• 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 2014-2015 Season Week 20

[h=1]FluWatch report: February 8 to 14, 2015 (Week 6)[/h] Posted 2015-02-20 For readers interested in the PDF version, the document is available for downloading or viewing:
FluWatch report: February 8 to 14, 2015 (Week 6) (PDF Version - 385 KB - 10 pages)

?? Help with PDF documents

Overall Summary
  • In week 06, all influenza indicators declined from, or remained similar to, the previous week.
  • Influenza activity in the Central and the Atlantic Provinces continued into week 06 (mainly due to influenza A) while activity in the Western provinces and the Territories declined.
  • For the past few weeks, influenza B detections have been increasing steadily, particularly in the Prairies and in Quebec.
  • A(H3N2) continues to be the most common type of influenza affecting Canadians. Seniors continue to have the highest number of positive laboratory detections, hospitalizations and deaths.
  • Detections of respiratory syncytial virus (RSV) continue to be the second most frequently detected virus after influenza.
  • Evidence from the National Microbiology Laboratory (NML) does indicate that this year?s vaccine will continue to provide protection against the circulating A(H1N1) and B strains.

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
[h=2]Influenza/ILI Activity (geographic spread)[/h] In week 06, seven regions reported widespread activity: in MB, ON(2). QC(2), PEI and NL. Twenty-one regions reported localized activity: in AB, MB, ON(5), QC(2), NB(7), and NS(5). Twenty-two regions reported sporadic activity: in YK, NT(2), NU, BC(5), AB(4), SK(3), MB(2), QC(2), NS, and NL. No activity was reported for eight regions: NU(2), MB, NS(3) and NF(2). Compared to the previous week, influenza activity declined overall in the Western provinces while influenza activity increased or remained similar in the Central and Atlantic provinces.
Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 6​
​
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
[h=2]Influenza and Other Respiratory Virus Detections[/h] In week 06, the number of positive influenza tests (1,625) and the percentage positive for influenza A (16.3%) continued to decline from the previous week The percentage of positive influenza B tests continued to increase and was 3.6 % in week 06, the highest this season thus far (Figure 2). In week 06, influenza B accounted for 33%-52% of influenza detections in AB, SK and QC. To date, 95% of influenza detections have been influenza A, and 99.7% of those subtyped have been A(H3N2) (Table 1). To date this season, detailed information on age and type/subtype has been received for 28,650 cases. A significantly greater proportion of laboratory detections of influenza have been reported in adults ≥65 years of age (61%) this season (Table 2) compared to the 2013-14 season when only 15.6% of cases were in adults ≥65 years of age.
Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2014-15​
2015-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
In week 06, the number of positive respiratory syncytial virus (RSV) tests decreased to 914 RSV detections and remains the second most frequently detected virus after influenza (Figure 3). In week 06, the percent positive for RSV detections were highest in the Prairies and has surpassed the percent positive for influenza detections in those regions. Detections of RSV since week 38 have been higher than in the previous season. Detections of all other respiratory viruses except human metapneumovirus decreased in week 06. Detections of respiratory viruses (other than RSV) have generally been lower this season compared to the previous season.
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, 2014-15​
2015-w06-fg3-eng.gif
​
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 marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 1: Weekly and cumulative numbers of positive influenza specimens
by type, subtype and province, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Reporting provinces [SUP]1[/SUP] Weekly
(February 8 to February 14, 2015) Cumulative
(August 24 to February 14, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1)pdm09 A(H3) A(UnS) B Total A Total A(H1)pdm09 A(H3) A(UnS) [TD="class: alignCenter"]B Total[/TD]
[/TR]
[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]
[TR]
BC [TD="class: alignCenter"]174[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]102[/TD]
[TD="class: alignCenter"]69[/TD]
[TD="class: alignCenter"]9[/TD]
[TD="class: alignCenter"]3046[/TD]
[TD="class: alignCenter"]12[/TD]
[TD="class: alignCenter"]2228[/TD]
[TD="class: alignCenter"]806[/TD]
[TD="class: alignCenter"]93[/TD]
[/TR]
[TR]
AB [TD="class: alignCenter"]31[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]22[/TD]
[TD="class: alignCenter"]9[/TD]
[TD="class: alignCenter"]33[/TD]
[TD="class: alignCenter"]3573[/TD]
[TD="class: alignCenter"]8[/TD]
[TD="class: alignCenter"]3412[/TD]
[TD="class: alignCenter"]153[/TD]
[TD="class: alignCenter"]371[/TD]
[/TR]
[TR]
SK [TD="class: alignCenter"]18[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]13[/TD]
[TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]12[/TD]
[TD="class: alignCenter"]1610[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1092[/TD]
[TD="class: alignCenter"]518[/TD]
[TD="class: alignCenter"]46[/TD]
[/TR]
[TR]
MB [TD="class: alignCenter"]32[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]29[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]1078[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]369[/TD]
[TD="class: alignCenter"]709[/TD]
[TD="class: alignCenter"]33[/TD]
[/TR]
[TR]
ON [TD="class: alignCenter"]535[/TD]
[TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]199[/TD]
[TD="class: alignCenter"]331[/TD]
[TD="class: alignCenter"]37[/TD]
[TD="class: alignCenter"]9422[/TD]
[TD="class: alignCenter"]17[/TD]
[TD="class: alignCenter"]4079[/TD]
[TD="class: alignCenter"]5326[/TD]
[TD="class: alignCenter"]152[/TD]
[/TR]
[TR]
QC [TD="class: alignCenter"]366[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]366[/TD]
[TD="class: alignCenter"]181[/TD]
[TD="class: alignCenter"]10517[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]422[/TD]
[TD="class: alignCenter"]10091[/TD]
[TD="class: alignCenter"]716[/TD]
[/TR]
[TR]
NB [TD="class: alignCenter"]89[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]89[/TD]
[TD="class: alignCenter"]11[/TD]
[TD="class: alignCenter"]665[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]102[/TD]
[TD="class: alignCenter"]563[/TD]
[TD="class: alignCenter"]35[/TD]
[/TR]
[TR]
NS [TD="class: alignCenter"]49[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]49[/TD]
[TD="class: alignCenter"]8[/TD]
[TD="class: alignCenter"]353[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]123[/TD]
[TD="class: alignCenter"]230[/TD]
[TD="class: alignCenter"]34[/TD]
[/TR]
[TR]
PE [TD="class: alignCenter"]18[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]18[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]98[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]95[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]2[/TD]
[/TR]
[TR]
NL [TD="class: alignCenter"]17[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]17[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]537[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]53[/TD]
[TD="class: alignCenter"]484[/TD]
[TD="class: alignCenter"]4[/TD]
[/TR]
[TR]
Canada [TD="class: alignCenter"]1,329[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]8[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]357[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]964[/TD]
[TD="class: alignCenter"]296[/TD]
[TD="class: alignCenter"]30899[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]42[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]11975[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]18882[/TD]
[TD="class: alignCenter"]1486[/TD]
[/TR]
[TR]
Percentage[SUP]2[/SUP] [TD="class: alignCenter"]81.8%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]0.6%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]26.9%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]72.5%[/TD]
[TD="class: alignCenter"]18.2%[/TD]
[TD="class: alignCenter"]95.4%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]0.1%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]38.8%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]61.1%[/TD]
[TD="class: alignCenter"]4.6%[/TD]
[/TR]
[/TABLE]
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
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, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups (years) Weekly
(February 8 to February 14, 2015) Cumulative
(August 24 to February 14, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) [TD="class: alignCenter"]Total[/TD]
A Total A(H1) pdm09 A(H3) A (UnS) [TD="class: alignCenter"]Total[/TD]
# % [/TR]
[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]
[TR]
<5 [TD="class: alignCenter"]61[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]8[/TD]
[TD="class: alignCenter"]53[/TD]
[TD="class: alignCenter"]18[/TD]
[TD="class: alignCenter"]1875[/TD]
[TD="class: alignCenter"]9[/TD]
[TD="class: alignCenter"]734[/TD]
[TD="class: alignCenter"]1132[/TD]
[TD="class: alignCenter"]119[/TD]
[TD="class: alignCenter"]1994[/TD]
[TD="class: alignCenter"]7.0%[/TD]
[/TR]
[TR]
5-19 [TD="class: alignCenter"]29[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]25[/TD]
[TD="class: alignCenter"]38[/TD]
[TD="class: alignCenter"]1654[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]900[/TD]
[TD="class: alignCenter"]753[/TD]
[TD="class: alignCenter"]191[/TD]
[TD="class: alignCenter"]1845[/TD]
[TD="class: alignCenter"]6.4%[/TD]
[/TR]
[TR]
20-44 [TD="class: alignCenter"]58[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]7[/TD]
[TD="class: alignCenter"]51[/TD]
[TD="class: alignCenter"]46[/TD]
[TD="class: alignCenter"]3154[/TD]
[TD="class: alignCenter"]11[/TD]
[TD="class: alignCenter"]1545[/TD]
[TD="class: alignCenter"]1598[/TD]
[TD="class: alignCenter"]222[/TD]
[TD="class: alignCenter"]3376[/TD]
[TD="class: alignCenter"]11.8%[/TD]
[/TR]
[TR]
45-64 [TD="class: alignCenter"]106[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]13[/TD]
[TD="class: alignCenter"]93[/TD]
[TD="class: alignCenter"]58[/TD]
[TD="class: alignCenter"]3480[/TD]
[TD="class: alignCenter"]10[/TD]
[TD="class: alignCenter"]1516[/TD]
[TD="class: alignCenter"]1954[/TD]
[TD="class: alignCenter"]322[/TD]
[TD="class: alignCenter"]3802[/TD]
[TD="class: alignCenter"]13.3%[/TD]
[/TR]
[TR]
65+ [TD="class: alignCenter"]441[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]57[/TD]
[TD="class: alignCenter"]384[/TD]
[TD="class: alignCenter"]82[/TD]
[TD="class: alignCenter"]17033[/TD]
[TD="class: alignCenter"]8[/TD]
[TD="class: alignCenter"]6663[/TD]
[TD="class: alignCenter"]10362[/TD]
[TD="class: alignCenter"]490[/TD]
[TD="class: alignCenter"]17523[/TD]
[TD="class: alignCenter"]61.2%[/TD]
[/TR]
[TR]
Unknown [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"]108[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]92[/TD]
[TD="class: alignCenter"]16[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]110[/TD]
[TD="class: alignCenter"]0.4%[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]699[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]0[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]92[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]607[/TD]
[TD="class: alignCenter"]242[/TD]
[TD="class: alignCenter"]27304[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]39[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]11450[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]15815[/TD]
[TD="class: alignCenter"]1346[/TD]
[TD="class: alignCenter"]28650[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[TR]
Percentage[SUP]2[/SUP] [TD="class: alignCenter"]74.3%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]0.0%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]13.2%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]86.8%[/TD]
[TD="class: alignCenter"]25.7%[/TD]
[TD="class: alignCenter"]95.3%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]0.1%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]41.9%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]57.9%[/TD]
[TD="class: alignCenter"]4.7%[/TD]
[TD="class: alignCenter"] [/TD]
[TD="class: alignCenter"] [/TD]
[/TR]
[/TABLE]
[h=2]Antiviral Resistance[/h] During the 2014-2015 influenza season, the NML has tested 575 influenza viruses for resistance to oseltamivir and 574 influenza viruses for resistance to zanamivir and all were sensitive to both agents. A total of 856 (99.9%) influenza A viruses were resistant to amantadine (Table 3).
[TABLE="class: widthFull, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Virus type and subtype Oseltamivir Zanamivir Amantadine [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
# tested # resistant (%) # tested # resistant (%) # tested # resistant (%) [/TR]
[TR]
[TD="class: fontSize85, colspan: 7"][SUP]*[/SUP] NA - not applicable[/TD]
[/TR]
[TR]
A (H3N2) [TD="class: alignCenter"]491[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]490[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]855[/TD]
[TD="class: alignCenter"]854 (99.9%)[/TD]
[/TR]
[TR]
A (H1N1) [TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]2 (100%)[/TD]
[/TR]
[TR]
B [TD="class: alignCenter"]82[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]82[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]NA [SUP]*[/SUP][/TD]
[TD="class: alignCenter"]NA [SUP]*[/SUP][/TD]
[/TR]
[TR]
TOTAL [TD="class: alignCenter"]575[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]574[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]857[/TD]
[TD="class: alignCenter"]856[/TD]
[/TR]
[/TABLE]
[h=2]Influenza Strain Characterizations[/h] During the 2014-2015 influenza season, the National Microbiology Laboratory (NML) has characterized 194 influenza viruses [95 A(H3N2), 2 A(H1N1) and 97 influenza B].
Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assay (n=95), one virus was antigenically similar to A/Texas/50/2012, five showed reduced titers to A/Texas/50/2012 and 89 were antigenically similar to A/Switzerland/9715293/2013, which is the influenza A(H3N2) component recommended for the 2015 Southern Hemisphere influenza vaccine. Additionally, 686 A(H3N2) viruses were unable to be tested by HI assay; however, sequence analysis showed that 684 belonged to a genetic group that typically shows reduced titers to A/Texas/50/2012. Influenza A(H1N1): Two A(H1N1) viruses characterized were antigenically similar to A/California/7/2009. Influenza B: Of the 97 influenza B viruses characterized, 90 viruses were antigenically similar to B/Massachusetts/2/2012, three viruses showed reduced titers against B/Massachusetts/2/2012, and four were B/Brisbane/60/2008-like (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2014-2015, N = 194​
2015-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 2014-2015 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A/Texas/50/2012 (H3N2)-like virus, and a B/Massachusetts/2/2012-like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus is recommended.


Text equivalent for figure 4Influenza strain characterizations, Canada, 2013-2014, N =3
[h=2]Influenza-like Illness (ILI) Consultation Rate[/h] The national influenza-like-illness (ILI) consultation rate decreased to 44.5 consultations per 1,000, which is slightly above expected levels for week 06 (Figure 5). The rate was highest among the 5 to 19 years of age group (60.1 consultations per 1,000) and lowest among the adults ≥65 years of age (36.2 consultations per 1,000)
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, 2014-2015​
2015-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. 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
[h=2]Influenza Outbreak Surveillance[/h] In week 06, 74 new outbreaks of influenza were reported, which is slightly higher than the number of outbreaks reported in the previous week. The majority of the outbreaks occurred in the Central and Atlantic provinces. Sixty outbreaks were reported in long-term care facilities (LTCF), four in hospitals and 10 in institutional or community settings (Figure 6). An additional five outbreaks of ILI were reported in schools. Among the outbreaks in which the influenza subtype was known, four LTCF outbreaks were associated with A(H3N2) and five outbreaks were associated with influenza B. To date this season, 970 outbreaks in LTCFs have been reported and the majority of those with known subtypes were attributable to A(H3N2). There has been a higher number of reported influenza outbreaks to date this season compared to the same period in previous seasons.
Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2014-2015
2015-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
[h=2]Pharmacy Surveillance[/h] During week 06, the proportion of prescriptions for antivirals increased slightly to 298.1 antiviral prescriptions per 100,000 total prescriptions (from 289.9 per 100,000). The rate for antivirals since week 48 has been higher than the previous three seasons (Figure 7). The rate in infants and seniors increased in week 06, while the rate in children and adults decreased. The rate was highest amongst seniors at 527.0 per 100,000 total prescriptions and lowest among infants at 135.4 per 100,000 total prescriptions.
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2014-15​
2015-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
[h=2]Sentinel Hospital Influenza Surveillance[/h] Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In week 06, 14 laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network: seven cases of influenza A and seven cases of influenza B (Figure 8a). Among the reported cases, six (43%) were <2 years of age, seven (50%) were 2 to 9 years of age and one (7%) was 10-16 years of age. One case was admitted to the ICU. To date this season, 503 hospitalizations have been reported by the IMPACT network, 465 (93%) of which were cases of influenza A. Among cases for which the influenza A subtype was reported, 99% (142/144) were A(H3N2) (Table 4). To date, 57 cases were admitted to the ICU, of which 35 (61%) were 2 to 9 years of age (Figure 9a). Three 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, 56 laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network. Among the cases in week 06, 41 cases (73%) were in adults over the age of 65 and 46 cases (82%) had influenza A (Figure 8b). To date this season, 1,628 cases have been reported; 1,590 (98%) with influenza A. The majority of cases (83%) were among adults ≥65 years of age (Table 5). One hundred and nineteen ICU admissions have been reported and 89 cases were adults ≥65 years of age. A total of 86 ICU cases (72%) reported to have at least one underlying condition or comorbidity. Of the 82 ICU cases with known immunization status, 30 (37%) reported not having been vaccinated this season. Seventy-four deaths have been reported, 67 (91%) of the deaths were adults >65 years of age (Figure 9b).
Note: 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 marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (Aug. 24, 2014 to February 14, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) [TD="class: alignCenter"]Total[/TD]
[TD="class: alignCenter"]# (%)[/TD]
[/TR]
[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]
[TR]
0-5m [TD="class: alignCenter"]74[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]14[/TD]
[TD="class: alignCenter"]60[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]77 (15.3%)[/TD]
[/TR]
[TR]
6-23m [TD="class: alignCenter"]100[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]31[/TD]
[TD="class: alignCenter"]68[/TD]
[TD="class: alignCenter"]14[/TD]
[TD="class: alignCenter"]114 (22.7%)[/TD]
[/TR]
[TR]
2-4y [TD="class: alignCenter"]114[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]37[/TD]
[TD="class: alignCenter"]76[/TD]
[TD="class: alignCenter"]8[/TD]
[TD="class: alignCenter"]122 (24.3%)[/TD]
[/TR]
[TR]
5-9y [TD="class: alignCenter"]118[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]39[/TD]
[TD="class: alignCenter"]79[/TD]
[TD="class: alignCenter"]8[/TD]
[TD="class: alignCenter"]126 (25.0%)[/TD]
[/TR]
[TR]
10-16y [TD="class: alignCenter"]59[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]21[/TD]
[TD="class: alignCenter"]38[/TD]
[TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]64 (12.7%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]465[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]2[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]142[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]321[/TD]
[TD="class: alignCenter"]38[/TD]
[TD="class: alignCenter"]503[/TD]
[/TR]
[TR]
% [SUP]1[/SUP] [TD="class: alignCenter"]92.4%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.4%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]30.5%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]69.0%[/TD]
[TD="class: alignCenter"]7.6%[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[/TABLE]
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 5 - Cumulative numbers of adult hospitalizations with influenza reported by the PCIRN-SOS network, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (November 15, 2014 to February 14, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A(UnS) [TD="class: alignCenter"]Total[/TD]
[TD="class: alignCenter"]# (%)[/TD]
[/TR]
[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]
[TR]
16-20 [TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]5(%)[/TD]
[/TR]
[TR]
20-44 [TD="class: alignCenter"]88[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]37[/TD]
[TD="class: alignCenter"]50[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]90(6%)[/TD]
[/TR]
[TR]
45-64 [TD="class: alignCenter"]179[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]70[/TD]
[TD="class: alignCenter"]109[/TD]
[TD="class: alignCenter"]8[/TD]
[TD="class: alignCenter"]187(11%)[/TD]
[/TR]
[TR]
65+ [TD="class: alignCenter"]1318[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]511[/TD]
[TD="class: alignCenter"]804[/TD]
[TD="class: alignCenter"]28[/TD]
[TD="class: alignCenter"]1346(83%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]1590[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]4[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]619[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]967[/TD]
[TD="class: alignCenter"]38[/TD]
[TD="class: alignCenter"]1628[/TD]
[/TR]
[TR]
% [SUP]1[/SUP] [TD="class: alignCenter"]98%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]0%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]39%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]61%[/TD]
[TD="class: alignCenter"]2%[/TD]
[TD="class: alignCenter"]100%[/TD]
[/TR]
[/TABLE]
Figure 8 - Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2015-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)
2015-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, 2014-15
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2015-w06-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)
2015-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)
[h=2]Provincial/Territorial Influenza Hospitalizations and Deaths[/h] In week 06, 264 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories* which is less than the number reported in week 05 (n=292). Of the 264 hospitalizations, all but two were influenza A, and 77% were in patients ≥65 years of age. Since the start of the 2014-15 season, 4,817 hospitalizations have been reported; 4,715 (98%) with influenza A. Among cases for which the subtype of influenza A was reported, 99.7% were A(H3N2). The majority of cases (72%) were ≥65 years of age (Table 6). A total of 237 ICU admissions have been reported to date: 55% (130) were in adults ≥65 years of age and 30%(73) were in adults 20-64 years. A total of 342 deaths have been reported since the start of the season: four children <5 years of age, one child 5-19 years, 24 adults 20-64 years, and 313 adults ≥65 years of age. Adults 65 years of age or older represent 92% of all deaths reported this season. 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. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting.
[TABLE="class: widthFull, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (24 August 2014 to 14 February 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) [TD="class: alignCenter"]Total[/TD]
[TD="class: alignCenter"]# (%)[/TD]
[/TR]
[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]
[TR]
0-4 years [TD="class: alignCenter"]333[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]126[/TD]
[TD="class: alignCenter"]205[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]337 (7%)[/TD]
[/TR]
[TR]
5-19 years [TD="class: alignCenter"]210[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]107[/TD]
[TD="class: alignCenter"]102[/TD]
[TD="class: alignCenter"]13[/TD]
[TD="class: alignCenter"]223 (5%)[/TD]
[/TR]
[TR]
20-44 years [TD="class: alignCenter"]288[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]174[/TD]
[TD="class: alignCenter"]113[/TD]
[TD="class: alignCenter"]12[/TD]
[TD="class: alignCenter"]300 (6%)[/TD]
[/TR]
[TR]
45-64 years [TD="class: alignCenter"]435[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]188[/TD]
[TD="class: alignCenter"]246[/TD]
[TD="class: alignCenter"]9[/TD]
[TD="class: alignCenter"]444 (9%)[/TD]
[/TR]
[TR]
65+ years [TD="class: alignCenter"]3395[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]1595[/TD]
[TD="class: alignCenter"]1799[/TD]
[TD="class: alignCenter"]57[/TD]
[TD="class: alignCenter"]3452 (72%)[/TD]
[/TR]
[TR]
Unknown [TD="class: alignCenter"]54[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]50[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]7[/TD]
[TD="class: alignCenter"]61 (1%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]4715[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]7[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]2240[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]2468[/TD]
[TD="class: alignCenter"]102[/TD]
[TD="class: alignCenter"]4817[/TD]
[/TR]
[TR]
Percentage [SUP]1[/SUP] [TD="class: alignCenter"]97.9%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.1%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]47.5%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]52.3%[/TD]
[TD="class: alignCenter"]2.1%[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[/TABLE]
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2014-15 on the Public Health Agency of Canada website.
[h=2]Emerging Respiratory Pathogens[/h] Human Avian Influenza
Influenza A(H7N9): Since the last FluWatch report, no new laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus were reported by the World Health Organization. Globally to February 19, 2015, the WHO reported a total of 571 laboratory-confirmed human cases with avian influenza A(H7N9) virus, including 204 deaths. Documents related to the public health risk of influenza A(H7N9), as well as guidance for health professionals and advice for the public is updated regularly on the following websites:
PHAC - Avian influenza A(H7N9)
WHO - Avian Influenza A(H7N9)
Influenza A(H5N6): Since the last FluWatch report, no new cases of human infection with avian influenza A (H5N6) virus from China has been reported by the World Health Organization. Globally to February 19, 2015, the WHO has been informed of a total of three cases of avian influenza A (H5N6) virus, including two deaths.
Middle East Respiratory Syndrome Coronavirus (MERS-CoV)
Since the last FluWatch report, 6 new laboratory-confirmed cases of MERS-CoV have been reported by the World Health Organization. Globally, from September 2012 to February 19, 2015, the WHO has been informed of a total of 983 laboratory-confirmed cases of infection with MERS-CoV, including 360 deaths. All cases have either occurred in the Middle East or have had direct links to a primary case infected in the Middle East. The public health risk posed by MERS-CoV in Canada remains low (see the PHAC Assessment of Public Health Risk) and for the latest global risk assessment posted by the WHO on February 5, 2015: WHO MERS-CoV
Documents related to the public health risk of MERS-CoV, as well as guidance for health professionals and advice for the public is updated regularly on the following websites:
PHAC - Middle East respiratory syndrome coronavirus (MERS-CoV)
WHO - Coronavirus infections
Avian Influenza A(H5)
The Canadian Food Inspection Agency (CFIA) is continuing its investigation into an outbreak of highly pathogenic avian influenza H5N2 virus in British Columbia's Fraser Valley. To date, there have been 11 commercial infected premises and one non-commercial infected premise with H5N2.
On February 7, 2015 an additional non-commercial farm in the Fraser Valley was confirmed to be infected with highly pathogenic avian influenza H5N1. The CFIA applies the same disease control measures following detections of H5N1 and H5N2. The infected premise is under quarantine, depopulation of the affected birds has been completed and disposal measures are underway. The CFIA has now reduced the size of the restricted zone as progress continues to be made in the control of avian influenza in British Columbia. Avian influenza viruses do not pose risks to food safety when poultry and poultry products are properly handled and cooked. Further information on the outbreak is provided on the following CFIA website.
CFIA - Notifiable Avian Influenza
For the latest Travel Health Notice on Avian Influenza (H5N1) visit the following webpage: PHAC ? Travel Health Notice
...

http://www.phac-aspc.gc.ca/fluwatch/14-15/w06_15/index-eng.php
 
[h=1]FluWatch report: February 15 to 21, 2015 (Week 7)[/h] Posted 2015-02-27 For readers interested in the PDF version, the document is available for downloading or viewing:
FluWatch report: February 15 to 21, 2015 (Week 7) (PDF Version - 385 KB - 10 pages)

?? Help with PDF documents

Overall Summary
  • In week 07, all influenza indicators remained similar to, or declined, from the previous week.
  • Overall, elevated activity was mostly reported in the Central and Atlantic provinces.
  • For the past few weeks, influenza B detections have been increasing steadily, particularly in the Prairies and in Quebec. In week 07, influenza B detections were greater than influenza A detections in QC and AB. This increase in influenza B is expected as influenza B often shows up later in the flu season.
  • A(H3N2) continues to be the most common type of influenza affecting Canadians. Seniors continue to have the highest number of positive laboratory detections, hospitalizations and deaths.
  • Detections of respiratory syncytial virus (RSV) continue to be the second most frequently detected virus after influenza.
  • Evidence from the National Microbiology Laboratory (NML) does indicate that this year?s vaccine will continue to provide protection against the circulating A(H1N1) and B strains.

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 atFluWatch@phac-aspc.gc.ca
[h=2]Influenza/ILI Activity (geographic spread)[/h] In week 07, six regions reported widespread activity: in ON(2). QC(2), PEI and NL. Twenty regions reported localized activity: in AB, ON(5), QC(2), NB(6), NS(5) and NL. Twenty-six regions reported sporadic activity: in YK, NU(2), BC(5), AB(4), SK(3), MB(4), QC(2), NB, NS(3), and NL. No activity was reported in four regions: NU, MB, NS and NF. No data was reported from NT. Overall, influenza activity in week 07 was similar to the previous week with elevated activity (widespread and localized) mostly reported in the Central and Atlantic provinces.
Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 7​
​
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
[h=2]Influenza and Other Respiratory Virus Detections[/h] In week 07, the number of positive influenza tests (1,279) and the percentage positive for influenza A (12.2%) continued to decline from the previous week The percentage of positive influenza B tests continued to increase and was 5.3% in week 07, the highest this season thus far (Figure 2). In week 07, influenza B detections were greater than influenza A detections in QC and AB; accounting for 53% and 60% of influenza detections respectively. When comparing by influenza type, the majority of the influenza A cases (62%) were in the elderly while the majority of the influenza B cases (61%) were >45 years of age. To date, 94% of influenza detections have been influenza A, and 99.6% of those subtyped have been A(H3N2) (Table 1). To date this season, detailed information on age and type/subtype has been received for 29,741 cases. A significantly greater proportion of laboratory detections of influenza have been reported in adults ≥65 years of age (61%) this season (Table 2) compared to the 2013-14 season when only 16.1% of cases were in adults ≥65 years of age.
Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2014-15​
2015-w07-fg2-eng.gif
​
Text equivalent for figure 2Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2014-15
In week 07, detections of all respiratory viruses decreased from the previous week (Figure 3). Respiratory syncytial virus (RSV) remains the second most frequently detected virus after influenza with 817 detections. Detections of RSV since week 38 have been higher than in the previous season. Weekly detections of human metapneumovirus this season have been lower compared to the previous season.
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, 2014-15​
2015-w07-fg3-eng.gif
​
RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2014-2015
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 1: Weekly and cumulative numbers of positive influenza specimens
by type, subtype and province, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Reporting provinces [SUP]1[/SUP] Weekly
(February 15 to February 21, 2015) Cumulative
(August 24 to February 21, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1)pdm09 A(H3) A(UnS) B Total A Total A(H1)pdm09 A(H3) A(UnS) [TD="class: alignCenter"]B Total[/TD]
[/TR]
[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]
[TR]
BC [TD="class: alignCenter"]117[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]96[/TD]
[TD="class: alignCenter"]17[/TD]
[TD="class: alignCenter"]26[/TD]
[TD="class: alignCenter"]3163[/TD]
[TD="class: alignCenter"]16[/TD]
[TD="class: alignCenter"]2324[/TD]
[TD="class: alignCenter"]823[/TD]
[TD="class: alignCenter"]119[/TD]
[/TR]
[TR]
AB [TD="class: alignCenter"]23[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]16[/TD]
[TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]35[/TD]
[TD="class: alignCenter"]3597[/TD]
[TD="class: alignCenter"]9[/TD]
[TD="class: alignCenter"]3436[/TD]
[TD="class: alignCenter"]152[/TD]
[TD="class: alignCenter"]406[/TD]
[/TR]
[TR]
SK [TD="class: alignCenter"]7[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]1279[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]821[/TD]
[TD="class: alignCenter"]458[/TD]
[TD="class: alignCenter"]41[/TD]
[/TR]
[TR]
MB [TD="class: alignCenter"]16[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]13[/TD]
[TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]1096[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]379[/TD]
[TD="class: alignCenter"]717[/TD]
[TD="class: alignCenter"]38[/TD]
[/TR]
[TR]
ON [TD="class: alignCenter"]372[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]135[/TD]
[TD="class: alignCenter"]236[/TD]
[TD="class: alignCenter"]25[/TD]
[TD="class: alignCenter"]9850[/TD]
[TD="class: alignCenter"]18[/TD]
[TD="class: alignCenter"]4236[/TD]
[TD="class: alignCenter"]5596[/TD]
[TD="class: alignCenter"]183[/TD]
[/TR]
[TR]
QC [TD="class: alignCenter"]241[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]241[/TD]
[TD="class: alignCenter"]267[/TD]
[TD="class: alignCenter"]10758[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]422[/TD]
[TD="class: alignCenter"]10332[/TD]
[TD="class: alignCenter"]983[/TD]
[/TR]
[TR]
NB [TD="class: alignCenter"]54[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]54[/TD]
[TD="class: alignCenter"]15[/TD]
[TD="class: alignCenter"]719[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]102[/TD]
[TD="class: alignCenter"]617[/TD]
[TD="class: alignCenter"]50[/TD]
[/TR]
[TR]
NS [TD="class: alignCenter"]25[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]25[/TD]
[TD="class: alignCenter"]11[/TD]
[TD="class: alignCenter"]378[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]123[/TD]
[TD="class: alignCenter"]255[/TD]
[TD="class: alignCenter"]45[/TD]
[/TR]
[TR]
PE [TD="class: alignCenter"]7[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]7[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]105[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]102[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]2[/TD]
[/TR]
[TR]
NL [TD="class: alignCenter"]27[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]27[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]564[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]53[/TD]
[TD="class: alignCenter"]511[/TD]
[TD="class: alignCenter"]4[/TD]
[/TR]
[TR]
Canada [TD="class: alignCenter"]889[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]6[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]262[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]621[/TD]
[TD="class: alignCenter"]390[/TD]
[TD="class: alignCenter"]31509[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]48[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]11998[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]19463[/TD]
[TD="class: alignCenter"]1871[/TD]
[/TR]
[TR]
Percentage[SUP]2[/SUP] [TD="class: alignCenter"]69.5%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]0.7%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]29.5%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]69.9%[/TD]
[TD="class: alignCenter"]30.5%[/TD]
[TD="class: alignCenter"]94.4%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]0.2%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]38.1%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]61.8%[/TD]
[TD="class: alignCenter"]5.6%[/TD]
[/TR]
[/TABLE]
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
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, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups (years) Weekly
(February 15 to February 21, 2015) Cumulative
(August 24 to February 21, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) [TD="class: alignCenter"]Total[/TD]
A Total A(H1) pdm09 A(H3) A (UnS) [TD="class: alignCenter"]Total[/TD]
# % [/TR]
[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]
[TR]
<5 [TD="class: alignCenter"]35[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]30[/TD]
[TD="class: alignCenter"]19[/TD]
[TD="class: alignCenter"]1928[/TD]
[TD="class: alignCenter"]10[/TD]
[TD="class: alignCenter"]776[/TD]
[TD="class: alignCenter"]1142[/TD]
[TD="class: alignCenter"]140[/TD]
[TD="class: alignCenter"]2068[/TD]
[TD="class: alignCenter"]7.0%[/TD]
[/TR]
[TR]
5-19 [TD="class: alignCenter"]16[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]11[/TD]
[TD="class: alignCenter"]44[/TD]
[TD="class: alignCenter"]1687[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]919[/TD]
[TD="class: alignCenter"]767[/TD]
[TD="class: alignCenter"]249[/TD]
[TD="class: alignCenter"]1936[/TD]
[TD="class: alignCenter"]6.5%[/TD]
[/TR]
[TR]
20-44 [TD="class: alignCenter"]51[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]7[/TD]
[TD="class: alignCenter"]44[/TD]
[TD="class: alignCenter"]65[/TD]
[TD="class: alignCenter"]3234[/TD]
[TD="class: alignCenter"]11[/TD]
[TD="class: alignCenter"]1579[/TD]
[TD="class: alignCenter"]1644[/TD]
[TD="class: alignCenter"]296[/TD]
[TD="class: alignCenter"]3530[/TD]
[TD="class: alignCenter"]11.9%[/TD]
[/TR]
[TR]
45-64 [TD="class: alignCenter"]50[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]9[/TD]
[TD="class: alignCenter"]41[/TD]
[TD="class: alignCenter"]81[/TD]
[TD="class: alignCenter"]3580[/TD]
[TD="class: alignCenter"]14[/TD]
[TD="class: alignCenter"]1560[/TD]
[TD="class: alignCenter"]2006[/TD]
[TD="class: alignCenter"]414[/TD]
[TD="class: alignCenter"]3994[/TD]
[TD="class: alignCenter"]13.4%[/TD]
[/TR]
[TR]
65+ [TD="class: alignCenter"]319[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]63[/TD]
[TD="class: alignCenter"]255[/TD]
[TD="class: alignCenter"]123[/TD]
[TD="class: alignCenter"]17473[/TD]
[TD="class: alignCenter"]9[/TD]
[TD="class: alignCenter"]6861[/TD]
[TD="class: alignCenter"]10603[/TD]
[TD="class: alignCenter"]625[/TD]
[TD="class: alignCenter"]18098[/TD]
[TD="class: alignCenter"]60.9%[/TD]
[/TR]
[TR]
Unknown [TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]113[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]95[/TD]
[TD="class: alignCenter"]18[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]115[/TD]
[TD="class: alignCenter"]0.4%[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]475[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]1[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]91[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]383[/TD]
[TD="class: alignCenter"]332[/TD]
[TD="class: alignCenter"]28015[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]45[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]11790[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]16180[/TD]
[TD="class: alignCenter"]1726[/TD]
[TD="class: alignCenter"]29741[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[TR]
Percentage[SUP]2[/SUP] [TD="class: alignCenter"]58.9%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]0.2%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]19.2%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]80.6%[/TD]
[TD="class: alignCenter"]41.1%[/TD]
[TD="class: alignCenter"]94.2%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]0.2%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]42.1%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]57.8%[/TD]
[TD="class: alignCenter"]5.8%[/TD]
[TD="class: alignCenter"] [/TD]
[TD="class: alignCenter"] [/TD]
[/TR]
[/TABLE]
[h=2]Antiviral Resistance[/h] During the 2014-2015 influenza season, the NML has tested 659 influenza viruses for resistance to oseltamivir and 656 influenza viruses for resistance to zanamivir. All viruses were sensitive to zanamivir and one influenza A(H3N2) virus was resistant to oseltamivir. A total of 956 influenza A viruses (99.9%) were resistant to amantadine (Table 3).
[TABLE="class: widthFull, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Virus type and subtype Oseltamivir Zanamivir Amantadine [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
# tested # resistant (%) # tested # resistant (%) # tested # resistant (%) [/TR]
[TR]
[TD="class: fontSize85, colspan: 7"][SUP]*[/SUP] NA - not applicable[/TD]
[/TR]
[TR]
A (H3N2) [TD="class: alignCenter"]565[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]562[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]954[/TD]
[TD="class: alignCenter"]953 (99.9%)[/TD]
[/TR]
[TR]
A (H1N1) [TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]3 (100%)[/TD]
[/TR]
[TR]
B [TD="class: alignCenter"]92[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]92[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]NA [SUP]*[/SUP][/TD]
[TD="class: alignCenter"]NA [SUP]*[/SUP][/TD]
[/TR]
[TR]
TOTAL [TD="class: alignCenter"]659[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]656[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]957[/TD]
[TD="class: alignCenter"]956[/TD]
[/TR]
[/TABLE]
[h=2]Influenza Strain Characterizations[/h] During the 2014-2015 influenza season, the National Microbiology Laboratory (NML) has characterized 243 influenza viruses [110 A(H3N2), 2 A(H1N1) and 131 influenza B].
Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assay (n=110), one virus was antigenically similar to A/Texas/50/2012, five showed reduced titers to A/Texas/50/2012 and 104 were antigenically similar to A/Switzerland/9715293/2013, which is the influenza A(H3N2) component recommended for the 2015 Southern Hemisphere influenza vaccine. Additionally, 745 A(H3N2) viruses were unable to be tested by HI assay; however, sequence analysis showed that 743 belonged to a genetic group that typically shows reduced titers to A/Texas/50/2012. Influenza A(H1N1): Two A(H1N1) viruses characterized were antigenically similar to A/California/7/2009. Influenza B: Of the 131 influenza B viruses characterized, 124 viruses were antigenically similar to B/Massachusetts/2/2012, three viruses showed reduced titers against B/Massachusetts/2/2012, and four were B/Brisbane/60/2008-like (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2014-2015, N = 243​
2015-w07-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 2014-2015 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A/Texas/50/2012 (H3N2)-like virus, and a B/Massachusetts/2/2012-like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus is recommended.
The WHO has released the recommended composition of the influenza vaccine for the northern hemisphere for the 2015-2016 season. Trivalent vaccines are recommended to contain 1) an A/California/7/2009 (H1N1)pdm09-like virus 2) an A/Switzerland/9715293/2013 (H3N2)-like virus, and 3) an B/Phuket/3073/2013-like virus(Yamagata lineage). Quadrivalent vaccines are recommended to additionally contain a B/Brisbane/60/2008-like virus (Victoria lineage).


