title: Escherichia coli O157:H7 Infections Associated with Contaminated Pork Products - Alberta, Canada, July-October 2014.
abstract: During July-October 2014, an outbreak of 119 Escherichia coli O157:H7 infections in Alberta, Canada was identified through notifiable disease surveillance and investigated by local, provincial, and federal public health and food regulatory agencies. Twenty-three (19%) patients were hospitalized, six of whom developed hemolytic uremic syndrome; no deaths were reported. Informed by case interviews, seven potential food sources were identified and investigated. The majority of patients reported having consumed meals containing pork at Asian-style restaurants in multiple geographically diverse Alberta cities during their exposure period. Traceback investigations revealed a complex pork production and distribution chain entirely within Alberta. E. coli O157:H7-contaminated pork and pork production environments and mishandling of pork products were identified at all key points in the chain, including slaughter, processor, retail, and restaurant facilities. An outbreak-specific pulsed-field gel electrophoresis (PFGE) cluster pattern was found in clinical and pork E. coli O157:H7 isolates. Measures to mitigate the risk for exposure and illness included pork product recalls, destruction of pork products, temporary food facility closures, targeted interventions to mitigate improper pork-handling practices identified at implicated food facilities, and prosecution of a food facility operator. Pork should be considered a potential source in E. coli O157:H7 investigations and prevention messaging, and pork handling and cooking practices should be carefully assessed during regulatory food facility inspections.
authors.forename: Lance
authors.initials: L
authors.lastname: Honish
authors.forename: Nisha
authors.initials: N
authors.lastname: Punja
authors.forename: Sarah
authors.initials: S
authors.lastname: Nunn
authors.forename: Dale
authors.initials: D
authors.lastname: Nelson
authors.forename: Nyall
authors.initials: N
authors.lastname: Hislop
authors.forename: Garth
authors.initials: G
authors.lastname: Gosselin
authors.forename: Natisha
authors.initials: N
authors.lastname: Stashko
authors.forename: Darlene
authors.initials: D
authors.lastname: Dittrich
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000416:Alberta / Q000453:epidemiology; D000818:Animals; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D004927:Escherichia coli Infections / Q000453:epidemiology*; D019453:Escherichia coli O157 / Q000302:isolation & purification*; D005260:Female; D005516:Food Microbiology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D000069466:Red Meat / Q000382:microbiology*; D013552:Swine; D055815:Young Adult