Modeling transfer of Escherichia coli O157:H7 and Staphylococcus aureus during slicing of a cooked meat product.

Cross contamination is one of the most important contributing factors in foodborne illnesses originating in household environments. The objective of this research was to determine the transfer coefficients between a contaminated domestic slicing machine and a cooked meat product, during slicing. The microorganisms tested were Staphylococcus aureus (Gram positive) and Escherichia coli O157:H7 (Gram negative). The results showed that both microorganisms were able to transfer to all slices examined (20 successively sliced) and at different inoculum levels on the blade (10(8), 10(6) and 10(4)cfu/blade). The results also showed that the number of log cfu transferred per slice, during slicing, decreased logarithmically for both microorganisms at inoculum levels of 8 and 6log cfu/blade. The type of microorganism significantly influenced transfer coefficients (p<0.05) and there was an interaction between inoculum level and transfer coefficient for S. aureus (p<0.05), but not E. coli O157:H7. Finally, to describe bacterial transfer during slicing, two models (log-linear and Weibull) were fitted to concentration on slice data for both microorganisms (at 6 and 8 log cfu/blade), obtaining a good fit to data (R(2)⩾0.73).

Linking quantitative exposure assessment and risk management using the food safety objective concept: an example with Listeria monocytogenes in different cross-contamination scenarios.

A practical approach was used to achieve specified food safety objectives (FSOs) by incorporating risk assessment methodology. A series of cross-contamination scenarios at the retail level were evaluated in a spreadsheet and ranked according to their level of risk, and the degree to which they exceeded an FSO for Listeria monocytogenes (100 CFU/g) was determined. Percentiles and analyses of variance were used to identify which scenarios would be most likely not to achieve the FSO. It was also possible to incorporate into the model the effect of additional risk management interventions (e.g., hand washing method) by using "what if" scenarios analysis. The highest risk corresponded to the use of the same gloves to handle contaminated meat and then sliced ham compared with the safer method of using different gloves to handle each product. Nevertheless, in all scenarios bacterial concentrations could be higher than 10(8) CFU/g. A significant lack of knowledge regarding the transfer rates of L. monocytogenes was revealed, which provided the model with an important uncertainty component. The "what if" scenarios analysis based on the scenario representing handling food with bare hands followed by hand washing (scenario 2) revealed that the hand washing procedure had less impact than expected. This study illustrates the use of scenarios to model the most effective food processes and thus provide risk managers with appropriate information on which to base their decisions.

Risk assessment of use of cracked eggs in Canada.

In 1992, Agriculture and Agri-Food Canada (AAFC) amended its Egg Regulations to restrict movement of Canada C eggs (cracks) to federally registered processed egg stations for pasteurization. This was questioned by egg producers and some provinces on economic grounds. It was also in conflict with long-standing practices of marketing eggs in some provinces to retail stores, bakeries, restaurants and institutions or at the farm gate. In order to determine how much of a risk these eggs were to human health, AAFC requested that the Health Protection Branch (HPB) of Health Canada (HC) conduct a risk assessment. On the basis of outbreak data, the main hazard in these eggs was identified as Salmonella. Salmonellae may occasionally be present on shell eggs even after washing, and any Salmonella reaching the membranes can be transferred to an egg mixture through breaking, and will rapidly grow under improper storage conditions. A Relative Risk analysis showed that cracked eggs are 3 to 93 times more likely than uncracked shell eggs to cause outbreaks. A probability of illness of 1 in 3800 was derived from the 40 million cracked eggs produced in Canada and not pasteurized and the probable 10,500 illnesses arising from these. This was for the general population, but this would be greater for those who consume many shell eggs or would do so in an unsafe manner, or are more likely to be infected (5% of consumers who eat raw or lightly cooked eggs daily, rural communities with more opportunities for obtaining cracked eggs, and those who are immunocompromised and in institutions). Even though it is not possible to precisely determine the risk of salmonellosis through cracked eggs, this assessment indicated that there was enough of a concern that a management strategy was needed. Eight options for managing the risk were considered and ranked for acceptability by both HC and AAFC. Ideally, all cracked eggs should be broken and pasteurized, but this is impractical in certain regions of the country, and other options, such as sales to food processors operating under Good Manufacturing Practices (GMP), and at the farm gate in marked cartons and under controlled conditions, were considered to be acceptable, whereas sales to institutions and bakeries were not. This is the first fromal food-related microbiological risk assessment that HC has completed. Although this is a Canadian problem, any country producing eggs has to recognise that despite any regulations controlling the use of cracked eggs, economics will dictate that some of these will be consumed as whole eggs or egg products, and a management plan is desirable to limit hazardous practices associated with these eggs.

