The Canadian Pandemic Influenza Plan for the Health Sector

The SARS experience reinforced the need for preparedness activities as cited in the
Preparedness Section of the Plan. In particular, the need for resources and surge capacity
within the health system to deal with public health emergencies is highlighted. Advanced
preparation and removal of potential barriers in communication systems, data management
technology, and the acquisition and mobilization of supplemental health care workers and
settings are just a few of the other needs identified in the Plan and validated by the SARS
experience.
It is with this experience behind us that those involved in drafting this Plan have identified the
key action items listed in this Response Section.
5.0 Avian and Animal Influenza
Outbreaks caused by novel influenza viruses in avian or animal populations present
opportunities for transmission to humans. Sporadic human infection with a number of avian
(e.g. H5, H7, H9) and swine (e.g. H1N1) influenza subtypes have been documented. In
addition, there may be opportunities for reassortment between animal and human influenza
viruses when they simultaneously infect the same swine or human host. Such reassortment
events may result in the development of a new influenza virus subtype with pandemic
potential.
Since 2003, an unprecedented number of avian outbreaks of influenza have been detected
worldwide. Human cases, ranging in severity from conjunctivitis to fatal cases, have resulted
from these various outbreaks. The WHO global phases now include the occurrence of avian
and animal influenza outbreaks and the role of these outbreaks as potential precursors to a
pandemic.
As a result of the avian outbreak of H7N3 in British Columbia in 2004, a guideline document
was developed by PHAC to provide recommendations for public health authorities and other
stakeholders involved in the management of actual and potential human health issues related
to domestic avian influenza outbreaks. This document has recently been updated and
expanded to include guidance on the management of all AI events with potential human
health implications (see Human Health Issues Related to Avian Influenza in Canada, on the
PHAC website). Because the actions in the guideline document pertain to the new Canadian
Phases 1.1, 2.1 and 3.1, the human health issues document is referenced in the tables in
section 6 below. Although the control of animal influenza outbreaks is a key part of preventing
the emergence of a human influenza pandemic—and there are critical animal and human
health linkages—the responses to the actual animal outbreaks are best addressed in animal
health guidelines and plans. The Canadian Food Inspection Agency (CFIA) is the lead agency
for AI outbreak response and animal health and food safety issues.
6.0 Key Response Actions by Pandemic Phase
The key response actions listed in the following tables are organized by the component of the
response to which they relate (Component) and by the phase during which each action should
take place (Phase). High-level activities for emergency management and coordination have
also been added to the tables. It is assumed that each jurisdiction will refer to the phase that is
consistent with their respective levels of novel influenza activity. For example, if the southern
part of one province is experiencing localized pandemic activity, the Canadian Phase would be
6.2 (the Canadian Phase always reflects the highest level of activity in the country) and the
geographic areas or region with the activity would follow the actions under Phase 6.2.
Response 3