HAMILTON, Ont. – A second hospital in Hamilton, Ont., has declared an outbreak of C. difficile.

Hamilton General Hospital said it has four infected patients, while St. Joseph’s Healthcare has 16 cases, including one patient who died on Monday.

The Hamilton Spectator reported all 20 Hamilton cases were contracted inside the hospital.  

The last outbreak at St. Joseph’s saw over 100 patients get C. difficile with 16 people dying over a three-and-half-month period from late 2010 to early 2011.