Publications

hospital outbreak of clostridium perfringens food-poisoning.	an outbreak of clostridium perfringens (c.welchii) food-poisoning affected a third of the patients in a large hospital, and one frail patient died. c.perfringens type a, serotype 1, was isolated from 46 (61 per cent) of 76 patients examined and from food, and a new serotype (61) was isolated from 16. the attack-rate among patients who ate a minced-ham dish was 78 per cent. the cooking and storage of this mince was faulty: cuts of meat were much too large, they were kept at room temperature too l ...	1977	67498
an unusual outbreak of food-poisoning associated with meals-on-wheels.	an outbreak of food-poisoning after a meals-on-wheels lunch affected 49 persons, 1 of whom died. bacillus cereus serotype 10 and bacillus licheniformis were isolated in large numbers from many of the patients including the deceased and from the remains of the meal. clostridium perfringens (c. welchii) serotype 68, which was isolated from many of the patients and the deceased but not from the food, may also have been responsible. food kept warm during distribution can produce an ideal environment ...	1977	69207
the production of neuraminidase by food poisoning strains of clostridium welchii (c. perfringens).	the production of neuraminidase by a classical strain of clostridium welchii (c. perfringens) type a was studied. good yields were produced in 5% proteose peptone-water medium (ppw5); the enzyme was essentially extracellular but some further neuraminidase could be released by ultrasonic disintegration of the cells. this also released n-acyl neuraminic acid-aldolase (nan-aldolase) and the degree to which this interferes with the assay for neuraminidase was evaluated. forty-one british reference f ...	1975	167169
the quantitative bacteriology of some commercial bivalve shellfish entering british markets.	incidents of non-specific illness associated with the consumption of oysters have highlighted the lack of published information on the bacteriology of shellfish suitable for consumption. investigations showed that the majority of molluscan shellfish entering english markets conform to the accepted standard of less than 5 escherichia coli/ml. tissue. the numbers of e. coli were related to the sanitary quality of the growing area but no relation could be established between numbers of e. coli and ...	1975	168251
fungi and clostridia in hospital air: the effect of air-conditioning.		1975	173701
food poisoning in hospitals in scotland.	a review of 50 hospital-based outbreaks of food poisoning which were reported in scotland during 1973--7, is described. at least 1530 persons consuming hospital-prepared food were involved. thirty-one episodes were associated with clostridium perfringens (c. welchii), 11 were due to food-borne salmonella infection, three to enterotoxigenic staphylococcus aureus, and five incidents were of undetermined aetiology. this differs noticeably from the experience in england and wales where salmonellas a ...	1979	489961
hospital green salads and the effects of washing them.	each week from april 1989 to february 1990, a plate of green salad prepared in the hospital kitchen was examined microbiologically. of the 256 plates examined, 51% had total viable counts (tvcs) of greater than or equal to 10(5) colony forming units (cfu) g-1. staphylococcus aureus was present in 13 samples and escherichia coli in one sample. no listeria monocytogenes, clostridium perfringens or salmonella spp. were isolated. the effect of washing mustard and cress, cucumber and the different la ...	1991	1674258
outbreak of clostridium perfringens food poisoning.	an outbreak of diarrhoea occurred at a 647-bedded long-stay hospital from 11 to 14 june 1989. fifty-eight elderly residents developed symptoms and there were two deaths. the organism was identified as clostridium perfringens type a, serotype tw23. the source of the outbreak was found to be inadequately reheated minced beef served at lunchtime on 11 june. the reason why only 4 of the possible 16 wards receiving minced beef were affected was thought to be due to the division of the batch of minced ...	1991	1675646
an investigation into clostridium perfringens enterotoxin-associated diarrhoea.	an investigation was carried out to establish the incidence of diarrhoea associated with the presence of enterotoxigenic clostridium perfringens. the results indicate a high risk group, namely elderly hospitalized patients, who should be investigated for this organism in a similar way to clostridium difficile if symptoms occur. the significance of antibiotic association is suggested and cross-infection was shown to be a possibility. detection of the enterotoxin was accompanied in all cases by th ...	1991	1680904
crisis in our hospital kitchens: ancillary staffing levels during an outbreak of food poisoning in a long stay hospital.	an investigation into an outbreak of food poisoning caused by clostridium perfringens showed evidence of poor food handling by catering staff. the reasons behind this were explored by interviewing catering staff, analysing shifts and rotas, and looking at staff vacancies. morale was low because of staff shortages resulting from a long term recruitment problem. in consequence staff were working double shifts and often for weeks on end without a day off. the reasons for the recruitment problem inc ...	1990	2106996
