• FluTrackers.com Inc. does not provide medical advice. Information on this web site is collected from various internet resources, and the FluTrackers board of directors makes no warranty to the safety, efficacy, correctness or completeness of the information posted on this site by any author or poster. The information collated here is for instructional and/or discussion purposes only and is NOT intended to diagnose or treat any disease, illness, or other medical condition. Every individual reader or poster should seek advice from their personal physician/healthcare practitioner before considering or using any interventions that are discussed on this website. By continuing to access this website you agree to consult your personal physican before using any interventions posted on this website, and you agree to hold harmless FluTrackers.com Inc., the board of directors, the members, and all authors and posters for any effects from use of any medication, supplement, vitamin or other substance, device, intervention, etc. mentioned in posts on this website, or other internet venues referenced in posts on this website.
  • We are not asking for any donations. Do not donate to any entity who says they are raising funds for us.

Canada FluWatch Weekly Reports 2013-2014 Season Weeks 33 and 34

Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 6

Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 6

FluWatch report: February 2 to 8, 2014 (Week 06)

Posted 2014-02-14For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
<A title="Flu Watch (Version PDF, 113 KB - 6 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/13-14/w06_14/pdf/fw2014-06-eng.pdf">FluWatch report: February 2 to 8, 2014 (Week 06) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 291 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

?? Help with PDF documents


Overall Summary
  • In week 06, overall influenza activity continued to decrease in Canada, with the exception of ongoing activity in the more eastern provinces which experienced a later start to the influenza season.
  • The influenza A(H1N1) virus remains the most common influenza virus circulating this season although influenza B virus detections continue to increase.
  • Adults 20-64 years of age continue to be more affected by influenza this season.
  • To week 06, 2,818 hospitalizations have been reported, which is slightly lower compared to the same period last season. One hundred and forty-three deaths have been reported.
  • Overall influenza activity in Canada during the 2013-14 season has been similar to the 2012-13 season and is within expected levels for this time of year.
Influenza/ILI Activity (geographic spread)

In week 06, one region in Manitoba reported widespread activity, and 11 regions (in BC(1), AB(1), ON(6), QC(2) and NS(1)) reported localized activity (Figure 1). Influenza activity levels are declining, with fewer regions reporting widespread or localized activity.
Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 06


right_ofmap.gif



Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
Influenza and Other Respiratory Virus Detections

The number of positive influenza tests continued to decrease, from 2,183 in week 05 to 1,811 in week 06. The percentage of positive influenza tests decreased from 21.5% to 20.0% (Figure 2). Cumulative influenza virus detections to date remain predominantly influenza A (94%), and among those subtyped, 97% (9,203/9,505) were A(H1N1)pdm09. However, the percentage of positive tests for influenza B has been rising slowly in recent weeks to 12.8% of influenza detections in week 06 (Table 1). Among the 15,051 cases for which information on age and type/subtype has been received this season, 56.9% were 20-64 years of age and 15.6% were ≥65 years of age, which is different from the proportions observed during the 2012-13 season when 33.1% of cases were 20-64 years of age and 41.2% were ≥65 years of age (Table 2).
Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
2014-w06-fg2-eng.gif

Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
The number of positive tests for RSV continued the gradual increase observed since late November 2013. The percentage of the total number of tests that were positive has fluctuated during this period, but increased during the past three weeks. RSV in Canada shows a seasonal pattern with a broad peak over the winter months. The number of positive tests for other respiratory viruses has been relatively stable in recent weeks (Figure 3).
For more details, see the weekly Respiratory Virus Detections in Canada Report.
Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2013-14
2014-w06-fg3-eng.gif


Top of Page
RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly and cumulative numbers of positive influenza specimens
by type, subtype and province, Canada, 2013-14
</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=ac1 colSpan=5>Weekly
(February 2, 2013 to February 8, 2014)
</TH><TH id=ac8 colSpan=5>Cumulative
(August 25, 2013 to February 8, 2014)
</TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=4 headers=ac1>Influenza A</TH><TH id=ac7 headers=ac1>B</TH><TH id=ac9 colSpan=4 headers=ac8>Influenza A</TH><TH id=ac14 headers=ac8>B</TH></TR><TR class=bg-colour-grey-light><TH id=ac3 headers="ac1 ac2">A Total</TH><TH id=ac4 class=lightred headers="ac1 ac2">A(H1)pdm09</TH><TH id=ac5 class=lightred headers="ac1 ac2">A(H3)</TH><TH id=ac6 class=lightred headers="ac1 ac2">A(UnS)</TH><TH class=alignCenter headers="ac1 ac7">B Total</TH><TH id=ac10 headers="ac8 ac9">A Total</TH><TH id=ac11 class=lightred headers="ac8 ac9">A(H1)pdm09</TH><TH id=ac12 class=lightred headers="ac8 ac9">A(H3)</TH><TH id=ac13 class=lightred headers="ac8 ac9">A(UnS)</TH><TD class=alignCenter headers="ac8 ac14">B Total</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
</TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=alignLeft headers=ar1>BC</TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">123</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">100</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">11</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">12</TD><TD class=alignRight headers="ar1 ar2 ac1 ac7">8</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac10">1562</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac11">1436</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac12">54</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac13">72</TD><TD class=alignRight headers="ar1 ar2 ac8 ac14">52</TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">127</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">86</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">3</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">38</TD><TD class=alignRight headers="ar1 ar3 ac1 ac7">16</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac10">3394</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac11">3186</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac12">36</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac13">172</TD><TD class=alignRight headers="ar1 ar3 ac8 ac14">74</TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">77</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">57</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">1</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">19</TD><TD class=alignRight headers="ar1 ar4 ac1 ac7">6</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac10">1254</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac11">905</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac12">3</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac13">346</TD><TD class=alignRight headers="ar1 ar4 ac8 ac14">16</TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">55</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">43</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">12</TD><TD class=alignRight headers="ar1 ar5 ac1 ac7">0</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac10">473</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac11">319</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac12">1</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac13">153</TD><TD class=alignRight headers="ar1 ar5 ac8 ac14">13</TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">356</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">104</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">15</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">237</TD><TD class=alignRight headers="ar1 ar6 ac1 ac7">60</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac10">4922</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac11">2198</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac12">200</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac13">2524</TD><TD class=alignRight headers="ar1 ar6 ac8 ac14">170</TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">625</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">88</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">537</TD><TD class=alignRight headers="ar1 ar7 ac1 ac7">130</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac10">4024</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac11">537</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac12">3</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac13">3484</TD><TD class=alignRight headers="ar1 ar7 ac8 ac14">710</TD></TR><TR><TH id=ar8 class=alignLeft headers=ar1>NB</TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">141</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac6">141</TD><TD class=alignRight headers="ar1 ar8 ac1 ac7">2</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac10">1298</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac11">364</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac12">1</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac13">933</TD><TD class=alignRight headers="ar1 ar8 ac8 ac14">6</TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">14</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">13</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">1</TD><TD class=alignRight headers="ar1 ar9 ac1 ac7">1</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac10">100</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac11">76</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac12">4</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac13">20</TD><TD class=alignRight headers="ar1 ar9 ac8 ac14">1</TD></TR><TR><TH id=ar10 class=alignLeft headers=ar1>PE</TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">30</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac4">30</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac7">0</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac10">78</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac11">78</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac13">0</TD><TD class=alignRight headers="ar1 ar10 ac8 ac14">0</TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">32</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac6">32</TD><TD class=alignRight headers="ar1 ar11 ac1 ac7">8</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac10">290</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac11">104</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac13">186</TD><TD class=alignRight headers="ar1 ar11 ac8 ac14">107</TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">1580</TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac4">521</TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac5">30</TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac6">1029</TD><TD class=alignRight headers="ar1 ar12 ac1 ac7">231</TD><TD class=alignRight headers="ar1 ar12 ac8 ac9 ac10">17395</TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac11">9203</TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac12">302</TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac13">7890</TD><TD class=alignRight headers="ar1 ar12 ac8 ac14">1149</TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="ar1 ar13 ac1 ac2 ac3">87.2%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac4">33.0%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac5">1.9%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac6">65.1%</TD><TD class=alignRight headers="ar1 ar13 ac1 ac7">12.8%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac9 ac10">93.8%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac11">52.9%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac12">1.7%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac13">45.4%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac14">6.2%</TD></TR></TBODY></TABLE>
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups (years)</TH><TH id=bc1 colSpan=5>Weekly
(February 2 to February 8, 2014)
</TH><TH id=bc8 colSpan=7>Cumulative
(August 25, 2013 to February 8, 2014)
</TH></TR><TR class=bg-colour-yellow><TH id=bc2 colSpan=4 headers=bc1>Influenza A</TH><TH id=bc7 headers=bc1>B</TH><TH id=bc9 colSpan=4 headers=bc8>Influenza A</TH><TH id=bc14 headers=bc8>B</TH><TH id=bc15 colSpan=2 headers=bc8>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=bc3 headers="bc1 bc2">A Total</TH><TH id=bc4 class="lightred " headers="bc1 bc2">A(H1) pdm09</TH><TH id=bc5 class="lightred " headers="bc1 bc2">A(H3)</TH><TH id=bc6 class="lightred " headers="bc1 bc2">A (UnS)</TH><TD class=alignCenter headers="bc1 bc7">Total</TD><TH id=bc10 headers="bc8 bc9">A Total</TH><TH id=bc11 class="lightred " headers="bc8 bc9">A(H1) pdm09</TH><TH id=bc12 class="lightred " headers="bc8 bc9">A(H3)</TH><TH id=bc13 class="lightred " headers="bc8 bc9">A (UnS)</TH><TD class=alignCenter headers="bc8 bc14">Total</TD><TH id=bc16 headers="bc8 bc15">#</TH><TH id=bc17 headers="bc8 bc15">%</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13><SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
<SUP>3 </SUP>Table 2 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
</TD></TR></TFOOT><TBODY><TR><TH id=br2 class=alignLeft headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">185</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">52</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">133</TD><TD class=alignRight headers="br1 br2 bc1 bc7">17</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">2617</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">1226</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">20</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1371</TD><TD class=alignRight headers="br1 br2 bc8 bc14">124</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc16">2741</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc17">18.2%</TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">77</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">17</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">60</TD><TD class=alignRight headers="br1 br3 bc1 bc7">38</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1104</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">614</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">16</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">474</TD><TD class=alignRight headers="br1 br3 bc8 bc14">178</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc16">1282</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc17">8.5%</TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">229</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">71</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">157</TD><TD class=alignRight headers="br1 br4 bc1 bc7">33</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">4329</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">2421</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">26</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">1882</TD><TD class=alignRight headers="br1 br4 bc8 bc14">206</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc16">4535</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc17">30.1%</TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">232</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">74</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">4</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">154</TD><TD class=alignRight headers="br1 br5 bc1 bc7">40</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">3742</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">2068</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">36</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">1638</TD><TD class=alignRight headers="br1 br5 bc8 bc14">289</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc16">4031</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc17">26.8%</TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">147</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">39</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">4</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">104</TD><TD class=alignRight headers="br1 br6 bc1 bc7">39</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">1960</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">817</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">78</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">1065</TD><TD class=alignRight headers="br1 br6 bc8 bc14">390</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc16">2350</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc17">15.6%</TD></TR><TR><TH id=br7 class=alignLeft headers=br1>Unknown</TH><TD class=alignRight headers="br1 br7 bc1 bc2 bc3">9</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc4">7</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc6">2</TD><TD class=alignRight headers="br1 br7 bc1 bc7">0</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc10">112</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">95</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">7</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">10</TD><TD class=alignRight headers="br1 br7 bc8 bc14">0</TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc16">112</TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc17">0.7%</TD></TR><TR><TH id=br8 class=alignLeft headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">879</TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc4">260</TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc5">9</TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc6">610</TD><TD class=alignRight headers="br1 br8 bc1 bc7">167</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">13864</TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc11">7241</TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc12">183</TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc13">6440</TD><TD class=alignRight headers="br1 br8 bc8 bc14">1,187</TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc16">15051</TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc17">100.0%</TD></TR><TR><TH id=br9 class=alignLeft headers=br1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="br1 br9 bc1 bc2 bc3">84.0%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc4">29.6%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc5">1.0%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc6">69.4%</TD><TD class=alignRight headers="br1 br9 bc1 bc7">16.0%</TD><TD class=alignRight headers="br1 br9 bc8 bc9 bc10">92.1%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc11">52.2%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc12">1.3%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc13">46.5%</TD><TD class=alignRight headers="br1 br9 bc8 bc14">7.9%</TD><TD class=alignRight></TD><TD class=alignRight></TD></TR></TBODY></TABLE>

Top of Page
Influenza Strain Characterizations

During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 894 influenza viruses [48 A(H3N2), 755 A(H1N1)pdm09 and 91 influenza B]. The vast majority (99%) of viruses were similar to the strains recommended by the WHO for the 2013-14 seasonal influenza vaccine. Two A(H1N1)pdm09 viruses showed reduced titres to antiserum against the reference A/California/07/2009 strain. Nine influenza B viruses were similar to the strain recommended by the WHO for the 2011-12 vaccine (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2013-14, N = 894
2014-w06-fg4-eng.gif

The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
The recommended components for the 2013-2014 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009 (H1N1)pdm09-like virus, an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b (e.g. A/Texas/50/2012), and a B/Massachusetts/2/2012-like virus (Yamagata lineage).


Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
Antiviral Resistance

During the 2013-2014 influenza season, NML has tested 561 influenza viruses for resistance to oseltamivir and 552 viruses for resistance to zanamivir, and all were sensitive. All 549 influenza A viruses tested for amantadine resistance were resistant (Table 3).
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2013-2014</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=cr1 rowSpan=2>Virus type and subtype</TH><TH id=cc1 colSpan=2>Oseltamivir</TH><TH id=cc4 colSpan=2>Zanamivir</TH><TH id=cc7 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=cc2 headers=cc1># tested</TH><TH id=cc3 headers=cc1># resistant (%)</TH><TH id=cc5 headers=cc4># tested</TH><TH id=cc6 headers=cc4># resistant (%)</TH><TH id=cc8 headers=cc7># tested</TH><TH id=cc9 headers=cc7># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=cr2 class="alignLeft lightred" headers=cr1>A (H3N2)</TH><TD class=alignRight headers="cr1 cr2 cc1 cc2">41</TD><TD class=alignRight headers="cr1 cr2 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr2 cc4 cc5">41</TD><TD class=alignRight headers="cr1 cr2 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr2 cc7 cc8">53</TD><TD class=alignRight headers="cr1 cr2 cc7 cc9">53 (100%)</TD></TR><TR><TH id=cr3 class="alignLeft lightred" headers=cr1>A (H1N1)</TH><TD class=alignRight headers="cr1 cr3 cc1 cc2">472</TD><TD class=alignRight headers="cr1 cr3 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr3 cc4 cc5">463</TD><TD class=alignRight headers="cr1 cr3 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr3 cc7 cc8">496</TD><TD class=alignRight headers="cr1 cr3 cc7 cc9">496 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft lightred" headers=cr1>B</TH><TD class=alignRight headers="cr1 cr4 cc1 cc2">48</TD><TD class=alignRight headers="cr1 cr4 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr4 cc4 cc5">48</TD><TD class=alignRight headers="cr1 cr4 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr4 cc7 cc8">NA <SUP>*</SUP></TD><TD class=alignRight headers="cr1 cr4 cc7 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft lightred" headers=cr1>TOTAL</TH><TD class=alignRight headers="cr1 cr5 cc1 cc2">561</TD><TD class=alignRight headers="cr1 cr5 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr5 cc4 cc5">552</TD><TD class=alignRight headers="cr1 cr5 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr5 cc7 cc8">549</TD><TD class=alignRight headers="cr1 cr5 cc7 cc9">549 (100%)</TD></TR></TBODY></TABLE>
Influenza-like Illness (ILI) Consultation Rate

The national influenza-like-illness (ILI) consultation rate continued to decrease from 32.5/1,000 in week 05 to 27.2/1,000 in week 06; which is within the expected range for week 06 (Figure 5).
Figure 5. Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014
2014-w06-fg5-eng.gif

Note: No data available for mean rate for weeks 19 to 39 for the 1996-1997 through 2002-2003 seasons. Delays in the reporting of data may cause data to change retrospectively. The calculation of the average ILI consultation rate over 17 seasons was aligned with influenza activity in each season. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. The number of sentinel physicians in each province or territory is as follows: BC(21), AB(80), SK(11), MB(18), ON(169), QC(14), NB(29), NS(26), PE(4), NL(16), NU(1), NT(14), YT(13). Not all sentinel physicians report every week.
Text equivalent for figure 5Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

Top of Page
Influenza Outbreak Surveillance

In week 06, 13 new influenza outbreaks were reported: three in hospitals and 10 in long-term care (Figure 6). In addition, six outbreaks of influenza-like-illness were reported: one in a school and five in other facilities or communities.
Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2013-2014
2014-w06-fg6-eng.gif

1 All provinces and territories except NU report outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
Text equivalent for figure 6Overall number of new influenza outbreaks by report week, Canada, 2013-2014
Pharmacy Surveillance

In week 06, the proportion of prescriptions for influenza antivirals continued to decrease for all age groups, following the downward trend in laboratory detections of influenza. The largest proportion of prescriptions for antivirals continued to be among children 2-18 years of age followed by adults 19-64 years of age (Figure 7).
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14
2014-w06-fg7-eng.gif

Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group. Age-groups: Infant: 0-2y, Child: 2-18y; Adult: 19-64y, Senior: ≥65y.
Text equivalent for figure 7Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

Top of Page
Sentinel Hospital Influenza Surveillance

Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In week 06, 32 new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 55 in week 05, indicating that the number of new cases may be starting to decline. In week 06, influenza A was reported in 28 cases and influenza B in four cases (Figure 8a). Twenty-two (69%) of the cases were <5 years of age. Four ICU admissions were reported in week 06, one child under 6 months of age, one 6-23 months of age, one 2-4 years of age, and one 5-9 years of age; all with influenza A. No deaths were reported.
To date this season, a total of 450 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 95% of which have been influenza A, and almost all of those subtyped were A(H1N1)pdm09. Children under 5 years of age represent 77.8% of cases to date (Table 4). Sixty-eight ICU admissions have been reported; all but three cases with influenza A (the majority A(H1N1)pdm09), and 29 (43%) among children under 2 years of age (Figure 9a). Among the 56 ICU cases with available data, 38 (68%) were reported to have underlying medical conditions. No deaths have been reported.
Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
Adult Influenza Hospitalizations and Deaths (PCIRN)
In week 06, 40 new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations reported through active surveillance by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 52 in week 05. There has been a steady decline in the number of new cases over recent weeks. Among cases in week 06, 35 (87.5%) were influenza A, of which two were A(H1N1)pdm09 and 33 were A(unsubtyped). Four cases with influenza B and one case without information on the influenza type were reported (Figure 8b). The majority of hospitalizations occurred among adults ≥45 years of age (30; 75%). Three ICU admissions were reported in week 06: one case <20 years of age, one case 45-64 years of age and one case ≥65 years of age. No deaths were reported in week 06.
To date this season, 887 influenza-associated hospitalizations have been reported by the PCIRN-SOS network, 851 (95.9%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). ICU admission was required for 155 hospitalizations, all but five of which were cases with influenza A. More than three quarters of hospitalizations and approximately 80% of ICU admissions were ≥45 years of age. Of the 134 ICU admissions with available information, 86.6% (116/134) were reported to have at least one comorbidity. Of the 133 ICU admissions with information on influenza vaccination, 97 (72.9%) reported not having been vaccinated this season. Forty-three deaths have been reported, all with influenza A (26 A(H1N1)pdm09, one A(H3N2) and 13 A(unsubtyped)); five cases 20-44 years of age, 23 cases 45-64 years of age and 15 cases ≥65 years of age (Figure 9b).
Note: PCIRN-SOS conducted passive surveillance from April 30th to November 14th, 2013. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance began November 15th during which time PCIRN site coordinators investigate cases potentially related to influenza. Data from both active and passive surveillance reported during the 2013-14 season are included in this report. The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t4 class=alignCenter>Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=dr1 rowSpan=3>Age groups </TH><TH id=dc1 colSpan=6>Cumulative (Aug. 25, 2013 to February 8, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=dc2 colSpan=4 headers=dc1>Influenza A </TH><TH id=dc7 headers=dc1>B </TH><TH id=dc8 headers=dc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=dc3 headers="dc1 dc2">A Total </TH><TH id=dc4 class="lightred " headers="dc1 dc2">A(H1) pdm09 </TH><TH id=dc5 class="lightred " headers="dc1 dc2">A(H3) </TH><TH id=dc6 class="lightred " headers="dc1 dc2">A (UnS) </TH><TD class=alignCenter headers="dc1 dc7">Total</TD><TD class=alignCenter headers="dc1 dc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
</TD></TR></TFOOT><TBODY><TR><TH id=dr2 class=alignLeft headers=dr1>0-5m </TH><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc3">83</TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc4">23</TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc5">0</TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc6">60</TD><TD class=alignRight headers="dr1 dr2 dc1 dc7">2</TD><TD class=alignRight headers="dr1 dr2 dc1 dc8">85 (19%)</TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc3">127</TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc4">38</TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc5">1</TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc6">88</TD><TD class=alignRight headers="dr1 dr3 dc1 dc7">4</TD><TD class=alignRight headers="dr1 dr3 dc1 dc8">131 (29%)</TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc3">125</TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc4">43</TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc5">2</TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc6">80</TD><TD class=alignRight headers="dr1 dr4 dc1 dc7">9</TD><TD class=alignRight headers="dr1 dr4 dc1 dc8">134 (30%)</TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc3">64</TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc4">18</TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc5">0</TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc6">46</TD><TD class=alignRight headers="dr1 dr5 dc1 dc7">7</TD><TD class=alignRight headers="dr1 dr5 dc1 dc8">71 (16%)</TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc3">27</TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc4">11</TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc5">0</TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc6">16</TD><TD class=alignRight headers="dr1 dr6 dc1 dc7">2</TD><TD class=alignRight headers="dr1 dr6 dc1 dc8">29 (6%)</TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignRight headers="dr1 dr7 dc1 dc2 dc3">426</TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc4">133</TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc5">3</TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc6">290</TD><TD class=alignRight headers="dr1 dr7 dc1 dc7">24</TD><TD class=alignRight headers="dr1 dr7 dc1 dc8">450</TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP> </TH><TD class=alignRight headers="dr1 dr8 dc1 dc2 dc3">94.7%</TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc4">31.2%</TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc5">0.7%</TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc6">68.1%</TD><TD class=alignRight headers="dr1 dr8 dc1 dc7">5.3%</TD><TD class=alignRight headers="dr1 dr8 dc1 dc8">100.0%</TD></TR></TBODY></TABLE>
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 5 - Cumulative numbers of adult hospitalizations with influenza
reported by the PCIRN-SOS network, Canada, 2013-14
</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=er1 rowSpan=3>Age groups </TH><TH id=ec1 class=noWrap colSpan=6>Cumulative (Aug. 25, 2013 to February 8, 2014)<SUP>*</SUP></TH></TR><TR class=bg-colour-yellow><TH id=ec2 colSpan=4 headers=ec1>Influenza A </TH><TH id=ec7 headers=ec1>B </TH><TH id=ec8 headers=ec1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=ec3 headers="ec1 ec2">A Total </TH><TH id=ec4 class="lightred " headers="ec1 ec2">A(H1) pdm09 </TH><TH id=ec5 class="lightred " headers="ec1 ec2">A(H3) </TH><TH id=ec6 class="lightred " headers="ec1 ec2">A(UnS) </TH><TD class=alignCenter headers="ec1 ec7">Total</TD><TD class=alignCenter headers="ec1 ec8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t5_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.

<SUP id=footnote_t5_star>*</SUP>Three cases for which the influenza type has not yet been reported, and five cases for which the age-group was not reported, are not included in Table 5.
</TD></TR></TFOOT><TBODY><TR><TH id=er2 class=alignLeft headers=er1>16-20 </TH><TD class=alignRight headers="er1 er2 ec1 ec2 ec3">7</TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec4">3</TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec5">0</TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec6">4</TD><TD class=alignRight headers="er1 er2 ec1 ec7">1</TD><TD class=alignRight headers="er1 er2 ec1 ec8">8 (1%)</TD></TR><TR><TH id=er3 class=alignLeft headers=er1>20-44 </TH><TD class=alignRight headers="er1 er3 ec1 ec2 ec3">191</TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec4">105</TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec5">2</TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec6">84</TD><TD class=alignRight headers="er1 er3 ec1 ec7">2</TD><TD class=alignRight headers="er1 er3 ec1 ec8">193 (22%)</TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignRight headers="er1 er4 ec1 ec2 ec3">339</TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec4">157</TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec5">3</TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec6">179</TD><TD class=alignRight headers="er1 er4 ec1 ec7">5</TD><TD class=alignRight headers="er1 er4 ec1 ec8">344 (39%)</TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignRight headers="er1 er5 ec1 ec2 ec3">309</TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec4">159</TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec5">15</TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec6">135</TD><TD class=alignRight headers="er1 er5 ec1 ec7">25</TD><TD class=alignRight headers="er1 er5 ec1 ec8">334 (38%)</TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignRight headers="er1 er6 ec1 ec2 ec3">846</TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec4">424</TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec5">20</TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec6">402</TD><TD class=alignRight headers="er1 er6 ec1 ec7">33</TD><TD class=alignRight headers="er1 er6 ec1 ec8">879</TD></TR><TR><TH id=er7 class=alignLeft headers=er1>% <SUP>1</SUP></TH><TD class=alignRight headers="er1 er7 ec1 ec2 ec3">96%</TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec4">50%</TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec5">2%</TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec6">48%</TD><TD class=alignRight headers="er1 er7 ec1 ec7">4%</TD><TD class=alignRight headers="er1 er7 ec1 ec8">100%</TD></TR></TBODY></TABLE>
Figure 8. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w06-fg8a-eng.gif


Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w06-fg8b-eng.gif

* See footnote above following the section related to PCIRN-SOS data.
Text equivalent for figure 8bNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Adult hospitalizations (>16 year of age, PCIRN-SOS)
Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w06-fg9a-eng.gif

* One ICU admission for which age information is not available has not been included in Figure 9a.
Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w06-fg9b-eng.gif

Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Adult hospitalizations (≥16 year of age, PCIRN-SOS)

Top of Page
Provincial/Territorial Influenza Hospitalizations and Deaths

In week 06, 208 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories.<SUP>*</SUP> The majority were cases of influenza A (198, 95.2%), of which 96 (48.5%) were A(H1N1)pdm09, 8 (4.0%) were A(H3N2), and 94 (47.5%) were A(unsubtyped). Among the 12 ICU admissions reported in week 06, the majority (7, 58.3%) were adults 20-64 years of age. Fourteen deaths were reported, over half of which were adults 20-64 years of age. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total.
To date this season, 2,818 influenza-associated hospitalizations have been reported, 97.4% with influenza A. The majority (57.7%) of hospitalizations have been cases 45 years of age of older (Table 6). A total of 277 ICU admissions have been reported this season, and 70.4% were among adults 20-64 years of age. A total of 143 deaths have been reported. The highest proportion of deaths has been among adults 20-64 years of age (55.9%), followed by adults ≥65 years of age (35.7%). Influenza B has been detected infrequently among severe cases of influenza to date this season: in only 2.6% of hospitalizations, 1.1% of ICU admissions, and 1.4% of deaths. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.
* Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, NS, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t6 class=alignCenter>Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=fr1 rowSpan=3>Age groups </TH><TH id=fc1 colSpan=6>Cumulative (Aug. 25, 2013 to February 8, 2014)* </TH></TR><TR class=bg-colour-yellow><TH id=fc2 colSpan=4 headers=fc1>Influenza A </TH><TH id=fc7 headers=fc1>B </TH><TH id=fc8 headers=fc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=fc3 headers="fc1 fc2">A Total </TH><TH id=fc4 class=lightred headers="fc1 fc2">A(H1) pdm09 </TH><TH id=fc5 class=lightred headers="fc1 fc2">A(H3) </TH><TH id=fc6 class=lightred headers="fc1 fc2">A (UnS) </TH><TD class=alignCenter headers="fc1 fc7">Total</TD><TD class=alignCenter headers="fc1 fc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=8><SUP>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
* Seventy-seven cases for which age information is not available have not been included in Table 6.
</TD></TR></TFOOT><TBODY><TR><TH id=fr2 class=alignLeft headers=fr1>0-4 years </TH><TD class=alignRight headers="fr10 fr11 fc9 fc10 fc13">466</TD><TD class=alignRight headers="fr10 fr11 fc9 fc10 fc14">239</TD><TD class=alignRight headers="fr10 fr11 fc9 fc10 fc15">6</TD><TD class=alignRight headers="fr10 fr11 fc9 fc10 fc16">221</TD><TD class=alignRight headers="fr10 fr11 fc9 fc11">16</TD><TD class=alignRight headers="fr10 fr11 fc9 fc12">482 (18%)</TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years </TH><TD class=alignRight headers="fr10 fr12 fc9 fc10 fc13">104</TD><TD class=alignRight headers="fr10 fr12 fc9 fc10 fc14">56</TD><TD class=alignRight headers="fr10 fr12 fc9 fc10 fc15">5</TD><TD class=alignRight headers="fr10 fr12 fc9 fc10 fc16">43</TD><TD class=alignRight headers="fr10 fr12 fc9 fc11">8</TD><TD class=alignRight headers="fr10 fr12 fc9 fc12">112 (4%)</TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years </TH><TD class=alignRight headers="fr10 fr13 fc9 fc10 fc13">27</TD><TD class=alignRight headers="fr10 fr13 fc9 fc10 fc14">16</TD><TD class=alignRight headers="fr10 fr13 fc9 fc10 fc15">2</TD><TD class=alignRight headers="fr10 fr13 fc9 fc10 fc16">9</TD><TD class=alignRight headers="fr10 fr13 fc9 fc11">1</TD><TD class=alignRight headers="fr10 fr13 fc9 fc12">28 (1%)</TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignRight headers="fr10 fr14 fc9 fc10 fc13">488</TD><TD class=alignRight headers="fr10 fr14 fc9 fc10 fc14">357</TD><TD class=alignRight headers="fr10 fr14 fc9 fc10 fc15">3</TD><TD class=alignRight headers="fr10 fr14 fc9 fc10 fc16">128</TD><TD class=alignRight headers="fr10 fr14 fc9 fc11">4</TD><TD class=alignRight headers="fr10 fr14 fc9 fc12">492 (18%)</TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignRight headers="fr10 fr15 fc9 fc10 fc13">887</TD><TD class=alignRight headers="fr10 fr15 fc9 fc10 fc14">586</TD><TD class=alignRight headers="fr10 fr15 fc9 fc10 fc15">16</TD><TD class=alignRight headers="fr10 fr15 fc9 fc10 fc16">285</TD><TD class=alignRight headers="fr10 fr15 fc9 fc11">11</TD><TD class=alignRight headers="fr10 fr15 fc9 fc12">898 (33%)</TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignRight headers="fr10 fr16 fc9 fc10 fc13">697</TD><TD class=alignRight headers="fr10 fr16 fc9 fc10 fc14">384</TD><TD class=alignRight headers="fr10 fr16 fc9 fc10 fc15">44</TD><TD class=alignRight headers="fr10 fr16 fc9 fc10 fc16">269</TD><TD class=alignRight headers="fr10 fr16 fc9 fc11">32</TD><TD class=alignRight headers="fr10 fr16 fc9 fc12">729 (27%)</TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignRight headers="fr10 fr17 fc9 fc10 fc13">2669</TD><TD class="alignRight lightred" headers="fr10 fr17 fc9 fc10 fc14">1638</TD><TD class="alignRight lightred" headers="fr10 fr17 fc9 fc10 fc15">76</TD><TD class="alignRight lightred" headers="fr10 fr17 fc9 fc10 fc16">955</TD><TD class=alignRight headers="fr10 fr17 fc9 fc11">72</TD><TD class=alignRight headers="fr10 fr17 fc9 fc12">2741</TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP> </TH><TD class=alignRight headers="fr10 fr18 fc9 fc10 fc13">97.4%</TD><TD class="alignRight lightred" headers="fr10 fr18 fc9 fc10 fc14">61.4%</TD><TD class="alignRight lightred" headers="fr10 fr18 fc9 fc10 fc15">2.8%</TD><TD class="alignRight lightred" headers="fr10 fr18 fc9 fc10 fc16">35.8%</TD><TD class=alignRight headers="fr10 fr18 fc9 fc11">2.6%</TD><TD class=alignRight headers="fr10 fr18 fc9 fc12">100%</TD></TR></TBODY></TABLE>
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2013-14 on the Public Health Agency of Canada website.

.../
http://www.phac-aspc.gc.ca/fluwatch/13-14/w06_14/index-eng.php
 
Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 8

Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 8

FluWatch report: February 16 to 22, 2014 (Week 08)

Posted 2014-02-28For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
<A title="Flu Watch (Version PDF, 113 KB - 6 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/13-14/w08_14/pdf/fw2014-08-eng.pdf">FluWatch report: February 16 to 22, 2014 (Week 08) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 291 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

?? Help with PDF documents


Overall Summary
  • In week 08, overall influenza activity continued to decrease in Canada except in the eastern provinces which experienced a later start to the influenza season.
  • The influenza A(H1N1) virus remains the most common influenza virus circulating this season although influenza B virus detections continue to increase.
  • Adults 20-64 years of age continue to be more affected by influenza this season. However, the increasing circulation of influenza B may result in greater impact on older adults and children in the coming weeks.
  • To week 08, 3,093 hospitalizations and 171 deaths have been reported, which is fewer than were reported during the same period last season.
  • Overall influenza activity in Canada during the 2013-14 season has been similar to the 2012-13 season and is within expected levels for this time of year.
Influenza/ILI Activity (geographic spread)

In week 08, influenza activity levels continued to decline. No regions reported widespread activity and ten regions in eastern Canada (ON(5), QC(3) and NS(2)) reported localized activity (Figure 1).
Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 08


right_ofmap.gif



Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
Influenza and Other Respiratory Virus Detections

The number of positive influenza tests continued to decrease, from 1,315 in week 07 to 1,014 in week 08. The percentage of positive influenza tests decreased from 16.9% to 14.3% (Figure 2). Laboratory detections continue to follow a similar trend to the 2012-13 season, despite the difference in the predominant circulating virus. Cumulative influenza virus detections to date remain predominantly influenza A (92%), and among those subtyped, 97% (9,724/10,060) were A(H1N1)pdm09. However, the percentage of positive tests for influenza B has been rising slowly in recent weeks to 28.7% of influenza detections in week 08 (Table 1). A similar late-season wave of influenza B was observed during the 2012-13 and 2010-11 influenza seasons. Among the 16,968 cases for which information on age and type/subtype has been received this season, 56.1% were 20-64 years of age (Table 2).
Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
2014-w08-fg2-eng.gif

Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
The percentages of positive tests for RSV, human metapneumovirus and rhinovirus have been increasing over recent weeks. The percentage of positive tests for coronavirus and parainfluenza have been declining (Figure 3).
For more details, see the weekly Respiratory Virus Detections in Canada Report.
Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2013-14
2014-w08-fg3-eng.gif


Top of Page
RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly and cumulative numbers of positive influenza specimens
by type, subtype and province, Canada, 2013-14
</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=ac1 colSpan=5>Weekly
(February 16, 2013 to February 22, 2014)
</TH><TH id=ac8 colSpan=5>Cumulative
(August 25, 2013 to February 22, 2014)
</TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=4 headers=ac1>Influenza A</TH><TH id=ac7 headers=ac1>B</TH><TH id=ac9 colSpan=4 headers=ac8>Influenza A</TH><TH id=ac14 headers=ac8>B</TH></TR><TR class=bg-colour-grey-light><TH id=ac3 headers="ac1 ac2">A Total</TH><TH id=ac4 class=lightred headers="ac1 ac2">A(H1)pdm09</TH><TH id=ac5 class=lightred headers="ac1 ac2">A(H3)</TH><TH id=ac6 class=lightred headers="ac1 ac2">A(UnS)</TH><TH class=alignCenter headers="ac1 ac7">B Total</TH><TH id=ac10 headers="ac8 ac9">A Total</TH><TH id=ac11 class=lightred headers="ac8 ac9">A(H1)pdm09</TH><TH id=ac12 class=lightred headers="ac8 ac9">A(H3)</TH><TH id=ac13 class=lightred headers="ac8 ac9">A(UnS)</TH><TD class=alignCenter headers="ac8 ac14">B Total</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
</TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=alignLeft headers=ar1>BC</TH><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac3">80 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac4">43 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac5">8 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac6">29 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac7">12 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac10">1687 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac11">1526 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac12">51 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac13">110 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac14">77 </TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac3">75 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac4">35 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac5">3 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac6">37 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac7">7 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac10">3542 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac11">3265 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac12">42 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac13">235 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac14">90 </TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac3">17 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac4">11 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac6">6 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac7">3 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac10">1317 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac11">950 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac12">4 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac13">363 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac14">24 </TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac3">31 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac4">29 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac6">2 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac7">0 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac10">538 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac11">378 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac12">1 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac13">159 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac14">15 </TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac3">98 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac4">19 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac5">14 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac6">65 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac7">80 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac10">5248 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac11">2305 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac12">230 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac13">2713 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac14">305 </TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac3">323 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac4">37 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac6">286 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac7">178 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac10">4807 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac11">616 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac12">3 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac13">4188 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac14">1038 </TD></TR><TR><TH id=ar8 class=alignLeft headers=ar1>NB</TH><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac3">71 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac6">71 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac7">2 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac10">1418 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac11">364 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac12">1 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac13">1053 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac14">10 </TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac3">14 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac4">11 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac6">3 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac7">0 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac10">129 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac11">102 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac12">4 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac13">23 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac14">1 </TD></TR><TR><TH id=ar10 class=alignLeft headers=ar1>PE</TH><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac3">7 </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac4">6 </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac6">1 </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac7">0 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac10">115 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac11">114 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac12">0 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac13">1 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac14">0 </TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac3">7 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac6">7 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac7">9 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac10">324 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac11">104 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac12">0 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac13">220 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac14">123 </TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignCenter headers="ar1 ar12 ac1 ac2 ac3">723 </TD><TD class="alignCenter lightred" headers="ar1 ar12 ac1 ac2 ac4">191 </TD><TD class="alignCenter lightred" headers="ar1 ar12 ac1 ac2 ac5">25 </TD><TD class="alignCenter lightred" headers="ar1 ar12 ac1 ac2 ac6">507 </TD><TD class=alignCenter headers="ar1 ar12 ac1 ac7">291 </TD><TD class=alignCenter headers="ar1 ar12 ac8 ac9 ac10">19125 </TD><TD class="alignCenter lightred" headers="ar1 ar12 ac8 ac9 ac11">9724 </TD><TD class="alignCenter lightred" headers="ar1 ar12 ac8 ac9 ac12">336 </TD><TD class="alignCenter lightred" headers="ar1 ar12 ac8 ac9 ac13">9065 </TD><TD class=alignCenter headers="ar1 ar12 ac8 ac14">1683 </TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignCenter headers="ar1 ar13 ac1 ac2 ac3">71.3% </TD><TD class="alignCenter lightred" headers="ar1 ar13 ac1 ac2 ac4">26.4% </TD><TD class="alignCenter lightred" headers="ar1 ar13 ac1 ac2 ac5">3.5% </TD><TD class="alignCenter lightred" headers="ar1 ar13 ac1 ac2 ac6">70.1% </TD><TD class=alignCenter headers="ar1 ar13 ac1 ac7">28.7% </TD><TD class=alignCenter headers="ar1 ar13 ac8 ac9 ac10">91.9% </TD><TD class="alignCenter lightred" headers="ar1 ar13 ac8 ac9 ac11">50.8% </TD><TD class="alignCenter lightred" headers="ar1 ar13 ac8 ac9 ac12">1.8% </TD><TD class="alignCenter lightred" headers="ar1 ar13 ac8 ac9 ac13">47.4% </TD><TD class=alignCenter headers="ar1 ar13 ac8 ac14">8.1% </TD></TR></TBODY></TABLE>
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups (years)</TH><TH id=bc1 colSpan=5>Weekly
(February 16 to February 22, 2014)
</TH><TH id=bc8 colSpan=7>Cumulative
(August 25, 2013 to February 22, 2014)
</TH></TR><TR class=bg-colour-yellow><TH id=bc2 colSpan=4 headers=bc1>Influenza A</TH><TH id=bc7 headers=bc1>B</TH><TH id=bc9 colSpan=4 headers=bc8>Influenza A</TH><TH id=bc14 headers=bc8>B</TH><TH id=bc15 colSpan=2 headers=bc8>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=bc3 headers="bc1 bc2">A Total</TH><TH id=bc4 class="lightred " headers="bc1 bc2">A(H1) pdm09</TH><TH id=bc5 class="lightred " headers="bc1 bc2">A(H3)</TH><TH id=bc6 class="lightred " headers="bc1 bc2">A (UnS)</TH><TD class=alignCenter headers="bc1 bc7">Total</TD><TH id=bc10 headers="bc8 bc9">A Total</TH><TH id=bc11 class="lightred " headers="bc8 bc9">A(H1) pdm09</TH><TH id=bc12 class="lightred " headers="bc8 bc9">A(H3)</TH><TH id=bc13 class="lightred " headers="bc8 bc9">A (UnS)</TH><TD class=alignCenter headers="bc8 bc14">Total</TD><TH id=bc16 headers="bc8 bc15">#</TH><TH id=bc17 headers="bc8 bc15">%</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13><SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
<SUP>3 </SUP>Table 2 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
</TD></TR></TFOOT><TBODY><TR><TH id=br2 class=alignLeft headers=br1><5</TH><TD class=alignCenter headers="br1 br2 bc1 bc2 bc3">102 </TD><TD class=alignCenter headers="br1 br2 bc1 bc2 bc4">24 </TD><TD class=alignCenter headers="br1 br2 bc1 bc2 bc5">2 </TD><TD class=alignCenter headers="br1 br2 bc1 bc2 bc6">76 </TD><TD class=alignCenter headers="br1 br2 bc1 bc7">20 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc10">2936 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc11">1324 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc12">23 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc13">1589 </TD><TD class=alignCenter headers="br1 br2 bc8 bc14">173 </TD><TD class=alignCenter headers="br1 br2 bc8 bc15 bc16">3109 </TD><TD class=alignCenter headers="br1 br2 bc8 bc15 bc17">18.3% </TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignCenter headers="br1 br3 bc1 bc2 bc3">32 </TD><TD class=alignCenter headers="br1 br3 bc1 bc2 bc4">7 </TD><TD class=alignCenter headers="br1 br3 bc1 bc2 bc5">0 </TD><TD class=alignCenter headers="br1 br3 bc1 bc2 bc6">25 </TD><TD class=alignCenter headers="br1 br3 bc1 bc7">30 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc10">1216 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc11">654 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc12">18 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc13">544 </TD><TD class=alignCenter headers="br1 br3 bc8 bc14">261 </TD><TD class=alignCenter headers="br1 br3 bc8 bc15 bc16">1477 </TD><TD class=alignCenter headers="br1 br3 bc8 bc15 bc17">8.7% </TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignCenter headers="br1 br4 bc1 bc2 bc3">109 </TD><TD class=alignCenter headers="br1 br4 bc1 bc2 bc4">24 </TD><TD class=alignCenter headers="br1 br4 bc1 bc2 bc5">1 </TD><TD class=alignCenter headers="br1 br4 bc1 bc2 bc6">84 </TD><TD class=alignCenter headers="br1 br4 bc1 bc7">48 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc10">4729 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc11">2581 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc12">33 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc13">2115 </TD><TD class=alignCenter headers="br1 br4 bc8 bc14">305 </TD><TD class=alignCenter headers="br1 br4 bc8 bc15 bc16">5034 </TD><TD class=alignCenter headers="br1 br4 bc8 bc15 bc17">29.7% </TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignCenter headers="br1 br5 bc1 bc2 bc3">102 </TD><TD class=alignCenter headers="br1 br5 bc1 bc2 bc4">20 </TD><TD class=alignCenter headers="br1 br5 bc1 bc2 bc5">0 </TD><TD class=alignCenter headers="br1 br5 bc1 bc2 bc6">82 </TD><TD class=alignCenter headers="br1 br5 bc1 bc7">44 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc10">4102 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc11">2215 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc12">37 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc13">1850 </TD><TD class=alignCenter headers="br1 br5 bc8 bc14">389 </TD><TD class=alignCenter headers="br1 br5 bc8 bc15 bc16">4491 </TD><TD class=alignCenter headers="br1 br5 bc8 bc15 bc17">26.5% </TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignCenter headers="br1 br6 bc1 bc2 bc3">96 </TD><TD class=alignCenter headers="br1 br6 bc1 bc2 bc4">21 </TD><TD class=alignCenter headers="br1 br6 bc1 bc2 bc5">3 </TD><TD class=alignCenter headers="br1 br6 bc1 bc2 bc6">72 </TD><TD class=alignCenter headers="br1 br6 bc1 bc7">58 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc10">2211 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc11">900 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc12">88 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc13">1223 </TD><TD class=alignCenter headers="br1 br6 bc8 bc14">519 </TD><TD class=alignCenter headers="br1 br6 bc8 bc15 bc16">2730 </TD><TD class=alignCenter headers="br1 br6 bc8 bc15 bc17">16.1% </TD></TR><TR><TH id=br7 class=alignLeft headers=br1>Unknown</TH><TD class=alignCenter headers="br1 br7 bc1 bc2 bc3">7 </TD><TD class=alignCenter headers="br1 br7 bc1 bc2 bc4">0 </TD><TD class=alignCenter headers="br1 br7 bc1 bc2 bc5">5 </TD><TD class=alignCenter headers="br1 br7 bc1 bc2 bc6">2 </TD><TD class=alignCenter headers="br1 br7 bc1 bc7">1 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc10">125 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc11">98 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc12">14 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc13">13 </TD><TD class=alignCenter headers="br1 br7 bc8 bc14">2 </TD><TD class=alignCenter headers="br1 br7 bc8 bc15 bc16">127 </TD><TD class=alignCenter headers="br1 br7 bc8 bc15 bc17">0.7% </TD></TR><TR><TH id=br8 class=alignLeft headers=br1>Total</TH><TD class=alignCenter headers="br1 br8 bc1 bc2 bc3">448 </TD><TD class="alignCenter lightred " headers="br1 br8 bc1 bc2 bc4">96 </TD><TD class="alignCenter lightred " headers="br1 br8 bc1 bc2 bc5">11 </TD><TD class="alignCenter lightred " headers="br1 br8 bc1 bc2 bc6">341 </TD><TD class=alignCenter headers="br1 br8 bc1 bc7">201 </TD><TD class=alignCenter headers="br1 br8 bc8 bc9 bc10">15319 </TD><TD class="alignCenter lightred " headers="br1 br8 bc8 bc9 bc11">7772 </TD><TD class="alignCenter lightred " headers="br1 br8 bc8 bc9 bc12">213 </TD><TD class="alignCenter lightred " headers="br1 br8 bc8 bc9 bc13">7334 </TD><TD class=alignCenter headers="br1 br8 bc8 bc14">1649 </TD><TD class=alignCenter headers="br1 br8 bc8 bc15 bc16">16968 </TD><TD class=alignCenter headers="br1 br8 bc8 bc15 bc17">100.0% </TD></TR><TR><TH id=br9 class=alignLeft headers=br1>Percentage<SUP>2</SUP></TH><TD class=alignCenter headers="br1 br9 bc1 bc2 bc3">69.0% </TD><TD class="alignCenter lightred " headers="br1 br9 bc1 bc2 bc4">21.4% </TD><TD class="alignCenter lightred " headers="br1 br9 bc1 bc2 bc5">2.5% </TD><TD class="alignCenter lightred " headers="br1 br9 bc1 bc2 bc6">76.1% </TD><TD class=alignCenter headers="br1 br9 bc1 bc7">31.0% </TD><TD class=alignCenter headers="br1 br9 bc8 bc9 bc10">90.3% </TD><TD class="alignCenter lightred " headers="br1 br9 bc8 bc9 bc11">50.7% </TD><TD class="alignCenter lightred " headers="br1 br9 bc8 bc9 bc12">1.4% </TD><TD class="alignCenter lightred " headers="br1 br9 bc8 bc9 bc13">47.9% </TD><TD class=alignCenter headers="br1 br9 bc8 bc14">9.7% </TD><TD class=alignCenter></TD><TD class=alignCenter></TD></TR></TBODY></TABLE>

Top of Page
Influenza Strain Characterizations

During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 1150 influenza viruses [49 A(H3N2), 956 A(H1N1)pdm09 and 145 influenza B]. The vast majority (99%) of viruses were similar to the strains recommended by the WHO for the 2013-14 seasonal influenza vaccine. Two A(H1N1)pdm09 viruses showed reduced titres to antiserum against the reference A/California/07/2009 strain. Eleven influenza B viruses were similar to the strain recommended by the WHO for the 2011-12 vaccine (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2013-14, N = 1150
2014-w08-fg4-eng.gif

The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
The recommended components for the 2013-2014 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009 (H1N1)pdm09-like virus, an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b (e.g. A/Texas/50/2012), and a B/Massachusetts/2/2012-like virus (Yamagata lineage).


Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
Antiviral Resistance

During the 2013-2014 influenza season, NML has tested 774 influenza viruses for resistance to oseltamivir and 772 viruses for resistance to zanamivir, and all were sensitive. All 939 influenza A viruses tested for amantadine resistance were resistant (Table 3).
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2013-2014</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=cr1 rowSpan=2>Virus type and subtype</TH><TH id=cc1 colSpan=2>Oseltamivir</TH><TH id=cc4 colSpan=2>Zanamivir</TH><TH id=cc7 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=cc2 headers=cc1># tested</TH><TH id=cc3 headers=cc1># resistant (%)</TH><TH id=cc5 headers=cc4># tested</TH><TH id=cc6 headers=cc4># resistant (%)</TH><TH id=cc8 headers=cc7># tested</TH><TH id=cc9 headers=cc7># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=cr2 class="alignLeft lightred" headers=cr1>A (H3N2)</TH><TD class=alignCenter headers="cr1 cr2 cc1 cc2">45</TD><TD class=alignCenter headers="cr1 cr2 cc1 cc3">0</TD><TD class=alignCenter headers="cr1 cr2 cc4 cc5">45</TD><TD class=alignCenter headers="cr1 cr2 cc4 cc6">0</TD><TD class=alignCenter headers="cr1 cr2 cc7 cc8">74</TD><TD class=alignCenter headers="cr1 cr2 cc7 cc9">74 (100%)</TD></TR><TR><TH id=cr3 class="alignLeft lightred" headers=cr1>A (H1N1)</TH><TD class=alignCenter headers="cr1 cr3 cc1 cc2">654</TD><TD class=alignCenter headers="cr1 cr3 cc1 cc3">0</TD><TD class=alignCenter headers="cr1 cr3 cc4 cc5">652</TD><TD class=alignCenter headers="cr1 cr3 cc4 cc6">0</TD><TD class=alignCenter headers="cr1 cr3 cc7 cc8">865</TD><TD class=alignCenter headers="cr1 cr3 cc7 cc9">865 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft lightred" headers=cr1>B</TH><TD class=alignCenter headers="cr1 cr4 cc1 cc2">75</TD><TD class=alignCenter headers="cr1 cr4 cc1 cc3">0</TD><TD class=alignCenter headers="cr1 cr4 cc4 cc5">75</TD><TD class=alignCenter headers="cr1 cr4 cc4 cc6">0</TD><TD class=alignCenter headers="cr1 cr4 cc7 cc8">NA <SUP>*</SUP></TD><TD class=alignCenter headers="cr1 cr4 cc7 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft lightred" headers=cr1>TOTAL</TH><TD class=alignCenter headers="cr1 cr5 cc1 cc2">774</TD><TD class=alignCenter headers="cr1 cr5 cc1 cc3">0</TD><TD class=alignCenter headers="cr1 cr5 cc4 cc5">772</TD><TD class=alignCenter headers="cr1 cr5 cc4 cc6">0</TD><TD class=alignCenter headers="cr1 cr5 cc7 cc8">939</TD><TD class=alignCenter headers="cr1 cr5 cc7 cc9">939 (100%)</TD></TR></TBODY></TABLE>
Influenza-like Illness (ILI) Consultation Rate

The national influenza-like-illness (ILI) consultation rate decreased from 45.4/1,000 in week 07 to 22.0/1,000 in week 08; which is below the expected range for week 08 (Figure 5).
Figure 5. Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014
2014-w08-fg5-eng.gif

Note: No data available for mean rate for weeks 19 to 39 for the 1996-1997 through 2002-2003 seasons. Delays in the reporting of data may cause data to change retrospectively. The calculation of the average ILI consultation rate over 17 seasons was aligned with influenza activity in each season. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. The number of sentinel physicians in each province or territory is as follows: BC(21), AB(80), SK(11), MB(18), ON(169), QC(14), NB(29), NS(26), PE(4), NL(16), NU(1), NT(14), YT(13). Not all sentinel physicians report every week.
Text equivalent for figure 5Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

Top of Page
Influenza Outbreak Surveillance

In week 08, 11 new influenza outbreaks were reported: one in a hospital and ten in long-term care facilities (Figure 6). In addition, five outbreaks of influenza-like-illness were reported: four in schools and one in another facility or community.
Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2013-2014
2014-w08-fg6-eng.gif

1 All provinces and territories except NU report outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
Text equivalent for figure 6Overall number of new influenza outbreaks by report week, Canada, 2013-2014
Pharmacy Surveillance

In week 08, the proportion of prescriptions for influenza antivirals continued to decrease, following the downward trend in laboratory detections of influenza. The largest proportion of prescriptions for antivirals continued to be among children 2-18 years of age followed by adults 19-64 years of age (Figure 7). Within these age-groups, higher proportions of prescriptions for antivirals were observed among children >5 years of age and adults <45 years of age.
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14
2014-w08-fg7-eng.gif

Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group. Age-groups: Infant: 0-2y, Child: 2-18y; Adult: 19-64y, Senior: ≥65y.
Text equivalent for figure 7Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

Top of Page
Sentinel Hospital Influenza Surveillance

Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In week 08, 28 new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 42 in week 07. In week 08, influenza A was reported in 17 cases and influenza B in 11 cases. An increasing number of influenza B cases have been reported in the past two weeks (Figure 8a). Twenty-two (79%) of the cases in week 08 were ≥2 years of age. Two ICU admissions were reported in week 08, one 5-9 years of age and one 10-16 years of age. No deaths were reported.
To date this season, a total of 520 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 92% of which have been influenza A, and almost all of those subtyped (98%) were A(H1N1)pdm09. Children ≥2 years of age represent 54.6% of cases to date (Table 4). Seventy-nine ICU admissions have been reported, of which 46 (58%) were children ≥2 years of age (Figure 9a). Among the 76 ICU admission for which the influenza type reported, all but four were cases with influenza A, and 96% of those subtyped were A(H1N1)pdm09. Among the 65 ICU cases with available data, 44 (68%) were reported to have underlying medical conditions. No deaths have been reported.
Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
Adult Influenza Hospitalizations and Deaths (PCIRN)
In week 08, 27 new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations reported through active surveillance by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 45 in week 07. There has been a steady decline in the number of new cases over recent weeks. Among cases in week 08, 22 (81.5%) were influenza A, and four were influenza B (Figure 8b). The majority of hospitalizations occurred among adults ≥45 years of age (20; 74%). Three ICU admissions were reported in week 08, all 45-64 years of age with influenza A. No deaths were reported in week 08.
To date this season, 1030 influenza-associated hospitalizations have been reported by the PCIRN-SOS network, 980 (95.1%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). ICU admission was required for 180 hospitalizations, all but five of which were cases with influenza A (102 A(H1N1)pdm09, three A(H3N2) and 70 A(unsubtyped). More than three quarters of hospitalizations and approximately 80% of ICU admissions were ≥45 years of age. Of the 152 ICU admissions with available information, 133 (87.5%) were reported to have at least one comorbidity and of the 155 ICU admissions with available information 112 (72.3%) reported not having been vaccinated this season. Fifty-one deaths have been reported, all but one with influenza A (32 A(H1N1)pdm09, one A(H3N2) and 17 A(unsubtyped)); five cases 20-44 years of age, 26 cases 45-64 years of age and 20 cases ≥65 years of age (Figure 9b).
Note: PCIRN-SOS conducted passive surveillance from April 30th to November 14th, 2013. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance began November 15th during which time PCIRN site coordinators investigate cases potentially related to influenza. Data from both active and passive surveillance reported during the 2013-14 season are included in this report. The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t4 class=alignCenter>Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=dr1 rowSpan=3>Age groups </TH><TH id=dc1 colSpan=6>Cumulative (Aug. 25, 2013 to February 22, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=dc2 colSpan=4 headers=dc1>Influenza A </TH><TH id=dc7 headers=dc1>B </TH><TH id=dc8 headers=dc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=dc3 headers="dc1 dc2">A Total </TH><TH id=dc4 class="lightred " headers="dc1 dc2">A(H1) pdm09 </TH><TH id=dc5 class="lightred " headers="dc1 dc2">A(H3) </TH><TH id=dc6 class="lightred " headers="dc1 dc2">A (UnS) </TH><TD class=alignCenter headers="dc1 dc7">Total</TD><TD class=alignCenter headers="dc1 dc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
</TD></TR></TFOOT><TBODY><TR><TH id=dr2 class=alignLeft headers=dr1>0-5m </TH><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc3">92 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc4">27 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc5">0 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc6">65 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc7">2 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc8">94 (18%) </TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc3">137 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc4">38 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc5">1 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc6">98 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc7">5 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc8">142 (27%) </TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc3">146 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc4">46 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc5">2 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc6">98 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc7">14 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc8">160 (31%) </TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc3">73 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc4">22 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc5">0 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc6">51 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc7">17 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc8">90 (17%) </TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc3">31 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc4">13 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc5">0 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc6">18 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc7">3 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc8">34 (7%) </TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignCenter headers="dr1 dr7 dc1 dc2 dc3">479 </TD><TD class="lightred alignCenter" headers="dr1 dr7 dc1 dc2 dc4">146 </TD><TD class="lightred alignCenter" headers="dr1 dr7 dc1 dc2 dc5">3 </TD><TD class="lightred alignCenter" headers="dr1 dr7 dc1 dc2 dc6">330 </TD><TD class=alignCenter headers="dr1 dr7 dc1 dc7">41 </TD><TD class=alignCenter headers="dr1 dr7 dc1 dc8">520 </TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP> </TH><TD class=alignCenter headers="dr1 dr8 dc1 dc2 dc3">92.1% </TD><TD class="lightred alignCenter" headers="dr1 dr8 dc1 dc2 dc4">30.5% </TD><TD class="lightred alignCenter" headers="dr1 dr8 dc1 dc2 dc5">0.6% </TD><TD class="lightred alignCenter" headers="dr1 dr8 dc1 dc2 dc6">68.9% </TD><TD class=alignCenter headers="dr1 dr8 dc1 dc7">7.9% </TD><TD class=alignCenter headers="dr1 dr8 dc1 dc8">100.0% </TD></TR></TBODY></TABLE>
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 5 - Cumulative numbers of adult hospitalizations with influenza
reported by the PCIRN-SOS network, Canada, 2013-14
</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=er1 rowSpan=3>Age groups </TH><TH id=ec1 class=noWrap colSpan=6>Cumulative (Aug. 25, 2013 to February 22, 2014)<SUP>*</SUP></TH></TR><TR class=bg-colour-yellow><TH id=ec2 colSpan=4 headers=ec1>Influenza A </TH><TH id=ec7 headers=ec1>B </TH><TH id=ec8 headers=ec1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=ec3 headers="ec1 ec2">A Total </TH><TH id=ec4 class=lightred headers="ec1 ec2">A(H1) pdm09 </TH><TH id=ec5 class=lightred headers="ec1 ec2">A(H3) </TH><TH id=ec6 class=lightred headers="ec1 ec2">A(UnS) </TH><TD class=alignCenter headers="ec1 ec7">Total</TD><TD class=alignCenter headers="ec1 ec8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t5_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.

<SUP id=footnote_t5_star>*</SUP>One case for which the influenza type has not yet been reported, and four cases for which the age-group was not reported, are not included in Table 5.
</TD></TR></TFOOT><TBODY><TR><TH id=er2 class=alignLeft headers=er1>16-20 </TH><TD class=alignCenter headers="er1 er2 ec1 ec2 ec3">11</TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec4">3</TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec5">0</TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec6">8</TD><TD class=alignCenter headers="er1 er2 ec1 ec7">1</TD><TD class=alignCenter headers="er1 er2 ec1 ec8">12 (1%)</TD></TR><TR><TH id=er3 class=alignLeft headers=er1>20-44 </TH><TD class=alignCenter headers="er1 er3 ec1 ec2 ec3">218</TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec4">117</TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec5">3</TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec6">98</TD><TD class=alignCenter headers="er1 er3 ec1 ec7">3</TD><TD class=alignCenter headers="er1 er3 ec1 ec8">221 (22%)</TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignCenter headers="er1 er4 ec1 ec2 ec3">395</TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec4">182</TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec5">4</TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec6">209</TD><TD class=alignCenter headers="er1 er4 ec1 ec7">10</TD><TD class=alignCenter headers="er1 er4 ec1 ec8">405 (40%)</TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignCenter headers="er1 er5 ec1 ec2 ec3">352</TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec4">178</TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec5">22</TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec6">152</TD><TD class=alignCenter headers="er1 er5 ec1 ec7">35</TD><TD class=alignCenter headers="er1 er5 ec1 ec8">387 (38%)</TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignCenter headers="er1 er6 ec1 ec2 ec3">976</TD><TD class="alignCenter lightred" headers="er1 er6 ec1 ec2 ec4">480</TD><TD class="alignCenter lightred" headers="er1 er6 ec1 ec2 ec5">29</TD><TD class="alignCenter lightred" headers="er1 er6 ec1 ec2 ec6">467</TD><TD class=alignCenter headers="er1 er6 ec1 ec7">49</TD><TD class=alignCenter headers="er1 er6 ec1 ec8">1025</TD></TR><TR><TH id=er7 class=alignLeft headers=er1>% <SUP>1</SUP></TH><TD class=alignCenter headers="er1 er7 ec1 ec2 ec3">95%</TD><TD class="alignCenter lightred " headers="er1 er7 ec1 ec2 ec4">49%</TD><TD class="alignCenter lightred " headers="er1 er7 ec1 ec2 ec5">3%</TD><TD class="alignCenter lightred " headers="er1 er7 ec1 ec2 ec6">48%</TD><TD class=alignCenter headers="er1 er7 ec1 ec7">5%</TD><TD class=alignCenter headers="er1 er7 ec1 ec8">100%</TD></TR></TBODY></TABLE>
Figure 8. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w08-fg8a-eng.gif


Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w08-fg8b-eng.gif

* See footnote above following the section related to PCIRN-SOS data.
Text equivalent for figure 8bNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Adult hospitalizations (>16 year of age, PCIRN-SOS)
Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w08-fg9a-eng.gif

Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w08-fg9b-eng.gif

Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Adult hospitalizations (≥16 year of age, PCIRN-SOS)

Top of Page
Provincial/Territorial Influenza Hospitalizations and Deaths

In week 08, 119 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories.* The majority were cases of influenza A (103, 86.6%), of which 36 (35.0%) were A(H1N1)pdm09, one (1.0%) was A(H3N2), and 66 (64.1%) were A(unsubtyped). Seven of the eight ICU admissions reported in week 08 included age information, of which six were adults 20-64 years of age. Thirteen deaths were reported, 11 of which were adults ≥45 years of age. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total.
To date this season, 3,093 influenza-associated hospitalizations have been reported, 96.8% with influenza A. The majority (57.5%) of hospitalizations have been cases 45 years of age of older (Table 6). A total of 298 ICU admissions have been reported this season, of which 67.4% were among adults 20-64 years of age. A total of 171 deaths have been reported. The highest proportion of deaths has been among adults 20-64 years of age (52.6%), followed by adults ≥65 years of age (38.0%). Influenza B has been detected infrequently among severe cases of influenza to date this season: in only 3.2% of hospitalizations, 1.0% of ICU admissions, and 4.1 % of deaths. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.
* Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, NS, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t6 class=alignCenter>Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=fr1 rowSpan=3>Age groups </TH><TH id=fc1 colSpan=6>Cumulative (Aug. 25, 2013 to Fabruary 22, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=fc2 colSpan=4 headers=fc1>Influenza A</TH><TH id=fc7 headers=fc1>B</TH><TH id=fc8 headers=fc1>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=fc3 headers="fc1 fc2">A Total</TH><TH id=fc4 class=lightred headers="fc1 fc2">A(H1) pdm09</TH><TH id=fc5 class=lightred headers="fc1 fc2">A(H3)</TH><TH id=fc6 class=lightred headers="fc1 fc2">A (UnS)</TH><TD class=alignCenter headers="fc1 fc7">Total</TD><TD class=alignCenter headers="fc1 fc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=8><SUP>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
</TD></TR></TFOOT><TBODY><TR><TH id=fr2 class=alignLeft headers=fr1>0-4 years</TH><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc3">515 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc4">259 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc5">6 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc6">250 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc7">19 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc8">534 (17%) </TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years</TH><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc3">112 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc4">57 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc5">5 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc6">50 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc7">11 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc8">123 (4%) </TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years</TH><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc3">28 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc4">17 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc5">2 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc6">9 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc7">1 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc8">29 (1%) </TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc3">525 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc4">377 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc5">3 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc6">145 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc7">6 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc8">531 (17%) </TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc3">965 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc4">626 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc5">16 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc6">323 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc7">17 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc8">982 (32%) </TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc3">750 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc4">402 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc5">46 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc6">302 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc7">45 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc8">795 (26%) </TD></TR><TR><TH id=fr10 class=alignLeft headers=fr1>Unknown</TH><TD class=alignCenter headers="fr1 fr10 fc1 fc2 fc3">98 </TD><TD class=alignCenter headers="fr1 fr10 fc1 fc2 fc4">78 </TD><TD class=alignCenter headers="fr1 fr10 fc1 fc2 fc5">3 </TD><TD class=alignCenter headers="fr1 fr10 fc1 fc2 fc6">17 </TD><TD class=alignCenter headers="fr1 fr10 fc1 fc7">1 </TD><TD class=alignCenter headers="fr1 fr10 fc1 fc8">99 (3%) </TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignCenter headers="fr1 fr8 fc1 fc2 fc3">2993 </TD><TD class="alignCenter lightred" headers="fr1 fr8 fc1 fc2 fc4">1816 </TD><TD class="alignCenter lightred" headers="fr1 fr8 fc1 fc2 fc5">81 </TD><TD class="alignCenter lightred" headers="fr1 fr8 fc1 fc2 fc6">1096 </TD><TD class=alignCenter headers="fr1 fr8 fc1 fc7">100 </TD><TD class=alignCenter headers="fr1 fr8 fc1 fc8">3093 </TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP> </TH><TD class=alignCenter headers="fr1 fr9 fc1 fc2 fc3">96.8% </TD><TD class="alignCenter lightred" headers="fr1 fr9 fc1 fc2 fc4">60.7% </TD><TD class="alignCenter lightred" headers="fr1 fr9 fc1 fc2 fc5">2.7% </TD><TD class="alignCenter lightred" headers="fr1 fr9 fc1 fc2 fc6">36.6% </TD><TD class=alignCenter headers="fr1 fr9 fc1 fc7">3.2% </TD><TD class=alignCenter headers="fr1 fr9 fc1 fc8">100% </TD></TR></TBODY></TABLE>
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2013-14 on the Public Health Agency of Canada website.

.../
http://www.phac-aspc.gc.ca/fluwatch/13-14/w08_14/index-eng.php
 
Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 9

Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 9

FluWatch report: February 23 to March 1, 2014 (Week 09)

Posted 2014-03-07For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
<A title="Flu Watch (Version PDF, 113 KB - 6 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/13-14/w09_14/pdf/fw2014-09-eng.pdf">FluWatch report: February 23 to March 1, 2014 (Week 09) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 291 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

?? Help with PDF documents


Overall Summary
  • In week 09, influenza activity in Canada continues to decrease, following a pattern similar to the 2012-13 season.
  • The influenza A(H1N1) virus remains the most common influenza virus circulating this season, affecting a greater proportion of adults 20-64 years of age compared to last season.
  • Circulation of influenza B virus continues to increase.
  • The number of sentinel paediatric and adult hospitalizations continues to decline. To week 09, 3,238 hospitalizations and 182 deaths have been reported. Compared to the same period last season, fewer hospitalizations but a similar number of deaths have been reported.
  • A Canadian vaccine effectiveness study has estimated that immunization with the 2013-14 seasonal influenza vaccine has been 58.5% effective in reducing influenza-related hospitalizations (McNeil S, Shinde V, Andrew M et al.).
Influenza/ILI Activity (geographic spread)

In week 09, influenza activity levels continued to decline. One region in Quebec reported widespread activity and seven regions in eastern Canada (ON(4), QC(2) and NS(1)) reported localized activity (Figure 1).
Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 09


right_ofmap.gif



Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
Influenza and Other Respiratory Virus Detections

The number of positive influenza tests continued to decrease, from 985 in week 08 to 864 in week 09. The percentage of positive influenza tests decreased from 13.9% to 13.3% (Figure 2). Cumulative influenza virus detections to date remain predominantly influenza A (91%), and among those subtyped, 97% (9,933/10,290) were A(H1N1)pdm09. However, the percentage of positive tests for influenza B has been rising slowly in recent weeks to 36.7% of influenza detections in week 09 (Table 1). Among the 17,709 cases for which information on age and type/subtype has been received this season, 55.8% were 20-64 years of age (Table 2).
Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
2014-w09-fg2-eng.gif

Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
The number of positive tests for RSV declined slightly in week 09. The number of positive tests for parainfluenza increased slightly in week 09, interrupting the decline observed since early January. The number of positive tests for rhinovirus has been relatively stable, while the number of positive tests for coronavirus and human metapneumovirus has been declining over recent weeks (Figure 3).
For more details, see the weekly Respiratory Virus Detections in Canada Report.
Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2013-14
2014-w09-fg3-eng.gif


Top of Page
RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly and cumulative numbers of positive influenza specimens
by type, subtype and province, Canada, 2013-14
</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=ac1 colSpan=5>Weekly
(February 23, 2013 to March 1, 2014)
</TH><TH id=ac8 colSpan=5>Cumulative
(August 25, 2013 to March 1, 2014)
</TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=4 headers=ac1>Influenza A</TH><TH id=ac7 headers=ac1>B</TH><TH id=ac9 colSpan=4 headers=ac8>Influenza A</TH><TH id=ac14 headers=ac8>B</TH></TR><TR class=bg-colour-grey-light><TH id=ac3 headers="ac1 ac2">A Total</TH><TH id=ac4 class=lightred headers="ac1 ac2">A(H1)pdm09</TH><TH id=ac5 class=lightred headers="ac1 ac2">A(H3)</TH><TH id=ac6 class=lightred headers="ac1 ac2">A(UnS)</TH><TH class=alignCenter headers="ac1 ac7">B Total</TH><TH id=ac10 headers="ac8 ac9">A Total</TH><TH id=ac11 class=lightred headers="ac8 ac9">A(H1)pdm09</TH><TH id=ac12 class=lightred headers="ac8 ac9">A(H3)</TH><TH id=ac13 class=lightred headers="ac8 ac9">A(UnS)</TH><TD class=alignCenter headers="ac8 ac14">B Total</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
</TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=alignLeft headers=ar1>BC</TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">73</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">50</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">13</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">10</TD><TD class=alignRight headers="ar1 ar2 ac1 ac7">20</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac10">1731</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac11">1573</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac12">58</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac13">100</TD><TD class=alignRight headers="ar1 ar2 ac8 ac14">98</TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">43</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">16</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">1</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">26</TD><TD class=alignRight headers="ar1 ar3 ac1 ac7">15</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac10">3585</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac11">3297</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac12">44</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac13">244</TD><TD class=alignRight headers="ar1 ar3 ac8 ac14">105</TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">15</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">12</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">3</TD><TD class=alignRight headers="ar1 ar4 ac1 ac7">3</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac10">1332</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac11">962</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac12">4</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac13">366</TD><TD class=alignRight headers="ar1 ar4 ac8 ac14">27</TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">34</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">29</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">5</TD><TD class=alignRight headers="ar1 ar5 ac1 ac7">0</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac10">572</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac11">407</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac12">1</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac13">164</TD><TD class=alignRight headers="ar1 ar5 ac8 ac14">15</TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">105</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">32</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">12</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">61</TD><TD class=alignRight headers="ar1 ar6 ac1 ac7">94</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac10">5352</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac11">2341</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac12">242</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac13">2769</TD><TD class=alignRight headers="ar1 ar6 ac8 ac14">395</TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">214</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">35</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">179</TD><TD class=alignRight headers="ar1 ar7 ac1 ac7">174</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac10">5021</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac11">651</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac12">3</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac13">4367</TD><TD class=alignRight headers="ar1 ar7 ac8 ac14">1212</TD></TR><TR><TH id=ar8 class=alignLeft headers=ar1>NB</TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">37</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac4">2</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac6">35</TD><TD class=alignRight headers="ar1 ar8 ac1 ac7">2</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac10">1455</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac11">366</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac12">1</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac13">1088</TD><TD class=alignRight headers="ar1 ar8 ac8 ac14">12</TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">17</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">15</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">2</TD><TD class=alignRight headers="ar1 ar9 ac1 ac7">1</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac10">146</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac11">117</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac12">4</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac13">25</TD><TD class=alignRight headers="ar1 ar9 ac8 ac14">2</TD></TR><TR><TH id=ar10 class=alignLeft headers=ar1>PE</TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">1</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac4">1</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac7">0</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac10">116</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac11">115</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac13">1</TD><TD class=alignRight headers="ar1 ar10 ac8 ac14">0</TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">8</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac6">8</TD><TD class=alignRight headers="ar1 ar11 ac1 ac7">8</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac10">332</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac11">104</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac13">228</TD><TD class=alignRight headers="ar1 ar11 ac8 ac14">131</TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">547</TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac4">192</TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac5">26</TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac6">329</TD><TD class=alignRight headers="ar1 ar12 ac1 ac7">317</TD><TD class=alignRight headers="ar1 ar12 ac8 ac9 ac10">19642</TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac11">9933</TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac12">357</TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac13">9352</TD><TD class=alignRight headers="ar1 ar12 ac8 ac14">1997</TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="ar1 ar13 ac1 ac2 ac3">63.3%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac4">35.1%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac5">4.8%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac6">60.1%</TD><TD class=alignRight headers="ar1 ar13 ac1 ac7">36.7%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac9 ac10">90.8%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac11">50.6%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac12">1.8%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac13">47.6%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac14">9.2%</TD></TR></TBODY></TABLE>
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups (years)</TH><TH id=bc1 colSpan=5>Weekly
(February 23 to March 1, 2014)
</TH><TH id=bc8 colSpan=7>Cumulative
(August 25, 2013 to March 1, 2014)
</TH></TR><TR class=bg-colour-yellow><TH id=bc2 colSpan=4 headers=bc1>Influenza A</TH><TH id=bc7 headers=bc1>B</TH><TH id=bc9 colSpan=4 headers=bc8>Influenza A</TH><TH id=bc14 headers=bc8>B</TH><TH id=bc15 colSpan=2 headers=bc8>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=bc3 headers="bc1 bc2">A Total</TH><TH id=bc4 class="lightred " headers="bc1 bc2">A(H1) pdm09</TH><TH id=bc5 class="lightred " headers="bc1 bc2">A(H3)</TH><TH id=bc6 class="lightred " headers="bc1 bc2">A (UnS)</TH><TD class=alignCenter headers="bc1 bc7">Total</TD><TH id=bc10 headers="bc8 bc9">A Total</TH><TH id=bc11 class="lightred " headers="bc8 bc9">A(H1) pdm09</TH><TH id=bc12 class="lightred " headers="bc8 bc9">A(H3)</TH><TH id=bc13 class="lightred " headers="bc8 bc9">A (UnS)</TH><TD class=alignCenter headers="bc8 bc14">Total</TD><TH id=bc16 headers="bc8 bc15">#</TH><TH id=bc17 headers="bc8 bc15">%</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
<SUP>3 </SUP>Table 2 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
</TD></TR></TFOOT><TBODY><TR><TH id=br2 class=alignLeft headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">67</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">16</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">51</TD><TD class=alignRight headers="br1 br2 bc1 bc7">28</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">3034</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">1358</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">23</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1653</TD><TD class=alignRight headers="br1 br2 bc8 bc14">212</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc16">3246</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc17">18.3%</TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">19</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">4</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">15</TD><TD class=alignRight headers="br1 br3 bc1 bc7">37</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1246</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">669</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">18</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">559</TD><TD class=alignRight headers="br1 br3 bc8 bc14">317</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc16">1563</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc17">8.8%</TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">74</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">22</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">52</TD><TD class=alignRight headers="br1 br4 bc1 bc7">39</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">4843</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">2644</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">33</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">2166</TD><TD class=alignRight headers="br1 br4 bc8 bc14">361</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc16">5204</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc17">29.4%</TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">76</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">28</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">47</TD><TD class=alignRight headers="br1 br5 bc1 bc7">47</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">4217</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">2269</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">40</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">1908</TD><TD class=alignRight headers="br1 br5 bc8 bc14">453</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc16">4670</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc17">26.4%</TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">57</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">17</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">3</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">37</TD><TD class=alignRight headers="br1 br6 bc1 bc7">63</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">2292</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">936</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">95</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">1261</TD><TD class=alignRight headers="br1 br6 bc8 bc14">602</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc16">2894</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc17">16.3%</TD></TR><TR><TH id=br7 class=alignLeft headers=br1>Unknown</TH><TD class=alignRight headers="br1 br7 bc1 bc2 bc3">4</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc4">1</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc5">3</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc6">0</TD><TD class=alignRight headers="br1 br7 bc1 bc7">0</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc10">130</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">100</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">17</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">13</TD><TD class=alignRight headers="br1 br7 bc8 bc14">2</TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc16">132</TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc17">0.7%</TD></TR><TR><TH id=br8 class=alignLeft headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">297</TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc4">88</TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc5">7</TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc6">202</TD><TD class=alignRight headers="br1 br8 bc1 bc7">214</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">15762</TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc11">7976</TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc12">226</TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc13">7560</TD><TD class=alignRight headers="br1 br8 bc8 bc14">1947</TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc16">17709</TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc17">100.0%</TD></TR><TR><TH id=br9 class=alignLeft headers=br1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="br1 br9 bc1 bc2 bc3">58.1%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc4">29.6%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc5">2.4%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc6">68.0%</TD><TD class=alignRight headers="br1 br9 bc1 bc7">41.9%</TD><TD class=alignRight headers="br1 br9 bc8 bc9 bc10">89.0%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc11">50.6%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc12">1.4%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc13">48.0%</TD><TD class=alignRight headers="br1 br9 bc8 bc14">11.0%</TD><TD class=alignRight></TD><TD class=alignRight></TD></TR></TBODY></TABLE>

Top of Page
Influenza Strain Characterizations

During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 1248 influenza viruses [55 A(H3N2), 1022 A(H1N1)pdm09 and 171 influenza B]. The vast majority (99%) of viruses were similar to the strains recommended by the WHO for the 2013-14 seasonal influenza vaccine. Two A(H1N1)pdm09 viruses showed reduced titres to antiserum against the reference A/California/07/2009 strain. Thirteen influenza B viruses were similar to the strain recommended by the WHO for the 2011-12 vaccine (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2013-14, N = 1248
2014-w09-fg4-eng.gif

The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
The recommended components for the 2013-2014 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009 (H1N1)pdm09-like virus, an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b (e.g. A/Texas/50/2012), and a B/Massachusetts/2/2012-like virus (Yamagata lineage).


Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
Antiviral Resistance

During the 2013-2014 influenza season, NML has tested 883 influenza viruses for resistance to oseltamivir and all but two were sensitive. All 882 viruses tested for resistance to zanamivir were sensitive. All 1104 influenza A viruses tested for amantadine resistance were resistant (Table 3).
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2013-2014</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=cr1 rowSpan=2>Virus type and subtype</TH><TH id=cc1 colSpan=2>Oseltamivir</TH><TH id=cc4 colSpan=2>Zanamivir</TH><TH id=cc7 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=cc2 headers=cc1># tested</TH><TH id=cc3 headers=cc1># resistant (%)</TH><TH id=cc5 headers=cc4># tested</TH><TH id=cc6 headers=cc4># resistant (%)</TH><TH id=cc8 headers=cc7># tested</TH><TH id=cc9 headers=cc7># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=cr2 class="alignLeft lightred" headers=cr1>A (H3N2)</TH><TD class=alignRight headers="cr1 cr2 cc1 cc2">48</TD><TD class=alignRight headers="cr1 cr2 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr2 cc4 cc5">48</TD><TD class=alignRight headers="cr1 cr2 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr2 cc7 cc8">76</TD><TD class=alignRight headers="cr1 cr2 cc7 cc9">76 (100%)</TD></TR><TR><TH id=cr3 class="alignLeft lightred" headers=cr1>A (H1N1)</TH><TD class=alignRight headers="cr1 cr3 cc1 cc2">742</TD><TD class=alignRight headers="cr1 cr3 cc1 cc3">2 (0.3%)</TD><TD class=alignRight headers="cr1 cr3 cc4 cc5">741</TD><TD class=alignRight headers="cr1 cr3 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr3 cc7 cc8">1028</TD><TD class=alignRight headers="cr1 cr3 cc7 cc9">1028 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft lightred" headers=cr1>B</TH><TD class=alignRight headers="cr1 cr4 cc1 cc2">93</TD><TD class=alignRight headers="cr1 cr4 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr4 cc4 cc5">93</TD><TD class=alignRight headers="cr1 cr4 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr4 cc7 cc8">NA <SUP>*</SUP></TD><TD class=alignRight headers="cr1 cr4 cc7 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft lightred" headers=cr1>TOTAL</TH><TD class=alignRight headers="cr1 cr5 cc1 cc2">883</TD><TD class=alignRight headers="cr1 cr5 cc1 cc3">2 (0.2%)</TD><TD class=alignRight headers="cr1 cr5 cc4 cc5">882</TD><TD class=alignRight headers="cr1 cr5 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr5 cc7 cc8">1104</TD><TD class=alignRight headers="cr1 cr5 cc7 cc9">1104 (100%)</TD></TR></TBODY></TABLE>
Influenza-like Illness (ILI) Consultation Rate

The national influenza-like-illness (ILI) consultation rate increased from 20.3/1,000 in week 08 to 32.7/1,000 in week 09; which is within the expected range for week 09 (Figure 5).
Figure 5. Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014
2014-w09-fg5-eng.gif

Note: No data available for mean rate for weeks 19 to 39 for the 1996-1997 through 2002-2003 seasons. Delays in the reporting of data may cause data to change retrospectively. The calculation of the average ILI consultation rate over 17 seasons was aligned with influenza activity in each season. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. The number of sentinel physicians in each province or territory is as follows: BC(21), AB(80), SK(11), MB(18), ON(169), QC(14), NB(29), NS(26), PE(4), NL(16), NU(1), NT(14), YT(13). Not all sentinel physicians report every week.
Text equivalent for figure 5Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

Top of Page
Influenza Outbreak Surveillance

In week 09, five new influenza outbreaks in long-term care facilities were reported (Figure 6). In addition, one outbreak of influenza-like-illness was reported in a school.
Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2013-2014
2014-w09-fg6-eng.gif

1 All provinces and territories except NU report outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
Text equivalent for figure 6Overall number of new influenza outbreaks by report week, Canada, 2013-2014
Pharmacy Surveillance

In week 09, the proportion of prescriptions for influenza antivirals continued to decrease, with the largest proportion of prescriptions for antivirals continuing to be among children 2-18 years of age and adults 19-64 years of age (Figure 7). Within these age-groups, higher proportions of prescriptions for antivirals were observed among persons between 5 and 45 years of age.
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14
2014-w09-fg7-eng.gif

Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group. Age-groups: Infant: 0-2y, Child: 2-18y; Adult: 19-64y, Senior: ≥65y.
Text equivalent for figure 7Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

Top of Page
Sentinel Hospital Influenza Surveillance

Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In week 09, 18 new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 30 in week 08. In week 09, influenza A was reported in 14 cases and influenza B in four cases. A greater proportion of cases have been reported with influenza B cases in recent weeks, following the trend in laboratory detections (Figure 8a). Although the number of cases is small, a greater proportion of cases with influenza B have been children between 2 and 10 years of age compared to the younger age-groups affected by A(H1N1)pdm09 this season. No ICU admissions or deaths were reported in week 09.
To date this season, a total of 542 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 92% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children ≥2 years of age represent 55% of cases to date (Table 4). Seventy-nine ICU admissions have been reported, of which 46 (58%) were children ≥2 years of age (Figure 9a). Among the 77 ICU admission for which the influenza type reported, all but four were cases with influenza A, and 96% of those subtyped were A(H1N1)pdm09. Among the 67 ICU cases with available data, 45 (67%) were reported to have underlying medical conditions. No deaths have been reported.
Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
Adult Influenza Hospitalizations and Deaths (PCIRN)
In week 09, 21 new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations reported through active surveillance by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 44 in week 08. There has been a steady decline in the number of new cases over recent weeks, and a greater number of cases of influenza B. Among cases in week 09, 14 (66.7%) were influenza A, and seven were influenza B (Figure 8b). All but two hospitalizations occurred among adults ≥45 years of age. Three ICU admissions were reported in week 09, all ≥45 years of age, two with influenza A and one with influenza B. No deaths were reported in week 09.
To date this season, 1104 influenza-associated hospitalizations have been reported by the PCIRN-SOS network, 1036 (93.8%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). ICU admission was required for 192 hospitalizations, all but seven of which were cases with influenza A (107 A(H1N1)pdm09, four A(H3N2) and 74 A(unsubtyped)). More than three quarters of hospitalizations and approximately 80% of ICU admissions were ≥45 years of age. Of the 156 ICU admissions with available information, 137 (87.8%) were reported to have at least one comorbidity and of the 165 ICU admissions with available information 119 (72.1%) reported not having been vaccinated this season. Fifty-three deaths have been reported, all but two with influenza A (32 A(H1N1)pdm09, two A(H3N2) and 17 A(unsubtyped)); five cases 20-44 years of age, 26 cases 45-64 years of age and 22 cases ≥65 years of age (Figure 9b).
Note: PCIRN-SOS conducted passive surveillance from April 30th to November 14th, 2013. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance began November 15th during which time PCIRN site coordinators investigate cases potentially related to influenza. Data from both active and passive surveillance reported during the 2013-14 season are included in this report. The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t4 class=alignCenter>Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=dr1 rowSpan=3>Age groups </TH><TH id=dc1 colSpan=6>Cumulative (Aug. 25, 2013 to March 1, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=dc2 colSpan=4 headers=dc1>Influenza A </TH><TH id=dc7 headers=dc1>B </TH><TH id=dc8 headers=dc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=dc3 headers="dc1 dc2">A Total </TH><TH id=dc4 class="lightred " headers="dc1 dc2">A(H1) pdm09 </TH><TH id=dc5 class="lightred " headers="dc1 dc2">A(H3) </TH><TH id=dc6 class="lightred " headers="dc1 dc2">A (UnS) </TH><TD class=alignCenter headers="dc1 dc7">Total</TD><TD class=alignCenter headers="dc1 dc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
</TD></TR></TFOOT><TBODY><TR><TH id=dr2 class=alignLeft headers=dr1>0-5m </TH><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc3">96 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc4">28 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc5">0 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc6">68 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc7">2 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc8">98 (18%) </TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc3">142 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc4">39 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc5">1 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc6">102 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc7">5 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc8">147 (27%) </TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc3">148 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc4">47 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc5">2 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc6">99 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc7">15 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc8">163 (30%) </TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc3">75 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc4">22 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc5">1 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc6">52 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc7">20 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc8">95 (18%) </TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc3">35 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc4">13 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc5">0 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc6">22 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc7">4 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc8">39 (7%) </TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignRight headers="dr1 dr7 dc1 dc2 dc3">496 </TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc4">149 </TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc5">4 </TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc6">343 </TD><TD class=alignRight headers="dr1 dr7 dc1 dc7">46 </TD><TD class=alignRight headers="dr1 dr7 dc1 dc8">542 </TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP> </TH><TD class=alignRight headers="dr1 dr8 dc1 dc2 dc3">91.5% </TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc4">30.0% </TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc5">0.8% </TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc6">69.2% </TD><TD class=alignRight headers="dr1 dr8 dc1 dc7">8.5% </TD><TD class=alignRight headers="dr1 dr8 dc1 dc8">100.0% </TD></TR></TBODY></TABLE>
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 5 - Cumulative numbers of adult hospitalizations with influenza
reported by the PCIRN-SOS network, Canada, 2013-14
</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=er1 rowSpan=3>Age groups </TH><TH id=ec1 class=noWrap colSpan=6>Cumulative (Aug. 25, 2013 to March 1, 2014)<SUP>*</SUP></TH></TR><TR class=bg-colour-yellow><TH id=ec2 colSpan=4 headers=ec1>Influenza A </TH><TH id=ec7 headers=ec1>B </TH><TH id=ec8 headers=ec1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=ec3 headers="ec1 ec2">A Total </TH><TH id=ec4 class="lightred " headers="ec1 ec2">A(H1) pdm09 </TH><TH id=ec5 class="lightred " headers="ec1 ec2">A(H3) </TH><TH id=ec6 class="lightred " headers="ec1 ec2">A(UnS) </TH><TD class=alignCenter headers="ec1 ec7">Total</TD><TD class=alignCenter headers="ec1 ec8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.

