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