Sources of Enteric Disease in Canada



The public is exposed to the risk of enteric infection via foodborne, waterborne, and airborne sources, or via direct contact by infected persons or animals. Food-borne transmission of enteric disease is the most well-known and extensively studied area. Among all foods, meat and poultry products are the largest contributor of foodborne disease outbreaks. Consumption of these products has been linked to enteric infection caused by several important human pathogens such as Escherichia coli O157:H7, Salmonella enterica Typhimurium, S. Enteritidis, Campylobacter species, and viruses. Food animals carry some of these human pathogens with no clinical symptoms. For example, E. coli O157:H7 carried by young cattle, Salmonella and Campylobacter by poultry. Carriage of human pathogens in food animals has serious health implications because it means the farm is a significant reservoir of foodborne illness agents. The ecology of the most frequently occurring human pathogens in the farm environment is reviewed here. Other important vehicles of foodborne gastroenteritis include fruit and vegetables, seafood, and dairy products. Fruit and vegetables, as raw agricultural commodities, are vulnerable to microbial contamination during production, and minimal processing further magnifies the contamination level. The opportunity for fresh produce contamination at production is discussed. Seafood-associated enteric infection is usually the result of environmental contamination and eating raw or undercooked seafood. The frequency of environmental contamination of seafood is examined. Enteric infection due to dairy foods often implicated raw milk, improper pasteurization, and post pasteurization contamination as sources of the problem. Some of the dairy product-associated outbreaks are addressed. Waterborne transmission is a second common route for spreading enteric disease. However when it happens, it usually results in a large number of people being affected. Drinking and recreational waters are two main vehicles. Important waterborne disease agents such as Cryptosporidium, Giardia, Shigella, and E. coli Ol57:H7 are reviewed. Airborne transmission of enteric infection is the least studied area. Airborne microbial contamination and the closely related occupational hazards are acknowledged. Some of the enteric disease agents can be spread through direct contact either by infected animals or humans themselves. Among agents spread by animal contact are verocytotoxigenic E. coli, predominantly E. coli O157:H7, Salmonella species including S. Typhimurium DT104, and Cryptosporidium. Enteric infection by personal contact has been documented for Norwalk virus, hepatitis A, Shigella species, E. coli O157:H7, and Cryptosporidium. The role of direct contact in disease transmission is addressed.


Enteric Disease Hemolytic Uremic Syndrome Enteric Pathogen Enteric Infection Cryptosporidium Oocyst 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Ackman, D., S. Marks, P. Mack, M. Caldwell, T. Root, and G. Birkhead. 1997. Swimming-associated haemorrhagic colitis due to Escherichia coli 0157:H7 infection: evidence of prolonged contamination of a fresh water lake. Epidemiol. Infect. 119:1-8.CrossRefGoogle Scholar
  2. Adams, A. P., and J. C. Spendlove. 1970. Coliform aerosols emitted by sewage treatment plants. Sci. 169:1218-1220.CrossRefGoogle Scholar
  3. Ahmed, F. E. 1992. Review: assessing and managing risk due to consumption of seafood contaminated with microorganisms, parasites, and natural toxins in the US. Int. J. Food Sci. Technol. 27:243-260.Google Scholar
  4. Alamanos, Y., V. Maipa, S. Levidiotou, and E. Gessouli. 2000. A community waterborne outbreak of gastro-enteritis attributed to Shigella sonnei. Epidemiol. Infect. 125:499-503.CrossRefGoogle Scholar
  5. Al-Dagal, M., and D. Y. C. Fung. 1990. Aeromicrobiology- a review. Food Sci. Nutr. 29:333-340.Google Scholar
  6. Al-Ghazali, M. R., and S. K. Al-Azawi. 1988. Effects of sewage treatment on the removal of Listeria monocytogenes. J. Appl. Bacteriol. 65:203-208.CrossRefGoogle Scholar
  7. Al-Ghazali, M. R., and S. K. Al-Azawi. 1990. Listeria monocytogenes contamination of crops grown on soil treated with sewage sludge cake. J. Appl. Bacteriol. 69:642-647.CrossRefGoogle Scholar
  8. Altekruse, S. F., M. L. Cohen, and D. L. Swerdlow. 1997. Emerging foodborne diseases. Emerg. Infect. Dis. 3:285-293.Google Scholar
  9. Baloda, S. B., L. Christensen, and S. Trajcevska. 2001. Persistence of a Salmonella enterica serovar Typhimurium DT12 clone in a piggery and in agricultural soil amended with Salmonella-contaminated slurry. Appl. Environ. Microbiol. 67:2859-2862.CrossRefGoogle Scholar
  10. Barrell, R. A. E., P. R. Hunter, G. and Nichols. 2000. Microbiological standards for water and their relationship to health risk. Commun. Dis. Public Health, 3:8-13.Google Scholar
  11. Becker, K. M., C. L. Moe, K. L. Southwick, and J. N. MacCormack. 2000. Transmission of Norwalk virus during a football game. N. Engl. J. Med. 343:1223-1227.CrossRefGoogle Scholar
  12. Bell, A., R. Guasparini, D. Meeds, R. G. Mathias, and J. D. Farley. 1993. A swimming pool associated outbreak of cryptosporidiosis in British Columbia. Can. J. Public Health, 84:334-337.Google Scholar
