SURVEILLANCE AND HEALTH STATUS ASSESSMENT Page | 1 Page | 1 Public Health Surveillance Report Date: May 16, 2012
Alberta Respiratory Virus
Surveillance Report Update for Flu Week 19: (May 6-12, 2012)
An influenza report targeted to the general public is available at: http://www.health.alberta.ca/health-info/influenza-evidence.html
If you have questions about the Alberta Respiratory Virus Surveillance Report, or any of the indicators, please contact:
Weekly Update May 16, 2012 The purpose of this report is to inform Public Health staff, primary care providers, acute care staff and other community practitioners about recent and historical respiratory virus activity in the province of Alberta. Unless otherwise noted, all data presented are current as of the Saturday prior to the day the report is released.
Summary of What’s New
Alberta:
Of the respiratory viruses circulating in Alberta, rhino-enterovirus has continued to have the highest percent positive rate since
week 14, with a rate of 24.2% in week 19 (May 6-12, 2012). The percent positive rate of RSV was 53.8% in South zone as compared
to other zones (range 15.4 % to 27.6%) (Figure_1).
The rate of laboratory confirmed influenza B (per 100,000) was higher (0.45) than that of influenza A(H3) (0.08) in the province
during week 19 (Figure_2).
Compared to 45 influenza cases in week 18, only 23 cases were detected in week 19 in Alberta. The majority of these cases were
influenza B (17), only 3 were influenza A(H3) and 2 were influenza A(H1N1)pdm09 (Table_1).
So far this season, the province-wide age-specific rate (per 100,000) for influenza A(H1N1)pdm09 and B has been highest in the 0-
<2 year old age group and for influenza A(H3) it has been highest in the >=75 year old age group (Figure_3).
There have been no reports of ILI outbreaks with onset dates in week 19 in Alberta (Table 2) , (Figure_4).
The Health Link Alberta call rate (per 100,000) for cough or breathing concerns decreased from 11.9 in week 18 to 11.5 in week 19
(Figure 5).
In week 19, 0.3% and 0.2% of the total visits to Alberta sentinel physicians were attributed to ILI and LRTI respectively (Figure_6).
North America:
Influenza activity is continuing to decline in North America with influenza B as the predominant
virus in Canada, influenza A(H3N2) in the US, and A(H1N1)pdm09 in Mexico.
As of May 11 (FluWatch), in Canada all indicators of influenza activity have declined compared to
the previous week.
Overall, influenza activity continued to decline in the US and Mexico.
So far this season, the US CDC has reported 16 (out of 1,129 tested) influenza A(H1N1)pdm09
viruses to be resistant to Oseltamivir.
Antigenic Characterization & Antiviral Resistance by Canada National Microbiology Laboratory
for 2011-12:
Of 1,122 influenza virus samples, 201 (18%) A(H3N2) viruses were characterized as
A/Perth/16/2009, 189 (17%) A(H1N1) as A/California/07/2009, 348 (31%) influenza B viruses as
B/Brisbane/60/2008 (Victoria lineage) and 384 (34%) influenza B viruses were characterized as
B/Wisconsin/01/2010-like (Yamagata lineage).
All viral samples tested were found to be susceptible to Oseltamivir and Zanamivir, whereas all but
1 influenza A(H3N2) virus samples were resistant to Amantadine.
The 2011/12 trivalent influenza vaccination provided by AHS/AHW covers all strains mentioned
above except the influenza B isolates with Yamagata lineage.
Quick Links
Laboratory Data
ILI Outbreak Investigations
Calls to Health Link Alberta
Sentinel Physician Office Visits (TARRANT)
Influenza Immunizations
Data Notes
Current Global Information
FluWatch (PHAC)
FluView (US CDC)
HPA (UK)
WHO
Travel Advisories
SURVEILLANCE AND HEALTH STATUS ASSESSMENT Page | 2 Page | 2 Public Health Surveillance Report Date: May 16, 2012
Alberta Respiratory Virus
Surveillance Report Update for Flu Week 19: (May 6-12, 2012)
An influenza report targeted to the general public is available at: http://www.health.alberta.ca/health-info/influenza-evidence.html
If you have questions about the Alberta Respiratory Virus Surveillance Report, or any of the indicators, please contact:
International:
In the temperate zone of the Northern Hemisphere, influenza activity has been decreasing over the past few weeks, after peaking
in the majority of European countries. Low influenza activity has been reported in the Northern African and Eastern
Mediterranean regions. With the exception of the Republic of Korea, the temperate countries of Asia have also reported a decline
in influenza activity.
In the tropical zone, with the exception of the Dominican Republic, where an increase in influenza A(H3N2) detections was
reported, low influenza activity has been reported in South America, Central America, the Caribbean, sub-Saharan Africa, and
tropical Asia.
Influenza activity has continued to remain low or at inter-seasonal levels in the temperate zone of the Southern Hemisphere.
In the later part of the current influenza season, increased genetic and antigenic diversity has been noted in H3N2 viruses.
