Final Report
Response to Findings of Highly Pathogenic Avian Influenza (H7N3) in Saskatchewan, September 2007

---

Executive summary

• One avian influenza infected premises was found in southern Saskatchewan. All birds on the premises have been depopulated and buried on the index premises.
• While under investigation, the province of Saskatchewan was declared a control area and movement controls were put into place. As well, a 3 km radius "infected region" and 10 km radius "restricted region" were applied around the index premises, also with movement controls.
• Dedicated field teams have carried out sampling, as well as detailed analysis of the incident, in order to determine the scope of this case.
• Surveillance testing demonstrated no evidence of notifiable avian influenza in Saskatchewan.
• The control area was revoked on October 30, 2007. This removed all movement restrictions on birds and bird products in Saskatchewan, except for the index premises. Restrictions on the index premises were released on January 18, 2008 following the completion of the cleaning and disinfection.
• Introduction of the virus to the index premises is believed to be transmission from wild birds, possibly via contaminated drinking water drawn from a nearby dug-out, or via farm workers.

1.0 Saskatchewan poultry industry

The Saskatchewan poultry industry is widely distributed with 155 producers in the southern half of the province's 590 million square kilometres. There is some concentration of table egg producers in the southwestern section of the province and of broiler production centered near Saskatoon. The regions around Saskatoon and near Yorkton are the only areas where poultry facilities are in close proximity to each other.

Within Saskatchewan there are 10 broiler hatching-egg producers that maintain 162 000 birds in 49 barns. Farms typically house layers of multiple ages, pullets and roosters. Different age groups may share common airspace or be physically connected. There are two major chicken hatcheries and one seasonal hatchery in the province.

There are 68 registered broiler chicken premises that house just over 3.5 million broilers in 210 barns. Most farms operate multiple barns but flocks on a given farm are typically the same age with few multi-age facilities. The province produced 38 million kilograms of chicken in 2006. There are two chicken processing plants in Saskatchewan and most products are for Canadian consumption.

There are 64 registered table egg premises with the majority on mixed farming operations. These farms house approximately 700 000 birds. There is one major egg grading facility in the province.

The turkey industry consists of 13 premises that house approximately 335 000 birds. Many are processed in Alberta or Manitoba although both Saskatchewan processors have the capacity to slaughter turkeys.

There are currently no turkey or leghorn breeders in Saskatchewan. There are also no commercial duck or goose breeding operations.

Saskatchewan is responsible for 3.6% of total Canadian poultry and egg farm cash receipts. What is produced in Saskatchewan is utilized within that province. For this reason, one of the initial control measures taken was to declare the entire province a control area. In this way, containment was easily achieved while further testing and the epidemiological investigation were conducted to better define the scope of the incident.

2.0 Description of the findings on the index premises

On September 22, 2007, a poultry extension agrologist conducting a routine visit at a broiler hatching egg operation in the Regina Beach area noted increased mortality in a barn housing 24-week-old roosters (spikers). She relayed the report to the poultry extension veterinarian, who attended the premises the following day. He performed post-mortem examinations of birds and noted lesions suggestive of avian influenza (AI). Mortality in the flock of 390 spikers was reportedly 140 (36%) on September 22, 2007, and 100 (40%) on September 23, 2007. The veterinarian immediately reported his suspicion of avian influenza to the Canadian Food Inspection Agency (CFIA) as required by section 5 of the Health of Animals Act.

A CFIA diagnostic team attended the premises on September 23, 2007, and samples for virus detection were submitted to the Avian Influenza Virus Laboratory Network Laboratory in Saskatoon, Prairie Diagnostic Services (PDS). Samples for virus detection and serology were simultaneously submitted to the National Centre for Foreign Animal Diseases (NCFAD) in Winnipeg. A quarantine was placed on the premises pending laboratory results and no movements of poultry, poultry products, or things exposed to poultry or poultry products were allowed.

