Public Health Notice - Outbreak of E. coli infections linked to romaine lettuce

This update reflects three additional illnesses that have been reported in the outbreak since our last update on November 29, 2018. In Canada, there are now 27 illnesses under investigation. The Public Health Agency of Canada continues to advise residents in the affected provinces of Ontario, Quebec and New Brunswick to avoid eating romaine lettuce and salad mixes containing romaine lettuce, unless consumers can identify that the romaine lettuce being purchased did not come from an affected growing region in California outlined on the U.S. FDA’s website

Investigation summary

In Canada, as of December 6, 2018, there have been 27 confirmed cases of E. coli illness investigated in Ontario (4), Quebec (19), New Brunswick (1), and British Columbia (3). The illnesses in British Columbia were related to travel to Quebec, Ontario and the United States. Individuals became sick between mid-October and early November 2018. Nine individuals have been hospitalized, and two individuals suffered from hemolytic-uremic syndrome (HUS), which is a severe complication that can result from an E. coli infection. No deaths have been reported. Individuals who became ill are between 2 and 93 years of age. The majority of cases (52%) are male.

Most of the individuals who became sick reported eating romaine lettuce before their illnesses occurred. Individuals reported eating romaine lettuce at home, as well as in prepared salads purchased at grocery stores, or from menu items ordered at restaurants and fast food chains.

Laboratory analysis indicates that the illnesses reported in this outbreak are genetically related to illnesses reported in a previous E. coli outbreak from December 2017 that affected consumers in both Canada and the U.S. This tells us that the same strain of E. coli is causing illness in Canada and the US as was seen in 2017 and it suggests there may be a reoccurring source of contamination. Investigators are using evidence collected in both outbreaks to help identify the possible cause of the contamination in these events.

The CFIA is working with public health officials and the U.S. FDA to determine the source of the contamination in the romaine lettuce that was harvested in the Central Coast growing regions of northern and central California. As part of the food safety investigation, romaine lettuce was sampled and tested. To date, all products that have been tested have been negative for E. coli. The CFIA has advised industry not to import, distribute, sell, serve, or use romaine lettuce from the suspect areas in California identified in the U.S. FDA's investigation, and they are working to verify that these new actions are being implemented in the Canadian marketplace. 

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