FluWatch report: January 4 to January 10, 2015 (Week 1)

Overall summary

  • In week 1, seven of the thirteen provinces and territories reported widespread activity within their jurisdictions- the highest levels reported to date.
  • Similar to the previous week, there were a large number of newly-reported laboratory-confirmed outbreaks of influenza: 195 outbreaks in 9 provinces, of which 152 were in long-term care facilities (LTCF). This is record number of LTCF outbreaks reported over the last five influenza seasons.
  • The percent positive for laboratory detections of influenza decreased in week 01 in Canada - suggesting that the seasonal influenza has peaked.
  • Overall in week 01, many indicators such as laboratory detections, prescriptions for antiviral medications, paediatric hospitalizations and ILI consultations rate have decreased.
  • To date, the NML has found that the majority of A(H3N2) influenza specimens are not optimally matched to the vaccine strain. This may result in reduced vaccine effectiveness against the A(H3N2) virus. However, the vaccine can still provide some protection against A(H3N2) influenza illness and can offer protection against other influenza strains such as A(H1N1) and B

Download the alternative format
(PDF format, 796 KB, 10 pages)

Organization: Public Health Agency of Canada

Date published: 2015-01-16

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

On this page

Influenza/ILI Activity (geographic spread)

In week 01, 22 regions reported widespread activity: in BC(3), AB(5), SK, MB(2), ON(5), QC(3), NF(3). The same five regions in Alberta have reported widespread activity for the past 3 weeks. Thirteen regions reported localized activity: in SK, MB(3), ON, QC(3), NB(4) and PE and eight regions reported sporadic activity: in BC(2), SK, ON, NB(2), NF and NWT.

Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 01

Figure 1
Figure 1 Legend

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 Flu Activity website.

   Figure 1 Map of overall influenza/ILI activity level by province and territory, Canada, Week 1 - Text Description

In week 01, 22 regions reported widespread activity: in BC(3), AB(5), SK, MB(2), ON(5), QC(3), NF(3). The same five regions in Alberta have reported widespread activity for the past 3 weeks. Thirteen regions reported localized activity: in SK, MB(3), ON, QC(3), NB(4) and PE and eight regions reported sporadic activity: in BC(2), SK, ON, NB(2), NF and NWT.

Influenza and Other Respiratory Virus Detections

The number of positive tests decreased from 5,313 in week 53 to 4,579 in week 01. The percentage of positive influenza tests also decreased from 34.4% to 28.5% (Figure 2). This may be an indication that we have reached the peak in laboratory detections with the percent positive for influenza peaking in week 52 (35%) and the number of positive influenza tests peaking in week 53 (5,313). To date, 98% of influenza detections have been influenza A, and 99.8% of those subtyped have been A(H3) (Table 1). The timing of the season and predominant A(H3N2) subtype is similar to the pattern observed during the 2012-13 influenza season when percent positive for influenza peaked in week 52 (35%). To date, among the cases of influenza with reported age, the largest proportion was in adults ≥65 years of age (63%) (Table 2).

Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2014-15

Figure 2
   Figure 2 Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2014-15 - Text Description

The number of positive tests decreased from 5,313 in week 53 to 4,579 in week 01. The percentage of positive influenza tests also decreased from 34.4% to 28.5%.

In week 01, the number of positive RSV tests increased to 1,001 RSV detections up from 979 RSV detections in week 53. RSV remains the second most frequently detected virus after influenza. Detections of RSV since week 38 have been higher than in the previous season while detections of parainfluenza and adenovirus continue to follow their seasonal patterns of broad winter circulation (figure 3).

For more details, see the weekly Respiratory Virus Detections in Canada Report.

Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2014-15

Figure 3RSV: Respiratory syncytial virus; hMPV: Human metapneumovirus
   Figure 3 Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2014-15 - Text Description

The number of positive tests decreased from 5,313 in week 53 to 4,579 in week 01. The percentage of positive influenza tests also decreased from 34.4% to 28.5%.