The NCFAD confirmed the presence of influenza A virus on September 24, 2007, and real time Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) did not detect the presence of H5 or H7 subtypes. Tests were also negative for Newcastle disease, another disease of regulatory concern in poultry. The quarantine remained in place while additional diagnostic work was undertaken and a preliminary epidemiological investigation was completed.

On September 25, ancillary genetic testing demonstrated that the virus was of the H7N3 subtype. The virus was isolated on September 26 from swabs and tissues submitted from the spiker rooster barn that had experienced high mortality. This virus was characterized as influenza A, and was negative for H5 and H7 subtypes on RT-PCR, but negative for H5 and positive for H7 on conventional PCR. Due to the highly variable nature of the hemagglutinin gene, continual monitoring of the performance of hemagglutinin subtype specific real-time RT-PCR assays will be necessary in order to avoid or, at the very least, minimize problems of reduced sensitivity or false negatives in the future. The genetic sequence of the isolate was consistent with a highly pathogenic virus. The virus characterized was not the highly pathogenic H5N1 strain circulating in Asia.

The CFIA declared an outbreak of highly pathogenic notifiable avian influenza (HPNAI) and the World Organisation for Animal Health (OIE), Central Bureau, was advised on September 27, 2007, of these findings.

The index premises was a broiler hatching-egg operation of approximately 53 000 birds of multiple ages. There were two laying flocks consisting of 16 000 thirty-two-week-old birds housed in two barns, and 16 000 fifty-five-week-old birds housed in two barns. There were 16 000 ten-week-old pullets housed in three barns. There were four flocks of roosters in three barns; 782 one-week-old and 780 seventeen-week-old roosters in one divided barn, 2 650 ten-week-old roosters in one barn and the twenty-four-week old roosters in the affected barn. All birds were in confinement housing.

Additional sampling was carried out on the index premises on September 26 and 27, 2007. Laboratory results received on September 28, 2007, indicated that virtually all of the 32- and 55-week-old layers sampled were positive for the avian influenza virus (AIV) antibody on the enzyme linked immunosorbent assay (ELISA) test. The hemagglutination inhibition (HI) test results received on October 1, 2007, demonstrated that the titers in these birds were very high. This may indicate that AIV had circulated among these birds for some undetermined period of time prior to the detection of disease, perhaps a low pathogenicity strain of the HPNAI H7N3 virus isolated. Further investigation into this aspect of the outbreak is ongoing.

Blood samples taken from the affected roosters on September 23, 2007, revealed that about half of the birds sampled reacted positively to the ELISA test. The less sensitive HI test did not demonstrate titers at that time. Repeated sampling on September 25, 2007, revealed that 18 out of 20 samples were now positive to the ELISA test, and titers were demonstrated by HI for 16 of the samples. These titers were lower than those seen in the layer birds. These results are consistent with a more recent introduction of AIV.

The farm managers reported the movement of 24-week-old roosters from the affected barn on September 13, 2007, to the two barns that housed the 55-week-old layers. On September 18 and 19, 2007, additional roosters from the affected barn were introduced to the two barns that housed the 32-week-old layers. The roosters first exhibited clinical signs and increased mortality on September 22, 2007, and the 32-week-old layers also began to exhibit similar clinical signs and increased mortality prior to their depopulation on September 28. The 55-week-old layers appeared normal at that time.

It is possible that a low pathogenicity strain of the H7N3 virus was circulating among all groups of layers prior to September 13, 2007. During the movement of roosters to the older laying flock barns, AIV may have been introduced to the rooster barn by contaminated personnel or equipment. Between September 13 and 18, 2007, it appears that a low pathogenicity avian influenza (LPAI) virus circulated in the rooster barn and mutated to a highly pathogenic form. This became evident by September 22, 2007. HPNAI may have been introduced into the younger laying flock barns by the movement of roosters on September 18 and 19, 2007. The younger flock was beginning to exhibit signs of HPNAI by September 27, 2007.

