2003-11
March 22, 2003

Advisory

Update #7 - Severe Acute Respiratory Syndrome

As of March 22, 2003, Health Canada has received reports of nine individuals who have become ill with severe acute respiratory syndrome (SARS) in Ontario and British Columbia. These cases have either recently traveled to Hong Kong or have had close contact with these individuals. The details of the cases to date are as follows:

• Ontario: In a single family, 3 people have been hospitalized with severe pneumonia of unknown cause, 2 other members have died. In addition, individuals (2) with close contact with this family were hospitalized, one of whom has died.
• Ontario: a separate, unrelated case with recent travel to Hong Kong has also been hospitalized.
• British Columbia: one person has been hospitalized with SARS.

At this time, the cause of SARS remains unknown, however national and international laboratory testing and collaboration is ongoing. Here are the most recent developments:

Scientists at Health Canada's National Microbiology Laboratory in Winnipeg are now able to report that they have found evidence of human metapneumovirus (hMPV) in specimens from six of the eight cases they are studying. The metapneumovirus is part of paramyxoviridae family. These findings are consistent with the results previously released by scientists in Germany and Hong Kong.

The findings of the National Microbiology Laboratory are significant in that a common thread has been found in a majority of cases in Canada. This is a promising step in the ongoing investigation. Scientists will continue their work to try to verify the findings and to determine if there are other factors involved that are influencing the severity of this outbreak.

Paramyxoviruses can be responsible for mumps, measles, pneumonia and the common cold. The metapneumovirus was only recently identified in humans. It causes respiratory symptoms that are not usually as severe as those evidenced in the current outbreak. To date there are no antiviral medications that have been developed specifically to treat metapneumovirus.

These findings will not likely alter the current treatment for SARS patients.

Health Canada has initiated the following activities:

• We have expanded health alert card distribution at major airports in Canada. In addition to Pearson and Vancouver, these cards are being distributed at all airports that receive international flights from all destinations other than the United States.
• Health Canada issued a revised Travel Advisory on March 19. The overall risk for travelers appears to be low at this time. However, because of recent increases in cases of SARS in the City of Hanoi, Vietnam: Hong Kong Special Administrative Region; and Singapore and that transmission may not be limited to the hospital setting, Health Canada advises that persons planning elective or nonessential travel to the City of Hanoi, Vietnam; Hong Kong Special Administrative Region and Singapore may wish to postpone their trips until further notice.
• In collaboration with the provinces, territories, and local health units, Health Canada has begun enhanced surveillance for the recognition of SARS cases.
• Health Canada has also asked officials at the Pearson and Vancouver International Airports to carefully monitor passengers arriving from Hong Kong and Singapore to see if anyone has flu-like symptoms.
• Health Canada has sent staff to Pearson and Vancouver International Airports to support airport staff. Health professionals have been sent to each airport to help monitor passengers arriving on direct flights from Hong Kong and Singapore for flu-like symptoms and to assist those who appear to be ill.
• They have started distributing Health Alert Notices to all passengers arriving in or returning from Hong Kong and Singapore which will ask passengers to see a physician if they begin to have any symptoms related to SARS. These symptoms include a fever over 38.0 degrees Celsius AND one or more of the following respiratory symptoms: cough, shortness of breath or difficulty breathing.
• Health Canada's Workplace Health and Public Safety Programme is providing advice to federal employers on occupational health and safety matters. Health professionals from Health Canada's Workplace Health and Public Safety Programme were on site at the Pearson and Vancouver airports to provide information sessions for federal employees. They are available, at the employer's request, to provide sessions for federal employees at all airports that receive international flights from all destinations other than the United States. The Workplace Health and Safety Programme has issued an advisory and has spoken to or met with representatives of a number of federal departments to provide them with information and advice they can use in determining what health and safety measures they deem appropriate for their employees. It is Health Canada's position that Government of Canada workers are not considered to be at high risk of infection because of the limited contact with and proximity to the individuals. Therefore, Health Canada advises that the use of masks is not necessary. Health Canada continues to provide employer departments with the most current information and advice available on SARS.

Health Canada will continue to do everything it can to keep Canadians informed and will continue to work with the provinces and territories so that medical officers are fully informed and appropriate steps are taken to mitigate risk.

The information contained in this update is based on the best available information Health Canada has at this time.

For additional information on SARS, please contact Health Canada's information line at: 1-800-454-8302.

For information on previous travel advisories to South East Asia issued by Health Canada and the World Health Organization, please see the following links:

World Health Organization issues emergency travel advisory (March 15, 2003)

Health Canada Travel Advisory (March 20, 2003)

For Media Enquiries:
Emmanuel Chabot
Health Canada
(613) 957-1803