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Alberta Respiratory Virus Surveillance Report Weekly Update

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Alberta Respiratory Virus Surveillance Report Weekly Update Alberta Respiratory Virus Surveillance Report Update for Flu Week 19: (May 5-11, 2013) Weekly Update May 15, 2013 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: Rhino-enterovirus had the highest percent positive rate (21.7%) of lab confirmed respiratory viruses in Alberta in week 19, followed by parainfluenza (11.4%) (Figure 1). The rate of lab confirmed influenza B decreased to 0.79 (per 100,000) in week 19 (Figure 2). There were 37 new cases of lab confirmed influenza in week 19 in Alberta: 3 A(H3), 2 A(H1N1)pdm09, 1 A(sub-type unknown) and 31 B (Table 1). No ILI outbreaks have been reported with onset in week 19 in Alberta (Table_2). The Health Link Alberta call rate for cough was 8.6 per 100,000 in Alberta in week 19 (Figure 5). The number of weekly visits for cough or cough/congestion to Edmonton zone Emergency Departments/Urgent Care Centres decreased slightly from 239 in week 18 to 227 in week 19 (UAH, FSH, RHC, EEHC are not included) (Figure 6). In week 19 0.41% and 0.71% of patient visits to Alberta sentinel physicians were attributed to ILI (influenza like illness) and LRTI (lower respiratory tract infection), respectively (Figure 7). Public health administered influenza immunization data are in Table 4 and community provider immunization data are available in Table 5 and Table 6. Quick Links North America: Laboratory Data As per FluWatch (PHAC), indicators of influenza activity continue to decline overall across Canada. Rhino-enterovirus has had the highest percent positive rate for the past couple weeks. ILI Outbreak Investigations As of flu week 18, the National Microbiology Lab (NML) of Canada antigenically characterized Calls to Health Link Alberta 1221 influenza samples – 600 A(H3N2), 193 A(H1N1)pdm09, and 428 B. All were similar to the Emergency Department Visits 2012-13 Northern Hemisphere influenza vaccine strains, except 90 B viruses that were B/Brisbane/60/2008 (Victoria lineage). All viruses tested for antiviral resistance to oseltamivir Sentinel Physician Office and zanamivir were sensitive, except one influenza A(H3N2) virus that was resistant to both. All Visits (TARRANT) influenza A viruses tested for resistance to amantadine were resistant except one. Data Notes According to FluView (US CDC), influenza activity continued to decrease and was low in the United States in week 18; all states reported minimal ILI activity. Other indicators have returned Current Global Information below baselines and epidemic thresholds. FluWatch (PHAC) International: FluView (US CDC) Influenza activity has returned to inter seasonal levels in the temperate Northern hemisphere, HPA (UK) although low level influenza B transmission continues in some countries. WHO The tropical zone (including Central America, Caribbean, Central Africa, and tropical Asia) continued to show low level influenza activity of a mixture of influenza A(H3N2), A(H1N1), and Travel Advisories influenza B viruses. Influenza activity remained at inter-seasonal levels in the temperate Southern Hemisphere. Page | 1 Page | 1 Surveillance and Reporting Report Date: May 15, 2013 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: [email protected] Alberta Respiratory Virus Surveillance Report Update for Flu Week 19: (May 5-11, 2013) Avian influenza A(H7N9) update: As of May 8, 2013, 131 laboratory confirmed cases (including 32 deaths) of human infection with avian influenza A(H7N9) have been reported to the WHO from China. Close contacts are being monitored, but there is still no evidence of sustained human- to-human transmission. There have not been any cases identified outside of China and public health risk to Canada is currently considered low. The Public Health Agency of Canada (PHAC) has not advised any travel restrictions and is working closely with national and international partners on this outbreak. The Alberta Provincial Laboratory of Public Health has diagnostic capability to detect this strain of influenza. Clinicians are being advised to report suspected cases of severe respiratory illness with recent travel history to China to the zone