Costs of acute bacterial foodborne disease in Canada and the United States.

Bacterial foodborne disease is increasing in industrialized as well as developing countries. For Canada and the United States many millions of cases are believed to occur each year, based on extrapolations of survey data, human enteric isolations and reported foodborne disease cases. The economic impact of such a large number is probably in billions of dollars but the precise figure is difficult to calculate. Medical costs and lost income are easier to determine than losses to food companies, legal awards and settlements, value of lost leisure time, pain, grief, suffering and death. The evaluation of costs at the national level for Canada and the United States based on all available costs for 61 incidents showed that company losses and legal action are much higher than medical/hospitalization expenses, lost income or investigational costs. It was reckoned that on an annual basis an estimated 1 million cases of acute bacterial foodborne illness in Canada cost nearly $1.1 billion and 5.5 million cases in the United States cost nearly $7 billion. The value of deaths was a major contributor to the overall costs especially for diseases like listeriosis, salmonellosis, Vibrio infections, and haemorrhagic colitis. Salmonellosis is the economically most important disease because it affects all parts of the food system, unlike typhoid fever and botulism, which are largely controlled by public health authorities and the food industry.

Quantitative risk assessment for Escherichia coli O157:H7 in ground beef hamburgers.

Quantitative Risk Assessment (QRA) is a methodology used to organize and analyze scientific information to estimate the probability and severity of an adverse event. Applied to microbial food safety, the methodology can also help to identify those stages in the manufacture, distribution, handling, and consumption of foods that contribute to an increased risk of foodborne illness, and help focus resources and efforts to most effectively reduce the risk of foodborne pathogens. The term Process Risk Model (PRM) is introduced in this paper to describe the integration and application of QRA methodology with scenario analysis and predictive microbiology to provide an objective assessment of the hygienic characteristics of a manufacturing process. The methodology was applied to model the human health risk associated with Escherichia coli O157:H7 in ground beef hamburgers. The PRM incorporated two mathematical submodels; the first was intended to described the behaviour of the pathogen from the production of the food through processing, handling, and consumption to predict human exposure. The exposure estimate was then used as input to a dose-response model to estimate the health risk associated with consuming food from the process. Monte Carlo simulation was used to assess the effect of the uncertainty and variability in the model parameters on the predicted human health risk. The model predicted a probability of Hemolytic Uremic Syndrome of 3.7 x 10(-6) and a probability of mortality of 1.9 x 10(-7) per meal for the very young. These estimates are likely high for all hamburger meals, but may be reasonable for the home-prepared hamburgers described by this model. The efficacy of three risk mitigation strategies were evaluated by modifying the values of the predictive factors and comparing the new predicted risk. The average probability of illness was predicted to be reduced by 80% under a hypothetical mitigation strategy directed at reducing microbial growth during retail storage through a reduction in storage temperature. This strategy was predicted to be more effective than a hypothetical intervention which estimated a plausible reduction in the concentration of E. coli O157:H7 in the feces of cattle shedding the pathogen and one aimed at convincing consumers to cook hamburgers more thoroughly. The conclusions of this approach are only accurate to the extent that the model accurately represents the process. Currently, uncertainty and ignorance about the hygienic effects of the individual operations during production, processing, and handling limit the applicability of a PRM to specify HACCP criteria in a quantitative manner. However, with continuous improvement through stimulated research, a PRM should encompass all available information about the process, food, and pathogen and should be the most appropriate decision-support tool since it represents current knowledge.

A comparison study of the EF-18 agar/Hydrophobic Grid Membrane Filter (HGMF) method and the enzyme linked antibody (ELA)/HGMF method to the HPB standard method in the isolation of Salmonella.