  13. Besser, R. E., S. M. Lett, J. T. Weber, M. P. Doyle, T. J. Barett, J. G. Wells, and P. M. Griffin. 1993.An outbreak of diarrhea and hemolytic uremic syndrome from Escherichia coli 0157:H7 in fresh-pressed apple cider. J. Am. Med. Assoc. 269:2217-2220.CrossRefGoogle Scholar
  14. Beuchat, L. R., and J-H. Ryu. 1997. Produce handling and processing practices. Emerg. Infect. Dis.3:459-465.CrossRefGoogle Scholar
  15. Beutin, L., D. Geier, H. Steinruck, S. Zimmermann, and F. Scheutz. 1993. Prevalence and some properties of verotoxin (shiga-like toxin)-producing Escherichia coli in seven different species of healthy domestic animals. J. Clin. Microbiol. 31:2483-2488.Google Scholar
  16. Bhaskar, N., and T. M.R. Setty. 1994. Incidence of vibrios of public health significance in the farming phase of tiger shrimp [Penaeus monodon). J. Sci. Food Agric. 66:225-231.CrossRefGoogle Scholar
  17. Blostein, J. 1991. Shigellosis from swimming in a park pond in Michigan. Public Health Rep.106:317-322.Google Scholar
  18. Brewster, D. H., M. I. Brown, D. Robertson, G. L. Houghton, J. Bimson, and J. C. M. Sharp. 1994.An outbreak of Escherichia coli associated with children's paddling pool. Epidemiol. Infect.112:441-447.CrossRefGoogle Scholar
  19. Bryan, F. L., and M. P. Doyle. 1995. Health risks and consequences of Salmonella and Campylobacter jejuni in raw poultry. J. Food Protect. 58:326-344.Google Scholar
  20. Cassin, M. H., A. M. Lammerding, E. C. D. Todd, W. Rose, and R. S. McColl. 1998. Quantitative risk assessment for Escherichia coli O157:H7 in ground beef hamburgers. Int. J. Food Microbiol.41:21-44.CrossRefGoogle Scholar
  21. Center for Science in the Public Interest (CSPI). 1999. Produce-related outbreaks, 1990-1999[Online]. URL: (Accessed: February 18, 2002).Google Scholar
  22. The Centers for Disease Control and Prevention (CDC). 1990. Epidemiologic notes and reports swimming-associated cryptosporidiosis-Los Angeles County. Morb. Mortal. Wkly. Rep. 39:343-345.Google Scholar
  23. CDC. 1994a. Emerging infectious disease outbreak of Salmonella Enteritidis associated with nationally distributed ice cream products-Minnesota, South Dakota, and Wisconsin, 1994. Morb.Mortal. Wkly. Rep. 43:740-741.Google Scholar
  24. CDC. 1994b. Cryptosporidium infections associated with swimming pools-Dane County, Wisconsin,1993. Morb. Mortal. Wkly. Rep. 43:561-563.Google Scholar
  25. CDC. 1996a. Outbreak of trichinellosis associated with eating cougar jerky - Idaho, 1995. Morb.Mortal. Wkly. Rep. 45:205-206.Google Scholar
  26. CDC. 1996b. Salmonellosis associated with a thanksgiving dinner-Nevada, 1995. Morb. Mortal.Wkly. Rep. 45:1016-1017.Google Scholar
  27. CDC. 1996c. Shigella sonnei outbreak associated with contaminated drinking water-Island Park,Idaho, August 1995. Morb. Mortal. Wkly. Rep. 45:229-231.Google Scholar
  28. CDC. 1996d. Lake-associated outbreak of Escherichia coli O157:H7-Illinois, 1995. Morb. Mortal.Wkly. Rep. 45:437-439.Google Scholar
  29. CDC. 1997a. Outbreak of staphylococcal food poisoning associated with precooked ham - Florida,1997. Morb. Mortal. Wkly. Rep. 46:1189-1191.Google Scholar
  30. CDC. 1997b. Viral gastroenteritis associated with eating oysters-Louisiana, December 1996-January1997. Morb. Mortal. Wkly. Rep. 46:1109-1112.Google Scholar
  31. CDC. 1998a. Outbreak of Vibrio parahaemolyticus infections associated with eating raw oysters-Pacific Northwest, 1997. Morb. Mortal. Wkly. Rep. 47:457-462. CDC.Google Scholar
  32. 1998b. Plesiomonas shigelloides and Salmonella serotype Hartford infections associated with contaminated water supply-Livingston County, New York, 1996. Morb. Mortal. Wkly. Rep.47:394-396.Google Scholar
  33. CDC. 1999a. Outbreak of Vibrio parahaemolyticus infection associated with eating raw oysters and clams harvested from Long Island Sound-Connecticut, New Jersey, and New York, 1998. Morb.Mortal. Wkly. Rep. 48:48-51.Google Scholar
  34. CDC. 1999b. Public health dispatch: outbreak of Escherichia coli O157:H7 and Campylobacter among attendees of the Washington County fair-New York, 1999. Morb. Mortal. Wkly. Rep.48:803.Google Scholar
  35. CDC. 2000. Escherichia coliO157:H7 [Online]. URL: (Accessed: March 19, 2002).Google Scholar
  36. CDC. 2001a. Preliminary FoodNet data on the incidence of foodborne illnesses-selected sites,United States, 2000. Morb. Mortal. Wkly. Rep. 50:241-246.Google Scholar
  37. CDC. 2001b. Prevalence of parasites in fecal material from chlorinated swimming pools-United States, 1999. Morb. Mortal. Wkly. Rep. 50:410-412.Google Scholar
  38. CDC. 2001c. Outbreaks of Escherichia coli/O157:H7 infections among children associated with farm visits-Pennsylvania and Washington, 2000. Morb. Mortal. Wkly. Rep. 50:293-297.Google Scholar
  39. CDC. 2001 d. Outbreaks of multidrug-resistant Salmonella Typhimurium associated with veterinary facilities-Idaho, Minnesota, and Washington, 1999. Morb. Mortal. Wkly. Rep. 50:701-704.Google Scholar
  40. CDC. 2002. Outbreak of Salmonella serotype kottbus infections associated with eating alfalfa sprouts-Arizona, California, Colorado, and New Mexico, February-April 2001. Morb. Mortal.Wkly. Rep. 51:7-9.Google Scholar
  41. Chapman, P. A., J. Cornell, and C. Green. 2000. Infection with verocytotoxin-producing Escherichia coli 0157 during a visit to an inner city open farm. Epidemiol. Infect. 125:531-536.CrossRefGoogle Scholar
