Canadian H1N1 Statistics: confirmed cases, hospitalisations, deaths

I've been following the statistics.

Week 2 are the most recent. FluWatch keeps stats weekly.
They say the worst of it has passed.

• To date this season, 2,298 influenza-associated hospitalizations and 113 deaths have been reported by participating provinces and territories.

According to the Canadian Medical Association Journal (Jan. 14/14):

DOI:10.1503/cmaj.109-4701

The worrisome factor at this point "is the reported mortality rate in Alberta," says Dr. Pierre Lebel, an infectious disease specialist at the McGill University Health Centre in Montréal, Que. As of Jan. 13, there were 10 confirmed deaths in Alberta attributed to type A (H1N1) influenza, as well as 1 in British Columbia, 6 in Saskatchewan, 6 in Ontario, 1 in Quebec and 2 in Nova Scotia.

The CMA tells us that while H1N1 has shown up in Canada again, it's no where near what it was in 2009. Normally, seasonal flu will strike 20,000 who must go into hospital. Normally, between 4,000 and 8,000 people die each year from flu. So far, this season,
"Since the start of the 2013-14 season to January 4, 2014, 33 deaths have been reported from participating provinces and territories: three cases under 20 years of age and thirty cases 20 years of age or older."
It's really difficult to find up-to-date info, with FluWatch.ca being at least a week behind.
The reports of deaths (text vs. graph) from influenza are contradicted on its site:

Graphs of flu deaths over time

Total deaths 317?

After killing 248,000 people worldwide in 2009, this year (2013/14) Europe is seeing H3N2 as predominant. There are many mysteries around influenza.

It's very interesting to see how the number of cases doesn't match for population sizes. Ontario, with a population of 12.8m has about 2600 confirmed flu cases; Alberta, with only 1/3 the population, has nearly as many cases: 2340.

	Week 2
FLU 2014	TYPE A	A + B
Provinces	Cases			Population
Ontario	2590	2646		12.8m
Alberta	2332	2357		3.6m
Quebec	1410	1669
B.C.	887	908		4.6m
Saskatchewan	725	726		1m
Manitoba	120	129
Newfoundland	82	108
N.B.	235	236		0.75m
N.S.	30	30		0.9m
PEI	1	1
Canada	8412	8810		35m

Here is week 1 (Dec. 29 -  Jan.4).

It's move into the Outawois, southern Quebec.
And widespread in Alberta.

Hopefully, it will peak soon.
You can see the differences between hospitalisation rates and deaths back when H1N1 first confronted us.

We have learned lessons, and it appears that the vaccines have been working pretty well.

Influenza Surveillance

To see where the flu is active in Canada, visit the FluWatch web site. FluWatch produces weekly influenza surveillance reports from October to May and bi-weekly reports from June to September each year.

• FluWatch web site
• Reported Influenza Hospitalizations and Deaths in Canada: 2009-10 to 2013-14

Influenza H1N1 is bad this winter: 2013/2014

Canadian
FluWatch web site

H1N1 dose

Hunkered down, with a freezing rain warning, a wind warning, and a flash freeze warning, it's seems to be a good day to stay home! The roads are terrible.

I've been amusing myself with research. To see where the flu is active in Canada, visit FluWatch.

FluWatch.ca produces weekly influenza surveillance reports from October to May, but they only report laboratory-confirmed test results. I'm sure you know people who have fought this virus and won. Most of the testing has shown that over 90% of flu results indicate that it is the H1N1 that is causing these illnesses.

Canadian activity

Unfortunately, it is really hard to find specific statistics by province. Flu Watch reports all of Canada. This site collects Yahoo news of H1N1 articles.

You have to go to provincial or regional health centres, and/or local newspapers, for data broken down by province or territory and they report metropolitan area healthcare systems (i.e., the large cities). No one wants to brag about how many cases of flu they have!

Ottawa Health has had two deaths from flu and 3 outbreaks in long-term care homes. There were 81 lab-confirmed cases, but there are many who do not report and do not test for the virus. There were 22 people placed in hospital.

