Updated date:

Clostridium Bacteria in Foodborne Illness and Multiple Sclerosis

Linda Crampton is a writer and teacher with a first-class honors degree in biology. She often writes about the scientific basis of disease.

An Interesting and Sometimes Dangerous Bacterium

Clostridium perfringens is a microscopic bacterium that can have major effects on humans. It exists in different forms called strains. Depending on the strain, the bacterium can live peacefully in our gut, produce a nasty case of foodborne illness, cause gas gangrene, or perhaps cause multiple sclerosis.

The CDC (Centers for Disease Control and Prevention) says that C. perfringens is one of the most common causes of foodborne illness in the United States. Nearly a million cases are reported every year. The bacterium reproduces rapidly in a suitable environment.

Multiple sclerosis or MS is a disease in which the fatty insulation around nerve cells in the brain and spinal cord is destroyed. The insulation is made of a substance called myelin and is often known as the myelin sheath. Without this sheath, nerves are unable to conduct nerve impulses correctly. Patches of scar tissue called lesions develop where the myelin is destroyed. Oligodendrocytes, the cells that make the myelin sheath, are also destroyed. Recent discoveries suggest that a Clostridium perfringens toxin called epsilon might cause these effects in some people. The connection between the bacterium and MS is tentative but interesting.

The colon (colored green in this diagram) is the longest section of the large intestine and is home to a huge bacterial population. The population sometimes includes Clostridium perfringens.

The colon (colored green in this diagram) is the longest section of the large intestine and is home to a huge bacterial population. The population sometimes includes Clostridium perfringens.

Clostridium perfringens is a rod-shaped bacterium that produces spores in order to reproduce. The bacterium is nonmotile and often exists in pairs or short chains. It's an anaerobic organism, which means that it requires an environment without oxygen.

Clostridium perfringens

Clostridium perfringens can cause very unpleasant effects, depending on the strain of the bacterium and its abundance. A small population of C. perfringens lives in the intestine of some people as part of their normal microbe community.

All of us have bacteria and other microorganisms in our intestine. Most of these organisms are believed to be helpful. Harmful microbes are normally present at a low level and don't seem to hurt us. If their population increases, however, we may experience health problems.

C. perfringens is found in animal intestines as well as human ones. It enters food sources such as meats, stews, soups, and gravies, which are the most common sources of human infections. In addition, it's found in soil as a contaminant deposited by animal feces.

Clostridium perfringens cells and spores may be found in raw meat.

Clostridium perfringens cells and spores may be found in raw meat.

Foodborne illness is an infection or intoxication that results from eating food contaminated with viable (live) microorganisms or their toxins. Food poisoning is a form of foodborne illness and is caused by the ingestion of preformed toxins.

— U.S. Department of Agriculture (USDA)

Foodborne Illness

Some sources use the terms “foodborne illness” and ”food poisoning” to mean the same thing. Others consider food poisoning to be a subdivision of foodborne illness, as the USDA does in the quote above. Clostrium perfringens and the toxin that it produces can both cause problems in our body, whatever terminology is used. The bacterium sometimes has no effect when it's ingested. When a large number of C. perfringens cells are eaten, however, illness often results.

The bacteria are generally found in raw meat and poultry products. Their spores can survive at high temperatures, including those used in cooking. If cooked food is held at room temperature before being served, the spores will germinate, producing new bacterial cells that in turn produce a toxin.

Outbreaks of foodborne illness most often happen in institutions such as hospitals, prisons, and school cafeterias because food in these places isn't served immediately after cooking. The disorder may also arise at events involving catered food.

Possible Symptoms of the Illness

The chief symptoms of poisoning by C. perfringens are often abdominal cramps and diarrhea. The symptoms can be bad in anyone, but they are generally worse in children and elderly people.

The symptoms don't begin immediately after eating contaminated food. They commonly appear eight to twelve hours after ingestion and last for as long as twenty-four hours. In susceptible people, the symptoms may last for a lot longer, however. Diarrhea is sometimes so bad that fluid and electrolyte replacement is needed.

