The Incursion and Expansion of West Nile Virus Into Canada
Dr. Paul Sockett, Public Health Agency of Canada
A Webber Training Teleclass
The Incursion and Expansion
of West Nile Virus
into Canada
Partners in West Nile virus Surveillance and Response
Public Health Agency of Canada
Pest Management Regulatory Agency
First Nations and Inuit Health Branch
Healthy Environments and Consumer Safety Branch
Health Products and Food Branch
Communications, Marketing and Consultation Directorate
Provincial/Territorial Steering Committees
Paul Sockett PhD
Canadian Food Inspection Agency
I.K. Barker, M. Drebot, R.Lindsay, H. Artsob, and P. Buck
Department of National Defence
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Acknowledgement
We wish to acknowledge the contribution of
our federal and provincial partners who
participate in the National West Nile Virus
Surveillance Program
Canadian Cooperative Wildlife Health Centre
Chief Medical Officers of Health
Environment Canada
Department of Fisheries and Oceans
Blood Operators
International Linkages
Consumers’ Groups
Surveillance in Canada: 2000 - 2004
• Monitoring activities
include surveillance in:
•
•
•
•
2001
Dead birds
Mosquitoes
Horses
Humans
Results: Canada 2001
•
•
•
•
Parks Canada
First confirmed positive dead bird collected in
Windsor, Ontario on 8 August
WN virus was confirmed in 128 dead birds from
12 health regions in Ontario
Virus also confirmed in nine mosquito pools
from Ontario
WN virus confirmed in pool of over-wintering
mosquitoes, collected January 2002
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Health Professional
Organizations
The Incursion and Expansion of West Nile Virus Into Canada
Dr. Paul Sockett, Public Health Agency of Canada
A Webber Training Teleclass
Positive Test Results:
Canada 2001
Province
Number of
Confirmed Positive
Dead Birds
Number of
Confirmed
Positive Mosquito
Pools
Number of
Presumptive* or
Confirmed Positive
Horses
Ontario
128
9
0
Canada
128
9
0
* Requires additional testing before it can be considered a confirmed result
Results – Canada 2002 (1)
2002
•
•
•
•
Canada to the last week of December 2002
Results – Canada 2002 (2)
•
•
•
•
•
Saskatchewan confirmed first positive dead bird
found on 28 July in the city of Regina
Quebec confirmed first positive mosquito pool
collected on 1 August in Oka
Manitoba confirmed first two positive mosquito
pools collected on 8 August in Winnipeg
Manitoba announced first presumptive positive
horses on 16 August
Nova Scotia confirmed first positive dead bird
found on 20 August in Halifax Region
First confirmed positive dead bird found on 19
May in Peel Region, southern Ontario
Quebec confirmed first two positive dead birds
found on 13 June in Montreal-Centre
Ontario confirmed first positive mosquito pool
collected on 27 June in York Region
Manitoba confirmed first positive dead bird
found on 12 July in Interlake Region
2002
Provinces with WN virus activity1
Human cases 2
NS, QC, ON, MB, SK
426 (20)
Dead birds 3
556
Domestic Animals4
356
Mosquito Pools 3
305
WNv activity in a bird, mosquito pool, horse or human
and confirmed (number of deaths in brackets)
positive (number tested in brackets)
4 presumed or confirmed
5 Several cases are related to travel outside Canada
6 These figures represent the number of positive results reported to the CFIA as per the Immediately Notifiable Disease
Regulations
1
2probable
3 confirmed
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The Incursion and Expansion of West Nile Virus Into Canada
Dr. Paul Sockett, Public Health Agency of Canada
A Webber Training Teleclass
Spatial distribution in Ontario,
2002
Toronto (6.23)
Peel (5.36)
Halton (14.91)
Hamilton-Wentworth (3.50)
Niagara (4.20)
Windsor-Essex (9.34)
Alternate Modes of Transmission of
Human Infection due to WN virus:
Canada 2002
Route of transmission
Presumed
Confirmed
Blood transmission
