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Juan Mosquera holds his son Jasper, 4, as he receives a flu shot with little sister Hazel, 3, looking on at city hall in Toronto, Ont. Jan. 11, 2011.

Kevin Van Paassen/The Globe and Mail

A surge in seasonal influenza cases in parts of the country has clogged hospital emergency rooms, postponed elective surgeries and resulted in at least one public health unit expanding its flu-shot clinics.

The number of patients showing influenza-like symptoms continues to increase across the country, but has been particularly high in parts of Ontario, Manitoba and Quebec. Health officials say patients with respiratory problems inundated emergency departments during the holiday period in particular, putting a heavy strain on resources.

Unlike last year, when the H1N1 pandemic virus was the main influenza strain, public health officials are now battling H3N2, a seasonal flu that disproportionately affects the elderly and those with underlying health conditions. Toronto has had more than 700 laboratory-confirmed flu cases this season, compared to the 100 or so cases it sees every year. Winnipeg reported 135 flu cases between July, 2010, and Jan. 8; the city had nine lab-confirmed cases during the same period in 2007-08.

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"A colleague of mine and some others around here are starting to call this whole problem a flunami, which it probably is, based on the numbers of cases we're seeing," said James Downey, an infection control officer at Toronto East General Hospital.

Michael Gardam, medical director of infection prevention and control at the University Health Network, echoed the sentiment. "I've never seen a flu year like this," he said. "This is by far the worst flu year I've ever seen. It's a mess."

The concern among public health officials is that the hysteria around the H1N1 pandemic, which didn't turn out to be devastating, may have turned people off from getting the flu shot. They hope Canadians will be more inclined to get it once they realize the toll flu takes on the body. Toronto Public Health this week opened additional flu clinics in response to the increase in cases, and already it's reporting that more people are coming in for the vaccine.

Dr. Downey said his hospital, like others in the area, first began to see flu cases in November, and has since opened up a respiratory isolation area. He said staff have had nearly double the number of visits from patients with respiratory illnesses than in previous non-pandemic years. Some hospitals in Toronto and Winnipeg have had to cancel elective surgeries as they care for flu patients.

At UHN, Dr. Gardam said as many as 30 flu patients were moved to surgical beds because there was no room in the medical unit, and they remain there. UHN has admitted more than 130 patients showing flu-like symptoms, much more than the 65 it admitted during the H1N1 pandemic. A note from the network's president and chief executive officer, Bob Bell, sent to staff Tuesday said that if the flu situation doesn't ease, elective surgeries could be cancelled later this week.

It's difficult to say how long this virus will last, flu viruses being notoriously unpredictable.

Bryna Warshawsky, the associate medical officer of health for the Middlesex-London Health Unit in Ontario, said there have been eight outbreaks in long-term care facilities. The worst she's seen during flu season is 25 outbreaks. But Dr. Warshawsky noted that this could still be early on in the season. "We're not done. We're still in the middle of it," she said.

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Public health officials are urging Canadians, especially the elderly, children and pregnant women, to get the vaccine. The flu shot this year protects against H3N2 as well as H1N1.

Michael Routledge, lead medical officer of health at the Winnipeg Regional Health Authority, said, "We're continuing to get the message out that flu season is not over. That if people haven't had their flu shot this year, they should certainly consider doing that."

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