A food safety investigation by the Canadian Food Inspection Agency (CFIA) is ongoing, meaning it is possible for more to come.
The recalled products and flour investigation have been cited by the Public Health Agency of Canada (PHAC) side-by-side with notes on an outbreak of illness, with people being hit by a harmful E. Coli strain starting in November 2016. The last cases of illness date to the end of February 2017.
In all, 26 people (25 Canadians and one visitor) are confirmed with the same E. coli 0121 bacteria, carrying genetically matching bacteria in their systems, including five Newfoundlanders and Labradorians.
No one here remains in hospital and there have been no deaths associated with the outbreak.
Local cases
The province’s chief medical officer, Dr. David Allison, said people in this province should heed CFIA notices on recalled products, including the newly recalled flour products.
“It is a threat,” he said of E. coli 0121.
E. coli strains can be harmless to humans, but there are varieties — including 0121 — that can make people sick. For most people, it is a few days of stomach sickness before full recovery. In other cases, it can lead to stroke or permanent kidney damage, or be life-threatening.
It can be a week or more before symptoms appear, such as cramping, vomiting, nausea, severe headache and/or bloody or watery diarrhea. Fever is not typical.
Health professionals identified cases here, and their work led to the link to the national outbreak, through frontline care and laboratory work, Allison said.
“If somebody presents with bloody diarrhea and the physician or the emergency room puts it together and says this looks suspicious, they take a specimen, it gets cultured at the public-health lab,” he said.
The specimen is a stool sample. The lab is under Eastern Health, located at the Miller Centre in St. John’s.
“There’s a toxin. It’s called shiga toxin. If that’s identified, then that raises a red flag and we make sure those specimens get confirmed in Winnipeg, at the national microbiology lab,” Allison said. “So they (in Winnipeg) have the opportunity then of comparing the laboratory specimen that we send them with specimens from other places. Every once in a while they are able to make a connection and identify the fact that we have the same bacteria circulating or causing problems as another jurisdiction, another province.”
In this province, there were five individual cases of E.coli. Allison confirmed they were not family members.
“That’s also where part of the challenge is, because each individual has to be scrutinized,” he said, explaining that when a potential foodborne illness like E. coli poisoning is confirmed, there are general questions put to patients about what they have eaten.
As additional cases appear and connections are made, matching questionnaires will be filled out throughout Canada, trying to identify the source of the illness.
The five cases in this province appeared from early December to about the first week of January. Allison said this province has been part of discussions every week or two since, to discuss the scenario and any additional information available.
He said nailing down the source is becoming more and more difficult as food is distributed with wider reach.
An updated recall
“Several individuals who became ill reported having Robin Hood flour,” the PHAC has stated.
The PHAC and CFIA investigations led to sampling of flour products.
An initial food recall was issued in late March, when Smucker Foods of Canada Corp. called for the return or destruction of 10-kilogram bags of Robin Hood original, all-purpose flour with a best before date of April 17, 2018 and the production code 6 291 548, due to possible E. coli contamination.
The recall has since been updated more than once and now includes a collection of products produced by Ardent Mills, under the Creative Baker, Brodie, Golden Temple and Robin Hood brand names.
A complete list, including the specific lot numbers, best-before dates and product codes is available online through the CFIA and will be added to this story at www.thetelegram.com.
The CFIA confirmed for The Telegram some of the recalled products were shipped to Newfoundland and Labrador.
Ardent response
In a statement on Sunday, April 16, Ardent Mills noted the flours and mixes listed in the expansions of the recall, as per April 12 and April 16 updates, were added voluntarily, based on information from the CFIA and “an abundance of caution.”
The additions were not a result of any further illness reported.
The milling of wheat into flour, as the company explained, does not contain a step to kill bacteria. Bacteria present will be killed in cooking. Contaminated flour remains a risk, though, through unintended ingestion of raw flour or, say, a bite of raw cookie dough.
Ardent Mills stated it was aware of only one illness associated with eating its recalled flour, and that individual has recovered.
An email to a company spokeswoman Wednesday received no response prior to deadline.**
Two class-action lawsuits related to the E. coli outbreak and flour recall have been filed by firms in Calgary and Edmonton.
** NOTE: Just after The Telegram's print deadline, a response to emailed questions was received from an Ardent Mills spokeswoman. The company in aware of the many recorded cases of E. coli 0121 in late 2016-early 2017, but reiterated it is aware of only one case of illness directly linked to any recalled flour.
E. coli 0121 outbreak
26 — Cases of illness reported
4 — Provinces/territories with reported illness
6 — Hospitalizations reported as a result of outbreak
0 — Deaths as a result of outbreak
8 to 79 — Age range of patients
(Source: Public Health Agency of Canada, as of Tuesday, April 18, 2017.)
E. coli 0121 outbreak: a timeline
Nov. 13, 2016 (week of) — Reported onset of an illness/collection of samples leading to a confirmed case of E. coli 0121.
Jan. 13 — Notice issued by the Public Health Agency of Canada. Reports 12 cases confirmed of E. coli with a matching genetic fingerprint. The cases are in three provinces: British Columbia (4), Saskatchewan (4) and Newfoundland and Labrador (4).
Jan. 26 — Update noting two additional cases of E. coli 0121 illness, including one in Newfoundland and Labrador, with the total now standing at 14 cases.
Feb. 2 — Two more reports, both in Alberta, bring the national total to 16.
Feb. 27 — Three more cases are reported in British Columbia and another in Alberta, bringing the total to 20 cases.
