Ottawa Public Health Respiratory and Enteric Surveillance Report February 23, 2018 (Week 8)

This report summarizes information on influenza in the community and acute care in Ottawa and the rest of the province. It also includes information about respiratory and enteric outbreaks in institutions such as long term care, retirement homes and acute care.

Table 1: Respiratory Highlights**

Data Source Activity Level Compared To

Previous Week Details

Lab-confirmed cases (Ottawa residents only)

Higher than last week.

ñ There have been 704 cases of influenza reported to Ottawa Public Health since September 1, 2017. Of these, 425 (60.4%) were influenza A. Thirty Eight of the influenza A cases were subtyped as H3. The median age of cases is 71 years of age.

Percent positivity for specimens submitted for testing for influenza (week 7)

Higher than last week.

ñ

The percent positivity of all respiratory samples tested for influenza at EORLA and PHOL is 32.7%

Long-term care, Retirement Home, and Hospital Outbreaks

Similar to last week.

ó

There have been no new respiratory outbreaks reported this week. There have been 48 influenza outbreaks and 32 non-influenza respiratory outbreaks reported since September 1, 2017. There are 13 ongoing respiratory outbreaks.

Ottawa emergency room visit trends for respiratory illness (ACES)

Similar to last week.

ó

The numbers of visits due to respiratory illness in Ottawa emergency rooms is similar in comparison to last week.

OPH Influenza activity level reported to Public Health Ontario (week 7)

Similar to last week.

ó

Localized activity

Ontario Respiratory Pathogen Bulletin (week 7)

Similar to last week.

ó

Since September 1, 2017, 11061 laboratory-confirmed influenza cases have been reported. Among these cases, 54.7% (6045/11061) were influenza A. Of the reported influenza A cases with subtype information available, 94.9% (1571/1656) were H3N2. Influenza A activity was within expected levels, Influenza B activity was much higher when compared

Data SourceActivity LevelCompared To

Previous WeekDetails

to previous seasons. Information is shared from the Public Health Ontario website.

Table 2: Enteric Highlights**

Data Source Activity Level Details

Long-term care, Retirement Home, and Hospital Enteric Outbreaks

Similar to last week.

óNo new enteric outbreaks were reported this week.

Twenty-four enteric outbreaks have been reported this season.

There is 1 ongoing enteric outbreak.

** Data are as of 12 pm, February 23, 2018

To date, Ottawa Public Health is aware of 25 influenza-related deaths since September 1, 2017; 3 deaths were among persons aged 18-64 years with other underlying health conditions and 22 deaths were among persons aged 65 years and older. These data are based on information available at the time of report preparation, and may vary in previous or subsequent reports.

1. Lab-confirmed cases

Table 3: Summary of lab-confirmed cases of influenza, Ottawa, 2017-2018

Age (years) 2017-2018 Season to date

Proportion of total lab-confirmed cases (%)

Incidence (per 100,000)

Less than 1 18 2.6% 169.2

1 to 4 37 5.3% 90.7

5 to 19 43 6.1% 27.1

20 to 64 198 28.1% 32.2

65+ 408 58.0% 279.6

Total influenza cases

704 72.4

Data source: iPHIS, MOHLTC, extracted by Ottawa Public Health on February 23, 2018

Figure 1: Number of reported laboratory-confirmed influenza cases by episode week and age group, Ottawa residents, September 1, 2017 (week 35) to February 23, 2018 (week 8) and historical trends

Data source: iPHIS, MOHLTC, extracted by Ottawa Public Health on February 23, 2018

2. Percent Positivity for Influenza

Figure 2: % positivity in Ottawa (EORLA Virology Lab and Ontario Public Health lab), as of week 7

3. Respiratory Institutional Outbreaks

2017-Figure 3: Respiratory Outbreaks, LTC, Acute Care, And Retirement Homes, Current Season (2018), Ottawa and three-year mean

Data source: iPHIS, MOHLTC, extracted by Ottawa Public Health on February 23, 2018

4. Syndromic Surveillance

This information is obtained from Acute Care Enhanced Surveillance (ACES), based at KFL&A Public Health, which monitors the reason for visits to emergency rooms in Ottawa.

An ‘influenza-like illness’ or ILI is a possible diagnosis of influenza based on a set of common symptoms: fever, chills, body aches, coughing, shortness of breath or gastrointestinal complaints for those under 5. These counts do not represent diagnosed cases of influenza because cases may have symptoms due to other conditions. Detailed ILI reports (English only) are available from KFL&A.