Text equivalent for figure 4Influenza strain characterizations, Canada, 2014-2015, N =3
[h=2]Influenza-like Illness (ILI) Consultation Rate[/h] The national influenza-like-illness (ILI) consultation rate decreased to 32.7 consultations per 1,000, which is within expected levels for week 07 (Figure 5). The rate was highest among the 5 to 19 years of age group (83.3 consultations per 1,000) and lowest among the adults ≥65 years of age (18.7 consultations per 1,000).
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, 2014-2015​
2015-w07-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. 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, 2014-2015
[h=2]Influenza Outbreak Surveillance[/h] In week 07, 56 new outbreaks of influenza were reported, a decrease from the previous week. The majority of the outbreaks occurred in the Central and Atlantic provinces. Forty-five outbreaks were reported in long-term care facilities (LTCF), two in hospitals and nine in institutional or community settings (Figure 6). An additional seven outbreaks of ILI were reported in schools. Among the outbreaks in which the influenza subtype was known, three LTCF outbreaks were associated with A(H3N2) and two outbreaks were associated with influenza B. To date this season, 1,015 outbreaks in LTCFs have been reported and the majority of those with known subtypes were attributable to A(H3N2). There has been a higher number of reported influenza outbreaks to date this season compared to the same period in previous seasons.
Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2014-2015
2015-w07-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, 2014-2015
[h=2]Pharmacy Surveillance[/h] During week 07, the proportion of prescriptions for antivirals decreased to 226.4 antiviral prescriptions per 100,000 total prescriptions (from 299.6 per 100,000). The rate for antivirals since week 48 has been higher than the previous three seasons (Figure 7). The rate in all age groups decreased in week 07. The rate was highest among seniors at 407.0 per 100,000 total prescriptions and lowest among infants at 105.7 per 100,000 total prescriptions.
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2014-15​
2015-w07-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, 2014-15
[h=2]Sentinel Hospital Influenza Surveillance[/h] Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In week 07, 24 laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network: 12 cases of influenza A and 12 cases of influenza B (Figure 8a). Among the reported cases, 11 (46%) were <2 years of age, five (46%) were 2 to 9 years of age and two (8%) was 10-16 years of age. Two cases were admitted to the ICU. To date this season, 530 hospitalizations have been reported by the IMPACT network, 480 (91%) of which were cases of influenza A. Among cases for which the influenza A subtype was reported, 99% (157/159) were A(H3N2) (Table 4). To date, 65 cases were admitted to the ICU, of which 37 (57%) were 2 to 9 years of age (Figure 9a). Three 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 07, 60 laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network. Among the cases in week 07, 48 cases (80%) were in adults over the age of 65 and 48 cases (80%) had influenza A (Figure 8b). To date this season, 1,717 cases have been reported; 1,663 (97%) with influenza A. The majority of cases (83%) were among adults ≥65 years of age (Table 5). One hundred and twenty-nine ICU admissions have been reported and 97 cases were adults ≥65 years of age. A total of 94 ICU cases (73%) reported to have at least one underlying condition or comorbidity. Of the 91 ICU cases with known immunization status, 33 (36%) reported not having been vaccinated this season. Eighty deaths have been reported, 73 (91%) of the deaths were adults >65 years of age (Figure 9b).
Note: 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 marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (Aug. 24, 2014 to February 21, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) [TD="class: alignCenter"]Total[/TD]
[TD="class: alignCenter"]# (%)[/TD]
[/TR]
[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]
[TR]
0-5m [TD="class: alignCenter"]76[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]17[/TD]
[TD="class: alignCenter"]59[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]79 (14.9%)[/TD]
[/TR]
[TR]
6-23m [TD="class: alignCenter"]105[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]34[/TD]
[TD="class: alignCenter"]70[/TD]
[TD="class: alignCenter"]19[/TD]
[TD="class: alignCenter"]124 (23.4%)[/TD]
[/TR]
[TR]
2-4y [TD="class: alignCenter"]117[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]39[/TD]
[TD="class: alignCenter"]77[/TD]
[TD="class: alignCenter"]11[/TD]
[TD="class: alignCenter"]128 (24.2%)[/TD]
[/TR]
[TR]
5-9y [TD="class: alignCenter"]124[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]44[/TD]
[TD="class: alignCenter"]80[/TD]
[TD="class: alignCenter"]10[/TD]
[TD="class: alignCenter"]134 (25.3%)[/TD]
[/TR]
[TR]
10-16y [TD="class: alignCenter"]58[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]23[/TD]
[TD="class: alignCenter"]35[/TD]
[TD="class: alignCenter"]7[/TD]
[TD="class: alignCenter"]65 (12.3%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]480[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]2[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]157[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]321[/TD]
[TD="class: alignCenter"]50[/TD]
[TD="class: alignCenter"]530[/TD]
[/TR]
[TR]
% [SUP]1[/SUP] [TD="class: alignCenter"]90.6%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.4%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]32.7%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]66.9%[/TD]
[TD="class: alignCenter"]9.4%[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[/TABLE]
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 5 - Cumulative numbers of adult hospitalizations with influenza reported by the PCIRN-SOS network, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (November 15, 2014 to February 21, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A(UnS) [TD="class: alignCenter"]Total[/TD]
[TD="class: alignCenter"]# (%)[/TD]
[/TR]
[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]
[TR]
16-20 [TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]5(%)[/TD]
[/TR]
[TR]
20-44 [TD="class: alignCenter"]91[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]39[/TD]
[TD="class: alignCenter"]51[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]94(5%)[/TD]
[/TR]
[TR]
45-64 [TD="class: alignCenter"]183[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]75[/TD]
[TD="class: alignCenter"]108[/TD]
[TD="class: alignCenter"]15[/TD]
[TD="class: alignCenter"]198(12%)[/TD]
[/TR]
[TR]
65+ [TD="class: alignCenter"]1384[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]543[/TD]
[TD="class: alignCenter"]838[/TD]
[TD="class: alignCenter"]36[/TD]
[TD="class: alignCenter"]1420(83%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]1663[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]4[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]658[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]1001[/TD]
[TD="class: alignCenter"]54[/TD]
[TD="class: alignCenter"]1717[/TD]
[/TR]
[TR]
% [SUP]1[/SUP] [TD="class: alignCenter"]97%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]0%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]40%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]60%[/TD]
[TD="class: alignCenter"]3%[/TD]
[TD="class: alignCenter"]100%[/TD]
[/TR]
[/TABLE]
Figure 8 - Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2015-w07-fg8a-eng.gif
​
Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2015-w07-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, 2014-15: Adult hospitalizations (>16 year of age, PCIRN-SOS)
Figure 9 - Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2015-w07-fg9a-eng.gif
​
Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2015-w07-fg9b-eng.gif
​
Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15: Adult hospitalizations (≥16 year of age, PCIRN-SOS)
[h=2]Provincial/Territorial Influenza Hospitalizations and Deaths[/h] In week 07, 276 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories* which is slightly more than the number reported in week 06 (n=264).Of the 276 hospitalizations, all but 14 were due to influenza A, and 72% were in patients ≥65 years of age. Since the start of the 2014-15 season, 5,204 hospitalizations have been reported; 5,062 (97%) with influenza A. Among cases for which the subtype of influenza A was reported, 99.5% were A(H3N2). The majority of cases (72%) were ≥65 years of age (Table 6). A total of 254 ICU admissions have been reported to date: 55% (140) were in adults ≥65 years of age and 30% (75) were in adults 20-64 years. A total of 364 deaths have been reported since the start of the season: three children <5 years of age, one child 5-19 years, 24 adults 20-64 years, and 336 adults ≥65 years of age. Adults 65 years of age or older represent 93% of all deaths reported this season. 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. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting.
[TABLE="class: widthFull, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (24 August 2014 to 21 February 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) [TD="class: alignCenter"]Total[/TD]
[TD="class: alignCenter"]# (%)[/TD]
[/TR]
[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]
[TR]
0-4 years [TD="class: alignCenter"]353[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]130[/TD]
[TD="class: alignCenter"]221[/TD]
[TD="class: alignCenter"]7[/TD]
[TD="class: alignCenter"]360 (7%)[/TD]
[/TR]
[TR]
5-19 years [TD="class: alignCenter"]213[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]105[/TD]
[TD="class: alignCenter"]108[/TD]
[TD="class: alignCenter"]10[/TD]
[TD="class: alignCenter"]223 (4%)[/TD]
[/TR]
[TR]
20-44 years [TD="class: alignCenter"]248[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]127[/TD]
[TD="class: alignCenter"]119[/TD]
[TD="class: alignCenter"]14[/TD]
[TD="class: alignCenter"]262 (5%)[/TD]
[/TR]
[TR]
45-64 years [TD="class: alignCenter"]549[/TD]
[TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]262[/TD]
[TD="class: alignCenter"]282[/TD]
[TD="class: alignCenter"]27[/TD]
[TD="class: alignCenter"]576 (11%)[/TD]
[/TR]
[TR]
65+ years [TD="class: alignCenter"]3645[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]1686[/TD]
[TD="class: alignCenter"]1958[/TD]
[TD="class: alignCenter"]75[/TD]
[TD="class: alignCenter"]3720 (71%)[/TD]
[/TR]
[TR]
Unknown [TD="class: alignCenter"]54[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]50[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]9[/TD]
[TD="class: alignCenter"]63 (1%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]5062[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]11[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]2360[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]2691[/TD]
[TD="class: alignCenter"]142[/TD]
[TD="class: alignCenter"]5204[/TD]
[/TR]
[TR]
Percentage [SUP]1[/SUP] [TD="class: alignCenter"]97.3%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.2%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]46.6%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]53.2%[/TD]
[TD="class: alignCenter"]2.7%[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[/TABLE]
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2014-15 on the Public Health Agency of Canada website.
[h=2]Emerging Respiratory Pathogens[/h] Human Avian Influenza
Influenza A(H7N9): Since the last FluWatch report, one new laboratory-confirmed case of human infection with avian influenza A(H7N9) virus was reported by the World Health Organization. Globally to February 26, 2015, the WHO reported a total of 572 laboratory-confirmed human cases with avian influenza A(H7N9) virus, including 204 deaths. Documents related to the public health risk of influenza A(H7N9), as well as guidance for health professionals and advice for the public is updated regularly on the following websites:
PHAC - Avian influenza A(H7N9)
WHO - Avian Influenza A(H7N9)
Influenza A(H5N6): Since the last FluWatch report, no new cases of human infection with avian influenza A (H5N6) virus from China has been reported by the World Health Organization. Globally to February 26, 2015, the WHO has been informed of a total of three cases of avian influenza A (H5N6) virus, including two deaths.
Middle East Respiratory Syndrome Coronavirus (MERS-CoV)
Since the last FluWatch report, 47 new laboratory-confirmed cases of MERS-CoV have been reported by the World Health Organization. Globally, from September 2012 to February 26, 2015, the WHO has been informed of a total of 1,030 laboratory-confirmed cases of infection with MERS-CoV, including 381 deaths. All cases have either occurred in the Middle East or have had direct links to a primary case infected in the Middle East. The public health risk posed by MERS-CoV in Canada remains low (see the PHAC Assessment of Public Health Risk) and for the latest global risk assessment posted by the WHO on February 5, 2015: WHO MERS-CoV
Documents related to the public health risk of MERS-CoV, as well as guidance for health professionals and advice for the public is updated regularly on the following websites:
PHAC - Middle East respiratory syndrome coronavirus (MERS-CoV)
WHO - Coronavirus infections
Avian Influenza A(H5)
Since the last FluWatch report, no new information has been provided by the CFIA. Further information on the outbreak is provided on the following CFIA website.
CFIA - Notifiable Avian Influenza
For the latest Travel Health Notice on Avian Influenza (H5N1) visit the following webpage: PHAC ? Travel Health Notice.

.../
http://www.phac-aspc.gc.ca/fluwatch/14-15/w07_15/index-eng.php
 
[h=1]FluWatch report: February 22 to 28, 2015 (Week 8)[/h] Posted 2015-03-06 For readers interested in the PDF version, the document is available for downloading or viewing:
FluWatch report: February 22 to 28, 2015 (Week 8) (PDF Version - 385 KB - 10 pages)

?? Help with PDF documents

Overall Summary
  • In week 08, all influenza indicators except the influenza-like illness consultation rate remained similar to, or declined from the previous week.
  • Elevated influenza activity was mostly reported in the Central and Atlantic provinces and in a few regions in the Western provinces.
  • Influenza B detections continues to increase steadily, particularly in the Prairies and in Quebec. This increase in influenza B is expected as influenza B often shows up later in the flu season.
  • A(H3N2) continues to be the most common influenza virus this season and seniors continue to have the highest number of positive laboratory detections, hospitalizations and deaths.
  • Evidence from the National Microbiology Laboratory (NML) indicates that this year's vaccine will continue to provide protection against the circulating A(H1N1) and B strains.

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
[h=2]Influenza/ILI Activity (geographic spread)[/h] In week 08, two regions in Quebec reported widespread activity. Twenty-three regions reported localized activity: BC(2), AB(2), MB, ON(7), QC(2), NB(4), NS(3), PE and NL. Twenty-five regions reported sporadic activity: in YK, NU, NT(2), BC(3), AB(3), SK(3), MB(3), QC(2), NB(3), NS(3), and NL. No activity was reported in seven regions: NU, MB, NS(3) and NL(2). Overall when compared to the previous week, there was a decrease in widespread activity. The majority of widespread and localized activity was reported in the Central and Atlantic provinces; however, more regions reported localised activity compared to the previous week.
Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 8​
​
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
[h=2]Influenza and Other Respiratory Virus Detections[/h] In week 08, the number of positive influenza tests (1,242) and the percentage positive for influenza A (11.1%) continued to decline from the previous week. The percentage of positive influenza B tests continued to increase and was 5.9% in week 08 (Figure 2). Influenza B detections were greater than influenza A detections in QC and AB; accounting for 57% and 63% of influenza detections respectively. To date, 93% of influenza detections have been influenza A, and 99.5% of those subtyped have been A(H3N2) (Table 1). To date this season, detailed information on age and type/subtype has been received for 30,350 cases. A significantly greater proportion of laboratory detections of influenza have been reported in adults ≥65 years of age (61%) this season (Table 2) compared to the 2013-14 season when only 16.3% of cases were in adults ≥65 years of age.
Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2014-15​
2015-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, 2014-15
In week 08, detections of all respiratory viruses except parainfluenza and human metapneumovirus (hMPV) decreased from the previous week (Figure 3). Detections of respiratory syncytial virus (RSV) in week 08 were greater than the detections of influenza A with 867 detections (vs 818 detections of influenza A). In recent weeks, weekly detections of adenovirus, coronavirus, rhinovirus and parainfluenza have been greater than those reported in each of the past three seasons. Weekly detections of hMPV this season have been lower compared to the previous three seasons.
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, 2014-15​
2015-w08-fg3-eng.gif
​
RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2014-2015
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 1: Weekly and cumulative numbers of positive influenza specimens
by type, subtype and province, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Reporting provinces [SUP]1[/SUP] Weekly
(February 22 to February 28, 2015) Cumulative
(August 24 to February 28, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1)pdm09 A(H3) A(UnS) B Total A Total A(H1)pdm09 A(H3) A(UnS) [TD="class: alignCenter"]B Total[/TD]
[/TR]
[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]
[TR]
BC [TD="class: alignCenter"]36[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]28[/TD]
[TD="class: alignCenter"]7[/TD]
[TD="class: alignCenter"]22[/TD]
[TD="class: alignCenter"]3408[/TD]
[TD="class: alignCenter"]24[/TD]
[TD="class: alignCenter"]2550[/TD]
[TD="class: alignCenter"]834[/TD]
[TD="class: alignCenter"]176[/TD]
[/TR]
[TR]
AB [TD="class: alignCenter"]23[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]15[/TD]
[TD="class: alignCenter"]8[/TD]
[TD="class: alignCenter"]39[/TD]
[TD="class: alignCenter"]3621[/TD]
[TD="class: alignCenter"]10[/TD]
[TD="class: alignCenter"]3455[/TD]
[TD="class: alignCenter"]156[/TD]
[TD="class: alignCenter"]446[/TD]
[/TR]
[TR]
SK [TD="class: alignCenter"]17[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]11[/TD]
[TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]1293[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1293[/TD]
[TD="class: alignCenter"]51[/TD]
[/TR]
[TR]
MB [TD="class: alignCenter"]12[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]9[/TD]
[TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]1108[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]382[/TD]
[TD="class: alignCenter"]726[/TD]
[TD="class: alignCenter"]43[/TD]
[/TR]
[TR]
ON [TD="class: alignCenter"]341[/TD]
[TD="class: alignCenter"]7[/TD]
[TD="class: alignCenter"]113[/TD]
[TD="class: alignCenter"]221[/TD]
[TD="class: alignCenter"]48[/TD]
[TD="class: alignCenter"]10245[/TD]
[TD="class: alignCenter"]25[/TD]
[TD="class: alignCenter"]4357[/TD]
[TD="class: alignCenter"]5863[/TD]
[TD="class: alignCenter"]236[/TD]
[/TR]
[TR]
QC [TD="class: alignCenter"]200[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]200[/TD]
[TD="class: alignCenter"]260[/TD]
[TD="class: alignCenter"]10929[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]422[/TD]
[TD="class: alignCenter"]10503[/TD]
[TD="class: alignCenter"]1232[/TD]
[/TR]
[TR]
NB [TD="class: alignCenter"]145[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]26[/TD]
[TD="class: alignCenter"]119[/TD]
[TD="class: alignCenter"]25[/TD]
[TD="class: alignCenter"]864[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]128[/TD]
[TD="class: alignCenter"]736[/TD]
[TD="class: alignCenter"]43[/TD]
[/TR]
[TR]
NS [TD="class: alignCenter"]23[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]23[/TD]
[TD="class: alignCenter"]15[/TD]
[TD="class: alignCenter"]401[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]123[/TD]
[TD="class: alignCenter"]278[/TD]
[TD="class: alignCenter"]60[/TD]
[/TR]
[TR]
PE [TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]15[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]579[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]53[/TD]
[TD="class: alignCenter"]526[/TD]
[TD="class: alignCenter"]4[/TD]
[/TR]
[TR]
NL [TD="class: alignCenter"]15[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]15[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]579[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]53[/TD]
[TD="class: alignCenter"]526[/TD]
[TD="class: alignCenter"]4[/TD]
[/TR]
[TR]
Canada [TD="class: alignCenter"]818[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]8[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]191[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]613[/TD]
[TD="class: alignCenter"]424[/TD]
[TD="class: alignCenter"]32559[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]64[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]11578[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]20917[/TD]
[TD="class: alignCenter"]2329[/TD]
[/TR]
[TR]
Percentage[SUP]2[/SUP] [TD="class: alignCenter"]65.9%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]1.0%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]23.3%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]74.9%[/TD]
[TD="class: alignCenter"]34.1%[/TD]
[TD="class: alignCenter"]93.3%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]0.2%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]35.6%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]64.2%[/TD]
[TD="class: alignCenter"]6.7%[/TD]
[/TR]
[/TABLE]
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
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, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups (years) Weekly
(February 22 to February 28, 2015) Cumulative
(August 24 to February 28, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) [TD="class: alignCenter"]Total[/TD]
A Total A(H1) pdm09 A(H3) A (UnS) [TD="class: alignCenter"]Total[/TD]
# % [/TR]
[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]
[TR]
<5 [TD="class: alignCenter"]28[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]23[/TD]
[TD="class: alignCenter"]21[/TD]
[TD="class: alignCenter"]1936[/TD]
[TD="class: alignCenter"]12[/TD]
[TD="class: alignCenter"]723[/TD]
[TD="class: alignCenter"]1201[/TD]
[TD="class: alignCenter"]162[/TD]
[TD="class: alignCenter"]2098[/TD]
[TD="class: alignCenter"]6.9%[/TD]
[/TR]
[TR]
5-19 [TD="class: alignCenter"]13[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]35[/TD]
[TD="class: alignCenter"]1682[/TD]
[TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]895[/TD]
[TD="class: alignCenter"]782[/TD]
[TD="class: alignCenter"]269[/TD]
[TD="class: alignCenter"]1951[/TD]
[TD="class: alignCenter"]6.4%[/TD]
[/TR]
[TR]
20-44 [TD="class: alignCenter"]26[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]21[/TD]
[TD="class: alignCenter"]60[/TD]
[TD="class: alignCenter"]3251[/TD]
[TD="class: alignCenter"]13[/TD]
[TD="class: alignCenter"]1460[/TD]
[TD="class: alignCenter"]1778[/TD]
[TD="class: alignCenter"]369[/TD]
[TD="class: alignCenter"]3620[/TD]
[TD="class: alignCenter"]11.9%[/TD]
[/TR]
[TR]
45-64 [TD="class: alignCenter"]53[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]9[/TD]
[TD="class: alignCenter"]44[/TD]
[TD="class: alignCenter"]85[/TD]
[TD="class: alignCenter"]3609[/TD]
[TD="class: alignCenter"]13[/TD]
[TD="class: alignCenter"]1428[/TD]
[TD="class: alignCenter"]2168[/TD]
[TD="class: alignCenter"]512[/TD]
[TD="class: alignCenter"]4121[/TD]
[TD="class: alignCenter"]13.6%[/TD]
[/TR]
[TR]
65+ [TD="class: alignCenter"]245[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]43[/TD]
[TD="class: alignCenter"]202[/TD]
[TD="class: alignCenter"]136[/TD]
[TD="class: alignCenter"]17677[/TD]
[TD="class: alignCenter"]10[/TD]
[TD="class: alignCenter"]6543[/TD]
[TD="class: alignCenter"]11124[/TD]
[TD="class: alignCenter"]766[/TD]
[TD="class: alignCenter"]18443[/TD]
[TD="class: alignCenter"]60.8%[/TD]
[/TR]
[TR]
Unknown [TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]115[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]97[/TD]
[TD="class: alignCenter"]18[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]117[/TD]
[TD="class: alignCenter"]0.4%[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]367[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]6[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]66[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]295[/TD]
[TD="class: alignCenter"]337[/TD]
[TD="class: alignCenter"]28270[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]53[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]11146[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]17071[/TD]
[TD="class: alignCenter"]2080[/TD]
[TD="class: alignCenter"]30350[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[TR]
Percentage[SUP]2[/SUP] [TD="class: alignCenter"]52.1%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]1.6%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]18.0%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]80.4%[/TD]
[TD="class: alignCenter"]47.9%[/TD]
[TD="class: alignCenter"]93.1%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]0.2%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]39.4%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]60.4%[/TD]
[TD="class: alignCenter"]6.9%[/TD]
[TD="class: alignCenter"] [/TD]
[TD="class: alignCenter"] [/TD]
[/TR]
[/TABLE]
[h=2]Antiviral Resistance[/h] During the 2014-2015 influenza season, the NML has tested 764 influenza viruses for resistance to oseltamivir and 759 influenza viruses for resistance to zanamivir. All viruses were sensitive to zanamivir and one influenza A(H3N2) virus was resistant to oseltamivir. A total of 1042 influenza A viruses (99.9%) were resistant to amantadine (Table 3).
[TABLE="class: widthFull, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Virus type and subtype Oseltamivir Zanamivir Amantadine [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
# tested # resistant (%) # tested # resistant (%) # tested # resistant (%) [/TR]
[TR]
[TD="class: fontSize85, colspan: 7"][SUP]*[/SUP] NA - not applicable[/TD]
[/TR]
[TR]
A (H3N2) [TD="class: alignCenter"]651[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]646[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1038[/TD]
[TD="class: alignCenter"]1037 (99.9%)[/TD]
[/TR]
[TR]
A (H1N1) [TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]4 (100%)[/TD]
[/TR]
[TR]
B [TD="class: alignCenter"]110[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]110[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]NA [SUP]*[/SUP][/TD]
[TD="class: alignCenter"]NA [SUP]*[/SUP][/TD]
[/TR]
[TR]
TOTAL [TD="class: alignCenter"]764[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]759[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1042[/TD]
[TD="class: alignCenter"]1041[/TD]
[/TR]
[/TABLE]
[h=2]Influenza Strain Characterizations[/h] During the 2014-2015 influenza season, the National Microbiology Laboratory (NML) has characterized 277 influenza viruses [125 A(H3N2), 3 A(H1N1) and 149 influenza B].
Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assay (n=125), one virus was antigenically similar to A/Texas/50/2012, five showed reduced titers to A/Texas/50/2012 and 119 were antigenically similar to A/Switzerland/9715293/2013, which is the influenza A(H3N2) component recommended for the 2015 Southern Hemisphere influenza vaccine. Additionally, 827 A(H3N2) viruses were unable to be tested by HI assay; however, sequence analysis showed that 825 belonged to a genetic group that typically shows reduced titers to A/Texas/50/2012.
Influenza A(H1N1): Three A(H1N1) viruses characterized were antigenically similar to A/California/7/2009.
Influenza B: Of the 149 influenza B viruses characterized, 142 viruses were antigenically similar to B/Massachusetts/2/2012, three viruses showed reduced titers against B/Massachusetts/2/2012, and four were B/Brisbane/60/2008-like (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2014-2015, N = 277​
2015-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 2014-2015 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A/Texas/50/2012 (H3N2)-like virus, and a B/Massachusetts/2/2012-like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus is recommended.
The WHO has released the recommended composition of the influenza vaccine for the northern hemisphere for the 2015-2016 season. Trivalent vaccines are recommended to contain 1) an A/California/7/2009 (H1N1)pdm09-like virus 2) an A/Switzerland/9715293/2013 (H3N2)-like virus, and 3) an B/Phuket/3073/2013-like virus(Yamagata lineage). Quadrivalent vaccines are recommended to additionally contain a B/Brisbane/60/2008-like virus (Victoria lineage).


Text equivalent for figure 4Influenza strain characterizations, Canada, 2014-2015, N =3
[h=2]Influenza-like Illness (ILI) Consultation Rate[/h] The national influenza-like-illness (ILI) consultation rate increased to 52.0 consultations per 1,000, which is above expected levels for week 08 (Figure 5). The rate was highest among the 5 to 19 years of age group (67.7 consultations per 1,000) and lowest among the adults ≥65 years of age (34.6 consultations per 1,000)
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, 2014-2015​
2015-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. 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, 2014-2015
[h=2]Influenza Outbreak Surveillance[/h] In week 08, 31 new outbreaks of influenza were reported, a decrease from the previous week. The majority of the outbreaks occurred in the Central and Atlantic provinces. Twenty-four outbreaks were reported in long-term care facilities (LTCF) and seven in institutional or community settings (Figure 6). Among the outbreaks in which the influenza subtype was known, two LTCF outbreaks were associated with A(H3N2). To date this season, 1,039 outbreaks in LTCFs have been reported and the majority of those with known subtypes were attributable to A(H3N2). There have been a higher number of reported influenza outbreaks to date this season compared to the same period in previous seasons.
Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2014-2015
2015-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, 2014-2015
[h=2]Pharmacy Surveillance[/h] During week 08, the proportion of prescriptions for antivirals decreased to 157.8 antiviral prescriptions per 100,000 total prescriptions (from 221.8 per 100,000). The rate for antivirals since week 48 has been higher than the previous three seasons (Figure 7). The rate in all age groups decreased in week 08. The rate was highest among seniors at 260.3 per 100,000 total prescriptions and lowest among infants at 45.2 per 100,000 total prescriptions.
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2014-15​
2015-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, 2014-15
[h=2]Sentinel Hospital Influenza Surveillance[/h] Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In week 08, nine laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network: four cases of influenza A and five cases of influenza B (Figure 8a). A greater proportion of cases have been reported with influenza B in recent weeks, following the trend in laboratory detections. Among the reported cases, four (44%) were <2 years of age, three (44%) were 2 to 9 years of age and one (11%) was 10-16 years of age. One case was admitted to the ICU.
To date this season, 541 hospitalizations have been reported by the IMPACT network, 486 (90%) of which were cases of influenza A. Among cases for which the influenza A subtype was reported, 99% (157/159) were A(H3N2) (Table 4). To date, 66 cases were admitted to the ICU, of which 36 (55%) were 2 to 9 years of age (Figure 9a). A total of 38 ICU cases reported to have at least one underlying condition or comorbidity. Three 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, 67 laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network. Among the cases in week 08, 50 cases (75%) were in adults over the age of 65 and 53 cases (79%) had influenza A (Figure 8b).
To date this season, 1,810 cases have been reported; 1,741 (96%) with influenza A. The majority of cases (82%) were among adults ≥65 years of age (Table 5). One hundred and thirty-six ICU admissions have been reported and 103 cases were adults ≥65 years of age. A total of 97 ICU cases (71%) reported to have at least one underlying condition or comorbidity. Of the 94 ICU cases with known immunization status, 33 (35%) reported not having been vaccinated this season. Ninety-three deaths have been reported, 85 (91%) of the deaths were adults >65 years of age (Figure 9b).
Note: 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 marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (Aug. 24, 2014 to February 28, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) [TD="class: alignCenter"]Total[/TD]
[TD="class: alignCenter"]# (%)[/TD]
[/TR]
[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]
[TR]
0-5m [TD="class: alignCenter"]76[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]16[/TD]
[TD="class: alignCenter"]60[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]79 (14.6%)[/TD]
[/TR]
[TR]
6-23m [TD="class: alignCenter"]107[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]35[/TD]
[TD="class: alignCenter"]77[/TD]
[TD="class: alignCenter"]20[/TD]
[TD="class: alignCenter"]127 (23.5%)[/TD]
[/TR]
[TR]
2-4y [TD="class: alignCenter"]120[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]39[/TD]
[TD="class: alignCenter"]80[/TD]
[TD="class: alignCenter"]12[/TD]
[TD="class: alignCenter"]132 (24.4%)[/TD]
[/TR]
[TR]
5-9y [TD="class: alignCenter"]125[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]44[/TD]
[TD="class: alignCenter"]81[/TD]
[TD="class: alignCenter"]12[/TD]
[TD="class: alignCenter"]137 (25.3%)[/TD]
[/TR]
[TR]
10-16y [TD="class: alignCenter"]58[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]23[/TD]
[TD="class: alignCenter"]35[/TD]
[TD="class: alignCenter"]8[/TD]
[TD="class: alignCenter"]66 (12.2%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]486[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]2[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]157[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]327[/TD]
[TD="class: alignCenter"]55[/TD]
[TD="class: alignCenter"]541[/TD]
[/TR]
[TR]
% [SUP]1[/SUP] [TD="class: alignCenter"]89.8%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.4%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]32.3%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]67.3%[/TD]
[TD="class: alignCenter"]10.2%[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[/TABLE]
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 5 - Cumulative numbers of adult hospitalizations with influenza reported by the PCIRN-SOS network, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (November 15, 2014 to February 28, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A(UnS) [TD="class: alignCenter"]Total[/TD]
[TD="class: alignCenter"]# (%)[/TD]
[/TR]
[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]
[TR]
16-20 [TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]5(%)[/TD]
[/TR]
[TR]
20-44 [TD="class: alignCenter"]91[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]40[/TD]
[TD="class: alignCenter"]56[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]101(6%)[/TD]
[/TR]
[TR]
45-64 [TD="class: alignCenter"]195[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]79[/TD]
[TD="class: alignCenter"]116[/TD]
[TD="class: alignCenter"]19[/TD]
[TD="class: alignCenter"]214(12%)[/TD]
[/TR]
[TR]
65+ [TD="class: alignCenter"]1444[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]576[/TD]
[TD="class: alignCenter"]865[/TD]
[TD="class: alignCenter"]46[/TD]
[TD="class: alignCenter"]1490(82%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]1741[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]4[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]696[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]1041[/TD]
[TD="class: alignCenter"]69[/TD]
[TD="class: alignCenter"]1810[/TD]
[/TR]
[TR]
% [SUP]1[/SUP] [TD="class: alignCenter"]96%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]0%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]40%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]60%[/TD]
[TD="class: alignCenter"]4%[/TD]
[TD="class: alignCenter"]100%[/TD]
[/TR]
[/TABLE]
Figure 8 - Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2015-w08-fg8a-eng.gif
​
Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2015-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, 2014-15: Adult hospitalizations (>16 year of age, PCIRN-SOS)
Figure 9 - Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2015-w08-fg9a-eng.gif
Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)

Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15: Adult hospitalizations (≥16 year of age, PCIRN-SOS)
[h=2]Provincial/Territorial Influenza Hospitalizations and Deaths[/h] In week 08, 213 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories* which is less than the number reported in week 07 (n=276).Of the 213 hospitalizations, all but 16 were due to influenza A, and 73% were in patients ≥65 years of age. Since the start of the 2014-15 season, 5,493 hospitalizations have been reported; 5,312 (97%) with influenza A. Among cases for which the subtype of influenza A was reported, 99.5% were A(H3N2). The majority of cases (71%) were ≥65 years of age (Table 6). A total of 274 ICU admissions have been reported to date: 54% (n=149) were in adults ≥65 years of age and 30% (n=83) were in adults 20-64 years. A total of 389 deaths have been reported since the start of the season: three children <5 years of age, one child 5-19 years, 32 adults 20-64 years, and 353 adults ≥65 years of age. Adults 65 years of age or older represent 91% of all deaths reported this season. 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. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting.
[TABLE="class: widthFull, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (24 August 2014 to 28 February 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) [TD="class: alignCenter"]Total[/TD]
[TD="class: alignCenter"]# (%)[/TD]
[/TR]
[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]
[TR]
0-4 years [TD="class: alignCenter"]363[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]132[/TD]
[TD="class: alignCenter"]229[/TD]
[TD="class: alignCenter"]8[/TD]
[TD="class: alignCenter"]371 (7%)[/TD]
[/TR]
[TR]
5-19 years [TD="class: alignCenter"]218[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]107[/TD]
[TD="class: alignCenter"]111[/TD]
[TD="class: alignCenter"]16[/TD]
[TD="class: alignCenter"]234 (4%)[/TD]
[/TR]
[TR]
20-44 years [TD="class: alignCenter"]263[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]133[/TD]
[TD="class: alignCenter"]127[/TD]
[TD="class: alignCenter"]18[/TD]
[TD="class: alignCenter"]281 (5%)[/TD]
[/TR]
[TR]
45-64 years [TD="class: alignCenter"]581[/TD]
[TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]279[/TD]
[TD="class: alignCenter"]297[/TD]
[TD="class: alignCenter"]35[/TD]
[TD="class: alignCenter"]616 (11%)[/TD]
[/TR]
[TR]
65+ years [TD="class: alignCenter"]3832[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]1765[/TD]
[TD="class: alignCenter"]2066[/TD]
[TD="class: alignCenter"]94[/TD]
[TD="class: alignCenter"]3926 (71%)[/TD]
[/TR]
[TR]
Unknown [TD="class: alignCenter"]55[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]51[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]10[/TD]
[TD="class: alignCenter"]65 (1%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]5312[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]12[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]2467[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]2833[/TD]
[TD="class: alignCenter"]181[/TD]
[TD="class: alignCenter"]5493[/TD]
[/TR]
[TR]
Percentage [SUP]1[/SUP] [TD="class: alignCenter"]96.7%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.2%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]46.4%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]53.3%[/TD]
[TD="class: alignCenter"]3.3%[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[/TABLE]
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2014-15 on the Public Health Agency of Canada website.
[h=2]Emerging Respiratory Pathogens[/h] Human Avian Influenza
Influenza A(H7N9): Since the last FluWatch report, no new laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus were reported by the World Health Organization. Globally to March 6, 2015, the WHO reported a total of 572 laboratory-confirmed human cases with avian influenza A(H7N9) virus, including 204 deaths. Documents related to the public health risk of influenza A(H7N9), as well as guidance for health professionals and advice for the public is updated regularly on the following websites:
PHAC - Avian influenza A(H7N9)
WHO - Avian Influenza A(H7N9)
Influenza A(H5N6): Since the last FluWatch report, no new cases of human infection with avian influenza A (H5N6) virus from China has been reported by the World Health Organization. Globally to March 5, 2015, the WHO has been informed of a total of three cases of avian influenza A (H5N6) virus, including two deaths.
Middle East Respiratory Syndrome Coronavirus (MERS-CoV)
Since the last FluWatch report, 10 new laboratory-confirmed cases of MERS-CoV have been reported by the World Health Organization. Globally, from September 2012 to March 6, 2015, the WHO has been informed of a total of 1,040 laboratory-confirmed cases of infection with MERS-CoV, including 383 deaths. All cases have either occurred in the Middle East or have had direct links to a primary case infected in the Middle East. The public health risk posed by MERS-CoV in Canada remains low (see the PHAC Assessment of Public Health Risk) and for the latest global risk assessment posted by the WHO on February 5, 2015: WHO MERS-CoV
Documents related to the public health risk of MERS-CoV, as well as guidance for health professionals and advice for the public is updated regularly on the following websites:
PHAC - Middle East respiratory syndrome coronavirus (MERS-CoV)
WHO - Coronavirus infections
Avian Influenza A(H5)
Since the last FluWatch report, no new information has been provided by the CFIA. Further information on the outbreak is provided on the following CFIA website.
CFIA - Notifiable Avian Influenza

.../
http://www.phac-aspc.gc.ca/fluwatch/14-15/w08_15/index-eng.php
 
[h=1]FluWatch report: March 1 to 7, 2015 (Week 9)[/h] Posted 2015-03-13 For readers interested in the PDF version, the document is available for downloading or viewing:
FluWatch report: March 1 to 7, 2015 (Week 9) (PDF Version - 913 KB - 10 pages)

? ? Help with PDF documents

Overall Summary
  • In week 09, all influenza indicators remained similar to, or declined from the previous week.
  • Elevated influenza activity was mostly reported in the Central and Atlantic provinces
  • Influenza B detections continues to increase steadily, particularly in the West, the Prairies and in Quebec. It is mainly affecting individuals less than 64 years of age. This increase in influenza B is expected as influenza B often shows up later in the flu season.
  • A(H3N2) continues to be the most common influenza virus this season and seniors continue to have the highest number of positive laboratory detections, hospitalizations and deaths.
  • Evidence from the National Microbiology Laboratory (NML) indicates that this year's vaccine will continue to provide protection against the circulating A(H1N1) and B strains.

