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2009 swine flu outbreak in Canada

Confirmed cases  Unconfirmed or suspected cases
Disease	Swine flu
Virus strain	H1N1
Origin	Thought to be Veracruz, Mexico
Arrival date	26 April 2009
Deaths	0
Confirmed cases	101
Suspected cases	27
Suspected cases have not been confirmed as being due to this strain of influenza by laboratory tests, although some other strains may have been ruled out.

In March and April 2009, an outbreak of a new strain of influenza commonly referred to as "swine flu" infected many people in parts of Mexico, the United States, and Canada, and it recently spread to Canada on April 26. The new strain was identified as a combination of several different strains of Influenzavirus A, subtype H1N1, including derivatives of this subtype circulating in humans (see Human influenza), in birds (see Avian influenza), and in pigs (see Swine influenza). The World Health Organization (WHO) and the U.S. Centers for Disease Control (CDC) have expressed serious concerns that the novel strain, which transmits between humans and which has had a relatively high mortality rate in the possible and confirmed Mexican cases, has the potential to become a flu pandemic. 101 cases have been confirmed in Canada; thirty-three in Nova Scotia, twenty-nine in British Columbia, eighteen in Alberta, sixteen in Ontario, three in Quebec, one in New Brunswick and one in Manitoba. Several other suspected cases in Montreal and Quebec have been confirmed not to be swine flu.

Human cases

Maritime and Atlantic region

Nova Scotia's chief medical officer, Dr. Robert Strang, said on April 26 that the National Microbiology Laboratory in Winnipeg confirmed late the previous day that four people in the province between the ages of 12 and 18 were recovering from "relatively mild" cases of the disease. The four attend King's-Edgehill School preparatory school in Windsor, Nova Scotia; and one of the four infected students had been on a recent school trip to the Yucatan Peninsula.

As of April 27, Prince Edward Island was investigating a number of suspected cases. Furthermore, there is evidence that the disease is spreading beyond the first four Nova Scotia cases, as friends and relatives are starting to show symptoms. Robert Strang indicated that he expects the diseases to spread to the rest of Nova Scotia within a few weeks. On May 3, The Chronicle Herald reported that 17 more cases are confirmed, eleven related to the initial cases at King's Edgehill school in Windsor, with six more in the Halifax Regional Municipality.

On May 1, 2009, the first case in New Brunswick was confirmed to be present in Greater Moncton. The chief medical officer of health, Dr. Eilish Cleary, notes there will most likely be more cases emerging in the province.

Eastern region

On April 27, 2009, four cases were suspected to be swine flu in Ontario. This number grew to ten cases in five days.

As of April 30, there were 12 confirmed cases of swine flu in the Greater Toronto Area, and 14 cases as of May 3. Three cases were initially found in Durham Region, three in Port Perry (which were brought to Durham Region) two in York and one in Peel. This includes three women who returned from Cancun with the flu and then went to a casino after reporting their symptoms to a hospital. There are also 3 confirmed cases of swine flu in Toronto. The region itself was secondary epicenter during the 2003 SARS epidemic.

On April 30, 2009, the first case was confirmed in Québec in the Greater Montreal Area, with three more suspected cases under investigation. Another case was confirmed within the city of Montreal itself on May 2. Both cases are mid-aged men returning from Mexico recently and only show mild symptoms. On May 3, a 27-year old woman suffering from more serious effects has been hospitalized in Laval with her relatives suspected of spreading the disease.

Central and Western regions

So far no cases of swine flu have been found in Saskatchewan. Four cases are suspected, however.

As of May 3, 2009, there are eighteen confirmed cases of swine flu in Alberta.4 cases in edmonton This includes four young people who recently returned from Mexico. All individuals had a mild form of the illness and none of them had to be hospitalized.

On May 2, Canadian Food Inspection Agency executive vice-president Dr. Brian Evans announced that an infected Alberta farm worker recently returned from Mexico had apparently passed the virus to a swine herd in his care. Although the herd had been quarantined, Evans stressed that the infection represented no threat to food safety and judged the possibility of infected pigs passing the virus back to humans "remote." Evans said the infection of the herd was the first known case of the H1N1 virus being transmitted from humans to pigs.

