WEST NILE VIRUS: ONTARIO DOCTORS MUST REPORT

UNCLAS OTTAWA 000185

SIPDIS

STATE FOR OES/PCI, WHA/CAN (RUNNING)

HHS FOR OFFICE OF THE SECRETARY, OFFICE OF
INTERNATIONAL AFFAIRS (STEIGER)

CDC FOR EPIDEMIOLOGY PROGRAM OFFICE

E.O. 12958: N/A
TAGS: TBIO SENV CA
SUBJECT: WEST NILE VIRUS: ONTARIO DOCTORS MUST REPORT



1. Ontario is expected to make it mandatory soon to
report human cases of West Nile Virus to the provincial
Public Health Officer. "Reportable diseases" are listed
in regulations made under the statutory authority of
the province's Health Protection and Promotion Act.
This will make Ontario the first jurisdiction in Canada
to have such a mandatory reporting requirement for West
Nile Virus. According to Ontario health officials, of
the States adjacent to, or adjoining Ontario; i.e., New
York, Pennsylvania, Ohio and Michigan - currently only
New York has specific mandatory reporting requirements
for human incidents of West Nile infection.


2. Reporting by physicians to their local Public Health
Board is mandated by provincial legislation or
regulation, rather than by federal law. As a
consequence the list of diseases that are reportable
can vary slightly from province to province.


3. We anticipate that Quebec is the only province
likely to follow Ontario's lead in making WNV a
"reportable" disease before the 2003 Mosquito season
arrives. According to Health Canada figures, in 2002
the two provinces with the highest incidence of West
Nile Virus infection in humans were Ontario (with 76
confirmed cases) and Quebec (with only 7 confirmed
cases). In each province one death was confirmed due to
West Nile Virus in 2002. The third highest incidence
of human West Nile Virus infection was noted in the
province of Alberta with one case - and authorities
there have concluded that this individual likely
acquired the infection outside of Alberta.


4. Ontario's chief public health official, Dr. Colin
D'Cunha noted that a significant concern that has
driven the province to make WNV reportable is the fact
that WNV is transmissible via donated blood. As well,
D'Cunha said that knowledge of how many people in a
particular community are showing symptoms of WNV would
aid decision-makers when they consider measures, such
as spraying insecticide, to reduce the mosquito
population.


5. The Canadian federal list of reportable/notifiable
diseases does not currently include West Nile Virus,
although the federal government does collect data from
the provinces. Indeed, in Canada reporting by the
provinces of reportable diseases (also referred to as
notifiable diseases) to the Federal Government's Centre
for Infectious Disease Prevention and Control is
voluntary. A consensus of federal and provincial health
officials' opinion sets the list and as noted in
paragraph 2, provincial authorities make the necessary
change to their laws and regulations to mandate
physician reporting to provincial authorities. Although
there is currently no statutory authority at the
federal level to make disease reporting by physicians
mandatory to federal authorities, Health Canada
officials told us that legislation is being drafted
that would have this effect. Post will monitor
developments.

Cellucci