3.0 Disease control actions taken

The CFIA's disease control actions are based on four major disease control principles:

• rapid detection of newly infected flocks (surveillance);
• halting the spread of the disease, through movement controls, rapid destruction of infected flocks, and the pre-emptive destruction of commercial poultry flocks within 1 km of an infected premises;
• movement controls and surveillance on high-risk contact flocks and proximal flocks (within 3 km and 10 km); and
• preventing reinfection through the effective biocontainment of infective material (carcasses, manure and feed).

3.1 Working hypothesis on source and transmission of the disease

It has been well established that wild birds, especially waterfowl, act as reservoirs of avian influenza virus and may be the initial source of infection to domestic birds, through direct contact or contamination of feed and water. The province of Saskatchewan is situated in the middle of the western Prairies of Canada, between two major migratory bird flyways, the Central and the Mississippi.

The Canadian Cooperative Wildlife Health Centre coordinates surveillance for AIV in wild birds across Canada. Wild birds that are found dead (mortalities), and targeted species that are collected live, are tested by Matrix-PCR for AIV and strain typing is performed. In 2005 and 2006, there were no H7 strains identified from any wild birds submitted. As of February 11, 2008, a total of 397 mortalities from Saskatchewan, 11 from Alberta and 1 in Manitoba have tested negative for AIV. There was one positive test from a dead wild bird in Saskatchewan. Sampling of 1 400 live birds in Saskatchewan has revealed 244 positive for AIV by Matrix PCR. In Manitoba, out of 765 sampled, 79 have tested positive, and in Alberta 844 have been tested, yielding 131 positive findings. The strain type for these positive results has not been reported.

For the United States, the National Avian Influenza Surveillance website reports on February 7, 2008, that 3483 birds sampled in North Dakota this year and 2000 sampled in Montana showed no evidence of H5N1, but provided no further details. Personal communications with the United States Geological Service indicate H7N3 subtypes were identified in 18 submissions in 2006.

Low pathogenicity viruses can acquire virulence over time due to antigenic drift (small mutations) or antigenic shift (larger genetic changes). Because the virus is highly contagious, it spreads rapidly through a confined commercial poultry flock. High concentrations of virus are present in the respiratory and digestive tracts of infected birds. Fecal material from infected birds may contain up to 16 x 106 virions/g of feces and one gram may contain enough virus to infect one million birds.

The affected premises is located in a major wild bird breeding area related to the Central and Mississippi flyways. A large freshwater lake and a water lagoon system are located within 10 km of the premises. In addition, a freshwater dug-out is located on the premises and is used as a secondary water source for poultry. Possible means of introduction of the influenza virus in this case include contaminated drinking water from the dug-out, farm workers and wild animals.

3.1.1 Tracing

In accordance with CFIA's Hazard Specific Plan for Notifiable Avian Influenza and the OIE's Terrestrial Animal Health Code (2007), tracing of all poultry, poultry products and things exposed to poultry or poultry products into or out of the infected premises during the 21-day period prior to the onset of clinical signs of avian influenza was undertaken. This was to identify any contact premises at risk of having acquired AI from the index premises and any potential sources of introduction of the virus.

Tracing activities were undertaken for the following:

1. Vaccination crews were provided to the index premises by a non-governmental provider of social services in Regina, Saskatchewan These crews are assembled from people who present themselves to work each morning. They are often transient in nature and their movements aren't easily quantified. The flocks were vaccinated on September 18, 19 and 20, 2007. These crews consisted of 14 people per day. Many of these employees were present on multiple days. Twenty personnel in total were in attendance on the premises.

   Names of the people on these crews were provided to the CFIA by the non-governmental social services provider. A personnel questionnaire was administered to members of the vaccination crew to assess whether they were a potential source of introduction and whether they had subsequently contacted any other poultry operations.

   The organization had also provided pullet handling services to a commercial pullet growing operation on September 14, 2007. There were four individuals from this catching crew who were also part of the vaccination crews at the infected premises. The pullets were transported to a commercial table egg layer operation in the east central area of Saskatchewan. These pullets were tested in the security zone surveillance program and all samples from the flock were negative. The barns at the pullet grower operation were subjected to cleaning and disinfection, as was their regular practice before chicks were placed for another production cycle. The epidemiological assessment of the index farm does not suggest that this pullet grower operation was the source of AI.