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
[h=2]Influenza/ILI Activity (geographic spread)[/h] In week 09, no widespread activity was reported. Seventeen regions reported localized activity: AB, ON(7), QC, NB(3), NS(4), and NL. Twenty-seven regions reported sporadic activity: in YK, BC(5), AB(4), SK(2), MB(3), QC(5), NB(3), NS(2), PE and NL. No activity was reported in fourteen regions: NU(3), NT(2), SK, MB(2), NB, NS(3) and NF(2). When compared to the previous week, there was an overall decrease in influenza activity as there were less regions reporting activity and no regions reporting widespread activity.
Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 9​
​
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
[h=2]Influenza and Other Respiratory Virus Detections[/h] In week 09, the number of positive influenza tests (1,081) and the percentage positive for influenza A (8.6%) continued to decline from the previous week (Figure 2). The percentage of positive influenza B tests continued to increase and was 7.7% in week 09. Influenza B detections were greater than influenza A detections in many provinces (BC, AB, SK, MB, QC and PE). To date, 92% of influenza detections have been influenza A, and 99.4% of those subtyped have been A(H3N2) (Table 1). To date this season, detailed information on age and type/subtype has been received for 31,623 cases (Table 2). Adults =65 years of age have predominantly been affected by influenza A, accounting for 62% of influenza A detections. Influenza B, while much smaller in numbers, is mainly affecting individuals less than 64 years of age, accounting to 63% of influenza B detections.
Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2014-15​
2015-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, 2014-15
In week 09, detections of all respiratory viruses decreased from the previous week (Figure 3). Detections of respiratory syncytial virus (RSV) in week 09 were greater than the detections of influenza A with 757 detections (vs 572 detections of influenza A). In recent weeks, weekly detections of adenovirus, coronavirus, rhinovirus and parainfluenza have been greater than those reported in each of the past three seasons. Weekly detections of hMPV this season have been lower compared to the previous three seasons.
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, 2014-15​
2015-w09-fg3-eng.gif
​
RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2014-2015
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 1: Weekly and cumulative numbers of positive influenza specimens
by type, subtype and province, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Reporting provinces [SUP]1[/SUP] Weekly
(March 1 to March 7, 2015) Cumulative
(August 24 to March 7, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1)pdm09 A(H3) A(UnS) B Total A Total A(H1)pdm09 A(H3) A(UnS) [TD="class: alignCenter"]B Total[/TD]
[/TR]
[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]
[TR]
BC [TD="class: alignCenter"]25[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]16[/TD]
[TD="class: alignCenter"]8[/TD]
[TD="class: alignCenter"]28[/TD]
[TD="class: alignCenter"]3433[/TD]
[TD="class: alignCenter"]25[/TD]
[TD="class: alignCenter"]2566[/TD]
[TD="class: alignCenter"]842[/TD]
[TD="class: alignCenter"]204[/TD]
[/TR]
[TR]
AB [TD="class: alignCenter"]19[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]15[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]39[/TD]
[TD="class: alignCenter"]3640[/TD]
[TD="class: alignCenter"]10[/TD]
[TD="class: alignCenter"]3477[/TD]
[TD="class: alignCenter"]153[/TD]
[TD="class: alignCenter"]485[/TD]
[/TR]
[TR]
SK [TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]12[/TD]
[TD="class: alignCenter"]1300[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]836[/TD]
[TD="class: alignCenter"]464[/TD]
[TD="class: alignCenter"]68[/TD]
[/TR]
[TR]
MB [TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]12[/TD]
[TD="class: alignCenter"]1113[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]384[/TD]
[TD="class: alignCenter"]729[/TD]
[TD="class: alignCenter"]55[/TD]
[/TR]
[TR]
ON [TD="class: alignCenter"]228[/TD]
[TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]72[/TD]
[TD="class: alignCenter"]151[/TD]
[TD="class: alignCenter"]44[/TD]
[TD="class: alignCenter"]10490[/TD]
[TD="class: alignCenter"]30[/TD]
[TD="class: alignCenter"]4448[/TD]
[TD="class: alignCenter"]6012[/TD]
[TD="class: alignCenter"]285[/TD]
[/TR]
[TR]
QC [TD="class: alignCenter"]181[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]181[/TD]
[TD="class: alignCenter"]310[/TD]
[TD="class: alignCenter"]11110[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]422[/TD]
[TD="class: alignCenter"]10684[/TD]
[TD="class: alignCenter"]1542[/TD]
[/TR]
[TR]
NB [TD="class: alignCenter"]66[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]14[/TD]
[TD="class: alignCenter"]52[/TD]
[TD="class: alignCenter"]27[/TD]
[TD="class: alignCenter"]930[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]142[/TD]
[TD="class: alignCenter"]788[/TD]
[TD="class: alignCenter"]102[/TD]
[/TR]
[TR]
NS [TD="class: alignCenter"]35[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]35[/TD]
[TD="class: alignCenter"]27[/TD]
[TD="class: alignCenter"]436[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]123[/TD]
[TD="class: alignCenter"]313[/TD]
[TD="class: alignCenter"]87[/TD]
[/TR]
[TR]
PE [TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]7[/TD]
[TD="class: alignCenter"]113[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]110[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]13[/TD]
[/TR]
[TR]
NL [TD="class: alignCenter"]7[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]7[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]586[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]53[/TD]
[TD="class: alignCenter"]533[/TD]
[TD="class: alignCenter"]7[/TD]
[/TR]
[TR]
Canada [TD="class: alignCenter"]572[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]6[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]122[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]444[/TD]
[TD="class: alignCenter"]509[/TD]
[TD="class: alignCenter"]33151[/TD]
[TD="class: alignCenter"]70[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]12561[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]20520[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]2848[/TD]
[/TR]
[TR]
Percentage[SUP]2[/SUP] [TD="class: alignCenter"]52.9%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]1.0%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]21.3%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]77.6%[/TD]
[TD="class: alignCenter"]47.1%[/TD]
[TD="class: alignCenter"]92.1%[/TD]
[TD="class: alignCenter"]0.2%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]37.9%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]61.9%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]7.9%[/TD]
[/TR]
[/TABLE]
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
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, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups (years) Weekly
(March 1 to March 7, 2015) Cumulative
(August 24 to March 7, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) [TD="class: alignCenter"]Total[/TD]
A Total A(H1) pdm09 A(H3) A (UnS) [TD="class: alignCenter"]Total[/TD]
# % [/TR]
[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]
[TR]
<5 [TD="class: alignCenter"]27[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]24[/TD]
[TD="class: alignCenter"]25[/TD]
[TD="class: alignCenter"]2020[/TD]
[TD="class: alignCenter"]15[/TD]
[TD="class: alignCenter"]731[/TD]
[TD="class: alignCenter"]1274[/TD]
[TD="class: alignCenter"]196[/TD]
[TD="class: alignCenter"]2216[/TD]
[TD="class: alignCenter"]7.0%[/TD]
[/TR]
[TR]
5-19 [TD="class: alignCenter"]12[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]8[/TD]
[TD="class: alignCenter"]28[/TD]
[TD="class: alignCenter"]1734[/TD]
[TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]899[/TD]
[TD="class: alignCenter"]830[/TD]
[TD="class: alignCenter"]324[/TD]
[TD="class: alignCenter"]2058[/TD]
[TD="class: alignCenter"]6.5%[/TD]
[/TR]
[TR]
20-44 [TD="class: alignCenter"]32[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]7[/TD]
[TD="class: alignCenter"]25[/TD]
[TD="class: alignCenter"]66[/TD]
[TD="class: alignCenter"]3341[/TD]
[TD="class: alignCenter"]13[/TD]
[TD="class: alignCenter"]1483[/TD]
[TD="class: alignCenter"]1845[/TD]
[TD="class: alignCenter"]449[/TD]
[TD="class: alignCenter"]3790[/TD]
[TD="class: alignCenter"]12.0%[/TD]
[/TR]
[TR]
45-64 [TD="class: alignCenter"]39[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]33[/TD]
[TD="class: alignCenter"]113[/TD]
[TD="class: alignCenter"]3721[/TD]
[TD="class: alignCenter"]14[/TD]
[TD="class: alignCenter"]1443[/TD]
[TD="class: alignCenter"]2264[/TD]
[TD="class: alignCenter"]651[/TD]
[TD="class: alignCenter"]4372[/TD]
[TD="class: alignCenter"]13.8%[/TD]
[/TR]
[TR]
65+ [TD="class: alignCenter"]208[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]26[/TD]
[TD="class: alignCenter"]182[/TD]
[TD="class: alignCenter"]176[/TD]
[TD="class: alignCenter"]18104[/TD]
[TD="class: alignCenter"]11[/TD]
[TD="class: alignCenter"]6618[/TD]
[TD="class: alignCenter"]11475[/TD]
[TD="class: alignCenter"]966[/TD]
[TD="class: alignCenter"]19070[/TD]
[TD="class: alignCenter"]60.3%[/TD]
[/TR]
[TR]
Unknown [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"]115[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]97[/TD]
[TD="class: alignCenter"]18[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]117[/TD]
[TD="class: alignCenter"]0.4%[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]318[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]1[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]45[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]272[/TD]
[TD="class: alignCenter"]408[/TD]
[TD="class: alignCenter"]29035[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]58[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]11271[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]17706[/TD]
[TD="class: alignCenter"]2588[/TD]
[TD="class: alignCenter"]31623[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[TR]
Percentage[SUP]2[/SUP] [TD="class: alignCenter"]43.8%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.3%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]14.2%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]85.5%[/TD]
[TD="class: alignCenter"]56.2%[/TD]
[TD="class: alignCenter"]91.8%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.2%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]38.8%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]61.0%[/TD]
[TD="class: alignCenter"]8.2%[/TD]
[TD="class: alignCenter"] [/TD]
[TD="class: alignCenter"] [/TD]
[/TR]
[/TABLE]
[h=2]Antiviral Resistance[/h] During the 2014-2015 influenza season, the NML has tested 857 influenza viruses for resistance to oseltamivir and 853 influenza viruses for resistance to zanamivir. All viruses were sensitive to zanamivir and one influenza A(H3N2) virus was resistant to oseltamivir. A total of 1,062 influenza A viruses (99.9%) were resistant to amantadine (Table 3).
[TABLE="class: widthFull, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Virus type and subtype Oseltamivir Zanamivir Amantadine [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
# tested # resistant (%) # tested # resistant (%) # tested # resistant (%) [/TR]
[TR]
[TD="class: fontSize85, colspan: 7"][SUP]*[/SUP] NA - not applicable[/TD]
[/TR]
[TR]
A (H3N2) [TD="class: alignCenter"]705[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]701[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1059[/TD]
[TD="class: alignCenter"]1058 (99.9%)[/TD]
[/TR]
[TR]
A (H1N1) [TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]4 (100%)[/TD]
[/TR]
[TR]
B [TD="class: alignCenter"]148[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]148[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]NA [SUP]*[/SUP][/TD]
[TD="class: alignCenter"]NA [SUP]*[/SUP][/TD]
[/TR]
[TR]
TOTAL [TD="class: alignCenter"]857[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]853[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1063[/TD]
[TD="class: alignCenter"]1062[/TD]
[/TR]
[/TABLE]
[h=2]Influenza Strain Characterizations[/h] During the 2014-2015 influenza season, the National Microbiology Laboratory (NML) has characterized 305 influenza viruses [149 A(H3N2), 3 A(H1N1) and 153 influenza B]. Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assay (n=149), one virus was antigenically similar to A/Texas/50/2012, five showed reduced titers to A/Texas/50/2012 and 143 were antigenically similar to A/Switzerland/9715293/2013, which is the influenza A(H3N2) component recommended for the 2015 Southern Hemisphere influenza vaccine. Additionally, 893 A(H3N2) viruses were unable to be tested by HI assay; however, sequence analysis showed that 891 belonged to a genetic group that typically shows reduced titers to A/Texas/50/2012. Influenza A(H1N1): Three A(H1N1) viruses characterized were antigenically similar to A/California/7/2009. Influenza B:Of the 153 influenza B viruses characterized, 146 viruses were antigenically similar to B/Massachusetts/2/2012, three viruses showed reduced titers against B/Massachusetts/2/2012, and four were B/Brisbane/60/2008-like (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2014-2015, N = 305​
2015-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 2014-2015 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A/Texas/50/2012 (H3N2)-like virus, and a B/Massachusetts/2/2012-like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus is recommended.
The WHO has released the recommended composition of the influenza vaccine for the northern hemisphere for the 2015-2016 season. Trivalent vaccines are recommended to contain 1) an A/California/7/2009 (H1N1)pdm09-like virus 2) an A/Switzerland/9715293/2013 (H3N2)-like virus, and 3) an B/Phuket/3073/2013-like virus(Yamagata lineage). Quadrivalent vaccines are recommended to additionally contain a B/Brisbane/60/2008-like virus (Victoria lineage).


Text equivalent for figure 4Influenza strain characterizations, Canada, 2014-2015, N =3
[h=2]Influenza-like Illness (ILI) Consultation Rate[/h] The national influenza-like-illness (ILI) consultation rate decreased to 50.5 consultations per 1,000, which is above expected levels for week 09 (Figure 5). The rate was highest among the 5 to 19 years of age group (61.3 consultations per 1,000) and lowest among the adults =65 years of age (41.4 consultations per 1,000)
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, 2014-2015​
2015-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. 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, 2014-2015
[h=2]Influenza Outbreak Surveillance[/h] In week 09, 33 new outbreaks of influenza were reported. The majority of the outbreaks occurred in the Central and Atlantic provinces. Twenty-two outbreaks were reported in long-term care facilities (LTCF), six in hospitals and five in institutional or community settings (Figure 6). An additional five outbreaks of ILI were reported in schools. Among the outbreaks in which the influenza subtype was known, three LTCF outbreaks were associated with A(H3N2) and one outbreak was associated with influenza B. To date this season, 1,061 outbreaks in LTCFs have been reported and the majority of those with known subtypes were attributable to A(H3N2). There have been a higher number of reported influenza outbreaks to date this season compared to the same period in previous seasons.
Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2014-2015
2015-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, 2014-2015
[h=2]Pharmacy Surveillance[/h] During week 09, the proportion of prescriptions for antivirals decreased to 147.3 antiviral prescriptions per 100,000 total prescriptions (from 150.1 per 100,000). The rate for antivirals since week 48 has been higher than the previous three seasons (Figure 7). The rate in all age groups except infants decreased in week 09. The rate was highest among seniors at 210.1 per 100,000 total prescriptions and lowest among infants at 64.9 per 100,000 total prescriptions.
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2014-15​
2015-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, 2014-15
[h=2]Sentinel Hospital Influenza Surveillance[/h] Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In week 09, seventeen laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network: six cases of influenza A and eleven cases of influenza B (Figure 8a). A greater proportion of cases have been reported with influenza B in recent weeks, following the trend in laboratory detections. Among the reported cases, five (29%) were <2 years of age, nine (53%) were 2 to 9 years of age and three (17%) were 10-16 years of age. No ICU admissions were reported.
To date this season, 565 hospitalizations have been reported by the IMPACT network, 496 (88%) of which were cases of influenza A. Among cases for which the influenza A subtype was reported, 99% (159/161) were A(H3N2) (Table 4). To date, 69 cases were admitted to the ICU, of which 36 (52%) were 2 to 9 years of age (Figure 9a). A total of 38 ICU cases reported to have at least one underlying condition or comorbidity. Three 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, 63 laboratory-confirmed influenza-associated adult (=16 years of age) hospitalizations were reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network. Among the cases in week 09, 46 cases (73%) were in adults over the age of 65 and 43 cases (68%) had influenza A (Figure 8b).
To date this season, 1,898 cases have been reported; 1,801 (95%) with influenza A. The majority of cases (82%) were among adults =65 years of age (Table 5). One hundred and forty ICU admissions have been reported and 107 cases were adults =65 years of age. A total of 99 ICU cases (71%) reported to have at least one underlying condition or comorbidity. Of the 99 ICU cases with known immunization status, 35 (35%) reported not having been vaccinated this season. One hundred and six deaths have been reported, 97 (92%) of the deaths were adults >65 years of age (Figure 9B).
Note: 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 marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (Aug. 24, 2014 to March 7, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) [TD="class: alignCenter"]Total[/TD]
[TD="class: alignCenter"]# (%)[/TD]
[/TR]
[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]
[TR]
0-5m [TD="class: alignCenter"]79[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]16[/TD]
[TD="class: alignCenter"]63[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]83 (14.7%)[/TD]
[/TR]
[TR]
6-23m [TD="class: alignCenter"]109[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]36[/TD]
[TD="class: alignCenter"]72[/TD]
[TD="class: alignCenter"]23[/TD]
[TD="class: alignCenter"]132 (23.4%)[/TD]
[/TR]
[TR]
2-4y [TD="class: alignCenter"]121[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]40[/TD]
[TD="class: alignCenter"]80[/TD]
[TD="class: alignCenter"]15[/TD]
[TD="class: alignCenter"]136 (24.1%)[/TD]
[/TR]
[TR]
5-9y [TD="class: alignCenter"]127[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]44[/TD]
[TD="class: alignCenter"]83[/TD]
[TD="class: alignCenter"]16[/TD]
[TD="class: alignCenter"]143 (25.3%)[/TD]
[/TR]
[TR]
10-16y [TD="class: alignCenter"]60[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]23[/TD]
[TD="class: alignCenter"]37[/TD]
[TD="class: alignCenter"]11[/TD]
[TD="class: alignCenter"]71 (12.6%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]496[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]2[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]159[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]335[/TD]
[TD="class: alignCenter"]69[/TD]
[TD="class: alignCenter"]565[/TD]
[/TR]
[TR]
% [SUP]1[/SUP] [TD="class: alignCenter"]87.8%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.4%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]32.1%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]67.5%[/TD]
[TD="class: alignCenter"]12.2%[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[/TABLE]
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 5 - Cumulative numbers of adult hospitalizations with influenza reported by the PCIRN-SOS network, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (November 15, 2014 to March 7, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A(UnS) [TD="class: alignCenter"]Total[/TD]
[TD="class: alignCenter"]# (%)[/TD]
[/TR]
[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]
[TR]
16-20 [TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]3 (%)[/TD]
[/TR]
[TR]
20-44 [TD="class: alignCenter"]102[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]45[/TD]
[TD="class: alignCenter"]56[/TD]
[TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]108 (6%)[/TD]
[/TR]
[TR]
45-64 [TD="class: alignCenter"]207[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]88[/TD]
[TD="class: alignCenter"]119[/TD]
[TD="class: alignCenter"]24[/TD]
[TD="class: alignCenter"]231 (12%)[/TD]
[/TR]
[TR]
65+ [TD="class: alignCenter"]1489[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]632[/TD]
[TD="class: alignCenter"]854[/TD]
[TD="class: alignCenter"]67[/TD]
[TD="class: alignCenter"]1556 (82%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]1801[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]4[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]766[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]1031[/TD]
[TD="class: alignCenter"]97[/TD]
[TD="class: alignCenter"]1898[/TD]
[/TR]
[TR]
% [SUP]1[/SUP] [TD="class: alignCenter"]95%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]43%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]57%[/TD]
[TD="class: alignCenter"]5%[/TD]
[TD="class: alignCenter"]100%[/TD]
[/TR]
[/TABLE]
Figure 8 - Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15
A) Paediatric hospitalizations (≤16 years of age, IMPACT)

Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2015-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, 2014-15: Adult hospitalizations (>16 year of age, PCIRN-SOS)
Figure 9 - Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2015-w09-fg9a-eng.gif
Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)

Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15: Adult hospitalizations (≥16 year of age, PCIRN-SOS)
[h=2]Provincial/Territorial Influenza Hospitalizations and Deaths[/h] In week 09, 182 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories* which is less than the number reported in week 08 (n=213). Of the 182 hospitalizations, all but 28 were due to influenza A, and 74% were in patients =65 years of age. Since the start of the 2014-15 season, 5769 hospitalizations have been reported; 5541 (97%) with influenza A. Among cases for which the subtype of influenza A was reported, 99.5% were A(H3N2). The majority of cases (72%) were =65 years of age (Table 6). A total of 282 ICU admissions have been reported to date: 54% (n=153) were in adults =65 years of age and 31% (n=88) were in adults 20-64 years. A total of 413 deaths have been reported since the start of the season: three children <5 years of age, two children 5-19 years, 24 adults 20-64 years, and 384 adults =65 years of age. Adults 65 years of age or older represent 93% of all deaths reported this season. 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. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting.
[TABLE="class: widthFull, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (24 August 2014 to 7 March 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) [TD="class: alignCenter"]Total[/TD]
[TD="class: alignCenter"]# (%)[/TD]
[/TR]
[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]
[TR]
0-4 years [TD="class: alignCenter"]374[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]136[/TD]
[TD="class: alignCenter"]236[/TD]
[TD="class: alignCenter"]12[/TD]
[TD="class: alignCenter"]386 (7%)[/TD]
[/TR]
[TR]
5-19 years [TD="class: alignCenter"]237[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]119[/TD]
[TD="class: alignCenter"]116[/TD]
[TD="class: alignCenter"]31[/TD]
[TD="class: alignCenter"]268 (5%)[/TD]
[/TR]
[TR]
20-44 years [TD="class: alignCenter"]346[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]202[/TD]
[TD="class: alignCenter"]141[/TD]
[TD="class: alignCenter"]27[/TD]
[TD="class: alignCenter"]373 (6%)[/TD]
[/TR]
[TR]
45-64 years [TD="class: alignCenter"]518[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]216[/TD]
[TD="class: alignCenter"]299[/TD]
[TD="class: alignCenter"]29[/TD]
[TD="class: alignCenter"]547 (9%)[/TD]
[/TR]
[TR]
65+ years [TD="class: alignCenter"]4010[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]1843[/TD]
[TD="class: alignCenter"]2166[/TD]
[TD="class: alignCenter"]118[/TD]
[TD="class: alignCenter"]4128 (72%)[/TD]
[/TR]
[TR]
Unknown [TD="class: alignCenter"]56[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]52[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]11[/TD]
[TD="class: alignCenter"]67 (1%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]5541[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]12[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]2568[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]2961[/TD]
[TD="class: alignCenter"]228[/TD]
[TD="class: alignCenter"]5769[/TD]
[/TR]
[TR]
Percentage [SUP]1[/SUP] [TD="class: alignCenter"]96.0%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.2%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]46.3%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]53.4%[/TD]
[TD="class: alignCenter"]4.0%[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[/TABLE]
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2014-15 on the Public Health Agency of Canada website.
[h=2]Emerging Respiratory Pathogens[/h] Human Avian Influenza
Influenza A(H7N9): Since the last FluWatch report, 59 new laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus were reported by the World Health Organization. Globally to March 13, 2015, the WHO reported a total of 631 laboratory-confirmed human cases with avian influenza A(H7N9) virus, including 221 deaths. Documents related to the public health risk of influenza A(H7N9), as well as guidance for health professionals and advice for the public is updated regularly on the following websites:
PHAC - Avian influenza A(H7N9)
WHO - Avian Influenza A(H7N9)
Influenza A(H5N6): Since the last FluWatch report, no new cases of human infection with avian influenza A (H5N6) virus from China has been reported by the World Health Organization. Globally to March 13, 2015, the WHO has been informed of a total of three cases of avian influenza A (H5N6) virus, including two deaths.
Middle East Respiratory Syndrome Coronavirus (MERS-CoV)
Since the last FluWatch report, 20 new laboratory-confirmed cases of MERS-CoV have been reported by the World Health Organization. Globally, from September 2012 to March 13, 2015, the WHO has been informed of a total of 1,060 laboratory-confirmed cases of infection with MERS-CoV, including 394 deaths. All cases have either occurred in the Middle East or have had direct links to a primary case infected in the Middle East. The public health risk posed by MERS-CoV in Canada remains low (see the PHAC Assessment of Public Health Risk) and for the latest global risk assessment posted by the WHO on February 5, 2015: WHO MERS-CoV
Documents related to the public health risk of MERS-CoV, as well as guidance for health professionals and advice for the public is updated regularly on the following websites:
PHAC - Middle East respiratory syndrome coronavirus (MERS-CoV)
WHO - Coronavirus infections
Avian Influenza A(H5)
As of March 9, 2015, the CFIA has removed the avian influenza Primary Control Zone PCZ in British Columbia. Permits are no longer required for the movement of birds and bird products in British Columbia. Surveillance by the CFIA has not detected the H5N2 and H5N1 strains of the virus in domestic poultry since February 2, 2015.
CFIA - Notifiable Avian Influenza

.../
http://www.phac-aspc.gc.ca/fluwatch/14-15/w09_15/index-eng.php
 
[h=1]FluWatch report: March 8 to 14, 2015 (Week 10)[/h] Posted 2015-03-20 For readers interested in the PDF version, the document is available for downloading or viewing:
FluWatch report: March 8 to 14, 2015 (Week 10) (PDF Version - 824 KB - 10 pages)

? ? Help with PDF documents

Overall Summary
  • Elevated influenza activity was mostly reported in the Central and Atlantic provinces and in a few regions in the Western provinces. Widespread activity was reported in regions in Quebec and Newfoundland and Labrador.
  • Influenza B detections continue to increase steadily, particularly in the West, the Prairies and in Quebec and is mainly affecting individuals less than 65 years of age. This week, overall detections for influenza B surpassed that of influenza A. This increase in influenza B is expected as influenza B often shows up later in the flu season.
  • Despite the late-season circulation of influenza B, influenza A(H3N2) remains the most common influenza virus detected this season to date and seniors continue to be affected.
  • Evidence from the National Microbiology Laboratory (NML) indicates that this year's vaccine will continue to provide protection against the circulating A(H1N1) and B strains.

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
[h=2]Influenza/ILI Activity (geographic spread)[/h] In week 10, three regions reported widespread activity: QC(2) and NL. Seventeen regions reported localized activity: BC(3), AB, ON(7), QC, NB and NS(4). Twenty-eight regions reported sporadic activity: in YK, NT, NU, BC(2), AB(4), SK(3), MB(3), QC(3), NB(6), NS(3), and PE. No activity was reported in ten regions : NL(3). NS(2), MB(2), NT and NU(2).
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
[h=2]Influenza and Other Respiratory Virus Detections[/h] In week 10, the number of positive influenza tests (1,010) and the percentage positive for influenza A (6.6%) continued to decline from the previous week (Figure 2). The percentage of positive influenza B tests continued to increase and was 10.0% in week 10. Influenza B detections were greater than influenza A detections in many provinces (BC, AB, SK, MB, QC, PE and NS). To date, 91% of influenza detections have been influenza A, and 99.4% of those subtyped have been A(H3N2) (Table 1). To date this season, detailed information on age and type/subtype has been received for 32,237 cases (Table 2). Adults ≥65 years of age have predominantly been affected by influenza A, accounting for 62% of influenza A detections. Influenza B, while much smaller in numbers, is mainly affecting individuals less than 65 years of age, accounting for 61% of influenza B detections.
Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2014-15​
2015-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, 2014-15
In week 10, detections of all respiratory viruses decreased from the previous week (Figure 3). Since week 04, detections of parainfluenza have been greater than those reported in each of the past three seasons. Weekly detections of hMPV this season have been lower compared to the previous three seasons.
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, 2014-15​
2015-w10-fg3-eng.gif
​
RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2014-2015
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 1: Weekly and cumulative numbers of positive influenza specimens
by type, subtype and province, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Reporting provinces [SUP]1[/SUP] Weekly
(March 8 to March 14, 2015) Cumulative
(August 24 to March 14, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1)pdm09 A(H3) A(UnS) B Total A Total A(H1)pdm09 A(H3) A(UnS) B Total [/TR]
[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]
[TR]
BC [TD="class: alignCenter"]19[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]18[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]23[/TD]
[TD="class: alignCenter"]3452[/TD]
[TD="class: alignCenter"]25[/TD]
[TD="class: alignCenter"]2584[/TD]
[TD="class: alignCenter"]843[/TD]
[TD="class: alignCenter"]227[/TD]
[/TR]
[TR]
AB [TD="class: alignCenter"]8[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]45[/TD]
[TD="class: alignCenter"]3648[/TD]
[TD="class: alignCenter"]12[/TD]
[TD="class: alignCenter"]3484[/TD]
[TD="class: alignCenter"]152[/TD]
[TD="class: alignCenter"]531[/TD]
[/TR]
[TR]
SK [TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]11[/TD]
[TD="class: alignCenter"]1304[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]836[/TD]
[TD="class: alignCenter"]468[/TD]
[TD="class: alignCenter"]85[/TD]
[/TR]
[TR]
MB [TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]1118[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]385[/TD]
[TD="class: alignCenter"]733[/TD]
[TD="class: alignCenter"]61[/TD]
[/TR]
[TR]
ON [TD="class: alignCenter"]173[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]58[/TD]
[TD="class: alignCenter"]112[/TD]
[TD="class: alignCenter"]82[/TD]
[TD="class: alignCenter"]10684[/TD]
[TD="class: alignCenter"]34[/TD]
[TD="class: alignCenter"]4511[/TD]
[TD="class: alignCenter"]6139[/TD]
[TD="class: alignCenter"]379[/TD]
[/TR]
[TR]
QC [TD="class: alignCenter"]98[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]98[/TD]
[TD="class: alignCenter"]349[/TD]
[TD="class: alignCenter"]11208[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]422[/TD]
[TD="class: alignCenter"]10782[/TD]
[TD="class: alignCenter"]1891[/TD]
[/TR]
[TR]
NB [TD="class: alignCenter"]74[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]12[/TD]
[TD="class: alignCenter"]62[/TD]
[TD="class: alignCenter"]38[/TD]
[TD="class: alignCenter"]1004[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]154[/TD]
[TD="class: alignCenter"]850[/TD]
[TD="class: alignCenter"]140[/TD]
[/TR]
[TR]
NS [TD="class: alignCenter"]14[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]14[/TD]
[TD="class: alignCenter"]40[/TD]
[TD="class: alignCenter"]450[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]123[/TD]
[TD="class: alignCenter"]327[/TD]
[TD="class: alignCenter"]127[/TD]
[/TR]
[TR]
PE [TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]10[/TD]
[TD="class: alignCenter"]116[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]113[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]23[/TD]
[/TR]
[TR]
NL [TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]592[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]53[/TD]
[TD="class: alignCenter"]539[/TD]
[TD="class: alignCenter"]10[/TD]
[/TR]
[TR]
Canada [TD="class: alignCenter"]403[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]3[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]96[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]304[/TD]
[TD="class: alignCenter"]607[/TD]
[TD="class: alignCenter"]33576[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]76[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]12665[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]20835[/TD]
[TD="class: alignCenter"]3474[/TD]
[/TR]
[TR]
Percentage[SUP]2[/SUP] [TD="class: alignCenter"]39.9%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]0.7%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]23.8%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]75.4%[/TD]
[TD="class: alignCenter"]60.1%[/TD]
[TD="class: alignCenter"]90.6%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]0.2%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]37.7%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]62.1%[/TD]
[TD="class: alignCenter"]9.4%[/TD]
[/TR]
[/TABLE]
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
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, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups (years) Weekly
(March 8 to March 14, 2015) Cumulative
(August 24 to March 14, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) Total A Total A(H1) pdm09 A(H3) A (UnS) Total # % [/TR]
[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]
[TR]
<5 [TD="class: alignCenter"]13[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]11[/TD]
[TD="class: alignCenter"]26[/TD]
[TD="class: alignCenter"]2033[/TD]
[TD="class: alignCenter"]15[/TD]
[TD="class: alignCenter"]796[/TD]
[TD="class: alignCenter"]1222[/TD]
[TD="class: alignCenter"]226[/TD]
[TD="class: alignCenter"]2259[/TD]
[TD="class: alignCenter"]7.0%[/TD]
[/TR]
[TR]
5-19 [TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]32[/TD]
[TD="class: alignCenter"]1738[/TD]
[TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]937[/TD]
[TD="class: alignCenter"]796[/TD]
[TD="class: alignCenter"]360[/TD]
[TD="class: alignCenter"]2098[/TD]
[TD="class: alignCenter"]6.5%[/TD]
[/TR]
[TR]
20-44 [TD="class: alignCenter"]8[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]45[/TD]
[TD="class: alignCenter"]3350[/TD]
[TD="class: alignCenter"]14[/TD]
[TD="class: alignCenter"]1631[/TD]
[TD="class: alignCenter"]1705[/TD]
[TD="class: alignCenter"]500[/TD]
[TD="class: alignCenter"]3850[/TD]
[TD="class: alignCenter"]11.9%[/TD]
[/TR]
[TR]
45-64 [TD="class: alignCenter"]18[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]18[/TD]
[TD="class: alignCenter"]122[/TD]
[TD="class: alignCenter"]3741[/TD]
[TD="class: alignCenter"]15[/TD]
[TD="class: alignCenter"]1608[/TD]
[TD="class: alignCenter"]2118[/TD]
[TD="class: alignCenter"]786[/TD]
[TD="class: alignCenter"]4527[/TD]
[TD="class: alignCenter"]14.0%[/TD]
[/TR]
[TR]
65+ [TD="class: alignCenter"]80[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]76[/TD]
[TD="class: alignCenter"]208[/TD]
[TD="class: alignCenter"]18194[/TD]
[TD="class: alignCenter"]11[/TD]
[TD="class: alignCenter"]7064[/TD]
[TD="class: alignCenter"]11119[/TD]
[TD="class: alignCenter"]1192[/TD]
[TD="class: alignCenter"]19386[/TD]
[TD="class: alignCenter"]60.1%[/TD]
[/TR]
[TR]
Unknown [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"]115[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]97[/TD]
[TD="class: alignCenter"]18[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]117[/TD]
[TD="class: alignCenter"]0.4%[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]122[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]0[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]10[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]112[/TD]
[TD="class: alignCenter"]433[/TD]
[TD="class: alignCenter"]29171[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]60[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]12133[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]16978[/TD]
[TD="class: alignCenter"]3066[/TD]
[TD="class: alignCenter"]32237[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[TR]
Percentage[SUP]2[/SUP] [TD="class: alignCenter"]22.0%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]0.0%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]8.2%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]91.8%[/TD]
[TD="class: alignCenter"]78.0%[/TD]
[TD="class: alignCenter"]90.5%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]0.2%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]41.6%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]58.2%[/TD]
[TD="class: alignCenter"]9.5%[/TD]
[TD="class: alignCenter"] [/TD]
[TD="class: alignCenter"] [/TD]
[/TR]
[/TABLE]
[h=2]Antiviral Resistance[/h] During the 2014-2015 influenza season, the NML has tested 946 influenza viruses for resistance to oseltamivir and 943 influenza viruses for resistance to zanamivir. All viruses were sensitive to zanamivir and one influenza A(H3N2) virus was resistant to oseltamivir. A total of 1,144 influenza A viruses (99.9%) were resistant to amantadine (Table 3).
[TABLE="class: widthFull, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Virus type and subtype Oseltamivir Zanamivir Amantadine [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
# tested # resistant (%) # tested # resistant (%) # tested # resistant (%) [/TR]
[TR]
[TD="class: fontSize85, colspan: 7"][SUP]*[/SUP] NA - not applicable[/TD]
[/TR]
[TR]
A (H3N2) [TD="class: alignCenter"]773[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]770[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1141[/TD]
[TD="class: alignCenter"]1140 (99.9%)[/TD]
[/TR]
[TR]
A (H1N1) [TD="class: alignCenter"]169[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]169[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]4 (100%)[/TD]
[/TR]
[TR]
B [TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]NA [SUP]*[/SUP][/TD]
[TD="class: alignCenter"]NA [SUP]*[/SUP][/TD]
[/TR]
[TR]
TOTAL [TD="class: alignCenter"]946[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]943[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1145[/TD]
[TD="class: alignCenter"]1144[/TD]
[/TR]
[/TABLE]
[h=2]Influenza Strain Characterizations[/h] During the 2014-2015 influenza season, the National Microbiology Laboratory (NML) has characterized 373 influenza viruses [152 A(H3N2), 5 A(H1N1) and 216 influenza B].
Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assay (n=152), one virus was antigenically similar to A/Texas/50/2012, five showed reduced titers to A/Texas/50/2012 and 146 were antigenically similar to A/Switzerland/9715293/2013, which is the influenza A(H3N2) component recommended for the 2015 Southern Hemisphere influenza vaccine. Additionally, 913 A(H3N2) viruses were unable to be tested by HI assay; however, sequence analysis showed that 911 belonged to a genetic group that typically shows reduced titers to A/Texas/50/2012. Influenza A(H1N1): Five A(H1N1) viruses characterized were antigenically similar to A/California/7/2009. Influenza B: Of the 216 influenza B viruses characterized, 207 viruses were antigenically similar to B/Massachusetts/2/2012, three viruses showed reduced titers against B/Massachusetts/2/2012, and six were B/Brisbane/60/2008-like (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2014-2015, N = 373​
2015-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 2014-2015 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A/Texas/50/2012 (H3N2)-like virus, and a B/Massachusetts/2/2012-like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus is recommended.
The WHO has released the recommended composition of the influenza vaccine for the northern hemisphere for the 2015-2016 season. Trivalent vaccines are recommended to contain 1) an A/California/7/2009 (H1N1)pdm09-like virus 2) an A/Switzerland/9715293/2013 (H3N2)-like virus, and 3) an B/Phuket/3073/2013-like virus(Yamagata lineage). Quadrivalent vaccines are recommended to additionally contain a B/Brisbane/60/2008-like virus (Victoria lineage).


Text equivalent for figure 4Influenza strain characterizations, Canada, 2014-2015, N =3
[h=2]Influenza-like Illness (ILI) Consultation Rate[/h] The national influenza-like-illness (ILI) consultation rate remained similar to the previous week and was at 49.3 consultations per 1,000, which is within expected levels (Figure 5). The rate was highest among the 0 to 4 years of age group (60.7 consultations per 1,000) and lowest among the 5 to 19 years age group (35.1 consultations per 1,000).
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, 2014-2015​
2015-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. 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, 2014-2015
[h=2]Influenza Outbreak Surveillance[/h] In week 10, 38 new outbreaks of influenza were reported. The majority of the outbreaks occurred in the Central and Atlantic provinces. Thirty-two outbreaks were reported in long-term care facilities (LTCF), and six in institutional or community settings (Figure 6). An additional thirteen outbreaks of ILI were reported in schools. Among the outbreaks in which the influenza subtype was known, one LTCF outbreak was associated with A(H3N2) and five outbreaks were associated with influenza B. To date this season, 1,093 outbreaks in LTCFs have been reported and the majority of those with known subtypes were attributable to A(H3N2). There have been a higher number of reported influenza outbreaks to date this season compared to the same period in previous seasons.
Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2014-2015
2015-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, 2014-2015
[h=2]Pharmacy Surveillance[/h] During week 10, the proportion of prescriptions for antivirals decreased to 108.4 antiviral prescriptions per 100,000 total prescriptions (from 137.9 per 100,000). The rate for antivirals since week 48 has been higher than the previous three seasons (Figure 7). The rate in all age groups except infants decreased in week 10. The rate was highest among seniors at 142.9 per 100,000 total prescriptions and lowest among infants at 68.8 per 100,000 total prescriptions.
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2014-15​
2015-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 2,500 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, 2014-15
[h=2]Sentinel Hospital Influenza Surveillance[/h] Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In week 10, 17 laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network: four cases of influenza A and 13 cases of influenza B (Figure 8a). A greater proportion of cases have been reported with influenza B in recent weeks, following the trend in laboratory detections. Among the reported cases, five (29%) were <2 years of age, seven (41%) were 2 to 9 years of age and five (30%) were 10-16 years of age. One ICU admission was reported.
To date this season, 579 hospitalizations have been reported by the IMPACT network, 495 (86%) of which were cases of influenza A. Among cases for which the influenza A subtype was reported, 99% (162/164) were A(H3N2) (Table 4). To date, 72 cases were admitted to the ICU, of which 38 (53%) were 2 to 9 years of age (Figure 9a). A total of 39 ICU cases reported to have at least one underlying condition or comorbidity. Three 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, 44 laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network. Among the cases in week 10, 32 cases (73%) were in adults over the age of 65 and 25 cases (57%) had influenza B (Figure 8b).
To date this season, 1,961 cases have been reported; 1,832 (93%) with influenza A. The majority of cases (82%) were among adults ≥65 years of age (Table 5). One hundred and forty seven ICU admissions have been reported and 110 cases were adults ≥65 years of age. A total of 105 ICU cases (71%) reported to have at least one underlying condition or comorbidity. Of the 107 ICU cases with known immunization status, 37 (35%) reported not having been vaccinated this season. One hundred and thirteen deaths have been reported, 103 (91%) of the deaths were adults >65 years of age (Figure 9B).
Note: 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 marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (Aug. 24, 2014 to March 14, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) Total # (%) [/TR]
[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]
[TR]
0-5m [TD="class: alignCenter"]79[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]17[/TD]
[TD="class: alignCenter"]62[/TD]
[TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]85 (14.7%)[/TD]
[/TR]
[TR]
6-23m [TD="class: alignCenter"]107[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]35[/TD]
[TD="class: alignCenter"]71[/TD]
[TD="class: alignCenter"]23[/TD]
[TD="class: alignCenter"]130 (22.5%)[/TD]
[/TR]
[TR]
2-4y [TD="class: alignCenter"]121[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]40[/TD]
[TD="class: alignCenter"]80[/TD]
[TD="class: alignCenter"]19[/TD]
[TD="class: alignCenter"]140 (24.2%)[/TD]
[/TR]
[TR]
5-9y [TD="class: alignCenter"]128[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]45[/TD]
[TD="class: alignCenter"]83[/TD]
[TD="class: alignCenter"]21[/TD]
[TD="class: alignCenter"]149 (25.7%)[/TD]
[/TR]
[TR]
10-16y [TD="class: alignCenter"]60[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]25[/TD]
[TD="class: alignCenter"]35[/TD]
[TD="class: alignCenter"]15[/TD]
[TD="class: alignCenter"]75 (13.0%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]495[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]2[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]162[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]331[/TD]
[TD="class: alignCenter"]84[/TD]
[TD="class: alignCenter"]579[/TD]
[/TR]
[TR]
% [SUP]1[/SUP] [TD="class: alignCenter"]85.5%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]0.4%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]32.7%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]66.9%[/TD]
[TD="class: alignCenter"]14.5%[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[/TABLE]
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 5 - Cumulative numbers of adult hospitalizations with influenza reported by the PCIRN-SOS network, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (November 15, 2014 to March 14, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A(UnS) Total # (%) [/TR]
[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]
[TR]
16-20 [TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]4 (%)[/TD]
[/TR]
[TR]
20-44 [TD="class: alignCenter"]103[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]47[/TD]
[TD="class: alignCenter"]55[/TD]
[TD="class: alignCenter"]7[/TD]
[TD="class: alignCenter"]110 (6%)[/TD]
[/TR]
[TR]
45-64 [TD="class: alignCenter"]210[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]88[/TD]
[TD="class: alignCenter"]122[/TD]
[TD="class: alignCenter"]31[/TD]
[TD="class: alignCenter"]241 (12%)[/TD]
[/TR]
[TR]
65+ [TD="class: alignCenter"]1516[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]643[/TD]
[TD="class: alignCenter"]870[/TD]
[TD="class: alignCenter"]90[/TD]
[TD="class: alignCenter"]1606 (82%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]1832[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]4[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]779[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]1049[/TD]
[TD="class: alignCenter"]129[/TD]
[TD="class: alignCenter"]1961[/TD]
[/TR]
[TR]
% [SUP]1[/SUP] [TD="class: alignCenter"]93%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]0%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]43%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]57%[/TD]
[TD="class: alignCenter"]7%[/TD]
[TD="class: alignCenter"]100%[/TD]
[/TR]
[/TABLE]
Figure 8 - Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15
A) Paediatric hospitalizations (≤16 years of age, IMPACT)

Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2015-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, 2014-15: Adult hospitalizations (>16 year of age, PCIRN-SOS)
Figure 9 - Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2015-w10-fg9a-eng.gif
Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)

Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15: Adult hospitalizations (≥16 year of age, PCIRN-SOS)
[h=2]Provincial/Territorial Influenza Hospitalizations and Deaths[/h] In week 10, 139 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories* which is less than the number reported in week 09 (n=182). Of the 139 hospitalizations, all but 35 were due to influenza A, and 72% were in patients ≥65 years of age. Since the start of the 2014-15 season, 5,998 hospitalizations have been reported; 5,709 (95%) with influenza A. Among cases for which the subtype of influenza A was reported, 99.5% were A(H3N2). The majority of cases (72%) were ≥65 years of age (Table 6). A total of 302 ICU admissions have been reported to date: 54% (n=164) were in adults ≥65 years of age and 32% (n=96) were in adults 20-64 years. A total of 436 deaths have been reported since the start of the season: three children <5 years of age, three children 5-19 years, 26 adults 20-64 years, and 404 adults ≥65 years of age. Adults 65 years of age or older represent 93% of all deaths reported this season. 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. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting.
[TABLE="class: widthFull, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (24 August 2014 to 14 March 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) Total # (%) [/TR]
[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]
[TR]
0-4 years [TD="class: alignCenter"]378[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]137[/TD]
[TD="class: alignCenter"]239[/TD]
[TD="class: alignCenter"]19[/TD]
[TD="class: alignCenter"]397 (7%)[/TD]
[/TR]
[TR]
5-19 years [TD="class: alignCenter"]247[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]123[/TD]
[TD="class: alignCenter"]122[/TD]
[TD="class: alignCenter"]35[/TD]
[TD="class: alignCenter"]282 (5%)[/TD]
[/TR]
[TR]
20-44 years [TD="class: alignCenter"]353[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]208[/TD]
[TD="class: alignCenter"]142[/TD]
[TD="class: alignCenter"]33[/TD]
[TD="class: alignCenter"]386 (6%)[/TD]
[/TR]
[TR]
45-64 years [TD="class: alignCenter"]534[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]221[/TD]
[TD="class: alignCenter"]309[/TD]
[TD="class: alignCenter"]40[/TD]
[TD="class: alignCenter"]574 (10%)[/TD]
[/TR]
[TR]
65+ years [TD="class: alignCenter"]4141[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]1899[/TD]
[TD="class: alignCenter"]2240[/TD]
[TD="class: alignCenter"]151[/TD]
[TD="class: alignCenter"]4292 (72%)[/TD]
[/TR]
[TR]
Unknown [TD="class: alignCenter"]56[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]52[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]11[/TD]
[TD="class: alignCenter"]67 (1%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]5709[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]14[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]2640[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]3055[/TD]
[TD="class: alignCenter"]289[/TD]
[TD="class: alignCenter"]5998[/TD]
[/TR]
[TR]
Percentage [SUP]1[/SUP] [TD="class: alignCenter"]95.2%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]0.2%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]46.2%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]53.5%[/TD]
[TD="class: alignCenter"]4.8%[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[/TABLE]
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2014-15 on the Public Health Agency of Canada website.