epidemiology of diarrhoea caused by enterotoxigenic clostridium perfringens.	enterotoxigenic strains of clostridium perfringens have recently been implicated in some cases of antibiotic-associated diarrhoea. we present here the results of an epidemiological study of this disease. five cases of diarrhoea caused by c. perfringens serotype 41 occurred during a 9-week period, and then during a 6-week period there were three cases due to serotype 27 and two due to serotype 24; in all but one case two geriatric wards were involved. in total there were 16 cases in 22 months. al ...	1985	2866253
large outbreaks of clostridium perfringens food poisoning associated with the consumption of boiled salmon.	five large outbreaks of food poisoning are described in which clinical, epidemiological or laboratory data indicated clostridium perfringens as the causative organism. the foodstuff common to all incidents was boiled salmon served cold as an hors d 'oeuvre. in all cases the fish had been subject to a long period of cooling or storage between boiling and consumption. it is thought that multiplication of the organism occurred during this time. recommendations are made for the avoidance of further ...	1986	2874173
microbiological evaluation of a hospital delivered meals service using precooked chilled foods.	a delivered meals service supplying centrally produced, precooked, chilled foods to 24 hospitals was introduced in plymouth health district between august 1985 and july 1986. over 18 months, 3393 food items were examined microbiologically, using the criteria recommended by the department of health and social security (dhss) (1980). no salmonella spp., staphylococcus aureus or clostridium perfringens were detected. seventy-five (8.6%) of 876 cooked vegetable items had total viable counts (tvc) gr ...	1988	2899105
the epidemiology of clostridium welchii food poisoning.		1966	4292376
food poisoning caused by heat-sensitive clostridium welchii. a report of five recent outbreaks.		1968	4296414
degradation of steroids by intestinal bacteria. i. deconjugation of bile salts.		1970	4315139
disease associated with milk and dairy products: 1982.		1984	6318880
outbreaks of foodborne infectious intestinal disease in england and wales: 1992 and 1993.	we have analysed data from the surveillance scheme of general foodborne outbreaks of infectious intestinal disease in england and wales reported to, or otherwise identified by, the phls communicable disease surveillance centre in 1992 and 1993. data were available about 458 outbreaks, 197 (43%) in commercial catering premises (restaurants, cafés, hotels, public houses, and canteens), 77 (17%) associated with food prepared in private houses, and 58 (13%) in hospitals and residential institutions. ...	1995	7663603
a hospital outbreak of clostridium perfringens food poisoning--implications for food hygiene review in hospitals.	an outbreak of clostridium perfringens (c. perfringens) food poisoning affected 17 of 44 (38.6%) patients interviewed on two hospital wards. a case-control study showed a statistically significant association between the consumption of roast pork and illness (p < 0.01). c. perfringens type a, untypable serotype, was isolated from samples of pre-cooked vacuum sealed pork supplied by a local meat producer. faults were noted in the food production process at the factory. cuts of meat were too large ...	1995	7738342
general outbreaks of infectious intestinal disease in england and wales 1992 to 1994.	data from the surveillance scheme of general outbreaks of infectious intestinal disease in england and wales, reported to the phls communicable disease surveillance centre (cdsc), were used to review 1280 of the 1594 outbreaks identified between 1 january 1992 and 31 december 1994 for which a minimum data set was captured. the number of outbreaks reported in each regional health authority ranged from 31 in mersey to 221 in yorkshire. the commonest pathogens reported were salmonellas in 32% (412) ...	1996	8881602
risk factors for outbreaks of infectious intestinal disease linked to domestic catering.	the epidemiology of general outbreaks of infectious intestinal disease associated with domestic catering for large numbers is described and compared with foodborne outbreaks in other settings. from 1 january 1992 to 31 december 1994, the phls communicable disease surveillance centre identified 101 foodborne general outbreaks of infectious intestinal disease associated with domestic catering in england and wales (16% of all foodborne outbreaks). salmonella species were associated with 77 of the 1 ...	1996	8990573
outbreaks of infectious intestinal disease in residential institutions in england and wales 1992-1994.	data from the surveillance scheme of all general outbreaks of infectious intestinal disease in england and wales reported to or otherwise identified, by the public health laboratory service communicable disease surveillance centre (cdsc) in 1992 and 1994 were used to describe the epidemiology of outbreaks of infectious intestinal disease in residential institutions. outbreaks in residential institutions accounted for 22% (282/1275) of all outbreaks with most, 95% (268/282), occurring in homes fo ...	1997	9120324
nosocomial escherichia coli o157 infection.	nosocomial transmission of shiga toxin-producing escherichia coli o157 to two patients and three nurses is described. the index case presented with rectal bleeding rather than diarrhoea, and additional infection control measures were therefore only instituted after detection of the organism. of the nurses, two were asymptomatic and detected on a screening programme of all staff in contact with the affected patients. two patients died, one from clostridium perfringens bacteraemia. the use by staf ...	2000	10662560
deaths in captive penguins.		2000	10718596
