2003-11
March 24, 2003
7:00 pm

Advisory

Update #9 - Severe Acute Respiratory Syndrome

As of March 24, 2003, Health Canada has received reports of eleven individuals who have become ill with severe acute respiratory syndrome (SARS) in Ontario and British Columbia. There have been three deaths in Canada. All Canadian cases have occurred in persons who have traveled to Asia or had contact with SARS cases in the household or in a health-care setting. The details of the cases to date are as follows:

• Ontario: 10 total cases. To date, all cases have occurred in close family contacts of travelers returning from Hong Kong or in heath care workers who have cared for these cases.
• British Columbia: one person has been hospitalized with SARS after returning from travel in southeast Asia.

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:

Health Canada has deployed three epidemiologists to assist Toronto Public Health and the Ontario Ministry of Health with the investigation of SARS cases currently under investigation.The department has also provided draft guidelines for infection control and draft recommendations on actions for public health settings.

Health Canada is ready to respond to any requests for support from provinces and territories on the SARS issue.

Health Canada issued a revised Travel Advisory on March 23. The overall risk for travellers 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.

For further information on this travel advisory, please see:
www.phac-aspc.gc.ca/tmp-pmv/2003/sars0323_e.html

Scientists at Health Canada's National Microbiology Laboratory (NML) 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 NML 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. These findings will not likely alter the current treatment for SARS patients.

Health Canada has initiated the following activities:

• Health Canada is providing epidemiological expertise and laboratory support to provinces/territories and hospitals involved in managing the SARS cases.
• Health Canada is chairing five Working Groups made up of federal/provincial/territorial and public health officials, as well as other community-based experts dealing with such issues as infection control, treatment guidelines and public health measures.
• Health Canada is in daily contact with the provinces and territories, the World Health Organization (WHO) and the Centre for Disease Control (CDC).
• We have expanded health alert card distribution at major airports in Canada. In addition to Pearson and Vancouver, these cards are available at all airports that receive international flights from all destinations other than the United States.
• In collaboration with the provinces, territories, and local health units, Health Canada is leading enhanced surveillance activities 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 23, 2003)

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