title: Clostridium perfringens in London, July 2009: two weddings and an outbreak.
abstract: Food poisoning outbreaks caused by Clostridium perfringens enterotoxin occur occasionally in Europe but have become less common in recent years. This paper presents the microbiological and epidemiological results of a large C. perfringens outbreak occurring simultaneously at two weddings that used the same caterer. The outbreak involved several London locations and required coordination across multiple agencies. A case-control study (n=134) was carried out to analyse possible associations between the food consumed and becoming ill. Food, environmental and stool samples were tested for common causative agents, including enterotoxigenic C. perfringens. The clinical presentation and the epidemiological findings were compatible with C. perfringens food poisoning and C. perfringens enterotoxin was detected in stool samples from two cases. The case-control study found statistically significant associations between becoming ill and eating either a specific chicken or lamb dish prepared by the same food handler of the implicated catering company. A rapid outbreak investigation with preliminary real-time results and the successful collaboration between the agencies and the caterer led to timely identification and rectification of the failures in the food handling practices.
authors.affiliation: Health Protection Agency, Centre for Infections, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Eriksen
authors.forename: D
authors.initials: D
authors.lastname: Zenner
authors.forename: S R
authors.initials: SR
authors.lastname: Anderson
authors.forename: K
authors.initials: K
authors.lastname: Grant
authors.forename: D
authors.initials: D
authors.lastname: Kumar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000846:Anniversaries and Special Events; D016022:Case-Control Studies; D002648:Child; D003016:Clostridium perfringens / Q000302:isolation & purification*; D015331:Cohort Studies; D003296:Cooking; D004196:Disease Outbreaks; D004768:Enterotoxins / Q000032:analysis*; D004797:Enzyme-Linked Immunosorbent Assay; D005243:Feces / Q000382:microbiology; D005260:Female; D005506:Food Contamination; D005517:Foodborne Diseases / Q000453:epidemiology*; D005759:Gastroenteritis / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D004768:Enterotoxins; C035598:enterotoxin, Clostridium