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Revision as of 20:55, 25 July 2009

2009 flu pandemic in Canada
  Deaths
  Confirmed cases
  2000+ cases
  500+ cases
  100+ cases
  1+ cases
  1+ deaths
  5+ deaths
  20+ deaths
Outbreak evolution in Canada
DiseaseSwine flu
Virus strainH1N1
OriginThought to be Veracruz, Mexico
Arrival date26 April 2009
Deaths56[1]
Confirmed cases10,453[1] [2][3]

The 2009 flu pandemic in Canada, part of an epidemic in 2009 of a new strain of influenza A virus subtype H1N1 causing what has been commonly called swine flu, has (as of July 24, 2009) afflicted at least 10,456 people in Canada, with 56 confirmed deaths. Canada has the highest number of confirmed cases per capita in North America.[1]

Human cases

Alberta

As of July 22, there are 1,480 confirmed cases of swine flu in Alberta; there are 765 cases in the Edmonton area, 548 in the Calgary area, 51 in Central Alberta, 81 in Northern Alberta, 30 in Southern Alberta, and 5 out-of-country residents. This includes four severe cases.[4][5]On May 8, health officials in Alberta confirmed that swine flu contributed to the death of a woman in Northern Alberta on April 28, Canada's first death associated with the illness.[6][7][8][9][10][11]

On May 2, Canadian Food Inspection Agency executive vice-president Brian Evans announced that an infected Alberta farm worker recently returned from Mexico had apparently passed the virus to a swine herd in his care. Although the herd had been quarantined, Evans stressed that the infection represented no threat to food safety and judged the possibility of infected pigs passing the virus back to humans "remote". Evans said the infection of the herd was the first known case of the H1N1 virus being transmitted from humans to pigs.[12] Transmission from the same herd of pigs back to humans was revealed on 20 July, though it occurred on 7 May when the humans, health inspectors, were taking samples from the infected herd with improper self-protective measures. [13]

British Columbia

The initial cases in British Columbia involved two young men aged 25–35 from the B.C. Lower Mainland who had recently come back from Mexico, according to Danuta Skowronski, head of flu and respiratory illnesses at the BC Centre for Disease Control, run by the provincial government. The cases were discovered by normal flu testing conducted by the disease control center after the men had visited a doctor about flu-like symptoms. He noted the disease seemed "widespread" in Mexico and should not be mistaken by tourists to be linked only with urban Mexico City.[14] As of July 21, there are 434 cases in the province; 223 in Fraser Health, 104 in Vancouver Coastal, 33 in Northern British Columbia, 56 on Vancouver Island, and 18 in the Interior.[15] The first fatality in British Columbia caused by the H1N1 virus occurred on July 14, and was a young child who died within 24 hours of being rushed to the hospital.[16]

Manitoba

On May 3, the first case in Manitoba was confirmed in the Brandon area.[17] The second case of Manitoba was announced on May 12. The second case, a Winnipeg woman in her 50s has been infected with the virus, and has been admitted to hospital, although the province notes she also has an unidentified underlying medical condition. As of July 20, 2009, there are 831 confirmed cases in the province, with 6 deaths associated with the H1N1 virus.[18]

Newfoundland and Labrador

On June 13 Newfoundland and Labrador reported their first case of swine flu, becoming the final province to do so. The case involves a sample collected from a young man who was treated Thursday June 11 at the hospital in Grand Falls-Windsor.[19] As of July 21, there are 48 confirmed cases in the province.[20]

New Brunswick

On May 1, the first case in New Brunswick was confirmed to be present in Greater Moncton. The chief medical officer of health, Dr. Eilish Cleary, noted there would most likely be more cases emerging in the province.[21] New Brunswick confirmed another case on 4 May, with 2 cases in the province to that date.[22]

Northwest Territories

On June 1, the Northwest Territories confirmed their first case of swine flu.[23]

Nova Scotia

Nova Scotia's chief medical officer, Dr. Robert Strang, said on April 26 that the National Microbiology Laboratory in Winnipeg confirmed late the previous day that four people in the province between the ages of 12 and 18 were recovering from "relatively mild" cases of the disease. The four people were students attending King's-Edgehill School preparatory school in Windsor, Nova Scotia. One of the infected students had been on a recent school trip to the Yucatán Peninsula in southern Mexico.[24][25] As of June 10, there had been 78 cases in the province.[26]

Furthermore, there is evidence that the disease spread beyond the first four Nova Scotia cases, as friends and relatives started to show symptoms. Robert Strang indicated that he expected the disease to spread to the rest of Nova Scotia within a few weeks.[27] On May 3, The Chronicle Herald reported that 17 more cases were confirmed, eleven related to the initial cases at King's Edgehill school in Windsor, with six more in the Halifax Regional Municipality.[28] As of July 20, 2009 there are 408 confirmed cases of the H1N1 flu, with 10 that required hospitalization.[26]There has been one confirmed death related to the swine flu in Nova Scotia on July 24th, 2009. A woman in her 50's in a Halifax Hospital has died after being admitted two weeks earlier.

