Thank you very much.
Food-borne illnesses, of course, are legally reportable in Canada, but most, as you know, go unreported, either because they're not brought to medical attention or because the diagnosis is not confirmed by laboratory testing. In my reports, we estimated the true burden of food-borne illness in Toronto using methods developed by the Public Health Agency of Canada to fill in the missing unreported cases, and the results indicate that Toronto residents experience over 400,000 cases per year, or to put it another way, about one in six Torontonians gets a food-borne illness each year.
Now, although most of these illnesses are mild, they nonetheless are responsible for direct and indirect cost to the health care system and the economy, which we estimated to be in the range of about $500 million annually just within our city.
The food safety system in Canada is designed to prevent and respond to this large burden of illness, and it's a system that has important roles for governments and government agencies at all three levels of government, as well as for food producers, manufacturers, distributors, and retailers. Food safety is regulated at virtually every stage, from grow it to throw it.
Now, although the food safety system has many strengths, there are also some opportunities for improvement. I'd like to focus briefly on three areas that are within federal jurisdiction.
The first concerns transparency. Since about 2001 in Toronto, we've had a program of public disclosure of food safety performance. The results of all public health inspections of the 16,000 food premises in Toronto are available to the public at the door of the food premise when you walk in, they're available on a searchable public website, and they're available by telephone for those who don't use the Internet.
This program, which is called DineSafe, has promoted public awareness of food safety and provided a very strong incentive for food service operators to maintain good food safety practices and to quickly address any deficiencies that are identified during inspections. The DineSafe website, in fact, is one of the most frequently visited websites of the City of Toronto, and I would invite you to take a look at it. Based on our experience in our city, I would recommend that all federally regulated food facilities be subject to the same degree of public disclosure as those in Toronto.
The second area I'd like to speak to is food notification and recalls. The Canadian Food Inspection Agency is the national lead for notifying the public of potentially hazardous food products and for recalling products from sale. The decision to notify the public and recall a product is an important food safety intervention that can prevent illness and can even save lives. Timeliness is critical, as a hazardous product may still be leaving store shelves or being consumed in homes and restaurants as the outbreak investigation is proceeding.
Now, in our experience with several large-scale multi-jurisdictional outbreaks over the past several years, the Canadian Food Inspection Agency has generally waited for conclusive evidence that a specific product is responsible for documented human illness before taking action. Two examples come to mind. In a large salmonella outbreak in 2005, epidemiologic evidence pointed to bean sprouts produced at a Toronto facility as the probable source. In my assessment at the time, there was sufficient evidence to take action to protect the public. The CFIA, at that time, was not prepared to notify, so I closed the plant since it was within my jurisdiction to do so.
The second example concerns the 2008 listeriosis outbreak, in which at one point in the process the manufacturer notified customers not to use certain implicated products, and Ontario public health officials, at the provincial level, issued their own notification to consumers. Both actions were taken several days before the CFIA confirmed that the products had caused human illness based on finding matching strains of listeria from ill individuals and from unopened packages of food. In my view, in general, during the investigation of a food-borne outbreak, public health officials should have a bias toward health protection and should take action whenever there are reasonable and probable grounds to believe that a food product poses a health hazard. This is the standard that is included in Ontario public health legislation.
Finally, I think there are some practical steps that can be taken to improve inter-agency cooperation in the case of a large multi-jurisdictional outbreak. Existing protocols, such as the Foodborne Illness Outbreak Response Protocol, or FIORP, should be updated, and there should be substantial training in the protocol for all parties who may have to collaborate during an outbreak. During the 2008 listeriosis outbreak, it did not appear to me and my colleagues that the protocol was being used to guide the investigation and response, and some participants were apparently unaware of its status or its existence. It would be very useful to conduct simulation exercises, such as are used to prepare for other large emergencies—influenza pandemic comes to mind—to give responding agencies from all orders of government more experience in working effectively together during a large outbreak.
Thank you very much for your attention and for the opportunity to raise these issues with the committee.