.../
http://www.phac-aspc.gc.ca/fluwatch/14-15/w10_15/index-eng.php
 
[h=1]FluWatch report: March 15 to 21, 2015 (Week 11)[/h] Posted 2015-03-27 For readers interested in the PDF version, the document is available for downloading or viewing:
FluWatch report: March 15 to 21, 2015 (Week 11) (PDF Version - 824 KB - 10 pages)

? ? Help with PDF documents

Overall Summary
  • The majority of influenza activity is occurring in the Central and Atlantic provinces.
  • Influenza B detections continue to increase steadily across Canada while detections of influenza A continues to steadily decrease. This increase in influenza B is expected as influenza B often shows up later in the flu season.
  • Despite the late-season circulation of influenza B, influenza A(H3N2) remains the most common influenza virus detected this season to date and seniors continue to be affected.
  • Evidence from the National Microbiology Laboratory (NML) indicates that this year's vaccine will continue to provide protection against the circulating A(H1N1) and B strains.

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
[h=2]Influenza/ILI Activity (geographic spread)[/h] In week 11, four regions reported widespread activity: QC(3) and NL. Twenty-two regions reported localized activity: BC(2), AB, MB, ON(7), QC(2), NB(3), NS(5) and PE. Twenty-four regions reported sporadic activity: in YK, NT(2), BC(3), AB(4), SK(3), MB(2), QC, NB(3), NS(3), and NF(2). No activity was reported in eight regions : NU(3). MB(2), NB, NS, and NL.
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
[h=2]Influenza and Other Respiratory Virus Detections[/h] In week 11, the number of positive influenza tests (958) and the percentage positive for influenza A (5.4%) continued to decline from the previous week (Figure 2). The percentage of positive influenza B tests continued to increase and was 11.5% in week 11. Influenza B detections were greater than influenza A detections in many provinces (BC, AB, SK, MB, QC, PE and NS). To date, 89% of influenza detections have been influenza A, and 99.4% of those subtyped have been A(H3N2) (Table 1). To date this season, detailed information on age and type/subtype has been received for 33,253 cases (Table 2). Adults =65 years of age have predominantly been affected by influenza A, accounting for 62% of influenza A detections. Influenza B, while much smaller in numbers, is mainly affecting individuals less than 65 years of age, accounting for 60% of influenza B detections.
Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2014-15​
2015-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, 2014-15
In week 11, detections for all other respiratory viruses remained similar to, or decreased from, the previous week, except those for 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, 2014-15​
2015-w11-fg3-eng.gif
​
RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2014-2015
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 1: Weekly and cumulative numbers of positive influenza specimens
by type, subtype and province, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Reporting provinces [SUP]1[/SUP] Weekly
(March 15 to March 21, 2015) Cumulative
(August 24 to March 21, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1)pdm09 A(H3) A(UnS) B Total A Total A(H1)pdm09 A(H3) A(UnS) B Total [/TR]
[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]
[TR]
BC [TD="class: alignCenter"]10[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]10[/TD]
[TD="class: alignCenter"]38[/TD]
[TD="class: alignCenter"]3462[/TD]
[TD="class: alignCenter"]25[/TD]
[TD="class: alignCenter"]2584[/TD]
[TD="class: alignCenter"]853[/TD]
[TD="class: alignCenter"]265[/TD]
[/TR]
[TR]
AB [TD="class: alignCenter"]14[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]11[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]78[/TD]
[TD="class: alignCenter"]3662[/TD]
[TD="class: alignCenter"]13[/TD]
[TD="class: alignCenter"]3497[/TD]
[TD="class: alignCenter"]152[/TD]
[TD="class: alignCenter"]609[/TD]
[/TR]
[TR]
SK [TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]10[/TD]
[TD="class: alignCenter"]1306[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]837[/TD]
[TD="class: alignCenter"]469[/TD]
[TD="class: alignCenter"]108[/TD]
[/TR]
[TR]
MB [TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]11[/TD]
[TD="class: alignCenter"]1118[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]388[/TD]
[TD="class: alignCenter"]730[/TD]
[TD="class: alignCenter"]72[/TD]
[/TR]
[TR]
ON [TD="class: alignCenter"]138[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]46[/TD]
[TD="class: alignCenter"]89[/TD]
[TD="class: alignCenter"]98[/TD]
[TD="class: alignCenter"]10854[/TD]
[TD="class: alignCenter"]39[/TD]
[TD="class: alignCenter"]4561[/TD]
[TD="class: alignCenter"]6254[/TD]
[TD="class: alignCenter"]494[/TD]
[/TR]
[TR]
QC [TD="class: alignCenter"]81[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]81[/TD]
[TD="class: alignCenter"]318[/TD]
[TD="class: alignCenter"]11289[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]422[/TD]
[TD="class: alignCenter"]10863[/TD]
[TD="class: alignCenter"]2209[/TD]
[/TR]
[TR]
NB [TD="class: alignCenter"]38[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]10[/TD]
[TD="class: alignCenter"]28[/TD]
[TD="class: alignCenter"]36[/TD]
[TD="class: alignCenter"]1042[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]164[/TD]
[TD="class: alignCenter"]878[/TD]
[TD="class: alignCenter"]176[/TD]
[/TR]
[TR]
NS [TD="class: alignCenter"]14[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]14[/TD]
[TD="class: alignCenter"]53[/TD]
[TD="class: alignCenter"]464[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]123[/TD]
[TD="class: alignCenter"]341[/TD]
[TD="class: alignCenter"]180[/TD]
[/TR]
[TR]
PE [TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]120[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]117[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]26[/TD]
[/TR]
[TR]
NL [TD="class: alignCenter"]11[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]11[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]603[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]53[/TD]
[TD="class: alignCenter"]550[/TD]
[TD="class: alignCenter"]13[/TD]
[/TR]
[TR]
Canada [TD="class: alignCenter"]310[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]3[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]71[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]236[/TD]
[TD="class: alignCenter"]648[/TD]
[TD="class: alignCenter"]33920[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]82[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]12746[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]21092[/TD]
[TD="class: alignCenter"]4152[/TD]
[/TR]
[TR]
Percentage[SUP]2[/SUP] [TD="class: alignCenter"]32.4%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]1.0%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]22.9%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]76.1%[/TD]
[TD="class: alignCenter"]67.6%[/TD]
[TD="class: alignCenter"]89.1%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.2%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]37.6%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]62.2%[/TD]
[TD="class: alignCenter"]10.9%[/TD]
[/TR]
[/TABLE]
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
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, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups (years) Weekly
(March 15 to March 21, 2015) Cumulative
(August 24 to March 21, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) Total A Total A(H1) pdm09 A(H3) A (UnS) Total # % [/TR]
[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]
[TR]
<5 [TD="class: alignCenter"]13[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]11[/TD]
[TD="class: alignCenter"]33[/TD]
[TD="class: alignCenter"]2059[/TD]
[TD="class: alignCenter"]17[/TD]
[TD="class: alignCenter"]801[/TD]
[TD="class: alignCenter"]1241[/TD]
[TD="class: alignCenter"]267[/TD]
[TD="class: alignCenter"]2326[/TD]
[TD="class: alignCenter"]7.0%[/TD]
[/TR]
[TR]
5-19 [TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]30[/TD]
[TD="class: alignCenter"]1757[/TD]
[TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]946[/TD]
[TD="class: alignCenter"]805[/TD]
[TD="class: alignCenter"]430[/TD]
[TD="class: alignCenter"]2187[/TD]
[TD="class: alignCenter"]6.6%[/TD]
[/TR]
[TR]
20-44 [TD="class: alignCenter"]18[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]15[/TD]
[TD="class: alignCenter"]68[/TD]
[TD="class: alignCenter"]3388[/TD]
[TD="class: alignCenter"]16[/TD]
[TD="class: alignCenter"]1644[/TD]
[TD="class: alignCenter"]1728[/TD]
[TD="class: alignCenter"]592[/TD]
[TD="class: alignCenter"]3980[/TD]
[TD="class: alignCenter"]12.0%[/TD]
[/TR]
[TR]
45-64 [TD="class: alignCenter"]24[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]23[/TD]
[TD="class: alignCenter"]114[/TD]
[TD="class: alignCenter"]3803[/TD]
[TD="class: alignCenter"]17[/TD]
[TD="class: alignCenter"]1626[/TD]
[TD="class: alignCenter"]2160[/TD]
[TD="class: alignCenter"]944[/TD]
[TD="class: alignCenter"]4747[/TD]
[TD="class: alignCenter"]14.3%[/TD]
[/TR]
[TR]
65+ [TD="class: alignCenter"]105[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]16[/TD]
[TD="class: alignCenter"]88[/TD]
[TD="class: alignCenter"]227[/TD]
[TD="class: alignCenter"]18419[/TD]
[TD="class: alignCenter"]12[/TD]
[TD="class: alignCenter"]7143[/TD]
[TD="class: alignCenter"]11264[/TD]
[TD="class: alignCenter"]1471[/TD]
[TD="class: alignCenter"]19890[/TD]
[TD="class: alignCenter"]59.8%[/TD]
[/TR]
[TR]
Unknown [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"]120[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]99[/TD]
[TD="class: alignCenter"]21[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]123[/TD]
[TD="class: alignCenter"]0.4%[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]167[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]2[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]27[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]138[/TD]
[TD="class: alignCenter"]472[/TD]
[TD="class: alignCenter"]29546[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]68[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]12259[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]17219[/TD]
[TD="class: alignCenter"]3707[/TD]
[TD="class: alignCenter"]33253[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[TR]
Percentage[SUP]2[/SUP] [TD="class: alignCenter"]26.1%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]1.2%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]16.2%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]82.6%[/TD]
[TD="class: alignCenter"]73.9%[/TD]
[TD="class: alignCenter"]88.9%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.2%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]41.5%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]58.3%[/TD]
[TD="class: alignCenter"]11.1%[/TD]
[TD="class: alignCenter"] [/TD]
[TD="class: alignCenter"] [/TD]
[/TR]
[/TABLE]
[h=2]Antiviral Resistance[/h] During the 2014-2015 influenza season, the NML has tested 1,024 influenza viruses for resistance to oseltamivir and 1,021 influenza viruses for resistance to zanamivir. All viruses were sensitive to zanamivir and one influenza A(H3N2) virus was resistant to oseltamivir. A total of 1,223 influenza A viruses (99.9%) were resistant to amantadine (Table 3).
[TABLE="class: widthFull, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Virus type and subtype Oseltamivir Zanamivir Amantadine [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
# tested # resistant (%) # tested # resistant (%) # tested # resistant (%) [/TR]
[TR]
[TD="class: fontSize85, colspan: 7"][SUP]*[/SUP] NA - not applicable[/TD]
[/TR]
[TR]
A (H3N2) [TD="class: alignCenter"]811[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]809[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1218[/TD]
[TD="class: alignCenter"]1217 (99.9%)[/TD]
[/TR]
[TR]
A (H1N1) [TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]6 (100%)[/TD]
[/TR]
[TR]
B [TD="class: alignCenter"]207[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]207[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]NA [SUP]*[/SUP][/TD]
[TD="class: alignCenter"]NA [SUP]*[/SUP][/TD]
[/TR]
[TR]
TOTAL [TD="class: alignCenter"]1024[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]1021[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1224[/TD]
[TD="class: alignCenter"]1223[/TD]
[/TR]
[/TABLE]
[h=2]Influenza Strain Characterizations[/h] During the 2014-2015 influenza season, the National Microbiology Laboratory (NML) has characterized 414 influenza viruses [174 A(H3N2), 5 A(H1N1) and 235 influenza B].
Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assay (n=174), one virus was antigenically similar to A/Texas/50/2012, five showed reduced titers to A/Texas/50/2012 and 168 were antigenically similar to A/Switzerland/9715293/2013, which is the influenza A(H3N2) component recommended for the 2015 Southern Hemisphere influenza vaccine. Additionally, 971 A(H3N2) viruses were unable to be tested by HI assay; however, sequence analysis showed that 969 belonged to a genetic group that typically shows reduced titers to A/Texas/50/2012. Influenza A(H1N1): Five A(H1N1) viruses characterized were antigenically similar to A/California/7/2009. Influenza B: Of the 235 influenza B viruses characterized, 225 viruses were antigenically similar to B/Massachusetts/2/2012, three viruses showed reduced titers against B/Massachusetts/2/2012, and seven were B/Brisbane/60/2008-like (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2014-2015, N = 414​
2015-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 byWHO.
The recommended components for the 2014-2015 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A/Texas/50/2012 (H3N2)-like virus, and a B/Massachusetts/2/2012-like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus is recommended.
The WHO has released the recommended composition of the influenza vaccine for the northern hemisphere for the 2015-2016 season. Trivalent vaccines are recommended to contain 1) an A/California/7/2009 (H1N1)pdm09-like virus 2) an A/Switzerland/9715293/2013 (H3N2)-like virus, and 3) an B/Phuket/3073/2013-like virus(Yamagata lineage). Quadrivalent vaccines are recommended to additionally contain a B/Brisbane/60/2008-like virus (Victoria lineage).


Text equivalent for figure 4Influenza strain characterizations, Canada, 2014-2015, N =3
[h=2]Influenza-like Illness (ILI) Consultation Rate[/h] The national influenza-like-illness (ILI) consultation rate decreased in week 11 to 28.9 consultations per 1,000, which is within expected levels (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, 2014-2015​
2015-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. 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, 2014-2015
[h=2]Influenza Outbreak Surveillance[/h] In week 11, 63 new outbreaks of influenza were reported. The majority of the outbreaks occurred in the Central and Atlantic provinces. Forty-nine outbreaks were reported in long-term care facilities (LTCF), five in hospitals and nine in institutional or community settings (Figure 6). An additional two outbreaks of ILI were reported in schools. Among the outbreaks in which the influenza subtype was known (n=11), ten outbreaks were associated with influenza B (one in a hospital, seven in LTCFs, and two in an institutional or community setting). To date this season, 1,142 outbreaks in LTCFs have been reported and the majority of those with known subtypes were attributable to A(H3N2). There have been a higher number of reported influenza outbreaks to date this season compared to the same period in previous seasons.
Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2014-2015
2015-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, 2014-2015
[h=2]Pharmacy Surveillance[/h] During week 11, the proportion of prescriptions for antivirals was 119.1 antiviral prescriptions per 100,000 total prescriptions which was similar to the previous week. The rate for antivirals since week 48 has been higher than the previous three seasons (Figure 7). The rate in all age groups except seniors decreased in week 11. The rate was highest among seniors at 189.5 per 100,000 total prescriptions and lowest among infants at 50.5 per 100,000 total prescriptions.
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2014-15​
2015-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 2,500 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, 2014-15
[h=2]Sentinel Hospital Influenza Surveillance[/h] Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In week 11, 14 laboratory-confirmed influenza-associated paediatric (=16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network: five cases of influenza A and nine cases of influenza B (Figure 8a). A greater proportion of cases have been reported with influenza B in recent weeks, following the trend in laboratory detections. Among the reported cases, three (21%) were <2 years of age, ten (71%) were 2 to 9 years of age and one (7%) was 10-16 years of age. One ICU admission was reported.
To date this season, 595 hospitalizations have been reported by the IMPACT network, 502 (84%) of which were cases of influenza A. Among cases for which the influenza A subtype was reported, 99% (163/165) were A(H3N2) (Table 4). To date, 74 cases were admitted to the ICU, of which 39 (53%) were 2 to 9 years of age (Figure 9a). A total of 49 ICU cases reported to have at least one underlying condition or comorbidity. Three 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, 28 laboratory-confirmed influenza-associated adult (=16 years of age) hospitalizations were reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network. Among the cases in week 11, 20 cases (74%) were in adults over the age of 65 and 18 cases (67%) had influenza B (Figure 8b).
To date this season, 2,009 cases have been reported; 1,852 (92%) with influenza A. The majority of cases (82%) were among adults =65 years of age (Table 5). One hundred and forty nine ICU admissions have been reported and 112 cases were adults =65 years of age. A total of 107 ICU cases (72%) reported to have at least one underlying condition or comorbidity. Of the 114 ICU cases with known immunization status, 37 (32%) reported not having been vaccinated this season. One hundred and seventeen deaths have been reported, 107 (92%) of the deaths were adults >65 years of age (Figure 9B).
Note: 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 marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (Aug. 24, 2014 to March 21, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) Total # (%) [/TR]
[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]
[TR]
0-5m [TD="class: alignCenter"]81[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]18[/TD]
[TD="class: alignCenter"]63[/TD]
[TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]87 (14.6%)[/TD]
[/TR]
[TR]
6-23m [TD="class: alignCenter"]109[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]35[/TD]
[TD="class: alignCenter"]73[/TD]
[TD="class: alignCenter"]24[/TD]
[TD="class: alignCenter"]133 (22.4%)[/TD]
[/TR]
[TR]
2-4y [TD="class: alignCenter"]122[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]40[/TD]
[TD="class: alignCenter"]81[/TD]
[TD="class: alignCenter"]23[/TD]
[TD="class: alignCenter"]145 (24.4%)[/TD]
[/TR]
[TR]
5-9y [TD="class: alignCenter"]130[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]45[/TD]
[TD="class: alignCenter"]85[/TD]
[TD="class: alignCenter"]25[/TD]
[TD="class: alignCenter"]155 (26.1%)[/TD]
[/TR]
[TR]
10-16y [TD="class: alignCenter"]60[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]25[/TD]
[TD="class: alignCenter"]35[/TD]
[TD="class: alignCenter"]15[/TD]
[TD="class: alignCenter"]75 (12.6%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]502[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]2[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]163[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]337[/TD]
[TD="class: alignCenter"]93[/TD]
[TD="class: alignCenter"]595[/TD]
[/TR]
[TR]
% [SUP]1[/SUP] [TD="class: alignCenter"]84.4%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.4%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]32.5%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]67.1%[/TD]
[TD="class: alignCenter"]15.6%[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[/TABLE]
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 5 - Cumulative numbers of adult hospitalizations with influenza reported by the PCIRN-SOS network, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (November 15, 2014 to March 21, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A(UnS) Total # (%) [/TR]
[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]
[TR]
16-20 [TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]4 (%)[/TD]
[/TR]
[TR]
20-44 [TD="class: alignCenter"]104[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]48[/TD]
[TD="class: alignCenter"]55[/TD]
[TD="class: alignCenter"]8[/TD]
[TD="class: alignCenter"]112 (6%)[/TD]
[/TR]
[TR]
45-64 [TD="class: alignCenter"]214[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]89[/TD]
[TD="class: alignCenter"]125[/TD]
[TD="class: alignCenter"]38[/TD]
[TD="class: alignCenter"]252 (13%)[/TD]
[/TR]
[TR]
65+ [TD="class: alignCenter"]1531[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]661[/TD]
[TD="class: alignCenter"]867[/TD]
[TD="class: alignCenter"]110[/TD]
[TD="class: alignCenter"]1641 (82%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]1852[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]4[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]799[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]1049[/TD]
[TD="class: alignCenter"]157[/TD]
[TD="class: alignCenter"]2009[/TD]
[/TR]
[TR]
% [SUP]1[/SUP] [TD="class: alignCenter"]92%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]43%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]57%[/TD]
[TD="class: alignCenter"]8%[/TD]
[TD="class: alignCenter"]100%[/TD]
[/TR]
[/TABLE]
Figure 8 - Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15
A) Paediatric hospitalizations (≤16 years of age, IMPACT)

Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2015-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, 2014-15: Adult hospitalizations (>16 year of age, PCIRN-SOS)
Figure 9 - Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2015-w11-fg9a-eng.gif
Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)

Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15: Adult hospitalizations (≥16 year of age, PCIRN-SOS)
[h=2]Provincial/Territorial Influenza Hospitalizations and Deaths[/h] In week 11, 148 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories* which is slightly more than the number reported in week 10 (n=139). Of the 148 hospitalizations, all but 49 were due to influenza A, and 67% were in patients =65 years of age.
Since the start of the 2014-15 season, 6,249 hospitalizations have been reported; 5,877 (95%) with influenza A. Among cases for which the subtype of influenza A was reported, 99.5% were A(H3N2). The majority of cases (71%) were =65 years of age (Table 6). A total of 321 ICU admissions have been reported to date: 54% (n=172) were in adults =65 years of age and 32% (n=102) were in adults 20-64 years. A total of 462 deaths have been reported since the start of the season: three children <5 years of age, three children 5-19 years, 38 adults 20-64 years, and 418 adults =65 years of age. Adults 65 years of age or older represent 90% of all deaths reported this season. 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. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting.
[TABLE="class: widthFull, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (24 August 2014 to 21 March 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) Total # (%) [/TR]
[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]
[TR]
0-4 years [TD="class: alignCenter"]389[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]139[/TD]
[TD="class: alignCenter"]248[/TD]
[TD="class: alignCenter"]28[/TD]
[TD="class: alignCenter"]417 (7%)[/TD]
[/TR]
[TR]
5-19 years [TD="class: alignCenter"]259[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]127[/TD]
[TD="class: alignCenter"]130[/TD]
[TD="class: alignCenter"]43[/TD]
[TD="class: alignCenter"]302 (5%)[/TD]
[/TR]
[TR]
20-44 years [TD="class: alignCenter"]364[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]218[/TD]
[TD="class: alignCenter"]143[/TD]
[TD="class: alignCenter"]43[/TD]
[TD="class: alignCenter"]407 (7%)[/TD]
[/TR]
[TR]
45-64 years [TD="class: alignCenter"]547[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]226[/TD]
[TD="class: alignCenter"]317[/TD]
[TD="class: alignCenter"]52[/TD]
[TD="class: alignCenter"]599 (10%)[/TD]
[/TR]
[TR]
65+ years [TD="class: alignCenter"]4262[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]1958[/TD]
[TD="class: alignCenter"]2302[/TD]
[TD="class: alignCenter"]191[/TD]
[TD="class: alignCenter"]4453 (71%)[/TD]
[/TR]
[TR]
Unknown [TD="class: alignCenter"]56[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]52[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]15[/TD]
[TD="class: alignCenter"]71 (1%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]5877[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]14[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]2720[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]3143[/TD]
[TD="class: alignCenter"]372[/TD]
[TD="class: alignCenter"]6249[/TD]
[/TR]
[TR]
Percentage [SUP]1[/SUP] [TD="class: alignCenter"]94.0%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.2%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]46.3%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]53.5%[/TD]
[TD="class: alignCenter"]6.0%[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[/TABLE]
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2014-15 on the Public Health Agency of Canada website.
[h=2].../[/h] http://www.phac-aspc.gc.ca/fluwatch/14-15/w11_15/index-eng.php
 
[h=1]FluWatch report: March 22 to 28, 2015 (Week 12)[/h] Posted 2015-04-02 For readers interested in the PDF version, the document is available for downloading or viewing:
FluWatch report: March 22 to 28, 2015 (Week 12) (PDF Version - 902 KB - 10 pages)

? ? Help with PDF documents

Overall Summary
  • The majority of influenza activity continues to occur in the Central and Atlantic provinces.
  • Influenza B detections continue to increase steadily across Canada while detections of influenza A continues to steadily decrease. This increase in influenza B is expected as influenza B often shows up later in the flu season.
  • Influenza B is having a greater impact on adults less than 65 years of age, compared to influenza A(H3N2), which circulated earlier in the season.
  • Evidence from the National Microbiology Laboratory (NML) indicates that this year?s vaccine will continue to provide protection against the circulating A(H1N1) and B strains.

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
[h=2]Influenza/ILI Activity (geographic spread)[/h] In week 12, two regions in Quebec reported widespread activity. Twenty-two regions reported localized activity: BC, AB, MB(2), ON(7), QC(2), NB(3), NS(5) and NL. Twenty-eight regions reported sporadic activity: in YK, NT(2), BC(4), AB(4), SK(3), MB(2), QC(2), NB(4), NS(3), PE and NF(2). No activity was reported in six regions : NU(3). MB, NS, and NL.
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
[h=2]Influenza and Other Respiratory Virus Detections[/h] In week 12, the percentage positive for influenza A (4.7%) continued to decline from the previous week while the percentage of positive influenza B tests continued to increase (11.5%) (Figure 2). Influenza B detections were greater than influenza A in all provinces except NL. To date, 87% of influenza detections have been influenza A, and 99.3% of those subtyped have been A(H3N2) (Table 1). To date this season, detailed information on age and type/subtype has been received for 33,953 cases (Table 2). Adults ≥65 years of age have predominantly been affected by influenza A, accounting for 62% of influenza A detections. Influenza B, while much smaller in numbers, is mainly affecting individuals less than 65 years of age, they account for 60% of influenza B detections.
Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2014-15​
2015-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, 2014-15
In week 12, detections for all other respiratory viruses remained similar to, or decreased from, the previous week (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, 2014-15​
2015-w12-fg3-eng.gif
​
RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2014-2015
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 1: Weekly and cumulative numbers of positive influenza specimens
by type, subtype and province, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Reporting provinces [SUP]1[/SUP] Weekly
(March 22 to March 28, 2015) Cumulative
(August 24 to March 28, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1)pdm09 A(H3) A(UnS) B Total A Total A(H1)pdm09 A(H3) A(UnS) B Total [/TR]
[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]
[TR]
BC [TD="class: alignCenter"]26[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]19[/TD]
[TD="class: alignCenter"]7[/TD]
[TD="class: alignCenter"]32[/TD]
[TD="class: alignCenter"]3488[/TD]
[TD="class: alignCenter"]25[/TD]
[TD="class: alignCenter"]2603[/TD]
[TD="class: alignCenter"]860[/TD]
[TD="class: alignCenter"]297[/TD]
[/TR]
[TR]
AB [TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]58[/TD]
[TD="class: alignCenter"]3666[/TD]
[TD="class: alignCenter"]13[/TD]
[TD="class: alignCenter"]3502[/TD]
[TD="class: alignCenter"]151[/TD]
[TD="class: alignCenter"]667[/TD]
[/TR]
[TR]
SK [TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]11[/TD]
[TD="class: alignCenter"]1311[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]839[/TD]
[TD="class: alignCenter"]472[/TD]
[TD="class: alignCenter"]131[/TD]
[/TR]
[TR]
MB [TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]18[/TD]
[TD="class: alignCenter"]1119[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]389[/TD]
[TD="class: alignCenter"]730[/TD]
[TD="class: alignCenter"]90[/TD]
[/TR]
[TR]
ON [TD="class: alignCenter"]88[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]40[/TD]
[TD="class: alignCenter"]46[/TD]
[TD="class: alignCenter"]104[/TD]
[TD="class: alignCenter"]10959[/TD]
[TD="class: alignCenter"]41[/TD]
[TD="class: alignCenter"]4606[/TD]
[TD="class: alignCenter"]6312[/TD]
[TD="class: alignCenter"]626[/TD]
[/TR]
[TR]
QC [TD="class: alignCenter"]43[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]43[/TD]
[TD="class: alignCenter"]365[/TD]
[TD="class: alignCenter"]11332[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]422[/TD]
[TD="class: alignCenter"]10906[/TD]
[TD="class: alignCenter"]2574[/TD]
[/TR]
[TR]
NB [TD="class: alignCenter"]75[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]11[/TD]
[TD="class: alignCenter"]64[/TD]
[TD="class: alignCenter"]80[/TD]
[TD="class: alignCenter"]1117[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]175[/TD]
[TD="class: alignCenter"]942[/TD]
[TD="class: alignCenter"]256[/TD]
[/TR]
[TR]
NS [TD="class: alignCenter"]23[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]23[/TD]
[TD="class: alignCenter"]29[/TD]
[TD="class: alignCenter"]487[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]123[/TD]
[TD="class: alignCenter"]364[/TD]
[TD="class: alignCenter"]209[/TD]
[/TR]
[TR]
PE [TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]20[/TD]
[TD="class: alignCenter"]120[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]117[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]46[/TD]
[/TR]
[TR]
NL [TD="class: alignCenter"]7[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]7[/TD]
[TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]610[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]53[/TD]
[TD="class: alignCenter"]557[/TD]
[TD="class: alignCenter"]19[/TD]
[/TR]
[TR]
Canada [TD="class: alignCenter"]271[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]2[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]76[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]193[/TD]
[TD="class: alignCenter"]723[/TD]
[TD="class: alignCenter"]34209[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]84[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]12829[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]21296[/TD]
[TD="class: alignCenter"]4915[/TD]
[/TR]
[TR]
Percentage[SUP]2[/SUP] [TD="class: alignCenter"]27.3%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]0.7%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]28.0%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]71.2%[/TD]
[TD="class: alignCenter"]72.7%[/TD]
[TD="class: alignCenter"]87.4%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]0.2%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]37.5%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]62.3%[/TD]
[TD="class: alignCenter"]12.6%[/TD]
[/TR]
[/TABLE]
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
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, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups (years) Weekly
(March 22 to March 28, 2015) Cumulative
(August 24 to March 28, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) Total A Total A(H1) pdm09 A(H3) A (UnS) Total # % [/TR]
[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]
[TR]
<5 [TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]31[/TD]
[TD="class: alignCenter"]2069[/TD]
[TD="class: alignCenter"]19[/TD]
[TD="class: alignCenter"]804[/TD]
[TD="class: alignCenter"]1246[/TD]
[TD="class: alignCenter"]305[/TD]
[TD="class: alignCenter"]2374[/TD]
[TD="class: alignCenter"]7.0%[/TD]
[/TR]
[TR]
5-19 [TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]33[/TD]
[TD="class: alignCenter"]1760[/TD]
[TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]945[/TD]
[TD="class: alignCenter"]809[/TD]
[TD="class: alignCenter"]482[/TD]
[TD="class: alignCenter"]2242[/TD]
[TD="class: alignCenter"]6.6%[/TD]
[/TR]
[TR]
20-44 [TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]61[/TD]
[TD="class: alignCenter"]3407[/TD]
[TD="class: alignCenter"]16[/TD]
[TD="class: alignCenter"]1650[/TD]
[TD="class: alignCenter"]1741[/TD]
[TD="class: alignCenter"]669[/TD]
[TD="class: alignCenter"]4076[/TD]
[TD="class: alignCenter"]12.0%[/TD]
[/TR]
[TR]
45-64 [TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]133[/TD]
[TD="class: alignCenter"]3814[/TD]
[TD="class: alignCenter"]17[/TD]
[TD="class: alignCenter"]1631[/TD]
[TD="class: alignCenter"]2166[/TD]
[TD="class: alignCenter"]1107[/TD]
[TD="class: alignCenter"]4921[/TD]
[TD="class: alignCenter"]14.5%[/TD]
[/TR]
[TR]
65+ [TD="class: alignCenter"]72[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]15[/TD]
[TD="class: alignCenter"]57[/TD]
[TD="class: alignCenter"]178[/TD]
[TD="class: alignCenter"]18514[/TD]
[TD="class: alignCenter"]13[/TD]
[TD="class: alignCenter"]7176[/TD]
[TD="class: alignCenter"]11325[/TD]
[TD="class: alignCenter"]1701[/TD]
[TD="class: alignCenter"]20215[/TD]
[TD="class: alignCenter"]59.5%[/TD]
[/TR]
[TR]
Unknown [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"]120[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]99[/TD]
[TD="class: alignCenter"]21[/TD]
[TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]125[/TD]
[TD="class: alignCenter"]0.4%[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]92[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]1[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]17[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]74[/TD]
[TD="class: alignCenter"]437[/TD]
[TD="class: alignCenter"]29684[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]71[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]12305[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]17308[/TD]
[TD="class: alignCenter"]4269[/TD]
[TD="class: alignCenter"]33953[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[TR]
Percentage[SUP]2[/SUP] [TD="class: alignCenter"]17.4%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]1.1%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]18.5%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]80.4%[/TD]
[TD="class: alignCenter"]82.6%[/TD]
[TD="class: alignCenter"]87.4%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]0.2%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]41.5%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]58.3%[/TD]
[TD="class: alignCenter"]12.6%[/TD]
[TD="class: alignCenter"] [/TD]
[TD="class: alignCenter"] [/TD]
[/TR]
[/TABLE]
[h=2]Antiviral Resistance[/h] During the 2014-2015 influenza season, the NML has tested 1,094 influenza viruses for resistance to oseltamivir and 1,090 influenza viruses for resistance to zanamivir. All viruses were sensitive to zanamivir and one influenza A(H3N2) virus was resistant to oseltamivir. A total of 1,235 influenza A viruses (99.9%) were resistant to amantadine (Table 3).
[TABLE="class: widthFull, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Virus type and subtype Oseltamivir Zanamivir Amantadine [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
# tested # resistant (%) # tested # resistant (%) # tested # resistant (%) [/TR]
[TR]
[TD="class: fontSize85, colspan: 7"][SUP]*[/SUP] NA - not applicable[/TD]
[/TR]
[TR]
A (H3N2) [TD="class: alignCenter"]831[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]827[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1230[/TD]
[TD="class: alignCenter"]1229 (99.9%)[/TD]
[/TR]
[TR]
A (H1N1) [TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]6 (100%)[/TD]
[/TR]
[TR]
B [TD="class: alignCenter"]257[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]257[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]NA [SUP]*[/SUP][/TD]
[TD="class: alignCenter"]NA [SUP]*[/SUP][/TD]
[/TR]
[TR]
TOTAL [TD="class: alignCenter"]1094[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]1090[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1236[/TD]
[TD="class: alignCenter"]1235[/TD]
[/TR]
[/TABLE]
[h=2]Influenza Strain Characterizations[/h] During the 2014-2015 influenza season, the National Microbiology Laboratory (NML) has characterized 490 influenza viruses [176 A(H3N2), 9 A(H1N1) and 305 influenza B].
Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assay (n=176), one virus was antigenically similar to A/Texas/50/2012, five showed reduced titers to A/Texas/50/2012 and 170 were antigenically similar to A/Switzerland/9715293/2013, which is the influenza A(H3N2) component recommended for the 2015 Southern Hemisphere influenza vaccine. Additionally, 1025 A(H3N2) viruses were unable to be tested by HI assay; however, sequence analysis showed that 1023 belonged to a genetic group that typically shows reduced titers to A/Texas/50/2012. Influenza A(H1N1): Nine A(H1N1) viruses characterized were antigenically similar to A/California/7/2009. Influenza B: Of the 305 influenza B viruses characterized, 291 viruses were antigenically similar to B/Massachusetts/2/2012, three viruses showed reduced titers against B/Massachusetts/2/2012, and 14 were B/Brisbane/60/2008-like (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2014-2015, N = 490​
2015-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 byWHO.
The recommended components for the 2014-2015 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A/Texas/50/2012 (H3N2)-like virus, and a B/Massachusetts/2/2012-like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus is recommended.
The WHO has released the recommended composition of the influenza vaccine for the northern hemisphere for the 2015-2016 season. Trivalent vaccines are recommended to contain 1) an A/California/7/2009 (H1N1)pdm09-like virus 2) an A/Switzerland/9715293/2013 (H3N2)-like virus, and 3) an B/Phuket/3073/2013-like virus(Yamagata lineage). Quadrivalent vaccines are recommended to additionally contain a B/Brisbane/60/2008-like virus (Victoria lineage).


Text equivalent for figure 4Influenza strain characterizations, Canada, 2014-2015, N =3
[h=2]Influenza-like Illness (ILI) Consultation Rate[/h] The national influenza-like-illness (ILI) consultation rate decreased in week 12 to 20.5 consultations per 1,000, which is below expected levels (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, 2014-2015​
2015-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. 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, 2014-2015
[h=2]Influenza Outbreak Surveillance[/h] In week 12, 33 new outbreaks of influenza were reported. The majority of the outbreaks occurred in the Central and Atlantic provinces. Thirty-one outbreaks were reported in long-term care facilities (LTCF) and two in institutional or community settings (Figure 6). Among the outbreaks in which the influenza type was known (n=12), eight outbreaks were associated with influenza B. To date this season, 1,173 outbreaks in LTCFs have been reported and the majority of those with known subtypes were attributable to A(H3N2). There have been a higher number of reported influenza outbreaks to date this season compared to the same period in previous seasons.
Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2014-2015
2015-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, 2014-2015
[h=2]Pharmacy Surveillance[/h] During week 12, the proportion of prescriptions for antivirals decreased to 110.0 antiviral prescriptions per 100,000 total prescriptions (from 135.8 per 100,000). The rate for antivirals since week 48 has been higher than the previous three seasons (Figure 7). The rate in all age groups decreased in week 12. The rate was highest among seniors at 176.7 per 100,000 total prescriptions and lowest among infants at 10.4 per 100,000 total prescriptions.
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2014-15​
2015-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 2,500 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, 2014-15
[h=2]Sentinel Hospital Influenza Surveillance[/h] Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In week 12, 23 laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network. All 23 cases were influenza B (Figure 8a). A greater proportion of cases have been reported with influenza B in recent weeks, following the trend in laboratory detections. Among the reported cases, five (22%) were <2 years of age, ten (43%) were 2 to 9 years of age and eight (35%) were 10-16 years of age. Three ICU admissions were reported.
To date this season, 621 hospitalizations have been reported by the IMPACT network, 503 (81%) of which were cases of influenza A. Among cases for which the influenza A subtype was reported, 99% (162/164) were A(H3N2) (Table 4). To date, 79 cases were admitted to the ICU, of which 44 (56%) were 2 to 9 years of age (Figure 9a). A total of 51 ICU cases reported to have at least one underlying condition or comorbidity. Four 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, 40 laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network. Among the cases in week 12, 30 cases (75%) were in adults over the age of 65 and 25 cases (63%) had influenza B (Figure 8b).
To date this season, 2,071 cases have been reported; 1,876 (91%) with influenza A. The majority of cases (82%) were among adults ≥65 years of age (Table 5). One hundred and fifty one ICU admissions have been reported and 113 cases were adults ≥65 years of age. A total of 110 ICU cases (73%) reported to have at least one underlying condition or comorbidity. Of the 114 ICU cases with known immunization status, 38 (33%) reported not having been vaccinated this season. One hundred and twenty one deaths have been reported, 111 (92%) of the deaths were adults >65 years of age (Figure 9B).
Note: 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 marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (Aug. 24, 2014 to March 28, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) Total # (%) [/TR]
[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]
[TR]
0-5m [TD="class: alignCenter"]81[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]18[/TD]
[TD="class: alignCenter"]63[/TD]
[TD="class: alignCenter"]7[/TD]
[TD="class: alignCenter"]88 (14.2%)[/TD]
[/TR]
[TR]
6-23m [TD="class: alignCenter"]109[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]35[/TD]
[TD="class: alignCenter"]73[/TD]
[TD="class: alignCenter"]29[/TD]
[TD="class: alignCenter"]138 (22.2%)[/TD]
[/TR]
[TR]
2-4y [TD="class: alignCenter"]124[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]40[/TD]
[TD="class: alignCenter"]83[/TD]
[TD="class: alignCenter"]28[/TD]
[TD="class: alignCenter"]152 (24.5%)[/TD]
[/TR]
[TR]
5-9y [TD="class: alignCenter"]129[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]44[/TD]
[TD="class: alignCenter"]85[/TD]
[TD="class: alignCenter"]31[/TD]
[TD="class: alignCenter"]160 (25.8%)[/TD]
[/TR]
[TR]
10-16y [TD="class: alignCenter"]60[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]25[/TD]
[TD="class: alignCenter"]35[/TD]
[TD="class: alignCenter"]23[/TD]
[TD="class: alignCenter"]83 (13.4%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]503[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]2[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]162[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]339[/TD]
[TD="class: alignCenter"]118[/TD]
[TD="class: alignCenter"]621[/TD]
[/TR]
[TR]
% [SUP]1[/SUP] [TD="class: alignCenter"]81.0%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]0.4%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]32.2%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]67.4%[/TD]
[TD="class: alignCenter"]19.0%[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[/TABLE]
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 5 - Cumulative numbers of adult hospitalizations with influenza reported by the PCIRN-SOS network, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (November 15, 2014 to March 28, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A(UnS) Total # (%) [/TR]
[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]
[TR]
16-20 [TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]4 (%)[/TD]
[/TR]
[TR]
20-44 [TD="class: alignCenter"]104[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]54[/TD]
[TD="class: alignCenter"]49[/TD]
[TD="class: alignCenter"]10[/TD]
[TD="class: alignCenter"]114 (6%)[/TD]
[/TR]
[TR]
45-64 [TD="class: alignCenter"]214[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]92[/TD]
[TD="class: alignCenter"]121[/TD]
[TD="class: alignCenter"]48[/TD]
[TD="class: alignCenter"]262 (13%)[/TD]
[/TR]
[TR]
65+ [TD="class: alignCenter"]1555[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]732[/TD]
[TD="class: alignCenter"]820[/TD]
[TD="class: alignCenter"]136[/TD]
[TD="class: alignCenter"]1691 (82%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]1876[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]5[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]879[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]992[/TD]
[TD="class: alignCenter"]195[/TD]
[TD="class: alignCenter"]2071[/TD]
[/TR]
[TR]
% [SUP]1[/SUP] [TD="class: alignCenter"]91%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]0%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]47%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]53%[/TD]
[TD="class: alignCenter"]9%[/TD]
[TD="class: alignCenter"]100%[/TD]
[/TR]
[/TABLE]
Figure 8 - Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15
A) Paediatric hospitalizations (≤16 years of age, IMPACT)

Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2015-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, 2014-15: Adult hospitalizations (>16 year of age, PCIRN-SOS)
Figure 9 - Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2015-w12-fg9a-eng.gif
Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)

Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15: Adult hospitalizations (≥16 year of age, PCIRN-SOS)
[h=2]Provincial/Territorial Influenza Hospitalizations and Deaths[/h] In week 12, 148 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories*, which is similar to the number reported the previous week. Of the 148 hospitalizations, 97 (66%) were due to influenza A and 97 (65%) were in patients ≥65 years of age.
Since the start of the 2014-15 season, 6,499 hospitalizations have been reported; 6,008 (92.4%) with influenza A. Among cases for which the subtype of influenza A was reported, 99.5% were A(H3N2). The majority of cases (71%) were ≥65 years of age (Table 6). A total of 340 ICU admissions have been reported to date: 54% (n=183) were in adults ≥65 years of age and 32% (n=110) were in adults 20-64 years. A total of 479 deaths have been reported since the start of the season: three children <5 years of age, three children 5-19 years, 40 adults 20-64 years, and 433 adults ≥65 years of age. Adults 65 years of age or older represent 90% of all deaths reported this season. 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. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting.
[TABLE="class: widthFull, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (24 August 2014 to 28 March 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) Total # (%) [/TR]
[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]
[TR]
0-4 years [TD="class: alignCenter"]398[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]143[/TD]
[TD="class: alignCenter"]253[/TD]
[TD="class: alignCenter"]34[/TD]
[TD="class: alignCenter"]432 (7%)[/TD]
[/TR]
[TR]
5-19 years [TD="class: alignCenter"]266[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]130[/TD]
[TD="class: alignCenter"]134[/TD]
[TD="class: alignCenter"]56[/TD]
[TD="class: alignCenter"]322 (5%)[/TD]
[/TR]
[TR]
20-44 years [TD="class: alignCenter"]366[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]220[/TD]
[TD="class: alignCenter"]143[/TD]
[TD="class: alignCenter"]66[/TD]
[TD="class: alignCenter"]432 (7%)[/TD]
[/TR]
[TR]
45-64 years [TD="class: alignCenter"]564[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]234[/TD]
[TD="class: alignCenter"]326[/TD]
[TD="class: alignCenter"]63[/TD]
[TD="class: alignCenter"]627 (10%)[/TD]
[/TR]
[TR]
65+ years [TD="class: alignCenter"]4358[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]2024[/TD]
[TD="class: alignCenter"]2332[/TD]
[TD="class: alignCenter"]254[/TD]
[TD="class: alignCenter"]4612 (71%)[/TD]
[/TR]
[TR]
Unknown [TD="class: alignCenter"]56[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]52[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]18[/TD]
[TD="class: alignCenter"]74 (1%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]6008[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]14[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]2803[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]3191[/TD]
[TD="class: alignCenter"]491[/TD]
[TD="class: alignCenter"]6499[/TD]
[/TR]
[TR]
Percentage [SUP]1[/SUP] [TD="class: alignCenter"]92.4%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]0.2%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]46.7%[/TD]
[TD="class: bg-colour-blue alignCenter, bgcolor: #D7D7FF"]53.1%[/TD]
[TD="class: alignCenter"]7.6%[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[/TABLE]
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2014-15 on the Public Health Agency of Canada website.

