Abstract

Over a period of five years (1987-1991) practitioners in Amsterdam and Helmond have registered patients with complaints of acute gastro-enteritis. These patients completed a questionnaire and sent faecal samples to the Public Health Laboratory of Amsterdam or Eindhoven. The samples were examined for the presence of Salmonella, Shigella and Campylobacter species and sometimes for other enteropathogens. When available an aliquot of the sample was sent on to the National Institute of Public Health and Environmental Protection (RIVM) where it was examined for the presence of Clostridium perfringens enterotoxine (CPE). An enzym-linked immunosorbent assay (ELISA) was used to investigate the presence of CPE. Faecal samples were also screened for the presence of CPE neutralizing factors. In total 1261 faecal samples were investigated, 29 had CPE neutralizing factors. In 1195 (97%) of the remaining 1232 samples, no CPE was detected and in 37 (3%) samples, CPE was detected in concentrations varying from 1 to > 1000 ng per gram faeces. Lower concentrations CPE were mainly found in faeces from children younger than 5 years of age. In one third of the samples containing CPE, also another micro-organism, capable of causing complaints of gastro-enteritis, was found. This was especially the case with CPE concentrations lower than 1000 ng per gram faeces.