Alberta Respiratory Virus Surveillance Update · 2016-06-23 · Alberta Respiratory Virus...

Alberta Respiratory Virus Surveillance Report Update for Flu week 30-34 (Jul 26 – Aug 29, 2015)

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Surveillance and Reporting Public Health Surveillance and Infrastructure

If you have questions about the Alberta Respiratory Virus Surveillance Report, or any of the indicators, please contact: [email protected]

Weekly Update September 2, 2015

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 up to the Saturday prior to the day the report is released.

Alberta Rhino-enterovirus had the highest positivity among specimens tested for respiratory viruses in weeks 30 - 34 (Figure 1).

There were 5 new cases of lab confirmed influenza in weeks 30 - 34 in Alberta; 5 A(H3), 0 A(H1N1)pdm09, 0 A(unresolved subtype), and 0 B

(Table 1). So far this season (August 24, 2014 – August 29, 2015), there have been 4859 cases of lab confirmed influenza; 3729 A(H3), 14

A(H1N1)pdm09, 209 A(unresolved subtype) and 907 B.

In weeks 30 - 34, the weekly rates of influenza A and B in Alberta remained at or below 0.1 per 100,000 Albertans.

In weeks 30 - 34, the weekly influenza rates for all age groups were low (less than 0.7 per 100,000 Albertans).

There were 4 ILI outbreaks reported with onset in weeks 30 - 34 in Alberta (Table 2).

The Health Link Alberta weekly call rate for cough/ILI ranged between 3 and 7 calls per 100,000 Albertans in weeks 30 - 34 (Figure 6).

On average there were 169 weekly visits with ILI (1.7% of all visits) to Edmonton zone Emergency Departments/Urgent Care Centres (EDIS/E-triage sites) (Figure 7) and 216 weekly visits with ILI (2.4% of all visits) to Calgary zone Emergency Departments/Urgent Care Centres (SEC sites) in weeks 30 - 34 (Figure 8).

In weeks 30 - 34, 0.08% to 0.28% and 0.16% to 0.37% were the ranges for weekly percentage of patient visits to Alberta sentinel physicians attributed to ILI (influenza like illness) and LRTI (lower respiratory tract infection), respectively (Figure 9).

Public health administered influenza immunization data are available in Table 3, Table 4, Table 5 and Table 6.

North America

As per FluWatch (PHAC), influenza activity remained low in weeks 31 and 32 in Canada.

As of flu week 32, the National Microbiology Lab (NML) of Canada has antigenically characterized 1162 influenza samples – 216 A(H3N2), 24 A(H1N1)pdm09, and 922 B.

There were 1925 viruses tested for antiviral resistance to oseltamivir and 1923 for zanamivir. All were

sensitive except one which was resistant to oseltamivir. There were 1493 influenza A virus samples tested

for resistance to amantadine; all but one (99.9%), were resistant.

According to the week 33 FluView (US CDC) update, influenza activity in the US continued to decrease.

International

As per the most recent WHO influenza update (August 24, 2015), influenza activity in the northern

hemisphere was low.

In the tropical zone, influenza activity was mostly low with the exception of Southern China, which had

high but decreasing influenza activity.

In the southern hemisphere, influenza activity increased in Australia and New Zealand but decreased in

South America.

Quick Links Laboratory Data

ILI Outbreaks

Calls to Health Link Alberta

Emergency Department Visits

TARRANT Sentinel Physician

Visits Immunization Data Data Notes

2015-16 Northern Hemisphere Vaccine Recommendations

Current Global Information FluWatch (PHAC)

FluView (US CDC)

HPA (UK)

WHO

Travel Advisories

mailto:[email protected]

http://origin.phac-aspc.gc.ca/fluwatch/

http://www.cdc.gov/flu/weekly/

http://www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/SeasonalInfluenza/EpidemiologicalData/

http://www.who.int/csr/disease/influenza/en/

http://www.phac-aspc.gc.ca/tmp-pmv/pub-eng.php


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Laboratory Data

Figure 1: Alberta weekly respiratory specimen percent positivity, by virus type

0%

10%

20%

30%

40%

50%

60%

35 38 41 44 47 50 53 3 6 9 12 15 18 21 24 27 30 33

Pe

rce

nt P

osi

tive

Flu Week

ALBERTA

Adenovirus Coronavirus HmpvParainfluenza RSV Rhino-enterovirusMixed FluA FluB

Click here for ZONE figures of respiratory virus specimen percent positivity Source: DIAL – Provincial Laboratory specimens, data extracted on September 1, 2015. For more information on data definitions and sources, see Data Notes. “Percent positive” is the number of positive specimens for that virus as a percent of the total number of specimens tested for respiratory viruses.

