Laboratory test results show what local public health officials have suspected for a couple of weeks. Food served by church members to “thousands” of people was contaminated with bacteria that thrives when food is not kept hot enough. Hundreds of people reported falling ill.

Officials with the Cabarrus Health Alliance in North Carolina say the test results from the CDC show Brunswick stew served at the Poplar Tent Presbyterian Church was contaminated with Clostridium perfringens (C. perfringens). The bacterium is a common source of food poisoning, annually sickening 1 million or more people in the United States, according to the U.S. Centers for Disease Control and Prevention (CDC).

In recent days public health officials at local, state and federal levels have urged people who are preparing large group meals or are planning charity feeding events for the holidays to be aware of the “Danger Zone.”

“Bacteria can multiply rapidly if left at room temperature or in the ‘Danger Zone’ between 40 degrees F and 140 degrees F,” the CDC says. “Never leave perishable food out for more than 2 hours — or 1 hour if it’s hotter than 90 degrees F outside.”

The North Carolina outbreak
On Nov. 2, Cabarrus County health officials posted their first outbreak notice, reporting 13 illnesses among people who ate food from the church in Concord, NC. The Cabarrus Health Alliance officials requested that anyone who ate food from the event contact the health department. 

Less than 72 hours later, county officials updated their public notice. As of 11 a.m. Nov. 5 more than 200 people had contacted the health department regarding 468 people who ate food from the event. Of those people, two-thirds had fallen ill. 

“Poplar Tent Presbyterian Church staff have been extremely helpful and supportive during this investigation,” according to the county’s Nov. 5 update.

The health department reports the barbecue at Poplar Tent Presbyterian Church was on Nov. 1. The calendar on the church’s website shows preparation for the event ran from Oct. 22 through Oct. 31. 

By Nov. 7 the county had sent samples of food and fecal samples collected from sick people to the CDC to be tested.

“Samples of the barbecue pork, Brunswick stew, cole slaw and barbecue sauce were all tested to identify potential cause for illness. The Brunswick stew cultures tested positive for C. perfringens,” the Cabarrus Health Alliance reported late Nov. 16.

“C. perfringens is a common cause for food poisoning and infection often occurs when foods are prepared in large quantities and kept warm for a long time before serving. All other foods tested negative.”

People infected with C. perfringens usually develop diarrhea and abdominal cramps within 6 to 24 hours after eating contaminated food. The illness usually begins suddenly and lasts for less than 24 hours. Symptoms can be so severe that medical attention, especially for dehydration, can be required.

Young children, the elderly, pregnant women and people such as cancer patients who have weakened immune systems are at a greater risk of developing more serious infections and complications. People in the higher risk groups can be sick for two weeks and can easily become dehydrated. 

Although C. perfringens may live normally in the human intestine, according to the CDC, it can cause serious illness when food is contaminated with large numbers of C. perfringens bacteria that produce enough toxin in the intestines to cause illness.

During cooling and holding of food at temperatures from 54 degrees F to 140 degrees F (12°C–60°C), the bacteria grows very fast, according to the CDC. It can grow even faster between 109 degrees F and 117 degrees F (43°C–47°C). The bacteria produce a toxin inside the intestine that causes illness.