(Nov. 21, WEB EXCLUSIVE) Although no source has been confirmed, officials with the Food and Drug Administration and the California Department of Public Health are conducting farm investigations for possible links to an Ontario E. coli outbreak.

“We are following up on information from Canada about a potential link to romaine,” said Ken August, a public information officer for the California Department of Public Health, Sacramento.

As of Nov. 19, there were 30 confirmed cases of E. coli O157:H7 that matched the specific fingerprint of this outbreak. Until Nov. 19, cases had only been reported in Niagara, Halton, Guelph and Waterloo, but Hamilton joined the list with one case confirmed Nov. 19. There were 123 reported cases yet to be tested.

All of the establishments that were being investigated, including Jonathan’s Family Restaurant, Burlington; M.T. Bellies Tap, Welland; Little Red Rooster, Niagara-on-the-Lake; Pita Pit at the University of Guelph and St. Mary’s High School cafeteria, have turned up negative tests for E. coli and have been reopened.

Rene Cardinal, national manager of the fresh fruit and vegetables program at the Canadian Food Inspection Agency, said other commodities are still being tested, but that romaine is the prime suspect. Romaine is what led the inspection agency to California.

“What we have done is the preliminary traceback,” Cardinal said. “Let’s say they come up with another food item, all the ground work we’ve done is no good. On the flip side, if it’s confirmed that it is that food item, the traceback is done.”

The Hamilton case, confirmed by lab tests on Nov. 19, was not linked to any of the restaurants or cafeterias that other area health agencies had previously identified. Chris Mackie, associate medical officer of health for Hamilton Public Health Services, said the woman who reported the case also reported eating bagged lettuce.

“It seems like more of these people are reporting bagged lettuce, but we haven’t gotten any lab confirmed,” Mackie said. “In (the Hamilton woman’s) case, she doesn’t eat a lot of meat, she’s almost vegetarian, so it points to the lettuce.”

The most recent onset date, as of Nov. 19, was Nov. 6 in Guelph, said Andrew Morrison, spokesman for the Ministry of Health and Long-Term Care.

“Lettuce is just one of the things we’re testing,” he said. “We’re mostly looking at produce. It seems to be the commonality in the cases.”

Morrison said for a majority, 60%, of foodborne illnesses cases in Ontario, a source is never found. The province usually sees 350 cases per year, and this outbreak puts it up to between 250 and 300 for 2008.