As part of a comparative and collaborative study of rapid methods for the detection of Salmonella and the standard Health Protection Branch (HPB) method, six Federal and Provincial Laboratories compared the EF-18 agar/Hydrophobic Grid Membrane Filters (HGMF) method to the standard HPB method. Two Federal Laboratories also compared the enzyme linked antibody (ELA)/HGMF method (which is a further development of the EF-18 agar/HGMF method) to the standard method. During this study the false-negative rates ranged from 0% to 15% for the standard HPB method, from 5.88% to 43.5% for the EF-18 agar/HGMF method, and from 0% to 10.5% for the ELA/HGMF method. The EF-18 agar/HGMF method did not compare well with the standard HPB method due to the number of false-negatives. Problems with this method resulted from the inability to isolate colonies of Salmonella on the HGMF due to the small colony size, abnormal colony coloration, and overgrowth by competitors. The ELA/HGMF method, however, was shown to be comparable to the standard HPB method. The main advantages of this method are that the antibody-staining step is independent of colony coloration and carbohydrate utilization on the plating media; the ability to detect some unusual strains of Salmonella irrespective of their atypical reactions on the media; and the ELA staining can indicate the presence of Salmonella even when the HGMF is overgrown by competitors. Also, cultural confirmation can proceed simultaneously yet independently of the ELA staining procedure. The data presented here indicate that this method is worth further study.

A rapid and improved method for the detection of Vibrio parahaemolyticus and Vibrio vulnificus strains grown on hydrophobic grid membrane filters.

DNA probe-based detection methods were developed and characterized as an alternative to time-consuming and less specific conventional protocols. Digoxigenin-labeled probes were prepared by polymerase chain reaction amplification of the targeted sequences in the specific amplicons generated from genomic DNA. Specific probes with high yields were generated for the detection of the tlh gene of Vibrio parahaemolyticus and the cth gene of V. vulnificus. Colony (Southern) hybridization analyses were carried out using hydrophobic grid membrane filters (HGMFs) to allow biotype-specific differentiation of the two species. Eight strains of V. vulnificus and five strains of V. parahaemolyticus, including one standard (ATCC) strain of each biotype, were examined. Colony lysis, hybridization, and nonradioactive detection parameters were optimized for identification of the target biotypes arranged on the same HGMF and also on a conventional nylon membrane, thereby confirming the specificity of the probes and the comparative usefulness of the HGMFs. The experimental procedure presented here can be completed in 1 day. The protocol was designed specifically to identify the target Vibrio spp. and could potentially be used for the enumeration and differentiation of V. parahaemolyticus and V. vulnificus in foods.

Seafood-associated diseases and control in Canada.

Paralytic shellfish poisoning (PSP) has been documented for two centuries and control programmes have been operated for fifty years. Although some illnesses are reported almost every year, the last known death from PSP occurred in 1981. In more recent years, amnesic shellfish poisoning, ciguatera poisoning, diarrhoetic shellfish poisoning, scombroid (histamine) poisoning and tetramine poisoning have been documented. The most frequently observed of these diseases is scombroid poisoning from improperly stored fish, but PSP and ciguatera poisoning have the most serious consequences. Vibrio infections arising from naturally-contaminated shellfish are virtually unknown, and viral illnesses from polluted harvested waters are rare. Control is achieved through monitoring of waters for indicators of human pathogens. Inspection systems based on the hazard analysis and critical control point principles are being introduced into all areas of fish and shellfish harvesting. The Inspection Directorate of the Department of Fisheries and Oceans joined the new Canadian Food Inspection Agency in 1997, which co-ordinates all Federal control measures for food in Canada.

Analysis of environmental chemical residues in products of emerging aquaculture industry in Uganda as case study for Sub-Saharan Africa.

A study was conducted to analyse market-regulated heavy metals (lead, mercury and cadmium), organochlorine pesticides and total polychlorinated biphenyls (PCBs) in samples of 38 farmed fish comprising Nile tilapia (Oreochromis niloticus) (20 samples) and African catfish (Clarias gariepinus) (18 samples) from ten selected fish farms in Uganda. The goal of this case study was to understand the safety of aquaculture products from Sub-Saharan Africa. Lead was detected in all the 38 samples (maximum = 1.08 mg kg(-1) (dry weight)), mercury in 31 out of 38 samples (maximum = 0.35 mg kg(-1) (dry weight)), and cadmium in two samples (maximum = 0.03 mg kg(-1) (dry weight)). Total levels of PCBs were below the limit of detection of 0.02 mg kg(-1) (wet weight) in all the samples. Traces of 4,4'-dichloro-diphenyldichloroethylene (DDE) were detected in ten out of 38 samples (maximum = 0.01 mg kg(-1) (wet weight)) making it the most prevalent organochlorine pesticide. Other pesticides detected were: 4,4'-dichloro-diphenyl-trichloroethane (DDT) and endosulfan sulphate, which were found in one fish sample (both 0.002 mg kg(-1) (wet weight)). There was no statistically significant difference between the levels of lead and mercury in catfish and tilapia (t-test at p = 0.05). More catfish samples (eight) contained DDE as compared with tilapia (two). Cadmium, DDT and endosufan sulphate were only detected in catfish implying that catfish is more prone to contamination than tilapia. The levels of contaminants were below the US Food and Drug Administration (USFDA) action levels and European Union maximum residue limits (MRLs), indicating that such fish have the potential for export to these markets.

