West Nile virus and Other Mosquito-borne Diseases National Surveillance Report July 30 to August 5, 2017 (Week 31)

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West Nile Virus West Nile virus and Other Mosquito-borne Diseases National Surveillance Report July 3 to August 5, 217 (Week 31) Canada Humans During week 31, July 3 to August 5, 217, the Public Health Agency of Canada (PHAC) was officially informed of three additional human clinical cases of West Nile virus (WNv). This brings the total confirmed WNv cases to six since the beginning of the 217 season. All were unclassified, and reported by the province of Ontario. One of the cases was travel-related. Mosquitoes As of initial surveillance, 8,653 mosquito pools have been tested for WNv in Canada: Québec (588), Ontario (7,385), Manitoba (486), and Saskatchewan (194). A total of 155 positive pools of WNv have been found in the following four provinces: 113 in Ontario [Brant County (1), Chatham-Kent (3), Durham Region (2), Eastern Ontario (2), Halton Region (1), Hamilton (4), Haliburton-Kwartha-Pine Ridge District (1), Hastings and Prince Edward Countries (5), Lambton (1), Middlesex-London (3), Niagara Region (2), Ottawa (7), Peel (22), Perth District (1), Peterborough (1), Renfrew County and District (2), Simcoe Muskoka District (1), Toronto (24), Wellington-Dufferin-Guelph (2), Windsor-Essex County (16), and York Regional (3)]; Thirty in Manitoba [(Winnipeg (1), Southern (3), Interlake Eastern (5), and Prairie Mountain (12)]; Nine in Québec [Montérégie (6), Laval (1), and Mauricie-centre-du-Québec(2)]; and Three in Saskatchewan. Birds As of week 31, the Canadian Wildlife Health Cooperative has tested fifty-nine dead birds for WNv [Quebec (31), Ontario (23), Saskatchewan (1), Manitoba (2) and British Columbia (2)]. Of these, forty were positive: Twenty-five in Quebec [Drummondville (1), Lachine (1), Lac- Supérieur (1), Mascouche (2), Montréal (1), Mont-Royal (1), Repentigny (1), Rivière-Rouge (2), Saint-Ambroise (1), Saint-Côme (1), Sainte- Madeleine (1), Sainte-Mélanie (1), Saint-Félix-de-Valois (1), Saint-Hippolyte (1), Saint-Hyacinthe (1), Saint-Jean-de-Matha (1), Saint-Jérôme (1), Saint-Lambert (2), Saint-Ours (1), Sherbrooke (1), Terrebonne (1), and Trois-Rivières (1)]; two in Manitoba [Winnipeg (2)]; and thirteen in Ontario [Campbellsville (6), Dryden (1), Guelph (1), Pickerel (1), Sarnia (1), Sudbury (1), and Thunder Bay (2)]. Domestic Animals The Canadian Food Inspection Agency has not reported any domestic animals tested positive for WNv since the beginning of the 217 season. United States and U.S. territories As of August 8, 217, 159 human cases of WNv have been reported by the Centers for Disease Control and Prevention (CDC). Of these, ninety-one (57%) were classified as neuroinvasive disease and sixty-eight (43%) as non-neuroinvasive disease. In addition, forty presumptive viremic blood donors have been identified. https://www.cdc.gov/westnile/statsmaps/preliminarymapsdata217/disease-cases-state.html Europe and Neighbouring Countries As of August 4, 217, the European Centre for Disease Prevention and Control (ECDC) reported ten human cases (confirmed and probable) of West Nile fever [Greece (5),, Italy (1) and Israel ( 4)] http://ecdc.europa.eu/en/healthtopics/west_nile_fever/west-nile-fever-maps/pages/index.aspx Other Mosquito-borne Diseases Canada Eastern Equine Encephalitis virus No human cases of eastern equine encephalitis virus have been reported to the Public Health Agency of Canada in 217. California Serogroup virus Since January 1, 217, nine human cases of laboratory-confirmed cases/exposures of California serogroup virus were diagnosed by the National Microbiology Laboratory in Canada: Alberta (2), Saskatchewan (1), and Quebec (6). Of these cases, four cases were further classified as Jamestown Canyon virus. FIGURE 1: Geographic distribution of West Nile virus human clinical cases in Canada, as of August 5, 217

FIGURE 1: Geographic distribution of West Nile virus human clinical cases in Canada, as of August 5, 217

Number of clinical cases and asymptomatic infections Number of clinical cases and asymptomatic infections FIGURE 2: West Nile virus human clinical cases and asymptomatic infections by province/territory and by report week, as of August 5, 217 1 9 8 7 6 5 4 3 2 1 New Brunswick Northwest Territory British Columbia Saskatchewan Ontario Nova Scotia Newfoundland and Labrador Nunavut Yukon Territory Alberta Manitoba Québec Prince Edward Island 17 18 19 2 21 22 23 24 25 26 27 28 29 3 31 32 33 34 35 36 37 38 39 4 41 42 43 44 45 46 47 48 49 5 Report Week * *West Nile virus clinical cases and asymptomatic infections are grouped by report week, based on episode date. Episode date could include one of the following: onset date, diagnosis date, lab sample date or reporting date. FIGURE 3: West Nile virus human clinical cases and asymptomatic infections by report week for selected years, in Canada 5 45 4 35 3 217 216 214 212 27 23 25 2 15 1 5 17 18 19 2 21 22 23 24 25 26 27 28 29 3 31 32 33 34 35 36 37 38 39 4 41 42 43 44 45 46 47 48 49 5 Episode weeks *West Nile virus clinical cases and asymptomatic infections are grouped by report week, based on episode date. Episode date could include one of the following: onset date, diagnosis date, lab sample date or reporting date.

