Early Detection and Response Course for Health Professionals in Canada

The Immunization and Respiratory Infections Division of the Public Health Agency of Canada (PHAC) has funded the Canadian Public Health Association (CPHA) to develop, promote and deliver an accredited course for front-line and public health physicians in Canada. The course is required to assist in increasing Canada’s capacity to detect, report and contain emerging and re-emerging infectious diseases of public health significance. The course will be developed through consultation and consensus-building to meet national surveillance and laboratory requirements as well as international surveillance requirements in light of the World Health Organization’s revised International Health Regulations (IHR 2005) which come into force on June 15, 2007.

To functionally and effectively link primary care with specialized laboratory services and the larger public health system in Canada, endorsement of the course will be required from bodies that award accreditation of medical education for Canada’s public health physicians and primary health care physicians. CPHA will work collaboratively with several levels of authority to meet the requirements of the College of Family Physicians of Canada, the Royal College of Physicians and Surgeons of Canada, Provincial and Territorial Health Departments, the Canadian Public Health Laboratory Network and the Public Health Agency of Canada (PHAC).

CPHA will work with the assistance and support of an Advisory Council. Membership will consist of proposed representation from:

• College of Family Physicians of Canada
• Royal College of Physicians and Surgeons of Canada
• Canadian Public Health Laboratory Network
• Council of Chief Medical Officers of Health
• Canadian Medical Association
• Public Health Agency of Canada
• other organizations as deemed appropriate.

CPHA will develop web-based and paper-based versions of the accredited course in both official languages and will develop a train-the-trainer program that will be adapted to the provincial and territorial context. The web-based version will be evaluated through client feedback from primary care and local public health physicians as well as peer-review processes. The curriculum will be developed so that it can be updated regularly or be enhanced to integrate further modules on other specific emerging infections. The curriculum design will seek to include a minimum of two modules that will cover: early detection and reporting of emerging infectious disease; and detection and reporting requirements for avian influenza and pandemic influenza. Important work has been completed through Canada’s Pandemic Influenza Committee towards the development of national core reporting tools which will be included in the curriculum.

Background and Assumptions

The 2003 SARS experience demonstrated that Canadian laboratories faced challenges coordinating infectious disease testing and outbreak response activities and linking to epidemiologic data. As a result of lessons learned, the follow-up recommendations included a call for Canada to initiate an active and collaborative laboratory surveillance system to anticipate, detect and respond to infectious disease threats. The system that was proposed for Canada was based on improved integration of front-line laboratories into the public health system. With the release of Canada’s Pandemic Influenza Plan in 2004, it was also recognized that front-line healthcare workers and local public health authorities are important components in the detection of influenza in communities. It was recognized in parallel that most physicians would need guidance on the identification of a pandemic influenza, reporting protocols and caring for patients in that context. Analysis in light of both the SARS experience and the threat of pandemic influenza also confirmed that there was a need for physicians and the medical health community to be made aware of public health responsibilities under the International Health Regulations.