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2003-11
April 22, 2003
5 pm
Advisory
Update #36 - Severe Acute Respiratory Syndrome
New in this update:
Latest Canadian Numbers on SARS
As of April 22, 2003, Health Canada has received reports of 324 probable or
suspect cases of severe acute respiratory syndrome (SARS) in Canada. There
have been 14 deaths in Canada. To date, transmission has been limited to specific
transmission settings such as households, hospitals and specific community
settings. The information contained in this update is based on the information
available to Health Canada at this time.
The details of the cases to date are as follows:
- Ontario is reporting 136 probable and 125 suspect cases.
- British Columbia is reporting 4 probable and 47 suspect cases.
- New Brunswick is reporting 2 suspect cases.
- Saskatchewan is reporting 1 suspect case.
- Alberta is reporting 5 suspect cases.
- Prince Edward Island is reporting 4 suspect cases.
So far, 129 people have been discharged from hospitals in Ontario. These people
were treated as suspect cases or as probable cases.
These numbers are accurate as of 1:00 pm. Eastern Daylight Saving Time, April
22, 2003. For specific information on the provincial numbers, please contact
the appropriate provincial health department.
The World Health Organization has concluded that the coronavirus is the cause
of SARS. Health Canada's data still does not allow us to come to that conclusion;
however, national and international laboratory testing and collaboration is
ongoing.
Health Canada Investigation with Officials from the U.S.
Centers for Disease Control and Prevention
On April 20, Health Canada invited officials from the U.S. Centers for Disease
Control and Prevention (CDC) to come to Canada to lend their expertise to a
Health Canada-led investigation.
Despite the stringent infection control measures taken to date, we have seen
evidence of the transmission of SARS to the health-care workers who have been
on the front lines battling this outbreak. The Government of Ontario requested
Health Canada's assistance in this matter.
On Tuesday, April 22, three officials from the CDC will be arriving in Toronto.
They include an environmental hygienist, an industrial hygienist and a hospital
epidemiologist. Health Canada has been in regular contact with the CDC from
the beginning, but only now has there been a need for the specific expertise
that these officials can provide and that Health Canada does not have readily
available.
They will be assisting Health Canada officials as they spend time in hospitals
in Toronto, gathering information in order to compare the circumstances surrounding
those who were infected to those not infected.
Health Canada and the CDC will report as soon as possible, outlining the probable
cause of the transmission among health-care workers and recommendations for
additional measures that may be taken to prevent further spread.
Protecting Canada's Blood Supply
Health Canada issued formal direction to blood operators on April 10, 2003,
as a precaution, to protect the blood supply in Canada and recipients from
the possible threat of SARS. Although there is currently no evidence of transmission
of SARS through blood and blood components, Health Canada has directed blood
operators, to temporarily defer from donating blood (for a period of 10 days)
from persons who have:
- traveled within the previous 10 days to an affected area outside Canada.
The affected areas are currently: China, including the Hong Kong Special
Administrative Region; Hanoi, Vietnam; Singapore and Taiwan;
- been a patient, worked in, or visited a facility that is under quarantine
for SARS.
Health Canada has requested that provincial public health officials, when
investigating possible SARS cases, ask whether the individual has donated blood.
If the individual has donated blood within 10 days prior to the first day of
symptoms such as fever, public health officials are asked to notify Canadian
Blood Services and Héma-Québec. The donor's blood and blood products
will be withdrawn from the inventory.
Information for Travelers Expanded
Since Thursday, April 10th, as an added precautionary measure, Health Canada
has arranged for in-flight distribution of the yellow health alert card by
flight attendants to passengers on all direct flights from Hong Kong, Singapore
and Beijing.
Flight attendants will also ask passengers to fill out a traveller tracing
form (also known as content information cards) that will enable health authorities
to contact passengers over a two-week period after their arrival in Canada,
if necessary. These forms must be filled out before clearing customs. This
in-flight distribution will also be expanded to direct flights from other Asian
destinations in the near future.
Health Canada staff will not only continue to meet incoming flights, but also
will gather these contact forms from passengers.
Most Recent Travel Advisory Information
Due to the mounting concern about transmission of the SARS agent in non-hospital
and community settings in the City of Hanoi, Vietnam; the People's Republic
of China including the Hong Kong Special Administrative Region; Singapore;
and Taiwan, Health Canada recommends that people planning to travel to these
areas defer all travel until further notice. Health Canada also recommends
alternate routing be considered, when possible, if a traveller is transiting
through the People's Republic of China including the Hong Kong Special Administrative
Region; City of Hanoi, Vietnam; Singapore; or Taiwan. Health Canada is aware
that health authorities in these affected areas are making concerted efforts
to contain the spread of SARS in their populations. Given the uncertainties
of the current situation, Health Canada believes it is prudent to await the
outcome of national and international control measures before undertaking travel
to these destinations.
