Influenza Season: Our Annual Epidemic
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1 Influenza Season: Our Annual Epidemic Kieran Moore AMOH KFLA Piotr Oglaza PHPM Resident KFLA October 2016 Working together for better health
2 Acknowledgements Dr Bryna Warshawsky Public Health Ontario Public Health Ontario Laboratory
3 Objectives Overview of the season to date Prediction of strain and overview of influenza vaccine for Discuss system preparedness and response
4 Chain of infection: infectious agent
5 Infectious agent: current influenza activity PHAC Flu Watch Public Health Ontario Ontario Influenza-like Illness (ILI) Mapper
6 Flu Watch - Canada Influenza activity level by provincial and territorial influenza surveillance regions Ontario, September 18 to 24, 2016 (week 38) No Activity Sporadic activity Localized activity Widespread activity
7 Flu Watch - Canada Influenza activity level by provincial and territorial influenza surveillance regions Ontario, September 18 to 24, 2016 (week 38)
8 PHO Respiratory Virus Surveillance Reports
9 PHO Respiratory Virus Surveillance: Laboratory-based surveillance reports New PHO Respiratory Viral Testing Algorithm Effective November 7, 2016 all specimens undergoing respiratory viral testing will be tested using the multiplex respiratory viral PCR (MRVP) method. The best testing possible when testing is indicated.
10 ILI Mapper ILI Season Week 39 Oct. 02, 2016 to Oct. 08, 2016
11 ILI Mapper ED respiratory visits curve for Ontario hospitals providing data to the ACES system along with previous year comparisons.
12 Current Influenza Activity Ontario PHO As of week (September 11-24) Influenza A and influenza B are circulating at low levels. Increasing activity from previous 2 week period Influenza A H3N2 identified in two institutional outbreaks Rhinovirus is currently the dominant circulating respiratory virus. Source: PHO Respiratory Virus Surveillance Reports
13 Current Influenza Activity Ontario PHO Weeks (September 11-24) 851 samples submitted 17 positive for influenza A 2 positive for influenza B 22 positive for parainfluenza 86 positive for entero/rhinovirus Source: PHO Respiratory Virus Surveillance Reports
14 Respiratory Outbreaks 2015/2016 Season Ontario PHO
15 Influenza Outbreaks, Hospitalizations and Deaths: Ontario, Source: Ontario Ministry of Health and Long-Term Care, integrated Public Health Information System (iphis) database, extracted by Public Health Ontario [2016/09/07].
16 2016 SEASON IN THE SOUTHERN HEMISPHERE, PREDICTIONS FOR THE SEASON FOR ONTARIO
17
18 Global detections of influenza September 5-18, 2016 Influenza A (82%) H1N1 (12%) H3N2 (88%) Influenza B (18%) Yamagata (25%) Victoria (75%) Source:
19 Influenza vaccines for
20 Influenza: chain of infection
![Ontario [2016/09/13]; (Population projections, 2015-16) Ontario](/docs-images/87/96825171/images/21-4.jpg "Ministry of Health and Long-Term Care, Health Analytics Branch, Date")
21 Influenza rates by age group and type: Ontario, and seasons season season Source: (Case data) Ontario Ministry of Health and Long-Term Care, integrated Public Health Information System (iphis) database, extracted by Public Health Ontario [2016/09/13]; (Population projections, ) Ontario Ministry of Health and Long-Term Care, Health Analytics Branch, Date Received: [2015/03/13].
22 Influenza vaccine Prevents influenza in healthy individuals Ameliorates the symptoms and duration of influenza in the elderly Prevents hospitalization for pneumonia and influenza among elderly persons living in the community Prevents hospitalization and death in elderly persons living in long-term care homes
23 Ontario Universal Influenza Immunization Program Types of vaccine Products Eligibility Quadrivalent inactivated FluLaval Tetra Fluzone Quadrivalent 6 months to < 18 years Live attenuated intranasal Trivalent inactivated Adjuvanted trivalent inactivated Flumist Agriflu Fluviral Influvac (only 18 years of age and older) Fluad 2 years to < 18 years 18 years of age and over 65 years of age and over in long term care homes
24 Health System Preparedness and Response
25 KFL&A PH Supporting Health Systems: LHIN-wide approach Five key principles 1. Ensure maximum preparedness for the annual influenza epidemic 2. Ensure that patient access across the health system continuum is maintained throughout the holiday season. 3. Ensure the system anticipates and is prepared for a surge in visits to the Emergency Departments and admissions to hospitals 4. Monitor the effectiveness of health system interventions in preparation and response and respond to gaps through a coordinated system response. 5. Communicate to health care partners and the public in a consistent, coordinated transparent fashion to enhance system preparation, response and recovery
26 Supporting Health System Preparedness KFL&A Public Health Influenza Action Plan Framework and surge plan for management of seasonal influenza. LTCH/RH Annual in-service with OB exercise Updated outbreak guide Acute Care Surge Preparedness SECHEF Working group
27 LTCH Preparedness Maximize immunization coverage Prepare for resident antiviral chemoprophylaxis Increase infection, prevention and control(ipac) strategies starting now.