The cases in British Columbia involved two young men aged 25–35 from the B.C. Lower Mainland who had recently come back from Mexico, according to Dr. Danuta Skowronski, head of flu and respiratory illnesses at the BC Centre for Disease Control, run by the provincial government. The cases were discovered by normal flu testing conducted by the disease control center after the men had visited a doctor about flu-like symptoms. Skowronski said the two men had been asked to "self-isolate" themselves but had not officially been quarantined. He noted the disease seemed "widespread" in Mexico and should not be mistaken by tourists to be linked only with urban Mexico City.

On May 3, 2009, the first case in Manitoba was confirmed in the Brandon area.

Totals

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Cases by province/territory

Province/territory	Cases		Deaths
	Laboratory confirmed	Suspected	Attributed (confirmed)
Totals	101	27	0
Alberta	18	0	0
British Columbia	29	0	0
Manitoba	1	0	0
New Brunswick	1	0	0
Nova Scotia	33	3	0
Ontario	16	10	0
Quebec	3	5	0
Prince Edward Island	0	5	0
Saskatchewan	0	4	0
Not all cases have been confirmed as being due to this strain. Possible cases are cases of influenza-like illness (ILI) that have not been confirmed through testing to be due to this strain.

Template:WebSlice-end

Non-human cases

On May 2, it was revealed that the first incidence of the flu found in pigs, in Canada, was on a hogfarm in Alberta. It is suspected that an infected farmhand recently returned from Mexico passed the flu on to the pigs.

Response

Dr. Michael Gardam, director of infectious disease prevention and control at the Ontario Agency for Health Protection and Promotion, said in an interview with the CBC that an outbreak of swine flu in Ontario, Canada's most populous province, would not be as serious as the 2003 SARS epidemic. In preparing for and dealing with an influenza pandemic, the Public Health Agency of Canada follows the WHO's categories, but has expanded them somewhat. Despite initial reports of two swine influenza cases in Montreal's Lakeshore General Hospital, Johanne Simard of the Montreal Regional Health Board confirmed negative results for all quarantined patients at the hospital and that no quarantines were currently in effect at the hospital.The National Microbiology Laboratory in Winnipeg confirmed cases of human swine influenza virus in clinical specimens sent from Mexico for Mexico and the Canadians government issued a travel advisory for Mexico, warning Canadian who have returned from the country of the severe respiratory illness.

On April 26, the Government of Nova Scotia announced on a live webcast that four students in Windsor, Nova Scotia, have confirmed cases of swine flu. Later that day, the Federal Government confirmed the existence of a total of six cases in Canada; four in Nova Scotia and two in British Columbia. Federal Health minister Leona Aglukkaq said the Canadian federal government would take whatever measures were necessary to keep the public safe, and that as Canada continued to ramp out its surveillance efforts there would likely be more reported cases. She also said she had been in contact with her provincial and territorial counterparts and had ordered the Public Health Agency of Canada to alert border authories, quarantine officers and other officials. However, Canada's Chief Public Health Officer, Dr. David Butler-Jones, stated that the six affected Canadians suffered from only mild symptoms and have already started to recover. However, Butler-Jones warned against complacency, stating that the fact that only mild cases have been reported so far "doesn’t mean we won’t see either some more severe illness or potentially deaths." In both provinces, the cases either involved people who had recently returned from Mexico or those in close contact with such people.

See also

• 1918 flu pandemic
• Avian flu
• Severe acute respiratory syndrome (SARS)
• List of Canadian medical disasters

