Disease surveillance
====================

* David Butler-Jones, MD MHSc

*   © 2008 Canadian Medical Association or its licensors

I read the June 13 editorial in *CMAJ*1 on infectious disease surveillance and felt compelled to respond to its conclusions about our country's ability to deal with infectious disease outbreaks and an influenza pandemic.

Disease surveillance in Canada is very complex. It requires close cooperation and rapid information-sharing among many partners, from front-line health care workers to public health officials at all levels of government.

The Public Health Agency of Canada (PHAC) was recognized by the Auditor General for the important progress we have made, and continue to make, in improving disease information-sharing in Canada. Although there is always more to be done, Canada remains a leader in cooperating with partners and sharing information.

In addition, Canada is the first country to develop a national pandemic influenza plan for the health sector. Canada is the only country that has a contract with a domestic manufacturer to produce vaccine for every Canadian in a pandemic. Canada has stockpiled enough antiviral medication to treat all Canadians who need it in a pandemic. Under the leadership of Health Minister Tony Clement, the government of Canada has invested $1 billion into pandemic preparedness. We are a world leader in pandemic planning and much of what we have accomplished is the result of working together with our partners.

The provinces and territories share information with PHAC regularly, and we are working with them to establish more formal information-sharing agreements, such as the one we have with Ontario, to ensure the rapid flow of surveillance information. The ministers of health in all jurisdictions have approved, and will soon finalize, a memorandum on information-sharing during public health emergencies that will serve as the principal agreement through which health authorities will share information in an emergency.

A number of events such as the H2N2 alert involving laboratory influenza samples during the spring of 2005, the avian influenza outbreak in poultry in Saskatchewan in the fall of 2007 and the recent incident involving the isolation of a passenger train in northern Ontario have underscored the good working relationships we have with our partners. Furthermore, these events demonstrate our ability, and the ability of our provincial, territorial and international partners, to address public health threats effectively.

As for international disease surveillance, the agency's state of the art Global Public Health Intelligence Network monitors media reports worldwide in multiple languages and supplies much of the world's surveillance information. About 40% of the disease surveillance information the World Health Organization receives comes predominantly from this system.

Going forward as part of a larger investment in Canada Health Infoway, the federal government has dedicated funding to the development of Panorama, a unique electronic surveillance tool that will assist both in the management of Canadians who acquire infectious diseases and in the coordination of responses to outbreaks between jurisdictions.

Canadians should be confident that Canada has one of the best surveillance systems in the world, and together with the provinces and territories we continue to improve our capacity to respond to infectious disease threats.

## Footnotes

*   **Competing interests:** None declared.

## REFERENCE

1.  1. Attaran A. A legislative failure of epidemic proportions. CMAJ 2008;179:9.
    
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