<SUP id=t5_star>*</SUP> One case for which the influenza type has not yet been reported, and three cases for which the age-group was not reported, are not included in Table 5.
</TD></TR></TFOOT><TBODY><TR><TH id=er2 class=alignLeft headers=er1>16-20 </TH><TD class=alignRight headers="er1 er2 ec1 ec2 ec3">13</TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec4">3</TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec5">0</TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec6">10</TD><TD class=alignRight headers="er1 er2 ec1 ec7">1</TD><TD class=alignRight headers="er1 er2 ec1 ec8">14 (1%)</TD></TR><TR><TH id=er3 class=alignLeft headers=er1>20-44 </TH><TD class=alignRight headers="er1 er3 ec1 ec2 ec3">225</TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec4">123</TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec5">4</TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec6">98</TD><TD class=alignRight headers="er1 er3 ec1 ec7">4</TD><TD class=alignRight headers="er1 er3 ec1 ec8">229 (21%)</TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignRight headers="er1 er4 ec1 ec2 ec3">411</TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec4">191</TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec5">4</TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec6">216</TD><TD class=alignRight headers="er1 er4 ec1 ec7">13</TD><TD class=alignRight headers="er1 er4 ec1 ec8">424 (39%)</TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignRight headers="er1 er5 ec1 ec2 ec3">384</TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec4">189</TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec5">29</TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec6">166</TD><TD class=alignRight headers="er1 er5 ec1 ec7">49</TD><TD class=alignRight headers="er1 er5 ec1 ec8">433 (39%)</TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignRight headers="er1 er6 ec1 ec2 ec3">1033</TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec4">506</TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec5">37</TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec6">490</TD><TD class=alignRight headers="er1 er6 ec1 ec7">67</TD><TD class=alignRight headers="er1 er6 ec1 ec8">1100</TD></TR><TR><TH id=er7 class=alignLeft headers=er1>%<SUP>1</SUP></TH><TD class=alignRight headers="er1 er7 ec1 ec2 ec3">94%</TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec4">49%</TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec5">4%</TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec6">47%</TD><TD class=alignRight headers="er1 er7 ec1 ec7">6%</TD><TD class=alignRight headers="er1 er7 ec1 ec8">100%</TD></TR></TBODY></TABLE>
Figure 8. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w09-fg8a-eng.gif


Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w09-fg8b-eng.gif

* See footnote above following the section related to PCIRN-SOS data.
Text equivalent for figure 8bNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Adult hospitalizations (>16 year of age, PCIRN-SOS)
Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w09-fg9a-eng.gif

Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w09-fg9b-eng.gif

Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Adult hospitalizations (≥16 year of age, PCIRN-SOS)

Top of Page
Provincial/Territorial Influenza Hospitalizations and Deaths

In week 09, 134 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories.* The majority were cases of influenza A (101, 75.4%), of which 57 (56.4%) were A(H1N1)pdm09, four (4.0%) was A(H3N2), and 40 (39.6%) were A(unsubtyped). The proportion of cases with influenza B has been increasing in recent weeks. Six ICU admissions were reported in week 09, all with influenza A: three adults 45-64 years of age, one ≥65 years of age, and two with age not reported. Nine deaths were reported, two thirds of which were adults 65 years of age and older. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total.
To date this season, 3,238 influenza-associated hospitalizations have been reported, 95.9% with influenza A. The majority (57.6%) of hospitalizations have been cases 45 years of age of older (Table 6). A total of 307 ICU admissions have been reported this season, of which 67.1% were among adults 20-64 years of age. A total of 182 deaths have been reported. The highest proportion of deaths has been among adults 20-64 years of age (51.1%), followed by adults ≥65 years of age (39.6%). Influenza B has been detected infrequently among severe cases of influenza to date this season: in only 4.1% of hospitalizations, 1.0% of ICU admissions, and 4.4 % of deaths. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.
* Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, NS, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t6 class=alignCenter>Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=fr1 rowSpan=3>Age groups </TH><TH id=fc1 colSpan=6>Cumulative (Aug. 25, 2013 to March 1, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=fc2 colSpan=4 headers=fc1>Influenza A</TH><TH id=fc7 headers=fc1>B</TH><TH id=fc8 headers=fc1>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=fc3 headers="fc1 fc2">A Total</TH><TH id=fc4 class=lightred headers="fc1 fc2">A(H1) pdm09</TH><TH id=fc5 class=lightred headers="fc1 fc2">A(H3)</TH><TH id=fc6 class=lightred headers="fc1 fc2">A (UnS)</TH><TD class=alignCenter headers="fc1 fc7">Total</TD><TD class=alignCenter headers="fc1 fc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=8><SUP>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
</TD></TR></TFOOT><TBODY><TR><TH id=fr2 class=alignLeft headers=fr1>0-4 years</TH><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc3">530</TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc4">261</TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc5">6</TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc6">263</TD><TD class=alignRight headers="fr1 fr2 fc1 fc7">22</TD><TD class=alignRight headers="fr1 fr2 fc1 fc8">552 (17%)</TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years</TH><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc3">116</TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc4">60</TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc5">5</TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc6">51</TD><TD class=alignRight headers="fr1 fr3 fc1 fc7">15</TD><TD class=alignRight headers="fr1 fr3 fc1 fc8">131 (4%)</TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years</TH><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc3">32</TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc4">19</TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc5">2</TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc6">11</TD><TD class=alignRight headers="fr1 fr4 fc1 fc7">1</TD><TD class=alignRight headers="fr1 fr4 fc1 fc8">33 (1%)</TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc3">543</TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc4">391</TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc5">3</TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc6">149</TD><TD class=alignRight headers="fr1 fr5 fc1 fc7">9</TD><TD class=alignRight headers="fr1 fr5 fc1 fc8">552 (17%)</TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc3">999</TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc4">652</TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc5">17</TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc6">330</TD><TD class=alignRight headers="fr1 fr6 fc1 fc7">24</TD><TD class=alignRight headers="fr1 fr6 fc1 fc8">1023 (32%)</TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc3">784</TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc4">422</TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc5">50</TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc6">312</TD><TD class=alignRight headers="fr1 fr7 fc1 fc7">58</TD><TD class=alignRight headers="fr1 fr7 fc1 fc8">842 (26%)</TD></TR><TR><TH id=fr10 class=alignLeft headers=fr1>Unknown</TH><TD class=alignRight headers="fr1 fr10 fc1 fc2 fc3">101</TD><TD class=alignRight headers="fr1 fr10 fc1 fc2 fc4">79</TD><TD class=alignRight headers="fr1 fr10 fc1 fc2 fc5">3</TD><TD class=alignRight headers="fr1 fr10 fc1 fc2 fc6">19</TD><TD class=alignRight headers="fr1 fr10 fc1 fc7">4</TD><TD class=alignRight headers="fr1 fr10 fc1 fc8">105 (3%)</TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignRight headers="fr1 fr8 fc1 fc2 fc3">3105</TD><TD class="alignRight lightred" headers="fr1 fr8 fc1 fc2 fc4">1884</TD><TD class="alignRight lightred" headers="fr1 fr8 fc1 fc2 fc5">86</TD><TD class="alignRight lightred" headers="fr1 fr8 fc1 fc2 fc6">1135</TD><TD class=alignRight headers="fr1 fr8 fc1 fc7">133</TD><TD class=alignRight headers="fr1 fr8 fc1 fc8">3238</TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP> </TH><TD class=alignRight headers="fr1 fr9 fc1 fc2 fc3">95.9%</TD><TD class="alignRight lightred" headers="fr1 fr9 fc1 fc2 fc4">60.7%</TD><TD class="alignRight lightred" headers="fr1 fr9 fc1 fc2 fc5">2.8%</TD><TD class="alignRight lightred" headers="fr1 fr9 fc1 fc2 fc6">36.6%</TD><TD class=alignRight headers="fr1 fr9 fc1 fc7">4.1%</TD><TD class=alignRight headers="fr1 fr9 fc1 fc8">100%</TD></TR></TBODY></TABLE>
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2013-14 on the Public Health Agency of Canada website.

.../
http://www.phac-aspc.gc.ca/fluwatch/13-14/w09_14/index-eng.php
 
Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 10

Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 10

FluWatch report: March 2 to 8, 2014 (Week 10)

Posted 2014-03-14For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
<A title="Flu Watch (Version PDF, 113 KB - 6 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/13-14/w10_14/pdf/fw2014-10-eng.pdf">FluWatch report: March 2 to 8, 2014 (Week 10) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 291 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

?? Help with PDF documents

Overall Summary
  • In week 10, influenza activity in Canada continues to decrease overall, and is consistent with activity at this time in past influenza seasons.
  • The influenza A(H1N1) virus remains the most common influenza virus circulating this season. Circulation of influenza B virus continues to increase in recent weeks, resulting in increased paediatric and adult hospitalizations.
  • While the influenza A(H1N1) virus has mostly affected adults 20-64 years of age, influenza B cases are having a greater impact on adults 65 year of age and older.
  • As of week 10, 3,450 hospitalizations and 189 deaths have been reported from participating regions, which is comparable to reports in past influenza seasons.
Influenza/ILI Activity (geographic spread)

In week 10, influenza activity levels continued to decline. No region reported widespread activity and eight regions (SK(1), ON(5), and QC(2)) reported localized activity (Figure 1).
Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 10


right_ofmap.gif



Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
Influenza and Other Respiratory Virus Detections

The number of positive influenza tests continued to decrease, from 842 in week 09 to 752 in week 10. The percentage of positive influenza tests was similar to last week at 12.5% (Figure 2). Cumulative influenza virus detections to date have been predominantly influenza A (89%), and among those subtyped, 97% (10,089/10,458) were A(H1N1)pdm09. The percentage of positive tests for influenza B has been rising slowly in recent weeks, and was approximately equal to detections of influenza A in week 10 (Table 1). Among the 18,182 cases for which information on age and type/subtype has been received this season, 55.4% were 20-64 years of age (Table 2).
Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
2014-w10-fg2-eng.gif

Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
The number of positive tests for RSV has been declining gradually over recent weeks. The number of positive tests for parainfluenza, adenovirus and rhinovirus decreased in week 10, but increased for coronavirus, interrupting a decline since week 05. The number of positive tests for human metapneumovirus has been higher than during the same period last season and declined slightly in week 10 (Figure 3).
For more details, see the weekly Respiratory Virus Detections in Canada Report.
Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2013-14
2014-w10-fg3-eng.gif


Top of Page
RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly and cumulative numbers of positive influenza specimens
by type, subtype and province, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=ac1 colSpan=5>Weekly
(March 2, 2013 to March 8, 2014)</TH><TH id=ac8 colSpan=5>Cumulative
(August 25, 2013 to March 8, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=4 headers=ac1>Influenza A</TH><TH id=ac7 headers=ac1>B</TH><TH id=ac9 colSpan=4 headers=ac8>Influenza A</TH><TH id=ac14 headers=ac8>B</TH></TR><TR class=bg-colour-grey-light><TH id=ac3 headers="ac1 ac2">A Total</TH><TH id=ac4 class=lightred headers="ac1 ac2">A(H1)pdm09</TH><TH id=ac5 class=lightred headers="ac1 ac2">A(H3)</TH><TH id=ac6 class=lightred headers="ac1 ac2">A(UnS)</TH><TH class=alignCenter headers="ac1 ac7">B Total</TH><TH id=ac10 headers="ac8 ac9">A Total</TH><TH id=ac11 class=lightred headers="ac8 ac9">A(H1)pdm09</TH><TH id=ac12 class=lightred headers="ac8 ac9">A(H3)</TH><TH id=ac13 class=lightred headers="ac8 ac9">A(UnS)</TH><TD class=alignCenter headers="ac8 ac14">B Total</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=alignLeft headers=ar1>BC</TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">35</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">22</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">9</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">4</TD><TD class=alignRight headers="ar1 ar2 ac1 ac7">28</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac10">1734</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac11">1575</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac12">53</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac13">106</TD><TD class=alignRight headers="ar1 ar2 ac8 ac14">124</TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">63</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">31</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">1</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">31</TD><TD class=alignRight headers="ar1 ar3 ac1 ac7">17</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac10">3671</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac11">3360</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac12">49</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac13">262</TD><TD class=alignRight headers="ar1 ar3 ac8 ac14">122</TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">11</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">5</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">1</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">5</TD><TD class=alignRight headers="ar1 ar4 ac1 ac7">7</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac10">1343</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac11">967</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac12">5</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac13">371</TD><TD class=alignRight headers="ar1 ar4 ac8 ac14">34</TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">23</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">15</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">8</TD><TD class=alignRight headers="ar1 ar5 ac1 ac7">0</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac10">595</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac11">422</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac12">1</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac13">172</TD><TD class=alignRight headers="ar1 ar5 ac8 ac14">15</TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">82</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">33</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">9</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">40</TD><TD class=alignRight headers="ar1 ar6 ac1 ac7">128</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac10">5433</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac11">2386</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac12">253</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac13">2794</TD><TD class=alignRight headers="ar1 ar6 ac8 ac14">523</TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">130</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">14</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">116</TD><TD class=alignRight headers="ar1 ar7 ac1 ac7">179</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac10">5151</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac11">665</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac12">3</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac13">4483</TD><TD class=alignRight headers="ar1 ar7 ac8 ac14">1391</TD></TR><TR><TH id=ar8 class=alignLeft headers=ar1>NB</TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">25</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac4">4</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac6">21</TD><TD class=alignRight headers="ar1 ar8 ac1 ac7">6</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac10">1480</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac11">370</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac12">1</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac13">1109</TD><TD class=alignRight headers="ar1 ar8 ac8 ac14">18</TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">7</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">7</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac7">1</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac10">153</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac11">124</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac12">4</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac13">25</TD><TD class=alignRight headers="ar1 ar9 ac8 ac14">3</TD></TR><TR><TH id=ar10 class=alignLeft headers=ar1>PE</TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">1</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac4">1</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac7">1</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac10">117</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac11">116</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac13">1</TD><TD class=alignRight headers="ar1 ar10 ac8 ac14">1</TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">7</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac6">7</TD><TD class=alignRight headers="ar1 ar11 ac1 ac7">1</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac10">339</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac11">104</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac13">235</TD><TD class=alignRight headers="ar1 ar11 ac8 ac14">132</TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">384</TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac4">132</TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac5">20</TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac6">232</TD><TD class=alignRight headers="ar1 ar12 ac1 ac7">368</TD><TD class=alignRight headers="ar1 ar12 ac8 ac9 ac10">20016</TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac11">10089</TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac12">369</TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac13">9558</TD><TD class=alignRight headers="ar1 ar12 ac8 ac14">2363</TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="ar1 ar13 ac1 ac2 ac3">51.1%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac4">34.4%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac5">5.2%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac6">60.4%</TD><TD class=alignRight headers="ar1 ar13 ac1 ac7">48.9%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac9 ac10">89.4%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac11">50.4%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac12">1.8%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac13">47.8%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac14">10.6%</TD></TR></TBODY></TABLE>
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups (years)</TH><TH id=bc1 colSpan=5>Weekly
(March 2 to March 8, 2014)</TH><TH id=bc8 colSpan=7>Cumulative
(August 25, 2013 to March 8, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=bc2 colSpan=4 headers=bc1>Influenza A</TH><TH id=bc7 headers=bc1>B</TH><TH id=bc9 colSpan=4 headers=bc8>Influenza A</TH><TH id=bc14 headers=bc8>B</TH><TH id=bc15 colSpan=2 headers=bc8>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=bc3 headers="bc1 bc2">A Total</TH><TH id=bc4 class="lightred " headers="bc1 bc2">A(H1) pdm09</TH><TH id=bc5 class="lightred " headers="bc1 bc2">A(H3)</TH><TH id=bc6 class="lightred " headers="bc1 bc2">A (UnS)</TH><TD class=alignCenter headers="bc1 bc7">Total</TD><TH id=bc10 headers="bc8 bc9">A Total</TH><TH id=bc11 class="lightred " headers="bc8 bc9">A(H1) pdm09</TH><TH id=bc12 class="lightred " headers="bc8 bc9">A(H3)</TH><TH id=bc13 class="lightred " headers="bc8 bc9">A (UnS)</TH><TD class=alignCenter headers="bc8 bc14">Total</TD><TH id=bc16 headers="bc8 bc15">#</TH><TH id=bc17 headers="bc8 bc15">%</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
<SUP>3 </SUP>Table 2 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=br2 class=alignLeft headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">44</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">10</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">34</TD><TD class=alignRight headers="br1 br2 bc1 bc7">22</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">3098</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">1377</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">24</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1697</TD><TD class=alignRight headers="br1 br2 bc8 bc14">235</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc16">3333</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc17">18.3%</TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">18</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">5</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">13</TD><TD class=alignRight headers="br1 br3 bc1 bc7">33</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1268</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">676</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">18</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">574</TD><TD class=alignRight headers="br1 br3 bc8 bc14">355</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc16">1623</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc17">8.9%</TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">52</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">21</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">30</TD><TD class=alignRight headers="br1 br4 bc1 bc7">18</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">4913</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">2680</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">36</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">2197</TD><TD class=alignRight headers="br1 br4 bc8 bc14">385</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc16">5298</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc17">29.1%</TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">44</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">12</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">32</TD><TD class=alignRight headers="br1 br5 bc1 bc7">50</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">4269</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">2292</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">40</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">1937</TD><TD class=alignRight headers="br1 br5 bc8 bc14">507</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc16">4776</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc17">26.3%</TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">36</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">10</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">26</TD><TD class=alignRight headers="br1 br6 bc1 bc7">71</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">2337</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">949</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">96</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">1292</TD><TD class=alignRight headers="br1 br6 bc8 bc14">683</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc16">3020</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc17">16.6%</TD></TR><TR><TH id=br7 class=alignLeft headers=br1>Unknown</TH><TD class=alignRight headers="br1 br7 bc1 bc2 bc3">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc6">0</TD><TD class=alignRight headers="br1 br7 bc1 bc7">0</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc10">130</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">100</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">17</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">13</TD><TD class=alignRight headers="br1 br7 bc8 bc14">2</TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc16">132</TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc17">0.7%</TD></TR><TR><TH id=br8 class=alignLeft headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">194</TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc4">58</TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc5">1</TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc6">135</TD><TD class=alignRight headers="br1 br8 bc1 bc7">194</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">16015</TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc11">8074</TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc12">231</TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc13">7710</TD><TD class=alignRight headers="br1 br8 bc8 bc14">2167</TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc16">18182</TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc17">100.0%</TD></TR><TR><TH id=br9 class=alignLeft headers=br1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="br1 br9 bc1 bc2 bc3">50.0%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc4">29.9%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc5">0.5%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc6">69.6%</TD><TD class=alignRight headers="br1 br9 bc1 bc7">50.0%</TD><TD class=alignRight headers="br1 br9 bc8 bc9 bc10">88.1%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc11">50.4%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc12">1.4%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc13">48.1%</TD><TD class=alignRight headers="br1 br9 bc8 bc14">11.9%</TD><TD class=alignRight></TD><TD class=alignRight></TD></TR></TBODY></TABLE>

Top of Page
Influenza Strain Characterizations

During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 1401 influenza viruses [64 A(H3N2), 1131 A(H1N1)pdm09 and 206 influenza B]. The vast majority (99%) of viruses were similar to the strains recommended by the WHO for the 2013-14 seasonal influenza vaccine. Two A(H1N1)pdm09 viruses showed reduced titres to antiserum against the reference A/California/07/2009 strain. Fourteen influenza B viruses were similar to the strain recommended by the WHO for the 2011-12 vaccine (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2013-14, N = 1401
2014-w10-fg4-eng.gif

The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
The recommended components for the 2013-2014 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009 (H1N1)pdm09-like virus, an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b (e.g. A/Texas/50/2012), and a B/Massachusetts/2/2012-like virus (Yamagata lineage).


Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
Antiviral Resistance

During the 2013-2014 influenza season, NML has tested 996 influenza viruses for resistance to oseltamivir and all but two were sensitive. All 993 viruses tested for resistance to zanamivir were sensitive. All 1165 influenza A viruses tested for amantadine resistance were resistant (Table 3).
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2013-2014</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=cr1 rowSpan=2>Virus type and subtype</TH><TH id=cc1 colSpan=2>Oseltamivir</TH><TH id=cc4 colSpan=2>Zanamivir</TH><TH id=cc7 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=cc2 headers=cc1># tested</TH><TH id=cc3 headers=cc1># resistant (%)</TH><TH id=cc5 headers=cc4># tested</TH><TH id=cc6 headers=cc4># resistant (%)</TH><TH id=cc8 headers=cc7># tested</TH><TH id=cc9 headers=cc7># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=cr2 class="alignLeft lightred" headers=cr1>A (H3N2)</TH><TD class=alignRight headers="cr1 cr2 cc1 cc2">53</TD><TD class=alignRight headers="cr1 cr2 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr2 cc4 cc5">53</TD><TD class=alignRight headers="cr1 cr2 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr2 cc7 cc8">88</TD><TD class=alignRight headers="cr1 cr2 cc7 cc9">88 (100%)</TD></TR><TR><TH id=cr3 class="alignLeft lightred" headers=cr1>A (H1N1)</TH><TD class=alignRight headers="cr1 cr3 cc1 cc2">883</TD><TD class=alignRight headers="cr1 cr3 cc1 cc3">2 (0.2%)</TD><TD class=alignRight headers="cr1 cr3 cc4 cc5">830</TD><TD class=alignRight headers="cr1 cr3 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr3 cc7 cc8">1077</TD><TD class=alignRight headers="cr1 cr3 cc7 cc9">1077 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft lightred" headers=cr1>B</TH><TD class=alignRight headers="cr1 cr4 cc1 cc2">110</TD><TD class=alignRight headers="cr1 cr4 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr4 cc4 cc5">110</TD><TD class=alignRight headers="cr1 cr4 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr4 cc7 cc8">NA <SUP>*</SUP></TD><TD class=alignRight headers="cr1 cr4 cc7 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft lightred" headers=cr1>TOTAL</TH><TD class=alignRight headers="cr1 cr5 cc1 cc2">996</TD><TD class=alignRight headers="cr1 cr5 cc1 cc3">2 (0.2%)</TD><TD class=alignRight headers="cr1 cr5 cc4 cc5">993</TD><TD class=alignRight headers="cr1 cr5 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr5 cc7 cc8">1165</TD><TD class=alignRight headers="cr1 cr5 cc7 cc9">1165 (100%)</TD></TR></TBODY></TABLE>
Influenza-like Illness (ILI) Consultation Rate

The national influenza-like-illness (ILI) consultation rate increased from 32.7/1,000 in week 09 to 39.8/1,000 in week 10; but is still within the expected range for this time of year (Figure 5).
Figure 5. Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014
2014-w10-fg5-eng.gif

Note: No data available for mean rate for weeks 19 to 39 for the 1996-1997 through 2002-2003 seasons. Delays in the reporting of data may cause data to change retrospectively. The calculation of the average ILI consultation rate over 17 seasons was aligned with influenza activity in each season. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. The number of sentinel physicians in each province or territory is as follows: BC(21), AB(80), SK(11), MB(18), ON(169), QC(14), NB(29), NS(26), PE(4), NL(16), NU(1), NT(14), YT(13). Not all sentinel physicians report every week.
Text equivalent for figure 5Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

Top of Page
Influenza Outbreak Surveillance

In week 10, five new influenza outbreaks in long-term care facilities were reported, the same number as in week (Figure 6). In addition, two outbreaks of influenza-like-illness were reported in schools.
Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2013-2014
2014-w10-fg6-eng.gif

1 All provinces and territories except NU report outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
Text equivalent for figure 6Overall number of new influenza outbreaks by report week, Canada, 2013-2014
Pharmacy Surveillance

In week 10, the overall proportion of prescriptions for influenza antivirals continued to decrease. The largest proportion of prescriptions for antivirals continuing to be among children 2-18 years of age and adults 19-64 years of age, although the proportion of prescriptions for infants increased in week 10 (Figure 7).
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14
2014-w10-fg7-eng.gif

Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group. Age-groups: Infant: 0-2y, Child: 2-18y; Adult: 19-64y, Senior: ≥65y.
Text equivalent for figure 7Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

Top of Page
Sentinel Hospital Influenza Surveillance

Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In week 10, 35 new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 26 in week 09. In week 10, influenza A was reported in 23 cases and influenza B in 12 cases. A greater proportion of cases have been reported with influenza B cases in recent weeks, following the trend in laboratory detections (Figure 8a). Although the number of cases is small, a greater proportion of cases with influenza B this season have been children between 2 and 10 years of age compared to A(H1N1)pdm09. In week 10, one ICU admission was reported in a child 5-9 years of age with influenza B. No deaths were reported in week 10.
To date this season, a total of 591 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 90% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children <5 years of age represent 74% of cases to date (Table 4). Eighty-two ICU admissions have been reported, of which 55 (67%) were children <5 years of age (Figure 9a). All but four were cases with influenza A, and 96% of those subtyped were A(H1N1)pdm09. Among the 72 ICU cases with available data, 47 (65%) were reported to have underlying medical conditions. No deaths have been reported.
Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
Adult Influenza Hospitalizations and Deaths (PCIRN)
In week 10, 36 new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported through active surveillance by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 35 in week 09. In week 10, influenza B-associated hospitalizations surpassed those associated with influenza A for the first time this season. Among cases in week 10, 16 (44.4%) were influenza A, and 20 were influenza B (Figure 8b). All but five hospitalizations occurred among adults ≥45 years of age. No ICU admissions or deaths were reported in week 10.
To date this season, 1176 influenza-associated hospitalizations have been reported by the PCIRN-SOS network, 1074 (91.3%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). ICU admission was required for 201 hospitalizations, all but seven of which were cases with influenza A (110 A(H1N1)pdm09, five A(H3N2) and 79 A(unsubtyped)). More than three quarters of hospitalizations and approximately 80% of ICU admissions were ≥45 years of age. Of the 163 ICU admissions with available information, 143 (87.7%) were reported to have at least one comorbidity and of the 172 ICU admissions with available information 125 (72.7%) reported not having been vaccinated this season. Fifty-six deaths have been reported, all but three with influenza A (32 A(H1N1)pdm09, two A(H3N2) and 19 A(unsubtyped)); six cases 20-44 years of age, 27 cases 45-64 years of age and 23 cases ≥65 years of age (Figure 9b).
Note: PCIRN-SOS conducted passive surveillance from April 30th to November 14th, 2013. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance began November 15th during which time PCIRN site coordinators investigate cases potentially related to influenza. Data from both active and passive surveillance reported during the 2013-14 season are included in this report. The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t4 class=alignCenter>Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=dr1 rowSpan=3>Age groups </TH><TH id=dc1 colSpan=6>Cumulative (Aug. 25, 2013 to March 8, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=dc2 colSpan=4 headers=dc1>Influenza A </TH><TH id=dc7 headers=dc1>B </TH><TH id=dc8 headers=dc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=dc3 headers="dc1 dc2">A Total </TH><TH id=dc4 class="lightred " headers="dc1 dc2">A(H1) pdm09 </TH><TH id=dc5 class="lightred " headers="dc1 dc2">A(H3) </TH><TH id=dc6 class="lightred " headers="dc1 dc2">A (UnS) </TH><TD class=alignCenter headers="dc1 dc7">Total</TD><TD class=alignCenter headers="dc1 dc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=dr2 class=alignLeft headers=dr1>0-5m </TH><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc3">101</TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc4">30</TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc5">0</TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc6">71</TD><TD class=alignRight headers="dr1 dr2 dc1 dc7">3</TD><TD class=alignRight headers="dr1 dr2 dc1 dc8">104 (18%)</TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc3">153</TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc4">44</TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc5">1</TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc6">108</TD><TD class=alignRight headers="dr1 dr3 dc1 dc7">7</TD><TD class=alignRight headers="dr1 dr3 dc1 dc8">160 (27%)</TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc3">156</TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc4">51</TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc5">3</TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc6">102</TD><TD class=alignRight headers="dr1 dr4 dc1 dc7">18</TD><TD class=alignRight headers="dr1 dr4 dc1 dc8">174 (29%)</TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc3">80</TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc4">23</TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc5">0</TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc6">57</TD><TD class=alignRight headers="dr1 dr5 dc1 dc7">27</TD><TD class=alignRight headers="dr1 dr5 dc1 dc8">107 (18%)</TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc3">40</TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc4">15</TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc5">1</TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc6">24</TD><TD class=alignRight headers="dr1 dr6 dc1 dc7">6</TD><TD class=alignRight headers="dr1 dr6 dc1 dc8">46 (8%)</TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignRight headers="dr1 dr7 dc1 dc2 dc3">530</TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc4">163</TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc5">5</TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc6">362</TD><TD class=alignRight headers="dr1 dr7 dc1 dc7">61</TD><TD class=alignRight headers="dr1 dr7 dc1 dc8">591</TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP> </TH><TD class=alignRight headers="dr1 dr8 dc1 dc2 dc3">89.7%</TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc4">30.8%</TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc5">0.9%</TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc6">68.3%</TD><TD class=alignRight headers="dr1 dr8 dc1 dc7">10.3%</TD><TD class=alignRight headers="dr1 dr8 dc1 dc8">100.0%</TD></TR></TBODY></TABLE>
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 5 - Cumulative numbers of adult hospitalizations with influenza
reported by the PCIRN-SOS network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=er1 rowSpan=3>Age groups </TH><TH id=ec1 class=noWrap colSpan=6>Cumulative (Aug. 25, 2013 to March 8, 2014)<SUP>*</SUP></TH></TR><TR class=bg-colour-yellow><TH id=ec2 colSpan=4 headers=ec1>Influenza A </TH><TH id=ec7 headers=ec1>B </TH><TH id=ec8 headers=ec1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=ec3 headers="ec1 ec2">A Total </TH><TH id=ec4 class="lightred " headers="ec1 ec2">A(H1) pdm09 </TH><TH id=ec5 class="lightred " headers="ec1 ec2">A(H3) </TH><TH id=ec6 class="lightred " headers="ec1 ec2">A(UnS) </TH><TD class=alignCenter headers="ec1 ec7">Total</TD><TD class=alignCenter headers="ec1 ec8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.

<SUP id=t5_star>*</SUP> One case for which the influenza type has not yet been reported, and three cases for which the age-group was not reported, are not included in Table 5.</TD></TR></TFOOT><TBODY><TR><TH id=er2 class=alignLeft headers=er1>16-20 </TH><TD class=alignRight headers="er1 er2 ec1 ec2 ec3">13 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec4">3 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec5">0 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec6">10 </TD><TD class=alignRight headers="er1 er2 ec1 ec7">1 </TD><TD class=alignRight headers="er1 er2 ec1 ec8">14 (1%) </TD></TR><TR><TH id=er3 class=alignLeft headers=er1>20-44 </TH><TD class=alignRight headers="er1 er3 ec1 ec2 ec3">234 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec4">126 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec5">4 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec6">104 </TD><TD class=alignRight headers="er1 er3 ec1 ec7">6 </TD><TD class=alignRight headers="er1 er3 ec1 ec8">240 (20%) </TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignRight headers="er1 er4 ec1 ec2 ec3">423 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec4">194 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec5">4 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec6">225 </TD><TD class=alignRight headers="er1 er4 ec1 ec7">25 </TD><TD class=alignRight headers="er1 er4 ec1 ec8">448 (38%) </TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignRight headers="er1 er5 ec1 ec2 ec3">401 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec4">193 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec5">31 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec6">177 </TD><TD class=alignRight headers="er1 er5 ec1 ec7">69 </TD><TD class=alignRight headers="er1 er5 ec1 ec8">470 (40%) </TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignRight headers="er1 er6 ec1 ec2 ec3">1071 </TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec4">516 </TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec5">39 </TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec6">516 </TD><TD class=alignRight headers="er1 er6 ec1 ec7">101 </TD><TD class=alignRight headers="er1 er6 ec1 ec8">1172 </TD></TR><TR><TH id=er7 class=alignLeft headers=er1>%<SUP>1</SUP></TH><TD class=alignRight headers="er1 er7 ec1 ec2 ec3">91% </TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec4">48% </TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec5">4% </TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec6">48% </TD><TD class=alignRight headers="er1 er7 ec1 ec7">9% </TD><TD class=alignRight headers="er1 er7 ec1 ec8">100% </TD></TR></TBODY></TABLE>
Figure 8. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w10-fg8a-eng.gif


Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w10-fg8b-eng.gif

* See footnote above following the section related to PCIRN-SOS data.
Text equivalent for figure 8bNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Adult hospitalizations (>16 year of age, PCIRN-SOS)
Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w10-fg9a-eng.gif

Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w10-fg9b-eng.gif

Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Adult hospitalizations (≥16 year of age, PCIRN-SOS)

Top of Page
Provincial/Territorial Influenza Hospitalizations and Deaths

In week 10, 194 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories.* The majority were cases of influenza A (136, 70.1%), of which 58 (42.6%) were A(H1N1)pdm09, 12 (8.8%) were A(H3N2), and 66 (48.5%) were A(unsubtyped). The proportion of cases with influenza B has been increasing in recent weeks. Five of the seven ICU admissions in week 10 included age information: four of which were adults ≥45 years of age; all but one with influenza A. Seven deaths were reported, four of which were adults 65 years of age and older. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total.
To date this season, 3,450 influenza-associated hospitalizations have been reported, 94.5% with influenza A. The majority (57.7%) of hospitalizations have been cases 45 years of age of older (Table 6). A total of 316 ICU admissions have been reported this season, of which 66.5% were among adults 20-64 years of age. A total of 189 deaths have been reported. The highest proportion of deaths has been among adults 20-64 years of age (50.3%), followed by adults ≥65 years of age (40.2%). Influenza B has been detected infrequently among severe cases of influenza to date this season: in only 5.5% of hospitalizations, 1.3% of ICU admissions, and 5.3 % of deaths. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.
* Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, NS, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t6 class=alignCenter>Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=fr1 rowSpan=3>Age groups </TH><TH id=fc1 colSpan=6>Cumulative (Aug. 25, 2013 to March 8, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=fc2 colSpan=4 headers=fc1>Influenza A</TH><TH id=fc7 headers=fc1>B</TH><TH id=fc8 headers=fc1>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=fc3 headers="fc1 fc2">A Total</TH><TH id=fc4 class=lightred headers="fc1 fc2">A(H1) pdm09</TH><TH id=fc5 class=lightred headers="fc1 fc2">A(H3)</TH><TH id=fc6 class=lightred headers="fc1 fc2">A (UnS)</TH><TD class=alignCenter headers="fc1 fc7">Total</TD><TD class=alignCenter headers="fc1 fc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=8><SUP>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=fr2 class=alignLeft headers=fr1>0-4 years</TH><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc3">554 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc4">273 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc5">6 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc6">275 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc7">31 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc8">585 (17%) </TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years</TH><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc3">121 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc4">62 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc5">5 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc6">54 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc7">26 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc8">147 (4%) </TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years</TH><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc3">32 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc4">19 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc5">2 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc6">11 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc7">1 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc8">33 (1%) </TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc3">571 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc4">404 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc5">4 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc6">163 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc7">11 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc8">582 (17%) </TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc3">1038 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc4">667 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc5">20 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc6">351 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc7">40 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc8">1078 (31%) </TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc3">830 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc4">440 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc5">59 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc6">331 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc7">77 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc8">907 (26%) </TD></TR><TR><TH id=fr10 class=alignLeft headers=fr1>Unknown</TH><TD class=alignRight headers="fr1 fr10 fc1 fc2 fc3">114 </TD><TD class=alignRight headers="fr1 fr10 fc1 fc2 fc4">87 </TD><TD class=alignRight headers="fr1 fr10 fc1 fc2 fc5">3 </TD><TD class=alignRight headers="fr1 fr10 fc1 fc2 fc6">24 </TD><TD class=alignRight headers="fr1 fr10 fc1 fc7">4 </TD><TD class=alignRight headers="fr1 fr10 fc1 fc8">118 (3%) </TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignRight headers="fr1 fr8 fc1 fc2 fc3">3260 </TD><TD class="alignRight lightred" headers="fr1 fr8 fc1 fc2 fc4">1952 </TD><TD class="alignRight lightred" headers="fr1 fr8 fc1 fc2 fc5">99 </TD><TD class="alignRight lightred" headers="fr1 fr8 fc1 fc2 fc6">1209 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc7">190 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc8">3450 </TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP> </TH><TD class=alignRight headers="fr1 fr9 fc1 fc2 fc3">94.5% </TD><TD class="alignRight lightred" headers="fr1 fr9 fc1 fc2 fc4">59.9% </TD><TD class="alignRight lightred" headers="fr1 fr9 fc1 fc2 fc5">3.0% </TD><TD class="alignRight lightred" headers="fr1 fr9 fc1 fc2 fc6">37.1% </TD><TD class=alignRight headers="fr1 fr9 fc1 fc7">5.5% </TD><TD class=alignRight headers="fr1 fr9 fc1 fc8">100% </TD></TR></TBODY></TABLE>
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2013-14 on the Public Health Agency of Canada website.

.../
http://www.phac-aspc.gc.ca/fluwatch/13-14/w10_14/index-eng.php
 
Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 11

Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 11

FluWatch report: March 9 to 15, 2014 (Week 11)

Posted 2014-03-21For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
<A title="Flu Watch (Version PDF, 113 KB - 6 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/13-14/w11_14/pdf/fw2014-11-eng.pdf">FluWatch report: March 9 to 15, 2014 (Week 11) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 291 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

?? Help with PDF documents

Overall Summary
  • In week 11, influenza activity in Canada has increased slightly, with the majority of influenza viruses detected being influenza B. Overall, the influenza A(H1N1) virus remains the most common influenza virus circulating this season, and influenza activity remains within expected levels for this time of year.
  • While the influenza A(H1N1) virus has mostly affected adults 20-64 years of age this season, influenza B is having a greater impact on adults 65 years of age and older, as well as young persons 5 to 19 years of age.
  • As of week 11, 3,570 hospitalizations and 197 deaths have been reported from participating regions, which is comparable to reports in past influenza seasons.
  • A Public Health Agency of Canada survey, conducted in February 2014, estimates that 39% of the Canadian population received the 2013-14 seasonal influenza vaccine, with higher coverage of 69.5% in Canadians aged 65 years and older.
Influenza/ILI Activity (geographic spread)

In week 11, influenza activity levels increased slightly. One region in Quebec reported widespread activity and nine regions (BC(1), ON(5), and QC(3)) reported localized activity (Figure 1).
Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 11


right_ofmap.gif



Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
Influenza and Other Respiratory Virus Detections

The number of positive influenza tests increased slightly, from 743 in week 10 to 750 in week 11, driven by increasing detections of influenza B. The percentage of positive influenza tests increased from 12.3% in week 10 to 13.4% in week 11, with 65% of positive tests being influenza B (Figure 2). The highest percentages of influenza B among positive tests have been reported from Newfoundland & Labrador (29.2%) and Quebec (23.8%), followed by Ontario (11.1%) and British Columbia (8.1%). Despite the late-season circulation of influenza B, the predominant influenza virus this season remains A(H1N1)pdm09 (Table 1). Among the 18,962 cases for which information on age and type/subtype has been received this season, 54.9% were 20-64 years of age (Table 2). Significantly greater proportions of influenza B cases have been ≥65 years of age and 5-19 years of age compared to cases of A(H1N1)pdm09.

Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
2014-w11-fg2-eng.gif

Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
The number of positive tests for RSV has been declining gradually over recent weeks, similar to the trend observed in recent seasons. The number of positive tests for parainfluenza was stable in week 11 and has been on a downward trend since week 02. The number of positive tests for adenovirus and rhinovirus have decreased in recent weeks; and in week 11, detections of coronavirus resumed a decline that started in week 05. The number of positive tests for human metapneumovirus has been higher than during the same period last season and has been similar over the past 5 weeks (Figure 3).
For more details, see the weekly Respiratory Virus Detections in Canada Report.
Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2013-14
2014-w11-fg3-eng.gif


Top of Page
RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
<TABLE id=t1 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly and cumulative numbers of positive influenza specimens
by type, subtype and province, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=ac1 colSpan=5>Weekly
(March 9, 2013 to March 15, 2014)</TH><TH id=ac8 colSpan=5>Cumulative
(August 25, 2013 to March 15, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=4 headers=ac1>Influenza A</TH><TH id=ac7 headers=ac1>B</TH><TH id=ac9 colSpan=4 headers=ac8>Influenza A</TH><TH id=ac14 headers=ac8>B</TH></TR><TR class=bg-colour-grey-light><TH id=ac3 headers="ac1 ac2">A Total</TH><TH id=ac4 class=lightred headers="ac1 ac2">A(H1)pdm09</TH><TH id=ac5 class=lightred headers="ac1 ac2">A(H3)</TH><TH id=ac6 class=lightred headers="ac1 ac2">A(UnS)</TH><TH class=alignCenter headers="ac1 ac7">B Total</TH><TH id=ac10 headers="ac8 ac9">A Total</TH><TH id=ac11 class=lightred headers="ac8 ac9">A(H1)pdm09</TH><TH id=ac12 class=lightred headers="ac8 ac9">A(H3)</TH><TH id=ac13 class=lightred headers="ac8 ac9">A(UnS)</TH><TD class=alignCenter headers="ac8 ac14">B Total</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=alignLeft headers=ar1>BC</TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">30</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">18</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">6</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">6</TD><TD class=alignRight headers="ar1 ar2 ac1 ac7">33</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac10">1755</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac11">1592</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac12">50</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac13">113</TD><TD class=alignRight headers="ar1 ar2 ac8 ac14">155</TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">46</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">5</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">4</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">37</TD><TD class=alignRight headers="ar1 ar3 ac1 ac7">28</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac10">3719</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac11">3371</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac12">53</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac13">295</TD><TD class=alignRight headers="ar1 ar3 ac8 ac14">151</TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">6</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">5</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">1</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac7">10</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac10">1349</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac11">972</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac12">6</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac13">371</TD><TD class=alignRight headers="ar1 ar4 ac8 ac14">44</TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">27</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">24</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">3</TD><TD class=alignRight headers="ar1 ar5 ac1 ac7">0</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac10">622</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac11">446</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac12">1</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac13">175</TD><TD class=alignRight headers="ar1 ar5 ac8 ac14">15</TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">56</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">26</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">11</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">19</TD><TD class=alignRight headers="ar1 ar6 ac1 ac7">159</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac10">5488</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac11">2416</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac12">265</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac13">2807</TD><TD class=alignRight headers="ar1 ar6 ac8 ac14">682</TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">80</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">7</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">73</TD><TD class=alignRight headers="ar1 ar7 ac1 ac7">242</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac10">5231</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac11">672</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac12">3</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac13">4556</TD><TD class=alignRight headers="ar1 ar7 ac8 ac14">1633</TD></TR><TR><TH id=ar8 class=alignLeft headers=ar1>NB</TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">8</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac6">8</TD><TD class=alignRight headers="ar1 ar8 ac1 ac7">5</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac10">1488</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac11">370</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac12">1</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac13">1117</TD><TD class=alignRight headers="ar1 ar8 ac8 ac14">23</TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">10</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">10</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac7">0</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac10">163</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac11">134</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac12">4</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac13">25</TD><TD class=alignRight headers="ar1 ar9 ac8 ac14">3</TD></TR><TR><TH id=ar10 class=alignLeft headers=ar1>PE</TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">1</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac4">1</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac7">0</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac10">118</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac11">117</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac13">1</TD><TD class=alignRight headers="ar1 ar10 ac8 ac14">1</TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">1</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac6">1</TD><TD class=alignRight headers="ar1 ar11 ac1 ac7">8</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac10">340</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac11">104</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac13">236</TD><TD class=alignRight headers="ar1 ar11 ac8 ac14">140</TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">265</TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac4">96</TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac5">22</TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac6">147</TD><TD class=alignRight headers="ar1 ar12 ac1 ac7">485</TD><TD class=alignRight headers="ar1 ar12 ac8 ac9 ac10">20273</TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac11">10194</TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac12">383</TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac13">9696</TD><TD class=alignRight headers="ar1 ar12 ac8 ac14">2847</TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="ar1 ar13 ac1 ac2 ac3">35.3%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac4">36.2%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac5">8.3%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac6">55.5%</TD><TD class=alignRight headers="ar1 ar13 ac1 ac7">64.7%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac9 ac10">87.7%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac11">50.3%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac12">1.9%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac13">47.8%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac14">12.3%</TD></TR></TBODY></TABLE>
<TABLE id=t2 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups (years)</TH><TH id=bc1 colSpan=5>Weekly
(March 9 to March 15, 2014)</TH><TH id=bc8 colSpan=7>Cumulative
(August 25, 2013 to March 15, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=bc2 colSpan=4 headers=bc1>Influenza A</TH><TH id=bc7 headers=bc1>B</TH><TH id=bc9 colSpan=4 headers=bc8>Influenza A</TH><TH id=bc14 headers=bc8>B</TH><TH id=bc15 colSpan=2 headers=bc8>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=bc3 headers="bc1 bc2">A Total</TH><TH id=bc4 class="lightred " headers="bc1 bc2">A(H1) pdm09</TH><TH id=bc5 class="lightred " headers="bc1 bc2">A(H3)</TH><TH id=bc6 class="lightred " headers="bc1 bc2">A (UnS)</TH><TD class=alignCenter headers="bc1 bc7">Total</TD><TH id=bc10 headers="bc8 bc9">A Total</TH><TH id=bc11 class="lightred " headers="bc8 bc9">A(H1) pdm09</TH><TH id=bc12 class="lightred " headers="bc8 bc9">A(H3)</TH><TH id=bc13 class="lightred " headers="bc8 bc9">A (UnS)</TH><TD class=alignCenter headers="bc8 bc14">Total</TD><TH id=bc16 headers="bc8 bc15">#</TH><TH id=bc17 headers="bc8 bc15">%</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13><SUP id=footnote_t2_1>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP id=footnote_t2_2>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
<SUP id=footnote_t2_3>3 </SUP>Table 2 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=br2 class=alignLeft headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">36</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">6</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">5</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">25</TD><TD class=alignRight headers="br1 br2 bc1 bc7">30</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">3157</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">1404</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">31</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1722</TD><TD class=alignRight headers="br1 br2 bc8 bc14">277</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc16">3434</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc17">18.1%</TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">13</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">3</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">9</TD><TD class=alignRight headers="br1 br3 bc1 bc7">43</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1288</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">687</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">19</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">582</TD><TD class=alignRight headers="br1 br3 bc8 bc14">447</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc16">1735</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc17">9.1%</TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">39</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">17</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">21</TD><TD class=alignRight headers="br1 br4 bc1 bc7">45</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">4971</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">2751</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">40</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">2180</TD><TD class=alignRight headers="br1 br4 bc8 bc14">462</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc16">5433</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc17">28.7%</TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">49</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">10</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">38</TD><TD class=alignRight headers="br1 br5 bc1 bc7">78</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">4342</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">2339</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">45</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">1958</TD><TD class=alignRight headers="br1 br5 bc8 bc14">632</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc16">4974</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc17">26.2%</TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">39</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">9</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">29</TD><TD class=alignRight headers="br1 br6 bc1 bc7">116</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">2402</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">975</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">102</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">1325</TD><TD class=alignRight headers="br1 br6 bc8 bc14">849</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc16">3251</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc17">17.1%</TD></TR><TR><TH id=br7 class=alignLeft headers=br1>Unknown</TH><TD class=alignRight headers="br1 br7 bc1 bc2 bc3">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc6">0</TD><TD class=alignRight headers="br1 br7 bc1 bc7">0</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc10">132</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">102</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">18</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">12</TD><TD class=alignRight headers="br1 br7 bc8 bc14">3</TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc16">135</TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc17">0.7%</TD></TR><TR><TH id=br8 class=alignLeft headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">176</TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc4">45</TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc5">9</TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc6">122</TD><TD class=alignRight headers="br1 br8 bc1 bc7">312</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">16292</TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc11">8258</TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc12">255</TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc13">7779</TD><TD class=alignRight headers="br1 br8 bc8 bc14">2670</TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc16">18962</TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc17">100.0%</TD></TR><TR><TH id=br9 class=alignLeft headers=br1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="br1 br9 bc1 bc2 bc3">36.1%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc4">25.6%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc5">5.1%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc6">69.3%</TD><TD class=alignRight headers="br1 br9 bc1 bc7">63.9%</TD><TD class=alignRight headers="br1 br9 bc8 bc9 bc10">85.9%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc11">50.7%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc12">1.6%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc13">47.7%</TD><TD class=alignRight headers="br1 br9 bc8 bc14">14.1%</TD><TD class=alignRight></TD><TD class=alignRight></TD></TR></TBODY></TABLE>

Top of Page
Influenza Strain Characterizations

During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 1465 influenza viruses [67 A(H3N2), 1168 A(H1N1)pdm09 and 230 influenza B]. The vast majority (99%) of viruses were similar to the strains recommended by the WHO for the 2013-14 seasonal influenza vaccine. Two A(H1N1)pdm09 viruses showed reduced titres to antiserum against the reference A/California/07/2009 strain. Fifteen influenza B viruses were similar to the strain recommended by the WHO for the 2011-12 vaccine (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2013-14, N = 1465
2014-w11-fg4-eng.gif

The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
The recommended components for the 2013-2014 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009 (H1N1)pdm09-like virus, an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b (e.g. A/Texas/50/2012), and a B/Massachusetts/2/2012-like virus (Yamagata lineage).


Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
Antiviral Resistance

During the 2013-2014 influenza season, NML has tested 1098 influenza viruses for resistance to oseltamivir and all but two were sensitive. All 1102 viruses tested for resistance to zanamivir were sensitive. All 1264 influenza A viruses tested for amantadine resistance were resistant (Table 3).
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2013-2014</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=cr1 rowSpan=2>Virus type and subtype</TH><TH id=cc1 colSpan=2>Oseltamivir</TH><TH id=cc4 colSpan=2>Zanamivir</TH><TH id=cc7 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=cc2 headers=cc1># tested</TH><TH id=cc3 headers=cc1># resistant (%)</TH><TH id=cc5 headers=cc4># tested</TH><TH id=cc6 headers=cc4># resistant (%)</TH><TH id=cc8 headers=cc7># tested</TH><TH id=cc9 headers=cc7># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=cr2 class="alignLeft lightred" headers=cr1>A (H3N2)</TH><TD class=alignRight headers="cr1 cr2 cc1 cc2">55</TD><TD class=alignRight headers="cr1 cr2 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr2 cc4 cc5">55</TD><TD class=alignRight headers="cr1 cr2 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr2 cc7 cc8">91</TD><TD class=alignRight headers="cr1 cr2 cc7 cc9">91 (100%)</TD></TR><TR><TH id=cr3 class="alignLeft lightred" headers=cr1>A (H1N1)</TH><TD class=alignRight headers="cr1 cr3 cc1 cc2">913</TD><TD class=alignRight headers="cr1 cr3 cc1 cc3">2 (0.2%)</TD><TD class=alignRight headers="cr1 cr3 cc4 cc5">918</TD><TD class=alignRight headers="cr1 cr3 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr3 cc7 cc8">1173</TD><TD class=alignRight headers="cr1 cr3 cc7 cc9">1173 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft lightred" headers=cr1>B</TH><TD class=alignRight headers="cr1 cr4 cc1 cc2">130</TD><TD class=alignRight headers="cr1 cr4 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr4 cc4 cc5">129</TD><TD class=alignRight headers="cr1 cr4 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr4 cc7 cc8">NA <SUP>*</SUP></TD><TD class=alignRight headers="cr1 cr4 cc7 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft lightred" headers=cr1>TOTAL</TH><TD class=alignRight headers="cr1 cr5 cc1 cc2">1098</TD><TD class=alignRight headers="cr1 cr5 cc1 cc3">2 (0.2%)</TD><TD class=alignRight headers="cr1 cr5 cc4 cc5">1102</TD><TD class=alignRight headers="cr1 cr5 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr5 cc7 cc8">1264</TD><TD class=alignRight headers="cr1 cr5 cc7 cc9">1264 (100%)</TD></TR></TBODY></TABLE>
Influenza-like Illness (ILI) Consultation Rate

The national influenza-like-illness (ILI) consultation rate decreased from 36.9/1,000 in week 10 to 31.2/1,000 in week 11; and was below the expected range for week 11 (Figure 5).
Figure 5. Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014
2014-w11-fg5-eng.gif

Note: No data available for mean rate for weeks 19 to 39 for the 1996-1997 through 2002-2003 seasons. Delays in the reporting of data may cause data to change retrospectively. The calculation of the average ILI consultation rate over 17 seasons was aligned with influenza activity in each season. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. The number of sentinel physicians in each province or territory is as follows: BC(21), AB(80), SK(11), MB(18), ON(169), QC(14), NB(29), NS(26), PE(4), NL(16), NU(1), NT(14), YT(13). Not all sentinel physicians report every week.
Text equivalent for figure 5Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

Top of Page
Influenza Outbreak Surveillance

In week 11, nine new influenza outbreaks were reported: eight in long-term care facilities (LTCF) and one in a hospital (Figure 6). In addition, one outbreak of influenza-like-illness was reported in a school. Among the seven LTCF outbreaks with available data, three were reported to be due to influenza B.
Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2013-2014
2014-w11-fg6-eng.gif

1 All provinces and territories except NU report outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
Text equivalent for figure 6Overall number of new influenza outbreaks by report week, Canada, 2013-2014
Pharmacy Surveillance

In week 11, the overall proportion of prescriptions for influenza antivirals increased slightly, based on increases in all age-groups except children 2-18 years of age. The proportion of prescriptions for infants (<2 years of age) increased for the second week in a row, however, the number of prescriptions in this age-group is small. Overall this season, the largest proportion of prescriptions for antivirals has been among children 2-18 years of age and adults 19-64 years of age, in keeping with laboratory detections of influenza (Figure 7).
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14
2014-w11-fg7-eng.gif

Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group. Age-groups: Infant: 0-2y, Child: 2-18y; Adult: 19-64y, Senior: ≥65y.
Text equivalent for figure 7Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

Top of Page
Sentinel Hospital Influenza Surveillance

Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In week 11, 22 new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 38 in week 10. In keeping with the increased circulation of influenza B, influenza B was reported in 12 of the 22 cases in week 11 (Figure 8a). Although the number of cases is small, a greater proportion of cases with influenza B this season have been children between 2 and 10 years of age compared to A(H1N1)pdm09. In week 11, one ICU admission was reported in a child 6-23 months of age with influenza A(unsubtyped). No deaths were reported in week 11.
To date this season, a total of 613 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 88% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children <5 years of age represent 74% of cases to date (Table 4). Eighty-six ICU admissions have been reported, of which 58 (67%) were children <5 years of age (Figure 9a). All but five were cases with influenza A, and 96% of those subtyped were A(H1N1)pdm09. Among the 79 ICU cases with available data, 51 (65%) were reported to have underlying medical conditions. No deaths have been reported.
Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
Adult Influenza Hospitalizations and Deaths (PCIRN)
In week 11, 32 new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported through active surveillance by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 55 in week 10. In week 11, there continued to be more hospitalizations associated with influenza B than influenza A (Figure 8b). All but seven hospitalizations occurred among adults ≥45 years of age. No ICU admissions or deaths were reported in week 11.
To date this season, 1250 influenza-associated hospitalizations have been reported by the PCIRN-SOS network, 1105 (88.4%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). ICU admission was required for 209 hospitalizations, all but eight of which were cases with influenza A (112 A(H1N1)pdm09, five A(H3N2) and 84 A(unsubtyped)). More than three quarters of hospitalizations and approximately 80% of ICU admissions were ≥45 years of age. Of the 168 ICU admissions with available information, 148 (88.1%) were reported to have at least one comorbidity and of the 180 ICU admissions with available information 131 (72.8%) reported not having been vaccinated this season. Fifty-eight deaths have been reported, all but four with influenza A (32 A(H1N1)pdm09, two A(H3N2) and 20 A(unsubtyped)); six cases 20-44 years of age, 27 cases 45-64 years of age and 25 cases ≥65 years of age (Figure 9b).
Note: PCIRN-SOS conducted passive surveillance from April 30th to November 14th, 2013. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance began November 15th during which time PCIRN site coordinators investigate cases potentially related to influenza. Data from both active and passive surveillance reported during the 2013-14 season are included in this report. The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t4 class=alignCenter>Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=dr1 rowSpan=3>Age groups </TH><TH id=dc1 colSpan=6>Cumulative (Aug. 25, 2013 to March 15, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=dc2 colSpan=4 headers=dc1>Influenza A </TH><TH id=dc7 headers=dc1>B </TH><TH id=dc8 headers=dc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=dc3 headers="dc1 dc2">A Total </TH><TH id=dc4 class="lightred " headers="dc1 dc2">A(H1) pdm09 </TH><TH id=dc5 class="lightred " headers="dc1 dc2">A(H3) </TH><TH id=dc6 class="lightred " headers="dc1 dc2">A (UnS) </TH><TD class=alignCenter headers="dc1 dc7">Total</TD><TD class=alignCenter headers="dc1 dc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t4_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=dr2 class=alignLeft headers=dr1>0-5m </TH><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc3">102</TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc4">33</TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc5">0</TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc6">69</TD><TD class=alignRight headers="dr1 dr2 dc1 dc7">3</TD><TD class=alignRight headers="dr1 dr2 dc1 dc8">105 (17%)</TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc3">157</TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc4">45</TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc5">1</TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc6">111</TD><TD class=alignRight headers="dr1 dr3 dc1 dc7">9</TD><TD class=alignRight headers="dr1 dr3 dc1 dc8">166 (27%)</TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc3">159</TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc4">53</TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc5">3</TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc6">103</TD><TD class=alignRight headers="dr1 dr4 dc1 dc7">24</TD><TD class=alignRight headers="dr1 dr4 dc1 dc8">183 (30%)</TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc3">81</TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc4">25</TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc5">0</TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc6">56</TD><TD class=alignRight headers="dr1 dr5 dc1 dc7">30</TD><TD class=alignRight headers="dr1 dr5 dc1 dc8">111 (18%)</TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc3">41</TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc4">15</TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc5">1</TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc6">25</TD><TD class=alignRight headers="dr1 dr6 dc1 dc7">7</TD><TD class=alignRight headers="dr1 dr6 dc1 dc8">48 (8%)</TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignRight headers="dr1 dr7 dc1 dc2 dc3">540</TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc4">171</TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc5">5</TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc6">364</TD><TD class=alignRight headers="dr1 dr7 dc1 dc7">73</TD><TD class=alignRight headers="dr1 dr7 dc1 dc8">613</TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP> </TH><TD class=alignRight headers="dr1 dr8 dc1 dc2 dc3">88.1%</TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc4">31.7%</TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc5">0.9%</TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc6">67.4%</TD><TD class=alignRight headers="dr1 dr8 dc1 dc7">11.9%</TD><TD class=alignRight headers="dr1 dr8 dc1 dc8">100.0%</TD></TR></TBODY></TABLE>
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 5 - Cumulative numbers of adult hospitalizations with influenza
reported by the PCIRN-SOS network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=er1 rowSpan=3>Age groups </TH><TH id=ec1 class=noWrap colSpan=6>Cumulative (Aug. 25, 2013 to March 15, 2014)<SUP>*</SUP></TH></TR><TR class=bg-colour-yellow><TH id=ec2 colSpan=4 headers=ec1>Influenza A </TH><TH id=ec7 headers=ec1>B </TH><TH id=ec8 headers=ec1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=ec3 headers="ec1 ec2">A Total </TH><TH id=ec4 class="lightred " headers="ec1 ec2">A(H1) pdm09 </TH><TH id=ec5 class="lightred " headers="ec1 ec2">A(H3) </TH><TH id=ec6 class="lightred " headers="ec1 ec2">A(UnS) </TH><TD class=alignCenter headers="ec1 ec7">Total</TD><TD class=alignCenter headers="ec1 ec8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t5_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.

<SUP id=t5_star>*</SUP> One case for which the influenza type has not yet been reported, and three cases for which the age-group was not reported, are not included in Table 5.</TD></TR></TFOOT><TBODY><TR><TH id=er2 class=alignLeft headers=er1>16-20 </TH><TD class=alignRight headers="er1 er2 ec1 ec2 ec3">13</TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec4">3</TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec5">0</TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec6">10</TD><TD class=alignRight headers="er1 er2 ec1 ec7">1</TD><TD class=alignRight headers="er1 er2 ec1 ec8">14 (1%)</TD></TR><TR><TH id=er3 class=alignLeft headers=er1>20-44 </TH><TD class=alignRight headers="er1 er3 ec1 ec2 ec3">241</TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec4">127</TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec5">4</TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec6">110</TD><TD class=alignRight headers="er1 er3 ec1 ec7">10</TD><TD class=alignRight headers="er1 er3 ec1 ec8">251 (20%)</TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignRight headers="er1 er4 ec1 ec2 ec3">433</TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec4">201</TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec5">5</TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec6">227</TD><TD class=alignRight headers="er1 er4 ec1 ec7">35</TD><TD class=alignRight headers="er1 er4 ec1 ec8">468 (38%)</TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignRight headers="er1 er5 ec1 ec2 ec3">415</TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec4">201</TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec5">32</TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec6">182</TD><TD class=alignRight headers="er1 er5 ec1 ec7">98</TD><TD class=alignRight headers="er1 er5 ec1 ec8">513 (41%)</TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignRight headers="er1 er6 ec1 ec2 ec3">1102</TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec4">532</TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec5">41</TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec6">529</TD><TD class=alignRight headers="er1 er6 ec1 ec7">144</TD><TD class=alignRight headers="er1 er6 ec1 ec8">1246</TD></TR><TR><TH id=er7 class=alignLeft headers=er1>%<SUP>1</SUP></TH><TD class=alignRight headers="er1 er7 ec1 ec2 ec3">88%</TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec4">48%</TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec5">4%</TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec6">48%</TD><TD class=alignRight headers="er1 er7 ec1 ec7">12%</TD><TD class=alignRight headers="er1 er7 ec1 ec8">100%</TD></TR></TBODY></TABLE>
Figure 8. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w11-fg8a-eng.gif


Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w11-fg8b-eng.gif

* See footnote above following the section related to PCIRN-SOS data.
Text equivalent for figure 8bNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Adult hospitalizations (>16 year of age, PCIRN-SOS)
Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w11-fg9a-eng.gif

Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w11-fg9b-eng.gif

Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Adult hospitalizations (≥16 year of age, PCIRN-SOS)

Top of Page
Provincial/Territorial Influenza Hospitalizations and Deaths

In week 11, 94 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories.* As with other surveillance indicators in week 11, the majority were cases of influenza B (52, 55.3%). Among the five ICU admissions reported in week 11, three were adults 45-64 years of age. One death was reported in week 11, an adult ≥65 years of age with influenza B. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total.
To date this season, 3,570 influenza-associated hospitalizations have been reported, 93.2% with influenza A. The majority (57.4%) of hospitalizations have been cases 45 years of age of older. A significantly greater proportion of cases of influenza B have been ≥65 years of age compared to cases of A(H1N1)pdm09 this season (Table 6). A total of 324 ICU admissions have been reported this season, of which 66.6% were among adults 20-64 years of age. A total of 197 deaths have been reported. The highest proportion of deaths has been among adults 20-64 years of age (49.7%), followed by adults ≥65 years of age (40.6%). In keeping with the late-season circulation, influenza B has been increasingly reported among severe cases of influenza. To date this season, influenza B has been reported in 6.8% of hospitalizations, 1.5% of ICU admissions, and 5.6 % of deaths. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.
* Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, NS, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t6 class=alignCenter>Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=fr1 rowSpan=3>Age groups </TH><TH id=fc1 colSpan=6>Cumulative (Aug. 25, 2013 to March 15, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=fc2 colSpan=4 headers=fc1>Influenza A</TH><TH id=fc7 headers=fc1>B</TH><TH id=fc8 headers=fc1>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=fc3 headers="fc1 fc2">A Total</TH><TH id=fc4 class=lightred headers="fc1 fc2">A(H1) pdm09</TH><TH id=fc5 class=lightred headers="fc1 fc2">A(H3)</TH><TH id=fc6 class=lightred headers="fc1 fc2">A (UnS)</TH><TD class=alignCenter headers="fc1 fc7">Total</TD><TD class=alignCenter headers="fc1 fc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=8><SUP id=footnote_t6_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=fr2 class=alignLeft headers=fr1>0-4 years</TH><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc3">568</TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc4">275</TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc5">6</TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc6">287</TD><TD class=alignRight headers="fr1 fr2 fc1 fc7">36</TD><TD class=alignRight headers="fr1 fr2 fc1 fc8">604 (17%)</TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years</TH><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc3">125</TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc4">64</TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc5">6</TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc6">55</TD><TD class=alignRight headers="fr1 fr3 fc1 fc7">35</TD><TD class=alignRight headers="fr1 fr3 fc1 fc8">160 (4%)</TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years</TH><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc3">34</TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc4">19</TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc5">3</TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc6">12</TD><TD class=alignRight headers="fr1 fr4 fc1 fc7">1</TD><TD class=alignRight headers="fr1 fr4 fc1 fc8">35 (1%)</TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc3">577</TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc4">408</TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc5">4</TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc6">165</TD><TD class=alignRight headers="fr1 fr5 fc1 fc7">15</TD><TD class=alignRight headers="fr1 fr5 fc1 fc8">592 (17%)</TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc3">1052</TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc4">675</TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc5">21</TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc6">356</TD><TD class=alignRight headers="fr1 fr6 fc1 fc7">52</TD><TD class=alignRight headers="fr1 fr6 fc1 fc8">1104 (31%)</TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc3">844</TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc4">448</TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc5">63</TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc6">333</TD><TD class=alignRight headers="fr1 fr7 fc1 fc7">100</TD><TD class=alignRight headers="fr1 fr7 fc1 fc8">944 (26%)</TD></TR><TR><TH id=fr10 class=alignLeft headers=fr1>Unknown</TH><TD class=alignRight headers="fc1 fc2 fc3">127</TD><TD class=alignRight headers="fc1 fc2 fc4">92</TD><TD class=alignRight headers="fc1 fc2 fc5">3</TD><TD class=alignRight headers="fc1 fc2 fc6">29</TD><TD class=alignRight headers="fc1 fc7">4</TD><TD class=alignRight headers="fc1 fc8">128 (4%)</TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignRight headers="fr1 fr8 fc1 fc2 fc3">3327</TD><TD class="alignRight lightred" headers="fr1 fr8 fc1 fc2 fc4">1981</TD><TD class="alignRight lightred" headers="fr1 fr8 fc1 fc2 fc5">106</TD><TD class="alignRight lightred" headers="fr1 fr8 fc1 fc2 fc6">1237</TD><TD class=alignRight headers="fr1 fr8 fc1 fc7">243</TD><TD class=alignRight headers="fr1 fr8 fc1 fc8">3567</TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP> </TH><TD class=alignRight headers="fr1 fr9 fc1 fc2 fc3">93.3%</TD><TD class="alignRight lightred" headers="fr1 fr9 fc1 fc2 fc4">59.5%</TD><TD class="alignRight lightred" headers="fr1 fr9 fc1 fc2 fc5">3.2%</TD><TD class="alignRight lightred" headers="fr1 fr9 fc1 fc2 fc6">37.2%</TD><TD class=alignRight headers="fr1 fr9 fc1 fc7">6.8%</TD><TD class=alignRight headers="fr1 fr9 fc1 fc8">100%</TD></TR></TBODY></TABLE>
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2013-14 on the Public Health Agency of Canada website.

.../
http://www.phac-aspc.gc.ca/fluwatch/13-14/w11_14/index-eng.php
 
Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 12

Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 12

FluWatch report: March 16 to 22, 2014 (Week 12)

Posted 2014-03-28For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
<A title="Flu Watch (Version PDF, 113 KB - 6 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/13-14/w12_14/pdf/fw2014-12-eng.pdf">FluWatch report: March 16 to 22, 2014 (Week 12) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 291 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

?? Help with PDF documents

Overall Summary
  • In week 12, influenza activity in Canada continued to decrease slowly. Overall, the influenza A(H1N1) virus remains the most common influenza virus this season, however, most influenza viruses circulating in recent weeks have been influenza B.
  • While the influenza A(H1N1) virus has mostly affected adults 20-64 years of age this season, influenza B is having a greater impact on adults 65 years of age and older, as well as young persons 5 to 19 years of age.
  • As of week 12, 3,700 hospitalizations and 204 deaths have been reported from participating regions, which is comparable to reports in past influenza seasons.
  • Influenza activity remains within expected levels for this time of year.
Influenza/ILI Activity (geographic spread)

The number of regions reporting localized or widespread influenza activity has been stable in recent weeks, with the majority of activity reported in Eastern Canada. In week 12, no regions reported widespread activity and eight regions (BC(1), ON(5), and QC(2)) reported localized activity (Figure 1).
Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 12


right_ofmap.gif



Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
Influenza and Other Respiratory Virus Detections

The number of positive influenza tests decreased from 759 in week 11 to 619 (12.4% of tests) in week 12. Influenza B remained the predominant virus in week 12, representing 75% of influenza detections (Figure 2). The highest proportions of influenza B have been reported from Newfoundland & Labrador (30.4%) and Quebec (25.8%), followed by Ontario (13.6%) and British Columbia (9.3%). Despite the late-season circulation of influenza B, the predominant influenza virus this season remains A(H1N1)pdm09 (Table 1). Among the 19,468 cases for which information on age and type/subtype has been received this season, 54.5% were 20-64 years of age (Table 2). Significantly greater proportions of influenza B cases have been ≥65 years of age and 5-19 years of age compared to cases of A(H1N1)pdm09. Influenza detections among persons ≥65 years of age have been similar for the past 6 weeks, while detections in other age-groups are declining.

Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
2014-w12-fg2-eng.gif

Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
The number of positive tests for RSV has been declining gradually over recent weeks, similar to the trend observed in recent seasons. The number of positive tests for parainfluenza, adenovirus and coronavirus decreased in week 12, and has been declining since early February. Detections of rhinovirus have been relatively stable during the winter months, although these detections represent an increasing percentage of tests positive since early January. The number of positive tests for human metapneumovirus has been higher than during the same period last season and does not yet appear to have reached its peak (Figure 3).
For more details, see the weekly Respiratory Virus Detections in Canada Report.
Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2013-14
2014-w12-fg3-eng.gif


Top of Page
RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
<TABLE id=t1 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly and cumulative numbers of positive influenza specimens
by type, subtype and province, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=ac1 colSpan=5>Weekly
(March 16, 2013 to March 22, 2014)</TH><TH id=ac8 colSpan=5>Cumulative
(August 25, 2013 to March 22, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=4 headers=ac1>Influenza A</TH><TH id=ac7 headers=ac1>B</TH><TH id=ac9 colSpan=4 headers=ac8>Influenza A</TH><TH id=ac14 headers=ac8>B</TH></TR><TR class=bg-colour-grey-light><TH id=ac3 headers="ac1 ac2">A Total</TH><TH id=ac4 class=bg-colour-blue headers="ac1 ac2">A(H1)pdm09</TH><TH id=ac5 class=bg-colour-blue headers="ac1 ac2">A(H3)</TH><TH id=ac6 class=bg-colour-blue headers="ac1 ac2">A(UnS)</TH><TH class=alignCenter headers="ac1 ac7">B Total</TH><TH id=ac10 headers="ac8 ac9">A Total</TH><TH id=ac11 class=bg-colour-blue headers="ac8 ac9">A(H1)pdm09</TH><TH id=ac12 class=bg-colour-blue headers="ac8 ac9">A(H3)</TH><TH id=ac13 class=bg-colour-blue headers="ac8 ac9">A(UnS)</TH><TD class=alignCenter headers="ac8 ac14">B Total</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=alignLeft headers=ar1>BC</TH><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac3">17 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac6">17 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac7">24 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac10">1770 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac11">1589 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac12">52 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac13">129 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac14">181 </TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac3">38 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac4">4 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac5">2 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac6">32 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac7">24 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac10">3763 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac11">3393 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac12">57 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac13">313 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac14">176 </TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac3">1 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac4">1 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac6">0 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac7">5 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac10">1350 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac11">973 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac12">6 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac13">371 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac14">49 </TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac3">8 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac4">5 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac6">3 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac7">2 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac10">630 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac11">451 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac12">1 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac13">178 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac14">17 </TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac3">53 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac4">28 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac5">11 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac6">14 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac7">191 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac10">5537 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac11">2447 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac12">276 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac13">2814 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac14">873 </TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac3">33 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac4">3 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac6">30 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac7">197 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac10">5266 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac11">675 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac12">3 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac13">4588 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac14">1834 </TD></TR><TR><TH id=ar8 class=alignLeft headers=ar1>NB</TH><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac3">0 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac6">0 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac7">7 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac10">1488 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac11">370 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac12">1 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac13">1117 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac14">30 </TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac3">1 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac6">1 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac7">1 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac10">164 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac11">134 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac12">4 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac13">26 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac14">4 </TD></TR><TR><TH id=ar10 class=alignLeft headers=ar1>PE</TH><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac3">0 </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac6">0 </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac7">0 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac10">118 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac11">117 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac12">0 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac13">1 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac14">1 </TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac3">6 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac6">6 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac7">11 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac10">346 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac11">104 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac12">0 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac13">242 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac14">151 </TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignCenter headers="ar1 ar12 ac1 ac2 ac3">157 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac1 ac2 ac4">41 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac1 ac2 ac5">13 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac1 ac2 ac6">103 </TD><TD class=alignCenter headers="ar1 ar12 ac1 ac7">462 </TD><TD class=alignCenter headers="ar1 ar12 ac8 ac9 ac10">20432 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac8 ac9 ac11">10253 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac8 ac9 ac12">400 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac8 ac9 ac13">9779 </TD><TD class=alignCenter headers="ar1 ar12 ac8 ac14">3316 </TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignCenter headers="ar1 ar13 ac1 ac2 ac3">25.4% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac1 ac2 ac4">26.1% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac1 ac2 ac5">8.3% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac1 ac2 ac6">65.6% </TD><TD class=alignCenter headers="ar1 ar13 ac1 ac7">74.6% </TD><TD class=alignCenter headers="ar1 ar13 ac8 ac9 ac10">86.0% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac8 ac9 ac11">50.2% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac8 ac9 ac12">2.0% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac8 ac9 ac13">47.9% </TD><TD class=alignCenter headers="ar1 ar13 ac8 ac14">14.0% </TD></TR></TBODY></TABLE>
<TABLE id=t2 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups (years)</TH><TH id=bc1 colSpan=5>Weekly
(March 16 to March 22, 2014)</TH><TH id=bc8 colSpan=7>Cumulative
(August 25, 2013 to March 22, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=bc2 colSpan=4 headers=bc1>Influenza A</TH><TH id=bc7 headers=bc1>B</TH><TH id=bc9 colSpan=4 headers=bc8>Influenza A</TH><TH id=bc14 headers=bc8>B</TH><TH id=bc15 colSpan=2 headers=bc8>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=bc3 headers="bc1 bc2">A Total</TH><TH id=bc4 class="bg-colour-blue " headers="bc1 bc2">A(H1) pdm09</TH><TH id=bc5 class="bg-colour-blue " headers="bc1 bc2">A(H3)</TH><TH id=bc6 class="bg-colour-blue " headers="bc1 bc2">A (UnS)</TH><TD class=alignCenter headers="bc1 bc7">Total</TD><TH id=bc10 headers="bc8 bc9">A Total</TH><TH id=bc11 class="bg-colour-blue " headers="bc8 bc9">A(H1) pdm09</TH><TH id=bc12 class="bg-colour-blue " headers="bc8 bc9">A(H3)</TH><TH id=bc13 class="bg-colour-blue " headers="bc8 bc9">A (UnS)</TH><TD class=alignCenter headers="bc8 bc14">Total</TD><TH id=bc16 headers="bc8 bc15">#</TH><TH id=bc17 headers="bc8 bc15">%</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13><SUP id=footnote_t2_1>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP id=footnote_t2_2>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
<SUP id=footnote_t2_3>3 </SUP>Table 2 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=br2 class=alignLeft headers=br1><5</TH><TD class=alignCenter headers="br1 br2 bc1 bc2 bc3">22 </TD><TD class=alignCenter headers="br1 br2 bc1 bc2 bc4">2 </TD><TD class=alignCenter headers="br1 br2 bc1 bc2 bc5">3 </TD><TD class=alignCenter headers="br1 br2 bc1 bc2 bc6">17 </TD><TD class=alignCenter headers="br1 br2 bc1 bc7">26 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc10">3195 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc11">1415 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc12">34 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc13">1746 </TD><TD class=alignCenter headers="br1 br2 bc8 bc14">312 </TD><TD class=alignCenter headers="br1 br2 bc8 bc15 bc16">3507 </TD><TD class=alignCenter headers="br1 br2 bc8 bc15 bc17">18.0% </TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignCenter headers="br1 br3 bc1 bc2 bc3">6 </TD><TD class=alignCenter headers="br1 br3 bc1 bc2 bc4">1 </TD><TD class=alignCenter headers="br1 br3 bc1 bc2 bc5">0 </TD><TD class=alignCenter headers="br1 br3 bc1 bc2 bc6">5 </TD><TD class=alignCenter headers="br1 br3 bc1 bc7">16 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc10">1297 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc11">694 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc12">17 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc13">586 </TD><TD class=alignCenter headers="br1 br3 bc8 bc14">478 </TD><TD class=alignCenter headers="br1 br3 bc8 bc15 bc16">1775 </TD><TD class=alignCenter headers="br1 br3 bc8 bc15 bc17">9.1% </TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignCenter headers="br1 br4 bc1 bc2 bc3">22 </TD><TD class=alignCenter headers="br1 br4 bc1 bc2 bc4">6 </TD><TD class=alignCenter headers="br1 br4 bc1 bc2 bc5">1 </TD><TD class=alignCenter headers="br1 br4 bc1 bc2 bc6">15 </TD><TD class=alignCenter headers="br1 br4 bc1 bc7">41 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc10">5006 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc11">2766 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc12">39 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc13">2201 </TD><TD class=alignCenter headers="br1 br4 bc8 bc14">523 </TD><TD class=alignCenter headers="br1 br4 bc8 bc15 bc16">5529 </TD><TD class=alignCenter headers="br1 br4 bc8 bc15 bc17">28.4% </TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignCenter headers="br1 br5 bc1 bc2 bc3">16 </TD><TD class=alignCenter headers="br1 br5 bc1 bc2 bc4">3 </TD><TD class=alignCenter headers="br1 br5 bc1 bc2 bc5">0 </TD><TD class=alignCenter headers="br1 br5 bc1 bc2 bc6">13 </TD><TD class=alignCenter headers="br1 br5 bc1 bc7">54 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc10">4374 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc11">2361 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc12">49 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc13">1964 </TD><TD class=alignCenter headers="br1 br5 bc8 bc14">709 </TD><TD class=alignCenter headers="br1 br5 bc8 bc15 bc16">5083 </TD><TD class=alignCenter headers="br1 br5 bc8 bc15 bc17">26.1% </TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignCenter headers="br1 br6 bc1 bc2 bc3">20 </TD><TD class=alignCenter headers="br1 br6 bc1 bc2 bc4">1 </TD><TD class=alignCenter headers="br1 br6 bc1 bc2 bc5">1 </TD><TD class=alignCenter headers="br1 br6 bc1 bc2 bc6">18 </TD><TD class=alignCenter headers="br1 br6 bc1 bc7">128 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc10">2427 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc11">980 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc12">104 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc13">1343 </TD><TD class=alignCenter headers="br1 br6 bc8 bc14">1012 </TD><TD class=alignCenter headers="br1 br6 bc8 bc15 bc16">3439 </TD><TD class=alignCenter headers="br1 br6 bc8 bc15 bc17">17.7% </TD></TR><TR><TH id=br7 class=alignLeft headers=br1>Unknown</TH><TD class=alignCenter headers="br1 br7 bc1 bc2 bc3">0 </TD><TD class=alignCenter headers="br1 br7 bc1 bc2 bc4">0 </TD><TD class=alignCenter headers="br1 br7 bc1 bc2 bc5">0 </TD><TD class=alignCenter headers="br1 br7 bc1 bc2 bc6">0 </TD><TD class=alignCenter headers="br1 br7 bc1 bc7">0 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc10">132 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc11">102 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc12">18 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc13">12 </TD><TD class=alignCenter headers="br1 br7 bc8 bc14">3 </TD><TD class=alignCenter headers="br1 br7 bc8 bc15 bc16">135 </TD><TD class=alignCenter headers="br1 br7 bc8 bc15 bc17">0.7% </TD></TR><TR><TH id=br8 class=alignLeft headers=br1>Total</TH><TD class=alignCenter headers="br1 br8 bc1 bc2 bc3">86 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc1 bc2 bc4">13 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc1 bc2 bc5">5 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc1 bc2 bc6">68 </TD><TD class=alignCenter headers="br1 br8 bc1 bc7">265 </TD><TD class=alignCenter headers="br1 br8 bc8 bc9 bc10">16431 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc8 bc9 bc11">8318 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc8 bc9 bc12">261 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc8 bc9 bc13">7852 </TD><TD class=alignCenter headers="br1 br8 bc8 bc14">3037 </TD><TD class=alignCenter headers="br1 br8 bc8 bc15 bc16">19468 </TD><TD class=alignCenter headers="br1 br8 bc8 bc15 bc17">100.0% </TD></TR><TR><TH id=br9 class=alignLeft headers=br1>Percentage<SUP>2</SUP></TH><TD class=alignCenter headers="br1 br9 bc1 bc2 bc3">24.5% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc1 bc2 bc4">15.1% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc1 bc2 bc5">5.8% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc1 bc2 bc6">79.1% </TD><TD class=alignCenter headers="br1 br9 bc1 bc7">75.5% </TD><TD class=alignCenter headers="br1 br9 bc8 bc9 bc10">84.4% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc8 bc9 bc11">50.6% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc8 bc9 bc12">1.6% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc8 bc9 bc13">47.8% </TD><TD class=alignCenter headers="br1 br9 bc8 bc14">15.6% </TD><TD class=alignCenter></TD><TD class=alignCenter></TD></TR></TBODY></TABLE>

Top of Page
Influenza Strain Characterizations

During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 1,586 influenza viruses [76 A(H3N2), 1227 A(H1N1)pdm09 and 283 influenza B]. The vast majority (99%) of viruses were similar to the strains recommended by the WHO for the 2013-14 seasonal influenza vaccine. Two A(H1N1)pdm09 viruses showed reduced titres to antiserum against the reference A/California/07/2009 strain. Sixteen influenza B viruses were similar to the strain recommended by the WHO for the 2011-12 vaccine (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2013-2014, N = 1586
2014-w12-fg4-eng.gif

The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
The recommended components for the 2013-2014 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009 (H1N1)pdm09-like virus, an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b (e.g. A/Texas/50/2012), and a B/Massachusetts/2/2012-like virus (Yamagata lineage).


Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
Antiviral Resistance

During the 2013-2014 influenza season, NML has tested 1,191 influenza viruses for resistance to oseltamivir and all but two were sensitive. All 1,176 viruses tested for resistance to zanamivir were sensitive. All 1,320 influenza A viruses tested for amantadine resistance were resistant (Table 3).
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2013-2014</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=cr1 rowSpan=2>Virus type and subtype</TH><TH id=cc1 colSpan=2>Oseltamivir</TH><TH id=cc4 colSpan=2>Zanamivir</TH><TH id=cc7 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=cc2 headers=cc1># tested</TH><TH id=cc3 headers=cc1># resistant (%)</TH><TH id=cc5 headers=cc4># tested</TH><TH id=cc6 headers=cc4># resistant (%)</TH><TH id=cc8 headers=cc7># tested</TH><TH id=cc9 headers=cc7># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=cr2 class="alignLeft bg-colour-blue" headers=cr1>A (H3N2)</TH><TD class=alignCenter headers="cr1 cr2 cc1 cc2">55</TD><TD class=alignCenter headers="cr1 cr2 cc1 cc3">0</TD><TD class=alignCenter headers="cr1 cr2 cc4 cc5">55</TD><TD class=alignCenter headers="cr1 cr2 cc4 cc6">0</TD><TD class=alignCenter headers="cr1 cr2 cc7 cc8">94</TD><TD class=alignCenter headers="cr1 cr2 cc7 cc9">94 (100%)</TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignCenter headers="cr1 cr3 cc1 cc2">989</TD><TD class=alignCenter headers="cr1 cr3 cc1 cc3">2 (0.2%)</TD><TD class=alignCenter headers="cr1 cr3 cc4 cc5">977</TD><TD class=alignCenter headers="cr1 cr3 cc4 cc6">0</TD><TD class=alignCenter headers="cr1 cr3 cc7 cc8">1226</TD><TD class=alignCenter headers="cr1 cr3 cc7 cc9">1226 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignCenter headers="cr1 cr4 cc1 cc2">147</TD><TD class=alignCenter headers="cr1 cr4 cc1 cc3">0</TD><TD class=alignCenter headers="cr1 cr4 cc4 cc5">144</TD><TD class=alignCenter headers="cr1 cr4 cc4 cc6">0</TD><TD class=alignCenter headers="cr1 cr4 cc7 cc8">NA <SUP>*</SUP></TD><TD class=alignCenter headers="cr1 cr4 cc7 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft bg-colour-blue" headers=cr1>TOTAL</TH><TD class=alignCenter headers="cr1 cr5 cc1 cc2">1191</TD><TD class=alignCenter headers="cr1 cr5 cc1 cc3">2 (0.2%)</TD><TD class=alignCenter headers="cr1 cr5 cc4 cc5">1176</TD><TD class=alignCenter headers="cr1 cr5 cc4 cc6">0</TD><TD class=alignCenter headers="cr1 cr5 cc7 cc8">1320</TD><TD class=alignCenter headers="cr1 cr5 cc7 cc9">1320 (100%)</TD></TR></TBODY></TABLE>
Influenza-like Illness (ILI) Consultation Rate

The national influenza-like-illness (ILI) consultation rate increased from 27.4/1,000 in week 11 to 37.7/1,000 in week 12; which was within the expected range for week 12 (Figure 5).
Figure 5. Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014
2014-w12-fg5-eng.gif

Note: No data available for mean rate for weeks 19 to 39 for the 1996-1997 through 2002-2003 seasons. Delays in the reporting of data may cause data to change retrospectively. The calculation of the average ILI consultation rate over 17 seasons was aligned with influenza activity in each season. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. The number of sentinel physicians in each province or territory is as follows: BC(21), AB(80), SK(11), MB(18), ON(169), QC(14), NB(29), NS(26), PE(4), NL(16), NU(1), NT(14), YT(13). Not all sentinel physicians report every week.
Text equivalent for figure 5Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

Top of Page
Influenza Outbreak Surveillance

In week 12, thirteen new influenza outbreaks were reported: 12 in long-term care facilities (LTCF) and one in a hospital (Figure 6). Among the ten outbreaks with available data, eight (seven LTCF and the hospital outbreak) were reported to be due to influenza B.
Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2013-2014
2014-w12-fg6-eng.gif

1 All provinces and territories except NU report outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
Text equivalent for figure 6Overall number of new influenza outbreaks by report week, Canada, 2013-2014
Pharmacy Surveillance

In week 12, the proportion of prescriptions for antivirals among children 2-18 years of age and adults 19-64 years of age was similar to the previous week. Within the 2-18 year age-group, increases in the proportion of prescriptions for antivirals were observed among children 2-9 years of age and decreases among those 10-19 years of age. Overall this season, the largest proportion of prescriptions for antivirals has been among children 2-18 years of age and adults 19-64 years of age, in keeping with laboratory detections of influenza (Figure 7).
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14
2014-w12-fg7-eng.gif

Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group. Age-groups: Infant: 0-2y, Child: 2-18y; Adult: 19-64y, Senior: ≥65y.
Text equivalent for figure 7Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

Top of Page
Sentinel Hospital Influenza Surveillance

Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In week 12, 12 new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 22 in week 11; however, two centres did not report in week 12. In keeping with the increased circulation of influenza B, influenza B was reported in 5 of the 12 cases in week 12 (Figure 8a). Although the number of cases is small, a greater proportion of cases with influenza B this season have been children between 2 and 10 years of age compared to A(H1N1)pdm09. No ICU admissions or deaths were reported in week 12.
To date this season, a total of 625 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 87% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children <5 years of age represent 74% of cases to date (Table 4). Eighty-eight ICU admissions have been reported, of which 58 (68%) were children <5 years of age (Figure 9a). All but six were cases with influenza A, and 96% of those subtyped were A(H1N1)pdm09. Among the 85 ICU cases with available data, 54 (64%) were reported to have underlying medical conditions. No deaths have been reported.
Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
Adult Influenza Hospitalizations and Deaths (PCIRN)
In week 12, 15 new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported through active surveillance by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 62 in week 11. For a third week in a row, the majority of hospitalizations were associated with influenza B(Figure 8b). All but three hospitalizations occurred among adults ≥45 years of age. There was one ICU admission in an adult ≥65 years of age with influenza B, and no deaths reported in week 12.
To date this season, 1328 influenza-associated hospitalizations have been reported by the PCIRN-SOS network, 1138 (85.7%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). ICU admission was required for 220 hospitalizations, all but 11 of which were cases with influenza A (115 A(H1N1)pdm09, seven A(H3N2) and 87 A(unsubtyped)). Approximately 80% of hospitalizations and ICU admissions were ≥45 years of age. Of the 170 ICU admissions with available information, 150 (88.2%) were reported to have at least one comorbidity and of the 188 ICU admissions with available information 134 (71.3%) reported not having been vaccinated this season. Sixty-one deaths have been reported, all but five with influenza A (33 A(H1N1)pdm09, two A(H3N2) and 21 A(unsubtyped)); seven cases 20-44 years of age, 27 cases 45-64 years of age and 27 cases ≥65 years of age (Figure 9b).
Note: PCIRN-SOS conducted passive surveillance from April 30th to November 14th, 2013. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance began November 15th during which time PCIRN site coordinators investigate cases potentially related to influenza. Data from both active and passive surveillance reported during the 2013-14 season are included in this report. The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t4 class=alignCenter>Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=dr1 rowSpan=3>Age groups </TH><TH id=dc1 colSpan=6>Cumulative (Aug. 25, 2013 to March 22, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=dc2 colSpan=4 headers=dc1>Influenza A </TH><TH id=dc7 headers=dc1>B </TH><TH id=dc8 headers=dc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=dc3 headers="dc1 dc2">A Total </TH><TH id=dc4 class="bg-colour-blue " headers="dc1 dc2">A(H1) pdm09 </TH><TH id=dc5 class="bg-colour-blue " headers="dc1 dc2">A(H3) </TH><TH id=dc6 class="bg-colour-blue " headers="dc1 dc2">A (UnS) </TH><TD class=alignCenter headers="dc1 dc7">Total</TD><TD class=alignCenter headers="dc1 dc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t4_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=dr2 class=alignLeft headers=dr1>0-5m </TH><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc3">103</TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc4">33</TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc5">0</TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc6">70</TD><TD class=alignCenter headers="dr1 dr2 dc1 dc7">4</TD><TD class=alignCenter headers="dr1 dr2 dc1 dc8">107 (17%)</TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc3">160</TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc4">46</TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc5">1</TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc6">113</TD><TD class=alignCenter headers="dr1 dr3 dc1 dc7">11</TD><TD class=alignCenter headers="dr1 dr3 dc1 dc8">171 (27%)</TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc3">161</TD><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc4">53</TD><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc5">3</TD><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc6">105</TD><TD class=alignCenter headers="dr1 dr4 dc1 dc7">26</TD><TD class=alignCenter headers="dr1 dr4 dc1 dc8">187 (30%)</TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc3">81</TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc4">25</TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc5">0</TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc6">56</TD><TD class=alignCenter headers="dr1 dr5 dc1 dc7">31</TD><TD class=alignCenter headers="dr1 dr5 dc1 dc8">112 (18%)</TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc3">41</TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc4">15</TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc5">1</TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc6">25</TD><TD class=alignCenter headers="dr1 dr6 dc1 dc7">7</TD><TD class=alignCenter headers="dr1 dr6 dc1 dc8">48 (8%)</TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignCenter headers="dr1 dr7 dc1 dc2 dc3">546</TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc4">172</TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc5">5</TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc6">369</TD><TD class=alignCenter headers="dr1 dr7 dc1 dc7">79</TD><TD class=alignCenter headers="dr1 dr7 dc1 dc8">625</TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP> </TH><TD class=alignCenter headers="dr1 dr8 dc1 dc2 dc3">87.4%</TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc4">31.5%</TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc5">0.9%</TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc6">67.6%</TD><TD class=alignCenter headers="dr1 dr8 dc1 dc7">12.6%</TD><TD class=alignCenter headers="dr1 dr8 dc1 dc8">100.0%</TD></TR></TBODY></TABLE>
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 5 - Cumulative numbers of adult hospitalizations with influenza
reported by the PCIRN-SOS network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=er1 rowSpan=3>Age groups </TH><TH id=ec1 class=noWrap colSpan=6>Cumulative (Aug. 25, 2013 to March 22, 2014)<SUP>*</SUP></TH></TR><TR class=bg-colour-yellow><TH id=ec2 colSpan=4 headers=ec1>Influenza A </TH><TH id=ec7 headers=ec1>B </TH><TH id=ec8 headers=ec1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=ec3 headers="ec1 ec2">A Total </TH><TH id=ec4 class="bg-colour-blue " headers="ec1 ec2">A(H1) pdm09 </TH><TH id=ec5 class="bg-colour-blue " headers="ec1 ec2">A(H3) </TH><TH id=ec6 class="bg-colour-blue " headers="ec1 ec2">A(UnS) </TH><TD class=alignCenter headers="ec1 ec7">Total</TD><TD class=alignCenter headers="ec1 ec8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t5_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.

<SUP id=t5_star>*</SUP> One case for which the influenza type has not yet been reported, and three cases for which the age-group was not reported, are not included in Table 5.</TD></TR></TFOOT><TBODY><TR><TH id=er2 class=alignLeft headers=er1>16-20 </TH><TD class=alignCenter headers="er1 er2 ec1 ec2 ec3">13</TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec4">4</TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec5">0</TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec6">9</TD><TD class=alignCenter headers="er1 er2 ec1 ec7">2</TD><TD class=alignCenter headers="er1 er2 ec1 ec8">15 (1%)</TD></TR><TR><TH id=er3 class=alignLeft headers=er1>20-44 </TH><TD class=alignCenter headers="er1 er3 ec1 ec2 ec3">244</TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec4">128</TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec5">4</TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec6">112</TD><TD class=alignCenter headers="er1 er3 ec1 ec7">12</TD><TD class=alignCenter headers="er1 er3 ec1 ec8">256 (19%)</TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignCenter headers="er1 er4 ec1 ec2 ec3">444</TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec4">206</TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec5">7</TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec6">231</TD><TD class=alignCenter headers="er1 er4 ec1 ec7">43</TD><TD class=alignCenter headers="er1 er4 ec1 ec8">487 (37%)</TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignCenter headers="er1 er5 ec1 ec2 ec3">434</TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec4">207</TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec5">36</TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec6">191</TD><TD class=alignCenter headers="er1 er5 ec1 ec7">132</TD><TD class=alignCenter headers="er1 er5 ec1 ec8">566 (43%)</TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignCenter headers="er1 er6 ec1 ec2 ec3">1135</TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec4">545</TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec5">47</TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec6">543</TD><TD class=alignCenter headers="er1 er6 ec1 ec7">189</TD><TD class=alignCenter headers="er1 er6 ec1 ec8">1324</TD></TR><TR><TH id=er7 class=alignLeft headers=er1>%<SUP>1</SUP></TH><TD class=alignCenter headers="er1 er7 ec1 ec2 ec3">86%</TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec4">48%</TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec5">4%</TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec6">48%</TD><TD class=alignCenter headers="er1 er7 ec1 ec7">14%</TD><TD class=alignCenter headers="er1 er7 ec1 ec8">100%</TD></TR></TBODY></TABLE>
Figure 8. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w12-fg8a-eng.gif


Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w12-fg8b-eng.gif

* See footnote above following the section related to PCIRN-SOS data.
Text equivalent for figure 8bNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Adult hospitalizations (>16 year of age, PCIRN-SOS)
Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w12-fg9a-eng.gif

Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w12-fg9b-eng.gif

Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Adult hospitalizations (≥16 year of age, PCIRN-SOS)

Top of Page
Provincial/Territorial Influenza Hospitalizations and Deaths

In week 12, 119 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories.* As with other surveillance indicators in week 12, the majority were cases of influenza B (71, 59.7%). Two ICU admissions were reported in week 12, one adult 20-44 years of age and the other with age not reported, both with influenza A. Seven deaths were reported in week 12; four cases were ≥65 years of age, and three of the seven had influenza B. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total.
To date this season, 3,700 influenza-associated hospitalizations have been reported, 91.4% with influenza A. The majority (58.0%) of hospitalizations have been cases 45 years of age of older. A significantly greater proportion of cases of influenza B have been ≥65 years of age, and 5-19 years of age, compared to cases of A(H1N1)pdm09 this season (Table 6). A total of 326 ICU admissions have been reported this season, of which 66.8% were adults 20-64 years of age. A total of 204 deaths have been reported. The highest proportion of deaths has been among adults 20-64 years of age (49.5%), followed by adults ≥65 years of age (41.1%). In keeping with the late-season circulation, influenza B has been increasingly reported among hospitalized cases of influenza. To date this season, influenza B has been reported in 8.6% of hospitalizations and 6.9 % of deaths. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.
* Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, NS, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t6 class=alignCenter>Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=fr1 rowSpan=3>Age groups </TH><TH id=fc1 colSpan=6>Cumulative (Aug. 25, 2013 to March 22, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=fc2 colSpan=4 headers=fc1>Influenza A</TH><TH id=fc7 headers=fc1>B</TH><TH id=fc8 headers=fc1>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=fc3 headers="fc1 fc2">A Total</TH><TH id=fc4 class=bg-colour-blue headers="fc1 fc2">A(H1) pdm09</TH><TH id=fc5 class=bg-colour-blue headers="fc1 fc2">A(H3)</TH><TH id=fc6 class=bg-colour-blue headers="fc1 fc2">A (UnS)</TH><TD class=alignCenter headers="fc1 fc7">Total</TD><TD class=alignCenter headers="fc1 fc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=8><SUP id=footnote_t6_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=fr2 class=alignLeft headers=fr1>0-4 years</TH><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc3">579</TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc4">277</TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc5">7</TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc6">295</TD><TD class=alignCenter headers="fr1 fr2 fc1 fc7">44</TD><TD class=alignCenter headers="fr1 fr2 fc1 fc8">623 (17%)</TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years</TH><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc3">127</TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc4">64</TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc5">5</TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc6">58</TD><TD class=alignCenter headers="fr1 fr3 fc1 fc7">41</TD><TD class=alignCenter headers="fr1 fr3 fc1 fc8">168 (5%)</TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years</TH><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc3">34</TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc4">19</TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc5">3</TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc6">12</TD><TD class=alignCenter headers="fr1 fr4 fc1 fc7">2</TD><TD class=alignCenter headers="fr1 fr4 fc1 fc8">36 (1%)</TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc3">584</TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc4">413</TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc5">4</TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc6">167</TD><TD class=alignCenter headers="fr1 fr5 fc1 fc7">17</TD><TD class=alignCenter headers="fr1 fr5 fc1 fc8">601 (16%)</TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc3">1068</TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc4">680</TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc5">23</TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc6">365</TD><TD class=alignCenter headers="fr1 fr6 fc1 fc7">71</TD><TD class=alignCenter headers="fr1 fr6 fc1 fc8">1139 (31%)</TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc3">869</TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc4">451</TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc5">67</TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc6">351</TD><TD class=alignCenter headers="fr1 fr7 fc1 fc7">137</TD><TD class=alignCenter headers="fr1 fr7 fc1 fc8">1006 (27%)</TD></TR><TR><TH id=fr10 class=alignLeft headers=fr1>Unknown</TH><TD class=alignCenter headers="fc1 fc2 fc3">122</TD><TD class=alignCenter headers="fc1 fc2 fc4">95</TD><TD class=alignCenter headers="fc1 fc2 fc5">3</TD><TD class=alignCenter headers="fc1 fc2 fc6">24</TD><TD class=alignCenter headers="fc1 fc7">5</TD><TD class=alignCenter headers="fc1 fc8">127 (3%)</TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignCenter headers="fr1 fr8 fc1 fc2 fc3">3383</TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc4">1999</TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc5">112</TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc6">1272</TD><TD class=alignCenter headers="fr1 fr8 fc1 fc7">317</TD><TD class=alignCenter headers="fr1 fr8 fc1 fc8">3700</TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP> </TH><TD class=alignCenter headers="fr1 fr9 fc1 fc2 fc3">91.4%</TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc4">59.1%</TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc5">3.3%</TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc6">37.6%</TD><TD class=alignCenter headers="fr1 fr9 fc1 fc7">8.6%</TD><TD class=alignCenter headers="fr1 fr9 fc1 fc8">100%</TD></TR></TBODY></TABLE>
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2013-14 on the Public Health Agency of Canada website.

.../
http://www.phac-aspc.gc.ca/fluwatch/13-14/w12_14/index-eng.php
 
Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 13

Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 13

FluWatch report: March 23 to 29, 2014 (Week 13)

Posted 2014-04-04For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
<A title="Flu Watch (Version PDF, 113 KB - 6 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/13-14/w13_14/pdf/fw2014-13-eng.pdf">FluWatch report: March 23 to 29, 2014 (Week 13) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 291 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

?? Help with PDF documents

Overall Summary
  • In week 13, the decline in influenza activity in Canada has been slowed by continued circulation of influenza B. Overall, the influenza A(H1N1) virus remains the most common influenza virus this season, however, most influenza viruses circulating in recent weeks have been influenza B.
  • While the influenza A(H1N1) virus has mostly affected adults 20-64 years of age this season, influenza B is having a greater impact on adults 65 years of age and older, as well as young persons 5 to 19 years of age.
  • As of week 13, 3,856 hospitalizations and 215 deaths have been reported from participating regions, which is comparable to reports in past influenza seasons.
  • Influenza activity remains within expected levels for this time of year.
Influenza/ILI Activity (geographic spread)

The number of regions reporting localized or widespread influenza activity has been stable in recent weeks, with the majority of activity reported in Eastern Canada. In week 13, no regions reported widespread activity and eight regions (ON(5) and QC(3)) reported localized activity (Figure 1).
Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 13


right_ofmap.gif



Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
Influenza and Other Respiratory Virus Detections

The number of positive influenza tests increased from 608 in week 12 to 692 (14.2% of tests) in week 13. Influenza B remained the predominant virus in week 13, representing 79% of influenza detections (Figure 2). The highest proportions of influenza B this season have been reported from Newfoundland & Labrador (33.0%) and Quebec (27.7%), followed by Ontario (17.0%) and British Columbia (10.2%) (Table 1). Slightly more influenza B has been observed to date this season compared to the same time during the 2012-13 season. Among the 19,992 cases for which information on age and type/subtype has been received this season, 54.1% were 20-64 years of age (Table 2). Significantly greater proportions of influenza B cases have been ≥65 years of age and 5-19 years of age compared to cases of A(H1N1)pdm09. Influenza detections among persons ≥65 years of age increased in weeks 11 and 12 but decreased in week 13; while detections in other age-groups continue to decline.

Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
2014-w13-fg2-eng.gif

Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
The number of positive tests for RSV has been declining gradually over recent weeks, similar to the trend observed in recent seasons. The number of positive tests for parainfluenza and coronavirus continued to follow a downward trend since early February. More detections of adenovirus have been reported compared to last season, and have been relatively stable in recent weeks. Detections of rhinovirus have been relatively stable during the winter months, although these detections represent an increasing percentage of tests positive since early January. The number of positive tests for human metapneumovirus has been higher than during the same period last season; it declined in week 13 (Figure 3).
For more details, see the weekly Respiratory Virus Detections in Canada Report.
Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2013-14
2014-w13-fg3-eng.gif


Top of Page
RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
<TABLE id=t1 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly and cumulative numbers of positive influenza specimens
by type, subtype and province, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=ac1 colSpan=5>Weekly
(March 23, 2013 to March 29, 2014)</TH><TH id=ac8 colSpan=5>Cumulative
(August 25, 2013 to March 29, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=4 headers=ac1>Influenza A</TH><TH id=ac7 headers=ac1>B</TH><TH id=ac9 colSpan=4 headers=ac8>Influenza A</TH><TH id=ac14 headers=ac8>B</TH></TR><TR class=bg-colour-grey-light><TH id=ac3 headers="ac1 ac2">A Total</TH><TH id=ac4 class=lightred headers="ac1 ac2">A(H1)pdm09</TH><TH id=ac5 class=lightred headers="ac1 ac2">A(H3)</TH><TH id=ac6 class=lightred headers="ac1 ac2">A(UnS)</TH><TH class=alignCenter headers="ac1 ac7">B Total</TH><TH id=ac10 headers="ac8 ac9">A Total</TH><TH id=ac11 class=lightred headers="ac8 ac9">A(H1)pdm09</TH><TH id=ac12 class=lightred headers="ac8 ac9">A(H3)</TH><TH id=ac13 class=lightred headers="ac8 ac9">A(UnS)</TH><TD class=alignCenter headers="ac8 ac14">B Total</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=alignLeft headers=ar1>BC</TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">32</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">12</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">5</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">15</TD><TD class=alignRight headers="ar1 ar2 ac1 ac7">26</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac10">1794</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac11">1613</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac12">49</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac13">132</TD><TD class=alignRight headers="ar1 ar2 ac8 ac14">203</TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">28</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">14</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">14</TD><TD class=alignRight headers="ar1 ar3 ac1 ac7">19</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac10">3792</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac11">3420</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac12">57</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac13">315</TD><TD class=alignRight headers="ar1 ar3 ac8 ac14">195</TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">5</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">2</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">3</TD><TD class=alignRight headers="ar1 ar4 ac1 ac7">4</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac10">1355</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac11">975</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac12">6</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac13">374</TD><TD class=alignRight headers="ar1 ar4 ac8 ac14">53</TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">11</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">3</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">1</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">7</TD><TD class=alignRight headers="ar1 ar5 ac1 ac7">2</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac10">641</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac11">454</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac12">2</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac13">185</TD><TD class=alignRight headers="ar1 ar5 ac8 ac14">19</TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">41</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">13</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">17</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">11</TD><TD class=alignRight headers="ar1 ar6 ac1 ac7">265</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac10">5580</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac11">2462</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac12">293</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac13">2825</TD><TD class=alignRight headers="ar1 ar6 ac8 ac14">1145</TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">22</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">1</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">21</TD><TD class=alignRight headers="ar1 ar7 ac1 ac7">196</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac10">5288</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac11">676</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac12">3</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac13">4609</TD><TD class=alignRight headers="ar1 ar7 ac8 ac14">2030</TD></TR><TR><TH id=ar8 class=alignLeft headers=ar1>NB</TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac7">8</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac10">1488</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac11">370</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac12">1</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac13">1117</TD><TD class=alignRight headers="ar1 ar8 ac8 ac14">38</TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">3</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">3</TD><TD class=alignRight headers="ar1 ar9 ac1 ac7">0</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac10">167</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac11">134</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac12">4</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac13">29</TD><TD class=alignRight headers="ar1 ar9 ac8 ac14">4</TD></TR><TR><TH id=ar10 class=alignLeft headers=ar1>PE</TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">--</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac4">--</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac5">--</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac6">--</TD><TD class=alignRight headers="ar1 ar10 ac1 ac7">--</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac10">118</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac11">117</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac13">1</TD><TD class=alignRight headers="ar1 ar10 ac8 ac14">1</TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">7</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac6">7</TD><TD class=alignRight headers="ar1 ar11 ac1 ac7">23</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac10">353</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac11">104</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac13">249</TD><TD class=alignRight headers="ar1 ar11 ac8 ac14">174</TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class="alignRight noWrap" headers="ar1 ar12 ac1 ac2 ac3">149</TD><TD class="alignRight noWrap lightred" headers="ar1 ar12 ac1 ac2 ac4">45</TD><TD class="alignRight noWrap lightred" headers="ar1 ar12 ac1 ac2 ac5">23</TD><TD class="alignRight noWrap lightred" headers="ar1 ar12 ac1 ac2 ac6">81</TD><TD class="alignRight noWrap" headers="ar1 ar12 ac1 ac7">543</TD><TD class="alignRight noWrap" headers="ar1 ar12 ac8 ac9 ac10">20576</TD><TD class="alignRight noWrap lightred" headers="ar1 ar12 ac8 ac9 ac11">10325</TD><TD class="alignRight noWrap lightred" headers="ar1 ar12 ac8 ac9 ac12">415</TD><TD class="alignRight noWrap lightred" headers="ar1 ar12 ac8 ac9 ac13">9836</TD><TD class="alignRight noWrap" headers="ar1 ar12 ac8 ac14">3862</TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="ar1 ar13 ac1 ac2 ac3">21.5%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac4">30.2%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac5">15.4%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac6">54.4%</TD><TD class=alignRight headers="ar1 ar13 ac1 ac7">78.5%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac9 ac10">84.2%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac11">50.2%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac12">2.0%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac13">47.8%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac14">15.8%</TD></TR></TBODY></TABLE>
<TABLE id=t2 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups (years)</TH><TH id=bc1 colSpan=5>Weekly
(March 23 to March 29, 2014)</TH><TH id=bc8 colSpan=7>Cumulative
(August 25, 2013 to March 29, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=bc2 colSpan=4 headers=bc1>Influenza A</TH><TH id=bc7 headers=bc1>B</TH><TH id=bc9 colSpan=4 headers=bc8>Influenza A</TH><TH id=bc14 headers=bc8>B</TH><TH id=bc15 colSpan=2 headers=bc8>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=bc3 headers="bc1 bc2">A Total</TH><TH id=bc4 class="lightred " headers="bc1 bc2">A(H1) pdm09</TH><TH id=bc5 class="lightred " headers="bc1 bc2">A(H3)</TH><TH id=bc6 class="lightred " headers="bc1 bc2">A (UnS)</TH><TD class=alignCenter headers="bc1 bc7">Total</TD><TH id=bc10 headers="bc8 bc9">A Total</TH><TH id=bc11 class="lightred " headers="bc8 bc9">A(H1) pdm09</TH><TH id=bc12 class="lightred " headers="bc8 bc9">A(H3)</TH><TH id=bc13 class="lightred " headers="bc8 bc9">A (UnS)</TH><TD class=alignCenter headers="bc8 bc14">Total</TD><TH id=bc16 headers="bc8 bc15">#</TH><TH id=bc17 headers="bc8 bc15">%</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13><SUP id=footnote_t2_1>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP id=footnote_t2_2>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
<SUP id=footnote_t2_3>3 </SUP>Table 2 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=br2 class=alignLeft headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">11</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">2</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">8</TD><TD class=alignRight headers="br1 br2 bc1 bc7">24</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">3219</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">1436</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">34</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1749</TD><TD class=alignRight headers="br1 br2 bc8 bc14">348</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc16">3567</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc17">17.8%</TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">5</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">1</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">4</TD><TD class=alignRight headers="br1 br3 bc1 bc7">34</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1305</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">701</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">18</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">586</TD><TD class=alignRight headers="br1 br3 bc8 bc14">529</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc16">1834</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc17">9.2%</TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">13</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">4</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">9</TD><TD class=alignRight headers="br1 br4 bc1 bc7">31</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">5027</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">2783</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">39</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">2205</TD><TD class=alignRight headers="br1 br4 bc8 bc14">577</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc16">5604</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc17">28.0%</TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">15</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">5</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">2</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">8</TD><TD class=alignRight headers="br1 br5 bc1 bc7">74</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">4400</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">2375</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">53</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">1972</TD><TD class=alignRight headers="br1 br5 bc8 bc14">816</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc16">5216</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc17">26.1%</TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">16</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">4</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">2</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">10</TD><TD class=alignRight headers="br1 br6 bc1 bc7">117</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">2453</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">987</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">115</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">1351</TD><TD class=alignRight headers="br1 br6 bc8 bc14">1182</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc16">3635</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc17">18.2%</TD></TR><TR><TH id=br7 class=alignLeft headers=br1>Unknown</TH><TD class=alignRight headers="br1 br7 bc1 bc2 bc3">1</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc6">0</TD><TD class=alignRight headers="br1 br7 bc1 bc7">0</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc10">133</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">102</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">19</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">12</TD><TD class=alignRight headers="br1 br7 bc8 bc14">3</TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc16">136</TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc17">0.7%</TD></TR><TR><TH id=br8 class=alignLeft headers=br1>Total</TH><TD class="alignRight noWrap" headers="br1 br8 bc1 bc2 bc3">61</TD><TD class="alignRight noWrap lightred" headers="br1 br8 bc1 bc2 bc4">16</TD><TD class="alignRight noWrap lightred" headers="br1 br8 bc1 bc2 bc5">6</TD><TD class="alignRight noWrap lightred" headers="br1 br8 bc1 bc2 bc6">39</TD><TD class="alignRight noWrap" headers="br1 br8 bc1 bc7">280</TD><TD class="alignRight noWrap" headers="br1 br8 bc8 bc9 bc10">16537</TD><TD class="alignRight noWrap lightred" headers="br1 br8 bc8 bc9 bc11">8384</TD><TD class="alignRight noWrap lightred" headers="br1 br8 bc8 bc9 bc12">278</TD><TD class="alignRight noWrap lightred" headers="br1 br8 bc8 bc9 bc13">7875</TD><TD class="alignRight noWrap" headers="br1 br8 bc8 bc14">3455</TD><TD class="alignRight noWrap" headers="br1 br8 bc8 bc15 bc16">19992</TD><TD class="alignRight noWrap" headers="br1 br8 bc8 bc15 bc17">100.0%</TD></TR><TR><TH id=br9 class=alignLeft headers=br1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="br1 br9 bc1 bc2 bc3">17.9%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc4">26.2%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc5">9.8%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc6">63.9%</TD><TD class=alignRight headers="br1 br9 bc1 bc7">82.1%</TD><TD class=alignRight headers="br1 br9 bc8 bc9 bc10">82.7%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc11">50.7%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc12">1.7%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc13">47.6%</TD><TD class=alignRight headers="br1 br9 bc8 bc14">17.3%</TD><TD class=alignRight></TD><TD class=alignRight></TD></TR></TBODY></TABLE>

Top of Page
Influenza Strain Characterizations

During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 1,689 influenza viruses [82 A(H3N2), 1273 A(H1N1)pdm09 and 334 influenza B]. The vast majority (99%) of viruses were similar to the strains recommended by the WHO for the 2013-14 seasonal influenza vaccine. Two A(H1N1)pdm09 viruses showed reduced titres to antiserum against the reference A/California/07/2009 strain. Nineteen influenza B viruses were similar to the strain recommended by the WHO for the 2011-12 vaccine (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2013-2014, N = 1689
2014-w13-fg4-eng.gif

The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
The recommended components for the 2013-2014 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009 (H1N1)pdm09-like virus, an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b (e.g. A/Texas/50/2012), and a B/Massachusetts/2/2012-like virus (Yamagata lineage).


Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
Antiviral Resistance

During the 2013-2014 influenza season, NML has tested 1,290 influenza viruses for resistance to oseltamivir and all but two were sensitive. All 1,290 viruses tested for resistance to zanamivir were sensitive. All 1,378 influenza A viruses tested for amantadine resistance were resistant (Table 3).
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2013-2014</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=cr1 rowSpan=2>Virus type and subtype</TH><TH id=cc1 colSpan=2>Oseltamivir</TH><TH id=cc4 colSpan=2>Zanamivir</TH><TH id=cc7 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=cc2 headers=cc1># tested</TH><TH id=cc3 headers=cc1># resistant (%)</TH><TH id=cc5 headers=cc4># tested</TH><TH id=cc6 headers=cc4># resistant (%)</TH><TH id=cc8 headers=cc7># tested</TH><TH id=cc9 headers=cc7># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=cr2 class="alignLeft bg-colour-blue" headers=cr1>A (H3N2)</TH><TD class=alignRight headers="cr1 cr2 cc1 cc2">66 </TD><TD class=alignRight headers="cr1 cr2 cc1 cc3">0 </TD><TD class=alignRight headers="cr1 cr2 cc4 cc5">66 </TD><TD class=alignRight headers="cr1 cr2 cc4 cc6">0 </TD><TD class=alignRight headers="cr1 cr2 cc7 cc8">103 </TD><TD class=alignRight headers="cr1 cr2 cc7 cc9">103 (100%) </TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignRight headers="cr1 cr3 cc1 cc2">1046 </TD><TD class=alignRight headers="cr1 cr3 cc1 cc3">2 (0.2%) </TD><TD class=alignRight headers="cr1 cr3 cc4 cc5">1047 </TD><TD class=alignRight headers="cr1 cr3 cc4 cc6">0 </TD><TD class=alignRight headers="cr1 cr3 cc7 cc8">1275 </TD><TD class=alignRight headers="cr1 cr3 cc7 cc9">1275 (100%) </TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignRight headers="cr1 cr4 cc1 cc2">178 </TD><TD class=alignRight headers="cr1 cr4 cc1 cc3">0 </TD><TD class=alignRight headers="cr1 cr4 cc4 cc5">177 </TD><TD class=alignRight headers="cr1 cr4 cc4 cc6">0 </TD><TD class=alignRight headers="cr1 cr4 cc7 cc8">NA <SUP>*</SUP></TD><TD class=alignRight headers="cr1 cr4 cc7 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft bg-colour-blue" headers=cr1>TOTAL</TH><TD class=alignRight headers="cr1 cr5 cc1 cc2">1290 </TD><TD class=alignRight headers="cr1 cr5 cc1 cc3">2 (0.2%) </TD><TD class=alignRight headers="cr1 cr5 cc4 cc5">1290 </TD><TD class=alignRight headers="cr1 cr5 cc4 cc6">0 </TD><TD class=alignRight headers="cr1 cr5 cc7 cc8">1378 </TD><TD class=alignRight headers="cr1 cr5 cc7 cc9">1378 (100%) </TD></TR></TBODY></TABLE>
Influenza-like Illness (ILI) Consultation Rate

The national influenza-like-illness (ILI) consultation rate decreased from 37.5/1,000 in week 12 to 25.9/1,000 in week 13; which was within the expected range for week 13 (Figure 5).
Figure 5. Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014
2014-w13-fg5-eng.gif

Note: No data available for mean rate for weeks 19 to 39 for the 1996-1997 through 2002-2003 seasons. Delays in the reporting of data may cause data to change retrospectively. The calculation of the average ILI consultation rate over 17 seasons was aligned with influenza activity in each season. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. The number of sentinel physicians in each province or territory is as follows: BC(21), AB(80), SK(11), MB(18), ON(169), QC(14), NB(29), NS(26), PE(4), NL(16), NU(1), NT(14), YT(13). Not all sentinel physicians report every week.
Text equivalent for figure 5Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

Top of Page
Influenza Outbreak Surveillance

In week 13, thirteen new influenza outbreaks were reported. Twelve outbreaks were in long-term care facilities, and among the 11 with available data, all were influenza B. One outbreak of A(H1N1)pdm09 was reported in a hospital (Figure 6). In addition, one outbreak of influenza-like illness was reported in a school.
Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2013-2014
2014-w13-fg6-eng.gif

1 All provinces and territories except NU report outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
Text equivalent for figure 6Overall number of new influenza outbreaks by report week, Canada, 2013-2014
Pharmacy Surveillance

In week 13, the proportion of prescriptions for antivirals among adults 19-64 years of age was similar to recent weeks, but declined for other age-groups. Overall this season, the largest proportion of prescriptions for antivirals has been among children 2-18 years of age and adults 19-64 years of age, in keeping with laboratory detections of influenza (Figure 7).
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14
2014-w13-fg7-eng.gif

Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group. Age-groups: Infant: 0-2y, Child: 2-18y; Adult: 19-64y, Senior: ≥65y.
Text equivalent for figure 7Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

Top of Page
Sentinel Hospital Influenza Surveillance

Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In week 13, 15 new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 13 in week 12. Influenza B was reported in 11 of the 15 cases in week 13 (Figure 8a). Although the number of cases is small, a greater proportion of cases with influenza B this season have been children between 2 and 10 years of age compared to A(H1N1)pdm09. No ICU admissions or deaths were reported in week 13.
To date this season, a total of 642 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 86% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children <5 years of age represent 74% of cases to date (Table 4). Ninety-three ICU admissions have been reported, of which 63 (68%) were children <5 years of age (Figure 9a). All but six were cases with influenza A, and 97% of those subtyped were A(H1N1)pdm09. Among the 90 ICU cases with available data, 58 (64%) were reported to have underlying medical conditions. No deaths have been reported.
Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
Adult Influenza Hospitalizations and Deaths (PCIRN)
In week 13, 25 new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported through active surveillance by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 27 in week 12 (Figure 8b). This season, a significantly greater proportion of cases of influenza B have been ≥65 years of age compared to cases of A(H1N1)pdm09. For a fourth week in a row, the majority of hospitalizations were associated with influenza B, which was associated with a greater proportion of cases among adults ≥65 years of age. No ICU admissions or deaths were reported in week 13.
To date this season, 1403 influenza-associated hospitalizations have been reported by the PCIRN-SOS network, 1182 (84.2%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). ICU admission was required for 227 hospitalizations, all but 12 of which were cases with influenza A (119 A(H1N1)pdm09, seven A(H3N2) and 89 A(unsubtyped)). Approximately 80% of hospitalizations and ICU admissions were ≥45 years of age. Of the 176 ICU admissions with available information, 154 (87.5%) were reported to have at least one comorbidity and of the 193 ICU admissions with available information 138 (71.5%) reported not having been vaccinated this season. Sixty-five deaths have been reported, all but six with influenza A (34 A(H1N1)pdm09, three A(H3N2) and 22 A(unsubtyped)); seven cases 20-44 years of age, 27 cases 45-64 years of age and 31 cases ≥65 years of age (Figure 9b).
Note: PCIRN-SOS conducted passive surveillance from April 30th to November 14th, 2013. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance began November 15th during which time PCIRN site coordinators investigate cases potentially related to influenza. Data from both active and passive surveillance reported during the 2013-14 season are included in this report. The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t4 class=alignCenter>Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=dr1 rowSpan=3>Age groups </TH><TH id=dc1 colSpan=6>Cumulative (Aug. 25, 2013 to March 29, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=dc2 colSpan=4 headers=dc1>Influenza A </TH><TH id=dc7 headers=dc1>B </TH><TH id=dc8 headers=dc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=dc3 headers="dc1 dc2">A Total </TH><TH id=dc4 class="lightred " headers="dc1 dc2">A(H1) pdm09 </TH><TH id=dc5 class="lightred " headers="dc1 dc2">A(H3) </TH><TH id=dc6 class="lightred " headers="dc1 dc2">A (UnS) </TH><TD class=alignCenter headers="dc1 dc7">Total</TD><TD class=alignCenter headers="dc1 dc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t4_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=dr2 class=alignLeft headers=dr1>0-5m </TH><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc3">104 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc4">33 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc5">0 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc6">71 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc7">4 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc8">108 (17%) </TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc3">160 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc4">46 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc5">1 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc6">113 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc7">14 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc8">174 (27%) </TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc3">163 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc4">55 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc5">3 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc6">105 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc7">27 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc8">190 (30%) </TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc3">83 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc4">27 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc5">0 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc6">56 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc7">37 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc8">120 (19%) </TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc3">41 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc4">15 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc5">1 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc6">25 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc7">9 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc8">50 (8%) </TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignRight headers="dr1 dr7 dc1 dc2 dc3">551 </TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc4">176 </TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc5">5 </TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc6">370 </TD><TD class=alignRight headers="dr1 dr7 dc1 dc7">91 </TD><TD class=alignRight headers="dr1 dr7 dc1 dc8">642 </TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP> </TH><TD class=alignRight headers="dr1 dr8 dc1 dc2 dc3">85.8% </TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc4">31.9% </TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc5">0.9% </TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc6">67.2% </TD><TD class=alignRight headers="dr1 dr8 dc1 dc7">14.2% </TD><TD class=alignRight headers="dr1 dr8 dc1 dc8">100.0% </TD></TR></TBODY></TABLE>
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 5 - Cumulative numbers of adult hospitalizations with influenza
reported by the PCIRN-SOS network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=er1 rowSpan=3>Age groups </TH><TH id=ec1 class=noWrap colSpan=6>Cumulative (Aug. 25, 2013 to March 29, 2014)<SUP>*</SUP></TH></TR><TR class=bg-colour-yellow><TH id=ec2 colSpan=4 headers=ec1>Influenza A </TH><TH id=ec7 headers=ec1>B </TH><TH id=ec8 headers=ec1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=ec3 headers="ec1 ec2">A Total </TH><TH id=ec4 class=lightred headers="ec1 ec2">A(H1) pdm09 </TH><TH id=ec5 class=lightred headers="ec1 ec2">A(H3) </TH><TH id=ec6 class=lightred headers="ec1 ec2">A(UnS) </TH><TD class=alignCenter headers="ec1 ec7">Total</TD><TD class=alignCenter headers="ec1 ec8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t5_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.

<SUP id=t5_star>*</SUP> One case for which the influenza type has not yet been reported, and five cases for which the age-group was not reported, are not included in Table 5.</TD></TR></TFOOT><TBODY><TR><TH id=er2 class=alignLeft headers=er1>16-20 </TH><TD class=alignRight headers="er1 er2 ec1 ec2 ec3">13 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec4">4 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec5">0 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec6">9 </TD><TD class=alignRight headers="er1 er2 ec1 ec7">2 </TD><TD class=alignRight headers="er1 er2 ec1 ec8">15 (1%) </TD></TR><TR><TH id=er3 class=alignLeft headers=er1>20-44 </TH><TD class=alignRight headers="er1 er3 ec1 ec2 ec3">249 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec4">131 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec5">5 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec6">113 </TD><TD class=alignRight headers="er1 er3 ec1 ec7">14 </TD><TD class=alignRight headers="er1 er3 ec1 ec8">263 (19%) </TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignRight headers="er1 er4 ec1 ec2 ec3">465 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec4">217 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec5">7 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec6">241 </TD><TD class=alignRight headers="er1 er4 ec1 ec7">55 </TD><TD class=alignRight headers="er1 er4 ec1 ec8">520 (37%) </TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignRight headers="er1 er5 ec1 ec2 ec3">450 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec4">211 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec5">38 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec6">201 </TD><TD class=alignRight headers="er1 er5 ec1 ec7">149 </TD><TD class=alignRight headers="er1 er5 ec1 ec8">599 (43%) </TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignRight headers="er1 er6 ec1 ec2 ec3">1177 </TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec4">563 </TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec5">50 </TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec6">564 </TD><TD class=alignRight headers="er1 er6 ec1 ec7">220 </TD><TD class=alignRight headers="er1 er6 ec1 ec8">1397 </TD></TR><TR><TH id=er7 class=alignLeft headers=er1>%<SUP>1</SUP></TH><TD class=alignRight headers="er1 er7 ec1 ec2 ec3">84% </TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec4">48% </TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec5">4% </TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec6">48% </TD><TD class=alignRight headers="er1 er7 ec1 ec7">16% </TD><TD class=alignRight headers="er1 er7 ec1 ec8">100% </TD></TR></TBODY></TABLE>
Figure 8. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w13-fg8a-eng.gif


Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w13-fg8b-eng.gif

* See footnote above following the section related to PCIRN-SOS data.
Text equivalent for figure 8bNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Adult hospitalizations (>16 year of age, PCIRN-SOS)
Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w13-fg9a-eng.gif

Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w13-fg9b-eng.gif

Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Adult hospitalizations (≥16 year of age, PCIRN-SOS)

Top of Page
Provincial/Territorial Influenza Hospitalizations and Deaths

In week 13, 147 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories.<SUP>*</SUP> As with other surveillance indicators in week 13, the majority were cases of influenza B (104, 70.7%). Four ICU admissions were reported in week 13; one adult 20-44 years of age and the other three with age not reported; all with influenza A. Twelve deaths were reported in week 13; of which 11 were ≥65 years of age, and nine of the twelve had influenza B. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total.
To date this season, 3,856 influenza-associated hospitalizations have been reported, 89.0% with influenza A. The majority (58.1%) of hospitalizations have been cases 45 years of age of older. A significantly greater proportion of cases of influenza B have been ≥65 years of age, and 5-19 years of age, compared to cases of A(H1N1)pdm09 this season (Table 6). A total of 333 ICU admissions have been reported this season, of which 66.6% were adults 20-64 years of age. A total of 215 deaths have been reported. The highest proportion of deaths has been among adults 20-64 years of age (46.9%), followed by adults ≥65 years of age (44.2%). In keeping with the late-season circulation, influenza B has been increasingly reported among hospitalized cases of influenza. To date this season, influenza B has been reported in 11.0% of hospitalizations and 10.7 % of deaths. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.
* Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, NS, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t6 class=alignCenter>Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=fr1 rowSpan=3>Age groups </TH><TH id=fc1 colSpan=6>Cumulative (Aug. 25, 2013 to March 29, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=fc2 colSpan=4 headers=fc1>Influenza A</TH><TH id=fc7 headers=fc1>B</TH><TH id=fc8 headers=fc1>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=fc3 headers="fc1 fc2">A Total</TH><TH id=fc4 class=lightred headers="fc1 fc2">A(H1) pdm09</TH><TH id=fc5 class=lightred headers="fc1 fc2">A(H3)</TH><TH id=fc6 class=lightred headers="fc1 fc2">A (UnS)</TH><TD class=alignCenter headers="fc1 fc7">Total</TD><TD class=alignCenter headers="fc1 fc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=8><SUP id=footnote_t6_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=fr2 class=alignLeft headers=fr1>0-4 years</TH><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc3">588 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc4">280 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc5">7 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc6">301 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc7">59 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc8">647 (17%) </TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years</TH><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc3">129 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc4">64 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc5">5 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc6">60 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc7">55 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc8">184 (5%) </TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years</TH><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc3">35 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc4">20 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc5">3 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc6">12 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc7">2 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc8">37 (1%) </TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc3">590 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc4">413 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc5">4 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc6">173 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc7">26 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc8">616 (16%) </TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc3">1081 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc4">686 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc5">25 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc6">370 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc7">80 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc8">1161 (30%) </TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc3">881 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc4">456 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc5">72 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc6">353 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc7">198 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc8">1079 (28%) </TD></TR><TR><TH id=fr10 class=alignLeft headers=fr1>Unknown</TH><TD class=alignRight headers="fc1 fc2 fc3">127 </TD><TD class=alignRight headers="fc1 fc2 fc4">97 </TD><TD class=alignRight headers="fc1 fc2 fc5">3 </TD><TD class=alignRight headers="fc1 fc2 fc6">27 </TD><TD class=alignRight headers="fc1 fc7">5 </TD><TD class=alignRight headers="fc1 fc8">132 (3%) </TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignRight headers="fr1 fr8 fc1 fc2 fc3">3431 </TD><TD class="alignRight lightred" headers="fr1 fr8 fc1 fc2 fc4">2016 </TD><TD class="alignRight lightred" headers="fr1 fr8 fc1 fc2 fc5">119 </TD><TD class="alignRight lightred" headers="fr1 fr8 fc1 fc2 fc6">1296 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc7">425 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc8">3856 </TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP> </TH><TD class=alignRight headers="fr1 fr9 fc1 fc2 fc3">89.0% </TD><TD class="alignRight lightred" headers="fr1 fr9 fc1 fc2 fc4">58.8% </TD><TD class="alignRight lightred" headers="fr1 fr9 fc1 fc2 fc5">3.5% </TD><TD class="alignRight lightred" headers="fr1 fr9 fc1 fc2 fc6">37.8% </TD><TD class=alignRight headers="fr1 fr9 fc1 fc7">11.0% </TD><TD class=alignRight headers="fr1 fr9 fc1 fc8">100% </TD></TR></TBODY></TABLE>
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2013-14 on the Public Health Agency of Canada website.

.../
http://www.phac-aspc.gc.ca/fluwatch/13-14/w13_14/index-eng.php
 
Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 14

Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 14

FluWatch report: March 30 to April 5, 2014 (Week 14)

Posted 2014-04-11For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
<A title="Flu Watch (Version PDF, 113 KB - 6 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/13-14/w14_14/pdf/fw2014-14-eng.pdf">FluWatch report: March 30 to April 5, 2014 (Week 14) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 291 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

?? Help with PDF documents

Overall Summary
  • In week 14, influenza activity in Canada continues to decline slowly, with fewer cases of influenza B reported compared to the previous week. Although the influenza A(H1N1) virus was the most common influenza virus this season, the majority of influenza viruses circulating currently are influenza B.
  • While the influenza A(H1N1) virus has mostly affected adults 20-64 years of age this season, influenza B is having a greater impact on adults 65 years of age and older, as well as young persons 5 to 19 years of age.
  • As of week 14, 3,946 hospitalizations and 223 deaths have been reported from participating regions, which is comparable to reports in past influenza seasons.
  • Influenza activity remains within expected levels for this time of year.
Influenza/ILI Activity (geographic spread)

The number of regions reporting localized or widespread influenza activity has been stable in recent weeks, with the majority of activity reported in Eastern Canada. In week 14, one region in Ontario reported widespread activity and five regions (ON(4) and QC(1)) reported localized activity (Figure 1).
Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 14


right_ofmap.gif



Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
Influenza and Other Respiratory Virus Detections

The number of positive influenza tests decreased from 697 in week 13 to 613 (11.7% of tests) in week 14. Influenza B remained the predominant virus in week 14, representing 81% of influenza detections (Figure 2). The highest proportions of influenza B this season have been reported from Newfoundland & Labrador (34.5%) and Quebec (29.0%), followed by Ontario (20.5%) and British Columbia (10.2%) (Table 1). Slightly more influenza B has been observed to date this season compared to the same time during the 2012-13 season. Among the 20,448 cases for which information on age and type/subtype has been received this season, 53.8% were 20-64 years of age (Table 2). Significantly greater proportions of influenza B cases have been ≥65 years of age and 5-19 years of age compared to cases of A(H1N1)pdm09. The proportion of influenza detections among persons ≥65 years of age has increased in recent weeks, while the proportion of detections in other age-groups was stable or declining.

Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
2014-w14-fg2-eng.gif

Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
The number of positive tests for RSV has been declining gradually over recent weeks, similar to the trend observed in recent seasons. The number of positive tests for parainfluenza and coronavirus have followed a downward trend since early February but both increased in week 14. More detections of adenovirus and human metapneumovirus have been reported compared to the same period last season, but both have declined over the past two weeks. Detections of rhinovirus have been relatively stable during the winter months, although these detections represent an increasing percentage of tests positive since early January (Figure 3).
For more details, see the weekly Respiratory Virus Detections in Canada Report.
Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2013-14
2014-w14-fg3-eng.gif


Top of Page
RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
<TABLE id=t1 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly and cumulative numbers of positive influenza specimens
by type, subtype and province, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=ac1 colSpan=5>Weekly
(March 30, 2013 to April 5, 2014)</TH><TH id=ac8 colSpan=5>Cumulative
(August 25, 2013 to April 5, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=4 headers=ac1>Influenza A</TH><TH id=ac7 headers=ac1>B</TH><TH id=ac9 colSpan=4 headers=ac8>Influenza A</TH><TH id=ac14 headers=ac8>B</TH></TR><TR class=bg-colour-grey-light><TH id=ac3 headers="ac1 ac2">A Total</TH><TH id=ac4 class=lightred headers="ac1 ac2">A(H1)pdm09</TH><TH id=ac5 class=lightred headers="ac1 ac2">A(H3)</TH><TH id=ac6 class=lightred headers="ac1 ac2">A(UnS)</TH><TH class=alignCenter headers="ac1 ac7">B Total</TH><TH id=ac10 headers="ac8 ac9">A Total</TH><TH id=ac11 class=lightred headers="ac8 ac9">A(H1)pdm09</TH><TH id=ac12 class=lightred headers="ac8 ac9">A(H3)</TH><TH id=ac13 class=lightred headers="ac8 ac9">A(UnS)</TH><TD class=alignCenter headers="ac8 ac14">B Total</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=alignLeft headers=ar1>BC</TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">2</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">2</TD><TD class=alignRight headers="ar1 ar2 ac1 ac7">3</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac10">1780</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac11">1601</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac12">60</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac13">119</TD><TD class=alignRight headers="ar1 ar2 ac8 ac14">203</TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">15</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">13</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">2</TD><TD class=alignRight headers="ar1 ar3 ac1 ac7">31</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac10">3810</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac11">3441</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac12">58</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac13">311</TD><TD class=alignRight headers="ar1 ar3 ac8 ac14">226</TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">7</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">3</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">1</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">3</TD><TD class=alignRight headers="ar1 ar4 ac1 ac7">4</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac10">1362</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac11">978</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac12">7</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac13">377</TD><TD class=alignRight headers="ar1 ar4 ac8 ac14">57</TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">8</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">4</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">1</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">3</TD><TD class=alignRight headers="ar1 ar5 ac1 ac7">0</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac10">649</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac11">458</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac12">3</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac13">188</TD><TD class=alignRight headers="ar1 ar5 ac8 ac14">19</TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">51</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">6</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">24</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">21</TD><TD class=alignRight headers="ar1 ar6 ac1 ac7">300</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac10">5640</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac11">2468</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac12">318</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac13">2854</TD><TD class=alignRight headers="ar1 ar6 ac8 ac14">1458</TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">21</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">21</TD><TD class=alignRight headers="ar1 ar7 ac1 ac7">138</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac10">5309</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac11">676</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac12">3</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac13">4630</TD><TD class=alignRight headers="ar1 ar7 ac8 ac14">2168</TD></TR><TR><TH id=ar8 class=alignLeft headers=ar1>NB</TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac7">7</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac10">1488</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac11">370</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac12">1</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac13">1117</TD><TD class=alignRight headers="ar1 ar8 ac8 ac14">45</TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">3</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">3</TD><TD class=alignRight headers="ar1 ar9 ac1 ac7">0</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac10">170</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac11">134</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac12">4</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac13">32</TD><TD class=alignRight headers="ar1 ar9 ac8 ac14">4</TD></TR><TR><TH id=ar10 class=alignLeft headers=ar1>PE</TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac7">0</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac10">118</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac11">117</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac13">1</TD><TD class=alignRight headers="ar1 ar10 ac8 ac14">1</TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">7</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac6">7</TD><TD class=alignRight headers="ar1 ar11 ac1 ac7">16</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac10">360</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac11">104</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac13">256</TD><TD class=alignRight headers="ar1 ar11 ac8 ac14">190</TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">114</TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac4">26</TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac5">26</TD><TD class="alignRight lightred" headers="ar1 ar12 ac1 ac2 ac6">62</TD><TD class=alignRight headers="ar1 ar12 ac1 ac7">499</TD><TD class=alignRight headers="ar1 ar12 ac8 ac9 ac10">20686</TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac11">10347</TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac12">454</TD><TD class="alignRight lightred" headers="ar1 ar12 ac8 ac9 ac13">9885</TD><TD class=alignRight headers="ar1 ar12 ac8 ac14">4371</TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="ar1 ar13 ac1 ac2 ac3">18.6%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac4">22.8%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac5">22.8%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac1 ac2 ac6">54.4%</TD><TD class=alignRight headers="ar1 ar13 ac1 ac7">81.4%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac9 ac10">82.6%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac11">50.0%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac12">2.2%</TD><TD class="alignRight lightred" headers="ar1 ar13 ac8 ac9 ac13">47.8%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac14">17.4%</TD></TR></TBODY></TABLE>
<TABLE id=t2 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups (years)</TH><TH id=bc1 colSpan=5>Weekly
(March 30 to April 5, 2014)</TH><TH id=bc8 colSpan=7>Cumulative
(August 25, 2013 to April 5, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=bc2 colSpan=4 headers=bc1>Influenza A</TH><TH id=bc7 headers=bc1>B</TH><TH id=bc9 colSpan=4 headers=bc8>Influenza A</TH><TH id=bc14 headers=bc8>B</TH><TH id=bc15 colSpan=2 headers=bc8>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=bc3 headers="bc1 bc2">A Total</TH><TH id=bc4 class="lightred " headers="bc1 bc2">A(H1) pdm09</TH><TH id=bc5 class="lightred " headers="bc1 bc2">A(H3)</TH><TH id=bc6 class="lightred " headers="bc1 bc2">A (UnS)</TH><TD class=alignCenter headers="bc1 bc7">Total</TD><TH id=bc10 headers="bc8 bc9">A Total</TH><TH id=bc11 class="lightred " headers="bc8 bc9">A(H1) pdm09</TH><TH id=bc12 class="lightred " headers="bc8 bc9">A(H3)</TH><TH id=bc13 class="lightred " headers="bc8 bc9">A (UnS)</TH><TD class=alignCenter headers="bc8 bc14">Total</TD><TH id=bc16 headers="bc8 bc15">#</TH><TH id=bc17 headers="bc8 bc15">%</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13><SUP id=footnote_t2_1>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP id=footnote_t2_2>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
<SUP id=footnote_t2_3>3 </SUP>Table 2 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=br2 class=alignLeft headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">8</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">3</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">4</TD><TD class=alignRight headers="br1 br2 bc1 bc7">21</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">3232</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">1441</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">37</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1754</TD><TD class=alignRight headers="br1 br2 bc8 bc14">378</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc16">3610</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc17">17.7%</TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">3</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">3</TD><TD class=alignRight headers="br1 br3 bc1 bc7">21</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1310</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">703</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">19</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">588</TD><TD class=alignRight headers="br1 br3 bc8 bc14">569</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc16">1879</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc17">9.2%</TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">13</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">5</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">8</TD><TD class=alignRight headers="br1 br4 bc1 bc7">34</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">5043</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">2796</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">39</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">2208</TD><TD class=alignRight headers="br1 br4 bc8 bc14">641</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc16">5684</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc17">27.8%</TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">10</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">2</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">2</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">6</TD><TD class=alignRight headers="br1 br5 bc1 bc7">57</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">4416</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">2380</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">55</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">1981</TD><TD class=alignRight headers="br1 br5 bc8 bc14">911</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc16">5327</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc17">26.1%</TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">18</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">3</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">6</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">9</TD><TD class=alignRight headers="br1 br6 bc1 bc7">96</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">2484</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">992</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">125</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">1367</TD><TD class=alignRight headers="br1 br6 bc8 bc14">1324</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc16">3808</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc17">18.6%</TD></TR><TR><TH id=br7 class=alignLeft headers=br1>Unknown</TH><TD class=alignRight headers="br1 br7 bc1 bc2 bc3">2</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc4">1</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc6">1</TD><TD class=alignRight headers="br1 br7 bc1 bc7">1</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc10">135</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">102</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">20</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">13</TD><TD class=alignRight headers="br1 br7 bc8 bc14">5</TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc16">140</TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc17">0.7%</TD></TR><TR><TH id=br8 class=alignLeft headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">54</TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc4">14</TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc5">9</TD><TD class="alignRight lightred" headers="br1 br8 bc1 bc2 bc6">31</TD><TD class=alignRight headers="br1 br8 bc1 bc7">230</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">16620</TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc11">8414</TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc12">295</TD><TD class="alignRight lightred" headers="br1 br8 bc8 bc9 bc13">7911</TD><TD class=alignRight headers="br1 br8 bc8 bc14">3828</TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc16">20448</TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc17">100.0%</TD></TR><TR><TH id=br9 class=alignLeft headers=br1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="br1 br9 bc1 bc2 bc3">19.0%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc4">25.9%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc5">16.7%</TD><TD class="alignRight lightred" headers="br1 br9 bc1 bc2 bc6">57.4%</TD><TD class=alignRight headers="br1 br9 bc1 bc7">81.0%</TD><TD class=alignRight headers="br1 br9 bc8 bc9 bc10">81.3%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc11">50.6%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc12">1.8%</TD><TD class="alignRight lightred" headers="br1 br9 bc8 bc9 bc13">47.6%</TD><TD class=alignRight headers="br1 br9 bc8 bc14">18.7%</TD><TD class=alignRight></TD><TD class=alignRight></TD></TR></TBODY></TABLE>

Top of Page
Influenza Strain Characterizations

During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 1,740 influenza viruses [86 A(H3N2), 1,301 A(H1N1)pdm09 and 353 influenza B]. The vast majority (99%) of viruses were similar to the strains recommended by the WHO for the 2013-14 seasonal influenza vaccine. Two A(H1N1)pdm09 viruses showed reduced titres to antiserum against the reference A/California/07/2009 strain. Nineteen influenza B viruses were similar to the strain recommended by the WHO for the 2011-12 vaccine (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2013-2014, N = 1740
2014-w14-fg4-eng.gif

The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
The recommended components for the 2013-2014 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009 (H1N1)pdm09-like virus, an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b (e.g. A/Texas/50/2012), and a B/Massachusetts/2/2012-like virus (Yamagata lineage).


Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
Antiviral Resistance

During the 2013-2014 influenza season, NML has tested 1,368 influenza viruses for resistance to oseltamivir and all but two were sensitive. All 1,370 viruses tested for resistance to zanamivir were sensitive. All 1,454 influenza A viruses tested for amantadine resistance were resistant (Table 3).
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2013-2014</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=cr1 rowSpan=2>Virus type and subtype</TH><TH id=cc1 colSpan=2>Oseltamivir</TH><TH id=cc4 colSpan=2>Zanamivir</TH><TH id=cc7 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=cc2 headers=cc1># tested</TH><TH id=cc3 headers=cc1># resistant (%)</TH><TH id=cc5 headers=cc4># tested</TH><TH id=cc6 headers=cc4># resistant (%)</TH><TH id=cc8 headers=cc7># tested</TH><TH id=cc9 headers=cc7># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=cr2 class="alignLeft bg-colour-blue" headers=cr1>A (H3N2)</TH><TD class=alignRight headers="cr1 cr2 cc1 cc2">66</TD><TD class=alignRight headers="cr1 cr2 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr2 cc4 cc5">66</TD><TD class=alignRight headers="cr1 cr2 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr2 cc7 cc8">114</TD><TD class=alignRight headers="cr1 cr2 cc7 cc9">114 (100%)</TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignRight headers="cr1 cr3 cc1 cc2">1105</TD><TD class=alignRight headers="cr1 cr3 cc1 cc3">2 (0.2%)</TD><TD class=alignRight headers="cr1 cr3 cc4 cc5">1108</TD><TD class=alignRight headers="cr1 cr3 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr3 cc7 cc8">1340</TD><TD class=alignRight headers="cr1 cr3 cc7 cc9">1340 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignRight headers="cr1 cr4 cc1 cc2">197</TD><TD class=alignRight headers="cr1 cr4 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr4 cc4 cc5">196</TD><TD class=alignRight headers="cr1 cr4 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr4 cc7 cc8">NA <SUP>*</SUP></TD><TD class=alignRight headers="cr1 cr4 cc7 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft bg-colour-blue" headers=cr1>TOTAL</TH><TD class=alignRight headers="cr1 cr5 cc1 cc2">1368</TD><TD class=alignRight headers="cr1 cr5 cc1 cc3">2 (0.1%)</TD><TD class=alignRight headers="cr1 cr5 cc4 cc5">1370</TD><TD class=alignRight headers="cr1 cr5 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr5 cc7 cc8">1454</TD><TD class=alignRight headers="cr1 cr5 cc7 cc9">1454 (100%)</TD></TR></TBODY></TABLE>
Influenza-like Illness (ILI) Consultation Rate

The national influenza-like-illness (ILI) consultation rate increased from 22.8/1,000 in week 13 to 32.0/1,000 in week 14; but was still within the expected range for week 14 (Figure 5).
Figure 5. Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014
2014-w14-fg5-eng.gif

Note: No data available for mean rate for weeks 19 to 39 for the 1996-1997 through 2002-2003 seasons. Delays in the reporting of data may cause data to change retrospectively. The calculation of the average ILI consultation rate over 17 seasons was aligned with influenza activity in each season. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. The number of sentinel physicians in each province or territory is as follows: BC(21), AB(80), SK(11), MB(18), ON(169), QC(14), NB(29), NS(26), PE(4), NL(16), NU(1), NT(14), YT(13). Not all sentinel physicians report every week.
Text equivalent for figure 5Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

Top of Page
Influenza Outbreak Surveillance

In week 14, nine new influenza outbreaks were reported: six outbreaks in long-term care facilities, and three in hospitals (Figure 6). In addition, three outbreaks were reported in other settings or communities. Among the 12 influenza outbreaks, ten had data on the influenza type, and all were influenza B. Two additional outbreaks of influenza-like illness were reported in other settings or communities.
Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2013-2014
2014-w14-fg6-eng.gif

1 All provinces and territories except NU report outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
Text equivalent for figure 6Overall number of new influenza outbreaks by report week, Canada, 2013-2014
Pharmacy Surveillance

In week 14, the proportion of prescriptions for antivirals among all age-groups was similar to the previous week. Overall this season, the largest proportion of prescriptions for antivirals has been among children 2-18 years of age and adults 19-64 years of age, in keeping with laboratory detections of influenza (Figure 7). In contrast, the highest proportion of prescriptions for antivirals during the 2012-13 season was among adults ≥65 years of age.
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14
2014-w14-fg7-eng.gif

Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group. Age-groups: Infant: 0-2y, Child: 2-18y; Adult: 19-64y, Senior: ≥65y.
Text equivalent for figure 7Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

Top of Page
Sentinel Hospital Influenza Surveillance

Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In week 14, 11 new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 16 in week 13. Influenza B was reported in 9 of the 11 cases in week 14 (Figure 8a). Although the number of cases is small, a greater proportion of cases with influenza B this season have been children between 2 and 10 years of age compared to A(H1N1)pdm09. No ICU admissions or deaths were reported in week 14.
To date this season, a total of 653 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 85% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children <5 years of age represent 74% of cases to date (Table 4). Ninety-four ICU admissions have been reported, of which 64 (68%) were children <5 years of age (Figure 9a). All but six were cases with influenza A, and 97% of those subtyped were A(H1N1)pdm09. Among the 89 ICU cases with available data, 57 (64%) were reported to have underlying medical conditions. No deaths have been reported.
Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
Adult Influenza Hospitalizations and Deaths (PCIRN)
In week 14, 24 new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported through active surveillance by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 42 in week 13 (Figure 8b). This season, a significantly greater proportion of cases of influenza B have been ≥65 years of age compared to cases of A(H1N1)pdm09. For a fifth consecutive week, the majority of hospitalizations were associated with influenza B, with a greater proportion of cases among adults ≥65 years of age. One ICU admission in an adult ≥65 years of age with influenza B, and no deaths were reported in week 14.
To date this season, 1,481 influenza-associated hospitalizations have been reported by the PCIRN-SOS network, 1,206 (81.4%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). ICU admission was required for 238 hospitalizations, all but 16 of which were cases with influenza A (121 A(H1N1)pdm09, seven A(H3N2) and 94 A(unsubtyped)). Approximately 80% of hospitalizations and ICU admissions were ≥45 years of age. Of the 180 ICU admissions with available information, 157 (87.2%) were reported to have at least one comorbidity and of the 202 ICU admissions with available information 141 (69.8%) reported not having been vaccinated this season. Sixty-seven deaths have been reported, all but seven with influenza A (34 A(H1N1)pdm09, three A(H3N2) and 23 A(unsubtyped)); seven cases 20-44 years of age, 27 cases 45-64 years of age and 33 cases ≥65 years of age (Figure 9b).
Note: PCIRN-SOS conducted passive surveillance from April 30th to November 14th, 2013. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance began November 15th during which time PCIRN site coordinators investigate cases potentially related to influenza. Data from both active and passive surveillance reported during the 2013-14 season are included in this report. The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t4 class=alignCenter>Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=dr1 rowSpan=3>Age groups </TH><TH id=dc1 colSpan=6>Cumulative (Aug. 25, 2013 to April 5, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=dc2 colSpan=4 headers=dc1>Influenza A </TH><TH id=dc7 headers=dc1>B </TH><TH id=dc8 headers=dc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=dc3 headers="dc1 dc2">A Total </TH><TH id=dc4 class="lightred " headers="dc1 dc2">A(H1) pdm09 </TH><TH id=dc5 class="lightred " headers="dc1 dc2">A(H3) </TH><TH id=dc6 class="lightred " headers="dc1 dc2">A (UnS) </TH><TD class=alignCenter headers="dc1 dc7">Total</TD><TD class=alignCenter headers="dc1 dc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t4_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=dr2 class=alignLeft headers=dr1>0-5m </TH><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc3">105</TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc4">34</TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc5">0</TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc6">71</TD><TD class=alignRight headers="dr1 dr2 dc1 dc7">4</TD><TD class=alignRight headers="dr1 dr2 dc1 dc8">109 (17%)</TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc3">161</TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc4">50</TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc5">1</TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc6">110</TD><TD class=alignRight headers="dr1 dr3 dc1 dc7">16</TD><TD class=alignRight headers="dr1 dr3 dc1 dc8">177 (27%)</TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc3">165</TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc4">55</TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc5">3</TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc6">107</TD><TD class=alignRight headers="dr1 dr4 dc1 dc7">30</TD><TD class=alignRight headers="dr1 dr4 dc1 dc8">195 (30%)</TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc3">83</TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc4">27</TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc5">0</TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc6">56</TD><TD class=alignRight headers="dr1 dr5 dc1 dc7">39</TD><TD class=alignRight headers="dr1 dr5 dc1 dc8">122 (19%)</TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc3">40</TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc4">14</TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc5">1</TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc6">25</TD><TD class=alignRight headers="dr1 dr6 dc1 dc7">10</TD><TD class=alignRight headers="dr1 dr6 dc1 dc8">50 (8%)</TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignRight headers="dr1 dr7 dc1 dc2 dc3">554</TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc4">180</TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc5">5</TD><TD class="alignRight lightred" headers="dr1 dr7 dc1 dc2 dc6">369</TD><TD class=alignRight headers="dr1 dr7 dc1 dc7">99</TD><TD class=alignRight headers="dr1 dr7 dc1 dc8">653</TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP> </TH><TD class=alignRight headers="dr1 dr8 dc1 dc2 dc3">84.8%</TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc4">32.5%</TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc5">0.9%</TD><TD class="alignRight lightred" headers="dr1 dr8 dc1 dc2 dc6">66.6%</TD><TD class=alignRight headers="dr1 dr8 dc1 dc7">15.2%</TD><TD class=alignRight headers="dr1 dr8 dc1 dc8">100.0%</TD></TR></TBODY></TABLE>
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 5 - Cumulative numbers of adult hospitalizations with influenza
reported by the PCIRN-SOS network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=er1 rowSpan=3>Age groups </TH><TH id=ec1 class=noWrap colSpan=6>Cumulative (Aug. 25, 2013 to April 5, 2014)<SUP>*</SUP></TH></TR><TR class=bg-colour-yellow><TH id=ec2 colSpan=4 headers=ec1>Influenza A </TH><TH id=ec7 headers=ec1>B </TH><TH id=ec8 headers=ec1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=ec3 headers="ec1 ec2">A Total </TH><TH id=ec4 class=lightred headers="ec1 ec2">A(H1) pdm09 </TH><TH id=ec5 class=lightred headers="ec1 ec2">A(H3) </TH><TH id=ec6 class=lightred headers="ec1 ec2">A(UnS) </TH><TD class=alignCenter headers="ec1 ec7">Total</TD><TD class=alignCenter headers="ec1 ec8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t5_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.

<SUP id=t5_star>*</SUP> * Three cases for which the influenza type has not yet been reported, and five cases for which the age-group was not reported, are not included in Table 5.</TD></TR></TFOOT><TBODY><TR><TH id=er2 class=alignLeft headers=er1>16-20 </TH><TD class=alignRight headers="er1 er2 ec1 ec2 ec3">13 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec4">5 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec5">0 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec6">8 </TD><TD class=alignRight headers="er1 er2 ec1 ec7">2 </TD><TD class=alignRight headers="er1 er2 ec1 ec8">15 (1%) </TD></TR><TR><TH id=er3 class=alignLeft headers=er1>20-44 </TH><TD class=alignRight headers="er1 er3 ec1 ec2 ec3">254 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec4">131 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec5">6 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec6">117 </TD><TD class=alignRight headers="er1 er3 ec1 ec7">17 </TD><TD class=alignRight headers="er1 er3 ec1 ec8">271 (18%) </TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignRight headers="er1 er4 ec1 ec2 ec3">471 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec4">221 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec5">7 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec6">243 </TD><TD class=alignRight headers="er1 er4 ec1 ec7">67 </TD><TD class=alignRight headers="er1 er4 ec1 ec8">538 (37%) </TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignRight headers="er1 er5 ec1 ec2 ec3">463 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec4">214 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec5">43 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec6">206 </TD><TD class=alignRight headers="er1 er5 ec1 ec7">186 </TD><TD class=alignRight headers="er1 er5 ec1 ec8">649 (44%) </TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignRight headers="er1 er6 ec1 ec2 ec3">1201 </TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec4">571 </TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec5">56 </TD><TD class="alignRight lightred" headers="er1 er6 ec1 ec2 ec6">574 </TD><TD class=alignRight headers="er1 er6 ec1 ec7">272 </TD><TD class=alignRight headers="er1 er6 ec1 ec8">1473 </TD></TR><TR><TH id=er7 class=alignLeft headers=er1>%<SUP>1</SUP></TH><TD class=alignRight headers="er1 er7 ec1 ec2 ec3">82% </TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec4">48% </TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec5">5% </TD><TD class="alignRight lightred" headers="er1 er7 ec1 ec2 ec6">48% </TD><TD class=alignRight headers="er1 er7 ec1 ec7">18% </TD><TD class=alignRight headers="er1 er7 ec1 ec8">100% </TD></TR></TBODY></TABLE>
Figure 8. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w14-fg8a-eng.gif


Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w14-fg8b-eng.gif

* See footnote above following the section related to PCIRN-SOS data.
Text equivalent for figure 8bNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Adult hospitalizations (>16 year of age, PCIRN-SOS)
Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w14-fg9a-eng.gif

Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w14-fg9b-eng.gif

Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Adult hospitalizations (≥16 year of age, PCIRN-SOS)

Top of Page
Provincial/Territorial Influenza Hospitalizations and Deaths

In week 14, 89 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories.<SUP>*</SUP> As with other surveillance indicators in week 14, the majority were cases of influenza B (67, 75.3%). Seven ICU admissions were reported in week 14: one infant under 6 months of age, one adult 20-44 years of age, four adults 45-64 years of age, and one adult ≥65 years of age; five of the seven cases had influenza A. Five deaths were reported in week 14; all of which were adults ≥65 years of age, and four of the five had influenza B. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total.
To date this season, 3,946 influenza-associated hospitalizations have been reported, 87.5% with influenza A. The majority (58.3%) of hospitalizations have been cases 45 years of age of older. A significantly greater proportion of cases of influenza B have been ≥65 years of age, and 5-19 years of age, compared to cases of A(H1N1)pdm09 this season (Table 6). A total of 332 ICU admissions have been reported this season, of which 65.1% were adults 20-64 years of age. A total of 223 deaths have been reported. An equal proportion of deaths have been among adults 20-64 years of age and adults ≥65 years of age (each 45.7%). In keeping with the late-season circulation, influenza B has been increasingly reported among hospitalized cases of influenza. To date this season, influenza B has been reported in 12.5% of hospitalizations and 12.1% of deaths. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.
* Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, NS, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t6 class=alignCenter>Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=fr1 rowSpan=3>Age groups </TH><TH id=fc1 colSpan=6>Cumulative (Aug. 25, 2013 to April 5, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=fc2 colSpan=4 headers=fc1>Influenza A</TH><TH id=fc7 headers=fc1>B</TH><TH id=fc8 headers=fc1>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=fc3 headers="fc1 fc2">A Total</TH><TH id=fc4 class=lightred headers="fc1 fc2">A(H1) pdm09</TH><TH id=fc5 class=lightred headers="fc1 fc2">A(H3)</TH><TH id=fc6 class=lightred headers="fc1 fc2">A (UnS)</TH><TD class=alignCenter headers="fc1 fc7">Total</TD><TD class=alignCenter headers="fc1 fc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=8><SUP id=footnote_t6_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=fr2 class=alignLeft headers=fr1>0-4 years</TH><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc3">591 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc4">282 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc5">7 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc6">302 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc7">68 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc8">659 (17%) </TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years</TH><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc3">130 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc4">64 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc5">5 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc6">61 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc7">61 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc8">191 (5%) </TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years</TH><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc3">35 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc4">20 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc5">3 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc6">12 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc7">2 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc8">37 (1%) </TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc3">593 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc4">415 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc5">4 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc6">174 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc7">33 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc8">626 (16%) </TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc3">1089 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc4">688 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc5">25 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc6">376 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc7">94 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc8">1183 (30%) </TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc3">888 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc4">458 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc5">73 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc6">357 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc7">229 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc8">1117 (28%) </TD></TR><TR><TH id=fr10 class=alignLeft headers=fr1>Unknown</TH><TD class=alignRight headers="fc1 fc2 fc3">128 </TD><TD class=alignRight headers="fc1 fc2 fc4">97 </TD><TD class=alignRight headers="fc1 fc2 fc5">3 </TD><TD class=alignRight headers="fc1 fc2 fc6">28 </TD><TD class=alignRight headers="fc1 fc7">5 </TD><TD class=alignRight headers="fc1 fc8">133 (3%) </TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignRight headers="fr1 fr8 fc1 fc2 fc3">3454 </TD><TD class="alignRight lightred" headers="fr1 fr8 fc1 fc2 fc4">2024 </TD><TD class="alignRight lightred" headers="fr1 fr8 fc1 fc2 fc5">120 </TD><TD class="alignRight lightred" headers="fr1 fr8 fc1 fc2 fc6">1310 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc7">492 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc8">3946 </TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP> </TH><TD class=alignRight headers="fr1 fr9 fc1 fc2 fc3">87.5% </TD><TD class="alignRight lightred" headers="fr1 fr9 fc1 fc2 fc4">58.6% </TD><TD class="alignRight lightred" headers="fr1 fr9 fc1 fc2 fc5">3.5% </TD><TD class="alignRight lightred" headers="fr1 fr9 fc1 fc2 fc6">37.9% </TD><TD class=alignRight headers="fr1 fr9 fc1 fc7">12.5% </TD><TD class=alignRight headers="fr1 fr9 fc1 fc8">100% </TD></TR></TBODY></TABLE>
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2013-14 on the Public Health Agency of Canada website.

.../
http://www.phac-aspc.gc.ca/fluwatch/13-14/w14_14/index-eng.php
 
Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 15

Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 15

FluWatch report: April 6 to 12, 2014 (Week 15)

Posted 2014-04-17For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
<A title="Flu Watch (Version PDF, 113 KB - 6 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/13-14/w15_14/pdf/fw2014-15-eng.pdf">FluWatch report: April 6 to 12, 2014 (Week 15) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 291 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

?? Help with PDF documents

Overall Summary
  • In week 15, influenza activity in Canada was sustained by continued circulation of influenza B. Ontario reported a marked increase in influenza activity and some western provinces have also reported increases in detections of influenza B.
  • While the influenza A(H1N1) virus has mostly affected adults 20-64 years of age this season, influenza B is having a greater impact on adults 65 years of age and older, as well as young persons 5 to 19 years of age.
  • As of week 15, 4,070 hospitalizations and 226 deaths have been reported from participating regions, which is comparable to reports in past influenza seasons.
  • Influenza activity remains within expected levels for this time of year.
Influenza/ILI Activity (geographic spread)

The number of regions reporting localized or widespread influenza activity has been stable for the past seven weeks. In week 15, two regions (ON(1) and QC(1)) reported widespread activity and seven regions (BC(1), ON(4), NS(1) and NB(1)) reported localized activity. Data was not reported for five regions in week 15 (Figure 1).
Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 15


right_ofmap.gif



Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
Influenza and Other Respiratory Virus Detections

The number of positive influenza tests increased from 638 in week 14 to 722 (15.3% of tests) in week 15, revealing that influenza B circulation has not yet reached its peak in Canada. Influenza B remained the predominant virus in week 15, representing 88% of influenza detections (Figure 2). Influenza B detections are declining in Newfoundland & Labrador and Quebec, but are increasing sharply in Ontario. British Columbia, Alberta and Saskatchewan have also reported increases in influenza B detections in recent weeks (Table 1). Significantly greater proportions of influenza B cases have been ≥65 years of age and 5-19 years of age compared to cases of A(H1N1)pdm09. Among cases for which information on age and type/subtype has been received, 42.8% of the cases in week 15 were ≥65 years of age compared to 19.2% of cases for the season to date (Table 2).

Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
2014-w15-fg2-eng.gif

Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
The number of positive tests for RSV continued to decline from a peak in early February. The number of positive tests for parainfluenza and adenovirus have been variable in recent weeks. Detections of coronavirus had been on a downward trend, but have increased over the past two weeks. More detections human metapneumovirus have been reported compared to the same period last season, but they have declined sharply over the past three weeks. Detections of rhinovirus have been relatively stable during the winter months, although these detections represent an increasing percentage of tests positive since early January (Figure 3).
For more details, see the weekly Respiratory Virus Detections in Canada Report.
Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2013-14
2014-w15-fg3-eng.gif


Top of Page
RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
<TABLE id=t1 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly and cumulative numbers of positive influenza specimens
by type, subtype and province, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=ac1 colSpan=5>Weekly
(April 6, 2014 to April 12, 2014)</TH><TH id=ac8 colSpan=5>Cumulative
(August 25, 2013 to April 12, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=4 headers=ac1>Influenza A</TH><TH id=ac7 headers=ac1>B</TH><TH id=ac9 colSpan=4 headers=ac8>Influenza A</TH><TH id=ac14 headers=ac8>B</TH></TR><TR class=bg-colour-grey-light><TH id=ac3 headers="ac1 ac2">A Total</TH><TH id=ac4 class=bg-colour-blue headers="ac1 ac2">A(H1)pdm09</TH><TH id=ac5 class=bg-colour-blue headers="ac1 ac2">A(H3)</TH><TH id=ac6 class=bg-colour-blue headers="ac1 ac2">A(UnS)</TH><TH class=alignCenter headers="ac1 ac7">B Total</TH><TH id=ac10 headers="ac8 ac9">A Total</TH><TH id=ac11 class=bg-colour-blue headers="ac8 ac9">A(H1)pdm09</TH><TH id=ac12 class=bg-colour-blue headers="ac8 ac9">A(H3)</TH><TH id=ac13 class=bg-colour-blue headers="ac8 ac9">A(UnS)</TH><TD class=alignCenter headers="ac8 ac14">B Total</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=alignLeft headers=ar1>BC</TH><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac3">7 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac5">7 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac6">0 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac7">36 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac10">1787 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac11">1612 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac12">51 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac13">124 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac14">261 </TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac3">9 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac4">3 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac5">1 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac6">5 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac7">42 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac10">3819 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac11">3446 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac12">59 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac13">314 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac14">269 </TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac3">14 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac4">7 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac6">7 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac7">24 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac10">1376 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac11">985 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac12">7 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac13">384 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac14">81 </TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac3">5 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac4">2 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac6">3 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac7">1 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac10">654 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac11">460 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac12">3 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac13">191 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac14">20 </TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac3">35 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac4">8 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac5">13 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac6">14 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac7">389 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac10">5675 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac11">2476 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac12">334 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac13">2865 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac14">1847 </TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac3">15 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac4">1 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac5">1 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac6">13 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac7">116 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac10">5324 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac11">677 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac12">4 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac13">4643 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac14">2284 </TD></TR><TR><TH id=ar8 class=alignLeft headers=ar1>NB</TH><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac3">0 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac6">0 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac7">10 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac10">1488 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac11">370 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac12">1 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac13">1117 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac14">55 </TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac3">2 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac6">2 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac7">1 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac10">172 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac11">134 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac12">4 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac13">34 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac14">5 </TD></TR><TR><TH id=ar10 class=alignLeft headers=ar1>PE</TH><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac3">0 </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac6">0 </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac7">1 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac10">118 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac11">117 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac12">0 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac13">1 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac14">2 </TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac3">2 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac6">2 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac7">13 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac10">362 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac11">104 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac12">0 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac13">258 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac14">203 </TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignCenter headers="ar1 ar12 ac1 ac2 ac3">89 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac1 ac2 ac4">21 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac1 ac2 ac5">22 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac1 ac2 ac6">46 </TD><TD class=alignCenter headers="ar1 ar12 ac1 ac7">633 </TD><TD class=alignCenter headers="ar1 ar12 ac8 ac9 ac10">20775 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac8 ac9 ac11">10381 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac8 ac9 ac12">463 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac8 ac9 ac13">9931 </TD><TD class=alignCenter headers="ar1 ar12 ac8 ac14">5027 </TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignCenter headers="ar1 ar13 ac1 ac2 ac3">12.3% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac1 ac2 ac4">23.6% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac1 ac2 ac5">24.7% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac1 ac2 ac6">51.7% </TD><TD class=alignCenter headers="ar1 ar13 ac1 ac7">87.7% </TD><TD class=alignCenter headers="ar1 ar13 ac8 ac9 ac10">80.5% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac8 ac9 ac11">50.0% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac8 ac9 ac12">2.2% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac8 ac9 ac13">47.8% </TD><TD class=alignCenter headers="ar1 ar13 ac8 ac14">19.5% </TD></TR></TBODY></TABLE>
<TABLE id=t2 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups (years)</TH><TH id=bc1 colSpan=5>Weekly
(April 6 to April 12, 2014)</TH><TH id=bc8 colSpan=7>Cumulative
(August 25, 2013 to April 12, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=bc2 colSpan=4 headers=bc1>Influenza A</TH><TH id=bc7 headers=bc1>B</TH><TH id=bc9 colSpan=4 headers=bc8>Influenza A</TH><TH id=bc14 headers=bc8>B</TH><TH id=bc15 colSpan=2 headers=bc8>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=bc3 headers="bc1 bc2">A Total</TH><TH id=bc4 class="bg-colour-blue " headers="bc1 bc2">A(H1) pdm09</TH><TH id=bc5 class="bg-colour-blue " headers="bc1 bc2">A(H3)</TH><TH id=bc6 class="bg-colour-blue " headers="bc1 bc2">A (UnS)</TH><TD class=alignCenter headers="bc1 bc7">Total</TD><TH id=bc10 headers="bc8 bc9">A Total</TH><TH id=bc11 class="bg-colour-blue " headers="bc8 bc9">A(H1) pdm09</TH><TH id=bc12 class="bg-colour-blue " headers="bc8 bc9">A(H3)</TH><TH id=bc13 class="bg-colour-blue " headers="bc8 bc9">A (UnS)</TH><TD class=alignCenter headers="bc8 bc14">Total</TD><TH id=bc16 headers="bc8 bc15">#</TH><TH id=bc17 headers="bc8 bc15">%</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13><SUP id=footnote_t2_1>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP id=footnote_t2_2>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
<SUP id=footnote_t2_3>3 </SUP>Table 2 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=br2 class=alignLeft headers=br1><5</TH><TD class=alignCenter headers="br1 br2 bc1 bc2 bc3">6 </TD><TD class=alignCenter headers="br1 br2 bc1 bc2 bc4">0 </TD><TD class=alignCenter headers="br1 br2 bc1 bc2 bc5">0 </TD><TD class=alignCenter headers="br1 br2 bc1 bc2 bc6">6 </TD><TD class=alignCenter headers="br1 br2 bc1 bc7">21 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc10">3242 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc11">1442 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc12">38 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc13">1762 </TD><TD class=alignCenter headers="br1 br2 bc8 bc14">410 </TD><TD class=alignCenter headers="br1 br2 bc8 bc15 bc16">3652 </TD><TD class=alignCenter headers="br1 br2 bc8 bc15 bc17">17.4% </TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignCenter headers="br1 br3 bc1 bc2 bc3">3 </TD><TD class=alignCenter headers="br1 br3 bc1 bc2 bc4">1 </TD><TD class=alignCenter headers="br1 br3 bc1 bc2 bc5">0 </TD><TD class=alignCenter headers="br1 br3 bc1 bc2 bc6">2 </TD><TD class=alignCenter headers="br1 br3 bc1 bc7">30 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc10">1316 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc11">705 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc12">19 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc13">592 </TD><TD class=alignCenter headers="br1 br3 bc8 bc14">620 </TD><TD class=alignCenter headers="br1 br3 bc8 bc15 bc16">1936 </TD><TD class=alignCenter headers="br1 br3 bc8 bc15 bc17">9.2% </TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignCenter headers="br1 br4 bc1 bc2 bc3">7 </TD><TD class=alignCenter headers="br1 br4 bc1 bc2 bc4">1 </TD><TD class=alignCenter headers="br1 br4 bc1 bc2 bc5">0 </TD><TD class=alignCenter headers="br1 br4 bc1 bc2 bc6">6 </TD><TD class=alignCenter headers="br1 br4 bc1 bc7">43 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc10">5055 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc11">2802 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc12">40 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc13">2213 </TD><TD class=alignCenter headers="br1 br4 bc8 bc14">726 </TD><TD class=alignCenter headers="br1 br4 bc8 bc15 bc16">5781 </TD><TD class=alignCenter headers="br1 br4 bc8 bc15 bc17">27.5% </TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignCenter headers="br1 br5 bc1 bc2 bc3">12 </TD><TD class=alignCenter headers="br1 br5 bc1 bc2 bc4">0 </TD><TD class=alignCenter headers="br1 br5 bc1 bc2 bc5">0 </TD><TD class=alignCenter headers="br1 br5 bc1 bc2 bc6">12 </TD><TD class=alignCenter headers="br1 br5 bc1 bc7">68 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc10">4432 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc11">2382 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc12">56 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc13">1994 </TD><TD class=alignCenter headers="br1 br5 bc8 bc14">1025 </TD><TD class=alignCenter headers="br1 br5 bc8 bc15 bc16">5457 </TD><TD class=alignCenter headers="br1 br5 bc8 bc15 bc17">26.0% </TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignCenter headers="br1 br6 bc1 bc2 bc3">11 </TD><TD class=alignCenter headers="br1 br6 bc1 bc2 bc4">1 </TD><TD class=alignCenter headers="br1 br6 bc1 bc2 bc5">6 </TD><TD class=alignCenter headers="br1 br6 bc1 bc2 bc6">4 </TD><TD class=alignCenter headers="br1 br6 bc1 bc7">132 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc10">2505 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc11">995 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc12">138 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc13">1372 </TD><TD class=alignCenter headers="br1 br6 bc8 bc14">1517 </TD><TD class=alignCenter headers="br1 br6 bc8 bc15 bc16">4022 </TD><TD class=alignCenter headers="br1 br6 bc8 bc15 bc17">19.2% </TD></TR><TR><TH id=br7 class=alignLeft headers=br1>Unknown</TH><TD class=alignCenter headers="br1 br7 bc1 bc2 bc3">1 </TD><TD class=alignCenter headers="br1 br7 bc1 bc2 bc4">0 </TD><TD class=alignCenter headers="br1 br7 bc1 bc2 bc5">1 </TD><TD class=alignCenter headers="br1 br7 bc1 bc2 bc6">0 </TD><TD class=alignCenter headers="br1 br7 bc1 bc7">0 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc10">136 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc11">102 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc12">21 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc13">13 </TD><TD class=alignCenter headers="br1 br7 bc8 bc14">5 </TD><TD class=alignCenter headers="br1 br7 bc8 bc15 bc16">141 </TD><TD class=alignCenter headers="br1 br7 bc8 bc15 bc17">0.7% </TD></TR><TR><TH id=br8 class=alignLeft headers=br1>Total</TH><TD class=alignCenter headers="br1 br8 bc1 bc2 bc3">40 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc1 bc2 bc4">3 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc1 bc2 bc5">7 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc1 bc2 bc6">30 </TD><TD class=alignCenter headers="br1 br8 bc1 bc7">294 </TD><TD class=alignCenter headers="br1 br8 bc8 bc9 bc10">16686 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc8 bc9 bc11">8428 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc8 bc9 bc12">312 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc8 bc9 bc13">7946 </TD><TD class=alignCenter headers="br1 br8 bc8 bc14">4303 </TD><TD class=alignCenter headers="br1 br8 bc8 bc15 bc16">20989 </TD><TD class=alignCenter headers="br1 br8 bc8 bc15 bc17">100.0% </TD></TR><TR><TH id=br9 class=alignLeft headers=br1>Percentage<SUP>2</SUP></TH><TD class=alignCenter headers="br1 br9 bc1 bc2 bc3">12.0% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc1 bc2 bc4">7.5% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc1 bc2 bc5">17.5% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc1 bc2 bc6">75.0% </TD><TD class=alignCenter headers="br1 br9 bc1 bc7">88.0% </TD><TD class=alignCenter headers="br1 br9 bc8 bc9 bc10">79.5% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc8 bc9 bc11">50.5% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc8 bc9 bc12">1.9% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc8 bc9 bc13">47.6% </TD><TD class=alignCenter headers="br1 br9 bc8 bc14">20.5% </TD><TD class=alignCenter></TD><TD class=alignCenter></TD></TR></TBODY></TABLE>

Top of Page
Influenza Strain Characterizations

During the 2013-2014 influenza season, to week 14, the National Microbiology Laboratory (NML) has antigenically characterized 1,740 influenza viruses [86 A(H3N2), 1,301 A(H1N1)pdm09 and 353 influenza B]. The vast majority (99%) of viruses were similar to the strains recommended by the WHO for the 2013-14 seasonal influenza vaccine. Two A(H1N1)pdm09 viruses showed reduced titres to antiserum against the reference A/California/07/2009 strain. Nineteen influenza B viruses were similar to the strain recommended by the WHO for the 2011-12 vaccine (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2013-2014, N = 1740
2014-w15-fg4-eng.gif

The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
The recommended components for the 2013-2014 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009 (H1N1)pdm09-like virus, an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b (e.g. A/Texas/50/2012), and a B/Massachusetts/2/2012-like virus (Yamagata lineage).


Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
Antiviral Resistance

During the 2013-2014 influenza season, to week 14, NML has tested 1,368 influenza viruses for resistance to oseltamivir and all but two were sensitive. All 1,370 viruses tested for resistance to zanamivir were sensitive. All 1,454 influenza A viruses tested for amantadine resistance were resistant (Table 3).
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2013-2014</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=cr1 rowSpan=2>Virus type and subtype</TH><TH id=cc1 colSpan=2>Oseltamivir</TH><TH id=cc4 colSpan=2>Zanamivir</TH><TH id=cc7 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=cc2 headers=cc1># tested</TH><TH id=cc3 headers=cc1># resistant (%)</TH><TH id=cc5 headers=cc4># tested</TH><TH id=cc6 headers=cc4># resistant (%)</TH><TH id=cc8 headers=cc7># tested</TH><TH id=cc9 headers=cc7># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=cr2 class="alignLeft bg-colour-blue" headers=cr1>A (H3N2)</TH><TD class=alignCenter headers="cr1 cr2 cc1 cc2">66</TD><TD class=alignCenter headers="cr1 cr2 cc1 cc3">0</TD><TD class=alignCenter headers="cr1 cr2 cc4 cc5">66</TD><TD class=alignCenter headers="cr1 cr2 cc4 cc6">0</TD><TD class=alignCenter headers="cr1 cr2 cc7 cc8">114</TD><TD class=alignCenter headers="cr1 cr2 cc7 cc9">114 (100%)</TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignCenter headers="cr1 cr3 cc1 cc2">1105</TD><TD class=alignCenter headers="cr1 cr3 cc1 cc3">2 (0.2%)</TD><TD class=alignCenter headers="cr1 cr3 cc4 cc5">1108</TD><TD class=alignCenter headers="cr1 cr3 cc4 cc6">0</TD><TD class=alignCenter headers="cr1 cr3 cc7 cc8">1340</TD><TD class=alignCenter headers="cr1 cr3 cc7 cc9">1340 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignCenter headers="cr1 cr4 cc1 cc2">197</TD><TD class=alignCenter headers="cr1 cr4 cc1 cc3">0</TD><TD class=alignCenter headers="cr1 cr4 cc4 cc5">196</TD><TD class=alignCenter headers="cr1 cr4 cc4 cc6">0</TD><TD class=alignCenter headers="cr1 cr4 cc7 cc8">NA <SUP>*</SUP></TD><TD class=alignCenter headers="cr1 cr4 cc7 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft bg-colour-blue" headers=cr1>TOTAL</TH><TD class=alignCenter headers="cr1 cr5 cc1 cc2">1368</TD><TD class=alignCenter headers="cr1 cr5 cc1 cc3">2 (0.1%)</TD><TD class=alignCenter headers="cr1 cr5 cc4 cc5">1370</TD><TD class=alignCenter headers="cr1 cr5 cc4 cc6">0</TD><TD class=alignCenter headers="cr1 cr5 cc7 cc8">1454</TD><TD class=alignCenter headers="cr1 cr5 cc7 cc9">1454 (100%)</TD></TR></TBODY></TABLE>
Influenza-like Illness (ILI) Consultation Rate

The national influenza-like-illness (ILI) consultation rate was similar to the previous week at 30.7 consultations per 1,000 patient visits in week 15; which was within the expected range for week 15 (Figure 5).
Figure 5. Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014
2014-w15-fg5-eng.gif

Note: No data available for mean rate for weeks 19 to 39 for the 1996-1997 through 2002-2003 seasons. Delays in the reporting of data may cause data to change retrospectively. The calculation of the average ILI consultation rate over 17 seasons was aligned with influenza activity in each season. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. The number of sentinel physicians in each province or territory is as follows: BC(21), AB(80), SK(11), MB(18), ON(169), QC(14), NB(29), NS(26), PE(4), NL(16), NU(1), NT(14), YT(13). Not all sentinel physicians report every week.
Text equivalent for figure 5Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

Top of Page
Influenza Outbreak Surveillance

In week 15, nine new influenza outbreaks were reported in long-term care facilities (Figure 6). In addition, two outbreaks were reported in other settings or communities. Among the 11 influenza outbreaks, nine had data on the influenza type, and seven of these were influenza B. One additional outbreak of influenza-like illness was reported in a school in week 15.
Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2013-2014
2014-w15-fg6-eng.gif

1 All provinces and territories except NU report outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
Text equivalent for figure 6Overall number of new influenza outbreaks by report week, Canada, 2013-2014
Pharmacy Surveillance

In week 15, the proportion of prescriptions for antivirals among all age-groups was similar to the previous week. Overall this season, the largest proportion of prescriptions for antivirals has been among children 2-18 years of age and adults 19-64 years of age (Figure 7). The proportion of prescriptions for antivirals has increased in Ontario over recent weeks, in keeping with continued circulation of influenza B.
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14
2014-w15-fg7-eng.gif

Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group. Age-groups: Infant: 0-2y, Child: 2-18y; Adult: 19-64y, Senior: ≥65y.
Text equivalent for figure 7Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

Top of Page
Sentinel Hospital Influenza Surveillance

Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In week 15, 12 new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 11 in week 14. Influenza B was reported in 10 of the 12 cases in week 15 (Figure 8a). A greater proportion of cases with influenza B this season have been children between 2 and 10 years of age compared to A(H1N1)pdm09. Two ICU admissions were reported in week 15: one child 6-23 months of age with A(H1N1)pdm09, and one 5-9 years of age with influenza B. No deaths were reported in week 15.
To date this season, a total of 663 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 84% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children <5 years of age represent 74% of cases to date (Table 4). Ninety-seven ICU admissions have been reported, of which 66 (68%) were children <5 years of age (Figure 9a). All but six were cases with influenza A, and 97% of those subtyped were A(H1N1)pdm09. Among the 94 ICU cases with available data, 60 (64%) were reported to have underlying medical conditions. No deaths have been reported.
Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
Adult Influenza Hospitalizations and Deaths (PCIRN)
In week 15, 29 new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported through active surveillance by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 44 in week 14 (Figure 8b). This season, a significantly greater proportion of cases of influenza B have been ≥65 years of age compared to cases of A(H1N1)pdm09. For a sixth consecutive week, the majority of hospitalizations were associated with influenza B, with a greater proportion of cases among adults ≥65 years of age. Two ICU admissions were reported in week 15: one adult 20-44 years of age, and one ≥65 years of age, both with influenza B. No deaths were reported in week 15.
To date this season, 1,575 influenza-associated hospitalizations have been reported by the PCIRN-SOS network, 1,233 (78.3%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). Overall, fewer cases have been reported this season compared to the 2012-13 season, however, nearly four times more cases of influenza B have been reported compared to last year. ICU admission was required for 252 hospitalizations, all but 21 of which were cases with influenza A (122 A(H1N1)pdm09, eight A(H3N2) and 101 A(unsubtyped)). Approximately 80% of hospitalizations and ICU admissions were ≥45 years of age. Of the 186 ICU admissions with available information, 160 (86.0%) were reported to have at least one comorbidity and of the 210 ICU admissions with available information 148 (70.5%) reported not having been vaccinated this season. Seventy-two deaths have been reported, all but nine with influenza A (35 A(H1N1)pdm09, three A(H3N2) and 25 A(unsubtyped)); seven cases 20-44 years of age, 30 cases 45-64 years of age and 35 cases ≥65 years of age (Figure 9b).
Note: PCIRN-SOS conducted passive surveillance from April 30th to November 14th, 2013. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance began November 15th during which time PCIRN site coordinators investigate cases potentially related to influenza. Data from both active and passive surveillance reported during the 2013-14 season are included in this report. The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t4 class=alignCenter>Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=dr1 rowSpan=3>Age groups </TH><TH id=dc1 colSpan=6>Cumulative (Aug. 25, 2013 to April 12, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=dc2 colSpan=4 headers=dc1>Influenza A </TH><TH id=dc7 headers=dc1>B </TH><TH id=dc8 headers=dc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=dc3 headers="dc1 dc2">A Total </TH><TH id=dc4 class="bg-colour-blue " headers="dc1 dc2">A(H1) pdm09 </TH><TH id=dc5 class="bg-colour-blue " headers="dc1 dc2">A(H3) </TH><TH id=dc6 class="bg-colour-blue " headers="dc1 dc2">A (UnS) </TH><TD class=alignCenter headers="dc1 dc7">Total</TD><TD class=alignCenter headers="dc1 dc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t4_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=dr2 class=alignLeft headers=dr1>0-5m </TH><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc3">104</TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc4">34</TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc5">0</TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc6">70</TD><TD class=alignCenter headers="dr1 dr2 dc1 dc7">5</TD><TD class=alignCenter headers="dr1 dr2 dc1 dc8">109 (16%)</TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc3">162</TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc4">51</TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc5">1</TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc6">110</TD><TD class=alignCenter headers="dr1 dr3 dc1 dc7">18</TD><TD class=alignCenter headers="dr1 dr3 dc1 dc8">180 (27%)</TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc3">166</TD><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc4">55</TD><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc5">3</TD><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc6">108</TD><TD class=alignCenter headers="dr1 dr4 dc1 dc7">35</TD><TD class=alignCenter headers="dr1 dr4 dc1 dc8">201 (30%)</TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc3">83</TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc4">27</TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc5">0</TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc6">56</TD><TD class=alignCenter headers="dr1 dr5 dc1 dc7">40</TD><TD class=alignCenter headers="dr1 dr5 dc1 dc8">123 (19%)</TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc3">40</TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc4">14</TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc5">1</TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc6">25</TD><TD class=alignCenter headers="dr1 dr6 dc1 dc7">10</TD><TD class=alignCenter headers="dr1 dr6 dc1 dc8">50 (8%)</TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignCenter headers="dr1 dr7 dc1 dc2 dc3">555</TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc4">181</TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc5">5</TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc6">369</TD><TD class=alignCenter headers="dr1 dr7 dc1 dc7">108</TD><TD class=alignCenter headers="dr1 dr7 dc1 dc8">663</TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP> </TH><TD class=alignCenter headers="dr1 dr8 dc1 dc2 dc3">83.7%</TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc4">32.6%</TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc5">0.9%</TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc6">66.5%</TD><TD class=alignCenter headers="dr1 dr8 dc1 dc7">16.3%</TD><TD class=alignCenter headers="dr1 dr8 dc1 dc8">100.0%</TD></TR></TBODY></TABLE>
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 5 - Cumulative numbers of adult hospitalizations with influenza
reported by the PCIRN-SOS network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=er1 rowSpan=3>Age groups </TH><TH id=ec1 class=noWrap colSpan=6>Cumulative (Aug. 25, 2013 to April 12, 2014)<SUP>*</SUP></TH></TR><TR class=bg-colour-yellow><TH id=ec2 colSpan=4 headers=ec1>Influenza A </TH><TH id=ec7 headers=ec1>B </TH><TH id=ec8 headers=ec1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=ec3 headers="ec1 ec2">A Total </TH><TH id=ec4 class=bg-colour-blue headers="ec1 ec2">A(H1) pdm09 </TH><TH id=ec5 class=bg-colour-blue headers="ec1 ec2">A(H3) </TH><TH id=ec6 class=bg-colour-blue headers="ec1 ec2">A(UnS) </TH><TD class=alignCenter headers="ec1 ec7">Total</TD><TD class=alignCenter headers="ec1 ec8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t5_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.

<SUP id=t5_star>*</SUP> Two cases for which the influenza type has not yet been reported, and five cases for which the age-group was not reported, are not included in Table 5.</TD></TR></TFOOT><TBODY><TR><TH id=er2 class=alignLeft headers=er1>16-20 </TH><TD class=alignCenter headers="er1 er2 ec1 ec2 ec3">13 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec4">5 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec5">0 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec6">8 </TD><TD class=alignCenter headers="er1 er2 ec1 ec7">2 </TD><TD class=alignCenter headers="er1 er2 ec1 ec8">15 (1%) </TD></TR><TR><TH id=er3 class=alignLeft headers=er1>20-44 </TH><TD class=alignCenter headers="er1 er3 ec1 ec2 ec3">260 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec4">134 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec5">6 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec6">120 </TD><TD class=alignCenter headers="er1 er3 ec1 ec7">24 </TD><TD class=alignCenter headers="er1 er3 ec1 ec8">284 (18%) </TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignCenter headers="er1 er4 ec1 ec2 ec3">483 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec4">225 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec5">9 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec6">249 </TD><TD class=alignCenter headers="er1 er4 ec1 ec7">79 </TD><TD class=alignCenter headers="er1 er4 ec1 ec8">562 (36%) </TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignCenter headers="er1 er5 ec1 ec2 ec3">472 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec4">217 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec5">46 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec6">209 </TD><TD class=alignCenter headers="er1 er5 ec1 ec7">235 </TD><TD class=alignCenter headers="er1 er5 ec1 ec8">707 (45%) </TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignCenter headers="er1 er6 ec1 ec2 ec3">1228 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec4">581 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec5">61 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec6">586 </TD><TD class=alignCenter headers="er1 er6 ec1 ec7">340 </TD><TD class=alignCenter headers="er1 er6 ec1 ec8">1568 </TD></TR><TR><TH id=er7 class=alignLeft headers=er1>%<SUP>1</SUP></TH><TD class=alignCenter headers="er1 er7 ec1 ec2 ec3">78% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec4">47% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec5">5% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec6">48% </TD><TD class=alignCenter headers="er1 er7 ec1 ec7">22% </TD><TD class=alignCenter headers="er1 er7 ec1 ec8">100% </TD></TR></TBODY></TABLE>
Figure 8. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w15-fg8a-eng.gif


Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w15-fg8b-eng.gif

* See footnote above following the section related to PCIRN-SOS data.
Text equivalent for figure 8bNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Adult hospitalizations (>16 year of age, PCIRN-SOS)
Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w15-fg9a-eng.gif

Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w15-fg9b-eng.gif

Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Adult hospitalizations (≥16 year of age, PCIRN-SOS)

Top of Page
Provincial/Territorial Influenza Hospitalizations and Deaths

In week 15, 121 laboratory-confirmed influenza-associated hospitalizations were reported from seven of the nine participating provinces and territories.* As with other surveillance indicators in week 15, the majority were cases of influenza B (95, 78.5%). Two ICU admissions were reported in week 15: one adult 45-64 years of age and one ≥65 years of age. Three deaths were reported in week 15; one adult 20-44 years of age and two adults ≥65 years of age. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total.
To date this season, 4,070 influenza-associated hospitalizations have been reported, 85.5% with influenza A. The majority (58.7%) of hospitalizations have been cases 45 years of age of older. A significantly greater proportion of cases of influenza B have been ≥65 years of age, and 5-19 years of age, compared to cases of A(H1N1)pdm09 this season (Table 6). A total of 334 ICU admissions have been reported this season, of which 65.0% were adults 20-64 years of age. A total of 226 deaths have been reported. An equal proportion of deaths have been among adults 20-64 years of age and adults ≥65 years of age (each 46%). In keeping with the late-season circulation, influenza B has been increasingly reported among hospitalized cases of influenza. To date this season, influenza B has been reported in 14.5% of hospitalizations and 11.5% of deaths. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.
* Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, NS, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t6 class=alignCenter>Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=fr1 rowSpan=3>Age groups </TH><TH id=fc1 colSpan=6>Cumulative (Aug. 25, 2013 to April 12, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=fc2 colSpan=4 headers=fc1>Influenza A</TH><TH id=fc7 headers=fc1>B</TH><TH id=fc8 headers=fc1>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=fc3 headers="fc1 fc2">A Total</TH><TH id=fc4 class=bg-colour-blue headers="fc1 fc2">A(H1) pdm09</TH><TH id=fc5 class=bg-colour-blue headers="fc1 fc2">A(H3)</TH><TH id=fc6 class=bg-colour-blue headers="fc1 fc2">A (UnS)</TH><TD class=alignCenter headers="fc1 fc7">Total</TD><TD class=alignCenter headers="fc1 fc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=8><SUP id=footnote_t6_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=fr2 class=alignLeft headers=fr1>0-4 years</TH><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc3">599 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc4">283 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc5">10 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc6">306 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc7">72 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc8">671 (16%) </TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years</TH><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc3">131</TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc4">64 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc5">6 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc6">61 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc7">70 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc8">201 (5%) </TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years</TH><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc3">35 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc4">20 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc5">3 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc6">12 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc7">4 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc8">39 (1%) </TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc3">595 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc4">416 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc5">4 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc6">175 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc7">40 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc8">635 (16%) </TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc3">1094 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc4">691 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc5">26 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc6">377 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc7">112 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc8">1206 (30%) </TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc3">897 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc4">459 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc5">78 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc6">360 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc7">285 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc8">1182 (28%) </TD></TR><TR><TH id=fr10 class=alignLeft headers=fr1>Unknown</TH><TD class=alignCenter headers="fc1 fc2 fc3">129 </TD><TD class=alignCenter headers="fc1 fc2 fc4">97 </TD><TD class=alignCenter headers="fc1 fc2 fc5">3 </TD><TD class=alignCenter headers="fc1 fc2 fc6">29 </TD><TD class=alignCenter headers="fc1 fc7">7 </TD><TD class=alignCenter headers="fc1 fc8">136 (3%) </TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignCenter headers="fr1 fr8 fc1 fc2 fc3">3480 </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc4">2030 </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc5">130 </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc6">1320 </TD><TD class=alignCenter headers="fr1 fr8 fc1 fc7">590 </TD><TD class=alignCenter headers="fr1 fr8 fc1 fc8">4070 </TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP> </TH><TD class=alignCenter headers="fr1 fr9 fc1 fc2 fc3">85.5% </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc4">58.3% </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc5">3.7% </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc6">37.9% </TD><TD class=alignCenter headers="fr1 fr9 fc1 fc7">14.5% </TD><TD class=alignCenter headers="fr1 fr9 fc1 fc8">100% </TD></TR></TBODY></TABLE>
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2013-14 on the Public Health Agency of Canada website.

.../
http://www.phac-aspc.gc.ca/fluwatch/13-14/w15_14/index-eng.php
 
Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 16

Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 16

FluWatch report: April 13 to 19, 2014 (Week 16)

Posted 2014-04-25For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
<A title="Flu Watch (Version PDF, 113 KB - 6 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/13-14/w16_14/pdf/fw2014-16-eng.pdf">FluWatch report: April 13 to 19, 2014 (Week 16) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 291 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

?? Help with PDF documents

Overall Summary
  • In week 16, influenza B continued to circulate in several regions across Canada. Influenza activity remains within expected levels for this time of year, and is consistent with late-season circulation of influenza B.
  • While the influenza A(H1N1) virus has mostly affected adults 20-64 years of age this season, influenza B is having a greater impact on adults 65 years of age and older, as well as young persons 5 to 19 years of age.
  • As of week 16, 4,211 hospitalizations and 235 deaths have been reported from participating regions, which is comparable to reports in past influenza seasons.
Influenza/ILI Activity (geographic spread)

The number of regions reporting localized or widespread influenza activity has been stable for the past eight weeks. In week 16, no region reported widespread activity and seven regions (BC(1), ON(5) and NS(1)) reported localized activity (Figure 1).
Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 16


right_ofmap.gif



Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
Influenza and Other Respiratory Virus Detections

The number of positive influenza tests decreased from 736 in week 15 to 587 in week 16, although this represented an increasing percentage of positive tests (16.1%) (Figure 2). Influenza B remained the predominant virus in week 16, representing 92% of influenza detections. Influenza B continues to circulate in many regions across Canada. Influenza detections are declining in Newfoundland & Labrador, but increasing in other Atlantic provinces. Detections are stable in Quebec, and after a sharp increase over recent weeks, detections in Ontario declined in week 16. British Columbia, Alberta and Saskatchewan have also reported increases in influenza B detections in recent weeks (Table 1). Significantly greater proportions of influenza B cases have been ≥65 years of age and 5-19 years of age compared to cases of A(H1N1)pdm09. Among cases for which information on age and type/subtype has been received, 40.2% of the cases in week 16 were ≥65 years of age compared to 19.5% of cases for the season to date (Table 2).

Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
2014-w16-fg2-eng.gif

Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
The number of positive tests for RSV continued to decline from a peak in early February. The number of positive tests for parainfluenza and adenovirus have been variable in recent weeks. Detections of coronavirus have been on a downward trend since mid-January. More detections human metapneumovirus have been reported compared to the same period last season, but they continue to decline. Detections of rhinovirus have been relatively stable during the winter months, although these detections represent an increasing percentage of tests positive since early January (Figure 3).
For more details, see the weekly Respiratory Virus Detections in Canada Report.
Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2013-14
2014-w16-fg3-eng.gif


Top of Page
RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
<TABLE id=t1 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly and cumulative numbers of positive influenza specimens
by type, subtype and province, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=ac1 colSpan=5>Weekly
(April 13, 2014 to April 19, 2014)</TH><TH id=ac8 colSpan=5>Cumulative
(August 25, 2013 to April 19, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=4 headers=ac1>Influenza A</TH><TH id=ac7 headers=ac1>B</TH><TH id=ac9 colSpan=4 headers=ac8>Influenza A</TH><TH id=ac14 headers=ac8>B</TH></TR><TR class=bg-colour-grey-light><TH id=ac3 headers="ac1 ac2">A Total</TH><TH id=ac4 class=bg-colour-blue headers="ac1 ac2">A(H1)pdm09</TH><TH id=ac5 class=bg-colour-blue headers="ac1 ac2">A(H3)</TH><TH id=ac6 class=bg-colour-blue headers="ac1 ac2">A(UnS)</TH><TH class=alignCenter headers="ac1 ac7">B Total</TH><TH id=ac10 headers="ac8 ac9">A Total</TH><TH id=ac11 class=bg-colour-blue headers="ac8 ac9">A(H1)pdm09</TH><TH id=ac12 class=bg-colour-blue headers="ac8 ac9">A(H3)</TH><TH id=ac13 class=bg-colour-blue headers="ac8 ac9">A(UnS)</TH><TD class=alignCenter headers="ac8 ac14">B Total</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=alignLeft headers=ar1>BC</TH><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac3">3 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac6">3 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac7">35 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac10">1791 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac11">1612 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac12">46 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac13">133 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac14">296 </TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac3">14 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac4">3 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac5">7 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac6">4 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac7">36 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac10">3833 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac11">3451 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac12">68 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac13">314 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac14">305 </TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac3">4 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac4">1 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac5">1 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac6">2 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac7">17 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac10">1380 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac11">986 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac12">8 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac13">386 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac14">98 </TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac3">n/a </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac4">n/a </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac5">n/a </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac6">n/a </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac7">n/a </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac10">654 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac11">460 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac12">3 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac13">191 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac14">20 </TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac3">12 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac4">4 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac5">4 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac6">4 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac7">318 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac10">5688 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac11">2483 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac12">342 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac13">2863 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac14">2177 </TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac3">10 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac6">10 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac7">114 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac10">5334 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac11">677 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac12">4 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac13">4653 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac14">2398 </TD></TR><TR><TH id=ar8 class=alignLeft headers=ar1>NB</TH><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac3">0 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac6">0 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac7">14 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac10">1488 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac11">370 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac12">1 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac13">1117 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac14">69 </TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac3">2 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac6">2 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac7">7 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac10">174 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac11">134 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac12">4 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac13">36 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac14">12 </TD></TR><TR><TH id=ar10 class=alignLeft headers=ar1>PE</TH><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac3">1 </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac4">1 </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac6">0 </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac7">0 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac10">119 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac11">118 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac12">0 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac13">1 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac14">2 </TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac3">n/a </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac4">n/a </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac5">n/a </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac6">n/a </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac7">n/a </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac10">362 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac11">104 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac12">0 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac13">258 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac14">203 </TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignCenter headers="ar1 ar12 ac1 ac2 ac3">46 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac1 ac2 ac4">9 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac1 ac2 ac5">12 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac1 ac2 ac6">25 </TD><TD class=alignCenter headers="ar1 ar12 ac1 ac7">541 </TD><TD class=alignCenter headers="ar1 ar12 ac8 ac9 ac10">20823 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac8 ac9 ac11">10395 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac8 ac9 ac12">476 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac8 ac9 ac13">9952 </TD><TD class=alignCenter headers="ar1 ar12 ac8 ac14">5580 </TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignCenter headers="ar1 ar13 ac1 ac2 ac3">7.8% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac1 ac2 ac4">19.6% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac1 ac2 ac5">26.1% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac1 ac2 ac6">54.3% </TD><TD class=alignCenter headers="ar1 ar13 ac1 ac7">92.2% </TD><TD class=alignCenter headers="ar1 ar13 ac8 ac9 ac10">78.9% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac8 ac9 ac11">49.9% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac8 ac9 ac12">2.3% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac8 ac9 ac13">47.8% </TD><TD class=alignCenter headers="ar1 ar13 ac8 ac14">21.1% </TD></TR></TBODY></TABLE>
<TABLE id=t2 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups (years)</TH><TH id=bc1 colSpan=5>Weekly
(April 13 to April 19, 2014)</TH><TH id=bc8 colSpan=7>Cumulative
(August 25, 2013 to April 19, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=bc2 colSpan=4 headers=bc1>Influenza A</TH><TH id=bc7 headers=bc1>B</TH><TH id=bc9 colSpan=4 headers=bc8>Influenza A</TH><TH id=bc14 headers=bc8>B</TH><TH id=bc15 colSpan=2 headers=bc8>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=bc3 headers="bc1 bc2">A Total</TH><TH id=bc4 class="bg-colour-blue " headers="bc1 bc2">A(H1) pdm09</TH><TH id=bc5 class="bg-colour-blue " headers="bc1 bc2">A(H3)</TH><TH id=bc6 class="bg-colour-blue " headers="bc1 bc2">A (UnS)</TH><TD class=alignCenter headers="bc1 bc7">Total</TD><TH id=bc10 headers="bc8 bc9">A Total</TH><TH id=bc11 class="bg-colour-blue " headers="bc8 bc9">A(H1) pdm09</TH><TH id=bc12 class="bg-colour-blue " headers="bc8 bc9">A(H3)</TH><TH id=bc13 class="bg-colour-blue " headers="bc8 bc9">A (UnS)</TH><TD class=alignCenter headers="bc8 bc14">Total</TD><TH id=bc16 headers="bc8 bc15">#</TH><TH id=bc17 headers="bc8 bc15">%</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13><SUP id=footnote_t2_1>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP id=footnote_t2_2>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
<SUP id=footnote_t2_3>3 </SUP>Table 2 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=br2 class=alignLeft headers=br1><5</TH><TD class=alignCenter headers="br1 br2 bc1 bc2 bc3">4 </TD><TD class=alignCenter headers="br1 br2 bc1 bc2 bc4">1 </TD><TD class=alignCenter headers="br1 br2 bc1 bc2 bc5">0 </TD><TD class=alignCenter headers="br1 br2 bc1 bc2 bc6">3 </TD><TD class=alignCenter headers="br1 br2 bc1 bc7">18 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc10">3248 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc11">1446 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc12">40 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc13">1762 </TD><TD class=alignCenter headers="br1 br2 bc8 bc14">442 </TD><TD class=alignCenter headers="br1 br2 bc8 bc15 bc16">3690 </TD><TD class=alignCenter headers="br1 br2 bc8 bc15 bc17">17.2% </TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignCenter headers="br1 br3 bc1 bc2 bc3">2 </TD><TD class=alignCenter headers="br1 br3 bc1 bc2 bc4">1 </TD><TD class=alignCenter headers="br1 br3 bc1 bc2 bc5">1 </TD><TD class=alignCenter headers="br1 br3 bc1 bc2 bc6">0 </TD><TD class=alignCenter headers="br1 br3 bc1 bc7">33 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc10">1317 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc11">706 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc12">20 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc13">591 </TD><TD class=alignCenter headers="br1 br3 bc8 bc14">677 </TD><TD class=alignCenter headers="br1 br3 bc8 bc15 bc16">1994 </TD><TD class=alignCenter headers="br1 br3 bc8 bc15 bc17">9.3% </TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignCenter headers="br1 br4 bc1 bc2 bc3">5 </TD><TD class=alignCenter headers="br1 br4 bc1 bc2 bc4">3 </TD><TD class=alignCenter headers="br1 br4 bc1 bc2 bc5">0 </TD><TD class=alignCenter headers="br1 br4 bc1 bc2 bc6">2 </TD><TD class=alignCenter headers="br1 br4 bc1 bc7">50 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc10">5061 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc11">2805 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc12">42 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc13">2214 </TD><TD class=alignCenter headers="br1 br4 bc8 bc14">811 </TD><TD class=alignCenter headers="br1 br4 bc8 bc15 bc16">5872 </TD><TD class=alignCenter headers="br1 br4 bc8 bc15 bc17">27.4% </TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignCenter headers="br1 br5 bc1 bc2 bc3">8 </TD><TD class=alignCenter headers="br1 br5 bc1 bc2 bc4">0 </TD><TD class=alignCenter headers="br1 br5 bc1 bc2 bc5">0 </TD><TD class=alignCenter headers="br1 br5 bc1 bc2 bc6">8 </TD><TD class=alignCenter headers="br1 br5 bc1 bc7">65 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc10">4442 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc11">2384 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc12">56 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc13">2002 </TD><TD class=alignCenter headers="br1 br5 bc8 bc14">1135 </TD><TD class=alignCenter headers="br1 br5 bc8 bc15 bc16">5577 </TD><TD class=alignCenter headers="br1 br5 bc8 bc15 bc17">26.0% </TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignCenter headers="br1 br6 bc1 bc2 bc3">12 </TD><TD class=alignCenter headers="br1 br6 bc1 bc2 bc4">0 </TD><TD class=alignCenter headers="br1 br6 bc1 bc2 bc5">7 </TD><TD class=alignCenter headers="br1 br6 bc1 bc2 bc6">5 </TD><TD class=alignCenter headers="br1 br6 bc1 bc7">113 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc10">2524 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc11">997 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc12">149 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc13">1378 </TD><TD class=alignCenter headers="br1 br6 bc8 bc14">1668 </TD><TD class=alignCenter headers="br1 br6 bc8 bc15 bc16">4192 </TD><TD class=alignCenter headers="br1 br6 bc8 bc15 bc17">19.5% </TD></TR><TR><TH id=br7 class=alignLeft headers=br1>Unknown</TH><TD class=alignCenter headers="br1 br7 bc1 bc2 bc3">0 </TD><TD class=alignCenter headers="br1 br7 bc1 bc2 bc4">0 </TD><TD class=alignCenter headers="br1 br7 bc1 bc2 bc5">0 </TD><TD class=alignCenter headers="br1 br7 bc1 bc2 bc6">0 </TD><TD class=alignCenter headers="br1 br7 bc1 bc7">1 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc10">136 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc11">102 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc12">21 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc13">13 </TD><TD class=alignCenter headers="br1 br7 bc8 bc14">6 </TD><TD class=alignCenter headers="br1 br7 bc8 bc15 bc16">142 </TD><TD class=alignCenter headers="br1 br7 bc8 bc15 bc17">0.7% </TD></TR><TR><TH id=br8 class=alignLeft headers=br1>Total</TH><TD class=alignCenter headers="br1 br8 bc1 bc2 bc3">31 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc1 bc2 bc4">5 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc1 bc2 bc5">8 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc1 bc2 bc6">18 </TD><TD class=alignCenter headers="br1 br8 bc1 bc7">280 </TD><TD class=alignCenter headers="br1 br8 bc8 bc9 bc10">16728 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc8 bc9 bc11">8440 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc8 bc9 bc12">328 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc8 bc9 bc13">7960 </TD><TD class=alignCenter headers="br1 br8 bc8 bc14">4739 </TD><TD class=alignCenter headers="br1 br8 bc8 bc15 bc16">21467 </TD><TD class=alignCenter headers="br1 br8 bc8 bc15 bc17">100.0% </TD></TR><TR><TH id=br9 class=alignLeft headers=br1>Percentage<SUP>2</SUP></TH><TD class=alignCenter headers="br1 br9 bc1 bc2 bc3">10.0% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc1 bc2 bc4">16.1% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc1 bc2 bc5">25.8% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc1 bc2 bc6">58.1% </TD><TD class=alignCenter headers="br1 br9 bc1 bc7">90.0% </TD><TD class=alignCenter headers="br1 br9 bc8 bc9 bc10">77.9% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc8 bc9 bc11">50.5% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc8 bc9 bc12">2.0% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc8 bc9 bc13">47.6% </TD><TD class=alignCenter headers="br1 br9 bc8 bc14">22.1% </TD><TD class=alignCenter></TD><TD class=alignCenter></TD></TR></TBODY></TABLE>

Top of Page
Influenza Strain Characterizations

During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 1,814 influenza viruses [93 A(H3N2), 1,320 A(H1N1)pdm09 and 401 influenza B]. The vast majority (99%) of viruses were similar to the strains recommended by the WHO for the 2013-14 seasonal influenza vaccine. Two A(H1N1)pdm09 viruses showed reduced titres to antiserum against the reference A/California/07/2009 strain. Twenty influenza B viruses were similar to the strain recommended by the WHO for the 2011-12 vaccine (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2013-2014, N = 1814
2014-w16-fg4-eng.gif

The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
The recommended components for the 2013-2014 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009 (H1N1)pdm09-like virus, an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b (e.g. A/Texas/50/2012), and a B/Massachusetts/2/2012-like virus (Yamagata lineage).


Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
Antiviral Resistance

During the 2013-2014 influenza season, NML has tested 1,557 influenza viruses for resistance to oseltamivir and all but two were sensitive. All 1,479 viruses tested for resistance to zanamivir were sensitive. All 1,474 influenza A viruses tested for amantadine resistance were resistant (Table 3).
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2013-2014</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=cr1 rowSpan=2>Virus type and subtype</TH><TH id=cc1 colSpan=2>Oseltamivir</TH><TH id=cc4 colSpan=2>Zanamivir</TH><TH id=cc7 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=cc2 headers=cc1># tested</TH><TH id=cc3 headers=cc1># resistant (%)</TH><TH id=cc5 headers=cc4># tested</TH><TH id=cc6 headers=cc4># resistant (%)</TH><TH id=cc8 headers=cc7># tested</TH><TH id=cc9 headers=cc7># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=cr2 class="alignLeft bg-colour-blue" headers=cr1>A (H3N2)</TH><TD class=alignCenter headers="cr1 cr2 cc1 cc2">75</TD><TD class=alignCenter headers="cr1 cr2 cc1 cc3">0</TD><TD class=alignCenter headers="cr1 cr2 cc4 cc5">70</TD><TD class=alignCenter headers="cr1 cr2 cc4 cc6">0</TD><TD class=alignCenter headers="cr1 cr2 cc7 cc8">119</TD><TD class=alignCenter headers="cr1 cr2 cc7 cc9">119 (100%)</TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignCenter headers="cr1 cr3 cc1 cc2">1216</TD><TD class=alignCenter headers="cr1 cr3 cc1 cc3">2 (0.2%)</TD><TD class=alignCenter headers="cr1 cr3 cc4 cc5">1180</TD><TD class=alignCenter headers="cr1 cr3 cc4 cc6">0</TD><TD class=alignCenter headers="cr1 cr3 cc7 cc8">1355</TD><TD class=alignCenter headers="cr1 cr3 cc7 cc9">1355 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignCenter headers="cr1 cr4 cc1 cc2">266</TD><TD class=alignCenter headers="cr1 cr4 cc1 cc3">0</TD><TD class=alignCenter headers="cr1 cr4 cc4 cc5">229</TD><TD class=alignCenter headers="cr1 cr4 cc4 cc6">0</TD><TD class=alignCenter headers="cr1 cr4 cc7 cc8">NA <SUP>*</SUP></TD><TD class=alignCenter headers="cr1 cr4 cc7 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft bg-colour-blue" headers=cr1>TOTAL</TH><TD class=alignCenter headers="cr1 cr5 cc1 cc2">1557</TD><TD class=alignCenter headers="cr1 cr5 cc1 cc3">2 (0.1%)</TD><TD class=alignCenter headers="cr1 cr5 cc4 cc5">1479</TD><TD class=alignCenter headers="cr1 cr5 cc4 cc6">0</TD><TD class=alignCenter headers="cr1 cr5 cc7 cc8">1474</TD><TD class=alignCenter headers="cr1 cr5 cc7 cc9">1474 (100%)</TD></TR></TBODY></TABLE>
Influenza-like Illness (ILI) Consultation Rate

The national influenza-like-illness (ILI) consultation rate decreased from 27.9 consultations per 1,000 patient visits in week 15 to 23.2 / 1,000 in week 16; which was within the expected range for week 16 (Figure 5).
Figure 5. Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014
2014-w16-fg5-eng.gif

Note: No data available for mean rate for weeks 19 to 39 for the 1996-1997 through 2002-2003 seasons. Delays in the reporting of data may cause data to change retrospectively. The calculation of the average ILI consultation rate over 17 seasons was aligned with influenza activity in each season. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. The number of sentinel physicians in each province or territory is as follows: BC(21), AB(80), SK(11), MB(18), ON(169), QC(14), NB(29), NS(26), PE(4), NL(16), NU(1), NT(14), YT(13). Not all sentinel physicians report every week.
Text equivalent for figure 5Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

Top of Page
Influenza Outbreak Surveillance

In week 16, seven new influenza outbreaks were reported: five in long-term care facilities, one in a hospital (Figure 6), and one in another setting or community. Among the seven influenza outbreaks, four had data on the influenza type, and all were influenza B. One additional outbreak of influenza-like illness was reported in a school in week 16.
Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2013-2014
2014-w16-fg6-eng.gif

1 All provinces and territories except NU report outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
Text equivalent for figure 6Overall number of new influenza outbreaks by report week, Canada, 2013-2014
Pharmacy Surveillance

In week 16, the proportion of prescriptions for antivirals was similar to the previous week. Overall this season, the largest proportion of prescriptions for antivirals has been among children 2-18 years of age and adults 19-64 years of age (Figure 7). In keeping with laboratory detections of influenza, the proportion of prescriptions for antivirals in Ontario decreased in week 16.
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14
2014-w16-fg7-eng.gif

Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group. Age-groups: Infant: 0-2y, Child: 2-18y; Adult: 19-64y, Senior: ≥65y.
Text equivalent for figure 7Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

Top of Page
Sentinel Hospital Influenza Surveillance

Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In week 16, eight new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 14 in week 15. All the cases reported in week 16 had influenza B (Figure 8a). A greater proportion of cases with influenza B this season have been children between 2 and 10 years of age compared to A(H1N1)pdm09. One ICU admission was reported in week 16 in a child 10-16 years of age with influenza B. No deaths were reported in week 16.
To date this season, a total of 672 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 83% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children <5 years of age represent 74% of cases to date (Table 4). Ninety-seven ICU admissions have been reported, of which 66 (68%) were children <5 years of age (Figure 9a). All but six were cases with influenza A, and 97% of those subtyped were A(H1N1)pdm09. Among the 94 ICU cases with available data, 60 (64%) were reported to have underlying medical conditions. No deaths have been reported.
Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
Adult Influenza Hospitalizations and Deaths (PCIRN)
In week 16, 20 new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported through active surveillance by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 47 in week 15 (Figure 8b). This season, a significantly greater proportion of cases of influenza B have been ≥65 years of age compared to cases of A(H1N1)pdm09. Since the beginning of March the majority of hospitalizations have been associated with influenza B, with a greater proportion of cases among adults ≥65 years of age. One ICU admission was reported in week 16, an adult 20-44 years of age with influenza B. No deaths were reported in week 16.
To date this season, 1,642 influenza-associated hospitalizations have been reported by the PCIRN-SOS network, 1,248 (76.0%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). Overall, fewer cases have been reported this season compared to the 2012-13 season, however, nearly four times more cases of influenza B have been reported compared to last year. ICU admission was required for 263 hospitalizations, all but 30 of which were cases with influenza A (126 A(H1N1)pdm09, eight A(H3N2) and 99 A(unsubtyped)). Approximately 80% of hospitalizations and ICU admissions were ≥45 years of age. Of the 193 ICU admissions with available information, 165 (85.5%) were reported to have at least one comorbidity and of the 219 ICU admissions with available information 156 (71.2%) reported not having been vaccinated this season. Seventy-eight deaths have been reported, all but ten with influenza A (41 A(H1N1)pdm09, three A(H3N2) and 24 A(unsubtyped)); seven cases 20-44 years of age, 32 cases 45-64 years of age and 39 cases ≥65 years of age (Figure 9b).
Note: PCIRN-SOS conducted passive surveillance from April 30th to November 14th, 2013. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance began November 15th during which time PCIRN site coordinators investigate cases potentially related to influenza. Data from both active and passive surveillance reported during the 2013-14 season are included in this report. The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t4 class=alignCenter>Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=dr1 rowSpan=3>Age groups </TH><TH id=dc1 colSpan=6>Cumulative (Aug. 25, 2013 to April 19, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=dc2 colSpan=4 headers=dc1>Influenza A </TH><TH id=dc7 headers=dc1>B </TH><TH id=dc8 headers=dc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=dc3 headers="dc1 dc2">A Total </TH><TH id=dc4 class="bg-colour-blue " headers="dc1 dc2">A(H1) pdm09 </TH><TH id=dc5 class="bg-colour-blue " headers="dc1 dc2">A(H3) </TH><TH id=dc6 class="bg-colour-blue " headers="dc1 dc2">A (UnS) </TH><TD class=alignCenter headers="dc1 dc7">Total</TD><TD class=alignCenter headers="dc1 dc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t4_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=dr2 class=alignLeft headers=dr1>0-5m </TH><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc3">104 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc4">34 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc5">0 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc6">70 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc7">7 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc8">111 (17%) </TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc3">162 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc4">51 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc5">1 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc6">110 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc7">21 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc8">183 (27%) </TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc3">166 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc4">55 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc5">3 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc6">108 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc7">35 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc8">201 (30%) </TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc3">83 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc4">27 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc5">1 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc6">55 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc7">42 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc8">125 (19%) </TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc3">40 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc4">14 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc5">1 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc6">25 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc7">12 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc8">52 (8%) </TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignCenter headers="dr1 dr7 dc1 dc2 dc3">555 </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc4">181 </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc5">6 </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc6">368 </TD><TD class=alignCenter headers="dr1 dr7 dc1 dc7">117 </TD><TD class=alignCenter headers="dr1 dr7 dc1 dc8">672 </TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP> </TH><TD class=alignCenter headers="dr1 dr8 dc1 dc2 dc3">82.6% </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc4">32.6% </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc5">1.1% </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc6">66.3% </TD><TD class=alignCenter headers="dr1 dr8 dc1 dc7">17.4% </TD><TD class=alignCenter headers="dr1 dr8 dc1 dc8">100.0% </TD></TR></TBODY></TABLE>
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 5 - Cumulative numbers of adult hospitalizations with influenza
reported by the PCIRN-SOS network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=er1 rowSpan=3>Age groups </TH><TH id=ec1 class=noWrap colSpan=6>Cumulative (Aug. 25, 2013 to April 19, 2014)<SUP>*</SUP></TH></TR><TR class=bg-colour-yellow><TH id=ec2 colSpan=4 headers=ec1>Influenza A </TH><TH id=ec7 headers=ec1>B </TH><TH id=ec8 headers=ec1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=ec3 headers="ec1 ec2">A Total </TH><TH id=ec4 class=bg-colour-blue headers="ec1 ec2">A(H1) pdm09 </TH><TH id=ec5 class=bg-colour-blue headers="ec1 ec2">A(H3) </TH><TH id=ec6 class=bg-colour-blue headers="ec1 ec2">A(UnS) </TH><TD class=alignCenter headers="ec1 ec7">Total</TD><TD class=alignCenter headers="ec1 ec8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t5_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.

<SUP id=t5_star>*</SUP> Two cases for which the influenza type has not yet been reported, and five cases for which the age-group was not reported, are not included in Table 5.</TD></TR></TFOOT><TBODY><TR><TH id=er2 class=alignLeft headers=er1>16-20 </TH><TD class=alignCenter headers="er1 er2 ec1 ec2 ec3">13 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec4">5 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec5">0 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec6">8 </TD><TD class=alignCenter headers="er1 er2 ec1 ec7">2 </TD><TD class=alignCenter headers="er1 er2 ec1 ec8">15 (1%) </TD></TR><TR><TH id=er3 class=alignLeft headers=er1>20-44 </TH><TD class=alignCenter headers="er1 er3 ec1 ec2 ec3">265 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec4">142 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec5">6 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec6">117 </TD><TD class=alignCenter headers="er1 er3 ec1 ec7">28 </TD><TD class=alignCenter headers="er1 er3 ec1 ec8">293 (18%) </TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignCenter headers="er1 er4 ec1 ec2 ec3">487 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec4">235 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec5">9 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec6">243 </TD><TD class=alignCenter headers="er1 er4 ec1 ec7">90 </TD><TD class=alignCenter headers="er1 er4 ec1 ec8">577 (35%) </TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignCenter headers="er1 er5 ec1 ec2 ec3">478 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec4">225 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec5">50 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec6">203 </TD><TD class=alignCenter headers="er1 er5 ec1 ec7">272 </TD><TD class=alignCenter headers="er1 er5 ec1 ec8">750 (46%) </TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignCenter headers="er1 er6 ec1 ec2 ec3">1243 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec4">607 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec5">65 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec6">571 </TD><TD class=alignCenter headers="er1 er6 ec1 ec7">392 </TD><TD class=alignCenter headers="er1 er6 ec1 ec8">1635 </TD></TR><TR><TH id=er7 class=alignLeft headers=er1>%<SUP>1</SUP></TH><TD class=alignCenter headers="er1 er7 ec1 ec2 ec3">76% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec4">49% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec5">5% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec6">46% </TD><TD class=alignCenter headers="er1 er7 ec1 ec7">24% </TD><TD class=alignCenter headers="er1 er7 ec1 ec8">100% </TD></TR></TBODY></TABLE>
Figure 8. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w16-fg8a-eng.gif


Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w16-fg8b-eng.gif

* See footnote above following the section related to PCIRN-SOS data.
Text equivalent for figure 8bNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Adult hospitalizations (>16 year of age, PCIRN-SOS)
Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w16-fg9a-eng.gif

Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w16-fg9b-eng.gif

Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Adult hospitalizations (≥16 year of age, PCIRN-SOS)

Top of Page
Provincial/Territorial Influenza Hospitalizations and Deaths

In week 16, 112 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories.* As with other surveillance indicators in week 16, the majority were cases of influenza B (92, 82.1%). One ICU admission was reported in week 16, an adult ≥65 years of age with influenza A. Eight deaths were reported this week; two adults 45-64 years of age and six adults ≥65 years of age, all with influenza B. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total.
To date this season, 4,211 influenza-associated hospitalizations have been reported, 83.6% with influenza A. The majority (59.0%) of hospitalizations have been cases 45 years of age of older. A significantly greater proportion of cases of influenza B have been ≥65 years of age, and 5-19 years of age, compared to cases of A(H1N1)pdm09 this season (Table 6). A total of 343 ICU admissions have been reported this season, of which 64.7% were adults 20-64 years of age. A total of 235 deaths have been reported. A slightly higher proportion of deaths has been among adults ≥65 years of age (47.2%) followed by adults 20-64 years of age (44.6%). In keeping with the late-season circulation, influenza B has been increasingly reported among hospitalized cases of influenza. To date this season, influenza B has been reported in 16.4% of hospitalizations and 15.3% of deaths. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.
* Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, NS, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t6 class=alignCenter>Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=fr1 rowSpan=3>Age groups </TH><TH id=fc1 colSpan=6>Cumulative (Aug. 25, 2013 to April 19, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=fc2 colSpan=4 headers=fc1>Influenza A</TH><TH id=fc7 headers=fc1>B</TH><TH id=fc8 headers=fc1>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=fc3 headers="fc1 fc2">A Total</TH><TH id=fc4 class=bg-colour-blue headers="fc1 fc2">A(H1) pdm09</TH><TH id=fc5 class=bg-colour-blue headers="fc1 fc2">A(H3)</TH><TH id=fc6 class=bg-colour-blue headers="fc1 fc2">A (UnS)</TH><TD class=alignCenter headers="fc1 fc7">Total</TD><TD class=alignCenter headers="fc1 fc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=8><SUP id=footnote_t6_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=fr2 class=alignLeft headers=fr1>0-4 years</TH><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc3">606 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc4">286 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc5">10 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc6">310 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc7">77 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc8">683 (16%) </TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years</TH><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc3">132 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc4">64 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc5">6 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc6">62 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc7">79 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc8">211 (5%) </TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years</TH><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc3">35 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc4">20 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc5">3 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc6">12 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc7">4 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc8">39 (1%) </TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc3">603 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc4">421 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc5">4 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc6">178 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc7">45 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc8">648 (15%) </TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc3">1102 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc4">697 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc5">27 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc6">378 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc7">138 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc8">1240 (29%) </TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc3">908 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc4">460 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc5">79 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc6">369 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc7">338 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc8">1246 (30%) </TD></TR><TR><TH id=fr10 class=alignLeft headers=fr1>Unknown</TH><TD class=alignCenter headers="fr1 fr10 fc1 fc2 fc3">134 </TD><TD class=alignCenter headers="fr1 fr10 fc1 fc2 fc4">99 </TD><TD class=alignCenter headers="fr1 fr10 fc1 fc2 fc5">3 </TD><TD class=alignCenter headers="fr1 fr10 fc1 fc2 fc6">32 </TD><TD class=alignCenter headers="fr1 fr10 fc1 fc7">10 </TD><TD class=alignCenter headers="fr1 fr10 fc1 fc8">144 (3%) </TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignCenter headers="fr1 fr8 fc1 fc2 fc3">3520 </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc4">2047 </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc5">132 </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc6">1341 </TD><TD class=alignCenter headers="fr1 fr8 fc1 fc7">691 </TD><TD class=alignCenter headers="fr1 fr8 fc1 fc8">4211 </TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP> </TH><TD class=alignCenter headers="fr1 fr9 fc1 fc2 fc3">83.6% </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc4">58.2% </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc5">3.8% </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc6">38.1% </TD><TD class=alignCenter headers="fr1 fr9 fc1 fc7">16.4% </TD><TD class=alignCenter headers="fr1 fr9 fc1 fc8">100% </TD></TR></TBODY></TABLE>
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2013-14 on the Public Health Agency of Canada website.
.../

http://www.phac-aspc.gc.ca/fluwatch/13-14/w16_14/index-eng.php
 
Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 17

Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 17

FluWatch report: April 20 to 26, 2014 (Week 17)

Posted 2014-05-02For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
<A title="Flu Watch (Version PDF, 113 KB - 6 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/13-14/w17_14/pdf/fw2014-17-eng.pdf">FluWatch report: April 20 to 26, 2014 (Week 17) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 291 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

?? Help with PDF documents

Overall Summary
  • In week 17, influenza B continued to circulate in several regions across Canada. This sustained influenza activity remains within expected levels for this time of year, and is consistent with late-season circulation of influenza B.
  • Influenza B is having a greater impact on adults 65 years of age and older and young persons 5 to 19 years of age, compared to influenza A(H1N1) which circulated earlier in the year. The proportion of hospitalizations with influenza among these age-groups has increased in recent weeks, and outbreaks of influenza B have been reported in long-term care facilities.
  • As of week 17, 4,393 hospitalizations and 244 deaths have been reported from participating regions, which is fewer than were reported last year.
Influenza/ILI Activity (geographic spread)

The number of regions reporting localized or widespread influenza activity has been stable during March and April. In week 17, no region reported widespread activity and six regions (MB(1) and ON(5)) reported localized activity (Figure 1).
Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 17


right_ofmap.gif



Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
Influenza and Other Respiratory Virus Detections

The number of positive influenza tests decreased slightly from 619 in week 16 to 576 (13.4% of tests) in week 17 (Figure 2). Influenza B remained the predominant virus in week 17, representing 88% of influenza detections. Influenza B continues to circulate in many regions across Canada with many jurisdictions reporting sustained levels of influenza detections over recent weeks. An exception is Ontario, where, after a sharp increase in mid-April, detections have since declined (Table 1). The pattern of influenza circulation during the 2012-13 and 2013-14 seasons has been similar, although this season the predominant circulating subtype of influenza A was A(H1N1)pdm09 and there has been more late-season circulation of influenza B. Significantly greater proportions of influenza B cases have been ≥65 years of age and 5-19 years of age compared to cases of A(H1N1)pdm09. Among cases for which information on age and type/subtype has been received, 43% of the cases in week 17 were ≥65 years of age compared to 20% of cases for the season to date (Table 2). However, in some jurisdictions, detections of influenza B may be a reflection of testing related to outbreaks in long-term care facilities.
Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
2014-w17-fg2-eng.gif

Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
The number of positive tests for RSV and coronavirus continued to decline, in keeping with their seasonal pattern of winter circulation. The number of positive tests for parainfluenza and adenovirus have been variable in recent weeks. More detections human metapneumovirus have been reported compared to the previous three seasons, but have been declining since mid-March. Detections of rhinovirus have been relatively stable during the winter months, but have been increasing during late-March and April, in keeping with its seasonal distribution in recent years demonstrating a small peak of detections in the spring and a larger peak in the fall (Figure 3).
For more details, see the weekly Respiratory Virus Detections in Canada Report.
Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2013-14
2014-w17-fg3-eng.gif


Top of Page
RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
<TABLE id=t1 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class="alignCenter margin10px">Table 1: Weekly and cumulative numbers of positive influenza specimens
by type, subtype and province, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=ac1 colSpan=5>Weekly
(April 20, 2013 to April 26, 2014)</TH><TH id=ac8 colSpan=5>Cumulative
(August 25, 2013 to April 26, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=4 headers=ac1>Influenza A</TH><TH id=ac7 headers=ac1>B</TH><TH id=ac9 colSpan=4 headers=ac8>Influenza A</TH><TH id=ac14 headers=ac8>B</TH></TR><TR class=bg-colour-grey-light><TH id=ac3 headers="ac1 ac2">A Total</TH><TH id=ac4 class=" bg-colour-blue" headers="ac1 ac2">A(H1)pdm09</TH><TH id=ac5 class=" bg-colour-blue" headers="ac1 ac2">A(H3)</TH><TH id=ac6 class=" bg-colour-blue" headers="ac1 ac2">A(UnS)</TH><TH class=alignCenter headers="ac1 ac7">B Total</TH><TH id=ac10 headers="ac8 ac9">A Total</TH><TH id=ac11 class=" bg-colour-blue" headers="ac8 ac9">A(H1)pdm09</TH><TH id=ac12 class=" bg-colour-blue" headers="ac8 ac9">A(H3)</TH><TH id=ac13 class=" bg-colour-blue" headers="ac8 ac9">A(UnS)</TH><TD class=alignCenter headers="ac8 ac14">B Total</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=alignLeft headers=ar1>BC</TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">9</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">9</TD><TD class=alignRight headers="ar1 ar2 ac1 ac7">27</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac10">1800</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac11">1612</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac12">49</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac13">139</TD><TD class=alignRight headers="ar1 ar2 ac8 ac14">318</TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">8</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">5</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">3</TD><TD class=alignRight headers="ar1 ar3 ac1 ac7">42</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac10">3843</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac11">3451</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac12">75</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac13">317</TD><TD class=alignRight headers="ar1 ar3 ac8 ac14">348</TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">3</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">2</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">1</TD><TD class=alignRight headers="ar1 ar4 ac1 ac7">17</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac10">1383</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac11">988</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac12">8</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac13">387</TD><TD class=alignRight headers="ar1 ar4 ac8 ac14">115</TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">16</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">2</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">2</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">12</TD><TD class=alignRight headers="ar1 ar5 ac1 ac7">8</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac10">676</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac11">462</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac12">5</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac13">209</TD><TD class=alignRight headers="ar1 ar5 ac8 ac14">30</TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">19</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">2</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">12</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">5</TD><TD class=alignRight headers="ar1 ar6 ac1 ac7">274</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac10">5711</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac11">2486</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac12">354</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac13">2871</TD><TD class=alignRight headers="ar1 ar6 ac8 ac14">2461</TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">12</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">12</TD><TD class=alignRight headers="ar1 ar7 ac1 ac7">109</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac10">5346</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac11">677</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac12">4</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac13">4665</TD><TD class=alignRight headers="ar1 ar7 ac8 ac14">2511</TD></TR><TR><TH id=ar8 class=alignLeft headers=ar1>NB</TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac7">17</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac10">1488</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac11">370</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac12">1</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac13">1117</TD><TD class=alignRight headers="ar1 ar8 ac8 ac14">86</TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac7">3</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac10">174</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac11">134</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac12">4</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac13">36</TD><TD class=alignRight headers="ar1 ar9 ac8 ac14">15</TD></TR><TR><TH id=ar10 class=alignLeft headers=ar1>PE</TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac7">0</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac10">119</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac11">118</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac13">1</TD><TD class=alignRight headers="ar1 ar10 ac8 ac14">2</TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">5</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac6">5</TD><TD class=alignRight headers="ar1 ar11 ac1 ac7">7</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac10">369</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac11">104</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac13">265</TD><TD class=alignRight headers="ar1 ar11 ac8 ac14">218</TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">72</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac4">6</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac5">19</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac6">47</TD><TD class=alignRight headers="ar1 ar12 ac1 ac7">504</TD><TD class=alignRight headers="ar1 ar12 ac8 ac9 ac10">20909</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac11">10402</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac12">500</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac13">10007</TD><TD class=alignRight headers="ar1 ar12 ac8 ac14">6104</TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="ar1 ar13 ac1 ac2 ac3">12.5%</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac4">8.3%</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac5">26.4%</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac6">65.3%</TD><TD class=alignRight headers="ar1 ar13 ac1 ac7">87.5%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac9 ac10">77.4%</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac11">49.7%</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac12">2.4%</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac13">47.9%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac14">22.6%</TD></TR></TBODY></TABLE>
<TABLE id=t2 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups (years)</TH><TH id=bc1 colSpan=5>Weekly
(April 20 to April 26, 2014)</TH><TH id=bc8 colSpan=7>Cumulative
(August 25, 2013 to April 26, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=bc2 colSpan=4 headers=bc1>Influenza A</TH><TH id=bc7 headers=bc1>B</TH><TH id=bc9 colSpan=4 headers=bc8>Influenza A</TH><TH id=bc14 headers=bc8>B</TH><TH id=bc15 colSpan=2 headers=bc8>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=bc3 headers="bc1 bc2">A Total</TH><TH id=bc4 class="bg-colour-blue " headers="bc1 bc2">A(H1) pdm09</TH><TH id=bc5 class="bg-colour-blue " headers="bc1 bc2">A(H3)</TH><TH id=bc6 class="bg-colour-blue " headers="bc1 bc2">A (UnS)</TH><TD class=alignCenter headers="bc1 bc7">Total</TD><TH id=bc10 headers="bc8 bc9">A Total</TH><TH id=bc11 class="bg-colour-blue " headers="bc8 bc9">A(H1) pdm09</TH><TH id=bc12 class="bg-colour-blue " headers="bc8 bc9">A(H3)</TH><TH id=bc13 class="bg-colour-blue " headers="bc8 bc9">A (UnS)</TH><TD class=alignCenter headers="bc8 bc14">Total</TD><TH id=bc16 headers="bc8 bc15">#</TH><TH id=bc17 headers="bc8 bc15">%</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13><SUP id=footnote_t2_1>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP id=footnote_t2_2>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
<SUP id=footnote_t2_3>3 </SUP>Table 2 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=br2 class=alignLeft headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">2</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">2</TD><TD class=alignRight headers="br1 br2 bc1 bc7">18</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">3252</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">1447</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">40</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1765</TD><TD class=alignRight headers="br1 br2 bc8 bc14">479</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc16">3731</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc17">17.0%</TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">5</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">4</TD><TD class=alignRight headers="br1 br3 bc1 bc7">30</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1324</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">706</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">22</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">596</TD><TD class=alignRight headers="br1 br3 bc8 bc14">727</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc16">2051</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc17">9.4%</TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">9</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">1</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">7</TD><TD class=alignRight headers="br1 br4 bc1 bc7">24</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">5073</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">2807</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">43</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">2223</TD><TD class=alignRight headers="br1 br4 bc8 bc14">855</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc16">5928</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc17">27.0%</TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">8</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">4</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">4</TD><TD class=alignRight headers="br1 br5 bc1 bc7">65</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">4452</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">2385</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">59</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">2008</TD><TD class=alignRight headers="br1 br5 bc8 bc14">1244</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc16">5696</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc17">26.0%</TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">17</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">4</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">13</TD><TD class=alignRight headers="br1 br6 bc1 bc7">104</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">2553</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">997</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">153</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">1403</TD><TD class=alignRight headers="br1 br6 bc8 bc14">1823</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc16">4376</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc17">20.0%</TD></TR><TR><TH id=br7 class=alignLeft headers=br1>Unknown</TH><TD class=alignRight headers="br1 br7 bc1 bc2 bc3">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc6">0</TD><TD class=alignRight headers="br1 br7 bc1 bc7">1</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc10">136</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">102</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">21</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">13</TD><TD class=alignRight headers="br1 br7 bc8 bc14">7</TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc16">143</TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc17">0.7%</TD></TR><TR><TH id=br8 class=alignLeft headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">41</TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc4">1</TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc5">10</TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc6">30</TD><TD class=alignRight headers="br1 br8 bc1 bc7">242</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">16790</TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc11">8444</TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc12">338</TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc13">8008</TD><TD class=alignRight headers="br1 br8 bc8 bc14">5135</TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc16">21925</TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc17">100.0%</TD></TR><TR><TH id=br9 class=alignLeft headers=br1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="br1 br9 bc1 bc2 bc3">14.5%</TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc4">2.4%</TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc5">24.4%</TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc6">73.2%</TD><TD class=alignRight headers="br1 br9 bc1 bc7">85.5%</TD><TD class=alignRight headers="br1 br9 bc8 bc9 bc10">76.6%</TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc11">50.3%</TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc12">2.0%</TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc13">47.7%</TD><TD class=alignRight headers="br1 br9 bc8 bc14">23.4%</TD><TD class=alignRight></TD><TD class=alignRight></TD></TR></TBODY></TABLE>

Top of Page
Influenza Strain Characterizations

During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 1,830 influenza viruses [94 A(H3N2), 1,325 A(H1N1)pdm09 and 411 influenza B]. The vast majority (99%) of viruses were similar to the strains recommended by the WHO for the 2013-14 seasonal influenza vaccine. Two A(H1N1)pdm09 viruses showed reduced titres to antiserum against the reference A/California/07/2009 strain. Twenty-two influenza B viruses were similar to the strain recommended by the WHO for the 2011-12 vaccine (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2013-2014, N = 1830
2014-w17-fg4-eng.gif

The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
The recommended components for the 2013-2014 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009 (H1N1)pdm09-like virus, an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b (e.g. A/Texas/50/2012), and a B/Massachusetts/2/2012-like virus (Yamagata lineage).


Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
Antiviral Resistance

During the 2013-2014 influenza season, NML has tested 1,636 influenza viruses for resistance to oseltamivir and all but two were sensitive. All 1,635 viruses tested for resistance to zanamivir were sensitive. All 1,499 influenza A viruses tested for amantadine resistance were resistant (Table 3).
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2013-2014</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=cr1 rowSpan=2>Virus type and subtype</TH><TH id=cc1 colSpan=2>Oseltamivir</TH><TH id=cc4 colSpan=2>Zanamivir</TH><TH id=cc7 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=cc2 headers=cc1># tested</TH><TH id=cc3 headers=cc1># resistant (%)</TH><TH id=cc5 headers=cc4># tested</TH><TH id=cc6 headers=cc4># resistant (%)</TH><TH id=cc8 headers=cc7># tested</TH><TH id=cc9 headers=cc7># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=cr2 class="alignLeft bg-colour-blue" headers=cr1>A (H3N2)</TH><TD class=alignRight headers="cr1 cr2 cc1 cc2">80</TD><TD class=alignRight headers="cr1 cr2 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr2 cc4 cc5">80</TD><TD class=alignRight headers="cr1 cr2 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr2 cc7 cc8">128</TD><TD class=alignRight headers="cr1 cr2 cc7 cc9">128 (100%)</TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignRight headers="cr1 cr3 cc1 cc2">1254</TD><TD class=alignRight headers="cr1 cr3 cc1 cc3">2 (0.2%)</TD><TD class=alignRight headers="cr1 cr3 cc4 cc5">1254</TD><TD class=alignRight headers="cr1 cr3 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr3 cc7 cc8">1371</TD><TD class=alignRight headers="cr1 cr3 cc7 cc9">1371 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignRight headers="cr1 cr4 cc1 cc2">302</TD><TD class=alignRight headers="cr1 cr4 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr4 cc4 cc5">301</TD><TD class=alignRight headers="cr1 cr4 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr4 cc7 cc8">NA <SUP>*</SUP></TD><TD class=alignRight headers="cr1 cr4 cc7 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft bg-colour-blue" headers=cr1>TOTAL</TH><TD class=alignRight headers="cr1 cr5 cc1 cc2">1636</TD><TD class=alignRight headers="cr1 cr5 cc1 cc3">2 (0.1%)</TD><TD class=alignRight headers="cr1 cr5 cc4 cc5">1635</TD><TD class=alignRight headers="cr1 cr5 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr5 cc7 cc8">1474</TD><TD class=alignRight headers="cr1 cr5 cc7 cc9">1499 (100%)</TD></TR></TBODY></TABLE>
Influenza-like Illness (ILI) Consultation Rate

The national influenza-like-illness (ILI) consultation rate decreased from 23.5 consultations per 1,000 patient visits in week 16 to 21.8 / 1,000 in week 17; which was within the expected range for week 17 (Figure 5).
Figure 5. Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014
2014-w17-fg5-eng.gif

Note: No data available for mean rate for weeks 19 to 39 for the 1996-1997 through 2002-2003 seasons. Delays in the reporting of data may cause data to change retrospectively. The calculation of the average ILI consultation rate over 17 seasons was aligned with influenza activity in each season. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. The number of sentinel physicians in each province or territory is as follows: BC(21), AB(80), SK(11), MB(18), ON(169), QC(14), NB(29), NS(26), PE(4), NL(16), NU(1), NT(14), YT(13). Not all sentinel physicians report every week.
Text equivalent for figure 5Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

Top of Page
Influenza Outbreak Surveillance

In week 17, eight new influenza outbreaks were reported, all in Ontario: seven in long-term care facilities and one in a hospital. All were outbreaks of influenza B (Figure 6). To date, fewer outbreaks in long-term care facilities, and a similar number of hospital outbreaks, have been reported compared to last season.
Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2013-2014
2014-w17-fg6-eng.gif

1 All provinces and territories except NU report outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
Text equivalent for figure 6Overall number of new influenza outbreaks by report week, Canada, 2013-2014
Pharmacy Surveillance

In week 17, the proportion of prescriptions for antivirals was similar to the previous week, in keeping with laboratory detections of influenza. The proportion of prescriptions for antivirals increased among infants <2 years of age and adults ≥65 years of age, although these rates are more variable. Overall this season, the largest proportion of prescriptions for antivirals has been among children 2-18 years of age and adults 19-64 years of age (Figure 7).
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14
2014-w17-fg7-eng.gif

Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group. Age-groups: Infant: 0-2y, Child: 2-18y; Adult: 19-64y, Senior: ≥65y.
Text equivalent for figure 7Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

Top of Page
Sentinel Hospital Influenza Surveillance

Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In week 17, nine new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to 11 in week 16. Six cases reported in week 17 had influenza B, and the remaining cases had influenza A(unsubtyped) (Figure 8a). A greater proportion of cases with influenza B this season have been children between 2 and 10 years of age compared to A(H1N1)pdm09. No ICU admissions or deaths were reported in week 17.
To date this season, a total of 683 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 82% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children <5 years of age represent 73% of cases to date (Table 4). Ninety-seven ICU admissions have been reported, of which 66 (68%) were children <5 years of age (Figure 9a). All but six were cases with influenza A, and 97% of those subtyped were A(H1N1)pdm09. Among the 94 ICU cases with available data, 60 (64%) were reported to have underlying medical conditions. No deaths have been reported.
Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
Adult Influenza Hospitalizations and Deaths (PCIRN)
In week 17, 19 new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported through active surveillance by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 53 in week 16 (Figure 8b). This season, a significantly greater proportion of cases of influenza B have been ≥65 years of age compared to cases of A(H1N1)pdm09. Since the beginning of March the majority of hospitalizations have been associated with influenza B, with a greater proportion of cases among adults ≥65 years of age. Three ICU admissions were reported in week 17, one adult 45-64 years of age with influenza A and two adults ≥65 years of age, one with influenza A and one with influenza B. No deaths were reported in week 17.
To date this season, 1,724 influenza-associated hospitalizations have been reported by the PCIRN-SOS network, 1,270 (73.7%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). Overall, fewer cases have been reported this season compared to the 2012-13 season, however, more than four times more cases of influenza B have been reported compared to last year. ICU admission was required for 276 hospitalizations, all but 37 of which were cases with influenza A (126 A(H1N1)pdm09, eight A(H3N2) and 105 A(unsubtyped)). A greater proportion of cases have been admitted to the ICU this season compared to last year, but the proportion of deaths has been similar. Of the 196 ICU admissions with available information, 168 (85.7%) were reported to have at least one comorbidity and of the 229 ICU admissions with available information 160 (69.9%) reported not having been vaccinated this season. Eighty-four deaths have been reported, all but 11 with influenza A (45 A(H1N1)pdm09, three A(H3N2) and 25 A(unsubtyped)); eight cases 20-44 years of age, 32 cases 45-64 years of age and 44 cases ≥65 years of age (Figure 9b).
Note: PCIRN-SOS conducted passive surveillance from April 30th to November 14th, 2013. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance began November 15th during which time PCIRN site coordinators investigate cases potentially related to influenza. Data from both active and passive surveillance reported during the 2013-14 season are included in this report. The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t4 class=alignCenter>Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=dr1 rowSpan=3>Age groups </TH><TH id=dc1 colSpan=6>Cumulative (Aug. 25, 2013 to April 26, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=dc2 colSpan=4 headers=dc1>Influenza A </TH><TH id=dc7 headers=dc1>B </TH><TH id=dc8 headers=dc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=dc3 headers="dc1 dc2">A Total </TH><TH id=dc4 class="bg-colour-blue " headers="dc1 dc2">A(H1) pdm09 </TH><TH id=dc5 class="bg-colour-blue " headers="dc1 dc2">A(H3) </TH><TH id=dc6 class="bg-colour-blue " headers="dc1 dc2">A (UnS) </TH><TD class=alignCenter headers="dc1 dc7">Total</TD><TD class=alignCenter headers="dc1 dc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t4_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=dr2 class=alignLeft headers=dr1>0-5m </TH><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc3">104</TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc4">34</TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc5">0</TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc6">70</TD><TD class=alignRight headers="dr1 dr2 dc1 dc7">8</TD><TD class=alignRight headers="dr1 dr2 dc1 dc8">112 (16%)</TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc3">163</TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc4">51</TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc5">1</TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc6">111</TD><TD class=alignRight headers="dr1 dr3 dc1 dc7">21</TD><TD class=alignRight headers="dr1 dr3 dc1 dc8">184 (27%)</TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc3">166</TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc4">55</TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc5">3</TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc6">108</TD><TD class=alignRight headers="dr1 dr4 dc1 dc7">37</TD><TD class=alignRight headers="dr1 dr4 dc1 dc8">203 (30%)</TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc3">84</TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc4">27</TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc5">1</TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc6">56</TD><TD class=alignRight headers="dr1 dr5 dc1 dc7">48</TD><TD class=alignRight headers="dr1 dr5 dc1 dc8">132 (19%)</TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc3">40</TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc4">14</TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc5">1</TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc6">25</TD><TD class=alignRight headers="dr1 dr6 dc1 dc7">12</TD><TD class=alignRight headers="dr1 dr6 dc1 dc8">52 (8%)</TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignRight headers="dr1 dr7 dc1 dc2 dc3">557</TD><TD class="alignRight bg-colour-blue" headers="dr1 dr7 dc1 dc2 dc4">181</TD><TD class="alignRight bg-colour-blue" headers="dr1 dr7 dc1 dc2 dc5">6</TD><TD class="alignRight bg-colour-blue" headers="dr1 dr7 dc1 dc2 dc6">370</TD><TD class=alignRight headers="dr1 dr7 dc1 dc7">126</TD><TD class=alignRight headers="dr1 dr7 dc1 dc8">683</TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP> </TH><TD class=alignRight headers="dr1 dr8 dc1 dc2 dc3">81.6%</TD><TD class="alignRight bg-colour-blue" headers="dr1 dr8 dc1 dc2 dc4">32.5%</TD><TD class="alignRight bg-colour-blue" headers="dr1 dr8 dc1 dc2 dc5">1.1%</TD><TD class="alignRight bg-colour-blue" headers="dr1 dr8 dc1 dc2 dc6">66.4%</TD><TD class=alignRight headers="dr1 dr8 dc1 dc7">18.4%</TD><TD class=alignRight headers="dr1 dr8 dc1 dc8">100.0%</TD></TR></TBODY></TABLE>
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 5 - Cumulative numbers of adult hospitalizations with influenza
reported by the PCIRN-SOS network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=er1 rowSpan=3>Age groups </TH><TH id=ec1 class=noWrap colSpan=6>Cumulative (Aug. 25, 2013 to April 26, 2014)<SUP>*</SUP></TH></TR><TR class=bg-colour-yellow><TH id=ec2 colSpan=4 headers=ec1>Influenza A </TH><TH id=ec7 headers=ec1>B </TH><TH id=ec8 headers=ec1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=ec3 headers="ec1 ec2">A Total </TH><TH id=ec4 class=bg-colour-blue headers="ec1 ec2">A(H1) pdm09 </TH><TH id=ec5 class=bg-colour-blue headers="ec1 ec2">A(H3) </TH><TH id=ec6 class=bg-colour-blue headers="ec1 ec2">A(UnS) </TH><TD class=alignCenter headers="ec1 ec7">Total</TD><TD class=alignCenter headers="ec1 ec8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t5_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.

<SUP id=t5_star>*</SUP> Two cases for which the influenza type has not yet been reported, and six cases for which the age-group was not reported, are not included in Table 5.</TD></TR></TFOOT><TBODY><TR><TH id=er2 class=alignLeft headers=er1>16-20 </TH><TD class=alignRight headers="er1 er2 ec1 ec2 ec3">13</TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec4">5</TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec5">0</TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec6">8</TD><TD class=alignRight headers="er1 er2 ec1 ec7">2</TD><TD class=alignRight headers="er1 er2 ec1 ec8">15 (1%)</TD></TR><TR><TH id=er3 class=alignLeft headers=er1>20-44 </TH><TD class=alignRight headers="er1 er3 ec1 ec2 ec3">267</TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec4">142</TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec5">6</TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec6">119</TD><TD class=alignRight headers="er1 er3 ec1 ec7">31</TD><TD class=alignRight headers="er1 er3 ec1 ec8">298 (17%)</TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignRight headers="er1 er4 ec1 ec2 ec3">492</TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec4">235</TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec5">9</TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec6">248</TD><TD class=alignRight headers="er1 er4 ec1 ec7">104</TD><TD class=alignRight headers="er1 er4 ec1 ec8">596 (35%)</TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignRight headers="er1 er5 ec1 ec2 ec3">493</TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec4">229</TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec5">51</TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec6">213</TD><TD class=alignRight headers="er1 er5 ec1 ec7">315</TD><TD class=alignRight headers="er1 er5 ec1 ec8">808 (47%)</TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignRight headers="er1 er6 ec1 ec2 ec3">1265</TD><TD class="alignRight bg-colour-blue" headers="er1 er6 ec1 ec2 ec4">611</TD><TD class="alignRight bg-colour-blue" headers="er1 er6 ec1 ec2 ec5">66</TD><TD class="alignRight bg-colour-blue" headers="er1 er6 ec1 ec2 ec6">588</TD><TD class=alignRight headers="er1 er6 ec1 ec7">452</TD><TD class=alignRight headers="er1 er6 ec1 ec8">1717</TD></TR><TR><TH id=er7 class=alignLeft headers=er1>%<SUP>1</SUP></TH><TD class=alignRight headers="er1 er7 ec1 ec2 ec3">74%</TD><TD class="alignRight bg-colour-blue" headers="er1 er7 ec1 ec2 ec4">48%</TD><TD class="alignRight bg-colour-blue" headers="er1 er7 ec1 ec2 ec5">5%</TD><TD class="alignRight bg-colour-blue" headers="er1 er7 ec1 ec2 ec6">46%</TD><TD class=alignRight headers="er1 er7 ec1 ec7">26%</TD><TD class=alignRight headers="er1 er7 ec1 ec8">100%</TD></TR></TBODY></TABLE>
Figure 8. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w17-fg8a-eng.gif


Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w17-fg8b-eng.gif

* See footnote above following the section related to PCIRN-SOS data.
Text equivalent for figure 8bNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Adult hospitalizations (>16 year of age, PCIRN-SOS)
Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w17-fg9a-eng.gif

Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w17-fg9b-eng.gif

Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Adult hospitalizations (≥16 year of age, PCIRN-SOS)

Top of Page
Provincial/Territorial Influenza Hospitalizations and Deaths

In week 17, 170 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories<SUP>*</SUP>. As with other surveillance indicators in week 17, the majority were cases of influenza B (149, 87.6%). One ICU admission was reported in week 17, an adult 20-44 years of age with influenza A(H1N1)pdm09. Eight deaths were reported this week; two children 2-14 years of age with influenza A, and six adults ≥65 years of age with influenza B. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total.
To date this season, 4,393 influenza-associated hospitalizations have been reported, 80.7% with influenza A. The majority (59.9%) of hospitalizations have been cases 45 years of age of older. A significantly greater proportion of cases of influenza B have been ≥65 years of age, and 5-19 years of age, compared to cases of A(H1N1)pdm09 this season (Table 6). A total of 346 ICU admissions have been reported this season, of which 65.3% were adults 20-64 years of age. A total of 244 deaths have been reported. The highest proportion of deaths has been among adults ≥65 years of age (48.0%) followed by adults 20-64 years of age (43.0%). In keeping with the late-season circulation, influenza B has been increasingly reported among hospitalized cases of influenza. To date this season, influenza B has been reported in 19.3% of hospitalizations and 17.2% of deaths. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.
* Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, NS, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t6 class=alignCenter>Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=fr1 rowSpan=3>Age groups </TH><TH id=fc1 colSpan=6>Cumulative (Aug. 25, 2013 to April 26, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=fc2 colSpan=4 headers=fc1>Influenza A</TH><TH id=fc7 headers=fc1>B</TH><TH id=fc8 headers=fc1>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=fc3 headers="fc1 fc2">A Total</TH><TH id=fc4 class=bg-colour-blue headers="fc1 fc2">A(H1) pdm09</TH><TH id=fc5 class=bg-colour-blue headers="fc1 fc2">A(H3)</TH><TH id=fc6 class=bg-colour-blue headers="fc1 fc2">A (UnS)</TH><TD class=alignCenter headers="fc1 fc7">Total</TD><TD class=alignCenter headers="fc1 fc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=8><SUP id=footnote_t6_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=fr2 class=alignLeft headers=fr1>0-4 years</TH><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc3">607</TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc4">287</TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc5">10</TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc6">310</TD><TD class=alignRight headers="fr1 fr2 fc1 fc7">90</TD><TD class=alignRight headers="fr1 fr2 fc1 fc8">697 (16%)</TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years</TH><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc3">133</TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc4">65</TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc5">6</TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc6">62</TD><TD class=alignRight headers="fr1 fr3 fc1 fc7">84</TD><TD class=alignRight headers="fr1 fr3 fc1 fc8">217 (5%)</TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years</TH><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc3">36</TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc4">21</TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc5">3</TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc6">12</TD><TD class=alignRight headers="fr1 fr4 fc1 fc7">5</TD><TD class=alignRight headers="fr1 fr4 fc1 fc8">41 (1%)</TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc3">607</TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc4">424</TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc5">4</TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc6">179</TD><TD class=alignRight headers="fr1 fr5 fc1 fc7">53</TD><TD class=alignRight headers="fr1 fr5 fc1 fc8">660 (15%)</TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc3">1105</TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc4">699</TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc5">27</TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc6">379</TD><TD class=alignRight headers="fr1 fr6 fc1 fc7">166</TD><TD class=alignRight headers="fr1 fr6 fc1 fc8">1271 (29%)</TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc3">921</TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc4">461</TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc5">87</TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc6">373</TD><TD class=alignRight headers="fr1 fr7 fc1 fc7">439</TD><TD class=alignRight headers="fr1 fr7 fc1 fc8">1360 (31%)</TD></TR><TR><TH id=fr10 class=alignLeft headers=fr1>Unknown</TH><TD class=alignRight headers="fc1 fc2 fc3">134</TD><TD class=alignRight headers="fc1 fc2 fc4">99</TD><TD class=alignRight headers="fc1 fc2 fc5">3</TD><TD class=alignRight headers="fc1 fc2 fc6">32</TD><TD class=alignRight headers="fc1 fc7">13</TD><TD class=alignRight headers="fc1 fc8">147 (3%)</TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignRight headers="fr1 fr8 fc1 fc2 fc3">3543</TD><TD class="alignRight bg-colour-blue" headers="fr1 fr8 fc1 fc2 fc4">2056</TD><TD class="alignRight bg-colour-blue" headers="fr1 fr8 fc1 fc2 fc5">140</TD><TD class="alignRight bg-colour-blue" headers="fr1 fr8 fc1 fc2 fc6">1347</TD><TD class=alignRight headers="fr1 fr8 fc1 fc7">850</TD><TD class=alignRight headers="fr1 fr8 fc1 fc8">4393</TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP> </TH><TD class=alignRight headers="fr1 fr9 fc1 fc2 fc3">80.7%</TD><TD class="alignRight bg-colour-blue" headers="fr1 fr9 fc1 fc2 fc4">58.0%</TD><TD class="alignRight bg-colour-blue" headers="fr1 fr9 fc1 fc2 fc5">4.0%</TD><TD class="alignRight bg-colour-blue" headers="fr1 fr9 fc1 fc2 fc6">38.0%</TD><TD class=alignRight headers="fr1 fr9 fc1 fc7">19.3%</TD><TD class=alignRight headers="fr1 fr9 fc1 fc8">100%</TD></TR></TBODY></TABLE>
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2013-14 on the Public Health Agency of Canada website.