Preventing Foodborne Illness

The CDC says that to avoid the growth of Clostridium perfringens spores, cooked meat dishes should be held at a temperature that is greater than 140°F (60°C) or less than 41°F (5°C) if they aren't being served very soon. Leftovers should be heated to at least 165°F (74°C). These temperatures should prevent spores from germinating. If the spores germinate, the new cells will reproduce and quickly form a large population of dangerous bacteria.

It's important to realize that it may not be possible to identify contaminated food by inspection. The appearance, odor, and taste of the food may be normal. This is one reason why it's so important to keep food under safe conditions.

The link between C. perfringens and foodborne illness is confirmed and well known. The possible link between the bacterium and multiple sclerosis is very intriguing but is more tentative.

What Is Multiple Sclerosis or MS?

Symptoms of multiple sclerosis vary greatly and depend on the part of the central nervous system (brain and spinal cord) where the lesions are located. Not all patients experience all of the symptoms listed below, and some experience different symptoms from the most common ones. The seriousness of the symptoms also varies.

The most common symptoms of MS include the following:

  • fatigue
  • numbness
  • tingling
  • burning sensations
  • tremors
  • balance problems
  • muscle weakness
  • muscle spasticity (stiffness)
  • speech, vision, bladder, or bowel problems

A person with MS may also experience memory and thinking problems. These symptoms are usually mild, however.

Although multiple sclerosis may lead to disability (but doesn't always do so), the lifespan of an MS patient is the same as or only slightly less than that of a person without MS.

Types of Multiple Sclerosis

Multiple sclerosis is currently classified into three types.

  • In Relapsing Remitting MS, or RRMS, periods when symptoms appear alternate with periods when they're absent or greatly reduced. The duration of the flare-ups and the remissions varies. About 85% to 90% of MS patients have this type of the disease.
  • In Primary Progressive MS, or PPMS, the symptoms of the disease gradually get worse over time once they start. The disease may stabilize for short periods, but the overall trend is for the symptoms to worsen. It's estimated that about 10% to 15% of people with MS have this form of the disease.
  • Secondary Progressive MS, or SPMS generally follows Relaxing Remitting MS that has existed for many years. The disease consists of active and inactive periods, but the condition gradually worsens over time.

A fourth category of disease has been identified. The condition may or may not lead to multiple sclerosis. In Clinically Isolated Syndrome (CIS), a person has experienced an episode of inflammation and demyelination, but the disorder doesn't yet match one of the MS types.

Two Epstein Barr virions (virus particles) on the top left and bottom right of the photo; this virus has been linked to multiple sclerosis

Two Epstein Barr virions (virus particles) on the top left and bottom right of the photo; this virus has been linked to multiple sclerosis

Possible Causes of the Disease

The cause of multiple sclerosis is unknown. Many different ideas have arisen over the years, but none of them have been proved. This is very frustrating for MS patients and their families. A definitive cause could pave the way for an effective treatment and perhaps even a cure for the disease.

Many investigators think that the cause of MS is a combination of environmental and genetic factors. Research has shown an association between multiple sclerosis and infection by the Epstein-Barr virus, smoking, and a lack of vitamin D manufacture in the skin due to insufficient sunlight in the environment. These factors may cause MS only in people with a specific genetic makeup, however. Some researchers think the factors don't cause MS but worsen the disease once it has begun. Obesity is also believed to make multiple sclerosis worse.

Another common theory is that multiple sclerosis is an autoimmune disease. The immune system's purpose to to destroy microbes and dangerous molecules that enter the body. In an autoimmune disease, for an unknown reason the body's immune system attacks and destroys its own tissues. As the neurologist in the video below says, however, some aspects of MS indicate that it's an autoimmune condition while others don't. The immune system may be involved in just the initiation of the disease or in just the progression of the disease.

