Canada Gazette, Part I, Volume 148, Number 46: ORDERS IN COUNCIL

November 15, 2014

PUBLIC HEALTH AGENCY OF CANADA

QUARANTINE ACT

Minimizing the Risk of Exposure to Ebola Virus Disease in Canada Order (No. 2)

P.C. 2014-1264 November 10, 2014

Whereas the Governor in Council is of the opinion that

• (a) there is an outbreak of a communicable disease, namely Ebola virus disease, in Guinea, Liberia and Sierra Leone;
• (b) the introduction or spread of the disease would pose an imminent and severe risk to public health in Canada;
• (c) the entry of persons who have recently been in any of those countries into Canada may introduce or contribute to the spread of the disease in Canada; and
• (d) no reasonable alternatives to prevent the introduction or spread of the disease are available;

Therefore, His Excellency the Governor General in Council, on the recommendation of the Minister of Health, pursuant to section 58 of the Quarantine Act (see footnote a), makes the annexed Minimizing the Risk of Exposure to Ebola Virus Disease in Canada Order (No. 2).

MINIMIZING THE RISK OF EXPOSURE TO EBOLA VIRUS DISEASE IN CANADA ORDER (NO. 2)

Definition of “Agency”

1. In this Order, “Agency” means the Public Health Agency of Canada.

Conditions of entry — Guinea, Liberia or Sierra Leone

2. (1) A person who has been in Guinea, Liberia or Sierra Leone in the 21 days before the day of their entry into Canada must, on entry into Canada,

• (a) disclose that fact to a screening officer at the entry point;
• (b) immediately undergo a medical examination if a quarantine officer determines that the person is exhibiting symptoms of Ebola virus disease;
• (c) immediately report to a public health authority or the Agency, as specified by a quarantine officer, in the manner that the officer specifies, if the officer determines that the person is not exhibiting symptoms of Ebola virus disease and if
  • (i) the person knows they have been exposed to the Ebola virus, or
  • (ii) the person had unprotected direct contact with a person exhibiting symptoms of Ebola virus disease, with the contaminated environment or cadaver of such a person, or with a vector that is capable of transmitting the Ebola virus; and
• (d) if they are not a person referred to in paragraph (b) or (c), report to a public health authority or the Agency, as specified by a quarantine officer, in the manner that the officer specifies.

Persons required to undergo medical examination

(2) A person who is required to undergo a medical examination under paragraph (1)(b) must, after undergoing the examination,

• (a) contact a quarantine officer before leaving the place where the examination takes place and answer any questions that are related to the person's exposure or possible exposure to the Ebola virus;
• (b) if they meet at least one of the criteria set out in subparagraphs (1)(c)(i) and (ii),
  • (i) immediately report to a public health authority or the Agency, as specified by the quarantine officer, in the manner that the officer specifies, and
  • (ii) isolate themselves without delay, and remain in isolation from other persons until the expiry of the 21-day period that begins on the day on which the person enters Canada, as instructed by the public health authority or the Agency, as the case may be;
• (c) if they do not meet any of the criteria set out in subparagraphs (1)(c)(i) and (ii), report to a public health authority or the Agency, as specified by the quarantine officer, in the manner that the officer specifies; and
• (d) do the following during the 21-day period that begins on the day on which the person enters Canada:
  • (i) measure their body temperature twice a day, record the measurements in writing and report them to the public health authority or the Agency, as the case may be, in the time and manner that it specifies,
  • (ii) if they are required to report to a public health authority, answer any questions about their body temperature or symptoms that they are asked by an official of the authority or the Agency,
  • (iii) if they are required to report to the Agency, answer any questions about their body temperature or symptoms that they are asked by an official of the Agency,
  • (iv) report any travel intentions to the public health authority or the Agency, as the case may be, and
  • (v) immediately report any symptom of Ebola virus disease to, and follow any instructions provided by, the public health authority or the Agency, as the case may be.

Persons at higher risk of developing symptoms

(3) A person who is required to report to a public health authority or the Agency under paragraph (1)(c) must comply with the obligations set out in subparagraph (2)(b)(ii) and paragraph (2)(d).

Persons at risk of developing symptoms

(4) A person who is required to report to a public health authority or the Agency under paragraph (1)(d) must comply with the obligations set out in paragraph (2)(d).

Exception

(5) A person who is hospitalized because they exhibit the symptoms of Ebola virus disease is not required to comply with the obligations set out in subsections (2) to (4) while they are hospitalized.

Reduction in 21-day period

(6) If a person can prove that, since leaving Guinea, Liberia or Sierra Leone but before entering Canada, they have been in a place other than Guinea, Liberia or Sierra Leone, including on a ship in international waters, the 21-day period referred to in subparagraph (2)(b)(ii) and paragraph (2)(d) is reduced by the number of days that the person spent in the place.