Table 1: Weekly and cumulative numbers of positive influenza specimens by type, subtype and province, Canada, 2014-15
Reporting provincesFootnote 1 Weekly (January 4 to January 10, 2015) Cumulative (August 24, 2014 to January 10, 2015)
Influenza A B Influenza A B
A Total A(H1)pdm09 A(H3) A Footnote (Uns) B Total A Total A(H1)pdm09 A(H3) A(UnS) B Total
BC 807 0 264 543 12 1699 2 726 971 39
AB 394 0 257 137 0 32 3517 2 3279 236
SK 104 0 0 104 0 898 0 0 898 5
MB 267 0 41 226 7 617 0 186 431 12
ON 1216 0 305 911 11 4622 5 1906 2711 59
QC 1332 0 0 1332 66 8301 3 422 7876 245
NB 37 0 0 37 0 70 0 5 65 2
NS 25 0 12 13 2 72 0 29 43 9
PE 8 0 8 0 0 23 1 20 2 1
NL 130 0 0 130 0 342 0 53 289 2
Canada 4320 0 887 3433 130 20161 13 6626 13522 526
Percentage Footnote 2 97.1% 0.0% 20.5% 79.5% 2.9% 97.5% 0.1% 32.9% 67.1% 2.5%
Table 2. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reportingFootnote 1,Footnote 3, Canada, 2014-15
Age groups (years) Weekly January 4 to January 10, 2015 Cumulative (August 24, 2014 to January 10, 2015)
Influenza A B Influenza A B Influenza A and B
A Total A(H1) pdm09 A(H3) A Footnote (Uns) Total A Total A(H1) pdm09 A(H3) A (UnS) Total # %
<5 126 0 17 109 10 1210 4 520 686 55 1265 6.8%
5-19 81 0 13 68 8 1085 0 622 463 62 1147 6.1%
20-44 256 0 35 221 15 2127 1 870 1256 77 2204 11.8%
45-64 325 0 36 289 28 2229 1 759 1469 99 2328 12.5%
65+ 1800 0 240 1560 43 11525 4 3561 7960 194 11719 62.7%
Unknown 3 0 1 2 1 30 0 18 12 1 31 0.2%
Total 2591 0 342 2249 105 18206 10 6350 11846 488 18694 100.0%
PercentageFootnote 2, 96.1% 0.0% 13.2% 86.8% 3.9% 97.4% 0.1% 34.9% 65.1% 2.6%    

Antiviral Resistance

During the 2014-2015 influenza season, NML has tested 235 influenza viruses for resistance to oseltamivir and 233influenza viruses for resistance to zanamivir and all were sensitive to both agents. A total of 339 (99.7%) of influenza A viruses tested for amantadine resistance were resistant (Table 3).

Table 3. Antiviral resistance by influenza virus type and subtype, Canada, 2014-15
Virus type and subtype Oseltamivir Zanamivir Amantadine
# tested # resistant (%) # tested # resistant (%) # tested # resistant (%)
A (H3N2) 206 0 204 0 338 337 (99.7%)
A (H1N1) 2 0 2 0 2 2 (100%)
B 27 0 27 0 NATable 3 - Footnote * NA Table 3 - Footnote *
TOTAL 235 0 235 0 340 339

Influenza Strain Characterizations

During the 2014-2015 influenza season, the National Microbiology Laboratory (NML) has characterized 89 influenza viruses [55 A(H3N2), 2 A(H1N1) and 32 influenza B]. The majority of circulating influenza B and A(H1N1) viruses have been antigenically similar (good match) to the recommended strains for the 2014-15 seasonal influenza vaccine, while the majority of A(H3N2) viruses have shown evidence of an antigenic drift (sub-optimal match) from the vaccine strain.

Influenza A (H3N2): When tested by hemagglutination inhibition (HI) assay (n=55), one virus was antigenically similar to A/Texas/50/2012, five showed reduced titers to A/Texas/50/2012 and 49 were antigenically similar to A/Switzerland/9715293/2013, which is the influenza A(H3N2) component recommended for the 2015 Southern Hemisphere influenza vaccine. Additionally, 250 A(H3N2) viruses were unable to be tested by HI assay; however, sequence analysis showed that 249 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 32 influenza B viruses characterized, 29 viruses were antigenically similar to B/Massachusetts/2/2012, and three viruses showed reduced titers (Figure 4).

Figure 4. Influenza strain characterizations, Canada, 2014-2015, N = 89

Figure 4

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.

