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WINNIPEG, Manitoba (Reuters) - Canada's food-safety system was caught unprepared and acted without a sense of urgency during last year's outbreak of listeriosis in which 22 people died after eating contaminated deli meat, according to a report released on Tuesday.
Sheila Weatherill, a nurse and health executive who led a federally appointed investigation into last summer's outbreak, said in her report there was evidence of contamination on meat-production lines months before the outbreak, but it was not effectively monitored.
A shortage of food-safety workers, with some on summer vacation, and insufficient training of food inspectors contributed to the outbreak, Weatherill said.
Last summer, contaminated deli meats from a Maple Leaf Foods processing plant in Toronto were linked to 22 deaths and sickness among many more people.
"I learned this summer's outbreak was rare and it was a complex event that defies simple explanations," Weatherill said in a news conference in Ottawa.
"Until the system is remedied, events like those of the summer of 2008 remain a real risk."
After an extensive investigation, Maple Leaf said it believed two slicers at the plant had been harboring listeria bacteria. The company tried to correct a listeria problem in the plant in 2007 and 2008 with sanitation and thought it was under control, the report said.
Maple Leaf didn't initially report the listeria because the government did not require it to do so. The company said on Tuesday that it has since improved its food safety measures.
"We thought we had a good food safety program last August, but our efforts failed with tragic consequences," said Michael McCain, Maple Leaf president and chief executive.
Weatherill made 57 recommendations to the federal government. Among them were:
* Improved training for food inspectors
* Giving Canada's public health agency the lead role in responding to national food-borne emergencies
* Ordering an external audit to look at whether more inspectors are needed
* Boosting monitoring of some production plants and products based on higher risk.
Agriculture and Agri-Food Minister Gerry Ritz, whose responsibilities include the agency that oversees food inspection, did not say if his government would implement all the recommendations, but said it would use them as "part of a guideline" to strengthen the food-safety system.
The government has already carried out some recommendations, such as making listeria testing and reporting by food companies mandatory and hiring more inspectors, Ritz said.
"There is no perfect answer (to preventing an outbreak), no one to stand up and say, 'I did it.' Everyone takes responsibility for their portion of it," Ritz said.
The report's recommendations may make Canada's food system safer, said Bob Kingston, president of the Agriculture Union-Public Service Alliance of Canada, the union that represents food inspection workers. But Kingston said he's concerned that the government and union don't agree on some basic figures critical to improving the system, such as the number of food inspectors.
"Here we are a year later and we're quibbling about numbers," Kingston said.
Almost 80 percent of those who became sick lived in a personal care home or were staying in a hospital that served meats from large packages prepared for institutions.
Earlier this year, Maple Leaf reached a tentative C$25 million ($22.7 million) settlement in a series of class-action lawsuits related to the outbreak.
Maple Leaf stock was up 5 Canadian cents, or 0.6 percent, at C$8.95 on the Toronto Stock Exchange on Tuesday afternoon.
Reporting by Rod Nickel; editing by Peter Galloway