Outbreak of Clostridium perfringens food poisoning linked to leeks in cheese sauce: an unusual source

Alex Bhattacharya*, Saran Shantikumar, Damon Beaufoy, Adrian Allman, Deborah Fenelon, Karen Reynolds, Andrea Normington, Musarrat Afza, Daniel Todkill

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)
693 Downloads (Pure)

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.

Original languageEnglish
Article numbere43
JournalEpidemiology and Infection
Volume148
Early online date27 Feb 2020
DOIs
Publication statusE-pub ahead of print - 27 Feb 2020

Bibliographical note

Funding Information: No Funding Information.

Open Access: This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Publisher Copyright: © Crown Copyright, 2020. Published by Cambridge University Press.

Citation: Bhattacharya A, Shantikumar S, Beaufoy D, Allman A, Fenelon D, Reynolds K, Normington A, Afza M, Todkill D (2020). Outbreak of Clostridium perfringens food poisoning linked to leeks in cheese sauce: an unusual source. Epidemiology and Infection 148, e43, 1–7.

DOI: https://doi.org/10.1017/S095026882000031X

Keywords

  • Cheese
  • Clostridium perfringens
  • leeks
  • outbreak

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