  42. Chapman, P. A., C. A. Siddons, A. T. Cerdan Malo, and M. A. Harkin. 1997. A 1-year study of Escherichia coli O157:H7 in cattle, sheep, pigs, and poultry. Epidemiol. Infect. 119:245-250.CrossRefGoogle Scholar
  43. Cieslak, P. R., T. J. Barett, P. M. Griffin, K. F. Gensheimer, G. Beckett, J. Buffington, and M. G. Smith.1993. Escherichia coli O157:H7 infection from a manured garden. Lancet, 342:367.CrossRefGoogle Scholar
  44. Coia, J. E., J. C. M. Sharp, D. M. Campbell, J. Curnow, and C. N. Ramsay. 1998. Environmental risk factors for sporadic Escherichia coli O157:H7 infection in Scotland: results of a descriptive epidemiology study. J. Infect. 36:317-321.CrossRefGoogle Scholar
  45. Collins, J. E. 1997. Impact of changing consumer lifestyles on the emergence/reemergence of food-borne pathogens. Emerg. Infect. Dis. 3:471-479.CrossRefGoogle Scholar
  46. Communicable Disease Report weekly (CDR). 1993. Cryptosporidiosis. Public Health Lab. Service,3:89.Google Scholar
  47. CDR. 1994. Cryptosporidiosis associated with farm visits. Public Health Lab. Service, 4:73.Google Scholar
  48. Crampin, M., G. Willshaw, R. Hancock, T. Djuretic, C. Elstob, A. Rouse, T. Cheasty, and J. Stuart.1999. Outbreak of Escherichia coli 0157 infection associated with a music festival. Eur. J. Clin.Microbiol. Infect. Dis. 18:286-288.CrossRefGoogle Scholar
  49. Croonenberghs, R. E. 2000. Contamination of shellfish-growing area. In: R. E. Martin, E. P. Carter,G. J. Flick, Jr., and L. M. Davis (eds.). Marine & freshwater products handbook. Technomic publishing co., Inc., Lancaster, Pennsylvania. pp. 665-693.Google Scholar
  50. Cuff, W. R., R. Ahmed, D. L. Woodward, C. G. Clark, and F. G. Rodgers. 2000. Enteric pathogens identified in Canada-annual summary 1998. National Laboratory for Enteric Pathogens,pp. 1,67.Google Scholar
  51. Current, W. L., and L. S. Garcia. 1991. Cryptosporidiosis. Clin. Microbiol. Rev. 4:325-358.Google Scholar
  52. Dalsgaard, A. 1998. The occurrence of human pathogenic Vibrio spp. and Salmonella in aquaculture.Int. J. Food Sci. Technol. 33:127-138.CrossRefGoogle Scholar
  53. D’Aoust, J-Y., D. W. Warburton, and A. M. Sewell. 1985. Salmonella typhimurium phage-type 10 from cheddar cheese implicated in a major Canadian foodborne outbreak. J. Food Protect.48:1062-1066.Google Scholar
  54. Davis, L. J., H. L. Roberts, D. D. Juranek, S. R. Framn, and R. Soave. 1998. A survey of risk factors for cryptosporidiosis in New York City: drinking water and other exposures. Epidemiol. Infect.121:357-367.CrossRefGoogle Scholar
  55. Dawson, A., R. Griffin, A. Fleetwood, and N. J. Barrett. 1995. Farm visits and zoonoses. Commun.Dis. Rep. 5:R81-R85.Google Scholar
  56. DePaola, A., C. A. Kaysner, J. Bowers, and D. W. Cook. 2000. Environmental investigations of Vibrio parahaemolyticus in oysters after outbreaks in Washington, Texas, and New York (1997 and 1998). Appl. Environ. Microbiol. 66:4649-4654.CrossRefGoogle Scholar
  57. DeRegnier, D., L. Cole, D. G. Schupp, and S. Erlandsen. 1989. Viability of Giardia cysts suspended in lake, river, and tap water. Appl. Environ. Microbiol. 55:1223-1229.Google Scholar
  58. DesRosiers, A., J. M. Fairbrother, R. P. Johnson, C. Desautels, A. Letellier, and S. Quessy. 2001.Phenotypic and genotypic characterization of Escherichia coli verotoxin-producing isolates from humans and pigs. J. Food Protect. 64:1904-1911.Google Scholar
  59. Dev, V. J., M. Main, and I. Gould. 1991. Waterborne outbreak of Escherichia coli O157:H7. Lancet,337:1412.CrossRefGoogle Scholar
  60. Doores, S. 1999. Food safety-current status and future needs. A report from the American Academy of Microbiology, pp. 7-14.Google Scholar
  61. El-Gazzar, F. E., and E. H. Marth. 1992. Salmonellae, salmonellosis, and dairy foods: a review.J. Dairy Sci. 75:2327-2343.CrossRefGoogle Scholar
  62. Ellis, A., M. Preston, A. Borczyk, B. Miller, P. Stone, B. Hatton, A. Chagla, and J. Hockin. 1998.A community outbreak of Salmonella berta associated with a soft cheese product. Epidemiol.Infect. 120:29-35.CrossRefGoogle Scholar
  63. Fernandes. C. F., G. J. Flick, Jr, J. L. Silva, and T. A. McCaskey. 1997. Comparison of quality in aquacultured fresh catfish fillets II. Pathogens E. coli 0157:H7, Campylobacter, Vibrio, Plesiomonas,and Klebsiella. J. Food Protect. 60:1182-1188.Google Scholar
  64. Fey, P. D., T. J. Safranek, M. E. Rupp, E. F. Dunne, E. Ribot, P. C. Iwen, P. A. Bradford, F. J. Angulo,and S. H. Hinrichs. 2000. Ceftriaxone-resistant Salmonella infection acquired by a child from cattle. N. Engl. J. Med. 342:1242-1249.CrossRefGoogle Scholar
  65. Food and Drug Administration (FDA). 1998. Guidance to industry-guide to minimize microbial food safety hazards for fresh fruits and vegetables. U.S. Department of Health and Human Services,Center for Food Safety and Applied Nutrition, October 1998.Google Scholar
  66. Food Safety and Inspection Service (FSIS). 1996. Nationwide pork microbiological baseline data collection program: market hogs [Online]. URL: and (Accessed: April11, 2002).Google Scholar
  67. FSIS. 2001. Progress report on Salmonella testing of raw meat and poultry products, 1998-2000[Online]. URL: (Accessed: April 11,2002).Google Scholar
