KFLA Public Health Informatics | KFLA Public Health

ONTARIO ILI ACTIVITY TRENDS

Weekly Influenza-Like Illness (ILI) Activity Level Indicator determined by data reported to the Acute Care Enhanced Surveillance (ACES) System supported by the Ministry of Health and Long Term Care and based at KFLA Public Health.

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Ontario
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(Sept 28 - Oct. 4)
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(Oct. 5 - 11)
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(Oct. 12 - 18)
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Flu Season Week 46 | Nov. 08, 2014 - Nov. 15, 2014

Seasonal Influenza Risk Assessment Process

From November to April, the Ministry of Health and Long-Term Care reviews a set of indicators on a weekly basis to assess how the province is progressing through the influenza season. These indicators include data from syndromic and laboratory surveillance systems, as well as health system utilization data.

The ministry is piloting a classification system to describe influenza activity and to support decision-making by health organizations. Over the course of the 2014/2015 influenza season, the classification system will be validated for future improvements. This system describes influenza activity according to a green, yellow, orange and red colour scheme :

 
Influenza-related activity is at low seasonal levels.

No significant increases in influenza activity are expected this week.

  • No significant impacts on the acute care or other sectors are anticipated this week associated with influenza virus activity.
    • Visits to emergency departments for complaints related to respiratory syndromes are expected to be less than 10% of total emergency department visit volume.
    • Admissions to hospitals for pneumonia or influenza-link-illness (ILI) are expected to be less than 8% of total emergency department admission volume.
  • This week is a good opportunity to focus on influenza prevention activities including reviews of infection prevention & control measures such as hand hygiene strategies and the immunization of health workers and clients / patients / residents.

 
Influenza-related activity is at elevated seasonal levels.

This week influenza is expected to increase as part of a seasonal peak in activity or decrease from a seasonal peak.

  • Limited impacts on the acute care sector and other sectors of the health system are expected this week associated with influenza virus activity. Some acute care settings may continue to see impacts on their organizations after influenza activity has peeked in their communities due to the residual effects of high admission rates in previous weeks.
    • Visits to emergency departments for complaints related to respiratory syndromes are expected to be 10-12.5% of total emergency department visit volume.
    • Admissions to hospitals for pneumonia or ILI are expected to be 8-10% of total emergency department admission volume.
  • Organizations may see increases in staff absenteeism rates associated with influenza virus activity.
  • This is a good opportunity for organizations to continue to focus on influenza prevention activities including reviews of infection prevention & control measures such as hand hygiene strategies and the immunization of health workers and clients/ patients/ residents. It is also a good time for organizations to review plans to ensure that they have the capacity to respond to increased demand for influenza-related services. Contact the ministry for more information about prevention and preparedness activities at emergencymanagement.moh@ontario.ca or 1-866-212-2272.

 
Influenza-related activity is at elevated seasonal levels and may be reaching peak levels this week.

  • Impacts on the acute care and other sectors of the health system associated with influenza virus activity are likely to occur this week.
    • Visits to emergency departments for complaints related to respiratory syndromes are expected to be 12.5-15% of total emergency department visit volume.
    • Admissions to hospitals for pneumonia or ILI are expected to be 10-12% of total emergency department admission volume.
  • Organizations may see increases in staff absenteeism rates associated with influenza virus activity.
  • Organizations may need to implement plans to increase their capacity to respond to the need for additional services. Contact the ministry for more information about prevention, preparedness and response activities at emergencymanagement.moh@ontario.ca or 1-866-212-2272.

 
Influenza-related activity is at greatly elevated levels.

  • Impacts on the health system associated with influenza virus activity are expected this week.
    • Visits to emergency departments for complaints related to respiratory syndromes are expected to be greater than 15% of total emergency department visit volume.
    • Admissions to hospitals for pneumonia or ILI are expected to be greater than12% of total emergency department admission volume.
  • Organizations may see increases in staff absenteeism rates associated with influenza virus activity.
  • Organizations may need to implement plans to increase their capacity to respond to the need for additional services. Contact the ministry for more information about prevention, preparedness and response activities at emergencymanagement.moh@ontario.ca or 1-866-212-2272.

For more information about this project piloting a classification system to describe influenza activity, please contact the ministry's Emergency Management Branch by email at emergencymanagement.moh@ontario.ca or by phone at 1-866-212-2272.

Additional Info

  • The color coding system is applicable to provincial alerting and then customized to individual health unit geographies by the ACES team after historical review of baseline data.
  • This map uses the percentage of outpatient visits to emergency departments and admissions to hospitals for influenza-like illness to measure the ILI activity level within a health unit. This data is reviewed weekly and is collected in real time from participating hospitals. Maps are updated every Monday throughout the influenza season, so there is a maximum time lag of one week depending on when the website is accessed. It does not, however, measure the extent of geographic spread of flu within a local public health agency. Therefore, outbreaks occurring in a single city or area could cause the health unit to display high activity levels.
  • Data collected in ACES may disproportionately represent certain populations within a health unit, and therefore, may not accurately depict the full picture of influenza activity for the whole health unit.
  • Data displayed in this map is based on data collected from local hospitals in ACES. The data presented in this map is preliminary and may change as more data is received. Differences in the data presented here by ACES and independently by some local health agencies likely represent differing levels of data completeness with data presented by the local health agency likely being the more complete.
  • Predictions for changes in the percentage of outpatient visits to the acute care sector take into consideration the current percentage of outpatients visits to Emergency departments and admissions to hospitals for pneumonia and ILI together with an understanding of the circulating strains of influenza in Ontario and their epidemiology as reported by Public Health Ontario in their PHO laboratory-based respiratory pathogen surveillance report.

The analysis is done on the data provided in real time to the ACES system from hospital partners. The data is analyzed weekly on each Monday for the data available up to the week ending Saturday. The website will be updated no later than the end of the business day that same Monday.

The epidemic curves for the provincial summary of data are here:

1. ED respiratory visits curve for Ontario hospitals providing data to the ACES system along with previous year comparisons.

2. Historical admissions to hospital for Pneumonia/ILI syndrome as a percentage of total emergent admissions to all ACES participating hospitals in Ontario (inset graph shows the latest 8 week period).

3. Age breakdowns of Pneumonia/ILI admissions for Ontario hospitals participating in the ACES system.

4. Provincial Serfling curve showing historical baseline data and 95% confidence limit threshold levels compared with actual ED visit proportions of respiratory and fever/ili complaints (inset graph shows the latest 8 week period).

5. Comparison of ED respiratory visits and lab confirmed influenza cases for health units participating in the ACES system (Lab data source: Ontario Respiratory Virus Bulletin, Surveillance Services and Public Health Ontario Laboratories, Public Health Ontario)

6. Historical comparison of ED respiratory visits and Pneumonia/ILI admissions