title: Escherichia coli O157:H7 Outbreak Associated with the Consumption of Beef and Veal Tartares in the Province of Quebec, Canada, in 2013.
abstract: OBJECTIVE
  An Escherichia coli O157:H7 outbreak occurred in 2013 that was associated with the consumption of beef and veal tartares in the province of Quebec. This report describes the results of the ensuing investigation.
  
  
  METHODS
  As the outbreak was identified, all individuals in the province of Quebec affected with the same strain of E. coli O157:H7 as defined by pulsed-field gel electrophoresis were interviewed using a standardized questionnaire. Cases reported from other provinces in Canada were interviewed by their public health authorities and the results were reported to the Quebec public health authorities. Microbiological and environmental investigations were conducted by the Sous-ministériat à la santé animale et à l'inspection des aliments du Ministère de l'Agriculture, des Pêcheries et de l'Alimentation du Québec, by the Ville de Montréal's Food Inspection Branch, and by the Canadian Food Inspection Agency at the restaurants, suppliers, and slaughterhouses identified.
  
  
  RESULTS
  In total, seven individuals in three different Canadian provinces became ill following infection with the same outbreak strain of E. coli O157:H7. Two cases were hospitalized and one had severe hemolytic uremic syndrome. No deaths were reported. Two restaurant locations serving different tartare meals including, beef, veal, salmon, tuna, and duck were identified as potential sources of the outbreak. No deficiencies at the restaurant locations were observed during inspections by food inspectors.
  
  
  CONCLUSIONS
  The risk of consuming tartare can be lowered when basic hygienic rules are followed, temperature is strictly controlled, and fresh meat is used. However, even if handling, chopping, and temperature control during storage of the meat are considered adequate, tartare is a raw product and the risk of contamination is present. Consumers should be advised that consuming this product can lead to serious illness.
authors.affiliation: 1 Ministère de la Santé et des Services Sociaux , Québec, Canada .
authors.forename: Colette
authors.initials: C
authors.lastname: Gaulin
authors.affiliation: 2 Ministère de l'Agriculture , des Pêcheries, et de l'Alimentation du Québec, Québec, Canada .
authors.forename: Danielle
authors.initials: D
authors.lastname: Ramsay
authors.affiliation: 3 Health Canada, Health Products and Food Branch , Ottawa, Ontario, Canada .
authors.forename: Angela
authors.initials: A
authors.lastname: Catford
authors.affiliation: 4 Laboratoire de Santé Publique du Québec (INSPQ) , Sainte-Anne de Bellevue, Province de Québec, Canada .|5 Département de Microbiologie, Infectiologie, et Immunologie, Université de Montréal , Montréal, Québec, Canada .|6 Institut National de Santé Publique du Québec , Montréal, Québec, Canada .
authors.forename: Sadjia
authors.initials: S
authors.lastname: Bekal
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D002417:Cattle; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology; D019453:Escherichia coli O157 / Q000302:isolation & purification*; D005506:Food Contamination / Q000032:analysis; D005511:Food Handling; D005516:Food Microbiology; D006463:Hemolytic-Uremic Syndrome / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D008461:Meat Products / Q000382:microbiology; D011792:Quebec / Q000453:epidemiology; D000069466:Red Meat / Q000382:microbiology*; D012147:Restaurants; D011795:Surveys and Questionnaires; D055815:Young Adult