E. coli outbreaks used to mainly be linked to hamburgers, but the last decade has seen recall after recall of tainted romaine lettuce coming into Canada from the United States. At least seven people have died, and hundreds have been sickened or hospitalized in both countries.
Toddler Lucas Parker was one of them.
In the fall of 2018, his parents, Nathan Parker and Karla Terry of Richmond, B.C., took Lucas and his siblings to Disneyland, their first trip outside Canada. But what they couldn’t know at the time was that a few bites of romaine salad Lucas ate one night at a small California roadside restaurant would change their lives forever.
Soon after that dinner, an outbreak of E. coli O157: H7 contamination spread across both Canada and the United States — eventually leaving 35 people hospitalized.
Like most people who get sick from this strain of E. coli, Lucas, then two years old, didn’t show symptoms right away. When he started feeling unwell, the family headed out for the long drive home. By the time he was in a Canadian hospital, the E. coli had shut down one of his kidneys and led to two brain injuries. There are no current treatments for E. coli that can help alleviate infections or prevent complications.
Lucas can no longer walk, talk or see.
“Lucas was just a beaming ray of light … he was a caring person … a cheeky boy, a loving brother,” said his father, Nathan Parker. “I remember him in the hospital waking up out of a coma and looking around, just lost, not talking, not walking, not moving much. Such a brain injury that his brain was so swollen that there was no comfort, there was nothing. It was just hell.”
‘Most devastatingly injured human’
Bill Marler, an American lawyer and food-safety advocate who has been fighting for food safety for almost 30 years, represents Lucas and his parents. Marler has filed suit on behalf of the family against the restaurant where they ate, as well as the farm and suppliers of the lettuce; the case is currently in the discovery phase in a court system slowed down because of the COVID-19 pandemic.
Lucas, “is the most devastatingly injured human who has survived a food-borne illness outbreak — ever,” said Marler. “The fact that he survived at all and his parents care for him as gently and as caringly as they do is a testament to them.”
Food-safety advocate and lawyer Bill Marler. (David MacIntosh/CBC)
Between 2009 and 2018, the U.S. Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) say they identified 40 food-borne outbreaks of infections from this strain of E. coli in the U.S. with a confirmed or suspected link to leafy greens.
Marler says he believes cows — and a society that values convenient, bagged lettuce — are to blame.
WATCH | The full Marketplace investigation:
Canada has been hit by a number of romaine lettuce recalls. We set out to the U.S., where the majority of our leafy greens come from, to dig up why E. coli outbreaks continue to plague our food supply. We meet one B.C. family whose lives have been forever changed by a contaminated salad. 12:51
Proximity of cattle
The vast majority of the romaine eaten in North America comes from lettuce grown in areas of California such as the Salinas Valley, or Yuma, Ariz. Many of those romaine lettuce fields have cattle nearby.
“We all know where E. coli O157: H7 comes from — it comes from cows,” said Marler. “And when you have a 100,000-cow feedlot, a dirt road, a canal and then leafy greens for as far as the eyes can see … it doesn’t take a rocket scientist to figure out what happened.”
While the FDA hasn’t made new rules for lettuce growers, it has called on produce growers to prevent contamination by increasing buffer zones with nearby cattle, and to use other suggested strategies included in its 2020 Leafy Green STEC Action Plan, such as assessing risk to water sources and developing stronger traceability records.
John Boelts, a Yuma, Ariz.-based lettuce farmer, says food-borne illness outbreaks are not only extremely rare, but farmers like him are already doing more than what the FDA requires to keep the food supply safe.
“Farmers’ practices are remarkable these days, not just mine but everybody in my business,” Boelts said. “I think we’re doing everything humanly possible today.”
Like many lettuce farmers, Boelts does independent testing of the irrigation water surrounding his fields, and makes sure that irrigation water never touches the edible parts of his crops.
Boelts says he’s also taken steps to keep animals away, but he doesn’t believe having a cow feedlot nearby his fields is an issue.
“That feedlot has been around since the 1930s, 1940s and we’ve been producing leafy greens in this area for about that length of time,” Boelts said. “If there really was an issue we would be having an issue more frequently.”
Marler argues that convenient bagged salads have helped the spread of contaminated lettuce. One head of E. coli-contaminated lettuce can be cut, processed, mixed with other lettuce, and then cross-contaminate many different packages of bagged salads.
“The E. coli outbreaks linked to romaine lettuce and other leafy greens blew up in the last decade and a half because we wanted bagged salads,” he said. “We wanted to be able to go to the grocery store, restaurants wanted to be able to not have someone in the back chopping up lettuce, they just wanted to open a bag and dump it in your salad bowl and good to go…. It’s industrialized agriculture, convenience, and it’s killing us.”
Lawrence Goodridge, a professor of food safety at the University of Guelph in Ontario, agrees that the majority of E. coli lettuce outbreaks occur with bagged salads. He says that while E. coli outbreaks are actually quite rare, there are things that consumers should be doing, starting with avoiding prepackaged salads.
“To reduce the risk of developing a food-borne illness, consumers should purchase whole heads of lettuce and then remove the outer leaves,” Goodridge said. Consumers should also wash the inner leaves thoroughly. While buying head lettuce and washing it thoroughly won’t eliminate the risk of E. coli, Goodridge says it can help mitigate it.
The Canadian Food Inspection Agency (CFIA) says it can use a number of measures to assess if romaine lettuce imported from the United States is safe to eat for Canadians. The CFIA took steps to improve safety for Canadians last fall; importers had to show their lettuce was either free of E. coli or did not come from California’s Salinas Valley. Those measures never targeted lettuce from Yuma, Ariz., and have now since expired. The CFIA says it will reassess its rules later this year.
In Marler’s view, outbreaks will continue to happen if the source of the contamination isn’t addressed.
“These outbreaks will keep happening in Canada as well as the U.S. unless we deal with the environmental contamination caused by growing lettuce in close proximity to cattle,” he said.
Lucas Parker is now nearly five years old. He can no longer walk, talk or see. (David MacIntosh/CBC)
Lucas Parker is now almost five years old. All his meals are liquified and ingested through a tube in his stomach.
“I ordered a salad. I thought I was doing the right thing, you know?” said Lucas’s father. “And because of a breakdown somewhere else it turned out to be the most fatal mistake in the world.”
He thinks not enough people know about the potential dangers of E. coli-contaminated romaine lettuce.
“I want people to be made aware that anything, you know, should never be taken for granted — because you could eat something that can just take your life away, take your joy away.”
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The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
