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FluWatch report: November 5, 2017 to November 11, 2017 (week 45) - Canada.ca

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FluWatch report: November 5, 2017 to November 11, 2017 (week 45)
Influenza activity crossed the seasonal threshold in week 45, indicating the beginning of the influenza season at the national level.
The number and percentage of laboratory tests positive for both influenza A and B is higher for this time of year compared to previous seasons. The majority of influenza detections continue to be A(H3N2) although an elevated number of influenza B detections have also been reported.
The number of influenza-related hospitalizations and regions reporting sporadic and localized activity are above the expected levels for this time of year.
For more information on the flu, see our
Flu(influenza)
web page.
On this page
Influenza/ILI Activity (geographic spread)
Laboratory Confirmed Influenza Detections
Syndromic/Influenza-like Illness Surveillance
Influenza Outbreak Surveillance
Severe Outcomes Influenza Surveillance
Influenza Strain Characterizations
Antiviral Resistance
Provincial and International Influenza Reports
FluWatch definitions for the 2017-2018 season
Influenza/Influenza-like Illness Activity (geographic spread)
In week 45, six regions in Alberta (5) and Ontario (1) reported localized activity, and 22 regions (British Columbia (4), Saskatchewan (2), Ontario (5), Quebec (5), New Brunswick (2), Nova Scotia (1), Prince Edward Island (1), Newfoundland and Labrador (1) and Yukon (1)) reported sporadic activity. Consistent with the increased number of influenza detections this season, a greater number of regions are reporting sporadic activity compared to previous seasons. In week 45, the number of regions reporting localized activity was above expected levels.
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Organization:
Public Health Agency of Canada
Date published:
2017-11-17
Flu (influenza)
Influenza surveillance
Figure 1 – Map of overall influenza/ILI activity level by province and territory, Canada, 2017-18, Week 45
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 in the mapping feature found in the
Weekly Influenza Reports
.
Figure 1 - Text Description
Figure 1 - Map of overall influenza/ILI activity level by province and territory, Canada
Influenza Surveillance Region
Activity Level
Newfoundland - Central
No Activity
Newfoundland - Eastern
Sporadic
Grenfell Labrador
No Activity
Newfoundland - Western
No Activity
Prince Edward Island
Sporadic
Nova Scotia - Central (Zone 4)
No Activity
Nova Scotia - Western (Zone 1)
No Activity
Nova Scotia - Northern (Zone 2)
No Activity
Nova Scotia - Eastern (Zone 3)
Sporadic
New Brunswick - Public Health Region 1
Sporadic
New Brunswick - Public Health Region 2
Sporadic
New Brunswick - Public Health Region 3
No Activity
New Brunswick - Public Health Region 4
No Activity
New Brunswick - Public Health Region 5
No Activity
New Brunswick - Public Health Region 6
No Activity
New Brunswick - Public Health Region 7
No Activity
Nord-est Québec
No Activity
Québec et Chaudieres-Appalaches
Sporadic
Centre-du-Québec
Sporadic
Montréal et Laval
Sporadic
Ouest-du-Québec
Sporadic
Montérégie
Sporadic
Ontario - Central East
Sporadic
Ontario - Central West
Sporadic
Ontario - Eastern
Sporadic
Ontario - North East
Localized
Ontario - North West
No Activity
Ontario - South West
Sporadic
Ontario - Toronto
Sporadic
Manitoba - Interlake-Eastern
No Data
Manitoba - Northern Regional
No Data
Manitoba - Prairie Mountain
No Data
Manitoba - South
No Data
Manitoba - Winnipeg
No Data
Saskatchewan - North
No Activity
Saskatchewan - Central
Sporadic
Saskatchewan - South
Sporadic
Alberta - North Zone
Localized
Alberta - Edmonton
Localized
Alberta - Central Zone
Localized
Alberta - Calgary
Localized
Alberta - South Zone
Localized
British Columbia - Interior
Sporadic
British Columbia - Fraser
Sporadic
British Columbia - Vancouver Coastal
Sporadic
British Columbia - Vancouver Island
Sporadic
British Columbia - Northern
No Activity
Yukon
Sporadic
Northwest Territories - North
No Activity
Northwest Territories - South
No Activity
Nunavut - Baffin
No Activity
Nunavut - Kivalliq
No Activity
Nunavut - Kitimeot
No Activity
Laboratory Confirmed Influenza Detections
In week 45, the number of both influenza A and B detections continued to increase, and the percentage of tests positive crossed the seasonal threshold of 5%. Laboratory detections of influenza have entered seasonal levels two weeks earlier than the median of the past seven seasons. The number and percentage of both influenza A and B tests positive is higher for this time of year compared to the same period during the previous seven seasons. Influenza B detections are elevated at 1% of tests positive in week 45; a level not typically reached until late January. For data on other respiratory virus detections, see the
Respiratory Virus Detections in Canada Report
.