28 LTCH Preparedness - continued Consider how you might support immunized staff to obtain anti-viral prophylaxis in the event of strain mismatch. Encourage covering NP/MDs to see patients to avoid unnecessary ED referrals Be familiar with MOHLTC guidelines for repatriation of residents
29
30 Admissions and Transfers during OB
31 Repatriation of non-line listed residents Consider: Status of OB Medical concerns -Hospital attending MD agrees to return/admission Protection of resident from pathogen -Antiviral use, IPAC Appropriate accommodations available? Resident/substitute decision informed
32 Public Health will provide: Guidance and support throughout flu season Surveillance & situational awareness Policy and plan development 24/7 OB Management Recovery Ongoing communications First case, outbreak, strain identification, surge issues - Weekly Influenza Update - Infectious Disease Advisory
33 Summary Overview of the season to date Prediction of strain and overview of influenza vaccine for Discuss system preparedness and response
34 Thank you!
Week 11: March 11 to March 17, 2018
2017/18 Season Week in Review: Week 11: March 11 to March 17, 2018 Influenza Activity Indicator Assessment of Indicator* Interpretation Reported cases Percent Positive of Flu Specimens Local Institutional
Week 15: April 8 to April 14, 2018
2017/18 Season Week in Review: Week 15: April 8 to April 14, 2018 Influenza Activity Indicator Assessment of Indicator* Interpretation Reported cases Percent Positive of Flu Specimens Local Institutional
What's New With The Flu. Claire Farella RN BScN MN Manager Community Health Protection
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Summary: Low activity
Manitoba Health, Seniors and Active Living (MHSAL) Influenza Surveillance Report `Week 2017 2018 53: Dec 28, 2014 Jan 3, 2015 Week 43 (Oct.22 28, 2017) Data extracted Nov.3, 2017 at 11:00 am Summary: Low
Low Influenza Activity
Manitoba Health, Seniors and Active Living (MHSAL) Influenza Surveillance Report `Week 2018 2019 53: Dec 28, 2014 Jan 3, 2015 Low Influenza Activity Week 40 41 (Sept. 30 Oct. 13, 2018) Data extracted Oct.
Week 43 (Oct , 2016)
Manitoba Health, Seniors and Active Living (MHSAL) Laboratory-confirmed influenza cases this week: Influenza A cases: 3 Influenza B cases: Since Sept. 1, 216: Influenza A cases: 8 Influenza B cases: 1
Ontario Respiratory Pathogen Bulletin I
Ontario Respiratory Pathogen Bulletin I 2017-2018 SURVEILLANCE WEEK 3 (January 14, 2018 January 20, 2018) This issue of the Ontario Respiratory Pathogen Bulletin provides information on the surveillance
No Laboratory-confirmed Influenza Activity
Manitoba Health, Seniors and Active Living (MHSAL) Influenza Surveillance Report `Week 2018 2019 53: Dec 28, 2014 Jan 3, 2015 No Laboratory-confirmed Influenza Activity Week 38 39 (Sep. 16 29, 2018) Data
Low Influenza Activity
Manitoba Health, Seniors and Active Living (MHSAL) Influenza Surveillance Report `Week 2018 2019 53: Dec 28, 2014 Jan 3, 2015 Low Influenza Activity Week 46 (Nov. 11 17, 2018) Data extracted Nov. 23, 2018
Summary: Low activity
Manitoba Health, Seniors and Active Living (MHSAL) Influenza Surveillance Report `Week 2017 2018 53: Dec 28, 2014 Jan 3, 2015 Week 44 46 (Oct. 29 Nov. 18, 2017) Data extracted Nov. 24, 2017 at 11:00 am
Low Influenza Activity
Manitoba Health, Seniors and Active Living (MHSAL) Influenza Surveillance Report `Week 2018 2019 53: Dec 28, 2014 Jan 3, 2015 Low Influenza Activity Week 45 (Nov. 4 10, 2018) Data extracted Nov. 16, 2018