general outbreaks of infectious intestinal disease linked with poultry, england and wales, 1992-1999.	between 1992 and 1999, 1426 foodborne general outbreaks of infectious intestinal disease (iid) were reported to the public health laboratory service communicable disease surveillance centre. a fifth were associated with the consumption of poultry. chicken was implicated in almost three quarters of these outbreaks, turkey in over a fifth and duck in 2% of outbreaks. the organisms most frequently reported were salmonella (30% of outbreaks), clostridium perfringens (21%) and campylobacter (6%). ove ...	2001	11732355
general outbreaks of infectious intestinal disease linked with red meat, england and wales, 1992-1999.	between 1992 and 1999, 1,426 foodborne general outbreaks of infectious intestinal disease (iid) were reported to the public health laboratory service (phls) communicable disease surveillance centre (cdsc). sixteen percent were linked with the consumption of red meat. over 5,000 people were affected, with 186 hospital admissions and nine deaths. beef (34%) and pig meat (32%) were the most frequently implicated meat types, with lamb implicated in 11% of outbreaks. the organisms most frequently rep ...	2001	12109392
trends in indigenous foodborne disease and deaths, england and wales: 1992 to 2000.	commitment to food safety is evidenced by high profile governmental initiatives around the globe. to measure progress towards targets, policy makers need to know the baseline from which they started.	2002	12427786
the alpha antitoxin content of the international reference preparations of clostridium welchii types b and d antitoxins.	the alpha antitoxin contents of the international reference preparations of clostridium welchii types b and d antitoxins were assayed against two type a test toxins-cl. welchii (perfringens) test toxin p2, issued by the statens seruminstitut, copenhagen, and cl. welchii test toxin agx 1373, issued by the wellcome research laboratories, england-the alpha toxin contents of which were first determined against the international standard alpha antitoxin. three methods of assay were used: mouse killin ...	1956	13342930
food poisoning in england and wales, 1961.		1962	13996858
characteristics of clostridium perfringens strains associated with food and food-borne disease.	hall, herbert e. (robert a. taft sanitary engineering center, cincinnati, ohio), robert angelotti, keith h. lewis, and milton j. foter. characteristics of clostridium perfringens strains associated with food and food-borne disease. j. bacteriol. 85:1094-1103. 1963.-a total of 83 strains of clostridium perfringens-30 from england, europe, and asia, associated with food-poisoning outbreaks; 28 from the united states, associated with outbreaks or contaminated foods; and 25 from natural or pathologi ...	1963	14044000
an outbreak of cl. welchii food poisoning.		1963	14053533
outbreak of clostridium welchii food-poisoning.		1963	14066182
food poisoning in england and wales, 1962.		1963	14082204
food poisoning in england and wales, 1963. a report of the public health laboratory service.		1964	14207185
wessex shopping basket survey - a structured approach to local food sampling.	the shopping basket approach to food sampling, in which ready-to-eat food items from a shopping list were sampled at premises chosen at random, was adopted by 15 environmental health departments in the wessex region. a total of 2037 samples were analysed over a 30-month period. the microbiological quality varied considerably between food categories, with gravy and stock samples giving the highest proportion of satisfactory results. sliced meats, cooked rice and sandwiches gave the poorest overal ...	2003	14594701
waterfowl and the bacteriological quality of amenity ponds.	this study investigated the impact of waterfowl on the bacteriological quality of village ponds in east yorkshire, north-east england. water and sediment samples were collected from ponds with and without resident ducks and geese; faecal indicator and potentially pathogenic bacteria were assayed by membrane filtration and by selective enrichment. escherichia coli, faecal streptococci and, to a degree, clostridium perfringens were more abundant in ponds with waterfowl; salmonella was isolated in ...	2004	15497814
detection of viral, bacterial, and parasitological rna or dna of nine intestinal pathogens in fecal samples archived as part of the english infectious intestinal disease study: assessment of the stability of target nucleic acid.	fecal samples were collected from cases and controls as part of the infectious intestinal disease (iid) study in england and were stored as frozen suspensions for 8 to 12 years. the purpose of this study was to apply pcr-based procedures to assess the stability of pathogen-specific nucleic acid sequences present in this archive. samples from which cryptosporidium, giardia, salmonella, campylobacter, enteroaggregative escherichia coli (eaggec), enterotoxigenic clostridium perfringens, rotaviruses ...	2005	15905692
large outbreak of salmonella phage type 1 infection with high infection rate and severe illness associated with fast food premises.	to describe the epidemiology of an outbreak of salmonella enteritidis phage type 1 (pt1) infection associated with a fast food premises, and to identify the causative factors leading to an acute outbreak with high attack rate and severe illness including hospital admission.	2009	19464715