Figure 2 – Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2017-18, weeks 35 to 45
The shaded area indicates weeks where the positivity rate was at least 5% and a minimum of 15 positive tests were observed, signalling the period of
seasonal influenza activity
.
Figure 2 - Text Description
Figure 2 - Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2017-18
Report Week
A(Unsubtyped)
A(H3)
A(H1)pdm09
Influenza B
35
4
20
6
5
36
7
28
1
3
37
7
14
13
4
38
18
31
3
5
39
18
53
1
8
40
24
41
1
5
41
32
50
0
11
42
27
73
1
15
43
44
107
3
21
44
59
113
3
31
45
63
143
7
46
<tr> <td>46</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>47</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>48</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>49</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>50</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>51</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>52</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>1</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>2</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>3</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>4</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>5</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>6</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>7</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>8</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>9</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>10</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>11</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>12</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>13</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>14</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>15</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>16</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>17</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>18</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>19</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>20</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>21</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>22</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>23</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>24</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>25</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>26</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>27</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>28</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>29</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>30</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>31</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>32</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>33</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>34</td> <td>0</td> <td>0</td> <td>0</td> <td>0</td> </tr>
To date this season, 1186 laboratory-confirmed influenza detections have been reported, of which 86% have been influenza A. Influenza A(H3N2) has been the most common subtype detected this season, representing 95% of subtyped influenza A detections. For more detailed weekly and cumulative influenza data, see the text descriptions for Figures 2 and 3 or the
Respiratory Virus Detections in Canada Report
.
Figure 3 – Cumulative numbers of positive influenza specimens by type/subtype and province/territory, Canada, 2017-18, week 45
Figure 3 - Text Description
Figure 3 - Cumulative numbers of positive influenza specimens by type/subtype and province/territory, Canada, 2017-18
Reporting
provinces
Table Figure 3 - Footnote
1
Week (November 5, 2017 to November 11, 2017)
Cumulative (August 27, 2017 to November 11, 2017)
Influenza A
B
Influenza A
B
A & B
Total
A
Total
A
(H1)pdm09
A
(H3)
A(UnS)
Table Figure 3 - Footnote
3
B
Total
A
Total
A
(H1)pdm09
A
(H3)
A(UnS)
Table Figure 3 - Footnote
3
B
Total
BC
14
0
10
4
5
164
9
134
21
24
188
AB
148
2
108
38
30
510
12
392
106
81
591
SK
2
0
0
2
1
35
0
22
13
13
48
MB
2
0
2
0
0
6
0
5
1
0
6
ON
24
5
15
4
3
125
18
72
35
15
140
QC
13
0
0
13
5
87
0
0
87
22
109
NB
7
0
5
2
0
70
0
35
35
2
72
NS
0
0
0
0
1
4
0
0
4
1
5
PE
1
0
1
0
0
7
0
7
0
0
7
NL
1
0
0
1
0
5
0
3
2
1
6
YT
1
0
0
1
0
6
0
4
2
3
9
NT
0
0
0
0
0
0
0
0
0
0
0
NU
0
0
0
0
0
4
0
4
0
1
5
Canada
213
7
141
65
45
1023
39
678
306
163
1186
Percentage
Table Figure 3 - Footnote
2
83%
3%
66%
31%
17%
86%
4%
66%
30%
14%
100%
Table Figure 3 - Footnote 1
Specimens from NT, YT, and NU are sent to reference laboratories in other provinces.
