{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T16:15:36Z","timestamp":1769271336800,"version":"3.49.0"},"reference-count":33,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T00:00:00Z","timestamp":1727654400000},"content-version":"unspecified","delay-in-days":273,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2024]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:p>An investigation into an outbreak of <jats:italic>Salmonella<\/jats:italic> Newport infections in Canada was initiated in July 2020. Cases were identified across several provinces through whole-genome sequencing (WGS). Exposure data were gathered through case interviews. Traceback investigations were conducted using receipts, invoices, import documentation, and menus. A total of 515 cases were identified in seven provinces, related by 0\u20136 whole-genome multi-locus sequence typing (wgMLST) allele differences. The median age of cases was 40 (range 1\u2013100), 54% were female, 19% were hospitalized, and three deaths were reported. Forty-eight location-specific case sub-clusters were identified in restaurants, grocery stores, and congregate living facilities. Of the 414 cases with exposure information available, 71% (295) had reported eating onions the week prior to becoming ill, and 80% of those cases who reported eating onions, reported red onion specifically. The traceback investigation identified red onions from Grower A in California, USA, as the likely source of the outbreak, and the first of many food recall warnings was issued on 30 July 2020. <jats:italic>Salmonella<\/jats:italic> was not detected in any tested food or environmental samples. This paper summarizes the collaborative efforts undertaken to investigate and control the largest <jats:italic>Salmonella<\/jats:italic> outbreak in Canada in over 20 years.<\/jats:p>","DOI":"10.1017\/s0950268824001055","type":"journal-article","created":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T11:08:58Z","timestamp":1727694538000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":4,"title":["A multi-provincial outbreak of <i>Salmonella<\/i> Newport infections associated with red onions: A report of the largest <i>Salmonella<\/i> outbreak in Canada in over 20 years"],"prefix":"10.1017","volume":"152","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3603-4715","authenticated-orcid":false,"given":"Leann","family":"Denich","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joyce M.","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3051-0437","authenticated-orcid":false,"given":"Courtney R.","family":"Smith","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marsha","family":"Taylor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robin","family":"Atkinson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Boyd","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda","family":"Chui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lance","family":"Honish","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leah","family":"Isaac","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashley","family":"Kearney","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer J.","family":"Liang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor","family":"Mah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna J. W.","family":"Manore","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7105-3770","authenticated-orcid":false,"given":"Zachary D.","family":"McCormic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia","family":"Misfeldt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Celine","family":"Nadon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kane","family":"Patel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davendra","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Todd","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"April","family":"Hexemer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2024,9,30]]},"reference":[{"key":"S0950268824001055_r27","unstructured":"[27] Public Health Agency of Canada (2020) Public Health Notice \u2013 United States Outbreak of E. coli Infections Linked to Romaine Lettuce with Implications for Canadians. 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R Foundation for Statistical Computing, Vienna, Austria. Available at: https:\/\/www.R-project.org\/."