Canadian Summary:
During week 52, localized influenza activity was reported in one health region in British Columbia and one health region in Ontario (Toronto). 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 1612 reports of laboratory tests for influenza, with 43 influenza A and 30 influenza B detections. Most of the influenza A detections (70%) were in British Columbia and most of the influenza B detections (97%) were in Alberta (see table below).

Influenza-like Illness (ILI):
ILI consultation rate was calculated as 29 per 1000 patient visits in week 52, which is below the expected range for this week (see ILI graph).

Outbreaks:
During week 52, 2 new LTCF outbreaks were reported (Ontario & British Columbia). To date this season, 8 LTCF outbreaks have been reported (1 each in Ontario, Manitoba & Saskatchewan, and 5 in British Columbia).

Antigenic Characterization:
Since the start of the 2005-2006 influenza season, the National Microbiology Laboratory (NML) has antigenically characterized 39 influenza viruses; 20 A/California/07/2004(H3N2)-like viruses (12 in British Columbia, 3 in Saskatchewan and 5 in Ontario), 16 B/Hong Kong/330/2001-like viruses (1 in the Yukon,1 in British Columbia & 14 in Alberta) 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% (20) 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 16% (3/19) of the influenza B characterizations have matched the vaccine strain (B/Shanghai/361/2002-like viruses). The remaining 84% (16/19) 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 52, 3 laboratory-confirmed influenza-associated hospitalizations (in British Columbia) were reported through the IMPACT (Immunization Monitoring Program ACTive) network. All were due to influenza A. Fourteen cases (1 in Ontario, 1 in Alberta & 12 in British Columbia) have been reported to IMPACT since the start of this influenza season.

United States: CDC
During week 51, influenza activity continued to increase in the western United States. The proportion of patient visits to sentinel providers for ILI (3.1%) was above the national baseline, while the proportion of deaths due to pneumonia and influenza (7.0%) remains below baseline levels. Since 2 October 2005, CDC has received reports of five influenza-associated pediatric deaths, one of which occurred in week 51. Since 1 October 2005, the CDC has antigenically characterized 26 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, 2 B/Yamagata/16/1988-lineage viruses and 1 B/Victoria/2/1987-lineage virus.

• CDC

International:
EISS: In week 52, clinical influenza activity in Europe remains at baseline levels. The total number of weekly influenza virus detections remains low: 54% were influenza A and 46% were influenza B.

• EISS

Human Avian Influenza:
During week 01/2006, the WHO reported the first 2 human cases with avian influenza (H5N1) infection in Turkey. Both cases were fatal. The first case was a 14-year-old boy who was hospitalized on 1 January 2006 and died the same day. The second case was his 15-year-old sister who was also hospitalized on 1 January 2006 and died on 5 January 2006. These 2 cases mark the first confirmed reports of human infection with avian influenza outside East Asia.

• 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: December 25, 2005 - December 31, 2005 Season to Date: August 28, 2005 - December 31, 2005 Total # Influenza Tests # of Positive Tests Total # Influenza Tests # of Positive Tests Influenza A Influenza B Total Influenza A Influenza B Total NL 21 0 0 0 221 0 0 0 PE 0 0 0 0 51 0 0 0 NS         247 0 0 0 NB 22 0 0 0 378 0 0 0 QC 460 4 1 5 4087 12 2 14 ON 383 5 0 5 6470 15 1 16 MB 60 0 0 0 794 1 0 1 SK 109 0 0 0 1853 13 2 15 AB 392 4 29 33 4846 5 144 149 BC 165 30 0 30 1669 114 5 119 Canada 1612 43 30 73 20616 160 154 314

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, December 25 to December 31, 2005 (Week 52)
	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=39]

(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