Return to Table Figure 3 - Footnote
1
referrer
Table Figure 3 - Footnote 2
Percentage of tests positive for sub-types of influenza A are a percentage of all influenza A detections.
Return to Table Figure 3 - Footnote
2
referrer
Table Figure 3 - Footnote 3
Unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available.
Return to
first
Table Figure 3 - Footnote
3
referrer
Discrepancies in values in Figures 2 and 3 may be attributable to differing data sources.
Cumulative data includes updates to previous weeks.
To date this season, detailed information on age and type/subtype has been received for 1009 laboratory-confirmed influenza cases (
Table 1
). Among all influenza cases with reported age and type/subtype information, slightly less than half of the cases have been reported in adults 65 years of age and older. This proportion was higher among cases of influenza A (50%) compared to influenza B (33%).
Table 1 - Cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reporting, Canada, 2017-18, weeks 35 to 45
Age groups (years)
Cumulative (November 5, 2017 to November 11, 2017)
Influenza A
B
Influenza A and B
A Total
A(H1) pdm09
A(H3)
A (UnS)
Table 1 Footnote
1
Total
#
%
0-4
51
9
29
13
16
67
7%
5-19
73
4
40
29
23
96
10%
20-44
150
6
96
48
23
173
17%
45-64
165
10
103
52
29
194
19%
65+
435
4
352
79
4
479
47%
Total
874
33
620
221
135
1009
100%
Table 1 Footnote 1
UnS: unsubtyped: The specimen was typed as influenza A, but no result for subtyping was available;
Return to table 1 footnote
1
referrer
Syndromic/Influenza-like Illness Surveillance
Healthcare Professionals Sentinel Syndromic Surveillance
In week 45, 1.2% of visits to healthcare professionals were due to influenza-like illness; a decrease compared to the previous week, and below the 5-year average.
Figure 4 - Percentage of visits for ILI reported by sentinels by report week, Canada, 2017-18, weeks 35 to 45
Number of Sentinels Reporting in Week 45: 115
The shaded area represents the maximum and minimum percentage of visits for ILI reported by week from seasons 2012-13 to 2017-18
Figure 4 - Text Description
Figure 4 - Percentage of visits for ILI reported by sentinels by report week, Canada, 2017-18
Report week
2017-18
Average
Min
Max
35
0.4%
0.8%
0.5%
1.2%
36
0.5%
0.8%
0.7%
1.0%
37
0.7%
0.9%
0.7%
1.0%
38
0.7%
1.1%
1.0%
1.4%
39
1.1%
1.1%
0.9%
1.4%
40
1.2%
1.3%
0.9%
1.6%
41
1.8%
1.4%
0.9%
2.4%
42
1.6%
1.4%
1.0%
1.9%
43
1.8%
1.3%
1.0%
1.5%
44
1.5%
1.3%
0.9%
1.6%
45
1.2%
1.3%
1.2%
1.5%
<tr> <td>46</td> <td>&nbsp;</td> <td>1.6%</td> <td>1.0%</td> <td>2.0%</td> </tr> <tr> <td>47</td> <td>&nbsp;</td> <td>1.5%</td> <td>1.1%</td> <td>1.9%</td> </tr> <tr> <td>48</td> <td>&nbsp;</td> <td>1.6%</td> <td>0.8%</td> <td>2.1%</td> </tr> <tr> <td>49</td> <td>&nbsp;</td> <td>1.5%</td> <td>1.0%</td> <td>2.5%</td> </tr> <tr> <td>50</td> <td>&nbsp;</td> <td>2.3%</td> <td>1.3%</td> <td>3.7%</td> </tr> <tr> <td>51</td> <td>&nbsp;</td> <td>2.5%</td> <td>1.6%</td> <td>4.1%</td> </tr> <tr> <td>52</td> <td>&nbsp