In the central nervous system or CNS, oligodendrocytes wrap layers of their cell membrane around nerve cells (neurons) to form the myelin sheath. In the peripheral nervous system, Schwann cells do the same job. In multiple sclerosis, the myelin sheath and oligodendrocytes in the CNS are damaged and destroyed.

The myelin sheath around neurons in the CNS is made by projections from cells called oligodendrocytes. Multiple oligodendrocytes are needed to cover the length of the neuron. The membrane layers in the sheath are rich in fatty acids.

The myelin sheath around neurons in the CNS is made by projections from cells called oligodendrocytes. Multiple oligodendrocytes are needed to cover the length of the neuron. The membrane layers in the sheath are rich in fatty acids.

Clostridium perfringens and MS: A Possible Link

The discoveries about the relationship between bacteria and MS are very interesting and are hopefully very significant. If a bacterial toxin is proven to be a cause of multiple sclerosis, it may be possible to create new treatments for the disease. This may help at least some patients. Scientists use the results of both animal and human investigations to support their claim that some strains of C. perfringens can cause multiple sclerosis.

Five strains of Clostridium perfringens exist. They are identified by the first five letters of the alphabet. The toxin known as epsilon is made by types B and D of the bacterium.

C. perfringens and Epsilon Discoveries: A Timeline

In 2013, researchers at the Weill Cornell Medical College made some interesting discoveries in relation to C. perfringens, epsilon, and MS.

  • The researchers found both Clostridium perfringens type B and epsilon in a multiple sclerosis patient who had "actively enhancing " lesions. This was the first discovery of the type B bacterium in humans.
  • The scientists also found that Clostridium perfringens type A was present in 50% of the people without MS who were surveyed and only 23% of the people with MS. The type A strain of the bacterium hasn't been linked to MS and is often a normal gut inhabitant.
  • In addition, the researchers discovered that 10% of blood serum or spinal fluid samples taken from people with MS contained antibodies for epsilon while only 1% of the fluids from people without multiple sclerosis contained the antibodies. This indicates that the immune system of the people with MS had received prior exposure to the toxin.

In 2014, the same researchers that made the above discoveries reported that mice given epsilon developed brain damage similar to that which occurs in human MS patients. Other researchers have shown that epsilon causes MS-like symptoms in ruminant animals. In 2015, scientists reported that epsilon binds to the myelin of Chinese hamster nerve cells. Other researchers discovered that in lab equipment, epsilon binds to mouse oligodendrocytes and kills them.

In 2018, some British researchers discovered that MS patients in the United States were significantly more likely to have antibodies against the epsilon toxin than people without the disease. They said that the discovery "warrants further investigation." In 2020, researchers at Eastern Washington University described the microbiome in people with MS (including their often larger population of C. perfringens compared to the situation in healthy people) and discussed how modifying the microbiome might be helpful.

The Blood-Brain Barrier

The endothelial cells (green) of the capillaries in the brain lie very close together. This blocks the movement of many substances into the brain.

The endothelial cells (green) of the capillaries in the brain lie very close together. This blocks the movement of many substances into the brain.

Many substances are unable to cross the blood-brain barrier, which means that they can't leave blood capillaries to enter the brain. Some substances can cross the barrier, however. They enter the brain by the techniques mentioned in the diagram above.

Epsilon, the Blood-Brain Barrier, and the Nervous System

The human brain (and the mouse brain) is protected by capillaries that form the blood-brain barrier. Unlike other capillaries, those in the blood-brain barrier contain tightly packed cells that prevent the passage of many types of molecules into the brain. Epsilon is able to cross the barrier, however.

Researchers think that epsilon not only crosses the barrier around the brain but also binds to receptors on the myelin sheath around the nerves. It may also bind to receptors on the cell body of the oligodendrocytes, which is the part that contains the nucleus. The presence of the epsilon may lead to the destruction of myelin and the death of the oligodendrocytes. Further research is needed in order to determine whether this scenario actually occurs in the human body, and if it does, to reveal more details about the process.

