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Sporadic influenza activity reported in a few regions of the country

During week 42, sporadic activity continued to be reported in Alberta (northern region) and Ontario (Toronto and central east regions), while the rest of the country reported no activity (see map). In week 42, 5 (0.4%) of the 1,329 specimens tested for influenza virus were positive (see table). Ten (67%) of the 15 influenza detections so far this season were influenza A viruses. The ILI consultation rate remained low with a rate of 13 per 1,000 patient visits in week 42 (see ILI graph) with a sentinel response rate of 63%. There have been no influenza outbreaks reported so far this season.

Antigenic Characterization:
The National Microbiology Laboratory (NML) has characterized four influenza viruses for the 2006-2007 influenza season, one A/Wisconsin/67/2005(H3N2)-like virus from Ontario and three A/New Caledonia/20/99(H1N1)-like from Alberta. Both strains are included in the composition of the 2006-2007 Canadian influenza vaccine.

Antiviral Resistance:
The NML has tested three influenza A isolates for amantadine resistance this season and found that one influenza A(H3N2) was resistant to amantadine. The other isolates were influenza A/H1N1 which remain sensitive to amantadine. Because approximately 80% of the influenza A isolates from the 2005-2006 influenza season were resistant to amantadine, the Public Health Agency of Canada does not recommend the use of this drug for treatment or prophylaxis against influenza for the 2006-2007 season. This recommendation will be revisited if new information becomes available.

For further information:

• Interim Recommendation for Use of Amantadine for Influenza
• Statement on Influenza vaccination for the 2006-2007 season
• Update on Influenza Vaccination for the 2005-2006 Season

Influenza-associated Pediatric Hospitalizations:
During week 42, no new laboratory-confirmed influenza-associated pediatric hospitalizations were reported through the Immunization Monitoring Program Active (IMPACT) network. One case has been reported to IMPACT since the start of this influenza season.

International:
CDC: CDC: During week 41, low levels of influenza activity were reported in the United States. Nine (1%) of the specimens tested were positive for influenza: six influenza A(H1) and three influenza B viruses. The proportion of patient visits for ILI and the proportion of deaths due to pneumonia and influenza remained below baseline levels.

• CDC

EISS: In week 42, low levels of influenza activity were reported in Europe with only sporadic cases of influenza being reported. Consultation rates for ILI remained at baseline levels. Of note, all four influenza A cases in France were in children.

• EISS

Human Avian Influenza:
No new cases of avian influenza have been reported to the WHO since 16 October 2006. Since the beginning of 2004, there have been a total of 256 laboratory confirmed cases of avian influenza including 151 deaths reported to WHO from Asia, Europe and Africa.

• WHO

Total number of influenza tests performed and number of positive tests by province/territory of testing laboratory, Canada, 2006-2007

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.html>

Number of influenza surveillance regions† reporting widespread or localized influenza activity, Canada, by report week, 2006-2007 (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, October 15, 2006 to October 21, 2006 (Week 42)
	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 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, 2006-2007

Percent positive influenza tests, compared to other respiratory viruses, Canada, by reporting week, 2006-2007

Influenza strain characterization, Canada, cumulative, 2006-2007 influenza season by the Respiratory Viruses Section at the National Microbiology Laboratory
[N=4]

{Strain characterization, number identified, per cent of total number}

NACI recommends that the trivalent vaccine for the 2006-2007 season in Canada contain A/New Caledonia/20/1999 (H1N1)-like, A/Wisconsin/67/2005 (H3N2)-like, and B/Malaysia/2506/2004-like virus antigens.

Influenza-like illness (ILI) consultation rates, Canada, by report week, 2006-2007 compared to 1996/97 through to 2005/06 seasons

Note: No data available for mean rate in previous years for weeks 19 to 39 (1996-1997 through 2002-2003 seasons).

Number of New Outbreaks in Long Term Care Facilities, Canada, by Report Week, 2006-2007

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

Definitions for the 2006-2007 season

[FluWatch]