;</td> <td>4.5%</td> <td>1.7%</td> <td>7.1%</td> </tr> <tr> <td>1</td> <td>&nbsp;</td> <td>3.7%</td> <td>1.7%</td> <td>5.2%</td> </tr> <tr> <td>2</td> <td>&nbsp;</td> <td>3.0%</td> <td>1.1%</td> <td>4.5%</td> </tr> <tr> <td>3</td> <td>&nbsp;</td> <td>2.5%</td> <td>1.3%</td> <td>3.6%</td> </tr> <tr> <td>4</td> <td>&nbsp;</td> <td>2.4%</td> <td>1.7%</td> <td>3.5%</td> </tr> <tr> <td>5</td> <td>&nbsp;</td> <td>2.7%</td> <td>2.0%</td> <td>4.4%</td> </tr> <tr> <td>6</td> <td>&nbsp;</td> <td>2.7%</td> <td>2.1%</td> <td>3.3%</td> </tr> <tr> <td>7</td> <td>&nbsp;</td> <td>2.4%</td> <td>1.7%</td> <td>3.0%</td> </tr> <tr> <td>8</td> <td>&nbsp;</td> <td>2.3%</td> <td>1.9%</td> <td>2.7%</td> </tr> <tr> <td>9</td> <td>&nbsp;</td> <td>2.2%</td> <td>1.8%</td> <td>2.7%</td> </tr> <tr> <td>10</td> <td>&nbsp;</td> <td>2.1%</td> <td>1.8%</td> <td>2.7%</td> </tr> <tr> <td>11</td> <td>&nbsp;</td> <td>2.1%</td> <td>1.7%</td> <td>2.7%</td> </tr> <tr> <td>12</td> <td>&nbsp;</td> <td>1.8%</td> <td>1.1%</td> <td>2.7%</td> </tr> <tr> <td>13</td> <td>&nbsp;</td> <td>1.7%</td> <td>1.2%</td> <td>2.6%</td> </tr> <tr> <td>14</td> <td>&nbsp;</td> <td>1.8%</td> <td>1.3%</td> <td>2.4%</td> </tr> <tr> <td>15</td> <td>&nbsp;</td> <td>1.6%</td> <td>0.9%</td> <td>1.9%</td> </tr> <tr> <td>16</td> <td>&nbsp;</td> <td>1.5%</td> <td>1.0%</td> <td>1.9%</td> </tr> <tr> <td>17</td> <td>&nbsp;</td> <td>1.5%</td> <td>0.9%</td> <td>2.2%</td> </tr> <tr> <td>18</td> <td>&nbsp;</td> <td>1.2%</td> <td>0.8%</td> <td>1.6%</td> </tr> <tr> <td>19</td> <td>&nbsp;</td> <td>1.3%</td> <td>1.0%</td> <td>1.7%</td> </tr> <tr> <td>20</td> <td>&nbsp;</td> <td>1.2%</td> <td>0.9%</td> <td>1.4%</td> </tr> <tr> <td>21</td> <td>&nbsp;</td> <td>0.9%</td> <td>0.3%</td> <td>1.3%</td> </tr> <tr> <td>22</td> <td>&nbsp;</td> <td>0.8%</td> <td>0.6%</td> <td>1.0%</td> </tr> <tr> <td>23</td> <td>&nbsp;</td> <td>0.9%</td> <td>0.6%</td> <td>1.2%</td> </tr> <tr> <td>24</td> <td>&nbsp;</td> <td>0.7%</td> <td>0.4%</td> <td>1.0%</td> </tr> <tr> <td>25</td> <td>&nbsp;</td> <td>1.2%</td> <td>0.5%</td> <td>1.6%</td> </tr> <tr> <td>26</td> <td>&nbsp;</td> <td>0.8%</td> <td>0.4%</td> <td>1.4%</td> </tr> <tr> <td>27</td> <td>&nbsp;</td> <td>0.8%</td> <td>0.4%</td> <td>1.5%</td> </tr> <tr> <td>28</td> <td>&nbsp;</td> <td>1.0%</td> <td>0.6%</td> <td>1.9%</td> </tr> <tr> <td>29</td> <td>&nbsp;</td> <td>0.8%</td> <td>0.5%</td> <td>1.1%</td> </tr> <tr> <td>30</td> <td>&nbsp;</td> <td>0.5%</td> <td>0.3%</td> <td>0.7%</td> </tr> <tr> <td>31</td> <td>&nbsp;</td> <td>0.9%</td> <td>0.3%</td> <td>1.4%</td> </tr> <tr> <td>32</td> <td>&nbsp;</td> <td>1.0%</td> <td>0.6%</td> <td>1.6%</td> </tr> <tr> <td>33</td> <td>&nbsp;</td> <td>1.2%</td> <td>0.4%</td> <td>2.1%</td> </tr> <tr> <td>34</td> <td>&nbsp;</td> <td>0.7%</td> <td>0.5%</td> <td>0.9%</td> </tr>
Participatory Syndromic Surveillance
FluWatchers is a participatory ILI surveillance system that relies on weekly voluntary submissions of syndromic information from Canadians across Canada.
