TD><TD class=alignCenter>7.2</TD></TR><TR><TH class="bg-colour-blue alignLeft">Underlying medical conditions<SUP>2</SUP>, %</TH><TD class=alignCenter>46.8
(646/1,380)
</TD><TD class=alignCenter>58.2
(159/274)
</TD><TD class=alignCenter>71.1
(54/76)
</TD><TD class=alignCenter>53.2
(1,710/3,217)
</TD><TD class=alignCenter>63.0
(563/893)
</TD><TD class=alignCenter>77.1
(219/284)
</TD><TD class=alignCenter>51.3
(2,356/4,597)
</TD><TD class=alignCenter>61.9
(722/1,167)
</TD><TD class=alignCenter>75.8
(273/360)
</TD></TR><TR><TH class="bg-colour-blue alignLeft">Pregnancy<SUP>3</SUP>, %</TH><TD class=alignCenter>28.0 (77/275)</TD><TD class=alignCenter>19.7 (15/76)</TD><TD class=alignCenter>28.6 (4/14)</TD><TD class=alignCenter>18.5 (185/1,002)</TD><TD class=alignCenter>8.5 (15/176)</TD><TD class=alignCenter>0.0</TD><TD class=alignCenter>20.5 (262/1,277)</TD><TD class=alignCenter>11.9 (30/252)</TD><TD class=alignCenter>8.0
(4/50)
</TD></TR><TR><TD colSpan=10><SUP>1 </SUP>These proportions are underestimates.
<SUP>2</SUP> Proportion of cases with at least one underlying medical condition (excluding pregnancy) among those for whom the information was available. Missing/unknown information has been removed from all calculations except for data reported on underlying condition from MB and ON, where it was not possible to delineate missing information from absence of underlying condition. For these two provinces, missing information has been included in the denominator. Note that Ontario retrospectively provided information to PHAC on underlying medical conditions of fatal cases. This increased the proportion of underlying medical conditions among deaths.
<SUP>3</SUP> Percent of pregnant women among women 15 to 44 years of age.
?Note that due to reporting delays, some PTs reported retrospectively on first wave cases.

</TD></TR></TBODY></TABLE>

Overall Influenza Summary - Week 1 (January 3, 2010 to January 9, 2010)

During week 1, all influenza indicators were either back to baseline or considerably under the expected level for this time of the year. The national ILI consultations rate were significantly below the expected range for this time of the year with 17 consultations per 1,000 patient visits. Only 1.3% of the specimens tested were positive for influenza compared to 16.4% for the respiratory syncytial virus.
In week 1, only one region (in ON) reported localized activity. Thirty-one regions in BC, AB, SK, MB, ON, QC, NB & NS reported sporadic activity, while twenty-two regions reported no activity in AB, ON, QC, NB, PE, NS, NL, YT & NT. No influenza outbreaks were reported this week.


<TABLE class=widthFull cellSpacing=0 cellPadding=0><TBODY><TR class=alignCenter><TD colSpan=2>Map of overall Influenza activity level by provinces and territories, Week 1, Canada



</TD></TR><TR class=alignCenter><TD>

</TD><TD><TABLE cellSpacing=0 cellPadding=1 border=0><TBODY><TR><TD align=middle><TABLE class=border-lite cellSpacing=1 cellPadding=1><TBODY><TR align=middle><TD>No Data </TD><TD>
leg_dots.gif
</TD></TR><TR class=alignCenter><TD>No Activity</TD><TD>
leg_ffffff.gif
</TD></TR><TR class=alignCenter><TD>Sporadic Activity</TD><TD>
leg_ccccff.gif
</TD></TR><TR align=middle><TD>Localized Activity</TD><TD>
leg_6666ff.gif
</TD></TR><TR align=middle><TD>Widespread
Activity
</TD><TD>
leg_000066.gif
</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR><TR><TD class=fontSize85 colSpan=2>Note: Influenza 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 (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.

</TD></TR></TBODY></TABLE>
Number of influenza surveillance regions<SUP>?</SUP> reporting widespread or localized influenza activity,
Canada, by report week, 2009-2010 (N=54)

2010-w01-fg1-eng.gif

flu0910-leg-fg1-eng.gif

? sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.

Overall Number of Influenza Outbreaks, Canada, by Report Week, 2009-2010

2010-w01-fg2-eng.gif

flu0910-leg-fg2-eng.gif

Note that this was the first year that all the provinces and territories were reporting on influenza outbreaks in schools (greater than 10% absenteeism on any day most likely due to ILI) which has increased considerably the total number of outbreaks reported compared to previous years.

ILI consultation rate
During week 1, the national ILI consultations rate was 17 consultations per 1,000 patient visits (see ILI graph) which was significantly below the expected range for this time of the year. All provinces and territories had either similar or lower ILI consultation rates compared to their respective ILI rates in the previous week. Those under 20 years of age still had the highest consultation rates, with 49 and 21 per 1,000 patient visits among children under 5 years of age and among those 5 to 19 years of age, respectively.
Influenza-like illness (ILI) consultation rates, Canada, by report week,
2009-2010 compared to 1996/97 through to 2008/09 seasons

2010-w01-fg3-eng.gif


flu0910-leg-fg3-eng.gif

Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons).
Delays in the reporting of data may cause data to change retrospectively.
Paediatric Influenza Hospitalizations and Deaths
In week 1, no laboratory-confirmed influenza-associated paediatric hospitalizations were reported through the Immunization Monitoring Program Active (IMPACT) network. 1,328 hospitalizations have been reported since week 17 (April 26): 97.1% of these hospitalizations were due to Pandemic (H1N1) 2009. Since the beginning of the pandemic, eleven paediatric deaths due to Pandemic (H1N1) 2009 were reported through the IMPACT network among children 16 years of age or under.
Laboratory Surveillance Summary
The proportion of tests that were positive for influenza was 1.3% during week 1 which represented a significant decrease since the peak observed during week 44 (see Tests table). All provinces had a lower proportion of positive tests for influenza compared to the previous week except ON and PEI. During week 1, a total of 41 specimens tested positive for influenza (40 A and 1 B) and 100% of the positive influenza A subtyped specimens were Pandemic (H1N1) 2009. Note that QC reported 44 positive specimen for A/H3N2 and 7 specimen for influenza B since August 30, 2009.
The proportion of positive respiratory syncytial virus tests was 16.4% during week 1 which was higher than the proportion observed for positive influenza tests over the past weeks. The proportion of positive parainfluenza tests was also slightly higher than the proportion of positive tests for influenza.

Influenza tests reported and percentage of tests positive, Canada,
by report week, 2009-2010

2010-w01-fg4-eng.gif

flu0910-leg-fg4-eng.gif


Percent positive influenza tests, compared to other respiratory viruses, Canada,
by reporting week, 2009-2010


2010-w01-fg5-eng.gif


flu0910-leg-fg5-eng.gif

Weekly & Cumulative numbers of positive influenza specimens, by Provincial Laboratories

<TABLE class=widthFull cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD class=fontSize85 colSpan=13>Note: Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals.
* Not subtyped

</TD></TR></TFOOT><TBODY></TBODY></TABLE>
http://www.phac-aspc.gc.ca/fluwatch/09-10/w01_10/index-eng.php
 
Re: Canada - FluWatch Pandemic (H1N1) 2009 virus Surveillance Week 2

Re: Canada - FluWatch Pandemic (H1N1) 2009 virus Surveillance Week 2

January 10 to January 16, 2010 (Week 2)



Posted 2010-01-22

Weekly and cumulative numbers of hospitalized cases, ICU admissions and deaths among Pandemic (H1N1) 2009 confirmed cases, Canada, to January 16, 2010?

<TABLE class="widthFull fontSize85" cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD colSpan=10><SUP id=star>*</SUP>Based on reporting date.
<SUP id=dstar>**</SUP>Based on epidemiological date, hospitalization date, death date and reporting date.
<SUP>1 </SUP>These provinces reported aggregate counts this week.
<SUP>2</SUP> Note change in total hospitalizations from last week's report: duplicates were removed.
<SUP>3</SUP>The new numbers reflect the situation since Jan. 4, 2010.
?Note that due to reporting delays, some PTs reported retrospectively on first wave cases.

</TD></TR></TFOOT><TBODY><TR><TH class=bg-colour-blue scope=col rowSpan=2>Province/
Territory
</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>Week 2
(January 10 to 16, 2010)*
</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>From August 30, 2009 to
January 16, 2010**
</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>From April 12 to August 29, 2009**</TH></TR><TR><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH></TR><TR><TH class=bg-colour-blue scope=row>BC<SUP>1,2</SUP></TH><TD class=alignCenter>--</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>981</TD><TD class=alignCenter>132</TD><TD class=alignCenter>50</TD><TD class=alignCenter>51</TD><TD class=alignCenter>20</TD><TD class=alignCenter>6</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>5</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1144</TD><TD class=alignCenter>208</TD><TD class=alignCenter>64</TD><TD class=alignCenter>129</TD><TD class=alignCenter>29</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>43</TD><TD class=alignCenter>39</TD><TD class=alignCenter>11</TD><TD class=alignCenter>23</TD><TD class=alignCenter>12</TD><TD class=alignCenter>4</TD></TR><TR><TH class=bg-colour-blue scope=row>MB<SUP>3</SUP></TH><TD class=alignCenter>10</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>161</TD><TD class=alignCenter>18</TD><TD class=alignCenter>4</TD><TD class=alignCenter>222</TD><TD class=alignCenter>43</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>11</TD><TD class=alignCenter>1</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1422</TD><TD class=alignCenter>240</TD><TD class=alignCenter>98</TD><TD class=alignCenter>392</TD><TD class=alignCenter>68</TD><TD class=alignCenter>25</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2483</TD><TD class=alignCenter>360</TD><TD class=alignCenter>81</TD><TD class=alignCenter>572</TD><TD class=alignCenter>104</TD><TD class=alignCenter>27</TD></TR><TR><TH class=bg-colour-blue scope=row>NB<SUP>1</SUP></TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>161</TD><TD class=alignCenter>33</TD><TD class=alignCenter>8</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>272</TD><TD class=alignCenter>42</TD><TD class=alignCenter>6</TD><TD class=alignCenter>17</TD><TD class=alignCenter>8</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>49</TD><TD class=alignCenter>9</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>274</TD><TD class=alignCenter>51</TD><TD class=alignCenter>18</TD><TD class=alignCenter>3</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>YT</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>15</TD><TD class=alignCenter>3</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NT</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>46</TD><TD class=alignCenter>7</TD><TD class=alignCenter>1</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NU?</TH><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>74</TD><TD class=alignCenter>6</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>29</TD><TD class=alignCenter>1</TD><TD class=alignCenter>4</TD><TD class=alignCenter>7057</TD><TD class=alignCenter>1142</TD><TD class=alignCenter>344</TD><TD class=alignCenter>1492</TD><TD class=alignCenter>292</TD><TD class=alignCenter>78</TD></TR></TBODY></TABLE>
Descriptive characteristics of laboratory-confirmed Canadian Pandemic (H1N1) 2009 hospitalized cases, ICU-admitted cases and deaths with core information available, reported to PHAC as of January 16, 2010<SUP><SUP>?</SUP> </SUP>

<TABLE class=fontSize85 cellSpacing=0 cellPadding=2 border=1><COLGROUP><COL width=98><COL width=95><COL width=82><COL width=69><COL width=97><COL width=77><COL width=59><COL width=96><COL width=82><COL width=67><TBODY><TR><TD rowSpan=2></TD><TH class=bg-colour-blue colSpan=3>From April 12 to August 29, 2009</TH><TH class=bg-colour-blue colSpan=3>From August 30, 2009 to January 16, 2010</TH><TH class=bg-colour-blue colSpan=3>Cumulative: From
April 12, 2009 to January 16, 2010
</TH></TR><TR><TH class=bg-colour-blue>Hospitalized cases (n=1492)</TH><TH class=bg-colour-blue>ICU-admitted
(n=292)
</TH><TH class=bg-colour-blue>Deaths
(n=78)
</TH><TH class=bg-colour-blue>Hospitalized
cases (n=6601)
</TH><TH class=bg-colour-blue>ICU-admitted
(n=1142)
</TH><TH class=bg-colour-blue>Deaths
(n=339)
</TH><TH class=bg-colour-blue>Hospitalized
cases
(n=8093)
</TH><TH class=bg-colour-blue>ICU-admitted
(n=1434)
</TH><TH class=bg-colour-blue>Deaths
(n=417)
</TH></TR><TR><TH class="bg-colour-blue alignLeft">Females, %</TH><TD class=alignCenter>51.3</TD><TD class=alignCenter>57.2</TD><TD class=alignCenter>62.8</TD><TD class=alignCenter>49.7</TD><TD class=alignCenter>49.6</TD><TD class=alignCenter>46.9</TD><TD class=alignCenter>50.0</TD><TD class=alignCenter>51.1</TD><TD class=alignCenter>49.9</TD></TR><TR><TH class="bg-colour-blue alignLeft">Median age</TH><TD class=alignCenter>23.0</TD><TD class=alignCenter>37.0</TD><TD class=alignCenter>51.0</TD><TD class=alignCenter>30.0</TD><TD class=alignCenter>47.0</TD><TD class=alignCenter>54.0</TD><TD class=alignCenter>28.0</TD><TD class=alignCenter>46.0</TD><TD class=alignCenter>53.0</TD></TR><TR><TH class="bg-colour-blue alignLeft">Aboriginal status<SUP>1</SUP>, % </TH><TD class=alignCenter>20.2-27.9</TD><TD class=alignCenter>16.1-21.8</TD><TD class=alignCenter>11.5-17.3</TD><TD class=alignCenter>4.5-5.6</TD><TD class=alignCenter>6.0-7.9</TD><TD class=alignCenter>6.2-8.8</TD><TD class=alignCenter>7.4-9.3</TD><TD class=alignCenter>8.0-10.7</TD><TD class=alignCenter>7.2-10.3</TD></TR><TR><TH class="bg-colour-blue alignLeft">Underlying medical
conditions<SUP>2</SUP>, %
</TH><TD class=alignCenter>46.8
(647/1383)
</TD><TD class=alignCenter>58.0
(159/274)
</TD><TD class=alignCenter>71.1
(54/76)
</TD><TD class=alignCenter>53.2
(1726/3246)
</TD><TD class=alignCenter>62.8
(561/893)
</TD><TD class=alignCenter>77.2
(220/285)
</TD><TD class=alignCenter>51.3
(2373/4629)
</TD><TD class=alignCenter>61.7
(720/1167)
</TD><TD class=alignCenter>75.9
(274/361)
</TD></TR><TR><TH class="bg-colour-blue alignLeft">Pregnancy<SUP>3</SUP>, %</TH><TD class=alignCenter>28.0
(77/275)
</TD><TD class=alignCenter>19.7
(15/76)
</TD><TD class=alignCenter>28.6
(4/14)
</TD><TD class=alignCenter>18.4
(186/1012)
</TD><TD class=alignCenter>8.5
(15/176)
</TD><TD class=alignCenter>0.0</TD><TD class=alignCenter>20.4
(263/1287)
</TD><TD class=alignCenter>11.9
(30/252)
</TD><TD class=alignCenter>8.0
(4/50)
</TD></TR><TR><TD colSpan=10><SUP>1 </SUP>Aboriginal peoples represent 3.5% of the Canadian population; however, for this analysis, Aboriginal peoples account for 2.7% of the Canadian population since Aboriginal status was not reported by two provinces where 23% of the Aboriginal population lives (ON, NS). Two methods were used to calculate proportions: one proportion was calculated by including ON and NS cases in the denominator (which is an underestimate of the true proportion); while the other proportion was calculated by excluding ON and NS cases in the denominator (which is an overestimate). The true proportion of affected Aboriginal peoples lies between these two estimates.
<SUP>2 </SUP>Proportion of cases with at least one underlying medical condition (excluding pregnancy) among those for whom the information was available.
<SUP>3</SUP> Percent of pregnant women among women 15 to 44 years of age.
? All cases admitted to ICU are included in the hospitalization count; however, not all the death cases have been previously hospitalized.

</TD></TR></TBODY></TABLE>

Overall Influenza Summary - Week 2 (January 10 to January 16, 2010)

During week 2, all influenza indicators were still either back to baseline or considerably under the expected level for this time of the year. The national ILI consultation rate slightly increased compared to the previous week but was significantly below the expected range for this time of the year with 21 consultations per 1,000 patient visits. Only 0.6% of the specimens tested were positive for influenza compared to 16.6% for the respiratory syncytial virus.
In week 2, only one region (in ON) reported localized activity. Twenty-six regions in BC, AB, SK, MB, ON, QC, NB, NS & NU reported sporadic activity, while twenty-seven regions reported no activity in AB, SK, ON, QC, NB, PE, NS, NL, YT & NT. No influenza outbreaks were reported this week.


<TABLE class=widthFull cellSpacing=0 cellPadding=0><TBODY><TR class=alignCenter><TD colSpan=2>Map of overall Influenza activity level by provinces and territories, Week 2, Canada



</TD></TR><TR class=alignCenter><TD>

</TD><TD><TABLE cellSpacing=0 cellPadding=1 border=0><TBODY><TR><TD align=middle><TABLE class=border-lite cellSpacing=1 cellPadding=1><TBODY><TR align=middle><TD>No Data </TD><TD>
leg_dots.gif
</TD></TR><TR class=alignCenter><TD>No Activity</TD><TD>
leg_ffffff.gif
</TD></TR><TR class=alignCenter><TD>Sporadic Activity</TD><TD>
leg_ccccff.gif
</TD></TR><TR align=middle><TD>Localized Activity</TD><TD>
leg_6666ff.gif
</TD></TR><TR align=middle><TD>Widespread
Activity
</TD><TD>
leg_000066.gif
</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR><TR><TD class=fontSize85 colSpan=2>Note: Influenza 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 (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.

</TD></TR></TBODY></TABLE>
Number of influenza surveillance regions<SUP>?</SUP> reporting widespread or localized influenza activity,
Canada, by report week, 2009-2010 (N=54)

2010-w02-fg1-eng.gif

flu0910-leg-fg1-eng.gif

? sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.

Overall Number of Influenza Outbreaks, Canada, by Report Week, 2009-2010

2010-w02-fg2-eng.gif

flu0910-leg-fg2-eng.gif

Note that this was the first year that all the provinces and territories were reporting on influenza outbreaks in schools (greater than 10% absenteeism on any day most likely due to ILI) which has increased considerably the total number of outbreaks reported compared to previous years.

ILI consultation rate
During week 2, the national ILI consultation rate was 21 consultations per 1,000 patient visits (see ILI graph) which slightly higher than last week but still significantly below the expected range for this time of the year. All provinces and territories had either similar or slightly higher ILI consultation rate compared to their respective ILI rates in the previous week except NS which had a lower rate this week. Those under 20 years of age still had the highest consultation rates, with 52 and 35 per 1,000 patient visits among children under 5 years of age and among those 5 to 19 years of age, respectively.
Influenza-like illness (ILI) consultation rates, Canada, by report week,
2009-2010 compared to 1996/97 through to 2008/09 seasons

2010-w02-fg3-eng.gif


flu0910-leg-fg3-eng.gif

Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons).
Delays in the reporting of data may cause data to change retrospectively.
Paediatric Influenza Hospitalizations and Deaths
In week 2, no laboratory-confirmed influenza-associated paediatric hospitalizations were reported through the Immunization Monitoring Program Active (IMPACT) network. 1,328 hospitalizations have been reported since week 17 (April 26): 97.1% of these hospitalizations were due to Pandemic (H1N1) 2009. Since the beginning of the pandemic, eleven paediatric deaths due to Pandemic (H1N1) 2009 were reported through the IMPACT network among children 16 years of age or under.
Laboratory Surveillance Summary
The proportion of tests that were positive for influenza was 0.6% during week 2 which remained low for a fourth consecutive week (see Tests table). All provinces had a lower proportion of positive tests for influenza compared to the previous week except QC which had similar proportions. During week 2, a total of 15 specimens tested positive for influenza (14 A and 1 B) and 100% of the positive influenza A subtyped specimens were Pandemic (H1N1) 2009. Note that QC reported 44 positive specimen for A/H3N2 and 7 specimen for influenza B while Ontario reported 5 specimen for influenza B since August 30, 2009.
The proportion of positive respiratory syncytial virus tests was 16.6% during week 2 which was still higher than the proportion observed for positive influenza tests over the past weeks.The proportion of positive parainfluenza and adenovirus tests were also slightly higher than the proportion of positive tests for influenza.

Influenza tests reported and percentage of tests positive, Canada,
by report week, 2009-2010

2010-w02-fg4-eng.gif

flu0910-leg-fg4-eng.gif


Percent positive influenza tests, compared to other respiratory viruses, Canada,
by reporting week, 2009-2010


2010-w02-fg5-eng.gif


flu0910-leg-fg5-eng.gif

Weekly & Cumulative numbers of positive influenza specimens, by Provincial Laboratories

<TABLE class=widthFull cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD class=fontSize85 colSpan=13>Note: Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals.
* Not subtyped

</TD></TR></TFOOT><TBODY></TBODY></TABLE>
http://www.phac-aspc.gc.ca/fluwatch/09-10/w02_10/index-eng.php
 
Re: Canada - FluWatch Pandemic (H1N1) 2009 virus Surveillance Week 3

Re: Canada - FluWatch Pandemic (H1N1) 2009 virus Surveillance Week 3

January 17 to January 23, 2010 (Week 3)



Posted 2010-01-29

Weekly and cumulative numbers of hospitalized cases, ICU admissions and deaths among Pandemic H1N1 2009 confirmed cases, Canada, to January 23, 2010?

<TABLE class="widthFull fontSize85" cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD colSpan=10><SUP id=star>*</SUP>Based on reporting date.
<SUP id=dstar>**</SUP>Based on epidemiological date, hospitalization date, death date and reporting date.
<SUP>1 </SUP>These provinces reported aggregate counts this week.
<SUP>2</SUP>The cumulative number of hospitalizations has decreased as it was determined some cases were out patients.
?Note that due to reporting delays, some PTs reported retrospectively on first wave cases.