2. The owner of the infected farm was interviewed using the Extended Epidemiology Questionnaire (Part H) of the CFIA's Avian Disease Premises Investigation Questionnaire (ADPIQ). Personnel biosecurity breaches were not identified. The eight farm employees were also interviewed individually to confirm the farm owner's report and ensure there were no potential sources or risks of spread that were unreported during the first interview. The risk of introduction of AIV from another poultry operation via farm personnel was deemed to be negligible.
3. A Saskatchewan company has been the sole source of feed for the infected premises for 22 years. This feed mill has no other commercial poultry clients. The truck which transports feed to the index farm is not subjected to any cleaning and disinfection procedures. Between the dates of September 1, 2007, and September 24, 2007, a total of 23 premises (including 6 deliveries to the index farm) were identified as being visited by this feed conveyance. All the producers were contacted by phone and each reported that they have no poultry on the premises.

   The feed mill was inspected and their processes and written procedures were reviewed. Opportunities for contamination may have existed during ingredient receiving, and birds, feathers and feces were observed in the receiving area. The pelleting machine achieves a minimum temperature of 55 degrees Celsius and this should be sufficient to kill AIV if the feed ingredients were contaminated. Procedures for the load-out area restricted the access of birds and there did not appear to be a contamination risk at this area. There is negligible risk that the feed was the source of AIV.

4. The hatchery conveyance utilized for egg pick-up at the index premises is dedicated to the index farm two days per week. The index premises provides enough eggs to fill the capacity of the truck at each pick-up so the egg truck travels directly from hatchery to farm to hatchery. The hatchery's on-farm biosecurity policy is comprehensive. The truck is subjected to cleaning and disinfection of the wheels and wheel wells as it enters and leaves each farm, and is completely cleaned and disinfected after unloading at the hatchery. A pallet jack travels with the egg truck to arrange pallets on the truck after they are loaded by the farm. It typically does not leave the truck, but if it does, it is sanitized before re-entering the truck. Drivers wear clean coveralls, gloves and boot covers for each site. The hatchery has records to document their protocols.

   Reusable plastic trays are used for eggs and chicks and new paper liners are used for chicks. A comprehensive cleaning and disinfection procedure is in place which includes a quality assurance step. Records indicate that the procedures were followed. The hatchery occasionally receives hatching eggs from a hatchery in the United States. These are shipped in cardboard boxes and inside the boxes, the eggs sit in a paper/cardboard type of filler. Neither the paper/cardboard filler nor the box is reused at the hatchery; both are recycled. The index premises did not receive any of the cardboard boxes of United States origin.

5. There is one commercial premises in the restricted region (10 km radius surrounding the infected premises). The ADPIQ was completed to assess any areas of common contact between these premises and none were identified.
6. Poultry extension personnel visited the infected farm immediately preceding the detection of avian influenza. They practised acceptable personal biosecurity procedures, including thorough cleaning of vehicles, clothing, and equipment preceding and following the farm visit. There is negligible likelihood of these personnel having introduced or transmitted the virus.

3.2 Movement restrictions

All movement of poultry, poultry products and things exposed to poultry or poultry products from the infected farm was restricted by quarantine enforced by the CFIA. Following the completion of supervised cleaning and disinfection, only authorized movement of equipment and vehicles was allowed.

The province of Saskatchewan was established as the control area by the Minister of Agriculture, under the Health of Animals Act on September 28, 2007. No live birds, including hatching eggs, were permitted to leave the province of Saskatchewan. Poultry meat and table eggs that had been federally inspected required a CFIA permit to leave the province. Movement of pet birds out of the province of Saskatchewan was subject to veterinary assessment and consultation with CFIA authorities.

Within Saskatchewan, CFIA-specific permits were required for movement of any birds or bird products (manure, litter, feathers, and meat or eggs) within or out of the restricted region (10 km perimeter of the affected farm). No live birds could be moved into the infected region (3 km perimeter from the affected farm) and CFIA-specific permits were required for all movement of birds or bird products (as described above) within or out of the infected region. Other movements within the province were unrestricted.

