FluWatch report: October 18 to October 24, 2015 (week 42)

Overall Summary

  • Overall, there is low influenza activity in Canada.
  • Influenza activity and detections decreased from the previous week.
  • No laboratory confirmed outbreaks have been reported in the last two weeks.
  • So far this season, influenza A(H3N2) has been the most common subtype affecting Canadians.
  • To date, the majority of influenza laboratory detections and hospitalizations have been in seniors greater than 65 years of age.
  • For more information on the flu, see our Flu (influenza) web page.

Are you a primary health care practitioner (General Practitioner, Nurse Practitioner or Registered Nurse) interested in becoming a FluWatch sentinel for the 2015-16 influenza season? Contact us at FluWatch@phac-aspc.gc.ca

On this page

Influenza/Influenza-like Illness Activity (geographic spread)

In week 42, sporadic influenza activity were reported in a few regions across Canada. One region in Ontario reported localized activity. The number of regions reporting influenza activity decreased from the previous week,from 12 regions reporting influenza activity in week 41 to 10 regions reporting influenza activity in week 42. Overall, the majority of regions in Canada reported no influenza activity.

Download the alternative format
(PDF format, 753 KB, 7 pages)

Organization:
Date published: 2015-10-30

Figure 1. Map of overall influenza/ILI activity level by province and territory, Canada, Week 42

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 - Text Description
In week 42, sporadic influenza activity was reported in a few regions across Canada. One region in Ontario reported localized activity.

Laboratory Confirmed Influenza Detections

In week 42, the percent positive for influenza detections remained low at 0.85%. The percent positive reported this week is lower than the percent positive reported the same week last season (1.96%). Since week 39, the percent positive for influenza detections have been decreasing (Figure 2).

Figure 2. Number of positive influenza tests and percentage of tests positive, by type, subtype and report week, Canada, 2015-16

Figure 2
Figure 2 - Text Description

In week 42, the percent positive for influenza detections remained low at 0.85%.

In week 42, the majority of detections in Canada have been reported from BC and ON, accounting for 75% of the influenza detections in Canada. A total of six jurisdictions have not reported any influenza cases. To date, 92% of influenza detections have been influenza A and the majority of those subtyped have been A(H3).

Figure 3. Cumulative numbers of positive influenza specimens by type/subtype and province, Canada, 2015-16

Figure 3

Note: Specimens from NT, YT, and NU are sent to reference laboratories in other provinces. Cumulative data includes updates to previous weeks.

Figure 3 - Text Description
Reporting provincesTable Figure 3 - Footnote 1 Weekly (October 18 to October 24, 2015) Cumulative (August 30, 2015 to October 24, 2015)
Influenza A B Influenza A B A & B Total
A Total A(H1)pdm09 A(H3) A Table Figure 3 - Footnote UnS B Total A Total A(H1)pdm09 A(H3) ATable Figure 3 - Footnote UnS B Total
BC 9 0 8 1 1 95 1 68 26 4 99
AB 3 0 1 2 0 34 4 26 4 5 39
SK 0 0 0 0 0 0 0 0 0 0 0
MB 0 0 0 0 0 1 0 0 1 1 2
ON 7 0 3 4 1 72 14 36 22 8 80
QC 2 0 0 2 0 15 0 0 15 1 16
NB 0 0 0 0 0 0 0 0 0 0 0
NS 0 0 0 0 0 2 0 1 1 0 2
PE 0 0 0 0 0 0 0 0 0 0 0
NL 0 0 0 0 1 2 0 2 0 1 3
YT 0 0 0 0 0 0 0 0 0 0 0
NT 0 0 0 0 0 0 0 0 0 0 0
NU 0 0 0 0 0 0 0 0 0 0 0
Canada 21 0 12 9 3 221 19 133 69 20 241
Percentage Table Figure 3 - Footnote 2 87.5% 0.0% 57.1% 42.9% 12.5% 91.7% 8.6% 60.2% 31.2% 8.3% 100.0%

Among cases with reported age, the largest proportion was in those ≥65 years of age (48%) (Table 1). Compared to the previous year during the same period, a greater proportion of cases in the 20-44 and 45-64 age groups have been reported to date (40% this year vs 24% last year)

Table 1. Weekly and cumulative numbers of positive influenza specimens by type, subtype and age-group reported through case-based laboratory reportingTable 1 - Footnote 1, Canada, 2015-16
Age groups (years) Weekly (October 18 to October 24, 2015) Cumulative (August 30, 2015 to October 24, 2015)
Influenza A B Influenza A B Influenza A and B
A Total A(H1) pdm09 A(H3) A Table 1 - Footnote UnS Total A Total A(H1) pdm09 A(H3) A Table 1 - Footnote UnS Total # %
<5 0 0 0 0 0 7 1 6 0 1 8 4.0%
5-19 1 0 0 1 0 10 1 5 4 4 14 7.0%
20-44 2 0 2 0 0 25 5 12 8 3 28 14.0%
45-64 3 0 1 2 0 48 7 29 12 3 51 25.5%
65+ 2 0 0 2 2 92 2 71 19 6 98 49.0%
Unknown 0 0 0 0 0 1 0 1 0 0 1 0.5%
Total 8 0 3 5 2 183 16 124 43 17 200 100.0%
PercentageTable 1 - Footnote 2 80.0% 0.0% 37.5% 62.5% 20.0% 91.5% 8.7% 67.8% 23.5% 8.5%    

For additional data on other respiratory virus detections see the Respiratory Virus Detections in Canada Report on the Public Health Agency of Canada website.

Influenza-like Illness Consultation Rate

The national influenza-like-illness (ILI) consultation rate increased from 22.3 consultations per 1,000 patient visits in week 41 to 31.4 per 1,000 visits in week 42. In week 42, the highest ILI consultation rate was found in the 0-4 age group and the lowest was found in the ≥65 years of age group (Figure 4).

