Voedselinfectie onder Engelse toeristen na een bezoek aan Amsterdam, juni 1992

Abstract

An outbreak of food poisoning with Clostridium perfringens occurred among 48 British tourists visiting Amsterdam, june 1992. Thirty-nine cases of illness (nausea, abdominal pain and diarrhoea occurred among 41 tourists who attended a meal on June 6, at an Amsterdam Chinese restaurant. No symptoms of illness were reported from 7 tourists that did not eat at the Chinese restaurant. An epidemiologic investigation was conducted by the Communicable Disease Surveillance Centre (CDSC), Colindale, London. CDSC reported this outbreak to the Foodborne Disease Coordinating Centre at the National Insitute of Public Health and Environmental Protection (RIVM), Bilthoven, the Netherlands. A full inspection of the restaurant had been carried out at once by the Amsterdam Inspectorate of Health Protection (KVW) and the staff was interviewed. It was necessary to take enforcement action by way of an Improvement Notice. Samples of the environment and various foods/ ingredients were taken for bacteriological examination. The Public Prosecutor will consider the advice of the KVW to undertake preventive measures. Clostridium perfringens-enterotoxin was detected in 6 out of 7 faecal samples taken from the British tourists. No such evidence was found in the food and environmental samples, taken 6 days after the meal at the restaurant. It was agreed that RIVM would translate the CDSC- questionnaire in order to extend the epidemiologic investigation if possible to a group of Dutch quests that visited the Chinese restaurant on June 6th. Although a tour-operator was initially willing to contact a group of 30 customers, they finally decided to deny all cooperation to the investigation. After a discussion with the Department of the Chief Medical Officer of Health (Division of Infectious Diseases), it was decided that there were no further means of action for the RIVM to identify the group of Dutch restaurant-quests.