# Wednesday, October 22, 2008
                 

A fast food restaurant has been linked to over one hundred suspected and confirmed cases of E. coli in North Bay, Ontario. Health officials have reported that the outbreak appears to have originated from a Harvey's restaurant. The particular restaurant in question was ordered to close after initial laboratory tests traced the strain of E. coli 0157:H7 to the specific location.

There are currently 158 cases of suspected E. coli; so far 35 have been confirmed. Health officials speculate that the origin of the outbreak stems from improper food handling (i.e. improperly sanitized counter surface) rather than originating from the food products, as no symptoms have occurred from patrons of other Harvey's restaurants throughout the province which would have received the same food products.  However, there are cases being reported from other parts of Ontario as the particular Harvey's location was patronized by travelers. Cases are being investigated in Toronto, Muskoka, Simcoe, Sudbury, Belleville and Trenton, as well as other neighboring communities in Northern Ontario. Currently 18 cases have been ruled out as originating from the Harvey's location.

Many Canadians still remember the E. coli outbreak that occurred in Walkerton, Ontario in May, 2000 where 2300 people became ill and 7 people died as a result of the town's water supply becoming contaminated. The Walkerton outbreak which was ultimately found to be a result of manure from a farmer’s field that was located near one of the town wells was Canada's most severe outbreak of E. coli. Canadian health authorities usually report only a few thousand cases of E. coli sickness per year for the whole country.

The term E. coli is an abbreviation for Escherichia coli and is a form of bacteria most commonly found in the intestines of humans as well as animals. There are hundreds of strains of the bacterium, with many strains being harmless to humans. However E. coli 0157:H7 is identified as the most dangerous to humans as it produces a powerful toxin that can cause severe illness. While the bacterium is mostly found in meat, it can also be found in unpasteurized milk and apple cider, as well as raw vegetables, cheese and contaminated water. Fruits and vegetables that grow close to the ground are susceptible to contamination as they can come into contact with improperly composted cattle manure that is used as a fertilizer. It can contaminate water as the bacteria that causes E. coli can be washed into creeks, rivers, etc. that may ultimately end up in sources for drinking water.

The symptoms of E. coli are generally characterized by severe abdominal cramping. This cramping occurs from merely hours after exposure, but can also take up to 10 days to show up. Diarrhea (sometimes bloody) can also occur in people who have been exposed to E. coli. It is possible for someone to have no symptoms, but still spread the bacteria to other people, who can then become quite ill. People who have suffered E. coli 0157:H7 poisoning are at a 30% higher risk of developing either high blood pressure or kidney damage, according to a Canadian study that was released in 2008. While most cases will resolve on their own within 5-10 days, a small number of cases of E. coli contamination can lead to a condition known as hemolytic uremic syndrome (HUS). This is a life-threatening condition which is treated in the intensive care units of hospitals. HUS kills approximately 3-5 % of people who contract it; it can also lead to lifelong complications for its survivors. These complications can include lifelong health issues such as blindness, paralysis as well as kidney failure.

 As E. coli can also be spread via human contact, it is also urged that people who are exhibiting symptoms do not go to their workplace so as to prevent spreading the bacteria. The bacteria is most often spread from person-to-person but can also be spread by hand-to-mouth contact. Anyone who has been infected with E. coli should not share dishes, glassware and/or cutlery with anyone else. As well, all bedding, towels, facecloths, etc. should be washed separately with hot water and bleach. Washing hands often and thoroughly will help reduce the possibility of spreading E. coli to other people, as well as not handling food products when actively sick (i.e. diarrhea). Ensure that all raw fruits and vegetables are washed thoroughly before cooking and/or cutting them; disinfect all cutting surfaces and utensils before and after as well.

If you suspect that you may have been exposed to this (or any other) E. coli outbreak it is important to contact your local health department to advise them of your situation. It is also important to receive medical care to ensure that all steps are being taken to ensure a speedy and full recovery. For more information regarding this or any other related topics, visit the Public Health Agency of Canada.

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