Table 1: New and cumulative laboratory confirmed influenza cases, by subtype, Alberta and Zones

Week 34 (23Aug2015 - 29AUG2015) Cumulative (24Aug2014 - 29AUG2015)

Influenza A Influenza B Influenza A Influenza B

A(H3)

A(H1N1)

pdm09

A

(unresolved

type due to

low viral

load) A (total) B (total) A(H3)

A(H1N1)

pdm09

A

(unresolved

type due to

low viral

load) A (total) B (total)

South 0 0 0 0 0 314 2 17 333 22

Calgary 0 0 0 0 0 1222 3 66 1291 320

Central 0 0 0 0 0 501 1 24 526 142

Edmonton 0 0 0 0 0 1165 5 72 1242 321

North 0 0 0 0 0 527 3 30 560 102

Alberta Total 0 0 0 0 0 3729 14 209 3952 907

Zones

Source: CDRS influenza cases, data extracted on September 1, 2015. For more information on data definitions and sources, see Data Notes.



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Figure 2: Alberta weekly rates (per 100,000) of lab confirmed influenza, by subtype

0

5

10

15

20

25

35 38 41 44 47 50 53 3 6 9 12 15 18 21 24 27 30 33

We

ekl

y ra

te (p

er 1

00,0

00)

Flu week

ALBERTA

Influenza A rate (2014-15) Influenza A rate (2013-14) Influenza A rate (2012-13)

Influenza B rate (2014-15) Influenza B rate (2013-14) Influenza B rate (2012-13)

Click here for ZONE figures - rates of lab confirmed influenza Source: CDRS influenza cases, data extracted on September 1, 2015. For more information on data definitions and sources, see Data Notes.

Figure 3: Alberta weekly rates (per 100,000) of lab confirmed respiratory viruses (excluding influenza), by virus type

0

2

4

6

8

10

35 38 41 44 47 50 53 3 6 9 12 15 18 21 24 27 30 33

We

ekl

y R

ate

(pe

r 100

,000

)

Flu Week

ALBERTA

Adenovirus rate Coronavirus rate hMPV rate Parainfluenza rate

RSV rate Mixed rate Rhino-enterovirus rate Click here for ZONE figures - rates of lab confirmed respiratory viruses

Source: DIAL – Provincial Laboratory specimens, data extracted on September 1, 2015. For more information on data definitions and sources, see Data Notes.



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Figure 4: Alberta weekly age-specific rates of lab confirmed influenza (per 100,000) by subtype

0

10

20

30

40

50

60

70

80

35 38 41 44 47 50 53 3 6 9 12 15 18 21 24 27 30 33Age

Sp

ecif

ic R

ate

(p

er 1

00

,00

0)

Flu Week

ALBERTA Influenza A(H1N1)PDM09

0 to < 2 years

2 to < 5 years

5 to < 9 years

9 to < 18 years

18 to < 65 years

65+ years

0

10

20

30

40

50

60

70

80

35 38 41 44 47 50 53 3 6 9 12 15 18 21 24 27 30 33

Age

Sp

ecif

ic R

ate

(p

er 1

00

,00

0)

Flu Week

ALBERTA Influenza A(H3)

0 to < 2 years

2 to < 5 years

5 to < 9 years

9 to < 18 years

18 to < 65 years

65+ years

0

10

20

30

40

50

60

70

80

35 38 41 44 47 50 53 3 6 9 12 15 18 21 24 27 30 33Age

Sp

ecif

ic R

ate

(p

er 1

00

,00

0)

Flu Week

ALBERTA Influenza B

0 to < 2 years

2 to < 5 years

5 to < 9 years

9 to < 18 years

18 to < 65 years

65+ years

Click here for ZONE figures - age specific rates of lab confirmed influenza




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Influenza-Like-Illness (ILI) Outbreak Investigations Figure 5: AHS investigated ILI outbreaks in Alberta facilities, by onset week and organism type

0

10

20

30

40

50

35 38 41 44 47 50 53 3 6 9 12 15 18 21 24 27 30 33

Nu

mb

er

of

Ou

tbre

aks

All AHS reported Influenza-Like-Illness

Outbreaks*

0

10

20

30

40

35 38 41 44 47 50 53 3 6 9 12 15 18 21 24 27 30 33

Nu

mb

er o

f Ou

tbre

aks

Confirmed Influenza A(H3)

0

5

10

15

20

35 38 41 44 47 50 53 3 6 9 12 15 18 21 24 27 30 33

Nu

mb

er o

f Ou

tbre

aks

Confirmed Influenza A(H1N1)

0

5

10

15

20

35 38 41 44 47 50 53 3 6 9 12 15 18 21 24 27 30 33

Num

ber o

f Out

brea

ks

Flu Week

Confirmed Influenza B

Acute Care Childcare Long term Care School (K-12) Supportive or Home Living Sites (SL/HL) Other

- - - Combined total for the 2013-14 season ― Combined total for the 2012-13 season Source: CDRS data extracted on September 1, 2015 (obtained via the Alberta Outbreak Reporting Form). For more information on data definitions and sources, see Data Notes. Note: Some outbreaks may involve more than one pathogen.