Movement of poultry products and table eggs from outside Saskatchewan through the province was not restricted. Transshipment of live birds and hatching eggs was by CFIA-specific permit. There were no restrictions on movement of poultry products or eggs purchased from grocery stores.

The Minister of Agriculture revoked the control area on October 30, 2007, which removed all movement restrictions on birds and bird products in Saskatchewan with the exception of the index premises, which remained under quarantine pending the completion of the cleaning and disinfection.

3.3 Surveillance

Surveillance activities were performed as indicated below for each of the regions. There were no farms identified as high risk contacts or as suspect farms. If such had been identified they would have been subjected to investigative testing.

3.3.1 Investigative testing

This protocol was developed to respond to any suspicion of disease on a given premises (e.g. suspect disease or a high-risk contact). A negative flock test following submission of oropharyngeal and cloacal swabs from at least 60 birds per barn (to give 95% confidence in detecting Influenza A if the prevalence in the barn were 5% or greater), from all barns on the premises and an epidemiological assessment would have been required from suspect premises. No suspect premises were identified.

3.3.2 Surveillance in the infected region (3 km area)

All farms with poultry in the infected region were subjected to surveillance, which included submission of oropharyngeal and cloacal swabs from at least 60 birds per barn (to give 95% confidence in detecting influenza A if the prevalence in the barn were 5% or greater), from all barns on the premises and serum samples from at least 20 birds per barn (to give 95% confidence in detecting Influenza A if the prevalence in the barn were 15% or greater). For small, non-commercial flocks, with less than the indicated number of birds, all birds were sampled. The collection of swabs was repeated on a weekly basis while the control area remained in place. Additionally, a weekly flock health questionnaire was submitted by the owner to the Saskatchewan Regional Emergency Operations Centre (Saskatchewan-REOC) by facsimile.

There were six small non-commercial flocks in the infected region and all of them have completed initial serological testing and weekly swabbing for four weeks with negative results.

3.3.3 Surveillance in the restricted region (10 km area)

Within the restricted region, all commercial flocks were required to complete the epidemiology questionnaire and were subjected to a complete flock test as described above within the first week following the detection of avian influenza. There is one commercial premises and the epidemiological assessment and flock investigative test were completed with negative results.

Dead bird surveillance was also initiated on this premises. At least five birds, that died or were sacrificed by the owner if there was no mortality, were left in designated bins by the farm gate once per week. The birds were swabbed by the CFIA and the carcasses disposed of by the owner. This method proved valuable in early detection of avian influenza during the 2004 outbreak in British Columbia.

Within the restricted region, a permit was required in order to move live birds or product. A negative flock test within the previous week was required in order to issue a permit to move eggs to the grading station. This requirement was applied to one non-commercial, as well as to the previously discussed commercial premises within the restricted region. A negative flock test within 48 hours would have been required to move broiler chickens to slaughter, but there were none within the region.

Based on observations during the 2004 British Columbia outbreak, small, non-commercial poultry holdings were deemed to be of low risk and were excluded from routine surveillance in the restricted region. Sick calls from non-commercial operators would have been investigated if received and testing would have been conducted to determine if the avian influenza virus was present. No investigations were required and no positive findings were determined in small, non-commercial holdings.

3.3.4 Surveillance in the security region (control area)

Surveillance activities in the security region (the balance of the control area outside of the restricted region) were directed towards enhancing opportunities for virus detection, in keeping with OIE recommendations. The protocols also ensured timely, accurate and reliable collection of samples and flock related data through on-farm sero-surveillance in order to demonstrate freedom from disease. This information was used to support a decision to revoke the Declaration of the Control Area on October 30, 2007.

Passive surveillance was enhanced by distribution of communication materials from the Saskatchewan-REOC to industry to increase producer awareness and encourage reporting. Additionally, Prairie Diagnostic Services (PDS) performed Matrix-PCR for influenza A on all undiagnosed poultry submissions. Investigative testing would have been conducted on all suspect farms, but none were identified.

