Diagnosis and epidemiological investigation of an outbreak of Clostridium perfringens food poisoning
Sanz, J.Carlos.; Domínguez, Mía.Felicitas.; Sagües, Mía.Jesús.; Fernández, M.; Feito, R.; Noguerales, R.; Asensio, A.; Fernández De La Hoz, K.
Enfermedades Infecciosas Y Microbiologia Clinica 20(3): 117-122
2002
ISSN/ISBN: 0213-005X PMID: 11904084 Document Number: 543576
Clostridium perfringens is a classical agent of food-borne disease but because of the mildness and self-limiting nature of the illness many cases go undiagnosed. An outbreak of diarrhoea due to C. perfringens in a public restaurant in Spain was investigated. An epidemiological survey was performed and the restaurant was inspected. The specific attack rates for the items on the menu were calculated. Odds ratios were calculated to investigate the independent association between each item and the disease using a logistic regression model. Investigation of C. perfringens toxin in the faeces of 4 symptomatic subjects and one exposed but asymptomatic subject was performed by the reverse passive latex agglutination test. The overall attack rate was 70.8%. The main symptoms were diarrhoea (100%) and abdominal pain (94%). Significant differences were found in specific attack rates for consumption of different menu items. However, the independent contribution of each item was significant only for consumption of ravioli with cheese sauce. Faecal detection of C. perfringens enterotoxin was positive in the 4 symptomatic subjects and negative in the exposed but asymptomatic subject. The overall attack rate in this outbreak was high. The clinical symptomatology was similar to previously published data. The epidemiological analysis revealed that ravioli with cheese sauce was responsible for transmission of the disease, and clinical investigation together with faecal enterotoxin detection established C. perfringens as the aetiological agent.