Epidemiology of foodborne diseases: a worldwide review.

Acute foodborne disease infections and intoxications are much more of a concern to governments and the food industry today than a few decades ago. Some of the factors that have led to this include the identification of new agents that have caused life-threatening conditions; the finding that traditional agents are being associated with foods that were of no concern previously: an increasing number of large outbreaks being reported; the impact of foodborne disease on children, the aging population and the immunocompromised; migrant populations demanding their traditional foods in the countries of settlement; the ease of worldwide shipment of fresh and frozen food; and the development of new food industries, including aquaculture. However, to meaningfully monitor increases or decreases in foodborne disease requires an effective surveillance system at the local, national and international levels. To date, resources have been limited for most countries and regions to do this, and our current knowledge is based, for the most part, on passive reporting mechanisms. Laboratory isolation data and reports of notifiable diseases have some value in observing timely changes in case numbers of some enteric diseases, but they usually do not indicate the reasons for these trends. Special epidemiological studies are useful for the area covered, but it is often questionable whether they can be extrapolated to other areas or countries. Outbreak investigations tell us that a certain set of circumstances led to illness and that another outbreak may occur under similar but not necessarily identical conditions. Control programmes have often been triggered by the conclusions from investigations of specific outbreaks. Unfortunately, the agent/ food combination leading to illness in many of the reported incidents were not predicted from existing databases, and no doubt foodborne agents will continue to surprise food control agencies in the foreseeable future. Nevertheless, data from around the world do show some common elements. Salmonella is still the most important agent causing acute foodborne disease, with Salmonella enteritidis and S. typhimurium being of most concern. Foods of animal origin, particularly, meat and eggs, were most often implicated. Desserts, ice cream and confectionery items were products also mentioned, but some of these would have egg as a raw or incompletely cooked ingredient. Incidents most frequently occurred in homes or restaurants, and the main factors contributing to outbreaks were poor temperature control in preparing, cooking and storing food. Clostridium botulinum, Salmonella and VTEC are more frequently documented in industrialized than in developing countries. ETEC, EPEC, Shigella, Vibrio cholerae and parasites are the main scourges in developing countries, but it is uncertain how many cases are attributed to food, to water or to person-to-person transmission. The apparent decrease of S. aureus and C. perfringens outbreaks in industrialized countries may be related to improved temperature control in the kitchen. An increasing number of illnesses are international in scope, with contamination in a commercial product occurring in one country and affecting persons in several other countries, or tourists being infected abroad and possibly transmitting the pathogen to others at home. For Salmonella, a rapid alert and response coordination is being encouraged through Salm-Net and other international programs. However, unless such a network is worldwide, tracking clusters of illnesses is going to fall on the countries where the first cases occur, and some of these have very limited resources for investigation and control. It was heartening to see funds recently being allocated to foodborne disease surveillance and control in several industrialized countries, but the same commitment is required by the World Health Organization for the international community.

Foodborne and Waterborne Disease in Canada - 1976 Annual Summary.