WHO Recommendation on Composition of 2012-2013 Northern Hemisphere Trivalent Influenza Vaccine (March 2, 2012):
A/California/7/2009 (H1N1)pdm09-like virus
A/Victoria/361/2011 (H3N2)-like virus
B/Wisconsin/1/2010-like virus (B/Yamagata lineage)
This recommendation changes the influenza A (H3N2) and influenza B components of the 2011-2012 Northern Hemisphere
vaccine formulation. The recommendation was based on surveillance data related to epidemiology and antigenic characteristics,
serological responses to 2011-2012 trivalent seasonal vaccines, and the availability of candidate strains and reagents
SURVEILLANCE AND HEALTH STATUS ASSESSMENT Page | 3 Page | 3 Public Health Surveillance Report Date: May 16, 2012
Alberta Respiratory Virus
Surveillance Report Update for Flu Week 19: (May 6-12, 2012)
An influenza report targeted to the general public is available at: http://www.health.alberta.ca/health-info/influenza-evidence.html
If you have questions about the Alberta Respiratory Virus Surveillance Report, or any of the indicators, please contact:
Laboratory Data Figure 1: Respiratory specimen percent positive rates, by virus type, by week, (2011-12)
0%
10%
20%
30%
40%
50%
60%
70%
35 37 39 41 43 45 47 49 51 1 3 5 7 9 11 13 15 17 19
Perc
ent P
osit
ive
Flu Week Number
ALBERTA
0%
10%
20%
30%
40%
50%
60%
70%
35 37 39 41 43 45 47 49 51 1 3 5 7 9 11 13 15 17 19
Perc
ent P
ositi
ve
Flu Week Number
SOUTH
0%
10%
20%
30%
40%
50%
60%
70%
35 37 39 41 43 45 47 49 51 1 3 5 7 9 11 13 15 17 19
Perc
ent P
osit
ive
Flu Week Number
CALGARY
0%
10%
20%
30%
40%
50%
60%
70%
35 37 39 41 43 45 47 49 51 1 3 5 7 9 11 13 15 17 19
Perc
ent P
osit
ive
Flu Week Number
CENTRAL
0%
10%
20%
30%
40%
50%
60%
70%
35 37 39 41 43 45 47 49 51 1 3 5 7 9 11 13 15 17 19
Pe
rce
nt
Po
siti
ve
Flu Week Number
EDMONTON
0%
10%
20%
30%
40%
50%
60%
70%
35 37 39 41 43 45 47 49 51 1 3 5 7 9 11 13 15 17 19
Pe
rce
nt
Po
siti
ve
Flu Week Number
NORTH
Adenovirus Coronavirus hMPV Flu A Flu B Parainfluenza
RSV Rhino-enterovirus Mixed
Source: DIAL – Provincial Laboratory (includes specimens received on or before May 12, 2012). For more information on data definitions and sources, see Data Notes. “Percent positive” for a virus is defined as the percentage of specimens tested for that particular virus with a positive result.
SURVEILLANCE AND HEALTH STATUS ASSESSMENT Page | 4 Page | 4 Public Health Surveillance Report Date: May 16, 2012
Alberta Respiratory Virus
Surveillance Report Update for Flu Week 19: (May 6-12, 2012)
An influenza report targeted to the general public is available at: http://www.health.alberta.ca/health-info/influenza-evidence.html
If you have questions about the Alberta Respiratory Virus Surveillance Report, or any of the indicators, please contact:
Figure 2: Rate of lab confirmed influenza (per 100,000) by subtype, by week specimen classified
0
2
4
6
8
10
12
14
35 37 39 41 43 45 47 49 51 1 3 5 7 9 11 13 15 17 19 21 23
Ra
te (
pe
r 1
00
,00
0)
Flu Week Number
ALBERTA
0
2
4
6
8
10
12
14
35 37 39 41 43 45 47 49 51 1 3 5 7 9 11 13 15 17 19 21 23
Ra
te (
pe
r 1
00
,00
0)
Flu Week Number
SOUTH
0
2
4
6
8
10
12
14
35 37 39 41 43 45 47 49 51 1 3 5 7 9 11 13 15 17 19 21 23
Ra
te (
pe
r 1
00
,00
0)
Flu Week Number
CALGARY
0
2
4
6
8
10
12
14
35 37 39 41 43 45 47 49 51 1 3 5 7 9 11 13 15 17 19 21 23
Ra
te (
pe
r 1
00
,00
0)
Flu Week Number
CENTRAL
____ Flu A(H3) (current season)
____ A(H1N1)pdm09 (current season)
____ Flu B (current season)
2010-11 Flu A(H3) 2010-11 A(H1N1)pdm09 2010-11 Flu B Source: The Alberta influenza outbreak response toolkit (includes cases with positive influenza specimens classified on or before May 12, 2012).
For more information on data definitions and sources, see Data Notes.
