Multipathogen Outbreak of <i>Bacillus cereus</i> and <i>Clostridium perfringens</i> Among Hospital Workers in Alaska, August 2021-Reference-Cited by-同舟云学术

Multipathogen Outbreak of Bacillus cereus and Clostridium perfringens Among Hospital Workers in Alaska, August 2021

Published:2023-05-13 Issue: Volume: Page:003335492311702
ISSN:0033-3549
Container-title:Public Health Reports
language:en
Short-container-title:Public Health Rep

Author:

Newell Katherine¹²^ORCID,Helfrich Kathryn¹,Isernhagen Heidi³,Jones Martin¹⁴,Stickel Gabriela⁵,McKeel Haley⁶,Castrodale Louisa¹,McLaughlin Joseph¹

Affiliation:

1. Section of Epidemiology, Alaska Division of Public Health, Alaska Department of Health, Anchorage, AK, USA

2. Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention, Atlanta, GA, USA

3. Food Safety and Sanitation Program, Alaska Department of Environmental Conservation, Anchorage, AK, USA

4. Center for State, Tribal, Local, and Territorial Support, Centers for Disease Control and Prevention, Atlanta, GA, USA

5. Enteric Bacteriology, Food and Shellfish Bacteriology Laboratories, Washington State Public Health Laboratories, Shoreline, WA, USA

6. Enteric Diseases Laboratory Branch, Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA

Abstract

Objective: Clostridium perfringens and Bacillus cereus are common causes of reported foodborne illness. On August 6, 2021, the Alaska Division of Public Health identified a multipathogen gastrointestinal outbreak among hospital staff in Homer, Alaska. The objectives of this study were to identify the outbreak source and prevent future illness. Methods: We conducted a retrospective cohort study of hospital staff who participated in luncheon events during August 5-7, 2021, and used an online survey to identify hospital staff with gastrointestinal illness. We defined case patients as people who reported new-onset gastrointestinal illness (diarrhea or abdominal cramping) after food consumption during the luncheon events. We calculated adjusted odds ratios of gastrointestinal illness associated with reported food exposures. We tested available food samples for C perfringens and B cereus and tested case patient stool specimens for C perfringens. We conducted an environmental investigation at the implicated vendor site. Results: Of 202 survey responses, 66 (32.7%) people reported acute gastrointestinal illness: 64 (97.0%) reported diarrhea, 62 (94.9%) reported abdominal cramps, and none were hospitalized. Of 79 people who consumed ham and pulled pork sandwiches, 64 (81.0%) met the case definition; this food item was significantly associated with increased odds of gastrointestinal illness (adjusted odds ratio = 296.4; 95% CI, 76.7-2019.1). C perfringens and B cereus were isolated at confirmatory levels from sandwich samples. C perfringens enterotoxin was detected in all 5 stool specimens tested. Environmental investigators observed other food items at the sandwich vendor that were refrigerated outside the required temperature range (>41 °F); no clear handling deficiencies for the implicated food were identified. Conclusion: Quick notification and effective collaboration can help detect an outbreak, identify the responsible food vehicle, and mitigate further risk.

Publisher

SAGE Publications

Subject

Public Health, Environmental and Occupational Health

Link

http://journals.sagepub.com/doi/pdf/10.1177/00333549231170220

Reference14 articles.

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2. Surveillance for Foodborne Disease Outbreaks — United States, 2009–2015

3. Centers for Disease Control and Prevention. Guide to confirming an etiology in foodborne disease outbreak. October 15, 2015. Accessed December 20, 2022. https://www.cdc.gov/foodsafety/outbreaks/investigating-outbreaks/confirming_diagnosis.html

4. Division of Environmental Health, Food Safety and Sanitation Program. Food establishment requirements. Alaska Department of Environmental Conservation. Accessed March 1, 2022. https://dec.alaska.gov/eh/fss/food/food-establishment-requirements