Romaine makes more Canadians ill while government says it will not be easy

Canada on Friday revealed the difficulty faced by health officials in finding the source of a persistent outbreak of E. coli. ColiO157: H7 in North America. They also reported more diseases in Canada.

Sick people say they have already eaten romaine lettuce before their illness occurs, reports the Public Health Agency of Canada. Individuals reported eating Romaine lettuce at home, as well as prepared salads purchased in grocery stores or from menu items ordered from restaurants and fast food chains.

"In addition, it is important to remember that we are looking for a small amount of E. coli O157-contaminated lettuce among the high volume of healthy lettuce that we buy, serve and consume on a daily basis in Canada." Public Health Agency of Canada reported.

He indicates that since April 1, 2017, the Canadian Food Inspection Agency has analyzed more than 2,000 samples of imported vegetables and salads, including romaine lettuce and prepackaged salads containing lettuce. as part of its regular microbiological surveillance program.

Canadian officials believe that since there is no positive result at this level of testing, it is likely that the level of contamination will be low.

At the beginning of the week, exposure in Canada had 18 confirmed cases limited to the provinces of Ontario and Quebec.

Canadian officials said Friday that as of November 23, 22 confirmed cases of E. coli disease had been investigated in Ontario (4), Quebec (17) and New Brunswick (1).

Thirty-two laboratory-confirmed diseases from the same outbreak of E. Coli O157: H7 have been reported in 11 US states. Of the 26 US patients for whom information is available, 13 were hospitalized. A person has developed hemolytic uremic syndrome, a type of kidney failure. No deaths have been reported in both countries.

In the United States, on November 19, the Federal Center for Disease Control and Protection (CDC) said that consumers, restaurants and retailers should not eat, serve or sell romaine lettuce until federal inspectors of food safety are aware of this outbreak.

The Public Health Agency of Canada stated, "As the risk is ongoing, she is advising Ontarians, Quebec and New Brunswick to avoid eating romaine lettuce and salad mixes containing romaine lettuce until more is known about the outbreak and the cause of the contamination. Residents of affected provinces are also encouraged to dispose of romaine lettuce at home and to properly wash and disinfect containers or bins that have been in contact with romaine lettuce. "

Epidemiological evidence from the United States and Canada indicates that romaine lettuce is a likely source of all 54 diseases of the international epidemic.

The current outbreak appears to be continuing as Romaine lettuce-related diseases continue to be reported, Canadian officials said. "These recent diseases indicate that contaminated romaine lettuce may still be on the market, including in restaurants, grocery stores and all food establishments. At the present time, evidence from Ontario, Quebec and New Brunswick suggests that there is a risk of E. coli infections associated with consumption of romaine lettuce .

People with this outbreak were infected with E. coli bacteria with the same DNA fingerprint as the E strain. Isolated coli of sick people during an outbreak in 2017 related to leafy greenery in the United States and romaine lettuce in Canada.

This latest outbreak is not linked to another multi-state outbreak of E. coli O157: H7 infection earlier this year, which was also linked to romaine lettuce, according to US officials. The epidemic, declared in late June, sickened 210 people in 36 states. Five people died

In Canada, based on the findings of the investigation to date, exposure to romaine lettuce has been identified as being the source of the current outbreak, but the cause of contamination n & # 39; It has not been determined, officials said.

Laboratory analyzes indicate that the diseases reported in this outbreak are genetically related to diseases reported during a previous outbreak of E. coli infection that occurred in December 2017 and that affected consumers in Canada and Canada. United States.

This confirms that the same strain of E. Coli is responsible for the disease in Canada and the United States that we saw in 2017 and it is possible that there is a source of recurring contamination. Investigators use the evidence collected during both outbreaks to help identify the possible cause of the disease at these events.

Those confirmed as patients of the current outbreak became ill between mid-October and early November 2018. No deaths were reported. People who have become ill are between 5 and 93 years old. Cases are divided equally between men and women.

"We know that Canadians want to be reassured about the safety of the foods they eat and feed their families," which is why the CFIA has increased the number of samples and tests of romaine lettuce in Canada, in light of the current situation. The sampling program involves romaine lettuce from different growing regions and different harvest periods.

Transmission of E. coli

Canada explains it this way: "E. Coli are bacteria that live naturally in the intestines of cattle, poultry and other animals. Raw fruits and vegetables that have been in contact with the feces of infected animals are a common source of E. coli disease. Green leafy vegetables, such as lettuce, can be contaminated in the field by soil, water, animals or poorly composted manure.

"Lettuce can also be infected by bacteria during and after harvest, when handling, storing and transporting the product. Contamination of lettuce is also possible at the grocery store, in the refrigerator, or countertops and cutting boards by cross-contamination with harmful bacteria from raw meat, poultry or seafood. Most strains d & # 39; E. Coli are harmless to humans, but some varieties cause disease. "

sYMPTOMS

People infected with E. coli can have a wide range of symptoms. Some do not get sick at all, although they can still pass on the infection to others. Others may have the feeling of having a stomach ache. In some cases, people become seriously ill and must be hospitalized.

The following symptoms may occur between one and ten days after contact with the bacteria:

• nausea
• vomiting
• a headache
• slight fever
• severe stomach cramps
• watery or bloody diarrhea

Most symptoms disappear within five to ten days. E. coli infections are not really a treatment, aside from disease monitoring, comfort and prevention of dehydration through proper hydration and nutrition. People who develop complications may require additional treatment, such as dialysis in case of kidney failure. You must contact your health care provider if symptoms persist.

All stakeholders are on the bridge for this outbreak investigation, including the Public Health Agency of Canada, the CFIA, Health Canada, the CDC, the FDA, as well as state and provincial agencies.