</TD></TR></TFOOT><TBODY><TR class=alignCenter><TH class=bg-colour-blue scope=col rowSpan=2>Province/
Territory

</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>Week 3
(January 17 to 23, 2010)*

</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>From August 30, 2009 to
January 23, 2010**

</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>From April 12 to August 29, 2009**</TH></TR><TR class=alignCenter><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH></TR><TR><TH class=bg-colour-blue scope=row>BC<SUP>1</SUP></TH><TD class=alignCenter>0</TD><TD class=alignCenter>4</TD><TD class=alignCenter>0</TD><TD class=alignCenter>980</TD><TD class=alignCenter>136</TD><TD class=alignCenter>50</TD><TD class=alignCenter>52</TD><TD class=alignCenter>20</TD><TD class=alignCenter>6</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>2</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1146</TD><TD class=alignCenter>210</TD><TD class=alignCenter>64</TD><TD class=alignCenter>129</TD><TD class=alignCenter>29</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>44</TD><TD class=alignCenter>40</TD><TD class=alignCenter>11</TD><TD class=alignCenter>23</TD><TD class=alignCenter>12</TD><TD class=alignCenter>4</TD></TR><TR><TH class=bg-colour-blue scope=row>MB<SUP>2</SUP></TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>155</TD><TD class=alignCenter>18</TD><TD class=alignCenter>4</TD><TD class=alignCenter>222</TD><TD class=alignCenter>43</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>29</TD><TD class=alignCenter>6</TD><TD class=alignCenter>3</TD><TD class=alignCenter>1443</TD><TD class=alignCenter>245</TD><TD class=alignCenter>101</TD><TD class=alignCenter>400</TD><TD class=alignCenter>69</TD><TD class=alignCenter>25</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>6</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2489</TD><TD class=alignCenter>361</TD><TD class=alignCenter>81</TD><TD class=alignCenter>572</TD><TD class=alignCenter>104</TD><TD class=alignCenter>27</TD></TR><TR><TH class=bg-colour-blue scope=row>NB<SUP>1</SUP></TH><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>162</TD><TD class=alignCenter>33</TD><TD class=alignCenter>8</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>272</TD><TD class=alignCenter>42</TD><TD class=alignCenter>6</TD><TD class=alignCenter>17</TD><TD class=alignCenter>8</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>49</TD><TD class=alignCenter>9</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>274</TD><TD class=alignCenter>51</TD><TD class=alignCenter>18</TD><TD class=alignCenter>3</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>YT</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>15</TD><TD class=alignCenter>3</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NT</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>46</TD><TD class=alignCenter>7</TD><TD class=alignCenter>1</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NU?</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>74</TD><TD class=alignCenter>6</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>39</TD><TD class=alignCenter>14</TD><TD class=alignCenter>3</TD><TD class=alignCenter>7081</TD><TD class=alignCenter>1155</TD><TD class=alignCenter>347</TD><TD class=alignCenter>1501</TD><TD class=alignCenter>293</TD><TD class=alignCenter>78</TD></TR></TBODY></TABLE>
Descriptive characteristics of laboratory-confirmed Canadian Pandemic H1N1 2009 hospitalized cases, ICU-admitted cases and deaths with core information available, reported to PHAC as of January 23, 2010<SUP><SUP>?</SUP> </SUP>

<TABLE class=fontSize85 cellSpacing=0 cellPadding=2 border=1><COLGROUP><COL width=98><COL width=95><COL width=82><COL width=69><COL width=97><COL width=77><COL width=59><COL width=96><COL width=82><COL width=67><TBODY><TR class=alignCenter><TD rowSpan=2></TD><TH class=bg-colour-blue colSpan=3>From April 12 to August 29, 2009</TH><TH class=bg-colour-blue colSpan=3>From August 30, 2009 to January 23, 2010</TH><TH class=bg-colour-blue colSpan=3>Cumulative: From
April 12, 2009 to January 23, 2010

</TH></TR><TR class=alignCenter><TH class=bg-colour-blue>Hospitalized cases (n=1501)</TH><TH class=bg-colour-blue>ICU-admitted
(n=293)

</TH><TH class=bg-colour-blue>Deaths
(n=78)

</TH><TH class=bg-colour-blue>Hospitalized
cases (n=6659)

</TH><TH class=bg-colour-blue>ICU-admitted
(n=1155)

</TH><TH class=bg-colour-blue>Deaths
(n=343)

</TH><TH class=bg-colour-blue>Hospitalized
cases
(n=8160)

</TH><TH class=bg-colour-blue>ICU-admitted
(n=1448)

</TH><TH class=bg-colour-blue>Deaths
(n=421)

</TH></TR><TR><TH class="bg-colour-blue alignLeft">Females, %</TH><TD class=alignCenter>51.5</TD><TD class=alignCenter>57.2</TD><TD class=alignCenter>62.8</TD><TD class=alignCenter>49.7</TD><TD class=alignCenter>49.7</TD><TD class=alignCenter>46.6</TD><TD class=alignCenter>50.0</TD><TD class=alignCenter>51.2</TD><TD class=alignCenter>49.6</TD></TR><TR><TH class="bg-colour-blue alignLeft">Median age</TH><TD class=alignCenter>23.0</TD><TD class=alignCenter>37.0</TD><TD class=alignCenter>51.0</TD><TD class=alignCenter>30.0</TD><TD class=alignCenter>47.0</TD><TD class=alignCenter>54.0</TD><TD class=alignCenter>28.0</TD><TD class=alignCenter>46.0</TD><TD class=alignCenter>53.0</TD></TR><TR><TH class="bg-colour-blue alignLeft">Aboriginal status<SUP>1</SUP>, % </TH><TD class=alignCenter>20.1-27.9</TD><TD class=alignCenter>16.0-21.8</TD><TD class=alignCenter>11.5-17.3</TD><TD class=alignCenter>4.6-6.1</TD><TD class=alignCenter>5.9-7.8</TD><TD class=alignCenter>6.1-8.8</TD><TD class=alignCenter>7.4-10.0</TD><TD class=alignCenter>7.9-10.6</TD><TD class=alignCenter>7.1-10.3</TD></TR><TR><TH class="bg-colour-blue alignLeft">Underlying medical
conditions<SUP>2</SUP>, %

</TH><TD class=alignCenter>46.6
(648/1392)

</TD><TD class=alignCenter>57.8
(159/275)

</TD><TD class=alignCenter>71.1
(54/76)

</TD><TD class=alignCenter>53.2
(1748/3285)

</TD><TD class=alignCenter>62.9
(569/904)

</TD><TD class=alignCenter>76.0
(218/287)

</TD><TD class=alignCenter>51.2
(2396/4677)

</TD><TD class=alignCenter>61.7
(728/1179)

</TD><TD class=alignCenter>74.9
(272/363)

</TD></TR><TR><TH class="bg-colour-blue alignLeft">Pregnancy<SUP>3</SUP>, %</TH><TD class=alignCenter>28.0
(77/275)

</TD><TD class=alignCenter>19.7
(15/76)

</TD><TD class=alignCenter>28.6
(4/14)

</TD><TD class=alignCenter>18.4
(188/1019)

</TD><TD class=alignCenter>8.4
(15/179)

</TD><TD class=alignCenter>2.8
(1/36)

</TD><TD class=alignCenter>20.5
(265/1294)

</TD><TD class=alignCenter>11.8
(30/255)

</TD><TD class=alignCenter>10.0
(5/50)

</TD></TR><TR><TD colSpan=10><SUP>1 </SUP>Since Aboriginal status is not reported by two provinces (which comprise 23% of the Aboriginal population) two methods were used to calculate proportions: one proportion was calculated by including ON and NS cases in the denominator (which is an underestimate of the true proportion); while the other proportion was calculated by excluding ON and NS cases in the denominator (which is an overestimate).
<SUP>2 </SUP>Proportion of cases with at least one underlying medical condition (excluding pregnancy) among those for whom the information was available.
<SUP>3</SUP> Percent of pregnant women among women 15 to 44 years of age.
? All cases admitted to ICU are included in the hospitalization count; however, not all the fatal cases have been hospitalized before dying.


</TD></TR></TBODY></TABLE>

Overall Influenza Summary - Week 3 (January 17 to January 23, 2010)

During week 3, all influenza indicators continued to be either at baseline levels or considerably under the expected levels for this time of the year. Only 0.04% of the specimens tested were positive for influenza and the pandemic H1N1 2009 strain still accounted for 100% of the positive influenza A subtyped specimens this week. Only one specimen tested positive for influenza B. While influenza activity was very low, the respiratory syncitial virus transmission continued to increase.
In week 3, only three regions (BC, ON) reported localized activity. Fourteen regions in BC, AB, ON, QC, NB & NS reported sporadic activity, while thirty-two regions reported no activity in AB, SK, MB, ON, QC, NB, PE, NS, NL, YT, NT & NU. The 3 influenza outbreaks reported this week were all in schools and occured in BC (1) and NB (2).


<TABLE class=widthFull cellSpacing=0 cellPadding=0><TBODY><TR class=alignCenter><TD colSpan=2>Map of overall Influenza activity level by provinces and territories, Week 3, Canada




</TD></TR><TR class=alignCenter><TD>


</TD><TD><TABLE cellSpacing=0 cellPadding=1 border=0><TBODY><TR><TD align=middle><TABLE class=border-lite cellSpacing=1 cellPadding=1><TBODY><TR align=middle><TD>No Data </TD><TD>
leg_dots.gif
</TD></TR><TR class=alignCenter><TD>No Activity</TD><TD>
leg_ffffff.gif
</TD></TR><TR class=alignCenter><TD>Sporadic Activity</TD><TD>
leg_ccccff.gif
</TD></TR><TR align=middle><TD>Localized Activity</TD><TD>
leg_6666ff.gif
</TD></TR><TR align=middle><TD>Widespread
Activity

</TD><TD>
leg_000066.gif
</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR><TR><TD class=fontSize85 colSpan=2>Note: Influenza 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 (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.


</TD></TR></TBODY></TABLE>
Number of influenza surveillance regions<SUP>?</SUP> reporting widespread or localized influenza activity,
Canada, by report week, 2009-2010 (N=54)

2010-w03-fg1-eng.gif

flu0910-leg-fg1-eng.gif

? sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.

Overall Number of Influenza Outbreaks, Canada, by Report Week, 2009-2010

2010-w03-fg2-eng.gif

flu0910-leg-fg2-eng.gif

Note that this was the first year that all the provinces and territories were reporting on influenza outbreaks in schools (greater than 10% absenteeism on any day most likely due to ILI) which has increased considerably the total number of outbreaks reported compared to previous years.

ILI consultation rate
During week 3, the national ILI consultation rate was 12 consultations per 1,000 patient visits (see ILI graph) which was similar to the previous weeks and still significantly below the expected range for this time of the year. All provinces and territories had either similar or slightly lower ILI consultation rates compared to their respective ILI rates in the previous week except SK which had a slightly higher rate this week. Those under 20 years of age still had the highest consultation rates, with 16 and 21 per 1,000 patient visits among children under 5 years of age and among those 5 to 19 years of age, respectively.
Influenza-like illness (ILI) consultation rates, Canada, by report week,
2009-2010 compared to 1996/97 through to 2008/09 seasons

2010-w03-fg3-eng.gif


flu0910-leg-fg3-eng.gif

Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons).
Delays in the reporting of data may cause data to change retrospectively.
Paediatric Influenza Hospitalizations and Deaths
In week 3, no laboratory-confirmed influenza-associated paediatric hospitalizations were reported through the Immunization Monitoring Program Active (IMPACT) network. 1328 hospitalizations have been reported since week 17 (April 26): 97.1% of these hospitalizations were due to pandemic H1N1 2009. Since the beginning of the pandemic, eleven paediatric deaths due to pandemic H1N1 2009 were reported through the IMPACT network among children 16 years of age or under.
Laboratory Surveillance Summary
The proportion of tests that were positive for influenza was 0.04% during week 3 which remained at very low level for a fifth consecutive week (see Tests table). All provinces had a lower proportion of positive tests for influenza compared to the previous week except ON and NB which had similar proportions. During week 3, a total of 8 specimens tested positive for influenza (7 A and 1 B) and 100% of the positive influenza A subtyped specimens were pandemic H1N1 2009. Note that QC reported 44 positive specimen for A/H3N2 and 7 specimen for influenza B while ON reported 6 specimen for influenza B since August 30, 2009. The proportion of positive respiratory syncytial virus tests increased to 21.4% during week 3. Positive specimens were reported from all provinces (data not shown).

Influenza tests reported and percentage of tests positive, Canada,
by report week, 2009-2010

2010-w03-fg4-eng.gif

flu0910-leg-fg4-eng.gif


Percent positive influenza tests, compared to other respiratory viruses, Canada,
by reporting week, 2009-2010


2010-w03-fg5-eng.gif


flu0910-leg-fg5-eng.gif

Weekly & Cumulative numbers of positive influenza specimens, by Provincial Laboratories

<TABLE class=widthFull cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD class=fontSize85 colSpan=13>


</TD></TR></TFOOT><TBODY><TR class=alignCenter><TH class=bg-colour-blue scope=col rowSpan=3>Reporting provinces</TH><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=6>Weekly (January 17 to January 23, 2010)</TH><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=6>Cumulative (August 30, 2009 to January 23, 2010)</TH></TR><TR class=alignCenter><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=5>Influenza A</TH><TH class="bg-colour-blue fontSize85" scope=col>B</TH><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=5>Influenza A</TH><TH class=bg-colour-blue scope=col>B</TH></TR><TR class=alignCenter><TH class="fontSize85 bg-colour-blue" scope=col>A Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H3)</TH><TH class="fontSize85 bg-colour-blue" scope=col>Pand H1N1</TH><TH class="fontSize85 bg-colour-blue" scope=col>A
(NS)*
</TH><TH class="fontSize85 bg-colour-blue" scope=col>Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H3)</TH><TH class="fontSize85 bg-colour-blue" scope=col>Pand H1N1</TH><TH class="fontSize85 bg-colour-blue" scope=col>A
(NS)*
</TH><TH class="fontSize85 bg-colour-blue" scope=col>Total</TH></TR><TR><TH class=bg-colour-blue scope=row>BC</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6369</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>5803</TD><TD class=alignCenter>565</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5860</TD><TD class=alignCenter>2</TD><TD class=alignCenter>5</TD><TD class=alignCenter>5755</TD><TD class=alignCenter>98</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2598</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>2298</TD><TD class=alignCenter>299</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1914</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1787</TD><TD class=alignCenter>127</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>7890</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3545</TD><TD class=alignCenter>4343</TD><TD class=alignCenter>6</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>10688</TD><TD class=alignCenter>1</TD><TD class=alignCenter>44</TD><TD class=alignCenter>10643</TD><TD class=alignCenter>0</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>NB</TH><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1856</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1835</TD><TD class=alignCenter>19</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>783</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>751</TD><TD class=alignCenter>32</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>97</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>96</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>951</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>951</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>7</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>7</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>39006</TD><TD class=alignCenter>6</TD><TD class=alignCenter>52</TD><TD class=alignCenter>33464</TD><TD class=alignCenter>5484</TD><TD class=alignCenter>14</TD></TR><TR><TD class=alignCenter scope=row colSpan=13>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces </TD></TR></TBODY></TABLE>

<TABLE class=widthFull cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD class=fontSize85 colSpan=13>Note: Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals.
* Not subtyped


</TD></TR></TFOOT><TBODY></TBODY></TABLE>
http://www.phac-aspc.gc.ca/fluwatch/09-10/w03_10/index-eng.php
 
Re: Canada - FluWatch Pandemic (H1N1) 2009 virus Surveillance Week 4

Re: Canada - FluWatch Pandemic (H1N1) 2009 virus Surveillance Week 4

January 24 to January 30, 2010 (Week 4)



Posted 2010-02-05

Weekly and cumulative numbers of hospitalized cases, ICU admissions and deaths among Pandemic H1N1 2009 confirmed cases, Canada, to January 30, 2010<SUP>?</SUP>

<TABLE class="widthFull fontSize85" cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD colSpan=10><SUP id=star>*</SUP>Based on reporting date.
<SUP id=dstar>**</SUP>Based on epidemiological date, hospitalization date, death date and reporting date.
<SUP>1</SUP> These provinces reported aggregate counts this week.
<SUP>2</SUP> The increase from last week is due to more detailed accounting of case reports from the second wave.
<SUP>3</SUP> The drop in the total number of cases is due to health units conducting data clean up and case re-classification.
? Note that due to reporting delays, some PTs reported retrospectively on first and second wave cases.

</TD></TR></TFOOT><TBODY><TR class=alignCenter><TH class=bg-colour-blue scope=col rowSpan=2>Province/
Territory
</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>Week 4
(January 24 to 30, 2010)*
</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>From August 30, 2009 to
January 30, 2010**
</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>From April 12 to August 29, 2009**</TH></TR><TR class=alignCenter><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH></TR><TR><TH class=bg-colour-blue scope=row>BC<SUP>1,2</SUP></TH><TD class=alignCenter>27</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1010</TD><TD class=alignCenter>136</TD><TD class=alignCenter>50</TD><TD class=alignCenter>49</TD><TD class=alignCenter>19</TD><TD class=alignCenter>6</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1147</TD><TD class=alignCenter>210</TD><TD class=alignCenter>64</TD><TD class=alignCenter>129</TD><TD class=alignCenter>29</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>44</TD><TD class=alignCenter>40</TD><TD class=alignCenter>11</TD><TD class=alignCenter>23</TD><TD class=alignCenter>12</TD><TD class=alignCenter>4</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>166</TD><TD class=alignCenter>18</TD><TD class=alignCenter>4</TD><TD class=alignCenter>213</TD><TD class=alignCenter>43</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>ON<SUP>3</SUP></TH><TD class=alignCenter>--</TD><TD class=alignCenter>--</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1427</TD><TD class=alignCenter>244</TD><TD class=alignCenter>102</TD><TD class=alignCenter>399</TD><TD class=alignCenter>69</TD><TD class=alignCenter>25</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2490</TD><TD class=alignCenter>361</TD><TD class=alignCenter>81</TD><TD class=alignCenter>572</TD><TD class=alignCenter>104</TD><TD class=alignCenter>27</TD></TR><TR><TH class=bg-colour-blue scope=row>NB<SUP>1</SUP></TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>162</TD><TD class=alignCenter>33</TD><TD class=alignCenter>8</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>272</TD><TD class=alignCenter>42</TD><TD class=alignCenter>6</TD><TD class=alignCenter>17</TD><TD class=alignCenter>8</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>49</TD><TD class=alignCenter>9</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>274</TD><TD class=alignCenter>51</TD><TD class=alignCenter>18</TD><TD class=alignCenter>3</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>YT</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>15</TD><TD class=alignCenter>3</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NT</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>46</TD><TD class=alignCenter>7</TD><TD class=alignCenter>1</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NU</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>74</TD><TD class=alignCenter>6</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>31</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>7108</TD><TD class=alignCenter>1154</TD><TD class=alignCenter>348</TD><TD class=alignCenter>1488</TD><TD class=alignCenter>292</TD><TD class=alignCenter>78</TD></TR></TBODY></TABLE>
Descriptive characteristics of laboratory-confirmed Canadian pandemic H1N1 2009 hospitalized cases, ICU-admitted cases and deaths with core information available, reported to PHAC as of January 30, 2010<SUP><SUP>?</SUP> </SUP>

<TABLE class=fontSize85 cellSpacing=0 cellPadding=2 border=1><COLGROUP><COL width=98><COL width=95><COL width=82><COL width=69><COL width=97><COL width=77><COL width=59><COL width=96><COL width=82><COL width=67><TBODY><TR class=alignCenter><TD rowSpan=2></TD><TH class=bg-colour-blue colSpan=3>From April 12 to August 29, 2009</TH><TH class=bg-colour-blue colSpan=3>From August 30, 2009 to January 30, 2010</TH><TH class=bg-colour-blue colSpan=3>Cumulative: From
April 12, 2009 to January 30, 2010
</TH></TR><TR class=alignCenter><TH class=bg-colour-blue>Hospitalized cases (n=1488)</TH><TH class=bg-colour-blue>ICU-admitted
(n=292)
</TH><TH class=bg-colour-blue>Deaths
(n=78)
</TH><TH class=bg-colour-blue>Hospitalized
cases (n=6654)
</TH><TH class=bg-colour-blue>ICU-admitted
(n=1155)
</TH><TH class=bg-colour-blue>Deaths
(n=344)
</TH><TH class=bg-colour-blue>Hospitalized
cases
(n=8142)
</TH><TH class=bg-colour-blue>ICU-admitted
(n=1446)
</TH><TH class=bg-colour-blue>Deaths
(n=422)
</TH></TR><TR><TH class="bg-colour-blue alignLeft">Females, %</TH><TD class=alignCenter>51.3</TD><TD class=alignCenter>57.2</TD><TD class=alignCenter>62.8</TD><TD class=alignCenter>49.7</TD><TD class=alignCenter>49.7</TD><TD class=alignCenter>46.8</TD><TD class=alignCenter>50.0</TD><TD class=alignCenter>51.2</TD><TD class=alignCenter>49.8</TD></TR><TR><TH class="bg-colour-blue alignLeft">Median age</TH><TD class=alignCenter>23.0</TD><TD class=alignCenter>37.0</TD><TD class=alignCenter>51.0</TD><TD class=alignCenter>30.0</TD><TD class=alignCenter>47.0</TD><TD class=alignCenter>54.0</TD><TD class=alignCenter>29.0</TD><TD class=alignCenter>46.0</TD><TD class=alignCenter>53.0</TD></TR><TR><TH class="bg-colour-blue alignLeft">Aboriginal status<SUP>1</SUP>, % </TH><TD class=alignCenter>20.0-27.8</TD><TD class=alignCenter>16.1-21.9</TD><TD class=alignCenter>11.5-17.3</TD><TD class=alignCenter>4.6-6.2</TD><TD class=alignCenter>5.9-7.8</TD><TD class=alignCenter>6.1-8.9</TD><TD class=alignCenter>7.4-10.0</TD><TD class=alignCenter>8.0-10.6</TD><TD class=alignCenter>7.1-10.4</TD></TR><TR><TH class="bg-colour-blue alignLeft">Underlying medical
conditions<SUP>2</SUP>, %
</TH><TD class=alignCenter>47.5
(652/1373)
</TD><TD class=alignCenter>60.2
(162/269)
</TD><TD class=alignCenter>73.3
(55/75)
</TD><TD class=alignCenter>54.6
(1753/3212)
</TD><TD class=alignCenter>63.8
(567/889)
</TD><TD class=alignCenter>78.4
(222/283)
</TD><TD class=alignCenter>52.5
(2405/4585)
</TD><TD class=alignCenter>63.0
(729/1158)
</TD><TD class=alignCenter>77.4
(277/358)
</TD></TR><TR><TH class="bg-colour-blue alignLeft">Pregnancy<SUP>3</SUP>, %</TH><TD class=alignCenter>27.6
(75/272)
</TD><TD class=alignCenter>19.7
(15/76)
</TD><TD class=alignCenter>28.6
(4/14)
</TD><TD class=alignCenter>18.5
(188/1017)
</TD><TD class=alignCenter>8.5
(15/177)
</TD><TD class=alignCenter>0.0
(0/36)
</TD><TD class=alignCenter>20.4
(263/1289)
</TD><TD class=alignCenter>11.9
(30/253)
</TD><TD class=alignCenter>8.0
(4/50)
</TD></TR><TR><TD colSpan=10><SUP>1 </SUP>Since Aboriginal status is not reported by two provinces (which comprise 23% of the Aboriginal population) two methods were used to calculate proportions: one proportion was calculated by including ON and NS cases in the denominator (which is an underestimate of the true proportion); while the other proportion was calculated by excluding ON and NS cases in the denominator (which is an overestimate).
<SUP>2 </SUP>Proportion of cases with at least one underlying medical condition (excluding pregnancy) among those for whom the information was available. Please note that results may differ slightly compared to the previous weeks due to updates in the national database.
<SUP>3</SUP> Percent of pregnant women among women 15 to 44 years of age.
?All cases admitted to ICU are included in the hospitalization count; however, not all the fatal cases have been hospitalized before dying.

</TD></TR></TBODY></TABLE>

Overall Influenza Summary - Week 4 (January 24 to January 30, 2010)

During week 4, all influenza indicators remained stable and continued to be either at baseline levels or considerably under the expected levels for this time of the year. While influenza activity was very low, the respiratory syncitial virus transmission continued to increase.
In week 4, only two regions (BC & NS) reported localized activity. Twenty-two regions in BC, AB, MB, ON, QC, NB, NS & NU reported sporadic activity, while thirty regions reported no activity in AB, SK, MB, ON, QC, NB, PE, NS, NL, YT & NT. 12 influenza outbreaks were reported this week; 11 in schools (2 in BC, 2 in NB and 7 in NS) while one occurred in a long-term care facility in NS.


<TABLE class=widthFull cellSpacing=0 cellPadding=0><TBODY><TR class=alignCenter><TD colSpan=2>Map of overall Influenza activity level by provinces and territories, Week 4, Canada



</TD></TR><TR class=alignCenter><TD>

</TD><TD><TABLE cellSpacing=0 cellPadding=1 border=0><TBODY><TR><TD align=middle><TABLE class=border-lite cellSpacing=1 cellPadding=1><TBODY><TR align=middle><TD>No Data </TD><TD>
leg_dots.gif
</TD></TR><TR class=alignCenter><TD>No Activity</TD><TD>
leg_ffffff.gif
</TD></TR><TR class=alignCenter><TD>Sporadic Activity</TD><TD>
leg_ccccff.gif
</TD></TR><TR align=middle><TD>Localized Activity</TD><TD>
leg_6666ff.gif
</TD></TR><TR align=middle><TD>Widespread
Activity
</TD><TD>
leg_000066.gif
</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR><TR><TD class=fontSize85 colSpan=2>Note: Influenza 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 (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.

</TD></TR></TBODY></TABLE>
Number of influenza surveillance regions<SUP>?</SUP> reporting widespread or localized influenza activity,
Canada, by report week, 2009-2010 (N=54)

2010-w04-fg1-eng.gif

flu0910-leg-fg1-eng.gif

? sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.

Overall Number of Influenza Outbreaks, Canada, by Report Week, 2009-2010

2010-w04-fg2-eng.gif

flu0910-leg-fg2-eng.gif

Note that this was the first year that all the provinces and territories were reporting on influenza outbreaks in schools (greater than 10% absenteeism on any day most likely due to ILI) which has increased considerably the total number of outbreaks reported compared to previous years.