SURVEILLANCE AND HEALTH STATUS ASSESSMENT Page | 5 Page | 5 Public Health Surveillance Report Date: May 16, 2012
Alberta Respiratory Virus
Surveillance Report Update for Flu Week 19: (May 6-12, 2012)
An influenza report targeted to the general public is available at: http://www.health.alberta.ca/health-info/influenza-evidence.html
If you have questions about the Alberta Respiratory Virus Surveillance Report, or any of the indicators, please contact:
Figure 2 (cont’d): Rate of lab confirmed influenza (per 100,000) by subtype, by week specimen classified
0
2
4
6
8
10
12
14
35 37 39 41 43 45 47 49 51 1 3 5 7 9 11 13 15 17 19 21 23
Ra
te (
pe
r 1
00
,00
0)
Flu Week Number
EDMONTON
0
2
4
6
8
10
12
14
35 37 39 41 43 45 47 49 51 1 3 5 7 9 11 13 15 17 19 21 23
Ra
te (
pe
r 1
00
,00
0)
Flu Week Number
NORTH
____ Flu A(H3) (current season)
____ A(H1N1)pdm09 (current season)
____ Flu B (current season)
2010-11 Flu A(H3) 2010-11 A(H1N1)pdm09 2010-11 Flu B
Week 19 (May 6-12, 2012) Cumulative (Aug 28,2011-May 12, 2012)
Influenza A Influenza B Influenza A Influenza B
A(H3)
A(H1N1)
pdm09
A (unresolved
type due to
low viral load)
A
(total) B A(H3)
A(H1N1)
pdm09
A
(unresolved
type due to
low viral
load)
A
(total) B (total)
South 2 1 0 3 2 137 17 1 155 11Calgary 1 0 0 1 4 230 31 7 268 43Central 0 0 0 0 1 100 22 2 124 53Edmonton 0 1 1 2 7 324 70 22 416 75North 0 0 0 0 3 105 39 9 153 24
Alberta Total 3 2 1 6 17 896 179 41 1116 206
Zones
Table 1: New and cumulative laboratory confirmed influenza cases, by subtype, by zone
Source: The Alberta influenza outbreak response toolkit (includes cases with positive influenza specimens classified on or before May 12, 2012). For more information on data definitions and sources, see Data Notes.
SURVEILLANCE AND HEALTH STATUS ASSESSMENT Page | 6 Page | 6 Public Health Surveillance Report Date: May 16, 2012
Alberta Respiratory Virus
Surveillance Report Update for Flu Week 19: (May 6-12, 2012)
An influenza report targeted to the general public is available at: http://www.health.alberta.ca/health-info/influenza-evidence.html
If you have questions about the Alberta Respiratory Virus Surveillance Report, or any of the indicators, please contact:
Figure 3: Age-specific rates of lab confirmed influenza (per 100,000) by subtype, Alberta and each zone (Aug 28, 2011-May 12, 2012)
0.010.020.030.040.050.060.070.080.090.0
100.0110.0120.0130.0140.0150.0160.0170.0
Ra
te (
pe
r 1
00
,00
0)
Age Group (years)
ALBERTA
0.010.020.030.040.050.060.070.080.090.0
100.0110.0120.0130.0140.0150.0160.0170.0
Ra
te (
pe
r 1
00
,00
0)
Age Group (years)
SOUTH
0.010.020.030.040.050.060.070.080.090.0
100.0110.0120.0130.0140.0150.0160.0170.0
Ra
te (
pe
r 1
00
,00
0)
Age Group (years)
CALGARY
0.010.020.030.040.050.060.070.080.090.0
100.0110.0120.0130.0140.0150.0160.0170.0
Rat
e (p
er 1
00,0
00)
Age Group (years)
CENTRAL
0.010.020.030.040.050.060.070.080.090.0
100.0110.0120.0130.0140.0150.0160.0170.0
Ra
te (
pe
r 1
00
,00
0)
Age Group (years)
EDMONTON
0.010.020.030.040.050.060.070.080.090.0
100.0110.0120.0130.0140.0150.0160.0170.0
Ra
te (
pe
r 1
00
,00
0)
Age Group (years)
NORTH
Flu A(H3) A(H1N1)pdm09 Flu B
Source: The Alberta influenza outbreak response toolkit (includes cases with positive influenza specimens classified on or before May 12, 2012). For more information on data definitions and sources, see Data Notes.
SURVEILLANCE AND HEALTH STATUS ASSESSMENT Page | 7 Page | 7 Public Health Surveillance Report Date: May 16, 2012
Alberta Respiratory Virus
Surveillance Report Update for Flu Week 19: (May 6-12, 2012)
An influenza report targeted to the general public is available at: http://www.health.alberta.ca/health-info/influenza-evidence.html
If you have questions about the Alberta Respiratory Virus Surveillance Report, or any of the indicators, please contact:
AHS Influenza-Like-Illness (ILI) Outbreak Investigations Figure 4: AHS investigated ILI outbreaks in Alberta facility types, by onset week, by organism type (2011-12)
0123456789
101112
35 37 39 41 43 45 47 49 51 1 3 5 7 9 11 13 15 17 19
Num
ber o
f Out
brea
ks
All AHS Reported Influenza-like-illness Outbreaks*
0
1
2
3
4
5
6
7
8
35 37 39 41 43 45 47 49 51 1 3 5 7 9 11 13 15 17 19
Numb
er of
Outb
reaks
Confirmed A(H1N1)pdm09
0
1
2
3
4
5
6
7
8
9
35 37 39 41 43 45 47 49 51 1 3 5 7 9 11 13 15 17 19
Numb
er of
Outb
reaks
Confirmed Flu A(H3)
0
1
2
3
4
5
6
7
8
35 37 39 41 43 45 47 49 51 1 3 5 7 9 11 13 15 17 19
Numb
er of
Out
brea
ks
Onset Week Number
Confirmed Flu B
Acute Care Childcare Long term Care School (K-12) Supportive or Home Living Sites (SL/HL) Other
"All reported outbreaks include those with a confirmed organism, those where no organism was confirmed, those pending lab confirmation and those where no specimens were tested. Note: Some outbreaks may involve more than one pathogen. Source: CDRS as of May 15, 2012 (obtained via the Alberta Outbreak Reporting Form).For more information on data definitions and sources, see Data Notes.
