Health Committee on March 7th, 2016

[Darshan Singh Kang, Liberal, Calgary Skyview, AB]

Thank you, sir.

[The Chair, Liberal, Bill Casey]

Now we'll have a Conservative, Mr. Webber.

[Len Webber, Conservative, Calgary Confederation, AB]

Thank you, Mr. Chair, and thank you to the panel. I appreciate your information.

Way back in February of this year, when I first heard about the Zika virus, it was almost like panic struck the media when the World Health Organization declared the Zika virus outbreak a public health emergency of international concern. Of course, I compared it to Ebola, or something that's very concerning. However, you say that the risk to Canadians is low.

I look at the symptoms, which are things like skin rashes, fever, muscle and joint pain, and headaches. The symptoms are mild and they last for about two to seven days. Most people recover from the infection without complications. The hospitalization rates are low. I'm pleased to hear that, and the fact that it's not comparable to Ebola or hepatitis, or whatever.

You mentioned there are about three million Canadians who travel to these infected countries, and we have 20 confirmed cases now. Are any of these confirmed cases pregnant women? That's the big risk right there. These pregnant women have the issue of deformation of their child.

Is it contagious other than through mosquitoes and through blood? Can you sneeze and give it to somebody else?

I have a question for our Canadian Blood Services doctors. Because of the symptoms and the fact that people fully recover from this, do you feel it's excessive that you're deferring blood, organs, and tissues? People are dying on tables waiting for these organs and tissues, and you're going to turn away a potential organ from someone who may have travelled to that area.

Is there a way for you to test these organs and tissues first, before deferring them? Have you had any cases of deferral of organs and tissues?

There's a whole pile of questions I've asked you

Just on procedure, Mr. Chair, if I don't use up my seven minutes, can I pass them on to my colleagues?

[The Chair, Liberal, Bill Casey]

Yes.

[Len Webber, Conservative, Calgary Confederation, AB]

All right. I would like to do that, then.

[The Chair, Liberal, Bill Casey]

You have four minutes and 17 seconds left.

[Len Webber, Conservative, Calgary Confederation, AB]

Thank you. Do my colleagues have any questions?

[The Chair, Liberal, Bill Casey]

Let's look at the answers first. You've loaded them up quite well.

[Dr. Gregory Taylor]

I hear three questions and they're all excellent.

In terms of pregnant women, as Matt said, we're doing all of the testing in Canada right now, both for the presence of the active virus in the blood and for antibodies towards the virus. The latter test is tough to interpret. It's very difficult to interpret, and we're suggesting that the doctor be aware of that and that they have a good conversation with their patient, either before or after that test.

Oftentimes, we don't know whether the sample is coming from a pregnant woman or not. We're aware of one in Canada at this time. There may be more, but we're not aware of them. Obviously, for confidentiality reasons, we're not indicating where this person is. It would be much too easy to identify them. But that's all we're aware of.

We expect the numbers will increase. Given the three million travellers, we expect we'll see a lot more people who are positive for that, hopefully not pregnant women but we'll see a lot more.

Regarding your question about whether it's contagious, no, you can't sneeze and that. The methods of transmission are limited to—and this is our scientific knowledge now—those two mosquito types.... The virus is in the mosquitoes, and they'd have to bite a person who is uninfected and inject that into them. There's also sexual transmission through semen. The virus is in the semen of a man who's been infected, and it lasts for up to two weeks after the infection onset. Rarely, as my colleagues were saying, there are a couple of cases involving blood transfusion in Brazil.

I'll pass that over to you.

[Dr. Dana Devine, Chief Medical and Scientific Officer, Canadian Blood Services]

Thank you.

I'll take your question about deferral, whether the deferral period of 21 days is too long and whether we are having a greater impact on the other side, which is the availability of tissues, organs, and blood products for Canadians.

We have put the 21-day deferral in place as a precautionary measure. As we learn more about the Zika virus and understand more about how it behaves in infected people and what the risk really is, we will keep looking at the deferral period to understand whether it's too much. What we feel right now is that it is the appropriate place for us to start, because we are lacking a lot of detail.