ILI consultation rate
During week 4, the national ILI consultation rate was 16 consultations per 1,000 patient visits (see ILI graph) which was similar to the previous weeks and still significantly below the expected range for this time of the year. All provinces and territories had either similar or slightly lower ILI consultation rates compared to their respective ILI rates in the previous week except SK which had a slightly higher rate this week. Those under 20 years of age still had the highest consultation rates, with 37 and 26 per 1,000 patient visits among children under 5 years of age and among those 5 to 19 years of age, respectively.
Influenza-like illness (ILI) consultation rates, Canada, by report week,
2009-2010 compared to 1996/97 through to 2008/09 seasons

2010-w04-fg3-eng.gif


flu0910-leg-fg3-eng.gif

Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons).
Delays in the reporting of data may cause data to change retrospectively.
Paediatric Influenza Hospitalizations and Deaths
In week 4, one laboratory-confirmed influenza-associated paediatric hospitalization was reported through the Immunization Monitoring Program Active (IMPACT) network. The case was reported as unsubtyped influenza A. 1318* hospitalizations have been reported since week 17 (April 26): 97.3% of these hospitalizations were due to pandemic H1N1 2009. Since the beginning of the pandemic, eleven paediatric deaths due to pandemic H1N1 2009 were reported through the IMPACT network among children 16 years of age or under.
*Delays in the reporting of data may cause data to change restrospectively.
Laboratory Surveillance Summary
The proportion of tests that were positive for influenza A was 0.6% during week 4 which remained at a very low level for a sixth consecutive week (see Tests table). All provinces had a similar or lower proportion of positive tests for influenza compared to the previous week except NS which had a higher proportion. During week 4, a total of 14 specimens tested positive for influenza (13 A and 1 B) and 100% of the positive influenza A subtyped specimens were pandemic H1N1 2009. Note that QC reported 44 positive specimen for A/H3N2 and 8 specimen for influenza B while ON reported 6 specimen for influenza B since August 30, 2009. The proportion of positive respiratory syncytial virus tests increased to 24.1% during week 4. Positive specimens were reported from all provinces except NB (data not shown).

Influenza tests reported and percentage of tests positive, Canada,
by report week, 2009-2010

2010-w04-fg4-eng.gif

flu0910-leg-fg4-eng.gif


Percent positive influenza tests, compared to other respiratory viruses, Canada,
by reporting week, 2009-2010


2010-w04-fg5-eng.gif


flu0910-leg-fg5-eng.gif

Weekly & Cumulative numbers of positive influenza specimens, by Provincial Laboratories

<TABLE class=widthFull cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD class=fontSize85 colSpan=13>Note: Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals.
* Not subtyped


</TD></TR></TFOOT><TBODY><TR class=alignCenter><TH class=bg-colour-blue scope=col rowSpan=3>Reporting provinces</TH><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=6>Weekly (January 24 to January 30, 2010)</TH><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=6>Cumulative (August 30, 2009 to January 30, 2010)</TH></TR><TR class=alignCenter><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=5>Influenza A</TH><TH class="bg-colour-blue fontSize85" scope=col>B</TH><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=5>Influenza A</TH><TH class=bg-colour-blue scope=col>B</TH></TR><TR class=alignCenter><TH class="fontSize85 bg-colour-blue" scope=col>A Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H3)</TH><TH class="fontSize85 bg-colour-blue" scope=col>Pand H1N1</TH><TH class="fontSize85 bg-colour-blue" scope=col>A
(NS)*
</TH><TH class="fontSize85 bg-colour-blue" scope=col>Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H3)</TH><TH class="fontSize85 bg-colour-blue" scope=col>Pand H1N1</TH><TH class="fontSize85 bg-colour-blue" scope=col>A
(NS)*
</TH><TH class="fontSize85 bg-colour-blue" scope=col>Total</TH></TR><TR><TH class=bg-colour-blue scope=row>BC</TH><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6370</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>5804</TD><TD class=alignCenter>565</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5863</TD><TD class=alignCenter>2</TD><TD class=alignCenter>5</TD><TD class=alignCenter>5757</TD><TD class=alignCenter>99</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2598</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>2298</TD><TD class=alignCenter>299</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1915</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1788</TD><TD class=alignCenter>127</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>7</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3</TD><TD class=alignCenter>4</TD><TD class=alignCenter>0</TD><TD class=alignCenter>7897</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3548</TD><TD class=alignCenter>4347</TD><TD class=alignCenter>6</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>10688</TD><TD class=alignCenter>1</TD><TD class=alignCenter>44</TD><TD class=alignCenter>10643</TD><TD class=alignCenter>0</TD><TD class=alignCenter>8</TD></TR><TR><TH class=bg-colour-blue scope=row>NB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1856</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1835</TD><TD class=alignCenter>19</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>784</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>751</TD><TD class=alignCenter>33</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>97</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>96</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>951</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>951</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>13</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>7</TD><TD class=alignCenter>6</TD><TD class=alignCenter>1</TD><TD class=alignCenter>39019</TD><TD class=alignCenter>6</TD><TD class=alignCenter>52</TD><TD class=alignCenter>33471</TD><TD class=alignCenter>5490</TD><TD class=alignCenter>15</TD></TR><TR><TD class=alignCenter scope=row colSpan=13>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces </TD></TR></TBODY></TABLE>
Sale of antivirals (AV) in Canada

During week 4, antiviral prescriptions monitoring results demonstrated a levelling-off in antiviral prescriptions among most provinces and territories. An analysis of antiviral data at the Health Region level demonstrated low antiviral prescription rates among all Health Regions for the week of January 24, 2010 to January 30, 2010. Only one Health Region reported an antiviral rate greater than 2.5 antivirals/1000 other prescriptions in NS.
2010-w4-av-eng.jpg

Reference: H1N1 Antiviral and OTC Surveillance Weekly Report. CFEZID, PHAC.
Canadian situation

Antigenic Characterization
Since September 1, 2009, the National Microbiology Laboratory (NML) has antigenically characterized 785 pandemic H1N1 2009 viruses and 10 seasonal influenza viruses (2 influenza A/H1N1, 7 H3N2, and 1 B virus) that were received from Canadian laboratories. Of the 785 pandemic H1N1 2009 viruses characterized, 781 (99.5%) were antigenically related to A/California/7/2009, which is the pandemic reference virus selected by WHO as the pandemic H1N1 2009 vaccine. Four viruses (0.5%) tested showed reduced titer with antisera produced against A/California/7/09. Of the seven seasonal influenza A (H3N2) viruses characterized, one was related to A/Brisbane/10/07, which is the influenza A/H3N2 component recommended for the 2009-10 influenza vaccine and six viruses were antigenically related to A/Perth/16/09, which is the WHO recommended influenza A (H3N2) component for the 2010 Southern Hemisphere vaccine.
Antiviral Resistance
NML: Pandemic H1N1 2009 viruses tested so far have been sensitive to zanamivir (927 samples) but resistant to amantadine (996 samples).
NML/Provinces: Thirteen cases of oseltamivir resistant pandemic H1N1 2009 were reported to date in Canada: one in British Columbia, four in Alberta, one in Manitoba, four in Ontario, two in Quebec, and one in New Brunswick. The 13 resistant cases were associated with oseltamivir treatment/prophylaxis.
International update

Global information
WHO: Worldwide more than 209 countries and overseas territories or communities reported laboratory confirmed cases of pandemic H1N1 2009, including at least 14,711 deaths as of January 24, 2010. Most temperate regions in the northern hemisphere passed a fall and wintertime peak of influenza activity between last October and late November 2009. However, pandemic H1N1 2009 virus transmission continued in several later affected areas in North Africa (Morocco, Algeria, Libya, Egypt), limited areas of eastern and south eastern Europe (Austria, Albania, Bulgaria, Slovakia, Russian Federation), and in parts of south and east Asia (northern and western India, Nepal, Sri Lanka, Bangladesh). In temperate regions of the southern hemisphere, sporadic cases of pandemic H1N1 2009 continued to be reported without evidence of sustained community transmission. Pandemic H1N1 2009 virus continued to be the predominant virus circulating worldwide. For the week of January 10 to 16, 2010 from FluNet reporting, pandemic H1N1 2009 accounted for 95% of all subtyped influenza A viruses detected in both northern and southern hemispheres. China reported outbreaks due to influenza B (48.8% of all influenza positive specimens). Sporadic detections of seasonal A(H1N1), A(H3N2) and influenza B viruses were reported from a few countries such as Iran, Japan, the Russian Federation and Tunisia. <HTTP: index.html en 2010_01_29 don csr www.who.int>and
<HTTP: index.html en csr www.who.int laboratory29_01_2010 swineflu disease>
Antiviral resistance: To date, 220 pandemic H1N1 2009 isolates worldwide have been found to be resistant to oseltamivir, all with the same H275Y mutation and all remain sensitive to zanamivir.
<HTTP: index.html en csr www.who.int laboratory29_01_2010 swineflu disease>
Geographic update
United States: During week 3 (January 17-23, 2010), influenza activity remained at much the same levels in the United States. No states reported widespread influenza activity, five states reported regional influenza activity, Puerto Rico and nine states reported local influenza activity, the District of Columbia, Guam, and 33 states reported sporadic influenza activity, and the U.S. Virgin Islands and three states reported no influenza activity. The proportion of outpatient visits for influenza-like illness (ILI) was 1.7% which was below the national baseline of 2.3% with only two of the 10 regions reporting ILI equal to their region-specific baseline. Cumulative hospitalization rates leveled off in all age groups and very few laboratory-confirmed pandemic H1N1 2009 hospitalizations were reported during the week 3. The proportion of deaths attributed to pneumonia and influenza was above the epidemic threshold. This increase was thought to result from an increase in reports of pneumonia-associated deaths in older people which are not necessarily related to flu illness. Five influenza-associated pediatric deaths were reported during week 3: four deaths were associated with pandemic H1N1 2009 infection and one was associated with an influenza A virus for which the subtype was undetermined. Of the subtyped influenza A viruses reported to CDC, 100% were pandemic H1N1 2009 viruses.
<HTTP: weekly flu www.cdc.gov />and <HTTP: www.cdc.gov update.htm h1n1flu>
Europe: For week 3/2010 (January 18-24, 2010), of the 26 countries reporting, five reported medium activity (Bulgaria, Malta, Poland, Romania, Slovakia) while all other remaining countries reported low activity. Of the five countries that reported intensity above baseline levels, an increasing trend was reported in Poland and Slovakia, a stable trend reported in Bulgaria and Romania, and a decreasing trend in Malta. Widespread activity was reported in two countries (Greece, Wales), and local or regional activity was reported in 11 countries (Austria, Bulgaria, Czech Republic, Estonia, France, Germany, Malta, Romania, Slovakia, Sweden, Scotland). Sporadic or no activity was reported in the remaining countries. The number of severe acute respiratory infection cases continued to decline during this period. Fifty-two percent of new cases were admitted to intensive care units and 37% required ventilation. Since week 40/2009, 99% of sub-typed specimens were identified as the pandemic H1N1 2009. Among tested specimens, 2.7% were resistant to oseltamivir. In week 3, nine countries reported 91 additional deaths which brought the total number of deaths since the beginning of the season to 1429 deaths.
<HTTP: en Documents healthtopics ecdc.europa.eu 100201_Influenza_A(H1N1)_Weekly_Executive_Update.pdf>and
<HTTP: en ecdc.europa.eu Publications publications 100129_EISN_Weekly_Influenza_Surveillance_Overview.pdf>
Asia: In west Asia, pandemic influenza activity continued to be geographically regional to widespread, however activity levels continued to decline or remained low since December 2009. In south Asia, pandemic influenza activity remained active but geographically variable. Northern India, Nepal, and Sri Lanka experienced recent peaks in late December 2009 and early January 2010. Activity remained stable but elevated in western India with declines experienced in northern India and overall low activity in southern and eastern India. Regional spread with low intensity was reported in Bangladesh. Overall activity in east Asia continued to decline although transmission remained active in some areas (North Korea, South Korea, Japan). In northern and southern China, pandemic H1N1 2009 isolations declined substantially since peaking early to mid November 2009; however, detections of influenza type B viruses have increased in recent weeks. In southeast Asia, transmission of pandemic H1N1 2009 persisted however, current activity levels were low or have declined substantially (Vietnam, Thailand). <HTTP: index.html en 2010_01_29 don csr www.who.int>
Weekly and cumulative numbers of deaths among due to pandemic H1N1 2009, by province/territory, Canada, as of February 4, 2010, 11h00 EDT

<TABLE class="width75 alignCenter" cellSpacing=0 cellPadding=1 border=1><TBODY><TR class=bg-colour-blue><TH scope=col>Province/ Territory</TH><TH scope=col>New Deaths
(from Jan. 28 to Feb. 4, 2010 11h00 EDT)
</TH><TH scope=col>Cumulative deaths</TH></TR><TR><TD class=alignCenter>BC</TD><TD class=alignCenter>0</TD><TD class=alignCenter>56</TD></TR><TR><TD class=alignCenter>AB</TD><TD class=alignCenter>0</TD><TD class=alignCenter>71</TD></TR><TR><TD class=alignCenter>SK</TD><TD class=alignCenter>0</TD><TD class=alignCenter>15</TD></TR><TR><TD class=alignCenter>MB</TD><TD class=alignCenter>0</TD><TD class=alignCenter>11</TD></TR><TR><TD class=alignCenter>ON</TD><TD class=alignCenter>1</TD><TD class=alignCenter>128</TD></TR><TR><TD class=alignCenter>QC</TD><TD class=alignCenter>0</TD><TD class=alignCenter>108</TD></TR><TR><TD class=alignCenter>NB</TD><TD class=alignCenter>0</TD><TD class=alignCenter>8</TD></TR><TR><TD class=alignCenter>NS</TD><TD class=alignCenter>0</TD><TD class=alignCenter>7</TD></TR><TR><TD class=alignCenter>PE</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TD class=alignCenter>NL</TD><TD class=alignCenter>0</TD><TD class=alignCenter>18</TD></TR><TR><TD class=alignCenter>YT</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3</TD></TR><TR><TD class=alignCenter>NT</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD></TR><TR><TD class=alignCenter>NU</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD></TR><TR><TD class=alignCenter>Canada</TD><TD class=alignCenter>1</TD><TD class=alignCenter>427</TD></TR></TBODY></TABLE>
http://www.phac-aspc.gc.ca/fluwatch/09-10/w04_10/index-eng.php
 
Re: Canada - FluWatch Pandemic (H1N1) 2009 virus Surveillance Week 5

Re: Canada - FluWatch Pandemic (H1N1) 2009 virus Surveillance Week 5

January 31 to February 6, 2010 (Week 5)



Posted 2010-02-12

Weekly and cumulative numbers of hospitalized cases, ICU admissions and deaths among Pandemic H1N1 2009 confirmed cases, Canada, to February 6, 2010<SUP>?</SUP>

<TABLE class="widthFull fontSize85" cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD colSpan=10><SUP id=star>*</SUP>Based on reporting date.
<SUP id=dstar>**</SUP>Based on epidemiological date, hospitalization date, death date and reporting date.
<SUP>1</SUP> Aggregate counts were reported this week.
<SUP>2</SUP> The drop in the total number of cases is due data clean up and case re-classification.
? Note that due to reporting delays, some PTs reported retrospectively on first and second wave cases.

</TD></TR></TFOOT><TBODY><TR class=alignCenter><TH class=bg-colour-blue scope=col rowSpan=2>Province/
Territory
</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>Week 5
(January 31 to February 6, 2010)*
</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>From August 30, 2009 to
February 6, 2010**
</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>From April 12 to August 29, 2009**</TH></TR><TR class=alignCenter><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH></TR><TR><TH class=bg-colour-blue scope=row>BC<SUP>1,2</SUP></TH><TD class=alignCenter>--</TD><TD class=alignCenter>--</TD><TD class=alignCenter>--</TD><TD class=alignCenter>1009</TD><TD class=alignCenter>135</TD><TD class=alignCenter>49</TD><TD class=alignCenter>49</TD><TD class=alignCenter>19</TD><TD class=alignCenter>6</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1147</TD><TD class=alignCenter>210</TD><TD class=alignCenter>64</TD><TD class=alignCenter>129</TD><TD class=alignCenter>29</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>44</TD><TD class=alignCenter>40</TD><TD class=alignCenter>11</TD><TD class=alignCenter>23</TD><TD class=alignCenter>12</TD><TD class=alignCenter>4</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>166</TD><TD class=alignCenter>18</TD><TD class=alignCenter>4</TD><TD class=alignCenter>213</TD><TD class=alignCenter>43</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>17</TD><TD class=alignCenter>4</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1444</TD><TD class=alignCenter>248</TD><TD class=alignCenter>103</TD><TD class=alignCenter>399</TD><TD class=alignCenter>69</TD><TD class=alignCenter>25</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2490</TD><TD class=alignCenter>361</TD><TD class=alignCenter>81</TD><TD class=alignCenter>572</TD><TD class=alignCenter>104</TD><TD class=alignCenter>27</TD></TR><TR><TH class=bg-colour-blue scope=row>NB<SUP>1,2</SUP></TH><TD class=alignCenter>--</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>161</TD><TD class=alignCenter>33</TD><TD class=alignCenter>8</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>4</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>276</TD><TD class=alignCenter>42</TD><TD class=alignCenter>6</TD><TD class=alignCenter>17</TD><TD class=alignCenter>8</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>49</TD><TD class=alignCenter>9</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>274</TD><TD class=alignCenter>51</TD><TD class=alignCenter>18</TD><TD class=alignCenter>3</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>YT</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>15</TD><TD class=alignCenter>3</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NT</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>46</TD><TD class=alignCenter>7</TD><TD class=alignCenter>1</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NU</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>74</TD><TD class=alignCenter>6</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>21</TD><TD class=alignCenter>4</TD><TD class=alignCenter>1</TD><TD class=alignCenter>7127</TD><TD class=alignCenter>1157</TD><TD class=alignCenter>348</TD><TD class=alignCenter>1488</TD><TD class=alignCenter>292</TD><TD class=alignCenter>78</TD></TR></TBODY></TABLE>
Descriptive characteristics of laboratory-confirmed Canadian pandemic H1N1 2009 hospitalized cases, ICU-admitted cases and deaths with core information available, reported to PHAC as of February 6, 2010<SUP><SUP>?</SUP> </SUP>

<TABLE class=fontSize85 cellSpacing=0 cellPadding=2 border=1><COLGROUP><COL width=98><COL width=95><COL width=82><COL width=69><COL width=97><COL width=77><COL width=59><COL width=96><COL width=82><COL width=67><TBODY><TR class=alignCenter><TD rowSpan=2></TD><TH class=bg-colour-blue colSpan=3>From April 12 to August 29, 2009</TH><TH class=bg-colour-blue colSpan=3>From August 30, 2009 to February 6, 2010</TH><TH class=bg-colour-blue colSpan=3>Cumulative: From
April 12, 2009 to February 6, 2010
</TH></TR><TR class=alignCenter><TH class=bg-colour-blue>Hospitalized cases (n=1488)</TH><TH class=bg-colour-blue>ICU-admitted
(n=292)
</TH><TH class=bg-colour-blue>Deaths
(n=78)
</TH><TH class=bg-colour-blue>Hospitalized
cases (n=6674)
</TH><TH class=bg-colour-blue>ICU-admitted
(n=1157)
</TH><TH class=bg-colour-blue>Deaths
(n=345)
</TH><TH class=bg-colour-blue>Hospitalized
cases
(n=8162)
</TH><TH class=bg-colour-blue>ICU-admitted
(n=1449)
</TH><TH class=bg-colour-blue>Deaths
(n=423)
</TH></TR><TR><TH class="bg-colour-blue alignLeft">Females, %</TH><TD class=alignCenter>51.3</TD><TD class=alignCenter>57.2</TD><TD class=alignCenter>62.8</TD><TD class=alignCenter>49.7</TD><TD class=alignCenter>49.7</TD><TD class=alignCenter>46.7</TD><TD class=alignCenter>50.0</TD><TD class=alignCenter>51.2</TD><TD class=alignCenter>49.6</TD></TR><TR><TH class="bg-colour-blue alignLeft">Median age</TH><TD class=alignCenter>23.0</TD><TD class=alignCenter>37.0</TD><TD class=alignCenter>51.0</TD><TD class=alignCenter>30.0</TD><TD class=alignCenter>47.0</TD><TD class=alignCenter>54.0</TD><TD class=alignCenter>29.0</TD><TD class=alignCenter>46.0</TD><TD class=alignCenter>53.0</TD></TR><TR><TH class="bg-colour-blue alignLeft">Aboriginal status<SUP>1</SUP>, % </TH><TD class=alignCenter>20.2-28.0</TD><TD class=alignCenter>16.1-21.9</TD><TD class=alignCenter>11.5-17.3</TD><TD class=alignCenter>4.6-6.1</TD><TD class=alignCenter>5.9-7.8</TD><TD class=alignCenter>6.1-8.9</TD><TD class=alignCenter>7.4-10.0</TD><TD class=alignCenter>7.9-10.6</TD><TD class=alignCenter>7.1-10.4</TD></TR><TR><TH class="bg-colour-blue alignLeft">Underlying medical
conditions<SUP>2</SUP>, %
</TH><TD class=alignCenter>47.5
(652/1373)
</TD><TD class=alignCenter>60.2
(162/269)
</TD><TD class=alignCenter>73.3
(55/75)
</TD><TD class=alignCenter>54.8
(1763/3216)
</TD><TD class=alignCenter>63.8
(567/889)
</TD><TD class=alignCenter>76.8
(218/284)
</TD><TD class=alignCenter>52.6
(2415/4589)
</TD><TD class=alignCenter>63.0
(729/1158)
</TD><TD class=alignCenter>77.4
(273/359)
</TD></TR><TR><TH class="bg-colour-blue alignLeft">Pregnancy<SUP>3</SUP>, %</TH><TD class=alignCenter>27.6
(75/272)
</TD><TD class=alignCenter>19.7
(15/76)
</TD><TD class=alignCenter>28.6
(4/14)
</TD><TD class=alignCenter>18.4
(187/1018)
</TD><TD class=alignCenter>8.4
(15/178)
</TD><TD class=alignCenter>0.0
(0/36)
</TD><TD class=alignCenter>20.3
(262/1,290)
</TD><TD class=alignCenter>11.8
(30/254)
</TD><TD class=alignCenter>8.0
(4/50)
</TD></TR><TR><TD colSpan=10><SUP>1 </SUP>Since Aboriginal status is not reported by two provinces (which comprise 23% of the Aboriginal population) two methods were used to calculate proportions: one proportion was calculated by including ON and NS cases in the denominator (which is an underestimate of the true proportion); while the other proportion was calculated by excluding ON and NS cases in the denominator (which is an overestimate).
<SUP>2 </SUP>Proportion of cases with at least one underlying medical condition (excluding pregnancy) among those for whom the information was available.
<SUP>3 </SUP>Percent of pregnant women among women 15 to 44 years of age.
? All cases admitted to ICU are included in the hospitalization count; however, not all the fatal cases have been hospitalized before dying.

</TD></TR></TBODY></TABLE>

Overall Influenza Summary - Week 5 (January 31 to February 6, 2010)

During week 5, all influenza indicators remained low for this time of the year. Only 0.4% of the specimens tested were positive for influenza A and the pandemic H1N1 2009 strain still accounted for 100% of the positive influenza A subtyped specimens this week.
In week 5, only one region (BC) reported localized activity. Twenty regions in BC, AB, MB, ON, QC, NB, NS & NU reported sporadic activity, while thirty-three regions reported no activity in BC, AB, SK, MB, ON, QC, NB, PE, NS, NL, YT & NT. The 8 influenza outbreaks reported this week were all in schools (1 in BC, 2 in NB and 5 in NS).


<TABLE class=widthFull cellSpacing=0 cellPadding=0><TBODY><TR class=alignCenter><TD colSpan=2>Map of overall Influenza activity level by provinces and territories, Week 5, Canada



</TD></TR><TR class=alignCenter><TD>

</TD><TD><TABLE cellSpacing=0 cellPadding=1 border=0><TBODY><TR><TD align=middle><TABLE class=border-lite cellSpacing=1 cellPadding=1><TBODY><TR align=middle><TD>No Data </TD><TD>
leg_dots.gif
</TD></TR><TR class=alignCenter><TD>No Activity</TD><TD>
leg_ffffff.gif
</TD></TR><TR class=alignCenter><TD>Sporadic Activity</TD><TD>
leg_ccccff.gif
</TD></TR><TR align=middle><TD>Localized Activity</TD><TD>
leg_6666ff.gif
</TD></TR><TR align=middle><TD>Widespread
Activity
</TD><TD>
leg_000066.gif
</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR><TR><TD class=fontSize85 colSpan=2>Note: Influenza 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 (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.