Active sero-surveillance of the broiler hatching-egg sector in the security region was instituted by the Saskatchewan-REOC. All of the broiler hatching-egg farms were sampled in a two-tiered approach. Three premises that were epidemiologically linked with the infected premises by a shared hatchery had 30 samples taken from each barn on the premises. The remaining premises had 30 samples per barn taken from each barn that housed birds of the oldest flock on the premises. This targeted surveillance of the highest risk flocks yielded negative results for NAI.

Active sero-surveillance of the table egg layer sector in the security region was undertaken on a sample of 25 flocks. Flocks were selected for sampling based on age. Samples from 30 birds were taken from each barn on the premises housing birds of the oldest flock on the premises. This represented targeted surveillance of the highest risk flocks. Sampling of 25 table egg layer farms (out of 64 farms) will provide 95% confidence of detecting infected farms if greater than 10% of farms are infected. The table egg layers are not a high-risk sector. All selected farms tested negative for NAI.

Active sero-surveillance of the broiler sector in the security region was undertaken on a census of eligible flocks. Eligibility was determined by the ability to complete testing and receive results prior to the flock's scheduled slaughter, and-due to the difficulty in obtaining sufficient blood volume from younger birds-by selecting those birds that were at least 4 weeks of age. All of the eligible broiler farms (18 out of 68 farms) were tested with negative results. The broilers are not a high-risk sector.

Active sero-surveillance of the turkey sector in the security region included all the turkey farms. Samples from 30 birds were taken from a randomly selected barn on the premises. The turkeys are not a high-risk sector. All samples were negative for NAI.

For each barn selected for inclusion, sampling of 30 birds provided 95% confidence of detecting sero-conversion if the prevalence was equal to or greater than 5% in the barn. Avian influenza is highly contagious and the within-barn prevalence is expected to quickly exceed 5% in an infected barn.

3.4 Destruction

The CFIA requires the employment of humane methods of flock destruction as recommended by the OIE and the American Veterinary Medical Association. Birds were destroyed on the affected premises by CO₂ inhalation. Euthanasia commenced on September 28 and all birds were euthanized by September 30, 2007. Representatives of organizations responsible for animal welfare were invited to observe the destruction activities.

3.5 Disposal activities

Bird carcasses from the affected farm were disposed of by deep burial. The burial site was selected and evaluated in consultation with provincial agriculture and environmental authorities to ensure compliance with local regulations and to minimize environmental impact. The site was located on the property of the farm owner.

The carcasses of birds were moved to the center of the barn floor after euthanasia and remained in the barns for at least 24 hours prior to disposal to permit decomposition to begin and reduce viral load. They were sprayed with detergent in water to reduce dust and feather dispersal prior to loading with a front-end loader. Each load was sprayed with a disinfectant before removal from the barn and loads were emptied into leak-proof rendering company trucks for transport to the burial pit. Each truckload was sprayed with disinfectant and covered with a tarp before movement and unloading into the burial pit. Wind conditions were variable on the days of disposal and extreme caution was exercised to ensure that potentially contaminated material did not escape.

Material from the composting area where the farmer usually disposed of dead birds was also buried, as was the litter that remained in the barns after bird carcasses had been removed.

3.6 Cleaning and disinfection of facilities and equipment

Protocols for cleaning and disinfection of avian influenza infected premises were developed in 2004. Cleaning and disinfection (C&D) activities are the physical and financial responsibility of the poultry producers but these activities have to be approved by and meet the standards set out by the CFIA. Adherence to the procedures is enforced and documented through a series of inspections by CFIA personnel. All areas and equipment potentially contaminated with AIV are included in the C&D protocol. All things, including CFIA equipment and vehicles, were cleaned and disinfected according to strict biosecurity protocols before they were removed from the infected premises. All persons leaving an infected premises are required to follow established biosecurity procedures.

