Outbreak Toolkit

Module 4: visual chronology

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PHAC-CFEZID Timeline of Events Example [2020-060] Multi-provincial outbreak investigation of Salmonella Newport in QC, ON, AB, and BC Outbreak Identification & Source Implication May 8: NESP reports that Salmonella Newport is flagging in ON for the week of April 26 – May 2, 2020. May 13: ON reports that five Salmonella Newport cases are found to be genetically related by WGS May 15: NESP reports that Salmonella Newport is flagging nationally, as well as in BC, AB and ON for the week of May 3-9, 2020 May 21: PNC’s weekly WGS summary reports include a multi-provincial cluster of nine Salmonella Newport cases that are genetically related by WGS in BC (2), AB (1) and ON (6). May 25: OICC assessment call is held with CFIA, HC, NML, and provincial public health partners in BC, AB, and ON. A national OICC is activated. May 28 (n=14): PNC’s weekly WGS summary reports include five more cases that are genetically related to this cluster by WGS in BC (1), AB (2), ON (1) and QC (1). Information sharing call is held. PHAC to re-interview cases using a standardized Salmonella hypothesis-generating questionnaire. Jun 1 (n=14): 2nd OICC call is held. PHAC to re-interview cases with a focused questionnaire. Jun 4 (n=16): 3rd OICC call is held. There are two new cases in BC that are genetically related to this cluster by WGS. Jun 5 (n=16): 4th OICC call is held. Jun 11 (n=18): 5th OICC call is held. There are two new cases in QC (1) and BC (1) that are genetically related to this cluster by WGS. Both cases reported illness onsets before the products were recalled. Jul 7: Outbreak is declared over. Traceback and Regulatory Activities, and Results of Product Testing May 25: CFIA begins traceback on spinach. Jun 1: CFIA reports that they conducted traceback of the spinach and based on product distribution, it is unlikely that spinach is the source of the outbreak. They will initiate traceback on other products, including nuts and seeds, but require more information. Jun 4: CFIA begins traceback on chia seeds. Jun 5: Focused questionnaires and CFIA traceback reveal that two brands of chia seeds reported by cases were packaged at the same facility. An epidemiological assessment is completed in preparation for a recall. OICC members agree all parties will share media lines and communication products for a coordinated response and will aim to post at the same time. Samples are obtained and submitted for testing from two cases’ homes, as well as from the facility and at the retail level. Jun 6: Health Risk Assessment completed by HC. CFIA recalls two brands of chia seeds Jun 11: Two samples from cases’ homes test positive for Salmonella. Jun 12: Four samples from the recalled lots (unopened product) test positive for Salmonella. None of the samples from the previous and subsequent lots of chia seeds or from the environmental samples test positive for Salmonella. Jun 18: Both samples from cases’ homes are found to be genetically related by WGS to the outbreak strain (these products tested positive for Salmonella on Jun 11). Jun 19: All four samples from the recalled lots (unopened product) are found to be genetically related by WGS to the outbreak strain (these products tested positive for Salmonella on Jun 12).