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2003-11 AdvisoryUpdate #42 - Severe Acute Respiratory SyndromeNew in this update:Latest Canadian Numbers on SARSAs of April 28, 2003, Health Canada has received reports of 344 probable or suspect cases of severe acute respiratory syndrome (SARS) in Canada. There have been 21 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:
Total # of probables discharged: 75 These numbers are accurate as of 1:00 pm. Eastern Daylight Saving Time, April 28, 2003. For specific information on the provincial numbers, please contact the appropriate provincial health department. Health Canada Rescinds Routine Access to RibavirinHealth Canada, through its Special Access Programme, will no longer provide routine access to ribavirin for the treatment of SARS. This decision stems from a recommendation by a working group advising Health Canada, comprised of health experts and clinicians from across Canada and representatives from the Centers for Disease Control and Prevention in the United States. After reviewing the existing anecdotal clinical experience with ribavirin, negative results from in vitro testing with ribavirin against SARS related coronavirus, and knowledge of reports of serious and unexpected adverse drug reactions, the working group reached a consensus that there is no data to support the continued use of ribavirin outside of clinical trials at this time. On April 27, Health Canada notified physicians that the continued access to the drug is contingent upon the submission and review of data in the possession of physicians with respect to the use, safety and efficacy of ribavirin for the treatment of SARS. Physicians currently treating patients with ribavirin are also strongly advised to critically re-examine the risk/benefit for each patient before continuing treatment. Health Canada Reaction to WHO Travel AdvisoryOn April 23, the World Health Organization (WHO) extended its recommendation to postpone non-essential travel to include Toronto. Health Canada formally challenged the WHO's assertion that Toronto is an unsafe place to visit through a letter sent to the WHO. Senior Health Canada and Ontario Ministry of Health officials met with WHO officials by teleconference. They reiterated our position that the WHO decision is based on outdated data and asked that they rescind the Advisory immediately. Health Minister Anne McLellan also outlined our objections in a call today with Dr. Gro Harlem Brundtland, the Director General of the World Health Organization. Health Canada does not support the WHO's position; it is safe to travel to Toronto. The Department reiterated this advice in a Domestic Health Travel Advice notice issued April 25 (http://www.phac-aspc.gc.ca/tmp-pmv/2003/sarsdomestic_e.html). We have a clear understanding of the specific settings in which this virus has been transmitted in Canada and confidence in the steps being taken to manage infection control. A CDC travel alert provides a more accurate assessment of the situation in Canada. It states that: "Currently, all cases in Toronto are linked to Toronto's original index case and spread has been through person-to-person contact. SARS transmission in Toronto has been limited to a small number of hospitals, households, and specific community settings." Government of Canada support for the SARS outbreakSince the SARS outbreak began over a month ago, the Government of Canada has been actively working with provincial, territorial and international partners to deal with this disease. Much of our effort has been focussed on six areas – investigation, laboratory diagnosis, infection control, treatment, travel and emergency response. Investigation: Health Canada is the first country to be invited by the World Health Organization (WHO) to send a team of officials to Hong Kong to help investigate risk factors involved in the possible environmental transmission of SARS in specified residential buildings in the Special Administrative Region of Hong Kong. The investigation would be conducted in the context of assisting the Hong Kong authorities to determine whether building mechanical systems (e.g., plumbing, ventilation, etc) played a role in spreading SARS at the Amoy Gardens and Metropole Hotel. Officials from Health Canada's Workplace Health and Public Safety Programme
(WHPSP) and National Microbiology Laboratory will participate in the investigation. Infection control: Health Canada has also directed blood operators to temporarily defer from donating blood (for a period of 10 days) from people who have:
At Ontario's request, Health Canada has agreed to lead an investigation, with some very specific technical assistance from the U.S. Centers for Disease Control and Prevention (CDC) in Atlanta, into the recent outbreak amongst health care workers. Health Canada, with the assistance of the CDC staff, will be gathering information in order to compare the circumstances surrounding those who were infected to those not infected, and will provide a report outlining the probable cause of the transmission among health care workers and recommendations for additional measures that may be taken to prevent further spread. Health Canada's Workplace Health and Public Safety Programme (WHPSP) is providing advice to federal employers in Canada and abroad on occupational health and safety matters. Teams of WHPSP physicians and nurses were on site at the Pearson, Vancouver and Dorval airports to provide information sessions on SARS to federal employees. They continue to provide information sessions to employers and employees at workplaces across the country, and answer daily enquiries from employers. WHPSP is providing ongoing occupational health advisories to federal government departments and agencies, including precautionary measures and what recommendations to protect the health and safety of employees. Travel:Incoming airline passengers All airlines on direct flights coming into Canada from Asia are distributing yellow Health Alert Notice forms and Traveller Contact Information Forms (TCIF). Health Canada personnel are collecting the TCIF as soon as passengers disembark the aircraft. In addition, Health Canada has placed Health Alert Notices with accompanying posters in all terminals for distribution to passengers from all other international flights (i.e. non-Asian flights) who are not being met by Health Canada personnel. These include airports in Halifax, St. John's, Quebec City, Montreal (Dorval and Mirabel), Toronto, Ottawa, Winnipeg, Regina, Saskatoon, Edmonton, Calgary and Vancouver. Outgoing airline passengers We are working with airlines to ensure that the check-in procedure includes confirmation that passengers have read the cherry coloured card. A Health Canada SARS team of health professionals is in place at Pearson to provide information to airline and airport staff. In very limited cases, this team will assist the individual traveller and, if necessary, arrange for the transportation of individuals to local medical facilities. Other travel measures: Emergency response: In addition to the health and safety measures outlined above, the Government of Canada has also made changes to Employment Insurance regulations to ensure that those in voluntary isolation can receive benefits without undue delay, thus reducing the financial hardship of individuals who have had to go into quarantine. Most Recent Travel Advisory InformationFor further information on Health Canada's travel advice, please see: http://www.phac-aspc.gc.ca/tmp-pmv/2003/sars0423_e.html 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) Media Enquiries:
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Last Updated: 2005-02-23 |