By: James Peacock

Health investigators in the Garfield County Public Health Department have been investigating reports of gastrointestinal illness in people who attended the Rifle Rodeo on June 5. The rodeo was held at the Garfield County Fairgrounds, and about 200 people attended the event. After the event concluded, it was not long afterward that reports of gastrointestinal illness began to trickle in. Some of these illnesses were reported as soon as 6 hours after the rodeo ended. The Garfield County Public Health Department was quick to launch an investigation.

Rifle Rodeo Did Not Follow Health Department Protocols

As the investigation progressed, it was revealed that the health department did not conduct site inspections of the vendors, which are usually required, prior to the rodeo. The department contends that it was not notified about food potentially being served at the Rifle Rodeo. Since 2008, when inspections of food serving vendors at events became the job of local health departments, restaurants that want to serve food at an event have to apply for a temporary event license. The application for this license requires a depiction of the booth’s set up and reinforces the requirements for proper food safety. Yvonne Long, Executive Director for Garfield County Public Health, stated, “In the case of the Rifle Rodeo, temporary event and coordinator permits were not submitted.”  Without the proper notification, there was no way the health department could have performed inspections prior to the event. Ms. Long also said, “One thing that we want the public to know is that for public events it is the coordinator’s responsibility to find out and comply with the rules, regulations, permits, sales tax requirements and licenses required to host an event.” The vendor at the Rifle Rodeo has a restaurant in the area, which is properly licensed and regulated, and has been inspected. Even though the proper permits were not applied for prior to the Rifle rodeo, it does not appear that the county is levying any fines in this instance.

Pathogen Found

The team of investigators, made up of “nurses, licensed food inspectors, regional and state epidemiologists, and the laboratory staff,” according to the county, has attempted to find both the pathogen and the source of the outbreak that has now sickened 80 people out of the 200 that attended the rodeo. As part of the investigation, health officials reached out in a variety of ways to those who attended the event, including on social media. By talking to as many people as possible, they were able to paint a much clearer picture of the illness outbreak taking place. After conducting these interviews, the health department announced that they had narrowed down the source of the outbreak, and ruled out airborne causes, waterborne, person-to-person transmission, E. coli, Salmonella, and Hepatitis A. The other major way that health officials conduct an investigation deals with the taking and testing of samples. The samples taken over the course of the investigation were sent to the Colorado Department of Public Health and Environment. After going through testing by state health officials, it was uncovered that the samples contained Clostridium perfringens. Though the outbreak can now be contributed to a foodborne pathogen, the source of the contamination is still unknown.

What is Clostridium Perfringens?

Clostridium perfringens is one of the most common causes of foodborne illness outbreaks in the United States, causing almost a million cases of illness per year. The only pathogens that cause more cases of illness are Salmonella and Campylobacter. C. perfringens causes quite a few outbreaks per year. Between 2001 and 2005, at least 51 different outbreaks were reported each year. The CDC estimates that there are likely to be more outbreaks, but because the bacteria usually cause a mild case of illness, many people affected by C. perfringens may not seek medical care. An outbreak will usually cause between 50 and 100 people to become ill. It takes a relatively large amount of the bacteria to cause illness. The illness can set in between 6 and 24 hours after exposure. C. perfringens replicates much more quickly than other pathogens, so more of the bacteria is present in a shorter amount of time. This not only helps explain why C. perfringens causes illness more quickly than other pathogens, but also helps explain why unrefrigerated foods are quickly susceptible to contamination. Clostridium perfringens bacteria are fairly resistant to the cold, though not as resistant as Listeria monocytogenes. The spores of C. perfringens are heat resistant, and some strains can survive in boiling water for over an hour.

When C. perfringens causes illness, symptoms including cramps and diarrhea will usually appear. C. perfringens will not typically cause fever or vomiting, and the illness is not transmitted from person to person. A C. perfringens infection will usually last for about 24 hours, although more serious cases can last up to two weeks. These infections are hardly ever fatal. There are an estimated 26 deaths associated with C. perfringens infections each year. Children, the elderly, and those with suppressed immune systems are at an increased risk of developing a serious infection. There are several complications that can be caused by a C. perfringens infection. The most common of these is diarrhea, which can cause dehydration if fluids are not properly replaced. More severe forms of the infection can cause necrosis, peritonitis, and septicemia.  Besides the common, gastrointestinal form of the illness, there is also another illness caused by Clostridium perfringens. Enteritis necroticans, also known as “pig-bel disease”, is often fatal and much more severe than the gastrointestinal illness. However, this form of the disease is extremely rare in the United States. Symptoms of Pig-bel disease include abdominal pain, bloody diarrhea, vomiting, patchy necrosis, and abdominal distention. Perfringens outbreaks are usually caused by meats and poultry that have not been cooked at a proper temperature or were not properly maintained at the set holding temperatures that prevent contamination. Meat containing products like gravies and stews, other meats, and Mexican foods are all also potential causes for a C. perfringens infection. C. perfringens infections are common in cafeterias, catered events, and other places where a large amount of food is prepared several hours prior to being served, like fairs and festivals. If you or a loved one eats at a catered event, like Rifle Rodeo, and then develops the symptoms associated with any gastrointestinal illness, contact a medical professional.