Data on foodborne disease in Canada in 1976 were compared with data for 1975. A total of 858 incidents, comprising 752 outbreaks and 106 single cases, causing illness in 5367 persons were reported for 1976. The number of outbreaks increased by 5.9% over those for 1975, but the total number of cases decreased by 24.5%. As for previous years, Staphylococcus aureus was responsible for more incidents (27) than any other agent. Other incidents were caused by Salmonella spp. (25), Clostridium perfringens (19) suspect mold and yeast (17), Bacillus spp. (10), Clostridium botulinum (4) and suspect Pseudomonas aeruginosa (4). Seven incidents of trichinosis occurred. Chemicals implicated in causing illness included metals, rancid compounds, a pesticide and solvents. The deaths of five persons were attributed to foodborne disease. About 35% of incidents and 41% of cases were associated with meat and poultry. Bakery products, vegetables, fruits and Chinese food continued to play a prominent role in the spread of foodborne disease, as in previous years. Mishandling of food took place mainly in foodservice establishments (18.9% of incidents, 52.7% of cases) or homes (10.5% of incidents, 6.8% of cases). However, mishandling by the manufacturer caused some problems, including three separate incidents involving fermented sausages. More than 60% of reported foodborne disease incidents occurred in Ontario and the number of incidents per 100,000 population was highest in Ontario and British Columbia. Narrative reports of foodborne outbreaks are presented. Relatively few illnesses resulted from consumption of, or contact with, water; a total of 9 incidents and 1476 cases occurred from ingestion of water and a further three incidents were recorded as a result of penetration of the skin by swimmers' itch parasite (many hundreds of cases) and invasion of wounds in swimmers by Vibrio parahaemolyticus .

Foodborne Disease in Canada - 1975 Annual Summary.

Data on foodborne disease in Canada in 1975 were compared with data for 1974. A total of 838 incidents, comprising 710 outbreaks and 128 single cases, and involving 7106 ill persons, was recorded for 1975. The number of outbreaks increased by 89% and single cases by 129% over those reported for 1974. As in 1974, Staphylococcus aureus was responsible for more incidents (37) than any other agent. Other incidents were caused by Salmonella (25), Clostridium perfringens (12), Clostridium botulinum (6), suspect mold and yeast (13) and suspect Streptococcus sp. (8). In both years, non-microbiological agents, mainly chemical, accounted for less than a quarter of the incidents of known etiology. Two persons were reported to have died through foodborne disease. About 41% of incidents and 50% of cases were associated with meat and poultry. Vegetables, fruits, bakery products, sandwiches and Chinese food also played a prominent role. Mishandling of food took place mainly in foodservice establishments (25% of incidents) or homes (20%). More than 60% of reported foodborne disease incidents occurred in Ontario. The number of incidents per 100,000 population was highest in the Northwest Territories (10.6), Ontario (6.4) and British Columbia (4.7). Narrative reports of five foodborne outbreaks are presented.

Foodborne and Waterborne Disease in Canada - 1978 Annual Summary.

Data on foodborne disease in Canada in 1978 are compared with data for 1977. A total of 836 incidents, comprising 642 outbreaks and 194 single cases, causing illness in 5960 persons was reported for 1978. The number of incidents and cases increased by 7.5% and 23.9%, respectively, from 1977 to 1978. Like the previous year, Salmonella spp. were responsible for more incidents (67) and cases (2171) than any other agent. Other incidents were caused by Staphylococcus aureus (31), suspect mold and yeast (17), Bacillus cereus (9), Clostridium perfringens (7), Clostridium botulinum (6), and Shigelli sonnet (1). Four incidents of trichinosis, and two each of mushroom, lupin alkaloid and paralytic shellfish poisoning occurred. One scombroid poisoning outbreak was reported. Chemicals implicated in causing illness included tin, rancid compounds and extraneous matter. The deaths of five persons were attributed to foodborne disease. About 32% of incidents and 39% of cases were associated with meat and poultry. Vegetables, fruits, bakery products and marine products were also important vehicles in causing foodborne disease. Mishandling of food took place mainly in foodservice establishments (25.6% of incidents, 56.1% of cases) and homes (12.4% of incidents, 6.4% of cases). However, mishandling by manufacturers caused some problems including salmonellosis from iced cakes made with cracked eggs and staphylococcal intoxication from ham, sausage, chicken and canned salmon. Over 54% of reported foodborne disease incidents occurred in Ontario and more than 18% in British Columbia, but the number of incidents per 100,000 population was highest in the Northwest Territories. Narrative reports of selected foodborne incidents are presented.

Foodborne and Waterborne Disease in Canada - 1979 Annual Summary.