.../
http://www.phac-aspc.gc.ca/fluwatch/13-14/w17_14/index-eng.php
 
Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 18

Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 18

FluWatch report: April 27 to 3 May, 2014 (Week 18)

Posted 2014-05-09

For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
<A title="Flu Watch (Version PDF, 113 KB - 6 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/13-14/w18_14/pdf/fw2014-18-eng.pdf">FluWatch report: April 27 to 3 May, 2014 (Week 18) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 291 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

?? Help with PDF documents
Overall Summary
  • In week 18, influenza B continued to circulate in several regions across Canada. This sustained influenza activity remains within expected levels for this time of year, and is consistent with late-season circulation of influenza B.
  • Influenza B is having a greater impact on adults 65 years of age and older and young persons 5 to 19 years of age, compared to influenza A(H1N1) which circulated earlier in the year.
  • As of week 18, 4,623 hospitalizations and 258 deaths have been reported from participating regions, which is fewer than were reported last year.
  • Globally, influenza activity in the northern hemisphere continues to decline, approaching inter-seasonal levels; influenza activity in the southern hemisphere remains low.
Influenza/ILI Activity (geographic spread)

After holding steady in March and April, the number of regions reporting localized or widespread influenza activity increased in week 18. In week 18, no region reported widespread activity and 12 regions (BC(1), MB(1), ON(5), QC(3) and NS(2)) reported localized activity (Figure 1).
Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 18


right_ofmap.gif



Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
Influenza and Other Respiratory Virus Detections

The number of positive influenza tests decreased from 580 in week 17 to 441 (11.7% of tests) in week 18 (Figure 2). Influenza B remained the predominant virus in week 18, representing 90% of influenza detections. Influenza B continues to circulate in many regions across Canada. Most jurisdictions report stable or declining levels of influenza detections over recent weeks. In week 18, Nova Scotia reported a sharp increase in influenza B detections which may have been due to testing related to outbreaks in long-term care facilities (Table 1). The pattern of influenza circulation during the 2012-13 and 2013-14 seasons has been similar, although this season the predominant circulating subtype of influenza A was A(H1N1)pdm09 and there has been more late-season circulation of influenza B. Significantly greater proportions of influenza B cases have been ≥65 years of age and 5-19 years of age compared to cases of A(H1N1)pdm09. Among cases for which information on age and type/subtype has been received, 51% of the cases in week 18 were ≥65 years of age compared to 20% of cases for the season to date (Table 2).
Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
2014-w18-fg2-eng.gif

Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
The number of positive tests for RSV and coronavirus continued to decline, in keeping with their seasonal pattern of winter circulation. The number of positive tests for parainfluenza and adenovirus have been variable in recent weeks. More detections of human metapneumovirus have been reported compared to the previous three seasons, but have been declining since mid-March. Detections of rhinovirus have been relatively stable during the winter months, but have been increasing during late-March and April, in keeping with its seasonal distribution in recent years demonstrating a small peak of detections in the spring and a larger peak in the fall (Figure 3).
For more details, see the weekly Respiratory Virus Detections in Canada Report.
Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2013-14
2014-w18-fg3-eng.gif


Top of Page
RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
<TABLE id=t1 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class="alignCenter margin10px">Table 1: Weekly and cumulative numbers of positive influenza specimens
by type, subtype and province, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=ac1 colSpan=5>Weekly
(April 27, 2013 to May 3, 2014)</TH><TH id=ac8 colSpan=5>Cumulative
(August 25, 2013 to May 3, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=4 headers=ac1>Influenza A</TH><TH id=ac7 headers=ac1>B</TH><TH id=ac9 colSpan=4 headers=ac8>Influenza A</TH><TH id=ac14 headers=ac8>B</TH></TR><TR class=bg-colour-grey-light><TH id=ac3 headers="ac1 ac2">A Total</TH><TH id=ac4 class=" bg-colour-blue" headers="ac1 ac2">A(H1)pdm09</TH><TH id=ac5 class=" bg-colour-blue" headers="ac1 ac2">A(H3)</TH><TH id=ac6 class=" bg-colour-blue" headers="ac1 ac2">A(UnS)</TH><TH class=alignCenter headers="ac1 ac7">B Total</TH><TH id=ac10 headers="ac8 ac9">A Total</TH><TH id=ac11 class=" bg-colour-blue" headers="ac8 ac9">A(H1)pdm09</TH><TH id=ac12 class=" bg-colour-blue" headers="ac8 ac9">A(H3)</TH><TH id=ac13 class=" bg-colour-blue" headers="ac8 ac9">A(UnS)</TH><TD class=alignCenter headers="ac8 ac14">B Total</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=alignLeft headers=ar1>BC</TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">13 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">2 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">10 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">1 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac7">6 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac10">1813 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac11">1616 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac12">57 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac13">140 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac14">324 </TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">0 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac7">32 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac10">3844 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac11">3454 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac12">76 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac13">314 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac14">381 </TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">0 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac7">19 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac10">1383 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac11">988 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac12">8 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac13">387 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac14">134 </TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">4 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">4 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac7">10 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac10">680 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac11">462 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac12">5 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac13">213 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac14">40 </TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">18 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">3 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">10 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">5 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac7">209 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac10">5729 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac11">2489 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac12">364 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac13">2876 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac14">2670 </TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">7 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">1 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">6 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac7">88 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac10">5353 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac11">677 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac12">5 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac13">4671 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac14">2601 </TD></TR><TR><TH id=ar8 class=alignLeft headers=ar1>NB</TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">0 </TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar8 ac1 ac7">7 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac10">1488 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac11">370 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac12">1 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac13">1117 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac14">93 </TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">0 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac7">18 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac10">174 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac11">134 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac12">4 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac13">36 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac14">33 </TD></TR><TR><TH id=ar10 class=alignLeft headers=ar1>PE</TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">0 </TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar10 ac1 ac7">0 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac10">119 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac11">118 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac12">0 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac13">1 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac14">2 </TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">2 </TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac6">2 </TD><TD class=alignRight headers="ar1 ar11 ac1 ac7">8 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac10">371 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac11">104 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac12">0 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac13">267 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac14">226 </TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">44 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac4">5 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac5">21 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac6">18 </TD><TD class=alignRight headers="ar1 ar12 ac1 ac7">397 </TD><TD class=alignRight headers="ar1 ar12 ac8 ac9 ac10">20954 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac11">10412 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac12">520 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac13">10022 </TD><TD class=alignRight headers="ar1 ar12 ac8 ac14">6504 </TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="ar1 ar13 ac1 ac2 ac3">10.0% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac4">11.4% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac5">47.7% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac6">40.9% </TD><TD class=alignRight headers="ar1 ar13 ac1 ac7">90.0% </TD><TD class=alignRight headers="ar1 ar13 ac8 ac9 ac10">76.3% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac11">49.7% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac12">2.5% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac13">47.8% </TD><TD class=alignRight headers="ar1 ar13 ac8 ac14">23.7% </TD></TR></TBODY></TABLE>
<TABLE id=t2 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups (years)</TH><TH id=bc1 colSpan=5>Weekly
(April 27 to May 3, 2014)</TH><TH id=bc8 colSpan=7>Cumulative
(August 25, 2013 to May 3, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=bc2 colSpan=4 headers=bc1>Influenza A</TH><TH id=bc7 headers=bc1>B</TH><TH id=bc9 colSpan=4 headers=bc8>Influenza A</TH><TH id=bc14 headers=bc8>B</TH><TH id=bc15 colSpan=2 headers=bc8>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=bc3 headers="bc1 bc2">A Total</TH><TH id=bc4 class="bg-colour-blue " headers="bc1 bc2">A(H1) pdm09</TH><TH id=bc5 class="bg-colour-blue " headers="bc1 bc2">A(H3)</TH><TH id=bc6 class="bg-colour-blue " headers="bc1 bc2">A (UnS)</TH><TD class=alignCenter headers="bc1 bc7">Total</TD><TH id=bc10 headers="bc8 bc9">A Total</TH><TH id=bc11 class="bg-colour-blue " headers="bc8 bc9">A(H1) pdm09</TH><TH id=bc12 class="bg-colour-blue " headers="bc8 bc9">A(H3)</TH><TH id=bc13 class="bg-colour-blue " headers="bc8 bc9">A (UnS)</TH><TD class=alignCenter headers="bc8 bc14">Total</TD><TH id=bc16 headers="bc8 bc15">#</TH><TH id=bc17 headers="bc8 bc15">%</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13><SUP id=footnote_t2_1>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP id=footnote_t2_2>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
<SUP id=footnote_t2_3>3 </SUP>Table 2 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=br2 class=alignLeft headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">1 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">1 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">0 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">0 </TD><TD class=alignRight headers="br1 br2 bc1 bc7">10 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">3257 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">1450 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">40 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1767 </TD><TD class=alignRight headers="br1 br2 bc8 bc14">501 </TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc16">3758 </TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc17">16.9% </TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">1 </TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">0 </TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">0 </TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">1 </TD><TD class=alignRight headers="br1 br3 bc1 bc7">15 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1326 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">706 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">22 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">598 </TD><TD class=alignRight headers="br1 br3 bc8 bc14">757 </TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc16">2083 </TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc17">9.3% </TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">4 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">0 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">1 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">3 </TD><TD class=alignRight headers="br1 br4 bc1 bc7">22 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">5077 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">2807 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">45 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">2225 </TD><TD class=alignRight headers="br1 br4 bc8 bc14">907 </TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc16">5984 </TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc17">26.8% </TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">0 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">0 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">0 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">0 </TD><TD class=alignRight headers="br1 br5 bc1 bc7">38 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">4456 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">2387 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">60 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">2009 </TD><TD class=alignRight headers="br1 br5 bc8 bc14">1331 </TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc16">5787 </TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc17">26.0% </TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">5 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">0 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">2 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">3 </TD><TD class=alignRight headers="br1 br6 bc1 bc7">91 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">2567 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">1000 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">163 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">1404 </TD><TD class=alignRight headers="br1 br6 bc8 bc14">1968 </TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc16">4535 </TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc17">20.3% </TD></TR><TR><TH id=br7 class=alignLeft headers=br1>Unknown</TH><TD class=alignRight headers="br1 br7 bc1 bc2 bc3">0 </TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc4">0 </TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc5">0 </TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc6">0 </TD><TD class=alignRight headers="br1 br7 bc1 bc7">0 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc10">136 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">102 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">21 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">13 </TD><TD class=alignRight headers="br1 br7 bc8 bc14">7 </TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc16">143 </TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc17">0.6% </TD></TR><TR><TH id=br8 class=alignLeft headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">11 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc4">1 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc5">3 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc6">7 </TD><TD class=alignRight headers="br1 br8 bc1 bc7">176 </TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">16819 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc11">8452 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc12">351 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc13">8016 </TD><TD class=alignRight headers="br1 br8 bc8 bc14">5471 </TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc16">22290 </TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc17">100.0% </TD></TR><TR><TH id=br9 class=alignLeft headers=br1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="br1 br9 bc1 bc2 bc3">5.9% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc4">9.1% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc5">27.3% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc6">63.6% </TD><TD class=alignRight headers="br1 br9 bc1 bc7">94.1% </TD><TD class=alignRight headers="br1 br9 bc8 bc9 bc10">75.5% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc11">50.3% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc12">2.1% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc13">47.7% </TD><TD class=alignRight headers="br1 br9 bc8 bc14">24.5% </TD><TD class=alignRight></TD><TD class=alignRight></TD></TR></TBODY></TABLE>

Top of Page
Influenza Strain Characterizations

During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 1,970 influenza viruses [106 A(H3N2), 1,353 A(H1N1)pdm09 and 511 influenza B]. The vast majority (99%) of viruses were similar to the strains recommended by the WHO for the 2013-14 seasonal influenza vaccine. Two A(H1N1)pdm09 viruses showed reduced titres to antiserum against the reference A/California/07/2009 strain. Twenty-six influenza B viruses were similar to the strain recommended by the WHO for the 2011-12 vaccine (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2013-2014, N = 1970
2014-w18-fg4-eng.gif

The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
The recommended components for the 2013-2014 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009 (H1N1)pdm09-like virus, an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b (e.g. A/Texas/50/2012), and a B/Massachusetts/2/2012-like virus (Yamagata lineage).


Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
Antiviral Resistance

During the 2013-2014 influenza season, NML has tested 1,714 influenza viruses for resistance to oseltamivir and all but three were sensitive. All 1,718 viruses tested for resistance to zanamivir were sensitive. All 1,511 influenza A viruses tested for amantadine resistance were resistant (Table 3).
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2013-2014</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=cr1 rowSpan=2>Virus type and subtype</TH><TH id=cc1 colSpan=2>Oseltamivir</TH><TH id=cc4 colSpan=2>Zanamivir</TH><TH id=cc7 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=cc2 headers=cc1># tested</TH><TH id=cc3 headers=cc1># resistant (%)</TH><TH id=cc5 headers=cc4># tested</TH><TH id=cc6 headers=cc4># resistant (%)</TH><TH id=cc8 headers=cc7># tested</TH><TH id=cc9 headers=cc7># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=cr2 class="alignLeft bg-colour-blue" headers=cr1>A (H3N2)</TH><TD class=alignRight headers="cr1 cr2 cc1 cc2">84</TD><TD class=alignRight headers="cr1 cr2 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr2 cc4 cc5">84</TD><TD class=alignRight headers="cr1 cr2 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr2 cc7 cc8">129</TD><TD class=alignRight headers="cr1 cr2 cc7 cc9">129 (100%)</TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignRight headers="cr1 cr3 cc1 cc2">1288</TD><TD class=alignRight headers="cr1 cr3 cc1 cc3">3 (0.2%)</TD><TD class=alignRight headers="cr1 cr3 cc4 cc5">1293</TD><TD class=alignRight headers="cr1 cr3 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr3 cc7 cc8">1382</TD><TD class=alignRight headers="cr1 cr3 cc7 cc9">1382 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignRight headers="cr1 cr4 cc1 cc2">342</TD><TD class=alignRight headers="cr1 cr4 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr4 cc4 cc5">341</TD><TD class=alignRight headers="cr1 cr4 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr4 cc7 cc8">NA <SUP>*</SUP></TD><TD class=alignRight headers="cr1 cr4 cc7 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft bg-colour-blue" headers=cr1>TOTAL</TH><TD class=alignRight headers="cr1 cr5 cc1 cc2">1714</TD><TD class=alignRight headers="cr1 cr5 cc1 cc3">3 (0.1%)</TD><TD class=alignRight headers="cr1 cr5 cc4 cc5">1718</TD><TD class=alignRight headers="cr1 cr5 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr5 cc7 cc8">1511</TD><TD class=alignRight headers="cr1 cr5 cc7 cc9">1511 (100%)</TD></TR></TBODY></TABLE>
Influenza-like Illness (ILI) Consultation Rate

The national influenza-like-illness (ILI) consultation rate decreased from 23.3 consultations per 1,000 patient visits in week 17 to 21.7 / 1,000 in week 18; which was slightly above the expected range for week 18 (Figure 5).
Figure 5. Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014
2014-w18-fg5-eng.gif

Note: No data available for mean rate for weeks 19 to 39 for the 1996-1997 through 2002-2003 seasons. Delays in the reporting of data may cause data to change retrospectively. The calculation of the average ILI consultation rate over 17 seasons was aligned with influenza activity in each season. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. The number of sentinel physicians in each province or territory is as follows: BC(21), AB(80), SK(11), MB(18), ON(169), QC(14), NB(29), NS(26), PE(4), NL(16), NU(1), NT(14), YT(13). Not all sentinel physicians report every week.
Text equivalent for figure 5Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

Top of Page
Influenza Outbreak Surveillance

The number of new influenza outbreaks increased sharply from eight in week 17 to 21 in week 18: 19 in long-term care facilities, one in a hospital (Figure 6), and one in another setting or community. However, overall laboratory detections of influenza declined in 5 of the 6 regions reporting outbreaks. Among the 21 influenza outbreaks, 12 had data on the influenza type, of which 10 were influenza B.
Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2013-2014
2014-w18-fg6-eng.gif

1 All provinces and territories except NU report outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
Text equivalent for figure 6Overall number of new influenza outbreaks by report week, Canada, 2013-2014
Pharmacy Surveillance

In week 18, the proportion of prescriptions for antivirals was similar to the previous week, in keeping with laboratory detections of influenza. The proportion of prescriptions for antivirals decreased among infants <2 years of age and increased among adults ≥65 years of age, although these rates are more variable. Overall this season, the largest proportion of prescriptions for antivirals has been among children 2-18 years of age and adults 19-64 years of age (Figure 7).
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14
2014-w18-fg7-eng.gif

Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group. Age-groups: Infant: 0-2y, Child: 2-18y; Adult: 19-64y, Senior: ≥65y.
Text equivalent for figure 7Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

Top of Page
Sentinel Hospital Influenza Surveillance

Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In week 18, five new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to nine in week 17. Four cases reported in week 18 had influenza B (Figure 8a). A greater proportion of cases with influenza B this season have been children between 2 and 10 years of age compared to A(H1N1)pdm09. One ICU admission was reported in week 18 in a child 5-9 years of age with influenza A(unsubtyped), and no deaths were reported.
To date this season, a total of 684 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 81% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children <5 years of age represent 73% of cases to date (Table 4). Ninety-eight ICU admissions have been reported, of which 66 (68%) were children <5 years of age (Figure 9a). All but six were cases with influenza A, and 97% of those subtyped were A(H1N1)pdm09. Among the 95 ICU cases with available data, 61 (64%) were reported to have underlying medical conditions. No deaths have been reported. A slightly smaller number of paediatric hospital admissions have been reported this year compared to the 2012-13 season.
Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
Adult Influenza Hospitalizations and Deaths (PCIRN)
In week 18, nine new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported through active surveillance by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 31 in week 17 (Figure 8b). Since the beginning of March the majority of hospitalizations have been associated with influenza B. This season, a significantly greater proportion of cases of influenza B have been ≥65 years of age compared to cases of A(H1N1)pdm09. The proportion of cases among adults ≥65 years of age has followed the distribution of influenza B, and has declined in recent weeks. No ICU admissions or deaths were reported in week 18.
To date this season, 1,798 influenza-associated hospitalizations have been reported by the PCIRN-SOS network, 1,284 (71.4%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). Overall, slightly fewer cases have been reported this season compared to the 2012-13 season, however, nearly five times more cases of influenza B have been reported compared to last year. ICU admission was required for 291 hospitalizations, all but 43 of which were cases with influenza A (131 A(H1N1)pdm09, eight A(H3N2) and 109 A(unsubtyped)). A greater proportion of cases have been admitted to the ICU this season compared to last year, but the proportion of deaths has been similar. Of the 201 ICU admissions with available information, 172 (85.6%) were reported to have at least one comorbidity and of the 244 ICU admissions with available information 169 (69.3%) reported not having been vaccinated this season. Ninety-two deaths have been reported, all but 15 with influenza A (47 A(H1N1)pdm09, four A(H3N2) and 26 A(unsubtyped)); nine cases 20-44 years of age, 33 cases 45-64 years of age and 50 cases ≥65 years of age (Figure 9b).
Note: PCIRN-SOS conducted passive surveillance from April 30th to November 14th, 2013. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance began November 15th during which time PCIRN site coordinators investigate cases potentially related to influenza. Data from both active and passive surveillance reported during the 2013-14 season are included in this report. The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t4 class=alignCenter>Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=dr1 rowSpan=3>Age groups </TH><TH id=dc1 colSpan=6>Cumulative (Aug. 25, 2013 to May 3, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=dc2 colSpan=4 headers=dc1>Influenza A </TH><TH id=dc7 headers=dc1>B </TH><TH id=dc8 headers=dc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=dc3 headers="dc1 dc2">A Total </TH><TH id=dc4 class="bg-colour-blue " headers="dc1 dc2">A(H1) pdm09 </TH><TH id=dc5 class="bg-colour-blue " headers="dc1 dc2">A(H3) </TH><TH id=dc6 class="bg-colour-blue " headers="dc1 dc2">A (UnS) </TH><TD class=alignCenter headers="dc1 dc7">Total</TD><TD class=alignCenter headers="dc1 dc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t4_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=dr2 class=alignLeft headers=dr1>0-5m </TH><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc3">104 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc4">34 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc5">0 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc6">70 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc7">8 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc8">112 (16%) </TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc3">163 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc4">51 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc5">1 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc6">111 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc7">21 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc8">184 (27%) </TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc3">166 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc4">55 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc5">3 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc6">108 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc7">39 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc8">205 (30%) </TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc3">82 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc4">27 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc5">1 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc6">54 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc7">50 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc8">132 (19%) </TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc3">39 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc4">14 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc5">1 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc6">24 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc7">12 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc8">51 (7%) </TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignRight headers="dr1 dr7 dc1 dc2 dc3">554 </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr7 dc1 dc2 dc4">181 </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr7 dc1 dc2 dc5">6 </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr7 dc1 dc2 dc6">367 </TD><TD class=alignRight headers="dr1 dr7 dc1 dc7">130 </TD><TD class=alignRight headers="dr1 dr7 dc1 dc8">684 </TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP> </TH><TD class=alignRight headers="dr1 dr8 dc1 dc2 dc3">81.0% </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr8 dc1 dc2 dc4">32.7% </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr8 dc1 dc2 dc5">1.1% </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr8 dc1 dc2 dc6">66.2% </TD><TD class=alignRight headers="dr1 dr8 dc1 dc7">19.0% </TD><TD class=alignRight headers="dr1 dr8 dc1 dc8">100.0% </TD></TR></TBODY></TABLE>
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 5 - Cumulative numbers of adult hospitalizations with influenza
reported by the PCIRN-SOS network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=er1 rowSpan=3>Age groups </TH><TH id=ec1 class=noWrap colSpan=6>Cumulative (Aug. 25, 2013 to May 3, 2014)<SUP>*</SUP></TH></TR><TR class=bg-colour-yellow><TH id=ec2 colSpan=4 headers=ec1>Influenza A </TH><TH id=ec7 headers=ec1>B </TH><TH id=ec8 headers=ec1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=ec3 headers="ec1 ec2">A Total </TH><TH id=ec4 class=bg-colour-blue headers="ec1 ec2">A(H1) pdm09 </TH><TH id=ec5 class=bg-colour-blue headers="ec1 ec2">A(H3) </TH><TH id=ec6 class=bg-colour-blue headers="ec1 ec2">A(UnS) </TH><TD class=alignCenter headers="ec1 ec7">Total</TD><TD class=alignCenter headers="ec1 ec8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t5_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.

<SUP id=t5_star>*</SUP> Two cases for which the influenza type has not yet been reported, and six cases for which the age-group was not reported, are not included in Table 5.</TD></TR></TFOOT><TBODY><TR><TH id=er2 class=alignLeft headers=er1>16-20 </TH><TD class=alignRight headers="er1 er2 ec1 ec2 ec3">13 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec4">5 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec5">0 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec6">8 </TD><TD class=alignRight headers="er1 er2 ec1 ec7">2 </TD><TD class=alignRight headers="er1 er2 ec1 ec8">15 (1%) </TD></TR><TR><TH id=er3 class=alignLeft headers=er1>20-44 </TH><TD class=alignRight headers="er1 er3 ec1 ec2 ec3">269 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec4">143 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec5">6 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec6">120 </TD><TD class=alignRight headers="er1 er3 ec1 ec7">37 </TD><TD class=alignRight headers="er1 er3 ec1 ec8">306 (17%) </TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignRight headers="er1 er4 ec1 ec2 ec3">498 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec4">236 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec5">10 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec6">252 </TD><TD class=alignRight headers="er1 er4 ec1 ec7">118 </TD><TD class=alignRight headers="er1 er4 ec1 ec8">616 (34%) </TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignRight headers="er1 er5 ec1 ec2 ec3">499 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec4">234 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec5">53 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec6">212 </TD><TD class=alignRight headers="er1 er5 ec1 ec7">354 </TD><TD class=alignRight headers="er1 er5 ec1 ec8">853 (48%) </TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignRight headers="er1 er6 ec1 ec2 ec3">1279 </TD><TD class="alignRight bg-colour-blue" headers="er1 er6 ec1 ec2 ec4">618 </TD><TD class="alignRight bg-colour-blue" headers="er1 er6 ec1 ec2 ec5">69 </TD><TD class="alignRight bg-colour-blue" headers="er1 er6 ec1 ec2 ec6">592 </TD><TD class=alignRight headers="er1 er6 ec1 ec7">511 </TD><TD class=alignRight headers="er1 er6 ec1 ec8">1790 </TD></TR><TR><TH id=er7 class=alignLeft headers=er1>%<SUP>1</SUP></TH><TD class=alignRight headers="er1 er7 ec1 ec2 ec3">71% </TD><TD class="alignRight bg-colour-blue" headers="er1 er7 ec1 ec2 ec4">48% </TD><TD class="alignRight bg-colour-blue" headers="er1 er7 ec1 ec2 ec5">5% </TD><TD class="alignRight bg-colour-blue" headers="er1 er7 ec1 ec2 ec6">46% </TD><TD class=alignRight headers="er1 er7 ec1 ec7">29% </TD><TD class=alignRight headers="er1 er7 ec1 ec8">100% </TD></TR></TBODY></TABLE>
Figure 8. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w18-fg8a-eng.gif


Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w18-fg8b-eng.gif

* See footnote above following the section related to PCIRN-SOS data.
Text equivalent for figure 8bNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Adult hospitalizations (>16 year of age, PCIRN-SOS)
Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w18-fg9a-eng.gif

Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w18-fg9b-eng.gif

Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Adult hospitalizations (≥16 year of age, PCIRN-SOS)

Top of Page
Provincial/Territorial Influenza Hospitalizations and Deaths

In week 18, 206 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories<SUP>*</SUP>. As with other surveillance indicators in week 18, the majority were cases of influenza B (171, 83.0%). One ICU admission was reported in week 18, an adult 45-64 years of age with influenza A(H1N1)pdm09. Thirteen deaths were reported this week; two adults 45-64 years of age and 11 adults ≥65 years of age, 12 of the 13 with influenza B. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total.
To date this season, 4,623 influenza-associated hospitalizations have been reported, 77.6% with influenza A. The majority (60.8%) of hospitalizations have been cases 45 years of age of older. A significantly greater proportion of cases of influenza B have been ≥65 years of age, and 5-19 years of age, compared to cases of A(H1N1)pdm09 this season (Table 6). A total of 351 ICU admissions have been reported this season, of which 65.5% were adults 20-64 years of age. A total of 258 deaths have been reported. The highest proportion of deaths has been among adults ≥65 years of age (49.6%) followed by adults 20-64 years of age (41.9%). In keeping with the late-season circulation, influenza B has been increasingly reported among hospitalized cases of influenza. To date this season, influenza B has been reported in 22.4% of hospitalizations and 21.3% of deaths. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.
* Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, NS, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t6 class=alignCenter>Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=fr1 rowSpan=3>Age groups </TH><TH id=fc1 colSpan=6>Cumulative (Aug. 25, 2013 to May 3, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=fc2 colSpan=4 headers=fc1>Influenza A</TH><TH id=fc7 headers=fc1>B</TH><TH id=fc8 headers=fc1>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=fc3 headers="fc1 fc2">A Total</TH><TH id=fc4 class=bg-colour-blue headers="fc1 fc2">A(H1) pdm09</TH><TH id=fc5 class=bg-colour-blue headers="fc1 fc2">A(H3)</TH><TH id=fc6 class=bg-colour-blue headers="fc1 fc2">A (UnS)</TH><TD class=alignCenter headers="fc1 fc7">Total</TD><TD class=alignCenter headers="fc1 fc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=8><SUP id=footnote_t6_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=fr2 class=alignLeft headers=fr1>0-4 years</TH><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc3">614 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc4">287 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc5">12 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc6">315 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc7">105 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc8">719 (16%) </TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years</TH><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc3">134 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc4">65 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc5">6 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc6">63 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc7">93 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc8">227 (5%) </TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years</TH><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc3">36 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc4">21 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc5">3 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc6">12 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc7">5 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc8">41 (1%) </TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc3">608 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc4">423 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc5">4 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc6">181 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc7">63 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc8">671 (15%) </TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc3">1117 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc4">704 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc5">30 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc6">383 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc7">201 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc8">1318 (29%) </TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc3">942 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc4">465 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc5">98 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc6">379 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc7">553 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc8">1495 (32%) </TD></TR><TR><TH id=fr10 class=alignLeft headers=fr1>Unknown</TH><TD class=alignRight headers="fc1 fc2 fc3">136 </TD><TD class=alignRight headers="fc1 fc2 fc4">99 </TD><TD class=alignRight headers="fc1 fc2 fc5">3 </TD><TD class=alignRight headers="fc1 fc2 fc6">34 </TD><TD class=alignRight headers="fc1 fc7">16 </TD><TD class=alignRight headers="fc1 fc8">152 (3%) </TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignRight headers="fr1 fr8 fc1 fc2 fc3">3587 </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr8 fc1 fc2 fc4">2064 </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr8 fc1 fc2 fc5">156 </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr8 fc1 fc2 fc6">1367 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc7">1036 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc8">4623 </TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP> </TH><TD class=alignRight headers="fr1 fr9 fc1 fc2 fc3">77.6% </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr9 fc1 fc2 fc4">57.5% </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr9 fc1 fc2 fc5">4.3% </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr9 fc1 fc2 fc6">38.1% </TD><TD class=alignRight headers="fr1 fr9 fc1 fc7">22.4% </TD><TD class=alignRight headers="fr1 fr9 fc1 fc8">100% </TD></TR></TBODY></TABLE>
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2013-14 on the Public Health Agency of Canada website.

.../
http://www.phac-aspc.gc.ca/fluwatch/13-14/w18_14/index-eng.php
 
Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 19

Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 19

FluWatch report: May 4 to May 10, 2014 (Week 19)

Posted 2014-05-16For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
<A title="Flu Watch (Version PDF, 113 KB - 6 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/13-14/w19_14/pdf/fw2014-19-eng.pdf">FluWatch report: May 4 to May 10, 2014 (Week 19) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 291 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

?? Help with PDF documents

Overall Summary
  • In week 19, influenza B continued to circulate in several regions across Canada, but levels are stable or declining. Late-season influenza B activity is past its peak, and remains within expected levels for this time of year. Influenza A activity has been steadily declining over the last four weeks.
  • Influenza B is having a greater impact on adults 65 years of age and older and young persons 5 to 19 years of age, compared to influenza A(H1N1) which circulated earlier in the year.
  • As of week 19, 4,731 hospitalizations and 275 deaths have been reported from participating regions, which is fewer than were reported last year.
Influenza/ILI Activity (geographic spread)

In week 19, no region reported widespread activity and eight regions reported localized activity, including all seven regions in Ontario and one region in Quebec (Figure 1). Two provinces did not report data for week 19, but both have reported only sporadic or no activity since early February.
Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 19


right_ofmap.gif



Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
Influenza and Other Respiratory Virus Detections

The number of positive influenza tests decreased from 445 in week 18 to 401 (11.0% of tests) in week 19. Nationally, late-season circulation of influenza B peaked in week 15 and continues to decline (Figure 2). Influenza B remained the predominant virus in week 19, representing 92% of influenza detections. Most jurisdictions have reported stable or declining levels of influenza detections over recent weeks (Table 1). Significantly greater proportions of influenza B cases have been ≥65 years of age and 5-19 years of age compared to cases of A(H1N1)pdm09. Among cases for which information on age and type/subtype has been received, 38% of the cases in week 19 were ≥65 years of age compared to 21% of cases for the season to date (Table 2).
Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
2014-w19-fg2-eng.gif

Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
The number of positive tests for RSV, coronavirus, human metapneumovirus, and rhinovirus has continued to decline in recent weeks. The number of positive tests for parainfluenza and adenovirus have been following a general upward trend in recent weeks, in keeping with their broader year-round circulation (Figure 3).
For more details, see the weekly Respiratory Virus Detections in Canada Report.
Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2013-14
2014-w19-fg3-eng.gif


Top of Page
RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
<TABLE id=t1 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class="alignCenter margin10px">Table 1: Weekly and cumulative numbers of positive influenza specimens
by type, subtype and province, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=ac1 colSpan=5>Weekly
(May 4 to 10, 2014)</TH><TH id=ac8 colSpan=5>Cumulative
(August 25, 2013 to May 10, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=4 headers=ac1>Influenza A</TH><TH id=ac7 headers=ac1>B</TH><TH id=ac9 colSpan=4 headers=ac8>Influenza A</TH><TH id=ac14 headers=ac8>B</TH></TR><TR class=bg-colour-grey-light><TH id=ac3 headers="ac1 ac2">A Total</TH><TH id=ac4 class=" bg-colour-blue" headers="ac1 ac2">A(H1)pdm09</TH><TH id=ac5 class=" bg-colour-blue" headers="ac1 ac2">A(H3)</TH><TH id=ac6 class=" bg-colour-blue" headers="ac1 ac2">A(UnS)</TH><TH class=alignCenter headers="ac1 ac7">B Total</TH><TH id=ac10 headers="ac8 ac9">A Total</TH><TH id=ac11 class=" bg-colour-blue" headers="ac8 ac9">A(H1)pdm09</TH><TH id=ac12 class=" bg-colour-blue" headers="ac8 ac9">A(H3)</TH><TH id=ac13 class=" bg-colour-blue" headers="ac8 ac9">A(UnS)</TH><TD class=alignCenter headers="ac8 ac14">B Total</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=alignLeft headers=ar1>BC</TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">7</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">6</TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">1</TD><TD class=alignRight headers="ar1 ar2 ac1 ac7">20</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac10">1820</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac11">1616</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac12">63</TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac13">141</TD><TD class=alignRight headers="ar1 ar2 ac8 ac14">344</TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">6</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">1</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">3</TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">2</TD><TD class=alignRight headers="ar1 ar3 ac1 ac7">38</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac10">3852</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac11">3455</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac12">81</TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac13">316</TD><TD class=alignRight headers="ar1 ar3 ac8 ac14">422</TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar4 ac1 ac7">22</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac10">1383</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac11">988</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac12">8</TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac13">387</TD><TD class=alignRight headers="ar1 ar4 ac8 ac14">156</TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">2</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">1</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">1</TD><TD class=alignRight headers="ar1 ar5 ac1 ac7">7</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac10">682</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac11">463</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac12">5</TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac13">214</TD><TD class=alignRight headers="ar1 ar5 ac8 ac14">47</TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">11</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">1</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">7</TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">3</TD><TD class=alignRight headers="ar1 ar6 ac1 ac7">211</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac10">5739</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac11">2490</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac12">371</TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac13">2878</TD><TD class=alignRight headers="ar1 ar6 ac8 ac14">2881</TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">4</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">4</TD><TD class=alignRight headers="ar1 ar7 ac1 ac7">48</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac10">5357</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac11">677</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac12">5</TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac13">4675</TD><TD class=alignRight headers="ar1 ar7 ac8 ac14">2649</TD></TR><TR><TH id=ar8 class=alignLeft headers=ar1>NB</TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar8 ac1 ac7">7</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac10">1488</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac11">370</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac12">1</TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac13">1117</TD><TD class=alignRight headers="ar1 ar8 ac8 ac14">100</TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar9 ac1 ac7">6</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac10">174</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac11">134</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac12">4</TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac13">36</TD><TD class=alignRight headers="ar1 ar9 ac8 ac14">39</TD></TR><TR><TH id=ar10 class=alignLeft headers=ar1>PE</TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac6">0</TD><TD class=alignRight headers="ar1 ar10 ac1 ac7">0</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac10">119</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac11">118</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac13">1</TD><TD class=alignRight headers="ar1 ar10 ac8 ac14">2</TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">2</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac4">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac5">0</TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac6">2</TD><TD class=alignRight headers="ar1 ar11 ac1 ac7">10</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac10">373</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac11">104</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac12">0</TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac13">269</TD><TD class=alignRight headers="ar1 ar11 ac8 ac14">236</TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">32</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac4">3</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac5">16</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac6">13</TD><TD class=alignRight headers="ar1 ar12 ac1 ac7">369</TD><TD class=alignRight headers="ar1 ar12 ac8 ac9 ac10">20987</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac11">10415</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac12">538</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac13">10034</TD><TD class=alignRight headers="ar1 ar12 ac8 ac14">6876</TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="ar1 ar13 ac1 ac2 ac3">8.0%</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac4">9.4%</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac5">50.0%</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac6">40.6%</TD><TD class=alignRight headers="ar1 ar13 ac1 ac7">92.0%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac9 ac10">75.3%</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac11">49.6%</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac12">2.6%</TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac13">47.8%</TD><TD class=alignRight headers="ar1 ar13 ac8 ac14">24.7%</TD></TR></TBODY></TABLE>
<TABLE id=t2 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups (years)</TH><TH id=bc1 colSpan=5>Weekly
(May 4 to May 10, 2014)</TH><TH id=bc8 colSpan=7>Cumulative
(August 25, 2013 to May 10, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=bc2 colSpan=4 headers=bc1>Influenza A</TH><TH id=bc7 headers=bc1>B</TH><TH id=bc9 colSpan=4 headers=bc8>Influenza A</TH><TH id=bc14 headers=bc8>B</TH><TH id=bc15 colSpan=2 headers=bc8>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=bc3 headers="bc1 bc2">A Total</TH><TH id=bc4 class="bg-colour-blue " headers="bc1 bc2">A(H1) pdm09</TH><TH id=bc5 class="bg-colour-blue " headers="bc1 bc2">A(H3)</TH><TH id=bc6 class="bg-colour-blue " headers="bc1 bc2">A (UnS)</TH><TD class=alignCenter headers="bc1 bc7">Total</TD><TH id=bc10 headers="bc8 bc9">A Total</TH><TH id=bc11 class="bg-colour-blue " headers="bc8 bc9">A(H1) pdm09</TH><TH id=bc12 class="bg-colour-blue " headers="bc8 bc9">A(H3)</TH><TH id=bc13 class="bg-colour-blue " headers="bc8 bc9">A (UnS)</TH><TD class=alignCenter headers="bc8 bc14">Total</TD><TH id=bc16 headers="bc8 bc15">#</TH><TH id=bc17 headers="bc8 bc15">%</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13><SUP id=footnote_t2_1>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP id=footnote_t2_2>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
<SUP id=footnote_t2_3>3 </SUP>Table 2 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=br2 class=alignLeft headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">0</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">0</TD><TD class=alignRight headers="br1 br2 bc1 bc7">5</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">3260</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">1451</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">39</TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1770</TD><TD class=alignRight headers="br1 br2 bc8 bc14">515</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc16">3775</TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc17">16.7%</TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">2</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">2</TD><TD class=alignRight headers="br1 br3 bc1 bc7">7</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1329</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">707</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">23</TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">599</TD><TD class=alignRight headers="br1 br3 bc8 bc14">777</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc16">2106</TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc17">9.3%</TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">4</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">2</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">0</TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">2</TD><TD class=alignRight headers="br1 br4 bc1 bc7">27</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">5080</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">2811</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">43</TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">2226</TD><TD class=alignRight headers="br1 br4 bc8 bc14">960</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc16">6040</TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc17">26.7%</TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">3</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">2</TD><TD class=alignRight headers="br1 br5 bc1 bc7">46</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">4464</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">2388</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">62</TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">2014</TD><TD class=alignRight headers="br1 br5 bc8 bc14">1408</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc16">5872</TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc17">26.0%</TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">10</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">3</TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">7</TD><TD class=alignRight headers="br1 br6 bc1 bc7">49</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">2578</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">1000</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">165</TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">1413</TD><TD class=alignRight headers="br1 br6 bc8 bc14">2084</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc16">4662</TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc17">20.6%</TD></TR><TR><TH id=br7 class=alignLeft headers=br1>Unknown</TH><TD class=alignRight headers="br1 br7 bc1 bc2 bc3">1</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc4">0</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc5">1</TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc6">0</TD><TD class=alignRight headers="br1 br7 bc1 bc7">0</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc10">137</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">102</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">22</TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">13</TD><TD class=alignRight headers="br1 br7 bc8 bc14">9</TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc16">146</TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc17">0.6%</TD></TR><TR><TH id=br8 class=alignLeft headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">20</TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc4">2</TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc5">5</TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc6">13</TD><TD class=alignRight headers="br1 br8 bc1 bc7">134</TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">16848</TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc11">8459</TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc12">354</TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc13">8035</TD><TD class=alignRight headers="br1 br8 bc8 bc14">5753</TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc16">22601</TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc17">100.0%</TD></TR><TR><TH id=br9 class=alignLeft headers=br1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="br1 br9 bc1 bc2 bc3">13.0%</TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc4">10.0%</TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc5">25.0%</TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc6">65.0%</TD><TD class=alignRight headers="br1 br9 bc1 bc7">87.0%</TD><TD class=alignRight headers="br1 br9 bc8 bc9 bc10">74.5%</TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc11">50.2%</TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc12">2.1%</TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc13">47.7%</TD><TD class=alignRight headers="br1 br9 bc8 bc14">25.5%</TD><TD class=alignRight></TD><TD class=alignRight></TD></TR></TBODY></TABLE>

Top of Page
Influenza Strain Characterizations

During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 2,039 influenza viruses [112 A(H3N2), 1,366 A(H1N1)pdm09 and 561 influenza B]. The vast majority (99%) of viruses were similar to the strains recommended by the WHO for the 2013-14 seasonal influenza vaccine. Two A(H1N1)pdm09 viruses showed reduced titres to antiserum against the reference A/California/07/2009 strain, and one A(H3N2) virus showed reduced titres to antiserum against the reference A/Texas/50/2012 strain. Twenty-six influenza B viruses were similar to the strain recommended by the WHO for the 2011-12 vaccine (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2013-2014, N = 2,039
2014-w19-fg4-eng.gif

The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
The recommended components for the 2013-2014 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009 (H1N1)pdm09-like virus, an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b (e.g. A/Texas/50/2012), and a B/Massachusetts/2/2012-like virus (Yamagata lineage).


Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
Antiviral Resistance

During the 2013-2014 influenza season, NML has tested 1,796 influenza viruses for resistance to oseltamivir and all but five were sensitive. All 1,796 viruses tested for resistance to zanamivir were sensitive. All 1,556 influenza A viruses tested for amantadine resistance were resistant (Table 3).
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2013-2014</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=cr1 rowSpan=2>Virus type and subtype</TH><TH id=cc1 colSpan=2>Oseltamivir</TH><TH id=cc4 colSpan=2>Zanamivir</TH><TH id=cc7 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=cc2 headers=cc1># tested</TH><TH id=cc3 headers=cc1># resistant (%)</TH><TH id=cc5 headers=cc4># tested</TH><TH id=cc6 headers=cc4># resistant (%)</TH><TH id=cc8 headers=cc7># tested</TH><TH id=cc9 headers=cc7># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=cr2 class="alignLeft bg-colour-blue" headers=cr1>A (H3N2)</TH><TD class=alignRight headers="cr1 cr2 cc1 cc2">92</TD><TD class=alignRight headers="cr1 cr2 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr2 cc4 cc5">92</TD><TD class=alignRight headers="cr1 cr2 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr2 cc7 cc8">143</TD><TD class=alignRight headers="cr1 cr2 cc7 cc9">143 (100%)</TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignRight headers="cr1 cr3 cc1 cc2">1320</TD><TD class=alignRight headers="cr1 cr3 cc1 cc3">5 (0.4%)</TD><TD class=alignRight headers="cr1 cr3 cc4 cc5">1321</TD><TD class=alignRight headers="cr1 cr3 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr3 cc7 cc8">1413</TD><TD class=alignRight headers="cr1 cr3 cc7 cc9">1413 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignRight headers="cr1 cr4 cc1 cc2">384</TD><TD class=alignRight headers="cr1 cr4 cc1 cc3">0</TD><TD class=alignRight headers="cr1 cr4 cc4 cc5">383</TD><TD class=alignRight headers="cr1 cr4 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr4 cc7 cc8">NA <SUP>*</SUP></TD><TD class=alignRight headers="cr1 cr4 cc7 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft bg-colour-blue" headers=cr1>TOTAL</TH><TD class=alignRight headers="cr1 cr5 cc1 cc2">1796</TD><TD class=alignRight headers="cr1 cr5 cc1 cc3">5 (0.3%)</TD><TD class=alignRight headers="cr1 cr5 cc4 cc5">1796</TD><TD class=alignRight headers="cr1 cr5 cc4 cc6">0</TD><TD class=alignRight headers="cr1 cr5 cc7 cc8">1556</TD><TD class=alignRight headers="cr1 cr5 cc7 cc9">1556 (100%)</TD></TR></TBODY></TABLE>
Influenza-like Illness (ILI) Consultation Rate

The national influenza-like-illness (ILI) consultation rate was similar to the previous week at 20.2 consultations per 1,000 patient visits in week 19; which was slightly above the expected range for week 19 (Figure 5).
Figure 5. Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014
2014-w19-fg5-eng.gif

Note: No data available for mean rate for weeks 19 to 39 for the 1996-1997 through 2002-2003 seasons. Delays in the reporting of data may cause data to change retrospectively. The calculation of the average ILI consultation rate over 17 seasons was aligned with influenza activity in each season. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. The number of sentinel physicians in each province or territory is as follows: BC(21), AB(80), SK(11), MB(18), ON(169), QC(14), NB(29), NS(26), PE(4), NL(16), NU(1), NT(14), YT(13). Not all sentinel physicians report every week.
Text equivalent for figure 5Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

Top of Page
Influenza Outbreak Surveillance

The number of new influenza outbreaks decreased from 21 in week 18 to seven in week 19 (Figure 6). All were in long-term care facilities and six of the seven outbreaks were influenza B. The 7th was an outbreak of influenza A(unsubtyped). Two provinces did not report data for week 19.
Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2013-2014
2014-w19-fg6-eng.gif

1 All provinces and territories except NU report outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
Text equivalent for figure 6Overall number of new influenza outbreaks by report week, Canada, 2013-2014
Pharmacy Surveillance

In week 19, the proportion of prescriptions for antivirals declined, in keeping with laboratory detections of influenza. Overall this season, the largest proportion of prescriptions for antivirals has been among children 2-18 years of age and adults 19-64 years of age (Figure 7).
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14
2014-w19-fg7-eng.gif

Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group. Age-groups: Infant: 0-2y, Child: 2-18y; Adult: 19-64y, Senior: ≥65y.
Text equivalent for figure 7Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

Top of Page
Sentinel Hospital Influenza Surveillance

Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In week 19, seven new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to six in week 18. Six cases reported in week 19 had influenza B (Figure 8a). A greater proportion of cases with influenza B this season have been children between 2 and 10 years of age compared to A(H1N1)pdm09. Two ICU admissions were reported in week 19 both children 6-23 months of age with influenza B, and no deaths were reported.
To date this season, a total of 689 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 80% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children <5 years of age represent 73% of cases to date (Table 4). One hundred and five ICU admissions have been reported, of which 70 (67%) were children <5 years of age (Figure 9a). All but 13 were cases with influenza A, and 97% of those subtyped were A(H1N1)pdm09. Among the 102 ICU cases with available data, 65 (64%) were reported to have underlying medical conditions. No deaths have been reported. A smaller number of paediatric hospital admissions have been reported this year compared to the 2012-13 season.
Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
Adult Influenza Hospitalizations and Deaths (PCIRN)
In week 19, 14 new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported through active surveillance by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 15 in week 18 (Figure 8b). Since the beginning of March the majority of hospitalizations have been associated with influenza B. This season, a significantly greater proportion of cases of influenza B have been ≥65 years of age compared to cases of A(H1N1)pdm09. Two ICU admissions were reported in week 19, one adult 45-64 years of age and one ≥65 years of age, both with influenza A(unsubtyped). No deaths were reported in week 19.
To date this season, 1,862 influenza-associated hospitalizations have been reported by the PCIRN-SOS network, 1,308 (70.2%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). Compared to the 2012-13 season, slightly more cases have been reported, although the peak number of cases was smaller. A greater number of cases have been reported during March and April compared to last year, with five times more cases of influenza B reported to date. ICU admission was required for 300 hospitalizations, all but 44 of which were cases with influenza A (133 A(H1N1)pdm09, eight A(H3N2) and 114 A(unsubtyped)). A greater proportion of cases have been admitted to the ICU this season compared to last year, but the proportion of deaths has been similar. Of the ICU admissions with available information, 85.0% (176/207) were reported to have at least one comorbidity, and 69.0% (171/248) reported not having been vaccinated this season. Ninety-nine deaths have been reported, all but 18 with influenza A (51 A(H1N1)pdm09, three A(H3N2) and 27 A(unsubtyped)); nine cases 20-44 years of age, 35 cases 45-64 years of age and 55 cases ≥65 years of age (Figure 9b). Among fatal cases with available information, 47.4% (36/76) were reported to have at least one comorbidity, and 93.2% (55/59) reported not having been vaccinated this season.
Note: PCIRN-SOS conducted passive surveillance from April 30th to November 14th, 2013. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance began November 15th during which time PCIRN site coordinators investigate cases potentially related to influenza. Data from both active and passive surveillance reported during the 2013-14 season are included in this report. The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t4 class=alignCenter>Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=dr1 rowSpan=3>Age groups </TH><TH id=dc1 colSpan=6>Cumulative (Aug. 25, 2013 to May 10, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=dc2 colSpan=4 headers=dc1>Influenza A </TH><TH id=dc7 headers=dc1>B </TH><TH id=dc8 headers=dc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=dc3 headers="dc1 dc2">A Total </TH><TH id=dc4 class="bg-colour-blue " headers="dc1 dc2">A(H1) pdm09 </TH><TH id=dc5 class="bg-colour-blue " headers="dc1 dc2">A(H3) </TH><TH id=dc6 class="bg-colour-blue " headers="dc1 dc2">A (UnS) </TH><TD class=alignCenter headers="dc1 dc7">Total</TD><TD class=alignCenter headers="dc1 dc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t4_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=dr2 class=alignLeft headers=dr1>0-5m </TH><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc3">103 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc4">35 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc5">0 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc6">68 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc7">8 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc8">111 (16%) </TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc3">162 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc4">56 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc5">1 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc6">105 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc7">25 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc8">187 (27%) </TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc3">165 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc4">55 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc5">3 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc6">107 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc7">42 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc8">207 (30%) </TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc3">82 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc4">27 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc5">1 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc6">54 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc7">50 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc8">132 (19%) </TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc3">40 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc4">14 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc5">1 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc6">25 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc7">12 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc8">52 (8%) </TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignRight headers="dr1 dr7 dc1 dc2 dc3">552 </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr7 dc1 dc2 dc4">187 </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr7 dc1 dc2 dc5">6 </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr7 dc1 dc2 dc6">359 </TD><TD class=alignRight headers="dr1 dr7 dc1 dc7">137 </TD><TD class=alignRight headers="dr1 dr7 dc1 dc8">689 </TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP> </TH><TD class=alignRight headers="dr1 dr8 dc1 dc2 dc3">80.1% </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr8 dc1 dc2 dc4">33.9% </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr8 dc1 dc2 dc5">1.1% </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr8 dc1 dc2 dc6">65.0% </TD><TD class=alignRight headers="dr1 dr8 dc1 dc7">19.9% </TD><TD class=alignRight headers="dr1 dr8 dc1 dc8">100.0% </TD></TR></TBODY></TABLE>
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 5 - Cumulative numbers of adult hospitalizations with influenza
reported by the PCIRN-SOS network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=er1 rowSpan=3>Age groups </TH><TH id=ec1 class=noWrap colSpan=6>Cumulative (Aug. 25, 2013 to May 10, 2014)<SUP>*</SUP></TH></TR><TR class=bg-colour-yellow><TH id=ec2 colSpan=4 headers=ec1>Influenza A </TH><TH id=ec7 headers=ec1>B </TH><TH id=ec8 headers=ec1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=ec3 headers="ec1 ec2">A Total </TH><TH id=ec4 class=bg-colour-blue headers="ec1 ec2">A(H1) pdm09 </TH><TH id=ec5 class=bg-colour-blue headers="ec1 ec2">A(H3) </TH><TH id=ec6 class=bg-colour-blue headers="ec1 ec2">A(UnS) </TH><TD class=alignCenter headers="ec1 ec7">Total</TD><TD class=alignCenter headers="ec1 ec8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t5_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.

<SUP id=t5_star>*</SUP> Two cases for which the influenza type has not yet been reported, and six cases for which the age-group was not reported, are not included in Table 5.</TD></TR></TFOOT><TBODY><TR><TH id=er2 class=alignLeft headers=er1>16-20 </TH><TD class=alignRight headers="er1 er2 ec1 ec2 ec3">12 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec4">5 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec5">0 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec6">7 </TD><TD class=alignRight headers="er1 er2 ec1 ec7">2 </TD><TD class=alignRight headers="er1 er2 ec1 ec8">14 (1%) </TD></TR><TR><TH id=er3 class=alignLeft headers=er1>20-44 </TH><TD class=alignRight headers="er1 er3 ec1 ec2 ec3">271 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec4">142 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec5">6 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec6">123 </TD><TD class=alignRight headers="er1 er3 ec1 ec7">41 </TD><TD class=alignRight headers="er1 er3 ec1 ec8">312 (17%) </TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignRight headers="er1 er4 ec1 ec2 ec3">509 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec4">239 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec5">9 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec6">261 </TD><TD class=alignRight headers="er1 er4 ec1 ec7">123 </TD><TD class=alignRight headers="er1 er4 ec1 ec8">632 (34%) </TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignRight headers="er1 er5 ec1 ec2 ec3">511 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec4">236 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec5">54 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec6">221 </TD><TD class=alignRight headers="er1 er5 ec1 ec7">385 </TD><TD class=alignRight headers="er1 er5 ec1 ec8">896 (48%) </TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignRight headers="er1 er6 ec1 ec2 ec3">1303 </TD><TD class="alignRight bg-colour-blue" headers="er1 er6 ec1 ec2 ec4">622 </TD><TD class="alignRight bg-colour-blue" headers="er1 er6 ec1 ec2 ec5">69 </TD><TD class="alignRight bg-colour-blue" headers="er1 er6 ec1 ec2 ec6">612 </TD><TD class=alignRight headers="er1 er6 ec1 ec7">551 </TD><TD class=alignRight headers="er1 er6 ec1 ec8">1854 </TD></TR><TR><TH id=er7 class=alignLeft headers=er1>%<SUP>1</SUP></TH><TD class=alignRight headers="er1 er7 ec1 ec2 ec3">70% </TD><TD class="alignRight bg-colour-blue" headers="er1 er7 ec1 ec2 ec4">48% </TD><TD class="alignRight bg-colour-blue" headers="er1 er7 ec1 ec2 ec5">5% </TD><TD class="alignRight bg-colour-blue" headers="er1 er7 ec1 ec2 ec6">47% </TD><TD class=alignRight headers="er1 er7 ec1 ec7">30% </TD><TD class=alignRight headers="er1 er7 ec1 ec8">100% </TD></TR></TBODY></TABLE>
Figure 8. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w19-fg8a-eng.gif


Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w19-fg8b-eng.gif

* See footnote above following the section related to PCIRN-SOS data.
Text equivalent for figure 8bNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Adult hospitalizations (>16 year of age, PCIRN-SOS)
Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w19-fg9a-eng.gif

Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w19-fg9b-eng.gif

Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Adult hospitalizations (≥16 year of age, PCIRN-SOS)

Top of Page
Provincial/Territorial Influenza Hospitalizations and Deaths

In week 19, 104 laboratory-confirmed influenza-associated hospitalizations were reported from seven of the nine participating provinces and territories<SUP>*</SUP>. As with other surveillance indicators in week 19, the majority were cases of influenza B (92, 88.5%). No ICU admissions were reported in week 19. Fourteen deaths were reported this week: one child under 6 months of age, one adult 45-64 years of age and 12 adults ≥65 years of age; 11 of the 14 with influenza B. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total.
To date this season, 4,731 influenza-associated hospitalizations have been reported, 76.1% with influenza A. The majority (61.1%) of hospitalizations have been cases 45 years of age of older. A significantly greater proportion of cases of influenza B have been ≥65 years of age, and 5-19 years of age, compared to cases of A(H1N1)pdm09 this season (Table 6). A total of 353 ICU admissions have been reported this season, of which 65.4% were adults 20-64 years of age. A total of 275 deaths have been reported. The highest proportion of deaths has been among adults ≥65 years of age (51.2%) followed by adults 20-64 years of age (39.6%). In keeping with the late-season circulation, influenza B has been increasingly reported among hospitalized cases of influenza. To date this season, influenza B has been reported in 23.9% of hospitalizations and 25.1% of deaths. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.
* Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, NS, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t6 class=alignCenter>Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=fr1 rowSpan=3>Age groups </TH><TH id=fc1 colSpan=6>Cumulative (Aug. 25, 2013 to May 10, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=fc2 colSpan=4 headers=fc1>Influenza A</TH><TH id=fc7 headers=fc1>B</TH><TH id=fc8 headers=fc1>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=fc3 headers="fc1 fc2">A Total</TH><TH id=fc4 class=bg-colour-blue headers="fc1 fc2">A(H1) pdm09</TH><TH id=fc5 class=bg-colour-blue headers="fc1 fc2">A(H3)</TH><TH id=fc6 class=bg-colour-blue headers="fc1 fc2">A (UnS)</TH><TD class=alignCenter headers="fc1 fc7">Total</TD><TD class=alignCenter headers="fc1 fc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=8><SUP id=footnote_t6_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=fr2 class=alignLeft headers=fr1>0-4 years</TH><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc3">616 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc4">287 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc5">12 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc6">317 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc7">111 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc8">727 (15%) </TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years</TH><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc3">134 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc4">65 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc5">6 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc6">63 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc7">102 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc8">236 (5%) </TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years</TH><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc3">36 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc4">21 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc5">3 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc6">12 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc7">5 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc8">41 (1%) </TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc3">613 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc4">424 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc5">5 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc6">184 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc7">68 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc8">681 (14%) </TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc3">1118 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc4">704 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc5">30 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc6">384 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc7">216 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc8">1334 (28%) </TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc3">947 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc4">467 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc5">100 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc6">380 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc7">610 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc8">1557 (33%) </TD></TR><TR><TH id=fr10 class=alignLeft headers=fr1>Unknown</TH><TD class=alignRight headers="fc1 fc2 fc3">136 </TD><TD class=alignRight headers="fc1 fc2 fc4">99 </TD><TD class=alignRight headers="fc1 fc2 fc5">3 </TD><TD class=alignRight headers="fc1 fc2 fc6">34 </TD><TD class=alignRight headers="fc1 fc7">19 </TD><TD class=alignRight headers="fc1 fc8">155 (3%) </TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignRight headers="fr1 fr8 fc1 fc2 fc3">3600 </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr8 fc1 fc2 fc4">2067 </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr8 fc1 fc2 fc5">159 </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr8 fc1 fc2 fc6">1374 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc7">1131 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc8">4731 </TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP> </TH><TD class=alignRight headers="fr1 fr9 fc1 fc2 fc3">76.1% </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr9 fc1 fc2 fc4">57.4% </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr9 fc1 fc2 fc5">4.4% </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr9 fc1 fc2 fc6">38.2% </TD><TD class=alignRight headers="fr1 fr9 fc1 fc7">23.9% </TD><TD class=alignRight headers="fr1 fr9 fc1 fc8">100% </TD></TR></TBODY></TABLE>
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2013-14 on the Public Health Agency of Canada website.

.../
http://www.phac-aspc.gc.ca/fluwatch/13-14/w19_14/index-eng.php
 
Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 20

Re: Canada FluWatch Weekly Reports 2013-2014 Season Week 20

FluWatch report: May 11 to May 17, 2014 (Week 20)

Posted 2014-05-23For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
<A title="Flu Watch (Version PDF, 113 KB - 6 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/13-14/w20_14/pdf/fw2014-20-eng.pdf">FluWatch report: May 11 to May 17, 2014 (Week 20) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 291 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

?? Help with PDF documents

Overall Summary
  • In week 20, influenza activity in Canada continued to decline, although some regions reported small increases in circulation of influenza B. Late-season influenza B activity is past its peak, and remains within expected levels for this time of year. Influenza A activity has been steadily declining over the last five weeks.
  • Influenza B is having a greater impact on adults 65 years of age and older and young persons 5 to 19 years of age, compared to influenza A(H1N1) which circulated earlier in the year.
  • As of week 20, 4,862 hospitalizations and 291 deaths have been reported from participating regions, which is fewer than were reported last year.
Note: This is the final weekly report for the 2013-14 influenza season. Fortnightly reports will commence on June 6th (for weeks 21 and 22). However, laboratory detections reported through the RVDSS and influenza activity level maps will be updated weekly on the FluWatch website.

Are you a primary health care practitioner (General Practitioner, Nurse Practitioner or Registered Nurse) interested in becoming a FluWatch sentinel for the 2014-15 influenza season? Contact us at FluWatch@phac-aspc.gc.ca
Influenza/ILI Activity (geographic spread)

In week 20, one region in Newfoundland & Labrador reported widespread activity and nine regions reported localized activity (MB(1), ON(6), QC(1), and NL(1)) (Figure 1).
Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 20


right_ofmap.gif



Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
Influenza and Other Respiratory Virus Detections

The number of positive influenza tests decreased from 400 in week 19 to 283 (9.2% of tests) in week 20. Nationally, late-season circulation of influenza B peaked in week 15 and continues to decline (Figure 2). Influenza B remained the predominant virus in week 20, representing 83% of influenza detections. Most jurisdictions have reported stable or declining levels of influenza detections over recent weeks, although slight increases were reported in week 20 in AB, SK and NL (Table 1). Significantly greater proportions of influenza B cases have been ≥65 years of age and 5-19 years of age compared to cases of A(H1N1)pdm09. Among cases for which information on age and type/subtype has been received, 43% of the cases in week 20 were ≥65 years of age compared to 21% of cases for the season to date (Table 2).
Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
2014-w20-fg2-eng.gif

Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
The number of positive tests for RSV, coronavirus, human metapneumovirus, and rhinovirus has continued to decline in recent weeks. The number of positive tests for parainfluenza has been following a general upward trend in recent weeks, and detections of adenovirus have been variable but declining over the past two weeks. These viruses show broader year-round circulation (Figure 3).
For more details, see the weekly Respiratory Virus Detections in Canada Report.
Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2013-14
2014-w20-fg3-eng.gif


Top of Page
RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
<TABLE id=t1 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class="alignCenter margin10px">Table 1: Weekly and cumulative numbers of positive influenza specimens
by type, subtype and province, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=ac1 colSpan=5>Weekly
(May 11 to 17, 2014)</TH><TH id=ac8 colSpan=5>Cumulative
(August 25, 2013 to May 17, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=4 headers=ac1>Influenza A</TH><TH id=ac7 headers=ac1>B</TH><TH id=ac9 colSpan=4 headers=ac8>Influenza A</TH><TH id=ac14 headers=ac8>B</TH></TR><TR class=bg-colour-grey-light><TH id=ac3 headers="ac1 ac2">A Total</TH><TH id=ac4 class=" bg-colour-blue" headers="ac1 ac2">A(H1)pdm09</TH><TH id=ac5 class=" bg-colour-blue" headers="ac1 ac2">A(H3)</TH><TH id=ac6 class=" bg-colour-blue" headers="ac1 ac2">A(UnS)</TH><TH class=alignCenter headers="ac1 ac7">B Total</TH><TH id=ac10 headers="ac8 ac9">A Total</TH><TH id=ac11 class=" bg-colour-blue" headers="ac8 ac9">A(H1)pdm09</TH><TH id=ac12 class=" bg-colour-blue" headers="ac8 ac9">A(H3)</TH><TH id=ac13 class=" bg-colour-blue" headers="ac8 ac9">A(UnS)</TH><TD class=alignCenter headers="ac8 ac14">B Total</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=alignLeft headers=ar1>BC</TH><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac3">0 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac6">0 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac7">11 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac10">1,807 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac11">1,614 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac12">53 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac13">140 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac14">362 </TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac3">18 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac4">5 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac5">7 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac6">6 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac7">43 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac10">3,871 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac11">3,460 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac12">90 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac13">321 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac14">465 </TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac3">0 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac6">0 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac7">23 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac10">1,383 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac11">988 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac12">8 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac13">387 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac14">179 </TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac3">0 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac6">0 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac7">0 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac10">682 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac11">463 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac12">5 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac13">214 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac14">47 </TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac3">18 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac5">8 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac6">10 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac7">104 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac10">5,757 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac11">2,490 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac12">380 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac13">2,887 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac14">2,984 </TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac3">6 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac6">6 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac7">35 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac10">5,363 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac11">677 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac12">5 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac13">4,681 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac14">2,684 </TD></TR><TR><TH id=ar8 class=alignLeft headers=ar1>NB</TH><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac3">2 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac5">1 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac6">1 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac7">4 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac10">1,490 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac11">370 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac12">2 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac13">1,118 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac14">104 </TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac3">1 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac5">1 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac6">0 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac7">4 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac10">175 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac11">134 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac12">5 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac13">36 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac14">43 </TD></TR><TR><TH id=ar10 class=alignLeft headers=ar1>PE</TH><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac3">-- </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac4">-- </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac5">-- </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac6">-- </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac7">-- </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac10">119 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac11">118 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac12">0 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac13">1 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac14">2 </TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac3">4 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac6">4 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac7">10 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac10">377 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac11">104 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac12">0 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac13">273 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac14">246 </TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignCenter headers="ar1 ar12 ac1 ac2 ac3">49 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac1 ac2 ac4">5 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac1 ac2 ac5">17 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac1 ac2 ac6">27 </TD><TD class=alignCenter headers="ar1 ar12 ac1 ac7">234 </TD><TD class=alignCenter headers="ar1 ar12 ac8 ac9 ac10">21,024 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac8 ac9 ac11">10,418 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac8 ac9 ac12">548 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac8 ac9 ac13">10,058 </TD><TD class=alignCenter headers="ar1 ar12 ac8 ac14">7,116 </TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignCenter headers="ar1 ar13 ac1 ac2 ac3">17.3% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac1 ac2 ac4">10.2% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac1 ac2 ac5">34.7% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac1 ac2 ac6">55.1% </TD><TD class=alignCenter headers="ar1 ar13 ac1 ac7">82.7% </TD><TD class=alignCenter headers="ar1 ar13 ac8 ac9 ac10">74.7% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac8 ac9 ac11">49.6% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac8 ac9 ac12">2.6% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac8 ac9 ac13">47.8% </TD><TD class=alignCenter headers="ar1 ar13 ac8 ac14">25.3% </TD></TR></TBODY></TABLE>
<TABLE id=t2 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups (years)</TH><TH id=bc1 colSpan=5>Weekly
(May 11 to May 17, 2014)</TH><TH id=bc8 colSpan=7>Cumulative
(August 25, 2013 to May 17, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=bc2 colSpan=4 headers=bc1>Influenza A</TH><TH id=bc7 headers=bc1>B</TH><TH id=bc9 colSpan=4 headers=bc8>Influenza A</TH><TH id=bc14 headers=bc8>B</TH><TH id=bc15 colSpan=2 headers=bc8>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=bc3 headers="bc1 bc2">A Total</TH><TH id=bc4 class="bg-colour-blue " headers="bc1 bc2">A(H1) pdm09</TH><TH id=bc5 class="bg-colour-blue " headers="bc1 bc2">A(H3)</TH><TH id=bc6 class="bg-colour-blue " headers="bc1 bc2">A (UnS)</TH><TD class=alignCenter headers="bc1 bc7">Total</TD><TH id=bc10 headers="bc8 bc9">A Total</TH><TH id=bc11 class="bg-colour-blue " headers="bc8 bc9">A(H1) pdm09</TH><TH id=bc12 class="bg-colour-blue " headers="bc8 bc9">A(H3)</TH><TH id=bc13 class="bg-colour-blue " headers="bc8 bc9">A (UnS)</TH><TD class=alignCenter headers="bc8 bc14">Total</TD><TH id=bc16 headers="bc8 bc15">#</TH><TH id=bc17 headers="bc8 bc15">%</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13><SUP id=footnote_t2_1>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP id=footnote_t2_2>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
<SUP id=footnote_t2_3>3 </SUP>Table 2 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=br2 class=alignLeft headers=br1><5</TH><TD class=alignCenter headers="br1 br2 bc1 bc2 bc3">2 </TD><TD class=alignCenter headers="br1 br2 bc1 bc2 bc4">0 </TD><TD class=alignCenter headers="br1 br2 bc1 bc2 bc5">2 </TD><TD class=alignCenter headers="br1 br2 bc1 bc2 bc6">0 </TD><TD class=alignCenter headers="br1 br2 bc1 bc7">12 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc10">3,264 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc11">1,451 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc12">44 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc13">1,769 </TD><TD class=alignCenter headers="br1 br2 bc8 bc14">532 </TD><TD class=alignCenter headers="br1 br2 bc8 bc15 bc16">3,796 </TD><TD class=alignCenter headers="br1 br2 bc8 bc15 bc17">16.6% </TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignCenter headers="br1 br3 bc1 bc2 bc3">1 </TD><TD class=alignCenter headers="br1 br3 bc1 bc2 bc4">0 </TD><TD class=alignCenter headers="br1 br3 bc1 bc2 bc5">0 </TD><TD class=alignCenter headers="br1 br3 bc1 bc2 bc6">1 </TD><TD class=alignCenter headers="br1 br3 bc1 bc7">20 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc10">1,331 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc11">707 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc12">25 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc13">599 </TD><TD class=alignCenter headers="br1 br3 bc8 bc14">807 </TD><TD class=alignCenter headers="br1 br3 bc8 bc15 bc16">2,138 </TD><TD class=alignCenter headers="br1 br3 bc8 bc15 bc17">9.4% </TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignCenter headers="br1 br4 bc1 bc2 bc3">5 </TD><TD class=alignCenter headers="br1 br4 bc1 bc2 bc4">5 </TD><TD class=alignCenter headers="br1 br4 bc1 bc2 bc5">0 </TD><TD class=alignCenter headers="br1 br4 bc1 bc2 bc6">0 </TD><TD class=alignCenter headers="br1 br4 bc1 bc7">17 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc10">5,089 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc11">2,817 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc12">46 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc13">2,226 </TD><TD class=alignCenter headers="br1 br4 bc8 bc14">989 </TD><TD class=alignCenter headers="br1 br4 bc8 bc15 bc16">6,078 </TD><TD class=alignCenter headers="br1 br4 bc8 bc15 bc17">26.6% </TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignCenter headers="br1 br5 bc1 bc2 bc3">3 </TD><TD class=alignCenter headers="br1 br5 bc1 bc2 bc4">0 </TD><TD class=alignCenter headers="br1 br5 bc1 bc2 bc5">1 </TD><TD class=alignCenter headers="br1 br5 bc1 bc2 bc6">2 </TD><TD class=alignCenter headers="br1 br5 bc1 bc7">36 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc10">4,470 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc11">2,389 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc12">64 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc13">2,017 </TD><TD class=alignCenter headers="br1 br5 bc8 bc14">1,460 </TD><TD class=alignCenter headers="br1 br5 bc8 bc15 bc16">5,930 </TD><TD class=alignCenter headers="br1 br5 bc8 bc15 bc17">26.0% </TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignCenter headers="br1 br6 bc1 bc2 bc3">17 </TD><TD class=alignCenter headers="br1 br6 bc1 bc2 bc4">0 </TD><TD class=alignCenter headers="br1 br6 bc1 bc2 bc5">9 </TD><TD class=alignCenter headers="br1 br6 bc1 bc2 bc6">8 </TD><TD class=alignCenter headers="br1 br6 bc1 bc7">56 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc10">2,598 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc11">1,000 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc12">174 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc13">1,424 </TD><TD class=alignCenter headers="br1 br6 bc8 bc14">2,162 </TD><TD class=alignCenter headers="br1 br6 bc8 bc15 bc16">4,760 </TD><TD class=alignCenter headers="br1 br6 bc8 bc15 bc17">20.8% </TD></TR><TR><TH id=br7 class=alignLeft headers=br1>Unknown</TH><TD class=alignCenter headers="br1 br7 bc1 bc2 bc3">0 </TD><TD class=alignCenter headers="br1 br7 bc1 bc2 bc4">0 </TD><TD class=alignCenter headers="br1 br7 bc1 bc2 bc5">0 </TD><TD class=alignCenter headers="br1 br7 bc1 bc2 bc6">0 </TD><TD class=alignCenter headers="br1 br7 bc1 bc7">0 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc10">137 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc11">102 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc12">22 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc13">13 </TD><TD class=alignCenter headers="br1 br7 bc8 bc14">9 </TD><TD class=alignCenter headers="br1 br7 bc8 bc15 bc16">146 </TD><TD class=alignCenter headers="br1 br7 bc8 bc15 bc17">0.6% </TD></TR><TR><TH id=br8 class=alignLeft headers=br1>Total</TH><TD class=alignCenter headers="br1 br8 bc1 bc2 bc3">28 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc1 bc2 bc4">5 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc1 bc2 bc5">12 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc1 bc2 bc6">11 </TD><TD class=alignCenter headers="br1 br8 bc1 bc7">141 </TD><TD class=alignCenter headers="br1 br8 bc8 bc9 bc10">16,889 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc8 bc9 bc11">8,466 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc8 bc9 bc12">375 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc8 bc9 bc13">8,048 </TD><TD class=alignCenter headers="br1 br8 bc8 bc14">5,959 </TD><TD class=alignCenter headers="br1 br8 bc8 bc15 bc16">22,848 </TD><TD class=alignCenter headers="br1 br8 bc8 bc15 bc17">100.0% </TD></TR><TR><TH id=br9 class=alignLeft headers=br1>Percentage<SUP>2</SUP></TH><TD class=alignCenter headers="br1 br9 bc1 bc2 bc3">16.6% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc1 bc2 bc4">17.9% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc1 bc2 bc5">42.9% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc1 bc2 bc6">39.3% </TD><TD class=alignCenter headers="br1 br9 bc1 bc7">83.4% </TD><TD class=alignCenter headers="br1 br9 bc8 bc9 bc10">73.9% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc8 bc9 bc11">50.1% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc8 bc9 bc12">2.2% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc8 bc9 bc13">47.7% </TD><TD class=alignCenter headers="br1 br9 bc8 bc14">26.1% </TD><TD class=alignCenter></TD><TD class=alignCenter></TD></TR></TBODY></TABLE>

Top of Page
Influenza Strain Characterizations

During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 2,052 influenza viruses [114 A(H3N2), 1,367 A(H1N1)pdm09 and 571 influenza B]. The vast majority (99%) of viruses were similar to the strains recommended by the WHO for the 2013-14 seasonal influenza vaccine. Two A(H1N1)pdm09 viruses showed reduced titres to antiserum against the reference A/California/07/2009 strain, and one A(H3N2) virus showed reduced titres to antiserum against the reference A/Texas/50/2012 strain. Twenty-six influenza B viruses were similar to the strain recommended by the WHO for the 2011-12 vaccine (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2013-2014, N = 2052
2014-w20-fg4-eng.gif

The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
The recommended components for the 2013-2014 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009 (H1N1)pdm09-like virus, an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b (e.g. A/Texas/50/2012), and a B/Massachusetts/2/2012-like virus (Yamagata lineage).


Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
Antiviral Resistance

During the 2013-2014 influenza season, NML has tested 1,883 influenza viruses for resistance to oseltamivir and all but five were sensitive. All 1,796 viruses tested for resistance to zanamivir were sensitive. All 1,570 influenza A viruses tested for amantadine resistance were resistant (Table 3).
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2013-2014</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=cr1 rowSpan=2>Virus type and subtype</TH><TH id=cc1 colSpan=2>Oseltamivir</TH><TH id=cc4 colSpan=2>Zanamivir</TH><TH id=cc7 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=cc2 headers=cc1># tested</TH><TH id=cc3 headers=cc1># resistant (%)</TH><TH id=cc5 headers=cc4># tested</TH><TH id=cc6 headers=cc4># resistant (%)</TH><TH id=cc8 headers=cc7># tested</TH><TH id=cc9 headers=cc7># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=cr2 class="alignLeft bg-colour-blue" headers=cr1>A (H3N2)</TH><TD class=alignCenter headers="cr1 cr2 cc1 cc2">95</TD><TD class=alignCenter headers="cr1 cr2 cc1 cc3">0</TD><TD class=alignCenter headers="cr1 cr2 cc4 cc5">92</TD><TD class=alignCenter headers="cr1 cr2 cc4 cc6">0</TD><TD class=alignCenter headers="cr1 cr2 cc7 cc8">150</TD><TD class=alignCenter headers="cr1 cr2 cc7 cc9">150 (100%)</TD></TR><TR><TH id=cr3 class="alignLeft bg-colour-blue" headers=cr1>A (H1N1)</TH><TD class=alignCenter headers="cr1 cr3 cc1 cc2">1338</TD><TD class=alignCenter headers="cr1 cr3 cc1 cc3">5 (0.4%)</TD><TD class=alignCenter headers="cr1 cr3 cc4 cc5">1321</TD><TD class=alignCenter headers="cr1 cr3 cc4 cc6">0</TD><TD class=alignCenter headers="cr1 cr3 cc7 cc8">1420</TD><TD class=alignCenter headers="cr1 cr3 cc7 cc9">1420 (100%)</TD></TR><TR><TH id=cr4 class="alignLeft bg-colour-blue" headers=cr1>B</TH><TD class=alignCenter headers="cr1 cr4 cc1 cc2">450</TD><TD class=alignCenter headers="cr1 cr4 cc1 cc3">0</TD><TD class=alignCenter headers="cr1 cr4 cc4 cc5">383</TD><TD class=alignCenter headers="cr1 cr4 cc4 cc6">0</TD><TD class=alignCenter headers="cr1 cr4 cc7 cc8">NA <SUP>*</SUP></TD><TD class=alignCenter headers="cr1 cr4 cc7 cc9">NA <SUP>*</SUP></TD></TR><TR><TH id=cr5 class="alignLeft bg-colour-blue" headers=cr1>TOTAL</TH><TD class=alignCenter headers="cr1 cr5 cc1 cc2">1883</TD><TD class=alignCenter headers="cr1 cr5 cc1 cc3">5 (0.3%)</TD><TD class=alignCenter headers="cr1 cr5 cc4 cc5">1796</TD><TD class=alignCenter headers="cr1 cr5 cc4 cc6">0</TD><TD class=alignCenter headers="cr1 cr5 cc7 cc8">1570</TD><TD class=alignCenter headers="cr1 cr5 cc7 cc9">1570 (100%)</TD></TR></TBODY></TABLE>
Influenza-like Illness (ILI) Consultation Rate

The national influenza-like-illness (ILI) consultation rate decreased from 20.2 consultations per 1,000 patient visits in week 19 to 17.2 per 1,000 in week 20; which was within the expected range for week 20 (Figure 5).
Figure 5. Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014
2014-w20-fg5-eng.gif

Note: No data available for mean rate for weeks 19 to 39 for the 1996-1997 through 2002-2003 seasons. Delays in the reporting of data may cause data to change retrospectively. The calculation of the average ILI consultation rate over 17 seasons was aligned with influenza activity in each season. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. The number of sentinel physicians in each province or territory is as follows: BC(21), AB(80), SK(11), MB(18), ON(169), QC(14), NB(29), NS(26), PE(4), NL(16), NU(1), NT(14), YT(13). Not all sentinel physicians report every week.
Text equivalent for figure 5Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

Top of Page
Influenza Outbreak Surveillance

The number of new influenza outbreaks decreased from eight in week 19 to four in week 20. Three of the four were in long-term care facilities (Figure 6) and the fourth was in another type of facility or community setting. Two of the four outbreaks for which the influenza type was identified were influenza B. One additional outbreak of ILI was reported in another type of facility or community setting.
Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2013-2014
2014-w20-fg6-eng.gif

1 All provinces and territories except NU report outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
Text equivalent for figure 6Overall number of new influenza outbreaks by report week, Canada, 2013-2014
Pharmacy Surveillance

In week 20, the proportion of prescriptions for antivirals was the same as the previous week, in keeping with laboratory detections of influenza. Overall this season, the largest proportion of prescriptions for antivirals has been among children 2-18 years of age and adults 19-64 years of age (Figure 7).
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14
2014-w20-fg7-eng.gif

Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group. Age-groups: Infant: 0-2y, Child: 2-18y; Adult: 19-64y, Senior: ≥65y.
Text equivalent for figure 7Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

Top of Page
Sentinel Hospital Influenza Surveillance

Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In week 20, two new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network, compared to seven in week 19. Both cases reported in week 20 had influenza B (Figure 8a). A greater proportion of cases with influenza B this season have been children between 2 and 10 years of age compared to A(H1N1)pdm09. One ICU admission was reported in week 20 of a child 2-4 years of age with influenza B, and no deaths were reported.
To date this season, a total of 692 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 80% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children <5 years of age represent 73% of cases to date (Table 4). One hundred and six ICU admissions have been reported, of which 70 (66%) were children <5 years of age (Figure 9a). All but 14 were cases with influenza A, and 97% of those subtyped were A(H1N1)pdm09. Among the 103 ICU cases with available data, 66 (64%) were reported to have underlying medical conditions. No deaths have been reported. A smaller number of paediatric hospital admissions have been reported this year compared to the 2012-13 season.
Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
Adult Influenza Hospitalizations and Deaths (PCIRN)
In week 20, six new laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported through active surveillance by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network, compared to 23 in week 19 (Figure 8b). May 15th marked the end of the active surveillance period for PCIRN-SOS. Since the beginning of March the majority of hospitalizations have been associated with influenza B, and the total number of cases has been declining since mid-April. No ICU admissions or deaths were reported in week 20.
To date this season, 1,919 influenza-associated hospitalizations have been reported by the PCIRN-SOS network, 1,320 (68.8%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). Compared to the 2012-13 season, slightly more cases have been reported, although the peak number of cases was smaller. A greater number of cases have been reported during March and April compared to last year, with nearly six times more cases of influenza B reported to date. ICU admission was required for 307 hospitalizations, of which 259 were cases with influenza A (134 A(H1N1)pdm09, nine A(H3N2) and 116 A(unsubtyped)), 47 were cases with influenza B and the influenza type was not reported for one case. A greater proportion of cases have been admitted to the ICU this season compared to last year, but the proportion of deaths has been similar. Of the ICU admissions with available information, 85.5% (183/214) were reported to have at least one comorbidity, and 69.2% (173/250) reported not having been vaccinated this season. Among the 104 deaths reported this season, all but 22 have been cases of influenza A (51 A(H1N1)pdm09, three A(H3N2) and 28 A(unsubtyped)); ten cases 20-44 years of age, 36 cases 45-64 years of age and 58 cases ≥65 years of age (Figure 9b). Among fatal cases with available information, 93.3% (56/60) were reported to have at least one comorbidity, and 49.4% (39/79) reported not having been vaccinated this season.
Note: PCIRN-SOS conducted passive surveillance from April 30th to November 14th, 2013. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance began November 15th during which time PCIRN site coordinators investigate cases potentially related to influenza. Data from both active and passive surveillance reported during the 2013-14 season are included in this report. The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t4 class=alignCenter>Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=dr1 rowSpan=3>Age groups </TH><TH id=dc1 colSpan=6>Cumulative (Aug. 25, 2013 to May 17, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=dc2 colSpan=4 headers=dc1>Influenza A </TH><TH id=dc7 headers=dc1>B </TH><TH id=dc8 headers=dc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=dc3 headers="dc1 dc2">A Total </TH><TH id=dc4 class="bg-colour-blue " headers="dc1 dc2">A(H1) pdm09 </TH><TH id=dc5 class="bg-colour-blue " headers="dc1 dc2">A(H3) </TH><TH id=dc6 class="bg-colour-blue " headers="dc1 dc2">A (UnS) </TH><TD class=alignCenter headers="dc1 dc7">Total</TD><TD class=alignCenter headers="dc1 dc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t4_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=dr2 class=alignLeft headers=dr1>0-5m </TH><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc3">104 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc4">36 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc5">0 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc6">68 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc7">8 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc8">112 (16%) </TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc3">162 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc4">56 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc5">1 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc6">105 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc7">25 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc8">187 (27%) </TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc3">165 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc4">55 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc5">3 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc6">107 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc7">43 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc8">208 (30%) </TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc3">82 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc4">28 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc5">1 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc6">53 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc7">51 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc8">133 (19%) </TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc3">40 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc4">14 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc5">1 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc6">25 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc7">12 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc8">52 (8%) </TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignCenter headers="dr1 dr7 dc1 dc2 dc3">553</TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc4">189 </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc5">6 </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc6">358 </TD><TD class=alignCenter headers="dr1 dr7 dc1 dc7">139 </TD><TD class=alignCenter headers="dr1 dr7 dc1 dc8">692 </TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP> </TH><TD class=alignCenter headers="dr1 dr8 dc1 dc2 dc3">79.9% </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc4">34.2% </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc5">1.1% </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc6">64.7% </TD><TD class=alignCenter headers="dr1 dr8 dc1 dc7">20.1% </TD><TD class=alignCenter headers="dr1 dr8 dc1 dc8">100.0% </TD></TR></TBODY></TABLE>
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 5 - Cumulative numbers of adult hospitalizations with influenza
reported by the PCIRN-SOS network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=er1 rowSpan=3>Age groups </TH><TH id=ec1 class=noWrap colSpan=6>Cumulative (Aug. 25, 2013 to May 15, 2014)<SUP>*</SUP></TH></TR><TR class=bg-colour-yellow><TH id=ec2 colSpan=4 headers=ec1>Influenza A </TH><TH id=ec7 headers=ec1>B </TH><TH id=ec8 headers=ec1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=ec3 headers="ec1 ec2">A Total </TH><TH id=ec4 class=bg-colour-blue headers="ec1 ec2">A(H1) pdm09 </TH><TH id=ec5 class=bg-colour-blue headers="ec1 ec2">A(H3) </TH><TH id=ec6 class=bg-colour-blue headers="ec1 ec2">A(UnS) </TH><TD class=alignCenter headers="ec1 ec7">Total</TD><TD class=alignCenter headers="ec1 ec8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t5_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.

