Professional Documents
Culture Documents
N American Plan For Avian & Pandemic Influenza
N American Plan For Avian & Pandemic Influenza
August 2007
North American Plan
For Avian & Pandemic Influenza
August 2007
Table of Contents
List Of Acronyms ........................................................................................................ IV
Executive Summary..................................................................................................... VI
Chapter 1: Introduction............................................................................................ 1
The Avian And Pandemic Influenza Threat........................................................................... 1
A Comprehensive Approach............................................................................................. 2
Canada....................................................................................................................... 6
Mexico....................................................................................................................... 6
Surveillance/Epidemiology................................................................................................... 14
Table of Contents
Border Control Measures Associated With Notifiable Avian Influenza ............................... 15
Laboratory Practices............................................................................................................ 16
Personnel............................................................................................................................. 16
Laboratory Practices...................................................................................................... 20
Regulatory Issues.......................................................................................................... 20
Mutual Assistance......................................................................................................... 21
Personnel Exchange....................................................................................................... 21
Stockpiles................................................................................................................... 21
Pre-departure Measures For Flights From Affected Countries To North America ............................ 24
Pre-departure Measures For Flights From North America When Disease Exists In North America....... 24
En Route Measures....................................................................................................... 24
Arrival Measures........................................................................................................... 24
Land Borders....................................................................................................................... 25
Information Sharing............................................................................................................ 25
II Table of Contents
Chapter 6: Critical Infrastructure Protection.................................................. 27
The SPP Framework ............................................................................................................. 27
Canada....................................................................................................................... 29
Mexico....................................................................................................................... 29
IV List of Acronyms
Executive Summary
Canada, Mexico and the United States face a growing This Plan outlines a collaborative North American
threat posed by the spread of avian influenza and the approach that recognizes controlling the spread of avian
potential emergence of a human influenza pandemic. influenza or a novel strain of human influenza, with
The highly pathogenic (HPAI) H5N1 avian influenza minimal economic disruption, is in the best interest
virus, which re-emerged in Asia in late 2003, has already of all three countries. Coordination among Canada,
spread to Europe, the Middle East and Africa. Although Mexico and the United States will be critical in the
the virus has not yet reached North America, Canada, event of an avian influenza outbreak or pandemic. The
Mexico and the United States must be prepared for Plan, therefore, describes the organizational emergency
the day when it—or some other highly contagious management frameworks in each of the three countries
virus—does. and how they intend to coordinate their activities. In
particular, the three countries recognize the importance
At the March 2006 Security and Prosperity Partnership of communicating effectively with the public about
of North America (SPP) summit in Cancun, the leaders avian and pandemic influenza in a cooperative and
of Canada, Mexico and the United States committed coordinated matter.
to developing a comprehensive, coordinated and sci-
ence-based North American approach to prepare for and Both animal and public health issues are addressed in the
manage avian and pandemic influenza. Plan, including notification, zoning and compartmental-
ization, surveillance, epidemiology, laboratory practices,
The North American Plan for Avian and Pandemic Influ- vaccines and antivirals, personnel, stockpiles and public
enza outlines how Canada, Mexico and the United States health measures.
intend to work together to combat an outbreak of avian
influenza or an influenza pandemic in North America. The Plan also addresses border and transportation issues,
including containment measures for air travel, maritime
The Plan complements national emergency management travel and land border crossings. A series of layered,
plans and builds upon the core principles of the Interna- collaborative measures among the three countries could
tional Partnership on Avian and Pandemic Influenza, the slow the spread of a novel strain of influenza, provid-
standards and guidelines of the World Organization for ing valuable time to mobilize resources, coordinate
Animal Health (OIE), the World Health Organization responses, and mitigate morbidity and mortality.
(WHO)—including the revised International Health
Regulations, as well as the rules and provisions of the Maintaining critical infrastructure and services will be
World Trade Organization (WTO) and the North essential during a pandemic. While influenza cannot
American Free Trade Agreement. physically damage critical infrastructure, a pandemic
could weaken it by diverting essential resources or
The North American Plan removing essential personnel from the workplace. This
will enhance collaboration in Plan, therefore, extends beyond the health sector to
include a coordinated approach to critical infrastructure
order to: protection, including the importance of business con-
• detect, contain and control an avian influenza tinuity planning and recognition of interdependencies
outbreak and prevent transmission to humans; among sectors.