   Figure 4 Influenza strain characterizations, Canada, 2014-2015, N = 89 - Text Description
Strain Number of specimens Percentage
A/Texas/50/2012-like 1 1%
reduced titres to A/Texas/50/2012 5 6%
A/California/07/2009-like 2 2%
A/Switzerland/97 15293/2013-like 49 55%
B/Massachusetts/2/2012-like 29 33%
reduced titres to B/Massachusetts/2/2012 3 3%
B/Brisbane/60/2008-like 0 0%

Influenza-like Illness (ILI) Consultation Rate

The national influenza-like-illness (ILI) consultation decreased in week 01 to 50.1 consultations per 1,000, which is above expected levels for week 01 (Figure 5). The rates were highest among the 0 to 4 years of age group (269.8 consultations per 1,000) and lowest among the adults ≥65 years of age (12.0 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

Figure 5

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.

   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, 2015-16 - Text Description

The national influenza-like-illness (ILI) consultation decreased in week 01 to 50.1 consultations per 1,000, which is above expected levels for week 01.

Influenza Outbreak Surveillance

In week 01, 195 new outbreaks of influenza were reported: 152 in long-term care facilities (LTCF), 12 in hospitals and 31 in institutional or community settings  (Figure 6). Among the outbreaks in which the influenza subtype was known, two LTCF outbreaks and four institutional or community setting outbreaks were associated with A(H3N2). To date this season, 623 outbreaks in LTCFs have been reported. The number of outbreaks reported since week 47 is above those of previous seasons and is similar to the numbers reported during the 2012-13 influenza season when influenza A(H3N2) also predominated. The majority of the outbreaks with known subtypes are attributable to A(H3N2).

Figure 6: Overall number of new laboratory-confirmed influenza outbreaks by report week, Canada, 2014-2015

Figure 6

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.

   Figure 6 Overall number of new laboratory-confirmed influenza outbreaks by report week, Canada, 2015-2016 - Text Description
Report week Hospitals Long Term Care Facilities Other
35 0 0 0
36 0 0 0
37 0 0 0
38 0 1 0
39 0 5 1
40 0 0 0
41 0 2 0
42 0 3 0
43 0 2 0
44 0 1 0
45 0 2 0
46 0 3 0
47 0 16 1
48 3 17 1
49 2 32 3
50 2 57 13
51 9 94 22
52 8 114 21
53 9 122 35
1 12 152 31

Pharmacy surveillance

During week 01, the proportion of prescriptions for antivirals decreased to 918.5 antiviral prescriptions per 100,000 total prescriptions (down from 969.6 per 100,000 total prescriptions). The rate for antivirals since week 48 has been higher than the previous three seasons (Figure 7). The rate in age groups except children decreased in week 01. The antiviral prescription rate remains the highest amongst seniors at 1,552.8 per 100,000 total prescriptions.

Figure 7. Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2014-15

Figure 7

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

   Figure 7 Proportion of prescription sales for influenza antivirals by age-group and week, Canada, 2015-16 - Text Description

Proportion of antiviral prescriptions per 100,000 total prescriptions in week 53 for the current season compared to previous seasons:
2014-15: 918.5; 2013-14: 252.5; 2012-13: 286.1; 2011-12: 34.9
Proportion of antiviral prescriptions by age-group in week 53 for the 2014-15 season:
Infant: 261.0; child: 477.4; adult: 563.5; senior: 1552.8.

Sentinel Hospital Influenza Surveillance

Paediatric Influenza Hospitalizations and Deaths (IMPACT)

In week 01, 44 laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations were reported by the Immunization Monitoring Program Active (IMPACT) network: 41 cases of influenza A and one case of influenza B (Figure 8a). Among the reported cases, 21 (48%) were <2 years of age, 19 (43%) were 2 to 9 years of age and 4 (9%) were 10-16 years of age. Four cases were admitted to the ICU. To date this season, 358 hospitalizations have been reported by the IMPACT network, 337 (94%) of which were cases of influenza A. Among cases for which the influenza A subtype was reported, 98% (127/129) were A(H3N2). Children <5 years of age represented 61% of cases  (Table 4). To date, 38 cases were admitted to the ICU, of which 22 (58%) were 2 to 9 years of age (Figure 9a).