</TD></TR></TBODY></TABLE>
Number of influenza surveillance regions<SUP>?</SUP> reporting widespread or localized influenza activity,
Canada, by report week, 2009-2010 (N=54)

2010-w05-fg1-eng.gif

flu0910-leg-fg1-eng.gif

? sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.

Overall Number of Influenza Outbreaks, Canada, by Report Week, 2009-2010

2010-w05-fg2-eng.gif

flu0910-leg-fg2-eng.gif

Note that this was the first year that all the provinces and territories were reporting on influenza outbreaks in schools (greater than 10% absenteeism on any day most likely due to ILI) which has increased considerably the total number of outbreaks reported compared to previous years.

ILI consultation rate
During week 5, the national ILI consultation rate was 13 consultations per 1,000 patient visits (see ILI graph) which was similar to the 10 previous weeks and still significantly below the expected range for this time of the year. All provinces and territories had either similar or slightly lower ILI consultation rates compared to their respective ILI rates in the previous week except NL which had a slightly higher rate this week. Those under 20 years of age still had the highest consultation rates, with 57 and 21 per 1,000 patient visits among children under 5 years of age and among those 5 to 19 years of age, respectively.
Influenza-like illness (ILI) consultation rates, Canada, by report week,
2009-2010 compared to 1996/97 through to 2008/09 seasons

2010-w05-fg3-eng.gif


flu0910-leg-fg3-eng.gif

Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons).
Delays in the reporting of data may cause data to change retrospectively.
Paediatric and Adult Influenza Hospitalizations and Deaths
In week 5, no laboratory-confirmed influenza-associated paediatric (under 17 years of age) hospitalizations were reported through the Immunization Monitoring Program Active (IMPACT) network. 1328* hospitalizations have been reported since week 17 (April 26): 97.1% of these hospitalizations were due to pandemic H1N1 2009. Since the beginning of the pandemic, eleven paediatric deaths due to pandemic H1N1 2009 were reported through the IMPACT network among children 16 years of age or under.
*Delays in the reporting of data may cause data to change restrospectively.
In week 5, no laboratory-confirmed influenza-associated adult (16 years of age or older) hospitalizations were reported through the Canadian Nosocomial Infection Surveillance Program (CNISP) from 12 of 50 reporting sites during this period. Since week 47 (November 22, 2009), 55 hospitalizations and 8 deaths have been reported through CNISP among adults 16 years of age or older. All of these hospitalizations and deaths were due to pandemic H1N1 2009. From June 1, 2009 to February 5, 2010, of the 552 laboratory-confirmed influenza cases among hospitalized adults reported through 27 of CNISP sentinel sites, 70% were pandemic H1N1 2009 cases. For these pandemic H1N1 2009 cases, most were among women (51%), 1.4% presented with influenza-associated bacteremia, 26% were admitted to the ICU, and 5% died (90% of whom had at least one underlying medical condition).
Please note the total number of CNISP reporting sites fluctuates weekly.
Laboratory Surveillance Summary
The proportion of tests that were positive for influenza A was 0.4% during week 5 which remained at a very low level (see Tests table). All provinces had a similar or lower proportion of positive tests for influenza compared to the previous week. During week 5, a total of 10 specimens tested positive for influenza (all A) and 100% of the positive influenza A subtyped specimens were pandemic H1N1 2009. Note that QC reported 44 positive specimens for A/H3N2 and 8 specimens for influenza B, ON reported 6 specimens for influenza B and 1 positive specimen for influenza B in NB since August 30, 2009. The proportion of positive respiratory syncytial virus tests increased to 25.2% during week 5. Positive specimens were reported from all provinces except NB (data not shown). Also, the proportion of positive parainfluenza and adenovirus tests were higher than the proportion of positive tests for influenza.

Influenza tests reported and percentage of tests positive, Canada,
by report week, 2009-2010

2010-w05-fg4-eng.gif

flu0910-leg-fg4-eng.gif


Percent positive influenza tests, compared to other respiratory viruses, Canada,
by reporting week, 2009-2010


2010-w05-fg5-eng.gif


flu0910-leg-fg5-eng.gif

Weekly & Cumulative numbers of positive influenza specimens, by Provincial Laboratories

<TABLE class=widthFull cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD class=fontSize85 colSpan=13>Note: Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals.
* Not subtyped


</TD></TR></TFOOT><TBODY><TR class=alignCenter><TH class=bg-colour-blue scope=col rowSpan=3>Reporting provinces</TH><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=6>Weekly (January 31 to February 6, 2010)</TH><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=6>Cumulative (August 30, 2009 to February 6, 2010)</TH></TR><TR class=alignCenter><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=5>Influenza A</TH><TH class="bg-colour-blue fontSize85" scope=col>B</TH><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=5>Influenza A</TH><TH class=bg-colour-blue scope=col>B</TH></TR><TR class=alignCenter><TH class="fontSize85 bg-colour-blue" scope=col>A Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H3)</TH><TH class="fontSize85 bg-colour-blue" scope=col>Pand H1N1</TH><TH class="fontSize85 bg-colour-blue" scope=col>A
(NS)*
</TH><TH class="fontSize85 bg-colour-blue" scope=col>Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H3)</TH><TH class="fontSize85 bg-colour-blue" scope=col>Pand H1N1</TH><TH class="fontSize85 bg-colour-blue" scope=col>A
(NS)*
</TH><TH class="fontSize85 bg-colour-blue" scope=col>Total</TH></TR><TR><TH class=bg-colour-blue scope=row>BC</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6370</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>5804</TD><TD class=alignCenter>565</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5866</TD><TD class=alignCenter>2</TD><TD class=alignCenter>5</TD><TD class=alignCenter>5759</TD><TD class=alignCenter>100</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2598</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>2298</TD><TD class=alignCenter>299</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1915</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1788</TD><TD class=alignCenter>127</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>5</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>7902</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3550</TD><TD class=alignCenter>4350</TD><TD class=alignCenter>6</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>10689</TD><TD class=alignCenter>1</TD><TD class=alignCenter>44</TD><TD class=alignCenter>10644</TD><TD class=alignCenter>0</TD><TD class=alignCenter>8</TD></TR><TR><TH class=bg-colour-blue scope=row>NB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1856</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1835</TD><TD class=alignCenter>19</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>785</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>752</TD><TD class=alignCenter>33</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>97</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>96</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>951</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>951</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>10</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6</TD><TD class=alignCenter>4</TD><TD class=alignCenter>0</TD><TD class=alignCenter>39029</TD><TD class=alignCenter>6</TD><TD class=alignCenter>52</TD><TD class=alignCenter>33477</TD><TD class=alignCenter>5494</TD><TD class=alignCenter>15</TD></TR><TR><TD class=alignCenter scope=row colSpan=13>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces </TD></TR></TBODY></TABLE>
Sale of antivirals (AV) in Canada

Nationally, antiviral prescriptions appear to be at the levels seen prior to the second wave. During week 5, antiviral prescriptions monitoring results demonstrated a levelling-off in antiviral prescriptions among most provinces and territories. An analysis of antiviral data at the Health Region level demonstrated low antiviral prescription rates among the vast majority of Health Regions for the week of January 31, 2010 to February 6, 2010. Like last week, only one Health Region had an antiviral rate greater than 2.5 antivirals/1000 other prescriptions in NS.
2010-w5-av-eng.jpg

Reference: H1N1 Antiviral and OTC Surveillance Weekly Report. CFEZID, PHAC.
Canadian situation

Antigenic Characterization
Since September 1, 2009, the National Microbiology Laboratory (NML) has antigenically characterized 790 pandemic H1N1 2009 viruses and 10 seasonal influenza viruses (2 influenza A/H1N1, 7 H3N2, and 1 B virus) that were received from Canadian laboratories. Of the 790 pandemic H1N1 2009 viruses characterized, 786 (99.5%) were antigenically related to A/California/7/2009, which is the pandemic reference virus selected by WHO as the pandemic H1N1 2009 vaccine. Four viruses (0.5%) tested showed reduced titer with antisera produced against A/California/7/09. Of the seven seasonal influenza A (H3N2) viruses characterized, one was related to A/Brisbane/10/07, which is the influenza A/H3N2 component recommended for the 2009-10 influenza vaccine and six viruses were antigenically related to A/Perth/16/09, which is the WHO recommended influenza A (H3N2) component for the 2010 Southern Hemisphere vaccine.
Antiviral Resistance
NML: Pandemic H1N1 2009 viruses tested so far have been sensitive to zanamivir (981 samples) but resistant to amantadine (1051 samples).
NML/Provinces: Thirteen cases of oseltamivir resistant pandemic H1N1 2009 were reported to date in Canada: one in British Columbia, four in Alberta, one in Manitoba, four in Ontario, two in Quebec, and one in New Brunswick. The 13 resistant cases were associated with oseltamivir treatment/prophylaxis.
International update

Global information
WHO:Worldwide more than 209 countries and overseas territories or communities reported laboratory confirmed cases of pandemic H1N1 2009, including at least 15,174 deaths as of January 31, 2010. In the temperate zone of the northern hemisphere, overall pandemic influenza activity continued to decline or remained low in most regions since peaking during late October and November 2009. Several areas continued to have evidence of active but declining transmission, particularly in North Africa (Morocco, Egypt) and in limited areas of Eastern Europe (Albania, Bulgaria, the Czech Republic, Georgia, Greece, Luxembourg, Romania) and East Asia (Japan, South Korea, Mongolia, Hong Kong SAR, northern and southern China). In temperate regions of the southern hemisphere, sporadic cases of pandemic H1N1 2009 continued to be reported without evidence of sustained community transmission. Pandemic H1N1 2009 virus continued to be the predominant virus circulating worldwide. Besides the increasing proportion of seasonal influenza type B viruses recently detected in China, low levels of seasonal H3N2 and type B viruses were circulating in parts of Africa, East and Southeast Asia and sporadic detections were reported in other continents.
<HTTP: www.who.int csr don en index.html 2010_02_5>and
<HTTP: www.who.int csr en index.html laboratory05_02_2010 swineflu disease>
Antiviral resistance: To date, 225 pandemic H1N1 2009 isolates worldwide have been found to be resistant to oseltamivir, all with the same H275Y mutation and all remain sensitive to zanamivir.
<HTTP: www.who.int csr en index.html laboratory05_02_2010 swineflu disease>
Geographic update
United States: During week 4 (January 24-30, 2010), influenza activity remained at much the same levels in the United States. While no states reported widespread influenza activity, the majority of states reported regional (6), local (10) or sporadic (31) activity. The U.S. Virgin Islands and three states reported no influenza activity. The proportion of outpatient visits for influenza-like illness (ILI) was 1.9% which was below the national baseline of 2.3% and region-specific baselines. Cumulative hospitalization rates leveled off in all age groups and very few laboratory-confirmed pandemic H1N1 2009 hospitalizations were reported during week 4. The proportion of deaths attributed to pneumonia and influenza decreased slightly over the previous week, but was still higher than expected for this time of year. Nine influenza-associated pediatric deaths were reported during week 4: eight deaths were associated with pandemic H1N1 2009 virus infection and one was associated with influenza A virus for which the subtype was undetermined. Of the subtyped influenza A viruses reported to CDC, 100% were pandemic H1N1 2009 viruses.
<HTTP: flu weekly www.cdc.gov />and <HTTP: www.cdc.gov update.htm h1n1flu>
Europe: In Europe for week 4/2010 (January 25-31, 2010), the pandemic H1N1 2009 was well past its peak and medium intensity transmission was confined to five countries (Bulgaria, Greece, Malta, Romania, Slovakia) while remaining countries reported low intensity. Widespread activity was reported in Greece and local or regional activity was reported in Austria, Bulgaria, Czech Republic, France, Germany, Italy, Malta, Romania, Slovakia, Sweden and Scotland. Sporadic or no activity was reported in the remaining 14 countries and England, Northern Ireland and Wales. For the majority of countries that reported age-specific incidence of ILI, the most affected age group was 0?14 years except in Austria and Norway; the most affected age group was 15?64 years. The number of reported SARI cases continued to decline. During week 4, 64 cases of severe acute respiratory infection were reported. All of the 41 influenza viruses isolated from among these cases were subtyped as the pandemic H1N1 2009 virus. Of these 41 cases, 27% had no known underlying medical condition. Of the 816 specimens collected by sentinel physicians in week 4, 9% were found positive for influenza A virus. Since week 40/2009, 99.4% of all subtyped specimens were identified as the pandemic H1N1 2009 virus. There was no indication of any increase in the circulation of non-pandemic influenza viruses since the beginning of the New Year. In week 4, seven countries reported 74 additional deaths which brought the total number of deaths since the beginning of the season to 1528 deaths.
<http://ecdc.europa.eu/en/activities/surveillance/EISN/Newsletter/100205_EISN_
Weekly_Influenza_Surveillance_Overview.pdf>
Asia: In south and southeast Asia, pandemic influenza activity remained active but geographically localized to regional with overall intensity reported as low to moderate in most places. In India, while activity continued to decline, the most active areas of transmission were in the western states. Overall ILI activity in Thailand remained low with some focal activity increases reported in several central and northern provinces. In east Asia, despite pandemic influenza transmission remaining active and geographically widespread; overall activity continued to decline (Japan, South Korea, Mongolia). In northern and southern China, ILI rates returned to seasonal levels; however, active transmission persisted. In China over the past few weeks, as the circulation of pandemic H1N1 2009 continued to decline an increase in the circulation of seasonal influenza type B viruses was noted (pandemic H1N1 2009 and seasonal type B viruses accounted for 34% and 66% of all influenza viruses detected, respectively). Active transmission of the pandemic H1N1 2009 virus also persisted in Hong Kong, although at much lower levels than an earlier peak of activity during September and October 2009. <HTTP: www.who.int csr don en index.html 2010_02_5>
Real-time weekly and cumulative numbers of deaths due to pandemic H1N1 2009, by province/territory, Canada, as of February 11, 2010, 12h00 EDT

<TABLE class="width75 alignCenter" cellSpacing=0 cellPadding=1 border=1><TBODY><TR class=bg-colour-blue><TH scope=col>Province/ Territory</TH><TH scope=col>New Deaths
(from February 7 to 11, 2010 12h00 EDT)
</TH><TH scope=col>Cumulative deaths</TH></TR><TR><TD class=alignCenter>BC</TD><TD class=alignCenter>0</TD><TD class=alignCenter>55</TD></TR><TR><TD class=alignCenter>AB</TD><TD class=alignCenter>0</TD><TD class=alignCenter>71</TD></TR><TR><TD class=alignCenter>SK</TD><TD class=alignCenter>0</TD><TD class=alignCenter>15</TD></TR><TR><TD class=alignCenter>MB</TD><TD class=alignCenter>0</TD><TD class=alignCenter>11</TD></TR><TR><TD class=alignCenter>ON</TD><TD class=alignCenter>0</TD><TD class=alignCenter>128</TD></TR><TR><TD class=alignCenter>QC</TD><TD class=alignCenter>0</TD><TD class=alignCenter>108</TD></TR><TR><TD class=alignCenter>NB</TD><TD class=alignCenter>0</TD><TD class=alignCenter>8</TD></TR><TR><TD class=alignCenter>NS</TD><TD class=alignCenter>0</TD><TD class=alignCenter>7</TD></TR><TR><TD class=alignCenter>PE</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TD class=alignCenter>NL</TD><TD class=alignCenter>0</TD><TD class=alignCenter>18</TD></TR><TR><TD class=alignCenter>YT</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3</TD></TR><TR><TD class=alignCenter>NT</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD></TR><TR><TD class=alignCenter>NU</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD></TR><TR><TD class=alignCenter>Canada</TD><TD class=alignCenter>0</TD><TD class=alignCenter>426</TD></TR></TBODY></TABLE>
http://www.phac-aspc.gc.ca/fluwatch/09-10/w05_10/index-eng.php
 
Re: Canada - FluWatch Pandemic (H1N1) 2009 virus Surveillance Week 6

Re: Canada - FluWatch Pandemic (H1N1) 2009 virus Surveillance Week 6

February 7 to February 13, 2010 (Week 6)



Posted 2010-02-19

Weekly and cumulative numbers of hospitalized cases, ICU admissions and deaths among Pandemic H1N1 2009 confirmed cases, Canada, to February 13, 2010<SUP>?</SUP>

<TABLE class="widthFull fontSize85" cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD colSpan=10><SUP id=star>*</SUP>Based on reporting date.
<SUP id=dstar>**</SUP>Based on epidemiological date, hospitalization date, death date and reporting date.
<SUP>1</SUP> Aggregate counts were reported this week.
? Note that due to reporting delays, some PTs reported retrospectively on first and second wave cases.

</TD></TR></TFOOT><TBODY><TR class=alignCenter><TH class=bg-colour-blue scope=col rowSpan=2>Province/
Territory
</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>Week 6
(February 7 to February 13, 2010)*
</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>From August 30, 2009 to
February 13, 2010**
</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>From April 12 to August 29, 2009**</TH></TR><TR class=alignCenter><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH></TR><TR><TH class=bg-colour-blue scope=row>BC<SUP>1,?</SUP></TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1009</TD><TD class=alignCenter>135</TD><TD class=alignCenter>50</TD><TD class=alignCenter>49</TD><TD class=alignCenter>19</TD><TD class=alignCenter>6</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1147</TD><TD class=alignCenter>210</TD><TD class=alignCenter>64</TD><TD class=alignCenter>129</TD><TD class=alignCenter>29</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>44</TD><TD class=alignCenter>40</TD><TD class=alignCenter>11</TD><TD class=alignCenter>23</TD><TD class=alignCenter>12</TD><TD class=alignCenter>4</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>166</TD><TD class=alignCenter>18</TD><TD class=alignCenter>4</TD><TD class=alignCenter>213</TD><TD class=alignCenter>43</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1444</TD><TD class=alignCenter>248</TD><TD class=alignCenter>103</TD><TD class=alignCenter>399</TD><TD class=alignCenter>69</TD><TD class=alignCenter>25</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2490</TD><TD class=alignCenter>361</TD><TD class=alignCenter>81</TD><TD class=alignCenter>572</TD><TD class=alignCenter>104</TD><TD class=alignCenter>27</TD></TR><TR><TH class=bg-colour-blue scope=row>NB<SUP>1</SUP></TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>161</TD><TD class=alignCenter>33</TD><TD class=alignCenter>8</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>276</TD><TD class=alignCenter>42</TD><TD class=alignCenter>6</TD><TD class=alignCenter>17</TD><TD class=alignCenter>8</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>49</TD><TD class=alignCenter>9</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>274</TD><TD class=alignCenter>51</TD><TD class=alignCenter>18</TD><TD class=alignCenter>3</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>YT</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>15</TD><TD class=alignCenter>3</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NT</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>46</TD><TD class=alignCenter>7</TD><TD class=alignCenter>1</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NU</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>74</TD><TD class=alignCenter>6</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>7127</TD><TD class=alignCenter>1157</TD><TD class=alignCenter>349</TD><TD class=alignCenter>1488</TD><TD class=alignCenter>292</TD><TD class=alignCenter>78</TD></TR></TBODY></TABLE>
Descriptive characteristics of laboratory-confirmed Canadian pandemic H1N1 2009 hospitalized cases, ICU-admitted cases and deaths with core information available, reported to PHAC as of February 13, 2010<SUP><SUP>?</SUP> </SUP>

<TABLE class=fontSize85 cellSpacing=0 cellPadding=2 border=1><TBODY><TR class=alignCenter><TD rowSpan=2></TD><TH class=bg-colour-blue colSpan=3>From April 12 to August 29, 2009</TH><TH class=bg-colour-blue colSpan=3>From August 30, 2009 to February 13, 2010</TH><TH class=bg-colour-blue colSpan=3>Cumulative: From
April 12, 2009 to February 13, 2010
</TH></TR><TR class=alignCenter><TH class=bg-colour-blue>Hospitalized cases (n=1488)</TH><TH class=bg-colour-blue>ICU-admitted
(n=292)
</TH><TH class=bg-colour-blue>Deaths
(n=78)
</TH><TH class=bg-colour-blue>Hospitalized
cases (n=6674)
</TH><TH class=bg-colour-blue>ICU-admitted
(n=1157)
</TH><TH class=bg-colour-blue>Deaths
(n=345)
</TH><TH class=bg-colour-blue>Hospitalized
cases
(n=8162)
</TH><TH class=bg-colour-blue>ICU-admitted
(n=1449)
</TH><TH class=bg-colour-blue>Deaths
(n=423)
</TH></TR><TR><TH class="bg-colour-blue alignLeft">Females, %</TH><TD class=alignCenter>51.3</TD><TD class=alignCenter>57.2</TD><TD class=alignCenter>62.8</TD><TD class=alignCenter>49.7</TD><TD class=alignCenter>49.7</TD><TD class=alignCenter>46.7</TD><TD class=alignCenter>50.0</TD><TD class=alignCenter>51.2</TD><TD class=alignCenter>49.6</TD></TR><TR><TH class="bg-colour-blue alignLeft">Median age</TH><TD class=alignCenter>23.0</TD><TD class=alignCenter>37.0</TD><TD class=alignCenter>51.0</TD><TD class=alignCenter>30.0</TD><TD class=alignCenter>47.0</TD><TD class=alignCenter>54.0</TD><TD class=alignCenter>29.0</TD><TD class=alignCenter>46.0</TD><TD class=alignCenter>53.0</TD></TR><TR><TH class="bg-colour-blue alignLeft">Aboriginal status<SUP>1</SUP>, % </TH><TD class=alignCenter>20.0-27.7</TD><TD class=alignCenter>16.1-21.9</TD><TD class=alignCenter>11.5-17.3</TD><TD class=alignCenter>4.6-6.1</TD><TD class=alignCenter>5.9-7.8</TD><TD class=alignCenter>6.1-8.9</TD><TD class=alignCenter>7.4-10.0</TD><TD class=alignCenter>7.9-10.6</TD><TD class=alignCenter>7.1-10.4</TD></TR><TR><TH class="bg-colour-blue alignLeft">Underlying medical
conditions<SUP>2</SUP>, %
</TH><TD class=alignCenter>47.5
(652/1373)
</TD><TD class=alignCenter>60.2
(162/269)
</TD><TD class=alignCenter>73.3
(55/75)
</TD><TD class=alignCenter>58.4
(1884/3226)
</TD><TD class=alignCenter>72.9
(655/899)
</TD><TD class=alignCenter>84.2
(240/285)
</TD><TD class=alignCenter>55.1
(2536/4599)
</TD><TD class=alignCenter>69.9
(817/1168)
</TD><TD class=alignCenter>81.9
(295/360)
</TD></TR><TR><TH class="bg-colour-blue alignLeft">Pregnancy<SUP>3</SUP>, %</TH><TD class=alignCenter>27.6
(75/272)
</TD><TD class=alignCenter>19.7
(15/76)
</TD><TD class=alignCenter>28.6
(4/14)
</TD><TD class=alignCenter>18.5
(188/1018)
</TD><TD class=alignCenter>8.4
(15/178)
</TD><TD class=alignCenter>0.0
(0/36)
</TD><TD class=alignCenter>20.4
(263/1290)
</TD><TD class=alignCenter>11.8
(30/254)
</TD><TD class=alignCenter>8.0
(4/50)
</TD></TR><TR><TD colSpan=10><SUP>1 </SUP>ince Aboriginal status is not reported by two provinces (which comprise 23% of the Aboriginal population) two methods were used to calculate proportions: one proportion was calculated by including ON and NS cases in the denominator (which is an underestimate of the true proportion); while the other proportion was calculated by excluding ON and NS cases in the denominator (which is an overestimate).
<SUP>2 </SUP>Proportion of cases with at least one underlying medical condition (excluding pregnancy) among those for whom the information was available. Please note that results may differ slightly compared to the previous weeks due to updates in the national database.
<SUP>3 </SUP>Percent of pregnant women among women 15 to 44 years of age.
? All cases admitted to ICU are included in the hospitalization count; however, not all the fatal cases have been hospitalized before dying.

</TD></TR></TBODY></TABLE>

Overall Influenza Summary - Week 6 (February 7 to February 13, 2010)

During week 6, all influenza indicators continued to decline compared to the previous week and were still considerably under the expected level for this time of the year. Only 0.24% of the specimens tested were positive for influenza A. Three out of four (75%) of the positive influenza A subtyped specimens were pandemic H1N1 2009 this week.
In week 6, nineteen regions in BC, AB, MB, ON, QC, NS & NU reported sporadic activity, while thirty-five regions reported no activity in BC, AB, SK, MB, ON, QC, NB, PE, NS, NL, YT & NT. The 5 influenza outbreaks reported this week were all in schools (NS).