• prevent or slow the entry of a novel strain of Taken together, the measures outlined in this Plan to
human influenza to North America; address both avian and pandemic influenza, as well
as related border and critical infrastructure issues, are
• minimize illness and deaths; and intended to provide a comprehensive, coordinated North
American approach to managing avian and pandemic
• sustain infrastructure and mitigate the impact to
influenza.
the economy and the functioning of society.
Executive Summary
VI
Chapter 1:
Introduction
Canada, Mexico and the United States face a growing shown an ability to transmit efficiently among humans,
threat posed by the spread of avian influenza and the there is concern that it will acquire this capability
potential emergence of a human influenza pandemic. through genetic mutation or exchange of genetic mate-
The highly pathogenic H5N1 virus, which re-emerged rial with a human influenza virus. If this does not hap-
in Asia in late 2003, has already spread to Europe, the pen with the currently circulating H5N1 viruses, history
Middle East and Africa. While the virus has not yet suggests that another novel influenza virus will emerge
reached North America, the three countries must be and cause the next influenza pandemic.
prepared for the day when it—or some other highly
contagious virus—does. Influenza pandemics have occurred intermittently over
the centuries. The last three influenza pandemics, in
The North American Plan for Avian and Pandemic 1918, 1957 and 1968, killed approximately 40 million,
Influenza (Plan) outlines a collaborative North American two million and one million people worldwide, respec-
approach that recognizes that controlling the spread of tively. Although the timing of an influenza pandemic
avian influenza or a novel strain of human influenza, cannot be predicted, history and science suggest that
with minimal economic disruption, is in the best interest the world will face at least one influenza pandemic this
of all three countries. It outlines how Canada, Mexico century. A worldwide outbreak of a new influenza virus
and the United States intend to work together to prepare could result in hundreds of thousands of deaths, millions
for and manage avian and pandemic influenza. of hospitalizations, and hundreds of billions of dollars in
direct and indirect costs to North American economies.
Chapter 1: Introduction
prosperity of the three countries are interdependent and • Base our actions on the best available science and
complementary. evidence-based decision making;
While recognizing the differences in respective legal and • Agree that the imposition and removal of veteri-
governmental frameworks among the three countries, nary or public health measures on the movement
their governments acknowledge the need to work col- of people, animals and goods, under our national
laboratively and with all levels of government, the private laws and international obligations, will not be
sector and among non-governmental organizations to more restrictive or maintained for a longer period
combat avian and pandemic influenza. than necessary to achieve the veterinary or public
health objective, so as to avoid unnecessary inter-
The three leaders set out a framework for cooperation ference with the movement of people and goods
on avian and pandemic influenza, which includes a within North America;
series of principles to guide collaboration. The leaders
also announced their intent to establish an avian and • Ensure that the business continuity plans of our
pandemic influenza Coordinating Body to follow up on respective governments consider the highly inter-
commitments. The development and implementation connected nature of our economies; and
of the North American Plan works in conjunction with
other trilateral mechanisms and ongoing efforts under • Strive to utilize clear and consistent messaging to
the SPP to fulfill the vision set out by the leaders. the public and international organizations that is
proactive, timely and accurate.
Chapter 1: Introduction
The North American Plan for Avian and Pandemic • Increasing transparency in disease reporting and
Influenza provides a framework for: improving surveillance; and
• The basic structure and mechanisms for trilateral • Building local capacity to identify, contain and
emergency coordination and communication; respond to an influenza pandemic.
Chapter 1: Introduction
Chapter 2:
Emergency Coordination
&
Communications
Canada, Mexico and the United States intend to coordi-
nate their emergency management activities, including
Overview of Federal Emergency
public communications. The three countries share a Management Structures
common approach based on the four pillars of emergency Canada, Mexico and the United States each have desig-
management: prevention and mitigation, preparedness, nated organizations, plans and facilities in place, consis-
response and recovery. Canada, Mexico and the United tent with their governmental structures and authorities,
States intend to work collaboratively in each of these areas to manage these activities during an outbreak of avian
to manage the threat of avian and pandemic influenza. influenza or an influenza pandemic.
