Guidance for Remote and Isolated (RI) Communities in the context of the pandemic (H1N1) 2009 outbreak

December 9, 2009

This guidance document is being provided by the Public Health Agency of Canada in consultation with the Remote and Isolated Communities Task Group (see Appendix B) of the Special Advisory Committee for H1N1 in response to the
pandemic (H1N1) 2009.

The guidance provided herein is based on current available information about this emerging disease and is subject to review and change as new information becomes available.

The Public Health Agency of Canada posts regular updates and related documents at www.phac-aspc.gc.ca.Executive Summary
Purpose
The Guidance for Remote and Isolated (RI) Communities in the context of the Pandemic (H1N1) 2009 Outbreak is intended to identify the unique challenges of remote and isolated communities in relation to public health planning, response and health service delivery during a pandemic. As a result of the challenges faced, guidelines and strategies are identified for the purposes of planning and responding to pandemic (H1N1) 2009. This document can be used by community health planners, public health departments, regional health authorities and the provinces and territories, as well as health care providers who work with remote and isolated communities.

Background on the Pandemic (H1N1) 2009 Outbreak
Pandemic (H1N1) 2009 has spread rapidly worldwide since the spring of 2009. The virus spreads mainly from person-to-person in the community setting, through droplets from coughing or sneezing or through direct and indirect contact with hands/surfaces. Current data suggests that the time from infection with H1N1 virus to the development of symptoms is on average 4 days, and a person who has untreated H1N1 can be contagious for up to one day prior to symptom onset until 7 days after illness onset. Individuals who are severely ill or immunocompromised, and children may shed virus for longer (up to 10 days for children or weeks to months for the immunocompromised)i . This being said, most cases of pandemic (H1N1) 2009 have been relatively mild. However, people living in remote and isolated communities in Canada may experience challenges with access to timely medical care in Canada and have experienced more severe disease than averageii, iii.

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