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Figure 5 continued: AHS investigated ILI outbreaks in Alberta facility types, by onset week and organism type

0

5

10

15

20

35 38 41 44 47 50 53 3 6 9 12 15 18 21 24 27 30 33

Nu

mb

er o

f Ou

tbre

aks

Confirmed Rhino-enterovirus

0

5

10

15

20

35 38 41 44 47 50 53 3 6 9 12 15 18 21 24 27 30 33

Nu

mb

er

of

Ou

tbre

aks

Confirmed RSV

0

5

10

15

20

35 38 41 44 47 50 53 3 6 9 12 15 18 21 24 27 30 33

Nu

mb

er

of

Ou

tbre

aks

Confirmed Parainfluenza

0

5

10

15

20

35 38 41 44 47 50 53 3 6 9 12 15 18 21 24 27 30 33

Nu

mb

er o

f Ou

tbre

aks

Flu Week

Confirmed Other **Respiratory Viruses

Acute Care Childcare Long term Care School (K-12) Supportive or Home Living Sites (SL/HL) Other

- - - Combined total for the 2013-14 season ― Combined total for the 2012-13 season ** Other confirmed respiratory viruses include influenza A (unresolved type), adenovirus, coronavirus, and hMPV. Source: CDRS data extracted on September 1, 2015 (obtained via the Alberta Outbreak Reporting Form). For more information on data definitions and sources, see Data Notes. Note: Some outbreaks may involve more than one pathogen.



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Table 2: New and cumulative AHS investigated ILI outbreaks, by onset date and by organism, Alberta and Zones

Long

Term

Care

SL/HLSchool

(K-12)

Acute

Care

Child

careOther

Long

Term

Care

SL/HLSchool

(K-12)

Acute

Care

Child

careOther Total

Confirmed Flu A(H3) - - - - - - 96 86 13 17 - 7 219Confirmed A(H1N1)pdm09 - - - - - - - - - - - - 0Confirmed Flu B - - - - - - 14 2 - 2 - - 18Confirmed RSV - - - - - - 9 7 - 1 - - 17Confirmed Parainfluenza - - - - - - 7 4 - - 1 - 12Confirmed Rhino-enterovirus - - - - - - 13 4 1 - - 1 19Confirmed other** respiratory viruses - - - - - - 7 4 - - 1 - 12Initial report only (lab results pending) - 1 - - - - - 1 - - - - 1Unknown (none confirmed or no specimen available) - - - - - - 10 3 14 1 4 - 32Total 0 1 0 0 0 0 156 111 28 21 6 8 330

Organism

Long

Term

Care

SL/HLSchool

(K-12)

Acute

Care

Child

careOther

Long

Term

Care

SL/HLSchool

(K-12)

Acute

Care

Child

careOther Total

Confirmed Flu A(H3) - - - - - - 7 19 - - - 1 27Confirmed A(H1N1)pdm09 - - - - - - - - - - - - 0Confirmed Flu B - - - - - - - - - - - - 0Confirmed RSV - - - - - - - - - - - - 0Confirmed Parainfluenza - - - - - - 1 2 - - - - 3Confirmed Rhino-enterovirus - - - - - - - - 1 - - - 1Confirmed other** respiratory viruses - - - - - - - - - - - - 0Initial report only (lab results pending) - - - - - - - - - - - - 0Unknown (none confirmed or no specimen available) - - - - - - 1 1 2 - - - 4Total 0 0 0 0 0 0 9 22 3 0 0 1 35

Organism

Long

Term

Care

SL/HLSchool

(K-12)

Acute

Care

Child

careOther

Long

Term

Care

SL/HLSchool

(K-12)

Acute

Care

Child

careOther Total

Confirmed Flu A(H3) - - - - - - 29 22 2 6 - - 59Confirmed A(H1N1)pdm09 - - - - - - - - - - - - 0Confirmed Flu B - - - - - - 5 1 - - - - 6Confirmed RSV - - - - - - 3 1 - - - - 4Confirmed Parainfluenza - - - - - - - 1 - - - - 1Confirmed Rhino-enterovirus - - - - - - 6 - - - - - 6Confirmed other** respiratory viruses - - - - - - 2 1 - - - - 3Initial report only (lab results pending) - - - - - - - - - - - - 0Unknown (none confirmed or no specimen available) - - - - - - 1 1 4 - - - 6Total 0 0 0 0 0 0 46 27 6 6 0 0 85

ALBERTA

Organism


SOUTH

CALGARY

** Other confirmed respiratory viruses include influenza A (unresolved type), adenovirus, coronavirus, and hMPV. Source: CDRS data extracted on September 1, 2015 (obtained via the Alberta Outbreak Reporting Form). For more information on data definitions and sources, see Data Notes. Note: Some outbreaks may involve more than one pathogen.