• Prevention and mitigation activities are directed Canada
at minimizing the effects of an avian or pandemic
influenza, including direct outcomes (e.g., illness Emergency management responsibilities in Canada
and death) and indirect associated effects (e.g., are shared by federal, provincial and territorial govern-
economic and social impacts). The three countries ments and their partners, including individual citizens
intend to implement these activities in a series of who have a responsibility to be prepared for disasters.
steps that would be coordinated to the greatest Provincial and territorial governments have responsibil-
extent possible. ity for emergency management within their respective
jurisdictions. The federal government exercises leadership
•P
reparedness requires that national contingency at the national level relating to emergency management
plans be in place for activities associated with an responsibilities in its exclusive fields of jurisdictions and
outbreak, including surveillance, detection, con- on lands and properties under federal responsibility.
tainment and response efforts. Training and regular
joint exercises with stakeholders to practice and test
these plans are essential. Key Federal Organizations
•R
esponse activities will depend on the character- •P
ublic Safety Canada is the federal department
istics of the avian or pandemic virus (virulence, that coordinates the overall federal government’s
attack rate, groups at highest risk, patterns of trans- domestic response efforts and provides support to
mission), which cannot be known in advance. If government and key national players in responding
necessary, the three countries intend to implement to events of national significance. Within Public
activities such as animal or public health measures, Safety Canada, the Government Operations Centre
information sharing and non-pharmaceutical inter- (GOC) operates around the clock as a mechanism to
ventions (hand washing, isolation of the sick, etc.) communicate and coordinate with federal, provin-
apply them consistently and regularly, and assess cial and territorial emergency operations centers.
their efficacy to determine whether adjustments to a
• Th
e Canadian Food Inspection Agency (CFIA)
planned response are necessary.
is mandated to take the lead role in responding to
•R
ecovery activities enable the restoration of animal health emergencies and has developed many
“normal” or pre-pandemic service levels. The three detailed plans and procedures in collaboration with
countries intend to initiate these post-event activi- the Public Health Agency of Canada, WHO and
ties as soon as possible, recognizing that they may others. The CFIA is the primary agency responsible
start at different times across the continent as the for prevention, preparation and response to an
pandemic waves move through geographic areas. avian influenza outbreak, supported by Public Safe-
• Th
e Public Health Agency of Canada (PHAC) An Emergency Management Framework for Canada.
monitors the international and domestic influ- The aim of this framework document is to enable consol-
enza situation and has developed The Canadian idation of federal, provincial and territorial collaborative
Pandemic Influenza Plan for the Health Sector in work and ensure more coherent, complementary action
collaboration with provincial/territorial representa- among the different federal, provincial and territorial
tives. PHAC is the primary federal agency address- government initiatives.
ing pandemic influenza preparedness and response,
supported by Public Safety Canada and Health
Mexico
Canada.
•H
ealth Canada engages and coordinates efforts Key Organizations
among domestic and international health partners.
The department is also responsible for supporting • Th
e Ministry of Health of Mexico (MoH), as
preparedness and response efforts in First Nations the head of the National Committee for Health
on reserve and Inuit communities; ensuring regula- Security (NCHS), is the lead agency for coordinat-
tory preparedness, including accelerated approval ing national preparedness and response activities
of a pandemic influenza vaccine; and spearheading related to public health emergencies such as an
federal workplace health initiatives. influenza pandemic, supporting the development
and implementation of plans at the federal, state
• Th
e Department of Foreign Affairs and Inter- and local levels. The NCHS includes all the federal
national Trade (DFAIT) is responsible for the areas of responsibility relevant to the response to
coordination of Canada’s international response, a pandemic (civil Protection, health sector, armed
including international efforts to contain the forces, agriculture, environment, communications
spread of a pandemic virus; communicating with and transportation, law enforcement). The MoH
foreign governments and international organiza- directly carries out epidemiological surveillance
tions; and managing foreign offers of assistance. and laboratory confirmation, as well as health care
DFAIT is also responsible for providing travel services organization, regulation and provision. The
advice and responding to the consular needs of preparedness and response activities to an influenza
Canadians in distress. pandemic are stated in the National Preparedness
and Response Plan for Pandemic Influenza, first
Emergency Plans published in September 2005.
The Canadian Pandemic Influenza Plan for the Health • Emergency management of any kind in Mexico is
Sector. The aim of this guidance document is to support coordinated by the General Coordination for Civil
health sector planning at the facility, local, regional, Protection (GCCP) of the Ministry of the Interior.
provincial/territorial and federal level. It covers prevention, The GCCP distributes available resources for
preparedness and response activities including surveillance, emergency response and operates through a network
vaccine programs, use of antivirals, health services, public of municipal and state civil protection agencies. In
health measures and communications. case of an influenza pandemic, the NCHS and the
National Committee for Civil Protection will work
Notifiable Avian Influenza Hazard Specific Plan. together for addressing the threat.
