Abstract

On 21 January 2012, the Norwegian Food Safety Authority was informed about gastrointestinal illness among 111 swimming club members, who were staying at a hotel in Trondheim. A hotel dinner on 20 January was their only common meal. Kitchen staff were interviewed, and food leftovers and kitchen environment were sampled. A case was defined as a swimming team member staying at the hotel from 20 to 22 January, who fell ill with diarrhoea, abdominal pain or nausea during this period. A total of 43 cases were identified, with median duration of symptoms of 35 hours. cpe-positive Clostridium perfringens (3.8 x 108 CFU), but not Bacillus cereus, was isolated from beef stew eaten by cases. cpe-negative C. perfringens was detected in a sample from the kitchen floor. SDS-PAGE showed indistinguishable protein profiles among C. perfringens cultures isolated from the beef stew, but slightly different profiles from the culture isolated from the kitchen floor. Cohort analysis showed that eating beef stew and rice was significantly associated with illness. No pathogens were detected in the rice. The temperature control of the stew, but not of the rice, was poor. Our results strongly indicate that cases were infected by Clostridium perfringens in beef stew that had inadequate temperature control during preparation.

Highlights

  • C. perfringens is a spore-forming bacterium widely distributed throughout the environment, which may cause food-borne disease [1]

  • The setting – a communal meal prepared in a commercial kitchen [1] – clinical symptoms and incubation period [2] were typical of C. perfringens infection

  • C. perfringens in high numbers, exceeding the assumed infection dose, was isolated from beef stew eaten by all cases but one

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Summary

Introduction

C. perfringens is a spore-forming bacterium widely distributed throughout the environment, which may cause food-borne disease [1]. C. perfringens enterotoxin (CPE) encoded by the cpe gene is the major virulence factor, causing tissue damage of intestinal epithelial cells in an infected person and leading to self-limiting diarrhoea and abdominal pain as main symptoms. The incubation period is 6–24 hours (usually 10–12 hours) [2]. The duration of illness is mostly reported to be a maximum of 24 hours. Longer duration has been reported from at least one outbreak (mean: 2.3 days; range: 1–10) [3]. The infective dose is estimated to be 106–107 cells [1,4]

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