In week 45, 1300 participants reported to FluWatchers, of which 2% reported symptoms of cough and fever in the preceding week and 29% of these consulted a healthcare professional. Among participants who reported cough and fever, 68% reported days missed from work or school, resulting in a combined total of 43 missed days.
Table 2 – Summary of influenza-like illness symptoms reported by participating Canadians, Canada, 2017-18, week 45
Number of Participants Reporting
Percentage participants reporting Cough and Fever
Percentage of participants with cough and fever who consulted a healthcare professional Facilities
Percentage of participants with cough and fever who reported missed days from work or school
Number of missed days from work or school
1300
2%
29%
68%
43
Influenza Outbreak Surveillance
In week 45, 8 new laboratory-confirmed influenza outbreaks were reported: three in hospitals, one in a long-term care facility, and four in other settings. Among the seven outbreaks with influenza type/subtype reported, all were associated with influenza A(H3N2).
To date this season, 26 influenza/ILI outbreaks have been reported, of which 9 occurred in LTC facilities. Among the 19 outbreaks for which the influenza type/subtype was reported, 15 were associated with influenza A (of which 13 were A(H3N2)), three were associated with influenza B, and one was associated with a mix of A(H3N2) and B. The number of outbreaks to date is within the expected range for this time of year.
Figure 5 - Number of new outbreaks of laboratory-confirmed influenza by report week, Canada, 2017-18, weeks 35 to 45
Figure 5 - Text Description
Figure 5 - Cumulative numbers of pediatric hospitalizations (≤16 years of age) with influenza by type and age-group reported by the IMPACT network, Canada, 2017-18
Report week
Hospitals
Long Term Care Facilities
Other
35
0
0
0
36
0
1
0
37
0
0
0
38
0
2
0
39
0
1
1
40
1
0
0
41
0
0
1
42
0
2
1
43
3
1
1
44
0
1
0
45
3
1
4
<tr> <td>46</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>47</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>48</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>49</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>50</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>51</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>52</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>1</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>2</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>3</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>4</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>5</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>6</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>7</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>8</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>9</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>10</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>11</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>12</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>13</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>14</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>15</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>16</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>17</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>18</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>19</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>20</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>21</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>22</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>23</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>24</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>25</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>26</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>27</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>28</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>29</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>30</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>31</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>32</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>33</td> <td>0</td> <td>0</td> <td>0</td> </tr> <tr> <td>34</td> <td>0</td> <td>0</td> <td>0</td> </tr>
Severe Outcomes Influenza Surveillance
Provincial/Territorial Influenza Hospitalizations and Deaths
In week 45, 25 influenza-associated hospitalizations were reported by participating provinces and territories
Footnote
1
.
To date this season, 211 influenza-associated hospitalizations have been reported, 92% of which were associated with influenza A, and 152 cases (72%) were in adults 65 years of age or older. The number of cases is considerably elevated relative to this period in the previous two seasons. Nine ICU admissions and five deaths have been reported.