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Table 2 continued: New and cumulative AHS investigated ILI outbreaks, by onset date and by organism, Alberta and Zones

Organism

Long

Term

Care

SL/HLSchool

(K-12)

Acute

Care

Child

careOther

Long

Term

Care

SL/HLSchool

(K-12)

Acute

Care

Child

careOther Total

Confirmed Flu A(H3) - - - - - - 16 13 2 1 - - 32Confirmed A(H1N1)pdm09 - - - - - - - - - - - - 0Confirmed Flu B - - - - - - 1 1 - - - - 2Confirmed RSV - - - - - - 1 2 - - - - 3Confirmed Parainfluenza - - - - - - 5 - - - - - 5Confirmed Rhino-enterovirus - - - - - - 1 - - - - - 1Confirmed other** respiratory viruses - - - - - - - - - - - - 0Initial report only (lab results pending) - - - - - - - - - - - - 0Unknown (none confirmed or no specimen available) - - - - - - 1 1 - - - - 2Total 0 0 0 0 0 0 25 17 2 1 0 0 45

Organism

Long

Term

Care

SL/HLSchool

(K-12)

Acute

Care

Child

careOther

Long

Term

Care

SL/HLSchool

(K-12)

Acute

Care

Child

careOther Total

Confirmed Flu A(H3) - - - - - - 32 22 2 9 - 4 69Confirmed A(H1N1)pdm09 - - - - - - - - - - - - 0Confirmed Flu B - - - - - - 8 - - 2 - - 10Confirmed RSV - - - - - - 5 4 - 1 - - 10Confirmed Parainfluenza - - - - - - 1 - - - - - 1Confirmed Rhino-enterovirus - - - - - - 5 4 - - - 1 10Confirmed other** respiratory viruses - - - - - - 5 3 - - - - 8Initial report only (lab results pending) - 1 - - - - - 1 - - - - 1Unknown (none confirmed or no specimen available) - - - - - - 6 - 6 1 4 - 17Total 0 1 0 0 0 0 62 34 8 13 4 5 126

Organism

Long

Term

Care

SL/HLSchool

(K-12)

Acute

Care

Child

careOther

Long

Term

Care

SL/HLSchool

(K-12)

Acute

Care

Child

careOther Total

Confirmed Flu A(H3) - - - - - . 12 10 7 1 - 2 32Confirmed A(H1N1)pdm09 - - - - - . - - - - - . 0Confirmed Flu B - - - - - . - - - - - . 0Confirmed RSV - - - - - . - - - - - . 0Confirmed Parainfluenza - - - - - . - 1 - - - . 1Confirmed Rhino-enterovirus - - - - - . 1 - - - - . 1Confirmed other** respiratory viruses - - - - - . - - - - 1 . 1Initial report only (lab results pending) - - - - - . - - - - - . 0Unknown (none confirmed or no specimen available) - - - - - . 1 - 2 - - . 3Total 0 0 0 0 0 0 14 11 9 1 1 2 38

NORTH

CENTRAL


EDMONTON

** Other confirmed respiratory viruses include influenza A (unresolved type), adenovirus, coronavirus, and hMPV. Source: CDRS data extracted on September 1, 2015 (obtained via the Alberta Outbreak Reporting Form). For more information on data definitions and sources, see Data Notes. Note: Some outbreaks may involve more than one pathogen.



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Calls to Health Link Alberta Figure 6: Weekly call rate (per 100,000) for cough or influenza-like illness, Alberta and Zones

0

10

20

30

40

50

35 39 43 47 51 2 6 10 14 18 22 26 30 34

We

ekl

y ca

ll ra

te (p

er 1

00

,00

0) ALBERTA

0

10

20

30

40

50

35 39 43 47 51 2 6 10 14 18 22 26 30 34

We

ekl

y ca

ll ra

te (p

er 1

00

,00

0) SOUTH

0

10

20

30

40

50

35 39 43 47 51 2 6 10 14 18 22 26 30 34

We

ekl

y ca

ll ra

te (p

er 1

00

,00

0) CALGARY

0

10

20

30

40

50

35 39 43 47 51 2 6 10 14 18 22 26 30 34

We

ekl

y ca

ll ra

te (p

er 1

00,0

00) CENTRAL

0

10

20

30

40

50

35 39 43 47 51 2 6 10 14 18 22 26 30 34

We

ekl

y ca

ll ra

te (p

er 1

00

,00

0)

Flu Week

EDMONTON

current call rate (2014-15) 2013-14 call rate

0

10

20

30

40

50

35 39 43 47 51 2 6 10 14 18 22 26 30 34

We

ekl

y ca

ll ra

te (p

er 1

00

,00

0)

Flu Week

NORTH

2012-13 call rate

Source: Sharp Focus - Health Link Alberta calls, data extracted on September 1, 2015 via the Alberta Real Time Syndromic Surveillance Net (ARTSSN). For more

information on data definitions and sources, see Data Notes.



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Emergency Department Visits Figure 7A: Weekly emergency department/urgent care centre (ED/UCC) visits with ILI during screening at triage,

Edmonton zone (EDIS and E-triage sites)

0

200

400

600

800

1000

1200

1400

35 38 41 44 47 50 53 3 6 9 12 15 18 21 24 27 30 33

We

ekl

y #

of

visi

ts w

ith

ILI

Flu Week

EDMONTON - EDIS/E-triage sites

ILI positive visits (2014-15) 2012-13 ILI positive visits 2013-14 ILI positive visits

Figure 7B: Weekly percentage of all ED/UCC visits with ILI during screening at triage, Edmonton zone (EDIS and E-triage sites)

0.0

2.0

4.0

6.0

8.0

10.0

12.0

35 38 41 44 47 50 53 3 6 9 12 15 18 21 24 27 30 33

We

ekl

y %

of v

isit

s w

ith

ILI

Flu Week

EDMONTON - EDIS/E-triage sites

% of total EDIS visits ILI positive (2014-15) 2012-13 % ILI positive 2013-14 % ILI positive

Source: EDIS and E-triage emergency department visits, data extracted on September 1, 2015 via the Alberta Real Time Syndromic Surveillance Net (ARTSSN). For more information on data definitions and sources, see Data Notes.