SURVEILLANCE AND HEALTH STATUS ASSESSMENT Page | 8 Page | 8 Public Health Surveillance Report Date: May 16, 2012
Alberta Respiratory Virus
Surveillance Report Update for Flu Week 19: (May 6-12, 2012)
An influenza report targeted to the general public is available at: http://www.health.alberta.ca/health-info/influenza-evidence.html
If you have questions about the Alberta Respiratory Virus Surveillance Report, or any of the indicators, please contact:
Figure 4 (cont’d): AHS investigated ILI outbreaks in Alberta facility types, by onset week, by organism type (2011-12)
0
1
2
3
4
5
6
7
8
35 37 39 41 43 45 47 49 51 1 3 5 7 9 11 13 15 17 19
Numb
er of
Out
brea
ks
Confirmed RSV
0
1
2
3
4
5
6
7
8
35 37 39 41 43 45 47 49 51 1 3 5 7 9 11 13 15 17 19
Num
ber o
f Out
brea
ks
Confirmed Parainfluenza
0
1
2
3
4
5
6
7
8
35 37 39 41 43 45 47 49 51 1 3 5 7 9 11 13 15 17 19
Numb
er of
Out
brea
ks
Confirmed Rhino-enterovirus
0
1
2
3
4
5
6
7
8
35 37 39 41 43 45 47 49 51 1 3 5 7 9 11 13 15 17 19
Num
ber o
f Out
brea
ks
Onset Week Number
Other confirmed Respiratory Viruses**
Acute Care Childcare Long term Care School (K-12) Supportive or Home Living Sites (SL/HL) Other
**Other confirmed respiratory viruses include adenovirus coronavirus and hMPV. Note: Some outbreaks may involve more than one pathogen.Source:
CDRS as of May 15, 2012 (obtained via the Alberta Outbreak Reporting Form). For more information on data definitions and sources, see Data Notes.
SURVEILLANCE AND HEALTH STATUS ASSESSMENT Page | 9 Page | 9 Public Health Surveillance Report Date: May 16, 2012
Alberta Respiratory Virus
Surveillance Report Update for Flu Week 19: (May 6-12, 2012)
An influenza report targeted to the general public is available at: http://www.health.alberta.ca/health-info/influenza-evidence.html
If you have questions about the Alberta Respiratory Virus Surveillance Report, or any of the indicators, please contact:
Long term
care SL/HL
School
(K-12)
Acute
Care Childcare Other
Long term
care SL/HL
School
(K-12)
Acute
Care Childcare Other
Confirmed Flu A(H3) - - - - - - 24 19 7 4 2 -
Confirmed A(H1N1)pdm09 - - - - - - 1 - 2 - 2 -
Confirmed Flu B - - - - - - 2 - 3 - - -
Confirmed RSV - - - - - - 6 - 1 1 2 -
Confirmed Parainfluenza - - - - - - 2 - - - 1 -
Confirmed Rhino-enterovirus - - - - - - 11 2 1 - - -
Other confirmed viruses** - - - - - - 9 5 - - - -
Initial report only (laboratory results
pending) - - - - - - 2 - - - - -Unknown (no organism confirmed or no
specimens available) - - - - - - 8 2 3 1 2 -
Total 0 0 0 0 0 0 65 28 17 6 9 0
Long term
care SL/HL
School
(K-12)
Acute
Care Childcare Other
Long term
care SL/HL
School
(K-12)
Acute
Care Childcare Other
Confirmed Flu A(H3) - - - - - - 1 6 - - 1 -
Confirmed A(H1N1)pdm09 - - - - - - - - - - - -
Confirmed Flu B - - - - - - - - - - - -
Confirmed RSV - - - - - - - - - - 1 -
Confirmed Parainfluenza - - - - - - - - - - - -
Confirmed Rhino-enterovirus - - - - - - - 1 - - - -
Other confirmed viruses** - - - - - - - 2 - - - -Initial report only (laboratory results
pending) - - - - - - - - - - - -Unknown (no organism confirmed or no
specimens available) - - - - - - - 1 - - - -
Total 0 0 0 0 0 0 1 10 0 0 2 0
Long term
care SL/HL
School
(K-12)
Acute
Care Childcare Other
Long term
care SL/HL
School
(K-12)
Acute
Care Childcare Other
Confirmed Flu A(H3) - - - - - - 12 3 3 1 - -
Confirmed A(H1N1)pdm09 - - - - - - 1 - - - - -
Confirmed Flu B - - - - - - 1 - 2 - - -
Confirmed RSV - - - - - - 2 - 1 1 - -
Confirmed Parainfluenza - - - - - - 1 - - - - -
Confirmed Rhino-enterovirus - - - - - - 2 - - - - -
Other confirmed viruses** - - - - - - 4 - - - - -Initial report only (laboratory results
pending) - - - - - - - - - - - -Unknown (no organism confirmed or no
specimens available) - - - - - - 2 - - 1 1 -
Total 0 0 0 0 0 0 25 3 6 3 1 0
CALGARY
Organism
Week 19 (May 6 - 12, 2012) Cumulative (Aug 28, 2011-May 12, 2012)
ALBERTA
SOUTH
Table 2: New & cumulative AHS investigated ILI outbreaks reported (by onset date), by organism, Alberta
Source: CDRS as of May 15, 2012 (obtained via the Alberta Outbreak Reporting Form). For more information on data definitions and sources, see Data Notes. **Other confirmed viruses include adenovirus, coronavirus and hMPV.