This plan outlines the response to be undertaken by the
Canadian Food Inspection Agency (CFIA) when there • Since 1996, Mexico has had a strong avian influ-
is suspicion of a developing outbreak of notifiable avian enza eradication campaign led by the Ministry of
influenza (NAI) or when an outbreak occurs. Agriculture (MoA), which is the federal agency
• Th
e Department of Transportation (DOT), in In the event of an outbreak of avian influenza, each country
cooperation with other key domestic (e.g., HHS, would advise the OIE on confirmation of the isolation and
DHS and DOS) and international partners (e.g., identification of a virus described in the Terrestrial Animal
Mexico’s Secretariat of Communications and Health Code as notifiable avian influenza, and implement
Transportation), is responsible for the coordinated contingency plans to control and/or eradicate the virus from
development and implementation of transporta- domestic poultry operations.
tion-focused plans to slow the spread of an
In the event of an influenza pandemic, the IHRs provide a
avian influenza outbreak or influenza pandemic.
legal framework under which States Parties and the WHO
DOT also works with these key stakeholders on
secretariat are to work together to protect against and
preparedness, prevention, response, mitigation
control the international spread of disease while avoiding
and recovery efforts intended to sustain the U.S.
unnecessary interference with international traffic and
transportation system, as well as counterpart sys-
trade. The IHRs establish a transparent process to be
tems in partner countries. Recognizing the special
followed by the WHO and IHR States Parties in response
challenges posed by the global aviation system,
to public health emergencies of international concern.
DOT’s Federal Aviation Administration (FAA) is
Provisions in the IHRs obligate States Parties to:
particularly active in working with its domestic
partners, as well as with its Canadian and Mexican • Notify the WHO of all potential public health
counterparts, on the above efforts. emergencies of international concern that occur
within their territories;
Emergency Plans • Develop, strengthen, and maintain core capacity for
surveillance, reporting, and response; and
• The White House released the National Strategy for
Pandemic Influenza and subsequently the Imple- • Establish a national focal point as the contact
mentation Plan for the strategy. These documents point for the WHO on all IHR matters.
guide the U.S. Government’s efforts to prepare for
and respond to avian and pandemic influenza.
• The National Response Plan (NRP), administered Prior to the IHRs’ entry into force, the WHO’s 59th World Health As-
by DHS, is the core plan for managing domestic sembly in 2006 adopted a resolution that called upon WHO Member
incidents. It details the federal coordinating States to “comply immediately, on a voluntary basis, with provisions
of the International Health Regulations (2005) considered relevant to
structures and processes used during incidents of the risk posed by avian influenza and pandemic influenza.” Canada,
national significance, including the federal pan- Mexico and the United States voluntarily implemented relevant provi-
sions of the IHRs.
Each country intends to use existing emergency manage- Specifically, the authorities of Canada, Mexico and the
ment structures for decision making at the national level. United States intend to conduct trilateral or bilateral
Canada, Mexico and the United States are to review existing exercises to assess and strengthen their emergency response
emergency coordination and communication mechanisms and contingency plans. In addition, each country intends
and enhance the exchange of detailed operations plans. to design and deliver training to maximize the effectiveness
of its respective emergency response and contingency
plans. Wherever possible, training and exercises should be
Emergency Response Assistance designed to maximize stakeholder involvement.
The provisions according to which Canada, Mexico
or the United States may request emergency response
assistance of one another include:
Avian and Pandemic Influenza
Communications
• When national human or material resources are Accurate and timely information before and during an
overextended; outbreak of avian or pandemic influenza will be critical to
• When an avian or pandemic influenza event in any the successful management of the situation. The public,
of the three countries poses a potential threat to governments and their key stakeholders need appropriate
either of the other two countries; or information to make effective and timely decisions.
• When an avian or pandemic influenza outbreak This purposeful exchange of information among
requires robust coordination of the North governments, the public and stakeholders, designed to
American response in order to minimize the risk prompt appropriate action, is generally referred to as
to animal and public health, minimize damage, “risk communications.” A common understanding of
and provide the basis for long-term social and and approach to the subject of risk communications can
economic recovery. help reduce the consequences of an outbreak of disease,
including loss of life, serious illness, and social and
economic disruption.
