Canada Gazette, Part I, Volume 149, Number 51: ORDERS IN COUNCIL

December 19, 2015

PUBLIC HEALTH AGENCY OF CANADA

QUARANTINE ACT

Minimizing the Risk of Exposure to Ebola Virus Disease in Canada Order (No. 4)

P.C. 2015-1276 December 11, 2015

Whereas the Governor in Council is of the opinion that there is no longer an outbreak of Ebola virus disease in Liberia and Sierra Leone;

And whereas the Governor in Council continues to be of the opinion that

• (a) there is an outbreak of Ebola virus disease in Guinea;
• (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 that country 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. 4).

MINIMIZING THE RISK OF EXPOSURE TO EBOLA VIRUS DISEASE IN CANADA ORDER (NO. 4)

Definition of “Agency”

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

Conditions of entry — Guinea

2. (1) A person who has been in Guinea 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 but before entering Canada, they have been in a place other than Guinea, 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 (No. 3) (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 March 31, 2016.

EXPLANATORY NOTE

(This note is not part of the Order.)

Proposal

This Order will repeal the Order entitled Minimizing the Risk of Exposure to Ebola Virus Disease in Canada Order (No. 3) and create a new Order entitled Minimizing the Risk of Exposure to Ebola Virus Disease in Canada Order (No. 4), whereby the same conditions outlined in Order (No. 3) will apply only to travellers who have visited Guinea within 21 days of entering Canada. Order (No. 4) will remain in effect until March 31, 2016.

Objective

This Order will ensure that the health and safety of the public remain protected as the Ebola outbreak continues, by ensuring that all travellers arriving to Canada from Guinea continue to identify themselves and be monitored by public health authorities until March 31, 2016.

Background

Ebola Virus Disease (EVD) 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.

While there has been progress in combatting the EVD outbreak in West Africa, at the 7th meeting of the International Health Regulations Emergency Committee regarding the EVD outbreak in West Africa, the Committee advised that the outbreak continues to constitute a Public Health Emergency of International Concern. As of November 30, 2015, there have been no cases of EVD in Canada.

On July 1, 2015, the Government of Canada made Minimizing the Risk of Exposure to Ebola Virus Disease in Canada Order (No. 3), which is in effect until December 31, 2015. Since the making of Order (No. 3), Liberia and Sierra Leone were both declared EVD-free by the World Health Organization. Sporadic cases in the region are to be expected. However, until Guinea is able to sustain 42 days of interrupted transmission, there is a continuing need to assess and monitor individuals with a travel history to Guinea. Therefore, the Government of Canada will continue to take enhanced action at Canada's borders and work closely with the provinces and territories to support the monitoring and, in some cases, isolation of travellers arriving in Canada who have recently been to this country. This need will extend beyond the current expiry date of December 31, 2015.

Extending these measures 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, and the 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

Minimizing the Risk of Exposure to Ebola Virus Disease in Canada Order (No. 4) continues to require that all travellers make known to a Screening Officer (a Canada Border Services Agent) if they have been in Guinea in the last 21 days. The Screening Officer will refer travellers with a recent history of travel to Guinea to a Quarantine Officer for detailed screening and 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 be 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 will be required to answer questions about their body temperature or symptoms and follow further directions.

All other travellers, including health care and humanitarian workers, 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 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. 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.

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 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

Provinces and territories were consulted on Order (No. 2) and will be informed of the extension of border measures through Order (No. 4). The Agency will continue to collaborate with provinces and territories on the implementation of the Order and address any forthcoming challenges or concerns.

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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