A suspected Clostridium perfringens outbreak affected 30 individuals in Greece in 2021, in response to a research.
In Might 2021, a number of gastroenteritis circumstances have been reported amongst college students and workers of a highschool on a Greek island. Day by day sizzling lunches have been delivered by a catering firm and consumed in lecture rooms.
In late Might, the Hellenic Nationwide Public Well being Group was knowledgeable by a regional unit of the Hellenic Meals Authority (EFET) a couple of cluster of gastroenteritis circumstances amongst 12 to 18-year-old college students and lecturers. The college is in a small city on a distant north-eastern Aegean Greek island, which had restricted capability for particular laboratory testing.
Affected person and meals sampling
Based mostly on a questionnaire, researchers obtained 129 responses from college students and workers and 30 sufferers have been recognized, of which 4 have been lecturers. Sixty % of circumstances have been girls, and the median age was 13 with a variety of 12 to 40 years outdated.
Most sick individuals had belly ache and diarrhea, whereas 19 reported fatigue. The median length of signs was a day, with a most of three days, and nobody was hospitalized.
Of 11 vital meals gadgets within the evaluation, the consumption of spaghetti with the bottom (minced) meat was related to the onset of gastroenteritis, as discovered within the research revealed within the journal Foodborne Pathogens and Illness.
Clostridium perfringens have been detected in two of three college students’ stool samples. Six samples from spaghetti with floor meat have been optimistic for Clostridium perfringens and 4 additionally examined optimistic for Bacillus cereus. The entire intact prepacked meals have been discovered within the faculty’s fridge and have been a part of the meal provided the day before today, simply earlier than the incidence of circumstances.
Investigation of Clostridium perfringens toxins in medical and meals samples was not carried out resulting from a scarcity of laboratory capability, so the pathogen behind the outbreak was not confirmed.
Meals sampling and additional inspection of the 2 concerned services have been performed by the EFET-Regional Directorate of the North Aegean Sea. The primary was the varsity the place meals have been delivered and the second was the institution the place meals was beforehand produced.
Investigations on the faculty and caterer
Deficiencies within the reception and distribution of meals, by the catering firm and the receiving committee on the faculty, have been recognized. The mass caterer didn’t precisely describe the kind of lunch dishes within the supply notes and the temperature of the meals was not checked on the receipt.
It was not specified whether or not the time elapsed between the preparation and consumption of lunch meals on the faculty was below two hours.
Environmental investigation revealed non-compliance round meals personnel coaching and Hazard Evaluation and Important Management Factors (HACCP) plan implementation within the meals institution.
Uncooked floor meat was provided, marinated, blanched, and frozen in a blast freezer till additional cooking 5 days later. Then, the spaghetti was cooked and blended with floor meat, transported, and served on the faculty.
After being cooked, meals have been packed in particular person parts and put right into a sizzling holding chamber. They have been quickly saved till all parts have been able to be loaded within the transport automobiles and positioned in isothermal containers.
Though the temperature of the chamber was meant to be 75 levels C (167 levels F), in the course of the investigation it was round 55 levels C (131 levels F).
No different outbreaks have been linked to the catering firm. A part of the identical floor meat batch was ready and served just a few days later elsewhere, with no points reported, suggesting there was mishandling in the course of the manufacturing of the meals or their distribution to the varsity, discovered the research.
Adjustments to reception and distribution of meals within the faculty have been utilized. Suggestions to the catering institution coated ample worker coaching and HACCP points, particularly concerning temperature/time controls throughout all manufacturing, dealing with, and distribution levels.
Lab capability to detect bacterial toxins within the nation and implementation of meals security measures at school settings must be strengthened, stated researchers.
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