Figure 4. Influenza-like-illness (ILI) consultation rates by age group and week, Canada, 2015-16

Figure 4

Delays in the reporting of data may cause data to change retrospectively. 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 4 - Text Description

Influenza-like illness consultation rate by age-group in week 42 for the 2015-16 season:
Age 0-4: 57.40; Age 5-19: 53.06; Age 20-64: 26.20; Age 65+: 13.40

Influenza Outbreak Surveillance

In week 42, no new laboratory-confirmed outbreaks of influenza were reported (Figure 5). There was one outbreak of ILI reported in a school. To date this season, seven outbreaks have been reported, which is lower than the number of outbreaks reported last year at this time (n=11).

Figure 5. Overall number of new laboratory-confirmed influenza outbreaksFigure 5 - Footnote 1 by report week, Canada, 2015-2016

Figure 5
Figure 5 - Text Description
Report week Hospitals Long Term Care Facilities Other
35 0 0 0
36 0 0 0
37 1 1 0
38 0 0 0
39 0 2 0
40 0 2 1
41 0 0 0
42 0 0 0

Sentinel Pediatric Hospital Influenza Surveillance

Paediatric Influenza Hospitalizations and Deaths (IMPACT)

To date this season, less than five laboratory-confirmed influenza-associated paediatric (≤16 years of age) hospitalizations have been reported by the Immunization Monitoring Program Active (IMPACT) network. All hospitalized cases were due to influenza A. To date, less than five ICU admissions have been reported.

Figure 6. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada, 2015-16, Paediatric hospitalizations (≤16 years of age, IMPACT)

Figure 6
Figure 6 - Text Description
Age-group (years) Hospitalizations ICU Admissions
0-5m 0.0% 0.0%
6-23m 0.0% 0.0%
2-4y 0.0% 0.0%
5-9y 0.0% 0.0%
10-16y 0.0% 0.0%

Figure 7. Number of cases of influenza reported by sentinel hospital networks, by week, Canada, 2015-16 Paediatric hospitalizations (≤16 years of age, IMPACT)

Figure 7

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.

Figure 7 - Text Description
Report week Influenza A Influenza B
35 0 0
36 0 0
37 0 0
38 0 0
39 0 0
40 0 0
41 0 0

Provincial/Territorial Influenza Hospitalizations and Deaths

Since the start of the 2015-16 season, 37 laboratory-confirmed influenza-associated hospitalizations were reported from participating provinces and territoriesFootnote *. All but three hospitlaizations were due to influenza A. The majority (60%) of patients were ≥65 years of age. Four ICU admissions have been reported.

Figure 8. Percentage of hospitalizations, ICU admissions and deaths with influenza reported by age-group, Canada 2015-16

Figure 8
Figure 8 - Text Description
Age-group (years) Hospitalizations (n=37) ICU admissions (n=4) Deaths (n=0)
0-4 2.7% 0.0% 0.0%
5-19 2.7% 0.0% 0.0%
20-44 10.8% 25.0% 0.0%
45-64 24.3% 50.0% 0.0%
65+ 59.5% 25.0% 0.0%

See additional data on Reported Influenza Hospitalizations and Deaths in Canada: 2011-12 to 2015-16 on the Public Health Agency of Canada website.

Influenza Strain Characterizations

During the 2015-16 influenza season, the National Microbiology Laboratory (NML) has characterized 12 influenza viruses [8 A(H3N2), 1 A(H1N1) and 3 influenza B].

Influenza A (H3N2): When tested by hemagglutination inhibition (HI), one H3N2 virus was antigenically characterized as A/Switzerland/9715293/2013-like using antiserum raised against cell-propagated A/Switzerland/9715293/2013.

Sequence analysis was done on seven H3N2 viruses. All seven viruses belonged to a genetic group for which most viruses were antigenically related to A/Switzerland/9715293/2013.

A/Switzerland/9715293/2013 is the A(H3N2) component of the Northern Hemisphere's vaccine.

Influenza A (H1N1): One H1N1 virus characterized was antigenically similar to A/California/7/2009, the A(H1N1) component of the 2015-16 influenza vaccine.

Influenza B: The three influenza B viruses characterized  were antigenically similar to the vaccine strain B/Phuket/3073/2013.

The recommended components for the 2015-2016 northern hemisphere trivalent influenza vaccine include: an A/California/7/2009(H1N1)pdm09-like virus, an /Switzerland/9715293/2013(H3N2)-like virus, and a B/Phuket/3073/2013 -like virus (Yamagata lineage). For quadrivalent vaccines, the addition of a B/Brisbane/60/2008-like virus is recommended.

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.

Antiviral Resistance

During the 2015-16 season, the National Microbiology Laboratory (NML) has tested 17 influenza viruses for resistance to oseltamivir and zanamivir. All viruses were sensitive to zanamivir and oseltamivir. All influenza A viruses tested were resistant to amantadine (Table 2).

Table 2. Antiviral resistance by influenza virus type and subtype, Canada, 2015-16
Virus type and subtype Oseltamivir Zanamivir Amantadine
# tested # resistant (%) # tested # resistant (%) # tested # resistant (%)
A (H3N2) 13 0 13 0 12 12 (100%)
A (H1N1) 1 0 1 0 1 1 (100%)
B 3 0 3 0 NA Table 2 - Footnote * NA Table 2 - Footnote *
TOTAL 17 0 17 0 13 13

International Influenza Reports


FluWatch definitions for the 2015-2016 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.

Report a problem or mistake on this page
Please select all that apply:

Thank you for your help!

You will not receive a reply. For enquiries, contact us.

Date modified: