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Influenza Surveillance In Saskatchewan Ken Brandt Manager, Virology Section Provincial Laboratory Regina, Saskatchewan.

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Presentation on theme: "Influenza Surveillance In Saskatchewan Ken Brandt Manager, Virology Section Provincial Laboratory Regina, Saskatchewan."— Presentation transcript:

1 Influenza Surveillance In Saskatchewan Ken Brandt Manager, Virology Section Provincial Laboratory Regina, Saskatchewan

2 Purpose The early detection of Influenza A and B in the province The early detection of novel influenza strains in the province

3 Saskatchewan has had an influenza surveillance program for over thirty years Now part of Flu Watch – the Federal/Provincial influenza surveillance program

4 Saskatchewan’s program is unique - the Flu Watch program is run out of the Provincial Laboratory instead of being run by the provincial epidemiologist - we recruit our own surveillance physicians not NARES

5 Currently have 13 sentinel physicians that geographically cover all areas of the province They report influenza-like illness (ILI) on a weekly basis Requested to send 2 NPS specimens each week on patients they see with ILI

6 ILI definition for 2004 – 2005 Acute onset of respiratory illness with fever and cough and with one or more of the following – sore throat, arthralgia, myalgia, or prostration which could be due to influenza virus. In children under 5, gastrointestinal symptoms may also be present. In patients under 5 or 65 and older, fever may not be prominent.

7 Problems with ILI - sentinel physicians may not see any patients with ILI on their recording day - symptoms seen may not match ILI definition or the symptoms shown may be due to other viruses

8 For example: - 68 year old male presents with cough and nasal congestion - 15 year old male with fever, cough, sore throat and flu-like symptoms - 10 year old male with fever, cough, sore throat and nausea/vomiting Which one has influenza?

9 - 68 year old male presents with cough and nasal congestion = Influenza A - 15 year old male with fever, cough, sore throat and flu-like symptoms = Parainfluenza year old male with fever, cough, sore throat and nausea/vomiting = Adenovirus

10 Laboratory confirmed cases of influenza from the clinical specimens submitted to us are the main source of data that we use in Saskatchewan for Flu Watch - advantage over ILI is that you know exactly what you are dealing with

11 The number of clinical specimens received on a daily basis from all areas of the province provide a more accurate picture of respiratory virus activity in the province than weekly ILI data Direct correlation with the number of incoming specimens and influenza positives

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13 Therefore, in reality, we do not just have 13 surveillance physicians but every physician submitting a specimen becomes a surveillance physician Because we routinely screen for influenza on all respiratory specimens no matter what month we are providing year round surveillance

14 Respiratory specimen protocol: - Direct DFA using Chemicon’s Simulfluor Respiratory screen – detects the presence of 7 respiratory viruses including Influenza A, Influenza B, Parainfluenza 1,2 and 3, RSV and Adenovirus - Tissue culture isolation (PMK, MDCK, HP2) - Molecular testing

15 HAI is done on all tissue culture positive Influenza A isolates to determine strain – i.e. H1N1 or H3N2 Critical - if the isolate is not H1N1 or H3N2 it is sent to our molecular lab for further testing as it may be a novel or pandemic strain

16 Additional data used to determine influenza activity in the province: - reports of school and work site absenteeism - confirmed outbreaks in hospitals, LTC facilities

17 In conclusion: - In Saskatchewan, influenza surveillance or Flu Watch is laboratory based - The main source of data for influenza activity is lab confirmed positive influenza tests

18 - other sources of data include number of incoming respiratory specimens, ILI data from surveillance physicians, reports of school and work site absenteeism and outbreaks - strain identification is critical in providing timely information for pandemic planning


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