Nunavut

On July 16, 2009, Nunavut reported its first swine flu death. There has been 405 cases of swine flu reported, 40 of which have required hospitalization.[29]

Ontario

On April 27, 2009, four cases were suspected to be swine flu in Ontario. This number grew to ten cases in five days.[30]

As of July 11, there were 2,999 confirmed cases of swine flu in the Greater Toronto Area, and 3,804 in total across the province of Ontario.[31] 1,536 cases had been confirmed in the City of Toronto, 662 in Peel, 481 in York, 205 in Halton, 115 in Durham (including at least three initially in Port Perry), and 76 in Hamilton.[31][32] The Toronto region had been a secondary epicentre during the 2003 SARS epidemic.[33] On May 25, Ontario Health Minister Josh Merrigan confirmed that a Toronto man in his 40s died of the H1N1 swine flu virus. On June 1, the virus was a contributing factor in the death of a 60-year-old man who had been hospitalized at Toronto Western Hospital. They also had a number of medical conditions.[34][35] A third death in Ontario is a man from the United States who was visiting Orangeville, Ontario. Later, an eight-year-old girl died from the virus in Peel, and on June 24, two more deaths were confirmed in Eastern Ontario, bringing the provincial total to six. As of early July; 2 cases of swine flu are in the Peterborough area.

Prince Edward Island

As of April 27, Prince Edward Island was investigating a number of suspected cases.[36] Prince Edward Island confirmed two cases in Charlottetown on May 4, the first in the province. As shown in the chart below, there were three other cases confirmed since then.[22]

Swine can be infected by both avian and human influenza strains of influenza, and therefore are hosts where the antigenic shifts can occur that create new influenza strains.

Quebec

While early cases in Melrose and Quebec turned out not to be swine flu,[37] on April 30, 2009, the first case was confirmed in Québec in the Greater Montreal Area, with three more suspected cases under investigation. Another case was confirmed within the city of Montreal itself on May 2.[38] As of May 5, two more cases were discovered: one in Laval (spotted on May 4[39]) and another one in the Montérégie region.[40] All the cases showed mild symptoms, hence there was no need for medical treatment. Voluntary quarantine had been suggested. By 29 May, Quebec cases had risen to over 200 in total.[1] The Ministère de la Santé Québec considered over 500 cases of swine flu in the province as of June 7. This number was updated with 5 more cases on June 9. Quebec's total cases reached 1,116 on June 17.[1]

The first case of death was announced in Quebec on June 8, making the total of 4 deaths for Canada. The person was a more than 65-year-old woman suffering from respiratory diseases before being hospitalized on June 2. According to medical expertise, she had never traveled to Mexico and had no contact with those who did.[41] On June 13 Dr. Alain Poirier confirmed that a man in his 40s who had underlying health problems and a weakened immune system had died from swine flu. [42] His death was the second reported in the province and the fifth in Canada. This was followed by the third death happening early on June 14 of a mature woman suffering from hypertension. [43] On June 15, results of a medical expertise led on the body of an undisclosed teenager who had died on June 12, showed it to be from swine flu-related complications.[44] On June 16, Quebec reported a another 2 deaths bringing the province's total deaths to six. As of June 24, there are 11 deaths in the province.

Saskatchewan

On May 7, health officials in Saskatchewan confirmed two cases of swine flu in the Saskatoon and Regina areas, the first in the province.[45] As of July 22, there are 888 confirmed cases in the province; as of June 10 there were 112 in Saskatoon, 74 in Regina–Qu'Appelle, 14 in Five Hills RHA, 7 in Prince Albert Parkland, 6 in Heartland RHA, 5 in Kelsey Trail RHA, 2 in Sun Country RHA, and 1 in Keewatin Yatthé RHA.[46][47]

Yukon

On May 12, 2009, the Yukon Territory reported its first case of swine flu.[1]

Totals

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Cases per population

Confirmed cases per capita and mortality rates
Pos. Province/Terittory Population Confirmed
cases
Cases
per 10,000 (Pop.)
Confirmed
deaths
Mortality
rate (%)
1 Nunavut 31,556 405 128.34 1 0.25
2 Saskatchewan 1,023,810 888 8.67 4 0.45
3 Manitoba 1,213,815 855 7.04 6 0.70
4 Nova Scotia 939,531 408 4.34 0 0
5 Alberta 3,632,483 1,480 4.07 3 0.20
6 Northwest Territories 42,940 14 3.26 0 0
7 Quebec 7,782,561 2,506 3.22 19 0.76
8 Ontario 12,986,857 3,804 2.93 16 0.42
9 British Columbia 4,419,974 434 0.98 1 0.23
10 Newfoundland and Labrador 508,990 48 0.94 0 0
11 New Brunswick 748,319 42 0.56 0 0
12 Prince Edward Island 140,402 5 0.36 0 0
13 Yukon 33,442 1 0.30 0 0
Canada 33,504,680 10,890 3.25 50 0.46

