Outbreak of Clostridium perfringens food poisoning linked to leeks in cheese sauce: an unusual source
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, environmen...
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| Veröffentlicht in: | Epidemiology and infection 2020-01, Vol.148, p.e43, Article e43 |
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| creator | Bhattacharya, Alex Shantikumar, Saran Beaufoy, Damon Allman, Adrian Fenelon, Deborah Reynolds, Karen Normington, Andrea Afza, Musarrat Todkill, Dan |
| description | 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. |
| doi_str_mv | 10.1017/S095026882000031X |
| format | Article |
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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.</description><identifier>ISSN: 0950-2688</identifier><identifier>EISSN: 1469-4409</identifier><identifier>DOI: 10.1017/S095026882000031X</identifier><identifier>PMID: 32102705</identifier><language>eng</language><publisher>England: Cambridge University Press</publisher><subject>Abdomen ; Campylobacter ; Cheese ; Clostridium perfringens ; Confidence intervals ; Cooking ; Councils ; Cramps ; Dairy products ; Diarrhea ; E coli ; Epidemics ; Epidemiology ; Food ; Food contamination ; Food contamination & poisoning ; Food poisoning ; Food safety ; Illnesses ; Laboratories ; Meals ; Original Paper ; Outbreaks ; Public health ; Questionnaires ; Restaurants ; Salmonella ; Sauces ; Temperature control</subject><ispartof>Epidemiology and infection, 2020-01, Vol.148, p.e43, Article e43</ispartof><rights>Copyright Cambridge University Press 2020</rights><rights>Crown Copyright 2020 2020 Crown Copyright</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c384t-106f5aec23dd3edbe9a6ab090864a22a3fe8be62470944f63c23452cbb591cc93</citedby><cites>FETCH-LOGICAL-c384t-106f5aec23dd3edbe9a6ab090864a22a3fe8be62470944f63c23452cbb591cc93</cites><orcidid>0000-0003-3000-2771 ; 0000-0001-9755-9203 ; 0000-0002-8565-5385 ; 0000-0002-4387-4117 ; 0000-0003-1924-2483 ; 0000-0002-7088-8549 ; 0000-0002-3392-6657 ; 0000-0002-4325-4786</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7058653/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7058653/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32102705$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bhattacharya, Alex</creatorcontrib><creatorcontrib>Shantikumar, Saran</creatorcontrib><creatorcontrib>Beaufoy, Damon</creatorcontrib><creatorcontrib>Allman, Adrian</creatorcontrib><creatorcontrib>Fenelon, Deborah</creatorcontrib><creatorcontrib>Reynolds, Karen</creatorcontrib><creatorcontrib>Normington, Andrea</creatorcontrib><creatorcontrib>Afza, Musarrat</creatorcontrib><creatorcontrib>Todkill, Dan</creatorcontrib><title>Outbreak of Clostridium perfringens food poisoning linked to leeks in cheese sauce: an unusual source</title><title>Epidemiology and infection</title><addtitle>Epidemiol Infect</addtitle><description>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.</description><subject>Abdomen</subject><subject>Campylobacter</subject><subject>Cheese</subject><subject>Clostridium perfringens</subject><subject>Confidence intervals</subject><subject>Cooking</subject><subject>Councils</subject><subject>Cramps</subject><subject>Dairy products</subject><subject>Diarrhea</subject><subject>E coli</subject><subject>Epidemics</subject><subject>Epidemiology</subject><subject>Food</subject><subject>Food contamination</subject><subject>Food contamination & poisoning</subject><subject>Food poisoning</subject><subject>Food safety</subject><subject>Illnesses</subject><subject>Laboratories</subject><subject>Meals</subject><subject>Original Paper</subject><subject>Outbreaks</subject><subject>Public health</subject><subject>Questionnaires</subject><subject>Restaurants</subject><subject>Salmonella</subject><subject>Sauces</subject><subject>Temperature 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| source | Cambridge Journals Open Access; DOAJ Directory of Open Access Journals; PubMed Central |
| subjects | Abdomen Campylobacter Cheese Clostridium perfringens Confidence intervals Cooking Councils Cramps Dairy products Diarrhea E coli Epidemics Epidemiology Food Food contamination Food contamination & poisoning Food poisoning Food safety Illnesses Laboratories Meals Original Paper Outbreaks Public health Questionnaires Restaurants Salmonella Sauces Temperature control |
| title | Outbreak of Clostridium perfringens food poisoning linked to leeks in cheese sauce: an unusual source |
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