Canada, Mexico and the United States intend to commu- • Pursue the development of risk communications
nicate effectively about avian and pandemic influenza in a strategies in relation to pandemic influenza to
cooperative and coordinated manner, as described below: help decision makers and individuals make well-
informed decisions and take appropriate actions on
• All three countries recognize that collaboration on health risk issues to help reduce mortality, morbid-
communications efforts at all stages of avian and ity and socio-economic disruption;
pandemic influenza management will minimize the
possibility of conflicting information or contradic- • Develop key messages related to avian and pandemic
tory messages; influenza for the specific use of senior officials;
• Identify opportunities to exercise pandemic influ- • Align with the WHO case definitions;
enza preparedness and response planning.
• Share regular situation reports with essential epide-
miological data, in the event of a pandemic;
Surveillance, Epidemiology And • Identify areas of technical assistance needed for
Laboratory Practices laboratory, surveillance and outbreak response;
Objectives for strengthening surveillance, epidemiology • Provide technical assistance through cross-border
and laboratory practices among the three countries projects to bolster surveillance efforts for seasonal
include the following: and pandemic influenza; and
* S hare their methods for distributing stock- The three countries recognize that issues of feasibility,
pile material, and logistics, impact, acceptability and compliance in imple-
menting public health measures are shaped by the context
* Identify distribution challenges and alterna- in which they would be implemented.
tive distribution strategies; and
To the extent possible, and in the context of local epide-
• Share best practices on the current use of, and miology, the countries intend to use the WHO phases
issues related to, stockpiles: as “triggers” to inform implementation of public health
measures. The countries intend to share information on
* S hare allocation strategies for the use of a
their planned approaches to public health measures such
pandemic influenza vaccine and antivirals, as
as the following:
developed and updated, and
• Public education (e.g. on hand washing, staying
* S hare antiviral strategies for containing an
home from work, workplace infection control);
initial focus of novel influenza virus of pan-
demic potential, as developed and updated. • The use of antivirals and vaccines;
Canada, Mexico and the United States will attempt to • Social distancing measures, including school closures
contain a novel strain of human influenza at its source, and the prohibition of community gatherings;
slow its spread to and reduce its impact in North Ameri-
ca. These efforts should allow the appropriate movement • Travel and border public health measures; and
of people and cargo across mutual land borders and • Isolation and quarantine.
ports of entry in a way to achieve the public health
objective with minimal social and economic impact. Travel and border public health measures should be
Each country should gauge the severity of the influenza compatible with the revised IHRs (2005), should be
pandemic and implement public health measures and/or tailored to the status of pandemic disease within North
community-based interventions accordingly. America and the level of public health risk associated with
cross-border movement, and should recognize the mutual
benefits of ongoing trade and economic activity.
If a novel strain of human influenza emerges outside social, economic and foreign policy consequences. Less
North America, the three countries intend to work restrictive measures could potentially provide similar
together to slow the introduction of the virus to the control benefits with fewer significant negative conse-
continent by preventing infected individuals from enter- quences. Such measures include appropriate restrictions
ing Canada, Mexico or the United States. There will also on air, land and maritime passenger travel; restrictions
be a WHO containment effort to contain the spread of on trade in animals and animal products that may carry
the virus at its source. Emphasizing a North American the influenza virus; and other similar measures.
approach, rather than individualized approaches among
Canada, Mexico and the United States, may be the Individual traveler screening for influenza-like illness and
best way to slow the spread of a novel strain of human risk of exposure to a novel strain of human influenza of
influenza into our respective countries. Strong disease all persons entering North America may help slow the
surveillance systems coupled with appropriate screening arrival of pandemic disease to the continent. However,
at all North American airports, seaports and regional such screening may not detect asymptomatic infected
perimeters may further delay the entry of a novel strain individuals, and individuals with influenza-like illness
of human influenza. may not be infected with a pandemic strain. Because some
asymptomatic travelers who are incubating influenza may
Because the specifics of how a novel strain of human become symptomatic while en route, overall screening
influenza will enter North America and how an epidemic effectiveness may be improved by adopting a layered
will actually play out are unknown, the implementation approach that includes pre-departure, en route and arrival
of a North American response must remain flexible and screening measures, with appropriate isolation and quar-
adaptable to a pandemic as it unfolds. Nevertheless, antine measures for individuals suspected of being infected
certain unifying principles regarding a North American and contacts who may have been exposed.