References

1. "CDC Press Briefing Transcripts April 24, 2009". CDC. 24 April 2009. Retrieved 2009-04-25.
2. Staff Writer (April 25, 2009). "Two released from quarantine at Lakeshore General". Montreal: CTV. Retrieved 2009-04-27.
3. "Flu Update, Sunday, April 26, 2009" (Press release). King's-Edgehill School. 26 April 2009. Retrieved April 26, 2009.
4. "Health officials confirm 6 cases of swine flu in Canada". CBC News. 26 April 2009.
5. ^ "Suspected swine flu cases on P.E.I. drop from eight to five". The Guardian. 28 April 2009. {{cite news}}: Unknown parameter |accessed= ignored (help)
6. "Swine flu symptoms spreading beyond Windsor, N.S., campus". CBC News. 2009-04-24. Retrieved 2009-04-28.
7. "Province's swine flu cases jump to 31". Chronicle Herald. 2009-05-03. Retrieved 2009-05-03.
8. ^ "Public health confirms 1st swine flu case in N.B." CBC News. 1 May 2009. Retrieved 1 May 2009.
9. ^ "Ontario probes suspected swine flu cases amid pandemic fears". CBC News. 2009-04-27. {{cite news}}: Unknown parameter |accessed= ignored (help)
10. "Canadian province of Ontario has 4 swine flu cases". Reuters. 2009-04-28. Retrieved 2009-04-28.
11. "Province confirms four cases of swine flu in Toronto area". CityPulse 24 News. 28 April 2009.
12. "Three more Canadians diagnosed with swine flu". CTV News. 29 April 2009.
13. Michele Mandel (30 April 2009). Toronto Sun http://www.torontosun.com/news/2009/04/30/9301126.html. {{cite news}}: Missing or empty |title= (help)
14. "New Ontario case pushes national swine flu total to 34". CBC. 2009-04-30.
15. "To control swine flu lets heed the lessons of SARS". New York Daily News. 30 April 2009.
16. ^ "1 confirmed case of swine flu in Quebec". CBC News. 30 April 2009. Retrieved 2009-05-01.
17. ^ CBC News (May 3rd 2009). "Swine flu epidemic on decline". CBC. {{cite news}}: Check date values in: |date= (help)
18. ^ "Swine Flu Fear Spreads; Four suspected cases in Saskatchewan". News Talk 980 CJME. 2009-04-27. {{cite news}}: Unknown parameter |accessed= ignored (help)
19. "Number of confirmed swine flu cases in Canada now at 85". CBC. 2009-05-02. Retrieved 2009-05-02.
20. "Two cases of swine flu confirmed in Alberta". CTV Media. 2009-04-28.
21. "Alberta confirms 2 cases of swine flu". CBC. April 28, 2009. Retrieved 2009-04-29..
22. "Alberta pigs likely infected with flu from worker: CFIA official". CBC.ca. 2009-05-03. Retrieved 2009-05-03.
23. Ebner David (26 April 2009). "Swine flu confirmed in Canada". The Globe and Mail.
24. "Flu strain arrives in Manitoba". Winnipeg Sun. 2009-05-03.
25. Tanya Talaga, Joanna Smith (30 April 2009). "Spike in cases of swine flu". Toronto Star.
26. "Province's swine flu cases jump to 31". Chronicle Herald. 2009-54-03. Retrieved ?. {{cite news}}: Check date values in: |accessdate= and |date= (help)
27. "Swine flu cases in N.S. hold at 4". CBC News. 29 April 2009.
28. Lauren Etter (3 May 2009). "Pigs in Canada Contract Flu Virus". Wall Street Journal. Retrieved 2009-05-03.
29. "Canada farm worker 'infects pigs'". BBC News. 3 May 2009. Retrieved 2009-05-03.
30. Ljunggren David, Anderson Scott (24 April 2009). "Swine flu not as serious as SARS: Canada's Ontario". Reuters.
31. "The Canadian Pandemic Influenza Plan for the Health Sector". Public Health Agency of Canada.
32. "Swine-flu fears at Lakeshore General unfounded". The Gazette (Montreal). 25 April 2009. Retrieved 2009-04-25.
33. "Canadian lab confirms human swine flu cases in Mexico". CBC News. 24 April 2009. Retrieved 1 May 2009.
34. "Travel advisory warns of severe respiratory illness in Mexico". 23 April 2009. Retrieved 1 May 2009.
35. "Health officials confirm swine flu in Canada". The Canadian Press. 26 April 2009. Retrieved 2009-04-26.
36. Staff Writer (April 26, 2009). "6 cases of swine flu confirmed in Canada: health officials". CBC News. Retrieved 2009-04-26.
37. Brennan Richard J (April 26, 2009). "Swine flu confirmed in Canada : Unlike deadly outbreak in Mexico, the cases in Nova Scotia and B.C. were mild and didn't require hospitalization". Toronto: The Star.
38. Staff Writer (April 26, 2009). "Six swine flu cases confirmed in Canada". CTV Media. Retrieved 2009-04-26.

External links

Canadian

• FightFlu.ca
• Health Canada: Preparing for a pandemic
• Public Health Agency of Canada: Swine Influenza

International

• Swine influenza, at the World Health Organization
• WHO's Pandemic Influenza Phases
• BioHealthBase Bioinformatics Resource Center – Database of influenza genomic sequences and related information.
• Centers for Disease Control and Prevention (CDC): Swine Influenza (Flu)
• Medical Encyclopedia Medline Plus: Swine Flu
• Medical Encyclopedia WebMD: Swine Flu Center

• Current events from April 2009
• 2009 in Canada
• 2009 swine flu outbreak
• Health in Canada