Canadian Summary:
During week 01, localized influenza activity was reported in one health region in British Columbia and two health regions in Ontario. Sporadic activity was reported in parts of Yukon, British Columbia, Alberta, Ontario and Quebec, while the rest of the country reported no activity. Over the one week period, the Public Health Agency of Canada received 2248 reports of laboratory tests for influenza, with 37 influenza A and 29 influenza B detections. Most of the influenza A detections (73%) were in British Columbia and most of the influenza B detections (93%) were in Alberta. (see table)

Influenza-like Illness (ILI):
ILI consultation rate was calculated as 17 per 1000 patient visits in week 01, which is below the expected range for this week. (see ILI graph)

Outbreaks: During week 01, two new LTCF outbreaks were reported (Ontario & British Columbia). To date this season, 10 LTCF outbreaks have been reported (1 each in Manitoba & Saskatchewan, 2 in Ontario and 6 in British Columbia).

Antigenic Characterization:
Since the start of the 2005-2006 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 77 influenza viruses; 40 A/California/07/2004(H3N2)-like viruses (24 in British Columbia, 4 in Alberta, 3 in Saskatchewan & 9 in Ontario), 34 B/Hong Kong/330/2001-like viruses (1 in the Yukon,1 in British Columbia, 29 in Alberta, 2 in Saskatchewan & 1 in Ontario) belonging to the B/Victoria/2/1987 lineage, and 3 B/Shanghai/361/2002-like viruses (British Columbia, Alberta & Ontario ) belonging to the B/Yamagata/16/1988 lineage.

* The 2005-2006 season Canadian vaccine contains an A/New Caledonia/20/1999(H1N1)-like, an A/California/7/2004(H3N2)-like, and a B/Shanghai/361/2002-like virus strain.

Vaccine Match:
To date, 100% (40) of the influenza A strains (A/California/07/2004(H3N2)-like viruses) characterized by the NML have matched the A/H3N2 strain included in the 2005-2006 Canadian vaccine. However, only 8% (3/37) of the influenza B characterizations have matched the vaccine strain (B/Shanghai/361/2002-like viruses). The remaining 92% (34/37) of the influenza B strains characterized by the NML have been B/Hong Kong/330/2001-like viruses, which belong to a separate lineage of viruses not covered by this year's vaccine. Most of the identifications of B/Hong Kong/330/2001-like viruses have been associated with school outbreaks in Alberta. No influenza A/H1N1 viruses have been identified to date.

Influenza-associated Pediatric Hospitalizations:
During week 01, two new laboratory-confirmed influenza-associated hospitalizations (in British Columbia) were reported through the IMPACT (Immunization Monitoring Program ACTive) network. Both were due to influenza A. An additional three cases from Alberta were reported (2 from week 52 & 1 from week 51) and all were due to influenza B. Nineteen cases (1 in Ontario, 4 in Alberta & 14 in British Columbia) have been reported to IMPACT since the start of this influenza season. To date, no influenza-associated pediatric deaths have been reported in Canada.

United States: CDC
During week 52, influenza activity continued to increase in the United States with 7 states reporting widespread activity. The proportion of patient visits to sentinel providers for ILI (3.3%) was above the national baseline, while the proportion of deaths due to pneumonia and influenza (6.8%) remains below baseline levels. Since 2 October 2005, CDC has received reports of five influenza-associated pediatric deaths. Since 1 October 2005, the CDC has antigenically characterized 31 influenza viruses: 21 A/California/07/2004(H3N2)-like viruses, 2 H3N2 showing reduced titers with antisera produced against A/California/07/2004(H3N2)-like viruses,1 A (H1) virus similar antigenically to the hemagglutinin of the vaccine strain A/New Caledonia/20/1999, 5 B/Yamagata/16/1988-lineage viruses and 2 B/Victoria/2/1987-lineage viruses.

• CDC

International:
EISS: In week 01, clinical influenza activity was twice as high as the baseline level in the Netherlands. In the rest of Europe, clinical activity remained at baseline levels. Both influenza A and B viruses have been detected since week 40/2005, but for the first time since 1996, more influenza B virus (53%) than influenza A virus (47%) detections were reported for Europe as a whole.