strategy on border protection are evident. Canada,
Mexico and the United States intend to develop coopera-
tive measures to 1) slow the entry of a novel strain of Air Travel
human influenza to North America; 2) mitigate disease,
suffering and death; 3) coordinate appropriate border Pre-Departure Measures for Flights from Affected
measures that will give due consideration to free trade; Countries to North America
and 4) mitigate impacts to the economy and the func-
tioning of our societies. Effective host-country health screening of all individuals
prior to departure may reduce the risk of infected travel-
All countries have the sovereign right to control the ers exposing fellow travelers, aircraft and vessel crews,
movement of people and goods across their borders. and others upon arrival. This is consistent with WHO
However, in the event of a widespread pandemic, highly guidance and with the newly revised IHRs (2005).
restrictive measures to control the movement of people
and goods might initially delay but would not stop the • It is expected that travelers departing for North
eventual spread of a novel strain of human influenza America from affected countries will be screened
to North America, and could have significant negative prior to departure in accordance with guidance
Chapter 5: Border Monitoring And Control Measures Associated With Pandemic Influenza 23
from WHO and the International Civil Aviation measures until WHO determines that exit screening is
Organization (ICAO). no longer effective at slowing the international spread of
pandemic disease.
• Canada, Mexico and the United States intend
to coordinate travel restrictions from affected coun-
tries with the collective understanding that many En Route Measures
factors would drive the decision to implement such
Given the short incubation period of influenza and the
restrictions, including case fatality rates, transmis-
length of some international flights, one can assume
sion characteristics of the virus and the efficacy of a
that some travelers with influenza will develop their first
source country’s exit-screening program.
symptoms during the journey. It is possible that addi-
• Canada, Mexico and the United States intend tional training of flight and cabin crews to detect and
to pursue cooperative arrangements with the manage ill travelers may decrease the risk for others on
international community to encourage voluntary board, as well as at the point of arrival in North America.
travel restrictions for non-essential travel from any When combined with pre-departure exit screening,
affected country. appropriate application of existing en route screening
measures may help detect those who have developed
signs of illness en route.
Pre-Departure Measures for Flights from North
America to Affected Countries When Disease Does • Canada, Mexico and the United States intend
Not Exist in North America to coordinate to determine best practices for the
in-flight management of ill travelers based on
Canada, Mexico and the United States intend to symptoms and existing reporting requirements.
coordinate public messaging to travelers departing North
America for affected countries. Messaging should be • All three countries intend to coordinate efforts and
consistent among the three countries and may include engage the international community and industry
information such as location of outbreaks, steps to reduce to establish protocols and minimum requirements
one’s risk of infection and public health measures that may for en route screening and reporting on flights
be performed on flights arriving from affected countries. bound for North America.
performing exit screening on departing passengers once Arrival or entry screening of passengers should serve as
community-wide outbreaks of pandemic influenza an important supplement to host country exit screening.
are prevalent within their borders. The three countries Travelers with influenza-like illness should be isolated
expect affected countries to implement exit screening and required to undergo appropriate public health-
The North American Aviation Trilateral established a common
ICAO recently adopted guidelines regarding communicable disease/ concept of operations (CONOPS) to enhance shared situational
avian influenza that include provisions for exit screening of interna- awareness and operational coordination among the three countries
tional travelers from affected areas. These guidelines can be found at on containment efforts related to pandemic influenza that involve the
http://www.icao.int/icao/en/med/guidelines.htm. North American aviation system. The CONOPS outlines common
Measures that are applied to individual travelers to determine the objectives, principles, communication mechanisms and protocols, and
likelihood of infection with a pandemic influenza virus and that may coordination requirements and processes that have been developed in
include assessment of signs/symptoms of illness and potential exposure accordance with Canadian, Mexican and U.S. national pandemic influ-
(travel and activity history). enza plans, as well as guidance from ICAO and WHO.
24 Chapter 5: Border Monitoring And Control Measures Associated With Pandemic Influenza
related diagnostic testing, while travelers who could travelers entering the North American region by
potentially have been exposed to pandemic influenza land, consistent with entry screening in the avia-
may be quarantined, as appropriate. tion and maritime environments.
