While it turned out to be a false alarm, the response of public health officials to an apparent outbreak of disease on a Via Rail train was a textbook example of how to react to an outbreak.
Around 9 a.m. yesterday, the Sudbury District Health Unit was notified of an unusual event on the Canadian – one woman dead and six others ill. The train was stopped in Foleyet, an isolated community in Northern Ontario.
Despite the remote location and unusual circumstances, public health was able to react within an hour. To contain the potential spread of disease, the sick were isolated in one car and other passengers quarantined, meaning they could not leave the train.
“The first thing you need – and the hardest thing to get – in these situations is information,” said Burgess Hawkins, manager of the environmental health division. “We didn't know what we were dealing with.”
Serendipitously, there was a doctor on the train able to monitor the health of the sick passengers.
Public health officials, the closest of whom was about 100 kilometres away in Timmins, made their way to the train. One passenger was airlifted to hospital. So were fluid samples from the others.
Lab tests were done. “It's a process of elimination,” Mr. Hawkins said. They tested for influenza, respiratory syncytial virus (RSV, a common respiratory ailment) and other viruses.
Meanwhile, federal, provincial and local officials were meeting by teleconference to exchange information and plan their response.
David Butler-Jones, Canada's chief public health officer, was in the operations centre in Ottawa – a facility designed to be the public nerve centre in the event of a pandemic outbreak, terrorist attack or natural disaster.
There was a series of teleconferences, again with an emphasis on “coms” (short for communications), Dr. Butler-Jones said. “You want to be transparent, but you also want to be accurate,” he said.
By mid afternoon, it was apparent there was no outbreak of infectious disease. Just a series of “confluent events” that raised alarm bells – one person dead of unknown causes, another with breathing problems and five others not feeling so well.
David Williams, Ontario's acting chief medical officer of health, delivered the news in a packed press conference. “Today went very well,” he said.
Dr. Williams was bombarded with questions from reporters suggesting public health officials overreacted.
But they acted by the book: Quickly, appropriately and professionally. It was a stark contrast to SARS, an outbreak whose response was later described as a “international embarrassment” by a blue-ribbon panel. Canada has invested a lot in pandemic preparedness over the past few years and the investment is paying off.
Officials in towns big and small routinely carry out exercises to prepare them to respond to public health crises.
“This incident gave us a good test of our systems and they turned out to be pretty good,” Mr. Hawkins said.
The reality too is that public health officials deal with outbreaks – suspected and real – all the time: in nursing homes, hospitals, schools and child-care centres.
But the unusual location, a train, attracted a lot of media attention.
Dr. Butler-Jones said the only surprise he had yesterday was how quickly the train incident became a national and even international story.
“But, in the end, I was really pleased with how everything turned out,” he said.
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