Canadian Summary:
Sporadic influenza activity was reported in British Columbia (weeks 37 & 38), Saskatchewan (week 38), and Quebec (week 38); the rest of the country reported no activity. During weeks 37 & 38, the Public Health Agency of Canada received 1223 reports of laboratory tests for influenza, including 2 influenza A detections (SK and BC) and 2 influenza B detections (QC and ON) (see table below). In week 38, one outbreak of influenza A/H3N2 was reported in a long-term care facility in Saskatchewan.

Influenza-like Illness (ILI):
ILI rates were reported as 20 per 1000 patient visits by 124 sentinels in week 37, and 23 per 1000 patient visits by 92 sentinels in week 38. (See ILI graph).

Influenza-associated Pediatric Hospitalizations:
During weeks 37 & 38, no new cases of laboratory confirmed influenza-associated hospitalizations were reported through the IMPAct (Immunization Monitoring Program Active) network.

Avian Influenza:
During the two-week report period, the WHO reported four human cases with H5N1 infection. One was retrospectively confirmed in Viet Nam, with a 35-year-old male who developed symptoms on 25 July and died on 31 July. The other three cases were confirmed in Indonesia, with a 37-year-old woman who developed symptoms on 31 August and died on 10 September in Jakarta; a 27-year-old woman who developed symptoms on 17 September and died on 26 September in Jakarta; an 8-year-old boy who remains in hospital for observation and treatment. Since mid December 2004, the WHO has confirmed 72 cases of human avian influenza cases with 28 deaths (39%).

According to FAO, highly pathogenic H5N1 avian influenza is now endemic in poultry in many parts of Indonesia. As influenza virus activity in Indonesia may increase during the wet season, from November to April, human exposure to animal virus could be greater during the coming months.

Currently, in all affected countries, most human cases with H5N1 infection have been linked to contact with poultry. In a few instances, limited human-to-human transmission of the virus may have occurred following close contact with a patient during the acute phase of illness. In all known instances, such transmission has been limited and has not led to larger outbreaks in the general community, indicating that the virus does not spread easily among people at this time.

• WHO

International:
Media reports in Russia: the Office International des Epizooties (OIE) reported that poultry infected with H5N1 has been reported in six divisions in Russia (Altai Territory, Chelyabinsk Region, Kurgan Region, Novosibirsk Region, Omsk Region, and Tiumen Region) since July 2005. GPHIN media scanning system: In the past seven days in Moscow, about 54,500 people were sick by flu and respiratory virus infections, and more than half of them were children. Physicians are seriously afraid of occurrence of a new fatally dangerous virus which can result from mixture of genes of a human and avian influenza.

• Office International des Epizooties (OIE)

New Zealand: During weeks 37 & 38, influenza activity levels were at baseline. Over 60% of the cases were adults aged more than 20 years and over 20% were children aged 5-19 years. To date, 88% of the laboratory tests were influenza B, with most identified as B/HongKong/330/2001-like.

• Public Health Surveillance New Zealand

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: September 11, 2005 to September 24, 2005 Season to Date: August 28, 2005 - September 24, 2005 Total # Influenza Tests # of Positive Tests Total # Influenza Tests # of Positive Tests Influenza A Influenza B Total Influenza A Influenza B Total NL 19 0 0 0 26 0 0 0 PE 0 0 0 0 2 0 0 0 NS 24 0 0 0 40 0 0 0 NB 17 0 0 0 31 0 0 0 QC 241 0 1 1 479 0 1 1 ON 310 0 1 1 517 0 1 1 MB 74 0 0 0 126 0 0 0 SK 158 1 0 1 298 1 0 1 AB 294 0 0 0 521 0 0 0 BC 62 1 0 1 163 1 0 1 Canada 1223 2 2 4 2203 2 2 4

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=52)

† 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, September 18, 2005 to September 24, 2005 (Week 38)
	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=0]

 

NACI recommends that the trivalent vaccine for the 2004-2005 season in Canada contain A/New Caledonia/20/99 (H1N1)-like, A/Fujian/411/2002 (H3N2)-like, and B/Shanghai/361/2002-like virus antigens.
Note: Vaccine producers may use antigenically equivalent strains because of their growth properties. A/Wyoming3/2003 and A/Kumamoto/102/2002 strains are antigenically equivalent to the A/Fujian/411/2002 (H3N2); B/Jilin/20/2003 and B/Jiangsu/10/2003 virus strains are antigenically equivalent to B/Shanghai/361/2002. The vaccines to be marketed in Canada for the 2004-2005 flu season contain A/New Caledonia/20/99 (H1N1), A/Wyoming/3/2003 (H3N2) and B/Jiangsu/10/2003 virus antigens.

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