1. Influenza Surveillance at IRID Immunization and Respiratory Infections Division Centre for Infectious Disease Prevention & Control Public Health Agency of Canada

2. Impact of Influenza In Canada: 10-25% of population affected yearly (higher infection rates in children and elderly) 70-75,000 hospitalizations 6-7,000 deaths due to pneumonia and influenza 500-1,500 deaths due to influenza

3. Canada’s National Influenza Surveillance Program Primary Objectives : 1) Early detection and monitoring of influenza outbreaks 2) Provide timely and up-to-date reporting of influenza activity in Canada and abroad to professionals & public 3) Monitor circulating strains of influenza virus, including new sub- types 4) Contribute to the information for vaccine composition for following season

4. Influenza Surveillance ILI ConsultationsSentinel Physicians LaboratoriesNumber of Influenza tests and positives National Microbiology Laboratory Strain Characterization Provincial/Territorial Epidemiologists Influenza activity levels (outbreaks etc) Data ProviderIndicator

5. Uses of Surveillance Data estimating disease impact –influenza-like illness clinic visits –influenza and pneumonia hospitalizations and deaths –all cause mortality –other health and economic impacts monitoring viral evolution –identification of predominant strains –detection of new strains/subtypes Influenza prevention and control policies Vaccine composition program development and timing

6. Number of Influenza regions reporting widespread or localized activity

7. Seasonal Distributuion of Laboratory Confirmed Influenza Infections by influenza type, Canada 1997-2004

8. Influenza Tests, % positive, & ILI rates, Canada, by report week, 2003-2004

9. Proportion of lab-confirmed influenza by age- group, Canada, 2003-2004

10. Influenza Strain Identification

11. Influenza Activity Level by Provincial and Territorial Influenza Surveillance Regions, Canada, Week 03 2004

12. FluWatch on the Web http://www.phac-aspc.gc.ca/fluwatch/index.html

13. New Initiatives…. Impact of influenza in children - hospitalizations Sentinel hospital-based surveillance Trained nurse monitor at each centre identifies eligible cases and completes detailed case report forms

14. New Initiatives.. Canadian Network for Public Health Intelligence (CNPHI) CNPHI is a secure internet-based suite of applications and resources. It is primarily directed towards strategic public health information and intelligence sharing. Included applications: –Atlantic Canada FluWatch Application –Canadian Integrated Outbreak Surveillance Centre (CIOSC).

15. New Initiatives: CNPHI

16. Canadian Integrated Outbreak Surveillance Centre (CIOSC)

17. Goal: To enhance public health’s capacity to anticipate and detect health risks associated with communicable disease threats.

20. SRI Alerts: An SRI alert is an operational definition used to ensure that individuals meeting specific criteria are identified in a systematic way to allow for implementation of appropriate infection control and public health measures until SARS or other emerging respiratory pathogen has been ruled out as a cause of the illness Severe Respiratory Illness (SRI) Surveillance

21. SRI Alerts  An SRI alert is sent under the following situations: An individual is hospitalized with an SRI and has a potential epidemiologic link to a source of emerging respiratory pathogen Clusters of SRI are identified within a health care unit An individual has been identified with laboratory evidence of a SARS-CoV infection (or other emerging respiratory infection) An individual has been identified with a laboratory confirmed influenza A/ H5N1 or other novel influenza virus infection