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Avian influenza A(H5N1): Canada's response

How Canada protects people and animals, including livestock, from avian influenza A(H5N1), also known as bird flu or avian flu.

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Current situation

On November 13, 2024, the Public Health Agency of Canada confirmed a human case of A(H5N1) in Canada. This is the first instance of a human case of A(H5N1) that came from transmission within Canada.

Statement from the Public Health Agency of Canada: Update on avian influenza and risk to Canadians

The risk of A(H5N1) to people in Canada remains low.

A(H5N1) is primarily a disease of birds, and has infected domestic poultry and a variety of mammals. We monitor A(H5N1) in humans and animals globally, including recent cases in U.S. dairy cattle.

The U.S. Department of Agriculture has detected A(H5N1) in unpasteurized milk from dairy cattle in some areas of the U.S.

The U.S. has also confirmed human cases, with exposure to suspected infected dairy cattle and poultry. No cases of A(H5N1) have been detected in dairy cows in Canada.

Milk must be pasteurized to be sold in Canada. The milk supply in Canada is considered safe based on evidence supporting the effectiveness of pasteurization at inactivating the A(H5N1) virus.

There's no current evidence that the virus can spread among humans.

We're monitoring this rapidly evolving situation closely and taking proactive measures to protect the health of people and livestock in Canada.

We work closely with provincial and territorial public health and animal health authorities, industry stakeholders and international partners, including the U.S. government. We take a proactive approach to preparing for and responding to A(H5N1) in Canada.

Protecting the health and safety of people and animals in Canada remains a top priority. This includes being prepared for future pandemics, as well as domestic and global health events.

Ongoing federal preparation for A(H5N1) includes:

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Risk assessment

About risk assessments

We assess risks to public health in order to:

A risk assessment informs the Public Health Agency of Canada and other professionals responsible for managing public health risks. The assessment supports planning, responses and decision making to improve health outcomes for people living in Canada or Canadians abroad.

Risk of human infection

Our latest rapid risk assessment for health professionals is based on the human case reports of A(H5N1) in North America. For the general Canadian population, the risk of human infection from animals is low.

However, those with higher-level exposure to infected animals are at increased risk and should take appropriate precautions.

While there's some uncertainty in these estimates, there's no current evidence that the virus is able to spread among humans.

Technical report:

Future risk

Potential future risks were assessed in both the rapid risk assessment as well as in an analysis of future risk scenarios. These highlight that it's important to consider the evolution of avian influenza viruses. The A(H5N1) virus remains primarily an avian virus. However, the continued transmission in animals and sporadic cases in people may increase the opportunity for the virus to adapt to humans.

Monitoring and surveillance

We actively monitor human and animal outbreaks in Canada and globally through a One Health approach. This approach considers the interconnectedness of the health of humans, animals and the environment.

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Monitoring in humans

We work with partners on a surveillance approach that includes different ways of monitoring flu-like illnesses. The FluWatch program is a national surveillance system to monitor flu and flu-like illnesses across Canada. It monitors seasonal flu and aims to detect new flu viruses in humans. Data sources include:

We also conduct routine surveillance of emerging respiratory pathogens like A(H5N1) in humans. We do this by following various intelligence sources, like the Global Public Health Intelligence Network (GPHIN).

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Monitoring in animals and milk

In collaboration with stakeholders, we're enhancing animal import controls and expanding surveillance to manage the possible emergence of A(H5N1) in Canada.

We already have protection measures to ensure the safety of our food supply. In May 2024, we expanded surveillance by:

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Lab capacity and testing

Testing in humans and animals

Canada's National Microbiology Laboratory (NML) and National Centre for Foreign Animal Disease Laboratory help to establish testing capacity in most regions.

Laboratory testing for A(H5N1) by these 2 national labs includes:

Wastewater monitoring

Some infectious diseases are shed in human and animal waste (urine and stool) and can be detected in wastewater. Infected people and animals can shed viruses and bacteria into the wastewater collection system, even if they don't have symptoms.

Wastewater monitoring is a rapidly evolving tool for public health surveillance. It alerts public health officials to diseases that may be spreading in a community. It's a non-invasive, cost-effective approach to monitor levels of disease activity over time and look for unusual changes or elevated disease levels.

The NML already tests wastewater for flu and several other infectious diseases. The NML is working with academic and international partners to investigate the best techniques to use wastewater testing for A(H5N1).

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Modelling

Modelling refers to using data to create models to help predict potential disease outbreak scenarios.

Building on what we learned from COVID-19, a generic model is ready to be adapted to A(H5N1) if human-to-human transmission occurs. 

The NML is working with government departments and their modelling networks to model bird migration into Canada. They're looking at transmission among wildlife to identify where and when risk is likely to be greatest. This will help us understand the potential risk of transmission to humans. 

Guidance

We continue to actively assess risks posed by A(H5N1) to people and animals in Canada. We provide updated recommendations and advice for prevention and control of infectious diseases in humans and animals, including poultry and livestock. This guidance is based on:

It's adjusted as needed to remain relevant to the evolving situation.

These recommendations guide public health authorities, health professionals and others to manage the human and animal health issues related to A(H5N1).

Typically, we provide guidance on topics such as:

Learn more for general public:

Learn more for health professionals and industry:

Science coordination

Coordinating science and research with federal, academic and science partners is important for preparing for and responding to A(H5N1).

We coordinate expert engagement by:

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Medical readiness

Vaccination

The Public Health Agency of Canada has purchased 500,000 doses of human vaccine against avian influenza as part of our:

Securing timely access to the vaccine is intended to proactively protect individuals with an increased risk of exposure to the virus. The purchased vaccine targets avian influenza A(H5N1) clade 2.3.4.4b viruses in humans. These are the viruses currently circulating in birds and mammals in North America and which have caused some serious human infections.

Provinces and territories will be allocated a supply of approved vaccines by Health Canada for potential use in their regions. If necessary, the vaccine can be used for a public health response based on risk conditions.

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Technical vaccination guidance

Preliminary guidance from Canada's National Advisory Committee on Immunization is available. Provinces and territories can consider it when deciding if, when and how to use this vaccine in a non-pandemic context. Vaccination will protect people who may be at increased risk of being exposed to the virus through animals infected with avian influenza.

Rapid response: Preliminary guidance on human vaccination against avian influenza in a non-pandemic context as of December 2024

Antiviral treatment

Antiviral treatment helps the body fight off harmful viruses. These drugs can ease symptoms and shorten the length of a viral infection.

The provincial and territorial National Antiviral Stockpile and the federal National Emergency Strategic Stockpile (NESS) hold supplies of the antivirals oseltamivir and zanamivir.

The NESS maintains enough stock to provide antiviral medication to 2.5% of the population in Canada. This supply would provide surge capacity when provinces and territories have exhausted their own National Antiviral Stockpile supply.

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Related links

For health professionals and industry

Guidance

Reporting

Surveillance

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