Data on foodborne disease in Canada in 1979 are compared with data for 1978. A total of 825 incidents, comprising 650 outbreaks and 175 single cases, causing illness in 5503 persons was reported for 1979. The number of incidents and cases decreased by 1.3% and 7.7%, respectively, from 1978 to 1979. Like the previous year, Salmonella spp. were responsible for more incidents (62) and cases (1754) than any other agent. Other incidents were caused by Staphylococcus aureus (29), suspect mold and yeast (18), Bacillus cereus (16), Clostridium perfringens (11), Bacillus subtilis (1) and Hafnia alvei (1). No Clostridium botulinum cases were reported. Five incidents of trichinosis, three of paralytic shellfish poisoning, two involving insect infestation and one each of scombroid, lupin alkaloid and broom tea poisoning and an allergic reaction from beef adulterated with pork were reported. Chemicals implicated in causing illness included tin, rancid compounds, monosodium glutamate and extraneous matter. The deaths of three persons were attributed to salmonellosis and probable mushroom poisoning. About 33% of incidents and 38% of cases were associated with meat and poultry. Vegetables, fruits, bakery products and marine products were also important vehicles in causing foodborne disease. Mishandling of food took place mainly in foodservice establishments (38.9% of incidents, 59.3% of cases) and homes (13.3% of incidents, 7.0% of cases). However, mishandling by manufacturers caused some problems including salmonellosis from a cake and staphylococcal intoxication from canned fish and sausages. Over 53% of reported foodborne disease incidents occurred in Ontario and more than 18% in British Columbia, but the number of incidents per 100,000 population was highest in the Northwest Territories. Narrative reports of selected foodborne incidents are presented. Four waterborne disease outbreaks were reported in 1979 with a total of 73 cases. Lack of adequate water treatment led to the illnesses in at least three of the outbreaks.

Foodborne Disease in Canada - 1974 Annual Summary.

Data on foodborne disease in Canada in 1974 were compared with data for 1973. A total of 442 incidents, comprising 387 outbreaks and 55 single cases, and involving 4,338 ill persons was recorded for 1974. The number of outbreaks increased by 17% and single cases by 57% over that reported for 1973. As in 1973, Staphylococcus aureus was responsible for more incidents (34) than any other agent. Other incidents were caused by Salmonella (24). Bacillus cereus (5), Clostridium botulinum (4), Clostridium perfringens (3) and Trichinella spiralis (6). Paralytic shellfish poison caused illness in 43 persons. Similar to the previous year, non-microbiological agents accounted for less than a quarter of the incidents of known etiology. Nine persons were reported to have died through foodborne disease. About 36% of incidents and 31% of cases were associated with meat and poultry. Vegetables, fruits, sandwiches, and bakery products also played a significant role. Mishandling of food took place primarily in food service establishments (29% of incidents) or homes (14%). More than 50% of foodborne illnesses occurred in Ontario and Quebec; the number of incidents per 100,000 population, however, was highest in the Northwest Territories (5.3) and British Columbia (4.8).

Foodborne and Waterborne Disease in Canada - 1977 Annual Summary.

Data on foodborne disease in Canada in 1977 were compared with data for 1976. A total of 777 incidents, comprising 660 outbreaks and 117 single cases, causing illness in 4810 persons was reported for 1977. The number of incidents and cases decreased by 9.7% and 10.4%, respectively, from 1976 to 1977. Unlike previous years, Salmonella spp. were responsible for more incidents (32) and cases (763) than any other agent. Other incidents were caused by Staphylococcus aureus (23), Clostridium perfringens (14), suspect mold and yeast (13), Bacillus spp. (11), Clostridium botulinum (5), Shigella sonnei (1) and suspect Pseudomonas aeruginosa (1). Three incidents of trichinosis, and two each of mushroom and paralytic shellfish poisoning occurred. Chemicals implicated in causing illness included tin, rancid compounds and extraneous matter. The deaths of two persons were attributed to foodborne disease. About 32% of incidents and 48% of cases were associated with meat and poultry. Bakery products, vegetables, fruits and Chinese food continued to play a prominent role in the spread of foodborne disease, as in previous years. Mishandling of food took place mainly in foodservice establishments (31.0% of incidents, 60.2% of cases) and homes (15.1% of incidents, 9.2% of cases). However, mishandling by the manufacturer caused some problems, including salmonellosis from cakes made with cracked eggs and staphylococcal intoxication from cheese prepared from a contaminated starter culture. More than 61% of reported foodborne disease incidents occurred in Ontario and over 16% in British Columbia, but the number of incidents per 100,000 population was highest in Northwest Territories and the Yukon. Relatively few illnesses resulted from the ingestion of water and none through contact with water with a total of 9 incidents and 305 cases. Narrative reports of foodborne and waterborne incidents are presented.