After four kids, I was familiar with the look.

“How long have you been pregnant,” I asked the thirty-something as we filled our plates during the catered lunch at a meeting in 2000 in Ottawa.

“About six weeks.”

The American media had been filled with coverage of listeria after the 1998-1999 Sara Lee Bil Mar hot dog outbreak in which 80 were sickened, 15 killed and  at least 6 pregnant women had miscarriages. Risk assessments had been conducted, people were talking about warning labels, and especially, the risks to pregnant women.

There was no such public discussion in Canada.

So as I watched the pregnant PhD load up on smoked salmon, cold cuts and soft cheese for lunch, I wondered, do I say something?

One of the biggest risks in pregnancy is protein deficiency. What if smoked salmon, cold cuts and soft cheeses were this woman’s biggest source of protein? (Turns out they were.)

Another big risk factor is stress. I didn’t want to freak her out. Besides, who the hell am I to say anything?

We sat together during lunch and chatted about babies, her aspirations and how she was feeling. Eventually I introduced the subject of listeria by talking about a risk assessment that had recently been published by the U.S. Food and Drug Administration, and that maybe she would be interested in looking at the results. I felt sorta goofy.

Eight years later, I don’t feel so goofy. Instead I’m frustrated at the lack of awareness, not only amongst pregnant women but amongst the elderly, other immunocompromised individuals, and the institutions and professionals that are supposed to look out for others.

Most of the now 12 confirmed and 6 suspected deaths related to Maple Leaf deli meats were consumed in places like nursing homes.

The Ontario Association of Non-Profit Homes and Services for Seniors, an umbrella group, was unaware of the recommendation that immunocompromised avoid deli meats to reduce the risk of listeria, unless they are thoroughly heated.

Association executive director Donna Rubin said,

"We’ve contacted dietitians that have long-standing experience in our homes and they’ve never been warned about listeriosis or deli meats being a huge issue or that they should be avoided.”

An Ontario Health Ministry spokesman said it has no specific policy against serving sliced meats in nursing homes, and Health Canada officials said banning certain foods from seniors homes is not in its jurisdiction. Health Canada has never recommended health facilities stop serving deli meats, noting that hospitals are a provincial responsibility.

In Calgary, two nursing home operators, Carewest and Bethany Care Society, confirmed some of their facilities serve cold meats.

Janice Kennedy, a Bethany spokeswoman, said,

"If public health says not to serve cold cuts to seniors, then we wouldn’t. We’re still meeting requirements."

It all sounds bureaucratic to me, as the death toll increases.

And the pregnant woman? When I saw her at another meeting a couple of months later, she thanked me for providing her with information about listeria and risky foods for pregnant mothers.