  68. Frenzen, P. D., E. E. DeBess, K. E. Hechemy, H. Kassenborg, M. Kennedy, K. McCombs, A. McNees,and the Foodnet Working Group. 2001. Consumer acceptance of irradiated meat and poultry in the United States. J. Food Protect. 64:2020-2026.Google Scholar
  69. Furtado, C., G. K. Adak, J. M. Stuart, P. G. Wall, H. S. Evans, and D. P. Casemore. 1998. Outbreaks of waterborne infectious intestinal disease in England and Wales, 1992-5. Epidemiol. Infect.121:109-119.CrossRefGoogle Scholar
  70. Garett, E. S., C. L. dos Santos, and M. L. Jahncke. 1997. Public, animal, and environmental health implications of aquaculture. Emerg. Infect. Dis. 3:453-457.CrossRefGoogle Scholar
  71. Gast, R. K., B. W. Mitchell, and P. S. Holt. 1999. Application of negative air ionization for reducing experimental airborne transmission of Salmonella enteritidis to chicks. Poult. Sci. 78:57-61.Google Scholar
  72. Gaulin, C. D., D. Ramsay, P. Cardinal, M-A. D’Halevyn. 1999. Gastroenteritis outbreak of viral origin related to imported strawberries consumption. Can. J. Public Health, 90:37-40.Google Scholar
  73. Greensmith, C. T., R. S. Stanwick, B. E. Elliot, and M. V. Fast. 1988. Giardiasis associated with the use of a water slide. Pediatr. Infect. Dis. J. 7:91-94.CrossRefGoogle Scholar
  74. Griffiths, M. W. 2000. The new face of food-borne illness. CMSA News, Can. Meat Sci. Assoc.,Ottawa ON, March:6-9.Google Scholar
  75. Guan, T. Y., G. Blank, A. Ismond, and R. V. Acker. 2001. Fate of foodborne bacterial pathogens in pesticide products. J. Sci. Food Agric. 81:503-512.CrossRefGoogle Scholar
  76. Hancock, D., T. Besser, J. Lejeune, M. Davis, and D. Rice. 2001. The control of VTEC in the animal reservoir. Int. J. Food Microbiol. 66:71-78.CrossRefGoogle Scholar
  77. Harter, L., F. Frost, G. Grunenfelder, K. Perkins-Jones, and J. Libby. 1984. Giardiasis in an infant and toddler swim class. Am. J. Public Health, 74:155-156.CrossRefGoogle Scholar
  78. Health Canada. 1995. Outbreak of Campylobacter infection among farm workers: an occupational hazard. Can. Commun. Dis. Rep. 21:153-156.Google Scholar
  79. Health Canada. 1997a. Outbreak of Vibrio parahaemolyticus related to raw oysters in British Columbia. Can. Commun. Dis. Rep. 23:145-148.Google Scholar
  80. Health Canada. 1997b. Hepatitis A outbreak in a socially-contained religious community in rural southern Ontario. Can. Commun. Dis. Rep. 23:161-166.Google Scholar
  81. Health Canada. 1998. The distribution of foodborne disease by risk setting - Ontario. Can. Commun. Dis. Rep. 24:61-64.Google Scholar
  82. Health Canada. 1999. Guidelines for raw ground beef products found positive for Escherichia coli O157:H7. Raw Foods of Animal Origin and Steering Committee. Guideline no. 10. Health Protection Branch, pp. 1-2.Google Scholar
  83. Health Canada. 2000a. Interim guidelines for the control of verotoxinogenic Escherichia coli including E. coli 0157:H7 in ready to eat fermented sausages containing beef or a beef product as an ingredient. Raw Foods of Animal Origin and Steering Committee. Guideline no. 12. Health Protection Branch, pp. 1-7.Google Scholar
  84. Health Canada. 2000b. Case-control study assessing the association between yersiniosis and exposure to salami. Can. Commun. Dis. Rep. 26:161-164.Google Scholar
  85. Health Canada. 2000c. Waterborne outbreak of gastroenteritis associated with a contaminated municipal water supply, Walkerton, Ontario, May-June 2000. Can. Commun. Dis. Rep. 26:170-173.Google Scholar
  86. Health Canada. 2000d. Drinking water quality and health-care utilization for gastrointestinal illness in greater Vancouver. Can. Commun. Dis. Rep. 26:211-214.Google Scholar
  87. Health Canada. 2000e. Hepatitis A in the northern interior of British Columbia: an outbreak among members of a First Nations community. Can. Commun. Dis. Rep. 26:157-161.Google Scholar
  88. Health Canada. 2001a. Outbreak of trichinellosis associated with arctic walruses in Northern Canada, 1999. Can. Commun. Dis. Rep. 27:31-36.Google Scholar
  89. Health Canada. 2001b. Waterborne cryptosporidiosis outbreak, North Battleford, Saskatchewan, spring 2001. Can. Commun. Dis. Rep. 27:185-192.Google Scholar
  90. Health Canada. 2001c. Clusters of Shigella sonnei in men who have sex with men, British Columbia, 2001. Can. Commun. Dis. Rep. 27:109-114.Google Scholar
  91. Health Canada. 2002a. Escherichia coli O157 outbreak associated with the ingestion of unpasteurized goat's milk in British Columbia, 2001. Can. Commun. Dis. Rep. 28:6-8.Google Scholar
  92. Health Canada. 2002b. Managing the health risks associated with Listeria monocytogenes in ready-to-eat foods. Food Directorate, Health Products and Food Branch, Health Canada. Policy ID: 2002-FD-01. Date issued: January 8, 2002.Google Scholar
  93. Health Canada. 2002c. Abbott's choice brand cheese products may contain Listeria monocytogenes [Online]. Health Hazard Alert, February 13, 2002. URL: corpaffr/recarapp/2002/20020213be.shtml (Accessed: February 15, 2002).Google Scholar
  94. Hedberg, C. W., J. A. Korlath, J. Y. D’Aoust, K. E. White, W. L. Schell, M. R. Miller, D. N. Camero, K. L. MacDonald, and M. T. Osterholm. 1992. A multistate outbreak of Salmonella javiana and Salmonella oranienburg infections due to consumption of contaminated cheese. J. Am. Med. Assoc. 268:3203-3207.CrossRefGoogle Scholar