.../
http://www.phac-aspc.gc.ca/fluwatch/14-15/w12_15/index-eng.php
 
[h=1]FluWatch report: March 29 to April 04, 2015 (Week 13)[/h] Posted 2015-04-10 For readers interested in the PDF version, the document is available for downloading or viewing:
FluWatch report: March 29 to April 04, 2015 (Week 13) (PDF Version - 902 KB - 10 pages)

? ? Help with PDF documents

Overall Summary
  • The majority of influenza activity continues to occur in the Central and Atlantic province however, less activity was reported this week from these regions.
  • The number of influenza A and B detections decreased this week.
  • Influenza B is having a greater impact on adults less than 65 years of age, compared to influenza A(H3N2), which circulated earlier in the season.
  • Evidence from the National Microbiology Laboratory (NML) indicates that this year's vaccine will continue to provide protection against the circulating A(H1N1) and B strains.

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
[h=2]Influenza/ILI Activity (geographic spread)[/h] In week 13, no regions reported widespread activity. Eighteen regions reported localized activity: AB, MB, ON(6), QC(3), NB(2), NS(3), PE and NL. Twenty-nine regions reported sporadic activity: in YK, NT(2), BC(3), AB(4), SK(3), MB(4), ON. QC(3), NB(5), and NS(3). Eleven regions reported no activity: NU(3), BC(2), NS(3), and NL(3).
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
[h=2]Influenza and Other Respiratory Virus Detections[/h] In week 13, the percentage positive for influenza A (3.4%) continued to decline from the previous week while the percentage of positive influenza B tests continued to increase (12.9%) (Figure 2).Influenza B detections were greater than influenza A in all provinces except NS. More influenza B has been observed to date this season (5,521) compared to the same time during the 2013-14 season (4,371). To date, 86% of influenza detections have been influenza A, and 99.3% of those subtyped have been A(H3N2) (Table 1). To date this season, detailed information on age and type/subtype has been received for 34,604 cases (Table 2). Adults ≥65 years of age have predominantly been affected by influenza A, accounting for 62% of influenza A detections. Influenza B, while much smaller in numbers, is mainly affecting individuals less than 65 years of age, they account for 60% of influenza B detections.
Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2014-15​
2015-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, 2014-15
In week 13, detections for all other respiratory viruses remained similar to, or decreased from, the previous week (Figure 3). Overall, the detections of other respiratory viruses have been declining since peaking in week 5.
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, 2014-15​
2015-w13-fg3-eng.gif
​
RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2014-2015
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 1: Weekly and cumulative numbers of positive influenza specimens
by type, subtype and province, Canada, 2014-15 [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]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Reporting provinces [SUP]1[/SUP] Weekly
(March 29 to April 04, 2015) Cumulative
(August 24 to April 04, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1)pdm09 A(H3) A(UnS) [TD]B Total[/TD]
A Total A(H1)pdm09 A(H3) A(UnS) [TD]B Total[/TD]
[/TR]
[TR]
BC [TD="class: alignRight"]7[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]7[/TD]
[TD="class: alignRight"]24[/TD]
[TD="class: alignRight"]3495[/TD]
[TD="class: alignRight"]25[/TD]
[TD="class: alignRight"]2603[/TD]
[TD="class: alignRight"]867[/TD]
[TD="class: alignRight"]321[/TD]
[/TR]
[TR]
AB [TD="class: alignRight"]14[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]11[/TD]
[TD="class: alignRight"]3[/TD]
[TD="class: alignRight"]45[/TD]
[TD="class: alignRight"]3680[/TD]
[TD="class: alignRight"]13[/TD]
[TD="class: alignRight"]3513[/TD]
[TD="class: alignRight"]154[/TD]
[TD="class: alignRight"]712[/TD]
[/TR]
[TR]
SK [TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]10[/TD]
[TD="class: alignRight"]1312[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]839[/TD]
[TD="class: alignRight"]473[/TD]
[TD="class: alignRight"]150[/TD]
[/TR]
[TR]
MB [TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]13[/TD]
[TD="class: alignRight"]1121[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]390[/TD]
[TD="class: alignRight"]731[/TD]
[TD="class: alignRight"]103[/TD]
[/TR]
[TR]
ON [TD="class: alignRight"]60[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]25[/TD]
[TD="class: alignRight"]34[/TD]
[TD="class: alignRight"]104[/TD]
[TD="class: alignRight"]11028[/TD]
[TD="class: alignRight"]43[/TD]
[TD="class: alignRight"]4633[/TD]
[TD="class: alignRight"]6352[/TD]
[TD="class: alignRight"]758[/TD]
[/TR]
[TR]
QC [TD="class: alignRight"]20[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]20[/TD]
[TD="class: alignRight"]274[/TD]
[TD="class: alignRight"]11352[/TD]
[TD="class: alignRight"]4[/TD]
[TD="class: alignRight"]422[/TD]
[TD="class: alignRight"]10926[/TD]
[TD="class: alignRight"]2848[/TD]
[/TR]
[TR]
NB [TD="class: alignRight"]30[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]5[/TD]
[TD="class: alignRight"]25[/TD]
[TD="class: alignRight"]62[/TD]
[TD="class: alignRight"]1147[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]180[/TD]
[TD="class: alignRight"]967[/TD]
[TD="class: alignRight"]318[/TD]
[/TR]
[TR]
NS [TD="class: alignRight"]16[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]16[/TD]
[TD="class: alignRight"]16[/TD]
[TD="class: alignRight"]503[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]123[/TD]
[TD="class: alignRight"]380[/TD]
[TD="class: alignRight"]225[/TD]
[/TR]
[TR]
PE [TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]16[/TD]
[TD="class: alignRight"]121[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]118[/TD]
[TD="class: alignRight"]2[/TD]
[TD="class: alignRight"]62[/TD]
[/TR]
[TR]
NL [TD="class: alignRight"]2[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]2[/TD]
[TD="class: alignRight"]5[/TD]
[TD="class: alignRight"]612[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]123[/TD]
[TD="class: alignRight"]489[/TD]
[TD="class: alignRight"]24[/TD]
[/TR]
[TR]
Canada [TD="class: alignRight"]152[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]1[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]43[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]108[/TD]
[TD="class: alignRight"]569[/TD]
[TD="class: alignRight"]34371[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]86[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]12944[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]21341[/TD]
[TD="class: alignRight"]5521[/TD]
[/TR]
[TR]
Percentage [SUP]2[/SUP] [TD="class: alignRight"]21.1%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]0.7%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]28.3%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]71.1%[/TD]
[TD="class: alignRight"]78.9%[/TD]
[TD="class: alignRight"]86.2%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]0.3%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]37.7%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]62.1%[/TD]
[TD="class: alignRight"]13.8%[/TD]
[/TR]
[/TABLE]
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
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, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups (years) Weekly
(March 29 to April 04, 2015) Cumulative
(August 24 to April 04, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) [TD]Total[/TD]
A Total A(H1) pdm09 A(H3) A (UnS) [TD]Total[/TD]
# % [/TR]
[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]
[TR]
<5 [TD="class: alignRight"]3[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]3[/TD]
[TD="class: alignRight"]32[/TD]
[TD="class: alignRight"]2073[/TD]
[TD="class: alignRight"]18[/TD]
[TD="class: alignRight"]805[/TD]
[TD="class: alignRight"]1250[/TD]
[TD="class: alignRight"]351[/TD]
[TD="class: alignRight"]2424[/TD]
[TD="class: alignRight"]7.0%[/TD]
[/TR]
[TR]
5-19 [TD="class: alignRight"]4[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]4[/TD]
[TD="class: alignRight"]35[/TD]
[TD="class: alignRight"]1770[/TD]
[TD="class: alignRight"]6[/TD]
[TD="class: alignRight"]951[/TD]
[TD="class: alignRight"]813[/TD]
[TD="class: alignRight"]536[/TD]
[TD="class: alignRight"]2306[/TD]
[TD="class: alignRight"]6.7%[/TD]
[/TR]
[TR]
20-44 [TD="class: alignRight"]6[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]6[/TD]
[TD="class: alignRight"]54[/TD]
[TD="class: alignRight"]3419[/TD]
[TD="class: alignRight"]16[/TD]
[TD="class: alignRight"]1652[/TD]
[TD="class: alignRight"]1751[/TD]
[TD="class: alignRight"]748[/TD]
[TD="class: alignRight"]4167[/TD]
[TD="class: alignRight"]12.0%[/TD]
[/TR]
[TR]
45-64 [TD="class: alignRight"]7[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]6[/TD]
[TD="class: alignRight"]98[/TD]
[TD="class: alignRight"]3835[/TD]
[TD="class: alignRight"]17[/TD]
[TD="class: alignRight"]1639[/TD]
[TD="class: alignRight"]2179[/TD]
[TD="class: alignRight"]1247[/TD]
[TD="class: alignRight"]5082[/TD]
[TD="class: alignRight"]14.7%[/TD]
[/TR]
[TR]
65+ [TD="class: alignRight"]46[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]17[/TD]
[TD="class: alignRight"]29[/TD]
[TD="class: alignRight"]168[/TD]
[TD="class: alignRight"]18602[/TD]
[TD="class: alignRight"]13[/TD]
[TD="class: alignRight"]7215[/TD]
[TD="class: alignRight"]11374[/TD]
[TD="class: alignRight"]1897[/TD]
[TD="class: alignRight"]20499[/TD]
[TD="class: alignRight"]59.2%[/TD]
[/TR]
[TR]
Unknown [TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]121[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]100[/TD]
[TD="class: alignRight"]21[/TD]
[TD="class: alignRight"]5[/TD]
[TD="class: alignRight"]126[/TD]
[TD="class: alignRight"]0.4%[/TD]
[/TR]
[TR]
Total [TD="class: alignRight"]66[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]0[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]18[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]48[/TD]
[TD="class: alignRight"]387[/TD]
[TD="class: alignRight"]29820[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]70[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]12362[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]17388[/TD]
[TD="class: alignRight"]4784[/TD]
[TD="class: alignRight"]34604[/TD]
[TD="class: alignRight"]100.0%[/TD]
[/TR]
[TR]
Percentage [SUP]2[/SUP] [TD="class: alignRight"]14.6%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]0.0%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]27.3%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]72.7%[/TD]
[TD="class: alignRight"]85.4%[/TD]
[TD="class: alignRight"]86.2%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]0.2%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]41.5%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]58.3%[/TD]
[TD="class: alignRight"]13.8%[/TD]
[TD="class: alignRight"] [/TD]
[TD="class: alignRight"] [/TD]
[/TR]
[/TABLE]
[h=2]Antiviral Resistance[/h] During the 2014-2015 influenza season, the NML has tested 1,121 influenza viruses for resistance to oseltamivir and zanamivir. All viruses were sensitive to zanamivir and one influenza A(H3N2) virus was resistant to oseltamivir. A total of 1,235 influenza A viruses (99.9%) were resistant to amantadine (Table 3).
[TABLE="class: widthFull, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Virus type and subtype Oseltamivir Zanamivir Amantadine [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
# tested # resistant (%) # tested # resistant (%) # tested # resistant (%) [/TR]
[TR]
[TD="class: fontSize85, colspan: 7"][SUP]*[/SUP] NA - not applicable[/TD]
[/TR]
[TR]
A (H3N2) [TD="class: alignRight"]834[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]834[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]1230[/TD]
[TD="class: alignRight"]1229 (99.9%)[/TD]
[/TR]
[TR]
A (H1N1) [TD="class: alignRight"]6[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]6[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]6[/TD]
[TD="class: alignRight"]6 (100%)[/TD]
[/TR]
[TR]
B [TD="class: alignRight"]281[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]281[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]NA [SUP]*[/SUP][/TD]
[TD="class: alignRight"]NA [SUP]*[/SUP][/TD]
[/TR]
[TR]
TOTAL [TD="class: alignRight"]1121[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]1121[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]1236[/TD]
[TD="class: alignRight"]1235[/TD]
[/TR]
[/TABLE]
[h=2]Influenza Strain Characterizations[/h] During the 2014-2015 influenza season, the National Microbiology Laboratory (NML) has characterized 558 influenza viruses [179 A(H3N2), 9 A(H1N1) and 370 influenza B].
Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assay (n=179), one virus was antigenically similar to A/Texas/50/2012, five showed reduced titers to A/Texas/50/2012 and 173 were antigenically similar to A/Switzerland/9715293/2013, which is the influenza A(H3N2) component recommended for the 2015 Southern Hemisphere influenza vaccine. Additionally, 1,035 A(H3N2) viruses were unable to be tested by HI assay; however, sequence analysis showed that 1,033 belonged to a genetic group that typically shows reduced titers to A/Texas/50/2012.
Influenza A(H1N1): Nine A(H1N1) viruses characterized were antigenically similar to A/California/7/2009.
Influenza B: Of the 370 influenza B viruses characterized, 351 viruses were antigenically similar to B/Massachusetts/2/2012, three viruses showed reduced titers against B/Massachusetts/2/2012, and 16 were B/Brisbane/60/2008-like (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2014-2015, N = 558​
2015-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 byWHO.
The recommended components for the 2014-2015 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A/Texas/50/2012 (H3N2)-like virus, and a B/Massachusetts/2/2012-like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus is recommended.
The WHO has released the recommended composition of the influenza vaccine for the northern hemisphere for the 2015-2016 season. Trivalent vaccines are recommended to contain 1) an A/California/7/2009 (H1N1)pdm09-like virus 2) an A/Switzerland/9715293/2013 (H3N2)-like virus, and 3) an B/Phuket/3073/2013-like virus(Yamagata lineage). Quadrivalent vaccines are recommended to additionally contain a B/Brisbane/60/2008-like virus (Victoria lineage).


Text equivalent for figure 4Influenza strain characterizations, Canada, 2014-2015, N =3
[h=2]Influenza-like Illness (ILI) Consultation Rate[/h] The national influenza-like-illness (ILI) consultation rate increased in week 13 to 31.2 consultations per 1,000, which is within expected levels (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, 2014-2015​
2015-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. 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, 2014-2015
[h=2]Influenza Outbreak Surveillance[/h] In week 13, 25 new outbreaks of influenza were reported. The majority of the outbreaks occurred in the Central and Atlantic provinces. Nineteen outbreaks were reported in long-term care facilities (LTCF), one in hospitals and five in institutional or community settings (Figure 6). Among the outbreaks in which the influenza type was known (n=9), seven outbreaks were associated with influenza B. To date this season, 1,192 outbreaks in LTCFs have been reported and the majority of those with known subtypes were attributable to A(H3N2). There have been a higher number of reported influenza outbreaks to date this season compared to the same period in previous seasons.
Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2014-2015
2015-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, 2014-2015
[h=2]Pharmacy Surveillance[/h] Pharmacy surveillance for sales of influenza antivirals has ended for the 2014-2015 influenza season (Figure 7).
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2014-15​
2015-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 2,500 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, 2014-15
[h=2]Sentinel Hospital Influenza Surveillance[/h] Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In week 13, 10 laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network. All 10 cases were influenza B (Figure 8a). A greater proportion of cases have been reported with influenza B in recent weeks, following the trend in laboratory detections. Among the reported cases, two (20%) were <2 years of age, five (50%) were 2 to 9 years of age and three (30%) were 10-16 years of age. Three ICU admissions were reported.
To date this season, 629 hospitalizations have been reported by the IMPACT network, 502 (80%) of which were cases of influenza A. Among cases for which the influenza A subtype was reported, 99% (162/164) were A(H3N2) (Table 4).To date, 82 cases were admitted to the ICU, of which 46 (56%) were 2 to 9 years of age (Figure 9a). A total of 54 ICU cases reported to have at least one underlying condition or comorbidity. Four 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, 24 laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network. Among the cases in week 13, 20 cases (83%) were in adults over the age of 65 and 14 cases (58%) had influenza B (Figure 8b).
To date this season, 2,101 cases have been reported; 1,887 (90%) with influenza A. The majority of cases (82%) were among adults ≥65 years of age (Table 5). One hundred and fifty four ICU admissions have been reported and 116 cases were adults ≥65 years of age. Among the 154 ICU admissions, 12 were due to influenza B (six in adults 45 to 64 years of age and six in adults over the age of 65). A total of 110 ICU cases (73%) reported to have at least one underlying condition or comorbidity. Of the 112 ICU cases with known immunization status, 38 (34%) reported not having been vaccinated this season. One hundred and twenty three deaths have been reported, 113 (92%) of the deaths were adults >65 years of age (Figure 9B).
Note: 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 marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (Aug. 24, 2014 to April 4, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) Total # (%) [/TR]
[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]
[TR]
0-5m [TD="class: alignRight"]81[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]18[/TD]
[TD="class: alignRight"]63[/TD]
[TD="class: alignRight"]8[/TD]
[TD="class: alignRight"]89 (14.1%)[/TD]
[/TR]
[TR]
6-23m [TD="class: alignRight"]109[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]35[/TD]
[TD="class: alignRight"]73[/TD]
[TD="class: alignRight"]29[/TD]
[TD="class: alignRight"]138 (21.9%)[/TD]
[/TR]
[TR]
2-4y [TD="class: alignRight"]123[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]40[/TD]
[TD="class: alignRight"]82[/TD]
[TD="class: alignRight"]32[/TD]
[TD="class: alignRight"]155 (24.6%)[/TD]
[/TR]
[TR]
5-9y [TD="class: alignRight"]129[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]44[/TD]
[TD="class: alignRight"]85[/TD]
[TD="class: alignRight"]33[/TD]
[TD="class: alignRight"]162 (25.8%)[/TD]
[/TR]
[TR]
10-16y [TD="class: alignRight"]60[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]25[/TD]
[TD="class: alignRight"]35[/TD]
[TD="class: alignRight"]25[/TD]
[TD="class: alignRight"]85 (13.5%)[/TD]
[/TR]
[TR]
Total [TD="class: alignRight"]502[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]2[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]162[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]338[/TD]
[TD="class: alignRight"]127[/TD]
[TD="class: alignRight"]629[/TD]
[/TR]
[TR]
% [SUP]1[/SUP] [TD="class: alignRight"]79.8%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]0.4%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]32.3%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]67.3%[/TD]
[TD="class: alignRight"]20.2%[/TD]
[TD="class: alignRight"]100.0%[/TD]
[/TR]
[/TABLE]
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 5 - Cumulative numbers of adult hospitalizations with influenza reported by the PCIRN-SOS network, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (November 15, 2014 to April 4, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A(UnS) Total # (%) [/TR]
[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]
[TR]
16-20 [TD="class: alignRight"]3[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]2[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]4 (%)[/TD]
[/TR]
[TR]
20-44 [TD="class: alignRight"]105[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]54[/TD]
[TD="class: alignRight"]50[/TD]
[TD="class: alignRight"]10[/TD]
[TD="class: alignRight"]115 (5%)[/TD]
[/TR]
[TR]
45-64 [TD="class: alignRight"]215[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]92[/TD]
[TD="class: alignRight"]122[/TD]
[TD="class: alignRight"]52[/TD]
[TD="class: alignRight"]267 (13%)[/TD]
[/TR]
[TR]
65+ [TD="class: alignRight"]1564[/TD]
[TD="class: alignRight"]3[/TD]
[TD="class: alignRight"]734[/TD]
[TD="class: alignRight"]827[/TD]
[TD="class: alignRight"]151[/TD]
[TD="class: alignRight"]1715 (82%)[/TD]
[/TR]
[TR]
Total [TD="class: alignRight"]1887[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]5[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]881[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]1001[/TD]
[TD="class: alignRight"]214[/TD]
[TD="class: alignRight"]2101[/TD]
[/TR]
[TR]
% [SUP]1[/SUP] [TD="class: alignRight"]90%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]0%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]47%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]53%[/TD]
[TD="class: alignRight"]10%[/TD]
[TD="class: alignRight"]100%[/TD]
[/TR]
[/TABLE]
Figure 8 - Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15
A) Paediatric hospitalizations (≤16 years of age, IMPACT)

Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2015-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, 2014-15: Adult hospitalizations (>16 year of age, PCIRN-SOS)
Figure 9 - Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2015-w13-fg9a-eng.gif
Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)

Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15: Adult hospitalizations (≥16 year of age, PCIRN-SOS)
[h=2]Provincial/Territorial Influenza Hospitalizations and Deaths[/h] In week 13, 120 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories[SUP]*[/SUP], which is less than the number reported the previous week. Of the 120 hospitalizations, 84 (70%) were due to influenza A and 82 (68%) were in patients ≥65 years of age.
Since the start of the 2014-15 season, 6,679 hospitalizations have been reported; 6,108 (91.5%) with influenza A. Among cases for which the subtype of influenza A was reported, 99.5% were A(H3N2). The majority of cases (71%) were ≥65 years of age (Table 6). A total of 352 ICU admissions have been reported to date: 53% (n=188) were in adults ≥65 years of age and 33% (n=116) were in adults 20-64 years. A total of 493 deaths have been reported since the start of the season: four children <5 years of age, three children 5-19 years, 40 adults 20-64 years, and 446 adults ≥65 years of age. Adults 65 years of age or older represent 91% of all deaths reported this season. 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. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting.
[TABLE="class: widthFull, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (24 August 2014 to 4 April 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) [TD="class: alignCenter"]Total[/TD]
[TD="class: alignCenter"]# (%)[/TD]
[/TR]
[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]
[TR]
0-4 years [TD="class: alignRight"]401[/TD]
[TD="class: alignRight"]2[/TD]
[TD="class: alignRight"]143[/TD]
[TD="class: alignRight"]256[/TD]
[TD="class: alignRight"]45[/TD]
[TD="class: alignRight"]446 (7%)[/TD]
[/TR]
[TR]
5-19 years [TD="class: alignRight"]267[/TD]
[TD="class: alignRight"]2[/TD]
[TD="class: alignRight"]130[/TD]
[TD="class: alignRight"]135[/TD]
[TD="class: alignRight"]65[/TD]
[TD="class: alignRight"]332 (5%)[/TD]
[/TR]
[TR]
20-44 years [TD="class: alignRight"]371[/TD]
[TD="class: alignRight"]3[/TD]
[TD="class: alignRight"]223[/TD]
[TD="class: alignRight"]145[/TD]
[TD="class: alignRight"]72[/TD]
[TD="class: alignRight"]443 (7%)[/TD]
[/TR]
[TR]
45-64 years [TD="class: alignRight"]572[/TD]
[TD="class: alignRight"]5[/TD]
[TD="class: alignRight"]239[/TD]
[TD="class: alignRight"]328[/TD]
[TD="class: alignRight"]73[/TD]
[TD="class: alignRight"]645 (10%)[/TD]
[/TR]
[TR]
65+ years [TD="class: alignRight"]4441[/TD]
[TD="class: alignRight"]2[/TD]
[TD="class: alignRight"]2066[/TD]
[TD="class: alignRight"]2373[/TD]
[TD="class: alignRight"]298[/TD]
[TD="class: alignRight"]4739 (71%)[/TD]
[/TR]
[TR]
Unknown [TD="class: alignRight"]56[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]52[/TD]
[TD="class: alignRight"]3[/TD]
[TD="class: alignRight"]18[/TD]
[TD="class: alignRight"]74 (1%)[/TD]
[/TR]
[TR]
Total [TD="class: alignRight"]6108[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]15[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]2853[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]3240[/TD]
[TD="class: alignRight"]571[/TD]
[TD="class: alignRight"]6679[/TD]
[/TR]
[TR]
Percentage [SUP]1[/SUP] [TD="class: alignRight"]91.5%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]0.2%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]46.7%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]53.0%[/TD]
[TD="class: alignRight"]8.5%[/TD]
[TD="class: alignRight"]100.0%[/TD]
[/TR]
[/TABLE]
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2014-15 on the Public Health Agency of Canada website.

.../
http://www.phac-aspc.gc.ca/fluwatch/14-15/w13_15/index-eng.php
 
[h=1]FluWatch report: April 5 to April 11, 2015 (Week 14)[/h] Posted 2015-04-17 For readers interested in the PDF version, the document is available for downloading or viewing:
FluWatch report: April 5 to April 11, 2015 (Week 14) (PDF Version - 908 KB - 10 pages)

? ? Help with PDF documents

Overall Summary
  • In week 14, influenza B continued to be the predominant influenza virus circulating in all provinces and territories.
  • The number of influenza A and B detections remained similar to the previous week. Other circulating respiratory viruses continue to decrease with the end of the 2014-15 flu season approaching.
  • Influenza B is having a greater impact on adults less than 65 years of age, compared to influenza A(H3N2), which circulated earlier in the season.
  • Evidence from the National Microbiology Laboratory (NML) indicates that this year's vaccine will continue to provide protection against the circulating A(H1N1) and B strains.

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
[h=2]Influenza/ILI Activity (geographic spread)[/h] In week 14, no regions reported widespread activity. Twenty-three regions reported localized activity: BC, AB, MB, ON(6), QC(4), NB(3), NS(4), PE and NL(2). Twenty-four regions reported sporadic activity: in YK, NT(2), BC(4), AB(4), SK(3), MB(2), ON. QC(2), NB(4), and NS. Eleven regions reported no activity: NU(3), MB(2), NS(4), and NL(2).
Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 14​
​
Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
[h=2]Influenza and Other Respiratory Virus Detections[/h] In week 14, the percentage positive for influenza A (2.2%) and B (12.2%) declined from the previous week (Figure 2). Influenza B detections were greater than influenza A in all provinces. More influenza B has been observed to date this season (6,130) compared to the same time during the 2013-14 season (5,027). To date, 85% of influenza detections have been influenza A, and 99.3% of those subtyped have been A(H3N2) (Table 1). To date this season, detailed information on age and type/subtype has been received for 35,137 cases (Table 2). Adults ≥65 years of age have predominantly been affected by influenza A, accounting for 62% of influenza A detections. Influenza B, while much smaller in numbers, is mainly affecting individuals less than 65 years of age, they account for 60% of influenza B detections.
Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2014-15​
2015-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, 2014-15
In week 14, detections for all other respiratory viruses remained similar to, or decreased from, the previous week (Figure 3). Overall, the detections of other respiratory viruses have been declining since peaking in week 5.
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, 2014-15​
2015-w14-fg3-eng.gif
​
RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2014-2015
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 1: Weekly and cumulative numbers of positive influenza specimens by type, subtype and province, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Reporting provinces [SUP]1[/SUP] Weekly
(April 5 to April 11, 2015) Cumulative
(August 24 to April 11, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1)pdm09 A(H3) A(UnS) [TD]B Total[/TD]
A Total A(H1)pdm09 A(H3) A(UnS) [TD]B Total[/TD]
[/TR]
[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]
[TR]
BC [TD="class: alignRight"]3[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]3[/TD]
[TD="class: alignRight"]21[/TD]
[TD="class: alignRight"]3498[/TD]
[TD="class: alignRight"]25[/TD]
[TD="class: alignRight"]2603[/TD]
[TD="class: alignRight"]870[/TD]
[TD="class: alignRight"]342[/TD]
[/TR]
[TR]
AB [TD="class: alignRight"]6[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]4[/TD]
[TD="class: alignRight"]2[/TD]
[TD="class: alignRight"]46[/TD]
[TD="class: alignRight"]3686[/TD]
[TD="class: alignRight"]13[/TD]
[TD="class: alignRight"]3519[/TD]
[TD="class: alignRight"]154[/TD]
[TD="class: alignRight"]758[/TD]
[/TR]
[TR]
SK [TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]9[/TD]
[TD="class: alignRight"]1312[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]839[/TD]
[TD="class: alignRight"]473[/TD]
[TD="class: alignRight"]176[/TD]
[/TR]
[TR]
MB [TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]16[/TD]
[TD="class: alignRight"]1121[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]390[/TD]
[TD="class: alignRight"]731[/TD]
[TD="class: alignRight"]119[/TD]
[/TR]
[TR]
ON [TD="class: alignRight"]43[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]25[/TD]
[TD="class: alignRight"]18[/TD]
[TD="class: alignRight"]110[/TD]
[TD="class: alignRight"]11077[/TD]
[TD="class: alignRight"]43[/TD]
[TD="class: alignRight"]4659[/TD]
[TD="class: alignRight"]6375[/TD]
[TD="class: alignRight"]884[/TD]
[/TR]
[TR]
QC [TD="class: alignRight"]24[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]24[/TD]
[TD="class: alignRight"]271[/TD]
[TD="class: alignRight"]11376[/TD]
[TD="class: alignRight"]4[/TD]
[TD="class: alignRight"]422[/TD]
[TD="class: alignRight"]10950[/TD]
[TD="class: alignRight"]3119[/TD]
[/TR]
[TR]
NB [TD="class: alignRight"]26[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]3[/TD]
[TD="class: alignRight"]23[/TD]
[TD="class: alignRight"]72[/TD]
[TD="class: alignRight"]1173[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]183[/TD]
[TD="class: alignRight"]990[/TD]
[TD="class: alignRight"]390[/TD]
[/TR]
[TR]
NS [TD="class: alignRight"]2[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]2[/TD]
[TD="class: alignRight"]14[/TD]
[TD="class: alignRight"]505[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]123[/TD]
[TD="class: alignRight"]382[/TD]
[TD="class: alignRight"]239[/TD]
[/TR]
[TR]
PE [TD="class: alignRight"]2[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]2[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]12[/TD]
[TD="class: alignRight"]123[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]120[/TD]
[TD="class: alignRight"]2[/TD]
[TD="class: alignRight"]74[/TD]
[/TR]
[TR]
NL [TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]5[/TD]
[TD="class: alignRight"]613[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]123[/TD]
[TD="class: alignRight"]490[/TD]
[TD="class: alignRight"]29[/TD]
[/TR]
[TR]
Canada [TD="class: alignRight"]107[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]0[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]34[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]73[/TD]
[TD="class: alignRight"]576[/TD]
[TD="class: alignRight"]34484[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]86[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]12981[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]21417[/TD]
[TD="class: alignRight"]6130[/TD]
[/TR]
[TR]
Percentage [SUP]2[/SUP] [TD="class: alignRight"]15.7%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]0.0%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]31.8%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]68.2%[/TD]
[TD="class: alignRight"]84.3%[/TD]
[TD="class: alignRight"]84.9%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]0.2%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]37.6%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]62.1%[/TD]
[TD="class: alignRight"]15.1%[/TD]
[/TR]
[/TABLE]
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
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, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups (years) Weekly
(April 5 to April 11, 2015) Cumulative
(August 24 to April 11, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) [TD]Total[/TD]
A Total A(H1) pdm09 A(H3) A (UnS) [TD]Total[/TD]
# % [/TR]
[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]
[TR]
<5 [TD="class: alignRight"]5[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]4[/TD]
[TD="class: alignRight"]32[/TD]
[TD="class: alignRight"]2081[/TD]
[TD="class: alignRight"]19[/TD]
[TD="class: alignRight"]807[/TD]
[TD="class: alignRight"]1255[/TD]
[TD="class: alignRight"]392[/TD]
[TD="class: alignRight"]2473[/TD]
[TD="class: alignRight"]7.0%[/TD]
[/TR]
[TR]
5-19 [TD="class: alignRight"]3[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]2[/TD]
[TD="class: alignRight"]31[/TD]
[TD="class: alignRight"]1775[/TD]
[TD="class: alignRight"]6[/TD]
[TD="class: alignRight"]953[/TD]
[TD="class: alignRight"]816[/TD]
[TD="class: alignRight"]577[/TD]
[TD="class: alignRight"]2352[/TD]
[TD="class: alignRight"]6.7%[/TD]
[/TR]
[TR]
20-44 [TD="class: alignRight"]3[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]2[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]36[/TD]
[TD="class: alignRight"]3426[/TD]
[TD="class: alignRight"]16[/TD]
[TD="class: alignRight"]1659[/TD]
[TD="class: alignRight"]1751[/TD]
[TD="class: alignRight"]804[/TD]
[TD="class: alignRight"]4230[/TD]
[TD="class: alignRight"]12.0%[/TD]
[/TR]
[TR]
45-64 [TD="class: alignRight"]6[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]3[/TD]
[TD="class: alignRight"]3[/TD]
[TD="class: alignRight"]74[/TD]
[TD="class: alignRight"]3845[/TD]
[TD="class: alignRight"]17[/TD]
[TD="class: alignRight"]1646[/TD]
[TD="class: alignRight"]2182[/TD]
[TD="class: alignRight"]1354[/TD]
[TD="class: alignRight"]5199[/TD]
[TD="class: alignRight"]14.8%[/TD]
[/TR]
[TR]
65+ [TD="class: alignRight"]25[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]8[/TD]
[TD="class: alignRight"]17[/TD]
[TD="class: alignRight"]188[/TD]
[TD="class: alignRight"]18637[/TD]
[TD="class: alignRight"]13[/TD]
[TD="class: alignRight"]7232[/TD]
[TD="class: alignRight"]11392[/TD]
[TD="class: alignRight"]2120[/TD]
[TD="class: alignRight"]20757[/TD]
[TD="class: alignRight"]59.1%[/TD]
[/TR]
[TR]
Unknown [TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]121[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]100[/TD]
[TD="class: alignRight"]21[/TD]
[TD="class: alignRight"]5[/TD]
[TD="class: alignRight"]126[/TD]
[TD="class: alignRight"]0.4%[/TD]
[/TR]
[TR]
Total [TD="class: alignRight"]42[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]0[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]15[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]27[/TD]
[TD="class: alignRight"]361[/TD]
[TD="class: alignRight"]29885[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]71[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]12397[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]17417[/TD]
[TD="class: alignRight"]5252[/TD]
[TD="class: alignRight"]35137[/TD]
[TD="class: alignRight"]100.0%[/TD]
[/TR]
[TR]
Percentage [SUP]2[/SUP] [TD="class: alignRight"]10.4%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]0.0%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]35.7%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]64.3%[/TD]
[TD="class: alignRight"]89.6%[/TD]
[TD="class: alignRight"]85.1%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]0.2%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]41.5%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]58.3%[/TD]
[TD="class: alignRight"]14.9%[/TD]
[TD="class: alignRight"] [/TD]
[TD="class: alignRight"] [/TD]
[/TR]
[/TABLE]
[h=2]Antiviral Resistance[/h] During the 2014-2015 influenza season, the NML has tested 1,197 influenza viruses for resistance to oseltamivir and 1,192 influenza viruses for resistance to zanamivir. All viruses were sensitive to zanamivir and one influenza A(H3N2) virus was resistant to oseltamivir. A total of 1,284 influenza A viruses (99.9%) were resistant to amantadine (Table 3).
[TABLE="class: widthFull, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Virus type and subtype Oseltamivir Zanamivir Amantadine [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
# tested # resistant (%) # tested # resistant (%) # tested # resistant (%) [/TR]
[TR]
[TD="class: fontSize85, colspan: 7"][SUP]*[/SUP] NA - not applicable[/TD]
[/TR]
[TR]
A (H3N2) [TD="class: alignRight"]846[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]843[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]1275[/TD]
[TD="class: alignRight"]1274 (99.9%)[/TD]
[/TR]
[TR]
A (H1N1) [TD="class: alignRight"]9[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]9[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]10[/TD]
[TD="class: alignRight"]10 (100%)[/TD]
[/TR]
[TR]
B [TD="class: alignRight"]342[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]340[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]NA [SUP]*[/SUP][/TD]
[TD="class: alignRight"]NA [SUP]*[/SUP][/TD]
[/TR]
[TR]
TOTAL [TD="class: alignRight"]1197[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]1192[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]1285[/TD]
[TD="class: alignRight"]1284[/TD]
[/TR]
[/TABLE]
[h=2]Influenza Strain Characterizations[/h] During the 2014-2015 influenza season, the National Microbiology Laboratory (NML) has characterized 611 influenza viruses [179 A(H3N2), 10 A(H1N1) and 422 influenza B].
Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assay (n=179), one virus was antigenically similar to A/Texas/50/2012, five showed reduced titers to A/Texas/50/2012 and 173 were antigenically similar to A/Switzerland/9715293/2013, which is the influenza A(H3N2) component recommended for the 2015 Southern Hemisphere influenza vaccine. Additionally, 1,054 A(H3N2) viruses were unable to be tested by HI assay; however, sequence analysis showed that 1,052 belonged to a genetic group that typically shows reduced titers to A/Texas/50/2012.
Influenza A(H1N1): Ten A(H1N1) viruses characterized were antigenically similar to A/California/7/2009.
Influenza B: Of the 422 influenza B viruses characterized, 400 viruses were antigenically similar to B/Massachusetts/2/2012, three viruses showed reduced titers against B/Massachusetts/2/2012, and 19 were B/Brisbane/60/2008-like (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2014-2015, N = 611​
2015-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 byWHO.
The recommended components for the 2014-2015 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A/Texas/50/2012 (H3N2)-like virus, and a B/Massachusetts/2/2012-like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus is recommended.
The WHO has released the recommended composition of the influenza vaccine for the northern hemisphere for the 2015-2016 season. Trivalent vaccines are recommended to contain 1) an A/California/7/2009 (H1N1)pdm09-like virus 2) an A/Switzerland/9715293/2013 (H3N2)-like virus, and 3) an B/Phuket/3073/2013-like virus(Yamagata lineage). Quadrivalent vaccines are recommended to additionally contain a B/Brisbane/60/2008-like virus (Victoria lineage).