1
1
Tissue/organ transplant
0
0
Breast milk
0
0
Transplacental
0
0
Needle/Scalpel blade
0
1
2003
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The Incursion and Expansion of West Nile Virus Into Canada
Dr. Paul Sockett, Public Health Agency of Canada
A Webber Training Teleclass
Key Findings for 2003 - Canada (1)
Key Findings for 2003 – Canada (2)
• Human cases from 24 July to late November;
peak from late August to late September
• 1494 human cases (146 WNNS), 14 deaths
• First confirmed positive bird in Ontario in
mid-April – by June, positives birds from
Alberta to East Coast
• 1633/11,332 positive birds in 2003 (556/3,219
in 2002
• Culex spp. primary vector (Culex tarsalis in
West and Culex pipiens/Culex restuans in
East)
• 445 positive horses, most in AB (180) and SK
(162)
Number of human cases of West Nile Virus by classification and symptom
onset date in Canada 2003
(n=1427, excludes 30 cases missing onset dates, 13 cases unclassified)
100
90
Age profile of human cases of West Nile virus by classification
in Canada 2003
West Nile Fever (n=1213, 27 missing onset)
West Nile Neurological Syndrome (n=214, 3 missing onset)
80
N o. cases
70
2003 Classified Cases
Mean
(SE)
Median
Range
n
60
50
WNv Fever
46.1
(0.5)
47
3 to 92
1240
WNv Neurological
Syndromes
55.0
(1.2)
54
0 to 92
217
All cases
47.4
(0.4)
47
0 to 92
1486
40
30
20
10
0
Jun Jun
20 27
Jul
04
Jul
11
Jul
18
Jul Aug Aug Aug Aug Aug Sep Sep Sep Sep Oct
25 01 08 15 22 29 05 12 19 26 03
Oct
10
Oct
17
Rate of West Nile virus illness by classification and age group
in Canada 2003
Number and rate of West Nile virus illness by age group
in Canada 2003
(n=1457, excludes 13 unknown classification)
(n=1470)
8.0
8.7
N um ber of C ases
8
6.6
7
6.0
300
250
6
4.8
5
3.8
200
150
2.0
100
50
9
7.7
350
4
2.7
2.1
7.0
3
2
0.4
1
0 to 9
10 to 19 20 to 29 30 to 39 40 to 49 50 to 59 60 to 69 70 to 79 80 to 89 90 and
over
West Nile Neurological Syndrome
6.7
5.4
5.0
4.3
3.5
4.0
2.7
3.0
1.9
2.0
1.0
0
0
7.5
West Nile Fever
6.0
R a te p e r 1 0 0 ,0 0 0
400
10
Number of cases
Rate per 100,000
R ate per 100,000
450
0.0
0.4
0.0
0 to 9
2.4
2.0
0.1
0.2
10 to 19
20 to 29
0.5
0.9
1.2
1.2
1.1
1.3
1.3
30 to 39
40 to 49
50 to 59
Age group (years)
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60 to 69
70 to 79
80 to 89
90 and
over
The Incursion and Expansion of West Nile Virus Into Canada
Dr. Paul Sockett, Public Health Agency of Canada
A Webber Training Teleclass
Number of, and Percentage of, Dead Birds Tested Positive for WNV,
by Report Week, Canada 2003 & 2004
100
2004
250
80
2003 % +ve
70
2004 % +ve
60
2003 # +ve
50
2004 # +ve
200
150
100
40
# positive
% Positive
90
30
50
20
10
0
0
15
17
19
21
23
25
27
2004
29
31
33
35
37
39
41
43
45
Report We ek
Number of human cases of West Nile Virus by classification and symptom
onset date in Canada 2004
(n=25)
Cumulative WNV Human Cases, by Report Week, Canada, 2003 & 2004
5
1500
West Nile Fever (n=12)
West Nile Neurological Syndrome (n=13)
1000
N o. cases
Cumulative # cases
4
500
3
2
1
0
23
24
25
26
27
28
29
30
31
32
33
34
2003
1
1
3
4
6
13
23
29
62
129
400
750 1024 1141 1187 1220 1229 1233 1233
2004
0
0
0
0
0
0
0
0
1
1
6
13
35
21
36
21
37
24
38
25
39
26
Report Week
2003 by week of disease symptom onset
40
29
41
29
0
Jun
20
Jun
27
Jul
04
Jul
11
Jul
18
Jul
25
Aug Aug Aug Aug Aug Sep Sep Sep Sep
01
08
15
22
29 05
12
19
26
2004 by best available episode date
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Oct
03
Oct
10
Oct
17
The Incursion and Expansion of West Nile Virus Into Canada
Dr. Paul Sockett, Public Health Agency of Canada
A Webber Training Teleclass
Age profile of human cases of West Nile virus by classification
in Canada
Mean
(SE)
Median
Range
n
WNv Fever
46.1
(0.5)
47
3 to 92
1240
WNv Neurological
Syndromes
55.0
(1.2)
54
0 to 92
217
All cases
47.4
(0.4)
47
0 to 92
1486
(n=25)
8
WNv Fever
Mean
44.6
