Two weddings and an outbreak: Clostridium perfringens in London, July 2009

I didn’t even come up with that headline. Those science journal writers are developing a sense of humor.

Eriksen et al. write in Eurosurveillance today:

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 analyze 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.

In the discussion, the authors write,

A blast chiller is normally used for cooling large quantities of food quickly by this particular caterer; however it was not being used appropriately at the time of the incident. Temperature control of foods during preparation, cooling, transportation and reheating was poor. Furthermore, the vans used for food transport had no refrigeration and these events took place in July. The evidence of insufficient hygiene, cooling and reheating at the catering company during transport and at both venues (according to environmental health department inspections) are in keeping with a toxin-related gastroenteritis outbreak, including C. perfringens.