A green fluorescent protein has been added to this oligodendrocyte. Oligodendrocytes make myelin and are destroyed in multiple sclerosis.

A green fluorescent protein has been added to this oligodendrocyte. Oligodendrocytes make myelin and are destroyed in multiple sclerosis.

Significance of the Epsilon Discoveries

The history of research into the causes of MS involves a disappointing pattern. Researchers announce that they've discovered a cause of the disease, people become excited, and then other researchers are unable to confirm the results of the experiment or survey. This pattern doesn't mean that the original researchers were dishonest. Human biology is very complex and research in this area is fraught with difficulty.

Nevertheless, the latest research is extremely interesting. C. perfringens type B is considered to be a very rare bacterial strain in humans. It does occur in cows and sheep and causes disease in these animals. It's possible that the type B bacterium or the epsilon that it produces is not as rare in humans as thought. Much more research involving many more human subjects needs to be performed to confirm the effect of C. perfringens on MS, however. It would be wonderful if the pace of the research increased. Scientists have known about the suspected link between the bacterium and MS since 2013 (and perhaps even earlier).

Even if epsilon can cause multiple sclerosis, it may do so only in a subset of patients. The discovery may still be very meaningful, however. It may help patients or potential patients by leading to new disease treatments or a vaccine. It may also help scientists to learn more about multiple sclerosis, a potentially debilitating and very frustrating disease.

References

  • Clostridium perfringens and food safety information from the CDC (Centers for Disease Control and Prevention)
  • Foodborne illness and food poisoning from the USDA
  • Types of MS from the National Multiple Sclerosis Society
  • Multiple sclerosis linked to food bacterium from the BBC (British Broadcasting Corporation)
  • Isolation of Clostridium perfrigens Type B in an Individual at First Presentation of Multiple Sclerosis Provides Clues for Environmental Triggers of Disease from PLOS One
  • The Myelin and Lymphocyte Protein MAL Is Required for Binding and Activity of Clostridium perfringens ε-Toxin from PLOS Pathogens
  • Clostridium perfringens Epsilon Toxin Causes Selective Death of Mature Oligodendrocytes and Central Nervous System Demyelination from the American Society for Microbiology
  • Evidence of C. perfringens epsilon toxin associated with multiple sclerosis from the Multiple Sclerosis Journal (a Sage journal)
  • The microbiome as a therapeutic target for multiple sclerosis from MDPI (an academic publisher)

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2014 Linda Crampton

Comments

Linda Crampton (author) from British Columbia, Canada on June 21, 2014:

Thank you, Peg. I appreciate your visit!

Peg Cole from North Dallas, Texas on June 21, 2014:

Incredible study of these bacteria as possible agents in the development of MS. You've made this quite interesting.

Linda Crampton (author) from British Columbia, Canada on February 17, 2014:

Hi, Deb. Yes, MS is very variable. Different people may experience different symptoms. It can sometimes be a challenge to deal with the disorder. Thanks for the visit.

Deb Hirt from Stillwater, OK on February 17, 2014:

MS is a true challenge, for everything that it entails can never be duplicated all the time. It is as if the drains are constantly changing, like all he different flus.

Linda Crampton (author) from British Columbia, Canada on February 12, 2014:

Hi, Writer Fox. I hope that the research will lead to a cure, too, or that it will at least lead to better treatments. Thanks for the comment.

Writer Fox from the wadi near the little river on February 12, 2014:

I hope that looking at a bacterial cause for Multiple Sclerosis will lead to a cure for this disease. You've presented some important information here and I hope it will help many people.

Linda Crampton (author) from British Columbia, Canada on February 06, 2014:

Thank you for the interesting comment, Easy Exercise. I hope you never experience a third case of food poisoning!