Figure 6 - Cumulative numbers of hospitalizations by age-group reported by participating provinces and territories, 2017-18
Figure 6 - Text Description
Cumulative numbers of hospitalizations by age-group reported by participating provinces and territories, 2017-18
Age Group
Total
0-4 yr
10
5-19 yr
9
20-44 yr
13
45-64 yr
27
65+ yr
152
Footnote 1
Influenza-associated hospitalizations are reported by NL, PE, NS, NB, MB, AB, YT and NT. Only hospitalizations that require intensive medical care are reported by SK.
Return to footnote
1
referrer
Pediatric Influenza Hospitalizations and Deaths
In week 45, three laboratory-confirmed influenza-associated pediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network.
To date this season, 20 pediatric hospitalizations have been reported by the IMPACT network, 17 of which were associated with influenza A. Seven ICU admissions and no deaths have been reported. The number of hospitalizations reported this season has been similar compared to the same period in recent seasons in which influenza A(H3N2) was the predominant circulating subtype (2014-15, 2016-17).
Figure 7 - Cumulative numbers of pediatric hospitalizations (≤16 years of age) with influenza by type and age-group reported by the IMPACT network, Canada, 2017-18 weeks 35-45
Figure 7 - Text Description
Cumulative numbers of pediatric hospitalizations (≤16 years of age) with influenza by type and age-group reported by the IMPACT network, Canada, 2017-18
Age Group
Total
0-5 mo
<5
6-23 mo
<5
2-4 yr
<5
5-9 yr
<5
10-16 yr
7
Figure 8 - Number of pediatric hospitalizations (≤16 years of age) with influenza reported by the IMPACT network, by week, Canada, 2017-18 weeks 35-45
Figure 8 - Text Description
Figure 8 - Number of pediatric hospitalizations (≤16 years of age) with influenza reported by the IMPACT network, by week, Canada, 2017-18 weeks 35-45
Report Week
2017-2018
Average
Min
Max
35
0
0
0
0
36
1
0
0
1
37
0
0
0
2
38
1
0
0
2
39
2
1
0
3
40
0
0
0
2
41
3
1
0
2
42
1
1
0
4
43
7
1
0
3
44
1
3
1
6
45
3
3
2
4
Influenza Strain Characterizations
During the 2017-18 influenza season, the National Microbiology Laboratory (NML) has characterized 69 influenza viruses [52 A(H3N2), 6 A(H1N1)pdm09 and 11 B viruses] that were received from Canadian laboratories.
Antigenic Characterization
Among influenza viruses characterized by hemagglutination inhibition assay during the 2017-18 season, all viruses were antigenically similar to the cell-culture propagated reference strains recommended by WHO.
Table 3 - Influenza antigenic strain characterizations, Canada, 2017-18 weeks 35-45
Strain Characterization Results
Count
Description
Influenza A (H3N2)
A/Hong Kong/4801/2014-like
8
Viruses antigenically similar to A/Hong Kong/4801/2014, the A(H3N2) component of the 2017-18 Northern Hemisphere's trivalent and quadrivalent vaccine.
Influenza A (H1N1)
A/Michigan/45/2015-like
6
Viruses antigenically similar to A/Michigan/45/2015, the A(H1N1) component of the 2017-18 Northern Hemisphere's trivalent and quadrivalent influenza vaccine.
Influenza B
B/Brisbane/60/2008-like
(Victoria lineage)
2
Viruses antigenically similar to B/Brisbane/60/2008, the influenza B component of the 2017-18 Northern Hemisphere’s trivalent and quadrivalent influenza vaccine.
B/Phuket/3073/2013-like
(Yamagata lineage)
9
Viruses antigenically similar to B/Phuket/3073/2013, the additional influenza B component of the 2017-18 Northern Hemisphere quadrivalent influenza vaccine.
Genetic Characterization of A(H3N2) viruses
During the 2017-18 season, 44 A(H3N2) viruses did not grow to sufficient titers for antigenic characterization by HI assay. Therefore, genetic characterization was performed to determine to which genetic group they belong. Sequence analysis showed that 32 H3N2 viruses belonged to genetic group 3C.2a and 12 viruses belonged to subclade 3C.2a1.
Additionally, of the eight influenza A(H3N2) viruses that were characterized antigenically as similar to A/Hong Kong/4801/2014, six belonged to genetic group 3C.2a and two viruses belonged to subclade 3C.2a1.
