title: A nursing home outbreak of Clostridium perfringens associated with pureed food.
abstract: OBJECTIVE
  To investigate and ascertain the source of a nursing home outbreak of gastroenteritis in Melbourne in 1997.
  
  
  METHODS
  A retrospective cohort study. We obtained fecal and food samples and environmental swabs, and reviewed food handling.
  
  
  RESULTS
  There were 25 cases, and 21 of these had their meals pureed (liquidised). The relative risk for eating pureed food and becoming ill was 5.8 (95% CI 2.2-15.4). Clostridium perfringens and its enterotoxin was detected in nine fecal samples. Samples of pureed food tested positive for coliforms.
  
  
  CONCLUSIONS
  This outbreak was caused by C. perfringens contaminating pureed food. Food liquidising provides opportunities for re-contamination of cooked food through the use of contaminated equipment and deficiencies in food handling practices. Pureed foods should be reheated to 70 degrees C after liquidising to inactivate pathogens.
  
  
  CONCLUSIONS
  Health care facilities need to take specific precautions to manage the special hazards involved in preparing pureed food.
authors.affiliation: Public Health & Development Division, Department of Human Services Victoria, Melbourne. graham.tallis@dhs.vic.gov.au
authors.forename: G
authors.initials: G
authors.lastname: Tallis
authors.forename: S
authors.initials: S
authors.lastname: Ng
authors.forename: C
authors.initials: C
authors.lastname: Ferreira
authors.forename: A
authors.initials: A
authors.lastname: Tan
authors.forename: J
authors.initials: J
authors.lastname: Griffith
mesh_terms: D000368:Aged; D003015:Clostridium Infections / Q000209:etiology* / Q000517:prevention & control; D003016:Clostridium perfringens; D003428:Cross Infection / Q000209:etiology* / Q000517:prevention & control; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D005260:Female; D005511:Food Handling / Q000379:methods; D005517:Foodborne Diseases / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D017053:Infection Control; D008297:Male; D009735:Nursing Homes; D012189:Retrospective Studies; D014739:Victoria