Clostridium Perfringens History

1. Clostridium Perfringens: Its Significance, Incidence, and PreventionBobbi Johnson, PhDWalden UniversityPUBH 8165-1Instructor: Dr. Stephen ArnoldSummer, 2011

2. Clostridium Perfringens History • Is also referred to as Clostridium Welchii • Was discovered in 1892 by George Nuttall and William Welch

3. What is Clostridium Perfringens? • It is an “anaerobic (unable to grow in oxygen), spore-forming gram-positive bacterium that is found in many environmental sources as well as in the intestines of humans and animals” (Center for Disease Control and Prevention, 2011). • It is a bacteria which can also be found in soils and sewages.

4. Toxins • Clostridium Perfringens Type A • Clostridium Perfringens Type B • Clostridium Perfringens Type C • Clostridium Perfringens Type D • Clostridium Perfringens Type E

5. Clostridium Perfringens Type A • Most common in humans • Produces alpha toxins • Apart of the normal flora of a cow’s intestines • Causes gastrointestinal disease hemorrhagic bowel syndrome (HBS) • Kills more than 80% of animals within 24-36 hours after first initial symptom • Causes mild food poisoning lasting up to 24 hours

6. Clostridium Perfringens Type B • Produces alpha, beta, and epsilon toxins • Rarely found in humans • Mostly in animals • Enterotoxemia is found in lambs, young calves, and foals

7. Clostridium Perfringens Type C • Produces alpha and beta toxins • First case in humans was during the 1940’s • Found in inappropriately cooked meats that are eaten by protein deficient populations • Causes necrosis of the intestines • Causes septicemia (blood in the bacteria that is associated with severe infections)

8. Clostridium Perfringens Type D • Produces alpha and epsilon toxins • Causes enterotoxaemia (affecting small intestines in animals • Swollen kidneys • Lung Oedema (fluid in the lungs) • Brain Oedemia (swelling) • Results from a change in feed that is protein rich

9. Clostridium Perfringens Type E • Produces alpha and iota toxins • Causes hemorrhagic enteritis • Enterotoxaemia in animals • Rarely found in humans

10. Incident Report for Humans • Most commonly reported foodborne illness • Between 10-20 outbreaks were reported annually in the U.S. during the past two decades even though hundreds of individuals are infected • Center for Disease Control and Prevention (CDC) estimated that nearly a million of these cases occur annually in the U.S.

11. Who is Considered at Risk?

12. Target Populations That Are Affected

13. Foods that are associated with Clostridium Perfringens • Stew • Soups • Gravy • Lamb • Fish • Shrimp • Crab • Beans • Potato salad • Macaroni and cheese

14. Symptoms in Humans • Recognized 8-12 hours after food consumption • Extreme abdominal pain • Diarrhea • Nausea • Illness lasting up to 24 hours • Dehydration • Fever and vomiting is not associated

15. What Causes Clostridium Food Poisoning? • Improper food handling • Foods that are not properly stored or prepared correctly • Poor temperature control • Foods left at room temperature between 68-140 degrees F

16. How is it Diagnosed? • Researchers detect the illness by the type of bacteria toxin found in stool samples or through various tests, which can conclude the number of bacteria found in samples.

17. How Can It Be Treated? • Oral rehydration • IV fluids • Electrolyte replacement • Antibiotics are NOTsuggested

18. Prevention • Keep hot foods hot! • Cook foods above 140 degrees F • Keep cold foods cold! • Within two hours from cooking a meal, leftover foods should be placed into the refrigerator or freezer at a temperature of 40 degrees F or less • Leftover foods • Reheating should be at least 165 degrees F

19. Additional Reading • http://www.foodpoisonjournal.com/foodborne-illness-outbreaks/clostridium-perfringens-information-and-statistics/ • http://www.cdc.gov/Features/ClostridiumPerfringens/ • http://textbookofbacteriology.net/clostridia.html • http://www.fda.gov/Food/ScienceResearch/LaboratoryMethods/BacteriologicalAnalyticalManualBAM/UCM070878 • http://www.cehs.siu.edu/fix/medmicro/clost.htm

20. References • Center for Disease Control and Prevention. (2011). Clostridium Perfringens. Retrieved from http://www.cdc.gov/foodborneburden/clostridium-perfringens.html • GlobalSecurity.org. (2011). Clostridium Perfringens Toxins. Retrieved from http://www.globalsecurity.org/wmd/intro/bio_clostridium.htm • PubMed Health. (2010). Thrombocytopenia. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001612/ • Extension. Progress in the Understanding of Hemorrhagic Bowel Syndrome. Retrieved from http://www.extension.org/pages/25183/progress-in-the-understanding-of-hemorrhagic-bowel-syndrome#Epidemiology • Iowa State University. (2004). Epsilon Toxin of Clostridium Perfringens. Retrieved from http://www.cfsph.iastate.edu/Factsheets/pdfs/epsilon_toxin_clostridium.pdf • MedlinePlus. (2011). Septicemia. Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/001355.htm • U.S. Food and Drug Administration. (2009). BBB Clostridium Perfringens. Retrieved from http://www.fda.gov/Food/FoodSafety/FoodborneIllness/FoodborneIllnessFoodbornePathogensNaturalToxins/BadBugBook/ucm070483.htm

21. References • Wrongdiagnosis. (2011). Prevalence and Incidence of Clostridium Perfringens Food Posioning. Retrieved from http://www.wrongidagnosis.com/c/clostridium_perfringens_food_poisoning/prevalence.htm • University of Florida IFAS Extension. (2009). Preventing Foodborne Illness Associated with Clostridium Perfringens. Retrieved from http://edis.ifas.ufl.edu/fs101 • Ohio State University. (1994). Clostridium Perfringens Not the 24 Hour Flu. Retrieved from http://ohioline.osu.edu/hyg-fact/5000/5568.html • Illinois Department of Public Health. (2011). Clostridium Perfringens. Retrieved from http://www.idph.state.il.us/Bioterrorism/factsheets/clostridium.htm • FoodSafety.gov. (2011). Clostridium Perfringens. Retrieved from http://www.foodsafety.gov/poisoning/causes/bacteriaviruses/cperfringens/index.html • Thefreedictionary.com. (2011). Enterotoxaemia. Retrieved from http://medical-dictionary.thefreedictionary.com/enterotoxaemia