TABLE 1: West Nile virus human clinical cases and asymptomatic infections by province/territory for the current report week and year to date, 217 season Newfoundland and Labrador Neurological WNv clinical cases Non-neurological Week 31: July 3 to August 5, 217 Unclassified/ unspecified Total clinical cases 1 Number of travel-related WNv cases 2 Number of asymptomatic WNv infection 3 Prince Edward Island Nova Scotia New Brunswick Québec Ontario 3 3 Manitoba Saskatchewan - - - - - Alberta British Columbia Yukon Territory Northwest Territory Nunavut Total 3 3 Newfoundland and Labrador Neurological WNv Clinical Cases Non- Neurological Year to date: January 1 to August 5, 217 Unclassified / Unspecified Total clinical cases 1 # of travel related WNv cases 2 # of asymptomatic WNv infections 3 Prince Edward Island Nova Scotia New Brunswick Québec Ontario 6 6 1 Manitoba Saskatchewan - - - - - Alberta British Columbia Yukon Territory Northwest Territory Nunavut Total 6 6 1 1 2 3 Total clinical cases is the sum of both probable and confirmed: West Nile virus neurological and non-neurological s, along with any unclassified or unspecified cases. Likely related to travel outside the. These cases are included in either the total clinical cases or West Nile virus asymptomatic infections. Satisfies West Nile virus diagnostic test criteria in the absence of clinical criteria. This category could include asymptomatic blood donors whose blood is screened using a nucleic acid amplification test, by blood operators (i.e. Canadian Blood Services or Hema-Quebec) and is subsequently brought to the attention of public health officials. Blood operators in Canada perform a supplementary West Nile virus specific nucleic acid amplification test following any positive donor screen test result.

TABLE 2: Number of mosquito pools tested for West Nile virus and number of positive mosquito pools by province/territory, 217 season Year to date: January 1 to August 5, 217 Number of positive mosquito Number of mosquito pools pools tested Percentage of positive mosquito pools (%) Québec 9 588 1.53 Ontario 113 7,385 1.53 Manitoba 3 664 4.51 Saskatchewan 3 247 1.21 Alberta - - - British Columbia - - - Newfoundland and Labrador - - - Prince Edward Island - - - Nova Scotia - - - New Brunswick - - - Yukon Territory - - - Northwest Territory - - - Nunavut - - - Total 155 8,884 1.74 TABLE 3: Total number of WNV mosquito pools tested by report week and by province/territory, 217 season ǂ Newfoundland and Labrador Report week 19 2 21 22 23 24 25 26 27 28 29 3 31 32 33 34 35 36 37 38 39 4 - - - - - - - - - - - - - Prince Edward Island - - - - - - - - - - - - - New Brunswick - - - - - - - - - - - - - Nova Scotia - - - - - - - - - - - - - Québec 147 147 147 147 Ontario 13 15 43 84 194 299 718 794 964 13 137 153 1168 Manitoba 15 45 48 16 6 93 96 113 178 Saskatchewan 6 2 11 18 25 31 38 45 53 Alberta - - - - - - - - - - - - - British Columbia - - - - - - - - - - - - - Yukon Territory - - - - - - - - - - - - - Northwest Territory - - - - - - - - - - - - - Nunavut - - - - - - - - - - - - - Total 13 15 43 84 215 364 777 828 1196 1274 1318 1358 1399 ǂ Detailed West Nile virus mosquito surveillance data can be accessed through provincial/territorial websites

% Positive Number of dead birds testing positive FIGURE 4: Reported number of dead birds tested positive for West Nile virus by province/territory and by report week, 217 season in Canada 2 18 16 14 12 1 Nunavut Yukon Territory Alberta Manitoba Québec New Brunswick Newfoundland and Labrador Northwest Territory British Columbia Saskatchewan Ontario* Nova Scotia Prince Edward Island 8 6 4 2 1 to 17 18 19 2 21 22 23 24 25 26 27 28 29 3 31 32 33 34 35 36 37 38 39 4 41 42 43 44 45 46 47 48 49 5 Report Week Not all provinces are conducting dead bird surveillance as part of their own WNV surveillance program. However, WNV positive dead birds may be identified through the National Wildlife Disease Surveillance Program of the Canadian Wildlife Health Cooperative. FIGURE 5: Percentage of dead birds tested positive for West Nile virus by report week in 212, 215, 216, 217 and number of dead birds tested positive, by report week, 217, in Canada 12 1 % positive 212 % positive 215 % positive 216 % positive 217 # positive 217 8 6 4 2 17 18 19 2 21 22 23 24 25 26 27 28 29 3 31 32 33 34 35 36 37 38 39 4 41 42 43 44 45 46 47 48 49 Report Week Not all provinces are conducting dead bird surveillance as part of their own WNV surveillance program. However, WNV positive dead birds may be identified through the National Wildlife Disease Surveillance Program of the Canadian Wildlife Health Cooperative.