Quarantine Act — powers and obligations

3. For greater certainty, this Order does not affect any of the powers and obligations set out in the Quarantine Act.

REPEAL

4. The Minimizing the Risk of Exposure to Ebola Virus Disease in Canada Order (see footnote 1) is repealed.

EFFECTIVE PERIOD

Effective period

5. This Order has effect for the period beginning on the day on which it is made and ending on June 30, 2015.

EXPLANATORY NOTE

(This note is not part of the Order.)

Proposal

The Order in Council, entitled Minimizing the Risk of Exposure to Ebola Virus Disease in Canada Order (No.2), sets out requirements for travellers arriving into Canada from countries affected by the Ebola Virus Disease (EVD) outbreak in West Africa.

Objective

The objective of this Order is to further protect the health and safety of the public by striving to ensure that all travellers arriving to Canada from Guinea, Liberia and Sierra Leone are identified and monitored by public health authorities.

Background

Ebola Virus Disease is a severe disease that causes haemorrhagic fever in humans and animals. Diseases that cause haemorrhagic fevers, such as Ebola, are often fatal as they affect the body's vascular system (how blood moves through the body). This can lead to significant internal bleeding and organ failure. On August 8, 2014, the World Health Organization declared the current EVD outbreak in West Africa a public health emergency of international concern under the International Health Regulations.

As the widespread and intense transmission of EVD continues in West Africa, there is recognition that travellers coming into Canada with a travel history from Guinea, Liberia and Sierra Leone need to be monitored. This is why the Government of Canada is taking enhanced action at Canada's borders and working closely with the provinces and territories to support the monitoring of travellers arriving in Canada who have recently been in Guinea, Liberia and Sierra Leone.

This added protection will complement other Canadian EVD preparedness and response activities, including the routine screening of all travellers at points of entry for EVD and other communicable diseases, the development of an EVD vaccine, providing mobile laboratory support, and the recent deployment and training of rapid response teams to ensure Canada is ready to respond in the event there is a first case of EVD in Canada.

Implications

Key obligations for travellers

The new Order will obligate all travellers to disclose to a screening officer (a Canada Border Services Agent) if they have been in Guinea, Liberia or Sierra Leone in the last 21 days. The screening officer will refer travellers with a recent history of travel to Guinea, Liberia or Sierra Leone to a quarantine officer for detailed screening and a temperature check.

Travellers who have EVD symptoms such as fever, chills, sore throat, or muscle aches will be immediately required to undergo a medical examination at a hospital and placed under isolation. The quarantine officer will coordinate the patient transfer with the province or the territory and local public health authorities. Symptomatic travellers who do not require hospitalization after the medical exam will be required to subsequently report to a public health authority or the Public Health Agency of Canada for continued monitoring, and may, depending on whether they have or may have been exposed to the Ebola virus, be required to isolate themselves and remain in isolation from other people for up to 21 days.

Travellers who have no symptoms of EVD but who have or may have been exposed to the Ebola virus (for example, needlestick injury, family contacts of Ebola cases) are at higher risk of developing EVD. These travellers will be required to immediately report to a public health authority specified by a quarantine officer and isolate themselves from other people without delay for up to 21 days after arrival into Canada. They will be monitored for EVD signs and symptoms, including twice-daily temperature checks, and be required to answer questions about their body temperature or symptoms and follow further directions.

Health care and humanitarian workers who have no EVD symptoms will be required to report to a public health authority or the Public Health Agency of Canada for up to 21 days after arrival in Canada. They will be required to take their temperature twice daily, self-monitor for EVD signs and symptoms, and report daily to a public health authority. They will also be required to report planned travel, answer any questions about their body temperature or symptoms and follow further directions. The public health authority will determine if any additional public health actions, such as isolation, are needed, e.g. following direct contact with Ebola patients, cadavers or the Ebola virus.

All other travellers who have no EVD symptoms and no known possible exposure to EVD will be required to report to a public health authority or the Public Health Agency of Canada for up to 21 days after arrival in Canada. They will be required to take their temperature twice daily, self-monitor for EVD signs and symptoms, and report daily to the public health authority. They will also be required to report planned travel, answer any questions about their body temperature or symptoms and follow further directions.

Travellers who develop symptoms of EVD will also be required to report immediately to a public health authority as instructed by the quarantine officer and follow any instructions provided.

Failure to comply with this new Order is an offence under section 71 of the Quarantine Act. The maximum penalties (on summary conviction) are a fine of up to $750,000 and/or imprisonment for six months.

Consultation

The chief medical officers of health from each province and territory have been consulted on this Order and are collaborating with the Public Health Agency of Canada. Provincial or territorial health authorities will also conduct the medical examination of symptomatic travellers referred by a quarantine officer.

Departmental contact

Gina Howell
Director
Office of Border Health Services
Public Health Agency of Canada
Telephone: 613-277-3045
Email: gina.howell@phac-aspc.gc.ca

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