Abstract
Introduction: Prior to 1996, sporadic cases of cyclosporiasis in Canada were most often associated with foreign travel and outbreaks throughout the world were associated with contaminated drinking water. In May 1996, the North York Public Health Department was notified of three laboratory-confirmed cases of cyclosporiasis among persons who attended a luncheon at a religious institution. A ceremonial bath (mikvah) was initially identified as a possible source of exposure to contaminated water.
Methods: Guests of a luncheon were interviewed regarding food, beverage and water exposure. The institution kitchen and water sources were inspected and environmental testing was performed.
Results: Eating strawberry flan, decorated with raspberries and blueberries, was associated with developing illness (relative risk =2.13, p=0.02). There was no evidence that water exposure was associated with illness.
Discussion: This event was the index Canadian cluster of a widespread North American outbreak associated with imported Guatemalan raspberries. The local investigation highlights the role of public health departments in multijurisdictional food-borne outbreaks of emerging pathogens.
Résumé
Introduction: Avant 1996, le cyclosporiasis au Canada a été le plus souvent associé aux voyages à l’étranger. Les manifestations précédentes ailleurs ont été associées à l’eau potable contaminée. En mai 1996, le bureau de santé publique de North York a enquêté sur la première mani festation signalée au Canada du cyclosporiasis.
Méthode: Les cas ont été confirmés à une institution où une exposition commune a eu lieu pour six cas de cyclosporiasis. On a sondé les invités à un déjeuner à propos de leur exposition à la nourriture. On a examiné la cuisine et les sources d’eau; on a fait des tests environnementaux.
Résultats: La consommation d’un flan à la fraise, qui contenait des fraises, des framboises et des bleuets, a été associée à l’attaque de la maladie (risque relatif =2,13, p=0,02). Il n’y avait pas d’évidence que l’eau de l’institution était associée à la maladie.
Discussion: Pendant l’enquête, il s’est avéré que cette manifestation représentait le groupe indicateur canadien d’une manifestation nord-americaine répandue, associée aux framboises importées du Guatemala. L’enquête locale fait apparaître le rôle des services de santé publique dans les flambées d’intoxications alimentaires dues à des pathogènes émergents qui couvrent plusieurs juridictions.
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