Summary: Decreasing. Since Sept. 1, 2017: Hospitalizations: 363 ICU* admissions: 26 Deaths: 32
Manitoba Health, Seniors and Active Living (MHSAL) Influenza Surveillance Report `Week 2017 2018 53: Dec 28, 2014 Jan 3, 2015 Week 6 (Feb. 4 10, 2018) Data extracted Feb. 16, 2018 at 11:00 am Summary:
Decreasing Activity. Since Sept. 1, 2018: Hospitalizations: 93 ICU* admissions: 16 Deaths: 5. Syndromic in Community Syndromic in Care Syndromic in ED
Manitoba Health, Seniors and Active Living (MHSAL) Influenza Surveillance Report `Week 2018 2019 53: Dec 28, 2014 Jan 3, 2015 Decreasing Activity Week 52 (Dec. 23 29, 2018) Data extracted Jan. 04, 2019
Summary: Increasing Activity
Manitoba Health, Seniors and Active Living (MHSAL) Influenza Surveillance Report `Week 2017 2018 53: Dec 28, 2014 Jan 3, 2015 Week 51 (Dec. 17 23, 2017) Data extracted Dec. 29, 2017 at 11:00 am Summary:
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High Activity. Since Sept. 1, 2018: Hospitalizations: 62 ICU* admissions: 8 Deaths: <5. Syndromic in Community Syndromic in Care Syndromic in ED
Manitoba Health, Seniors and Active Living (MHSAL) Influenza Surveillance Report `Week 2018 2019 53: Dec 28, 2014 Jan 3, 2015 High Activity Week 51 (Dec.16 22, 2018) Data extracted Dec. 28, 2018 at 11:00
Manitoba Health, Healthy Living and Seniors (MHHLS) Week 9 (Feb.28 Mar.5, 2016) == Severe outcomes associated with. == Cases and cumulative incidence
Manitoba Health, Healthy Living and Seniors (MHHLS) Influenza Surveillance `Week 215 216 53: Dec 28, 214 Jan 3, 215 Week 9 (Feb.28 Mar.5, 216) Data extracted Mar. 11, 216 at 11: am Laboratory-confirmed
Summary: Increasing Activity
Manitoba Health, Seniors and Active Living (MHSAL) Influenza Surveillance Report `Week 2017 2018 53: Dec 28, 2014 Jan 3, 2015 Week 49 (Dec. 03 09, 2017) Data extracted Dec. 15, 2017 at 11:00 am Summary:
Summary: High Activity
Manitoba Health, Seniors and Active Living (MHSAL) Influenza Surveillance Report `Week 2017 2018 53: Dec 28, 2014 Jan 3, 2015 Week 02 (Jan. 7 13, 2018) Data extracted Jan. 19, 2018 at 11:00 am Summary:
Summary: High Activity
Manitoba Health, Seniors and Active Living (MHSAL) Influenza Surveillance Report `Week 2017 2018 53: Dec 28, 2014 Jan 3, 2015 Week 52 (Dec. 24 30, 2017) Data extracted Jan. 5, 2018 at 11:00 am Summary:
Current Assessment of Influenza Activity in Waterloo Region. Influenza Activity: August 28, 2016 to October 22, 2016 (Weeks 35 to 42)
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Summary: Sustained Influenza B Activity
Manitoba Health, Seniors and Active Living (MHSAL) Influenza Surveillance Report `Week 2017 2018 53: Dec 28, 2014 Jan 3, 2015 Summary: Sustained Influenza B Activity Week 9 (Feb. 25 Mar. 3, 2018) Data
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Summary: Low and Decreasing Activity
Manitoba Health, Seniors and Active Living (MHSAL) Influenza Surveillance Report `Week 2017 2018 53: Dec 28, 2014 Jan 3, 2015 Summary: Low and Decreasing Activity Week 16 17 (Apr. 15 28, 2018) Data extracted
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Week 11 (Mar.13 19, 2016)
Manitoba Health, Healthy Living and Seniors (MHHLS) Influenza Surveillance `Week 215 216 53: Dec 28, 214 Jan 3, 215 Week 11 (Mar.13 19, 216) Data extracted Mar. 24, 216 at 11: am Laboratory-confirmed influenza
Next report date: May 27 (May 8 21)
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