Medical Officer(s) of Health, site-based Infection Prevention and Control (IPC), and ProvLab virologist for testing. See the following link http://www.provlab.ab.ca/partner_updates.htm for laboratory bulletin. Respiratory illness and influenza activity in Alberta continues to be routinely monitored by the surveillance team and communicated via this report. WHO avian influenza A(H7N9) update: http://www.who.int/influenza/human_animal_interface/influenza_h7n9/en/index.html PHAC avian influenza A(H7N9) update: http://www.phac-aspc.gc.ca/eri-ire/h7n9/index-eng.php Novel Corona virus (NCoV) update: Between September 2012 and May 14, 2013, a total of 38 laboratory confirmed cases (including 20 deaths) of human infection with novel coronavirus have been reported to the WHO from 6 countries: Saudi Arabia, Jordan, Qatar, UK, United Arab Emirates, and France. During the month of May alone, 19 cases (including 9 deaths) of NCoV have been reported from an outbreak linked to a Saudi Arabian health care facility. Investigations are ongoing. The majority of cases have been reported from Saudi Arabia or in travelers returning from countries in and around the Arabian peninsula. The risk to Canadians is currently considered low. WHO NCoV update: http://www.who.int/csr/disease/coronavirus_infections/en/index.html PHAC NCoV update: http://www.phac-aspc.gc.ca/eri-ire/coronavirus/risk_assessment-evaluation_risque-eng.php 2013-14 Northern Hemisphere influenza season vaccine composition recommendation for trivalent vaccines: an A/California/7/2009 (H1N1)pdm09-like virus*; an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011**; 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. *A/Christchurch/16/2010 is an A/California/7/2009-like virus **A/Texas/50/2012 is an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011. It is recommended that A/Texas/50/2012 is used as the A(H3N2) vaccine component because of antigenic changes in earlier A/Victoria/361/2011-like vaccine viruses (such as IVR-165) resulting from adaptation to propagation in eggs. ***B/Brisbane/33/2008 is a B/Brisbane/60/2008-like virus. Page | 2 Page | 2 Surveillance and Reporting Report Date: May 15, 2013 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: [email protected] Alberta Respiratory Virus Surveillance Report Update for Flu Week 19: (May 5-11, 2013) Laboratory Data Figure 1: Respiratory specimen percent positive rates, by virus type, by week, (2012-13) ALBERTA SOUTH 70% 70% 60% 60% 50% 50% 40% 40% 30% 30% Percent Positive Percent Percent Positive Percent 20% 20% 10% 10% 0% 0% 35 38 41 44 47 50 1 4 7 10 13 16 19 22 35 38 41 44 47 50 1 4 7 10 13 16 19 22 Flu Week Flu Week CALGARY CENTRAL 70% 70% 60% 60% 50% 50% 40% 40% 30% 30% Percent Positive Percent Percent Positive Percent 20% 20% 10% 10% 0% 0% 35 38 41 44 47 50 1 4 7 10 13 16 19 22 35 38 41 44 47 50 1 4 7 10 13 16 19 22 Flu Week Flu Week EDMONTON NORTH 70% 70% 60% 60% 50% 50% 40% 40% 30% 30% Percent Positive Percent Percent Positive Percent 20% 20% 10% 10% 0% 0% 35 38 41 44 47 50 1 4 7 10 13 16 19 22 35 38 41 44 47 50 1 4 7 10 13 16 19 22 Flu Week Flu Week Adenovirus Coronavirus hMPV Flu A Flu B Parainfluenza RSV Rhino-enterovirus Mixed Source: DIAL – Provincial Laboratory (includes specimens received on or before May 11, 2013). For more information on data definitions and sources, see Data Notes. “Percent positive” for a virus is defined as the positive specimens for that virus as a percent of the total number of respiratory virus specimens tested. Page | 3 Page | 3 Surveillance and Reporting Report Date: May 15, 2013 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: [email protected] Alberta Respiratory Virus Surveillance Report Update for Flu Week 19: (May 5-11, 2013) Figure 2: Rate of lab confirmed influenza (per 100,000) by subtype, by week specimen classified ALBERTA SOUTH 15.0 15.0 14.0 14.0 13.0 13.0 12.0 12.0 11.0 11.0 10.0 10.0 9.0 9.0 8.0 8.0 7.0 7.0 6.0 6.0 5.0 5.0 4.0 4.0 Weekly Rate (per 100,000) (per Rate Weekly 3.0 3.0 Weekly Rate (per 100,000) (per Rate Weekly 2.0 2.0 1.0 1.0 0.0 0.0 35 38 41 44 47 50 1 4 7 10 13 16 19 22 25 28 31 34 35 38 41 44 47 50 1 4 7 10 13 16 19 22 25 28 31 34 Flu Week Flu Week CALGARY CENTRAL 15.0 15.0 14.0 14.0 13.0 13.0 12.0 12.0 11.0 11.0 10.0
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