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American Journal of Epidemiology Vol. 127, No. 3: 605-611
Copyright © 1988 by The Johns Hopkins University School of Hygiene and Public Health

research-article

A LARGE CLOSTRIDIUM PERFRINGENS FOODBORNE OUTBREAK WITH AN UNUSUAL ATTACK RATE PATTERN

LYLE R. PETERSEN1,2, ROGER MSHAR2, GEORGE H. COOPER, JR.2, ARTHUR R. BRUCE3 and JAMES L. HADLER2,

1Division of Field Services, Epidemiology Program Office, Centers for Disease Control Atlanta, GA 30333
2Preventable Diseases Division, State of Connecticut Department of Health Services 150 Washington St, Hartford, CT 06106
3Laboratory Division, State of Connecticut Department of Health Services Hartford, CT

Send reprint requests to Dr. James L. Hadler at this address

On November 7, 1985, a Clostridium perfringens gastroenteritis outbreak occurred in approximately 44% of the 1,362 employees at a Connecticut factory. Although the same foods were served to all three shifts at an employee banquet on November 6, the attack rate was almost twice as high for those who ate on the day shift (attack rate = 50%) than for those on the evening shift (attack rate = 20%) or night shift (attack rate = 29%). Among employees of the day shift, attack rates were highest for those who ate during the first 30 minutes of the 2.5-hour day shift serving period and decreased throughout the serving period. The one-hour evening shift serving period had a similar trend toward higher attack rates earlier in the serving period. Four main-course foods were significantly associated with illness, and over 95% of the employees had eaten each of them. Stratified analysis Indicated that gravy was the responsible food and, furthermore, that the decreasing attack rate pattern within serving periods occurred only for those who ate gravy. The gravy had been prepared 12–24 hours in advance of banquet service. After it was prepared, the gravy was improperly cooled and was reheated shortly before and throughout the serving periods. Persons who ate gravy that had been reheated for the longest period of time had the lowest attack rate, probably because they were exposed to a lower concentration of organisms. This outbreak underscores the need for properly reheating food to prevent C. perfringens gastroenteritis and suggests that analysis of attack rate trends may provide important epidemiologic dues to understanding the causes of foodbome disease outbreaks.

Clostridlum perfringens; disease outbreaks; food handling; food poisoning


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