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January 2004
Update: Health Canada activities with respect to SARS
Health Canada has taken action in the following areas to strengthen its capacity
to respond to future infectious disease outbreaks, including a possible re-emergence
of SARS. Some of these areas include:
Epidemiology
In September 2003, Health Canada was involved in two SARS-related meetings.
The first took place in Banff, Alberta, where Health Canada experts participated
in an international workshop on mathematical modelling. The workshop brought
together international leaders and active researchers working in the areas
related to the modelling, simulations and analysis of the transmission dynamics
of SARS and other infectious diseases, to link mathematical, statistical,
epidemiologic sciences and operations research, in order to speed up the
process of finding effective tests and prevention and control measures. Health
Canada is also working on several research projects on the epidemiology of
SARS that were initiated during the outbreak and is updating infection control
guidelines.
In December 2003, Health Canada's National Microbiology Laboratory hosted
a Current Science of SARS Symposium, in conjunction with the
Canadian Institutes of Health Research, to review SARS research, surveillance
and public health issues. It included participants from the Government of Canada,
provincial partners (eg., Canadian Public Health Lab Network representatives,
Chief Medical Officers of Health from each province), key stakeholders in public
health, and international partners (eg., the U.S. Centers for Disease Control
and Prevention, World Health Organization).
Surveillance
In mid-September, Health Canada's Centre for Infectious Disease Prevention
and Control hosted an international workshop to discuss severe/emerging respiratory
infections (SARS) case definitions and surveillance. One of the key outcomes
of the meeting was to provide guidance on the detection, investigation and
response to any respiratory illness outbreak, including laboratory testing
guidelines. This type of generic approach is applicable to any emerging and
re-emerging respiratory infections.
In collaboration with the provinces and territories, Health Canada has developed
a series of public health tools to ensure that Canada is ready to identify
severe or emerging respiratory infections and quickly implement prevention
and control measures. These include:
- National Case Definitions for Severe Acute Respiratory Syndrome (SARS)
- Surveillance for Severe or Emerging Respiratory Infections in the SARS
Post-Outbreak Period
- Public Health Management of cases and Clusters of Severe Respiratory Illness
(SRI) in the Post-Outbreak Period
- SARS-CoV Laboratory Investigation Protocol for the SARS Post-Outbreak Period
In addition, the first phase of a national web-based alert system for respiratory
infections has been launched, and the next phase is underway.
Influenza and SARS
On August 15, the National Advisory Committee on Immunization (NACI) released
its statement on influenza vaccination. NACI states the importance of vaccination
for persons at high risk of influenza-related complications and those who
care for them. This will help minimize diagnostic confusion when trying to
determine if SARS is present. Recommended recipients include, but are not
limited to, residents of nursing homes and other chronic care facilities,
persons over 65 years of age, persons, including children, with chronic cardiac
or pulmonary disorders and health care workers and household contacts who
have significant contact with persons in these high-risk groups.
Vaccines and immunotherapy products
In August 2003, Health Canada hosted an international workshop to examine regulatory
issues associated with the development and licensing of SARS vaccines and
immunotherapy products. The workshop facilitated the necessary regulatory
process by identifying critical issues early on in product development and
developing a scientific basis for making regulatory decisions concerning
the clinical testing and licensing of SARS vaccines and immunotherapy products.
Lessons Learned
The report of the National Advisory Committee on SARS and Public Health was
released on October 7, 2003. The committee's recommendations, together with
findings from a number of other sources, will provide the Government of Canada
with the necessary direction to build a better public health system for the
21st century.
The Canadian Public Health Laboratory Network During SARS
The Canadian Public Health Laboratory Network (CPHLN) is a partnership of
federal, provincial, and territorial public health laboratories committed to
providing leadership in protecting the health of Canadians. During the SARS
outbreak in Canada, the CPHLN was responsible for defining the list of patient
specimens required for comprehensive SARS testing, for creating bio-safety
guidelines with Health Canada to protect front-line healthcare and laboratory
workers, and for their constant dedication and support of their colleagues
in Toronto, mostly by their clear thinking and daily sharing of ideas. The
CPHLN secretariat together with key National Microbiology Laboratory (NML)
personnel were responsible for operationalizing specimen processing, for building
the NML SARS database, and for facilitating productive national dialogue and
creating an atmosphere of cross-jurisdictional cooperation to deal with SARS.
SARS Screening
Health Canada continues to maintain vigilance at Canada's airports:
- Quarantine Officers are available at the Toronto, Vancouver, Montreal,
Edmonton, Calgary and Ottawa international airports, and we are expanding
the service to Halifax international airport. Health Canada continues to
provide up to date information to Quarantine Officers and Canadian Customs
officials about any suspected or confirmed cases of SARS worldwide.
- Travellers are asked to continue to monitor their health and report signs
of illness.
- The yellow and cherry Health Alert Notices have been replaced with an infectious
disease brochure that is available at major Canadian international airports,
and at train stations and ferry stations that handle international travel.
It is also available through travel medicine clinics and the Health Canada
travel medicine web sites.
- If a significant infectious disease outbreak occurs, screening measures
will be reinstated at Canada's airports within 24 to 96 hours.
These screening measures are in keeping with the recommendations in the Naylor
Committee Report, and are consistent with the recommendation of the World Health
Organization to remain vigilant.
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