Public Health Agency of Canada

Public Health Agency of Canada

July 17, 2009 12:50 ET

Canada Releases New H1N1 Outbreak Guidelines for Closed Facilities

OTTAWA, ONTARIO--(Marketwire - July 17, 2009) - Minister of Health Leona Aglukkaq, and Canada's Chief Public Health Officer, Dr. David Butler-Jones, today announced that new guidelines on outbreaks of H1N1 in closed facilities have been posted and distributed to stakeholders today. Closed facilities include long term care facilities and correctional facilities for young adults. The Public Health Agency of Canada has also released updated guidelines on clinical care in primary care facilities such as hospitals and clinics.

"This is part of our ongoing commitment to provide leadership on how the outbreak is managed in Canada," said Minister Aglukkaq. "We will continue to review and update our infection control guidance documents on a number of topics on an ongoing basis and post the revised documents on our website as we learn more about the virus and how it spreads."

"Throughout the outbreak, we have been updating our clinical care, infection control and public health measure guidelines," said Dr. Butler-Jones. "We continue to provide this information to ensure that our partners are informed with the information they need to manage this outbreak."

Minister Aglukkaq also announced that the Public Health Agency of Canada, in concert with provinces and territories, is ramping up the monitoring and surveillance of severe illnesses and measuring the community spread of H1N1, rather than individual cases.

"The goal of surveillance is to assess the impact of the H1N1 flu virus on our communities so that we can adapt our planned responses to the situation at hand," said Minister Aglukkaq. "Counting cases no longer serves our purposes. What we want to gain a better understanding of how and why the virus is behaving the way it does, and to be prepared for any changes in the virus or the illness it causes."

As of today, Canada will no longer be releasing individual confirmed cases of H1N1 flu virus three times weekly. Instead, the existing FluWatch surveillance program will be enhanced in order to give a more robust analysis of the national picture in Canada.

FluWatch will provide a weekly analysis that captures the extent and severity of the outbreak, including unusual activity such as increased severity and increased hospitalizations, and will identify any patterns or trends in community spread of the virus early on.

In addition to FluWatch, the Public Health Agency of Canada will provide twice-weekly national updates on H1N1-associated deaths and will report regularly on any unusual outbreaks or clusters of illness. FluWatch also includes reports on antiviral resistance.

FluWatch will include updates from additional Canadian surveillance systems, like the Canadian Nosocomial Infection Surveillance Program, which tracks outbreaks of hospital-acquired infections, and the Immunization Program Monitoring ACTIVE (IMPACT) which collects data on children who are hospitalized with vaccine-preventable disease. These existing networks are being enhanced to meet the ongoing surveillance demands for the H1N1 flu virus.

For more information on the Canadians response to the H1N1 flu virus, please visit



FluWatch is the Public Health Agency of Canada's (PHAC) national surveillance system that monitors the spread of influenza and influenza-like illnesses in Canada on an ongoing basis. It now includes reporting on the H1N1 flu virus pandemic. FluWatch is used by public health authorities and health professionals across Canada to help inform public health planning and reponse for influenza.

FluWatch, now in its thirteenth year, has a number of key objectives, which include:

- detect influenza outbreaks across the country as early as possible;

- provide timely, up-to-date information on influenza activity in Canada and abroad to health professionals;

- monitor circulating strains of influenza virus, including new sub-types of the virus, and their sensitivity to antiviral medications; and

- provide information to the World Health Organization (WHO) for its use in making recommendations on vaccine formulation for the following influenza season.

Click here for the latest FluWatch report: or to download the latest report in PDF.

How FluWatch works

The FluWatch program consists of a network of laboratories, hospitals, doctor's offices, and provincial and territorial ministries of health. This network provides information on a weekly basis to PHAC for use in its FluWatch reports.

FluWatch reports will be disseminated weekly, rather than bi-weekly, from July to September this year, in order to provide information on H1N1 flu virus in Canada and internationally.

In total, PHAC collects and analyses five types of information, some from this network and some from other sources, in developing FluWatch. These types of information include:

- laboratory results that detect influenza viruses and influenza strains in Canada;

- influenza-like illnesses (ILI) treated at network hospitals and doctor's offices across Canada;

- assessments of regional influenza activity from provincial and territorial epidemiologists;

- influenza hospitalizations in children at network hospitals; and

- relevant international information.

Detecting influenza viruses

On a weekly basis, laboratories participating in FluWatch report the total number of positive tests for influenza as well as the total number of tests performed to PHAC. Some laboratories provide additional epidemiological and laboratory information on a monthly basis.

Identifying influenza strains

PHAC's National Microbiology Laboratory (NML) monitors human influenza virus strains in collaboration with provincial laboratories and other Canadian hospital-and university-based laboratories. The NML provides this information to FluWatch.

The NML detects and describes changes in the circulating strains of influenza virus and also monitors the sensitivity of those strains to antiviral medications. The NML shares this information and actual samples of strains with the WHO to support its global influenza monitoring and its recommendations for vaccine formulation for the following influenza season.

Influenza-like-illnesses treated at FluWatch hospitals and doctor's offices

FluWatch maintains a network of hospitals and doctor's offices across the country. These hospitals and doctor's offices report for one day a week the total number of patients seen for an influenza-like illness and the total number of patients seen for any reason. Age group information for these patients is also collected. This information is analysed to produce a weekly rate of illness in Canada.

Assessments of regional influenza activity

Provincial and territorial epidemiologists assess the weekly influenza activity in their jurisdictions using various sources of information, including laboratory results, physician reports of influenza-like illnesses, and reports of outbreaks.

In addition, school and work absenteeism and emergency department and hospital admission information may also be used in assessing the level of influenza activity in a given region. Influenza activity levels are reported as: "no activity reported," "sporadic activity," "localized activity," or "widespread activity."

Influenza hospitalizations in children

Since the 2003-2004 influenza season, FluWatch has been monitoring severe illness associated with influenza through the Immunization Monitoring Program Active (IMPACT) network of paediatric hospitals, which includes 12 out of the13 major children's hospitals across the country and accounts for 90 per cent of major pediatric beds in Canada.

Laboratory-confirmed cases of influenza that require admission to hospital are identified by a nurse at each participating center, and detailed case report forms are completed and sent on a weekly basis to PHAC.

PHAC, in collaboration with its partners, is planning to add a network of major adult care hospitals across the country to provide similar information on adults.

International information

FluWatch also reports on international influenza activity drawn from surveillance reports published by public health authorities in other countries (e.g. US Centers for Disease Control and Prevention) and international surveillance systems (e.g. European Influenza Surveillance Scheme and the World Health Organization).

How FluWatch is shared:

During the influenza season (October to May), FluWatch disseminates weekly reports to the provincial/territorial health authorities, health professionals through a variety of mechanisms, including PHAC's FluWatch website, the Canadian Communicable Diseases Report (CCDR), as well as direct fax and e-mail to health professionals and other key stakeholders.

Contact Information

  • Public Health Agency of Canada
    Media Relations