SURVEILLANCE AND HEALTH STATUS ASSESSMENT Page | 10 Page | 10 Public Health Surveillance Report Date: May 16, 2012
Alberta Respiratory Virus
Surveillance Report Update for Flu Week 19: (May 6-12, 2012)
An influenza report targeted to the general public is available at: http://www.health.alberta.ca/health-info/influenza-evidence.html
If you have questions about the Alberta Respiratory Virus Surveillance Report, or any of the indicators, please contact:
Long term
care SL/HL
School
(K-12)
Acute
Care Childcare Other
Long term
care SL/HL
School
(K-12)
Acute
Care Childcare Other
Confirmed Flu A(H3) - - - - - - 1 2 - - - -
Confirmed A(H1N1)pdm09 - - - - - - - - - - 1 -
Confirmed Flu B - - - - - - 1 - - - - -
Confirmed RSV - - - - - - 1 - - - - -
Confirmed Parainfluenza - - - - - - 1 - - - - -
Confirmed Rhino-enterovirus - - - - - - 2 1 - - - -
Other confirmed viruses** - - - - - - 1 1 - - - -Initial report only (laboratory results
pending) - - - - - - 1 - - - - -Unknown (no organism confirmed or no
specimens available) - - - - - - 3 - - - - -
Total 0 0 0 0 0 0 11 4 0 0 1 0
Long term
care SL/HL
School
(K-12)
Acute
Care Childcare Other
Long term
care SL/HL
School
(K-12)
Acute
Care Childcare Other
Confirmed Flu A(H3) - - - - - - 8 7 - 3 1 -
Confirmed A(H1N1)pdm09 - - - - - - - - - - 1 -
Confirmed Flu B - - - - - - - - - - - -
Confirmed RSV - - - - - - 3 - - - 1 -
Confirmed Parainfluenza - - - - - - - - - - 1 -
Confirmed Rhino-enterovirus - - - - - - 7 - 1 - - -
Other confirmed viruses** - - - - - - 3 1 - - - -Initial report only (laboratory results
pending) - - - - - - - - - - - -Unknown (no organism confirmed or no
specimens available) - - - - - - 3 - 1 - - -
Total 0 0 0 0 0 0 24 8 2 3 4 0
Long term
care SL/HL
School
(K-12)
Acute
Care Childcare Other
Long term
care SL/HL
School
(K-12)
Acute
Care Childcare Other
Confirmed Flu A(H3) - - - - - - 2 1 4 - - -
Confirmed A(H1N1)pdm09 - - - - - - - - 2 - - -
Confirmed Flu B - - - - - - - - 1 - - -
Confirmed RSV - - - - - - - - - - - -
Confirmed Parainfluenza - - - - - - - - - - - -
Confirmed Rhino-enterovirus - - - - - - - - - - - -
Other confirmed viruses** - - - - - - 1 1 - - - -Initial report only (laboratory results
pending) - - - - - - 1 - - - - -Unknown (no organism confirmed or no
specimens available) - - - - - - - 1 2 - 1 -
Total 0 0 0 0 0 0 4 3 9 0 1 0
EDMONTON
NORTH
CENTRAL
Week 19 (May 6 - 12, 2012) Cumulative (Aug 28, 2011-May 12, 2012)
Table 2(cont'd): New & cumulative AHS investigated ILI outbreaks reported (by onset date), by organism, Alberta
Source: CDRS as of May 15, 2012 (obtained via the Alberta Outbreak Reporting Form). For more information on data definitions and sources, see Data Notes. **Other confirmed viruses include adenovirus, coronavirus and hMPV.
SURVEILLANCE AND HEALTH STATUS ASSESSMENT Page | 11 Page | 11 Public Health Surveillance Report Date: May 16, 2012
Alberta Respiratory Virus
Surveillance Report Update for Flu Week 19: (May 6-12, 2012)
An influenza report targeted to the general public is available at: http://www.health.alberta.ca/health-info/influenza-evidence.html
If you have questions about the Alberta Respiratory Virus Surveillance Report, or any of the indicators, please contact:
Calls to Health Link Alberta Figure 5: Call rate (per 100,000 Population) for cough or breathing concerns, by flu week (2011-12)
0
5
10
15
20
25
30
35
35 37 39 41 43 45 47 49 51 1 3 5 7 9 11 13 15 17 19 21 23
Cal
ls p
er 1
00,0
00 P
op
ula
tio
n
Flu Week Number
ALBERTA
0
5
10
15
20
25
30
35
35 37 39 41 43 45 47 49 51 1 3 5 7 9 11 13 15 17 19 21 23
Ca
lls
pe
r 1
00
,00
0 P
op
ula
tio
n
Flu Week Number
SOUTH
0
5
10
15
20
25
30
35
35 37 39 41 43 45 47 49 51 1 3 5 7 9 11 13 15 17 19 21 23
Ca
lls
pe
r 1
00
,00
0 P
op
ula
tio
n
Flu Week Number
CALGARY
0
5
10
15
20
25
30
35
35 37 39 41 43 45 47 49 51 1 3 5 7 9 11 13 15 17 19 21 23
Ca
lls
pe
r 1
00
,00
0 P
op
ula
tio
n
Flu Week Number
CENTRAL
0
5
10
15
20
25
30
35
35 37 39 41 43 45 47 49 51 1 3 5 7 9 11 13 15 17 19 21 23
Ca
lls
pe
r 1
00
,00
0 P
op
ula
tio
n
Flu Week Number
EDMONTON
0
5
10
15
20
25
30
35
35 37 39 41 43 45 47 49 51 1 3 5 7 9 11 13 15 17 19 21 23
Ca
lls
pe
r 1
00
,00
0 P
op
ula
tio
n
Flu Week Number
NORTH
Source: Sharp Focus - Health Link Alberta - via Alberta Real Time Syndromic Surveillance Net (ARTSSN) as of May 12, 2012. For more information
on data definitions and sources, see Data Notes.
