A Harvey’s restaurant in North Bay, Ontario, Canada,  remains closed as the number of confirmed and suspected sick with E. coli O157:H7 climbed to 159 today.

The public health folks in North Bay must be going nuts, but they, along with the operators of Harvey’s, have put public health first and closed the restaurant until more is known.

Locust Grove, Oklahoma, was also hammered by an E. coli outbreak, E. coli O111, linked to dining at the Country Cottage restaurant in August.. One person died, 72 were hospitalized and 241 others got sick before the outbreak was contained.

Today it was revealed that State Health Department officials allowed the Country Cottage to stay open temporarily — even after confirming six of eight initial food poisoning victims had eaten its food, internal documents show. That decision may have resulted in additional people getting sick.

Health Department officials admitted last week there is no set threshold in such cases for closing a restaurant suspected of being the source of an outbreak.

There are no guidelines. Epidemiological investigations are full of uncertainty. So is most of what is known about foodborne illness. But after the Salmonella-in-tomatoes-jalapenos outbreak this summer, public health officials are seemingly reluctant to go public. Industry has attempted to take matters into their own hands – which they should have been doing anyway – and is increasingly challenging public health investigations with its own test results, and unfortunately overstating the value of their own tests.

Listeria in Maple Leaf deli meats, Salmonella in produce, E. coli in Ontario and Oklahoma. There are no guidelines on when to go public. Federal agencies like the U.S. Food and Drug Administration and the Canadian Food Inspection Agency must come clean with the public and industry and articulate the basis for public notification, or even restaurant closures, during outbreaks of foodborne illness. Until then local health units are left cleaning up the mess.