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Canada:
Saskatchewan and Northwest Territories, and parts of Alberta, Manitoba, New
Brunswick and Nova Scotia report localized activity (see map).
During the week ending April 5 (week 14), sentinel physicians reported 37
cases of influenza-like illness (ILI) per 1000 patient visits, which is above
the expected range for this time of year. Health Canada received 1,592 reports
of laboratory tests for influenza, including 53 (3.3%) influenza A detections
and 123 (7.7%) influenza B detections (see table). The
National Microbiology Laboratory has antigenically characterised 325 influenza
viruses to date (see pie chart); all viruses identified to
date are closely related to the current vaccine strains. Other respiratory
virus detections are within the expected range for this time of year. To date
this season, there have been 31 reported outbreaks of laboratory-confirmed
influenza in long term care facilities (LTCF ), see graph.
SARS: As of 10 April 2003, a total of 98 individuals who meet the probable
case definition of SARS have been reported in Ontario (95) and British Columbia
(3), including 10 deaths; 154 individuals who meet the definition of a suspect
case of SARS have also been reported in British Columbia (32), Alberta (5),
Saskatchewan (1), Ontario (111), New Brunswick (2) and Prince Edward Island
(4). The case fatality rate in Canada is estimated at approximately 4.0% of
probable and suspect cases. Most of the case fatalities occurred in patients
with underlying illness, and nearly all were elderly patients over the age
of 70 years. Twenty-five probable cases have been discharged (25.5%) and of
the 63 probable cases currently hospitalized, 39 (65%) are improving or in
stable condition. In addition, nearly all of the suspect cases have either
recovered or are presently recovering. There is currently no evidence to suggest
community transmission of SARS in Canada.
Health Canada Website on SARS
United
States:
During week 13, influenza activity was reported as regional in 19 states and
sporadic in 28 states. Two states reported no activity. ILI accounted for
1.2% of patient visits to sentinel physicians (below the national baseline
of 1.9%). Sentinel cities reported 7.6% of deaths attributed to pneumonia
and influenza (below the epidemic threshold of 8.1% for this week). The CDC
received 1,465 reports of influenza tests, including 94 (6.4%) positive for
influenza: 61 A (unsubtyped), 11 A(H1), 3 A(H3N2), and 19 influenza B. Since
September 29, a total of 74,790 specimens have been tested for influenza;
8,791 (11.8%) were positive (4,513 influenza A and 4,278 influenza B). Of
the 425 viruses antigenically characterized to date, 7/63 (11%) of influenza
A (H3N2) isolates and 1/188 (<1%) of influenza B isolates showed reduced
titres to current vaccine strains.
CDC:<http://www.cdc.gov/ncidod/diseases/flu/weekly.htm>
International:
During week 14, EISS reported a predominance of influenza A in Europe, with
regional activity in Italy and local in France, Germany, Lithuania and Poland.
Influenza intensity levels are medium to low throughout Europe. More than
99% of the viruses detected through the EISS network so far this season are
closely related to the 2002-2003 vaccine strains. However, a very small number
of H3N2 viruses have shown reduced reactivity to A/Panama/2007/99 antiserum
(detected in England, Norway and Switzerland). The epidemiological and virological
significance of these viruses is unclear at present, but they do not seem
to be associated with any unusually severe disease. Country reports to WHO
indicate influenza activity in the Russian Federation was low. SARS:
As of 10 April 2003, 2871 SARS cases, including 111 deaths, have been reported
from 17 countries. The development of a diagnostic test has proved more problematic
than hoped. Three diagnostic tests (ELISA, IFA and PCR) are now available
however all have limitations as tools for bringing the SARS outbreak quickly
under control.
EISS (Europe): <http://www.eiss.org/cgi-files/bulletin_v2.cgi>
WHO:<http://www.who.int/globalatlas/default.asp>
WHO press release: <http://www.who.int/csr/don/2003_04_03a/en/>
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Total number of influenza tests
performed and number of positive tests by province/territory of testing laboratory,
Canada, 2002-2003
Province
of
reporting
laboratories |
Report Period:
March 30 - April 5, 2003 |
Season to Date:
August 25, 2002 - April 5, 2003 |
Total #
Influenza
Tests |
# of
Positive Tests |
Total #
Influenza
Tests |
# of
Positive Tests |
| Influenza
A |
Influenza
B |
Total
|
Influenza A |
Influenza
B |
Total
|
| NL |
35 |
1 |
0 |
1 |
451 |
14 |
15 |
29 |
| PE |
0 |
0 |
0 |
0 |
57 |
12 |
2 |
14 |
| NS |
53 |
0 |
0 |
0 |
617 |
23 |
38 |
61 |
| NB |
41 |
0 |
11 |
11 |
539 |
63 |
34 |
97 |
| QC |
412 |
6 |
35 |
41 |
9456 |
574 |
155 |
729 |
| ON |
263 |
4 |
0 |
4 |
14231 |
773 |
16 |
789 |
| MB |
61 |
5 |
9 |
14 |
1851 |
18 |
68 |
86 |
| SK |
199 |
3 |
42 |
45 |
3553 |
19 |
297 |
316 |
| AB |
380 |
30 |
23 |
53 |
8008 |
147 |
392 |
539 |
| BC |
148 |
4 |
3 |
7 |
1633 |
92 |
173 |
265 |
| Canada |
1592 |
53 |
123 |
176 |
40396 |
1735 |
1190 |
2925 |
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Specimens from NT, YT, and NU are sent to reference laboratories in
other provinces.
Note: Cumulative data include updates to previous weeks; due to reporting
delays, the sum of weekly report totals does 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/>
Number of influenza surveillance
regions† reporting widespread or localized influenza activity, Canada,
by report week, 2002-2003 (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 tests reported and percentage
of tests positive, Canada, by report week, 2002-2003
Percent positive influenza tests,
compared to other respiratory viruses by reporting week, Canada, 2002-2003
Influenza strain characterization,
Canada, cumulative, 2002-2003 influenza season by the Respiratory Viruses
Section at the National Microbiology Laboratory
[n=325]
Components of the 2002-2003 Canadian vaccine: A/New Caledonia/20/99 (H1N1)-like
virus, A/Panama/2007/99 (H3N2)-like virus and B/Hong Kong/330/2001-like virus.
Note: the influenza A(H1N2) virus strain is a reassortment virus derived
from the influenza A (H1N1) and A(H3N2) virus strains. This strain circulated
widely during the 2001-2002 season and like last season the current vaccine
is expected to provide protection against this virus.
Influenza-like illness (ILI) reporting
rates, Canada, by report week, 2002-2003 compared to 1996/97 through 2001/2002
seasons
Number of Outbreaks in Long Term
Care Facilities by Report Week, Canada, 2002-2003
Please note that the above graphs may change as late returns
come in.
Definitions for the 2002-2003
season
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