Investigation of a Clostridium perfringens Outbreak in Two Schools, New Taipei City, 2021

DOI: 10.6524/TEB.202409_40(17).0001

Cha-Shien Yen^1,2, Pei-Chen Chen³, Jih-Hui Lin⁴, Chien-Shun Chiou⁴, Hsiao-Lun Wei⁴, Chia-Ping Su^1*

2024 Vol.40 NO.17

Correspondence Author： Chia-Ping Su^1*

Abstract：

       In October 2021, over 100 students and staff from two boarding high schools developed gastroenteritis after dinner from the same caterer. We conducted a retrospective cohort study in one school using questionnaires to determine the possible sources of infection. The results showed that the median incubation period was 12.8 hours (range: 0.8–20 hours), and the most common symptoms were diarrhea (81.9%) and abdominal pain (70.0%). Kung-Pao chicken was significantly associated with illness (RR = 4.2; 95% CI 2.7–6.4). Leftovers and stool samples from 19 case-patients were positive for Clostridium perfringens, with whole genome sequencing revealing the same type of bacterial isolates from leftovers and two students from different schools. The growth of C. perfringens was likely due to improper food preservation. We recommend that, hen choosing a caterer, distance from the school should also be considered, so that cooked food could be stored above 60°C and consumed within 2 hours of preparation. Because only one sample was taken from leftovers from each school, it was difficult to determine the infection source from the dinner, even with positive pathogen findings. Therefore, we recommend that separate samples be taken from each meal during the dinner.