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Clostridium perfringens infection among inmates at a county jail--Wisconsin, August 2008.

On August 8, 2008, employees at a Wisconsin county jail noted nausea, vomiting, and diarrhea among more than 100 inmates during the early morning inspection. Seven inmates were seen by the jail nurse that morning. Following jail protocol, guards gave at least 60 inmates bismuth subsalicylate to relieve symptoms, and the jail nurse notified local health department staff members, who suspected a foodborne outbreak at the jail and initiated an investigation. This report summarizes the findings of an investigation by the Wisconsin Division of Public Health (WDPH) and the local health department, which determined the outbreak was caused by eating casserole containing ground turkey and beef (relative risk [RR] = 25.1) that was served during the evening meal on August 7. Clostridium perfringens enterotoxin was detected in stool samples collected from six ill inmates, and 43,000 CFU/g of the organism were isolated from a remaining sample of casserole. An environmental investigation determined the casserole was made with food items that were prepared and stored improperly. Proper food preparation and storage methods are especially important in large institutions such as jails and prisons, where large amounts of foods are prepared and served at one time.