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Clostridium perfringens (“C. perfringens”) is an anaerobic bacterium that is widely distributed throughout the environment. It also occurs in the intestines of humans and animals. Spores of the organism persist in soil, dust, water and areas subject to human or animal fecal pollution. C. perfringens is classified into 5 types (A–E) on the basis of its ability to produce one or more of the following toxins; alpha, beta, epsilon and iota (α, β, ε, and ι). Enterotoxin (CPE)-producing (cpe+) C. perfringens type A is continuously reported as one of the most common food poisoning agents.
As previously mentioned, C. perfringens poisoning is one of the most common reported food borne illnesses in the United States. Undercooked poultry is the most frequently implicated source. Institutional environments (such as school cafeterias, hospitals, nursing homes, prisons, etc.), where large quantities of food are prepared several hours before serving, are at the highest risk of experiencing a C. perfringens outbreak.
When exposed to extreme conditions, high temperature for example, C. perfringens pathogens can sporulate. These spores can be very resilient. They can, for instance survive at boiling temperature for up to one hour. When the environment once again becomes conducive to growth, the cells return to a vegetative state. Instances, such as when the product is “hot-held” at improper temperatures, improperly cooled or stored, etc, may lead to the production of large numbers of organisms. If the product is subsequently consumed, the pathogens can produce the toxins which result the onset of illness. Temperature abuse is cited as the most common circumstance in which C. perfringens outbreaks occur. The growth range for the bacteria is between 53 and122 degrees fahrenheit, with the optimal range falling being between 109 to 116 degrees.
In a typical outbreak, dozens, or in some cases hundreds of individuals can be affected. It is likely that some outbreaks go unreported because the implicated foods or patient feces are not tested for C. perfringens. The CDC estimates that about 10,000 actual cases occur annually.
Typically, symptoms occur 8 to 22 hours after the ingestion of a large number of organisms, and may include severe abdominal cramps and diarrhea. The illness is usually over within 24 hours, but less severe symptoms may persist in some individuals, particularly the elderly and infirm, for 1 or 2 weeks. A few deaths have been reported as a result of dehydration and other complications.
Diagnosis of C. perfringens poisoning can be made by determination of common symptomology or bacteriological testing. C. perfringens can be subjected to PFGE fingerprinting but is not tracked by PulseNet. Serological assays are used for detecting enterotoxin in the feces of patients and for testing the ability of strains to produce toxin. The procedures take 1-3 days.
Necrotic enteritis (pig-bel syndrome) is a more serious disease that can also be caused by C. perfringens in extremely rare cases. Deaths from necrotic enteritis, while rare, can result from intestinal infection and necrosis secondary to septicemia.
Berdanier, Carolyn, and Dwyer, Johanna and Feldman, Elaine. Handbook of Food and Nutrition: Second Edition. CRC Press, 2007.