Clostridium perfringens outbreak linked to shepherd's pie
PHE ePoster Library. Turvey A. Apr 10, 2019; 259617; 15614
Dr. Andrew Turvey
Dr. Andrew Turvey
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Abstract
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Abstract Background

A member of the public reported an outbreak of gastro-intestinal (GI) illness involving 33/35 people who ate at a pub. Cases reported stomach pains and diarrhoea with an onset 5-8 hours after the meal. The party ate shepherd's pie and apple pie with custard.

Methods:

An Outbreak Control Team (OCT) meeting was called by the Health Protection Team (HPT) with Environmental Health Officers (EHOs). It agreed actions to interview cases, obtain faecal and environmental samples and inspect the premises. Liaison with community leaders ensured that this was carried out in a timely way. Due to the menu, rapid onset times and symptoms, samples were tested for a full range of GI organisms, including toxin-formers.

Results

EHOs ascertained that the cooking/cooling times for the separate ingredients of the shepherds' pie and the final reheating of the completed pie appeared to be inadequate. Rapid co-ordination between HPT, EHOs, regional and national Public Health England (PHE) laboratories ensured that any organisms present were still viable and toxins detectable. Consequently 19/24 faecal samples were positive for enterotoxin producing Clostridium perfringens along with 9/10 positive samples from the shepherd's pie. 17/19 faecal isolates were found to have an identical molecular type of C perfringens to the samples from the pie - fAFLP type CLP.132 indicating that the shepherd's pie was the source of the outbreak.

Conclusions

C perfringens is a known toxin-forming organism which can contaminate food subjected to temperature abuse, causing illness in humans. The OCT advised that the premises should review their preparation methods to prevent a reoccurrence of the situation. EHOs are now considering legal proceedings against the food business operator. This outbreak is a good example of how community engagement can facilitate the investigation of an infectious disease. Funding Funded from routine public sector budgets (Health Protection Team, Environmental Health, Coroner's Office).
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