{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T11:05:50Z","timestamp":1788001550672,"version":"build-2784847793"},"reference-count":70,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T00:00:00Z","timestamp":1738713600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:p>Enteritis necroticans (EN) in humans caused by infection with <jats:italic>Clostridium perfringens<\/jats:italic> type C, once thought limited to the highlands of Papua New Guinea has been identified sporadically worldwide. Outbreaks still occur among children in low-income countries and isolated cases occur among children and adults in other countries. Here the disease seems to be associated with diabetes mellitus and other risk factors. <jats:italic>C. perfringens<\/jats:italic> type C is also an important cause of necrotizing enteritis among animals, particularly pigs. Research into the pathogenesis of this disease has confirmed the central role of beta toxin and its target, the endothelial cell. Unlike most bacterial enteric infections, the primary anatomic location of EN is the proximal small intestine, reasons for which are not completely understood. Ongoing surveillance for <jats:italic>C. perfringens<\/jats:italic> type C infection is warranted as well as public health measures of prevention in locations where environmental and food hygiene is poor.<\/jats:p>","DOI":"10.1371\/journal.pntd.0012836","type":"journal-article","created":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T18:42:50Z","timestamp":1738780970000},"page":"e0012836","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["Enteritis necroticans and Clostridium perfringens type C; Epidemiological and pathological findings over the past 20 years"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9548-229X","authenticated-orcid":true,"given":"Stuart","family":"Johnson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew M.","family":"Skinner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Calob","family":"Lostutter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trevor","family":"Duke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Horst","family":"Posthaus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,2,5]]},"reference":[{"issue":"3\u20134","key":"pntd.0012836.ref001","first-page":"136","article-title":"Pigbel in the 21st century: still here, and still in need of an effective surveillance system","volume":"56","author":"T Duke","year":"2013","journal-title":"P N G Med J"},{"issue":"1","key":"pntd.0012836.ref002","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/0035-9203(91)90183-Y","article-title":"The pigbel story of Papua New Guinea","volume":"85","author":"TG Murrell","year":"1991","journal-title":"Trans R Soc Trop Med Hyg"},{"issue":"2","key":"pntd.0012836.ref003","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1177\/1040638719900180","article-title":"Clostridium perfringens type C necrotic enteritis in pigs: diagnosis, pathogenesis, and prevention","volume":"32","author":"H Posthaus","year":"2020","journal-title":"J Vet Diagn Invest"},{"issue":"2","key":"pntd.0012836.ref004","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1177\/096777200501300208","article-title":"The death of Buddha: a medical enquiry","volume":"13","author":"TSN Chen","year":"2005","journal-title":"J Med Biogr"},{"issue":"4597","key":"pntd.0012836.ref005","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1136\/bmj.1.4597.267","article-title":"Enteritis necroticans due to Clostridium welchii type F","volume":"1","author":"J Zeissler","year":"1949","journal-title":"Br Med J"},{"issue":"12","key":"pntd.0012836.ref006","doi-asserted-by":"crossref","first-page":"4354","DOI":"10.1128\/IAI.00818-12","article-title":"Genotypic and phenotypic characterization of Clostridium perfringens isolates from Darmbrand cases in post-World War II Germany","volume":"80","author":"M Ma","year":"2012","journal-title":"Infect Immun"},{"issue":"1\u20132","key":"pntd.0012836.ref007","first-page":"27","article-title":"Some epidemiological features of pig-bel. 1966","volume":"48","author":"TGC Murrell","year":"2005","journal-title":"P N G Med J"},{"issue":"1","key":"pntd.0012836.ref008","first-page":"69","article-title":"The occurrence of Clostridium welchii type C in Papua New Guinea","volume":"22","author":"G Lawrence","year":"1979","journal-title":"P N G Med J"},{"issue":"1","key":"pntd.0012836.ref009","first-page":"45","article-title":"Changing patterns of disease in Papua New Guinea over a period of 40 years from 1962. 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