<TABLE class=widthFull cellSpacing=0 cellPadding=0><TBODY><TR class=alignCenter><TD colSpan=2>Map of overall Influenza activity level by provinces and territories, Week 6, Canada



</TD></TR><TR class=alignCenter><TD>

</TD><TD><TABLE cellSpacing=0 cellPadding=1 border=0><TBODY><TR><TD align=middle><TABLE class=border-lite cellSpacing=1 cellPadding=1><TBODY><TR align=middle><TD>No Data </TD><TD>
leg_dots.gif
</TD></TR><TR class=alignCenter><TD>No Activity</TD><TD>
leg_ffffff.gif
</TD></TR><TR class=alignCenter><TD>Sporadic Activity</TD><TD>
leg_ccccff.gif
</TD></TR><TR align=middle><TD>Localized Activity</TD><TD>
leg_6666ff.gif
</TD></TR><TR align=middle><TD>Widespread
Activity
</TD><TD>
leg_000066.gif
</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR><TR><TD class=fontSize85 colSpan=2>Note: Influenza 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 (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.

</TD></TR></TBODY></TABLE>
Number of influenza surveillance regions<SUP>?</SUP> reporting widespread or localized influenza activity,
Canada, by report week, 2009-2010 (N=54)

2010-w06-fg1-eng.gif

flu0910-leg-fg1-eng.gif

? sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.

Overall Number of Influenza Outbreaks, Canada, by Report Week, 2009-2010

2010-w06-fg2-eng.gif

flu0910-leg-fg2-eng.gif

Note that this was the first year that all the provinces and territories were reporting on influenza outbreaks in schools (greater than 10% absenteeism on any day most likely due to ILI) which has increased considerably the total number of outbreaks reported compared to previous years.

ILI consultation rate
During week 6, the national ILI consultation rate was 11 consultations per 1,000 patient visits (see ILI graph) which was similar to the previous weeks and still significantly below the expected range for this time of the year. All provinces and territories had similar ILI consultation rates compared to their respective ILI rates in the previous week. Those under 20 years of age still had the highest consultation rates, with 64 and 13 per 1,000 patient visits among children under 5 years of age and among those 5 to 19 years of age, respectively.
Influenza-like illness (ILI) consultation rates, Canada, by report week,
2009-2010 compared to 1996/97 through to 2008/09 seasons

2010-w06-fg3-eng.gif


flu0910-leg-fg3-eng.gif

Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons).
Delays in the reporting of data may cause data to change retrospectively.
Paediatric and Adult Influenza Hospitalizations and Deaths
In week 6, no laboratory-confirmed influenza-associated paediatric (under 17 years of age) hospitalizations were reported through the Immunization Monitoring Program Active (IMPACT) network. 1325* hospitalizations have been reported since week 17 (April 26): 97.0% of these hospitalizations were due to pandemic H1N1 2009. Since the beginning of the pandemic, eleven paediatric deaths due to pandemic H1N1 2009 were reported through the IMPACT network among children 16 years of age or under.
*Delays in the reporting of data may cause data to change restrospectively.
During week 6, no report was received from the Canadian Nosocomial Infection Surveillance Program (CNISP) on influenza-associated adult (16 years of age or older) hospitalizations and deaths. Since week 47 (November 22, 2009), 55 hospitalizations and 8 deaths have been reported through CNISP among adults 16 years of age or older. All of these hospitalizations and deaths were due to pandemic H1N1 2009. From June 1, 2009 to February 19, 2010, of the 552 laboratory-confirmed influenza cases among hospitalized adults reported through 27 of CNISP sentinel sites, 70% were pandemic H1N1 2009 cases. For these pandemic H1N1 2009 cases, most were among women (51%), 1.4% presented with influenza-associated bacteremia, 27% were admitted to the ICU, and 5% died (90% of whom had at least one underlying medical condition).
Please note the total number of CNISP reporting sites fluctuates weekly.
Laboratory Surveillance Summary
The proportion of tests that were positive for influenza A was 0.24% during week 6 which remained at a very low level (see Tests table). All provinces had a similar or lower proportion of positive tests for influenza compared to the previous week. During week 6, a total of 6 specimens tested positive for influenza (all A) and 3/4 (75%) of the positive influenza A subtyped specimens were pandemic H1N1 2009. Note that QC reported 44 positive specimens for A/H3N2 and 8 specimens for influenza B and ON reported 6 specimens for influenza B since August 30, 2009. The proportion of specimens positive for respiratory syncytial virus increased to 27.0% during week 6. Positive specimens were reported from all provinces except NB (data not shown). Also, the proportion of positive parainfluenza and adenovirus tests were higher than the proportion of positive tests for influenza.

Influenza tests reported and percentage of tests positive, Canada,
by report week, 2009-2010

2010-w06-fg4-eng.gif

flu0910-leg-fg4-eng.gif


Percent positive influenza tests, compared to other respiratory viruses, Canada,
by reporting week, 2009-2010


2010-w06-fg5-eng.gif


flu0910-leg-fg5-eng.gif

Weekly & Cumulative numbers of positive influenza specimens, by Provincial Laboratories

<TABLE class=widthFull cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD class=fontSize85 colSpan=13>Note: Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals.
* Not subtyped


</TD></TR></TFOOT><TBODY><TR class=alignCenter><TH class=bg-colour-blue scope=col rowSpan=3>Reporting provinces</TH><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=6>Weekly (February 7 to February 13, 2010)</TH><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=6>Cumulative (August 30, 2009 to February 13, 2010)</TH></TR><TR class=alignCenter><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=5>Influenza A</TH><TH class="bg-colour-blue fontSize85" scope=col>B</TH><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=5>Influenza A</TH><TH class=bg-colour-blue scope=col>B</TH></TR><TR class=alignCenter><TH class="fontSize85 bg-colour-blue" scope=col>A Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H3)</TH><TH class="fontSize85 bg-colour-blue" scope=col>Pand H1N1</TH><TH class="fontSize85 bg-colour-blue" scope=col>A
(NS)*
</TH><TH class="fontSize85 bg-colour-blue" scope=col>Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H3)</TH><TH class="fontSize85 bg-colour-blue" scope=col>Pand H1N1</TH><TH class="fontSize85 bg-colour-blue" scope=col>A
(NS)*
</TH><TH class="fontSize85 bg-colour-blue" scope=col>Total</TH></TR><TR><TH class=bg-colour-blue scope=row>BC</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6370</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>5804</TD><TD class=alignCenter>565</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5867</TD><TD class=alignCenter>2</TD><TD class=alignCenter>5</TD><TD class=alignCenter>5759</TD><TD class=alignCenter>101</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2598</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>2298</TD><TD class=alignCenter>299</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1915</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1788</TD><TD class=alignCenter>127</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>4</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>7906</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3552</TD><TD class=alignCenter>4351</TD><TD class=alignCenter>6</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>10689</TD><TD class=alignCenter>1</TD><TD class=alignCenter>44</TD><TD class=alignCenter>10644</TD><TD class=alignCenter>0</TD><TD class=alignCenter>8</TD></TR><TR><TH class=bg-colour-blue scope=row>NB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1856</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1835</TD><TD class=alignCenter>19</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>786</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>753</TD><TD class=alignCenter>33</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>97</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>96</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>951</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>951</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>6</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>39035</TD><TD class=alignCenter>7</TD><TD class=alignCenter>52</TD><TD class=alignCenter>33480</TD><TD class=alignCenter>5496</TD><TD class=alignCenter>14</TD></TR><TR><TD class=alignCenter scope=row colSpan=13>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces </TD></TR></TBODY></TABLE>
Sale of antivirals (AV) in Canada

Nationally, antiviral prescriptions appear to be at the levels seen prior to the second wave. During week 6, antiviral prescription monitoring demonstrated a levelling-off in antiviral prescriptions in most provinces and territories. An analysis of antiviral data at the Health Region level demonstrated low antiviral prescription rates among the vast majority of Health Regions for the week of February 7 to February 13, 2010. None of the Health Regions reported an antiviral rate greater than 2.5 antivirals/1000 other prescriptions.
2010-w6-av-eng.jpg

Reference: H1N1 Antiviral and OTC Surveillance Weekly Report. CFEZID, PHAC.
Canadian situation

Antigenic Characterization
Since September 1, 2009, the National Microbiology Laboratory (NML) has antigenically characterized 790 pandemic H1N1 2009 viruses and 10 seasonal influenza viruses (2 influenza A/H1N1, 7 H3N2, and 1 B virus) that were received from Canadian laboratories. Of the 790 pandemic H1N1 2009 viruses characterized, 786 (99.5%) were antigenically related to A/California/7/2009, which is the pandemic reference virus selected by WHO for the pandemic H1N1 2009 vaccine. Four viruses (0.5%) tested showed reduced titer with antisera produced against A/California/7/09. Of the seven seasonal influenza A (H3N2) viruses characterized, one was related to A/Brisbane/10/07, which is the influenza A/H3N2 component recommended for the 2009-10 influenza vaccine and six viruses were antigenically related to A/Perth/16/09, which is the WHO recommended influenza A (H3N2) component for the 2010 Southern Hemisphere vaccine.
Antiviral Resistance
NML: Pandemic H1N1 2009 viruses tested so far have been sensitive to zanamivir (981 samples) but resistant to amantadine (1051 samples).
NML/Provinces: Thirteen cases of oseltamivir resistant pandemic H1N1 2009 were reported to date in Canada: one in British Columbia, four in Alberta, one in Manitoba, four in Ontario, two in Quebec, and one in New Brunswick. The 13 resistant cases were associated with oseltamivir treatment/prophylaxis.
International update

Global information
WHO: Worldwide more than 212 countries and overseas territories or communities reported laboratory confirmed cases of pandemic H1N1 2009, including at least 15,292 deaths as of February 7, 2010. In the temperate zone of the Northern hemisphere, overall pandemic influenza activity continued to decline in most countries. The most active areas of transmission continue to be in later peaking areas, particularly Northern Africa, South Asia, and East Asia. In Europe, although pandemic influenza virus continues to circulate widely, particularly across central, southern, and eastern Europe, the overall intensity of pandemic influenza activity has declined substantially from peaks of activity seen earlier during the winter transmission period. In temperate regions of the southern hemisphere, sporadic cases of pandemic H1N1 2009 continued to be reported without evidence of sustained community transmission. Pandemic H1N1 2009 virus continued to be the predominant virus circulating worldwide. In addition to the increasing proportion of seasonal influenza type B viruses recently detected in China, low levels of seasonal H3N2 and type B viruses are circulating in parts of Africa, East and Southeast Asia and are being detected only sporadically in other continents.
<
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http://www.who.int/csr/don/2010_02_12/en/index.html> and
<
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http://www.who.int/csr/disease/swineflu/laboratory12_02_2010/en/index.html>
Antiviral resistance: To date, 245 pandemic H1N1 2009 isolates worldwide have been found to be resistant to oseltamivir, all with the same H275Y mutation and all remain sensitive to zanamivir.
<
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http://www.who.int/csr/disease/swineflu/laboratory12_02_2010/en/index.html>
Geographic update
United States: During week 5 (January 31-February 6, 2010), influenza activity remained at approximately the same levels as last week in the United States. 4.8% of the specimens tested this week were positive for influenza. While no states reported widespread influenza activity, 6 states reported regional influenza activity, Puerto Rico and 11 states reported local activity and the majority of the states reported sporadic influenza activity. The proportion of outpatient visits for influenza-like illness (ILI) was 2.1% which was below the national baseline of 2.3%. Three of 10 regions reported ILI above region-specific baseline levels. The proportion of deaths attributed to pneumonia and influenza decreased slightly over the previous week and remained below the epidemic threshold for this time of the year. Three influenza-associated pediatric deaths were reported during week 5: two deaths were associated with pandemic H1N1 2009 virus infection and one was associated with influenza A virus for which the subtype was undetermined. Of the subtyped influenza A viruses reported to CDC, 100% were pandemic H1N1 2009 viruses.
<
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http://www.cdc.gov/flu/weekly/>
Europe: In Europe for week 5/2010 (February 1-7, 2010), the pandemic H1N1 2009 was well past its peak. In eight countries (Austria, Bulgaria, Czech Republic, Germany, Greece, Italy, Malta, Slovakia), local or regional transmission of the pandemic virus continues at low to medium intensity. Elsewhere intensity was low, but sporadic transmission of the pandemic virus was reported in the majority of countries. For the majority of countries that reported age-specific incidence of ILI, the most affected age group was 0?14. The number of reported SARI (severe acute respiratory illness) cases continued to decline. Of the 62 SARI cases reported this week, 30 (48%) were known to have required ICU admission and 16 (24%) needed ventilator support. Of the 39 SARI cases for whom underlying conditions were reported, 9 (23%) had no known underlying condition. Asthma and other chronic lung diseases alone or associated with other conditions were reported in 12 (31%) cases. Of the 910 specimens collected by sentinel physicians, 76 (8.4%) were positive for influenza virus, mainly the pandemic virus; this is consistent with a declining trend. Since their peak in week 01/2010, the total number of respiratory syncytial virus (RSV) detections in 11 countries has been decreasing. However in Austria, Denmark, Estonia, Germany, Latvia and Sweden, the number of RSV positive samples has increased for at least two consecutive weeks. In contrast to the pandemic virus there is currently no evidence of virus circulation due to other influenza A viruses this week, but there is some circulation of influenza B viruses.
<
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http://ecdc.europa.eu/en/publications/Publications/100212_EISN_Weekly_Influenza_Surveillance_Overview.pdf>
Asia: In South and Southeast Asia, pandemic influenza virus continues to circulate widely across the region, however, overall activity continues to decrease or remain low in most places. In India, influenza activity continued to decline in all regions of the country, however, the most active areas of transmission are currently in the western states. In Thailand, overall activity remains low, although focal areas of increased ILI activity were reported in central and northern Thailand. In East Asia, pandemic influenza transmission remains geographically widespread across the region, however, overall activity continued to decline. In China, pandemic and seasonal influenza viruses continue to co-circulate, however, over the last several weeks, seasonal influenza type B viruses have been predominant. In Japan, influenza activity continues to decrease towards seasonal baselines, including in Okinawa which is experiencing greater levels of influenza activity than other parts of the country. In Republic of Korea (S. Korea), levels of ILI have decreased substantially to near baseline levels. In addition to the increasing proportion of seasonal influenza type B viruses recently detected in China, low levels of seasonal H3N2 and type B viruses are circulating in parts of East and Southeast Asia.
<
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http://www.who.int/csr/don/2010_02_12/en/index.html>
Real-time weekly and cumulative numbers of deaths due to pandemic H1N1 2009, by province/territory, Canada, as of February 18, 2010, 12h00 EDT

<TABLE class="width75 alignCenter" cellSpacing=0 cellPadding=1 border=1><TBODY><TR class=bg-colour-blue><TH scope=col>Province/ Territory</TH><TH scope=col>New Deaths
(from February 11 to 18, 2010 12h00 EDT)
</TH><TH scope=col>Cumulative deaths</TH></TR><TR><TD class=alignCenter>BC</TD><TD class=alignCenter>1</TD><TD class=alignCenter>56</TD></TR><TR><TD class=alignCenter>AB</TD><TD class=alignCenter>0</TD><TD class=alignCenter>71</TD></TR><TR><TD class=alignCenter>SK</TD><TD class=alignCenter>0</TD><TD class=alignCenter>15</TD></TR><TR><TD class=alignCenter>MB</TD><TD class=alignCenter>0</TD><TD class=alignCenter>11</TD></TR><TR><TD class=alignCenter>ON</TD><TD class=alignCenter>0</TD><TD class=alignCenter>128</TD></TR><TR><TD class=alignCenter>QC</TD><TD class=alignCenter>0</TD><TD class=alignCenter>108</TD></TR><TR><TD class=alignCenter>NB</TD><TD class=alignCenter>0</TD><TD class=alignCenter>8</TD></TR><TR><TD class=alignCenter>NS</TD><TD class=alignCenter>0</TD><TD class=alignCenter>7</TD></TR><TR><TD class=alignCenter>PE</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TD class=alignCenter>NL</TD><TD class=alignCenter>0</TD><TD class=alignCenter>18</TD></TR><TR><TD class=alignCenter>YT</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3</TD></TR><TR><TD class=alignCenter>NT</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD></TR><TR><TD class=alignCenter>NU</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD></TR><TR><TD class=alignCenter>Canada</TD><TD class=alignCenter>1</TD><TD class=alignCenter>427</TD></TR></TBODY></TABLE>
http://www.phac-aspc.gc.ca/fluwatch/09-10/w06_10/index-eng.php
 
Re: Canada - FluWatch Pandemic (H1N1) 2009 virus Surveillance Week 7 - 1 new death (Ont) Total 428

Re: Canada - FluWatch Pandemic (H1N1) 2009 virus Surveillance Week 7 - 1 new death (Ont) Total 428

<H1>February 14 to February 20, 2010 (Week 7)</H1>

Posted 2010-02-26

Weekly and cumulative numbers of hospitalized cases, ICU admissions and deaths among Pandemic H1N1 2009 confirmed cases, Canada, to February 20, 2010<SUP>?</SUP>

<TABLE class="widthFull fontSize85" cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD colSpan=10><SUP id=star>*</SUP>Based on reporting date.
<SUP id=dstar>**</SUP>Based on epidemiological date, hospitalization date, death date and reporting date.
<SUP>1</SUP> Aggregate counts were reported this week.
<SUP>2</SUP> This change from the previous count reflects more detailled accounting of case records with the regional health authorities rather than a true increase in recent case reports.
? Note that due to reporting delays, some PTs reported retrospectively on first and second wave cases.
</TD></TR></TFOOT><TBODY><TR class=alignCenter><TH class=bg-colour-blue scope=col rowSpan=2>Province/
Territory</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>Week 7
(February 14 to February 20, 2010)*</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>From August 30, 2009 to
February 20, 2010**</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>From April 12 to August 29, 2009**</TH></TR><TR class=alignCenter><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH></TR><TR><TH class=bg-colour-blue scope=row>BC<SUP>1,2</SUP></TH><TD class=alignCenter>22</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1031</TD><TD class=alignCenter>135</TD><TD class=alignCenter>51</TD><TD class=alignCenter>49</TD><TD class=alignCenter>19</TD><TD class=alignCenter>6</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1147</TD><TD class=alignCenter>210</TD><TD class=alignCenter>64</TD><TD class=alignCenter>129</TD><TD class=alignCenter>29</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>44</TD><TD class=alignCenter>40</TD><TD class=alignCenter>11</TD><TD class=alignCenter>23</TD><TD class=alignCenter>12</TD><TD class=alignCenter>4</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>166</TD><TD class=alignCenter>18</TD><TD class=alignCenter>4</TD><TD class=alignCenter>213</TD><TD class=alignCenter>43</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1444</TD><TD class=alignCenter>248</TD><TD class=alignCenter>103</TD><TD class=alignCenter>399</TD><TD class=alignCenter>69</TD><TD class=alignCenter>25</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2490</TD><TD class=alignCenter>361</TD><TD class=alignCenter>81</TD><TD class=alignCenter>572</TD><TD class=alignCenter>104</TD><TD class=alignCenter>27</TD></TR><TR><TH class=bg-colour-blue scope=row>NB<SUP>1</SUP></TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>161</TD><TD class=alignCenter>33</TD><TD class=alignCenter>8</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>276</TD><TD class=alignCenter>42</TD><TD class=alignCenter>6</TD><TD class=alignCenter>17</TD><TD class=alignCenter>8</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>49</TD><TD class=alignCenter>9</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>274</TD><TD class=alignCenter>51</TD><TD class=alignCenter>18</TD><TD class=alignCenter>3</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>YT</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>15</TD><TD class=alignCenter>3</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NT</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>46</TD><TD class=alignCenter>7</TD><TD class=alignCenter>1</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NU</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>74</TD><TD class=alignCenter>6</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>22</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>7149</TD><TD class=alignCenter>1157</TD><TD class=alignCenter>350</TD><TD class=alignCenter>1488</TD><TD class=alignCenter>292</TD><TD class=alignCenter>78</TD></TR></TBODY></TABLE>
Descriptive characteristics of laboratory-confirmed Canadian pandemic H1N1 2009 hospitalized cases, ICU-admitted cases and deaths with core information available, reported to PHAC as of February 20, 2010<SUP><SUP>?</SUP> </SUP>

<TABLE class=fontSize85 cellSpacing=0 cellPadding=2 border=1><TBODY><TR class=alignCenter><TD rowSpan=2> </TD><TH class=bg-colour-blue colSpan=3>From April 12 to August 29, 2009</TH><TH class=bg-colour-blue colSpan=3>From August 30, 2009 to February 20, 2010</TH><TH class=bg-colour-blue colSpan=3>Cumulative: From
April 12, 2009 to February 20, 2010</TH></TR><TR class=alignCenter><TH class=bg-colour-blue>Hospitalized cases (n=1488)</TH><TH class=bg-colour-blue>ICU-admitted
(n=292)</TH><TH class=bg-colour-blue>Deaths
(n=78)</TH><TH class=bg-colour-blue>Hospitalized
cases (n=6674)</TH><TH class=bg-colour-blue>ICU-admitted
(n=1157)</TH><TH class=bg-colour-blue>Deaths
(n=345)</TH><TH class=bg-colour-blue>Hospitalized
cases
(n=8162)</TH><TH class=bg-colour-blue>ICU-admitted
(n=1449)</TH><TH class=bg-colour-blue>Deaths
(n=423)</TH></TR><TR><TH class="bg-colour-blue alignLeft">Females, %</TH><TD class=alignCenter>51.3</TD><TD class=alignCenter>57.2</TD><TD class=alignCenter>62.8</TD><TD class=alignCenter>49.7</TD><TD class=alignCenter>49.7</TD><TD class=alignCenter>46.7</TD><TD class=alignCenter>50.0</TD><TD class=alignCenter>51.2</TD><TD class=alignCenter>49.6</TD></TR><TR><TH class="bg-colour-blue alignLeft">Median age</TH><TD class=alignCenter>23.0</TD><TD class=alignCenter>37.0</TD><TD class=alignCenter>51.0</TD><TD class=alignCenter>30.0</TD><TD class=alignCenter>47.0</TD><TD class=alignCenter>54.0</TD><TD class=alignCenter>29.0</TD><TD class=alignCenter>46.0</TD><TD class=alignCenter>53.0</TD></TR><TR><TH class="bg-colour-blue alignLeft">Aboriginal status<SUP>1</SUP>, % </TH><TD class=alignCenter>20.0-27.7</TD><TD class=alignCenter>16.1-21.9</TD><TD class=alignCenter>11.5-17.3</TD><TD class=alignCenter>4.6-6.1</TD><TD class=alignCenter>5.9-7.8</TD><TD class=alignCenter>6.1-8.9</TD><TD class=alignCenter>7.4-10.0</TD><TD class=alignCenter>7.9-10.6</TD><TD class=alignCenter>7.1-10.4</TD></TR><TR><TH class="bg-colour-blue alignLeft">Underlying medical
conditions<SUP>2</SUP>, %</TH><TD class=alignCenter>47.5
(652/1373)</TD><TD class=alignCenter>60.2
(162/269)</TD><TD class=alignCenter>73.3
(55/75)</TD><TD class=alignCenter>58.4
(1884/3226)</TD><TD class=alignCenter>72.9
(655/899)</TD><TD class=alignCenter>84.2
(240/285)</TD><TD class=alignCenter>55.1
(2536/4599)</TD><TD class=alignCenter>69.9
(817/1168)</TD><TD class=alignCenter>81.9
(295/360)</TD></TR><TR><TH class="bg-colour-blue alignLeft">Pregnancy<SUP>3</SUP>, %</TH><TD class=alignCenter>27.6
(75/272)</TD><TD class=alignCenter>19.7
(15/76)</TD><TD class=alignCenter>28.6
(4/14)</TD><TD class=alignCenter>18.5
(188/1018)</TD><TD class=alignCenter>8.4
(15/178)</TD><TD class=alignCenter>0.0
(0/36)</TD><TD class=alignCenter>20.4
(263/1290)</TD><TD class=alignCenter>11.8
(30/254)</TD><TD class=alignCenter>8.0
(4/50)</TD></TR><TR><TD colSpan=10><SUP>1 </SUP>Since Aboriginal status is not reported by two provinces (which comprise 23% of the Aboriginal population) two methods were used to calculate proportions: one proportion was calculated by including ON and NS cases in the denominator (which is an underestimate of the true proportion); while the other proportion was calculated by excluding ON and NS cases in the denominator (which is an overestimate).
<SUP>2 </SUP>Proportion of cases with at least one underlying medical condition (excluding pregnancy) among those for whom the information was available.
<SUP>3 </SUP>Percent of pregnant women among women 15 to 44 years of age.
? All cases admitted to ICU are included in the hospitalization count; however, not all the fatal cases have been hospitalized before dying.
</TD></TR></TBODY></TABLE>

Overall Influenza Summary - Week 7 (February 14 to February 20, 2010)

During week 7, overall influenza activity remained at approximately the same level as last week and all influenza indicators were still considerably below expected levels for this time of the year. While only 0.24% (6/2505) of the specimens tested were positive for influenza A this week, respiratory syncytial virus increased to 28.0% of positive respiratory specimens tested during week 7.
In week 6, twenty regions in AB, MB, ON, QC, NS & NU reported sporadic activity, while thirty-three regions reported no activity in BC, AB, SK, MB, ON, QC, NB, PE, NS, NL, YT & NT. One region in BC did not report activity this week. The 4 influenza outbreaks reported this week were all in schools (all in NS).


