title: Multi-Province Listeriosis Outbreak Linked to Contaminated Deli Meat Consumed Primarily in Institutional Settings, Canada, 2008.
abstract: A multi-province outbreak of listeriosis occurred in Canada from June to November 2008. Fifty-seven persons were infected with 1 of 3 similar outbreak strains defined by pulsed-field gel electrophoresis, and 24 (42%) individuals died. Forty-one (72%) of 57 individuals were residents of long-term care facilities or hospital inpatients during their exposure period. Descriptive epidemiology, product traceback, and detection of the outbreak strains of Listeria monocytogenes in food samples and the plant environment confirmed delicatessen meat manufactured by one establishment and purchased primarily by institutions was the source of the outbreak. The food safety investigation identified a plant environment conducive to the introduction and proliferation of L. monocytogenes and persistently contaminated with Listeria spp. This outbreak demonstrated the need for improved listeriosis surveillance, strict control of L. monocytogenes in establishments producing ready-to-eat foods, and advice to vulnerable populations and institutions serving these populations regarding which high-risk foods to avoid.
authors.affiliation: 1 Centre for Foodborne, Environmental, and Zoonotic Infectious Diseases , Public Health Agency of Canada, Guelph, Ontario, Canada .
authors.forename: Andrea
authors.initials: A
authors.lastname: Currie
authors.affiliation: 2 Bureau of Microbial Hazards , Health Canada, Ottawa, Ontario, Canada .
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Farber
authors.affiliation: 3 National Microbiology Laboratory , Public Health Agency of Canada, Winnipeg, Manitoba, Canada .
authors.forename: Céline
authors.initials: C
authors.lastname: Nadon
authors.affiliation: 4 Canadian Food Inspection Agency , Ottawa, Ontario, Canada .
authors.forename: Davendra
authors.initials: D
authors.lastname: Sharma
authors.affiliation: 5 Public Health Division, Ontario Ministry of Health and Long-Term Care , Toronto, Ontario, Canada .
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Whitfield
authors.affiliation: 6 Ministère de la santé et des services sociaux du Québec , Québec, Province de Québec, Canada .
authors.forename: Colette
authors.initials: C
authors.lastname: Gaulin
authors.affiliation: 7 Communicable Disease Prevention and Control Services, British Columbia Centre for Disease Control , Vancouver, British Columbia, Canada .
authors.forename: Eleni
authors.initials: E
authors.lastname: Galanis
authors.affiliation: 8 Laboratoire de santé publique du Québec , Sainte-Anne de Bellevue, Province de Québec, Canada .
authors.forename: Sadjia
authors.initials: S
authors.lastname: Bekal
authors.affiliation: 1 Centre for Foodborne, Environmental, and Zoonotic Infectious Diseases , Public Health Agency of Canada, Guelph, Ontario, Canada .
authors.forename: James
authors.initials: J
authors.lastname: Flint
authors.affiliation: 3 National Microbiology Laboratory , Public Health Agency of Canada, Winnipeg, Manitoba, Canada .
authors.forename: Lorelee
authors.initials: L
authors.lastname: Tschetter
authors.affiliation: 2 Bureau of Microbial Hazards , Health Canada, Ottawa, Ontario, Canada .
authors.forename: Franco
authors.initials: F
authors.lastname: Pagotto
authors.affiliation: 5 Public Health Division, Ontario Ministry of Health and Long-Term Care , Toronto, Ontario, Canada .
authors.forename: Brenda
authors.initials: B
authors.lastname: Lee
authors.affiliation: 4 Canadian Food Inspection Agency , Ottawa, Ontario, Canada .
authors.forename: Fred
authors.initials: F
authors.lastname: Jamieson
authors.affiliation: 5 Public Health Division, Ontario Ministry of Health and Long-Term Care , Toronto, Ontario, Canada .
authors.forename: Tina
authors.initials: T
authors.lastname: Badiani
authors.affiliation: 1 Centre for Foodborne, Environmental, and Zoonotic Infectious Diseases , Public Health Agency of Canada, Guelph, Ontario, Canada .
authors.forename: Diane
authors.initials: D
authors.lastname: MacDonald
authors.affiliation: 1 Centre for Foodborne, Environmental, and Zoonotic Infectious Diseases , Public Health Agency of Canada, Guelph, Ontario, Canada .
authors.forename: Andrea
authors.initials: A
authors.lastname: Ellis
authors.affiliation: 9 Canadian Field Epidemiology Program, Public Health Agency of Canada , Ottawa, Ontario, Canada .
authors.forename: Jennifer
authors.initials: J
authors.lastname: May-Hadford
authors.affiliation: 9 Canadian Field Epidemiology Program, Public Health Agency of Canada , Ottawa, Ontario, Canada .
authors.forename: Rachel
authors.initials: R
authors.lastname: McCormick
authors.affiliation: 1 Centre for Foodborne, Environmental, and Zoonotic Infectious Diseases , Public Health Agency of Canada, Guelph, Ontario, Canada .