Kelly A Burnett from United States on February 06, 2014:

I had food poisoning the other day - second time in my lifetime. We have ozonated water and I drank that AFTER the fact and it really helped. I must add ozonated water to my daily hydration but we only have one machine. Fascinating information about the MS research - very good to know.

Linda Crampton (author) from British Columbia, Canada on February 05, 2014:

Hi, Vellur. It is very interesting that Clostridium perfringens can cause food poisoning and possibly multiple sclerosis as well, although a different strain of the bacterium is involved (or potentially involved) in each disorder. Thanks for the visit and the vote!

Nithya Venkat from Dubai on February 05, 2014:

Great hub, never knew that food poisoning bacteria can be a cause of multiple sclerosis. Thank you for sharing this valuable information. Voted up.

Linda Crampton (author) from British Columbia, Canada on February 04, 2014:

That's the way that I feel, RTalloni. Even if the bacterial toxin is not directly involved in MS, the researchers should learn important information about the bacterium, the toxin, multiple sclerosis or our nervous system as they study the toxin's actions. Thank you very much for the pin and the link!

RTalloni on February 04, 2014:

It is impossible to think that such a discovery would not be extremely meaningful. Thank you for posting this hub. Pinning to my Food Poisoning/Food Safety board, and adding this link to my hub on preventing food poisoning, if you have no objection.

Linda Crampton (author) from British Columbia, Canada on February 04, 2014:

Thank you very much for the visit and the comment, Audrey!

Audrey Howitt from California on February 04, 2014:

So very interesting! too know very little about biology--but I find it interesting!

Linda Crampton (author) from British Columbia, Canada on February 04, 2014:

Thank you very much, Christy! I appreciate your comment as well as the vote and the share.

Christy Birmingham from British Columbia, Canada on February 04, 2014:

Excellent writing here, Alicia! I admit to knowing very little about MS - and you explain the types and other attributes very well. It's important to share the information and you are doing just that. Thank-you. Vote up. Share.

Linda Crampton (author) from British Columbia, Canada on February 03, 2014:

Hi, Crafty. I'm sorry that your mother has MS. The possible link between a Clostridium toxin and MS is quite a new suggestion, but it is interesting. The strain of Clostridium perfringens that causes food poisoning is different from the strain that has been linked to MS. It will be interesting to see what researchers discover about the different strains in the future, though!

CraftytotheCore on February 03, 2014:

Wow this is interesting. My mother has MS. I never knew food poisoning and MS could be linked. I find that fascinating because my mother did suffer food poisoning terribly one time after eating chicken! I'll have to tell her about this. Thank you for sharing this knowledge.

Linda Crampton (author) from British Columbia, Canada on February 03, 2014:

Thanks for the comment, Dianna. I'm sorry that you experienced food poisoning so recently!

Dianna Mendez on February 03, 2014:

I was reading through looking for the answer to my food poisonong at a local restaurant a few weeks back. Your information was helpful and I understand where it came from more clearly.

Linda Crampton (author) from British Columbia, Canada on February 03, 2014:

Thank you so much for the lovely comment and the vote, EGamboa. The fact that your family has experienced an increase in food poisoning incidences since you've moved is very interesting. I hope they don't continue to occur!

Eileen Gamboa from West Palm Beach on February 03, 2014:

Very good article, and very well researched. Side note: I can't tell you how many times me or one of my children have gotten food poisoning since we moved to Florida. Very, very uncomfortable. I think this is an important topic and giving you a thumbs up.

Linda Crampton (author) from British Columbia, Canada on February 03, 2014:

Hi, WriterJanis. Thanks for the visit. Like you, I hope that important advances are made in our knowledge of MS very soon.

Linda Crampton (author) from British Columbia, Canada on February 03, 2014:

Thank you very much for the comment, the vote and the share, Eddy! I hope you have a great day as well.

Janis from California on February 03, 2014:

With all of today's technology, I hope they will be able to figure out what causes this condition soon. So much useful information here.