Text equivalent for figure 4Influenza strain characterizations, Canada, 2014-2015, N =3
[h=2]Influenza-like Illness (ILI) Consultation Rate[/h] The national influenza-like-illness (ILI) consultation rate increased in week 14 to 49.4 consultations per 1,000, which is above expected levels (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, 2014-2015​
2015-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. 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, 2014-2015
[h=2]Influenza Outbreak Surveillance[/h] In week 14, 26 new outbreaks of influenza were reported. Similar to previous weeks, the majority of the outbreaks occurred in the Central and Atlantic provinces. Twenty outbreaks were reported in long-term care facilities (LTCF), one in hospitals and five in institutional or community settings (Figure 6). Among the outbreaks in which the influenza type was known (n=8), six outbreaks were associated with influenza B. To date this season, 1,212 outbreaks in LTCFs have been reported and the majority of those with known subtypes were attributable to A(H3N2). There have been a higher number of reported influenza outbreaks to date this season compared to the same period in previous seasons.
Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2014-2015
2015-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, 2014-2015
[h=2]Pharmacy Surveillance[/h] Pharmacy surveillance for sales of influenza antivirals has ended for the 2014-2015 influenza season (Figure 7).
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2014-15​
2015-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 2,500 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, 2014-15
[h=2]Sentinel Hospital Influenza Surveillance[/h] Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In week 14, 15 laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network. Fourteen cases were influenza B (Figure 8a). A greater proportion of cases have been reported with influenza B in recent weeks, following the trend in laboratory detections. Among the reported cases, one (7%) was <2 years of age, ten (67%) were 2 to 9 years of age and four (27%) were 10-16 years of age. One ICU admission was reported.
To date this season, 643 hospitalizations have been reported by the IMPACT network, 502 (80%) of which were cases of influenza A. Among cases for which the influenza A subtype was reported, 99% (162/164) were A(H3N2) (Table 4). To date, 82 cases were admitted to the ICU, of which 45 (55%) were 2 to 9 years of age (Figure 9a). A total of 54 ICU cases reported to have at least one underlying condition or comorbidity. Four 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, 30 laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported by the PHAC/CIHR Influenza Research Network (PCIRN) Serious Outcomes Surveillance (SOS) network. Among the cases in week 14, 21 cases (70%) were in adults over the age of 65 and 23 cases (77%) had influenza B (Figure 8b).
To date this season, 2,147 cases have been reported; 1,896 (88%) with influenza A. The majority of cases (82%) were among adults ≥65 years of age (Table 5). One hundred and fifty seven ICU admissions have been reported and 119 cases were adults ≥65 years of age. Among the 157 ICU admissions, 15 were due to influenza B (seven in adults 45 to 64 years of age and eight in adults over the age of 65). A total of 111 ICU cases (71%) reported to have at least one underlying condition or comorbidity. Of the 120 ICU cases with known immunization status, 38 (32%) reported not having been vaccinated this season. One hundred and twenty four deaths have been reported, 114 (92%) of the deaths were adults >65 years of age (Figure 9B).
Note: 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 marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (Aug. 24, 2014 to April 11, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) Total # (%) [/TR]
[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]
[TR]
0-5m [TD="class: alignRight"]81[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]18[/TD]
[TD="class: alignRight"]63[/TD]
[TD="class: alignRight"]8[/TD]
[TD="class: alignRight"]89 (13.8%)[/TD]
[/TR]
[TR]
6-23m [TD="class: alignRight"]109[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]35[/TD]
[TD="class: alignRight"]73[/TD]
[TD="class: alignRight"]29[/TD]
[TD="class: alignRight"]140 (21.8%)[/TD]
[/TR]
[TR]
2-4y [TD="class: alignRight"]123[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]40[/TD]
[TD="class: alignRight"]82[/TD]
[TD="class: alignRight"]32[/TD]
[TD="class: alignRight"]160 (24.9%)[/TD]
[/TR]
[TR]
5-9y [TD="class: alignRight"]129[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]44[/TD]
[TD="class: alignRight"]85[/TD]
[TD="class: alignRight"]33[/TD]
[TD="class: alignRight"]167 (26.0%)[/TD]
[/TR]
[TR]
10-16y [TD="class: alignRight"]60[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]25[/TD]
[TD="class: alignRight"]35[/TD]
[TD="class: alignRight"]25[/TD]
[TD="class: alignRight"]87 (13.5%)[/TD]
[/TR]
[TR]
Total [TD="class: alignRight"]502[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]2[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]162[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]338[/TD]
[TD="class: alignRight"]127[/TD]
[TD="class: alignRight"]643[/TD]
[/TR]
[TR]
% [SUP]1[/SUP] [TD="class: alignRight"]79.8%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]0.4%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]32.3%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]67.3%[/TD]
[TD="class: alignRight"]20.2%[/TD]
[TD="class: alignRight"]100.0%[/TD]
[/TR]
[/TABLE]
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 5 – Cumulative numbers of adult hospitalizations with influenza reported by the PCIRN-SOS network, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (November 15, 2014 to April 11, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A(UnS) Total # (%) [/TR]
[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]
[TR]
16-20 [TD="class: alignRight"]3[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]2[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]4 (%)[/TD]
[/TR]
[TR]
20-44 [TD="class: alignRight"]105[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]55[/TD]
[TD="class: alignRight"]49[/TD]
[TD="class: alignRight"]12[/TD]
[TD="class: alignRight"]117 (5%)[/TD]
[/TR]
[TR]
45-64 [TD="class: alignRight"]214[/TD]
[TD="class: alignRight"]2[/TD]
[TD="class: alignRight"]94[/TD]
[TD="class: alignRight"]118[/TD]
[TD="class: alignRight"]61[/TD]
[TD="class: alignRight"]275 (13%)[/TD]
[/TR]
[TR]
65+ [TD="class: alignRight"]1574[/TD]
[TD="class: alignRight"]3[/TD]
[TD="class: alignRight"]749[/TD]
[TD="class: alignRight"]822[/TD]
[TD="class: alignRight"]177[/TD]
[TD="class: alignRight"]1751 (82%)[/TD]
[/TR]
[TR]
Total [TD="class: alignRight"]1896[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]6[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]899[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]991[/TD]
[TD="class: alignRight"]251[/TD]
[TD="class: alignRight"]2147[/TD]
[/TR]
[TR]
% [SUP]1[/SUP] [TD="class: alignRight"]88%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]0%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]47%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]52%[/TD]
[TD="class: alignRight"]12%[/TD]
[TD="class: alignRight"]100%[/TD]
[/TR]
[/TABLE]
Figure 8 - Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2015-w14-fg8a-eng.gif

Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2015-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, 2014-15: Adult hospitalizations (>16 year of age, PCIRN-SOS)
Figure 9 - Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2015-w14-fg9a-eng.gif
Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2015-w14-fg9b-eng.gif

Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15: Adult hospitalizations (≥16 year of age, PCIRN-SOS)
[h=2]Provincial/Territorial Influenza Hospitalizations and Deaths[/h] In week 14, 122 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories[SUP]*[/SUP], which is similar to the number reported the previous week. Of the 122 hospitalizations, 84 (69%) were due to influenza A and 78 (64%) were in patients ≥65 years of age.
Since the start of the 2014-15 season, 6,847 hospitalizations have been reported; 6,195 (91%) with influenza A. Among cases for which the subtype of influenza A was reported, 99.5% were A(H3N2). The majority of cases (71%) were ≥65 years of age (Table 6). A total of 358 ICU admissions have been reported to date: 53% (n=190) were in adults ≥65 years of age and 33% (n=119) were in adults 20-64 years. A total of 511 deaths have been reported since the start of the season: four children <5 years of age, three children 5-19 years, 41 adults 20-64 years, and 463 adults ≥65 years of age. Adults 65 years of age or older represent 91% of all deaths reported this season. 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. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting.
[TABLE="class: widthFull, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (24 August 2014 to 11 April 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) [TD="class: alignCenter"]Total[/TD]
[TD="class: alignCenter"]# (%)[/TD]
[/TR]
[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]
[TR]
0-4 years [TD="class: alignRight"]408[/TD]
[TD="class: alignRight"]2[/TD]
[TD="class: alignRight"]146[/TD]
[TD="class: alignRight"]260[/TD]
[TD="class: alignRight"]51[/TD]
[TD="class: alignRight"]459 (7%)[/TD]
[/TR]
[TR]
5-19 years [TD="class: alignRight"]273[/TD]
[TD="class: alignRight"]2[/TD]
[TD="class: alignRight"]133[/TD]
[TD="class: alignRight"]138[/TD]
[TD="class: alignRight"]72[/TD]
[TD="class: alignRight"]345 (5%)[/TD]
[/TR]
[TR]
20-44 years [TD="class: alignRight"]372[/TD]
[TD="class: alignRight"]3[/TD]
[TD="class: alignRight"]223[/TD]
[TD="class: alignRight"]146[/TD]
[TD="class: alignRight"]78[/TD]
[TD="class: alignRight"]450 (7%)[/TD]
[/TR]
[TR]
45-64 years [TD="class: alignRight"]579[/TD]
[TD="class: alignRight"]4[/TD]
[TD="class: alignRight"]241[/TD]
[TD="class: alignRight"]334[/TD]
[TD="class: alignRight"]85[/TD]
[TD="class: alignRight"]664 (10%)[/TD]
[/TR]
[TR]
65+ years [TD="class: alignRight"]4507[/TD]
[TD="class: alignRight"]2[/TD]
[TD="class: alignRight"]2109[/TD]
[TD="class: alignRight"]2396[/TD]
[TD="class: alignRight"]348[/TD]
[TD="class: alignRight"]4855 (71%)[/TD]
[/TR]
[TR]
Unknown [TD="class: alignRight"]56[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]52[/TD]
[TD="class: alignRight"]3[/TD]
[TD="class: alignRight"]18[/TD]
[TD="class: alignRight"]74 (1%)[/TD]
[/TR]
[TR]
Total [TD="class: alignRight"]6195[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]14[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]2904[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]3277[/TD]
[TD="class: alignRight"]652[/TD]
[TD="class: alignRight"]6847[/TD]
[/TR]
[TR]
Percentage [SUP]1[/SUP] [TD="class: alignRight"]90.5%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]0.2%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]46.9%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]52.9%[/TD]
[TD="class: alignRight"]9.5%[/TD]
[TD="class: alignRight"]100.0%[/TD]
[/TR]
[/TABLE]
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2014-15 on the Public Health Agency of Canada website.

.../
http://www.phac-aspc.gc.ca/fluwatch/14-15/w14_15/index-eng.php
 
[h=1]FluWatch report: April 12 to April 18, 2015 (Week 15)[/h] Posted 2015-04-23 For readers interested in the PDF version, the document is available for downloading or viewing:
FluWatch report: April 12 to April 18, 2015 (Week 15) (PDF Version - 908 KB - 10 pages)

? ? Help with PDF documents

Overall Summary
  • Influenza B continued to be the most common influenza virus circulating in Canada. More influenza B detections have been observed to date this season, compared to the same time last season.
  • The number of influenza A and B detections remained similar to the previous week. Other circulating respiratory viruses continue to decrease with the end of the 2014-15 influenza season approaching.
  • Elevated influenza activity was mostly reported in the Central and Atlantic provinces. Widespread activity was reported in two regions in Quebec.
  • Influenza B is having a greater impact on adults less than 65 years of age, compared to influenza A(H3N2), which circulated earlier in the season.

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
[h=2]Influenza/ILI Activity (geographic spread)[/h] In week 15, two regions in QC reported widespread activity. Thirteen regions reported localized activity: MB(2), ON(6), QC(2), NB(2) and NS. Twenty-seven regions reported sporadic activity: in NU, BC(5), AB(5), SK(3), MB(3), ON. QC(2), NB(4), NS(2) and PE. Twelve regions reported no activity activity: in YK, NT(2), NU(2), NB, and NS(6).
Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 15​
​
Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
[h=2]Influenza and Other Respiratory Virus Detections[/h] In week 15, the percentage positive for influenza A (2.1%) and B (11.9%) declined from the previous week (Figure 2). Influenza B detections were greater than influenza A in all provinces with the exception of British Columbia. More influenza B has been observed to date this season (6,821) compared to the same time during the 2013-14 season (5,027). To date, 83.5% of influenza detections have been influenza A, and 99.3% of those subtyped have been A(H3N2) (Table 1). To date this season, detailed information on age and type/subtype has been received for 35,725 cases (Table 2). Adults =65 years of age have predominantly been affected by influenza A, accounting for 62% of influenza A detections. Influenza B, while much smaller in numbers, is mainly affecting individuals less than 65 years of age, they account for 59% of influenza B detections.
Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2014-15​
2015-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, 2014-15
In week 15, detections for all other respiratory viruses remained similar to, or decreased from, the previous week (Figure 3). Overall, the detections of other respiratory viruses have been declining since peaking in week 5.
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, 2014-15​
2015-w15-fg3-eng.gif
​
RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2014-2015
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 1: Weekly and cumulative numbers of positive influenza specimens by type, subtype and province, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Reporting provinces [SUP]1[/SUP] Weekly
(April 12 to April 18, 2015) Cumulative
(August 24 to April 18, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1)pdm09 A(H3) A(UnS) [TD]B Total[/TD]
A Total A(H1)pdm09 A(H3) A(UnS) [TD]B Total[/TD]
[/TR]
[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]
[TR]
BC [TD="class: alignCenter"]24[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]20[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]22[/TD]
[TD="class: alignCenter"]3512[/TD]
[TD="class: alignCenter"]28[/TD]
[TD="class: alignCenter"]2623[/TD]
[TD="class: alignCenter"]861[/TD]
[TD="class: alignCenter"]364[/TD]
[/TR]
[TR]
AB [TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]44[/TD]
[TD="class: alignCenter"]3689[/TD]
[TD="class: alignCenter"]13[/TD]
[TD="class: alignCenter"]3520[/TD]
[TD="class: alignCenter"]156[/TD]
[TD="class: alignCenter"]803[/TD]
[/TR]
[TR]
SK [TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]17[/TD]
[TD="class: alignCenter"]1312[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]839[/TD]
[TD="class: alignCenter"]473[/TD]
[TD="class: alignCenter"]208[/TD]
[/TR]
[TR]
MB [TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]25[/TD]
[TD="class: alignCenter"]1122[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]390[/TD]
[TD="class: alignCenter"]732[/TD]
[TD="class: alignCenter"]144[/TD]
[/TR]
[TR]
ON [TD="class: alignCenter"]34[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]18[/TD]
[TD="class: alignCenter"]15[/TD]
[TD="class: alignCenter"]144[/TD]
[TD="class: alignCenter"]11114[/TD]
[TD="class: alignCenter"]45[/TD]
[TD="class: alignCenter"]4683[/TD]
[TD="class: alignCenter"]6386[/TD]
[TD="class: alignCenter"]1047[/TD]
[/TR]
[TR]
QC [TD="class: alignCenter"]15[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]15[/TD]
[TD="class: alignCenter"]279[/TD]
[TD="class: alignCenter"]11397[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]422[/TD]
[TD="class: alignCenter"]10971[/TD]
[TD="class: alignCenter"]3433[/TD]
[/TR]
[TR]
NB [TD="class: alignCenter"]15[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]9[/TD]
[TD="class: alignCenter"]45[/TD]
[TD="class: alignCenter"]1188[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]189[/TD]
[TD="class: alignCenter"]999[/TD]
[TD="class: alignCenter"]435[/TD]
[/TR]
[TR]
NS [TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]511[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]123[/TD]
[TD="class: alignCenter"]387[/TD]
[TD="class: alignCenter"]245[/TD]
[/TR]
[TR]
PE [TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]130[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]127[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]107[/TD]
[/TR]
[TR]
NL [TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]616[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]123[/TD]
[TD="class: alignCenter"]493[/TD]
[TD="class: alignCenter"]35[/TD]
[/TR]
[TR]
Canada [TD="class: alignCenter"]105[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]4[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]49[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]51[/TD]
[TD="class: alignCenter"]593[/TD]
[TD="class: alignCenter"]34591[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]91[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]13039[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]21460[/TD]
[TD="class: alignCenter"]6821[/TD]
[/TR]
[TR]
Percentage [SUP]2[/SUP] [TD="class: alignCenter"]15.0%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]3.8%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]46.7%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]48.6%[/TD]
[TD="class: alignCenter"]85.0%[/TD]
[TD="class: alignCenter"]83.5%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.3%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]37.7%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]62.0%[/TD]
[TD="class: alignCenter"]16.5%[/TD]
[/TR]
[/TABLE]
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
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, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups (years) Weekly
(April 12 to April 18, 2015) Cumulative
(August 24 to April 18, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) [TD]Total[/TD]
A Total A(H1) pdm09 A(H3) A (UnS) [TD]Total[/TD]
# % [/TR]
[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]
[TR]
<5 [TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]28[/TD]
[TD="class: alignCenter"]2083[/TD]
[TD="class: alignCenter"]20[/TD]
[TD="class: alignCenter"]808[/TD]
[TD="class: alignCenter"]1255[/TD]
[TD="class: alignCenter"]426[/TD]
[TD="class: alignCenter"]2509[/TD]
[TD="class: alignCenter"]7.0%[/TD]
[/TR]
[TR]
5-19 [TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]51[/TD]
[TD="class: alignCenter"]1779[/TD]
[TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]955[/TD]
[TD="class: alignCenter"]818[/TD]
[TD="class: alignCenter"]679[/TD]
[TD="class: alignCenter"]2458[/TD]
[TD="class: alignCenter"]6.9%[/TD]
[/TR]
[TR]
20-44 [TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]43[/TD]
[TD="class: alignCenter"]3429[/TD]
[TD="class: alignCenter"]16[/TD]
[TD="class: alignCenter"]1662[/TD]
[TD="class: alignCenter"]1751[/TD]
[TD="class: alignCenter"]864[/TD]
[TD="class: alignCenter"]4293[/TD]
[TD="class: alignCenter"]12.0%[/TD]
[/TR]
[TR]
45-64 [TD="class: alignCenter"]8[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]90[/TD]
[TD="class: alignCenter"]3854[/TD]
[TD="class: alignCenter"]18[/TD]
[TD="class: alignCenter"]1652[/TD]
[TD="class: alignCenter"]2184[/TD]
[TD="class: alignCenter"]1467[/TD]
[TD="class: alignCenter"]5321[/TD]
[TD="class: alignCenter"]14.9%[/TD]
[/TR]
[TR]
65+ [TD="class: alignCenter"]25[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]19[/TD]
[TD="class: alignCenter"]197[/TD]
[TD="class: alignCenter"]18677[/TD]
[TD="class: alignCenter"]15[/TD]
[TD="class: alignCenter"]7257[/TD]
[TD="class: alignCenter"]11405[/TD]
[TD="class: alignCenter"]2341[/TD]
[TD="class: alignCenter"]21018[/TD]
[TD="class: alignCenter"]58.8%[/TD]
[/TR]
[TR]
Unknown [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"]0[/TD]
[TD="class: alignCenter"]100[/TD]
[TD="class: alignCenter"]19[/TD]
[TD="class: alignCenter"]7[/TD]
[TD="class: alignCenter"]126[/TD]
[TD="class: alignCenter"]0.4%[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]37[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]9[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]28[/TD]
[TD="class: alignCenter"]409[/TD]
[TD="class: alignCenter"]29941[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]75[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]12434[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]17432[/TD]
[TD="class: alignCenter"]5784[/TD]
[TD="class: alignCenter"]35725[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[TR]
Percentage [SUP]2[/SUP] [TD="class: alignCenter"]8.3%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.0%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]24.3%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]75.7%[/TD]
[TD="class: alignCenter"]91.7%[/TD]
[TD="class: alignCenter"]83.8%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.3%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]41.5%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]58.2%[/TD]
[TD="class: alignCenter"]16.2%[/TD]
[TD="class: alignCenter"] [/TD]
[TD="class: alignCenter"] [/TD]
[/TR]
[/TABLE]
[h=2]Antiviral Resistance[/h] During the 2014-2015 influenza season, the NML has tested 1,260 influenza viruses for resistance to oseltamivir and 1,258 influenza viruses for resistance to zanamivir. All viruses were sensitive to zanamivir and one influenza A(H3N2) virus was resistant to oseltamivir. A total of 1,308 influenza A viruses (99.9%) were resistant to amantadine (Table 3).
[TABLE="class: widthFull, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Virus type and subtype Oseltamivir Zanamivir Amantadine [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
# tested # resistant (%) # tested # resistant (%) # tested # resistant (%) [/TR]
[TR]
[TD="class: fontSize85, colspan: 7"][SUP]*[/SUP] NA - not applicable[/TD]
[/TR]
[TR]
A (H3N2) [TD="class: alignRight"]855[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]853[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]1298[/TD]
[TD="class: alignRight"]1297 (99.9%)[/TD]
[/TR]
[TR]
A (H1N1) [TD="class: alignRight"]9[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]9[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]11[/TD]
[TD="class: alignRight"]11 (100%)[/TD]
[/TR]
[TR]
B [TD="class: alignRight"]396[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]396[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]NA [SUP]*[/SUP][/TD]
[TD="class: alignRight"]NA [SUP]*[/SUP][/TD]
[/TR]
[TR]
TOTAL [TD="class: alignRight"]1260[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]1258[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]1309[/TD]
[TD="class: alignRight"]1308[/TD]
[/TR]
[/TABLE]
[h=2]Influenza Strain Characterizations[/h] During the 2014-2015 influenza season, the National Microbiology Laboratory (NML) has characterized 666 influenza viruses [180 A(H3N2), 10 A(H1N1) and 476 influenza B].
Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assay (n=180), six viruses were antigenically similar to A/Texas/50/2012, five showed reduced titers to A/Texas/50/2012 and 174 were antigenically similar to A/Switzerland/9715293/2013, which is the influenza A(H3N2) component recommended for the 2015 Southern Hemisphere influenza vaccine. Additionally, 1,071 A(H3N2) viruses were unable to be tested by HI assay; however, sequence analysis showed that 1,069 belonged to a genetic group that typically shows reduced titers to A/Texas/50/2012. Influenza A(H1N1): Ten A(H1N1) viruses characterized were antigenically similar to A/California/7/2009. Influenza B: Of the 476 influenza B viruses characterized, 452 viruses were antigenically similar to B/Massachusetts/2/2012, three viruses showed reduced titers against B/Massachusetts/2/2012, and 19 were B/Brisbane/60/2008-like (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2014-2015, N = 666​
2015-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 byWHO.
The recommended components for the 2014-2015 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A/Texas/50/2012 (H3N2)-like virus, and a B/Massachusetts/2/2012-like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus is recommended.
The WHO has released the recommended composition of the influenza vaccine for the northern hemisphere for the 2015-2016 season. Trivalent vaccines are recommended to contain 1) an A/California/7/2009 (H1N1)pdm09-like virus 2) an A/Switzerland/9715293/2013 (H3N2)-like virus, and 3) an B/Phuket/3073/2013-like virus(Yamagata lineage). Quadrivalent vaccines are recommended to additionally contain a B/Brisbane/60/2008-like virus (Victoria lineage).


Text equivalent for figure 4Influenza strain characterizations, Canada, 2014-2015, N =3
[h=2]Influenza-like Illness (ILI) Consultation Rate[/h] The national influenza-like-illness (ILI) consultation rate decreased in week 15 to 31.94 consultations per 1,000, which is above expected levels (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, 2014-2015​
2015-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. 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, 2014-2015
[h=2]Influenza Outbreak Surveillance[/h] In week 15, 21 new outbreaks of influenza were reported. Similar to previous weeks, the majority of the outbreaks occurred in the Central and Atlantic provinces. Nineteen outbreaks were reported in long-term care facilities (LTCF), and two in institutional or community settings (Figure 6). Among the outbreaks in which the influenza type was known (n=3), all outbreaks were associated with influenza B. To date this season, 1,231 outbreaks in LTCFs have been reported and the majority of those with known subtypes were attributable to A(H3N2). There have been a higher number of reported influenza outbreaks to date this season compared to the same period in previous seasons.
Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2014-2015
2015-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, 2014-2015
[h=2]Pharmacy Surveillance[/h] Pharmacy surveillance for sales of influenza antivirals has ended for the 2014-2015 influenza season (Figure 7).
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2014-15​
2015-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 2,500 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, 2014-15
[h=2]Sentinel Hospital Influenza Surveillance[/h] Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In week 15, 19 laboratory-confirmed influenza-associated paediatric (=16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network. Seventeen cases were influenza B (Figure 8a). A greater proportion of cases have been reported with influenza B in recent weeks, following the trend in laboratory detections. Among the reported cases, three (16%) were <2 years of age, eleven (58%) were 2 to 9 years of age and five (26%) were 10-16 years of age. One ICU admission was reported.
To date this season, 665 hospitalizations have been reported by the IMPACT network, 502 (80%) of which were cases of influenza A. Among cases for which the influenza A subtype was reported, 99% (162/164) were A(H3N2) (Table 4). To date, 82 cases were admitted to the ICU, of which 45 (55%) were 2 to 9 years of age (Figure 9a). A total of 54 ICU cases reported to have at least one underlying condition or comorbidity. Four 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, 16 laboratory-confirmed influenza-associated adult (=16 years of age) hospitalizations were reported by the PHAC/CIHR Influenza Research Network (CIRN) Serious Outcomes Surveillance (SOS) network. Among the cases in week 15, 12 cases (75%) were in adults over the age of 65 (Figure 8b). One death was reported in week 15 in an adult over the age of 65 years.
To date this season, 2,179 cases have been reported; 1,908 (88%) with influenza A. The majority of cases (81%) were among adults =65 years of age (Table 5). One hundred and sixty two ICU admissions have been reported and 117 cases were adults =65 years of age. Among the 162 ICU admissions, 19 were due to influenza B (ten in adults 45 to 64 years of age and nine in adults over the age of 65). A total of 113 ICU cases (70%) reported to have at least one underlying condition or comorbidity. Of the 118 ICU cases with known immunization status, 38 (32%) reported not having been vaccinated this season. One hundred and thirty deaths have been reported, 120 (92%) of the deaths were adults >65 years of age (Figure 9B).
Note: 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 marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (Aug. 24, 2014 to April 18, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) Total # (%) [/TR]
[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]
[TR]
0-5m [TD="class: alignRight"]81[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]18[/TD]
[TD="class: alignRight"]63[/TD]
[TD="class: alignRight"]8[/TD]
[TD="class: alignRight"]91 (13.7%)[/TD]
[/TR]
[TR]
6-23m [TD="class: alignRight"]109[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]35[/TD]
[TD="class: alignRight"]73[/TD]
[TD="class: alignRight"]29[/TD]
[TD="class: alignRight"]142 (21.4%)[/TD]
[/TR]
[TR]
2-4y [TD="class: alignRight"]123[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]40[/TD]
[TD="class: alignRight"]82[/TD]
[TD="class: alignRight"]32[/TD]
[TD="class: alignRight"]165 (24.8%)[/TD]
[/TR]
[TR]
5-9y [TD="class: alignRight"]129[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]44[/TD]
[TD="class: alignRight"]85[/TD]
[TD="class: alignRight"]33[/TD]
[TD="class: alignRight"]175 (26.3%)[/TD]
[/TR]
[TR]
10-16y [TD="class: alignRight"]60[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]25[/TD]
[TD="class: alignRight"]35[/TD]
[TD="class: alignRight"]25[/TD]
[TD="class: alignRight"]92 (13.8%)[/TD]
[/TR]
[TR]
Total [TD="class: alignRight"]502[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]2[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]162[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]338[/TD]
[TD="class: alignRight"]127[/TD]
[TD="class: alignRight"]665[/TD]
[/TR]
[TR]
% [SUP]1[/SUP] [TD="class: alignRight"]79.8%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]0.4%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]32.3%[/TD]
[TD="class: bg-colour-blue alignRight, bgcolor: #D7D7FF"]67.3%[/TD]
[TD="class: alignRight"]20.2%[/TD]
[TD="class: alignRight"]100.0%[/TD]
[/TR]
[/TABLE]
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 5 - Cumulative numbers of adult hospitalizations with influenza reported by the PCIRN-SOS network, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (November 15, 2014 to April 18, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A(UnS) Total # (%) [/TR]
[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]
[TR]
16-20 [TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]4 (%)[/TD]
[/TR]
[TR]
20-44 [TD="class: alignCenter"]105[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]55[/TD]
[TD="class: alignCenter"]49[/TD]
[TD="class: alignCenter"]15[/TD]
[TD="class: alignCenter"]120 (6%)[/TD]
[/TR]
[TR]
45-64 [TD="class: alignCenter"]215[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]97[/TD]
[TD="class: alignCenter"]116[/TD]
[TD="class: alignCenter"]65[/TD]
[TD="class: alignCenter"]280 (13%)[/TD]
[/TR]
[TR]
65+ [TD="class: alignCenter"]1585[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]755[/TD]
[TD="class: alignCenter"]826[/TD]
[TD="class: alignCenter"]190[/TD]
[TD="class: alignCenter"]1775 (81%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]1908[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]7[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]908[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]993[/TD]
[TD="class: alignCenter"]271[/TD]
[TD="class: alignCenter"]2179[/TD]
[/TR]
[TR]
% [SUP]1[/SUP] [TD="class: alignCenter"]88%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]48%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]52%[/TD]
[TD="class: alignCenter"]12%[/TD]
[TD="class: alignCenter"]100%[/TD]
[/TR]
[/TABLE]
Figure 8 - Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2015-w15-fg8a-eng.gif

Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2015-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, 2014-15: Adult hospitalizations (>16 year of age, PCIRN-SOS)
Figure 9 - Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2015-w15-fg9a-eng.gif
Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2015-w15-fg9b-eng.gif

Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15: Adult hospitalizations (≥16 year of age, PCIRN-SOS)
[h=2]Provincial/Territorial Influenza Hospitalizations and Deaths[/h] In week 15, 191 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories*, which more than the number reported the previous week. Of the 191 hospitalizations, 156 (82%) were due to influenza A and 125 (64%) were in patients =65 years of age.
Since the start of the 2014-15 season, 7,086 hospitalizations have been reported; 6,345 (90%) with influenza A. Among cases for which the subtype of influenza A was reported, 99.4% were A(H3N2). The majority of cases (71%) were =65 years of age (Table 6). A total of 368 ICU admissions have been reported to date: 52% (n=193) were in adults =65 years of age and 34% (n=124) were in adults 20-64 years. A total of 527 deaths have been reported since the start of the season: three children <5 years of age, four children 5-19 years, 42 adults 20-64 years, and 478 adults =65 years of age. Adults 65 years of age or older represent 91% of all deaths reported this season. 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. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting.
[TABLE="class: widthFull, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (24 August 2014 to 18 April 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) [TD="class: alignCenter"]Total[/TD]
[TD="class: alignCenter"]# (%)[/TD]
[/TR]
[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]
[TR]
0-4 years [TD="class: alignCenter"]416[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]150[/TD]
[TD="class: alignCenter"]264[/TD]
[TD="class: alignCenter"]60[/TD]
[TD="class: alignCenter"]476 (7%)[/TD]
[/TR]
[TR]
5-19 years [TD="class: alignCenter"]275[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]132[/TD]
[TD="class: alignCenter"]141[/TD]
[TD="class: alignCenter"]81[/TD]
[TD="class: alignCenter"]356 (5%)[/TD]
[/TR]
[TR]
20-44 years [TD="class: alignCenter"]380[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]228[/TD]
[TD="class: alignCenter"]148[/TD]
[TD="class: alignCenter"]92[/TD]
[TD="class: alignCenter"]472 (7%)[/TD]
[/TR]
[TR]
45-64 years [TD="class: alignCenter"]597[/TD]
[TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]255[/TD]
[TD="class: alignCenter"]336[/TD]
[TD="class: alignCenter"]99[/TD]
[TD="class: alignCenter"]696 (10%)[/TD]
[/TR]
[TR]
65+ years [TD="class: alignCenter"]4621[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]2190[/TD]
[TD="class: alignCenter"]2429[/TD]
[TD="class: alignCenter"]391[/TD]
[TD="class: alignCenter"]5012 (71%)[/TD]
[/TR]
[TR]
Unknown [TD="class: alignCenter"]56[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]52[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]18[/TD]
[TD="class: alignCenter"]74 (1%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]6345[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]17[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]3007[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]3321[/TD]
[TD="class: alignCenter"]741[/TD]
[TD="class: alignCenter"]7086[/TD]
[/TR]
[TR]
Percentage [SUP]1[/SUP] [TD="class: alignCenter"]89.5%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.3%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]47.4%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]52.3%[/TD]
[TD="class: alignCenter"]10.5%[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[/TABLE]
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2014-15 on the Public Health Agency of Canada website.
[h=2]Emerging Respiratory Pathogens[/h] Human Avian Influenza
Influenza A(H7N9): Since the last FluWatch report, no new laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus were reported by the World Health Organization. Globally to April 23, 2015, the WHO reported a total of 651 laboratory-confirmed human cases with avian influenza A(H7N9) virus, including 225 deaths. Documents related to the public health risk of influenza A(H7N9), as well as guidance for health professionals and advice for the public is updated regularly on the following websites:
PHAC - Avian influenza A(H7N9)
WHO - Avian Influenza A(H7N9)
Influenza A(H5N6): Since the last FluWatch report, no new cases of human infection with avian influenza A (H5N6) virus from China has been reported by the World Health Organization. Globally to April 23, 2015, the WHO has been informed of a total of three cases of avian influenza A (H5N6) virus, including two deaths.
Middle East Respiratory Syndrome Coronavirus (MERS-CoV)
Since the last FluWatch report, no new laboratory-confirmed cases of MERS-CoV have been reported by the World Health Organization. Globally, from September 2012 to April 23, 2015, the WHO has reported a total of 1,106 laboratory-confirmed cases of infection with MERS-CoV, including 421 deaths. All cases have either occurred in the Middle East or have had direct links to a primary case infected in the Middle East. The public health risk posed by MERS-CoV in Canada remains low (see the PHAC Assessment of Public Health Risk) and for the latest global risk assessment posted by the WHO on February 5, 2015: WHO MERS-CoV
Documents related to the public health risk of MERS-CoV, as well as guidance for health professionals and advice for the public is updated regularly on the following websites:
PHAC - Middle East respiratory syndrome coronavirus (MERS-CoV)
WHO - Coronavirus infections
Avian Influenza A(H5)
The Canadian Food Inspection Agency (CFIA) is continuing its investigation into the second outbreak of highly pathogenic avian influenza H5N2 virus in Oxford County, Ontario. To date, there has been two infected commercial premise. All premises located within the 10 km Avian Influenza Control Zone have been placed under quarantine. No human cases have been reported. Avian influenza viruses do not pose risks to food safety when poultry and poultry products are properly handled and cooked. Avian influenza rarely affects humans that do not have consistent contact with infected birds. Further information on the outbreak is provided on the following CFIA website:
CFIA - Notifiable Avian Influenza
[h=2].../[/h] http://www.phac-aspc.gc.ca/fluwatch/14-15/w15_15/index-eng.php
 
[h=1]FluWatch report: April 26 to May 2, 2015 (Week 17)[/h] Posted 2015-05-08 For readers interested in the PDF version, the document is available for downloading or viewing:
FluWatch report: April 26 to May 2, 2015 (Week 17) (PDF Version - 913 KB - 10 pages)

? ? Help with PDF documents

Overall Summary
  • Influenza B continues to be the most common influenza virus circulating in Canada; however, influenza B is past its peak and remains within expected levels for this time of year.
  • Overall, influenza activity in Canada continues to decline; however, elevated activity was still reported in week 17 (mostly in Central Canada and parts of the Atlantic Provinces).
  • Influenza B is having a greater impact on adults less than 65 years of age, compared to influenza A(H3N2), which predominated earlier in the season.
  • Fewer influenza hospitalizations were reported this week compared to the previous week. The majority of hospitalizations were due to influenza A and in adults ≥65 years of age.

