The first indication that staff were aware of the E. coli 0157 outbreak appears in two emails sent by the province's chief medical officer to staff with the Health Department and district health authorities on Dec. 31, 2012.
In one of the emails, Dr. Robert Strang says the Health Department was in the process of gathering more information about the outbreak and officials would meet on Jan. 2 to assess it.
Notes from that day's meeting, which were released under access-to-information legislation, show that Health Department officials knew there were dealing with seven confirmed cases of E. coli 0157 affecting people ranging in age from 18 to 83.
Those notes also show that six of those people reported eating at fast food restaurants and they showed symptoms of the bacterial infection from Dec. 23-26, 2012. Officials were also aware of an E. coli outbreak of the same strain in New Brunswick but decided to delay notifying the public, the notes show.
"There have been no media calls yet. Until we know what the link is, we will provide standardized messaging," the notes say.
"If NB is sending messaging out, we should be consistent. Delay 24 hours."
It wasn't until Jan. 4 that the department issued a news release confirming it was investigating the cases, two of which required hospital admission. No one died.
In an interview, Strang said he doesn't believe Health Department officials tried to withhold information from the public. Instead, he said they needed to gather more information from the people who contracted the infection.
"The judgment was that we needed to wait at least 24 hours ... so we have something concrete that we can say to the public," Strang said.
"What do you say publicly without doing unnecessary harm or creating unnecessary anxiety? So we'd respond if questions came to us, but we didn't feel we were ready yet to go proactively because we didn't have enough of the detail."
New Brunswick's Health Department went public with its outbreak of E. coli on Jan. 3, prompting calls to Nova Scotia's Health Department that day from the news media, the documents show.
Strang said New Brunswick's chief medical officer was able to tell the public a day earlier because that province's outbreak occurred a few days before the one in Nova Scotia.
He said he was first alerted by the on-call medical officer of health to reports of a few cases of E. coli over the weekend of Dec. 29 and 30.
"With the information I had, I wasn't concerned enough to bring people in on New Year's Day," he said. "My judgment was that it could certainly wait until the next working day."
Liberal health critic Leo Glavine said the province needs a more robust process to ensure timely disclosure of public health matters, such as the E. coli outbreak.
Glavine said because the strain of the bacteria is potentially fatal, Strang should have issued an alert earlier.
"I think within 24 hours, if the medical officer knows, he should be sending this information out to the public, he said.
The strain of E. coli was the same one found in the Walkerton, Ont., water disaster in 2000 that killed seven people.
Strang said the E. coli outbreak would have been treated differently if there had been an indication of ongoing sickness due to the bacteria.
"If we had a sense that there was an ongoing risk to the public, we would have been communicating that right away," said Strang.
The outbreak, which was also detected in Ontario, was later traced to shredded lettuce distributed by FreshPoint Inc. to KFC and Taco Bell restaurants.