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Figure 8A: Weekly ED/UCC visits with ILI during screening at triage, Calgary zone (SEC sites)

0

200

400

600

800

1000

1200

1400

35 38 41 44 47 50 53 3 6 9 12 15 18 21 24 27 30 33

We

ekl

y #

of

visi

ts w

ith

ILI

Flu Week

Calgary- SEC sites

ILI positive visits (2014-15) 2013-14 ILI positive visits

Figure 8B: Weekly percentage of all ED/UCC visits with ILI during screening at triage, Calgary zone (SEC sites)

0.0

2.0

4.0

6.0

8.0

10.0

12.0

14.0

35 38 41 44 47 50 53 3 6 9 12 15 18 21 24 27 30 33

We

ekl

y %

of v

isit

s w

ith

ILI

Flu Week

Calgary- SEC sites

% of total EDIS visits ILI positive (2014-15) 2013-14 % ILI positive

Source: SEC emergency department visits, data extracted on September 1, 2015 via the Alberta Real Time Syndromic Surveillance Net (ARTSSN). For more information on data definitions and sources, see Data Notes.



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TARRANT Sentinel Physician Office Visits Figure 9A: Alberta weekly sentinel physician patient visits (%) with ILI (Influenza Like Illness)

0.0

0.5

1.0

1.5

2.0

2.5

35 38 41 44 47 50 53 3 6 9 12 15 18 21 24 27 30 33

Wee

kly

% o

f vi

sits

wit

h IL

I

Flu Week

ALBERTA

% of total visits ILI positive (2014-15) 2012-13 % ILI positive 2013-14 % ILI positive

Figure 9B: Alberta weekly sentinel physician patient visits (%) with LRTI (Lower Respiratory Tract Infection)

0.0

0.5

1.0

1.5

2.0

2.5

3.0

35 38 41 44 47 50 53 3 6 9 12 15 18 21 24 27 30 33

We

ekl

y %

of

visi

ts w

ith

LR

TI

Flu Week

ALBERTA

% of total visits LRTI (2014-15) 2012-13 % LRTI 2013-14 % LRTI

Source: Tarrant Viral Watch program – www.tarrantviralwatch.ca, data extracted on September 1, 2015. For more information on data definitions and sources, see Data Notes.


http://www.tarrantviralwatch.ca/


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Table 3: Cumulative AHS (Public Health) delivered influenza immunizations, by risk group (to April 30, 2015)

Health care workers AHS/Covenant 734 2,240 1,439 2,707 5,362 12,482

Health care workers Total 2,471 6,004 2,959 7,022 7,067 25,523

Pregnant women 252 1,409 575 1,314 498 4,048

65 years of age and over 9,284 23,751 13,153 34,137 14,079 94,404

All children 6 months up to and including 23 months* Dose #1 2,095 12,901 2,480 8,246 2,782 28,504Dose #2 1,582 5,463 1,701 4,968 1,540 15,254Annual 927 5,330 1,087 3,977 1,236 12,557

All children 24 months up to and including 59 months* Dose #1 499 2,894 652 2,163 782 6,990Dose #2 385 998 393 1,051 393 3,220Annual 2,636 13,954 3,009 11,510 3,510 34,619

High risk: 5 years up to and including 8 years* Dose #1 24 205 51 122 61 463Dose #2 13 27 24 40 20 124Annual 279 1,512 390 1,592 611 4,384

High risk: 9 years up to and including 64 years 1,776 10,270 2,993 9,570 5,285 29,894

Healthy: 5 years up to and including 8 years* Dose #1 303 2,476 327 966 754 4,826Dose #2 221 480 180 442 363 1,686Annual 2,652 14,415 3,149 12,487 4,798 37,501

Healthy: 9 years up to and including 64 years 12,311 66,903 16,308 68,016 28,506 192,044

Total number of clients who have received Dose 1 of 2 2,921 18,476 3,510 11,497 4,379 40,783

Total number of clients who have received Dose 2 of 2 2,201 6,968 2,298 6,501 2,316 20,284

Total number of clients who have received an Annual Dose 32,588 143,548 43,623 149,625 65,590 434,974

Total Doses Administered 37,710 168,992 49,431 167,623 72,285 496,041

Priority Group Calgary Central Edmonton North AlbertaSouth

Source: AHS Zones (doses do not include those delivered by community 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.