<SUP id=t5_star>*</SUP> Two cases for which the influenza type has not yet been reported, and five cases for which the age-group was not reported, are not included in Table 5.</TD></TR></TFOOT><TBODY><TR><TH id=er2 class=alignLeft headers=er1>16-20 </TH><TD class=alignCenter headers="er1 er2 ec1 ec2 ec3">12 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec4">5 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec5">0 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec6">7 </TD><TD class=alignCenter headers="er1 er2 ec1 ec7">3 </TD><TD class=alignCenter headers="er1 er2 ec1 ec8">15 (1%) </TD></TR><TR><TH id=er3 class=alignLeft headers=er1>20-44 </TH><TD class=alignCenter headers="er1 er3 ec1 ec2 ec3">272 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec4">142 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec5">6 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec6">124 </TD><TD class=alignCenter headers="er1 er3 ec1 ec7">44 </TD><TD class=alignCenter headers="er1 er3 ec1 ec8">316 (17%) </TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignCenter headers="er1 er4 ec1 ec2 ec3">516 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec4">240 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec5">10 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec6">266 </TD><TD class=alignCenter headers="er1 er4 ec1 ec7">132 </TD><TD class=alignCenter headers="er1 er4 ec1 ec8">648 (34%) </TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignCenter headers="er1 er5 ec1 ec2 ec3">516 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec4">236 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec5">57 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec6">223 </TD><TD class=alignCenter headers="er1 er5 ec1 ec7">417 </TD><TD class=alignCenter headers="er1 er5 ec1 ec8">933 (49%) </TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignCenter headers="er1 er6 ec1 ec2 ec3">1316 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec4">623 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec5">73 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec6">620 </TD><TD class=alignCenter headers="er1 er6 ec1 ec7">596 </TD><TD class=alignCenter headers="er1 er6 ec1 ec8">1912 </TD></TR><TR><TH id=er7 class=alignLeft headers=er1>%<SUP>1</SUP></TH><TD class=alignCenter headers="er1 er7 ec1 ec2 ec3">69% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec4">47% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec5">6% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec6">47% </TD><TD class=alignCenter headers="er1 er7 ec1 ec7">31% </TD><TD class=alignCenter headers="er1 er7 ec1 ec8">100% </TD></TR></TBODY></TABLE>
Figure 8. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w20-fg8a-eng.gif


Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w20-fg8b-eng.gif

* See footnote above following the section related to PCIRN-SOS data.
Text equivalent for figure 8bNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Adult hospitalizations (>16 year of age, PCIRN-SOS)
Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w20-fg9a-eng.gif

Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w20-fg9b-eng.gif

Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Adult hospitalizations (≥16 year of age, PCIRN-SOS)

Top of Page
Provincial/Territorial Influenza Hospitalizations and Deaths

In week 20, 108 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories.* As with other surveillance indicators in week 20, the majority were cases of influenza B (99, 91.7%). Three ICU admissions and 14 deaths were reported in week 20. Ten of the 14 deaths were cases with influenza B; of these, 8 cases were adults ≥65 years of age, one was 45-64 years of age and one had no age reported. Among fatal cases with influenza A, two cases were 20-44 years of age, one was 45-64 years of age and one was ≥65 years of age. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total.
To date this season, 4,862 influenza-associated hospitalizations have been reported, 74.4% with influenza A. The majority (61.7%) of hospitalizations have been cases 45 years of age of older. A significantly greater proportion of cases of influenza B have been ≥65 years of age, and 5-19 years of age, compared to cases of A(H1N1)pdm09 this season (Table 6). A total of 362 ICU admissions have been reported this season, of which 64.6% were adults 20-64 years of age. A total of 291 deaths have been reported. The highest proportion of deaths has been among adults ≥65 years of age (51.9%) followed by adults 20-64 years of age (39.2%). In keeping with the late-season circulation, influenza B has been increasingly reported among hospitalized cases of influenza. To date this season, influenza B has been reported in 25.6% of hospitalizations and 27.1% of deaths. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.
* Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t6 class=alignCenter>Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=fr1 rowSpan=3>Age groups </TH><TH id=fc1 colSpan=6>Cumulative (Aug. 25, 2013 to May 17, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=fc2 colSpan=4 headers=fc1>Influenza A</TH><TH id=fc7 headers=fc1>B</TH><TH id=fc8 headers=fc1>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=fc3 headers="fc1 fc2">A Total</TH><TH id=fc4 class=bg-colour-blue headers="fc1 fc2">A(H1) pdm09</TH><TH id=fc5 class=bg-colour-blue headers="fc1 fc2">A(H3)</TH><TH id=fc6 class=bg-colour-blue headers="fc1 fc2">A (UnS)</TH><TD class=alignCenter headers="fc1 fc7">Total</TD><TD class=alignCenter headers="fc1 fc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=8><SUP id=footnote_t6_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=fr2 class=alignLeft headers=fr1>0-4 years</TH><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc3">617 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc4">287 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc5">12 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc6">318 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc7">116 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc8">733 (15%) </TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years</TH><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc3">134 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc4">65 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc5">6 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc6">63 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc7">103 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc8">237 (5%) </TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years</TH><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc3">38 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc4">21 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc5">4 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc6">13 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc7">6 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc8">44 (1%) </TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc3">615 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc4">424 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc5">5 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc6">186 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc7">76 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc8">691 (14%) </TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc3">1121 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc4">706 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc5">30 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc6">385 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc7">245 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc8">1366 (28%) </TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc3">952 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc4">467 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc5">104 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc6">381 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc7">680 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc8">1632 (34%) </TD></TR><TR><TH id=fr10 class=alignLeft headers=fr1>Unknown</TH><TD class=alignCenter headers="fc1 fc2 fc3">138 </TD><TD class=alignCenter headers="fc1 fc2 fc4">99 </TD><TD class=alignCenter headers="fc1 fc2 fc5">3 </TD><TD class=alignCenter headers="fc1 fc2 fc6">36 </TD><TD class=alignCenter headers="fc1 fc7">21 </TD><TD class=alignCenter headers="fc1 fc8">159 (3%) </TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignCenter headers="fr1 fr8 fc1 fc2 fc3">3615 </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc4">2069 </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc5">164 </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc6">1382 </TD><TD class=alignCenter headers="fr1 fr8 fc1 fc7">1247 </TD><TD class=alignCenter headers="fr1 fr8 fc1 fc8">4862 </TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP> </TH><TD class=alignCenter headers="fr1 fr9 fc1 fc2 fc3">74.4% </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc4">57.2% </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc5">4.5% </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc6">38.2% </TD><TD class=alignCenter headers="fr1 fr9 fc1 fc7">25.6% </TD><TD class=alignCenter headers="fr1 fr9 fc1 fc8">100% </TD></TR></TBODY></TABLE>
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2013-14 on the Public Health Agency of Canada website.

.../
http://www.phac-aspc.gc.ca/fluwatch/13-14/w20_14/index-eng.php
 
Re: Canada FluWatch Weekly Reports 2013-2014 Season Weeks 21 and 22

Re: Canada FluWatch Weekly Reports 2013-2014 Season Weeks 21 and 22

FluWatch report: May 18 to May 31, 2014 (Weeks 21 and 22)

Posted 2014-06-06For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
<A title="Flu Watch (Version PDF, 421 KB - 10 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/13-14/w22_14/pdf/fw2014-22-eng.pdf">FluWatch report: May 18 to May 31, 2014 (Weeks 21 and 22) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 421 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

?? Help with PDF documents

Overall Summary
  • In weeks 21 and 22, influenza activity in Canada continued to decline. Low-level circulation of influenza B continues to be reported, but activity remains within expected levels for this time of year.
  • Influenza B is having a greater impact on adults 65 years of age and older and young persons 5 to 19 years of age, compared to influenza A(H1N1) which circulated earlier in the year.
  • As of week 22, 5,086 hospitalizations and 313 deaths have been reported from participating regions, which is similar to the number reported last year.
Are you a primary health care practitioner (General Practitioner, Nurse Practitioner or Registered Nurse) interested in becoming a FluWatch sentinel for the 2014-15 influenza season? Contact us at FluWatch@phac-aspc.gc.ca
Influenza/ILI Activity (geographic spread)

In week 21, eight regions reported localized activity: seven regions in Ontario and one in Newfoundland & Labrador. In week 22, nine regions reported localized activity: seven were the same regions as in week 21, with one additional region each in Newfoundland & Labrador and Saskatchewan (Figure 1). Five regions did not report data in week 21 and in week 22.
Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 22


right_ofmap.gif



Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
Influenza and Other Respiratory Virus Detections

The number of positive influenza tests continued to decline from 310 in week 20 to 203 in week 21, and 133 (5.5% of tests) in week 22 (Figure 2). Influenza B remained the predominant virus in weeks 21 and 22, representing 80% of influenza detections. However, most jurisdictions have reported low or declining numbers of influenza detections in weeks 21 and 22 (Table 1). This season, A(H1N1)pdm09 predominantly affected adults 20-64 years of age and children <5 years of age, while influenza B affected greater proportions of adults ≥65 years of age and children 5-19 years of age (Table 2).
Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
2014-w22-fg2-eng.gif

Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
Detections of RSV, coronavirus, and human metapneumovirus have continued to decline and are approaching inter-seasonal levels. The number of positive tests for parainfluenza continued to follow an upward trend in recent weeks, and detections of adenovirus have been stable over the past three weeks, in keeping with the broader year-round circulation of these viruses. Detections of rhinovirus in recent weeks have been higher than during the same period over the past three seasons, however the number of positive tests decreased in weeks 21 and 22 (Figure 3).
For more details, see the weekly Respiratory Virus Detections in Canada Report.
Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2013-14
2014-w22-fg3-eng.gif


Top of Page
RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
<TABLE id=t1 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class="alignCenter margin10px">Table 1: Weekly and cumulative numbers of positive influenza specimens
by type, subtype and province, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=t1hc1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=t1hc2 colSpan=5>Weekly
(May 18 to 31, 2014)</TH><TH id=t1hc3 colSpan=5>Cumulative
(August 25, 2013 to May 31, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=t1hc4 colSpan=4 headers=t1hc2>Influenza A</TH><TH id=t1hc5 headers=t1hc2>B</TH><TH id=t1hc6 colSpan=4 headers=t1hc3>Influenza A</TH><TH id=t1hc7 headers=t1hc3>B</TH></TR><TR class=bg-colour-grey-light><TH id=t1hc8 headers="t1hc2 t1hc4">A Total</TH><TH id=t1hc9 class=" bg-colour-blue" headers="t1hc2 t1hc4">A(H1)pdm09</TH><TH id=t1hc10 class=" bg-colour-blue" headers="t1hc2 t1hc4">A(H3)</TH><TH id=t1hc11 class=" bg-colour-blue" headers="t1hc2 t1hc4">A(UnS)</TH><TH id=t1hc12 class=alignCenter headers="t1hc2 t1hc5">B Total</TH><TH id=t1hc13 headers="t1hc3 t1hc6">A Total</TH><TH id=t1hc14 class=" bg-colour-blue" headers="t1hc3 t1hc6">A(H1)pdm09</TH><TH id=t1hc15 class=" bg-colour-blue" headers="t1hc3 t1hc6">A(H3)</TH><TH id=t1hc16 class=" bg-colour-blue" headers="t1hc3 t1hc6">A(UnS)</TH><TD class=alignCenter headers="t1hc3 t1hc7">B Total</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available. </TD></TR></TFOOT><TBODY><TR><TH id=t1hr1 class=alignLeft headers=t1hc1>BC</TH><TD class=alignCenter headers="t1hr1 t1hc2 t1hc4 t1hc8">3</TD><TD class=alignCenter headers="t1hr1 t1hc2 t1hc4 t1hc9">0</TD><TD class=alignCenter headers="t1hr1 t1hc2 t1hc4 t1hc10">2</TD><TD class=alignCenter headers="t1hr1 t1hc2 t1hc4 t1hc11">1</TD><TD class=alignCenter headers="t1hr1 t1hc2 t1hc5 t1hc12">14</TD><TD class=alignCenter headers="t1hr1 t1hc3 t1hc6 t1hc13">1811</TD><TD class=alignCenter headers="t1hr1 t1hc3 t1hc6 t1hc14">1614</TD><TD class=alignCenter headers="t1hr1 t1hc3 t1hc6 t1hc15">57</TD><TD class=alignCenter headers="t1hr1 t1hc3 t1hc6 t1hc16">140</TD><TD class=alignCenter headers="t1hr1 t1hc3 t1hc7">374</TD></TR><TR><TH id=t1hr2 class=alignLeft headers=t1hc1>AB</TH><TD class=alignCenter headers="t1hr2 t1hc2 t1hc4 t1hc8">11</TD><TD class=alignCenter headers="t1hr2 t1hc2 t1hc4 t1hc9">1</TD><TD class=alignCenter headers="t1hr2 t1hc2 t1hc4 t1hc10">9</TD><TD class=alignCenter headers="t1hr2 t1hc2 t1hc4 t1hc11">1</TD><TD class=alignCenter headers="t1hr2 t1hc2 t1hc5 t1hc12">69</TD><TD class=alignCenter headers="t1hr2 t1hc3 t1hc6 t1hc13">3882</TD><TD class=alignCenter headers="t1hr2 t1hc3 t1hc6 t1hc14">3462</TD><TD class=alignCenter headers="t1hr2 t1hc3 t1hc6 t1hc15">103</TD><TD class=alignCenter headers="t1hr2 t1hc3 t1hc6 t1hc16">317</TD><TD class=alignCenter headers="t1hr2 t1hc3 t1hc7">535</TD></TR><TR><TH id=t1hr3 class=alignLeft headers=t1hc1>SK</TH><TD class=alignCenter headers="t1hr3 t1hc2 t1hc4 t1hc8">1</TD><TD class=alignCenter headers="t1hr3 t1hc2 t1hc4 t1hc9">0</TD><TD class=alignCenter headers="t1hr3 t1hc2 t1hc4 t1hc10">0</TD><TD class=alignCenter headers="t1hr3 t1hc2 t1hc4 t1hc11">1</TD><TD class=alignCenter headers="t1hr3 t1hc2 t1hc5 t1hc12">14</TD><TD class=alignCenter headers="t1hr3 t1hc3 t1hc6 t1hc13">1384</TD><TD class=alignCenter headers="t1hr3 t1hc3 t1hc6 t1hc14">988</TD><TD class=alignCenter headers="t1hr3 t1hc3 t1hc6 t1hc15">8</TD><TD class=alignCenter headers="t1hr3 t1hc3 t1hc6 t1hc16">388</TD><TD class=alignCenter headers="t1hr3 t1hc3 t1hc7">193</TD></TR><TR><TH id=t1hr4 class=alignLeft headers=t1hc1>MB</TH><TD class=alignCenter headers="t1hr4 t1hc2 t1hc4 t1hc8">2</TD><TD class=alignCenter headers="t1hr4 t1hc2 t1hc4 t1hc9">0</TD><TD class=alignCenter headers="t1hr4 t1hc2 t1hc4 t1hc10">2</TD><TD class=alignCenter headers="t1hr4 t1hc2 t1hc4 t1hc11">0</TD><TD class=alignCenter headers="t1hr4 t1hc2 t1hc5 t1hc12">11</TD><TD class=alignCenter headers="t1hr4 t1hc3 t1hc6 t1hc13">685</TD><TD class=alignCenter headers="t1hr4 t1hc3 t1hc6 t1hc14">463</TD><TD class=alignCenter headers="t1hr4 t1hc3 t1hc6 t1hc15">7</TD><TD class=alignCenter headers="t1hr4 t1hc3 t1hc6 t1hc16">215</TD><TD class=alignCenter headers="t1hr4 t1hc3 t1hc7">65</TD></TR><TR><TH id=t1hr5 class=alignLeft headers=t1hc1>ON</TH><TD class=alignCenter headers="t1hr5 t1hc2 t1hc4 t1hc8">37</TD><TD class=alignCenter headers="t1hr5 t1hc2 t1hc4 t1hc9">5</TD><TD class=alignCenter headers="t1hr5 t1hc2 t1hc4 t1hc10">25</TD><TD class=alignCenter headers="t1hr5 t1hc2 t1hc4 t1hc11">7</TD><TD class=alignCenter headers="t1hr5 t1hc2 t1hc5 t1hc12">84</TD><TD class=alignCenter headers="t1hr5 t1hc3 t1hc6 t1hc13">5796</TD><TD class=alignCenter headers="t1hr5 t1hc3 t1hc6 t1hc14">2495</TD><TD class=alignCenter headers="t1hr5 t1hc3 t1hc6 t1hc15">407</TD><TD class=alignCenter headers="t1hr5 t1hc3 t1hc6 t1hc16">2894</TD><TD class=alignCenter headers="t1hr5 t1hc3 t1hc7">3081</TD></TR><TR><TH id=t1hr6 class=alignLeft headers=t1hc1>QC</TH><TD class=alignCenter headers="t1hr6 t1hc2 t1hc4 t1hc8">7</TD><TD class=alignCenter headers="t1hr6 t1hc2 t1hc4 t1hc9">0</TD><TD class=alignCenter headers="t1hr6 t1hc2 t1hc4 t1hc10">1</TD><TD class=alignCenter headers="t1hr6 t1hc2 t1hc4 t1hc11">6</TD><TD class=alignCenter headers="t1hr6 t1hc2 t1hc5 t1hc12">50</TD><TD class=alignCenter headers="t1hr6 t1hc3 t1hc6 t1hc13">5370</TD><TD class=alignCenter headers="t1hr6 t1hc3 t1hc6 t1hc14">677</TD><TD class=alignCenter headers="t1hr6 t1hc3 t1hc6 t1hc15">6</TD><TD class=alignCenter headers="t1hr6 t1hc3 t1hc6 t1hc16">4687</TD><TD class=alignCenter headers="t1hr6 t1hc3 t1hc7">2734</TD></TR><TR><TH id=t1hr7 class=alignLeft headers=t1hc1>NB</TH><TD class=alignCenter headers="t1hr7 t1hc2 t1hc4 t1hc8">1</TD><TD class=alignCenter headers="t1hr7 t1hc2 t1hc4 t1hc9">0</TD><TD class=alignCenter headers="t1hr7 t1hc2 t1hc4 t1hc10">0</TD><TD class=alignCenter headers="t1hr7 t1hc2 t1hc4 t1hc11">1</TD><TD class=alignCenter headers="t1hr7 t1hc2 t1hc5 t1hc12">10</TD><TD class=alignCenter headers="t1hr7 t1hc3 t1hc6 t1hc13">1491</TD><TD class=alignCenter headers="t1hr7 t1hc3 t1hc6 t1hc14">370</TD><TD class=alignCenter headers="t1hr7 t1hc3 t1hc6 t1hc15">2</TD><TD class=alignCenter headers="t1hr7 t1hc3 t1hc6 t1hc16">1119</TD><TD class=alignCenter headers="t1hr7 t1hc3 t1hc7">114</TD></TR><TR><TH id=t1hr8 class=alignLeft headers=t1hc1>NS</TH><TD class=alignCenter headers="t1hr8 t1hc2 t1hc4 t1hc8">0</TD><TD class=alignCenter headers="t1hr8 t1hc2 t1hc4 t1hc9">0</TD><TD class=alignCenter headers="t1hr8 t1hc2 t1hc4 t1hc10">0</TD><TD class=alignCenter headers="t1hr8 t1hc2 t1hc4 t1hc11">0</TD><TD class=alignCenter headers="t1hr8 t1hc2 t1hc5 t1hc12">4</TD><TD class=alignCenter headers="t1hr8 t1hc3 t1hc6 t1hc13">175</TD><TD class=alignCenter headers="t1hr8 t1hc3 t1hc6 t1hc14">134</TD><TD class=alignCenter headers="t1hr8 t1hc3 t1hc6 t1hc15">5</TD><TD class=alignCenter headers="t1hr8 t1hc3 t1hc6 t1hc16">36</TD><TD class=alignCenter headers="t1hr8 t1hc3 t1hc7">47</TD></TR><TR><TH id=t1hr9 class=alignLeft headers=t1hc1>PE</TH><TD class=alignCenter headers="t1hr9 t1hc2 t1hc4 t1hc8">0</TD><TD class=alignCenter headers="t1hr9 t1hc2 t1hc4 t1hc9">0</TD><TD class=alignCenter headers="t1hr9 t1hc2 t1hc4 t1hc10">0</TD><TD class=alignCenter headers="t1hr9 t1hc2 t1hc4 t1hc11">0</TD><TD class=alignCenter headers="t1hr9 t1hc2 t1hc5 t1hc12">2</TD><TD class=alignCenter headers="t1hr9 t1hc3 t1hc6 t1hc13">119</TD><TD class=alignCenter headers="t1hr9 t1hc3 t1hc6 t1hc14">118</TD><TD class=alignCenter headers="t1hr9 t1hc3 t1hc6 t1hc15">0</TD><TD class=alignCenter headers="t1hr9 t1hc3 t1hc6 t1hc16">1</TD><TD class=alignCenter headers="t1hr9 t1hc3 t1hc7">4</TD></TR><TR><TH id=t1hr10 class=alignLeft headers=t1hc1>NL</TH><TD class=alignCenter headers="t1hr10 t1hc2 t1hc4 t1hc8">4</TD><TD class=alignCenter headers="t1hr10 t1hc2 t1hc4 t1hc9">0</TD><TD class=alignCenter headers="t1hr10 t1hc2 t1hc4 t1hc10">0</TD><TD class=alignCenter headers="t1hr10 t1hc2 t1hc4 t1hc11">4</TD><TD class=alignCenter headers="t1hr10 t1hc2 t1hc5 t1hc12">12</TD><TD class=alignCenter headers="t1hr10 t1hc3 t1hc6 t1hc13">381</TD><TD class=alignCenter headers="t1hr10 t1hc3 t1hc6 t1hc14">104</TD><TD class=alignCenter headers="t1hr10 t1hc3 t1hc6 t1hc15">0</TD><TD class=alignCenter headers="t1hr10 t1hc3 t1hc6 t1hc16">277</TD><TD class=alignCenter headers="t1hr10 t1hc3 t1hc7">258</TD></TR><TR><TH id=t1hr11 class=alignLeft headers=t1hc1>Canada</TH><TD class=alignCenter headers="t1hr11 t1hc2 t1hc4 t1hc8">66</TD><TD class="alignCenter bg-colour-blue" headers="t1hr11 t1hc2 t1hc4 t1hc9">6</TD><TD class="alignCenter bg-colour-blue" headers="t1hr11 t1hc2 t1hc4 t1hc10">39</TD><TD class="alignCenter bg-colour-blue" headers="t1hr11 t1hc2 t1hc4 t1hc11">21</TD><TD class=alignCenter headers="t1hr11 t1hc2 t1hc5 t1hc12">270</TD><TD class=alignCenter headers="t1hr11 t1hc3 t1hc6 t1hc13">21094</TD><TD class="alignCenter bg-colour-blue" headers="t1hr11 t1hc3 t1hc6 t1hc14">10425</TD><TD class="alignCenter bg-colour-blue" headers="t1hr11 t1hc3 t1hc6 t1hc15">595</TD><TD class="alignCenter bg-colour-blue" headers="t1hr11 t1hc3 t1hc6 t1hc16">10074</TD><TD class=alignCenter headers="t1hr11 t1hc3 t1hc7">7405</TD></TR><TR><TH id=t1hr12 class=alignLeft headers=t1hc1>Percentage<SUP>2</SUP></TH><TD class=alignCenter headers="t1hr12 t1hc2 t1hc4 t1hc8">19.6%</TD><TD class="alignCenter bg-colour-blue" headers="t1hr12 t1hc2 t1hc4 t1hc9">9.1%</TD><TD class="alignCenter bg-colour-blue" headers="t1hr12 t1hc2 t1hc4 t1hc10">59.1%</TD><TD class="alignCenter bg-colour-blue" headers="t1hr12 t1hc2 t1hc4 t1hc11">31.8%</TD><TD class=alignCenter headers="t1hr12 t1hc2 t1hc5 t1hc12">80.4%</TD><TD class=alignCenter headers="t1hr12 t1hc3 t1hc6 t1hc13">74.0%</TD><TD class="alignCenter bg-colour-blue" headers="t1hr12 t1hc3 t1hc6 t1hc14">49.4%</TD><TD class="alignCenter bg-colour-blue" headers="t1hr12 t1hc3 t1hc6 t1hc15">2.8%</TD><TD class="alignCenter bg-colour-blue" headers="t1hr12 t1hc3 t1hc6 t1hc16">47.8%</TD><TD class=alignCenter headers="t1hr12 t1hc3 t1hc7">26.0%</TD></TR></TBODY></TABLE>
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t2 class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=t2hc1 rowSpan=3>Age groups (years)</TH><TH id=t2hc2 colSpan=5>Weekly
(May 18 to May 31, 2014)</TH><TH id=t2hc3 colSpan=7>Cumulative
(August 25, 2013 to May 31, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=t2hc4 colSpan=4 headers=t2hc2>Influenza A</TH><TH id=t2hc5 headers=t2hc2>B</TH><TH id=t2hc6 colSpan=4 headers=t2hc3>Influenza A</TH><TH id=t2hc7 headers=t2hc3>B</TH><TH id=t2hc8 colSpan=2>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=t2hc9 headers="t2hc2 t2hc4">A Total</TH><TH id=t2hc10 class=bg-colour-blue headers="t2hc2 t2hc4">A(H1) pdm09</TH><TH id=t2hc11 class="bg-colour-blue " headers="t2hc2 t2hc4">A(H3)</TH><TH id=t2hc12 class="bg-colour-blue " headers="t2hc2 t2hc4">A (UnS)</TH><TD class=alignCenter headers="t2hc2 t2hc5">Total</TD><TH id=t2hc13 headers="t2hc3 t2hc6">A Total</TH><TH id=t2hc14 class="bg-colour-blue " headers="t2hc3 t2hc6">A(H1) pdm09</TH><TH id=t2hc15 class="bg-colour-blue " headers="t2hc3 t2hc6">A(H3)</TH><TH id=t2hc16 class="bg-colour-blue " headers="t2hc3 t2hc6">A (UnS)</TH><TD class=alignCenter headers="t2hc3 t2hc7">Total</TD><TH id=t2hc17 headers="t2hc3 t2hc8">#</TH><TH id=t2hc18 headers="t2hc3 t2hc8">%</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13><SUP id=footnote_t2_1>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP id=footnote_t2_2>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
<SUP id=footnote_t2_3>3 </SUP>Table 2 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=t2hr1 class=alignLeft headers=t2hc1><5</TH><TD class=alignCenter headers="t2hr1 t2hc2 t2hc4 t2hc9">6</TD><TD class=alignCenter headers="t2hr1 t2hc2 t2hc4 t2hc10">3</TD><TD class=alignCenter headers="t2hr1 t2hc2 t2hc4 t2hc11">1</TD><TD class=alignCenter headers="t2hr1 t2hc2 t2hc4 t2hc12">2</TD><TD class=alignCenter headers="t2hr1 t2hc2 t2hc5">19</TD><TD class=alignCenter headers="t2hr1 t2hc3 t2hc6 t2hc13">3269</TD><TD class=alignCenter headers="t2hr1 t2hc3 t2hc6 t2hc14">1453</TD><TD class=alignCenter headers="t2hr1 t2hc3 t2hc6 t2hc15">45</TD><TD class=alignCenter headers="t2hr1 t2hc3 t2hc6 t2hc16">1771</TD><TD class=alignCenter headers="t2hr1 t2hc3 t2hc7">554</TD><TD class=alignCenter headers="t2hr1 t2hc3 t2hc8 t2hc17">3823</TD><TD class=alignCenter headers="t2hr1 t2hc3 t2hc8 t2hc18">16.6%</TD></TR><TR><TH id=t2hr2 class=alignLeft headers=t2hc1>5-19</TH><TD class=alignCenter headers="t2hr2 t2hc2 t2hc4 t2hc9">0</TD><TD class=alignCenter headers="t2hr2 t2hc2 t2hc4 t2hc10">0</TD><TD class=alignCenter headers="t2hr2 t2hc2 t2hc4 t2hc11">0</TD><TD class=alignCenter headers="t2hr2 t2hc2 t2hc4 t2hc12">0</TD><TD class=alignCenter headers="t2hr2 t2hc2 t2hc5">10</TD><TD class=alignCenter headers="t2hr2 t2hc3 t2hc6 t2hc13">1333</TD><TD class=alignCenter headers="t2hr2 t2hc3 t2hc6 t2hc14">707</TD><TD class=alignCenter headers="t2hr2 t2hc3 t2hc6 t2hc15">27</TD><TD class=alignCenter headers="t2hr2 t2hc3 t2hc6 t2hc16">599</TD><TD class=alignCenter headers="t2hr2 t2hc3 t2hc7">819</TD><TD class=alignCenter headers="t2hr2 t2hc3 t2hc8 t2hc17">2152</TD><TD class=alignCenter headers="t2hr2 t2hc3 t2hc8 t2hc18">9.3%</TD></TR><TR><TH id=t2hr3 class=alignLeft headers=t2hc1>20-44</TH><TD class=alignCenter headers="t2hr3 t2hc2 t2hc4 t2hc9">8</TD><TD class=alignCenter headers="t2hr3 t2hc2 t2hc4 t2hc10">1</TD><TD class=alignCenter headers="t2hr3 t2hc2 t2hc4 t2hc11">5</TD><TD class=alignCenter headers="t2hr3 t2hc2 t2hc4 t2hc12">2</TD><TD class=alignCenter headers="t2hr3 t2hc2 t2hc5">21</TD><TD class=alignCenter headers="t2hr3 t2hc3 t2hc6 t2hc13">5097</TD><TD class=alignCenter headers="t2hr3 t2hc3 t2hc6 t2hc14">2818</TD><TD class=alignCenter headers="t2hr3 t2hc3 t2hc6 t2hc15">51</TD><TD class=alignCenter headers="t2hr3 t2hc3 t2hc6 t2hc16">2228</TD><TD class=alignCenter headers="t2hr3 t2hc3 t2hc7">1017</TD><TD class=alignCenter headers="t2hr3 t2hc3 t2hc8 t2hc17">6114</TD><TD class=alignCenter headers="t2hr3 t2hc3 t2hc8 t2hc18">26.5%</TD></TR><TR><TH id=t2hr4 class=alignLeft headers=t2hc1>45-64</TH><TD class=alignCenter headers="t2hr4 t2hc2 t2hc4 t2hc9">5</TD><TD class=alignCenter headers="t2hr4 t2hc2 t2hc4 t2hc10">3</TD><TD class=alignCenter headers="t2hr4 t2hc2 t2hc4 t2hc11">2</TD><TD class=alignCenter headers="t2hr4 t2hc2 t2hc4 t2hc12">0</TD><TD class=alignCenter headers="t2hr4 t2hc2 t2hc5">34</TD><TD class=alignCenter headers="t2hr4 t2hc3 t2hc6 t2hc13">4476</TD><TD class=alignCenter headers="t2hr4 t2hc3 t2hc6 t2hc14">2392</TD><TD class=alignCenter headers="t2hr4 t2hc3 t2hc6 t2hc15">66</TD><TD class=alignCenter headers="t2hr4 t2hc3 t2hc6 t2hc16">2018</TD><TD class=alignCenter headers="t2hr4 t2hc3 t2hc7">1503</TD><TD class=alignCenter headers="t2hr4 t2hc3 t2hc8 t2hc17">5979</TD><TD class=alignCenter headers="t2hr4 t2hc3 t2hc8 t2hc18">25.9%</TD></TR><TR><TH id=t2hr5 class=alignLeft headers=t2hc1>65+</TH><TD class=alignCenter headers="t2hr5 t2hc2 t2hc4 t2hc9">26</TD><TD class=alignCenter headers="t2hr5 t2hc2 t2hc4 t2hc10">0</TD><TD class=alignCenter headers="t2hr5 t2hc2 t2hc4 t2hc11">19</TD><TD class=alignCenter headers="t2hr5 t2hc2 t2hc4 t2hc12">7</TD><TD class=alignCenter headers="t2hr5 t2hc2 t2hc5">73</TD><TD class=alignCenter headers="t2hr5 t2hc3 t2hc6 t2hc13">2630</TD><TD class=alignCenter headers="t2hr5 t2hc3 t2hc6 t2hc14">1001</TD><TD class=alignCenter headers="t2hr5 t2hc3 t2hc6 t2hc15">184</TD><TD class=alignCenter headers="t2hr5 t2hc3 t2hc6 t2hc16">1445</TD><TD class=alignCenter headers="t2hr5 t2hc3 t2hc7">2245</TD><TD class=alignCenter headers="t2hr5 t2hc3 t2hc8 t2hc17">4875</TD><TD class=alignCenter headers="t2hr5 t2hc3 t2hc8 t2hc18">21.1%</TD></TR><TR><TH id=t2hr6 class=alignLeft headers=t2hc1>Unknown</TH><TD class=alignCenter headers="t2hr6 t2hc2 t2hc4 t2hc9">0</TD><TD class=alignCenter headers="t2hr6 t2hc2 t2hc4 t2hc10">0</TD><TD class=alignCenter headers="t2hr6 t2hc2 t2hc4 t2hc11">0</TD><TD class=alignCenter headers="t2hr6 t2hc2 t2hc4 t2hc12">0</TD><TD class=alignCenter headers="t2hr6 t2hc2 t2hc5">0</TD><TD class=alignCenter headers="t2hr6 t2hc3 t2hc6 t2hc13">137</TD><TD class=alignCenter headers="t2hr6 t2hc3 t2hc6 t2hc14">102</TD><TD class=alignCenter headers="t2hr6 t2hc3 t2hc6 t2hc15">22</TD><TD class=alignCenter headers="t2hr6 t2hc3 t2hc6 t2hc16">13</TD><TD class=alignCenter headers="t2hr6 t2hc3 t2hc7">9</TD><TD class=alignCenter headers="t2hr6 t2hc3 t2hc8 t2hc17">146</TD><TD class=alignCenter headers="t2hr6 t2hc3 t2hc8 t2hc18">0.6%</TD></TR><TR><TH id=t2hr7 class=alignLeft headers=t2hc1>Total</TH><TD class=alignCenter headers="t2hr7 t2hc2 t2hc4 t2hc9">45</TD><TD class="alignCenter bg-colour-blue" headers="t2hr7 t2hc2 t2hc4 t2hc10">7</TD><TD class="alignCenter bg-colour-blue" headers="t2hr7 t2hc2 t2hc4 t2hc11">27</TD><TD class="alignCenter bg-colour-blue" headers="t2hr7 t2hc2 t2hc4 t2hc12">11</TD><TD class=alignCenter headers="t2hr7 t2hc2 t2hc5">157</TD><TD class=alignCenter headers="t2hr7 t2hc3 t2hc6 t2hc13">16942</TD><TD class="alignCenter bg-colour-blue" headers="t2hr7 t2hc3 t2hc6 t2hc14">8473</TD><TD class="alignCenter bg-colour-blue" headers="t2hr7 t2hc3 t2hc6 t2hc15">395</TD><TD class="alignCenter bg-colour-blue" headers="t2hr7 t2hc3 t2hc6 t2hc16">8074</TD><TD class=alignCenter headers="t2hr7 t2hc3 t2hc7">6147</TD><TD class=alignCenter headers="t2hr7 t2hc3 t2hc8 t2hc17">23089</TD><TD class=alignCenter headers="t2hr7 t2hc3 t2hc8 t2hc18">100.0%</TD></TR><TR><TH id=t2hr8 class=alignLeft headers=t2hc1>Percentage<SUP>2</SUP></TH><TD class=alignCenter headers="t2hr8 t2hc2 t2hc4 t2hc9">22.3%</TD><TD class="alignCenter bg-colour-blue" headers="t2hr8 t2hc2 t2hc4 t2hc10">15.6%</TD><TD class="alignCenter bg-colour-blue" headers="t2hr8 t2hc2 t2hc4 t2hc11">60.0%</TD><TD class="alignCenter bg-colour-blue" headers="t2hr8 t2hc2 t2hc4 t2hc12">24.4%</TD><TD class=alignCenter headers="t2hr8 t2hc2 t2hc5">77.7%</TD><TD class=alignCenter headers="t2hr8 t2hc3 t2hc6 t2hc13">73.4%</TD><TD class="alignCenter bg-colour-blue" headers="t2hr8 t2hc3 t2hc6 t2hc14">50.0%</TD><TD class="alignCenter bg-colour-blue" headers="t2hr8 t2hc3 t2hc6 t2hc15">2.3%</TD><TD class="alignCenter bg-colour-blue" headers="t2hr8 t2hc3 t2hc6 t2hc16">47.7%</TD><TD class=alignCenter headers="t2hr8 t2hc3 t2hc7">26.6%</TD><TD class=alignCenter headers=t2hr8></TD><TD class=alignCenter headers=t2hr8></TD></TR></TBODY></TABLE>


Top of Page
Influenza Strain Characterizations

During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 2,210 influenza viruses [136 A(H3N2), 1,389 A(H1N1)pdm09 and 685 influenza B]. The vast majority (99%) of viruses were similar to the strains recommended by the WHO for the 2013-14 seasonal influenza vaccine. Two A(H1N1)pdm09 viruses showed reduced titres to antiserum against the reference A/California/07/2009 strain, and one A(H3N2) virus showed reduced titres to antiserum against the reference A/Texas/50/2012 strain. Twenty-six influenza B viruses were similar to the strain recommended by the WHO for the 2011-12 vaccine (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2013-2014, N = 2,210
2014-w22-fg4-eng.gif

The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
The recommended components for the 2013-2014 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b (e.g. A/Texas/50/2012), and a B/Massachusetts/2/2012-like virus (Yamagata lineage).


Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
Antiviral Resistance

During the 2013-2014 influenza season, NML has tested 2,047 influenza viruses for resistance to oseltamivir and all but five were sensitive. All 2,048 viruses tested for resistance to zanamivir were sensitive. All 1,604 influenza A viruses tested for amantadine resistance were resistant (Table 3).
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2013-2014</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=t3hc1 rowSpan=2>Virus type and subtype</TH><TH id=t3hc2 colSpan=2>Oseltamivir</TH><TH id=t3hc3 colSpan=2>Zanamivir</TH><TH id=t3hc4 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=t3hc5 headers=t3hc2># tested</TH><TH id=t3hc6 headers=t3hc2># resistant (%)</TH><TH id=t3hc7 headers=t3hc3># tested</TH><TH id=t3hc8 headers=t3hc3># resistant (%)</TH><TH id=t3hc9 headers=t3hc4># tested</TH><TH id=t3hc10 headers=t3hc4># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=t3hr1 class="alignLeft bg-colour-blue" headers=t3hc1>A (H3N2)</TH><TD class=alignCenter headers="t3hr1 t3hc2 t3hc5">111</TD><TD class=alignCenter headers="t3hr1 t3hc2 t3hc6">0</TD><TD class=alignCenter headers="t3hr1 t3hc3 t3hc7">111</TD><TD class=alignCenter headers="t3hr1 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr1 t3hc4 t3hc9">170</TD><TD class=alignCenter headers="t3hr1 t3hc4 t3hc10">170 (100%)</TD></TR><TR><TH id=t3hr2 class="alignLeft bg-colour-blue" headers=t3hc1>A (H1N1)</TH><TD class=alignCenter headers="t3hr2 t3hc2 t3hc5">1373</TD><TD class=alignCenter headers="t3hr2 t3hc2 t3hc6">5 (0.4%)</TD><TD class=alignCenter headers="t3hr2 t3hc3 t3hc7">1375</TD><TD class=alignCenter headers="t3hr2 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr2 t3hc4 t3hc9">1434</TD><TD class=alignCenter headers="t3hr2 t3hc4 t3hc10">1434 (100%)</TD></TR><TR><TH id=t3hr3 class="alignLeft bg-colour-blue" headers=t3hc1>B</TH><TD class=alignCenter headers="t3hr3 t3hc2 t3hc5">563</TD><TD class=alignCenter headers="t3hr3 t3hc2 t3hc6">0</TD><TD class=alignCenter headers="t3hr3 t3hc3 t3hc7">562</TD><TD class=alignCenter headers="t3hr3 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr3 t3hc4 t3hc9">NA1</TD><TD class=alignCenter headers="t3hr3 t3hc4 t3hc10">NA1</TD></TR><TR><TH id=t3hr4 class="alignLeft bg-colour-blue" headers=t3hc1>TOTAL</TH><TD class=alignCenter headers="t3hr4 t3hc2 t3hc5">2047</TD><TD class=alignCenter headers="t3hr4 t3hc2 t3hc6">5 (0.2%)</TD><TD class=alignCenter headers="t3hr4 t3hc3 t3hc7">2048</TD><TD class=alignCenter headers="t3hr4 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr4 t3hc4 t3hc9">1604</TD><TD class=alignCenter headers="t3hr4 t3hc4 t3hc10">1604 (100%)</TD></TR></TBODY></TABLE>
Influenza-like Illness (ILI) Consultation Rate

The national influenza-like-illness (ILI) consultation rate continued to decrease from 16.6 consultations per 1,000 patient visits in week 20 to 18.1 per 1,000 in week 21 and 13.2 per 1,000 in week 22. Rates for weeks 21 and 22 were above the expected range for this time of year (Figure 5).
Figure 5. Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014
2014-w22-fg5-eng.gif

Note: No data available for mean rate for weeks 19 to 39 for the 1996-1997 through 2002-2003 seasons. Delays in the reporting of data may cause data to change retrospectively. The calculation of the average ILI consultation rate over 17 seasons was aligned with influenza activity in each season. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. The number of sentinel physicians in each province or territory is as follows: BC(21), AB(80), SK(11), MB(18), ON(169), QC(14), NB(29), NS(26), PE(4), NL(16), NU(1), NT(14), YT(13). Not all sentinel physicians report every week.
Text equivalent for figure 5Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

Top of Page
Influenza Outbreak Surveillance

The number of new influenza outbreaks was low in weeks 21 and 22, with three outbreaks reported in long-term care facilities (Figure 6). Three additional outbreaks of ILI were reported in other types of facilities or community settings during this two-week period.
Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2013-2014
2014-w22-fg6-eng.gif

1 All provinces and territories except NU report outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
Text equivalent for figure 6Overall number of new influenza outbreaks by report week, Canada, 2013-2014
Pharmacy Surveillance

In weeks 21 and 22, the proportion of prescriptions for antivirals continued to decline and is approaching inter-seasonal levels. Overall this season, the largest proportion of prescriptions for antivirals has been among children 2-18 years of age and adults 19-64 years of age (Figure 7).
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14
2014-w22-fg7-eng.gif

Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group. Age-groups: Infant: 0-2y, Child: 2-18y; Adult: 19-64y, Senior: ≥65y.
Text equivalent for figure 7Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

Top of Page
Sentinel Hospital Influenza Surveillance

Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In weeks 21 and 22, four new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network. All four were cases of influenza B, one child 6-23 months of age and three 2-4 years of age (Figure 8a). A greater proportion of cases with influenza B this season have been children between 2 and 10 years of age compared to A(H1N1)pdm09. No ICU admissions were reported in weeks 21 or 22. One death was reported which occurred in early April, a child <6 months of age with influenza B.
To date this season, a total of 696 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 79% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children <5 years of age represent 73% of cases to date (Table 4). One hundred and ten ICU admissions have been reported, of which 72 (65%) were children <5 years of age (Figure 9a). All but 14 were cases with influenza A, and 97% of those subtyped were A(H1N1)pdm09. Among the 106 ICU cases with available data, 67 (63%) were reported to have underlying medical conditions. One death has been reported this season. A smaller number of paediatric hospital admissions have been reported this year compared to the 2012-13 season.
Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
Adult Influenza Hospitalizations and Deaths (PCIRN)
Active surveillance of laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network ended on May 15th. During the period of passive surveillance from May 16 to 31, 2014, 29 new influenza-associated hospitalizations were reported, including four ICU admissions and one death (Figure 8b). Among these 29 cases, 26 (90%) were cases ≥65 years of age and 62% were associated with influenza B. May 31st marks the end of PCIRN-SOS reporting for the 2013-14 season.
To date this season, 1,985 influenza-associated hospitalizations have been reported by the PCIRN-SOS network, 1,338 (67.4%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). Compared to the 2012-13 season, slightly more cases have been reported, although the peak number of cases was smaller. A greater number of cases have been reported during March and April compared to last year, with six times more cases of influenza B reported. ICU admission was required for 321 hospitalizations, of which 263 were cases with influenza A (137 A(H1N1)pdm09, ten A(H3N2) and 116 A(unsubtyped)), 57 were cases with influenza B and the influenza type was not reported for one case. A greater proportion of cases have been admitted to the ICU this season compared to last year, but the proportion of deaths has been similar. Of the ICU admissions with available information, 85.9% (189/220) were reported to have at least one comorbidity, and 68.2% (176/258) reported not having been vaccinated this season. Among the 112 deaths reported this season, all but 28 have been cases of influenza A (51 A(H1N1)pdm09, three A(H3N2) and 30 A(unsubtyped)); ten cases 20-44 years of age, 37 cases 45-64 years of age and 65 cases ≥65 years of age (Figure 9b). Among fatal cases with available information, 93.8% (60/64) were reported to have at least one comorbidity, and 48.2% (40/83) reported not having been vaccinated this season.
Note: During the 2013-14 influenza season, PCIRN-SOS conducted passive surveillance from August 25<SUP>th</SUP> to November 14<SUP>th</SUP>, 2013, and May 16<SUP>th</SUP> to 31<SUP>st</SUP>. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance was conducted between November 15<SUP>th</SUP>, 2013 and May 15<SUP>th</SUP>, 2014 during which time PCIRN site coordinators investigated cases potentially related to influenza. Data from both active and passive surveillance reported during the 2013-14 season are included in this report. The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t4 class=alignCenter>Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=t4hc1 rowSpan=3>Age groups </TH><TH id=t4hc2 colSpan=6>Cumulative (Aug. 25, 2013 to May 31, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=t4hc3 colSpan=4 headers=t4hc2>Influenza A </TH><TH id=t4hc4 headers=t4hc2>B </TH><TH id=t4hc5 headers=t4hc2>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=t4hc6 headers="t4hc2 t4hc3">A Total </TH><TH id=t4hc7 class=bg-colour-blue headers="t4hc2 t4hc3">A(H1) pdm09 </TH><TH id=t4hc8 class="bg-colour-blue " headers="t4hc2 t4hc3">A(H3) </TH><TH id=t4hc9 class="bg-colour-blue " headers="t4hc2 t4hc3">A (UnS) </TH><TD class=alignCenter headers="t4hc2 t4hc4">Total</TD><TD class=alignCenter headers="t4hc2 t4hc5"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t4_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=t4hr1 class=alignLeft headers=t4hc1>0-5m </TH><TD class=alignCenter headers="t4hr1 t4hc2 t4hc3 t4hc6">104</TD><TD class=alignCenter headers="t4hr1 t4hc2 t4hc3 t4hc7">37</TD><TD class=alignCenter headers="t4hr1 t4hc2 t4hc3 t4hc8">0</TD><TD class=alignCenter headers="t4hr1 t4hc2 t4hc3 t4hc9">67</TD><TD class=alignCenter headers="t4hr1 t4hc2 t4hc4">9</TD><TD class=alignCenter headers="t4hr1 t4hc2 t4hc5">113 (16%)</TD></TR><TR><TH id=t4hr2 class=alignLeft headers=t4hc1>6-23m </TH><TD class=alignCenter headers="t4hr2 t4hc2 t4hc3 t4hc6">162</TD><TD class=alignCenter headers="t4hr2 t4hc2 t4hc3 t4hc7">57</TD><TD class=alignCenter headers="t4hr2 t4hc2 t4hc3 t4hc8">1</TD><TD class=alignCenter headers="t4hr2 t4hc2 t4hc3 t4hc9">104</TD><TD class=alignCenter headers="t4hr2 t4hc2 t4hc4">26</TD><TD class=alignCenter headers="t4hr2 t4hc2 t4hc5">188 (27%)</TD></TR><TR><TH id=t4hr3 class=alignLeft headers=t4hc1>2-4y </TH><TD class=alignCenter headers="t4hr3 t4hc2 t4hc3 t4hc6">164</TD><TD class=alignCenter headers="t4hr3 t4hc2 t4hc3 t4hc7">55</TD><TD class=alignCenter headers="t4hr3 t4hc2 t4hc3 t4hc8">3</TD><TD class=alignCenter headers="t4hr3 t4hc2 t4hc3 t4hc9">106</TD><TD class=alignCenter headers="t4hr3 t4hc2 t4hc4">46</TD><TD class=alignCenter headers="t4hr3 t4hc2 t4hc5">210 (30%)</TD></TR><TR><TH id=t4hr4 class=alignLeft headers=t4hc1>5-9y </TH><TD class=alignCenter headers="t4hr4 t4hc2 t4hc3 t4hc6">81</TD><TD class=alignCenter headers="t4hr4 t4hc2 t4hc3 t4hc7">28</TD><TD class=alignCenter headers="t4hr4 t4hc2 t4hc3 t4hc8">1</TD><TD class=alignCenter headers="t4hr4 t4hc2 t4hc3 t4hc9">52</TD><TD class=alignCenter headers="t4hr4 t4hc2 t4hc4">52</TD><TD class=alignCenter headers="t4hr4 t4hc2 t4hc5">133 (19%)</TD></TR><TR><TH id=t4hr5 class=alignLeft headers=t4hc1>10-16y </TH><TD class=alignCenter headers="t4hr5 t4hc2 t4hc3 t4hc6">40</TD><TD class=alignCenter headers="t4hr5 t4hc2 t4hc3 t4hc7">14</TD><TD class=alignCenter headers="t4hr5 t4hc2 t4hc3 t4hc8">1</TD><TD class=alignCenter headers="t4hr5 t4hc2 t4hc3 t4hc9">25</TD><TD class=alignCenter headers="t4hr5 t4hc2 t4hc4">12</TD><TD class=alignCenter headers="t4hr5 t4hc2 t4hc5">52 (7%)</TD></TR><TR><TH id=t4hr6 class=alignLeft headers=t4hc1>Total </TH><TD class=alignCenter headers="t4hr6 t4hc2 t4hc3 t4hc6">551</TD><TD class="alignCenter bg-colour-blue" headers="t4hr6 t4hc2 t4hc3 t4hc7">191</TD><TD class="alignCenter bg-colour-blue" headers="t4hr6 t4hc2 t4hc3 t4hc8">6</TD><TD class="alignCenter bg-colour-blue" headers="t4hr6 t4hc2 t4hc3 t4hc9">354</TD><TD class=alignCenter headers="t4hr6 t4hc2 t4hc4">145</TD><TD class=alignCenter headers="t4hr6 t4hc2 t4hc5">696</TD></TR><TR><TH id=t4hr7 class=alignLeft headers=t4hc1>% <SUP>1</SUP></TH><TD class=alignCenter headers="t4hr7 t4hc2 t4hc3 t4hc6">79.2%</TD><TD class="alignCenter bg-colour-blue" headers="t4hr7 t4hc2 t4hc3 t4hc7">34.7%</TD><TD class="alignCenter bg-colour-blue" headers="t4hr7 t4hc2 t4hc3 t4hc8">1.1%</TD><TD class="alignCenter bg-colour-blue" headers="t4hr7 t4hc2 t4hc3 t4hc9">64.2%</TD><TD class=alignCenter headers="t4hr7 t4hc2 t4hc4">20.8%</TD><TD class=alignCenter headers="t4hr7 t4hc2 t4hc5">100.0%</TD></TR></TBODY></TABLE>
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 5 - Cumulative numbers of adult hospitalizations with influenza
reported by the PCIRN-SOS network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=t5hc1 rowSpan=3>Age groups </TH><TH id=t5hc2 class=noWrap colSpan=6>Cumulative (Aug. 25, 2013 to 31 May, 2014)<SUP>*</SUP></TH></TR><TR class=bg-colour-yellow><TH id=t5hc3 colSpan=4 headers=t5hc2>Influenza A </TH><TH id=t5hc4 headers=t5hc2>B </TH><TH id=t5hc5 headers=t5hc2>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=t5hc6 headers="t5hc2 t5hc3">A Total </TH><TH id=t5hc7 class=bg-colour-blue headers="t5hc2 t5hc3">A(H1) pdm09 </TH><TH id=t5hc8 class=bg-colour-blue headers="t5hc2 t5hc3">A(H3) </TH><TH id=t5hc9 class=bg-colour-blue headers="t5hc2 t5hc3">A(UnS) </TH><TD class=alignCenter headers="t5hc2 t5hc4">Total</TD><TD class=alignCenter headers="t5hc2 t5hc5"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t5_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.

<SUP id=t5_star>*</SUP>Two cases for which the influenza type has not yet been reported, and four cases for which the age-group was not reported, are not included in Table 5.</TD></TR></TFOOT><TBODY><TR><TH id=t5hr1 class=alignLeft headers=t5hc1>16-20 </TH><TD class=alignCenter headers="t5hr1 t5hc2 t5hc3 t5hc6">13</TD><TD class=alignCenter headers="t5hr1 t5hc2 t5hc3 t5hc7">5</TD><TD class=alignCenter headers="t5hr1 t5hc2 t5hc3 t5hc8">1</TD><TD class=alignCenter headers="t5hr1 t5hc2 t5hc3 t5hc9">7</TD><TD class=alignCenter headers="t5hr1 t5hc2 t5hc4">2</TD><TD class=alignCenter headers="t5hr1 t5hc2 t5hc5">15 (1%)</TD></TR><TR><TH id=t5hr2 class=alignLeft headers=t5hc1>20-44 </TH><TD class=alignCenter headers="t5hr2 t5hc2 t5hc3 t5hc6">276</TD><TD class=alignCenter headers="t5hr2 t5hc2 t5hc3 t5hc7">142</TD><TD class=alignCenter headers="t5hr2 t5hc2 t5hc3 t5hc8">7</TD><TD class=alignCenter headers="t5hr2 t5hc2 t5hc3 t5hc9">127</TD><TD class=alignCenter headers="t5hr2 t5hc2 t5hc4">47</TD><TD class=alignCenter headers="t5hr2 t5hc2 t5hc5">323 (16%)</TD></TR><TR><TH id=t5hr3 class=alignLeft headers=t5hc1>45-64 </TH><TD class=alignCenter headers="t5hr3 t5hc2 t5hc3 t5hc6">521</TD><TD class=alignCenter headers="t5hr3 t5hc2 t5hc3 t5hc7">245</TD><TD class=alignCenter headers="t5hr3 t5hc2 t5hc3 t5hc8">12</TD><TD class=alignCenter headers="t5hr3 t5hc2 t5hc3 t5hc9">264</TD><TD class=alignCenter headers="t5hr3 t5hc2 t5hc4">135</TD><TD class=alignCenter headers="t5hr3 t5hc2 t5hc5">656 (33%)</TD></TR><TR><TH id=t5hr4 class=alignLeft headers=t5hc1>65+ </TH><TD class=alignCenter headers="t5hr4 t5hc2 t5hc3 t5hc6">525</TD><TD class=alignCenter headers="t5hr4 t5hc2 t5hc3 t5hc7">238</TD><TD class=alignCenter headers="t5hr4 t5hc2 t5hc3 t5hc8">61</TD><TD class=alignCenter headers="t5hr4 t5hc2 t5hc3 t5hc9">226</TD><TD class=alignCenter headers="t5hr4 t5hc2 t5hc4">460</TD><TD class=alignCenter headers="t5hr4 t5hc2 t5hc5">985 (50%)</TD></TR><TR><TH id=t5hr5 class=alignLeft headers=t5hc1>Total </TH><TD class=alignCenter headers="t5hr5 t5hc2 t5hc3 t5hc6">1335</TD><TD class="alignCenter bg-colour-blue" headers="t5hr5 t5hc2 t5hc3 t5hc7">630</TD><TD class="alignCenter bg-colour-blue" headers="t5hr5 t5hc2 t5hc3 t5hc8">81</TD><TD class="alignCenter bg-colour-blue" headers="t5hr5 t5hc2 t5hc3 t5hc9">624</TD><TD class=alignCenter headers="t5hr5 t5hc2 t5hc4">644</TD><TD class=alignCenter headers="t5hr5 t5hc2 t5hc5">1979</TD></TR><TR><TH id=t5hr6 class=alignLeft headers=t5hc1>%<SUP>1</SUP></TH><TD class=alignCenter headers="t5hr6 t5hc2 t5hc3 t5hc6">67%</TD><TD class="alignCenter bg-colour-blue" headers="t5hr6 t5hc2 t5hc3 t5hc7">47%</TD><TD class="alignCenter bg-colour-blue" headers="t5hr6 t5hc2 t5hc3 t5hc8">6%</TD><TD class="alignCenter bg-colour-blue" headers="t5hr6 t5hc2 t5hc3 t5hc9">47%</TD><TD class=alignCenter headers="t5hr6 t5hc2 t5hc4">33%</TD><TD class=alignCenter headers="t5hr6 t5hc2 t5hc5">100%</TD></TR></TBODY></TABLE>
Figure 8. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w22-fg8a-eng.gif


Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w22-fg8b-eng.gif

* See footnote above following the section related to PCIRN-SOS data.
Text equivalent for figure 8bNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Adult hospitalizations (>16 year of age, PCIRN-SOS)
Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w22-fg9a-eng.gif

Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w22-fg9b-eng.gif

Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Adult hospitalizations (≥16 year of age, PCIRN-SOS)

Top of Page
Provincial/Territorial Influenza Hospitalizations and Deaths

In weeks 21 and 22, 218 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories.* As with other surveillance indicators in weeks 21 and 22, the majority were cases of influenza B (202, 92.7%). Two ICU admissions and 22 deaths were reported in weeks 21 and 22. Nineteen of the 22 deaths were cases with influenza B; two were adults 45-64 years of age, and 20 were adults ≥65 years of age. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total.
To date this season, 5,086 influenza-associated hospitalizations have been reported, 71.4% with influenza A. The majority (62.6%) of hospitalizations have been cases 45 years of age of older. A significantly greater proportion of cases of influenza B have been ≥65 years of age, and 5-19 years of age, compared to cases of A(H1N1)pdm09 this season (Table 6). A total of 367 ICU admissions have been reported this season, of which 64.5% were adults 20-64 years of age. A total of 313 deaths have been reported. The highest proportion of deaths has been among adults ≥65 years of age (54.3%) followed by adults 20-64 years of age (37.1%). In keeping with the late-season circulation, influenza B has been increasingly reported among hospitalized cases of influenza. To date this season, influenza B has been reported in 28.6% of hospitalizations and 31.3% of deaths. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.
* Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t6 class=alignCenter>Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=t6hc1 rowSpan=3>Age groups </TH><TH id=t6hc2 colSpan=6>Cumulative (Aug. 25, 2013 to May 31, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=t6hc3 colSpan=4 headers=t6hc2>Influenza A</TH><TH id=t6hc4 headers=t6hc2>B</TH><TH id=t6hc5 headers=t6hc2>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=t6hc6 headers="t6hc2 t6hc3">A Total</TH><TH id=t6hc7 class=bg-colour-blue headers="t6hc2 t6hc3">A(H1) pdm09</TH><TH id=t6hc8 class=bg-colour-blue headers="t6hc2 t6hc3">A(H3)</TH><TH id=t6hc9 class=bg-colour-blue headers="t6hc2 t6hc3">A (UnS)</TH><TD class=alignCenter headers="t6hc2 t6hc4">Total</TD><TD class=alignCenter headers="t6hc2 t6hc5"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=8><SUP id=footnote_t6_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=t6hr1 class=alignLeft headers=t6hc1>0-4 years</TH><TD class=alignCenter headers="t6hr1 t6hc2 t6hc3 t6hc6">620</TD><TD class=alignCenter headers="t6hr1 t6hc2 t6hc3 t6hc7">288</TD><TD class=alignCenter headers="t6hr1 t6hc2 t6hc3 t6hc8">13</TD><TD class=alignCenter headers="t6hr1 t6hc2 t6hc3 t6hc9">319</TD><TD class=alignCenter headers="t6hr1 t6hc2 t6hc4">124</TD><TD class=alignCenter headers="t6hr1 t6hc2 t6hc5">744 (15%)</TD></TR><TR><TH id=t6hr2 class=alignLeft headers=t6hc1>5-14 years</TH><TD class=alignCenter headers="t6hr2 t6hc2 t6hc3 t6hc6">135</TD><TD class=alignCenter headers="t6hr2 t6hc2 t6hc3 t6hc7">65</TD><TD class=alignCenter headers="t6hr2 t6hc2 t6hc3 t6hc8">6</TD><TD class=alignCenter headers="t6hr2 t6hc2 t6hc3 t6hc9">64</TD><TD class=alignCenter headers="t6hr2 t6hc2 t6hc4">109</TD><TD class=alignCenter headers="t6hr2 t6hc2 t6hc5">244 (5%)</TD></TR><TR><TH id=t6hr3 class=alignLeft headers=t6hc1>15-19 years</TH><TD class=alignCenter headers="t6hr3 t6hc2 t6hc3 t6hc6">39</TD><TD class=alignCenter headers="t6hr3 t6hc2 t6hc3 t6hc7">22</TD><TD class=alignCenter headers="t6hr3 t6hc2 t6hc3 t6hc8">4</TD><TD class=alignCenter headers="t6hr3 t6hc2 t6hc3 t6hc9">13</TD><TD class=alignCenter headers="t6hr3 t6hc2 t6hc4">6</TD><TD class=alignCenter headers="t6hr3 t6hc2 t6hc5">45 (1%)</TD></TR><TR><TH id=t6hr4 class=alignLeft headers=t6hc1>20-44 years </TH><TD class=alignCenter headers="t6hr4 t6hc2 t6hc3 t6hc6">616</TD><TD class=alignCenter headers="t6hr4 t6hc2 t6hc3 t6hc7">425</TD><TD class=alignCenter headers="t6hr4 t6hc2 t6hc3 t6hc8">5</TD><TD class=alignCenter headers="t6hr4 t6hc2 t6hc3 t6hc9">186</TD><TD class=alignCenter headers="t6hr4 t6hc2 t6hc4">88</TD><TD class=alignCenter headers="t6hr4 t6hc2 t6hc5">704 (14%)</TD></TR><TR><TH id=t6hr5 class=alignLeft headers=t6hc1>45-64 years </TH><TD class=alignCenter headers="t6hr5 t6hc2 t6hc3 t6hc6">1125</TD><TD class=alignCenter headers="t6hr5 t6hc2 t6hc3 t6hc7">707</TD><TD class=alignCenter headers="t6hr5 t6hc2 t6hc3 t6hc8">31</TD><TD class=alignCenter headers="t6hr5 t6hc2 t6hc3 t6hc9">387</TD><TD class=alignCenter headers="t6hr5 t6hc2 t6hc4">277</TD><TD class=alignCenter headers="t6hr5 t6hc2 t6hc5">1402 (28%)</TD></TR><TR><TH id=t6hr6 class=alignLeft headers=t6hc1>65+ years </TH><TD class=alignCenter headers="t6hr6 t6hc2 t6hc3 t6hc6">960</TD><TD class=alignCenter headers="t6hr6 t6hc2 t6hc3 t6hc7">468</TD><TD class=alignCenter headers="t6hr6 t6hc2 t6hc3 t6hc8">107</TD><TD class=alignCenter headers="t6hr6 t6hc2 t6hc3 t6hc9">385</TD><TD class=alignCenter headers="t6hr6 t6hc2 t6hc4">821</TD><TD class=alignCenter headers="t6hr6 t6hc2 t6hc5">1781 (35%)</TD></TR><TR><TH id=t6hr7 class=alignLeft headers=t6hc1>Unknown</TH><TD class=alignCenter headers="t6hr7 t6hc2 t6hc3 t6hc6">138</TD><TD class=alignCenter headers="t6hr7 t6hc2 t6hc3 t6hc7">99</TD><TD class=alignCenter headers="t6hr7 t6hc2 t6hc3 t6hc8">3</TD><TD class=alignCenter headers="t6hr7 t6hc2 t6hc3 t6hc9">36</TD><TD class=alignCenter headers="t6hr7 t6hc2 t6hc4">28</TD><TD class=alignCenter headers="t6hr7 t6hc2 t6hc5">166 (3%)</TD></TR><TR><TH id=t6hr8 class=alignLeft headers=t6hc1>Total </TH><TD class=alignCenter headers="t6hr8 t6hc2 t6hc3 t6hc6">3633</TD><TD class="alignCenter bg-colour-blue" headers="t6hr8 t6hc2 t6hc3 t6hc7">2074</TD><TD class="alignCenter bg-colour-blue" headers="t6hr8 t6hc2 t6hc3 t6hc8">169</TD><TD class="alignCenter bg-colour-blue" headers="t6hr8 t6hc2 t6hc3 t6hc9">1390</TD><TD class=alignCenter headers="t6hr8 t6hc2 t6hc4">1453</TD><TD class=alignCenter headers="t6hr8 t6hc2 t6hc5">5086</TD></TR><TR><TH id=t6hr9 class=alignLeft headers=t6hc1>Percentage <SUP>1</SUP></TH><TD class=alignCenter headers="t6hr9 t6hc2 t6hc3 t6hc6">71.4%</TD><TD class="alignCenter bg-colour-blue" headers="t6hr9 t6hc2 t6hc3 t6hc7">57.1%</TD><TD class="alignCenter bg-colour-blue" headers="t6hr9 t6hc2 t6hc3 t6hc8">4.7%</TD><TD class="alignCenter bg-colour-blue" headers="t6hr9 t6hc2 t6hc3 t6hc9">38.3%</TD><TD class=alignCenter headers="t6hr9 t6hc2 t6hc4">28.6%</TD><TD class=alignCenter headers="t6hr9 t6hc2 t6hc5">100%</TD></TR></TBODY></TABLE>
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2013-14 on the Public Health Agency of Canada website.

.../
http://www.phac-aspc.gc.ca/fluwatch/13-14/w22_14/index-eng.php
 
Re: Canada FluWatch Weekly Reports 2013-2014 Season Weeks 23 and 24

Re: Canada FluWatch Weekly Reports 2013-2014 Season Weeks 23 and 24

FluWatch report: June 1 to June 14, 2014 (Weeks 23 and 24)

Posted 2014-06-20For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
<A title="Flu Watch (Version PDF, 421 KB - 10 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/13-14/w24_14/pdf/fw2014-24-eng.pdf">FluWatch report: June 1 to June 14, 2014 (Weeks 23 and 24) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 421 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

?? Help with PDF documents

Overall Summary
  • In weeks 23 and 24, influenza activity in Canada continued to decline and is approaching inter-seasonal levels. Influenza B has circulated later into the spring than in previous seasons, but overall activity remains within expected levels.
  • As of week 24, 5,272 hospitalizations and 326 deaths have been reported from participating regions, which is slightly more hospitalizations but fewer deaths than were reported last year.
Are you a primary health care practitioner (General Practitioner, Nurse Practitioner or Registered Nurse) interested in becoming a FluWatch sentinel for the 2014-15 influenza season? Contact us at FluWatch@phac-aspc.gc.ca
Influenza/ILI Activity (geographic spread)

In week 23, nine regions reported localized activity (ON(6), PE(1), NS(1), NL(1)). In week 24, four of these regions continued to report localized activity (ON(3) and NL(1)) (Figure 1). Five regions did not report data in week 23 and in week 24.
Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 24


right_ofmap.gif



Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
Influenza and Other Respiratory Virus Detections

The number of positive influenza tests continued to decline from 141 in week 22 to 60 in week 23, and 57 (2.8% of tests) in week 24 (Figure 2). Influenza B remained the predominant virus in weeks 23 and 24, representing 69% of influenza detections. Most jurisdictions have reported low numbers of influenza detections in weeks 23 and 24 (Table 1). This season, A(H1N1)pdm09 predominantly affected adults 20-64 years of age and children <5 years of age, while influenza B affected greater proportions of adults ≥65 years of age and children 5-19 years of age (Table 2).
Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
2014-w24-fg2-eng.gif

Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
Detections of RSV, coronavirus, and human metapneumovirus have continued to decline and are approaching inter-seasonal levels. The number of positive tests for parainfluenza declined slightly in weeks 23 and 24, and detections of adenovirus have been stable over recent weeks, in keeping with the broader year-round circulation of these viruses. Detections of rhinovirus in recent weeks have been higher than during the same period over the past three seasons, however the number of positive tests decreased in weeks 23 and 24 (Figure 3).
For more details, see the weekly Respiratory Virus Detections in Canada Report.
Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2013-14
2014-w24-fg3-eng.gif


Top of Page
RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
<TABLE id=t1 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class="alignCenter margin10px">Table 1: Weekly and cumulative numbers of positive influenza specimens
by type, subtype and province, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=ac1 colSpan=5>Weekly
(June 1 to June 14, 2014)</TH><TH id=ac8 colSpan=5>Cumulative
(August 25, 2013 to June 14, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=4 headers=ac1>Influenza A</TH><TH id=ac7 headers=ac1>B</TH><TH id=ac9 colSpan=4 headers=ac8>Influenza A</TH><TH id=ac14 headers=ac8>B</TH></TR><TR class=bg-colour-grey-light><TH id=ac3 headers="ac1 ac2">A Total</TH><TH id=ac4 class=" bg-colour-blue" headers="ac1 ac2">A(H1)pdm09</TH><TH id=ac5 class=" bg-colour-blue" headers="ac1 ac2">A(H3)</TH><TH id=ac6 class=" bg-colour-blue" headers="ac1 ac2">A(UnS)</TH><TH class=alignCenter headers="ac1 ac7">B Total</TH><TH id=ac10 headers="ac8 ac9">A Total</TH><TH id=ac11 class=" bg-colour-blue" headers="ac8 ac9">A(H1)pdm09</TH><TH id=ac12 class=" bg-colour-blue" headers="ac8 ac9">A(H3)</TH><TH id=ac13 class=" bg-colour-blue" headers="ac8 ac9">A(UnS)</TH><TD class=alignCenter headers="ac8 ac14">B Total</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available. </TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=alignLeft headers=ar1>BC</TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">11 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">11 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac7">6 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac10">1,822 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac11">1,614 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac12">69 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac13">139 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac14">377 </TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">7 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">3 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">4 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac7">19 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac10">3,889 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac11">3,462 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac12">107 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac13">320 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac14">554 </TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">0 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac7">2 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac10">1,384 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac11">988 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac12">8 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac13">388 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac14">195 </TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">0 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac7">7 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac10">685 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac11">463 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac12">7 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac13">215 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac14">72 </TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">12 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">2 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">3 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">7 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac7">18 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac10">5,816 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac11">2,497 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac12">410 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac13">2,909 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac14">3,102 </TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">6 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">6 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac7">8 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac10">5,376 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac11">677 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac12">6 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac13">4,693 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac14">2,742 </TD></TR><TR><TH id=ar8 class=alignLeft headers=ar1>NB</TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">0 </TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar8 ac1 ac7">8 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac10">1,491 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac11">370 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac12">2 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac13">1,119 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac14">122 </TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">0 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac7">5 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac10">175 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac11">134 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac12">5 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac13">36 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac14">52 </TD></TR><TR><TH id=ar10 class=alignLeft headers=ar1>PE</TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">0 </TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar10 ac1 ac7">1 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac10">119 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac11">118 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac12">0 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac13">1 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac14">5 </TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">0 </TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar11 ac1 ac7">7 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac10">381 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac11">104 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac12">0 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac13">277 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac14">265 </TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">36 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac4">2 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac5">17 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac6">17 </TD><TD class=alignRight headers="ar1 ar12 ac1 ac7">81 </TD><TD class=alignRight headers="ar1 ar12 ac8 ac9 ac10">21,138 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac11">10,427 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac12">614 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac13">10,097 </TD><TD class=alignRight headers="ar1 ar12 ac8 ac14">7,486 </TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="ar1 ar13 ac1 ac2 ac3">30.8% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac4">5.6% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac5">47.2% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac6">47.2% </TD><TD class=alignRight headers="ar1 ar13 ac1 ac7">69.2% </TD><TD class=alignRight headers="ar1 ar13 ac8 ac9 ac10">73.8% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac11">49.3% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac12">2.9% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac13">47.8% </TD><TD class=alignRight headers="ar1 ar13 ac8 ac14">26.2% </TD></TR></TBODY></TABLE>
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t2 class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups (years)</TH><TH id=bc1 colSpan=5>Weekly
(June 1 to June 14, 2014)</TH><TH id=bc8 colSpan=7>Cumulative
(August 25, 2013 to June 14, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=bc2 colSpan=4 headers=bc1>Influenza A</TH><TH id=bc7 headers=bc1>B</TH><TH id=bc9 colSpan=4 headers=bc8>Influenza A</TH><TH id=bc14 headers=bc8>B</TH><TH id=bc15 colSpan=2 headers=bc8>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=bc3 headers="bc1 bc2">A Total</TH><TH id=bc4 class="bg-colour-blue " headers="bc1 bc2">A(H1) pdm09</TH><TH id=bc5 class="bg-colour-blue " headers="bc1 bc2">A(H3)</TH><TH id=bc6 class="bg-colour-blue " headers="bc1 bc2">A (UnS)</TH><TD class=alignCenter headers="bc1 bc7">Total</TD><TH id=bc10 headers="bc8 bc9">A Total</TH><TH id=bc11 class="bg-colour-blue " headers="bc8 bc9">A(H1) pdm09</TH><TH id=bc12 class="bg-colour-blue " headers="bc8 bc9">A(H3)</TH><TH id=bc13 class="bg-colour-blue " headers="bc8 bc9">A (UnS)</TH><TD class=alignCenter headers="bc8 bc14">Total</TD><TH id=bc16 headers="bc8 bc15">#</TH><TH id=bc17 headers="bc8 bc15">%</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13><SUP id=footnote_t2_1>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP id=footnote_t2_2>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
<SUP id=footnote_t2_3>3 </SUP>Table 2 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=br2 class=alignLeft headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">1 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">0 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">0 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">1 </TD><TD class=alignRight headers="br1 br2 bc1 bc7">2 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">3,270 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">1,453 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">41 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1,776 </TD><TD class=alignRight headers="br1 br2 bc8 bc14">557 </TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc16">3,827 </TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc17">16.5% </TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">1 </TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">0 </TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">0 </TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">1 </TD><TD class=alignRight headers="br1 br3 bc1 bc7">4 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1,334 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">707 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">27 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">600 </TD><TD class=alignRight headers="br1 br3 bc8 bc14">823 </TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc16">2,157 </TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc17">9.3% </TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">7 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">1 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">2 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">4 </TD><TD class=alignRight headers="br1 br4 bc1 bc7">8 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">5,104 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">2,818 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">54 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">2,232 </TD><TD class=alignRight headers="br1 br4 bc8 bc14">1,027 </TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc16">6,131 </TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc17">26.5% </TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">4 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">1 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">1 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">2 </TD><TD class=alignRight headers="br1 br5 bc1 bc7">13 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">4,481 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">2,394 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">66 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">2,021 </TD><TD class=alignRight headers="br1 br5 bc8 bc14">1,519 </TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc16">6,000 </TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc17">25.9% </TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">9 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">0 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">0 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">9 </TD><TD class=alignRight headers="br1 br6 bc1 bc7">16 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">2,644 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">1,001 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">177 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">1,466 </TD><TD class=alignRight headers="br1 br6 bc8 bc14">2,269 </TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc16">4,913 </TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc17">21.2% </TD></TR><TR><TH id=br7 class=alignLeft headers=br1>Unknown</TH><TD class=alignRight headers="br1 br7 bc1 bc2 bc3">1 </TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc4">0 </TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc5">0 </TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc6">1 </TD><TD class=alignRight headers="br1 br7 bc1 bc7">0 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc10">137 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">102 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">21 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">14 </TD><TD class=alignRight headers="br1 br7 bc8 bc14">9 </TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc16">146 </TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc17">0.6% </TD></TR><TR><TH id=br8 class=alignLeft headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">23 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc4">2 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc5">3 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc6">18 </TD><TD class=alignRight headers="br1 br8 bc1 bc7">43 </TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">16,970 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc11">8,475 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc12">386 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc13">8,109 </TD><TD class=alignRight headers="br1 br8 bc8 bc14">6,204 </TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc16">23,174 </TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc17">100.0% </TD></TR><TR><TH id=br9 class=alignLeft headers=br1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="br1 br9 bc1 bc2 bc3">34.8% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc4">8.7% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc5">13.0% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc6">78.3% </TD><TD class=alignRight headers="br1 br9 bc1 bc7">65.2% </TD><TD class=alignRight headers="br1 br9 bc8 bc9 bc10">73.2% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc11">49.9% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc12">2.3% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc13">47.8% </TD><TD class=alignRight headers="br1 br9 bc8 bc14">26.8% </TD><TD class=alignRight></TD><TD class=alignRight></TD></TR></TBODY></TABLE>


Top of Page
Influenza Strain Characterizations

During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 2,261 influenza viruses [150 A(H3N2), 1,389 A(H1N1)pdm09 and 722 influenza B]. The vast majority (99%) of viruses were similar to the strains recommended by the WHO for the 2013-14 seasonal influenza vaccine. Two A(H1N1)pdm09 viruses showed reduced titres to antiserum against the reference A/California/07/2009 strain, and one A(H3N2) virus showed reduced titres to antiserum against the reference A/Texas/50/2012 strain. Twenty-seven influenza B viruses were similar to the strain recommended by the WHO for the 2011-12 vaccine (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2013-2014, N = 2,261
2014-w24-fg4-eng.gif

The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
The recommended components for the 2013-2014 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b (e.g. A/Texas/50/2012), and a B/Massachusetts/2/2012-like virus (Yamagata lineage).


Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
Antiviral Resistance

During the 2013-2014 influenza season, NML has tested 2,125 influenza viruses for resistance to oseltamivir and all but five were sensitive. All 2,130 viruses tested for resistance to zanamivir were sensitive. All 1,630 influenza A viruses tested for amantadine resistance were resistant (Table 3).
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2013-2014</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=t3hc1 rowSpan=2>Virus type and subtype</TH><TH id=t3hc2 colSpan=2>Oseltamivir</TH><TH id=t3hc3 colSpan=2>Zanamivir</TH><TH id=t3hc4 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=t3hc5 headers=t3hc2># tested</TH><TH id=t3hc6 headers=t3hc2># resistant (%)</TH><TH id=t3hc7 headers=t3hc3># tested</TH><TH id=t3hc8 headers=t3hc3># resistant (%)</TH><TH id=t3hc9 headers=t3hc4># tested</TH><TH id=t3hc10 headers=t3hc4># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=t3hr1 class="alignLeft bg-colour-blue" headers=t3hc1>A (H3N2)</TH><TD class=alignRight headers="t3hr1 t3hc2 t3hc5">128</TD><TD class=alignRight headers="t3hr1 t3hc2 t3hc6">0</TD><TD class=alignRight headers="t3hr1 t3hc3 t3hc7">128</TD><TD class=alignRight headers="t3hr1 t3hc3 t3hc8">0</TD><TD class=alignRight headers="t3hr1 t3hc4 t3hc9">188</TD><TD class=alignRight headers="t3hr1 t3hc4 t3hc10">188 (100%)</TD></TR><TR><TH id=t3hr2 class="alignLeft bg-colour-blue" headers=t3hc1>A (H1N1)</TH><TD class=alignRight headers="t3hr2 t3hc2 t3hc5">1378</TD><TD class=alignRight headers="t3hr2 t3hc2 t3hc6">5 (0.4%)</TD><TD class=alignRight headers="t3hr2 t3hc3 t3hc7">1384</TD><TD class=alignRight headers="t3hr2 t3hc3 t3hc8">0</TD><TD class=alignRight headers="t3hr2 t3hc4 t3hc9">1442</TD><TD class=alignRight headers="t3hr2 t3hc4 t3hc10">1442 (100%)</TD></TR><TR><TH id=t3hr3 class="alignLeft bg-colour-blue" headers=t3hc1>B</TH><TD class=alignRight headers="t3hr3 t3hc2 t3hc5">619</TD><TD class=alignRight headers="t3hr3 t3hc2 t3hc6">0</TD><TD class=alignRight headers="t3hr3 t3hc3 t3hc7">618</TD><TD class=alignRight headers="t3hr3 t3hc3 t3hc8">0</TD><TD class=alignRight headers="t3hr3 t3hc4 t3hc9">NA <SUP>*</SUP></TD><TD class=alignRight headers="t3hr3 t3hc4 t3hc10">NA <SUP>*</SUP></TD></TR><TR><TH id=t3hr4 class="alignLeft bg-colour-blue" headers=t3hc1>TOTAL</TH><TD class=alignRight headers="t3hr4 t3hc2 t3hc5">2125</TD><TD class=alignRight headers="t3hr4 t3hc2 t3hc6">5 (0.2%)</TD><TD class=alignRight headers="t3hr4 t3hc3 t3hc7">2130</TD><TD class=alignRight headers="t3hr4 t3hc3 t3hc8">0</TD><TD class=alignRight headers="t3hr4 t3hc4 t3hc9">1630</TD><TD class=alignRight headers="t3hr4 t3hc4 t3hc10">1630 (100%)</TD></TR></TBODY></TABLE>
Influenza-like Illness (ILI) Consultation Rate

The national influenza-like-illness (ILI) consultation rate continued to decrease from 13.2 consultations per 1,000 patient visits in week 22 to 11.6 per 1,000 in week 23 and 8.4 per 1,000 in week 24. The rate for week 23 was slightly above the expected range for this time of year, but the rate for week 24 with within the expected range (Figure 5).
Figure 5. Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014
2014-w24-fg5-eng.gif

Note: No data available for mean rate for weeks 19 to 39 for the 1996-1997 through 2002-2003 seasons. Delays in the reporting of data may cause data to change retrospectively. The calculation of the average ILI consultation rate over 17 seasons was aligned with influenza activity in each season. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. The number of sentinel physicians in each province or territory is as follows: BC(21), AB(80), SK(11), MB(18), ON(169), QC(14), NB(29), NS(26), PE(4), NL(16), NU(1), NT(14), YT(13). Not all sentinel physicians report every week.
Text equivalent for figure 5Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

Top of Page
Influenza Outbreak Surveillance

The number of new influenza outbreaks was low in weeks 23 and 24, with two outbreaks reported in long-term care facilities (Figure 6).
Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2013-2014
2014-w24-fg6-eng.gif

1 All provinces and territories except NU report outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
Text equivalent for figure 6Overall number of new influenza outbreaks by report week, Canada, 2013-2014
Pharmacy Surveillance

In weeks 23 and 24, the proportion of prescriptions for antivirals continued to decline and is approaching inter-seasonal levels. Overall this season, the largest proportion of prescriptions for antivirals has been among children 2-18 years of age and adults 19-64 years of age (Figure 7).
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14
2014-w24-fg7-eng.gif

Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group. Age-groups: Infant: 0-2y, Child: 2-18y; Adult: 19-64y, Senior: ≥65y.
Text equivalent for figure 7Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

Top of Page
Sentinel Hospital Influenza Surveillance

Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In weeks 23 and 24, two new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network. Both were cases of influenza B in children 2-4 years of age (Figure 8a). A greater proportion of cases with influenza B this season have been children between 2 and 10 years of age compared to A(H1N1)pdm09. No ICU admissions or deaths were reported in weeks 23 or 24. Five of the 12 IMPACT hospitals have not had an influenza-associated paediatric admission in at least four weeks.
To date this season, a total of 709 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 78% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children <5 years of age represent 73% of cases to date (Table 4). One hundred and ten ICU admissions have been reported, of which 72 (65%) were children <5 years of age (Figure 9a). All but 14 were cases with influenza A, and 97% of those subtyped were A(H1N1)pdm09. Among the 107 ICU cases with available data, 68 (64%) were reported to have underlying medical conditions. One death has been reported this season. A smaller number of paediatric hospital admissions have been reported this year compared to the 2012-13 season.
Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
Adult Influenza Hospitalizations and Deaths (PCIRN)
Surveillance of laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network has ended for the 2013-14 season (Figure 8b). A summary of PCIRN-SOS data for the 2013-14 season will be included in the FluWatch annual report of influenza surveillance in Canada.
During passive and active surveillance<SUP>*</SUP> from August 25th, 2013 to May 31st, 2014, 1,985 influenza-associated hospitalizations were reported by the PCIRN-SOS network, 1,338 (67.4%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). Compared to the 2012-13 season, slightly more cases were reported, although the peak number of cases was smaller. A greater number of cases were reported during March and April compared to last year, with six times more cases of influenza B reported. ICU admission was required for 321 hospitalizations, of which 263 were cases with influenza A (137 A(H1N1)pdm09, ten A(H3N2) and 116 A(unsubtyped)), 57 were cases with influenza B and the influenza type was not reported for one case. A greater proportion of cases were admitted to the ICU this season compared to last year, but the proportion of deaths was similar. Of the ICU admissions with available information, 85.9% (189/220) were reported to have at least one comorbidity, and 68.2% (176/258) reported not having been vaccinated this season. Among the 112 deaths reported this season, all but 28 were cases of influenza A (51 A(H1N1)pdm09, three A(H3N2) and 30 A(unsubtyped)); ten cases 20-44 years of age, 37 cases 45-64 years of age and 65 cases ≥65 years of age (Figure 9b). Among fatal cases with available information, 93.8% (60/64) were reported to have at least one comorbidity, and 48.2% (40/83) reported not having been vaccinated this season.
Note: During the 2013-14 influenza season, PCIRN-SOS conducted passive surveillance from August 25<SUP>th</SUP> to November 14<SUP>th</SUP>, 2013, and May 16<SUP>th</SUP> to 31<SUP>st</SUP>. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance was conducted between November 15<SUP>th</SUP>, 2013 and May 15<SUP>th</SUP>, 2014 during which time PCIRN site coordinators investigated cases potentially related to influenza. Data from both active and passive surveillance reported during the 2013-14 season are included in this report. The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t4 class=alignCenter>Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=dr1 rowSpan=3>Age groups </TH><TH id=dc1 colSpan=6>Cumulative (Aug. 25, 2013 to June 14, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=dc2 colSpan=4 headers=dc1>Influenza A </TH><TH id=dc7 headers=dc1>B </TH><TH id=dc8 headers=dc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=dc3 headers="dc1 dc2">A Total </TH><TH id=dc4 class=bg-colour-blue headers="dc1 dc2">A(H1) pdm09 </TH><TH id=dc5 class=bg-colour-blue headers="dc1 dc2">A(H3) </TH><TH id=dc6 class=bg-colour-blue headers="dc1 dc2">A (UnS) </TH><TD class=alignCenter headers="dc1 dc7">Total</TD><TD class=alignCenter headers="dc1 dc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t4_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=dr2 class=alignLeft headers=dr1>0-5m </TH><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc3">107 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc4">37 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc5">0 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc2 dc6">70 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc7">10 </TD><TD class=alignRight headers="dr1 dr2 dc1 dc8">117 (17%) </TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc3">162 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc4">57 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc5">1 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc2 dc6">104 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc7">29 </TD><TD class=alignRight headers="dr1 dr3 dc1 dc8">191 (27%) </TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc3">163 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc4">55 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc5">3 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc2 dc6">105 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc7">49 </TD><TD class=alignRight headers="dr1 dr4 dc1 dc8">212 (30%) </TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc3">85 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc4">31 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc5">1 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc2 dc6">53 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc7">54 </TD><TD class=alignRight headers="dr1 dr5 dc1 dc8">139 (20%) </TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc3">38 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc4">13 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc5">1 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc2 dc6">24 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc7">12 </TD><TD class=alignRight headers="dr1 dr6 dc1 dc8">50 (7%) </TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignRight headers="dr1 dr7 dc1 dc2 dc3">555 </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr7 dc1 dc2 dc4">193 </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr7 dc1 dc2 dc5">6 </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr7 dc1 dc2 dc6">356 </TD><TD class=alignRight headers="dr1 dr7 dc1 dc7">154 </TD><TD class=alignRight headers="dr1 dr7 dc1 dc8">709 </TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP></TH><TD class=alignRight headers="dr1 dr8 dc1 dc2 dc3">78.3% </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr8 dc1 dc2 dc4">34.8% </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr8 dc1 dc2 dc5">1.1% </TD><TD class="alignRight bg-colour-blue" headers="dr1 dr8 dc1 dc2 dc6">64.1% </TD><TD class=alignRight headers="dr1 dr8 dc1 dc7">21.7% </TD><TD class=alignRight headers="dr1 dr8 dc1 dc8">100.0% </TD></TR></TBODY></TABLE>
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 5 - Cumulative numbers of adult hospitalizations with influenza
reported by the PCIRN-SOS network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=er1 rowSpan=3>Age groups </TH><TH id=ec1 class=noWrap colSpan=6>Cumulative (Aug. 25, 2013 to May 31, 2014)<SUP>*</SUP></TH></TR><TR class=bg-colour-yellow><TH id=ec2 colSpan=4 headers=ec1>Influenza A </TH><TH id=ec7 headers=ec1>B </TH><TH id=ec8 headers=ec1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=ec3 headers="ec1 ec2">A Total </TH><TH id=ec4 class=bg-colour-blue headers="ec1 ec2">A(H1) pdm09 </TH><TH id=ec5 class=bg-colour-blue headers="ec1 ec2">A(H3) </TH><TH id=ec6 class=bg-colour-blue headers="ec1 ec2">A(UnS) </TH><TD class=alignCenter headers="ec1 ec7">Total</TD><TD class=alignCenter headers="ec1 ec8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t5_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.