A/Hong Kong/4801/2014-like virus belongs to genetic group 3C.2a and is the influenza A/H3N2 component of the 2017-18 Northern Hemisphere influenza vaccine.
Antiviral Resistance
During the 2017-18 season, the National Microbiology Laboratory (NML) has tested 83 influenza viruses for resistance to oseltamivir and zanamivir, and all viruses were sensitive (
Table 4
).
Table 4 - Antiviral resistance by influenza virus type and subtype, Canada, 2017-18 weeks 35-45
Virus type and subtype
Oseltamivir
Zanamivir
# tested
# resistant (%)
# tested
# resistant (%)
A (H3N2)
66
0 (0%)
66
0 (0%)
A (H1N1)
6
0 (0%)
6
0 (0%)
B
11
0 (0%)
11
0 (0%)
TOTAL
83
0 (0%)
83
0 (0%)
Note: Since the 2009 pandemic, all circulating influenza A viruses have been resistant to amantadine, and it is therefore not currently recommended for use in the treatment of influenza. During the 2017-18 season, the subset of influenza A viruses that were tested for resistance to amantadine were resistant.
Provincial and International Influenza Reports
World Health Organization influenza update
World Health Organization FluNet
WHO Influenza at the human-animal interface
Centers for Disease Control and Prevention seasonal influenza report
European Centre for Disease Prevention and Control - epidemiological data
South Africa Influenza surveillance report
New Zealand Public Health Surveillance
Australia Influenza Report
Pan-American Health Organization Influenza Situation Report
Alberta Health - Influenza Surveillance Report
BC - Centre for Disease Control (BCCDC) - Influenza Surveillance
New Brunswick - Influenza Surveillance Reports
Newfoundland and Labrador - Surveillance and Disease Reports
Nova Scotia - Flu Information
Public Health Ontario - Ontario Respiratory Pathogen Bulletin
Quebec - Système de surveillance de la grippe
Manitoba - Epidemiology and Surveillance - Influenza Reports
Saskatchewan - influenza Reports
PEI - Influenza Summary
FluWatch definitions for the 2017-2018 season
The FluWatch report is compiled from a number of data sources. Surveillance information contained in this report is a reflection of the surveillance data available to FluWatch at the time of production. Delays in reporting of data may cause data to change retrospectively
Influenza/Influenza-like Illness (ILI) Activity
Influenza/ILI activity levels, as represented on the map, are assigned and reported by Provincial and Territorial Ministries of Health, based on laboratory confirmations, primary care consultations for ILI and reported outbreaks. ILI data may be reported through sentinel physicians, emergency room visits or health line telephone calls, and the detemination of an increase is based on the assessment of the provincial/territorial epidemiologist. Maps from previous weeks, including any retrospective updates, are available in the mapping feature found in the
Weekly Influenza Reports
.
Influenza/ILI activity level
1 = No activity:
no laboratory-confirmed influenza detections in the reporting week, however, sporadically occurring ILI may be reported
2 = Sporadic:
sporadically occurring ILI and lab confirmed influenza detection(s) with
no outbreaks
detected within the influenza surveillance region
Footnote
3 = Localized:
evidence of increased ILI
Footnote
*
and
lab confirmed influenza detection(s) together with
outbreaks
in schools, hospitals, residential institutions and/or other types of facilities occurring in
less than 50% of the influenza surveillance region
Footnote
4 = Widespread:
evidence of increased ILI
Footnote
*
and
lab confirmed influenza detection(s) together with
outbreaks
in schools, hospitals, residential institutions and/or other types of facilities occurring
in greater than or equal to 50% of the influenza surveillance region
Footnote
Footnote *
More than just sporadic as determined by the provincial/territorial epidemiologist.
Return to footnote
*
referrer
Footnote †
Influenza surveillance regions within the province or territory as defined by the provincial/territorial epidemiologist.
