Public Health Agency of Canada Response Plan for the Management of the Ebola Disease caused by Sudan Virus, 2022

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Organization: Public Health Agency of Canada

Date published: December 2022

Cat.: H14-423/2022E-PDF

ISBN: 978-0-660-46270-7

Pub.: 220582

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On September 20, 2022, the Uganda health authorities declared an outbreak of Ebola disease caused by Sudan virus or Sudan Virus Disease (SVD). Ebola disease is a severe, acute viral illness caused by ribonucleic acid (RNA) viruses of the genus Ebolavirus, which belongs to the Filoviridae family. Sudan ebolavirus is 1 of 4 Ebola virus species that cause disease in humans. The virus that is causing this outbreak is known as Sudan virus (SUDV) and is the only virus that belongs to the Sudan ebolavirus species. SUDV is considered especially virulent and associated with higher case fatality rates. There are no licensed vaccines or effective therapeutics for the prevention or treatment for SUDV; however, experimental vaccines are currently undergoing clinical trials. Supportive care, including rehydration with oral or intravenous fluids and treatment of specific symptoms help improve clinical outcomes.

The viruses that cause Ebola disease, including SUDV, are transmitted from person-to-person through direct contact with blood and/or other body fluids (for example, feces, urine, vomitus, saliva, sweat) from an infected symptomatic person or dead body and/or indirect contact with surfaces or fomites (for example, needles and medical equipment) that are contaminated with these fluids. As of September 25, 2022, the risk of public health impact is considered by WHO to be very high at the national level (Uganda), high at the regional level and low at the global level. WHO's rapid risk assessment will be revised in the coming days based on available information. WHO scenario planning indicates a sustained outbreak lasting 6 to 8 months. In the absence of licensed vaccines and therapeutics for the prevention and treatment of SVD, WHO considers the risk of a potential serious public health impact is high.

The Government of Canada, including the Public Health Agency of Canada (PHAC) and other federal government departments, is working with international partners to monitor the outbreak of SVD in Uganda. Additionally, work is ongoing with provinces and territories (PTs) in the instance of a potential introduction of the disease into Canada. PHAC's Centre for Integrated Risk Assessment (CIRA) has conducted a Rapid Risk Assessment to evaluate the likelihood and impact of SVD introduction into Canada. Between October 24 and January 16, 2023, the risk of SVD introduction through refugees and other travellers from Uganda is considered very low, and the impact of SVD introduction into Canada is considered minor. The overall risk for the Canadian population is currently considered low.


This response plan supports the following objectives:

Guiding principles and assumptions

Canada's response to the SVD outbreak in Uganda is based on existing plans and guidance related to public health events and pandemic preparedness and builds on lessons learned from past public health emergencies. It is further guided by the following principles outlined in the FPT Public Health Response Plan for Biological Events.

Key areas of focus

Risk assessment

The Public Health Agency of Canada will work closely with its national and international partners to assess the risk of SVD to Canadians on an ongoing basis. Risk assessment involves:

Coordinated communication and response with provinces and territories

PHAC's emergency response to the SVD outbreak in Uganda is at Level 2, which is heightened awareness. A collaboration is ongoing via the Public Health Network (PHN) Council, the Council of Chief Medical Officers of Health (CCMOH), the Canadian Public Health Laboratory Network (CPHLN) and other partners to establish the steps to follow should the WHO declare a "Public Health Emergency of International Concern (PHEIC)" that requires escalation of FPT public health responses. As per the terms of reference of the PHN and the FPT Public Health Response Plan for Biological Events, a time-limited technical working group will be established to support a Pan-Canadian response.

A technical working group will advise the FPT Conference of Deputy Ministers of Health on the coordination of FPT preparedness and response planning across the health sector and will make recommendations related to policy, technical and operational issues in public health. Any decisions with policy implications are required to go to the Conference of FPT Deputy Ministers of Health for consideration, as appropriate.

Coordinated communication and response with other Government departments and Non-Governmental Organizations (NGOs)

PHAC is collaborating with other government departments including Immigration Refugee and Citizenship Canada (IRCC), Canadian Border Services Agency (CBSA), Global Affairs Canada (GAC) and Transport Canada (TC) to examine the roles and responsibilities of each department in reducing the risk of introduction of infectious diseases including SVD. Work is ongoing to identify specific strategies and decisions required to mitigate risk and the process to implement any required decisions. Key responsibilities include risk identification and minimization (PHAC), securing Canada's borders (CBSA in collaboration with PHAC's Border and Travel Health Program), outbreak management activities overseas (IRCC), international coordination (GAC) and protecting the safety of aircrafts, passengers and crew members (TC).

For close to 20 years, PHAC's National Microbiology Laboratory (NML) team has been offering on-site diagnostic support and have worked alongside the WHO and Médecins Sans Frontières (MSF) to support them in containing high consequence pathogen outbreaks, including the largest and most complex Ebola disease outbreak in West Africa during 2014 to 2016. GAC has ongoing projects that support MSF in their emergency health operations in Uganda. This includes funds to support existing/establish new Ebola treatment units in affected districts. Through an ongoing GAC funded project with the Canadian Red Cross Society, the Canadian Red Cross has allocated funds to the International Federation of Red Cross and Red Crescent Societies (IFRC) relief operations in Uganda.

Public communications

PHAC will use an agile, proactive approach to be able to pivot based on the global context. The current communications approach focuses on what is being done to help reduce the risk of an Ebola disease outbreak in Canada. PTs will be engaged through the PHN Communications Group to coordinate communication activities with a risk communications perspective to ensure Canadians have the information they need to protect their health.

Responsive, high-profile communications activities will be taken if there is a positive case of Ebola disease in Canada, this includes:

The following information on Ebola disease can be found on

Border measures

Canada also has a number of border measures in place, guided by the Quarantine Act, to mitigate the potential risk of the introduction and spread of communicable diseases into Canada, including Ebola disease.

As of Saturday, October 8, 2022, enhanced border measures were implemented at Ports of Entry (POEs) by the Canadian Borders Services Agency (CBSA) with public health guidance from PHAC, including the following:

Public health guidance and advice

To help minimize the risk of transmission of SUDV in Canada and support the management of cases, PHAC will continue to develop and update public health technical guidance and advice as new information becomes available. Public health response will work through FPT tables to engage other government departments and relevant expert groups to develop and communicate public health guidance and information including:

Surveillance, reporting and laboratory capacity

PHAC's public health response includes establishing surveillance and reporting systems for SVD, reporting on the situation in Canada and enhancing laboratory capacity by:

Clinical management

The Agency's response for clinical management includes supporting public health and clinical partners involved in identifying and managing the disease by:

Infection prevention and control

The Agency's response for infection prevention and control (IPC) includes:

Medical countermeasures

The medical countermeasures includes:

Scientific evidence generation and monitoring

The collective FPT public health response to Ebola disease caused by Sudan virus is evidence-informed and grounded in science. In order to increase the foundation of knowledge and scientific evidence to guide decision making, the following approaches will be considered:


While the likelihood and impact of an SVD introduction into Canada from the current outbreak in Uganda is low, the Government of Canada, including the Public Health Agency of Canada and other federal government departments, are coordinating their efforts to monitor and respond to this outbreak. The health and well-being for persons who live in Canada is of top priority for the Government of Canada and this will be addressed through the key areas presented in this response plan.

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