TORONTO — Romaine lettuce has emerged as a possible culprit in an E. coli outbreak in southwestern Ontario while health officials have identified two more more confirmed illnesses, raising that total to 26.
Health officials in the Niagara Region say an increasingly refined set of investigations and analyses has led them to suspect romaine lettuce is the source.
“The one thing that stood out — and we were sort of suspecting this and looking for it from our previous investigations ... the romaine lettuce was the only thing that was significantly related to the ill cases,” said Doug Sider, the region’s associate medical officer of health.
The number of confirmed illnesses from E. coli 0157:H7 in the Niagara, Halton, Guelph and Waterloo regions now stands at 26, and the number of probable cases has climbed from 64 to 102.
Laboratory testing has determined that cases in the four health units have the same DNA fingerprint.
Andrew Morrison, spokesperson for the Ministry of Health and Long-Term Care, said the significant increase in probable cases is due to a change by Wellington-Dufferin-Guelph Public Health to align its definition of E. coli symptoms and diagnosis with the provinces’.
Morrison said investigators working with the Canadian Food Inspection Agency are still working to determine the exact source of the outbreak including identifying the supply chain for each affected establishment.
“Beyond the matches of the DNA fingerprint, there is no commonality,” he said. “It is bizarre and highly frustrating.”
Two restaurants, M.T. Bellies in Welland, and The Little Red Rooster in Niagara-on-the-Lake were linked to that region’s outbreak. Both restaurants closed to assist authorities with their investigations, but reopened last week.
Most of the 14 confirmed cases in Niagara Region were linked to one of the restaurants, but those that weren’t seem to point to the lettuce as well, Sider said.
“A small number weren’t linked to the restaurants although they ate common produce that we were concerned about, which has largely been a focus on romaine lettuce,” he said.
Sider said the handful of people not linked to either M.T. Bellies or The Little Red Rooster ate elsewhere, but still ate romaine lettuce.
While analysis suggests produce is the source of contamination, the two restaurants do not share a supplier, so the Canadian Food Inspection Agency will be looking back further to see if there was a common point of distribution, Sider said.
As for the outbreak itself, it appears to have subsided, he said.
“There’s no evidence that there’s an ongoing produce contamination problem, certainly here in Niagara Region,” he said.
“Whatever occurred seemed to have occurred back in the middle part of October.”
Officials in Halton are looking at the same time period, from mid- to late October, and officials in Guelph want to speak with anyone experiencing symptoms who ate at the University of Guelph campus since Oct. 21.

North Bay Harvey’s reopens 
Also today, a Harvey’s restaurant in North Bay linked to a separate E. coli outbreak suspected of sickening up to 250 people has been cleared to reopen.
The restaurant was closed Oct. 12 after officials linked it to the outbreak, which left one child in critical condition in hospital.
The North Bay Parry Sound District Health Unit says the Harvey’s will reopen to the public tomorrow.
A thorough sanitization was done, and public health officials will increase their surveillance of the restaurant once it reopens.
There are 251 people with confirmed, probable or suspected cases of E. coli 0157:H7, and of those, 50 have been confirmed.
One child remains in the Hospital for Sick Children in Toronto with a complication of E. coli — hemolytic uremic syndrome, which can cause acute and chronic kidney failure, particularly in young children.

With files from Jackson Hayes, The Hamilton Spectator