A review of major foodborne outbreaks affecting Canada in the last two decades

Critical evaluation of foodborne disease outbreaks is important for informing changes that increase the effectiveness of investigation, control, and prevention efforts. This review describes significant foodborne outbreaks that occurred in Canada between 2008 and 2023. Eight major outbreaks were described with most occurring solely within Canada, and three involving cross-border transmission with the United States (US). Implicated food vehicles included deli meats, beef, frozen breaded chicken products, oysters, and produce. Foods were linked to retail, food production, and community settings, with some associated with high-risk environments, such as long-term care facilities. Notable outbreaks discussed include: (i) the 2008 Listeria monocytogenes outbreak linked to ready-to-eat deli meats resulting in 57 identified cases and 24 deaths, and (ii) the 2020 Salmonella Newport outbreak linked to imported red onions from the US which led to over 1600 identified cases across both countries. These outbreaks highlight the importance of interjurisdictional and multinational collaboration and data sharing for detection and control. Their public health significance is also discussed by reporting on the traceability, technological, and regulatory changes which led to substantial advancement of Canada’s food safety system following these outbreaks. Climate change as an emerging threat and emerging technologies (e.g., artificial intelligence) are discussed. Opportunities to continue strengthening the food safety system include training opportunities for food industries, integration of syndromic surveillance, enhanced cross-border tracking systems, and equity considerations to tailor public education interventions. This review serves to share lessons learned with a global audience and present opportunities to strengthen the food safety system and supply chains.