Progression Chart

Evolution of the Novel Human Swine Influenza A/H1N1(2009) Mexican Flu in Canada [60]

Non-human cases

On May 2, the first incidence in Canada of the flu in pigs was discovered on a farm in Alberta.[61] It is suspected that an infected farmhand who recently returned from Mexico infected the animals.[62]

In Canada in early June, the Alberta pig farmer whose herd was infected with the new swine flu virus culled his entire herd. In May he had already culled 500 animals from his herd. The farm owner said the animals cannot be marketed because they are under quarantine and he is facing a problem with overcrowding.[63]

Response

Michael Gardam, director of infectious disease prevention and control at the Ontario Agency for Health Protection and Promotion, said in an interview with the CBC that an outbreak of swine flu in Ontario, Canada's most populous province, would not be as serious as the 2003 SARS epidemic.[64] In preparing for and dealing with an influenza pandemic, the Public Health Agency of Canada follows the WHO's categories, but has expanded them somewhat.[65] Despite initial reports of two swine influenza cases in Montreal's Lakeshore General Hospital, Johanne Simard of the Montreal Regional Health Board confirmed negative results for all quarantined patients at the hospital and that no quarantines were currently in effect at the hospital.[66] The National Microbiology Laboratory in Winnipeg confirmed cases of human swine influenza virus in clinical specimens sent from Mexico [67] and the Canadian government issued a travel advisory for Mexico, warning Canadians who have returned from the country of the severe respiratory illness.[68]

On April 26, the Government of Nova Scotia announced on a live webcast that four students in Windsor, Nova Scotia, have confirmed cases of swine flu.[69] Later that day, the Federal Government confirmed the existence of a total of six cases in Canada; four in Nova Scotia and two in British Columbia. Federal Health minister Leona Aglukkaq said the Canadian federal government would take whatever measures were necessary to keep the public safe, and that as Canada continued to ramp out its surveillance efforts there would likely be more reported cases. She also said she had been in contact with her provincial and territorial counterparts and had ordered the Public Health Agency of Canada to alert border authories, quarantine officers and other officials.[70] However, Canada's Chief Public Health Officer, David Butler-Jones, stated that the six affected Canadians suffered from only mild symptoms and have already started to recover. However, Butler-Jones warned against complacency, stating that the fact that only mild cases have been reported so far "doesn’t mean we won’t see either some more severe illness or potentially deaths."[71] In both provinces, the cases either involved people who had recently returned from Mexico or those in close contact with such people.[72]

In a step towards understanding the outbreak, and developing a vaccine, Canadian scientists completed the first full genetic sequencing of the H1N1 swine flu virus on 6 May.[73]

The high percentage of mild to severe cases amongst First Nations Peoples in Manitoba and Northern Ontario, when compared to the general population, have raised questions about the vulnerability of these communities to H1N1 across Canada. [74] [75] Concerns have also risen about whether the Canadian government’s pandemic preparation plan is able to properly address the specific needs of these communities. [76]

Timeline

2009 A(H1N1) Outbreak and Pandemic Milestones in North America
27 April First case confirmed in Canada.
30 April Quebec First confirmed case in Quebec
3 May Alberta First known cases of reverse zoonosis in the world.
Alberta First known infected pigs found in the world.
7 May Alberta First death confirmed in Canada.
Alberta First case of zoonosis in Canada, where an infected pig infects a human.
Saskatchewan First confirmed case in Saskatchewan.
8 May Canada Community outbreaks confirmed in Canada.
12 May Yukon First confirmed case in the Yukon.
8 June Quebec First death in Queebc.
22 July Quebec First case of Oseltamivir (Tamiflu) resistance found in Canada.

See also

References

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  74. ^ [http http://www2.canada.com/saskatoonstarphoenix/columnists/story.html?id=9e42d002-c8f0-4889-9337-41271a149455 "First Nations prime ground for H1N1 pandemic"]. The Star Phoenix. 2009-06-19. Retrieved 2009-07-02. {{cite news}}: Check |url= value (help)
  75. ^ "First Nations Chief In Manitoba Declares State Of Emergency Over H1N1 Virus". AHN. 2009-06-25. Retrieved 2009-07-02.
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