clostridium perfringens in london, july 2009: two weddings and an outbreak.	food poisoning outbreaks caused by clostridium perfringens enterotoxin occur occasionally in europe but have become less common in recent years. this paper presents the microbiological and epidemiological results of a large c. perfringens outbreak occurring simultaneously at two weddings that used the same caterer. the outbreak involved several london locations and required coordination across multiple agencies. a case-control study (n=134) was carried out to analyse possible associations betwee ...	2010	20587363
a 17-year review of foodborne outbreaks: describing the continuing decline in england and wales (1992-2008).	systematic national surveillance of foodborne disease outbreaks effectively serves the development of public health policy on food safety. the health protection agency has maintained a collaborative surveillance system for foodborne outbreaks in england and wales since 1992. up to 2008, 2429 foodborne outbreaks were identified, described and analysed for changes over time. salmonella spp. accounted for half of the outbreaks, although the proportion of these decreased over the surveillance period ...	2011	20696086
empathy dolls: are they a source of cross-contamination between patients?	following a cluster of two patients with identical strains of clostridium perfringens prosthetic joint infections on an ortho-geriatric ward in a teaching hospital in england, investigations were conducted into infection control practices. it emerged that empathy dolls were being used to help alleviate agitation in dementia patients; this had been introduced without consultation with the infection prevention and control team. environmental testing of the doll pre and post laundry at different te ...	2014	24661788
investigating an outbreak of clostridium perfringens gastroenteritis in a school using smartphone technology, london, march 2013.	on 22 march 2013, 150 of 1,255 students (13–17 years) and staff at a school in london reported gastrointestinal symptoms; onset peaked 8 to 12 hours after a lunch served in the school on 21 march. we performed a retrospective cohort study of all students and staff. we defined cases as school attenders on 20 and 21 march with onset of gastrointestinal symptoms between 20 and 23 march. we tested food, environmental and stool samples of cases for common pathogens and bacterial toxins. we administer ...	2014	24852955
enforcement of science-using a clostridium perfringens outbreak investigation to take legal action.	we report an outbreak of clostridium perfringens in a care home in north east england.	2016	25972386
an epidemiological review of gastrointestinal outbreaks associated with clostridium perfringens, north east of england, 2012-2014.	an anecdotal increase in c. perfringens outbreaks was observed in the north east of england during 2012-2014. we describe findings of investigations in order to further understanding of the epidemiology of these outbreaks and inform control measures. all culture-positive (>105 c.f.u./g) outbreaks reported to the north east health protection team from 1 january 2012 to 31 december 2014 were included. epidemiological (attack rate, symptom profile and positive associations with a suspected vehicle ...	2016	26567801
assessment of the microbiological quality of meat pies from retail sale in england 2013.	outbreaks of foodborne illness caused by bacillus cereus and listeria monocytogenes in england associated with meat pie consumption were detected in 2012. to obtain baseline data for pies unrelated to outbreaks, 862 samples of ready-to-eat meat pies were collected at retail or from catering facilities in england in 2013 and examined to enumerate food-poisoning bacteria and indicator organisms using organization for standardization (iso) methods for listeria spp. including l. monocytogenes (iso 1 ...	2016	27296425
adult necrotising enterocolitis-pig-bel disease: a pacific disease in london.	adult necrotising enterocolitis secondary clostridium perfringens type c-pig-bel disease-is rarely seen outside of pacific populations, with the highest incidence being in papau new guinea. we present the first reported case of pig-bel disease in a previously well patient without diabetes following food poisoning since 1996. in this case, the enterotoxin-induced disease necessitated emergency laparotomy and bowel resection following the failure of medical treatment and worsening septic shock. we ...	2016	27793875
an assessment of the microbiological quality of liver-based pâté in england 2012-13: comparison of samples collected at retail and from catering businesses.	the purpose of this study was to investigate the microbiological quality of liver pâté. during 2012-13, a total of 870 samples, unrelated to the investigation of food-poisoning outbreaks, were collected either at retail (46%), catering (53%) or the point of manufacture (1%) and were tested using standard methods to detect salmonella spp. or campylobacter spp., and to enumerate for listeria spp., including listeria monocytogenes, clostridium perfringens, coagulase-positive staphylococci including ...	2017	28190406
an assessment of the microbiological quality of lightly cooked food (including sous-vide) at the point of consumption in england.	this observational study aims to investigate the microbiological quality of commercially prepared lightly cooked foods with a major component of food of animal origin and collected as would be served to a consumer. a total of 356 samples were collected from catering (92%), retail (7%) or producers (1%) and all were independent of known incidents of foodborne illness. using standard methods, all samples were tested for: the presence of campylobacter spp. and salmonella spp. and enumerated for lev ...	2017	28236815