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    Public Health Notice Update - Outbreak of E. coli infections linked to various flours and flour products

    April 20, 2017

    This notice has been updated to reflect two additional cases that have been reported in the outbreak investigation. There are now 28 cases of E.coli O121 linked to various flours and flour products. The Canadian Food Inspection Agency has issued food recall warnings for various flours and flour products related to the outbreak investigation. These recall warnings were triggered by findings during the food safety investigation into this outbreak. Canadians are advised to not eat or use any recalled flour or flour products. These food recall warnings and this outbreak are a reminder that it is not safe to taste or eat raw dough or batter regardless of the type of flour used as raw flour can be contaminated with harmful bacteria such as E. coli. Follow safe flour handling practices to reduce your risk of becoming sick.

    Why you should take note?

    The Public Health Agency of Canada is collaborating with federal and provincial public health partners to investigate an outbreak of Escherichia coli, called E. coli O121 that has been linked to various flour and flour products produced by Ardent Mills. The Canadian Food Inspection Agency (CFIA) has issued food recall warnings advising Canadians of various flours and flour products under brand names Brodie, Creative Baker, Golden Temple, and Robin Hood, which were produced by Ardent Mills. These food recall warnings were triggered by CFIA findings during its food safety investigation into this outbreak.

    These food recall warnings and this outbreak are a reminder that it is not safe to taste or eat raw dough or batter, regardless of the type of flour used as raw flour can be contaminated with harmful bacteria such as E. coli.

    Canadians are advised not to use or eat any recalled flour or flour products. For additional food recall details on product brand names and lot codes, please consult CFIA's website for this investigation. Restaurants and retailers are also advised not to sell or serve any recalled products, or any items that may have been prepared or produced using recalled products.

    The investigation is ongoing and it is possible that more products linked to the outbreak investigation may be identified. The CFIA is continuing its food safety investigation which may lead to the recall of other products. If other high-risk products are recalled, the CFIA will notify the public through updated food recall warnings.

    E. coli are bacteria that live naturally in the intestines of cattle, poultry, other animals, and humans. Most E. coli are harmless to humans. However, there are many different strains of E. coli, and some varieties can cause serious illness.

    While most people made ill by E. coli experience a few days of upset stomach and then recover fully, infections can sometimes be life threatening.

    Investigation Summary

    There have been 28 cases of E. coli O121 with a matching genetic fingerprint. Canadian cases were reported in five provinces: British Columbia (12), Saskatchewan (4), Alberta (5), Ontario (1) and Newfoundland and Labrador (5). One of the 28 cases was a visitor to Canada. The illness onset dates range from November 2016 to March 2017. Seven individuals have been hospitalized. These individuals have recovered or are recovering. No deaths have been reported. The average age of ill individuals is 24 years.

    During the food safety investigation, samples of Robin Hood All Purpose, Original flour were collected and did test positive for E. coli O121. Several individuals who became ill reported having contact with Robin Hood flour. The CFIA has issued food recall warnings for various flours and flours products produced by Ardent Mills that were triggered by findings during the food safety investigation into this outbreak. The investigation is ongoing and it is possible that additional products linked to the outbreak investigation may be identified.

    Who is most at risk?

    Although anyone can get an E. coli infection, pregnant women, those with compromised immune systems, young children and older adults are most at risk for developing serious complications.

    What you should do to protect your health?

    Check to see if you have any of the recalled products in your home or place of business. If you do:

    Do not use or eat recalled flour or flour products. If you have a recalled flour product in your home, secure the recalled product in a plastic bag and throw it out or return it to the store where it was purchased for a refund.
    If you have flour without its original packaging and are unsure if it is included in the food recall, throw it out just to be safe.
    Thoroughly wash any containers that were used to store the recalled product before using them again.
    If you suspect you may have used recalled flour to make baked goods or a non-baked product, such as children's play-dough, throw it out. Wash all surfaces or containers where the product may have been used or stored.
    Wash your hands with soap and warm water immediately following any contact with the recalled product.
    For general use of flour, the following tips will also help reduce your risk of becoming ill:

    Do not taste raw dough, batter or any other product containing uncooked flour. Eating a small amount could make you sick.
    Bake or cook items made with raw dough or batter before eating them.
    Always use hot water and soap to wash any bowls, utensils, or surfaces that flour was used on.
    Wash your hands with soap and warm water immediately after touching flour, raw dough or batter.
    Contact your healthcare provider if you think you have become ill from eating raw dough or batter or from consuming or handling a flour product.

    Symptoms

    People infected with E. coli can have a wide range of symptoms. Some do not get sick at all, though they can still spread the infection to others. Others feel as though they have a bad case of upset stomach. Still others become seriously ill and must be hospitalized.

    The following symptoms can appear within one to ten days after contact with the bacteria:

    severe stomach cramps
    watery or bloody diarrhea
    vomiting
    nausea
    headache
    little or no fever
    Most symptoms clear up within five to ten days without needing to see a healthcare professional. However, some people who are infected with E. coli develop life-threatening symptoms, including kidney failure, seizures and stroke. While most individuals will recover completely, others may suffer permanent health effects, like kidney damage. Death can also result in extremely rare cases.

    Public Health Agency of Canada

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