<TABLE class=widthFull cellSpacing=0 cellPadding=0><TBODY><TR class=alignCenter><TD colSpan=2>Map of overall Influenza activity level by provinces and territories, Week 7, Canada


</TD></TR><TR class=alignCenter><TD>
</TD><TD><TABLE cellSpacing=0 cellPadding=1 border=0><TBODY><TR><TD align=middle><TABLE class=border-lite cellSpacing=1 cellPadding=1><TBODY><TR align=middle><TD>No Data </TD><TD>
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</TD></TR><TR class=alignCenter><TD>No Activity</TD><TD>
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</TD></TR><TR class=alignCenter><TD>Sporadic Activity</TD><TD>
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</TD></TR><TR align=middle><TD>Localized Activity</TD><TD>
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</TD></TR><TR align=middle><TD>Widespread
Activity</TD><TD>
leg_000066.gif
</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR><TR><TD class=fontSize85 colSpan=2>Note: Influenza 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 (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.
</TD></TR></TBODY></TABLE>
Number of influenza surveillance regions<SUP>?</SUP> reporting widespread or localized influenza activity,
Canada, by report week, 2009-2010 (N=54)

2010-w07-fg1-eng.gif

flu0910-leg-fg1-eng.gif

? sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.

Overall Number of Influenza Outbreaks, Canada, by Report Week, 2009-2010

2010-w07-fg2-eng.gif

flu0910-leg-fg2-eng.gif

Note that this was the first year that all the provinces and territories were reporting on influenza outbreaks in schools (greater than 10% absenteeism on any day most likely due to ILI) which has increased considerably the total number of outbreaks reported compared to previous years.

ILI consultation rate
During week 7, the national ILI consultation rate was 15 consultations per 1,000 patient visits (see ILI graph) which was similar to previous weeks and is still below the expected range for this time of year. All provinces and territories had similar or lower ILI consultation rates compared to their respective ILI rates in the previous weeks except PE, NS and NL which had a slightly higher rate this week. Those under 20 years of age still had the highest consultation rates: 40 per 1,000 among children under 5 years of age and 27 per 1,000 among those 5 to 19 years of age.
Influenza-like illness (ILI) consultation rates, Canada, by report week,
2009-2010 compared to 1996/97 through to 2008/09 seasons

2010-w07-fg3-eng.gif


flu0910-leg-fg3-eng.gif

Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons).
Delays in the reporting of data may cause data to change retrospectively.
Paediatric and Adult Influenza Hospitalizations and Deaths
In week 7, one laboratory-confirmed influenza-associated paediatric (under 17 years of age) hospitalization was reported through the Immunization Monitoring Program Active (IMPACT) network. The case was reported as pandemic H1N1 2009. 1327* hospitalizations have been reported since week 17 (April 26): 96.9% of these hospitalizations were due to pandemic H1N1 2009. Since the beginning of the pandemic, ten paediatric deaths due to pandemic H1N1 2009 were reported through the IMPACT network among children 16 years of age or under. The total number of paediatric deaths has changed from 11 to 10 since an investigation confirmed that the case was not pandemic H1N1 2009 positive. 70% of those deaths reported at least one underlying medical condition.
*Delays in the reporting of data may cause data to change restrospectively.
During weeks 6 and 7, no new laboratory-confirmed influenza-associated adult (16 years of age and older) hospitalizations were reported through the Canadian Nosocomial Infection Surveillance Program (CNISP) from 15 of 50 reporting sites. Since week 47 (November 22, 2009), 55 hospitalizations and 8 deaths have been reported through CNISP among adults 16 years of age or older. All of these hospitalizations and deaths were due to pandemic H1N1 2009. From June 1, 2009 to February 19, 2010, of the 552 laboratory-confirmed influenza cases among hospitalized adults reported through 27 of CNISP sentinel sites, 70% were pandemic H1N1 2009 cases, 28% were unsubtyped influenza A and the remaining 2% were either influenza A/H1N1, influenza A/H3N2 or influenza B. For these pandemic H1N1 2009 cases, 1.4% presented with influenza-associated bacteremia, 27% were admitted to the ICU, and 5% died (90% of whom had at least one underlying medical condition).
Please note the total number of CNISP reporting sites fluctuates weekly.
Laboratory Surveillance Summary
The proportion of tests that were positive for influenza A was 0.24% during week 7 which remained at a very low level (see Tests table). All provinces had a similar or lower proportion of positive tests for influenza compared to the previous week except Quebec which had a higher proportion this week. During week 7, a total of 6 specimens tested positive for influenza (all A) and 3/4 (75%) of the positive influenza A subtyped specimens were pandemic H1N1 2009. Note that QC reported 44 positive specimens for A/H3N2 and 8 specimens for influenza B and ON reported 6 specimens for influenza B since August 30, 2009. The proportion of specimens positive for respiratory syncytial virus (RSV) increased to 28.0% during week 7. Positive specimens for RSV were reported from all provinces except NB (data not shown). The proportion of positive parainfluenza and adenovirus tests remained under the 3% positivity rate.

Influenza tests reported and percentage of tests positive, Canada,
by report week, 2009-2010

2010-w07-fg4-eng.gif

flu0910-leg-fg4-eng.gif


Percent positive influenza tests, compared to other respiratory viruses, Canada,
by reporting week, 2009-2010


2010-w07-fg5-eng.gif


flu0910-leg-fg5-eng.gif

Weekly & Cumulative numbers of positive influenza specimens, by Provincial Laboratories

<TABLE class=widthFull cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD class=fontSize85 colSpan=13>Note: Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals.
* Not subtyped

</TD></TR></TFOOT><TBODY><TR class=alignCenter><TH class=bg-colour-blue scope=col rowSpan=3>Reporting provinces</TH><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=6>Weekly (February 14 to February 20, 2010)</TH><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=6>Cumulative (August 30, 2009 to February 20, 2010)</TH></TR><TR class=alignCenter><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=5>Influenza A</TH><TH class="bg-colour-blue fontSize85" scope=col>B</TH><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=5>Influenza A</TH><TH class=bg-colour-blue scope=col>B</TH></TR><TR class=alignCenter><TH class="fontSize85 bg-colour-blue" scope=col>A Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H3)</TH><TH class="fontSize85 bg-colour-blue" scope=col>Pand H1N1</TH><TH class="fontSize85 bg-colour-blue" scope=col>A
(NS)*</TH><TH class="fontSize85 bg-colour-blue" scope=col>Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H3)</TH><TH class="fontSize85 bg-colour-blue" scope=col>Pand H1N1</TH><TH class="fontSize85 bg-colour-blue" scope=col>A
(NS)*</TH><TH class="fontSize85 bg-colour-blue" scope=col>Total</TH></TR><TR><TH class=bg-colour-blue scope=row>BC</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6370</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>5804</TD><TD class=alignCenter>565</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5868</TD><TD class=alignCenter>2</TD><TD class=alignCenter>5</TD><TD class=alignCenter>5760</TD><TD class=alignCenter>101</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2598</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>2298</TD><TD class=alignCenter>299</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1915</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1788</TD><TD class=alignCenter>127</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>7907</TD><TD class=alignCenter>4</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3552</TD><TD class=alignCenter>4351</TD><TD class=alignCenter>6</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>4</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>10693</TD><TD class=alignCenter>1</TD><TD class=alignCenter>44</TD><TD class=alignCenter>10646</TD><TD class=alignCenter>2</TD><TD class=alignCenter>8</TD></TR><TR><TH class=bg-colour-blue scope=row>NB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1856</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1835</TD><TD class=alignCenter>19</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>786</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>753</TD><TD class=alignCenter>33</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>97</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>96</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>951</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>951</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>6</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>39041</TD><TD class=alignCenter>8</TD><TD class=alignCenter>52</TD><TD class=alignCenter>33483</TD><TD class=alignCenter>5498</TD><TD class=alignCenter>14</TD></TR><TR><TD class=alignCenter scope=row colSpan=13>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces </TD></TR></TBODY></TABLE>
Sale of antivirals (AV) in Canada

During week 7, antiviral prescription monitoring continued to demonstrate a levelling-off in antiviral prescriptions with little change compared to last week among all provinces and territories. An analysis of antiviral data at the Health Region level demonstrated low antiviral prescription rates among all Health Regions for the week of February 14 to February 20, 2010. None of the Health Regions reported an antiviral rate greater than 2.5 antivirals/1000 other prescriptions.
2010-w7-av-eng.jpg

Reference: H1N1 Antiviral and OTC Surveillance Weekly Report. CFEZID, PHAC.
Canadian situation

Antigenic Characterization
Since September 1, 2009, the National Microbiology Laboratory (NML) has antigenically characterized 835 pandemic H1N1 2009 viruses and 13 seasonal influenza viruses (3 influenza A/H1N1, 9 H3N2, and 1 B virus) that were received from Canadian laboratories. Of the 835 pandemic H1N1 2009 viruses characterized, 831 (99.5%) were antigenically related to A/California/7/2009, which is the pandemic reference virus selected by WHO for the pandemic H1N1 2009 vaccine. Four viruses (0.5%) tested showed reduced titer with antisera produced against A/California/7/09. Of the nine seasonal influenza A (H3N2) viruses characterized, one was related to A/Brisbane/10/07, which was the influenza A/H3N2 component recommended for the 2009-10 influenza vaccine and eight viruses were antigenically related to A/Perth/16/09, which is the WHO recommended influenza A (H3N2) component for the 2010 -2011 Northern Hemishpere vaccine. Three seasonal influenza A/H1N1 viruses characterized were related to A/Brisbane/59/07, which was the influenza A/H1N1 component recommended for the 2009-10 influenza vaccine.
Antiviral Resistance
NML: Thirteen cases of oseltamivir resistant pandemic H1N1 2009 were reported to date in Canada: one in British Columbia, four in Alberta, one in Manitoba, four in Ontario, two in Quebec, and one in New Brunswick. The 13 resistant cases were associated with oseltamivir treatment/prophylaxis.
NML/Provinces: All pandemic H1N1 2009 viruses tested so far have been sensitive to zanamivir (1031 samples) but resistant to amantadine (1115 samples).
International update

Global information
WHO: As of February 14, 2010, over 212 countries and overseas territories or communities worldwide reported cases of pandemic H1N1 2009 (at least 15,921 deaths). During weeks 1-4, pandemic H1N1 2009 viruses persisted in some countries around the world although the majority of Northern Hemisphere countries reported decreasing activity. Activity in the Southern Hemisphere was variable but mainly sporadic. The pandemic virus continued to be the predominant circulating influenza virus in all countries where influenza was reported with the exception of China where influenza B was the predominant virus.
<
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http://www.who.int/csr/don/2010_02_19/en/index.html> and
<
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http://www.who.int/csr/disease/influenza/update/en/index.html>
On February 23, 2010, the Director General of the WHO sought the Emergency Committee's views on the determination of the pandemic status. After reviewing the evidence (i.e. new community level transmission activity in West Africa, winter months of the Southern Hemisphere has not yet started), and holding extensive discussion, it was determined that there had been no change in the pandemic phase. The situation will be monitored closely and the Committee will convene again to discuss the global pandemic status in the next several weeks.
<
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http://www.who.int/csr/disease/swineflu/7th_meeting_ihr/en/index.html>
Antiviral resistance: To date, 248 pandemic H1N1 2009 isolates worldwide have been found to be resistant to oseltamivir, all with the same H275Y mutation and all remain sensitive to zanamivir.
<
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http://www.who.int/csr/disease/swineflu/update_oseltamivir_resistant20100210.pdf>
2010-2011 influenza season vaccine: The WHO recommends that the following viruses be used for influenza vaccines in the 2010-2011 influenza season (northern hemisphere): an A/California/7/2009 (H1N1)-like virus; an A/Perth/16/2009 (H3N2)-like virus; and a B/Brisbane/60/2008-like virus.
<
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http://www.who.int/csr/disease/influenza/recommendations2010_11north/en/index.html>
Geographic update
United States: During week 6, influenza activity remained at approximately the same levels as last week in the United States with the majority of states reporting sporadic influenza activity (6 states reported regional and 11 states and Puerto Rico reporting localized). Of the 3,656 specimens tested for influenza in week 6, 129 (3.5%) were positive for influenza (125 were influenza A and 4 were influenza B). All of the influenza A viruses subtyped were pandemic H1N1 2009 viruses. The proportion of deaths attributed to pneumonia and influenza increased slightly but remained below the epidemic threshold. The proportion of outpatient visits for ILI (2.1%) remained below baseline levels. Two influenza-associated pediatric deaths were reported this week and both were associated with pandemic H1N1 2009 virus infection.
<
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http://www.cdc.gov/flu/weekly/>
Europe: The 2009 influenza A(H1N1) pandemic is well past its winter peak in Europe, with the majority of the countries reporting only sporadic transmission of the pandemic virus. In seven countries (the majority of which are in Eastern Europe), local or regional transmission of the pandemic virus continued at low to medium intensity. In addition to the pandemic H1N1 2009 virus, there was currently no evidence of wide circulation of other influenza A viruses. A few influenza B viruses have been detected. Respiratory syncytial virus detections continued to decline since peaking in week 1. Additionally, the number of severe acute respiratory infection cases by week of onset (29 reported in week 6) has been declining since the peak in week 46.
<
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http://ecdc.europa.eu/en/publications/Publications/100219_EISN_Weekly_Influenza_Surveillance_Overview.pdf>
Asia: In Southeast Asia, several countries (Thailand, Myanmar and Indonesia) reported an increasing trend of respiratory diseases activity but overall intensity remained low. In South Asia, influenza activity persisted in the northern and western states of India, however, overall influenza activity continued to decline or remained low in other countries. In East and West Asia, transmission of pandemic influenza virus persisted but was either steadily declining or the overall intensity of current activity remained low, with the exception of North Korea where an increasing trend of respiratory diseases activity was reported.
<
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http://www.who.int/csr/don/2010_02_19/en/index.html>
Africa: Several countries in West Africa reported increases in the number of cases but there is as yet insufficient evidence to conclude that widespread community transmission is occurring. In North Africa, pandemic influenza transmission persists but activity has declined substantially over the past month. In Sub-Saharan Africa, sporadic pandemic influenza virus transmission was reported.
<
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http://www.who.int/csr/don/2010_02_19/en/index.html>
Southern Hemisphere
Australia: As at 12 February 2010, there have been 37,713 confirmed cases of pandemic (H1N1) 2009 and 191 deaths reported in Australia. National influenza activity remains low and is at levels experienced at the same time in previous years. <http://www.healthemergency.gov.au/internet/healthemergency/publishing.nsf/Content/ozflucurrent.htm>
New Zealand: As of February 21, 2010, there have been 3,300 cases of pandemic H1N1 2009 reported in New Zealand with 20 deaths. ILI consultation rates have remained below baseline levels since the beginning of the year. <http://www.surv.esr.cri.nz/PDF_surveillance/Virology/FluWeekRpt/2010/FluWeekRpt201007.pdf>
Real-time weekly and cumulative numbers of deaths due to pandemic H1N1 2009, by province/territory, Canada, as of February 25, 2010, 12h00 EDT

<TABLE class="width75 alignCenter" cellSpacing=0 cellPadding=1 border=1><TBODY><TR class=bg-colour-blue><TH scope=col>Province/ Territory</TH><TH scope=col>New Deaths
(from February 18 to February 25, 2010 12h00 EDT)</TH><TH scope=col>Cumulative deaths</TH></TR><TR><TD class=alignCenter>BC</TD><TD class=alignCenter>0</TD><TD class=alignCenter>56</TD></TR><TR><TD class=alignCenter>AB</TD><TD class=alignCenter>0</TD><TD class=alignCenter>71</TD></TR><TR><TD class=alignCenter>SK</TD><TD class=alignCenter>0</TD><TD class=alignCenter>15</TD></TR><TR><TD class=alignCenter>MB</TD><TD class=alignCenter>0</TD><TD class=alignCenter>11</TD></TR><TR><TD class=alignCenter>ON</TD><TD class=alignCenter>1</TD><TD class=alignCenter>129</TD></TR><TR><TD class=alignCenter>QC</TD><TD class=alignCenter>0</TD><TD class=alignCenter>108</TD></TR><TR><TD class=alignCenter>NB</TD><TD class=alignCenter>0</TD><TD class=alignCenter>8</TD></TR><TR><TD class=alignCenter>NS</TD><TD class=alignCenter>0</TD><TD class=alignCenter>7</TD></TR><TR><TD class=alignCenter>PE</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TD class=alignCenter>NL</TD><TD class=alignCenter>0</TD><TD class=alignCenter>18</TD></TR><TR><TD class=alignCenter>YT</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3</TD></TR><TR><TD class=alignCenter>NT</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD></TR><TR><TD class=alignCenter>NU</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD></TR><TR><TD class=alignCenter>Canada</TD><TD class=alignCenter>1</TD><TD class=alignCenter>428</TD></TR></TBODY></TABLE>
http://www.phac-aspc.gc.ca/fluwatch/09-10/w07_10/index-eng.php
 
Re: Canada - FluWatch Pandemic (H1N1) virus Surveillance Week 8 - 429 deaths Total

Re: Canada - FluWatch Pandemic (H1N1) virus Surveillance Week 8 - 429 deaths Total

February 21 to February 27, 2010 (Week 8)



Posted 2010-03-05

Weekly and cumulative numbers of hospitalized cases, ICU admissions and deaths among Pandemic H1N1 2009 confirmed cases, Canada, April 12, to February 27, 2010<SUP>?</SUP>

<TABLE class="widthFull fontSize85" cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD colSpan=10><SUP id=star>*</SUP>Based on reporting date.
<SUP id=dstar>**</SUP>Based on epidemiological date, hospitalization date, death date and reporting date.
<SUP>1</SUP> Aggregate counts were reported this week.
<SUP>2</SUP> The increase from last week is due to more detailed accounting of retrospective case records from the regional health authorities rather than an increase in new case reports.
? Note that due to reporting delays, some provinces and territories reported retrospectively on first and second wave cases.

</TD></TR></TFOOT><TBODY><TR class=alignCenter><TH class=bg-colour-blue scope=col rowSpan=2>Province/
Territory
</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>Week 8
(February 21 to February 27, 2010)*
</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>From August 30, 2009 to
February 27, 2010**
</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>From April 12 to August 29, 2009**</TH></TR><TR class=alignCenter><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH></TR><TR><TH class=bg-colour-blue scope=row>BC<SUP>1,2</SUP></TH><TD class=alignCenter>0</TD><TD class=alignCenter>13</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1031</TD><TD class=alignCenter>148</TD><TD class=alignCenter>52</TD><TD class=alignCenter>49</TD><TD class=alignCenter>19</TD><TD class=alignCenter>5</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1147</TD><TD class=alignCenter>210</TD><TD class=alignCenter>64</TD><TD class=alignCenter>129</TD><TD class=alignCenter>29</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>44</TD><TD class=alignCenter>40</TD><TD class=alignCenter>11</TD><TD class=alignCenter>23</TD><TD class=alignCenter>12</TD><TD class=alignCenter>4</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>166</TD><TD class=alignCenter>18</TD><TD class=alignCenter>4</TD><TD class=alignCenter>213</TD><TD class=alignCenter>43</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1444</TD><TD class=alignCenter>250</TD><TD class=alignCenter>104</TD><TD class=alignCenter>399</TD><TD class=alignCenter>69</TD><TD class=alignCenter>25</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2491</TD><TD class=alignCenter>361</TD><TD class=alignCenter>81</TD><TD class=alignCenter>572</TD><TD class=alignCenter>104</TD><TD class=alignCenter>27</TD></TR><TR><TH class=bg-colour-blue scope=row>NB<SUP>1</SUP></TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>161</TD><TD class=alignCenter>33</TD><TD class=alignCenter>8</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>276</TD><TD class=alignCenter>42</TD><TD class=alignCenter>6</TD><TD class=alignCenter>17</TD><TD class=alignCenter>8</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>49</TD><TD class=alignCenter>9</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NL<SUP>2</SUP></TH><TD class=alignCenter>31</TD><TD class=alignCenter>8</TD><TD class=alignCenter>0</TD><TD class=alignCenter>305</TD><TD class=alignCenter>59</TD><TD class=alignCenter>18</TD><TD class=alignCenter>3</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>YT</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>15</TD><TD class=alignCenter>3</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NT</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>46</TD><TD class=alignCenter>7</TD><TD class=alignCenter>1</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NU</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>74</TD><TD class=alignCenter>6</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>32</TD><TD class=alignCenter>23</TD><TD class=alignCenter>1</TD><TD class=alignCenter>7181</TD><TD class=alignCenter>1180</TD><TD class=alignCenter>352</TD><TD class=alignCenter>1488</TD><TD class=alignCenter>292</TD><TD class=alignCenter>77</TD></TR></TBODY></TABLE>
Descriptive characteristics of laboratory-confirmed Canadian pandemic H1N1 2009 hospitalized cases, ICU-admitted cases and deaths with core information available, reported to PHAC as of February 27, 2010<SUP><SUP>?</SUP> </SUP>

<TABLE class=fontSize85 cellSpacing=0 cellPadding=2 border=1><TBODY><TR class=alignCenter><TD rowSpan=2></TD><TH class=bg-colour-blue colSpan=3>From April 12 to August 29, 2009</TH><TH class=bg-colour-blue colSpan=3>From August 30, 2009 to February 27, 2010</TH><TH class=bg-colour-blue colSpan=3>Cumulative: From
April 12, 2009 to February 27, 2010
</TH></TR><TR class=alignCenter><TH class=bg-colour-blue>Hospitalized cases (n=1488)</TH><TH class=bg-colour-blue>ICU-admitted
(n=292)
</TH><TH class=bg-colour-blue>Deaths
(n=77)
</TH><TH class=bg-colour-blue>Hospitalized
cases (n=6733)
</TH><TH class=bg-colour-blue>ICU-admitted
(n=1180)
</TH><TH class=bg-colour-blue>Deaths
(n=347)
</TH><TH class=bg-colour-blue>Hospitalized
cases
(n=8221)
</TH><TH class=bg-colour-blue>ICU-admitted
(n=1472)
</TH><TH class=bg-colour-blue>Deaths
(n=424)
</TH></TR><TR><TH class="bg-colour-blue alignLeft">Females, %</TH><TD class=alignCenter>51.3</TD><TD class=alignCenter>57.2</TD><TD class=alignCenter>62.3</TD><TD class=alignCenter>49.7</TD><TD class=alignCenter>49.4</TD><TD class=alignCenter>47.0</TD><TD class=alignCenter>50.0</TD><TD class=alignCenter>51.0</TD><TD class=alignCenter>49.8</TD></TR><TR><TH class="bg-colour-blue alignLeft">Median age</TH><TD class=alignCenter>23.0</TD><TD class=alignCenter>37.0</TD><TD class=alignCenter>51.0</TD><TD class=alignCenter>30.0</TD><TD class=alignCenter>47.0</TD><TD class=alignCenter>54.0</TD><TD class=alignCenter>29.0</TD><TD class=alignCenter>46.0</TD><TD class=alignCenter>53.5</TD></TR><TR><TH class="bg-colour-blue alignLeft">Aboriginal status<SUP>1</SUP>, % </TH><TD class=alignCenter>20.0-27.7</TD><TD class=alignCenter>16.1-21.9</TD><TD class=alignCenter>11.7-17.6</TD><TD class=alignCenter>4.5-6.1</TD><TD class=alignCenter>5.8-7.7</TD><TD class=alignCenter>6.1-8.9</TD><TD class=alignCenter>7.3-9.9</TD><TD class=alignCenter>7.8-10.4</TD><TD class=alignCenter>7.1-10.4</TD></TR><TR><TH class="bg-colour-blue alignLeft">Underlying medical
conditions<SUP>2</SUP>, %
</TH><TD class=alignCenter>47.5
(652/1373)
</TD><TD class=alignCenter>60.2
(162/269)
</TD><TD class=alignCenter>73.3
(55/75)
</TD><TD class=alignCenter>58.6
(1920/3275)
</TD><TD class=alignCenter>73.1
(669/915)
</TD><TD class=alignCenter>84.2
(240/285)
</TD><TD class=alignCenter>55.3
(2572/4648)
</TD><TD class=alignCenter>70.2
(831/1184)
</TD><TD class=alignCenter>81.9
(295/360)
</TD></TR><TR><TH class="bg-colour-blue alignLeft">Pregnancy<SUP>3</SUP>, %</TH><TD class=alignCenter>27.6
(75/272)
</TD><TD class=alignCenter>19.7
(15/76)
</TD><TD class=alignCenter>28.6
(4/14)
</TD><TD class=alignCenter>18.2
(187/1027)
</TD><TD class=alignCenter>8.3
(15/180)
</TD><TD class=alignCenter>0.0
(0/36)
</TD><TD class=alignCenter>20.2
(262/1299)
</TD><TD class=alignCenter>11.7
(30/256)
</TD><TD class=alignCenter>8.0
(4/50)
</TD></TR><TR><TD colSpan=10><SUP>1 </SUP>Since Aboriginal status is not reported by two provinces (which comprise 23% of the Aboriginal population) two methods were used to calculate proportions: one proportion was calculated by including ON and NS cases in the denominator (which is an underestimate of the true proportion); while the other proportion was calculated by excluding ON and NS cases in the denominator (which is an overestimate).
<SUP>2 </SUP>Proportion of cases with at least one underlying medical condition (excluding pregnancy) among those for whom the information was available.
<SUP>3 </SUP>Percent of pregnant women among women 15 to 44 years of age.
? All cases admitted to ICU are included in the hospitalization count; however, not all the fatal cases have been hospitalized before dying.