authors.forename: Carmen
authors.initials: C
authors.lastname: Savelli
authors.affiliation: 5 Public Health Division, Ontario Ministry of Health and Long-Term Care , Toronto, Ontario, Canada .
authors.forename: Dean
authors.initials: D
authors.lastname: Middleton
authors.affiliation: 10 Provincial Public Health Laboratory, Ontario Ministry of Health and Long-Term Care , Toronto, Ontario, Canada .
authors.forename: Vanessa
authors.initials: V
authors.lastname: Allen
authors.affiliation: 9 Canadian Field Epidemiology Program, Public Health Agency of Canada , Ottawa, Ontario, Canada .
authors.forename: Francois-William
authors.initials: FW
authors.lastname: Tremblay
authors.affiliation: 7 Communicable Disease Prevention and Control Services, British Columbia Centre for Disease Control , Vancouver, British Columbia, Canada .
authors.forename: Laura
authors.initials: L
authors.lastname: MacDougall
authors.affiliation: 11 British Columbia Public Health Microbiology and Reference Laboratory, British Columbia Centre for Disease Control , Vancouver, British Columbia, Canada .
authors.forename: Linda
authors.initials: L
authors.lastname: Hoang
authors.affiliation: 12 Environmental Health Services, British Columbia Centre for Disease Control , Vancouver, British Columbia, Canada .
authors.forename: Sion
authors.initials: S
authors.lastname: Shyng
authors.affiliation: 13 Alberta Health , Edmonton, Alberta, Canada .
authors.forename: Doug
authors.initials: D
authors.lastname: Everett
authors.affiliation: 14 Provincial Laboratory for Public Health , Edmonton, Alberta, Canada .
authors.forename: Linda
authors.initials: L
authors.lastname: Chui
authors.affiliation: 14 Provincial Laboratory for Public Health , Edmonton, Alberta, Canada .
authors.forename: Marie
authors.initials: M
authors.lastname: Louie
authors.affiliation: 15 Saskatchewan Ministry of Health , Regina, Saskatchewan, Canada .
authors.forename: Helen
authors.initials: H
authors.lastname: Bangura
authors.affiliation: 16 Saskatchewan Disease Control Laboratory , Regina, Saskatchewan, Canada .
authors.forename: Paul N
authors.initials: PN
authors.lastname: Levett
authors.affiliation: 17 Manitoba Health , Healthy Living and Seniors, Winnipeg, Manitoba, Canada .
authors.forename: Krista
authors.initials: K
authors.lastname: Wilkinson
authors.affiliation: 18 Cadham Provincial Laboratory , Manitoba Health, Winnipeg, Manitoba, Canada .
authors.forename: John
authors.initials: J
authors.lastname: Wylie
authors.affiliation: 19 New Brunswick Enteric Reference Laboratory , Saint John, New Brunswick, Canada .
authors.forename: Janet
authors.initials: J
authors.lastname: Reid
authors.affiliation: 4 Canadian Food Inspection Agency , Ottawa, Ontario, Canada .
authors.forename: Brian
authors.initials: B
authors.lastname: Major
authors.affiliation: 4 Canadian Food Inspection Agency , Ottawa, Ontario, Canada .
authors.forename: Dave
authors.initials: D
authors.lastname: Engel
authors.affiliation: 4 Canadian Food Inspection Agency , Ottawa, Ontario, Canada .
authors.forename: Donna
authors.initials: D
authors.lastname: Douey
authors.affiliation: 4 Canadian Food Inspection Agency , Ottawa, Ontario, Canada .
authors.forename: George
authors.initials: G
authors.lastname: Huszczynski
authors.affiliation: 4 Canadian Food Inspection Agency , Ottawa, Ontario, Canada .
authors.forename: Joe
authors.initials: J
authors.lastname: Di Lecci
authors.affiliation: 4 Canadian Food Inspection Agency , Ottawa, Ontario, Canada .
authors.forename: Judy
authors.initials: J
authors.lastname: Strazds
authors.affiliation: 4 Canadian Food Inspection Agency , Ottawa, Ontario, Canada .
authors.forename: Josée
authors.initials: J
authors.lastname: Rousseau
authors.affiliation: 4 Canadian Food Inspection Agency , Ottawa, Ontario, Canada .
authors.forename: Kenneth
authors.initials: K
authors.lastname: Ma
authors.affiliation: 4 Canadian Food Inspection Agency , Ottawa, Ontario, Canada .
authors.forename: Leah
authors.initials: L
authors.lastname: Isaac
authors.affiliation: 4 Canadian Food Inspection Agency , Ottawa, Ontario, Canada .
authors.forename: Urszula
authors.initials: U
authors.lastname: Sierpinska
mesh_terms: D000328:Adult; D000368:Aged; D002170:Canada; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D005506:Food Contamination; D005516:Food Microbiology; D006801:Humans; D008089:Listeria monocytogenes / Q000302:isolation & purification*; D008088:Listeriosis / Q000453:epidemiology*; D008134:Long-Term Care; D008297:Male; D008461:Meat Products / Q000382:microbiology*; D008875:Middle Aged