On March 17, 2011, the Minnesota Department of Health (MDH) was notified by Anoka County Community Health and Environmental Services (ACCHES) of gastrointestinal illnesses in inmates at a juvenile correctional facility. MDH epidemiology staff interviewed all inmates and some staff from the juvenile correctional facility about illness history and food consumption from March 14 through March 16.

ACCHES Environmental Health Specialists visited the central kitchen in Anoka on March 17 to
evaluate food preparation and handling procedures. Inmates and staff responsible for food preparation were interviewed about recent history of gastrointestinal illness. Food handling procedures were also evaluated at the juvenile correctional facility. Additional discussions with kitchen staff were held from March 17 through March 23.

Thirty-seven persons were interviewed, including 26 juvenile inmates from three “pods” or separate
areas, eight workhouse inmates, two juvenile facility staff, and one workhouse staff. Thirty-two people met the case definition of an outbreak associated case. No one was hospitalized and no one died.

Four stool samples from cases at the juvenile correctional facility tested positive for Clostridium
perfringens enterotoxin A. Three were positive for C. perfringens by culture, and isolates were
indistinguishable by pulsed-field gel electrophoresis. Of the three specimens that were positive for C. perfringens by culture, one also grew a very small amount of Staphylococcus aureus (two colonies), and was positive for S. aureus enterotoxin D.

By univariate analysis, eating scalloped potatoes and ham for dinner on March 16 and juice served for breakfast on March 14.

This was an outbreak of Clostridium perfringens intoxications associated with eating scalloped potatoes and ham on March 16. Illnesses were identified at two of five facilities served by a central kitchen, suggesting that a problem occurred at the central kitchen. The food most likely was not kept at the correct holding temperature. Additional temperature abuse at the kitchen at the
juvenile facility likely contributed to the high attack rate among juvenile inmates.