The emergency response that kicked into gear when a woman died on a crosscountry train Friday may have turned out to a false alarm.
But public health officials say it was the type of rapid reaction needed to detect and contain future SARS-like outbreaks.
Further, they said this kind of lightning-fast response to clusters of unusual illnesses is actually a sign the system is working.
"Had we had that high level of suspicion in Toronto, for example, at the beginning of SARS, they may not have had the number of cases they subsequently had,'' said Dr. Perry Kendall, British Columbia's chief medical officer of health.
"So I think it's important that this is the new normal. And I think we will have events that turn out not to be events as we try and screen for events that might be events.''
Attempts to limit the spread of dangerous diseases require early intervention, investigation and isolation of potentially contagious people. And that was the type of response mounted when authorities learned a woman had died and others were complaining of flu-like illness on a Toronto-bound Via Rail train which had stopped in the northern Ontario village of Foleyet.
The passengers from two carriages were quarantined, one woman was sent by air ambulance to hospital in Timmins, Ont., and emergency response workers in hazmat suits descended on the scene.
Across the country, public health officials linked into conference calls alerting them to the unfolding situation.
"What worked and what was great, I thought, was that within a couple of hours of this happening people across the country who have a mandate to look into this and launch surveillance and activities were all informed,'' said Kendall.
"It's a successful test of the system.''
By day's end, Ontario authorities were able to rule out an infectious diseases outbreak. It appeared the dead woman may have succumbed to a heart attack. And the woman taken to hospital tested negative there for influenza and respiratory syncytial virus, which causes flu-like symptoms.
But at the beginning of the day, all authorities knew was that a woman who had been seemingly fine the night before had died suddenly, others were sick and that the group included tourists from Australia who may have passed through Asia on their way to Canada, said Dr. David Butler-Jones, Canada's chief public health officer.
"Given that there's still H5N1 (avian influenza) and while we haven't seen much person-to-person spread, one person dying and another person requiring airlifting and a bunch of other people sick, that kind of throws up some quick flags,'' Butler-Jones said in an interview.
The events also quickly drew the attention of people outside of Canada. Public health circles in the U.S. were buzzing with the news. Senior communications staff at the U.S. Centers for Disease Control in Atlanta spotted via a Google News alert that a train had been quarantined in Canada and sent out feelers to find out what was happening.
"In our view, it's essential to scan the horizon,'' said CDC spokesperson David Daigle.
"Because if SARS taught us anything . . . it's the idea of that global village and that one country's outbreak can easily become yours.''
In light of the remote location, Ontario officials knew it would be several hours before they could get results from even the first tests, done at Timmins on specimens taken from the woman who was flown to the Northern Ontario city's hospital.
Decisions had to be made on very little evidence.
Infectious diseases specialist Dr. Michael Gardam said he felt the call to quarantine the train was the right one, given the circumstances.
"And the second you're going to quarantine and treat it seriously, the EMS people have to wear hazmat gear,'' he noted. "Once you go down that road, you really have no choice. You can't call it a half quarantine.''
The 2005 SARS outbreak has heightened global sensitivity to the threat of infectious diseases. And as SARS epicentre, Ontario's response trigger has been set to err on the side of caution.
Dr. Donald Low, one of the experts who led the SARS response and now the medical director of the Ontario Public Health Laboratories, acknowledged there is still a degree of fear among health-care workers and Emergency Measures staff in cases like this.
"On top of that, you have a system where people want to do right. They want to have learned from their past experiences. They respond and respond quickly. And sometimes you over-respond,'' Low said.
"That's just the price you pay for that kind of system.... It's the cost of doing business.''