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Alberta Respiratory Virus
Surveillance Report Update for Flu Week 19: (May 6-12, 2012)
An influenza report targeted to the general public is available at: http://www.health.alberta.ca/health-info/influenza-evidence.html
If you have questions about the Alberta Respiratory Virus Surveillance Report, or any of the indicators, please contact:
Sentinel Physician Office Visits (TARRANT)
0.0
0.4
0.8
1.2
1.6
2.0
35 37 39 41 43 45 47 49 51 1 3 5 7 9 11 13 15 17 19 21 23
% o
f V
isit
s
Flu Week Number
Figure 6: Sentinel physician patient visits (%) with ILI and LRTI, by flu week, Alberta (2011-12)
South Calgary Central Edmonton North Alberta
Number of reporting physicians 4 16 13 6 1 40
Source: Tarrant Viral Watch program – www.tarrantviralwatch.ca. For more information on data definitions and sources, see Data Notes.
% ILI (Influenza-like Illness) % LRTI (Lower Respiratory Tract Infection)
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Alberta Respiratory Virus
Surveillance Report Update for Flu Week 19: (May 6-12, 2012)
An influenza report targeted to the general public is available at: http://www.health.alberta.ca/health-info/influenza-evidence.html
If you have questions about the Alberta Respiratory Virus Surveillance Report, or any of the indicators, please contact:
Influenza Immunizations
South Calgary Central Edmonton North Alberta
Long term care staff 0 0 0 0 0 0
Health care workers 0 0 0 2 1 3
Pregnant women 0 0 0 0 0 0
Residents of long term care 0 0 0 0 0 0
65 years of age and over 0 0 0 1 2 3
Dose #1 0 0 0 2 0 2
Dose #2 3 20 3 50 4 80
Annual 0 0 0 0 0 0
Dose #1 0 0 0 1 0 1
Dose #2 0 11 0 5 0 16
Annual 0 0 0 0 0 0
Dose #1 0 0 0 0 0 0
Dose #2 0 0 0 0 0 0
Annual 0 0 0 0 0 0
High risk: 9 years up to and including 64 years 0 0 0 3 2 5
Dose #1 0 0 0 0 0 0
Dose #2 0 1 0 2 0 3
Annual 0 0 0 0 0 0
Healthy: 9 years up to and including 64 years 2 0 0 5 1 8
Total number of clients who have received 1 dose 2 0 0 14 6 22
Total number of 2nd doses administered to those eligible* 3 32 3 57 4 99
Total Doses Administered 5 32 3 71 10 121
High risk: 5 years up to and including 8
years*
Healthy: 5 years up to and including 8
years*
Table 3: New AHS (Public Health) Delivered Influenza Immunizations, by priority group (Apr 29-30, 2012)
Priority Group
All children 6 months up to and including
23 months*
All children 24 months up to and
including 59 months*
South Calgary Central Edmonton North Alberta
Long term care staff 524 431 556 390 1,026 2,927
Health care workers 1,619 4,765 2,937 5,424 4,040 18,785
Pregnant women 227 1,192 323 1,228 474 3,444
Residents of long term care 1,088 2,210 870 882 1,233 6,283
65 years of age and over 13,561 37,639 21,044 47,532 15,483 135,259
Dose #1 1,529 8,596 1,838 6,379 1,984 20,326
Dose #2 925 4,740 1,283 3,463 1,047 11,458
Annual 678 5,554 925 2,368 876 10,401
Dose #1 420 1,281 380 1,168 362 3,611
Dose #2 305 640 205 505 171 1,826
Annual 1,591 9,929 2,001 6,960 2,359 22,840
Dose #1 25 119 55 100 64 363
Dose #2 22 39 20 42 11 134
Annual 252 2,283 520 1,334 695 5,084
High risk: 9 years up to and including 64 years 3,331 16,236 6,129 16,650 7,829 50,175
Dose #1 133 449 160 450 261 1,453
Dose #2 59 195 107 157 69 587
Annual 1,470 8,367 1,935 5,959 2,301 20,032
Healthy: 9 years up to and including 64 years 15,011 78,427 20,515 66,873 24,901 205,727
Total number of clients who have received 1 dose 41,459 177,478 60,188 163,697 63,888 506,710
Total number of 2nd doses administered to those eligible* 1,311 5,614 1,615 4,167 1,298 14,005
Total Doses Administered 42,770 183,092 61,803 167,864 65,186 520,715
High risk: 5 years up to and including 8
years*
Healthy: 5 years up to and including 8
years*
Table 4: Cumulative AHS (Public Health) Delivered Influenza Immunizations, by priority group (Oct 2, 2011-Apr 30, 2012)
Priority Group
All children 6 months up to and including
23 months*
All children 24 months up to and
including 59 months*
Source: AHS Zones (doses do not include those delivered by external providers). For more information on data definitions and sources, see Data Notes. *Children under 9 years of age who have not received at least one dose in past years require two doses, given at least 4 weeks apart .Note: April 30th was the last day of the influenza immunization program for the current season.