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
[h=2]Influenza/ILI Activity (geographic spread)[/h] In week 17, one region in QC and one region in NL reported widespread activity. Twelve regions reported localized activity: SK, MB, ON(7), QC, NL and NB. Twenty-five regions reported sporadic activity: NT, BC(4), AB(5), SK(2), MB(3), QC(4), NL, NB(4), and NS. Nineteen regions reported no activity: YK, NT, NU(3), BC, MB, NL, NB(2), NS(8), and PE.
Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 17​
​
Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
[h=2]Influenza and Other Respiratory Virus Detections[/h] In week 17, the percentage positive for influenza A (0.9%) and B (9.2%) declined from the previous week (Figure 2). Influenza B remained the predominant virus in week 17, representing 90% of influenza detections. Most jurisdictions reported stable or declining levels of influenza detections over recent weeks. To date, 82% of influenza detections have been influenza A, and 99.6% of those subtyped have been A(H3N2) (Table 1). To date this season, detailed information on age and type/subtype has been received for 36,155 cases (Table 2). Adults ≥65 years of age have predominantly been affected by influenza A, accounting for 62% of influenza A detections. Influenza B, while much smaller in numbers, is mainly affecting individuals less than 65 years of age, they account for 59% of influenza B detections.
Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2014-15​
2015-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, 2014-15
In week 17, detections for all other respiratory viruses decreased from the previous week (Figure 3). In recent weeks, detections of human metapneumovirus and parainfluenza have been higher than those reported in each of the past three seasons.
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, 2014-15​
2015-w17-fg3-eng.gif
​
RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2014-2015
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 1: Weekly and cumulative numbers of positive influenza specimens by type, subtype and province, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Reporting provinces [SUP]1[/SUP] Weekly
(April 26 to May 2, 2015) Cumulative
(August 24 to May 2, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1)pdm09 A(H3) A(UnS) [TD]B Total[/TD]
A Total A(H1)pdm09 A(H3) A(UnS) [TD]B Total[/TD]
[/TR]
[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]
[TR]
BC [TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]30[/TD]
[TD="class: alignCenter"]3519[/TD]
[TD="class: alignCenter"]28[/TD]
[TD="class: alignCenter"]2626[/TD]
[TD="class: alignCenter"]865[/TD]
[TD="class: alignCenter"]415[/TD]
[/TR]
[TR]
AB [TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]37[/TD]
[TD="class: alignCenter"]3699[/TD]
[TD="class: alignCenter"]14[/TD]
[TD="class: alignCenter"]3531[/TD]
[TD="class: alignCenter"]154[/TD]
[TD="class: alignCenter"]881[/TD]
[/TR]
[TR]
SK [TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]16[/TD]
[TD="class: alignCenter"]1314[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]839[/TD]
[TD="class: alignCenter"]475[/TD]
[TD="class: alignCenter"]272[/TD]
[/TR]
[TR]
MB [TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]20[/TD]
[TD="class: alignCenter"]1122[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]390[/TD]
[TD="class: alignCenter"]732[/TD]
[TD="class: alignCenter"]185[/TD]
[/TR]
[TR]
ON [TD="class: alignCenter"]9[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]8[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]80[/TD]
[TD="class: alignCenter"]11149[/TD]
[TD="class: alignCenter"]48[/TD]
[TD="class: alignCenter"]4709[/TD]
[TD="class: alignCenter"]6392[/TD]
[TD="class: alignCenter"]1297[/TD]
[/TR]
[TR]
QC [TD="class: alignCenter"]21[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]21[/TD]
[TD="class: alignCenter"]129[/TD]
[TD="class: alignCenter"]11408[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]422[/TD]
[TD="class: alignCenter"]11003[/TD]
[TD="class: alignCenter"]3737[/TD]
[/TR]
[TR]
NB [TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]21[/TD]
[TD="class: alignCenter"]1195[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]193[/TD]
[TD="class: alignCenter"]1002[/TD]
[TD="class: alignCenter"]505[/TD]
[/TR]
[TR]
NS [TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]511[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]123[/TD]
[TD="class: alignCenter"]387[/TD]
[TD="class: alignCenter"]258[/TD]
[/TR]
[TR]
PE [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"]131[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]128[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]108[/TD]
[/TR]
[TR]
NL [TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]7[/TD]
[TD="class: alignCenter"]622[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]123[/TD]
[TD="class: alignCenter"]499[/TD]
[TD="class: alignCenter"]48[/TD]
[/TR]
[TR]
Canada [TD="class: alignCenter"]37[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]9[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]28[/TD]
[TD="class: alignCenter"]344[/TD]
[TD="class: alignCenter"]34691[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]96[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]13084[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]21511[/TD]
[TD="class: alignCenter"]7706[/TD]
[/TR]
[TR]
Percentage [SUP]2[/SUP] [TD="class: alignCenter"]9.7%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.0%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]24.3%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]75.7%[/TD]
[TD="class: alignCenter"]90.3%[/TD]
[TD="class: alignCenter"]81.8%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.3%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]37.7%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]62.0%[/TD]
[TD="class: alignCenter"]18.2%[/TD]
[/TR]
[/TABLE]
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
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, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups (years) Weekly
April 26 to May 2, 2015 Cumulative
(August 24 to May 2, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) [TD]Total[/TD]
A Total A(H1) pdm09 A(H3) A (UnS) [TD]Total[/TD]
# % [/TR]
[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]
[TR]
<5 [TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]13[/TD]
[TD="class: alignCenter"]2091[/TD]
[TD="class: alignCenter"]22[/TD]
[TD="class: alignCenter"]809[/TD]
[TD="class: alignCenter"]1260[/TD]
[TD="class: alignCenter"]489[/TD]
[TD="class: alignCenter"]2580[/TD]
[TD="class: alignCenter"]7.1%[/TD]
[/TR]
[TR]
5-19 [TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]21[/TD]
[TD="class: alignCenter"]1783[/TD]
[TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]957[/TD]
[TD="class: alignCenter"]820[/TD]
[TD="class: alignCenter"]709[/TD]
[TD="class: alignCenter"]2492[/TD]
[TD="class: alignCenter"]6.8%[/TD]
[/TR]
[TR]
20-44 [TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]33[/TD]
[TD="class: alignCenter"]3436[/TD]
[TD="class: alignCenter"]16[/TD]
[TD="class: alignCenter"]1669[/TD]
[TD="class: alignCenter"]1751[/TD]
[TD="class: alignCenter"]970[/TD]
[TD="class: alignCenter"]44406[/TD]
[TD="class: alignCenter"]12.1%[/TD]
[/TR]
[TR]
45-64 [TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]41[/TD]
[TD="class: alignCenter"]3863[/TD]
[TD="class: alignCenter"]21[/TD]
[TD="class: alignCenter"]1658[/TD]
[TD="class: alignCenter"]2184[/TD]
[TD="class: alignCenter"]1626[/TD]
[TD="class: alignCenter"]5489[/TD]
[TD="class: alignCenter"]15.1%[/TD]
[/TR]
[TR]
65+ [TD="class: alignCenter"]13[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]11[/TD]
[TD="class: alignCenter"]95[/TD]
[TD="class: alignCenter"]18721[/TD]
[TD="class: alignCenter"]15[/TD]
[TD="class: alignCenter"]7280[/TD]
[TD="class: alignCenter"]11426[/TD]
[TD="class: alignCenter"]2646[/TD]
[TD="class: alignCenter"]21367[/TD]
[TD="class: alignCenter"]58.6%[/TD]
[/TR]
[TR]
Unknown [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"]120[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]101[/TD]
[TD="class: alignCenter"]19[/TD]
[TD="class: alignCenter"]7[/TD]
[TD="class: alignCenter"]127[/TD]
[TD="class: alignCenter"]0.3%[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]23[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]3[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]20[/TD]
[TD="class: alignCenter"]203[/TD]
[TD="class: alignCenter"]30014[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]80[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]12474[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]17460[/TD]
[TD="class: alignCenter"]6447[/TD]
[TD="class: alignCenter"]36461[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[TR]
Percentage [SUP]2[/SUP] [TD="class: alignCenter"]10.2%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.0%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]13.0%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]87.0%[/TD]
[TD="class: alignCenter"]89.8%[/TD]
[TD="class: alignCenter"]82.3%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.3%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]41.6%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]58.2%[/TD]
[TD="class: alignCenter"]17.7%[/TD]
[TD="class: alignCenter"] [/TD]
[TD="class: alignCenter"] [/TD]
[/TR]
[/TABLE]
[h=2]Antiviral Resistance[/h] During the 2014-2015 influenza season, the NML has tested 1,382 influenza viruses for resistance to oseltamivir and 1,379 influenza viruses for resistance to zanamivir. All viruses were sensitive to zanamivir and one influenza A(H3N2) virus was resistant to oseltamivir. A total of 1,351 influenza A viruses (99.9%) were resistant to amantadine (Table 3).
[TABLE="class: widthFull, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Virus type and subtype Oseltamivir Zanamivir Amantadine [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
# tested # resistant (%) # tested # resistant (%) # tested # resistant (%) [/TR]
[TR]
[TD="class: fontSize85, colspan: 7"][SUP]*[/SUP] NA - not applicable[/TD]
[/TR]
[TR]
A (H3N2) [TD="class: alignRight"]876[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]874[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]1338[/TD]
[TD="class: alignRight"]1337 (99.9%)[/TD]
[/TR]
[TR]
A (H1N1) [TD="class: alignRight"]10[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]10[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]14[/TD]
[TD="class: alignRight"]14 (100%)[/TD]
[/TR]
[TR]
B [TD="class: alignRight"]496[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]495[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]NA [SUP]*[/SUP][/TD]
[TD="class: alignRight"]NA [SUP]*[/SUP][/TD]
[/TR]
[TR]
TOTAL [TD="class: alignRight"]1382[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]1379[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]1352[/TD]
[TD="class: alignRight"]1351[/TD]
[/TR]
[/TABLE]
[h=2]Influenza Strain Characterizations[/h] During the 2014-2015 influenza season, the National Microbiology Laboratory (NML) has characterized 750 influenza viruses [185 A(H3N2), 15 A(H1N1) and 550 influenza B].
Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assay (n=185), one virus was antigenically similar to A/Texas/50/2012, five showed reduced titers to A/Texas/50/2012 and 179 were antigenically similar to A/Switzerland/9715293/2013, which is the influenza A(H3N2) component recommended for the 2015 Southern Hemisphere influenza vaccine. Additionally, 1,105 A(H3N2) viruses were unable to be tested by HI assay; however, sequence analysis showed that 1,103 belonged to a genetic group that typically shows reduced titers to A/Texas/50/2012. Influenza A(H1N1): Fifteen A(H1N1) viruses characterized were antigenically similar to A/California/7/2009. Influenza B: Of the 550 influenza B viruses characterized, 523 viruses were antigenically similar to B/Massachusetts/2/2012, three viruses showed reduced titers against B/Massachusetts/2/2012, and 24 were B/Brisbane/60/2008-like (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2014-2015, N = 750​
2015-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 byWHO.
The recommended components for the 2014-2015 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A/Texas/50/2012 (H3N2)-like virus, and a B/Massachusetts/2/2012-like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus is recommended.


Text equivalent for figure 4Influenza strain characterizations, Canada, 2014-2015, N =3
[h=2]Influenza-like Illness (ILI) Consultation Rate[/h] In week 17, the national influenza-like-illness (ILI) consultation rate declined from the previous week to 18.7 consultations per 1,000 (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, 2014-2015​
2015-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. 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, 2014-2015
[h=2]Influenza Outbreak Surveillance[/h] In week 17, eight new outbreaks of influenza were reported. All outbreaks were reported in long-term care facilities (LTCF) (Figure 6). and three of the eight outbreaks were associated with influenza B. To date this season, 1,254 outbreaks in LTCFs have been reported and the majority of those with known subtypes were attributable to A(H3N2). There have been a higher number of reported influenza outbreaks to date this season compared to the same period in previous seasons.
Figure 6. Overall number of new influenza outbreaks by report week, Canada, 2014-2015
2015-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, 2014-2015
[h=2]Pharmacy Surveillance[/h] Pharmacy surveillance for sales of influenza antivirals has ended for the 2014-2015 influenza season (Figure 7).
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2014-15​
2015-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 2,500 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, 2014-15
[h=2]Sentinel Hospital Influenza Surveillance[/h] Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In week 17, nine laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network. All cases were influenza B (Figure 8a). A greater proportion of cases have been reported with influenza B in recent weeks, following the trend in laboratory detections. Among the reported cases, four (44%) were <2 years of age and five (56%) were 2 to 9 years of age. No ICU cases were reported.
To date this season, 676 hospitalizations have been reported by the IMPACT network, 509 (75%) of which were cases of influenza A. Among cases for which the influenza A subtype was reported, 98% (161/164) were A(H3N2) (Table 4). To date, 83 cases were admitted to the ICU, of which 46 (55%) were 2 to 9 years of age (Figure 9a). A total of 54 ICU cases reported to have at least one underlying condition or comorbidity. Four 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, five laboratory-confirmed influenza-associated adult (≥16 years of age) hospitalizations were reported by the Canadian Immunization Research Network (CIRN) Serious Outcomes Surveillance (SOS) network. All reported cases were influenza B. Three cases (60%) were in adults over the age of 65 (Figure 8b).
To date this season, 2,228 cases have been reported; 1,912 (86%) with influenza A. The majority of cases (81%) were among adults ≥65 years of age (Table 5). One hundred and seventy two ICU admissions have been reported and 128 cases were adults ≥65 years of age. Among the 172 ICU admissions, 27 were due to influenza B (12 in adults 45 to 64 years of age and 15 in adults over the age of 65). A total of 123 ICU cases (72%) reported to have at least one underlying condition or comorbidity. Of the 123 ICU cases with known immunization status, 40 (33%) reported not having been vaccinated this season. One hundred and thirty-five deaths have been reported, 124 (92%) of the deaths were adults >65 years of age (Figure 9B).
Note: 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 marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (Aug. 24, 2014 to May 2, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) Total # (%) [/TR]
[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]
[TR]
0-5m [TD="class: alignCenter"]81[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]18[/TD]
[TD="class: alignCenter"]63[/TD]
[TD="class: alignCenter"]12[/TD]
[TD="class: alignCenter"]93 (13.8%)[/TD]
[/TR]
[TR]
6-23m [TD="class: alignCenter"]114[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]36[/TD]
[TD="class: alignCenter"]76[/TD]
[TD="class: alignCenter"]34[/TD]
[TD="class: alignCenter"]148 (21.9%)[/TD]
[/TR]
[TR]
2-4y [TD="class: alignCenter"]124[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]38[/TD]
[TD="class: alignCenter"]85[/TD]
[TD="class: alignCenter"]45[/TD]
[TD="class: alignCenter"]169 (25.0%)[/TD]
[/TR]
[TR]
5-9y [TD="class: alignCenter"]129[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]44[/TD]
[TD="class: alignCenter"]85[/TD]
[TD="class: alignCenter"]49[/TD]
[TD="class: alignCenter"]178 (26.3%)[/TD]
[/TR]
[TR]
10-16y [TD="class: alignCenter"]61[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]25[/TD]
[TD="class: alignCenter"]36[/TD]
[TD="class: alignCenter"]27[/TD]
[TD="class: alignCenter"]88 (13.0%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]509[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]3[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]161[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]345[/TD]
[TD="class: alignCenter"]167[/TD]
[TD="class: alignCenter"]676[/TD]
[/TR]
[TR]
% [SUP]1[/SUP] [TD="class: alignCenter"]75.3%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.6%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]31.6%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]67.8%[/TD]
[TD="class: alignCenter"]24.7%[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[/TABLE]
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 5 - Cumulative numbers of adult hospitalizations with influenza reported by the PCIRN-SOS network, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (November 15, 2014 to May 2, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A(UnS) Total # (%) [/TR]
[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]
[TR]
16-20 [TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]4 (%)[/TD]
[/TR]
[TR]
20-44 [TD="class: alignCenter"]106[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]56[/TD]
[TD="class: alignCenter"]49[/TD]
[TD="class: alignCenter"]16[/TD]
[TD="class: alignCenter"]122 (5%)[/TD]
[/TR]
[TR]
45-64 [TD="class: alignCenter"]217[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]99[/TD]
[TD="class: alignCenter"]115[/TD]
[TD="class: alignCenter"]76[/TD]
[TD="class: alignCenter"]293 (13%)[/TD]
[/TR]
[TR]
65+ [TD="class: alignCenter"]1586[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]760[/TD]
[TD="class: alignCenter"]822[/TD]
[TD="class: alignCenter"]223[/TD]
[TD="class: alignCenter"]1809 (81%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]1912[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]8[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]916[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]988[/TD]
[TD="class: alignCenter"]316[/TD]
[TD="class: alignCenter"]2228[/TD]
[/TR]
[TR]
% [SUP]1[/SUP] [TD="class: alignCenter"]86%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]48%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]52%[/TD]
[TD="class: alignCenter"]14%[/TD]
[TD="class: alignCenter"]100%[/TD]
[/TR]
[/TABLE]
Figure 8 - Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2015-w17-fg8a-eng.gif

Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2015-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, 2014-15: Adult hospitalizations (>16 year of age, PCIRN-SOS)
Figure 9 - Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2015-w17-fg9a-eng.gif
Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2015-w17-fg9b-eng.gif

Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15: Adult hospitalizations (≥16 year of age, PCIRN-SOS)
[h=2]Provincial/Territorial Influenza Hospitalizations and Deaths[/h] In week 17, 88 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories*, which is lower than the number reported the previous week. Of the 88 hospitalizations, 53 (60%) were due to influenza A and 45 (51%) were in patients ≥65 years of age.
Since the start of the 2014-15 season, 7,375 hospitalizations have been reported; 6,471 (88%) with influenza A. Among cases for which the subtype of influenza A was reported, 99.3% were A(H3N2). The majority of cases (71%) were ≥65 years of age (Table 6). A total of 384 ICU admissions have been reported to date: 53% (n=202) were in adults ≥65 years of age and 33% (n=128) were in adults 20-64 years. A total of 555 deaths have been reported since the start of the season: three children <5 years of age, four children 5-19 years, 42 adults 20-64 years, and 506 adults ≥65 years of age. Adults 65 years of age or older represent 91% of all deaths reported this season. 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. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting.
[TABLE="class: widthFull, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (24 August 2014 to 2 May 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) [TD="class: alignCenter"]Total[/TD]
[TD="class: alignCenter"]# (%)[/TD]
[/TR]
[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]
[TR]
0-4 years [TD="class: alignCenter"]422[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]150[/TD]
[TD="class: alignCenter"]269[/TD]
[TD="class: alignCenter"]73[/TD]
[TD="class: alignCenter"]495 (7%)[/TD]
[/TR]
[TR]
5-19 years [TD="class: alignCenter"]277[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]133[/TD]
[TD="class: alignCenter"]142[/TD]
[TD="class: alignCenter"]95[/TD]
[TD="class: alignCenter"]372 (5%)[/TD]
[/TR]
[TR]
20-44 years [TD="class: alignCenter"]385[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]232[/TD]
[TD="class: alignCenter"]149[/TD]
[TD="class: alignCenter"]104[/TD]
[TD="class: alignCenter"]489 (7%)[/TD]
[/TR]
[TR]
45-64 years [TD="class: alignCenter"]614[/TD]
[TD="class: alignCenter"]9[/TD]
[TD="class: alignCenter"]261[/TD]
[TD="class: alignCenter"]344[/TD]
[TD="class: alignCenter"]124[/TD]
[TD="class: alignCenter"]738 (10%)[/TD]
[/TR]
[TR]
65+ years [TD="class: alignCenter"]4717[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]2245[/TD]
[TD="class: alignCenter"]2469[/TD]
[TD="class: alignCenter"]488[/TD]
[TD="class: alignCenter"]5205 (71%)[/TD]
[/TR]
[TR]
Unknown [TD="class: alignCenter"]56[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]52[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]20[/TD]
[TD="class: alignCenter"]76 (1%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]6471[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]22[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]3073[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]3376[/TD]
[TD="class: alignCenter"]904[/TD]
[TD="class: alignCenter"]7375[/TD]
[/TR]
[TR]
Percentage [SUP]1[/SUP] [TD="class: alignCenter"]87.7%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.3%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]47.5%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]52.2%[/TD]
[TD="class: alignCenter"]12.3%[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[/TABLE]
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2014-15 on the Public Health Agency of Canada website.
[h=2]Emerging Respiratory Pathogens[/h] Human Avian Influenza
Influenza A(H7N9): Since the last FluWatch report, no new laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus were reported by the World Health Organization. Globally to May 5, 2015, the WHO reported a total of 651 laboratory-confirmed human cases with avian influenza A(H7N9) virus, including 225 deaths. Documents related to the public health risk of influenza A(H7N9), as well as guidance for health professionals and advice for the public is updated regularly on the following websites:
PHAC - Avian influenza A(H7N9)
WHO - Avian Influenza A(H7N9)
Middle East Respiratory Syndrome Coronavirus (MERS-CoV)
Since the last FluWatch report, no new laboratory-confirmed cases of MERS-CoV have been reported by the World Health Organization. Globally, from September 2012 to May 5, 2015, the WHO has reported a total of 1,110 laboratory-confirmed cases of infection with MERS-CoV, including 422 deaths. All cases have either occurred in the Middle East or have had direct links to a primary case infected in the Middle East. The public health risk posed by MERS-CoV in Canada remains low (see the PHAC Assessment of Public Health Risk) and for the latest global risk assessment posted by the WHO on February 5, 2015: WHO MERS-CoV
Documents related to the public health risk of MERS-CoV, as well as guidance for health professionals and advice for the public is updated regularly on the following websites:
PHAC - Middle East respiratory syndrome coronavirus (MERS-CoV)
WHO - Coronavirus infections
Avian Influenza A(H5)
The Canadian Food Inspection Agency (CFIA) is continuing its investigation into the second outbreak of highly pathogenic avian influenza H5N2 virus in Oxford County, Ontario. To date, there has been three infected commercial premises. Individual quarantines and Avian Influenza Control Zones have been established. No human cases have been reported. Avian influenza viruses do not pose risks to food safety when poultry and poultry products are properly handled and cooked. Avian influenza rarely affects humans that do not have consistent contact with infected birds. Further information on the outbreak is provided on the following CFIA website:
CFIA - Notifiable Avian Influenza

.../
http://www.phac-aspc.gc.ca/fluwatch/14-15/w17_15/index-eng.php
 
[h=1]FluWatch report: May 3 to May 9, 2015 (Week 18)[/h] Posted 2015-05-15 For readers interested in the PDF version, the document is available for downloading or viewing:
FluWatch report: May 3 to May 9, 2015 (Week 18) (PDF Version - 915 KB - 10 pages)

? ? Help with PDF documents

Overall Summary
  • Influenza B continues to be the most common influenza virus circulating in Canada; however, influenza B is past its peak and remains within expected levels for this time of year.
  • Overall, influenza activity in Canada continues to decrease; however, elevated activity was still reported in week 18 (mostly in Central Canada and parts of British Columbia).
  • Influenza B is having a greater impact on adults less than 65 years of age compared to influenza A(H3N2), which predominated earlier in the season.
  • As of week 18, 7,448 hospitalizations and 562 deaths have been reported from participating regions, which is more than were reported last year at this time (4,731 hospitalizations and 275 deaths).

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
[h=2]Influenza/ILI Activity (geographic spread)[/h] In week 18, one region in BC and one region in NL reported widespread activity. Ten regions reported localized activity: BC(2), ON(6), and QC(2). Twenty-six regions reported sporadic activity: NT, BC, AB(5), SK(3), MB(4), ON, QC(4), NL, NB(5), and NS. Twenty regions reported no activity: YK, NT, NU(3), BC, MB, NL(2), NB(2), NS(8), and PE.
Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 18​
​
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
[h=2]Influenza and Other Respiratory Virus Detections[/h] The number of positive influenza tests decreased from 381 in week 17 to 299 in week 18. Influenza B remained the predominant virus in week 18, representing 89% of influenza detections. Most jurisdictions reported stable or declining levels of influenza detections over recent weeks. To date, 81% of influenza detections have been influenza A, and 99.3% of those subtyped have been A(H3N2) (Table 1). To date this season, detailed information on age and type/subtype has been received for 36,794 cases (Table 2). Adults ≥65 years of age have predominantly been affected by influenza A, accounting for 62% of influenza A detections. Influenza B, while much smaller in numbers, is mainly affecting individuals less than 65 years of age. Adults under the age of 64 years accounted for 59% of influenza B detections.
Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2014-15​
2015-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, 2014-15
In week 18, detections for all other respiratory viruses except rhinovirus and human metapneumovirus decreased from the previous week (Figure 3). The percent positive for rhinovirus increased from 13% in week 17 to 20% in week 18.
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, 2014-15​
2015-w18-fg3-eng.gif
​
RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2014-2015
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 1: Weekly and cumulative numbers of positive influenza specimens by type, subtype and province, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Reporting provinces [SUP]1[/SUP] Weekly
(May 3 to May 9, 2015) Cumulative
(August 24 to May 9, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1)pdm09 A(H3) A(UnS) B Total A Total A(H1)pdm09 A(H3) A(UnS) B Total [/TR]
[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]
[TR]
BC [TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]18[/TD]
[TD="class: alignCenter"]3522[/TD]
[TD="class: alignCenter"]28[/TD]
[TD="class: alignCenter"]2629[/TD]
[TD="class: alignCenter"]865[/TD]
[TD="class: alignCenter"]433[/TD]
[/TR]
[TR]
AB [TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]31[/TD]
[TD="class: alignCenter"]3700[/TD]
[TD="class: alignCenter"]14[/TD]
[TD="class: alignCenter"]3531[/TD]
[TD="class: alignCenter"]155[/TD]
[TD="class: alignCenter"]912[/TD]
[/TR]
[TR]
SK [TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]1314[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]839[/TD]
[TD="class: alignCenter"]475[/TD]
[TD="class: alignCenter"]286[/TD]
[/TR]
[TR]
MB [TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]12[/TD]
[TD="class: alignCenter"]1124[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]390[/TD]
[TD="class: alignCenter"]733[/TD]
[TD="class: alignCenter"]197[/TD]
[/TR]
[TR]
ON [TD="class: alignCenter"]8[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]7[/TD]
[TD="class: alignCenter"]87[/TD]
[TD="class: alignCenter"]11157[/TD]
[TD="class: alignCenter"]48[/TD]
[TD="class: alignCenter"]4710[/TD]
[TD="class: alignCenter"]6399[/TD]
[TD="class: alignCenter"]1400[/TD]
[/TR]
[TR]
QC [TD="class: alignCenter"]16[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]16[/TD]
[TD="class: alignCenter"]83[/TD]
[TD="class: alignCenter"]11445[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]422[/TD]
[TD="class: alignCenter"]11019[/TD]
[TD="class: alignCenter"]3820[/TD]
[/TR]
[TR]
NB [TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]19[/TD]
[TD="class: alignCenter"]1195[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]193[/TD]
[TD="class: alignCenter"]1002[/TD]
[TD="class: alignCenter"]524[/TD]
[/TR]
[TR]
NS [TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]511[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]123[/TD]
[TD="class: alignCenter"]387[/TD]
[TD="class: alignCenter"]260[/TD]
[/TR]
[TR]
PE [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"]131[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]128[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]108[/TD]
[/TR]
[TR]
NL [TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]10[/TD]
[TD="class: alignCenter"]624[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]123[/TD]
[TD="class: alignCenter"]501[/TD]
[TD="class: alignCenter"]58[/TD]
[/TR]
[TR]
Canada [TD="class: alignCenter"]32[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]1[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]4[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]27[/TD]
[TD="class: alignCenter"]267[/TD]
[TD="class: alignCenter"]34723[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]97[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]13088[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]21538[/TD]
[TD="class: alignCenter"]7998[/TD]
[/TR]
[TR]
Percentage [SUP]2[/SUP] [TD="class: alignCenter"]10.7%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]3.1%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]12.5%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]84.4%[/TD]
[TD="class: alignCenter"]89.3%[/TD]
[TD="class: alignCenter"]81.3%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.3%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]37.7%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]62.0%[/TD]
[TD="class: alignCenter"]18.7%[/TD]
[/TR]
[/TABLE]
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
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, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups (years) Weekly
May 3 to May 9, 2015 Cumulative
(August 24 to May 9, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) Total A Total A(H1) pdm09 A(H3) A (UnS) Total # % [/TR]
[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]
[TR]
<5 [TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]10[/TD]
[TD="class: alignCenter"]2092[/TD]
[TD="class: alignCenter"]22[/TD]
[TD="class: alignCenter"]809[/TD]
[TD="class: alignCenter"]1261[/TD]
[TD="class: alignCenter"]508[/TD]
[TD="class: alignCenter"]2600[/TD]
[TD="class: alignCenter"]7.1%[/TD]
[/TR]
[TR]
5-19 [TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]20[/TD]
[TD="class: alignCenter"]1783[/TD]
[TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]957[/TD]
[TD="class: alignCenter"]820[/TD]
[TD="class: alignCenter"]751[/TD]
[TD="class: alignCenter"]2534[/TD]
[TD="class: alignCenter"]6.9%[/TD]
[/TR]
[TR]
20-44 [TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]25[/TD]
[TD="class: alignCenter"]3441[/TD]
[TD="class: alignCenter"]16[/TD]
[TD="class: alignCenter"]1671[/TD]
[TD="class: alignCenter"]1754[/TD]
[TD="class: alignCenter"]1018[/TD]
[TD="class: alignCenter"]4459[/TD]
[TD="class: alignCenter"]12.1%[/TD]
[/TR]
[TR]
45-64 [TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]39[/TD]
[TD="class: alignCenter"]3869[/TD]
[TD="class: alignCenter"]21[/TD]
[TD="class: alignCenter"]1658[/TD]
[TD="class: alignCenter"]2190[/TD]
[TD="class: alignCenter"]1705[/TD]
[TD="class: alignCenter"]5574[/TD]
[TD="class: alignCenter"]15.1%[/TD]
[/TR]
[TR]
65+ [TD="class: alignCenter"]9[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]9[/TD]
[TD="class: alignCenter"]78[/TD]
[TD="class: alignCenter"]18739[/TD]
[TD="class: alignCenter"]15[/TD]
[TD="class: alignCenter"]7286[/TD]
[TD="class: alignCenter"]11438[/TD]
[TD="class: alignCenter"]2761[/TD]
[TD="class: alignCenter"]21500[/TD]
[TD="class: alignCenter"]58.4%[/TD]
[/TR]
[TR]
Unknown [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"]120[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]101[/TD]
[TD="class: alignCenter"]19[/TD]
[TD="class: alignCenter"]7[/TD]
[TD="class: alignCenter"]127[/TD]
[TD="class: alignCenter"]0.3%[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]19[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]19[/TD]
[TD="class: alignCenter"]172[/TD]
[TD="class: alignCenter"]30044[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]80[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]12482[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]17482[/TD]
[TD="class: alignCenter"]6750[/TD]
[TD="class: alignCenter"]36794[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[TR]
Percentage [SUP]2[/SUP] [TD="class: alignCenter"]9.9%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.0%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.0%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]100.0%[/TD]
[TD="class: alignCenter"]90.1%[/TD]
[TD="class: alignCenter"]81.7%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.3%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]41.5%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]58.2%[/TD]
[TD="class: alignCenter"]18.3%[/TD]
[TD="class: alignCenter"] [/TD]
[TD="class: alignCenter"] [/TD]
[/TR]
[/TABLE]
[h=2]Antiviral Resistance[/h] During the 2014-2015 influenza season, the NML has tested 1,446 influenza viruses for resistance to oseltamivir and 1,444 influenza viruses for resistance to zanamivir. All viruses were sensitive to zanamivir and one influenza A(H3N2) virus was resistant to oseltamivir. A total of 1,365 influenza A viruses (99.9%) were resistant to amantadine (Table 3).
[TABLE="class: widthFull, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Virus type and subtype Oseltamivir Zanamivir Amantadine [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
# tested # resistant (%) # tested # resistant (%) # tested # resistant (%) [/TR]
[TR]
[TD="class: fontSize85, colspan: 7"][SUP]*[/SUP] NA - not applicable[/TD]
[/TR]
[TR]
A (H3N2) [TD="class: alignRight"]890[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]888[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]1350[/TD]
[TD="class: alignRight"]1349 (99.9%)[/TD]
[/TR]
[TR]
A (H1N1) [TD="class: alignRight"]15[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]15[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]16[/TD]
[TD="class: alignRight"]16 (100%)[/TD]
[/TR]
[TR]
B [TD="class: alignRight"]541[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]541[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]NA [SUP]*[/SUP][/TD]
[TD="class: alignRight"]NA [SUP]*[/SUP][/TD]
[/TR]
[TR]
TOTAL [TD="class: alignRight"]1446[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]1444[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]1366[/TD]
[TD="class: alignRight"]1365[/TD]
[/TR]
[/TABLE]
[h=2]Influenza Strain Characterizations[/h] During the 2014-2015 influenza season, the National Microbiology Laboratory (NML) has characterized 849 influenza viruses [190 A(H3N2), 17 A(H1N1) and 642 influenza B].
Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assay (n=190), one virus was antigenically similar to A/Texas/50/2012, five showed reduced titers to A/Texas/50/2012 and 184 were antigenically similar to A/Switzerland/9715293/2013, which is the influenza A(H3N2) component recommended for the 2015 Southern Hemisphere influenza vaccine. Additionally, 1,129 A(H3N2) viruses were unable to be tested by HI assay; however, sequence analysis showed that 1,127 belonged to a genetic group that typically shows reduced titers to A/Texas/50/2012. Influenza A(H1N1): Seventeen A(H1N1) viruses characterized were antigenically similar to A/California/7/2009. Influenza B: Of the 642 influenza B viruses characterized, 602 viruses were antigenically similar to B/Massachusetts/2/2012, three viruses showed reduced titers against B/Massachusetts/2/2012, and 37 were B/Brisbane/60/2008-like (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2014-2015, N = 849​
2015-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 byWHO.
The recommended components for the 2014-2015 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A/Texas/50/2012 (H3N2)-like virus, and a B/Massachusetts/2/2012-like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus is recommended.


Text equivalent for figure 4Influenza strain characterizations, Canada, 2014-2015, N =3
[h=2]Influenza-like Illness (ILI) Consultation Rate[/h] In week 18, the national influenza-like-illness (ILI) consultation rate increased from the previous week to 23.1 consultations per 1,000 (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, 2014-2015​
2015-w18-fg5-eng.gif
​
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. 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, 2014-2015
[h=2]Influenza Outbreak Surveillance[/h] In week 18, 14 new outbreaks of influenza were reported: two due to influenza B, one due to influenza A and 11 for which the influenza type was not provided. Eleven outbreaks were reported in long-term care facilities (LTCF) and three in institutional or community settings (Figure 6). To date this season, 1,265 outbreaks in LTCFs have been reported and the majority of those with known subtypes were attributable to A(H3N2). There have been a higher number of reported influenza outbreaks to date this season compared to the same period in previous seasons.
Figure 6. Overall number of new laboratory-confirmed influenza outbreaks by report week, Canada, 2014-2015
2015-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, 2014-2015
[h=2]Pharmacy Surveillance[/h] Pharmacy surveillance for sales of influenza antivirals has ended for the 2014-2015 influenza season (Figure 7).
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2014-15​
2015-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 2,500 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, 2014-15
[h=2]Sentinel Hospital Influenza Surveillance[/h] Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In week 18, six laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network. All cases were influenza B (Figure 8a). A greater proportion of cases have been reported with influenza B in recent weeks, following the trend in laboratory detections. Among the reported cases, three (50%) were <2 years of age and three (50%) were 2 to 9 years of age. One ICU case was reported.
To date this season, 681 hospitalizations have been reported by the IMPACT network, 509 (75%) of which were cases of influenza A. Among cases for which the influenza A subtype was reported, 98% (161/164) were A(H3N2) (Table 4). To date, 86 cases were admitted to the ICU, of which 49 (57%) were 2 to 9 years of age (Figure 9a). A total of 56 ICU cases reported to have at least one underlying condition or comorbidity. Four 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)
Surveillance has ended for the 2014-2015 influenza season.
This season, 2,228 cases have been reported; 1,912 (86%) with influenza A. The majority of cases (81%) were among adults ≥65 years of age (Table 5). One hundred and seventy two ICU admissions have been reported and 128 cases were adults ≥65 years of age. Among the 172 ICU admissions, 27 were due to influenza B (12 in adults 45 to 64 years of age and 15 in adults over the age of 65). A total of 123 ICU cases (72%) reported to have at least one underlying condition or comorbidity. Of the 123 ICU cases with known immunization status, 40 (33%) reported not having been vaccinated this season. One hundred and thirty-five deaths have been reported, 124 (92%) of the deaths were adults >65 years of age (Figure 9B).
Note: 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 marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (Aug. 24, 2014 to May 9, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) Total # (%) [/TR]
[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]
[TR]
0-5m [TD="class: alignCenter"]81[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]18[/TD]
[TD="class: alignCenter"]63[/TD]
[TD="class: alignCenter"]13[/TD]
[TD="class: alignCenter"]94 (13.8%)[/TD]
[/TR]
[TR]
6-23m [TD="class: alignCenter"]114[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]36[/TD]
[TD="class: alignCenter"]76[/TD]
[TD="class: alignCenter"]35[/TD]
[TD="class: alignCenter"]149 (21.9%)[/TD]
[/TR]
[TR]
2-4y [TD="class: alignCenter"]124[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]38[/TD]
[TD="class: alignCenter"]85[/TD]
[TD="class: alignCenter"]47[/TD]
[TD="class: alignCenter"]171 (25.1%)[/TD]
[/TR]
[TR]
5-9y [TD="class: alignCenter"]129[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]44[/TD]
[TD="class: alignCenter"]85[/TD]
[TD="class: alignCenter"]50[/TD]
[TD="class: alignCenter"]179 (26.3%)[/TD]
[/TR]
[TR]
10-16y [TD="class: alignCenter"]61[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]25[/TD]
[TD="class: alignCenter"]36[/TD]
[TD="class: alignCenter"]27[/TD]
[TD="class: alignCenter"]88 (12.9%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]509[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]3[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]161[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]345[/TD]
[TD="class: alignCenter"]172[/TD]
[TD="class: alignCenter"]681[/TD]
[/TR]
[TR]
% [SUP]1[/SUP] [TD="class: alignCenter"]74.7%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.6%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]31.6%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]67.8%[/TD]
[TD="class: alignCenter"]25.3%[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[/TABLE]
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 5 - Cumulative numbers of adult hospitalizations with influenza reported by the PCIRN-SOS network, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (November 15, 2014 to May 9, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A(UnS) Total # (%) [/TR]
[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]
[TR]
16-20 [TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]4 (%)[/TD]
[/TR]
[TR]
20-44 [TD="class: alignCenter"]106[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]56[/TD]
[TD="class: alignCenter"]49[/TD]
[TD="class: alignCenter"]16[/TD]
[TD="class: alignCenter"]122 (5%)[/TD]
[/TR]
[TR]
45-64 [TD="class: alignCenter"]217[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]99[/TD]
[TD="class: alignCenter"]115[/TD]
[TD="class: alignCenter"]76[/TD]
[TD="class: alignCenter"]293 (13%)[/TD]
[/TR]
[TR]
65+ [TD="class: alignCenter"]1586[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]760[/TD]
[TD="class: alignCenter"]822[/TD]
[TD="class: alignCenter"]223[/TD]
[TD="class: alignCenter"]1809 (81%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]1912[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]8[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]916[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]988[/TD]
[TD="class: alignCenter"]316[/TD]
[TD="class: alignCenter"]2228[/TD]
[/TR]
[TR]
% [SUP]1[/SUP] [TD="class: alignCenter"]86%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]48%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]52%[/TD]
[TD="class: alignCenter"]14%[/TD]
[TD="class: alignCenter"]100%[/TD]
[/TR]
[/TABLE]
Figure 8 - Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2015-w18-fg8a-eng.gif

Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2015-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, 2014-15: Adult hospitalizations (>16 year of age, PCIRN-SOS)
Figure 9 - Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2015-w18-fg9a-eng.gif
Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2015-w18-fg9b-eng.gif

Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15: Adult hospitalizations (≥16 year of age, PCIRN-SOS)
[h=2]Provincial/Territorial Influenza Hospitalizations and Deaths[/h] In week 18, 78 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories*, which is lower than the number reported the previous week. Of the 78 hospitalizations, 46 (59%) were due to influenza A and 38 (49%) were in patients ≥65 years of age.
Since the start of the 2014-15 season, 7,448 hospitalizations have been reported; 6,510 (87%) with influenza A. Among cases for which the subtype of influenza A was reported, 99.3% were A(H3N2). The majority of cases (70%) were ≥65 years of age (Table 6). A total of 382 ICU admissions have been reported to date: 53% (n=202) were in adults ≥65 years of age and 34% (n=128) were in adults 20-64 years. A total of 562 deaths have been reported since the start of the season: three children <5 years of age, four children 5-19 years, 43 adults 20-64 years, and 512 adults ≥65 years of age. Influenza A has been reported in 92% of deaths. Adults 65 years of age or older represent 91% of all deaths reported this season. 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, and QC. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting.
[TABLE="class: widthFull, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (24 August 2014 to 2 May 9015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) Total # (%) [/TR]
[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]
[TR]
0-4 years [TD="class: alignCenter"]424[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]150[/TD]
[TD="class: alignCenter"]270[/TD]
[TD="class: alignCenter"]76[/TD]
[TD="class: alignCenter"]500 (7%)[/TD]
[/TR]
[TR]
5-19 years [TD="class: alignCenter"]256[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]118[/TD]
[TD="class: alignCenter"]138[/TD]
[TD="class: alignCenter"]86[/TD]
[TD="class: alignCenter"]342 (5%)[/TD]
[/TR]
[TR]
20-44 years [TD="class: alignCenter"]319[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]168[/TD]
[TD="class: alignCenter"]147[/TD]
[TD="class: alignCenter"]70[/TD]
[TD="class: alignCenter"]389 (5%)[/TD]
[/TR]
[TR]
45-64 years [TD="class: alignCenter"]711[/TD]
[TD="class: alignCenter"]11[/TD]
[TD="class: alignCenter"]347[/TD]
[TD="class: alignCenter"]353[/TD]
[TD="class: alignCenter"]185[/TD]
[TD="class: alignCenter"]896 (12%)[/TD]
[/TR]
[TR]
65+ years [TD="class: alignCenter"]4744[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]2260[/TD]
[TD="class: alignCenter"]2481[/TD]
[TD="class: alignCenter"]500[/TD]
[TD="class: alignCenter"]5244 (70%)[/TD]
[/TR]
[TR]
Unknown [TD="class: alignCenter"]56[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]52[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]21[/TD]
[TD="class: alignCenter"]77 (1%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]6510[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]23[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]3095[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]3392[/TD]
[TD="class: alignCenter"]938[/TD]
[TD="class: alignCenter"]7448[/TD]
[/TR]
[TR]
Percentage [SUP]1[/SUP] [TD="class: alignCenter"]87.4%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.4%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]47.5%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]52.1%[/TD]
[TD="class: alignCenter"]12.6%[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[/TABLE]
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2014-15 on the Public Health Agency of Canada website.
.../

http://www.phac-aspc.gc.ca/fluwatch/14-15/w18_15/index-eng.php
 
[h=1]FluWatch report: May 10 to May 16, 2015 (Week 19)[/h] Posted 2015-05-22 For readers interested in the PDF version, the document is available for downloading or viewing:
FluWatch report: May 10 to May 16, 2015 (Week 19) (PDF Version - 916 KB - 10 pages)

? ? Help with PDF documents

Overall Summary
  • Influenza B continues to be the most common influenza virus circulating in Canada; however, influenza B is past its peak and remains within expected levels for this time of year.
  • Overall, influenza activity in Canada continues to decrease; however, elevated activity was still reported in week 19 (mostly in parts of Central Canada and Newfoundland).
  • Based on laboratory detections, influenza B is having a greater impact on adults less than 65 years of age compared to influenza A(H3N2), which predominated earlier in the season.
  • As of week 19, 7,549 hospitalizations and 576 deaths have been reported from participating regions, which is more than were reported last year at this time (4,862 hospitalizations and 291 deaths).