Eiddwen from Wales on February 03, 2014:

Interesting and very useful Alicia.Voting up and sharing for sure. here's wishing you a great day my friend.

Eddy.

Linda Crampton (author) from British Columbia, Canada on February 03, 2014:

Thanks, Bill. Living with MS must have been hard for both your wife and you. I hope researchers make a breakthrough in their understanding of the disease very soon.

Linda Crampton (author) from British Columbia, Canada on February 03, 2014:

Thank you very much, DDE! I appreciate your kind comment.

Linda Crampton (author) from British Columbia, Canada on February 03, 2014:

So do I, ologsinquito. I have an acquaintance with the disorder. She deals with it as well as she can, but it does affect her life significantly. Thanks for the comment.

Linda Crampton (author) from British Columbia, Canada on February 03, 2014:

Thank you, Jodah. I appreciate your visit and comment.

Linda Crampton (author) from British Columbia, Canada on February 03, 2014:

Ghaelach, I'm so sorry about your osteomyelitis. What an unpleasant condition to live with. I hope the future goes as well as possible for you.

Thank you very much for the vote and the share. Best wishes to you.

Bill Holland from Olympia, WA on February 03, 2014:

My first wife had MS...I know more about it than I ever wanted to know. Well done Alicia; keep educating and keep raising awareness.

Devika Primić from Dubrovnik, Croatia on February 03, 2014:

Clostridium Bacteria, Food Poisoning and Multiple Sclerosis is a brilliantly focused hub and so well researched your hubs are informative and most educational.

ologsinquito from USA on February 03, 2014:

This is really interesting. I wish there were better treatments for MS.

John Hansen from Gondwana Land on February 03, 2014:

Very informative article o MS and the possible link to Clostridium. I had never heard of this but it is a matter of concern. Good hub Alicia.

Ghaelach on February 03, 2014:

Morning Linda.

A awesome article, full of important information. Although I don't have MS, I can relate very well to the problems they have to put up with.

Ten years ago I contracted MRSA in hospital after an OP. The strain that I have is Chronic Osteomyelitis in my ankle of which has now traveled over most of my body. Osteomyelitis is a bacteria that is in the bone marrow, this can and as by me travel over the whole body through the bones. It sets little nestsaround the body and sleeps (Dormant) until it wakes up and causes awful pain in the persons bones. Also when a person has an accident and breaks a bone, this is life threatening if the bone marrow comes in contact with the persons blood, i.e. blood poisoning and possible death.

You have written an info full hub and I'm sure those people with MS will agree with everything you have told us.

Voted up and sharing.

LOL Ghaelach

Linda Crampton (author) from British Columbia, Canada on February 02, 2014:

Hi, Faith. Clostridium is scary. Generally the Type A strain causes food poisoning, but there's still a lot to learn about the bacterium. I've had just one case of food poisoning in my life, and it was definitely horrible. My experience doesn't sound as bad as yours, though! I'm sorry that your mother had such unpleasant symptoms before she died.

Thank you very much for the comment, the votes and the share, Faith. I hope your week is wonderful, too.

Faith Reaper from southern USA on February 02, 2014:

Fascinating and scary to think that the bacteria associated with food poisoning may cause multiple sclerosis! I have had two severe cases of food poisoning in my life and I can tell you I thought I was going to die. One was from seafood and the other from food eaten at an outdoor picnic, probably containing mayo. Of course, one can die from such. Very interesting facts concerning MS. My mother had these same symptoms before she died. She did lose muscle control in her legs, tremors and experienced memory loss.

Excellent article. Up and more and sharing.

Have a great week ahead,

Faith Reaper

Linda Crampton (author) from British Columbia, Canada on February 02, 2014:

Thank you very much, blueheron. I love biology, too!

Sharon Vile from Odessa, MO on February 02, 2014:

Fascinating! I love biology-related stuff. One of my daughters is a biologist and would also love this article.

Related Articles