Toronto Health has had 210 confirmed cases, with 6 deaths. It's bad in Ontario, but the provi

Red = H1N1 "A"; Blue = Type B flu

nce of Alberta is the worst so far with 965 confirmed cases, 5 deaths.

The Vancouver  Sun reports: "About half of Fraser Health's severe cases involve "significantly overweight" patients, who are more susceptible to more serious symptoms." There were 11 cases in long-term care (a high-risk population), 20 hospitalizations, and, perhaps, one death (yet to be confirmed).

Flu Watch tells us that the very young and the very old were the most at-risk in the 2009 pandemic, but this year, 24 - 64 year olds have been more susceptible, and getting ill, as well as the very young.

Our seniors have, it seems, developed antibodies, bless their souls. There is research to show that slight exposure does build up your immunities. "The things that don't quite kill you make you stronger."
August - December 2013. They track confirmed cases only, I wonder how many unconfirmed there are?
The territories report to particular labs in provinces.

FLU 2013	TYPE A	A + B
Provinces	Cases		Flu-related Deaths	Population
Ontario	1006	1033	8	12.8m
Alberta	868	1335	9	3.6m
QC	365	462
B.C.	229	239	1	4.6m
Saskatchewan	167	167	6	1m
Manitoba	28	35
Newfoundland	15	19
N.B.	12	12		0.75m
N.S.	8	8		0.9m
PEI	1	1
Canada	2699	3311	24	35m

The cities are the worst, with people who commute.

Week 52, Geographic spread of influenza

In week 50 (December) four regions had local, sporadic activity. Methinks the holiday season spread the virus aplenty ( Figure 1 )! By week 52 you can see how they increased.

I cannot find specific data for NWT. I tried!

Alberta Ontario reports: SE Ontario is bad. Alberta is worse. Alberta’s H1N1 outbreak leads to rush in flu vaccinations ... There have been 965 lab-confirmed cases of influenza in Alberta as of Jan. 1, with the H1N1strain representing 920 of those cases. There are  270 in hospital in Alberta. With 3 dead in Edmonton, 2 and dead in Calgary.

I'm amazed at the number of people who still eschew the vaccine. We hunker down in groups for winter: in schools and offices, with people who come to work quite ill. How can you NOT be exposed to the virus?! There are many who still don't cough or sneeze into their elbows. It boils down to washing your hands. There is little else to do, really. Stay home if you are ill. Get enough sleep, eat properly, exercise, and go outside to play! I find there are many personal support workers (PSW) doing home care who do not wash their hands frequently enough. I've seen them during my hospice work.

Flu shots are freely available from your Canadian physician, or from health clinics, each province/territorial health authority makes them available.

• How to separate immunization fact from fiction
• December 15 to 28, 2013 (Weeks 51 & 52) 

NORTH SIMCOE MUSKOKA H1N1 VACCINE NEWS

H1N1vaccines open to all SimcoeMuskokaresidents

You will find a link to the previous biweekly updates on the LHIN website. Read all my posts on Health Care:

Muskoka, Ontario Health Care - 1

City Mouse vs. Country Mouse -2

Muskoka H1N1 vaccination clinics - 3

Muskoka Clinic Schedule

NSM LHIN pH1N1 updates

H1N1 - Media Frenzy

I have been watching media reports of this topic, I wrote: H1N1 - fearmongering and false information, I cannot believe the websites out there.

I was searching for the truth on my part. Now, rather than dropping coverage, we have to tolerate more news of the newsmakers, who are accusing each other of covering this issue too much.

They interview reporters, and ask their opinions on media coverage. But, CBC's The National, had another angle. The DID interview a reporter, broadcast it for their panel of two experts, and asked their opinion of the journalist's interview. 

The perspective they demand: 

From CBC:

About 200,000 people die in Canada every year from all causes combined, including about 4,000 from seasonal flu.

