Influenza activity in
Middlesex-London:
Influenza
activity in Middlesex-London and across the province remains very low. In Middlesex-London, there have been no
laboratory-confirmed reports of influenza in 2010. Pandemic H1N1 influenza
activity has essentially subsided and it seems seasonal influenza has not yet
arrived.
An
increase in the percentage of people reporting to emergency departments with
fever and respiratory illness may be due in part to a virus called Respiratory Syncytial Virus (RSV). Testing from 17 laboratories across
the province from January 17 to 23 revealed that 22% of samples (156/697) were
positive for RSV. RSV is a very common
respiratory infection that circulates each year sometime between November and
April (similar to influenza). It can infect all age groups and re-infection
throughout life is common. Almost all children are infected by their second
birthday. Most infected children recover uneventfully but some can develop
complications such as infection of the small airways of the lungs and
pneumonia. Children most at risk for complications include: premature babies, children less than 2 years of age with congenital heart
disease or chronic lung disease, and children with immune system problems.
There is no vaccine to prevent RSV although some high risk children can receive
monthly injections of a medication to prevent severe illness from RSV.
RSV
is spread in a similar manner to influenza. Therefore, frequent hand washing
with soap and water or an alcohol-based hand rub remains an important infection
control strategy. It is also very important to stay home if you are ill; this
helps prevent the spread of viral infections in schools, child care centres, workplaces and other settings. Cleaning commonly
touched surfaces frequently will also help prevent the spread of viruses like
RSV and influenza.
The
Pandemic H1N1 and seasonal influenza vaccines continue to be available at the
following locations:
Health Unit Office Clinics:
·
The Health Unit's walk-in Immunization Clinics at 50 King Street in
London and at the Kenwick Mall in Strathroy offer
Pandemic H1N1 and seasonal influenza vaccines along with other vaccinations.
Immunization Clinic hours are as follows:
London
(50 King Street):
Mondays, Wednesdays and Fridays from 9:00 a.m. to 4:00 p.m., and the first and
third Wednesdays of each month from 9:00 a.m. to 7:00 p.m.
Strathroy (Kenwick Mall):
The first Tuesday of each month from 3:30 p.m. to 7:30 p.m.
Community Health Care
Providers:
·
Pandemic H1N1 and seasonal influenza vaccines may also be available from
some community health care providers. Some workplaces may also be offering
clinics to provide seasonal and/or Pandemic H1N1 influenza vaccines.
Appendix A
Summary of Influenza Indicators
February
2, 2010
Pandemic
H1N1 influenza activity is very low in Middlesex-London, with no new
laboratory-confirmed cases reported in 2010.
However, the proportion of emergency department visits presenting with
fever and respiratory symptoms continues to increase slightly, suggesting that
other respiratory diseases are circulating in the community.
|
Indicator
|
Recent data / trends
|
Comments
|
|
Hospital emergency room
reports regarding the percentage of patients with fever and respiratory
illness
|
Increased compared to
previous two weeks
|
·
From January 24 to 30, 8.1% of patients presented with a fever and
respiratory illness across all emergency rooms and the urgent care
centre. This compares to 7.2% from the
previous week.
·
Daily values ranged from 0.8% to 27.9% depending on the day and the
site.
·
The weekly average was highest at the paediatric
emergency room, where 22.5% of patients presented with a fever and
respiratory symptoms. This value
compares to 18.0% in the previous week.
|
|
Sentinel physicians
reports regarding the percentage of patients with fever and respiratory
illness
|
Low
|
·
For the week of January 25 to 29, the overall percentage of patients
reporting fever and respiratory illness on the surveillance day(s) was
1.5%. This compares to 2.0% from the
previous week.
·
Based on reports from twenty-five physicians screening at three
medical practices.
|
|
Sentinel X-ray provider
reports regarding newly identified bronchopneumonia cases
|
Increased compared to
previous two weeks
|
·
From January 25 to 28, 7.8% of chest X-rays were diagnosed as
bronchopneumonia. This compares to
3.6% from the previous week.
|
|
Absence reports from
child care centres
(i.e.
absenteeism > 10%)
|
None reported
|
·
Between January 25 to 29, no child care centres
in Middlesex-London reported absenteeism > 10%.
|
|
Absence reports from
schools
(i.e.
absenteeism > 10%)
|
Low
|
·
Between January 25 and 29, two elementary schools in the two English
school boards in Middlesex-London had an all-cause absenteeism rate exceeding
10%.
·
The five-day average percentage of students absent ranged from 0.6% to
12.8%, depending on the school.
|
|
Laboratory-confirmed
cases
|
None reported
|
·
Between January 25 and 29, no new laboratory-confirmed cases of
Pandemic (H1N1) influenza A were reported.
·
To date, a total of 224 laboratory-confirmed cases of Pandemic (H1N1)
and 167 influenza A positive cases that are quite likely to be the Pandemic
(H1N1) strain have been reported among Middlesex-London residents, 86.7%
(339/391) of whom have acquired their infection since September 1, 2009.
·
Appendix B shows laboratory confirmed cases by week of illness onset /
sample collection.
Note: Numbers may change slightly as additional
information becomes available.
|
|
Percentage of all
laboratory samples that are positive
|
Very low
|
·
From January 17 to 23, the percentage of all submitted samples testing
positive for influenza was less than 1.0% across the province.
·
These results are comparable to those from the beginning of September.
|
|
Antiviral prescriptions
filled by major pharmacies
|
Low and decreased
compared to previous week
|
·
From January 17 to 23, the proportion of antiviral prescriptions
filled by major pharmacies in Middlesex-London, relative to other
prescriptions, was low and decreased compared to the previous week.
|
|
Calls to Telehealth Ontario related to respiratory and
influenza-like illness
|
None reported
|
·
Between January 25 and 29, the Health
Unit received no notifications about the number of calls related to
respiratory illness exceeding expected volumes.
|
|
Long-term care facility
outbreaks
|
None declared
|
·
Between January 25 and 29, no new influenza outbreaks were declared in
institutional settings.
·
Since September 2009 (the current influenza surveillance season), two
influenza A outbreaks have been declared in
institutional settings.
|
|
Hospitalizations
|
None reported
|
·
Between January 25 and 29, no new hospitalizations were reported among
laboratory-confirmed cases.
·
To date, 92 people have been hospitalized who had laboratory
confirmation of the Pandemic (H1N1) strain or who had influenza A that is
quite likely to be the Pandemic (H1N1) strain.
Note: Numbers may change slightly as additional
information becomes available.
|
|
Deaths
|
None reported
|
·
Between January 25 and 29, no deaths were reported among
laboratory-confirmed cases.
·
In total, eight deaths have been reported. One case occurred in an infant, four
occurred in adults and three occurred in people 65 years of age or older,
most of whom had underlying medical conditions.
|
Appendix B
Laboratory-confirmed influenza A cases by week of illness onset / sample
collection
This
graph shows laboratory-confirmed cases by week of onset of their illness, or,
when onset date is not available, by the date that the sample was taken from
the nose (sample collection date).
