ARCHIVED - E. coli O157:H7 Food Safety Investigation
Gort's Gouda Cheese Farm – September 2013
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The Canadian Food Inspection Agency (CFIA) is committed to the continued improvement of Canada's food safety system. The CFIA is also dedicated to reporting on food safety incidents that have caused serious illnesses in Canada or have otherwise significant interest to the Canadian public.
This report provides a summary of the food safety investigation and recall activities conducted by the CFIA after being notified of Escherichia coli 0157:H7 (E. coli O157:H7) illnesses associated with the consumption of various raw milk cheeses produced by Gort's Gouda Cheese Farm (Establishment 4478).
On September 12, 2013, the Public Health Agency of Canada (PHAC) notified the CFIA of an E. coli O157:H7 cluster of illnesses in Alberta and British Columbia. PHAC activated an Outbreak Investigation Coordinating Committee (OICC) the following day. Preliminary epidemiological information that was gathered and analyzed by the OICC suggested cheese products from Gort's Gouda Cheese Farm (Est. 4478) were the potential source of these illnesses.
The CFIA initiated a food safety investigation at Gort's Gouda Cheese Farm on September 14, 2013 to determine the extent of the problem, identify possible products at risk and take the necessary measures to protect the public.
On September 17, 2013, the CFIA in collaboration with Gort's Gouda Cheese Farm issued a health hazard alert advising the public not to consume certain raw milk cheese products because they may be contaminated with E. coli O157:H7 bacteria. Gort's Gouda Cheese Farm raw milk cheese products were also recalled from the hotel, restaurant and institution level by the company.
The CFIA food safety investigation officially concluded on October 2, 2013. All food safety concerns identified during this investigation have been corrected by Gort's Gouda Cheese Farm. Other administrative, non-food safety related issues of non-compliance were also addressed within accepted time frames. A total of 28 confirmed illnesses were reported to be related to the consumption of Gort's Gouda Cheese Farm raw milk cheese products.
Investigation of Gort's Gouda Cheese Farm
The CFIA food safety investigation into Gort's Gouda Cheese Farm was guided by PHAC's epidemiological investigation and included collection of samples and analysis of production, testing and inspection data. Health Canada subsequently used this information to support its health risk assessment.
Sampling and Recall Activities
Initially, the CFIA sampled and tested a total of 120 units of raw milk cheeses available at Gort's Gouda Cheese Farm on September 14, 2013 to determine if there was evidence of product contamination.
Results from these tests and PHAC's epidemiological assessment report which identified raw milk cheese as a "strong link" to the illnesses, prompted the CFIA to submit a health risk assessment request to Health Canada on September 16, 2013. On September 17, 2013, Health Canada assigned a health risk category 1 for all raw milk cheese products manipulated, packaged and cut by Gort's Gouda Cheese Farm on or after May 27, 2013. That same day, Gort's Gouda Cheese Farm initiated a voluntary recall of those cheese products and the CFIA issued a recall warning to the public.
The CFIA tested additional raw and pasteurized milk products produced by Gort's Gouda Cheese Farm which were not included in the voluntary recall. This was done in order to assess the safety of all of the company's products and to further investigate the root cause of the contamination. The Agency reported that none of the products tested outside of the scope of the recall were detected to carry E. coli O157:H7.
The CFIA in collaboration with provincial partners also tested additional samples that were part of the recall and were made available from consumer's homes. The CFIA reported five positive samples from unopened packages, and both the British Columbia Centre for Disease Control (BC CDC) and Alberta Health Services each reported one positive sample from an open package. All seven raw milk cheese products were reported positive for E. coli O157:H7 and all seven positives had a genetic fingerprint that matched the outbreak strain.
The CFIA conducted an in-depth investigation at the Gort's Gouda Cheese Farm facility from September 18-25, 2013 to examine potential sources of contamination. The British Columbia Ministry of Agriculture, the BC CDC and the British Columbia Interior Health Authority also inspected sections of the facility where the CFIA's authority does not extend, including the milking and retail areas.
The CFIA focused its inspections on conditions and practices within the processing area and reviewed in detail the processing, maturation, cutting and packaging areas. Environmental samples at the facility were also obtained from locations where contamination may occur but all were reported to be clear of E. coli O157:H7.
Root Cause Analysis
The root cause analysis for this event was based on inspection findings and data from epidemiological and testing analyses.
The initial epidemiological conclusion that unpasteurized, not pasteurized, cheese products were likely the source of the outbreak was supported by results from products sampled by the CFIA as well as the health risk assessment from Health Canada given only to certain raw milk cheese products.
Overall evidence indicated that there were a number of opportunities for contamination to occur in the earlier stages of the raw milk cheese manufacturing process.
The potential for contamination during cutting, handling and packaging was also found to be a possible risk factor.
Despite extensive efforts, the CFIA concluded that there was no evidence available to confirm the source of the E. coli O157:H7 contamination.
The CFIA identified areas for improvements at the processing facility and requested Gort's Gouda Cheese Farm to submit a Corrective Action Plan. The company was requested to make enhancements in sanitation practices, equipment design and building maintenance.
All food safety concerns identified during the investigation have been corrected. Gort's Gouda Cheese Farm corrected other administrative and non-food safety related issues within accepted time frames.
The CFIA continues to work with their provincial partners to monitor compliance of this facility.
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