Return to footnote
referrer
Laboratory-Confirmed Influenza Detections
Provincial, regional and some hospital laboratories report the weekly number of tests and detections of influenza and other respiratory viruses. Provincial public health laboratories submit demographic information for cases of influenza. This case-level data represents a subset of influenza detections reported through aggregate reporting. Specimens from NT, YT, and NU are sent to reference laboratories in the provinces for testing. Cumulative data includes updates to previous weeks. Discrepancies in values in Figures 2 and 3 may be attributable to differing data sources.
Syndromic/Influenza-like Illness Surveillance
FluWatch maintains a network of primary care practitioners who report the weekly proportion of ILI cases seen in their practice. Independent sentinel networks in BC, AB, and SK compile their data for reporting to FluWatch. Not all sentinel physicians report every week.
Definition of Influenza-like-illness (ILI):
Acute onset of respiratory illness with fever and cough and with one or more of the following - sore throat, arthralgia, myalgia, or prostration which is likely due to influenza. In children under 5 years of age, gastrointestinal symptoms may also be present. In patients under 5 or 65 years and older, fever may not be prominent.
Influenza Outbreak Surveillance
Outbreaks of influenza or ILI are reported from all provinces and territories, according to the definitions below. However, reporting of outbreaks of influenza/ILI from different types of facilities differs between jurisdictions. All provinces and territories with the exception of NU report influenza outbreaks in long-term care facilities. All provinces and territories with the exception of NU and QC report outbreaks in hospitals.
Outbreak definitions:
Schools:
Greater than 10% absenteeism (or absenteeism that is higher (e.g. >5-10%) than expected level as determined by school or public health authority) which is likely due to ILI.
Hospitals and residential institutions:
two or more cases of ILI within a seven-day period, including at least one laboratory-confirmed case of influenza. Residential institutions include but are not limited to long-term care facilities (LTCF) and prisons.
Workplace:
Greater than 10% absenteeism on any day which is most likely due to ILI.
Other settings:
two or more cases of ILI within a seven-day period, including at least one laboratory-confirmed case of influenza; i.e. closed communities.
Serious Outcome Influenza Surveillance
Provincial/Territorial Influenza Hospitalizations and Deaths
Influenza-associated hospitalizations and deaths are reported by 8 Provincial and Territorial Ministries of Health (excluding BC, NU, ON and QC). The hospitalization or death does not have to be attributable to influenza, a positive laboratory test is sufficient for reporting. Only hospitalizations that require intensive medical care are reported by SK.
Due to changes in participating provinces and territories, comparisons to previous years should be done with caution.
Pediatric Influenza Hospitalizations and Deaths
The Immunization Monitoring Program Active (IMPACT) network reports the weekly number of hospitalizations with influenza among children admitted to one of the 12 participating paediatric hospitals in 8 provinces. These represent a subset of all influenza-associated pediatric hospitalizations in Canada.
Influenza Strain Characterizations and Antiviral Resistance
Provincial public health laboratories send a subset of influenza virus isolates to the National Microbiology Laboratory for strain characterization and antiviral resistance. These represent a subset of all influenza detections in Canada and the proportion of isolates of each type and subtype is not necessarily representative of circulating viruses.
Antigenic strain characterization data reflect the results of hemagglutination inhibition (HI) testing compared to the reference influenza strains recommended by
WHO
. Genetic strain characterization data are based on analysis of the sequence of the viral hemagglutinin (HA) gene.
Antiviral resistance testing is conducted by phenotypic and genotypic methods on influenza virus isolates submitted to the National Microbiology Laboratory. All isolates are tested for oseltamivir and zanamivir and a subset are tested for resistance to amantadine.
Abbreviations:
Newfoundland/Labrador (NL), Prince Edward Island (PE), New Brunswick (NB), Nova Scotia (NS), Quebec (QC), Ontario (ON), Manitoba (MB), Saskatchewan (SK), Alberta (AB), British Columbia (BC), Yukon (YT), Northwest Territories (NT), Nunavut (NU).
This
report
is available on the Government of Canada Influenza webpage.
Ce
rapport
est disponible dans les deux langues officielles.
We would like to thank all the Fluwatch surveillance partners who are participating in this year's influenza surveillance program.
Page details
Date modified:
2017-11-28