Cleaning and disinfection of the physical structures on the index premises was initiated once manure and litter removal had been completed. The Saskatchewan poultry industry board leaders approved funding of a contract with a local company experienced in cleaning and disinfection of poultry barns to facilitate cleaning and disinfection of this premises. The cleaning and disinfection of the affected premises was completed January 18, 2008, under CFIA supervision.

In accordance with the current guidelines of the OIE Terrestrial Animal Health Code (2007), declaration of freedom from highly pathogenic avian influenza following an outbreak may be made three months following the completion of cleaning and disinfection of the last infected premises.

4.0 Response infrastructure

4.1 The role of the CFIA

The Canadian Food Inspection Agency is the lead agency whenever a reportable animal disease, such as notifiable avian influenza, is detected. Supportive roles are assumed by other federal, provincial and municipal agencies, veterinary associations and producer organizations.

4.1.1 The CFIA's foreign animal disease plans

The CFIA has developed contingency strategies and operational plans to deal with potential incursions of foreign animal and reportable diseases. The Foreign Animal Disease Eradication Support (FADES) Plan is the framework of federal-provincial cooperative agreements that specify the roles and responsibilities of federal and provincial government stakeholders during an animal disease emergency. The Notifiable Avian Influenza Hazard Specific Plan forms part of the overall plan to deal specifically with an incursion of NAI; it supplies background information on the disease itself, as well as outlining the principles of control and eradication, disinfection of infected premises and surveillance. The emergency response organization and the detailed procedures to implement these contingency plans are set out in the CFIA Emergency Book and the CFIA Animal Health Functional Plan.

4.1.2 Emergency Operations Centres established

When a high-risk specimen is submitted because of evidence of a disease that is federally reportable (e.g. NAI), the area and national emergency response teams are alerted. Once the diagnosis is confirmed, a sequence of events is activated that put in place the control and eradication procedures described in the NAI Hazard Specific Plan, the CFIA Animal Health Functional Plan and the CFIA Emergency Book. At the discretion of the Regional Operations Director, a local emergency operations centre (EOC) is established to coordinate the field investigation and disease control activities. In addition, a national EOC is established at Headquarters in Ottawa to support the field activities associated with disease control and eradication policy, legal issues, communications, consultations with producer groups, international relations and interprovincial liaison.

4.1.2.1 Saskatchewan Regional Emergency Operations Centre

The Saskatchewan-REOC was activated in Regina on September 27, 2007, at the CFIA Regional Office. The Saskatchewan-REOC initiated the Incident Command System described in the Animal Health Functional Plan.

The Province of Saskatchewan's emergency response operations were co-located and coordinated with the CFIA's Saskatchewan-REOC (in the same building). A unified command under the Incident Command System facilitated a close working relationship between federal, provincial and municipal agencies involved with human health, animal health, the environment, logistics support and information technology services.

The Prairie Diagnostic Services Laboratory was available to support the diagnostic laboratory capacity of the CFIA through previous development of diagnostic capacity as a member of the Canadian AI Laboratory Network. Saskatchewan Agriculture and Food (SAF)-Regulatory and Inspection Management Branch provided support in veterinary epidemiology and surveillance, consultation on disposal methods and requirements, and liaison with Saskatchewan Health.

Emergency assistance with logistics is provided provincially and federally through two organizations-Provincial Emergency Preparedness and Public Safety Canada. These organizations worked together with the CFIA to acquire the equipment and people necessary to mount surveillance, destruction and disposal operations in the field.

4.1.2.2 National EOC

On September 27, 2007, the National Emergency Operations Centre (NEOC) was activated in Ottawa. The situation was declared to be an emergency on September 28, 2007. A National Emergency Response Team was established with the Vice-President of Operations as National Incident Commander.

4.2 Communications

Daily inter-agency briefings were held at Saskatchewan-REOC that included CFIA staff, section heads and representatives from provincial and municipal governments, public health agencies, and industry. Communications with foreign governments were handled through the NEOC.

Communication with the media was managed through official CFIA spokespersons, who were designated at the beginning of the response to handle all contacts with the media. Media became aware of the quarantine and reported activity on the index farm on September 26, 2007. There was a CFIA technical briefing in conjunction with SAF on September 27, 2007, to confirm the diagnosis.

