# Wednesday, 22 October 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.

posted on Wednesday, 22 October 2008 15:26:57 (GMT Daylight Time, UTC+01:00)  #   
# Monday, 06 October 2008
                 

Ontario public health officials are trying to contact 27 people who have been exposed to tuberculosis from a passenger on a bus traveling from Toronto to Windsor this past August. The passengers are being publicly urged to contact their local health units in order to be tested for TB as a safeguard. As the TB bacteria cannot be detected for at least 3 weeks following exposure, people may not be aware that they could potentially become ill. The risk that other passengers may have been exposed is low, but it is still necessary to be tested to determine if anyone else has caught the disease.

Approximately 1600 new cases of TB are reported in Canada every year, so the risk of developing the disease is relatively low. However, it can have serious health risks, so it is important for Canadians to recognize the symptoms as well as minimize the risk of becoming infected. TB is transmitted by frequent exposure to someone that has active tuberculosis; the bacterium is spread via sneezing, singing, coughing, etc. It is not as contagious as other diseases such as influenza or the chicken pox.

Most people can be exposed to TB bacteria and not develop the disease. It is possible for the immune system to effectively kill the germs. If this doesn't happen the bacteria can remain alive in the body which is called TB infection. Someone with TB infection will show no symptoms and not fall ill; they are also at no risk of spreading the disease. TB infection occurs when the immune system cannot stop the bacteria from growing; this risk is highest within 2 years of becoming infected. Approximately 10% of people will become infected with tuberculosis within their lifetime.

The symptoms of tuberculosis in the lungs are:

• bad cough that lasts longer than 3 weeks
• pain in the chest
• feeling very weak and/or tired
• coughing up blood and/or sputum
• loss of appetite
• fever and/or night sweats

A simple skin test can determine whether or not a person has a TB infection. This is accomplished by a very small amount of non-infectious TB protein being injected under the surface of the skin; a hard swelling will develop within 48-72 hours if the person is infected. At this point the health care provider will probably recommend antibiotic treatment in order to prevent the infection from developing into TB disease. Additional tests as well as chest x-rays may be needed in order to determine whether or not TB disease is present.

For those people who have TB disease it is extremely important to be treated as soon as the disease has been determined. A course of antibiotics for a minimum of 6 months is needed in order to kill all of the TB bacteria. Finishing the course of treatment is vital in order to prevent the risk of developing a strain of the disease that will be drug resistant, which is harder as well as more expensive to treat. As well, people who do not finish the treatment also pose a risk of spreading TB to others.

People with a weakened immune system are more at risk of developing TB infection and/or disease. People who have HIV/AIDS are 50-170 times more likely to develop TB disease; therefore this population group should always be tested for TB. Conversely, people who test positive for TB infection and/or disease should also get tested for HIV in order to help the physician determine the best course of treatment. Other populations that have an increased risk for TB infection are anyone:

• who has come into close contact with someone who has or is suspected to have active TB
• with a history of active TB and/or has had an x-ray suggesting that they had TB in the past but did not receive treatment
• who is living in an Aboriginal community that has a high rate of TB infection and/or disease
•  who is living or working at a long-term care facility, correctional facility
• who has had an organ transplant and is being treated with immunity-suppressing drugs
• who has a lung disease known as silicosis
• who has chronic lung failure and requires dialysis
• who has cancer of the head and/or neck
•  who has been infected with the TB bacteria within the past 2 years
•  who has had a chest x-ray that shows signs of old TB
• who is being treated with glucocorticoids
• who is receiving treatment with tumor necrosis factor alpha inhibitors (for auto-immune disorders such as rheumatoid arthritis)
• who has any type of diabetes
• who is underweight with a body mass index of under 20
• who smokes one pack of cigarettes or more per day
• who is under five years old when first infected with the bacteria

If you suspect that you have been exposed to someone that has tuberculosis, make an appointment with your health care provider for testing. You can also visit The Lung Association website for more information regarding tuberculosis.

posted on Monday, 06 October 2008 15:40:02 (GMT Daylight Time, UTC+01:00)  #   
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