</TD></TR></TBODY></TABLE>

Overall Influenza Summary - Week 8 (February 21 to February 27, 2010)

During week 8, overall influenza activity remained at approximately the same level as last week and all influenza indicators were still considerably below expected levels for this time of the year. Of the 2,646 specimens tested for influenza in week 8, 7 (0.26%) were positive of which 6 (86%) were for influenza A and one (14%) was positive for influenza B. Of the 5 influenza A viruses that were subtyped, all were pandemic H1N1 2009. Respiratory syncytial virus detections were still high but the proportion of positive detections declined for the first time since the beginning of 2010 to 24.0% in week 8.
In week 8, 14 regions in AB, ON, QC & NS reported sporadic activity, while 39 regions reported no activity. One region in BC is not reporting until further notice. No influenza outbreaks were reported this week.


<TABLE class=widthFull cellSpacing=0 cellPadding=0><TBODY><TR class=alignCenter><TD colSpan=2>Map of overall Influenza activity level by provinces and territories, Week 8, Canada



</TD></TR><TR class=alignCenter><TD>

</TD><TD><TABLE cellSpacing=0 cellPadding=1 border=0><TBODY><TR><TD align=middle><TABLE class=border-lite cellSpacing=1 cellPadding=1><TBODY><TR align=middle><TD>No Data </TD><TD>
leg_dots.gif
</TD></TR><TR class=alignCenter><TD>No Activity</TD><TD>
leg_ffffff.gif
</TD></TR><TR class=alignCenter><TD>Sporadic Activity</TD><TD>
leg_ccccff.gif
</TD></TR><TR align=middle><TD>Localized Activity</TD><TD>
leg_6666ff.gif
</TD></TR><TR align=middle><TD>Widespread
Activity
</TD><TD>
leg_000066.gif
</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR><TR><TD class=fontSize85 colSpan=2>Note: Influenza 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 (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.

</TD></TR></TBODY></TABLE>
Number of influenza surveillance regions<SUP>?</SUP> reporting widespread or localized influenza activity,
Canada, by report week, 2009-2010 (N=54)

2010-w08-fg1-eng.gif

flu0910-leg-fg1-eng.gif

? sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.

Overall Number of Influenza Outbreaks, Canada, by Report Week, 2009-2010

2010-w08-fg2-eng.gif

flu0910-leg-fg2-eng.gif

Note that this was the first year that all the provinces and territories were reporting on influenza outbreaks in schools (greater than 10% absenteeism on any day most likely due to ILI) which has increased considerably the total number of outbreaks reported compared to previous years.

ILI consultation rate
During week 8, the national ILI consultation rate was 10 consultations per 1,000 patient visits (see ILI graph) which was still considerably below the expected range for this time of year (range from 25 to 44 consultations per 1,000 patient visits). All provinces and territories had similar or lower ILI consultation rates compared to their respective ILI rates in the previous weeks except NB which had a slightly higher rate this week. Those under 20 years of age still had the highest consultation rates with 18 ILI consultations per 1,000 patients visits.
Influenza-like illness (ILI) consultation rates, Canada, by report week,
2009-2010 compared to 1996/97 through to 2008/09 seasons

2010-w08-fg3-eng.gif


flu0910-leg-fg3-eng.gif

Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons).
Delays in the reporting of data may cause data to change retrospectively.
Paediatric and Adult Influenza Hospitalizations and Deaths
In week 8, one laboratory-confirmed influenza-associated paediatric (under 17 years of age) hospitalization was reported through the Immunization Monitoring Program Active (IMPACT) network. The hospitalization was due to influenza A (unsubtyped). A total of 1328* hospitalizations have been reported since week 17 (April 26, 2009), of which 96.8% were due to pandemic H1N1 2009. Since the beginning of the pandemic, ten paediatric deaths due to pandemic H1N1 2009 were reported through the IMPACT network among children 16 years of age or under. Seven (70%) of those deaths reported had at least one underlying medical condition.
*Delays in the reporting of data may cause data to change restrospectively.
During week 8, no new laboratory-confirmed influenza-associated adult (16 years of age and older) hospitalizations were reported through the Canadian Nosocomial Infection Surveillance Program (CNISP) from 14 of 50 reporting sites. Since week 47 (November 22, 2009), 55 hospitalizations and 8 deaths have been reported through CNISP among adults 16 years of age or older. All of these hospitalizations and deaths were due to pandemic H1N1 2009. From June 1, 2009 to February 19, 2010, of the 552 laboratory-confirmed influenza cases among hospitalized adults reported through 27 of CNISP sentinel sites, 385 (70%) were pandemic H1N1 2009 cases, 152 (28%) were unsubtyped influenza A and the remaining 11 (2%) were either influenza A/H1N1, influenza A/H3N2 or influenza B. For these pandemic H1N1 2009 cases, 1.3% (5/365) presented with influenza-associated bacteremia, 27% (100/376) were admitted to the ICU, and 5% (20/385) died (90% of whom had at least one underlying medical condition).
Please note the total number of CNISP reporting sites fluctuates weekly and most of the reporting sites started in late fall 2009.
Laboratory Surveillance Summary
The proportion of tests that were positive for influenza during week 8 (0.26%, 7/2,646) remained at a very low level for this time of year (see Tests table). Of the positive tests, 6 (86%) were for influenza A and one (14%) was positive for influenza B. Of the 5 influenza A viruses that were subtyped, all were pandemic H1N1 2009. All provinces had a similar or lower proportion of positive tests for influenza compared to the previous weeks. Note that since August 30, 2009, influenza A/H3N2 detections were highest in QC (84.6% or 44/52) and influenza B detections were highest in QC (60% or 9/15) and ON (40% or 6/15). Respiratory syncytial virus detections were still high but the proportion of positive detections declined for the first time since the beginning of 2010 to 24.0% in week 8. Positive specimens for RSV were reported from all provinces except NB and NL (data not shown). The proportion of positive parainfluenza and adenovirus tests remained under the 3% positivity rate.

Influenza tests reported and percentage of tests positive, Canada,
by report week, 2009-2010

2010-w08-fg4-eng.gif

flu0910-leg-fg4-eng.gif


Percent positive influenza tests, compared to other respiratory viruses, Canada,
by reporting week, 2009-2010


2010-w08-fg5-eng.gif


flu0910-leg-fg5-eng.gif

Weekly & Cumulative numbers of positive influenza specimens, by Provincial Laboratories, Canada, 2009-2010

<TABLE class=widthFull cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD class=fontSize85 colSpan=13>Note: Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals.
* Not subtyped

</TD></TR></TFOOT><TBODY><TR class=alignCenter><TH class=bg-colour-blue scope=col rowSpan=3>Reporting provinces</TH><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=6>Weekly (February 21 to February 27, 2010)</TH><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=6>Cumulative (August 30, 2009 to February 27, 2010)</TH></TR><TR class=alignCenter><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=5>Influenza A</TH><TH class="bg-colour-blue fontSize85" scope=col>B</TH><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=5>Influenza A</TH><TH class=bg-colour-blue scope=col>B</TH></TR><TR class=alignCenter><TH class="fontSize85 bg-colour-blue" scope=col>A Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H3)</TH><TH class="fontSize85 bg-colour-blue" scope=col>Pand H1N1</TH><TH class="fontSize85 bg-colour-blue" scope=col>A
(NS)*
</TH><TH class="fontSize85 bg-colour-blue" scope=col>Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H3)</TH><TH class="fontSize85 bg-colour-blue" scope=col>Pand H1N1</TH><TH class="fontSize85 bg-colour-blue" scope=col>A
(NS)*
</TH><TH class="fontSize85 bg-colour-blue" scope=col>Total</TH></TR><TR><TH class=bg-colour-blue scope=row>BC</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6370</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>5804</TD><TD class=alignCenter>565</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5868</TD><TD class=alignCenter>2</TD><TD class=alignCenter>5</TD><TD class=alignCenter>5760</TD><TD class=alignCenter>101</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2598</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>2298</TD><TD class=alignCenter>299</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1915</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1788</TD><TD class=alignCenter>127</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>7912</TD><TD class=alignCenter>4</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3556</TD><TD class=alignCenter>4352</TD><TD class=alignCenter>6</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>10695</TD><TD class=alignCenter>1</TD><TD class=alignCenter>44</TD><TD class=alignCenter>10648</TD><TD class=alignCenter>2</TD><TD class=alignCenter>9</TD></TR><TR><TH class=bg-colour-blue scope=row>NB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1856</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1835</TD><TD class=alignCenter>19</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>787</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>753</TD><TD class=alignCenter>34</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>97</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>96</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>951</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>951</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>39049</TD><TD class=alignCenter>8</TD><TD class=alignCenter>52</TD><TD class=alignCenter>33489</TD><TD class=alignCenter>5500</TD><TD class=alignCenter>15</TD></TR><TR><TD class=alignCenter scope=row colSpan=13>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces </TD></TR></TBODY></TABLE>
Sale of antivirals (AV) in Canada

During week 8, antiviral prescription monitoring continued to demonstrate a levelling-off in antiviral prescriptions with little change compared to last week among all provinces and territories. An analysis of antiviral data at the Health Region level demonstrated low antiviral prescription rates among all Health Regions for the week of February 21 to February 27, 2010. Only one Health Region in AB reported an antiviral rate greater than 2.5 antivirals/1000 other prescriptions.
2010-w8-av-eng.jpg

Reference: H1N1 Antiviral and OTC Surveillance Weekly Report. CFEZID, PHAC.
Canadian situation

Antigenic Characterization
Since September 1, 2009, the National Microbiology Laboratory (NML) has antigenically characterized 835 pandemic H1N1 2009 viruses and 16 seasonal influenza viruses (3 influenza A/H1N1, 10 H3N2, and 3 B virus) that were received from Canadian laboratories. Of the 835 pandemic H1N1 2009 viruses characterized, 831 (99.5%) were antigenically related to A/California/7/2009, which is the pandemic reference virus selected by WHO for the pandemic H1N1 2009 vaccine. Four viruses (0.5%) tested showed reduced titer with antisera produced against A/California/7/09. Of the ten seasonal influenza A (H3N2) viruses characterized, two were related to A/Brisbane/10/07, which was the influenza A/H3N2 component recommended for the 2009-10 influenza vaccine and eight viruses were antigenically related to A/Perth/16/09, which is the WHO recommended influenza A (H3N2) component for the 2010 -2011 Northern Hemishpere vaccine. Three seasonal influenza A/H1N1 viruses characterized were related to A/Brisbane/59/07, which was the influenza A/H1N1 component recommended for the 2009-10 influenza vaccine.Of the three influenza B virus characterized, two were antigenically related to B/Brisbane/60/08, which was the recommended influenza B component for the 2009-10 influenza vaccine. One B virus was related to the previous vaccine virus B/Florida/4/2006 (Yamagata lineage).
Antiviral Resistance
NML/Provinces: Thirteen cases of oseltamivir resistant pandemic H1N1 2009 were reported to date in Canada: one in British Columbia, four in Alberta, one in Manitoba, four in Ontario, two in Quebec, and one in New Brunswick. The 13 resistant cases were associated with oseltamivir treatment/prophylaxis
NML: All pandemic H1N1 2009 viruses tested so far have been sensitive to zanamivir (1042 samples) but resistant to amantadine (1121 samples).
International update

Global information
WHO: As of February 26, 2010, over 213 countries and overseas territories or communities worldwide reported cases of pandemic H1N1 2009 (at least 16,226 deaths). In the temperate zone of the northern hemisphere, pandemic influenza virus continued to be detected across many countries, however, overall influenza activity continued to wane in most places. The most active areas of transmission were currently in parts of South and Southeast Asia and in limited areas of Eastern and Southeastern Europe. Pandemic influenza (H1N1) 2009 virus continued to be the predominant influenza virus circulating worldwide. In addition to the increasing proportion of seasonal influenza type B viruses recently detected in China, low levels of seasonal H3N2 and type B viruses were circulating in parts of Africa and Asia. Respiratory disease activity was increasing in many areas of the world due to increasing transmission of influenza type B and respiratory syncytial virus. Seasonal influenza H3N2 continued to be detected in areas of Asia and east Africa.
<
Icons-External-Link.gif
http://www.who.int/csr/don/2010_02_26/en/index.html>
Antiviral resistance: To date, 253 pandemic H1N1 2009 isolates worldwide have been found to be resistant to oseltamivir, all with the same H275Y mutation and all remained sensitive to zanamivir.
<
Icons-External-Link.gif
http://www.who.int/csr/disease/swineflu/Oseltamivirresistant2010_02_26.pdf>
2010-2011 influenza season vaccine: The WHO recommends that the following viruses be used for influenza vaccines in the 2010-2011 influenza season (northern hemisphere): an A/California/7/2009 (H1N1)-like virus; an A/Perth/16/2009 (H3N2)-like virus; and a B/Brisbane/60/2008-like virus.
<
Icons-External-Link.gif
http://www.who.int/csr/disease/influenza/recommendations2010_11north/en/index.html>
Geographic update
United States: During week 7, influenza activity remained at approximately the same levels as last week in the United States with the majority of states reporting sporadic influenza activity (3 states reported regional and 8 states and Puerto Rico reporting localized). Of the 4,209 specimens tested for influenza in week 7, 185 (4.4%) were positive for influenza (181 were influenza A and 4 were influenza B). All of the influenza A viruses subtyped were pandemic H1N1 2009 viruses. The proportion of deaths attributed to pneumonia and influenza (7.4%) and the proportion of outpatient visits for ILI (1.8%) declined from the previous week and both remain below baseline levels. Three influenza-associated pediatric deaths were reported this week: one was associated with pandemic H1N1 2009 virus infection and the other two were associated with influenza A (subtype undetermined).
<
Icons-External-Link.gif
http://www.cdc.gov/flu/weekly/index.htm>
Europe: The 2009 influenza A(H1N1) pandemic is well past its winter peak in Europe, with the majority of the countries reporting only sporadic activity or no geographic spread of the pandemic virus. Although circulation of 2009 pandemic A(H1N1) influenza virus has diminished, there was still no evidence of wide circulation of other influenza A viruses apart from few influenza A(H3N2) and B viruses.
<
Icons-External-Link.gif
http://ecdc.europa.eu/en/activities/surveillance/EISN/Newsletter/100226_EISN_Weekly_Influenza_Surveillance_Overview.pdf>
Asia: In Southeast Asia, pandemic influenza virus continued to circulate in some areas, however, the overall intensity of respiratory diseases activity remained low and unchanged, except in a few countries (Brunei Darussalam, Myanmar and Thailand). Pandemic influenza and seasonal influenza type B viruses continued to co-circulate in East Asia. In China, the proportion of positive seasonal influenza type B viruses increased during the last week. Overall influenza activity continued to decline in Japan, South Korea, Hong Kong SAR (China) and in Chinese Taipei. In South Asia, overall influenza activity remained low, however, pandemic influenza virus transmission persisted in the western part of India. In West Asia, an increasing trend of respiratory diseases was reported in Afghanistan, however, it is unknown if the recent increase is associated with circulation of influenza virus.
<
Icons-External-Link.gif
http://www.who.int/csr/don/2010_02_26/en/index.html>
Africa: In North Africa, pandemic influenza virus continued to circulate at low levels as rates of illness in most countries in the region continued to decline or return to baseline. In Sub-Saharan Africa, pandemic influenza virus transmission continued to be sporadic in most areas of the continent. Several countries in West Africa continued to report slight increases in the numbers of confirmed cases of pandemic influenza indicating that community transmission is likely beginning in the area; however, data were very limited.
<
Icons-External-Link.gif
http://www.who.int/csr/don/2010_02_26/en/index.html>
Central & South America and the Caribbean: In the the Americas, pandemic influenza virus continued to circulate at low levels but overall pandemic influenza activity continued to decline or remain low in most places. In Central America and Caribbean, pandemic influenza virus transmission persisted but overall activity remained low or unchanged in most places.
<
Icons-External-Link.gif
http://www.who.int/csr/don/2010_02_26/en/index.html>
Australia: As of 19 February 2010, there have been 37,713 confirmed cases of pandemic (H1N1) 2009 reported in Australia. National influenza activity remained low and was at levels experienced at the same time in previous years.
< http://www.healthemergency.gov.au/internet/healthemergency/publishing.nsf/Content/ozflucurrent.htm>
New Zealand: As of February 28, 2010, there have been 3,300 cases of pandemic H1N1 2009 reported in New Zealand with 20 deaths. The ILI consultation rate for week 8 was 14.3 per 100,000 which was below baseline.
< http://www.surv.esr.cri.nz/PDF_surveillance/Virology/FluWeekRpt/2010/FluWeekRpt201007.pdf>
Real-time weekly and cumulative numbers of deaths due to pandemic H1N1 2009, by province/territory, Canada, from February 25 to March 4, 2010, 12h00 EDT

<TABLE class="width75 alignCenter" cellSpacing=0 cellPadding=1 border=1><TBODY><TR class=bg-colour-blue><TH scope=col>Province/ Territory</TH><TH scope=col>New Deaths
(from February 25 to March 4, 2010 12h00 EDT)
</TH><TH scope=col>Cumulative deaths</TH></TR><TR><TD class=alignCenter>BC</TD><TD class=alignCenter>0</TD><TD class=alignCenter>57</TD></TR><TR><TD class=alignCenter>AB</TD><TD class=alignCenter>0</TD><TD class=alignCenter>71</TD></TR><TR><TD class=alignCenter>SK</TD><TD class=alignCenter>0</TD><TD class=alignCenter>15</TD></TR><TR><TD class=alignCenter>MB</TD><TD class=alignCenter>0</TD><TD class=alignCenter>11</TD></TR><TR><TD class=alignCenter>ON</TD><TD class=alignCenter>0</TD><TD class=alignCenter>129</TD></TR><TR><TD class=alignCenter>QC</TD><TD class=alignCenter>0</TD><TD class=alignCenter>108</TD></TR><TR><TD class=alignCenter>NB</TD><TD class=alignCenter>0</TD><TD class=alignCenter>8</TD></TR><TR><TD class=alignCenter>NS</TD><TD class=alignCenter>0</TD><TD class=alignCenter>7</TD></TR><TR><TD class=alignCenter>PE</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TD class=alignCenter>NL</TD><TD class=alignCenter>0</TD><TD class=alignCenter>18</TD></TR><TR><TD class=alignCenter>YT</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3</TD></TR><TR><TD class=alignCenter>NT</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD></TR><TR><TD class=alignCenter>NU</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD></TR><TR><TD class=alignCenter>Canada</TD><TD class=alignCenter>0</TD><TD class=alignCenter>429</TD></TR></TBODY></TABLE>
http://www.phac-aspc.gc.ca/fluwatch/09-10/w08_10/index-eng.php
 
Re: Canada - FluWatch Pandemic (H1N1) virus Surveillance Week 8 - 429 deaths Total

Re: Canada - FluWatch Pandemic (H1N1) virus Surveillance Week 8 - 429 deaths Total

February 28 to March 6, 2010 (Week 9)

Posted 2010-03-12


Weekly and cumulative numbers of hospitalized cases, ICU admissions and deaths among Pandemic H1N1 2009 confirmed cases, Canada, April 12, 2009 to March 6, 2010<SUP>?</SUP>

<TABLE class="widthFull fontSize85" cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD colSpan=10><SUP id=star>*</SUP>Based on reporting date.
<SUP id=dstar>**</SUP>Based on epidemiological date, hospitalization date, death date and reporting date.
<SUP>1</SUP> Aggregate counts were reported this week.
? Note that due to reporting delays, some provinces and territories reported retrospectively on first and second wave cases.