For further information on this travel advisory, please see:
www.phac-aspc.gc.ca/tmp-pmv/2003/sars0416_e.html
Health Canada Support for Ontario
- At the request of Ontario, Health Canada shipped 10,000 masks to Toronto
as a stop-gap measure until the province receives additional masks from its
supplier. These masks are part of Health Canada's national emergency stockpile
(National Emergency Stockpile System). Health Canada is also assisting to
identify sources for masks in Canada and off-shore.
- Health Canada has deployed an additional eight personnel to Ontario to
work with the Ontario team. This is in addition to the six staff Health Canada
has deployed to assist Toronto's public health unit and the Ontario Ministry
of Health with the investigation of the SARS cases. The department has also
provided guidelines for infection control and recommendations on actions
for public health settings.
- On March 31, 2003, Health Canada sent two mobile x-ray machines and processors
to Toronto for two isolation units being set up in non-hospital facilities.
- Health Canada is ready to respond to additional requests for support from
Ontario and other provinces and territories.
Health Canada's SARS Screening Initiative at Pearson Airport
- Since April 1, 2003, Health Canada has been informing all departing travellers
from Pearson International Airport and Toronto Island Airport (since April
15) about SARS through the Health Alert Notice (cherry cards). Cards are
also being distributed at Union Station in Toronto to people travelling by
train.
- The local airport authority has placed the Health Alert Notices and posters
at strategic locations at the Pearson International Airport informing travellers
who meet certain criteria to defer their flights. These criteria include:
having SARS symptoms (fever, cough, shortness of breath and difficulty breathing);
having been in contact with a SARS-affected person in the last 10 days; and,
having visited a health facility that has been identified by public health
officials as being affected by SARS.
- If passengers have symptoms, Health Canada recommends that they seek medical
advice as soon as possible. Call ahead to your physician or your local public
health unit/department for information about the appropriate Emergency Department
or established SARS Centre you should visit for medical assessment.
- If passengers have visited a SARS-affected facility or have had contact
with a SARS-affected person, they are instructed to call their local health
department.
- A Health Canada SARS Team of physicians and nurses have been deployed
to Pearson to provide information to airline and airport staff.
- Passengers seeking further information are advised to call the Health
Canada SARS Info Line at 1-800-454-8302.
- Health Canada will be continually monitoring the situation on the ground
at Pearson and will respond accordingly.
- Health Canada is asking for the cooperation of local health authorities,
the airline industry and the travelling public on this initiative.
Summary of Key Health Canada Activities to date
- Health Canada understands the public concern over SARS. This is an unknown
disease that concerns all Canadians. Health Canada is taking this public
health situation very seriously and has taken a number of steps to protect
the health of Canadians and the travelling public, and to reduce the possibility
of transmitting SARS to others.
- Health Canada activities include 24-hour monitoring and surveillance of
this disease in Canada and around the world.
- Continuous laboratory testing is underway at Health Canada's National Microbiology
Laboratory in Winnipeg in a race to find the cause of SARS.
- There are also increased visual screening measures for airline passengers,
workplace health and safety initiatives, and prevention and promotion activities.
- Health Canada has expanded Health Alert Notice distribution at major airports
in Canada. These Health Alert Notices 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 has sent staff to Pearson, Vancouver and Dorval International
Airports to support airport staff.
- Health Canada's Workplace Health and Public Safety Programme (WPHSP) is
providing advice to federal employers on occupational health and safety matters.
Information sessions for federal employees are available, at the employer's
request. To date, there have been more than 100 information sessions provided
to federal staff at airports and workplaces. Such sessions continue to be
available at the employer's request. The Programme issues updated advisories
to provide federal departments with the most current information and advice
available on SARS. Health Canada advises that the use of masks is not necessary
in federal workplaces.
- Health Canada is collaborating and coordinating efforts with our counterparts
across Canada, including the Chief Medical Officers of Health in each province
and territory. Health Canada is chairing five Working Groups made up of experts
dealing with such issues as infection control, treatment guidelines and public
health measures.
- Health Canada is providing expertise, advice, personnel, and medical supplies
and equipment to Ontario.
- Health Canada is also in daily contact with our partners worldwide, including
the U.S. Centers for Disease Control and Prevention (CDC) as well the World
Health Organization (WHO) in an effort to try and find the source and cure
for this syndrome.
- Health Canada's collaboration is further facilitated with the presence
of Health Canada staff at the WHO headquarters in Geneva. In addition, Health
Canada and the CDC have exchanged staff members to work in each other's Emergency
Response Centres.
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.
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 (April 2, 2003) 
Health Canada
Travel Advisory (April 14, 2003)
For Media Enquiries:
Emmanuel Chabot
Health Canada
(613) 957-1803
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