SURVEILLANCE AND HEALTH STATUS ASSESSMENT Page | 14 Page | 14 Public Health Surveillance Report Date: May 16, 2012
Alberta Respiratory Virus
Surveillance Report Update for Flu Week 19: (May 6-12, 2012)
An influenza report targeted to the general public is available at: http://www.health.alberta.ca/health-info/influenza-evidence.html
If you have questions about the Alberta Respiratory Virus Surveillance Report, or any of the indicators, please contact:
Influenza Immunizations (cont.)
South Calgary Central Edmonton North Alberta
Long term care staff 442 5,621 2,023 5,615 344 14,045
Health care workers 2,313 20,863 5,502 18,540 2,662 49,880
Pregnant women 377 2,200 94 498 204 3,373
Residents of long term care 333 5,266 1,616 6,184 87 13,486
65 years of age and over 7,581 37,984 5,374 25,226 1,901 78,066
Dose #1 109 175 104 161 275 824
Dose #2 3 98 10 101 57 269
Annual 185 335 47 329 166 1,062
Dose #1 10 119 51 74 108 362
Dose #2 0 27 2 40 35 104
Annual 166 747 145 542 542 2,142
Dose #1 1 18 3 13 4 39
Dose #2 0 2 0 4 2 8
Annual 30 216 29 448 156 879
High risk: 9 years up to and including 64 years 6,780 21,084 2,314 15,551 2,619 48,348
Dose #1 2 26 4 24 48 104
Dose #2 0 8 1 12 20 41
Annual 151 761 188 822 892 2,814
Healthy: 9 years up to and including 64 years 10,201 70,281 6,554 40,323 11,557 138,916
Total number of clients who have received 1 dose 28,681 165,696 24,048 114,350 21,565 354,340
Total number of 2nd doses administered to those eligible* 3 135 13 157 114 422
Total Doses Administered 28,684 165,831 24,061 114,507 21,679 354,762
All children 6 months up to and including
23 months*
All children 24 months up to and
including 59 months*
High risk: 5 years up to and including 8
years*
Healthy: 5 years up to and including 8
years*
Table 5: Cumulative Doses Administered by All Community Providers and First Nations and Inuit Health Branch(Oct 2,2011-Mar 31,2012) Report 1 and 2
Priority Group
South Calgary Central Edmonton North Alberta
Long term care staff 966 6,052 2,579 6,005 1,370 16,972
Health care workers 3,932 25,628 8,439 23,964 6,702 68,665
Pregnant women 604 3,392 417 1,726 678 6,817
Residents of long term care 1,421 7,476 2,486 7,066 1,320 19,769
65 years of age and over 21,142 75,623 26,418 72,758 17,384 213,325
Dose #1 1,638 8,771 1,942 6,540 2,259 21,150
Dose #2 928 4,838 1,293 3,564 1,104 11,727
Annual 863 5,889 972 2,697 1,042 11,463
Dose #1 430 1,400 431 1,242 470 3,973
Dose #2 305 667 207 545 206 1,930
Annual 1,757 10,676 2,146 7,502 2,901 24,982
Dose #1 26 137 58 113 68 402
Dose #2 22 41 20 46 13 142
Annual 282 2,499 549 1,782 851 5,963
High risk: 9 years up to and including 64 years 10,111 37,320 8,443 32,201 10,448 98,523
Dose #1 135 475 164 474 309 1,557
Dose #2 59 203 108 169 89 628
Annual 1,621 9,128 2,123 6,781 3,193 22,846
Healthy: 9 years up to and including 64 years 25,212 148,708 27,069 107,196 36,458 344,643
Total number of clients who have received 1 dose 70,140 343,174 84,236 278,047 85,453 861,050
Total number of 2nd doses administered to those eligible* 1,314 5,749 1,628 4,324 1,412 14,427
Total Doses Administered 71,454 348,923 85,864 282,371 86,865 875,477
Table 6: Cumulative Doses Administered (AHS as of Apr 30, 2012 + Community Providers and First Nations and Inuit Health Branch as of Mar 31,2011)
Priority Group
All children 6 months up to and including
23 months*
All children 24 months up to and
including 59 months*
High risk: 5 years up to and including 8
years*
Healthy: 5 years up to and including 8
years*
Source: AHS Zones. Community providers submit reports twice a year, once at end of December and once at the end of the season. For more information on data definitions and sources, see Data Notes.*Children under 9 years of age who have not received at least one dose in past years require two doses, given at least 4 weeks apart.