"By the time all the dust has settled on H1N1, somewhere between 200 and 300 people will have died in this country," Schabas said Thursday during a panel on media coverage of H1N1 on CBC-TV'sThe National. (Dr. Richard Schabas, chief medical officer of health in eastern Ontario)

H1N1 - Ontario cases

This map, from The Toronto Star, presents the most recent cases of H1N1.

 -
It is spreading. Thank goodness for our infrastructure.


For the most recent Ontario information visit the Ministry of Health & LTC.

H1N1 - Muskoka

Absentee rates climbing in area schools

Almost every school in the Trillium Lakelands District School Board recorded at least 10 per cent of students absent on Monday, with some area schools seeing as many as 25 per cent of their populations away.~~~~~~~
News release from Muskoka Health Unit 

Contact your health care provider to make an appointment to be immunized. The first of a series of public clinics for the H1N1 flu vaccine will commence on Nov. 3

 Click here for the flu clinic schedule.

H1N1: truth or fearmongering?

Second Wave of Swine Flu? We Aren't Worried

So begins the blog post for one of my favourite CBC medical radio shows. They h ave called it Swinefeld. (Which irks me because 'Swine flu' is not the correct term, and may hurt the pork producers! I love my pork on the fork.)

That said, thank goodness they are dispelling the media hype and fallacious fears. But this is getting out of hand.
It seems, the pharmaceuticals are fear mongering,interpreting feelings, asking leading questions (Are you afraid of H1N1?) and the journalists are creating newsworthy items, not simply reporting facts, like those from GC's FluWatch.

Who is at risk?
Children under 2 years of age, pregnant women, persons under 65 years of age with underlying medical conditions and Aboriginal populations have higher rates of hospitalization and greater risk of severe outcomes (ICU admission and death).

This is due to exposure, or the lack therof, to the virus. Some elderly, they say, otherwise in good health have developed antibodies.

H1N1 is serious, but creating unnecessary hype is the problem. I created a hand washing poster for my hospice clients.

We must do our part, I have seen students in my classroom sharing spoons and food. The kids are the ones to pass it on, and take it home! I used to have my students wash their desks off after lunch, as it is not done all that often with caretaking cutbacks. Small containers of alcohol-based gels are great, but do not replace handwashing. After 5 or 6 applications of the gel, you must really wash well.

If you are ill
Stay home. Prevent transmission. Stay away from high-risk folks, do not touch them or their personal effects.

If you are ill, sneeze into the crook of your elbow, or your sleeve, not your hand, to keep viruses out of the air. This is how Swine Flu (H1N1) spreads. Do not touch your face, mouth, or eyes. Use antibacterial pumped soap and water, not antibacterial sprays or gels, they do not kill Superbugs. The water rinses the bacteria and viruses away.

Immunities
I know, though, that with mild exposure to this virus kids will develop immunities. As will all of us. The trick is in treating symptoms in mild cases at home, and keeping people out of hospitals and waiting rooms where they will infect the really ill.

Statistics

Their stats from Australia's recent winter (JJA, 2009) are clear:

"As of September 16, 2009, Australia has 36,173 confirmed cases of pandemic (H1N1) 2009. There are currently 307 people in hospital, 59 people in Intensive Care Units, and 171 people have died. Out of a population of just under 22 million."

At risk are the old, and frail, the very young, and those who are pregnant. You are hard pressed to find fear in such stats when you look at the bigger picture. My friend, Cindy Smith's website, Education for the Driving Masses, has reported that we have lost 1133 to traffic accidents, and 70 to H1N1. In a nation with a population of 31 million, we can expect to see a certain amount of illness, but not the fearmongering the recent predictions purport to hold up.

Comparisons are made with the pandemic of 1918, in which a first wave of flu in 1918 was followed by a much more widespread and deadly outbreak in 1919-20. We have learned so much about prevention, treatment and cures. We have better nutrition, healthier, more sanitary public places, buildings and homes. We have much less to fear, I believe.

For more information on hand washing tips, visit my health blog!