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
[h=2]Influenza/ILI Activity (geographic spread)[/h] In week 19, one region in QC and one region in NL reported widespread activity. Eight regions reported localized activity: MB, ON(5), QC, and NL. Twenty-three regions reported sporadic activity: BC(4), AB(5), SK(3), MB(2), ON(2), QC(4), NL, NB, and NS.
Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 19​
​
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
[h=2]Influenza and Other Respiratory Virus Detections[/h] The number of positive influenza tests decreased from 314 in week 18 to 220 in week 19. Influenza B remained the predominant virus in week 19, representing 93% of influenza detections. Most jurisdictions reported stable or declining levels of influenza detections over recent weeks. To date, 81% of influenza detections have been influenza A, and 99.2% of those subtyped have been A(H3N2) (Table 1). To date this season, detailed information on age and type/subtype has been received for 36,997 cases (Table 2). Adults ≥65 years of age have predominantly been affected by influenza A, accounting for 62% of influenza A detections. Influenza B, while much smaller in numbers, is mainly affecting individuals less than 65 years of age. Adults under the age of 64 years accounted for 59% of influenza B detections.
Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2014-15​
2015-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, 2014-15
In week 19, detections for all other respiratory viruses decreased from the previous week and are approaching inter-seasonal levels (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, 2014-15​
2015-w19-fg3-eng.gif
​
RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2014-2015
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 1: Weekly and cumulative numbers of positive influenza specimens by type, subtype and province, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Reporting provinces [SUP]1[/SUP] Weekly
(May 10 to May 16, 2015) Cumulative
(August 24 to May 16, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1)pdm09 A(H3) A(UnS) B Total A Total A(H1)pdm09 A(H3) A(UnS) B Total [/TR]
[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]
[TR]
BC [TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]33[/TD]
[TD="class: alignCenter"]3525[/TD]
[TD="class: alignCenter"]28[/TD]
[TD="class: alignCenter"]2629[/TD]
[TD="class: alignCenter"]868[/TD]
[TD="class: alignCenter"]466[/TD]
[/TR]
[TR]
AB [TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]25[/TD]
[TD="class: alignCenter"]3701[/TD]
[TD="class: alignCenter"]14[/TD]
[TD="class: alignCenter"]3531[/TD]
[TD="class: alignCenter"]156[/TD]
[TD="class: alignCenter"]937[/TD]
[/TR]
[TR]
SK [TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]11[/TD]
[TD="class: alignCenter"]1315[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]839[/TD]
[TD="class: alignCenter"]476[/TD]
[TD="class: alignCenter"]311[/TD]
[/TR]
[TR]
MB [TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]17[/TD]
[TD="class: alignCenter"]1124[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]390[/TD]
[TD="class: alignCenter"]733[/TD]
[TD="class: alignCenter"]214[/TD]
[/TR]
[TR]
ON [TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]49[/TD]
[TD="class: alignCenter"]11162[/TD]
[TD="class: alignCenter"]50[/TD]
[TD="class: alignCenter"]4714[/TD]
[TD="class: alignCenter"]6398[/TD]
[TD="class: alignCenter"]1456[/TD]
[/TR]
[TR]
QC [TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]50[/TD]
[TD="class: alignCenter"]11449[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]422[/TD]
[TD="class: alignCenter"]11023[/TD]
[TD="class: alignCenter"]3870[/TD]
[/TR]
[TR]
NB [TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]1195[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]193[/TD]
[TD="class: alignCenter"]1002[/TD]
[TD="class: alignCenter"]530[/TD]
[/TR]
[TR]
NS [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"]511[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]123[/TD]
[TD="class: alignCenter"]387[/TD]
[TD="class: alignCenter"]261[/TD]
[/TR]
[TR]
PE [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"]131[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]128[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]108[/TD]
[/TR]
[TR]
NL [TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]12[/TD]
[TD="class: alignCenter"]629[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]123[/TD]
[TD="class: alignCenter"]506[/TD]
[TD="class: alignCenter"]70[/TD]
[/TR]
[TR]
Canada [TD="class: alignCenter"]16[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]3[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]13[/TD]
[TD="class: alignCenter"]204[/TD]
[TD="class: alignCenter"]34742[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]99[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]13092[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]21551[/TD]
[TD="class: alignCenter"]8223[/TD]
[/TR]
[TR]
Percentage [SUP]2[/SUP] [TD="class: alignCenter"]7.3%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.0%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]18.8%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]81.3%[/TD]
[TD="class: alignCenter"]92.7%[/TD]
[TD="class: alignCenter"]80.9%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.3%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]37.7%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]62.0%[/TD]
[TD="class: alignCenter"]19.1%[/TD]
[/TR]
[/TABLE]
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
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, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups (years) Weekly
May 10 to May 16, 2015 Cumulative
(August 24 to May 16, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) Total A Total A(H1) pdm09 A(H3) A (UnS) Total # % [/TR]
[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]
[TR]
<5 [TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]7[/TD]
[TD="class: alignCenter"]2091[/TD]
[TD="class: alignCenter"]22[/TD]
[TD="class: alignCenter"]809[/TD]
[TD="class: alignCenter"]1260[/TD]
[TD="class: alignCenter"]524[/TD]
[TD="class: alignCenter"]2615[/TD]
[TD="class: alignCenter"]7.1%[/TD]
[/TR]
[TR]
5-19 [TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]14[/TD]
[TD="class: alignCenter"]1781[/TD]
[TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]956[/TD]
[TD="class: alignCenter"]819[/TD]
[TD="class: alignCenter"]755[/TD]
[TD="class: alignCenter"]2536[/TD]
[TD="class: alignCenter"]6.9%[/TD]
[/TR]
[TR]
20-44 [TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]32[/TD]
[TD="class: alignCenter"]3443[/TD]
[TD="class: alignCenter"]16[/TD]
[TD="class: alignCenter"]1672[/TD]
[TD="class: alignCenter"]1755[/TD]
[TD="class: alignCenter"]1065[/TD]
[TD="class: alignCenter"]4508[/TD]
[TD="class: alignCenter"]12.2%[/TD]
[/TR]
[TR]
45-64 [TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]36[/TD]
[TD="class: alignCenter"]3874[/TD]
[TD="class: alignCenter"]22[/TD]
[TD="class: alignCenter"]1659[/TD]
[TD="class: alignCenter"]2193[/TD]
[TD="class: alignCenter"]1762[/TD]
[TD="class: alignCenter"]5636[/TD]
[TD="class: alignCenter"]15.2%[/TD]
[/TR]
[TR]
65+ [TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]44[/TD]
[TD="class: alignCenter"]18745[/TD]
[TD="class: alignCenter"]15[/TD]
[TD="class: alignCenter"]7289[/TD]
[TD="class: alignCenter"]11441[/TD]
[TD="class: alignCenter"]2830[/TD]
[TD="class: alignCenter"]21575[/TD]
[TD="class: alignCenter"]58.3%[/TD]
[/TR]
[TR]
Unknown [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"]120[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]101[/TD]
[TD="class: alignCenter"]19[/TD]
[TD="class: alignCenter"]7[/TD]
[TD="class: alignCenter"]127[/TD]
[TD="class: alignCenter"]0.3%[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]7[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]2[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]5[/TD]
[TD="class: alignCenter"]133[/TD]
[TD="class: alignCenter"]30054[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]81[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]12486[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]17487[/TD]
[TD="class: alignCenter"]6943[/TD]
[TD="class: alignCenter"]36997[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[TR]
Percentage [SUP]2[/SUP] [TD="class: alignCenter"]5.0%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.0%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]28.6%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]71.4%[/TD]
[TD="class: alignCenter"]95.0%[/TD]
[TD="class: alignCenter"]81.2%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.3%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]41.5%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]58.2%[/TD]
[TD="class: alignCenter"]18.8%[/TD]
[TD="class: alignCenter"] [/TD]
[TD="class: alignCenter"] [/TD]
[/TR]
[/TABLE]
[h=2]Antiviral Resistance[/h] During the 2014-2015 influenza season, the NML has tested 1,499 influenza viruses for resistance to oseltamivir and 1,444 influenza viruses for resistance to zanamivir. All viruses were sensitive to zanamivir and one influenza A(H3N2) virus was resistant to oseltamivir. A total of 1,390 influenza A viruses (99.9%) were resistant to amantadine (Table 3).
[TABLE="class: widthFull, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Virus type and subtype Oseltamivir Zanamivir Amantadine [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
# tested # resistant (%) # tested # resistant (%) # tested # resistant (%) [/TR]
[TR]
[TD="class: fontSize85, colspan: 7"][SUP]*[/SUP] NA - not applicable[/TD]
[/TR]
[TR]
A (H3N2) [TD="class: alignRight"]901[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]888[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]1372[/TD]
[TD="class: alignRight"]1371 (99.9%)[/TD]
[/TR]
[TR]
A (H1N1) [TD="class: alignRight"]17[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]15[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]19[/TD]
[TD="class: alignRight"]19 (100%)[/TD]
[/TR]
[TR]
B [TD="class: alignRight"]581[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]541[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]NA [SUP]*[/SUP][/TD]
[TD="class: alignRight"]NA [SUP]*[/SUP][/TD]
[/TR]
[TR]
TOTAL [TD="class: alignRight"]1499[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]1444[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]1391[/TD]
[TD="class: alignRight"]1390[/TD]
[/TR]
[/TABLE]
[h=2]Influenza Strain Characterizations[/h] During the 2014-2015 influenza season, the National Microbiology Laboratory (NML) has characterized 898 influenza viruses [195 A(H3N2), 18 A(H1N1) and 685 influenza B].
Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assay (n=195), one virus was antigenically similar to A/Texas/50/2012, five showed reduced titers to A/Texas/50/2012 and 189 were antigenically similar to A/Switzerland/9715293/2013, which is the influenza A(H3N2) component recommended for the 2015 Southern Hemisphere influenza vaccine. Additionally, 1,143 A(H3N2) viruses were unable to be tested by HI assay; however, sequence analysis showed that 1,141 belonged to a genetic group that typically shows reduced titers to A/Texas/50/2012. Influenza A(H1N1): Eighteen A(H1N1) viruses characterized were antigenically similar to A/California/7/2009. Influenza B: Of the 685 influenza B viruses characterized, 643 viruses were antigenically similar to B/Massachusetts/2/2012, three viruses showed reduced titers against B/Massachusetts/2/2012, and 39 were B/Brisbane/60/2008-like (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2014-2015, N = 898​
2015-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 byWHO.
The recommended components for the 2014-2015 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A/Texas/50/2012 (H3N2)-like virus, and a B/Massachusetts/2/2012-like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus is recommended.


Text equivalent for figure 4Influenza strain characterizations, Canada, 2014-2015, N =3
[h=2]Influenza-like Illness (ILI) Consultation Rate[/h] In week 19, the national influenza-like-illness (ILI) consultation rate increased from the previous week to 23.8 consultations per 1,000 (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, 2014-2015​
2015-w19-fg5-eng.gif
​
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. 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, 2014-2015
[h=2]Influenza Outbreak Surveillance[/h] In week 19, 10 new outbreaks of influenza were reported. Eight outbreaks were reported in long-term care facilities (LTCF) and two in institutional or community settings (Figure 6). Among the outbreaks in which the influenza type was known (n=3), all were associated with influenza B. To date this season, 1,273 outbreaks in LTCFs have been reported and the majority of those with known subtypes were attributable to A(H3N2). There have been a higher number of reported influenza outbreaks to date this season compared to the same period in previous seasons.
Figure 6. Overall number of new laboratory-confirmed influenza outbreaks by report week, Canada, 2014-2015
2015-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, 2014-2015
[h=2]Pharmacy Surveillance[/h] Pharmacy surveillance for sales of influenza antivirals has ended for the 2014-2015 influenza season (Figure 7).
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2014-15​
2015-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 2,500 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, 2014-15
[h=2]Sentinel Hospital Influenza Surveillance[/h] Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In week 19, three laboratory-confirmed influenza-associated paediatric (=16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network. All cases were influenza B (Figure 8a). A greater proportion of cases have been reported with influenza B in recent weeks, following the trend in laboratory detections. Among the reported cases, two (67%) were <2 years of age and one (33%) was 10 to 16 years of age. No ICU admissions were reported.
To date this season, 685 hospitalizations have been reported by the IMPACT network, 509 (74%) of which were cases of influenza A. Among cases for which the influenza A subtype was reported, 98% (161/164) were A(H3N2) (Table 4). To date, 85 cases were admitted to the ICU, of which 48 (57%) were 2 to 9 years of age (Figure 9a). A total of 56 ICU cases reported to have at least one underlying condition or comorbidity. Four 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)
Surveillance has ended for the 2014-2015 influenza season.
This season, 2,228 cases have been reported; 1,912 (86%) with influenza A. The majority of cases (81%) were among adults ≥65 years of age (Table 5). One hundred and seventy two ICU admissions have been reported and 128 cases were adults ≥65 years of age. Among the 172 ICU admissions, 27 were due to influenza B (12 in adults 45 to 64 years of age and 15 in adults over the age of 65). A total of 123 ICU cases (72%) reported to have at least one underlying condition or comorbidity. Of the 123 ICU cases with known immunization status, 40 (33%) reported not having been vaccinated this season. One hundred and thirty-five deaths have been reported, 124 (92%) of the deaths were adults >65 years of age (Figure 9B).
Note: 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 marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (Aug. 24, 2014 to May 16, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) Total # (%) [/TR]
[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]
[TR]
0-5m [TD="class: alignCenter"]81[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]18[/TD]
[TD="class: alignCenter"]63[/TD]
[TD="class: alignCenter"]14[/TD]
[TD="class: alignCenter"]95 (13.9%)[/TD]
[/TR]
[TR]
6-23m [TD="class: alignCenter"]114[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]36[/TD]
[TD="class: alignCenter"]76[/TD]
[TD="class: alignCenter"]36[/TD]
[TD="class: alignCenter"]150 (21.9%)[/TD]
[/TR]
[TR]
2-4y [TD="class: alignCenter"]124[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]38[/TD]
[TD="class: alignCenter"]85[/TD]
[TD="class: alignCenter"]47[/TD]
[TD="class: alignCenter"]171 (25.0%)[/TD]
[/TR]
[TR]
5-9y [TD="class: alignCenter"]129[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]44[/TD]
[TD="class: alignCenter"]85[/TD]
[TD="class: alignCenter"]50[/TD]
[TD="class: alignCenter"]179 (26.1%)[/TD]
[/TR]
[TR]
10-16y [TD="class: alignCenter"]61[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]25[/TD]
[TD="class: alignCenter"]36[/TD]
[TD="class: alignCenter"]29[/TD]
[TD="class: alignCenter"]90 (13.1%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]509[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]3[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]161[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]345[/TD]
[TD="class: alignCenter"]176[/TD]
[TD="class: alignCenter"]685[/TD]
[/TR]
[TR]
% [SUP]1[/SUP] [TD="class: alignCenter"]74.3%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.6%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]31.6%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]67.8%[/TD]
[TD="class: alignCenter"]25.7%[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[/TABLE]
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 5 - Cumulative numbers of adult hospitalizations with influenza reported by the PCIRN-SOS network, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (November 15, 2014 to May 9, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A(UnS) Total # (%) [/TR]
[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]
[TR]
16-20 [TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]4 (%)[/TD]
[/TR]
[TR]
20-44 [TD="class: alignCenter"]106[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]56[/TD]
[TD="class: alignCenter"]49[/TD]
[TD="class: alignCenter"]16[/TD]
[TD="class: alignCenter"]122 (5%)[/TD]
[/TR]
[TR]
45-64 [TD="class: alignCenter"]217[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]99[/TD]
[TD="class: alignCenter"]115[/TD]
[TD="class: alignCenter"]76[/TD]
[TD="class: alignCenter"]293 (13%)[/TD]
[/TR]
[TR]
65+ [TD="class: alignCenter"]1586[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]760[/TD]
[TD="class: alignCenter"]822[/TD]
[TD="class: alignCenter"]223[/TD]
[TD="class: alignCenter"]1809 (81%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]1912[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]8[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]916[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]988[/TD]
[TD="class: alignCenter"]316[/TD]
[TD="class: alignCenter"]2228[/TD]
[/TR]
[TR]
% [SUP]1[/SUP] [TD="class: alignCenter"]86%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]48%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]52%[/TD]
[TD="class: alignCenter"]14%[/TD]
[TD="class: alignCenter"]100%[/TD]
[/TR]
[/TABLE]
Figure 8 - Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2015-w19-fg8a-eng.gif

Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2015-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, 2014-15: Adult hospitalizations (>16 year of age, PCIRN-SOS)
Figure 9 - Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2015-w19-fg9a-eng.gif
Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2015-w18-fg9b-eng.gif

Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15: Adult hospitalizations (≥16 year of age, PCIRN-SOS)
[h=2]Provincial/Territorial Influenza Hospitalizations and Deaths[/h] In week 19, 37 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories*, which is lower than the number reported the previous week. Of the 37 hospitalizations, 20 (54%) were due to influenza A and 15 (41%) were in patients ≥65 years of age.
Since the start of the 2014-15 season, 7,549 hospitalizations have been reported; 6,540 (87%) with influenza A. Among cases for which the subtype of influenza A was reported, 99.2% were A(H3N2). The majority of cases (70%) were ≥65 years of age (Table 6). A total of 389 ICU admissions have been reported to date: 53% (n=203) were in adults ≥65 years of age and 76% were due to influenza A. A total of 576 deaths have been reported since the start of the season: three children <5 years of age, four children 5-19 years, 43 adults 20-64 years, and 526 adults ≥65 years of age. Influenza A has been reported in 91% of deaths. Adults 65 years of age or older represent 91% of all deaths reported this season. 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, and QC. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting.
[TABLE="class: widthFull, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (24 August 2014 to 16 May 9015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) Total # (%) [/TR]
[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]
[TR]
0-4 years [TD="class: alignCenter"]425[/TD]
[TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]150[/TD]
[TD="class: alignCenter"]270[/TD]
[TD="class: alignCenter"]83[/TD]
[TD="class: alignCenter"]508 (7%)[/TD]
[/TR]
[TR]
5-19 years [TD="class: alignCenter"]258[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]120[/TD]
[TD="class: alignCenter"]138[/TD]
[TD="class: alignCenter"]90[/TD]
[TD="class: alignCenter"]348 (5%)[/TD]
[/TR]
[TR]
20-44 years [TD="class: alignCenter"]321[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]168[/TD]
[TD="class: alignCenter"]149[/TD]
[TD="class: alignCenter"]77[/TD]
[TD="class: alignCenter"]398 (5%)[/TD]
[/TR]
[TR]
45-64 years [TD="class: alignCenter"]718[/TD]
[TD="class: alignCenter"]12[/TD]
[TD="class: alignCenter"]352[/TD]
[TD="class: alignCenter"]354[/TD]
[TD="class: alignCenter"]197[/TD]
[TD="class: alignCenter"]915 (12%)[/TD]
[/TR]
[TR]
65+ years [TD="class: alignCenter"]4762[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]2274[/TD]
[TD="class: alignCenter"]2484[/TD]
[TD="class: alignCenter"]541[/TD]
[TD="class: alignCenter"]5303 (70%)[/TD]
[/TR]
[TR]
Unknown [TD="class: alignCenter"]56[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]52[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]21[/TD]
[TD="class: alignCenter"]77 (1%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]6540[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]26[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]3116[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]3398[/TD]
[TD="class: alignCenter"]1009[/TD]
[TD="class: alignCenter"]7549[/TD]
[/TR]
[TR]
Percentage [SUP]1[/SUP] [TD="class: alignCenter"]86.6%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.4%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]47.6%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]52.0%[/TD]
[TD="class: alignCenter"]13.4%[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[/TABLE]
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2014-15 on the Public Health Agency of Canada website.

.../
http://www.phac-aspc.gc.ca/fluwatch/14-15/w19_15/index-eng.php
 
[h=1]FluWatch report: May 17 to May 23, 2015 (Week 20)[/h] Posted 2015-05-29 For readers interested in the PDF version, the document is available for downloading or viewing:
FluWatch report: May 17 to May 23, 2015 (Week 20) (PDF Version - 915 KB - 10 pages)

? ? Help with PDF documents

Overall Summary
  • Influenza B continues to be the most common influenza virus circulating in Canada; however, influenza B is past its peak and remains within expected levels for this time of year.
  • Overall, influenza activity in Canada continues to decrease as we approach the end of the influenza season.
  • Based on laboratory detections, influenza B is having a greater impact on adults less than 65 years of age compared to influenza A(H3N2), which predominated earlier in the season.
  • As of week 20, 7,602 hospitalizations and 579 deaths have been reported from participating regions, which is more than were reported last year at this time (4,867 hospitalizations and 293 deaths).

Please Note: This is the final weekly report for the 2014-15 influenza season. Bi-weekly reports will start on June 12th (for weeks 21 and 22). Laboratory detections reported through the RVDSS will be updated weekly on the FluWatch website.
[h=2]Influenza/ILI Activity (geographic spread)[/h] In week 20, nine regions reported localized activity: BC, ON(5), QC and NL(2). Twenty-one regions reported sporadic activity: BC(3), AB(5), SK(3), MB(2), ON(2), QC(5), and NB.
Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 20​
​
Note: Influenza/ILI activity levels, as represented on this map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, sentinel ILI rates and reported outbreaks. Please refer to detailed definitions at the end of the report. Maps from previous weeks, including any retrospective updates, are available on the FluWatch website.
Text equivalent for figure 1Map of overall Influenza activity level by province and territory, Canada
[h=2]Influenza and Other Respiratory Virus Detections[/h] The number of positive influenza tests decreased from 233 in week 19 to 124 in week 20. Influenza B remained the predominant virus in week 20, representing 98% of influenza detections. All jurisdictions reported declining levels of influenza detections this week. To date, 81% of influenza detections have been influenza A (Table 1). To date this season, detailed information on age and type/subtype has been received for 37,126 cases (Table 2). Adults ≥65 years of age have predominantly been affected by influenza A, accounting for 62% of influenza A detections. Influenza B, while much smaller in numbers, is mainly affecting individuals less than 65 years of age. Adults under the age of 64 years accounted for 59% of influenza B detections.
Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2014-15​
2015-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, 2014-15
In week 20, detections for all other respiratory viruses decreased from the previous week and are approaching inter-seasonal levels (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, 2014-15​
2015-w20-fg3-eng.gif
​
RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
Text equivalent for figure 3Overall Number of Influenza Outbreaks, Canada, by Report Week, 2014-2015
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 1: Weekly and cumulative numbers of positive influenza specimens by type, subtype and province, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Reporting provinces [SUP]1[/SUP] Weekly
(May 17 to May 23, 2015) Cumulative
(August 24 to May 23, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1)pdm09 A(H3) A(UnS) B Total A Total A(H1)pdm09 A(H3) A(UnS) B Total [/TR]
[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]
[TR]
BC [TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]14[/TD]
[TD="class: alignCenter"]3525[/TD]
[TD="class: alignCenter"]28[/TD]
[TD="class: alignCenter"]2629[/TD]
[TD="class: alignCenter"]868[/TD]
[TD="class: alignCenter"]480[/TD]
[/TR]
[TR]
AB [TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]21[/TD]
[TD="class: alignCenter"]3702[/TD]
[TD="class: alignCenter"]14[/TD]
[TD="class: alignCenter"]3533[/TD]
[TD="class: alignCenter"]155[/TD]
[TD="class: alignCenter"]957[/TD]
[/TR]
[TR]
SK [TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]9[/TD]
[TD="class: alignCenter"]1315[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]839[/TD]
[TD="class: alignCenter"]476[/TD]
[TD="class: alignCenter"]334[/TD]
[/TR]
[TR]
MB [TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]1124[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]390[/TD]
[TD="class: alignCenter"]733[/TD]
[TD="class: alignCenter"]220[/TD]
[/TR]
[TR]
ON [TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]33[/TD]
[TD="class: alignCenter"]11164[/TD]
[TD="class: alignCenter"]50[/TD]
[TD="class: alignCenter"]4714[/TD]
[TD="class: alignCenter"]6400[/TD]
[TD="class: alignCenter"]1498[/TD]
[/TR]
[TR]
QC [TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]32[/TD]
[TD="class: alignCenter"]11449[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]422[/TD]
[TD="class: alignCenter"]11023[/TD]
[TD="class: alignCenter"]3902[/TD]
[/TR]
[TR]
NB [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"]1195[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]193[/TD]
[TD="class: alignCenter"]1002[/TD]
[TD="class: alignCenter"]530[/TD]
[/TR]
[TR]
NS [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"]511[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]123[/TD]
[TD="class: alignCenter"]387[/TD]
[TD="class: alignCenter"]261[/TD]
[/TR]
[TR]
PE [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"]131[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]128[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]108[/TD]
[/TR]
[TR]
NL [TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]629[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]123[/TD]
[TD="class: alignCenter"]506[/TD]
[TD="class: alignCenter"]76[/TD]
[/TR]
[TR]
Canada [TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]1[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]2[/TD]
[TD="class: alignCenter"]121[/TD]
[TD="class: alignCenter"]34745[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]99[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]13094[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]21552[/TD]
[TD="class: alignCenter"]8366[/TD]
[/TR]
[TR]
Percentage [SUP]2[/SUP] [TD="class: alignCenter"]2.4%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.0%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]33.3%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]66.7%[/TD]
[TD="class: alignCenter"]97.6%[/TD]
[TD="class: alignCenter"]80.6%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.3%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]37.7%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]62.0%[/TD]
[TD="class: alignCenter"]19.4%[/TD]
[/TR]
[/TABLE]
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
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, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups (years) Weekly
May 17 to May 23, 2015 Cumulative
(August 24 to May 23, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) Total A Total A(H1) pdm09 A(H3) A (UnS) Total # % [/TR]
[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]
[TR]
<5 [TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]10[/TD]
[TD="class: alignCenter"]2091[/TD]
[TD="class: alignCenter"]22[/TD]
[TD="class: alignCenter"]809[/TD]
[TD="class: alignCenter"]1260[/TD]
[TD="class: alignCenter"]541[/TD]
[TD="class: alignCenter"]2632[/TD]
[TD="class: alignCenter"]7.1%[/TD]
[/TR]
[TR]
5-19 [TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]17[/TD]
[TD="class: alignCenter"]1781[/TD]
[TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]956[/TD]
[TD="class: alignCenter"]819[/TD]
[TD="class: alignCenter"]774[/TD]
[TD="class: alignCenter"]2555[/TD]
[TD="class: alignCenter"]6.9%[/TD]
[/TR]
[TR]
20-44 [TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]20[/TD]
[TD="class: alignCenter"]3443[/TD]
[TD="class: alignCenter"]17[/TD]
[TD="class: alignCenter"]1673[/TD]
[TD="class: alignCenter"]1753[/TD]
[TD="class: alignCenter"]1094[/TD]
[TD="class: alignCenter"]4537[/TD]
[TD="class: alignCenter"]12.2%[/TD]
[/TR]
[TR]
45-64 [TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]15[/TD]
[TD="class: alignCenter"]3874[/TD]
[TD="class: alignCenter"]22[/TD]
[TD="class: alignCenter"]1659[/TD]
[TD="class: alignCenter"]2193[/TD]
[TD="class: alignCenter"]1783[/TD]
[TD="class: alignCenter"]5657[/TD]
[TD="class: alignCenter"]15.2%[/TD]
[/TR]
[TR]
65+ [TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]30[/TD]
[TD="class: alignCenter"]18746[/TD]
[TD="class: alignCenter"]15[/TD]
[TD="class: alignCenter"]7290[/TD]
[TD="class: alignCenter"]11441[/TD]
[TD="class: alignCenter"]2872[/TD]
[TD="class: alignCenter"]21618[/TD]
[TD="class: alignCenter"]58.2%[/TD]
[/TR]
[TR]
Unknown [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"]120[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]101[/TD]
[TD="class: alignCenter"]19[/TD]
[TD="class: alignCenter"]7[/TD]
[TD="class: alignCenter"]127[/TD]
[TD="class: alignCenter"]0.3%[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]1[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0[/TD]
[TD="class: alignCenter"]92[/TD]
[TD="class: alignCenter"]30055[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]82[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]12488[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]17485[/TD]
[TD="class: alignCenter"]7071[/TD]
[TD="class: alignCenter"]37126[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[TR]
Percentage [SUP]2[/SUP] [TD="class: alignCenter"]1.1%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.0%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]100.0%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.0%[/TD]
[TD="class: alignCenter"]98.9%[/TD]
[TD="class: alignCenter"]81.0%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.3%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]41.6%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]58.2%[/TD]
[TD="class: alignCenter"]19.0%[/TD]
[TD="class: alignCenter"] [/TD]
[TD="class: alignCenter"] [/TD]
[/TR]
[/TABLE]
[h=2]Antiviral Resistance[/h] During the 2014-2015 influenza season, the NML has tested 1,561 influenza viruses for resistance to oseltamivir and 1,559 influenza viruses for resistance to zanamivir. All viruses were sensitive to zanamivir and one influenza A(H3N2) virus was resistant to oseltamivir. A total of 1,427 influenza A viruses (99.9%) were resistant to amantadine (Table 3).
[TABLE="class: widthFull, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Virus type and subtype Oseltamivir Zanamivir Amantadine [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
# tested # resistant (%) # tested # resistant (%) # tested # resistant (%) [/TR]
[TR]
[TD="class: fontSize85, colspan: 7"][SUP]*[/SUP] NA - not applicable[/TD]
[/TR]
[TR]
A (H3N2) [TD="class: alignRight"]901[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]900[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]1408[/TD]
[TD="class: alignRight"]1407 (99.9%)[/TD]
[/TR]
[TR]
A (H1N1) [TD="class: alignRight"]18[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]18[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]20[/TD]
[TD="class: alignRight"]20 (100%)[/TD]
[/TR]
[TR]
B [TD="class: alignRight"]642[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]641[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]NA [SUP]*[/SUP][/TD]
[TD="class: alignRight"]NA [SUP]*[/SUP][/TD]
[/TR]
[TR]
TOTAL [TD="class: alignRight"]1561[/TD]
[TD="class: alignRight"]1[/TD]
[TD="class: alignRight"]1559[/TD]
[TD="class: alignRight"]0[/TD]
[TD="class: alignRight"]1428[/TD]
[TD="class: alignRight"]1427[/TD]
[/TR]
[/TABLE]
[h=2]Influenza Strain Characterizations[/h] During the 2014-2015 influenza season, the National Microbiology Laboratory (NML) has characterized 961 influenza viruses [198 A(H3N2), 21 A(H1N1) and 742 influenza B].
Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assay (n=198), one virus was antigenically similar to A/Texas/50/2012, five showed reduced titers to A/Texas/50/2012 and 192 were antigenically similar to A/Switzerland/9715293/2013, which is the influenza A(H3N2) component recommended for the 2015 Southern Hemisphere influenza vaccine. Additionally, 1,160 A(H3N2) viruses were unable to be tested by HI assay; however, sequence analysis showed that 1,158 belonged to a genetic group that typically shows reduced titers to A/Texas/50/2012. Influenza A(H1N1): Twenty-one A(H1N1) viruses characterized were antigenically similar to A/California/7/2009. Influenza B: Of the 742 influenza B viruses characterized, 683 viruses were antigenically similar to B/Massachusetts/2/2012, three viruses showed reduced titers against B/Massachusetts/2/2012, and 56 were B/Brisbane/60/2008-like (Figure 4).
Figure 4. Influenza strain characterizations, Canada, 2014-2015, N = 961​
2015-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 byWHO.
The recommended components for the 2014-2015 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an A/Texas/50/2012 (H3N2)-like virus, and a B/Massachusetts/2/2012-like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus is recommended.


Text equivalent for figure 4Influenza strain characterizations, Canada, 2014-2015, N =3
[h=2]Influenza-like Illness (ILI) Consultation Rate[/h] In week 20, the national influenza-like-illness (ILI) consultation rate decreased from the previous week to 16.1 consultations per 1,000 (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, 2014-2015​
2015-w20-fg5-eng.gif
​
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. 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, 2014-2015
[h=2]Influenza Outbreak Surveillance[/h] In week 20, four new outbreaks of influenza were reported. Two outbreaks were reported in long-term care facilities (LTCF) and two in institutional or community settings (Figure 6). To date this season, 1,275 outbreaks in LTCFs have been reported and the majority of those with known subtypes were attributable to A(H3N2). There have been a higher number of reported influenza outbreaks to date this season compared to the same period in previous seasons.
Figure 6. Overall number of new laboratory-confirmed influenza outbreaks by report week, Canada, 2014-2015
2015-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, 2014-2015
[h=2]Pharmacy Surveillance[/h] Pharmacy surveillance for sales of influenza antivirals has ended for the 2014-2015 influenza season (Figure 7).
Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2014-15​
2015-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 2,500 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, 2014-15
[h=2]Sentinel Hospital Influenza Surveillance[/h] Paediatric Influenza Hospitalizations and Deaths (IMPACT)
In week 20, nine laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network. All cases were influenza B (Figure 8a). A greater proportion of cases have been reported with influenza B in recent weeks, following the trend in laboratory detections. Among the reported cases, two (22%) were <2 years of age, three (33%) were 2 to 9 years of age and four (44%) were 10 to 16 years of age. One ICU admission was reported.
To date this season, 697 hospitalizations have been reported by the IMPACT network, 510 (73%) of which were cases of influenza A. Among cases for which the influenza A subtype was reported, 98% (162/165) were A(H3N2) (Table 4). To date, 88 cases were admitted to the ICU, of which 48 (55%) were 2 to 9 years of age (Figure 9a). A total of 55 ICU cases reported to have at least one underlying condition or comorbidity. Five 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)
Surveillance has ended for the 2014-2015 influenza season.
This season, 2,228 cases have been reported; 1,912 (86%) with influenza A. The majority of cases (81%) were among adults ≥65 years of age (Table 5). One hundred and seventy two ICU admissions have been reported and 128 cases were adults ≥65 years of age. Among the 172 ICU admissions, 27 were due to influenza B (12 in adults 45 to 64 years of age and 15 in adults over the age of 65). A total of 123 ICU cases (72%) reported to have at least one underlying condition or comorbidity. Of the 123 ICU cases with known immunization status, 40 (33%) reported not having been vaccinated this season. One hundred and thirty-five deaths have been reported, 124 (92%) of the deaths were adults >65 years of age (Figure 9B).
Note: 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 marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (Aug. 24, 2014 to May 23, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) Total # (%) [/TR]
[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]
[TR]
0-5m [TD="class: alignCenter"]82[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]19[/TD]
[TD="class: alignCenter"]63[/TD]
[TD="class: alignCenter"]14[/TD]
[TD="class: alignCenter"]96 (13.8%)[/TD]
[/TR]
[TR]
6-23m [TD="class: alignCenter"]114[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]36[/TD]
[TD="class: alignCenter"]76[/TD]
[TD="class: alignCenter"]40[/TD]
[TD="class: alignCenter"]154 (22.1%)[/TD]
[/TR]
[TR]
2-4y [TD="class: alignCenter"]124[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]38[/TD]
[TD="class: alignCenter"]85[/TD]
[TD="class: alignCenter"]49[/TD]
[TD="class: alignCenter"]173 (24.8%)[/TD]
[/TR]
[TR]
5-9y [TD="class: alignCenter"]129[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]44[/TD]
[TD="class: alignCenter"]85[/TD]
[TD="class: alignCenter"]51[/TD]
[TD="class: alignCenter"]180 (25.8%)[/TD]
[/TR]
[TR]
10-16y [TD="class: alignCenter"]61[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]25[/TD]
[TD="class: alignCenter"]36[/TD]
[TD="class: alignCenter"]33[/TD]
[TD="class: alignCenter"]94 (13.5%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]510[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]3[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]162[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]345[/TD]
[TD="class: alignCenter"]187[/TD]
[TD="class: alignCenter"]697[/TD]
[/TR]
[TR]
% [SUP]1[/SUP] [TD="class: alignCenter"]73.2%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.6%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]31.8%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]67.6%[/TD]
[TD="class: alignCenter"]26.8%[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[/TABLE]
[TABLE="class: widthFull marginBottom30px, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 5 - Cumulative numbers of adult hospitalizations with influenza reported by the PCIRN-SOS network, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (November 15, 2014 to May 23, 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A(UnS) Total # (%) [/TR]
[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]
[TR]
16-20 [TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]2[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]4 (%)[/TD]
[/TR]
[TR]
20-44 [TD="class: alignCenter"]106[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]56[/TD]
[TD="class: alignCenter"]49[/TD]
[TD="class: alignCenter"]16[/TD]
[TD="class: alignCenter"]122 (5%)[/TD]
[/TR]
[TR]
45-64 [TD="class: alignCenter"]217[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]99[/TD]
[TD="class: alignCenter"]115[/TD]
[TD="class: alignCenter"]76[/TD]
[TD="class: alignCenter"]293 (13%)[/TD]
[/TR]
[TR]
65+ [TD="class: alignCenter"]1586[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]760[/TD]
[TD="class: alignCenter"]822[/TD]
[TD="class: alignCenter"]223[/TD]
[TD="class: alignCenter"]1809 (81%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]1912[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]8[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]916[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]988[/TD]
[TD="class: alignCenter"]316[/TD]
[TD="class: alignCenter"]2228[/TD]
[/TR]
[TR]
% [SUP]1[/SUP] [TD="class: alignCenter"]86%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]48%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]52%[/TD]
[TD="class: alignCenter"]14%[/TD]
[TD="class: alignCenter"]100%[/TD]
[/TR]
[/TABLE]
Figure 8 - Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2015-w20-fg8a-eng.gif

Text equivalent for figure 8aNumber of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2015-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, 2014-15: Adult hospitalizations (>16 year of age, PCIRN-SOS)
Figure 9 - Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15
A) Paediatric hospitalizations (≤16 years of age, IMPACT)
2015-w20-fg9a-eng.gif
Text equivalent for figure 9aPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15: Paediatric hospitalizations (≤16 years of age, IMPACT)
B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)
2015-w20-fg9b-eng.gif

Text equivalent for figure 9bPercentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15: Adult hospitalizations (≥16 year of age, PCIRN-SOS)
[h=2]Provincial/Territorial Influenza Hospitalizations and Deaths[/h] In week 20, 38 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territories*. Of the 38 hospitalizations, 25 (66%) were due to influenza A and 22 (58%) were in patients ≥65 years of age.
Since the start of the 2014-15 season, 7,602 hospitalizations have been reported; 6,565 (86%) with influenza A. Among cases for which the subtype of influenza A was reported, 99.1% were A(H3N2). The majority of cases (70%) were ≥65 years of age (Table 6). A total of 391 ICU admissions have been reported to date: 52% (n=203) were in adults ≥65 years of age and 75% were due to influenza A. A total of 579 deaths have been reported since the start of the season: three children <5 years of age, four children 5-19 years, 43 adults 20-64 years, and 529 adults ≥65 years of age. Influenza A has been reported in 91% of deaths. Adults 65 years of age or older represent 91% of all deaths reported this season. 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, and QC. Only hospitalizations that require intensive medical care are reported by Saskatchewan. ICU admissions are not distinguished among hospital admissions reported from Ontario. Data may also include cases reported by the IMPACT and PCIRN networks. The number of new influenza-associated hospitalizations and deaths reported for the current week may include cases from Ontario that occurred in previous weeks, as a result of retrospective updates to the cumulative total. It is important to note that the hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting.
[TABLE="class: widthFull, border: 1, cellpadding: 2, cellspacing: 0, width: 746"]
Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2014-15 [TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Age groups Cumulative (24 August 2014 to 23 May 2015) [/TR]
[TR="class: bg-colour-yellow, bgcolor: #F9F6D0"]
Influenza A B Influenza A and B [/TR]
[TR="class: bg-colour-grey-light, bgcolor: #ECECEC"]
A Total A(H1) pdm09 A(H3) A (UnS) Total # (%) [/TR]
[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]
[TR]
0-4 years [TD="class: alignCenter"]426[/TD]
[TD="class: alignCenter"]6[/TD]
[TD="class: alignCenter"]150[/TD]
[TD="class: alignCenter"]270[/TD]
[TD="class: alignCenter"]85[/TD]
[TD="class: alignCenter"]511 (7%)[/TD]
[/TR]
[TR]
5-19 years [TD="class: alignCenter"]258[/TD]
[TD="class: alignCenter"]0[/TD]
[TD="class: alignCenter"]120[/TD]
[TD="class: alignCenter"]138[/TD]
[TD="class: alignCenter"]93[/TD]
[TD="class: alignCenter"]351 (5%)[/TD]
[/TR]
[TR]
20-44 years [TD="class: alignCenter"]322[/TD]
[TD="class: alignCenter"]4[/TD]
[TD="class: alignCenter"]169[/TD]
[TD="class: alignCenter"]149[/TD]
[TD="class: alignCenter"]80[/TD]
[TD="class: alignCenter"]402 (5%)[/TD]
[/TR]
[TR]
45-64 years [TD="class: alignCenter"]720[/TD]
[TD="class: alignCenter"]12[/TD]
[TD="class: alignCenter"]354[/TD]
[TD="class: alignCenter"]354[/TD]
[TD="class: alignCenter"]203[/TD]
[TD="class: alignCenter"]923 (12%)[/TD]
[/TR]
[TR]
65+ years [TD="class: alignCenter"]4783[/TD]
[TD="class: alignCenter"]5[/TD]
[TD="class: alignCenter"]2291[/TD]
[TD="class: alignCenter"]2487[/TD]
[TD="class: alignCenter"]554[/TD]
[TD="class: alignCenter"]5337 (70%)[/TD]
[/TR]
[TR]
Unknown [TD="class: alignCenter"]56[/TD]
[TD="class: alignCenter"]1[/TD]
[TD="class: alignCenter"]52[/TD]
[TD="class: alignCenter"]3[/TD]
[TD="class: alignCenter"]22[/TD]
[TD="class: alignCenter"]78 (1%)[/TD]
[/TR]
[TR]
Total [TD="class: alignCenter"]6565[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]28[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]3136[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]3401[/TD]
[TD="class: alignCenter"]1037[/TD]
[TD="class: alignCenter"]7602[/TD]
[/TR]
[TR]
Percentage [SUP]1[/SUP] [TD="class: alignCenter"]86.4%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]0.4%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]47.8%[/TD]
[TD="class: alignCenter bg-colour-blue, bgcolor: #D7D7FF"]51.8%[/TD]
[TD="class: alignCenter"]13.6%[/TD]
[TD="class: alignCenter"]100.0%[/TD]
[/TR]
[/TABLE]
See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2014-15 on the Public Health Agency of Canada website.
.../

http://www.phac-aspc.gc.ca/fluwatch/14-15/w20_15/index-eng.php
 
You must log in or register to reply here.
Back
Top