Enforcement of science-using a Clostridium perfringens outbreak investigation to take legal action

Clostridium perfringens Foodborne Outbreak during an Athletic Event in Northern Greece, June 2019

Background: Food safety is a major public health consideration during athletic events. On 27 June 2019, the Hellenic National Public Health Organization was notified of a cluster of gastroenteritis cases among athletes of four of the 47 teams participating at the Panhellenic Handball Championship for children. Methods: A retrospective cohort study among the members of the four teams was performed. The local public health authority visited the restaurants where common meals took place, amassed information on the preparation of meals, and collected samples of leftovers. Stool samples were tested for Salmonella spp. and Shigella spp. Results: Consumption of minced beef had a statistically significant association with disease occurrence [RR:8.29 (95%CI 1,31-52,7)]. Samples of meat were found positive for Clostridium perfringens. It was documented that the meat was not stored and re-heated as indicated. Stool samples were negative for Salmonella spp. and Shigella spp. and were not tested for the Clostridium perfringens toxin. Conclusion: Specific standards should be kept to prevent outbreaks during athletic events. This was the first time that a foodborne outbreak due to Clostridium perfringens was investigated in the country. Laboratory investigation for toxins should be enhanced, especially in foodborne outbreaks where clinical manifestations of cases are found to be compatible with infection caused by a toxin.

Foodborne pathogens

Foodborne pathogens are causing a great number of diseases with significant effects on human health and economy. The characteristics of the most common pathogenic bacteria (Bacillus cereus, Campylobacter jejuni, Clostridium botulinum, Clostridium perfringens, Cronobacter sakazakii, Esherichia coli, Listeria monocytogenes, Salmonella spp., Shigella spp., Staphylococccus aureus, Vibrio spp. and Yersinia enterocolitica), viruses (Hepatitis A and Noroviruses) and parasites (Cyclospora cayetanensis, Toxoplasma gondii and Trichinella spiralis), together with some important outbreaks, are reviewed. Food safety management systems based on to classical hazard-based approach has been proved to be inefficient, and risk-based food safety approach is now suggested from leading researchers and organizations. In this context, a food safety management system should be designed in a way to estimate the risks to human health from food consumption and to identify, select and implement mitigation strategies in order to control and reduce these risks. In addition, the application of suitable food safety education programs for all involved people in the production and consumption of foods is suggested.