WNv Neurological
Syndromes
All cases
(SE)
Median
(5.2)
Range
45.5
5 to 83
n
46.6
(6.3)
50
(4.1)
3 to 88
47
3 to 88
0
0.16
5
0.14
0.10
0
3
0.05
2
12
13
0
4
1
48.5
0.20
6
N u m b er o f C ases
2004 Classified Cases
0
Number of cases
Rate per 100,000
7
0.05
0.06
0
0.03
0.00
0
0
0 to 9
25
R ate per 100,000
2003 Classified Cases
Number and rate of West Nile virus illness by age group
in Canada 2004
10 to 19
20 to 29
30 to 39
40 to 49
50 to 59
60 to 69
70 to 79
80 and
over
Age group (years)
Rate of West Nile virus illness by classification and age group
in Canada 2004
(n=25)
0.14
West Nile Fever
0.12
0.12
West Nile Neurological Syndrome
R a te p e r 1 0 0 ,0 0 0
0.08
0.08
0.06
0.05
0.04
0.03 0.02
• For 2005, PHAC will continue its coordinating role with
regional offices, P/Ts and other federal Departments. Key
objective will be to sustain messaging while supporting
provincial/territorial efforts
0.04
0.04
– Facilitate information-sharing through communications committee
– Continue public education with in-store promotion
– FNIHB’s public education campaign will focus on personal
protective measures (avoiding mosquito bites and eliminating
sources of standing water)
– Host media technical briefing early in the season
0.03
0.02
0.02
0.00
0.00
0.00
0.00
0.00
0 to 9
10 to 19
20 to 29
30 to 39
40 to 49
50 to 59
60 to 69
Communications Approach
– Served as a credible source of information
– Ensured consistent messaging and reached high risk populations
0.10
0.10
0.10
0.04
• To date
70 to 79
80 to 89
Canada to the last week of December 2004
2002
2003
2004
NS, QC, ON,
MB, SK
NS, NB, QC, ON,
MB, SK, AB
QC, ON, MB,
SK, AB
426 (20)
14945 (14)
265 (2)
Dead birds 3
556
1633 (11332)
416 (6236)
Domestic Animals4
356
4456
146
Mosquito Pools 3
305
578
176
Provinces with WN virus
activity1
Summary
Human cases 2
WNv activity in a bird, mosquito pool, horse or human
and confirmed (number of deaths in brackets)
positive (number tested in brackets)
4 presumed or confirmed
5 Several cases are related to travel outside Canada
6 These figures represent the number of positive results reported to the CFIA as per the Immediately Notifiable Disease
Regulations
1
2probable
3 confirmed
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The Incursion and Expansion of West Nile Virus Into Canada
Dr. Paul Sockett, Public Health Agency of Canada
A Webber Training Teleclass
West Nile virus Spread:
August 1999 to
December 2004
Human Cases
Canada and USA: 1999-2004
2002
2004
Year
1999
2001
2003
2000
.
Dominican
Republic
Cayman
Islands
Canada
USA
1999
62(6)
2000
21(2)
2001
66(9)
2002
426 (20)
4156 (284)
2003
1388 (14)
9862 (264)
2004
26 (0)
2470 (88)
(number of deaths in brackets)
USA
1999
2000
2001
62 (6)
21 (2)
66 (9)
Canada
2002
2003
2004
4156 (284) 9862 (264) 2470 (88)
426 (20)
(number of deaths in brackets)
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1494 (14)
26 (2)
The Incursion and Expansion of West Nile Virus Into Canada
Dr. Paul Sockett, Public Health Agency of Canada
A Webber Training Teleclass
Other 2005 Teleclasses
For more information, please consult the
Public Health Agency of Canada’s WN virus
website at:
www.westnilevirus.gc.ca
Pour plus d’informations, consulter le site
Web d’Agence de santé publique du Canada
sur le virus du Nil occidental à l’adresse
suivante:
www.virusduniloccidental.gc.ca
For more information, refer to
www.webbertraining.com/schedule.cfm
June 2
– Skin Rashes & Infection Control – Spot That Spot
June 9
– Measuring the Cost of Hospital Infection
with Dr. Justin Graham
with Dr. Barry Cookson
June 14
– Controlling Mumps in the Community
June 16
– Antiseptic Practice and Procedure with Sue Crow
June 30
– Infection Control in First Response Emergency
Services with Margaret McKenzie
with Dr. Isabel Oliver
Questions?
Contact Paul Webber [email protected]
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