  95. Heng, B. H., K. T. Goh, S. Doraisingham, and G. H. Quek. 1994. Prevalence of hepatitis A virus infection among sewage workers in Singapore. Epidemiol. Infect. 113:121-128.CrossRefGoogle Scholar
  96. Henry, B., B. Warshawsky, I. Gutmanis, J. Reffle, J. Dow, G. Pollett, C. LeBer, M. Naus, F. Jamieson, R. Ahmed, and D. H. Werker. 2001. Outbreak of Escherichia coli 0157:H7 infections associated with a petting zoo at a fall fair, Ontario, Canada, 1999 [Online]. Field Epidemiology Training Program 2001 Abstracts, Health Canada. URL: abs01_e.html (Accessed: December 15, 2001).Google Scholar
  97. Hildebrand, J. M., H. C. Maguire, R. E. Holliman, and E. Kangesu. 1996. An outbreak of Escherichia coli O157:H7 infection linked to paddling pools. Commun. Dis. Rep. 6:R33-R36.Google Scholar
  98. Ho, M-S., R. I. Glass, S. S. Monroe, H. P. Madore, S. Stine, P. F. Pinsky, D. Cubitt, C. Ashley, and E. O. Caul. 1989. Viral gastroenteritis aboard a cruise ship. Lancet, 2: 961-964.CrossRefGoogle Scholar
  99. Hume, M. E., D. J. Nisbet, S. A. Buckley, R. L. Ziprin, R. C. Anderson, and L. H. Stanker. 2001. Inhibition of in vitro Salmonella typhimurium colonization in porcine cecal bacteria continuous-flow competitive exclusion cultures. J. Food Protect. 64:17-22.Google Scholar
  100. Isaac-Renton, J., W. Moorehead, and A. Ross. 1996. Longitudinal studies of Giardia contamination in two community drinking water supplies: cyst levels, parasite viability, and health impact. Appl. Environ. Microbiol. 62:47-54.Google Scholar
  101. Isaacson, M, P. H. Canter, P. Effler, L. Arntzen, P. Bomans, and R. Heenan. 1993. Haemorrhagic colitis epidemic in Africa. Lancet, 341:961.CrossRefGoogle Scholar
  102. Jackson, S. G., R. B. Goodbrand, R. P. Johnson, V. G. Odorico, D. Alves, K. Rahn, J. B. Wilson, M. K.Welch, and R. Khakhria. 1998. Escherichia coli 0157:H7 diarrhoea associated with well water and infected cattle on an Ontario farm. Epidemiol. Infect. 120:17-20.CrossRefGoogle Scholar
  103. Jiang, X., and M. P. Doyle. 1999. Fate of Escherichia coli Oil57:H7 and Salmonella Enteritidis on currency. J. Food Protect. 62:805-807.Google Scholar
  104. Joce, R. E., J. Bruce, D. Kiely, N. D. Noah, W. B. Dempster, R. Stalker, P. Gumsley, P. A. Chapman, P.Norman, J. Watkins, H. V. Smith, T. J. Price, and D. Watts. 1991. An outbreak of cryptosporidiosis associated with a swimming pool. Epidemiol. Infect. 107:497-508.CrossRefGoogle Scholar
  105. Jones, D. L. 1999. Potential health risks associated with the persistence of Escherichia coli 0157 in agricultural environments. Soil Use Manage. 15:76-83.CrossRefGoogle Scholar
  106. Jones, K. 2000. Seven dead from e-coli contamination in Ontario, Canada [Online]. URL: (Accessed: April 9, 2002).Google Scholar
  107. Karmali, M. A., B. T. Steele, M. Petric, and C. Lim. 1983. Sporadic cases of hemolytic-uremic syndrome associated with faecal cytotoxin and cytotoxin producing Escherichia coli in stools.Lancet, 1:619-620.CrossRefGoogle Scholar
  108. Keene, W. E., J. M. McAnulty, F. C. Hoesly, L. P. Williams, K. Hedberg, G. L. Oxman, T. J. Barrett,M. A. Pfaller, and D. W. Fleming. 1994. A swimming-associated outbreak of hemorrhagic colitis caused by Escherichia coli 0157:H7 and Shigella sonnei. N. Engl. J. Med. 331:579-584.CrossRefGoogle Scholar
  109. Keene, W. E., E. Sazie, J. Kok, D. H. Rice, D. D. Hancock, V. K. Balan, T. Zhao, and M. P. Doyle. 1997.An outbreak of Escherichia coli O157:H7 infections traced to jerky made from deer meat. J. Am.Med. Assoc. 277:1229-1231.CrossRefGoogle Scholar
  110. Kotula, A. W., and B. S. Emswiler-Rose. 1988. Airborne microorganisms in a pork processing establishment. J. Food Protect. 51:935-937.Google Scholar
  111. Kramer, J. M., J. A. Frost, F. J. Bolton, and D. R. A. Wareing. 2000. Campylobacter contamination of raw meat and poultry at retail sale: identification of multiple types and comparison with isolates from human infection. J. Food Protect. 63:1654-1659.Google Scholar
  112. Laberge, I., M. W. Griffiths, and M. W. Griffiths. 1996. Prevalence, detection and control of Cryptosporidium parvum in food. Int. J. Food Microbiol. 31:1-26.CrossRefGoogle Scholar
  113. Licence, K., K. R. Oates, B. A. Synge, and T. M. S. Reid. 2001. An outbreak of E. coli 0157 infection with evidence of spread from animals to man through contamination of a private water supply.Epidemiol. Infect. 126:135-138.Google Scholar
  114. Lindell, S. S., and P. Quinn. 1973. Shigella sonnei isolated from well water. Appl. Microbiol. 26:424-425.Google Scholar
  115. Lindsay J. A. 1997. Chronic sequelae of foodborne disease. Emerg. Infect. Dis. 3:443-452.CrossRefGoogle Scholar
  116. Mac Kenzie, W. R., N. J. Hoxie, M. E. Proctor, M. S. Gradus, K. A. Blair, D. E. Peterson, J. J. Kazmierczak,D. G. Addiss, K. R. Fox, J. B. Rose, and J. P. Davis. 1994. A massive outbreak in Milwaukee of Cryptosporidium infection transmitted through the public water supply. N. Engl. J. Med.331:161-167.CrossRefGoogle Scholar
  117. Mackey, B. 1989. The incidence of food poisoning bacteria on red meat and poultry in the United Kingdom. Food Sci. Technol. Today, 3:246-250.Google Scholar