},{"key":"S0950268824001055_r14","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268822001571"},{"key":"S0950268824001055_r3","doi-asserted-by":"publisher","DOI":"10.1089\/fpd.2012.1389"},{"key":"S0950268824001055_r6","doi-asserted-by":"publisher","DOI":"10.4315\/0362-028X.JFP-12-126"},{"key":"S0950268824001055_r13","unstructured":"[13] Government of Canada (2021) Methods for the Analysis of Extraneous Material in Foods. Available at: https:\/\/www.canada.ca\/en\/health-canada\/services\/food-nutrition\/research-programs-analytical-methods\/analytical-methods\/compendium-methods\/methods-analysis-extraneous-material-foods-compendium-analytical-methods.html."},{"key":"S0950268824001055_r16","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268819001547"},{"key":"S0950268824001055_r15","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1005741"},{"key":"S0950268824001055_r12","doi-asserted-by":"publisher","DOI":"10.1186\/s12864-018-5243-3"},{"key":"S0950268824001055_r5","doi-asserted-by":"publisher","DOI":"10.1016\/j.foodcont.2019.106899"},{"key":"S0950268824001055_r24","unstructured":"[24] Public Health Agency of Canada (2019) Public Health Notice: Outbreak of E. coli Infections Linked to Fresh Express Brand Sunflower Crisp Chopped Salad Kits. Available at: https:\/\/www.canada.ca\/en\/public-health\/services\/public-health-notices\/2019\/outbreak-e-coli-salad-kits.html."},{"key":"S0950268824001055_r25","unstructured":"[25] Public Health Agency of Canada (2020) Public Health Notice: Outbreak of Cyclospora Infections Linked to Salad Products and Fresh Herbs. Available at: https:\/\/www.canada.ca\/en\/public-health\/services\/public-health-notices\/2020\/outbreak-cyclospora-infections-salad-products.html."},{"key":"S0950268824001055_r26","unstructured":"[26] Public Health Agency of Canada (2020) Public Health Notice: Outbreak of Salmonella Infections Linked to Peaches Imported from the United States. Available at: https:\/\/www.canada.ca\/en\/public-health\/services\/public-health-notices\/2020\/outbreak-salmonella-infections-peaches-imported-united-states.html."},{"key":"S0950268824001055_r21","unstructured":"[21] Public Health Agency of Canada (2018) Public Health Notice \u2013 Outbreak of E. coli Infections Linked to Romaine Lettuce. Available at: https:\/\/www.canada.ca\/en\/public-health\/services\/public-health-notices\/2018\/outbreak-ecoli-infections-linked-romaine-lettuce.html."},{"key":"S0950268824001055_r31","doi-asserted-by":"publisher","DOI":"10.4315\/JFP-21-112"},{"key":"S0950268824001055_r2","unstructured":"[2] Government of Canada (2021) National Enteric Surveillance Program Annual Summary 2020."},{"key":"S0950268824001055_r10","unstructured":"[10] StataCorp (2017) Stata Statistical Software: Release 15. StataCorp LLC, College Station, TX."},{"key":"S0950268824001055_r18","unstructured":"[18] Public Health Agency of Canada (2015) Public Health Notice Update \u2013 Outbreak of E.coli Infections with Possible Link to Leafy Greens. Available at: https:\/\/www.canada.ca\/en\/public-health\/services\/public-health-notices\/2015\/public-health-notice-update-outbreak-e-coli-infections-possible-link-leafy-greens.html."},{"key":"S0950268824001055_r23","unstructured":"[23] Public Health Agency of Canada (2018) Public Health Notice \u2013 Outbreak of Salmonella Infections Possibly Linked to Long English Cucumbers. Available at: https:\/\/www.canada.ca\/en\/public-health\/services\/public-health-notices\/2018\/outbreak-salmonella-infections-under-investigation.html."},{"key":"S0950268824001055_r30","doi-asserted-by":"publisher","DOI":"10.3201\/eid2610.191418"},{"key":"S0950268824001055_r32","unstructured":"[32] U.S. Food and Drug Administration (2020, July) Investigation Report: Factors Potentially Contributing to the Contamination of Red Onions Implicated in the Summer 2020 Outbreak of Salmonella Newport. Available at https:\/\/www.fda.gov\/food\/outbreaks-foodborne-illness\/factors-potentially-contributing-contamination-red-onions-implicated-summer-2020-outbreak-salmonella."},{"key":"S0950268824001055_r20","unstructured":"[20] Public Health Agency of Canada (2017) Public Health Notice \u2013 Outbreak of E. coli Infections Linked to Romaine Lettuce. 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Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0), which permits non-commercial re-use, distribution, and reproduction in any medium, provided that no alterations are made and the original article is properly cited. The written permission of Cambridge University Press must be obtained prior to any commercial use and\/or adaptation of the article.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e106"}}