Monday July 28 – OICC call #2

Day 8: Monday July 28, 2014 (n=12)

An OICC call is held with investigative partners. The epi summary you prepared was distributed prior to the call (Module 2 – Epi summary). There are a total of 12 confirmed cases under investigation (SK=4, AB=3, BC=1, MB=4). Hypothesis-generation interviews or activities have identified romaine lettuce, red bell peppers, cherry tomatoes, mushrooms, hamburgers, bacon as well as strawberries to be of interest for further investigation.

The following information is shared on the call:

Provincial updates:

  • Saskatchewan (n=4):
    • SK-02 and SK-06 ate hamburgers at a Canada Day BBQ – local public health is still following up with the host of the BBQ to determine possible brands and locations of purchase.
    • SK-03 ate hamburgers (not connected to Canada Day BBQ) and cannot recall brand.
    • SK-09 ate hamburgers at daughter’s house; local public health is attempting to follow up with daughter to obtain brand information.
  • Alberta (n=3):
    • AB-04 ate hamburgers at a friend’s house, does not know brand.
    • AB-07 probably ate hamburger at a party
    • AB-12 had multiple burgers during exposure period, does not recall brand
  • British Columbia (n=1): case is a vegetarian, no hamburger exposure.
  • Manitoba (n=4): local health authorities have been unable to contact any of their cases.

Food safety update:

  • CFIA reports that they have traced back the romaine lettuce eaten by the Saskatchewan cases to a common distributor (Distributor X) that sources all of its lettuce from a single farm in Saskatchewan (Farm A). Distributor X is the sole supplier for Farm A and does not distribute outside of SK. For June and July, all of Distributor X’s lettuce was from Farm A. As none of the other cases have traveled to, or consumed food from Saskatchewan, it is unlikely that this romaine lettuce is the source of the outbreak.

Next steps:

  • CFIA would like to initiate traceback on hamburgers, but require more product details.
  • The OICC members agree that the next step should be to refine the hypotheses and gather more detailed information on exact brands of hamburgers, ground meat, as well as lettuce, from cases. Also, product details on red bell peppers, cherry tomatoes, mushrooms, bacon and strawberries should be collected.
  • Provinces agree to use a focused questionnaire on new cases and attempt to re-interview certain cases with the questionnaire (e.g., recent cases, cases that were cooperative and/or had good recall). PHAC is asked to draft the focused questionnaire and circulate it to provincial epidemiologists for review as soon as possible.