March 13 — The total is reported at 24, with four more cases in British Columbia. The source of the outbreak is still not identified.
March 28 — A food recall warning is issued through the Canadian Food Inspection Agency, seeking the return or destruction of 10-kilogram bags of Robin Hood original, all-purpose flour with a best before date of April 17, 2018 and the production code 6 291 548. The concern is E. coli 0121 contamination.
April 5 — The recall is expanded to include more products, with 26 cases now reported of matching E. coli. One of the cases was a visitor to the country. To date, six individuals had to be hospitalized, all between November 2016 and February 2017. No deaths reported.
April 13 — The recall is expanded again and now includes select flours under the Brodie, Creative Baker, Golden Temple and Robin Hood labels, produced by Ardent Mills. The country is reminded it is not safe to taste raw dough or batter as it can be contaminated with harmful bacteria.
(Source: Public Health Agency of Canada. Note: All dates cite information reported on the day.)
http://www.phac-aspc.gc.ca/phn-asp/2017/outbreak-ecoli-eng.php
RECALLED FLOURS
• Brodie — Self-raising cake and pastry; 1 kg; Production code: 6 291 548; BB: Jan. 17, 2018; UPC: 0 59000 01484 5.
• Golden Temple — Sooji Creamy Wheat; 2 kg; Production code: 6 292 548; BB: Jan. 18, 2018; UPC: 0 59000 01552 1.
• Creative Baker — All purpose; 10 kg; Production code: 6 300 SK; BB: Oct. 26, 2017; UPC: 6 28622 10180 8.
• Creative Baker — Whole Wheat; 10 kg; Production code: 6 292 SK; BB: Apr. 18, 2017; UPC: 6 28622 10131 0.
• Creative Baker — All purpose; 20 kg; Production code: 6 291 SK; BB: Oct. 17, 2017; UPC: 6 28622 10142 6.
• Robin Hood — All purpose, Original; 1 kg; Production code: 6 288 548; BB: April 14, 2018; UPC: 0 59000 01632 0.
• Robin Hood — All purpose, Original; 1 kg; Production code: 6 289 548; BB: April 15, 2018; UPC: 0 59000 01632 0.
• Robin Hood — All purpose, Original; 1 kg; Production code: 6 289 548; BB: April 16, 2018; UPC: 0 59000 01632 0.
• Robin Hood — All purpose, Original; 1 kg; Production code: 6 291 548; BB: April 17, 2018; UPC: 0 59000 01632 0.
• Robin Hood — All purpose, Original; 10 kg; Production code: 6 288 548; BB: April 14, 2018; UPC: 0 59000 01652 8.
• Robin Hood — All purpose, Original; 10 kg; Production code: 6 289 548; BB: April 15, 2018; UPC: 0 59000 01652 8.
• Robin Hood — All purpose, Original; 10 kg; Production code: 6 292 548; BB: April 18, 2018; UPC: 0 59000 01652 8.
• Robin Hood — Best for Blending; 2.5 kg; Production code: 6 307 548; BB: Feb. 2, 2018; UPC: 0 59000 01534 7.
• Robin Hood — Best for Blending; 2.5 kg; Production code: 6 308 548; BB: Feb. 3, 2018; UPC: 0 59000 01534 7.
• Robin Hood — All purpose, Unbleached; 5 kg; Production code: 6 300 548; BB April 26, 2018; UPC: 0 59000 01685 6.
• Robin Hood — All purpose, Original; 5 kg; Production code: 6 300 548; BB April 26, 2018; UPC: 0 59000 01654 2.
• Robin Hood — Bread and Roll Mix Homestyle White; 1.36 kg; Production code: 6 300 548; BB Aug. 26, 2017; UPC: 0 59000 00238 5.
• Robin Hood — Best for Blending; 2.5 kg; Production code: 6 298 548; BB Jan. 24, 2018; UPC: 0 59000 01534 7.
• Robin Hood — Best for Blending; 2.5 kg; Production code: 6 299 548; BB Jan. 25, 2018; UPC: 0 59000 01534 7.
• Robin Hood — All purpose, Unbleached; 5 kg; Production code: 6 299 548; BB April 25, 2018; UPC: 0 59000 01685 6.
• Robin Hood — Best for Bread, Homestyle White; 5 kg; Production code: 6 299 548; BB April 25, 2018; UPC: 0 59000 01519 4.
• Robin Hood — Bread and Roll Mix Homestyle White; 1.36 kg; Production code: 6 299 548; BB Aug. 25, 2017; UPC: 0 59000 00238 5.
• Robin Hood — All purpose, Original; 5 kg; Production code: 6 301 548; BB April 27, 2018; UPC: 0 59000 01654 2.
• Robin Hood — All purpose, Unbleached; 5 kg; Production code: 6 301 548; BB April 27, 2018; UPC: 0 59000 01685 6.
• Robin Hood — All purpose, Original; 10 kg; Production code: 6 302 548; BB April 28, 2018; UPC: 0 59000 01652 8.
• Robin Hood — All purpose, Original; 5 kg; Production code: 6 302 548; BB April 28, 2018; UPC: 0 59000 01654 2.
• Robin Hood — All purpose, Unbleached; 5 kg; Production code: 6 303 548; BB April 28, 2018; UPC: 0 59000 01685 6.
• Robin Hood — All purpose, Unbleached; 5 kg; Production code: 6 303 548; BB: Apr. 29, 2018; UPC: 0 59000 01685 6.
• Robin Hood — All purpose, Original; 10 kg; Production code: 6 291 548; BB April 17, 2018; UPC: 0 59000 01652 8.
