If Ebola reaches Canada, public will be first to know: expert

Canadian health officials have been reassuring the public they are safe, after reports spread of a potential-but-unlikely case of Ebola at a Toronto hospital this week.

The University Health Network said on Friday that they were confident a patient who had travelled to West Africa and returned with a fever did not have Ebola, but were testing the isolated patient as a precaution.

The news of a possible case of Ebola in Canada became public after news agencies obtained a letter circulated to staff at the University Health Network detailing the incident.

“Ebola is one of several diagnoses being considered at this point and we will follow set procedures to determine what the patient care needs are,” the note read, according to the National Post.

A UHN representative confirmed the incident to Yahoo Canada News, underlining the point that Ebola was considered out of an abundance of caution, and stressing that the public would be the first to know if health officials truly suspected the deadly virus had reached the country.

“(This instance) would be a really unlikely case of Ebola. Essentially the patient technically fit the criteria that triggers our whole response, but there are a number of factors that make us believe that Ebola is really unlikely,” Dr. Michael Gardam, UHN’s medical director of infection prevention and control, told Yahoo Canada News.

“This is one of those things were the criteria we use are very, very sensitive. So we are going to pick up a whole whack of people who don’t have it. The whole system is designed to ensure we don’t miss anybody.”

Dr. Gardam said the patient had travelled to a region suffering from an Ebola outbreak and was showing signs of a fever. The UHN operates both Toronto General Hospital and Toronto Western Hospital, the latter of which has been selected as the contact point during the international Ebola scare.

The spread of Ebola through West Africa has left some 3,000 people dead and thousands more infected. Liberia, Guinea, Nigeria, Senegal and Sierra Leone have been the hardest hit, but cases have recently been confirmed in several other countries, including Germany and the United States.

Twenty other suspected cases of Ebola have been tested and cleared in Canadian patients in recent months, according to federal health officials. The latest Toronto patient will undergo testing, and samples will be sent to the National Microbiology Laboratory in Winnipeg to determine whether Ebola is present.

But with the case reaching the public through an internal memo, some wonder how forthcoming Canada’s health network will be with future cases. Dr. Gardam says the University Health Network would want the public to know that information as soon as reasonably possible.

“We would recognize right off the bat that having a case of Ebola in Canada would be international news,” said Dr. Gardam. “Our approach would be to meet with a whole bunch of people really, really quickly – government, etc. – and then we would bring that to the public. I would imagine it would be an orchestrated series of media conferences, not unlike what they are doing in Dallas. One thing we wouldn’t do is not tell anybody about it.”

In Dallas, there has been a full-court response to providing details about the case. The Center for Disease Control has reported on their role in the response, and hospital officials have given daily updates since the case was confirmed.

Health Canada has said the country has an Ebola preparedness plan in place, which will quickly identify and prevent the spread of infections. The public response would not be unlike what followed the SARS outbreak.

"Canada is well prepared with a number of systems in place to identify and prevent the spread of serious infectious diseases like Ebola, such as working closely with our international partners to gather and assess information and administering the Quarantine Act at all points of entry into Canada," Dr. Gregory Taylor, Canada’s chief public health officer, said recently.

Ebola has been on Canada’s list of national notifiable diseases since 2000, which means any suspected case in a Canadian hospital is reported to the federal government through the Canadian Notifiable Disease Surveillance System. The Pan-American Health Organization and World Health Organization would be alerted immediately. The policy on publicly reporting cases of Ebola, however, is a little less clear.

The Public Health Agency of Canada did not provide details to Yahoo Canada News by deadline regarding how or when the public would be alerted to the presence of such a virus.

Dr. Gardam, however, suggested the public would be alerted almost immediately, even in cases when Ebola was suspected but not confirmed.

“There is a lot of real fear surrounding this virus. People get really upset really quickly. It all comes down to the likelihood of someone having it,” he said.

“If we had a person who had come here from Liberia who had fever, vomiting and diarrhea and told us they had been in contact with somebody, I personally would feel we should let you know that sooner rather than later, even before we have the test results back. We would say we have someone here we are actually worried about.

“I would argue, in my experience, it would not be helpful to hide that. It is going to come out anyway.”