  118. MacLean, J. D., J. Viallet, C. Law, and M. Staudt. 1989. Trichinosis in the Canadian Arctic: report of five outbreaks and a new clinical syndrome. J. Infect. Dis. 160:513-520.CrossRefGoogle Scholar
  119. Madden, J. M. 1992. Microbial pathogens in fresh produce-the regulatory perspective. J. Food Protect. 55:821-823.Google Scholar
  120. Mahoney, F. J., T. A. Farley, K. Y. Kelso, S. A. Wilson, J. M. Horan, and L. M. McFarland. 1992.An outbreak of hepatitis A associated with swimming in a public pool. J. Infect. Dis. 165:613-618.CrossRefGoogle Scholar
  121. Marshall, B., P. Flynn, D. Kamely, and S. B. Levy. 1988. Survival of Escherichia coli with and without ColEl::Tn5 after aerosol dispersal in a laboratory and a farm environment. Appl. Environ.Microbiol. 54:1776-1783.Google Scholar
  122. Martin, J. H., and D. L. Marshall. 1995. Characteristics and control of potential foodborne pathogens in cultured dairy foods. Cultured Dairy Products J. 30:9-16.Google Scholar
  123. McAnulty, J. M., D. W. Fleming, and A. H. Gonzalez. 1994. A community-wide outbreak of cryptosporidiosis associated with swimming at a wave pool.J. Am. Med. Assoc. 272:1597-1600.CrossRefGoogle Scholar
  124. McAnulty, J. M., W. E. Keene, D. Leland, F. Hoesly, B. Hinds, G. Stevens, and D. W. Fleming. 2000.Contaminated drinking water in one town manifesting as an outbreak of cryptosporidiosis in another. Epidemiol. Infect. 125:79-86.CrossRefGoogle Scholar
  125. McGowan, K. L., Wickersham, E., and N. A. Strockbine. 1989. Escherichia coli O157:H7 from water.Lancet, i:967-968.CrossRefGoogle Scholar
  126. Mead P. S., L. Slutsker, V. Dietz, L. F. McCaig, J. S. Bresee, C. Shapiro, P. M. Griffin, and R. V. Tauxe.1999. Food-related illness and death in the United States. Emerg. Infect. Dis. 5:607-625.CrossRefGoogle Scholar
  127. Millard, P. S., K. F. Gensheimer, D. G. Addiss, D. M. Sosin, G. A. Beckett, A. Houck-Jankoski, and A. Hudson. 1994. An outbreak of cryptosporidiosis from fresh-pressed apple cider. J. Am. Med.Assoc. 272:1592-1596.CrossRefGoogle Scholar
  128. Milne, L. M., A. Pom, I. Strudley, G. C. Pritchard, R. Crooks, M. Hall, G. Duckworth, C. Seng,M. D. Susman, J. Kearney, R. J. Wiggins, M. Moulsdale, T. Cheasty, and G. A. Willshaw. 1999.Escherichia coli 0157:H7 incident associated with a farm open to members of the public.Commun. Dis. Public Health, 2:22-26.Google Scholar
  129. Modi, R., Y. Hirvi, A. Hill, and M. W. Griffiths. 2001. Effect of phage on survival of Salmonella Enteritidis during manufacture and storage of cheddar cheese made from raw and pasteurized milk. J. Food Protect. 64:927-933.Google Scholar
  130. Morgan, D., C. P. Newman, D. N. Hutchinson, A. M. Walker, B. Rowe, and F. Majid. 1993. Verotoxin producing Escherichia coli 157 infections associated with the consumption of yoghurt.Epidemiol. Infect. 111:181-187.CrossRefGoogle Scholar
  131. Morgan, G. M., C. Newman, S. R. Palmer, J. B. Allen, W. Shepherd, A. M. Rampling, R. E. Warren,R. J. Gross, S. M. Scotland, and H. R. Smith. 1988. First recognized community outbreak of haemorrhagic colitis due to verotoxin producing Escherichia coli O157:H7 in the UK. Epidemiol. Infect. 101:83-91.CrossRefGoogle Scholar
  132. Nijsten, R., N. London, A. Van Den Bogaard, and E. Stobberingh. 1994. Resistance in faecal Escherichia coli isolated from pigfarmers and abattoir workers. Epidemiol. Infect. 113:45-52.CrossRefGoogle Scholar
  133. O’Brien, S. J., G. K. Adak, and C. Gilham. 2001. Contact with farming environment as a major risk factor for Shiga toxin (vero cytotoxin)-producing Escherichia coliO157:H7 infection in humans.Emerg. Infect. Dis. 7:1049-1051.CrossRefGoogle Scholar
  134. Ogden, I. D., D. R. Fenlon, A.J. A. Vinten, and D. Lewis. 2001. The fate of Escherichia coli O157:H7 in soil and its potential to contaminate drinking water. Int. J. Food Microbiol. 66:111-117.CrossRefGoogle Scholar
  135. Ostroff, S. M., G. Kapperud, L. C. Hutwagner, T. Nesbakken, N. H. Bean, J. Lassen, and R. V. Tauxe.1994. Sources of sporadic Yersinia enterocolitica infections in Norway: a prospective case-control study. Epidemiol. Infect. 112:133-141.CrossRefGoogle Scholar
  136. Paunio, M., R. Pebody, M. Keskimaki, M. Kokki, P. Ruutu, S. Oinonen, V. Vuotari, A. Siitonen,E. Lahti, and P. Leinikki. 1999. Swimming-associated outbreak of Escherichia coli 0157:H7.Epidemiol. Infect. 122:1-5.CrossRefGoogle Scholar
  137. Payment, P. 1989. Bacterial colonization of domestic reverse-osmosis water filtration units. Can.J. Microbiol. 35:1065-1067.CrossRefGoogle Scholar
  138. Payment, P., A. Berte, M. Prevost, B. Menard, and B. Barbeau. 2000. Occurrence of pathogenic microorganisms in the Saint Lawrence River (Canada) and comparison of health risks for populations using it as their source of drinking water. Can. J. Microbiol. 46:565-576.Google Scholar
  139. Payment, P., A. Berube, D. Perreault, R. Armon, and M. Trudel. 1989. Concentrations of Giardia lamblia cysts, Legionella pneumophila, Clostridium perfringens, human enteric viruses, and coliphages from large volumes of drinking water, using a single filtration. Can. J. Microbiol.35:932-935.Google Scholar
  140. Pearson, A. D., M. Greenwood, T. D. Healing, D. Rollins, M. Shahamat, J. Donaldson, and R. R.Colwell. 1993. Colonization of broiler chickens by waterborne Campylobacter jejuni. Appl.Environ. Microbiol. 59:987-996.Google Scholar
