The Canadian Food Inspection Agency has determined that the same bagged lettuce from Aunt Mid's Produce Co. that has been implicated in the US outbreak was imported into Canada and distributed to institutions and food service operations in Ontario. Two Ontario residents have fallen ill as a result of infection with the same strain of E. coli O157:H7 that caused the US outbreak.
Some of the imported lettuce was served to patients in the Windsor Regional Hospital (across the river from Detroit). Eight of the patients have shown symptoms of gastrointestinal infection and are being tested for E. coli O157:H7. It's unclear whether the two confirmed Canadian cases are among the eight from the Windsor hospital.
The hospital's president complained in an interview with the Canadian Broadcasting Corporation that federal officials had been slow to warn him about the contaminated lettuce. He pointed out that the Michigan Department of Community Health issued a warning linking the outbreak in that state to Aunt Mid's lettuce on September 26th. The hospital was only alerted to the potential problem by CFIA on October 1st.
But CFIA claims that it was advised of the US outbreak by the Public Health Agency of Canada only at noon on September 30th, and proceeded immediately to investigate the distribution chain of the imported lettuce. The agency says that it alerted the hospital staff as soon as it realized that the lettuce had been supplied to Windsor Regional.
Meanwhile, Aunt Mid's continues to protest its innocence with great vigor. A notice on the company's web site, dated October 1, 2008, says that the company has "... freely and graciously extended to the various departments of the State of Michigan access to its processing facility and has provided additional product samples, for testing by those departments." The notice also states categorically that "NO AUNT MID'S PRODUCTS HAVE BEEN FOUND TO BE CONTAMINATED." Nevertheless, the results of epidemiological investigations seem to be pointing a increasingly sharper finger at this Detroit-based produce distributor.
One thing that is still unclear, at least based on the information that has been made public, is where else this lettuce might have travelled. We can't help noticing the coincidence of a cluster of eight E. coli O157:H7 illnesses under investigation in Boulder County, Colorado. Some students at the University of Colorado at Boulder are part of that outbreak, although there is no indication of campus food service operations being the source. And an unlicensed day care facility in Aurora, CO also has experienced a cluster of six illnesses due to E. coli O157:H7. One of those children – a three year old boy – died as a result of his infection.
There has been no indication, either in the media or on the Colorado Department of Health web site, that these illness clusters are related to the outbreak in Michigan, Illinois, et cetera. Perhaps the timing is coincidental.
One thing, though is certain. The longer the trace-back investigation to determine the source of the contaminated lettuce drags on, the greater the likelihood that more people will become infected – at least until the shelf life of the bagged lettuce expires.