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Table 4: Community provider* delivered influenza immunizations by risk group (excluding FNIHB**) - Sep 1, 2014 to Mar 31, 2015***

Health care workers AHS/Covenant 4,278 19,518 3,723 22,248 446 0 50,213

Health care workers Total 6,238 32,174 7,312 29,581 638 0 75,943

Pregnant women 661 2,131 82 618 83 0 3,575

65 years of age and over 3,737 26,355 3,301 19,576 370 0 53,339

Dose #1 4 334 0 222 0 0 560

Dose #2 4 131 0 166 0 0 301

Annual 3 849 1 287 1 0 1,141

Dose #1 6 217 0 147 2 0 372

Dose #2 5 68 0 49 0 0 122

Annual 27 1,140 1 749 37 0 1,954

Dose #1 3 75 0 103 0 0 181

Dose #2 0 7 0 10 0 0 17

Annual 12 429 2 106 1 0 550

High risk: 9 years up to and including 64 years 1,479 12,700 555 9,205 369 0 24,308

Dose #1 2 282 0 212 1 0 497

Dose #2 0 38 0 31 1 0 70

Annual 41 2,168 1 857 61 0 3,128

Healthy: 9 years up to and including 64 years 5,322 52,328 2,136 29,639 5,806 0 95,231

Total number of clients who have received Dose 1 of 2 15 908 0 684 3 0 1,610

Total number of clients who have received Dose 2 of 2 9 244 0 256 1 0 510

Total number of clients who have received an Annual Dose 17,520 130,274 13,391 90,618 7,366 0 259,169

Total Doses Administered 17,544 131,426 13,391 91,558 7,370 0 261,289

All children 6 months up to and including 23 months

All children 24 months up to and including 59 months

Priority Group Calgary Central Edmonton NorthSouth Alberta

High risk: 5 years up to and including 8 years

Healthy: 5 years up to and including 8 years

Unassigned

Zone

*Includes physicians, AHS non-public health and non-AHS community providers.

** FNIHB = First Nation Inuit Health Branch. *** Includes data from Public Health zones from Sep 1, 2014 to Mar 31, 2015 and data from Alberta Health Physician's claims files from Apr 1 to 11, 2015.



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Table 5: Cumulative influenza immunizations delivered by AHS public health (September 29 to April 30, 2015) + community providers* (September 1 to March 31, 2015) ** by risk group

Health care workers AHS/Covenant 5,012 21,758 5,162 24,955 5,808 0 62,695

Health care workers Total 8,709 38,178 10,271 36,603 7,705 0 101,466

Pregnant women 913 3,540 657 1,932 581 0 7,623

65 years of age and over 13,021 50,106 16,454 53,713 14,449 0 147,743

Dose #1 2,099 13,235 2,480 8,468 2,782 0 29,064Dose #2 1,586 5,594 1,701 5,134 1,540 0 15,555

Annual 930 6,179 1,088 4,264 1,237 0 13,698

Dose #1 505 3,111 652 2,310 784 0 7,362Dose #2 390 1,066 393 1,100 393 0 3,342

Annual 2,663 15,094 3,010 12,259 3,547 0 36,573

Dose #1 27 280 51 225 61 0 644Dose #2 13 34 24 50 20 0 141

Annual 291 1,941 392 1,698 612 0 4,934

High risk: 9 years up to and including 64 years 3,255 22,970 3,548 18,775 5,654 0 54,202

Dose #1 305 2,758 327 1,178 755 0 5,323Dose #2 221 518 180 473 364 0 1,756

Annual 2,693 16,583 3,150 13,344 4,859 0 40,629

Healthy: 9 years up to and including 64 years 17,633 119,231 18,444 97,655 34,312 0 287,275

Total number of clients who have received Dose 1 of 2 2,936 19,384 3,510 12,181 4,382 0 42,393

Total number of clients who have received Dose 2 of 2 2,210 7,212 2,298 6,757 2,317 0 20,794

Total number of clients who have received an Annual Dose 50,108 273,822 57,014 240,243 72,956 0 694,143

Total Doses Administered 55,254 300,418 62,822 259,181 79,655 0 757,330

All children 24 months up to and including 59 months*

High risk: 5 years up to and including 8 years*

NorthUnassigned

ZoneCentral EdmontonSouth

All children 6 months up to and including 23 months*

Alberta

Healthy: 5 years up to and including 8 years*

Priority Group Calgary

*Includes physicians, AHS non-public health and non-AHS community providers.

** Includes data from Public Health zones from Sep 1, 2014 to Mar 31, 2015



16



Table 6: Influenza immunization doses as of April 30, 2015 administered by zone and provider type

Public Health 37,710 168,992 49,431 167,623 72,285 0 496,041Pharmacist

140,095 208,199 51,612 157,318 29,898 0 487,122

Physician2

7,873 73,239 3,868 42,427 431 0 127,838

FNIHB3 1,314 2,534 1,105 889 4,656 0 10,498

AHS non-Public Health2

4,693 26,390 7,059 21,189 851 0 60,182

Other non-AHS2

4,978 31,797 2,464 27,942 6,088 0 73,269

Total Doses Administered 96,663 511,151 115,539 417,388 114,209 0 1,254,950

SouthProvider Type Calgary Central Edmonton NorthUnassigned

ZoneAlberta

¹ Data provided by Alberta Health, for doses administered up to Mar 31, 2015.

² Data from Public Health zones for doses administered up to Mar 31, 2015. 3 Data from First Nations Inuit Health Branch for doses administered up to Mar 31, 2015.



