Links in new E. coli outbreak unclear

Eleven cases connected to single Niagara restaurant, but officials concerned about source of four other incidents

JOSH WINGROVE

The Globe and Mail - Canada

October 28, 2008

Ontario's second E. coli outbreak this month continues to grow, and although a restaurant has been pinpointed as a possible source, officials fear "something broader" could be behind it.

The 15 reported cases stem from the Niagara-on-the-Lake area. Five cases are lab-confirmed and three more strongly suspected, said Dr. Doug Sider, the associate medical officer of health in Niagara Region. The other seven cases are being tested. The first illnesses showed up late Friday.

"At this point in time, things are fairly actively expanding," Dr. Sider said. "As is quite often the case early on in these outbreaks, we're more in the investigative, detective mode rather than being able to come to conclusions."

Eleven of the people had eaten recently at the Little Red Rooster restaurant in Niagara-on-the-Lake. It's the remaining four, who hadn't eaten there, who are of special concern to Dr. Sider.

"Is there something broader going on? That is what I think we're more concerned about," he said.

The owners of the Little Red Rooster voluntarily closed it Friday and say they're co-operating with the investigation. It will remain closed until Dr. Sider's office instructs them otherwise, co-owner Mary Lynn Pullman said yesterday.

Two of the illnesses required people be admitted to a hospital, including one in British Columbia - a tourist who'd visited the Niagara region, the only out-of-province illness reported. None of the illnesses are life-threatening.

The outbreak comes on the heels of a similar one connected to a Harvey's restaurant in North Bay, Ont., about 450 kilometres north.

In that outbreak, which was first noted on Oct. 11, 217 illnesses have now been reported. All but two are in Ontario, with one each in Quebec and B.C.

None of those cases have been fatal. The most serious, a young girl who was taken to Toronto's Hospital for Sick Children in critical condition, has improved, officials said yesterday.

The numbers in North Bay are rising because of people reporting their symptoms late, rather than a number of new cases occurring, officials said.

Both the North Bay and Niagara outbreaks are of the O157:H7 E. coli strain, the same one that killed seven people in Walkerton, Ont., in 2000.

There's nothing so far to indicate Ontario's two current outbreaks are linked, but nothing is being ruled out, Dr. Sider said.

"I think it's too early for the molecular fingerprinting to say whether it's the same [sub] strain that was involved in North Bay," he said.

Dr. Sider said there are now slight delays in receiving test results from the provincial lab that analyzes E. coli samples, given the scope of the concurrent outbreaks.

"It must swamp the system," added Brett Finlay, a University of British Columbia microbiologist and E. coli expert.

"It takes a lot of detective work to sort it all out. It's much more difficult than it should seem on the surface."

The Niagara and North Bay outbreaks could possibly be connected by something such as a single food supplier, he said. He noted an announcement yesterday that an E. coli vaccine, Econiche, which he helped to develop, has been fully licensed for use in Canada. E. coli enters the food system through beef or cattle excrement; the vaccine is designed to immunize cattle against E. coli.

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