In view of the fact that we could not find any issues with
the kitchen or the food preparation, but given that poor
food preparation practices are the contributing factor
in the majority of C. perfringens foodborne outbreaks
[2], we felt it was still worthwhile recommending to
the school/catering company (i) reviewing standards
and procedures to ensure adequate heat penetration
in bulk cooking processes and adequate temperature
control of food after initial cooking, and (ii) reviewing
the preparation, storage and serving of raw garnishes.
Our main recommendation for the Health Protection
Agency (as of 1 April 2013 Public Health England) and
other health agencies is to explore opportunities for
using smartphone technology for distributing questionnaires.
There is evidence that smartphones are
being used for data collection and surveillance purposes
with good effect [14,15].
As many people now
have access to mobile devices such as smartphones
this would provide an alternative distribution channel
for questionnaires which may improve the speed and
completeness of response rates in future epidemiological
studies.
Finally, we recommend an assessment of the validity of
different data collection tools, including smartphones,
in different outbreak settings.