17



Appendix

Zones figure 1: Weekly respiratory specimen percent positivity, by virus type and zone

0%

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NORTHAdenovirus

Coronavirus

Hmpv

Parainfluenza

RSV

Rhino-enterovirus

Mixed

FluA

FluB

Click here to return to Alberta figure - respiratory virus specimen percent positivity

Source: DIAL – Provincial Laboratory specimens, data extracted on September 1, 2015. For more information on data definitions and sources, see Data Notes. “Percent positive” is the number of positive specimens for that virus as a percent of the total number of specimens tested for respiratory viruses.



18



Zones figure 2: Weekly rates (per 100,000) of lab confirmed influenza, by subtype and Zone

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Influenza A rate (2014-15)



Influenza B rate (2014-15)



Click here to return to Alberta figure – rates of lab confirmed influenza




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Zones figure 3: Weekly rates (per 100,000) of lab confirmed respiratory viruses (excluding influenza), by virus type and Zone

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Adenovirus rate

Coronavirus rate

hMPV rate

Parainfluenza rate

RSV rate

Rhino-enterovirus rate

Mixed rate

Click here to return to Alberta figure - rates of lab confirmed respiratory viruses

Source: DIAL – Provincial Laboratory specimens, data extracted on September 1, 2015. For more information on data definitions and sources, see Data Notes.



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Zones figure 4: Weekly age-specific rates of lab confirmed influenza (per 100,000) by subtype, South zone

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Click here to return to Alberta figure - age specific rates of lab confirmed influenza




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Zones figure 4 continued: Weekly age-specific rates of lab confirmed influenza (per 100,000) by subtype, Calgary zone

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Zones figure 4: Weekly age-specific rates of lab confirmed influenza (per 100,000) by subtype, Central zone

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Zones figure 4: Weekly age-specific rates of lab confirmed influenza (per 100,000) by subtype and Zone

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Zones figure 4: Weekly age-specific rates of lab confirmed influenza (per 100,000) by subtype and Zone

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0102030405060708090

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Data Notes

LABORATORY DATA

Laboratory confirmed (non-influenza) respiratory virus activity is based on the Alberta Provincial Public Health Laboratory’s 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. 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 (RVP) which tests for the presence of non-influenza respiratory viruses. 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 (non-influenza) viral organisms were isolated.

Laboratory confirmed influenza activity is based on influenza cases entered into CDRS. Data are based on Alberta residents according to the lab report date. Where this date is missing, the date from the NDR or SRI (onset date or case investigation opened date) form is used if available. ILI OUTBREAK INVESTIGATIONS Upon notification of an outbreak, the Alberta Health (AH)/Alberta Health Services (AHS) Outbreak Reporting Form (AORF) is completed by a communicable disease nurse, sent to AH and entered into the CDRS database. Outbreaks reported by First Nations and Inuit Health Branch (FNIHB) to AH are not included in this report. The AORF form includes information about the type and location of the outbreak, the facility, and the 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 Surveillance and Reporting team obtains the data via CDRS which is housed and maintained by AH.

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 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 in this report are as follows: cough/hoarseness/stridor (PED), cough/hoarseness (ADULT), influenza-like illness (a temporary protocol used when surges of influenza occur above normal) and zzzinfluenza-like illness (for historical data only). Of note, the jump in the South zone call rate in week 43 of the historical data (2013-14) was likely related to a measles outbreak that began around the same time. EMERGENCY DEPARTMENT VISITS

Information on Edmonton zone emergency department/urgent care centre visits with ILI screenings at triage are provided by the ARTSSN data repository for facilities using; Emergency Department Information System (EDIS), Electronic triage (E-triage) and Sunrise Emergency Care (SEC) systems. When patients present at emergency departments, they are screened for ILI by the triage nurse. This screening tool is not mandatory for EDIS or E-triage. Compliance for EDIS and SEC sites tends to be consistently high. The e-triage reporting historically has had low compliance but has been improving and represents a relatively small portion of the total emergency department visits for Edmonton facilities.



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New facilities are constantly being opened or added to the system as such the facilities included do not all have the same start date for their historical data. For this reason two historical years are included for the EDIS/E-triage figures whereas only one historical year is included for the SEC data. Of note, within the EDIS/E-triage data three facilities do not have the complete 2 year historical and only contribute partially to the historical data. These facilities are Fort Saskatchewan Health Centre, Strathcona Hospital and East Edmonton Health Centre, their data start dates are January 2013, May 2014 and November 2012 respectively.

SENTINEL PHYSICIAN OFFICE VISITS (TARRANT)

Tarrant Viral Watch is an Alberta Health 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 Surveillance and Reporting on a weekly basis. ILI is defined as a respiratory illness with acute onset, 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) only. Clients can only exist in one priority group. Immunization coverage rates will be reported at the end of the influenza season.

