Ministry of Health
Ministère de la Santé
and Long-Term Care
et des Soins de longue durée

Chief Medical Officer of Health
Médecin hygiéniste en chef

Public Health Division

Division de la santé publique
11th Floor, Hepburn Block
Édifice Hepburn, 11e étage
Queen’s Park
Queen’s Park
Toronto ON M7A 1R3
Toronto ON M7A 1R3

Telephone: (416) 212-3831

Téléphone: (416) 212-3831
Facsimile: (416) 325-8412
Télécopieur: (416) 325-8412

TO : Health Sector Partners
RE: Influenza A(H7N9) Virus in China

Dear Colleagues,
On April 1, 2013, the World Health Organization (WHO) confirmed that individuals in China had
been infected with influenza A(H7N9).
Influenza A(H7N9) viruses normally circulate among birds. Human infections with avian influenza
are rare but have occurred in the past, most commonly after exposure to infected poultry. This is
the first time that this avian influenza A subtype (H7N9) has been found in humans.
There is no vaccine currently available for this subtype of influenza virus. Preliminary test results
provided by the WHO Collaborating Centre in China suggest that the virus is susceptible to
neuraminidase inhibitors (i.e., oseltamivir and zanamivir).
To date, no cases of human infection with the H7N9 virus have been identified outside of China.
The risk posed to Ontarians by this virus is considered low at this time based on the lack of
confirmed human-to-human transmission and the geographic distribution of illness detection.
Although the risk is low, health care providers should consider the possibility of novel influenza
A(H7N9) virus infection in persons with respiratory illness that meet the exposure criteria, such as
recent travel to China. Attached is the Ministry of Health and Long-Term Care (ministry) guidance
document on influenza A(H7N9) for health workers and health sector employers with information on
what to be on the lookout for, laboratory testing and treatment recommendations, and appropriate
occupational health & safety and infection prevention & control measures. This document will be
posted on the ministry website once the translation has been completed. We will provide you with
an update on the status of its posting during the health sector partner teleconferences that have
been arranged for Monday, April 15th, 2013.
There are a number of resources that health workers and health sector employers can turn to for more information on the influenza A(H7N9) virus:  World Health Organization’ Public Health Agency of Canada’ Centers for Disease Control and Prevention’ Nature’s summary of
Please disseminate this memo and the attached guidance document to your members, employees
and/or health partners. by
Original signed by

Arlene King, MD, MHSc, FRCPC
Chief Medical Officer of Health


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