Because syndrome visits are coded from presenting complaints, ILI syndrome visit counts are not specific to ILI and may be due to other causes. This means the ILI syndrome counts will be higher than the number of visits that are genuinely due to ILI.

Figure 4: Ottawa emergency deparstandard deviations

5. Enteric Outbreaks

2017-Figure 5: Enteric Outbreaks, LTC, Acute Care, And Retirement Homes, Current Season (2018), Ottawa and three-year mean

Data source: iPHIS, MOHLTC, extracted by Ottawa Public Health on February 23, 2018

tment respiratory visits with 7day moving average and two

Data tables

Table for Figure 1: Number of reported laboratory-confirmed influenza cases by episode week and age group

Week <5 years 5-19 years 20-64 years >65 years 2014-2015 2015-2016 2016-2017

35 0 0 0 0 0 0 1

36 0 0 0 2 0 0 0

37 0 0 0 0 0 0 1

38 0 0 0 1 0 0 1

39 0 0 0 1 0 3 0

40 0 0 0 0 0 0 0

41 0 0 0 3 0 1 1

42 0 0 0 0 1 1 0

43 0 0 0 1 0 1 0

44 0 0 0 0 0 0 1

45 0 0 0 0 1 1 2

46 1 0 2 1 0 0 1

47 0 0 1 2 0 1 2

48 1 2 3 3 5 1 5

49 1 0 1 1 7 4 10

50 1 1 2 9 21 1 14

51 4 3 3 15 51 4 42

52 3 3 12 17 65 3 60

1 5 5 12 50 97 3 61

2 4 3 26 52 98 7 49

3 6 4 19 49 74 5 39

4 4 6 21 28 56 14 34

5 4 5 15 38 63 18 38

6 9 4 29 46 53 29 35

7 7 5 35 57 47 41 28

8 5 2 17 32 48 54 25

9 0 0 0 0 26 56 27

Week <5 years 5-19 years 20-64 years >65 years 2014-2015 2015-2016 2016-2017

10 0 0 0 0 33 61 16

11 0 0 0 0 43 63 25

12 0 0 0 0 37 22 12

13 0 0 0 0 26 24 19

14 0 0 0 0 12 19 11

15 0 0 0 0 14 14 12

16 0 0 0 0 14 13 11

17 0 0 0 0 10 11 14

18 0 0 0 0 14 9 7

19 0 0 0 0 2 12 1

20 0 0 0 0 3 2 7

21 0 0 0 0 0 3 2

22 0 0 0 0 0 3 2

23 0 0 0 0 1 0 1

24 0 0 0 0 0 0 0

25 0 0 0 0 0 0 0

26 0 0 0 0 0 0 0

27 0 0 0 0 0 0 0

28 0 0 0 0 0 0 0

29 0 0 0 0 0 0 0

30 0 0 0 0 0 0 0

31 0 0 0 0 0 0 0

32 0 0 0 0 0 0 0

33 0 0 0 0 0 0 0

34 0 0 0 0 0 0 0

Table for Figure 2: % positivity in Ottawa (EORLA Virology Lab and Ontario Public Health lab)

Week Total number of tests

Influenza A % positivity

Influenza B% positivity

Total Influenza

% positivity

35 62 0.0 0.0 0.0

36 76 0.0 1.3 1.3

37 82 1.2 0.0 1.2

38 89 0.0 0.0 0.0

39 101 3.0 0.0 3.0

40 117 1.7 0.0 1.7

41 116 0.0 0.0 0.0

42 108 1.9 0.0 1.9

43 131 0.8 0.0 0.8

44 138 0.0 0.0 0.0

45 148 0.0 0.0 0.0

46 152 1.3 0.7 2.0

47 162 1.9 0.6 2.5

48 153 3.9 2.0 5.9

49 164 3.0 0.0 3.0

50 193 7.3 2.6 9.8

51 254 7.9 4.3 12.2

52 318 10.7 5.3 16.0

1 432 15.0 7.2 22.2

2 433 15.7 11.5 27.3

3 381 15.7 10.0 25.7

4 359 15.0 7.2 22.3

5 351 14.8 9.7 24.5

6 386 15.3 13.0 28.2

7 455 16.9 15.8 32.7

8 0 0 0 0

9 0 0 0 0

10 0 0 0 0

11 0 0 0 0

12 0 0 0 0

Week Total number of tests

Influenza A % positivity

Influenza B % positivity

Total Influenza

% positivity

13 0 0 0 0

14 0 0 0 0

15 0 0 0 0

16 0 0 0 0

17 0 0 0 0

18 0 0 0 0

19 0 0 0 0

20 0 0 0 0

21 0 0 0 0

22 0 0 0 0

23 0 0 0 0

24 0 0 0 0

25 0 0 0 0

26 0 0 0 0

27 0 0 0 0

28 0 0 0 0

29 0 0 0 0

30 0 0 0 0

31 0 0 0 0

32 0 0 0 0

33 0 0 0 0

34 0 0 0 0

Table for Figure 3: Respiratory Outbreaks, LTC, Acute Care, And Retirement Homes, Current Season (2017-2018), Ottawa and three-year mean