In support of the spokespersons, a team of Area and Headquarters communications officers was brought together to prepare public notices and press releases, and to coordinate media interviews. The federal team worked closely with provincial and municipal government communicators. The CFIA website was updated regularly.

4.3 The role of poultry producer organizations

Over the last year, the poultry industry in Saskatchewan had developed a Saskatchewan Poultry Industry Emergency Management Team (SPIEMT) to prepare an emergency response contingency plan for animal disease emergency response situations like NAI. All the poultry industry association boards as well as the feed and hatchery support industries are represented and members of the CFIA and Saskatchewan Agriculture and Food provided assistance in development of the plan. The SPIEMT co-chairs were the primary contacts with the CFIA and responsible for distributing information to the poultry producers, as well as consulting on the limits for the control area and the surveillance plan. They provided industry data to support GIS mapping and facilitated producer understanding of the provincial surveillance plan required to achieve confidence that NAI was not present in the control area beyond the initial infected premises.

4.4 The role of human health agencies

As avian influenza is considered a zoonosis and some strains can represent a health risk for people, contacts were initiated with local, provincial and federal public health authorities.

The local public health response was coordinated and delivered by the Regina Qu'Appelle Health Region (RQHR), Population Health Branch-Saskatchewan Health, and Saskatchewan Labour in partnership with the Occupational Safety and Health Advisor (OSH)-CFIA and Workplace Health and Public Safety Programme-Health Canada. Laboratory support was provided by Saskatchewan Disease Control Laboratory, Saskatchewan Health in collaboration with the National Microbiology Laboratory-Public Health Agency of Canada (PHAC). The PHAC provided technical support and deployed a field epidemiologist from the Canadian Field Epidemiology Program to assist Saskatchewan Health with both the public health and employee health responses, and enhanced human health surveillance.

Public health measures were directed at preventing direct infection of exposed individuals through prudent use of personal protective equipment. Secondary preventive measures included oseltamivir (Tamiflu®) prophylaxis to reduce viral replication and influenza vaccination to reduce the likelihood of influenza co-infections (human and avian strains) and re-assortment.

Enhanced surveillance activities were conducted to (1) determine the extent of human infection and/or clinical disease (if any) in exposed individuals, (2) obtain further information on exposure history and compliance with personal protective measures, (3) measure compliance with influenza vaccination and oseltamivir prophylaxis and (4) document adverse events. Seven individuals were identified with new or worsening ocular or influenza-like illness symptoms during the investigation. All seven individuals were negative for influenza by direct fluorescent antibody, enzyme immunoassay, and PCR. A complete report will be generated by Saskatchewan Health, RQHR and Saskatchewan Labour summarizing the surveillance findings.

4.4.1 Occupational health and safety

Health Canada, through its Workplace Health and Public Safety Programme, provided an Occupational Health Advisory for federal employees who were involved in avian influenza control. This stressed the importance of the proper use of personal protective equipment, hand hygiene, self-monitoring for influenza-like symptoms and, if affected, self-isolation and reporting to public health authorities. The advisory also recommended vaccination with the current influenza vaccine and prophylactic use of antiviral medication while exposed to infected poultry and for seven days afterward.

All CFIA staff were provided with training sessions on proper biosafety procedures and the requirements of Occupational Safety and Health guidelines as outlined in the Canada Labour Code, Part II. A CFIA OSH advisor was on site during the response activities.

Compliance was monitored and enforced regarding the proper use of personal protective equipment, safe work and hygiene practices and reporting accidents. The buddy surveillance system was implemented to minimize the risk of accidents or biocontainment breaches.

Saskatchewan Health and the Regina Qu'Appelle Health Region provided consultative occupational health and safety support to CFIA personnel and administered vaccinations and prophylactic medications.

Click on image for a larger view

Map: Saskatchewan Poultry Producer

Click on image for a larger view

Map: Avian influenza Movement Restriction Regions 2007