<SUP id=t5_star>*</SUP>Two cases for which the influenza type has not yet been reported, and four cases for which the age-group was not reported, are not included in Table 5.</TD></TR></TFOOT><TBODY><TR><TH id=er2 class=alignLeft headers=er1>16-20 </TH><TD class=alignRight headers="er1 er2 ec1 ec2 ec3">13 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec4">5 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec5">1 </TD><TD class=alignRight headers="er1 er2 ec1 ec2 ec6">7 </TD><TD class=alignRight headers="er1 er2 ec1 ec7">2 </TD><TD class=alignRight headers="er1 er2 ec1 ec8">15 (1%) </TD></TR><TR><TH id=er3 class=alignLeft headers=er1>20-44 </TH><TD class=alignRight headers="er1 er3 ec1 ec2 ec3">276 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec4">142 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec5">7 </TD><TD class=alignRight headers="er1 er3 ec1 ec2 ec6">127 </TD><TD class=alignRight headers="er1 er3 ec1 ec7">47 </TD><TD class=alignRight headers="er1 er3 ec1 ec8">323 (16%) </TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignRight headers="er1 er4 ec1 ec2 ec3">521 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec4">245 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec5">12 </TD><TD class=alignRight headers="er1 er4 ec1 ec2 ec6">264 </TD><TD class=alignRight headers="er1 er4 ec1 ec7">135 </TD><TD class=alignRight headers="er1 er4 ec1 ec8">656 (33%) </TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignRight headers="er1 er5 ec1 ec2 ec3">525 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec4">238 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec5">61 </TD><TD class=alignRight headers="er1 er5 ec1 ec2 ec6">226 </TD><TD class=alignRight headers="er1 er5 ec1 ec7">460 </TD><TD class=alignRight headers="er1 er5 ec1 ec8">985 (50%) </TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignRight headers="er1 er6 ec1 ec2 ec3">1335 </TD><TD class="alignRight bg-colour-blue" headers="er1 er6 ec1 ec2 ec4">630 </TD><TD class="alignRight bg-colour-blue" headers="er1 er6 ec1 ec2 ec5">81 </TD><TD class="alignRight bg-colour-blue" headers="er1 er6 ec1 ec2 ec6">624 </TD><TD class=alignRight headers="er1 er6 ec1 ec7">644 </TD><TD class=alignRight headers="er1 er6 ec1 ec8">1979 </TD></TR><TR><TH id=er7 class=alignLeft headers=er1>%<SUP>1</SUP></TH><TD class=alignRight headers="er1 er7 ec1 ec2 ec3">67% </TD><TD class="alignRight bg-colour-blue" headers="er1 er7 ec1 ec2 ec4">47% </TD><TD class="alignRight bg-colour-blue" headers="er1 er7 ec1 ec2 ec5">6% </TD><TD class="alignRight bg-colour-blue" headers="er1 er7 ec1 ec2 ec6">47% </TD><TD class=alignRight headers="er1 er7 ec1 ec7">33% </TD><TD class=alignRight headers="er1 er7 ec1 ec8">100% </TD></TR></TBODY></TABLE>
Figure 8. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w24-fg8a-eng.gif


Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w24-fg8b-eng.gif

* See footnote above following the section related to PCIRN-SOS data.
Text equivalent for figure 8bNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Adult hospitalizations (>16 year of age, PCIRN-SOS)
Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w24-fg9a-eng.gif

Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w22-fg9b-eng.gif

Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Adult hospitalizations (≥16 year of age, PCIRN-SOS)

Top of Page
Provincial/Territorial Influenza Hospitalizations and Deaths

In weeks 23 and 24, 141 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories.<SUP>*</SUP>As with other surveillance indicators in weeks 23 and 24, the majority were cases of influenza B (115, 81.6%). There were no ICU admissions reported in weeks 23 & 24. Twelve deaths were reported: one adult 45-64 years of age, and 11 adults ≥65 years of age; 11 of the 12 were cases of influenza B. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total.
To date this season, 5,272 influenza-associated hospitalizations have been reported, 69.6% with influenza A. The majority of hospitalizations have been cases 45 years of age of older: 27.1% 45-64 years of age and 35.9% ≥65 years of age. A significantly greater proportion of cases of influenza B have been ≥65 years of age, and 5-19 years of age, compared to cases of A(H1N1)pdm09 this season (Table 6). A total of 375 ICU admissions have been reported this season, of which 64.0% were adults 20-64 years of age. A total of 326 deaths have been reported. The highest proportion of deaths has been among adults ≥65 years of age (55.8%) followed by adults 20-64 years of age (35.9%). In keeping with the late-season circulation, influenza B has been increasingly reported among hospitalized cases of influenza. To date this season, influenza B has been reported in 30.4% of hospitalizations and 33.7% of deaths. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.
* Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t6 class=alignCenter>Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=fr1 rowSpan=3>Age groups </TH><TH id=fc1 colSpan=6>Cumulative (Aug. 25, 2013 to June 14 2014)</TH></TR><TR class=bg-colour-yellow><TH id=fc2 colSpan=4 headers=fc1>Influenza A</TH><TH id=fc7 headers=fc1>B</TH><TH id=fc8 headers=fc1>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=fc3 headers="fc1 fc2">A Total</TH><TH id=fc4 class=bg-colour-blue headers="fc1 fc2">A(H1) pdm09</TH><TH id=fc5 class=bg-colour-blue headers="fc1 fc2">A(H3)</TH><TH id=fc6 class=bg-colour-blue headers="fc1 fc2">A (UnS)</TH><TD class=alignCenter headers="fc1 fc7">Total</TD><TD class=alignCenter headers="fc1 fc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=8><SUP id=footnote_t6_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=fr2 class=alignLeft headers=fr1>0-4 years</TH><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc3">623 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc4">288 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc5">13 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc2 fc6">322 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc7">133 </TD><TD class=alignRight headers="fr1 fr2 fc1 fc8">756 (14%) </TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years</TH><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc3">137 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc4">65 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc5">6 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc2 fc6">66 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc7">115 </TD><TD class=alignRight headers="fr1 fr3 fc1 fc8">252 (5%) </TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years</TH><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc3">39 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc4">22 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc5">4 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc2 fc6">13 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc7">9 </TD><TD class=alignRight headers="fr1 fr4 fc1 fc8">48 (1%) </TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc3">620 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc4">424 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc5">7 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc2 fc6">189 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc7">97 </TD><TD class=alignRight headers="fr1 fr5 fc1 fc8">717 (14%) </TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc3">1130 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc4">710 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc5">32 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc2 fc6">388 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc7">301 </TD><TD class=alignRight headers="fr1 fr6 fc1 fc8">1431 (27%) </TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc3">981 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc4">469 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc5">115 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc2 fc6">397 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc7">914 </TD><TD class=alignRight headers="fr1 fr7 fc1 fc8">1895 (36%) </TD></TR><TR><TH id=fr10 class=alignLeft headers=fr1>Unknown</TH><TD class=alignRight headers="fc1 fc2 fc3">138 </TD><TD class=alignRight headers="fc1 fc2 fc4">99 </TD><TD class=alignRight headers="fc1 fc2 fc5">3 </TD><TD class=alignRight headers="fc1 fc2 fc6">36 </TD><TD class=alignRight headers="fc1 fc7">35 </TD><TD class=alignRight headers="fc1 fc8">173 (3%) </TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignRight headers="fr1 fr8 fc1 fc2 fc3">3668 </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr8 fc1 fc2 fc4">2077 </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr8 fc1 fc2 fc5">180 </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr8 fc1 fc2 fc6">1411 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc7">1604 </TD><TD class=alignRight headers="fr1 fr8 fc1 fc8">5272 </TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP></TH><TD class=alignRight headers="fr1 fr9 fc1 fc2 fc3">69.6% </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr9 fc1 fc2 fc4">56.6% </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr9 fc1 fc2 fc5">4.9% </TD><TD class="alignRight bg-colour-blue" headers="fr1 fr9 fc1 fc2 fc6">38.5% </TD><TD class=alignRight headers="fr1 fr9 fc1 fc7">30.4% </TD><TD class=alignRight headers="fr1 fr9 fc1 fc8">100% </TD></TR></TBODY></TABLE>
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2013-14 on the Public Health Agency of Canada website.

.../
http://www.phac-aspc.gc.ca/fluwatch/13-14/w24_14/index-eng.php
 
Re: Canada FluWatch Weekly Reports 2013-2014 Season Weeks 25 and 26

Re: Canada FluWatch Weekly Reports 2013-2014 Season Weeks 25 and 26

FluWatch report: June 15 to June 28, 2014 (Weeks 25 and 26)

Posted 2014-07-04For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
<A title="Flu Watch (Version PDF, 421 KB - 10 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/13-14/w26_14/pdf/fw2014-26-eng.pdf">FluWatch report: June 15 to June 28, 2014 (Weeks 25 and 26) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 421 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

?? Help with PDF documents


Overall Summary
  • In weeks 25 and 26, influenza activity in Canada continued to decline and is approaching inter-seasonal levels. Influenza B has circulated later into the spring than in previous seasons, but overall activity remains within expected levels. There have been no new influenza outbreaks reported in the last three weeks.
  • As of week 26, 5,358 hospitalizations and 332 deaths have been reported from participating regions, which is slightly more hospitalizations but fewer deaths than were reported last year.
Are you a primary health care practitioner (General Practitioner, Nurse Practitioner or Registered Nurse) interested in becoming a FluWatch sentinel for the 2014-15 influenza season? Contact us at FluWatch@phac-aspc.gc.ca
Influenza/ILI Activity (geographic spread)

In week 25, two regions in Ontario reported localized activity. In week 26, one of these regions continued to report localized activity (Figure 1). Eight regions did not report data in week 25 and one region did not report data in week 26.
Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 26


right_ofmap.gif



Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
Influenza and Other Respiratory Virus Detections

The number of positive influenza tests continued to decline from 57 in week 24 to 35 in week 25, and remained stable at 35 (2.0% of tests) in week 26 (Figure 2). Influenza B declined in weeks 25 and 26, representing 46% of influenza detections. Most jurisdictions have reported low numbers of influenza detections in weeks 25 and 26 (Table 1). This season, A(H1N1)pdm09 predominantly affected adults 20-64 years of age and children <5 years of age, while influenza B affected greater proportions of adults ≥65 years of age and children 5-19 years of age (Table 2).
Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
2014-w26-fg2-eng.gif

Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
Detections of RSV, coronavirus, and human metapneumovirus have continued to decline and are approaching inter-seasonal levels. The number of positive tests for parainfluenza declined slightly in weeks 25 and 26, and detections of adenovirus have been stable over recent weeks, in keeping with the broader year-round circulation of these viruses. Detections of rhinovirus in recent weeks have been higher than during the same period over the past three seasons, however the number of positive tests decreased in weeks 25 and 26 (Figure 3).
For more details, see the weekly Respiratory Virus Detections in Canada Report.
Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2013-14
2014-w26-fg3-eng.gif


Top of Page
RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
<TABLE id=t1 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class="alignCenter margin10px">Table 1: Weekly and cumulative numbers of positive influenza specimens
by type, subtype and province, Canada, 2013-14
</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=ac1 colSpan=5>Weekly
(June 15 to June 28, 2014)
</TH><TH id=ac8 colSpan=5>Cumulative
(August 25, 2013 to June 28, 2014)
</TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=4 headers=ac1>Influenza A</TH><TH id=ac7 headers=ac1>B</TH><TH id=ac9 colSpan=4 headers=ac8>Influenza A</TH><TH id=ac14 headers=ac8>B</TH></TR><TR class=bg-colour-grey-light><TH id=ac3 headers="ac1 ac2">A Total</TH><TH id=ac4 class=" bg-colour-blue" headers="ac1 ac2">A(H1)pdm09</TH><TH id=ac5 class=" bg-colour-blue" headers="ac1 ac2">A(H3)</TH><TH id=ac6 class=" bg-colour-blue" headers="ac1 ac2">A(UnS)</TH><TH class=alignCenter headers="ac1 ac7">B Total</TH><TH id=ac10 headers="ac8 ac9">A Total</TH><TH id=ac11 class=" bg-colour-blue" headers="ac8 ac9">A(H1)pdm09</TH><TH id=ac12 class=" bg-colour-blue" headers="ac8 ac9">A(H3)</TH><TH id=ac13 class=" bg-colour-blue" headers="ac8 ac9">A(UnS)</TH><TD class=alignCenter headers="ac8 ac14">B Total</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
</TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=alignLeft headers=ar1>BC</TH><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac3">6 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac2 ac6">6 </TD><TD class=alignCenter headers="ar1 ar2 ac1 ac7">10 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac10">1825 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac11">1614 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac12">67 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac9 ac13">144 </TD><TD class=alignCenter headers="ar1 ar2 ac8 ac14">384 </TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac3">12 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac5">10 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac2 ac6">2 </TD><TD class=alignCenter headers="ar1 ar3 ac1 ac7">8 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac10">3899 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac11">3462 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac12">120 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac9 ac13">317 </TD><TD class=alignCenter headers="ar1 ar3 ac8 ac14">569 </TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac3">0 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac2 ac6">0 </TD><TD class=alignCenter headers="ar1 ar4 ac1 ac7">2 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac10">1384 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac11">988 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac12">8 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac9 ac13">388 </TD><TD class=alignCenter headers="ar1 ar4 ac8 ac14">197 </TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac3">0 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac2 ac6">0 </TD><TD class=alignCenter headers="ar1 ar5 ac1 ac7">0 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac10">685 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac11">463 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac12">7 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac9 ac13">215 </TD><TD class=alignCenter headers="ar1 ar5 ac8 ac14">72 </TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac3">16 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac4">2 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac5">6 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac2 ac6">8 </TD><TD class=alignCenter headers="ar1 ar6 ac1 ac7">6 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac10">5826 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac11">2499 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac12">413 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac9 ac13">2914 </TD><TD class=alignCenter headers="ar1 ar6 ac8 ac14">3109 </TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac3">2 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac2 ac6">2 </TD><TD class=alignCenter headers="ar1 ar7 ac1 ac7">2 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac10">5377 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac11">677 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac12">6 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac9 ac13">4694 </TD><TD class=alignCenter headers="ar1 ar7 ac8 ac14">2745 </TD></TR><TR><TH id=ar8 class=alignLeft headers=ar1>NB</TH><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac3">0 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac2 ac6">0 </TD><TD class=alignCenter headers="ar1 ar8 ac1 ac7">4 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac10">1491 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac11">370 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac12">2 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac9 ac13">1119 </TD><TD class=alignCenter headers="ar1 ar8 ac8 ac14">130 </TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac3">0 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac2 ac6">0 </TD><TD class=alignCenter headers="ar1 ar9 ac1 ac7">0 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac10">175 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac11">134 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac12">5 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac9 ac13">36 </TD><TD class=alignCenter headers="ar1 ar9 ac8 ac14">52 </TD></TR><TR><TH id=ar10 class=alignLeft headers=ar1>PE</TH><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac3">0 </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac2 ac6">0 </TD><TD class=alignCenter headers="ar1 ar10 ac1 ac7">0 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac10">119 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac11">118 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac12">0 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac9 ac13">1 </TD><TD class=alignCenter headers="ar1 ar10 ac8 ac14">5 </TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac3">2 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac4">0 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac5">0 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac2 ac6">2 </TD><TD class=alignCenter headers="ar1 ar11 ac1 ac7">0 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac10">383 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac11">104 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac12">0 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac9 ac13">279 </TD><TD class=alignCenter headers="ar1 ar11 ac8 ac14">265 </TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignCenter headers="ar1 ar12 ac1 ac2 ac3">38 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac1 ac2 ac4">2 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac1 ac2 ac5">16 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac1 ac2 ac6">20 </TD><TD class=alignCenter headers="ar1 ar12 ac1 ac7">32 </TD><TD class=alignCenter headers="ar1 ar12 ac8 ac9 ac10">21164 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac8 ac9 ac11">10429 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac8 ac9 ac12">628 </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar12 ac8 ac9 ac13">10107 </TD><TD class=alignCenter headers="ar1 ar12 ac8 ac14">7528 </TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignCenter headers="ar1 ar13 ac1 ac2 ac3">54.3% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac1 ac2 ac4">5.3% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac1 ac2 ac5">42.1% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac1 ac2 ac6">52.6% </TD><TD class=alignCenter headers="ar1 ar13 ac1 ac7">45.7% </TD><TD class=alignCenter headers="ar1 ar13 ac8 ac9 ac10">73.8% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac8 ac9 ac11">49.3% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac8 ac9 ac12">3.0% </TD><TD class="bg-colour-blue alignCenter" headers="ar1 ar13 ac8 ac9 ac13">47.8% </TD><TD class=alignCenter headers="ar1 ar13 ac8 ac14">26.2% </TD></TR></TBODY></TABLE>
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t2 class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups (years)</TH><TH id=bc1 colSpan=5>Weekly
(June 15 to June 28, 2014)
</TH><TH id=bc8 colSpan=7>Cumulative
(August 25, 2013 to June 28, 2014)
</TH></TR><TR class=bg-colour-yellow><TH id=bc2 colSpan=4 headers=bc1>Influenza A</TH><TH id=bc7 headers=bc1>B</TH><TH id=bc9 colSpan=4 headers=bc8>Influenza A</TH><TH id=bc14 headers=bc8>B</TH><TH id=bc15 colSpan=2 headers=bc8>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=bc3 headers="bc1 bc2">A Total</TH><TH id=bc4 class="bg-colour-blue " headers="bc1 bc2">A(H1) pdm09</TH><TH id=bc5 class="bg-colour-blue " headers="bc1 bc2">A(H3)</TH><TH id=bc6 class="bg-colour-blue " headers="bc1 bc2">A (UnS)</TH><TD class=alignCenter headers="bc1 bc7">Total</TD><TH id=bc10 headers="bc8 bc9">A Total</TH><TH id=bc11 class="bg-colour-blue " headers="bc8 bc9">A(H1) pdm09</TH><TH id=bc12 class="bg-colour-blue " headers="bc8 bc9">A(H3)</TH><TH id=bc13 class="bg-colour-blue " headers="bc8 bc9">A (UnS)</TH><TD class=alignCenter headers="bc8 bc14">Total</TD><TH id=bc16 headers="bc8 bc15">#</TH><TH id=bc17 headers="bc8 bc15">%</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13><SUP id=footnote_t2_1>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP id=footnote_t2_2>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
<SUP id=footnote_t2_3>3 </SUP>Table 2 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
</TD></TR></TFOOT><TBODY><TR><TH id=br2 class=alignLeft headers=br1><5</TH><TD class=alignCenter headers="br1 br2 bc1 bc2 bc3">0 </TD><TD class=alignCenter headers="br1 br2 bc1 bc2 bc4">0 </TD><TD class=alignCenter headers="br1 br2 bc1 bc2 bc5">0 </TD><TD class=alignCenter headers="br1 br2 bc1 bc2 bc6">0 </TD><TD class=alignCenter headers="br1 br2 bc1 bc7">1 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc10">3270 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc11">1453 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc12">42 </TD><TD class=alignCenter headers="br1 br2 bc8 bc9 bc13">1775 </TD><TD class=alignCenter headers="br1 br2 bc8 bc14">558 </TD><TD class=alignCenter headers="br1 br2 bc8 bc15 bc16">3828 </TD><TD class=alignCenter headers="br1 br2 bc8 bc15 bc17">16.5% </TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignCenter headers="br1 br3 bc1 bc2 bc3">1 </TD><TD class=alignCenter headers="br1 br3 bc1 bc2 bc4">0 </TD><TD class=alignCenter headers="br1 br3 bc1 bc2 bc5">0 </TD><TD class=alignCenter headers="br1 br3 bc1 bc2 bc6">1 </TD><TD class=alignCenter headers="br1 br3 bc1 bc7">2 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc10">1334 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc11">707 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc12">25 </TD><TD class=alignCenter headers="br1 br3 bc8 bc9 bc13">602 </TD><TD class=alignCenter headers="br1 br3 bc8 bc14">828 </TD><TD class=alignCenter headers="br1 br3 bc8 bc15 bc16">2162 </TD><TD class=alignCenter headers="br1 br3 bc8 bc15 bc17">9.3% </TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignCenter headers="br1 br4 bc1 bc2 bc3">2 </TD><TD class=alignCenter headers="br1 br4 bc1 bc2 bc4">0 </TD><TD class=alignCenter headers="br1 br4 bc1 bc2 bc5">0 </TD><TD class=alignCenter headers="br1 br4 bc1 bc2 bc6">2 </TD><TD class=alignCenter headers="br1 br4 bc1 bc7">2 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc10">5107 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc11">2819 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc12">54 </TD><TD class=alignCenter headers="br1 br4 bc8 bc9 bc13">2234 </TD><TD class=alignCenter headers="br1 br4 bc8 bc14">1029 </TD><TD class=alignCenter headers="br1 br4 bc8 bc15 bc16">6136 </TD><TD class=alignCenter headers="br1 br4 bc8 bc15 bc17">26.4% </TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignCenter headers="br1 br5 bc1 bc2 bc3">5 </TD><TD class=alignCenter headers="br1 br5 bc1 bc2 bc4">0 </TD><TD class=alignCenter headers="br1 br5 bc1 bc2 bc5">2 </TD><TD class=alignCenter headers="br1 br5 bc1 bc2 bc6">3 </TD><TD class=alignCenter headers="br1 br5 bc1 bc7">8 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc10">4486 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc11">2394 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc12">68 </TD><TD class=alignCenter headers="br1 br5 bc8 bc9 bc13">2024 </TD><TD class=alignCenter headers="br1 br5 bc8 bc14">1528 </TD><TD class=alignCenter headers="br1 br5 bc8 bc15 bc16">6014 </TD><TD class=alignCenter headers="br1 br5 bc8 bc15 bc17">25.9% </TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignCenter headers="br1 br6 bc1 bc2 bc3">14 </TD><TD class=alignCenter headers="br1 br6 bc1 bc2 bc4">1 </TD><TD class=alignCenter headers="br1 br6 bc1 bc2 bc5">10 </TD><TD class=alignCenter headers="br1 br6 bc1 bc2 bc6">3 </TD><TD class=alignCenter headers="br1 br6 bc1 bc7">7 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc10">2657 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc11">1002 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc12">179 </TD><TD class=alignCenter headers="br1 br6 bc8 bc9 bc13">1476 </TD><TD class=alignCenter headers="br1 br6 bc8 bc14">2279 </TD><TD class=alignCenter headers="br1 br6 bc8 bc15 bc16">4936 </TD><TD class=alignCenter headers="br1 br6 bc8 bc15 bc17">21.3% </TD></TR><TR><TH id=br7 class=alignLeft headers=br1>Unknown</TH><TD class=alignCenter headers="br1 br7 bc1 bc2 bc3">1 </TD><TD class=alignCenter headers="br1 br7 bc1 bc2 bc4">0 </TD><TD class=alignCenter headers="br1 br7 bc1 bc2 bc5">0 </TD><TD class=alignCenter headers="br1 br7 bc1 bc2 bc6">1 </TD><TD class=alignCenter headers="br1 br7 bc1 bc7">0 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc10">137 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc11">102 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc12">21 </TD><TD class=alignCenter headers="br1 br7 bc8 bc9 bc13">14 </TD><TD class=alignCenter headers="br1 br7 bc8 bc14">9 </TD><TD class=alignCenter headers="br1 br7 bc8 bc15 bc16">146 </TD><TD class=alignCenter headers="br1 br7 bc8 bc15 bc17">0.6% </TD></TR><TR><TH id=br8 class=alignLeft headers=br1>Total</TH><TD class=alignCenter headers="br1 br8 bc1 bc2 bc3">23 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc1 bc2 bc4">1 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc1 bc2 bc5">12 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc1 bc2 bc6">10 </TD><TD class=alignCenter headers="br1 br8 bc1 bc7">20 </TD><TD class=alignCenter headers="br1 br8 bc8 bc9 bc10">16991 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc8 bc9 bc11">8477 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc8 bc9 bc12">389 </TD><TD class="bg-colour-blue alignCenter" headers="br1 br8 bc8 bc9 bc13">8125 </TD><TD class=alignCenter headers="br1 br8 bc8 bc14">6231 </TD><TD class=alignCenter headers="br1 br8 bc8 bc15 bc16">23222 </TD><TD class=alignCenter headers="br1 br8 bc8 bc15 bc17">100.0% </TD></TR><TR><TH id=br9 class=alignLeft headers=br1>Percentage<SUP>2</SUP></TH><TD class=alignCenter headers="br1 br9 bc1 bc2 bc3">53.5% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc1 bc2 bc4">4.3% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc1 bc2 bc5">52.2% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc1 bc2 bc6">43.5% </TD><TD class=alignCenter headers="br1 br9 bc1 bc7">46.5% </TD><TD class=alignCenter headers="br1 br9 bc8 bc9 bc10">73.2% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc8 bc9 bc11">49.9% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc8 bc9 bc12">2.3% </TD><TD class="bg-colour-blue alignCenter" headers="br1 br9 bc8 bc9 bc13">47.8% </TD><TD class=alignCenter headers="br1 br9 bc8 bc14">26.8% </TD><TD class=alignCenter></TD><TD class=alignCenter></TD></TR></TBODY></TABLE>


Top of Page
Influenza Strain Characterizations

During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 2,358 influenza viruses [169 A(H3N2), 1,397 A(H1N1)pdm09 and 792 influenza B]. The vast majority (99%) of viruses were similar to the strains recommended by the WHO for the 2013-14 seasonal influenza vaccine. Two A(H1N1)pdm09 viruses showed reduced titres to antiserum against the reference A/California/07/2009 strain, and one A(H3N2) virus showed reduced titres to antiserum against the reference A/Texas/50/2012 strain. Twenty-eight influenza B viruses were similar to the strain recommended by the WHO for the 2011-12 vaccine (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2013-2014, N = 2358
2014-w26-fg4-eng.gif

The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
The recommended components for the 2013-2014 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b (e.g. A/Texas/50/2012), and a B/Massachusetts/2/2012-like virus (Yamagata lineage).


Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
Antiviral Resistance

During the 2013-2014 influenza season, NML has tested 2,302 influenza viruses for resistance to oseltamivir and all but five were sensitive. All 2,300 viruses tested for resistance to zanamivir were sensitive. All 1,647 influenza A viruses tested for amantadine resistance were resistant (Table 3).
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2013-2014</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=t3hc1 rowSpan=2>Virus type and subtype</TH><TH id=t3hc2 colSpan=2>Oseltamivir</TH><TH id=t3hc3 colSpan=2>Zanamivir</TH><TH id=t3hc4 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=t3hc5 headers=t3hc2># tested</TH><TH id=t3hc6 headers=t3hc2># resistant (%)</TH><TH id=t3hc7 headers=t3hc3># tested</TH><TH id=t3hc8 headers=t3hc3># resistant (%)</TH><TH id=t3hc9 headers=t3hc4># tested</TH><TH id=t3hc10 headers=t3hc4># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=t3hr1 class="alignLeft bg-colour-blue" headers=t3hc1>A (H3N2)</TH><TD class=alignCenter headers="t3hr1 t3hc2 t3hc5">157</TD><TD class=alignCenter headers="t3hr1 t3hc2 t3hc6">0</TD><TD class=alignCenter headers="t3hr1 t3hc3 t3hc7">156</TD><TD class=alignCenter headers="t3hr1 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr1 t3hc4 t3hc9">204</TD><TD class=alignCenter headers="t3hr1 t3hc4 t3hc10">204 (100%)</TD></TR><TR><TH id=t3hr2 class="alignLeft bg-colour-blue" headers=t3hc1>A (H1N1)</TH><TD class=alignCenter headers="t3hr2 t3hc2 t3hc5">1397</TD><TD class=alignCenter headers="t3hr2 t3hc2 t3hc6">5 (0.4%)</TD><TD class=alignCenter headers="t3hr2 t3hc3 t3hc7">1398</TD><TD class=alignCenter headers="t3hr2 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr2 t3hc4 t3hc9">1443</TD><TD class=alignCenter headers="t3hr2 t3hc4 t3hc10">1443 (100%)</TD></TR><TR><TH id=t3hr3 class="alignLeft bg-colour-blue" headers=t3hc1>B</TH><TD class=alignCenter headers="t3hr3 t3hc2 t3hc5">748</TD><TD class=alignCenter headers="t3hr3 t3hc2 t3hc6">0</TD><TD class=alignCenter headers="t3hr3 t3hc3 t3hc7">746</TD><TD class=alignCenter headers="t3hr3 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr3 t3hc4 t3hc9">NA <SUP>*</SUP></TD><TD class=alignCenter headers="t3hr3 t3hc4 t3hc10">NA <SUP>*</SUP></TD></TR><TR><TH id=t3hr4 class="alignLeft bg-colour-blue" headers=t3hc1>TOTAL</TH><TD class=alignCenter headers="t3hr4 t3hc2 t3hc5">2302</TD><TD class=alignCenter headers="t3hr4 t3hc2 t3hc6">5 (0.2%)</TD><TD class=alignCenter headers="t3hr4 t3hc3 t3hc7">2300</TD><TD class=alignCenter headers="t3hr4 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr4 t3hc4 t3hc9">1647</TD><TD class=alignCenter headers="t3hr4 t3hc4 t3hc10">1647 (100%)</TD></TR></TBODY></TABLE>
Influenza-like Illness (ILI) Consultation Rate

The national influenza-like-illness (ILI) consultation rate increased from 8.2 consultations per 1,000 patient visits in week 24 to 13.7 per 1,000 in week 25. The rate decreased again in week 26 to 9.0 per 1,000. The rates for week 25 and 26 were above the expected range for this time of year (Figure 5).
Figure 5. Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014
2014-w26-fg5-eng.gif

Note: No data available for mean rate for weeks 19 to 39 for the 1996-1997 through 2002-2003 seasons. Delays in the reporting of data may cause data to change retrospectively. The calculation of the average ILI consultation rate over 17 seasons was aligned with influenza activity in each season. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. The number of sentinel physicians in each province or territory is as follows: BC(21), AB(80), SK(11), MB(18), ON(169), QC(14), NB(29), NS(26), PE(4), NL(16), NU(1), NT(14), YT(13). Not all sentinel physicians report every week.
Text equivalent for figure 5Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

Top of Page
Influenza Outbreak Surveillance

No new influenza outbreaks were reported in weeks 25 and 26 (Figure 6).
Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2013-2014
2014-w26-fg6-eng.gif

1 All provinces and territories except NU report outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
Text equivalent for figure 6Overall number of new influenza outbreaks by report week, Canada, 2013-2014
Pharmacy Surveillance

In weeks 25 and 26, the proportion of prescriptions for antivirals continued to decline and is approaching inter-seasonal levels. Overall this season, the largest proportion of prescriptions for antivirals has been among children 2-18 years of age and adults 19-64 years of age (Figure 7).
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14
2014-w26-fg7-eng.gif

Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group. Age-groups: Infant: 0-2y, Child: 2-18y; Adult: 19-64y, Senior: ≥65y.
Text equivalent for figure 7Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

Top of Page
Sentinel Hospital Influenza Surveillance

Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In weeks 25 and 26, no new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations, ICU admissions or deaths were reported by the Immunization Monitoring Program Active (IMPACT) network (Figure 8a).
To date this season, a total of 708 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 79% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children <5 years of age represent 73% of cases to date (Table 4). One hundred and twelve ICU admissions have been reported, of which 74 (66%) were children <5 years of age (Figure 9a). All but 19 were cases with influenza A, and 97% of those subtyped were A(H1N1)pdm09. Among the 98 ICU cases with available data, 71 (72%) were reported to have underlying medical conditions. One death has been reported this season. A smaller number of paediatric hospital admissions have been reported this year compared to the 2012-13 season.
Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
Adult Influenza Hospitalizations and Deaths (PCIRN)
Surveillance of laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network has ended for the 2013-14 season (Figure 8b). A summary of PCIRN-SOS data for the 2013-14 season will be included in the FluWatch annual report of influenza surveillance in Canada.
During passive and active surveillance* from August 25th, 2013 to May 31st, 2014, 1,985 influenza-associated hospitalizations were reported by the PCIRN-SOS network, 1,338 (67.4%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). Compared to the 2012-13 season, slightly more cases were reported, although the peak number of cases was smaller. A greater number of cases were reported during March and April compared to last year, with six times more cases of influenza B reported. ICU admission was required for 321 hospitalizations, of which 263 were cases with influenza A (137 A(H1N1)pdm09, ten A(H3N2) and 116 A(unsubtyped)), 57 were cases with influenza B and the influenza type was not reported for one case. A greater proportion of cases were admitted to the ICU this season compared to last year, but the proportion of deaths was similar. Of the ICU admissions with available information, 85.9% (189/220) were reported to have at least one comorbidity, and 68.2% (176/258) reported not having been vaccinated this season. Among the 112 deaths reported this season, all but 28 were cases of influenza A (51 A(H1N1)pdm09, three A(H3N2) and 30 A(unsubtyped)); ten cases 20-44 years of age, 37 cases 45-64 years of age and 65 cases ≥65 years of age (Figure 9b). Among fatal cases with available information, 93.8% (60/64) were reported to have at least one comorbidity, and 48.2% (40/83) reported not having been vaccinated this season.
Note: During the 2013-14 influenza season, PCIRN-SOS conducted passive surveillance from August 25<SUP>th</SUP> to November 14<SUP>th</SUP>, 2013, and May 16<SUP>th</SUP> to 31<SUP>st</SUP>. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance was conducted between November 15<SUP>th</SUP>, 2013 and May 15<SUP>th</SUP>, 2014 during which time PCIRN site coordinators investigated cases potentially related to influenza. Data from both active and passive surveillance reported during the 2013-14 season are included in this report. The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t4 class=alignCenter>Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=dr1 rowSpan=3>Age groups </TH><TH id=dc1 colSpan=6>Cumulative (Aug. 25, 2013 to June 28, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=dc2 colSpan=4 headers=dc1>Influenza A </TH><TH id=dc7 headers=dc1>B </TH><TH id=dc8 headers=dc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=dc3 headers="dc1 dc2">A Total </TH><TH id=dc4 class=bg-colour-blue headers="dc1 dc2">A(H1) pdm09 </TH><TH id=dc5 class=bg-colour-blue headers="dc1 dc2">A(H3) </TH><TH id=dc6 class=bg-colour-blue headers="dc1 dc2">A (UnS) </TH><TD class=alignCenter headers="dc1 dc7">Total</TD><TD class=alignCenter headers="dc1 dc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t4_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
</TD></TR></TFOOT><TBODY><TR><TH id=dr2 class=alignLeft headers=dr1>0-5m </TH><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc3">106 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc4">37 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc5">0 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc6">69 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc7">11 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc8">117 (17%) </TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc3">164 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc4">57 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc5">1 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc6">106 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc7">28 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc8">192 (27%) </TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc3">163 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc4">55 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc5">3 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc6">105 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc7">48 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc8">211 (30%) </TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc3">85 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc4">31 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc5">1 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc6">53 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc7">54 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc8">139 (20%) </TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc3">38 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc4">13 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc5">1 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc6">24 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc7">11 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc8">49 (7%) </TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignCenter headers="dr1 dr7 dc1 dc2 dc3">556 </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc4">193 </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc5">6 </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc6">357 </TD><TD class=alignCenter headers="dr1 dr7 dc1 dc7">152 </TD><TD class=alignCenter headers="dr1 dr7 dc1 dc8">708 </TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP></TH><TD class=alignCenter headers="dr1 dr8 dc1 dc2 dc3">78.5% </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc4">34.7% </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc5">1.1% </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc6">64.2% </TD><TD class=alignCenter headers="dr1 dr8 dc1 dc7">21.5% </TD><TD class=alignCenter headers="dr1 dr8 dc1 dc8">100.0% </TD></TR></TBODY></TABLE>
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 5 - Cumulative numbers of adult hospitalizations with influenza
reported by the PCIRN-SOS network, Canada, 2013-14
</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=er1 rowSpan=3>Age groups </TH><TH id=ec1 class=noWrap colSpan=6>Cumulative (Aug. 25, 2013 to June 28, 2014)<SUP>*</SUP></TH></TR><TR class=bg-colour-yellow><TH id=ec2 colSpan=4 headers=ec1>Influenza A </TH><TH id=ec7 headers=ec1>B </TH><TH id=ec8 headers=ec1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=ec3 headers="ec1 ec2">A Total </TH><TH id=ec4 class=bg-colour-blue headers="ec1 ec2">A(H1) pdm09 </TH><TH id=ec5 class=bg-colour-blue headers="ec1 ec2">A(H3) </TH><TH id=ec6 class=bg-colour-blue headers="ec1 ec2">A(UnS) </TH><TD class=alignCenter headers="ec1 ec7">Total</TD><TD class=alignCenter headers="ec1 ec8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t5_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.

<SUP id=t5_star>*</SUP>Two cases for which the influenza type has not yet been reported, and four cases for which the age-group was not reported, are not included in Table 5.
</TD></TR></TFOOT><TBODY><TR><TH id=er2 class=alignLeft headers=er1>16-20 </TH><TD class=alignCenter headers="er1 er2 ec1 ec2 ec3">13 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec4">5 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec5">1 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec6">7 </TD><TD class=alignCenter headers="er1 er2 ec1 ec7">2 </TD><TD class=alignCenter headers="er1 er2 ec1 ec8">15 (1%) </TD></TR><TR><TH id=er3 class=alignLeft headers=er1>20-44 </TH><TD class=alignCenter headers="er1 er3 ec1 ec2 ec3">276 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec4">142 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec5">7 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec6">127 </TD><TD class=alignCenter headers="er1 er3 ec1 ec7">47 </TD><TD class=alignCenter headers="er1 er3 ec1 ec8">323 (16%) </TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignCenter headers="er1 er4 ec1 ec2 ec3">521 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec4">245 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec5">12 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec6">264 </TD><TD class=alignCenter headers="er1 er4 ec1 ec7">135 </TD><TD class=alignCenter headers="er1 er4 ec1 ec8">656 (33%) </TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignCenter headers="er1 er5 ec1 ec2 ec3">525 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec4">238 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec5">61 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec6">226 </TD><TD class=alignCenter headers="er1 er5 ec1 ec7">460 </TD><TD class=alignCenter headers="er1 er5 ec1 ec8">985 (50%) </TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignCenter headers="er1 er6 ec1 ec2 ec3">1335 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec4">630 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec5">81 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec6">624 </TD><TD class=alignCenter headers="er1 er6 ec1 ec7">644 </TD><TD class=alignCenter headers="er1 er6 ec1 ec8">1979 </TD></TR><TR><TH id=er7 class=alignLeft headers=er1>%<SUP>1</SUP></TH><TD class=alignCenter headers="er1 er7 ec1 ec2 ec3">67% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec4">47% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec5">6% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec6">47% </TD><TD class=alignCenter headers="er1 er7 ec1 ec7">33% </TD><TD class=alignCenter headers="er1 er7 ec1 ec8">100% </TD></TR></TBODY></TABLE>
Figure 8. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w26-fg8a-eng.gif


Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w26-fg8b-eng.gif

* See footnote above following the section related to PCIRN-SOS data.
Text equivalent for figure 8bNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Adult hospitalizations (>16 year of age, PCIRN-SOS)
Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w26-fg9a-eng.gif

Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w26-fg9b-eng.gif

Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Adult hospitalizations (≥16 year of age, PCIRN-SOS)

Top of Page
Provincial/Territorial Influenza Hospitalizations and Deaths

In weeks 25 and 26, 55 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories.* As with other surveillance indicators in weeks 25 and 26, the majority were cases of influenza B (44, 80.0%). There were no ICU admissions reported in weeks 25 & 26. Five deaths were reported: 1 adult 45-64 years of age, and 4 adults ≥65 years of age; 4 of the 5 with influenza B. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total.
To date this season, 5,358 influenza-associated hospitalizations have been reported, 68.9% with influenza A. The majority (63.2%) of hospitalizations have been cases 45 years of age of older. A significantly greater proportion of cases of influenza B have been ≥65 years of age, and 5-14 years of age, compared to cases of A(H1N1)pdm09 this season (Table 6). A total of 380 ICU admissions have been reported this season, of which 63.9% were adults 20-64 years of age. A total of 332 deaths have been reported. The highest proportion of deaths has been among adults ≥65 years of age (56.0%) followed by adults 20-64 years of age (35.8%). In keeping with the late-season circulation, influenza B has been increasingly reported among hospitalized cases of influenza. To date this season, influenza B has been reported in 31.1% of hospitalizations and 34.6% of deaths. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.
* Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t6 class=alignCenter>Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=fr1 rowSpan=3>Age groups </TH><TH id=fc1 colSpan=6>Cumulative (Aug. 25, 2013 to June 28, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=fc2 colSpan=4 headers=fc1>Influenza A</TH><TH id=fc7 headers=fc1>B</TH><TH id=fc8 headers=fc1>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=fc3 headers="fc1 fc2">A Total</TH><TH id=fc4 class=bg-colour-blue headers="fc1 fc2">A(H1) pdm09</TH><TH id=fc5 class=bg-colour-blue headers="fc1 fc2">A(H3)</TH><TH id=fc6 class=bg-colour-blue headers="fc1 fc2">A (UnS)</TH><TD class=alignCenter headers="fc1 fc7">Total</TD><TD class=alignCenter headers="fc1 fc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=8><SUP id=footnote_t6_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
</TD></TR></TFOOT><TBODY><TR><TH id=fr2 class=alignLeft headers=fr1>0-4 years</TH><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc3">626 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc4">289 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc5">13 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc6">324 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc7">141 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc8">767 (14%) </TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years</TH><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc3">136 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc4">65 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc5">6 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc6">65 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc7">121 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc8">257 (5%) </TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years</TH><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc3">40 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc4">23 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc5">4 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc6">13 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc7">9 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc8">49 (1%) </TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc3">623</TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc4">425 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc5">9 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc6">189 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc7">104 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc8">727 (14%) </TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc3">1133 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc4">711 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc5">34 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc6">388 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc7">307 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc8">1440 (27%) </TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc3">997 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc4">471 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc5">123 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc6">403 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc7">948 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc8">1945 (36%) </TD></TR><TR><TH id=fr10 class=alignLeft headers=fr1>Unknown</TH><TD class=alignCenter headers="fc1 fc2 fc3">138 </TD><TD class=alignCenter headers="fc1 fc2 fc4">99 </TD><TD class=alignCenter headers="fc1 fc2 fc5">3 </TD><TD class=alignCenter headers="fc1 fc2 fc6">36 </TD><TD class=alignCenter headers="fc1 fc7">35 </TD><TD class=alignCenter headers="fc1 fc8">173 (3%) </TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignCenter headers="fr1 fr8 fc1 fc2 fc3">3693 </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc4">2083 </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc5">192 </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc6">1418 </TD><TD class=alignCenter headers="fr1 fr8 fc1 fc7">1665 </TD><TD class=alignCenter headers="fr1 fr8 fc1 fc8">5358 </TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP></TH><TD class=alignCenter headers="fr1 fr9 fc1 fc2 fc3">68.6% </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc4">56.4% </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc5">5.2% </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc6">38.4% </TD><TD class=alignCenter headers="fr1 fr9 fc1 fc7">31.1% </TD><TD class=alignCenter headers="fr1 fr9 fc1 fc8">100% </TD></TR></TBODY></TABLE>
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2013-14 on the Public Health Agency of Canada website.

...
http://www.phac-aspc.gc.ca/fluwatch/13-14/w26_14/index-eng.php
 
Re: Canada FluWatch Weekly Reports 2013-2014 Season Weeks 27 and 28

Re: Canada FluWatch Weekly Reports 2013-2014 Season Weeks 27 and 28

FluWatch report: June 29 to July 12, 2014 (Weeks 27 and 28)

Posted 2014-07-18For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
<A title="Flu Watch (Version PDF, 411 KB - 10 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/13-14/w28_14/pdf/fw2014-28-eng.pdf">FluWatch report: June 29 to July 12, 2014 (Weeks 27 and 28) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 411 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

?? Help with PDF documents


Overall Summary
  • Influenza activity in Canada is at inter-seasonal levels with most jurisdictions reporting only sporadic detections of influenza and no influenza or ILI outbreaks. Influenza B circulated later into the spring than in previous seasons, but overall activity remained within expected levels.
  • As of week 28, 5,414 hospitalizations and 340 deaths have been reported from participating regions, which is slightly more hospitalizations but fewer deaths than were reported last year.
Are you a primary health care practitioner (General Practitioner, Nurse Practitioner or Registered Nurse) interested in becoming a FluWatch sentinel for the 2014-15 influenza season? Contact us at FluWatch@phac-aspc.gc.ca
Influenza/ILI Activity (geographic spread)

In week 27, one region in Ontario reported localized influenza/ILI activity. In week 28, no region reported localized activity (Figure 1). Seven regions did not report data in week 27 and 16 regions did not report data in week 28.
Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 28


right_ofmap.gif



Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
Influenza and Other Respiratory Virus Detections

The number of positive influenza tests declined from 30 in week 26 to 21 in week 27, and remained stable at 20 (1.5% of tests) in week 28 (Figure 2). Influenza B circulated later into the spring than in previous seasons, but detections are now at inter-seasonal levels. Most jurisdictions have reported only sporadic numbers of influenza detections in recent weeks (Table 1). This season, A(H1N1)pdm09 predominantly affected adults 20-64 years of age and children <5 years of age, while influenza B affected greater proportions of adults ≥65 years of age and children 5-19 years of age (Table 2).
Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
2014-w28-fg2-eng.gif

Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
Detections of RSV, coronavirus, and human metapneumovirus have continued to decline and are near inter-seasonal levels. The number of positive tests for parainfluenza and adenovirus continued to follow a downward trend. Detections of rhinovirus were higher in May and June than during the same period over the past three seasons, however the number of positive tests continues to decrease (Figure 3).
For more details, see the weekly Respiratory Virus Detections in Canada Report.
Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2013-14
2014-w28-fg3-eng.gif


Top of Page
RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
<TABLE id=t1 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class="alignCenter margin10px">Table 1: Weekly and cumulative numbers of positive influenza specimens
by type, subtype and province, Canada, 2013-14
</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=t1hc1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=t1hc2 colSpan=5>Weekly
(June 29 to July 12, 2014)
</TH><TH id=t1hc3 colSpan=5>Cumulative
(August 25, 2013 to July 12, 2014)
</TH></TR><TR class=bg-colour-yellow><TH id=t1hc4 colSpan=4 headers=t1hc2>Influenza A</TH><TH id=t1hc5 headers=t1hc2>B</TH><TH id=t1hc6 colSpan=4 headers=t1hc3>Influenza A</TH><TH id=t1hc7 headers=t1hc3>B</TH></TR><TR class=bg-colour-grey-light><TH id=t1hc8 headers="t1hc2 t1hc4">A Total</TH><TH id=t1hc9 class=" bg-colour-blue" headers="t1hc2 t1hc4">A(H1)pdm09</TH><TH id=t1hc10 class=" bg-colour-blue" headers="t1hc2 t1hc4">A(H3)</TH><TH id=t1hc11 class=" bg-colour-blue" headers="t1hc2 t1hc4">A(UnS)</TH><TH id=t1hc12 class=alignCenter headers="t1hc2 t1hc5">B Total</TH><TH id=t1hc13 headers="t1hc3 t1hc6">A Total</TH><TH id=t1hc14 class=" bg-colour-blue" headers="t1hc3 t1hc6">A(H1)pdm09</TH><TH id=t1hc15 class=" bg-colour-blue" headers="t1hc3 t1hc6">A(H3)</TH><TH id=t1hc16 class=" bg-colour-blue" headers="t1hc3 t1hc6">A(UnS)</TH><TD class=alignCenter headers="t1hc3 t1hc7">B Total</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
</TD></TR></TFOOT><TBODY><TR><TH id=t1hr1 class=alignLeft headers=t1hc1>BC</TH><TD class=alignCenter headers="t1hr1 t1hc2 t1hc4 t1hc8">11</TD><TD class=alignCenter headers="t1hr1 t1hc2 t1hc4 t1hc9">1</TD><TD class=alignCenter headers="t1hr1 t1hc2 t1hc4 t1hc10">9</TD><TD class=alignCenter headers="t1hr1 t1hc2 t1hc4 t1hc11">1</TD><TD class=alignCenter headers="t1hr1 t1hc2 t1hc5 t1hc12">3</TD><TD class=alignCenter headers="t1hr1 t1hc3 t1hc6 t1hc13">1836</TD><TD class=alignCenter headers="t1hr1 t1hc3 t1hc6 t1hc14">1615</TD><TD class=alignCenter headers="t1hr1 t1hc3 t1hc6 t1hc15">78</TD><TD class=alignCenter headers="t1hr1 t1hc3 t1hc6 t1hc16">143</TD><TD class=alignCenter headers="t1hr1 t1hc3 t1hc7">387</TD></TR><TR><TH id=t1hr2 class=alignLeft headers=t1hc1>AB</TH><TD class=alignCenter headers="t1hr2 t1hc2 t1hc4 t1hc8">4</TD><TD class=alignCenter headers="t1hr2 t1hc2 t1hc4 t1hc9">1</TD><TD class=alignCenter headers="t1hr2 t1hc2 t1hc4 t1hc10">3</TD><TD class=alignCenter headers="t1hr2 t1hc2 t1hc4 t1hc11">0</TD><TD class=alignCenter headers="t1hr2 t1hc2 t1hc5 t1hc12">3</TD><TD class=alignCenter headers="t1hr2 t1hc3 t1hc6 t1hc13">3903</TD><TD class=alignCenter headers="t1hr2 t1hc3 t1hc6 t1hc14">3463</TD><TD class=alignCenter headers="t1hr2 t1hc3 t1hc6 t1hc15">124</TD><TD class=alignCenter headers="t1hr2 t1hc3 t1hc6 t1hc16">316</TD><TD class=alignCenter headers="t1hr2 t1hc3 t1hc7">572</TD></TR><TR><TH id=t1hr3 class=alignLeft headers=t1hc1>SK</TH><TD class=alignCenter headers="t1hr3 t1hc2 t1hc4 t1hc8">0</TD><TD class=alignCenter headers="t1hr3 t1hc2 t1hc4 t1hc9">0</TD><TD class=alignCenter headers="t1hr3 t1hc2 t1hc4 t1hc10">0</TD><TD class=alignCenter headers="t1hr3 t1hc2 t1hc4 t1hc11">0</TD><TD class=alignCenter headers="t1hr3 t1hc2 t1hc5 t1hc12">1</TD><TD class=alignCenter headers="t1hr3 t1hc3 t1hc6 t1hc13">1384</TD><TD class=alignCenter headers="t1hr3 t1hc3 t1hc6 t1hc14">988</TD><TD class=alignCenter headers="t1hr3 t1hc3 t1hc6 t1hc15">8</TD><TD class=alignCenter headers="t1hr3 t1hc3 t1hc6 t1hc16">388</TD><TD class=alignCenter headers="t1hr3 t1hc3 t1hc7">198</TD></TR><TR><TH id=t1hr4 class=alignLeft headers=t1hc1>MB</TH><TD class=alignCenter headers="t1hr4 t1hc2 t1hc4 t1hc8">0</TD><TD class=alignCenter headers="t1hr4 t1hc2 t1hc4 t1hc9">0</TD><TD class=alignCenter headers="t1hr4 t1hc2 t1hc4 t1hc10">0</TD><TD class=alignCenter headers="t1hr4 t1hc2 t1hc4 t1hc11">0</TD><TD class=alignCenter headers="t1hr4 t1hc2 t1hc5 t1hc12">0</TD><TD class=alignCenter headers="t1hr4 t1hc3 t1hc6 t1hc13">685</TD><TD class=alignCenter headers="t1hr4 t1hc3 t1hc6 t1hc14">463</TD><TD class=alignCenter headers="t1hr4 t1hc3 t1hc6 t1hc15">7</TD><TD class=alignCenter headers="t1hr4 t1hc3 t1hc6 t1hc16">215</TD><TD class=alignCenter headers="t1hr4 t1hc3 t1hc7">72</TD></TR><TR><TH id=t1hr5 class=alignLeft headers=t1hc1>ON</TH><TD class=alignCenter headers="t1hr5 t1hc2 t1hc4 t1hc8">8</TD><TD class=alignCenter headers="t1hr5 t1hc2 t1hc4 t1hc9">0</TD><TD class=alignCenter headers="t1hr5 t1hc2 t1hc4 t1hc10">7</TD><TD class=alignCenter headers="t1hr5 t1hc2 t1hc4 t1hc11">1</TD><TD class=alignCenter headers="t1hr5 t1hc2 t1hc5 t1hc12">4</TD><TD class=alignCenter headers="t1hr5 t1hc3 t1hc6 t1hc13">5830</TD><TD class=alignCenter headers="t1hr5 t1hc3 t1hc6 t1hc14">2499</TD><TD class=alignCenter headers="t1hr5 t1hc3 t1hc6 t1hc15">420</TD><TD class=alignCenter headers="t1hr5 t1hc3 t1hc6 t1hc16">2911</TD><TD class=alignCenter headers="t1hr5 t1hc3 t1hc7">3112</TD></TR><TR><TH id=t1hr6 class=alignLeft headers=t1hc1>QC</TH><TD class=alignCenter headers="t1hr6 t1hc2 t1hc4 t1hc8">1</TD><TD class=alignCenter headers="t1hr6 t1hc2 t1hc4 t1hc9">0</TD><TD class=alignCenter headers="t1hr6 t1hc2 t1hc4 t1hc10">0</TD><TD class=alignCenter headers="t1hr6 t1hc2 t1hc4 t1hc11">1</TD><TD class=alignCenter headers="t1hr6 t1hc2 t1hc5 t1hc12">1</TD><TD class=alignCenter headers="t1hr6 t1hc3 t1hc6 t1hc13">5378</TD><TD class=alignCenter headers="t1hr6 t1hc3 t1hc6 t1hc14">677</TD><TD class=alignCenter headers="t1hr6 t1hc3 t1hc6 t1hc15">6</TD><TD class=alignCenter headers="t1hr6 t1hc3 t1hc6 t1hc16">4695</TD><TD class=alignCenter headers="t1hr6 t1hc3 t1hc7">2746</TD></TR><TR><TH id=t1hr7 class=alignLeft headers=t1hc1>NB</TH><TD class=alignCenter headers="t1hr7 t1hc2 t1hc4 t1hc8">0</TD><TD class=alignCenter headers="t1hr7 t1hc2 t1hc4 t1hc9">0</TD><TD class=alignCenter headers="t1hr7 t1hc2 t1hc4 t1hc10">0</TD><TD class=alignCenter headers="t1hr7 t1hc2 t1hc4 t1hc11">0</TD><TD class=alignCenter headers="t1hr7 t1hc2 t1hc5 t1hc12">3</TD><TD class=alignCenter headers="t1hr7 t1hc3 t1hc6 t1hc13">1491</TD><TD class=alignCenter headers="t1hr7 t1hc3 t1hc6 t1hc14">370</TD><TD class=alignCenter headers="t1hr7 t1hc3 t1hc6 t1hc15">2</TD><TD class=alignCenter headers="t1hr7 t1hc3 t1hc6 t1hc16">1119</TD><TD class=alignCenter headers="t1hr7 t1hc3 t1hc7">133</TD></TR><TR><TH id=t1hr8 class=alignLeft headers=t1hc1>NS</TH><TD class=alignCenter headers="t1hr8 t1hc2 t1hc4 t1hc8">0</TD><TD class=alignCenter headers="t1hr8 t1hc2 t1hc4 t1hc9">0</TD><TD class=alignCenter headers="t1hr8 t1hc2 t1hc4 t1hc10">0</TD><TD class=alignCenter headers="t1hr8 t1hc2 t1hc4 t1hc11">0</TD><TD class=alignCenter headers="t1hr8 t1hc2 t1hc5 t1hc12">0</TD><TD class=alignCenter headers="t1hr8 t1hc3 t1hc6 t1hc13">175</TD><TD class=alignCenter headers="t1hr8 t1hc3 t1hc6 t1hc14">134</TD><TD class=alignCenter headers="t1hr8 t1hc3 t1hc6 t1hc15">5</TD><TD class=alignCenter headers="t1hr8 t1hc3 t1hc6 t1hc16">36</TD><TD class=alignCenter headers="t1hr8 t1hc3 t1hc7">52</TD></TR><TR><TH id=t1hr9 class=alignLeft headers=t1hc1>PE</TH><TD class=alignCenter headers="t1hr9 t1hc2 t1hc4 t1hc8">0</TD><TD class=alignCenter headers="t1hr9 t1hc2 t1hc4 t1hc9">0</TD><TD class=alignCenter headers="t1hr9 t1hc2 t1hc4 t1hc10">0</TD><TD class=alignCenter headers="t1hr9 t1hc2 t1hc4 t1hc11">0</TD><TD class=alignCenter headers="t1hr9 t1hc2 t1hc5 t1hc12">0</TD><TD class=alignCenter headers="t1hr9 t1hc3 t1hc6 t1hc13">119</TD><TD class=alignCenter headers="t1hr9 t1hc3 t1hc6 t1hc14">118</TD><TD class=alignCenter headers="t1hr9 t1hc3 t1hc6 t1hc15">0</TD><TD class=alignCenter headers="t1hr9 t1hc3 t1hc6 t1hc16">1</TD><TD class=alignCenter headers="t1hr9 t1hc3 t1hc7">5</TD></TR><TR><TH id=t1hr10 class=alignLeft headers=t1hc1>NL</TH><TD class=alignCenter headers="t1hr10 t1hc2 t1hc4 t1hc8">2</TD><TD class=alignCenter headers="t1hr10 t1hc2 t1hc4 t1hc9">0</TD><TD class=alignCenter headers="t1hr10 t1hc2 t1hc4 t1hc10">0</TD><TD class=alignCenter headers="t1hr10 t1hc2 t1hc4 t1hc11">2</TD><TD class=alignCenter headers="t1hr10 t1hc2 t1hc5 t1hc12">0</TD><TD class=alignCenter headers="t1hr10 t1hc3 t1hc6 t1hc13">385</TD><TD class=alignCenter headers="t1hr10 t1hc3 t1hc6 t1hc14">104</TD><TD class=alignCenter headers="t1hr10 t1hc3 t1hc6 t1hc15">0</TD><TD class=alignCenter headers="t1hr10 t1hc3 t1hc6 t1hc16">281</TD><TD class=alignCenter headers="t1hr10 t1hc3 t1hc7">265</TD></TR><TR><TH id=t1hr11 class=alignLeft headers=t1hc1>Canada</TH><TD class=alignCenter headers="t1hr11 t1hc2 t1hc4 t1hc8">26</TD><TD class="alignCenter bg-colour-blue" headers="t1hr11 t1hc2 t1hc4 t1hc9">2</TD><TD class="alignCenter bg-colour-blue" headers="t1hr11 t1hc2 t1hc4 t1hc10">19</TD><TD class="alignCenter bg-colour-blue" headers="t1hr11 t1hc2 t1hc4 t1hc11">5</TD><TD class=alignCenter headers="t1hr11 t1hc2 t1hc5 t1hc12">15</TD><TD class=alignCenter headers="t1hr11 t1hc3 t1hc6 t1hc13">21186</TD><TD class="alignCenter bg-colour-blue" headers="t1hr11 t1hc3 t1hc6 t1hc14">10431</TD><TD class="alignCenter bg-colour-blue" headers="t1hr11 t1hc3 t1hc6 t1hc15">650</TD><TD class="alignCenter bg-colour-blue" headers="t1hr11 t1hc3 t1hc6 t1hc16">10105</TD><TD class=alignCenter headers="t1hr11 t1hc3 t1hc7">7542</TD></TR><TR><TH id=t1hr12 class=alignLeft headers=t1hc1>Percentage<SUP>2</SUP></TH><TD class=alignCenter headers="t1hr12 t1hc2 t1hc4 t1hc8">63.4%</TD><TD class="alignCenter bg-colour-blue" headers="t1hr12 t1hc2 t1hc4 t1hc9">7.7%</TD><TD class="alignCenter bg-colour-blue" headers="t1hr12 t1hc2 t1hc4 t1hc10">73.1%</TD><TD class="alignCenter bg-colour-blue" headers="t1hr12 t1hc2 t1hc4 t1hc11">19.2%</TD><TD class=alignCenter headers="t1hr12 t1hc2 t1hc5 t1hc12">36.6%</TD><TD class=alignCenter headers="t1hr12 t1hc3 t1hc6 t1hc13">73.7%</TD><TD class="alignCenter bg-colour-blue" headers="t1hr12 t1hc3 t1hc6 t1hc14">49.2%</TD><TD class="alignCenter bg-colour-blue" headers="t1hr12 t1hc3 t1hc6 t1hc15">3.1%</TD><TD class="alignCenter bg-colour-blue" headers="t1hr12 t1hc3 t1hc6 t1hc16">47.7%</TD><TD class=alignCenter headers="t1hr12 t1hc3 t1hc7">26.3%</TD></TR></TBODY></TABLE>
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t2 class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=t2hc1 rowSpan=3>Age groups (years)</TH><TH id=t2hc2 colSpan=5>Weekly
(June 29 to July 12, 2014)
</TH><TH id=t2hc3 colSpan=7>Cumulative
(August 25, 2013 to July 12, 2014)
</TH></TR><TR class=bg-colour-yellow><TH id=t2hc4 colSpan=4 headers=t2hc2>Influenza A</TH><TH id=t2hc5 headers=t2hc2>B</TH><TH id=t2hc6 colSpan=4 headers=t2hc3>Influenza A</TH><TH id=t2hc7 headers=t2hc3>B</TH><TH id=t2hc8 colSpan=2>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=t2hc9 headers="t2hc2 t2hc4">A Total</TH><TH id=t2hc10 class="bg-colour-blue " headers="t2hc2 t2hc4">A(H1) pdm09</TH><TH id=t2hc11 class="bg-colour-blue " headers="t2hc2 t2hc4">A(H3)</TH><TH id=t2hc12 class="bg-colour-blue " headers="t2hc2 t2hc4">A (UnS)</TH><TD class=alignCenter headers="t2hc2 t2hc5">Total</TD><TH id=t2hc13 headers="t2hc3 t2hc6">A Total</TH><TH id=t2hc14 class="bg-colour-blue " headers="t2hc3 t2hc6">A(H1) pdm09</TH><TH id=t2hc15 class="bg-colour-blue " headers="t2hc3 t2hc6">A(H3)</TH><TH id=t2hc16 class="bg-colour-blue " headers="t2hc3 t2hc6">A (UnS)</TH><TD class=alignCenter headers="t2hc3 t2hc7">Total</TD><TH id=t2hc17 headers="t2hc3 t2hc8">#</TH><TH id=t2hc18 headers="t2hc3 t2hc8">%</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13><SUP id=footnote_t2_1>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP id=footnote_t2_2>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
<SUP id=footnote_t2_3>3 </SUP>Table 2 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
</TD></TR></TFOOT><TBODY><TR><TH id=t2hr1 class=alignLeft headers=t2hc1><5</TH><TD class=alignCenter headers="t2hr1 t2hc2 t2hc4 t2hc9">1</TD><TD class=alignCenter headers="t2hr1 t2hc2 t2hc4 t2hc10">0</TD><TD class=alignCenter headers="t2hr1 t2hc2 t2hc4 t2hc11">1</TD><TD class=alignCenter headers="t2hr1 t2hc2 t2hc4 t2hc12">0</TD><TD class=alignCenter headers="t2hr1 t2hc2 t2hc5">0</TD><TD class=alignCenter headers="t2hr1 t2hc3 t2hc6 t2hc13">3270</TD><TD class=alignCenter headers="t2hr1 t2hc3 t2hc6 t2hc14">1452</TD><TD class=alignCenter headers="t2hr1 t2hc3 t2hc6 t2hc15">43</TD><TD class=alignCenter headers="t2hr1 t2hc3 t2hc6 t2hc16">1775</TD><TD class=alignCenter headers="t2hr1 t2hc3 t2hc7">558</TD><TD class=alignCenter headers="t2hr1 t2hc3 t2hc8 t2hc17">3828</TD><TD class=alignCenter headers="t2hr1 t2hc3 t2hc8 t2hc18">16.5%</TD></TR><TR><TH id=t2hr2 class=alignLeft headers=t2hc1>5-19</TH><TD class=alignCenter headers="t2hr2 t2hc2 t2hc4 t2hc9">0</TD><TD class=alignCenter headers="t2hr2 t2hc2 t2hc4 t2hc10">0</TD><TD class=alignCenter headers="t2hr2 t2hc2 t2hc4 t2hc11">0</TD><TD class=alignCenter headers="t2hr2 t2hc2 t2hc4 t2hc12">0</TD><TD class=alignCenter headers="t2hr2 t2hc2 t2hc5">0</TD><TD class=alignCenter headers="t2hr2 t2hc3 t2hc6 t2hc13">1334</TD><TD class=alignCenter headers="t2hr2 t2hc3 t2hc6 t2hc14">707</TD><TD class=alignCenter headers="t2hr2 t2hc3 t2hc6 t2hc15">25</TD><TD class=alignCenter headers="t2hr2 t2hc3 t2hc6 t2hc16">602</TD><TD class=alignCenter headers="t2hr2 t2hc3 t2hc7">828</TD><TD class=alignCenter headers="t2hr2 t2hc3 t2hc8 t2hc17">2162</TD><TD class=alignCenter headers="t2hr2 t2hc3 t2hc8 t2hc18">9.3%</TD></TR><TR><TH id=t2hr3 class=alignLeft headers=t2hc1>20-44</TH><TD class=alignCenter headers="t2hr3 t2hc2 t2hc4 t2hc9">2</TD><TD class=alignCenter headers="t2hr3 t2hc2 t2hc4 t2hc10">0</TD><TD class=alignCenter headers="t2hr3 t2hc2 t2hc4 t2hc11">0</TD><TD class=alignCenter headers="t2hr3 t2hc2 t2hc4 t2hc12">2</TD><TD class=alignCenter headers="t2hr3 t2hc2 t2hc5">3</TD><TD class=alignCenter headers="t2hr3 t2hc3 t2hc6 t2hc13">5109</TD><TD class=alignCenter headers="t2hr3 t2hc3 t2hc6 t2hc14">2819</TD><TD class=alignCenter headers="t2hr3 t2hc3 t2hc6 t2hc15">53</TD><TD class=alignCenter headers="t2hr3 t2hc3 t2hc6 t2hc16">2237</TD><TD class=alignCenter headers="t2hr3 t2hc3 t2hc7">1030</TD><TD class=alignCenter headers="t2hr3 t2hc3 t2hc8 t2hc17">6139</TD><TD class=alignCenter headers="t2hr3 t2hc3 t2hc8 t2hc18">26.4%</TD></TR><TR><TH id=t2hr4 class=alignLeft headers=t2hc1>45-64</TH><TD class=alignCenter headers="t2hr4 t2hc2 t2hc4 t2hc9">1</TD><TD class=alignCenter headers="t2hr4 t2hc2 t2hc4 t2hc10">0</TD><TD class=alignCenter headers="t2hr4 t2hc2 t2hc4 t2hc11">0</TD><TD class=alignCenter headers="t2hr4 t2hc2 t2hc4 t2hc12">1</TD><TD class=alignCenter headers="t2hr4 t2hc2 t2hc5">2</TD><TD class=alignCenter headers="t2hr4 t2hc3 t2hc6 t2hc13">4486</TD><TD class=alignCenter headers="t2hr4 t2hc3 t2hc6 t2hc14">2393</TD><TD class=alignCenter headers="t2hr4 t2hc3 t2hc6 t2hc15">68</TD><TD class=alignCenter headers="t2hr4 t2hc3 t2hc6 t2hc16">2025</TD><TD class=alignCenter headers="t2hr4 t2hc3 t2hc7">1521</TD><TD class=alignCenter headers="t2hr4 t2hc3 t2hc8 t2hc17">6007</TD><TD class=alignCenter headers="t2hr4 t2hc3 t2hc8 t2hc18">25.8%</TD></TR><TR><TH id=t2hr5 class=alignLeft headers=t2hc1>65+</TH><TD class=alignCenter headers="t2hr5 t2hc2 t2hc4 t2hc9">3</TD><TD class=alignCenter headers="t2hr5 t2hc2 t2hc4 t2hc10">0</TD><TD class=alignCenter headers="t2hr5 t2hc2 t2hc4 t2hc11">2</TD><TD class=alignCenter headers="t2hr5 t2hc2 t2hc4 t2hc12">1</TD><TD class=alignCenter headers="t2hr5 t2hc2 t2hc5">1</TD><TD class=alignCenter headers="t2hr5 t2hc3 t2hc6 t2hc13">2657</TD><TD class=alignCenter headers="t2hr5 t2hc3 t2hc6 t2hc14">1002</TD><TD class=alignCenter headers="t2hr5 t2hc3 t2hc6 t2hc15">177</TD><TD class=alignCenter headers="t2hr5 t2hc3 t2hc6 t2hc16">1478</TD><TD class=alignCenter headers="t2hr5 t2hc3 t2hc7">2276</TD><TD class=alignCenter headers="t2hr5 t2hc3 t2hc8 t2hc17">4933</TD><TD class=alignCenter headers="t2hr5 t2hc3 t2hc8 t2hc18">21.2%</TD></TR><TR><TH id=t2hr6 class=alignLeft headers=t2hc1>Unknown</TH><TD class=alignCenter headers="t2hr6 t2hc2 t2hc4 t2hc9">2</TD><TD class=alignCenter headers="t2hr6 t2hc2 t2hc4 t2hc10">0</TD><TD class=alignCenter headers="t2hr6 t2hc2 t2hc4 t2hc11">2</TD><TD class=alignCenter headers="t2hr6 t2hc2 t2hc4 t2hc12">0</TD><TD class=alignCenter headers="t2hr6 t2hc2 t2hc5">5</TD><TD class=alignCenter headers="t2hr6 t2hc3 t2hc6 t2hc13">152</TD><TD class=alignCenter headers="t2hr6 t2hc3 t2hc6 t2hc14">106</TD><TD class=alignCenter headers="t2hr6 t2hc3 t2hc6 t2hc15">26</TD><TD class=alignCenter headers="t2hr6 t2hc3 t2hc6 t2hc16">20</TD><TD class=alignCenter headers="t2hr6 t2hc3 t2hc7">28</TD><TD class=alignCenter headers="t2hr6 t2hc3 t2hc8 t2hc17">180</TD><TD class=alignCenter headers="t2hr6 t2hc3 t2hc8 t2hc18">0.8%</TD></TR><TR><TH id=t2hr7 class=alignLeft headers=t2hc1>Total</TH><TD class=alignCenter headers="t2hr7 t2hc2 t2hc4 t2hc9">9</TD><TD class="alignCenter bg-colour-blue" headers="t2hr7 t2hc2 t2hc4 t2hc10">0</TD><TD class="alignCenter bg-colour-blue" headers="t2hr7 t2hc2 t2hc4 t2hc11">5</TD><TD class="alignCenter bg-colour-blue" headers="t2hr7 t2hc2 t2hc4 t2hc12">4</TD><TD class=alignCenter headers="t2hr7 t2hc2 t2hc5">11</TD><TD class=alignCenter headers="t2hr7 t2hc3 t2hc6 t2hc13">17008</TD><TD class="alignCenter bg-colour-blue" headers="t2hr7 t2hc3 t2hc6 t2hc14">8479</TD><TD class="alignCenter bg-colour-blue" headers="t2hr7 t2hc3 t2hc6 t2hc15">392</TD><TD class="alignCenter bg-colour-blue" headers="t2hr7 t2hc3 t2hc6 t2hc16">8137</TD><TD class=alignCenter headers="t2hr7 t2hc3 t2hc7">6241</TD><TD class=alignCenter headers="t2hr7 t2hc3 t2hc8 t2hc17">23249</TD><TD class=alignCenter headers="t2hr7 t2hc3 t2hc8 t2hc18">100.0%</TD></TR><TR><TH id=t2hr8 class=alignLeft headers=t2hc1>Percentage<SUP>2</SUP></TH><TD class=alignCenter headers="t2hr8 t2hc2 t2hc4 t2hc9">45.0%</TD><TD class="alignCenter bg-colour-blue" headers="t2hr8 t2hc2 t2hc4 t2hc10">0.0%</TD><TD class="alignCenter bg-colour-blue" headers="t2hr8 t2hc2 t2hc4 t2hc11">55.6%</TD><TD class="alignCenter bg-colour-blue" headers="t2hr8 t2hc2 t2hc4 t2hc12">44.4%</TD><TD class=alignCenter headers="t2hr8 t2hc2 t2hc5">55.0%</TD><TD class=alignCenter headers="t2hr8 t2hc3 t2hc6 t2hc13">73.2%</TD><TD class="alignCenter bg-colour-blue" headers="t2hr8 t2hc3 t2hc6 t2hc14">49.9%</TD><TD class="alignCenter bg-colour-blue" headers="t2hr8 t2hc3 t2hc6 t2hc15">2.3%</TD><TD class="alignCenter bg-colour-blue" headers="t2hr8 t2hc3 t2hc6 t2hc16">47.8%</TD><TD class=alignCenter headers="t2hr8 t2hc3 t2hc7">26.8%</TD><TD class=alignCenter headers=t2hr8></TD><TD class=alignCenter headers=t2hr8></TD></TR></TBODY></TABLE>


Top of Page
Influenza Strain Characterizations

During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 2,424 influenza viruses [171 A(H3N2), 1,396 A(H1N1)pdm09 and 857 influenza B]. The vast majority (99%) of viruses were similar to the strains recommended by the WHO for the 2013-14 seasonal influenza vaccine. Two A(H1N1)pdm09 viruses showed reduced titres to antiserum against the reference A/California/07/2009 strain, and one A(H3N2) virus showed reduced titres to antiserum against the reference A/Texas/50/2012 strain. Twenty-nine influenza B viruses were similar to the strain recommended by the WHO for the 2011-12 vaccine (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2013-2014, N = 2424
2014-w28-fg4-eng.gif

The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
The recommended components for the 2013-2014 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b (e.g. A/Texas/50/2012), and a B/Massachusetts/2/2012-like virus (Yamagata lineage).


Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
Antiviral Resistance

During the 2013-2014 influenza season, NML has tested 2,390 influenza viruses for resistance to oseltamivir and all but five were sensitive. All 2,387 viruses tested for resistance to zanamivir were sensitive. All 1,667 influenza A viruses tested for amantadine resistance were resistant (Table 3).
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2013-2014</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=t3hc1 rowSpan=2>Virus type and subtype</TH><TH id=t3hc2 colSpan=2>Oseltamivir</TH><TH id=t3hc3 colSpan=2>Zanamivir</TH><TH id=t3hc4 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=t3hc5 headers=t3hc2># tested</TH><TH id=t3hc6 headers=t3hc2># resistant (%)</TH><TH id=t3hc7 headers=t3hc3># tested</TH><TH id=t3hc8 headers=t3hc3># resistant (%)</TH><TH id=t3hc9 headers=t3hc4># tested</TH><TH id=t3hc10 headers=t3hc4># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=t3hr1 class="alignLeft bg-colour-blue" headers=t3hc1>A (H3N2)</TH><TD class=alignCenter headers="t3hr1 t3hc2 t3hc5">167</TD><TD class=alignCenter headers="t3hr1 t3hc2 t3hc6">0</TD><TD class=alignCenter headers="t3hr1 t3hc3 t3hc7">165</TD><TD class=alignCenter headers="t3hr1 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr1 t3hc4 t3hc9">218</TD><TD class=alignCenter headers="t3hr1 t3hc4 t3hc10">218 (100%)</TD></TR><TR><TH id=t3hr2 class="alignLeft bg-colour-blue" headers=t3hc1>A (H1N1)</TH><TD class=alignCenter headers="t3hr2 t3hc2 t3hc5">1403</TD><TD class=alignCenter headers="t3hr2 t3hc2 t3hc6">5 (0.4%)</TD><TD class=alignCenter headers="t3hr2 t3hc3 t3hc7">1404</TD><TD class=alignCenter headers="t3hr2 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr2 t3hc4 t3hc9">1449</TD><TD class=alignCenter headers="t3hr2 t3hc4 t3hc10">1449 (100%)</TD></TR><TR><TH id=t3hr3 class="alignLeft bg-colour-blue" headers=t3hc1>B</TH><TD class=alignCenter headers="t3hr3 t3hc2 t3hc5">820</TD><TD class=alignCenter headers="t3hr3 t3hc2 t3hc6">0</TD><TD class=alignCenter headers="t3hr3 t3hc3 t3hc7">818</TD><TD class=alignCenter headers="t3hr3 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr3 t3hc4 t3hc9">NA <SUP>*</SUP></TD><TD class=alignCenter headers="t3hr3 t3hc4 t3hc10">NA <SUP>*</SUP></TD></TR><TR><TH id=t3hr4 class="alignLeft bg-colour-blue" headers=t3hc1>TOTAL</TH><TD class=alignCenter headers="t3hr4 t3hc2 t3hc5">2390</TD><TD class=alignCenter headers="t3hr4 t3hc2 t3hc6">5 (0.2%)</TD><TD class=alignCenter headers="t3hr4 t3hc3 t3hc7">2387</TD><TD class=alignCenter headers="t3hr4 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr4 t3hc4 t3hc9">1667</TD><TD class=alignCenter headers="t3hr4 t3hc4 t3hc10">1667 (100%)</TD></TR></TBODY></TABLE>
Influenza-like Illness (ILI) Consultation Rate

The national influenza-like-illness (ILI) consultation rate increased from 8.7 consultations per 1,000 patient visits in week 26 to 9.9 per 1,000 in week 27 and 11.8 per 1,000 in week 28. The rates for weeks 25 to 28 have been above the expected range for this time of year (Figure 5).
Figure 5. Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014
2014-w28-fg5-eng.gif

Note: No data available for mean rate for weeks 19 to 39 for the 1996-1997 through 2002-2003 seasons. Delays in the reporting of data may cause data to change retrospectively. The calculation of the average ILI consultation rate over 17 seasons was aligned with influenza activity in each season. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. The number of sentinel physicians in each province or territory is as follows: BC(21), AB(80), SK(11), MB(18), ON(169), QC(14), NB(29), NS(26), PE(4), NL(16), NU(1), NT(14), YT(13). Not all sentinel physicians report every week.
Text equivalent for figure 5Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

Top of Page
Influenza Outbreak Surveillance

No new influenza outbreaks were reported in Weeks 27 and 28 (Figure 6).
Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2013-2014
2014-w26-fg6-eng.gif

1 All provinces and territories except NU report outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
Text equivalent for figure 6Overall number of new influenza outbreaks by report week, Canada, 2013-2014
Pharmacy Surveillance

In weeks 27 and 28, the proportion of prescriptions for antivirals is approaching inter-seasonal levels. Overall this season, the largest proportion of prescriptions for antivirals has been among children 2-18 years of age and adults 19-64 years of age (Figure 7).
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14
2014-w28-fg7-eng.gif

Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group. Age-groups: Infant: 0-2y, Child: 2-18y; Adult: 19-64y, Senior: ≥65y.
Text equivalent for figure 7Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

Top of Page
Sentinel Hospital Influenza Surveillance

Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In weeks 27 and 28, no new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations, ICU admissions or deaths were reported by the Immunization Monitoring Program Active (IMPACT) network (Figure 8a). No paediatric hospitalizations or ICU admissions have been reported from IMPACT since week 23.
To date this season, a total of 716 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 78% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children <5 years of age represent 73% of cases to date (Table 4). One hundred and seventeen ICU admissions have been reported, of which 74 (65%) were children <5 years of age (Figure 9a). All but 22 were cases with influenza A, and 98% of those subtyped were A(H1N1)pdm09. Among the 103 ICU cases with available data, 74 (72%) were reported to have underlying medical conditions. One death has been reported this season. A smaller number of paediatric hospital admissions have been reported this year compared to the 2012-13 season.
Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
Adult Influenza Hospitalizations and Deaths (PCIRN)
Surveillance of laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network has ended for the 2013-14 season (Figure 8b). A summary of PCIRN-SOS data for the 2013-14 season will be included in the FluWatch annual report of influenza surveillance in Canada.
During passive and active surveillance* from August 25<SUP>th</SUP>, 2013 to May 31<SUP>st</SUP>, 2014, 1,985 influenza-associated hospitalizations were reported by the PCIRN-SOS network, 1,338 (67.4%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). Compared to the 2012-13 season, slightly more cases were reported, although the peak number of cases was smaller. A greater number of cases were reported during March and April compared to last year, with six times more cases of influenza B reported. ICU admission was required for 321 hospitalizations, of which 263 were cases with influenza A (137 A(H1N1)pdm09, ten A(H3N2) and 116 A(unsubtyped)), 57 were cases with influenza B and the influenza type was not reported for one case. A greater proportion of cases were admitted to the ICU this season compared to last year, but the proportion of deaths was similar. Of the ICU admissions with available information, 85.9% (189/220) were reported to have at least one comorbidity, and 68.2% (176/258) reported not having been vaccinated this season. Among the 112 deaths reported this season, all but 28 were cases of influenza A (51 A(H1N1)pdm09, three A(H3N2) and 30 A(unsubtyped)); ten cases 20-44 years of age, 37 cases 45-64 years of age and 65 cases ≥65 years of age (Figure 9b). Among fatal cases with available information, 93.8% (60/64) were reported to have at least one comorbidity, and 48.2% (40/83) reported not having been vaccinated this season.
Note: During the 2013-14 influenza season, PCIRN-SOS conducted passive surveillance from August 25<SUP>th</SUP> to November 14<SUP>th</SUP>, 2013, and May 16<SUP>th</SUP> to 31<SUP>st</SUP>. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance was conducted between November 15<SUP>th</SUP>, 2013 and May 15<SUP>th</SUP>, 2014 during which time PCIRN site coordinators investigated cases potentially related to influenza. Data from both active and passive surveillance reported during the 2013-14 season are included in this report. The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t4 class=alignCenter>Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=dr1 rowSpan=3>Age groups </TH><TH id=dc1 colSpan=6>Cumulative (Aug. 25, 2013 to July 12, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=dc2 colSpan=4 headers=dc1>Influenza A </TH><TH id=dc7 headers=dc1>B </TH><TH id=dc8 headers=dc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=dc3 headers="dc1 dc2">A Total </TH><TH id=dc4 class=bg-colour-blue headers="dc1 dc2">A(H1) pdm09 </TH><TH id=dc5 class=bg-colour-blue headers="dc1 dc2">A(H3) </TH><TH id=dc6 class=bg-colour-blue headers="dc1 dc2">A (UnS) </TH><TD class=alignCenter headers="dc1 dc7">Total</TD><TD class=alignCenter headers="dc1 dc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t4_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
</TD></TR></TFOOT><TBODY><TR><TH id=dr2 class=alignLeft headers=dr1>0-5m </TH><TD class=alignCenter>107</TD><TD class=alignCenter>39</TD><TD class=alignCenter>0</TD><TD class=alignCenter>68</TD><TD class=alignCenter>12</TD><TD class=alignCenter>119 (17%)</TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignCenter>164</TD><TD class=alignCenter>60</TD><TD class=alignCenter>1</TD><TD class=alignCenter>103</TD><TD class=alignCenter>31</TD><TD class=alignCenter>195 (27%)</TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignCenter>162</TD><TD class=alignCenter>59</TD><TD class=alignCenter>3</TD><TD class=alignCenter>100</TD><TD class=alignCenter>47</TD><TD class=alignCenter>209 (29%)</TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignCenter>85</TD><TD class=alignCenter>34</TD><TD class=alignCenter>1</TD><TD class=alignCenter>50</TD><TD class=alignCenter>56</TD><TD class=alignCenter>141 (20%)</TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignCenter>38</TD><TD class=alignCenter>13</TD><TD class=alignCenter>1</TD><TD class=alignCenter>24</TD><TD class=alignCenter>14</TD><TD class=alignCenter>52 (7%)</TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignCenter>556</TD><TD class="alignCenter bg-colour-blue">205</TD><TD class="alignCenter bg-colour-blue">6</TD><TD class="alignCenter bg-colour-blue">345</TD><TD class=alignCenter>160</TD><TD class=alignCenter>716</TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP></TH><TD class=alignCenter>77.7%</TD><TD class="alignCenter bg-colour-blue">36.9%</TD><TD class="alignCenter bg-colour-blue">1.1%</TD><TD class="alignCenter bg-colour-blue">62.1%</TD><TD class=alignCenter>22.3%</TD><TD class=alignCenter>100.0%</TD></TR></TBODY></TABLE>
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 5 - Cumulative numbers of adult hospitalizations with influenza
reported by the PCIRN-SOS network, Canada, 2013-14
</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=er1 rowSpan=3>Age groups </TH><TH id=ec1 class=noWrap colSpan=6>Cumulative (Aug. 25, 2013 to 31 May, 2014)<SUP>*</SUP></TH></TR><TR class=bg-colour-yellow><TH id=ec2 colSpan=4 headers=ec1>Influenza A </TH><TH id=ec7 headers=ec1>B </TH><TH id=ec8 headers=ec1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=ec3 headers="ec1 ec2">A Total </TH><TH id=ec4 class=bg-colour-blue headers="ec1 ec2">A(H1) pdm09 </TH><TH id=ec5 class=bg-colour-blue headers="ec1 ec2">A(H3) </TH><TH id=ec6 class=bg-colour-blue headers="ec1 ec2">A(UnS) </TH><TD class=alignCenter headers="ec1 ec7">Total</TD><TD class=alignCenter headers="ec1 ec8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t5_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.

