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A daycare at the centre of an E. coli outbreak at several daycares is seen in Calgary on Sept. 15, 2023.Jeff McIntosh/The Canadian Press

One child-care facility was lucky enough to get the chicken for lunch instead of meat loaf that day. Some of the kids at another facility didn’t eat the meal, as they preferred non-Western food and usually brought snacks from home. In another child-care centre, only a few of the meatloaf slices were eaten because they were cut too big, and caregivers noticed the ground-meat dish looked “rosy coloured,” similar to medium-rare steak.

These were the twists of fate outlined in government reports into one of Canada’s largest-ever outbreaks of E. coli, showing that the 2023 outbreak could have been much worse.

To be clear, it was, as Alberta Premier Danielle Smith described it, “a living nightmare” for the families involved last September – when 359 children along with dozens of adults got sick after contaminated food prepared in a centralized kitchen was distributed to child-care centres across Calgary.

About 10 per cent of those kids and one adult ended up in hospital with serious illness. Nearly two dozen patients were diagnosed with the dire complication of a severe bowel infection called hemolytic uremic syndrome, which can lead to kidney failure. No one died but some are facing continuing health issues. According to the reports, one saving grace came in the form of a medical team with specialized knowledge of Shiga toxin-producing E. coli at the Alberta Children’s Hospital.

Based on an Alberta Health Services (AHS) investigation and epidemiological data, the province also confirmed what has long been believed: that beef meat loaf and vegan loaf meals served for lunch at the child-care centres on Aug. 29 were the likely sources of infection.

Ms. Smith and her cabinet ministers were front-and-centre for the release of the two reports on Monday: one from a special review panel focused on food-safety standards in child-care settings, and the other from AHS looking at the details of the E. coli outbreak itself.

Now, the question is how quickly and how hard her government will go when it comes to reforming food-safety rules and culture. And frankly, Albertans are still waiting for the “consequences” Ms. Smith had promised last September.

It’s clear there are massive gaps. As the report from the panel chaired by former Calgary police chief Rick Hanson said: “the food safety expectations of Albertans are not being met. The system responsible for food safety is in need of significant update and reform.” In government speak, this is akin to blaring an alarm.

And this should send a chill down everyone’s spine: “Prosecutions under the Public Health Act and its regulations for serious food safety infractions are exceptionally rare and, in some years, non-existent.”

The daycare operator at the centre of the outbreak was the Fueling Brains Academy, which has the same owners as the shared kitchen. Before the outbreak, public health inspectors had observed a number of violations, including a cockroach infestation and food being transported without temperature controls. Directors Faisal Alimohd and Anil Karim have been charged under municipal bylaws for operating without the appropriate business license; they have entered a not-guilty plea ahead of a trial in September. Class-action lawsuits are also in the works.

But the pace of government change is unclear. It said on Monday that work is already under way to increase the frequency of inspections at child-care and food distribution facilities, and to improve response times when someone raises a food-safety concern. But the Premier said its response might require consultations, and new legislation could come this fall, or as late as the spring.

And even after the government reports, we still don’t know where exactly the nasty strain of E. coli that ended up in the meatloaf came from.

Officials are still not sure whether the outbreak started as the result of a contaminated ingredient, or through an infected food handler – and whether there’s a link to a separate E. coli case involving privately purchased, uninspected beef. The E. coli strains from the two cases have been matched through genome sequencing, which is highly unlikely to be happenstance, according to Laura McDougall, senior medical officer of health for AHS.

This is the key question not only for public health, but also for a province economically dependent and culturally entwined with its beef and agriculture industry (E. coli from the intestines of cattle can get into meat during slaughter). Alberta Agriculture and Irrigation is still investigating.

All of this can offer a deeply painful lesson, if we care to learn it. Cracking down on child-care operators that don’t hold their food-prep standards to the highest level of care, as well as those who would skirt the province’s rules for slaughtering and selling meat, is a law-and-order agenda everyone can get behind.

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