• EISS

Human Avian Influenza:
As of 13 January, 2006, the WHO has confirmed a total of 18 human cases with avian influenza (H5N1) in Turkey in their situation updates; however, only 4 of these have been officially verified by the WHO collaborating centre laboratory in the UK. These 4 cases are reported in the cumulative case table. Update of the table is pending final verification of the other 14 cases. The WHO has also confirmed an additional case of avian influenza (H5N1) in a 6-year-old boy from China on 10 January, 2006.

• WHO

 

Total number of influenza tests performed and number of positive tests by province/territory of testing laboratory, Canada, 2005-2006

Province of reporting laboratories Report Period: January 1, 2006 to January 7, 2006 Season to Date: August 28, 2005 - January 7, 2006 Total # Influenza Tests # of Positive Tests Total # Influenza Tests # of Positive Tests Influenza A Influenza B Total Influenza A Influenza B Total NL 14 0 0 0 235 0 0 0 PE 4 0 0 0 55 0 0 0 NS 23 0 0 0 305 0 0 0 NB         378 0 0 0 QC 622 3 0 3 4709 15 2 17 ON 581 6 0 6 7165 21 1 22 MB 69 0 0 0 863 1 0 1 SK 132 0 0 0 1985 13 2 15 AB 634 1 27 28 5480 6 171 177 BC 169 27 2 29 1838 141 7 148 Canada 2248 37 29 66 23013 197 183 380

Specimens from NT, YT, and NU are sent to reference laboratories in other provinces.

Note: Cumulative data includes updates to previous weeks; due to reporting delays, the sum of weekly report totals do not add up to cumulative totals.

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)

Respiratory virus laboratory detections in Canada, by geographic regions, are available weekly on the following website:
<http://www.phac-aspc.gc.ca/bid-bmi/dsd-dsm/rvdi-divr/index-eng.php>

Number of influenza surveillance regions† reporting widespread or localized influenza activity, Canada, by report week, 2005-2006 (N=76)

† sub-regions within the province or territory as defined by the provincial/territorial epidemiologist. Graph may change as late returns come in.

Influenza Activity Level by Provincial and Territorial Influenza Surveillance Regions, Canada, January 1 to January 7, 2006 (Week 1)
	No Data No Activity Sporadic Activity Localized Activity Widespread Activity
Note: Influenza 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 (see graphs and tables) and outbreaks. Please refer to detailed definitions for the 2005-2006 season. For areas where no data is reported, late reports from these provinces and territories will appear on the FluWatch website. Select single maps by report week to get this updated information. <http://dsol-smed.phac-aspc.gc.ca/dsol-smed/fluwatch/fluwatch.phtml?lang=e> Click on the map to view provinces/territories and maps for other weeks.

Influenza tests reported and percentage of tests positive, Canada, by report week, 2005-2006

Percent positive influenza tests, compared to other respiratory viruses by reporting week, Canada, 2005-2006

Influenza strain characterization, Canada, cumulative, 2005-2006 influenza season by the Respiratory Viruses Section at the National Microbiology Laboratory
[N=77]

(Strain characterization, number identified, per cent of total number)

NACI recommends that the trivalent vaccine for the 2005-2006 season in Canada contain A/New Caledonia/20/99 (H1N1)-like, A/California/7/2004 (H3N2)-like, and B/Shanghai/361/2002-like virus antigens.

* The B/Shanghai/361/2002-like virus belongs to the B/Yamagata/16/88 lineage; the B/Hong Kong/330/01-like virus belongs to the B/Victoria/02/87 lineage which is not covered by this year's vaccine.

Influenza-like illness (ILI) reporting rates, Canada, by report week, 2005-2006 compared to 1996/97 through 2004/2005 seasons

Note: No data available for mean rate in previous years for weeks 21 to 39 (1996-1997 through 2002-2003 seasons). During weeks 20-39, 2002-2003/2004-2005 seasons, ILI is reported once every two weeks, on even weeks only

Number of Outbreaks in Long Term Care Facilities by Report Week, Canada, 2005-2006

Please note that the above graphs may change as late returns come in.

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Definitions for the 2005-2006 season