Chapter 5: Border Monitoring And Control Measures Associated With Pandemic Influenza 25
Chapter 6:
Critical Infrastructure
Protection
Canada, Mexico and the United States share much of influenza, contingency plans should be developed to
their critical infrastructure. Although a pandemic threat- minimize and limit the economic consequences. The
ens the health of workers, as opposed to causing physical ability to control animal movement, eliminate infected
damage to systems, worker absenteeism could disrupt the and exposed susceptible populations and do more effec-
efficient flow of critical goods and services. For example, tive general surveillance allows authorities responsible for
critical workers sustain the flow of electricity as well animal health to respond more effectively to disease out-
as natural gas and petroleum. These critical goods and breaks and minimize the risk to the human population.
services are part of a vast, interconnected system serving
all of North America. Beyond energy and power, other
critical infrastructure and key resource (hereafter, critical
The SPP Framework
infrastructure) sectors, from manufacturing operations A collaborative North American approach emphasizing
to transport, banking systems to food delivery service, and supporting critical infrastructure planning, pre-
could also be affected. Moreover, a pandemic could paredness, response and recovery processes is fundamen-
significantly interrupt the ability of private and govern- tal to the proper functioning of these essential systems
ment-owned businesses to sustain critical infrastructure. within and across borders during a pandemic. This Plan
is intended to be consistent with the efforts undertaken
To reduce the negative effects of a pandemic on North
as part of the North American emergency management
American critical infrastructure, Canada, Mexico and
framework “to develop a common approach to critical
the United States intend to make every reasonable effort
infrastructure protection, [and] to coordinate responses
to coordinate before, during and after a pandemic; to
to cross-border incidents.”
establish a mutually supportive operating environment;
and to assist one another in improving the resiliency of Major interdependencies among Canada, Mexico and
critical infrastructure in the face of the pandemic threat. the United States include the following:
Once established, this operational framework is intended
to be applicable to critical infrastructure sectors, as well • Canada and the United States are each other’s
as to all publicly and state-owned businesses in general. largest trading partners, moving over $1.9 billion
(USD) worth of goods and services across the
Business continuity planning is recognized internation- border every day;
ally as a key method of providing for the continuous
delivery of essential services and products during disrup- • Mexico is the United States’ third-largest trading
tions and is vital to the building of resilient infrastruc- partner, with nearly $300 billion in bilateral trade
ture. All critical infrastructure sectors, and indeed all between the two countries;
enterprises, large and small, public and private, including
• Every year, the United States supplies Mexico with
government institutions, should strive to maintain
millions of gallons of water from the Colorado
critical operations during an influenza pandemic. The
three countries intend to promote business continuity
planning in their public and private sectors as a key
method of mitigating the impacts of pandemic influenza,
providing for continuous service delivery and laying the http://www.whitehouse.gov/news/releases/2006/03/20060331.html or
groundwork for rapid recovery. http://www.pm.gc.ca/eng/media.asp?id=1085
http://geo.international.gc.ca/can-am/washington/trade_and_invest-
While the potential impacts of an avian influenza ment/trade_partnership-en.asp
www.census.gov/foreign-trade/balance/c2010.html#2006 and http://
outbreak may not be on the same scale as pandemic
mexico.usembassy.gov/mexico/trade_info.html
•S
trategic Facilities (e.g., Physical Protection of The countries intend to develop mutually acceptable
Strategic Facilities) risk, vulnerability and interdependency assessment
procedures and methodologies. The countries also intend
to undertake joint and/or coordinated risk assessments.
Improving Critical An important output of these assessments would be the
Infrastructure Resiliency identifications of interdependencies, potential choke-
points and potential single-point failures within and
Sustaining interdependent critical infrastructure
across critical infrastructure sectors. Occurring within
operations demands commitment, mutual support and
individual businesses or small numbers of like businesses,
collaboration from all relevant public and private sector
single-point failures can be triggered when a component
critical infrastructure protection partners. The input of
on which a system or an operation depends fails and has
the private sector will be vital in Canada and the United
no alternate component to back it up or take its place.
States, where up to 85 percent of critical infrastructure
Any number of vulnerabilities, including those caused by
is owned and operated by the private sector. While
interdependencies and single-points of failure, may increase
businesses and local communities are at the forefront of
the probability for cascading consequences across sectors.
the response to and recovery from a pandemic, govern-
To the greatest extent possible, any joint risk, vulnerability
ments should maintain situational awareness of critical
and interdependency assessment should occur prior to a
infrastructure to identify potential problems. Where
pandemic outbreak to enhance compatibility and to share
appropriate, governments should coordinate timely
knowledge of differences in each country’s approach to criti-
national, regional and local support among appropriate
cal infrastructure protection.
public and private sector resources.
The 2003 North American Electrical Blackout: An Accidental Experi-
ment in Atmospheric Chemistry, www.atmos.umd.edu/~russ/Black-
outFinal.pdf
•P
andemic Contact Lists: The countries should
Borders develop contact lists of all appropriate key critical
The three countries are to make reasonable efforts to infrastructure public and private sector partners in
coordinate border actions to sustain critical infrastruc- order to improve coordination among all partners
ture. Borders represent a significant vulnerability to the domestically and internationally during a pandemic.
countries’ interdependent critical infrastructure sectors These lists should be updated regularly, perhaps
because where cross-border movement is restricted, sup- annually, and should also include clearly established
ply chain and personnel movements can be significantly communications roles and responsibilities.
disrupted. Thus, they may represent chokepoints that •S
hared Pandemic Risk Communications: The
may negatively affect international commerce. Given the three countries should facilitate the coordination
significant degree of North American integration, the of shared pandemic risk communications strate-
agri-food sector is particularly vulnerable to disruptions gies among all public and private sector critical
in cross-border trade, as there is significant cross-border infrastructure security partners within their own
movement in key farm inputs, intermediate agricultural countries. The need for timely, accurate, credible
products and final food products. and consistent information that is tailored to
specific audiences is extremely important and is
Impact of Disease versus Impact of described more fully in Chapter 2.
Border Disruptions •C
ollaborative Monitoring and Information
The three countries’ border actions should be well coordi- Sharing for Pandemics: The three countries
nated and communicated with critical infrastructure busi- should carry out appropriate actions for collabora-
nesses, and should be carefully managed for the health and tive monitoring and effective information sharing
safety of citizens while minimizing economic disruption for pandemics. Government officials and business
to the extent possible, given legal requirements relating to leaders cannot now effectively predict or quickly
animal health, plant health and food safety. identify the options to prevent single-point failures
or cascading consequences. Canada, Mexico and
��������������������������������������������������������
NAFTA: www.ustr.gov/Trade_Agreements/Regional/NAFTA/Sec-
the United States should explore the existing infor-
tion_Index.html
10 NAFTA: A Decade of Strengthening a Dynamic Relationship, www. mation-sharing mechanisms and develop a new
ustr.gov/assets/Trade_Agreements/Regional/NAFTA/asset_upload_ collaborative system to monitor the most critical
file606_3595.pdf
PS
Develop key messages related to avian and pandemic
E influenza for the specific use of senior officials.
October 2007 HHS
MoH, MoA
PS
Share best practices regarding risk communications and
G identify gaps in behavioral research.
September 2007 HHS
MoH
PS
Establish procedures and pathways to exchange pre-
H release information during an event. [
September 2007 HHS
MoH
PHAC
Identify areas of technical assistance needed for labora-
B tory, surveillance and outbreak response.
September 2007 HHS
MoH
PHAC
Facilitate the ability to provide personnel assistance in a
G pandemic.
September 2007 HHS
MoH, MoFA
PHAC
H Establish public health liaisons. December 2007 HHS
MoH, MoFA
PHAC
I Enhance information sharing on stockpile planning. December 2007 HHS
MoH, MoFA
PS
Develop mutually acceptable risk, vulnerability and interde- December
A pendency assessment procedures and methodologies. 2009
DHS
CISEN
PS
December DHS
B Undertake joint and/or coordinated risk assessments.
2009 CISEN
PS
Develop contact lists of all appropriate key critical infra-
C structure public and private sector partners.
June 2008 DHS
CISEN
Mexico:
• Ministry of Agriculture
• Ministry of Health
Working Groups
• Where possible, existing SPP working groups,
governmental structures or trilateral/bilateral
mechanisms will conduct the analysis and develop
policies and procedures that inform all levels
of government in their ability to deal with the
North American, cross-sectoral impacts of avian
and pandemic influenza, avoiding where possible
duplicating efforts
Administrative Support
• Administrative and logistical support for the SPP
Coordinating Body is the responsibility of each
national authority.
Frequency of Meetings
• Quarterly or as called by the chairs; in person or by
teleconference.