A nursing home outbreak of Clostridium perfringens associated with pureed food

Objective: To investigate and ascertain the source of a nursing home outbre ak of gastroenteritis in Melbourne in 1997. Method: A retrospective cohort study. We obtained fecal and food samples an d environmental swabs, and reviewed food handling. Results: There were 25 cases, and 21 of these had their meals pureed (liqui dised). The relative risk for eating pureed food and becoming ill was 5.8 ( 95% CI 2.2-15.4). Clostridium perfringens and its enterotoxin was detected in nine fecal samples. Samples of pureed food tested positive for coliforms . Conclusions: This outbreak was caused by C. perfringens contaminating puree d food. Food liquidising provides opportunities for re-contamination of coo ked food through the use of contaminated equipment and deficiencies in food handling practices. Pureed foods should be reheated to 70 degrees C after liquidising to inactivate pathogens. Implications: Health care facilities need to take specific precautions to m anage the special hazards involved in preparing pureed food.