  141. Pillai, S. D., K. W. Widmer, S. E. Dowd, and S. C. Ricke. 1996. Occurrence of airborne bacteria and pathogen indicators during land application of sewage sludge. Appl. Environ. Microbiol.62:296-299.Google Scholar
  142. Pontello, M., L. Sodano, A. Nastasi, C. Mammina, M. Astuti, M. Domenichini, G. Belluzzi, E. Soccini,M. G. Silvestri, M. Gatti, E. Gerosa, and A. Montagna. 1998. A community-based outbreak of Salmonella enteríca serotype Typhimurium associated with salami consumption in Northern Italy. Epidemiol. Infect. 120:209-214.CrossRefGoogle Scholar
  143. Porter, J. D., H. P. Ragazzoni, J. D. Buchanon, H. A. Waskin, D. D. Juranek, and W. E. Parkin. 1988.Giardia transmission in a swimming pool. Am. J. Public Health, 78:659-662.CrossRefGoogle Scholar
  144. Potter, A., S. Gomis, G. Mutwiri, and D. Wilson. 2000. Vaccines for the prevention of Escherichia coli 0157:H7 colonization of cattle [Online]. Inventory Can. Agri-Food Res. URL: (Accessed: January 21,2002).Google Scholar
  145. Puech, M. C., J. M. McAnulty, M. Lesjak, N. Shaw, L. Heron, and J. M. Watson. 2001. A statewide outbreak of cryptosporidiosis in New South Wales associated with swimming at public school.Epidemiol. Infect. 126:389-396.CrossRefGoogle Scholar
  146. Rabsch, W., B. M. Hargis, R. M. Tsolis, R. A. Kingsley, K-H. Hinz, H. Tschäpe, and A. J. Bäumler.2000. Competitive exclusion of Salmonella Enteritidis by Salmonella Gallinarum in poultry.Emerg. Infect. Dis. 6:443-448.CrossRefGoogle Scholar
  147. Ratnam, S., F. Stratton, C. O’Keefe, A. Roberts, R. Coates, M. Yetman, S. Squires, R. Khakhria, and J. Hockin. 1999. Salmonella enteritidis outbreak due to contaminated cheese-Newfoundland.Can. Commun. Dis. Rep. 25:17.Google Scholar
  148. Robertson, L. J., A. T. Campbell, and H. V. Smith. 1992. Survival of Cryptosporidium parvum oocysts under various environmental pressures. Appl. Environ. Microbiol. 55:1519-1522.Google Scholar
  149. Rose, J. B., and T. R. Slifko. 1999. Giardia Cryptosporidium, and Cyclospora and their impact on foods: a review. J. Food Protect. 62:1059-1070.Google Scholar
  150. Satterthwaite, P., K. Pritchard, and D. Floyd. 1999. Case-control study of Yersinia infections in Auckland. Aust. N. Z. J. Public Health, 23:482-485.CrossRefGoogle Scholar
  151. Schlech, W. F., P. M. Lavigne, R. A. Bortolussi, A. C. Allen, E. V. Haldene, A. J. Wort, A. W. Hightower,S. E. Johnston, S. H. King, E. S. Nicholls, and C. V. Broome. 1983. Epidemic listeriosis-evidence for transmission by food. N. Engl. J. Med. 308:203-206.CrossRefGoogle Scholar
  152. Seo, K. H., B. W. Mitchell, P. S. Holt, and R. K. Gast. 2001. Bactericidal effects of negative air ions on airborne and surface Salmonella Enteritidis from an artificially generated aerosol. J. Food Protect. 64:113-116.Google Scholar
  153. Shiferaw, B., S. Yang, P. Cieslak, D. Vugia, R. Marcus, J. Koehler, V. Deneen, F. Angulo, and the FoodNet working group. 2000. Prevalence of high-risk food consumption and food-handling practices among adults: a multistate survey, 1996 to 1997. J. Food Protect. 63:1538-1543.Google Scholar
  154. Shukla, R., R. Slack, A. George, T. Cheasty, B. Rowe, and J. Scutter. 1995. Escherichia coli 0157 infection associated with a farm visitor center. Commun. Dis. Rep. 5:R86-R90.Google Scholar
  155. Smith, H. V., C. A. Paton, M. M. A. Mitambo, and R. W. A. Girdwood. 1997. Sporulation of Cyclospora sp. oocysts. Appl. Environ. Microbiol. 63:1631-1632.Google Scholar
  156. Solomon, E. B., S. Yaron, and K. R. Matthews. 2002. Transmission of Escherichia coli 0157:H7 from contaminated manure and irrigation water to lettuce plant tissue and its subsequent internalization. Appl. Environ. Microbiol. 68:367-400.CrossRefGoogle Scholar
  157. Sorvillo, F. J., S. H. Waterman, J. K. Vogt, and N. England. 1988. Shigellosis associated with recreational water contact in Los Angeles County. Am. J. Tropic. Med. Hyg. 38:613-617.Google Scholar
  158. Spake, A. 1997. O is for outbreak. U.S. News World Rep. 123:70-84.Google Scholar
  159. Steele, B. T., N. Murphy, and C. P. Ranee. 1982. An outbreak of hemolytic uremic syndrome associated with ingestion of fresh apple juice. J. Pediatr.l01:963-965.Google Scholar
  160. Swanenburg, M., H. A. P. Urlings, D. A. Keuzenkamp, and J. M. A. Snijders. 2001. Salmonella in the lairage of pig slaughterhouses. J. Food Protect. 64:12-16.Google Scholar
  161. Swerdlow, D. L., B. A. Woodruff, R. C. Brady, P. M. Griffin, S. Tippen, H. D. Donnell, Jr., E. Geldreich,B. J. Payne, A. Meyer, Jr., J. G. Wells, et al. 1992. A waterborne outbreak in Missouri of Escherichia coli O157:H7 associated with bloody diarrhea and death. Ann. Int. Med. 117:812-819.Google Scholar
  162. Tauxe, R. V. 1997. Emerging foodborne diseases: an evolving public health challenge. Emerg. Infect.Dis. 3:425-434.CrossRefGoogle Scholar
  163. Tauxe, R., H. Kruse, C. Hedberg, M. Potter, J. Madden, and K. Wachsmuth. 1997. Microbial hazards and emerging issues associated with produce-a preliminary report to the National Advisory Committee on Microbiologic Criteria for Foods, 60:1400-1408.Google Scholar
  164. Tauxe, R. V., J. Vandepitte, G. Wauters, S. M. Martin, V. Goossens, P. De Mol, R. Van Noyen, and G.Thiers. 1987. Yersinia enterocolitica infections and pork: the missing link. Lancet, 1:1129-1132.CrossRefGoogle Scholar