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 01, 106 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, compared to 137 in week 53. Among cases in week 01, 96 cases (91%) were in adults over the age of 65 and 105 cases (99%) had influenza A (Figure 8b). To date this season, 672 cases have been reported; 664 (99%) with influenza A. The majority of cases (85%) were among adults ≥65 years of age (Table 5). Forty ICU admissions have been reported and the majority of cases (75%) were adults ≥65 years of age, most (69%) with known underlying conditions or comorbidities. Twenty-six deaths have been reported, all but three 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 4 - Cumulative numbers of paediatric hospitalizations with influenza reported by the IMPACT network, Canada, 2014-15
Age groups Cumulative (Aug. 24, 2014 to January 10, 2015)
Influenza A B Influenza A and B
A Total A(H1) pdm09 A(H3) AFootnote (Uns) Total # (%)
0-5m 42 0 13 29 2 44 (12.3%)
6-23m 78 1 25 52 8 86 (24.0%)
2-4y 87 1 34 52 4 91 (25.4%)
5-9y 85 0 35 50 5 90 (25.1%)
10-16y 45 0 20 25 0 47 (13.1%)
Total 337 2 127 208 21 358
% Footnote 1 94.1% 0.6% 37.7% 61.7% 5.9% 100.0%
Table 5 - Cumulative numbers of adult hospitalizations with influenza reported by the PCIRN-SOS network, Canada, 2014-15
Age groups Cumulative (November 15, 2014 to January 10, 2015)
Influenza A B Influenza A and B
A Total A(H1) pdm09 A(H3) AFootnote (Uns) Total # (%)
16-20 3 0 0 3 0 3 (%)
20-44 38 0 10 28 0 38 (6%)
45-64 63 0 21 42 0 63 (9%)
65+ 560 2 131 427 8 568 (85%)
Total 664 2 162 500 8 672
% Footnote 1 99% 0% 24% 75% 1% 100%

Figure 8 - Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15

8A) Paediatric hospitalizations (≤16 years of age, IMPACT)

Figure 8A
   Figure 8A Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2015-16 - Text Description
Report week Influenza A Influenza B
35 0 0
36 0 0
37 2 0
38 1 0
39 1 0
40 1 0
41 2 0
42 1 0
43 3 1
44 4 0
45 4 0
46 9 3
47 8 1
48 15 4
49 30 2
50 43 2
51 55 1
52 65 2
53 49 1
1 41 3

Figure 8B - Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2014-15

8B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)

Figure 8BNote: Data for week 46 is based on data collected for 1 day only and do not represent the number of hospitalizations for the entire week.
   Figure 8B Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2015-16 - Text Description
Report week Influenza A Influenza B Untyped
35 n/a n/a n/a
36 n/a n/a n/a
37 n/a n/a n/a
38 n/a n/a n/a
39 n/a n/a n/a
40 n/a n/a n/a
41 n/a n/a n/a
42 n/a n/a n/a
43 n/a n/a n/a
44 n/a n/a n/a
45 n/a n/a n/a
46 3 0 0
47 10 0 0
48 34 0 0
49 40 0 0
50 78 3 0
51 101 0 1
52 137 2 0
53 90 2 0
1 105 1 0

Figure 9 - Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15

9A) Paediatric hospitalizations (≤16 years of age, IMPACT)

Figure 9a
   Figure 9A Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15 A) Paediatric hospitalizations (≤16 years of age, IMPACT) - Text Description
Age-group (years) Hospitalizations(n=358) ICU admissions(n=38)
0-5m 12.3% 0.0%
6-23m 24.0% 21.1%
2-4y 25.4% 36.8%
5-9y 25.1% 21.1%
10-16y 13.1% 21.1%

9B) Adult hospitalizations (≥16 year of age, PCIRN-SOS)

Figure 9b
   Figure 9B Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2014-15 B) Adult hospitalizations (≥16 year of age, CIRN) - Text Description
Age-group (years) Hospitalizations (n=672) ICU admissions(n=40) Deaths (n=26)
16-20 0.4% 2.5% 0.0%
20-44 5.7% 5.0% 0.0%
45-64 9.4% 17.5% 11.5%
65+ 84.5% 75.0% 88.5%

