Field Epidemiology Training Fellow, North West Field Service, Public Health England, London, UK.
Specialist Registrar, FS West Midlands, Public Health England, London, UK.
Epidemiol Infect. 2020 Feb 27;148:e43. doi: 10.1017/S095026882000031X.
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.
2018 年 12 月 11 日至 13 日，英格兰西米德兰兹地区的当地公共卫生部门接到 34 例腹泻伴腹痛报告。症状于 2018 年 12 月 7 日至 9 日在一家餐厅食用圣诞餐后约 10 小时出现。开展了一项回顾性病例对照研究、环境和微生物学调查，以确定来源并控制疫情。进行了一项分析性研究，计算了比值比（OR）和 95%置信区间（CI）。有 40 人被招募到分析性研究（40 人中 28 例为病例）。多变量分析发现，奶酪酱中的韭菜是唯一与疾病相关的食物（优势比 51.1；95%置信区间 4.13-2492.1）。环境调查发现食品安全存在重大漏洞，包括烹饪和热保温过程中的温度控制失误、生熟食物之间可能发生交叉污染以及剩余奶酪酱重复用于第二天的服务。在暴露期间未采集食物样本。两份粪便样本中检出产气荚膜梭菌，其中一份证实了肠毒素基因。奶酪酱是该病原体的一种不常见载体，这是在英国首次报告。
