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. 2020 Feb 27:148:e43.
doi: 10.1017/S095026882000031X.

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

Alex Bhattacharya  1 , Saran Shantikumar  2 , Damon Beaufoy  3 , Adrian Allman  4 , Deborah Fenelon  5 , Karen Reynolds  6 , Andrea Normington  7 , Musarrat Afza  8 , Dan Todkill  9
Affiliations

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

Alex Bhattacharya et al. Epidemiol Infect. .

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.

Keywords: Cheese; Clostridium perfringens; leeks; outbreak.

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Conflict of interest statement

None.

Figures

Fig. 1.
Fig. 1.
Epidemic curve by date and time of onset reported among cases, West Midlands, England, Dec 2018 (n = 28).
Fig. 2.
Fig. 2.
Automated recordings of food temperatures between 7–9 December 2018 of three meats, gravy and unspecified vegetables.
See this image and copyright information in PMC

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