Monali Varia, Manager Infection Prevention & SurveillanceLydia Cheng, Epidemiologist
October 1, 2019
‘Tis the (outbreak) season
Topics
• Public Health updates
• Influenza activity 2018/19
• Planning for 2019/20 respiratory illness season
Comprehensive Health Status Report• Describes the current state
of health outcomes and related risk factors for Peel residents
• Tracks changes in health outcomes from 2008 to 2018
• Highlights important issues to inform the next 10-year Public Health Strategic Plan
Successes
Peel’s growing and aging population20% growth since 2006
Adding an additional 300,000 people by 2031
Longer life expectancy
Life expectancy is higher in Peel compared to
Ontario (86.1 years for females, 82.6 for males)
High rates of immunization
Incidence for diseases where Peel has high vaccine coverage has
decreased
Decline in smoking ratesSmoking rates in Peel declined from 20% to 11% over a 15-year
period
Decline in many chronic diseasesRates of heart disease, stroke and lung cancer in Peel have decreased over the past 2 decades
Opportunities and emerging issues
Emerging issues Early indicators of health impacts of climate change
Increased rate of emergency department visits for mental health conditions in youth and young adults
High rates of diabetes
The incidence rate in Peel for those aged 20 to 49 years has doubled over
the past 20 years
Cancer-causing infectious pathogens
1,200 cancer diagnoses in Peel from 2003-12 were
the result of human papillomavirus, hepatitis
B and C infections
No improvement in nutrition or
physical activityOnly 26% of Peel
residents aged 12 and older are physically active
during leisure time
High level of sedentary behaviour
67% of Peel grade 7-12 students spend more than
the recommended 2 hours of recreational screen time per day
Common themes and cross-cutting issues
• Some groups in Peel have poor health behavioursand/or health outcomes across a range of issues
– Males (smoking, drinking, cannabis use, higher rates of chronic diseases)
– Youth and young adults (mental health conditions, STIs)
To access the full report, visit:https://www.peelregion.ca/health/resources/reports.htm
2018/19 Influenza Activity in Peel
• 1502 confirmed cases, very little influenza B circulating
• Peak activity over the winter break
• 16 influenza outbreaks – all influenza A → total 156 outbreak-associated cases
What might we expect for 2019/20 influenza season?
Australia’s influenza season
• Earlier start to the season
• H3N2 predominated
• Clinical severity overall was low
• Overall good vaccine match
2019/20 Northern Hemisphere Influenza Vaccine Composition (WHO)
• A/Brisbane/02/2018 (H1N1)pdm09-like virus
• A/Kansas/14/2017 (H3N2)-like virus
• B/Colorado/06/2017-like virus (B/Victoria lineage)
Plus (for Quadrivalent vaccine)
• B/Phuket/3073/2013-like virus (B/Yamagata)
Four publicly-funded influenza vaccine products
Vaccine Formulation Format Eligibility
Fluzone® High-Dose
High-dose TIV Pre-filled syringe 65 years and older
FluLaval® Tetra QIV Multi-dose vial 6 months and older
Fluzone®Quadrivalent
QIV Pre-filled syringe and multi-dose vial
6 months and older
Afluria® Tetra QIV Pre-filled syringe 5 years and older
TIV=trivalent inactivated vaccine; QIV=quadrivalent
How can we think differently about facility outbreaks?
http://www.hnhblhin.on.ca/~/media/sites/hnhb/For%20HSPs/NRPH%20Outbreak%20Mgmt%20Dashboard%20Overview2.pdf?la=en
In other jurisdictions…
Outbreak Summary: Peel ABC Long-Term Care Home
Time difference between illness onset dates of index case and last case
Outbreaks reported to Peel Public Health
Includes residents and staff cases
Time for your reflections and your questions
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