SURVEILLANCE AND HEALTH STATUS ASSESSMENT Page | 15 Page | 15 Public Health Surveillance Report Date: May 16, 2012
Alberta Respiratory Virus
Surveillance Report Update for Flu Week 19: (May 6-12, 2012)
An influenza report targeted to the general public is available at: http://www.health.alberta.ca/health-info/influenza-evidence.html
If you have questions about the Alberta Respiratory Virus Surveillance Report, or any of the indicators, please contact:
Data Notes
LABORATORY DATA Information on laboratory confirmed respiratory virus activity is based on two web-based applications supported by the Canadian Network for Public Health Intelligence (CNPHI):
1) The Alberta Provincial Public Health Laboratory DIAL system (Data Integration for Alberta Laboratories) – a specimen based system. Data are based on specimens obtained from residents of Alberta according to the date the sample was received at the Provincial laboratory.
2) The Alberta Influenza Outbreak Response Toolkit – an influenza case based system. Data are based on Alberta residents according to the date the sample was classified as influenza sub-type.
Respiratory samples submitted for testing at the Alberta Provincial Laboratory are first tested for influenza A & B. Those with a negative influenza result are then tested using the respiratory virus panel or RVP which tests for the presence of the non-influenza respiratory viruses presented in this report. Samples from physicians participating in the Tarrant program and patients admitted to intensive or critical care units are tested for both non-influenza and influenza viruses. Definition for “mixed” – a single sample where multiple viral organisms were isolated.
ILI OUTBREAK INVESTIGATIONS Upon notification of an outbreak, the Alberta Health & Wellness (AHW)/Alberta Health Services (AHS) Outbreak Reporting Form (AORF) is completed by a communicable disease nurse, sent to AHW and entered into the CDRS database. Outbreaks reported by First Nations and Inuit Health (FNIH) to AHW are not included in this report. The AORF form includes information about the type and location of the outbreak, the facility, and causative organism. Note that zone specific outbreaks are those reported by that zone, however specific cases may reside or have been exposed and/or infected outside of that zone. Not all outbreaks result in an organism being confirmed and for those that are confirmed, there may be a delay between reporting and identification of the organism; outbreaks are classified by the organism listed as the ILI Organism Confirmed on the AORF. This report does not include outbreaks suspected or confirmed to be caused by bacteria (i.e. pertussis, invasive pneumococcal disease) or viruses causing rash-like illness such as measles, rubella (German measles) or chickenpox. In this report, outbreaks are reported according to the onset date of the first case; where onset date is not available, the date the investigation is opened is used. The AHS Public Health Surveillance team obtains the data via CDRS which is housed and maintained by AHW.
CALLS TO HEALTH LINK ALBERTA Health Link Alberta is a 24 hour a day, 7 day a week nurse-operated service that provides the public with advice and information about health symptoms and concerns. The original data source for calls to Health Link Alberta for cough and breathing difficulties is the Health Link database called Sharp Focus (obtained via the Alberta Real Time Syndromic Surveillance Net - ARTSSN). Note that one individual may place multiple calls.
The Health Link protocols selected for inclusion are as follows: cough/hoarseness/stridor (PED), cough/hoarseness (ADULT), and breathing concerns > 2 mo. (PED) (historically breathing difficulties >6 mo. and <6 mo. (PED)).
SENTINEL PHYSICIAN OFFICE VISITS (TARRANT) Tarrant Viral Watch is an AHW-funded program intended to monitor ILI (Influenza-like Illness) and LRTI (Lower Respiratory Tract Infections) in the community. Volunteer sentinel physician offices provide data to the Tarrant program, which in turn provide them to AHS Public Health Surveillance on a weekly basis. ILI is defined as a respiratory illness with acute onset, with fever, and cough, and with 1 or more of sore throat, arthralgia, myalgia or prostration-which may be due to influenza virus (presentation may vary in pediatric and elderly populations). LRTI is defined as any acute infection with significant involvement of the respiratory tract below the larynx, as identified by history, physical signs and/or radiological findings. If a patient has ILI with lower tract involvement, they are coded as LRTI. Note that the definition of ILI may vary from other definitions.
INFLUENZA IMMUNIZATIONS Influenza immunization data are reported by AHS zones. Numbers are available to the AHS Public Health Surveillance team at the beginning of the week for the doses administered the previous week (Sunday to Saturday). It includes those doses administered by AHS (Public Health). Note: April
30th was the last day of the influenza immunization program for the current season. Community providers submit reports twice a year, once at the end of December and once at the end of the season. Clients can only exist in one priority group. Immunization coverage rates will be reported at the end of the influenza season.
SURVEILLANCE AND HEALTH STATUS ASSESSMENT Page | 16 Page | 16 Public Health Surveillance Report Date: May 16, 2012
Alberta Respiratory Virus
Surveillance Report Update for Flu Week 19: (May 6-12, 2012)
An influenza report targeted to the general public is available at: http://www.health.alberta.ca/health-info/influenza-evidence.html
If you have questions about the Alberta Respiratory Virus Surveillance Report, or any of the indicators, please contact:
POPULATION NUMBERS Population data values used to calculate rates were obtained from the Alberta Health and Wellness (AHW) Interactive Health Data Application (IHDA). http://www.ahw.gov.ab.ca/IHDA_Retrieval/ - Immunization category. Click on View Data Notes for a detailed description of definitions and methodology. In addition to what is posted online, further breakdowns by age group were obtained by AHW staff. * Flu week numbers are the same as those defined by the Public Health Agency of Canada’s (PHAC) FluWatch.