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A nurse administers an H1N1 flu shot at the International centre in Mississauga, October 29, 2009.J.P. Moczulski/The Globe and Mail

Ontario public-health officials are urging residents to get vaccinated as influenza spreads rapidly through the province - a recent seven-fold increase in seasonal flu cases compared to previous years.

Influenza has hit particularly hard in the Greater Toronto Area and in Eastern Ontario, clogging emergency departments and forcing hospitals to postpone elective surgeries. Last week alone, there were 720 lab-confirmed cases in the province, compared to the 120 cases usually seen around this time of year.

"Predicting flu is worse than predicting the weather. It does come, and it has come, and struck most in the GTA area," David Williams, the province's associate chief medical officer of health, said at a news conference Thursday. "We're dealing with that at this time."

The current strain circulating is H3N2, which disproportionately affects the elderly and those with underlying health conditions. Eighty more people were hospitalized in the past week, and there have been about seven new deaths associated with respiratory illnesses (between September and Jan. 1, there were 189 hospitalizations and 10 deaths among lab-confirmed influenza cases).

This flu season is a bit unusual: Influenza usually moves eastward from British Columbia, but that province has had a relatively mild season, while parts of Ontario, Manitoba and Quebec have been hit hard. The spread of flu is caused by a variety of factors, including fluctuating temperatures, vaccination rates, crowding and lack of proper hand hygiene, but none of them adequately explain why those three provinces have been most affected.

Asked why the Toronto area has so much flu, Michael Gardam, medical director of infection prevention and control at the University Health Network, replied: "The million-dollar question. Nobody has an answer to that one. Flu is very unpredictable."

In response to the influx of cases, Toronto Public Health has opened additional flu clinics. And although more people are trickling in to get the shot, vaccination rates for the province are still down as much as 25 per cent over pre-pandemic years.

Hospital visits, meanwhile, continue to increase. Bob Bell, president and CEO of UHN, said the number of patients being diagnosed with influenza has put a lot of pressure on front-line staff in emergency departments. UHN has admitted more than 130 patients showing flu-like symptoms, much more than the 65 it admitted during the H1N1 pandemic "The people working in our emergency departments and on our general medicine units are coping with a big strain and a big surge at this point," Mr. Bell said.

Dr. Williams said surveys have shown that people don't get vaccinated because they didn't have the time or didn't think to do so. But some public health officials wonder if post-pandemic complacency has something to do with the low vaccination rates. They worry that the fact that many people sailed through last year's much-hyped H1N1 pandemic virus will keep Canadians from getting a shot this year.

Health Minister Deb Matthews defended the government's actions around H1N1, and called on residents to get their flu shot. The province, she said, took steps to get Ontarians vaccinated and prepare hospitals for an influx of patients. As a result, she said, it was able to mitigate the effects of H1N1 and dodge what could have been a more severe pandemic.

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