  165. Teltsch, B., and E. Katzenelson. 1978. Airborne enteric bacteria and viruses from spray irrigation with wastewater. Appl. Environ. Microbiol. 35:290-296.Google Scholar
  166. Thorne, P. S., M. S. Kiekhaefer, P. Whitten, and K. J. Donham. 1992. Comparison of bioaerosol sampling methods in barns housing swine. Appl. Environ. Microbiol. 58:2543-2551.Google Scholar
  167. Tillett, H. E., J. de Louvois, and P. G. Wall. 1998. Surveillance of outbreaks of waterborne infectious disease: categorizing levels of evidence. Epidemiol. Infect. 120:37-42.CrossRefGoogle Scholar
  168. Todd, E. C. D.; P. Chatman, and V. Rodrigues. 2000. Annual summaries of foodborne and water-borne disease in Canada, 1994 and 1995, Health Products and Food Branch, Health Canada,Polyscience Publications Inc., Laval, Quebec.Google Scholar
  169. Tozzi, A. E., A. Niccolini, A. Caprioli, I. Luzzi, G. Montini, G. Zacchello, A. Gianviti, F. Principato,and G. Rizzoni. 1994. A community outbreak of haemolytic-uraemic syndrome in children occurring in a large area of Northern Italy over a period of several months. Epidemiol. Infect.113:209-219.CrossRefGoogle Scholar
  170. Tschäpe, H., R. Prager, W. Streckel, A. Fruth., E. Tietze, and G. Böhme. 1995. Verotoxinogenic Citrobacter freundii associated with severe gastroenteritis and cases of haemolytic uraemic syndrome in a nursery school: green butter as the infection source. Epidemiol. Infect. 114:441-450.CrossRefGoogle Scholar
  171. University of Guelph press release (UGPR). 1997. E. coli-contaminated well water linked to gastrointestinal illness. May 22.Google Scholar
  172. Van Donkersgoed, J., T. Graham, and V. Gannon. 1999. The prevalence of verotoxins, Escherichia coli O157:H7, and Salmonella in the feces and rumen of cattle at processing. Can. Vet. J. 40:332-338.Google Scholar
  173. Vasavada, P. C. 1988. Pathogenic bacteria in milk-a review. J. Dairy Sci. 71:2809-2816.CrossRefGoogle Scholar
  174. Wachtel, M. R., L. C. Whitehand, and R. E. Mandrell. 2002. Association of Escherichia coli O157:H7 with preharvest leaf lettuce upon exposure to contaminated irrigation water. J. Food Protect.65:18-25.Google Scholar
  175. Wallis, P. M., S. L. Erlandsen, J. L. Isaac-Renton, M. E. Olson, W. J. Robertson, and H. Van Keulen.1996. Prevalence of Giardia cysts and Cryptosporidium oocysts and characterization of Giardia spp. isolated from drinking water in Canada. Appl. Environ. Microbiol. 62:2789-2797.Google Scholar
  176. Wang, G., T. Zhao, and M. P. Doyle. 1996. Fate of Enterohemorrhagic Escherichia coli 0157:H7 in bovine feces. Appl. Environ. Microbiol. 62:2567-2570.Google Scholar
  177. Warburton, D. W. 1993. A review of the microbiological quality of bottled water sold in Canada.Part 2. The need for more stringent standards and regulations. Can. J. Microbiol. 39:158-168.CrossRefGoogle Scholar
  178. Warburton, D. W., and K. L. Dodds. 1992. A review of the microbiological quality of bottled water sold in Canada between 1981 and 1989. Can. J. Microbiol. 38:12-19.CrossRefGoogle Scholar
  179. Warshawsky, B. 2001. An E. coli O157:H7 outbreak associated with an animal exhibit [Online].Middlesez-London Health Unit Investigation and Recommendations. Executive Summary.URL: (Accessed: March 4, 2002).Google Scholar
  180. Wells, J. G., L. D. Shipman, K. D. Greene, E. G. Sowers, J. H. Green, D. N. Cameron, F. P. Downes, M. L.Martin, M. Griffin, S. M. Ostroff, M. E. Potter, R. V. Tauxe, and I. K. Wachsmuth. 1991. Isolation of Escherichia coli serotype O157:H7 and other shiga-like-toxin-producing E. coli from dairy cattle. J. Clin. Microbiol. 29:985-989.Google Scholar
  181. Wells, S. J., P. J. Fedorka-Cray, D. A. Dargatz, K. Ferris, and A. Green. 2001. Fecal shedding of Salmonella spp. by dairy cows on farm and at cull cow markets. J. Food Protect. 64:3-11.Google Scholar
  182. Wilson, J., J. Spika, R. Clarke, R. Johnson, S. Renwick, M. Karmali, H. Lior, D. Alves, and C. Gyles.1998. Verocytotoxigenic Escherichia coli infection in dairy farm families. Can. Commun. Dis.Rep. 24-3.Google Scholar
  183. World Health Organization (WHO). 1993. In: WHO guidelines for drinking water quality, 2nd ed.Vol. 1 - Recommendations. Geneva, WHO. pp. 8-29.Google Scholar
  184. World Health Organization (WHO). 1999. Food safety - report by the Director-General. EB105/10,2 December 1999. pp. 1-2.Google Scholar
  185. World Health Organization (WHO). 2000. Bottled drinking-water [Online]. Fact Sheet No. 256,October, 2000. URL: (Accessed: February 8, 2002).Google Scholar
  186. Wood, J. D., G. A. Chalmers, R. A. Fenton, J. Pritchard, M. Schoonderwoerd, and W. L. Lichtenberger.1991. Persistent shedding of Salmonella enteritidis from the udder of a cow. Can. Vet. J. 32:738-741.Google Scholar
  187. Zhao, T., M. P. Doyle, P. Zhao, P. Blake, and F-M, Wu. 2001. Chlorine inactivation of Escherichia coli O157:H7 in water. J. Food Protect. 64:1607-1609.Google Scholar
  188. Zottola, E. A., D. L. Schmeltz, and J. J. Jezeski. 1970. Isolation of salmonellae and other air-borne microorganisms in turkey processing plants. J. Milk Food Technol. 33:395-399.Google Scholar

Copyright information

© Springer Science+Business Media New York 2003

Authors and Affiliations

  1. 1.University of ManitobaWinnipeg

Personalised recommendations