Between 12 July and 29 September 2013, 29 individuals in five Canadian provinces became ill following infection with the same strain of Escherichia coli O157:H7 as defined by molecular typing results. Five case patients were hospitalized, and one died. Twenty-six case patients (90%) reported eating Gouda cheese originating from a dairy plant in British Columbia. All of the 22 case patients with sufficient product details available reported consuming Gouda cheese made with raw milk; this cheese had been produced between March and July 2013 and was aged for a minimum of 60 days. The outbreak strain was isolated from the implicated Gouda cheese, including one core sample obtained from an intact cheese wheel 83 days after production. The findings indicate that raw milk was the primary source of the E. coli O157:H7, which persisted through production and the minimum 60-day aging period. This outbreak is the third caused by E. coli O157:H7 traced to Gouda cheese made with raw milk in North America. These findings provide further evidence that a 60-day ripening period cannot ensure die-off of pathogens that might be present in raw milk Gouda cheese after production and have triggered an evaluation of processing conditions, physicochemical parameters, and options to mitigate the risk of E. coli O157:H7 infection associated with raw milk Gouda cheese produced in Canada.
The application of systematic reviews is increasing in the agri-food public health sector to investigate the efficacy of policy-relevant interventions. In order to enhance the uptake and utility of these reviews for decision-making, there is a need to develop summary formats that are written in plain language and incorporate supporting contextual information. The objectives of this study were (1) to develop a guideline for summarizing systematic reviews in one- and three-page formats, and (2) to apply the guideline on two published systematic reviews that investigated the efficacy of vaccination and targeted feed and water additives to reduce Salmonella colonization in broiler chickens. Both summary formats highlight the key systematic review results and implications in plain language. Three-page summaries also incorporated four categories of contextual information (cost, availability, practicality, and other stakeholder considerations) to complement the systematic review findings. We collected contextual information through structured rapid reviews of the peer-reviewed and gray literature and by conducting interviews with 12 topic specialists. The overall utility of the literature searches and interviews depended on the specific intervention topic and contextual category. In general, interviews with topic specialists were the most useful and efficient method of gathering contextual information. Preliminary evaluation with five end-users indicated positive feedback on the summary formats. We estimate that one-page summaries could be developed by trained science-to-policy professionals in 3-5 days, while three-page summaries would require additional resources and time (e.g., 2-4 weeks). Therefore, one-page summaries are more suited for routine development, while three-page summaries could be developed for a more limited number of high-priority reviews. The summary guideline offers a structured and transparent approach to support the utilization of systematic reviews in decision-making in this sector. Future research is necessary to evaluate the utility of these summary formats for a variety of end-users in different contexts.
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