A second pathogen is in play in a northeast Louisiana outbreak thought to be caused by jambalaya served at a softball fundraising event Monday.

By Friday afternoon, 125 people were confirmed sick and investigators found some of them are positive for the bacterium Clostridium perfringens. Thursday state health officials said they had confirmed Salmonella in some victims.

Clostridium perfringens under high magnification.

With only about 10,000 people in Caldwell Parish and about 400 residents in Columbia, LA, where the illnesses are centered, an outbreak of this size means just about everyone knows someone is sick. Of the victims, 37 have required hospitalization. The overall age range of victims is 15 to 72 years.

One person who reportedly ate the suspect jambalaya has died. However, autopsy results are pending, so health officials are not yet attributing his death to the outbreak.

People with questions or concerns this weekend can call the after hours phone line at the health department, 800-256-2748.

Public health officials have not named the fundraising event or organizations specifically, but they have asked that anyone who ate any of the jambalaya and become sick to immediately seek medical attention. The Caldwell Parish sheriff, who is among the outbreak victims, told local media earlier this week that the jambalaya sale was a softball fundraiser.

Additional people could become ill, partly because of varying incubation times in different people and partly because people may have uneaten portions of the suspect jambalaya in their homes, which could be consumed or contaminate other foods, counter tops, utensils, etc.

Salmonella bacteria under high magnification.

As with many foodborne pathogens, both Salmonella and Clostridium perfringens bacteria usually cause abdominal cramps and diarrhea. However, Salmonella infections often cause fever and vomiting, which are generally not experienced by people sickened by Clostridium perfringens.

Symptoms usually come on suddenly, as soon six hours after exposure with Clostridium perfringens, but can take as long as a few days, according to public health officials in Louisiana and at the federal Centers for Disease Control and Prevention.

One of the biggest dangers of foodborne illnesses is dehydration because of diarrhea. Louisiana health officials are recommending that anyone who can’t keep water down should seek medical attention to ensure they have adequate fluids. Dehydration great hampers the body’s ability to fight infection, which can lead to life-threatening situations.

It may be a perfect storm scenario at work in the small northeast Louisiana town, in terms of foodborne illness outbreaks. The recipe for such a storm includes a multi-ingredient food — especially if it includes seafood, poultry or meat — often prepared in large quantities and held and served over a period of hours.

The multiple ingredients for foods such as jambalaya make it difficult for investigators to pinpoint what specific sources of pathogens. By preparing large quantities of food, contamination that might normally be limited to a few servings is spread through hundreds or thousands of servings.

Finally, food prepared for events is often held before serving or served over a long period of time. If foods are not constantly held at high enough temperatures, Clostridium perfringens in particular can multiply very quickly. Inadequate temperature control also allows Salmonella to thrive.