Provincial/Territorial Influenza Hospitalizations and Deaths

In week 01, 566 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territoriesFootnote * ; all but eight with influenza A, and 79% were patients ≥65 years of age. Since the start of the 2014-15 season, 2161 hospitalizations have been reported; 2121 (98%) with influenza A. Among cases for which the subtype of influenza A was reported, 99.6% (914/917) were A(H3N2). The majority of cases (69%) were ≥65 years of age (Table 6). Sixty two ICU admissions have been reported in adults ≥65 years of age with influenza A and 34 ICU admissions have been reported in adults 20-64 years. A total of 125 deaths have been reported since the start of the season: one child <5 years of age, one child 5-19 years, six adults 20-64 years, and 117 adults ≥65 years of age. Adults 65 years of age or older represent 94% of all deaths reported this season. Detailed clinical information (e.g. underlying medical conditions) is not known for these cases.

Table 6. Cumulative number of hospitalizations with influenza reported by the participating provinces and territories, Canada, 2014-15
Age groups Cumulative (24 August 2014 to 10 January 2015)
Influenza A B Influenza A and B
A Total A(H1) pdm09 A(H3) AFootnote (Uns) Total # (%)
0-4 years 175 1 74 100 3 178 (8%)
5-19 years 115 0 67 48 2 117 (5%)
20-44 years 117 1 56 60 5 122 (6%)
45-64 years 226 1 109 116 5 231 (11%)
65+ years 1471 0 591 880 24 1495 (69%)
Unknown 17 0 17 0 1 18 (1%)
Total 2121 3 914 1204 40 2161
Percentage Footnote 1 97.4% 0.3% 70.3% 29.4% 2.6% 100.0%

See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2014-15 on the Public Health Agency of Canada website.

Emerging Respiratory Pathogens

Human Avian Influenza
Influenza A(H7N9): Since the last FluWatch report, no new laboratory-confirmed case of human infection with avian influenza A(H7N9) virus have been reported by the World Health Organization. Globally to January 16, 2015, the WHO has been informed of a total of 470 laboratory-confirmed human cases with avian influenza A(H7N9) virus, including 182 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:

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 January 16, 2015, the WHO has been informed of a total of two cases of avian influenza A (H5N6) virus, including one death.

Middle East Respiratory Syndrome Coronavirus (MERS-CoV)
Since the last FluWatch report, 5 new laboratory-confirmed cases of MERS-CoV have been reported by the World Health Organization. Globally, from September 2012 to January 16, 2015, the WHO has been informed of a total of 950 laboratory-confirmed cases of infection with MERS-CoV, including 350 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).

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:

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. No new sites have been identified since December 19, 2014. Strict surveillance will continue in the area for the next 90 days and if no additional cases of avian influenza are found within this period, the zone can be considered free of avian influenza. 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.

Enterovirus D68 (EV-D68)
BCCDC reported a death associated with EV-D68 in a young child <5 years of age which occurred earlier in the fall of 2014. Additional information is provided in the following report:

Information related to enterovirus D68, as well as guidance for health professionals and advice for the public is updated regularly:

International Influenza Reports


FluWatch definitions for the 2014-2015 season

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).

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, gastrointestinal symptoms may also be present. In patients under 5 or 65 and older, fever may not be prominent.

ILI/Influenza outbreaks

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.
Note: it is recommended that ILI school outbreaks be laboratory confirmed at the beginning of influenza season as it may be the first indication of community transmission in an area.
Hospitals and residential institutions:
two or more cases of ILI within a seven-day period, including at least one laboratory confirmed case. Institutional outbreaks should be reported within 24 hours of identification. Residential institutions include but 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; i.e. closed communities.

Note that reporting of outbreaks of influenza/ILI from different types of facilities differs between jurisdictions.

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:

  1. evidence of increased ILIFootnote * and
  2. lab confirmed influenza detection(s) together with
  3. outbreaks in schools, hospitals, residential institutions and/or other types of facilities occurring in less than 50% of the influenza surveillance regionFootnote

4 = Widespread:

  1. evidence of increased ILIFootnote * and
  2. lab confirmed influenza detection(s) together with
  3. outbreaks in schools, hospitals, residential institutions and/or other types of facilities occurring in greater than or equal to 50% of the influenza surveillance regionFootnote

Note: ILI data may be reported through sentinel physicians, emergency room visits or health line telephone calls.

We would like to thank all the Fluwatch surveillance partners who are participating in this year's influenza surveillance program.

Date modified: