Ontario's chief medical officer of health said he was initially unaware that restaurants and deli counters, not just institutions, were at risk. (CBC)

The response to food-borne disease outbreaks such as listeriosis needs to be strengthened and better co-ordinated, Ontario's chief medical officer of health said Friday, as three federal reports also called for gaps to be filled.

Dr. David Williams recommended that the federal government and the provinces better co-ordinate their handling of illnesses such as last summer's listeriosis outbreak that killed 21 people.

The 25-page report included a timeline of the outbreak, showing nearly a month went by between the first death and a widespread recall of the packaged meat products linked to the illnesses.

After the first death on July 18, Williams said he asked the Canadian Food Inspection Agency repeatedly for information about its investigation but never received any updates.

CFIA also failed to share information about where the meat products linked to the outbreak were distributed. Williams thought they were only at long-term care homes and hospitals, but eventually learned restaurants and deli counters were risks, too.

"If I had known that these products had gone out to the general public, I would have recommended a wider recall sooner," Williams said.

When symptoms develop, diagnosing the illness and tracing its cause is time-consuming and often painstaking, Williams said.

Despite extensive detective work, the source is often never identified, as was the case in last year's outbreak of E. coli associated with a fast-food restaurant in North Bay, Ont.

To strengthen the ability of public health systems to respond quickly and effectively to food-borne illness outbreaks, Williams recommended several steps:

• The federal government should consider expanding regional capacity to do molecular fingerprinting tests of bacterial strains — a tool that's moved from research into more standardized use — rather than always sending samples to federal laboratories in Winnipeg and Ottawa for testing.
• The Ontario Public Health Laboratory's capacity to test and monitor bacterial strains should be expanded.
• Local public health units should be educated about the best sampling techniques to improve testing timelines and manage outbreaks better, given that hundreds of brands of foods are now shipped across the country.
• Improve the co-ordination of information and advice in managing outbreaks between federal and provincial inspectors and public health agencies, including labs.

Lessons learned

The report described a jurisdictional struggle between health officials from the Canadian Food Inspection Agency and provincial health officers.

Initially, Toronto public health inspectors were not allowed to enter the Maple Leaf Foods plant in Toronto linked to the outbreak because of that struggle.

Also on Friday, the CFIA, Health Canada and the Public Health Agency of Canada each released on their websites reports titled Lessons Learned into the listeriosis outbreak.

Overall, those reports suggest the federal government lacks expertise in meat hygiene and clarity on identifying the cause of problems and tracking tainted foods — a painstaking and time-consuming process.

One report revealed that the CFIA never activated an emergency operations centre as laid out in its emergency response protocol.

Meat plant inspections

The CFIA refused to do any public interviews on Friday. The agency's report did not take responsibility for poor communication, but admitted to a need for better collaboration with provincial public health authorities.

A separate CFIA report said the listeriosis crisis prompted the government to reinstate and toughen environmental inspections at meat plants, which were stopped in 2005 when the U.S. Department of Agriculture made that change.

Twice yearly federal inspections of meat plants that were cancelled in 2005 are now done six times a year.

The findings are worrying, said MP Carolyn Bennett, the federal Liberal public health critic.

"The lack of leadership from the federal officials and the federal government does not make me feel comfortable in a future outbreak," Bennett said in Toronto.

Maple Leaf's president has apologized, and Maple Leaf has agreed to pay $27 million to settle class-action lawsuits related to the outbreak.

Prime Minister Stephen Harper named former Edmonton health-care executive Sheila Weatherill to lead an investigation into the outbreak. Weatherill's report is due in July.

With files from Canadian Press