Outbreak ofClostridium perfringensfood poisoning linked to leeks in cheese sauce: an unusual source

Abstract

Between 11–13 December 2018, local public health authorities in the West Midlands, England were alerted to 34 reports of diarrhoea with abdominal cramps. Symptom onset was ~10 h after diners ate Christmas meals at a restaurant between 7–9 December 2018. A retrospective case-control study, environmental and microbiological investigations were undertaken to determine the source and control the outbreak. An analytical study was undertaken with odds ratios (OR) and 95% confidence intervals (CI). Forty persons were recruited to the analytical study (28/40 cases). Multivariable analysis found that leeks in cheese sauce was the only item associated with illness (aOR 51.1; 95% CI 4.13–2492.1). Environmental investigations identified significant lapses in food safety, including lapses in temperature control during cooking and hot holding, likely cross-contamination between raw and cooked foods and the reuse of leftover cheese sauce for the next day's service. No food samples were taken during the exposure period. Two faecal samples were positive for Clostridium perfringens with one confirming the enterotoxigenic gene. Cheese sauce is an unusual vehicle for the organism and the first time this has been reported in England.

Epidemiological investigation of a food poisoning outbreak: a study among hostel dwelling students and resident doctors of a tertiary healthcare facility of India

“…The most common symptoms associated with both Clostridium perfringens and Bacillus Cereus are food-poisoning is abdominal cramps and diarrhoea with spontaneous recovery within 24-48 hours. (11,12) Clostridium perfringens commonly isolated from contaminated meet, poultries, legumes and gravies while Bacillus cereus commonly grows in meats, vegetables and cereals. ( 5) Food poisoning outbreaks associated with Clostridium perfringens and Bacillus Cereus are being previously reported in hostel settings.…”

Foodborne Clostridioides Species: Pathogenicity, Virulence and Biocontrol Options

“…The beta toxin coded by the cpb2 gene is the most lethal poultry toxin and has been isolated in many poultry birds that also display MDR [72]. Bhattacharya et al (2020) reported on an outbreak of enterotoxigenic C. perfringens associated with the consumption of reheated cheese sauce [37]. C. perfringens has one of the fastest known bacterial doubling times of 8-12 min at 43 • C and 12-17 min at 37 • C [43] giving it a competitive advantage in colonising the GIT, resulting in dysbiosis and pathogenicity.…”

Unveiling the pathogenic mechanisms of Clostridium perfringens toxins and virulence factors

“…This “survivability” means that C. perfringens has been associated with many infections and diseases, including being the second leading cause of foodborne bacterial disease in the United States (causing one million illnesses yearly) and Europe's fourth leading cause [ 3–5 ]. In England, 8-13% of foodborne gastrointestinal outbreaks are estimated to be associated with this bacterium (90,000 cases of C. perfringens per year) [ 6 ] .…”