<SUP id=t5_star>*</SUP>Two cases for which the influenza type has not yet been reported, and four cases for which the age-group was not reported, are not included in Table 5.
</TD></TR></TFOOT><TBODY><TR><TH id=er2 class=alignLeft headers=er1>16-20 </TH><TD class=alignCenter headers="er1 er2 ec1 ec2 ec3">13 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec4">5 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec5">1 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec6">7 </TD><TD class=alignCenter headers="er1 er2 ec1 ec7">2 </TD><TD class=alignCenter headers="er1 er2 ec1 ec8">15 (1%) </TD></TR><TR><TH id=er3 class=alignLeft headers=er1>20-44 </TH><TD class=alignCenter headers="er1 er3 ec1 ec2 ec3">276 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec4">142 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec5">7 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec6">127 </TD><TD class=alignCenter headers="er1 er3 ec1 ec7">47 </TD><TD class=alignCenter headers="er1 er3 ec1 ec8">323 (16%) </TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignCenter headers="er1 er4 ec1 ec2 ec3">521 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec4">245 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec5">12 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec6">264 </TD><TD class=alignCenter headers="er1 er4 ec1 ec7">135 </TD><TD class=alignCenter headers="er1 er4 ec1 ec8">656 (33%) </TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignCenter headers="er1 er5 ec1 ec2 ec3">525 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec4">238 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec5">61 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec6">226 </TD><TD class=alignCenter headers="er1 er5 ec1 ec7">460 </TD><TD class=alignCenter headers="er1 er5 ec1 ec8">985 (50%) </TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignCenter headers="er1 er6 ec1 ec2 ec3">1335 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec4">630 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec5">81 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec6">624 </TD><TD class=alignCenter headers="er1 er6 ec1 ec7">644 </TD><TD class=alignCenter headers="er1 er6 ec1 ec8">1979 </TD></TR><TR><TH id=er7 class=alignLeft headers=er1>%<SUP>1</SUP></TH><TD class=alignCenter headers="er1 er7 ec1 ec2 ec3">67% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec4">47% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec5">6% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec6">47% </TD><TD class=alignCenter headers="er1 er7 ec1 ec7">33% </TD><TD class=alignCenter headers="er1 er7 ec1 ec8">100% </TD></TR></TBODY></TABLE>
Figure 8. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w28-fg8a-eng.gif


Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w26-fg8b-eng.gif

* See footnote above following the section related to PCIRN-SOS data.
Text equivalent for figure 8bNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Adult hospitalizations (>16 year of age, PCIRN-SOS)
Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w28-fg9a-eng.gif

Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w26-fg9b-eng.gif

Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Adult hospitalizations (≥16 year of age, PCIRN-SOS)

Top of Page
Provincial/Territorial Influenza Hospitalizations and Deaths

In week 27 & 28, 48 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories.* The majority were cases of influenza B (34, 70.8%). One ICU admission was reported in an adult ≥65 years of age. Three deaths were reported in adults ≥65 years of age; two were attributable to influenza A and one to influenza B. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total.
To date this season, 5,414 influenza-associated hospitalizations have been reported, 68.5% with influenza A. The majority (63.3%) of hospitalizations have been cases 45 years of age of older. A significantly greater proportion of cases of influenza B have been ≥65 years of age compared to cases of A(H1N1)pdm09 this season (Table 6). A total of 383 ICU admissions have been reported this season, of which 64.0% were adults 20-64 years of age. A total of 340 deaths have been reported. The highest proportion of deaths has been among adults ≥65 years of age (56.8%) followed by adults 20-64 years of age (35.3%). In keeping with the late-season circulation, influenza B has been increasingly reported among hospitalized cases of influenza. To date this season, influenza B has been reported in 31.5% of hospitalizations and 35.6% of deaths. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.
* Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t6 class=alignCenter>Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=t6hc1 rowSpan=3>Age groups </TH><TH id=t6hc2 colSpan=6>Cumulative (Aug. 25, 2013 to July 12, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=t6hc3 colSpan=4 headers=t6hc2>Influenza A</TH><TH id=t6hc4 headers=t6hc2>B</TH><TH id=t6hc5 headers=t6hc2>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=t6hc6 headers="t6hc2 t6hc3">A Total</TH><TH id=t6hc7 class=bg-colour-blue headers="t6hc2 t6hc3">A(H1) pdm09</TH><TH id=t6hc8 class=bg-colour-blue headers="t6hc2 t6hc3">A(H3)</TH><TH id=t6hc9 class=bg-colour-blue headers="t6hc2 t6hc3">A (UnS)</TH><TD class=alignCenter headers="t6hc2 t6hc4">Total</TD><TD class=alignCenter headers="t6hc2 t6hc5"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=8><SUP id=footnote_t6_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
</TD></TR></TFOOT><TBODY><TR><TH id=t6hr1 class=alignLeft headers=t6hc1>0-4 years</TH><TD class=alignCenter headers="t6hr1 t6hc2 t6hc3 t6hc6">627</TD><TD class=alignCenter headers="t6hr1 t6hc2 t6hc3 t6hc7">289</TD><TD class=alignCenter headers="t6hr1 t6hc2 t6hc3 t6hc8">14</TD><TD class=alignCenter headers="t6hr1 t6hc2 t6hc3 t6hc9">324</TD><TD class=alignCenter headers="t6hr1 t6hc2 t6hc4">145</TD><TD class=alignCenter headers="t6hr1 t6hc2 t6hc5">772 (14%)</TD></TR><TR><TH id=t6hr2 class=alignLeft headers=t6hc1>5-14 years</TH><TD class=alignCenter headers="t6hr2 t6hc2 t6hc3 t6hc6">136</TD><TD class=alignCenter headers="t6hr2 t6hc2 t6hc3 t6hc7">65</TD><TD class=alignCenter headers="t6hr2 t6hc2 t6hc3 t6hc8">6</TD><TD class=alignCenter headers="t6hr2 t6hc2 t6hc3 t6hc9">65</TD><TD class=alignCenter headers="t6hr2 t6hc2 t6hc4">123</TD><TD class=alignCenter headers="t6hr2 t6hc2 t6hc5">259 (5%)</TD></TR><TR><TH id=t6hr3 class=alignLeft headers=t6hc1>15-19 years</TH><TD class=alignCenter headers="t6hr3 t6hc2 t6hc3 t6hc6">40</TD><TD class=alignCenter headers="t6hr3 t6hc2 t6hc3 t6hc7">23</TD><TD class=alignCenter headers="t6hr3 t6hc2 t6hc3 t6hc8">4</TD><TD class=alignCenter headers="t6hr3 t6hc2 t6hc3 t6hc9">13</TD><TD class=alignCenter headers="t6hr3 t6hc2 t6hc4">9</TD><TD class=alignCenter headers="t6hr3 t6hc2 t6hc5">49 (1%)</TD></TR><TR><TH id=t6hr4 class=alignLeft headers=t6hc1>20-44 years </TH><TD class=alignCenter headers="t6hr4 t6hc2 t6hc3 t6hc6">625</TD><TD class=alignCenter headers="t6hr4 t6hc2 t6hc3 t6hc7">426</TD><TD class=alignCenter headers="t6hr4 t6hc2 t6hc3 t6hc8">11</TD><TD class=alignCenter headers="t6hr4 t6hc2 t6hc3 t6hc9">188</TD><TD class=alignCenter headers="t6hr4 t6hc2 t6hc4">107</TD><TD class=alignCenter headers="t6hr4 t6hc2 t6hc5">732 (14%)</TD></TR><TR><TH id=t6hr5 class=alignLeft headers=t6hc1>45-64 years </TH><TD class=alignCenter headers="t6hr5 t6hc2 t6hc3 t6hc6">1134</TD><TD class=alignCenter headers="t6hr5 t6hc2 t6hc3 t6hc7">711</TD><TD class=alignCenter headers="t6hr5 t6hc2 t6hc3 t6hc8">34</TD><TD class=alignCenter headers="t6hr5 t6hc2 t6hc3 t6hc9">389</TD><TD class=alignCenter headers="t6hr5 t6hc2 t6hc4">314</TD><TD class=alignCenter headers="t6hr5 t6hc2 t6hc5">1448 (27%)</TD></TR><TR><TH id=t6hr6 class=alignLeft headers=t6hc1>65+ years </TH><TD class=alignCenter headers="t6hr6 t6hc2 t6hc3 t6hc6">1010</TD><TD class=alignCenter headers="t6hr6 t6hc2 t6hc3 t6hc7">473</TD><TD class=alignCenter headers="t6hr6 t6hc2 t6hc3 t6hc8">130</TD><TD class=alignCenter headers="t6hr6 t6hc2 t6hc3 t6hc9">407</TD><TD class=alignCenter headers="t6hr6 t6hc2 t6hc4">971</TD><TD class=alignCenter headers="t6hr6 t6hc2 t6hc5">1981 (37%)</TD></TR><TR><TH id=t6hr7 class=alignLeft headers=t6hc1>Unknown</TH><TD class=alignCenter headers="t6hr7 t6hc2 t6hc3 t6hc6">138</TD><TD class=alignCenter headers="t6hr7 t6hc2 t6hc3 t6hc7">99</TD><TD class=alignCenter headers="t6hr7 t6hc2 t6hc3 t6hc8">3</TD><TD class=alignCenter headers="t6hr7 t6hc2 t6hc3 t6hc9">36</TD><TD class=alignCenter headers="t6hr7 t6hc2 t6hc4">35</TD><TD class=alignCenter headers="t6hr7 t6hc2 t6hc5">173 (3%)</TD></TR><TR><TH id=t6hr8 class=alignLeft headers=t6hc1>Total </TH><TD class=alignCenter headers="t6hr8 t6hc2 t6hc3 t6hc6">3710</TD><TD class="alignCenter bg-colour-blue" headers="t6hr8 t6hc2 t6hc3 t6hc7">2086</TD><TD class="alignCenter bg-colour-blue" headers="t6hr8 t6hc2 t6hc3 t6hc8">202</TD><TD class="alignCenter bg-colour-blue" headers="t6hr8 t6hc2 t6hc3 t6hc9">1422</TD><TD class=alignCenter headers="t6hr8 t6hc2 t6hc4">1704</TD><TD class=alignCenter headers="t6hr8 t6hc2 t6hc5">5414</TD></TR><TR><TH id=t6hr9 class=alignLeft headers=t6hc1>Percentage <SUP>1</SUP></TH><TD class=alignCenter headers="t6hr9 t6hc2 t6hc3 t6hc6">68.5%</TD><TD class="alignCenter bg-colour-blue" headers="t6hr9 t6hc2 t6hc3 t6hc7">56.2%</TD><TD class="alignCenter bg-colour-blue" headers="t6hr9 t6hc2 t6hc3 t6hc8">5.4%</TD><TD class="alignCenter bg-colour-blue" headers="t6hr9 t6hc2 t6hc3 t6hc9">38.3%</TD><TD class=alignCenter headers="t6hr9 t6hc2 t6hc4">31.5%</TD><TD class=alignCenter headers="t6hr9 t6hc2 t6hc5">100%</TD></TR></TBODY></TABLE>
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2013-14 on the Public Health Agency of Canada website.

.../
http://www.phac-aspc.gc.ca/fluwatch/13-14/w28_14/index-eng.php
 
Re: Canada FluWatch Weekly Reports 2013-2014 Season Weeks 31 and 32

Re: Canada FluWatch Weekly Reports 2013-2014 Season Weeks 31 and 32

FluWatch report: July 27 to August 9, 2014 (Weeks 31 and 32)

Posted 2014-08-15For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
<A title="Flu Watch (Version PDF, 419 KB - 10 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/13-14/w32_14/pdf/fw2014-32-eng.pdf">FluWatch report: July 27 to August 9, 2014 (Weeks 31 and 32) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 419 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

?? Help with PDF documents

Overall Summary
  • Influenza activity in Canada remains at inter-seasonal levels with only sporadic detections of influenza A(H3N2) and influenza B.
  • In weeks 31 and 32, one influenza outbreak and one paediatric hospitalization were reported.
  • As of week 32, 5,442 hospitalizations and 342 deaths have been reported from participating regions, which is more hospitalizations but a similar number of deaths than were reported last year.
Are you a primary health care practitioner (General Practitioner, Nurse Practitioner or Registered Nurse) interested in becoming a FluWatch sentinel for the 2014-15 influenza season? Contact us at FluWatch@phac-aspc.gc.ca
Influenza/ILI Activity (geographic spread)

In weeks 31 and 32, most regions in Canada reported no influenza/ILI activity. During these two weeks, one region in Ontario reported localized activity. In week 32, five regions (BC(1), AB(1), SK(1) and QC(2)) reported sporadic activity (Figure 1). In week 31, six regions did not report data, and in week 32, ten regions did not report.
Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 32


right_ofmap.gif



Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
Influenza and Other Respiratory Virus Detections

The number of positive influenza tests was at inter-seasonal levels in week 31 (9 detections) and week 32 (5 detections), with <1% of tests positive for the past three weeks (Figure 2). Most jurisdictions have reported only sporadic numbers of influenza detections in recent weeks (Table 1). Over the past 6 weeks, 76 influenza detections were reported, of which 67% were influenza A and 35/38 of those subtyped were influenza A(H3N2). Compared to A(H1N1)pdm09 which was predominant earlier this season, both influenza B and A(H3N2) have affected a greater proportion of adults ≥65 years of age (Table 2).
Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
2014-w32-fg2-eng.gif

Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
In weeks 31 and 32, detections of other respiratory viruses were at inter-seasonal levels (RSV, coronavirus, and human metapneumovirus) or on a downward trend in keeping with their usual pattern of seasonal circulation (parainfluenza, adenovirus and rhinovirus) (Figure 3).
For more details, see the weekly Respiratory Virus Detections in Canada Report.
Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2013-14
2014-w32-fg3-eng.gif


Top of Page
RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
<TABLE id=t1 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class="alignCenter margin10px">Table 1: Weekly and cumulative numbers of positive influenza specimens
by type, subtype and province, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=t1hc1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=t1hc2 colSpan=5>Two weeks
(July 27 to August 9, 2014)</TH><TH id=t1hc3 colSpan=5>Cumulative
(August 25, 2013 to August 9, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=t1hc4 colSpan=4 headers=t1hc2>Influenza A</TH><TH id=t1hc5 headers=t1hc2>B</TH><TH id=t1hc6 colSpan=4 headers=t1hc3>Influenza A</TH><TH id=t1hc7 headers=t1hc3>B</TH></TR><TR class=bg-colour-grey-light><TH id=t1hc8 headers="t1hc2 t1hc4">A Total</TH><TH id=t1hc9 class=bg-colour-blue headers="t1hc2 t1hc4">A(H1)pdm09</TH><TH id=t1hc10 class=" bg-colour-blue" headers="t1hc2 t1hc4">A(H3)</TH><TH id=t1hc11 class=" bg-colour-blue" headers="t1hc2 t1hc4">A(UnS)</TH><TH id=t1hc12 class=alignCenter headers="t1hc2 t1hc5">B Total</TH><TH id=t1hc13 headers="t1hc3 t1hc6">A Total</TH><TH id=t1hc14 class=" bg-colour-blue" headers="t1hc3 t1hc6">A(H1)pdm09</TH><TH id=t1hc15 class=" bg-colour-blue" headers="t1hc3 t1hc6">A(H3)</TH><TH id=t1hc16 class=" bg-colour-blue" headers="t1hc3 t1hc6">A(UnS)</TH><TD class=alignCenter headers="t1hc3 t1hc7">B Total</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available. </TD></TR></TFOOT><TBODY><TR><TH id=t1hr1 class=alignLeft headers=t1hc1>BC</TH><TD class=alignCenter>4</TD><TD class=alignCenter>0</TD><TD class=alignCenter>3</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1838</TD><TD class=alignCenter>1616</TD><TD class=alignCenter>79</TD><TD class=alignCenter>143</TD><TD class=alignCenter>386</TD></TR><TR><TH id=t1hr2 class=alignLeft headers=t1hc1>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>1</TD><TD class=alignCenter>3905</TD><TD class=alignCenter>3463</TD><TD class=alignCenter>126</TD><TD class=alignCenter>316</TD><TD class=alignCenter>573</TD></TR><TR><TH id=t1hr3 class=alignLeft headers=t1hc1>SK</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>1385</TD><TD class=alignCenter>988</TD><TD class=alignCenter>8</TD><TD class=alignCenter>389</TD><TD class=alignCenter>198</TD></TR><TR><TH id=t1hr4 class=alignLeft headers=t1hc1>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>685</TD><TD class=alignCenter>463</TD><TD class=alignCenter>7</TD><TD class=alignCenter>215</TD><TD class=alignCenter>72</TD></TR><TR><TH id=t1hr5 class=alignLeft headers=t1hc1>ON</TH><TD class=alignCenter>5</TD><TD class=alignCenter>0</TD><TD class=alignCenter>4</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>5847</TD><TD class=alignCenter>2499</TD><TD class=alignCenter>433</TD><TD class=alignCenter>2915</TD><TD class=alignCenter>3119</TD></TR><TR><TH id=t1hr6 class=alignLeft headers=t1hc1>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>1</TD><TD class=alignCenter>5381</TD><TD class=alignCenter>677</TD><TD class=alignCenter>6</TD><TD class=alignCenter>4698</TD><TD class=alignCenter>2748</TD></TR><TR><TH id=t1hr7 class=alignLeft headers=t1hc1>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>1491</TD><TD class=alignCenter>370</TD><TD class=alignCenter>2</TD><TD class=alignCenter>1119</TD><TD class=alignCenter>134</TD></TR><TR><TH id=t1hr8 class=alignLeft headers=t1hc1>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>175</TD><TD class=alignCenter>134</TD><TD class=alignCenter>5</TD><TD class=alignCenter>36</TD><TD class=alignCenter>52</TD></TR><TR><TH id=t1hr9 class=alignLeft headers=t1hc1>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>119</TD><TD class=alignCenter>118</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>5</TD></TR><TR><TH id=t1hr10 class=alignLeft headers=t1hc1>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>385</TD><TD class=alignCenter>104</TD><TD class=alignCenter>0</TD><TD class=alignCenter>281</TD><TD class=alignCenter>265</TD></TR><TR><TH id=t1hr11 class=alignLeft headers=t1hc1>Canada</TH><TD class=alignCenter>11</TD><TD class="alignCenter bg-colour-blue">0</TD><TD class="alignCenter bg-colour-blue">7</TD><TD class="alignCenter bg-colour-blue">4</TD><TD class=alignCenter>3</TD><TD class=alignCenter>21211</TD><TD class="alignCenter bg-colour-blue">10432</TD><TD class="alignCenter bg-colour-blue">666</TD><TD class="alignCenter bg-colour-blue">10113</TD><TD class=alignCenter>7552</TD></TR><TR><TH id=t1hr12 class=alignLeft headers=t1hc1>Percentage<SUP>2</SUP></TH><TD class=alignCenter>78.6%</TD><TD class="alignCenter bg-colour-blue">0.0%</TD><TD class="alignCenter bg-colour-blue">63.6%</TD><TD class="alignCenter bg-colour-blue">36.4%</TD><TD class=alignCenter>21.4%</TD><TD class=alignCenter>73.7%</TD><TD class="alignCenter bg-colour-blue">49.2%</TD><TD class="alignCenter bg-colour-blue">3.1%</TD><TD class="alignCenter bg-colour-blue">47.7%</TD><TD class=alignCenter>26.3%</TD></TR></TBODY></TABLE>
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t2 class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=t2hc1 rowSpan=3>Age groups (years)</TH><TH id=t2hc2 colSpan=5>Two weeks
(July 27 to August 9, 2014)</TH><TH id=t2hc3 colSpan=7>Cumulative
(August 25, 2013 to August 9, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=t2hc4 colSpan=4 headers=t2hc2>Influenza A</TH><TH id=t2hc5 headers=t2hc2>B</TH><TH id=t2hc6 colSpan=4 headers=t2hc3>Influenza A</TH><TH id=t2hc7 headers=t2hc3>B</TH><TH id=t2hc8 colSpan=2>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=t2hc9 headers="t2hc2 t2hc4">A Total</TH><TH id=t2hc10 class=bg-colour-blue headers="t2hc2 t2hc4">A(H1) pdm09</TH><TH id=t2hc11 class=bg-colour-blue headers="t2hc2 t2hc4">A(H3)</TH><TH id=t2hc12 class=bg-colour-blue headers="t2hc2 t2hc4">A (UnS)</TH><TD class=alignCenter headers="t2hc2 t2hc5">Total</TD><TH id=t2hc13 headers="t2hc3 t2hc6">A Total</TH><TH id=t2hc14 class=bg-colour-blue headers="t2hc3 t2hc6">A(H1) pdm09</TH><TH id=t2hc15 class=bg-colour-blue headers="t2hc3 t2hc6">A(H3)</TH><TH id=t2hc16 class=bg-colour-blue headers="t2hc3 t2hc6">A (UnS)</TH><TD class=alignCenter headers="t2hc3 t2hc7">Total</TD><TH id=t2hc17 headers="t2hc3 t2hc8">#</TH><TH id=t2hc18 headers="t2hc3 t2hc8">%</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13><SUP id=footnote_t2_1>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP id=footnote_t2_2>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
<SUP id=footnote_t2_3>3 </SUP>Table 2 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=t2hr1 class=alignLeft headers=t2hc1><5</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>3272</TD><TD class=alignCenter>1454</TD><TD class=alignCenter>43</TD><TD class=alignCenter>1775</TD><TD class=alignCenter>558</TD><TD class=alignCenter>3830</TD><TD class=alignCenter>16.5%</TD></TR><TR><TH id=t2hr2 class=alignLeft headers=t2hc1>5-19</TH><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1336</TD><TD class=alignCenter>707</TD><TD class=alignCenter>27</TD><TD class=alignCenter>602</TD><TD class=alignCenter>831</TD><TD class=alignCenter>2167</TD><TD class=alignCenter>9.3%</TD></TR><TR><TH id=t2hr3 class=alignLeft headers=t2hc1>20-44</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>5114</TD><TD class=alignCenter>2819</TD><TD class=alignCenter>55</TD><TD class=alignCenter>2240</TD><TD class=alignCenter>1033</TD><TD class=alignCenter>6147</TD><TD class=alignCenter>26.4%</TD></TR><TR><TH id=t2hr4 class=alignLeft headers=t2hc1>45-64</TH><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>0</TD><TD class=alignCenter>0</TD><TD class=alignCenter>4494</TD><TD class=alignCenter>2396</TD><TD class=alignCenter>73</TD><TD class=alignCenter>2025</TD><TD class=alignCenter>1531</TD><TD class=alignCenter>6025</TD><TD class=alignCenter>25.9%</TD></TR><TR><TH id=t2hr5 class=alignLeft headers=t2hc1>65+</TH><TD class=alignCenter>2</TD><TD class=alignCenter>0</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>1</TD><TD class=alignCenter>2669</TD><TD class=alignCenter>1002</TD><TD class=alignCenter>181</TD><TD class=alignCenter>1486</TD><TD class=alignCenter>2286</TD><TD class=alignCenter>4955</TD><TD class=alignCenter>21.3%</TD></TR><TR><TH id=t2hr6 class=alignLeft headers=t2hc1>Unknown</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>137</TD><TD class=alignCenter>102</TD><TD class=alignCenter>21</TD><TD class=alignCenter>14</TD><TD class=alignCenter>9</TD><TD class=alignCenter>146</TD><TD class=alignCenter>0.6%</TD></TR><TR><TH id=t2hr7 class=alignLeft headers=t2hc1>Total</TH><TD class=alignCenter>4</TD><TD class="alignCenter bg-colour-blue">0</TD><TD class="alignCenter bg-colour-blue">3</TD><TD class="alignCenter bg-colour-blue">1</TD><TD class=alignCenter>2</TD><TD class=alignCenter>17022</TD><TD class="alignCenter bg-colour-blue">8480</TD><TD class="alignCenter bg-colour-blue">400</TD><TD class="alignCenter bg-colour-blue">8142</TD><TD class=alignCenter>6248</TD><TD class=alignCenter>23270</TD><TD class=alignCenter>100.0%</TD></TR><TR><TH id=t2hr8 class=alignLeft headers=t2hc1>Percentage<SUP>2</SUP></TH><TD class=alignCenter>66.7%</TD><TD class="alignCenter bg-colour-blue">0.0%</TD><TD class="alignCenter bg-colour-blue">75.0%</TD><TD class="alignCenter bg-colour-blue">25.0%</TD><TD class=alignCenter>33.3%</TD><TD class=alignCenter>73.1%</TD><TD class="alignCenter bg-colour-blue">49.8%</TD><TD class="alignCenter bg-colour-blue">2.3%</TD><TD class="alignCenter bg-colour-blue">47.8%</TD><TD class=alignCenter>26.9%</TD><TD class=alignCenter></TD><TD class=alignCenter></TD></TR></TBODY></TABLE>


Top of Page
Influenza Strain Characterizations

During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 2,468 influenza viruses [179 A(H3N2), 1,402 A(H1N1)pdm09 and 887 influenza B]. The vast majority (99%) of viruses were similar to the strains recommended by the WHO for the 2013-14 seasonal influenza vaccine. Two A(H1N1)pdm09 viruses showed reduced titres to antiserum against the reference A/California/07/2009 strain, and one A(H3N2) virus showed reduced titres to antiserum against the reference A/Texas/50/2012 strain. Thirty influenza B viruses were similar to the strain recommended by the WHO for the 2011-12 vaccine (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2013-2014, N = 2468
2014-w32-fg4-eng.gif

The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
The recommended components for the 2013-2014 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b (e.g. A/Texas/50/2012), and a B/Massachusetts/2/2012-like virus (Yamagata lineage).


Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
Antiviral Resistance

During the 2013-2014 influenza season, NML has tested 2,473 influenza viruses for resistance to oseltamivir and all but five were sensitive. All 2,470 viruses tested for resistance to zanamivir were sensitive. All 1,685 influenza A viruses tested for amantadine resistance were resistant (Table 3).
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2013-2014</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=t3hc1 rowSpan=2>Virus type and subtype</TH><TH id=t3hc2 colSpan=2>Oseltamivir</TH><TH id=t3hc3 colSpan=2>Zanamivir</TH><TH id=t3hc4 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=t3hc5 headers=t3hc2># tested</TH><TH id=t3hc6 headers=t3hc2># resistant (%)</TH><TH id=t3hc7 headers=t3hc3># tested</TH><TH id=t3hc8 headers=t3hc3># resistant (%)</TH><TH id=t3hc9 headers=t3hc4># tested</TH><TH id=t3hc10 headers=t3hc4># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=t3hr1 class="alignLeft bg-colour-blue" headers=t3hc1>A (H3N2)</TH><TD class=alignCenter headers="t3hr1 t3hc2 t3hc5">174</TD><TD class=alignCenter headers="t3hr1 t3hc2 t3hc6">0</TD><TD class=alignCenter headers="t3hr1 t3hc3 t3hc7">172</TD><TD class=alignCenter headers="t3hr1 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr1 t3hc4 t3hc9">226</TD><TD class=alignCenter headers="t3hr1 t3hc4 t3hc10">226 (100%)</TD></TR><TR><TH id=t3hr2 class="alignLeft bg-colour-blue" headers=t3hc1>A (H1N1)</TH><TD class=alignCenter headers="t3hr2 t3hc2 t3hc5">1410</TD><TD class=alignCenter headers="t3hr2 t3hc2 t3hc6">5 (0.4%)</TD><TD class=alignCenter headers="t3hr2 t3hc3 t3hc7">1411</TD><TD class=alignCenter headers="t3hr2 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr2 t3hc4 t3hc9">1459</TD><TD class=alignCenter headers="t3hr2 t3hc4 t3hc10">1459 (100%)</TD></TR><TR><TH id=t3hr3 class="alignLeft bg-colour-blue" headers=t3hc1>B</TH><TD class=alignCenter headers="t3hr3 t3hc2 t3hc5">889</TD><TD class=alignCenter headers="t3hr3 t3hc2 t3hc6">0</TD><TD class=alignCenter headers="t3hr3 t3hc3 t3hc7">887</TD><TD class=alignCenter headers="t3hr3 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr3 t3hc4 t3hc9">NA <SUP>*</SUP></TD><TD class=alignCenter headers="t3hr3 t3hc4 t3hc10">NA <SUP>*</SUP></TD></TR><TR><TH id=t3hr4 class="alignLeft bg-colour-blue" headers=t3hc1>TOTAL</TH><TD class=alignCenter headers="t3hr4 t3hc2 t3hc5">2473</TD><TD class=alignCenter headers="t3hr4 t3hc2 t3hc6">5 (0.2%)</TD><TD class=alignCenter headers="t3hr4 t3hc3 t3hc7">2470</TD><TD class=alignCenter headers="t3hr4 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr4 t3hc4 t3hc9">1685</TD><TD class=alignCenter headers="t3hr4 t3hc4 t3hc10">1685 (100%)</TD></TR></TBODY></TABLE>
Influenza-like Illness (ILI) Consultation Rate

The national influenza-like-illness (ILI) consultation rate decreased from 8.7 consultations per 1,000 patient visits in week 30 to 3.2 per 1,000 in week 31 and increased to 10.2 per 1,000 in week 32. The rates for weeks 25 to 30, and 32, were been above the expected range for this time of year (Figure 5).
Figure 5. Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014
2014-w32-fg5-eng.gif

Note: No data available for mean rate for weeks 19 to 39 for the 1996-1997 through 2002-2003 seasons. Delays in the reporting of data may cause data to change retrospectively. The calculation of the average ILI consultation rate over 17 seasons was aligned with influenza activity in each season. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. The number of sentinel physicians in each province or territory is as follows: BC(21), AB(80), SK(11), MB(18), ON(169), QC(14), NB(29), NS(26), PE(4), NL(16), NU(1), NT(14), YT(13). Not all sentinel physicians report every week.
Text equivalent for figure 5Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

Top of Page
Influenza Outbreak Surveillance

No new outbreaks of influenza were reported in week 32. One new outbreak of influenza A(unsubtyped) was reported in a facility in week 31 (Figure 6).
Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2013-2014
2014-w32-fg6-eng.gif

1 All provinces and territories except NU report outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
Text equivalent for figure 6Overall number of new influenza outbreaks by report week, Canada, 2013-2014
Pharmacy Surveillance

In weeks 31 and 32, the proportion of prescriptions for antivirals is at inter-seasonal levels. Overall this season, the largest proportion of prescriptions for antivirals has been among children 2-18 years of age and adults 19-64 years of age (Figure 7).
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

2014-w32-fg7-eng.gif

Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group. Age-groups: Infant: 0-2y, Child: 2-18y; Adult: 19-64y, Senior: ≥65y.
Text equivalent for figure 7Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

Top of Page
Sentinel Hospital Influenza Surveillance

Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In weeks 31 and 32, one new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalization, was reported by the Immunization Monitoring Program Active (IMPACT) network, a case of influenza B in a child 2-4 years of age (Figure 8a). No ICU admissions or deaths have been reported from IMPACT since week 23.
To date this season, a total of 714 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 78% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children <5 years of age represent 73% of cases to date (Table 4). One hundred and seventeen ICU admissions have been reported, of which 75 (65%) were children <5 years of age (Figure 9a). All but 23 were cases with influenza A, and 98% of those subtyped were A(H1N1)pdm09. Among the 116 ICU cases with available data, 74 (64%) were reported to have underlying medical conditions. One death has been reported this season. A similar number of paediatric hospital admissions have been reported this year compared to the 2012-13 season.
Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
Adult Influenza Hospitalizations and Deaths (PCIRN)
Surveillance of laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network has ended for the 2013-14 season (Figure 8b). A summary of PCIRN-SOS data for the 2013-14 season will be included in the FluWatch annual report of influenza surveillance in Canada.
During passive and active surveillance* from August 25th, 2013 to May 31st, 2014, 1,985 influenza-associated hospitalizations were reported by the PCIRN-SOS network, 1,338 (67.4%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). Compared to the 2012-13 season, slightly more cases were reported, although the peak number of cases was smaller. A greater number of cases were reported during March and April compared to last year, with six times more cases of influenza B reported. ICU admission was required for 321 hospitalizations, of which 263 were cases with influenza A (137 A(H1N1)pdm09, ten A(H3N2) and 116 A(unsubtyped)), 57 were cases with influenza B and the influenza type was not reported for one case. A greater proportion of cases were admitted to the ICU this season compared to last year, but the proportion of deaths was similar. Of the ICU admissions with available information, 85.9% (189/220) were reported to have at least one comorbidity, and 68.2% (176/258) reported not having been vaccinated this season. Among the 112 deaths reported this season, all but 28 were cases of influenza A (51 A(H1N1)pdm09, three A(H3N2) and 30 A(unsubtyped)); ten cases 20-44 years of age, 37 cases 45-64 years of age and 65 cases ≥65 years of age (Figure 9b). Among fatal cases with available information, 93.8% (60/64) were reported to have at least one comorbidity, and 48.2% (40/83) reported not having been vaccinated this season.
Note: During the 2013-14 influenza season, PCIRN-SOS conducted passive surveillance from August 25<SUP>th</SUP> to November 14<SUP>th</SUP>, 2013, and May 16<SUP>th</SUP> to 31<SUP>st</SUP>. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance was conducted between November 15<SUP>th</SUP>, 2013 and May 15<SUP>th</SUP>, 2014 during which time PCIRN site coordinators investigated cases potentially related to influenza. Data from both active and passive surveillance reported during the 2013-14 season are included in this report. The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t4 class=alignCenter>Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=dr1 rowSpan=3>Age groups </TH><TH id=dc1 colSpan=6>Cumulative (Aug. 25, 2013 to August 9, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=dc2 colSpan=4 headers=dc1>Influenza A </TH><TH id=dc7 headers=dc1>B </TH><TH id=dc8 headers=dc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=dc3 headers="dc1 dc2">A Total </TH><TH id=dc4 class=bg-colour-blue headers="dc1 dc2">A(H1) pdm09 </TH><TH id=dc5 class=bg-colour-blue headers="dc1 dc2">A(H3) </TH><TH id=dc6 class=bg-colour-blue headers="dc1 dc2">A (UnS) </TH><TD class=alignCenter headers="dc1 dc7">Total</TD><TD class=alignCenter headers="dc1 dc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t4_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=dr2 class=alignLeft headers=dr1>0-5m </TH><TD class=alignCenter>106</TD><TD class=alignCenter>38</TD><TD class=alignCenter>0</TD><TD class=alignCenter>68</TD><TD class=alignCenter>12</TD><TD class=alignCenter>118 (17%)</TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignCenter>165</TD><TD class=alignCenter>62</TD><TD class=alignCenter>1</TD><TD class=alignCenter>102</TD><TD class=alignCenter>31</TD><TD class=alignCenter>196 (27%)</TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignCenter>161</TD><TD class=alignCenter>59</TD><TD class=alignCenter>3</TD><TD class=alignCenter>99</TD><TD class=alignCenter>47</TD><TD class=alignCenter>208 (29%)</TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignCenter>84</TD><TD class=alignCenter>33</TD><TD class=alignCenter>1</TD><TD class=alignCenter>50</TD><TD class=alignCenter>55</TD><TD class=alignCenter>139 (19%)</TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignCenter>39</TD><TD class=alignCenter>13</TD><TD class=alignCenter>1</TD><TD class=alignCenter>25</TD><TD class=alignCenter>14</TD><TD class=alignCenter>53 (7%)</TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignCenter>555</TD><TD class="alignCenter bg-colour-blue">205</TD><TD class="alignCenter bg-colour-blue">6</TD><TD class="alignCenter bg-colour-blue">344</TD><TD class=alignCenter>159</TD><TD class=alignCenter>714</TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP></TH><TD class=alignCenter>77.7%</TD><TD class="alignCenter bg-colour-blue">36.9%</TD><TD class="alignCenter bg-colour-blue">1.1%</TD><TD class="alignCenter bg-colour-blue">62.0%</TD><TD class=alignCenter>22.3%</TD><TD class=alignCenter>100.0%</TD></TR></TBODY></TABLE>
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 5 - Cumulative numbers of adult hospitalizations with influenza
reported by the PCIRN-SOS network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=er1 rowSpan=3>Age groups </TH><TH id=ec1 class=noWrap colSpan=6>Cumulative (Aug. 25, 2013 to 31 May, 2014)<SUP>*</SUP></TH></TR><TR class=bg-colour-yellow><TH id=ec2 colSpan=4 headers=ec1>Influenza A </TH><TH id=ec7 headers=ec1>B </TH><TH id=ec8 headers=ec1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=ec3 headers="ec1 ec2">A Total </TH><TH id=ec4 class=bg-colour-blue headers="ec1 ec2">A(H1) pdm09 </TH><TH id=ec5 class=bg-colour-blue headers="ec1 ec2">A(H3) </TH><TH id=ec6 class=bg-colour-blue headers="ec1 ec2">A(UnS) </TH><TD class=alignCenter headers="ec1 ec7">Total</TD><TD class=alignCenter headers="ec1 ec8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t5_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.

<SUP id=t5_star>*</SUP>Two cases for which the influenza type has not yet been reported, and four cases for which the age-group was not reported, are not included in Table 5.</TD></TR></TFOOT><TBODY><TR><TH id=er2 class=alignLeft headers=er1>16-20 </TH><TD class=alignCenter headers="er1 er2 ec1 ec2 ec3">13 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec4">5 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec5">1 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec6">7 </TD><TD class=alignCenter headers="er1 er2 ec1 ec7">2 </TD><TD class=alignCenter headers="er1 er2 ec1 ec8">15 (1%) </TD></TR><TR><TH id=er3 class=alignLeft headers=er1>20-44 </TH><TD class=alignCenter headers="er1 er3 ec1 ec2 ec3">276 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec4">142 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec5">7 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec6">127 </TD><TD class=alignCenter headers="er1 er3 ec1 ec7">47 </TD><TD class=alignCenter headers="er1 er3 ec1 ec8">323 (16%) </TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignCenter headers="er1 er4 ec1 ec2 ec3">521 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec4">245 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec5">12 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec6">264 </TD><TD class=alignCenter headers="er1 er4 ec1 ec7">135 </TD><TD class=alignCenter headers="er1 er4 ec1 ec8">656 (33%) </TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignCenter headers="er1 er5 ec1 ec2 ec3">525 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec4">238 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec5">61 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec6">226 </TD><TD class=alignCenter headers="er1 er5 ec1 ec7">460 </TD><TD class=alignCenter headers="er1 er5 ec1 ec8">985 (50%) </TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignCenter headers="er1 er6 ec1 ec2 ec3">1335 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec4">630 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec5">81 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec6">624 </TD><TD class=alignCenter headers="er1 er6 ec1 ec7">644 </TD><TD class=alignCenter headers="er1 er6 ec1 ec8">1979 </TD></TR><TR><TH id=er7 class=alignLeft headers=er1>%<SUP>1</SUP></TH><TD class=alignCenter headers="er1 er7 ec1 ec2 ec3">67% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec4">47% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec5">6% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec6">47% </TD><TD class=alignCenter headers="er1 er7 ec1 ec7">33% </TD><TD class=alignCenter headers="er1 er7 ec1 ec8">100% </TD></TR></TBODY></TABLE>
Figure 8. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w32-fg8a-eng.gif


Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w26-fg8b-eng.gif

* See footnote above following the section related to PCIRN-SOS data.
Text equivalent for figure 8bNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Adult hospitalizations (>16 year of age, PCIRN-SOS)
Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w32-fg9a-eng.gif

Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w26-fg9b-eng.gif

Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Adult hospitalizations (≥16 year of age, PCIRN-SOS)

Top of Page
Provincial/Territorial Influenza Hospitalizations and Deaths

In week 31 and 32, 10 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories.* The majority were cases of influenza B (9, 90%). There were two deaths and no ICU admissions reported in weeks 31 and 32. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total.
To date this season, 5,442 influenza-associated hospitalizations have been reported, 68.3% with influenza A. The majority (63.4%) of hospitalizations have been cases 45 years of age of older. A significantly greater proportion of cases of influenza B have been ≥65 years of age compared to cases of A(H1N1)pdm09 this season (Table 6). A total of 384 ICU admissions have been reported this season, of which 64.0% were adults 20-64 years of age. A total of 342 deaths have been reported. The highest proportion of deaths has been among adults ≥65 years of age (56.7%) followed by adults 20-64 years of age (35.4%). In keeping with the late-season circulation, influenza B has been increasingly reported among hospitalized cases of influenza. To date this season, influenza B has been reported in 31.7% of hospitalizations and 35.7% of deaths. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.
* Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t6 class=alignCenter>Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=t6hc1 rowSpan=3>Age groups </TH><TH id=t6hc2 colSpan=6>Cumulative (Aug. 25, 2013 to August 9, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=t6hc3 colSpan=4 headers=t6hc2>Influenza A</TH><TH id=t6hc4 headers=t6hc2>B</TH><TH id=t6hc5 headers=t6hc2>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=t6hc6 headers="t6hc2 t6hc3">A Total</TH><TH id=t6hc7 class=bg-colour-blue headers="t6hc2 t6hc3">A(H1) pdm09</TH><TH id=t6hc8 class=bg-colour-blue headers="t6hc2 t6hc3">A(H3)</TH><TH id=t6hc9 class=bg-colour-blue headers="t6hc2 t6hc3">A (UnS)</TH><TD class=alignCenter headers="t6hc2 t6hc4">Total</TD><TD class=alignCenter headers="t6hc2 t6hc5"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=8><SUP id=footnote_t6_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=t6hr1 class=alignLeft headers=t6hc1>0-4 years</TH><TD class=alignCenter>628</TD><TD class=alignCenter>290</TD><TD class=alignCenter>14</TD><TD class=alignCenter>324</TD><TD class=alignCenter>148</TD><TD class=alignCenter>776 (14%)</TD></TR><TR><TH id=t6hr2 class=alignLeft headers=t6hc1>5-14 years</TH><TD class=alignCenter>136</TD><TD class=alignCenter>65</TD><TD class=alignCenter>6</TD><TD class=alignCenter>65</TD><TD class=alignCenter>124</TD><TD class=alignCenter>260 (5%)</TD></TR><TR><TH id=t6hr3 class=alignLeft headers=t6hc1>15-19 years</TH><TD class=alignCenter>40</TD><TD class=alignCenter>23</TD><TD class=alignCenter>4</TD><TD class=alignCenter>13</TD><TD class=alignCenter>10</TD><TD class=alignCenter>50 (1%)</TD></TR><TR><TH id=t6hr4 class=alignLeft headers=t6hc1>20-44 years </TH><TD class=alignCenter>625</TD><TD class=alignCenter>425</TD><TD class=alignCenter>11</TD><TD class=alignCenter>189</TD><TD class=alignCenter>108</TD><TD class=alignCenter>733 (13%)</TD></TR><TR><TH id=t6hr5 class=alignLeft headers=t6hc1>45-64 years </TH><TD class=alignCenter>1135</TD><TD class=alignCenter>711</TD><TD class=alignCenter>36</TD><TD class=alignCenter>388</TD><TD class=alignCenter>316</TD><TD class=alignCenter>1451 (27%)</TD></TR><TR><TH id=t6hr6 class=alignLeft headers=t6hc1>65+ years </TH><TD class=alignCenter>1013</TD><TD class=alignCenter>473</TD><TD class=alignCenter>135</TD><TD class=alignCenter>405</TD><TD class=alignCenter>986</TD><TD class=alignCenter>1999 (37%)</TD></TR><TR><TH id=t6hr7 class=alignLeft headers=t6hc1>Unknown</TH><TD class=alignCenter>138</TD><TD class=alignCenter>99</TD><TD class=alignCenter>3</TD><TD class=alignCenter>36</TD><TD class=alignCenter>35</TD><TD class=alignCenter>173 (3%)</TD></TR><TR><TH id=t6hr8 class=alignLeft headers=t6hc1>Total </TH><TD class=alignCenter>3715</TD><TD class="alignCenter bg-colour-blue">2086</TD><TD class="alignCenter bg-colour-blue">209</TD><TD class="alignCenter bg-colour-blue">1420</TD><TD class=alignCenter>1727</TD><TD class=alignCenter>5442</TD></TR><TR><TH id=t6hr9 class=alignLeft headers=t6hc1>Percentage <SUP>1</SUP></TH><TD class=alignCenter>68.3%</TD><TD class="alignCenter bg-colour-blue">56.2%</TD><TD class="alignCenter bg-colour-blue">5.6%</TD><TD class="alignCenter bg-colour-blue">38.2%</TD><TD class=alignCenter>31.7%</TD><TD class=alignCenter>100%</TD></TR></TBODY></TABLE>
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2013-14 on the Public Health Agency of Canada website.

.../
http://www.phac-aspc.gc.ca/fluwatch/13-14/w32_14/index-eng.php
 
Re: Canada FluWatch Weekly Reports 2013-2014 Season Weeks 33 and 34

FluWatch report: August 10 to August 23, 2014 (Weeks 33 and 34)

Posted 2014-08-29For readers interested in the <ABBR title="Portable Document Format">PDF</ABBR> version, the document is available for downloading or viewing:
<A title="Flu Watch (Version PDF, 419 KB - 10 pages)" href="http://www.phac-aspc.gc.ca/fluwatch/13-14/w34_14/pdf/fw2014-34-eng.pdf">FluWatch report: August 10 to August 23, 2014 (Weeks 33 and 34) (<ABBR title="Portable Document Format">PDF</ABBR> Version - 419 <ABBR title=Kilobytes>KB</ABBR> - 10 pages)

?? Help with PDF documents


Overall Summary
  • Influenza activity in Canada remains at expected levels for this time of year with very few laboratory detections of influenza.
  • Other respiratory virus detections (RSV, coronavirus, and human metapneumovirus) are also at expected levels. Detections of parainfluenza and adenovirus have decreased in this reporting period.
  • In week 34, two influenza outbreaks were reported.
  • As of week 34, 5,457 hospitalizations and 344 deaths have been reported from participating regions, which is more hospitalizations but a similar number of deaths than were reported last year.
Note: This is the final report for the 2013-2014 influenza season. The first FluWatch report of the 2014-2015 influenza season will be published on September 12, 2014. Alternate week reporting will continue until October 10, 2014 when weekly reporting will resume. Laboratory detections reported through the Respiratory Virus Detection Surveillance System and influenza activity level maps continue to be updated weekly on the FluWatch website.

Are you a primary health care practitioner (General Practitioner, Nurse Practitioner or Registered Nurse) interested in becoming a FluWatch sentinel for the 2014-15 influenza season? Contact us at FluWatch@phac-aspc.gc.ca
Influenza/ILI Activity (geographic spread)

In weeks 33 and 34, most regions in Canada reported no influenza/ILI activity. In week 34, four regions (BC(1), QC(1) and NL(2)) reported sporadic activity; and two regions reported localized activity (BC(1), NL(1)). In week 33, nine regions did not report data, and in week 34, 17 regions did not report.
Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 34


right_ofmap.gif



Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
Influenza and Other Respiratory Virus Detections

The number of positive influenza tests was at inter-seasonal levels in week 33 (8 detections) and week 34 (9 detections), with <1% of tests positive for the past five weeks (Figure 2). Most jurisdictions have reported only sporadic numbers of influenza detections in recent weeks (Table 1). Over the past 8 weeks, 91 influenza detections were reported, of which 67% were influenza A and 37/44 of those subtyped were influenza A(H3N2). Compared to A(H1N1)pdm09 which was predominant earlier this season, both influenza B and A(H3N2) have affected a greater proportion of adults ≥65 years of age (Table 2).
Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
2014-w34-fg2-eng.gif

Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2013-14
In weeks 33 and 34, detections of most other respiratory viruses were at inter-seasonal levels (RSV, coronavirus, and human metapneumovirus). Parainfluenza and adenovirus are showing a downward trend. Detections of rhinovirus increased in weeks 33 and 34, which is in keeping with the usual pattern of seasonal circulation (Figure 3).
For more details, see the weekly Respiratory Virus Detections in Canada Report.
Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2013-14
2014-w34-fg3-eng.gif


Top of Page
RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2013-2014
<TABLE id=t1 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 1: Weekly and cumulative numbers of positive influenza specimens
by type, subtype and province, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=ar1 rowSpan=3>Reporting provinces <SUP>1</SUP></TH><TH id=ac1 colSpan=5>Two weeks (August 10 to 23, 2014)</TH><TH id=ac8 colSpan=5>Cumulative
(August 25, 2013 to August 23, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=ac2 colSpan=4 headers=ac1>Influenza A</TH><TH id=ac7 headers=ac1>B</TH><TH id=ac9 colSpan=4 headers=ac8>Influenza A</TH><TH id=ac14 headers=ac8>B</TH></TR><TR class=bg-colour-grey-light><TH id=ac3 headers="ac1 ac2">A Total</TH><TH id=ac4 class=" bg-colour-blue" headers="ac1 ac2">A(H1)pdm09</TH><TH id=ac5 class=" bg-colour-blue" headers="ac1 ac2">A(H3)</TH><TH id=ac6 class=" bg-colour-blue" headers="ac1 ac2">A(UnS)</TH><TH class=alignCenter headers="ac1 ac7">B Total</TH><TH id=ac10 headers="ac8 ac9">A Total</TH><TH id=ac11 class=" bg-colour-blue" headers="ac8 ac9">A(H1)pdm09</TH><TH id=ac12 class=" bg-colour-blue" headers="ac8 ac9">A(H3)</TH><TH id=ac13 class=" bg-colour-blue" headers="ac8 ac9">A(UnS)</TH><TD class=alignCenter headers="ac8 ac14">B Total</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=11><SUP>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=ar2 class=alignLeft headers=ar1>BC</TH><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac3">4 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac5">1 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac2 ac6">3 </TD><TD class=alignRight headers="ar1 ar2 ac1 ac7">0 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac10">1838 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac11">1616 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac12">77 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac9 ac13">145 </TD><TD class=alignRight headers="ar1 ar2 ac8 ac14">388 </TD></TR><TR><TH id=ar3 class=alignLeft headers=ar1>AB</TH><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac3">6 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac4">3 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac5">3 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar3 ac1 ac7">0 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac10">3911 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac11">3466 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac12">129 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac9 ac13">316 </TD><TD class=alignRight headers="ar1 ar3 ac8 ac14">573 </TD></TR><TR><TH id=ar4 class=alignLeft headers=ar1>SK</TH><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac3">1 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac4">1 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar4 ac1 ac7">0 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac10">1386 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac11">989 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac12">8 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac9 ac13">389 </TD><TD class=alignRight headers="ar1 ar4 ac8 ac14">198 </TD></TR><TR><TH id=ar5 class=alignLeft headers=ar1>MB</TH><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac3">0 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar5 ac1 ac7">0 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac10">685 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac11">463 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac12">7 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac9 ac13">215 </TD><TD class=alignRight headers="ar1 ar5 ac8 ac14">72 </TD></TR><TR><TH id=ar6 class=alignLeft headers=ar1>ON</TH><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac3">1 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac5">1 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar6 ac1 ac7">0 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac10">5848 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac11">2499 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac12">434 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac9 ac13">2915 </TD><TD class=alignRight headers="ar1 ar6 ac8 ac14">3119 </TD></TR><TR><TH id=ar7 class=alignLeft headers=ar1>QC</TH><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac3">1 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac2 ac6">1 </TD><TD class=alignRight headers="ar1 ar7 ac1 ac7">1 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac10">5382 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac11">677 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac12">6 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac9 ac13">4699 </TD><TD class=alignRight headers="ar1 ar7 ac8 ac14">2749 </TD></TR><TR><TH id=ar8 class=alignLeft headers=ar1>NB</TH><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac3">0 </TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar8 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar8 ac1 ac7">0 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac10">1491 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac11">370 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac12">2 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac9 ac13">1119 </TD><TD class=alignRight headers="ar1 ar8 ac8 ac14">134 </TD></TR><TR><TH id=ar9 class=alignLeft headers=ar1>NS</TH><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac3">0 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar9 ac1 ac7">0 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac10">175 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac11">134 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac12">5 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac9 ac13">36 </TD><TD class=alignRight headers="ar1 ar9 ac8 ac14">52 </TD></TR><TR><TH id=ar10 class=alignLeft headers=ar1>PE</TH><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac3">0 </TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar10 ac1 ac2 ac6">0 </TD><TD class=alignRight headers="ar1 ar10 ac1 ac7">0 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac10">119 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac11">118 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac12">0 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac9 ac13">1 </TD><TD class=alignRight headers="ar1 ar10 ac8 ac14">5 </TD></TR><TR><TH id=ar11 class=alignLeft headers=ar1>NL</TH><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac3">1 </TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac4">0 </TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac5">0 </TD><TD class=alignRight headers="ar1 ar11 ac1 ac2 ac6">1 </TD><TD class=alignRight headers="ar1 ar11 ac1 ac7">2 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac10">386 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac11">104 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac12">0 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac9 ac13">282 </TD><TD class=alignRight headers="ar1 ar11 ac8 ac14">267 </TD></TR><TR><TH id=ar12 class=alignLeft headers=ar1>Canada</TH><TD class=alignRight headers="ar1 ar12 ac1 ac2 ac3">14 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac4">4 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac5">5 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac1 ac2 ac6">5 </TD><TD class=alignRight headers="ar1 ar12 ac1 ac7">3 </TD><TD class=alignRight headers="ar1 ar12 ac8 ac9 ac10">21221 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac11">10436 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac12">668 </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar12 ac8 ac9 ac13">10117 </TD><TD class=alignRight headers="ar1 ar12 ac8 ac14">7557 </TD></TR><TR><TH id=ar13 class=alignLeft headers=ar1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="ar1 ar13 ac1 ac2 ac3">82.4% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac4">28.6% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac5">35.7% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac1 ac2 ac6">35.7% </TD><TD class=alignRight headers="ar1 ar13 ac1 ac7">17.6% </TD><TD class=alignRight headers="ar1 ar13 ac8 ac9 ac10">73.7% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac11">49.2% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac12">3.1% </TD><TD class="alignRight bg-colour-blue" headers="ar1 ar13 ac8 ac9 ac13">47.7% </TD><TD class=alignRight headers="ar1 ar13 ac8 ac14">26.3% </TD></TR></TBODY></TABLE>
<TABLE id=t2 class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting<SUP>3</SUP>, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=br1 rowSpan=3>Age groups (years)</TH><TH id=bc1 colSpan=5>Two weeks
(August 10 to 23, 2014)</TH><TH id=bc8 colSpan=7>Cumulative
(August 25, 2013 to August 23, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=bc2 colSpan=4 headers=bc1>Influenza A</TH><TH id=bc7 headers=bc1>B</TH><TH id=bc9 colSpan=4 headers=bc8>Influenza A</TH><TH id=bc14 headers=bc8>B</TH><TH id=bc15 colSpan=2 headers=bc8>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=bc3 headers="bc1 bc2">A Total</TH><TH id=bc4 class="bg-colour-blue " headers="bc1 bc2">A(H1) pdm09</TH><TH id=bc5 class="bg-colour-blue " headers="bc1 bc2">A(H3)</TH><TH id=bc6 class="bg-colour-blue " headers="bc1 bc2">A (UnS)</TH><TD class=alignCenter headers="bc1 bc7">Total</TD><TH id=bc10 headers="bc8 bc9">A Total</TH><TH id=bc11 class="bg-colour-blue " headers="bc8 bc9">A(H1) pdm09</TH><TH id=bc12 class="bg-colour-blue " headers="bc8 bc9">A(H3)</TH><TH id=bc13 class="bg-colour-blue " headers="bc8 bc9">A (UnS)</TH><TD class=alignCenter headers="bc8 bc14">Total</TD><TH id=bc16 headers="bc8 bc15">#</TH><TH id=bc17 headers="bc8 bc15">%</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=13><SUP id=footnote_t2_1>1 </SUP>Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.
<SUP id=footnote_t2_2>2 </SUP>Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
<SUP id=footnote_t2_3>3 </SUP>Table 2 includes specimens for which demographic information was reported. These represent a subset of all positive influenza cases reported.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=br2 class=alignLeft headers=br1><5</TH><TD class=alignRight headers="br1 br2 bc1 bc2 bc3">1 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc4">0 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc5">1 </TD><TD class=alignRight headers="br1 br2 bc1 bc2 bc6">0 </TD><TD class=alignRight headers="br1 br2 bc1 bc7">0 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc10">3274 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc11">1454 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc12">44 </TD><TD class=alignRight headers="br1 br2 bc8 bc9 bc13">1776 </TD><TD class=alignRight headers="br1 br2 bc8 bc14">558 </TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc16">3832 </TD><TD class=alignRight headers="br1 br2 bc8 bc15 bc17">16.5% </TD></TR><TR><TH id=br3 class=alignLeft headers=br1>5-19</TH><TD class=alignRight headers="br1 br3 bc1 bc2 bc3">0 </TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc4">0 </TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc5">0 </TD><TD class=alignRight headers="br1 br3 bc1 bc2 bc6">0 </TD><TD class=alignRight headers="br1 br3 bc1 bc7">1 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc10">1336 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc11">707 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc12">27 </TD><TD class=alignRight headers="br1 br3 bc8 bc9 bc13">602 </TD><TD class=alignRight headers="br1 br3 bc8 bc14">831 </TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc16">2167 </TD><TD class=alignRight headers="br1 br3 bc8 bc15 bc17">9.3% </TD></TR><TR><TH id=br4 class=alignLeft headers=br1>20-44</TH><TD class=alignRight headers="br1 br4 bc1 bc2 bc3">2 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc4">2 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc5">0 </TD><TD class=alignRight headers="br1 br4 bc1 bc2 bc6">0 </TD><TD class=alignRight headers="br1 br4 bc1 bc7">0 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc10">5117 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc11">2821 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc12">54 </TD><TD class=alignRight headers="br1 br4 bc8 bc9 bc13">2242 </TD><TD class=alignRight headers="br1 br4 bc8 bc14">1033 </TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc16">6150 </TD><TD class=alignRight headers="br1 br4 bc8 bc15 bc17">26.4% </TD></TR><TR><TH id=br5 class=alignLeft headers=br1>45-64</TH><TD class=alignRight headers="br1 br5 bc1 bc2 bc3">1 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc4">0 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc5">1 </TD><TD class=alignRight headers="br1 br5 bc1 bc2 bc6">0 </TD><TD class=alignRight headers="br1 br5 bc1 bc7">1 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc10">4496 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc11">2396 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc12">74 </TD><TD class=alignRight headers="br1 br5 bc8 bc9 bc13">2026 </TD><TD class=alignRight headers="br1 br5 bc8 bc14">1532 </TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc16">6028 </TD><TD class=alignRight headers="br1 br5 bc8 bc15 bc17">25.9% </TD></TR><TR><TH id=br6 class=alignLeft headers=br1>65+</TH><TD class=alignRight headers="br1 br6 bc1 bc2 bc3">3 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc4">0 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc5">0 </TD><TD class=alignRight headers="br1 br6 bc1 bc2 bc6">3 </TD><TD class=alignRight headers="br1 br6 bc1 bc7">1 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc10">2673 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc11">1002 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc12">182 </TD><TD class=alignRight headers="br1 br6 bc8 bc9 bc13">1489 </TD><TD class=alignRight headers="br1 br6 bc8 bc14">2286 </TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc16">4959 </TD><TD class=alignRight headers="br1 br6 bc8 bc15 bc17">21.3% </TD></TR><TR><TH id=br7 class=alignLeft headers=br1>Unknown</TH><TD class=alignRight headers="br1 br7 bc1 bc2 bc3">0 </TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc4">0 </TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc5">0 </TD><TD class=alignRight headers="br1 br7 bc1 bc2 bc6">0 </TD><TD class=alignRight headers="br1 br7 bc1 bc7">0 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc10">137 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc11">102 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc12">21 </TD><TD class=alignRight headers="br1 br7 bc8 bc9 bc13">14 </TD><TD class=alignRight headers="br1 br7 bc8 bc14">9 </TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc16">146 </TD><TD class=alignRight headers="br1 br7 bc8 bc15 bc17">0.6% </TD></TR><TR><TH id=br8 class=alignLeft headers=br1>Total</TH><TD class=alignRight headers="br1 br8 bc1 bc2 bc3">7 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc4">2 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc5">2 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc1 bc2 bc6">3 </TD><TD class=alignRight headers="br1 br8 bc1 bc7">3 </TD><TD class=alignRight headers="br1 br8 bc8 bc9 bc10">17033 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc11">8482 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc12">402 </TD><TD class="alignRight bg-colour-blue" headers="br1 br8 bc8 bc9 bc13">8149 </TD><TD class=alignRight headers="br1 br8 bc8 bc14">6249 </TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc16">23282 </TD><TD class=alignRight headers="br1 br8 bc8 bc15 bc17">100.0% </TD></TR><TR><TH id=br9 class=alignLeft headers=br1>Percentage<SUP>2</SUP></TH><TD class=alignRight headers="br1 br9 bc1 bc2 bc3">70.0% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc4">28.6% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc5">28.6% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc1 bc2 bc6">42.9% </TD><TD class=alignRight headers="br1 br9 bc1 bc7">30.0% </TD><TD class=alignRight headers="br1 br9 bc8 bc9 bc10">73.2% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc11">49.8% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc12">2.4% </TD><TD class="alignRight bg-colour-blue" headers="br1 br9 bc8 bc9 bc13">47.8% </TD><TD class=alignRight headers="br1 br9 bc8 bc14">26.8% </TD><TD class=alignRight></TD><TD class=alignRight></TD></TR></TBODY></TABLE>


Top of Page
Influenza Strain Characterizations

During the 2013-2014 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 2,486 influenza viruses [187 A(H3N2), 1,404 A(H1N1)pdm09 and 895 influenza B]. The vast majority (99%) of viruses were similar to the strains recommended by the WHO for the 2013-14 seasonal influenza vaccine. Two A(H1N1)pdm09 viruses showed reduced titres to antiserum against the reference A/California/07/2009 strain, and one A(H3N2) virus showed reduced titres to antiserum against the reference A/Texas/50/2012 strain. Thirty influenza B viruses were similar to the strain recommended by the WHO for the 2011-12 vaccine (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2013-2014, N = 2486
2014-w34-fg4-eng.gif

The NML receives a proportion of the number of influenza positive specimens from provincial laboratories for strain characterization and antiviral resistance testing. Characterization data reflect the results of haemagglutination inhibition (HAI) testing compared to the reference influenza strains recommended by WHO.
The recommended components for the 2013-2014 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b (e.g. A/Texas/50/2012), and a B/Massachusetts/2/2012-like virus (Yamagata lineage).


Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
Antiviral Resistance

During the 2013-2014 influenza season, NML has tested 2,491 influenza viruses for resistance to oseltamivir and all but five were sensitive. All 2,488 viruses tested for resistance to zanamivir were sensitive. All 1,686 influenza A viruses tested for amantadine resistance were resistant (Table 3).
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION>Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2013-2014</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=t3hc1 rowSpan=2>Virus type and subtype</TH><TH id=t3hc2 colSpan=2>Oseltamivir</TH><TH id=t3hc3 colSpan=2>Zanamivir</TH><TH id=t3hc4 colSpan=2>Amantadine</TH></TR><TR class=bg-colour-yellow><TH id=t3hc5 headers=t3hc2># tested</TH><TH id=t3hc6 headers=t3hc2># resistant (%)</TH><TH id=t3hc7 headers=t3hc3># tested</TH><TH id=t3hc8 headers=t3hc3># resistant (%)</TH><TH id=t3hc9 headers=t3hc4># tested</TH><TH id=t3hc10 headers=t3hc4># resistant (%)</TH></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP>*</SUP> NA - not applicable</TD></TR></TFOOT><TBODY><TR><TH id=t3hr1 class="alignLeft bg-colour-blue" headers=t3hc1>A (H3N2)</TH><TD class=alignCenter headers="t3hr1 t3hc2 t3hc5">182</TD><TD class=alignCenter headers="t3hr1 t3hc2 t3hc6">0</TD><TD class=alignCenter headers="t3hr1 t3hc3 t3hc7">180</TD><TD class=alignCenter headers="t3hr1 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr1 t3hc4 t3hc9">227</TD><TD class=alignCenter headers="t3hr1 t3hc4 t3hc10">227 (100%)</TD></TR><TR><TH id=t3hr2 class="alignLeft bg-colour-blue" headers=t3hc1>A (H1N1)</TH><TD class=alignCenter headers="t3hr2 t3hc2 t3hc5">1412</TD><TD class=alignCenter headers="t3hr2 t3hc2 t3hc6">5 (0.4%)</TD><TD class=alignCenter headers="t3hr2 t3hc3 t3hc7">1413</TD><TD class=alignCenter headers="t3hr2 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr2 t3hc4 t3hc9">1459</TD><TD class=alignCenter headers="t3hr2 t3hc4 t3hc10">1459 (100%)</TD></TR><TR><TH id=t3hr3 class="alignLeft bg-colour-blue" headers=t3hc1>B</TH><TD class=alignCenter headers="t3hr3 t3hc2 t3hc5">897</TD><TD class=alignCenter headers="t3hr3 t3hc2 t3hc6">0</TD><TD class=alignCenter headers="t3hr3 t3hc3 t3hc7">895</TD><TD class=alignCenter headers="t3hr3 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr3 t3hc4 t3hc9">NA <SUP>*</SUP></TD><TD class=alignCenter headers="t3hr3 t3hc4 t3hc10">NA <SUP>*</SUP></TD></TR><TR><TH id=t3hr4 class="alignLeft bg-colour-blue" headers=t3hc1>TOTAL</TH><TD class=alignCenter headers="t3hr4 t3hc2 t3hc5">2491</TD><TD class=alignCenter headers="t3hr4 t3hc2 t3hc6">5 (0.2%)</TD><TD class=alignCenter headers="t3hr4 t3hc3 t3hc7">2488</TD><TD class=alignCenter headers="t3hr4 t3hc3 t3hc8">0</TD><TD class=alignCenter headers="t3hr4 t3hc4 t3hc9">1686</TD><TD class=alignCenter headers="t3hr4 t3hc4 t3hc10">1686 (100%)</TD></TR></TBODY></TABLE>
Influenza-like Illness (ILI) Consultation Rate

The national influenza-like-illness (ILI) consultation rate decreased from 9.0 consultations per 1,000 patient visits in week 32 to 5.4 per 1,000 in week 33 and increased to 7.9 per 1,000 in week 34. The rates for weeks 25 to 34 were above the expected range for this time of year (Figure 5).
Figure 5. Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014
2014-w34-fg5-eng.gif

Note: No data available for mean rate for weeks 19 to 39 for the 1996-1997 through 2002-2003 seasons. Delays in the reporting of data may cause data to change retrospectively. The calculation of the average ILI consultation rate over 17 seasons was aligned with influenza activity in each season. In BC, AB, and SK, data is compiled by a provincial sentinel surveillance program for reporting to FluWatch. The number of sentinel physicians in each province or territory is as follows: BC(21), AB(80), SK(11), MB(18), ON(169), QC(14), NB(29), NS(26), PE(4), NL(16), NU(1), NT(14), YT(13). Not all sentinel physicians report every week.
Text equivalent for figure 5Influenza-like-illness (ILI) consultation rates by report week, compared to the 1996-97 through to 2012-13 seasons (with pandemic data suppressed), Canada, 2013-2014

Top of Page
Influenza Outbreak Surveillance

No new outbreaks of influenza were reported in week 33. Two new outbreaks were reported in week 34: one in a long-term care facility and the other in another setting (Figure 6).
Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2013-2014
2014-w34-fg6-eng.gif

1 All provinces and territories except NU report outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals. Outbreaks of influenza or influenza-like-illness in other facilities are reported to FluWatch but reporting varies between jurisdictions. Outbreak definitions are included at the end of the report.
Text equivalent for figure 6Overall number of new influenza outbreaks by report week, Canada, 2013-2014
Pharmacy Surveillance

In weeks 33 and 34, the proportion of prescriptions for antivirals is at inter-seasonal levels. Overall this season, the largest proportion of prescriptions for antivirals has been among children 2-18 years of age and adults 19-64 years of age (Figure 7).
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14
2014-w34-fg7-eng.gif

Note: Pharmacy sales data are provided to the Public Health Agency of Canada by Rx Canada Inc. and sourced from major retail drug chains representing over 3,000 stores nationwide (excluding Nunavut) in 85% of Health Regions. Data provided include the number of new antiviral prescriptions (for Tamiflu and Relenza) and the total number of new prescriptions dispensed by Province/Territory and age group. Age-groups: Infant: 0-2y, Child: 2-18y; Adult: 19-64y, Senior: ≥65y.
Text equivalent for figure 7Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2013-14

Top of Page
Sentinel Hospital Influenza Surveillance

Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In weeks 33 and 34, no new laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network (Figure 8a). No ICU admissions or deaths have been reported from IMPACT since week 23.
To date this season, a total of 714 influenza-associated paediatric hospitalizations have been reported by the IMPACT network, 78% of which have been influenza A, and almost all of those subtyped (97%) were A(H1N1)pdm09. Children <5 years of age represent 73% of cases to date (Table 4). One hundred and sixteen ICU admissions have been reported, of which 75 (65%) were children <5 years of age (Figure 9a). All but 22 were cases with influenza A, and 98% of those subtyped were A(H1N1)pdm09. Among the 116 ICU cases with available data, 74 (64%) were reported to have underlying medical conditions. One death has been reported this season. A similar number of paediatric hospital admissions have been reported this year compared to the 2012-13 season.
Note: The number of hospitalizations reported through IMPACT represents a subset of all influenza-associated paediatric hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
Adult Influenza Hospitalizations and Deaths (PCIRN)
Surveillance of laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network has ended for the 2013-14 season (Figure 8b). A summary of PCIRN-SOS data for the 2013-14 season will be included in the FluWatch annual report of influenza surveillance in Canada.
During passive and active surveillance* from August 25th, 2013 to May 31st, 2014, 1,985 influenza-associated hospitalizations were reported by the PCIRN-SOS network, 1,338 (67.4%) with influenza A, predominantly A(H1N1)pdm09 (Table 5). Compared to the 2012-13 season, slightly more cases were reported, although the peak number of cases was smaller. A greater number of cases were reported during March and April compared to last year, with six times more cases of influenza B reported. ICU admission was required for 321 hospitalizations, of which 263 were cases with influenza A (137 A(H1N1)pdm09, ten A(H3N2) and 116 A(unsubtyped)), 57 were cases with influenza B and the influenza type was not reported for one case. A greater proportion of cases were admitted to the ICU this season compared to last year, but the proportion of deaths was similar. Of the ICU admissions with available information, 85.9% (189/220) were reported to have at least one comorbidity, and 68.2% (176/258) reported not having been vaccinated this season. Among the 112 deaths reported this season, all but 28 were cases of influenza A (51 A(H1N1)pdm09, three A(H3N2) and 30 A(unsubtyped)); ten cases 20-44 years of age, 37 cases 45-64 years of age and 65 cases ≥65 years of age (Figure 9b). Among fatal cases with available information, 93.8% (60/64) were reported to have at least one comorbidity, and 48.2% (40/83) reported not having been vaccinated this season.
Note: During the 2013-14 influenza season, PCIRN-SOS conducted passive surveillance from August 25<SUP>th</SUP> to November 14<SUP>th</SUP>, 2013, and May 16<SUP>th</SUP> to 31<SUP>st</SUP>. Cases reported during this period were identified by laboratory detection of influenza among patients admitted to participating hospitals. Active surveillance was conducted between November 15<SUP>th</SUP>, 2013 and May 15<SUP>th</SUP>, 2014 during which time PCIRN site coordinators investigated cases potentially related to influenza. Data from both active and passive surveillance reported during the 2013-14 season are included in this report. The number of hospitalizations reported through PCIRN represents a subset of all influenza-associated adult hospitalizations in Canada. Delays in the reporting of data may cause data to change retrospectively.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t4 class=alignCenter>Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=dr1 rowSpan=3>Age groups </TH><TH id=dc1 colSpan=6>Cumulative (Aug. 25, 2013 to August 23, 2014) </TH></TR><TR class=bg-colour-yellow><TH id=dc2 colSpan=4 headers=dc1>Influenza A </TH><TH id=dc7 headers=dc1>B </TH><TH id=dc8 headers=dc1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=dc3 headers="dc1 dc2">A Total </TH><TH id=dc4 class=bg-colour-blue headers="dc1 dc2">A(H1) pdm09 </TH><TH id=dc5 class=bg-colour-blue headers="dc1 dc2">A(H3) </TH><TH id=dc6 class=bg-colour-blue headers="dc1 dc2">A (UnS) </TH><TD class=alignCenter headers="dc1 dc7">Total</TD><TD class=alignCenter headers="dc1 dc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t4_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=dr2 class=alignLeft headers=dr1>0-5m </TH><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc3">107 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc4">38 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc5">0 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc2 dc6">69 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc7">11 </TD><TD class=alignCenter headers="dr1 dr2 dc1 dc8">118 (17%) </TD></TR><TR><TH id=dr3 class=alignLeft headers=dr1>6-23m </TH><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc3">166 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc4">63 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc5">1 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc2 dc6">102 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc7">31 </TD><TD class=alignCenter headers="dr1 dr3 dc1 dc8">197 (28%) </TD></TR><TR><TH id=dr4 class=alignLeft headers=dr1>2-4y </TH><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc3">161 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc4">59 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc5">3 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc2 dc6">99 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc7">47 </TD><TD class=alignCenter headers="dr1 dr4 dc1 dc8">208 (29%) </TD></TR><TR><TH id=dr5 class=alignLeft headers=dr1>5-9y </TH><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc3">83 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc4">33 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc5">1 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc2 dc6">49 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc7">55 </TD><TD class=alignCenter headers="dr1 dr5 dc1 dc8">138 (19%) </TD></TR><TR><TH id=dr6 class=alignLeft headers=dr1>10-16y </TH><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc3">38 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc4">13 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc5">1 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc2 dc6">24 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc7">15 </TD><TD class=alignCenter headers="dr1 dr6 dc1 dc8">53 (7%) </TD></TR><TR><TH id=dr7 class=alignLeft headers=dr1>Total </TH><TD class=alignCenter headers="dr1 dr7 dc1 dc2 dc3">555 </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc4">206 </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc5">6 </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr7 dc1 dc2 dc6">343 </TD><TD class=alignCenter headers="dr1 dr7 dc1 dc7">159 </TD><TD class=alignCenter headers="dr1 dr7 dc1 dc8">714 </TD></TR><TR><TH id=dr8 class=alignLeft headers=dr1>% <SUP>1</SUP></TH><TD class=alignCenter headers="dr1 dr8 dc1 dc2 dc3">77.7% </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc4">37.1% </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc5">1.1% </TD><TD class="bg-colour-blue alignCenter" headers="dr1 dr8 dc1 dc2 dc6">61.8% </TD><TD class=alignCenter headers="dr1 dr8 dc1 dc7">22.3% </TD><TD class=alignCenter headers="dr1 dr8 dc1 dc8">100.0% </TD></TR></TBODY></TABLE>
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION class=alignCenter>Table 5 - Cumulative numbers of adult hospitalizations with influenza
reported by the PCIRN-SOS network, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=er1 rowSpan=3>Age groups </TH><TH id=ec1 class=noWrap colSpan=6>Cumulative (Aug. 25, 2013 to 31 May, 2014)<SUP>*</SUP></TH></TR><TR class=bg-colour-yellow><TH id=ec2 colSpan=4 headers=ec1>Influenza A </TH><TH id=ec7 headers=ec1>B </TH><TH id=ec8 headers=ec1>Influenza A and B </TH></TR><TR class=bg-colour-grey-light><TH id=ec3 headers="ec1 ec2">A Total </TH><TH id=ec4 class=bg-colour-blue headers="ec1 ec2">A(H1) pdm09 </TH><TH id=ec5 class=bg-colour-blue headers="ec1 ec2">A(H3) </TH><TH id=ec6 class=bg-colour-blue headers="ec1 ec2">A(UnS) </TH><TD class=alignCenter headers="ec1 ec7">Total</TD><TD class=alignCenter headers="ec1 ec8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=7><SUP id=footnote_t5_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.

<SUP id=t5_star>*</SUP>Two cases for which the influenza type has not yet been reported, and four cases for which the age-group was not reported, are not included in Table 5.</TD></TR></TFOOT><TBODY><TR><TH id=er2 class=alignLeft headers=er1>16-20 </TH><TD class=alignCenter headers="er1 er2 ec1 ec2 ec3">13 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec4">5 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec5">1 </TD><TD class=alignCenter headers="er1 er2 ec1 ec2 ec6">7 </TD><TD class=alignCenter headers="er1 er2 ec1 ec7">2 </TD><TD class=alignCenter headers="er1 er2 ec1 ec8">15 (1%) </TD></TR><TR><TH id=er3 class=alignLeft headers=er1>20-44 </TH><TD class=alignCenter headers="er1 er3 ec1 ec2 ec3">276 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec4">142 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec5">7 </TD><TD class=alignCenter headers="er1 er3 ec1 ec2 ec6">127 </TD><TD class=alignCenter headers="er1 er3 ec1 ec7">47 </TD><TD class=alignCenter headers="er1 er3 ec1 ec8">323 (16%) </TD></TR><TR><TH id=er4 class=alignLeft headers=er1>45-64 </TH><TD class=alignCenter headers="er1 er4 ec1 ec2 ec3">521 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec4">245 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec5">12 </TD><TD class=alignCenter headers="er1 er4 ec1 ec2 ec6">264 </TD><TD class=alignCenter headers="er1 er4 ec1 ec7">135 </TD><TD class=alignCenter headers="er1 er4 ec1 ec8">656 (33%) </TD></TR><TR><TH id=er5 class=alignLeft headers=er1>65+ </TH><TD class=alignCenter headers="er1 er5 ec1 ec2 ec3">525 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec4">238 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec5">61 </TD><TD class=alignCenter headers="er1 er5 ec1 ec2 ec6">226 </TD><TD class=alignCenter headers="er1 er5 ec1 ec7">460 </TD><TD class=alignCenter headers="er1 er5 ec1 ec8">985 (50%) </TD></TR><TR><TH id=er6 class=alignLeft headers=er1>Total </TH><TD class=alignCenter headers="er1 er6 ec1 ec2 ec3">1335 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec4">630 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec5">81 </TD><TD class="bg-colour-blue alignCenter" headers="er1 er6 ec1 ec2 ec6">624 </TD><TD class=alignCenter headers="er1 er6 ec1 ec7">644 </TD><TD class=alignCenter headers="er1 er6 ec1 ec8">1979 </TD></TR><TR><TH id=er7 class=alignLeft headers=er1>%<SUP>1</SUP></TH><TD class=alignCenter headers="er1 er7 ec1 ec2 ec3">67% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec4">47% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec5">6% </TD><TD class="bg-colour-blue alignCenter" headers="er1 er7 ec1 ec2 ec6">47% </TD><TD class=alignCenter headers="er1 er7 ec1 ec7">33% </TD><TD class=alignCenter headers="er1 er7 ec1 ec8">100% </TD></TR></TBODY></TABLE>
Figure 8. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w34-fg8a-eng.gif


Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w26-fg8b-eng.gif

* See footnote above following the section related to PCIRN-SOS data.
Text equivalent for figure 8bNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2013-14: Adult hospitalizations (>16 year of age, PCIRN-SOS)
Figure 9. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2014-w34-fg9a-eng.gif

Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2014-w26-fg9b-eng.gif

Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2013-14: Adult hospitalizations (≥16 year of age, PCIRN-SOS)

Top of Page
Provincial/Territorial Influenza Hospitalizations and Deaths

In weeks 33 and 34, two laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories*, both adults ≥65 years of age. There were no deaths and only one ICU admission reported in weeks 33 and 34. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total.
To date this season, 5,457 influenza-associated hospitalizations have been reported, 68.3% with influenza A. The majority (63.4%) of hospitalizations have been cases 45 years of age of older. A significantly greater proportion of cases of influenza B have been ≥65 years of age compared to cases of A(H1N1)pdm09 this season (Table 6). A total of 394 ICU admissions have been reported this season, of which 65.0% were adults 20-64 years of age. A total of 344 deaths have been reported. The highest proportion of deaths has been among adults ≥65 years of age (56.1%) followed by adults 20-64 years of age (36.6%). In keeping with the late-season circulation, influenza B has been increasingly reported among hospitalized cases of influenza. To date this season, influenza B has been reported in 31.7% of hospitalizations and 35.5% of deaths. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.
* Note: Influenza-associated hospitalizations are not reported to PHAC by the following Provinces and Territory: BC, NU, QC, and NB. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks.
<TABLE class=widthFull border=1 cellSpacing=0 cellPadding=2><CAPTION id=t6 class=alignCenter>Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2013-14</CAPTION><THEAD><TR class=bg-colour-yellow><TH id=fr1 rowSpan=3>Age groups </TH><TH id=fc1 colSpan=6>Cumulative (Aug. 25, 2013 to August 23, 2014)</TH></TR><TR class=bg-colour-yellow><TH id=fc2 colSpan=4 headers=fc1>Influenza A</TH><TH id=fc7 headers=fc1>B</TH><TH id=fc8 headers=fc1>Influenza A and B</TH></TR><TR class=bg-colour-grey-light><TH id=fc3 headers="fc1 fc2">A Total</TH><TH id=fc4 class=bg-colour-blue headers="fc1 fc2">A(H1) pdm09</TH><TH id=fc5 class=bg-colour-blue headers="fc1 fc2">A(H3)</TH><TH id=fc6 class=bg-colour-blue headers="fc1 fc2">A (UnS)</TH><TD class=alignCenter headers="fc1 fc7">Total</TD><TD class=alignCenter headers="fc1 fc8"># (%)</TD></TR></THEAD><TFOOT><TR><TD class=fontSize85 colSpan=8><SUP id=footnote_t6_1>1</SUP> Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.</TD></TR></TFOOT><TBODY><TR><TH id=fr2 class=alignLeft headers=fr1>0-4 years</TH><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc3">630 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc4">295 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc5">14 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc2 fc6">321 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc7">148 </TD><TD class=alignCenter headers="fr1 fr2 fc1 fc8">778 (14%) </TD></TR><TR><TH id=fr3 class=alignLeft headers=fr1>5-14 years</TH><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc3">136 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc4">65 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc5">6 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc2 fc6">65 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc7">124 </TD><TD class=alignCenter headers="fr1 fr3 fc1 fc8">260 (5%) </TD></TR><TR><TH id=fr4 class=alignLeft headers=fr1>15-19 years</TH><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc3">40 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc4">23 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc5">4 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc2 fc6">13 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc7">10 </TD><TD class=alignCenter headers="fr1 fr4 fc1 fc8">50 (1%) </TD></TR><TR><TH id=fr5 class=alignLeft headers=fr1>20-44 years </TH><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc3">628</TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc4">430 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc5">10 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc2 fc6">188 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc7">108 </TD><TD class=alignCenter headers="fr1 fr5 fc1 fc8">736 (13%) </TD></TR><TR><TH id=fr6 class=alignLeft headers=fr1>45-64 years </TH><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc3">1141 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc4">717 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc5">36 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc2 fc6">388 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc7">316 </TD><TD class=alignCenter headers="fr1 fr6 fc1 fc8">1457 (27%) </TD></TR><TR><TH id=fr7 class=alignLeft headers=fr1>65+ years </TH><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc3">1015 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc4">474 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc5">136 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc2 fc6">405 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc7">988 </TD><TD class=alignCenter headers="fr1 fr7 fc1 fc8">2003 (37%) </TD></TR><TR><TH id=fr10 class=alignLeft headers=fr1>Unknown</TH><TD class=alignCenter headers="fc1 fc2 fc3">138 </TD><TD class=alignCenter headers="fc1 fc2 fc4">99 </TD><TD class=alignCenter headers="fc1 fc2 fc5">3 </TD><TD class=alignCenter headers="fc1 fc2 fc6">36 </TD><TD class=alignCenter headers="fc1 fc7">35 </TD><TD class=alignCenter headers="fc1 fc8">173 (3%) </TD></TR><TR><TH id=fr8 class=alignLeft headers=fr1>Total </TH><TD class=alignCenter headers="fr1 fr8 fc1 fc2 fc3">3728</TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc4">2103 </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc5">209 </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr8 fc1 fc2 fc6">1416 </TD><TD class=alignCenter headers="fr1 fr8 fc1 fc7">1729 </TD><TD class=alignCenter headers="fr1 fr8 fc1 fc8">5457 </TD></TR><TR><TH id=fr9 class=alignLeft headers=fr1>Percentage <SUP>1</SUP></TH><TD class=alignCenter headers="fr1 fr9 fc1 fc2 fc3">68.3% </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc4">56.4% </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc5">5.6% </TD><TD class="bg-colour-blue alignCenter" headers="fr1 fr9 fc1 fc2 fc6">38.0% </TD><TD class=alignCenter headers="fr1 fr9 fc1 fc7">31.7% </TD><TD class=alignCenter headers="fr1 fr9 fc1 fc8">100% </TD></TR></TBODY></TABLE>
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2013-14 on the Public Health Agency of Canada website.

.../
http://www.phac-aspc.gc.ca/fluwatch/13-14/w34_14/index-eng.php
 
You must log in or register to reply here.
Back
Top