Investigative summary of the Escherichia coli outbreak associated with a restaurant in North Bay, Ontario, October to November 2008

The small number of secondary cases (individuals infected by other E. coli cases) can be attributed to the public health actions implemented at the outset and reinforced throughout the outbreak by the Health Unit. [...] After the NBPSDHU MOH was notified, information gathered from the interviews and food histories was reviewed to identify common exposures by the PHIs, Director of Environmental Health (EH), the Manager of Communicable Disease Control (CDC) program, the Director of Infectious Disease (ID) and the MOH. [...] A verbal Section 13 order under the Ontario Health Protection and Promotion Act (HPPA) was issued to the manager of Harvey’s by the Manager of EH, and the establishment was closed at 20:45. [...] A written copy of the closure order was provided to the owner/operator of Harvey’s in North Bay and the MOH met with the President of Harvey’s to provide an update on the investigation. [...] Case finding and surveillance was enhanced by the NBPSDHU during the outbreak through the utilization of the following activities: 1. Development and administration of a standardized risk factor/exposure questionnaire to all cases reporting gastrointestinal illness (Appendix C); 2. A posting on the Canadian Integrated Outbreak Surveillance Centre (CIOSC) requesting other health regions to report a