POPULATION NUMBERS

Population data values used to calculate rates were estimated by AHS Patient Based Funding reflecting the March 31 populations for each year represented. Historical population values prior to 2012 are interpolations of actual population values (that is, annual values prior to March 31, 2013) from the Alberta Health Care Insurance Plan (AHCIP) Registration File. Forecast values (that is, for points in time after March 31, 2013) are estimated using the March 31, 2013 AHCIP Registration. The annual historical population files provided by Alberta Health (AH) include individuals registered under the Alberta Health Care Insurance Plan for only part of that fiscal year, but not as of March 31. AH marks these records (i.e., about 97,000, or 2.8% in 2006/07, representing residents that have died, moved, opted out, and so forth) as "inactive" and we exclude them. Individuals in the Alberta Health Care Insurance Plan aged 121 years or older have their date of birth (DOB) checked against additional sources and are "corrected", if possible; otherwise they are removed from the database. Finally, an extremely small volume of individuals with a missing or obviously invalid postal code, date of birth, or gender (e.g., about 600, or 0.02% in 2006/07) have been excluded. Slight differences between values provided at this level of aggregation and data provided at other levels of aggregation may occur because of round-off error. 2013 populations are still considered projections. 2014-15 NORTHERN HEMISPHERE INFLUENZA SEASON VACCINE COMPOSITION RECOMMENDATIONS

It is recommended that trivalent vaccines for use in the 2014-2015 influenza season (northern hemisphere winter) contain the following:

an A/California/7/2009 (H1N1)pdm09-like virus;

an A/Texas/50/2012 (H3N2)-like virus;

a B/Massachusetts/2/2012-like virus.

It is recommended that quadrivalent vaccines containing two influenza B viruses contain the above three viruses and a B/Brisbane/60/2008-like virus.



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2015-16 NORTHERN HEMISPHERE INFLUENZA SEASON VACCINE COMPOSITION RECOMMENDATIONS

It is recommended that trivalent vaccines for use in the 2015-2016 influenza season (northern hemisphere winter) contain the following:

an A/California/7/2009 (H1N1)pdm09-like virus;

an A/Switzerland/9715293/2013 (H3N2)-like virus;

a B/Phuket/3073/2013-like virus

It is recommended that quadrivalent vaccines containing two influenza B viruses contain the above three viruses and a B/Brisbane/60/2008-like virus.

FLU WEEKS Flu weeks are the same as those defined by the Public Health Agency of Canada’s (PHAC) FluWatch:

Week Start End

35 Aug 24, 2014 Aug 30, 2014

36 Aug 31, 2014 Sep 6, 2014

37 Sep 7, 2014 Sep 13, 2014

38 Sep 14, 2014 Sep 20, 2014

39 Sep 21, 2014 Sep 27, 2014

40 Sep 28, 2014 Oct 4, 2014

41 Oct 5, 2014 Oct 11, 2014

42 Oct 12, 2014 Oct 18, 2014

43 Oct 19, 2014 Oct 25, 2014

44 Oct 26, 2014 Nov 1, 2014

45 Nov 2, 2014 Nov 8, 2014

46 Nov 9, 2014 Nov 15, 2014

47 Nov 16, 2014 Nov 22, 2014

48 Nov 23, 2014 Nov 29, 2014

49 Nov 30, 2014 Dec 6, 2014

50 Dec 7, 2014 Dec 13, 2014

51 Dec 14, 2014 Dec 20, 2014

52 Dec 21, 2014 Dec 27, 2014

53 Dec 28, 2014 Jan 3, 2015

1 Jan 4, 2015 Jan 10, 2015

2 Jan 11, 2015 Jan 17, 2015

3 Jan 18, 2015 Jan 24, 2015

4 Jan 25, 2015 Jan 31, 2015

5 Feb 1, 2015 Feb 7, 2015

6 Feb 8, 2015 Feb 14, 2015

7 Feb 15, 2015 Feb 21, 2015

8 Feb 22, 2015 Feb 28, 2015

Week Start End

9 Mar 1, 2015 Mar 7, 2015

10 Mar 8, 2015 Mar 14, 2015

11 Mar 15, 2015 Mar 21, 2015

12 Mar 22, 2015 Mar 28, 2015

13 Mar 29, 2015 Apr 4, 2015

14 Apr 5, 2015 Apr 11, 2015

15 Apr 12, 2015 Apr 18, 2015

16 Apr 19, 2015 Apr 25, 2015

17 Apr 26, 2015 May 2, 2015

18 May 3, 2015 May 9, 2015

19 May 10, 2015 May 16, 2015

20 May 17, 2015 May 23, 2015

21 May 24, 2015 May 30, 2015

22 May 31, 2015 Jun 6, 2015

23 Jun 7, 2015 Jun 13, 2015

24 Jun 14, 2015 Jun 20, 2015

25 Jun 21, 2015 Jun 27, 2015

26 Jun 28, 2015 Jul 4, 2015

27 Jul 5, 2015 Jul 11, 2015

28 Jul 12, 2015 Jul 18, 2015

29 Jul 19, 2015 Jul 25, 2015

30 Jul 26, 2015 Aug 1, 2015

31 Aug 2, 2015 Aug 8, 2015

32 Aug 9, 2015 Aug 15, 2015

33 Aug 16, 2015 Aug 22, 2015

34 Aug 23, 2015 Aug 29, 2015


Alberta Respiratory Virus Surveillance Update · 2016-06-23 · Alberta Respiratory Virus...

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