M E M O   /   N O T E   D E   S E R V I C E



To / Destinataire

Mayor and Members of Council /

Maire et membres du Conseil


File/N° de fichier:


From / Expéditeur

Dr. Isra Levy, Medical Officer of Health (Acting) / Médecin chef en santé publique (par intérim)


Date:  2 June 2008/le 2 juin 2008

Subject / Objet

Ottawa Public Health Delivery of the Ontario Universal Influenza Immunization Program (UIIP) / Exécution du Programme universel de vaccination antigrippale de l’Ontario par Santé publique Ottawa



Influenza, a highly contagious disease of the respiratory tract, continues to be a significant source of morbidity and mortality in Ottawa and around the world.  Annually, in Canada, 500 – 1,500 deaths are attributed to influenza; while influenza and community-acquired pneumonia account for up to 60,000 hospitalizations.  Between 10 and 20 per cent of the population is affected in a typical season.


Groups at increased risk for influenza complications include the elderly and individuals of any age who are immuno-compromised or who have underlying chronic medical conditions.  Due to the high incidence of hospitalization with influenza in children under 2 years of age, this age group as well as their contacts, such as pregnant women and caregivers, are also considered high priority groups for immunization against influenza.


The impact of influenza can be substantially reduced through immunization and through the public health management of outbreaks in institutions such as Long Term Care Homes (LTCH), retirement homes, hospitals and childcare facilities.


Ottawa Public Health Activities: 2007-2008 Influenza Season


The Ottawa Public Health divisions of Infectious Disease Prevention and Control, Environmental and Health Protection, and Evidence, Preparedness and Information work collaboratively to deliver the Universal Influenza Immunization Program (UIIP) to Ottawa residents and to provide support to Ottawa’s hospitals, LTCH, retirement homes and workplaces.  The following provides a summary of activities undertaken by OPH in the promotion and provision of influenza immunization.



1.      Distribution of Publicly Funded Influenza Vaccine in Ottawa

Approximately 424,000 doses of influenza vaccine were distributed to area physicians, hospitals, long term care and residential facilities, nursing service providers, emergency service workers and workplaces.


2.      Preparation of Professional Reference Packages

Approximately 800 information packages were prepared and sent to all Ottawa physicians, acute and chronic care hospitals, LTCH, retirement homes and nursing service providers.  These packages include clinical information about the influenza vaccine, MOHLTC reporting requirements and vaccine ordering directions.


3. Support for Immunization of Long Term Care Residents and Health Care Workers

To prevent outbreaks, hospitalizations and deaths among vulnerable populations the Ontario Ministry of Health and Long Term Care has set the goal of immunizing at least 70% of staff in hospitals, and 90% of residents and staff of LTCH and Retirement Homes.  Residential, palliative care, psychiatric, and other such group homes are also targeted for the same reason.  The immunization rates for Ottawa’s facilities in the fall of 2007 were:

·         94% of residents (approximately 4,000) and 73% of staff in 27 of 29 LTCH

·           92% of residents (approximately 3,000) and 75% of staff in 43 of Ottawa’s 56 Retirement Homes

·           58% of staff  (approximately 19,000) in Ottawa hospitals.


4. Community Immunization Clinics

Forty Ottawa Public Health influenza immunization clinics were held from October 27/07 to January 17/08 with 35,500 individuals immunized. 

Criteria for clinic site selection includes equitable distribution of geographic/community locations, sufficient size to accommodate reception/waiting areas, injection administration areas, and post-injection waiting areas for up to 2000 people over a six-hour period, ease of accessibility, including easy accessibility for clients in wheelchairs and physically challenged clients, and adequate parking.


5. Street Health Immunization Clinics

Public Health Nurses from the Street Health program, together with their community partners immunized more than 893 “high risk clients” at shelters, drop-in centres and various outreach sites across the city.


6. Workplace Clinics

Approximately 30,000 people received influenza immunization through employer sponsored workplace clinics. OPH provides resource material and consultation services to employers to assist them in the provision of on-site clinics for their employees.


7.  Community Presentations and Displays

Public Health Nurses participated in educational sessions and community events including the annual Outbreak Management Education Forum, the Ottawa Police Services health fair, and presentations at workplaces.


The Outbreak Management Team, a multi-disciplinary team of Public Health Nurses and Public Health Inspectors held the fourth annual Outbreak Educational Forum on November 6, 2007. One hundred and fifty representatives from 71 Ottawa and area health care facilities (HCF) and 7 nursing agencies attended.


8.      Preparation of Multi-lingual Information

The influenza immunization consent form and health promotion information is available in 14 languages.  In addition to French and English: Arabic, Cambodian, Chinese, Farsi, Italian, Korean, Russian, Somali, Spanish, Tagalog, Urdu and Vietnamese translations are available.


9.      Investigation of Respiratory Outbreaks

From September 2007 to April 17, 2008 the Outbreak Management Team, has investigated 65 respiratory outbreaks. Thirty-two influenza outbreaks were laboratory confirmed, affecting 437 residents and 121 staff members.  This team guides the staff of Ottawa HCF in implementing outbreak control measures and facilitates services such as laboratory sample pick up and testing.  The goal is to contain infectious outbreaks as well as reduce the number of hospitalizations and deaths.  As of April 17, 2008 there have been 19 deaths (4.3% of all cases) and 33 hospitalizations (7.6% of all cases) in Ottawa from the confirmed influenza outbreaks.


10.    Respiratory Outbreak Surveillance

The Evidence, Preparedness and Information Division of OPH collects data from a variety of sources in order to monitor the health of our community and inform our infection control practices.  Laboratory-confirmed influenza is reportable to public health under the Health Protection and Promotion Act (HPPA). Case-related information is stored in Integrated Public Health Information System (iPHIS).


Information is collected from long-term care facilities and hospitals under the HPPA on a daily basis during an active outbreak.  The Influenza Update is updated weekly on Ottawa.ca (<http://www.ottawa.ca/residents/health/statistics/weekly_influenza_en.html> ) and contains the most recent influenza information for Ottawa’s health community and general population. The report uses descriptive epidemiology to monitor the impact of sporadic influenza cases and influenza outbreaks in the population of Ottawa.



11. Participation in Regional and Ottawa Health Care Facility Infection Control Committees

Public Health staff are consultant members of the infection control committees of Ottawa’s hospitals and long-term care facilities, providing public health expertise on measures necessary to prevent and contain the spread of infectious diseases. As well, OPH coordinates meetings of the Ottawa Infection Control Liaison Group, a regional forum for infection control professionals.


In 2007 OPH participated on a regional committee chaired by the Champlain Infection Control Network to develop strategies to increase influenza immunization in health care workers. The resulting pilot project is currently undergoing evaluation.


Ottawa Public Health estimates that the programs and activities that support universal influenza immunization is reaching over 50% of our total population and, as noted, over 90% of vulnerable populations in long term care homes and retirement homes. This is a major factor in reducing the overall morbidity and most importantly mortality from this disease. 



I.G. Levy, MB BCh, M.Sc., FRCPC, FACPM

Medical Officer of Health (Acting) / Médecin chef en santé publique (par intérim)






cc:        Kent Kirkpatrick, City Manager

Steve Kanellakos, Deputy City Manager, Community and Protective Services

Marc Desjardins, Committee Coordinator, Community and Protective Services