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A deadly listeriosis outbreak caused by tainted plant-based milks has spread to a fourth province and sickened at least one child, according to the Public Health Agency of Canada.

PHAC issued a public-health notice Tuesday saying six more cases of the bacterial illness have been identified since July 17, when the agency revealed that two Canadians had died and another 10 had been made seriously ill by refrigerated alternative milks that were the subject of nationwide recalls issued on July 8.

Two new cases were identified in Ontario, three in Quebec and one in Alberta – the first known case in that province. PHAC also said Tuesday that those who fell ill ranged in age from 7 to 89. The agency’s July 17 notice said the youngest patient was 37, meaning at least one of the newly reported cases is in a child.

The Canadian Food Inspection Agency (CFIA), which is responsible for ensuring the safety of Canada’s food supply, and the French food giant Danone, which makes the recalled Silk and Great Value brand almond, cashew, oat and coconut milks, have refused to name the third-party Ontario factory where the outbreak began.

Federal Health Minster Mark Holland, in response to a question from The Globe and Mail at an unrelated news conference on July 23, said he would look into releasing the name of the food-processing plant.

“The loss of life as a result of food contamination is something that should never happen in Canada,” Mr. Holland said. “As to the releasing of the name, I know that there are legal issues involved in that, but I think your question is a fair one, and so I have to kind of adjudicate and navigate those legal matters, but let me get back to you in short order because your question is fair.”

A CFIA media spokesperson responded to The Globe by e-mail on Monday – nearly a week after Mr. Holland’s news conference – to say the agency would not reveal the name of the factory.

“The CFIA can confirm that Danone uses a third-party manufacturer. The affected products were produced by Danone using a dedicated line at that facility. All products made on this line have been recalled and production on this line has been stopped while the investigation is ongoing,” the statement said. “The CFIA’s ability to share more information, like facility location, during food safety investigations and recalls is restricted by the Access to Information Act and the Safe Food for Canadians Act.”

Listeria monocytogenes, the bacteria that cause listeriosis, are hardy pathogens that can survive refrigeration and freezing. Major outbreaks of listeriosis in the past have been linked to cantaloupe, soft cheeses, ice cream, chocolate milk and cold cuts, among other food and drinks.

A 2008 outbreak that began at a Maple Leaf Foods plant in Toronto killed 22 people, the deadliest such outbreak in Canadian history.

Most people who ingest listeria never get sick. But in rare cases – typically in people who are immunocompromised – the bacteria can cause life-threatening infections of the blood and neurological system. Listeriosis in pregnancy is also associated with an increased risk of miscarriage or stillbirth.

Of the 18 cases so far linked to recalled alternative milks, 13 were sick enough to require treatment in hospital, PHAC said.

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