An E. coli outbreak in Canada that was initially linked to a restaurant in Edmonton, Alberta, has grown to include people who do not have any connections to Mama Nita’s Binalot, and one of them has died.

Described as “extremely complex” by Dr. Chris Sikora, medical officer of health for the Edmonton Zone, the ongoing outbreak has sickened at least 34 people. Eleven of the people have been admitted to hospitals, according to a news release from Alberta Health Services. During a news conference on April 20, another medical officer for the Edmonton Zone said the death was not linked to food from Mama Nita’s Binalot.

“Although today we do not have a grip on a specific source, we have various leads that we’re exploring with rigor,” Edmonton Zone Medical Officer Dr. Jasmine Hasselback said during the news conference.

The outbreak of E. coli O157:H7 infections in Alberta coincides with an ongoing outbreak in the United States. The U.S. outbreak, also involving the O157:H7 strain, is linked to romaine lettuce. It has sickened 53 people across 16 states. 

Canadian officials say the 34 lab-confirmed cases there represent a significantly higher number of infections than is considered normal. However, the Edmonton medical officers said the public’s risk of infection is low.

Alberta public health officials reported the 13 most recent lab-confirmed cases of E. coli O157:H7 infection, which are not linked to the restaurant, are connected to the illnesses among the restaurant patrons. The Alberta health officials are working with officials in other Canadian provinces and the Public Health Agency of Canada on the outbreak investigation.

People who ate at Mama Nita’s Binalot restaurant in Edmonton started becoming ill in late March. The Environmental Public Health division of Alberta Health Services (AHS) has been working with the restaurant owners, who voluntarily closed until the health agency gave them clearance to reopen. 

“AHS no longer has public health concerns related to this business,” according to the agency’s news release.

Advice for the public
The predominant symptom associated with E. coli O157:H7 is diarrhea, which may be bloody. In more severe forms of the disease, a form of kidney failure called hemolytic uremic syndrome (HUS) can develop.

Symptoms usually start one to 10 days after eating food contaminated with E. coli bacteria. Anyone who starts to develop symptoms of infection should visit a health care clinic or physician as soon as possible. It’s important to mention possible exposure to E. coli O157:H7 so proper testing and treatment can be determined.

The incubation period for E. coli typically runs from one to ten days, meaning the time from exposure to show symptoms. While most people recover on their own, complications involving HUS can turn deadly, especially for high-risk groups.

Children, the elderly and the immunocompromised people such as cancer patients are at greater risk of complications from E. coli O157:H7.