In terms of the availability of organs, we are not aware of any case of an organ donor travelling in a Zika-risk area and then becoming a problem for deferral potential.

The other thing that comes in with organ donation is that there is always physician choice. Because of the rarity of organs and the length of the wait list in the country, there is more latitude for being an organ donor than there is for being a blood donor.

On the stem cell front, we are aware of one case in which we had a stem cell donor who was lined up for a recipient, and the donor had a Mexican holiday planned and was not prepared to reschedule. Fortunately, the transplant centre had multiple match donors who could have donated to the patient, so the patient is getting the transplant anyway, even though the donor has elected not to change the Mexican holiday plans.

[Len Webber, Conservative, Calgary Confederation, AB]

Thank you. I appreciate that.

Sorry, you have four more minutes, so go ahead.

[The Chair, Liberal, Bill Casey]

You have 50 seconds.

[Colin Carrie, Conservative, Oshawa, ON]

Fifty seconds? Wow, I could never talk for just 50 seconds.

First of all, Dr. Taylor, these handouts you have are excellent. I have not seen these before from the Public Health Agency of Canada. Are these readily available?

[Dr. Gregory Taylor]

Yes.

[Colin Carrie, Conservative, Oshawa, ON]

Where would people get these? Are they on the Internet? Where are they coming from?

To pick up on what my colleague Mr. Kang was saying, I think a lot of it is about communication. The media is really picking up on this microcephaly issue. It's a lot of stress.

When I asked the question in the House, the minister pointed me to a website and I couldn't find any of this material. How long have you had this out on the Internet?

[Dr. Gregory Taylor]

It's been for a while. We are also tweeting them with attachments. Those are infographics you're looking at, which we've been designing and trying to communicate. I think they are in our tweets and on Facebook. I'll have to get back to you in terms of how long they've been up, but they've been up for a bit, a few weeks.

[Colin Carrie, Conservative, Oshawa, ON]

I am curious to know whether you are disseminating them actively to different agencies, such as travel agencies. People get their information from different sources. I think the best treatment is prevention, if we can get that information out. What are you doing to get the information out to stakeholders and to people who could disseminate it to average Canadians who are travelling?

[Dr. Gregory Taylor]

We typically put the information through our travel health notices. That is something we put out on an ongoing basis, routinely. We thought that was the best way.

It's actually picked up by the app. We have a travel app now where our information is hidden within the typical advisories about what's happening. People can get that through their app.

Those are the normal routes we've been taking, as well as the tweets, Facebook, our website, etc. We don't typically go directly to travel agents. A lot of people just do their own travel. We find it more effective to do it through the normal channels where it gets disseminated.

[Colin Carrie, Conservative, Oshawa, ON]

Is there evidence to suggest that it is effective?

As I said, it's all about the communication part of it. Some Canadians aren't getting the information. There is a little bit.... I won't call it hysteria, but when you see a baby with microcephaly, this is a significant deformity, even though there may not be any direct evidence of a causal nature between the two. Is there a way you could measure it, to make sure this information is getting out to Canadians?

[Dr. Gregory Taylor]

Yes. We sometimes do that. That's where we do surveys, contact people, and look at whether the information is going out. We have not done that yet. That might be something to consider in the future.

[Colin Carrie, Conservative, Oshawa, ON]

That would be great.

Is that my 50 seconds?

[The Chair, Liberal, Bill Casey]

Yes. You did well.

[Colin Carrie, Conservative, Oshawa, ON]

Thanks.

[The Chair, Liberal, Bill Casey]

Mr. Davies had raised this issue.

You have the floor.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you, Mr. Chairman.

Thank you to all of the panel members for being here.

I had the benefit of attending a talk on Friday at UBC. It was led by an OB/GYN specialist in disease prevention, Dr. Deborah Money. She led us through a state-of-the-art description of where we're at with the Zika virus. I realize and appreciate that we are in a real state of development; probably we're learning data every month.

What I took away from the talk on Friday was that the link between the Zika virus and grave outcomes in pregnant women and fetal damage is fairly strong at this point. Would that be fair to say?