</TD></TR></TFOOT><TBODY><TR class=alignCenter><TH class=bg-colour-blue scope=col rowSpan=2>Province/
Territory
</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>Week 9
(February 28 to March 6, 2010)*
</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>From April 12, 2009 to
March 6, 2010**
</TH></TR><TR class=alignCenter><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH></TR><TR><TH class=bg-colour-blue scope=row>BC<SUP>1</SUP></TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1080</TD><TD class=alignCenter>167</TD><TD class=alignCenter>57</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1276</TD><TD class=alignCenter>239</TD><TD class=alignCenter>71</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>67</TD><TD class=alignCenter>52</TD><TD class=alignCenter>15</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>379</TD><TD class=alignCenter>61</TD><TD class=alignCenter>11</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1843</TD><TD class=alignCenter>319</TD><TD class=alignCenter>129</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3063</TD><TD class=alignCenter>465</TD><TD class=alignCenter>108</TD></TR><TR><TH class=bg-colour-blue scope=row>NB<SUP>1</SUP></TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>163</TD><TD class=alignCenter>34</TD><TD class=alignCenter>8</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>293</TD><TD class=alignCenter>50</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>50</TD><TD class=alignCenter>9</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>308</TD><TD class=alignCenter>60</TD><TD class=alignCenter>18</TD></TR><TR><TH class=bg-colour-blue scope=row>YT</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>15</TD><TD class=alignCenter>3</TD><TD class=alignCenter>3</TD></TR><TR><TH class=bg-colour-blue scope=row>NT</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>52</TD><TD class=alignCenter>7</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>NU</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>80</TD><TD class=alignCenter>6</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>8669</TD><TD class=alignCenter>1472</TD><TD class=alignCenter>429</TD></TR></TBODY></TABLE>

To date, the national cumulative crude hospitalization rate was 25.7 per 100,000 population with the highest rates in children less than 5 years of age (100.4 per 100,000). The cumulative crude mortality rate was 1.3 per 100,000 population with those 45 years and older having the highest mortality rate (2.1 per 100,000). The national crude ICU admission rate was 4.4 per 100,000 population. The ICU admission rate was elevated in adults 45 to 64 years (6.4 per 100,000) as well as children under five years of age (6.2 per 100,000).
Descriptive characteristics of laboratory-confirmed Canadian pandemic H1N1 2009 hospitalized cases, ICU-admitted cases and deaths with core information available, reported to PHAC as of March 6, 2010<SUP><SUP>?</SUP> </SUP>

<TABLE class=fontSize85 cellSpacing=0 cellPadding=2 border=1><TBODY><TR class=alignCenter><TD rowSpan=2></TD><TH class=bg-colour-blue colSpan=3>From April 12 to August 29, 2009</TH><TH class=bg-colour-blue colSpan=3>From August 30, 2009 to March 6, 2010</TH><TH class=bg-colour-blue colSpan=3>Cumulative: From
April 12, 2009 to March 6, 2010
</TH></TR><TR class=alignCenter><TH class=bg-colour-blue>Hospitalized cases (n=1488)</TH><TH class=bg-colour-blue>ICU-admitted
(n=292)
</TH><TH class=bg-colour-blue>Deaths
(n=78)
</TH><TH class=bg-colour-blue>Hospitalized
cases (n=6733)
</TH><TH class=bg-colour-blue>ICU-admitted
(n=1180)
</TH><TH class=bg-colour-blue>Deaths
(n=347)
</TH><TH class=bg-colour-blue>Hospitalized
cases
(n=8221)
</TH><TH class=bg-colour-blue>ICU-admitted
(n=1472)
</TH><TH class=bg-colour-blue>Deaths
(n=424)
</TH></TR><TR><TH class="bg-colour-blue alignLeft">Females, %</TH><TD>51.3</TD><TD>57.2</TD><TD>62.3</TD><TD>49.7</TD><TD>49.4</TD><TD>47.0</TD><TD>50.0</TD><TD>51.0</TD><TD>49.8</TD></TR><TR><TH class="bg-colour-blue alignLeft">Median age</TH><TD>23.0</TD><TD>37.0</TD><TD>51.0</TD><TD>30.0</TD><TD>47.0</TD><TD>54.0</TD><TD>29.0</TD><TD>46.0</TD><TD>53.5</TD></TR><TR><TH class="bg-colour-blue alignLeft">Aboriginal status<SUP>1</SUP>, % </TH><TD>20.0-27.7</TD><TD>16.1-21.9</TD><TD>11.7-17.6</TD><TD>4.5-6.1</TD><TD>5.8-7.7</TD><TD>6.1-8.9</TD><TD>7.3-9.9</TD><TD>7.8-10.4</TD><TD>7.1-10.4</TD></TR><TR><TH class="bg-colour-blue alignLeft">Underlying medical
conditions<SUP>2</SUP>, %
</TH><TD>47.5
(652/1373)
</TD><TD>60.2
(162/269)
</TD><TD>73.3
(55/75)
</TD><TD>58.6
(1920/3275)
</TD><TD>73.1
(669/915)
</TD><TD>84.2
(240/285)
</TD><TD>55.3
(2572/4648)
</TD><TD>70.2
(831/1184)
</TD><TD>81.9
(295/360)
</TD></TR><TR><TH class="bg-colour-blue alignLeft">Pregnancy<SUP>3</SUP>, %</TH><TD>27.6
(75/272)
</TD><TD>19.7
(15/76)
</TD><TD>28.6
(4/14)
</TD><TD>18.2
(187/1027)
</TD><TD>8.3
(15/180)
</TD><TD>0.0
(0/36)
</TD><TD>20.2
(262/1299)
</TD><TD>11.7
(30/256)
</TD><TD>8.0
(4/50)
</TD></TR><TR><TD colSpan=10><SUP>1 </SUP>Since Aboriginal status is not reported by two provinces (which comprise 23% of the Aboriginal population) two methods were used to calculate proportions: one proportion was calculated by including ON and NS cases in the denominator (which is an underestimate of the true proportion); while the other proportion was calculated by excluding ON and NS cases in the denominator (which is an overestimate).
<SUP>2</SUP> Proportion of cases with at least one underlying medical condition (excluding pregnancy) among those for whom the information was available.
<SUP>3 </SUP>Percent of pregnant women among women 15 to 44 years of age.
? All cases admitted to ICU are included in the hospitalization count; however, not all the fatal cases have been hospitalized before dying.

</TD></TR></TBODY></TABLE>

Overall Influenza Summary - Week 9 (February 29 to March 6, 2010)

During week 9, the overall influenza activity remained low for at least 11 consecutive weeks and all influenza indicators were still considerably below expected levels for this time of the year. For the first time since the beginning of the pandemic, the proportion of positive tests for influenza B (0.08%) was higher than the proportion for influenza A (0,04%).
In week 9, only one region (BC) reported localized activity. 10 regions in ON, QC & NS reported sporadic activity, while 41 regions reported no activity. One region in AB did not report this week, and one region in BC is not reporting until further notice. One influenza outbreak was reported this week in a school (BC).


<TABLE class=widthFull cellSpacing=0 cellPadding=0><TBODY><TR class=alignCenter><TD colSpan=2>Map of overall Influenza activity level by provinces and territories, Week 9, Canada



</TD></TR><TR class=alignCenter><TD>

</TD><TD><TABLE cellSpacing=0 cellPadding=1 border=0><TBODY><TR><TD align=middle><TABLE class=border-lite cellSpacing=1 cellPadding=1><TBODY><TR align=middle><TD>No Data </TD><TD>
leg_dots.gif
</TD></TR><TR class=alignCenter><TD>No Activity</TD><TD>
leg_ffffff.gif
</TD></TR><TR class=alignCenter><TD>Sporadic Activity</TD><TD>
leg_ccccff.gif
</TD></TR><TR align=middle><TD>Localized Activity</TD><TD>
leg_6666ff.gif
</TD></TR><TR align=middle><TD>Widespread
Activity
</TD><TD>
leg_000066.gif
</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR><TR><TD class=fontSize85 colSpan=2>Note: Influenza 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 (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.

</TD></TR></TBODY></TABLE>
Number of influenza surveillance regions<SUP>?</SUP> reporting widespread or localized influenza activity,
Canada, by report week, 2009-2010 (N=54)

2010-w09-fg1-eng.gif

flu0910-leg-fg1-eng.gif

? sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.

Overall Number of Influenza Outbreaks, Canada, by Report Week, 2009-2010

2010-w09-fg2-eng.gif

flu0910-leg-fg2-eng.gif

Note that this was the first year that all the provinces and territories were reporting on influenza outbreaks in schools (greater than 10% absenteeism on any day most likely due to ILI) which has increased considerably the total number of outbreaks reported compared to previous years.

ILI consultation rate
During week 9, the national ILI consultation rate was 17.4 consultations per 1,000 patient visits (see ILI graph) which was still considerably below the expected range for this time of year (range from 31.8 to 53.0 consultations per 1,000 patient visits). All reporting provinces and territories had similar or lower ILI consultation rates compared to their respective ILI rates in the previous weeks except NB which had a slightly higher rate again this week. Those under 20 years of age still had the highest consultation rates: 29.7 per 1,000 among children under 5 years of age and 32.3 per 1,000 among those 5 to 19 years of age.
Influenza-like illness (ILI) consultation rates, Canada, by report week,
2009-2010 compared to 1996/97 through to 2008/09 seasons

2010-w09-fg3-eng.gif


flu0910-leg-fg3-eng.gif

Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons).
Delays in the reporting of data may cause data to change retrospectively.
Laboratory Surveillance Summary
The proportion of tests that were positive for influenza during week 9 (0.12%, 3/2,574) remained at a very low level for this time of year (see Tests table). Of the three positive specimens, one (33%) was positive for influenza A (pandemic H1N1 2009) and two (67%) were positive for influenza B. All provinces had a similar or lower proportion of positive tests for influenza compared to the previous weeks. Note that since August 30, 2009, influenza A/H3N2 detections were highest in QC (85% or 44/52) and influenza B detections were highest in QC (53% or 9/17) and ON (47% or 8/17). Respiratory syncytial virus detections were still high with a proportion of positive tests of 24.0% in week 9. Positive specimens for RSV were reported from all provinces except NB (data not shown). The proportion of positive parainfluenza and adenovirus tests remained under the 3% positivity rate.

Influenza tests reported and percentage of tests positive, Canada,
by report week, 2009-2010

2010-w09-fg4-eng.gif

flu0910-leg-fg4-eng.gif


Percent positive influenza tests, compared to other respiratory viruses, Canada,
by reporting week, 2009-2010


2010-w09-fg5-eng.gif


flu0910-leg-fg5-eng.gif

Weekly & Cumulative numbers of positive influenza specimens, by Provincial Laboratories, Canada, 2009-2010

<TABLE class=widthFull cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD class=fontSize85 colSpan=13>Note: Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals.
* Not subtyped

</TD></TR></TFOOT><TBODY></TBODY></TABLE>
http://www.phac-aspc.gc.ca/fluwatch/09-10/w09_10/index-eng.php
 
Re: Canada - FluWatch Pandemic (H1N1) virus Surveillance Week 10 - 429 deaths Total

Re: Canada - FluWatch Pandemic (H1N1) virus Surveillance Week 10 - 429 deaths Total

March 7 to March 13, 2010 (Week 10)



Posted 2010-03-19

Weekly and cumulative numbers of hospitalized cases, ICU admissions and deaths among Pandemic H1N1 2009 confirmed cases, Canada, April 12, 2009 to March 13, 2010<SUP>?</SUP>

<TABLE class="widthFull fontSize85" cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD colSpan=10><SUP id=star>*</SUP>Based on reporting date.
<SUP id=dstar>**</SUP>Based on epidemiological date, hospitalization date, death date and reporting date.
<SUP>1</SUP> Aggregate counts were reported this week.
? Note that due to reporting delays, some provinces and territories reported retrospectively on first and second wave cases.

</TD></TR></TFOOT><TBODY><TR class=alignCenter><TH class=bg-colour-blue scope=col rowSpan=2>Province/
Territory
</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>Week 10
(March 7 to March 13, 2010)*
</TH><TH class=bg-colour-blue scope=colgroup colSpan=3>Total (From April 12, 2009 to
March 13, 2010)**
</TH></TR><TR class=alignCenter><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH><TH class=bg-colour-blue scope=col>Hospitalized cases</TH><TH class=bg-colour-blue scope=col>ICU admissions</TH><TH class=bg-colour-blue scope=col>Deaths</TH></TR><TR><TH class=bg-colour-blue scope=row>BC<SUP>1</SUP></TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1080</TD><TD class=alignCenter>167</TD><TD class=alignCenter>57</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1276</TD><TD class=alignCenter>239</TD><TD class=alignCenter>71</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>67</TD><TD class=alignCenter>52</TD><TD class=alignCenter>15</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>379</TD><TD class=alignCenter>61</TD><TD class=alignCenter>11</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1843</TD><TD class=alignCenter>319</TD><TD class=alignCenter>129</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3063</TD><TD class=alignCenter>465</TD><TD class=alignCenter>108</TD></TR><TR><TH class=bg-colour-blue scope=row>NB<SUP>1</SUP></TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>163</TD><TD class=alignCenter>34</TD><TD class=alignCenter>8</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>293</TD><TD class=alignCenter>50</TD><TD class=alignCenter>7</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>50</TD><TD class=alignCenter>9</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>308</TD><TD class=alignCenter>60</TD><TD class=alignCenter>18</TD></TR><TR><TH class=bg-colour-blue scope=row>YT</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>15</TD><TD class=alignCenter>3</TD><TD class=alignCenter>3</TD></TR><TR><TH class=bg-colour-blue scope=row>NT</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>52</TD><TD class=alignCenter>7</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>NU</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>80</TD><TD class=alignCenter>6</TD><TD class=alignCenter>1</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>8669</TD><TD class=alignCenter>1472</TD><TD class=alignCenter>429</TD></TR></TBODY></TABLE>

To date, the national cumulative crude hospitalization rate was 25.7 per 100,000 population with the highest rates in children less than 5 years of age (100.4 per 100,000). The cumulative crude mortality rate was 1.3 per 100,000 population with those 45 years and older having the highest mortality rate (2.1 per 100,000). The national crude ICU admission rate was 4.4 per 100,000 population. The ICU admission rate was elevated in adults 45 to 64 years (6.4 per 100,000) as well as children under five years of age (6.2 per 100,000).
Descriptive characteristics of laboratory-confirmed Canadian pandemic H1N1 2009 hospitalized cases, ICU-admitted cases and deaths with core information available, reported to PHAC as of March 13, 2010<SUP><SUP>?</SUP> </SUP>

<TABLE class=fontSize85 cellSpacing=0 cellPadding=2 border=1><TBODY><TR class=alignCenter><TD rowSpan=2></TD><TH class=bg-colour-blue colSpan=3>From April 12 to August 29, 2009</TH><TH class=bg-colour-blue colSpan=3>From August 30, 2009 to March 13, 2010</TH><TH class=bg-colour-blue colSpan=3>From
April 12, 2009 to March 13, 2010
</TH></TR><TR class=alignCenter><TH class=bg-colour-blue>Hospitalized cases (n=1488)</TH><TH class=bg-colour-blue>ICU-admitted
(n=292)
</TH><TH class=bg-colour-blue>Deaths
(n=77)
</TH><TH class=bg-colour-blue>Hospitalized
cases (n=6733)
</TH><TH class=bg-colour-blue>ICU-admitted
(n=1180)
</TH><TH class=bg-colour-blue>Deaths
(n=347)
</TH><TH class=bg-colour-blue>Hospitalized
cases
(n=8221)
</TH><TH class=bg-colour-blue>ICU-admitted
(n=1472)
</TH><TH class=bg-colour-blue>Deaths
(n=424)
</TH></TR><TR><TH class="bg-colour-blue alignLeft">Females, %</TH><TD class=alignCenter>51.3</TD><TD class=alignCenter>57.2</TD><TD class=alignCenter>62.3</TD><TD class=alignCenter>49.7</TD><TD class=alignCenter>49.4</TD><TD class=alignCenter>47.0</TD><TD class=alignCenter>50.0</TD><TD class=alignCenter>51.0</TD><TD class=alignCenter>49.8</TD></TR><TR><TH class="bg-colour-blue alignLeft">Median age</TH><TD class=alignCenter>23.0</TD><TD class=alignCenter>37.0</TD><TD class=alignCenter>51.0</TD><TD class=alignCenter>30.0</TD><TD class=alignCenter>47.0</TD><TD class=alignCenter>54.0</TD><TD class=alignCenter>29.0</TD><TD class=alignCenter>46.0</TD><TD class=alignCenter>53.5</TD></TR><TR><TH class="bg-colour-blue alignLeft">Aboriginal status<SUP>1</SUP>, % </TH><TD class=alignCenter>20.0-27.7</TD><TD class=alignCenter>16.1-21.9</TD><TD class=alignCenter>11.7-17.6</TD><TD class=alignCenter>4.5-6.1</TD><TD class=alignCenter>5.8-7.7</TD><TD class=alignCenter>6.1-8.9</TD><TD class=alignCenter>7.3-9.9</TD><TD class=alignCenter>7.8-10.4</TD><TD class=alignCenter>7.1-10.4</TD></TR><TR><TH class="bg-colour-blue alignLeft">Underlying medical
conditions<SUP>2</SUP>, %
</TH><TD class=alignCenter>47.5
(652/1373)
</TD><TD class=alignCenter>60.2
(162/269)
</TD><TD class=alignCenter>73.3
(55/75)
</TD><TD class=alignCenter>58.6
(1920/3275)
</TD><TD class=alignCenter>73.1
(669/915)
</TD><TD class=alignCenter>84.2
(240/285)
</TD><TD class=alignCenter>55.3
(2572/4648)
</TD><TD class=alignCenter>70.2
(831/1184)
</TD><TD class=alignCenter>81.9
(295/360)
</TD></TR><TR><TH class="bg-colour-blue alignLeft">Pregnancy<SUP>3</SUP>, %</TH><TD class=alignCenter>27.6
(75/272)
</TD><TD class=alignCenter>19.7
(15/76)
</TD><TD class=alignCenter>28.6
(4/14)
</TD><TD class=alignCenter>18.2
(187/1027)
</TD><TD class=alignCenter>8.3
(15/180)
</TD><TD class=alignCenter>0.0
(0/36)
</TD><TD class=alignCenter>20.2
(262/1299)
</TD><TD class=alignCenter>11.7
(30/256)
</TD><TD class=alignCenter>8.0
(4/50)
</TD></TR><TR><TD colSpan=10><SUP>1 </SUP>Since Aboriginal status is not reported by two provinces (which comprise 23% of the Aboriginal population) two methods were used to calculate proportions: one proportion was calculated by including ON and NS cases in the denominator (which is an underestimate of the true proportion); while the other proportion was calculated by excluding ON and NS cases in the denominator (which is an overestimate).
<SUP>2</SUP> Proportion of cases with at least one underlying medical condition (excluding pregnancy) among those for whom the information was available.
<SUP>3 </SUP>Percent of pregnant women among women 15 to 44 years of age.
? All cases admitted to ICU are included in the hospitalization count; however, not all the fatal cases have been hospitalized before dying.

</TD></TR></TBODY></TABLE>

Overall Influenza Summary - Week 10 (March 7 to March 13, 2010)

Overall influenza activity remained low and had been so for at least 12 consecutive weeks, all influenza indicators were still considerably below expected levels for this time of the year. The proportion of tests that were positive for influenza during week 10 (0.34%, 8/2,383) increased slightly compared to the previous week, but still remained at a very low level for this time of year.
In week 10, 12 regions in BC, AB, ON, QC & NS reported sporadic activity, while 41 regions reported no activity. One region in BC is not reporting until further notice. The three influenza outbreaks reported this week were all in schools (NS).


<TABLE class=widthFull cellSpacing=0 cellPadding=0><TBODY><TR class=alignCenter><TD colSpan=2>Map of overall Influenza activity level by provinces and territories, Week 10, Canada



</TD></TR><TR class=alignCenter><TD>

</TD><TD><TABLE cellSpacing=0 cellPadding=1 border=0><TBODY><TR><TD align=middle><TABLE class=border-lite cellSpacing=1 cellPadding=1><TBODY><TR align=middle><TD>No Data </TD><TD>
leg_dots.gif
</TD></TR><TR class=alignCenter><TD>No Activity</TD><TD>
leg_ffffff.gif
</TD></TR><TR class=alignCenter><TD>Sporadic Activity</TD><TD>
leg_ccccff.gif
</TD></TR><TR align=middle><TD>Localized Activity</TD><TD>
leg_6666ff.gif
</TD></TR><TR align=middle><TD>Widespread
Activity
</TD><TD>
leg_000066.gif
</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR><TR><TD class=fontSize85 colSpan=2>Note: Influenza 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 (see graphs and tables) and reported outbreaks. Please refer to detailed definitions on the last page. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website.

</TD></TR></TBODY></TABLE>
Number of influenza surveillance regions<SUP>?</SUP> reporting widespread or localized influenza activity,
Canada, by report week, 2009-2010 (N=54)

2010-w10-fg1-eng.gif

flu0910-leg-fg1-eng.gif

? sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.

Overall Number of Influenza Outbreaks, Canada, by Report Week, 2009-2010

2010-w10-fg2-eng.gif

flu0910-leg-fg2-eng.gif

Note that this was the first year that all the provinces and territories were reporting on influenza outbreaks in schools (greater than 10% absenteeism on any day most likely due to ILI) which has increased considerably the total number of outbreaks reported compared to previous years.

ILI consultation rate
During week 10, the national ILI consultation rate was 17.4 consultations per 1,000 patient visits (see ILI graph) which was still considerably below the expected range for this time of year (range from 25.7 to 45.9 consultations per 1,000 patient visits). All reporting provinces and territories had similar ILI consultation rates compared to their respective ILI rates in the previous weeks except BC and AB which had a higher rate this week. Those under 20 years of age still had the highest consultation rates: 35.9 per 1,000 among children under 5 years of age and 31.7 per 1,000 among those 5 to 19 years of age.
Influenza-like illness (ILI) consultation rates, Canada, by report week,
2009-2010 compared to 1996/97 through to 2008/09 seasons

2010-w10-fg3-eng.gif


flu0910-leg-fg3-eng.gif

Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons).
Delays in the reporting of data may cause data to change retrospectively.
Laboratory Surveillance Summary
The proportion of tests that were positive for influenza during week 10 (0.34%, 8/2,383) increased slightly compared to the previous week, but still remained at a very low level for this time of year (see Tests table). Of the eight positive specimens, four (50%) were positive for pandemic H1N1 2009, two (25%) were unsubtyped influenza A and two (25%) were positive for influenza B. All provinces had a similar or lower proportion of positive tests for influenza compared to the previous weeks except BC which had a slightly higher rate this week. Note that since August 30, 2009, influenza A/H3N2 detections were highest in QC (85% or 44/52) and influenza B detections were highest in QC (47% or 9/19) and ON (53% or 10/19). Respiratory syncytial virus detections peaked during week 7 (28.3%), but were still high this week with a proportion of positive tests of 19.7%. Positive specimens for RSV were reported from all provinces (data not shown). The proportion of positive parainfluenza (2.1%) and adenovirus (1.8%) tests remained low during week 10.

Influenza tests reported and percentage of tests positive, Canada,
by report week, 2009-2010

2010-w10-fg4-eng.gif

flu0910-leg-fg4-eng.gif


Percent positive influenza tests, compared to other respiratory viruses, Canada,
by reporting week, 2009-2010


2010-w10-fg5-eng.gif


flu0910-leg-fg5-eng.gif

Weekly & Cumulative numbers of positive influenza specimens, by Provincial Laboratories, Canada, 2009-2010

<TABLE class=widthFull cellSpacing=0 cellPadding=2 border=1><TFOOT><TR><TD class=fontSize85 colSpan=13>Note: Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals.
* Not subtyped

</TD></TR></TFOOT><TBODY><TR class=alignCenter><TH class=bg-colour-blue scope=col rowSpan=3>Reporting provinces</TH><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=6>Weekly (March 7 to March 13, 2010)</TH><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=6>Cumulative (August 30, 2009 to March 13, 2010)</TH></TR><TR class=alignCenter><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=5>Influenza A</TH><TH class="bg-colour-blue fontSize85" scope=col>B</TH><TH class="bg-colour-blue fontSize85" scope=colgroup colSpan=5>Influenza A</TH><TH class=bg-colour-blue scope=col>B</TH></TR><TR class=alignCenter><TH class="fontSize85 bg-colour-blue" scope=col>A Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H3)</TH><TH class="fontSize85 bg-colour-blue" scope=col>Pand H1N1</TH><TH class="fontSize85 bg-colour-blue" scope=col>A
(NS)*
</TH><TH class="fontSize85 bg-colour-blue" scope=col>Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A Total</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H1)</TH><TH class="fontSize85 bg-colour-blue" scope=col>A(H3)</TH><TH class="fontSize85 bg-colour-blue" scope=col>Pand H1N1</TH><TH class="fontSize85 bg-colour-blue" scope=col>A
(NS)*
</TH><TH class="fontSize85 bg-colour-blue" scope=col>Total</TH></TR><TR><TH class=bg-colour-blue scope=row>BC</TH><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>6374</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>5808</TD><TD class=alignCenter>565</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>AB</TH><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>5870</TD><TD class=alignCenter>2</TD><TD class=alignCenter>5</TD><TD class=alignCenter>5760</TD><TD class=alignCenter>103</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>SK</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2598</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>2298</TD><TD class=alignCenter>299</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>MB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1915</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1788</TD><TD class=alignCenter>127</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>ON</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>2</TD><TD class=alignCenter>7800</TD><TD class=alignCenter>4</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3556</TD><TD class=alignCenter>4240</TD><TD class=alignCenter>10</TD></TR><TR><TH class=bg-colour-blue scope=row>QC</TH><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>10699</TD><TD class=alignCenter>4</TD><TD class=alignCenter>44</TD><TD class=alignCenter>10649</TD><TD class=alignCenter>2</TD><TD class=alignCenter>9</TD></TR><TR><TH class=bg-colour-blue scope=row>NB</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1856</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1835</TD><TD class=alignCenter>19</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NS</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>787</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>753</TD><TD class=alignCenter>34</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>PE</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>97</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>96</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>NL</TH><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>951</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>951</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD></TR><TR><TH class=bg-colour-blue scope=row>Canada</TH><TD class=alignCenter>6</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>4</TD><TD class=alignCenter>2</TD><TD class=alignCenter>2</TD><TD class=alignCenter>38947</TD><TD class=alignCenter>11</TD><TD class=alignCenter>52</TD><TD class=alignCenter>33494</TD><TD class=alignCenter>5390</TD><TD class=alignCenter>19</TD></TR><TR><TD class=alignCenter scope=row colSpan=13>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces </TD></TR></TBODY></TABLE>
http://www.phac-aspc.gc.ca/fluwatch/09-10/w10_10/index-eng.php
 
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