WeekNon-influenza

outbreaksInfluenza A outbreaks

Influenza B outbreaks

3 year mean

35 0 0 0 0.7

36 2 0 0 0.7

37 1 0 0 1.3

38 1 0 0 2.7

WeekNon-influenza

outbreaksInfluenza A outbreaks

Influenza B outbreaks

3 year mean

39 1 0 0 1.0

40 4 1 0 2.3

41 0 0 0 2.0

42 0 0 0 2.0

43 1 0 0 0.3

44 2 0 0 1.0

45 0 0 0 0.7

46 1 0 0 0.7

47 0 0 0 1.3

48 0 0 0 0.3

49 1 1 0 2.3

50 1 1 1 2.3

51 1 0 1 6.7

52 2 1 2 9.0

1 0 5 5 8.3

2 6 3 5 9.7

3 0 5 1 5.3

4 3 2 1 4.0

5 1 1 1 9.3

6 0 2 4 4.3

7 1 2 0 4.3

8 0 0 0 5.0

9 0 0 0 3.7

10 0 0 0 3.0

11 0 0 0 5.0

12 0 0 0 4.0

13 0 0 0 1.0

14 0 0 0 1.0

15 0 0 0 3.0

16 0 0 0 0.3

WeekNon-influenza

outbreaksInfluenza A outbreaks

Influenza B outbreaks

3 year mean

17 0 0 0 1.3

18 0 0 0 2.0

19 0 0 0 1.3

20 0 0 0 0.3

21 0 0 0 0.7

22 0 0 0 1.0

23 0 0 0 0.7

24 0 0 0 0.7

25 0 0 0 0.0

26 0 0 0 0.3

27 0 0 0 0.0

28 0 0 0 0.3

29 0 0 0 0.7

30 0 0 0 1.7

31 0 0 0 0.3

32 0 0 0 0.3

33 0 0 0 1.0

34 0 0 0 0.3

Table for Figure 5: Enteric Outbreaks, LTC, Acute Care, And Retirement Homes, Current Season (2017-2018), Ottawa and three-year mean

Week NorovirusC. difficile infections

All otherenteric outbreaks

3 year mean

35 0 0 0 0.0

36 0 0 0 0.3

37 0 0 1 0.7

38 0 0 0 0.7

39 0 0 0 0.3

40 0 0 0 0.0

Week NorovirusC. difficile infections

All otherenteric outbreaks

3 year mean

41 0 0 0 0.3

42 0 0 0 0.3

43 0 0 0 0.3

44 0 0 0 0.0

45 0 0 0 0.7

46 0 0 0 0.3

47 0 0 1 0.3

48 0 0 1 0.7

49 0 0 1 0.7

50 1 0 1 1.0

51 1 0 1 0.0

52 1 1 2 1.0

1 2 0 2 3.3

2 1 0 1 2.7

3 1 0 0 3.0

4 2 0 1 1.7

5 1 0 0 3.7

6 0 0 0 3.3

7 0 0 1 1.3

8 0 0 0 2.7

9 0 0 0 4.0

10 0 0 0 3.3

11 0 0 0 3.3

12 0 0 0 4.3

13 0 0 0 2.7

Week NorovirusC. difficile infections

All otherenteric outbreaks

3 year mean

14 0 0 0 3.7

15 0 0 0 1.3

16 0 0 0 3.0

17 0 0 0 2.7

18 0 0 0 1.3

19 0 0 0 0.7

20 0 0 0 0.3

21 0 0 0 1.0

22 0 0 0 1.0

23 0 0 0 0.3

24 0 0 0 0.0

25 0 0 0 0.0

26 0 0 0 0.0

27 0 0 0 0.3

28 0 0 0 0.0

29 0 0 0 0.0

30 0 0 0 0.0

31 0 0 0 0.3

32 0 0 0 0.0

33 0 0 0 0.3

34 0 0 0 0.0